BACKGROUND: Conventional catheter ablation of cardiac arrhythmias is associated with radiation risks for patients and laboratory personnel. However, nonfluoroscopic catheter guidance may increase the risk for inadvertent cardiac injury. A novel radiofrequency ablation catheter capable of real-time tissue-tip contact force measurements may compensate for nonfluoroscopic safety issues. OBJECTIVE: To investigate the feasibility of contact force-controlled zero-fluoroscopy catheter ablation. METHODS: In 30 patients (including 12 pediatric patients), zero-fluoroscopy catheter ablation of right-sided (right atrium, n = 20; right ventricle, n = 2) and left atrial (n = 8) arrhythmias was attempted. Inclusion criteria were symptomatic suspected atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia, focal right atrial and ventricular arrhythmias, and lone atrial fibrillation. A novel irrigated-tip catheter with an integrated contact force sensor was used for nonfluoroscopic 3-dimensional electroanatomical mapping and radiofrequency ablation. Transseptal access was gained under transesophageal guidance for ablation of left-sided arrhythmias. RESULTS: Procedural success without fluoroscopy was achieved in 29 of the 30 patients (97%). In 1 patient, endocardial nonfluoroscopic ablation failed because of an epicardial accessory pathway within a coronary sinus aneurysm. Mean total contact force and amplitude of force undulations were kept below 50 g during mapping and below 40 g during ablation to prevent contact force peaks (>100 g). Apart from a transient second-degree type I atrioventricular block, no complications occurred. The mean procedure time was 2.8 ± 0.9 hours. There were no arrhythmia recurrences during a mean follow-up of 6.2 ± 4.2 months. CONCLUSION: Contact force-controlled zero-fluoroscopy catheter ablation is generally feasible in right-sided and left atrial cardiac arrhythmias.
BACKGROUND: Conventional catheter ablation of cardiac arrhythmias is associated with radiation risks for patients and laboratory personnel. However, nonfluoroscopic catheter guidance may increase the risk for inadvertent cardiac injury. A novel radiofrequency ablation catheter capable of real-time tissue-tip contact force measurements may compensate for nonfluoroscopic safety issues. OBJECTIVE: To investigate the feasibility of contact force-controlled zero-fluoroscopy catheter ablation. METHODS: In 30 patients (including 12 pediatric patients), zero-fluoroscopy catheter ablation of right-sided (right atrium, n = 20; right ventricle, n = 2) and left atrial (n = 8) arrhythmias was attempted. Inclusion criteria were symptomatic suspected atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia, focal right atrial and ventricular arrhythmias, and lone atrial fibrillation. A novel irrigated-tip catheter with an integrated contact force sensor was used for nonfluoroscopic 3-dimensional electroanatomical mapping and radiofrequency ablation. Transseptal access was gained under transesophageal guidance for ablation of left-sided arrhythmias. RESULTS: Procedural success without fluoroscopy was achieved in 29 of the 30 patients (97%). In 1 patient, endocardial nonfluoroscopic ablation failed because of an epicardial accessory pathway within a coronary sinus aneurysm. Mean total contact force and amplitude of force undulations were kept below 50 g during mapping and below 40 g during ablation to prevent contact force peaks (>100 g). Apart from a transient second-degree type I atrioventricular block, no complications occurred. The mean procedure time was 2.8 ± 0.9 hours. There were no arrhythmia recurrences during a mean follow-up of 6.2 ± 4.2 months. CONCLUSION: Contact force-controlled zero-fluoroscopy catheter ablation is generally feasible in right-sided and left atrial cardiac arrhythmias.
Authors: Johannes C von Alvensleben; Macdonald Dick; David J Bradley; Martin J LaPage Journal: J Interv Card Electrophysiol Date: 2014-11-22 Impact factor: 1.900
Authors: P Seizer; V Bucher; C Frische; D Heinzmann; M Gramlich; I Müller; A Henning; M Hofbeck; G Kerst; M Gawaz; J Schreieck Journal: Herz Date: 2015-10-13 Impact factor: 1.443
Authors: Hisaki Makimoto; Christian-H Heeger; Tina Lin; Andreas Rillig; Andreas Metzner; Erik Wissner; Shibu Mathew; Sebastian Deiss; Peter Rausch; Christine Lemeš; Karl-Heinz Kuck; Feifan Ouyang; Roland Richard Tilz Journal: Clin Res Cardiol Date: 2015-04-18 Impact factor: 5.460
Authors: Reza Wakili; Sebastian Clauss; Viola Schmidt; Michael Ulbrich; Anton Hahnefeld; Franziska Schüssler; Johannes Siebermair; Stefan Kääb; Heidi L Estner Journal: Clin Res Cardiol Date: 2013-10-06 Impact factor: 5.460
Authors: Mansour Razminia; Hany Demo; Carlos Arrieta-Garcia; Oliver J D'Silva; Theodore Wang; Richard F Kehoe Journal: J Atr Fibrillation Date: 2014-06-30