BACKGROUND: Catheter contact is important for radiofrequency (RF) ablation. Local electrical catheter-to-tissue coupling has been described as a tool to objectively measure contact. OBJECTIVE: We hypothesized that pulmonary vein isolation (PVI) ablation using electrical coupling information (ECI) would yield higher rates of PVI than an approach without ECI. METHODS:Forty patients with atrial fibrillation were prospectively included. In each patient, 1 pair of pulmonary veins (PVs) was randomly chosen to be encircled with ECI available while the other pair was encircled without use of ECI. RESULTS: The rate of PVI was significantly higher in PVs encircled with ECI available (58% vs 30%; P = .024). PV encircling with coupling resulted in slightly longer procedure (26.5 [interquartile range {IQR} 22-32.5] vs 23.5 [IQR 19-26.5] minutes; P = .019), fluoroscopy (9.0 [IQR 6-12] vs 6.9 [IQR 4-8.6] minutes; P = .011), and RF (20.0 [IQR 16.5-23.5] vs 17.3 [IQR 15.1-20.6] minutes; P = .015) times. For nonisolated PVs, the coupling group had significantly fewer gaps (3.0 [IQR 1.8-7] vs 6.0 [IQR 4-11]; P = 0.021) and gap mapping/closure needed shorter procedure (9.0 [IQR 4-16] vs 13.0 [IQR 11-21] minutes; P = .04), fluoroscopy (3.9 [IQR 2-7.1] vs 6.0 [IQR 4.6-7.9] minutes; P = .038), and RF (1.9 [IQR 0.9-5] vs 5.2 [IQR 3.3-8.6] minutes; P = .016) times. CONCLUSIONS: The use of ECI improved lesion deployment measured as higher rates of PVI after anatomical encircling. For nonisolated PVs, fewer gaps and faster gap closure were found using ECI.
RCT Entities:
BACKGROUND: Catheter contact is important for radiofrequency (RF) ablation. Local electrical catheter-to-tissue coupling has been described as a tool to objectively measure contact. OBJECTIVE: We hypothesized that pulmonary vein isolation (PVI) ablation using electrical coupling information (ECI) would yield higher rates of PVI than an approach without ECI. METHODS: Forty patients with atrial fibrillation were prospectively included. In each patient, 1 pair of pulmonary veins (PVs) was randomly chosen to be encircled with ECI available while the other pair was encircled without use of ECI. RESULTS: The rate of PVI was significantly higher in PVs encircled with ECI available (58% vs 30%; P = .024). PV encircling with coupling resulted in slightly longer procedure (26.5 [interquartile range {IQR} 22-32.5] vs 23.5 [IQR 19-26.5] minutes; P = .019), fluoroscopy (9.0 [IQR 6-12] vs 6.9 [IQR 4-8.6] minutes; P = .011), and RF (20.0 [IQR 16.5-23.5] vs 17.3 [IQR 15.1-20.6] minutes; P = .015) times. For nonisolated PVs, the coupling group had significantly fewer gaps (3.0 [IQR 1.8-7] vs 6.0 [IQR 4-11]; P = 0.021) and gap mapping/closure needed shorter procedure (9.0 [IQR 4-16] vs 13.0 [IQR 11-21] minutes; P = .04), fluoroscopy (3.9 [IQR 2-7.1] vs 6.0 [IQR 4.6-7.9] minutes; P = .038), and RF (1.9 [IQR 0.9-5] vs 5.2 [IQR 3.3-8.6] minutes; P = .016) times. CONCLUSIONS: The use of ECI improved lesion deployment measured as higher rates of PVI after anatomical encircling. For nonisolated PVs, fewer gaps and faster gap closure were found using ECI.
Authors: Michael A Jones; David Webster; Kelvin C K Wong; Christopher Hayes; Norman Qureshi; Kim Rajappan; Yaver Bashir; Timothy R Betts Journal: J Interv Card Electrophysiol Date: 2014-09-19 Impact factor: 1.900
Authors: Alexander Wutzler; Martin Huemer; Abdul Shokor Parwani; Florian Blaschke; Wilhelm Haverkamp; Leif-Hendrik Boldt Journal: Arch Med Sci Date: 2014-05-13 Impact factor: 3.318
Authors: Gordon A Begg; James O'Neill; Afzal Sohaib; Ailsa McLean; Chris B Pepper; Lee N Graham; Andrew J Hogarth; Stephen P Page; Richard G Gillott; Nicola Hill; Jacqueline Walshaw; Richard J Schilling; Prapa Kanagaratnam; Muzahir H Tayebjee Journal: PLoS One Date: 2019-04-03 Impact factor: 3.240