About: Electrical reconnection after pulmonary vein isolation is contingent on contact force during initial treatment results from the EFFICAS I study     Goto   Sponge   NotDistinct   Permalink

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  • Background-Pulmonary vein isolation is the most prevalent approach for catheter ablation of paroxysmal atrial fibrillation. Long-term success of the procedure is diminished by arrhythmia recurrences occurring predominantly because of reconnections in previously isolated pulmonary veins. The aim of the EFFICAS I multicenter study was to demonstrate the correlation between contact force (CF) parameters during initial procedure and the incidence of isolation gaps (gap) at 3-month follow-up. Method and Results-A radiofrequency ablation catheter with integrated CF sensor (TactiCath, Endosense, Geneva, Switzerland) was used to perform pulmonary vein isolation in 46 patients with paroxysmal atrial fibrillation. During the ablation procedure, the operator was blinded to CF information. At follow-up, an interventional diagnostic procedure was performed to assess gap location as correlated to index procedure ablation parameters. At follow-up, 65% (26/40) of patients showed 1 gaps. Ablations with minimum Force-Time Integral (FTI) <400 gs showed increased likelihood for reconnection (P<0.001). Reconnection correlated strongly with minimum CF (P<0.0001) and minimum FTI (P=0.0007) at the site of gap. Gap occurrence showed a strong trend with lower average CF and average FTI. CF and FTI are generally higher on the right side, although the left anterior segment presents a unique challenge to achieve stable position with good CF. Conclusions-Minimum CF and minimum FTI values are strong predictors of gap formation. Optimal CF parameter recommendations are a target CF of 20 g and a minimum FTI of 400 gs for each new lesion.
  • Background-Pulmonary vein isolation is the most prevalent approach for catheter ablation of paroxysmal atrial fibrillation. Long-term success of the procedure is diminished by arrhythmia recurrences occurring predominantly because of reconnections in previously isolated pulmonary veins. The aim of the EFFICAS I multicenter study was to demonstrate the correlation between contact force (CF) parameters during initial procedure and the incidence of isolation gaps (gap) at 3-month follow-up. Method and Results-A radiofrequency ablation catheter with integrated CF sensor (TactiCath, Endosense, Geneva, Switzerland) was used to perform pulmonary vein isolation in 46 patients with paroxysmal atrial fibrillation. During the ablation procedure, the operator was blinded to CF information. At follow-up, an interventional diagnostic procedure was performed to assess gap location as correlated to index procedure ablation parameters. At follow-up, 65% (26/40) of patients showed 1 gaps. Ablations with minimum Force-Time Integral (FTI) <400 gs showed increased likelihood for reconnection (P<0.001). Reconnection correlated strongly with minimum CF (P<0.0001) and minimum FTI (P=0.0007) at the site of gap. Gap occurrence showed a strong trend with lower average CF and average FTI. CF and FTI are generally higher on the right side, although the left anterior segment presents a unique challenge to achieve stable position with good CF. Conclusions-Minimum CF and minimum FTI values are strong predictors of gap formation. Optimal CF parameter recommendations are a target CF of 20 g and a minimum FTI of 400 gs for each new lesion. (en)
Title
  • Electrical reconnection after pulmonary vein isolation is contingent on contact force during initial treatment results from the EFFICAS I study
  • Electrical reconnection after pulmonary vein isolation is contingent on contact force during initial treatment results from the EFFICAS I study (en)
skos:prefLabel
  • Electrical reconnection after pulmonary vein isolation is contingent on contact force during initial treatment results from the EFFICAS I study
  • Electrical reconnection after pulmonary vein isolation is contingent on contact force during initial treatment results from the EFFICAS I study (en)
skos:notation
  • RIV/00023001:_____/13:00058671!RIV14-MZ0-00023001
http://linked.open...avai/predkladatel
http://linked.open...avai/riv/aktivita
http://linked.open...avai/riv/aktivity
  • N
http://linked.open...iv/cisloPeriodika
  • 2
http://linked.open...vai/riv/dodaniDat
http://linked.open...aciTvurceVysledku
http://linked.open.../riv/druhVysledku
http://linked.open...iv/duvernostUdaju
http://linked.open...titaPredkladatele
http://linked.open...dnocenehoVysledku
  • 72327
http://linked.open...ai/riv/idVysledku
  • RIV/00023001:_____/13:00058671
http://linked.open...riv/jazykVysledku
http://linked.open.../riv/klicovaSlova
  • gaps; contact force; catheter ablation; atrial fibrillation (en)
http://linked.open.../riv/klicoveSlovo
http://linked.open...odStatuVydavatele
  • US - Spojené státy americké
http://linked.open...ontrolniKodProRIV
  • [55EF67BBBC51]
http://linked.open...i/riv/nazevZdroje
  • Circulation-Arrhythmia and Electrophysiology
http://linked.open...in/vavai/riv/obor
http://linked.open...ichTvurcuVysledku
http://linked.open...cetTvurcuVysledku
http://linked.open...UplatneniVysledku
http://linked.open...v/svazekPeriodika
  • 6
http://linked.open...iv/tvurceVysledku
  • Kautzner, Josef
  • Kuck, Karl-Heinz
  • Wichterle, Dan
  • Neužil, Petr
  • Lambert, Hendrik
  • Petru, Jan
  • Reddy, Vivek Y.
  • Shah, Dipen
  • Yulzari, Aude
  • Wissner, Erik
http://linked.open...ain/vavai/riv/wos
  • 000320667700021
issn
  • 1941-3149
number of pages
http://bibframe.org/vocab/doi
  • 10.1161/CIRCEP.113.000374
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