Universität zu Köln

Schaeffer, Benjamin, Willems, Stephan, Meyer, Christian, Lueker, Jakob, Akbulak, Ruken O., Moser, Julia, Jularic, Mario, Eickholt, Christian ORCID: 0000-0002-5458-9688, Schwarzl, Jana M., Gunawardene, Melanie, Kuklik, Pawel, Sultan, Arian, Hoffmann, Boris A. and Steven, Daniel (2018). Contact force facilitates the achievement of an unexcitable ablation line during pulmonary vein isolation. Clin. Res. Cardiol., 107 (8). S. 632 - 642. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1861-0692

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Abstract

Aims Contact force (CF) catheters provide catheter-tissue contact information to improve outcome of pulmonary vein isolation (PVI) in paroxysmal atrial fibrillation (PAF). We evaluated different target-CF values for achievement of the additional endpoint of an unexcitable ablation line. Methods A total of 106 patients undergoing PVI were randomized into three groups (G) (G1: target-CF 15 g, G2: target-CF 10 g, G3: CF concealed from operator). The PVI encircling line was divided into predefined sections. Excitable tissue along the PVI-line identified by high output pacing (10 V, 2 ms) was targeted for further ablation. Results Mean average CF was 17.4 +/- 4.7 g (G1) vs. 12.3 +/- 6.0 g (G2) vs. 11.1 +/- 6.5 g (G 3) (p < 0.001). Primary unexcitable ablation lines were found in 38.6, 19.4 and 5.7% (G1, G2, G3 respectively; G1 vs. G2 p < 0.05, G1 vs. G3 p < 0.001, G2 vs. G3 ns). Additional radiofrequency (RF)-energy to achieve unexcitability was lowest in G1 (3.6 +/- 3.1 kJ vs. 8.6 +/- 7.2 kJ (G2) and 10.4 +/- 6.7 (G3), p <= 0.001, G2 vs. G3 ns) with accordingly lowest additional RF applications in G1 (3.0 +/- 2.6 vs. 7.0 +/- 5.4 in G2 and 8.4 +/- 4.0 in G3; G1 vs. G2 and G3, p < 0.001, G 2 vs. G 3 ns). Sections along ablation lines with low initial CF were most likely to reveal excitability. Single procedure success was 81.9 vs. 73.5 vs. 71.4% (G 1, 2 and 3, p = 0.6) during 437 +/- 254 day follow-up. Conclusion Higher tip-to-tissue CF during PVI facilitates the achievement of an unexcitable ablation line, requiring less additional RF-energy.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schaeffer, Benjamin UNSPECIFIED UNSPECIFIED UNSPECIFIED Willems, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Lueker, Jakob UNSPECIFIED UNSPECIFIED UNSPECIFIED Akbulak, Ruken O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Moser, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Jularic, Mario UNSPECIFIED UNSPECIFIED UNSPECIFIED Eickholt, Christian UNSPECIFIED orcid.org/0000-0002-5458-9688 UNSPECIFIED Schwarzl, Jana M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gunawardene, Melanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuklik, Pawel UNSPECIFIED UNSPECIFIED UNSPECIFIED Sultan, Arian UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoffmann, Boris A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Steven, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-177146
DOI:	10.1007/s00392-018-1228-0
Journal or Publication Title:	Clin. Res. Cardiol.
Volume:	107
Number:	8
Page Range:	S. 632 - 642
Date:	2018
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1861-0692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LEFT ATRIAL ABLATION; CATHETER ABLATION; RADIOFREQUENCY ABLATION; PACE CAPTURE; SENSING TECHNOLOGY; FIBRILLATION; RECONNECTION; SYSTEM; PREDICTION; CONDUCTION Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17714