Journal article
Contact force sensing for ablation of persistent atrial fibrillation: A randomized, multicenter trial
Heart rhythm, Vol.15(2), pp.201-208
02/01/2018
DOI: 10.1016/j.hrthm.2017.10.010
PMID: 29030237
Abstract
Impact of contact force sensing (CFS) on ablation of persistent atrial fibrillation (PeAF) is unknown.
The purpose of the TOUCH AF (Therapeutic Outcomes Using Contact force Handling during Ablation of Persistent Atrial Fibrillation) randomized trial was to compare CFS-guided ablation to a CFS-blinded strategy.
Patients (n = 128) undergoing first-time ablation for persistent AF were randomized to a CFS-guided vs CFS-blinded strategy. In the CFS-guided procedure, operators visualized real-time force data. In the blinded procedure, force data were hidden. Wide antral pulmonary vein isolation plus a roof line were performed. Patients were followed at 3, 6, 9, and 12 months with clinical visit, ECG, and 48-hour Holter monitoring. The primary endpoint was cumulative radiofrequency (RF) time for all procedures. Atrial arrhythmia >30 seconds after 3 months was a recurrence.
PeAF was continuous for 26 weeks (interquartile range [IQR] 13–52), and left atrial size was 45 ± 5 mm. Force in the CFS-blinded and CFS-guided arms was 12 g [IQR 6–20] and 14 g [IQR 9–20] (P = .10), respectively. Total RF time did not differ between CFS-guided and CFS-blinded groups (49 ± 14 min vs 50 ± 20 min, respectively; P = .70). Single procedure freedom from atrial arrhythmia was 60% in the CFS-guided arm and 63% in the CFS-blinded arm off drugs. Lesions with gaps were associated with significantly less force (11.4 g [IQR 6–19] vs 13.2 g [IQR 8–20], respectively; P = .0007) and less force-time integral (174 gs [IQR 91–330] vs 210 gs [IQR 113–388], respectively; P <.001).
CFS-guided ablation resulted in no difference to RF time or 12-month outcome. Lower force/force-time integral was associated with significantly more gaps.
Details
- Title: Subtitle
- Contact force sensing for ablation of persistent atrial fibrillation: A randomized, multicenter trial
- Creators
- Sergio Conti - Southlake Regional Health Centre, Newmarket, Ontario, CanadaRukshen Weerasooriya - Hollywood Private HospitalPaul Novak - Royal Jubilee HospitalJean Champagne - Laval University Cardiac and Pulmonary Institute, Quebec, CanadaHong Euy Lim - Southlake Regional Health Centre, Newmarket, Ontario, CanadaLaurent Macle - Montreal Heart InstituteYaariv Khaykin - Southlake Regional Health Centre, Newmarket, Ontario, CanadaAlfredo Pantano - Southlake Regional Health Centre, Newmarket, Ontario, CanadaAtul Verma - Southlake Regional Health Centre, Newmarket, Ontario, Canada
- Resource Type
- Journal article
- Publication Details
- Heart rhythm, Vol.15(2), pp.201-208
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.hrthm.2017.10.010
- PMID
- 29030237
- ISSN
- 1547-5271
- eISSN
- 1556-3871
- Number of pages
- 8
- Language
- English
- Date published
- 02/01/2018
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984822990502771
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