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Contact force facilitates the achievement of an unexcitable ablation line during pulmonary vein isolation

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Contact force facilitates the achievement of an unexcitable ablation line during pulmonary vein isolation. / Schaeffer, Benjamin; Willems, Stephan; Meyer, Christian; Lüker, Jakob; Akbulak, Ruken Ö; Moser, Julia; Jularic, Mario; Eickholt, Christian; Schwarzl, Jana M; Gunawardene, Melanie; Kuklik, Pawel; Sultan, Arian; Hoffmann, Boris A; Steven, Daniel.

in: CLIN RES CARDIOL, Jahrgang 107, Nr. 8, 08.2018, S. 632-641.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Schaeffer, B, Willems, S, Meyer, C, Lüker, J, Akbulak, RÖ, Moser, J, Jularic, M, Eickholt, C, Schwarzl, JM, Gunawardene, M, Kuklik, P, Sultan, A, Hoffmann, BA & Steven, D 2018, 'Contact force facilitates the achievement of an unexcitable ablation line during pulmonary vein isolation', CLIN RES CARDIOL, Jg. 107, Nr. 8, S. 632-641. https://doi.org/10.1007/s00392-018-1228-0

APA

Schaeffer, B., Willems, S., Meyer, C., Lüker, J., Akbulak, R. Ö., Moser, J., Jularic, M., Eickholt, C., Schwarzl, J. M., Gunawardene, M., Kuklik, P., Sultan, A., Hoffmann, B. A., & Steven, D. (2018). Contact force facilitates the achievement of an unexcitable ablation line during pulmonary vein isolation. CLIN RES CARDIOL, 107(8), 632-641. https://doi.org/10.1007/s00392-018-1228-0

Vancouver

Schaeffer B, Willems S, Meyer C, Lüker J, Akbulak RÖ, Moser J et al. Contact force facilitates the achievement of an unexcitable ablation line during pulmonary vein isolation. CLIN RES CARDIOL. 2018 Aug;107(8):632-641. https://doi.org/10.1007/s00392-018-1228-0

Bibtex

@article{1c72c88b48c74c75a9516399489bcf51,
title = "Contact force facilitates the achievement of an unexcitable ablation line during pulmonary vein isolation",
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.",
keywords = "Atrial Fibrillation/physiopathology, Body Surface Potential Mapping/methods, Catheter Ablation/instrumentation, Equipment Design, Female, Follow-Up Studies, Heart Conduction System/physiopathology, Humans, Male, Middle Aged, Prospective Studies, Pulmonary Veins/surgery, Treatment Outcome",
author = "Benjamin Schaeffer and Stephan Willems and Christian Meyer and Jakob L{\"u}ker and Akbulak, {Ruken {\"O}} and Julia Moser and Mario Jularic and Christian Eickholt and Schwarzl, {Jana M} and Melanie Gunawardene and Pawel Kuklik and Arian Sultan and Hoffmann, {Boris A} and Daniel Steven",
year = "2018",
month = aug,
doi = "10.1007/s00392-018-1228-0",
language = "English",
volume = "107",
pages = "632--641",
journal = "CLIN RES CARDIOL",
issn = "1861-0684",
publisher = "D. Steinkopff-Verlag",
number = "8",

}

RIS

TY - JOUR

T1 - Contact force facilitates the achievement of an unexcitable ablation line during pulmonary vein isolation

AU - Schaeffer, Benjamin

AU - Willems, Stephan

AU - Meyer, Christian

AU - Lüker, Jakob

AU - Akbulak, Ruken Ö

AU - Moser, Julia

AU - Jularic, Mario

AU - Eickholt, Christian

AU - Schwarzl, Jana M

AU - Gunawardene, Melanie

AU - Kuklik, Pawel

AU - Sultan, Arian

AU - Hoffmann, Boris A

AU - Steven, Daniel

PY - 2018/8

Y1 - 2018/8

N2 - 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.

AB - 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.

KW - Atrial Fibrillation/physiopathology

KW - Body Surface Potential Mapping/methods

KW - Catheter Ablation/instrumentation

KW - Equipment Design

KW - Female

KW - Follow-Up Studies

KW - Heart Conduction System/physiopathology

KW - Humans

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Pulmonary Veins/surgery

KW - Treatment Outcome

U2 - 10.1007/s00392-018-1228-0

DO - 10.1007/s00392-018-1228-0

M3 - SCORING: Journal article

C2 - 29500567

VL - 107

SP - 632

EP - 641

JO - CLIN RES CARDIOL

JF - CLIN RES CARDIOL

SN - 1861-0684

IS - 8

ER -