CF-sensing catheter ablation of AF can reduce the incidence of major complications and generate better outcomes compared with NCF-sensing catheters during the 12-month follow-up period
Contact force ( CF ) monitoring can be useful in accomplishing circumferential pulmonary vein ( PV ) isolation for atrial fibrillation ( AF ) .
This meta- analysis aim ed to assess the efficacy and safety of a CF-sensing catheter in treating AF .
EFFICAS II: optimization of catheter contact force improves outcome of pulmonary vein isolation for paroxysmal atrial fibrillation
Aims A challenge of pulmonary vein isolation ( PVI ) in catheter ablation for paroxysmal atrial fibrillation ( PAF ) is electrical reconnection of the PV . EFFICAS I showed correlation between contact force ( CF ) parameters and PV durable isolation but no prospect i ve evaluation was made . EFFICAS II was a multicentre study to prospect ively assess the impact of CF guidance for an effective reduction of PVI gaps . Methods and results Pulmonary vein isolation using a radiofrequency ( RF ) ablation catheter with an integrated force sensor ( TactiCath ™ ) was performed in patients with PAF . Operators were provided EFFICAS I-based CF guidelines [ target 20 g , range 10–30 g , minimum 400 g s force-time integral ( FTI ) ] . Conduction gaps were assessed by remapping of PVs after 3 months , and gap rate was compared with EFFICAS I outcome . At follow up , 24 patients had 85 % of PVs remaining isolated , compared with 72 % in EFFICAS I ( P = 0.037 ) in which CF guidelines were not used . The remaining 15 % of gaps correlated to the number of catheter moves at creating the PVI line , quantified as Continuity Index . For PV lines with contiguous lesions and low catheter moves , durable isolation was 81 % in EFFICAS I and 98 % in EFFICAS II ( P = 0.005 ) . At index procedure , the number of lesions was reduced by 15 % in EFFICAS II vs. EFFICAS I. Conclusion The use of CF with the above guidelines and contiguous deployment of RF lesions in EFFICAS II study result ed in more durable PVI in catheter ablation of PAF
CF-sensing catheter ablation of AF can reduce the incidence of major complications and generate better outcomes compared with NCF-sensing catheters during the 12-month follow-up period
Contact force ( CF ) monitoring can be useful in accomplishing circumferential pulmonary vein ( PV ) isolation for atrial fibrillation ( AF ) .
This meta- analysis aim ed to assess the efficacy and safety of a CF-sensing catheter in treating AF .