Clinical Impact of an Open-Irrigated Radiofrequency Catheter with Direct Force Measurement on Atrial Fibrillation Ablation

Background: Electrode-tissue contact is crucial for adequate lesion formation in radiofrequency catheter ablation (RFCA). Objective: We assessed the impact of direct catheter force measurement on acute procedural parameters during RFCA of atrial fibrillation (AF). Methods: Fifty consecutive patients (28 male) with paroxysmal AF who underwent their first procedure of circumferential pulmonary vein (PV) isolation (PVI) were assigned to either RFCA using (1) a standard 3.5-mm open-irrigated-tip catheter or (2) a catheter with contact force measurement capabilities. Using the endpoint of PVI with entry and exit block, acute procedural parameters were assessed. Results: Procedural data showed a remarkable decline in ablation time (radiofrequency time needed for PVI) from 50.5 +/- 15.9 to 39.0 +/- 11.0 minutes (P = 0.007) with a reduction in overall procedure duration from 185 +/- 46 to 154 +/- 39 minutes (P = 0.022). In parallel, the total energy delivered could be significantly reduced from 70,926 +/- 19,470 to 58,511 +/- 14,655 Ws (P = 0.019). The number of acute PV reconnections declined from 36% to 12% (P = 0.095). Conclusions: The use of contact force sensing technology is able to significantly reduce ablation and procedure times in PVI. In addition, energy delivery is substantially reduced by avoiding radiofrequency ablation in positions with insufficient surface contact. Procedural efficacy and safety of this new feature have to be evaluated in larger cohorts. (PACE 2012; 35:13121318)