Recurrence after pulmonary vein isolation is associated with low contact force

被引:6
作者
Tofig, Bawer Jalal [1 ,2 ]
Lukac, Peter [1 ]
Borregaard, Rune [1 ]
Nielsen, Jan Moller [1 ]
Jensen, Henrik Kjaerulf [1 ]
Gerdes, Christian [1 ]
Kristensen, Jens [1 ]
Nielsen, Jens Cosedis [1 ]
Kristiansen, Steen Buus [1 ]
机构
[1] Aarhus Univ Hosp, Dept Cardiol, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark
[2] Aarhus Univ Hosp, Dept Clin Med, Aarhus, Denmark
关键词
Ablation; atrial fibrillation; contact force; dragging; point by point; pvi; PAROXYSMAL ATRIAL-FIBRILLATION; RADIOFREQUENCY CATHETER ABLATION; SENSING CATHETER; LESION SIZE; TRIAL; RECONNECTION; IMPACT; VALUES; MODEL;
D O I
10.1080/14017431.2017.1405067
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives. Recurrent arrhythmia after pulmonary vein isolation (PVI) by radiofrequency (RF) ablation in patients with atrial fibrillation (AFIB) remains a significant challenge. Using contact force (CF) sensing ablation catheters, we aimed to identify procedure related parameters associated with recurrence after de-novo PVI in patients with AFIB. Methods. Consecutive patients undergoing a de-novo PVI procedure (n=120, 63% paroxysmal and 37% persistent AFIB) employing a force-sensing ablation catheter were included. A clinical control including electrocardiogram and 120hour of Holter-recording at 12-months was performed in all patients. Recurrence was defined as any documented AFIB or atrial flutter more than 30seconds on Holter-recording after an initial blanking period of three months. Results. Recurrence occurred in 44 patients (37%). Mean CF was lower in patients with recurrent arrhythmia (22.2 +/- 9.5 vs. 28.8 +/- 9.3g, p<.001). In multi-variable analyses lower mean CF (OR 0.9 (95% CI 0.8-1.0), p=.03), and higher percentage of ablation time with a CF <10 grams (OR 1.1 (95% CI 1.0-1.1), p=.004) were both associated with recurrence in two distinct models. Dragging during ablation compared with point-by-point ablation technique was associated with recurrence in both models (OR 19.2 (95% CI 2.9-130.0), p=.002, and OR 21.7 (95% CI 2.7-176.2), p=.004). Conclusions. Low CF and dragging during ablation as compared with point-by-point ablation technique were associated with recurrent arrhythmia in patients with AFIB undergoing de-novo PVI by RF ablation.
引用
收藏
页码:28 / 33
页数:6
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