Laboratorio di Elettrofisiologia, Clinica Mediterranea, 80122 Napoli, Italy.
Europace. 2014 Mar;16(3):335-40. doi: 10.1093/europace/eut262. Epub 2013 Dec 12.
Catheter-tissue contact is critical for effective lesion creation in radiofrequency catheter ablation (RFCA). In a multicentre prospective study, we assessed the effect of direct contact force (CF) measurement on acute procedural parameters during RFCA of atrial fibrillation (AF).
A new open-irrigated tip catheter with CF sensing (SmartTouch™, Biosense Webster Inc.) was used. All the patients underwent the first ablation procedure for paroxysmal AF with antral pulmonary vein (PV) isolation, aiming at entry and exit conduction block in all PVs. Ninety-five patients were enroled in nine centres and successfully underwent ablation. Overall procedure time, fluoroscopy time, and ablation time were 138.0 ± 67.0, 14.3 ± 11.2, and 33.8 ± 19.4 min, respectively. The mean CF value during ablation was 12.2 ± 3.9 g. Force time integral (FTI) analysis showed that patients achieving a value below the median of 543.0gs required longer procedural (158.0 ± 74.0 vs. 117.0 ± 52.0 min, P = 0.004) and fluoroscopy (17.5 ± 13.0 vs. 11.0 ± 7.7 min, P = 0.007) times as compared with those in whom FTI was above this value. Patients in whom the mean CF during ablation was >20 g required shorter procedural time (92.0 ± 23.0 vs. 160.0 ± 67.0 min, P = 0.01) as compared with patients in whom this value was <10 g. Four groin haematomas were the only complications observed.
Contact force during RFCA for PV isolation affects procedural parameters, in particular procedural and fluoroscopy times, without increasing complications.
在射频导管消融（RFCA）中，导管-组织接触对于有效创建病变至关重要。在一项多中心前瞻性研究中，我们评估了直接接触力（CF）测量对 RFCA 治疗心房颤动（AF）时急性程序参数的影响。
使用了一种带有 CF 传感器的新型开放式灌流尖端导管（SmartTouch™，Biosense Webster Inc.）。所有患者均接受了第一次消融程序，用于阵发性 AF 伴肺静脉（PV）隔离，旨在使所有 PV 的入口和出口传导阻滞。95 名患者在 9 个中心入组并成功接受了消融。总的手术时间、透视时间和消融时间分别为 138.0±67.0、14.3±11.2 和 33.8±19.4 分钟。消融过程中的平均 CF 值为 12.2±3.9 g。力时间积分（FTI）分析表明，达到中位数以下 543.0gs 的患者需要更长的手术（158.0±74.0 比 117.0±52.0 分钟，P=0.004）和透视（17.5±13.0 比 11.0±7.7 分钟，P=0.007）时间，与 FTI 值高于该值的患者相比。消融过程中平均 CF 值>20 g 的患者需要更短的手术时间（92.0±23.0 比 160.0±67.0 分钟，P=0.01），与 CF 值<10 g 的患者相比。仅观察到 4 例腹股沟血肿并发症。
在 RFCA 治疗 PV 隔离时，接触力会影响程序参数，特别是手术和透视时间，而不会增加并发症。
