Nair Girish M, Yeo Colin, MacDonald Zachary, Ainslie Mark P, Alqarawi Wael A, Nery Pablo B, Redpath Calum J, Sadek Mouhannad, Spence Stewart, Green Martin S, Birnie David H
Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, Canada.
J Cardiovasc Electrophysiol. 2017 Sep;28(9):984-993. doi: 10.1111/jce.13280. Epub 2017 Sep 1.
Contact force (CF) sensing is a novel technology used for catheter ablation of atrial fibrillation (AF). We compared the single procedure success of CF-guided pulmonary vein isolation (PVI) with that of non-CF guided PVI during a 3-year (1,095 days) follow up period and analyzed the pattern of pulmonary vein (PV) reconnection.
A cohort of 167 subjects (68 CF vs. 99 non-CF) with paroxysmal AF were included in the study. Atrial arrhythmia (AA) recurrence was defined as documented AF, atrial flutter, or atrial tachycardia lasting >30 seconds and occurring after 90 days.
Subjects in the CF group showed a statistically nonsignificant improvement in AA free survival compared to those in the non-CF group (66.2% vs. 51.5%; P value: 0.06). A greater propensity for reconnection was noted around the right-sided PVs compared to left-sided PVs related in both catheter ablation groups. For example, in the CF group 36% of right-sided segments reconnected compared to 16% of left-sided segments (P value <0.01).
A greater propensity for reconnection was noted around the right sided PV segments in both the CF and non-CF groups. The explanation for this finding was related to greater catheter instability around the right sided veins. Further research is needed to explore the utility of a "real-time" composite indicator that includes RF energy, CF and catheter stability in predicting transmural lesion formation during catheter ablation.
接触力（CF）传感是一种用于心房颤动（AF）导管消融的新技术。我们比较了在3年（1095天）随访期内CF引导下肺静脉隔离（PVI）与非CF引导下PVI的单次手术成功率，并分析了肺静脉（PV）重新连接的模式。
本研究纳入了167例阵发性AF患者（68例CF组与99例非CF组）。房性心律失常（AA）复发定义为记录到的AF、心房扑动或心房性心动过速持续>30秒且在90天后发生。
与非CF组相比，CF组患者的无AA生存期有统计学上无显著意义的改善（66.2%对51.5%；P值：0.06）。在两个导管消融组中，右侧PV周围的重新连接倾向均高于左侧PV。例如，在CF组中，右侧节段36%重新连接，而左侧节段为16%（P值<0.01）。
CF组和非CF组右侧PV节段周围均有更高的重新连接倾向。这一发现的解释与右侧静脉周围导管稳定性更高有关。需要进一步研究探索一种包括射频能量、CF和导管稳定性的“实时”综合指标在预测导管消融过程中透壁损伤形成方面的效用。
