Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-134 - Contact Force-guided Catheter Ablation For Paroxysmal Atrial Fibrillation: Acute And Long-term Outcome (ID 1208)

 R. Jiang: Nothing relevant to disclose.


Background: Contact force-sensing (CF) catheter can provide real-time catheter-tissue CF during atrial fibrillation (AF) radiofrequency (RF) ablation.
Objective: To evaluate the effectiveness and safety of ablation guided by the appropriate CF.
Methods: Patients with paroxysmal AF undergoing first-time ablation were randomized into CF group and no-CF group. Pulmonary vein isolation (PVI) was performed by using CF-sensing catheter, with CF information available to the operator in CF group and blinded in the no-CF group. Acute PV reconnection was assessed with 30 minutes waiting period and adenosine triphosphate (ATP) testing. The primary endpoint was freedom from AF in long-term follow-up.
Results: From July 2015 to January 2019,120 paroxysmal atrial fibrillation patients (mean age of 61±9 years, 58% male) were randomized into CF group(n=60) and no-CF group(n=60). PVI was achieved in all patients. There’s no significant difference for RF time per PV circle between two groups (p=0.992), but the incidence of first-pass isolation in all PVs was significantly higher in CF group (69% vs 47%, p=0.025). 34% patients in CF group and 40% patients in no-CF group had acute PV (≥1) reconnection after 30 minutes waiting phase (p=0.496), while 7% and 9% patients had acute PV (≥1) reconnection in the following ATP-testing (p=0.725). No significant difference of success rates was observed at 23months (IQR 12-25months) between two groups (82% vs. 72% for CF and no-CF group, respectively, p=0.171).No major complication was observed in both groups.
Conclusion: CF-guided ablation benefits first-pass PV isolation, but not improves long-term success rates, or reduces acute PV reconnection.