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- Title
Acute Pulmonary Vein Reconnection after Ablation using Contact- Force Sensing Catheters: Incidence, Timing, and Ablation Lesion Characteristics.
- Authors
Balouch, Muhammad; Dong Juang; Sivasambu, Bhradeev; Bajwa, Rizma J.; Zghaib, Tarek; Chrispin, Jonathan; Berger, Ronald D.; Hiroshi Ashikaga; Calkins, Hugh; Marine, Joseph E.; Spragg, David D.
- Abstract
Background: Acute pulmonary vein (PV) reconnection predicts atrial fibrillation (AF) recurrence after ablation. Contact-force (CF) sensing catheters improve lesion delivery. We assessed the incidence, timing, location, and lesion characteristics of acute reconnection after PV isolation with CF sensing catheters. Methods: Patients undergoing radiofrequency ablation for AF from October 2016 to February 2017 were studied. Assessment for acute reconnection at 20 and 40 minute intervals was performed in each isolated PV. Additional lesions were applied as needed. Lesion location, contact force, power, duration, impedance, and force-time integral values were compared at sites with and without reconnection. Results: Twenty-two patients (60.6 + 1.8 years; 36.4% female; 27.3% persistent AF; CHA2DS2VASC 1.9 + 0.3) were included. Eightyeight veins were isolated. Eleven reconnections occurred in 10 patients; 9 occurred by 20 minutes and 2 between 20 - 40 minutes. Most reconnections (6/11) were in the left superior PV. Of 4993 ablation points analyzed, 72 were at acute reconnection sites, and no differences in average contact force (11.4 + 8.1 vs 11.3 + 7.1 gm, p=0.868), power (29.7 + 3.9 vs 29.9 + 4.6 watts, p=0.620), impedance (64.1 + 60 vs 72.5 + 60, p=0.236) and the force time integral (86.9 + 78.8 vs 99.7 + 100 gm/sec, p=0.282) were found. Conclusion: Acute PV reconnection rates using CF sensing catheters are roughly 12.5%, with the majority occurring within 20 minutes. We found no significant differences in characteristics of ablation points in areas of reconnection. Optimum wait periods after isolation to check for acute reconnection may be as brief as 20 minutes.
- Subjects
ADULT respiratory distress syndrome; CATHETER ablation; ATRIAL fibrillation prevention
- Publication
JAFIB: Journal of Atrial Fibrillation, 2018, Vol 11, Issue 2, p1
- ISSN
1941-6911
- Publication type
Article