Document Detail


Contact Force-Controlled Zero-Fluoroscopy Catheter Ablation of Right-sided and Left Atrial Arrhythmia Substrates.
MedLine Citation:
PMID:  22222276     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Conventional catheter ablation of cardiac arrhythmias is associated with radiation risks for patients and laboratory personnel. However, nonfluoroscopic catheter guidance may increase the risk for inadvertent cardiac injury. A novel radiofrequency ablation catheter capable of real-time tissue-tip contact force measurements may compensate for nonfluoroscopic safety issues. OBJECTIVE: This study investigated the feasibility of contact force-controlled zero-fluoroscopy catheter ablation. METHODS: In 30 patients (including 12 pediatric patients), zero-fluoroscopy catheter ablation of right-sided (right atrium n=20, right ventricle n=2) and left atrial arrhythmias (n=8) was attempted. Inclusion criteria were symptomatic suspected atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia, focal right atrial and ventricular arrhythmias and lone atrial fibrillation. A novel irrigated-tip catheter with integrated contact force sensor was used for nonfluoroscopic three-dimensional electroanatomical mapping and radiofrequency ablation. Transseptal access was gained under transesophageal guidance for ablation of left-sided arrhythmias. RESULTS: Procedural success without fluoroscopy was achieved in 29 of 30 patients (97%). In one patient, endocardial nonfluoroscopic ablation failed due to an epicardial accessory pathway within a coronary sinus aneurysm. Mean total contact force and amplitude of force undulations were kept <50 g during mapping and <40 g during ablation to prevent contact force peaks >100 g. Apart from a transient second-degree type I AV block, no complications occurred. Mean procedure time was 2.8 ± 0.9 hours. There were no arrhythmia recurrences during a mean follow-up of 6.2 ± 4.2 months. CONCLUSION: Contact force-controlled zero-fluoroscopy catheter ablation is generally feasible in right-sided and left atrial cardiac arrhythmias.
Authors:
Gunter Kerst; Hans-Jörg Weig; Slawomir Weretka; Peter Seizer; Michael Hofbeck; Meinrad Gawaz; Jürgen Schreieck
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-2
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Inc.
Affiliation:
Kinderheilkunde II, Pädiatrische Kardiologie, Eberhard-Karls-Universität Tübingen, Tübingen, Germany.
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