Publication Date

2-1-2020

Journal

The Texas Heart Institute Journal

DOI

10.14503/THIJ-17-6441

PMID

32148445

Publication Date(s)

February 2020

Language

English

PMCID

PMC7046358

PubMedCentral® Posted Date

2-1-2020

PubMedCentral® Full Text Version

Post Print

Published Open-Access

yes

Keywords

Adult, Aged, Cardiac Catheterization, Cardiac Catheters, Catheter Ablation, Equipment Design, Female, Heart Rate, Heart Ventricles, Humans, Male, Middle Aged, Operative Time, Recurrence, Retrospective Studies, Time Factors, Transducers, Pressure, Treatment Outcome, Ventricular Premature Complexes

Abstract

We evaluated whether an irrigated contact force–sensing catheter would improve the safety and effectiveness of radiofrequency ablation of premature ventricular contractions originating from the right ventricular outflow tract.

We retrospectively reviewed the charts of patients with symptomatic premature ventricular contractions who underwent ablation with a contact force–sensing catheter (56 patients, SmartTouch) or conventional catheter (59 patients, ThermoCool) at our hospital from August 2013 through December 2015. During a mean follow-up of 16 ± 5 months, 3 patients in the conventional group had recurrences, compared with none in the contact force group. Complications occurred only in the conventional group (one steam pop; 2 ablations suspended because of significantly increasing impedance). In the contact force group, the median contact force during ablation was 10 g (interquartile range, 7–14 g). Times for overall procedure (36.9 ± 5 min), fluoroscopy (86.3 ± 22.7 s), and ablation (60.3 ± 21.4 s) were significantly shorter in the contact force group than in the conventional group (46.2 ± 6.2 min, 107.7 ± 30 s, and 88.7 ± 32.3 s, respectively; P <0.001). In the contact force group, cases with a force-time integral <560 gram-seconds (g-s) had significantly longer procedure and fluoroscopy times (both P <0.001) than did those with a force-time integral ≥560 g-s.

These findings suggest that ablation of premature ventricular contractions originating from the right ventricular outflow tract with an irrigated contact force–sensing catheter instead of a conventional catheter shortens overall procedure, fluoroscopy, and ablation times without increasing risk of recurrence or complications.

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