Use of a contact force-sensing ablation catheter with advanced catheter location significantly reduces fluoroscopy time and radiation dose in catheter ablation of atrial fibrillation

Europace. 2016 Feb;18(2):211-8. doi: 10.1093/europace/euv186. Epub 2015 Aug 27.

Abstract

Aims: The aim of this study was to evaluate the 'real-world' impact of a novel contact force (CF)-sensing (SmartTouch™, Biosense Webster, Diamond Bar, CA, USA) catheter coupled with an advanced catheter location (ACL) system on fluoroscopy time and fluoroscopy dose during atrial fibrillation (AF) ablation.

Methods and results: This was a retrospective observational cohort study of prospectively collected data of 1515 consecutive patients undergoing paroxysmal AF (PAF) and persistent AF (PerAF) ablation at a single institution between 2009 and 2014. Patients undergoing AF ablation with the SmartTouch catheter and the ACL system (SmartTouch group, n = 510) were compared with those undergoing AF ablation without this technology (control group, n = 1005). The primary outcomes were total fluoroscopy time (min) and fluoroscopy dose as measured by the dose-area product (mGy cm(2)). Secondary endpoints included total procedure time, total ablation time, and major cardiac complications (tamponade, pericardial effusion, and urgent cardiac surgery). The SmartTouch group had significantly lower fluoroscopy times (9.5 vs. 41 min, P < 0.001), radiation doses (1044 vs. 3571 mGy cm(2), P < 0.001), and shorter procedural time (195 vs. 240 min, P < 0.001) when compared with the control group. This was statistically significant for both PAF and PerAF ablations and for both de novo and redo AF procedures. After a learning curve, a median fluoroscopy time of 3.5 min (interquartile range 6) for all AF ablations was achieved. There was no difference in the rate of cardiac complications (∼ 1.5%).

Conclusion: SmartTouch™ CF-sensing catheter use with ACL™ during AF ablation significantly reduces fluoroscopy times by 77%, radiation dose by 71%, and procedural time by 19% but does not improve overall safety or the risk of cardiac complications.

Keywords: Ablation; Atrial fibrillation; Contact force; Fluoroscopy; Radiation.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atrial Fibrillation / diagnostic imaging
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / surgery*
  • Cardiac Catheters*
  • Catheter Ablation / adverse effects
  • Catheter Ablation / instrumentation*
  • Clinical Competence
  • Equipment Design
  • Fluoroscopy
  • Humans
  • Learning Curve
  • Operative Time
  • Postoperative Complications / etiology
  • Radiation Dosage*
  • Radiation Exposure / prevention & control*
  • Radiography, Interventional / adverse effects
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Transducers, Pressure*
  • Treatment Outcome