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Comparison of the efficacy between impedance-guided and contact force-guided atrial fibrillation ablation using an automated annotation system

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Author(s)
Hyoung-Seob ParkIn-Cheol KimYun-Kyeong ChoHyuck-Jun YoonHyungseop KimChang-Wook NamSeongwook HanSeung-Ho HurYoon-Nyun KimKwon-Bae Kim
Keimyung Author(s)
Kim, Yoon NyunHur, Seung HoNam, Chang WookKim, Hyung SeopCho, Yun KyeongPark, Hyoung SeobYoon, Hyuck JunKim, In CheolHan, Seong WookKim, Kwon Bae
Department
Dept. of Internal Medicine (내과학)
Journal Title
1880-4276
Issued Date
2018
Volume
34
Issue
3
Keyword
atrial fibrillationcatheter ablationcontact forceimpedancepulmonary vein
Abstract
Background:

This study compared the efficacy of catheter ablation of atrial fibrillation (AF) between impedance (IMP)-guided and contact force (CF)-guided annotation using the automated annotation system (VisiTag™).

Methods:

Fifty patients undergoing pulmonary vein isolation (PVI) for AF were randomized to the IMP-guided or CF-guided groups. The annotation criteria for VisiTag™ were a 10 second minimum ablation time and 2 mm maximum catheter movement range. A minimum CF of 10 g was added to the criteria in the CF-guided group. In the IMP-guided group, a minimum IMP drop of over 5 Ω was added to the criteria.

Results:

The rates of successful PVI after an initial ablation line were higher in the CF-guided group (80% vs 48%, P = .018). Although average CF was similar between two groups, the average force-time integral (FTI) was significantly higher in the CF-guided group (298.3 ± 65. 2 g·s vs 255.1 ± 38.3 g·s, P = .007). The atrial arrhythmia-free survival at 1 year demonstrated no difference between the two groups (84.0% in the IMP-guided group vs 80.0% in the CF-guided group, P = .737). If the use of any antiarrhythmic drug beyond the blanking period was considered as a failure, the clinical success rate at 1 year was 52.0% for the CF-guided group vs 56.0% for the IMP-guided group (P = .813).

Conclusions:

Atrial fibrillation ablation using an automated annotation system guided by CF improved the success rate of PVI after the initial circumferential ablation. An IMP-guided annotation combined with catheter stability criteria showed similar clinical outcomes as compared to the CF-guided annotation.
Keimyung Author(s)(Kor)
김윤년
허승호
남창욱
김형섭
조윤경
박형섭
윤혁준
김인철
한성욱
김권배
Publisher
School of Medicine (의과대학)
Citation
Hyoung-Seob Park et al. (2018). Comparison of the efficacy between impedance-guided and contact force-guided atrial fibrillation ablation using an automated annotation system. 1880-4276, 34(3), 239–246–239–246. doi: 10.1002/joa3.12054
Type
Article
ISSN
1880-4276
DOI
10.1002/joa3.12054
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41157
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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