Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Endowed Professor
Language English
Title Comparison between Contact Force Monitoring and Unipolar Signal Modification as a Guide for Catheter Ablation of Atrial Fibrillation: A Prospective Multi-Center Randomized Controlled Study
Conference The 66th Annual Meeting of The Japanese Heart Rhythm Society
Promoters Japanese Heart Rhythm Society
Conference Type Nationwide Conferences
Presentation Type Speech
Lecture Type General
Publisher and common publisher◎EJIMA Koichiro, KATO Ken, OKADA Ayako, WAKISAKA Osamu, KIMURA Ryusuke, ISHIZAWA Makoto, IMAI Taku, TOYAMA Yuko, SHODA Morio, HAGIWARA Nobuhisa
Date 2019/07/26
(city and name of the country)
Yokohama, JAPAN
Summary *Oral Presentation 20
AF Ablation/Ablation Index

[Object] To compare the outcomes of catheter ablation of atrial fibrillation (AF) between contact force (CF) monitoring and unipolar signal modification (USM)as a guide.

[Methods] A total of 142 patients with paroxysmalAF were randomly assigned to undergo catheter ablation using either CF monitoring (CF-guided group) or USM (USM-guided group) as a guide for the ablation. In both groups, CF sensing irrigated-tip ablation catheters were used and a circumferential PVI guided by electro-anatomical mapping was performed. In the USM-guided group, the force data were hidden. In the CF-guided group, the unipolar signals were hidden and a CF of 20 g (with range of 10-30 g) and minimum force time integral (FTI) of 400 g s were the target of each radiofrequency application. The primary endpoint was rate of atrial tachyarrhythmias recurrence without antiarrhythmic drug at 12-month follow-up (blanking period of 3months).

[Results] During the 12-month follow-up period, 85% in the USM-guided group and 70% in the CF-guided group remained free from recurrences (p=0.031). The incidence of time dependent and ATP provoked early electrical reconnections between the left atrium and PVs, procedural time, fluoroscopic time, and average FTI did not significantly differ between the two groups. The radiofrequency time for the PVI was shorter in the USM-guided group than CF-guided group but was not statistically significant (p=0.077).

[Conclusions] USM was superior to the CF as an endpoint for radiofrequency energy delivery during PVI in patients with paroxysmal AF in terms of the 12-month recurrence free rate.