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Force-Sensing Catheters During Pediatric Radiofrequency Ablation: The FEDERATION Study
Aarti S Dalal1, Hoang H Nguyen1, Tammy Bowman1
1Division of Pediatric Cardiology, Washington University School of Medicine/St. Louis Children's Hospital, St. Louis, MO.
Journal of the American Heart Association
|May 19, 2017
Summary
The TactiCath catheter effectively treats pediatric heart conditions using lower forces than in adults. This study shows its safety and efficacy in young patients with congenital heart disease.
Area of Science:
- Cardiology
- Pediatric Electrophysiology
- Medical Devices
Background:
- Optimal parameters for TactiCath (TC) in atrial fibrillation (AF) ablation include 20g contact force and 400g·s force-time integral for transmural lesions.
- Evaluation of TC in pediatric and congenital heart disease (CHD) patients is needed.
Purpose of the Study:
- To assess the efficacy and safety of the TactiCath (TC) force-sensing ablation catheter in pediatric patients with congenital heart disease (CHD).
Main Methods:
- Retrospective chart and case review of 102 patients undergoing electrophysiology study and ablation from June 2015 to March 2016.
- 58 patients underwent ablation with a force-sensing catheter (TC group).
- Analysis of patient demographics, diagnoses, ablation parameters, and outcomes.
Main Results:
- The TC group (n=58) had a median age of 14 years, including 15 patients with abnormal cardiac anatomy.
- Common diagnoses included accessory pathway-mediated tachycardia (30) and atrioventricular nodal reentrant tachycardia (24).
- Median contact force was 6g, force-time integral 149g·s, with 10% recurrence and no acute/median-term complications.
Conclusions:
- TactiCath is effective in pediatric CHD patients, utilizing lower forces than reported in adult AF literature.
- Transmural lesions may not be necessary for all pediatric arrhythmias like AVNRT.
- TC may offer surrogate markers for successful slow pathway ablation.
