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Assessment of ablation catheter contact on valve annulus: Implications on accessory pathway ablation

Wai Kah Choo1, Hariharan Raju2, Jonathan Lipton3

  • 1Cardiology Department, Royal Melbourne Hospital, Melbourne, Australia; Cardiology Department, Royal Darwin Hospital, Darwin, Australia.

Indian Pacing and Electrophysiology Journal
|March 28, 2019
PubMed
Abstract

Insights

Catheter contact force is crucial for successful radiofrequency ablation. Many procedures show low contact force, and perceived force doesn't match actual measurements, potentially impacting accessory pathway ablation success.

Area of Science:

  • Electrophysiology
  • Cardiovascular Interventions
  • Medical Device Technology

Background:

  • Catheter-tissue contact force significantly influences lesion efficacy and recurrence rates in accessory pathway (AP) radiofrequency ablation.
  • Adequate catheter contact is essential for successful ablation procedures.

Purpose of the Study:

  • To evaluate the adequacy and operator perception of catheter contact force on the tricuspid and mitral annuli during radiofrequency ablation.
  • To determine if perceived contact force correlates with measured contact force.

Main Methods:

  • Data from 42 patients undergoing catheter ablation were analyzed.
  • Operators, blinded to contact force, reported perceived contact at specific tricuspid and mitral annular sites.
  • Contact force was measured using specialized catheters via long vascular sheaths.

Main Results:

  • Mean contact force was significantly lower on the tricuspid annulus (6.1 g) compared to the mitral annulus (9.8 g).
  • A high proportion of sites (81.7%) had less than 10 g of contact force.
  • Perceived contact force did not correlate with measured contact force (p > 0.67).

Conclusions:

  • A significant number of catheter applications exhibit low contact force, even with experienced operators and long sheaths.
  • Operator perception of contact force does not reliably predict actual measured force.
  • These findings suggest potential implications for the success rates of accessory pathway ablation.
Keywords:
AblationAccessory pathwayContact forceMitral annulusTricuspid annulus

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