Catheter-tissue contact force for pulmonary veins isolation: A pilot multicentre study on effect on procedure and fluoroscopy time

Aims: Catheter–tissue contact is critical for effective lesion creation in radiofrequency catheter ablation (RFCA). In a multicen- tre prospective study, we assessed the effect of direct contact force (CF) measurement on acute procedural parameters during RFCA of atrial fibrillation (AF). Methods and results: A new open-irrigated tip catheter with CF sensing (SmartTouchTM, Biosense Webster Inc.) was used. All the patients under- went the first ablation procedure for paroxysmal AF with antral pulmonary vein (PV) isolation, aiming at entry and exit con- duction block in all PVs. Ninety-five patients were enroled in nine centres and successfully underwent ablation. Overall procedure time, fluoroscopy time, and ablation time were 138.0 + 67.0, 14.3 + 11.2, and 33.8 + 19.4 min, respectively. The mean CF value during ablation was 12.2 + 3.9 g. Force time integral (FTI) analysis showed that patients achieving a value below the median of 543.0gs required longer procedural (158.0 + 74.0 vs. 117.0 + 52.0 min, P ¼ 0.004) and fluoros- copy (17.5 + 13.0 vs. 11.0 + 7.7 min, P ¼ 0.007) times as compared with those in whom FTI was above this value. Patients in whom the mean CF during ablation was .20 g required shorter procedural time (92.0 + 23.0 vs. 160.0 + 67.0 min, P= 0.01) as compared with patients in whom this value was ,10 g. Four groin haematomas were the only complications observed. Conclusion: Contact force during RFCA for PV isolation affects procedural parameters, in particular procedural and fluoroscopy times, without increasing complications.