Analysis of catheter contact force during atrial fibrillation ablation using the robotic navigation system: results from a randomized study

Antonio Dello Russo, Gaetano Fassini, Sergio Conti, Michela Casella, Antonio Di Monaco, Eleonora Russo, Stefania Riva, Massimo Moltrasio, Fabrizio Tundo, Giuseppe de Martino, G. Joseph Gallinghouse, Luigi Di Biase, Andrea Natale, Claudio Tondo

Research output: Contribution to journalArticle

Abstract

Purpose: Contact with cardiac tissue is an important determinant of lesion efficacy during atrial fibrillation (AF) ablation. The Sensei X™ robotic navigation system (RNS) (Hansen Medical, Mountain View, CA, USA) has been validated for contact force (CF) sensing expressed in grams (g). The Thermocool® SmartTouch™ catheter enables the measurement of catheter tip CF and direction inside the heart. We aimed to investigate the catheter CF with and without RNS during pulmonary vein isolation (PVI) procedures. Methods: Eighty patients with symptomatic AF (56 males, age 63 ± 18) were enrolled in this study. Fifty-seven patients had paroxysmal AF and 23 early persistent AF. All procedures were performed with the Thermocool® SmartTouch™ ablation catheter. Forty patients were randomized to perform PVI with the Sensei X™ RNS (group 1), while in the other 40 patients (group 2), PVI was performed without the RNS. Results: AF ablation was performed successfully in all patients without complications, while contact force was kept in the established 10–40 g range. A significantly higher CF was documented on the PVs in group 1 compared to group 2. The 1-year freedom from AF recurrence was higher in group 1 compared to group 2 (90 vs. 65 %, p = 0.04). Moreover, a significant reduction of fluoroscopy time was noted in the RNS group (13 ± 10 vs. 20 ± 10 min, respectively, p = 0.05). Conclusions: The Sensei X™ RNS permits a significantly higher CF during transcatheter AF ablation with a low rate of AF recurrence at clinical follow-up.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalJournal of Interventional Cardiac Electrophysiology
DOIs
Publication statusAccepted/In press - Jan 21 2016

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Robotics
Atrial Fibrillation
Catheters
Pulmonary Veins
Recurrence
Catheter Ablation
Fluoroscopy

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Contact force
  • Pulmonary vein isolation
  • Robotic navigation system

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Analysis of catheter contact force during atrial fibrillation ablation using the robotic navigation system : results from a randomized study. / Dello Russo, Antonio; Fassini, Gaetano; Conti, Sergio; Casella, Michela; Di Monaco, Antonio; Russo, Eleonora; Riva, Stefania; Moltrasio, Massimo; Tundo, Fabrizio; de Martino, Giuseppe; Gallinghouse, G. Joseph; Di Biase, Luigi; Natale, Andrea; Tondo, Claudio.

In: Journal of Interventional Cardiac Electrophysiology, 21.01.2016, p. 1-7.

Research output: Contribution to journalArticle

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abstract = "Purpose: Contact with cardiac tissue is an important determinant of lesion efficacy during atrial fibrillation (AF) ablation. The Sensei X™ robotic navigation system (RNS) (Hansen Medical, Mountain View, CA, USA) has been validated for contact force (CF) sensing expressed in grams (g). The Thermocool{\circledR} SmartTouch™ catheter enables the measurement of catheter tip CF and direction inside the heart. We aimed to investigate the catheter CF with and without RNS during pulmonary vein isolation (PVI) procedures. Methods: Eighty patients with symptomatic AF (56 males, age 63 ± 18) were enrolled in this study. Fifty-seven patients had paroxysmal AF and 23 early persistent AF. All procedures were performed with the Thermocool{\circledR} SmartTouch™ ablation catheter. Forty patients were randomized to perform PVI with the Sensei X™ RNS (group 1), while in the other 40 patients (group 2), PVI was performed without the RNS. Results: AF ablation was performed successfully in all patients without complications, while contact force was kept in the established 10–40 g range. A significantly higher CF was documented on the PVs in group 1 compared to group 2. The 1-year freedom from AF recurrence was higher in group 1 compared to group 2 (90 vs. 65 {\%}, p = 0.04). Moreover, a significant reduction of fluoroscopy time was noted in the RNS group (13 ± 10 vs. 20 ± 10 min, respectively, p = 0.05). Conclusions: The Sensei X™ RNS permits a significantly higher CF during transcatheter AF ablation with a low rate of AF recurrence at clinical follow-up.",
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author = "{Dello Russo}, Antonio and Gaetano Fassini and Sergio Conti and Michela Casella and {Di Monaco}, Antonio and Eleonora Russo and Stefania Riva and Massimo Moltrasio and Fabrizio Tundo and {de Martino}, Giuseppe and Gallinghouse, {G. Joseph} and {Di Biase}, Luigi and Andrea Natale and Claudio Tondo",
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T1 - Analysis of catheter contact force during atrial fibrillation ablation using the robotic navigation system

T2 - results from a randomized study

AU - Dello Russo, Antonio

AU - Fassini, Gaetano

AU - Conti, Sergio

AU - Casella, Michela

AU - Di Monaco, Antonio

AU - Russo, Eleonora

AU - Riva, Stefania

AU - Moltrasio, Massimo

AU - Tundo, Fabrizio

AU - de Martino, Giuseppe

AU - Gallinghouse, G. Joseph

AU - Di Biase, Luigi

AU - Natale, Andrea

AU - Tondo, Claudio

PY - 2016/1/21

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N2 - Purpose: Contact with cardiac tissue is an important determinant of lesion efficacy during atrial fibrillation (AF) ablation. The Sensei X™ robotic navigation system (RNS) (Hansen Medical, Mountain View, CA, USA) has been validated for contact force (CF) sensing expressed in grams (g). The Thermocool® SmartTouch™ catheter enables the measurement of catheter tip CF and direction inside the heart. We aimed to investigate the catheter CF with and without RNS during pulmonary vein isolation (PVI) procedures. Methods: Eighty patients with symptomatic AF (56 males, age 63 ± 18) were enrolled in this study. Fifty-seven patients had paroxysmal AF and 23 early persistent AF. All procedures were performed with the Thermocool® SmartTouch™ ablation catheter. Forty patients were randomized to perform PVI with the Sensei X™ RNS (group 1), while in the other 40 patients (group 2), PVI was performed without the RNS. Results: AF ablation was performed successfully in all patients without complications, while contact force was kept in the established 10–40 g range. A significantly higher CF was documented on the PVs in group 1 compared to group 2. The 1-year freedom from AF recurrence was higher in group 1 compared to group 2 (90 vs. 65 %, p = 0.04). Moreover, a significant reduction of fluoroscopy time was noted in the RNS group (13 ± 10 vs. 20 ± 10 min, respectively, p = 0.05). Conclusions: The Sensei X™ RNS permits a significantly higher CF during transcatheter AF ablation with a low rate of AF recurrence at clinical follow-up.

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KW - Atrial fibrillation

KW - Catheter ablation

KW - Contact force

KW - Pulmonary vein isolation

KW - Robotic navigation system

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