Simultaneous assessment of contact pressure and local electrical coupling index using robotic navigation

Antonio Dello Russo, Gaetano Fassini, Michela Casella, Fabrizio Bologna, Osama Al-Nono, Daniele Colombo, Viviana Biagioli, Pasquale Santangeli, Luigi Di Biase, Martina Zucchetti, Benedetta Majocchi, Vittoria Marino, Joseph J. Gallinghouse, Andrea Natale, Claudio Tondo

Research output: Contribution to journalArticle

Abstract

Purpose: Contact with cardiac tissue is a determinant of lesion efficacy during atrial fibrillation (AF) ablation. The Sensei®X Robotic Catheter System (Hansen Medical, CA) has been validated for contact force sensing. The electrical coupling index (ECI) from the EnSite Contact™ system (St. Jude Medical, MN) has been validated as an indicator of tissue contact. We aimed at analyzing ECI behavior during radiofrequency (RF) pulses maintaining a stable contact through the robotic navigation contact system. Methods: In 15 patients (age, 59 ± 12) undergoing AF ablation, pulmonary vein (PV) isolation was guided by the Sensei®X System, employing the Contact™ catheter. Results: During the procedure, we assessed ECI changes associated with adequate contact based on the IntelliSense® force-sensing technology (Hansen Medical, CA. Baseline contact (27 ± 8 g/cm2) ECI value was 99 ± 13, whereas ECI values in a noncontact site (0 g/cm2) and in a light contact site (1-10 g/cm2) were respectively 66 ± 12 and 77 ± 10 (p <0.0001). Baseline contact ECI values were not different depending on AF presentation (paroxysmal AF, 98 ± 9; persistent AF, 100 ± 9) or on cardiac rhythm (sinus rhythm, 97 ± 7; AF,101 ± 10). In all PVs, ECI was significantly reduced during and after ablation (ECI during RF, 56 ± 15; ECI after RF, 72 ± 16; p <0.001). A mean reduction of 32.2 % during RF delivery and 25.4 % immediately after RF discontinuation compared with baseline ECI was observed. Conclusions: Successful PV isolation is associated with a significant decrease in ECI of at least 20 %. This may be used as a surrogate marker of effective lesion in AF ablation.

Original languageEnglish
Pages (from-to)23-31
Number of pages9
JournalJournal of Interventional Cardiac Electrophysiology
Volume40
Issue number1
DOIs
Publication statusPublished - 2014

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Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Catheter tip-to-tissue contact
  • Electrical coupling index
  • Radiofrequency

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

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