Multicentre randomised trial comparing contact force with electrical coupling index in atrial flutter ablation (VERISMART trial)
| Autor: | Christopher B. Pepper, Stephen P. Page, Richard Gillott, Lee N. Graham, Muzahir H. Tayebjee, Richard J. Schilling, Gordon A. Begg, Nicola J. Hill, Jacqueline Walshaw, Andrew J. Hogarth, Afzal Sohaib, Ailsa McLean, James O’Neill, Prapa Kanagaratnam |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Time Factors medicine.medical_treatment 02 engineering and technology 030204 cardiovascular system & hematology Pathology and Laboratory Medicine Cardiac Catheters Electrocardiography 0302 clinical medicine Mathematical and Statistical Techniques Recurrence Atrial Fibrillation Clinical endpoint Secondary Prevention Medicine and Health Sciences Prospective Studies Aged 80 and over Multidisciplinary medicine.diagnostic_test Statistics Atrial fibrillation Heart Middle Aged Ablation Spring Catheter Treatment Outcome Bioassays and Physiological Analysis Atrial Flutter Physical Sciences Cardiology Catheter Ablation Medicine Engineering and Technology Female Seasons Anatomy Arrhythmia Research Article Biotechnology Adult medicine.medical_specialty Catheters Science 0206 medical engineering Materials Science Material Properties Capacitance Catheter ablation Bioengineering Research and Analysis Methods Contact force 03 medical and health sciences Signs and Symptoms Diagnostic Medicine Internal medicine medicine Electrocoagulation Humans Statistical Methods Aged Analysis of Variance business.industry Myocardium Electrophysiological Techniques Biology and Life Sciences medicine.disease 020601 biomedical engineering Lesions Cardiovascular Anatomy Earth Sciences Medical Devices and Equipment Cardiac Electrophysiology business Atrial flutter Mathematics Follow-Up Studies |
| Zdroj: | PLoS ONE PLoS ONE, Vol 14, Iss 4, p e0212903 (2019) |
| ISSN: | 1932-6203 |
| Popis: | IntroductionElectrical coupling index (ECI) and contact force (CF) have been developed to aid lesion formation during catheter ablation. ECI measures tissue impedance and capacitance whilst CF measures direct contact. The aim was to determine whether the presence of catheter / tissue interaction information, such as ECI and CF, reduce time to achieve bidirectional cavotricuspid isthmus block during atrial flutter (AFL) ablation.MethodsPatients with paroxysmal or persistent AFL were randomised to CF visible (range 5-40g), CF not visible, ECI visible (change of 12%) or ECI not visible. Follow-up occurred at 3 and 6 months and included a 7 day ECG recording. The primary endpoint was time to bidirectional cavotricuspid isthmus block.Results114 patients were randomised, 16 were excluded. Time to bidirectional block was significantly shorter when ECI was visible (median 30.0 mins (IQR 31) to median 10.5mins (IQR 12) p 0.023) versus ECI not visible. There was a trend towards a shorter time to bidirectional block when CF was visible. Higher force was applied when CF was visible (median 9.03g (IQR 7.4) vs. 11.3g (5.5) p 0.017). There was no difference in the acute recurrence of conduction between groups. The complication rate was 2%, AFL recurrence was 1.1% and at 6 month follow-up, 12% had atrial fibrillation.ConclusionThe use of tissue contact information during AFL ablation was associated with reduced time taken to achieve bidirectional block when ECI was visible. Contact force data improved contact when visible with a trend towards a reduction in the procedural endpoint. ClinicalTrials.gov trial identifier: NCT02490033. |
| Databáze: | OpenAIRE |
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