• Elisabeth Sigmund, Helmut Puererfellner, Michael Derndorfer, Georgios Kollias, Siegmund Winter, Josef Aichinger, Hans-Joachim Nesser, and Martin Martinek.
• Department of Cardiology, Elisabethinen University Teaching Hospital of the Universities Innsbruck, Vienna, Graz, Linz, Austria.
• Pacing Clin Electrophysiol. 2015 Feb 1; 38 (2): 201-8.

BackgroundSufficient electrode-tissue contact is crucial for adequate lesion formation in radiofrequency catheter ablation (RFCA).ObjectiveWe assessed the impact of direct catheter force measurement on acute procedural parameters and outcome of RFCA for paroxysmal and persistent atrial fibrillation (AF).MethodsNinety-nine consecutive patients (70% men) with paroxysmal (63.6%) or persistent AF underwent left atrial RFCA using a 3.5-mm open-irrigated-tip (OIT) catheter with contact force measurement capabilities (group 1). For comparison a case-matched cohort with standard OIT catheters was used (99 patients; group 2). Case matching included gender, type of AF, number or RFCA procedures, and type of procedure.ResultsProcedural data showed a significant decline in radiofrequency ablation time from 52 ± 20 to 44 ± 16 minutes (P = 0.003) with a remarkable mean reduction in overall procedure time of 34 minutes (P = 0.0001; 225.8 ± 53.1 vs 191.9 ± 53.3 minutes). In parallel, the total fluoroscopy time could be significantly reduced from 28.5 ± 11.0 to 19.9 ± 9.3 minutes (P = 0.0001) as well as fluoroscopy dose from 74.1 ± 58.0 to 56.7 ± 38.9 Gy/cm(2) (P = 0.016). Periprocedural complications were similar in both groups.ConclusionsThe use of contact force sensing technology is able to significantly reduce ablation, procedure, and fluoroscopy times as well as dose in RFCA of AF in a mixed case-matched group of paroxysmal and persistent AF. Energy delivery is substantially reduced by avoiding radiofrequency ablation in positions with insufficient surface contact. Additionally 12-month outcome data showed increased efficacy. Such time saving and equally safe technology may have a relevant impact on laboratory management and increased cost effectiveness.© 2014 Wiley Periodicals, Inc.

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