Higher Contact Force Values Associated With Better Mid Term Outcome Of Paroxysmal Atrial Fibrillation Ablation Using The Smarttouch (Tm) Catheter

Aims Real-time measurement of contact force (CF) during catheter ablation of atrial fibrillation (AF) has been recently suggested to potentially impact procedural outcome. However, the role of CF intensity on mid-term results using the SmartTouch (TM) catheter has not been investigated so far.Methods and results Pulmonary vein isolation (PVI) using the SmartTouch (TM) catheter was performed in 100 eligible patients (age 62 +/- 8; 79% men) undergoing a first procedure of paroxysmal AF catheter ablation. Continuous CF monitoring during catheter ablation allowed calculation of mean CF per patient. Patients were dichotomized into high CF (>= 22 g, upper quartile) and low CF (<22 g, remaining) and enroled in a standardized follow-up programme (after a 3-month blanking period), free from antiarrhythmic therapy, with regular evaluations including 24 h Hotter recordings at 1,3, 6, 9, 12, 18, and 24 months. Atrial fibrillation relapse was defined as any symptomatic or asymptomatic atrial arrhythmia lasting >30 s. The average CF among all procedures was 19.6 +/- 3.7 g. Though complete PVI was eventually achieved in all cases in both groups, success using an exclusively anatomical approach was higher in the high CF group (92.0 vs. 72.0%; P = 0.04). During a mean follow-up of 19 +/- 5 months, a lower incidence of AF relapse was observed in higher CF patients (4.0 vs. 20.0%; tog rank P = 0.04). Pericardial tamponade occurred in one patient in the higher CF group. No thromboembolism or procedure-associated deaths were observed.Conclusion Higher values of CF overall during antral PVI appear to be associated with a higher Likelihood of sinus rhythm maintenance without significantly increasing the complication rate.