Abstract
This multicenter European survey systematically evaluated the impact of using contact force-sensing catheters (CFSCs) on fluoroscopy and procedure time in interventional electrophysiology. Data from 25 participating centers were collected and analyzed, also considering important confounders. With the use of CFSCs, fluoroscopy time was reduced for right- and left-sided atrial ablations (median −6.4 to −9.6 min, p < 0.001 for both groups), whereas no such effect could be found for ventricular ablations. Moreover, the use of CFSCs was associated with an increase in procedure time for right-sided atrial and ventricular ablations (median +26.0 and +44.0 min, respectively, p < 0.001 for both groups), but not for left-sided atrial ablations. These findings were confirmed independent of career level and operator volume, except for very highly experienced electrophysiologists, in whom the effect was blunted. In the subset of pulmonary vein isolations (PVIs), CFSCs were shown to reduce both fluoroscopy and procedure time. In conclusion, the use of CFSCs was associated with a reduced fluoroscopy time for atrial ablations and an increased procedure time for right atrial and ventricular ablations. These effects were virtually independent of the operator experience and caseload. When considering only PVIs as an important subset, CFSCs were shown to reduce both fluoroscopy and procedure time.
Highlights
Contact force-sensing catheters (CFSCs) provide instantaneous feedback regarding the tissue catheter interface, making the ablation lesions more predictable
A more precise and effective placing of ablation points with CFSCs has been shown to translate into better clinical results, e.g., after pulmonary vein isolations performed for the treatment of atrial fibrillation [2,3]
In our observational European survey, we demonstrated that CFSCs helped to reduce fluoroscopy time in right- or left-sided atrial ablation procedures, whereas no effect was found in ventricular ablations
Summary
Contact force-sensing catheters (CFSCs) provide instantaneous feedback regarding the tissue catheter interface, making the ablation lesions more predictable. The additional attributable lifetime risk of developing a malignancy was calculated to be 0.16% if a patient had undergone a single pulmonary vein isolation with a median fluoroscopy time of 23 min [8]. This seems noteworthy, as the mean fluoroscopy time for pulmonary vein isolations is longer than in electrophysiological (EP) procedures for the treatment of other supraventricular arrhythmias [9]. The use of CFSCs for pulmonary vein isolations and other EP procedures may be potentially beneficial to both patients and staff by reducing fluoroscopy time. With this European survey, we sought to investigate the contemporary use of CFSCs and their impact on fluoroscopy and procedure time
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