The Impact of Steerable Sheaths on Catheter Stability of Ablation for Paroxysmal Atrial Fibrillation, Evaluated by Contact Force
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Keywords

Atrial fibrillation
Catheter stability
Contact force
Pulmonary vein isolation
Steerable sheath

Categories

How to Cite

Xu, C. ., Xu, B., Peng, F. ., Pan, J. ., Lou, Y. ., Yan, L. ., & Xing, Y. (2022). The Impact of Steerable Sheaths on Catheter Stability of Ablation for Paroxysmal Atrial Fibrillation, Evaluated by Contact Force. Iranian Red Crescent Medical Journal, 24(4). Retrieved from https://ircmj.org/index.php/IRCMJ/article/view/1732

Abstract

Background: Catheter ablation (CA) is a potentially curative method for treatment of severe symptomatic and drug-refractory atrial fibrillation (AF).

Objectives: This study aimed to evaluate the impact of steerable sheaths on catheter stability in paroxysmal AF based on contact force (CF).

Methods: Fifty-two patients were included in this study and they were randomly enrolled to two groups: Pulmonary vein isolation using steerable (Group 1, n=26) or fixed-curve (Group 2, n=26) sheaths employing a force-sensing ablation catheter. We analyzed the operator-blinded and unblinded CFs when the operators were satisfied with the catheter position.

Results: The average CF was 23.56±9.43 g (Group 1) vs. 22.03±10.56 g (Group 2) for the blind condition (P<0.05) and 24.61±10.46 g (Group 1) vs. 22.18± 9.84 g (Group 2) for the unblinded condition (P<0.05). There was significant heterogeneity of CFs between the segments: the CFs of the anterior-middle, anteroinferior, posterior-middle, and inferior posteroinferior segments of the right pulmonary vein (RPV), as well as of the roof, superior anterosuperior, anterior-middle, inferior anteroinferior, and inferior posteroinferior segments of the left pulmonary vein (LPV), showed statistical differences in the blinded condition (P<0.05). The CFs of the roof, anterosuperior, anterior-middle, and inferior anteroinferior, and posteroinferior segments of the RPV, and LPV showed statistical differences in the unblinded condition (P<0.05). Posterior and roof segments showed enhanced CFs in both groups. Group one had a lower proportion of acute reconnection rate and less tendency for recurrence.

Conclusion: In conclusion, catheter stability improved with steerable sheaths owing to the potential of attaining higher CFs. This advantage was independent of CF guidance and exhibited a specific distribution pattern.

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References

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