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Contact-force sensing technology improves long-term clinical outcomes after a first pulmonary vein isolation procedure – a propensity score analysis
Session:
CO 15 - Prémio Investigação Clínica
Speaker:
João Pedro Vilaça Delgado de Almeida e Mesquita
Congress:
CPC 2018
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.4 Atrial Fibrillation - Treatment
Session Type:
Comunicações Orais
FP Number:
---
Authors:
João Mesquita; Diogo Cavaco; António Ferreira; Elisabete Vaz; Pedro Lopes Do Carmo; Francisco Moscoso Costa; Francisco Bello Morgado; Miguel Mendes; Pedro Adragão
Abstract
<h3><strong>Background:</strong> </h3> <p>Contact-force sensing (CFS) technology reduces acute electrical reconnection after pulmonary vein isolation (PVI), but its long-term clinical outcomes remain unclear.</p> <h3><strong>Objective:</strong> </h3> <p>To evaluate CFS technology impact in the long-term freedom from AF after a first PVI, in comparison to a conventional catheter (no CFS).</p> <h3><strong>Methods:</strong> </h3> <p>Single-center observational registry including 1083 patients (age 60 years (IQR 51-67), LA volume 57 ml/m2 (IQR 54-72), 67% males) with drug-resistant AF who underwent a first PVI between 2007-2015. Endpoint was AF/AT/AFL relapse after a 3-month blanking period. Thermocool® (no CFS) and Thermocool®SmartTouch® (CFS) (Biosense Webster Inc., CA, US) catheters were compared. A minimum contact force of 10g was expected for RF application. A propensity score (PS) model was developed using CFS as the dependent variable and relevant baseline characteristics as covariates. PS probabilities in the treatment group (CFS) were matched in a 1:2 fashion to the nearest control patient (no CFS).</p> <h3><strong>Results:</strong> </h3> <p>PS matched 325 patients who underwent PVI using CFS with 634 controls, yielding well-balanced groups (Fig A). 102 (31%) patients relapsed in the CFS group vs 290 (46%) in control (P<0.001) - annual relapse rates 11.6%/year vs 13.5%/year, respectively (P=0.029, Fig B). Ablation using CFS was associated with shorter procedure (140 (IQR 111-173) vs 174 (IQR 133-219) min (P<0.001)) and fluoroscopy (17 (IQR 12-24) vs 22 (15-38) min (P<0.001)) times. Major complications were rare (<1.4%) and similar between both groups.</p> <h3><strong>Conclusion:</strong> </h3> <p>CFS technology seems to improve long-term freedom from AF after PVI and is associated with shorter procedures and radiation exposure.</p>
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