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Curso de Atualização em Medicina Cardiovascular 2019
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Atrial fibrillation ablation with remote magnetic navigation. The new indicator of catheter tip to tissue contact: a tool or a toy?
Session:
Posters 5 - Écran 3 - Arritmologia
Speaker:
Leonor Parreira
Congress:
CPC 2019
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.4 Atrial Fibrillation - Treatment
Session Type:
Posters
FP Number:
---
Authors:
Leonor Parreira; Pedro Lopes Do Carmo; Diogo Cavaco; Joana Pinho; Rafael Jerónimo; João Carmo; Francisco Moscoso Costa; Ana Sofia Soares; Maria Salomé Carvalho; Katya Reis Santos; Pedro Adragão
Abstract
<p><strong>Background: </strong>Until recently, contact assessment technology was not available for remote magnetic navigation system (MNS) Stereotaxis <sup>TM</sup>. Since May 2017 the e-Contact <sup>T M</sup> module is available, and it permits a semi-quantitative assessment of the catheter tip-to-tissue contact. </p> <p><strong>Aims:</strong> Evaluate the impact of this new contact tool in atrial fibrillation (AF) ablation.</p> <p><strong>Methods: </strong>Since January 2018 we studied all consecutive patients subjected to a first AF ablation using the MNS with the e-Contact module. We excluded redo procedures. A control group of consecutive patients who underwent a first AF ablation between January and December 2016 were included. The level of contact is displayed in a semi-quantitative mode by a starburst with more or less spikes (no contact , medium and optimal), see Figure. In the e-Contact group the RF application was interrupted whenever the contact indicator showed poor contact. The methodology used in AF ablation was ipsilateral pulmonary vein isolation (PVI). We evaluated the CHADSVASC score, left atrium volume and type of AF, total duration of the procedure, RF application time and radiation dose and the need for additional lines between ipsilateral pulmonary veins.</p> <p><strong>Results: </strong>We performed PVI with the e-Contact technology in 117 patients and without e-Contact in 129 patients. The two groups did not differ in age, gender, type of AF AF, CHADSVASC score and LA volume. The success rate for all 4 PVI was 100% in both groups and there were no major complications. In the group with e-Contact additional lines between ipsilateral veins were less frequently needed (42% vs 70%, p<0.0001). There was a significant reduction in the duration of the RF application needed to achieve PVI (3453 (3320-5316) sec vs 3557 (3145-5550) sec, p<0.0001), that resulted in a shorter duration of the procedure in the e-Contact group (146 (127-174) min vs 195 (164-230) min, p<0.0001. The radiation dose was not significantly different.</p> <p><strong>Conclusion: </strong>In this group of patients the new contact technology proved to be an innovative tool, aiding in the achievement of success, with less RF duration and leading to a shorter duration of the procedure. </p>
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