Purpose: Contact with cardiac tissue is a determinant of lesion efficacy during atrial fibrillation (AF) ablation. The SenseiÂ®X Robotic Catheter System (Hansen Medical, CA) has been validated for contact force sensing. The electrical coupling index (ECI) from the EnSite Contactâ¢ system (St. Jude Medical, MN) has been validated as an indicator of tissue contact. We aimed at analyzing ECI behavior during radiofrequency (RF) pulses maintaining a stable contact through the robotic navigation contact system. Methods: In 15 patients (age, 59 Â± 12) undergoing AF ablation, pulmonary vein (PV) isolation was guided by the SenseiÂ®X System, employing the Contactâ¢ catheter. Results: During the procedure, we assessed ECI changes associated with adequate contact based on the IntelliSenseÂ® force-sensing technology (Hansen Medical, CA. Baseline contact (27 Â± 8 g/cm2) ECI value was 99 Â± 13, whereas ECI values in a noncontact site (0 g/cm2) and in a light contact site (1-10 g/cm2) were respectively 66 Â± 12 and 77 Â± 10 (p < 0.0001). Baseline contact ECI values were not different depending on AF presentation (paroxysmal AF, 98 Â± 9; persistent AF, 100 Â± 9) or on cardiac rhythm (sinus rhythm, 97 Â± 7; AF,101 Â± 10). In all PVs, ECI was significantly reduced during and after ablation (ECI during RF, 56 Â± 15; ECI after RF, 72 Â± 16; p < 0.001). A mean reduction of 32.2 % during RF delivery and 25.4 % immediately after RF discontinuation compared with baseline ECI was observed. Conclusions: Successful PV isolation is associated with a significant decrease in ECI of at least 20 %. This may be used as a surrogate marker of effective lesion in AF ablation.
Simultaneous assessment of contact pressure and local electrical coupling index using robotic navigation / A. Dello Russo, G. Fassini, M. Casella, F. Bologna, O. Al-Nono, D. Colombo, V. Biagioli, P. Santangeli, L. Di Biase, M. Zucchetti, B. Majocchi, V. Marino, J.J. Gallinghouse, A. Natale, C. Tondo. - In: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY. - ISSN 1383-875X. - 40:1(2014), pp. 23-31.
|Titolo:||Simultaneous assessment of contact pressure and local electrical coupling index using robotic navigation|
NATALE, ANDREA PRISCO LORENZO (Penultimo)
TONDO, CLAUDIO (Ultimo)
|Parole Chiave:||Atrial fibrillation; Catheter ablation; Catheter tip-to-tissue contact; Electrical coupling index; Radiofrequency; Aged; Atrial Fibrillation; Catheter Ablation; Electric Impedance; Electrophysiologic Techniques, Cardiac; Female; Humans; Male; Middle Aged; Plethysmography, Impedance; Pressure; Robotics; Surgery, Computer-Assisted; Cardiology and Cardiovascular Medicine; Physiology (medical); Medicine (all)|
|Settore Scientifico Disciplinare:||Settore MED/11 - Malattie dell'Apparato Cardiovascolare|
|Data di pubblicazione:||2014|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1007/s10840-014-9882-2|
|Appare nelle tipologie:||01 - Articolo su periodico|