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Contact-force local impedance algorithm to guide effective pulmonary vein isolation in AF patients: 1-year outcome from an international multicenter clinical setting.
Solimene, Franscesco; Maggio, Ruggero; De Sanctis, Valerio; Escande, William; Malacrida, Maurizio; Stabile, Giuseppe; Zakine, Cyril; Champ-Rigot, Laure; Anselmino, Matteo; Ferraro, Anna; Mantica, Massimo; Zucchelli, Giulio; Dell'Era, Gabriele; Mascia, Giuseppe; Ricci Maga, Renata; Pandozi, Claudio; Rossi, Pietro; Scaglione, Marco; Zingarini, Gianluca; Garnier, Fabien; Loricchio, Maria Luisa; Pelargonio, Gemma; Lepillier, Antoine.
Afiliação
  • Solimene F; Department of Cardiac Electrophysiology and Arrhythmology, Clinica Montevergine, Mercogliano, Italy.
  • Maggio R; Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy.
  • De Sanctis V; Laboratorio Di Elettrofisiologia, Infermi Hospital, 29, Rivoli, Italy. ruggero.maggio@gmail.com.
  • Escande W; IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy.
  • Malacrida M; Centre Cardiologique du Nord, Saint-Denis, France.
  • Stabile G; Boston Scientific, Milan, Italy.
  • Zakine C; Mediterranea Cardiocentro, Naples, Italy.
  • Champ-Rigot L; Clinique NCT, St Cyr Sur Loire, France.
  • Anselmino M; Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France.
  • Ferraro A; Division of Cardiology, Department of Medical Sciences, "Città Della Salute E Della Scienza Di Torino" Hospital, University of Turin, Turin, Italy.
  • Mantica M; Laboratorio Di Elettrofisiologia, Infermi Hospital, 29, Rivoli, Italy.
  • Zucchelli G; IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy.
  • Dell'Era G; Second Division of Cardiology, Cardiac-Thoracic-Vascular Department, New Santa Chiara Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
  • Mascia G; Azienda Ospedaliera Universitaria "Maggiore Della Carità", Novara, Italy.
  • Ricci Maga R; IRCCS San Martino Polyclinic Hospital, Genoa, Italy.
  • Pandozi C; Boston Scientific, Milan, Italy.
  • Rossi P; San Filippo Neri Hospital, Rome, Italy.
  • Scaglione M; Fatebenefratelli Isola Tiberina - Gemelli Isola Hospital, Rome, Italy.
  • Zingarini G; Cardinal Massaia Hospital, Asti, Italy.
  • Garnier F; S. Maria Della Misericordia Hospital, Perugia, Italy.
  • Loricchio ML; Centre Hospitalier de Dijon Bourgogne, Dijon, France.
  • Pelargonio G; Sandro Pertini Hospital, Rome, Italy.
  • Lepillier A; Istituto Di Cardiologia Università Cattolica del Sacro Cuore, Rome, Italy.
Article em En | MEDLINE | ID: mdl-38972960
ABSTRACT

BACKGROUND:

The combination of highly localized impedance (LI) and contact force (CF) may improve tissue characterization and lesion prediction during radiofrequency (RF) pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF).

OBJECTIVE:

We report the outcomes of our acute and long-term clinical evaluation of CF-LI-guided PVI in consecutive AF ablation cases from an international multicenter clinical setting.

METHODS:

Three hundred twenty-four consecutive patients from 20 European centers undergoing RF catheter ablation with the Stablepoint™ catheter were enrolled in the CHARISMA registry. Of these, 275 had a minimum follow-up of 1 year and were included in the primary analysis.

RESULTS:

The mean procedure duration was 115 ± 47 min, and the mean fluoroscopy time was 9.9 ± 6 min. At the end of the procedures, all PVs had been successfully isolated in all study patients. Minor complications were reported in 12 patients (4.4%). At 1 year, 36 (13.1%) patients had had an AF recurrence, and freedom from antiarrhythmic drugs and AF recurrence was achieved in 228 (82.9%) patients. The recurrence rate was higher in patients with persistent AF (21/116, 18.1%) than in those with paroxysmal AF (15/159, 9.4%; p = 0.0459). On multivariate logistic analysis adjusted for baseline confounders, only time > 6 months from first diagnosis of AF to ablation (HR = 2.93, 95%CI 1.03 to 8.36, p = 0.0459) was independently associated with recurrences.

CONCLUSION:

An ablation strategy for PVI guided by CF-LI technology proved safe and effective and resulted in a low recurrence rate of AF over 1-year follow-up, irrespective of the underlying AF type. CLINICAL TRIAL REGISTRATION Catheter Ablation of Arrhythmias with a High-Density Mapping System in Real-World Practice. (CHARISMA). URL http//clinicaltrials.gov/ Identifier NCT03793998.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Interv Card Electrophysiol Assunto da revista: CARDIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Itália

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Interv Card Electrophysiol Assunto da revista: CARDIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Itália