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Association between the use of contact force-sensing catheters and cardiac tamponade in atrial fibrillation ablation.

ABSTRACT: INTRODUCTION:Cardiac tamponade is a rare but life-threatening complication during atrial fibrillation (AF) catheter ablation. Contact force (CF)-sensing catheters improve ablation effectiveness. However, the impact of the application of CF-sensing catheters on the occurrence of cardiac tamponade remains unclear. The aim of this study is to evaluate the "real-world" impact of CF-sensing catheters on cardiac tamponade during AF ablation in an experienced medical center. METHODS AND RESULTS:This was a retrospective study of consecutive de novo AF ablation procedures at Beijing Anzhen Hospital between 2013 and 2016. The ablation procedure was divided into a CF group and a non-CF group. Logistic regression analysis was used to evaluate the association between the use of CF-sensing catheters and the risk of cardiac tamponade. A total of 5313 patients with AF were involved in this study. The incidence of cardiac tamponade in the CF group was significantly higher than that in the non-CF group (1.07% vs. 0.44%, P?=?0.009). Of the cardiac tamponade cases in the non-CF group, 45.45% were delayed compared with 10% in the CF group (P?=?0.011). Multivariate logistic regression analysis showed that CF-sensing catheters increased the risk of cardiac tamponade (OR?=?2.34, 95% CI?=?1.17-4.26, P?=?0.015). Stratified analysis revealed patients with a smaller left atrium dimension, lower ejection fraction, longer procedure duration, or longer ablation duration had a greater risk of cardiac tamponade during ablation with CF-sensing catheters. CONCLUSIONS:CF-sensing catheters increase the risk of cardiac tamponade during AF ablation.

SUBMITTER: Liu N

PROVIDER: S-EPMC6660577 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Association between the use of contact force-sensing catheters and cardiac tamponade in atrial fibrillation ablation.

Liu Nian N Zhao Qianqian Q Li Linling L Zhang Mengxia M Huang Jiao J Wei Sheng S Wen Songnan S Ruan Yanfei Y Guo Xueyuan X Li Songnan S Jiang Chengxi C Tang Ribo R Sang Caihua C Long Deyong D Yu Ronghui R Bai Rong R Du Xin X Dong Jianzeng J Ma Changsheng C

Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 20190202 2

<h4>Introduction</h4>Cardiac tamponade is a rare but life-threatening complication during atrial fibrillation (AF) catheter ablation. Contact force (CF)-sensing catheters improve ablation effectiveness. However, the impact of the application of CF-sensing catheters on the occurrence of cardiac tamponade remains unclear. The aim of this study is to evaluate the "real-world" impact of CF-sensing catheters on cardiac tamponade during AF ablation in an experienced medical center.<h4>Methods and resu ...[more]

PMID: 30712075

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Project description:IntroductionAblation Index, also known as VISITAG SURPOINT™, is a novel lesion-quality marker that improves outcomes in radiofrequency (RF) catheter ablation of atrial fibrillation (AF). There is no direct evidence on the comparative effectiveness of RF ablation with Ablation Index and cryoballoon (CB). The objective of the present study was to conduct a matching-adjusted indirect comparison (MAIC) using individual patient-level data (IPD) to compare the effectiveness of RF ablation with Ablation Index to that of CB on recurrence of atrial arrhythmias 12 months after catheter ablation in patients with paroxysmal AF (PAF).MethodsIndividual patient-level data for RF ablation with Ablation Index were obtained from two studies: Solimene et al. [J Interv Card Electrophysiol 54(1):9-15, 2019] and Hussein et al. [J Cardiovasc Electrophysiol 28(9):1037-1047, 2017]. Comparable CB studies identified from a systematic literature review were pooled. Prognostic variables for adjustment were ranked a priori by several practicing electrophysiologists. In the absence of a common treatment arm between the Ablation Index and CB studies, an unanchored MAIC was conducted. Primary analysis compared the Solimene et al. study to pooled CB studies. A secondary analysis compared pooled RF ablation with Ablation Index studies to pooled CB studies. Several scenario and sensitivity analyses were conducted.ResultsPrimary analyses showed statistically significant reductions in the rate of arrhythmia recurrence with RF ablation with Ablation Index compared to CB in unmatched, unadjusted (HR 0.50, 95% CI 0.27-0.95) and matched (0.42, 0.21-0.86) analyses. Greater reductions in the rate of arrhythmia recurrence that favored RF ablation with Ablation Index were observed after matching and adjusting for age (0.41, 0.20-0.85), age and left ventricular ejection fraction (0.37, 0.16-0.88), and age, sex, and left ventricular ejection fraction (0.30, 0.13-0.71). Secondary and sensitivity analyses showed similar reductions.ConclusionsRadiofrequency ablation with Ablation Index was associated with reductions in recurrence of atrial arrhythmias at 12 months compared to CB in unmatched and unadjusted, matched, and matched and adjusted comparisons.

Dataset Information

Association between the use of contact force-sensing catheters and cardiac tamponade in atrial fibrillation ablation.

Publications

Association between the use of contact force-sensing catheters and cardiac tamponade in atrial fibrillation ablation.

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