{"title":"50w导管消融用于房颤初始肺静脉隔离的可行性和有效性。","authors":"Kazuhisa Matsumoto MD, PhD, Naomichi Tanaka MD, PhD, Wataru Sasaki MD, Tsukasa Naganuma MD, Masataka Narita MD, Daisuke Kawano MD, Hitoshi Mori MD, PhD, Kenta Tsutsui MD, PhD, Yoshifumi Ikeda MD, PhD, Takahide Arai MD, PhD, Shintaro Nakano MD, PhD, Kazuo Matsumoto MD, PhD, Ritsushi Kato MD, PhD","doi":"10.1002/joa3.13191","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>A novel contact force (CF) sensing catheter with a mesh-shaped irrigation tip (TactiFlexTM SE, Abbott), is expected to provide safe and effective radiofrequency ablation. Our previous study revealed that the TactiFlex catheter needs a higher power for pulmonary vein isolation (PVI) due to the long tip length. This study aimed to examine the feasibility and safety of a 50 W ablation with the TactiFlex for PVI of atrial fibrillation (AF).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A PVI was performed in 100 AF patients using TactiFlex catheters with a 50 W setting, 5-20 g CF, and 15–20 s ablation time. The primary outcomes included a successful PVI, the incidence of first-pass isolations (FPIs), the presence of PV conduction gaps, and the incidence of complications.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>FPIs were achieved for 82/100 (82%) right pulmonary veins (RPVs) and 87/100 (87%) left PVs (LPVs). Among the unsuccessful RPV FPIs, residual carina potentials were observed in 16/18 cases (89%), PV gaps in 1/18 cases (5.5%), and both carina and PV gaps in 1/18 cases (5.5%). Similarly, among the unsuccessful LPV FPIs, residual carina potentials were observed in 11/13 cases (84.6%), PV gaps in 1/13 cases (7.7%), and both carina and PV gaps in 1/13 cases (7.7%). Periesophageal nerve injury occurred in 1/100 cases (1%), and no cardiac tamponade occurred. The overall AF-free rate at one-year was 81.7%.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The 50 W ablation with the TactiFlex demonstrated a high rate of an FPI, low incidence of PV gaps, and proved to be a safe and effective approach for the initial PVI of AF.</p>\n </section>\n </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 1","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730719/pdf/","citationCount":"0","resultStr":"{\"title\":\"Feasibility and efficacy of 50 W ablation with the TactiFlex catheter for the initial pulmonary vein isolation of atrial fibrillation\",\"authors\":\"Kazuhisa Matsumoto MD, PhD, Naomichi Tanaka MD, PhD, Wataru Sasaki MD, Tsukasa Naganuma MD, Masataka Narita MD, Daisuke Kawano MD, Hitoshi Mori MD, PhD, Kenta Tsutsui MD, PhD, Yoshifumi Ikeda MD, PhD, Takahide Arai MD, PhD, Shintaro Nakano MD, PhD, Kazuo Matsumoto MD, PhD, Ritsushi Kato MD, PhD\",\"doi\":\"10.1002/joa3.13191\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>A novel contact force (CF) sensing catheter with a mesh-shaped irrigation tip (TactiFlexTM SE, Abbott), is expected to provide safe and effective radiofrequency ablation. Our previous study revealed that the TactiFlex catheter needs a higher power for pulmonary vein isolation (PVI) due to the long tip length. This study aimed to examine the feasibility and safety of a 50 W ablation with the TactiFlex for PVI of atrial fibrillation (AF).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A PVI was performed in 100 AF patients using TactiFlex catheters with a 50 W setting, 5-20 g CF, and 15–20 s ablation time. The primary outcomes included a successful PVI, the incidence of first-pass isolations (FPIs), the presence of PV conduction gaps, and the incidence of complications.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>FPIs were achieved for 82/100 (82%) right pulmonary veins (RPVs) and 87/100 (87%) left PVs (LPVs). Among the unsuccessful RPV FPIs, residual carina potentials were observed in 16/18 cases (89%), PV gaps in 1/18 cases (5.5%), and both carina and PV gaps in 1/18 cases (5.5%). Similarly, among the unsuccessful LPV FPIs, residual carina potentials were observed in 11/13 cases (84.6%), PV gaps in 1/13 cases (7.7%), and both carina and PV gaps in 1/13 cases (7.7%). Periesophageal nerve injury occurred in 1/100 cases (1%), and no cardiac tamponade occurred. The overall AF-free rate at one-year was 81.7%.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>The 50 W ablation with the TactiFlex demonstrated a high rate of an FPI, low incidence of PV gaps, and proved to be a safe and effective approach for the initial PVI of AF.</p>\\n </section>\\n </div>\",\"PeriodicalId\":15174,\"journal\":{\"name\":\"Journal of Arrhythmia\",\"volume\":\"41 1\",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-11-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730719/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Arrhythmia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/joa3.13191\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Arrhythmia","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/joa3.13191","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Feasibility and efficacy of 50 W ablation with the TactiFlex catheter for the initial pulmonary vein isolation of atrial fibrillation
Background
A novel contact force (CF) sensing catheter with a mesh-shaped irrigation tip (TactiFlexTM SE, Abbott), is expected to provide safe and effective radiofrequency ablation. Our previous study revealed that the TactiFlex catheter needs a higher power for pulmonary vein isolation (PVI) due to the long tip length. This study aimed to examine the feasibility and safety of a 50 W ablation with the TactiFlex for PVI of atrial fibrillation (AF).
Methods
A PVI was performed in 100 AF patients using TactiFlex catheters with a 50 W setting, 5-20 g CF, and 15–20 s ablation time. The primary outcomes included a successful PVI, the incidence of first-pass isolations (FPIs), the presence of PV conduction gaps, and the incidence of complications.
Results
FPIs were achieved for 82/100 (82%) right pulmonary veins (RPVs) and 87/100 (87%) left PVs (LPVs). Among the unsuccessful RPV FPIs, residual carina potentials were observed in 16/18 cases (89%), PV gaps in 1/18 cases (5.5%), and both carina and PV gaps in 1/18 cases (5.5%). Similarly, among the unsuccessful LPV FPIs, residual carina potentials were observed in 11/13 cases (84.6%), PV gaps in 1/13 cases (7.7%), and both carina and PV gaps in 1/13 cases (7.7%). Periesophageal nerve injury occurred in 1/100 cases (1%), and no cardiac tamponade occurred. The overall AF-free rate at one-year was 81.7%.
Conclusions
The 50 W ablation with the TactiFlex demonstrated a high rate of an FPI, low incidence of PV gaps, and proved to be a safe and effective approach for the initial PVI of AF.
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