defined anatomic boundaries, can occur in 10% of patients.1 Extend this to the 10- to 12-cm circumference around the typical PV antrum, and the importance of uniform transmural lesions is apparent.
Article see p 63
It was recognized early that the Achille’s heal to AF ablation was early PV reconnection after ablation.2 Although temperature rises and limited power delivery may have limited lesion depth using early 4-mm-tip catheters, the development of irrigated tip catheters has improved our ability to make large enough lesions to achieve transmurality in the atrium.
Yet, PV reconnection continued to occur. I recall as a fellow being told by an attending to “ride the wave,” as I tried to balance the catheter on the left atrial appendage ridge while the patient …show more content…
There was a direct correlation between catheter/ tissue contact force during ablation and the resulting lesion volume in a canine thigh muscle preparation. This important study led to the early adoption of steerable sheaths to maintain better contact force during AF ablation in many centers. The next step in the evolution of catheter ablation was clearly the advent of the contact force–sensing catheter. The initial published results of the first European study using a contact force– sensing catheter6 supported the concept that contact force was the missing link in AF ablation. When mean catheter contact force during ablation was 20 g, the success rate improved dramatically to 80%.
In this edition of Circulation: Arrhythmia and
Electrophysiology, Ullah et al7 perform a detailed analysis of the relationship between impedance changes, electrogram amplitude, and contact force in 15 patients undergoing catheter ablation of persistent AF; the majority used the Hanson robotic system. An irrigated contact force–sensing catheter
(SmartTouch, Biosense Webster, Inc, Diamond Bar, CA) was used with a maximum power delivery of 30 W and
Article see p 63
It was recognized early that the Achille’s heal to AF ablation was early PV reconnection after ablation.2 Although temperature rises and limited power delivery may have limited lesion depth using early 4-mm-tip catheters, the development of irrigated tip catheters has improved our ability to make large enough lesions to achieve transmurality in the atrium.
Yet, PV reconnection continued to occur. I recall as a fellow being told by an attending to “ride the wave,” as I tried to balance the catheter on the left atrial appendage ridge while the patient …show more content…
There was a direct correlation between catheter/ tissue contact force during ablation and the resulting lesion volume in a canine thigh muscle preparation. This important study led to the early adoption of steerable sheaths to maintain better contact force during AF ablation in many centers. The next step in the evolution of catheter ablation was clearly the advent of the contact force–sensing catheter. The initial published results of the first European study using a contact force– sensing catheter6 supported the concept that contact force was the missing link in AF ablation. When mean catheter contact force during ablation was 20 g, the success rate improved dramatically to 80%.
In this edition of Circulation: Arrhythmia and
Electrophysiology, Ullah et al7 perform a detailed analysis of the relationship between impedance changes, electrogram amplitude, and contact force in 15 patients undergoing catheter ablation of persistent AF; the majority used the Hanson robotic system. An irrigated contact force–sensing catheter
(SmartTouch, Biosense Webster, Inc, Diamond Bar, CA) was used with a maximum power delivery of 30 W and