Long-Term Efficacy Of Radiofrequency Ablation With Contact Force Sensing Catheter In Paroxysmal Atrial Fibrillation Patients

【Objective】To compare the long-term efficacy after raidofrequency catheter ablation of paroxysmal atrial fibrillation(PAF)patients with contact force sensing catheter or traditional open-irrigated tip catheter.【Methods】Retrospectively analyze PAF patients who received initial circumferential pulmonary vein isolation(CPVI)in Shanghai General Hospital from Jaunary,2013 to june,2015.A total of 243 patients were enrolled,of whom 138 patients were divided into contact force sensing open-irrigated tip catheter group(Thermo Cool Smarttouch? Catheter,Biosense Webster Inc,CA,USA;ST group)while 105 patients were divided into traditional open-irrigated tip catheter(Thermo Cool Navistar;Biosense Webster Inc,CA,USA;TC group).Endpoint of the catheter ablation is bi-directional electrical isolation of left atrium and pulmonary vein.The duration of operation and X-ray exposure,rate of postoperation complications and long-term efficacy remaining in sinus rhythm were compared.【Results】Among 243 patients enrolled,the average age was 61.65 ± 10.12 years old,61.7% were male,50.6% with hypertension,12.3% with diabetes,7.4% had a history of cerebral infarction,and 8.6% with congestive heart failure.There were no statistically significant differences in baseline clinical characteristics between the two groups,including age,gender,comorbidity,left atrial diameter,and left ventricular ejection fraction.All the patients enrolled completed CPVI and were confirmed bi-directional electrical isolation of left atrium and pulmonary vein.Compared ST group with TC group,the duration of operation was shorter and the duration of X-ray exposure was longer,but there was no significantly difference(196.20 ± 52.2 vs 198.6 ± 36.6 min,P = 0.486;15.81 ± 7.22 vs 12.50 ± 4.65 min,P = 0.231).There were 2 cases of hematoma in the ST group.1 case of hematoma and 1case of pericardial tamponade appeared in the TC group.There was no significant difference in the incidence of complications between the two groups(P=0.782).The success rate at 1 year after PVI was significantly higher in the ST group than in the TC group(87.7% vs.77.1%,P = 0.03).After mean 53.0 ± 3.7 follow-up,the success rate in the ST group was significantly higher than that in the TC group(82.6 % vs 71.4%,P = 0.038).【Conclusion】Contact force sensing open-irrigated tip catheter is associated with significantly improved long-term success rate after catheter ablation in patients with PAF.