Mechanisms of Pulmonary Vein Reconnection After Radiofrequency Ablation of Atrial Fibrillation: The Deterministic Role of Contact Force and Interlesion Distance

• DOI: 10.1111/jce.12396
• Publication Date: 2014-02-27T23:54:45Z
• Authors: CHAN‐IL PARK; HEIKO LEHRMANN; CORNELIUS KEYL; REINHOLD WEBER; JOCHEN SCHIEBELING; JUERGEN ALLGEIER; PATRICK SCHURR; ASHOK SHAH; FRANZ‐JOSEF NEUMANN; THOMAS ARENTZ; AMIR S. JADIDI
• Keywords: Contact force

Mechanisms of Pulmonary Vein Reconnection After Radiofrequency Ablation Atrial Fibrillation Introduction vein reconnection (PVR) is an important cause AF recurrence after ablation. With the advent force sensing catheters, catheter–tissue contact can be determined quantitatively. Since (CF) plays a major role in determining characteristics RF lesion, we prospectively assessed mechanisms PVR with regard to catheter‐contact and lesion distances patients undergoing Methods Results Forty symptomatic underwent wide circumferential PV isolation (PVI) SmartTouch™ CF catheter. The exact locations acute PVI spontaneous or adenosine‐provoked were annotated on CARTO. One thousand nine hundred twenty‐six lesions isolated 153 PVs. occurred 35 (23%) PVs: 22 (63%) 13 (37%) spontaneous. was significantly lower at versus sites for within 6 mm from these sites: mean 5 11 g (P < 0.0001) force–time integral (FTI) 225 415 gs 0.0001); 86% 10 (FTI 400 gs); remaining 14% ablation long interlesion distance (≥5 mm) despite ≥ g. Eighty percent located anteriorly. There no significant differences arrhythmia freedom between without (69%) (67%; P = 1.0). Conclusions Acutely durable achieved when are delivered <5 mm. majority occur anteriorly due inadequate distances.