{"id":3677,"date":"2008-10-03T12:09:17","date_gmt":"2008-10-03T11:09:17","guid":{"rendered":"https:\/\/touchcardio.com\/?p=3677"},"modified":"2024-10-08T09:48:12","modified_gmt":"2024-10-08T08:48:12","slug":"175-ablation-catheter-motion-detection-during-contact-force-and-visitag-module-guided-pulmonary-vein-isolation-improving-the-accuracy-of-radiofrequency-annotation","status":"publish","type":"post","link":"https:\/\/touchcardio.com\/interventional-cardiology\/journal-articles\/175-ablation-catheter-motion-detection-during-contact-force-and-visitag-module-guided-pulmonary-vein-isolation-improving-the-accuracy-of-radiofrequency-annotation\/","title":{"rendered":"175\/Ablation catheter motion detection during contact force and VISITAG Module-guided pulmonary vein isolation \u2013 Improving the accuracy of radiofrequency annotation"},"content":{"rendered":"<p class=\"Body-Text\"><strong><span class=\"_5-Bold\">B<\/span><span class=\"_5-Bold\">ackground:<\/span>\u00a0<\/strong>During contact force (CF) and VISITAG\u2122 Module (Biosense Webster) guided pulmonary vein isolation (PVI), ACCURESP\u2122 respiratory motion adjustment is recommended, although without\u00a0<span class=\"Italics\">in vivo<\/span>\u00a0validation.<\/p>\n<p class=\"Body-Text\"><strong><span class=\"_5-Bold\">Objective:<\/span>\u00a0<\/strong>Since accurate LAPW radiofrequency (RF) annotation is crucial to avoid oesophageal thermal injury, we compared ACCURESP\u2122 setting (\u201con\u201d versus \u201coff\u201d) on RF annotation at the left atrial posterior wall (LAPW).<\/p>\n<p class=\"Body-Text\"><strong><span class=\"_5-Bold\">Methods:<\/span>\u00a0<\/strong>From a twenty-five patient cohort undergoing CF PVI (continuous RF, 30 W) using general anaesthesia and VISITAG\u2122 Module annotation-guidance (force-over-time 100% minimum 1 g, 2 mm position stability, ACCURESP\u2122 \u201coff\u201d), respiratory motion detection occurred in eight, permitting retrospective comparison of ACCURESP\u2122 settings.<\/p>\n<p class=\"Body-Text\"><strong><span class=\"_5-Bold\">Results:<\/span><\/strong>\u00a0There were significant differences in LAPW RF data annotation according to ACCURESP\u2122 setting (<em><span class=\"Italics\">Table 1<\/span><\/em>). Comparing ACCURESP\u2122 \u2019on\u2018 versus \u2019off\u2018, respectively: total annotated sites 82 versus 98; Median RF duration per-site 13.3 s versus 10.6 s (p&lt;0.0001); Median force time integral 177 g.s versus 130 g.s (p=0.0002); Mean inter-lesion distance (ILD) 6.0 mm versus 4.8 mm (p=0.002). Considering only annotated site 1-to-2 transitions, three occurred with 0 g CF; ACCURESP\u2122 \u2019on\u2018 minus \u2019off\u2018 difference in RF duration was &lt;0.6 s. However, 13 site 1-to-2 transitions during constant catheter-tissue contact (ILD range 2.1\u20137.0 mm) demonstrated a mean difference in annotated RF duration at site 1, of 3.7 s (range: \u20131.3\u201311.3 s). Reconstituted curves displaying catheter position data, CF, impedance and site 1-to-2 transition according to ACCURESP\u2122 setting, demonstrated multiple markers of catheter movement coinciding with ACCURESP\u2122 \u2019off\u2019.<\/p>\n<p class=\"Body-Text\"><strong><span class=\"_5-Bold\">Conclusions:<\/span>\u00a0<\/strong>During CF and VISITAG\u2122 Module annotation-guided PVI, ACCURESP\u2122 respiratory adjustment results in important delays to the identification and annotation of sites of deliberate catheter motion of up to 5\u20137 mm at the LAPW. Therefore, previously derived ablation targets using ACCURESP\u2122 set \u201con\u201d may be importantly flawed, and on-going respiratory adjustment use is likely to represent an important impediment towards greater PVI procedural reproducibility, efficacy and safety. In contrast, RF annotation with ACCURESP\u2122 set \u201coff\u201d demonstrated suitable catheter motion detection capabilities. Based on these findings, we recommend setting ACCURESP\u2122 \u201coff\u201d during VISITAG\u2122 Module and CF-guided PVI.<\/p>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3566 size-large\" src=\"https:\/\/touchcardio.com\/wp-content\/uploads\/sites\/4\/2019\/10\/Abstr174-1024x487.png\" alt=\"\" width=\"1024\" height=\"487\" srcset=\"https:\/\/touchcardio.com\/wp-content\/uploads\/sites\/4\/2019\/10\/Abstr174-1024x487.png 1024w, https:\/\/touchcardio.com\/wp-content\/uploads\/sites\/4\/2019\/10\/Abstr174-300x143.png 300w, https:\/\/touchcardio.com\/wp-content\/uploads\/sites\/4\/2019\/10\/Abstr174-768x365.png 768w, https:\/\/touchcardio.com\/wp-content\/uploads\/sites\/4\/2019\/10\/Abstr174.png 1429w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background:\u00a0During contact force (CF) and VISITAG\u2122 Module (Biosense Webster) guided pulmonary vein isolation (PVI), ACCURESP\u2122 respiratory motion adjustment is recommended, although without\u00a0in vivo\u00a0validation. Objective:\u00a0Since accurate LAPW radiofrequency (RF) annotation is crucial to avoid oesophageal thermal injury, we compared ACCURESP\u2122 setting (\u201con\u201d versus \u201coff\u201d) on RF annotation at the left atrial posterior wall (LAPW). Methods:\u00a0From a [&hellip;]<\/p>\n","protected":false},"author":77776,"featured_media":3227,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","rank_math_lock_modified_date":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3677","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","vocabulary_1-interventional-cardiology"],"acf":[],"_links":{"self":[{"href":"https:\/\/touchcardio.com\/wp-json\/wp\/v2\/posts\/3677"}],"collection":[{"href":"https:\/\/touchcardio.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/touchcardio.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/touchcardio.com\/wp-json\/wp\/v2\/users\/77776"}],"replies":[{"embeddable":true,"href":"https:\/\/touchcardio.com\/wp-json\/wp\/v2\/comments?post=3677"}],"version-history":[{"count":2,"href":"https:\/\/touchcardio.com\/wp-json\/wp\/v2\/posts\/3677\/revisions"}],"predecessor-version":[{"id":3683,"href":"https:\/\/touchcardio.com\/wp-json\/wp\/v2\/posts\/3677\/revisions\/3683"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/touchcardio.com\/wp-json\/wp\/v2\/media\/3227"}],"wp:attachment":[{"href":"https:\/\/touchcardio.com\/wp-json\/wp\/v2\/media?parent=3677"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/touchcardio.com\/wp-json\/wp\/v2\/categories?post=3677"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/touchcardio.com\/wp-json\/wp\/v2\/tags?post=3677"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}