Key result
Contact force sensing shows no benefit over traditional catheters for outflow tract PVC ablation.
Why the study?
Appropriately sized and properly designed studies comparing outflow tract PVC ablation outcomes between contact force sensing and traditional catheters were lacking.
Does the use of contact force sensing ablation catheters improve acute success and long-term recurrence-free survival compared to traditional catheters in patients with outflow tract premature ventricular complexes?
Cohort (n=150)
No
Does the use of contact force sensing ablation catheters improve acute success and long-term recurrence-free survival compared to traditional catheters in patients with outflow tract premature ventricular complexes?
Contact force sensing catheters do not appear to offer a clinical advantage over traditional irrigated catheters for outflow tract PVC ablation.
Answers are grounded in this paper and cite their sources.
No outcome difference with contact force sensing versus traditional catheters in outflow tract PVC ablation; hypothesis-generating and requires randomized confirmation.
AIMS: Unlike in atrial fibrillation ablation, there is a lack of appropriately sized and properly designed studies regarding outflow tract (OT) premature ventricular complex (PVC) ablation outcomes with contact force sensing (CFS) catheters. We aimed to compare the acute success-, complication-, and long-term recurrence rates of manual CFS catheters with traditional irrigated catheters (T) in OT PVC ablation. METHODS AND RESULTS: Single-centre, propensity-matched data of 75-75 patients ablated for right-sided OT (RVOT) or left-sided OT (LVOT) PVCs in 2015-17 with CFS or T catheters were compared. Acute success rate, peri-procedural complications, post-procedural daily PVC burden, and long-term recurrence rates were compared on intention-to-treat basis. Acute success rate equalled 80% in both groups, with no difference in force values in the CFS group comparing successful or failed cases [12.0 (8.75-17.0) vs. 16.0 (10.25-22.25) g, P = 0.21]. There were three cases of pseudo-aneurysm and one cardiac tamponade. PVC burden fell significantly from baseline 22 (15-30)% to 2 (0-10)% (P < 0.0001), with no difference between catheter types [CFS: 1 (0-7)% vs. T: 4 (1-12) %; P = 0.21]. There was no significant difference in recurrence-free survival of CFS and T catheters (58 vs. 59%, P = 0.29) during 12 months of follow-up, respectively. Recurrence in the CFS group did not differ either by the force exerted below or above the median value of 12 g (P = 0.66). CONCLUSION: Both types of catheters can effectively reduce OT PVC burden with minimal serious complication rates. Ablation with CFS or T catheters gives similar acute- and long-term results.
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Ábrahám et al. (2020) conducted a cohort in Outflow tract premature ventricular complexes (n=150). Contact force sensing (CFS) catheters vs. Traditional manual irrigated catheters was evaluated on Recurrence-free survival at 12 months (recurrence defined as >5% daily PVC burden) (p=0.29). Contact force sensing catheters and traditional manual catheters demonstrated similar 12-month recurrence-free survival rates (58% vs 59%, p=0.29) and identical acute success rates (80%) in outflow tract PVC ablation.
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