Key result
Manual skin counter-traction resolves ~96% of positional patch alerts during pulsed field ablation.
Why the study?
Suspected back-patch-related positional alerts during pulsed field ablation can interfere with procedural accuracy and require effective resolution methods.
Observational (n=45)
No
A simple manual skin counter-traction maneuver can rapidly resolve CARTO system positional alerts caused by cough-induced back-patch displacement during pulsed field ablation, preserving procedural workflow.
May allow rapid intra-procedural alert resolution in pulsed field ablation; leaves open confirmation in larger prospective cohorts.
of the manual counter-traction maneuver for suspected back-patch-related positional alerts during PFA. Cough-related body movement caused suspected cranial-side back-patch displacement and triggered CARTO positional alerts. Light cranial skin counter-traction was applied opposite to the apparent patch-shift direction without direct contact with the patch. Among 23 alert episodes, 22 were resolved, with a median correction time of 1.62 s and a median measured displacement of 11.69 mm. Pre- and post-alert anatomical maps showed no gross mismatch on visual comparison, although small localization errors cannot be excluded.
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Yamano et al. (2026) conducted an observational in Paroxysmal atrial fibrillation (n=45). Manual counter-traction maneuver was evaluated on Resolution of positional alert episodes. A manual skin counter-traction maneuver successfully resolved 95.7% (22 of 23) of back-patch-related positional alert episodes during pulsed field ablation.
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