Background: Catheter ablation (CA) is a potentially curative method for treatment of severe symptomatic and drug-refractory atrial fibrillation (AF).
Objectives: This study aimed to evaluate the impact of steerable sheaths on catheter stability in paroxysmal AF based on contact force (CF).
Methods: Fifty-two patients were included in this study and they were randomly enrolled to two groups: Pulmonary vein isolation using steerable (Group 1, n=26) or fixed-curve (Group 2, n=26) sheaths employing a force-sensing ablation catheter. We analyzed the operator-blinded and unblinded CFs when the operators were satisfied with the catheter position.
Results: The average CF was 23.56±9.43 g (Group 1) vs. 22.03±10.56 g (Group 2) for the blind condition (P<0.05) and 24.61±10.46 g (Group 1) vs. 22.18± 9.84 g (Group 2) for the unblinded condition (P<0.05). There was significant heterogeneity of CFs between the segments: the CFs of the anterior-middle, anteroinferior, posterior-middle, and inferior posteroinferior segments of the right pulmonary vein (RPV), as well as of the roof, superior anterosuperior, anterior-middle, inferior anteroinferior, and inferior posteroinferior segments of the left pulmonary vein (LPV), showed statistical differences in the blinded condition (P<0.05). The CFs of the roof, anterosuperior, anterior-middle, and inferior anteroinferior, and posteroinferior segments of the RPV, and LPV showed statistical differences in the unblinded condition (P<0.05). Posterior and roof segments showed enhanced CFs in both groups. Group one had a lower proportion of acute reconnection rate and less tendency for recurrence.
Conclusion: In conclusion, catheter stability improved with steerable sheaths owing to the potential of attaining higher CFs. This advantage was independent of CF guidance and exhibited a specific distribution pattern.
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