Simultaneous assessment of contact pressure and local electrical coupling index using robotic navigation

Antonio Dello Russo, Gaetano Fassini, Michela Casella, Fabrizio Bologna, Osama Al-Nono, Daniele Colombo, Viviana Biagioli, Pasquale Santangeli, Luigi Di Biase, Martina Zucchetti, Benedetta Majocchi, Vittoria Marino, Joseph J. Gallinghouse, Andrea Natale, Claudio Tondo

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: Contact with cardiac tissue is a determinant of lesion efficacy during atrial fibrillation (AF) ablation. The Sensei®X Robotic Catheter System (Hansen Medical, CA) has been validated for contact force sensing. The electrical coupling index (ECI) from the EnSite Contact™ system (St. Jude Medical, MN) has been validated as an indicator of tissue contact. We aimed at analyzing ECI behavior during radiofrequency (RF) pulses maintaining a stable contact through the robotic navigation contact system. Methods: In 15 patients (age, 59 ± 12) undergoing AF ablation, pulmonary vein (PV) isolation was guided by the Sensei®X System, employing the Contact™ catheter. Results: During the procedure, we assessed ECI changes associated with adequate contact based on the IntelliSense® force-sensing technology (Hansen Medical, CA. Baseline contact (27 ± 8 g/cm2) ECI value was 99 ± 13, whereas ECI values in a noncontact site (0 g/cm2) and in a light contact site (1-10 g/cm2) were respectively 66 ± 12 and 77 ± 10 (p < 0.0001). Baseline contact ECI values were not different depending on AF presentation (paroxysmal AF, 98 ± 9; persistent AF, 100 ± 9) or on cardiac rhythm (sinus rhythm, 97 ± 7; AF,101 ± 10). In all PVs, ECI was significantly reduced during and after ablation (ECI during RF, 56 ± 15; ECI after RF, 72 ± 16; p < 0.001). A mean reduction of 32.2 % during RF delivery and 25.4 % immediately after RF discontinuation compared with baseline ECI was observed. Conclusions: Successful PV isolation is associated with a significant decrease in ECI of at least 20 %. This may be used as a surrogate marker of effective lesion in AF ablation.

Original languageEnglish (US)
Pages (from-to)23-31
Number of pages9
JournalJournal of Interventional Cardiac Electrophysiology
Volume40
Issue number1
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Robotics
Atrial Fibrillation
Pressure
Pulmonary Veins
Catheters
Biomarkers
Technology
Light

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Catheter tip-to-tissue contact
  • Electrical coupling index
  • Radiofrequency

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

Cite this

Simultaneous assessment of contact pressure and local electrical coupling index using robotic navigation. / Dello Russo, Antonio; Fassini, Gaetano; Casella, Michela; Bologna, Fabrizio; Al-Nono, Osama; Colombo, Daniele; Biagioli, Viviana; Santangeli, Pasquale; Di Biase, Luigi; Zucchetti, Martina; Majocchi, Benedetta; Marino, Vittoria; Gallinghouse, Joseph J.; Natale, Andrea; Tondo, Claudio.

In: Journal of Interventional Cardiac Electrophysiology, Vol. 40, No. 1, 2014, p. 23-31.

Research output: Contribution to journalArticle

Dello Russo, A, Fassini, G, Casella, M, Bologna, F, Al-Nono, O, Colombo, D, Biagioli, V, Santangeli, P, Di Biase, L, Zucchetti, M, Majocchi, B, Marino, V, Gallinghouse, JJ, Natale, A & Tondo, C 2014, 'Simultaneous assessment of contact pressure and local electrical coupling index using robotic navigation', Journal of Interventional Cardiac Electrophysiology, vol. 40, no. 1, pp. 23-31. https://doi.org/10.1007/s10840-014-9882-2
Dello Russo, Antonio ; Fassini, Gaetano ; Casella, Michela ; Bologna, Fabrizio ; Al-Nono, Osama ; Colombo, Daniele ; Biagioli, Viviana ; Santangeli, Pasquale ; Di Biase, Luigi ; Zucchetti, Martina ; Majocchi, Benedetta ; Marino, Vittoria ; Gallinghouse, Joseph J. ; Natale, Andrea ; Tondo, Claudio. / Simultaneous assessment of contact pressure and local electrical coupling index using robotic navigation. In: Journal of Interventional Cardiac Electrophysiology. 2014 ; Vol. 40, No. 1. pp. 23-31.
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abstract = "Purpose: Contact with cardiac tissue is a determinant of lesion efficacy during atrial fibrillation (AF) ablation. The Sensei{\circledR}X Robotic Catheter System (Hansen Medical, CA) has been validated for contact force sensing. The electrical coupling index (ECI) from the EnSite Contact™ system (St. Jude Medical, MN) has been validated as an indicator of tissue contact. We aimed at analyzing ECI behavior during radiofrequency (RF) pulses maintaining a stable contact through the robotic navigation contact system. Methods: In 15 patients (age, 59 ± 12) undergoing AF ablation, pulmonary vein (PV) isolation was guided by the Sensei{\circledR}X System, employing the Contact™ catheter. Results: During the procedure, we assessed ECI changes associated with adequate contact based on the IntelliSense{\circledR} force-sensing technology (Hansen Medical, CA. Baseline contact (27 ± 8 g/cm2) ECI value was 99 ± 13, whereas ECI values in a noncontact site (0 g/cm2) and in a light contact site (1-10 g/cm2) were respectively 66 ± 12 and 77 ± 10 (p < 0.0001). Baseline contact ECI values were not different depending on AF presentation (paroxysmal AF, 98 ± 9; persistent AF, 100 ± 9) or on cardiac rhythm (sinus rhythm, 97 ± 7; AF,101 ± 10). In all PVs, ECI was significantly reduced during and after ablation (ECI during RF, 56 ± 15; ECI after RF, 72 ± 16; p < 0.001). A mean reduction of 32.2 {\%} during RF delivery and 25.4 {\%} immediately after RF discontinuation compared with baseline ECI was observed. Conclusions: Successful PV isolation is associated with a significant decrease in ECI of at least 20 {\%}. This may be used as a surrogate marker of effective lesion in AF ablation.",
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T1 - Simultaneous assessment of contact pressure and local electrical coupling index using robotic navigation

AU - Dello Russo, Antonio

AU - Fassini, Gaetano

AU - Casella, Michela

AU - Bologna, Fabrizio

AU - Al-Nono, Osama

AU - Colombo, Daniele

AU - Biagioli, Viviana

AU - Santangeli, Pasquale

AU - Di Biase, Luigi

AU - Zucchetti, Martina

AU - Majocchi, Benedetta

AU - Marino, Vittoria

AU - Gallinghouse, Joseph J.

AU - Natale, Andrea

AU - Tondo, Claudio

PY - 2014

Y1 - 2014

N2 - Purpose: Contact with cardiac tissue is a determinant of lesion efficacy during atrial fibrillation (AF) ablation. The Sensei®X Robotic Catheter System (Hansen Medical, CA) has been validated for contact force sensing. The electrical coupling index (ECI) from the EnSite Contact™ system (St. Jude Medical, MN) has been validated as an indicator of tissue contact. We aimed at analyzing ECI behavior during radiofrequency (RF) pulses maintaining a stable contact through the robotic navigation contact system. Methods: In 15 patients (age, 59 ± 12) undergoing AF ablation, pulmonary vein (PV) isolation was guided by the Sensei®X System, employing the Contact™ catheter. Results: During the procedure, we assessed ECI changes associated with adequate contact based on the IntelliSense® force-sensing technology (Hansen Medical, CA. Baseline contact (27 ± 8 g/cm2) ECI value was 99 ± 13, whereas ECI values in a noncontact site (0 g/cm2) and in a light contact site (1-10 g/cm2) were respectively 66 ± 12 and 77 ± 10 (p < 0.0001). Baseline contact ECI values were not different depending on AF presentation (paroxysmal AF, 98 ± 9; persistent AF, 100 ± 9) or on cardiac rhythm (sinus rhythm, 97 ± 7; AF,101 ± 10). In all PVs, ECI was significantly reduced during and after ablation (ECI during RF, 56 ± 15; ECI after RF, 72 ± 16; p < 0.001). A mean reduction of 32.2 % during RF delivery and 25.4 % immediately after RF discontinuation compared with baseline ECI was observed. Conclusions: Successful PV isolation is associated with a significant decrease in ECI of at least 20 %. This may be used as a surrogate marker of effective lesion in AF ablation.

AB - Purpose: Contact with cardiac tissue is a determinant of lesion efficacy during atrial fibrillation (AF) ablation. The Sensei®X Robotic Catheter System (Hansen Medical, CA) has been validated for contact force sensing. The electrical coupling index (ECI) from the EnSite Contact™ system (St. Jude Medical, MN) has been validated as an indicator of tissue contact. We aimed at analyzing ECI behavior during radiofrequency (RF) pulses maintaining a stable contact through the robotic navigation contact system. Methods: In 15 patients (age, 59 ± 12) undergoing AF ablation, pulmonary vein (PV) isolation was guided by the Sensei®X System, employing the Contact™ catheter. Results: During the procedure, we assessed ECI changes associated with adequate contact based on the IntelliSense® force-sensing technology (Hansen Medical, CA. Baseline contact (27 ± 8 g/cm2) ECI value was 99 ± 13, whereas ECI values in a noncontact site (0 g/cm2) and in a light contact site (1-10 g/cm2) were respectively 66 ± 12 and 77 ± 10 (p < 0.0001). Baseline contact ECI values were not different depending on AF presentation (paroxysmal AF, 98 ± 9; persistent AF, 100 ± 9) or on cardiac rhythm (sinus rhythm, 97 ± 7; AF,101 ± 10). In all PVs, ECI was significantly reduced during and after ablation (ECI during RF, 56 ± 15; ECI after RF, 72 ± 16; p < 0.001). A mean reduction of 32.2 % during RF delivery and 25.4 % immediately after RF discontinuation compared with baseline ECI was observed. Conclusions: Successful PV isolation is associated with a significant decrease in ECI of at least 20 %. This may be used as a surrogate marker of effective lesion in AF ablation.

KW - Atrial fibrillation

KW - Catheter ablation

KW - Catheter tip-to-tissue contact

KW - Electrical coupling index

KW - Radiofrequency

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