216-14: CF Stability Correlates with Clinical Effectiveness in PAF Ablation

Purpose of the study: We evaluated the correlation between 12-month (M) success (freedom from symptomatic atrial fibrillation [AF] recurrence) and catheter-tissue contact stability (percentage of time investigators were within a preselected contact force [CF] working range) in real-world setting from the multicenter observational THERMOCOOL SMARTTOUCH® registry. Methods used: Correlation between catheter-tissue contact stability, determined by percentage of time investigators were within a preselected contact force (CF) working range, and 12-M success (freedom from symptomatic AF recurrence) was evaluated. Summary of results: A total of 242 patients (enrolled, 262) met inclusion/exclusion criteria and underwent RFA (age, 58.8 ± 11.3 years; 70.7% males; 91.7% Caucasian). Among patients with available CF data, 71% (112/158) and 19% (30/158) of CF working ranges were between 5–40 g and 10–40 g, respectively. At 12-M, success was 75.7% (95% CI: 69.7, 80.7). Success improved significantly when investigators stayed within preselected CF range ≥80% vs <80% of the time (83.9% vs 64.6%; P = 0.005). Using sensitivity analysis, an increase in success rate by 13–23% was observed when investigators stayed within preselected CF range ≥76–91% of the time vs <76–91% of the time (success ranges: 81–90% vs 58–71%). Average CF did not correlate with long-term success (Regression analysis; n = 158; OR [95% Wald CI], 1.1 [0.1, 1.2]; P = 0.070).