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Impact of catheter contact angle on lesion formation and durability of pulmonary vein isolation
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  • Masayuki Ohta,
  • Kentaro Hayashi,
  • Hiroyuki Sato,
  • Takahiro Noto,
  • Kandoh Kawahatsu,
  • Masaya Katagiri,
  • Tomohiro Mita,
  • Yoshio Kazuno,
  • Shunsuke Sasaki,
  • Takahiro Doi,
  • Mitsugu Hirokami,
  • Shigemichi Tanaka,
  • Satoshi Yuda
Masayuki Ohta
Teine Keijinkai Hospital
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Kentaro Hayashi
Teine Keijinkai Hospital
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Hiroyuki Sato
Teine Keijinkai Hospital
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Takahiro Noto
Teine Keijinkai Hospital
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Kandoh Kawahatsu
Teine Keijinkai Hospital
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Masaya Katagiri
Teine Keijinkai Hospital
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Tomohiro Mita
Teine Keijinkai Hospital
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Yoshio Kazuno
Teine Keijinkai Hospital
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Shunsuke Sasaki
Teine Keijinkai Hospital
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Takahiro Doi
Teine Keijinkai Hospital
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Mitsugu Hirokami
Teine Keijinkai Hospital
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Shigemichi Tanaka
Teine Keijinkai Hospital
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Satoshi Yuda
Teine Keijinkai Hospital
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Abstract

Introduction Little is known on the effect of catheter contact angle on lesion formation and durability of pulmonary vein isolation (PVI). Methods Both in vitro experiment and retrospective observational study were conducted. For in vitro experiment, radiofrequency lesions were created on explanted swine hearts in three different catheter contact angles (0°, 45°, and 90°). In the retrospective observational study, we assessed patients who had undergone repeat catheter ablation due to atrial fibrillation recurrence after initial PVI. When pulmonary vein (PV) reconnection was observed, we analyzed the previous ablation points within and without the gap area. The gap areas were defined where ablation had changed the PV activation sequence or eliminated the PV potential in the repeat session. Results In the in vitro experiment, lesion width was the smallest (5.3 ± 0.4 mm) in perpendicular contact compared to 0° (vs 5.8 ± 0.5 mm, p=0.040) and 45° (vs 6.4 ± 0.4 mm, p<0.001). In the retrospective observational study, we assessed 666 tags of 16 patients with PV reconnections, and 60 tags were in the gap area. Tags in the gap area had longer interlesion distance (odds ratio [OR] 1.49, p < 0.001), greater contact force variability (OR 1.03, p = 0.008), and higher rate of perpendicular contact (OR 3.26, p < 0.001) on multivariate analysis. Conclusion Perpendicular contact was associated with a smaller lesion and higher rate of PV reconnection.