How is contact force implemented in routine clinical practice? Results from a French National Survey

Background Combination of elementary parameters (force, time, power, impedance drop) have been proposed to optimize radiofrequency (RF) delivery. They have been partially validated in clinical studies. Purpose We conducted a survey to assess their implementation into clinical practice. Methods A 36-question electronic form was sent to 105 electrophysiologists including some general questions concerning the practice of catheter atrial fibrillation ablation and items concerning the parameters used for contact-force (CF)-guided ablation. Results Answers from 95 electrophysiologists (EP) were collected (89% response rate). The CF-catheters used were Smart Touch, Biosense (53%), Tacticath, Saint-Jude Medical (13%), or both (26%). The power applied on the left atrial (LA) anterior (LAAW) and posterior (LAPW) wall was respectively 26–34 W (for 73% of the EP) and below 25 W (89% of the EP). Most of the EP used nominal parameters of Visitag (40%). Seventy-five percent of the users did not use automatic display of the impedance drop. For the Tacticath users, 56% used a target value of 400 gs on the LAAW and 300 to 400 gs on the LAPW. Lesion size index was anecdotically used ( Fig. 1 ). Conclusions The parameters used for CF-guided ablation are widely variable among the different operators. Further prospective studies are needed to validate the targets for automatic annotation of the RF applications.