Importance of these findings: Historical perspective
Automated RF annotation has been shown to allow both the derivation of
hypothetically ideal “per-site” target RF ablation parameters and
their subsequent delivery during CF-guided PVI.3–5,8However, such parameters can only be considered appropriate if
“derivation phase” methodology employed a suitable definition for
stable sites of catheter-tissue interaction during RF application.
Notwithstanding the theoretical difficulty resulting from any CF filter
permitting intermittent catheter-tissue contact (i.e. by definition a
stable site can only occur in the setting of constant catheter-tissue
contact), the foundational study supporting a regional difference in
ablation target values additionally used ACCURESP™ RMA “on” in all
cases; procedures performed under GA and with IPPV failing to trigger
motion detection had the tidal volume increased to ensure respiratory
motion triggering and RMA “on” use in all (Molloy Das, personal
communication).5 Following this present report’s
demonstration that RMA use during automated RF annotation results in the
failure to immediately identify catheter tip movements of up to 7mm,
these previously identified ablation targets are likely to be
importantly flawed.