Analysis
The question was whether ACCURESP™ RMA “on” versus “off” settings
resulted in significant differences in the number of annotated sites,
individual site RF duration, ILD, total impedance drop, mean CF and FTI,
at the LAPW. RMA “on” versus “off” annotation accuracy with respect
to the time of deliberate catheter motion was assessed at all automated
site 1-to-2 ablation catheter transitions (i.e. site 1-to-2 transitions
at each of the left and right PVI encirclements) by visual inspection of
reconstituted catheter position, CF and impedance curves. Ablation
catheter motion associated with transition between annotated sites
1-to-2 was identified according to any of the following criteria:
(1) Site 1 annotation “end” due to a 0g CF event (i.e. CF breaching
the VISITAG™ Module force-over-time filter of 100% minimum 1g);
(2) Inter-ablation site transition during constant catheter-tissue
contact, but accompanied by UE morphology change from pure R at site-1
completion, to RS at site-2 onset (i.e. indicating movement from a site
of TM ablation effect to an adjacent, ablation naïve site), or
(3) Inter-ablation site transition during constant catheter-tissue
contact, with pure R UE morphology at both site-1 completion and site-2
onset (i.e. within the thermal penumbra of partial ablation
effect9).
Subsequent LAPW annotated RF site-to-site transitions were similarly
identified and described. VISITAG™ Module data comprising catheter tip
x,y,z coordinates at 60 Hz and without RMA (i.e. from the
“RawPositions” data file) were exported to R10 for
analysis. The standard deviation (SD) over a rolling one second period
– as utilised by CARTO®3 system for position
stability annotation – was calculated from the Euclidean distances
shifted between each position. These “position stability” data were
plotted according to the patient interface unit (PIU) system time,
alongside CF at 20Hz and impedance at 10Hz (derived from the exported
“ContactForceData” “AblationData” files, respectively) and
end-expiration timing (from the “EndExperium” file). Finally, PIU
start and stop times for annotated sites were obtained for each
ACCURESP™ setting (from “AblationSites” files).