Contact force catheter ablation for the treatment of persistent atrial fibrillation: Results from the PERSIST‐END study

• Published in: Journal of cardiovascular electrophysiology 2023-02, Vol.34 (2), p.279-290
• Main Authors: Lo, Monica, Nair, Devi, Mansour, Moussa, Calkins, Hugh, Reddy, Vivek Y., Colley, B. Judson, Tanaka‐Esposito, Christine, Sundaram, Sri, DeLurgio, David B., Sanders, Prashanthan, Khatib, Sammy, Bernard, Michael, Olson, Nicholas, Gibson, Douglas, Miller, Amber, Li, Jingyun, Natale, Andrea
• Format: Article
• Language: English
• Subjects: Ablation; Arrhythmia; atrial fibrillation; Atrial Fibrillation - diagnosis; Atrial Fibrillation - drug therapy; Atrial Fibrillation - surgery; Atrial Flutter; Cardiac arrhythmia; catheter ablation; Catheter Ablation - adverse effects; Catheter Ablation - methods; Catheters; clinical trial; Fibrillation; Health care; Health services utilization; Heart Conduction System; Humans; persistent atrial fibrillation; Prospective Studies; Pulmonary Veins - surgery; Quality of Life; Radiofrequency ablation; Recurrence; Safety; Sensors; Tachycardia; Treatment Outcome
• ISSN: 1045-3873; 1540-8167
• DOI: 10.1111/jce.15742

Introduction Use of a novel magnetic sensor enabled optical contact force ablation catheter has been established to be safe and effective for treatment of symptomatic drug‐refractory paroxysmal atrial fibrillation (AF) but has yet to be demonstrated in the persistent AF (PersAF) population. Methods PERSIST‐END was a multicenter, prospective, nonrandomized, investigational study designed to demonstrate the safety and effectiveness of TactiCath™ Ablation Catheter, Sensor Enabled™(SE) (TactiCath SE) for use in the treatment of subjects with documented PersAF refractory or intolerant to at least one Class I/III AAD. The ablation strategy included pulmonary vein isolation and additional targets at physician discretion. Follow‐up through 15‐months, including a 3‐month blanking period and 3‐month therapy consolidation period, was performed with cardiac event and Holter monitoring. Primary safety, primary effectiveness, clinical success, and quality of life (QOL) endpoints were analyzed. Results Of 224 subjects enrolled at 21 investigational sites in the United States and Australia, 223 underwent ablation with the investigational catheter. The primary safety event rate was 3.1% (seven events in seven subjects). The Kaplan–Meier estimate of freedom from AF/atrial flutter/atrial tachycardia recurrence at 15‐months was 61.6% and clinical success at 15 months was 89.8%. Subject QOL significantly improved following ablation as assessed via AFEQT (31.6 point increase, p