Wednesday's AF Summit, held at the annual Heart Rhythm Society conference in Boston, brought to light many issues surrounding catheter ablation. A constant theme through the day was the need to improve long-term ablation outcomes. Presenters agreed that catheter ablation to treat paroxysmal atrial fibrillation (AF) is a better alternative than antiarrhythmic drugs, but that there is still more to be done to achieve better longer-term success.
Dr. Vivek Reddy, of the Mount Sinai School of Medicine, started the day with his talk on pulmonary vein reconnections. While Dr. Reddy discussed several factors he believes important to achieving durable pulmonary vein isolation, there was a particular emphasis on the need to create good lesions. A good lesion is one that is making contact with the tissue and, in his words, is doing something. In the US, because contact force-sensing ablation catheters are not available, Dr. Reddy relies on intracardiac echocardiography imaging to verify he is making contact and measures impedance drops to ensure the lesion is achieving its goal.
In Europe, however, the story is a bit different because contact force-sensing catheters are available. Dr. Nadir Saoudi of Monaco discussed these catheters in his presentation Contact-Sensing Catheters: Do They Improve Outcomes and overall, his review of the available data was positive. He concluded that contact force assessment has the potential to improve procedural efficacy, shorten procedure times, and enhance safety. Other European physicians clearly agree with his assessment because, according to Millennium Research Group's recent Perception Pulse study, shortly after Biosense Webster's introduction of its SmartTouch contact force-sensing catheter in Europe late in 2010, it was already being used by 13 percent of surveyed physicians. By Q4 of 2011, its penetration had nearly doubled and was being used by 22 percent of respondents.
Given the strong adoption of force-sensing catheters in Europe, the Food and Drug Administration approval of these catheters in the US could be huge for the electrophysiology mapping and ablation device market.