Introduction. The value of contact force information for ablation of LA anterior line is unknown. In a prospective randomized\nclinical trial,we investigated if information on contact force during left atrial (LA) anterior line ablation reduces total radiofrequency\ntime and results in higher rates of bidirectional line block in patients undergoing pulmonary vein isolation (PVI) plus substrate\nmodification. Methods. We included patients with indication for pulmonary vein isolation (PVI) and additional substrate\nmodification. For LA anterior line ablation, patients were randomized to contact force information visible (n=35) or blinded\n(n=37). Patients received contrast enhanced cardiac magnetic resonance imaging (cMRI) before and 3-6 months after ablation to\nvisualize the LA anterior line. Primary endpoint was radiofrequency time to achieve bidirectional line block. Secondary endpoints\nwere completeness of the LA anterior line on cMRI, distribution of contact force, procedural data, adverse events, and 12 months\nsuccess rate. Results. In 72 patients (64±9 years, 68% male), bidirectional LA anterior line block was achieved in 70 (97%) patients.\nRadiofrequency time to bidirectional block did not differ significantly across groups (contact force information visible 23±18min\nversus contact force information blinded 21±15min, p=0.50). The LA anterior line was discernable on cMRI in 40 patients (82%)\nwithout significant differences across randomization groups (p=0.46). No difference in applied contact force was found depending\non cMRI line visibility. Twelve-month success and adverse event rates were comparable across groups. Conclusion. Information on\ncontact force does not significantly improve the ablation of LA anterior lines. Clinical Trial Registration.The trial was registered at\nhttp://www.clinicaltrials.gov by identifier: NCT02217657.
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