{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T08:30:42Z","timestamp":1789201842140,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,6,16]],"date-time":"2015-06-16T00:00:00Z","timestamp":1434412800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>Contact Force During Cavotricuspid Isthmus Ablation<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Recurrent atrial flutter following cavotricuspid isthmus (CTI) ablation remains a significant problem. The prevalence of low contact force (CF) during CTI ablation using standard tools is unknown. Our aim was to characterize the prevalence of low CF applications when experienced operators performed CTI ablation using \u201ctraditional\u201d markers of contact blinded to CF measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Average CF (grams, g) and force\u2010time integral (FTI) was analyzed in 458 lesions in 17 patients undergoing CTI ablation. The isthmus was divided into the annular, mid and caval segments for region\u2010specific analysis. Despite \u201cgood\u201d contact using traditional markers, there was significant variability in CF <jats:italic>within<\/jats:italic> each isthmus segment (e.g., annular CTI 1\u201357 g). A high proportion of lesions had a CF &lt;10 g (40%). Lowest CF was the annular (median 9 g), followed by the mid (12 g) and the caval CTI (18 g, P &lt; 0.001). Sites of acute CTI re\u2010connection had a lower average CF and FTI than nonreconnected sites (P &lt; 0.05). Each 1 g increase in CF was associated with a 16% reduction in risk of recovered CTI conduction (95% confidence interval: 4\u201327%, P = 0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Use of surrogate markers of \u201cgood contact\u201d during ablation by experienced operators in the absence of real\u2010time CF sensing resulted in nearly half of all lesions being delivered with low CF with marked region\u2010specific variability in CF. Low CF was implicated in longer time to achieve conduction block and increased risk of acute reconnection. These findings underscore the importance of real\u2010time CF measurements for optimizing ablation of typical atrial flutter.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.12707","type":"journal-article","created":{"date-parts":[[2015,5,8]],"date-time":"2015-05-08T06:35:58Z","timestamp":1431066958000},"page":"826-831","source":"Crossref","is-referenced-by-count":23,"title":["High Incidence of Low Catheter\u2010Tissue Contact Force at the Cavotricuspid Isthmus During Catheter Ablation of Atrial Flutter: Implications for Achieving Isthmus Block"],"prefix":"10.1111","volume":"26","author":[{"given":"SAURABH","family":"KUMAR","sequence":"first","affiliation":[{"name":"Department of Cardiology, The Royal Melbourne Hospital, and Department of Medicine University of Melbourne  Parkville Victoria Australia"},{"name":"Department of Medicine University of Melbourne  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JOSEPH B.","family":"MORTON","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Royal Melbourne Hospital, and Department of Medicine University of Melbourne  Parkville Victoria Australia"},{"name":"Department of Medicine University of Melbourne  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GEOFFREY","family":"LEE","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Royal Melbourne Hospital, and Department of Medicine University of Melbourne  Parkville Victoria Australia"},{"name":"Department of Medicine University of Melbourne  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KAREN","family":"HALLORAN","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Melbourne  Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PETER M.","family":"KISTLER","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Melbourne  Victoria Australia"},{"name":"Department of Cardiology Alfred Hospital and Baker IDI  Prahran Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JONATHAN M.","family":"KALMAN","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Royal Melbourne Hospital, and Department of Medicine University of Melbourne  Parkville Victoria Australia"},{"name":"Department of Medicine University of Melbourne  Victoria 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