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).