Insight into contact force local impedance technology for predicting effective pulmonary vein isolation.
Front Cardiovasc Med
; 10: 1169037, 2023.
Article
em En
| MEDLINE
| ID: mdl-37476572
ABSTRACT
Background:
Highly localized impedance (LI) measurements during atrial fibrillation (AF) ablation have the potential to act as a reliable predictor of the durability of the lesions created.Objective:
We aimed to collect data on the procedural parameters affecting LI-guided ablation in a large multicenter registry.Methods:
A total of 212 consecutive patients enrolled in the CHARISMA registry and undergoing their first pulmonary vein (PV) isolation for paroxysmal and persistent AF were included.Results:
In all, 13,891 radiofrequency (RF) applications of ≥3â s duration were assessed. The first-pass PV isolation rate was 93.3%. A total of 80 PV gaps were detected. At successful ablation spots, baseline LI and absolute LI drop were larger than at PV gap spots (161.4 ± 19â Ω vs. 153.0 ± 13â Ω, p < 0.0001 for baseline LI; 22.1 ± 9â Ω vs. 14.4 ± 5â Ω, p < 0.0001 for LI drop). On the basis of Receiver operating characteristic curve analysis, the ideal LI drop, which predicted successful ablation, was >21â Ω at anterior sites and >18â Ω at posterior sites. There was a non-linear association between the magnitude of LI drop and contact-force (CF) (r = 0.14, 95% CI 0.13-0.16, p < 0.0001) whereas both CF and LI drop were inversely related with delivery time (DT) (-0.22, -0.23 to -0.20, p < 0.0001 for CF; -0.27, -0.29 to -0.26, p < 0.0001 for LI drop).Conclusion:
An LI drop >21â Ω at anterior sites and >18â Ω at posterior sites predicts successful ablation. A higher CF was associated with an increased likelihood of ideal LI drop. The combination of good CF and adequate LI drop allows a significant reduction in RF DT. Clinical trial registration http//clinicaltrials.gov/, identifier NCT03793998.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Front Cardiovasc Med
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
França