The role of local impedance drop in the acute lesion efficacy during pulmonary vein isolation performed with a new contact force sensing catheter

The role of local impedance drop in the acute lesion efficacy during pulmonary vein isolation performed with a new contact force sensing catheter

Abstract Funding Acknowledgements Type of funding sources: None. Background Pulmonary vein isolation (PVI) is the cornerstone treatment for paroxysmal atrial fibrillation (AF). The effective lesion creation during the PVI is essential to reach optimal long-term results. Purpose Our pilot study aimed...

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Veröffentlicht in:Europace (London, England) England), 2022-05, Vol.24 (Supplement_1)
Hauptverfasser: Szegedi, N, Perge, P, Sallo, Z, Piros, K, Nagy, VK, Osztheimer, I, Merkely, B, Geller, L
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container_title Europace (London, England)
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creator Szegedi, N
Perge, P
Sallo, Z
Piros, K
Nagy, VK
Osztheimer, I
Merkely, B
Geller, L
description Abstract Funding Acknowledgements Type of funding sources: None. Background Pulmonary vein isolation (PVI) is the cornerstone treatment for paroxysmal atrial fibrillation (AF). The effective lesion creation during the PVI is essential to reach optimal long-term results. Purpose Our pilot study aimed to evaluate the role of local impedance drop in lesion formation during pulmonary vein isolation with a novel contact force sensing ablation catheter that records local impedance as well and to find a local impedance cut-off value that predicts successful lesion formation. Materials and methods After completing point-by-point radiofrequency pulmonary vein isolation, the success of the applications was evaluated by pacing along the ablation line at 10 mA, 2 ms pulse width. Lesions were considered successful if loss of local capture was achieved. Results Out of 645 applications, 561 were successful and 84 were unsuccessful. Compared to the unsuccessful ablation points, the successful applications were shorter (p=0.0429) and had a larger local impedance drop (p
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Background Pulmonary vein isolation (PVI) is the cornerstone treatment for paroxysmal atrial fibrillation (AF). The effective lesion creation during the PVI is essential to reach optimal long-term results. Purpose Our pilot study aimed to evaluate the role of local impedance drop in lesion formation during pulmonary vein isolation with a novel contact force sensing ablation catheter that records local impedance as well and to find a local impedance cut-off value that predicts successful lesion formation. Materials and methods After completing point-by-point radiofrequency pulmonary vein isolation, the success of the applications was evaluated by pacing along the ablation line at 10 mA, 2 ms pulse width. Lesions were considered successful if loss of local capture was achieved. Results Out of 645 applications, 561 were successful and 84 were unsuccessful. Compared to the unsuccessful ablation points, the successful applications were shorter (p=0.0429) and had a larger local impedance drop (p&lt;0.0001). There was no difference between successful and unsuccessful applications in terms of mean contact force (p=0.8571), force-time integral (p=0.0699) and contact force range (p=0.0519). The optimal cut-point for the local impedance drop indicating successful lesion formation was 21.80 Ohms on the anterior wall [AUC=0.80 (0.75-0.86), p&lt;0.0001], and 18.30 Ohms on the posterior wall [AUC=0.77 (0.72-0.83), p&lt;0.0001]. A local impedance drop larger than 21.80 Ohms on the anterior wall and 18.30 Ohms on the posterior wall was associated with an increased probability of effective lesion creation [OR=11.21, 95%CI 4.22–29.81, p&lt;0.0001; and OR=7.91, 95%CI 3.77–16.57, p&lt;0.0001, respectively]. Conclusion The measurement of the local impedance may predict optimal lesion formation. A local impedance drop &gt; 21.80 Ohms on the anterior wall and &gt; 18.30 Ohms on the posterior wall significantly increases the probability of creating a successful lesion. Figure 1. Figure 2.</description><identifier>ISSN: 1099-5129</identifier><identifier>EISSN: 1532-2092</identifier><identifier>DOI: 10.1093/europace/euac053.220</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>Europace (London, England), 2022-05, Vol.24 (Supplement_1)</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2021. For permissions please email: Journals.permissions@oup.com. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids></links><search><creatorcontrib>Szegedi, N</creatorcontrib><creatorcontrib>Perge, P</creatorcontrib><creatorcontrib>Sallo, Z</creatorcontrib><creatorcontrib>Piros, K</creatorcontrib><creatorcontrib>Nagy, VK</creatorcontrib><creatorcontrib>Osztheimer, I</creatorcontrib><creatorcontrib>Merkely, B</creatorcontrib><creatorcontrib>Geller, L</creatorcontrib><title>The role of local impedance drop in the acute lesion efficacy during pulmonary vein isolation performed with a new contact force sensing catheter</title><title>Europace (London, England)</title><description>Abstract Funding Acknowledgements Type of funding sources: None. Background Pulmonary vein isolation (PVI) is the cornerstone treatment for paroxysmal atrial fibrillation (AF). The effective lesion creation during the PVI is essential to reach optimal long-term results. Purpose Our pilot study aimed to evaluate the role of local impedance drop in lesion formation during pulmonary vein isolation with a novel contact force sensing ablation catheter that records local impedance as well and to find a local impedance cut-off value that predicts successful lesion formation. Materials and methods After completing point-by-point radiofrequency pulmonary vein isolation, the success of the applications was evaluated by pacing along the ablation line at 10 mA, 2 ms pulse width. Lesions were considered successful if loss of local capture was achieved. Results Out of 645 applications, 561 were successful and 84 were unsuccessful. Compared to the unsuccessful ablation points, the successful applications were shorter (p=0.0429) and had a larger local impedance drop (p&lt;0.0001). There was no difference between successful and unsuccessful applications in terms of mean contact force (p=0.8571), force-time integral (p=0.0699) and contact force range (p=0.0519). The optimal cut-point for the local impedance drop indicating successful lesion formation was 21.80 Ohms on the anterior wall [AUC=0.80 (0.75-0.86), p&lt;0.0001], and 18.30 Ohms on the posterior wall [AUC=0.77 (0.72-0.83), p&lt;0.0001]. A local impedance drop larger than 21.80 Ohms on the anterior wall and 18.30 Ohms on the posterior wall was associated with an increased probability of effective lesion creation [OR=11.21, 95%CI 4.22–29.81, p&lt;0.0001; and OR=7.91, 95%CI 3.77–16.57, p&lt;0.0001, respectively]. Conclusion The measurement of the local impedance may predict optimal lesion formation. A local impedance drop &gt; 21.80 Ohms on the anterior wall and &gt; 18.30 Ohms on the posterior wall significantly increases the probability of creating a successful lesion. Figure 1. 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Background Pulmonary vein isolation (PVI) is the cornerstone treatment for paroxysmal atrial fibrillation (AF). The effective lesion creation during the PVI is essential to reach optimal long-term results. Purpose Our pilot study aimed to evaluate the role of local impedance drop in lesion formation during pulmonary vein isolation with a novel contact force sensing ablation catheter that records local impedance as well and to find a local impedance cut-off value that predicts successful lesion formation. Materials and methods After completing point-by-point radiofrequency pulmonary vein isolation, the success of the applications was evaluated by pacing along the ablation line at 10 mA, 2 ms pulse width. Lesions were considered successful if loss of local capture was achieved. Results Out of 645 applications, 561 were successful and 84 were unsuccessful. Compared to the unsuccessful ablation points, the successful applications were shorter (p=0.0429) and had a larger local impedance drop (p&lt;0.0001). There was no difference between successful and unsuccessful applications in terms of mean contact force (p=0.8571), force-time integral (p=0.0699) and contact force range (p=0.0519). The optimal cut-point for the local impedance drop indicating successful lesion formation was 21.80 Ohms on the anterior wall [AUC=0.80 (0.75-0.86), p&lt;0.0001], and 18.30 Ohms on the posterior wall [AUC=0.77 (0.72-0.83), p&lt;0.0001]. A local impedance drop larger than 21.80 Ohms on the anterior wall and 18.30 Ohms on the posterior wall was associated with an increased probability of effective lesion creation [OR=11.21, 95%CI 4.22–29.81, p&lt;0.0001; and OR=7.91, 95%CI 3.77–16.57, p&lt;0.0001, respectively]. Conclusion The measurement of the local impedance may predict optimal lesion formation. A local impedance drop &gt; 21.80 Ohms on the anterior wall and &gt; 18.30 Ohms on the posterior wall significantly increases the probability of creating a successful lesion. Figure 1. Figure 2.</abstract><pub>Oxford University Press</pub><doi>10.1093/europace/euac053.220</doi><oa>free_for_read</oa></addata></record>
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title The role of local impedance drop in the acute lesion efficacy during pulmonary vein isolation performed with a new contact force sensing catheter
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