Local impedance drop guided versus lesion size index guided pulmonary vein isolation: acute success and reconnections

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Insufficient lesion depth and discontinuity of lesion lines are reasons for reconnections after point-by-point radiofrequency pulmonary vein isolation (PVI). Different technologies have shown to be useful for prediction of effective lesions. Measurement of the magnitude of local tissue impedance drop (LID) and calculation of lesion size index (LSI) based on monitoring of contact force are examples for corresponding technologies. Purpose To compare the acute efficacy of LID guided with LSI guided PVI. Methods In this retrospective study we compared two groups of patients who underwent point-by-point radiofrequency PVI for treatment of atrial fibrillation. In the LID-guided group (n=35) energy was delivered using IntellaNav MiFi (Boston Scientific, MA, USA) ablation catheter. Ablation was terminated when LID reached a plateau (Figure A). In the LSI-guided group (n=31) lesions were created using Tacticath (Abbott, MA, USA) ablation catheter until the target LSI was reached in each point (LSI=5 for anterior and LSI=4 for posterior segments respectively, Figure B). The inter-lesion distance of