Novel Impedance-Guided Contact Mapping Technique for the Circular Multielectrode Pulsed-Field Ablation Catheter.

Figures

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  FIGURE 1. (A) PulseSelect electrodes 1, 3, 5, 7, and 9 mapped to FARAPULSE E1–E5 for Contact Index; blue indicates Δimpedance > 5%. (B) Example in the RSPV showing contact/non‐contact electrodes. (C) Jumper‐cable connections for Contact Index (yellow) and ring visualization (red).

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  FIGURE 2. ROC analysis of Δimpedance (%) in the LA body for ICE‐defined contact vs. non‐contact; Δimpedance 5% maximized the Youden index.

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  FIGURE 3. Post‐ablation voltage maps showing representative examples from two cases. (A) (Case 1): Voltage map corresponding to Figure 1, demonstrating complete PVI at sites tagged in green (Δimpedance > 5%, tag diameter 5 mm). (B) (Case 3): Another representative case with contiguous tags and no acute gaps, indicating a complete lesion set.

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  FIGURE 4. (A) Relationship between Δimpedance and peak frequency across 256 points. The regression equation is Y = 0.01 X + 4.14 (R 2 = 0.03), indicating no meaningful correlation. (B) Peak‐frequency distributions at sites with Δimpedance > 5% versus ≤ 5%. Although a statistically significant difference was observed, substantial overlap prevented determination of a practical cutoff. LA, left atrium; LAA, left atrial appendage; LIPV, left inferior pulmonary vein; LSPV, left superior pulmonary vein; PVI, pulmonary vein isolation; RIPV, right inferior pulmonary vein; RSPV, right superior pulmonary vein.