Insight into contact force local impedance technology for predicting effective pulmonary vein isolation
Key result
Localized impedance drop of ~22 Ω predicts successful PVI during AF ablation.
- P<0.0001
- n=212
Why the study?
Highly localized impedance measurements during AF ablation can potentially predict lesion durability, but data on procedural parameters affecting localized impedance-guided ablation were needed from a large multicenter registry.
Does the magnitude of localized impedance drop predict successful pulmonary vein isolation during atrial fibrillation ablation?
Population
212 consecutive patients undergoing first PV isolation for paroxysmal and persistent AF
Comparison
Successful ablation spots vs PV gap spots during localized impedance-guided ablation
Design
Multicenter registry study
Authors
Discussion
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Implication
Localized impedance thresholds may aid lesion assessment in AF ablation; hypothesis-generating pending randomized confirmation of outcomes.
Study Design
Type
Observational (n=212)
Multicenter
Yes
Structured PICO
Does the magnitude of localized impedance drop predict successful pulmonary vein isolation during atrial fibrillation ablation?
P
Population
212 consecutive patients enrolled in the CHARISMA registry undergoing their first pulmonary vein (PV) isolation for paroxysmal and persistent AF
I
Intervention
Radiofrequency ablation guided by highly localized impedance (LI) measurements
O
Outcome
Successful ablation (first-pass PV isolation and absence of PV gaps)surrogate
Main Result
Absolute Event Rate: 22.1% vs 14.4%
p-value: p=<0.0001
A localized impedance drop of >21 Ω at anterior sites and >18 Ω at posterior sites predicts successful pulmonary vein isolation during AF ablation.
Cite This Study
Lepillier et al. (2023) conducted an observational in Paroxysmal and persistent atrial fibrillation (n=212). Localized impedance (LI)-guided ablation was evaluated on Absolute localized impedance (LI) drop at successful ablation spots versus PV gap spots (p=<0.0001). An absolute localized impedance drop >21 Ω at anterior sites and >18 Ω at posterior sites predicts successful pulmonary vein isolation during atrial fibrillation ablation.