An insufficient local impedance drop with STABLEPOINT was associated with gap formation during PVI, with optimal cutoff values for LI drop and %LI drop identified as 20.0 ohms and 11.6%.
Observational (n=102)
Blinded to LI data
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What are the optimal local impedance drop parameters for predicting successful pulmonary vein isolation during catheter ablation in patients with atrial fibrillation?
An absolute local impedance drop of 20.0 ohms and a relative drop of 11.6% are optimal cutoffs for predicting successful pulmonary vein isolation during atrial fibrillation ablation.
INTRODUCTION: Local impedance (LI) parameters of IntellaNav STABLEPOINT for successful pulmonary vein isolation (PVI) of atrial fibrillation (AF) remain unclear. The purpose of this study was to seek LI data achieving successful PVI. METHODS: Consecutive AF patients who underwent catheter ablation with STABLEPOINT were prospectively enrolled in two centers. PVI was performed under a constant 35-or 40-watt power, 20-s duration, and >5-g contact force. The operators were blinded to the LI data. The characteristics of all ablation points with/without conduction gaps (Unsuccess or Success tags) after the first-attempt PVI were evaluated for the right/left PVs and anterior/posterior wall (RPV/LPV and AW/PW, respectively), and cutoff values of LI data were calculated for successful lesion formation. RESULTS: A total of 5257 ablation points in 102 patients (65 58-72 years old, 65.7% male) were evaluated. The LI drop values were higher in the Success tags than Unsuccess tags on the LPV-AW and RPV-AW/PW (p < .001), except for the LPV-PW (p = .105). The %LI drop values (LI drop/initial LI) were higher for the Success tags in all areas (15.8 12.2%-19.6% vs. 11.6 9.7%-15.6% in LPV-AW: p < .001, 15.0 11.5%-19.3% vs. 11.4 8.7%-17.3% in LPV-PW: p = .035, 15.3 11.5%-19.4% vs. 9.9 8.1%-13.7% in RPV-AW: p < .001, and 13.3 10.1%-17.4% vs. 8.1 6.3%-9.5% in RPV-PW, p < .001). The LI drop and %LI drop cutoff values were 20.0 ohms and 11.6%, respectively. CONCLUSIONS: An insufficient LI drop with STABLEPOINT was associated with a gap formation during PVI, and the best cutoff values for the LI drop and %LI drop were 20.0 ohms and 11.6%, respectively.
Fukaya et al. (Tue,) conducted a observational in Atrial fibrillation (n=102). IntellaNav STABLEPOINT catheter ablation vs. Unsuccessful ablation points (conduction gaps) was evaluated on Local impedance (LI) drop and %LI drop for successful lesion formation. An insufficient local impedance drop with STABLEPOINT was associated with gap formation during PVI, with optimal cutoff values for LI drop and %LI drop identified as 20.0 ohms and 11.6%.