November 15, 2022Journal of Cardiovascular Electrophysiology
Optimal local impedance parameters for successful pulmonary vein isolation in patients with atrial fibrillation
Key result
STABLEPOINT local impedance drops below ~20 ohms linked to gap formation during PVI.
- n=102
Why the study?
Local impedance parameters of the IntellaNav STABLEPOINT catheter for successful pulmonary vein isolation in atrial fibrillation remain unclear.
What are the optimal local impedance drop parameters for predicting successful pulmonary vein isolation during catheter ablation in patients with atrial fibrillation?
Population
102 consecutive AF patients undergoing catheter ablation at two centers
Comparison
Ablation points without conduction gaps vs with conduction gaps
Design
Two-center prospective operator-blinded observational study
Authors
Discussion
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Implication
May inform real-time lesion assessment during PVI; hypothesis-generating and requires prospective validation before guiding practice.
Study Design
Type
Observational (n=102)
Blinding
Blinded to LI data
Multicenter
Yes
Structured PICO
What are the optimal local impedance drop parameters for predicting successful pulmonary vein isolation during catheter ablation in patients with atrial fibrillation?
P
Population
102 consecutive patients with atrial fibrillation undergoing catheter ablation, median age 65 [58-72] years, 65.7% male. A total of 5257 ablation points were evaluated.
I
Intervention
Catheter ablation using IntellaNav STABLEPOINT catheter with constant 35- or 40-watt power, 20-s duration, and >5-g contact force.
C
Comparator
Ablation points with conduction gaps (Unsuccess tags) versus those without conduction gaps (Success tags).
O
Outcome
Local impedance (LI) drop and %LI drop cutoff values for successful lesion formation (no conduction gaps after first-attempt PVI).surrogate
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.
Cite This Study
Fukaya et al. (2022) conducted an 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%.