Local impedance guides catheter ablation in patients with ventricular tachycardia
Key result
Local impedance drop was significantly higher for VT-terminating compared to non-terminating radiofrequency ablation (18 Ω vs 13 Ω; P=0.03), indicating its utility in guiding VT ablation.
Why the study?
Catheter contact and tissue characteristics are relevant for successful RFC ablation, prompting investigation of local impedance relative to generator impedance and its applicability as an indicator of effective ablation in VT patients.
Does local impedance measurement indicate effective radiofrequency current ablation in patients with recurrent ventricular tachycardia?
Population
28 patients with recurrent VT undergoing RFC-ablation (625 RFC-applications)
Comparison
Local impedance vs generator impedance
Authors
Discussion
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Member takes
Implication
Local impedance drop may support real-time VT ablation assessment; leaves open whether it improves outcomes in prospective trials.
Study Design
Type
Observational (n=28)
Structured PICO
Does local impedance measurement indicate effective radiofrequency current ablation in patients with recurrent ventricular tachycardia?
P
Population
28 patients with recurrent ventricular tachycardia (VT) undergoing radiofrequency current (RFC)-ablation
I
Intervention
Radiofrequency current (RFC)-ablation using a novel ablation catheter incorporating three mini-electrodes to measure local impedance (LI)
O
Outcome
Baseline impedance, Δimpedance during ablation and drop rate (Δimpedance/time) for local impedance (LI) in relation to generator impedance (GI) and VT terminationsurrogate
Main Result
Absolute Event Rate: 18% vs 13%
p-value: p=.03
Local impedance measured via a novel catheter is a sensitive parameter that reflects tissue characteristics and can indicate effective radiofrequency ablation for ventricular tachycardia.
Cite This Study
Münkler et al. (2019) conducted an observational in recurrent ventricular tachycardia (n=28). Radiofrequency current ablation with local impedance monitoring vs. Non-terminating ablation was evaluated on Local impedance drop (ΔLI) for VT-terminating vs non-terminating ablation (p=.03). Local impedance drop was significantly higher for VT-terminating compared to non-terminating radiofrequency ablation (18 Ω vs 13 Ω; P=0.03), indicating its utility in guiding VT ablation.