Key result
In clinical pulmonary vein isolation, contact angle was an independent predictor of local impedance drop (β = 0.139, 95% CI 0.111-0.167, p < 0.001), with more parallel angles inducing higher drops.
Why the study?
To clarify the correlation between local impedance drop and catheter contact parameters, including contact force and contact angle, during radiofrequency ablation.
Do catheter contact parameters (contact angle and contact force) correlate with local impedance drop during pulmonary vein isolation in patients with paroxysmal atrial fibrillation?
Observational (n=15)
Do catheter contact parameters (contact angle and contact force) correlate with local impedance drop during pulmonary vein isolation in patients with paroxysmal atrial fibrillation?
Effect estimate: β = 0.139 (95% CI 0.111-0.167)
p-value: p=< .001
A more parallel contact angle during pulmonary vein isolation is independently associated with a higher local impedance drop, suggesting it may facilitate more effective lesion formation.
Parallel contact angles were associated with larger LI drops in PVI; hypothesis-generating for angle-optimized ablation pending prospective outcome trials.
INTRODUCTION: Local impedance (LI) drop during radiofrequency (RF) application is monitored to assess the lesion formation. Recently, a novel ablation catheter has been introduced to clinical setting, which is capable of monitoring LI and catheter contact parameters including contact force (CF) and contact angle (CA). This study aimed to clarify the correlation between LI drop and catheter contact parameters. METHODS AND RESULTS: This prospective study included 15 paroxysmal atrial fibrillation (AF) patients who underwent initial pulmonary vein isolation (PVI). First-pass encircling point-by-point PV ablation was performed by using a 4.5-mm irrigated ablation catheter, with monitoring LI, CF, and CA. RF energy was applied for 30 s at each site with 30 W. Stable ablation points were analyzed to examine the correlation between LI drop and catheter contact parameters. Among 903 ablation points, 499 stable ablation points (55.2%) were analyzed. CA showed good correlation with LI drop (ρ = 0.418, p < .001). Maximum CF, minimum CF, average CF, and initial CF all showed weak correlation with LI drop (ρ = 0.201, p < .001; ρ = 0.224, p < .001; ρ = 0.258, p < .001; and ρ = 0.212, p < .001, respectively). Multivariate analysis demonstrated that CA was an independent factor of LI drop among the catheter contact parameters (β = 0.139, 95% CI = 0.111-0.167, p < .001). The LI drop in the blocked segments was significantly higher than that in the electrical conduction gap segments (27.3 ± 9.8 vs. 19.6 ± 6.4 Ω, p < .001) CONCLUSION: In clinical PVI use, both CF and CA were correlated with LI drop. More parallel CA could induce higher LI drop, which may lead to effective lesion formation.
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Yasumoto et al. (2022) conducted an observational in paroxysmal atrial fibrillation (n=15). Radiofrequency ablation with local impedance and contact parameter monitoring was evaluated on Correlation between local impedance drop and catheter contact parameters (β = 0.139, 95% CI 0.111-0.167, p=< .001). In clinical pulmonary vein isolation, contact angle was an independent predictor of local impedance drop (β = 0.139, 95% CI 0.111-0.167, p < 0.001), with more parallel angles inducing higher drops.
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