What is the clinical evidence from this study?

Study design: Observational. Population: Cavotricuspid isthmus-dependent atrial flutter (n=50). Intervention: Effective ablation sites (local impedance drop) vs. Ineffective ablation sites. Primary outcome: Absolute local impedance drop (Ω) (p=<0.001).

What does this research mean for the field?

Effective ablation sites during contact force-guided cavotricuspid isthmus radiofrequency ablation exhibit significantly greater absolute and percentage local impedance drops compared to ineffective sites. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

February 4, 2022Journal of ArrhythmiaOpen Access

Local impedance measurements during contact force‐guided cavotricuspid isthmus ablation for predicting an effective radiofrequency ablation

Q: What are the key findings of this study?

Effective ablation sites during contact force-guided cavotricuspid isthmus ablation had significantly greater absolute local impedance drops compared to ineffective sites (median 22 Ω vs 14 Ω, p<0.001).

Q: What does this research mean for the field?

Effective ablation sites during contact force-guided cavotricuspid isthmus radiofrequency ablation exhibit significantly greater absolute and percentage local impedance drops compared to ineffective sites. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Effective CTI ablation sites link to ~57% larger local impedance drops than ineffective sites.

P<0.001
n=50

Why the study?

An ablation catheter combining contact force and local impedance monitoring was recently launched, prompting evaluation of the relationship between these values during cavotricuspid isthmus radiofrequency catheter ablation.

Does local impedance monitoring during contact force-guided cavotricuspid isthmus ablation predict effective radiofrequency ablation lesion formation?

Comparison

Effective ablation sites vs ineffective ablation sites

Design

Retrospective observational study

Authors

TSTakehito SasakiGunma Prefectural Cardiovascular Center KNKohki NakamuraGunma Prefectural Cardiovascular Center KMKentaro MinamiDokkyo University

Discussion

Member takes

Implication

Local impedance drop may predict effective ablation sites; leaves open prospective validation of targeted thresholds.

Study Design

Type

Observational (n=50)

Multicenter

Structured PICO

Does local impedance monitoring during contact force-guided cavotricuspid isthmus ablation predict effective radiofrequency ablation lesion formation?

Population

50 consecutive patients (mean age 67 years, 30% female) undergoing first cavotricuspid isthmus radiofrequency catheter ablation, followed for a median of 169 days.

Exposure

Radiofrequency catheter ablation using an ablation catheter capable of simultaneous contact force (CF) and local impedance (LI) monitoring (IntellaNav StablePoint, Boston Scientific).

Comparator

Ineffective ablation sites (internal comparison of 602 first-pass RF applications).

Outcome

Prediction of effective ablation (first-pass conduction block without gaps) based on local impedance (LI) drops.surrogate

Main Result

Absolute Event Rate: 22% vs 14%

p-value: p=<0.001

Local impedance drops during contact force-guided cavotricuspid isthmus ablation can predict effective lesion formation, with absolute drops of ≥21 Ω and percentage drops of ≥10.8% serving as potential targets.

Limitations

Retrospective, non-randomized, single-center study with a limited sample size.
Focused on acute success rather than long-term efficacy of the procedure.
Contact force and local impedance values fluctuated with respiratory movements.
Did not evaluate the relationship between local impedance and anatomical features of the cavotricuspid isthmus.
Retrospective, non-randomized, single-center study with a limited sample size
Focused on the acute success of the CF- and LI-guided CTI-RFCA, long-term efficacy remains unknown
CF and LI values fluctuated with respiratory movements during the CTI-RFCA
Did not evaluate the relationship between the LI and anatomical features of the CTI

Cite This Study

Sasaki et al. (2022) conducted an observational in Cavotricuspid isthmus-dependent atrial flutter (n=50). Effective ablation sites (local impedance drop) vs. Ineffective ablation sites was evaluated on Absolute local impedance drop (Ω) (p=<0.001). Effective ablation sites during contact force-guided cavotricuspid isthmus ablation had significantly greater absolute local impedance drops compared to ineffective sites (median 22 Ω vs 14 Ω, p<0.001).

synapsesocial.com/papers/6a1c763766d062ff2dc3d7e3 https://doi.org/10.1002/joa3.12680

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February 4, 2022Journal of ArrhythmiaOpen Access

Local impedance measurements during contact force‐guided cavotricuspid isthmus ablation for predicting an effective radiofrequency ablation

View Full Paper

Ask AI

Bookmark

Key result

Effective CTI ablation sites link to ~57% larger local impedance drops than ineffective sites.

P<0.001
n=50

Why the study?

Does local impedance monitoring during contact force-guided cavotricuspid isthmus ablation predict effective radiofrequency ablation lesion formation?

Comparison

Effective ablation sites vs ineffective ablation sites

Design

Retrospective observational study

Authors

TSTakehito SasakiGunma Prefectural Cardiovascular Center KNKohki NakamuraGunma Prefectural Cardiovascular Center KMKentaro MinamiDokkyo University

Discussion

Member takes

Implication

Local impedance drop may predict effective ablation sites; leaves open prospective validation of targeted thresholds.

Study Design

Type

Observational (n=50)

Multicenter

Structured PICO

Does local impedance monitoring during contact force-guided cavotricuspid isthmus ablation predict effective radiofrequency ablation lesion formation?

Population

50 consecutive patients (mean age 67 years, 30% female) undergoing first cavotricuspid isthmus radiofrequency catheter ablation, followed for a median of 169 days.

Exposure

Radiofrequency catheter ablation using an ablation catheter capable of simultaneous contact force (CF) and local impedance (LI) monitoring (IntellaNav StablePoint, Boston Scientific).

Comparator

Ineffective ablation sites (internal comparison of 602 first-pass RF applications).

Outcome

Prediction of effective ablation (first-pass conduction block without gaps) based on local impedance (LI) drops.surrogate

Main Result

Absolute Event Rate: 22% vs 14%

p-value: p=<0.001

Limitations

Retrospective, non-randomized, single-center study with a limited sample size.
Focused on acute success rather than long-term efficacy of the procedure.
Contact force and local impedance values fluctuated with respiratory movements.
Did not evaluate the relationship between local impedance and anatomical features of the cavotricuspid isthmus.
Retrospective, non-randomized, single-center study with a limited sample size
Focused on the acute success of the CF- and LI-guided CTI-RFCA, long-term efficacy remains unknown
CF and LI values fluctuated with respiratory movements during the CTI-RFCA
Did not evaluate the relationship between the LI and anatomical features of the CTI

Cite This Study

synapsesocial.com/papers/6a1c763766d062ff2dc3d7e3 https://doi.org/10.1002/joa3.12680

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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