When local impedance meets contact force: preliminary experience from the CHARISMA registry

Figures

• 

  Fig. 1. A Identification of 7 ablation sites around the right (RPV) and left (LPV) pairs of pulmonary veins. Anterior superior: R1, L1. Anterior inferior: R2, L2. Inferior: R3, L3. Posterior inferior: R4, L4. Carina: R5, L5. Posterior superior: R6, L6. Superior: R7, L7. LIPV = left inferior pulmonary vein; LSPV = left superior pulmonary vein; RIPV = right inferior pulmonary vein; RSPV = right superior pulmonary vein. B Example of visualization of CF and DirectSense™ tool on the Rhythmia™ mapping system during ablation. C Point-by-point RF delivery created contiguous ablation spots encircling the PVs. The maximal inter-lesion distance between two neighboring lesions was set ≤ 6 mm and was automatically measured through the Autotag™ software. CF settings were at the individual operator’s discretion, within the range of 5 to 40 g

• 

  Fig. 2. A Multidimensional relationship between RF delivery time, CF values, and LI drop values. B Radar plot showing the relationship between RF delivery time and CF values according to different degrees of LI drop. This Kiviat chart displays multivariate data (RF delivery time) with values represented on axes starting from the same point. The apexes of the Kiviat charts represent different CF intervals (5–14 g, 15–24 g, and ≥ 25 g), whereas the lines represent different degrees of LI drop (blue line for 10–19 Ω LI drop values, orange line for 20–29 Ω LI drop values and grey line for LI drop values ≥ 30 Ω). RF delivery time is represented according to CF and LI drop intervals. C Radar plot showing the relationship between RF delivery time and LI drop values according to different degrees of CF. This Kiviat chart displays multivariate data (RF delivery time) with values represented on axes starting from the same point. The apexes of the Kiviat charts represent different LI drop intervals (10–19 Ω, 20–29 Ω, and ≥ 30 Ω), whereas the lines represent different degrees of CF (blue line for 5–14 g CF values, orange line for 15–24 g CF values, and grey line for CF values ≥ 25 g). RF delivery…

• 

  Fig. 3. Details of relationships among the three key parameters: RF delivery time and LI drop according to different levels of CF (A); RF delivery time and CF according to different degrees of LI drop (B); and CF and LI drop according to different values of RF delivery time (C)

• 

  Fig. 4. Details of the distribution of baseline LI (A), LI drop (B), RF delivery time (C), and CF values (D) according to location sites: anterior sites vs posterior sites, LPV sites vs RPV sites and inferior vs superior sites

• 

  Fig. 5. Details of the distribution of RF applications, CF, ablated tissue impedance values, and RF delivery times according to location sites. This Kiviat chart displays multivariate data with values represented on axes starting from the same point. Each apex of the Kiviat charts represents a location site according with seven distinct sections of right (R) and left (L) pairs of PVs (anterior superior R1, L1; anterior inferior R2, L2; inferior R3, L3; posterior inferior R4, L4; carina R5, L5; posterior superior R6, L6; superior R7, L7). Blue, orange, and grey dots represent the mean LI drop values, CF values, and RF delivery time values according to location sites