What is the clinical evidence from this study?

Study design: Observational. Population: Arrhythmia requiring catheter ablation (n=31). Intervention: Intellanav MiFi OI catheter vs. Unsuccessful lesions. Primary outcome: Median local impedance drop for successful vs unsuccessful lesions in the left ventricle (p=0.001).

What question did this study set out to answer?

To evaluate the initial clinical performance of a novel catheter equipped with a local impedance algorithm for tissue characterization and lesion assessment during ablation.

June 2, 2018Journal of Cardiovascular Electrophysiology

First clinical use of novel ablation catheter incorporating local impedance data

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Key result

Ablation with the Intellanav MiFi OI catheter showed a significantly larger median local impedance drop for successful versus unsuccessful lesions in the left ventricle (16.0 vs 9.4 Ω, P=0.001).

Why the study?

Does the Intellanav MiFi OI catheter provide local impedance data that correlates with successful lesion formation in patients undergoing ablation?

Population

31 patients undergoing ablation, mean age 65±6 years, 20 male

Design

Case_series

Authors

CMClaire MartinUniversité Claude Bernard Lyon 1 RMRuairidh MartinFreeman Hospital PGParag GajendragadkarUniversity of Oxford

Discussion

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Implication

Initial experience supports feasibility of impedance-guided mapping; leaves open clinical outcome benefits pending larger trials.

Key Points

To evaluate the initial clinical performance of a novel catheter equipped with a local impedance algorithm for tissue characterization and lesion assessment during ablation.
Assessed 31 patients (mean age 65±6 years, 20 male) undergoing cardiac catheter ablation.
Recorded local impedance, generator impedance, and electrogram amplitude across blood pool, healthy myocardium, and dense scar regions before, during, and after ablation using the Intellanav MiFi OI catheter with the DirectSense algorithm.
Successful lesions resulting in loss of local tissue capture showed significantly larger median local impedance drops than unsuccessful lesions in both the left ventricle (16.0 Ω [12.1–19.8] vs. 9.4 Ω [5.4–15.6], P = 0.001) and left atrium (14.6 Ω [10.0–18.3] vs. 6.8 Ω [4.7–13.0], P = 0.049).
Percentage drop in local impedance was significantly higher in successful compared to unsuccessful lesions in the left ventricle (17.1% vs. 10.6%, P = 0.002) and left atrium (14.2% vs. 7.5%, P = 0.005).
Local impedance was lower in dense scar than in healthy tissue or blood pool and demonstrated an exponential relationship with maximum electrogram amplitude.

Study Design

Type

Observational (n=31)

Structured PICO

Does the Intellanav MiFi OI catheter provide local impedance data that correlates with successful lesion formation in patients undergoing ablation?

Population

31 patients (mean age 65 years, 35% female) undergoing catheter ablation.

Exposure

Ablation using the Intellanav MiFi OI catheter (Boston Scientific) incorporating a 'DirectSense' algorithm to measure local tissue impedance (LI)

Outcome

Local impedance (LI) drop for successful versus unsuccessful lesionssurrogate

Main Result

Absolute Event Rate: 16% vs 9.4%

p-value: p=0.001

The novel Intellanav MiFi OI catheter provides reproducible local impedance recordings that correlate with successful lesion formation during ablation.

Cite This Study

Martin et al. (2018) conducted an observational in Arrhythmia requiring catheter ablation (n=31). Intellanav MiFi OI catheter vs. Unsuccessful lesions was evaluated on Median local impedance drop for successful vs unsuccessful lesions in the left ventricle (p=0.001). Ablation with the Intellanav MiFi OI catheter showed a significantly larger median local impedance drop for successful versus unsuccessful lesions in the left ventricle (16.0 vs 9.4 Ω, P=0.001).

synapsesocial.com/papers/6a7723da576efb0ddaf71ce7 https://doi.org/10.1111/jce.13654

Topics

Persistent AF management Atrial fibrillation AF ablation outcomes Ventricular arrhythmias

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Bookmark

First clinical use of novel ablation catheter incorporating local impedance data

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

First clinical use of novel ablation catheter incorporating local impedance data

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

Also Consider