Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
September 5, 2026Journal of Interventional Cardiac Electrophysiology

Averaged impedance drops below 10% show no significant link to conduction gaps during radiofrequency ablation.

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Real-time monitoring of myocardial tissue response during radiofrequency applications using a mesh-shaped flexible irrigation tip ablation catheter remains challenging.

Does averaged impedance drop percentage (AID%) accurately predict conduction gaps and lesion characteristics during radiofrequency catheter ablation?

Population

30 patients undergoing initial pulmonary vein isolation (1,423 radiofrequency applications) and an ex-vivo porcine model

Comparison

Radiofrequency applications within conduction gap segments vs non-conduction gap segments

Design

Retrospective clinical study and ex-vivo experimental study

Key result

An averaged impedance drop percentage (AID%) <10% was not significantly associated with conduction gaps during radiofrequency ablation (OR 1.560; 95% CI 0.970-2.500; P=0.065).

Authors

NNNobuhiro NakamuraSOSatoshi OkaAWAkinori Wakamiya

Discussion

Loading...

Member takes

Overview

AID% <10% does not predict conduction gaps; leaves open its utility as a lesion-quality surrogate pending prospective validation.

Key Points

  • To assess the dynamics of averaged impedance drop percentage (AID%) during flexible-tip radiofrequency catheter ablation and evaluate its relationship with conduction gaps and lesion characteristics.
  • Retrospectively analyzed 1,423 radiofrequency applications across 30 patients undergoing initial pulmonary vein isolation with the TactiFlex catheter to assess AID% within conduction gap segments.
  • Performed mechanistic validation using an ex vivo porcine myocardial model across 152 lesions under varying radiofrequency power, contact force, and duration settings.
  • AID% was marginally lower in conduction gap vs. non-gap segments (10.2 [8.3–12.2]% vs. 10.9 [9.0–13.1]%, p=0.002), demonstrating limited discriminative accuracy (AUC 0.58, 95% CI 0.53–0.63).
  • In mixed-effects logistic regression accounting for clustering, AID% <10% was not significantly associated with conduction gaps (OR 1.560, 95% CI 0.970–2.500, p=0.065), whereas average power was significant.
  • Ex vivo lesion dimensions varied significantly across different power, contact force, and duration settings even when target AID% remained constant.

Study Design

Type

Observational (n=30)

Structured PICO

Does averaged impedance drop percentage (AID%) accurately predict conduction gaps and lesion characteristics during radiofrequency catheter ablation?

P
Population
30 patients undergoing initial pulmonary vein isolation using the TactiFlex catheter, contributing 1,423 radiofrequency applications.
E
Exposure
Radiofrequency catheter ablation using a mesh-shaped flexible irrigation tip ablation catheter (TactiFlex) with monitoring of averaged impedance drop percentage (AID%)
C
Comparator
Radiofrequency applications in non-conduction gap segments vs. conduction gap segments
O
Outcome
Association of averaged impedance drop percentage (AID%) with conduction gaps and lesion characteristicssurrogate

Main Result

Odds Ratio: 1.56 (95% CI 0.97–2.5)

p-value: p=0.065

Averaged impedance drop percentage (AID%) has limited ability to discriminate conduction gap segments and should be used as a marker of tissue response rather than a stand-alone lesion-quality metric.

Cite This Study

Nakamura et al. (2026) conducted an observational in Atrial fibrillation (undergoing pulmonary vein isolation) (n=30). Averaged impedance drop percentage (AID%) <10% vs. AID% ≥10% was evaluated on Radiofrequency applications in conduction gap segments (OR 1.560, 95% CI 0.970-2.500, p=0.065). An averaged impedance drop percentage (AID%) <10% was not significantly associated with conduction gaps during radiofrequency ablation (OR 1.560; 95% CI 0.970-2.500; P=0.065).

synapsesocial.com/papers/6a9c015c6b95aff0620ec816https://doi.org/10.1007/s10840-026-02427-2
View Full Paper
Ask AI
Bookmark
Share

Also Consider

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

  1. 1Averaged Impedance Drop Estimates Conduction Gap During Pulmonary Vein Isolation in Atrial Fibrillation2026
  2. 2Impact of impedance decrease during radiofrequency current application for atrial fibrillation ablation on myocardial lesion and gap formation2018 · 12 citations
  3. 3Limitations of Baseline Impedance, Impedance Drop and Current for Radiofrequency Catheter Ablation Monitoring: Insights from In silico Modeling2022 · 13 citations
  4. 4Impedance Monitoring During Radiofrequency Catheter Ablation in Humans1992 · 71 citations
  5. 5Averaging Real-Time Impedance Enhances the Prediction of Steam Pop Risk and Lesion Characteristics2025