The role of local impedance drop in the acute lesion efficacy during pulmonary vein isolation performed with a new contact force sensing catheter-A pilot study.
<h4>Introduction</h4>Our pilot study aimed to evaluate the role of local impedance drop in lesion formation during pulmonary vein isolation with a novel contact force sensing ablation catheter that records local impedance as well and to find a local impedance cut-off value that predicts...
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2021
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oai:doaj.org-article:e6f1e568b308458f91c61ed6ecba21f72021-12-02T20:08:13ZThe role of local impedance drop in the acute lesion efficacy during pulmonary vein isolation performed with a new contact force sensing catheter-A pilot study.1932-620310.1371/journal.pone.0257050https://doaj.org/article/e6f1e568b308458f91c61ed6ecba21f72021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0257050https://doaj.org/toc/1932-6203<h4>Introduction</h4>Our pilot study aimed to evaluate the role of local impedance drop in lesion formation during pulmonary vein isolation with a novel contact force sensing ablation catheter that records local impedance as well and to find a local impedance cut-off value that predicts successful lesion formation.<h4>Materials and methods</h4>After completing point-by-point radiofrequency pulmonary vein isolation, the success of the applications was evaluated by pacing along the ablation line at 10 mA, 2 ms pulse width. Lesions were considered successful if loss of local capture was achieved.<h4>Results</h4>Out of 645 applications, 561 were successful and 84 were unsuccessful. Compared to the unsuccessful ablation points, the successful applications were shorter (p = 0.0429) and had a larger local impedance drop (p<0.0001). There was no difference between successful and unsuccessful applications in terms of mean contact force (p = 0.8571), force-time integral (p = 0.0699) and contact force range (p = 0.0519). The optimal cut-point for the local impedance drop indicating successful lesion formation was 21.80 Ohms on the anterior wall [AUC = 0.80 (0.75-0.86), p<0.0001], and 18.30 Ohms on the posterior wall [AUC = 0.77 (0.72-0.83), p<0.0001]. A local impedance drop larger than 21.80 Ohms on the anterior wall and 18.30 Ohms on the posterior wall was associated with an increased probability of effective lesion creation [OR = 11.21, 95%CI 4.22-29.81, p<0.0001; and OR = 7.91, 95%CI 3.77-16.57, p<0.0001, respectively].<h4>Conclusion</h4>The measurement of the local impedance may predict optimal lesion formation. A local impedance drop > 21.80 Ohms on the anterior wall and > 18.30 Ohms on the posterior wall significantly increases the probability of creating a successful lesion.Nándor SzegediZoltán SallóPéter PergeKatalin PirosVivien Klaudia NagyIstván OsztheimerBéla MerkelyLászló GellérPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0257050 (2021) |
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Medicine R Science Q Nándor Szegedi Zoltán Salló Péter Perge Katalin Piros Vivien Klaudia Nagy István Osztheimer Béla Merkely László Gellér The role of local impedance drop in the acute lesion efficacy during pulmonary vein isolation performed with a new contact force sensing catheter-A pilot study. |
| description |
<h4>Introduction</h4>Our pilot study aimed to evaluate the role of local impedance drop in lesion formation during pulmonary vein isolation with a novel contact force sensing ablation catheter that records local impedance as well and to find a local impedance cut-off value that predicts successful lesion formation.<h4>Materials and methods</h4>After completing point-by-point radiofrequency pulmonary vein isolation, the success of the applications was evaluated by pacing along the ablation line at 10 mA, 2 ms pulse width. Lesions were considered successful if loss of local capture was achieved.<h4>Results</h4>Out of 645 applications, 561 were successful and 84 were unsuccessful. Compared to the unsuccessful ablation points, the successful applications were shorter (p = 0.0429) and had a larger local impedance drop (p<0.0001). There was no difference between successful and unsuccessful applications in terms of mean contact force (p = 0.8571), force-time integral (p = 0.0699) and contact force range (p = 0.0519). The optimal cut-point for the local impedance drop indicating successful lesion formation was 21.80 Ohms on the anterior wall [AUC = 0.80 (0.75-0.86), p<0.0001], and 18.30 Ohms on the posterior wall [AUC = 0.77 (0.72-0.83), p<0.0001]. A local impedance drop larger than 21.80 Ohms on the anterior wall and 18.30 Ohms on the posterior wall was associated with an increased probability of effective lesion creation [OR = 11.21, 95%CI 4.22-29.81, p<0.0001; and OR = 7.91, 95%CI 3.77-16.57, p<0.0001, respectively].<h4>Conclusion</h4>The measurement of the local impedance may predict optimal lesion formation. A local impedance drop > 21.80 Ohms on the anterior wall and > 18.30 Ohms on the posterior wall significantly increases the probability of creating a successful lesion. |
| format |
article |
| author |
Nándor Szegedi Zoltán Salló Péter Perge Katalin Piros Vivien Klaudia Nagy István Osztheimer Béla Merkely László Gellér |
| author_facet |
Nándor Szegedi Zoltán Salló Péter Perge Katalin Piros Vivien Klaudia Nagy István Osztheimer Béla Merkely László Gellér |
| author_sort |
Nándor Szegedi |
| title |
The role of local impedance drop in the acute lesion efficacy during pulmonary vein isolation performed with a new contact force sensing catheter-A pilot study. |
| title_short |
The role of local impedance drop in the acute lesion efficacy during pulmonary vein isolation performed with a new contact force sensing catheter-A pilot study. |
| title_full |
The role of local impedance drop in the acute lesion efficacy during pulmonary vein isolation performed with a new contact force sensing catheter-A pilot study. |
| title_fullStr |
The role of local impedance drop in the acute lesion efficacy during pulmonary vein isolation performed with a new contact force sensing catheter-A pilot study. |
| title_full_unstemmed |
The role of local impedance drop in the acute lesion efficacy during pulmonary vein isolation performed with a new contact force sensing catheter-A pilot study. |
| title_sort |
role of local impedance drop in the acute lesion efficacy during pulmonary vein isolation performed with a new contact force sensing catheter-a pilot study. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/e6f1e568b308458f91c61ed6ecba21f7 |
| work_keys_str_mv |
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