Arrhythmias & electrophysiologyCohort study
Ablation characteristics associated with steam pops in ablation index-guided radiofrequency ablation of atrial fibrillation
- Observational study
Authors' conclusion
The incidence of steam pops during ablation of AF is infrequent. Impedance drop is the only ablation parameter that could predict the occurrence of steam pops.
Study context
- Population
- Patients with AF undergoing ablation index-guided radiofrequency (RF) ablation (paroxysmal AF: bilateral circumferential pulmonary vein (PV) ablation; persistent AF: additional linear ablation)
- Participants
- 3,263 patients
- Exposure
- Steam pop sites vs adjacent anatomical locations
- Outcome
- Occurrence and potential predictors of steam pops
Main finding
As reported in the abstract
Steam pops
Steam pops
81 (2.5%)
Steam pops at mitral isthmus
6 (0.4%)
Steam pops at tricuspid isthmus (CTI)
16 (0.9%)
Steam pops along roofline
7 (0.5%)
Observational data: associations, not effects.
Further findings
Impedance drop
P < 0.001
Optimal impedance-drop cut-offs for predicting steam pops
- Within first 3 s
- > 9.5 Ω
- Within first 5 s
- > 10.5 Ω
- Within first 10 s
- > 13.5 Ω
- Whole ablation
- > 18.5 Ω
Safety
Pericardial tamponade
- Pericardial tamponade
- 1
Original publication
Ablation characteristics associated with steam pops in ablation index-guided radiofrequency ablation of atrial fibrillation. Europace. Published 8 April 2025. doi:10.1093/europace/euaf084
Summarised from the published abstract; every number is checked against it