Arrhythmias & electrophysiologyCohort study
Early rapid local impedance drop is associated with acute lesion efficacy during pulmonary vein isolation
- Observational study
Authors' conclusion
A rapid and enduring drop of the LI may predict effective lesion formation, while slightly changing or unchanged LI is associated with unsuccessful applications. A moderate LI drop during the first 4 s of radiofrequency application predicts ineffective radiofrequency delivery.
Study context
- Population
- Point-by-point pulmonary vein isolation with a contact force sensing catheter559 successful, 84 unsuccessful applications
- Participants
- 559 vs 84
- Exposure
- Successful vs unsuccessful RF applications
- Successfuln = 559
- Unsuccessfuln = 84reference
- Outcome
- Temporal characteristics of LI drop during ablation and correlation with acute lesion efficacy
Main finding
As reported in the abstract
LI drop and lesion efficacy
Successful
161-150-141 Ω
Local impedance (LI) baseline-2 s-10 s
Unsuccessful
153 vs. 145 Ω
LI baseline vs 2 s
Unsuccessful vs UnsuccessfulOdds ratio (CI)P value
failing to reach the <9 Ω cut-point predicts unsuccessful application
3.82(2.34–6.25)
P < 0.001- LI drop <9 Ω at 4 s for unsuccessful application
- AUC 0.73 (CI 0.67–0.76); P < 0.001
- Successful: higher baseline LI
- P < 0.001
- Successful: larger LI drop during ablation
- P < 0.001
- Unsuccessful: drop baseline to 2 s
- P < 0.001
- Unsuccessful: no further LI change after 2 s
- P = 0.99
- Successful: further significant LI decrease
- P < 0.001
Observational data: associations, not effects.
Original publication
Early rapid local impedance drop is associated with acute lesion efficacy during pulmonary vein isolation. Europace. Published 7 October 2024. doi:10.1093/europace/euae260
Summarised from the published abstract; every number is checked against it