When local impedance meets contact force: preliminary experience from the CHARISMA registry

被引:9
|
作者
Solimene, Francesco [1 ]
De Sanctis, Valerio [2 ]
Maggio, Ruggero [3 ]
Malacrida, Maurizio [4 ]
Segreti, Luca [5 ]
Anselmino, Matteo [6 ]
Schillaci, Vincenzo [1 ]
Mantica, Massimo [2 ]
Scaglione, Marco [7 ]
Dello Russo, Antonio [8 ]
Cauti, Filippo Maria [9 ]
Zingarini, Gianluca [10 ]
Pandozi, Claudio [11 ]
Cavaiani, Marco [4 ]
Ferraro, Anna [3 ]
Maglia, Giampiero [12 ]
Stabile, Giuseppe [1 ,13 ]
机构
[1] Clin Montevergine, Avellino, Mercogliano, Italy
[2] Ist Clin St Ambrogio, Dept Cardiac Electrophysiol & Pacing, Via Luigi Giuseppe Faravelli 16, I-20149 Milan, Italy
[3] Infermi Hosp, Rivoli, Italy
[4] Boston Sci, Milan, Italy
[5] Azienda Osped Univ Pisana, New Santa Chiara Hosp, Cardiac Thorac Vasc Dept, Div Cardiol 2, Pisa, Italy
[6] Univ Turin, Citta Salute & Sci Torino Hosp, Dept Med Sci, Div Cardiol, Turin, Italy
[7] Cardinal Massaia Hosp, Asti, Italy
[8] Marche Polytech Univ, Cardiol & Arrhythmol Clin, Ancona, Italy
[9] Osped San Giovanni Calibita, Fatebefratelli, Arrhythmol Unit, Rome, Italy
[10] Osped Santa Maria Misericordia, Perugia, Italy
[11] San Filippo Neri Hosp, Div Cardiol, Rome, Italy
[12] Azienda Osped Pugliese Ciaccio, Catanzaro, Italy
[13] Anthea Hosp, Bari, Italy
关键词
Atrial fibrillation; Catheter ablation; Local impedance; Contact force; Lesion formation; PVI; RADIOFREQUENCY CATHETER ABLATION; ATRIAL-FIBRILLATION;
D O I
10.1007/s10840-022-01163-7
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose Highly localized impedance (LI) measurements during atrial fibrillation (AF) ablation have emerged as a viable real-time indicator of tissue characteristics and the consequent durability of the lesions created. We investigated the impact of catheter-tissue contact force (CF) on LI behavior during pulmonary vein isolation (PVI). Methods Forty-five consecutive patients of the CHARISMA registry undergoing de novo AF radiofrequency (RF) catheter ablation with a novel open-irrigated-tip catheter endowed with CF and LI measurement capabilities (Stablepoint (TM) catheter, Boston Scientific) were included. Results A total of 2895 point-by-point RF applications were analyzed (RF delivery time (DT) = 8.7 +/- 4s, CF = 13 +/-+/- 8 g, LI drop = 23 +/-+/- 7 Omega). All PVs were successfully isolated in an overall procedure time of 118 +/-+/- 34 min (fluoroscopy time = 13 +/-+/- 8 min). The magnitude of LI drop weakly correlated with CF (r = 0.13, 95% confidence interval (CI): 0.09 to 0.16, p < 0.0001), whereas both CF and LI drop inversely correlated with DT (r = -0.26, 95%CI: -0.29 to -0.22, p < 0.0001 for CF; r = -0.36, 95%CI: -0.39 to -0.33, p < 0.0001 for LI). For each 10 g of CF, LI drop markedly increased from 22.4 +/- 7 Omega to 24.0 +/- 8 Omega at 5 to 25 g CF intervals (5-14 g of CF vs 15-24 g of CF, p < 0.0001), whereas it showed smooth transition over 25 g (24.8 +/- 7 Omega at >= 25 g CF intervals, p = 0.0606 vs 15-24 g of CF). No major complications occurred during the procedures or within 30 days. Conclusions CF significantly affects LI drop and probable consequent lesion formation during RF PVI. The benefit of higher contact (> 25 g) between the catheter and the tissue appears to have less impact on LI drop.
引用
收藏
页码:749 / 758
页数:10
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