In:
Journal of Cardiovascular Electrophysiology, Wiley, Vol. 34, No. 9 ( 2023-09), p. 1869-1877
Abstract:
Since the local impedance (LI) of the ablation catheter reflects tissue characteristics, the efficacy of higher power (HP) compared to lower power (LP) in LI‐guided ablation may differ from other index‐guided ablations. Objective This study aimed to assess the efficacy of HP ablation in LI‐guided ablation of atrial fibrillation (AF). Methods A prospective observational study was conducted, enrolling patients undergoing de novo ablation for AF. Pulmonary vein isolation was performed using point‐by‐point ablation with a RHYTHMIA HDx TM Mapping System and an open‐irrigated ablation catheter with mini‐electrodes (IntellaNav MIFI OI). Ablation was stopped when the LI drop reached 30 ohms, three seconds after the LI plateaued, or when ablation time reached 30 s. To balance the baseline differences, a unique method was used in which the power was changed between HP (45 W to anterior wall/40 W to posterior wall) and LP (35 W/30 W) alternately for each adjacent point. Results A total of 551 ablations in 10 patients were analyzed (HP, n = 276; LP, n = 275). The maximum LI drop was significantly larger (HP: 28.3 ± 5.4 vs. LP: 24.8 ± 6.3 ohm), and the time to minimum LI was significantly shorter (HP: 15.0 ± 6.3 vs. LP: 19.3 ± 6.6 s) in the HP setting. The unipolar electrogram analysis of three patients revealed that the electrogram indicating transmural lesion formation was observed more frequently in the HP setting. Conclusion In LI‐guided ablation, the HP could achieve a larger LI drop and shorter time to minimum LI, which may result in more transmural lesion formation compared to a LP setting.
Type of Medium:
Online Resource
ISSN:
1045-3873
,
1540-8167
Language:
English
Publisher:
Wiley
Publication Date:
2023
detail.hit.zdb_id:
2037519-0
