Ablation Index and Surround Flow Catheter Irrigation: Impedance-Based Appraisal in Clinical Ablation

JACC. Clinical Electrophysiology
Waqas UllahRichard J Schilling

Abstract

This study sought to assess the impact of ablation power and catheter irrigation during clinical radiofrequency ablation using impedance drop. In preclinical studies, ablation power and catheter irrigation are determinants of ablation efficacy. Static 30-s left atrial ablations were delivered in patients undergoing their first atrial fibrillation ablation. Impedance drop during ablation (as a measure of efficacy) was compared using the following: the force time integral (FTI); the FTI-P (a cumulative multiple FTI and ablation power), and ablation index (AI), a weighted algorithm including contact force, power, and duration. Comparison was also made between a conventionally irrigated (SmartTouch [ST]) versus surround flow (STSF) contact force-sensing catheter. We analyzed 1,013 ablations. For both catheters, the Spearman correlation was higher between impedance drop and AI (rho = 0.89 ST, 0.84 STSF) than FTI-P (rho = 0.71 ST, 0.53 STSF) or FTI (rho = 0.77 ST, 0.52 STSF); p < 0.0005 for each. STSF ablations had lower minimum catheter tip temperatures (25°C [interquartile range (IQR): 25°C to 27°C] vs. 35°C [IQR: 34°C to 36°C]; p < 0.005), and lesser impedance drop per FTI or AI (p < 0.005 for both). For STSF, impedance drop plate...Continue Reading

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Citations

Jul 18, 2019·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Michela CasellaClaudio Tondo
Sep 14, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Benjamin BerteRichard Kobza
May 6, 2020·Journal of Cardiovascular Electrophysiology·Giuseppe StabileFrancesco Solimene
Jul 16, 2020·Journal of Cardiovascular Electrophysiology·Junji YamaguchiTetsuo Sasano
Jul 31, 2020·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Philipp HoffmannTill F Althoff
Jul 31, 2018·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Francesco SolimeneGiuseppe Stabile
Sep 11, 2018·Circulation Journal : Official Journal of the Japanese Circulation Society·Paula MünklerRoland Richard Tilz
Feb 4, 2019·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Francesco SantoroAndreas Rillig
Feb 26, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Clemens Jilek, Waqas Ullah
Jan 7, 2020·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Kyoichiro YazakiNobuhisa Hagiwara
Jan 24, 2021·Journal of Cardiovascular Electrophysiology·Oluwaseun AdeolaGregory Michaud
Mar 31, 2021·Pacing and Clinical Electrophysiology : PACE·Edd MacleanJonathan M Behar
Aug 3, 2021·Cardiology Research and Practice·Zheng CaiYaling Han

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