Local impedance drop–guided versus lesion size index–guided pulmonary vein isolation-Reference-Cited by-同舟云学术

Local impedance drop–guided versus lesion size index–guided pulmonary vein isolation

Published:2024-07-12 Issue: Volume: Page:
ISSN:1572-8595
Container-title:Journal of Interventional Cardiac Electrophysiology
language:en
Short-container-title:J Interv Card Electrophysiol

Author:

Lian Evgeny^ORCID,Pantlik Robert,Maslova Vera^ORCID,Willert Sven,Moser Fabian^ORCID,Remppis Andrew^ORCID,Frank Derk^ORCID,Demming Thomas^ORCID

Abstract

Abstract Background Local tissue impedance drop (LID) and lesion size index (LSI) technologies are valuable for predicting effective lesion formation. This study compares the acute and long-term efficacy of LID-guided versus LSI-guided pulmonary vein isolation (PVI) for atrial fibrillation treatment. Methods We retrospectively analyzed two patient groups undergoing radiofrequency PVI. In the LID-guided group (n = 35), ablation was performed without contact force monitoring, stopping at the LID plateau (target LID 12 Ohm posterior, 16 Ohm anterior). In the LSI-guided group (n = 31), ablation used contact force information with target LSI (5 anterior, 4 posterior). Both groups utilized a power of 40 W anterior and 30 W posterior, with < 6 mm inter-lesion distance. Gap mapping and touch-up ablation were done if necessary. Results PVI was achieved with a significantly shorter ablation time in the LSI-guided group (25 min [21;31] vs 30 [27;35], p = 0.035). PV gaps were more frequent in the LID-guided group (74% vs 42%, p = 0.016). Over 11.5 ± 2.9 months follow-up, arrhythmia recurrence was higher in the LID-guided group (34.3% vs 16.1%, p = 0.037). A redo procedure performed in 10 (28.6%) patients in the LID-guided group and 3 (9.7%) in the LSI-guided group showed chronic PV reconnections in 7 out of 10 (70%) and 2 out of 3 (67%) patients, respectively. Conclusions LSI-guided ablation results in shorter ablation time and fewer PV gaps compared to LID-guided ablation. Despite initial success, LID-guided ablation had higher arrhythmia recurrence and PV reconnections during long-term follow-up compared to LSI-guided ablation. Graphical abstract

Funder

Universitätsklinikum Schleswig-Holstein - Campus Kiel

Publisher

Springer Science and Business Media LLC

Link

https://link.springer.com/content/pdf/10.1007/s10840-024-01870-3.pdf

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