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Impact of impedance decrease during radiofrequency current application for atrial fibrillation ablation on myocardial lesion and gap formation

BACKGROUND: The clinical impact of a decrease in impedance during radiofrequency catheter ablation (RFCA) has not been fully clarified. The aim of the study was to analyze the impact of impedance decrease and to determine its optimal cutoff value during RFCA. METHODS: We evaluated 34 consecutive pat...

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Autores principales: Inaba, Osamu, Nagata, Yasutoshi, Sekigawa, Masahiro, Miwa, Naoyuki, Yamaguchi, Junji, Miyamoto, Takamichi, Goya, Masahiko, Hirao, Kenzo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6009992/
https://www.ncbi.nlm.nih.gov/pubmed/29951139
http://dx.doi.org/10.1002/joa3.12056
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author Inaba, Osamu
Nagata, Yasutoshi
Sekigawa, Masahiro
Miwa, Naoyuki
Yamaguchi, Junji
Miyamoto, Takamichi
Goya, Masahiko
Hirao, Kenzo
author_facet Inaba, Osamu
Nagata, Yasutoshi
Sekigawa, Masahiro
Miwa, Naoyuki
Yamaguchi, Junji
Miyamoto, Takamichi
Goya, Masahiko
Hirao, Kenzo
author_sort Inaba, Osamu
collection PubMed
description BACKGROUND: The clinical impact of a decrease in impedance during radiofrequency catheter ablation (RFCA) has not been fully clarified. The aim of the study was to analyze the impact of impedance decrease and to determine its optimal cutoff value during RFCA. METHODS: We evaluated 34 consecutive patients (total 3264 lesions, mean age 66 ± 8.7 years, 10 females) who underwent their first ablation for atrial fibrillation (AF). The impedance decrease, average contact force (CF), application time, force‐time integral (FTI), product of impedance decrease and application time (PIT), and the product of impedance decrease and FTI (PIFT) were measured for all lesions. Levels of cardiac troponin I (TrpI) were measured for assessment of myocardial injury. The incidence of intraprocedural pulmonary vein‐left atrium reconnection or dormant conduction (reconnection) was determined. The relationships between the ablation parameters and the increase in TrpI (ΔTrpI) were evaluated. The predictive value of the parameters for reconnection was assessed using receiver operating characteristic (ROC) curve analysis. RESULTS: Reconnection was detected in 18 patients. Average FTI and PIT were significantly correlated with ΔTrpI (FTI: r (2) = .19, P = .0090, PIT: r (2) = .21, P = .0058). PIFT was correlated with ΔTrpI and was the best of the three indexes (PIFT: r (2) = .29, P = .0010). In ROC curve analysis, the area under the curve for predicting reconnection was 0.71 and the optimal cutoff value was 5200 for PIFT (sensitivity 78%, specificity 63%). CONCLUSION: The combination of CF and a decrease in impedance could be important in the evaluation of myocardial lesions and reconnection during RFCA.
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spelling pubmed-60099922018-06-27 Impact of impedance decrease during radiofrequency current application for atrial fibrillation ablation on myocardial lesion and gap formation Inaba, Osamu Nagata, Yasutoshi Sekigawa, Masahiro Miwa, Naoyuki Yamaguchi, Junji Miyamoto, Takamichi Goya, Masahiko Hirao, Kenzo J Arrhythm Original Articles BACKGROUND: The clinical impact of a decrease in impedance during radiofrequency catheter ablation (RFCA) has not been fully clarified. The aim of the study was to analyze the impact of impedance decrease and to determine its optimal cutoff value during RFCA. METHODS: We evaluated 34 consecutive patients (total 3264 lesions, mean age 66 ± 8.7 years, 10 females) who underwent their first ablation for atrial fibrillation (AF). The impedance decrease, average contact force (CF), application time, force‐time integral (FTI), product of impedance decrease and application time (PIT), and the product of impedance decrease and FTI (PIFT) were measured for all lesions. Levels of cardiac troponin I (TrpI) were measured for assessment of myocardial injury. The incidence of intraprocedural pulmonary vein‐left atrium reconnection or dormant conduction (reconnection) was determined. The relationships between the ablation parameters and the increase in TrpI (ΔTrpI) were evaluated. The predictive value of the parameters for reconnection was assessed using receiver operating characteristic (ROC) curve analysis. RESULTS: Reconnection was detected in 18 patients. Average FTI and PIT were significantly correlated with ΔTrpI (FTI: r (2) = .19, P = .0090, PIT: r (2) = .21, P = .0058). PIFT was correlated with ΔTrpI and was the best of the three indexes (PIFT: r (2) = .29, P = .0010). In ROC curve analysis, the area under the curve for predicting reconnection was 0.71 and the optimal cutoff value was 5200 for PIFT (sensitivity 78%, specificity 63%). CONCLUSION: The combination of CF and a decrease in impedance could be important in the evaluation of myocardial lesions and reconnection during RFCA. John Wiley and Sons Inc. 2018-04-16 /pmc/articles/PMC6009992/ /pubmed/29951139 http://dx.doi.org/10.1002/joa3.12056 Text en © 2018 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Inaba, Osamu
Nagata, Yasutoshi
Sekigawa, Masahiro
Miwa, Naoyuki
Yamaguchi, Junji
Miyamoto, Takamichi
Goya, Masahiko
Hirao, Kenzo
Impact of impedance decrease during radiofrequency current application for atrial fibrillation ablation on myocardial lesion and gap formation
title Impact of impedance decrease during radiofrequency current application for atrial fibrillation ablation on myocardial lesion and gap formation
title_full Impact of impedance decrease during radiofrequency current application for atrial fibrillation ablation on myocardial lesion and gap formation
title_fullStr Impact of impedance decrease during radiofrequency current application for atrial fibrillation ablation on myocardial lesion and gap formation
title_full_unstemmed Impact of impedance decrease during radiofrequency current application for atrial fibrillation ablation on myocardial lesion and gap formation
title_short Impact of impedance decrease during radiofrequency current application for atrial fibrillation ablation on myocardial lesion and gap formation
title_sort impact of impedance decrease during radiofrequency current application for atrial fibrillation ablation on myocardial lesion and gap formation
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6009992/
https://www.ncbi.nlm.nih.gov/pubmed/29951139
http://dx.doi.org/10.1002/joa3.12056
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