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Impedance-guided Radiofrequency Ablation: Using Impedance to Improve Ablation Outcomes

Despite the achievement of acute conduction block during catheter ablation, the recovery of conduction at previously ablated sites remains a primary factor implicated in arrhythmia recurrence after initial ablation. Real-time markers of adequate ablation lesion creation are needed to ensure durable...

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Detalles Bibliográficos
Autores principales: Chinitz, Jason S., Michaud, Gregory F., Stephenson, Kent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MediaSphere Medical 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252711/
https://www.ncbi.nlm.nih.gov/pubmed/32477757
http://dx.doi.org/10.19102/icrm.2017.081003
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author Chinitz, Jason S.
Michaud, Gregory F.
Stephenson, Kent
author_facet Chinitz, Jason S.
Michaud, Gregory F.
Stephenson, Kent
author_sort Chinitz, Jason S.
collection PubMed
description Despite the achievement of acute conduction block during catheter ablation, the recovery of conduction at previously ablated sites remains a primary factor implicated in arrhythmia recurrence after initial ablation. Real-time markers of adequate ablation lesion creation are needed to ensure durable ablation success. However, the assessment of acute lesion formation is challenging, and requires interpretation of surrogate markers of lesion creation that are frequently unreliable. Careful monitoring of impedance changes during radiofrequency catheter ablation has emerged as a highly specific marker of local tissue destruction. Ablation strategies guided by close impedance monitoring during ablation applications have been demonstrated to achieve high levels of success for ablation of atrial fibrillation. Impedance decrease during ablation may therefore be used as an additional endpoint beyond acute conduction block, in order to improve the durability of ablation lesions. In this manuscript, available methods of real-time lesion assessment are reviewed, and the rationale and technique for impedance-guided ablation are described.
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spelling pubmed-72527112020-05-28 Impedance-guided Radiofrequency Ablation: Using Impedance to Improve Ablation Outcomes Chinitz, Jason S. Michaud, Gregory F. Stephenson, Kent J Innov Card Rhythm Manag Research Review Despite the achievement of acute conduction block during catheter ablation, the recovery of conduction at previously ablated sites remains a primary factor implicated in arrhythmia recurrence after initial ablation. Real-time markers of adequate ablation lesion creation are needed to ensure durable ablation success. However, the assessment of acute lesion formation is challenging, and requires interpretation of surrogate markers of lesion creation that are frequently unreliable. Careful monitoring of impedance changes during radiofrequency catheter ablation has emerged as a highly specific marker of local tissue destruction. Ablation strategies guided by close impedance monitoring during ablation applications have been demonstrated to achieve high levels of success for ablation of atrial fibrillation. Impedance decrease during ablation may therefore be used as an additional endpoint beyond acute conduction block, in order to improve the durability of ablation lesions. In this manuscript, available methods of real-time lesion assessment are reviewed, and the rationale and technique for impedance-guided ablation are described. MediaSphere Medical 2017-10-15 /pmc/articles/PMC7252711/ /pubmed/32477757 http://dx.doi.org/10.19102/icrm.2017.081003 Text en Copyright: © 2017 Innovations in Cardiac Rhythm Management http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Review
Chinitz, Jason S.
Michaud, Gregory F.
Stephenson, Kent
Impedance-guided Radiofrequency Ablation: Using Impedance to Improve Ablation Outcomes
title Impedance-guided Radiofrequency Ablation: Using Impedance to Improve Ablation Outcomes
title_full Impedance-guided Radiofrequency Ablation: Using Impedance to Improve Ablation Outcomes
title_fullStr Impedance-guided Radiofrequency Ablation: Using Impedance to Improve Ablation Outcomes
title_full_unstemmed Impedance-guided Radiofrequency Ablation: Using Impedance to Improve Ablation Outcomes
title_short Impedance-guided Radiofrequency Ablation: Using Impedance to Improve Ablation Outcomes
title_sort impedance-guided radiofrequency ablation: using impedance to improve ablation outcomes
topic Research Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252711/
https://www.ncbi.nlm.nih.gov/pubmed/32477757
http://dx.doi.org/10.19102/icrm.2017.081003
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