Interactions of contact force, impedance and power during repeat atrial arrhythmia ablation after previous atrial fibrillation ablation.

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm Pub Date : 2024-09-16 DOI:10.1016/j.hrthm.2024.09.026

Fares-Alexander Alken, Katharina Scherschel, Ernan Zhu, Bahram Wafaisade, Ann-Kathrin Kahle, Christian Meyer

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引用次数: 0

Abstract

Background: Acutely effective repeat radiofrequency catheter ablation (RFCA) after previous atrial fibrillation ablation depends on several parameters including local impedance (LI), contact force (CF) and power.

Objective: To investigate the relationship of LI, CF and power to the LI drop in a repeat atrial RFCA environment.

Methods: Consecutive patients undergoing repeat atrial RFCA were studied. High-quality local electrograms (EGMs) were analyzed regarding morphology changes indicating effective RFCA and associated LI dynamics. The influence of baseline LI, mean CF and power on the LI drop was analyzed. Investigated power levels included ≤25 W, 30 W and ≥40 W.

Results: 1390 RFCA points from 48 patients (48 % female, median age 70 years) were analyzed. 40.5% of 309 analyzed EGMs showed effective RFCA morphology changes with a higher median LI drop (effective 19.7 Ω vs partially effective 14.1 Ω, p<0.001). CF showed the highest correlation to the LI drop within high baseline LI and when applying ≥40 W (low baseline LI, R=0.39; intermediate, R=0.66; high, R=0.72). Within low baseline LI regions, CF levels showed a lower correlation to the LI drop (≤25 W, R=0.30; 30 W, R=0.35; ≥40 W, R=0.39). A mean CF ≥10 g resulted in elevated LI drops with higher power compared to lower power within all baseline LI tertiles (p<0.001 each).

Conclusion: Within rather high baseline LI regions, CF plays a greater role for the maximum LI drop when higher power is chosen. A mean CF ≥10 g ensures increased LI drops with increasing power levels.

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房颤消融术后重复房性心律失常消融过程中接触力、阻抗和功率的相互作用。

背景：既往心房颤动消融术后重复射频导管消融术（RFCA）的急性有效取决于几个参数，包括局部阻抗（LI）、接触力（CF）和功率：研究重复心房 RFCA 环境中 LI、CF 和功率与 LI 下降的关系：方法：对接受重复心房 RFCA 的连续患者进行研究。对高质量的局部电图（EGM）进行分析，了解表明有效 RFCA 的形态变化和相关 LI 动态变化。分析了基线 LI、平均 CF 和功率对 LI 下降的影响。研究的功率水平包括≤25 W、30 W和≥40 W：分析了 48 名患者（48% 为女性，中位年龄为 70 岁）的 1390 个 RFCA 点。在分析的 309 个 EGM 中，40.5% 显示出有效的 RFCA 形态变化，中位 LI 下降幅度较大（有效为 19.7 Ω，部分有效为 14.1 Ω，p）：在基线 LI 相当高的区域内，当选择更高功率时，CF 对最大 LI 下降的作用更大。平均 CF ≥10 g 可确保随着功率水平的增加，LI 下降幅度增大。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart rhythm 医学-心血管系统

CiteScore

10.50

自引率

5.50%

发文量

1465

审稿时长

24 days

期刊介绍： HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability. HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community. The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.