Peak frequency drop: a novel intraprocedural parameter predicting acute conduction gaps post-pulmonary vein isolation.

IF 2.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Interventional Cardiac Electrophysiology Pub Date : 2025-08-01 Epub Date: 2025-02-18 DOI:10.1007/s10840-025-02019-6

Yoshiaki Mizutani, Yuma Matsumoto, Keisuke Nishio, Hiroya Sakai, Gen Fujiwara, Daishi Nonokawa, Yuichiro Makino, Hitomi Suzuki, Hitoshi Ichimiya, Yasuhiro Uchida, Junji Watanabe, Masaaki Kanashiro, Satoshi Yanagisawa, Yasuya Inden, Toyoaki Murohara

{"title":"Peak frequency drop: a novel intraprocedural parameter predicting acute conduction gaps post-pulmonary vein isolation.","authors":"Yoshiaki Mizutani, Yuma Matsumoto, Keisuke Nishio, Hiroya Sakai, Gen Fujiwara, Daishi Nonokawa, Yuichiro Makino, Hitomi Suzuki, Hitoshi Ichimiya, Yasuhiro Uchida, Junji Watanabe, Masaaki Kanashiro, Satoshi Yanagisawa, Yasuya Inden, Toyoaki Murohara","doi":"10.1007/s10840-025-02019-6","DOIUrl":null,"url":null,"abstract":"Background: The identification of potential gap sites after pulmonary vein isolation (PVI) and prevention of these warning points during ablation are crucial. We evaluated the changes in peak frequency (PF) on electrograms and examined the relationship between its value and the residual pulmonary vein (PV) gap after PVI.Methods: We included patients with a PV gap after PVI with a power setting of 50 W using a novel irrigated-tip catheter (TactiFlex, Abbott). The PF on bipolar electrograms in the ablation catheter was recorded immediately before and after ablation at all available ablation points, using Omnipolar technology near field. We compared the pre- and post-PF values, changes in PF, contact force, and impedance drop between points with and without a PV gap following PVI.Results: A total of 695 ablation points in 13 patients were analyzed. There were 19 and 676 points with and without the PV gap, respectively. The PV gap group demonstrated significantly lower PF drop and contact force (-14 ± 43 Hz vs. 61 ± 57 Hz, p < 0.001; and 8 [7-10] g vs. 10 [4-14] g, p = 0.039), and higher post-PF (226 ± 49 Hz vs. 176 ± 47 Hz, p < 0.001) than in the non-PV gap group. The PF drop had the highest area under the curve of 0.878 (95% confidence interval: 0.791-0.964) on receiver operating characteristic curve analysis for predicting the PV gap, with a cutoff value of 10.5 Hz (sensitivity, 81.8%; specificity, 89.5%).Conclusion: PF drop during PVI is a useful parameter for predicting the non-PV gap with a high probability.","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1035-1044"},"PeriodicalIF":2.6000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Interventional Cardiac Electrophysiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10840-025-02019-6","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/18 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The identification of potential gap sites after pulmonary vein isolation (PVI) and prevention of these warning points during ablation are crucial. We evaluated the changes in peak frequency (PF) on electrograms and examined the relationship between its value and the residual pulmonary vein (PV) gap after PVI.

Methods: We included patients with a PV gap after PVI with a power setting of 50 W using a novel irrigated-tip catheter (TactiFlex, Abbott). The PF on bipolar electrograms in the ablation catheter was recorded immediately before and after ablation at all available ablation points, using Omnipolar technology near field. We compared the pre- and post-PF values, changes in PF, contact force, and impedance drop between points with and without a PV gap following PVI.

Results: A total of 695 ablation points in 13 patients were analyzed. There were 19 and 676 points with and without the PV gap, respectively. The PV gap group demonstrated significantly lower PF drop and contact force (-14 ± 43 Hz vs. 61 ± 57 Hz, p < 0.001; and 8 [7-10] g vs. 10 [4-14] g, p = 0.039), and higher post-PF (226 ± 49 Hz vs. 176 ± 47 Hz, p < 0.001) than in the non-PV gap group. The PF drop had the highest area under the curve of 0.878 (95% confidence interval: 0.791-0.964) on receiver operating characteristic curve analysis for predicting the PV gap, with a cutoff value of 10.5 Hz (sensitivity, 81.8%; specificity, 89.5%).

Conclusion: PF drop during PVI is a useful parameter for predicting the non-PV gap with a high probability.

查看原文本刊更多论文

峰值频率下降：一种新的术中参数预测肺静脉隔离后急性传导间隙。

背景：肺静脉隔离（PVI）后潜在间隙位置的识别和消融过程中这些警告点的预防至关重要。我们评估了电图上峰值频率（PF）的变化，并研究了其值与PVI后残余肺静脉（PV）间隙的关系。方法：我们纳入了PVI后PV间隙的患者，功率设置为50 W，使用一种新型的尖端冲洗导管（tactical flex, Abbott）。使用近场Omnipolar技术，在消融前后立即记录消融导管内所有可用消融点的双极电图PF。我们比较了PVI前后的PF值、PF的变化、接触力和PVI后有无PV间隙点之间的阻抗下降。结果：分析13例患者共695个消融点。有PV差距和没有PV差距分别为19分和676分。PVI间隙组PF下降和接触力显著低于前者（-14±43 Hz vs. 61±57 Hz）。结论：PVI期间PF下降是预测非PV间隙高概率的有用参数。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

期刊介绍： The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.