Use of impedance-based catheter tip-to-tissue contact assessment (electroanatomic coupling index, ECI) in typical right atrial flutter ablation

Purpose The electrical coupling index (ECI) (Abbott, USA) is a marker of tissue contact and ablation depth developed particularly for atrial fibrillation treatment. We sought to evaluate if these measures can be also a marker of lesion efficacy during cavotricuspid isthmus (CTI) ablation for typical...

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Bibliographic Details
Published in:Journal of interventional cardiac electrophysiology 2018-11, Vol.53 (2), p.225-231
Main Authors: Maines, Massimiliano, Peruzza, Francesco, Zorzi, Alessandro, Catanzariti, Domenico, Angheben, Carlo, Del Greco, Maurizio
Format: Article
Language:English
Subjects:
Ablation
Aged
Anatomic Landmarks - diagnostic imaging
Atrial Flutter - diagnostic imaging
Atrial Flutter - surgery
Body Surface Potential Mapping - methods
Cardiac Catheters
Cardiology
Catheters
Cohort Studies
Complications
Coupling
Electric contacts
Electric Impedance
Electrocardiography
Equipment Design
Female
Fibrillation
Flutter
Humans
Impedance
Male
Males
Medical instruments
Medicine
Medicine & Public Health
Middle Aged
Multimedia Report
Patients
Prognosis
Radio frequency
Recurrence
Reoperation - methods
Risk Assessment
ROC Curve
Treatment Outcome
Vibration
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Summary:Purpose The electrical coupling index (ECI) (Abbott, USA) is a marker of tissue contact and ablation depth developed particularly for atrial fibrillation treatment. We sought to evaluate if these measures can be also a marker of lesion efficacy during cavotricuspid isthmus (CTI) ablation for typical right atrial flutter. Methods We assessed the ECI values in patients undergoing typical right atrial flutter point-by-point ablation guided by the Ensite Velocity Contact™ (St. Jude Medical, now Abbott St. Paul, MN, USA) electroanatomic mapping system. ECI values were collected before, during (at the plateau), and after radiofrequency (RF) delivery. The physician was blinded to ECI and judged ablation efficacy according to standard parameters (impedance drop, local potential reduction, and/or split in two separate potentials). Patients were followed up at 3 and 12 months. Results Fifteen consecutive patients (11 males, mean age 69.2 ± 10.6 years) with a history of typical right atrial flutter were included in this study. A total of 158 RF applications were assessed (mean 10.5 ± 6.6 per patient, range 6–28). The absolute and percentage ECI variations (pre-/post-ablation) were significantly greater when applications were effective ( p  
ISSN:1383-875X
1572-8595
DOI:10.1007/s10840-018-0375-6