A novel local impedance algorithm to guide effective pulmonary vein isolation in atrial fibrillation patients: Preliminary experience across different ablation sites from the CHARISMA pilot study

• Published in: Journal of cardiovascular electrophysiology 2020-09, Vol.31 (9), p.2319-2327
• Main Authors: Segreti, Luca, De Simone, Antonio, Schillaci, Vincenzo, Bongiorni, Maria Grazia, Pelargonio, Gemma, Pandozi, Claudio, Di Cori, Andrea, Stabile, Giuseppe, Pepe, Marco, Zucchelli, Giulio, Shopova, Gergana, De Lucia, Raffaele, Ferrari, Chiara, Casati, Francesca, Malacrida, Maurizio, Solimene, Francesco
• Format: Article
• Language: English
• Subjects: Ablation; Algorithms; atrial fibrillation; Cardiac arrhythmia; catheter ablation; Catheters; DirectSense; Fibrillation; lesion formation; local impedance; Steam; Voltage
• ISSN: 1045-3873; 1540-8167
• DOI: 10.1111/jce.14647

Introduction Recently, a novel technology able to measure local impedance (LI) and tissue characteristics has been made available for clinical use. This analysis explores the relationships among LI and generator impedance (GI) parameters in atrial fibrillation (AF) patients. Characterization of LI among different ablation spots and procedural success were also evaluated. Methods and Results Consecutive patients undergoing AF ablation from the CHARISMA registry at five Italian centers were included. A novel radiofrequency (RF) ablation catheter with a dedicated algorithm (DIRECTSENSE™) was used to measure LI and to guide ablation. The ablation endpoint was pulmonary vein (PV) isolation. We analyzed 2219 ablation spots created around PVs in 46 patients for AF ablation. The mean baseline tissue impedance was 105.8 ± 14 Ω for LI versus 91.8 ± 10 Ω for GI (p