Evaluation and comparison of impedance and amplitude changes in lesion index‐guided pulmonary vein isolation

作者：Yutaro Kaneko, Yoshihisa Naruse, Taro Narumi, Makoto Sano, Tsuyoshi Urushida, Yuichiro Maekawa · 发表于：Journal of Arrhythmia · 年份：2023 · DOI：10.1002/joa3.12966 · 被引用次数：2 · 研究领域：Cardiac Arrhythmias and Treatments、Atrial Fibrillation Management and Outcomes、Cardiac pacing and defibrillation studies

Background: The lesion index (LSI) has been used to estimate lesion formation after radiofrequency catheter ablation. However, the impedance drop and decrease in bipolar amplitude of intracardiac electrograms, which are parameters that are traditionally used to predict effective ablation lesions, are not used to calculate LSI. Therefore, we aimed to investigate the association between LSI and traditional parameters. Methods: = 379). The LSI targets were 4.5 for the posterior left atrium and 5.2 for the anterior left atrium. After excluding 583 points at which it was difficult to measure the amplitude, 772 ablation points during sinus rhythm were included in the analysis of bipolar amplitude. Results: The target LSI was achieved at 1177 points (86.9%). The median total impedance drop and amplitude just after ablation were 16.0 [13.0-20.0] Ω and 0.21 [0.14-0.30] mV, respectively. There were significant differences among the 3 groups in the impedance and amplitude before ablation, power, target LSI, final LSI, contact force, and interlesion distance. An impedance drop of >10 Ω or an amplitude reduction of >50% was achieved at 95% and 82% of the study points, respectively. There were no major complications at any of the ablation points. Conclusion: LSI-guided PVI seemed to be useful for making sufficient ablation lesions, as assessed by the conventional parameters of impedance and amplitude change.