ArticleHCA healthcare journal of medicine2025
Optimal Local Impedance Parameters for Catheter Ablation of the Cavo-tricuspid Isthmus in Atrial Flutter Patients: A Retrospective Analysis.
Article in HCA healthcare journal of medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Atrial flutter is a common arrhythmia, and catheter ablation offers a potentially curative intervention. However, there is a continued desire to enhance the procedure's efficiency and safety to optimize patient outcomes. Recently, local impedance (LI) has garnered attention as a novel approach to optimizing ablation procedures. The parameters of LI change when associated with durable ablation lesions for cavo-tricuspid isthmus (CTI) which remains poorly defined. This study aims to address this gap through analysis of gathered data. Methods: We conducted a retrospective data analysis of 121 consecutive patients who underwent local impedance-guided catheter ablation of the CTI for typical atrial flutter. The durability of the ablated lesions was assessed using high-resolution activation and voltage mapping to detect conduction gaps. The maximum LI drop was calculated for each ablation point. Each point was assessed by 3-dimensional electroanatomic mapping with binary categorization denoting either durable/successful ablation lesion or non-durable/unsuccessful ablation lesion. In addition, subjective evaluation of catheter-tissue contact was assessed by a single proceduralist using intracardiac echocardiography (ICE) and was then stratified as high-level contact, intermediate-level contact, and low-level contact. A total of 1814 ablation points were analyzed. Results: The mean maximum drop in LI was significantly different ( Conclusion: Our results give insight into the relationship between maximal local impedance change and the achievement of a durable block along the CTI.
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