ArticleJournal of arrhythmia2026
Contact Index-Guided Pulsed Field Ablation: A Two-Phase Validation of the Impedance Change Threshold to Prevent Acute Pulmonary Vein Gaps.
Article in Journal of arrhythmia, 2026. 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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8 authors.
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Abstract
Background: Pulsed field ablation (PFA) for atrial fibrillation (AF) requires adequate catheter-tissue contact. The Contact Index visualizes impedance change for the pentaspline catheter, but a validated contact threshold is unknown. Objective: The objective of this study is to define an impedance-change cutoff that predicts sufficient contact to prevent acute pulmonary vein gaps (PVG) during pulmonary vein isolation (PVI), and to validate Contact-Index-guided PVI. Methods: A prospective, single-center, two-phase study was performed. Phase 1 ( Results: In Phase 1, PVG occurred in 13/320 segments across 2/10 patients (4/40 veins). Impedance change was lower at PVG-positive than PVG-negative segments (median 2 [0-6.5]% vs. 24 [17-32]%, Conclusions: An impedance-change threshold of ≥ 10% on the Contact Index reliably indicates adequate contact with the pentaspline catheter and, when enforced, reduces acute PVG without prolonging procedures.
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