Clinical implications of local impedance measurement using the IntellaNav MiFi OI ablation catheter: an ex vivo study

Abstract

Purpose

Clinical implication of local impedance (LI) for radiofrequency (RF) ablation has not been fully established. This study aimed to investigate this point using IntellaNav MiFi OITM catheter.

Methods

LI and generator impedance drops (ΔLI and ΔGI) were evaluated in excised porcine hearts (N = 16) during RF applications at a range of powers (30 and 50 W), contact forces (5–40 g), and durations (10–180 s) using perpendicular or parallel catheter orientation. Additionally, temporal LI changes were assessed.

Results

Of the 240 lesions without steam pops (92.3%), ΔLI showed better correlations with lesion surface area (ρ = 0.55 vs 0.36, P = 0.004), maximum depth (ρ = 0.53 vs 0.14, P < 0.001), and lesion volume (ρ = 0.64 vs 0.23, P < 0.001) than ΔGI. Furthermore, %LI-drop (ΔLI/initial LI) demonstrated stronger correlations with lesion surface area (ρ = 0.60 vs 0.55, P < 0.001), maximum depth (ρ = 0.57 vs 0.53, P < 0.001), and volume (ρ = 0.69 vs 0.64, P < 0.001) than ΔLI. Parallel catheter orientation improved correlation of ΔLI with lesion surface area (ρ = 0.63 vs 0.40, P = 0.015) and depth (ρ = 0.68 vs 0.45, P = 0.008) and created a larger surface lesion (36.3[29.2–42.7] mm2 vs 28.8[21.6–34.2] mm2, P < 0.001) than the perpendicular. LI of the lesions significantly differed between baseline, immediately after RF, and 5 min after (P < 0.01). LI reaching plateau, larger initial LI, ΔLI, and %LI-drop, and larger RF power and longer duration were observed in pop lesions (P < 0.05).

Conclusions

%LI-drop demonstrated a better correlation with lesion size than ΔLI. LI may be used as an additional parameter to predict lesion size and steam pops. Temporal variation and catheter orientation should be considered to interpret LI.

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Acknowledgements

We are grateful to Mr. Tomohiro Nagao, an employee of Boston Scientific Japan, for a technical support of this experiment.

Funding

This work was supported by JSPS KAKENHI Grant Number JP20K17074.

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Affiliations

Authors

Contributions

Each author contributes to this study as follows. Conception and design of the study: Masateru Takigawa, Claire A Martin, Yoshihide Takahashi, Masahiko Goya, Tetsuo Sasano. Analysis and interpretation of data: Hidehiro Iwakawa, Masateru Takigawa, Toyoto Iwata, Claire A Martin, Tatsuhiko Anzai, Kunihiko Takahashi, Miki Amemiya, Tasuku Yamamoto, Masahiro Sekigawa, Yasuhiro Shirai, Susumu Tao, Tatsuya Hayashi, Yoshihide Takahashi. Drafting of the article: Hidehiro Iwakawa, Masateru Takigawa, Claire A Martin. Critical revision of the article for important intellectual content: Hidehiro Iwakawa, Masateru Takigawa, Claire A Martin, Yoshihide Takahashi, Masahiko Goya, Hiroyuki Watanabe, Tetsuo Sasano. Final approval of the article: Masateru Takigawa, Claire A Martin, Yoshihide Takahashi, Masahiko Goya, Hiroyuki Watanabe, Tetsuo Sasano.

Corresponding author

Correspondence to Masateru Takigawa.

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Conflict of interest

M.T. and Y.T. have received scholarship donations from Boston Scientific. C.M. has received consulting fees from Boston Scientific. Other authors declare that there are no conflicts of interest.

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Iwakawa, H., Takigawa, M., Goya, M. et al. Clinical implications of local impedance measurement using the IntellaNav MiFi OI ablation catheter: an ex vivo study. J Interv Card Electrophysiol (2021). https://doi.org/10.1007/s10840-021-00954-8

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Keywords

  • Cardiac arrhythmia
  • Catheter ablation
  • Radiofrequency
  • Local impedance
  • Lesion
  • Tissue