Novel Measure of Local Impedance Predicts Catheter-Tissue Contact and Lesion Formation
Novel Measure of Local Impedance Predicts Catheter-Tissue Contact and Lesion Formation
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DOI：
10.1161/circep.117.005831
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发表时间：
2018-04-01
影响因子：
8.4
通讯作者：
Bollmann, Andreas
中科院分区：
文献类型：
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作者：
Sulkin, Matthew S.;Laughner, Jacob I.;Bollmann, Andreas
背景：消融导管与心肌之间的耦合对于射频消融的组织热传导至关重要。本研究的目的是评估消融导管上的新型局部阻抗（LI）测量是否可识别导管组织耦合并预测损伤形成。（n=10只猪）和体内（n=10; 50-70 kg猪），使用试验用电解剖标测系统测量消融导管的阻抗，远端电极中包含电极（Rhythmia和IntellaNav MiFi OI，Boston Scientific）。将取出的组织放置在安装在天平上的温热（37 ℃）盐水浴中，在多个导管角度下测量距离组织15 mm至导管组织压缩5 mm处的LI。用31和50 W持续5至45秒创建病变（n=90）。在LI的体内评价期间，通过心内超声引导心肌（n=90）和血池（n=30）的测量，而操作者对LI数据不知情。在心室中用31和50 W持续45秒创建病变（n=72）。心肌LI（119.7 Omega）明显大于血池LI（67.6 Omega; P
BACKGROUND: Coupling between the ablation catheter and myocardium is critical to resistively heat tissue with radiofrequency ablation. The objective of this study was to evaluate whether a novel local impedance (LI) measurement on an ablation catheter identifies cathetertissue coupling and is predictive of lesion formation.METHODS AND RESULTS: LI was studied in explanted hearts (n=10 swine) and in vivo (n=10; 50-70 kg swine) using an investigational electroanatomic mapping system that measures impedance from an ablation catheter with mini-electrodes incorporated in the distal electrode (Rhythmia and IntellaNav MiFi OI, Boston Scientific). Explanted tissue was placed in a warmed (37 degrees C) saline bath mounted on a scale, and LI was measured 15 mm away from tissue to 5 mm of cathetertissue compression at multiple catheter angles. Lesions were created with 31 and 50 W for 5 to 45 seconds (n=90). During in vivo evaluation of LI, measurements of myocardium (n=90) and blood pool (n=30) were guided by intracardiac ultrasound while operators were blinded to LI data. Lesions were created with 31 and 50 W for 45 seconds in the ventricles (n=72). LI of myocardium (119.7 Omega) was significantly greater than that of blood pool (67.6 Omega; P