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Local impedance guides catheter ablation in patients with ventricular tachycardia

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Local impedance guides catheter ablation in patients with ventricular tachycardia. / Münkler, Paula; Gunawardene, Melanie A; Jungen, Christiane; Klatt, Niklas; Schwarzl, Jana M; Akbulak, Ruken Ö; Dinshaw, Leon; Hartmann, Jens; Jularic, Mario; Kahle, Ann-Kathrin; Riedel, René; Merbold, Lydia; Eickholt, Christian; Willems, Stephan; Meyer, Christian.

In: J CARDIOVASC ELECTR, Vol. 31, No. 1, 01.01.2020, p. 61-69.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Münkler, P, Gunawardene, MA, Jungen, C, Klatt, N, Schwarzl, JM, Akbulak, RÖ, Dinshaw, L, Hartmann, J, Jularic, M, Kahle, A-K, Riedel, R, Merbold, L, Eickholt, C, Willems, S & Meyer, C 2020, 'Local impedance guides catheter ablation in patients with ventricular tachycardia', J CARDIOVASC ELECTR, vol. 31, no. 1, pp. 61-69. https://doi.org/10.1111/jce.14269

APA

Münkler, P., Gunawardene, M. A., Jungen, C., Klatt, N., Schwarzl, J. M., Akbulak, R. Ö., Dinshaw, L., Hartmann, J., Jularic, M., Kahle, A-K., Riedel, R., Merbold, L., Eickholt, C., Willems, S., & Meyer, C. (2020). Local impedance guides catheter ablation in patients with ventricular tachycardia. J CARDIOVASC ELECTR, 31(1), 61-69. https://doi.org/10.1111/jce.14269

Vancouver

Münkler P, Gunawardene MA, Jungen C, Klatt N, Schwarzl JM, Akbulak RÖ et al. Local impedance guides catheter ablation in patients with ventricular tachycardia. J CARDIOVASC ELECTR. 2020 Jan 1;31(1):61-69. https://doi.org/10.1111/jce.14269

Bibtex

@article{a21e80c66c284b56a38473c7096fdbad,
title = "Local impedance guides catheter ablation in patients with ventricular tachycardia",
abstract = "AIMS: Catheter contact and local tissue characteristics are relevant information for successful radiofrequency current (RFC)-ablation. Local impedance (LI) has been shown to reflect tissue characteristics and lesion formation during RFC-ablation. Using a novel ablation catheter incorporating three mini-electrodes, we investigated LI in relation to generator impedance (GI) in patients with ventricular tachycardia (VT) and its applicability as an indicator of effective RFC-ablation.METHODS AND RESULTS: Baseline impedance, Δimpedance during ablation and drop rate (Δimpedance/time) were analyzed for 625 RFC-applications in 28 patients with recurrent VT undergoing RFC-ablation. LI was lower in scarred (87.0 Ω [79.0-95.0]) compared to healthy myocardium (97.5 Ω ([82.75-111.50]; P = .03) while GI did not differ between scarred and healthy myocardium. ΔLI was higher (18 Ω [9.4-26.0]) for VT-terminating as compared to non-terminating RFC-ablation (ΔLI 13 Ω [8.85-18.0]; P = .03), but did not differ for ΔGI between terminating vs nonterminating RFC-ablation. Correspondingly, LI drop rate was higher for RFC-ablation terminating the VT compared with RFC-ablation not terminating the VT (0.63 Ω/s [0.52-0.76] vs 0.32 Ω [0.20-0.58]; P = .008) while there was no difference for GI drop rate. ΔLI was higher in patients with nonischemic cardiomyopathy vs patients with ischemic cardiomyopathy (16 Ω [11.0-20.0] vs 11.0 Ω [7.85-17.00]; P = .003).CONCLUSION: Our findings suggest that LI is a sensitive parameter to guide RFC-ablation in patients with VT. LI indicates differences in tissue characteristics and generally is higher in patients with nonischemic cardiomyopathy. Hence, the etiology of the underlying cardiomyopathy needs to be considered when adopting LI for monitoring catheter ablation of VT.",
keywords = "Action Potentials, Aged, Cardiomyopathies/complications, Catheter Ablation/adverse effects, Electric Impedance, Female, Heart Rate, Humans, Male, Middle Aged, Risk Factors, Tachycardia, Ventricular/diagnosis, Time Factors, Treatment Outcome",
author = "Paula M{\"u}nkler and Gunawardene, {Melanie A} and Christiane Jungen and Niklas Klatt and Schwarzl, {Jana M} and Akbulak, {Ruken {\"O}} and Leon Dinshaw and Jens Hartmann and Mario Jularic and Ann-Kathrin Kahle and Ren{\'e} Riedel and Lydia Merbold and Christian Eickholt and Stephan Willems and Christian Meyer",
note = "{\textcopyright} 2019 The Authors. Journal of Cardiovascular Electrophysiology published by Wiley Periodicals, Inc.",
year = "2020",
month = jan,
day = "1",
doi = "10.1111/jce.14269",
language = "English",
volume = "31",
pages = "61--69",
journal = "J CARDIOVASC ELECTR",
issn = "1045-3873",
publisher = "Wiley-Blackwell",
number = "1",

}

RIS

TY - JOUR

T1 - Local impedance guides catheter ablation in patients with ventricular tachycardia

AU - Münkler, Paula

AU - Gunawardene, Melanie A

AU - Jungen, Christiane

AU - Klatt, Niklas

AU - Schwarzl, Jana M

AU - Akbulak, Ruken Ö

AU - Dinshaw, Leon

AU - Hartmann, Jens

AU - Jularic, Mario

AU - Kahle, Ann-Kathrin

AU - Riedel, René

AU - Merbold, Lydia

AU - Eickholt, Christian

AU - Willems, Stephan

AU - Meyer, Christian

N1 - © 2019 The Authors. Journal of Cardiovascular Electrophysiology published by Wiley Periodicals, Inc.

PY - 2020/1/1

Y1 - 2020/1/1

N2 - AIMS: Catheter contact and local tissue characteristics are relevant information for successful radiofrequency current (RFC)-ablation. Local impedance (LI) has been shown to reflect tissue characteristics and lesion formation during RFC-ablation. Using a novel ablation catheter incorporating three mini-electrodes, we investigated LI in relation to generator impedance (GI) in patients with ventricular tachycardia (VT) and its applicability as an indicator of effective RFC-ablation.METHODS AND RESULTS: Baseline impedance, Δimpedance during ablation and drop rate (Δimpedance/time) were analyzed for 625 RFC-applications in 28 patients with recurrent VT undergoing RFC-ablation. LI was lower in scarred (87.0 Ω [79.0-95.0]) compared to healthy myocardium (97.5 Ω ([82.75-111.50]; P = .03) while GI did not differ between scarred and healthy myocardium. ΔLI was higher (18 Ω [9.4-26.0]) for VT-terminating as compared to non-terminating RFC-ablation (ΔLI 13 Ω [8.85-18.0]; P = .03), but did not differ for ΔGI between terminating vs nonterminating RFC-ablation. Correspondingly, LI drop rate was higher for RFC-ablation terminating the VT compared with RFC-ablation not terminating the VT (0.63 Ω/s [0.52-0.76] vs 0.32 Ω [0.20-0.58]; P = .008) while there was no difference for GI drop rate. ΔLI was higher in patients with nonischemic cardiomyopathy vs patients with ischemic cardiomyopathy (16 Ω [11.0-20.0] vs 11.0 Ω [7.85-17.00]; P = .003).CONCLUSION: Our findings suggest that LI is a sensitive parameter to guide RFC-ablation in patients with VT. LI indicates differences in tissue characteristics and generally is higher in patients with nonischemic cardiomyopathy. Hence, the etiology of the underlying cardiomyopathy needs to be considered when adopting LI for monitoring catheter ablation of VT.

AB - AIMS: Catheter contact and local tissue characteristics are relevant information for successful radiofrequency current (RFC)-ablation. Local impedance (LI) has been shown to reflect tissue characteristics and lesion formation during RFC-ablation. Using a novel ablation catheter incorporating three mini-electrodes, we investigated LI in relation to generator impedance (GI) in patients with ventricular tachycardia (VT) and its applicability as an indicator of effective RFC-ablation.METHODS AND RESULTS: Baseline impedance, Δimpedance during ablation and drop rate (Δimpedance/time) were analyzed for 625 RFC-applications in 28 patients with recurrent VT undergoing RFC-ablation. LI was lower in scarred (87.0 Ω [79.0-95.0]) compared to healthy myocardium (97.5 Ω ([82.75-111.50]; P = .03) while GI did not differ between scarred and healthy myocardium. ΔLI was higher (18 Ω [9.4-26.0]) for VT-terminating as compared to non-terminating RFC-ablation (ΔLI 13 Ω [8.85-18.0]; P = .03), but did not differ for ΔGI between terminating vs nonterminating RFC-ablation. Correspondingly, LI drop rate was higher for RFC-ablation terminating the VT compared with RFC-ablation not terminating the VT (0.63 Ω/s [0.52-0.76] vs 0.32 Ω [0.20-0.58]; P = .008) while there was no difference for GI drop rate. ΔLI was higher in patients with nonischemic cardiomyopathy vs patients with ischemic cardiomyopathy (16 Ω [11.0-20.0] vs 11.0 Ω [7.85-17.00]; P = .003).CONCLUSION: Our findings suggest that LI is a sensitive parameter to guide RFC-ablation in patients with VT. LI indicates differences in tissue characteristics and generally is higher in patients with nonischemic cardiomyopathy. Hence, the etiology of the underlying cardiomyopathy needs to be considered when adopting LI for monitoring catheter ablation of VT.

KW - Action Potentials

KW - Aged

KW - Cardiomyopathies/complications

KW - Catheter Ablation/adverse effects

KW - Electric Impedance

KW - Female

KW - Heart Rate

KW - Humans

KW - Male

KW - Middle Aged

KW - Risk Factors

KW - Tachycardia, Ventricular/diagnosis

KW - Time Factors

KW - Treatment Outcome

U2 - 10.1111/jce.14269

DO - 10.1111/jce.14269

M3 - SCORING: Journal article

C2 - 31701589

VL - 31

SP - 61

EP - 69

JO - J CARDIOVASC ELECTR

JF - J CARDIOVASC ELECTR

SN - 1045-3873

IS - 1

ER -