Pacing and Ablation Technique Using Microelectrode for Pulmonary Vein Isolation Using a Local Impedance-Guided...

Area of Science:

• Electrophysiology
• Medical Device Technology
• Cardiac Ablation

Background:

• The IntellaNav MiFi OI catheter features local impedance (LI) monitoring and mini-electrodes.
• Pulmonary vein isolation (PVI) is a key procedure in treating cardiac arrhythmias.

Purpose of the Study:

• To investigate target LI values for successful PVI using the MiFi catheter with pacing and ablation.
• To evaluate the utility of LI changes in predicting conduction gaps during PVI.

Main Methods:

• Twenty-seven patients underwent PVI using the MiFi catheter with mini-electrode pacing.
• Local impedance (LI) changes, generator impedance (GI) changes, and time to capture loss were assessed.

Main Results:

• First-pass isolation was achieved in 57.7% of right PVs and 84.6% of left PVs.
• Smaller impedance drops (LI and GI) were observed at gap sites compared to non-gap sites (p < 0.0001 for LI drop).
• Cutoff values for predicting no gaps were identified: 15.0 Ω for LI drop and -13.74% for %LI drop.

Conclusions:

• LI changes are more significant than GI changes and effectively predict conduction gaps during PVI.
• Identified cutoff values for LI drop can predict the absence of gaps, aiding PVI success.
• LI monitoring with the MiFi catheter supports effective PVI using pacing and ablation, even without CF sensors.