Scholarlink

Background <p>The identification of potential gap sites after pulmonary vein isolation (PVI) and prevention of these warning points during ablation are crucial. We evaluated the changes in peak frequency (PF) on electrograms and examined the relationship between its value and the residual pulmonary vein (PV) gap after PVI.</p> Methods <p>We included patients with a PV gap after PVI with a power setting of 50 W using a novel irrigated-tip catheter (TactiFlex, Abbott). The PF on bipolar electrograms in the ablation catheter was recorded immediately before and after ablation at all available ablation points, using Omnipolar technology near field. We compared the pre- and post-PF values, changes in PF, contact force, and impedance drop between points with and without a PV gap following PVI.</p> Results <p>A total of 695 ablation points in 13 patients were analyzed. There were 19 and 676 points with and without the PV gap, respectively. The PV gap group demonstrated significantly lower PF drop and contact force (-14 ± 43&#xa0;Hz vs. 61 ± 57&#xa0;Hz, <i>p</i> &lt; 0.001; and 8 [7–10] g vs. 10 [4–14] g, <i>p</i> = 0.039), and higher post-PF (226 ± 49&#xa0;Hz vs. 176 ± 47&#xa0;Hz, <i>p</i> &lt; 0.001) than in the non-PV gap group. The PF drop had the highest area under the curve of 0.878 (95% confidence interval: 0.791–0.964) on receiver operating characteristic curve analysis for predicting the PV gap, with a cutoff value of 10.5&#xa0;Hz (sensitivity, 81.8%; specificity, 89.5%).</p> Conclusion <p>PF drop during PVI is a useful parameter for predicting the non-PV gap with a high probability.</p> Graphical abstract <p>The PF drop during PVI is a useful parameter for predicting the PV gap with high probability.</p> <p>AUC, area under the curve; CI, confidence interval; PF, peak frequency; PV, pulmonary vein</p> <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Peak frequency drop: a novel intraprocedural parameter predicting acute conduction gaps post-pulmonary vein isolation

  • 期刊论文

  • 发表日期：

    2025年2月18日

查看全文
  • Yoshiaki Mizutani,
  • Yuma Matsumoto,
  • Keisuke Nishio,
  • Hiroya Sakai,
  • Gen Fujiwara,
  • Daishi Nonokawa,
  • Yuichiro Makino,
  • Hitomi Suzuki,
  • Hitoshi Ichimiya,
  • Yasuhiro Uchida,
  • Junji Watanabe,
  • Masaaki Kanashiro,
  • Satoshi Yanagisawa,
  • Yasuya Inden,
  • Toyoaki Murohara

摘要

Background

The identification of potential gap sites after pulmonary vein isolation (PVI) and prevention of these warning points during ablation are crucial. We evaluated the changes in peak frequency (PF) on electrograms and examined the relationship between its value and the residual pulmonary vein (PV) gap after PVI.

Methods

We included patients with a PV gap after PVI with a power setting of 50 W using a novel irrigated-tip catheter (TactiFlex, Abbott). The PF on bipolar electrograms in the ablation catheter was recorded immediately before and after ablation at all available ablation points, using Omnipolar technology near field. We compared the pre- and post-PF values, changes in PF, contact force, and impedance drop between points with and without a PV gap following PVI.

Results

A total of 695 ablation points in 13 patients were analyzed. There were 19 and 676 points with and without the PV gap, respectively. The PV gap group demonstrated significantly lower PF drop and contact force (-14 ± 43 Hz vs. 61 ± 57 Hz, p < 0.001; and 8 [7–10] g vs. 10 [4–14] g, p = 0.039), and higher post-PF (226 ± 49 Hz vs. 176 ± 47 Hz, p < 0.001) than in the non-PV gap group. The PF drop had the highest area under the curve of 0.878 (95% confidence interval: 0.791–0.964) on receiver operating characteristic curve analysis for predicting the PV gap, with a cutoff value of 10.5 Hz (sensitivity, 81.8%; specificity, 89.5%).

Conclusion

PF drop during PVI is a useful parameter for predicting the non-PV gap with a high probability.

Graphical abstract

The PF drop during PVI is a useful parameter for predicting the PV gap with high probability.

AUC, area under the curve; CI, confidence interval; PF, peak frequency; PV, pulmonary vein