TY - JOUR
T1 - Dielectric response as a novel marker for ablation lesion quality
T2 - Relation to conventional ablation parameters
AU - Abeln, Bob G. S.
AU - van Dijk, Vincent F.
AU - Balt, Jippe C.
AU - Wijffels, Maurits C. E. F.
AU - Boersma, Lucas V. A.
N1 - Funding Information: We thank Tom Haagen from EPD Solutions for help with data extraction from the KODEX-EPD system and Ted Abeln for help with data preparation using Python. Publisher Copyright: © 2023 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.
PY - 2023/10
Y1 - 2023/10
N2 - Background: The tissue response viewer (TRV) is a novel marker for ablation lesion quality that aims to classify lesions into transmural or nontransmural lesions (high or low dielectric response, HDR or LDR) using dielectric-based tissue assessment. The objective of this study was to gain insight in the TRV by relating its outcomes to conventional ablation parameters. Methods: Patients that had repeat ablation for atrial fibrillation with a dielectric imaging-based mapping system were enrolled. All ablation data were downloaded from the mapping system and analyzed to explore associations between TRV outcomes and other ablation parameters. Results: The cohort included 24 patients, in which 58 pulmonary veins and 8 superior vena cavas were targeted. A total of 388 energy applications were applied, resulting in 639 ablation points. The system classified 36% of ablation points as HDR and 44% as LDR. The system did not provide a dielectric response in 20%. The system's ability to provide a dielectric response was related to longer ablation duration and absence of dragging ablation. HDR (versus LDR) was multivariably associated with longer energy applications, higher mean ablation power, and lower wall thickness. Greater impedance drop was univariably associated with HDR. Conclusion: Outcomes of the TRV are associated with conventional ablation parameters (e.g., duration and power) but also local wall thickness. Catheter stability seems important for successful lesion assessment with the TRV. Further reduction of missing outcomes and validation of the tool are warranted before widespread use.
AB - Background: The tissue response viewer (TRV) is a novel marker for ablation lesion quality that aims to classify lesions into transmural or nontransmural lesions (high or low dielectric response, HDR or LDR) using dielectric-based tissue assessment. The objective of this study was to gain insight in the TRV by relating its outcomes to conventional ablation parameters. Methods: Patients that had repeat ablation for atrial fibrillation with a dielectric imaging-based mapping system were enrolled. All ablation data were downloaded from the mapping system and analyzed to explore associations between TRV outcomes and other ablation parameters. Results: The cohort included 24 patients, in which 58 pulmonary veins and 8 superior vena cavas were targeted. A total of 388 energy applications were applied, resulting in 639 ablation points. The system classified 36% of ablation points as HDR and 44% as LDR. The system did not provide a dielectric response in 20%. The system's ability to provide a dielectric response was related to longer ablation duration and absence of dragging ablation. HDR (versus LDR) was multivariably associated with longer energy applications, higher mean ablation power, and lower wall thickness. Greater impedance drop was univariably associated with HDR. Conclusion: Outcomes of the TRV are associated with conventional ablation parameters (e.g., duration and power) but also local wall thickness. Catheter stability seems important for successful lesion assessment with the TRV. Further reduction of missing outcomes and validation of the tool are warranted before widespread use.
KW - atrial fibrillation
KW - dielectric imaging
KW - dielectric response
KW - electroanatomic mapping
KW - radiofrequency ablation
UR - http://www.scopus.com/inward/record.url?scp=85166617669&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/joa3.12907
DO - https://doi.org/10.1002/joa3.12907
M3 - Article
C2 - 37799786
SN - 1880-4276
VL - 39
SP - 776
EP - 783
JO - Journal of arrhythmia
JF - Journal of arrhythmia
IS - 5
ER -