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Comparison of two catheters measuring local impedance: local impedance variation vs lesion characteristics and steam pops

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

The size of the distal electrode and the method of measuring local impedance (LI) are different between the IntellaNav MiFi-OI™ (MiFi-OI) and IntellaNav STABLE POINT™ (SP) catheters. We investigated the impact of these differences on LI, efficacy, and safety of radiofrequency (RF) applications.

Methods

RF applications at a range of powers (30 W, 40 W, and 50 W), contact forces (10 g and 20 g), and durations (10–120 s) were performed in excised porcine hearts (N = 48). LI variation was defined by δLI-drop (= initial LI − post-RF LI) and %LI-drop (= δLI-drop/initial LI) × 100, and the relationship between lesion characteristics and LI variation was compared.

Results

A total of 576 lesions were examined. Although absolute δLI-drop during RF applications was significantly larger for the SP than MiFi-OI catheter (47[31–65]ohm for SP vs 37[24–51]ohm for MiFi-OI, p < 0.0001), %LI-drop was similar (23.3 [15.5–30.6]% in SP vs 24.9[17.3–32.5]% in MiFi-OI, p = 0.10). Although lesions produced by both catheters were similarly correlated with LI variation, the SP catheter produced generally larger lesions (depth; 5.0 [3.7–6.1]mm vs 4.7 [3.3–6.0]mm, p = 0.06; surface areas, 46.9 [36.8–58.8]mm2 vs 44.7 [34.3–55.5]mm2, p = 0.02; volume, 321 [165–533]mm3 vs 265[141–471]mm3, p = 0.02). Steam pops were similarly observed with both catheters. In both catheters, %LI-drop was superior to δLI-drop in correlation to lesion size (p < 0.0001) and in predicting steam pops (p < 0.01).

Conclusions

Although no difference in safety profile is observed between MiFi-OI and SP catheters, the SP catheter produces larger lesions. %LI-drop is superior to δLI-drop in correlation to lesion size and in predicting steam pops as well as in normalizing the difference between catheters.

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Acknowledgements

We are grateful to Mr. Tomohiro Nagao, an employee of Boston Scientific Japan, for a technical support of this experiment.

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Author notes

  1. Miki Amemiya and Masateru Takigawa were equally contributed to this work as a first author.

Authors and Affiliations

  1. Department of Cardiology, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan

    Miki Amemiya, Masateru Takigawa, Masahiko Goya, Yuki Shimizu, Takashi Ikenouchi, Tatsuaki Kamata, Tasuku Yamamoto, Takuro Nishimura, Yasuhiro Shirai, Susumu Tao, Shinsuke Miyazaki & Tetsuo Sasano

  2. Department of Cardiology, Royal Papworth Hospital, Papworth Road, Cambridge Biomedical Campus, Cambridge, CB2 OAY, UK

    Claire A. Martin

  3. Department of Biostatistics M&D Data Science Center, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan

    Tatsuhiko Anzai & Kunihiko Takahashi

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  1. Miki Amemiya
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Corresponding author

Correspondence to Masateru Takigawa.

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Ethics approval

The ethical committee of Tokyo Medical and Dental University granted an exemption from requiring ethics approval because this research was neither a clinical study nor an animal experiment.

Conflict of interest

Dr. Martin and Dr. Miyazaki have received consulting fees from Boston Scientific. Dr. Takigawa and Miyazaki received endowments from Medtronic Japan, Boston Scientific, Japan Lifeline, and WIN international. All other authors declare no competing interests.

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Amemiya, M., Takigawa, M., Goya, M. et al. Comparison of two catheters measuring local impedance: local impedance variation vs lesion characteristics and steam pops. J Interv Card Electrophysiol 65, 419–428 (2022). https://doi.org/10.1007/s10840-022-01214-z

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  • DOI: https://doi.org/10.1007/s10840-022-01214-z

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