Gavin S Chu1,2, Peter Calvert1,3, Piotr Futyma4, Wern Yew Ding1,3, Richard Snowdon1, Dhiraj Gupta1,3. 1. Department of Cardiology, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK. 2. Department of Cardiovascular Sciences, University of Leicester, Leicester, UK. 3. Research Unit, Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK. 4. Department of Cardiology, Medical College of the University of Rzeszów, St. Joseph's Heart Rhythm Center, Rzeszów, Poland, Rzeszów, Poland.
Abstract
INTRODUCTION: Radiofrequency catheter ablation is a cornerstone of treatment for many cardiac arrhythmias. Progression in three-dimensional mapping and contact-force sensing technologies have improved our capability to achieve success, but challenges still remain. METHODS: In this article, we discuss the importance of overall circuit impedance in radiofrequency lesion formation. This is followed by a review of the literature regarding recently developed "local impedance" technology and its current and future potential applications and limitations, in the context of established surrogate markers currently used to infer effective ablation. RESULTS: We discuss the role of local impedance in assessing myocardial substrate, as well as its role in clinical studies of ablation. We also discuss safety considerations, limitations and ongoing research. CONCLUSION: Local impedance is a novel tool which has the potential to tailor ablation in a manner distinct from other established metrics.
INTRODUCTION: Radiofrequency catheter ablation is a cornerstone of treatment for many cardiac arrhythmias. Progression in three-dimensional mapping and contact-force sensing technologies have improved our capability to achieve success, but challenges still remain. METHODS: In this article, we discuss the importance of overall circuit impedance in radiofrequency lesion formation. This is followed by a review of the literature regarding recently developed "local impedance" technology and its current and future potential applications and limitations, in the context of established surrogate markers currently used to infer effective ablation. RESULTS: We discuss the role of local impedance in assessing myocardial substrate, as well as its role in clinical studies of ablation. We also discuss safety considerations, limitations and ongoing research. CONCLUSION: Local impedance is a novel tool which has the potential to tailor ablation in a manner distinct from other established metrics.