Dielectric response as a novel marker for ablation lesion quality: Relation to conventional ablation parameters
Abstract 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 in...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-10-01
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| Series: | Journal of Arrhythmia |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/joa3.12907 |
| _version_ | 1797666342208274432 |
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| author | Bob G. S. Abeln Vincent F. vanDijk Jippe C. Balt Maurits C. E. F. Wijffels Lucas V. A. Boersma |
| author_facet | Bob G. S. Abeln Vincent F. vanDijk Jippe C. Balt Maurits C. E. F. Wijffels Lucas V. A. Boersma |
| author_sort | Bob G. S. Abeln |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-03-11T19:57:11Z |
| format | Article |
| id | doaj.art-2502ce9e3d26498e8795c91d698fe034 |
| institution | Directory Open Access Journal |
| issn | 1880-4276 1883-2148 |
| language | English |
| last_indexed | 2024-03-11T19:57:11Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-2502ce9e3d26498e8795c91d698fe0342023-10-04T14:42:16ZengWileyJournal of Arrhythmia1880-42761883-21482023-10-0139577678310.1002/joa3.12907Dielectric response as a novel marker for ablation lesion quality: Relation to conventional ablation parametersBob G. S. Abeln0Vincent F. vanDijk1Jippe C. Balt2Maurits C. E. F. Wijffels3Lucas V. A. Boersma4Cardiology Department St. Antonius Hospital Nieuwegein the NetherlandsCardiology Department St. Antonius Hospital Nieuwegein the NetherlandsCardiology Department St. Antonius Hospital Nieuwegein the NetherlandsCardiology Department St. Antonius Hospital Nieuwegein the NetherlandsCardiology Department St. Antonius Hospital Nieuwegein the NetherlandsAbstract 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.https://doi.org/10.1002/joa3.12907atrial fibrillationdielectric imagingdielectric responseelectroanatomic mappingradiofrequency ablation |
| spellingShingle | Bob G. S. Abeln Vincent F. vanDijk Jippe C. Balt Maurits C. E. F. Wijffels Lucas V. A. Boersma Dielectric response as a novel marker for ablation lesion quality: Relation to conventional ablation parameters Journal of Arrhythmia atrial fibrillation dielectric imaging dielectric response electroanatomic mapping radiofrequency ablation |
| title | Dielectric response as a novel marker for ablation lesion quality: Relation to conventional ablation parameters |
| title_full | Dielectric response as a novel marker for ablation lesion quality: Relation to conventional ablation parameters |
| title_fullStr | Dielectric response as a novel marker for ablation lesion quality: Relation to conventional ablation parameters |
| title_full_unstemmed | Dielectric response as a novel marker for ablation lesion quality: Relation to conventional ablation parameters |
| title_short | Dielectric response as a novel marker for ablation lesion quality: Relation to conventional ablation parameters |
| title_sort | dielectric response as a novel marker for ablation lesion quality relation to conventional ablation parameters |
| topic | atrial fibrillation dielectric imaging dielectric response electroanatomic mapping radiofrequency ablation |
| url | https://doi.org/10.1002/joa3.12907 |
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