Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Experimental methods D-PO01 - Featured Poster Session (ID 11) Poster

D-PO01-178 - First Clinical Experience, Feasibility Of The Multi Electrode Impedance System To Assess Individual Electrode Contact With Circular Multi Electrode Catheters (ID 952)

 R. Van Es: Nothing relevant to disclose.


Background: Electrode-tissue contact is an important predictor for the success of pulmonary vein isolation (PVI). With circular multi-electrode ablation catheters, as used for irreversible electroporation (IRE), measuring electrode-tissue contact force for each individual electrode is technically challenging. We have developed the Multi Electrode Impedance System (MEIS) that measures individual electrode tissue contact by applying a small current between adjacent electrode pairs while measuring the voltage between every electrode and a skin patch.
Objective: Determine the feasibility of MEIS to assess individual electrode tissue contact using a circular multi-electrode catheter.
Methods: In 6 patients undergoing PVI with IRE, MEIS was used to record individual electrode contact while electrograms were recorded using an electrophysiology recording system (Prucka CardioLab). A >30s section of the recordings during which a 7 French 14-electrode (2.5mm electrodes; 2.5 mm spacing) circular IRE ablation catheter was roving in the left atrium was selected for analysis. MEIS values during the P-wave and maximum absolute unipolar electrogram dV/dt of the P-wave were determined. A three-level linear mixed model was fitted to compare MEIS with dV/dt, using a random slope and random intercept per patient and electrode.
Results: A total of 7462 measurements (89±45 per patient on 14 electrodes) were performed. MEIS showed a significant relation with unipolar dV/dt (r2=0.502, p<0.001) with a slope of 10mV/s per Ohm.
Conclusion: MEIS showed a significant relation with dV/dt that is commonly used as a surrogate measure of electrode-tissue contact.