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1. Registro Español de Ablación con Catéter. XX Informe Oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2020)

Author

Ignasi Anguera Camós, Óscar Cano Pérez, and Rocío Cózar León

Subjects
Tachycardia, Registry, medicine.medical_specialty, TAM, taquicardia auricular macrorreentrante, AF, atrial fibrillation, medicine.medical_treatment, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Ablación con catéter, Arritmia, Catheter ablation, Article, Electrofisiología, Interquartile range, CTI, cavotricuspid isthmus, Internal medicine, medicine, Complication rate, IVT, idiopathic ventricular tachycardia, TVI, taquicardia ventricular idiopática, MAT, macrorreentrant atrial tachycardia, business.industry, TIN, taquicardia intranodular, TAF, taquicardia auricular focal, Atrial fibrillation, medicine.disease, Ablation, TV-NIAM, taquicardia ventricular asociada con cardiopatía y no relacionada con cicatriz posinfarto, Electrophysiology, Heart Rhythm, ANRT, atrioventricular nodal reentrant tachycardia, VT-AMI, ventricular tachycardia with postinfarction scar, FA, fibrilación auricular, FAT, focal atrial tachycardia, VT-NAMI, ventricular tachycardia associated with nonischemic heart disease, ICT, istmo cavotricuspídeo, TV-IAM, taquicardia ventricular relacionada con cicatriz posinfarto, Catheter Ablation, Cardiology, Registro, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Arrhythmia
Abstract

INTRODUCTION AND OBJECTIVES: This article reports the results of the 2020 Spanish Catheter Ablation Registry, a year marked by the SARS-CoV-2 pandemic. METHODS: Data were collected retrospectively through completion and return of a specific form by the participating centers. RESULTS: Data from 97 centers (67 public, 30 private) were analyzed. A total of 15 169 ablation procedures were reported with a mean of 155 ± 117 and a median [interquartile range] of 115 [62-227]. Because of the SARS-CoV-2 pandemic, both procedures and participating centers markedly decreased (-3380 procedures, -18%) and there were 5 centers less than in 2019. The most common procedure continued to be atrial fibrillation ablation (4513; 30%), well ahead of the remaining substrates, followed by ablation of the cavotricuspid isthmus (3188; 21%), and intranodal re-entry tachycardia (2808; 18%). Ablation of these 3 substrates continued to form the bulk of the procedures. The total success rate was slightly lower than in previous years (88%) with a similar complication rate (n = 309; 2%) and mortality (n = 7; 0.04%). A total of 243 procedures were performed in pediatric patients (1.6%). CONCLUSIONS: The Spanish Catheter Ablation Registry systematically and continuously reflects the national trajectory, which, in 2020, was markedly affected by the SARS-CoV-2 pandemic. Although slightly lower than in previous years, the success rate remained high, with a low complication rate.

Published
2021
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2. Role of catheter location on local impedance measurements and clinical outcome with the new direct sense technology in cardiac ablation procedures.

Author

Pesch E, Riesinger L, Vonderlin N, Kupusovic J, Koehler M, Bruns F, Janosi RA, Kochhäuser S, Dobrev D, Rassaf T, Wakili R, and Siebermair J

Abstract

Background: A novel catheter technology (direct sense, DS) enables periprocedural local impedance (LI) measurement for estimation of tissue contact during radiofrequency ablation (RFA) for real-time assessment of lesion generation. This measure reflects specific local myocardial conduction properties in contrast to the established global impedance (GI) using a neutral body electrode. Our study aimed to assess representative LI values for the cardiac chambers, to evaluate LI drop in response to RF delivery and to compare those values to established GI measures in patients undergoing RFA procedures., Methods and Results: Seventy-three patients undergoing RFA with the DS technology were included. Within the cardiac chambers, baseline LI was significantly different, with the highest values in the left atrium (LA 107.5 ± 14.3 Ω; RV 104.6 Ω ± 12.9 Ω; LV 100.7 Ω ± 11.7 Ω, and RA 100.5 Ω ± 13.4 Ω). Baseline LI was positively correlated to the corresponding LI drop during RF delivery (R 2  = 0.26, p = 0.01) representing a promising surrogate of lesion generation. The observed mean LI drop (15.6 ± 9.5 Ω) was threefold higher as GI drop (4.9 ± 7.4 Ω), p < 0.01. We evaluated the clinical outcome in a subgroup of patients undergoing DS-guided pulmonary vein isolation, which was comparable regarding arrhythmia recurrence to a conventional ablation cohort (57 % vs 50 %, p = 0.2)., Conclusion: We provide detailed information on LI measures in electrophysiological procedures with significant differences within the cardiac chambers highlighting that RFA-related LI drop can serve as a promising surrogate for real-time assessment of lesion generation. Guiding the electrophysiologist in RFA procedures, this additional information promises to improve safety profile and success rates in the interventional treatment of arrhythmias., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Authors.)

Published
2022
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