Mori Hitoshi, Fukaya Hidehira, Matsumoto Kazuhisa, Narita Masataka, Naganuma Tsukasa, Sasaki Wataru, Tanaka Naomichi, Kawano Daisuke, Ikeda Yoshifumi, Matsumoto Kazuo, Kato Ritsushi
Department of Cardiology, Saitama Medical University, International Medical Center, Hidaka, Saitama, Japan.
Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
Pacing Clin Electrophysiol. 2025 Feb;48(2):216-223. doi: 10.1111/pace.15144. Epub 2025 Jan 27.
The IntellaNav MiFi OI catheter (MiFi) is equipped with a sensor for local impedance (LI) monitoring and three mini-electrodes. In this study, we investigated the target LI values for a successful pulmonary vein isolation (PVI) under the pacing and ablation technique using the MiFi catheter.
Twenty-seven patients underwent PVI using the MiFi catheter under mini electrode pacing from the MiFi catheter. The local impedance (LI) changes, generator impedance (GI) changes, and the time to capture loss were evaluated.
First-pass isolations were obtained in 15 patients (57.7 %) for right PVs and in 22 patients (84.6 %) for left PVs. At gap sites, the impedance decrease was smaller than at non-gap sites (non-gap sites vs. gap sites; LI drop, 23.2 [±10.3] vs. 15.6 [±7.7] Ω, p < 0.0001; GI drop, 4.8 [±4.1] vs. 2.7 [3.9] Ω, p = 0.0026; %LI drop, -19.3 [±7.4] vs. -13.1 [±6.1] %, p < 0.0001; % GI drop, -5.1 [±4.2] vs. -2.9 [±4.2] %, p = 0.0020), suggesting that changes in impedance could be useful for predicting gaps. The cutoff values for predicting no gaps were identified as 15.0 Ω for the LI drop and -13.74% for the %LI drop.
The LI showed greater changes than the GI and was also useful for predicting gaps. The cutoff values of 15.0 Ω for the LI drop and -13.74% for the %LI drop could predict conduction gaps. Under the monitoring of the LI, the pacing and ablation technique proved useful for PVI, even though the MiFi catheter does not have a CF sensor or ablation indices.
IntellaNav MiFi OI导管（MiFi）配备了用于局部阻抗（LI）监测的传感器和三个微型电极。在本研究中，我们研究了在使用MiFi导管的起搏和消融技术下成功进行肺静脉隔离（PVI）的目标LI值。
27例患者在MiFi导管的微型电极起搏下使用MiFi导管进行PVI。评估局部阻抗（LI）变化、发生器阻抗（GI）变化和捕获丧失时间。
右肺静脉首次隔离成功率为15例（57.7%），左肺静脉为22例（84.6%）。在间隙部位，阻抗下降小于非间隙部位（非间隙部位与间隙部位；LI下降，23.2[±10.3]对15.6[±7.7]Ω，p<0.0001；GI下降，4.8[±4.1]对2.7[3.9]Ω，p=0.0026；%LI下降，-19.3[±7.4]对-13.1[±6.1]%，p<0.0001；%GI下降，-5.1[±4.2]对-2.9[±4.2]%，p=0.0020），这表明阻抗变化可能有助于预测间隙。预测无间隙的截断值确定为LI下降15.0Ω和%LI下降-13.74%。
LI变化比GI变化更大，也有助于预测间隙。LI下降的截断值为15.0Ω，%LI下降的截断值为-13.74%，可预测传导间隙。在LI监测下，尽管MiFi导管没有CF传感器或消融指数，但起搏和消融技术被证明对PVI有用。
