Determinants of impedance during radiofrequency catheter ablation in humans

Abstract

Radiofrequency catheter ablation has become the treatment of choice for selected patients with paroxysmal supraventricular tachycardia due to atrioventricular node reentry or the Wolff-Parkinson-White syndrome. 1–3 Despite encouraging results described in several series, the optimal energy delivery strategy has not been defined. Lesion formation occurs during radiofrequency ablation as the result of resistive heating at the electrode-tissue interface. 4 The magnitude of heat generation is proportional to power density at the point of contact. 5 Electrosurgical units currently being used for radiofrequency ablation have a low source impedance and therefore approximate constant voltage sources. With such a device, one preselects a given output voltage. Applied power is proportional to the square of this output voltage and is inversely proportional to the load impedance imposed by the ablation catheter, patient and indifferent electrode. Thus, the effectiveness of any given energy application may be influenced by the impedance of the system. This study characterizes impedance during radiofrequency catheter ablation in humans, and defines the relation between clinical and ablation parameters, and measured impedance.