{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T10:31:50Z","timestamp":1793442710390,"version":"4.5.0"},"reference-count":0,"publisher":"HCA Healthcare","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HCA Healthcare Journal of Medicine"],"abstract":"<jats:p>Background \nAtrial flutter is a common arrhythmia, and catheter ablation offers a potentially curative intervention. However, there is a continued desire to enhance the procedure\u2019s efficiency and safety to optimize patient outcomes. Recently, local impedance (LI) has garnered attention as a novel approach to optimizing ablation procedures. The parameters of LI change when associated with durable ablation lesions for cavo-tricuspid isthmus (CTI) which remains poorly defined. This study aims to address this gap through analysis of gathered data.\nMethods \nWe conducted a retrospective data analysis of 121 consecutive patients who underwent local impedance-guided catheter ablation of the CTI for typical atrial flutter. The durability of the ablated lesions was assessed using high-resolution activation and voltage mapping to detect conduction gaps. The maximum LI drop was calculated for each ablation point. Each point was assessed by 3-dimensional electroanatomic mapping with binary categorization denoting either durable\/successful ablation lesion or non-durable\/unsuccessful ablation lesion. In addition, subjective evaluation of catheter-tissue contact was assessed by a single proceduralist using intracardiac echocardiography (ICE) and was then stratified as high-level contact, intermediate-level contact, and low-level contact. A total of 1814 ablation points were analyzed.\nResults \nThe mean maximum drop in LI was significantly different (P &lt; .0001) between the -16.38 ohms (95% confidence interval [CI], -17.54 to -15.23) for unsuccessful lesions and -20.79 ohms (95% CI, -21.20 to -20.38) for successful lesions. Among patients with at least 1 unsuccessful lesion, the maximum drop in LI was -16.38 for those that were unsuccessful in comparison to -19.81 for successful lesions (95% CI [-20.56, -19.06], P &lt; .0001). The mean maximum drop in LI was progressively smaller moving from the high-level contact group (-25.93 \u00b1 9.35), to the intermediate-level contact group (-19.04 \u00b1 7.64), and again for the low-level contact group (-13.84 \u00b1 6.93).\nConclusion \nOur results give insight into the relationship between maximal local impedance change and the achievement of a durable block along the CTI.<\/jats:p>","DOI":"10.36518\/2689-0216.2153","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T18:39:42Z","timestamp":1767379182000},"source":"Crossref","is-referenced-by-count":1,"title":["Optimal Local Impedance Parameters for Catheter Ablation of the Cavo-tricuspid Isthmus in Atrial Flutter Patients: A Retrospective Analysis"],"prefix":"10.36518","volume":"6","author":[{"given":"Yamann","family":"Sahlool","sequence":"first","affiliation":[{"name":"Los Robles Regional Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yann","family":"Dacquay","sequence":"additional","affiliation":[{"name":"Los Robles Regional Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saro","family":"Avedikian","sequence":"additional","affiliation":[{"name":"Los Robles Regional Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Hwan J","family":"Kim","sequence":"additional","affiliation":[{"name":"Los Robles Regional Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Sovari","sequence":"additional","affiliation":[{"name":"Los Robles Regional Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"22435","published-online":{"date-parts":[[2025,12,31]]},"container-title":["HCA Healthcare Journal of Medicine"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T09:49:35Z","timestamp":1793440175000},"score":1,"resource":{"primary":{"URL":"https:\/\/scholarlycommons.hcahealthcare.com\/hcahealthcarejournal\/vol6\/iss6\/4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,31]]},"references-count":0,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,12,31]]}},"URL":"https:\/\/doi.org\/10.36518\/2689-0216.2153","relation":{},"ISSN":["2689-0216"],"issn-type":[{"value":"2689-0216","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,31]]}}}