A Novel Impedance-guided Contact Mapping Technique for the Circular Multielectrode Pulsed-Field Ablation Catheter

Pulsed field ablation (PFA) has emerged as a promising technology for atrial fibrillation (AF) treatment. However, real-time catheter-tissue contact assessment remains a critical limitation, particularly for ring-type catheters lacking force sensing. We report a novel impedance-guided mapping method—i-Pulse—adapted for the PulseSelect™ catheter using the EnSite™ X Contact Index, originally designed for the Farapulse™ system. This workflow enables real-time contact assessment by reassigning catheter electrodes and visualizing impedance changes ≥ 5Ω as contact tags. In a series of four patients undergoing zero-fluoroscopy PFA, i-Pulse facilitated accurate lesion delivery without procedural complications. The technique integrates ICE guidance and 3D mapping to overcome fluoroscopy dependence and enhances procedural reproducibility. i-Pulse may offer a valuable contact evaluation strategy for current PFA practice, especially for non-magnetic catheters.