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Impact of tip design and thermocouple location on the efficacy and safety of radiofrequency application

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

The FlexAbility™ SE catheter has a laser-cut 8Fr 4-mm flexible tip irrigated through laser-cut kerfs with a thermocouple 0.3 mm from the distal end. The TactiCath™ SE catheter has an 8Fr 3.5-mm tip and 6-irrigation port with a thermocouple 2.67 mm proximal to the tip. We investigated the impact of these differences on the efficacy and safety of radiofrequency (RF) applications.

Methods

RF applications at a range of powers (20 W, 30 W, and 40 W), contact forces (5 g, 15 g, and 25 g), and durations (10–60 s) using perpendicular/parallel catheter orientation were performed in excised porcine hearts. Lesion characteristics and incidence of steam pops were compared.

Results

A total of 540 lesions were examined. The FlexAbility™ SE catheter produced smaller lesion depths (4.0 mm vs. 4.4 mm, p = 0.014 at 20 W; 4.6 mm vs. 5.6 mm, p = 0.015 at 30 W), surface areas (22.7mm2 vs. 29.2mm2 at 20 W, p = 0.005; 23.2mm2 vs. 28.7mm2, p = 0.009 at 30 W), and volumes (126.1mm3 vs. 175.1mm3, p = 0.018 at 20 W; 183.2mm3 vs. 304.3mm3, p = 0.002 at 30 W) with perpendicular catheter placement. However, no differences were observed with parallel catheter placement. Steam-pops were significantly less frequently observed with the FlexAbility™ SE catheter (4% vs. 22%, p < 0.001) irrespective of catheter direction to the tissue. Multivariate analysis showed that use of the TactiCath™ SE catheter, power ≥ 40 W, contact force ≥ 25 g, RF duration > 30 s, parallel angle, and impedance drop ≥ 20Ω were significantly associated with occurrence of steam-pops.

Conclusions

The FlexAbility™ SE catheter reduced the risk of steam-pops but produced smaller lesions with perpendicular catheter placement compared to the TactiCath™ SE catheter.

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Acknowledgements

We appreciate a technical support for this experiment from Mr. Kazuyoshi Moriya, Mr. Masashi Uemoto, Mr. Ryoto Shiga, Ms. Mio Suzuki, and Ms. Lisa Sakurai from Abbott Medical Japan LLC.

Funding

This work was partially supported by JSPS KAKENHI Grant Number JP20K17074.

Author information

Author notes

  1. Junji Yamaguchi and Masateru Takigawa contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiovascular Medicine, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan

    Junji Yamaguchi, Masateru Takigawa, Masahiko Goya, Miki Amemiya, Tasuku Yamamoto, Takuro Nishimura, Rena Nakamura, Yasuhiro Shirai, Susumu Tao, Shinsuke Miyazaki, Yoshihide Takahashi & Tetsuo Sasano

  2. Department of Clinical and Diagnostic Laboratory Science, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan

    Junji Yamaguchi

  3. Royal Papworth Hospital, Cambridge, UK

    Claire Martin

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  1. Junji Yamaguchi
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  2. Masateru Takigawa
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Corresponding author

Correspondence to Masateru Takigawa.

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Conflict of interest

Drs. Takigawa and Takahashi received endowments from Medtronic Japan, Boston Scientific, Japan Lifeline, and WIN international. No other authors have conflicts of interest to declare.

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Yamaguchi, J., Takigawa, M., Goya, M. et al. Impact of tip design and thermocouple location on the efficacy and safety of radiofrequency application. J Interv Card Electrophysiol 66, 885–896 (2023). https://doi.org/10.1007/s10840-022-01219-8

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  • DOI: https://doi.org/10.1007/s10840-022-01219-8

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