First clinical experience of a dedicated irrigated-tip radiofrequency ablation catheter for the ablation of cavotricuspid isthmus-dependent atrial flutter
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Different types of irrigated-tip ablation catheters are available for ablation of atrial flutter (AFL). The aim of this study was to compare an established with a novel dedicated Gold irrigated-tip catheter for ablation of AFL.
Methods and results
We compared consecutive patients undergoing ablation of AFL using a standard 3.5 mm irrigated-tip platinum–iridium (Pt–Ir) catheter (Thermocool, TC-group) and a 3.5 mm irrigated gold-tip catheter (Gold-group) specifically designed for cavotricuspid isthmus ablation (CTI). The primary endpoint was acute efficacy (net RF time) to achieve block across the CTI. Secondary endpoints included procedure time, fluoroscopy duration, complications, and recurrence of AFL.153 patients (age 68 ± 11 years, 74% male) were included. Net RF time to achieve CTI block was not different between the TC-group (793 ± 503 s) and the Gold-group (706 ± 422 s; p = 0.406). Total procedure time was not significantly different between the TC-group (70 ± 26 min) and the Gold-group (70 ± 27 min; p = 0.769). A significant difference between the groups was identified for the fluoroscopy duration (TC-group: 934 ± 537 s, Gold-group: 596 ± 362 s, p < 0.001). There were no major complications observed in the groups. Recurrence of AFL occurred in 3 of 66 (5%) in the TC-group and in 2 of 87 (2%) in the Gold-group (p = 0.652).
In conclusion, acute and chronic efficacy of the irrigated Pt–Ir and gold-tip catheters were comparable. However, the dedicated catheter design was associated with decreased fluoroscopy duration.
KeywordsAtrial flutter Radiofrequency ablation Catheter ablation Irrigated gold-tip
Compliance with ethical standards
Conflict of interest
Sven Knecht—received compensation for advisory boards with Boston Scientific and Biotronik. Fabian Burch—no conflict of interest. Aline Mühl—no conflict of interest. Florian Spies—no conflict of interest. Tobias Reichlin—no conflict of interest. Beat Schaer—no conflict of interest. David Altmann—no conflict of interest. Peter Ammann—no conflict of interest. Stefan Osswald—no conflict of interest. Christian Sticherling—Advisory Board of Medtronic and Biotronik, received educational grants from Biotronik and research Grant from Biosense Webster (outside the submitted work). Michael Kühne—proctor for Medtronic, speakers bureau for Boston Scientific, St Jude Medical, and Biotronik.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 2.Feld GK, Fleck RP, Chen PS, Boyce K, Bahnson TD, Stein JB et al (1992) Radiofrequency catheter ablation for the treatment of human type 1 atrial flutter. Identification of a critical zone in the reentrant circuit by endocardial mapping techniques. Circulation 86:1233–1240CrossRefPubMedGoogle Scholar
- 4.Feld GK, Daubert JP, Weiss R, Miles WM, Pelkey W, Cryoablation Atrial Flutter Efficacy Trial Investigators (2008) Acute and long-term efficacy and safety of catheter cryoablation of the cavotricuspid isthmus for treatment of type 1 atrial flutter. Heart Rhythm 5:1009–1014CrossRefPubMedGoogle Scholar
- 6.Lewalter T, Bitzen A, Wurtz S, Blum R, Schlodder K, Yang A et al (2005) Gold-tip electrodes—a new “deep lesion” technology for catheter ablation? In vitro comparison of a gold alloy versus platinum-iridium tip electrode ablation catheter. J Cardiovasc Electrophysiol 16:770–772CrossRefPubMedGoogle Scholar
- 13.Ilg KJ, Kühne M, Crawford T, Chugh A, Jongnarangsin K, Good E et al (2011) Randomized comparison of cavotricuspid isthmus ablation for atrial flutter using an open irrigation-tip versus a large-tip radiofrequency ablation catheter. J Cardiovasc Electrophysiol 22:1007–1012CrossRefPubMedGoogle Scholar