Which is the best catheter to perform atrial fibrillation ablation? A comparison between standard ThermoCool, SmartTouch, and Surround Flow catheters

  • Luigi Sciarra
  • Paolo Golia
  • Andrea Natalizia
  • Ermenegildo De Ruvo
  • Serena Dottori
  • Antonio Scarà
  • Alessio Borrelli
  • Lucia De Luca
  • Marco Rebecchi
  • Alessandro Fagagnini
  • Alberto Bandini
  • Fabrizio Guarracini
  • Marcello Galvani
  • Leonardo Calò
Article

Abstract

Introduction

Catheter ablation (CA) is an established therapy for atrial fibrillation (AF). The SmartTouch catheter (STc) provides information about catheter tip to tissue contact force (CF). The Surround Flow catheter (SFc) provides a uniform cooling of the tip during ablation. We sought to analyze the impact of STc and SFc on CA of paroxysmal AF in terms of feasibility and acute efficacy.

Methods and results

Sixty-three patients (mean age 57.6 ± 9.8 years, 53 males) with paroxysmal AF underwent pulmonary veins (PVs) antral isolation, by using standard ThermoCool catheter (TCc) in 21, STc in 21, and SFc in 21. Total procedural, fluoroscopy, and radiofrequency (RF) delivery times; percentage of persistently deconnected PVs after 30 min; and percentage of isolated PVs at the end of the procedure were measured.

The use of both STc and SFc obtained a reduction of fluoroscopy time (TCc 34 ± 18 min, STc 20 ± 10 min, p < 0.001; SFc 21 ± 13 min, p = 0.02 vs TCc) and RF time (TCc 41 ± 13 min, STc 30 ± 14 min, p = 0.013; SFc 30 ± 9 min, p < 0.01 vs TCc). The use of STc resulted in a reduction of procedural time (TCc 181 ± 53 min, STc 140 ± 53 min, p < 0.001; SFc 170 ± 51 min, p = NS vs TCc). The percentage of isolated PVs was comparable between groups (TCc 96 % vs STc 98 % vs SFc 96 %; p = NS). The percentage of deconnected PVs at 30 min was lower in TCc (89 %) than in STc (95 %) and in SFc (95 %) group (p < 0.05).

Conclusions

Both STc and SFc allowed a simplification of CA of paroxysmal AF. In addition, they reduced early PVs reconnection.

Condensed abstract

Sixty-three patients with paroxysmal AF underwent ablation by standard ThermoCool, SmartTouch, or Surround Flow catheter. Both the SmartTouch and the Surround Flow significantly reduced radiofrequency and fluoroscopy times, as well as pulmonary veins reconnection rate at 30 min. Moreover, the SmartTouch reduced overall duration of the procedure.

Keywords

Atrial fibrillation Catheter ablation Ablation catheters Irrigated ablation Contact force 

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Luigi Sciarra
    • 1
  • Paolo Golia
    • 2
  • Andrea Natalizia
    • 3
  • Ermenegildo De Ruvo
    • 1
  • Serena Dottori
    • 3
  • Antonio Scarà
    • 1
  • Alessio Borrelli
    • 1
  • Lucia De Luca
    • 1
  • Marco Rebecchi
    • 1
  • Alessandro Fagagnini
    • 1
  • Alberto Bandini
    • 2
  • Fabrizio Guarracini
    • 1
  • Marcello Galvani
    • 2
  • Leonardo Calò
    • 1
  1. 1.Cardiology DepartmentPoliclinico CasilinoRomeItaly
  2. 2.Cardiology DepartmentMorgagni-Pierantoni HospitalForlìItaly
  3. 3.Biosense Webster ItalyJohnson and Johnson MedicalMilanItaly

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