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Background  Cavotricuspid isthmus ( CTI ) radiofrequency ( RF ) catheter ablation is the standard treatment for patients suffering from  CTI ‐dependent atrial flutter ( AFL ). The aim of this study was to compare the use in clinical practice of 8‐mm gold‐tip catheter (8mm RFC ) and open‐irrigated gold‐tip catheter (irr RFC ) for  RF  typical  AFL  ablation.    Methods  Patients with typical  AFL  were treated with 8mm RFC  or irr RFC  catheters according to investigator preferences. The primary endpoint was the cumulative radiofrequency time ( CRFT ). Fluoroscopy time, acute and 6‐month success rates were secondary endpoints.    Results  After excluding 3 patients with left  AFL , 157 of the enrolled patients (median age 71.8 [interquartile range, 64.1‐76.2], 76% men, 91% in  NYHA  class ≤ II , 65% with no structural heart disease) were analyzed: 74 (47%) subjects were treated with the 8mm RFC  and 83 (53%) with the irr RFC . The median  CRFT  was 3 [2‐6] minutes in the 8mm RFC  group and 5 [3‐7] minutes in the irr RFC  group ( P  = .183). There were no significant differences in ablation success rates, intraprocedural  CTI  reconnections, audible steam pops, and procedural times. In the 8mm RFC  group, a significantly lower fluoroscopy time was observed as compared to the irr RFC  group (8 [5‐12] vs 15 [10‐20] minutes,  P  < .001). During the follow‐up period,  AFL  recurrences were documented in 3 patients in the 8mm RFC  group and 2 in the irr RFC  group ( P  = .655).    Conclusions  The 8mm RFC  and the irr RFC  performed similarly in routine practice for  CTI  ablation in terms of cumulative  RF  time, acute and 6‐month success rates. Fluoroscopy time was significantly lower in the 8mm RFC  group.

A comparison of 8‐mm and open‐irrigated gold‐tip catheters for typical atrial flutter ablation: Data from a prospective multicenter registry