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Prospective Randomized Comparison of 8‐mm Gold‐Tip, Externally Irrigated‐Tip and 8‐mm Platinum‐Iridium Tip Catheters for Cavotricuspid Isthmus Ablation
Author(s) -
SACHER FRÉDÉRIC,
O'NEILL MARK D.,
JAIS PIERRE,
HUFFER LINDA L.,
LABORDERIE JULIEN,
DERVAL NICOLAS,
DEPLAGNE ANTOINE,
TAKAHASHI YOSHIHIDE,
JONNSON ANDERS,
HOCINI MELEZE,
CLEMENTY JACQUES,
HAISSAGUERRE MICHEL
Publication year - 2007
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2007.00861.x
Subject(s) - medicine , ablation , catheter , fluoroscopy , catheter ablation , surgery , radiofrequency ablation , nuclear medicine , cardiology
Radiofrequency (RF) ablation of the cavotricuspid isthmus (CTI) can be performed using different types of ablation catheter. Gold tip electrodes have the theoretical advantage of creating bigger lesions than standard platinum‐iridium electrode. This prospective, randomized study compares the clinical efficacy of 8‐mm gold tip catheter, externally irrigated and 8‐mm platinum‐iridium tip (Pt tip) catheters. Methods and Results: Sixty consecutive patients (51 men, 60 ± 10 years) undergoing de novo CTI ablation for documented typical atrial flutter were randomized to one of the following ablation catheters: 8‐mm gold tip catheter, an externally irrigated‐tip (Irr. tip) catheter, or an 8‐mm Pt tip catheter. The procedural endpoint was achievement of bidirectional isthmus conduction block with ≤ 20 minutes of RF energy application. The latter was achieved equally with the 3 catheters (95% for gold tip, 100% for irrigated tip, 95% for Pt tip) and the durations of RF (10 ± 6, 10 ± 4, 13 ± 8 minutes), fluoroscopy (12 ± 6, 12 ± 7, 15 ± 12 minutes) and the procedure (34 ± 23, 38 ± 24, 40 ± 30 minutes) were similar in all groups. The maximal targeted power could not be reached in at least one location in 40% of patients with gold tip and in 35% of patients with Pt tip catheters whereas it was always achieved with an Irr. tip catheter (P = 0.003, P = 0.008). The reduction in impedance during RF delivery was greater with Irr. tip (11 ± 7 Ω) than with gold (7 ± 4 Ω, P = 0.02) or Pt tip (5 ± 3 Ω, P = 0.001) catheters. Conclusion: This study demonstrates equivalent efficacies of gold, platinum‐iridium and externally Irr. tip catheters for successful de novo ablation of the CTI.