Universität zu Köln

Plenge, Tobias, van den Bruck, Jan-Hendrik, Lueker, Jakob, Sultan, Arian and Steven, Daniel (2020). Porous tip contact force-sensing catheters for pulmonary vein isolation: performance in a clinical routine setting. J. Interv. Card. Electrophysiol., 57 (2). S. 251 - 260. DORDRECHT: SPRINGER. ISSN 1572-8595

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Abstract

Purpose In catheter ablation of atrial fibrillation (AF), contact force (CF)-sensing catheters with an irrigated tip are used to deliver radiofrequency (RF) energy to the tissue. The ThermoCool (R) Smarttouch (TM) Surroundflow catheter (STSF) integrates CF-sensing technology and a new porous tip for advanced external cooling. The aim was to evaluate the performance and safety of STSF in a clinical setting of pulmonary vein isolation (PVI) in comparison with standard contact force-sensing catheter (ST). Methods We assigned consecutive patients (n = 80, prospectively, open-label, non-randomized) with symptomatic AF to either PVI with STSF (n = 60) or ST (n = 20). Results Total ablation time to achieve PVI was significantly shorter in STSF compared to that in ST (STSF, 1556 +/- 435 s vs. ST, 1922 +/- 961 s; p = 0.045). Ablation time to achieve loss of pace capture of left pulmonary veins was shorter using STSF (left veins, 155 +/- 140 s vs. 291 +/- 188 s; p = 0.01; right veins, 208 +/- 196 s vs. 369 +/- 306 s; p = 0.09). Furthermore, administered irrigation fluid was significantly reduced in STSF (241.4 +/- 79.6 ml vs. 540.3 +/- 229.5 ml; p < 0.01). CF was lower during ablation of left pulmonary veins. One steam pop occurred in STSF, which did not lead to pericardial effusion (vs. no steam pop in ST). The Kaplan-Meier estimate 12-month AF recurrence was 34.3% and 37.7% (p = 0.8). Conclusions Integrating CF technology and the porous tip technology enables effective energy transfer to the tissue resulting in shorter ablation time and less irrigation fluid administration. In our cohort, PVI using the STSF was not associated with an increased complication rate or AF recurrence rate after 12-month follow-up when compared with the ST.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Plenge, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED van den Bruck, Jan-Hendrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Lueker, Jakob UNSPECIFIED UNSPECIFIED UNSPECIFIED Sultan, Arian UNSPECIFIED UNSPECIFIED UNSPECIFIED Steven, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-342735
DOI:	10.1007/s10840-019-00591-2
Journal or Publication Title:	J. Interv. Card. Electrophysiol.
Volume:	57
Number:	2
Page Range:	S. 251 - 260
Date:	2020
Publisher:	SPRINGER
Place of Publication:	DORDRECHT
ISSN:	1572-8595
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ATRIAL-FIBRILLATION; ABLATION CATHETER; RADIOFREQUENCY ABLATION; LESION SIZE; DORMANT CONDUCTION; SAFETY; TRIAL; RECONNECTION; SMARTTOUCH; THERMOCOOL Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/34273