Background Electrode cooling by saline irrigation facilitates radiofrequency (RF) energy penetration into deep tissue during RF catheter ablation (RFCA). We hypothesized that irrigation tip catheter (ITC) shortens procedure time and results in better outcome of RFCA for atrial fibrillation (AF) compared with conventional 8 mm tip catheter (8TC).
Methods and Results Of 94 patients (mean age 54.7±10.9 years, male 82%) with AF (paroxysmal AF [PAF] 58, persistent AF [PeAF] 36), 53 patients underwent RFCA utilizing ITC and 41 underwent by 8TC. We performed circumferential 4 pulmonary vein isolation (4PVI), and the linear ablation at the left atrium and cavotricuspid isthmus block were added if AF was inducible after 4PVI. Results: 1. Total procedure time (229.9±62 min vs. 235.1±69 min, p=NS), fluoroscopic time (52.9±20 min vs. 56.8±22 min, p=NS), and ablation number with titrated RF energy (127.3±45 vs. 134.5±51, p=NS) were not different between two groups. 2. Minor stroke or transient ischemic attack rate was 3.8% (2/53) in ITC group and 4.9% (2/41) in 8TC group (p=NS), respectively. Char formation was more common in 8TC (53.8%) than ITC (10%, p<0.05). 3. Hemopericardium occurred in 5.7% (3/53) of ITC group and 7.3% (3/41) in 8TC group (p=NS), respectively. 4. During 5.7±1.7 months of follow-up, AF recurrences were 3.7% (2/38) in ITC group and 12.2% (5/41) in 8TC group, respectively (p=NS).
Conclusion The procedure time, complication rate, and short term clinical outcome using ITC were similar to those using 8TC, but ITC results in lower char formation and tendency toward lower complications and recurrence of AF compared with 8TC.
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