Abstract 13473: Effect of Catheter Orientation on Lesion Formation: A Comparison Between the Irrigated Flexible Tip Catheter and the Irrigated Rigid Tip Catheter
Introduction: A flexible fully irrigated catheter has been developed to reduce formation of char and coagulum at the catheter tissue interface and also to conform to the endocardial surface with better contact.
Hypothesis: Because of the tip design, ablation at different angles with a flexible electrode (4mm) tip fully irrigated catheter (CF: Therapy Cool Flex TM, SJM) will result in similar lesions whereas ablation in a perpendicular orientation with a standard traditional 6-hole rigid electrode (4mm) open irrigated catheter (CP: Therapy Cool Path™, SJM) will be more effective than ablation at a 20° angle.
Methods: Under the same settings lesions were created in a thigh muscle preparation using CF and CP catheters in 90° and 20° in 7 pigs. Post procedure 2, 3, 5 triphenyltetrazolium chloride (TTC) was injected into the femoral artery to demarcate ablated from non ablated tissue. The thigh muscle was then excised and fixed with formalin solution and examined grossly. All lesion measurements were performed in a blinded manner to catheter type and settings.
Results: Table: 101 ablation lesions (51 at 90° and 50 at 20°) were created with the CP catheter and 95 ablation lesions (48 at 90° and 47 at 20°) were created with the CF catheter using the same ablation parameters. Ablation with the CP catheter in the 90° orientation resulted in deeper lesions with larger maximum diameters compared to ablation at a 20° angle. There was no difference in lesion depth or diameters when ablating with the CF catheter.
Conclusion: Ablation with the CF catheter compared to the CP catheter resulted in consistent lesion characteristics regardless of catheter orientation. These findings may be due to better tissue catheter interface contact due to the fully irrigated flexible design of the CF catheter allowing better conformity. These findings may translate into better outcomes in clinical studies.
- © 2011 by American Heart Association, Inc.