Abstract 14063: Safety and Outcomes of the 56 Holes New Open Irrigated Sf Catheter During Catheter Ablation of Atrial Fibrillation
Introduction: Success rate of radiofrequency (RF) catheter ablation of atrial fibrillation (AF) has improved with the use of open irrigated catheter. Recently a new open irrigated catheter with 56 holes has been introduced. This new catheter has been questioned and recently an increased rate of atrio-esophageal fistula (ASF) has been reported. We sought to compare complications following ablation for AF when utilizing the standard 3.5 mm open irrigated catheter (Biosense Webster, USA) and the 56 holes open irrigated catheter (Navistar thermocool SF, Biosense Webster, USA) in a large patient population undergoing extensive left atrial ablation.
Methods: 3369 consecutive patients (pts) undergoing non paroxysmal AF ablation in the period between January 2009 and May 2013 were included in this study. 2132 pts undergo ablation with the standard 3.5 thermo cool unidirectional catheter (group 1) while 1237 undergo ablation with the 56 holes SF open irrigated unidirectional catheter (group 2). Major complications were assessed and compared. In all pts pulmonary vein antral ablation and non PV triggers ablation was performed utilizing up to 45 watt (30 watts in the coronary sinus) and limiting the application time to 20 seconds per site. In all pts posterior wall ablation utilizing 30 Watts and limiting the application to 20 seconds per ablation target were performed. In all pts an esophageal temperature probe was utilized to locate the esophagus and to discontinue RF in case of temperature increase >40 C°.
Results: Baseline clinical characteristics were similar between groups. Twelve pericardial effusion requiring pericardiocentesis and in one patients surgery occurred in group 1 (0.56%) while 5 pericardial effusion requiring pericardiocentesis and not requiring surgery occurred in group 2(0.40%) (p=0.53). At follow up no ASF was reported in group 1 one ASF in group 2 (p=0.37). Re-hospitalization due to fluid overload was observed in 324 patients (15%) in group 1 and in 18 patients (1.5%) in group 2 (p<0.001).
Conclusion: Cather ablation utilizing the new 56 holes open irrigated SF unidirectional catheter is as safe as the standard thermocool. Re-hospitalization due to fluid overload following AF ablation is significantly reduced with the 56 holes SF catheter.
- © 2013 by American Heart Association, Inc.