Abstract 16675: Rapid Pulmonary Vein Isolation Using a Novel Diamond Tip Temperature Controlled Irrigated RF Catheter: First-in-man Clinical Experience
Introduction: A novel irrigated RF catheter with a diamond tip (for rapid cooling by virtue of its high thermal diffusivity) and six surface thermocouples (that reflect tissue temperature) allows one to perform rapid temperature-controlled irrigated ablation (DiamondTemp; ACT, Inc.). High resolution-electrograms (EGM) from its split-tip electrode allows for rapid lesion assessment. We sought to prospectively determine this approach by evaluating its use during pulmonary vein (PV) isolation.
Methods: Thirty-five patients (24 men, 60±10 years) with symptomatic, drug-refractory AF were prospectively enrolled at a single center (Grp1). Point-by-point PV isolation was performed in temperature-control mode (60°C/50W) until a 75-80% reduction in the split-tip EGM amplitude. Outcomes were compared with a historical control group undergoing PV isolation with a Thermocool irrigated catheter (n=35; Grp2). At 3 months, patients underwent a remapping procedure regardless of symptomatology.
Results: All PVs were successfully isolated in pairs in both groups. Mean RF time for complete PV isolation was reduced by 70% (26.5±5.2 vs 89.2±27.2 min; p<0.001), fluoroscopy times were shorter (11.2±8.5 vs 19.5±6.8 min; p<0.001), and dormant conduction rates were lower (0/35 vs 5/35 pts; p=0.024) in Grp 1 vs 2. There was one occurrence of pericardial effusion eight hours post- procedure and no occurrences of char, steam pop or embolic events in Grp 1. Of patients undergoing remapping (13/35) at a mean of 83±16 days, durable PV isolation was present in 90% (45 of 50 PVs). At 3 months, 3 of 35 (14%) patients had recurrent AF. Two of these patients with recurrence were remapped; however, PVs were noted to be durably isolated.
Conclusion: This first-in-man series demonstrates that safe, rapid, durable PV isolation is achievable with this novel temperature-controlled irrigated RF ablation catheter.
Author Disclosures: J. Iwasawa: None. J.S. Koruth: Research Grant; Modest; ACT, BIOSENSE WEBSTER, Vytronus. Consultant/Advisory Board; Modest; Biosense Webster, St Jude. Research Grant; Significant; MODEST, Significant, Significant. Consultant/Advisory Board; Significant; Significant, Signifcant. P. Neuzil: None. J. Petru: None. S. Kralovec: None. V.Y. Reddy: Ownership Interest; Modest; ACT.
- © 2016 by American Heart Association, Inc.