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Which is the best catheter to perform atrial fibrillation ablation? A comparison between standard ThermoCool, SmartTouch, and Surround Flow catheters

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Abstract

Introduction

Catheter ablation (CA) is an established therapy for atrial fibrillation (AF). The SmartTouch catheter (STc) provides information about catheter tip to tissue contact force (CF). The Surround Flow catheter (SFc) provides a uniform cooling of the tip during ablation. We sought to analyze the impact of STc and SFc on CA of paroxysmal AF in terms of feasibility and acute efficacy.

Methods and results

Sixty-three patients (mean age 57.6 ± 9.8 years, 53 males) with paroxysmal AF underwent pulmonary veins (PVs) antral isolation, by using standard ThermoCool catheter (TCc) in 21, STc in 21, and SFc in 21. Total procedural, fluoroscopy, and radiofrequency (RF) delivery times; percentage of persistently deconnected PVs after 30 min; and percentage of isolated PVs at the end of the procedure were measured.

The use of both STc and SFc obtained a reduction of fluoroscopy time (TCc 34 ± 18 min, STc 20 ± 10 min, p < 0.001; SFc 21 ± 13 min, p = 0.02 vs TCc) and RF time (TCc 41 ± 13 min, STc 30 ± 14 min, p = 0.013; SFc 30 ± 9 min, p < 0.01 vs TCc). The use of STc resulted in a reduction of procedural time (TCc 181 ± 53 min, STc 140 ± 53 min, p < 0.001; SFc 170 ± 51 min, p = NS vs TCc). The percentage of isolated PVs was comparable between groups (TCc 96 % vs STc 98 % vs SFc 96 %; p = NS). The percentage of deconnected PVs at 30 min was lower in TCc (89 %) than in STc (95 %) and in SFc (95 %) group (p < 0.05).

Conclusions

Both STc and SFc allowed a simplification of CA of paroxysmal AF. In addition, they reduced early PVs reconnection.

Condensed abstract

Sixty-three patients with paroxysmal AF underwent ablation by standard ThermoCool, SmartTouch, or Surround Flow catheter. Both the SmartTouch and the Surround Flow significantly reduced radiofrequency and fluoroscopy times, as well as pulmonary veins reconnection rate at 30 min. Moreover, the SmartTouch reduced overall duration of the procedure.

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Acknowledgements

The authors thank Dr. Samuele Guerzoni for his assistance in data collection.

Conflict of Interest

The authors declared no conflicts of interest.

A.N. and S.D. are employees of Biosense Webster Italy

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Authors and Affiliations

  1. Cardiology Department, Policlinico Casilino, Rome, Italy

    Luigi Sciarra, Ermenegildo De Ruvo, Antonio Scarà, Alessio Borrelli, Lucia De Luca, Marco Rebecchi, Alessandro Fagagnini, Fabrizio Guarracini & Leonardo Calò

  2. Cardiology Department, Morgagni-Pierantoni Hospital, Forlì, Italy

    Paolo Golia, Alberto Bandini & Marcello Galvani

  3. Biosense Webster Italy, Johnson and Johnson Medical, Milan, Italy

    Andrea Natalizia & Serena Dottori

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  1. Luigi Sciarra
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Correspondence to Paolo Golia.

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Luigi Sciarra and Paolo Golia equally contributed to the manuscript.

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Sciarra, L., Golia, P., Natalizia, A. et al. Which is the best catheter to perform atrial fibrillation ablation? A comparison between standard ThermoCool, SmartTouch, and Surround Flow catheters. J Interv Card Electrophysiol 39, 193–200 (2014). https://doi.org/10.1007/s10840-014-9874-2

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  • DOI: https://doi.org/10.1007/s10840-014-9874-2

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