Prospective randomized comparison of closed cooled-tip versus 8-mm-tip catheters for radiofrequency ablation of typical atrial flutter.

Abstract

INTRODUCTION:

Cooled-tip and 8-mm-tip catheters have been found to be more effective than conventional 4-mm-tip catheters for radiofrequency (RF) ablation of common atrial flutter. The aim of this study was to compare the efficacy and safety of cooled-tip and 8-mm-tip catheters for flutter ablation in a randomized, prospective study.

METHODS AND RESULTS:

In 100 consecutive patients referred for ablation of common atrial flutter, cavotricuspid ablation was performed with a closed cooled-tip catheter (n = 50) or an 8-mm-tip ablation catheter (n = 50). RF current was applied for 60 to 120 seconds at powers of 40 to 50 W with the closed cooled-tip catheter and in a temperature-controlled mode (65 degrees C/70 W) with the 8-mm-tip catheter. The endpoint was achievement of a bidirectional isthmus conduction block. Cross-over was performed after 15 unsuccessful RF applications for each of the catheters. Complete bidirectional isthmus block was achieved in 99% of patients. Cross-over was performed in 11 patients after primary use of the cooled-tip catheter and in 9 patients after primary ablation with the 8-mm-tip catheter. No significant differences were found in the procedure parameters, such as overall RF applications (12.4 +/- 11.3 vs 12.9 +/- 8.6), ablation duration (42 +/- 43 min vs 39 +/- 27 min), and fluoroscopy time (17.0 +/- 18.7 min vs 15.7 +/- 10.7 min). In a mean follow-up of 8.3 months, 1 patient in the cooled-tip group and 3 patients in the 8-mm-tip group had recurrence of common atrial flutter.

CONCLUSION:

Use of the closed cooled-tip ablation catheter and the 8-mm-tip catheter have equal and high efficacy for RF ablation of common atrial flutter.

• Authors: Juergen Schreieck, Bernhard Zrenner, Johanna Kumpmann, Gjin Ndrepepa, Michael A E Schneider, Isabel Deisenhofer, Claus Schmitt
• Journal: Journal of cardiovascular electrophysiology (J Cardiovasc Electrophysiol) Vol. 13 Issue 10 Pg. 980-5 (Oct 2002) ISSN: 1045-3873 [Print] United States
• PMID: 12435182 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Topics

• Aged
• Atrial Flutter (complications, surgery)
• Catheter Ablation (instrumentation)
• Cross-Over Studies
• Electric Countershock (instrumentation)
• Electrodes, Implanted
• Electrophysiologic Techniques, Cardiac
• Equipment Design
• Equipment Safety
• Female
• Follow-Up Studies
• Heart Block (complications, surgery)
• Heart Conduction System (pathology, surgery)
• Humans
• Male
• Middle Aged
• Postoperative Complications (etiology)
• Prospective Studies
• Recurrence
• Reoperation
• Treatment Outcome