Effects of open-irrigated radiofrequency ablation catheter design on lesion formation and complications: in vitro comparison of 6 different devices

J Cardiovasc Electrophysiol. 2013 Oct;24(10):1157-62. doi: 10.1111/jce.12175. Epub 2013 May 29.

Abstract

Introduction: Open-irrigated radiofrequency ablation catheters with slight differences in tip architecture are widely used, although limited comparative data are available. The purpose of this study was to compare the lesion size and potential complications produced by commercially available open-irrigated catheters in an in vitro porcine heart model.

Methods and results: Six catheters were tested (Biosense Webster Thermocool, Boston Scientific Open irrigated, St. Jude CoolPath, St. Jude CoolPath Duo, Biosense Webster Thermocool SF, St. Jude Cool Flex) at 20 and 35 W power-control, under 2 different blood flows (0.1 and 0.5 m/s) and at 2 target durations (30 and 60 seconds). A total of 601 lesions were made in 26 in vitro preparations. The tip temperature profile showed significant differences between the catheters (P < 0.001) with the Thermocool SF registering the lowest. Only the surface diameter and the depth at maximum diameter of the lesion were influenced by the design of the ablation electrode. The lesion volume did not show significant differences between catheters for any power, application duration or blood flow condition. Char and pops occurred more often at 35 W with only slight differences between the catheters.

Conclusions: Tip design of the 6 different irrigated catheters does not affect the lesion total volume, although a slight difference in lesion geometry in terms of surface diameter and depth at maximum diameter is present. The catheters show a slight different in vitro safety profile.

Keywords: atrial fibrillation; catheter ablation; irrigated catheter; lesion size; radiofrequency ablation.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cardiac Catheters*
  • Catheter Ablation / adverse effects
  • Catheter Ablation / instrumentation*
  • Equipment Design
  • Heart Ventricles / pathology
  • Heart Ventricles / surgery*
  • In Vitro Techniques
  • Materials Testing
  • Models, Animal
  • Myocardium / pathology
  • Swine
  • Temperature
  • Therapeutic Irrigation / adverse effects
  • Therapeutic Irrigation / instrumentation*
  • Time Factors