Radiofrequency ablation using the second-generation temperature-controlled diamond tip system in paroxysmal and persistent atrial fibrillation: results from FASTR-AF

Neužil, Petr; Poty, Hervé; Chillou, Christian de; Petrů, Jan; Getman, Michael K.; Li, Shufeng; Funasako, Moritoshi; Durand-Dubief, Alexis; Combes, Stéphane; Albenque, Jean‐Paul

doi:10.1007/s10840-022-01234-9

Cited by 3 publications

(4 citation statements)

References 21 publications

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“…Usage of the novel catheter significantly reduced procedure times of de novo pulmonary vein isolations. These results are in line with the recently published papers by Kautzner et al [ 4 ], Starek et al [ 5 ], and Neuzil et al [ 6 ] and expectations for an ablation approach that uses higher energy outputs.…”

Section: Discussionsupporting

confidence: 92%

Early real-world experience using temperature-guided diamond tip facilitated high-power ablation for catheter ablation of atrial fibrillation

Dittrich

Braun

Bergau

et al. 2023

J Interv Card Electrophysiol

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Section: Discussionsupporting

confidence: 92%

Early real-world experience using temperature-guided diamond tip facilitated high-power ablation for catheter ablation of atrial fibrillation

Dittrich

Braun

Bergau

et al. 2023

J Interv Card Electrophysiol

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“…From these accurate real-time temperature readings, the power is then modulated, thus allowing the resistive heating to remain in the optimal therapeutic range. Our findings show that at temperature set-points of both 50 and 60 °C, increasing ablation duration will provide greater lesion width and depth with a plateauing effect for depth at 60 s. In previous DTA atrial fibrillation clinical trials, ablation recommendations were a temperature set-point of 60 °C, and ablation termination guidance was 3 to 5 s beyond electrogram amplitude attenuation of 75 to 80% [ 20 , 23 – 25 ]. During the DIAMOND-AF trial, the average application duration, with the first-generation DTA system, was 14.7 ± 5.3 s resulting in a 79.1% freedom from recurrence of any atrial arrhythmia during the 12-month follow-up.…”

Section: Discussionmentioning

confidence: 76%

“…The study was conducted using the DTA system FASTR RF generator (model CEDTG200), which has been previously described [ 21 , 25 ]. In brief, the temperature-controlled system takes readings every 20ms from 6 external thermocouples; 3 located on the distal tip and 3 proximal to the RF electrode.…”

Section: Methodsmentioning

confidence: 99%

“…Through externally located thermocouples, incorporation of industrial diamond, and a low irrigation rate, the DiamondTemp ablation (DTA) system (Medtronic Inc, Minnesota, MN) has established a tip-tissue interface temperature accuracy of 2-4 °C [22]. Recent clinical successes have been demonstrated for atrial arrhythmias with ablation parameters akin to HPSD [23][24][25][26][27]. However, the data for ventricular or thicker tissue applications using a similar approach are less understood [28,29].…”

Section: Introductionmentioning

confidence: 99%

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Characterizing lesion morphology of a novel diamond-tip temperature-controlled irrigated radiofrequency ablation catheter

Dhanjal

Schmidt

Getman

et al. 2023

J Interv Card Electrophysiol

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Background The DiamondTemp ablation (DTA) system is a novel temperature-controlled irrigated radiofrequency (RF) ablation system that accurately measures tip-tissue temperatures for real-time power modulation. Lesion morphologies from longer RF durations with the DTA system have not been previously described. We sought to evaluate lesion characteristics of the DTA system when varying the application durations. Methods A bench model using porcine myocardium was used to deliver discrete lesions in a simulated clinical environment. The DTA system was power-limited at 50 W with temperature set-points of 50 °C and 60 °C (denoted Group_50 and Group_60). Application durations were randomized with a range of 5–120 s. Results In total, 280 applications were performed. Steam pops were observed in five applications: two applications at 90 s and three applications at 120 s. Lesion size (depth and maximum width) increased significantly with longer applications, until 60 s for both Group_50 and Group_60 (depth: 4.5 ± 1.2 mm and 5.6 ± 1.3 mm; maximum width: 9.3 ± 2.7mm and 11.2 ± 1.7mm, respectively). As lesions transition from resistive to conductive heating (longer than 10 s), the maximum width progressed in a sub-surface propagation. Using a “Time after Temperature 60 °C” (TaT60) analysis, depths of 2–3 mm occur in 0–5 s and depths plateau at 4.6 ± 0.8 mm between 20 and 30 s. Conclusions The DTA system rapidly creates wide lesions with lesion depth increasing over time with application durations up to 60 s. Using a TaT60 approach is a promising ablation guidance that would benefit from further investigation.

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High-Power Short-Duration Radiofrequency Application for Faster and Safer Pulmonary Vein Isolation

Castrejón-Castrejón,

Martínez Cossiani,

Basterra Sola

et al. 2024

JACC: Clinical Electrophysiology

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Radiofrequency ablation using the second-generation temperature-controlled diamond tip system in paroxysmal and persistent atrial fibrillation: results from FASTR-AF

Cited by 3 publications

References 21 publications

Early real-world experience using temperature-guided diamond tip facilitated high-power ablation for catheter ablation of atrial fibrillation

Early real-world experience using temperature-guided diamond tip facilitated high-power ablation for catheter ablation of atrial fibrillation

Characterizing lesion morphology of a novel diamond-tip temperature-controlled irrigated radiofrequency ablation catheter

High-Power Short-Duration Radiofrequency Application for Faster and Safer Pulmonary Vein Isolation

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