Safety verification of a novel irrigation catheter with flexible tip of laser‐cut kerfs and contact force sensor

Yamaguchi, Junji; Takigawa, Masateru; Goya, Masahiko; Yamamoto, Tasuku; Ikenouchi, Takashi; Iwakawa, Hidehiro; Negishi, Miho; Goto, Kentaro; Shigeta, Takatoshi; Nishimura, Takuro; Takamiya, Tomomasa; Tao, Susumu; Miyazaki, Shinsuke; Sasano, Tetsuo

doi:10.1111/pace.14868

Cited by 5 publications

(1 citation statement)

References 22 publications

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“…The different companies updated their catheters to improve safety and efficacy by the possibility to deliver higher power and ensure better tip-tissue stability, not only by contact-force sensors but also by new tip features (e.g., TactiFlex, Abbott) [ 46 , 47 ]. In this context, irrigated catheters were equipped with tip thermocouples in order to get tissue/tip temperature feedback and thus achieve a real “temperature-controlled” RF delivery (Qdot Micro, Biosense Webster, and DiamondTemp, Medtronic).…”

Section: Energy Sources For Af Ablationmentioning

confidence: 99%

Ablation of Paroxysmal Atrial Fibrillation: between Present and Future

Robles,

Palamà,

Scarà

et al. 2024

Rev. Cardiovasc. Med.

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Pulmonary vein isolation (PVI) is the established cornerstone for atrial fibrillation (AF) ablation, indeed current guidelines recognize PVI as the gold standard for first-time AF ablation, regardless of if it is paroxysmal or persistent. Since 1998 when Haïssaguerre pioneered AF ablation demonstrating a burden reduction after segmental pulmonary vein (PV) ablation, our approach to PVI was superior in terms of methodology and technology. This review aims to describe how paroxysmal atrial fibrillation ablation has evolved over the last twenty years. We will focus on available techniques, a mechanistic understanding of paroxysmal AF genesis and the possibility of a tailored approach for the treatment of AF, before concluding with a future perspective.

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Section: Energy Sources For Af Ablationmentioning

confidence: 99%

Ablation of Paroxysmal Atrial Fibrillation: between Present and Future

Robles,

Palamà,

Scarà

et al. 2024

Rev. Cardiovasc. Med.

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An optimized approach for increasing lesion size in temperature‐controled setting using a catheter with a surface thermocouple and efficient irrigation

Takigawa,

Yamaguchi,

Goya

et al. 2024

Journal of Arrhythmia

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BackgroundWe explore an optimized approach for increasing lesion size using a novel ablation catheter with a surface thermocouple and efficient irrigation in a temperature‐control setting.MethodsWe conducted radiofrequency applications at various power levels (35 W, 40 W, and 45 W), contact forces (CFs, 10 g/20 g), and durations (60 s/120 s/180 s) in perpendicular/parallel catheter orientations, with normal saline irrigation (NS‐irrigation) and Half NS‐irrigation (HNS‐irrigation) in an ex‐vivo model (Step 1). In addition, we performed applications (35 W/40 W/45 W for 60 s/120 s/180 s in NS‐irrigation and 35 W/40 W for 60 s/120 s/180 s in HNS‐irrigation) in four swine (Step 2), evaluating lesion characteristics and the occurrence of steam pops.ResultsIn Step 1, out of 288 lesions, we observed 47 (16.3%) steam pops, with 13 in NS‐irrigation and 34 in HNS‐irrigation (p = .001). Although steam pops were mostly observed with the most aggressive setting (45 W/180 s, 54%) with NS‐irrigation, they happened in less aggressive settings with HNS irrigation. Lesion size significantly increased with longer‐duration ablation but not with HNS‐irrigation. The optimal %impedance‐drop cutoff to predict steam pops was 20% with a negative‐predictive‐value (NPV) = 95.1% including NS‐ and HNS‐irrigation groups, and 22% with an NPV = 96.1% in NS‐irrigation group. In Step 2, similar to the ex‐vivo model, lesion size significantly increased with longer‐duration ablation but not with HNS‐irrigation. Steam pops were absent with NS‐irrigation (0/35) even with the largest %impedance‐drop reaching 31% at 45 W/180 s. All steam pops were observed with HNS‐irrigation (6/21, 29%). The optimal %impedance‐drop cutoff predicting steam pops was 24% with an NPV = 96.3% including both NS‐ and HNS‐irrigation groups.ConclusionsRather than using HNS‐irrigation, very long‐duration of radiofrequency applications up to 45 W/180 s may be recommended to safely and effectively increase lesion dimensions using this catheter with NS‐irrigation.

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Feasibility and efficacy of 50 W ablation with the TactiFlex catheter for the initial pulmonary vein isolation of atrial fibrillation

Matsumoto,

Tanaka,

Sasaki

et al. 2024

Journal of Arrhythmia

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BackgroundA novel contact force (CF) sensing catheter with a mesh‐shaped irrigation tip (TactiFlexTM SE, Abbott), is expected to provide safe and effective radiofrequency ablation. Our previous study revealed that the TactiFlex catheter needs a higher power for pulmonary vein isolation (PVI) due to the long tip length. This study aimed to examine the feasibility and safety of a 50 W ablation with the TactiFlex for PVI of atrial fibrillation (AF).MethodsA PVI was performed in 100 AF patients using TactiFlex catheters with a 50 W setting, 5‐20 g CF, and 15–20 s ablation time. The primary outcomes included a successful PVI, the incidence of first‐pass isolations (FPIs), the presence of PV conduction gaps, and the incidence of complications.ResultsFPIs were achieved for 82/100 (82%) right pulmonary veins (RPVs) and 87/100 (87%) left PVs (LPVs). Among the unsuccessful RPV FPIs, residual carina potentials were observed in 16/18 cases (89%), PV gaps in 1/18 cases (5.5%), and both carina and PV gaps in 1/18 cases (5.5%). Similarly, among the unsuccessful LPV FPIs, residual carina potentials were observed in 11/13 cases (84.6%), PV gaps in 1/13 cases (7.7%), and both carina and PV gaps in 1/13 cases (7.7%). Periesophageal nerve injury occurred in 1/100 cases (1%), and no cardiac tamponade occurred. The overall AF‐free rate at one‐year was 81.7%.ConclusionsThe 50 W ablation with the TactiFlex demonstrated a high rate of an FPI, low incidence of PV gaps, and proved to be a safe and effective approach for the initial PVI of AF.

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Safety verification of a novel irrigation catheter with flexible tip of laser‐cut kerfs and contact force sensor

Cited by 5 publications

References 22 publications

Ablation of Paroxysmal Atrial Fibrillation: between Present and Future

Ablation of Paroxysmal Atrial Fibrillation: between Present and Future

An optimized approach for increasing lesion size in temperature‐controled setting using a catheter with a surface thermocouple and efficient irrigation

Feasibility and efficacy of 50 W ablation with the TactiFlex catheter for the initial pulmonary vein isolation of atrial fibrillation

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