Arrhythmia Center, Korea University Medicine, Seoul, Republic of Korea.
PLoS One. 2020 Oct 1;15(10):e0239339. doi: 10.1371/journal.pone.0239339. eCollection 2020.
Open irrigation ablation catheters are now the standard in radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). Among various irrigation catheters, laser-cut slit-based irrigation system (Cool Flex and FlexAbility) has a unique design to cool the catheter tip more efficiently. We aimed to assess the safety of slit-based irrigation catheters regarding prevention of procedure-related ischemic complication in AF patients undergoing RFCA. The analysis was performed with Korea University Medicine Anam Hospital RFCA registry. Procedure-related ischemic complication was defined as ischemic stroke or transient ischemic attack (TIA) occurring within 30 days after RFCA. Patients were divided into 3 groups: non-irrigation, hole-based irrigation, and slit-based irrigation catheter groups. A total of 3,120 AF patients underwent first RFCA. Non-irrigation, non-slit-based irrigation, and slit-based irrigation catheters were used in 290, 1,539, and 1,291 patients, respectively. As compared with non-irrigation and non-slit-based irrigation catheter groups, slit-based irrigation catheter group had significantly older age, higher prevalence of non-paroxysmal AF, large left atrial size, and decreased left atrial appendage flow velocity. The CHA2DS2-VASc score was not different among the 3 groups. Procedure-related ischemic complication occurred in 17 patients (0.54%) with 16 ischemic strokes and 1 TIA event: 5/290 (1.72%), 11/1,539 (0.71%), and 1/1,291 (0.08%) events in non-irrigation, non-slit-based irrigation, and slit-based irrigation catheter groups, respectively (p = 0.001). Slit-based irrigation catheter was superior in direct comparison with non-slit-based irrigation catheter (0.71% vs. 0.08%; p = 0.009). Slit-based irrigation catheters were highly effective in preventing procedure-related ischemic complications.
开放式灌洗消融导管目前是射频导管消融（RFCA）治疗心房颤动（AF）的标准。在各种灌洗导管中，激光切割狭缝式灌洗系统（Cool Flex 和 FlexAbility）具有独特的设计，可更有效地冷却导管尖端。我们旨在评估基于狭缝的灌洗导管在预防接受 RFCA 的 AF 患者与手术相关的缺血性并发症方面的安全性。该分析使用了韩国大学医学安山医院的 RFCA 登记处进行。手术相关的缺血性并发症定义为 RFCA 后 30 天内发生的缺血性中风或短暂性脑缺血发作（TIA）。患者被分为 3 组：非灌洗组、孔式灌洗组和狭缝式灌洗导管组。共有 3120 例 AF 患者接受了首次 RFCA。分别在 290 例、1539 例和 1291 例患者中使用了非灌洗、非狭缝式灌洗和狭缝式灌洗导管。与非灌洗和非狭缝式灌洗导管组相比，狭缝式灌洗导管组患者年龄较大，非阵发性 AF 患病率较高，左心房较大，左心耳血流速度降低。3 组患者的 CHA2DS2-VASc 评分无差异。17 例（0.54%）患者发生与手术相关的缺血性并发症，其中 16 例为缺血性中风，1 例为 TIA：非灌洗组 5/290（1.72%），非狭缝式灌洗组 11/1539（0.71%），狭缝式灌洗导管组 1/1291（0.08%）（p = 0.001）。与非狭缝式灌洗导管相比，狭缝式灌洗导管具有优势（0.71%比 0.08%；p = 0.009）。狭缝式灌洗导管在预防与手术相关的缺血性并发症方面非常有效。
