Heart Rhythm Management Center, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
J Interv Card Electrophysiol. 2022 Sep;64(3):751-757. doi: 10.1007/s10840-022-01152-w. Epub 2022 Mar 3.
Radiofrequency (RF) catheter ablation is widely accepted as a first-line therapy for cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL). The novel DiamondTemp (DT) catheter with temperature feedback during RF ablation has been released recently on the market. The purpose of this study was to evaluate the impact of DiamondTemp (DT) technology on ablation efficiency during AFL.
In this single-center study, 30 consecutive patients with typical AFL indicated to ablation of CTI were included. The first 15 patients underwent CTI ablation using 8-mm tip catheter, and the following 15 patients underwent temperature-controlled RF ablation using DT catheter. The endpoints were number and mean total duration of RF applications, mean temperature reached in the setting of CTI, procedural times, and fluoroscopy times.
There were no significant differences between the two groups concerning baseline characteristics. Mean duration of the each application (71.5 s ± 30.6 vs 12.4 s ± 13.2, p value < 0.001), mean total duration of RF applications (517,73 s ± 377,96 vs 112,8 s ± 43,58; p value < 0.001), procedural times (51.6 min ± 24.2 vs 38.6 ± 8.2; p = 0.03), and fluoroscopy times (16.2 min ± 10.2 vs 8 min ± 4.24; p = 0.005) were longer in the 8-mm ablation catheter group. Mean temperature measurements (51.9 °C ± 3.59 vs 56.7 °C ± 3.34, p value < 0.003) were as well lower in the 8-mm ablation catheter group.
Catheter ablation of CTI-dependent AFL by means of DT resulted in a significant reduction of total and single application RF delivery time, procedure, and fluoroscopy times.
射频(RF)导管消融术被广泛认为是治疗三尖瓣峡部依赖型房扑(AFL)的一线治疗方法。最近市场上推出了具有 RF 消融过程中温度反馈功能的新型 DiamondTemp(DT)导管。本研究旨在评估 DiamondTemp(DT)技术对 AFL 消融效率的影响。
在这项单中心研究中,纳入了 30 例拟行三尖瓣峡部消融的典型 AFL 患者。前 15 例患者使用 8 毫米尖端导管进行 CTI 消融,随后 15 例患者使用 DT 导管进行温度控制的 RF 消融。研究终点为 RF 应用的数量和平均总时间、三尖瓣峡部设定温度、手术时间和透视时间。
两组患者的基线特征无显著差异。每次应用的平均持续时间(71.5±30.6 秒与 12.4±13.2 秒,p 值<0.001)、RF 应用的平均总持续时间(517.73±377.96 秒与 112.8±43.58 秒,p 值<0.001)、手术时间(51.6±24.2 分钟与 38.6±8.2 分钟,p=0.03)和透视时间(16.2±10.2 分钟与 8 分钟±4.24 分钟,p=0.005)在 8 毫米消融导管组更长。8 毫米消融导管组的平均温度测量值(51.9°C±3.59°C 与 56.7°C±3.34°C,p 值<0.003)也更低。
通过 DT 进行三尖瓣峡部依赖型 AFL 的导管消融可显著减少 RF 输送的总时间和单次应用时间,以及手术和透视时间。