The use of a 12-channel irrigated-tip catheter for cavotricuspid isthmus ablation significantly increased the risk of steam pops compared to a 6-channel catheter (13% vs 0%, P=0.018).
RCT (n=95)
Yes
Does a 12-channel irrigated-tip catheter improve procedural efficiency or safety compared to a 6-channel catheter in patients undergoing cavotricuspid isthmus ablation?
The addition of proximal irrigation holes to a radiofrequency ablation catheter does not improve procedural efficiency but significantly increases the risk of steam pops, likely due to distorted temperature feedback.
Absolute Event Rate: 13% vs 0%
p-value: p=0.018
INTRODUCTION: Open irrigation during radiofrequency (RF) application allows a higher power delivery in the setting of temperature-controlled ablation, without causing blood clots. This study sought to evaluate the clinical value of the additional 6 supplementary channels at the proximal catheter tip compared to a standard irrigated RF catheter with 6 conventional channels present at the distal tip only. METHODS AND RESULTS: Ninety-five consecutive patients were prospectively randomized to cavotricuspid isthmus ablation using an 3.5 mm tip ablation catheter with 6 distal irrigation channels (6C; 48 patients) or an 4 mm tip ablation catheter with 12 irrigation channels (12C; 47 patients) disposed at the distal (6 channels) and proximal (6 additional channels) catheter tip. There was no significant difference between the 12C and the 6C irrigated-tip catheter concerning the total procedural duration, the RF duration, the fluoroscopic duration, and the amount of irrigation. Conversely, there were significantly more patients who experienced at least one steam pop while using the 12C as compared to the 6C irrigated-tip catheter (0% vs 13%, respectively, P = 0.018). CONCLUSION: The addition of proximal irrigation holes at the catheter tip do not facilitate lesion formation during RF ablation, but significantly increases the risk of steam pop. This is probably the consequence of an increase distortion of the temperature feedback.
Knecht et al. (Fri,) conducted a rct in Patients undergoing cavotricuspid isthmus ablation (n=95). 12-channel irrigated-tip ablation catheter vs. 6-channel irrigated-tip ablation catheter was evaluated on Incidence of at least one steam pop (p=0.018). The use of a 12-channel irrigated-tip catheter for cavotricuspid isthmus ablation significantly increased the risk of steam pops compared to a 6-channel catheter (13% vs 0%, P=0.018).