First clinical experience using the DiamondTemp catheter and a novel omnipolar high-resolution mapping system for atrial fibrillation ablation

BACKGROUND: The DiamondTemp (DT) radiofrequency ablation (RFA) catheter has been introduced as a new tool for atrial fibrillation (AF) ablation. The new technology allows for temperature-controlled irrigated ablation and real-time lesion assessment. Recently, the EnSite X mapping system became commercially available allowing for omnipolar and ultra-high-resolution mapping. We aimed to assess the feasibility of the new DT RFA catheter in performing AF ablation procedures in conjunction with the novel EnSite X system under routine clinical conditions. METHODS: We analyzed data from 10 consecutive patients who underwent AF ablation using the DT RFA catheter guided by EnSite X. Procedural data and short-term follow-up were assessed as well as potential technical issues. RESULTS: Nine out of 10 patients underwent de-novo pulmonary vein isolation (PVI), and 1 patient underwent repeat ablation. First-pass isolation was observed in 7/10 patients. Total procedure duration (skin-to-skin) was 88.9 ± 30.1 min, and left atrium dwell time was 70 ± 22.3 min. The mean number of RF applications needed for PVI and additional ablation was 70.52 ± 26.70. The HD Grid SE mapping catheter was utilized in 8 patients and the Advisor SE in 2 patients. Bidirectional block of the applied lines was achieved in all patients. No steam pops were observed, and no intraprocedural complications occurred. CONCLUSIONS: This first clinical series demonstrated that temperature-controlled irrigated ablation in combination with the novel omnipolar and high-resolution mapping system resulted in rapid, efficient, and durable lesion formation under routine clinical conditions. Randomized controlled trials are needed to elucidate the impact on lesion formation, long-term outcomes, and reproducibility of our initial findings.