Porous tip radiofrequency ablation catheter reduced heart failure‐related complications and healthcare resource utilization in paroxysmal atrial fibrillation patients

Introduction A 56‐hole porous tip radiofrequency catheter was developed to provide more uniform cooling with less fluid delivery than a prior 6‐hole irrigated design. This study aimed to evaluate the impact of contact force (CF) ablation with the porous tip on complications (congestive heart failure [CHF] and non‐CHF related), healthcare resource utilization, and procedural efficiency in patients undergoing de novo paroxysmal atrial fibrillation (PAF) ablations in a real‐world setting. Methods Consecutive de novo PAF ablations were performed between February 2014 and March 2019 by six operators at a single US academic center. The 6‐hole design was used through December 2016 with the 56‐hole porous tip adopted in October 2016. The outcomes of interest included symptomatic CHF presentation and CHF‐related complications. Results Of 174 patients who were included, mean age was 61.1 ± 10.8 years, 67.8% were male, and 25.3% had a history of CHF. Ablation with the porous tip catheter significantly decreased fluid delivery (1177 vs. 1912 mL with the 6‐hole design; p < .0001). CHF‐related complications within 7 days, particularly fluid overload, were substantially reduced with the porous tip (15.2% vs. 5.3% of patients; p = .0281) and the proportion of patients with symptomatic CHF presentation within 30 days postablation was significantly lower (14.7% vs. 32.5%; p = .0058). Conclusion The 56‐hole porous tip led to significantly reduced CHF‐related complications and healthcare utilization in PAF patients undergoing CF catheter ablation when compared to the prior 6‐hole design. This reduction likely results from the significant decrease in fluid delivery during the procedure.