Key result
Diffuse irrigation using the Coolflex catheter did not significantly improve procedural duration, RF duration, fluoroscopic duration, or fluid amount compared to a standard irrigated-tip catheter.
Why the study?
Does a 4 mm tip fully irrigated ablation catheter improve procedural outcomes compared to a standard 3.5 mm tip ablation catheter with six distal irrigation channels in patients with typical atrial flutter?
RCT (n=60)
randomized
Does a 4 mm tip fully irrigated ablation catheter improve procedural outcomes compared to a standard 3.5 mm tip ablation catheter with six distal irrigation channels in patients with typical atrial flutter?
The use of a diffusely irrigated ablation catheter tip does not provide procedural advantages over a standard six-channel irrigated-tip catheter for right atrial flutter ablation.
No procedural benefit from diffuse irrigation in flutter ablation; confirms standard six-channel irrigated tips remain adequate.
AIMS: Recent developments of open irrigated catheters have sought to create uniform cooling of the entire ablating electrode. The aim of this randomized study was to assess whether the diffuse irrigation of the Coolflex(®) (CF) catheter results in improved short-term procedural benefits in patients undergoing ablation of right atrial typical flutter. METHODS AND RESULTS: Sixty consecutive patients (age 62 ± 13) with typical atrial flutter were prospectively randomized to ablation of the cavotricuspid isthmus (CTI) using either a standard 3.5 mm tip ablation catheter with six distal irrigation channels (6C) (30 patients) or a 4 mm tip fully irrigated ablation catheter (CF) (30 patients). There were no significant differences seen between procedures performed with the diffusely irrigated CF catheter and the standard six-channel irrigated-tip catheter. This concerned the total procedural duration RF duration, fluoroscopic duration, the total amount of irrigation fluid, and the occurrence of steam pop. CONCLUSIONS: The use of a diffuse irrigation at the ablation catheter tip does neither facilitate lesion formation nor reduce the amount of irrigation during RF ablation for typical right atrial flutter using recommended flow and power settings.
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Ramoul et al. (2014) conducted an RCT in typical atrial flutter (n=60). 4 mm tip fully irrigated ablation catheter (Coolflex) vs. Standard 3.5 mm tip ablation catheter with six distal irrigation channels was evaluated on Short-term procedural benefits (procedural duration, RF duration, fluoroscopic duration, irrigation fluid amount, steam pop). Diffuse irrigation using the Coolflex catheter did not significantly improve procedural duration, RF duration, fluoroscopic duration, or fluid amount compared to a standard irrigated-tip catheter.
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