Key result
vHPSD QDOT ablation produces deeper lesions than TactiFlex but shallower than SmartTouch in gel models.
Why the study?
Rapid temperature rises during very high-power short-duration RFA may cause complications, and the impact of electrode design differences between catheters was unclear.
Does the QDOT Micro catheter produce different lesion dimensions and temperatures compared to SmartTouch and TactiFlex SE during vHPSD radiofrequency ablation in a gel tank model?
Does the QDOT Micro catheter produce different lesion dimensions and temperatures compared to SmartTouch and TactiFlex SE during vHPSD radiofrequency ablation in a gel tank model?
Absolute Event Rate: 1.93% vs 1.88%
p-value: p=0.02
In a gel tank model, vHPSD ablation with the QDOT catheter achieved greater dimensions and temperatures than TactiFlex, while SmartTouch and 0.45% saline increased the risk of steam pops.
Electrode design differences may affect vHPSD lesions in vitro; leaves open clinical translation and safety.
Background Very high‐power short‐duration (vHPSD) radiofrequency ablation (RFA) is an alternative strategy for pulmonary vein isolation. However, rapid temperature rises may cause complications. The QDOT Micro is designed to detect temperature rises for automatic power and irrigation flow adjustments. We compared how differences in ablation electrode design between three RFA catheters impact vHPSD lesions. Methods vHPSD RFA was performed within a validated gel tank model. Four‐second ablations were delivered with stable contact force using the QDOT, SmartTouch, and TactiFlex SE at 60, 70, 80, and 90 watts, positioned perpendicular (90°), oblique (45°), and parallel (0°) to the ablation target, utilizing 0.9% and 0.45% “half‐normal” saline (HNS) irrigation. The SmartTouch and TactiFlex were operated in power‐controlled mode, and each configuration was repeated three times, with images captured every second to characterize lesions. Results In total, 216 vHPSD lesions were delivered. At 90 W, 90°, and 0.9% saline, the QDOT produced lesions with a mean depth of 1.93 mm. The TactiFlex produced shallower lesions, with a mean depth of 1.88 mm ( p = 0.02), and the SmartTouch produced the deepest, with a mean depth of 2.37 mm ( p < 0.001). The mean diameter of QDOT lesions, at 4.63 mm, was comparable to TactiFlex lesions (4.58 mm, p = 0.8), whilst the SmartTouch lesions were significantly wider than both the QDOT and TactiFlex (6.04 mm, p < 0.001). Steam‐pop risk, based on lesion temperature, was lowest for the TactiFlex. Conclusion vHPSD lesions produced with the QDOT achieved greater dimensions and temperatures than those with the TactiFlex under controlled conditions, suggesting a difference in the cooling profile of the ablation electrodes. vHPSD with the SmartTouch or 0.45% HNS are likely to increase the risk of steam pops.
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Turnbull et al. (2026) studied Pulmonary vein isolation (in vitro model) (n=216). QDOT Micro catheter vs. SmartTouch and TactiFlex SE catheters was evaluated on Mean lesion depth at 90 W, 90°, and 0.9% saline (p=0.02). In a gel tank model, very high-power short-duration ablation with the QDOT catheter produced deeper lesions (1.93 mm) than TactiFlex (1.88 mm, p=0.02) but shallower than SmartTouch (2.37 mm, p<0.001).
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