Key result
Non-irrigated 4 mm and 8 mm gold tip catheters produced significantly deeper lesions than platinum-iridium catheters in porcine tissue (e.g., 4 mm liver: 4.67 vs 2.9 mm, P<0.0001).
Why the study?
Does a gold tip electrode ablation catheter increase lesion depth compared to a platinum-iridium tip catheter in an in vitro model?
Does a gold tip electrode ablation catheter increase lesion depth compared to a platinum-iridium tip catheter in an in vitro model?
Non-irrigated gold tip ablation catheters produce deeper lesions than platinum-iridium catheters in vitro, but this advantage is lost with irrigated tip catheters.
Gold-tip lesion depths in vitro are hypothesis-generating; human studies needed before clinical consideration.
AIMS: We compared a newly developed irrigated gold tip electrode ablation catheter and a gold tip 4 and 8 mm catheter with the corresponding platinum-iridium (Pt) tip catheters in an in vitro setting. METHODS AND RESULTS: In a flow chamber simulating physiological flow conditions, radiofrequency catheter ablation was performed on tissue samples of porcine endomyocardium and liver. Lesion depth, energy and temperature delivery, and popping frequency were determined. Two hundred and fifty-three ablations were conducted. Four and eight millimetre, gold tip electrode catheters produced significantly deeper lesions compared with the Pt tip electrode (liver 4 mm: 4.67 +/- 1.7 vs. 2.9 +/- 1.0 mm, P < 0.0001; endomyocardium 4 mm: 3.88 +/- 1.1 vs. 2.81 +/- 0.7 mm, P < 0.001; liver 8 mm: 3.98 +/- 1.0 vs. 2.03 +/- 1.1 mm, P < 0.001; endomyocardium 8 mm: 4.00 +/- 0.9 vs. 3.39 +/- 0.8 mm, P < 0.001) and correlated with the amount of energy delivery. Popping frequency was significantly higher in gold tip electrodes. In irrigated tip electrodes, there was no difference in the lesion depth comparing gold with Pt (liver: 5.18 +/- 0.7 vs. 5.01 +/- 0.7 mm, P = ns; endomyocardium: 4.89 +/- 0.7 vs. 4.78 +/- 0.8 mm, P = ns). There was a trend towards less popping in the gold tip electrode. CONCLUSION: Both 4 and 8 mm not-irrigated gold tip catheters produced deeper lesions than the corresponding Pt tip catheter. In irrigated tip catheters, gold and Pt tip material did not show differences in the lesion depth.
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Linhart et al. (2009) studied In vitro tissue ablation (n=253). Gold tip electrode ablation catheter vs. Platinum-iridium (Pt) tip electrode ablation catheter was evaluated on Lesion depth. Non-irrigated 4 mm and 8 mm gold tip catheters produced significantly deeper lesions than platinum-iridium catheters in porcine tissue (e.g., 4 mm liver: 4.67 vs 2.9 mm, P<0.0001).
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