Key result
Endocardial ablation using the FlexAbility catheter resulted in a lower risk of steam pops compared to ThermoCool SF (P=0.013) with no significant difference in lesion sizes.
Why the study?
Does the FlexAbility ablation catheter improve safety or lesion size compared to ThermoCool and ThermoCool SF catheters in a canine model?
RCT (n=12)
Chamber-level
Does the FlexAbility ablation catheter improve safety or lesion size compared to ThermoCool and ThermoCool SF catheters in a canine model?
The FlexAbility catheter produces similar lesion sizes to standard solid-tip catheters but with a lower risk of steam pops in a canine model.
Answers are grounded in this paper and cite their sources.
Animal findings do not support clinical adoption; hypothesis-generating and leaves open translation to human ablation procedures.
INTRODUCTION: Next-generation catheters have been developed to reduce irrigation volume and preserve power delivery. A novel design uses a flexible tip (FlexAbility™ catheter) that directs flow to the contact surface. Because of recent safety issues with new catheters, we undertook a study in a canine heart with 3 irrigated catheters to compare efficacy and safety. METHODS: Endocardial ablation was performed by 2 independent operators in 12 anesthetized canines with the FlexAbility (St. Jude Medical), ThermoCool™ (Biosense Webster), and ThermoCool™ SF (Biosense Webster) catheters. Endocardial RF lesions were delivered with each catheter in all 4 chambers of each animal for 52 ± 16 seconds. Each chamber was randomized to receive ablation from one catheter with recording of safety events. Cardiac pathology was performed with triphenyl tetrazolium chloride stain. RESULTS: Average lesion dimensions were not significantly different between the 3 catheters. FlexAbility™ demonstrated a lower risk of steam pops relative to ThermoCool SF (P-value = 0.013) despite equal mean power and radiofrequency time. High-temperature generator shutdowns were observed with FlexAbility™ but not with either ThermoCool catheter. High-temperature shutdowns were associated with larger average impedance drops (28.5 ohms vs. 19 ohms) without compromising lesion size. CONCLUSIONS: The FlexAbility™ tip is safe and effective with no significant difference in lesion sizes compared to both standard ThermoCool and ThermoCool SF. FlexAbility™ has a significantly lower risk of steam pops compared to ThermoCool SF in a beating heart as defined predominantly by an abrupt rise of impedance.
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Winterfield et al. (2015) conducted an RCT in Endocardial ablation (n=12). FlexAbility catheter vs. ThermoCool and ThermoCool SF catheters was evaluated on Lesion dimensions and steam pops (p=0.013). Endocardial ablation using the FlexAbility catheter resulted in a lower risk of steam pops compared to ThermoCool SF (P=0.013) with no significant difference in lesion sizes.
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