Gold vs. platinum-iridium tip catheter for cavotricuspid isthmus ablation: the AURUM 8 study
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Gold vs. platinum-iridium tip catheter for cavotricuspid isthmus ablation: the AURUM 8 study. / AURUM 8 Study Investigators.
in: EUROPACE, Jahrgang 13, Nr. 1, 01.2011, S. 102-108.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Gold vs. platinum-iridium tip catheter for cavotricuspid isthmus ablation: the AURUM 8 study
AU - Lewalter, Thorsten
AU - Weiss, Christian
AU - Spencker, Sebastian
AU - Jung, Werner
AU - Haverkamp, Wilhelm
AU - Willems, Stephan
AU - Deneke, Thomas
AU - Kautzner, Josef
AU - Wiedemann, Michael
AU - Siebels, Jürgen
AU - Pitschner, Heinz Friedrich
AU - Hoffmann, Ellen
AU - Hindricks, Gerd
AU - Zabel, Markus
AU - Vester, Ernst
AU - Schwacke, Harald
AU - Mittmann-Braun, Erica
AU - Lickfett, Lars
AU - Hoffmeister, Sabine
AU - Proff, Jochen
AU - Mewis, Christian
AU - Bauer, Wolfgang
AU - AURUM 8 Study Investigators
PY - 2011/1
Y1 - 2011/1
N2 - AIMS: Gold electrodes have the theoretical advantage of creating bigger lesions than platinum-iridium (Pt-Ir) electrodes. We performed a prospective randomized study to compare the clinical efficacy of standard 8 mm Pt-Ir tip catheter (control) and 8 mm gold-tip catheters in the ablation of the cavotricuspid isthmus (CTI)-dependent atrial flutter.METHODS AND RESULTS: A total of 463 patients undergoing CTI ablation in 19 clinical centres were randomized to receive the treatment by gold-tip or control catheter. The primary endpoint was cumulative radiofrequency (RF) application duration until achieving bidirectional CTI block. It did not differ significantly for the two catheters. The gold-tip catheter was, however, associated with a higher ablation success rate (94.3 vs. 89.0%, P = 0.042) and a substantially lower incidence of char and coagulum formation (4.8 vs. 37.9%, P < 0.001), which required exchange of 1 gold-tip (0.4%) and 10 control catheters (4.6%, P = 0.005). The gold-tip catheter delivered more mean power (52 ± 12 W) than the control catheter (48 ± 13 W, P < 0.001). Both mean and maximum temperatures measured by the thermocouple integrated in the catheter tip were statistically significantly lower in the gold (mean: 53.2 ± 4.7°C, max: 68.7 ± 6.6°C) than in the control catheter (54.3 ± 5.2 and 70.2 ± 7.0°C, respectively, P < 0.05). Fluoroscopy time, procedure duration, procedural-related complications, and arrhythmia recurrence during 6 months of follow-up did not differ between the two catheters.CONCLUSION: Owing to a higher primary ablation success rate and reduced incidence of char/coagulum formation, gold may be preferred over Pt-Ir as electrode material for 8 mm tip catheters for CTI ablation. ClinicalTrials.gov: NCT00326001 (http://clinicaltrials.gov/ct2/show/NCT00326001).
AB - AIMS: Gold electrodes have the theoretical advantage of creating bigger lesions than platinum-iridium (Pt-Ir) electrodes. We performed a prospective randomized study to compare the clinical efficacy of standard 8 mm Pt-Ir tip catheter (control) and 8 mm gold-tip catheters in the ablation of the cavotricuspid isthmus (CTI)-dependent atrial flutter.METHODS AND RESULTS: A total of 463 patients undergoing CTI ablation in 19 clinical centres were randomized to receive the treatment by gold-tip or control catheter. The primary endpoint was cumulative radiofrequency (RF) application duration until achieving bidirectional CTI block. It did not differ significantly for the two catheters. The gold-tip catheter was, however, associated with a higher ablation success rate (94.3 vs. 89.0%, P = 0.042) and a substantially lower incidence of char and coagulum formation (4.8 vs. 37.9%, P < 0.001), which required exchange of 1 gold-tip (0.4%) and 10 control catheters (4.6%, P = 0.005). The gold-tip catheter delivered more mean power (52 ± 12 W) than the control catheter (48 ± 13 W, P < 0.001). Both mean and maximum temperatures measured by the thermocouple integrated in the catheter tip were statistically significantly lower in the gold (mean: 53.2 ± 4.7°C, max: 68.7 ± 6.6°C) than in the control catheter (54.3 ± 5.2 and 70.2 ± 7.0°C, respectively, P < 0.05). Fluoroscopy time, procedure duration, procedural-related complications, and arrhythmia recurrence during 6 months of follow-up did not differ between the two catheters.CONCLUSION: Owing to a higher primary ablation success rate and reduced incidence of char/coagulum formation, gold may be preferred over Pt-Ir as electrode material for 8 mm tip catheters for CTI ablation. ClinicalTrials.gov: NCT00326001 (http://clinicaltrials.gov/ct2/show/NCT00326001).
KW - Aged
KW - Atrial Flutter/surgery
KW - Catheter Ablation/instrumentation
KW - Electrodes
KW - Female
KW - Follow-Up Studies
KW - Gold
KW - Humans
KW - Iridium
KW - Male
KW - Middle Aged
KW - Platinum
KW - Prospective Studies
KW - Recurrence
KW - Retrospective Studies
KW - Thermal Conductivity
KW - Treatment Outcome
U2 - 10.1093/europace/euq339
DO - 10.1093/europace/euq339
M3 - SCORING: Journal article
C2 - 20876601
VL - 13
SP - 102
EP - 108
JO - EUROPACE
JF - EUROPACE
SN - 1099-5129
IS - 1
ER -