Revival of the Forgotten
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Revival of the Forgotten : Temperature-Controlled Catheter Ablation of the Pulmonary Veins Using the Novel DiamondTemp Ablation System. / Rottner, Laura; Moser, Fabian; Moser, Julia; Schleberger, Ruben; Lemoine, Marc; Münkler, Paula; Dinshaw, Leon; Kirchhof, Paulus; Ouyang, Feifan; Rillig, Andreas; Metzner, Andreas; Reissmann, Bruno.
In: INT HEART J, Vol. 63, No. 3, 2022, p. 504-509.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Revival of the Forgotten
T2 - Temperature-Controlled Catheter Ablation of the Pulmonary Veins Using the Novel DiamondTemp Ablation System
AU - Rottner, Laura
AU - Moser, Fabian
AU - Moser, Julia
AU - Schleberger, Ruben
AU - Lemoine, Marc
AU - Münkler, Paula
AU - Dinshaw, Leon
AU - Kirchhof, Paulus
AU - Ouyang, Feifan
AU - Rillig, Andreas
AU - Metzner, Andreas
AU - Reissmann, Bruno
PY - 2022
Y1 - 2022
N2 - Pulmonary vein (PV) isolation (PVI) by continuous, transmural and durable lesions is decisive for ensuring long-term freedom from atrial fibrillation (AF). AF ablation requires irrigated tip catheters to reduce thromboembolic complications. This precluded temperature-controlled delivery of radiofrequency (RF) energy.The aim of this study was to evaluate feasibility, acute efficacy, and safety of an irrigated, temperature-controlled ablation catheter [DiamondTemp™ (DT) Medtronic®] for PVI.Consecutive patients with AF underwent PVI using the DT catheter combined with high-power short-duration RF applications. Ablation settings were (1) a catheter tip temperature limit of 60°C, (2) a temperature-controlled power of 50 W, and (3) application duration of 10 seconds. The primary endpoint was acute isolation of PVs, reassessed after a 30-minute waiting period. Secondary endpoints included procedural parameters (defined as a catheter tip temperature of 50°C > 3 seconds, an impedance drop of 5-10 Ω) and the occurrence of serious adverse events.Fifty consecutive patients [mean age 66 ± 12 years, 38 (76%) women, 24 patients with paroxysmal AF (48%)] were included. Median procedure and left atrial dwell time was 89 [68; 107] and 63 [52; 79] minutes, respectively. Mean number of RF applications was 59 ± 20, and mean total RF duration was 14 ± 6 minutes. Acute PVI was achieved in all patients solely using DT ablation. Acute PV reconnection within the waiting period occurred in five patients; all reconnected PVs were successfully reisolated. One major complication occurred.In this study, the DT ablation system demonstrated high acute efficacy for PVI. Temperature-controlled ablation in conjunction with high-power short-duration applications might be effectively supported.
AB - Pulmonary vein (PV) isolation (PVI) by continuous, transmural and durable lesions is decisive for ensuring long-term freedom from atrial fibrillation (AF). AF ablation requires irrigated tip catheters to reduce thromboembolic complications. This precluded temperature-controlled delivery of radiofrequency (RF) energy.The aim of this study was to evaluate feasibility, acute efficacy, and safety of an irrigated, temperature-controlled ablation catheter [DiamondTemp™ (DT) Medtronic®] for PVI.Consecutive patients with AF underwent PVI using the DT catheter combined with high-power short-duration RF applications. Ablation settings were (1) a catheter tip temperature limit of 60°C, (2) a temperature-controlled power of 50 W, and (3) application duration of 10 seconds. The primary endpoint was acute isolation of PVs, reassessed after a 30-minute waiting period. Secondary endpoints included procedural parameters (defined as a catheter tip temperature of 50°C > 3 seconds, an impedance drop of 5-10 Ω) and the occurrence of serious adverse events.Fifty consecutive patients [mean age 66 ± 12 years, 38 (76%) women, 24 patients with paroxysmal AF (48%)] were included. Median procedure and left atrial dwell time was 89 [68; 107] and 63 [52; 79] minutes, respectively. Mean number of RF applications was 59 ± 20, and mean total RF duration was 14 ± 6 minutes. Acute PVI was achieved in all patients solely using DT ablation. Acute PV reconnection within the waiting period occurred in five patients; all reconnected PVs were successfully reisolated. One major complication occurred.In this study, the DT ablation system demonstrated high acute efficacy for PVI. Temperature-controlled ablation in conjunction with high-power short-duration applications might be effectively supported.
KW - Aged
KW - Atrial Fibrillation/surgery
KW - Catheter Ablation/methods
KW - Equipment Design
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Pulmonary Veins/surgery
KW - Treatment Outcome
U2 - 10.1536/ihj.21-844
DO - 10.1536/ihj.21-844
M3 - SCORING: Journal article
C2 - 35650152
VL - 63
SP - 504
EP - 509
JO - INT HEART J
JF - INT HEART J
SN - 1349-2365
IS - 3
ER -
