Cavotricuspid isthmus ablation with large-tip gold alloy versus platinum-iridium-tip electrode catheters

A. Kardos, Csaba Foldesi, Attila Mihalcz, Tamas Szili-Torok

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Gold has excellent electrical conductive properties and creates deeper and wider lesions than platinum-iridium during radiofrequency (RF) ablation in vitro. We tested the maximum voltage-guided technique (MVGT) of cavotricuspid isthmus (CTI) ablation using two 8-mm tip catheters containing gold (group G) or platinum-iridium (group PI). Methods: We enrolled 31 patients who underwent CTI ablation. In group G (n = 15) CTI ablation was performed with a gold-tip ablation catheter, while in group PI (n = 16) a platinum-iridium tip was used. Ablation was guided by CTI potentials with the highest amplitude until achievement of bidirectional block (BIB). If BIB was not achieved after 10 RF applications, RF was delivered via a 3.5-mm irrigated-tip catheter. Success rate, procedure duration, duration of fluoroscopic exposure, and number of RF applications were measured. Results: BIB was achieved in all patients in group G, while in group PI an irrigated tip was used in four patients (0% vs 25%, P <0.001). These four patients required a total of 21 additional RF applications (5.25 ± 2.22). Procedure time (56.4 ± 12 vs 73.1 ± 15 minutes P <0.05) and fluoroscopic explosure (4.9 ± 2.3 vs 7.1 ± 3.8 minutes, P <0.01) were shorter in group G than in group PI. Mean number of RF applications was lower (4.6 ± 1.9 vs 6.6 ± 3.1 P <0.001) and total RF duration shorter (280 ± 117 vs 480 ± 310 seconds) in group G than in group PI. No difference was observed in the number of recurrences at a 6 month-follow up (1 in group G vs 1 in group PI). Conclusion: Using the MVGT of CTI ablation, gold-tip catheters were associated with shorter procedural and fluoroscopic times, and fewer RF applications.

Original languageEnglish
JournalPACE - Pacing and Clinical Electrophysiology
Volume32
Issue numberSUPPL. 1
DOIs
Publication statusPublished - Mar 2009

Fingerprint

Gold Alloys
Iridium
Platinum
Electrodes
Catheters
Gold
Catheter Ablation
Recurrence

Keywords

  • Atrial flutter
  • Cavotricuspid isthmus
  • Flutter ablation
  • Gold-tip catheter

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Cavotricuspid isthmus ablation with large-tip gold alloy versus platinum-iridium-tip electrode catheters. / Kardos, A.; Foldesi, Csaba; Mihalcz, Attila; Szili-Torok, Tamas.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 32, No. SUPPL. 1, 03.2009.

Research output: Contribution to journalArticle

@article{80a1152fb76d4483bfc03bc27a9a11a6,
title = "Cavotricuspid isthmus ablation with large-tip gold alloy versus platinum-iridium-tip electrode catheters",
abstract = "Background: Gold has excellent electrical conductive properties and creates deeper and wider lesions than platinum-iridium during radiofrequency (RF) ablation in vitro. We tested the maximum voltage-guided technique (MVGT) of cavotricuspid isthmus (CTI) ablation using two 8-mm tip catheters containing gold (group G) or platinum-iridium (group PI). Methods: We enrolled 31 patients who underwent CTI ablation. In group G (n = 15) CTI ablation was performed with a gold-tip ablation catheter, while in group PI (n = 16) a platinum-iridium tip was used. Ablation was guided by CTI potentials with the highest amplitude until achievement of bidirectional block (BIB). If BIB was not achieved after 10 RF applications, RF was delivered via a 3.5-mm irrigated-tip catheter. Success rate, procedure duration, duration of fluoroscopic exposure, and number of RF applications were measured. Results: BIB was achieved in all patients in group G, while in group PI an irrigated tip was used in four patients (0{\%} vs 25{\%}, P <0.001). These four patients required a total of 21 additional RF applications (5.25 ± 2.22). Procedure time (56.4 ± 12 vs 73.1 ± 15 minutes P <0.05) and fluoroscopic explosure (4.9 ± 2.3 vs 7.1 ± 3.8 minutes, P <0.01) were shorter in group G than in group PI. Mean number of RF applications was lower (4.6 ± 1.9 vs 6.6 ± 3.1 P <0.001) and total RF duration shorter (280 ± 117 vs 480 ± 310 seconds) in group G than in group PI. No difference was observed in the number of recurrences at a 6 month-follow up (1 in group G vs 1 in group PI). Conclusion: Using the MVGT of CTI ablation, gold-tip catheters were associated with shorter procedural and fluoroscopic times, and fewer RF applications.",
keywords = "Atrial flutter, Cavotricuspid isthmus, Flutter ablation, Gold-tip catheter",
author = "A. Kardos and Csaba Foldesi and Attila Mihalcz and Tamas Szili-Torok",
year = "2009",
month = "3",
doi = "10.1111/j.1540-8159.2008.02270.x",
language = "English",
volume = "32",
journal = "PACE - Pacing and Clinical Electrophysiology",
issn = "0147-8389",
publisher = "Wiley-Blackwell",
number = "SUPPL. 1",

}

TY - JOUR

T1 - Cavotricuspid isthmus ablation with large-tip gold alloy versus platinum-iridium-tip electrode catheters

AU - Kardos, A.

AU - Foldesi, Csaba

AU - Mihalcz, Attila

AU - Szili-Torok, Tamas

PY - 2009/3

Y1 - 2009/3

N2 - Background: Gold has excellent electrical conductive properties and creates deeper and wider lesions than platinum-iridium during radiofrequency (RF) ablation in vitro. We tested the maximum voltage-guided technique (MVGT) of cavotricuspid isthmus (CTI) ablation using two 8-mm tip catheters containing gold (group G) or platinum-iridium (group PI). Methods: We enrolled 31 patients who underwent CTI ablation. In group G (n = 15) CTI ablation was performed with a gold-tip ablation catheter, while in group PI (n = 16) a platinum-iridium tip was used. Ablation was guided by CTI potentials with the highest amplitude until achievement of bidirectional block (BIB). If BIB was not achieved after 10 RF applications, RF was delivered via a 3.5-mm irrigated-tip catheter. Success rate, procedure duration, duration of fluoroscopic exposure, and number of RF applications were measured. Results: BIB was achieved in all patients in group G, while in group PI an irrigated tip was used in four patients (0% vs 25%, P <0.001). These four patients required a total of 21 additional RF applications (5.25 ± 2.22). Procedure time (56.4 ± 12 vs 73.1 ± 15 minutes P <0.05) and fluoroscopic explosure (4.9 ± 2.3 vs 7.1 ± 3.8 minutes, P <0.01) were shorter in group G than in group PI. Mean number of RF applications was lower (4.6 ± 1.9 vs 6.6 ± 3.1 P <0.001) and total RF duration shorter (280 ± 117 vs 480 ± 310 seconds) in group G than in group PI. No difference was observed in the number of recurrences at a 6 month-follow up (1 in group G vs 1 in group PI). Conclusion: Using the MVGT of CTI ablation, gold-tip catheters were associated with shorter procedural and fluoroscopic times, and fewer RF applications.

AB - Background: Gold has excellent electrical conductive properties and creates deeper and wider lesions than platinum-iridium during radiofrequency (RF) ablation in vitro. We tested the maximum voltage-guided technique (MVGT) of cavotricuspid isthmus (CTI) ablation using two 8-mm tip catheters containing gold (group G) or platinum-iridium (group PI). Methods: We enrolled 31 patients who underwent CTI ablation. In group G (n = 15) CTI ablation was performed with a gold-tip ablation catheter, while in group PI (n = 16) a platinum-iridium tip was used. Ablation was guided by CTI potentials with the highest amplitude until achievement of bidirectional block (BIB). If BIB was not achieved after 10 RF applications, RF was delivered via a 3.5-mm irrigated-tip catheter. Success rate, procedure duration, duration of fluoroscopic exposure, and number of RF applications were measured. Results: BIB was achieved in all patients in group G, while in group PI an irrigated tip was used in four patients (0% vs 25%, P <0.001). These four patients required a total of 21 additional RF applications (5.25 ± 2.22). Procedure time (56.4 ± 12 vs 73.1 ± 15 minutes P <0.05) and fluoroscopic explosure (4.9 ± 2.3 vs 7.1 ± 3.8 minutes, P <0.01) were shorter in group G than in group PI. Mean number of RF applications was lower (4.6 ± 1.9 vs 6.6 ± 3.1 P <0.001) and total RF duration shorter (280 ± 117 vs 480 ± 310 seconds) in group G than in group PI. No difference was observed in the number of recurrences at a 6 month-follow up (1 in group G vs 1 in group PI). Conclusion: Using the MVGT of CTI ablation, gold-tip catheters were associated with shorter procedural and fluoroscopic times, and fewer RF applications.

KW - Atrial flutter

KW - Cavotricuspid isthmus

KW - Flutter ablation

KW - Gold-tip catheter

UR - http://www.scopus.com/inward/record.url?scp=60849105073&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=60849105073&partnerID=8YFLogxK

U2 - 10.1111/j.1540-8159.2008.02270.x

DO - 10.1111/j.1540-8159.2008.02270.x

M3 - Article

C2 - 19250078

AN - SCOPUS:60849105073

VL - 32

JO - PACE - Pacing and Clinical Electrophysiology

JF - PACE - Pacing and Clinical Electrophysiology

SN - 0147-8389

IS - SUPPL. 1

ER -