Document Detail


Prospective randomized comparison of 8-mm gold-tip, externally irrigated-tip and 8-mm platinum-iridium tip catheters for cavotricuspid isthmus ablation.
MedLine Citation:
PMID:  17537205     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Radiofrequency (RF) ablation of the cavotricuspid isthmus (CTI) can be performed using different types of ablation catheter. Gold tip electrodes have the theoretical advantage of creating bigger lesions than standard platinum-iridium electrode. This prospective, randomized study compares the clinical efficacy of 8-mm gold tip catheter, externally irrigated and 8-mm platinum-iridium tip (Pt tip) catheters. METHODS AND RESULTS: Sixty consecutive patients (51 men, 60 +/- 10 years) undergoing de novo CTI ablation for documented typical atrial flutter were randomized to one of the following ablation catheters: 8-mm gold tip catheter, an externally irrigated-tip (Irr. tip) catheter, or an 8-mm Pt tip catheter. The procedural endpoint was achievement of bidirectional isthmus conduction block with < or = 20 minutes of RF energy application. The latter was achieved equally with the 3 catheters (95% for gold tip, 100% for irrigated tip, 95% for Pt tip) and the durations of RF (10 +/- 6, 10 +/- 4, 13 +/- 8 minutes), fluoroscopy (12 +/- 6, 12 +/- 7, 15 +/- 12 minutes) and the procedure (34 +/- 23, 38 +/- 24, 40 +/- 30 minutes) were similar in all groups. The maximal targeted power could not be reached in at least one location in 40% of patients with gold tip and in 35% of patients with Pt tip catheters whereas it was always achieved with an Irr. tip catheter (P = 0.003, P = 0.008). The reduction in impedance during RF delivery was greater with Irr. tip (11 +/- 7 ohms) than with gold (7 +/- 4 ohms, P = 0.02) or Pt tip (5 +/- 3 ohms, P = 0.001) catheters. CONCLUSION: This study demonstrates equivalent efficacies of gold, platinum-iridium and externally Irr. tip catheters for successful de novo ablation of the CTI.
Authors:
Frédéric Sacher; Mark D O'Neill; Pierre Jais; Linda L Huffer; Julien Laborderie; Nicolas Derval; Antoine Deplagne; Yoshihide Takahashi; Anders Jonnson; Meleze Hocini; Jacques Clementy; Michel Haissaguerre
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2007-05-30
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  18     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-20     Completed Date:  2007-08-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  709-13     Citation Subset:  IM    
Affiliation:
Université Bordeaux II-Hôpital Cardiologique du Haut-Lévêque, Bordeaux-Pessac, France. frederic.sacher@chu-bordeaux.fr
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Flutter / pathology,  surgery
Catheter Ablation / instrumentation*,  methods
Catheterization / standards
Female
Follow-Up Studies
Gold* / standards
Humans
Iridium* / standards
Male
Middle Aged
Platinum* / standards
Prospective Studies
Tricuspid Valve / pathology,  surgery*
Chemical
Reg. No./Substance:
37186-87-1/platinum-iridium alloy; 7439-88-5/Iridium; 7440-06-4/Platinum; 7440-57-5/Gold

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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