Enhanced efficiency of a novel porous irrigated RF ablation catheter for pulmonary vein isolation

Background: Irrigated tip radiofrequency (RF) catheter ablation is the most frequently used technology for pulmonary vein isolation (PVI). The purpose of this study was to compare the efficiency and the safety of 2 different open irrigated tip RF catheters. Methods: 160 patients with symptomatic AF (29% persistent, 68% male, 61±10 years) were randomized to circumferential PVI using 2 different irrigated tip catheter: (1) The novel Thermocool® SF with a porous tip (56 holes) or (2) the Thermocool® catheter with 6 irrigation holes at the distal tip in power- and temperature-controlled modes. Results: Total procedure time and RF duration were significantly shorter with SF® vs. Thermocool® catheter: 142.5 min. vs 165 min. (p < 0.0001) and 35.4 min. vs 39.9 min. (p < 0.001), respectively. Similarly, the total fluoroscopy time and dose were shorter with SF® vs. Thermocool® catheter: 21 min. vs 24 min. (p = 0.02) and 1014.5 μGy m2 vs 1377 μGy m2 (p < 0.0001), respectively. Irrigation volume was lower with SF® 600 ml vs 1100 ml, (p < 0.0001) and the rate of complications were not significantly different (0.6% vs 0.49%, p = 0.66). At 17.3±6 months follow-up, there were no significant differences with regard to arrhythmia freedom between SF® (72%) and TC® groups (78%) (p = 0.978). Conclusions: PVI with the novel irrigated tip SF catheter shows significantly better procedural efficiency without higher incidence of complications.