Clinical experience with a novel, irrigated, flexible tip ablation catheter in atrial fibrillation ablation

This paper aimed at assessing clinical efficacy and safety of a new fully irrigated and flexible tip catheter (Therapy™ Cool Flex™, St Jude Medical, St. Paul, MN, USA) in ablation of atrial fibrillation (AF).

The study enrolled 117 consecutive patients with symptomatic AF who underwent for the first time a circumferential pulmonary vein isolation with a new irrigated and flexible tip catheter.

All patients underwent successful pulmonary vein circumferential ablation. The mean procedure duration was 100 ± 27 min, total fluoroscopy time was 7.4 ± 5 min. The mean number of RF lesion was 139 ± 43 and the mean total RF time was 22.45 ± 3.9 min. Median follow-up was 665 ± 241 days. Through Kaplan-Meier analysis, overall event-free survival was 79.7%. In details, arrhythmia free survival was 85.4% in patients with persistent AF, 76% in paroxysmal AF and 75% in chronic AF. Three patients (2.5%) suffered from minor vascular complication (groin hematoma). Two patients (1.7%) suffered from pericardial effusion, treated with pericardiocentesis and with no sequelae. We did not observe any atrioesophageal fistula or pulmonary vein stenosis.

The present study represents the largest cohort of patients receiving AF ablation with this new tip-flexible catheter. It demonstrated comparable efficacy to that previously reported, with a very low complication rate and procedural time. A head-to-head clinical trial would be necessary to address the relative efficacy of catheter type.