Revival of the Forgotten

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• Pulmonary vein (PV) isolation is crucial for long-term freedom from atrial fibrillation (AF).
• Traditional irrigated tip catheters for AF ablation preclude temperature-controlled radiofrequency (RF) energy delivery.
• This limitation hinders optimal lesion creation and may increase thromboembolic risks.

Purpose of the Study:

• To evaluate the feasibility, acute efficacy, and safety of an irrigated, temperature-controlled ablation catheter (DiamondTemp™) for PV isolation in AF patients.
• To assess the performance of high-power short-duration RF applications with temperature control.

Main Methods:

• Fifty consecutive AF patients underwent PV isolation using the DiamondTemp™ catheter.
• Ablation settings included a 60°C tip temperature limit, 50W power, and 10-second application duration.
• Acute PVI was the primary endpoint, reassessed after a 30-minute waiting period.

Main Results:

• Acute PVI was achieved in all patients using the DiamondTemp™ system.
• PV reconnection occurred in five patients within the waiting period but was successfully re-isolated.
• The system demonstrated high acute efficacy with one major complication reported.

Conclusions:

• The DiamondTemp™ ablation system shows high acute efficacy for pulmonary vein isolation.
• Temperature-controlled ablation combined with high-power short-duration applications is a viable strategy for AF treatment.
• This approach may offer an effective and potentially safer method for AF ablation.