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Related Experiment Video

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Difference in Microembolic Signals Between Flex-Tip Versus Non-Flex-Tip Type Catheters During High-Power

Yoshiaki Mizutani1, Satoshi Yanagisawa2, Mizuki Ichikawa3

  • 1Department of Cardiology, Yokkaichi Municipal Hospital, Yokkaichi, Japan.

Journal of Cardiovascular Electrophysiology
|August 26, 2025
PubMed
Summary

The novel flex-tip ablation catheter significantly reduced microembolic signals (MESs) during high-power short-duration (HPSD) ablation compared to non-flex-tip catheters. This suggests flex-tip catheters may offer safer HPSD ablation for atrial fibrillation.

Keywords:
flex‐tip catheterhigh‐power short‐durationinternal carotid artery ultrasoundmicroembolic signalspulmonary vein isolation

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Area of Science:

  • Cardiovascular Interventions
  • Medical Device Technology
  • Electrophysiology

Background:

  • A novel flex-tip ablation catheter features a unique distal tip designed for optimized irrigation flow.
  • High-power short-duration (HPSD) ablation is an effective treatment for atrial fibrillation.
  • Evaluating microembolic signals (MESs) is crucial for assessing the safety of ablation procedures.

Purpose of the Study:

  • To compare the incidence of MESs during HPSD radiofrequency ablation between flex-tip and non-flex-tip ablation catheters.
  • To assess the safety and efficacy of a novel flex-tip catheter in reducing embolic events.

Main Methods:

  • Retrospective analysis of 70 patients undergoing first-time HPSD ablation (50W) for atrial fibrillation.
  • Clinical assessment of MESs using carotid ultrasound-Doppler throughout pulmonary vein isolation.
  • Experimental ablation on porcine heart tissue to evaluate MESs with both catheter types.

Main Results:

  • The flex-tip group showed significantly lower numbers of MESs, MESs per point, and MESs per second compared to the non-flex-tip group (p < 0.001).
  • Post-propensity score matching, MESs remained significantly lower in the flex-tip group (p = 0.013), especially bubble-type MESs (p = 0.023).
  • Experimental studies confirmed significantly fewer MESs with the flex-tip catheter (p = 0.002).

Conclusions:

  • Flex-tip catheter ablation significantly reduces MES detection compared to non-flex-tip catheters at 50W.
  • The findings suggest that flex-tip catheters may enable safer HPSD ablation procedures.
  • The optimized irrigation design of the flex-tip catheter likely contributes to reduced embolic events.