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

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.