Multicatheter Comparison of Very High-Power Short-Duration Radiofrequency Ablation Lesions

Area of Science:

• Electrophysiology
• Medical Devices
• Cardiovascular Interventions

Background:

• Very high-power short-duration (vHPSD) radiofrequency ablation (RFA) is an alternative strategy for pulmonary vein isolation.
• Rapid temperature rises during RFA can lead to complications.
• The QDOT Micro catheter features automatic power and irrigation adjustments based on temperature detection.

Purpose of the Study:

• To compare the impact of different ablation electrode designs on vHPSD lesions.
• To evaluate lesion characteristics generated by three distinct RFA catheter designs.

Main Methods:

• vHPSD RFA was performed in a gel tank model using QDOT, SmartTouch, and TactiFlex SE catheters.
• Ablations were delivered at varying power settings (60-90 watts) and irrigation concentrations (0.9% and 0.45% half-normal saline).
• Lesions were characterized based on depth, diameter, and temperature to assess steam-pop risk.

Main Results:

• The SmartTouch catheter produced the deepest (2.37 mm) and widest (6.04 mm) lesions.
• The QDOT catheter generated deeper lesions (1.93 mm) compared to the TactiFlex (1.88 mm).
• The TactiFlex catheter exhibited the lowest risk of steam pops.

Conclusions:

• Catheter electrode design influences vHPSD lesion dimensions and temperature.
• The QDOT catheter achieved greater lesion dimensions than the TactiFlex, indicating differences in cooling profiles.
• Using the SmartTouch catheter or 0.45% half-normal saline may increase the risk of steam pops.