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RF Ablation Catheter Tip Material versus Lesion Geometry – The Value of Gold

  • Introduction: Radiofrequency ablation allows successful treatment of most supraventricular reentrant and focal tachycardias and an increasing number of ventricular tachycardias. Different catheter tips are used. While AV nodal reentrant tachycardias require catheters with a tip of 4mm length, an 8 mm tip electrodes will be used for atrial flutter. A pulmonary vein isolation will be performed usingIntroduction: Radiofrequency ablation allows successful treatment of most supraventricular reentrant and focal tachycardias and an increasing number of ventricular tachycardias. Different catheter tips are used. While AV nodal reentrant tachycardias require catheters with a tip of 4mm length, an 8 mm tip electrodes will be used for atrial flutter. A pulmonary vein isolation will be performed using 4 mm irrigated tip electrodes to achieve larger and deeper lesions. The need of a tubing set and pump for saline transfusion is a disadvantage of this technique. Gold tip electrodes can alternatively be used to produce increases in lesion size. Aim of this study was to compare RF ablation catheters of exactly the same geometry with either platin-iridum or gold tip. Methods: Gold provides an almost four-fold thermal conductivity compared with platinum-iridium. The Cerablate G flutter (Osypka AG, Rheinfelden-Herten) is a newly designed radiofrequency ablation catheter with an 8 mm gold tip. Its power delivery was compared with the Cerablate flutter of same geometry but platin-iridium tip. Therefore, in-vitro RF ablations were performed using pork meat in a 0.9% saline solution at 37°C temperature. A pulsed volume flow was generated using a pump to simulate the blood flow. Temperature controlled ablations of 60 seconds using 45, 55 and 65°C and a maximum of 70W RF power were performed. Results: Using the Osypka HAT300smart ablator, cumulative power of 167, 474 and 672W was delivered with gold tip against 121, 227 and 310 W with platin-iridium tip. By the Stockert SmartAblate G4 ablator, 202, 546 and 1075W was delivered with gold tip against 117, 246 and 394W with platin-iridium using 45, 55 and 65°C temperature. Conclusion: During in-vitro investigations, the gold tip electrodes allowed a in power delivery increase of 117 up to 173%. Thus, gold tips can be used to increase lesion depth and diameter without cooling equipment.show moreshow less

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Metadaten
Author:Bruno IsmerGND, Fabian Holzer, Manuel Braun
Publisher:Walter de Gruyter
Place of publication:Berlin, Boston
Date of Publication (online):2014/09/27
Pagenumber:1
Language:English
GND Keyword:Austausch; Katheter
Parent Title (Multiple languages):Biomedical Engineering / Biomedizinische Technik
Volume:59
Issue:S1
ISSN:0013-5585 (Print)
ISSN:1862-278X (Online)
First Page:1202
Document Type:Conference Proceeding
Institutes:Bibliografie
Release Date:2017/10/25
Licence (German):License LogoEs gilt das UrhG
Note:
BMT 2014 - 48th DGBMT Annual Conference, October 8th-10th 2014, Hannover, Germany
DOI:https://doi.org/10.1515/bmt-2014-5015