Open Access

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 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.

Special implant connection module was developed to combine full features of two commercial heart rhythm simulators, ARSI-4 and Intersim II, into a master-slave teaching system. Seven workstations were equipped with the Carelink and Homemonitoring remote patient monitoring systems. This combination enables in-vitro training of physicians, nurses and students in pace-maker and defibrillator measurements during implantation and individual programming in the follow-up. Thus, extended sets of arrhythmias and electrode problems can be used to simulate problems and their solutions in a wide range of the clinical routine.