Feasibility, Safety and Durability of Porcine Atrial Ablation using a Lattice-Tip Temperature-Controlled Radiofrequency Ablation Catheter.

INTRODUCTION: Pulmonary vein (PV) isolation using standard radiofrequency (RF) catheters is limited by incomplete contiguity and prolonged procedural times. A novel, 9 mm lattice-tip irrigated RF catheter can create wide lesions rapidly in swine atria. METHODS: In five swine, temperature limited (75 degrees C) irrigated RF for 5 seconds/ablation was selected, to isolate 7 PVs (5 right superior and 2 inferior common) and create 5 right atrial lines. After 4 weeks, repeat mapping and additional ablation to create atrial isthmus lesions was performed. The chronic lesions were submitted for histology. This was compared to right superior PV isolation data using standard 3.5mm irrigated tip ablation in 6 swine. RESULTS: All targeted PVs (7 of 7, 100%) were acutely isolated. Durable isolation was observed in all 6 of 6 PVs treated with 5 second applications, but not in one PV inadvertently treated with a 4 second application. For the durably isolated PVs, the mean lesion count/PV and total RF time/PV was 16.3+/-5.2 applications and 81.3+/-25.9 seconds for the right superior and 14.5+/-0.7 applications and 71.1+/-5.5 seconds for the inferior common PV. Right atrial linear ablation was performed with a lesion count of 12+/-2.3 applications and RF times of 59.5+/-12.5 seconds. Cavotricuspid and mitral isthmus linear ablations were transmural along their entire length All 53/53 (100%) sections were transmural on histology. CONCLUSION: Rapid and durable PV isolation and linear atrial ablation is feasible with this novel 9mm lattice-tip catheter. This article is protected by copyright. All rights reserved.