Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Ablation Techniques D-PO02 - Poster Session II (ID 47) Poster

D-PO02-183 - Temperature-controlled Lattice-tip Ablation Catheter Improves Clinical Outcomes In Patients With Paroxysmal Atrial Fibrillation (ID 243)

Abstract

Background: PVI is the mainstay of AF ablation. Long-term success with the standard 3.5 mm RF ablation catheters is limited by high PV reconnection rates. Recently, a first-in-human clinical series used a novel lattice-tip RF catheter, that generates a large thermal footprint, to rapidly and safely perform point-by-point PVI.
Objective: To compare the clinical outcomes of PAF ablation between the lattice catheter and a standard 3.5mm RF catheter.
Methods: We retrospectively analyzed 40 PAF pts who underwent PVI with a standard 3.5 mm RF catheter (Thermocool STSF; 30-50W; 20-40s) and 40 PAF pts who underwent PVI with the lattice catheter (Tmax 73-80°C; 2-5s) and compatible mapping system (Sphere-9 & Prism-1; Affera Inc).
Results: The groups were well matched for age (61.2±10.1 vs 63.5±9.2) and AAD use (70% vs 72%). The acute procedural success was 100% in both groups. At 154±92 days post-procedure, protocol-mandated remapping of the lattice pts revealed durable PVI in all but one reconnected RSPV. About 54% (6 of 11 pts) in the standard RF group underwent a redo-procedure for clinical recurrences, of which 66% (4 of 6 pts) had at least 1 PV reconnection. At 310±113 days follow up, the freedom from AT/AF in the lattice group was 97% (39 of 40 pts) compared with 72% (29 of 40 pts) in the standard RF group.
Conclusion: Temperature-controlled lattice-tip point-by-point ablation produces durable PVI which translates into greater freedom from atrial arrhythmias when compared with conventional 3.5 mm RF ablation. Additional work is necessary to determine if the high clinical success with lattice-tip ablation is solely explained by durable PVI, or whether other mechanisms may also be at work.

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