Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Quality Measures & Complications D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-204 - Laser-cut Slit-based Irrigation Catheter Can Prevent Procedure-related Ischemic Complications (ID 495)


Background: Open irrigation ablation catheters are now the standard in radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). Among various irrigation catheters, laser-cut slit-based irrigation system (Cool FlexTM and FlexAbilityTM) has a unique design to cool the catheter tip more efficiently.
Objective: We aimed to assess the safety of slit-based irrigation catheters regarding prevention of procedure-related ischemic complication in AF patients undergoing RFCA.
Methods: The analysis was performed with Korea University Medicine Anam Hospital RFCA registry. Procedure-related ischemic complication was defined as ischemic stroke or transient ischemic attack (TIA) occurring within 30 days after RFCA. Patients were divided into 3 groups: non-irrigation, hole-based irrigation, and slit-based irrigation catheter groups.
Results: A total of 3,120 AF patients underwent first RFCA. Non-irrigation, hole-based irrigation, and slit-based irrigation catheters were used in 290, 1,540, and 1,290 patients, respectively. As compared with non-irrigation and hole-based irrigation catheter groups, slit-based irrigation catheter group had significantly older age, higher prevalence of non-paroxysmal AF, large left atrial size, and decreased left atrial appendage flow velocity. The CHA2DS2-VASc score was not different among the 3 groups. Procedure-related ischemic complication occurred in 17 patients (0.54%) with 16 ischemic strokes and 1 TIA event. Stroke and TIAs occurred in 5/290 (1.72%), 12/1540 (0.78%), and 0/1090 (0.0%) patients in non-irrigation, non-slit irrigation, and slit irrigation catheter groups, respectively (p < 0.001; Figure 1). Slit irrigation catheter was superior in direct comparison with non-slit irrigation catheters (p = 0.001).
Conclusion: Slit irrigation catheters were highly effective in preventing procedure-related ischemic complications.