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. 2025 Jan 22;14(3):701.
doi: 10.3390/jcm14030701.

Comparison of a Novel Temperature-Controlled Diamond-Tip Catheter and a Power-Controlled Gold-Tip Catheter for the Irrigated Ablation of Cavotricuspid Isthmus-Dependent Atrial Flutter

Eric Auf der Maur  1 , Thomas Kueffer  1 , Gregor Thalmann  1 , Nikola A Kozhuharov  1 , Oskar Galuszka  1 , Salik Ur Rehman Iqbal  1 , Antonio Madaffari  1 , Helge Servatius  1 , Andreas Haeberlin  1 , Fabian Noti  1 , Hildegard Tanner  1 , Laurent Roten  1 , Tobias Reichlin  1
Affiliations

Comparison of a Novel Temperature-Controlled Diamond-Tip Catheter and a Power-Controlled Gold-Tip Catheter for the Irrigated Ablation of Cavotricuspid Isthmus-Dependent Atrial Flutter

Eric Auf der Maur et al. J Clin Med. .

Abstract

Background/Objectives: Radiofrequency (RF) ablation of the cavotricuspid isthmus (CTI) is a recommended treatment option for typical atrial flutter (AFL). While power-controlled ablation has been the current standard, a novel temperature-controlled ablation system has been introduced. We aimed to compare the procedural efficacy and one-year outcome of a temperature-controlled diamond-tip catheter with an established power-controlled gold-tip catheter. Methods: Consecutive patients undergoing ablation of CTI-dependent AFL using a power-controlled catheter or the novel temperature-controlled catheter were enrolled. Patients were followed up using a 7-day electrocardiogram after 3, 6, and 12 months. The primary endpoint was acute efficacy (procedural success, total RF, and procedure time). The secondary endpoint was the recurrence of typical AFL during follow-up. Results: In total, 38 patients undergoing temperature-controlled ablation were enrolled and compared to 283 patients undergoing power-controlled ablation. A bidirectional CTI block was achieved in 100% in the temperature-controlled group and 97.5% in the power-controlled group (p = 0.7). The total RF time (median: 192 sec (IQR 138-311) vs. 643 sec (IQR 386-1079), p < 0.001) and total procedure time (median: 45 min (IQR 34-57) vs. 52 min (IQR 39-70), p = 0.01) were shorter with temperature-controlled ablation. At the one-year follow-up, there was no difference in the recurrence of typical AFL between groups. Conclusions: Utilization of temperature-controlled ablation for typical AFL increased procedural efficiency with shorter RF and procedure times compared to power-controlled ablation. The recurrence rate of typical AFL after one year was low and did not differ amongst groups.

Keywords: ablation; atrial flutter; catheter; cavotricuspid isthmus.

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Conflict of interest statement

T. Reichlin has received research grants from the Swiss National Science Foundation, the Swiss Heart Foundation, the Sitem Insel support fund, Biotronik, Boston Scientific, and Medtronic, all for work outside the submitted study. He has received speaker/consulting honoraria or travel support from Abbott/SJM, Biosense-Webster, Biotronik, Boston Scientific, and Medtronic. He has received support for his institution’s fellowship program from Abbott/SJM, Biosense-Webster, Biotronik, Boston-Scientific, and Medtronic. L. Roten has received research grants from Medtronic, the Swiss National Foundation, the Swiss Heart Foundation, the Immanuel and Ilse Straub Foundation, and the Sitem Insel Support Fund, all for work outside the submitted study. He has received speaker fees/honoraria from Biosense Webster, Boston Scientific, Abbott, and Medtronic. A. Haeberlin: Travel fees/educational grants from Medtronic, Biotronik, Abbott, and Philips/Spectranetics without impact on his personal remuneration. He serves as a proctor for Medtronic. He has received research grants from the Swiss National Science Foundation, the Swiss Innovation agency Innosuisse, the Swiss Heart Foundation, the University of Bern, University Hospital Bern, the Velux Foundation, the Hasler Foundation, the Swiss Heart Rhythm Foundation, and the Novartis Research Foundation. He is co-founder and CEO of Act-Inno AG.T. Kueffer: He has received a research grant from the Swiss Heart Foundation. All other authors have no relationships relevant to the contents of this paper to disclose.

Figures

Figure 1
Figure 1
Flowchart showing the patient selection process.
Figure 2
Figure 2
Box plot comparing the procedure time and total radiofrequency (RF) application time between groups.
Figure 3
Figure 3
Kaplan–Meier curve showing the survival-free time from recurrence of typical AFL in the temperature-controlled diamond-tip catheter group (red) and the power-controlled gold-tip catheter group (blue).
See this image and copyright information in PMC

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