open access

Ahead of print
Original Article
Submitted: 2022-06-03
Accepted: 2022-10-10
Published online: 2022-12-29
Get Citation

First clinical experience using the DiamondTemp catheter and a novel omnipolar high-resolution mapping system for atrial fibrillation ablation

Christian Sohns1, Thomas Fink1, Leonard Bergau1, Martin Braun1, Mustapha El Hamriti1, Vanessa Sciacca1, Denise Guckel1, Moneeb Khalaph1, Guram Imnadze1, Philipp Sommer1
DOI: 10.5603/CJ.a2022.0122
·
Pubmed: 36588311
Affiliations
  1. Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Germany

open access

Ahead of print
Original articles
Submitted: 2022-06-03
Accepted: 2022-10-10
Published online: 2022-12-29

Abstract

Background: The DiamondTemp (DT) radiofrequency ablation (RFA) catheter has been introduced as a new tool for atrial fibrillation (AF) ablation. The new technology allows for temperature-controlled irrigated ablation and real-time lesion assessment. Recently, the EnSite X mapping system became commercially available allowing for omnipolar and ultra-high-resolution mapping. We aimed to assess the feasibility of the new DT RFA catheter in performing AF ablation procedures in conjunction with the novel EnSite X system under routine clinical conditions. Methods: We analyzed data from 10 consecutive patients who underwent AF ablation using the DT RFA guided by EnSite X. Procedural data and short-term follow-up were assessed as well as potential technical issues. Results: Nine out of 10 patients underwent de-novo pulmonary vein isolation (PVI), and one patient underwent repeat ablation. First-pass isolation was observed in 7/10 patients. Total procedure duration (skin-to-skin) was 88.9 ± 30.1 min, and left atrium dwell time was 70 ± 22.3 min. The mean number of RF applications needed for PVI and additional ablation was 70.52 ± 26.70. The HD Grid SE mapping catheter was utilized in 8 patients and the Advisor SE in 2 patients. Bidirectional block of the applied lines was achieved in all patients. No steam pops were observed, and no intraprocedural complications occurred. Conclusions: This first clinical series demonstrated that temperature-controlled irrigated ablation in combination with the novel omnipolar and high-resolution mapping system resulted in rapid, efficient, and durable lesion formation under routine clinical conditions. Randomized controlled trials are needed to elucidate the impact on lesion formation, long-term outcomes, and reproducibility of our initial findings.

Abstract

Background: The DiamondTemp (DT) radiofrequency ablation (RFA) catheter has been introduced as a new tool for atrial fibrillation (AF) ablation. The new technology allows for temperature-controlled irrigated ablation and real-time lesion assessment. Recently, the EnSite X mapping system became commercially available allowing for omnipolar and ultra-high-resolution mapping. We aimed to assess the feasibility of the new DT RFA catheter in performing AF ablation procedures in conjunction with the novel EnSite X system under routine clinical conditions. Methods: We analyzed data from 10 consecutive patients who underwent AF ablation using the DT RFA guided by EnSite X. Procedural data and short-term follow-up were assessed as well as potential technical issues. Results: Nine out of 10 patients underwent de-novo pulmonary vein isolation (PVI), and one patient underwent repeat ablation. First-pass isolation was observed in 7/10 patients. Total procedure duration (skin-to-skin) was 88.9 ± 30.1 min, and left atrium dwell time was 70 ± 22.3 min. The mean number of RF applications needed for PVI and additional ablation was 70.52 ± 26.70. The HD Grid SE mapping catheter was utilized in 8 patients and the Advisor SE in 2 patients. Bidirectional block of the applied lines was achieved in all patients. No steam pops were observed, and no intraprocedural complications occurred. Conclusions: This first clinical series demonstrated that temperature-controlled irrigated ablation in combination with the novel omnipolar and high-resolution mapping system resulted in rapid, efficient, and durable lesion formation under routine clinical conditions. Randomized controlled trials are needed to elucidate the impact on lesion formation, long-term outcomes, and reproducibility of our initial findings.

Get Citation

Keywords

atrial fibrillation, pulmonary vein isolation, DiamondTemp, EnSite X, radiofrequency ablation

About this article
Title

First clinical experience using the DiamondTemp catheter and a novel omnipolar high-resolution mapping system for atrial fibrillation ablation

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2022-12-29

Page views

311

Article views/downloads

123

DOI

10.5603/CJ.a2022.0122

Pubmed

36588311

Keywords

atrial fibrillation
pulmonary vein isolation
DiamondTemp
EnSite X
radiofrequency ablation

Authors

Christian Sohns
Thomas Fink
Leonard Bergau
Martin Braun
Mustapha El Hamriti
Vanessa Sciacca
Denise Guckel
Moneeb Khalaph
Guram Imnadze
Philipp Sommer

References (12)
  1. Iwasawa J, Koruth JS, Petru J, et al. Temperature-controlled radiofrequency ablation for pulmonary vein isolation in patients with atrial fibrillation. J Am Coll Cardiol. 2017; 70(5): 542–553.
  2. Haines DE. The biophysics of radiofrequency catheter ablation in the heart: the importance of temperature monitoring. Pacing Clin Electrophysiol. 1993; 16(3 Pt 2): 586–591.
  3. Ramak R, Lipartiti F, Mojica J, et al. Comparison between the novel diamond temp and the classical 8-mm tip ablation catheters in the setting of typical atrial flutter. J Interv Card Electrophysiol. 2022; 64(3): 751–757.
  4. Al-Sheikhli J, Patchett I, Lim VG, et al. Initial experience of temperature-controlled irrigated radiofrequency ablation for ischaemic cardiomyopathy ventricular tachycardia ablation. J Interv Card Electrophysiol. 2022 [Epub ahead of print].
  5. Kuck KH, Brugada J, Fürnkranz A, et al. FIRE AND ICE Investigators. Cryoballoon or radiofrequency ablation for paroxysmal atrial fibrillation. N Engl J Med. 2016; 374(23): 2235–2245.
  6. Starek Z, Lehar F, Jez J, et al. Efficacy and safety of novel temperature-controlled radiofrequency ablation system during pulmonary vein isolation in patients with paroxysmal atrial fibrillation: TRAC-AF study. J Interv Card Electrophysiol. 2022; 64(2): 375–381.
  7. Verma A, Schmidt MM, Lalonde JP, et al. Assessing the relationship of applied force and ablation duration on lesion size using a diamond tip catheter ablation system. Circ Arrhythm Electrophysiol. 2021; 14(7): e009541.
  8. Starek Z, Lehar F, Jez J, et al. A novel temperature-controlled radiofrequency catheter ablation system used to treat patients with paroxysmal atrial fibrillation. JACC Clin Electrophysiol. 2021; 7(3): 352–363.
  9. Bhaskaran A, Chik W, Pouliopoulos J, et al. Five seconds of 50-60 W radio frequency atrial ablations were transmural and safe: an in vitro mechanistic assessment and force-controlled in vivo validation. Europace. 2017; 19(5): 874–880.
  10. Kottmaier M, Popa M, Bourier F, et al. Safety and outcome of very high-power short-duration ablation using 70 W for pulmonary vein isolation in patients with paroxysmal atrial fibrillation. Europace. 2020; 22(3): 388–393.
  11. Reddy VY, Grimaldi M, De Potter T, et al. Pulmonary vein isolation with very high power, short duration, temperature-controlled lesions: the QDOT-FAST trial. JACC Clin Electrophysiol. 2019; 5(7): 778–786.
  12. Richard Tilz R, Sano M, Vogler J, et al. Very high-power short-duration temperature-controlled ablation versus conventional power-controlled ablation for pulmonary vein isolation: The fast and furious - AF study. Int J Cardiol Heart Vasc. 2021; 35: 100847.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Grupa Via Medica, ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl