title: Prospective randomized comparison of 8-mm gold-tip, externally irrigated-tip and 8-mm platinum-iridium tip catheters for cavotricuspid isthmus ablation.
abstract: BACKGROUND
  Radiofrequency (RF) ablation of the cavotricuspid isthmus (CTI) can be performed using different types of ablation catheter. Gold tip electrodes have the theoretical advantage of creating bigger lesions than standard platinum-iridium electrode. This prospective, randomized study compares the clinical efficacy of 8-mm gold tip catheter, externally irrigated and 8-mm platinum-iridium tip (Pt tip) catheters.
  
  
  RESULTS
  Sixty consecutive patients (51 men, 60 +/- 10 years) undergoing de novo CTI ablation for documented typical atrial flutter were randomized to one of the following ablation catheters: 8-mm gold tip catheter, an externally irrigated-tip (Irr. tip) catheter, or an 8-mm Pt tip catheter. The procedural endpoint was achievement of bidirectional isthmus conduction block with < or = 20 minutes of RF energy application. The latter was achieved equally with the 3 catheters (95% for gold tip, 100% for irrigated tip, 95% for Pt tip) and the durations of RF (10 +/- 6, 10 +/- 4, 13 +/- 8 minutes), fluoroscopy (12 +/- 6, 12 +/- 7, 15 +/- 12 minutes) and the procedure (34 +/- 23, 38 +/- 24, 40 +/- 30 minutes) were similar in all groups. The maximal targeted power could not be reached in at least one location in 40% of patients with gold tip and in 35% of patients with Pt tip catheters whereas it was always achieved with an Irr. tip catheter (P = 0.003, P = 0.008). The reduction in impedance during RF delivery was greater with Irr. tip (11 +/- 7 ohms) than with gold (7 +/- 4 ohms, P = 0.02) or Pt tip (5 +/- 3 ohms, P = 0.001) catheters.
  
  
  CONCLUSIONS
  This study demonstrates equivalent efficacies of gold, platinum-iridium and externally Irr. tip catheters for successful de novo ablation of the CTI.
authors.affiliation: Université Bordeaux II-Hôpital Cardiologique du Haut-Lévêque, Bordeaux-Pessac, France. frederic.sacher@chu-bordeaux.fr
authors.forename: Frédéric
authors.initials: F
authors.lastname: Sacher
authors.forename: Mark D
authors.initials: MD
authors.lastname: O'Neill
authors.forename: Pierre
authors.initials: P
authors.lastname: Jais
authors.forename: Linda L
authors.initials: LL
authors.lastname: Huffer
authors.forename: Julien
authors.initials: J
authors.lastname: Laborderie
authors.forename: Nicolas
authors.initials: N
authors.lastname: Derval
authors.forename: Antoine
authors.initials: A
authors.lastname: Deplagne
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Anders
authors.initials: A
authors.lastname: Jonnson
authors.forename: Meleze
authors.initials: M
authors.lastname: Hocini
authors.forename: Jacques
authors.initials: J
authors.lastname: Clementy
authors.forename: Michel
authors.initials: M
authors.lastname: Haissaguerre
mesh_terms: D000368:Aged; D001282:Atrial Flutter / Q000473:pathology / Q000601:surgery; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods; D002404:Catheterization / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006046:Gold / Q000592:standards; D006801:Humans; D007495:Iridium / Q000592:standards; D008297:Male; D008875:Middle Aged; D010984:Platinum / Q000592:standards; D011446:Prospective Studies; D014261:Tricuspid Valve / Q000473:pathology / Q000601:surgery*
chemical_list: C077763:platinum-iridium alloy; D007495:Iridium; D010984:Platinum; D006046:Gold