title: Is there a potential benefit to increased irrigation channels during radiofrequency ablation? Results from a two-center prospective randomized study.
abstract: BACKGROUND
  Open irrigation during radiofrequency (RF) application allows a higher power delivery in the setting of temperature-controlled ablation, without causing blood clots. This study sought to evaluate the clinical value of the additional 6 supplementary channels at the proximal catheter tip compared to a standard irrigated RF catheter with 6 conventional channels present at the distal tip only.
  
  
  RESULTS
  Ninety-five consecutive patients were prospectively randomized to cavotricuspid isthmus ablation using an 3.5 mm tip ablation catheter with 6 distal irrigation channels (6C; 48 patients) or an 4 mm tip ablation catheter with 12 irrigation channels (12C; 47 patients) disposed at the distal (6 channels) and proximal (6 additional channels) catheter tip. There was no significant difference between the 12C and the 6C irrigated-tip catheter concerning the total procedural duration, the RF duration, the fluoroscopic duration, and the amount of irrigation. Conversely, there were significantly more patients who experienced at least one steam pop while using the 12C as compared to the 6C irrigated-tip catheter (0% vs 13%, respectively, P = 0.018).
  
  
  CONCLUSIONS
  The addition of proximal irrigation holes at the catheter tip do not facilitate lesion formation during RF ablation, but significantly increases the risk of steam pop. This is probably the consequence of an increase distortion of the temperature feedback.
authors.affiliation: Brugmann University Hospital, Brussels, Belgium. sebastien.knecht@chubrugmann.be
authors.forename: Sébastien
authors.initials: S
authors.lastname: Knecht
authors.forename: Frédéric
authors.initials: F
authors.lastname: Sacher
authors.forename: Andrei
authors.initials: A
authors.lastname: Forclaz
authors.forename: Thierry
authors.initials: T
authors.lastname: Verbeet
authors.forename: Mélèze
authors.initials: M
authors.lastname: Hocini
authors.forename: Matthew
authors.initials: M
authors.lastname: Wright
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Tran-Ngoc
authors.forename: Marielle
authors.initials: M
authors.lastname: Morissens
authors.forename: Béatrice
authors.initials: B
authors.lastname: Peperstraete
authors.forename: Nicolas
authors.initials: N
authors.lastname: Derval
authors.forename: Pierre
authors.initials: P
authors.lastname: Jaïs
authors.forename: Nick
authors.initials: N
authors.lastname: Linton
authors.forename: Pierre
authors.initials: P
authors.lastname: Decoodt
authors.forename: Michel
authors.initials: M
authors.lastname: Haïssaguerre
authors.forename: José
authors.initials: J
authors.lastname: Castro-Rodriguez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods* / Q000706:statistics & numerical data*; D015897:Comorbidity; D005060:Europe / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D007507:Therapeutic Irrigation / Q000706:statistics & numerical data*; D016896:Treatment Outcome