title: Which is the best catheter to perform atrial fibrillation ablation? A comparison between standard ThermoCool, SmartTouch, and Surround Flow catheters.
abstract: BACKGROUND
  Catheter ablation (CA) is an established therapy for atrial fibrillation (AF). The SmartTouch catheter (STc) provides information about catheter tip to tissue contact force (CF). The Surround Flow catheter (SFc) provides a uniform cooling of the tip during ablation. We sought to analyze the impact of STc and SFc on CA of paroxysmal AF in terms of feasibility and acute efficacy.
  
  
  RESULTS
  Sixty-three patients (mean age 57.6 ± 9.8 years, 53 males) with paroxysmal AF underwent pulmonary veins (PVs) antral isolation, by using standard ThermoCool catheter (TCc) in 21, STc in 21, and SFc in 21. Total procedural, fluoroscopy, and radiofrequency (RF) delivery times; percentage of persistently deconnected PVs after 30 min; and percentage of isolated PVs at the end of the procedure were measured. The use of both STc and SFc obtained a reduction of fluoroscopy time (TCc 34 ± 18 min, STc 20 ± 10 min, p < 0.001; SFc 21 ± 13 min, p = 0.02 vs TCc) and RF time (TCc 41 ± 13 min, STc 30 ± 14 min, p = 0.013; SFc 30 ± 9 min, p < 0.01 vs TCc). The use of STc resulted in a reduction of procedural time (TCc 181 ± 53 min, STc 140 ± 53 min, p < 0.001; SFc 170 ± 51 min, p = NS vs TCc). The percentage of isolated PVs was comparable between groups (TCc 96 % vs STc 98 % vs SFc 96 %; p = NS). The percentage of deconnected PVs at 30 min was lower in TCc (89 %) than in STc (95 %) and in SFc (95 %) group (p < 0.05).
  
  
  CONCLUSIONS
  Both STc and SFc allowed a simplification of CA of paroxysmal AF. In addition, they reduced early PVs reconnection. Sixty-three patients with paroxysmal AF underwent ablation by standard ThermoCool, SmartTouch, or Surround Flow catheter. Both the SmartTouch and the Surround Flow significantly reduced radiofrequency and fluoroscopy times, as well as pulmonary veins reconnection rate at 30 min. Moreover, the SmartTouch reduced overall duration of the procedure.
authors.affiliation: Cardiology Department, Policlinico Casilino, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Sciarra
authors.forename: Paolo
authors.initials: P
authors.lastname: Golia
authors.forename: Andrea
authors.initials: A
authors.lastname: Natalizia
authors.forename: Ermenegildo
authors.initials: E
authors.lastname: De Ruvo
authors.forename: Serena
authors.initials: S
authors.lastname: Dottori
authors.forename: Antonio
authors.initials: A
authors.lastname: Scarà
authors.forename: Alessio
authors.initials: A
authors.lastname: Borrelli
authors.forename: Lucia
authors.initials: L
authors.lastname: De Luca
authors.forename: Marco
authors.initials: M
authors.lastname: Rebecchi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Fagagnini
authors.forename: Alberto
authors.initials: A
authors.lastname: Bandini
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Guarracini
authors.forename: Marcello
authors.initials: M
authors.lastname: Galvani
authors.forename: Leonardo
authors.initials: L
authors.lastname: Calò
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000601:surgery*; D006328:Cardiac Catheterization / Q000295:instrumentation*; D017115:Catheter Ablation / Q000295:instrumentation*; D022062:Electrophysiologic Techniques, Cardiac / Q000295:instrumentation; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery; D011846:Radio Waves; D013997:Time Factors; D016896:Treatment Outcome