PO-04-199 CHARACTERISTICS AND SAFETY OF A NOVEL CONTACT-FORCE SENSING IRRIGATED CATHETER WITH A FLEXIBLE TIP WITH LASER-CUT KERFS

Abstract

The Tactiflex™ SE catheter has a laser-cut 8Fr 4-mm flexible tip irrigated through laser-cut kerfs with a contact-force sensor. We investigated the characteristics of lesion formation and superiority in this catheter to the TactCathTM SE. RF applications at a range of powers (30 W, 40 W, and 50 W), contact forces (10g and 20 g), durations (10–60 s) using perpendicular/parallel catheter orientation with half- or normal-saline irrigation were performed in excised porcine hearts. Lesion characteristics and incidence of steam pops were compared. Incidence of steam-pops were also examined in the clinical setting. A total of 576 RF-lesions were examined. The Tactiflex™ SE catheter demonstrated significantly a lower risk of steam-pops (5(1.7%) vs 59(205%), P<0.0001). Tactiflex™ SE generally produced smaller lesion volume (193 [98-554]mm3 vs 263 [139-436]mm3, p<0.0001), and this difference was mainly due to the differencnt lesion size in perpendicular catheter placement (249 [126-414]mm3 vs 162 [78-309]mm3, P<0.0001). Although Half-saline irrigation tended to increase the lesion volume in both catheters, incidence of steam-pops was also increased with TactCathTM SE, but not with Tactiflex™ SE. %impedance-drop (=absolute impedance-drop/initial impedance) of 20%, predicted steam-pops with a sensitivity and specificity of 100% and 89.6%, respectively (Figure 1). All 1977 RF-applications in the initial 30 patients treated with Tactiflex™ SE catheter for 17AFs, 1AVNRT, 10PVCs, and 2VTs were displayed in the Figure 2. Median RF-energy and power, contact force, and %impedance drop was 692[489-916]J, 36[30-45]W, 12[8-16]g, and 13[11-16]%, and 3 (0.5%) RF-applications were related to pericardial effusion without audible steam-pops with a %impedance-drop of 28%, 34%, and 35%. The FlexAbility™ SE catheter reduced the risk of steam-pops but produced smaller lesions with perpendicular catheter placement compared to the TactiCath™ SE catheter. %impedance-drop<20% may be a reasonable values to safely apply RF-applications with the FlexAbility™ SE.