Details

Autor(en) / Beteiligte

• Lewalter, Thorsten
• Weiss, Christian
• Spencker, Sebastian
• Jung, Werner
• Haverkamp, Wilhelm
• Willems, Stephan
• Deneke, Thomas
• Kautzner, Josef
• Wiedemann, Michael
• Siebels, Jürgen
• Pitschner, Heinz Friedrich
• Hoffmann, Ellen
• Hindricks, Gerd
• Zabel, Markus
• Vester, Ernst
• Schwacke, Harald
• Mittmann-Braun, Erica
• Lickfett, Lars
• Hoffmeister, Sabine
• Proff, Jochen
• Mewis, Christian
• Bauer, Wolfgang

Titel

Gold vs. platinum-iridium tip catheter for cavotricuspid isthmus ablation: the AURUM 8 study

Ist Teil von

• Europace (London, England), 2011-01, Vol.13 (1), p.102-108

Ort / Verlag

England

Erscheinungsjahr

2011

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Gold electrodes have the theoretical advantage of creating bigger lesions than platinum-iridium (Pt-Ir) electrodes. We performed a prospective randomized study to compare the clinical efficacy of standard 8 mm Pt-Ir tip catheter (control) and 8 mm gold-tip catheters in the ablation of the cavotricuspid isthmus (CTI)-dependent atrial flutter. A total of 463 patients undergoing CTI ablation in 19 clinical centres were randomized to receive the treatment by gold-tip or control catheter. The primary endpoint was cumulative radiofrequency (RF) application duration until achieving bidirectional CTI block. It did not differ significantly for the two catheters. The gold-tip catheter was, however, associated with a higher ablation success rate (94.3 vs. 89.0%, P = 0.042) and a substantially lower incidence of char and coagulum formation (4.8 vs. 37.9%, P < 0.001), which required exchange of 1 gold-tip (0.4%) and 10 control catheters (4.6%, P = 0.005). The gold-tip catheter delivered more mean power (52 ± 12 W) than the control catheter (48 ± 13 W, P < 0.001). Both mean and maximum temperatures measured by the thermocouple integrated in the catheter tip were statistically significantly lower in the gold (mean: 53.2 ± 4.7°C, max: 68.7 ± 6.6°C) than in the control catheter (54.3 ± 5.2 and 70.2 ± 7.0°C, respectively, P < 0.05). Fluoroscopy time, procedure duration, procedural-related complications, and arrhythmia recurrence during 6 months of follow-up did not differ between the two catheters. Owing to a higher primary ablation success rate and reduced incidence of char/coagulum formation, gold may be preferred over Pt-Ir as electrode material for 8 mm tip catheters for CTI ablation. ClinicalTrials.gov: NCT00326001 (http://clinicaltrials.gov/ct2/show/NCT00326001).