QDOT MICROTM Catheter for
Cavotricuspid isthmus ablation
Beside the fact that QDOT MICROTM Catheter QMODE+
based ablation for PVI has been evaluated in several trials and studies
there is only limited data for catheter ablation of the cavotricuspid
isthmus (CTI) in patients presenting with typical atrial flutter (AFL),
(Figure 3 ). The main concern about vHPSD is the lack of
transmurality in regions with thicker tissue like the CTI. However, data
utilizing 50W in studies by Kwon et al. and Yavin et al. reported a
success rate for CTI block of 100%.
Schillaci et al. evaluated vHPSD ablation of the CTI in 28 consecutive
patients (FAST) and compared the data to the last 30 consecutive
patients who, previously, underwent CTI ablation by STSF guided by AI
(control). For both groups an ILD of ≤ 6 mm was aimed. The vHPSD
ablation was as effective as AI-guided ablation in achieving acute CTI
block (first pass rate: 89% vs 93%, p = 0.59), with a shorter
RF time (88 ± 40 seconds vs 492 ± 269 seconds,p < 0.001) and similar procedure (30 ± 4 min vs
34 ± 10 min, p = 0.5) time was observed.
Besides PVI in the FAST and FURIOUS PVI study CTI block was achieved by
Qmode+ only in 13 / 13 patients. In one patient with a repeat procedure
the CTI was checked and was found to be durable blocked. Similar
findings have been evaluated in the FAST and FURIOUS CTI study. Here
complete CTI block using vHPSD ablation was achieved in all 15 patients.
A median of 23 (20, 39) RF applications over a median RF ablation time
of 92 (78, 154) seconds were applied and no periprocedural
complications, no charring and no steam pops were observed.
The preliminary data show that vHPSD ablation might represent an
effective and safe strategy to achieve bidirectional CTI block for the
treatment of typical AFL.