Irrigated-tip vs conventional-tip catheters for primary ablation of posteroseptal and right free-wall accessory pathways: a prospective randomized study

Abstract

Irrigated-tip catheters are not more efficient than conventional catheters in initial RFA of the posteroseptal and right free-wall APs. Therefore, the use of irrigated-tip catheters is justifiable only for ablation of the APs resistant to previously attempted conventional RFA.

Safety and Efficacy of Open Irrigated‐Tip Catheter Ablation of Wolff‐Parkinson‐White Syndrome in Children and Adolescents

“…Specifically, secondary use of irrigated technology was accompanied by procedural success in adult patients with left lateral AP, in cases of right posteroseptal APs (with applications in the coronary sinus), or even in paraseptal APs. 4,[7][8][9]13 In this study, we have exhibited not only a similarly high acute success rate (95.1%) with previous registries but, in addition, we have detected the total absence of recurrences, assessed by clinical and electrocardiographic parameters, based on 1 year consistent follow-up. Specifically, reasons for ablation failure in our study patients (catheter stability and proximity to atrioventricular node) were not related with catheter characteristics.…”

“…In the setting of adult patients with WPW, irrigated‐tip catheters have been periodically used after a prior failed ablation. Specifically, secondary use of irrigated technology was accompanied by procedural success in adult patients with left lateral AP, in cases of right posteroseptal APs (with applications in the coronary sinus), or even in paraseptal APs . In this study, we have exhibited not only a similarly high acute success rate (95.1%) with previous registries but, in addition, we have detected the total absence of recurrences, assessed by clinical and electrocardiographic parameters, based on 1 year consistent follow‐up.…”

“…Recent developments include the use of irrigated‐tip catheters which allow the delivery of greater energy to tissues and have been proven to be safe and effective in eliminating AP conduction resistant to conventional catheters in adult patients, irrespective of the location . However, there are persistent concerns regarding the safety of irrigated catheters in the pediatric population and there is a paucity of data regarding their use in this age group.…”

“…[4][5][6] Recent developments include the use of irrigated-tip catheters which allow the delivery of greater energy to tissues and have been proven to be safe and effective in eliminating AP conduction resistant to conventional catheters in adult patients, irrespective of the location. [7][8][9] However, there are persistent concerns regarding the safety of irrigated catheters in the pediatric population and there is a paucity of data regarding their use in this age group. Therefore, in this report we aimed to present our experience, in terms of effectiveness and safety, of irrigated catheter technology in children and adolescents who underwent ablation of WPW in our center.…”

Irrigated‐tip catheters for radiofrequency ablation of right‐sided accessory pathways in adolescents

“…In the study of Mujovic et al. in 50 adults with right‐sided APs, recurrence was still high using ITC (18.2% vs 16.7%) . ITC ablation has the advantage that structures such as epicardial (posteroseptal) APs are more affected than superficial endocardial structures.…”