Predictor Criteria for Selection of Irrigated-Tip Catheter for the Ablation of Accessory Pathways in Comparison with Non-Irrigated-Tip Conventional Radiofrequency Ablation

Abstract

Objectives: This study aims to evaluate the selection criteria for irrigated-tip catheters compared to non-irrigated-tip conventional radiofrequency (RF) catheter ablation in patients with Accessory Pathways (APs). Methodology: A prospective study was conducted on 100 adult patients diagnosed with APs who underwent RF catheter ablation. Among them, 51 patients were treated using non-irrigated-tip catheters, while 49 received ablation with irrigated-tip catheters. Key variables, including patient demographics, presenting symptoms, electrocardiographic (ECG) findings, echocardiographic results, electrophysiological mapping, and procedural outcomes, were recorded and analyzed. Results: The mean patient age was 35.9 years, with a male predominance of 57%. Electrophysiological mapping revealed a significantly higher involvement of lateral and middle cardiac vein pathways in the irrigated-tip catheter group compared to the non-irrigated group (44.9% vs. 25.5%, p=0.03). Patients treated with irrigated-tip catheters exhibited a markedly lower recurrence rate (0% vs. 17.7%, p<0.05) and fewer intraoperative failures (4.1% vs. 19.6%, p<0.05). Additionally, impedance and power values were significantly higher in the irrigated group (p<0.05). Conclusion: Irrigated-tip catheters demonstrate superior efficacy compared to non-irrigated-tip catheters for the ablation of APs, with significantly lower recurrence rates and reduced intraoperative failures. These findings suggest that irrigated-tip catheters should be considered for complex or challenging AP locations.