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First clinical experience of high-power ablation of atrial fibrillation with a novel contact force-sensing gold-tip catheter

Background Contact force (CF)-sensing catheters are commonly used in the field of radiofrequency (RF) ablation to treat atrial fibrillation (AF). Increasing ablation power (e.g., 50 W) has been suggested as a method to reduce procedure times whilst creating safe and lasting lesions. Methods We report the first clinical evidence of a 50 W point-by-point RF ablation in 25 consecutive patients with symptomatic AF using a novel CF-sensing catheter with a gold tip (AlCath Force, Biotronik). We collected and analyzed procedural and ablation parameters. The safety and efficacy of the catheter were evaluated. Results Altogether, 985 RF lesions in 25 patients were created with a mean number of 39.4 ± 16.3 lesions per patient. The total skin-to-skin procedure time was 116.1 ± 35.1 min, and the mean total area dose product was 10.9 ± 5.1 Gy*cm2. The mean RF time per procedure was 13.2 ± 6.6 min. The mean RF time per lesion was 20.2 ± 8.4 s. The mean CF was 15.7 ± 7.6 g. We observed a mean force time integral of 274.7 ± 11.1 gs (range: 53 to 496 gs). Acute procedural success, defined as entrance and exit block in all pulmonary veins, could be obtained in all cases. No procedure- or device-related serious adverse events were observed. No audible steam pops occurred. Optical inspection of the catheter after the procedure showed neither charring nor clotting. Conclusions We provide the first evidence for the safety and efficacy of 50 W ablation using the AlCath Force gold-tip catheter. These data must be supported by a larger multi-center study.