Diamond-Embedded Temperature Control Catheter Enables Faster and More Efficient Cavotricuspid Isthmus Ablation Compared to Contact Force Sensing Catheters

Abstract

Background

Cavotricuspid isthmus (CTI) ablation is a well-established treatment for atrial flutter (AFL). The DiamondTemp (DT) catheter provides precise real-time tissue temperature feedback during radiofrequency (RF) ablation, optimizing energy delivery. While the efficacy of DT in ablation procedures has been demonstrated, its performance in CTI ablation compared with contact force (CF)-sensing irrigated catheters remains underexplored. This study assessed the efficiency and safety of the DT catheter in CTI ablation.

Methods

We retrospectively analyzed consecutive patients who underwent CTI ablation between August 2022 and May 2024. Patients were classified into DT and non-DT groups (TactiFlex, QDOT MICRO, SmartTouch SF, or StablePoint). The primary endpoint was total RF application time. Secondary endpoints included the number of RF applications, total procedure time, acute success rate defined as bidirectional conduction block, and periprocedural complications. All procedures were performed under general anesthesia, using 3D mapping systems.

Results

A total of 126 patients (mean age 67.4 years, 81.0% male) were included. Bidirectional block was achieved in all patients. Median total RF time was significantly shorter in the DT group compared with the non-DT group (131.0 [89.0–212.0] vs. 269.0 [196.0–469.0] sec, p < 0.001). The DT group required fewer RF applications (p < 0.001) and had a shorter total procedure time (p < 0.001). No complications occurred.

Conclusion

CTI ablation with the DiamondTemp catheter significantly reduced total RF time and the number of RF applications while maintaining acute procedural success and safety. These findings suggest that the DiamondTemp catheter offers procedural efficiency advantages over conventional CF-sensing catheters in CTI ablation.