OBJECTIVES

Considerable advancement in radiofrequency (RF) ablation technology has occurred in recent years. More recently, the THERMOCOOL SMARTTOUCH^® SF (STSF) Catheter, a contact force (CF) catheter with porous tip design, was introduced. Unlike the THERMOCOOL SMARTTOUCH^® (ST) Catheter, which was the earlier generation CF catheter with standard irrigation, the STSF Catheter incorporates CF technology with an advanced fluid delivery mechanism (porous tip). This study examined if there is a variation within AF patients ablated using the STSF Catheter versus the ST Catheter.

METHODS

Patients with a primary diagnosis of AF (≥18 years) who underwent RF ablation between 09/01/2016–03/31/2018 were identified from the Premier Healthcare database. Using a text search strategy of hospital charge descriptors, catheter brand was identified and patients were classified into two groups: STSF Catheter group or ST Catheter group. Demographic, clinical, and provider characteristics among the two groups of patients were compared.

RESULTS

There were 1,445 patients in STSF Catheter group and 1,766 in ST Catheter group. A significantly greater proportion of patients in the STSF Catheter group were in the age group ≥70 years (35.09%vs30.18%;p=0.0031), and had Medicare as the primary payer (52.11%vs45.41%;p=0.0002) versus those in the ST Catheter group. STSF patients were more likely to have a CHADS₂VASc score of ≥3 (43.39%vs35.28%;p<0.001) compared to the ST patients. Further, a higher proportion of the STSF patients had persistent AF (36.68%vs32.79%;p=0.0210), obesity (23.88%vs19.42%;p=0.0022), diabetes (20.90%vs17.27%;p=0.0090), atrial flutter (41.38%vs32.67%;p<0.0001), valvular disease (21.87%vs12.34%;p<0.0001), cardiomyopathy (12.87%vs9.68%;p=0.0042), hypertension (69.48%vs63.08%;p=0.0001), and heart failure (20.69%vs17.84%;p=0.0407) compared to ST patients.

CONCLUSIONS

Further research is needed to better understand the factors influencing this channeling of sicker AF patients being ablated using the THERMOCOOL SMARTTOUCH^® SF Catheter versus the THERMOCOOL SMARTTOUCH^® Catheter.