The Clinical Factors for Temperature Rise in the Electrodes of the Open Irrigated Catheter during Pulmonary Vein Isolation

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Aim: The aim of the study was to investigate the clinical factors for temperature rise (TR) in the electrodes of open irrigated catheter during extensive pulmonary vein isolation (EPVI). Methods: The present study included 65 consecutive patients with AF who underwent EPVI with open irrigated catheter. The upper limit of temperature sensor of 43 degrees Celsius was determined. The incidences of TR and the clinical features of patients with TR were examined. Results: TR was observed in 45 patients (69%) without any thromboembolic events. Patients with TR were likely to have paroxysmal AF (80% vs. 40%, P<0.001) and smaller left atrial (LA) diameter (39±6 mm vs. 44±7 mm, P<0.001) compared to patients without. Fifty-one percent of TR occurred at the roof of bilateral PV. The second RF applications at the same site where TR occurred with lower RF power enabled to deliver the RF durations without TR in these patients. Conclusion: TR was frequently occurred in patients with paroxysmal AF and smaller LA diameter. RF applications with lower power at the roof of PV should be considered to avoid thrombus formation and to deliver the effective RF applications in these patients.