A recent study examining the viability of a temperature-controlled ablation system for ventricular tachycardia found that using a temperature-controlled irrigated radiofrequency ablation catheter was safe and effective, with a low rate of recurrence at six months.
Tissue temperature is a key factor in creating successful lesions when catheter ablation using radiofrequency energy is performed. However, due to the cooling effect of saline irrigation, it is difficult to measure during conventional radiofrequency ablation.
The TRAC-VT study tested the use of an irrigated radiofrequency ablation system that modulates power levels based on real-time tissue temperature.
Temperature-controlled irrigated radiofrequency could reduce the risk of overheating during catheter ablation, particularly where longer ablations were required for deeper lesions.
The researchers enrolled 38 patients (68 ± 12 years of age and 84% male) with sustained monomorphic ventricular tachycardia and structural heart disease. The patients had an average of 1.7 ± 1.2 ventricular tachycardias targeted per patient.
Catheter ablation was performed in temperature-control mode, with a saline irrigation rate of 8ml/min and temperature set points of 55 or 60°C, power output ≤ 50 W and radiofrequency application time of up to 45 seconds per application.
The patients were monitored for heart-related conditions for 30 days after the procedure. In addition, the researchers determined efficacy through ‘acute success’ when the clinicians could no longer induce relevant ventricular tachycardias after the procedure.
Each patient received an average of 41 radiofrequency ablation applications. The procedure was successful in 100% of cases, with no adverse safety concerns.
‘Safe and effective’ option for ventricular tachycardia
At six months follow-up, which was completed in 92% of patients, 81% of patients remained free from ventricular tachycardia, with just three patients needing a repeat ablation due to ventricular tachycardia recurrence.
The findings confirmed that the novel temperature-controlled radiofrequency ablation system was safe and highly effective, with a low rate of ventricular tachycardia recurrence at six months.
The researchers said further direct comparative studies to other ablation technologies may help elucidate the potential clinical benefits of a temperature-controlled radiofrequency ablation strategy for the treatment of ventricular arrhythmias.
Reference
Kautzner, J et al. Safety and efficacy of a temperature-controlled ablation system for ventricular tachycardia: Results from the TRAC-VT study. J Interv Card Electrophysiol 2025; Feb 01: DOI: 10.1007/s10840-025-01995-z.
