The Texas Cardiac Arrhythmia Institute (TCAI) at St. David’s Medical Center became, on February 26, the first facility in the United States to use the ThermoCool® SmartTouch® Catheter, after it was approved by the U.S. Food and Drug Administration (FDA). The procedure was performed by cardiac electrophysiologist and executive director of TCAI Andrea Natale, M.D., F.H.R.S., F.A.C.C., F.E.S.C. TCAI was also part of the clinical trial to study the use of the ThermoCool SmartTouch Catheter to treat Atrial Fibrillation, or A Fib, a common heart rhythm disorder.
The ThermoCool SmartTouch Catheter enables doctors to accurately control the amount of contact force applied to the heart wall during radiofrequency catheter ablation procedures. This can increase the effectiveness and safety of the procedure for patients.
Dr. Natale explains that before ThermoCool SmartTouch, it was difficult for physicians, during catheter ablation, to determine whether or not they were maintaining good contact with the tissue. “Maintaining close contact with the tissue and knowing how much pressure you are applying against the heart wall results in the creation of better lesions and ultimately means better outcomes for the patients,” he said.
During a minimally invasive catheter ablation procedure, doctors insert a therapeutic catheter through a small incision in the groin, where it is then guided up to the heart through a blood vessel. Once it reaches the left upper chamber of the heart (atrium), the catheter delivers radiofrequency energy to the heart wall to create lesions that block faulty electrical impulses that can cause heart rhythm disorders. Providing doctors with the ability to apply stable contact force during catheter ablation has been shown to improve patient outcomes, as poor tissue contact force may result in incomplete lesion formation that could result in the need for additional treatment, and too much contact force may damage the tissue.
The results from a clinical trial that studied the safety and effectiveness of the device showed that, after one year, patients experienced a 74 percent success rate after treatment with the ThermoCool SmartTouch Catheter. Importantly, data from the trial showed higher success rates the longer physicians stayed within a targeted contact force range, with one-year results demonstrating an 88 percent success rate when physicians stayed within a targeted range 85 percent of the time or more.
A Fib, a progressive disease that increases in severity and frequency if left untreated, affects about 3 million Americans. If not treated, A Fib can lead to chronic fatigue, congestive heart failure and stroke. Most A Fib patients today are treated with drugs, but about half of patients are not able to control their abnormal heart rhythm with drugs or find they cannot tolerate the side effects. When medication proves to be unsuccessful, the American College of Cardiology and the American Heart Association suggest catheter ablation as a safe and effective treatment option. Clinical studies show that success rates for A Fib treatments such as catheter ablation decrease the longer the disease is left untreated, so early intervention is recommended.