Temperature-limited applications of mini-electrode catheter: authors' reply

We thank Dr Caldwell and colleagues¹ for the insightful comments on our paper examining the efficacy of cavotricuspid isthmus (CTI)-dependent atrial flutter ablation by the mini-electrode catheter.² We agree with the authors that lesion volume is related to the surface area of contact between electrode tip and endocardium and that voltage-directed CTI ablation is an effective technique.

Limited power delivery from using temperature control mode in the mini-electrode arm likely resulted from the location of the tip temperature sensor in this catheter. This, we believe, played a significant role in the less favourable outcome noted with this catheter.

Caldwell et al. propose yet another possible mechanism whereby the contact area between ablative tip and tissue is inadvertently minimized as the operator attempts to optimize signal on the mini-electrode catheter as they nicely demonstrate in the attached figure. We thank the authors for their unique insight.

Conflict of interest: none declared.

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