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Christian Sohns, Thomas Fink, Leonard Bergau, Martin Braun, Mustapha El Hamriti, Vanessa Sciacca, Denise Guckel, Moneeb Khalaph, Guram Imnadze, Philipp Sommer

• \(\bf Background:\) The DiamondTemp (DT) radiofrequency ablation (RFA) catheter has been introduced as a new tool for atrial fibrillation (AF) ablation. The new technology allows for temperature-controlled irrigated ablation and real-time lesion assessment. Recently, the EnSite X mapping system became commercially available allowing for omnipolar and ultra-high-resolution mapping. We aimed to assess the feasibility of the new DT RFA catheter in performing AF ablation procedures in conjunction with the novel EnSite X system under routine clinical conditions. \(\bf Methods:\) We analyzed data from 10 consecutive patients who underwent AF ablation using the DT RFA catheter guided by EnSite X. Procedural data and short-term follow-up were assessed as well as potential technical issues. \(\bf Results:\) Nine out of 10 patients underwent de-novo pulmonary vein isolation (PVI), and 1 patient underwent repeat ablation. First pass isolation was observed in 7/10 patients. Total procedure duration (skin-to-skin) was 88.9 \(\pm\) 30.1 min, and left atrium dwell time was 70 \(\pm\) 22.3 min. The mean number of RF applications needed for PVI and additional ablation was 70.52 \(\pm\) 26.70. The HD Grid SE mapping catheter was utilized in 8 patients and the Advisor SE in 2 patients. Bidirectional block of the applied lines was achieved in all patients. No steam pops were observed, and no intraprocedural complications occurred. \(\bf Conclusions:\) This first clinical series demonstrated that temperature-controlled irrigated ablation in combination with the novel omnipolar and high-resolution mapping system resulted in rapid, efficient, and durable lesion formation under routine clinical conditions. Randomized controlled trials are needed to elucidate the impact on lesion formation, long-term outcomes, and reproducibility of our initial findings.