A Golden Opportunity: Looking back at BIOTRONIK’s GoldTip Ablation. How it Began and Where it’s Headed

As we mark 60 years of BIOTRONIK, we reflect on our remarkable milestones and game-changing innovations. Among them is GoldTip, a technology that turns 20 this year.

In 2001, BIOTRONIK’s newly formed Electrophysiology (EP) team started working on perfecting a new ablation technique – one aimed at producing deeper lesions, but less likely to overheat and cause pops or charring. Wolfgang Geistert, having just joined BIOTRONIK in February of that year, had the idea to switch out the standard platinum iridium tip common to ablation catheters and use gold instead. “Gold’s physical properties made it a natural choice in many respects. It has both a much higher thermal conductivity and heat capacity than platinum. As gold is a better heat sink than platinum, it could cool faster by taking heat energy away from tissue and transferring it to the blood – thereby reducing the chances of charring,” explains Geistert, who is now VP of Research & Development at BIOTRONIK sister company VascoMed. 

But there was one big problem at the beginning. Gold is soft and very difficult to work with. The team’s early attempts at incorporating it into a catheter prototype often ended with scratches and dents at the beginning. 

But then, while putting a prototype together, one developer’s previous career as a dental assistant gave the EP team the breakthrough idea they needed: dental gold. It proved to combine the heat conductivity and capacity with the required durability, so the team began testing their gold prototype head-to-head against platinum catheters.  

In 2003, BIOTRONIK EP teamed up with Dr. Thorsten Lewalter, then at Bonn’s University Clinic, eventually presenting the first head-to-head evidence at the annual German Cardiology Society meeting that year. The gold-tip was able to achieve deeper lesions in identical test conditions, especially in cases of atrial flutter, ostial pulmonary vein disconnection and left ventricular tachycardia. Researchers noted it could be especially helpful in the thicker left ventricle. 

With encouraging first data, researcher Robert Blum, who is still at BIOTRONIK today, pressed ahead with product development. First, he found that BIOTRONIK’s gold catheter could create lesions that were 35 percent deeper in the same period of ablation time as a platinum-iridium tip catheter. The gold tip also remained cooler during procedures, even while ablating deeper, with no coagulation episodes observed. 

As BIOTRONIK prepared to bring its new GoldTip catheter to the RF ablation market, Dr. Lewalter spearheaded an in vitro comparison of gold and platinum-iridium tips in 2005 to optimize this further, finding that gold could deliver 38 percent more power to the tip while maintaining the exact same temperature conditions as a platinum-iridium tip. 

Since then, around a dozen studies have looked at this golden advantage, confirming benefits like reduced thrombus risk, less fluoroscopy time and fewer RF applications, along with greater ablation power delivery and a reduced risk of charring. BIOTRONIK’S EP team is proud to have been the first to bring the advantage of gold electrodes to arrhythmia patients. 

As the electrophysiology market continues to evolve and the number of patients in need of ablation therapy to treat atrial fibrillation grows, BIOTRONIK is constantly striving to advance its solutions to benefit both physicians and their patients. With GoldTip ablation technology in use all over the world 20 years after it was first invented, BIOTRONIK looks forward to the exciting new uses for a classic technology in today’s cathlab. 

If you’re interested in more topics related to ablation and electrophysiology, please continue reading here.