Introduction

Radiofrequency ablation (RFA) is commonly used for the treatment of cardiac arrhythmias. In recent years, advancements in catheter manufacturing technologies allowed for more complex catheter designs, including the assessment of contact by force measurement at the catheter’s tip. These catheters are widely used and have been demonstrated to be effective in complex ablation procedures including ablation of atrial fibrillation as well as ventricular arrhythmias.1–5 The biophysics of RFA are well understood and lesion size is mainly a function of power, energy delivery time, catheter-to-tissue contact force per area, and stability6. This knowledge and the rise of force sensing catheters allowed the field to develop algorithms to predict lesion formation and –quality7–12. These novel algorithms are nowadays used in conjunction with conventional markers like tactile feedback, impedance drop, loss of pace capture, or electrogram amplitude attenuation1,13. For the algorithms to perform well, reliance on accurate cather-to-tissue contact force measurement is key. For some force sensing catheters, the accuracy of their sensors was externally validated previously14. Several latest generation models however have not been tested yet, including two catheter designs that newly gained CE mark approval in 2020 (Stablepoint, Boston Scientific; and AcQBlate® Force, Biotronik/Acutus).
This study aimed to compare the four currently commercially available contact force-sensing ablation catheters regarding the accuracy of their contact force sensor measurements.