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.