Validation of the accuracy of contact force measurement by contemporary force-sensing ablation catheters

IntroductionContact force sensing catheters are widely used for ablation of cardiac arrhythmias. They allow quantification of catheter-to-tissue contact, which is an important determinant for lesion formation and may reduce the risk of complications. The accuracy of these sensors may vary across the measurement range, catheter-to-tissue angle, and amongst manufacturers. We aim to compare the accuracy and reproducibility of four different force sensing ablation catheters. MethodsA measurement setup containing a heated saline water bath with an integrated force measurement unit was constructed and validated. Subsequently, we investigated four different catheter models, each equipped with a unique measurement technology: Tacticath Quartz (Abbott), AcQBlate Force (Biotronik/Acutus), Stablepoint (Boston Scientific), and Smarttouch SF (Biosense Webster). For each model, the accuracy of three different catheters was measured within the range of 0-60 g and at contact angles of 0 degrees, 30 degrees, 45 degrees, 60 degrees, and 90 degrees. ResultsIn total, 6685 measurements were performed using 4 x 3 catheters (median of 568, interquartile range: 511-606 measurements per catheter). Over the entire measurement-range, the force measured by the catheters deviated from the real force by the following absolute mean values: Tacticath 1.29 +/- 0.99 g, AcQBlate Force 2.87 +/- 2.37 g, Stablepoint 1.38 +/- 1.29 g, and Smarttouch 2.26 +/- 2.70 g. For some models, significant under- and overestimation of >10 g were observed at higher forces. Mean absolute errors of all models across the range of 10-40 g were <3 g. ConclusionContact measured by force-sensing catheters is accurate with 1-3 g deviation within the range of 10-40 g. Significant errors can occur at higher forces with potential clinical consequences.

Automated summary

This study aims to compare the accuracy and reproducibility of four different force sensing ablation catheters. The results show that the contact force measured by these catheters deviates by 1-3 g from the actual force within the range of 10-40 g. However, significant errors can occur at higher forces, potentially impacting clinical outcomes.