Validation of the accuracy of contact force measurement by contemporary
force-sensing ablation catheters
Abstract
Introduction: Contact 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 and we aim to compare the accuracy and
reproducibility of four different force sensing ablation catheters.
Methods: A 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 grams and at contact angles of 0°, 30°, 45°, 60°, and 90°.
Results: In total, 6685 measurements were performed using 4x3
catheters (median of 568, IQR 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 1.29g ±0.99g, AcQBlate Force 2.87g ±2.37g, Stablepoint 1.38g
±1.29g, and Smarttouch 2.26g ±2.70g. For some models, significant under-
and overestimation of >10g were observed at higher forces.
Mean absolute errors of all models across the range of 10-40g were
<3g. Conclusion: Contact measured by force-sensing
catheters is accurate with 1-3g deviation within the range of 10g to
40g. Significant errors can occur at higher forces with potential
clinical consequences.