title: Safety and Clinical Outcome of Catheter Ablation of Ventricular Arrhythmias Using Contact Force Sensing: Consecutive Case Series.
abstract: BACKGROUND
  Poor catheter-to-myocardial contact can lead to ineffective ablation lesions and suboptimal outcome. Contact force (CF) sensing catheters in ventricular tachyarrhythmia (VT) ablations have not been studied for their long-term efficacy.
  
  
  OBJECTIVE
  The aim of this study was to compare CF ablation to manual ablation (MAN) and remote magnetic navigation (RMN) ablation for safety and efficacy in acute and long-term outcome.
  
  
  METHODS
  A total of 239 consecutive patients who underwent VT ablation with the use of MAN, CF, or RMN catheters were included in this single-center cohort study from January 2007 until March 2014. The primary endpoints were procedural success, acute major complications, and VT recurrences at follow-up. The median follow-up period was 25 months.
  
  
  RESULTS
  Acute success was achieved in 182 out of 239 procedures (76%). Acute success in manual ablation, CF ablation and RMN ablation was 71%, 71%, and 86%, respectively (P = 0.03). Major complications occurred in 3.3% and there were less major complications (P = 0.04) in the RMN group. After an initial successful procedure, 66 of 182 patients (36%) had a recurrence during follow-up. This was not significantly different between groups. Using an intention-to-treat analysis, 124 patients (52%) had a recurrence. The recurrence rate was lowest in the RMN group.
  
  
  CONCLUSIONS
  The use of CF sensing catheters did not improve procedural outcome or safety profile in comparison to non-CF sensing ablation in this observational study of ventricular arrhythmia ablations.
authors.affiliation: Department of Clinical Electrophysiology, Erasmus Medical Center, Rotterdam, The Netherlands.|Department of Clinical Electrophysiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Astrid Armanda
authors.initials: AA
authors.lastname: Hendriks
authors.affiliation: Department of Clinical Electrophysiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Ferdi
authors.initials: F
authors.lastname: Akca
authors.affiliation: Department of Clinical Electrophysiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Lara
authors.initials: L
authors.lastname: Dabiri Abkenari
authors.affiliation: Department of Clinical Electrophysiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Muchtiar
authors.initials: M
authors.lastname: Khan
authors.affiliation: Department of Clinical Electrophysiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Rohit
authors.initials: R
authors.lastname: Bhagwandien
authors.affiliation: Department of Clinical Electrophysiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Sing-Chien
authors.initials: SC
authors.lastname: Yap
authors.affiliation: Department of Clinical Electrophysiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Sip
authors.initials: S
authors.lastname: Wijchers
authors.affiliation: Department of Clinical Electrophysiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Tamas
authors.initials: T
authors.lastname: Szili-Torok
keywords: catheter ablation; contact force; remote magnetic navigation; ventricular tachycardia