Contact Force Sensing Research Articles

TCT-540 Second-Generation Cryoballoon Ablation vs Contact-Force Sensing Radiofrequency Ablation in Paroxysmal Atrial Fibrillation: An Updated Systematic Review and Meta-Analysis

TCT-540 Second-Generation Cryoballoon Ablation vs Contact-Force Sensing Radiofrequency Ablation in Paroxysmal Atrial Fibrillation: An Updated Systematic Review and Meta-Analysis

Contact Force Sensing and Control for Inserting Operation During Precise Assembly Using a Micromanipulator Integrated With Force Sensors

This paper proposes a novel contact force sensing and control method for the inserting operation during precise assembly process, which is based on a micromanipulator integrated with force sensors. At first, theoretical analysis is carried out to calculate the admissible contact force between the gripped holes and the pegs. The contact force thresholds which are smaller than the admissible contact forces are adopted in the control algorithm to avoid the rotating of the gripped holes during assembly process. The force sensors are calibrated using an ATI force sensor and the conversing coefficients are calculated. The admissible contact forces are tested when different contact distance and preload force are adopted. The performance of the proposed contact force sensing and control method is verified by carrying out the task of applying contact force on the surface of the gripped holes with different contacting speeds. The results indicate that the contact force can be adjusted to be smaller than the threshold 1 and the peg-in-hole assembly can be completed successfully. <i>Note to Practitioners</i>&#x2014;This paper proposes a novel contact force sensing method during the inserting operation. Compared with the traditional contact force sensing method, this paper adopts the force sensor integrated into the micromanipulator instead of commercial force sensor to detect the contact force between two parts. To ensure the assembling precision, the theoretical analysis is conducted to calculated the admissible contact force to avoid the sliding and rotating of the gripped micro part during assembling. This work efficiently simplifies the contact force sensing and control process, where complex calibration process needn&#x2019;t to be carried out to eliminate the influence of the mass of the micromanipulator on the testing results. In addition, the assembling costs are reduced by replacing commercial force sensors with strain gauges.

Combination of Intracardiac Echocardiography and Contact Force Sensing for Left Ventricular Papillary Muscle Arrhythmias.

The catheter ablation of ventricular arrhythmias (VAs) arising from the left ventricular (LV) papillary muscles (PMs) is challenging. This study sought to address whether the combination of intracardiac echocardiography (ICE) and contact force sensing (CFS) can improve the acute and long-term ablation outcomes of left ventricular papillary muscle arrhythmias. From May 2015 to August 2022, a total of thirty-three patients underwent catheter ablation for LV PM arrhythmias: VAs were located in anterolateral PMs in 11 and posteromedial PMs in 22. A combination of intracardiac echocardiography (ICE) and contact force sensing (CFS) was used in 21 of the 33 procedures. A mean of 6.93 ± 4.91 for lesions was used per patient, comparable between the CFS/ICE and no ICE/CFS (4.90 ± 2.23 vs. 10.17 ± 5.89; p = 0.011). The mean CF achieved in the ICE/CFS group was 7.52 ± 3.31 g. Less X-ray time was used in the combination group (CFS/ICE: 165.67 ± 47.80 S vs. no ICE/CFS: 365.00 ± 183.73 S; p < 0.001). An acute success rate of 100% was achieved for the ICE/CFS group (n = 22) and 66.67% for the no ICE/CFS group (n = 8). VA recurrence at the 11.21 ± 7.21-month follow-up was 14.2% for the ICE/CFS group and 50% for the no ICE/CFS group (p = 0.04). No severe complications occurred in all patients. The combination of intracardiac echocardiography (ICE) and contact force sensing (CFS) could provide precise geometries of cardiac endocavitary structures and accurate contact information for the catheter during ablation, which improved acute and long-term ablation outcomes. The routine adoption of this strategy should be considered to improve the outcomes of LV PM VA ablation.

A Novel Catheter Distal Contact Force Sensing for Cardiac Ablation Based on Fiber Bragg Grating with Temperature Compensation.

To accurately achieve distal contact force, a novel temperature-compensated sensor is developed and integrated into an atrial fibrillation (AF) ablation catheter. A dual elastomer-based dual FBGs structure is used to differentiate the strain on the two FBGs to achieve temperature compensation, and the design is optimized and validated by finite element simulation. The designed sensor has a sensitivity of 90.5 pm/N, resolution of 0.01 N, and root-mean-square error (RMSE) of 0.02 N and 0.04 N for dynamic force loading and temperature compensation, respectively, and can stably measure distal contact forces with temperature disturbances. Due to the advantages, i.e., simple structure, easy assembly, low cost, and good robustness, the proposed sensor is suitable for industrial mass production.

Kirigami Design of Flexible and Conformal Tactile Sensor on Sphere‐shaped Surface for Contact Force Sensing

AbstractFlexible tactile sensors can be used as the human–machine interactions for tactile information. Integration of flexible tactile sensor onto complex curved surfaces usually generates high assembly strains or stresses, thus reducing the accuracy of tactile sensing. This paper presents a novel flexible tactile sensor using a devisable kirigami structural design for conformal integration of curved surfaces with low assembly strain. The target sphere object's surface is divided into several fan‐shaped pieces and then flattened into 2D patterns for the structural design and arrangement of tactile sensors. Each piece of tactile sensor has three sensing units including one triangular‐shaped and two quadrilateral‐shaped sensing units. The fabricated tactile sensor with tri‐unit and quad‐unit is characterized with the sensitivity of 0.0112 and 0.0081 kPa−1 in sensing range of 0–80 kPa, respectively. Numerical simulation results show the tactile sensor has generally low assembly strain (&lt;1.0%) when integrated onto a tennis ball, and experimental results demonstrate that the relative changes of initial resistance and calculated sensitivity are less than 4.0% before and after integration. The contact force sensing in tennis ball games with different actions demonstrates the potential of using the designed tactile sensor for further athletic training and other applications.

Catheter ablation for papillary muscle arrhythmias: A systematic review.

BackgroundCatheter ablation of papillary muscle ventricular arrhythmias (PM‐VAs) has been associated with unsatisfactory results. Features that may affect acute and long‐term procedural outcomes are not well established.ObjectiveTo systematically review the available data in the literature assessing efficacy and safety of PM‐VAs catheter ablation.MethodsAn online search of PubMed, Cochrane Registry, Web of Science, Scopus and EMBASE libraries (from inception to March 1, 2021) was performed, in addition to manual screening. Twenty‐one observational noncontrolled case‐series were considered eligible for the systematic review, including 536 patients.ResultsPostero‐medial PM harbored 60.8% of PM‐VAs, while antero‐lateral PM and right ventricular PMs 34.9% and 4.3% of cases, respectively. The mean acute success rate of the index ablation procedure was 88.1% (95% CI 82.8% to 91.9%, p < .001, I2 0%). After a mean follow‐up period of 15.5 ± 17.4 months, pooled long‐term arrhythmia‐free rate was 69.2%, while the pooled long‐term success rate after multiple ablation procedure was 84.9%. Overall, procedure complications occurred in nine patients (1.7%) and no procedure‐related deaths were reported. The use of intracardiac echocardiography (ICE) as well as contact force sensing (CFS) and irrigated catheters during ablation was associated with higher rates of arrhythmia‐freedom at long‐term follow‐up.ConclusionsCatheter ablation is an effective and safe strategy for PM‐VAs, with an acute success rate of 88.1%, a long‐term success rate of 69.2%, with a relatively low procedural complication rate. The use of ICE, irrigated catheters and catheters with CFS capability was associated with higher rates of arrhythmia‐freedom at long‐term follow‐up.

Contact Force-Sensing versus Standard Catheters in Non-Fluoroscopic Radiofrequency Catheter Ablation of Idiopathic Outflow Tract Ventricular Arrhythmias.

Background: Adequate contact between the catheter tip and tissue is important for optimal lesion formation and, in some procedures, it has been associated with improved effectiveness and safety. We evaluated the potential benefits of contact force-sensing (CFS) catheters during non-fluoroscopic radiofrequency catheter ablation (NF-RFCA) of idiopathic ventricular arrhythmias (VAs) originating from outflow tracts (OTs). Methods: A group of 102 patients who underwent NF-RFCA (CARTO, Biosense Webster Inc., Irvine, CA, USA) of VAs from OTs between 2014 to 2018 was retrospectively analyzed. Results: We included 52 (50.9%) patients in whom NF-RFCA was performed using CFS catheters and 50 (49.1%) who were ablated using standard catheters. Arrhythmias were localized in the right and left OT in 70 (68.6%) and 32 (31.4%) patients, respectively. The RFCA acute success rate was 96.1% (n = 98) and long-term success during a minimum 12-month follow-up (mean 51.3 ± 21.6 months) was 85.3% (n = 87), with no difference between CFS and standard catheters. There was no difference in complications rate between CFS (n = 1) and standard catheter (n = 2) ablations. Conclusions: There is no additional advantage of CFS catheters use over standard catheters during NF-RFCA of OT-VAs in terms of procedural effectiveness and safety.

Outcomes of manual versus remote magnetic navigation for catheter ablation of ventricular tachycardia: a systematic review and updated meta-analysis.

Ventricular tachycardia (VT) ablation is a complex procedure that requires remarkable catheter manipulation skill, great mapping accuracy and catheter stability, and can expose patients to serious complications. Magnetic navigation system (RMN)-guided ablation and contact force-sensing (CFS) catheters have the potential to overcome these obstacles. We performed a systematic review and updated meta-analysis of all available studies evaluating the outcomes of VT ablation by using RMN-guided compared to manual navigation (MAN)-guided, with and without CFS catheters. MEDLINE/PubMed, Cochrane, and Google Scholar were searched for randomized controlled trials (RCT) or observational studies with multivariate adjustment comparing RMN-guided versus MAN-guided VT ablation. Thirteen studies enrolling 1348 patients (656 RMN-guided vs. 692 MAN-guided) were included. CFS catheter were used in 14% of MAN-guided patients. In comparison to MAN-guided and CFS-guided, RMN-guided VT ablation was associated with a significant higher acute ablation success (OR 2.32, 1.66-3.23 and OR 2.91, 1.29-6.53, respectively) but similar results in term of long-term VT recurrence (OR 0.75, 0.56-1.01 and OR 0.79, 0.27-2.36, respectively). RMN-guided showed a better safety profile (for all complications, OR 0.52, 0.34-0.81) and allowed a significant x-ray reduction compared to MAN-guided (OR 0.21, 0.14-0.32) and CFS-guided VT ablation (OR 0.23, 0.11-0.52, all 95% CI). RMN-guided was superior to MAN-guided and CFS-guided VT ablation in term of acute ablation success, all complications endpoint, and reduction of fluoroscopy exposure, but did not reduce long-term VT recurrence. Large prospective multicenter randomized trials are needed to confirm these findings.

Similar outcomes with manual contact force ablation catheters and traditional catheters in the treatment of outflow tract premature ventricular complexes.

AimsUnlike in atrial fibrillation ablation, there is a lack of appropriately sized and properly designed studies regarding outflow tract (OT) premature ventricular complex (PVC) ablation outcomes with contact force sensing (CFS) catheters. We aimed to compare the acute success-, complication-, and long-term recurrence rates of manual CFS catheters with traditional irrigated catheters (T) in OT PVC ablation.Methods and resultsSingle-centre, propensity-matched data of 75–75 patients ablated for right-sided OT (RVOT) or left-sided OT (LVOT) PVCs in 2015–17 with CFS or T catheters were compared. Acute success rate, peri-procedural complications, post-procedural daily PVC burden, and long-term recurrence rates were compared on intention-to-treat basis. Acute success rate equalled 80% in both groups, with no difference in force values in the CFS group comparing successful or failed cases [12.0 (8.75–17.0) vs. 16.0 (10.25–22.25) g, P = 0.21]. There were three cases of pseudo-aneurysm and one cardiac tamponade. PVC burden fell significantly from baseline 22 (15–30)% to 2 (0–10)% (P < 0.0001), with no difference between catheter types [CFS: 1 (0–7)% vs. T: 4 (1–12) %; P = 0.21]. There was no significant difference in recurrence-free survival of CFS and T catheters (58 vs. 59%, P = 0.29) during 12 months of follow-up, respectively. Recurrence in the CFS group did not differ either by the force exerted below or above the median value of 12 g (P = 0.66).ConclusionBoth types of catheters can effectively reduce OT PVC burden with minimal serious complication rates. Ablation with CFS or T catheters gives similar acute- and long-term results.

Strategies for Catheter Ablation of Left Ventricular Papillary Muscle Arrhythmias: AnInstitutional Experience.

This study sought to address whether technological innovations such as contact force sensing (CFS) can improve acute and long-term ablation outcomes of left ventricular papillary muscle (LV PAP) ventricular arrhythmias (VAs). Catheter ablation of LV PAP VAs has been less efficacious than another focal VAs. It remains unclear whether technological innovations such as CFS can improve acute and long-term ablation outcomes of LV PAP VA. From January 2015 to December 2019, a total of 137 patients underwent LV PAP VA ablation. VA site of origin (SOO) was identified using activation and pace-mapping guided by intracardiac echocardiography. Radiofrequency energy (20 to 50W for 60 to 90 s) was delivered by irrigated catheter with or without CFS. We defined acute success as complete suppression of targeted VA≥30min post ablation and clinical success as ≥80% VA burden reduction at outpatient follow-up. VA manifested as premature ventricular complexes in 98 (71%), nonsustained ventricular tachycardia in 18 (13%), sustained ventricular tachycardia in 12 (9%) and premature ventricular complexes induced ventricular fibrillation in 9 (7%). VA SOO was anterolateral PAP in 51 (37%), posteromedial PAP in 73 (53%), and both PAPs in 13 (10%). VAs were targeted using CFS in 97 (71%) and non-CFS in 40 (29%). After a single procedure, acute success was achieved in 130 (95%) and clinical success was achieved in 112 (82%); neither was impacted by VA SOO and/or CFS. Complications occurred in 5 patients (3.6%). Independent of CFS technology, intracardiac echocardiography-guided catheter ablation is highly efficacious and may be considered as first-line therapy in the management of LV PAP VA.

IMPACT OF CONTACT FORCE SENSING TECHNOLOGY ON ACUTE PROCEDURAL OUTCOMES AND CHRONIC PULMONARY VEIN RECONNECTION RATES IN PATIENTS WITH ATRIAL FIBRILLATION UNDERGOING CATHETER ABLATION

Chronic pulmonary vein reconnection (CPVR) remains a challenge in atrial fibrillation (AF) patients (pts) undergoing catheter ablation. Preventing CPVR may improve the long-term outcome of AF ablation. In this study, we report the impact of contact force sensing (CFS) technology on CPVR rates.

Contact-force radiofrequency ablation of non-paroxysmal atrial fibrillation: improved outcomes with increased experience.

Clinical trials have failed to reliably show improved outcomes with utilization of contact-force sensing (CFS) radiofrequency (RF) ablation catheters. It is unknown whether the unfavorable outcomes observed in these trials are attributable to inexperience with CFS technology. To compare catheter ablation outcomes of stepwise linear ablation with versus without CFS technology and to assess the impact of operator experience with CFS technology on procedural outcomes. Clinical outcomes were evaluated in 228 consecutive NPAF patients undergoing first-time left atrial ablation using a stepwise linear approach. Arrhythmia recurrence was assessed using 2-week event monitors at 3-month intervals following index ablation. A total of 228 patients were included in our study. There was no statistically significant difference in risk of recurrent atrial arrhythmias at 12 and 24months between CFS and non-CFS patients (p = 0.5 and p = 0.169). The time to recurrence of atrial arrhythmias at 24months in the second half of CFS patients was significantly lower when compared to both the first half of CFS patients (p = 0.002) and non-CFS patients (p = 0.005). While there was no difference in overall outcomes between CFS and non-CFS ablation using a stepwise linear approach in patients with NPAF, procedural efficacy of the second half of CFS patients was significantly improved compared to both the first half of CFS patients and all non-CFS patients. Lack of benefit seen in clinical trials using CFS technology may be related to operator inexperience with CFS ablation catheters at the time of the trials.

META-ANALYSIS ON THE IMPACT OF CONTACT FORCE SENSING CATHETERS ON OUTCOMES IN ATRIAL FIBRILLATION ABLATION: A FOCUS ON RANDOMIZED CONTROLLED TRIAL VERSUS OBSERVATIONAL DATA

One determinant of failure of atrial fibrillation (AF) ablation is the lack of transmural lesions. Contact force sensing (CFS) catheters enable real-time assessment of the amount of force applied at the catheter-tissue interface, with higher contact force associated with lesions of greater size.

Endo/epicardial ablation of ventricular arrhythmias with contact force-sensing catheters in arrhythmogenic right ventricular dysplasia/cardiomyopathy.

Objective:To control ventricular arrhythmia in arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C), ablation may be required both from the endocardial and epicardial side. In this study, we analyzed the results of contact force–sensing (CFS) catheters in the endo/epicardial ablation of ventricular arrhythmias in ARVD/C.Methods:We included 17 patients with ARVD/C, 5 of whom had premature ventricular contractions (PVC), and the rest of them were admitted with a ventricular tachycardia (VT) storm, between September 2014 and October 2016. We divided patients into two groups: the PVC and VT groups. Irrigated CFS catheters (Smart Touch, Biosense Webster, Inc.) were utilized in all procedures.Results:In the PVC group, the mean ratio of PVC during the 24-hour Holter monitoring was 31.8±7.6%. The mean contact force during mapping and ablation in the right ventricle was 13±1.2 and 12.8±1.9 grams, respectively. The mean follow-up duration was 15±3.1 months for the PVC group. The left ventricular ejection fraction improved in all patients (52.8±10%). All patients in the VT group underwent endo/epicardial ablation, except one. The mean contact force during the endocardium and epicardium mapping was 12.5±1.2 and 12.5±4.6 grams, respectively. The mean contact force during ablation for the endocardium and epicardium was 12.1±1.4 and 12.8±1.9 grams, respectively. All clinical and non-clinical VTs were ablated successfully, except in 2 patients who still had non-clinical VTs. The mean follow-up was 15.5±4.5 months. None of the VT patients experienced electrical storm or death. Two patients had single shock, and 1 patient had two shocks during the follow-up.Conclusion:Endo/epicardial ablation of ventricular arrhythmias with CFS catheters in ARVD/C seems to be promising.

Role of Contact Force Sensing in Catheter Ablation of Cardiac Arrhythmias: Evolution or History Repeating Itself?

Adequate catheter-tissue contact facilitates efficient heat energy transfer to target tissue. Tissue contact is thus critical to achieving lesion transmurality and success of radiofrequency (RF) ablation procedures, a fact recognized more than 2 decades ago. The availability of real-time contact force (CF)-sensing catheters has reinvigorated the field of ablation biophysics and optimized lesion formation. The ability to measure and display CF came with the promise of dramatic improvement in safety and efficacy; however, CF quality was noted to have just as important an influence on lesion formation as absolute CF quantity. Multiple other factors have emerged as key elements influencing effective lesion formation, including catheter stability, lesion contiguity and continuity, lesion density, contact homogeneity across a line of ablation, spatiotemporal dynamics of contact governed by cardiac and respiratory motion, contact directionality, and anatomic wall thickness, in addition to traditional ablation indices of power and RF duration. There is greater appreciation of surrogate markers as a guide to lesion formation, such as impedance fall, loss of pace capture, and change in unipolar electrogram morphology. In contrast, other surrogates such as tactile feedback, catheter motion, and electrogram amplitude are notably poor predictors of actual contact and lesion formation. This review aims to contextualize the role of CF sensing in lesion formation with respect of the fundamental principles of biophysics of RF ablation and summarize the state-of-the-art evidence behind the role of CF in optimizing lesion formation.

Contact force sensing for ablation of persistent atrial fibrillation: A randomized, multicenter trial

Impact of contact force sensing (CFS) on ablation of persistent atrial fibrillation (PeAF) is unknown. The purpose of the TOUCH AF (Therapeutic Outcomes Using Contact force Handling during Ablation of Persistent Atrial Fibrillation) randomized trial was to compare CFS-guided ablation to a CFS-blinded strategy. Patients (n = 128) undergoing first-time ablation for persistent AF were randomized to a CFS-guided vs CFS-blinded strategy. In the CFS-guided procedure, operators visualized real-time force data. In the blinded procedure, force data were hidden. Wide antral pulmonary vein isolation plus a roof line were performed. Patients were followed at 3, 6, 9, and 12 months with clinical visit, ECG, and 48-hour Holter monitoring. The primary endpoint was cumulative radiofrequency (RF) time for all procedures. Atrial arrhythmia >30 seconds after 3 months was a recurrence. PeAF was continuous for 26 weeks (interquartile range [IQR] 13-52), and left atrial size was 45 ± 5 mm. Force in the CFS-blinded and CFS-guided arms was 12 g [IQR 6-20] and 14 g [IQR 9-20] (P = .10), respectively. Total RF time did not differ between CFS-guided and CFS-blinded groups (49 ± 14 min vs 50 ± 20 min, respectively; P = .70). Single procedure freedom from atrial arrhythmia was 60% in the CFS-guided arm and 63% in the CFS-blinded arm off drugs. Lesions with gaps were associated with significantly less force (11.4 g [IQR 6-19] vs 13.2 g [IQR 8-20], respectively; P = .0007) and less force-time integral (174 gs [IQR 91-330] vs 210 gs [IQR 113-388], respectively; P <.001). CFS-guided ablation resulted in no difference to RF time or 12-month outcome. Lower force/force-time integral was associated with significantly more gaps.

073_16835-L4 Endo/Epicardial Ablation of Ventricular Arrhytmias With Contact Force Sensing Catheters in Arrhytmogenic Right Ventricular Dysplasia/Cardiomyopathy

In this study we sought results of contact force sensing (CFS) catheters in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C). We included 17 ARVD/C patients, five of whom have premature ventricular contractions (PVC) and the rest admitted with ventricular tachycardia (VT) storm.

Temperature-Insensitive Contact Force Sensing in Bi-Directional Catheter Using Fiber Bragg Grating Pair

Bi-directional catheters are commonly used in electrophysiology mapping and ablation procedures. We have designed and demonstrated a temperature-insensitive contact force sensor for bi-directional catheters with variable curve diameter during deflection. The compact force sensor is based on a fiber Bragg grating (FBG) pair, where both FBGs have the same center wavelength and are fixed at two opposite deflection arcs of the bi-directional catheter. When the catheter is deflected or when contact force is applied to the catheter, bifurcation of the FBG pair spectrum is observed. The amount of spectral bifurcation and the applied contact force has a linear relationship. Contact force measurement, therefore, is accomplished by measuring the change in the spectral bifurcation of the FBG pair, i.e., the change in the Bragg wavelength difference between the two FBGs. Since the approach relies solely on the amount of spectral bifurcation of the FBG pair instead of the Bragg wavelength shift of one single FBG, the proposed contact force sensor is temperature insensitive.

Abstract 9860: Safety and Clinical Outcome of Catheter Ablation of Ventricular Arrhythmias Using Contact Force Sensing, Consecutive Case Series

Introduction: Poor catheter-to-myocardial contact can lead to ineffective ablation lesions and suboptimal outcome. Contact force (CF) sensing catheters in ventricular tachycardia (VT) ablations has not been studied for their long term efficacy. Hypothesis: The hypothesis is that CF ablation is superior to manual ablation (MAN) and non-inferior to remote magnetic navigation (RMN) ablation for safety and efficacy in acute and long term outcome. Methods: A total of 249 consecutive patients 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 average follow-up period was ± 20 months. Results: Acute success was achieved in 191 out of 249 procedures (75.9%). Acute success in manual ablation, CF ablation and RMN ablation was 70.1%, 72.3% and 85.2% respectively (P = 0.038). Major complications occurred in 3.2% and there was a trend towards less major complications (P = 0.055) in the RMN group. Thirty-six percent of the patients with an initially successful procedure had a recurrence during follow-up (CF 41.2% MAN 37.5% RMN 32.0% P = NS). Conclusions: The use of CF sensing catheters does not improve the procedural outcome or safety profile in comparison to non-CF sensing ablation in ventricular arrhythmias. RMN non-CF sensing ablation has the highest procedural success rate. Future studies are necessary to investigate the role of CF in VT ablation and to define the optimal force.

Safety and Clinical Outcome of Catheter Ablation of Ventricular Arrhythmias Using Contact Force Sensing: Consecutive Case Series.

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. 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. 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. 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. 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.