Catheter Contact Force: A Review of Emerging Techniques and Technologies in AF Ablation

Catheter ablation for atrial fibrillation (AF) has gained significant attention during the last decade. Owing to the increase in patients undergoing AF ablation with only moderate long-term outcomes, there is considerable interest in developing new tools to assist the electrophysiologist during the procedure. Catheter contact force (CF) has been known to be an important determinant of radiofrequency (RF) lesion quality during pulmonary vein isolation (PVI) for over 20 years, yet it is only recently that the technology to allow the real-time measurement of catheter tip-to-tissue CF during the ablation procedure has been possible. Direct assessment of lesions during ablation has so far been elusive, with indirect measures being used as a surrogate of transmurality. Novel technologies such as microwave radiometry, magnetic resonance thermometry, and near-field ultrasound are attempting to address this problem. This review will discuss the role of emerging techniques and technologies to achieve permanent lesions during a single ablation procedure.