Comparison of contact force sensing and non-contact force sensing catheters in ischemic cardiomyopathy patients with high ventricular arrhythmia burden.

Background: Catheter ablation of ventricular tachycardia (VT) and electrical storm (ES) controls recurrences and improves survival in ischemic cardiomyopathy. Adequate contact of the catheter with the tissue during mapping and ablation is required for successful outcomes. We aimed to determine the acute procedural and long-term outcomes of ablation of the electrical storm or frequent shocks with and without contact force sensing catheters in ischemic cardiomyopathy.

Methods: The study retrospectively included 110 ischemic cardiomyopathy patients with electrical storm or frequent shocks. Mapping and ablation were performed with contact force sensing catheters in 46 patients (Contact force [CF] group) and without contact force sensing catheters in 64 patients (non-Contact force[non-CF) group).

Results: The acute procedural success was not different between groups (p = 0.438). After a median follow-up of 25 months (14-37) for the CF group and 26 months (11-46) for the non-CF group (p = 0.687) VT free survival was 71.74% in the CF group and 65.62% in the non-CF group (p = 0.552). The rate of recurrence occurring as an electrical storm was more in the non-CF group than the CF group (4.35% versus 20.31%, p = 0.018). The rate of death from any cause was less in the CF group than the non-CF group (4.35% versus 28.12%, p = 0.008). The predictors of recurrence as ES and mortality were the use of non-contact force sensing catheter and inducibility of any VT after the procedure.

Conclusions: The use of contact force sensing catheter seems to be better in terms of reducing ES as a recurrence and mortality in ischemic VT patients.