Contact-force-sensing-based radiofrequency catheter ablation in paroxysmal supraventricular tachycardias (COBRA-PATH): a randomized controlled trial

While contact-force (CF) technology has gained traction in atrial fibrillation ablation, limited data exist regarding its utility in supraventricular tachycardia (SVT) ablation.

To evaluate whether CF-sensing catheter ablation offers procedural advantages over conventional ablation for treatment of SVT by comparing the number of radiofrequency (RF) applications, and assessing safety, efficacy, and long-term outcomes.

In this randomized trial, patients with SVT (AVNRT/AVRT) were assigned to either CF-sensing or conventional ablation. The primary endpoint was the total number of RF applications. Secondary endpoints included RF time, fluoroscopy time, procedural duration, acute and long-term success, and adverse events. Follow-up included ECGs at 3 and 12 months, with Holter monitoring if symptoms recurred.

A total of 107 patients with SVT (mean age 49.4±14.7 years; 47.7% male) were assigned to CF-sensing (n=54) or conventional ablation (n=53). Acute procedural success was achieved in 98.1% of patients in both arms. The median number of RF applications did not differ significantly between CF (3.5 [1.8–8.3]) and control groups (4.0 [2.0–11.0]; p = 0.43). There were no significant differences in RF time, fluoroscopy time, or procedural duration (p> 0.05). Twelve-month single-procedure success was 94.4% in the CF group vs. 98.1% in the control group (p = 0.61). Adverse event rates were similar (0% CF vs. 5.7% control; p = 0.12).

CF-sensing catheter ablation did not reduce the number of applications or improve procedural metrics in SVT ablation. Both CF and conventional ablation demonstrated high efficacy and comparable safety profiles.