Table 1. Impact of CF sensing technology on on procedural and fluoroscopy time.

PAF= paroxysmal atrial fibrillation; OIC= open-irrigated-tip catheter; CF= contact force; PVI= pulmonary vein isolation; FTI= force-time integral; SF= surround flow; PerAF= persistent atrial fibrillation

Study	Important features	CF sensing technology	Aims and methods	Fluoroscopy time	Procedure time	Key findings
Reddy et al [17] 2012	32 PAF	Optical fibers	an OIC with CF mapping capabilities	Higher CF was not associated to changes in fluoroscopy time (32±24 vs 55±32 min, p=0.25)	Higher CF was not associated to changes in procedure time (211±88 vs 188±51 min, p=0.61)	CF did not affect procedural parameters
Wutzler et al [18] 2014	143 with PAF and PerAF	Optical fibers	an OIC or an OIC with CF mapping capabilities	There were no significant differences observed in fluoroscopy time, although reduced in the contact force group	Procedure duration was significantly shorter in the contact force group (128.4 ±29 min vs. 157.7 ±30.8 min, p = 0.001).	the use of CF information resulted in a shorter procedure time
Martinek et al [8] 2012	50 PAF	Precision spring	a standard 3.5-mm OIC or a catheter with CF measurement capabilities	28.6 ±17.4 vs 23.6±13.1 min, p= 0.312	185±46 vs 154±39 min p= 0.022	The use of CF sensing technology was able to significantly reduce ablation and procedure times in PVI.
Marion et al [9] 2014	60 PAF	Precision spring	a new OIC CF catheter or a non-CF OIC	CF use was associated with significant reductions in fluoroscopy exposure (20.1 ± 4 vs 26.7 ± 5 minutes, p < 0.01)	CF technology was associated with a significant reduction in overall procedure time	the use of CF information resulted in a shorter procedure and fluoroscopy times
Stabile et al [19] 2014	95 PAF	Precision Spring	a new OIC with CF sensing	Patients in whom the mean CF during ablation was > 20 g required shorter procedural time (92±23 vs.160±67 min, p = 0.01) as compared with patients in whom this value was < 10 g.	value below the median of 543 gs required longer procedural (158.0±74.0 vs. 117.0±52.0 min, p = 0.004) times as compared with those in whom FTI was above this value	CF affected procedural parameters, in particular procedural and fluoroscopy times, without increasing complications
Sciarra et al 10 2014	63 PAF	Precision spring	impact of a standard OIC, SF OIC and CF catheter	ST and CF catheter obtained a reduction of fluoroscopy time (OIC 34 ± 18 min, CF 20 ± 10 min, p < 0.001; SF 21 ± 13 min, p = 0.02 vs OIC)	STc resulted in a reduction of procedural time (TCc 181 ± 53 min, STc 140 ± 53 min, p < 0.001; SFc 170 ± 51 min, p = NS vs TCc).	Both the CF and the SF OIC catheters significantly reduced radiofrequency and fluoroscopy times, as well as pulmonary veins reconnection rate at 30 min. Moreover, the CF catheter reduced overall duration of the procedure
Jarman et al [11] 2014	600 with PAF and PerAF	Precision spring	CF and non CF catheters	the use of CF catheters was associated with reduced fluoroscopy time in multivariate analysis (reduction by 7.7 (5.0-10.5) minutes; p<0.001)		Fluoroscopy time was lower when CF technology was employed in all types of AF ablation procedures
Sigmund et al [12] 2015	198 with PAF and PerAF	Precision spring	3.5-mm OIC with CF measurement capabilities and a standard OIC	total fluoroscopy time could be significantly reduced from 28.5 ± 11.0 to 19.9 ± 9.3 minutes (P = 0.0001)	Procedural data showed a significant decline in overall procedure time of 34 minutes (p = 0.0001; 225.8 ± 53.1 vs 191.9 ± 53.3 minutes).	The use of CF technology was able to significantly reduce ablation, procedure, and fluoroscopy times as well as dose in RFCA of AF