Background Recurrence after pediatric catheter ablation often reflects limited lesion durability. The SmartTouch Surround Flow (STSF) contact‑force–sensing, open‑irrigated catheter is designed to provide uniform cooling and stable tip–tissue contact, potentially improving lesion durability and workflow efficiency. We compared STSF with conventional RF systems in children.Methods In this multicenter retrospective study across three high‑volume EP centers in China (Dec 2023–Sep 2024), we included first‑time ablation patients aged 1–14 years; catheter selection was non‑random and followed routine clinical practice. The primary endpoint was recurrence of the index arrhythmia off antiarrhythmic drugs during follow‑up. Secondary endpoints included all‑cause mortality, stroke/systemic embolism, acute coronary syndrome, repeat ablation, and prespecified peri‑procedural complications. Follow‑up was performed at 3, 6, and 12 months. We also compared procedural efficiency, radiation metrics, ablation parameters, and operator‑reported convenience (Operational Convenience Score, OCS).Results Among 386 patients (STSF n = 266; conventional RF n = 120) with broadly comparable baseline profiles, unadjusted between‑group comparisons showed that STSF was associated with shorter procedure time (135.27 ± 63.20 vs 189.73 ± 92.96 min; P = 0.01), less fluoroscopy (301.8 ± 146.65 vs 424.62 ± 210.51 s; P = 0.01), lower dose‑area product (DAP: 20.59 ± 16.06 vs 37.57 ± 19.19 Gy·cm²; P < 0.01), and lower cumulative air kerma (101.19 ± 78.04 vs 189.58 ± 94.05 mGy; P < 0.001). STSF also showed shorter ablation time (380.31 ± 180.71 vs 462.39 ± 255.49 s; P < 0.01), lower operating temperature (40.81 ± 6.06 vs 43.31 ± 4.18 ℃; P < 0.01), slightly lower power (32.06 ± 4.93 vs 32.62 ± 3.58 W; P < 0.01), and marginally fewer applications (5.17 ± 7.64 vs 5.21 ± 3.10; P = 0.03). No cases of moderate‑to‑severe valvular regurgitation, third‑degree AV block, or LBBB occurred in the STSF group; the conventional RF group had one case each. Other prespecified complications were absent in both groups. Operator convenience scores favored STSF (7.86 ± 1.82 vs 6.45 ± 1.19; P < 0.001). One‑year recurrence was low and similar (2.60% vs 4.16%; log‑rank P = 0.99). Subgroup analyses across AVNRT, AVRT/WPW, and PVCs supported consistent advantages in radiation reduction and procedural efficiency with STSF, while the lower operating temperature with comparable or slightly lower power aligned with the hypothesized mechanism of more uniform, predictable energy delivery.Conclusions In pediatric catheter ablation, STSF maintained efficacy and safety while substantially improving procedural efficiency and reducing radiation exposure, and it was associated with superior operator‑reported usability. These real‑world, multicenter observational data support STSF as a pragmatic, radiation‑sparing strategy; prospective randomized studies with extended follow‑up are warranted to confirm long‑term lesion durability and better characterize rare adverse events.