Circulation. Arrhythmia and electrophysiology最新文献

{"title":"Impact of Diagnosis to Ablation Time on Recurrence of Atrial Fibrillation and Clinical Outcomes After Catheter Ablation: A Systematic Review and Meta-Analysis With Reconstructed Time-to-Event Data.","authors":"Ahmed Mazen Amin, Hossam Elbenawi, Ubaid Khan, Omar Almaadawy, Mustafa Turkmani, Wael Abdelmottaleb, Mohammed Essa, Mohamed Abuelazm, Basel Abdelazeem, Zain Ul Abideen Asad, Abhishek Deshmukh, Mark S Link, Christopher V DeSimone","doi":"10.1161/CIRCEP.124.013261","DOIUrl":"10.1161/CIRCEP.124.013261","url":null,"abstract":"<p><strong>Background: </strong>Current clinical guidelines emphasize the significance of rhythm control with catheter ablation but lack guidance on the timing of atrial fibrillation (AF) ablation relative to the diagnosis time. We aim to investigate the latest evidence on the impact of diagnosis to ablation time (DAT) on clinical outcomes after AF ablation.</p><p><strong>Methods: </strong>We searched PubMed, Web of Science, Scopus, Embase, and Cochrane Central Register of Controlled Trials through August 2024. Pairwise, prognostic, and reconstructed time-to-event data meta-analyses were conducted using R V. 4.3.1. Our primary end point was time to first AF recurrence, with secondary end points of all-cause mortality, tamponade, stroke, and heart failure.</p><p><strong>Results: </strong>Our cohort included 23 studies with 43 711 patients. Shorter DAT was significantly associated with reduced AF recurrence across both paroxysmal and persistent AF subgroups (<i>P</i><0.01). There was a significant decrease in benefit for paroxysmal AF over time and a slight decrease in benefit for persistent AF over time. However, the benefit remained significant in both over time. DAT per year was significantly associated with a 10% increased risk of AF recurrence. Reconstructed Kaplan-Meier analysis showed that DAT >1 year was significantly associated with a 70% increased risk of AF recurrence in paroxysmal AF and 30% in persistent AF. DAT ≤1 year was significantly associated with decreased all-cause mortality (<i>P</i><0.01) and showed a trend toward an association with a lower incidence of stroke (<i>P</i>=0.08). However, there was no significant difference in heart failure between DAT ≤1 year and DAT >1 year.</p><p><strong>Conclusions: </strong>Early ablation is more beneficial in paroxysmal AF, with a notable decrease in benefit over time, while in persistent AF, the benefit remains significant but slightly decreases over time. Shorter DAT was significantly associated with decreased all-cause mortality and showed a trend toward an association with a lower incidence of stroke.</p><p><strong>Registration: </strong>URL: https://www.crd.york.ac.uk/prospero/display_record.php?; Unique identifier: CRD42024525542.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013261"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a Demography-Based Adaptive QT Correction Formula Using Pediatric and Adult Datasets Acquired From Humans and Guinea Pigs.","authors":"Kazi T Haq, Kate M McLean, Grace C Anderson-Barker, Charles I Berul, Michael J Shattock, Nikki Gillum Posnack","doi":"10.1161/CIRCEP.124.013237","DOIUrl":"10.1161/CIRCEP.124.013237","url":null,"abstract":"<p><strong>Background: </strong>QT correction (QTc) formulae are widely used in clinical and research settings but often underperform, possibly due to demographic influences on the QT-heart rate (HR) relationship. To address this limitation, we developed an adaptive QTc (QTcAd) formula, which adjusts for demographic factors like age, and compared its efficacy to other standard formulae.</p><p><strong>Methods: </strong>The QTcAd formula was tested across diverse age groups with different HR in both humans and guinea pigs. Using retrospective ECG data from 1819 pediatric patients at Children's National Hospital and 2400 subjects from the Pediatric Heart Network database, alongside in vivo (N=55) and ex vivo (N=66) guinea pig ECG recordings, we evaluated the formula's effectiveness. Linear regression fit parameters of QTc-HR (slope and <i>R</i>²) were utilized for performance assessment. To evaluate the accuracy of the predicted QTc, we acquired epicardial electrical and optical voltage data from Langendorff-perfused guinea pig hearts.</p><p><strong>Results: </strong>In both human subjects and guinea pigs, the QTcAd formula (QTcAd=QT+(|<i>m</i>|×(HR-HR_mean)) consistently outperformed other formulae across all age groups. For instance, in a 20-year-old human group, the QTcAd formula successfully nullified the inverse QT-HR relationship (<i>R</i>²=5.1×10^-10, slope=-3.5×10^-5), whereas the Bazett formula failed to achieve comparable effectiveness (<i>R</i>²=0.21, slope=0.91). Moreover, the QTcAd formula exhibited better accuracy than the age-specific Benatar QTc formula, which overcorrected QTc (1-week human QT: 263.8±14.8 ms, QTcAd: 263.8±7.3 ms, <i>P</i>=0.62; Benatar QTc: 422.5±7.3 ms, <i>P</i><0.0001). The optically measured pseudo-QT interval (143±22.5 ms, n=44) was better approximated by QTcAd (180.6±17.0 ms) compared with all other formulae. Furthermore, we demonstrated that the QTcAd formula was not inferior to individual-specific QTc formulae.</p><p><strong>Conclusions: </strong>The demography-based QTcAd formula showed superior performance across human and guinea pig age groups, which may enhance the efficacy of rate-corrected K.M.M. for cardiovascular disease diagnosis, risk stratification, and drug safety testing in children and adults.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013237"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Sequential, Colocalized Radiofrequency and Pulsed Field Ablation on Cardiac Lesion Size and Histology.","authors":"Atul Verma, Jennifer Maffre, Tushar Sharma, Salman Farshchi-Heydari","doi":"10.1161/CIRCEP.124.013143","DOIUrl":"10.1161/CIRCEP.124.013143","url":null,"abstract":"<p><strong>Background: </strong>Sequential application of radiofrequency with pulsed field (PF) ablation may increase lesion depth while preserving the advantages of PF. The study's aim was to determine lesion dimensions of sequential, colocalized radiofrequency and PF ablation.</p><p><strong>Methods: </strong>A preclinical study using swine (n=4) performed lesions in the right/left ventricles. Ablations were performed with a force-sensing 3.5-mm irrigated-tip ablation catheter using a generator delivering both radiofrequency and PF. PF was delivered using unipolar, biphasic pulses at a standard dose (PF index, 300) with 4-mL/min irrigation. Radiofrequency was delivered at 50 W for 10 s (15 mL/min). Lesions were created by applying colocalized radiofrequency followed by sequential application of PF on the same location, PF followed by sequential application of radiofrequency on the same location, PF alone, or radiofrequency alone. Tissue was collected after 2 hours for lesion assessment. Results are mean±SD.</p><p><strong>Results: </strong>Forty-five lesions were analyzed. The lesion depth of radiofrequency alone was 4.9±0.8 mm. The mean lesion depth and width for PF alone were 3.5±0.6 and 5.1±1.8 mm. Lesion depths for combined applications were significantly greater versus PF alone (6.2±1.8 mm radiofrequency followed by sequential application of PF on the same location; 5.7±1.3 mm PF followed by sequential application of radiofrequency on the same location; <i>P</i><0.0001 for both). Lesion widths were also significantly greater with combined therapy versus PF alone (8.6±1.8 mm radiofrequency followed by sequential application of PF on the same location; 8.9±2.1 mm PF followed by sequential application of radiofrequency on the same location; <i>P</i><0.0001 for both). Histology for both combined lesions showed central thermal necrosis surrounded by a hemorrhagic and transitional PF zone.</p><p><strong>Conclusions: </strong>Combined, colocalized radiofrequency and PF, irrespective of order, show significantly increased lesion size compared with the same dose of PF or radiofrequency alone.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013143"},"PeriodicalIF":9.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discrimination Between Anterior and Posterior Left Atrial Roof Area Ablation by a Cryoballoon.","authors":"Tetsuma Kawaji, Takanori Aizawa, Misaki Naka, Saki Yamano, Bao Bingyuan, Shun Hojo, Yuji Tezuka, Shintaro Matsuda, Masashi Kato, Takafumi Yokomatsu, Shinji Miki","doi":"10.1161/CIRCEP.124.013093","DOIUrl":"10.1161/CIRCEP.124.013093","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013093"},"PeriodicalIF":9.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superior Vena Cava Isolation With Cryoballoon in AF Ablation: Randomized CAVAC AF Trial.","authors":"Víctor Castro-Urda, Melodie Segura-Dominguez, Diego Jiménez-Sánchez, Cristina Aguilera-Agudo, Paula Vela-Martín, Alvaro Lorente-Ros, Daniel García-Rodriguez, David Sánchez-Ortiz, Chinh Pham-Trung, Eusebio García-Izquierdo, Susana Mingo-Santos, Jorge Toquero-Ramos, Ignacio Fernández-Lozano","doi":"10.1161/CIRCEP.124.012917","DOIUrl":"10.1161/CIRCEP.124.012917","url":null,"abstract":"<p><strong>Background: </strong>Superior vena cava (SVC) has been considered a specific trigger in atrial fibrillation development.</p><p><strong>Methods: </strong>We investigated the efficacy and safety of combining cryoballoon pulmonary vein isolation (PVI) with SVC ablation compared with PVI alone in 100 patients with paroxysmal or non-long-standing persistent atrial fibrillation. Patients were randomly assigned to either the PVI+SVC ablation group or the PVI-only group. Each patient was given a mobile device to record a daily ECG and detect atrial tachyarrhythmias.</p><p><strong>Results: </strong>The primary end point, freedom from any atrial tachyarrhythmia recurrence between 91 and 365 days post-catheter ablation, did not significantly differ between the 2 groups (62.9% versus 72%; <i>P</i>=0.41). However, the PVI+SVC group exhibited higher rates of phrenic nerve paralysis (20.8% versus 6%; <i>P</i>=0.003) and transient sinus node injury (18.8% versus 0%; <i>P</i>=0.001) compared with the PVI-only group. The median burden of atrial tachyarrhythmia showed no significant difference (<i>P</i>=0.91).</p><p><strong>Conclusions: </strong>The addition of SVC ablation to PVI did not enhance freedom from atrial tachyarrhythmia at 12 months, and it led to increased complications. These findings do not support the routine inclusion of SVC ablation in cryoballoon procedures for first-time catheter ablation in patients with paroxysmal or non-long-standing persistent atrial fibrillation.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e012917"},"PeriodicalIF":9.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic Resonance Imaging in the Assessment of the Risk of Sudden Death in Cardiac Sarcoidosis: What Is Extensive or Significant Late Gadolinium Enhancement?","authors":"Pauli Pöyhönen, Jukka Lehtonen, Suvi Syväranta, Diana Velikanova, Henriikka Mälkönen, Piia Simonen, Hanna-Kaisa Nordenswan, Valtteri Uusitalo, Tapani Vihinen, Kari Kaikkonen, Petri Haataja, Tuomas Kerola, Tuomas T Rissanen, Ville Vepsäläinen, Aleksi Alatalo, Päivi Pietilä-Effati, Markku Kupari","doi":"10.1161/CIRCEP.124.013239","DOIUrl":"10.1161/CIRCEP.124.013239","url":null,"abstract":"<p><strong>Background: </strong>Cardiac sarcoidosis involves a significant but difficult-to-define risk of sudden cardiac death (SCD). Current guidelines recommend consideration of an implantable cardioverter defibrillator for patients with extensive or significant myocardial late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging. However, extensive/significant LGE is not defined.</p><p><strong>Methods: </strong>A nationwide cardiac sarcoidosis registry was screened for patients entered before 2020 with cardiac magnetic resonance imaging done before or <3 months after diagnosis. Available studies were re-analyzed for LGE mass as a percentage of left ventricular (LV) mass and the number of LGE-positive LV segments in a 17-segment model. The occurrence of fatal or aborted SCD and ventricular tachycardia (VT) prompting therapy was recorded until the end of 2020 and subjected to cumulative incidence analyses, including competing events (LV assist device implantations, heart transplantations, and fatalities other than SCD). The predictors of SCD/VT were assessed using Fine and Gray modeling and time-dependent receiver operating characteristic analysis.</p><p><strong>Results: </strong>Altogether, 305 patients (66% women, median age 51) with clinically manifest, definite (45%) or probable cardiac sarcoidosis (55%) were analyzed. On follow-up (median, 4.0 years), 21 SCDs, 60 VTs, and 14 competing events were noted. Both LGE mass and the number of LGE segments predicted the composite of SCD/VT (<i>P</i><0.001), with receiver operating characteristic analyses identifying LGE mass ≥9.9% and ≥6 LGE segments as discriminative thresholds. At presentation, 70 patients were free of class I and class IIa implantable cardioverter defibrillator indications unrelated to LGE. Their 5-year rate of SCD/VT was 6.3% (0.0-14.8%) with LGE mass <9.9% versus 21.5% (6.5-36.6%) with higher LGE mass, and 6.9% (0.0-16.3%) with <6 LGE segments versus 20.5% (5.9-35.2%) with ≥6 segments.</p><p><strong>Conclusions: </strong>In cardiac sarcoidosis, myocardial LGE making up ≥9.9% of LV mass or affecting ≥6 LV segments may suggest prognostically significant LV involvement and a high risk of SCD. However, prospective validation of the thresholds is needed.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013239"},"PeriodicalIF":9.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preprocedural Screening Tool to Guide Nonpulmonary Vein Trigger Testing in First-Time Atrial Fibrillation Ablation.","authors":"Alireza Oraii, Corentin Chaumont, Oriol Rodriguez-Queralto, Michal Wasiak, Munveer Thind, Carli J Peters, Erica Zado, Balaram Krishna J Hanumanthu, Timothy M Markman, Matthew C Hyman, Cory M Tschabrunn, Gustavo Guandalini, Andres Enriquez, Poojita Shivamurthy, Ramanan Kumareswaran, Michael P Riley, David Lin, Robert D Schaller, Saman Nazarian, David J Callans, Gregory E Supple, Fermin C Garcia, David S Frankel, Sanjay Dixit, Francis E Marchlinski","doi":"10.1161/CIRCEP.124.013351","DOIUrl":"10.1161/CIRCEP.124.013351","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing first-time atrial fibrillation (AF) ablation can benefit from targeting non-pulmonary vein (PV) triggers. Preprocedural identification of high-risk individuals can guide planning of ablation strategy. This study aimed to create a preprocedural screening tool to identify patients at risk of non-PV triggers during first-time AF ablation.</p><p><strong>Methods: </strong>All patients who underwent first-time AF ablation at the Hospital of the University of Pennsylvania between 2018 and 2022 were identified. Those who underwent non-PV trigger provocative maneuvers or had spontaneous non-PV trigger firing were included. Non-PV triggers were defined as non-PV ectopic beats triggering AF or sustained focal atrial tachycardia that occurred spontaneously, after AF cardioversion, or after standard provocative maneuvers. The provocative maneuvers included incremental isoproterenol infusion (3, 6, 12, and 20-30 µg/min) and an atrial burst pacing protocol. Risk factors associated with non-PV triggers in a stepwise multivariable logistic regression model with backward elimination were used to create a risk score.</p><p><strong>Results: </strong>A total of 163 (8.0%) of 2038 patients had non-PV triggers during first-time AF ablation. Based on the multivariable model, we created a risk score using female sex (1 point; odds ratio [OR], 1.90 [95% CI, 1.36-2.67]), sinus node dysfunction (1 point; OR, 1.84 [95% CI, 1.04-3.24]), prior cardiac surgery (1 point; OR, 2.26 [95% CI, 1.45-3.53]), moderate to severe left atrial enlargement (2 points; OR, 3.43 [95% CI, 2.46-4.79]), and cardiac sarcoidosis/amyloidosis (4 points; OR, 7.24 [95% CI, 3.03-17.33]). Internal validation using bootstrap resampling showed an optimism-adjusted C statistic of 0.715 (95% CI, 0.678-0.751). Among all first-time AF ablations, 68.1% of procedures were low-risk for non-PV triggers (scores 0-1, 4.3% risk), 17.8% were intermediate-risk (score 2, 10.5% risk), and 14.1% were high-risk (score ≥3, 22.6% risk).</p><p><strong>Conclusions: </strong>A preprocedural screening tool can classify patients based on their risk of non-PV triggers during first-time AF ablation. This risk score can guide operators to identify patients who would benefit most from adjunctive non-PV trigger testing. However, further validation is needed to confirm these findings.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013351"},"PeriodicalIF":9.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary Involvement With Pulsed Field Ablation and Radiofrequency Ablation: Preclinical Insights.","authors":"Iwanari Kawamura, Rahul Bhardwaj, Assaf Govari, Christopher T Beeckler, Jennifer Maffre, Salman Farshchi-Heydari, Benjamin Manacop, Tushar Sharma, Vivek Y Reddy, Jacob S Koruth","doi":"10.1161/CIRCEP.124.013161","DOIUrl":"10.1161/CIRCEP.124.013161","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013161"},"PeriodicalIF":9.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cryoballoon Pulmonary Vein Isolation With Versus Without Additional Right Atrial Linear Ablation for Persistent Atrial Fibrillation: The CRALAL Randomized Clinical Trial.","authors":"Daehoon Kim, Hee Tae Yu, Jaemin Shim, Junbeom Park, Yong-Soo Baek, Sang Won Park, Dae-Kyeong Kim, Young-Ah Park, Tae-Hoon Kim, Jae-Sun Uhm, Boyoung Joung, Moon-Hyoung Lee, Hui-Nam Pak","doi":"10.1161/CIRCEP.124.013408","DOIUrl":"10.1161/CIRCEP.124.013408","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary vein isolation (PVI) alone is less effective in patients with persistent atrial fibrillation (AF) compared with those with paroxysmal AF. We investigate whether additional linear ablation from the superior vena cava to the right atrial septum and cavotricuspid isthmus ablation improves the rhythm outcome of patients with persistent AF undergoing cryoballoon PVI (Cryo-PVI).</p><p><strong>Methods: </strong>In this investigator-initiated, multicenter, randomized clinical trial, 289 patients with persistent AF refractory to antiarrhythmic drug therapy were randomized 1:1 to either Cryo-PVI with additional right atrium (RA) linear ablation or Cryo-PVI alone. The primary end point was any documented atrial arrhythmia lasting ≥30 seconds after a 3-month blanking period after ablation. The secondary end points were atrial arrhythmia recurrence or antiarrhythmic drug use after a 3-month blanking period, complications, and total procedure time.</p><p><strong>Results: </strong>During the median follow-up of 24 months (median age, 63 years; 23.9% women), the atrial arrhythmia recurrence was less frequent in the additional RA ablation group (n=50, 37.5%) than in the Cryo-PVI alone group (n=69, 53.1%; absolute difference, -15.6% [95% CI, -27.9% to -3.4%]; hazard ratio, 0.66 [95% CI, 0.46-0.94]). Antiarrhythmic drugs were prescribed after the 3-month period to 72 (49.3%) patients in the additional RA ablation group and 79 (55.2%) patients in the Cryo-PVI alone group. No difference was found in complication rate between the 2 groups. Total procedure time was longer in the additional RA ablation group (median, 88 versus 72 minutes; <i>P</i><0.001).</p><p><strong>Conclusions: </strong>Additional RA linear ablation beyond Cryo-PVI improved the ablation outcome compared with that of PVI alone in persistent AF patients.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013408"},"PeriodicalIF":9.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of ARVC Risk Calculators in (Likely) Pathogenic Plakophilin-2 Variant Carriers Without Definite ARVC Diagnosis.","authors":"Steven A Muller, Babken Asatryan, Brittney Murray, Crystal Tichnell, Moniek G P J Cox, Ahmad S Amin, Sing-Chien Yap, Alessio Gasperetti, Richard T Carrick, Julia Cadrin-Tourigny, Marish I F J Oerlemans, Hugh Calkins, J Peter van Tintelen, Cynthia A James, Anneline S J M Te Riele","doi":"10.1161/CIRCEP.124.013144","DOIUrl":"10.1161/CIRCEP.124.013144","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013144"},"PeriodicalIF":9.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}