EuropacePub Date : 2026-09-02DOI: 10.1093/europace/euag241
Teodor Serban, Marc Salis, Arianna Bettelini, Céline Moser, Andrea Papa, Sven Knecht, Thomas Nestelberger, Christoph Kaiser, Gregor Leibundgut, Beat Schaer, Philipp Krisai, Felix Mahfoud, Michael Kühne, Christian Sticherling, Patrick Badertscher
{"title":"Prognostic value of isolated PR interval prolongation after transcatheter aortic valve implantation.","authors":"Teodor Serban, Marc Salis, Arianna Bettelini, Céline Moser, Andrea Papa, Sven Knecht, Thomas Nestelberger, Christoph Kaiser, Gregor Leibundgut, Beat Schaer, Philipp Krisai, Felix Mahfoud, Michael Kühne, Christian Sticherling, Patrick Badertscher","doi":"10.1093/europace/euag241","DOIUrl":"10.1093/europace/euag241","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886928","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}
EuropacePub Date : 2026-09-02DOI: 10.1093/europace/euag175
Andre Assis Lopes do Carmo, Gustavo de Araújo Silva, Maria do Carmo Pereira Nunes
{"title":"Response to the letter regarding 'Outcomes of functional ventricular tachycardia ablation vs. medical therapy in Chagas cardiomyopathy patients with implantable cardioverter-defibrillators: a competing risks analysis'.","authors":"Andre Assis Lopes do Carmo, Gustavo de Araújo Silva, Maria do Carmo Pereira Nunes","doi":"10.1093/europace/euag175","DOIUrl":"10.1093/europace/euag175","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":"28 9","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988366","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":"Response to 'Upgrade procedures of pacemakers or implantable cardioverter-defibrillators require creative clinical decision making and careful planning that begins at the first implantation'.","authors":"Daniel Keene, Nandita Kaza, Haran Burri, Archana Rao, Jens Cosedis Nielsen","doi":"10.1093/europace/euag240","DOIUrl":"10.1093/europace/euag240","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":"28 9","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037183","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}
EuropacePub Date : 2026-09-02DOI: 10.1093/europace/euag226
Fengwei Zou, Justin Song, Karen Lee, Nikil Prasad, Sarah Xu, Ariel Gidon, Shubhi Pandey, Jishu Motta, Lowell Safren, Cristian Zamora Rosales, Yuval Shafir, Jose Matias, Nils Guttenplan, Dhanunjaya Lakkireddy, Vincenzo Mirco La Fazia, Sanghamitra Mohanty, Andrea Natale, Xiaodong Zhang, Luigi Di Biase
{"title":"Pulsed field atrial fibrillation ablation with variable loop circular catheter: outcomes from large US registry.","authors":"Fengwei Zou, Justin Song, Karen Lee, Nikil Prasad, Sarah Xu, Ariel Gidon, Shubhi Pandey, Jishu Motta, Lowell Safren, Cristian Zamora Rosales, Yuval Shafir, Jose Matias, Nils Guttenplan, Dhanunjaya Lakkireddy, Vincenzo Mirco La Fazia, Sanghamitra Mohanty, Andrea Natale, Xiaodong Zhang, Luigi Di Biase","doi":"10.1093/europace/euag226","DOIUrl":"10.1093/europace/euag226","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13564222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818082","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}
EuropacePub Date : 2026-09-02DOI: 10.1093/europace/euag221
Paolo Compagnucci, Luca Finori, Michela Casella, Alessio Gasperetti, Henry D Huang, Yari Valeri, Leonardo D'Angelo, Francesca Campanelli, Giorgio Giacomini, Giovanni Volpato, Laura Cipolletta, Quintino Parisi, Luigi Di Biase, Andrea Natale, Pasquale Santangeli, Antonio Dello Russo
{"title":"Ventricular pulsed field ablation from bench to bedside: preclinical and clinical evidence from a systematic review and meta-analysis.","authors":"Paolo Compagnucci, Luca Finori, Michela Casella, Alessio Gasperetti, Henry D Huang, Yari Valeri, Leonardo D'Angelo, Francesca Campanelli, Giorgio Giacomini, Giovanni Volpato, Laura Cipolletta, Quintino Parisi, Luigi Di Biase, Andrea Natale, Pasquale Santangeli, Antonio Dello Russo","doi":"10.1093/europace/euag221","DOIUrl":"10.1093/europace/euag221","url":null,"abstract":"<p><strong>Aims: </strong>Evidence supporting the use of pulsed field ablation (PFA) for ventricular arrhythmia (VA) ablation remains limited and heterogeneous, and the relationship between preclinical lesion characteristics and clinical outcomes is incompletely defined. We sought to systematically summarize preclinical lesion metrics and clinical outcomes of ventricular PFA.</p><p><strong>Methods and results: </strong>We performed a systematic review and meta-analysis of preclinical and clinical studies of ventricular PFA. Preclinical studies reporting lesion depth or transmurality and clinical studies detailing procedural efficacy and safety were included. Random-effects models were used to pool lesion characteristics and clinical outcomes. Seventy-five studies were included (33 preclinical, 43 clinical; 355 patients). In preclinical models, mean lesion depth was 5.96 mm(95%CI, 5.07-6.84) in healthy endocardium and 5.19 mm (95%CI, 2.58-7.79) in healthy epicardium. Notably, lesion depth was quantitatively similar in models of scarred myocardium (5.96 mm; 95%CI, 5.39-6.53). Lesion transmurality was variable in healthy tissues (32%; 95%CI, 15-52%) but higher within scar (53%; 95%CI, 36-70%). Consistently, lesion depth was similar between PFA and RF in healthy myocardium, but greater with PFA in scarred models (within-study mean depth difference, 2.09 mm; 95%CI, 0.84-3.34). Greater contact force, repeated applications, and higher energy/duration settings were associated with increased lesion depth. Clinically, acute success was high for both premature ventricular complexes (PVCs,90%; 95%CI, 83-96%) and ventricular tachycardia (VT;92%; 95%CI, 87-96%) in studies with ≥3patients. Over a mean follow-up of approximately 5months, recurrence rates were 19% (95%CI, 12-28%) for PVCs and 21% (95%CI, 10-35%) for VT. The overall complication rate was 10% (95%CI, 5-17%) in studies with ≥3patients, with coronary artery spasm and conduction disturbances representing the most frequent adverse events.</p><p><strong>Conclusion: </strong>Ventricular PFA demonstrates high acute efficacy and encouraging mid-term outcomes, supported by preclinical evidence of favourable lesion penetration within scarred myocardium. Safety considerations-particularly coronary and conduction system effects-and the heterogeneity of preclinical evidence highlight the need for further investigation.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789932","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}
EuropacePub Date : 2026-09-02DOI: 10.1093/europace/euag123
Ja-Kyoung Yoon, Kyung-Jin Ahn, Soo-Jin Kim, Chang-Ha Lee, I Seok Kang, Jinyoung Song, June Huh, Sang-Yun Lee, Mi Kyoung Song, Seung Min Baek, Jae-Suk Baek, Seul Gi Cha, Chun Soo Park, Eun Seok Choi, Hoon Ko, Se Yong Jung, Joowon Lee, Jae Young Lee, Yeo Hyang Kim, Young-Seok Lee, Eun-Jung Bae
{"title":"Late arrhythmias following Fontan completion: insights from a Korean Multicentre Fontan Registry of over 1000 extracardiac conduit surgeries.","authors":"Ja-Kyoung Yoon, Kyung-Jin Ahn, Soo-Jin Kim, Chang-Ha Lee, I Seok Kang, Jinyoung Song, June Huh, Sang-Yun Lee, Mi Kyoung Song, Seung Min Baek, Jae-Suk Baek, Seul Gi Cha, Chun Soo Park, Eun Seok Choi, Hoon Ko, Se Yong Jung, Joowon Lee, Jae Young Lee, Yeo Hyang Kim, Young-Seok Lee, Eun-Jung Bae","doi":"10.1093/europace/euag123","DOIUrl":"10.1093/europace/euag123","url":null,"abstract":"<p><strong>Aims: </strong>Awareness of long-term arrhythmia complications after Fontan surgery is increasing, but the impact of surgical type and risk factors on arrhythmia development remain incompletely understood.</p><p><strong>Methods and results: </strong>We retrospectively analysed 1492 Fontan patients from the Korean multicentre registry (1979-2019), categorized into atriopulmonary connection (AP) (n = 106), lateral tunnel (LT) (n = 234), and extracardiac conduit (ECC) (n = 1143) with a median follow-up of 14 years. Arrhythmias occurred in 13.3% of patients at a median age of 17.3 years (tachyarrhythmias 9.9%, bradyarrhythmias 6.8%). At 20 years, freedom from any arrhythmia, tachyarrhythmia, and bradyarrhythmia was 82.5%, 86.9%, and 90.5%, respectively. On multivariable analysis, AP (HR 5.89, 95% CI 3.75-9.25; P < 0.001) and LT (HR 2.85, 95% CI 1.93-4.21; P < 0.001) were associated with a higher risk of arrhythmia compared with ECC. Older age at Fontan surgery also independently increased arrhythmia risk (HR 1.06, 95% CI 1.03-1.10; P < 0.001). Compared with ECC Fontan, LT Fontan and AP Fontan were associated with a progressively higher risk of both tachyarrhythmias (HR 2.99 and 8.20, respectively) and bradyarrhythmias (HR 2.63 and 5.47, respectively; all P < 0.001). The all-cause mortality rate and Fontan failure rate were 9.3% (0.69 per 100 patient-years) and 20.0% (1.61 per 100 patient-years), respectively. Late-onset arrhythmias were associated with an increased risk of mortality and Fontan failure (P = 0.003 and P < 0.001).</p><p><strong>Conclusion: </strong>This large, long-term registry shows that ECC Fontan confers a lower arrhythmia risk than LT or AP, and arrhythmias serve as a marker of Fontan failure and mortality in post-Fontan patients.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"28 9","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963234","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}
EuropacePub Date : 2026-09-02DOI: 10.1093/europace/euag174
Alexander H Maass, Hessel F Groenveld, Michiel Rienstra
{"title":"Upgrade procedures of pacemakers or implantable cardioverter-defibrillators require creative clinical decision making and careful planning that begins at the first implantation.","authors":"Alexander H Maass, Hessel F Groenveld, Michiel Rienstra","doi":"10.1093/europace/euag174","DOIUrl":"10.1093/europace/euag174","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":"28 9","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13611650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037190","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}
EuropacePub Date : 2026-09-02DOI: 10.1093/europace/euag227
Jason G Andrade, Lucas V A Boersma, Melanie A Gunawardene, Nitesh Sood, Devi Nair, Atul Verma, Laurent Macle, Stavros Mountantonakis
{"title":"Practical guide on the use of the PulseSelect pulsed field ablation system for atrial fibrillation ablation procedures.","authors":"Jason G Andrade, Lucas V A Boersma, Melanie A Gunawardene, Nitesh Sood, Devi Nair, Atul Verma, Laurent Macle, Stavros Mountantonakis","doi":"10.1093/europace/euag227","DOIUrl":"10.1093/europace/euag227","url":null,"abstract":"<p><p>Pulsed field ablation (PFA), which employs intermittent short-duration high-voltage electrical impulses to induce cellular membrane pore formation, is one of the most substantial innovations in the field of cardiac electrophysiology. In contrast to thermal ablation using radiofrequency or cryoenergy, PFA is theoretically capable of preferential tissue destruction, avoiding the negative effects of thermal energy and minimizing the risk of collateral damage. The optimal use of PFA requires operators to adapt their procedural approach to the novel catheter and energy source. The purpose of this manuscript is to summarize the best practice procedural considerations related to PFA with the PulseSelect ablation catheter, within the context of the contemporary evidence-base and with a focus on a predominantly fluoroscopy-based workflow. A foundational approach to pulmonary vein isolation with the PulseSelect catheter would reduce procedural heterogeneity, ultimately improving patient outcomes through the adoption of standardized evidence-based practices.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818106","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}