Europace最新文献

{"title":"Atrial fibrillation burden in clinical practice, research, and technology development: a clinical consensus statement of the European Society of Cardiology Council on Stroke and the European Heart Rhythm Association.","authors":"Wolfram Doehner, Giuseppe Boriani, Tatjana Potpara, Carina Blomstrom-Lundqvist, Rod Passman, Luciano A Sposato, Dobromir Dobrev, Ben Freedman, Isabelle C Van Gelder, Taya V Glotzer, Jeff S Healey, Theodore Karapanayiotides, Gregory Y H Lip, Jose Luis Merino, George Ntaios, Renate B Schnabel, Jesper H Svendsen, Emma Svennberg, Rolf Wachter, Karl Georg Haeusler, A John Camm","doi":"10.1093/europace/euaf019","DOIUrl":"10.1093/europace/euaf019","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is one of the most common cardiac diseases and a complicating comorbidity for multiple associated diseases. Many clinical decisions regarding AF are currently based on the binary recognition of AF being present or absent with the categorical appraisal of AF as continued or intermittent. Assessment of AF in clinical trials is largely limited to the time to (first) detection of an AF episode. Substantial evidence shows, however, that the quantitative characteristic of intermittent AF has a relevant impact on symptoms, onset, and progression of AF and AF-related outcomes, including mortality. Atrial fibrillation burden is increasingly recognized as a suitable quantitative measure of intermittent AF that provides an estimate of risk attributable to AF, the efficacy of antiarrhythmic treatment, and the need for oral anticoagulation. However, the diversity of assessment methods and the lack of a consistent definition of AF burden prevent a wider clinical applicability and validation of actionable thresholds of AF burden. To facilitate progress in this field, the AF burden Consensus Group, an international and multidisciplinary collaboration, proposes a unified definition of AF burden. Based on current evidence and using a modified Delphi technique, consensus statements were attained on the four main areas describing AF burden: Defining the characteristics of AF burden, the recording principles, the clinical relevance in major clinical conditions, and implementation as an outcome in the clinic and in clinical trials. According to this consensus, AF burden is defined as the proportion of time spent in AF expressed as a percentage of the recording time, undertaken during a specified monitoring duration. A pivotal requirement for validity and comparability of AF burden assessment is a continuous or near-continuous duration of monitoring that needs to be reported together with the AF burden assessment. This proposed unified definition of AF burden applies independent of comorbidities and outcomes. However, the disease-specific actionable thresholds of AF burden need to be defined according to the targeted clinical outcomes in specific populations. The duration of the longest episode of uninterrupted AF expressed as a time duration should also be reported when appropriate. A unified definition of AF burden will allow for comparability of clinical study data to expand evidence and to establish actionable thresholds of AF burden in various clinical conditions. This proposed definition of AF burden will support risk evaluation and clinical treatment decisions in AF-related disease. It will further promote the development of clinical trials studying the clinical relevance of intermittent AF. A unified approach on AF burden will finally inform the technology development of heart rhythm monitoring towards validated technology to meet clinical needs.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 3","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11901050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613689","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":"Thermal side effects during pulsed field ablation: an analysis using computer modelling.","authors":"Marcela Mercado-Montoya, Tatiana Gomez-Bustamante, Steven R Mickelsen, Erik Kulstad, Ana González-Suárez, Lawrence J Overzet","doi":"10.1093/europace/euaf035","DOIUrl":"10.1093/europace/euaf035","url":null,"abstract":"<p><strong>Aims: </strong>Pulsed field ablation (PFA) is described as non-thermal, but data from oncology and cardiology show thermal effects occur. The specific waveform parameters influencing thermal energy development during PFA are unclear. The aim of this study is to numerically evaluate the thermal effects of PFA on myocardial and oesophageal tissue at various peak voltage conditions.</p><p><strong>Methods and results: </strong>A three-dimensional computer model of the left atrium quantified thermal effects from PFA at peak voltages of 1, 1.5, and 2 kV. Energy was applied using a bipolar configuration with far-field and symmetry boundaries set as electrically insulating. A monophasic waveform with a 100 μs pulse width and a 1 s gap between pulses was applied for a total of 50 pulses, mimicking clinical conditions. Minimal temperature rise in the oesophagus was observed with 1 kV pulses (214.5 J). At 1.5 and 2 kV (570.3 and 1.23 kJ), temperatures reached 46.3°C and >62°C, respectively, after a single pulse train. These findings suggest that repeated applications could lead to even higher temperatures, especially if good tissue contact is obtained. These results align with data from other medical fields using pulsed field treatments.</p><p><strong>Conclusion: </strong>Thermal effects from PFA depend on the total energy deposited, with peak voltage being a significant factor. Current commercially available PFA systems have the potential to induce collateral thermal injury with repeated applications of pulsed field energy. This highlights the need for careful monitoring and adjustment of PFA parameters in clinical settings.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440392","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":"Aggressive ablation vs. regular ablation for persistent atrial fibrillation: a multicentre real-world cohort study.","authors":"Kaige Li, Yangbin Shi, Xinhua Wang, Ping Ye, Bing Han, Weifeng Jiang, Yu Zhang, Qidong Zheng, Anjing Ji, Menghe Zhang, Yanzhe Wang, Shaohui Wu, Kai Xu, Mu Qin, Xu Liu, Xumin Hou","doi":"10.1093/europace/euaf045","DOIUrl":"10.1093/europace/euaf045","url":null,"abstract":"<p><strong>Aims: </strong>Current guidelines for the optimal ablation strategy for persistent atrial fibrillation (PerAF) remain unclear. While our previous RCT confirmed the favourable prognosis of aggressive ablation, real-world evidence is still lacking.</p><p><strong>Methods and results: </strong>Among 4833 PerAF patients undergoing catheter ablation at 10 centres, two groups were defined: regular ablation (PVI-only or PVI plus anatomical ablation) and aggressive ablation (anatomical plus electrogram-guided ablation), with 1560 patients each after propensity score (PS) matching. The primary endpoint was 12-month AF/atrial tachycardia (AT) recurrence-free survival off anti-arrhythmic drugs after a single procedure. Additional PS matching was performed within the regular group between PVI-only and anatomical ablation (n = 455 each). Furthermore, anatomical ablation from the regular group was independently matched with aggressive ablation (n = 1362 each). At 12 months, the aggressive group showed superior AF/AT-free survival (66.2% vs. 59.3%, P < 0.001; HR 0.745), similar AT recurrence (12.0% vs. 11.3%, P = 0.539), and significantly higher procedural AF termination (67.0% vs. 21.0%, P < 0.001) than regular group. Moreover, patients with AF termination had improved AF/AT-free survival (72.3% vs. 55.2%, P < 0.001). Safety endpoints did not differ significantly between the two groups. Both the ablation outcomes and AF termination rate showed increasing trends with the extent of ablation aggressiveness but declined with extremely aggressive ablation. After additional PS matching, within the regular group, no statistical differences were observed though AF/AT-free survival in the anatomical group was slightly higher than the PVI-only group (60.7% vs. 55.6%, P = 0.122); while aggressive ablation showed improved AF/AT-free survival compared to anatomical ablation alone from regular group (67.5% vs. 59.9%, P < 0.001).</p><p><strong>Conclusion: </strong>Aggressive ablation achieved more favourable outcomes than regular ablation, and moderately aggressive ablation may be associated with better clinical outcomes. AF termination is a reliable ablation endpoint.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572364","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":"Biventricular vs. right ventricular pacing devices in patients anticipated to require frequent ventricular pacing (BioPace).","authors":"Reinhard C Funck, Hans-Helge Müller, Maurizio Lunati, Luc De Roy, Norbert Klein, Eckhard Meisel, Goran Milasinovic, Mark D Carlson, Michael Wittenberg, Gerhard Hindricks, Jean-Jacques Blanc","doi":"10.1093/europace/euaf029","DOIUrl":"10.1093/europace/euaf029","url":null,"abstract":"<p><strong>Aims: </strong>Right ventricular (RV) pacing may promote left ventricular (LV) dysfunction. Particularly in patients with preserved LV ejection fraction (LVEF), narrow QRS, and anticipated high ventricular pacing burden (HVPB), evidence is missing that biventricular (BiV) pacing can improve clinical outcome. We therefore evaluated whether implantation of a BiV pacing device (BiVPD) compared with a RV pacing device (RVPD) may improve clinical outcome in predominantly this kind of patients.</p><p><strong>Methods and results: </strong>In the Biventricular Pacing for atrioventricular Block to Prevent Cardiac Desynchronization (BioPace) trial [multicentre, single-blinded (patients), randomized, parallel group], patients were equally allocated to either receive a BiVPD or a RVPD. Co-primary endpoints were (i) the composite of time to death or first heart failure hospitalization and (ii) survival time. We analysed 1810 randomized patients (median age: 73.5 years; female sex: 31.7%; mean LVEF 55.4%; mean QRS 118.4 ms), 902 to BiV and 908 to RV pacing. During mean follow-up of 68.8 months, the difference in the primary composite endpoint between both groups [346 vs. 363 events, hazard ratio (HR) 0.878; 95% confidence interval (CI) 0.756-1.020; P = 0.0882) or in mortality (305 vs. 307 deaths, HR 0.926; 95% CI 0.789-1.088; P = 0.3492) was smaller than 20%.</p><p><strong>Conclusion: </strong>In patients, predominantly with preserved LVEF, narrow QRS, and HVPB, superiority of implanting BiVPDs compared with RVPDs could not be proven. Right ventricular pacing may be less harmful for this kind of patients than often suggested and primary BiV pacing does not clearly improve their clinical outcome.</p><p><strong>Clinical trial registration: </strong>Registered in ClinicalTrials.gov, number NCT00187278 (https://clinicaltrials.gov/ct2/show/study/NCT00187278).</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 3","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656594","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":"Impact of the presence of sinus rhythm during cavotricuspid isthmus ablation for atrial flutter on the incidence of future new-onset atrial fibrillation: insights from an international multi-center registry.","authors":"Josip Katic, Patrick Badertscher, Ivan Zeljkovic, Peter Ammann, Tobias Reichlin, Sven Knecht, Philipp Krisai, Michael Kühne, Christian Sticherling","doi":"10.1093/europace/euaf039","DOIUrl":"https://doi.org/10.1093/europace/euaf039","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556303","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":"Persistent Atrial Fibrillation Ablation: Glimpsing the Light Ahead?","authors":"Xiaofeng Hu, Luigi Di Biase, Xumin Hou, Xu Liu","doi":"10.1093/europace/euaf037","DOIUrl":"https://doi.org/10.1093/europace/euaf037","url":null,"abstract":"<p><p>Current ablation strategies for persistent atrial fibrillation (AF) remain suboptimal, with success rates around 50%. Pulmonary vein isolation (PVI) serves as the cornerstone of ablation, yet adjunctive strategies have shown inconsistent results in randomized controlled trials. This review critically examines the outcomes and limitations of these approaches while identifying key barriers to success, including incomplete understanding of AF mechanisms, patient heterogeneity, technical challenges in achieving durable lesions, and the absence of standardized procedural endpoints. A novel electro-anatomically guided ablation protocol is proposed, integrating advanced mapping techniques and procedural endpoints aimed at achieving AF termination. Furthermore, it discusses emerging technologies such as pulsed field ablation (PFA), which hold promise for enhancing safety and long-term outcomes. These insights provide a framework for future research and the optimization of persistent AF ablation strategies.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440391","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":"Lactobacillus gasseri prevents ibrutinib-associated atrial fibrillation through butyrate.","authors":"Ling Shi, Yu Duan, Ning Fang, Ning Zhang, Sen Yan, Kunna Wang, Te Hou, Zhiqi Wang, Xiaohui Jiang, Qianhui Gao, Song Zhang, Yue Li, Yun Zhang, Yongtai Gong","doi":"10.1093/europace/euaf018","DOIUrl":"10.1093/europace/euaf018","url":null,"abstract":"<p><strong>Background: </strong>Ibrutinib, a widely used anti-cancer drug, is known to significantly increase the susceptibility to atrial fibrillation (AF). While it is recognized that drugs can reshape the gut microbiota, influencing both therapeutic effectiveness and adverse events, the role of gut microbiota in ibrutinib-induced AF remains largely unexplored.</p><p><strong>Method: </strong>Utilizing 16S rRNA gene sequencing, faecal microbiota transplantation, metabonomics, electrophysiological examination, and molecular biology methodologies, we sought to validate the hypothesis that gut microbiota dysbiosis promotes ibrutinib-associated AF and to elucidate the underlying mechanisms.</p><p><strong>Result: </strong>We found that ibrutinib administration pre-disposes rats to AF. Interestingly, ibrutinib-associated microbial transplantation conferred increased susceptibility to AF in rats. Notably, ibrutinib induced a significantly decrease in the abundance of Lactobacillus gasseri (L. gasseri), and oral supplementation of L. gasseri or its metabolite, butyrate (BA), effectively prevented rats from ibrutinib-induced AF. Mechanistically, BA inhibits the generation of reactive oxygen species, thereby ameliorating atrial structural remodelling. Furthermore, we demonstrated that ibrutinib inhibited the growth of L. gasseri by disrupting the intestinal barrier integrity.</p><p><strong>Conclusion: </strong>Collectively, our findings provide compelling experimental evidence supporting the potential efficacy of targeting gut microbes in preventing ibrutinib-associated AF, opening new avenues for therapeutic interventions.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002455","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":"Evoked delayed potential ablation for post-myocardial infarction ventricular tachycardia: results from a large prospective multicentre study.","authors":"Marta de Riva, Reinder Evertz, Peter Lukac, Lukas R C Dekker, Yuri Blaauw, Rachel M A Ter Bekke, Yoshitaka Kimura, Rypko J Beukema, Alexandre Ouss, Bart A Mulder, Kevin Vernooy, Adrianus P Wijnmaalen, Katja Zeppenfeld","doi":"10.1093/europace/euaf003","DOIUrl":"10.1093/europace/euaf003","url":null,"abstract":"<p><strong>Aims: </strong>The optimal substrate ablation approach for post-myocardial infarction (MI) ventricular tachycardia (VT) is unknown. Proposed ablation targets are prone to individual interpretation making the ablation outcome potentially operator dependent. Evoked delayed potentials (EDPs) are a well-defined target. Evoked delayed potential ablation was effective in preventing post-MI VT recurrence in a prior study. The aims of this study were to assess long-term outcomes of EDP ablation in a large multicentre cohort of post-MI patients and to compare ablation outcomes between centres with and without prior experience in EDP ablation.</p><p><strong>Methods and results: </strong>Patients with post-MI VT undergoing ablation in one centre performing EDP ablation since 2013 and five centres without prior experience in EDP ablation were prospectively included. A uniform mapping protocol including right ventricular extra-stimulation aiming to EDP identification was followed. Ablation endpoints were EDP elimination and VT non-inducibility. Patients were followed for VT recurrence, mortality, heart transplant, and left ventricular assist device implantation. In total, 130 patients were included. The protocol was successfully performed in 99%, and in 94%, EDPs were identified and ablated. In total, 78% of patients were rendered non-inducible. Ventricular tachycardia-free survival was 78% [95% confidence interval (CI) 71-85] and 71% (95% CI 63-80) at 6 and 12 months, respectively. No difference in VT-free survival was observed among centres with and without prior experience in EPD ablation.</p><p><strong>Conclusion: </strong>In a large multicentre prospective cohort of patients with post-MI VT, EDP ablation resulted in good long-term outcomes. Importantly, VT recurrence rates did not differ among centres with and without prior experience in EDP ablation, indicating that this approach can be easily reproduced by operators previously not familiar with the technique.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 2","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482507","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":"Pulmonary vein reconnection rates after pulse field ablation: time for a reality check?","authors":"Alessio Gasperetti, Luigi Di Biase","doi":"10.1093/europace/euaf014","DOIUrl":"10.1093/europace/euaf014","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002608","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":"Comparative analysis of anaesthesia modalities in pulmonary vein isolation: insights from a prospective multicentre registry.","authors":"Eias Massalha, Amer Dakka, Avi Sabbag, Anat Berkovitch, Ibrahim Marai, Yoav Michowitz, Michael Glikson, Yuval Konstantino, Moti Haim, David Luria, Alexander Omelchenko, Avishag Laish-Farkash, Mahmoud Suleiman, Eran Leshem, Eyal Nof, Roy Beinart","doi":"10.1093/europace/euae301","DOIUrl":"10.1093/europace/euae301","url":null,"abstract":"<p><strong>Aims: </strong>Atrial fibrillation (AF), the most common sustained arrhythmia in adults, is increasing in prevalence globally. Catheter ablation (CA), particularly pulmonary vein isolation (PVI), is a key treatment option. Pulmonary vein isolation can be performed using different energy sources, including cryoballoon ablation (CBA), radiofrequency ablation (RFA), or pulse field ablation. Anaesthesia modalities for these procedures include general anaesthesia (GA), deep sedation (DS), and conscious sedation (CS). However, the optimal anaesthesia modality remains unclear, as previous studies have shown mixed outcomes. This study aims to compare the safety and efficacy of different anaesthesia modalities in PVI.</p><p><strong>Methods and results: </strong>This prospective, multicentre study, based on the Israeli Catheter Ablation Registry, evaluated the impact of different anaesthesia modalities on procedural outcomes and safety in AF ablation. Data from 1002 patients who underwent PVI between January 2019 and December 2021 across 14 centres were analysed. Patients were stratified by anaesthesia modality-CS vs. GA, with the latter encompassing DS. Key outcomes, including AF recurrence, procedural complications, and success rates, were evaluated over a 24-month follow-up period. Additionally, a sensitivity analysis was performed for the subgroup of patients who underwent CBA. Of the 1002 patients, 53% received GA, 6.3% DS, and 40% CS, with CBA used in 84% of cases. Complete PVI was achieved in 91% of patients, with comparable success rates observed between CS and GA groups. No significant differences were found between CS and GA modalities in terms of AF recurrence rates at 12 months (15% vs. 16%) and 24 months (19.5% vs. 21.2%), or in 12-month rehospitalization rates (19.8% vs. 16.5%). Sensitivity analysis of the CBA subgroup yielded similar results, with no significant differences in AF recurrence, complications, or procedural duration between CS and GA modalities.</p><p><strong>Conclusion: </strong>Conscious sedation is as safe and effective as general anaesthesia in AF ablation, particularly with cryoablation. The choice of anaesthesia appears to be driven by patient characteristics and institutional factors without affecting long-term outcomes such as AF recurrence or complication rates.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 2","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432816","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}