Europace最新文献

{"title":"Comprehensive analysis of desmosomal protein remodelling identifies desmocollin-2 as potential biomarker for arrhythmogenic cardiomyopathy.","authors":"Jie Ren, Zhenliang Hu, Lingmin Wu, Deniz Akdis, Weiquan Ye, Ardan M Saguner, Mingming Su, Hongbin Dong, Zhongli Chen, Dan Hu, Shengshou Hu, Firat Duru, Liang Chen","doi":"10.1093/europace/euaf199","DOIUrl":"10.1093/europace/euaf199","url":null,"abstract":"<p><strong>Aims: </strong>Arrhythmogenic cardiomyopathy (ACM) is a genetically-determined disease characterized by malignant arrhythmias and sudden cardiac death, particularly in young individuals. Mutations in desmosomal genes are a major cause of ACM, but the role of desmocollin-2 (DSC2) remains understudied.</p><p><strong>Methods and results: </strong>We conducted a multi-cohort study with 52 ACM patients, 29 with dilated cardiomyopathy (DCM), 17 with hypertrophic cardiomyopathy (HCM), and 45 controls. Immunofluorescence, immunohistochemical staining, and western blot were used to assess DSC2 expression. DSC2 expression was significantly reduced in ACM myocardium compared to controls and other cardiomyopathies (P < 0.0001), consistent across ACM subtypes and validated in an independent cohort. DSC2 down-regulation correlated with clinical characteristics such as age at onset of arrhythmia and heart transplantation. DSC2 reduction in the right ventricle effectively discriminated ACM patients from controls (ROC AUC = 0.8017, P < 0.0001) and distinguished ACM from other cardiac diseases. Immunohistochemical staining in the Swiss cohort confirmed that 11 out of 12 (91.7%) ACM cases exhibited significantly reduced DSC2 signal intensity compared to normal donors. RNA-Seq analysis revealed significant down-regulation of DSC2 genes in ACM tissues.</p><p><strong>Conclusion: </strong>DSC2 remodelling is a hallmark of ACM, harbouring significant diagnostic implications. DSC2 reduction is a robust biomarker for ACM, showing high sensitivity and specificity across different subtypes. Future research should elucidate the mechanisms underlying DSC2 down-regulation.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947734","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":"Software-based analysis of T-wave morphology: identifying the electrocardiogram signature of high-risk long QT syndrome.","authors":"Alessandra Pia Porretta, Charles Morgat, Elodie Surget, Véronique Fressart, Adrien Bloch, Nathalie Neyroud, Fabio Badilini, Martino Vaglio, Isabelle Denjoy, Fabrice Extramiana","doi":"10.1093/europace/euaf213","DOIUrl":"10.1093/europace/euaf213","url":null,"abstract":"<p><strong>Aims: </strong>Despite T-wave morphology abnormalities being well-known distinctive ECG features in patients with long QT syndrome (LQTS), the subjectivity of qualitative 'eyeballing' in T-wave characterization still hampers its integration into diagnostic/prognostic criteria. We herein evaluated whether our quantitative software-based analysis of T-wave morphology (AnTwM) applied to digital ECGs may identify predictors of cardiac events (CEs) in our cohort of LQTS patients.</p><p><strong>Methods and results: </strong>We enrolled LQT1, LQT2, and LQT3 patients having at least one digital ECG from our cohort of genotype-confirmed LQTS patients. Automated AnTwM analysis, using Glasgow and Bravo algorithms embedded in the CalECG software (AMPS-IIc, USA), provided scalar descriptors of ventricular repolarization. Cox regression analyses identified potential predictors of CEs (i.e. syncope, sudden cardiac death, resuscitated cardiac arrest, or appropriate shock delivered by implantable cardioverter defibrillators). A total of 467 (58% female) patients were followed up for 15 ± 9 years, including 253 (54.2%) LQT1, 182 (39%) LQT2, and 32 (6.8%) LQT3 patients. Corrected QT interval predicted CEs in the whole population (1 ms QTc increase: HR = 1.01, 95% CI: 1.0-1.01, P = 0.03) but not across genotyped subpopulations. Genotype-specific ECG markers associated with a greater risk of CEs were (i) those expressing a delayed accumulation of the mid-late T-wave area (decreased t25 and increased t50) among LQT1 patients and (ii) those expressing T-wave flattening/widening (decreased T-wave ascending/descending slopes) among LQT2 patients.</p><p><strong>Conclusion: </strong>The software-based AnTwM on digital ECGs represented a reliable tool in clinical practice and identified unique ECG T-wave 'fingerprints' that allowed prediction of CEs in a genotype-specific manner.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 9","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191499","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":"When age meets genetics: refining heart failure risk prediction in young atrial fibrillation.","authors":"Bin Deng, Wenhua Liu","doi":"10.1093/europace/euaf201","DOIUrl":"10.1093/europace/euaf201","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947541","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":"Long-term all-cause mortality and hospitalizations after catheter ablation in patients with paroxysmal and persistent atrial fibrillation.","authors":"Christopher C Cheung, Feng Qiu, Olivia Haldenby, Derek S Chew, Anthony S L Tang, Allan C Skanes, Yaariv Khaykin, Pablo B Nery, Andrew C T Ha, Jeffrey S Healey, Damian P Redfearn, Paul Angaran, Andrew Ha, Bhavanesh Makanjee, Umjeet S Jolly, Eugene Crystal, Sheldon M Singh, Dennis T Ko","doi":"10.1093/europace/euaf152","DOIUrl":"https://doi.org/10.1093/europace/euaf152","url":null,"abstract":"<p><strong>Aims: </strong>Persistent atrial fibrillation (AF) patients undergoing a catheter ablation are at risk for adverse outcomes, due to comorbidities and a more advanced arrhythmia substrate. There may be barriers to catheter ablation in patients with persistent AF, compared to those with paroxysmal AF. We compared long-term outcomes after ablation in patients with paroxysmal and persistent AF.</p><p><strong>Methods and results: </strong>Patients undergoing de novo AF catheter ablation from April 2012 to March 2022 in Ontario, Canada, were included. The primary outcome was a composite of all-cause mortality and all-cause hospitalization. Inverse probability of treatment weighting created balanced cohorts of paroxysmal and persistent AF patients. Cox proportional hazards models estimated the effect on persistent vs. paroxysmal AF. There were 10 788 patients who underwent an ablation. Persistent AF patients accounted for 25% of the population. In our weighted cohort, patients had similar age (standardized difference 0.027), female sex [standardized difference (SD) 0.018], and medical comorbidities (Charlson comorbidity score; 0.5% in both, SD 0.018). In the weighted cohort, the primary composite outcome occurred in 5.5% in paroxysmal AF and 6.3% in persistent AF at 30 days (HR 1.15, 95% CI 0.94-1.40, P = 0.168), 19.8% vs. 19.7% at 1 year (HR 1.00, 95% CI 0.90-1.11, P = 0.971), and 34.1% vs. 35.4% at 3 years (HR 1.05, 95% CI 0.97-1.13, P = 0.269). There was no increased risk of the individual components at 30 days, 1 year, or 3 years.</p><p><strong>Conclusion: </strong>The risk of all-cause mortality and hospitalization outcomes in persistent and paroxysmal AF patients undergoing ablation was similar at 30 days, 1 year, and 3 years post-ablation. The impact of persistent AF on long-term outcomes (i.e. all-cause mortality) is primarily attributable to comorbid conditions.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 9","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085481","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":"Implementation of lead V8 as a simple non-invasive tool to improve patient selection in cardiac resynchronization therapy and guide left ventricular lead placement.","authors":"Jacqueline Joza, Johan van Koll, Vadivelu Ramalingam, Peter Tai, Vidal Essebag, Tomy A Hadjis, Theo A R Lankveld, Antonius M W van Stipdonk, Jesse H J Rijks, Uyên C Nguyên, Justin Luermans, Atul Verma, Kevin Vernooy","doi":"10.1093/europace/euaf194","DOIUrl":"10.1093/europace/euaf194","url":null,"abstract":"<p><strong>Aims: </strong>Cardiac resynchronization therapy (CRT) improves outcomes in heart failure patients with electrical dyssynchrony. The QLV interval, a marker of delayed left ventricular (LV) activation, independently predicts CRT response. This study aimed to determine whether activation time measured in surface ECG lead V8 reflects posterolateral LV delay by correlating with the QLV interval during biventricular (BiV) CRT implantation.</p><p><strong>Methods and results: </strong>Consecutive patients with wide QRS (non-RBBB) undergoing BiV-CRT or generator change were prospectively enrolled. Surface ECGs were recorded with the V5 electrode repositioned to the V8 location. Local wavefront activation was determined using the steepest negative downslope of the precordial leads, referred to as the negative derivative activation time (NDAT). The LV lead was connected to the EP recording system, and NDAT and QLV measurements were obtained. Forty-three patients were included. The NDAT in V8 strongly correlated with the QLV interval (r = 0.895; mean difference 1 ± 11 ms) across both LBBB and IVCD patterns. In contrast, NDAT in V6 showed weaker correlation (r = 0.592; mean difference 21 ± 24 ms). During LV-only pacing, a QS morphology in V8 consistently indicated posterolateral lead placement. More anterior/apical lead positions showed larger QLV-negative derivative activation time (NDAT) V8 differences and non-QS morphologies, indicating suboptimal positioning.</p><p><strong>Conclusion: </strong>NDAT in lead V8 is a non-invasive marker of delayed activation in the posterolateral LV, outperforming V6 in identifying late activation. When combined with LV-paced QRS morphology, V8 facilitates accurate lead localization without additional tools. These findings may support the use of lead V8 to refine patient selection and optimize CRT delivery.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947222","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":"Prevalence and multiple predictors of left atrial low voltage in paroxysmal and non-paroxysmal atrial fibrillation patients undergoing ablation: a systematic review and meta-analysis.","authors":"Carlo-Agostino Oliva, Matteo Morello, Jordana Kron, Kenneth A Ellenbogen, Michele Golino, Roberto De Ponti","doi":"10.1093/europace/euaf206","DOIUrl":"10.1093/europace/euaf206","url":null,"abstract":"<p><strong>Aims: </strong>In the left atrium (LA), low-voltage areas (LVAs) detected at electroanatomic mapping in patients with atrial fibrillation (AF) are considered expression of atrial cardiomyopathy (AtCM). This meta-analysis aims at assessing the prevalence and predictors of LVAs in a larger AF population undergoing catheter ablation.</p><p><strong>Methods and results: </strong>Studies comparing patients undergoing LA ablation with vs. those without LVAs were included. Meta-analyses were conducted to estimate the prevalence and odds ratios (ORs) for LVAs. Twenty-two studies with 5278 patients were included. Low-voltage areas were present both in paroxysmal (28%) and non-paroxysmal (41%) patients. The strongest predictors of LVA presence were: age > 65 years (OR 3.41), CHA2DS2-VASc score (OR 3.29), non-paroxysmal AF (OR 3.19), NT-proBNP > 365 pg/mL (OR 2.47), female sex (OR 2.40), E/e' ratio (OR 2.31), eGFR < 60 mL/min/m2 (OR 2.28), and LA volume indexed > 34 mL/m2 (OR 1.98). Comorbidities were also predictors but with lower ORs. In subgroup analysis, female sex (OR 3.90) was a predictor only in non-paroxysmal, while LA diameter (OR 2.51) and body mass index (BMI; OR 1.85) positively correlated only in paroxysmal AF. Meta-regression analysis showed that non-paroxysmal AF and age were independently and significantly associated with a greater reduction in BMI in patients with compared to those without LVAs.</p><p><strong>Conclusion: </strong>Low-voltage areas can be present in both paroxysmal and non-paroxysmal AF, and can be predicted by multiple clinical, echocardiographic, and biomarker variables. The impact of female sex, LA diameter, and BMI on LVA presence varies according to the type of AF.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947569","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 renal function on the efficacy of low-voltage area ablation after pulmonary vein isolation: a sub-analysis of the SUPPRESS-AF trial.","authors":"Yasuhiro Matsuda, Masaharu Masuda, Toshiaki Mano, Takuya Tsujimura, Hiroyuki Uematsu, Hirotaka Ooka, Satoshi Kudo, Mizuki Ochi, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Yosuke Hata, Sho Nakao, Masaya Kusuda, Wataru Ariyasu, Akihiro Sunaga, Nobuaki Tanaka, Tetsuya Watanabe, Hitoshi Minamiguchi, Yasuyuki Egami, Takafumi Oka, Tomoko Minamisaka, Takashi Kanda, Masato Okada, Masato Kawasaki, Koji Tanaka, Nobuhiko Makino, Hirota Kida, Shungo Hikoso, Tomoharu Dohi, Koichi Inoue, Yohei Sotomi, Yasushi Sakata","doi":"10.1093/europace/euaf205","DOIUrl":"10.1093/europace/euaf205","url":null,"abstract":"<p><strong>Aims: </strong>The SUPPRESS-AF trial showed that pulmonary vein isolation (PVI) plus low-voltage area (LVA) ablation may reduce atrial fibrillation (AF) recurrence in some subgroups. Renal dysfunction is a cause of LVAs due to atrial cardiomyopathy and is also a risk factor for AF recurrence after catheter ablation. The aim of this study was to investigate the efficacy of LVA ablation after PVI stratified by renal function.</p><p><strong>Methods and results: </strong>This study was a sub-analysis of the SUPPRESS-AF trial, a multicentre, prospective, randomized, open-label trial. A total of 341 consecutive patients who underwent initial radiofrequency catheter ablation for persistent AF and whose LVAs were ≥5 cm2 were analysed. Patients were randomized to PVI alone (PVI-alone group) or LVA ablation after PVI [PVI + LVA-ablation (ABL) group]. Primary outcome was defined as the recurrence of atrial tachyarrhythmias during the 12 months following ablation. Estimated glomerular filtration rate (eGFR) was assessed before ablation, and patients were stratified by chronic kidney disease (CKD) stage. The mean eGFR was 60 ± 16 mL/min/1.73 m2, and 146 (43%) patients developed the primary outcome. In patients with CKD G1-2 (eGFR ≥ 60 mL/min/1.73 m2), freedom from the primary outcome was similar between the PVI + LVA-ABL and PVI-alone groups (53.1% vs. 55.3%, P = 0.59). In contrast, in patients with CKD G3a-5 (eGFR < 60 mL/min/1.73 m2), freedom from the primary outcome was significantly higher in the PVI + LVA-ABL group than in the PVI-alone group (69.1% vs. 43.3%; P = 0.004).</p><p><strong>Conclusion: </strong>In patients with renal dysfunction, LVA ablation after PVI reduced AF recurrence after radiofrequency catheter ablation for persistent AF.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946508","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":"Real-world experience with the pentaspline pulsed field ablation system: one-year outcomes of the FARADISE registry.","authors":"Lucas V A Boersma, Gábor Széplaki, Antonio Dello Russo, Ignacio García-Bolao, Michael Efremidis, Nándor Szegedi, Stephan Willems, Haris Haqqani, Estelle Gandjbakhch, Francesco Solimene, George Andrikopoulos, Martin Fiala, Pascal Defaye, Armin Luik, Patrick Lugenbiel, Lars Eckardt, Alexandre Ouss, Jean-Manuel Herzet, Javier Ramos Maqueda, Sélim Abbey, Joaquín Osca, Azlan Hussin, Nele Cielen, Madeline Johnson, Elizabeth M Albrecht, Brad S Sutton, Johan Vijgen","doi":"10.1093/europace/euaf182","DOIUrl":"10.1093/europace/euaf182","url":null,"abstract":"<p><strong>Aims: </strong>Clinical studies with protocol-mandated workflow and monitoring have analysed performance of pulsed field ablation (PFA) for treating atrial fibrillation (AF). The FARADISE registry captures global use of the pentaspline PFA catheter in real-world clinical practice with a follow-up of 3 years.</p><p><strong>Methods and results: </strong>FARADISE is a prospective, non-randomized, multi-national registry (NCT05501873) that enrolled subjects clinically indicated for ablation using the pentaspline PFA catheter per medical judgement and hospital standard-of-care. Procedural characteristics, safety, and clinical effectiveness up to 12-months were collected. In total, 1158 AF patients received PFA across 48 centres in 21 countries (64 ± 11 years, 33% female, 90% de novo, 65% paroxysmal AF). Pulmonary vein isolation (PVI)-only procedures were performed in 80.8% of paroxysmal vs. 57.5% for non-paroxysmal patients (P < 0.01). Median procedure, left atrial dwell, and fluoroscopy times were 51[40-70], 31[24-41], and 12[8-17] min, respectively. The rate of early onset serious adverse events was 1.5% and did not differ by ablation strategy or AF indication. At 1-year, clinical effectiveness was 80.8% for paroxysmal AF and 67.7% for non-paroxysmal AF, with no difference within indication by lesion set (paroxysmal: 81.2% PVI-only vs. 79.0% PVI+, P = 0.65; non-paroxysmal: 67.5% PVI-only vs. 67.7% PVI+, P = 0.79). Acute results reinforce a short procedural learning curve with no difference in 1-year effectiveness by operator experience.</p><p><strong>Conclusion: </strong>The FARADISE registry provides a snapshot of real-world clinical use of the pentaspline PFA catheter. Acute results demonstrate favourable procedural and safety outcomes regardless of AF indication. One-year outcomes are encouraging, with no differences seen within indication based on ablation strategy.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 9","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947588","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":"Ganglionated plexi ablation impact on atrial fibrillation mechanisms and outcomes in patients with low scar burden.","authors":"Shohreh Honarbakhsh, Caroline Roney, Sayed Al-Aidarous, Caterina Vidal Horrach, Pier D Lambiase, Ross J Hunter","doi":"10.1093/europace/euaf178","DOIUrl":"10.1093/europace/euaf178","url":null,"abstract":"<p><strong>Aims: </strong>Persistent atrial fibrillation (AF) ablation success rates remain limited. The aim was to evaluate the impact of ganglionated plexi (GP) ablation on AF mechanisms and outcomes in patients with low scar burden.</p><p><strong>Methods and results: </strong>Patients undergoing persistent AF ablation were included. Patients that had <30% low voltage zones (LVZs) in the left atrium underwent pulmonary vein isolation and GP ablation. Dominant frequency (DF), coronary sinus (CS) electrogram characteristics, and AF inducibility score were assessed pre- and post-GP ablation. Ganglionated plexi ablation response was determined. One hundred twenty patients were included, of which 84 (70.0%) patients had <30% LVZs and underwent GP ablation. An ablation response was seen in all patients [AF termination (66.7%) and CL slowing of ≥30 ms (33.3%)]. The average DF, CS cycle length variability (CLV), and CS activation pattern stability (APS) pre-GP ablation were predictive of AF termination. Ganglionated plexi ablation resulted in a significant change in the DF (6.3 ± 1.2 Hz pre-GP ablation vs. 5.1 ± 1.0 Hz; P < 0.001), CS CLV (40.2 ± 6.5 ms vs. 28.2 ± 6.8%; P < 0.001), and CS APS (25.2 ± 5.8% vs. 35.2 ± 6.5%; P < 0.001). Atrial fibrillation inducibility was harder post-GP ablation than pre-GP ablation (3.8 ± 1.2 AF inducibility score pre-ablation vs. 1.3 ± 1.8 AF inducibility score post-ablation; P < 0.001). Seventy-eight out of the 84 (92.9%) patients were free from AF/atrial tachycardia (AT) off anti-arrhythmic drugs at 12-months.</p><p><strong>Conclusion: </strong>Ganglionated plexi ablation results in a mechanistic impact in AF with an ablation response, changes in DF, CS electrogram characteristics, and AF inducibility score. Pulmonary vein isolation and GP ablation in patients with minimal LVZs results in a high freedom from AF/AT.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947760","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":"Electrical storm ablation: absolute benefit, risk-score discordance, and clinical equity.","authors":"Shiuan-Chih Chen, Chun-Chieh Chen","doi":"10.1093/europace/euaf228","DOIUrl":"10.1093/europace/euaf228","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091479","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}