Heart rhythm最新文献

{"title":"One-year outcomes of a conformable single-shot pulsed-field ablation catheter for the treatment of paroxysmal atrial fibrillation","authors":"Vivek Y. Reddy MD ,&nbsp;Petr Peichl MD, PhD ,&nbsp;Josef Kautzner MD, PhD ,&nbsp;Elad Anter MD ,&nbsp;Andreas Metzner MD ,&nbsp;Jacob Koruth MD ,&nbsp;Pierre Jais MD ,&nbsp;Gediminas Rackauskas MD ,&nbsp;Jan Petru MD ,&nbsp;Moritoshi Funasako MD ,&nbsp;Germanas Marinskis MD ,&nbsp;Mohit Turagam MD ,&nbsp;Audrius Aidietis MD ,&nbsp;Jada M. Selma PhD ,&nbsp;Vojtech Nejedlo ,&nbsp;Fred Kueffer MS ,&nbsp;Khaldoun G. Tarakji MD, MPH ,&nbsp;Andrea Natale MD ,&nbsp;Petr Neuzil MD, PhD","doi":"10.1016/j.hrthm.2025.04.031","DOIUrl":"10.1016/j.hrthm.2025.04.031","url":null,"abstract":"<div><h3>Background</h3><div>Most single-shot pulsed-field ablation (PFA) catheters require extensive repositioning for pulmonary vein isolation (PVI), posing a challenge for obtaining contiguous, durable lesions.</div></div><div><h3>Objective</h3><div>To determine 1-year outcomes of a single-shot, all-in-one mapping and ablation PFA catheter for treating paroxysmal atrial fibrillation (PAF).</div></div><div><h3>Methods</h3><div>After PVI with the large-lattice catheter with expandable tip (Sphere-360), follow-up included Holter monitoring at 180 and 365 days and scheduled/symptomatic trans-telephonic monitoring (TTM) or modeled insertable loop recorder (ILR) data. Efficacy outcomes were acute PVI and 12-month freedom from atrial arrhythmias (AA), after 90-day blanking. Optional invasive remapping at 75 days facilitated waveform refinement from PULSE1, PULSE2, to the optimized PULSE3.</div></div><div><h3>Results</h3><div>At 3 centers, 100 PAF patients underwent PFA with PULSE1 (<em>n</em> = 30), PULSE2 (<em>n</em> = 20), or PULSE3 (<em>n</em> = 50). Procedure, left atrial dwell, and fluoroscopy times were 57.9 ± 20.6, 22.2 ± 11.8 and 6.8 ± 5.7 minutes, respectively. All 395 targeted PVs were acutely isolated, with a transpired PVI time of 11.5 ± 6.0 minutes, using 4.0 ± 1.3 lesions/PV. There were no primary safety events (serious device-related events within 7 days post-PFA). PVI durability with PULSE3 (<em>n</em> = 40) was 98% (per-vein) and 93% (per-patient). One-year freedom from AA recurrence was 82.0% (95% CI:73.0%–88.3%) overall, and 88.0% (95%CI, 75.2%–94.4%) for PULSE3 patients. Of the ILR sub-cohort (n = 15 PULSE3 patients), 3 patients (20%) had recurrences, with an AA burden reduction from 26% (baseline) to 1.6% (post-ablation).</div></div><div><h3>Conclusion</h3><div>The large lattice PFA catheter was efficient, safe, and effective in treating PAF. The observed high PVI durability translated to clinical effectiveness, even in continuously monitored patients.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2551-2561"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endothelial function improvement and the outcomes after catheter ablation of persistent atrial fibrillation","authors":"Keisuke Okawa MD, PhD ,&nbsp;Yuya Sudo MD ,&nbsp;Takeshi Morimoto MD, PhD, MPH ,&nbsp;Ryu Tsushima MD ,&nbsp;Akihiro Oka MD ,&nbsp;Masahiro Sogo MD ,&nbsp;Masatomo Ozaki MD ,&nbsp;Masahiko Takahashi MD","doi":"10.1016/j.hrthm.2025.05.022","DOIUrl":"10.1016/j.hrthm.2025.05.022","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e1028-e1029"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel approach to treat atrial tachycardia by catheter ablation in patients after orthotopic biatrial heart transplantation: The L-line","authors":"Moneeb Khalaph MD ,&nbsp;Nadica Trajkovska MD ,&nbsp;Christian Sohns MD ,&nbsp;Denise Guckel MD ,&nbsp;Maxim Didenko MD ,&nbsp;Martin Braun MD ,&nbsp;Guram Imnadze MD ,&nbsp;Philipp Lucas MD ,&nbsp;Thomas Fink MD ,&nbsp;Vanessa Sciacca MD ,&nbsp;Sebastian Beyer MD ,&nbsp;Gregor Nageler MD ,&nbsp;Jan Fleischhauer MD ,&nbsp;René Schramm MD ,&nbsp;Angelika Costard-Jäckle MD ,&nbsp;Henrik Fox MD ,&nbsp;Jan Gummert MD ,&nbsp;Philipp Sommer MD, FHRS ,&nbsp;Mustapha El Hamriti MD","doi":"10.1016/j.hrthm.2025.05.060","DOIUrl":"10.1016/j.hrthm.2025.05.060","url":null,"abstract":"<div><h3>Background</h3><div>Atrial tachycardia (AT) is commonly observed after orthotopic biatrial heart transplantation (O-BA-HTx). Its clinical presentation, relationship to atrial anastomoses, and electrophysiologic characteristics remain controversial. Novel radiofrequency-guided catheter ablation (RFCA) strategies using electroanatomical mapping and myocardial substrate characterization have emerged, but data on their efficacy in this patient group are scarce.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the efficacy and safety of a novel RFCA strategy for AT in O-BA-HTx patients and assess long-term arrhythmia-free survival.</div></div><div><h3>Methods</h3><div>Overall, 37 consecutive O-BA-HTx patients with therapy-refractory AT underwent prospectively an RFCA between 2017 and 2024. Procedural parameters, acute and long-term outcomes, and complications were assessed.</div></div><div><h3>Results</h3><div>The cohort (mean age 56.9 ± 16.3 years, 83.8% male) underwent RFCA of AT. Electrophysiologic diagnoses included:</div><div><ul><li><span>1.</span><span><div><strong>Atrio-atrial dissociation:</strong><ul><li><span>•</span><span><div>Cavotricuspid isthmus-dependent atrial flutter (64.6%, n = 24).</div></span></li><li><span>•</span><span><div>Perimitral atrial flutter (5.3%, n = 2).</div></span></li></ul></div></span></li><li><span>2.</span><span><div><strong>Atrio-atrial association:</strong><ul><li><span>•</span><span><div>Right atrium (RA) (27.5%, n = 10), all involving lateral conduction, where an RA-lateral line successfully terminated all ATs.</div></span></li><li><span>•</span><span><div>Left atrium (2.6%, n = 1).</div></span></li></ul></div></span></li></ul></div><div>The L-line approach, which combines cavotricuspid isthmus and RA-lateral line ablation, was responsible for AT termination in 92.1% (n = 34) of cases. All procedures were performed without any major complications. The median follow-up was 26 months (interquartile range 19–60), and only 2 patients (5.3%) experienced AT recurrence. Remarkably, achieving freedom from AT was associated with freedom from atrial fibrillation, highlighting the effectiveness of addressing AT as a trigger for atrial fibrillation.</div></div><div><h3>Conclusion</h3><div>The novel L-Line approach is a safe, effective, and reproducible approach for AT ablation in O-BA-HTx patients, with favorable long-term arrhythmia-free survival.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e959-e967"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical and electrocardiographic phenotype of patients with genotype-negative long QT syndrome","authors":"Vanessa Karlinski Vizentin MD ,&nbsp;Raquel Neves MD ,&nbsp;Sahej Bains BS ,&nbsp;Iuri Ferreira Felix MD ,&nbsp;David J. Tester BS ,&nbsp;J. Martijn Bos MD, PhD ,&nbsp;John R. Giudicessi MD, PhD ,&nbsp;Michael J. Ackerman MD, PhD","doi":"10.1016/j.hrthm.2025.05.053","DOIUrl":"10.1016/j.hrthm.2025.05.053","url":null,"abstract":"<div><h3>Background</h3><div><span>Long QT syndrome (LQTS) is a </span>genetic<span> heart disease that increases the risk of ventricular arrhythmias<span> and sudden cardia arrest. Despite advances in genetic testing, a small subset of patients with LQTS remain genetically elusive.</span></span></div></div><div><h3>Objective</h3><div>This study aimed to determine the prevalence and clinical characteristics of patients with a phenotype of LQTS but without a genotype.</div></div><div><h3>Methods</h3><div>This study aimed to identify phenotype-positive, genotype-negative patients with LQTS seen at Mayo Clinic (2000–2024). Retrospective data included demographics, clinical evaluations, electrocardiograms, and genetic results. Diagnosis adhered to established criteria, and genotype-negative LQTS was defined by the absence of pathogenic variants despite clinical presentation.</div></div><div><h3>Results</h3><div>The study included 1829 patients with LQTS. Of these, 1706 (93%) had pathogenic or likely pathogenic variants, and 95 patients (5%) had upgraded clinical variants of uncertain significance, leaving 32 (1.7%) with negative genetic tests. Among the genotype-negative patients, 17 underwent next-generation sequencing, identifying a genetic cause in 6 cases (0.3% of the total). The mean age at diagnosis for the remaining 26 patients was 25 ± 15 years, with 76% being women and an average initial corrected QT of 498 ± 41 ms. Fourteen patients (53%) experienced cardiac events prior to diagnosis, and 11 (44%) received an implantable cardioverter-defibrillator. The mean follow-up period was 8 ± 7 years.</div></div><div><h3>Conclusion</h3><div>Genotype-negative LQTS accounted for &lt; 2% of our cohort, highlighting diagnostic and management challenges. Comprehensive clinical evaluation and advanced genetic testing remain essential for accurate diagnosis and care.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e921-e930"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Localized abnormal Q waves are not associated with echocardiographic regional wall motion abnormalities","authors":"Yoav Granot MD ,&nbsp;Tal Ben Shaul MD ,&nbsp;Shir Frydman MD ,&nbsp;Michal Laufer Perl MD ,&nbsp;Shmuel Banai MD ,&nbsp;Yan Topilsky MD ,&nbsp;Ofer Havakuk MD","doi":"10.1016/j.hrthm.2025.05.056","DOIUrl":"10.1016/j.hrthm.2025.05.056","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e1030-e1031"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SCAI/HRS technical review on transcatheter left atrial appendage occlusion","authors":"Edmond M. Cronin MB BCh BAO, FHRS ,&nbsp;Steven Filby MD, FSCAI ,&nbsp;Michael E. Field MD, FHRS ,&nbsp;Chetan Huded MD, FSCAI ,&nbsp;Julia H. Indik MD, PhD, FHRS ,&nbsp;Abhishek Sharma MD, FSCAI ,&nbsp;Chelsea Armah MPH ,&nbsp;Scott Firestone MS ,&nbsp;Angela M. Fix MPH, MCW ,&nbsp;Emily Senerth MS, MPH ,&nbsp;Rebecca L. Morgan PhD, MPH ,&nbsp;Yngve Falck-Ytter MD","doi":"10.1016/j.hrthm.2025.05.049","DOIUrl":"10.1016/j.hrthm.2025.05.049","url":null,"abstract":"<div><h3>Background</h3><div>Nonvalvular atrial fibrillation (NVAF) is associated with an increased risk of stroke due to thrombus formation in the left atrial appendage, where over 90% of thrombi originate. While oral anticoagulation (OAC) is the standard therapy for stroke prevention, many patients cannot tolerate long-term OAC due to bleeding risks. Percutaneous left atrial appendage occlusion (LAAO) has emerged as an alternative strategy. Despite its rapid adoption, substantial variability exists in clinical practice regarding patient selection, imaging techniques, procedural guidance, and postprocedural management. This systematic review aims to collect and synthesize evidence to inform the development of new Society for Cardiovascular Angiography &amp; Interventions and the Heart Rhythm Society guidelines on LAAO.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, and Cochrane Library from inception through January 5, 2024, for studies of the percutaneous LAAO procedure. Eligible studies were conducted in adults with NVAF undergoing LAAO, or with peridevice leak or device-related thrombus after an occlusion procedure. Studies of surgical LAAO, double device or combined procedures, and devices that are not currently marketed in the United States were excluded. Data were extracted from studies in duplicate and summarized using meta-analysis and narrative synthesis. Risk of bias (RoB) was assessed using the RoB in nonrandomized studies of interventions tool, and version 2 of the Cochrane RoB tool for randomized trials (RoB 2.0). Overall certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach.</div></div><div><h3>Results</h3><div>Our search identified 3769 titles and abstracts, of which 27 studies met eligibility criteria and contributed data to the analysis. Data were abstracted to address outcomes of LAAO for stroke prevention in patients with NVAF, in comparison to OAC, no therapy, and across various approaches including preprocedure imaging, intraprocedure guidance, and postprocedure antithrombotic regimens.</div></div><div><h3>Conclusions</h3><div>Left atrial appendage occlusion is an effective alternative to OAC for stroke prevention in NVAF patients with bleeding risks, but uncertainties remain regarding imaging strategies and postprocedural management.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e1064-e1074"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tissue characteristics underlying endocardial local impedance subtypes in chronic myocardial infarction","authors":"Júlia Aranyó MD ,&nbsp;Daina Martínez-Falguera MSc ,&nbsp;Albert Teis MD, PhD ,&nbsp;Edgar Fadeuilhe MD ,&nbsp;Oriol Rodríguez-Leor MD, PhD ,&nbsp;Víctor Bazan MD, PhD ,&nbsp;Axel Sarrias MD ,&nbsp;Cristian Tebe MPH, PhD ,&nbsp;Roger Villuendas MD, PhD ,&nbsp;Victoria Delgado MD, PhD ,&nbsp;Antoni Bayés-Genís MD, PhD ,&nbsp;Carolina Gálvez-Montón DVM, PhD ,&nbsp;Felipe Bisbal MD, PhD","doi":"10.1016/j.hrthm.2025.05.017","DOIUrl":"10.1016/j.hrthm.2025.05.017","url":null,"abstract":"<div><h3>Background</h3><div>Local impedance (LI) mapping is feasible and provides additional tissue characterization<span> of the ventricular tachycardia substrate. Data on tissue composition underlying the LI spectrum are lacking.</span></div></div><div><h3>Objective</h3><div><span>To describe the tissue composition underlying different LI subtypes in a chronic myocardial infarction (MI) </span>swine model.</div></div><div><h3>Methods</h3><div><span><span>One month after non-reperfused anterior MI, 18 </span>Landrace<span> Large White pigs underwent delayed-enhancement </span></span>cardiac magnetic resonance<span><span> (DE-CMR) and endocardial left ventricular (LV) LI mapping. DE-CMR images were post-processed off-line to obtain </span>LV wall thickness, scar subtypes, and border zone (BZ) corridors, and were co-registered with LI maps. Tissue samples were obtained from abnormal LI sites.</span></div></div><div><h3>Results</h3><div>Low LI zones exhibited more pronounced wall thinning compared to intermediate LI tissue (2.8 ± 0.7 vs 3.8 ± 0.9 mm; <em>P &lt;</em><span> .001) and correlated with DE-CMR dense endocardial scarring (91.4%) and with epicardial scarring (75% dense and 24% BZ tissue). Intermediate LI tissue exhibited predominantly subendocardial scarring, with more heterogeneous distribution (45% dense, 47% BZ, and 8% healthy tissue) and less epicardial involvement (73% healthy tissue). Most DE-CMR BZ corridors (75.6%) colocalized with intermediate LI tissue. Histologically, tissue from intermediate LI zones displayed less collagen I (</span><em>P</em> = .008), collagen III (<em>P</em> = .053), and collagen volume fraction (<em>P</em> = .021), and greater vascular density (<em>P</em> = .075), compared to low LI zones.</div></div><div><h3>Conclusions</h3><div>Areas of low LI had a higher proportion of dense, transmural scar and wall thinning compared to intermediate LI areas. DE-CMR BZ corridors colocalized with intermediate LI in most cases. LI subtypes showed distinctive histological composition.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e968-e977"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and effectiveness of a novel balloon-in-basket pulsed-field ablation catheter for the treatment of paroxysmal and persistent AF: Volt-AF IDE trial acute results","authors":"Monica Lo MD ,&nbsp;Alok Gambhir MD, PhD, FHRS ,&nbsp;Sri Sundaram MD ,&nbsp;Prashanthan Sanders MBBS, PhD, FHRS ,&nbsp;David DeLurgio MD ,&nbsp;Amar Trivedi MD ,&nbsp;Stavros Mountantonakis MD, MBA ,&nbsp;Chris Woods MD, PhD, FHRS ,&nbsp;Petr Neuzil MD ,&nbsp;Atul Verma MD ,&nbsp;Joaquin Osca MD ,&nbsp;Peter Loh MD, PhD ,&nbsp;Hugh Calkins MD ,&nbsp;David Strouse MD ,&nbsp;Gian-Battista Chierchia MD ,&nbsp;Brett Atwater MD ,&nbsp;Emily Wenzel MD ,&nbsp;Wenjiao Lin MS ,&nbsp;Amber Miller PhD ,&nbsp;Dhanunjaya Lakkireddy MD, FHRS","doi":"10.1016/j.hrthm.2025.04.037","DOIUrl":"10.1016/j.hrthm.2025.04.037","url":null,"abstract":"<div><h3>Background</h3><div>Increasing use of Pulsed Field Ablation (PFA) to treat atrial fibrillation (AF) has led to concerns related to tissue contact, hemolysis, and electroanatomic mapping integration. A novel balloon-in-basket PFA catheter offers form and function to address these concerns.</div></div><div><h3>Objective</h3><div>The VOLT-AF Investigational Device Exemption (IDE) study is a prospective, single-arm global IDE study designed to demonstrate the Volt PFA system (Abbott Laboratories, Chicago, Illinois) is safe and effective for the treatment of paroxysmal AF (PAF) and persistent AF (PersAF).</div></div><div><h3>Methods</h3><div>Symptomatic, drug-refractory PAF and PersAF subjects were enrolled for de novo ablation. Ablation strategy was pulmonary vein isolation-only using the Volt PFA catheter with EnSite X EP System integration for visualization and dynamic contact display. End points were the rate of the device- or procedure-related SAE within 7 days and acute procedural success.</div></div><div><h3>Results</h3><div>A total of 392 subjects (57 roll-in, 335 primary analysis, 51.8% PAF, 64.7% men, age 65.0 ± 11.0 years) were enrolled at 38 sites from April to September 2024. Acute isolation was observed in 99.4% of veins (666/670) in 98.2% of patients with PAF (162/165), and in 99.8% of veins (633/634) in 99.4% of patients with PersAF (154/155), with 18.5 ± 3.6 applications/patient. Primary safety endpoint events occurred in 1.9% of subjects. Procedural efficiency and acute outcomes did not differ with fluoroscopy use. Conscious or deep sedation was associated with increased procedural efficiency, with no difference in acute success compared with general anesthesia. No clinically relevant hemolysis or kidney injury was reported.</div></div><div><h3>Conclusion</h3><div>These results demonstrate the acute safety and effectiveness of a novel balloon-in-basket PFA catheter to treat paroxysmal and persistent AF. Long-term outcome follow-up is ongoing.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2524-2533"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcome of His bundle pacing with a current of injury compared with left bundle branch area pacing","authors":"Pietro Palmisano MD ,&nbsp;Maurizio Collantoni MD ,&nbsp;Salvatore Bonanno MD ,&nbsp;Marco Giuranna MD ,&nbsp;Amato Santoro MD ,&nbsp;Giuseppe Dattilo MD, PhD ,&nbsp;Pasquale Crea MD, PhD ,&nbsp;Erberto Carluccio MD ,&nbsp;Michele Accogli MD ,&nbsp;Giovanni Coluccia MD","doi":"10.1016/j.hrthm.2025.06.019","DOIUrl":"10.1016/j.hrthm.2025.06.019","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e1032-e1033"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-early catheter ablation vs drug therapy in atrial fibrillation: Results from the CABANA trial","authors":"Zhen Wang MD ,&nbsp;Mingxiao Li MD ,&nbsp;Chao Jiang MD ,&nbsp;Manlin Zhao MD ,&nbsp;Hang Guo MD ,&nbsp;Yiwei Lai MD ,&nbsp;Yufeng Wang MD ,&nbsp;Mingyang Gao MD ,&nbsp;Shijun Xia MD ,&nbsp;Liu He PhD ,&nbsp;Xueyuan Guo MD ,&nbsp;Songnan Li MD ,&nbsp;Nian Liu MD ,&nbsp;Chenxi Jiang MD ,&nbsp;Ribo Tang MD ,&nbsp;Ning Zhou MD ,&nbsp;Caihua Sang MD ,&nbsp;Deyong Long MD ,&nbsp;Xin Du MD ,&nbsp;Jianzeng Dong MD ,&nbsp;Changsheng Ma MD","doi":"10.1016/j.hrthm.2024.11.010","DOIUrl":"10.1016/j.hrthm.2024.11.010","url":null,"abstract":"<div><h3>Background</h3><div>Early rhythm control reduces the risk of cardiovascular events in patients with atrial fibrillation<span><span> (AF). Despite the superiority of catheter ablation in maintaining </span>sinus rhythm, the knowledge gaps regarding the prognostic benefits of non-early (onset of AF ≥1 year) ablation remain.</span></div></div><div><h3>Objective</h3><div>The study aimed to describe outcomes of non-early AF in the CABANA trial.</div></div><div><h3>Methods</h3><div><span>CABANA randomized AF participants to catheter ablation or drug therapy. The primary end point was a composite of death, disabling stroke, serious </span>bleeding, or cardiac arrest. Secondary end points included all-cause mortality and all-cause mortality or cardiovascular hospitalization.</div></div><div><h3>Results</h3><div>A total of 2178 patients (median age, 67 years; 810 [37.2%] female) were included, 1122 (51.5%) with non-early AF. For the primary outcome, the adjusted hazard ratio (aHR) of ablation vs drug therapy was 0.83 (95% confidence interval [CI], 0.53–1.30; <em>P</em> = .413) in non-early AF patients and 0.78 (95% CI, 0.52–1.16; <em>P</em> = .220) in early AF patients (interaction <em>P</em> value = .787). Non-early ablation resulted in a relative reduction of 26% and 23% in all-cause mortality (aHR, 0.74; 95% CI, 0.42–1.33; <em>P</em> = .314) and all-cause mortality or cardiovascular hospitalization (aHR, 0.77; 95% CI, 0.65–0.91; <em>P</em> = .002), respectively. After exclusion of patients with prior heart failure, non-early AF patients receiving ablation still had a significantly lower risk of all-cause mortality or cardiovascular hospitalization (aHR, 0.78; 95% CI, 0.65–0.93; <em>P</em> = .005).</div></div><div><h3>Conclusion</h3><div>Non-early AF patients may benefit from catheter ablation similar to early AF patients. Catheter ablation may be an effective treatment strategy to reduce the composite risk of all-cause mortality or cardiovascular hospitalization in non-early AF patients.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2534-2542"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}