Journal of Arrhythmia最新文献

{"title":"Snare technique is useful for leadless pacemaker implantation in a patient with severe right atrial dilatation","authors":"Kosuke Hirose MD,&nbsp;Tomoki Fukui MD,&nbsp;Miwa Miyoshi MD, PhD,&nbsp;Nobuyuki Ogasawara MD","doi":"10.1002/joa3.70075","DOIUrl":"https://doi.org/10.1002/joa3.70075","url":null,"abstract":"<p>Leadless pacemaker implantation in a patient with severe right atrium dilation was unsuccessful using the conventional approach. The delivery system failed to gain sufficient backup force from the atrial wall and moved upward within the dilated atrium. To overcome this, the snare technique was employed. By securing the slightly distal portion of the top of the shaft curve, the pushing force was effectively transmitted to the tip of the system, creating a stable gooseneck shape for successful implantation.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical evaluation of ECG parameter analysis in hypertrophic cardiomyopathy staging: A closer look","authors":"Brijesh Sathian PhD,&nbsp;Hanadi Al Hamad MD","doi":"10.1002/joa3.70074","DOIUrl":"https://doi.org/10.1002/joa3.70074","url":null,"abstract":"&lt;p&gt;We commend the authors for their comprehensive study, &lt;i&gt;“Electrocardiographic Parameter Profiles for Differentiating Hypertrophic Cardiomyopathy Stages”&lt;/i&gt; (Hirota et al.) in the &lt;i&gt;Journal of Arrhythmia&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; While the study provides valuable insights into ECG parameter variations across various stages of hypertrophic cardiomyopathy (HCM), we believe that some aspects of the study's design and interpretation require further examination. Below are several critical points that challenge the findings or methodological choices presented in the article.&lt;/p&gt;&lt;p&gt;Hirota et al. attempt to define a set of ECG parameters that can differentiate HCM from its dilated phase (dHCM), yet they fail to account for the well-established heterogeneity of ECG manifestations across HCM subtypes. For example, in HCM-apical cases, T-wave inversions are often observed, whereas dHCM cases may present more subtle ECG changes because of the progression of left ventricular dysfunction. A study by Hughes et al. emphasizes that distinct ECG abnormality patterns are typically seen in the apical variant compared to the basal form.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; The authors' grouping of all HCM types may lead to overlooking crucial features that could impact differential diagnosis. A more subtype-specific analysis would provide clearer, actionable insights for clinicians.&lt;/p&gt;&lt;p&gt;While the authors rely on AI-enhanced ECG analysis, they do not adequately discuss inter-observer variability, which is a known issue in ECG interpretation. AI models, while promising, can be susceptible to errors in clinical environments where interpretations by multiple clinicians may vary. A study by Sharma et al. shows that ECG interpretation in HCM is highly dependent on the experience of the practitioner, with significant inter-observer variability leading to inconsistent results.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Although AI can help mitigate some of these issues, the authors' study does not sufficiently address the limitations of their model in handling such clinical variability or the real-world challenges of using AI models across different healthcare settings.&lt;/p&gt;&lt;p&gt;The study overlooks the fact that coexisting conditions, such as hypertension, atrial fibrillation, and diabetes, which are prevalent in patients with HCM, can significantly influence ECG readings. For example, left ventricular hypertrophy because of hypertension may present similarly to HCM on an ECG, particularly in terms of QRS complex alterations, but these conditions require different management strategies. Hwang et al. and Mekhaimar et al. argue that failure to account for such comorbidities in diagnostic models for HCM can lead to incorrect classification, reducing diagnostic accuracy.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; The absence of adjustment for these confounding factors in the authors' analysis diminishes the clinical applicability and external validity of their findings.&lt;/p&gt;&lt;p&gt;In conclusion, while Hirota et al.'s st","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylactic implantation of cardioverter-defibrillator in patients with advanced light-chain amyloidosis—A pilot study","authors":"Hui-Qiang Wei MD,&nbsp;Jinghua Wang MD,&nbsp;Yuanhong Liang MD,&nbsp;Shuang Xia MD,&nbsp;Liwen Li MD,&nbsp;Liye Zhong MD","doi":"10.1002/joa3.70068","DOIUrl":"https://doi.org/10.1002/joa3.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ventricular arrhythmias (VAs) and electromechanical dissociation have been observed as the most common causes of sudden cardiac death (SCD) in patients with light chain (AL) amyloidosis. However, an implantable cardioverter-defibrillator (ICD) has rarely been implanted in patients with advanced AL amyloidosis due to very poor prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between July 2021 and December 2022, 10 patients with advanced cardiac AL amyloidosis referred to our institute who received prophylactic ICD implantation were prospectively recruited. The primary endpoint was the prevalence of VAs and appropriate ICD therapies determined by ICD interrogation. The secondary endpoint was all-cause mortality during the follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a mean follow-up of 12.1 ± 4.4 months, sustained ventricular tachycardia (VT)/ventricular fibrillation (VF) occurred in 4 of 10 (40%) patients. One patient had spontaneous termination of VT before the delivery of ICD therapy, and the remaining 3 patients had ICD therapies used, either ATP or shock. Inappropriate shock was not recorded in any patients. Patients with sustained VT/VF had wider QRS duration (143 ± 41 vs. 99 ± 10 ms, <i>p</i> = 0.03) and a higher incidence of bundle branch block (BBB)/interventricular conduction delay (IVCD) (75% vs. 0%, <i>p</i> = 0.01) compared to those without.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>VAs are commonly observed among patients with advanced AL amyloidosis, and ICD therapy can be effective in successfully treating sustained VA in these patients. On the basis of our preliminary data, prophylactic ICD implantation may be proposed to the advanced AL amyloidosis to improve the survival rate in selected patients with advanced AL amyloidosis, especially for the patients with wider QRS duration and BBB/IVCD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary hypertension and outcomes following left atrial appendage occlusion device placement for atrial fibrillation: A population-based analysis","authors":"Nadhem Abdallah MD,&nbsp;Momen Alsayed MBBS","doi":"10.1002/joa3.70071","DOIUrl":"https://doi.org/10.1002/joa3.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pulmonary hypertension (PH) is linked to poor outcomes in cardiac procedures, but data on left atrial appendage occlusion device (LAAOD) placement are limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the 2016–2020 Nationwide Readmission Database, we compared in-hospital outcomes between AF patients with and without PH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 48,692 AF-LAAOD patients, 5.9% had PH. PH was associated with higher mortality, prolonged ventilation, AKI, vasopressor use, interatrial septum repair, LOS, and costs. No differences were found in the odds of readmissions, major bleeding events, vascular complications, stroke, or cardiac arrest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PH in AF-LAAOD patients is associated with higher fatal and nonfatal adverse outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial experiences and technical insights of pulmonary vein isolation with FARAPULSE pulsed field ablation in patients implanted with WATCHMAN left atrial appendage closure devices: The first report in Japan","authors":"Ryuki Chatani MD,&nbsp;Hiroshi Tasaka MD,&nbsp;Shunsuke Kubo MD,&nbsp;Mitsuru Yoshino MD,&nbsp;Kazushige Kadota MD, PhD","doi":"10.1002/joa3.70065","DOIUrl":"https://doi.org/10.1002/joa3.70065","url":null,"abstract":"<p>We performed pulsed field ablation using FARAPULSE after left atrial appendage closure (LAAC). We should confirm flower configurations did not overlap with the LAAC device using intracardiac echocardiography and 3-D mapping system and without LAAC device artifacts by real-time electrograms. If overlapping, push the flower configuration deeper and tilt posteriorly to resolve.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial to “Efficacy of an alternative positioning of intracardiac defibrillation catheters in atrial fibrillation ablation”","authors":"Hideharu Okamatsu MD,&nbsp;Ken Okumura MD","doi":"10.1002/joa3.70066","DOIUrl":"https://doi.org/10.1002/joa3.70066","url":null,"abstract":"&lt;p&gt;Atrial fibrillation (AF) is the most prevalent atrial arrhythmia in developed countries. With the increase in the aging population, the number of patients with AF has been increasing. Catheter ablation has become a widely used treatment for AF, with pulmonary vein (PV) isolation (PVI) being the standard approach. As the technologies of ablation advance, complete PVI can be achieved within a shorter procedure time. In radiofrequency catheter ablation, lesion size markers incorporating contact force, radiofrequency application power, and radiofrequency application time enable the operator to create PVI lesions efficiently. Cryoballoon ablation is another technology that allows PVI more easily. Pulsed-field ablation is a new technology that accomplishes PVI without causing collateral organ damage and PV stenosis. With the progress of these ablation technologies, many operators have streamlined the procedure workflow to reduce procedure time and minimize procedure-related complications. Internal jugular vein puncture has been performed to advance the electrode catheter into the coronary sinus (CS) to evaluate the anatomy of the CS, record the left atrial and CS potentials, and perform cardioversion to convert AF to sinus rhythm with the use of specific intracardiac defibrillation catheters (ICDC). However, with the advancement of ablation technologies, some operators insert the electrode catheter into the CS via the femoral vein and inferior vena cava (IVC) instead of the internal jugular vein and superior vena cava (SVC) to avoid internal jugular vein puncture, which has some risk of complications, including vascular injury, hematoma, and pneumothorax, and simplify the workflow. BeeAT via IVC approach (Japan Lifeline, Tokyo) is an ICDC designed to insert the electrode catheter into the CS via the IVC. In performing cardioversion, the operator is recommended to insert the distal part of electrodes in the CS and locate the proximal part in the right atrium (RA), forming an alpha-loop configuration (CS/RA configuration). The operator sometimes needs to insert the distal part into the CS deeply to position the proximal part in the RA. However, inserting the distal part deeply into the CS to make an alpha-loop configuration is difficult in some patients because of variations in the location and configuration of the CS ostium. Moreover, unintentional insertion of the distal part of electrodes into the branch of the CS may result in venous perforation and cardiac tamponade. Thus, placement of the ICDC in the CS and RA is sometimes challenging and time-consuming, needs extra fluoroscopy, and causes a risk of CS perforation.&lt;/p&gt;&lt;p&gt;Ohashi et al. studied the efficacy of the new ICDC configuration in performing cardioversion by evaluating 81 patients undergoing cardioversion with ICDC during the AF ablation procedure.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; They initially evaluated the ICDC configuration, inserting the distal part of electrodes in CS and locating the proxi","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143830976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repolarization time map in catheter ablation for scar-related reentrant ventricular tachycardia","authors":"Naoya Kataoka MD, PhD,&nbsp;Teruhiko Imamura MD, PhD, FESC, FAHA, FACC, FHFSA, FAPSC, FACP, FJCS, FJCC, FJSH,&nbsp;Takahisa Koi MD, PhD,&nbsp;Keisuke Uchida MD,&nbsp;Koichiro Kinugawa MD, PhD","doi":"10.1002/joa3.70070","DOIUrl":"https://doi.org/10.1002/joa3.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ventricular tachycardias (VTs) associated with scar tissue involve reentry mechanisms influenced by both conduction abnormalities and repolarization heterogeneity. However, existing mapping techniques have predominantly focused on conduction delay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study analyzed 33 consecutive cases of catheter ablation for sustained VT. The EnSite system was employed to measure repolarization time (RT) with a high-pass filter setting of 0.05 Hz. We compared the characteristics and concordance rates of short RT areas, defined as white or red-colored regions, with those identified through conventional mappings in relation to ablation targets. These short RT areas were defined based on the longest interval from the QRS onset to the maximal <i>dV</i>/<i>dt</i> point of unipolar potentials, which was divided into eight equal segments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 31 VTs across 26 cases, we found that 18 (58%) of the identified ablation targets corresponded to deceleration zones (DZs). Of them, 16 (89%) also overlapped with areas of short RTs. Notably, among the remaining 13 VTs without ablation targets corresponding to DZs, 9 (69%) had ablation targets located in areas with short RTs. The distribution analysis revealed that 84% of short RT regions were located near the exit site, whereas 75% of DZs were situated near the entrance site. The distance between the two was 16 mm (interquartile range: 6.5–27.5 mm).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study underscored the potential of RT mapping in identifying ablation targets in scar-related VTs. Incorporating both repolarization heterogeneity and conduction delay could significantly enhance the understanding of the intricate circuits involved in these arrhythmias.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manifest type B Wolff-Parkinson-White syndrome complicated with slow/fast atrioventricular nodal reentrant tachycardia: A case report","authors":"Daiki Yamashita MD,&nbsp;Yoshihiko Kagawa MD, PhD,&nbsp;Shinichi Harada MD,&nbsp;Fumiya Uchida BHS,&nbsp;Kaoru Dohi MD, PhD","doi":"10.1002/joa3.70069","DOIUrl":"https://doi.org/10.1002/joa3.70069","url":null,"abstract":"<p>The unstable left-sided AP was a bystander in AVRT via the right-sided AP, and the right-sided AP was a bystander in AVNRT in this case. Interestingly, the right-sided AP was either part of the circuit or a bystander.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to assess clinical implication of catheter ablation for ventricular tachycardia in patients with structural heart diseases","authors":"Sayaka Matsumoto,&nbsp;Naoya Kataoka MD, PhD,&nbsp;Teruhiko Imamura MD, PhD","doi":"10.1002/joa3.70064","DOIUrl":"https://doi.org/10.1002/joa3.70064","url":null,"abstract":"<p>Catheter ablation for ventricular tachycardia (VT) in patients with structural heart disease has increasingly become prevalent, primarily due to advancements in functional substrate mapping techniques. However, clinicians have expressed concern regarding potential procedure-related declines in cardiac function consequent to myocardial injury. The authors demonstrated that left ventricular ejection fraction (LVEF) remained preserved in the majority of patients postablation<span>¹</span>; nonetheless, several pertinent issues warrant consideration.</p><p>The PAINESD score serves as a valuable tool for stratifying the risk of ablation-related complications, including deterioration of cardiac function and the development of heart failure, with an LVEF of less than 25% constituting one of the key criteria.<span>²</span> In the current study, nearly half of the subjects exhibited preserved LVEF at baseline.<span>¹</span> Consequently, any minor procedural reductions in LVEF might exert minimal clinical significance within this specific subgroup. Refining their findings by excluding patients with preserved LVEF could potentially enhance the interpretability and applicability of the outcomes.</p><p>Numerous participants received comprehensive pharmacotherapy, commonly referred to as the “fantastic four” regimen.<span>¹</span> Approximately half of the participants presented with preserved LVEF. However, robust evidence supporting the necessity and efficacy of these medications in this particular population remains limited.<span>³</span> Notably, the present study identified the administration of renin-angiotensin system inhibitors as a risk factor associated with reduced cardiac function following ablation. Baseline LVEF levels may represent a confounding variable influencing this observation.</p><p>The clinical significance of observed improvements in LVEF among patients already exhibiting preserved ejection fraction remains ambiguous. Evaluating the reduction in low-voltage myocardial areas during postablation follow-up could provide critical insights into the genuine impact of catheter ablation procedures in this subset of patients.</p><p>Finally, delineating the optimal area for ablation remains a significant technical challenge. Recent literature indicates the length of VT isthmus averages approximately 17 mm,<span>⁴</span> typically necessitating only four to five ablation lesions using standard radiofrequency catheters. Such minimally invasive catheter ablation techniques theoretically minimize detrimental effects on cardiac function. Future research endeavors should focus on advancing mapping methodologies to precisely define optimal ablation targets, thereby potentially mitigating adverse effects on cardiac function.<span>⁵</span></p><p>Authors declare no conflict of interests for this article.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indirect epicardial targeting of left atrial tachycardia using Bachmann's bundle: A case report of successful ablation from pulmonary artery","authors":"Yakup Yunus Yamanturk MD,&nbsp;Muhammed Emin Teker MD,&nbsp;Emre Ozerdem MD,&nbsp;Ahmet Lutfi Sertdemir MD,&nbsp;Basar Candemir","doi":"10.1002/joa3.70056","DOIUrl":"https://doi.org/10.1002/joa3.70056","url":null,"abstract":"<p>Successful rhythm control by standard endocardial methods may become quite challenging in some atrial tachycardia cases, very few of which may need extraordinarily different approaches after the initial failure of extensive endocardial ablation, such as epicardial ablation after subxiphoid puncture, or venous alcohol injection inside the vein of Marshall. With a good understanding of the structures nearby the LA, endocardially failed epicardial ATs can still be successfully ablated without directly entering the pericardial space.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}