Journal of Arrhythmia最新文献

{"title":"Pulsed-field ablation to isolate common inferior pulmonary veins in a patient with recurrent atrial fibrillation","authors":"Machiko Miyoshi MD, PhD,&nbsp;Kanae Hasegawa MD, PhD,&nbsp;Masato Shimada TR,&nbsp;Hiroshi Tada MD, PhD","doi":"10.1002/joa3.70058","DOIUrl":"https://doi.org/10.1002/joa3.70058","url":null,"abstract":"<p>This is the first report of a successful isolation of the common trunk of inferior pulmonary veins (PV) using pulsed-field ablation (PFA). PFA is easier and more reliable than conventional ablation methods for ablation in patients with PV anomalies and/or a small left atrium and for extensive ablation such as box isolation.\u0000 <figure>\u0000 <div><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801916","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":"Clinical impact of very high-power-short-duration catheters on biomarkers after atrial fibrillation ablation","authors":"Andrea Bernardini MD,&nbsp;Alessandro Paoletti Perini MD, PhD,&nbsp;Cristiano Salvatore Zaccaria MD,&nbsp;Davide Ciliberti MD,&nbsp;Umberto Signorini MD,&nbsp;Francesco Grossi MD,&nbsp;Raffaele Martone MD, PhD,&nbsp;Serena Fatucchi MD,&nbsp;Alenja Bertini MD,&nbsp;Anna Arretini MD,&nbsp;Lisa Innocenti MD,&nbsp;Irene Capecchi MD,&nbsp;Margherita Padeletti MD, PhD,&nbsp;Massimo Milli MD,&nbsp;Andrea Giomi MD, PhD","doi":"10.1002/joa3.70060","DOIUrl":"https://doi.org/10.1002/joa3.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Very high-power short-duration (vHPSD) catheters are associated with less irrigation fluid load than standard (STD RF) ablation catheters. However, the impact of this fluid reduction on biomarkers in pulmonary vein isolation (PVI) for atrial fibrillation (AF) remains unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Aim</h3>\u0000 \u0000 <p>Biomarkers of heart failure, myocardial injury, and systemic inflammation status as Brain Natriuretic Peptide (BNP), high-sensitivity Troponin I (hsTnI), and C-reactive protein (CRP) were collected pre- and post-procedure of PVI for symptomatic AF. The study aimed to assess the impact of vHPSD catheter compared to an STD catheter (respectively irrigation of 8 vs. 15 mL/min during ablation) on biomarker alterations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 83 consecutive patients (59 males [71.1%], mean age 62.6 ± 11 years), with vHPSD catheters used in 53 cases (63.9%). No significant baseline differences were observed between groups.Fluid irrigation resulted in significantly lower with vHPSD catheter than STD RF (434.8 ± 105.6 vs. 806.6 ± 256.5 mL, <i>p</i> &lt; .001). Correspondingly, BNP variation was significantly lower in the vHPSD group than in the STD RF group, both in absolute change (12 [IQR −9–47] pg/mL vs. 44.5 [IQR 21–88.7] pg/mL, <i>p</i> = .002) and percentage change (16.3 [IQR −13.2–108.6] % vs. 84.1 [IQR 32.5–172.1] %, <i>p</i> = .012). When considering absolute values, a statistically significant increase in BNP was found only in the STD catheter group (from 52 [IQR 35.2–113.5] to 113 [IQR 66.7–189.5] pg/mL, <i>p</i> &lt; .001), whereas no significant increase was observed in the vHPSD group (<i>p</i> = .06). CRP levels increased post-PVI in both groups, but the delta was significantly lower in the vHPSD group (<i>p</i> = .025). No significant differences in post-procedural hsTnI were detected between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The use of a vHPSD catheter is associated with reduced fluid irrigation and a correspondingly smaller increase in BNP, a biomarker indicative of fluid overload and heart failure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801915","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":"Investigation of predictive parameters for recurrence in patients undergoing electrical cardioversion for atrial fibrillation","authors":"Levent Pay MD,&nbsp;Ozan Tezen MD,&nbsp;Tuğba Çetin MD,&nbsp;Ahmet Çağdaş Yumurtaş MD,&nbsp;Kıvanç Keskin MD,&nbsp;Şeyda Dereli MD,&nbsp;Ertan Arter MD,&nbsp;Yusuf Oflu MD,&nbsp;Faysal Şaylık MD,&nbsp;Berke Cenktug Korucu MD,&nbsp;Tufan Çınar MD,&nbsp;Mert İlker Hayıroğlu MD","doi":"10.1002/joa3.70053","DOIUrl":"https://doi.org/10.1002/joa3.70053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Electrical cardioversion (ECV) is a technique used to restore sinus rhythm in atrial fibrillation (AF), aiming to reduce AF-related symptoms. Various recurrence predictors, such as non-paroxysmal pattern, prolonged duration, chronic obstructive pulmonary disease, advanced age, or left atrial dilation, have been identified. Hence, the aim of our study was to determine the parameters that could predict AF recurrence in the long term in patients who underwent ECV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred seventy-two patients who underwent electrical cardioversion due to AF at our tertiary center were included in the study. Patients with recurrent AF after cardioversion were defined as the AF recurrence (+) group, and those with normal sinus rhythm were defined as the AF recurrence (−) group. Parameters that would predict AF recurrence were investigated between these two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AF recurrence was observed in 91 patients, while 81 patients did not experience any recurrence. The prediction model, constructed using multivariate Cox regression analysis, included six variables: non- high-density lipoprotein (HDL) cholesterol, free T3, mean corpuscular volume (MCV), left atrium anterior–posterior diameter, number of cardioversions, and oral anticoagulant use. ROC curve analysis demonstrated that our prediction model effectively distinguished between patients with arrhythmia relapse and those without, with an AUC value of 0.719 (<i>p</i> &lt; .05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study revealed that AF recurrence after ECV can be predicted by our prediction model consisting of patient characteristics, disease factors, and various biochemical parameters. The current study demonstrated a statistically significant association between the number of cardioversions and non-HDL cholesterol levels in patients with recurrent AF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749349","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":"A simplified, fluoroless workflow for atrial fibrillation pulsed field electroporation","authors":"William K. Chan MD,&nbsp;Umjeet S. Jolly MD","doi":"10.1002/joa3.70057","DOIUrl":"https://doi.org/10.1002/joa3.70057","url":null,"abstract":"<p>We detail a streamlined workflow using intracardiac echocardiography that does not require internal jugular venous access, pre-procedural imaging, or additional multielectrode catheters. Overall, this may improve the efficiency and reduce the overall costs of PFA with a variable loop circular mapping catheter without necessarily compromising on efficacy or safety.\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":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749353","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":"Differential response of myocardium and His bundle to steroid therapy in a patient with cardiac sarcoidosis: A change of pacing threshold in His bundle pacing with cardiac sarcoidosis","authors":"Kenji Baba MD,&nbsp;Shogo Sakamoto MD, PhD,&nbsp;Moritoshi Irishio MD,&nbsp;Toru Kataoka MD, PhD,&nbsp;Daiju Fukuda MD, PhD","doi":"10.1002/joa3.70055","DOIUrl":"https://doi.org/10.1002/joa3.70055","url":null,"abstract":"<p>A patient with cardiac sarcoidosis who had introduced His bundle pacing and caused threshold deterioration was treated with steroid therapy, which resulted in lead threshold improvement and avoidance of lead replacement. Additionally, the thresholds of improvement with steroid therapy vary between the myocardium and His bundle in these patients.\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":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749331","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":"Radiofrequency or cryoablation or medical therapy for paroxysmal atrial fibrillation: An indirect comparison of effectiveness","authors":"Roberto Brunoro PharmD,&nbsp;Lorenzo Di Spazio PharmD,&nbsp;Melania Rivano PharmD,&nbsp;Luca Cancanelli PharmD,&nbsp;Chiara Nunzia Fasano Celentano PharmD,&nbsp;Daniele Mengato PharmD,&nbsp;Andrea Messori PharmD","doi":"10.1002/joa3.70054","DOIUrl":"https://doi.org/10.1002/joa3.70054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Paroxysmal atrial fibrillation (PAF) is commonly treated with pharmacological therapies, but these may be insufficient for symptom control. Radiofrequency and cryoballoon ablation have emerged as alternative strategies. This study aimed to compare the efficacy of cryoballoon ablation, radiofrequency ablation, and anti-arrhythmic drugs as initial therapies for symptomatic PAF based on randomized trial data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were extracted from randomized trials, and individual patient data were reconstructed from Kaplan–Meier curves using artificial intelligence techniques. Time-to-event analysis was performed to evaluate arrhythmia recurrence, with hazard ratios (HRs) as the primary measure of efficacy. A heterogeneity analysis was conducted to assess variability between studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five randomized trials were included in the analysis. Significant between-trial heterogeneity was observed. Both cryoballoon ablation (HR 0.48; 95% CI: 0.36–0.63; <i>p</i> &lt; .001) and radiofrequency ablation (HR 0.54; 95% CI: 0.37–0.80; <i>p</i> = .002) demonstrated superior efficacy compared to anti-arrhythmic drug therapy in reducing arrhythmia recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Cryoballoon and radiofrequency ablation are more effective than anti-arrhythmic drugs for initial therapy in symptomatic PAF. These findings support the use of ablation techniques as preferred interventions in this patient population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749332","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":"“A on V” tachycardia in a patient with diseased His bundle","authors":"Abhinav B. Anand DM,&nbsp;Yash Y. Lokhandwala DM","doi":"10.1002/joa3.70052","DOIUrl":"https://doi.org/10.1002/joa3.70052","url":null,"abstract":"<p>We present a case of narrow complex, near simultaneous “A on V” tachycardia in a patient with diseased His bundle (intrahisian delay:35 ms; HV: 72 ms) and describe response to adenosine, RV overdrive pacing and parahisian resetting to elucidate the tachycardia mechanism.\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":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717385","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":"Does organized atrial tachycardia after a pulmonary vein isolation-only procedure portend better outcome of repeat ablation compared to recurrent atrial fibrillation?","authors":"Tamás János Riesz MD,&nbsp;Gábor Bencsik MD, PhD,&nbsp;László Sághy MD, PhD,&nbsp;Róbert Pap MD, PhD","doi":"10.1002/joa3.70049","DOIUrl":"https://doi.org/10.1002/joa3.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Better outcome has been suggested for repeat procedures after atrial fibrillation (AF) ablation, when recurrence presented as organized atrial tachycardia (OAT) compared to recurrent AF. However, this contradicts the finding of more advanced atrial remodeling in patients with OAT recurrence and may be related to iatrogenesis by substrate modification during the index procedure. Therefore, we examined the prognostic significance of the type of recurrent arrhythmia after pulmonary vein isolation (PVI) without additional substrate modification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included 185 patients (88 female, 64 ± 9 years) undergoing repeat ablation after index PVI for recurrent OAT (24%) or AF (76%). The recurrence rate, arrhythmia-free survival time, and the type of further recurrences were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was no difference in the rate and mean time of arrhythmia-free survival between patients with OAT versus AF recurrence after the first (49% vs. 52%, <i>p</i> = .72 and 51.08 ± 6.66 vs. 53.37 ± 4.75 months, <i>p</i> = .54, respectively) and last (60% vs. 58%, <i>p</i> = .80 and 63.2 ± 7.04 vs. 61.2 ± 5.32 months, <i>p</i> = .23, respectively) redo procedure. AF occurred in the majority of subsequently recurring patients in both groups. No significant difference was found in the outcome of redo procedures between patients with typical flutter and atypical OAT, but a higher rate of successful rhythm control was observed in those with paroxysmal, as compared to persistent AF recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>After a PVI-only index procedure, recurrent OAT is not associated with a better outcome of redo procedures compared to recurrent AF. After repeat ablations, both groups experience AF as the dominant further recurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690190","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 “Impact of intracardiac pattern matching settings on the activation map of accessory pathways using open window mapping”","authors":"Yosuke Nakatani MD, PhD","doi":"10.1002/joa3.70050","DOIUrl":"https://doi.org/10.1002/joa3.70050","url":null,"abstract":"&lt;p&gt;In the case report published in the Journal of Arrhythmia,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Morioku et al. evaluated the contribution of the intracardiac pattern matching (ICPM) algorithm, integrated within the CARTO3 system (Biosense Webster Inc., Diamond Bar, CA, USA), to the accuracy of annotations in open window mapping (OWM) for atrioventricular accessory pathway (AP). They compared the frequency of misannotations under various settings: without ICPM, based solely on atrial potentials, based solely on ventricular potentials, and based on both atrial and ventricular potentials. The results showed that ICPM reduced the frequency of misannotations, particularly when both atrial and ventricular potentials were utilized, demonstrating the greatest reduction in the misannotations (frequency of misannotations: without ICPM 0.75% vs. ICPM based on atrial and ventricular potentials 0.1%).&lt;/p&gt;&lt;p&gt;Recent advancements in 3D mapping systems have enabled high-density mapping, significantly enhancing the mapping accuracy. High-density mapping addresses the challenges of localizing accessory pathways using conventional methods, which involve point-by-point mapping to identify the connection sites of the AP to the atria or ventricle, or the site where the AP potential is recorded. The accuracy of 3D mapping improves with an increase in the mapping points. However, manually annotating local electrograms with a large number of mapping points can be challenging. Therefore, automatic annotation is necessary for high-density mapping, but a misannotation to the incorrect chamber could compromise the mapping accuracy. The issue of misannotations is particularly crucial in mapping atrioventricular APs as it necessitates mapping near the valvular annulus, where misannotations of far-field potentials from the ventricle during atrial mapping or from the atria during ventricular mapping can occur. To address this problem, OWM, which sets a mapping window that includes both atrial and ventricular potentials, was devised.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Two critical premises must be met to guarantee the accuracy of the OWM. The first is that the near-field potential is correctly annotated. OWM generally uses the dV/dt value in the unipolar signal to annotate near-field potentials. To enhance the accuracy of those annotations, it is essential to eliminate the influence of far-field potentials on the recorded potentials. A dedicated mapping catheter with a small electrode size and short inter-electrode distance can be useful in eliminating the influence of far-field potentials.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; We have reported that a multispline mapping catheter with closely spaced microelectrodes (OCTARAY, Biosense Webster) is beneficial for OWM.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The second premise is that OWM is performed during the correct rhythm. Ectopic beats are frequently induced by mechanical stimulation during contact mapping, leading to misannotations. However, this problem has not","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690191","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":"A new scoring system to predict the risk of late recurrence in extended follow-up after atrial fibrillation catheter ablation: APCEL score","authors":"Taner Ulus MD,&nbsp;Ahmet Şekip Ahmadi MD,&nbsp;Ertuğrul Çolak MD","doi":"10.1002/joa3.70048","DOIUrl":"https://doi.org/10.1002/joa3.70048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In studies where risk scores used to determine the risk of late recurrence after atrial fibrillation (AF) catheter ablation were defined, significant differences were observed in terms of parameters such as post-procedural follow-up time, pre-procedural AF time, energy sources used for ablation, and cut-off values of left atrium (LA) diameter. Considering all these factors, we aimed to develop a new recurrence risk score for prolonged follow-up after AF ablation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 206 patients who underwent index AF catheter ablation for paroxysmal or persistent AF. Independent predictors of late recurrence were identified at a median follow-up of 40 months (range: 21–57), and a risk score was created. The predictive ability of this score for late recurrence was compared with that of other risk scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Independent predictors of late recurrence development included pre-ablation AF duration &gt;19 months, persistent AF, early recurrence, chronic obstructive pulmonary disease, and LA volume index &gt;31 mL/m². The APCEL risk score, derived from these factors (Early recurrence: 3 points, AF duration &gt;19 months: 2 points, others: 1 point), demonstrated good predictive performance for late recurrence at 6th [AUC: 0.940, 95% CI: 0.896–0.983], 12th [AUC: 0.865, 95% CI: 0.796–0.932], 24th [AUC: 0.814, 95% CI: 0.743–0.885], and 36th months [AUC: 0.798, 95% CI: 0.726–0.868].</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The APCEL score, calculated at the end of the blanking period for patients who underwent AF ablation, can effectively identify those at high risk of late recurrence during extended follow-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689643","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}