Journal of Arrhythmia最新文献

{"title":"Ablation at the Coronary Sinus Diverticular Neck for a Posteroseptal Accessory Pathway With Coronary Sinus Ostial Atresia","authors":"Taiki Kitahara,&nbsp;Masafumi Shimojo,&nbsp;Satoshi Yanagisawa,&nbsp;Tomomichi Suzuki,&nbsp;Yasuya Inden","doi":"10.1002/joa3.70471","DOIUrl":"10.1002/joa3.70471","url":null,"abstract":"<p>After failed annular ablation for a posteroseptal accessory pathway with coronary sinus ostial atresia, direct coronary sinus angiography delineated a coronary sinus diverticulum with left atrial drainage. Targeted mapping localized the effective ablation site to the diverticular neck, where radiofrequency delivery eliminated accessory pathway conduction.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024796","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":"Catheter Ablation Versus Medical Therapy in Atrial Fibrillation With Heart Failure With Reduced or Mildly Reduced Ejection Fraction: A GRADE-Assessed Systematic Review and Meta-Analysis","authors":"Aleena Amir Malik,&nbsp;Nasir Saeed,&nbsp;Goodluck Oparaugo,&nbsp;Muhammad Waqar Shahid,&nbsp;Waqas Kareem,&nbsp;Fatima Yousaf,&nbsp;Zain Ul Abedeen,&nbsp;Fatima Sajjad,&nbsp;Kashif Yousaf,&nbsp;Fizza Kazmi,&nbsp;Rubab Zahra,&nbsp;Ishfaq Ali,&nbsp;Sahil Kumar,&nbsp;Tanzeela Gul,&nbsp;Zartasha Rahim,&nbsp;Abdul Basit,&nbsp;Manal Sharif,&nbsp;Anum Noor,&nbsp;Habib ur Rehman,&nbsp;Imdad Ullah Shah,&nbsp;Abdullah Afridi","doi":"10.1002/joa3.70464","DOIUrl":"10.1002/joa3.70464","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Catheter ablation is an established rhythm-control strategy for atrial fibrillation (AF), but its effectiveness in patients with heart failure with reduced or mildly reduced ejection fraction (HFrEF/HFmrEF) remains incompletely defined. We performed a GRADE-assessed systematic review and meta-analysis comparing catheter ablation with conventional medical therapy in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Embase, and the Cochrane Library were searched from inception to February 2026. Randomized controlled trials and observational cohort studies enrolling adults with AF and left ventricular ejection fraction (LVEF) ≤ 50% were included. Primary outcomes were all-cause mortality, cardiovascular mortality, and change in LVEF. Secondary outcomes were change in B-type natriuretic peptide (BNP) and cardiovascular hospitalization. Random-effects models were used, and certainty of evidence was assessed using GRADE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirteen studies involving 131 492 participants were included. Catheter ablation significantly reduced all-cause mortality (RR 0.61, 95% CI 0.51–0.71) and cardiovascular mortality (RR 0.46, 95% CI 0.31–0.66), improved LVEF (MD 6.47%, 95% CI 4.47–8.47), and reduced BNP levels (MD −136.85 pg/mL, 95% CI −190.46 to −83.23). No significant reduction was observed in cardiovascular hospitalization (RR 0.78, 95% CI 0.53–1.13). Mortality benefits were consistent across subgroup analyses by study design and baseline LVEF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Catheter ablation was associated with lower mortality and improved cardiac function compared with medical therapy in patients with AF and HFrEF/HFmrEF. Further studies specifically evaluating HFmrEF populations are warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016833","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 Simple Manual Maneuver for Suspected Back-Patch-Related Positional Alerts During Pulsed Field Ablation","authors":"Saki Yamano,&nbsp;Tetsuma Kawaji,&nbsp;Misaki Naka,&nbsp;Ryuta Ishida,&nbsp;Masaya Kitamori,&nbsp;Masashi Kato,&nbsp;Takafumi Yokomatsu,&nbsp;Shinji Miki","doi":"10.1002/joa3.70470","DOIUrl":"10.1002/joa3.70470","url":null,"abstract":"<p>Summary of the manual counter-traction maneuver for suspected back-patch-related positional alerts during PFA. Cough-related body movement caused suspected cranial-side back-patch displacement and triggered CARTO positional alerts. Light cranial skin counter-traction was applied opposite to the apparent patch-shift direction without direct contact with the patch. Among 23 alert episodes, 22 were resolved, with a median correction time of 1.62 s and a median measured displacement of 11.69 mm. Pre- and post-alert anatomical maps showed no gross mismatch on visual comparison, although small localization errors cannot be excluded.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024849","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":"Unexpected Right Atrial Crossing of the Sphere-9 Catheter Despite Stable Left Atrial Sheath Position","authors":"Takeru Ikenaga,&nbsp;Masatsugu Nozoe,&nbsp;Takanori Watanabe,&nbsp;Hiroshi Mannoji,&nbsp;Toru Kubota","doi":"10.1002/joa3.70462","DOIUrl":"10.1002/joa3.70462","url":null,"abstract":"<p>The Sphere-9 catheter unexpectedly crossed into the right atrium despite stable left atrial sheath position. A perpendicular, sheath-supported approach may have facilitated passage of the flexible lattice tip through a small interatrial communication while the sheath remained within the left atrium.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024896","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":"Hemoglobin Levels as a Marker of Arrhythmia Recurrence After Atrial Fibrillation Ablation","authors":"Yasuharu Matsunaga-Lee,&nbsp;Yasuyuki Egami,&nbsp;Ayako Sugino,&nbsp;Noriyuki Kobayashi,&nbsp;Masaru Abe,&nbsp;Hiroaki Nohara,&nbsp;Shodai Kawanami,&nbsp;Koji Yasumoto,&nbsp;Naotaka Okamoto,&nbsp;Masamichi Yano,&nbsp;Masami Nishino","doi":"10.1002/joa3.70473","DOIUrl":"10.1002/joa3.70473","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Low hemoglobin (Hb) is associated with hemodynamic stress and adverse cardiac remodeling. However, its clinical significance for arrhythmia recurrence after atrial fibrillation (AF) ablation remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively studied 2202 patients undergoing AF ablation between 2014 and 2024 (radiofrequency ablation [RFA]: <i>n</i> = 1606; cryoballoon ablation [CBA]: <i>n</i> = 596). In the RFA cohort, patients were stratified by Hb quartiles, and the lowest quartile cut-off (Hb &lt; 12.4 g/dL) was applied to the CBA cohort. The primary endpoint was AF or atrial tachycardia recurrence beyond a 90-day blanking period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the RFA cohort, low Hb was associated with a higher risk of arrhythmia recurrence after the index procedure (adjusted HR 1.33, 95% CI 1.07–1.65) and after multiple procedures (adjusted HR 1.57, 95% CI 1.22–2.02). No significant association was observed in the CBA cohort (adjusted HR 1.03, 95% CI 0.68–1.54). The interaction between Hb level and ablation modality was not statistically significant (<i>p</i> for interaction = 0.177). In the pooled analysis, low Hb was independently associated with arrhythmia recurrence in the total population (adjusted HR 1.24, 95% CI 1.03–1.50) and in patients with non-paroxysmal AF (adjusted HR 1.43, 95% CI 1.11–1.85), but not in those with paroxysmal AF (adjusted HR 1.06, 95% CI 0.80–1.39).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Lower Hb levels were associated with an increased risk of arrhythmia recurrence. The association differed according to AF type, suggesting that low Hb may reflect an adverse atrial substrate rather than a procedural effect.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024883","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":"High-Density Spectral Analysis for Bi-Atrial Arrhythmogenic Substrate During Non-Paroxysmal Atrial Fibrillation","authors":"Nobunari Tomura,&nbsp;Keitaro Senoo,&nbsp;Taku Ohkawa,&nbsp;Yusuke Kakei,&nbsp;Kohei Kawai,&nbsp;Masahiro Makino,&nbsp;Jun Munakata,&nbsp;Tomonori Miki,&nbsp;Yukinori Kato,&nbsp;Kento Fukui,&nbsp;Hiroki Kitajima,&nbsp;Suguru Nishiuchi,&nbsp;Ken Kakita,&nbsp;Daisuke Sato,&nbsp;Hirokazu Shiraishi,&nbsp;Satoaki Matoba","doi":"10.1002/joa3.70477","DOIUrl":"10.1002/joa3.70477","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Spectral analysis has been utilized to identify localized sites exhibiting high dominant frequency (DF) and high regularity—the critical arrhythmogenic substrate driving atrial fibrillation (AF). This study aimed to elucidate the spectral characteristics of focal activation (FoA) and rotational activation (RoA) sites during AF using a high-density mapping system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>CARTOFINDER mapping was prospectively performed in both atria of 47 consecutive non-paroxysmal AF patients using the Octaray catheter prior to ablation. Endocardial unipolar electrograms were exported offline for spectral analysis of DF and the regularity index (RI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CARTOFINDER assessed a total of 48 153 mapping points. Given substantial inter-subject variability in mean DF, the difference between each point's DF and the subject-level mean DF was defined as the dominant frequency deviation (DFD). The left atrium (LA) demonstrated significantly higher DFD and RI than the right atrium (both <i>p</i> &lt; 0.001), with the LA roof recording the highest values across all segments. Both FoA and RoA sites exhibited significantly higher DFD and RI compared with sites without FoA and RoA (both <i>p</i> &lt; 0.001). DFD and RI increased progressively with increasing FoA repetitions (both <i>p</i> &lt; 0.001). In contrast, high-repetition RoA sites (&gt; 16 repetitions) showed a significantly higher RI (0.42 ± 0.13 vs. 0.36 ± 0.12, <i>p</i> &lt; 0.001) but a paradoxically lower DFD (0.14 ± 0.64 Hz vs. 0.26 ± 0.74 Hz, <i>p</i> &lt; 0.001) compared with low-repetition RoA sites.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The combination of CARTOFINDER mapping and spectral analysis may contribute to the mechanistic understanding of non-paroxysmal AF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016909","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 Characteristics and Timing of Accessory Pathway Reconduction During Catheter Ablation of Accessory Pathways","authors":"Wataru Sasaki,&nbsp;Hitoshi Mori,&nbsp;Daisuke Kawano,&nbsp;Kei Matsumoto,&nbsp;Naomichi Tanaka,&nbsp;Tsukasa Naganuma,&nbsp;Masataka Narita,&nbsp;Kazuhisa Matsumoto,&nbsp;Yoshifumi Ikeda,&nbsp;Takahide Arai,&nbsp;Shintaro Nakano,&nbsp;Ritsushi Kato","doi":"10.1002/joa3.70469","DOIUrl":"https://doi.org/10.1002/joa3.70469","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Catheter ablation of accessory pathways has high acute success rates; however, accessory pathway (AP) recurrence remains a clinically relevant issue. Although intra-procedural AP reconduction is frequently encountered during ablation procedures, its timing, predictors, and clinical significance remain insufficiently characterized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to investigate the timing, electrophysiologic characteristics, and clinical implications of intra-procedural AP reconduction during catheter ablation of manifest and concealed accessory pathways.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 128 patients with manifest or concealed AP who underwent catheter ablation at our institution between May 28, 2015, and February 2025. Details of cases in which AP reconduction was observed during the 30 min waiting period after successful ablation, including clinical and procedural characteristics, were compared with those of patients without reconduction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Intra-procedural AP reconduction occurred in 23 patients (18.0%). The mean time to reconduction was 16.7 ± 7.0 min, with a maximum interval of 27 min. Compared with patients without reconduction, those with reconduction had a significantly longer time to pathway interruption, more frequent broad or oblique APs, and more complex procedural approaches requiring multiple anatomical access routes. Intra-procedural reconduction was also associated with subsequent late recurrence. Fifteen of 23 events (65.2%) occurred ≥ 15 min after AP elimination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Intra-procedural AP reconduction during catheter ablation of accessory pathways is not uncommon and appears to be associated with specific electrophysiologic and procedural characteristics as well as late recurrence. These findings may facilitate identification of patients at higher risk of reconduction and help guide intra-procedural assessment during catheter ablation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70469","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994340","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":"Permanent Cardiac Pacing in Children: A 30-Year Follow-Up Retrospective Study in a Single Pediatric Asian Center","authors":"Jiahui Charmaine Chan,&nbsp;Dyan Zhewei Zhang,&nbsp;Koh Zhi Xuan,&nbsp;Sreekanthan Sundararaghavan,&nbsp;Jonathan Tze Liang Choo,&nbsp;Kah Leng Ho,&nbsp;Eric Tien Siang Lim,&nbsp;Ju Le Tan,&nbsp;Nurhafizah Binte Abdul Aziz,&nbsp;Wan Ting Chan,&nbsp;Monika Kotecha,&nbsp;Jan Hau Lee,&nbsp;Teng Hong Tan","doi":"10.1002/joa3.70459","DOIUrl":"https://doi.org/10.1002/joa3.70459","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Permanent cardiac pacing in children is commonly indicated in high-grade atrioventricular block. These patients require long-term ventricular pacing (Vp), multiple device changes, and lead revisions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To describe a single pediatric center's 30-year experience with permanent pacemaker implantation, focusing on long-term device-associated complications (DACs) and pacing-induced cardiomyopathy (PIC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective observational study at KK Women's and Children's Hospital, Singapore. Patients with permanent pacemakers followed between January 1, 1994 and December 31, 2024 were included. Primary outcomes were DAC and PIC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-three patients underwent 113 pacemaker lead implantations; 51 (96.2%) had epicardial systems. Median follow-up was 12 years (interquartile range [IQR] 9–19 years). Median age at first pacemaker implantation was 16 months (IQR 2 months to 7.7 years). Congenital complete heart block was the most common indication (26 [49%]), followed by postoperative complete heart block (17 [32%]). Freedom from lead-associated complications was 85% and 83% at 5 and 10 years, respectively. Eight (15%) patients developed PIC. All patients with PIC had concomitant congenital heart disease (CHD) (8/8). CHD was present in 28.9% (13/45) of patients without PIC. Recovery of ventricular function occurred in two patients following pacing modification, but not in those managed with medical therapy alone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this pediatric cohort with predominantly epicardial pacing systems, long-term DAC rates were acceptable. PIC occurred primarily in patients with CHD. These findings support careful pacing strategy selection and long-term surveillance in children requiring permanent pacing.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70459","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994341","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":"Association Between the Change in Interleukin-6 Levels and Early Recurrence of Atrial Fibrillation: A Comparison of Pulsed Field Ablation and Radiofrequency Ablation","authors":"Ken Watanabe,&nbsp;Takanori Arimoto,&nbsp;Mashu Toyoshima,&nbsp;Kyoko Koyama,&nbsp;Yuta Kobayashi,&nbsp;Naoaki Hashimoto,&nbsp;Masafumi Watanabe","doi":"10.1002/joa3.70456","DOIUrl":"https://doi.org/10.1002/joa3.70456","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Early recurrence of atrial fibrillation (ERAF) within the 3-month blanking period is associated with procedural inflammation and increased risk of late recurrence. Pulsed field ablation (PFA) reportedly has a lower ERAF rate than radiofrequency ablation (RFA), but the underlying inflammatory mechanisms remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We compared 23 patients undergoing atrial fibrillation ablation (PFA: <i>n</i> = 16; RFA: <i>n</i> = 7). Perioperative changes in inflammatory markers, myocardial injury markers, hemolysis markers, and the incidence of ERAF were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PFA exhibited significantly greater myocardial injury and hemolysis, but markedly lower systemic inflammation than RFA, characterized by lower Δinterleukin-6 (IL-6) levels (4.6 ± 1.7 vs. 8.1 ± 3.8 pg/mL, <i>p</i> = 0.008). ERAF occurred more frequently in RFA (3/7, 43% vs. 1/16, 6%, <i>p</i> = 0.033), which was accompanied by significantly higher ΔIL-6 levels (9.1 ± 4.2 vs. 4.9 ± 2.3 pg/mL, <i>p</i> = 0.010). Multivariate logistic regression analysis identified ΔIL-6 as an independent predictor of ERAF (OR 2.158, 95% CI 1.125–13.020, <i>p</i> = 0.013).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PFA induces less systemic inflammation than RFA, despite causing greater myocardial injury. This reduced inflammatory response is independently associated with the lower incidence of ERAF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70456","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994552","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":"Successful Extensive Pulsed Field Ablation for Atrial Fibrillation Without Leadless Pacemaker Interference","authors":"Gen Matsuura,&nbsp;Hidehira Fukaya,&nbsp;Tomoharu Yoshizawa,&nbsp;Atsuhiko Sugimoto,&nbsp;Junya Ako","doi":"10.1002/joa3.70457","DOIUrl":"10.1002/joa3.70457","url":null,"abstract":"<p>Although Pulsed field ablation (PFA) has demonstrated efficacy for atrial fibrillation, its safety in patients with leadless pacemaker remains uncertain. This case suggests that extensive PFA involving persistent left superior vena cava, superior vena cava, and left atrial posterior wall can be safely performed without device interference.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990067","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}