Journal of Cardiovascular Electrophysiology最新文献

{"title":"Fluoroscopy Integration Module Enhanced Localization of Intramural Premature Ventricular Complex in Ethanol Ablation.","authors":"Oguzhan Ekrem Turan, Resit Yigit Yilancioglu, Umut Inevi, Emin Evren Ozcan","doi":"10.1111/jce.70132","DOIUrl":"https://doi.org/10.1111/jce.70132","url":null,"abstract":"<p><strong>Aims: </strong>The Fluoroscopy Integration Module (FIM) is a novel feature in electroanatomic mapping systems that enhances real-time visualization of coronary venous anatomy during mapping and ablation of intramural premature ventricular complexes (PVCs). This report demonstrates the clinical utility of FIM in guiding side branch vein selection and precise ethanol ablation targeting for intramural PVCs.</p><p><strong>Methods and results: </strong>The target venous branch was selected under FIM guidance in patients with intramural PVCs where RF ablation failed. Ethanol was applied to the venous branch extending to the center of the intersection of ablation tags or early activation areas where transient suppression occurred.</p><p><strong>Conclusion: </strong>The fluoroscopy integration module significantly improves procedural precision in targeting intramural PVCs, facilitating effective ethanol ablation and optimizing clinical success.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of a Cryo-Anchoring Catheter for Linear Ablation.","authors":"Jaspal Singh Gill, Viral Sagar, Lisa Leung, Zaki Akhtar, Zia Zuberi, Mark M Gallagher","doi":"10.1111/jce.70131","DOIUrl":"https://doi.org/10.1111/jce.70131","url":null,"abstract":"<p><strong>Background: </strong>Linear ablation lesions are used in multiple ablation strategies including left atrial roof lines, and mitral and tricuspid isthmus lines. A continuous and transmural line is mandatory for effective lesions. A proposed catheter employs cryo-anchoring: the tip initially freezes to adhere to the tissue, permitting the shaft of the catheter to be applied firmly against tissue to create linear lesions.</p><p><strong>Methods: </strong>Ex vivo tests were performed in a 35°C water bath on turkey skeletal muscle, lamb, and porcine myocardial tissue. The experimental setup allowed the quantification of force exerted from the catheter onto the tissue with bidirectional strain-gauge measurement. Five protocols evaluated: force for tissue or equipment failure during traction, consistency experiments to evaluate the safe level of traction, force for tissue failure in forward pressure, contact force effect on time to transmural lesion, and contact force effect on lesion depth.</p><p><strong>Results: </strong>Tissue failure in traction occurred at the lowest force of 3.9 kg. This occurred at the ventricular apex of a lamb heart, whereas atrial samples tolerated > 10 kg of force before failure. Correlations between force, lesion thickness, and time to the formation of a transmural lesion were observed. Lesions of 3-4 mm depth occurred at 45 g forward pressure with 60 s lesions. The time required to attain this depth fell to 20 s with forces over 200 g.</p><p><strong>Conclusion: </strong>There is a broad safety margin between the force required to enhance lesion formation during cryotherapy and the force that can disrupt tissue, both for traction and forward pressure.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The First Cut Is the Deepest? Reimbursement Reductions Impact on Atrial Fibrillation Management.","authors":"Rohit Malhotra","doi":"10.1111/jce.70130","DOIUrl":"https://doi.org/10.1111/jce.70130","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lesion Depth Optimization in High-Power Radiofrequency Ablation: Evaluating Single High-Power and Combined Very High-Power Applications.","authors":"Hidehiro Iwakawa, Masateru Takigawa, Ryosuke Kato, Junji Yamaguchi, Masaki Honda, Ryo Tateishi, Miho Negishi, Iwanari Kawamura, Kentaro Goto, Takuro Nishimura, Kazuya Yamao, Susumu Tao, Sayaka Suzuki, Takehiro Iwanaga, Shinsuke Miyazaki, Hiroyuki Watanabe, Tetsuo Sasano","doi":"10.1111/jce.70125","DOIUrl":"https://doi.org/10.1111/jce.70125","url":null,"abstract":"<p><strong>Background: </strong>A very high-power short-duration (vHPSD) radiofrequency (RF) ablation creates shallower lesions, which may be insufficient in thick myocardial regions.</p><p><strong>Aims: </strong>To clarify an effective ablation strategy following the initial vHPSD application and determine the best approach to create sufficient lesion depth in thick myocardial regions using ex vivo and in vivo models.</p><p><strong>Methods: </strong>Lesion metrics were compared under various settings: 35 W versus 50 W with the same target ablation index (AI) (Step 1); double vHPSD ablations versus vHPSD followed by AI-guided ablation (Step 2); double applications (DA) with vHPSD followed by AI-guided ablation with a target AI of 450 versus single application (SA) with a target AI of 550 at 50 W (Step 3).</p><p><strong>Results: </strong>Lesion depth was comparable between groups with the same AI but different RF powers. Lesions were significantly deeper in the vHPSD ablation followed by a target AI of 450 compared to double vHPSD ablations (vHPSD + vHPSD, 3.4 [3.1-3.6] mm; vHPSD + AI 450 at 35 W, 4.4 [4.1-4.9] mm; vHPSD + AI 450 at 50 W, 4.5 [4.1-4.9] mm, p < 0.001). High-power SA with a target AI of 550 created significantly deeper lesions than vHPSD + AI 450 (DA vs. SA, 4.5 [3.5-5.3] mm vs. 5.0 [4.1-5.9] mm, p = 0.01).</p><p><strong>Conclusions: </strong>AI-guided RF applications following vHPSD effectively increased lesion depth more than repeated vHPSD. However, a single high-power application targeting a higher AI resulted in the deepest lesions. This strategy may be particularly beneficial in thick atrial myocardial regions to enhance lesion durability and improve procedural outcomes.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Interatrial Septal Adipose Tissue Volume and Attenuation in Predicting Atrial Tachyarrhythmias Recurrence Following Catheter Ablation.","authors":"Shinichi Tachibana, Osamu Inaba, Yukihiro Inamura, Takamitsu Takagi, Kentaro Nakata, Yuhei Isonaga, Hiroaki Ohya, Yutaka Matsumura, Shinsuke Miyazaki, Tetsuo Sasano","doi":"10.1111/jce.70124","DOIUrl":"https://doi.org/10.1111/jce.70124","url":null,"abstract":"<p><strong>Background: </strong>Left atrial epicardial adipose tissue (LA-EAT) is associated with atrial tachyarrhythmia (AF/AT) recurrence following atrial fibrillation (AF) ablation, of which we recently reported interatrial septal adipose tissue (IAS-AT) has a higher predictive value. This study evaluated the predictive value of IAS-AT volume/attenuation for AF/AT recurrence and compared it with that of other LA-EAT segments.</p><p><strong>Methods: </strong>Preoperative multidetector computed tomography (CT) was performed on 350 consecutive patients undergoing initial AF ablation. LA-EAT was defined as tissue with CT attenuation between -190 and -30 Hounsfield units (HU), and IAS-AT was specifically measured in the atrial septum.</p><p><strong>Results: </strong>AF/AT recurrence occurred in 71 patients (20.3%) during a mean follow-up of 408 ± 142 days. The mean IAS-AT volume was 1.8 ± 1.5 mL, and attenuation was -69.3 ± 8.9 HU. IAS-AT volume (≥ 1.7 mL; hazard ratio [HR] 2.12, 95% confidence interval [CI] 1.26-3.56, p = 0.004) and attenuation (≤-66.7 HU; HR 2.31, 95% CI 1.25-4.26, p = 0.007) were independent predictors of AF/AT recurrence. Receiver operating characteristic analyses revealed that the predictive value of IAS-AT attenuation was comparable to that of LA-EAT attenuation other than IAS-AT (area under the curve (AUC), 0.611 vs. 0.602; p = 0.815). However, IAS-AT volume was superior to LA-EAT volume other than IAS-AT in predicting recurrent AF/AT (AUC, 0.67 vs. 0.58; p = 0.001).</p><p><strong>Conclusion: </strong>IAS-AT volume and attenuation are significant predictors of AF/AT recurrence, with IAS-AT volume providing an enhanced predictive value compared to other LA-EAT segment volumes. IAS-AT may be an indicator of AF/AT recurrence after AF ablation.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Ex Vivo Evaluation of Air Intrusion Into Pulsed Field Ablation Sheaths During Ablation and Mapping Catheter Insertion.","authors":"Chad Gier, Erik Simon, Aamir Ahmed, Graham Peigh, Shivam Patel, Jayson Baman, Aravind Kalluri, Kasen Culler, Kaustubha D Patil, Anna Pfenniger, Alexandru Chicos, Susan S Kim, Albert C Lin, Rod S Passman, Bradley P Knight, Nishant Verma","doi":"10.1111/jce.70129","DOIUrl":"https://doi.org/10.1111/jce.70129","url":null,"abstract":"<p><strong>Introduction: </strong>Pulsed field ablation (PFA) is the newest ablation technology, and currently, no data exist on the amount of air intrusion into new, large bore PFA sheaths during ablation or mapping catheter insertion.</p><p><strong>Methods: </strong>An ex vivo study was performed using various combinations of commercially available PFA ablation catheters and sheaths. Common mapping catheters and a non-PFA steerable sheath were also evaluated as a reference. The siphon principle was used to create negative pressure to simulate left atrial pressure during spontaneous inspiration. Ablation and mapping catheters were advanced to the end of the sheaths under negative pressure and then removed. Air was withdrawn from the sheaths and was measured in milliliters (mL).</p><p><strong>Results: </strong>A total of 55 trials were performed. The average volume of air intrusion with all sheath/catheter combinations was 9.6 + 5.2 mL. The 13 Fr (inner diameter) Faradrive sheath (Boston Scientific Inc.) entrained significantly more air (16.5 + 4.1 mL) compared with the 12 Fr FlexCath Contour sheath (Medtronic Inc.) (6.1 + 2.7 mL, p < 0.01), 13 Fr Agilis NxT sheath (Abbott Inc.) (8.7 + 1.8 mL, p < 0.01), and Vizigo sheath (Johnson & Johnson MedTech Inc.) (5.8 + 2.1 mL, p < 0.01), regardless of the catheter used. There was significantly higher volume of air intrusion with the Farawave ablation catheter through the Faradrive sheath (13.6 + 2.0 mL) than through the 13 Fr Agilis (9.4 + 2.1 mL, p = 0.03) or the PulseSelect through FlexCath Contour sheath (4.0 + 2.7 mL, p < 0.01). Mapping catheters entrained significantly more air than ablation catheters in both the Faradrive (18.0 ± 4.1 mL vs. 13.6 ± 4.1 mL, p = 0.04) and the FlexCath Contour (7.1 ± 2.2 mL vs. 4.0 ± 2.7 mL, p = 0.03).</p><p><strong>Conclusion: </strong>Using a model that simulates left atrial PFA in spontaneously breathing patients, a large volume of air intrusion was observed during insertion and removal of ablation and mapping catheters into new, large bore PFA sheaths. New sheath designs are needed to minimize air intrusion during catheter exchanges to avoid air embolism when performing PFA using left atrial delivery sheaths.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Atrial Flutter (AFL) Using Intrinsic Antitachycardia Pacing (iATP) Protocol.","authors":"Joshua R Silverstein, Manasvi Gupta, Troy Jackson, Chaojing Duan, Caitlin Phalunas, Ali Noory, Dallin Kelly, George Shaw, Mati Friehling, Emerson Liu, William Belden, Tharian S Cherian, Amit J Thosani","doi":"10.1111/jce.70115","DOIUrl":"https://doi.org/10.1111/jce.70115","url":null,"abstract":"<p><strong>Background: </strong>Traditional management of atrial flutter (AFl) includes catheter ablation and pharmacological therapy. Antitachycardia pacing (ATP) has been explored as an alternative, with variable efficacy in terminating atrial arrhythmias. The intrinsic ATP (iATP) algorithm, previously validated for ventricular tachycardia, may offer enhanced efficacy in the atrium by leveraging programmed stimulation (PS).</p><p><strong>Objective: </strong>This study evaluates the efficacy of iATP in terminating AFl and compares it to traditional ramp pacing protocols.</p><p><strong>Methods: </strong>A prospective, randomized crossover trial was conducted in patients undergoing AFl ablation. Three ATP protocols were tested: (1) ramp pacing at 91% of tachycardia cycle length (TCL), (2) ramp pacing at 81% TCL, and (3) iATP, which incorporated PS with decrementing extra-stimuli. The primary endpoint was termination of AFl or acceleration to atrial fibrillation (AF), which was considered beneficial for rate control.</p><p><strong>Results: </strong>Seventeen patients completed the protocol. AFl termination rates were 17.6% (Protocol 1), 20.5% (Protocol 2), and 38% (iATP). The iATP protocol also induced AF in 8 cases, compared to 1 and 4 cases in Protocols 1 and 2, respectively. The increased efficacy of iATP is attributed to its ability to introduce premature wavefronts into the excitable gap, enhancing termination rates.</p><p><strong>Conclusion: </strong>iATP demonstrated superior efficacy in terminating AFl and accelerating it to AF compared to traditional ramp pacing. These findings support further exploration of iATP as a pacing-based intervention in atrial arrhythmia management. Future studies should assess its broader applicability in atypical AFl and AF.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-Way Ablation With a Cryoballoon on the Left Atrium Roof Using a Novel Button-on Technique: A Retrospective Study.","authors":"Norikazu Watanabe, Shuhei Arai, Kouhei Yoshikawa, Mai Ohhoshi, Koichi Yoshitake, Masayuki Shibata, Atuso Namiki, Taku Asano, Toshiro Shinke","doi":"10.1111/jce.70122","DOIUrl":"https://doi.org/10.1111/jce.70122","url":null,"abstract":"<p><strong>Introduction: </strong>Cryoballoon ablation (CryoBA) of the left atrium (LA) roof is usually performed via Achieve catheter anchoring (Medtronic Inc., Minneapolis, MN, USA) of the left superior pulmonary vein (LSPV) and right superior pulmonary vein (RSPV) (two-way CryoBA). The nadir temperature during anchoring of the RSPV is cooler than that during anchoring of the LSPV. Creation of the LA roof line using CryoBA with only an Achieve catheter and sheath bending is difficult. Therefore, we developed a new technique using a push button (Button-on Technique) to stabilize a cryoballoon (CB) on the LA roof and performed LA roof ablation by anchoring only the RSPV (one-way CryoBA). This study aimed to determine the effect of one-way CryoBA and two-way CryoBA on the LA roof.</p><p><strong>Methods and results: </strong>This retrospective study included 80 patients with persistent atrial fibrillation treated at our hospital between May 2019 and 2021 (one-way CryoBA group, 40 patients; two-way CryoBA group, 40 patients). CryoBA on the LA roof and pulmonary vein isolation were performed using a 28-mm second-generation CB for 180 s during each application. Nadir temperatures and gaps on the LA roof during the first pass were compared between the one-way CryoBA and two-way CryoBA groups. Nadir temperatures during one-way CryoBA from the middle to the left side of the LA roof were significantly decreased compared with those during two-way CryoBA (p < 0.01). Touch-up ablations of the LA roof after the first pass were performed in 1 of 40 patients (2.5%) and in 6 of 40 patients (15%) of the one-way CryoBA and two-way CryoBA groups, respectively, suggesting the presence of significantly fewer gaps in the one-way CryoBA group than in the two-way CryoBA group (p = 0.038).</p><p><strong>Conclusion: </strong>One-way CryoBA with the Button-on Technique can make nadir temperatures on the LA roof from the middle to the left side cooler compared with two-way CryoBA, causing fewer gaps on the LA roof during the first pass.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Variant in SLC4A3 Gene Mutation Associated With Familial Short QT Syndrome and Sudden Death.","authors":"Pasquale Crea, Carla Giustetto, Antonino Micari, Letteria Bruno, Francesco De Luca, Lilia Oreto","doi":"10.1111/jce.70126","DOIUrl":"https://doi.org/10.1111/jce.70126","url":null,"abstract":"<p><strong>Introduction: </strong>Short QT syndrome (SQTS) is a rare genetic arrhythmia associated with an increased risk of sudden cardiac death.</p><p><strong>Background: </strong>Variants in the SLC4A3 gene have recently been linked to SQTS, though clinical evidence is limited.</p><p><strong>Methods: </strong>We evaluated a 13-year-old girl with a short QT interval and her family through ECG and genetic testing.</p><p><strong>Results: </strong>A novel heterozygous SLC4A3 mutation (c.1157G>T; p.Gly386Val) was identified in the proband and her mother, both with short QT intervals. The family history included multiple cases of sudden unexplained death and epilepsy. Antiarrhythmic drugs failed to prolong QT. The mutation was absent in other asymptomatic relatives.</p><p><strong>Conclusion: </strong>This report describes a previously unreported SLC4A3 variant associated with familial SQTS and sudden death, reinforcing the gene's pathogenic role.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Impact of Spontaneous Conversion to Sinus Rhythm in Patients With Symptomatic Paroxysmal Atrial Fibrillation: A Propensity-Matched Follow-Up Study.","authors":"Marco Valerio Mariani, Tommaso Recchioni, Nicola Pierucci, Sara Trivigno, Pietro Cipollone, Raffaele Maria Bruti, Domenico Laviola, Marta Palombi, Andrea Matteucci, Agostino Piro, Cristina Chimenti, Gioacchino Galardo, Francesco Pugliese, Carmine Dario Vizza, Carlo Lavalle","doi":"10.1111/jce.70128","DOIUrl":"https://doi.org/10.1111/jce.70128","url":null,"abstract":"<p><strong>Background: </strong>Paroxysmal atrial fibrillation (PAF) patients do not invariably progress to persistent AF, with a consistent group of patients showing AF regression during follow-up. The prognostic implications of spontaneous conversion (SCV) to sinus rhythm (SR) in those patients has never been evaluated yet.</p><p><strong>Objective: </strong>To evaluate the long-term prognostic impact of early SCV to SR in patients presenting with symptomatic, hemodynamically stable, PAF in the emergency department (ED).</p><p><strong>Methods: </strong>Consecutive patients with symptomatic, hemodynamically stable PAF were included. Patients discharged in SR and followed-up thereafter were stratified based on the occurrence of SCV within 6 h from ED admission. Propensity score matching (PSM) was employed to adjust for relevant baseline differences. The primary outcome was a composite of progression to permanent AF, progression to persistent AF, initiation of antiarrhythmic drugs, AF ablation and need for pharmacologic or electrical cardioversion. Secondary outcomes included AF episodes frequency and individual components of the composite outcome.</p><p><strong>Results: </strong>Out of 158 patients, 52 experienced SCV while 106 required active cardioversion. After PSM, 52 matched pairs were analyzed. During a median follow-up of 17.0 months (IQR: 12.8-21.3 months), the primary composite outcome occurred significantly less frequently in the SCV group compared to the non-SCV group (21 vs. 41 events; log-rank p < 0.001). SCV was associated with a significant reduction of primary outcome occurrence (OR 0.361 [95% CI: 0.176; 0.739], p-value 0.005). The SCV group also exhibited a lower arrhythmic burden, with fewer AF episodes (median 1 [3] vs. 2 [4], p < 0.001) and reduced need for cardioversion (p = 0.008). The primary and secondary outcomes did not differ among SCV and non-SCV groups in the unmatched population.</p><p><strong>Conclusions: </strong>SCV in patients with PAF is associated with lower arrhythmic burden and reduced need for rhythm-control strategies at follow-up.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}