Journal of Cardiovascular Electrophysiology最新文献

{"title":"In-Hospital Outcomes and Peri-Procedural Complications of Leadless Pacemaker Compared to Traditional Transvenous Pacemaker in Patients With End-Stage Renal Disease.","authors":"Mansunderbir Singh, Sahith Reddy Thotamgari, Rahul Vyas, Hunter Smeltzer, Aakash Sheth, Pratik Agrawal, Vijaywant Brar","doi":"10.1111/jce.70056","DOIUrl":"https://doi.org/10.1111/jce.70056","url":null,"abstract":"<p><strong>Background: </strong>End-stage renal disease (ESRD) is an independent predictor of morbidity and mortality in patients undergoing invasive procedures, including permanent pacemaker implantation. Leadless pacemakers (L-VVI) have emerged as an alternative to traditional transvenous pacemakers (TV-VVI), especially in ESRD patients to reduce infection rates and preserve vasculature for dialysis access. However, there is limited data comparing the safety and procedural complications following L-VVI and TV-VVI implantation in ESRD patients.</p><p><strong>Methods: </strong>We utilized the National Inpatient Sample (NIS) database between January 1, 2016 and December 31, 2019, to identify patients with ESRD using ICD-10 CM codes. The L-VVI implantation was identified using ICD-10 PCS code \"02HK3NZ.\" TV-VVI implantation was identified with following ICD-10 PCS codes: 0JH604Z, 0JH605Z, 02HK3JZ, 02HK4JZ, 02HK3MZ, and 02HK4MZ. Propensity score matching was used to balance the baseline covariates between L-VVI and TV-VVI groups. An absolute standardized mean difference of < 5% (0.05) was considered an acceptable difference for adequate balance between two groups. Logistic regression was used to analyze the association. All statistical analyses were performed using weighted values.</p><p><strong>Results: </strong>During our study period, we identified 2065 (11.5%) hospitalizations for L-VVI implantation and 15,880 (88.5%) hospitalizations for TV-VVI implantation in patients with ESRD. After 1 to 2 propensity matching, 2065 hospitalizations in L-VVI group and 4130 hospitalizations in TV-VVI group were included in the analysis. ESRD patients who underwent l-VVI had higher rates of device infection (OR 1.93, 95% CI 1.52-2.44, p < 0.001), device thrombus (OR 1.95, 95% CI 1.47-2.57, p < 0.001), pericardial effusion (OR 1.42, 95% CI 1.10-1.83, p = 0.007), vascular complications (OR 4.02, 95% CI 1.88-8.62, p < 0.001), and venous thromboembolism (OR 2.79, 95% CI 1.96-3.97, p < 0.001) when compared to patients who underwent TV-VVI. The odds of all-cause in-hospital mortality (OR 1.2, 95% CI 0.97-1.49, p = 0.09), cardiac arrest (OR 1.0, 95% CI 0.82-1.20, p = 0.99), cardiac tamponade (OR 0.56, 95% CI 0.28-1.15, p = 0.11), and bleeding complications (OR 1.01, 95% CI 0.87-1.14, p = 0.99) were similar between the two groups.</p><p><strong>Conclusion: </strong>In patients with ESRD, those who underwent L-VVI implantation had higher likelihood of peri-procedural complications, but similar all-cause in-hospital mortality compared to those who underwent TV-VVI implantation. Larger prospective observational data are needed to validate these findings, which can help guide in appropriate patient selection for L-VVI implantation.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835199","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":"Ablation Index-Guided Radiofrequency Ablation for Atrial Fibrillation: An Updated Meta-Analysis on Its Procedural Efficacy and Safety Profiles.","authors":"Majd Al Deen Alhuarrat, David Flomenbaum, Marco Schiavone, Maisha Maliha, Mohamad Anas Oudih, Munther Hammad, Michael Freilich, Xiadong Zhang, Vincenzo Micro La Fazia, Aung Lin, Jacopo Marazzato, Samuel J Apple, Giuseppe Ammirati, Stepan Esagian, Batool Al Zyoud, Fengwei Zou, Aurelia Minuti, Nils Guttenplan, Sanghamitra Mohanty, Andrea Natale, Dhanunjaya Lakkireddy, Luigi Di Biase","doi":"10.1111/jce.70039","DOIUrl":"https://doi.org/10.1111/jce.70039","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is the most common sustained arrhythmia, with radiofrequency ablation (RFA) being a key treatment strategy. Despite its success, AF recurrence postablation is significant, and the ablation index (AI) was introduced to improve lesion quality and clinical outcomes. The aim of this study was to provide updated safety and efficacy data regarding AI-guided ablation strategy. A systematic literature review was performed utilizing the PubMed, Embase, Cochrane, and Web-of-Science databases to retrieve double-arm retrospective and prospective studies comparing AI-guided ablation to non-AI guided ablation from inception until January-2024. The initial literature search yielded 700 studies, with 18 double-arm full articles included in the analysis after screening and exclusions. The cohort consisted of 2030 patients undergoing AI-guided ablation and 1580 undergoing non-AI-guided ablation. The average age of the cohort was 64.09 ± 9.86 years, with a median follow-up period of 12 months. AI-guided ablation was associated with lower AF recurrence (22% vs 32%, OR = 0.67, 95% CI = 0.59-0.77, p < 0.001). It also resulted in shorter total procedure time (145 min vs 159 min, SMD = -0.47, 95% CI = -0.78--0.16, p = 0.005) and fluoroscopy time (8.8 min vs 11.3 min, SMD = -0.35, 95% CI = -0.55 to -0.20, p < 0.001). No significant difference was observed in ablation time. First pass isolation was more likely with AI-guided ablation (80% vs 60%, OR = 1.44, 95% CI = 1.04-2.01, p = 0.037). Complication rates were similar between groups (OR = 0.79, 95% CI = 0.47-1.32, p = 0.33). In conclusion, AI-guided ablation significantly reduces AF recurrence and procedure times compared to non-AI-guided methods, without increasing complication rates, indicating its efficacy and safety in clinical practice.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816740","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":"Cover Image, Volume 36, Issue 8","authors":"Alaa A. Shalaby,&nbsp;Bassem S. Hendawy,&nbsp;Daniel G. Wann,&nbsp;Aditya Bhonsale,&nbsp;Krishna Kancharla,&nbsp;Andrew Voigt,&nbsp;Sandeep Jain,&nbsp;Mark Estes,&nbsp;Samir Saba,&nbsp;Konstantinos N. Aronis","doi":"10.1111/jce.70045","DOIUrl":"https://doi.org/10.1111/jce.70045","url":null,"abstract":"<p>The cover image is based on the article <i>Evidence of late septal coronary involvement after bipolar radiofrequency ablation in a patient with Lamin A/C cardiomyopathy</i> by Alaaeldin Shalaby et al., https://doi.org/10.1111/jce.16721\u0000 \u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jce.70045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoughts on Anticoagulation and Left Atrial Appendage Thrombus After a Large Cohort Study.","authors":"Jiaqian Xu, Yinghan Sun","doi":"10.1111/jce.70055","DOIUrl":"https://doi.org/10.1111/jce.70055","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816743","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":"Cardiac Contractility Modulation In Symptomatic Heart Failure With Reduced Ejection Fraction: A Systematic Review and Single-Arm Meta-Analysis.","authors":"Ricardo F O Suruagy-Motta, Christian K Fukunaga, Everton V B da Silva, Gabriel R Neves, Karlos D A Dos Santos, Laila L P Vieira, Maria H N N Sampaio, Beatriz C de Pádua Carvalho, Edvaldo F X Júnior, Alexandra R D Brígido, Alfredo A M R Filho, Guilherme D de Carvalho","doi":"10.1111/jce.70053","DOIUrl":"https://doi.org/10.1111/jce.70053","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with reduced ejection fraction (HFrEF) is a leading cause of morbidity and mortality, with many patients remaining symptomatic despite optimal medical therapy. Cardiac contractility modulation (CCM), which delivers non-excitatory electrical impulses during the refractory period, enhances myocardial contractility without increasing oxygen demand. This therapy targets symptomatic HFrEF patients with narrow QRS complexes who are ineligible for cardiac resynchronization therapy (CRT).</p><p><strong>Methods: </strong>We performed a systematic review and single-arm meta-analysis, following PRISMA guidelines, to evaluate the functional, structural, and quality-of-life effects of CCM in symptomatic HFrEF patients. Primary outcomes were 6-min walk test (6MWT), peak oxygen consumption (peak VO₂), New York Heart Association (NYHA) functional class, and Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores. Secondary outcomes included left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), and left ventricular end-diastolic volume (LVEDV).</p><p><strong>Results: </strong>Fifteen studies encompassing 1658 patients were included. CCM therapy resulted in a significant improvement in 6MWT distance (mean increase: 44.96 m, 95% CI: 2.73-87.20; p = 0.037) and a reduction in NYHA functional class (mean change: -0.89, 95% CI: -1.18 to -0.60; p < 0.001). Quality of life, as measured by MLHFQ, improved significantly (mean decrease: 11.83 points, 95% CI: -15.65 to -8.02; p < 0.001). Although there was a nominal increase in Peak VO₂ (mean increase: 0.13 mL/kg/min, 95% CI: -0.73 to 0.98; p = 0.770), it was not statistically significant. Structural improvements included a 5.96% increase in LVEF (95% CI: 4.65-7.26; p < 0.001), a reduction in LVESV of 24.17 mL (95% CI: -40.12 to -8.22; p = 0.003), and a reduction in LVEDV of 18.44 mL (95% CI: -29.97 to -6.91; p = 0.002). Sensitivity analyses confirmed the robustness of these findings.</p><p><strong>Conclusion: </strong>CCM therapy provides significant improvements in functional capacity, symptom relief, quality of life, and cardiac remodeling in symptomatic HFrEF patients who are ineligible for CRT. These findings support the role of CCM in addressing an important therapeutic gap. Further large-scale randomized trials are needed to validate long-term clinical outcomes.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816741","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":"Concerns Regarding the Safety and Diagnostic Accuracy of Single-Delayed-Phase Cardiac CT Before Ablation.","authors":"Malik Abdul Rehman Rasheed, Maham Ejaz, Muhammad Furqan Ahsan, Mirza Muhammad Hadeed Khawar","doi":"10.1111/jce.70051","DOIUrl":"https://doi.org/10.1111/jce.70051","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816742","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":"Intermittent Ventricular Pre-Excitation: Clinical Features and Electrophysiological Properties.","authors":"Antonio Gianluca Robles, Zefferino Palamà, Francesco Santoro, Martin Rauber, Bor Antolič, Domenico Gianfrancesco, Francesco Bartolomucci, Pierluigi Pellegrino, Simona Alfieri, Alessio Borelli, Antonio Scarà, Gabriele De Masi De Luca, Ermenegildo de Ruvo, Leonardo Calò, Matevž Jan, Andrej Pernat, Silvio Romano, Luigi Sciarra","doi":"10.1111/jce.70035","DOIUrl":"https://doi.org/10.1111/jce.70035","url":null,"abstract":"<p><strong>Background: </strong>Intermittent ventricular pre-excitation has long been considered a low-risk marker for sudden death. Accessory pathways (APs) with high-risk intermittent antegrade conductive properties may exist, but this still represents a gray area in current guidelines. We evaluated differences in risk characteristics between symptomatic and asymptomatic patients with intermittent pre-excitation (IPX) and those with persistent pre-excitation (PPX) in a multicenter international registry.</p><p><strong>Methods: </strong>392 consecutive patients [IPX: 79 (20.15%); PPX: 313 (79.85%)] underwent electrophysiological (EP) study. Data on arrhythmia inducibility (AVRT/AF), AP antegrade conduction properties (ERP/SPERRI), site, and number were collected.</p><p><strong>Results: </strong>No significant differences were found in demographic characteristics and EP features between PPX and IPX patients, including antegrade conductive properties, prevalence of multiple APs, and AP locations, except for AVRT inducibility which was more frequent in IPX group. Similarly, no differences were detected between symptomatic and asymptomatic IPX patients.</p><p><strong>Conclusions: </strong>Except for AVRT inducibility, our study shows no significant differences in demographic and other electrophysiological features between PPX and IPX patients. Likewise, no differences in demographic and EP features were detected between symptomatic and asymptomatic IPX patients. Therefore, intermittent pre-excitation is an unreliable noninvasive marker of arrhythmic risk and it warrants an invasive risk assessment via EP study.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799160","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":"Hemolysis Induced by Pulsed-Field Ablation of Atrial Arrhythmias: A Comparative Analysis of Current Systems.","authors":"Johannes Bruss, Thomas Kueffer, Hildegard Tanner, Fabian Noti, Andreas Haeberlin, Gregor Thalmann, Nikola Asenov Kozhuharov, Boldizsar Kovacs, Valon Spahiu, Claudia Herrera Siklody, Tobias Reichlin, Laurent Roten","doi":"10.1111/jce.70049","DOIUrl":"https://doi.org/10.1111/jce.70049","url":null,"abstract":"<p><strong>Introduction: </strong>Pulsed-field ablation (PFA) is an emerging technology associated with dose-dependent hemolysis as a recently recognized side effect. This study aimed to compare hemolysis levels and assess dose-dependency across three PFA systems: a pentaspline catheter (PSC), a lattice-tip focal catheter (LTFC), and a variable loop circular catheter (VLCC).</p><p><strong>Methods: </strong>Patients treated for atrial arrhythmias with the LTFC (n = 29) or the VLCC (n = 30) were included from a prospective registry. A matched cohort of patients treated with the PSC (n = 28) was recruited from the same registry. Creatinine levels and markers of hemolysis were measured pre-ablation and 1 day postablation.</p><p><strong>Results: </strong>Haptoglobin levels decreased significantly more with the PSC and VLCC compared to the LTFC (-0.65 [-0.76, -0.49] g/L; -0.56 [-0.78, -0.43] g/L, -0.21 [-0.32, -0.1] g/L, respectively; p < 0.001 for both). Per-application decreases in haptoglobin also differed (-17.5 [-20.38, -13.58] mg/L, -24.35 [-36.36, -17.92] mg/L, -3.61 [-5.98, -2.13] mg/L, respectively; p < 0.001 for both). There was no significant difference in haptoglobin decrease between the PSC and VLCC per procedure (p = 1.0). Haptoglobin decrease per application was significantly larger with the VLCC compared to the PSC (p = 0.0048). Per procedure LDH increase followed a similar trend (49 [18, 81.25] U/L; 14 [6, 60] U/L; 13 [-4, 46] U/L; respectively; p = 0.037). No hemolysis-related complications were observed.</p><p><strong>Conclusions: </strong>Hemolysis levels vary significantly among PFA platforms. Focal PFA catheters induce less hemolysis per procedure and application compared to large-footprint catheters.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799179","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":"Sudden Death in the Young: A Nationwide Prospective Epidemiological Study of Sudden Death in Young People Aged 1-35 Years in the Mediterranean Island of Cyprus.","authors":"Loizos Antoniades, Constantinos Antoniades, Hera Moustra Heracleous, Georgia Daniel, Alexandros Protonotarios, Aris Anastasakis, Adalena Tsatsoppoulou, Petros Agathangelou","doi":"10.1111/jce.70037","DOIUrl":"https://doi.org/10.1111/jce.70037","url":null,"abstract":"<p><strong>Background and aims: </strong>This study aimed to explore the etiology, incidence, and epidemiological characteristics of sudden death (SD) cases among individuals aged 1-35 years, through a systemic evaluation of all SDs in Cyprus over a 11-year period.</p><p><strong>Methods and results: </strong>From 2005 to 2015, all cases of SDs involving individuals aged 1-35 years, who were citizens or permanent residents of the Republic of Cyprus, were recorded and studied. The incidence of SD in young individuals in Cyprus was 2.16 cases per 100 000 people annually. Out of the 74 recorded cases, cardiac causes were identified in 43.24% (n = 32) of SD cases, with 28.38% (n = 21) attributed to noncardiac factors. Cardiac causes predominated in males (n = 25/50, 50.00%), while noncardiac causes were more prevalent in females (n = 12/24, 50.00%). Among all SD cases, cardiomyopathies, particularly hypertrophic cardiomyopathy, accounted for 24.32% (n = 18) cases, followed by pulmonary embolism (n = 8, 10.81%) and viral myocarditis (n = 7, 9.46%) as the second and third leading causes, respectively. Other causes of SDs were myocardial infarction (n = 5, 6.76%), and hemorrhagic stroke (n = 4, 5.41%). Aortic aneurysm rupture, adrenal hemorrhage, and pulmonary aspiration each constituted 4.05% (n = 3) of SD cases. The cause of death remained indeterminate in 28.38% (n = 21) of SD cases.</p><p><strong>Conclusions: </strong>SD in the young is predominantly of cardiac origin, although a significant proportion of cases is also attributed to noncardiac causes. Despite thorough post-mortem examinations, including microscopic pathology, histological, and immune-histological analyses, a considerable number of SD cases remain unclear.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789255","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":"Immediate Leg Mobilization is Feasible After Catheter Ablation of Atrial Fibrillation Using Large Vascular Access Sheaths (Pulsed Field and Cryoballoon Ablation).","authors":"Riya Sam, Romil Patel, Lavisha Singh, Westby Fisher, Mark Metzl, Jose Nazari, Alex Ro, Hany Demo, Jeremiah Wasserlauf","doi":"10.1111/jce.70050","DOIUrl":"https://doi.org/10.1111/jce.70050","url":null,"abstract":"<p><strong>Background: </strong>Vascular recovery from catheter ablation (CA) has traditionally required a period of leg immobilization which can lead to discomfort and prolonged time to discharge.</p><p><strong>Objective: </strong>The objective of this study was to compare a strategy of immediate leg mobilization (IM) using suture-mediated closure devices against traditional vascular recovery consisting of figure-of-eight suture and 4 h bed rest (BR) after CA of atrial fibrillation (AF) using large vascular access sheaths for cryoballoon ablation (CBA) and pulsed field ablation (PFA).</p><p><strong>Methods: </strong>Two hundred subjects were retrospectively analyzed: 100 IM and 100 BR. Vascular closure in IM consisted of a single suture-mediated closure delivered to each of three venotomies. Following the procedure, both legs could be mobilized immediately with no head-of-bed restriction. Ambulation was instructed at 1 h, and discharge at 3 h postprocedure. Hemostasis in BR was achieved using figure-of-eight sutures and 4 h of BR. The primary endpoint was the incidence of vascular complications. The secondary endpoint was time to discharge.</p><p><strong>Results: </strong>The mean age was 68.4 ± 11.7 years. In total, 72% of subjects in IM and 5% of the subjects in BR were treated with PFA. There was no difference in vascular complications (1 IM vs. 0 BR, p = 0.316). Time to discharge was shorter in IM (4.2 ± 2.6 h vs. 6.0 ± 2.7 h, p < 0.05).</p><p><strong>Conclusion: </strong>Immediate mobilization with suture-mediated vascular closure following CBA or PFA was associated with no difference in vascular complications compared to 4 h BR and shorter time to discharge. Further studies are needed to illustrate potential benefits to patient comfort and satisfaction.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789254","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}