Journal of Interventional Cardiac Electrophysiology最新文献

{"title":"Posterior wall isolation with pulsed field ablation or radiofrequency ablation with vein of Marshall ethanol ablation for repeat catheter ablation of recurrent atrial fibrillation.","authors":"Corinne Isenegger, Philipp Krisai, Sven Knecht, Josip Katic, Nicolas Schaerli, Gian Voellmin, Felix Mahfoud, Christian Sticherling, Michael Kühne, Patrick Badertscher","doi":"10.1007/s10840-025-01991-3","DOIUrl":"https://doi.org/10.1007/s10840-025-01991-3","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcome after ablation of persistent atrial fibrillation in patients with postprocedurally unmasked sinus node disease.","authors":"Verena Kantenwein, Elisabeth Martini, Bernhard Haller, Marta Telishevska, Felix Bourier, Tilko Reents, Marc Kottmaier, Sarah Lengauer, Isabel Deisenhofer, Christof Kolb","doi":"10.1007/s10840-025-01998-w","DOIUrl":"https://doi.org/10.1007/s10840-025-01998-w","url":null,"abstract":"<p><strong>Background: </strong>About three percent of patients with persistent atrial fibrillation (AF) additionally suffer from a concealed sinus node disease (SND). We sought to determine the success of ablation one year after ablation of persistent AF in patients with postprocedurally unmasked SND.</p><p><strong>Methods and results: </strong>In total, 2539 patients with an ablation of persistent AF at our centre were screened for a postprocedurally unmasked SND, which made acute cardiac pacing necessary within one week after ablation. In a propensity score-matched case-control study (1:2 matching), the long-term ablation success of 51 patients (mean age 73 ± 8 years, 59% male) with unmasked SND after ablation of persistent AF was compared to that of 102 patients without SND after ablation of persistent AF. Controls were matched to cases based on the propensity score considering age, body mass index, left ventricular ejection fraction, gender, blood pressure, diabetes mellitus, atrial low voltage, previous number of ablations, and method of ablation. One year after ablation of persistent AF, 20 (39%) patients with postprocedurally unmasked SND and 61 (60%) patients without postprocedurally unmasked SND were in sinus rhythm (OR 0.43, 95% CI 0.22 to 0.90, p = 0.017). The number of repeat ablation procedures within the follow-up year did not differ significantly between cases and controls (mean 0.60 ± 0.68 vs 0.53 ± 0.80, rate ratio 1.14, 95% CI 0.72 to 1.78, p = 0.566).</p><p><strong>Conclusion: </strong>In patients with a postprocedurally unmasked SND after ablation of persistent AF, long-term ablation success seems to be worse compared to patients without postprocedurally unmasked SND.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive prediction of atrial cardiomyopathy characterized by multipolar high-density contact mapping.","authors":"Moritz T Huttelmaier, Alexander Gabel, Jonas Herting, Manuel Vogel, Stefan Störk, Stefan Frantz, Caroline Morbach, Thomas H Fischer","doi":"10.1007/s10840-025-02001-2","DOIUrl":"https://doi.org/10.1007/s10840-025-02001-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Atrial cardiomyopathy (AC) establishes links between atrial fibrillation (AF), left atrial (LA) mechanical dysfunction, structural remodeling, and thromboembolic events. Early diagnosis of AC may impact AF treatment and stroke risk prevention. Modern endocardial contact-mapping provides high-resolution electro-anatomical (EA) maps of the LA, thus allowing to display the myocardial substrate based on impaired signal amplitude and to characterize AC. Correlation of invasively assessed AC using a novel, multipolar mapping catheter (OCTARAY™, Biosense Webster, limited market release) and LA echocardiographic parameters could form the basis for a set of echo parameters for non-invasive prediction of AC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We retrospectively identified 50 adult patients who underwent primary pulmonary vein isolation (PVI) for paroxysmal or persistent AF between 08/22 and 05/23 fulfilling the selection criteria: (i) EA mapping with a novel multipolar mapping catheter (Octaray®); (ii) acquisition of voltage maps in sinus rhythm (SR) with ≥ 5000 points/map; and (iii) transthoracic echocardiography acquired in SR ≤ 48 h before PVI. Exclusion criterion was previous LA ablation. We generated EA maps with two sets of upper voltage thresholds (0.2-0.5 mV and 0.2-1.0 mV) and assessed total LA low voltage area (LVA). As LVA thresholds for the classification of AC are not yet established, an unsupervised machine learning cluster analysis was performed using a Gaussian mixture model (GMM), and two groups of patients with mild and severe AC were identified. Based on these two groups, we selected echo parameters for further analysis by applying the Boruta algorithm. The predictive capacity of the selected parameters was evaluated using a support vector machine.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean age of the studied sample (n = 50) was 63 ± 11 years, 62% were men, 64% showed persistent AF, median CHA&lt;sub&gt;2&lt;/sub&gt;DS&lt;sub&gt;2&lt;/sub&gt;-VASc score was 2 (quartiles 1, 3), and NT-proBNP was 190 (71, 391) pg/ml. A median of 5771 (5217, 6988) points/map were acquired. GMM yielded clusters of mild AC (n = 28) and severe AC (n = 22). Median LVA was 0.6 cm&lt;sup&gt;2&lt;/sup&gt; (&lt; 0.5 mV) resp. 4.1 cm&lt;sup&gt;2&lt;/sup&gt; (&lt; 1.0 mV) in group mild AC and 6.9 cm&lt;sup&gt;2&lt;/sup&gt; (&lt; 0.5 mV) resp. 27.2 cm&lt;sup&gt;2&lt;/sup&gt; (&lt; 1.0 mV) in group severe AC. Several echocardiographic parameters differed between the groups of mild and severe AC: dynamic LA parameters (end diastolic LA reservoir strain: 24.5% (22, 29) vs 15% (12, 19), p &lt; 0.001; LA reservoir strain at atrial contraction: 22% (19, 25) vs 15% (11, 18), p &lt; 0.001, end diastolic LA contraction strain: 13% (8, 15) vs 7.5% (3, 13), p &lt; 0.01) as well as LA end-systolic volume index to a´ ratio (LAVI/a': 297 (231,365) vs 510 (326,781), p &lt; 0.01). Consistent distribution of NT-proBNP (mild AC: 125 (48,189) pg/ml, severe AC: 408 (254,557) pg/ml, p &lt; 0.0001) and CHA&lt;sub&gt;2&lt;/sub&gt;DS&lt;sub&gt;2&lt;/sub&gt;-VASc score (mild AC: 1 (1-","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Near-zero fluoroscopy workflow for pulmonary vein isolation in atrial fibrillation using a variable loop, 3D-integrated circular PFA catheter (Varipulse™): initial single-center experience with the first 35 patients.","authors":"M Borlich, S Groschke, J Wietgrefe, F Witt, A Paulssen, S Fichtlscherer, A Elsässer, H Nef, L Iden","doi":"10.1007/s10840-025-01981-5","DOIUrl":"https://doi.org/10.1007/s10840-025-01981-5","url":null,"abstract":"<p><strong>Background: </strong>Catheter ablation is a standard atrial fibrillation (AF) treatment, traditionally using radiofrequency (RF) or cryoablation, which carries the risk of damaging nearby structures. Pulsed field ablation (PFA) offers partly tissue-selective energy application with minimal collateral damage. This study evaluated a near-zero fluoroscopy workflow with the novel VARIPULSE™ catheter, combining advanced mapping for optimized PFA delivery and reduced radiation. Here, we investigate the safety, efficiency, and effectiveness of this approach in the first 35 patients treated.</p><p><strong>Objective: </strong>This study aimed to assess the procedural characteristics, safety, and acute efficacy of pulmonary vein isolation (PVI) using the VARIPULSE™ PFA catheter in patients with AF, while specifically evaluating a near-zero fluoroscopy workflow to minimize radiation exposure during the procedure.</p><p><strong>Methods: </strong>Thirty-five consecutive patients with paroxysmal or persistent AF underwent pulmonary vein isolation (PVI) using the VARIPULSE™ PFA catheter. Procedures were conducted under general anesthesia or deep sedation. Key procedural endpoints included acute pulmonary vein isolation, total procedure time, left atrial (LA) dwell time, fluoroscopy time and dose, and safety outcomes, with a focus on assessing the feasibility of a near-zero fluoroscopy workflow.</p><p><strong>Results: </strong>Thirty patients underwent near-zero fluoroscopy atrial fibrillation ablation using the novel VARIPULSE™ Pulsed Field Ablation catheter. Patients had a median age of 70 years and typical cardiovascular comorbidities, with 54% presenting with paroxysmal AF. Thirty-three of 35 patients (94%) had a normal left ventricular systolic function (> 60%). The median CHA₂DS₂-VA score was 2 (IQR 1-3.75). Sinus rhythm was observed in 66% of cases at procedure start. Median fluoroscopy time was 0.8 min, total median procedure time 53 min, median LA dwell time 38 min, and median fluoroscopy dose 20.4 µGym². Pulmonary vein isolation was achieved in 100% of cases without radiofrequency touch-up. No major complications occurred.</p><p><strong>Conclusion: </strong>The VARIPULSE™ Pulsed Field Ablation system enables an efficient, nearly fluoroscopy-free atrial fibrillation ablation with a simple, easily integrable workflow in the electrophysiology lab. Complete pulmonary vein isolation was achieved in all cases without radiofrequency touch-ups, and the procedure was safe with no major complications. This demonstrates the potential for widespread adoption of this technology and workflow.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulsed field ablation of atrial fibrillation in the setting of pulmonary vein stents: a case report.","authors":"Cyrus M Nouraee, Jason D Engelmann, Konstantinos C Siontis","doi":"10.1007/s10840-025-02005-y","DOIUrl":"https://doi.org/10.1007/s10840-025-02005-y","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of left atrial myopathy and post-ablation remodeling on quality of life: a DECAAF II sub-analysis.","authors":"Ghassan Bidaoui, Han Feng, Nour Chouman, Ala Assaf, Chanho Lim, Hadi Younes, Mayana Bsoul, Christian Massad, Francisco Tirado Polo, Yishi Jia, Yingshou Liu, Abboud Hassan, William Rittmeyer, Mario Mekhael, Charbel Noujaim, Amitabh C Pandey, Swati Rao, Omar Kreidieh, Nassir F Marrouche, Eoin Donnellan","doi":"10.1007/s10840-025-02002-1","DOIUrl":"https://doi.org/10.1007/s10840-025-02002-1","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is associated with adverse remodeling of the left atrium (LA). The impact of the extent of atrial myopathy and post-ablation remodeling on quality-of-life (QoL) outcomes has not been studied.</p><p><strong>Objective: </strong>The aim of our study was to investigate the association between atrial myopathy and post-ablation remodeling on quality-of-life outcomes in patients with persistent AF.</p><p><strong>Methods: </strong>We conducted an analysis of DECAAF II participants who underwent late-gadolinium enhancement MRI (LGE-MRI) before and after AF ablation. We assessed atrial myopathy and post-ablation atrial remodeling, scar formation, and fibrosis coverage with ablation. QoL metrics were assessed using the Short Form Survey (SF-36) and Atrial Fibrillation Severity Scale (AFSS). Uni- and multivariable regression models were developed for this analysis.</p><p><strong>Results: </strong>Six hundred thirteen patients with persistent AF were included in our analyses. At baseline, AFSS burden and total AFSS score were 18.94 ± 7.35 and 12.24 ± 8.17, respectively. Following ablation, all QoL and AFSS metrics improved in both the pulmonary vein isolation (PVI) and MRI-guided fibrosis ablation groups. On average, one unit of post-ablation reduction in left atrial volume index (LAVI) was associated with an improvement of 0.085 in total AFSS score (p = 0.001), 0.01 in shortness of breath with activity (p < 0.001), 0.15 in AF burden (p < 0.001), - 0.016 in global well-being (p = 0.018), 0.519 in health change (p < 0.001), 0.19 in vitality (vitality (p = 0.01), and 0.27 in physical functioning (p = 0.001). Baseline fibrosis and residual fibrosis post-ablation were associated with improved vitality and general health.</p><p><strong>Conclusion: </strong>Atrial myopathy and post-ablation atrial remodeling significantly impact QoL in patients with persistent AF undergoing ablation.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conduction system pacing versus biventricular pacing for atrial fibrillation in patients undergoing atrioventricular junction ablation: a meta-analysis.","authors":"Favour Markson, Mohamad Raad","doi":"10.1007/s10840-025-02004-z","DOIUrl":"https://doi.org/10.1007/s10840-025-02004-z","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of a temperature-controlled ablation system for ventricular tachycardia: Results from the TRAC-VT study.","authors":"Josef Kautzner, Javier Moreno, Claudio Tondo, Frédéric Anselme, James Burrell, Daniel Becker, Petr Peichl, Ian Patchett, Tarvinder Dhanjal","doi":"10.1007/s10840-025-01995-z","DOIUrl":"https://doi.org/10.1007/s10840-025-01995-z","url":null,"abstract":"<p><strong>Background: </strong>Catheter ablation using radiofrequency (RF) energy is an established treatment for ventricular tachycardia (VT). Tissue temperature is a key determinant of successful lesion creation, and yet, it is difficult to measure during conventional RF ablation because of the cooling effect of high-flow rate saline irrigation. The TRAC-VT study evaluated the safety and efficacy of a novel irrigated RF ablation system modulating power based on real-time tissue temperature.</p><p><strong>Methods: </strong>Patients with sustained monomorphic VT and structural heart disease (SHD) were enrolled. Catheter ablation was performed in temperature-control mode (irrigation 8 ml/min, temperature set-points 55 or 60 °C, and power output ≤ 50 W), with RF applications for ≤ 45 s. The primary safety endpoint was a composite of cardiovascular-specific serious procedure-related adverse events within 30 days post-ablation. The primary effectiveness endpoint was acute success (i.e., non-inducibility of all clinically relevant VTs).</p><p><strong>Results: </strong>Thirty-eight patients were enrolled with monomorphic VT (age 68 ± 12 years and 84% male), with an average of 1.7 ± 1.2 VTs targeted per patient. In total, 41 ± 23 RF applications per patient were delivered. Acute procedural success was 100% (95% CI, 91-100%). No primary safety endpoints were observed. Six-month follow-up was completed in 92% of patients with 81% (95% CI, 65-91%) freedom from sustained or treated VT. A repeat ablation was performed in three patients.</p><p><strong>Conclusions: </strong>Ablation of VT in SHD, using a temperature-controlled irrigated RF catheter, was safe and effective with a low rate of VT recurrence at 6 months.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pre-ablation cardiorespiratory fitness and echocardiographic parameters on atrial fibrillation ablation outcomes.","authors":"Robert C Ward, Kathryn Larson, David Hodge, Joshua Slusser, Jose Medina-Inojosa, Thomas G Allison, Amanda R Bonikowske, Christopher V DeSimone","doi":"10.1007/s10840-025-01993-1","DOIUrl":"https://doi.org/10.1007/s10840-025-01993-1","url":null,"abstract":"<p><strong>Background: </strong>Studies have shown a correlation between greater cardiorespiratory fitness (CRF) and lower risk of incident and recurrent atrial fibrillation (AF). Transthoracic echocardiographic (TTE) parameters correlate to CRF and risk of AF. However, there is scarce data regarding the interplay of CRF, echocardiographic parameters, and AF ablation outcomes. Our study sought to investigate how CRF and echocardiographic parameters impact AF ablation outcomes.</p><p><strong>Methods: </strong>We evaluated the Mayo Clinic Cardiorespiratory Exercise database from January 1, 2013, through December 31, 2017, to include all patients who underwent cardiopulmonary exercise testing and an AF ablation in temporal proximity.</p><p><strong>Results: </strong>A total of 205 patients (mean age 61.2 years, 74% male) were included for analysis. Fitness was calculated with peak VO2 when available and exercise time when VO2 was not available. Lower baseline fitness correlated to larger left atrial volumes, lower medial mitral e' values, and higher E/e' ratios. Lower baseline fitness correlated to higher risk of AF recurrence post-ablation in a simple model, but lost significance when multiple variables were accounted for. Lower baseline fitness also correlated to a higher AF burden post-ablation at one year.</p><p><strong>Conclusions: </strong>Lower baseline CRF likely correlates to more malignant and difficult to treat AF. Lower fitness also correlated to larger left atria and TTE parameters suggestive of diastolic dysfunction.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A simple technique for manipulating a pentaspline pulsed field ablation catheter to select right inferior pulmonary vein using vertebral body alignment.","authors":"Yoshiaki Mizutani, Daishi Nonokawa, Masaaki Kanashiro, Satoshi Yanagisawa, Yasuya Inden, Toyoaki Murohara","doi":"10.1007/s10840-025-01999-9","DOIUrl":"https://doi.org/10.1007/s10840-025-01999-9","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}