Journal of Interventional Cardiac Electrophysiology最新文献

{"title":"Catheter ablation of atrial fibrillation in elderly and very elderly patients: safety, outcomes, and quality of life.","authors":"Chadi Tabaja, Arwa Younis, Pasquale Santangeli, Ruth Madden, Tyler Taigen, Medhat Farwati, Katsuhide Hayashi, Lorenzo Braghieri, John Rickard, Benjamin M Klein, Aritra Paul, Thomas J Dresing, David O Martin, Mandeep Bhargava, Mohamed Kanj, Jakub Sroubek, Hiroshi Nakagawa, Walid I Saliba, Oussama M Wazni, Ayman A Hussein","doi":"10.1007/s10840-023-01659-w","DOIUrl":"10.1007/s10840-023-01659-w","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) risk increases with age. We aim to assess the efficacy and safety of catheter ablation in the older population.</p><p><strong>Methods: </strong>All patients undergoing AF ablation (2013-2021) at our institution were enrolled in a prospectively maintained registry. The primary endpoint was AF recurrence. Patients were divided into 3 groups: non-elderly (< 65 years), elderly (65-75 years), and very elderly (> 75 years). Patient surveys at baseline and during follow-up were used to calculate quality of life (QoL) metrics: the AF severity score as well as the AF burden.</p><p><strong>Results: </strong>A total of 7020 patients were included (42% non-elderly, 42% elderly, and 16% very elderly). Periprocedural major complications were low (< 1.5%) and similar in all groups besides pericardial effusion which was more frequent with older age and similar between the elderly and very elderly. At 3 years, AF recurrence for persistent AF (PersAF) was highest in the very elderly group (48%), followed by the elderly group (42%), and was the lowest in the non-elderly group (36%). In paroxysmal AF (PAF), there was no difference in AF recurrence between the elderly and non-elderly, while the very elderly remained associated with a significantly increased risk. Multivariable Cox analysis confirmed these findings (PersAF; elderly: HR = 1.23, P = 0.003; very elderly: HR = 1.44, P < 0.001) (PAF; elderly: HR = 1.04, P = 0.62; very elderly: HR = 1.30, P = 0.01). Catheter ablation resulted in a significant improvement in quality of life, irrespective of age group.</p><p><strong>Conclusion: </strong>Catheter ablation in elderly and very elderly patients is safe, efficacious, and associated with QoL benefits. Overall, major complications were minimal and did not differ significantly between age groups, with the exception of pericardial effusions which were higher in the elderly and very elderly compared to non-elderly adults. Very elderly patients had a higher rate of AF recurrence when compared with elderly or non-elderly patients. Nevertheless, ablation resulted in a remarkable improvement in QoL and a reduction of AF burden and AF symptoms with a similar magnitude, irrespective of age.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41235983","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":"Intracardiac echocardiography-guided pulsed-field ablation for successful ablation of atrial fibrillation: a propensity-matched analysis from a large nationwide multicenter experience.","authors":"Antonio Dello Russo, Claudio Tondo, Vincenzo Schillaci, Michela Casella, Saverio Iacopino, Stefano Bianchi, Gaetano Fassini, Antonio Rossillo, Paolo Compagnucci, Marco Schiavone, Armando Salito, Ruggero Maggio, Laura Cipolletta, Sakis Themistoclakis, Claudio Pandozi, Pasquale Filannino, Pietro Rossi, Carlo Bonanno, Quintino Parisi, Maurizio Malacrida, Francesco Solimene","doi":"10.1007/s10840-023-01699-2","DOIUrl":"10.1007/s10840-023-01699-2","url":null,"abstract":"<p><strong>Background: </strong>Intracardiac echocardiography (ICE) is increasingly employed in atrial fibrillation (AF) ablation procedures, with the potential to enhance procedural efficacy. Nevertheless, there is currently a lack of evidence assessing the impact of ICE on the efficiency, effectiveness, and safety outcomes in the context of novel pulsed-field ablation (PFA) for AF.</p><p><strong>Purpose: </strong>We aimed to assess whether the use of ICE could improve procedural parameters in a large population undergoing AF ablation with FARAPULSE™ catheter.</p><p><strong>Methods: </strong>Consecutive patients who had undergone PFA of AF from nine Italian centers were included. In procedures where the ICE catheter was employed for guidance (ICE-guided group), it was used to maneuver the PFA catheter within the left atrium to achieve optimal contact with atrial structures.</p><p><strong>Results: </strong>We analyzed 556 patients: 357 (66%) with paroxysmal AF, 499 (89.7%) de novo PVI. ICE-guided procedures (n = 138) were propensity matched with patients with a standard approach (n = 138), and their outcomes were compared. During ICE-guided procedures, no improvement in procedural metrics was recorded (ICE vs Standard, 23 ± 6 min vs 18.5 ± 9 min for time to PVI, p < 0.0001; 38.8 ± 7 vs 32.5 ± 5 number of PFA deliveries to achieve PVI, p < 0.0001; 68.8 ± 19 min vs 71.8 ± 29 min for primary operator time, p = 0.5301; 16.1 ± 8 min vs 18.2 ± 10 min for fluoroscopy time, p = 0.5476) except for support time (76.8 ± 26 min vs 91.4 ± 37 min, p = 0.0046). No major procedure-related adverse events were reported.</p><p><strong>Conclusion: </strong>Our findings confirmed that PFA could be consistently performed in a rapid, safe, and efficacious manner. The use of ICE to guide PFA was not associated with an improvement in procedural metrics.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138176343","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":"Clinical impact of capsulectomy during cardiac implantable electronic device generator replacement: a prospective randomized trial.","authors":"Hwajung Kim, Soohyun Kim, Soyoon Park, Sunhwa Kim, Young Choi, Ju Youn Kim, Yong-Seog Oh, Sung-Hwan Kim","doi":"10.1007/s10840-024-01765-3","DOIUrl":"10.1007/s10840-024-01765-3","url":null,"abstract":"<p><strong>Background: </strong>The avascular capsule around the generator of the cardiac implantable electronic device (CIED) could be susceptible to bacterial colonization and source of infection. Capsulectomy during CIED generator replacement may be beneficial in preventing device infection, but there is a lack of evidence.</p><p><strong>Methods: </strong>This prospective randomized trial, conducted from December 2013 to December 2019, included 195 patients divided equally into two groups. In the intervention group (n = 97), capsule removal was performed on the floor of the pocket, while it was not performed in the control group (n = 98). In both groups, swab culture was performed in the pocket. The primary outcome was the occurrence of device infection requiring pocket revision.</p><p><strong>Results: </strong>A total of 195 patients were included (mean age 70.2 ± 13.6 years, 55.4% women), with an average follow-up period of 54.3 ± 28.9 months. Among 182 patients undergoing microbiological cultures of pockets, 19 (10.4%) were confirmed positive, and Staphylococcus species were identified most frequently. The primary outcome occurred in 4 (2.1%), and there was no significant difference between the two groups (3.1% vs. 1.0%, p = 0.606). Hematoma has occurred in 10 patients (3.1% vs. 7.1%, p = 0.338), one of them required wound revision. In multivariable analysis, the occurrence of hematoma was the only independent risk factor associated with device infection (HR 13.6, 95% CI 1.02-181.15, p = 0.048).</p><p><strong>Conclusions: </strong>In this long-term prospective study, capsulectomy during the replacement of the generator did not reduce the incidence of device infection. There was no association between bacterial colonization in the capsule around the generator and CIED infection.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905814","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":"Post-procedural inappropriate sinus tachycardia after cardioneural ablation for malignant swallow syncope.","authors":"Nikhila Chelikam, Aashish Katapadi, Naga Venkata K Pothineni, Rakesh Gopinathannair, Rajesh Kabra, Rangarao Tummala, Andrea Yang, Dhanunjaya Lakkireddy, Douglas Darden","doi":"10.1007/s10840-024-01893-w","DOIUrl":"https://doi.org/10.1007/s10840-024-01893-w","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875086","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":"Association between the number of altered late potential criteria and increased arrhythmic risk in Brugada syndrome patients.","authors":"Joana Brito, Nuno Cortez-Dias, Gustavo Lima da Silva, Afonso Nunes Ferreira, Inês Aguiar Ricardo, Nelson Cunha, Pedro Silvério António, Irina Neves, Sandra Paiva, Ana Paixão, Fernanda Gaspar, Adília Silva, Andreia Magalhães, Pedro Marques, Fausto J Pinto, João de Sousa","doi":"10.1007/s10840-023-01685-8","DOIUrl":"10.1007/s10840-023-01685-8","url":null,"abstract":"<p><strong>Background: </strong>Brugada syndrome (BrS) is associated with abnormal electrophysiological properties at right ventricular epicardium, consisting of fragmented electrograms extending well beyond QRS termination. We aimed to evaluate the utility of signal-averaged electrocardiogram (SA-ECG) for the noninvasive assessment of late potentials (LP) and risk stratification of BrS patients.</p><p><strong>Methods: </strong>A prospective, observational, single-center study of BrS patients is submitted to SA-ECG with the determination of the total filtered QRS duration (fQRS), root mean square voltage of the 40 ms terminal portion of the QRS (RMS40), and duration of the low-amplitude electric potential component of the terminal portion of the QRS (LAS40). LP were considered positive when above standard cut-offs: fQRS > 114 ms, RMS40 < 20 µV, and LAS40 > 38 ms. The rates of malignant arrhythmic events (MAEs), defined as sudden death or appropriate shocks, were compared in relation to clinical characteristics and SA-ECG findings.</p><p><strong>Results: </strong>A total of 106 BrS patients (mean age, 48 ± 12 years, 67.9% male) were studied, 49% with type-1 spontaneous pattern and 81% asymptomatic. During a median follow up of 4.7 years, 10 patients (7.1%) suffered MAEs, including 4 sudden deaths. The presence of LP was significantly associated with the arrhythmic risk, which increased with the number of altered LP criteria. In comparison to the patients who had none or 1 altered LP criterium, MAE risk was 4.7 times higher in those with 2 altered criteria and 9.4 times higher in those with 3 altered LP criteria.</p><p><strong>Conclusions: </strong>SA-ECG may be a useful tool for risk stratification in BrS. The presence of 2 or 3 abnormal LP criteria could identify a subset of asymptomatic patients at high risk of arrhythmic events.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107591466","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":"Vein of Marshall ethanol infusion for recurrent atrial fibrillation in patients with durably isolated pulmonary veins.","authors":"Gregory Cunn, Apoor Patel, Kristie Coleman, Eric Dulmovits, Nicholas Skipitaris, Laurence Epstein, Stavros Mountantonakis, Stuart Beldner","doi":"10.1007/s10840-024-01877-w","DOIUrl":"https://doi.org/10.1007/s10840-024-01877-w","url":null,"abstract":"<p><strong>Background: </strong>Vein of Marshall (VoM) ethanol ablation has a proven benefit in patients with persistent atrial fibrillation (AF) undergoing index procedure; however, its role in repeat ablation is unknown. We sought to evaluate the benefit of empiric VoM ethanol ablation in addition to posterior wall isolation (PWI) during the repeat procedure in patients with durable pulmonary vein (PV) isolation from prior ablation.</p><p><strong>Methods: </strong>Twenty-three patients (age 67.1 + / - 7.4, 74% males) who received empiric VoM ethanol infusion in addition to PWI were matched for age, gender, ejection fraction, and left atrial size with forty-six patients receiving empiric PWI alone. All patients in the study group underwent additional ablation on mitral isthmus to complete the lateral mitral isthmus line. Additional ablation was based on program and trigger stimulation. Primary outcome was freedom from AF after a blanking period of 3 months by qualification of symptoms, EKG, wearable, or implantable monitor or device.</p><p><strong>Results: </strong>The study group had a higher average BMI (35.07 + / - 8.98 vs. 30.85 + / - 5.65, p = 0.033) and rate of persistent AF (83.0% vs. 54.3%, p = 0.029) versus the control. The 1-year AF-free survival for the study and control groups was 20 (86.96%) and 28 (60.1%) patients (p = 0.027). Cox proportional hazard regression analysis showed a significant reduction in AF recurrence in the study group (HR 0.25, 95% CI 0.073-0.843, p = 0.026).</p><p><strong>Conclusion: </strong>Among patients undergoing repeat catheter ablation for recurrent AF with durably isolated PVs, the addition of VoM ethanol infusion increased the likelihood of remaining free from AF at 12 months.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792651","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":"Mid-term clinical outcomes of left bundle branch area pacing compared to accurate right ventricular septal pacing.","authors":"Yousaku Okubo, Takumi Sakai, Shogo Miyamoto, Yukimi Uotani, Naoto Oguri, Motoki Furutani, Shunsuke Miyauchi, Sho Okamura, Takehito Tokuyama, Yukiko Nakano","doi":"10.1007/s10840-024-01890-z","DOIUrl":"https://doi.org/10.1007/s10840-024-01890-z","url":null,"abstract":"<p><strong>Background: </strong>Although left bundle branch area pacing (LBBAP) reportedly results in fewer adverse outcomes after implantation than conventional stylet-guided right ventricular septal pacing (RVSP), previous studies have not compared LBBAP with accurate RVSP using a delivery catheter. The aim of this study was to compare clinical outcomes between LBBAP and accurate RVSP among patients with atrioventricular block (AVB).</p><p><strong>Methods: </strong>This single-center observational study enrolled 160 patients requiring RV pacing due to symptomatic AVB between September 2018 and December 2021. Primary composite outcomes included all-cause death, hospitalization due to heart failure (HF), and upgrading to biventricular pacing. Secondary composite outcomes included any procedural and postprocedural complications.</p><p><strong>Results: </strong>Overall, 160 patients were analyzed (LBBAP, n = 81; RVSP, n = 79). No significant differences in baseline characteristics were observed between the two groups. The RV pacing burden at 1 year after implantation was 90.8% ± 20.4% and 86.2% ± 22.6%, respectively (p = 0.21). During a mean follow-up of 840 ± 369 days, the incidence of the primary outcome was significantly lower with LBBAP (4.9%) compared to RVSP (22.8%) (Log-rank p = 0.02). There was no significant difference in the incidence of the secondary outcome between the two groups (3.7% vs. 5.1%, p = 0.65). In the multivariate analysis, baseline QRS duration, RV pacing burden, and LBBAP were independently associated with the primary outcome (baseline QRS duration: hazard ratio [HR], 1.01; 95% confidence interval [CI], 1.00-1.02; p < 0.001; RV pacing burden: HR, 1.01; 95% CI, 1.00-1.02; p < 0.001; LBBAP: HR, 0.45; 95% CI, 0.31-0.64; p < 0.001).</p><p><strong>Conclusion: </strong>In patients requiring frequent RV pacing, LBBAP was associated with reduced adverse clinical outcome compared to accurate RVSP using a delivery catheter.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788345","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":"Incidental ablation of ganglionated plexus during atrial fibrillation ablation","authors":"Stephen Keane, Darshak Patel, Brian Otto, Lily Englander, Ramanan Kumareswaran, David Lin, Michael P. Riley, Saman Nazarian, Francis E. Marchlinski, Timothy M. Markman","doi":"10.1007/s10840-024-01886-9","DOIUrl":"https://doi.org/10.1007/s10840-024-01886-9","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Cardioneuroablation targeting the autonomic nerves within ganglionated plexus (GP) has been used to treat atrial fibrillation (AF). Incidental cardioneuroablation may be an important mechanism by which pulmonary vein isolation (PVI) is effective. Automated fractionation mapping software can identify regions of fractionation correlating with GP locations.</p><h3 data-test=\"abstract-sub-heading\">Objective</h3><p>To examine the overlap between standard PVI ablation lesions and fractionated electrograms suggestive of GP.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We retrospectively examined AF ablations performed from 2021 to 2023 that included only PVI performed using wide antral circumferential isolation without prospective evaluation of fractionation. Retrospectively, a fractionation map was created (width 10 ms, refractory time 30 ms, roving sensitivity 0.1 mv, and threshold of 2). We evaluated the anatomic overlap between PVI lesions and fractionation in regions associated with GP.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Among 52 patients (mean 65 (IQR 46–74) years, 82% male, and 69% paroxysmal AF), sites of fractionation corresponding to GP locations were seen in all cases. PVI ablation incidentally overlapped with fractionation in 50 (96%) patients. On average, 26% of the fractionation corresponding with GP locations were incidentally ablated. The highest proportion of fractionated areas were ablated in the left superior (36%) and right superior (31%) GP regions. More complete incidental ablation of these regions was associated with a greater intraprocedural increase in heart rate (<i>ρ</i> = 0.46, <i>p</i> &lt; 0.001), which was subsequently associated with freedom from AF during 15.9 ± 5.2 months of follow-up.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Patients undergoing AF ablation universally have fractionated electrograms corresponding to anticipated sites of GP. Partial ablation of these regions frequently occurs incidentally during PVI.</p><h3 data-test=\"abstract-sub-heading\">Graphical Abstract</h3>\u0000","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141785303","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":"Selective complex fractionated atrial electrogram ablation based on the number-of-fractionation for persistent atrial fibrillation refractory to pulmonary vein isolation","authors":"Masahiro Mizobuchi, Tomoki Yamashita, Tatsushi Sato, Atsushi Funatsu, Tomoko Kobayashi, Shigeru Nakamura","doi":"10.1007/s10840-024-01889-6","DOIUrl":"https://doi.org/10.1007/s10840-024-01889-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Previous studies have suggested that the prolonged or highly fractionated electrograms during atrial fibrillation (AF) are closely related to the reentrant driver regions. We hypothesized that exploration and ablation of these critical complex atrial fractionated electrograms (CFAE) may improve the outcome of persistent AF (PeAF) refractory to conventional PVI.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A total of 73 PeAF patients with residual inducibility or failed cardioversions of AF after PVI were enrolled and underwent number-of-fractionation mapping (NFM) by counting the number of fractionations in 2.5 s at each of the points using the CARTO3 (ICL mode) and EnSite (fractionation map) systems. After NFM, selective CFAE ablation (NFM-CA) targeting the sites of the upper 40% of the counted fraction number (NF40) was performed as an additional procedure for refractory PeAF. We investigated the prognosis of these patients within 24 months after the index ablation procedure and the relationship between changes in activation patterns during the ablation procedure and their prognosis. We also performed a propensity score–matched analysis comparing these patients with historical controls (HC) to identify the optimal indications for NFM-CA.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The AF/AT free survival rate was 79.1% at 12 months and 56.7% at 24 months. Patients with AF termination or AF cycle length prolongation &gt; 21 ms during the procedure had significantly better AF/AT-free survival rates than those without notable activation changes (87.7% vs. 69.0%, logrank <i>p</i> = 0.028). After propensity-matched analysis, AF/AT-free survival showed comparable results between the two groups (1 year; NFM 72.1% vs. HC 77.1%, logrank <i>p</i> = 0.649).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>NFM-CA is a versatile and less invasive adjunctive procedure for patients with PVI-refractory PeAF who showed a comparable prognosis to patients with PVI-compliant PeAF. In particular, remarkable activation changes during the procedure (AFCL prolongation &gt; 21 ms or acute termination) suggest a favorable prognosis.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141772286","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":"Step-by-step application of a new ganglionated plexus mapping method in a patient with vasovagal syncope.","authors":"Şükriye Ebru Önder, Tümer Erdem Güler, Serdar Bozyel, Nur Dalgıç, Abdülcebbar Şipal, Metin Çağdaş, Emre Kılıç, Henry Huang, Tolga Aksu","doi":"10.1007/s10840-024-01885-w","DOIUrl":"https://doi.org/10.1007/s10840-024-01885-w","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751877","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}