Li Shu, Zhen Yuan, Yi Lu, Shenghui Ma, Chunhui Liu, Zhejun Cai
{"title":"Correction: Ablation of slow activation areas in addition to pulmonary vein isolation improves the maintenance of the sinus rhythm in patients with persistent atrial fibrillation.","authors":"Li Shu, Zhen Yuan, Yi Lu, Shenghui Ma, Chunhui Liu, Zhejun Cai","doi":"10.1007/s10840-025-02026-7","DOIUrl":"10.1007/s10840-025-02026-7","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572348","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}
María Cespón-Fernández, Domenico G Della Rocca, Michele Magnocavallo, Andrés Betancur, Ilenia Lombardo, Luigi Pannone, Giampaolo Vetta, Antonio Sorgente, Marco Polselli, Charles Audiat, Alvise Del Monte, Stéphane Combes, Lorenzo Marcon, Ingrid Overeinder, Kazutaka Nakasone, Sahar Mouram, Sanghamitra Mohanty, Stefano Bianchi, Alexandre Almorad, Juan Sieira, Gezim Bala, Erwin Ströker, Pietro Rossi, Andrea Sarkozy, Serge Boveda, Andrea Natale, Carlo de Asmundis, Gian-Battista Chierchia
{"title":"Redo ablation procedures to treat recurrent atrial arrhythmias via a pentaspline pulsed field ablation catheter: a prospective, multicenter experience.","authors":"María Cespón-Fernández, Domenico G Della Rocca, Michele Magnocavallo, Andrés Betancur, Ilenia Lombardo, Luigi Pannone, Giampaolo Vetta, Antonio Sorgente, Marco Polselli, Charles Audiat, Alvise Del Monte, Stéphane Combes, Lorenzo Marcon, Ingrid Overeinder, Kazutaka Nakasone, Sahar Mouram, Sanghamitra Mohanty, Stefano Bianchi, Alexandre Almorad, Juan Sieira, Gezim Bala, Erwin Ströker, Pietro Rossi, Andrea Sarkozy, Serge Boveda, Andrea Natale, Carlo de Asmundis, Gian-Battista Chierchia","doi":"10.1007/s10840-025-02021-y","DOIUrl":"https://doi.org/10.1007/s10840-025-02021-y","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing atrial fibrillation (AF) catheter ablation may require redo procedures involving pulmonary vein (PV) re-isolation and/or ablation of extra-PV sites. Pulsed field ablation (PFA) offers a highly selective energy source for cardiac tissue, with the potential to reduce collateral damage to adjacent structures. This study aimed to evaluate the feasibility and efficacy of redo ablation using a pentaspline PFA system.</p><p><strong>Methods: </strong>Patients undergoing redo procedures with a pentaspline PFA system at three international centers were enrolled. A workflow was established based on rhythm at presentation: sinus rhythm (Group 1), atrial flutter/atrial tachycardia (Group 2), or AF (Group 3). Propensity score matching was used for comparison between PFA- and RF-based redo ablations.</p><p><strong>Results: </strong>A total of 117 patients were included (Group 1: 64, Group 2: 18, Group 3: 35). PV re-isolation was required in 71.9% and 72.2% of Group 1 and 2 patients, respectively. PFA terminated all cases of non-cavotricuspid isthmus dependent flutter and 45.7% of cases of AF. One major complication (0.9%; frontal cerebral hematoma) was documented. Freedom from atrial tachyarrhythmias at 12 months was 78.3% (95% CI 69.6-84.8%) without statistically significant differences among groups (Group 1: 85.7%; Group 2: 77%; Group 3: 65.5%; p = 0.053). PFA led to similar arrhythmia freedom compared to RF, but with significantly shorter procedural and dwelling times.</p><p><strong>Conclusion: </strong>The adoption of a pentaspline PFA system for repeat ablation procedures was feasible, safe, and effective at 1-year follow-up. No clinical differences were observed between PFA and RF; however, redo PFA cases were significantly shorter.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557157","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}
Mark T Mills, Peter Calvert, Calum Phenton, Nicole Worthington, Derick Todd, Simon Modi, Reza Ashrafi, Richard Snowdon, Dhiraj Gupta, Vishal Luther
{"title":"An approach to electroanatomical mapping with a pentaspline pulsed field catheter to guide atrial fibrillation ablation.","authors":"Mark T Mills, Peter Calvert, Calum Phenton, Nicole Worthington, Derick Todd, Simon Modi, Reza Ashrafi, Richard Snowdon, Dhiraj Gupta, Vishal Luther","doi":"10.1007/s10840-025-01980-6","DOIUrl":"https://doi.org/10.1007/s10840-025-01980-6","url":null,"abstract":"<p><strong>Background: </strong>Pulsed field ablation (PFA) of atrial fibrillation (AF) using a pentaspline multi-electrode catheter is commonly performed under fluoroscopic guidance. No data exist on the integration of this catheter within a three-dimensional electroanatomical mapping (3D-EAM) system for left atrial voltage and activation mapping, posterior wall isolation (PWI), or redo ablation. This technical report reviews an approach whereby mapping is performed using the pentaspline PFA catheter itself within an open architectural impedance-based 3D-EAM system.</p><p><strong>Methods: </strong>Cases involved mapping with the PFA catheter itself, with real-time visualisation of the guidewire tip and catheter within the 3D-EAM system. In certain cases, additional 3D-EAM was performed with a grid-style high-density mapping catheter for comparison.</p><p><strong>Results: </strong>In a series of 22 patients (45% female, mean age 63 ± 13 years, 55% paroxysmal AF, 27% redo procedures), mapping increased procedural times (mean 108 min vs. 68 min in fluoroscopy-only controls), without reducing fluoroscopy times. Three potential advantages of mapping with the PFA catheter were identified: (1) The technique helped identify sleeves of incomplete pulmonary vein isolation after index applications. (2) In the four cases mapped with both the PFA and grid-style catheters, voltage maps appeared concordant. (3) The technique helped facilitate robust PWI and identify inadvertent partial PWI.</p><p><strong>Conclusions: </strong>3D-EAM with a pentaspline PFA catheter itself is feasible, without the need for high-density mapping catheters. This approach has potential advantages over fluoroscopic-only guidance, although its long-term efficacy and cost-effectiveness require formal assessment.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542298","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}
Jannis Dickow, Nele Gessler, Omar Anwar, Johannes Feldhege, Tim Harloff, Jens Hartmann, Mario Jularic, Rahin Wahedi, Borislav Dinov, Peter Wohlmuth, Stephan Willems, Melanie Gunawardene
{"title":"Safety of immediate catheter ablation of ventricular arrhythmias in patients admitted via the emergency department.","authors":"Jannis Dickow, Nele Gessler, Omar Anwar, Johannes Feldhege, Tim Harloff, Jens Hartmann, Mario Jularic, Rahin Wahedi, Borislav Dinov, Peter Wohlmuth, Stephan Willems, Melanie Gunawardene","doi":"10.1007/s10840-025-02020-z","DOIUrl":"https://doi.org/10.1007/s10840-025-02020-z","url":null,"abstract":"<p><strong>Background: </strong>In patients with ventricular arrhythmias (VA) admitted via the emergency department (ED), immediate catheter ablation (CA-VA) might be indicated to stabilize patients. However, the unstable condition of these patients may increase periprocedural risk. This study evaluated the periprocedural safety of immediate CA-VA in patients admitted via the ED.</p><p><strong>Methods and results: </strong>In total, 223 ED patients who underwent immediate CA-VA from 01/2017 to 12/2022 (mean age 66 ± 13 years, 19% female, 55% heart failure, 59% coronary artery disease) were analyzed in terms of in-hospital outcomes (periprocedural death, pericardial tamponade, thromboembolic events, major bleedings). To address differences to elective patients, ED patients were compared with 784 elective CA-VA patients (mean age 59 ± 15 years, 34% female, 20% heart failure, 33% coronary artery disease, all p < 0.001): ED patients experienced higher rates of periprocedural complications (6.3% vs. 2.0%, p = 0.002) driven by thromboembolic events (2.2% vs. 0.4%, p = 0.02). Life-threatening complications were not different between groups (cardiac tamponade: 2.2% vs. 1.4%, p = 0.56; stroke: 0.9% vs. 0.4%, p = 0.67). Seven ED patients (3.1%) died unrelated to the procedure during hospitalization vs. none in the elective CA-VA group. Emergency admission (OR 3.07, 95% CI 1.48-6.38), age (OR 2.12, 95% CI 1.22-3.70), and heart failure (OR 1.99, 95% CI 0.96-4.15) were independently associated with periprocedural complications and overall death during hospitalization.</p><p><strong>Conclusion: </strong>Patients with VA admitted via the ED were older, sicker, and more often presented with ventricular tachycardia than elective CA-VA patients. Immediate CA-VA was associated with higher rates of periprocedural complications, driven by thromboembolic events; however, no procedure-related death occurred.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523701","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}
Ahmad Keelani, Lorenzo Bartoli, Alessio Gasperetti, Sorin Popescu, Marco Schiavone, Anna Traub, Huong-Lan Phan, Marcel Feher, Thomas Fink, Vanessa Sciacca, Martin Nitschke, Julia Vogler, Charlotte Eitel, Giovanni Forleo, Christian-H Heeger, Roland R Tilz
{"title":"Safety and efficacy of atrial fibrillation ablation in kidney transplant patients.","authors":"Ahmad Keelani, Lorenzo Bartoli, Alessio Gasperetti, Sorin Popescu, Marco Schiavone, Anna Traub, Huong-Lan Phan, Marcel Feher, Thomas Fink, Vanessa Sciacca, Martin Nitschke, Julia Vogler, Charlotte Eitel, Giovanni Forleo, Christian-H Heeger, Roland R Tilz","doi":"10.1007/s10840-025-02006-x","DOIUrl":"https://doi.org/10.1007/s10840-025-02006-x","url":null,"abstract":"<p><strong>Introduction: </strong>Managing atrial fibrillation in kidney transplant patients poses a challenge for both nephrologists and cardiologists. Data regarding the safety and efficacy of catheter ablation in this patient's cohort is scarce.</p><p><strong>Methods and results: </strong>In this two-center prospective study, we included all consecutive kidney transplant patients who underwent atrial fibrillation ablation between April 2017 and March 2022. A 1:3 propensity score matching created a control group of non-transplant AF patients undergoing ablation. We included 16 kidney transplant patients and 48 matched controls. Ablation was successful in all patients. The periprocedural complication rate (6.3% in the kidney transplant group vs. 6.3% in the control group, p value = 1) did not differ between the two groups. One transplant patient experienced graft dysfunction after a complication. At 18 months, AF recurrence-fee rates were 69% in the transplant group and 70.1% in controls (p = 0.95). By the last follow-up, all transplant patients had discontinued antiarrhythmic drugs, while 19.6% of the patients in the control group were treated with antiarrhythmic drugs (p = 0.09). Kidney function in the transplant group remained stable (eGFR 32 [23.8, 40.5] ml/min/1.73 m<sup>2</sup> before vs. 34 [29.8, 38] ml/min/1.73 m<sup>2</sup> at last follow up, p = 0.93).</p><p><strong>Conclusions: </strong>This study demonstrates that catheter ablation is a viable option for treating AF in kidney transplant patients, with comparable outcomes to non-transplanted individuals. Discontinuing antiarrhythmic drugs reduces drug interaction risks, but minimizing procedural complications remains critical to preserving graft function.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523693","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}
Siddharth Agarwal, Zain Ul Abideen Asad, Muhammad Bilal Munir, Alan Sugrue, Nicholas Y Tan, Freddy Del-Carpio Munoz, Siva K Mulpuru, Yong-Mei Cha, Christopher V DeSimone, Abhishek Deshmukh
{"title":"Regional differences in the outcomes of leadless pacemaker implantation in the USA.","authors":"Siddharth Agarwal, Zain Ul Abideen Asad, Muhammad Bilal Munir, Alan Sugrue, Nicholas Y Tan, Freddy Del-Carpio Munoz, Siva K Mulpuru, Yong-Mei Cha, Christopher V DeSimone, Abhishek Deshmukh","doi":"10.1007/s10840-025-02023-w","DOIUrl":"https://doi.org/10.1007/s10840-025-02023-w","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501966","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}
Sabrina Oebel, Joaquin Garcia Garcia, Arash Arya, Cosima Jahnke, Ingo Paetsch, Susanne Löbe, Kerstin Bode, Rachel M A Ter Bekke, Kevin Vernooy, Nikolaos Dagres, Gerhard Hindricks, Angeliki Darma
{"title":"Late gadolinium enhancement imaging for the prediction of ventricular tachycardia ablation outcome.","authors":"Sabrina Oebel, Joaquin Garcia Garcia, Arash Arya, Cosima Jahnke, Ingo Paetsch, Susanne Löbe, Kerstin Bode, Rachel M A Ter Bekke, Kevin Vernooy, Nikolaos Dagres, Gerhard Hindricks, Angeliki Darma","doi":"10.1007/s10840-025-02017-8","DOIUrl":"https://doi.org/10.1007/s10840-025-02017-8","url":null,"abstract":"<p><strong>Background: </strong>Preprocedural cardiac magnetic resonance (CMR) imaging is crucial for identifying ventricular scar areas, borderline zones, and potential reentry channels. This study aimed to evaluate the impact of late gadolinium enhancement (LGE) core and borderline mass on the acute and long-term outcomes of ventricular tachycardia (VT) ablation in patients with structural heart disease (SHD).</p><p><strong>Methods and results: </strong>A total of 204 consecutive patients underwent CMR before scheduled VT ablation. Of these, 38 were excluded due to incomplete LGE quantification caused by device-related imaging artifacts, and 19 had no detectable left ventricular (LV) LGE, resulting in a final cohort of 147 patients with positive LGE (median age 64 years, 57% with non-ischemic cardiomyopathy [NICM], median left ventricular ejection fraction 38%, 61% with defibrillators). Patients with ischemic cardiomyopathy (ICM) had higher LV mass (86 vs. 75 g, P = 0.005) and LGE core mass (21 vs. 12 g, P = 0.001) compared to NICM patients, while borderline LGE mass was similar (2.9 vs. 2.5 g, P = 0.240). ICM patients more frequently presented with transmural inferior scars, whereas NICM patients exhibited more diffuse, non-transmural LGE patterns, particularly in the inferolateral, inferoseptal, and anteroseptal regions. Post-ablation, 28 patients (19%) remained acutely inducible (with clinical VT in two), and 53 patients (36%) experienced VT recurrence within a 20-month follow-up period. Neither high LGE core mass nor borderline mass predicted VT inducibility or recurrence. Most patients with clinical deterioration had NICM with septal involvement.</p><p><strong>Conclusion: </strong>In patients with SHD undergoing VT ablation, neither high LGE core mass nor borderline mass was predictive of postprocedural VT inducibility or recurrence.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468317","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}
Muhammad Arslan Ul Hassan, Sana Mushtaq, Tao Li, Zhen Yang, Abdul Rehman, Al-Qaisi Mohammed Abdulkarem
{"title":"Correlation between diagnosis-to-ablation time and atrial fibrillation recurrence: a systematic review and meta-analysis.","authors":"Muhammad Arslan Ul Hassan, Sana Mushtaq, Tao Li, Zhen Yang, Abdul Rehman, Al-Qaisi Mohammed Abdulkarem","doi":"10.1007/s10840-025-02015-w","DOIUrl":"https://doi.org/10.1007/s10840-025-02015-w","url":null,"abstract":"<p><strong>Background: </strong>The time from the initial diagnosis of atrial fibrillation (AF) to the index ablation procedure, known as diagnosis-to-ablation time (DAT), is a modifiable risk factor that is correlated to affect the recurrence of AF. The objective of this meta-analysis was to examine the correlation between diagnosis-to-ablation time and AF recurrence.</p><p><strong>Methods: </strong>A systematic search was performed in PubMed, Google Scholar, and Cochrane Library from database inception till June 2024. Studies reporting diagnosis-to-ablation time and its relation with AF recurrence were included. The primary analysis evaluated outcomes segregated by DAT ≤ 1 year versus > 1 year. Random-effects model with the Mantel-Haenszel method was used to evaluate AF recurrence.</p><p><strong>Results: </strong>Of the 9177 articles, only 6 observational studies got through the inclusion criteria with a total participant count of 14,862. DAT of greater than 1 year was associated with increased risk of AF recurrence in all the included studies while DAT of ≤ 1 year was correlated with lower risk of AF recurrence (RR, 0.76 (95% CI, 0.73-0.79); P < 0.01). Similarly, DAT of ≤ 3 years was correlated with lower AF recurrence risk (RR, 0.82 (95% CI, 0.79-0.85); P < 0.01).</p><p><strong>Conclusion: </strong>Evidence from observational cohorts suggests that the optimum time for ablation in AF patients is less than 1 year and a DAT of ≤ 1 year is linked to 24% lower chances of recurrence in AF patients, compared to DAT of ≥ 1 year.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468316","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}
Roberto Scacciavillani, Jackson J Liang, Piotr Futyma
{"title":"Bipolar ablation: another arrow in the electrophysiologist's quiver when targeting intramural ventricular arrhythmias.","authors":"Roberto Scacciavillani, Jackson J Liang, Piotr Futyma","doi":"10.1007/s10840-025-01984-2","DOIUrl":"https://doi.org/10.1007/s10840-025-01984-2","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472555","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}