Journal of Interventional Cardiac Electrophysiology最新文献

{"title":"The risk still remains: left circumflex artery subocclusion after radiofrequency application inside the coronary sinus during mitral isthmus block.","authors":"Muhieddine Omar Chokr, Luan Vieira Rodrigues, Wlademir Dos Santos Junior, Jose Roberto Maiello, Omar Samir Choukr, Afonso Dalmazio Souza Mario, Eduardo Pelegrineti Targueta, Mauricio Ibrahim Scanavacc","doi":"10.1007/s10840-025-02039-2","DOIUrl":"https://doi.org/10.1007/s10840-025-02039-2","url":null,"abstract":"<p><strong>Introduction: </strong>In ablation procedures for patients with perimitral atrial tachycardia, it is often necessary to apply radiofrequency energy inside the coronary sinus. Although this location is anatomically close to the left circumflex artery, its occlusion is a rare complication. A 40-year-old man underwent ablation for perimitral atrial tachycardia with radiofrequency applications inside the coronary sinus to create a lateral mitral block line. Minutes after the tachycardia was interrupted, the patient suddenly developed ST-segment elevation in the inferior leads and underwent successful angioplasty of the circumflex artery, with good clinical evolution over a 30-month follow-up period.</p><p><strong>Discussion: </strong>Coronary artery injury secondary to radiofrequency ablation procedures is a rare complication. However, the incidence of circumflex artery injury during applications inside the coronary sinus may be underestimated, as suggested by some studies. Several strategies, including meticulous procedural planning, can help mitigate this risk. However, further research is essential to develop strategies that eliminate the risk altogether.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811496","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":"Breaking barriers in atrial ablations: pulsed field ablation over left atrial scar lesions.","authors":"Panteleimon E Papakonstantinou, Kifayat Qazalbash, Gabor Szeplaki","doi":"10.1007/s10840-025-02032-9","DOIUrl":"https://doi.org/10.1007/s10840-025-02032-9","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811494","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":"The use of cardiac imaging in patients undergoing atrial fibrillation ablation.","authors":"Gaia Filiberti, Giulia Antonelli, Giulio Falasconi, Alessandro Villaschi, Stefano Figliozzi, Martina Maria Ruffo, Antonio Taormina, Guido Del Monaco, Alessia Chiara Latini, Sebastiano Carli, Kamil Stankowski, Stefano Valcher, Nicola Cesani, Francesco Amata, Alessandro Giaj Levra, Filippo Giunti, Giacomo Carella, David Soto-Iglesias, Dario Turturiello, Federico Landra, Andrea Saglietto, Emanuele Curti, Pietro Francia, Julio Martí-Almor, Diego Penela, Antonio Berruezo","doi":"10.1007/s10840-025-02035-6","DOIUrl":"https://doi.org/10.1007/s10840-025-02035-6","url":null,"abstract":"<p><p>Cardiac imaging (CI), including echocardiography, multidetector computed tomography (MDCT), and cardiac magnetic resonance (CMR), is gaining increasing interest to aid atrial fibrillation (AF) ablation procedures, from pre-procedural planning to intra-procedural guidance. Transthoracic echocardiography is widely used for imaging, especially for preprocedural assessment, while transesophageal and intracardiac echocardiography (ICE) are used for intraprocedural guidance during transseptal puncture. Cardiac MDCT, leveraging its high spatial resolution, offers a detailed anatomical visualization of cardiac chambers and adjacent structures; moreover, left atrial wall thickness assessed by MDCT may guide radiofrequency energy titration to enhance procedural safety and efficiency. At the same time, CMR allows for detailed myocardial tissue characterization and the detection of fibrosis. ICE, MDCT, and CMR also permit intra-procedural image integration with electroanatomical maps, allowing to be aware of a greater amount of intra-procedural real-time information regarding the anatomy and the local characteristics of the tissue in contact with the ablation catheter. One of the primary objectives of performing CI-aided AF ablations is to increase procedural safety and to permit more personalized procedures, according to the characteristics of each patient. This review offers a comprehensive overview of the current applications of CI during the different phases of AF ablation and explores the potential future applications of CI in this context.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803624","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 outcomes of pace-and-ablate strategy in patients with atrial fibrillation.","authors":"Johan van Koll, Madelon D E A Engels, Jesse H J Rijks, Madelon Salari, Jelle Luijten, Joost Lumens, Vanessa P M van Empel, Sjoerd W Westra, Antonius M W van Stipdonk, Theo A R Lankveld, Sevasti M Chaldoupi, Jacqueline Joza, Rypko J Beukema, Justin G L M Luermans, Dominik K Linz, Kevin Vernooy","doi":"10.1007/s10840-025-02038-3","DOIUrl":"https://doi.org/10.1007/s10840-025-02038-3","url":null,"abstract":"<p><strong>Background: </strong>The pace-and-ablate strategy is second -line therapy to obtain rate control in patients with persistent symptomatic atrial fibrillation (AF) when other treatment options fail. This study aims to evaluate long-term effects on clinical outcomes following pace-and-ablate strategy in AF patients.</p><p><strong>Methods: </strong>This retrospective study includes patients who underwent successful pacemaker implantation (right ventricular pacing (RVP) or cardiac re-synchronization therapy (CRT)) followed by atrioventricular node ablation (AVNA) between 2010 and 2020. Patients were treated according to the prevailing guidelines. The primary endpoint was a composite of all-cause mortality and heart failure hospitalization (HFH). Secondary endpoints were individual outcomes of all-cause mortality, HFH, and left-ventricular ejection fraction (LVEF) change.</p><p><strong>Results: </strong>Two hundred ninety-eight patients were included, 162 undergoing RVP, and 136 receiving CRT, with a median follow-up of 5.8 years [4.1-8.0]. The primary endpoint occured in 47% of the RVP group and 49% of the CRT group (p = 0.206). All-cause mortality occurred in 36% of the RVP group and in 45% of the CRT group (p = 0.005). HFH occurred in 22% of the RVP group and in 15% of the CRT group (p = 0.328), with 17(10%) upgrades to CRT in the RVP group. Median LVEF in the RVP group remained stable (56% [49-60] to 53% [43-57]; p = 0.081), while it improved in the CRT group (31% [22-38] to 43% [32-51]; p < 0.001).</p><p><strong>Conclusion: </strong>Mortality and HFH in patients with AF managed through a pace-and-ablate strategy are high. Reassuringly, LVEF deterioration requiring upgrade to CRT is uncommon in patients undergoing RVP with normal baseline LVEF before AVNA. CRT improves LVEF in patients with reduced LVEF before AVNA.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803622","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":"Acute outcomes and learning curve from the initial patients treated with the PulseSelect system: a real-world multicenter experience of pulsed field ablation.","authors":"Giulio Molon, Stefano Nardi, Gianfranco Mitacchione, Antonio Dello Russo, Danilo Ricciardi, Roberto Mantovan, Luca Bontempi, Alessandro Costa, Luigi Argenziano, Edoardo Casali, Vincenzo Turco, Giuseppe Boriani","doi":"10.1007/s10840-025-02036-5","DOIUrl":"https://doi.org/10.1007/s10840-025-02036-5","url":null,"abstract":"<p><strong>Introduction: </strong>Catheter ablation is a cornerstone in managing patients with symptomatic, drug-refractory atrial fibrillation (AF), and while effective, traditional thermal ablation techniques are associated with rare but significant complications due to a non-selective thermal energy transfer to all biologic tissues. Pulsed field ablation (PFA) offers a non-thermal approach, targeting myocardial tissue selectively while sparing adjacent structures. The PulseSelect system is a novel PFA platform, and this analysis examines the procedural outcomes, acute complications, and the learning curve associated with introduction of the PulseSelect system in six European centers.</p><p><strong>Methods: </strong>The One Shot to Pulmonary Vein Isolation (1STOP) project prospectively included 131 patients with paroxysmal or persistent AF treated with the PulseSelect system across six centers. Procedural data, patient characteristics, and acute outcomes were summarized. Additionally, sedation protocols, fluoroscopic times, and acute success rates were reported.</p><p><strong>Results: </strong>Patients (mean age 61.7 ± 9.7 years; 31.3% female) had predominantly paroxysmal AF (80.9%). Median procedural and fluoroscopy times were 55.0 and 16.0 min, respectively. General anesthesia was used in 75.5% of cases, while in the remaining 24.5% moderate sedation protocols allowed procedures (even in 15.1% without an anesthesiologist). Acute PVI success was 100%, and no major complications were observed. A short learning curve was noted, with significant reductions in procedural times after the initial 2-3 cases at each center.</p><p><strong>Conclusion: </strong>The PulseSelect system showed short procedural times, with a rapid learning curve, thus leading with high procedural efficiency. In 1 out of 4 cases general anesthesia was not applied, and no major complications were observed.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780379","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":"Left bundle branch area pacing prevails over His bundle pacing for heart failure patients undergoing atrioventricular node ablation in permanent atrial fibrillation: a network meta-analysis.","authors":"Jing-Wen Ding, Yu-Ang Jiang, Qiu-Ting Wang, Chu Guo, Jian-Hui Yao, Gong-Qiang Dai, Jing-Chen, Huai-Sheng Ding","doi":"10.1007/s10840-025-02034-7","DOIUrl":"https://doi.org/10.1007/s10840-025-02034-7","url":null,"abstract":"<p><strong>Background: </strong>Atrioventricular node ablation (AVNA) and pacemaker implantation enhance prognosis in heart failure patients experiencing rapid ventricular response due to atrial fibrillation. This meta-analysis assessed the clinical benefits of various pacing modalities following AVNA.</p><p><strong>Methods: </strong>The electrophysiological endpoint was defined as QRS duration, while the echocardiographic endpoint was the change in left ventricular ejection fraction. Secondary endpoints included pacing threshold, mortality rates, and improvements in the 6-min walk test.</p><p><strong>Results: </strong>This meta-analysis of 13 studies involving 1257 patients suggested that His bundle pacing (HBP) and left bundle branch area pacing (LBBAP) conferred an advantage in narrowing QRS duration compared to biventricular pacing (BVP) (HBP vs BVP OR = - 59.05, 95%CI = - 73.12 to - 44.97; LBBAP vs BVP OR = - 48.64, 95%CI = - 64.05 to - 33.24). The findings of echocardiographic endpoints suggested that LBBAP and HBP emerged as the optimal strategies over RVP (vs HBP OR = - 7.59, 95%CI = - 11.85 to - 3.32; vs LBBAP OR = - 6.58, 95%CI = - 12.08 to - 1.07). LBBAP reduced all-cause mortality compared to BVP (OR = 0.10, 95%CI = 0.01-0.78); however, no significant differences in all-cause mortality were observed between LBBAP and HBP. The pacing threshold of LBBAP was significantly lower than HBP (OR = - 0.40, 95%CI = - 0.57 to - 0.23).</p><p><strong>Conclusion: </strong>LBBAP not only demonstrated superior clinical outcomes regarding mortality compared to ventricular pacing strategies, but also was associated with a lower pacing threshold than HBP, thereby indicating its potential advantage over HBP in patients undergoing AVNA and subsequent pacemaker implantation.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772468","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":"Variability in high-voltage impedance: an exploratory case study on human specimens.","authors":"Willeke van der Stuijt, Kirsten M Kooiman, Lonneke Smeding, Reinoud E Knops","doi":"10.1007/s10840-023-01569-x","DOIUrl":"10.1007/s10840-023-01569-x","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"489-491"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9924817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A catheter ablation case of confluent inferior and left superior pulmonary veins: a rare pulmonary vein variation.","authors":"Yuki Tanaka, Masaru Yamaki, Yasumi Igarashi","doi":"10.1007/s10840-025-01988-y","DOIUrl":"10.1007/s10840-025-01988-y","url":null,"abstract":"<p><p>Pulmonary vein (PV) variations are commonly detected by preoperative imaging modalities in catheter ablation for atrial fibrillation. However, rare variations that have not been previously reported exist. The present case is the first reported instance of three PVs originating from a common trunk. Contrast-enhanced cardiac computed tomography revealed that the left superior, left inferior, and right inferior PVs originated from the common trunk. Additionally, 3-dimensional electroanatomical mapping revealed interesting findings, showing that the three PVs and their common trunk were scarred areas prior to catheter ablation. The rare common PV may have no arrhythmogenic substrate in the PV antrum or common trunk.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"493-496"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006751","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 impact of atrial fibrillation catheter ablation on heart failure with preserved ejection fraction.","authors":"Harsh Patel, Rezwan Munshi, Aakash Sheth, Siddharth Agarwal, Freddy Del-Carpio Munoz, Guru Kowlgi, Christopher V DeSimone, Mohamed Rafa Labedi, Sourbha Dani, Abhishek Deshmukh","doi":"10.1007/s10840-024-01939-z","DOIUrl":"10.1007/s10840-024-01939-z","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of catheter ablation as a treatment approach for patients with concurrent atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF) has been inadequately investigated.</p><p><strong>Objective: </strong>This study's objective was to assess the effectiveness of atrial fibrillation ablation (AFA) in patients with heart failure with preserved ejection fraction.</p><p><strong>Methods: </strong>Utilizing the TriNetX research network, we identified individuals aged 18 and older with atrial fibrillation (AF) and concurrent heart failure with preserved ejection fraction (HFpEF) from January 1, 2010, to June 1, 2021. Patients were further classified based on their catheter ablation procedure, using Current Procedural Terminology codes. Following propensity-score matching, each cohort consisted of 9440 patients. The primary endpoint was all-cause mortality at two years and secondary outcomes during the 2-year follow-up encompassing readmissions for heart failure, AF, and stroke.</p><p><strong>Results: </strong>In propensity-matched cohort, patients with AF and HFpEF who underwent AFA plus medical therapy had significantly lower all-cause mortality at two years than those who did not undergo AFA (hazard ratio (HR): 0.37, 95% CI: 0.34-0.40; P < 0.001) even after matching antiarrhythmic medications. At two years, secondary outcomes including HF readmissions (HR: 0.86 95% CI: 0.84-0.89; P < 0.001) and stroke readmissions (HR: 0.66 95% CI: 0.59-0.73; P < 0.001) were lower in the AFA group.</p><p><strong>Conclusion: </strong>AFA amongst AF patients with concomitant HFpEF showed a significant reduction in all-cause mortality. It also leads to significant reductions in readmissions due to HF and ischemic stroke at two years.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"681-689"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877149","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":"Effective ablation settings that predict chronic scar after atrial ablation with HELIOSTAR™ multi-electrode radiofrequency balloon catheter.","authors":"Yuki Ishidoya, Eugene Kwan, Bram Hunt, Matthias Lange, Tushar Sharma, Derek J Dosdall, Rob S Macleod, Eugene G Kholmovski, T Jared Bunch, Ravi Ranjan","doi":"10.1007/s10840-024-01948-y","DOIUrl":"10.1007/s10840-024-01948-y","url":null,"abstract":"<p><strong>Background: </strong>Radiofrequency balloon (RFB) ablation (HELIOSTAR™, Biosense Webster) has been developed to improve pulmonary vein ablation efficiency over traditional point-by-point RF ablation approaches. We aimed to find effective parameters for RFB ablation that result in chronic scar verified by late gadolinium enhancement cardiac magnetic resonance (LGE-CMR).</p><p><strong>Methods: </strong>A chronic canine model (n = 8) was used to ablate in the superior vena cava (SVC), the right superior and the left inferior pulmonary vein (RSPV and LIPV), and the left atrial appendage (LAA) with a circumferential ablation approach (RF energy was delivered to all electrodes simultaneously) for 20 s or 60 s. The electroanatomical map with the ablation tags was projected onto the 3-month post-ablation LGE-CMR. Tags were divided into two groups depending on whether they correlated with CMR-based scar (ScarTags) or non-scar tissue (Non-ScarTags). The effective parameters for scar formation were estimated by multivariate logistic regression.</p><p><strong>Results: </strong>This study assessed 80 lesions in the SVC, 80 lesions in the RSPV, 20 lesions in the LIPV, and 30 lesions in the LAA (168 ScarTags and 42 Non-ScarTags). In the multivariate analysis, two variables were associated with chronic scar formation: temperature of electrode before energy application (odds ratio (OR) 0.805, p = 0.0075) and long RF duration (OR 2.360, p = 0.0218), whereas impedance drop was not associated (OR 0.986, p = 0.373).</p><p><strong>Conclusion: </strong>Lower temperature of the electrode before ablation and long ablation duration are critical parameters for durable atrial scar formation with RFB ablation.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"625-633"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729674","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}