Journal of Interventional Cardiac Electrophysiology最新文献

{"title":"Volumetric lesion analysis and validation of various bipolar configurations in radiofrequency ablation of ventricular myocardium in a bovine model.","authors":"Saikiran Kakarla, UmaShankar Pr, Sabari Saravanan, Narayanan Namboodiri","doi":"10.1007/s10840-024-01927-3","DOIUrl":"https://doi.org/10.1007/s10840-024-01927-3","url":null,"abstract":"<p><strong>Background: </strong>The bipolar radiofrequency ablation(B-RFA) strategy was increasingly used to target deep intramural re-entrant foci responsible for the arrhythmia not ablated by conventional unipolar RFA / sequential unipolar RFA. Lesional characteristics of various bipolar configurations were largely unknown.</p><p><strong>Objective: </strong>To investigate the lesional geometry in relation to various factors to determine the most effective ablation strategy that minimises steam pops and achieves transmurality. To assess the temperatures at the return electrode.</p><p><strong>Methods: </strong>A custom-made validated ex-vivo bipolar ablation model was used to assess lesion formation. The myocardial sample was placed between two ablation catheters in four different orientations. Lesions were created using different power (30 W, 40 W, 50 W) and time settings(30, 40 and 50 s) with different catheter orientations. Data was analysed using binary logistic regression and multiple linear regression.</p><p><strong>Results: </strong>Among 107 lesions, The volume of the active catheter lesion (266 +/- 137 mm^3) significantly differed from their return electrode counterparts (130 +/- 91.8 mm^3) (p < 0.001), and the temperatures at the return electrode end were lower than at the active electrode (p = 0.004). Higher power and longer duration application led to more frequent steam pops (p < 0.001), while true parallel configuration resulted in fewer steam pops (p < 0.001).</p><p><strong>Conclusion: </strong>A custom model without ground electrode temperature monitoring is safe and cost-effective. The safest strategy is a true parallel configuration with an inter-electrode distance of at least 15 mm and a power of 30 W to 40 W, which generates lower steam pops and better transmurality.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467639","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":"Fluoroscopy-free cardioneuroablation for functional bradycardia: a single-center experience.","authors":"Parnia Abolhassan Choubdar, Megan Gruber, Jose Carlos Pachon-M, Stephen Manu, Mansour Razminia, John Clark","doi":"10.1007/s10840-024-01926-4","DOIUrl":"https://doi.org/10.1007/s10840-024-01926-4","url":null,"abstract":"<p><strong>Background: </strong>Cardioneuroablation (CNA) is an emerging treatment for cardioinhibitory syncope and functional AV block. This study aimed to evaluate the safety and efficacy of a fluoroless CNA approach using three-dimensional mapping and extracardiac vagal stimulation (ECVS).</p><p><strong>Methods: </strong>This prospective observational study included 22 patients (mean age 21 years) with clinically significant functional bradycardia who underwent fluoroless CNA. Procedural success was defined as elimination or significant attenuation of the vagal response to ECVS.</p><p><strong>Results: </strong>CNA was successfully performed in all patients with a mean procedure time of 251 min. Fluoroscopy was avoided in 91% of cases. At a mean follow-up of 11.4 months, 77% of patients remained symptom-free. Among pacemaker patients, 90% did not require further pacing, and 6/10 (60%) have had their pacemakers turned off. No complications were seen during the procedure.</p><p><strong>Conclusions: </strong>Fluoroscopy-free CNA is a safe and effective treatment for functional bradycardia, offering high procedural success rates and favorable symptom-free outcomes while minimizing radiation exposure.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391105","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":"Invasive management of atrial tachycardias using a novel lattice-tip catheter combining high-density mapping and dual ablation properties: initial real-world experience.","authors":"Ourania Kariki, Panagiotis Mililis, Athanasios Saplaouras, Theodoros Efremidis, Stylianos Dragasis, Konstantinos P Letsas, Michael Efremidis","doi":"10.1007/s10840-024-01928-2","DOIUrl":"https://doi.org/10.1007/s10840-024-01928-2","url":null,"abstract":"<p><strong>Background: </strong>Invasive management of atrial tachycardias(ATs) requires proper diagnosis of the mechanism followed by elimination of the responsible substrate. A novel lattice-tip catheter with both high-density mapping and dual ablation properties(radiofrequency-RF/pulsed field ablation-PFA) has been recently introduced for catheter ablation of atrial fibrillation. We present the first study to assess its performance in the management of ATs (diagnostic and therapeutic).</p><p><strong>Methods: </strong>Patients with documented ATs were selected. Activation mapping was used for the establishment of the AT mechanism. Confirmation with entrainment was performed, whenever appropriate. Accuracy of the activation mapping in diagnosis, acute ablation efficacy, and procedural characteristics were the study endpoints.</p><p><strong>Results: </strong>Twenty patients were included (12 cavotricuspid isthmus-dependent atrial flutters, 5 mitral flutters, 2 roof flutters, and 2 focal ATs). Proper diagnosis was established by activation mapping in all cases. The mean mapping time was 7.85 ± 3.06 min with 296.82 ± 150.9 mean mapping points/minute. The mean ablation time was 54.25 ± 42.97 s. Conversion to sinus rhythm during ablation was achieved in all cases with the exception of a roof flutter that converted to mitral flutter and a case of a parahisian AT in which ablation was not attempted. Patients that received ablation did not experience any arrhythmia recurrence in a mean follow up of 4.14 ± 0.91 months. No major or minor complications occurred.</p><p><strong>Conclusion: </strong>The lattice-tip catheter and its dedicated electroanatomical mapping system provided sufficiently detailed activation mapping for the diagnosis of the AT mechanism. The delivered lesions were highly effective acutely, with no adverse events. However, limitations exist and should be acknowledged.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391106","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":"Peak frequency mapping in Brugada Syndrome.","authors":"Paulo Medeiros, Pedro A Sousa, Carolina Saleiro, Natália António, Patrícia Alves, João Ferreira, Luís Elvas, Lino Gonçalves","doi":"10.1007/s10840-024-01925-5","DOIUrl":"https://doi.org/10.1007/s10840-024-01925-5","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372062","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 potato model: A root of all pulsed field ablation experimentation?","authors":"Martin van Zyl, Christopher V DeSimone","doi":"10.1007/s10840-024-01924-6","DOIUrl":"https://doi.org/10.1007/s10840-024-01924-6","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372063","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":"Response to \"How to demonstrate the advantage of cryoballoon pulmonary vein isolation over cavotricuspid isthmus ablation in patients with typical atrial flutter\".","authors":"Peter Calvert, Dhiraj Gupta","doi":"10.1007/s10840-024-01855-2","DOIUrl":"10.1007/s10840-024-01855-2","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1479-1480"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554971","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 rare presentation of Ebstein's anomaly: left-sided accessory pathway and tricuspid stenosis.","authors":"Kathryn H Schwartzman, Jack R Stines, Hemal M Nayak, Utkarsh Kohli","doi":"10.1007/s10840-024-01784-0","DOIUrl":"10.1007/s10840-024-01784-0","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1495-1497"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119804","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":"Outcomes of patients with cardiac amyloidosis undergoing percutaneous left atrial appendage occlusion.","authors":"Siddharth Agarwal, Sukriti Banthiya, Agam Bansal, Muhammad Bilal Munir, Christopher V DeSimone, Abhishek Deshmukh, Zain Ul Abideen Asad","doi":"10.1007/s10840-024-01843-6","DOIUrl":"10.1007/s10840-024-01843-6","url":null,"abstract":"<p><strong>Background: </strong>There is limited data on the safety and efficacy of left atrial appendage occlusion (LAAO) devices in patients with cardiac amyloidosis. We examined the outcomes of patients with cardiac amyloidosis undergoing LAAO device implantation in a nationally representative cohort of patients.</p><p><strong>Methods: </strong>The National Readmissions Database (NRD) was analyzed from 2016 to 2019 to identify patients ≥ 18 years old with atrial fibrillation (AF) undergoing LAAO. Patients were divided into those with cardiac amyloidosis and those without cardiac amyloidosis. A multivariable logistic regression model was utilized to assess the independent association of cardiac amyloidosis with in-hospital, 30-day/90-day/180-day outcomes after adjusting for confounders.</p><p><strong>Results: </strong>Our cohort included 54,900 LAAO implantation procedures, of which 220 (0.4%) had cardiac amyloidosis. Patients with cardiac amyloidosis had a lower proportion of women and a lower prevalence of comorbidities including anemia, obesity, diabetes, and peripheral vascular disorders but a higher prevalence of stroke, as compared to those without cardiac amyloidosis. On multivariable analysis, cardiac amyloidosis was associated with significantly higher odds of peri-procedural major adverse events (adjusted odds ratio [aOR]: 2.69; 95% confidence interval [CI]: 1.41-5.14; p<0.01) and neurological complications (aOR: 5.48; 95% CI: 2.47-12.8; p<0.01). There was no difference in the odds of other peri-procedural complications, in-hospital mortality, hospital resource utilization, and 30/90/180-day all-cause/bleeding/stroke-related readmissions between both groups.</p><p><strong>Conclusion: </strong>Patients with cardiac amyloidosis undergoing LAAO device implantation have an increased risk of peri-procedural complications without any difference in bleeding/stroke-related readmissions. These hypothesis-generating findings need validation in future prospective studies.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1657-1665"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186104","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":"Efficacy and safety of catheter ablation for atrial fibrillation in elderly patients: a systematic review and meta-analysis.","authors":"Marcos Roberto Queiroz França, Carlos Arturo Morillo, André Assis Lopes Carmo, Marina Mayrink, Reynaldo Castro Miranda, André Dias Nassar Naback, Immaculate Nevis, Gustavo Araújo Silva, Antonio Luiz Pinho Ribeiro, Bruno Ramos Nascimento","doi":"10.1007/s10840-024-01755-5","DOIUrl":"10.1007/s10840-024-01755-5","url":null,"abstract":"<p><strong>Background: </strong>Catheter ablation (CA) is a well-established therapy for patients with atrial fibrillation (AF); however, there is paucity of data for elderly patients. We aimed to assess long-term efficacy and safety of CA for elderly patients with AF.</p><p><strong>Methods: </strong>Medline, BVS, Cochrane, and Embase were searched through April 2023 to investigate comparative outcomes between elderly patients > 75 or 80 years, as per-study cutoff, and individuals ≤ 75/80 years, undergoing CA. Primary efficacy and safety endpoints (AF recurrence and procedure-related major complications) were pooled with the Comprehensive Meta-Analysis 3.0 software. Subgroup analyses were performed by age groups and type of procedure (radiofrequency vs. cryoballoon).</p><p><strong>Results: </strong>Four thousand eight hundred twenty-nine titles were screened, and 27 studies were included, being 26 observational and 1 randomized trial, comprising 117,869 patients, being 8714 (7.4%) elderly > 75/80 years, with follow-up from 11.7 to 72.3 months. In comparative studies (N = 17 studies), elderly > 75/80 years had a higher risk of AF recurrence compared to those ≤ 75/80: relative risk (RR) 1.16 (95% CI 1.05-1.27, p = 0.002. However, funnel plot indicated publication bias, and after imputation of 5 studies, the groups were similar (RR 1.07 (95% CI 0.97-1.19)). The rates of major complications (N = 14 studies) were higher in elderly > 75/80 years (RR 1.30 (95% CI 1.10-1.54), I² = 0, p = 0.002), but were similar in cryoablation studies (N = 7) (RR 1.10, 95% CI 0.94-1.29, p = 0.24, I² = 0.0). Results were similar when individual study arms (N = 27 studies) were pooled.</p><p><strong>Conclusion: </strong>AF ablation is feasible in elderly patients > 75/80 years, with success rates compared to younger individuals. Complication rates, however, were higher.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1691-1707"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139642290","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":"Single plane multipolar catheter for accurate activation mapping of papillary muscle ectopy.","authors":"Parth Makker, Kristie M Coleman, Dimitrios Varrias, James Gabriels, Gregory Cunn, Moussa Saleh, Haisam Ismail, Stuart Beldner, Stavros E Mountantonakis","doi":"10.1007/s10840-024-01826-7","DOIUrl":"10.1007/s10840-024-01826-7","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1671-1673"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140911741","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}