Indian Pacing and Electrophysiology Journal最新文献

{"title":"Non-invasive programmed stimulation to confirm left bundle branch capture during outpatient follow-up: a case report.","authors":"Leonardo Marinaccio, Giorgia Ugolini, Francesco Vetta, Luciano Babuin","doi":"10.1016/j.ipej.2026.03.003","DOIUrl":"10.1016/j.ipej.2026.03.003","url":null,"abstract":"<p><strong>Background: </strong>Left bundle branch area pacing (LBBAP) is a physiological pacing technique that ensures near-normal ventricular activation. However, confirming left bundle branch (LBB) capture during follow up can be challenging when standard criteria are inconclusive. This report describes the use of non-invasive programmed stimulation (NIPS) via a pacemaker programmer to confirm LBB capture in an outpatient setting.</p><p><strong>Case presentation: </strong>We describe a 70-year-old Caucasian male who received a dual-chamber pacemaker (Zenex DR, Abbott, Sylmar, CA, USA) for symptomatic paroxysmal 2:1 atrioventricular block with a left ventricular ejection fraction of 48%. One month after implantation, LBBAP capture could not be confirmed using conventional criteria because of atypical QRS morphology. NIPS was safely performed using the device programmer. Programmed stimulation with extra stimuli induced a transition from non-selective to selective LBB capture, demonstrated by prolongation of the V1 R-wave peak time and changes in QRS morphology. No arrhythmias occurred during the test.</p><p><strong>Conclusion: </strong>This case illustrates the practical application of the principles of programmed stimulation in an outpatient setting to confirm LBB capture, especially in ambiguous cases where conventional criteria are inconclusive.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel use of an atrial Aveir AR pacemaker implanted in the right ventricle for a pediatric patient with prolonged sinus pause.","authors":"Kenan S Wayne, Daniel Cortez","doi":"10.1016/j.ipej.2026.03.010","DOIUrl":"10.1016/j.ipej.2026.03.010","url":null,"abstract":"<p><p>Leadless pacemakers offer an attractive alternative to transvenous systems in children but are limited by vascular size, cardiac chamber dimensions, and device-specific characteristics. We describe the first implantation of an atrial Aveir AR leadless pacemaker in the right ventricle of a pediatric patient using a superior venous approach. A 7-year-old, 23.7-kg girl presented with recurrent syncope and was found to have an 8.7-s sinus pause on ambulatory monitoring consistent with sinus node dysfunction. Pre-procedural echocardiography and ultrasound assessment demonstrated relatively small atrial dimensions and identified the right internal jugular vein (1 cm) as the largest available central vessel compared with the femoral and left internal jugular veins. To optimize catheter maneuverability and accommodate the 27-Fr delivery sheath, a right internal jugular approach was selected. The Aveir AR device was advanced across the tricuspid valve and fixed to the mid-right ventricular septum on the first attempt, with stable sensing and capture parameters and no periprocedural complications (threshold 0.5 V at 0.2 ms, impedance 400 Ω, R-wave 5.9 mV). The patient was discharged within 24 hours and remained asymptomatic with preserved device function on one month follow-up, with threshold 0.75 V at 0.2 ms, impedance 410 Ω, R-wave 8.3 mV, and with <1% pacing, predicted longevity at 15.9 years. This case illustrates that superior venous access can facilitate safe ventricular deployment of an Aveir AR leadless pacemaker in select pediatric patients with sinus pauses.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-shot AF ablation, Leadless pacemakers and LAAO are EP, not IC procedures.","authors":"Tolga Aksu, Mina K Chung","doi":"10.1016/j.ipej.2026.03.009","DOIUrl":"https://doi.org/10.1016/j.ipej.2026.03.009","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147373133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focal atrial fibrillation mimicking atrial tachycardia: Which mapping approach identifies the true source?","authors":"Yoshimi Onishi, Toshihiko Gokan, Yoshitaka Iso, Hiroshi Suzuki","doi":"10.1016/j.ipej.2026.03.008","DOIUrl":"10.1016/j.ipej.2026.03.008","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147373151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left atrial appendage occlusion versus NOACs in atrial fibrillation: Which way is the weight of evidence tilting in 2026?","authors":"Sivaram Neppala, Adil Ahmed, Priyansh Patel, Hemal M Nayak","doi":"10.1016/j.ipej.2026.03.007","DOIUrl":"10.1016/j.ipej.2026.03.007","url":null,"abstract":"<p><p>Preventing stroke is a key aspect of managing atrial fibrillation (AF). Non-vitamin K antagonist oral anticoagulants (NOACs) have become the preferred choice due to their improved safety profiles and ease of use compared to warfarin. At the same time, left atrial appendage occlusion (LAAO) has evolved from being an option only for patients unable to tolerate anticoagulation to a legitimate treatment supported by clinical trials, longer-term follow-up, and real-world data. As ongoing research progresses, clinicians are increasingly considering whether LAAO could potentially replace long-term anticoagulation. This review analyzes comparative evidence on NOACs versus LAAO through 2026, focusing on stroke prevention, bleeding complications, survival, procedural risks, long-term outcomes, and appropriate patient selection. Special attention is given to the Indian subcontinent, where bleeding tendencies, coexisting conditions, medication adherence, and access to medical care create unique challenges compared to Western populations. Available evidence shows NOACs remain the standard initial therapy for most AF patients. However, LAAO delivers an important alternative for selected individuals at elevated bleeding risk, those experiencing recurrent clots despite proper anticoagulation, or patients unable to maintain lifelong drug treatment.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of functional LV septal pacing.","authors":"J Van Koll, J G L M Luermans, J Joza, K Vernooy","doi":"10.1016/j.ipej.2026.03.002","DOIUrl":"10.1016/j.ipej.2026.03.002","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of large lattice-tip dual energy catheter for left ventricular summit arrhythmia ablation.","authors":"Daniel Hanna, Andrew Kossack, Adam Frank, Dinesh Sharma","doi":"10.1016/j.ipej.2026.03.001","DOIUrl":"10.1016/j.ipej.2026.03.001","url":null,"abstract":"<p><strong>Background: </strong>Ventricular arrhythmias arising from the left ventricular (LV) summit are technically challenging to ablate because of limited accessibility and proximity to the coronary arteries. Dual energy lattice-tip catheter (DLTC) could provide both very high-power temperature-controlled radiofrequency (RF) ablation and pulse field (PF) ablation.</p><p><strong>Objective: </strong>To describe the use of combined radiofrequency (RF) and pulsed field (PF) ablation using a dual-energy large lattice-tip catheter for treatment of ventricular tachycardia originating from the LV summit region.</p><p><strong>Methods: </strong>We report a 66-year-old man with atrial fibrillation, heart failure with reduced ejection fraction, and recurrent VT despite prior endocardial and epicardial radiofrequency ablation. Mapping localized the PVC/VT to a LV summit-adjacent region, with an endocardial target along the superior septum/LVOT consistent with an intramural or epicardial summit substrate. Given prior failed RF ablations compassionate-use ablation with the dual-energy lattice-tip catheter and Affera™ mapping system (Medtronic, Minneapolis, MN) was performed under intracardiac echocardiogram guidance. Interventional cardiology was directly involved, providing coronary angiography and intravascular imaging before and after ablation to ensure the absence of vasospasm or ischemia.</p><p><strong>Results: </strong>At 6 week follow up, following dual-energy ablation with DLTC, there was significant suppression of ventricular arrhythmia off antiarrhythmic amiodarone. There was no evidence of coronary injury post ablation confirmed by coronary angiogram and intravascular ultrasound. This case highlights the feasibility of high-power temperature controlled-RFA and focal PFA for VT in anatomically regions where success with conventional energy sources is limited.</p><p><strong>Conclusion: </strong>Combined RF and PF ablation using the DLTC achieved safe and effective ablation of LV summit ventricular tachycardia without coronary injury.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accessory pathway ablation: When the going gets tough, the tough go epicardial","authors":"Yogesh Jagannath Kulkarni,&nbsp;Sirish Chandra Srinath,&nbsp;Anand Manickavasagam,&nbsp;John Roshan Jacob","doi":"10.1016/j.ipej.2026.01.006","DOIUrl":"10.1016/j.ipej.2026.01.006","url":null,"abstract":"<div><div>A 38-year-old lady presented with recurrent episodes of palpitations since the last four years. The electrocardiogram (ECG) during tachycardia indicated pre-excited atrial fibrillation, while the baseline ECG revealed preexcitation with QS waves in the inferior leads. Initial attempts at endocardial ablation and ablation via the coronary sinus approach did not yield successful results. Subsequently, we successfully ablated the inferoparaseptal (posteroseptal) pathway by utilizing a percutaneous epicardial approach. This method should be considered in cases where other techniques fail.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"26 2","pages":"Pages 159-161"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulsed field ablation: Biophysical principles and practical considerations in atrial fibrillation treatment","authors":"Shivaraj Patil,&nbsp;Suraj Kapa,&nbsp;Abhishek J. Deshmukh","doi":"10.1016/j.ipej.2026.03.006","DOIUrl":"10.1016/j.ipej.2026.03.006","url":null,"abstract":"<div><div>Pulsed field ablation (PFA) is an emerging nonthermal ablation modality for the treatment of atrial fibrillation. Unlike conventional thermal energy sources such as radiofrequency and cryoablation, PFA delivers high-voltage pulsed electric fields that induce irreversible electroporation, resulting in selective cardiomyocyte death while largely preserving surrounding extracellular structures. The biological response to pulsed electric fields depends on parameters such as field strength, pulse duration, waveform configuration, and number of pulses. Variations in electroporation thresholds among different cell types contribute to the relative myocardial selectivity observed with PFA. Lesion formation is also influenced by electrode configuration, catheter–tissue contact, and electric field distribution. Early clinical experience and large registries suggest that PFA enables efficient pulmonary vein isolation with a favorable safety profile and reduced risk of collateral injury compared with thermal ablation technologies. This review summarizes the fundamental biophysical mechanisms underlying pulsed electric field ablation and discusses practical considerations for its clinical application in atrial fibrillation ablation.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"26 2","pages":"Pages 103-113"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent wide complex tachycardia: Where is the target for ablation?","authors":"Shohei Kataoka,&nbsp;Edward P. Gerstenfeld","doi":"10.1016/j.ipej.2026.01.004","DOIUrl":"10.1016/j.ipej.2026.01.004","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"26 2","pages":"Pages 188-191"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}