Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing最新文献

{"title":"Acute outcomes of cryoballoon vs. circular vs. pentaspline pulsed-field ablation catheters in combined pulmonary vein isolation and roof line ablation.","authors":"Joerg Yogarajah, Julie Hutter, Patrick Kahle, Philipp Beaujean, Marko Tomic, Andreas Hain, Samuel Sossalla, Thomas Neumann, Malte Kuniss","doi":"10.1007/s10840-025-02078-9","DOIUrl":"10.1007/s10840-025-02078-9","url":null,"abstract":"<p><strong>Background: </strong>Single-shot ablation systems are widely used for pulmonary vein isolation (PVI) in atrial fibrillation (AF). The use of novel pulsed-field ablation (PFA) systems enables ablation beyond PVI, such as left atrial roof ablation (LARA), which may improve outcomes in persistent AF.</p><p><strong>Objective: </strong>This study aimed to compare the acute efficacy, feasibility, and safety of PVI combined with LARA using three different single-shot ablation systems in patients with persistent AF and left atrial enlargement undergoing their first AF ablation.</p><p><strong>Methods: </strong>Consecutive patients undergoing PVI with LARA using cryoballoon or PFA systems were included. Baseline characteristics, procedural parameters, and complication rates were assessed.</p><p><strong>Results: </strong>We included 125 patients with persistent AF and left atrial dilation, divided into cryoballoon (n = 65), pentaspline PFA (n = 30), and circular PFA (n = 30) groups. Acute PVI was achieved in 100% of veins. Fewer applications were required for LARA with cryoballoon vs. PFA (4 vs. 8 vs. 10, P < 0.001). Conduction block was confirmed in 95%, 100%, and 100% of patients (P = 0.421). Procedural times were longer with cryoballoon (87.0 vs. 64.0 vs. 68.0 min, P < 0.001), but fluoroscopy times were shorter (12.2 vs. 15.3 vs. 15.1 min, P = 0.002). Contrast medium use was higher in the cryoballoon group (P < 0.001). Adverse events were rare and predominantly minor, with three complications in the cryoballoon group and one in the PFA groups (P = 0.493).</p><p><strong>Conclusion: </strong>All single-shot ablation systems demonstrated comparable efficacy and safety for PVI and LARA, with differences in procedural feasibility. Further and larger studies are needed.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":"1637-1646"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of continuous positive airway pressure on atrial fibrillation recurrence after catheter ablation in patients with obstructive sleep apnea: a systematic review and meta-analysis.","authors":"Eduardo Dan Itaya, Caique M P Ternes, Timothy Maher, Amanda A D Fernandes, Ana Vitoria Rocha, Catherine Wippel, André Rivera, Andrew H Locke, Andre d'Avila","doi":"10.1007/s10840-025-02063-2","DOIUrl":"10.1007/s10840-025-02063-2","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is associated with an increased risk of atrial fibrillation (AF). However, the impact of continuous positive airway pressure (CPAP) on the recurrence of AF after catheter ablation (CA) in patients with OSA remains unclear.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCTs) and observational studies comparing CPAP vs. no CPAP use for OSA treatment and recurrence of AF following CA. Heterogeneity was assessed with I² statistics.</p><p><strong>Results: </strong>We included 1 RCT and 10 observational studies with 1536 patients with OSA who underwent CA for AF, of whom 53% used CPAP. Mean follow-up ranged from 3 to 42 months. In the pooled analysis, AF recurrence (OR 0.37; 95% CI 0.23-0.58; p < 0.01) was significantly lower in patients treated with CPAP compared with no CPAP. In the subgroup analysis, the AF recurrence in the CPAP group was also significantly lower after restricting to studies with longer follow-up periods ≥ 18 months (OR 0.28; 95% CI 0.18-0.46; p < 0.01) and in studies with a greater proportion of persistent AF (≥ 50%) (OR 0.31; 95% CI 0.16-0.61; p < 0.01).</p><p><strong>Conclusion: </strong>In patients with OSA and AF who underwent CA, CPAP use was associated with reduced AF recurrence compared to no CPAP use. Most of the data available is derived from observational studies, and the only RCT showed no difference between groups. Thus, results should be interpreted with caution.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":"1749-1759"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288060","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":"Effect of SGLT2 inhibitors on atrial fibrillation recurrence after catheter ablation in patients with type 2 diabetes in the United States: a TriNetX database study.","authors":"Allahdad Khan, Muhammad Raffey Shabbir, Tehreem Asghar, Jamil Nasrallah, Kumail Mustafa Ali, Maryam Asghar, Raza Aslam, Mahrukh Imtiaz, Usman Ali Akbar, Matthew G Bates, Raheel Ahmed","doi":"10.1007/s10840-025-02146-0","DOIUrl":"https://doi.org/10.1007/s10840-025-02146-0","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a common cardiac arrhythmia associated with significant morbidity and mortality, particularly in patients with type 2 diabetes mellitus (T2DM). Catheter ablation is a key treatment for AF, but recurrence rates remain high. Sodium-glucose cotransporter 2 inhibitors (SGLT2i), used for glycemic control in T2DM, have shown potential in reducing arrhythmias. This study investigates the effect of SGLT2i on AF recurrence after catheter ablation in T2DM patients.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the TriNetX Global Collaborative Network, identifying adults aged 18-80 years with type 2 diabetes mellitus (T2DM) who underwent catheter ablation for atrial fibrillation (AF) between 2013 and 2024. Patients were grouped by prior use of SGLT2 inhibitors. Propensity score matching (PSM) was applied on 66 covariates to balance baseline demographics, comorbidities, medications, laboratory values, and echocardiographic parameters. Outcomes included redo AF ablation, additional atrial ablation lines, electrical cardioversion, and anti-arrhythmic use.</p><p><strong>Results: </strong>After PSM, 6,180 matched pairs were analyzed. SGLT2 inhibitor use was associated with a lower redo AF ablation rate (8.8% vs. 12.7%; RR 1.44, p < 0.001), fewer additional ablation procedures (4.6% vs. 5.7%, p = 0.021), and reduced anti-arrhythmic drug use (57.2% vs. 65.2%, p < 0.001). No significant difference was seen in electrical cardioversion rates.</p><p><strong>Conclusion: </strong>Among T2DM patients undergoing AF ablation, SGLT2 inhibitor therapy was linked to reduced need for repeat ablation, fewer complex ablation procedures, and decreased reliance on anti-arrhythmic medications, suggesting a potential rhythm-stabilizing benefit.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357512","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":"The impact of dapagliflozin on left atrial functions and recurrence in non-diabetic patients in the early post-cryoablation period.","authors":"Ali Ugur Soysal, Damla Raimoglou, Asli Soysal, Adem Atici, Sukran Nur Sanli, Ahmet Atil Aygun, Arda Ceviker, Hakan Yalman, Murat Cimci, Baris Ikitimur, Bilgehan Karadag, Tolga Aksu, Kivanc Yalin","doi":"10.1007/s10840-025-02151-3","DOIUrl":"https://doi.org/10.1007/s10840-025-02151-3","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter 2 (SGLT-2) inhibitors had a significant improvement in strain parameters and lower atrial fibrillation (AF) recurrence. The aim of this study is to determine the impact of SGLT-2 inhibitors on left atrial (LA) mechanical functions and recurrence in the early period after Cryoballoon ablation (CBA) for paroxysmal AF in non-diabetic patients.</p><p><strong>Methods: </strong>Consecutive eighty non-diabetic preserved ejection fraction patients with paroxysmal AF underwent CBA were analyzed. After the procedure, dapagliflozin was initiated in 40 out of 80 patients. LA strain parameters were evaluated before and 3 months after the procedure compared in groups using and not using dapagliflozin. Recurrence was evaluated through holter-ECG monitoring performed at regular intervals.</p><p><strong>Results: </strong>In the group of patients using SGLT-2 inhibitors, a significant decrease in LA diameter and indexed LA volume values (40.9 ± 4.2 mm vs. 39.6 ± 3.8 mm, p = 0.001 and 32.6 ± 8.2 ml/m2 vs. 30.8 ± 7.7 ml/m2, p = 0.006), and a significant improvement in LA conduit strain value were observed (-14.4 ± 7.5% vs. -18.5 ± 6.9%, p < 0.001). Additionally, as the indicators of left atrial compliance, LA reservoir strain and LA conduit strain showed a significantly improvement in the group using SGLT-2 inhibitors (p = 0.025, p delta = 0.045, respectively) and non-recurrence group (p < 0.001).</p><p><strong>Conclusion: </strong>In non-diabetic paroxysmal AF patients using dapagliflozin significant improvement in mechanical functions can be achieved even in the early period after CBA. In addition, patients using SGLT-2 inhibitors, a significant improvement in left atrial compliance is observed. Further studies with larger population are needed to prove its potential contribution on AF freedom after AF ablation.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351414","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":"When low is not low enough: zero-fluoroscopy atrial fibrillation ablation using the VARIPULSE™ pulsed field system-a prospective single-center study.","authors":"E Simeon, S Roeun, M Miled, O Villejoubert, P Jorrot, N Mignot, J Durand, A Aissani, F Sebag","doi":"10.1007/s10840-025-02162-0","DOIUrl":"https://doi.org/10.1007/s10840-025-02162-0","url":null,"abstract":"<p><strong>Background: </strong>Pulsed field ablation (PFA) has emerged as a non-thermal, tissue-selective modality for pulmonary vein isolation (PVI) in atrial fibrillation (AF) treatment, potentially minimizing collateral damage to adjacent structures. The VARIPULSE™ PFA system, integrated with the CARTO™ 3 electroanatomical mapping system, facilitates real-time catheter visualization, enabling procedures with minimal or no fluoroscopy. The objective is to evaluate the feasibility and acute safety of performing zero-fluoroscopy AF catheter ablation using the VARIPULSE™ PFA system in a cohort of consecutive patients with paroxysmal or persistent AF for 1 year.</p><p><strong>Methods: </strong>A prospective, single-center study was conducted involving consecutive patients undergoing AF ablation (PVI ± linear ablations) with the VARIPULSE™ system. Procedures were guided exclusively by the CARTO™ 3 system, without the use of fluoroscopy as well as intracardiac echocardiography (ICE). Data on procedural parameters, acute success rates, and complications were collected and analyzed.</p><p><strong>Results: </strong>A total of 121 consecutive patients were included in the study during 1 year with 60% of paroxysmal AF. Additional extra-pulmonary vein ablation (CTI or posterior wall isolation or both) was performed in 93 patients (76.9%). The mean time procedure was 44.5 ± 15.2 min and the success rate of zero-fluoroscopy was 98.4%. Two patients had an acute complication (1 TIA and 1 cardiogenic shock).</p><p><strong>Conclusion: </strong>This study demonstrates the feasibility, safety, and time-efficiency of a fully standardized fluoroscopy-free workflow, including posterior wall and CTI ablation. The use of TEE instead of ICE enhances cost-efficiency, potentially facilitating broader adoption of the protocol. However, the single-center nature of the study and the lack of a comparative fluoroscopy group represent important limitations.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351445","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":"Biochemical evidence and clinical significance of hemolysis following catheter ablation with a lattice-tip PFA catheter.","authors":"Ourania Kariki, Konstantinos Pamporis, Athanasios Saplaouras, Panagiotis Mililis, Theodoros Efremidis, Antonios Martinos, Stavroula Koskina, Anna Kostopoulou, George Poulos, Stylianos Dragasis, Eleni Nikoli, Konstantinos P Letsas, Michael Efremidis","doi":"10.1007/s10840-025-02163-z","DOIUrl":"https://doi.org/10.1007/s10840-025-02163-z","url":null,"abstract":"<p><strong>Background: </strong>Intravascular hemolysis(IH) is an inherent limitation of pulsed field ablation(PFA) technology. The severity of IH is multifactorial and differs between PFA systems. This study aimed to assess the biochemical evidence and clinical significance of IH induced by a lattice-tip PFA catheter.</p><p><strong>Methods: </strong>Patients with atrial fibrillation(AF) undergoing catheter ablation with a lattice-tip PFA catheter or with radiofrequency (RF) (50/90 W) were eligible. Changes in haptoglobin, hemoglobin(Hb), lactate dehydrogenase(LDH), indirect bilirubin, and creatinine were assessed in blood samples collected at baseline (T0), immediately (T1), and 24-h (T2) post-ablation. Clinically relevant IH was defined as changes in biochemical markers of hemolysis in combination with a hemoglobin drop ≥ 2 g/dL or renal biomarker changes fulfilling criteria for AKI. Furthermore, in order to properly interpret the observed changes in haptoglobin, \"biochemical events\" previously associated with direct markers of IH were analyzed [(T2 haptoglobin ≤ 0.25 g/l, T2/T0 haptoglobin ratio < 0.85, and T2-T0 haptoglobin difference < Q1 (-0.1 g/l)].</p><p><strong>Results: </strong>A total of 142 patients [102/142 (72%) in PFA group; 40/142 (28%) in RF group] were included, with comparable characteristics. Significant changes in Hb and LDH were found in both groups. The PFA group experienced a greater decrease in haptoglobin levels compared to RF (MD = -0.02 g/L, 95% CI [-0.04, 0]; p = 0.043), while \"biochemical events\" were infrequent and similar between groups. None of the participants fulfilled the definition of clinically relevant IH. In the PFA group, the number of lesions was marginally associated with greater biomarker changes.</p><p><strong>Conclusions: </strong>In this observational real-world cohort, the lattice-tip PFA catheter was associated with statistically significant, yet relatively small reductions of haptoglobin post-procedurally compared to RF, with no case of clinically relevant IH being reported.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351384","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":"Evaluation of variable inter-pulse delay and timing on pulsed field ablation lesion characteristics.","authors":"Nathaniel A Steiger, Daniel Campos-Villarreal, Logan McClennen, Justin Bilenker, Mark Zurcher, Melvin Lorenzo, Carlos Patino, Carlos Matos, Carolina Hoyas-Ochoa, Usha B Tedrow, Paul C Zei, Jorge E Romero, William H Sauer","doi":"10.1007/s10840-025-02142-4","DOIUrl":"https://doi.org/10.1007/s10840-025-02142-4","url":null,"abstract":"<p><strong>Background: </strong>Irreversible electroporation with pulsed-field ablation (PFA) represents a promising modality via myocyte-selective treatment of arrhythmias. However, aside from voltage, a thorough evaluation of PFA output parameters on lesion characteristics has not been performed.</p><p><strong>Objective: </strong>To demonstrate the impact of timing cycle attributes on PFA lesion characteristics using an established in vitro electroporation model.</p><p><strong>Methods: </strong>Russet potato slabs underwent unipolar PFA using a 3.5-mm electrode catheter connected to a programmable PFA generator. PFA waveforms were delivered with a train ranging from 1 to 3 biphasic pulses, 1 to 50 cycles, frequency of 50 kHz, inter-pulse delay of 200 to 1310 ms, and with repeated applications using variable inter-application pauses from 5 to 20 s. Experiments were repeated with varying voltage outputs. The slabs were sliced, stained, and measured.</p><p><strong>Results: </strong>Increasing number of cycles and number of PFA applications were associated with larger lesions but reached a plateau effect despite increased total energy delivered. There was a linear relationship between increasing inter-pulse delay and depth. There was no change in lesion size with application period.</p><p><strong>Conclusion: </strong>Increasing the inter-pulse delay of pulse sequences created deeper lesions despite total energy remaining constant and achieved similar depths compared to pulses that used more cycles and greater number of applications. Modulating inter-pulse delay may be useful for controlling lesion depth without increasing total application energy delivery, which may reduce risks associated with high energy PFA pulses. Further research is required to correlate these in vitro findings with in vivo results and clinical outcomes.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351418","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":"Validation of an automated premature ventricular contraction mapping algorithm.","authors":"Yuji Ishida, Michael R Gold, Joshua E Payne, Adam R Bainey, Michael E Field, Patrick Badertscher, Jeffrey R Winterfield","doi":"10.1007/s10840-025-02150-4","DOIUrl":"https://doi.org/10.1007/s10840-025-02150-4","url":null,"abstract":"<p><strong>Background: </strong>Catheter mapping and ablation of premature ventricular contractions (PVCs) requires accurate annotation of earliest local activation time (LAT), but displacement in catheter position between sinus rhythm (SR) and the PVC complicates three-dimensional mapping localization. An automated algorithm to annotate LAT sites at the corresponding sinus rhythm sites would provide an alternative to manual annotation and improve procedural efficiency.</p><p><strong>Methods: </strong>A retrospective single center study assessed 64 patients undergoing catheter ablation of PVCs. We divided the study patients into two groups: the patients underwent RF ablation using the CARTO 3 version 7 with LAT-hybrid™ module (hybrid group) and the other patients using the CARTO 3 version 6 without LAT-hybrid™ module (conventional group).</p><p><strong>Results: </strong>The primary results of this study demonstrate that the mean hybrid distance is 4.03 ± 2.33 mm, and this automated algorithm can correct for the positional shift with accuracy comparable to manual correction. Moreover, this algorithm showed significantly shorter RF time and the shorter PVC offset compared to the conventional method.</p><p><strong>Conclusion: </strong>PVC mapping with the LAT-hybrid™ module demonstrated that an automated algorithm can map in more detail with no compromise in accuracy. The LAT-hybrid™ module showed significantly shorter RF time and PVC offset from the earliest LAT in LVOT cases.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338421","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":"Obstructive sleep apnea screening performance of the STOP-BANG questionnaire and a home sleep apnea test device in atrial fibrillation ablation candidates.","authors":"Jasper Vermeer, Maarten van den Broek, Tineke Vinck-de Greef, Hennie Janssen, Pauline van Hirtum, Sebastiaan Overeem, Lukas Dekker","doi":"10.1007/s10840-025-02131-7","DOIUrl":"https://doi.org/10.1007/s10840-025-02131-7","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) contributes to the onset and progression of atrial fibrillation (AF) and negatively affects AF ablation outcomes. OSA screening in AF patients is often conducted with the STOP-BANG questionnaire, although its validation is lacking. This study aims to evaluate the screening value of the STOP-BANG questionnaire and a home sleep apnea test (HSAT) device for OSA in patients referred for AF ablation.</p><p><strong>Methods: </strong>Patients referred for their first AF ablation and without prior OSA diagnosis underwent both the STOP-BANG questionnaire and a HSAT device based on peripheral arterial tonometry (PAT). Patients with a PAT-derived apnea-hypopnea index (pAHI) of 5 or more events per hour subsequently underwent clinical polysomnography (PSG). This PSG was used for definitive OSA diagnosis and to determine the diagnostic values of the STOP-BANG and HSAT.</p><p><strong>Results: </strong>Of 67 patients initially screened with the STOP-BANG and HSAT, 58 completed PSG after excluding those with pAHI < 5/hour or who declined further testing. Among these 58 patients, STOP-BANG (score ≥ 3) correctly screened 84% of cases, while HSAT was more accurate (97%, P-value < 0.002). Among the 67 initially screened patients, 56 (84%) received a new OSA diagnosis. Of these, 21 (38%) had mild OSA, 17 (30%) moderate OSA and 18 (32%) severe OSA.</p><p><strong>Conclusion: </strong>The high OSA prevalence highlights the importance of OSA screening in patients referred for AF ablation. In this cohort, HSAT demonstrated superior accuracy, compared to the STOP-BANG questionnaire and may be considered the preferred OSA screening tool in outpatient AF clinics.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314451","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":"Circular over-the-wire pulsed field ablation for atrial fibrillation: differences in outcomes between conscious sedation or general anesthesia.","authors":"M Van der Graaf, B G S Abeln, V F Van Dijk, M Liebregts, M C E F Wijffels, J C Balt, L V A Boersma","doi":"10.1007/s10840-025-02134-4","DOIUrl":"https://doi.org/10.1007/s10840-025-02134-4","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary vein isolation (PVI) using pulsed field ablation (PFA) is typically performed under general anesthesia (GA) due to patient discomfort and pain. However, procedures under GA require specialized personnel for airway management. PFA systems with suitable characteristics may enable PFA-procedures to be performed under bolus- administered conscious sedation (CS).</p><p><strong>Objective: </strong>Assess the feasibility, safety, and efficacy of performing PVI with a circular-over-the-wire PFA catheter under CS, compared to GA.</p><p><strong>Methods: </strong>We conducted a single-center registry study of atrial fibrillation (AF) patients undergoing an ablation with the circular over-the-wire PFA catheter, between January 29 and December 31, 2024, at the St. Antonius Hospital, The Netherlands. CS was used if no anesthesiology team was available. Endpoints included acute isolation of ablation targets, procedural characteristics and freedom from adverse events.</p><p><strong>Results: </strong>The analysis included 174 consecutive patients (67.2% male, mean age 62.8 ± 9.3 years), with 62.1% having paroxysmal AF. GA was used in 132 patients (75.9%). There were no differences in baseline characteristics between the groups. Total number of applications was higher in the GA group: 33.0 [IQR 32.0; 36.0] vs. 32.0 [IQR 32.0; 33.0], p < 0.001. Median skin-to-skin procedural time was comparable between groups: GA 39.0 min [IQR 34.0;46.0] vs. CS 42.0 min [IQR 37.5; 46.0], P = N.S. Acute procedural efficacy was 100% in both groups. One patient in the GA group experienced a major bleeding complication.</p><p><strong>Conclusion: </strong>Conscious sedation offers an efficient and safe alternative to general anesthesia for patients undergoing a procedure with use of the circular over-the-wire PFA catheter.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305249","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}