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

{"title":"Depression and inflammatory markers in patients undergoing ICD implantation.","authors":"Sofia Plakoutsi, Dimitrios Sfairopoulos, Elizabeth Florou, Tong Liu, Aris Bechlioulis, Christos Katsouras, Petros Skapinakis, Panagiotis Korantzopoulos","doi":"10.1007/s10840-025-02133-5","DOIUrl":"https://doi.org/10.1007/s10840-025-02133-5","url":null,"abstract":"","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133100","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":"Older age is not an independent predictor of syncope recurrence following cardioneuroablation for reflex syncope.","authors":"Piotr Kulakowski, Agnieszka Sikorska, Tomasz Krynski, Michał Niedzwiedz, Malgorzata Soszynska, Jakub Baran, Roman Piotrowski","doi":"10.1007/s10840-025-02139-z","DOIUrl":"https://doi.org/10.1007/s10840-025-02139-z","url":null,"abstract":"<p><strong>Background: </strong>Cardioneuroablation (CNA) is a promising tool to treat reflex syncope; however, optimal age cut-off values to undergo CNA have not been established.</p><p><strong>Methods: </strong>This is a prospective observational single-center study which included all consecutive patients with cardioinhibitory reflex syncope treated with CNA who completed at least 1 year of follow-up. Bi-atrial CNA was performed using anatomical approach with the use of electro-anatomical mapping system, intracardiac echocardiography and extracardiac vagal stimulation.</p><p><strong>Results: </strong>The study group consisted of 209 patients (mean age 39.5 ± 13.6, 121 (58%) females). During a median follow-up of 27 months, 166 (79.4%) patients remained free from syncope recurrence, and syncope burden was significantly reduced (6.67 syncope/year vs. 0.26 syncope/year, p = 0.00001). Univariate analysis showed that hypertension, number of syncopal episodes, and age ≥ 60 years were associated with syncope recurrence; however, age was not an independent variable predicting the outcome. There was no significant difference in the outcome between patients aged < 40 vs. ≥ 40 or < 50 vs. ≥ 50 years. The reduction of syncope burden was significant in younger age groups but not in patients aged ≥ 60 years. During follow-up, six patients received pacemaker-all were >50 years old.</p><p><strong>Conclusions: </strong>Age is not an independent predictor of CNA efficacy; however, patients aged >60 years, particularly those with concomitant hypertension and a high number of syncopal episodes, tend to have higher syncope recurrence and less reduction in syncope burden than younger people. The need for permanent pacing due to ineffective CNA increases with age, starting from 55 years.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126854","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":"Gastroparesis as a potential complication of pentaspline pulsed field ablation without endoscopic esophageal injury.","authors":"Mourad Haj Abdo, Thomas Deneke, Karin Nentwich, Ivaylo Chakarov, Arthur Berkovitz, Elena Sauer, Martjin Rogiers, Christiane Neumann, Lisa Costello-Boerrigter, Sebastian Barth, Khalil Haj Abdo, Lepasova Mihajloska, Ralf Surber, Ulrich Lüsebrink, Anja Schade","doi":"10.1007/s10840-025-02130-8","DOIUrl":"https://doi.org/10.1007/s10840-025-02130-8","url":null,"abstract":"<p><strong>Background: </strong>Pulsed field ablation (PFA) is a new nonthermal, ablation modality for pulmonary vein isolation (PVI) that is cardiac tissue selective. Compelling acute and long-term success rates and good safety features have been reported using a pentaspline PFA catheter. Thus far, no atrio-esophageal fistula (AEF) related to PFA has been reported. However, this fatal complication is rare and endoscopically detected esophageal lesions (EDEL) may serve as a more sensitive instrument to document esophageal safety. This study aimed to evaluate the esophageal safety of the Farapulse™ PFA system by systematically using upper endoscopy post-ablation in a large, single-center cohort.</p><p><strong>Methods: </strong>Patients with symptomatic atrial fibrillation (AF) underwent PVI using the pentaspline PFA system. Additional left atrial posterior PFA application was used in some cases. All patients underwent esophageal endoscopy within 1 day post-ablation. Follow-up visits occurred 3 and 12 months post-procedure. The patients had 48 h-Holter monitoring performed before each visit.</p><p><strong>Results: </strong>Consecutive, symptomatic AF patients (n = 228, 87.6% paroxysmal) were enrolled. The patients were relatively young (age 59.4 ± 11.7 years), 67.4% male, and had a normal mean left ventricular function of 60 ± 8%. Mean left atrial diameter was 41 ± 4 mm. All PVs were successfully isolated. The procedure time was 55 ± 11 min, fluoroscopy duration was 7 ± 3 min, and the median dose area product was 563 ± 410 cGy cm². Major procedural complications were only two AV fistula, which did not require intervention. No stroke, pericardial tamponade, or phrenic nerve damage occurred. EDEL were not detected in any patient. Gastroparesis occurred in nine (4%) cases.</p><p><strong>Conclusions: </strong>The lack of EDEL post-PVI using the pentaspline PFA-catheter in this large AF cohort highlights the esophageal safety of this method. Gastroparesis was observed in a small minority, but relationship with PFA is still to be determined.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093398","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":"\"Poor man's\" left bundle branch area pacing as a bailout strategy: a case series and a practical guide of stylet-driven LBBAP without sheath support.","authors":"Andreas Müssigbrodt, Romain Vergier, Mickael Cohen, Alpha Barry, Francesco Montereggi, Guram Imnadze","doi":"10.1007/s10840-025-02093-w","DOIUrl":"https://doi.org/10.1007/s10840-025-02093-w","url":null,"abstract":"<p><p>Left bundle branch area pacing (LBBAP) is a physiological pacing method as it yields narrow QRS complexes and minimizes the risk of asynchronous ventricular activation. Due to its numerous advantages, it has gained wide acceptance among electrophysiologists. We explain a simplified technique of LBBAP with a conventional stylet-driven lead without use of sheath support and demonstrate its feasibility in a case series with four patients.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056552","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":"Indirect treatment comparison of two pulsed field ablation systems for the treatment of persistent atrial fibrillation.","authors":"Kazuo Matsumoto, Kelly A van Bragt, Fred J Kueffer, Waruiru Mburu, Khaldoun G Tarakji","doi":"10.1007/s10840-025-02124-6","DOIUrl":"https://doi.org/10.1007/s10840-025-02124-6","url":null,"abstract":"<p><strong>Background: </strong>Catheter ablation is beneficial in patients with symptomatic persistent atrial fibrillation (PerAF), and pulsed field ablation (PFA) is a promising energy source to safely and durably create ablation lesions. However, catheter-specific \"PFA waveforms and designs\" result in effectiveness and safety profiles that are not transferable to other PFA technologies. A head-to-head comparison between the dual-energy, wide-footprint lattice-tip (Sphere-9, Medtronic) and pentaspline PFA catheter (Farawave, Boston Scientific) is not yet available. Consequently, this study aims to perform an indirect treatment comparison (ITC).</p><p><strong>Methods: </strong>Outcomes (efficacy, safety, and procedure times) between the SPHERE Per-AF trial (N = 212; NCT05120193) and ADVANTAGE AF trial (N = 260; NCT05443594) studies were compared using matched-adjusted indirect comparison (MAIC) methods. Matching was performed based on subjects' baseline characteristics.</p><p><strong>Results: </strong>After matching, SPHERE Per-AF showed a higher probability (OR 0.51 (95% CI:0.32 - 0.80), p = 0.003) of 12-month freedom from arrhythmias (77.4%) compared to ADVANTAGE AF (63.5%). There was no evidence of adjusted probability of a primary safety difference (OR 0.76 (95% CI:0.17 - 3.42), p = 0.72) between trials (1.8% vs. 2.3%, respectively). Adjusted procedure and pulmonary vein isolation time were comparable, but fluoroscopy time was significantly shorter in SPHERE Per-AF compared to ADVANTAGE AF (-14.4 min (95% CI:-16.2, -12.5); p < 0.01).</p><p><strong>Conclusion: </strong>PFA is generally safe and efficient; however, in this ITC, SPHERE Per-AF showed a higher probability of treatment success in PerAF patients compared to ADVANTAGE AF. Overall, these results underline possible differences even amongst PFA systems, which must be validated in randomized trials. Until then, MAIC methods fill the current evidence gap. Registry and the Registration No. SPHERE Per-AF: NCT05120193 and ADVANTAGE AF: NCT05443594.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031684","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":"Assessing the role of ICD in Chagas heart disease: a systematic review, meta-analysis, and meta-regression.","authors":"Lucas M Barbosa, Vinícius Martins Rodrigues Oliveira, Ivo Queiroz, Natanael de Paula Portilho, William Jakymiu Furtado, Natasha Maranhão Vieira Rodrigues, Karoline Moraes Guedes, Beatriz Araújo, Eduardo Dan Itaya, Kauê Abreu Chagas, Hilária Saugo Faria, Larissa C Hespanhol, Fabrício Pelucci Machado, Caroline de Oliveira Fischer-Bacca, Maria do Carmo P Nunes","doi":"10.1007/s10840-025-02109-5","DOIUrl":"https://doi.org/10.1007/s10840-025-02109-5","url":null,"abstract":"<p><strong>Background: </strong>Chagas heart disease (ChD) is a significant public health concern in Latin America, contributing to a high incidence of sudden cardiac death (SCD). Despite advances in heart failure treatment, management of Chagas cardiomyopathy has not progressed accordingly. While ICDs are effective for primary and secondary prevention in other conditions, patients with ChD often experience more frequent episodes of ventricular tachycardia, and ICD use may provide a negative impact and increase mortality. This meta-analysis focuses on ICD use in ChD patients, providing a comparative analysis with other etiologies.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and Cochrane databases for studies evaluating ICD use in ChD. We pooled event prevalence for single-arm analyses and calculated risk ratios (RR) for pairwise comparisons with non-ChD, using a random effects model with 95% confidence intervals (CI). Statistical analyses were conducted using R version 4.4.3.</p><p><strong>Results: </strong>Twenty-three studies were included, comprising a pooled population of 2833 patients, with 1679 (59.2%) diagnosed with ChD. The ACM rate was 22.59% (95% CI 17.09 to 29.25). Notably, the appropriate intervention rate was 58.50% (95% CI 50.06 to 66.29), with ChD patients showing a higher incidence compared to non-ChD (RR 1.61; 95% CI 1.13 to 2.29; p < 0.01; I2 = 63%). Inappropriate therapy occurred in 7.64% (95% CI 4.98 to 11.54) of cases, while electrical storms were reported in 23.49% (95% CI 13.88 to 36.89) of ChD patients.</p><p><strong>Conclusion: </strong>Overall, although ICDs can be a viable option that offers therapeutic benefits, their use in ChD patients requires careful evaluation to optimize 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":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025175","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":"Comparison of artificial intelligence-adjudicated spatiotemporal dispersion in spontaneous vs. induced atrial fibrillation among patients with persistent AF.","authors":"Jonathan Alfred, Giulio Mastella, Isabel Rattka, Niklas Jurik, Eimo Martens, Karl-Ludwig Laugwitz, Manuel Rattka","doi":"10.1007/s10840-025-02122-8","DOIUrl":"https://doi.org/10.1007/s10840-025-02122-8","url":null,"abstract":"","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014297","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":"Bipolar radiofrequency ablation for refractory scar-related interatrial septal tachycardias: a multicenter study.","authors":"Piotr Futyma, Łukasz Zarębski, Lohit Garg, Sanghamitra Mohanty, Vincenzo Mirco La Fazia, Prem Geeta Torlapati, Francis E Marchlinski, Andrea Natale, Pasquale Santangeli","doi":"10.1007/s10840-025-02120-w","DOIUrl":"https://doi.org/10.1007/s10840-025-02120-w","url":null,"abstract":"<p><strong>Background: </strong>Catheter ablation of scar-related interatrial septal atrial tachycardias (IAS-ATs) is challenging and can be refractory to conventional unipolar radiofrequency catheter ablation (RFCA).</p><p><strong>Aim: </strong>This multicenter study investigated the safety and efficacy of bipolar radiofrequency catheter ablation (Bi-RFCA) in patients with IAS-AT refractory to conventional unipolar RFCA.</p><p><strong>Methods: </strong>Consecutive patients with scar-related IAS-AT refractory to conventional unipolar RFA across three electrophysiological centers were included in the study. Bi-RFCA with power up to 40 W and duration up to 60 s was performed with two ablation catheters across the IAS at sites identified with activation and entrainment mapping. Acute termination and noninducibility of the targeted IAS-AT was used as the intraprocedural ablation endpoint. Arrhythmia-free survival from any atrial arrhythmia (AT or atrial fibrillation) lasting > 30 s was used as a follow-up outcome measure.</p><p><strong>Results: </strong>A total of 17 patients (12 males, age 62 ± 13) were included in the study. Acute elimination of arrhythmia with Bi-RFCA was achieved in all patients. Mean procedure time was 173 ± 69 min, mean bipolar RF time 209 ± 193 s, and mean power 39 ± 3 W. During 11 ± 3 months of follow-up, AT/AF recurrence was observed in 2 (12%) patients. No steam pops occurred during any of the Bi-RFCA applications and no other complications occurred during procedures or follow-up.</p><p><strong>Conclusion: </strong>Bi-RFCA is an effective and safe strategy to target scar-related IAS-AT refractory to standard unipolar RFCA.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007045","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":"Comparison of a guidewire with an uninsulated tip versus dedicated radiofrequency wire with discrete electrode for energy-based transseptal puncture: a pre-clinical study.","authors":"Amin Al-Ahmad, Pamela Horton Embrey, Rodney Horton, Christian Balkovec, Rhodaba Ebady, Aravin Sukumar, Saja Al-Dujaili, Andrea Natale","doi":"10.1007/s10840-025-02126-4","DOIUrl":"https://doi.org/10.1007/s10840-025-02126-4","url":null,"abstract":"<p><strong>Background: </strong>Dedicated radiofrequency (RF) needles and wires for transseptal puncture (TSP) achieve better outcomes vs. electrified open-ended needles and guidewires due to optimized electrode design and energy delivery. This study benchmarked TSP performance between the dedicated VersaCross wire system (VC; Boston Scientific) and an electrified guidewire with an alternative electrode configuration similar to commercially available devices.</p><p><strong>Methods: </strong>A 0.025″ guidewire (Cordis) was modified to mimic the 15 cm 0.025″ distal uninsulated wire length of the HOTWIRE (Atraverse) device and electrified using a ValleyLab generator (EG; 30-50 W, 1 s and 300 ms). EG was extended 0-3.5 mm from the dilator tip to mimic clinical use. RF puncture using VC and EG was performed on ex vivo porcine septa (n = 18) and in vivo swine heart (n = 3), to compare TSP performance, thermal damage and energy output measured using an oscilloscope.</p><p><strong>Results: </strong>Ex vivo, VC had 100% TSP success with 1 attempt using 1 s (constant) and 300 ms (pulse) modes; EG demonstrated higher failure rates and less consistency at 30 W (78%) and 40 W (88%), requiring more RF applications, longer duration and energy output. EG crossings ex vivo and in vivo showed thermal damage on septa and device charring along the uninsulated distal end, unlike VC. Successful TSP with EG (1 s, 30-50 W) in vivo demonstrated wire charring and thrombus along the uninsulated wire length within the dilator.</p><p><strong>Conclusion: </strong>Manual protrusion of a wire with a long uninsulated length can be difficult to control in a clinical setting, thus, introducing variability, excess energy, and risk of thermal injury and thrombus formation. A purpose-built electrode and dedicated generator optimize RF delivery for efficient and safe TSP.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007024","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":"Virtual screens for cardiac ablation procedures in augmented reality.","authors":"Timothy R Maher, David N Kenigsberg, Jonathan R Silva, Jennifer N Avari Silva, Andrew H Locke","doi":"10.1007/s10840-025-02121-9","DOIUrl":"https://doi.org/10.1007/s10840-025-02121-9","url":null,"abstract":"","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986375","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}