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

{"title":"Clockwise \"Mitral Isthmus Block\" complicating ablation of left free wall accessory pathways - two cases and review of the literature.","authors":"Nikola Kocovic, Koichi Nagashima, Reginald T Ho","doi":"10.1007/s10840-025-02119-3","DOIUrl":"https://doi.org/10.1007/s10840-025-02119-3","url":null,"abstract":"<p><strong>Background: </strong>Mitral isthmus block (MIB) complicating radiofrequency ablation (RFA) of orthodromic reciprocating tachycardia (ORT) using left - sided accessory pathways (APs) is poorly understood.</p><p><strong>Methods: </strong>Two cases and a systematic review of the literature of patients (pts) who developed MIB complicating left - sided ORT RFA is presented.</p><p><strong>Results: </strong>Among 27 pts (34 ± 12 years old, 54% female, 68% concealed AP), 15 (56%) had ≥ 1 failed RFA procedure. One RF lesion caused MIB in 6 (22%) (≤ 3 lesions in 11 (41%)). MIB caused switch from eccentric to pseudo-concentric atrial activation (23/27 (85%)) without increasing septal ventriculo-atrial (VA_His) intervals/ ORT cycle lengths (17/18 (94%)). Recurrent ORT with \"concentric\" activation was misdiagnosed as atrio-ventricular nodal reentrant tachycardia (AVNRT) in 3 (11%) - 1 requiring pacemaker implantation after slow pathway (SP) RFA. By targeting earliest retrograde atrial activation on the high mitral annular free wall (1-3 o'clock (17/19 (89%)) above the line of block (LOB), successful AP RFA occurred in 23/23 (100%).</p><p><strong>Conclusions: </strong>Left free wall ORTs with RFA - induced MIB are (1) difficult ablations with > 50% requiring > 1 procedure, (2) can masquerade as AVNRT causing unnecessary SP RFA, and (3) are successfully ablated on the high mitral annular free wall predominantly between 1 and 3 o'clock and always superior to the LOB.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986339","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 averaged impedance drop percent as a real-time parameter for safe and effective prolonged radiofrequency ablation using the TactiFlex SE catheter: an ex vivo study.","authors":"Kazumasa Suga, Kodai Yamazaki, Taku Sakurai, Ryusuke Ota, Tomoyuki Ota, Hiroyuki Kato, Hisashi Murakami, Kenji Kada, Naoya Tsuboi, Satoshi Yanagisawa, Yasuya Inden, Toyoaki Murohara","doi":"10.1007/s10840-025-02112-w","DOIUrl":"https://doi.org/10.1007/s10840-025-02112-w","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":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986333","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":"Lessons learned from the first in human sequential colocalized PFA and RF lesions.","authors":"Daniel Alyesh, Nicholas Palmeri, Sri Sundaram","doi":"10.1007/s10840-025-02103-x","DOIUrl":"https://doi.org/10.1007/s10840-025-02103-x","url":null,"abstract":"<p><p>The era of pulsed field ablation (PFA) has yielded considerable improvements in procedural safety for atrial fibrillation. However, given the fixed size and depth of the electrical field in first generation PFA modalities, ablation of substrates beyond the pulmonary veins with heterogeneity of tissue thickness can be challenging. Sequential PFA and radiofrequency (RF) from a focal tip catheter may offer an advantage in these challenging substrates with potential to deliver safe and deeper lesions. In our report, we describe the first in human experience of sequential colocalized PFA and RF lesions with a 3.5-mm investigational dual energy catheter.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860072","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":"Atrial fibrillation and flutter conversion with pulsed electric field delivery: preclinical proof of concept.","authors":"Nicholas Y Tan, Freddy Del-Carpio Munoz, Jason A Tri, Taro Koya, Naoto Otsuka, Christopher V DeSimone, Suraj Yalamuri, Elad Maor, Quim Castellvi, Antoni Ivorra, Damijan Miklavčič, Samuel J Asirvatham","doi":"10.1007/s10840-025-02115-7","DOIUrl":"https://doi.org/10.1007/s10840-025-02115-7","url":null,"abstract":"<p><strong>Introduction: </strong>Device-based therapies for treating atrial fibrillation (AF) episodes are limited. Using pulsed electric fields (PEF) to induce reversible electroporation of cardiac tissue may effectively terminate AF. Thus, we aimed to assess the feasibility of PEF delivery for converting atrial arrhythmias via reversible electroporation.</p><p><strong>Methods and results: </strong>Four swine models were used in this acute study. Custom-made decapolar catheters for PEF delivery were deployed with the following configurations: (1) Endocardial right atrium (RA) and coronary sinus (CS), n = 2; and (2) Endocardial RA and epicardial left atrium (epiLA), n = 2. AF and atrial flutter (AFL) were induced with programmed stimulation. PEF delivery was performed using the BTX 830 generator. For each attempt, a single monophasic pulse at 10 or 20 µs pulse width was administered, with voltage varied across attempts (range 750-3000 V). Successful (type 1 and 2 breaks) and unsuccessful conversion attempts were recorded. Post-PEF signal changes and arrhythmias were identified. A total of 58 AF/AFL (28 and 30 respectively) episodes were induced. Of the 37 successful conversion attempts, 33 (89.1%) were type 1 breaks. Conversion success probabilities generally increased with higher voltages for both configurations. Greater than 70% conversion success was seen with ≥ 1500 V for the RA/CS configuration and ≥ 2000 V for the RA/epiLA configuration. Arrhythmias including intra-atrial delay and high-grade atrioventricular block were seen, usually following successive PEF deliveries. Significant muscle stimulation was provoked with the current experimental setup.</p><p><strong>Conclusion: </strong>Termination of atrial arrhythmias with PEF delivery is feasible, although further work is required to optimize its efficacy and safety.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857389","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":"Long-term outcome of catheter ablation of left fascicular ventricular arrhythmias.","authors":"Ilaria My, Fabian Moser, Fabian W Loeck, Julius Obergassel, Laura Rottner, Marc D Lemoine, Paulus Kirchhof, Daniel Steven, Arian Sultan, Stephan Willems, Christian Meyer, Bruno Reissmann, Andreas Rillig, Andreas Metzner, Feifan Ouyang","doi":"10.1007/s10840-025-02116-6","DOIUrl":"https://doi.org/10.1007/s10840-025-02116-6","url":null,"abstract":"<p><strong>Background: </strong>Due to their low prevalence in Europe, data on optimal treatment of ventricular arrhythmias (VAs) involving the left ventricular conduction system are scarce.</p><p><strong>Aim: </strong>To report on clinical and procedural characteristics and long-term outcomes of European patients undergoing catheter ablation of primary ventricular complexes (PVCs) and ventricular tachycardias (VTs) involving the left ventricular conduction system.</p><p><strong>Methods and results: </strong>This study includes 27 retrospectively identified Caucasian patients (10/27 (37%) women, median age 44.5 (IQR 33-55.75) who underwent electrophysiological examinations at a tertiary ablation center over a period of 14 years (between 2009 and 2022). Mapping and ablation were performed via transaortic and/or transseptal approach. Post-ablation follow-up (FU) was performed via regular Holter-ECGs and clinical evaluations, or via structured FU within the prospective TRUST registry (ClinicalTrials.gov Identifier: NCT05521451). VAs were located in the left posterior fascicle (LPF) in 21/27 patients (78%), the left anterior fascicle (LAF) in 4 (15%), and the upper septum (US) in 2 (7%). Among patients presenting with arrhythmias involving the LPF, the majority (12/21, 57%) presented with sustained VTs, and 9/21 (43%) experienced PVCs/non-sustained (ns)-VTs. In contrast, among those with arrhythmias involving the LAF, the predominant clinical presentation was PVCs or ns-VTs (3/4, 75%). Of the two patients with arrhythmias involving the US region, one (50%) presented with PVCs and ns-VTs, and the other (50%) with sustained VT. Ablation was acutely successful in 24 patients (89%) with a procedure time of 130 ± 49 min. Three of the 27 patients (11%) underwent re-ablation due to early arrhythmia recurrence. No procedure-related complications occurred except left fascicular posterior block in four (15%) and a complete left bundle block in one patient (4%). Arrhythmia-free survival after a median follow-up of 30 (IQR 14-62) months was 73%.</p><p><strong>Conclusion: </strong>VAs predominantly presented as tachycardia involving the posterior fascicle and as PVCs involving the anterior fascicle and both can be treated by catheter ablation with favorable long-term clinical outcome.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857390","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 contact force sensing and non-contact force sensing catheters in ischemic cardiomyopathy patients with high ventricular arrhythmia burden.","authors":"Fırat Özcan, Serkan Cay, Özcan Özeke, Meryem Kara, Ahmet Korkmaz, Elif Hande Çetin Özcan, Duygu Koçyiğit, Tolga Aksu, Dursun Aras, Serkan Topaloğlu","doi":"10.1007/s10840-025-02097-6","DOIUrl":"https://doi.org/10.1007/s10840-025-02097-6","url":null,"abstract":"<p><strong>Background: </strong>Catheter ablation of ventricular tachycardia (VT) and electrical storm (ES) controls recurrences and improves survival in ischemic cardiomyopathy. Adequate contact of the catheter with the tissue during mapping and ablation is required for successful outcomes. We aimed to determine the acute procedural and long-term outcomes of ablation of the electrical storm or frequent shocks with and without contact force sensing catheters in ischemic cardiomyopathy.</p><p><strong>Methods: </strong>The study retrospectively included 110 ischemic cardiomyopathy patients with electrical storm or frequent shocks. Mapping and ablation were performed with contact force sensing catheters in 46 patients (Contact force [CF] group) and without contact force sensing catheters in 64 patients (non-Contact force[non-CF) group).</p><p><strong>Results: </strong>The acute procedural success was not different between groups (p = 0.438). After a median follow-up of 25 months (14-37) for the CF group and 26 months (11-46) for the non-CF group (p = 0.687) VT free survival was 71.74% in the CF group and 65.62% in the non-CF group (p = 0.552). The rate of recurrence occurring as an electrical storm was more in the non-CF group than the CF group (4.35% versus 20.31%, p = 0.018). The rate of death from any cause was less in the CF group than the non-CF group (4.35% versus 28.12%, p = 0.008). The predictors of recurrence as ES and mortality were the use of non-contact force sensing catheter and inducibility of any VT after the procedure.</p><p><strong>Conclusions: </strong>The use of contact force sensing catheter seems to be better in terms of reducing ES as a recurrence and mortality in ischemic VT patients.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144824820","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":"Rapid staining protocol for electroporated potato models: a novel approach for evaluating pulsed field ablation lesions.","authors":"Daniel Campos-Villarreal, Tessa O'Reilly, Nathaniel A Steiger, William H Sauer","doi":"10.1007/s10840-025-02105-9","DOIUrl":"https://doi.org/10.1007/s10840-025-02105-9","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":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144819029","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":"Use of S-ICD tunneling tool for percutaneous epicardial access during ventricular tachycardia ablation.","authors":"Jackson J Liang, Nithi Tokavanich, Frank Bogun","doi":"10.1007/s10840-025-02113-9","DOIUrl":"https://doi.org/10.1007/s10840-025-02113-9","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":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144819031","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 for idiopathic premature ventricular complexes: evaluation of acute and chronic lesion characteristics with cardiac magnetic resonance imaging.","authors":"Cheng Cai, Zhiwei Ai, Jun Wang, Yi Xu, Weizhu Ju, Changlun Ye, Gang Yang, Hongwu Chen, Hailei Liu, Zidun Wang, Xiaohong Jiang, Chang Cui, Jiale Dong, Minglong Chen","doi":"10.1007/s10840-025-02098-5","DOIUrl":"https://doi.org/10.1007/s10840-025-02098-5","url":null,"abstract":"<p><strong>Background: </strong>To date, data about pulsed field ablation (PFA) for ventricular arrhythmias are limited, and cardiac magnetic resonance (CMR) characteristics of acute and chronic PFA lesions in the ventricles have not been described. This study sought to examine feasibility and efficacy of premature ventricular complex (PVC) ablation using focal PFA, as well as assess acute and chronic lesion characteristics using CMR.</p><p><strong>Methods: </strong>This was a prospective, single-arm study performed at two centers in China. Consecutive patients with frequent, symptomatic PVCs were consented and recruited. All procedures were performed using a comprehensive cardiac PFA system. PVC burden evaluation and CMR were performed before the procedure, within 3 days, and at approximately 6 months post-procedure.</p><p><strong>Results: </strong>Twelve patients (mean age 54 ± 14 years, 41.7% female) were included and underwent ablation. The PVCs originated in the right ventricular outflow tract in seven (58.3%) patients, the left ventricular outflow tract in three (25%) patients, the left anterior papillary muscle in one (8.3%) patient and para-Hisian septum in one (8.3%) patient, respectively. Nine (75%) patients had complete elimination of PVCs after PFA. The PFA lesions were visualized and quantified by CMR in 6 out of 12 patients. The median volume evaluated by acute late gadolinium enhancement was 726 (430, 1544) mm³ and significantly decreased to 445 (288, 715) mm³ in the chronic stage (P = 0.031).</p><p><strong>Conclusion: </strong>PFA showed favorable efficacy and safety in patients with frequent PVCs. CMR imaging allows clear visualization and quantitative analysis of PFA lesions, which showed a significant size regression from acute to chronic period.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144802448","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":"First in-human reverse LOT-CRT defibrillator.","authors":"Nicolas Clementy, Nicolas Raczka, Catherine Sportouch, Maxime Pons, Jean Pierre Jabbour, Franck Raczka","doi":"10.1007/s10840-025-02111-x","DOIUrl":"https://doi.org/10.1007/s10840-025-02111-x","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":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786440","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}