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

{"title":"Pulsed field ablation of the cavotricuspid isthmus using a balloon-in-basket system.","authors":"Joseph A Kheir, Lukas Urbanek, Andrea Urbani, Melanie Gunawardene, Alexandra Marx, Julia Lurz, David Schaack, Matteo Rocchetti, Soroosh Najafi, Alexandra Steyer, K R Julian Chun, Boris Schmidt","doi":"10.1007/s10840-025-02102-y","DOIUrl":"https://doi.org/10.1007/s10840-025-02102-y","url":null,"abstract":"<p><strong>Background: </strong>Pulsed field ablation (PFA) has emerged as a promising modality for pulmonary vein isolation (PVI) in atrial fibrillation (AF), with favourable safety and efficacy profiles. However, its application to other arrhythmias, such as typical atrial flutter (AFl), remains exploratory. The Volt™ PFA system (Abbott Laboratories), a novel balloon-in-basket catheter capable of mapping, pacing and delivering ablating energy, has been validated for PVI, but has not yet been used for the treatment of AFl cavotricuspid isthmus (CTI) dependent. We report the first documented case of successful concomitant PVI and CTI ablation using the Volt™ PFA system. A 73-year-old male with persistent AF and atrial flutter was referred for catheter ablation. After PVI was completed, typical AFl was induced during catheter manipulation. Activation mapping and entrainment confirmed CTI-dependent flutter. Despite the presence of a pacemaker and the balloon-shaped catheter, a linear ablation line was delivered across the CTI using selectively activated splines. Tachycardia was terminated after six PFA applications, and bidirectional CTI block was confirmed. The patient was discharged two days post-procedure without complications.</p><p><strong>Discussion: </strong>This case demonstrates the feasibility of using the balloon-in-basket Volt™ PFA catheter for CTI ablation. Mapping integration and selective spline activation enabled precise lesion placement in a linear anatomical region, overcoming the expected limitations of a balloon-based system. While the acute outcome was successful, long-term safety and efficacy of this off-label use warrant further investigation.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763008","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":"Hitting the pause button: taking athlete physiology into account when considering pacemaker placement.","authors":"Sean Swearingen, Sahishnu Patel, Ian Law","doi":"10.1007/s10840-025-02047-2","DOIUrl":"10.1007/s10840-025-02047-2","url":null,"abstract":"","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":"961-963"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121972","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":"Clear criterion for the therapeutic endpoint of non-reproducible atrioventricular node reentry with a smooth atrioventricular node function curve.","authors":"Akiko Kodama, Suguru Nishiuchi, Yuko Miki, Yuji Matsuo, Taiki Masuyama, Kenichi Kaseno, Shingo Yoshimura, Takehito Sasaki, Kohki Nakamura, Shigeto Naito","doi":"10.1007/s10840-025-02073-0","DOIUrl":"10.1007/s10840-025-02073-0","url":null,"abstract":"","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":"965-966"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153285","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 bundle branch pacing vs. biventricular pacing for cardiac resynchronization therapy in the long-term: a prospective, non-randomized, cohort study.","authors":"Jieruo Chen, Zefeng Wang, Fei Hang, Weiping Sun, Haiwei Li, Yongquan Wu","doi":"10.1007/s10840-025-02104-w","DOIUrl":"https://doi.org/10.1007/s10840-025-02104-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":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763006","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":"Advancing cardiac resynchronization therapy techniques: evaluating safety, efficacy, and long-term outcomes with percutaneous coronary venoplasty and balloon capping.","authors":"Burcu Kodal, Aziz Inan Celik, Tahir Bezgin, Nart Zafer Baytugan, Abdulcebbar Sipal, Sadiye Nur Dalgic, Sukriye Ebru Onder, Serdar Bozyel, Tumer Erdem Guler, Metin Cagdas, Carlos A Morillo, Tolga Aksu","doi":"10.1007/s10840-025-02064-1","DOIUrl":"10.1007/s10840-025-02064-1","url":null,"abstract":"<p><strong>Background: </strong>Cardiac resynchronization therapy (CRT) is a cornerstone treatment for heart failure patients with wide QRS complexes. Optimal left ventricular (LV) lead placement is crucial for CRT success but can be challenging due to anatomical complexities within the coronary venous system. This study evaluates the safety, efficacy, and long-term outcomes of percutaneous coronary venoplasty (PCV) and a novel \"balloon capping\" technique for overcoming challenging coronary venous anatomies.</p><p><strong>Methods: </strong>We retrospectively analyzed 44 CRT patients, divided into two groups: those undergoing PCV-assisted LV lead implantation (n = 15) and those receiving conventional CRT implantation (n = 29). A novel \"balloon capping\" technique was employed in select cases to navigate tortuous venous pathways. Baseline characteristics, procedural details, and clinical outcomes, including changes in ejection fraction (EF), QRS duration, and NYHA class, were compared. The Kaplan-Meier and Cox regression analyses evaluated long-term outcomes.</p><p><strong>Results: </strong>PCV was associated with successful LV lead placement in all cases, despite significantly smaller target vessel diameters (p < 0.001). ΔEF was significantly greater in the PCV group (p = 0.030), indicating improved CRT response. Balloon capping was employed in 11.4% of cases, achieving comparable procedural success and clinical outcomes. There were no significant differences in mortality or hospitalizations between groups.</p><p><strong>Conclusion: </strong>CRT was associated with significant improvements in ΔEF, with PCV facilitating successful LV lead placement in anatomically challenging cases. Larger studies are needed to confirm these findings and explore their long-term clinical implications.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":"1065-1073"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096820","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":"Predictors of iatrogenic atrial septal defects: analysis of fibrotic atrial cardiomyopathy, valvular disease, and transseptal sheath size.","authors":"Emanuel Heil, Jin-Hong Gerds-Li, Matthias Bock, Frank Heinzel, Gerhard Hindricks, Felix Hohendanner","doi":"10.1007/s10840-025-02065-0","DOIUrl":"10.1007/s10840-025-02065-0","url":null,"abstract":"<p><strong>Background: </strong>Transseptal puncture (TSP) for left atrial access is routinely used during various cardiac interventions, including ablation for atrial tachyarrhythmia. However, in selected patients, subsequent iatrogenic atrial septal defects (iASD) persist. This study determines whether fibrotic atrial cardiomyopathy (FACM) or mitral valve regurgitation (MR) are predictors of persistent iASD development post-TSP.</p><p><strong>Methods: </strong>We analyzed data from patients undergoing radiofrequency ablation with high-density electroanatomical mapping for recurrent atrial tachyarrhythmias after a primary pulmonary vein isolation using either cryo or RF technologies. Patients were categorized based on transesophageal echocardiography findings: (1) competent atrial septum (cAS) (2), iASD, or (3) a patent foramen ovale (PFO). Differences in FACM and MR were assessed across these groups.</p><p><strong>Results: </strong>Of 149 patients (age 67.7 ± 9.7 years), 125 (83.9%) had cAS, 8 (5.4%) iASD, and 16 (10.7%) PFO. No significant differences were observed in age (p = 0.932), BMI (p = 0.612), or LVEF (p = 0.581). The TSP sheath size was not associated with iASD occurrence (p = 0.857). Common surrogates of FACM, i.e., LAVI (p = 0.114), LA area (p = 0.156), mean left atrial pressure (LAP; p = 0.459), or total low-voltage area burden (p = 0.058) did not differ significantly among groups. MR was not linked to increased LAP (at first (p = 0.290) and second procedure (p = 0.212)) or a higher incidence of iASD (at first (p = 0.155) and second procedure (p = 0.917)). Mean LAP did not correlate with LA size (p = 0.471) or low-voltage extent (p = 0.084).</p><p><strong>Conclusion: </strong>Our findings underscore that iASDs post-TSP for left atrial ablation are uncommon and unrelated to TSP sheath size, FACM, or MR, further minimizing concerns for routine interventions in patients with more advanced arrhythmia substrate or valvular disease.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":"1001-1008"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096823","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":"Pulsed field ablation for pulmonary vein isolation provoked ganglionated plexus-mediated vagal atrial fibrillation.","authors":"Kentaro Goto, Shinsuke Miyazaki, Miho Negishi, Masaki Honda, Ryo Tateishi, Iwanari Kawamura, Takuro Nishimura, Kazuya Yamao, Susumu Tao, Masateru Takigawa, Tetsuo Sasano","doi":"10.1007/s10840-025-02106-8","DOIUrl":"https://doi.org/10.1007/s10840-025-02106-8","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":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746863","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":"Deep sedation for ventricular tachycardia ablation: balancing safety, inducibility, and hemodynamic stability.","authors":"Nathaniel Christian Miller, Yasuhiro Shirai, Amrish Deshmukh","doi":"10.1007/s10840-025-02091-y","DOIUrl":"https://doi.org/10.1007/s10840-025-02091-y","url":null,"abstract":"","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710549","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":"Reversible pulsed field ablation for facilitating safe and effective mitral isthmus block.","authors":"Emanuele Curti, Francesco Maria Brasca, Giulia Girardengo, Salvatore Rizzo, Valeria Rella, Federico Landra, Filippo Brucato, Giovanni Battista Perego","doi":"10.1007/s10840-025-02100-0","DOIUrl":"https://doi.org/10.1007/s10840-025-02100-0","url":null,"abstract":"","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710550","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":"Regional disparities in the care and outcomes of atrial fibrillation patients in a universal health care system: a population-based cohort study.","authors":"Mohammed Shurrab, Andrew C T Ha, Jason G Andrade, Christopher C Cheung, Guy Amit, Allan Skanes, Girish M Nair, Feng Qiu, Olivia Haldenby, Travis Quevillon, Paul Angaran, Damian P Redfearn, Ratika Parkash, Jeff S Healey, Dennis T Ko","doi":"10.1007/s10840-025-02094-9","DOIUrl":"https://doi.org/10.1007/s10840-025-02094-9","url":null,"abstract":"<p><strong>Introduction: </strong>While prior studies have shown regional disparities in patients with myocardial infarction and heart failure within a universal health care, there are limited data on the association between different regions within a universal health care system and outcomes after an atrial fibrillation (AF) diagnosis. In this context, we aimed to assess variations in processes of care and outcomes among patients with the diagnosis of AF presenting to the emergency department (ED).</p><p><strong>Methods: </strong>We conducted a population-based retrospective cohort study of all adult patients (≥ 18 years) with their first presentation to the ED with AF between April 1, 2012, and March 31, 2022 in Ontario, Canada. We divided the analyses into five major Ontario Health Regions (North, East, Central, Toronto, and West). North was used as the reference group. The primary outcome was all-cause mortality or admission. Secondary outcomes included all-cause mortality, all-cause admission, and all-cause ED visit. We examined outcomes up to 1 year from index AF diagnosis. Cox proportional hazards regression analysis was used to study the association of different regions and outcomes.</p><p><strong>Results: </strong>Among 104,383 patients with the diagnosis of AF in the ED (mean age 69.4 years, 47.1% female), there were significant differences between Ontario Health Regions in physician follow-up (less access to primary care in North or a cardiologist in West) and procedures performed (less cardioversions or ablations performed in North). There was a significantly lower rate of the primary outcome of all-cause mortality or admission in Ontario Health Regions compared to the North (East HR 0.87 (0.83, 0.90), Central HR 0.87 (0.83, 0.91), Toronto HR 0.88 (0.84, 0.92), and West HR 0.87 (0.84, 0.91)). Similar findings were noted with lower all-cause admission and all-cause ED visit in Ontario Health Regions compared to the North, but all-cause mortality did not differ between regions.</p><p><strong>Conclusions: </strong>Despite universal health care and prescription medication coverage, regional variations exist in the management of AF patients. Patients in Northern Ontario were less likely to visit a primary care physician and had worse outcomes driven by higher admission rate after AF diagnosis.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693096","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}