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

{"title":"Remote monitoring of leadless pacemakers using a novel conductive telemetry communication method.","authors":"Sri Sundaram, Nitika Chellappa, Kunal Chaniary, Monica Lo, Devi Nair, Rajesh Banker","doi":"10.1007/s10840-025-02095-8","DOIUrl":"https://doi.org/10.1007/s10840-025-02095-8","url":null,"abstract":"<p><strong>Background: </strong>Remote care has become part of the standard of care for cardiac rhythm device management. The Aveir™ single-chamber (AR and VR) and dual-chamber (DR) leadless pacemaker (LP) systems (Abbott, Abbott Park, IL) utilize a novel conductive telemetry communication schema for device interrogation and programming. A patient transmitter is designed as an at-home remote monitoring solution that interrogates the Aveir leadless pacemaker system via conductive telemetry and transmits the patient data.</p><p><strong>Objective: </strong>To characterize the performance of a remote care system that interrogates implanted Aveir LP systems via conductive telemetry.</p><p><strong>Methods: </strong>Patients implanted with an Aveir DR, VR, or AR system were enrolled in a data collection study upon hospital IRB approval of the study. The study protocol included (1) in-clinic interrogation of the LP system using the patient transmitter in a controlled setting, in two modes of use (hand-held and wired modes); and (2) optional at-home interrogation using the patient transmitter.</p><p><strong>Results: </strong>Thirty-one (25 males/6 females) subjects in three centers completed in-clinic interrogation of their Aveir system using the patient transmitter in both modes of use. Eighteen subjects completed at-home interrogation. Transmitter performance was comparable between modes of use, and between in-clinic and at-home interrogation. In all subjects 31/31 (100%), end-to-end remote care system use was successful.</p><p><strong>Conclusion: </strong>The initial, real-world experience of utilizing an end-to-end remote care system with Aveir LP patients demonstrated feasibility of this technology to offer an at-home remote monitoring solution for leadless pacemaker patients via conductive telemetry (Funded by Abbott Laboratories; Clinical Trials.gov ID:NCT06542133).</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":"144693097","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":"Geographic and clinical patterns of left atrial appendage occlusion utilization across the United States.","authors":"Brian Zenger, Alexander E Kolomaya, Ravi Ranjan, T Jared Bunch, Benjamin A Steinberg","doi":"10.1007/s10840-025-02096-7","DOIUrl":"https://doi.org/10.1007/s10840-025-02096-7","url":null,"abstract":"<p><strong>Background: </strong>Left Atrial Appendage Occlusion (LAAO) has become a more common procedure designed to reduce stroke risk in patients who are intolerant of systemic anticoagulation. The speed of adoption and broader application to patients outside of the narrow trial patients motivates an assessment to understand whether specific operator characteristics affect procedural volume.</p><p><strong>Methods: </strong>Using US CMS and Open Payments datasets, we explored LAAO procedural volumes, including temporal and geographical trends. We also examined how operator characteristics affected procedural volumes, including specialty, individual yearly procedural volume, and payments from LAAO manufacturers to clinicians.</p><p><strong>Results: </strong>LAAO procedural volume increased from 6,069 to 29,083 and 15 to 80 procedures per 100,000 enrollees from 2017 to 2021. Clinicians performing LAAO increased from 293 to 1038 and were primarily split between cardiac electrophysiology, interventional cardiology, and other cardiology subspecialties (48% Vs. 21% vs 26%, respectively, in 2021). There was a considerable geographic variation in procedural volume, with 46 states below 100 procedures per 100,000 enrollees. The highest-use state had over 250 LAAO procedures per 100,000 enrollees. Nearly all states saw an increase in procedural volume from 2017 to 2021. We found no meaningful correlation between payments from device manufacturers to clinicians and procedural volume.</p><p><strong>Conclusions: </strong>We found a significant increase and high geographic variability in LAAO use throughout the United States. No clinically meaningful correlation existed between payments from LAAO manufacturers to clinicians and subsequent procedural volume.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669271","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":"Assessment of contact force variability in the MAGiC catheter under different magnetic field strengths, vector orientations, and catheter extensions in robotic magnetic navigation.","authors":"Michal Orczykowski, Maciej Bak, Andrzej Glowniak, Krzysztof Kaczmarek, Piotr Urbanek, Robert Bodalski, Krzysztof Dubowski, Anna Jargielo, Pawel Derejko, Pawel Ptaszynski, Lukasz Szumowski","doi":"10.1007/s10840-025-02092-x","DOIUrl":"https://doi.org/10.1007/s10840-025-02092-x","url":null,"abstract":"<p><strong>Background: </strong>Contact force (CF) in manually controlled catheters is crucial for forming an optimal lesion. There is lack of published data on CF values of MAGiC catheter (Stereotaxis, St. Louis, MO, USA) in magnetic field.</p><p><strong>Methods: </strong>We conducted a total of 2500 CF measurements using the Robotic Magnetic Navigation (RMN) system (Stereotaxis, St. Louis, MO, USA), a magnetic-guided 8,5 Fr RF ablation catheter MAGiC (Stereotaxis, St. Louis, MO, USA) inserted through a long sheath, and a precision jewelry scale (IKEME, Guangdong, CN). We analyzed the impact on the obtained CF values of five different magnetic field vectors (transverse, caudal, cranial, sagittal, and anterior), two field strengths (0.1 T and 0.08 T), and five catheter extension configurations from the long sheath. Additionally, we compared the CF values of the MAGiC catheter and the THERMOCOOL® RMT Catheter (Biosense Webster, Irvine, CA, USA) using two models.</p><p><strong>Results: </strong>The measured CF values of MAGiC catheter ranged from 5.62 to 21.61 g (0.1 T) and 3.63 to 20.74 g (0.08 T) and varied depending on the vectors. CF was higher at 0.1 T than 0.08 T, with values ranging from 9.32 to 21.61 g (0.1 T) and 8.71 to 20.74 g (0.08 T). In Model I comparison of MAGiC and THERMOCOOL® RMT, the MAGiC catheter had significantly higher CF (p < 0.001) in 28/30 measurements scenarios. In Model II, CF was higher in 24/30 scenarios (p < 0.001).</p><p><strong>Conclusion: </strong>The MAGiC catheter provides consistently optimal CF values across multiple orientations and catheter extension models, outperforming the THERMOCOOL® RMT Catheter in most scenarios.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629433","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":"Beyond contact: troponin and the case for ablation index-guided AF ablation.","authors":"Auroa Badin, Anish Amin","doi":"10.1007/s10840-025-02085-w","DOIUrl":"https://doi.org/10.1007/s10840-025-02085-w","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":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602798","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":"Inflammatory markers and atrial fibrillation recurrence in patients with atrial fibrillation after cryoballoon ablation.","authors":"Nuo Li, De-Gang Mo","doi":"10.1007/s10840-025-02088-7","DOIUrl":"https://doi.org/10.1007/s10840-025-02088-7","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":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568312","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 results of the MAGiC robotic magnetic navigation radiofrequency ablation catheter.","authors":"Gediminas Rackauskas, Ricardas Kundelis, Audrius Aidietis, Jurate Barysiene, Diana Sudaviciene, Justinas Bacevicius, Monika Kezeviciute, Germanas Marinskis, Niels Christian Foldager Sandgaard, Christian Jøns, Xu Chen, Peter Karl Jacobsen","doi":"10.1007/s10840-025-02082-z","DOIUrl":"https://doi.org/10.1007/s10840-025-02082-z","url":null,"abstract":"<p><strong>Background: </strong>Robotic magnetic navigation (RMN) has demonstrated clinical utility in treating arrhythmia patients by providing direct distal-tip control of an ablation catheter, enhancing catheter precision, safety, and stability with an atraumatic catheter design. We aimed to assess the first in-human efficacy and safety of the new RMN-guided MAGiCTM radiofrequency ablation catheter.</p><p><strong>Methods: </strong>This prospective, multicenter single-arm, unblinded study enrolled 67 patients with arrhythmias that met EHRA guidelines for catheter ablation. All patients were treated for their index arrhythmia with the MAGiC RMN catheter. All other devices used in the procedures were approved for treatment including a RMN System (Genesis/Niobe^®) used to navigate the MAGiC catheter. Acute procedural success and adverse events were assessed for all patients through discharge from the hospital in the days following the procedure.</p><p><strong>Results: </strong>Sixty-seven patients were treated as follows: 25 cases of atrioventricular nodal reentrant tachycardia, 19 of premature ventricular contractions, 8 of Wolf-Parkinson-White (WPW) syndrome, 8 of atrial fibrillation, 3 of atrial flutter, and 4 of ventricular tachycardia. Acute procedural success was 94%. There was one cardiac tamponade due to perforation of the right ventricular outflow tract during ablation. Otherwise, no adverse events were observed.</p><p><strong>Conclusion: </strong>The results of this study demonstrate good acute efficacy and safety of the MAGiC RMN ablation catheter independent of underlying arrhythmias. Contact force and stability with MAGiC seem improved compared to previous catheters available with RMN, and therefore radiofrequency energy delivery needs careful attention, especially in thin areas of the myocardium. Additional long-term data are needed.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487724","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":"Head-to-head comparison of pulsed-field ablation, high-power short-duration ablation, cryoballoon and conventional radiofrequency ablation by MRI-based ablation lesion assessment.","authors":"Mariona Regany-Closa, Josep Pomes-Perez, Eric Invers-Rubio, Roger Borras, Berta Pellicer-Sendra, Susanna Prat-Gonzalez, Rosario Jesus Perea, Carlos Igor Morr, Jean-Baptiste Guichard, Elena Arbelo, Jose Maria Tolosana, Eduard Guasch, Andreu Porta-Sanchez, Marta Sitges, Josep Brugada, Ivo Roca-Luque, Lluís Mont, Till F Althoff","doi":"10.1007/s10840-025-02086-9","DOIUrl":"https://doi.org/10.1007/s10840-025-02086-9","url":null,"abstract":"<p><strong>Background: </strong>Novel concepts for pulmonary vein isolation (PVI) like pulsed-field ablation (PFA) or high-power short-duration ablation (HPSD) promise favorable profiles of safety and efficacy. However, clinical comparisons of those novel concepts with conventional ablation approaches regarding ablation lesions are lacking. To systematically investigate lesion characteristics of novel ablation concepts, we performed a prospective head-to-head comparison using late gadolinium enhancement (LGE)-CMR.</p><p><strong>Methods: </strong>This study included patients undergoing first-time PVI-only atrial fibrillation ablation-either by ablation index-guided radiofrequency ablation (RF), cryoballoon ablation (CRYO), HPSD (90W, 4 s), or PFA (Farapulse). All patients received an LGE-CMR 3 months post-ablation to assess ablation lesions.</p><p><strong>Results: </strong>Post-ablation LGE-CMRs from 138 patients were analyzed (43 RF, 40 CRYO, 25 PFA, 30 HPSD). PFA resulted in the least continuous LGE lesion with the lowest proportion of complete PV-encircling LGE lesions (PFA 12%, HPSD 40%, RF 26%, CRYO 24%; p = 0.0069). Ablation with the CRYO and PFA single-shot devices resulted in the widest lesions. Of note, HPSD lesions were significantly wider than conventional RF lesions (PFA 12.7 mm, HPSD 10.9 mm, RF 8.7 mm; CRYO 13.3 mm; p < 0.0001).</p><p><strong>Conclusions: </strong>Lesion characteristics differed significantly among the four ablation techniques. HPSD ablation resulted in the most continuous LGE lesions. Of note, HPSD lesions were also wider than conventional RF lesions, thus corroborating the concept of a shallower HPSD lesion geometry from experimental studies. PFA lesions cover relatively large areas but are more inhomogeneous. Wether this indicates ineffective ablation or lower detectability of PFA lesions by LGE-CMR remains unknown.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487725","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":"Epicardial ventricular tachycardia ablation with a pentaspline catheter during left ventricular assist device placement.","authors":"Joshua E Payne, Marshall Bell, Luke Cunningham, Sean Halleran","doi":"10.1007/s10840-025-02068-x","DOIUrl":"https://doi.org/10.1007/s10840-025-02068-x","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":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478484","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 wall thickness correlates with pulmonary vein reconnection following atrial fibrillation ablation.","authors":"Alexander Kushnir, Chirag R Barbhaiya, Lior Jankelson, Douglas Holmes, Anthony Aizer, David Park, Scott Bernstein, Michael A Spinelli, Leonid Garber, Felix Yang, Elizabeth Rosinski, Larry A Chinitz","doi":"10.1007/s10840-025-02089-6","DOIUrl":"10.1007/s10840-025-02089-6","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary vein (PV) isolation is the cornerstone of radiofrequency (RF) ablation for atrial fibrillation (AF) and PV reconnection is a common cause of recurrent AF. The relationship between PV ostial wall thickness (WT) and durable PV isolation is a matter of ongoing investigation. Additionally, the relationship between catheter impedance and WT is not well understood. We studied the relationship between PV ostial WT, ablation lesion metrics, and PV reconnection.</p><p><strong>Methods: </strong>16 patients were identified who underwent an initial and redo AF ablation procedure and had a cardiac CTA analyzed using ADAS-3D imaging software performed prior to the initial ablation. Ablation lesion metrics from the initial ablation procedure were collected from the electroanatomic mapping software. Reconnected and isolated PV were identified based on electroanatomic mapping data collected at the redo AF ablation procedure. Patients with reconnected PV exhibited thicker left atrial walls (1.4 mm vs 1.2 mm, P < 0.05) and reconnected veins exhibited thicker ostial walls (1.7 mm, vs 1.5 mm, P < 0.05). LA volume, number of ablation lesions, and ablation lesion time were not significantly different between reconnected and isolated PV. Impedance drop during ablation was greater in patients with reconnected PV compared to patients with isolated PV (- 9.0 Ω vs - 6.6 Ω, P < 0.05). There was no correlation between PV ostial WT and ablation lesion impedance drop.</p><p><strong>Conclusion: </strong>PV reconnection was associated with thicker LA and PV ostial WT. Future studies will examine whether targeting thicker PV ostial tissue with more aggressive lesion metrics or different ablation technology can improve PV isolation and ablationoutcomes.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337439","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":"Impact of ablation on regional strain from 4D computed tomography in the left atrium.","authors":"Noah Mehringer, Lauren Severance, Aaron Park, Gordon Ho, Elliot McVeigh","doi":"10.1007/s10840-025-02087-8","DOIUrl":"10.1007/s10840-025-02087-8","url":null,"abstract":"<p><strong>Background: </strong>Ablation for atrial fibrillation targets an arrhythmogenic substrate in the left atrium (LA) myocardium with therapeutic energy, resulting in a scar tissue. Although a global LA function typically improves after ablation, the injured tissue is stiffer and non-contractile. The local functional impact of ablation has not been thoroughly investigated.</p><p><strong>Methods: </strong>This study retrospectively analyzed the LA mechanics of 15 subjects who received a four-dimensional computed tomography (4DCT) scan pre- and post-ablation for atrial fibrillation. LA volumes were automatically segmented at every frame by a trained neural network and converted into surface meshes. A local endocardial strain was computed at a resolution of 2 mm from the deforming meshes. The LA endocardial surface was automatically divided into five walls and further into 24 sub-segments using the left atrial positioning system. Intraoperative notes gathered during the ablation procedure informed which regions received ablative treatment.</p><p><strong>Results: </strong>In an average of 18 months after ablation, the strain is decreased by 16.3% in the septal wall and by 18.3% in the posterior wall. In subjects who were imaged in sinus rhythm both before and after the procedure, the effect of ablation reduced the regional strain by 15.3% (p = 0.012). Post-ablation strain maps demonstrated spatial patterns of reduced strain which matched the ablation pattern.</p><p><strong>Conclusion: </strong>This study demonstrates the capability of 4DCT to capture high-resolution changes in the left atrial strain in response to tissue damage and explores the quantification of a regionally reduced LA function from the scar tissue.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334815","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}