Pacing and clinical electrophysiology : PACE最新文献

{"title":"S-ICD in Hypertrophic Cardiomyopathy: Fewer Complications Without Increased Inappropriate Shocks Versus Transvenous Systems.","authors":"Christopher Monkhouse, James Malcolmson, Edward Maclean, Luke Sevier, Jess Platten, Mehul Dhinoja, Nikolaos Papageorgiou, Anthony W Chow, Shohreh Honarbakhsh, Richard J Schilling, Ross J Hunter, Pier D Lambiase, Saidi A Mohiddin, Syed Ahsan","doi":"10.1111/pace.70133","DOIUrl":"10.1111/pace.70133","url":null,"abstract":"<p><strong>Background: </strong>The subcutaneous implantable cardioverter defibrillators (S-ICD) in hypertrophic cardiomyopathy (HCM) remains controversial. HCM patients are often younger and exposed to longer-term risks: complications and inappropriate therapy (IT). The S-ICD avoids vascular risks associated with transvenous ICDs (TV-ICD), but the rate of IT remains a concern. We conducted a retrospective observational study in HCM patients who received ICDs: assessing outcomes and utilizing a multi-event statistical model, we provide a novel assessment of the cumulative complication risk.</p><p><strong>Methods: </strong>A retrospective study of all HCM patients who received an ICD at a tertiary center from 2006 to 2022 was conducted, utilizing electronic pacing and health records. Cox-proportion hazard models were applied for comparative outcome analysis and a multi-event statistical model was used to assess the cumulative burden of complications. Propensity score matching was used to adjust for baseline differences.</p><p><strong>Results: </strong>We analysed data from 611 patients, with 141 receiving S-ICDs (26.7%). S-ICD patients had significantly fewer complications over a maximal follow-up of 137 months (HR 0.309, 95% CI 0.103-0.923, p = 0.035). Multi-event analysis demonstrated a cumulative increase in complications over time for TV-ICD patients (HR 0.258, 95% CI 0.109-0.644, p = 0.004), conversely no S-ICD patients experienced multiple complications. There was no difference in therapy rates or mortality between matched groups.</p><p><strong>Conclusion: </strong>The S-ICD is associated with fewer complications than TV-ICD, this is amplified by multi-event analysis, but without differences in IT. This should be discussed with HCM patients, as the S-ICD could provide a better benefit/risk ratio.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"551-562"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004927","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":"Hemolysis After Pulsed Field Ablation With a Variable-Loop Irrigated Circular Catheter.","authors":"Iwanari Kawamura, Shinsuke Miyazaki, Ryosuke Kato, Ken Takahashi, Miho Negishi, Masaki Honda, Ryo Tateishi, Kentaro Goto, Takuro Nishimura, Kazuya Yamao, Kentaro Takahashi, Kensuke Ihara, Susumu Tao, Masateru Takigawa, Tetsuo Sasano","doi":"10.1111/pace.70208","DOIUrl":"10.1111/pace.70208","url":null,"abstract":"<p><strong>Introduction: </strong>Hemolysis is a recognized complication of endocardial pulsed field ablation (PFA), and its severity is influenced by factors such as the number of applications, tissue contact, and characteristics of the PFA system. However, most existing data are based on the Pentaspline catheter, and limited information is available regarding hemolysis with other PFA systems.</p><p><strong>Methods and results: </strong>We evaluated hemolysis in seven consecutive patients with paroxysmal atrial fibrillation undergoing PFA using a variable-loop irrigated circular catheter (VLCC; Varipulse, Biosense Webster) and a dedicated generator (TRUPULSE). All procedures included pulmonary vein and posterior wall isolation, guided by a tissue proximity indicator (TPI). A median of 32 applications was delivered per patient. Plasma-free hemoglobin levels significantly increased from 0.01 (0.00-0.01) g/dL before the procedure to 0.05 (0.04-0.06) g/dL after the procedure (p < 0.001). Post-procedural reductions in hemoglobin levels and increases in bilirubin and lactate dehydrogenase levels were also observed, along with subnormal haptoglobin levels in 50% of patients. Creatine kinase levels increased significantly from 84 (82-146) U/L preoperatively to 323 (272-369) U/L postoperatively (p = 0.018). No cases of acute kidney injury occurred, and renal function remained stable post-procedure.</p><p><strong>Conclusion: </strong>This is the first study to evaluate hemolysis with a VLCC-based PFA using plasma-free hemoglobin as a biomarker. These findings underscore the importance of evaluating each PFA system individually to better understand their safety and biophysical effects.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"656-659"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470821","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":"Transjugular Leadless Pacemaker Implantation in an Adolescent With Central Hypoventilation Syndrome: A Case Report.","authors":"Marzia Giaccardi, Gulio Porcedda, Zaccaria Ricci, Hendrik Bonnemeier, Benito Baldauf","doi":"10.1111/pace.70146","DOIUrl":"10.1111/pace.70146","url":null,"abstract":"<p><strong>Background: </strong>Permanent pacing in pediatric patients is complicated by small body size, vascular access limitations, and the need for durable long-term management. Leadless pacemakers offer an emerging alternative that minimizes infection and lead-related complications, yet vascular access remains a key challenge in young patients.</p><p><strong>Case presentation: </strong>We report a 14-year-old male with congenital central hypoventilation syndrome (CCHS; PHOX2B polyalanine repeat mutation 20/26) who presented with recurrent nocturnal oxygen desaturation secondary to prolonged sinus pauses despite tracheostomy-assisted mechanical ventilation. Continuous implantable loop recorder monitoring confirmed pauses of up to 10 s, temporally associated with desaturation events. Given the small caliber of the femoral veins and the need for long-term pacing, a leadless pacemaker was implanted via the right internal jugular vein. Device positioning was optimized under fluoroscopic guidance to achieve stable septal fixation with excellent electrical parameters (sensing: 9 mV; threshold 0.5 V at 0.24 ms; impedance: 530 Ω). The procedure and recovery were uneventful.</p><p><strong>Follow-up: </strong>At 1-year follow-up, pacing burden was 1% with stable sensing and threshold parameters, and no recurrent desaturation episodes were observed.</p><p><strong>Conclusion: </strong>This case highlights the complex interplay between arrhythmia and oxygen desaturation in CCHS, illustrating how permanent pacing can restore both rhythm and ventilatory stability. Transjugular leadless pacemaker implantation represents a safe and effective option for adolescents when femoral access is limited. In younger patients, careful anatomical assessment, awareness of long-term device management, and individualized selection between retrievable and established systems are essential to optimize outcomes.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"606-609"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047730","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":"Difficulty and Complications of Lead Extraction-Is ICD Lead Design Important?","authors":"Andrzej Kutarski, Wojciech Jacheć, Paweł Stefańczyk, Łukasz Tułecki, Dorota Nowosielecka","doi":"10.1111/pace.70144","DOIUrl":"10.1111/pace.70144","url":null,"abstract":"<p><strong>Background: </strong>Transvenous removal of implantable cardioverter-defibrillator (ICD) leads is considered to be more difficult and risky. The goal was to explore the impact of ICD lead design on transvenous lead extraction (TLE) safety and effectiveness.</p><p><strong>Methods: </strong>Analysis of 3929 TLE procedures (including 1068 with ICD lead extraction) were analyzed retrospectively.</p><p><strong>Results: </strong>The extracted ICD leads were about three years younger than pacemaker (PM) leads (medians: 61.00 vs. 97.00 months). The rate of major TLE complications (MC) was significantly higher in the PM lead extraction group (2.25% vs. 0.75%; p = 0.002) and complete procedural success was achieved significantly less often (by 4.11%; p < 0.001 in entire group of patients and by 3.74%; p < 0.001 in patients matched according to age of extracted lead). However, no significant differences were found in the scores of TLE complexity and major complications during extraction of ICD leads produced by different manufacturers. Lower rates of complete procedural success, compared to Medtronic ICD leads, were found in patients with Abbott and Biotronik ICD leads (99.45% vs. 97.32%; p = 0.009 and 96.65%; p = 0.003).</p><p><strong>Conclusions: </strong>1. ICD lead implant duration was 3.17 years shorter and perhaps for this reason ICD lead extraction was often less difficult, the procedure less complex and MC significantly rare (0.75%) in comparison with PM lead extraction (2.55%). There were no differences between groups matched according to age of extracted lead. Achieving of complete procedural success was lower in PM lead extraction both in entire as in matched group of patients. 2. There were no significant differences in the complexity of TLE procedures or the incidence of major complications depending on ICD lead manufacturer, despite the fact that Biotronik leads were 16-19 months older. 3. The extraction of Abbot and Biotronik leads was associated with a lower rate of complete procedural success (by 2.13% and 2.80%).</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"563-572"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115467","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 Epicardial Adipose Tissue Associated With Persistent AF Termination During Pulmonary Vein Isolation.","authors":"Bowen Qiu, Jianfan Shen, Lei Chen, Chuanyi Sang, Deyu Yang, Sihua Ding, Xiuwei Wang, Wensu Chen, Chaoqun Zhang","doi":"10.1111/pace.70157","DOIUrl":"10.1111/pace.70157","url":null,"abstract":"<p><strong>Background: </strong>Termination of persistent atrial fibrillation (PersAF) during radiofrequency catheter ablation (RFCA) is closely related to the outcome of the ablation. Epicardial adipose tissue (EAT) plays an important role in the maintenance of AF. The role of EAT on the termination of PersAF has not been reported. The aim of this study was to evaluate the association between left atrial EAT (LA-EAT) and termination of PersAF during pulmonary vein isolation (PVI).</p><p><strong>Methods: </strong>This was a single-center retrospective observational study. Consecutive enrolment of PersAF who underwent first-time radiofrequency ablation between January 2021 and August 2022. All patients underwent computed tomography angiography (CTA) examination of the left atrium, and the LA-EAT was measured using medical software (Advantage Workstation 4.6, GE, USA). Termination of PersAF during ablation was defined as conversion of AF to sinus rhythm (SR) or stable atrial flutter (AFL)/atrial tachycardia (AT).</p><p><strong>Results: </strong>A total of 203 PersAF patients were enrolled, atrial fibrillation rhythm termination during PVI in 42 patients. Multivariate analysis showed that duration of AF, Heart failure (HF), and LA-EAT volume (OR = 0.960; 95%CI: 0.926- 0.996, p = 0.029) were independent predictors of termination. ROC analysis showed that the model including AF duration, HF, and LA-EAT had an effective ability to predict the termination (AUC = 0.734, 95% CI:0.647-0.802, p < 0.001). When LA-EAT was integrated into the model of characteristics routinely (including AF duration and HF), the discrimination and reclassification accuracy for the termination were significantly improved (NRI 0.2143, 95% CI 0.0724-0.3562, p = 0.003; IDI 0.0291, 95% CI 0.0047-0.0535, p = 0.019). The analysis revealed a statistically significant difference in overall arrhythmia recurrence between the termination group and non-termination group (log-rank p = 0.038).</p><p><strong>Conclusion: </strong>LA-EAT is independently associated with the termination of PersAF during PVI CLINICAL TRIAL NUMBER: Not applicable.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"531-539"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215414","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":"Reduced Early Recurrence After Pulmonary Vein Isolation With Pulsed Field Ablation Compared to Thermal Ablation.","authors":"Sebastian Weyand, Simon Hanger, Viola Adam, Paloma Biehler, Patricia Hägele, Stephanie Löbig, Andrei Pinchuk, Christian Waechter, Peter Seizer","doi":"10.1111/pace.70171","DOIUrl":"10.1111/pace.70171","url":null,"abstract":"<p><strong>Background: </strong>Early recurrence of atrial tachyarrhythmia (ERAT) during the 90-day blanking period after pulmonary vein isolation (PVI) remains a challenge and has been associated with increased healthcare utilization and patient anxiety. Comparative data on ERAT incidence across energy modalities, including pulsed field ablation (PFA), high-power short-duration (HPSD), very high-power short-duration (vHPSD), and cryoballoon ablation, are limited.</p><p><strong>Objectives: </strong>To assess and compare the incidence and timing of ERAT following PVI using four ablation technologies.</p><p><strong>Methods: </strong>In this single-center observational cohort study, 671 consecutive patients undergoing first-time PVI were screened. One hundred consecutive patients undergoing cryoballoon ablation were included as reference group, and three additional groups (HPSD, vHPSD, PFA; each n = 100) were propensity score-matched based on age, sex, BMI, and AF type. ERAT was defined as a clinically detected episode of atrial fibrillation or atrial tachycardia lasting >30 s within 90 days after PVI, documented by 12-lead ECG or Holter monitoring during scheduled or clinically indicated rhythm surveillance. Procedural characteristics, procedural success, and safety were evaluated.</p><p><strong>Results: </strong>Among 400 matched patients, PFA was associated with a significantly lower ERAT incidence compared to thermal ablation (3% vs. 15%-19%, p < 0.01). In PFA patients, ERAT occurred exclusively between Days 31 and 90. Thermal energy groups showed higher rates of early recurrences, often requiring clinical interventions, including hospitalizations and cardioversions. Multivariate analysis did not identify any additional clinical predictors of ERAT.</p><p><strong>Conclusions: </strong>PFA was associated with a significantly lower rate of early arrhythmias, which may be related to differences in tissue injury mechanisms. These findings suggest PFA may offer a clinical advantage in reducing clinically relevant ERAT and the associated healthcare burden after PVI.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"540-550"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147314727","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":"Technical Feasibility of the RHYTHMIA Mapping System in Pediatric Patients Weighing Less Than 20Kg.","authors":"Wataru Sasaki, Taisuke Nabeshima, Kouta Nagaoka, Hitoshi Mori, Daisuke Kudo, Naomichi Tanaka, Tsukasa Naganuma, Masataka Narita, Kazuhisa Matsumoto, Yoshifumi Ikeda, Naokata Sumitomo, Kazuo Matsumoto, Ritsushi Kato","doi":"10.1111/pace.70151","DOIUrl":"10.1111/pace.70151","url":null,"abstract":"<p><strong>Background: </strong>Catheter ablation in pediatric patients remains technically challenging. The RHYTHMIA high-density mapping system is increasingly used in pediatric electrophysiology; however, procedural experience in patients weighing less than 20 kg is limited.</p><p><strong>Methods: </strong>We retrospectively analyzed 125 pediatric patients who underwent catheter ablation for supraventricular arrhythmias using the RHYTHMIA system. The patients were divided into two groups according to body weight: ≥20 kg group (n = 111) and the <20 kg group (n = 14). The mapping time, number of mapping beats, and mapping electrodes were compared for the right atrium (RA), and left atrium (LA), along with the manual re-annotation points and incidence of complications.</p><p><strong>Results: </strong>A total of 184 maps were analyzed. No significant differences were found in mapping time, accepted beats, and electrograms (RA, ≥20 kg group [n = 104] vs. <20 kg group [n = 11]; mapping time, 13.8 min[10.1-18.3] vs. 17.4 min[9.4-25.3], p = 0.95; accepted beats, 744 beats[548-1095] vs. 953 beats[654-1079], p = 0.57; electrograms, 6871 electrograms[5074-10885] vs. 6650 electrograms[4474-9527], p = 0.30) (LA, ≥20 kg group [n = 62] vs. <20 kg group [n = 7]; mapping time, 11.5 min[8.1-18.3] vs. 14.5 min[8.5-15.4], p = 0.97; accepted beats, 619 beats[354-1007] vs. 512 beats[316-810], p = 0.89; electrograms, 6809 electrograms[4025-10108] vs. 4338 electrograms[3369-8693], p = 0.93). In the RA, <20 kg group required more re-annotations than ≥20 kg group, while no significant differences in complications were observed between the groups.</p><p><strong>Conclusions: </strong>Use of the RHYTHMIA mapping system in carefully selected pediatric patients weighing less than 20 kg was technically feasible and not associated with major procedural complications. These findings support its cautious use with appropriate case selection and operator vigilance.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"523-530"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121755","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, Safety, and Net Clinical Benefit of Post-Atrial Fibrillation Ablation Anticoagulation.","authors":"Mustafa Abomohsen, Ahmed Elmorsy Mohamed, Abdul Hakim Almakadma, Azad Mojahedi, Zeyad Kholeif, Aya Elalfy, Mahmoud Shams, Ahmed Farid Gadelmawla, Imad Samman Tahhan, Mohab Elnashar, Rana Rashwan, Mohamed Elnady, Moshe Gunsburg","doi":"10.1111/pace.70224","DOIUrl":"10.1111/pace.70224","url":null,"abstract":"<p><strong>Background: </strong>The optimal long-term antithrombotic strategy after apparently successful catheter ablation of atrial fibrillation (AF) remains uncertain, particularly in patients who meet conventional guideline thresholds for oral anticoagulation (OAC).</p><p><strong>Objectives: </strong>To compare continuation versus cessation strategies of long-term OAC after successful AF ablation and to quantify net clinical benefit (NCB) integrating thromboembolic and bleeding outcomes.</p><p><strong>Methods: </strong>We searched PubMed, Cochrane CENTRAL, and Embase from inception through February 2026 for randomized and comparative observational studies evaluating long-term OAC continuation versus cessation (no OAC and/or switch to aspirin) after successful AF ablation. Risk of bias was assessed using RoB2 for randomized trials and a modified Newcastle-Ottawa Scale (NOS) for observational studies. Random-effects meta-analyses used a restricted maximum likelihood estimator with Hartung-Knapp adjustment. NCB was calculated as: thromboembolic event rate - (1.5 × major bleeding rate).</p><p><strong>Results: </strong>Six studies met the inclusion criteria (four randomized trials and two observational cohorts). Stroke/transient ischemic attack (TIA) events were reported in six studies and were not significantly different between OAC continuation and cessation strategies (OR 0.69; 95% CI 0.24-1.99; p = 0.49). Systemic embolism (three studies) did not differ between groups (p = 0.12). Major bleeding (five studies) was numerically higher with continued OAC but not statistically significant (OR 2.07; 95% CI 0.88-4.86; p = 0.09). In NCB analysis, continued OAC yielded more negative or near-neutral NCB values, whereas, the cessation strategies were less negative or marginally positive; the fixed-effect risk difference in NCB (continued OAC vs cessation) was +0.00067 (95% CI -0.00279 to +0.00413).</p><p><strong>Conclusion: </strong>This meta-analysis suggests that after successful AF ablation, continuing OAC does not significantly reduce stroke risk compared to cessation or switching to aspirin, but it may increase major bleeding. While NCB trends favor cessation, the low absolute event rates and the risk of silent AF recurrence necessitate caution.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"590-601"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147523707","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":"Balloon-Shaped Pulsed Field Ablation for Pulmonary Vein Isolation and Atrial Lesions.","authors":"Song Zuo, Caihua Sang, Jue Wang, Xiangyi Kong, Jingrui Zhang, Mingyang Gao, Wenli Dai, Junmeng Zhang, Xueyuan Guo, Xiaoxia Liu, Ning Zhou, Songnan Li, Long Huang, Zhidai Mo, Hao Chen, Nian Liu, Jianzeng Dong, Changsheng Ma","doi":"10.1111/pace.70143","DOIUrl":"10.1111/pace.70143","url":null,"abstract":"<p><strong>Introduction: </strong>The cryoballoon catheter is a gold-standard single-shot device for pulmonary vein isolation (PVI). Pulsed-field ablation (PFA) is a tissue-selective, nonthermal cardiac ablation modality. We assessed the preclinical safety and durability of a novel conformal, balloon-shaped, single-shot PFA catheter for PVI and circular atrial lesions.</p><p><strong>Methods: </strong>A 13 Fr balloon-shaped PFA catheter (PFBalloon^TM, 20 electrodes, 24 mm diameter, EnChannel Medical) was applied using a biphasic waveform of microsecond scale (± 750 V, 4.9 s per application). In 10 swine, superior vena cava (SVC), left superior PV (LSPV), right superior PV (RSPV) and right atrial appendage (RAA) were targeted for isolation. Localization of PFBalloon was evaluated by fluoroscopy and intracardiac echocardiography (ICE). PFA was delivered in a novel tailored configuration (small ring, large ring, or global pulse) to minimize diaphragm stimulation and optimize pulse efficiency. Five swine were assessed at 30 days post-procedure for lesion durability, gross pathology, and histologic examination, while the remaining five swine were evaluated at 90 days to assess longer term outcomes.</p><p><strong>Results: </strong>In all 10 swine, PFA resulted in 100% successful acute isolation of the SVC, RSPV, and LSPV using 4.2 ± 0.6, 5.0 ± 1.1, and 4.4 ± 1.8 applications per vein, respectively, and acute isolation of RAA in 9/10 swine using 5.3 ± 2.0 applications. At 30 days post-procedure, 14 out of 20 targeted sites (70.0%) remained isolated in five pigs. At 90 days, 19 out of 20 sites (95.0%) remained isolated in the remaining five pigs. The overall pulse configurations were 9.0% small ring, 25.4% large ring, and 65.6% global. PFA did not affect phrenic nerve function, with very few microbubbles recorded on ICE. No major complications were observed.</p><p><strong>Conclusions: </strong>In this preclinical study, a novel conformal, balloon-shaped catheter designed for single-shot PVI can create durable isolation without complications.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"644-655"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146152210","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":"A Mid-Tracing Mystery During Narrow QRS Complex Tachycardia: What Is the Mechanism?","authors":"Selin Yondem, Ozcan Ozeke, Sona Huseynova, Idriz Merovci, Can Ozkan, Meryem Kara, Elif Hande Ozcan Cetin, Esra Sadikoglu, Ahmet Korkmaz, Firat Ozcan, Serkan Cay, Dursun Aras, Serkan Topaloglu","doi":"10.1111/pace.70201","DOIUrl":"10.1111/pace.70201","url":null,"abstract":"<p><p>Specific tachycardia characteristics, such as the zones of initiation, transition, and termination, may yield important insights into the underlying mechanism of the tachycardia even before diagnostic maneuvers are performed.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"573-575"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147392042","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}