Arrhythmia & Electrophysiology Review最新文献

{"title":"The Atrioventricular and Ventriculo-arterial Junctions: A Clinical Perspective for Electrophysiological and Structural Intervention. Part 1: The Atrioventricular Junctions.","authors":"Robert H Anderson, Damian Sanchez-Quintana, Diane E Spicer, Justin T Tretter, Demosthenes G Katritsis","doi":"10.15420/aer.2025.30","DOIUrl":"10.15420/aer.2025.30","url":null,"abstract":"<p><p>An in-depth knowledge of the anatomy of the atrioventricular and ventriculo-arterial junctions of the heart is necessary for the safe implementation of transcatheter approaches for electrophysiological and structural intervention. In the first part of this review, the atrioventricular junctional areas are revisited from the perspective of their anatomy.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"14 ","pages":"e26"},"PeriodicalIF":3.3,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12606455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511460","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":"The Atrioventricular and Ventriculo-arterial Junctions: A Clinical Perspective for Electrophysiological and Structural Intervention. Part 2: The Ventriculo-arterial Junctions.","authors":"Robert H Anderson, Damian Sanchez-Quintana, Diane E Spicer, Justin T Tretter, Demosthenes G Katritsis","doi":"10.15420/aer.2025.31","DOIUrl":"10.15420/aer.2025.31","url":null,"abstract":"<p><p>An in-depth knowledge of the anatomy of the atrioventricular and ventriculo-arterial junctions of the heart is necessary for the safe implementation of transcatheter approaches for electrophysiological and structural intervention. In the second part of this review, the ventriculo-arterial junctional areas are revisited from the perspective of their anatomy.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"14 ","pages":"e27"},"PeriodicalIF":3.3,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12606451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511554","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":"Anaesthesia for Pulsed Field Ablation Procedures.","authors":"Christian-Hendrik Heeger, Natig Gassanov, Mirza Mutallimov","doi":"10.15420/aer.2025.28","DOIUrl":"10.15420/aer.2025.28","url":null,"abstract":"<p><p>Pulsed field ablation (PFA) is a novel, non-thermal technology used in catheter ablation procedures. Despite its growing clinical adoption, a standardised sedation protocol has not yet been established. Well-coordinated anaesthesia management is essential for procedural success, patient safety and comfort. This review examines various sedation strategies, highlighting their respective benefits and risks, and offers practical recommendations to optimise anaesthesia management during PFA procedures. PFA enables selective myocardial ablation while preserving surrounding structures such as the oesophagus and phrenic nerve. However, inadequate sedation may lead to complications such as haemodynamic instability or airway issues. This article provides an overview of sedation protocols, monitoring strategies and anaesthetic challenges to enhance the safety and efficiency of PFA procedures. Proper anaesthesia planning plays a crucial role in ensuring the safe and successful execution of PFA and contributes to the development of standardised protocols in cardiac electrophysiology.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"14 ","pages":"e25"},"PeriodicalIF":3.3,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12593675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480848","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":"Complexity and Perplexity of Pulsed Field Ablation: An Engineering Perspective.","authors":"Bor Kos, Matej Reberšek, Damijan Miklavčič","doi":"10.15420/aer.2025.37","DOIUrl":"10.15420/aer.2025.37","url":null,"abstract":"<p><p>Pulsed field ablation (PFA), recently introduced as a non-thermal and selective method for cardiac ablation, was associated with great promise, hope and expectation, but also raised some concerns and left some questions unanswered, in particular with respect to waveform. To better understand the challenges associated with the design and development of safe and efficient PFA systems, the underlying mechanism of electroporation at the membrane, cellular and tissue levels is described. The three interdependent components of each system, that is, the waveform, the catheter and the generator, are then addressed. The effect of the different waveform parameters on treatment outcomes is reviewed, and the consequences of a potential mismatch of the three components in the development of a safe and efficient PFA system are highlighted.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"14 ","pages":"e24"},"PeriodicalIF":4.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12590401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480879","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":"Durability of Pulsed Field Ablation Lesions: Current Understanding and Future Directions.","authors":"Kars Neven, Anna Füting, Stefan Hartl, Nico Reinsch","doi":"10.15420/aer.2025.36","DOIUrl":"10.15420/aer.2025.36","url":null,"abstract":"<p><p>Pulsed field ablation (PFA) represents a paradigm shift in the catheter-based treatment of AF, offering myocardial-selective ablation through the non-thermal mechanism of irreversible electroporation. Despite promising early outcomes, the durability of PFA lesions, particularly over mid-and long-term follow-up, remains a critical area of investigation. This review incorporates preclinical and clinical data on PFA lesion durability, explores biophysical underpinnings, evaluates procedural variables influencing outcomes, and identifies ongoing challenges and future research priorities.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"14 ","pages":"e23"},"PeriodicalIF":3.3,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12590398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480813","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":"Electrophysiology Training in Crisis: The Unintended Consequences of Shape of Training.","authors":"Mark T Mills, Thomas A Slater, Ashley M Nisbet, Dhiraj Gupta, John Paisey","doi":"10.15420/aer.2025.60","DOIUrl":"10.15420/aer.2025.60","url":null,"abstract":"","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"14 ","pages":"e22"},"PeriodicalIF":3.3,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12590385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480841","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":"Pulmonary Vein Isolation: Cornerstone of Atrial Fibrillation Ablation and Its Evolving Challenges. A Critical Review.","authors":"Eleftherios M Kallergis, Emmanuel N Simantirakis","doi":"10.15420/aer.2025.20","DOIUrl":"10.15420/aer.2025.20","url":null,"abstract":"<p><p>AF is the most common cardiac arrhythmia, affecting millions worldwide. Catheter ablation has evolved into a cornerstone treatment for AF, offering better rhythm control and symptom relief than antiarrhythmic medications in selected patients. Over the past few decades, AF ablation has evolved significantly. Initially, right atrial approaches were explored before shifting to the left atrium, with pulmonary vein isolation emerging as the principal strategy. Attempts at substrate modification, including complex fractionated atrial electrograms ablation, linear lesions and rotorbased approaches, have been explored, but yielded inconsistent results. Recent studies reaffirm pulmonary vein isolation as the cornerstone of AF ablation. This review critically evaluates the evolution of AF ablation, the scientific rationale behind different strategies, technological advancements and future directions in the field.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"14 ","pages":"e21"},"PeriodicalIF":3.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12532168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328290","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":"Complications, Troubleshooting and Follow-up for Left Bundle Branch Area Pacing.","authors":"Parikshit S Sharma, Pugazhendhi Vijayaraman, Haran Burri","doi":"10.15420/aer.2024.12","DOIUrl":"10.15420/aer.2024.12","url":null,"abstract":"<p><p>Conduction system pacing, particularly left bundle branch area pacing (LBBAP), has become a popular form of lead implantation for patients with ventricular pacing indications. Success rates are reportedly high, and complication rates are relatively low. However, complications with LBBAP are unique and follow-up and troubleshooting need to be more meticulous. This paper reviews some of the short- and longer-term complications that one may see with LBBAP. Guidance on device programming, follow-up and tips on troubleshooting for LBBAP is also provided.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"14 ","pages":"e20"},"PeriodicalIF":3.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205321","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":"Aortic Atherosclerosis Detection on Transesophageal Echocardiography is Associated with Left Atrial Appendage Thrombus in Low Thromboembolic Risk Patients.","authors":"Samah AlKharji, Mohamed Al Rawahi, Ahmed AlTurki, George Thanassoulis, Martin L Bernier, Thao Huynh, Vidal Essebag, Jacqueline Joza","doi":"10.15420/aer.2025.02","DOIUrl":"10.15420/aer.2025.02","url":null,"abstract":"<p><strong>Background: </strong>Elevated CHA₂DS₂-VASc scores are considered to be predictors of left atrial appendage (LAA) thrombus (LAAT); however, individuals with low scores remain at risk. Studies have indicated that aortic atherosclerosis (AA) is associated with increased stroke risk. AA on transoesophageal echocardiography (TOE) has been overlooked as a 'vascular' variable in the CHA₂DS₂-VASc score.</p><p><strong>Aims: </strong>Determine the prevalence of LAAT in patients with low thromboembolic risk and the correlation of AA with LAAT.</p><p><strong>Methods: </strong>We performed a retrospective review of all TOEs performed for patients who underwent electrophysiology procedures at the McGill University Health Centre from 2012 to 2017 and collected pertinent clinical and echocardiography variables. We reviewed all TOEs to evaluate the presence and severity of AA using the Katz score, American Society of Echocardiography (ASE) grade and the Ferrari score. In patients with a CHADS₂ of 0 and CHA₂DS₂-VASc score of ≤1, logistical regression and receiver operating characteristic curves were used to identify predictors for LAAT.</p><p><strong>Results: </strong>592 patients underwent a pre-procedure TOE and were included in the analysis. Among 249 patients with CHA₂DS₂-VASc scores ≤1, 7.5% had LAA. AA burden by Katz score was an independent predictor of LAAT (area under the curve (AUC) 0.76 95% CI [0.60-0.92]) for CHA₂DS₂-VASc ≤1.</p><p><strong>Conclusion: </strong>AA visualised on TOE was significantly associated with an increased risk of LAAT development in patients with low CHA₂DS₂-VASc scores. Incorporating AA assessment into risk stratification may enhance clinical decision-making for the use of anticoagulation for patients with AF. Future studies are warranted to evaluate the use of other imaging modalities for AA detection.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"14 ","pages":"e19"},"PeriodicalIF":3.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079563","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":"1 - Young Investigator Award Winner: Integrated Optical Mapping and Ex Vivo MRI to Study Ventricular Tachycardia Substrates Post-Myocardial Infarction in the Rabbit Heart.","authors":"Michael Freeman, Francis Burton, Colin Berry, Godfrey Smith, Rachel Myles","doi":"10.15420/aer.2025.14.s1","DOIUrl":"10.15420/aer.2025.14.s1","url":null,"abstract":"","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"14 ","pages":"2-3"},"PeriodicalIF":3.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144990948","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}