The Year in Hungarian Cardiology 2022: Arrhythmias

The year 2022 yielded remarkable scientific papers from Hungary from the field of cardiac arrhythmias. During the search for improved efficacy of pulmonary vein isolation (PVI) interesting topics, such as first-line cryoballoon ablation, use of visualizable steerable sheaths, ablation on the intervenous carina, high-power and very high-power short-duration ablation techniques were investigated. We also learned important lessons from studies investigating the relationship between left atrial anatomy assessed by cardiac computed tomography (CT) and acute/long-term outcomes of PVI procedures. In the field of ablation of supraventricular tachycardias (SVT) researchers demonstrated better outcomes with prophylactic ablation of the peri-incisional isthmus in postoperative atrial flutters, limitations of ventricular pacing maneuvers in paroxysmal SVT diagnostics, the superiority of intracardiac echocardiography (ICE) guided slow pathway ablation, and the feasibility and safety of zero/minimal fluoroscopy approach. Detailed baseline characteristics of patients from the BUDAPEST-CRT Upgrade Trial (NCT02270840.) were reported. Regarding cardiac resynchronization therapy interesting details were also published about reverse electrical remodeling, and the impact of premature ventricular contractions on atrial remodeling. We got valuable data on the comparative efficacy and safety of laser vs. mechanical lead extraction sheaths. In the field of genetics of cardiac arrhythmias, a robust systematic review was performed and published by a Hungarian multicenter collaboration about the different phenotypic and genotypic manifestations of the CACNA1C gene mutations. Finally, a focused issue of the Cardiologia Hungarica on cardiac arrhythmias should be highlighted.