Contemporary Trends in Pulsed Field Ablation for Cardiac Arrhythmias.

Pulsed field ablation (PFA) is a catheter-based procedure that utilizes short high voltage and short-duration electrical field pulses to induce tissue injury. The last decade has yielded significant scientific progress and quickened interest in PFA as an energy modality leading to the emergence of the clinical use of PFA technologies for the treatment of atrial fibrillation. It is generally agreed that more research is needed to improve our biophysical understanding of PFA for clinical cardiac applications as well as its potential as a potential alternative energy source to thermal ablation modalities for the treatment of other arrhythmias.

Comparison of long-term outcomes of minimally invasive coronary artery bypass grafting and percutaneous coronary intervention for left main disease.

Background: Minimally invasive coronary artery bypass grafting (MICS-CABG) is frequently used for coronary revascularization, but the comparison of long-term clinical results with percutaneous coronary intervention (PCI) in left main disease (LMDs) remains unclear. The present study sought to determine the long-term outcomes of MICS-CABG and PCI in patients with LMDs.

Methods: A total of 551 consecutive patients [man: 457 (82.

Heavy menstrual bleeding in adolescents: Evaluation of diagnostic indicators and treatment preferences.

Objective: Heavy menstrual bleeding (HMB) is a significant health concern that may lead to critical medical care and impaired quality of life. The aim of the present study was to identify the clinical indicators of common causes of HMB in adolescents and evaluate the factors influencing the treatment preferences of clinicians.

Methods: Between 2010 and 2022, the electronic medical records of adolescents between the ages of 10-18 with HMB were reviewed, and a final of 205 adolescents was included.

Plasma Exchange and N-Acetylcysteine Therapy in a Case of Congenital Thrombotic Thrombocytopenic Purpura Presenting With Acute Renal Failure.

Congenital thrombotic thrombocytopenic purpura (cTTP), which is associated with mutations in the gene for a disintegrin and metalloproteinase with a thrombospondin type 1 motif member 13 (ADAMTS13), is a chronic and lifelong disease. The clinical course is variable. Regularly using ADAMTS13-containing products such as fresh frozen plasma (FFP) for long-term prophylaxis is the most important treatment to prevent thrombotic microangiopathy (TMA) episodes.

A New Predisposing Factor for Postoperative Atrial Fibrillation: Tube Insertion Site.

Background:  The aim of this study is to compare the insertion sites of drainage tubes placed in the left thorax after elective coronary artery bypass grafting (CABG) surgeries.

Materials And Methods:  Patients were divided into two groups based on the site of tube insertion into the left hemithorax: those with a tube inserted from the subxiphoid region and those with a tube inserted from the left intercostal region. Comparative analyses between these two groups and factor analyses contributing to the outcome were performed.

Long-Term Differences in Autonomic Alterations After Cryoballoon vs Radiofrequency Atrial Fibrillation Ablation.

Background: The long-term natural history of autonomic alterations following catheter ablation of drug-refractory paroxysmal atrial fibrillation is poorly defined.

Objectives: The authors sought to define the long-term impact of thermal catheter ablation on the cardiac autonomic system.

Methods: The study included 346 patients with drug-refractory paroxysmal atrial fibrillation undergoing pulmonary vein isolation using thermal ablation energy (radiofrequency or cryoballoon ablation).

Neuromodulation for Vasovagal Syncope and Bradyarrhythmias.

Catheter-based neuromodulation of intrinsic cardiac autonomic nervous system is increasingly being used to improve outcomes in patients with vasovagal syncope and bradyarrhythmias caused by vagal overactivity. However, there is still no consensus for patient selection, technical steps, and procedural end points. This review takes the reader on a practical exploration of neuromodulation for bradyarrhythmias, concentrating on the critical aspects of proper patient selection, evidence-based insights, and anatomic intricacies within the intrinsic cardiac autonomic nervous system.

Cardioneuroablation for the treatment of reflex syncope and functional bradyarrhythmias: A Scientific Statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS) and the Latin American Heart Rhythm Society (LAHRS).

Cardioneuroablation has emerged as a potential alternative to cardiac pacing in selected cases with vasovagal reflex syncope, extrinsic vagally induced sinus bradycardia-arrest or atrioventricular block. The technique was first introduced decades ago, and its use has risen over the past decade. However, as with any intervention, proper patient selection and technique are a prerequisite for a safe and effective use of cardioneuroablation therapy.

Diagnostic yield of head-up tilt table test in hypertrophic cardiomyopathy and unexplained syncope: the knot does not seem to be unraveling.

Background: Conflicting results have been published considering the diagnostic performance of head-up tilt test (HUTT) in patients with hypertrophic cardiomyopathy (HCM). We aimed to conduct a meta-analysis to evaluate the diagnostic value of HUTT in the evaluation of unexplained syncope in patients with HCM.

Methods: We performed a structured systematic database search using the following keywords: hypertrophic cardiomyopathy, syncope, unexplained syncope, head-up tilt test, tilt table test, tilt testing, orthostatic stress, autonomic function, autonomic response.

Efficacy of T-cell assays for the diagnosis of primary defects in cytotoxic lymphocyte exocytosis.

Primary hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disorder associated with autosomal recessive variants in genes required for perforin-mediated lymphocyte cytotoxicity. A rapid diagnosis is crucial for successful treatment. Although defective cytotoxic T lymphocyte (CTL) function causes pathogenesis, quantification of natural killer (NK)-cell exocytosis triggered by K562 target cells currently represents a standard diagnostic procedure for primary HLH.

Cardioneuroablation for Cardioinhibitory Vasovagal Syncope: Rationale, Approaches, and Its Role in Long-Term Management.

Purpose Of Review: Cardioneuroablation (CNA) has emerged as a potential alternative to pacemaker therapy in well-selected cases with vasovagal syncope (VVS). In recent years, the number of CNA procedures performed by electrophysiologists has considerably risen. However, some important questions, including proper patient selection and long-term results, remain unanswered.

Current practices of craniospinal irradiation techniques in Turkey: a comprehensive dosimetric analysis.

Objective: This study evaluates various craniospinal irradiation (CSI) techniques used in Turkish centers to understand their advantages, disadvantages and overall effectiveness, with a focus on enhancing dose distribution.

Methods: Anonymized CT scans of adult and pediatric patients, alongside target volumes and organ-at-risk (OAR) structures, were shared with 25 local radiotherapy centers. They were tasked to develop optimal treatment plans delivering 36 Gy in 20 fractions with 95% PTV coverage, while minimizing OAR exposure.

Identification of the molecular etiology in rare congenital hemolytic anemias using next-generation sequencing with exome-based copy number variant analysis.

Objectives: In congenital hemolytic anemias (CHA), it is not always possible to determine the specific diagnosis by evaluating clinical findings and conventional laboratory tests. The aim of this study is to evaluate the utility of next-generation sequencing (NGS) and clinical-exome-based copy number variant (CNV) analysis in patients with CHA.

Methods: One hundred and forty-three CHA cases from 115 unrelated families referred for molecular analysis were enrolled in the study.