Atrial Fibrillation Ablation During Hospitalization for Acute Heart Failure: Feasibility and Role of Pulsed Field Ablation.

Introduction: Atrial fibrillation (AF) can cause or aggravate heart failure (HF). Catheter ablation (CA) is an effective treatment for AF. This study focused on the feasibility and outcomes of emergent AF ablation performed during hospitalization for acute HF.

Periprocedural acute haemodynamic decompensation during substrate-based ablation of scar-related ventricular tachycardia: a rare and unpredictable event.

Aims: Patients with structural heart disease (SHD) undergoing catheter ablation (CA) for ventricular tachycardia (VT) are at considerable risk of periprocedural complications, including acute haemodynamic decompensation (AHD). The PAINESD score was proposed to predict the risk of AHD. The goal of this study was to validate the PAINESD score using the retrospective analysis of data from a large-volume heart centre.

Autonomic Changes Are More Durable After Radiofrequency Than Pulsed Electric Field Pulmonary Vein Ablation.

Background: Pulmonary vein isolation (PVI) by radiofrequency (RF) energy is associated with a collateral ganglionated plexi ablation. Pulsed electric field (PEF) is a nonthermal energy source that preferentially affects the myocardial cells and spares neural tissue.

Objectives: This study investigated whether PVI by a PEF compared with RF energy will result in less prominent alteration of the cardiac autonomic nervous system.

Gender differences in major vascular complications of catheter ablation for atrial fibrillation.

Aims: Catheter ablation (CA) for atrial fibrillation (AF) has a considerable risk of procedural complications. Major vascular complications (MVCs) appear to be the most frequent. This study investigated gender differences in MVCs in patients undergoing CA for AF in a high-volume tertiary center.

Impact of access route to the left ventricle on asymptomatic periprocedural brain injury: the results of a randomized trial in patients undergoing catheter ablation of ventricular tachycardia.

Aims: Catheter ablation of ventricular tachycardia (VT) is an effective treatment in patients with structural heart disease (SHD) and recurrent arrhythmias. However, the procedure is associated with the risk of complications, including both manifest and asymptomatic cerebral thromboembolic events. We hypothesized that periprocedural asymptomatic brain injury (ABI) can be reduced by using transseptal instead of the retrograde access route to the left ventricle (LV).

An approach to classifying occupational exposures to endocrine disrupting chemicals by sex hormone function using an expert judgment process.

Endocrine disrupting chemicals (EDCs) are exogenous substances that interfere with the endocrine system and cause adverse effects. We aimed to classify the effects of 24 known EDCs, prevalent in certain occupations, according to four modes of action (estrogenic, antiestrogenic, androgenic, and/or antiandrogenic). A literature search, stratified into four types of literature was conducted (namely: national and international agency reports; review articles; primary studies; ToxCast).

In-hospital and 12-month follow-up outcome from the ESC-EORP EHRA Atrial Fibrillation Ablation Long-Term registry: sex differences.

Aim: The purpose of this study was to compare sex differences of atrial fibrillation (AF) catheter ablation (CA) and to analyse the opportunities for improved outcomes.

Methods And Results: All data were collected from the Atrial Fibrillation Ablation Long-Term registry, a prospective, multinational study conducted by the ESC-EORP European Heart Rhythm Association (EHRA) under the EURObservational Research Programme (ESC-EORP). A total of 104 centres in 27 European countries participated.

Resting and Exercise-Induced Left Atrial Hypertension in Patients With Atrial Fibrillation: The Causes and Implications for Catheter Ablation.

Objectives: The aim of this paper was to investigate the prevalence of resting and exercise-induced left atrial hypertension (LAH) in patients with nonvalvular atrial fibrillation (AF), association of the LAH with other cardiac abnormalities, and its implications for AF catheter ablation.

Background: The clinical role of LAH in patients with established AF is largely unknown.

Methods: Patients scheduled for catheter ablation of AF (n = 240; age 60 ± 10 years; 67% men, 62% paroxysmal AF) underwent detailed echocardiography, assessment of quality of life (QoL), left atrial (LA) voltage mapping, and measurement of the LA pressure at rest and during isometric handgrip exercise.

Catheter ablation of atrial fibrillation in elderly population.

Background: Although elderly patients have been included in published series of catheter ablation for atrial fibrillation (AF), clinical benefit and safety remain still less defined in this population. A retrospective analysis of the results of catheter ablation for AF in a large volume center focused on comparison of elderly patients with the rest of the patient cohort was conducted in this study.

Methods: Consecutive patients who underwent catheter ablation for AF between January 2001 and December 2016 were analysed.

The tip of the muscle is a dominant location of ventricular ectopy originating from papillary muscles in the left ventricle.

Introduction: Frequent ventricular premature complexes (VPCs) may cause symptoms and/or lead to deterioration of LV systolic function. Although frequent VPCs may be abolished by catheter ablation, it may be challenging in case of their origin from the LV papillary muscles (PMs). Our collaborative study aimed to analyze in detail the site of origin and the outcome of ablation.

Ultrasound-guided versus conventional femoral venipuncture for catheter ablation of atrial fibrillation: a multicentre randomized efficacy and safety trial (ULTRA-FAST trial).

Aims: Complications of catheter ablation for atrial fibrillation (AF) are frequently related to vascular access. We hypothesized that ultrasound-guided (USG) venipuncture may facilitate the procedure and reduce complication rates.

Methods And Results: We conducted a multicentre, randomized trial in patients undergoing catheter ablation for AF on uninterrupted anticoagulation therapy.

Outcomes of ventricular tachycardia ablation in patients with structural heart disease: The impact of electrical storm.

Aims: To investigate predictors of long-term outcomes after catheter ablation (CA) for ventricular tachycardia (VT) and the impact of electrical storm (ES) prior to index ablation procedures.

Methods: We studied consecutive patients with structural heart disease and VT (n = 328; age: 63±12 years; 88% males; 72% ischaemic cardiomyopathy; LVEF: 32±12%) who had undergone CA. According to presenting arrhythmia at baseline, they were divided into ES (n = 93, 28%) and non-ES groups.

Differential effect of ganglionic plexi ablation in a patient with neurally mediated syncope and intermittent atrioventricular block.

Aims: In patients with severe neurally mediated syncope (NMS), radiofrequency catheter ablation (RFA) of ganglionic plexi (GP) has been proposed as a new therapeutic approach. Cardio-inhibitory response during NMS is usually related to the sinoatrial (SA) and less frequently to atrioventricular (AV) node. Differential effect of GP ablation on SA and AV node is poorly understood.

Catheter Ablation of Ventricular Tachycardia in the Presence of an Old Endocavitary Thrombus Guided by Intracardiac Echocardiography.

Background: Catheter ablation of ventricular tachycardia (VT) in patients with structural heart disease (SHD) is effective in prevention of arrhythmia recurrences. However, endocardial ablation may be challenging in the presence of organized left ventricular (LV) endocavitary thrombus. Our goal was to analyze the results of VT ablation in patients with identified old thrombus.

Bipolar radiofrequency catheter ablation for refractory perimitral flutter: a case report.

Background: Mitral isthmus is often targeted as a part of stepwise approach during radiofrequency ablation for persistent atrial ablation. Acute success rate in achieving the mitral isthmus block is only modest, late reconduction rate is relatively high and, consequently, incomplete lesion may be proarrhythmic. We describe the first-in-man experience with successful MI ablation by bipolar RF energy delivery.

Catheter Ablation of Ventricular Tachycardia as the First-Line Therapy in Patients With Coronary Artery Disease and Preserved Left Ventricular Systolic Function: Long-Term Results.

Introduction: Patients with coronary artery disease (CAD), relatively preserved left ventricular ejection fraction (LVEF), and hemodynamically tolerated ventricular tachycardia (VT) may benefit from catheter ablation as the first-line treatment. Our aim was to analyze the long-term results of VT ablation in this population.

Methods And Results: Thirty-one patients (1 woman, mean age 67 ± 10 years) with CAD, tolerated VT, and LVEF ≥40% underwent catheter ablation as the first-line treatment of the arrhythmia.

EFFICAS II: optimization of catheter contact force improves outcome of pulmonary vein isolation for paroxysmal atrial fibrillation.

Aims: A challenge of pulmonary vein isolation (PVI) in catheter ablation for paroxysmal atrial fibrillation (PAF) is electrical reconnection of the PV. EFFICAS I showed correlation between contact force (CF) parameters and PV durable isolation but no prospective evaluation was made. EFFICAS II was a multicentre study to prospectively assess the impact of CF guidance for an effective reduction of PVI gaps.

Complications of catheter ablation of ventricular tachycardia: a single-center experience.

Background: Catheter ablation has become an established treatment modality for a broad spectrum of ventricular tachycardias (VTs). We analyzed incidence and predictors of major complications of VT ablation procedures in a high-volume expert center.

Methods And Results: We evaluated 548 consecutive patients who underwent 722 ablation procedures, 473 (65.

Successful ablation of ventricular tachycardia after correction of tetralogy of Fallot.

We present a case of a patient who, after correction of tetralogy of Fallot (TOF), experienced runs of ventricular tachycardia (VT). Mapping of the aortic root showed that the critical component of the reentry was located within the noncoronary cusp. The potential explanations of such an unusual isthmus location may be the presence of myocardial extensions in the aortic root or the close vicinity of the right ventricle (RV) to the noncoronary cusp, since in TOF the aorta overrides the RV.

Locations of high contact force during left atrial mapping in atrial fibrillation patients: electrogram amplitude and impedance are poor predictors of electrode-tissue contact force for ablation of atrial fibrillation.

Background: During radiofrequency ablation, high electrode-tissue contact force (CF) is associated with increased risk of steam pop and perforation. The purpose of this study, in patients undergoing ablation of paroxysmal atrial fibrillation, was to: (1) identify factors producing high CF during left atrial (LA) and pulmonary vein mapping; (2) determine the ability of atrial potential amplitude and impedance to predict CF; and (3) explore the feasibility of controlling radiofrequency power based on CF.

Methods And Results: A high-density map of LA/pulmonary veins (median 328 sites) was obtained in 18 patients undergoing atrial fibrillation ablation using a 7.

Complications of catheter ablation for atrial fibrillation in a high-volume centre with the use of intracardiac echocardiography.

Aims: Catheter ablation (CA) for atrial fibrillation (AF) is a complex procedure that is associated with higher risk of complications. This study aimed at exploring the complication rate and corresponding risk factors in a high-volume centre with routine use of intracardiac echocardiography (ICE).

Methods And Results: In total 1192 consecutive AF ablation procedures (100% ICE-guided; 96.

A pilot study of systolic dyssynchrony index by real time three-dimensional echocardiography and Doppler tissue imaging parameters predicting the hemodynamic response to biventricular pacing in the early postoperative period after cardiac surgery.

Objective: To evaluate systolic dyssynchrony index (SDI) measured by real time three-dimensional echocardiography (RT3DE) and Doppler tissue imaging (DTI) dyssynchrony parameters in predicting the hemodynamic response to biventricular (BIV) pacing in the early postoperative period after cardiac surgery. To compare right ventricular (RV) and BIV pacing using invasively measured hemodynamic values.

Methods: A prospective randomized clinical study enrolling 11 patients with ischemic heart disease, concomitant valvular heart disease, and left ventricular ejection fraction (LVEF) ≤ 35% comparing preoperative SDI by RT3DE and DTI LV dyssynchrony parameters to hemodynamic values obtained during RV or BIV sequential (DDD) epicardial pacing in the first 72 hours after cardiac surgery.