Pulsed Field Ablation: A Comprehensive Update.

One of the recent advancements in the field of cardiac electrophysiology is pulsed field ablation (PFA). PFA is a novel energy modality that does not rely on thermal processes to achieve ablation which, in turn, results in limited collateral damage to surrounding structures. In this review, we discuss the mechanisms, safety, efficacy, and clinical applications of PFA for the management of atrial and ventricular arrhythmias.

Left bundle branch pacing vs ventricular septal pacing for cardiac resynchronization therapy.

Background: The outcomes of left bundle branch pacing (LBBP) and left ventricular septal pacing (LVSP) in patients with heart failure remain to be learned.

Objective: The objective of this study was to assess the echocardiographic and clinical outcomes of LBBP, LVSP, and deep septal pacing (DSP).

Methods: This retrospective study included patients who met the criteria for cardiac resynchronization therapy (CRT) and underwent attempted LBBP in 5 Mayo centers.

Sex Disparities in Cardiovascular Disease.

Cardiovascular disease is the leading cause of death in women. It remains underdiagnosed, undertreated, and portends worse outcomes in women than men. Disparities exist in every stage of science, from bench research to the editorial board of major journals and in every cardiovascular subspecialty.

Cardiac implantable electronic devices in female patients: Esthetic, breast implant, and anatomic considerations.

Introduction: The implantation of a cardiac implantable electronic device (CIED) can have esthetic and psychological consequences on patients. We explore a heart team model for care coordination and discuss esthetic approaches for improved cosmetic outcomes in patients undergoing (CIED)-related procedures or de novo implantation.

Methods: Patients undergoing CIED surgery for approved indications between June 2015 and June 2022 were identified.

Exposing influence campaigns in the age of LLMs: a behavioral-based AI approach to detecting state-sponsored trolls.

The detection of state-sponsored trolls operating in influence campaigns on social media is a critical and unsolved challenge for the research community, which has significant implications beyond the online realm. To address this challenge, we propose a new AI-based solution that identifies troll accounts solely through behavioral cues associated with their sequences of sharing activity, encompassing both their actions and the feedback they receive from others. Our approach does not incorporate any textual content shared and consists of two steps: First, we leverage an LSTM-based classifier to determine whether account sequences belong to a state-sponsored troll or an organic, legitimate user.

Cardiac Resynchronisation with Conduction System Pacing.

To date, biventricular pacing (BiVP) has been the standard pacing modality for cardiac resynchronisation therapy. However, it is non-physiological, with the activation spreading between the left ventricular epicardium and right ventricular endocardium. Up to one-third of patients with heart failure who are eligible for cardiac resynchronisation therapy do not derive benefit from BiVP.

Catheter ablation of atrial fibrillation in patients with and without hypertrophic cardiomyopathy: systematic review and meta-analysis.

Background: Atrial fibrillation (AF) is common in hypertrophic cardiomyopathy (HCM). There is limited data regarding the outcomes of AF catheter ablation in HCM patients. In this study, we aimed to synthesize all available evidence on the effectiveness of ablation of AF in patients with HCM compared to those without HCM.

Anatomy and Pathology of the Cardiac Conduction System.

The cardiac conduction system is formed of histologically and electrophysiologically distinct specialized tissues uniquely located in the human heart. Understanding the anatomy and pathology of the cardiac conduction system is imperative to an interventional electrophysiologist to perform safe ablation and device therapy for the management of cardiac arrhythmias and heart failure. The current review summarizes the normal and developmental anatomy of the cardiac conduction system, its variation in the normal heart and congenital anomalies, and its pathology and discusses important clinical pearls for the proceduralist.

Mapping and ablation of ventricular fibrillation substrate.

Ventricular fibrillation (VF) is a life-threatening arrhythmia and a common cause of sudden cardiac death (SCD). A basic understanding of its mechanistic underpinning is crucial for enhancing our knowledge to develop innovative mapping and ablation techniques for this lethal rhythm. Significant advances in our understanding of VF have been made especially in the basic science and pre-clinical experimental realms.

Evaluation and Catheter Ablation of Ventricular Arrhythmias in Cardiac Sarcoidosis.

Ventricular arrhythmias are a common clinical manifestation in patients with cardiac sarcoidosis (CS) and other arrhythmogenic inflammatory cardiomyopathies (AIC). The management of sustained ventricular arrhythmias in these patients presents unique challenges. Current therapies include immunosuppressive, antiarrhythmic agents, and catheter ablation.

Catheter Ablation of Ventricular Fibrillation.

Ventricular fibrillation (VF) is a common cause of sudden cardiac death (SCD) and is unfortunately without a cure. Current therapies focus on prevention of SCD, such as implantable cardioverter-defibrillator (ICD) implantation and anti-arrhythmic agents. Significant progress has been made in improving our understanding and ability to target the triggers of VF, via advanced mapping and ablation techniques, as well as with autonomic modulation.

Substrate Characterization and Outcomes of Catheter Ablation of Ventricular Arrhythmias in Patients With Mitral Annular Disjunction.

Background: Mitral annular disjunction (MAD) has recently been recognized as an arrhythmogenic entity. Data on the electrophysiological substrate as well as the outcomes of catheter ablation of ventricular arrhythmias in patients with MAD is limited.

Methods: Forty patients with MAD (mean age 47±15 years; 70% female) underwent catheter ablation for ventricular arrhythmias.