A tailored substrate-based approach using focal pulsed field catheter ablation in patients with atrial fibrillation and advanced atrial substrate: Procedural data and 6-months success rates.

Background: Focal pulsed-field ablation (F-PFA) integrated in electroanatomical mapping (EAM) systems allows tailored lesion sets in patients with atrial fibrillation (AF).

Objective: To determine feasibility, safety and 6-months outcome of F-PFA for a tailored substrate-based catheter ablation (CA) approach in patients with AF and advanced atrial substrate.

Methods: Consecutive patients with AF and advanced atrial substrate treated by a F-PFA system (Cardiofocus) through contact-force sensing catheters integrated in EAM systems were prospectively enrolled.

Quest for the ideal assessment of electrical ventricular dyssynchrony in cardiac resynchronization therapy.

This paper reviews the literature on assessing electrical dyssynchrony for patient selection in cardiac resynchronization therapy (CRT). The guideline-recommended electrocardiographic (ECG) criteria for CRT are QRS duration and morphology, established through inclusion criteria in large CRT trials. However, both QRS duration and LBBB morphology have their shortcomings.

Selecting repetitive focal and rotational activation patterns with the highest probability of being a source of atrial fibrillation.

Introduction: Repetitive focal and rotational activation patterns are currently used as additional ablation targets for atrial fibrillation (AF). However, there is no evidence that all these detected targets are actual sources of AF. In this paper, we present an approach that detects and ranks AF activation patterns not only based on the degree of pattern repetitiveness but also on the extent to which they are able to entrain their vicinity.

Reverse electrical remodelling after cardiac resynchronization therapy in a patient undergoing left bundle branch area pacing: a case report.

Background: Left bundle branch area pacing (LBBAP) has been introduced as an alternative to biventricular pacing in cardiac resynchronization therapy (CRT). Several studies describe echocardiographic reverse remodelling after LBBAP. Reverse electrical remodelling after LBBAP has not yet been described.

Local atrial bipolar electrogram voltage drops during cardiac magnetic resonance guided catheter ablation of typical atrial flutter: Associations with delivered radiofrequency energy and peri-procedural imaging.

Background: Cardiac magnetic resonance (CMR)-guided catheter ablation of the cavotricuspid isthmus (CTI) has been proven feasible, but determinants of local electrogram (EGM) voltage drops during radiofrequency (RF) applications are unknown.

Objective: The purpose of this study was to investigate local atrial bipolar EGM voltage drops and the association with delivered RF energy and anatomical information derived from peri-procedural CMR imaging.

Methods: In consecutive patients undergoing CMR-guided CTI ablation procedures, relative EGM voltage drops for RF applications ≥20 seconds were calculated.