Outcomes of Concomitant Atrial Fibrillation Ablation and Left Atrial Appendage Closure: A Retrospective Single-Center Experience.

Background: Catheter ablation is an effective therapy in the management of atrial fibrillation (AF). Left atrial appendage closure (LAAC) is an alternative to anticoagulation for stroke prevention in patients with bleeding risks.

Objectives: The purpose of this study was to assess the safety and efficacy of combining AF ablation and LAAC in a single procedure.

Outcomes of Atrial Fibrillation Ablation in Heart Failure Subtypes.

Background: Catheter ablation (CA) improves clinical outcomes in patients with atrial fibrillation (AF) and heart failure (HF) with reduced ejection fraction (HFrEF). We aimed to evaluate the impact of CA on clinical and quality-of-life outcomes across HF subtypes.

Methods: All patients undergoing AF ablation at a tertiary center were enrolled in a prospective registry and included in this study (2013-2021).

Left ventricular mass as a modulator of ventricular arrhythmia risk and sex differences after CRT for nonischemic cardiomyopathy and LBBB.

Background: The risk of ventricular arrhythmias (VAs) after cardiac resynchronization therapy (CRT) has been associated with ischemic disease/scar, sex, and possibly left ventricular mass (LVM).

Objective: The purpose of this study was to evaluate sex differences and baseline/postimplant change in LVM on VA risk after CRT implantation in patients with nonischemic cardiomyopathy and left bundle branch block.

Methods: In patients meeting the criteria, baseline and follow-up echocardiographic images were obtained for LVM assessment.

Characteristics of rumen microbiota and isolates found in high propionate and low methane-producing dairy cows.

Ruminal methane production is the main sink for metabolic hydrogen generated during rumen fermentation, and is a major contributor to greenhouse gas (GHG) emission. Individual ruminants exhibit varying methane production efficiency; therefore, understanding the microbial characteristics of low-methane-emitting animals could offer opportunities for mitigating enteric methane. Here, we investigated the association between rumen fermentation and rumen microbiota, focusing on methane production, and elucidated the physiological characteristics of bacteria found in low methane-producing cows.

Ventricular Tachycardia Ablation Endpoints: Moving Beyond Noninducibility.

In patients with structural heart disease and ventricular tachycardia (VT) undergoing catheter ablation, the response to programmed electrical stimulation (PES) at the end of the procedure has been traditionally used to evaluate the acute success and predict long-term outcomes. Although noninducibility at PES has been extensively investigated and validated in clinical trials and large multicenter registries, its performance in predicting long-term freedom from VT is suboptimal. In addition, PES has inherent limitations related to the influence of background antiarrhythmic drug therapy, periprocedural use of anesthesia, and the heterogeneity in PES protocols.

Polylysine-Containing Hydrogel Formulation of Fuzapladib, Inhibitor of Leukocyte-Function Associated Antigen-1 (LFA-1) Activation, for Sustained Release.

The aim of the present study was to develop an injectable hydrogel (HG) formulation of fuzapladib sodium (FZP), an animal drug for acute pancreatitis (AP), with the use of polyethyleneoxide (PEO) and polylysine (pLys), a cationic polymer. A mixture of pLys and FZP was added to PEO to prepare an HG formulation, and the formulation was optimized by release test and viscosity measurements. Circular dichroism (CD) and infrared absorption (IR) spectral analyses were applied to clarify the intermolecular interactions between FZP and pLys.

Utility and Limitations of Ablation Index for Guiding Therapy in Ventricular Myocardium.

Background: Ablation index (AI) is used for guiding therapy during pulmonary vein isolation. However, its potential utility in ventricular myocardium is unknown.

Objectives: This study sought to examine the correlation between AI and lesion dimensions in healthy and infarcted ventricles.

The Kagoshima-DVT Score Is a Useful Predictive Model for Cancer-Associated Thrombosis in Patients With Gastrointestinal Cancer.

Cancer-associated thrombosis (CAT) is a common complication of cancer and has received increasing attention; the Khorana Risk Score (KRS) is a recommended but insufficient risk assessment model for CAT. We propose a novel Kagoshima-DVT score (KDS) to predict preoperative deep vein thrombosis (DVT). This scoring method scores D-dimer ≥1.

Atrial Endocardial Unipolar Voltage Mapping for Detection of Viable Intramural Myocardium: A Proof-of-Concept Study.

Background: Endocardial bipolar voltage amplitude is largely derived from endocardial and subendocardial wall layers. This may result in situations of low bipolar voltage amplitude despite the presence of mid-myocardial including epicardial (ie, intramural-epicardial) viable myocardium. This study examined the utility of endocardial unipolar voltage mapping for detection of viable intramural-epicardial atrial myocardium.

Lattice-tip catheter for single-shot pulmonary vein isolation with pulsed field ablation.

Background: A compressible lattice-tip catheter designed for focal ablation using radiofrequency or pulsed-field energies has been recently described. The objective of this study is to describe a new lattice catheter designed for single-shot pulmonary vein isolation (PVI).

Methods: This 8F catheter consists of a compressible lattice tip that is delivered over the wire and is expandable up to 34 mm (SpherePVI™, Affera Inc.

Effect of Pulsed-Field and Radiofrequency Ablation on Heterogeneous Ventricular Scar in a Swine Model of Healed Myocardial Infarction.

Background: Pulsed-field ablation (PFA) is a nonthermal energy with higher selectivity to myocardial tissue in comparison to radiofrequency ablation (RFA). We compared the effects of PFA and RFA on heterogeneous ventricular scar in a swine model of healed infarction.

Methods: In 9 swine, myocardial infarction was created by balloon occlusion of the left anterior descending artery.

The utility of combining continuous wavelet transform analysis and high-density voltage map in predicting the long-term outcomes after ablation of persistent atrial fibrillation.

Background: Continuous wavelet transform (CWT) analysis is a frequency analysis to detect areas of stable high-frequent activity (stable pseudo frequency [sPF]) during atrial fibrillation (AF). As previously reported, patients with the highest sPF area in pulmonary veins (PV) showed better short-term outcomes after PV isolation (PVI). This study sought to evaluate the efficacy of CWT analysis in predicting the long-term (2 years) outcomes after PVI.

Development of stabilized fuzapladib solution for injection: forced degradation study and pharmacokinetic evaluation.

The aim of the present study was to develop and evaluate stabilized injection solutions of fuzapladib sodium hydrate using antioxidants as the stabilizers. To estimate the possible degradation factors and pathways of fuzapladib, forced degradation studies were conducted under thermal, acid, base, oxidative, and light conditions. To select an optimal excipient to stabilize fuzapladib under a solution state, a screening study of antioxidants was carried out to evaluate their effects to inhibit the degradation.

Increasing Lesion Dimensions of Bipolar Ablation by Modulating the Surface Area of the Return Electrode.

Objectives: This study sought to examine the effect of the return electrode's surface area on bipolar RFA lesion size.

Background: Bipolar radiofrequency ablation (RFA) is typically performed between 2 3.5-mm tip catheters serving as active and return electrodes.

A case series of very slow atrioventricular nodal reentrant tachycardia resembling junctional tachycardia.

Introduction: The surface electrocardiography of typical atrioventricular nodal reentrant tachycardia (AVNRT) shows simultaneous ventricular-atrial (RP) activation with pseudo R' in V1 and typical heart rates ranging from 150 to 220/min. Slower rates are suspicious for junctional tachycardia (JT). However, occasionally we encounter typical AVNRT with slow ventricular rates.

Nanocrystal solid dispersion of fuzapladib free acid with improved oral bioavailability.

This study aimed to develop an oral nanocrystal solid dispersion (nCSD) of fuzapladib (FZP) with enhanced absorbability for the treatment of acute pancreatitis (AP). The hydration properties of crystalline FZP free acid (crystalline FZP) and FZP sodium salt (FZP/Na) were assessed to select a stable crystal form. The nCSD of FZP free acid (nCSD/FZP) was prepared using a multi-inlet vortex mixer and evaluated in terms of physicochemical and pharmacokinetic properties.

How to use bipolar and unipolar electrograms for selecting successful ablation sites of ventricular premature contractions.

Background: Local activation time is often determined by the maximal negative of the extracellular unipolar potential (-dV/dT). While this is accurate in 2-dimensional uniform tissue, propagation through nonuniform or 3-dimensional structures have shown discordance between -dV/dT and local activation time.

Objective: The purpose of this study was to examine the relationship between bipolar and unipolar electrograms for selecting successful ablation sites of endocardial (superficial) vs intramural (deep) ventricular premature contractions (VPCs).

Direction-aware mapping algorithms have minimal impact on bipolar voltage maps created using high-resolution multielectrode catheters.

Introduction: Direction-aware mapping algorithms improve the accuracy of voltage mapping by measuring the maximal voltage amplitude recorded in the direction of wavefront propagation. While beneficial for stationary catheters, its utility for roving catheters collecting electrograms (EGMs) at multiple angles is unknown.

Objective: To compare the directional dependence of bipolar voltage amplitude between stationary and roving catheters.