Preventive catheter ablation for ventricular arrhythmias in patients with end-stage heart failure referred for heart transplantation evaluation: Rationale for and design of the CASTLE-VT trial.

Aims: Timely referrals for transplantation and left ventricular assist device (LVAD) play a key role in favourable outcomes in patients with advanced heart failure (HF). Cardiovascular mortality, driven by sudden cardiac death, is the main reason for dying while waiting for heart transplantation (HTx). The purpose of the Preventive Catheter Ablation for ventricular arrhythmiaS in patients with end-sTage heart faiLure rEferred for heart transplantation eValuaTion (CASTLE-VT) trial is to test the hypothesis that prophylactic catheter ablation of arrhythmogenic ventricular scar tissue will reduce mortality, need for LVAD implantation, and urgent HTx in patients with end-stage HF related to ischaemic cardiomyopathy (ICM).

Left Atrial Wall Thickness Estimated by Cardiac CT: Implications for Catheter Ablation of Atrial Fibrillation.

Atrial wall thickness (AWT) is a significant factor in understanding the pathological physiological substrate of atrial fibrillation, with a potentially substantial impact on the outcomes of catheter ablation procedures. Precise measurements of the AWT may provide valuable insights for categorising patients with AF and planning targeted interventions. The purpose of this study was to evaluate the characteristics of the left atrium (LA) using non-invasive multidetector computed tomography (MDCT) scans and subsequent three-dimensional (3D) image post-processing using novel software designed to calculate atrial thickness dimensions and mass.

Standard Defibrillator Leads for Left Bundle Branch Area Pacing: First-in-Man Experience and Short-Term Follow-Up.

The authors report for the first time to their knowledge, implantation of a standard implantable cardioverter-defibrillator lead for permanent delivery of left bundle branch area pacing. Implantation was successful and safe in 11 of 12 patients, with adequate defibrillation testing, good electrical and electrocardiographic parameters, and uneventful device-related short-term follow-up.

Pressure waveform analysis for occlusion assessment significantly reduces contrast medium use in cryoballoon pulmonary vein isolation.

Background: Pulmonary vein (PV) occlusion is crucial for adequate lesion formation during cryoballoon-guided pulmonary vein isolation (CB-PVI). PV occlusion is usually confirmed by angiographies over the inflated balloon device. The aim of our study was to analyze the safety and efficacy of pressure waveform-based PV occlusion assessment during CB-PVI utilizing a novel fully integrated pressure analysis tool.

Atrial fibrillation ablation workflow optimization facilitated by high-power short-duration ablation and high-resolution mapping.

Aims: Pulmonary vein isolation (PVI) for catheter ablation of atrial fibrillation (AF) is a time-demanding procedure. High-power short-duration (HPSD) ablation protocols and high-density mapping catheters have recently been introduced to clinical practice. We investigated the impact of high-density mapping and HPSD ablation protocols on procedural timing, efficacy, and safety by comparing different standardized set-ups.

Pulsed field ablation for atrial fibrillation - Lessons from magnetic resonance imaging.

Pulsed field ablation (PFA) is a promising technology for the treatment of atrial fibrillation (AF). Due to its unique tissue selectivity, PFA potentially bears superior characteristics as compared to established thermal energy sources in AF ablation procedures. Cardiovascular magnetic resonance imaging (CMR) using late gadolinium enhancement (LGE) is an established tool in the analysis of myocardial fibrosis representing atrial cardiomyopathy as well as ablation-induced atrial scar formation following catheter ablation with thermal energy.

What can anatomy teach the electrophysiologist for diagnostic procedures?

Even for a basic study, the electrophysiologist needs to have a clear mental picture of cardiac anatomy when positioning the diagnostic catheters. This review highlights some of the features of the four cardiac chambers relevant for translating anatomic knowledge into an understanding of fluoroscopy images and electrograms. Integration of images from real cardiac anatomy into three-dimensional mapping based on electrograms and "virtual" anatomy is crucial for the success and safety of diagnostic and therapeutic electrophysiological procedures.

[Relevant anatomy of epicardial space for the electrophysiologists].

The arrhythmogenic substrate in patients with Chagas cardiomyopathy, arrhythmogenic dysplasia, postmyocarditis nonischemic dilative cardiomyopathy as well as after extensive posterior or anterior wall myocardial infarction is predominantly located epicardially. This can necessitate epicardial access for an effective, substrate-based catheter ablation of the ventricular tachycardia (VT). Anterior percutaneous epicardial puncture represents the standard approach for epicardial VT ablation.

Amplified sinus-P-wave reveals localization and extent of left atrial low-voltage substrate: implications for arrhythmia freedom following pulmonary vein isolation.

Aims: Presence of arrhythmogenic left atrial (LA) low-voltage substrate (LVS) is associated with reduced arthythmia freedom rates following pulmonary vein isolation (PVI) in persistent atrial fibrillation (AF). We hypothesized that LA-LVS modifies amplified sinus-P-wave (APW) characteristics, enabling identification of patients at risk for arrhythmia recurrences following PVI.

Methods And Results: Ninety-five patients with persistent AF underwent high-density (>1200 sites) voltage mapping in sinus rhythm.

Overview of the current electrophysiology (EP) state of affairs in Russia.

Russia is the largest country in the world based on the landmass, covering more than one-eighth of the earth's inhabited area. Russia faces challenges in electrophysiology (EP) care including insufficient and uneven financing, complicated system for identifying optimal treatment for individual patients, relative paucity of reasonable educational and certification scope for electrophysiologists, suboptimal national statistical data gathering regarding heart rhythm disorders and EP devices in use, and weak networking of medical information. In comparison with the average level of EP utilization in ESC countries, Russia utilizes around 50% in pacemaker; 10% in ICD; 8% in cardiac resynchronization therapy; 55% in ablations; and 45% in AF ablations.

Mechanisms of sex differences in atrial fibrillation: role of hormones and differences in electrophysiology, structure, function, and remodelling.

Atrial fibrillation (AF) is the clinically most prevalent rhythm disorder with large impact on quality of life and increased risk for hospitalizations and mortality in both men and women. In recent years, knowledge regarding epidemiology, risk factors, and patho-physiological mechanisms of AF has greatly increased. Sex differences have been identified in the prevalence, clinical presentation, associated comorbidities, and therapy outcomes of AF.

Distributed Cognition and Process Management Enabling Individualized Translational Research: The NIH Undiagnosed Diseases Program Experience.

The National Institutes of Health Undiagnosed Diseases Program (NIH UDP) applies translational research systematically to diagnose patients with undiagnosed diseases. The challenge is to implement an information system enabling scalable translational research. The authors hypothesized that similar complex problems are resolvable through process management and the distributed cognition of communities.