Advancing Surgical Arrhythmia Ablation: Novel Insights on 3D Printing Applications and Two Biocompatible Materials.

To date, studies assessing the safety profile of 3D printing materials for application in cardiac ablation are sparse. Our aim is to evaluate the safety and feasibility of two biocompatible 3D printing materials, investigating their potential use for intra-procedural guides to navigate surgical cardiac arrhythmia ablation. Herein, we 3D printed various prototypes in varying thicknesses (0.

Redo procedures after sinus node sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia.

Aims: A novel sinus node (SN) sparing hybrid ablation for inappropriate sinus node tachycardia (IST)/postural orthostatic tachycardia syndrome (POTS) has been demonstrated to be an effective and safe therapeutic option in patients with symptomatic drug-resistant IST/POTS. The aim of this study was to evaluate the long-term rate of redo procedures after hybrid IST ablation and procedural strategy, outcomes and safety of redo procedures.

Methods And Results: All consecutive patients from 2015 to 2023 were prospectively enrolled in the UZ Brussel monocentric IST/POTS registry.

Safety of the Radiofrequency Balloon for Pulmonary Vein Isolation: A Focus on Lesion Metric Analysis of Posterior Electrodes.

Previous clinical studies on pulmonary vein isolation (PVI) with radiofrequency balloons (RFB) reported safe and effective procedures for a 20 s RF delivery via posterior electrodes. Recent recommendations from the manufacturer suggest reducing the application time to 15 s on the posterior wall (PW) when facing the esophagus region. Here, we retrospectively assess whether 15 s of RF delivery time on posterior electrodes is safe while still ensuring lesion metrics of sufficient quality.

3D mapping challenges in hybrid video-assisted thoracoscopic surgical ablation of Brugada syndrome.

Objectives: Brugada syndrome is a life-threatening disease with an arrhythmogenic substrate located in the epicardium of right ventricle outflow tract. Therefore, the correct region identification is crucial for a successful ablation procedure. Various mapping techniques can be adopted to elaborate this issue, but they were all initially developed for endovascular use.

Outcomes of pulmonary vein isolation with radiofrequency balloon vs. cryoballoon ablation: a multi-centric study.

Aims: Cryoballoon (CB) ablation is the mainstay of single-shot pulmonary vein isolation (PVI). A radiofrequency balloon (RFB) catheter has recently emerged as an alternative. However, these two technologies have not been compared.

Hybrid atrial fibrillation ablation: long-term outcomes from a single-centre 10-year experience.

Aims: Hybrid atrial fibrillation (AF) ablation is a promising approach in non-paroxysmal AF. The aim of this study is to assess the long-term outcomes of hybrid ablation in a large cohort of patients after both an initial and as a redo procedure.

Methods And Results: All consecutive patients undergoing hybrid AF ablation at UZ Brussel from 2010 to 2020 were retrospectively evaluated.

Compatibility assessment of a temperature-controlled radiofrequency catheter with a novel electroanatomical mapping system.

Background: The novel DiamondTemp ablation system (DTA) and EnSiteX mapping System (EAM) are both CE-Marked and FDA approved medical devices. The DTA has been validated by its manufacturer only in combination with previous version of EnSite System-EnSite Precision. The aim of this study was to evaluate compatibility of DTA with EnSite X with a previously developed protocol.

Posterior wall isolation via a multi-electrode radiofrequency balloon catheter: feasibility, technical considerations, endoscopic findings and comparison with cryoballoon technologies.

Background: Posterior wall (PW) isolation is an important adjunctive ablation target in patients with non-paroxysmal atrial fibrillation (AF). Traditionally performed with point-by-point radiofrequency (RF) ablation, PW isolation has also been performed with different cryoballoon technologies. We aimed at assessing the feasibility of PW isolation with the novel RF balloon catheter Heliostar™ (Biosense Webster, CA, USA).

3D-Printed Biomaterial Testing in Response to Cryoablation: Implications for Surgical Ventricular Tachycardia Ablation.

The lack of thermally and mechanically performant biomaterials represents the major limit for 3D-printed surgical guides, aimed at facilitating complex surgery and ablations. Cryosurgery is a treatment for cardiac arrhythmias. It consists of obtaining cryolesions, by freezing the target tissue, resulting in selective and irreversible damage.

Pulmonary vein isolation with the radiofrequency balloon catheter: a single centre prospective study.

Aims: The multielectrode radiofrequency balloon catheter (RFB) has been developed to achieve safe and effective pulmonary vein isolation (PVI) for atrial fibrillation (AF) ablation. This single-centre study aimed to evaluate the midterm clinical outcome and predictors of single-shot PVI with the novel RFB.

Methods And Results: All consecutive patients with symptomatic paroxysmal or persistent AF undergoing first-time PVI with the RFB were prospectively included.

Evaluation of photogrammetry for medical application in cardiology.

In the field of medicine, photogrammetry has played for long time a marginal role due to the significant amount of work required that made it impractical for an extended medical use. Developments in digital photogrammetry occurred in the recent years, that have steadily increased the interest and application of this technique. The present study aims to compare photogrammetry reconstruction of heart with computed tomography (CT) as a reference.

Heart rate variability and microvolt T wave alternans changes during ajmaline test may predict prognosis in Brugada syndrome.

Purpose: Drug-induced type I Brugada syndrome (BrS) is associated with a ventricular arrhythmia (VA) rate of 1 case per 100 person-years. This study aims to evaluate changes in electrocardiographic (ECG) parameters such as microvolt T wave alternans (mTWA) and heart rate variability (HRV) at baseline and during ajmaline testing for BrS diagnosis.

Methods: Consecutive patients diagnosed with BrS during ajmaline testing with 5-year follow-up were included in this study.

A 3D-printed surgical guide for ischemic scar targeting and ablation.

Background: 3D printing technology development in medical fields allows to create 3D models to assist preoperative planning and support surgical procedures. Cardiac ischemic scar is clinically associated with malignant arrhythmias. Catheter ablation is aimed at eliminating the arrhythmogenic tissue until the sinus rhythm is restored.

Development of a 3D printed surgical guide for Brugada syndrome substrate ablation.

Background: Brugada syndrome (BrS) is a disease associated with ventricular arrhythmias and sudden cardiac death. Epicardial ablation has demonstrated high therapeutic efficacy in preventing ventricular arrhythmias. The purpose of this research is to define a workflow to create a patient-specific 3D-printed tool to be used as a surgical guide for epicardial ablation in BrS.

Temperature analysis of 3D-printed biomaterials during unipolar and bipolar radiofrequency ablation procedure.

Background: Due to their mechanical properties, the MED625FLX and TPU95A could be appropriate candidates for cardiac 3D surgical guide use during radiofrequency ablation (RFA) treatment.

Methods: RFA aims to destroy the heart tissue, which cause arrhythmias, by applying a radiofrequency (RF) energy at critical temperature above +50.0°C, where the thermal damage is considered not reversible.

Universal Method of Compatibility Assessment for Novel Ablation Technologies With Different 3D Navigation Systems.

Background: New technologies for ablation procedures are often produced by different companies with no cross-compatibility out of the box. This is not a negligible clinical problem since those separately developed devices are often used together. The aim of this study was to develop a bench-testing method to assess compatibility between the DiamondTemp ablation system (DTA) and the Rhythmia electroanatomic mapping system (EAM).

Incidence and Predictors of Cardiac Arrhythmias in Patients With COVID-19.

Background: Coronavirus disease 2019 (COVID-19) is a systemic disease caused by severe acute respiratory syndrome coronavirus 2. Arrhythmias are frequently associated with COVID-19 and could be the result of inflammation or hypoxia. This study aimed to define the incidence of arrhythmias in patients with COVID-19 and to correlate arrhythmias with pulmonary damage assessed by computed tomography (CT).

Atrial Fibrillation Global Changes after Pulmonary Vein and Posterior Wall Isolation: A Charge Density Mapping Study.

Background: Non-contact charge density (CD) mapping allows a global visualization of left atrium (LA) activation and of activation patterns during atrial fibrillation (AF). The aim of this study was to analyze, with CD mapping, the changes in persistent AF induced by pulmonary vein isolation (PVI) and LA posterior wall isolation (LAPWI).

Methods: Patients undergoing PVI + LAPWI using the Arctic Front Advance PRO cryoballoon system were included in the study.

3D Printed Surgical Guide for Coronary Artery Bypass Graft: Workflow from Computed Tomography to Prototype.

Patient-specific three-dimensional (3D) printed models have been increasingly used in many medical fields, including cardiac surgery for which they are used as planning and communication tools. To locate and plan the correct region of interest for the bypass placement during coronary artery bypass graft (CABG) surgery, cardiac surgeons can pre-operatively rely on different medical images. This article aims to present a workflow for the production of a patient-specific 3D-printed surgical guide, from data acquisition and image segmentation to final prototyping.

Comparison between the novel diamond temp and the classical 8-mm tip ablation catheters in the setting of typical atrial flutter.

Purpose: Radiofrequency (RF) catheter ablation is widely accepted as a first-line therapy for cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL). The novel DiamondTemp (DT) catheter with temperature feedback during RF ablation has been released recently on the market. The purpose of this study was to evaluate the impact of DiamondTemp (DT) technology on ablation efficiency during AFL.