Effects of key parameters on pulsed field ablation of atrial fibrillation: potato experiments.

Aims: The study aims to investigate the impact of key parameters of pulsed field ablation (PFA) on lesion depth, including voltage (V), pulse width (PW), number of pulses (P), and ablation number (N), using potato models.

Methods: Potatoes are utilized as a display of the irreversible electroporation lesion. The key ablation parameters were varied systematically to explore its influences on lesion depths.

Distribution characteristics of Purkinje fibres in the canine left ventricle.

Purkinje-related ventricular arrhythmias have been increasingly reported, and with the development of catheter ablation techniques, intervention for Purkinje-related arrhythmias has been shown to be effective. The characteristics of Purkinje fibres orientation in the 12 canine left ventricles were observed at a gross level by staining the endocardium with Lugol's solution. Purkinje fibres were observed microscopically by HE, Masson's, PAS glycogen, and Cx40 immunohistochemical staining.

Efficacy and safety of a novel hexaspline pulsed field ablation system in patients with paroxysmal atrial fibrillation: the PLEASE-AF study.

Aims: Pulsed field ablation (PFA) is an emerging non-thermal ablative modality demonstrating considerable promise for catheter ablation of atrial fibrillation (AF). However, these PFA trials have almost universally included only Caucasian populations, with little data on its effect on other races/ethnicities. The PLEASE-AF trial sought to study the 12-month efficacy and the safety of a multi-electrode hexaspline PFA catheter in treating a predominantly Asian/Chinese population of patients with drug-refractory paroxysmal AF.

Percutaneous left atrial appendage closure with SeaLA device in non-valvular atrial fibrillation.

Objectives: The clinical efficacy and safety of a novel left atrial appendage (LAA) occluder of the SeaLA closure system in patients with nonvalvular atrial fibrillation (NVAF) were reported.

Background: Patients with NVAF are at a higher risk of stroke compared to healthy individuals. Left atrial appendage closure (LAAC) has emerged as a prominent strategy for reducing the risk of thrombosis in individuals with NVAF.

One-year outcomes of wide antral cryoballoon ablation guided by high-density mapping vs. conventional cryoballoon ablation for atrial fibrillation: a propensity score-matched study.

Background: Pulmonary vein isolation with wide antral ablation leads to better clinical outcomes for the treatment of atrial fibrillation, but the isolation lesion is invisible in conventional cryoballoon ablation. In this study, we aim to investigate the efficacy of the wide pulmonary vein isolation technique that includes the intervenous carina region, guided by high-density mapping, compared with pulmonary vein isolation alone without the mapping system.

Methods: We conducted a propensity score-matched comparison of 74 patients who underwent a wide cryoballoon ablation guided by high-density mapping (mapping group) and 74 controls who underwent conventional cryoballoon ablation in the same period (no-mapping group).

Guidewire Ablation within the Coronary Venous System for Epicardial or Intramural Ventricular Arrhythmia: A Preclinical Study of Biophysical Characterization.

Background: Catheter ablation failure poses a clinical challenge for epicardial or intramural ventricular arrhythmia (VA); however, guidewire ablation within the coronary venous system (CVS) may be effective and safe for targeting VAs.

Methods: The ex vivo phase included four steps. In step 1, the steam pop incidence rates during guidewire ablation at power settings of 5, 10, 15, 20, and 25 W were analyzed using 10 mm- and 20 mm-tip guidewires.

An individualized criterion for left bundle branch capture in patients with a narrow QRS complex.

Background: Left bundle branch (LBB) pacing (LBBP) is a physiological pacing; however, the accuracy of current electrocardiographic criteria for LBBP remains inadequate.

Objective: The purpose of this study was to establish a novel individualized criterion to improve the accuracy of LBBP determination in patients with a narrow QRS complex.

Methods: Patients in whom both LBBP and left ventricular septal pacing (LVSP) were acquired during operation were enrolled.

Bachmann's Bundle Modification in Addition to Circumferential Pulmonary Vein Isolation for Atrial Fibrillation: A Novel Ablation Strategy.

Background: Bachmann's bundle (BB) is the main pathway of interatrial connection that could be involved in the development of atrial fibrillation (AF). Based on this hypothesis, we raised a novel ablation strategy, BB modification in addition to circumferential pulmonary vein isolation (CPVI-BB) in patients with AF.

Methods: A retrospective cohort of patients with AF who underwent CPVI-BB or CPVI alone from March 2018 to July 2021 was enrolled in our study.

Effects of parameters on radiofrequency guidewire ablation: In vitro and in vivo experiments.

Background: A novel ablation technique with guidewire has emerged as a promising approach for mapping and ablation of arrhythmias originating from left ventricular summit. However, its biophysical characteristics have not been fully clarified.

Methods And Results: In the in vitro experiment, guidewire ablation (GA) was performed in vessel models of 1.

Catheter ablation of idiopathic left fascicular ventricular tachycardia: Implications of false tendons for mapping and ablation.

Introduction: The anatomical substrate for idiopathic left ventricular tachycardia (ILVT) remains speculative. Purkinje networks surrounding false tendons (FTs) might be involved in the reentrant circuit of ILVT. The objective was to evaluate the anatomical and electrophysiological features of false tendons FTs in relation to ILVT.

Bilateral septal pacing in combination with coronary venous pacing for cardiac resynchronization therapy.

Background: Conventional right ventricular pacing combined with coronary venous pacing (CVP) is a mainstay for cardiac resynchronization therapy (CRT). However, QRS duration of conventional CRT may be frequently more than 130 ms. This study aimed to evaluate the effectiveness of QRS narrowing by bilateral septal pacing (BSP) in combination with CVP for CRT (BSP-CRT).

Intracardiac echocardiography Chinese expert consensus.

In recent years, percutaneous catheter interventions have continuously evolved, becoming an essential strategy for interventional diagnosis and treatment of many structural heart diseases and arrhythmias. Along with the increasing complexity of cardiac interventions comes ever more complex demands for intraoperative imaging. Intracardiac echocardiography (ICE) is well-suited for these requirements with real-time imaging, real-time monitoring for intraoperative complications, and a well-tolerated procedure.

Characteristics and Ablation Outcomes of Atrial Tachycardia in Patients with Prior Cardiac Surgery vs. Spontaneous Scars: Where Are the Differences?

(1) Background: Atrial scars play an important role in atrial tachycardia (AT). They can not only be found in patients with prior cardiac surgery (PCS) but also in patients without PCS or significant structural heart disease, in which case the scar is called a spontaneous scar (SS). This study aims to compare the characteristics, mechanisms and ablation outcomes of AT in patients with PCS and SS.

2021 Asian Pacific Society of Cardiology Consensus Recommendations on the Use of P2Y1 Receptor Antagonists in the Asia-Pacific Region: Special Populations.

Advanced age, diabetes, and chronic kidney disease not only increase the risk for ischaemic events in chronic coronary syndromes (CCS) but also confer a high bleeding risk during antiplatelet therapy. These special populations may warrant modification of therapy, especially among Asians, who have displayed characteristics that are clinically distinct from Western patients. Previous guidance has been provided regarding the classification of high-risk CCS and the use of newer-generation P2Y inhibitors (i.

Derivation and Verification of the Relationship between Ablation Index and Baseline Impedance.

Objective: To explore the quantitative adjustment of ablation index (AI) under different baseline impedance to achieve similar lesion dimensions.

Methods: (1) Keeping the AIs relatively constant, the lesion dimensions in different baseline impedances were studied. (2) According to Joule's law,  =  RT, keeping the current () unchanged, the powers corresponding to different baseline impedances can be obtained.

Catheter ablation of premature ventricular complexes associated with left ventricular false tendons.

Background: Clinical studies have suggested that there is a significant correlation between left ventricular (LV) false tendon and premature ventricular complexes (PVCs).

Objective: This study aimed to investigate the electrophysiological characteristics and the outcome of radiofrequency catheter ablation (RFCA) for this category of PVCs.

Methods: From a total of 2284 patients with idiopathic PVCs who underwent catheter ablation at 6 institutions in China, intracardiac echocardiography (ICE) was used during the procedure in 346 cases; 10 patients (2.

The change of cardiac axis deviation in catheter ablation of verapamil-sensitive idiopathic left ventricular tachycardia.

Background: The underlying mechanism of verapamil-sensitive idiopathic left ventricular tachycardia (ILVT) has been postulated to be reentrant activation in the Purkinje fiber network of the left posterior fascicle or the left anterior fascicle (LAF). However, changing of cardiac axis deviation in sinus rhythm (SR) or during ILVT after radiofrequency catheter ablation (RFCA) has been rarely analyzed.

Methods: Of the 232 patients with sustained ILVT induced and surface electrocardiogram (ECG) in SR recorded before and after RFCA, the changes of ECG morphology in SR and during ILVT were analyzed.

Circulating Soluble ST2 Predicts All-Cause Mortality in Severe Heart Failure Patients with an Implantable Cardioverter Defibrillator.

Background: Heart failure (HF) is the terminal stage of all cardiovascular events. Although implantable cardioverter defibrillator (ICD) therapies have reduced mortality among the high-risk HF population, it is necessary to determine whether certain factors can predict mortality even after cardiac device implantation. Growth stimulation expressed gene 2 (ST2) is an emerging biomarker for HF patient stratification in different clinical settings.

A simple and practical criterion for determining a failed His-bundle pacing.

Aims: To establish a simple criterion for determining a failed His-bundle pacing (HBP). This criterion states that if stimulus to QRS end interval is longer than His-bundle potential to QRS end interval ('S-QRSend > H-QRSend') then a failed HBP can be determined.

Methods And Results: We performed retrospective analysis on 737 pacing tests around His-bundle in 241 patients and prospective analysis on 400 tests in 123 patients.

QRS complex axis deviation changing in catheter ablation of left fascicular ventricular tachycardia.

Aims: The mechanisms of the QRS complex axis deviation changing of idiopathic left fascicular ventricular tachycardia (FVT) during or after radiofrequency catheter ablation were investigated in this study, which were still not well defined.

Methods And Results: In the index procedure, FVTs characterized by right bundle branch block configuration and left-axis deviation (LAD-FVT) were ablated at the VT exit site guided by the earliest ventricular activation with fused presystolic Purkinje potential (PP) in 234 consecutive patients. A new type of FVT characterized by right-axis deviation (RAD-FVT) was identified after successful elimination of the LAD-FVT in 12 patients, including 9 patients during the index procedure and 3 patients during follow-up.

Purkinje Fibers in Canine False Tendons: New Anatomical and Electrophysiological Findings.

Introduction: Purkinje system and false tendons (FTs) are related to ventricular arrhythmia, but the association between Purkinje fibers and FTs is not clear. This study investigated the associations of anatomical and electrophysiological characteristics between Purkinje fibers and FTs.

Methods And Results: We optimized the protocol of Lugol's iodine solution staining of Purkinje fibers to study the anatomical structure and originated a novel electrophysiological mapping method, named the direct visual mapping (DVM) method, to study the electrophysiological characteristics.