Aims: An association between obstructive sleep apnoea (OSA) and atrial fibrillation (AF) has been established. However, studies on the role of OSA in AF recurrence after catheter ablation have yielded conflicting results, and the effect of OSA treatment by continuous positive airway pressure (CPAP) on the success rate of AF catheter ablation is indeterminate. The aim of this meta-analysis was to investigate the rate of AF recurrence after catheter ablation in patients with AF with or without OSA and to evaluate the relationship between CPAP therapy and AF recurrence.
Methods And Results: We performed an online search and identified five studies involving 3743 patients with AF. Patients with OSA had a 31% greater risk of AF recurrence after catheter ablation than did patients without OSA [relative ratio (RR) = 1.31, P = 0.00], and this risk increased by 57% in patients with OSA not undergoing CPAP therapy (RR = 1.57, P = 0.00). However, CPAP users had a risk of AF recurrence similar to that of patients without OSA (RR = 1.25, P = 0.37), and this similarity was maintained even after the removal of study heterogeneity (RR = 0.99, P = 0.39).
Conclusion: Obstructive sleep apnoea was associated with AF recurrence after catheter ablation. The efficacy of catheter ablation for AF was similar between patients without OSA and patients with OSA undergoing CPAP treatment.
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http://dx.doi.org/10.1093/europace/euu066 | DOI Listing |
Rev Cardiovasc Med
January 2025
Arrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Center for Cardiovascular Diseases, 100037 Beijing, China.
Background: The substrates for arrhythmias in myocarditis and ischemic heart disease (IHD) are different, but it is yet to be determined whether there is a difference in outcomes following catheter ablation (CA) for ventricular tachycardia (VT) associated with these two conditions. This study aimed to compare outcomes after CA of VT in patients with myocarditis versus those with IHD.
Methods: Patients undergoing CA for sustained VT confirmed by endomyocardial biopsy as myocarditis, and patients with IHD experiencing sustained VT undergoing CA were retrospectively enrolled from February 2017 to March 2023.
World J Cardiol
January 2025
Department of Internal Medicine-II, Paracelsus Medical University Salzburg, Salzburg 5020, Austria.
The recurrence of atrial fibrillation (AF) in patients after successful radiofrequency catheter ablation (RFCA) appears to be an unresolved clinical issue and needs to be clearly elucidated. There are many factors associated with AF recurrence, such as duration of AF, male sex, concomitant heart failure, hemodynamic parameters, chronic obstructive pulmonary disease, hypertension, obstructive sleep apnea, hyperthyroidism, smoking and obesity. However, the inflammatory changes are strongly associated with electrical and structural cardiac remodeling, cardiac damage, myocardial fibrotic changes, microvascular dysfunction and altered reparative response.
View Article and Find Full Text PDFJ Arrhythm
February 2025
Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan.
Background: Successful isolation of the superior vena cava (SVC) using a functional conduction block between the right atrium (RA) and SVC has been documented. However, a comparison of this approach with the conventional method (CM) of circumferential ablation of the RA-SVC junction, based on angiography, remains unexplored.
Objective: In this study, we employed the innovative omnipolar mapping technology (OT) to discern the RA-SVC connection and compared clinical outcomes with those from CM.
J Arrhythm
February 2025
Heart Center Munich-Bogenhausen, Department of Cardiology and Internal Intensive Care Medicine Munich Hospital Bogenhausen, Munich Municipal Hospital Group Munich Germany.
Purpose: Pulmonary vein isolation (PVI) is effective in treating atrial fibrillation (AF), but outcomes are worse for persistent AF (persAF) patients than paroxysmal AF (PAF) patients. The study aimed to identify differences in left atrial (LA) and left atrial appendage (LAA) anatomy in different AF types.
Methods: In a single-center observational study, a blinded retrospective analysis of preprocedural cardiac computed tomography angiography (CCTA) images was performed.
The circular-shaped PulseSelectâ„¢ PFA catheter has demonstrated comparable efficacy to traditional thermal catheter ablation in achieving pulmonary vein isolation (PVI), while preventing thermally mediated complications. However, this catheter does not have any objective parameters to confirm real-time tissue-catheter contact. We report a case in which PVI was achieved through PFA using optimal biplane fluoroscopic angulations which were more useful for accurately assessing and adjusting the position and rotation of the circular catheter electrodes than the conventional fluoroscopic angulations.
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