Review
Cardiac & Cardiovascular Systems
Chang-Hao Xu, Feng Xiong, Wei-Feng Jiang, Xu Liu, Tao Liu, Mu Qin
Summary: Despite significant progress in understanding atrial fibrillation, there are still challenges in its treatment. The review focuses on the rotor mechanism and compares recent clinical approaches to identifying rotors. Though initial studies have shown promising results in rotor ablation, there are some inconclusive outcomes. Hence, there is a need to improve the resolution of mapping techniques and address limitations in current research methodology.
Article
Physiology
Chiara Bartolucci, Claudio Fabbri, Corrado Tomasi, Paolo Sabbatani, Stefano Severi, Cristiana Corsi
Summary: This study proposed a tool for testing the ability of different catheter shapes to detect rotors in different conditions. Results showed that all configurations detected the rotor correctly when in contact with the atrial wall and at 1 mm distance from it, regardless of geometry, coverage, and inter-electrode distance. The developed computational framework is well suited to investigate how mapping catheter geometry and location affect AF driver detection, making it a reliable tool for designing and testing new mapping catheters.
FRONTIERS IN PHYSIOLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
Jonathan M. Kalman, Ahmed M. Al-Kaisey, Ramanathan Parameswaran, Joshua Hawson, Robert D. Anderson, Michael Lim, David Chieng, Stephen A. Joseph, Alex McLellan, Joseph B. Morton, Paul B. Sparks, Geoffrey Lee, Prashanthan Sanders, Peter M. Kistler
Summary: This study aimed to determine if the timing of catheter ablation for atrial fibrillation (AF) affects arrhythmia outcomes. The results showed that there was no significant difference in the atrial arrhythmia free survival at 12 months post-ablation between patients who underwent early ablation and those who underwent delayed ablation. Other secondary outcomes also showed no significant difference. Therefore, delaying AF ablation by 12 months for antiarrhythmic drug management does not reduce the efficacy of ablation.
EUROPEAN HEART JOURNAL
(2023)
Review
Cardiac & Cardiovascular Systems
Gianluigi Bisleri, Arjun K. Pandey, Subodh Verma, Syed M. Ali Hassan, Bobby Yanagawa, Masud Khandaker, Mario Gaudino, Andrea M. Russo, Atul Verma, Deepak L. Bhatt, Andrew C. T. Ha
Summary: Hybrid ablation is a novel therapy that combines minimally invasive surgical and percutaneous catheter-based techniques for the management of atrial fibrillation (AF). Observational studies have shown approximately 70% success rates but higher risks compared to catheter-based ablation. Hybrid ablation is typically offered to patients with persistent or longstanding persistent AF, requiring two procedures. While a randomized trial demonstrated its superiority over catheter-based ablation, it also showed higher complication rates. Contemporary studies have shown a decrease in the incidence of serious complications. Additional randomized trials are needed to determine the risks, benefits, and cost effectiveness of hybrid ablation in clinical practice.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Geoffroy Ditac, Pierre Jean Cottinet, Minh Quyen Le, Daniel Grinberg, Josselin Duchateau, Kevin Gardey, Arnaud Dulac, Antoine Deliniere, Christelle Haddad, Julie Boussuge-Roze, Frederic Sacher, Pierre Jais, Philippe Chevalier, Francis Bessiere
Summary: Atrial fibrillation (AF) catheter ablation procedure contributes significantly to GHG emissions, with a carbon footprint of 76.9 kg CO2-e. With approximately 600,000 annual procedures worldwide, AF catheter ablation leads to 125 tons of CO2 emissions every day, equivalent to a daily car ride of 700,000 km. Electrophysiology catheters and patches are identified as the main contributors to the carbon footprint, highlighting the importance of reducing, reusing, and recycling these items.
Article
Cardiac & Cardiovascular Systems
Karim Benali, Paul Khairy, Nefissa Hammache, Adrian Petzl, Antoine Da Costa, Atul Verma, Jason G. Andrade, Laurent Macle
Summary: A systematic review and pooled analysis of randomized control trials showed that catheter ablation of atrial fibrillation is associated with low rates of procedure-related complications and mortality, which have declined over the past decade.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Ghaith Zaatari, Raul Mitrani, Jorge Bohorquez, Jason Ng, Justin Ng, Harold Rivner, Alex Velasquez, Litsa Lambrakos, Rishi Arora, Jeffrey J. Goldberger
Summary: This study compared the recurrence of electrogram morphology in the left and right atria in patients undergoing initial and repeat ablation for persistent atrial fibrillation. The results showed that electrogram morphology recurrence was mainly observed in the left atrium, and the shortest cycle length recurrence occurred during the initial ablation process. Most sites had low recurrence, suggesting that they may not be critical for maintaining atrial fibrillation.
JACC-CLINICAL ELECTROPHYSIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Daisetsu Aoyama, Shinsuke Miyazaki, Kanae Hasegawa, Ryohei Nomura, Shota Kakehashi, Moe Mukai, Machiko Miyoshi, Junya Yamaguchi, Yusuke Sato, Yuichiro Shiomi, Hiroyuki Ikeda, Kentaro Ishida, Hiroyasu Uzui, Hiroshi Tada
Summary: This retrospective study investigates the association between AF activation patterns and clinical outcomes post-ablation. It found that non-paroxysmal AF, larger left atrial size, and higher left atrial activation ratios are predictive factors for AF recurrence.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Elena Arbelo, Nikolaos Dagres
Summary: This article critically reviews the recommendations of the 2020 ESC guidelines for the management of AF in light of two landmark trials, emphasizing the safety of contemporary rhythm control treatment and the importance of personalized treatment strategies.
Article
Physiology
Jae-Hyuk Lee, Oh-Seok Kwon, Hee Tae Yu, Tae-Hoon Kim, Jae-Sun Uhm, Boyoung Joung, Moon-Hyoung Lee, Hui-Nam Pak
Summary: Catheter ablation is an effective method for treating atrial fibrillation, but it may lead to atrial tissue damage and increase the risk of stiff LA physiology. Factors such as diabetes, E/Em ratio, LA pulse pressure, low LA voltage, empirical extra-PV ablation, and radiofrequency ablation duration are associated with stiff LA physiology after AFCA.
FRONTIERS IN PHYSIOLOGY
(2021)
Review
Cardiac & Cardiovascular Systems
Ramanathan Parameswaran, Ahmed M. Al-Kaisey, Jonathan M. Kalman
Summary: Catheter ablation is a key strategy for managing atrial fibrillation, with technological advancements focusing on improving safety and effectiveness. Guidelines recommend the procedure for symptomatic patients with paroxysmal or persistent AF, but evidence from trials is mixed. Pulmonary vein isolation remains a cornerstone technique in AF ablation, with ongoing developments in technology aimed at enhancing patient outcomes.
NATURE REVIEWS CARDIOLOGY
(2021)
Review
Immunology
Dishiwen Liu, Yajia Li, Qingyan Zhao
Summary: Atrial fibrillation (AF) is a serious healthcare burden with high morbidity and complications. Catheter ablation, although curable, currently has a low long-term success rate. Inflammation and fibrosis play significant roles in AF progression, and the artificial inflammatory response caused by catheter ablation may impact long-term prognosis. This review focuses on the different types of inflammatory cell death induced by various ablation techniques, as well as the structural and electrical remodeling caused by inflammation and its association with AF recurrence after catheter ablation. Pulsed-field ablation shows promise as a revolutionary innovation with faster, safer, better tissue selectivity, and less inflammatory response.
JOURNAL OF INFLAMMATION RESEARCH
(2023)
Article
Cardiac & Cardiovascular Systems
Lu Zhou, Liu He, Wei Wang, Changyi Li, Songnan Li, Ribo Tang, Caihua Sang, Nian Liu, Chenxi Jiang, Ronghui Yu, Deyong Long, Xin Du, Jianzeng Dong, Changsheng Ma
Summary: This study aimed to compare the effect of catheter ablation and drug therapy on recurrent AT/AF patients after AF catheter ablation. The results showed that repeat catheter ablation may significantly reduce the risk of composite cardiovascular mortality, ischemic stroke, and major bleeding events compared to medical therapy in patients with recurrent AT/AF after a catheter ablation procedure. However, there were no statistically significant differences between the two groups in terms of secondary endpoints.
Review
Cardiac & Cardiovascular Systems
Zhi-Jie Mao, Yan Pei, Hui Lin, Yin Xiang, Zhou-Qing Huang, Fang-Yi Xiao, Yi-He Chen
Summary: High-power radiofrequency catheter ablation shows superior efficacy in maintaining sinus rhythm for patients with atrial fibrillation, while also reducing procedure and fluoroscopy times. Additionally, there is no significant difference in the risk of complications between high-power and conventional-power ablation techniques.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Review
Medicine, General & Internal
Francesco Maria Angelo Brasca, Roberto Mene, Giovanni Battista Perego
Summary: Atrial fibrillation (AF) is a common arrhythmia, especially in patients with structural heart disease (SHD). Catheter ablation (CA) has emerged as an effective strategy for rhythm control in AF patients and has potential benefits beyond symptom relief. This review summarizes the current knowledge of CA in SHD patients.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Cardiac & Cardiovascular Systems
Roberto Keegan, Leonardo Onetto, Franco Gregorietti, Ricardo Urruti, Luigi Di Biase
Summary: Andersen-Tawil syndrome type 1 is a rare genetic disease characterized by muscular paralysis and various arrhythmias. Catheter ablation is considered as a treatment option for patients with monomorphic arrhythmias, but the exact mechanism and location of successful ablation is still unclear.
JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Stephan List, Christian Meinhardt, Julian Mueller, Thomas Deneke, Sebastian Barth, Christian Waechter, Ulrich Luesebrink, Albrecht Elsaesser, Alexander Arlt, Philipp Halbfass
Summary: The aim of this study was to evaluate the incidence of ablation-induced esophageal lesions and gastroparesis in patients undergoing high-power short-duration atrial fibrillation ablation using different target ablation index values. The results showed that 18.5% of patients had esophageal lesions or gastroparesis after ablation, and this was associated with higher ablation index values and lower body mass index.
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Fengwei Zou, Luigi Di Biase, Sanghamitra Mohanty, Xiaodong Zhang, Sai Shishir Shetty, Carola Gianni, Domenico G. G. Della Rocca, Aung Lin, Roberto Arosio, Marco Schiavone, Giovanni Forleo, Angel Mayedo, Bryan MacDonald, Amin Al-Ahmad, Mohamed Bassiouny, G. Joseph Gallinghouse, Rodney Horton, John D. D. Burkhardt, Andrea Natale
Summary: This study found that 1/4 of patients undergoing PVC ablation had AF, and patients with AF had lower long-term success rates. This is likely due to older age, worse LV function, and higher prevalence of multiple PVC morphologies in patients with concurrent AF.
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Luigi Di Biase, Jacopo Marazzato
Article
Cardiac & Cardiovascular Systems
Sanjeev Saksena, April Slee, Andrea Natale, Dhanunjaya R. Lakkireddy, Dipen Shah, Luigi Di Biase, Thorsten Lewalter, Rangadham Nagarakanti, Pasquale Santangeli
Summary: Prevalent atrial fibrillation is associated with increased cardiovascular death and hospitalizations in heart failure patients with preserved ejection fraction. It has an independent impact on cardiovascular disease and heart failure morbidity.
Article
Cardiac & Cardiovascular Systems
Sanghamitra Mohanty, John D. Burkhardt, Luigi Di Biase, Prasant Mohanty, Sai Shishir Shetty, Carola Gianni, Domenico G. Della Rocca, Karim K. Baho, Trevor Morris, Angel Mayedo, Bryan MacDonald, Amin Al-Ahmad, Mohamed Bassiouny, Gerald Joseph Gallinghouse, Rodney Horton, Andrea Natale
Summary: This study aimed to compare the clinical benefits between targeted ablation of all Premature ventricular complex (PVC) morphologies and ablation of predominant PVC only. Analysis of 171 patients with reduced LVEF and high PVC burden (>10%/day) showed that ablation of all PVC morphologies was associated with significantly lower PVC burden and improvement of LVEF at long-term follow-up, compared with ablation of the dominant morphology only.
Article
Cardiac & Cardiovascular Systems
Domenico G. Della Rocca, Michele Magnocavallo, Christoffel J. Van Niekerk, Thomas Gilhofer, Grace Ha, Gabriele D'Ambrosio, Sanghamitra Mohanty, Carola Gianni, Jennifer Galvin, Giampaolo Vetta, Carlo Lavalle, Luigi Di Biase, Antonio Sorgente, Gian-Battista Chierchia, Carlo de Asmundis, Lukas Urbanek, Boris Schmidt, J. Christoph Geller, Dhanunjaya R. Lakkireddy, Moussa Mansour, Jacqueline Saw, Rodney P. Horton, Douglas Gibson, Andrea Natale
Summary: Chronic kidney disease has prognostic value in patients undergoing percutaneous left atrial appendage occlusion, affecting the risks of thrombo-embolism and major bleeding.
Editorial Material
Cardiac & Cardiovascular Systems
Lucas Boersma, Luigi Di Biase, Stylianos Tzeis
Article
Cardiac & Cardiovascular Systems
Luigi Di Biase, Fengwei Zou, Aung N. Lin, Vito Grupposo, Jacopo Marazzato, Nicola Tarantino, Domenico Della Rocca, Sanghamitra Mohanty, Andrea Natale, Majd Al Deen Alhuarrat, Guy Haiman, David Haimovich, Richard A. Matthew, Jaclyn Alcazar, Graca Costa, Roy Urman, Xiaodong Zhang
Summary: This study aimed to evaluate the feasibility of a new deep learning imaging algorithm in comparison to cardiac computed tomography (CT) for left atrial anatomical rendering during atrial fibrillation (AF) ablation. The algorithm successfully reconstructed the anatomical structures of the left atrium and showed comparable results to CT measurements. The integration of this algorithm with intracardiac echocardiography (ICE) has the potential to streamline the workflow of AF ablation.
Editorial Material
Cardiac & Cardiovascular Systems
Fengwei Zou, Luigi Di Biase
Review
Cardiac & Cardiovascular Systems
Andrea Natale, Katja Zeppenfeld, Paolo Della Bella, Xu Liu, Avi Sabbag, Pasquale Santangeli, Philipp Sommer, Christian Sticherling, Xiaodong Zhang, Luigi Di Biase
Summary: This article discusses the history, current state, and future directions of ventricular tachycardia ablation, highlighting the importance of Europace journal as a platform for publishing groundbreaking research in this field.
Article
Cardiac & Cardiovascular Systems
Majd Al Deen Alhuarrat, Sumant Pargaonkar, Kusha Rahgozar, Israel Safiriyu, Xiadong Zhang, Robert T. Faillace, Luigi Di Biase
Summary: The study aims to examine the differences in outcomes between sexes in patients undergoing Watchman device implantation for left atrial appendage occlusion (LAAO). The results suggest that females are more likely to experience cardiac, renal, bleeding, pulmonary, and TEE-related complications following LAAO, and they also have higher mortality rates, longer hospital stays, and higher rates of discharge to facilities.
Article
Cardiac & Cardiovascular Systems
Paige Mass, Justin Opfermann, R. T. Vito Grupposo, Luigi DiBiase, Charles I. Berul, Bradley C. Clark
Summary: This study evaluated the impact of a novel catheter torque tool (Peritorq) on catheter integrity during the use of diagnostic and ablation catheters in an adult porcine model. The results showed that there were no significant differences in catheter measurements with and without the torque tool. Subjective assessment by the operator indicated significant improvements in maneuverability and stability using the torque tool, with no significant impact on catheter integrity.
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
(2023)
Article
Medicine, General & Internal
Julian Mueller, Karin Nentwich, Artur Berkovitz, Kai Sonne, Olena Kozlova, Sebastian Barth, Alexandru Deacanu, Christian Waechter, Philipp Halbfass, Heiko Lehrmann, Thomas Deneke
Summary: This study investigated the characteristics of patients undergoing redo AF ablation and the impact of different ablation strategies. The results showed that pulmonary vein reconnection was common among all techniques of AF ablation, and different ablation strategies did not improve long-term success.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Fengwei Zou, David Flomenbaum, Nilarun Chowdhuri, Vito Grupposo, Luigi Di Biase, Xiaodong Zhang
Summary: This case report presents a successful ablation procedure in a patient with rare anatomical abnormalities. The procedure was performed through a unique approach and was found to be both feasible and safe with the support of various tools.
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
(2023)
