Congenital absence of the left atrial appendage (LAA) is an extremely rare anatomical variation with important implications for the management of atrial fibrillation (AF). Additionally, atrial natriuretic peptide (ANP) production may be compensated by the right atrial appendage (RAA) in cases of congenital LAA deficiency.

Successful (radiofrequency) PVI has no effect on cardiovascular afferent autonomic reflex integrity, despite alterations in heart rate variability (HRV). Therefore, are observations of HRV alterations being predictive of PVI outcomes simply a marker of adequate ablation or does the autonomic nervous system directly influence PVI outcomes?

The left image shows an intraoperative fluoroscopic view with left–right inversion, and the right image is a postoperative noncontrast CT. Both demonstrate the right ventricular lead positioned in the interventricular septum.

The successful elimination of left ventricular (LV) summit premature ventricular contractions (PVCs) using surgical endocardial cryoablation. Guided by preoperative activation mapping, cryoablation was performed during aortic valve replacement without epicardial access. This approach effectively resolved PVCs refractory to catheter ablation.

Intracardiac electrocardiograms were recorded during a narrow QRS supraventricular tachycardia following atrial extrastimulation. What is the mechanism?

During routine heart rate variability recording in an elderly male, bi-peaked R waves were recorded consistently. Initially, it was thought to be because of technical issues, which were ruled out systematically; next, it was believed to have been caused by cardiac pathology, which was evaluated using ECG and echocardiography.

Radiopaque tape offers a practical and effective solution to visualize key anatomical landmarks for safe implantation of extravascular implantable cardioverter defibrillator (EV-ICD).

The initial activation phase of distal bi-EGM of focal PVCs was quantitatively analyzed using 5 numerical parameters, t_½, S, dV/dt, T_s, and De#. From the left to the right: (a) myocardial model showing estimated successful and unsuccessful ablation site; (b) mapping and ablation; (c) ASCII data download and reconstruction; (d) calculation of 5 parameters; (e) results. Among these, t_½, S, and T_s are precise in quantifying the sharpness and earliness of distal bi-EGM, differentiating the near-field from far-field bi-EGM for guiding successful ablation.

Uncommon sites of epicardial accessory pathways: coronary sinus, atrial appendage, aortic cusps.

Tripolar Laplacian electrogram (TLE) is one of the multipolar electrograms. TLE has a lower voltage amplitude than bipolar electrograms for all activation patterns and wavefront angles, and it removes more noise and far-field potentials. TLE is useful for analyzing low-voltage and fractionated electrograms regardless of the wavefront angle.

Dual-chamber leadless pacing with Aveir DR offers a breakthrough alternative for patients at high risk of infection or with limited vascular access. By enabling both atrial and ventricular pacing without transvenous leads, this technology improves AV synchrony and may revolutionize future cardiac rhythm management, including defibrillation and resynchronization therapies.

We encountered a case in which a guidewire and PulseSelect™ catheter became entrapped within a pulmonary vein during atrial fibrillation ablation. Although careful manual traction allowed successful retrieval without complications, the maneuver carried a risk of serious adverse events. Operators should be aware of this rare but important complication and avoid excessive catheter advancement into a distal pulmonary vein to minimize the risk of entrapment.

This cross-tissue transcriptome-wide association study identified five novel AF susceptibility genes (CAMK2D, SPAST2L, CEP68, FKBP7, and SHRMOO3). Elevated expression of FKBP7, CEP68, and CAMK2D increases AF risk, while SPATS2L shows a protective effect, with colocalization analysis implicating CEP68 and SPATS2L as prioritized candidates. This study highlights SPATS2L and CEP68 as potential functional candidate genes in AF pathogenesis.

Significant increase in mortality rates during the first decade (1999–2008), with an annual percent change of 7.80%, followed by a moderate increase from 2008 to 2020. Females had a higher mortality rate compared to males. Among racial groups, NH White individuals had the highest mortality rates.

The smartwatch ECG algorithm achieved 86% sensitivity and 94% specificity with an sAUC of 96%, while manual readings by trained personnel reached 96% sensitivity, 95% specificity, and an sAUC of 98% in a brand-specific subgroup analysis. These findings demonstrate that the smartwatch ECG detects AFib, although 3% of results are unreadable.

CKD and increased LAVI may increase the likelihood of new-onset HF in AF patients, while hypertension, diabetes, CAD, smoking, and obesity were not significant risk factors for new-onset HF in our study.

The effectiveness of implantable cardioverter-defibrillator (ICD) versus amiodarone in cancer patients remains unclear. Using 2010–2015 cancer registry data from 36 hospitals in Osaka, Japan, we found that ICD significantly improves cancer patients' prognosis compared to amiodarone.

Rivaroxaban or apixaban is as safe and effective as VKAs in patients with AF and kidney failure with hemodialysis. Even on oral anticoagulants, these patients remain at high risk of cardiovascular events and all-cause mortality. Integrated care and holistic management are important for this high-risk population.

Residual unipolar voltage at the site of pulmonary vein–left atrium conjunction after pulmonary vein isolation may be related to thicker left atrial wall thickness and larger epicardial adipose tissue volume and be the predictor of atrial fibrillation recurrence, suggesting the non-transmural blockline between pulmonary vein and left atrium.

A neonate with refractory supraventricular tachycardia complicated by necrotizing enterocolitis. Various antiarrhythmic drugs were ineffective, and the tachycardia was controlled with intravenous nifekalant. The accessory pathway was successfully ablated at a weight of 3.0 kg without complications.

This case demonstrates that an immediate superior vena cava (SVC) conduction block may occur during pulsed field ablation (PFA) due to anatomical proximity, a positive tissue proximity index, and a narrow SVC diameter. However, lesions not directly influenced by PFA tend to regress and may be reversible, leading to SVC potential reconduction. CS, coronary sinus; d, distal; LAO, left oblique view; LL, left lateral; p, proximal; PA, posteroanterior view; RA, right atrial; RAO, right oblique view; RSPV, right superior pulmonary vein; RV, right ventricular; SUP, superior view.

Among propensity-matched cohorts eligible for SCD-HeFT, primary prevention ICD/CRT-D reduced the risk of all-cause mortality with an adjusted hazard ratio of 0.616 (p = 0.026). The cumulative incidence of first appropriate therapy in the defibrillator therapy group was nearly identical to that of all-cause death in the conventional therapy group.

MPP or a fused AV delay can improve hemodynamics compared with c-CRT or a short AV delay. Combining MPP and fused AV delay significantly improves hemodynamics. QRS shortening can predict increased dp/dt; however, the effect was not the same between LV and BiV pacing.

A Medtronic MRI-conditional device connected to an MRI-non-conditional VDD lead, which required specific adjustments in MRI mode settings to enable safe imaging. Although switching to MRI mode from VDD mode or VVI mode was not possible, it became possible after switching to DDD mode.

Epicardial radiofrequency ablation significantly reduces recurrent ventricular arrhythmias and ICD shocks in Brugada syndrome, with excellent long-term safety and no reported mortality. Epicardial ablation is an effective strategy for sustained rhythm stabilization.

A lower but also a higher mean contact-force was associated with suboptimal vHPSD applications. Hence, a “16-gram window” of contact-force, from 6 to 22 g, could optimize energy application in vHPSD ablation.

This retrospective study included 232 consecutive persistent atrial fibrillation patients according to the inclusion criteria. Despite patients characteristics with more severe atrial substrates in the Bepridil group, Kaplan–Meier curves showed no significant difference in the AF/AT freedom rate and clinical adverse events between the Bepridil and No-AADs groups. This finding remained consistent after adjusting for baseline characteristics and considering bepridil as a time-dependent covariable. No adverse events related to bepridil were observed during the study.

This study aimed to investigate the differences in the appearance of atrioventricular block (AVB) between cryoablation and radiofrequency (RF) ablation for atrioventricular nodal re-entrant tachycardia (AVNRT). Our findings revealed that cryoablation for AVNRT has a higher incidence of transient AVB than RF ablation. Cryoablation gradually causes atrioventricular conduction disturbances when AVB occurs inadvertently, which takes longer than RF ablation.

An elderly man with a history of a prior inferior wall myocardial infarction underwent ablation for an atypical right atrial flutter. Electroanatomic mapping revealed diffuse scarring on the anterior, anterolateral, and posterior right atrium, presumably due to atrial infarction from the prior inferior wall myocardial infarction, forcing the activation wavefront through an area of slow conduction across the lower end of the crista terminalis, leading to lower loop reentry in a counterclockwise fashion around the inferior vena cava and a 12-lead ECG showing positive flutter waves in the inferior leads reflecting septal activation in a cranio-caudal direction.