Meta-analysis of 2353 paroxysmal AF patients shows pulsed-field ablation (PFA) reduces total procedure time by 39 min and left-atrial dwell time, increases fluoroscopy time by 11 min, and achieves 1-year AF-free survival and safety rates comparable to radiofrequency ablation. High heterogeneity may reflect operator learning curves and catheter workflows.

Device embolization following left atrial appendage closure occurs in 0.6%–1.5% of cases and represents a rare but serious complication that can be effectively managed through tailored percutaneous retrieval strategies with high procedural success rates when performed by experienced operators.

A shorter distance from the cavotricuspid isthmus to the right coronary artery reduces the success rate of achieving first-pass conduction block during cryoablation for cavotricuspid isthmus-dependent atrial flutter, likely due to the warming effect of coronary blood flow.

Spontaneous superior vena cava (SVC)–right atrium (RA) conduction block lines, visualized as white lines using the extended early meets-late (EEML) tool in the CARTO system, were associated with durable long-term SVC isolation, supporting the efficacy of the white-line approach.

This study reveals that respiratory phase and anthropometric parameters significantly impact the xiphoid-to-pericardium distance, with expiration increasing the depth. These findings support the use of preprocedural ultrasound to optimize subxiphoid epicardial access, enhance safety, and inform needle selection based on individual anatomical characteristics.

Targeted ablation of atrial drivers and fragmented potentials showed a trend toward lower atrial fibrillation recurrence and significantly reduced premature atrial contractions, highlighting the bottom region of the left atrium as a promising ablation target in long-standing persistent AF.

Lipid trajectory patterns are linked to cardiovascular outcomes in elderly Asian patients with atrial fibrillation; specifically, stable mid-range total cholesterol and LDL, along with persistently high HDL levels, are associated with improved survival.

This study first measured frequency power profiles during the QRS complex (QRS) in HCM patients. The high-frequency content (150–250 Hz) hidden in the QRS can predict L-VAs in HCM, even if fragmented or notched QRS is not observed.

In patients with repaired congenital heart disease and macro reentrant atrial tachycardias, a strategy of high-density mapping, using a combination of isochronal late activation mapping, activation timing, voltage mapping, and entrainment mapping along with selective ablation targeted to the critical isthmi yields excellent (90%) arrhythmia-free medium-term survival.

Compound motor action potential (CMAP) signals were sharp and stable, with minimal pacing artifacts and far-field ventricular waves. Diaphragmatic CMAP monitoring using a BeeAT catheter positioned in the subdiaphragmatic inferior vena cava appears to offer a feasible and effective approach during cryoballoon ablation.

Dual-chamber open-window mapping (OWM) combined with high-density mapping revealed early atrioventricular conduction on the lateral tricuspid annulus, consistent with a Mahaim fiber. Catheter ablation targeting the ventricular insertion site led to successful elimination of the accessory pathway and noninducibility of tachycardia.

We describe a novel double-balloon technique incorporating a wedged Berman catheter to manage distal collateral drainage from the vein of Marshall (VOM) via a bridge collateral to the great cardiac vein, thereby enabling effective ethanol infusion. This technique may represent a viable alternative for anatomically challenging VOM ethanol infusion cases.

Safe and effective mapping of focal atrial tachycardia from the left atrial appendage using an array catheter enabled successful ablation in a pediatric patient without complications.

Isolated persistent left superior vena cava (PLSVC) provides limited access during transvenous pacemaker implantation. We present a case of implantation of a leadless pacemaker for atrioventricular block with isolated PLSVC. A leadless pacemaker is an alternative strategy to a transvenous pacemaker; however, some technical tips are required: (1) the prevention of the mis-insertion in the dilated coronary sinus and (2) the pre-assessment of the anatomy of the right atrium and ventricle.

The use of extremely low-dose amiodarone (50 mg once daily) was safe and effective in Japanese patients with persistent AF. A low baseline KL-6 level may indicate patients at lower risk for amiodarone-related interstitial pneumonia.

The objective of the study was to evaluate the prognostic implications of the arrhythmic and QTc burden in Takotsubo cardiomyopathy. We found that atrial arrhythmias and ventricular arrhythmias significantly increased in-hospital morbidity and mortality, while prolonged QTc only increased in-hospital morbidity. It is critically important to recognize this high-risk and unique subset of Takotsubo patients in order to optimally treat and improve clinical outcomes.

This case report describes the first occurrence of capture of the left bundle branch by a temporary pacing catheter that inadvertently perforated the interventricular septum during a transcatheter aortic valve implantation.

Extracardiac vagal stimulation (ECVS) is a novel, safe tool inducing controlled AV/VA block. It assists SVT differential diagnosis, pathway unmasking, and ablation endpoint confirmation, adding value to EP procedures for supraventricular tachycardias.

The prevalence of cancer increased with time in view of cardio-oncology or oncocardiology, which has organically developed as a new discipline. The data showed similar patterns of distribution in patients with both arrhythmias and ischemic heart diseases.

This systematic review aims to determine whether MVS reduces the incidence of VA and SCD in patients with MVP. Available studies show a likely reduction when surgery is performed in line with current guideline-directed indications; however, a residual risk of VA and SCD remains.

We observed that an increase in the right ventricular (RV) pacing threshold tended to precede that of the His-bundle threshold. Multivariate analysis identified two predictors of chronic threshold deterioration: an RV pacing threshold ≥ 3.0 V/0.4 ms at 1 week after implantation and the lead shape at the time of implantation.

Taking advantage of the characteristics of the novel compact external loop recorder (ELR; eMEMO®), we investigated the usefulness of ELR measurement. As a result, the patch-type ELR, which is waterproof and can continuously record regardless of restrictions such as bathing or exercise, is useful for detecting stable arrhythmias in patients.

Impact of Aortomitral Continuity Calcification on Conduction Disturbances After TAVI with the Myval Valve.

This study evaluates the impact of different CIED lead types (ICD, RV-PM, His-PM) on the progression of tricuspid regurgitation (TR). The effect of CIED leads on TR grade represents a spectrum related to the type of lead traversing the tricuspid valve.

Prevalence of cardiac fibrosis and sarcoidosis in patients with advanced conduction system disease.

AI-ECG risk classification in a community-based health screening program was associated with AF detection through 7-day monitoring. Detection rates increased with risk level, especially in older adults, supporting its potential as a population-based screening tool.

Successful catheter ablation of frequent PVCs in a patient with PVC-induced cardiomyopathy resulted in a marked improvement in left ventricular ejection fraction (LVEF), accompanied by complete resolution of migraine with aura attacks. This case illustrates both cardiac and neurological benefits of PVC burden reduction through ablation.

This meta-analysis of six cohort studies (n = 1,183) found that athletes with transvenous or subcutaneous ICDs had 13% appropriate and 4% inappropriate shock rates, with no serious adverse events. Findings support individualized return-to-play decisions, considering arrhythmia type, ICD programming, and psychological support.

While a magnetic flux density of 10 Gauss could potentially cause electromagnetic interference, tablets have a magnetic flux density exceeding 600 Gauss. Tablets may generate a sufficiently strong magnetic flux density to interfere with cardiac devices implanted in the abdomen.

ICE is a viable alternative to TEE for guiding LAAO in atrial fibrillationpatients unable to tolerate anti-coagulants, especially those unfit for general anesthesia. It offers high procedural success, reduced device use, and comparable safety, though with a slightly increased risk of pericardial effusion.

This study on 13 Cardiac implantable electronic device (CIED) models revealed that surface magnetic fields of tablets, laptops, smartphones, and household magnets exceeded 10 G, potentially triggering magnet response mode. Activation occurred at ≤15 mm for electronic devices and ≤7 mm for household magnets. Magnet response was not observed >18 mm. These findings underscore the risk of unintended magnet response at close proximity, necessitating patient education and healthcare professional awareness regarding safe device use and variable magnet mode operation across CIED manufacturers.

High-power ablation guided by lesion size index (HP-LSI) results in fewer pulmonary vein conduction gaps, shorter procedural time, and improved long-term rhythm outcomes compared to the high-power, time-restricted (HPSD) strategy.

We enrolled 50 ablation sites (12, 10, 8.5, and 5.5 W) in 11 patients where the esophageal temperature reached 39°C within 5 s after ablation. Although ablation duration was correlated with power settings, total energy and maximal esophageal temperature did not differ significantly among the 4 groups.

The comparison of long-term sinus node function between atrial fibrillation (AF) patients with sick sinus syndrome (SSS) who underwent pulmonary vein isolation (PVI) alone versus those who received additional empirical superior vena cava isolation (SVCI). At 36 months following the final ablation procedure, no significant differences were observed between the groups in terms of minimum heart rate, maximum sinus pause duration, or pacemaker implantation avoidance rate.

An integrated transseptal wire system enabled successful left atrial access through the elastic resistance posed by a large GORE CARDIOFORM ASD occluder after failed RF needle attempt, allowing large-bore cryoballoon sheath advancement via sequential sheath technique for atrial fibrillation ablation without procedural complications.

Lead-associated endocarditis, characterized by large vegetations, poses a significant risk of embolization during transvenous lead extraction, necessitating surgical intervention that may be contraindicated in critically ill patients. We describe a successful catheter-based debulking of massive vegetation extending to the right ventricular apex using a steerable sheath and leadless retrieval system.

Left atrial intramural hematoma (LAIH) is an exceedingly rare complication that occurs following catheter ablation in the right atrium. The present case is the first to implicate coronary sinus catheter manipulation—rather than left atrial intervention—as a potential mechanism of LAIH.