Implementation of lead V8 as a simple non-invasive tool to improve patient selection in CRT and guide LV lead placement.

Background And Aims: CRT improves outcomes in heart failure patients with electrical dyssynchrony. The QLV interval, a marker of delayed left ventricular (LV) activation, independently predicts CRT response. This study aimed to determine whether activation time measured in surface ECG lead V8 reflects postero-lateral LV delay by correlating with the QLV interval during biventricular (BiV) CRT implantation.

PRevention of sudden cardiac death aFter myocardial infarction by defibrillator implantation: Design and rationale of the PROFID EHRA randomized clinical trial.

Background: Randomized clinical trials from over 20 years ago demonstrated that an implantable cardioverter defibrillator (ICD) improved survival for patients with severely reduced left ventricular ejection fraction (LVEF) after myocardial infarction (MI) compared with optimal medical therapy (OMT) alone. Since then advances in therapy have led to the reduction in the incidence of sudden cardiac death (SCD) in this population, whilst complication rates from ICD implantation are still substantial.

Objectives: To determine whether OMT without ICD implantation is not inferior to OMT with ICD implantation with respect to all-cause mortality.

Effectiveness and Safety of Intramyocardial Needle Ablation for Refractory Ventricular Tachycardia and Premature Ventricular Complexes: A Systematic Review and Meta-Analysis.

Introduction: Intramyocardial needle ablation is a novel technique for treating refractory ventricular tachycardia (VT) and premature ventricular complexes (PVC). However, studies defining the effectiveness and safety of this procedure are limited. This meta-analysis aims to evaluate the safety and effectiveness of needle ablation for VT and PVC refractory to standard ablation.

Innate Immunity and Platelets: Unveiling Their Role in Chronic Pancreatitis and Pancreatic Cancer.

Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive and lethal forms of cancer, characterized by a highly desmoplastic tumor microenvironment. One main risk factor is chronic pancreatitis (CP). Progression of CP to PDAC is greatly influenced by persistent inflammation promoting genomic instability, acinar-ductal metaplasia, and pancreatic intraepithelial neoplasia (PanIN) formation.

Pulsed field ablation: The basics relating to effectiveness, durability, and safety.

Pulsed field ablation (PFA) represents an innovative energy delivery approach for cardiac arrhythmia treatment, characterized by a favorable safety profile and effective myocardial lesion formation. It has demonstrated high acute pulmonary vein isolation rates with a reduced incidence of injury to adjacent anatomical structures. Nonetheless, procedure-specific complications such as haemolysis, intravascular gas formation, and coronary vasospasm have been observed and warrant further evaluation.

PVI With CF-Sensing Large-Tip Focal PFA Catheter With 3D Mapping for Paroxysmal AF: Omny-IRE 3-Month Results.

Background: Omny-IRE (A Study For Treatment of Paroxysmal Atrial Fibrillation [PAF] With the OMNYPULSE Catheter and the TRUPULSE Generator) evaluated safety and effectiveness of a novel large-tip focal, multielectrode, contact force-sensing, pulsed field ablation catheter with electroanatomic mapping integration.

Objectives: This study sought to assess 3-month safety and effectiveness of the platform for treating symptomatic paroxysmal atrial fibrillation.

Methods: Pulmonary vein isolation (PVI) was performed using the OMNYPULSE Platform.

Pulsed Field Ablation for Persistent Atrial Fibrillation: 1-Year Results of ADVANTAGE AF.

Background: Pulsed field ablation (PFA) has gained prominence for pulmonary vein isolation (PVI) to treat atrial fibrillation, but there are limited outcome data on PFA to treat persistent atrial fibrillation (PerAF).

Objectives: This study sought to determine the safety and efficacy of PVI + posterior wall ablation (PWA) with PFA in PerAF.

Methods: ADVANTAGE AF (A Prospective Single Arm Open Label Study of the FARAPULSE Pulsed Field Ablation System in Subjects with Persistent Atrial Fibrillation) is a prospective, single-arm, multicenter pivotal investigational device exemption study of PerAF patients undergoing PVI+PWA with the pentaspline PFA catheter.

Safety and effectiveness of a novel balloon-in-basket pulsed-field ablation catheter for the treatment of paroxysmal and persistent AF: Volt-AF IDE trial acute results.

Background: Increasing use of Pulsed Field Ablation (PFA) to treat atrial fibrillation (AF) has led to concerns related to tissue contact, hemolysis, and electroanatomic mapping integration. A novel balloon-in-basket PFA catheter offers form and function to address these concerns.

Objective: The VOLT-AF Investigational Device Exemption (IDE) study is a prospective, single-arm global IDE study designed to demonstrate the Volt PFA system (Abbott Laboratories, Chicago, Illinois) is safe and effective for the treatment of paroxysmal AF (PAF) and persistent AF (PersAF).

Pulsed Field Ablation of Persistent Atrial Fibrillation With Continuous Electrocardiographic Monitoring Follow-Up: ADVANTAGE AF Phase 2.

Background: There are sparse high-quality safety and effectiveness data for pulsed field ablation (PFA) of persistent atrial fibrillation (PerAF), in which lesions beyond pulmonary vein isolation (PVI) are often placed. In addition, no large trials have used insertable cardiac monitors for continuous rhythm monitoring after ablation in patients with PerAF or after PFA in any atrial fibrillation population. In Phase 2 of the ADVANTAGE AF study (A Prospective Single Arm Open Label Study of the FARAPULSE Pulsed Field Ablation System in Subjects With Persistent Atrial Fibrillation), patients with PerAF underwent PFA for PVI and posterior wall ablation (PWA) and, in a subcohort, cavotricuspid isthmus ablation for typical atrial flutter.

Acute Procedural Results of Pulsed Field Cryoablation for Persistent Atrial Fibrillation: Multicenter First-in-Human PARALELL Trial.

Introduction: Pulsed Field Cryoablation (PFCA) is a dual-energy cardiac ablation modality consisting of short-duration ultra-low temperature cryoablation (ULTC) followed immediately by pulsed field ablation (PFA) delivered from the same catheter. It is hypothesized that PFCA may improve contact stability during PFA, while maintaining lesion depth and effectiveness of ULTC.

Methods: PARALELL is a first-in-human multicenter study evaluating safety and effectiveness of a novel PFCA catheter and system in patients with persistent atrial fibrillation (PsAF) using the combination of pulmonary vein (PVI) and posterior wall (PWI) isolation.

Intracardiac electrogram analysis may allow for prediction of lesion transmurality after pulsed field ablation of atria in a porcine model.

Background: Pulsed field ablation (PFA) is a novel cardiac ablation modality with an increasing clinical acceptance in treatment of atrial fibrillation due to its clinical efficacy and excellent safety profile. However, intraprocedural guidance for PFA to ensure durable pulmonary vein isolation (PVI) is lacking.

Objective: We quantified changes in intracardiac electrograms (iEGMs) following PFA and radiofrequency ablation (RFA) and investigated their applicability for prediction of lesion transmurality.

Artificial intelligence for individualized treatment of persistent atrial fibrillation: a randomized controlled trial.

Although pulmonary vein isolation (PVI) has become the cornerstone ablation procedure for atrial fibrillation (AF), the optimal ablation procedure for persistent and long-standing persistent AF remains elusive. Targeting spatio-temporal electrogram dispersion in a tailored procedure has been suggested as a potentially beneficial alternative to a conventional PVI-only procedure. In this multicenter, randomized, controlled, double-blind, superiority trial, patients with drug-refractory persistent AF were randomly assigned to a tailored ablation procedure targeting areas of spatio-temporal dispersion, as detected by an artificial intelligence (AI) algorithm, in addition to PVI (tailored arm, n = 187, 23% women) or to a conventional PVI-only procedure (anatomical arm, n = 183, 19% women).

Electrographic Flow Mapping Provides Prognosis for AF Ablation Outcomes Across Two Independent Prospective Patient Cohorts.

Electrographic flow (EGF) mapping allows for the visualization and quantification of atrial fibrillation (AF) wavefront propagation patterns. EGF-identified sources were shown in the randomized controlled trial to significantly increase the likelihood of AF recurrence within 1 year if left unablated. Electrographic flow consistency (EGFC) additionally measures the stability of observed wavefront patterns, such that patients with more organization have a healthier substrate and lower recurrence.

Effect of Sequential, Colocalized Radiofrequency and Pulsed Field Ablation on Cardiac Lesion Size and Histology.

Background: Sequential application of radiofrequency with pulsed field (PF) ablation may increase lesion depth while preserving the advantages of PF. The study's aim was to determine lesion dimensions of sequential, colocalized radiofrequency and PF ablation.

Methods: A preclinical study using swine (n=4) performed lesions in the right/left ventricles.

First-in-human trial of atrial fibrillation ablation using real-time tissue optical assessment to predict pulsed field lesion durability.

Aims: Loss of bipolar electrograms immediately after pulsed field ablation (PFA) makes lesion durability assessment challenging.

Objective: The aim of this trial (NCT06700226) was to evaluate a novel ablation system that can optically predict lesion durability by detecting structural changes in the tissue during ablation.

Methods And Results: Patients with paroxysmal atrial fibrillation underwent pulmonary vein isolation (PVI) using PFA (AblaView®, MedLumics).

AF-FLOW Global Registry Confirms Validity of Electrographic Flow Mapping as a Phenotyping Tool for Atrial Fibrillation.

Background: Electrographic flow (EGF) mapping allows for the visualization of global atrial wavefront propagations. One mechanism of initiation and maintenance of atrial fibrillation (AF) is stimulation from EGF-identified focal sources that serve as driver sites of fibrillatory conduction. Electrographic flow consistency (EGFC) further quantifies the concordance of observed wavefront patterns, indicating that a healthier substrate shows more organized wavefront propagation and higher EGFC.

The Protective Effect of IL-17A in Pneumonic Plague Can Be Compensated by Effective Vaccines and Immunization Strategies in Mice.

Plague, caused by , poses a public health threat not only due to sporadic outbreaks across the globe but also due to its potential as a biothreat agent. Ironically, among the seven deadliest pandemics in global history, three were caused by . Pneumonic plague, the more contagious and severe form of the disease, is difficult to contain, requiring either prophylactic antibiotic treatment or vaccination.

Biophysics and electrophysiology of pulsed field ablation in normal and infarcted porcine cardiac ventricular tissue.

Pulsed Field Ablation (PFA) is a new ablation method being rapidly adopted for treatment of atrial fibrillation, which shows advantages in safety and efficiency over radiofrequency and cryo-ablation. In this study, we used an in vivo swine model (10 healthy and 5 with chronic myocardial infarct) for ventricular PFA, collecting intracardiac electrograms, electro-anatomical maps, native T1-weighted and late gadolinium enhancement MRI, gross pathology, and histology. We used 1000-1500 V pulses, with 1-16 pulse trains to vary PFA dose.

Collective dynamics on constrained three-lane exclusion process.

The motivation behind the proposed study stems from multilane traffic systems with finite availability of particles. Our investigation revolves around a totally asymmetric simple exclusion process incorporating a finite reservoir and the occurrence of lane-switching phenomena. The study delves into the system's characteristics, including phase diagrams, density profiles, phase transitions, finite-size effects, and shock positions.

2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation.

In the last three decades, ablation of atrial fibrillation (AF) has become an evidence-based safe and efficacious treatment for managing the most common cardiac arrhythmia. In 2007, the first joint expert consensus document was issued, guiding healthcare professionals involved in catheter or surgical AF ablation. Mounting research evidence and technological advances have resulted in a rapidly changing landscape in the field of catheter and surgical AF ablation, thus stressing the need for regularly updated versions of this partnership which were issued in 2012 and 2017.

Arrhythmogenicity of monophasic and biphasic PFA waveforms in a porcine model.

Objective: The potential risk of inducing ventricular arrhythmias was explored by employing pulsed field ablation (PFA) through the administration of both monophasic and biphasic waveform deliveries.

Methods: PFA was applied to specific locations in the right ventricle (RV, n = 5 sites) in swine (n = 2), utilizing identical settings with consistent amplitude, pulse width, and a number of pulses for both monophasic and biphasic waveforms. PFA deliveries were precisely timed in 10-ms intervals across the entire T wave.