Pulsed-Field Ablation of Atrial Flutter: Insights From a Large Volume U.S. Center.

Background: Pulsed-field ablation (PFA) is increasingly used in clinical practice for atrial fibrillation, but its utility in atrial flutter (AFL) ablation is not yet established.

Objectives: This study sought to evaluate the safety, effectiveness, and procedural outcomes of PFA in treating AFL across different subtypes.

Methods: This study included 311 consecutive patients undergoing ablation of 368 AFLs using PFA.

Safety of Same-Day Discharge Following Pulsed-Field Ablation Versus Radiofrequency Ablation: A Comparative Analysis.

Background: Same-day discharge (SDD) after catheter ablation is increasingly adopted to improve patient convenience and reduce healthcare costs. While SDD following radiofrequency ablation (RFA) is well-documented, no data exist on SDD in patients undergoing pulsed-field ablation (PFA) for atrial fibrillation (AF).

Objective: To evaluate the safety of SDD in patients undergoing PFA and RFA for AF, with an exploratory comparison of practice patterns and outcomes.

Role of the Bridge balloon in improving the safety of transvenous lead extraction procedures.

Background: Transvenous lead extraction (TLE) procedures are complex and carry an increased risk of superior vena cava (SVC) tears. Approved by the US Food and Drug Administration in February 2016, the Bridge balloon was designed to temporarily occlude the SVC in cases of SVC tears and facilitate surgical repair.

Objective: The purpose of this study was to evaluate the impact of introducing the Bridge balloon into clinical practice on reducing periprocedural mortality during TLE.

Pulsed field ablation with a pentaspline catheter for ventricular arrhythmias: First US series.

Background: Pulsed field ablation (PFA) with a pentaspline catheter has recently been approved by the US Food and Drug Administration for catheter ablation of atrial fibrillation. Evidence of its application for ablation of ventricular arrhythmias remains limited.

Objective: The purpose of this study was to evaluate the safety and efficacy of pentaspline PFA for ventricular arrhythmias.

Prolonged hospitalization after catheter ablation of ventricular tachycardia: Predictors and outcomes.

Background: In patients with structural heart disease undergoing catheter ablation of ventricular tachycardia (VT), prolonged postablation hospitalization may be a predictor of poor outcomes.

Objective: This study sought to identify predictors of prolonged hospitalization after VT ablation and their impact on subsequent outcomes.

Methods: This retrospective cohort study analyzed 318 patient cases undergoing VT ablation from January 2022 to October 2024.

Procedural outcomes and predictors of lead extraction requiring a bailout femoral approach from a prospective registry at a large volume US center.

Background: Transvenous lead extraction (TLE) remains a complex procedure most commonly performed via the superior approach using the initial implant vein. The femoral approach is typically used as a "bailout" strategy aiming to increase success rate.

Objective: The study aimed to evaluate the procedural outcomes and factors associated with the "bailout" femoral approach in TLE.

Outcomes of Concomitant Atrial Fibrillation Ablation and Left Atrial Appendage Closure: A Retrospective Single-Center Experience.

Background: Catheter ablation is an effective therapy in the management of atrial fibrillation (AF). Left atrial appendage closure (LAAC) is an alternative to anticoagulation for stroke prevention in patients with bleeding risks.

Objectives: The purpose of this study was to assess the safety and efficacy of combining AF ablation and LAAC in a single procedure.

Left ventricular mass as a modulator of ventricular arrhythmia risk and sex differences after CRT for nonischemic cardiomyopathy and LBBB.

Background: The risk of ventricular arrhythmias (VAs) after cardiac resynchronization therapy (CRT) has been associated with ischemic disease/scar, sex, and possibly left ventricular mass (LVM).

Objective: The purpose of this study was to evaluate sex differences and baseline/postimplant change in LVM on VA risk after CRT implantation in patients with nonischemic cardiomyopathy and left bundle branch block.

Methods: In patients meeting the criteria, baseline and follow-up echocardiographic images were obtained for LVM assessment.

Comparison of outcomes and required tools between transvenous extraction of pacemaker and implantable cardioverter defibrillator leads: Insight from single high-volume center experience.

Introduction: Reports of comparison with procedural outcomes for implantable cardioverter defibrillator (ICD) and pacemaker (PM) transvenous lead extraction (TLE) are old and limited. We sought to compare the safety, efficacy, and procedural properties of ICD and PM TLE and assess the impact of lead age.

Methods: The study cohort included all consecutive patients with ICD and PM TLE in the Cleveland Clinic Prospective TLE Registry between 2013 and 2022.

Cryoballoon pulmonary vein isolation versus radiofrequency ablation of the pulmonary veins and left atrial posterior wall: Patient-reported outcomes.

Background: Data are lacking on patient-reported outcomes (PRO) following cryoballoon ablation (CBA) versus radiofrequency ablation (RFA). We sought to evaluate QoL and clinical outcomes of cryoballoon pulmonary vein isolation only (CRYO-PVI-ONLY) versus RFA with PVI and posterior wall isolation (RF-PVI+PWI) in a large prospective PRO registry.

Methods: Patients who underwent AF ablation (2013-2016) at our institution were enrolled in an automated, prospectively maintained PRO registry.

Extraction outcomes of implantable cardioverter-defibrillator leads vary by manufacturer and model family.

Aims: Transvenous lead extraction (TLE) of implantable cardioverter-defibrillator (ICD) leads is considered challenging. The structure of each ICD leads is variable between manufacturer and model families. The net impact of lead family on the safety and effectiveness of TLE is poorly characterized.

Ischemic or Coronary Evaluations in Patients With Monomorphic VT Electrical Storm Undergoing VT Ablation.

Background: Monomorphic ventricular tachycardia (VT) electrical storm (ES) in patients with coronary artery disease is dependent on scarred myocardium. The role of routine ischemic or coronary evaluations before ablation in patients presenting with monomorphic VT storm, without acute coronary syndrome (ACS), remains unknown.

Objectives: This study sought to assess the impact of ischemic or coronary evaluations on procedural outcomes and post-ablation mortality in monomorphic VT storm patients.

Impact of obesity on catheter ablation of atrial fibrillation: Patient characteristics, procedural complications, outcomes, and quality of life.

Introduction: Obesity is a well-known risk factor for atrial fibrillation (AF). We aim to evaluate the effect of baseline obesity on procedural complications, AF recurrence, and symptoms following catheter ablation (CA).

Methods: All consecutive patients undergoing AF ablation (2013-2021) at our center were enrolled in a prospective registry.

Atrial Fibrillation Ablation in Young Adults: Measuring Quality of Life Using Patient-Reported Outcomes Over 5 Years.

Background: Ablation is used for both rhythm control and improved quality of life (QoL) in atrial fibrillation (AF). It has been suggested that young adults may experience high recurrence rates after ablation and data remain lacking regarding QoL benefits. We aimed to investigate AF ablation outcomes and QoL benefits in young adults undergoing AF ablation using a large prospectively maintained registry and automated patient-reported outcomes (PRO).

Clinical predictors of incomplete coronary sinus lead removal during transvenous lead extraction in patients with cardiac resynchronization therapy.

Background: Reports of coronary sinus (CS) lead removal include small studies with short implant durations. Procedural outcomes for mature CS leads removed with long duration implantation are unavailable.

Objective: The purpose of this study was to examine the safety, efficacy, and clinical predictors of incomplete CS lead removal by transvenous lead extraction (TLE) in a large long implant duration cardiac resynchronization therapy patient cohort.