Impact of inter-hospital transfers and admissions to transfer hubs on outcomes of cardiac implantable electronic device-associated infective endocarditis.

Background: Transvenous lead extraction/removal (TLE) is recommended for management of cardiac implantable electronic device (CIED)-associated infective endocarditis (IE). The effect of inter-hospital transfer on management and outcomes of CIED-associated IE has not been studied.

Objective: To analyze the impact of inter-hospital transfer on management and outcome of CIED-associated IE.

Premature Ventricular Complexes After Ablation for Paroxysmal Atrial Fibrillation and Recurrent Atrial Arrhythmias: The admIRE Subanalysis.

Background: Premature ventricular complexes (PVCs) have been reported to independently predict incident atrial fibrillation in the general population. The prognostic importance of PVCs after catheter ablation for paroxysmal atrial fibrillation (PAF) is unknown.

Objectives: In patients undergoing catheter ablation for PAF, we assessed whether postablation PVCs influence the risk for recurrence.

HRS call-to-action: Improved MRI access for patients with cardiovascular implantable electronic devices.

Access to magnetic resonance imaging (MRI) remains limited for many patients with cardiovascular implantable electronic devices (CIEDs), despite evidence demonstrating safety under appropriate conditions. This call-to-action statement from the Heart Rhythm Society (HRS) aims to describe persistent barriers to MRI access for patients with a CIED and to provide practical, actionable recommendations for the improvement of clinical care. Developed by a multidisciplinary writing committee, this document addresses regulatory, operational, and institutional challenges; highlights findings from a recent HRS member survey on MRI access; and outlines the impact of evolving vendor-specific MRI exclusions.

HRS/ACC scientific statement: Guiding principles on same-day discharge for intracardiac catheter ablation procedures.

Percutaneous catheter ablation in interventional cardiac electrophysiology has evolved over the past several decades. Technologic advances and evolving procedural strategies have improved procedural efficiencies, increased success rates, and lowered complication rates. These advances have increased the ability to treat more patients successfully; however, limitations to access have grown.

HRS/ACC Scientific Statement: Guiding Principles on Same-Day Discharge for Intracardiac Catheter Ablation Procedures.

Percutaneous catheter ablation in interventional cardiac electrophysiology has evolved over the past several decades. Technologic advances and evolving procedural strategies have improved procedural efficiencies, increased success rates, and lowered complication rates. These advances have increased the ability to treat more patients successfully; however, limitations to access have grown.

Early versus late atrial fibrillation recurrence after pulsed field ablation: insights from the admIRE trial.

Aims: Studies have shown correlations between early recurrence (ER) and late recurrence (LR) of atrial arrhythmia after ablation with thermal technologies. This admIRE trial (NCT05293639) subanalysis aims to analyse ER vs. LR in patients with paroxysmal atrial fibrillation (PAF) undergoing pulsed field ablation (PFA).

Impact of hospital lead extraction volume on management of cardiac implantable electronic device-associated infective endocarditis.

Aims: Utilization of transvenous lead extraction/removal (TLE) for the management of cardiac implantable electronic device (CIED)-associated infective endocarditis (IE) remains low. The aim of this study was to examine the impact of hospital TLE procedural volume on TLE utilization and outcomes for patients with CIED-associated IE.

Methods And Results: Using the Nationwide Readmissions Database, we evaluated 21 545 admissions for patients (mean age 70 years, 39% female) with CIEDs hospitalized with IE at TLE centres.

Design, Testing, and Validation of a Soft Robotic Sensor Array Integrated with Flexible Electronics for Mapping Cardiac Arrhythmias.

Cardiac mapping is a crucial procedure for diagnosing and treating cardiac arrhythmias. Still, current clinical techniques face limitations including insufficient electrode coverage, poor conformability to complex heart chamber geometries, and high costs. This study explores the design, testing, and validation of a 64-electrode soft robotic catheter that addresses these challenges in cardiac mapping.

Pulsed Field Ablation to Treat Paroxysmal Atrial Fibrillation: Safety and Effectiveness in the AdmIRE Pivotal Trial.

Background: Evidence from clinical trials of early pulsed field ablation (PFA) systems in treating atrial fibrillation has demonstrated their promising potential to reduce complications associated with conventional thermal modalities while maintaining efficacy. However, the lack of a fully integrated mapping system, a staple technology of most modern electrophysiology procedures, poses limitations in lesion creation and workflow options. A novel variable-loop PFA catheter integrated with an electroanatomic mapping system has been developed that allows for real-time nonfluoroscopic procedural guidance and lesion indexing as well as feedback of tissue-to-catheter proximity.

Predictors of Shock-Reduction Programming and Its Impact on Implantable Cardioverter-Defibrillator Therapies and Mortality: The CERTITUDE Registry.

Background: Shock-reduction implantable cardioverter-defibrillator programming (SRP) was associated with fewer therapies and improved survival in randomized controlled trials, but real-world studies investigating SRP and associated outcomes are limited.

Methods And Results: The BIOTRONIK CERTITUDE registry was linked with the Medicare database. We included all patients with an implantable cardioverter-defibrillator implanted between August 22, 2012 and September 30, 2021 in the United States.

Left bundle branch area pacing using a stylet-driven, retractable-helix lead: Short-term results from a prospective multicenter IDE trial (the BIO-CONDUCT study).

Background: Left bundle branch area pacing (LBBAP) has swiftly emerged as a safe and effective alternative to right ventricular pacing. Limited data exist on the use of retractable-helix, stylet-driven leads for LBBAP.

Objective: The objective of this study was to prospectively evaluate the performance and safety of a stylet-driven pacing lead in a rigorously controlled multicenter trial to support US market application.

Rates of pulmonary vein reconnection at repeat ablation for recurrent atrial fibrillation and its impact on outcomes among females and males.

Background: Several studies have demonstrated that females have a higher risk of arrhythmia recurrence after pulmonary vein (PV) isolation for atrial fibrillation (AF). There are limited data on sex-based differences in PV reconnection rates at repeat ablation. We aimed to investigate sex-based differences in electrophysiological findings and atrial arrhythmia recurrence after repeat AF ablation METHODS: We conducted a retrospective study of 161 consecutive patients (32% female, age 65 ± 10 years) who underwent repeat AF ablation after index PV isolation between 2010 and 2022.

Localized Re-Entry Is a Frequent Mechanism of De Novo Atypical Flutter.

Background: Limited data exist about the origins and mechanisms of atypical atrial flutter that occurs in the absence of prior ablation or surgery.

Objectives: The aims of this study were to report a large cohort of patients who presented for catheter ablation of de novo atypical flutters, to identify the most common locations and mechanisms of arrhythmia, and to describe outcomes after ablation.

Methods: Demographic, electrophysiological, and outcome data were collected for patients who underwent ablation of de novo atypical flutter.

Early Stroke and Mortality After Percutaneous Left Atrial Appendage Occlusion in Patients With Atrial Fibrillation.

Background: Percutaneous endocardial left atrial appendage occlusion (LAAO) is an alternative therapy for stroke prevention in patients with atrial fibrillation who are poor candidates for oral anticoagulants. Oral anticoagulation is generally discontinued 45 days following successful LAAO. Real-world data on early stroke and mortality following LAAO are lacking.

Safety and Efficacy of a Novel Approach to Pulmonary Vein Isolation Using Prolonged Apneic Oxygenation.

Background: Improved ablation catheter-tissue contact results in more effective ablation lesions. Respiratory motion causes catheter instability, which impacts durable pulmonary vein isolation (PVI).

Objectives: This study sought to evaluate the safety and efficacy of a novel ablation strategy involving prolonged periods of apneic oxygenation during PVI.