Sex-Related Differences in Non-Pulmonary Vein Triggers During Initial Atrial Fibrillation Ablation.

Importance: Atrial fibrillation (AF) ablation aims to eliminate all AF triggers. Non-pulmonary vein (PV) triggers are observed in up to 10% of patients referred for a first AF ablation procedure. However, there are limited data on sex-specific differences in non-PV triggers.

Intracardiac echocardiography for left ventricular diastolic function assessment during atrial fibrillation ablation.

Background: Left ventricular (LV) diastolic dysfunction is associated with the development of atrial fibrillation (AF) and risk of recurrence after ablation. The use of an intracardiac echocardiography (ICE) for diastolic function assessment during ablation procedures has not been evaluated.

Objectives: To evaluate the feasibility and utility of ICE obtained measures of LV diastolic function including peak tricuspid regurgitation velocity, trans-mitral flow velocity, mitral annular tissue Doppler velocities, and pulmonary vein flow velocities in patients undergoing AF ablation.

Incidence of Pacing-Induced Cardiomyopathy Among Patients With Leadless Versus Transvenous Ventricular Pacemakers.

Background: Frequent nonphysiological ventricular pacing and resultant pacing-induced cardiomyopathy are well characterized in transvenous pacemakers (TVP). The incidence of pacing-induced cardiomyopathy in leadless pacemakers (LP) is less understood, particularly compared with TVP.

Methods: We utilized the TriNetX Analytics Network database to identify 2594 propensity score-matched patients who underwent implantation of LP and TVP between January 1, 2016, and January 1, 2023.

Polysomnography validation of SANSA to detect obstructive sleep apnea.

Study Objectives: Evaluate the performance of a novel home sleep apnea test with embedded ECG (SANSA, Huxley Medical, Inc.) in the diagnosis of obstructive sleep apnea (OSA).

Methods: This prospective multicenter validation study included 340 participants who underwent simultaneous polysomnography (PSG) and SANSA recordings across 7 clinical sites.

Temporary Restoration of Sinus Rhythm Improves Outcomes of Catheter Ablation for Longstanding Persistent Atrial Fibrillation.

Background: Long-standing persistent atrial fibrillation (LSPAF) is associated with adverse atrial structural and electrical remodeling, limiting the success of catheter ablation (CA).

Objective: To determine whether temporary restoration of sinus rhythm (TRSR) can improve the single procedure efficacy of CA in patients with LSPAF.

Methods: Patients with LSPAF undergoing their first CA between 2016 and 2022 were included.

Catheter ablation of atrial fibrillation in patients with cardiac amyloidosis and sarcoidosis: procedural findings and outcomes.

Aims: The diagnosis of infiltrative cardiomyopathies has increased over last years. Catheter ablation is becoming the preferred approach for managing atrial fibrillation (AF) in these patients. This study aims to characterize differences in procedural findings during AF ablation in patients with and without infiltrative cardiomyopathies.

HRS Scientific Documents Methodology Manual: Executive summary.

The Heart Rhythm Society (HRS) Scientific Documents Pathway was established to support the development of high-quality, evidence-informed scientific statements that advance the field of electrophysiology through the synthesis and communication of foundational knowledge, translational insights, and emerging trends. Unlike clinical practice guidelines, scientific documents are not designed to offer practice recommendations. Instead, they provide a framework for understanding scientific domains that impact the arrhythmia care community.

Epicardial placement of implantable cardioverter-defibrillators in adults: Technical considerations, system performance, and clinical outcomes.

Background: Surgical implantation of epicardial implantable cardioverter-defibrillator (ICD) is considered when transvenous ICD placement is not feasible because of congenital anomalies, venous obstruction, or prior infections. Epicardial pacemakers are well-studied but less is known about contemporary epicardial ICD systems in adults.

Objectives: This case series details the indications, techniques, safety, and long-term performance of surgically implanted epicardial high voltage (HV) coils and leads in adults.

Coronary venous ethanol infusion for treatment of refractory ventricular arrhythmias.

Background: Coronary venous ethanol infusion or coronary venous ethanol ablation (CVEA) has been used to treat ventricular arrhythmias (VAs) refractory to radiofrequency ablation (RFA).

Objective: This single-center study aimed to describe acute- and subacute-term safety and efficacy of CVEA for the management of refractory VAs.

Methods: Patients who underwent CVEA for refractory ventricular tachycardia (VT) or premature ventricular contractions (PVCs) at our center were included.

Ablation of ventricular tachycardia from right ventricular aneurysms in patients with arrhythmogenic cardiomyopathy guided by intracardiac echocardiography.

Background: The best approach for ablating ventricular tachycardia (VT) targeting right ventricular (RV) free wall aneurysms in arrhythmogenic right ventricular cardiomyopathy (ARVC) remains undefined.

Objective: We aimed to describe the technical approach, safety, and long-term efficacy of endocardial ablation of VT originating from RV free wall aneurysms in ARVC patients.

Methods: We identified ARVC patients with VT mapped to intracardiac echocardiography (ICE)-defined RV free wall aneurysms who underwent endocardial ablation targeting the aneurysmal area.

Multidiagnostic chest-worn patch to detect obstructive sleep apnea and cardiac arrhythmias.

Study Objectives: Evaluate the performance of the SANSA device to simultaneously assess obstructive sleep apnea and cardiac arrhythmias.

Methods: Participants suspected or known to have obstructive sleep apnea underwent polysomnography while wearing SANSA. SANSA's algorithm was trained using 86 records and tested on 67 to evaluate training bias.

Spatial ventricular gradient is associated with pacing-induced cardiomyopathy.

Background: Pacing-induced cardiomyopathy (PICM) is a frequent complication of right ventricular pacing that often requires reoperation for biventricular or conduction system pacing. Better methods for predicting PICM may inform initial pacing strategy and follow-up monitoring.

Objective: The purpose of this study was to determine whether the spatial ventricular gradient (SVG), a vectorcardiographic marker of ventricular electrical and mechanical heterogeneity, is associated with the subsequent development of PICM.

Preprocedural Screening Tool to Guide Nonpulmonary Vein Trigger Testing in First-Time Atrial Fibrillation Ablation.

Background: Patients undergoing first-time atrial fibrillation (AF) ablation can benefit from targeting non-pulmonary vein (PV) triggers. Preprocedural identification of high-risk individuals can guide planning of ablation strategy. This study aimed to create a preprocedural screening tool to identify patients at risk of non-PV triggers during first-time AF ablation.