Percutaneous Aspiration Thrombectomy in Patients With Persistent Left Atrial Appendage Thrombus: A Case Series.

Background: Persistent left atrial appendage (LAA) thrombosis in patents with contraindications or who are refractory to intensive antithrombotic therapy remains a clinical challenge. Although LAA closure with limited manipulation is performed in patients with small distal nonmobile thrombi, larger more proximal mobile thrombi are usually deemed a contraindication to percutaneous LAA closure due to the inherent risk of iatrogenic thromboembolism. In this population, percutaneous aspiration thrombectomy (AT) is a potential treatment modality.

2025 SCAI/HRS clinical practice guidelines on transcatheter left atrial appendage occlusion.

Background: Left atrial appendage occlusion (LAAO) devices reduce the risk of atrial fibrillation-associated stroke relative to no oral anticoagulation. However, uncertainty and practice variation persist in the areas of patient selection, periprocedural imaging, adjunctive antithrombotic therapy, and management of peridevice leak (PDL) and device-related thrombus. The Society for Cardiovascular Angiography & Interventions and Heart Rhythm Society developed these evidence-based guidelines to support clinicians, patients, and other stakeholders in management decisions regarding LAAO.

Remote monitoring of leadless pacemakers using a novel conductive telemetry communication method.

Background: Remote care has become part of the standard of care for cardiac rhythm device management. The Aveir™ single-chamber (AR and VR) and dual-chamber (DR) leadless pacemaker (LP) systems (Abbott, Abbott Park, IL) utilize a novel conductive telemetry communication schema for device interrogation and programming. A patient transmitter is designed as an at-home remote monitoring solution that interrogates the Aveir leadless pacemaker system via conductive telemetry and transmits the patient data.

Two-year follow-up of the safety and clinical outcomes of stylet-driven leads for left bundle branch area pacing compared with right ventricular pacing in the Medicare population.

Background: Stylet-driven leads have been increasingly used for left bundle branch area pacing (LBBAP). The long-term outcomes associated with LBBAP by stylet-driven leads have not been reported in a large cohort.

Objective: The purpose of this study was to compare the safety and clinical outcomes of stylet-driven leads placed at LBBAP vs right ventricular pacing (RVP) locations in dual-chamber (DC) pacemaker patients using large real-world data.

Direct Comparison of Two Commercially Available Pulsed Field Ablation Systems for Atrial Fibrillation; Procedure Characteristics and Acute Outcomes.

Background: There are few comparative studies on the everyday clinical outcomes of commercially available pulsed field ablation (PFA) systems for atrial fibrillation (AF).

Objective: This study evaluates the acute efficacy and safety outcomes of the FARAPULSE™ (pentaspline catheter) and PulseSelect™ (circular catheter) system.

Methods: International, multicenter, registry on patients with paroxysmal or persistent AF, undergoing a first ablation using either PFA system between January 29th, 2024 and September 1st, 2024.

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.

Atrial helix-fixation leadless pacemaker: real-world single-chamber implant experience.

Background: Single -chamber ventricular leadless pacemakers (LPs) are well established. A dual-chamber LP system has recently become available with distinct atrial and ventricular devices. Single-chamber atrial pacing with transvenous devices is infrequent due to future upgrade concerns.

Ensuring catheter-tissue contact with intracardiac echocardiography during pulsed-field ablation improves procedure outcome in patients with atrial fibrillation.

Background: Catheter-tissue contact is critical in creating durable lesions during pulsed-field ablation (PFA) of atrial fibrillation (AF).

Objective: This study aimed to compare the reconnection rate of previously ablated targets using PFA with vs without intracardiac echocardiography (ICE) guidance for confirmation of tissue contact.

Methods: This multicenter prospective study included consecutive patients with paroxysmal and persistent AF undergoing their first procedure using the PFA system.

Commercial Implant Experience of a Helix-Fixation Dual-Chamber Leadless Pacemaker.

Introduction: The AVEIR DR pacemaker (Abbott) is a dual-chamber leadless pacemaker (LP) system that includes right atrial and right ventricular helix-fixation LPs (ALP, VLP), with atrioventricular synchrony maintained via wireless communication between the two devices. The initial, multi-center commercial implant experience of the AVEIR DR dual-chamber LP system has yet to be evaluated.

Methods: Patients indicated for dual-chamber pacing after US commercial release were consecutively included.

Premature ventricular contraction detection and estimation of daily burden by an insertable cardiac monitor.

Background: Premature ventricular contraction (PVC) burden is a clinically important metric in the context of PVC-induced cardiomyopathy and is commonly obtained via ambulatory electrocardiogram (ECG) monitoring.

Objective: The purpose of this analysis is to characterize the performance of a novel PVC detection algorithm capable of identifying single PVCs and PVC sequences (couplets and triplets) for estimation of 24-hour PVC burden in an insertable cardiac monitor (ICM).

Methods: Performance of the ICM algorithm for detecting PVCs was validated by replaying 748 patient-triggered ICM-recorded ECG episodes from 184 patients through the ICM device.

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.

First-in-human study of a leadless pacemaker system for left bundle branch area pacing.

Background: Leadless pacemakers (LPs) are limited by the current inability to perform left bundle branch area pacing (LBBAP).

Objective: The purpose of this first-in-human acute feasibility study was to evaluate the safety and performance of a novel helix-based LP with an extended electrode for LBBAP (LP).

Methods: After obtaining informed consent, the LP (Aveir CSP LP) was temporarily deployed in patients with indications for LP implantation.

Comparison of left atrial appendage closure and oral anti-coagulation after catheter ablation for atrial fibrillation: Concomitant and sequential cohorts of the OPTION randomized controlled trial.

Background: Left atrial appendage closure (LAAC) can be performed in separate procedures with cardiac ablation (sequentially) or concomitantly in the same operative session.

Objective: The OPTION trial aims to compare the efficacy and safety of LAAC with oral anticoagulation (OAC) in patients who have undergone catheter ablation for atrial fibrillation (AF). The objective of this sub-analysis is to evaluate LAAC vs OAC within concomitant and sequential ablation timings.

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.