PPG-based smartphone application vs usual care for atrial fibrillation screening: A European multicenter randomized trial.

Background: Atrial fibrillation (AF) is the most frequent arrhythmia worldwide and a major cause of ischemic stroke. Screening tools are becoming increasingly popular to detect AF for stroke prevention, yet data from randomized trials are lacking.

Objective: The purpose of this study was to analyze AF detection rates using a smartphone application with early intervention (intervention group) compared with no intervention (sham group).

Visualization of monopolar biphasic focal pulsed field ablation lesions 3 months after pulmonary vein isolation on high-resolution 3-dimensional dark-blood late gadolinium enhancement cardiac magnetic resonance images.

Background: Dark-blood late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) imaging is used to visualize ablation lesions after pulmonary vein isolation (PVI) by cryo- and radiofrequency ablation. The performance of dark-blood LGE CMR in visualizing chronic ablation lesions after PVI by monopolar biphasic focal pulsed field ablation (F-PFA) remains unclear.

Objective: This study aimed to determine the visibility and optimal image intensity ratio (IIR) threshold for F-PFA lesion visualization in dark-blood LGE CMR scans 3 months after PVI.

Ultra-short-term heart rate variability using a photoplethysmography-based smartphone application: a TeleCheck-AF subanalysis.

Aims: Autonomic nervous system activation plays an important role in the pathophysiology of atrial fibrillation (AF). It can be determined using heart rate variability (HRV). We aimed to evaluate the feasibility of using photoplethysmography (PPG) recordings for the assessment of the ultra-short-term HRV.

Ablation of cavotricuspid isthmus-dependent atrial flutter using a focal monopolar pulsed-field ablation catheter: Feasibility, periprocedural coronary spasms and conduction disorders.

Background: Pulsed-field ablation for the treatment of cavotricuspid isthmus (CTI)-dependent atrial flutter has been associated with coronary spasms (CS) and atrioventricular conduction disorders (CD).

Objectives: The purpose of this study was to evaluate the feasibility of CTI ablation using a monopolar focal pulsed-field ablation (F-PFA) catheter and to assess the risk of CS and CD during and after the procedure.

Methods: We prospectively enrolled patients with atrial flutter treated with an F-PFA system (CardioFocus, Marlborough, MA) or by focal radiofrequency ablation (RFA) using contact force-sensing catheters integrated into electroanatomic mapping systems.

Targeted epicardial pulsed field ablation of atrial ganglionated plexi: Electrophysiological and histologic analysis in pigs.

Background: Modulation of autonomic nervous system activation by ganglionated plexi (GP) ablation is considered a key component of atrial fibrillation (AF) treatment. Endocardial pulsed field ablation (PFA) has limited impact on epicardially located GPs owing to their significant distance from the endocardium, whereas epicardial PFA delivery directly to GP sites may display antiarrhythmic effects by effective ablation of GPs with minimal collateral myocardial damage.

Objective: This study aimed to determine antiarrhythmic and structural effects of epicardial PFA delivery to atrial GP sites.

Heart rate variability in patients with cardiovascular diseases.

Heart rate variability (HRV) has been reported to predict overall mortality and the risk of cardiovascular disease events in patients, including those with heart failure. However, inconsistent methods of recording and analyzing HRV parameters, along with a lack of randomized data substantiating its clinical efficacy and potential to guide treatment decisions for improved patient outcomes, have limited its use in clinical settings. With the advancements in technologies such as artificial intelligence and machine learning, and emergence of ablation procedures that can alter autonomic function, this article re-explores HRV assessment methods, their potential for clinical application, the issues encountered in using them in clinical research, and potential approaches to studying HRV in the future (Graphical Abstract).

Association of atrial fibrillation burden and clinical profile with blood biomarkers: Results from the ISOLATION Ablation Cohort.

Background: Advances have been made in identifying biomarkers for atrial fibrillation (AF) outcomes.

Objective: The link between clinical determinants, especially AF burden, and blood biomarkers remains underexplored.

Methods: We conducted a cross-sectional analysis of AF patients scheduled for catheter ablation in the ISOLATION study (July 2020-May 2022, NCT04342312).

Periprocedural Safety of Interventional Electrophysiological Procedures in Octogenarians and Nonagenarians.

Background: Catheter ablation is an established treatment for cardiac arrhythmia. There is a lack of data on invasive electrophysiological (EP) procedures in aged patients.

Methods: Consecutive patients ≥ 80 years who underwent catheter ablation or left atrial appendage closure procedures between January 2005 and December 2017 in a high-volume center were retrospectively studied and compared to a matched control group of individuals < 80 years of age.

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.

Long-term outcomes of pace-and-ablate strategy in patients with atrial fibrillation.

Background: The pace-and-ablate strategy is second -line therapy to obtain rate control in patients with persistent symptomatic atrial fibrillation (AF) when other treatment options fail. This study aims to evaluate long-term effects on clinical outcomes following pace-and-ablate strategy in AF patients.

Methods: This retrospective study includes patients who underwent successful pacemaker implantation (right ventricular pacing (RVP) or cardiac re-synchronization therapy (CRT)) followed by atrioventricular node ablation (AVNA) between 2010 and 2020.

Diabetes and Atrial Fibrillation: Insight From Basic to Translational Science Into the Mechanisms and Management.

In spite of significant progress made in the management in recent decades, atrial fibrillation (AF) continues to cause increased mortality and significant morbidities, including heart failure and stroke. Diabetes mellitus (DM) is an independent risk factor for AF, and adds risks to increased mortality and hospitalizations when present along with AF. The pathophysiology of AF related to DM is complex with many inter-related factors.

State of the Art of Artificial Intelligence in Clinical Electrophysiology in 2025: A Scientific Statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), and the ESC Working Group on E-Cardiology.

Aims: Artificial intelligence (AI) has the potential to transform cardiac electrophysiology (EP), particularly in arrhythmia detection, procedural optimization, and patient outcome prediction. However, a standardized approach to reporting and understanding AI-related research in EP is lacking. This scientific statement aims to develop and apply a checklist for AI-related research reporting in EP to enhance transparency, reproducibility, and understandability in the field.

PULSE survey: Population Survey on Knowledge, Gaps and Perception of Heart Rhythm disorders-an initiative of the Scientific Initiatives Committee of the European Heart Rhythm Association.

Aims: Despite increasing prevalence, the general population lacks knowledge regarding diagnosis, implications, and management of cardiac arrhythmias (CA). This study aims to assess public perception of CA and identify knowledge gaps.

Methods And Results: The 36-item PULSE survey was disseminated via social media to the general population and conducted under the auspices of the European Heart Rhythm Association Scientific Initiatives Committee (EHRA SIC) with EHRA patient committee support.

First Experience Using a Novel Variable Loop Catheter for Mapping and Pulsed Field Ablation of Atrial Fibrillation.

Background And Aims: A novel multielectrode variable loop catheter (VLC) has been introduced for atrial fibrillation (AF) ablation enabling 3D electroanatomic mapping and concomitant pulsed field ablation (PFA). This study sought to investigate the VLC under routine clinical conditions for AF ablation.

Methods: Consecutive patients with symptomatic AF undergoing first-time AF ablation were prospectively enrolled.

Feasibility of repeated on-demand smartphone app-based approximation of time spent with atrial fibrillation and symptoms in patients after catheter ablation: Data from the ISOLATION study.

Background: The preferred outcome after atrial fibrillation (AF) ablation is reducing AF burden, reflected by time spent with AF. Digital tools provide novel strategies to approximate time spent with AF.

Objectives: The purpose of this study was to assess the feasibility of repeated on-demand heart rhythm and symptom monitoring and analyze time spent with AF and symptoms over 12 months after AF ablation.

Hypertension and Atrial Fibrillation: Insight From Basic to Translational Science Into the Mechanisms and Management.

There is a parallel epidemic of atrial fibrillation (AF) and hypertension (HTN) occurring globally. Both AF and HTN are no longer confined to the older population. The pathophysiology of AF related to HTN is complex with many inter-related factors.

Multimorbidity Is Associated With Symptom Severity and Disease Progression in Patients with Paroxysmal Atrial Fibrillation-Data From the RACE V Study.

Background: Multimorbidity is common among patients with atrial fibrillation (AF) and is associated with worse outcomes. We aimed to investigate the association between multimorbidity, AF progression and AF symptom severity in patients with paroxysmal AF.

Methods And Results: The RACE V (Reappraisal of AF: Interaction Between Hypercoagulability, Electrical Remodeling, and Vascular Destabilization in the Progression of AF) study included patients with paroxysmal AF and continuous rhythm monitoring.