Very high-power short-duration using 70W and a flexible tip ablation catheter for pulmonary vein isolation: the POWER PULSE randomized controlled trial.

Aims: Very high-power short-duration (vHPSD) was developed to optimize radiofrequency ablation for atrial fibrillation (AF). However, data on vHPSD ≥ 70W remains limited. We investigated acute efficacy, safety and long-term rhythm outcomes of vHPSD-70W in a randomized controlled trial.

Very High-Power Short-Duration Ablation for Atrial Fibrillation in Adults With Congenital Heart Disease.

Introduction: Data regarding safety and long-term outcome of very high-power-short duration (vHPSD) ablation in adult congenital heart disease (ACHD) patients with paroxysmal or persistent atrial fibrillation (AF) are lacking.

Methods: Retrospective observational single-center study. The data of 66 consecutive ACHD patients (mean age 60 ± 12.

Early ablation leads to better outcome in patients < 55 years with persistent atrial fibrillation.

The question of optimal timing for catheter ablation of atrial fibrillation (AF) to achieve best outcomes remains a crucial clinical issue. As AF occurs less frequently in younger patients, data regarding Diagnosis-to-Ablation Time (DAT) is especially limited in patients under the age of 55 years with persistent AF. We therefore analyzed the temporal relationship between initial AF presentation and timing of catheter ablation in this cohort.

Focal pulsed field ablation in complex atrial tachycardia: First clinical experience and 1-year outcome.

Background: Pulsed field ablation (PFA) has become increasingly important in the treatment of cardiac arrhythmias. In addition to single-shot devices mainly used for pulmonary vein isolation, focal PFA may provide a treatment option that increases the versatility of the technique.

Objective: The purpose of this study was to provide data on feasibility, safety, and long-term outcome of focal PFA for ablation of complex atrial tachycardia (AT).

Radiofrequency ablation-Real-time visualization of lesions and their correlation with underlying parameters.

Background: Lesion durability and transmurality are crucial for successful radiofrequency (RF) ablation. This study provides a model of real-time RF lesion visualization and insights into the role of underlying parameters, as local impedance (LI).

Methods: A force-sensing, LI-sensing catheter was used for lesion creation in an ex vivo model involving cross-sections of porcine cardiac preparations.

Renal function and periprocedural complications in patients undergoing left atrial catheter ablation: A comparison between uninterrupted direct oral anticoagulants and phenprocoumon administration.

Background: Data regarding uninterrupted oral anticoagulation in patients with chronic kidney disease (CKD) during catheter ablation for left atrial arrhythmias is limited. This study aimed to evaluate the safety and efficacy of periprocedural uninterrupted direct oral anticoagulants (DOAC) compared with uninterrupted phenprocoumon in patients with CKD undergoing left atrial catheter ablation.

Methods And Results: We conducted a retrospective single-center study of patients who underwent left atrial catheter ablation between 2016 and 2019 with underlying chronic kidney disease (glomerular filtration rate (GFR) between 15 and 45 ml/min).

First clinical data on artificial intelligence-guided catheter ablation in long-standing persistent atrial fibrillation.

Introduction: Despite advanced ablation strategies and major technological improvements, treatment of persistent atrial fibrillation (AF) remains challenging and the underlying pathophysiology is not fully understood. This study analyzed the multiple procedure outcome and safety of catheter ablation of spatiotemporal dispersions (DISPERS) detected by artificial intelligence (AI)-guided software in patients with long-standing persistent AF.

Methods And Results: The Volta VX1 software was used for 50 consecutive patients undergoing catheter ablation for persistent AF.

Long-Term Follow-Up of Empirical Slow Pathway Ablation in Pediatric and Adult Patients with Suspected AV Nodal Reentrant Tachycardia.

Background: The aim of this study was to assess long-term efficacy and safety of empirical slow pathway (ESP) ablation in pediatric and adult patients with a special interest in patients without dual AV nodal physiology (DAVNP).

Methods: A retrospective single-center review of patients who underwent ESP ablation between December 2014 and September 2022 was performed. Follow-up included telephone communication, letter questionnaire and outpatient presentation.

The influence of electrode-tissue-coverage on RF lesion formation and local impedance: Insights from an ex vivo model.

Background: The influence of power, duration and contact force (CF) on radiofrequency (RF) lesion formation is well known, whereas data on local impedance (LI) and electrode-tissue-coverage (ETC) is scarce. The objective was to investigate their effect on lesion formation in an ex vivo model.

Methods And Results: An ex vivo model was developed utilizing cross-sections of porcine heart preparations and a force-sensing, LI-measuring catheter.

Mechanisms of late arrhythmia recurrence after initially successful pulmonary vein isolation in patients with atrial fibrillation.

Background: Catheter ablation is an effective treatment for atrial fibrillation (AF,) but arrhythmia recurrence occurs in a relevant number of patients. Mechanisms of late occurring arrhythmias after ablation procedures are not fully understood. We analyzed electrophysiological mechanisms of early and late arrhythmia recurrences in patients who underwent radiofrequency-based catheter ablation of AF.

Ultrasound-Guided Access Reduces Vascular Complications in Patients Undergoing Catheter Ablation for Cardiac Arrhythmias.

Background: Femoral vascular access using the standard anatomic landmark-guided method is often limited by peripheral artery disease and obesity. We investigated the effect of ultrasound-guided vascular puncture (UGVP) on the rate of vascular complications in patients undergoing catheter ablation for atrial or ventricular arrhythmias. Methods: The data of 479 patients (59% male, mean age 68 years ± 11 years) undergoing catheter ablation for left atrial (n = 426; 89%), right atrial (n = 28; 6%) or ventricular arrhythmias (n = 28; 6%) were analyzed.

Late arrhythmia recurrence after atrial fibrillation ablation: incidence, mechanisms and clinical implications.

Background And Objectives: Catheter ablation of atrial fibrillation (AF) has become a well-established and widely used therapy, with pulmonary vein isolation (PVI) being the key modality of ablation. However, arrhythmia recurrences after PVI are common, with a relevant number of patients undergoing repeat ablation. Arrhythmia recurrence after PVI may vary regarding time point and mode of recurrence.