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Background: Left bundle branch block (LBBB) and atrial fibrillation (AF) are commonly coexisting conditions. The impact of LBBB on catheter ablation of AF has not been well determined. This study aims to explore the long-term outcomes of patients with AF and LBBB after catheter ablation.
Methods: Forty-two patients with LBBB of 11,752 patients who underwent catheter ablation of AF from 2011 to 2020 were enrolled as LBBB group. After propensity score matching in a 1:4 ratio, 168 AF patients without LBBB were enrolled as non-LBBB group. Late recurrence and a composite endpoint of stroke, all-cause mortality, and cardiovascular hospitalization were compared between the two groups.
Results: Late recurrence rate was significantly higher in the LBBB group than that in the non-LBBB group (54.8% vs. 31.5%, p = .034). Multivariate analysis showed that LBBB was an independent risk factor for late recurrence after catheter ablation of AF (hazard ratio [HR] 2.19, 95% confidence interval [CI] 1.09-4.40, p = .031). LBBB group was also associated with a significantly higher incidence of the composite endpoint (21.4% vs. 6.5%, HR 3.98, 95% CI 1.64-9.64, p = .002).
Conclusions: LBBB was associated with a higher risk for late recurrence and a higher incidence of composite endpoint in the patients underwent catheter ablation.
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http://dx.doi.org/10.1111/pace.14954 | DOI Listing |
J Innov Card Rhythm Manag
August 2025
Cardiology Division, Hamilton Health Sciences, Arrhythmia Service Unit, McMaster University, Hamilton, ON, Canada.
We present a case of a 71-year-old woman with symptomatic paroxysmal atrial fibrillation and atypical atrial flutter (AFL), ultimately diagnosed with a rare type 3 macro-re-entrant biatrial tachycardia (BiAT). Despite initial pulmonary vein isolation and anterior line ablation for atypical AFL, she experienced recurrent AFL requiring a complex redo ablation. Successful termination of the tachycardia was achieved by extending ablation to the septal regions of both atria.
View Article and Find Full Text PDFFront Physiol
August 2025
Department of Electrophysiology, King Abdulaziz Cardiac Center, King Abdullah International Medical Research Center (KAIMRC), MNGHA, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Background: Mitral valve prolapse (MVP) is a common condition, typically benign, but in a small subset of patients, it may lead to life-threatening arrhythmias and sudden cardiac death (SCD). This arrhythmogenic MVP phenotype is often associated with bileaflet prolapse, mitral annular disjunction (MAD), and myocardial fibrosis identified via late gadolinium enhancement (LGE) on cardiac MRI.
Case Summary: Our patient is a 49-year-old man presented with monomorphic ventricular tachycardia and near-syncope.
Front Physiol
August 2025
Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China.
Background: Pulsed electric field ablation (PFA) techniques for treating cardiac arrhythmias have attracted considerable interest. For example, atrial fibrillation can be effectively treated by pulmonary vein isolation using PFA. However, some arrhythmias originate deep within the myocardium, making them difficult to reach with conventional ablation methods.
View Article and Find Full Text PDFHeart Rhythm O2
August 2025
Cardiac Electrophysiology Section, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Background: Cardiac amyloidosis (CA) is characterized by atrial myopathy, which predisposes patients to atrial fibrillation (AF) and other atrial arrhythmias (AA). Although catheter ablation of AA is effective in the general population, its efficacy and safety in patients with CA remain unclear.
Objective: The study aimed to evaluate outcomes in patients with CA undergoing catheter ablation for typical atrial flutter (TAFL) and left atrial (LA) arrhythmias and to assess the presence and influence of LA low-voltage areas (LVA) in the latter.
Heart Rhythm O2
August 2025
Division of Cardiology, Tokyo Metropolitan Ohkubo Hospital, Shinjyuku-ku, Tokyo, Japan.
Background: Various methods have been devised for catheter ablation of persistent atrial fibrillation (AF). However, it remains difficult to understand the mechanism of AF and to determine the optimal method.
Objective: This study aimed to evaluate the effectiveness of rotor modification (RM) compared to posterior wall isolation (PWI) in the treatment of persistent AF.