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Objectives: Sustained monomorphic ventricular tachycardia (SMVT) is a life-threatening condition that is often observed in patients with structural heart disease. Catheter ablation (CA) ablation is an effective and well-established treatment for the scar-related ventricular tachycardias (VTs). Sometimes, due to patient fragility or contraindications to CA, a noninvasive procedure is required. In these cases, VT ablation with stereotactic arrhythmia radioablation (STAR) for SMVTs supported by the CardioInsight mapping system seems to be a promising and effective noninvasive approach.
Methods And Results: We report a case of a 55-year-old male smoker and heavy alcohol consumer who developed ischemic heart disease and frequent refractory SMVT relative to antiarrhythmic drugs. Catheter ablation was not practicable due to the presence of an apical thrombosis in the left ventricle. The CardioInsight system (Cardioinsight Technologies Inc., Cleveland, OH, USA) was useful for noninvasively mapping the VTs, identifying two target areas on the septum and anterior wall of the left ventricle. A personalized STAR treatment plan was carefully designed, and it was delivered in a few minutes. During follow-up, a significant reduction in the arrhythmia burden was documented.
Conclusions: Stereotactic arrhythmia radioablation supported by the CardioInsight system could be an alternative treatment for VTs when catheter ablation is not possible. Larger studies are needed to investigate this technique.
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http://dx.doi.org/10.3390/jcdd11080239 | DOI Listing |
Heart Rhythm
September 2025
Translational Cardiology Group, Health Research Institute, Santiago de Compostela, Spain; CIBERCV, Madrid, España. Electronic address:
Background: High % of low-voltage area (LVA), a surrogate of scar, is associated with atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). Noninvasive biomarkers of LVA are a medical need for PVI decision.
Objective: We aimed to identify the proteome profile of plasma extracellular vesicles (EVs) associated with high % LVA, their cellular origin, and their regulation by hyperglycemia.
BMJ Open
September 2025
Arrhythmia Center, Chinese Academy of Medical Sciences Fuwai Hospital, Beijing, China.
Objectives: To evaluate the efficacy and safety of adding Superior Vena Cava Isolation (SVCI) to Pulmonary Vein Isolation (PVI) in patients with drug-refractory paroxysmal atrial fibrillation (PAF).
Design: Systematic review and meta-analysis of randomised controlled trials (RCTs) using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, supplemented with Trial Sequential Analysis (TSA) to assess evidence sufficiency.
Data Sources: We searched PubMed, EMBASE, the Cochrane Library (CENTRAL) and Web of Science for relevant studies published up to 13 July 2025.
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.
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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.
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