Latest Advances in Catheter Ablation

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (20 February 2024) | Viewed by 3890

Special Issue Editors


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Guest Editor
Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
Interests: cardiac device implant and extraction; catheter ablation of arrhythmias; cardiomyopathies
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Special Issue Information

Dear Colleagues, 

The transcatheter ablation of cardiac arrhythmias is a reproducible and effective treatment in current clinical practice. Research in this field is constantly evolving in line with innovation, especially in intracavity mapping systems, new forms of energy, and other tools for supporting the transcatheter cardiac ablation of simple and complex cardiac arrhythmias. The multidisciplinary collaboration of anesthesiologists and cardiac surgeons is often required to clinically assess patients with cardiac arrhythmias for hybrid ablations or hemodynamic support, in order to perform redo procedures for atrial fibrillation or ventricular tachycardia with hemodynamic instability. Furthermore, cardiac imaging methods such as cardiac magnetic resonance, cardiac computed tomography, and intracardiac echocardiography play a pivotal role in the assessment of different arrhythmic substrates and in driving ablative treatment. The aim of this Special Issue is to explore the latest innovations in this field, with a particular focus on the latest technical advances related to cardiac arrhythmias and substrates.

Dr. Fabrizio Guarracini
Dr. Patrizio Mazzone
Guest Editors

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Keywords

  • atrial fibrillation
  • ventricular tachycardia
  • paroxysmal supraventricular tachycardia
  • cardiac catheter ablation
  • intracardiac mapping system

Published Papers (3 papers)

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Research

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11 pages, 1388 KiB  
Article
Combined Area of Left and Right Atria May Outperform Atrial Volumes as a Predictor of Recurrences after Ablation in Patients with Persistent Atrial Fibrillation—A Pilot Study
by Andrei D. Mărgulescu, Caterina Mas-Lladó, Susanna Prat-Gonzàlez, Rosario Jesus Perea, Roger Borras, Eva Benito, Francisco Alarcón, Eduard Guasch, Jose María Tolosana, Elena Arbelo, Marta Sitges, Josep Brugada and Lluís Mont
Medicina 2024, 60(1), 151; https://doi.org/10.3390/medicina60010151 - 13 Jan 2024
Viewed by 836
Abstract
Background and Objectives: Left atrial (LA) remodelling and dilatation predicts atrial fibrillation (AF) recurrences after catheter ablation. However, whether right atrial (RA) remodelling and dilatation predicts AF recurrences after ablation has not been fully evaluated. Materials and Methods: This is an [...] Read more.
Background and Objectives: Left atrial (LA) remodelling and dilatation predicts atrial fibrillation (AF) recurrences after catheter ablation. However, whether right atrial (RA) remodelling and dilatation predicts AF recurrences after ablation has not been fully evaluated. Materials and Methods: This is an observational study of 85 consecutive patients (aged 57 ± 9 years; 70 [82%] men) who underwent cardiac magnetic resonance before first catheter ablation for AF (40 [47.1%] persistent AF). Four-chamber cine-sequence was selected to measure LA and RA area, and ventricular end-systolic image phase to obtain atrial 3D volumes. The effect of different variables on event-free survival was investigated using the Cox proportional hazards model. Results: In patients with persistent AF, combined LA and RA area indexed to body surface area (AILA + RA) predicted AF recurrences (HR = 1.08, 95% CI 1.00–1.17, p = 0.048). An AILA + RA cut-off value of 26.7 cm2/m2 had 72% sensitivity and 73% specificity for predicting recurrences in patients with persistent AF. In this group, 65% of patients with AILA + RA > 26.7 cm2/m2 experienced AF recurrence within 2 years of follow-up (median follow-up 11 months), compared to 25% of patients with AILA + RA ≤ 26.7 cm2/m2 (HR 4.28, 95% CI 1.50–12.22; p = 0.007). Indices of LA and RA dilatation did not predict AF recurrences in patients with paroxysmal AF. Atrial 3D volumes did not predict AF recurrences after ablation. Conclusions: In this pilot study, the simple measurement of AILA + RA may predict recurrences after ablation of persistent AF, and may outperform measurements of atrial volumes. In paroxysmal AF, atrial dilatation did not predict recurrences. Further studies on the role of RA and LA remodelling are needed. Full article
(This article belongs to the Special Issue Latest Advances in Catheter Ablation)
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Review

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13 pages, 820 KiB  
Review
Contemporary Advances in Cardiac Remote Monitoring: A Comprehensive, Updated Mini-Review
by Alberto Preda, Raffaele Falco, Chiara Tognola, Marco Carbonaro, Sara Vargiu, Michela Gallazzi, Matteo Baroni, Lorenzo Gigli, Marisa Varrenti, Giulia Colombo, Gabriele Zanotto, Cristina Giannattasio, Patrizio Mazzone and Fabrizio Guarracini
Medicina 2024, 60(5), 819; https://doi.org/10.3390/medicina60050819 - 16 May 2024
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Abstract
Over the past decade, remote monitoring (RM) has become an increasingly popular way to improve healthcare and health outcomes. Modern cardiac implantable electronic devices (CIEDs) are capable of recording an increasing amount of data related to CIED function, arrhythmias, physiological status and hemodynamic [...] Read more.
Over the past decade, remote monitoring (RM) has become an increasingly popular way to improve healthcare and health outcomes. Modern cardiac implantable electronic devices (CIEDs) are capable of recording an increasing amount of data related to CIED function, arrhythmias, physiological status and hemodynamic parameters, providing in-depth and updated information on patient cardiovascular function. The extensive use of RM for patients with CIED allows for early diagnosis and rapid assessment of relevant issues, both clinical and technical, as well as replacing outpatient follow-up improving overall management without compromise safety. This approach is recommended by current guidelines for all eligible patients affected by different chronic cardiac conditions including either brady- and tachy-arrhythmias and heart failure. Beyond to clinical advantages, RM has demonstrated cost-effectiveness and is associated with elevated levels of patient satisfaction. Future perspectives include improving security, interoperability and diagnostic power as well as to engage patients with digital health technology. This review aims to update existing data concerning clinical outcomes in patients managed with RM in the wide spectrum of cardiac arrhythmias and Hear Failure (HF), disclosing also about safety, effectiveness, patient satisfaction and cost-saving. Full article
(This article belongs to the Special Issue Latest Advances in Catheter Ablation)
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9 pages, 773 KiB  
Review
Potential Application of Pulsed Field Ablation in Ventricular Arrhythmias
by Jie Qiu, Meiyan Dai, Yang Bai and Guangzhi Chen
Medicina 2023, 59(4), 723; https://doi.org/10.3390/medicina59040723 - 7 Apr 2023
Cited by 4 | Viewed by 2034
Abstract
Pulsed field ablation (PFA) is a new ablative method for the therapy of arrhythmia. Recent preclinical and clinical studies have already demonstrated the feasibility and safety of PFA for the treatment of atrial fibrillation (AF). However, the application of PFA may not be [...] Read more.
Pulsed field ablation (PFA) is a new ablative method for the therapy of arrhythmia. Recent preclinical and clinical studies have already demonstrated the feasibility and safety of PFA for the treatment of atrial fibrillation (AF). However, the application of PFA may not be limited to the above fields. There are some data on the application of PFA on ventricular arrhythmias (VAs), such as ventricular fibrillation (VF) and ventricular tachycardia (VT). Further, a case report about PFA has been published recently, in which PFA was successfully applied to the ablation of premature ventricular contractions (PVCs) from the right ventricular outflow tract. Thus, we aimed to review recent research findings of PFA in ventricular ablation and evaluate the possibility of its application in VAs. Full article
(This article belongs to the Special Issue Latest Advances in Catheter Ablation)
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