Ventricular Arrhythmias: Current Advances and Future Perspectives

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

Deadline for manuscript submissions: 30 June 2026 | Viewed by 3041

Special Issue Editors


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Guest Editor
1. Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
2. Electrophysiology Unit “Casa di Cura Villa Verde”, 74121 Taranto, Italy
Interests: cardiac electrophysiology; cardiac pacing; sports cardiology; atrial fibrillation; sudden cardiac death

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Guest Editor
1. San Carlo di Nancy Hospital, Rome, Italy
2. Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
Interests: cardiac electrophysiology; cardiac pacing; atrial fibrillation; sudden cardiac death; heart failure

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Guest Editor Assistant
Department of Cardiology, L. Bonomo Hospital, ASL BT, Andria, Italy
Interests: cardiac electrophysiology; cardiac pacing; atrial fibrillation; sudden cardiac death

Special Issue Information

Dear Colleagues,

Ventricular arrhythmias (VAs) represent a large panorama that is continuously expanding. Indeed, significant progress is affecting different fields, such as the following:

  • Sudden death risk stratification in cardiomyopathies and channelopathies. In particular, the application of imaging (e.g., cardiac magnetic resonance) and genetic data increasingly interplay in the stratification of new risk scores. These methods inextricably integrate with anamnestic data and the 12-lead electrocardiogram, with applications for young people and athletes also.
  • Development of new tools and strategies for mapping and treating VAs. They may consist in the application of new energy sources like pulse field ablation or recent designs of novel ablator catheters or, on the other hand, employment of new high-density mapping catheters and algorithms/software of 3D mapping systems to improve and facilitate the quick and accurate annotation of pathologic electrograms and reconstruction of the mechanisms of the arrhythmia;
  • VA treatment is not only based on catheter ablation. Devices (transvenous, subcutaneous, or extravascular ICD, CRT, physiological pacing, etc.), drugs, and neuromodulation (e.g., sympathectomy) also comprise the available instruments.

These are just some illustrative main topics on which original research articles or review are welcome in this Special Issue.

Please keep in mind the blooming of artificial intelligence and the digital transformation that medicine is undergoing, which also impact VAs knowledge and treatment.

We believe this Special Issue enrich the field of ventricular arrhythmias with expert contributions.

Dr. Zefferino Palamà
Dr. Antonio Scarà
Guest Editors

Dr. Antonio Gianluca Robles
Guest Editor Assistant

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Keywords

  • sudden death
  • cardiomyopathies
  • catheter ablation
  • cardiac mapping
  • cardiac imaging

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Published Papers (3 papers)

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Research

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15 pages, 1010 KB  
Article
Long-Term Outcomes After Radiofrequency Catheter Ablation of Idiopathic Outflow Tract Premature Ventricular Contractions
by Sladjana Bozovic-Ogarevic, Zoran Bukumiric, Dejan Kojic, Milovan Bojic, Aleksandra Grbovic, Danijela Tasic, Dragica Dekic, Ljiljana Rankovic-Nicic, Suncica Panic, Marko Filipovic, Zorana Bogicevic, Milan Arsic and Nebojsa Tasic
Medicina 2026, 62(5), 813; https://doi.org/10.3390/medicina62050813 - 24 Apr 2026
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Abstract
Background and Objectives: Idiopathic ventricular arrhythmias commonly occur in patients without structural heart disease and most often present as premature ventricular contractions (PVCs). Although generally considered benign, a high PVC burden may cause symptoms, reduce quality of life, and lead to reversible [...] Read more.
Background and Objectives: Idiopathic ventricular arrhythmias commonly occur in patients without structural heart disease and most often present as premature ventricular contractions (PVCs). Although generally considered benign, a high PVC burden may cause symptoms, reduce quality of life, and lead to reversible PVC-induced cardiomyopathy. This study aimed to evaluate long-term outcomes after radiofrequency catheter ablation of idiopathic outflow tract PVCs. Materials and Methods: This single-center retrospective study included 101 patients with idiopathic PVCs who underwent radiofrequency catheter ablation. PVC burden and clinical outcomes were assessed at baseline and during follow-up at 3 months, 12 months, and 5 years. Procedural success, predictors of success, and changes in antiarrhythmic drug therapy were analyzed. Results: During follow-up, a marked reduction in PVC burden was observed compared with baseline values. The median PVC burden decreased from 21.89% at baseline to 0.79% at 3 months, 0.23% at 12 months, and 0.09% at the 5-year follow-up after ablation. Acute procedural success was achieved in 88.1% of patients. Long-term success at 5 years was observed in 80.2% of patients. The use of antiarrhythmic drugs decreased during follow-up. Left ventricular ejection fraction remained stable, with no significant difference between baseline and 5-year values. Monomorphic PVC morphology and procedural success at 12 months were identified as independent predictors of long-term success. Conclusions: Radiofrequency catheter ablation provides effective and sustained reduction in PVC burden in patients with idiopathic outflow tract PVCs, with high acute success rates, durable long-term outcomes, and reduced reliance on antiarrhythmic drug therapy. Full article
(This article belongs to the Special Issue Ventricular Arrhythmias: Current Advances and Future Perspectives)
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Review

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16 pages, 763 KB  
Review
Structural and Echocardiographic Abnormalities in Congenital Long QT Syndrome: A Review of the Literature
by Austė Markevičiūtė, Patricija Lapinskaitė, Mariola Kovalevska, Audronė Vaitiekienė and Diana Rinkūnienė
Medicina 2026, 62(5), 829; https://doi.org/10.3390/medicina62050829 - 27 Apr 2026
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Abstract
Congenital Long QT Syndrome (LQTS) is a hereditary cardiac channelopathy defined by delayed ventricular repolarization and an elevated risk of life-threatening ventricular arrhythmias. Recent echocardiographic studies using speckle-tracking and strain imaging have identified subtle abnormalities in ventricular and atrial mechanics among LQTS patients, [...] Read more.
Congenital Long QT Syndrome (LQTS) is a hereditary cardiac channelopathy defined by delayed ventricular repolarization and an elevated risk of life-threatening ventricular arrhythmias. Recent echocardiographic studies using speckle-tracking and strain imaging have identified subtle abnormalities in ventricular and atrial mechanics among LQTS patients, including reduced global longitudinal strain, impaired diastolic function, enlarged left atrial volumes and a consistently negative electromechanical window. These findings challenge the traditional concept of LQTS as solely an electrical disease and support evolving evidence of a subclinical cardiomyopathic phenotype. Left atrial remodeling, although less studied, may represent an underrecognized component of LQTS with potential implications for arrhythmia vulnerability and diastolic dysfunction. This review summarizes current evidence on electromechanical and structural cardiac involvement in congenital LQTS, highlights its diagnostic and clinical implications, and outlines future directions for research in this evolving field. Full article
(This article belongs to the Special Issue Ventricular Arrhythmias: Current Advances and Future Perspectives)
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25 pages, 1334 KB  
Review
Arrhythmogenic Risk in iPSC-Derived Cardiomyocytes: Current Limitations and Therapeutic Perspectives
by Dhienda C. Shahannaz, Tadahisa Sugiura, Brandon E. Ferrell and Taizo Yoshida
Medicina 2025, 61(11), 2056; https://doi.org/10.3390/medicina61112056 - 18 Nov 2025
Cited by 6 | Viewed by 1815
Abstract
Background and Objectives: Induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) have revolutionized cardiac research by providing patient-specific models for studying arrhythmias. However, their clinical application is hindered by arrhythmogenic risks associated with grafted iPSC-CMs. This review aims to delineate the current limitations in [...] Read more.
Background and Objectives: Induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) have revolutionized cardiac research by providing patient-specific models for studying arrhythmias. However, their clinical application is hindered by arrhythmogenic risks associated with grafted iPSC-CMs. This review aims to delineate the current limitations in iPSC-CM-based arrhythmia modeling and explore emerging therapeutic strategies to mitigate these risks. Materials and Methods: A comprehensive literature review was conducted, focusing on studies published in the last two decades that address the electrophysiological characteristics of iPSC-CMs, their arrhythmogenic potential, and therapeutic interventions. Sources include peer-reviewed journals, clinical trial reports, and recent advancements in stem cell technology. Results: Findings indicate that while iPSC-CMs offer a promising platform for arrhythmia modeling, challenges such as cellular heterogeneity, immaturity, and proarrhythmic potential persist. Advancements in maturation protocols, co-culture systems, and gene editing techniques have shown promise in enhancing the safety profile of iPSC-CMs. Conclusions: Addressing the arrhythmogenic risks associated with iPSC-CMs requires a multifaceted approach, including improved differentiation protocols, maturation strategies, and therapeutic interventions. Continued research is essential to translate these models into safe and effective clinical applications. Full article
(This article belongs to the Special Issue Ventricular Arrhythmias: Current Advances and Future Perspectives)
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