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Cardiac Electrophysiology and Catheter Ablation of Different Arrhythmias

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Rehabilitation".

Deadline for manuscript submissions: 17 December 2024 | Viewed by 2202

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Special Issue Editors

Dr. Hussam Ali

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Guest Editor

Arrhythmia and EP Research Center, IRCCS MultiMedica, Sesto San Giovanni, 20099 Milan, Italy
Interests: catheter ablation; cardiac mapping; pacing maneuvers; subcutaneous ICD; atrial fibrillation; WPW; sudden cardiac death

Dr. Antonio Frontera

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Guest Editor

Directer of Cardiac Arrhythmia Department, Humanitas Research Hospital IRCCS, Via Alessandro Manzoni, 56, Rozzano, 20089 Milano, Italy
Interests: catheter ablation; sudden cardiac death; atrial fibrillation; substrates mapping; novel ablation and pacing technologies

Special Issue Information

Dear Colleagues,

The catheter ablation of cardiac arrhythmias has evolved over the past few decades, using different techniques and energies, and has proven to be superior to pharmacological therapy in various clinical settings. Understanding the underlying electrophysiological mechanisms and correlated anatomical substrates remains crucial to guide successful ablation and improve clinical outcomes. Despite massive advances in catheter ablation safety and efficacy, many challenging arrhythmias and conditions require further studies and research to optimize arrhythmic patient care.

The scope of this Special Issue, “Cardiac Electrophysiology and Catheter Ablation of Different Arrhythmias”, focuses on cardiac arrhythmias management, including, but not limited to, diagnosis, intracardiac mapping, and catheter ablation.

Original or review articles addressing novel ablation technologies or energies, state-of-the-art reviews, gaps in the current knowledge, and challenging arrhythmic conditions are welcome.

Dr. Hussam Ali
Dr. Antonio Frontera
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

cardiac electrophysiology
cardiac arrhythmias
atrial fibrillation
catheter ablation

Published Papers (3 papers)

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Research

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12 pages, 4481 KiB

Open AccessArticle

Anatomical and Electrophysiological Characteristics of Dual-Loop Re-Entry in Atypical Atrial Flutter: Implications for Mapping and Catheter Ablation

by Nicolas Johner, Mehdi Namdar and Dipen C. Shah

J. Clin. Med. 2024, 13(10), 2847; https://doi.org/10.3390/jcm13102847 - 12 May 2024

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Abstract

Background: Atypical atrial flutter (AFL) can be challenging to ablate, especially when involving dual-loop re-entry. We sought to assess the electroanatomical characteristics of single- and dual-loop AFLs in patients undergoing catheter ablation. Methods: We analyzed 25 non-cavotricuspid isthmus-dependent macro-re-entrant AFL in 19 consecutive patients. Three-dimensional high-density activation mapping was performed, and active re-entry loops were confirmed by entrainment mapping. Results: Of 25 AFLs (24 left, 1 right atrial), 13 (52%) exhibited dual-loop re-entry. The most common circuits included, in 6/13 (46% of dual loops), a perimitral re-entry with a second loop around the right/left pulmonary veins (PV) and, in 6/13 (46%), involved a right PV ostium with a second loop around either a functional conduction block or another PV. Ablation at the common isthmus of dual-loop AFLs and at the critical isthmus of single-loop AFLs terminated the arrhythmia more frequently than ablation at a secondary isthmus of dual-loop AFLs (5/6 (83%) and 8/11 (73%) versus 1/8 (13%), respectively, p = 0.013). Conclusions: More than half of AFLs exhibited a dual-loop re-entrant mechanism. Most critical isthmuses were found at the mitral isthmus, the left atrial roof or right PV ostia. Ablation targeting the common isthmus resulted in a higher termination rate. Full article

(This article belongs to the Special Issue Cardiac Electrophysiology and Catheter Ablation of Different Arrhythmias)

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11 pages, 1242 KiB

Open AccessArticle

Real World Data from Catheter Ablation of Ventricular Tachycardias and Premature Ventricular Complexes in a Tertiary Care Center

by Christian Schlatzer, Jan Berg, Firat Duru, Corinna Brunckhorst, Ardan M. Saguner and Laurent M. Haegeli

J. Clin. Med. 2024, 13(8), 2310; https://doi.org/10.3390/jcm13082310 - 17 Apr 2024

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Abstract

Background: Catheter ablation in patients with ventricular arrhythmias (VA), such as ventricular tachycardias (VT) or frequent premature ventricular complexes (PVC), is increasingly considered an effective and safe therapy when performed in experienced centers. This study sought to determine acute success rates and complication rates of ablation procedures for patients with VA in a Swiss tertiary care center. Methods: All patients who underwent ablation therapy for VT and PVC at the University Heart Center in Zurich, Switzerland, between March 2012 and April 2017 were included in this analysis. Results: A total of 120 patients underwent catheter ablation for VT and PVC (69 and 51, respectively). Seventy percent of patients were male, and the mean age was 55.3 years. The most common indication for ablation was high PVC burden (47.5%), followed by paroxysmal VT (38.3%), ICD shocks (23.3%), incessant VT (12.5%), electrical storm (7.5%), and syncope (3.3%). Acute success rates for VT and PVC ablations were 94.2% and 92.2%, respectively. Rates for complications (including major and minor) for VT and PVC were 10.1% and 7.8%, respectively. Complications occurred only in patients with structural heart disease; no complications were noted in structurally normal hearts. Conclusions: Our results suggest that catheter ablation for VT and PVC has high acute success rates with a reasonable risk for complications in the setting of tertiary care centers, comparable to those reported in other studies. Full article

(This article belongs to the Special Issue Cardiac Electrophysiology and Catheter Ablation of Different Arrhythmias)

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Review

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16 pages, 1072 KiB

Open AccessReview

Anti-Arrhythmic Effects of Heart Failure Guideline-Directed Medical Therapy and Their Role in the Prevention of Sudden Cardiac Death: From Beta-Blockers to Sodium-Glucose Cotransporter 2 Inhibitors and Beyond

by Wael Zaher, Domenico Giovanni Della Rocca, Luigi Pannone, Serge Boveda, Carlo de Asmundis, Gian-Battista Chierchia and Antonio Sorgente

J. Clin. Med. 2024, 13(5), 1316; https://doi.org/10.3390/jcm13051316 - 26 Feb 2024

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Abstract

Sudden cardiac death (SCD) accounts for a substantial proportion of mortality in heart failure with reduced ejection fraction (HFrEF), frequently triggered by ventricular arrhythmias (VA). This review aims to analyze the pathophysiological mechanisms underlying VA and SCD in HFrEF and evaluate the effectiveness of guideline-directed medical therapy (GDMT) in reducing SCD. Beta-blockers, angiotensin receptor–neprilysin inhibitors, and mineralocorticoid receptor antagonists have shown significant efficacy in reducing SCD risk. While angiotensin-converting enzyme inhibitors and angiotensin receptor blockers exert beneficial impacts on the renin-angiotensin-aldosterone system, their direct role in SCD prevention remains less clear. Emerging treatments like sodium-glucose cotransporter 2 inhibitors show promise but necessitate further research for conclusive evidence. The favorable outcomes of those molecules on VA are notably attributable to sympathetic nervous system modulation, structural remodeling attenuation, and ion channel stabilization. A multidimensional pharmacological approach targeting those pathophysiological mechanisms offers a complete and synergy approach to reducing SCD risk, thereby highlighting the importance of optimizing GDMT for HFrEF. The current landscape of HFrEF pharmacotherapy is evolving, with ongoing research needed to clarify the full extent of the anti-arrhythmic benefits offered by both existing and new treatments. Full article

(This article belongs to the Special Issue Cardiac Electrophysiology and Catheter Ablation of Different Arrhythmias)

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