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Catheter Ablation of Cardiac Arrhythmias: Current Updates and Perspectives
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Catheter Ablation of Cardiac Arrhythmias: Current Updates and Perspectives

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

Deadline for manuscript submissions: 10 July 2024 | Viewed by 6103

Special Issue Editor

Dr. Shaojie Chen

E-Mail Website
Guest Editor
1. Cardioangiologisches Centrum Bethanien (CCB), Kardiologie, Agaplesion Markus Krankenhaus, Akademisches Lehrkrankenhaus der Goethe-Universität Frankfurt am Main, Frankfurt, Germany
2. Medicine Section, Universität zu Lübeck, Lubeck, Germany
Interests: general cardiology; arrhythmias/electrophysiology/catheter ablation; hypertension; heart failure; stroke
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Catheter ablation is an effective treatment option for cardiac arrhythmia. For decades, there have been remarkable advancements in mapping and ablation techniques and technology, helping clinicians further understand the mechanism of arrhythmias, in order to facilitate procedures, and to improve the safety of ablation and patients’ clinical outcomes. The aim and scope of this Special Issue mainly focus on, but are not limited to, the following: current mapping and ablation techniques for arrhythmias, procedural endpoints and outcomes, procedural complications, and prevention strategies. We welcome original research, systematic reviews, state-of-the-art reviews, challenging/informative case series, challenging/informative images in mapping and ablation, new technologies, etc.

Dr. Shaojie Chen
Guest Editor

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

  • ablation
  • arrhythmia
  • electrophysiology
  • atrial fibrillation
  • atrial flutter
  • atrial tachycardia
  • mapping
  • supraventricular tachycardia
  • ventricular arrhythmia

Published Papers (5 papers)

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Review

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13 pages, 298 KiB  
Review
Catheter Ablation for Channelopathies: When Is Less More?
by Adhya Mehta, Rishi Chandiramani, Binita Ghosh, Babken Asatryan, Adrija Hajra and Andreas S. Barth
J. Clin. Med. 2024, 13(8), 2384; https://doi.org/10.3390/jcm13082384 - 19 Apr 2024
Viewed by 193
Abstract
Ventricular fibrillation (VF) is a common cause of sudden cardiac death in patients with channelopathies, particularly in the young population. Although pharmacological treatment, cardiac sympathectomy, and implantable cardioverter defibrillators (ICD) have been the mainstay in the management of VF in patients with channelopathies, [...] Read more.
Ventricular fibrillation (VF) is a common cause of sudden cardiac death in patients with channelopathies, particularly in the young population. Although pharmacological treatment, cardiac sympathectomy, and implantable cardioverter defibrillators (ICD) have been the mainstay in the management of VF in patients with channelopathies, they are associated with significant adverse effects and complications, leading to poor quality of life. Given these drawbacks, catheter ablation has been proposed as a therapeutic option for patients with channelopathies. Advances in imaging techniques and modern mapping technologies have enabled increased precision in identifying arrhythmia triggers and substrate modification. This has aided our understanding of the underlying pathophysiology of ventricular arrhythmias in channelopathies, highlighting the roles of the Purkinje network and the epicardial right ventricular outflow tract in arrhythmogenesis. This review explores the role of catheter ablation in managing the most common channelopathies (Brugada syndrome, congenital long QT syndrome, short QT syndrome, and catecholaminergic polymorphic ventricular tachycardia). While the initial results for ablation in Brugada syndrome are promising, the long-term efficacy and durability of ablation in different channelopathies require further investigation. Given the genetic and phenotypic heterogeneity of channelopathies, future studies are needed to show whether catheter ablation in patients with channelopathies is associated with a reduction in VF, and psychological distress stemming from recurrent ICD shocks, particularly relative to other available therapeutic options (e.g., quinidine in high-risk Brugada patients). Full article
(This article belongs to the Special Issue Catheter Ablation of Cardiac Arrhythmias: Current Updates and Perspectives)
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18 pages, 3260 KiB  
Review
Evolving Role of Catheter Ablation for Atrial Fibrillation: Early and Effective Rhythm Control
by Shaojie Chen, Yuehui Yin, Zhiyu Ling, Christian Meyer, Helmut Pürerfellner, Martin Martinek, Márcio Galindo Kiuchi, Piotr Futyma, Lin Zhu, Alexandra Schratter, Jiazhi Wang, Willem-Jan Acou, Philipp Sommer, Feifan Ouyang, Shaowen Liu, Julian K. R. Chun and Boris Schmidt
J. Clin. Med. 2022, 11(22), 6871; https://doi.org/10.3390/jcm11226871 - 21 Nov 2022
Cited by 5 | Viewed by 2350
Abstract
Catheter Ablation (CA) is an effective therapeutic option in treating atrial fibrillation (AF). Importantly, recent data show that CA as a rhythm control strategy not only significantly reduces AF burden, but also substantially improves clinical hard endpoints. Since AF is a progressive disease, [...] Read more.
Catheter Ablation (CA) is an effective therapeutic option in treating atrial fibrillation (AF). Importantly, recent data show that CA as a rhythm control strategy not only significantly reduces AF burden, but also substantially improves clinical hard endpoints. Since AF is a progressive disease, the time of Diagnosis-to-Intervention appears crucial. Recent evidence shows that earlier rhythm control is associated with a lower risk of adverse cardiovascular outcomes in patients with early AF. Particularly, CA as an initial first line rhythm control strategy is associated with significant reduction of arrhythmia recurrence and rehospitalization in patients with paroxysmal AF. CA is shown to significantly lower the risk of progression from paroxysmal AF to persistent AF. When treating persistent AF, the overall clinical success after ablation remains unsatisfactory, however the ablation outcome in patients with “early” persistent AF appears better than those with “late” persistent AF. “Adjunctive” ablation on top of pulmonary vein isolation (PVI), e.g., ablation of atrial low voltage area, left atrial posterior wall, vein of Marshall, left atrial appendage, etc., may further reduce arrhythmia recurrence in selected patient group. New ablation concepts or new ablation technologies have been developing to optimize therapeutic effects or safety profile and may ultimately improve the clinical outcome. Full article
(This article belongs to the Special Issue Catheter Ablation of Cardiac Arrhythmias: Current Updates and Perspectives)
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8 pages, 3193 KiB  
Case Report
Long QT Syndrome and WPW Syndrome: A Very Rare Association between Two Causes of Sudden Cardiac Death in a Young Patient
by Radu Gabriel Vătășescu, Silvia Deaconu, Corneliu Nicolae Iorgulescu, Gabriela Marascu, Bogdan Oprita and Alexandru Deaconu
J. Clin. Med. 2024, 13(3), 804; https://doi.org/10.3390/jcm13030804 - 30 Jan 2024
Viewed by 767
Abstract
Long QT syndrome (LQT) and WPW syndrome are causes of sudden cardiac death (SCD) in the young, and their association has been rarely reported. A 26-year-old woman presented with recurrent syncope. Her ECG showed a short PR interval, wide QRS (150 ms) due [...] Read more.
Long QT syndrome (LQT) and WPW syndrome are causes of sudden cardiac death (SCD) in the young, and their association has been rarely reported. A 26-year-old woman presented with recurrent syncope. Her ECG showed a short PR interval, wide QRS (150 ms) due to a delta wave, and QT prolongation (QT 580 ms, QTc 648 ms). ECG monitoring documented recurrent salvos of a self-terminating wide QRS tachycardia, generally slightly polymorphic, sometimes with “torsade des pointes” (TdP) appearance, which were linked to the syncopal/presyncope episodes. Electrophysiologic monitoring diagnosed a right para-hisian accessory pathway with a very short ERP (240 ms baseline, <200 ms after isoproterenol). The pathway was ablated successfully. Despite QRS narrowing (80 ms), QT prolongation persisted after ablation (QT 620 ms, QTc 654 ms), with short runs of TdP, despite beta-blocker treatment, which was increased to the maximal dosage. A dual-chamber implantable cardioverter defibrillator (ICD) was implanted. To our knowledge, this is the first case report of an association between LQT and WPW syndrome in which both conditions are associated with an increased risk of SCD. Full article
(This article belongs to the Special Issue Catheter Ablation of Cardiac Arrhythmias: Current Updates and Perspectives)
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13 pages, 1348 KiB  
Systematic Review
Epicardial Adipose Tissue and Atrial Fibrillation Recurrence following Catheter Ablation: A Systematic Review and Meta-Analysis
by Ioannis Anagnostopoulos, Maria Kousta, Charalampos Kossyvakis, Nikolaos Taxiarchis Paraskevaidis, Dimitrios Vrachatis, Spyridon Deftereos and Georgios Giannopoulos
J. Clin. Med. 2023, 12(19), 6369; https://doi.org/10.3390/jcm12196369 - 05 Oct 2023
Viewed by 846
Abstract
(1)Introduction: Catheter ablation has become a cornerstone for the management of patients with atrial fibrillation (AF). Nevertheless, recurrence rates remain high. Epicardial adipose tissue (EAT) has been associated with AF pathogenesis and maintenance. However, the literature has provided equivocal results regarding the relationship [...] Read more.
(1)Introduction: Catheter ablation has become a cornerstone for the management of patients with atrial fibrillation (AF). Nevertheless, recurrence rates remain high. Epicardial adipose tissue (EAT) has been associated with AF pathogenesis and maintenance. However, the literature has provided equivocal results regarding the relationship between EAT and post-ablation recurrence.(2) Purpose: to investigate the relationship between total and peri-left atrium (peri-LA) EAT with post-ablation AF recurrence. (3) Methods: major electronic databases were searched for articles assessing the relationship between EAT, quantified using computed tomography, and the recurrence of AF following catheter ablation procedures. (4) Results: Twelve studies (2179 patients) assessed total EAT and another twelve (2879 patients) peri-LA EAT. Almost 60% of the included patients had paroxysmal AF and recurrence was documented in 34%. Those who maintained sinus rhythm had a significantly lower volume of peri-LA EAT (SMD: −0.37, 95%; CI: −0.58–0.16, I2: 68%). On the contrary, no significant difference was documented for total EAT (SMD: −0.32, 95%; CI: −0.65–0.01; I2: 92%). No differences were revealed between radiofrequency and cryoenergy pulmonary venous isolation. No publication bias was identified. (5) Conclusions: Only peri-LA EAT seems to be predictive of post-ablation AF recurrence. These findings may reflect different pathophysiological roles of EAT depending on its location. Whether peri-LA EAT can be used as a predictor and target to prevent recurrence is a matter of further research. Full article
(This article belongs to the Special Issue Catheter Ablation of Cardiac Arrhythmias: Current Updates and Perspectives)
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7 pages, 2534 KiB  
Case Report
Not Just a One-Way: Mahaim Accessory Pathway Concomitantly Supporting Orthodromic Atrioventricular Re-Entrant Tachycardia
by Alexandru Deaconu, Viviana Gondos and Radu Vatasescu
J. Clin. Med. 2023, 12(1), 159; https://doi.org/10.3390/jcm12010159 - 25 Dec 2022
Cited by 1 | Viewed by 1380
Abstract
Introduction: We report the case of a 41-year-old female with documented narrow QRS tachycardia. During electrophysiological study, both orthodromic and antidromic atrioventricular reentry tachycardia (AVRT) were demonstrated as well as short episodes of pre-excited atrial fibrillation. Programmed atrial stimulation resulted in decremental anterograde [...] Read more.
Introduction: We report the case of a 41-year-old female with documented narrow QRS tachycardia. During electrophysiological study, both orthodromic and antidromic atrioventricular reentry tachycardia (AVRT) were demonstrated as well as short episodes of pre-excited atrial fibrillation. Programmed atrial stimulation resulted in decremental anterograde conduction on the AP, thus confirming an unexpected Mahaim accessory pathway (AP) diagnosis. Discussion: Limited 3D activation maps of the right atrium during orthoAVRT, respectively, and the right ventricle (RV) during antiAVRT were constructed and helped accurately describe the atrial and ventricular insertion points, which were superposed on the tricuspid ring, confirming the existence of a single short atrio-ventricular right free wall AP. Short atrioventricular APs with anterograde Mahaim-type conduction concomitantly sustaining orthodromic AVRT are extremely rare. Conclusions: Electroanatomical 3D mapping may help both to clarify the diagnosis and increase the success rate by accurately describing the insertion points of complex accessory pathways. Full article
(This article belongs to the Special Issue Catheter Ablation of Cardiac Arrhythmias: Current Updates and Perspectives)
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