{"title":"Feasibility of ethanol ablation of the vein of Marshall in patients with coronary sinus leads","authors":"Nithi Tokavanich MD, Jasneet Devgun DO, Krit Jongnarangsin MD, Aman Chugh MD, FHRS","doi":"10.1016/j.hroo.2024.10.007","DOIUrl":"10.1016/j.hroo.2024.10.007","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 1","pages":"Pages 108-109"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Previous studies have reported the presence of fat between the septopulmonary bundle and the septoatrial bundle on the left atrial (LA) roof. This fat may increase the wall thickness and protect the septopulmonary bundle from radiofrequency energy, potentially leading to conduction gaps.
Objective
This study aimed to determine whether fat on the LA roof can be identified using intracardiac echocardiography (ICE) and whether its presence affects the procedural outcomes of pulmonary vein isolation (PVI).
Methods
We evaluated 94 patients undergoing first-time radiofrequency catheter ablation for atrial fibrillation (60 men [63.8%]; mean age 65.7±10.7 years; 46 with paroxysmal atrial fibrillation [48.9%]) between February 2021 and September 2023. ICE was used to visualize the LA roof, and hypoechoic regions suggestive of fat were marked within the CARTOSOUND map (Biosense Webster, Irvine, CA). PVI was then performed with a personalized isolation line, avoiding fat regions when feasible.
Results
Fat on the LA roof was identified in 35 of 94 patients (37.2%). Conduction gaps on the left pulmonary vein roof were observed in 7 of 35 patients with fat (20.0%) and 1 of 59 patients without fat (1.7%) (P=.004). Among patients with conduction gaps, 7 of 8 (87.5%) had a PVI line that crossed a fat region. No significant differences were noted in conduction gaps in other areas between the 2 groups.
Conclusion
The findings indicate that the presence of fat on the LA roof, as identified using ICE, may be associated with a higher incidence of conduction gaps after PVI.
{"title":"Impact of fat on the left atrial roof identified using intracardiac echocardiography during pulmonary vein isolation procedures","authors":"Yuhi Hasebe MD, PhD , Takashi Noda MD, PhD , Makoto Nakano MD, PhD , Takahiko Chiba MD, PhD , Hiroyuki Sato MD , Nobuhiko Yamamoto MD, PhD , Tomohiro Ito MD , Koji Kumagai MD, PhD , Satoshi Yasuda MD, PhD","doi":"10.1016/j.hroo.2024.11.001","DOIUrl":"10.1016/j.hroo.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have reported the presence of fat between the septopulmonary bundle and the septoatrial bundle on the left atrial (LA) roof. This fat may increase the wall thickness and protect the septopulmonary bundle from radiofrequency energy, potentially leading to conduction gaps.</div></div><div><h3>Objective</h3><div>This study aimed to determine whether fat on the LA roof can be identified using intracardiac echocardiography (ICE) and whether its presence affects the procedural outcomes of pulmonary vein isolation (PVI).</div></div><div><h3>Methods</h3><div>We evaluated 94 patients undergoing first-time radiofrequency catheter ablation for atrial fibrillation (60 men [63.8%]; mean age 65.7±10.7 years; 46 with paroxysmal atrial fibrillation [48.9%]) between February 2021 and September 2023. ICE was used to visualize the LA roof, and hypoechoic regions suggestive of fat were marked within the CARTOSOUND map (Biosense Webster, Irvine, CA). PVI was then performed with a personalized isolation line, avoiding fat regions when feasible.</div></div><div><h3>Results</h3><div>Fat on the LA roof was identified in 35 of 94 patients (37.2%). Conduction gaps on the left pulmonary vein roof were observed in 7 of 35 patients with fat (20.0%) and 1 of 59 patients without fat (1.7%) (<em>P</em>=.004). Among patients with conduction gaps, 7 of 8 (87.5%) had a PVI line that crossed a fat region. No significant differences were noted in conduction gaps in other areas between the 2 groups.</div></div><div><h3>Conclusion</h3><div>The findings indicate that the presence of fat on the LA roof, as identified using ICE, may be associated with a higher incidence of conduction gaps after PVI.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 1","pages":"Pages 3-10"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The increasing prevalence of cannabis use, with an estimated 219 million users globally, underscores the need to examine its potential health impacts. This review focuses on the arrhythmogenic properties of cannabis, particularly considering its active component, tetrahydrocannabinol, and its interactions with the endocannabinoid system. Epidemiological data and multiple studies indicate a significant association between cannabis use and various arrhythmias, particularly atrial fibrillation. The risk is notably higher among younger users and males. Additionally, case reports have linked cannabis use to other arrhythmias such as ventricular tachycardia and ventricular fibrillation, especially in individuals with underlying cardiac abnormalities. This review also discusses the arrhythmogenic potential of synthetic cannabinoids, which are more potent than natural tetrahydrocannabinol. Despite some studies suggesting no significant difference in arrhythmia burden between cannabis users and nonusers, the preponderance of evidence supports a correlation between cannabis use and increased arrhythmia risk. Given the rising tetrahydrocannabinol content in cannabis products and the limited data on the long-term cardiovascular effects, this review underscores the need for large-scale prospective studies. Until more comprehensive data are available, it is advisable for patients with channelopathies, structural heart disease, or prior myocardial infarction to avoid cannabis use.
{"title":"Arrhythmias and cannabis use: A comprehensive overview","authors":"Shweta Paulraj MD , Prakash Upreti MD , Ketan Tamirisa , Uyanga Batnyam MD","doi":"10.1016/j.hroo.2024.10.020","DOIUrl":"10.1016/j.hroo.2024.10.020","url":null,"abstract":"<div><div>The increasing prevalence of cannabis use, with an estimated 219 million users globally, underscores the need to examine its potential health impacts. This review focuses on the arrhythmogenic properties of cannabis, particularly considering its active component, tetrahydrocannabinol, and its interactions with the endocannabinoid system. Epidemiological data and multiple studies indicate a significant association between cannabis use and various arrhythmias, particularly atrial fibrillation. The risk is notably higher among younger users and males. Additionally, case reports have linked cannabis use to other arrhythmias such as ventricular tachycardia and ventricular fibrillation, especially in individuals with underlying cardiac abnormalities. This review also discusses the arrhythmogenic potential of synthetic cannabinoids, which are more potent than natural tetrahydrocannabinol. Despite some studies suggesting no significant difference in arrhythmia burden between cannabis users and nonusers, the preponderance of evidence supports a correlation between cannabis use and increased arrhythmia risk. Given the rising tetrahydrocannabinol content in cannabis products and the limited data on the long-term cardiovascular effects, this review underscores the need for large-scale prospective studies. Until more comprehensive data are available, it is advisable for patients with channelopathies, structural heart disease, or prior myocardial infarction to avoid cannabis use.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 1","pages":"Pages 78-85"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143178405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.hroo.2024.10.008
Matthew Hanson MD , Carli Peters MD , Andres Enriquez MD , Fermin Garcia MD
The coronary venous system offers a route for mapping and ablation of ventricular arrhythmias with suspected epicardial or intramural origins. Coronary venous mapping helps the operator to select the best ablation approach, decide when percutaneous epicardial access may be necessary and provides an opportunity for therapeutic interventions, including radiofrequency application inside the coronary veins or ethanol infusion. In this article we review the anatomy of the coronary venous system, the scenarios in which coronary venous mapping can be helpful and the technical aspects involved in coronary venous mapping.
{"title":"Cardiac venous system mapping for ventricular arrhythmia localization","authors":"Matthew Hanson MD , Carli Peters MD , Andres Enriquez MD , Fermin Garcia MD","doi":"10.1016/j.hroo.2024.10.008","DOIUrl":"10.1016/j.hroo.2024.10.008","url":null,"abstract":"<div><div>The coronary venous system offers a route for mapping and ablation of ventricular arrhythmias with suspected epicardial or intramural origins. Coronary venous mapping helps the operator to select the best ablation approach, decide when percutaneous epicardial access may be necessary and provides an opportunity for therapeutic interventions, including radiofrequency application inside the coronary veins or ethanol infusion. In this article we review the anatomy of the coronary venous system, the scenarios in which coronary venous mapping can be helpful and the technical aspects involved in coronary venous mapping.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 1","pages":"Pages 70-77"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.hroo.2024.12.003
Jeanne E. Poole MD, FHRS
{"title":"State of the Journal 2025","authors":"Jeanne E. Poole MD, FHRS","doi":"10.1016/j.hroo.2024.12.003","DOIUrl":"10.1016/j.hroo.2024.12.003","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 1","pages":"Pages 1-2"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143128518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Catheter ablation (CA) of atrial fibrillation (AF) has been proven to benefit patients with symptomatic AF and heart failure. However, the data on neurological outcomes including cerebrovascular accidents (CVA) and dementia remain controversial.
Objective
We aimed to determine the effect of CA on neurological events during long-term follow-up.
Methods
We performed a systematic review and meta-analysis of patients with AF who underwent CA of AF. The MEDLINE, EMBASE, and Web of Science databases were comprehensively searched from inception to January 2024. Studies that reported incidence of CVA and dementia in patients with AF were. Data from each study were combined by a random-effects model. The results were reported in risk ratios with 95% confidence intervals (CIs).
Results
A total of 29 studies and 379,993 patients (mean age 58 ± 4 years, 30% women) were included in the analysis. Mean follow-up was 36 ± 23 months (range 12–120 months). Patients who underwent CA of AF had a lower risk of developing CVA compared with medical management (odds ratio [OR] 0.54, 95% CI 0.42–0 69, I2 = 91%). Moreover, the risk of dementia was lower in the CA group compared with medical management (OR 0.51, 95% CI 0.4–0.66, I2 = 74%). The incidence of CVA in the CA group was 1% (95% CI 1%–2%, I2 = 97%), and the incidence of dementia was 2% (95% CI 2%–8%, I2 = 97%).
Conclusion
CA of AF resulted in lower risk of CVA and dementia compared with medical management alone at long-term follow-up.
{"title":"Catheter ablation for atrial fibrillation and risk of neurologic disease","authors":"Mohammed Al-Sadawi MBBCh, Nithi Tokavanich MD, Jasneet Devgun MD, Michael Ghannam MD, Rakesh Latchamsetty MD, Krit Jongsarangsin MD, Hakan Oral MD","doi":"10.1016/j.hroo.2024.11.004","DOIUrl":"10.1016/j.hroo.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Catheter ablation (CA) of atrial fibrillation (AF) has been proven to benefit patients with symptomatic AF and heart failure. However, the data on neurological outcomes including cerebrovascular accidents (CVA) and dementia remain controversial.</div></div><div><h3>Objective</h3><div>We aimed to determine the effect of CA on neurological events during long-term follow-up.</div></div><div><h3>Methods</h3><div>We performed a systematic review and meta-analysis of patients with AF who underwent CA of AF. The MEDLINE, EMBASE, and Web of Science databases were comprehensively searched from inception to January 2024. Studies that reported incidence of CVA and dementia in patients with AF were. Data from each study were combined by a random-effects model. The results were reported in risk ratios with 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>A total of 29 studies and 379,993 patients (mean age 58 ± 4 years, 30% women) were included in the analysis. Mean follow-up was 36 ± 23 months (range 12–120 months). Patients who underwent CA of AF had a lower risk of developing CVA compared with medical management (odds ratio [OR] 0.54, 95% CI 0.42–0 69, I<sup>2</sup> = 91%). Moreover, the risk of dementia was lower in the CA group compared with medical management (OR 0.51, 95% CI 0.4–0.66, I<sup>2</sup> = 74%). The incidence of CVA in the CA group was 1% (95% CI 1%–2%, I<sup>2</sup> = 97%), and the incidence of dementia was 2% (95% CI 2%–8%, I<sup>2</sup> = 97%).</div></div><div><h3>Conclusion</h3><div>CA of AF resulted in lower risk of CVA and dementia compared with medical management alone at long-term follow-up.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 1","pages":"Pages 32-38"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.hroo.2024.11.002
Steven Creasy MMath , Vadim Alexeenko PhD , Gregory Y.H. Lip MD, DFM , Gary Tse BA, MBBS, MA, MPH, PhD, MFPH , Philip J. Aston PhD, BSc , Kamalan Jeevaratnam DAHP, DVM, MMedSc, PhD
Background
The current clinical practice to diagnose atrial fibrillation (AF) requires repeated episodic monitoring and significantly underperform in their ability to detect AF episodes.
Objective
There is therefore potential for artificial intelligence–based methods to assist in the detection of AF. Better understanding of the optimal parameters for this detection can potentially improve the sensitivity for detecting AF.
Methods
Ten-second, 12-lead electrocardiogram signals were analyzed using complexity algorithms combined with machine learning techniques to predict patients who had a previously detected AF episode but had since returned to normal sinus rhythm. An investigation was performed into the impact of the sampling frequency of the electrocardiogram signal on the accuracy of the machine learning models used.
Results
Using a single complexity algorithm showed a peak accuracy of 0.69 when using signals sampled at 125 Hz. In particular, it was noted that improved accuracy occurred when using lead V6 compared with other available leads.
Conclusion
Based on these results, there is potential for 12-lead electrocardiogram signals to be recorded at 125 Hz as standard and used in conjunction with complexity analysis to aid in the detection of patients with AF.
{"title":"Electrocardiogram sampling frequency for the optimal performance of complexity analysis and machine learning models: Discrimination between patients with and without paroxysmal atrial fibrillation using sinus rhythm electrocardiograms","authors":"Steven Creasy MMath , Vadim Alexeenko PhD , Gregory Y.H. Lip MD, DFM , Gary Tse BA, MBBS, MA, MPH, PhD, MFPH , Philip J. Aston PhD, BSc , Kamalan Jeevaratnam DAHP, DVM, MMedSc, PhD","doi":"10.1016/j.hroo.2024.11.002","DOIUrl":"10.1016/j.hroo.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>The current clinical practice to diagnose atrial fibrillation (AF) requires repeated episodic monitoring and significantly underperform in their ability to detect AF episodes.</div></div><div><h3>Objective</h3><div>There is therefore potential for artificial intelligence–based methods to assist in the detection of AF. Better understanding of the optimal parameters for this detection can potentially improve the sensitivity for detecting AF.</div></div><div><h3>Methods</h3><div>Ten-second, 12-lead electrocardiogram signals were analyzed using complexity algorithms combined with machine learning techniques to predict patients who had a previously detected AF episode but had since returned to normal sinus rhythm. An investigation was performed into the impact of the sampling frequency of the electrocardiogram signal on the accuracy of the machine learning models used.</div></div><div><h3>Results</h3><div>Using a single complexity algorithm showed a peak accuracy of 0.69 when using signals sampled at 125 Hz. In particular, it was noted that improved accuracy occurred when using lead V<sub>6</sub> compared with other available leads.</div></div><div><h3>Conclusion</h3><div>Based on these results, there is potential for 12-lead electrocardiogram signals to be recorded at 125 Hz as standard and used in conjunction with complexity analysis to aid in the detection of patients with AF.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 1","pages":"Pages 48-57"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.hroo.2024.10.022
Jeanne du Fay de Lavallaz MD, PhD , Sven Knecht MSc , Tobias Reichlin MD , Philipp Krisai MD , Diego Mannhart MD , Teodor Serban MD , Laurent Roten MD , Rebecca Arnet MD , Corinne Isenegger MD , Judith Minder MD , Fabian Jordan MD , Christian Sticherling MD , Michael Kühne MD , Patrick Badertscher MD
Background
Recently, a novel cryoballoon ablation system (POLARx) for the treatment of atrial fibrillation has been introduced.
Objective
We aimed at systematically reviewing the efficacy and safety of the POLARx compared with the ArcticFront system.
Methods
Structured systematic database search for articles published between 2021 and 2024 reporting the efficacy and/or safety of the POLARx system for atrial fibrillation ablation. The co-primary endpoints were the long-term efficacy and safety of the POLARx system.
Results
Of the 24 studies with 5364 patients (weighted mean age 62.4 years) included, 15 compared the POLARx system (1746 patients) with the ArcticFront system (2282 patients). Despite significantly lower temperatures at isolation (POLARx –46.3 °C, ArcticFront –31.6 °C, P < .01) and nadir temperatures (POLARx –56.5 °C, ArcticFront –47.8 °C, P < .01), the POLARx system did not show a better acute (98.9% and 99.2% successfully ablated patients and 99.5% and 99.8% successfully ablated pulmonary veins in the POLARx and ArcticFront groups, respectively) or long-term (after a weighted mean follow-up of 12.6 months, the success rate was 69.5% with POLARx and 60.2% with ArcticFront, P = .98) efficacy. While most complications were similar between the POLARx and ArcticFront groups, the incidence of phrenic nerve palsies in the pooled cohorts (all POLARx vs all ArcticFront control patients) differed (2.7% vs 1.6% in the POLARx vs ArcticFront groups; odds ratio 1.79, 95% confidence interval 1.14–2.83, P = .01).
Conclusion
The novel POLARx system provided similar efficiency and acute/long-term efficacy but showed a higher incidence of phrenic nerve palsies compared with the ArcticFront system.
{"title":"Novel vs established cryoballoon ablation system for atrial fibrillation: A systematic review and meta-analysis","authors":"Jeanne du Fay de Lavallaz MD, PhD , Sven Knecht MSc , Tobias Reichlin MD , Philipp Krisai MD , Diego Mannhart MD , Teodor Serban MD , Laurent Roten MD , Rebecca Arnet MD , Corinne Isenegger MD , Judith Minder MD , Fabian Jordan MD , Christian Sticherling MD , Michael Kühne MD , Patrick Badertscher MD","doi":"10.1016/j.hroo.2024.10.022","DOIUrl":"10.1016/j.hroo.2024.10.022","url":null,"abstract":"<div><h3>Background</h3><div>Recently, a novel cryoballoon ablation system (POLARx) for the treatment of atrial fibrillation has been introduced.</div></div><div><h3>Objective</h3><div>We aimed at systematically reviewing the efficacy and safety of the POLARx compared with the ArcticFront system.</div></div><div><h3>Methods</h3><div>Structured systematic database search for articles published between 2021 and 2024 reporting the efficacy and/or safety of the POLARx system for atrial fibrillation ablation. The co-primary endpoints were the long-term efficacy and safety of the POLARx system.</div></div><div><h3>Results</h3><div>Of the 24 studies with 5364 patients (weighted mean age 62.4 years) included, 15 compared the POLARx system (1746 patients) with the ArcticFront system (2282 patients). Despite significantly lower temperatures at isolation (POLARx –46.3 °C, ArcticFront –31.6 °C, <em>P</em> < .01) and nadir temperatures (POLARx –56.5 °C, ArcticFront –47.8 °C, <em>P</em> < .01), the POLARx system did not show a better acute (98.9% and 99.2% successfully ablated patients and 99.5% and 99.8% successfully ablated pulmonary veins in the POLARx and ArcticFront groups, respectively) or long-term (after a weighted mean follow-up of 12.6 months, the success rate was 69.5% with POLARx and 60.2% with ArcticFront, <em>P</em> = .98) efficacy. While most complications were similar between the POLARx and ArcticFront groups, the incidence of phrenic nerve palsies in the pooled cohorts (all POLARx vs all ArcticFront control patients) differed (2.7% vs 1.6% in the POLARx vs ArcticFront groups; odds ratio 1.79, 95% confidence interval 1.14–2.83, <em>P</em> = .01).</div></div><div><h3>Conclusion</h3><div>The novel POLARx system provided similar efficiency and acute/long-term efficacy but showed a higher incidence of phrenic nerve palsies compared with the ArcticFront system.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 1","pages":"Pages 21-31"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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