Heart Rhythm O2最新文献

{"title":"Thrombosis occurring during transseptal puncture with electrocautery: A case report","authors":"Xiaohong Fu MM ,&nbsp;Jia Gao MD, PhD ,&nbsp;Min Guo MD, PhD,&nbsp;Meng Sun MD, PhD,&nbsp;Nan Zhang MD, PhD,&nbsp;Rui Wang MD, PhD","doi":"10.1016/j.hroo.2025.10.004","DOIUrl":"10.1016/j.hroo.2025.10.004","url":null,"abstract":"<div><div>Electrocautery-assisted transseptal puncture offers clinical advantages but is associated with potential complications. Herein, we describe a case encountered during radiofrequency ablation for atrial fibrillation, in which intracardiac echocardiography detected a thrombus that formed after electrocautery and guidewire traversal of the interatrial septum. The thrombus appeared as a hyperechoic, cord-like structure adherent to the right atrial side of the interatrial septum. Prompt heparin administration led to thrombus resolution without embolization, enabling the procedure to continue safely. This case underscores the thrombotic risk of electrocautery transseptal puncture and highlights the need for further research on optimal anticoagulation strategies.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 183-187"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulsed field ablation: The pitfall of remote stunning or the importance of contact and contiguity","authors":"Hans Kottkamp MD ,&nbsp;Carlos Felipe Antepara Amador MD ,&nbsp;Lea Melki PhD ,&nbsp;Laura Shenavai MD ,&nbsp;Burghard Schumacher MD","doi":"10.1016/j.hroo.2025.10.015","DOIUrl":"10.1016/j.hroo.2025.10.015","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 191-192"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transthoracic echocardiographic and artificial intelligence-enabled electrocardiography predictors of atrial arrhythmia recurrence after surgical ablation","authors":"Dylan Goings MD ,&nbsp;Ikram U. Haq MBBS ,&nbsp;Arman Arghami MD, MPH ,&nbsp;Zachi Attia PhD ,&nbsp;Gabor Bagameri MD ,&nbsp;Michael Brandt MD ,&nbsp;Freddy Del-Carpio Munoz MD, FHRS ,&nbsp;Paul A. Friedman MD, FHRS ,&nbsp;Kimberly A. Holst MD ,&nbsp;Peter A. Noseworthy MD, MBA, FHRS ,&nbsp;Konstantinos C. Siontis MD, FHRS ,&nbsp;Alan Sugrue MB, BCh, FHRS ,&nbsp;Ammar M. Killu MBBS, FHRS","doi":"10.1016/j.hroo.2025.11.001","DOIUrl":"10.1016/j.hroo.2025.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Recurrence of atrial fibrillation (AF)/flutter (AFl) after surgical ablation remains difficult to predict. Integration of novel biomarkers may enhance risk stratification.</div></div><div><h3>Objective</h3><div>This study aimed to assess whether combining preoperative transthoracic echocardiography (TTE) and artificial intelligence-enabled electrocardiography (AI-ECG) scores improves the prediction of AF/AFl recurrence after surgical ablation.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 1696 patients who underwent surgical AF/AFl ablation from 2006 to 2025 with available preoperative TTE and ECG and postblanking (90-day) ECG follow-up. Clinical, TTE, and AI-ECG variables (AF probability, ECG-estimated age, heart failure with preserved ejection fraction, left ventricular dysfunction, and aortic stenosis scores) were assessed. Cox proportional hazards and random survival forest models (80:20 train-test split) identified predictors of recurrence.</div></div><div><h3>Results</h3><div>Among 1696 patients (mean age 67.3 ± 10.2 years; 61.7% male), 949 (56%) had AF/AFl recurrence over a median 3.14-year follow-up. Patients with recurrence had larger left atrial area (30.4 vs 24.5 cm²), elevated mitral E-wave velocity (1.015 vs 0.896 m/s), and adverse AI-ECG biomarkers for AF probability, ECG-estimated age, heart failure with preserved ejection fraction, left ventricular dysfunction, and aortic stenosis (all <em>P</em> &lt; .001). In multivariable analysis, independent predictors of recurrence included higher ECG-AF probability (<em>P</em> &lt; .0001), older ECG-estimated age (<em>P</em> = .0002), left atrial area (<em>P</em> = .046), body mass index (<em>P</em> = .036), and diastolic blood pressure (hazard ratio 1.008/mm Hg; <em>P</em> = .010). The final Cox model achieved a concordance index of ∼0.67 and a 3-year Brier score of 0.21, with 3-year freedom-from-arrhythmia rates of ∼85% vs ∼43% for the lowest- vs highest-risk quartiles. Random survival forest modeling yielded a slightly higher concordance index (∼0.69).</div></div><div><h3>Conclusion</h3><div>Preoperative AI-ECG biomarkers (AF probability, age discordance) and TTE markers of atrial remodeling independently predicted AF/AFl recurrence after surgical AF/AFl ablation. Integration of these metrics improved risk stratification.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 9-17"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in procedural characteristics, safety, and clinical outcomes of pulsed field ablation for atrial fibrillation","authors":"Fabian Jordan MD ,&nbsp;Behnam Subin MD ,&nbsp;Corinne Isenegger MD ,&nbsp;Jonas Brügger MD ,&nbsp;Jeanne du Fay de Lavallaz MD, PhD ,&nbsp;Christine S. Zuern MD ,&nbsp;Emel Kaplan MD ,&nbsp;David Spreen MD ,&nbsp;Sven Knecht DSc ,&nbsp;Philipp Krisai MD ,&nbsp;Nicolas Schaerli MD ,&nbsp;Beat Schär MD ,&nbsp;Gian Völlmin MS ,&nbsp;Felix Mahfoud MD ,&nbsp;Christian Sticherling MD ,&nbsp;Michael Kühne MD ,&nbsp;Patrick Badertscher MD","doi":"10.1016/j.hroo.2025.10.010","DOIUrl":"10.1016/j.hroo.2025.10.010","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies on pulmonary vein isolation (PVI) for the treatment of atrial fibrillation (AF) using conventional thermal techniques have shown inconsistent sex-related outcomes. Pulsed field ablation (PFA) is a novel energy source offering myocardial-selective ablation. However, sex-specific data on its performance are limited.</div></div><div><h3>Objective</h3><div>This study aimed to compare procedural characteristics, safety, and clinical outcomes of PFA in female and male patients undergoing AF ablation.</div></div><div><h3>Methods</h3><div>This prospective study included consecutive patients with paroxysmal or persistent AF undergoing PFA-based PVI using a pentaspline catheter. Follow-up was conducted at 3, 6, and 12 months. A 1:1 propensity score-matched cohort was created to evaluate sex-specific outcomes.</div></div><div><h3>Results</h3><div>Among 425 patients, 134 (32%) were women. Compared with men, women were older (median 70 vs 65 years; <em>P</em> &lt; .001), more frequently had paroxysmal AF (60% vs 45%; <em>P</em> = .006), and had lower rates of coronary artery disease (6% vs 14%; <em>P</em> = .029). Although overall procedural times were similar, female patients with paroxysmal AF had significantly longer procedure, left atrial dwell, and fluoroscopy times than males. Complication rates were comparable (1.5% in women vs 0.7% in men; <em>P</em> = .371). After propensity score matching (133 women to 133 men), arrhythmia recurrence at 1-year follow-up was higher in women (23% vs 12%; <em>P</em> = .017; hazard ratio 2.2; standard error 0.34).</div></div><div><h3>Conclusion</h3><div>Significant sex-related differences exist in clinical outcomes after PVI with PFA in AF. Further studies exploring underlying mechanisms and tailored approaches may enhance outcomes in female patients.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 37-45"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SGLT2 inhibitors and risk of atrial fibrillation recurrence after catheter ablation: A systematic review and meta-analysis of observational studies","authors":"Marco Zuin MD, MS, FESC, FACC, FANMCO ,&nbsp;Francesco Vitali MD, PhD ,&nbsp;Luca Canovi MD ,&nbsp;Michele Malagù MD ,&nbsp;Cristina Balla MD, PhD ,&nbsp;Matteo Serenelli MD ,&nbsp;Alessandro Fucili MD, PhD ,&nbsp;Matteo Bertini MD, PhD, FAIAC","doi":"10.1016/j.hroo.2025.10.017","DOIUrl":"10.1016/j.hroo.2025.10.017","url":null,"abstract":"<div><h3>Background</h3><div>Sodium–glucose cotransporter 2 inhibitors (SGLT2i) exhibit potential antiarrhythmic effects, but their influence on atrial fibrillation (AF) recurrence after catheter ablation (CA) remains unclear.</div></div><div><h3>Objective</h3><div>This study aimed to assess the association between SGLT2i therapy and the risk of recurrent AF after CA through an updated systematic review and meta-analysis of observational studies.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed and Scopus (inception to July 2025) identified eligible observational studies. Pooled hazard ratios for AF recurrence after CA were estimated using Mantel–Haenszel random-effects models, with heterogeneity assessed by I². The protocol was registered in PROSPERO (CRD42024620765).</div></div><div><h3>Results</h3><div>6 observational studies were included, comprising 2165 patients (mean age 65.2 years; 34.9% female), of whom 663 received SGLT2i therapy and 1502 did not. The average follow-up duration was 19.9 months. Pooled analysis showed a significantly reduced risk of AF recurrence in patients treated with SGLT2i compared with those not receiving SGLT2i (hazard ratio 0.49; 95% confidence interval 0.36–0.67; <em>P</em> &lt; .0001; I² = 68.3%). Subgroup analyses confirmed consistent benefits in both diabetic and nondiabetic patients and with the use of radiofrequency or cryoablation. A multivariable meta-regression model including age, female sex, diabetes mellitus, and follow-up duration accounted for a significant portion of the observed heterogeneity (R² = 58.1%; <em>P</em> = .01).</div></div><div><h3>Conclusion</h3><div>SGLT2i therapy is associated with a significantly lower risk of AF recurrence after CA, independent of diabetic status. Further randomized controlled trials are warranted to validate these findings and explore the mechanisms underlying this association.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 53-60"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causality of atrial fibrillation and left atrial traits: Genetic and epigenetic perspectives","authors":"Dihui Cai MMed ,&nbsp;Jie Xu MD, PhD ,&nbsp;Yuheng Jiao MMSc ,&nbsp;Yinyin Shen BMed ,&nbsp;Yingying Liao BMed ,&nbsp;Wei Han MD, PhD","doi":"10.1016/j.hroo.2025.10.018","DOIUrl":"10.1016/j.hroo.2025.10.018","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) is associated with left atrial (LA) abnormalities, yet the causality between them is not well defined.</div></div><div><h3>Objective</h3><div>This study aimed to investigate the genetic correlations and bidirectional causality between AF and LA traits.</div></div><div><h3>Methods</h3><div>We used genome-wide association study (GWAS) data from FinnGen and other cohorts. Linkage disequilibrium score regression was applied for estimates of genetic correlations, and Mendelian randomization (MR) analysis was conducted for causality analysis.</div></div><div><h3>Results</h3><div>Linkage disequilibrium score regression revealed significant genetic correlations between LA traits and AF. Forward MR analyses established causal associations of AF on LA active emptying fraction (LAaEF) (β = −0.092; <em>P</em> = 2.29 × 10⁻¹⁴), LA minimum volume (LAmin) (β = 0.083; <em>P</em> = 1.11 × 10⁻¹¹), and LA maximum volume (β = 0.063; <em>P</em> = 5.43 × 10⁻⁸), whereas no causal relationship was observed with LA passive emptying fraction. Reverse MR indicated a causal effect of LAaEF on AF (odds ratio [OR] 0.736; <em>P</em> = .003). Epigenetic MR identified 3 CpG sites for AF (cg27529934, cg13639451, and cg07191189), which showed causal relationships with LA traits. Moreover, LA traits were causally associated with heart failure (LAaEF, OR 0.879; <em>P</em> = .013; LAmin, OR 1.119; <em>P</em> = .037) and cardioembolic stroke (LAaEF, OR 0.689; <em>P</em> = .010; LA passive emptying fraction, OR 0.556; <em>P</em> = .002; LAmin, OR 1.733; <em>P</em> = .045).</div></div><div><h3>Conclusion</h3><div>LAaEF is bidirectionally causally linked with AF, underscoring its importance in the management of AF. Epigenetic modifications, as evidenced by specific CpG sites, may contribute to atrial remodeling in AF, offering new avenues for research into the AF pathophysiology.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 143-151"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac resynchronization therapy in patients with cancer: A single cancer center experience","authors":"Nicholas King MD ,&nbsp;Meera Kapadia MD ,&nbsp;Scott Schubert MD ,&nbsp;Jerril Jacob MD ,&nbsp;Juhee Song PhD ,&nbsp;Salil Kumar MD ,&nbsp;Leslie Ynalvez MD ,&nbsp;Bharat Kantharia MD, FHRS ,&nbsp;Anita Deswal MD ,&nbsp;Kaveh Karimzad MD","doi":"10.1016/j.hroo.2025.10.006","DOIUrl":"10.1016/j.hroo.2025.10.006","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 188-190"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac lead perforation: Mechanisms, detection, and therapeutic approaches","authors":"Ameer Awashra MD ,&nbsp;Mohammed AbuBaha MD ,&nbsp;Hossam Salameh MD ,&nbsp;Hammam Jallad MD ,&nbsp;Aya Milhem MD ,&nbsp;Anwar Zahran MD ,&nbsp;Aseel Badwan MD ,&nbsp;Fathi Milhem MD ,&nbsp;Abdalhakim Shubietah MD","doi":"10.1016/j.hroo.2025.08.008","DOIUrl":"10.1016/j.hroo.2025.08.008","url":null,"abstract":"<div><div>Cardiac lead perforation is an infrequent but serious complication of cardiac implantable electronic devices, with possibly lethal consequences if left untreated. Because of its very varied clinical appearance and lack of established criteria, perforation still presents diagnostic and therapeutic hurdles despite continuous improvements in lead design and insertion procedures. This review summarizes current research on the processes, risk factors, and clinical range of lead perforation. Thin myocardial walls, especially at the right ventricular apex; active-fixation leads; and operator-dependent elements, such as lead placement and torque, are important anatomic and procedural contributions. Steroid usage, low body mass index, and female sex all increase risk. A strong index of suspicion is often required for prompt diagnosis because presentations vary from asymptomatic instances to severe tamponade. Device interrogation must be integrated with imaging modalities, particularly computed tomography and echocardiography, which each have unique benefits based on the clinical setting, to achieve accurate detection. From cautious observation in stable patients to immediate percutaneous or surgical intervention in unstable or worsening situations, management approaches are highly customized. New technologies, including subcutaneous implantable cardioverter-defibrillators and leadless pacemakers, have the potential to lower the incidence of perforations, but they also present new difficulties that need to be further investigated. Importantly, the lack of consistent diagnostic standards hinders study/ comparability and postpones the creation of guidelines. Standardizing diagnostic criteria, establishing multicenter prospective registries, developing machine learning-based risk stratification tools, and conducting clinical trials to inform the treatment of asymptomatic or delayed perforations are among the top goals for the future. To improve patient outcomes and advance clinical practice, international cooperation and uniform reporting standards are crucial.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 156-170"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial experience with the extravascular implantable cardioverter-defibrillator in pediatric patients","authors":"Mark Walsh MD ,&nbsp;Ciara Ryan MD ,&nbsp;Terence Prendiville MD ,&nbsp;Frank Casey MD ,&nbsp;Brian McCrossan MD ,&nbsp;Colin McMahon MD ,&nbsp;Kevin P. Walsh MD","doi":"10.1016/j.hroo.2025.10.020","DOIUrl":"10.1016/j.hroo.2025.10.020","url":null,"abstract":"<div><h3>Background</h3><div>There is growing experience worldwide with the extravascular implantable cardioverter-defibrillator (EV-ICD). It is a single-lead implantable cardioverter-defibrillator that is implanted behind the sternum and can provide emergency pacing.</div></div><div><h3>Objective</h3><div>We describe the initial experience of 12 implantations in pediatric patients at our hospital.</div></div><div><h3>Methods</h3><div>The data on all Aurora EV-ICD (Medtronic) implantations from a single center from May 2024 to April 2025 were reviewed. Patient demographics, procedural characteristics, complications, outcome data, and device follow-up data were reviewed. The data are presented as medians and ranges.</div></div><div><h3>Results</h3><div>A total of 12 patients underwent implantation of the EV-ICD. The median age at the time of implantation was 14.5 years (9–16 years), and the median weight was 51 kg (27–82 kg). All patients underwent successful implantation. There was 1 pleural lead placement, which was rectified 5 days later; there were no other complications. The median procedure time was 1 hour and 50 minutes (range 1 hour and 43 minutes to 2 hours and 14 minutes), and the median fluoroscopy time was 2 minutes and 12 seconds (range 1 minute and 34 seconds to 3 minutes and 23 seconds). Except for the lead repositioning, no patients required extraction of the device to date, nor have any received inappropriate shocks. Device parameters such as sensing and impedance remained stable over time.</div></div><div><h3>Conclusion</h3><div>The EV-ICD can safely be implanted in pediatric patients with good short-term results. Further studies are required to establish the longer-term safety of the device in young people.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 103-108"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-hospital outcomes of catheter ablation for ventricular tachycardia in patients with prior coronary artery bypass grafting","authors":"Mahmoud Eisa MD, FHRS ,&nbsp;Hossam Elbenawi MD ,&nbsp;Magdi Zordok MD ,&nbsp;Ehab Hassan Hady MD ,&nbsp;Riyadh Saif MD ,&nbsp;Amir Hanafi MD ,&nbsp;Mohan Rao MD ,&nbsp;Harsh Patel MD, FHRS ,&nbsp;Justin Z. Lee MD ,&nbsp;Abhishek J. Deshmukh MD ,&nbsp;Christopher V. DeSimone MD, PhD, FHRS","doi":"10.1016/j.hroo.2025.09.001","DOIUrl":"10.1016/j.hroo.2025.09.001","url":null,"abstract":"<div><h3>Background</h3><div>Catheter ablation is an established therapy for recurrent ventricular tachycardia (VT). However, outcomes in patients with prior coronary artery bypass grafting (CABG) remain poorly defined.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate in-hospital outcomes following VT ablation in patients with and without a history of CABG.</div></div><div><h3>Methods</h3><div>We used the National Inpatient Sample database (2008–2022) to identify adults with a primary diagnosis of VT who underwent ablation. Patients were stratified by prior CABG status. Propensity score weighting (PSW) was applied to adjust for baseline characteristics. The primary outcome was in-hospital mortality. Secondary outcomes included procedural complications and measures of health care utilization. A subgroup analysis was performed for patients with coronary artery disease (CAD).</div></div><div><h3>Results</h3><div>Among 35,860 patients undergoing VT ablation, 18.2% had a history of CABG. After PSW, in-hospital mortality was similar between CABG and non-CABG groups (2.0% vs 2.3%, <em>P =</em> 0.771). Prior CABG was associated with higher rates of cardiac arrest (2.2% vs 1.1%, <em>P =</em> 0.03) and acute myocardial infarction (AMI) (5.2% vs 2.7%, <em>P =</em> 0.014), but lower rates of pericardial complications (0.9% vs 7.3%, <em>P &lt;</em> 0.001). In the CAD subgroup, the association between CABG and AMI was attenuated and trended toward a higher incidence in the CABG group.</div></div><div><h3>Conclusion</h3><div>In this national cohort, prior CABG was not associated with increased in-hospital mortality or major complications after VT ablation. Patients who underwent CABG experienced higher rates of AMI and cardiac arrest but fewer pericardial complications. In a CAD- subgroup, the AMI association was attenuated and trended in the same direction.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 109-118"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}