BackgroundCatheter ablation of ventricular arrhythmias (VAs) arising from the left ventricle`s (LV) papillary muscles (PM) is challenging. In this study we present results of catheter ablation using multiple energy sources and image‐based approaches.MethodsFifty‐three patients (49 ± 17 years old; 34% females; median LV ejection fraction 53 ± 11%) underwent catheter cryoablation or radiofrequency (RF) ablation with non‐contact force sensing (Non‐CFS) catheters and cardiac computed tomography integration (CTII) into the electroanatomical mapping system or contact force sensing RF (CFS RF) ablation catheters and intracardiac echo‐facilitated 3D electroanatomical mapping. Ventricular arrhythmias foci were mapped at either the anterolateral (ALPM) or posteromedial papillary muscles (PMPM). Ablation was performed using an 8‐mm cryoablation catheter (CRYO); a Non‐CFS 4‐mm open‐irrigated RF catheter; or a CFS RF 3.5‐mm open‐irrigated tip catheter, via transmitral or transaortic approach.ResultsAcute success rate was 83% for Non‐CFS RF/CTII; 100% for CRYO/CTII (n = 16) and CFS RF/ICE3D (n = 14) (P = 0.03). Catheter stability was achieved in all patients treated with Cryo/CTII. VA recurrence at 12 months follow‐up was 48% (n = 11) for Non‐CFS RF/CTII; 19% (n = 3) for CRYO/CTII; and 7% (n = 1) for CFS RF/ICE3D (P = 0.02).ConclusionsNon‐CFS/CTII was associated with an increased risk of recurrence of the clinical arrhythmia. Ablation with either CFS RF/ICE3D or CRYO/CTII showed high acute success rates and low recurrence rates during follow‐up. Cryoablation provided stable contact and was less arrhythmogenic.

SUMMARYIntroduction: Management of atrial fibrillation (AF) is hampered by frequent recurrences after restoration of sinus rhythm. Delayed interatrial conduction has been associated with the development of AF in different clinical settings. The aim of our study was to assess whether advanced interatrial block (aIAB) was associated with AF recurrence after pharmacological cardioversion with two different antiarrhythmic drugs. Methods: We included 61 patients with recent onset AF without structural heart disease that underwent successful pharmacological cardioversion. Thirty-one patients received a single oral dose of propafenone, and 30 patients received iv vernakalant. A 12-lead ECG (filter 150 Hz, 25 mm/s, 10 mm/mV) after conversion was evaluated for the presence of interatrial block (IAB); partial (pIAB): P-wave duration > 120 ms, and advanced (aIAB): P-wave > 120 ms and biphasic morphology (AE) in inferior leads. Clinical follow-up and electrocardiographic recordings were performed for a 12-month period. Results: Age was 58 AE 10.4 years and 50.8% were male. aIAB was present in 11 patients (18%) and pIAB in 10 (16.4%). At 1-year follow-up, 22 patients (36%) had AF recurrence. The recurrence rate with aIAB was 90.9% versus 70% in those with pIAB and 12.5% in normal P-wave duration (P = 0.001). The presence of aIAB was strongly associated with AF recurrence (odds ratio 18.4 in multivariable modeling). Recurrence was not affected by the drug used for cardioversion (P = 0.92). Conclusion: Advanced interatrial block is associated with higher risk of AF recurrence at 1 year after pharmacological cardioversion, independent of the drug used.

Methods Study DesignWe conducted a longitudinal and prospective cohort study of all the consecutive patients undergoing scheduled PVI between June 2015 and May 2016 at the Instituto Cardiovascular de Buenos Aires (ICBA). Patients with paroxysmal or persistent atrial fibrillation (AF), either refractory or intolerant to antiarrhythmic therapy, and those with recurrent AF undergoing a new pulmonary vein ablation were included.The information was introduced in the database of the electrophysiology laboratory of the ICBA and was prospectively retrieved.

The aim of the study is to evaluate the success rate, freedom from AF and complications associated with AF CA in HF patients with preserved or reduced LVEF. The predictors of AF recurrence, the rate of HF hospitalizations and the NYHA functional class after one year of follow-up according to the presence or absence of SR will also be analyzed. Methods Study design and population We conducted a prospective, observational and single-center study. Consecutive patients with a history of AF and signs and symptoms of HF or LVEF less than 45%, who underwent CA between July 2011 and March 2016, were included. The patients were refractory to or

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