Recurrent AF following selective PV isolation is overwhelmingly associated with PV electrical reconnection. Repeat PV isolation without linear ablation provides effective treatment for recurrent AF in patients in whom an initial PV isolation procedure failed, independent of clinical characteristics.

Electroanatomic mapping during sinus rhythm allows accurate 3D characterization of infarct architecture and defines the relationship of electrophysiological and anatomic abnormalities. This technique may prove useful in devising anatomically based strategies for ablation of ventricular tachycardia.

Left atrial thrombus identified on ICE may occur during LA catheter ablation procedures despite aggressive anticoagulation. Spontaneous echo contrast may predict risk for LA thrombus formation. Left atrial thrombus may be successfully withdrawn into the RA under ICE imaging with no overt complications.

ICE-diagnosed SEC before transseptal catheterization identifies an increased risk of LA thrombus. Increased intensity of heparin anticoagulation (ACT >300 seconds) during LA ablation for AF may prevent LA thrombus formation especially in patients with SEC.

A hypoxic and acidic tumor microenvironment (TME) plays a significant role in cancer development through complex cellular signaling networks, and it is thus challenging to completely eradicate tumors via monotherapy. Here, PEGylated CoFe 2 O 4 nanoflowers (CFP) with multiple enzymatic activities, serving as bioreactors responsive to TME cues, were synthesized via a typical solvothermal method for augmented sonodynamic therapy (SDT) and chemodynamic therapy (CDT) with elicitation of robust immune response. The CFP occupying multivalent elements (Co 2+/3+ , Fe 2+/3+ ) exhibited strong Fenton-like and catalase-like activity. In another aspect, CFP itself is a brand-new sonosensitizer for highperformance SDT based on ultrasound-triggered electron (e − )/ hole (h + ) pair separation from the energy band with promptness and high efficiency. With efficient enrichment in tumorous tissue as revealed by magnetic resonance imaging, CPF could generate • OH for CDT relying on Fenton-like reactions. Moreover, catalase-mimicking CFP could react with endogenous H 2 O 2 to generate molecular oxygen, and high O 2 level may promote the production of 1 O 2 for SDT. What's more, the reactive oxygen species obtained from combined SDT/CDT could efficiently trigger immunogenic cell death through a synergistic therapy based on the elicitation of antitumor immunity with the aid of an immune checkpoint blockade for the sake of suppressing primary and distant tumors as well as lung metastasis. Taken together, this paradigm delivers useful insights for developing in-coming nanocomposites based on cobalt ferrite for cancer theranostics.

Ostial ablation for PV isolation may induce a mild-to-moderate increase in PV flow velocity, which can be identified using an ultrasound catheter with Doppler color flow imaging. Increases in PV flow velocity (<158 cm/sec) after a primary ablation procedure appear to be well tolerated, and a return toward baseline flow characteristics should be anticipated by 3 months. A more cautious approach may be required for patients undergoing repeat PV isolation.

The delivery of multiple RF ablation lesions, often necessary for cure of IST, can cause considerable atrial swelling and resultant narrowing of the SVC-RA junction. Smaller venous structures, such as the coronary sinus and the pulmonary veins, would also be expected to be vulnerable to this complication. Thus, ICE imaging may be helpful in preventing excessive tissue swelling leading to venous occlusion during catheter ablation procedures.

No abstract