Heart rhythm
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Non-Invasive Median Nerve Stimulation with a Wearable Stimulator to Reduce Atrial Arrhythmia Recurrence after Atrial Fibrillation Ablation: The NEUROPULSE Pilot

Sep 20, 2026

The authors aimed to evaluate the effectiveness of non-invasive median nerve stimulation (MNS) as an adjunct therapy to reduce atrial arrhythmia recurrence following atrial fibrillation (AF) ablation. In a randomized pilot study involving 77 patients, those receiving active MNS experienced significantly fewer arrhythmia events compared to the sham group, suggesting that MNS may improve rhythm outcomes without additional myocardial injury. The findings indicate a need for further investigation in larger trials to confirm these results.

Integrated Hemodynamic Sensing, Electrical Sensing, and Ventricular Pacing from a Novel Substernal Lead: An Acute Human Study

Sep 20, 2026

The authors aimed to evaluate the acute feasibility and performance of a novel 3-dimensional substernal shock lead that integrates hemodynamic sensing, electrical sensing, and ventricular pacing in humans. In a prospective study involving five patients, they successfully demonstrated that the lead could be placed and removed without adverse events, while providing interpretable hemodynamic signals that corresponded with various cardiac rhythms. These results support the potential for developing physiology-guided extravascular ICD systems, although further research is needed for chronic performance validation.

Quantitative CT Lead Localization Reveals Proximal Left Bundle Targeting Facilitates Superior Physiologic Pacing

Sep 20, 2026

The authors aimed to determine whether a quantitative CT-based classification of conduction system pacing (CSP) lead positions could improve physiological pacing outcomes by identifying the optimal lead placement along the conduction axis. Their findings indicate that proximal lead positioning (within 25 mm of the His bundle) significantly enhances near-native paced activation compared to distal placements, highlighting the necessity of quantitative imaging for accurate lead localization, as traditional methods like ECG and procedural labels were insufficient.

STAR Apollo™ Map-Guided Redo Ablation for Recurrent Persistent Atrial Fibrillation after Prior Pulmonary Vein Isolation: Procedural Feasibility, Safety, and Twelve-Month Rhythm Outcomes from a Prospective Multicenter Study (NCT05826665)

Sep 20, 2026

The authors aimed to evaluate the procedural feasibility, safety, and 12-month rhythm outcomes of STAR Apollo™ Map-guided redo ablation in patients with recurrent persistent atrial fibrillation (AF) following prior pulmonary vein isolation (PVI). The study found that the procedure was feasible and safe, with a significant proportion of patients achieving sinus rhythm and symptom improvement at 12 months. However, the authors note that the study's design limits the ability to establish the incremental efficacy of STAR guidance compared to standard PVI re-isolation.

Isolated Phrenic and Vagus Nerve Stimulation and Conduction Suppression Induced by Electroporation Pulses

Sep 18, 2026

The authors aimed to investigate how different pulse parameters of biphasic electroporation pulses affect the excitation and conduction suppression of isolated swine phrenic and vagus nerves. They found that stimulation thresholds and conduction suppression were significantly influenced by pulse width and amplitude, with high-amplitude pulses causing reversible conduction suppression. This study provides insights into the neural effects of pulsed field ablation, which may help explain clinical phenomena such as bradycardia and coronary vasospasm.

Epicardial adipose tissue in paroxysmal and persistent atrial fibrillation ablation using photon counting CT and automated 3D atrial segmentation: The Prospective AFAT Study

Sep 18, 2026

The study aimed to quantify biatrial epicardial adipose tissue (EAT) using photon-counting CT and assess its relationship with arrhythmia recurrence after catheter ablation in patients with paroxysmal and persistent atrial fibrillation (AF). The findings revealed that higher left atrial EAT volumes were associated with increased recurrence of arrhythmias in persistent AF but not in paroxysmal AF, suggesting that EAT may serve as a useful imaging biomarker for predicting outcomes in AF patients.

Heart Rhythm Society and Heart Rhythm advocates position statement: Prior authorization in cardiac electrophysiology: Evidence, policy, and reform

Sep 17, 2026

The authors investigate how prior authorization (PA) requirements from Medicare Advantage and commercial insurers create barriers to necessary cardiac electrophysiology care, leading to patient harm and increased administrative burdens. They analyze the financial and structural factors contributing to these denials, review oversight findings, and highlight the clinical consequences of PA delays. The paper concludes with recommendations for improving the appeals process and advocating for reform in the regulatory landscape.

Sodium-Glucose Cotransporter-2 Inhibitor Use and Lower Left Atrial Epicardial Adipose Tissue Volume Across Metabolic Phenotypes in Atrial Fibrillation

Sep 17, 2026

The authors aimed to determine whether the use of sodium-glucose cotransporter-2 inhibitors (SGLT2i) is associated with reduced left atrial epicardial adipose tissue volume (LA-EATV) in patients with atrial fibrillation (AF) undergoing ablation, and how this association varies across different metabolic phenotypes. Their findings indicate that SGLT2i use is linked to approximately 25% lower LA-EATV, with the association being stronger in patients with elevated triglyceride levels and weaker in those with higher body mass index. These results suggest a potential metabolic phenotype influence on the efficacy of SGLT2i in modifying LA-EATV, warranting further investigation.

Diagnostic and therapeutic challenges in Andersen-Tawil syndrome

Sep 17, 2026

The authors investigate the diagnostic and therapeutic challenges associated with Andersen-Tawil syndrome (ATS), a rare genetic disorder characterized by ventricular arrhythmias, periodic paralysis, and phenotypic variability. They highlight the complexities in diagnosis due to phenotypic heterogeneity and the limited evidence for effective treatments, emphasizing the need for individualized management strategies and multidisciplinary evaluation. The paper underscores the importance of understanding the underlying genetic mechanisms and the variability in patient responses to treatment.

The Effect of Glucagon-Like Peptide-1 Receptor Agonists versus Sodium-Glucose Cotransporter-2 Inhibitors Alone and in Combination on AF Recurrence and Cardiovascular Outcomes after Catheter Ablation for Atrial Fibrillation

Sep 17, 2026

The authors aimed to evaluate the effects of glucagon-like peptide-1 receptor agonists (GLP-1 RA), sodium-glucose cotransporter-2 inhibitors (SGLT2i), and their combination on atrial fibrillation (AF) recurrence after catheter ablation. Their findings indicated that while AF recurrence rates were similar across all treatment groups, combination therapy significantly reduced all-cause mortality compared to either treatment alone.