L.V.A. Ablation Works Best in Enlarged Atria 09/29/25
Welcome to Cardiology Today â Recorded September 29, 2025. This episode summarizes 5 key cardiology studies on topics like ablation depth and dilated cardiomyopathy. Key takeaway: L.V.A. Ablation Works Best in Enlarged Atria.
Article Links:
Article 1: Premature Ventricular Contractions on Healthy and Diseased Hearts: Differential Acute Effect of Coupling Interval and Location. (Heart rhythm)
Article 2: Electrical Impedance Spectroscopy Facilitates Quantitative Depth Monitoring of Pulsed Field Ablation: An Impedimetric Approach with Preclinical Validation. (Heart rhythm)
Article 3: What is the Diagnostic Utility of Cardiac Magnetic Resonance Imaging in Unselected Patients with Premature Ventricular Contractions and Non-Sustained Ventricular Tachycardia? (The American journal of cardiology)
Article 4: Intellectual and Neurodevelopmental Delays in Pediatric Catecholaminergic Polymorphic Ventricular Tachycardia: Distinct Characteristics and a More Malignant Neurocardiac Phenotype. (Circulation. Arrhythmia and electrophysiology)
Article 5: Efficacy of Low-Voltage-Area Ablation Is Enhanced in Patients With Advanced Left Atrial Enlargement: A Subanalysis of the SUPPRESS-AF Trial. (Circulation. Arrhythmia and electrophysiology)
Full episode page: https://podcast.explainheart.com/podcast/l-v-a-ablation-works-best-in-enlarged-atria-09-29-25/
đ Featured Articles
Article 1: Premature Ventricular Contractions on Healthy and Diseased Hearts: Differential Acute Effect of Coupling Interval and Location.
Journal: Heart rhythm
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41016420
Summary: This swine study compared premature ventricular contraction induced changes in left ventricular pressure in healthy hearts versus hearts with dilated cardiomyopathy. Premature ventricular contractions delivered at shorter coupling intervals resulted in greater acute hemodynamic dysfunction, with this effect being more pronounced in diseased hearts. The findings suggest that premature ventricular contraction induced cardiomyopathy is likely related to the timing of the contraction and is exacerbated by pre-existing heart disease.
Article 2: Electrical Impedance Spectroscopy Facilitates Quantitative Depth Monitoring of Pulsed Field Ablation: An Impedimetric Approach with Preclinical Validation.
Journal: Heart rhythm
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41016419
Summary: This preclinical study demonstrates that electrical impedance spectroscopy can accurately monitor ablation depth during pulsed field ablation procedures. The change rate of low-frequency impedance correlated with lesion depth in both monopolar and bipolar pulsed field ablation settings. This technology holds promise for real-time, quantitative assessment of ablation depth, potentially improving the safety and efficacy of pulsed field ablation for cardiac arrhythmias.
Article 3: What is the Diagnostic Utility of Cardiac Magnetic Resonance Imaging in Unselected Patients with Premature Ventricular Contractions and Non-Sustained Ventricular Tachycardia?
Journal: The American journal of cardiology
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41016532
Summary: Cardiac Magnetic Resonance Imaging identified structural heart disease in a significant proportion of patients, with late gadolinium enhancement being the most common finding. Cardiac Magnetic Resonance Imaging is valuable for risk stratifying patients with premature ventricular contractions and non-sustained ventricular tachycardia, especially when clinical suspicion for structural heart disease is present.
Article 4: Intellectual and Neurodevelopmental Delays in Pediatric Catecholaminergic Polymorphic Ventricular Tachycardia: Distinct Characteristics and a More Malignant Neurocardiac Phenotype.
Journal: Circulation. Arrhythmia and electrophysiology
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41000018
Summary: This study identifies a distinct neurocardiac phenotype of catecholaminergic polymorphic ventricular tachycardia in children characterized by intellectual and neurodevelopmental delays. Patients with this phenotype exhibited a higher burden of ventricular arrhythmias and sudden cardiac death compared to those without neurodevelopmental delays. The findings suggest a more malignant form of catecholaminergic polymorphic ventricular tachycardia with unique clinical features requiring heightened surveillance and management.
Article 5: Efficacy of Low-Voltage-Area Ablation Is Enhanced in Patients With Advanced Left Atrial Enlargement: A Subanalysis of the SUPPRESS-AF Trial.
Journal: Circulation. Arrhythmia and electrophysiology
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41000017
Summary: This subanalysis of the SUPPRESS-A.F. trial reveals that low-voltage-area ablation for persistent atrial fibrillation is more effective in patients with advanced left atrial enlargement. Patients with larger left atrial diameters experienced a greater benefit from low-voltage-area ablation compared to those with less atrial remodeling. The study suggests that left atrial size may be a useful marker to guide patient selection for low-voltage-area ablation in persistent atrial fibrillation.
đ Transcript
Today’s date is September 29, 2025. Welcome to Cardiology Today. Here are the latest research findings.
Article number one. Premature Ventricular Contractions on Healthy and Diseased Hearts: Differential Acute Effect of Coupling Interval and Location. This swine study compared premature ventricular contraction induced changes in left ventricular pressure in healthy hearts versus hearts with dilated cardiomyopathy. Premature ventricular contractions delivered at shorter coupling intervals resulted in greater acute hemodynamic dysfunction, with this effect being more pronounced in diseased hearts. The findings suggest that premature ventricular contraction induced cardiomyopathy is likely related to the timing of the contraction and is exacerbated by pre-existing heart disease.
Article number two. Electrical Impedance Spectroscopy Facilitates Quantitative Depth Monitoring of Pulsed Field Ablation: An Impedimetric Approach with Preclinical Validation. This preclinical study demonstrates that electrical impedance spectroscopy can accurately monitor ablation depth during pulsed field ablation procedures. The change rate of low-frequency impedance correlated with lesion depth in both monopolar and bipolar pulsed field ablation settings. This technology holds promise for real-time, quantitative assessment of ablation depth, potentially improving the safety and efficacy of pulsed field ablation for cardiac arrhythmias.
Article number three. What is the Diagnostic Utility of Cardiac Magnetic Resonance Imaging in Unselected Patients with Premature Ventricular Contractions and Non-Sustained Ventricular Tachycardia? This retrospective study evaluated the diagnostic utility of Cardiac Magnetic Resonance Imaging in patients with premature ventricular contractions and non-sustained ventricular tachycardia. Cardiac Magnetic Resonance Imaging identified structural heart disease in a significant proportion of patients, with late gadolinium enhancement being the most common finding. Cardiac Magnetic Resonance Imaging is valuable for risk stratifying patients with premature ventricular contractions and non-sustained ventricular tachycardia, especially when clinical suspicion for structural heart disease is present.
Article number four. Intellectual and Neurodevelopmental Delays in Pediatric Catecholaminergic Polymorphic Ventricular Tachycardia: Distinct Characteristics and a More Malignant Neurocardiac Phenotype. This study identifies a distinct neurocardiac phenotype of catecholaminergic polymorphic ventricular tachycardia in children characterized by intellectual and neurodevelopmental delays. Patients with this phenotype exhibited a higher burden of ventricular arrhythmias and sudden cardiac death compared to those without neurodevelopmental delays. The findings suggest a more malignant form of catecholaminergic polymorphic ventricular tachycardia with unique clinical features requiring heightened surveillance and management.
Article number five. Efficacy of Low-Voltage-Area Ablation Is Enhanced in Patients With Advanced Left Atrial Enlargement: A Subanalysis of the SUPPRESS-AF Trial. This subanalysis of the SUPPRESS-A.F. trial reveals that low-voltage-area ablation for persistent atrial fibrillation is more effective in patients with advanced left atrial enlargement. Patients with larger left atrial diameters experienced a greater benefit from low-voltage-area ablation compared to those with less atrial remodeling. The study suggests that left atrial size may be a useful marker to guide patient selection for low-voltage-area ablation in persistent atrial fibrillation.
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đ Keywords
ablation depth, dilated cardiomyopathy, pulsed field ablation, late gadolinium enhancement, neurodevelopmental delay, ventricular arrhythmias, left atrial enlargement, low-voltage-area ablation, coupling interval, sudden cardiac death, SUPPRESS-A.F. trial, non-sustained ventricular tachycardia, atrial fibrillation, cardiac ablation, electrical impedance spectroscopy, lesion monitoring, catecholaminergic polymorphic ventricular tachycardia, hemodynamic dysfunction, structural heart disease, premature ventricular contractions, Cardiac Magnetic Resonance Imaging, ventricular pressure, intellectual disability, atrial remodeling.
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