Citations 2
Incidence and type of recurrent ventricular arrhythmia in patients with arrhythmic mitral valve prolapse and implantable cardioverter defibrillator for secondary prevention
Kneizeh, Kinan , Sacher, F, Notaristefano, Francesco , Vlachos, Konstantinos , Ditac, Geoffroy , Duchâteau, Josselin , Munoz, Freddy Del‐Carpio , Jaworski, K, Alqarawi, Wael, Vandenberk, Bert , Verheul, Lisa M , Hassnik, Rutger J , Deville, Lucas, Yvorel, Cédric , Boukhris, Marouane , Pierrard, Romain, Ploux, Sylvain , Witte, K K, Costa, A Da, Bénali, Karim , Sacher, Frederic , Del-Carpio Munoz, Freddy , Jaworski, Krysztof , Figliozzi, Stefano , Verheul, Lisa M , Hassnik, Rutger J , Deville, Lucas , Yvorel, Cedric , Boukhris, Marouane , Pierrard, Romain , Ploux, Sylvain , Jaïs, Pierre , Hocini, Mélèze , Frontera, Antonio , Witte, Klaus K , Pürerfellner, Helmut , Haissaguerre, Michel , Da Costa, Antoine , Benali, Karim , Kneizeh, Kinan , Sacher, Frédéric , Duchâteau, Josselin , Alqarawi, Wael , Vandenberk, Bert , Jaı̈s, Pierre
Europace | May 3, 2026 | Volume: 28 | Issue: 6 | Pages: No page available
Abstract Aims Mitral valve prolapse (MVP) is a common valvular disorder associated with ventricular arrhythmias (VAs) in a subgroup of patients, known as arrhythmic MVP (AMVP). Arrhythmic MVP patients with malignant VAs typically receive an implantable cardioverter-defibrillator (ICD) for secondary prevention. However, data regarding the incidence of appropriate ICD therapy and the type of arrhythmia recurrence in this population remain scarce. This study aimed to evaluate the incidence of appropriate ICD therapies and type of arrhythmia recurrence in AMVP patients with an ICD implanted for secondary prevention. Methods and results A systematic literature search was conducted in PubMed/MEDLINE and EMBASE databases until January 2025. Studies reporting the incidence of appropriate ICD therapy in AMVP patients were included. A total of 9 studies met the inclusion criteria, resulting in 166 AMVP patients with ICDs for secondary prevention. The mean age was 41.8 years, with 55.8% of patients being female. Over a weighted mean follow-up of 4.9 ± 3.1 years, 34.9% [95% confidence interval (CI): 28.1–42.5] of the patients experienced recurrence of VA. The pooled incidence of appropriate ICD therapies during follow-up was 8.1 per 100 person-years (95% CI: 5.6–10.5, I2: 11.7%). Regarding the type of arrhythmic recurrence, the majority of arrhythmias (53.8%, 95% CI: 44.3–63.0%) were in the form of ventricular fibrillation or polymorphic ventricular tachycardia (VT), while the remaining arrhythmias were reported as monomorphic VT. Among 67 ventricular arrhythmic episodes reported in 7 studies with available data, 65 required shock therapy, corresponding to a shock proportion of 97.0% (95% CI: 89.6–99.6%). Conclusion Arrhythmic MVP patients with ICDs for secondary prevention exhibit a high risk of recurrent arrhythmias, with recurrences in the form of polymorphic VA occurring in more than half of the cases. PROSPERO registration number: CRD42024588610
Stroke and systemic embolism following atrial fibrillation ablation: the EMBOL-AF Global Registry
Castrejón-Castrejón, Sergio , Heeger, Christian-Hendrik H., Veltmann, Christian, Schaack, David , Nies, Moritz , Gunawardene, Melanie , Steven, Daniel , Tscholl, Verena , Roten, Laurent, Sommer, Philipp, Spartalis, Michael , Seitz, Julien , Kistler, Peter M, Chen, Minglong, Wang, Q , Munoz, Freddy Del-Carpio, Wijnmaalen, Adrianus P. , Moreno, Javier , Albarrán-Rincón, Ramón, Sanders, Prashanthan, Blessberger, Hermann , Laredo, Mikaël, Krahnefeld, Olaf , Pernat, Andrej , Aro, Aapo L. , Martinez, Eduardo Castellanos, Scazzuso, Fernando , Neven, Kars , Yorgun, Hikmet , Natale, Andrea, Joung, Boyoung, Wichterle, Dan, Cay, Serkan, Andorin, Antoine , Kato, Hiroyuki, Carnero, Guillermo, Maciąg, Aleksander, Garkina, S. V. , Deharo, Jean-Claude, Sadek, Mouhannad M, Iwasaki, Yu-ki, Beiert, Thomas , Choi, Eue-Keun, Kojic, D, Bergau, Leonard, Lellouche, N, Cortés, Luis Arabia, Camargo, Juan Manuel, Inaba, Osamu, Szegedi, Nándor , Piccini, Jonathan P., Marijon, Eloi, Mazurek, M , Sandgaard, Niels C F, Francke, Alexander , Schumacher, Burghard, Sánchez, Christian David Adams, Garcia-Izquierdo, E G I Eusebio, Guerra, Jose M., Aboulmaaty, Mervat , Jansen, Henning , Metzner, Andreas , García, Cecilia Zapata , Chun, J. K. R., Merino, José L, investigators, The EMBOL-AF, Benkouar, Riad, Abello, Maurício, Aguinaga, Luis, Correa, Mariel Alvarez , Estrada, Alejandro , Figueroa, Jorge, López, Leonardo Guido, Mondragón, Ignacio, Hovakimyan, Tatevik , Kalman, Jonathan, Maisels, Leonid, Kistler, Bruno Scardamaglia, Crowley, Rose , Steinwender, Clemens , Kousta, Mary, Scherr, Daniel, Goelly, Katharina Ingrid, Rocca, Domenico Giovanni Della, Potter, Tom J R De, Boškić, Mario, D’Avila, Andre, Guimarães, Henrique Cerqueira , Slater, Charles , Saad, Eduardo, Marchov, D. , Ayala-Paredes, Félix Alejandro, Glover, Benedict, Khaykin, Yaariv, Silva, Armando Pérez, Salvatici, Luis Quiñiñir, Li, Mingfang, Yao, Yan, Zhou, Li , Yi, Fu, Zeng, Rui, Molano, Luis Fernando Pava, Velasco, Víctor Manuel, Ramírez, Santiago Giraldo , Morales, Luis Carlos Saenz, Radeljić, Vjekoslav , Larsen, Jacob Moesgaard, Jacobsen, Peter Karl, Liñero, Mikel, Patete, Manuel , Hallon, Luis, Rivadeneira, José Llorente, Moustafa, Ahmed, Botros, Michael Sobhy, Minois, Damien , Anselme, Frédéric, Bakouboula, Babé, Schaaf, Mathieu , Boveda, Serge, Richard-Vitton, Robin, Détis, Nicolas, Fauchier, Laurent, Pierre, Bertrand , García, Rodrigue, Degand, Bruno , Salaün, Alexandre, Gandjbakhch, Estelle, Martins, Raphael, Maury, Philippe, Milhem, Antoine , Arnaout, Alain Al, Pavin, Dominique , Piot, Olivier, Ballatore, Andrea, Zhao, Alexandre , Papiashvili, Giorgi , Rekvava, Roin , Avranas, Konstantinos, Eckardt, Lars, Forkmann, Mathias , Busch, Sonia, Harloff, Tim, Halbfass, Philipp, Hilss, Karen Anja, Kaufmann, Jan , Thilotray, Christian, Poley, Phillip, Küchler, Mirco , Tilz, Roland Richard, Maslova, Vera , Lian, Evgeny, Füting, Anna , Letsas, Konstantinos P., Papakonstatinou, Panteleimon, Tzeis, Stylianos, Geller, Laszlo, Narasimhan, Calambur, Koduri, Venkata Krishna Chaitanya, Ghosh, Anindya, Lubis, Anggia Chairuddin , Emkanjoo, Zahra , Eslami, Masoud, Conti, Sergio, Perrotta, Laura , Pieragnoli, Paolo , Poggi, Sara, Ruggiero, Donatella, Aurino, L, Russo, Vicenzo, Hashiguchi, Naotaka , SHIMIZU, Wataru, Yodogawa, Kenji , Suga, Kazumasa , Yamaguchi, Takanori, Bakytzhanuly, Abay, Dussekeyeva, Gulnoza, Dehkhanova, Shakhnoza, Kupics, Kaspars, Jubele, Kristine, Refaat, Marwan M, Ghazawi, Alaaeddine El, Sammut, Mark A, Márquez-Murillo, Manlio F., Rogel-Martínez, Ulises, Nolasco, Karla Bozada, Khurelbaatar, Mungun-Ulzii, Dagdan, Batnaran, Kooijman, Edwin, Martin, Andrew, Kiliszek, Marek, Kulakowski, Piotr, Żuk, Anna , Lebreiro, Ana , Diaz, Nuno Cortez, Cozma, Dragos, Grecu, Mihaela, Rudzik, Roxana, Sipos, Sergiu, Vatasescu, Radu, Lebedev, Dmitry, Lee, So-Ryoung, Kim, Daehoon, Luque, Miguel Amores , Arenal, Ángel, Alonso, Pablo Ávila , Sanchez, Antonio Berruezo, Cabanas-Grandío, Pilar, Cózar-León, Rocío, Díaz-Infante, Ernesto, Fernández-Armenta, Juan, Fernández-Gómez, Juan Manuel, Jaén, Eusebio García-Izquierdo , García-Olea, Alain, Gaztañaga, Larraitz , Guasch, E, Criado, José Luis Ibáñez, Garrido, Beatriz Jáuregui, Sierra, Cristina Martin, Osca, Joaquin, Castellano, Nicasio Pérez, Ocete, Blanca Quesada, Rivas-Gándara, Nuria, Rubio-Campal, José Manuel, Brotons, J.A. Sánchez, Sánchez-Somonte, Paula, Segura, Jose Maria, Segura-Villalobos, Federico, Hernández, Pablo Ruiz, Soria, Laura Valverde , Fengsrud, Espen, Reichlin, Tobias, Krisai, Philipp, Tramèr, Lucas, Ngarmukos, Tachapong , Trines, Serge A., Mulder, Bart A. , İhtisas, Yüksek, Yilancioğlu, Yiğit, Şahin, Durmuş Yıldıray , Yalin, Kivanc, Yalman, Hakan , Aytemir, Kudret, Martin, Claire A , Zeriouh, Sarah , Abbas, Mohamed Magdi, Chamoun, Nadia , Bsoul, Mayana, Mohanty, Sanghamitra, Uzokov, Jamol, Benchetrit, Chamia, Choi, Jong‐Il , Joung, Boyoung , Roten, Laurent , Del-Carpio Munoz, Freddy , Sanders, Prashanthan , Sticherling, Christian , Joung, Boyoung , Wichterle, Dan , Cay, Serkan , Kato, Hiroyuki , Deharo, Jean Claude , Choi, Eue-Keun , Bergau, Leonard , Lellouche, Nicolas , Marijon, Eloi , Ramos Jiménez, Javier , Metzner, Andreas , Pürerfellner, Helmut , Merino, Jose L , Heeger, Christian-Hendrik H. , Veltmann, Christian , Sommer, Philipp , Kistler, Peter M. , Chen, Ming-Long , Munoz, Freddy Del‐Carpio , Albarrán‐Rincón, Ramón , Sanders, Prashanthan , Laredo, Mikael , Guénancia, Charles , Natale, Andrea , Almorad, Alexandre , Ruwald, Martin H , Carnero, Guillermo A. , Deharo, Jean‐Claude , Sadek, Mouhannad M. , Iwasaki, Yu‐ki , Choi, Eue‐Keun , Kojić, Dejan , Sousa, João de , Bergau, Leonard , Inaba, Osamu , Piccini, Jonathan P. , Marijon, Éloi , Sandgaard, Niels C. F. , Stiles, Martin K. , García‐Izquierdo, Eusebio, Ares, Gerardo Ruiz , Aguinaga, Luis, Munawar, Dian Andina , Puvrez, Alexis , Gölly, Katharina Ingrid , Rocca, Domenico G. Della , Begić, Edin , d'Avila, Andre, Guimaraes, Henrique, Saad, Eduardo , Dzhinsov, Krasimir R. , TRAYKOV, VASSIL BORISLAVOV , Paredes, Felix Ayala , Glover, Benedict , Macle, Laurent , Khaykin, Yaariv , Pérez-Silva, Armando , Díaz, Juan Carlos , Giraldo-Ramírez, Santiago, Morales, Luis C. Sàenz, Đula, Kristijan , Peichl, Petr , Larsen, Jacob Moesgaard , Jacobsen, Peter Karl , Hallon, Luis A., Rivadeneira, José Elizardo Llorente , Botros, Michael, Anselme, Frédéric , Chaumont, Corentin , Bakouboula, Babé , Bovéda, Serge , Richard-Vitton, Robin , Boulé, Stéphane , Fauchier, Laurent , Garcia, Rodrigue , Salaun, Alexandre, Gandjbakhch, Estelle , Martins, Raphaël P. , Maury, Philippe , Beneyto, Maxime M , Piot, Olivier , Ballatore, Andrea , Asbach, Stefan , Avranas, Konstantinos, Didenko, Maxim , Eckardt, Lars , Harloff, Tim , Halbfaß, Philipp , Tilz, Roland Richard , Lian, Evgeny, Sohns, Christian , Lüker, Jakob , Zabel, Markus , Letsas, Κonstantinos P. , Leventopoulos, Georgios , Tzeis, Stylianos , Kupó, Péter , Geller, Laszlo A. , Narasimhan, Calambur, Pandurangi, Ulhas M. , Ghosh, Anindya , Haim, Moti , Konstantino, Yuval , Barletta, Valentina , Cipolletta, Laura , Conti, Sergio , Sgarito, Giuseppe A. , Poggi, Sara , Ruggiero, Donatella , Ejima, Koichiro , Shimizu, Wataru, Kato, Hiroyuki, Abdrakhmanov, Ayan Suleimenovich , Bakytzhanuly, A, Kupics, Kaspars , Jubele, Kristīne , Refaat, Marwan M., Ghazawi, Alaaeddine El , Sammut, Mark Adrian , Rojel-Martínez, Ulises, Bozada-Nolasco, Karla I., Denysiuk, Piotr , Farkowski, Michał M. , Futyma, Piotr , Zarębski, Łukasz , Kiliszek, Marek , Kulakowski, Piotr , Lenarczyk, Radosław , Miśkowiec, Dawid Łukasz , Sousa, Pedro , Grecu, Mihaela, Arenal, Ángel , Cabanas‐Grandío, Pilar , León, Rocío Cózar , Dı́az-Infante, Ernesto , Fernandez-Armenta, Juan, Olea, Alain García, Guasch, Eduard , Ibáñez, José Luis , Garrido, Beatriz Jáuregui, Osca, Joaquín , Rivas‐Gándara, Nuria , Campal, J M Rubio, Sánchez-Somonte, Paula , Segura, José María, Fengsrud, Espen , Bergonti, Marco , Reichlin, Tobias , Krisai, Philipp , Tramèr, Lucas , Trines, Serge A.I.P. , Özkan, Eyüp , Özcan, Emin Evren , Yılancıoğlu, Yiğit, Yalın, Kıvanç , Aytemir, Kudret , Abbas, Mohamed Magdy, Akoum, Nazem , Bsoul, Mayana , Mohanty, Sanghamitra
European Heart Journal | March 31, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
Abstract Background and Aims Stroke and systemic embolism are recognized but poorly characterized complications of atrial fibrillation (AF) and left atrial flutter (AFL) catheter ablation. Their incidence, outcomes, and procedural associations remain insufficiently defined. Methods Retrospective global registry was initiated by the European Heart Rhythm Association Scientific Committee. A secure database captured data from ablation centres worldwide on general AF and left AFL ablation activity, as well as detailed information on patients with symptomatic embolic events between 2017 and 2024. Results Overall, 204 centres reported 335 743 ablation procedures and 550 embolic events (incidence 0.16%). Centre-level rate ranged from 0% to 3.1%. Most events were cerebral (94%), followed by peripheral (5%), and combined (1%). Coronary air embolism accounted for 62% of all peripheral events. Intraprocedural events occurred in 93 patients (17%), within 72 h in 357 (78%) and beyond 72 h in 100 (22%); 128 cases (23%) were diagnosed after hospital discharge. Nonparoxysmal AF (0.23% vs 0.15%; P < .001), centre experience, and ablation energy source (radiofrequency, 0.16%; cryoballoon, 0.16%; pulsed field ablation, 0.25%; laserballoon, 0.88%; P < .001) were associated with embolic risk. Median NIHSS score after stroke was 4 (interquartile range, 2–9). Three-month follow-up was available for 518 patients with embolism (95%): 181 (35%) had sequelae and 16 (3%) died. Conclusions Symptomatic embolic events are infrequent but associated with significant morbidity and mortality. Most events occur early, though a substantial proportion arise later. Higher event rates were observed with laser and possibly with pulsed field ablation. A greater centre experience was associated with a lower embolism incidence.