Citations 2
Sex specific differences patients with arrhythmic mitral valve prolapse with in sustained arrhythmias - a SAVE-MVP collaboration sub analysis
Heller, E, Aabel, E W, Ollitrault, P, Baudinaud, P, Bergonti, M, Bhardwaj, P K, Delling, F, Riva, M De, Haddad, C H, Huttin, O, Krebsova, A, Siontis, K, Laredo, M, Nagy, A, Sabbag, A, Heller, Eyal , Aabel, E W, Ollitrault, Pierre , Baudinaud, Pierre , Bergonti, Marco , Bhardwaj, Priya , Delling, Francesca N. , Huttin, Olivier , Krebsová, Alice , Siontis, Konstantinos C. , Laredo, Mikael , Nagy, A, Sabbag, A
Europace | June 25, 2026 | Volume: 28 | Issue: Supplement_1 | Pages: No page available
Abstract Background Arrhythmogenic mitral valve prolapse (AMVP) is increasingly recognized as a cause of sustained ventricular arrhythmias (VA) and sudden cardiac death. Although prior studies have identified clinical and imaging risk markers in AMVP, it remains unclear whether the arrhythmogenic phenotype differs between women and men. Purpose To investigate sex-specific differences in clinical profiles, structural substrates, and arrhythmia presentations in patients with AMVP who experienced sustained VA. Methods We conducted a sex-based sub-analysis of a multicenter cohort (35 centers from 15 countries) of patients with AMVP and sustained VA. Participants were grouped by sex and by initial arrhythmia type (sustained monomorphic ventricular tachycardia [SMVT] vs ventricular fibrillation [VF]). Data collected included clinical history, ECG findings, echocardiographic measurements, and cardiac MRI (CMR) markers, such as late gadolinium enhancement (LGE) patterns and mitral annular disjunction (MAD). These factors were compared across groups. Results The study comprised 129 women (57%) and 96 men (43%). Women were diagnosed at younger ages (39±16 years vs. 49±16 years, p<0.03) and had more frequently a family history of MVP (22% vs 10%, p=0.027). MAD was significantly more common in women (66% vs 48%, p=0.015) while LGE was more frequently observed in men than women (N=39 (72%) vs N=41 (53%), p=0.028), with no significant regional patterns (myocardial and/or papillary muscle). ECG T-wave inversion (p=0.627), PVC burden (p>0.03) and arrhythmia types were similar in men and women. However, stress was a more often commonly recognized as the initiating trigger for VA in men than in women (38% [N=24] vs. 18% [N=18], p<0.05). The overwhelming majority of VA were initiated by PVCs in both sexes with no differences in the initiating mechanisms. Conclusion In patients with AMVP presenting with sustained VA, the arrhythmic phenotype and initiating mechanisms are similar between sexes, although stress was a significantly stronger trigger for VA in men. Women more often exhibited MAD, whereas LGE was more frequent in men. These findings suggest that structural and tissue-based markers, rather than sex alone, contribute to the development of malignant arrhythmias in AMVP.
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.