Background The increasing use of intracardiac echocardiography (ICE) in the ablation of premature ventricular complexes (PVCs) has raised questions about its true efficacy and safety. Objective To evaluate the long-term outcome and periprocedural complications of PVCs ablation with and without ICE. Methods This retrospective study collected the periprocedural complications and PVC burden post ablation. The risk factors of PVC recurrence was further explored. Results The study included patients treated without ICE (control group, n=451) and with ICE (ICE group, n=155) from May 2019 to July 2022. The ICE group demonstrated significantly lower fluoroscopy times and X-ray doses. There were no major complications in the ICE group, and the difference in the occurrence of periprocedural complications between the groups was not statistically significant (p=0.072). The long-term success rates were similar for the control and ICE groups (89.6% and 87.1%, respectively). The origin of PVCs was identified as the independent factor for ablation success. Conclusions The use of ICE did not confer an advantage with regard to long-term success in PVCs ablation. To thoroughly evaluate the safety and effectiveness of ICE in PVCs ablation, a prospective, multicenter, randomized study is warranted.

Background Previous research indicates disparities in atrial fibrillation (AF) recurrence and complications following catheter ablation in women; however, long-term outcomes based on gender remain underexplored. Objective This study evaluated the long-term rates of AF recurrence and major adverse cardiovascular and cerebrovascular events (MACCE) following catheter ablation, investigating gender-related risk factors to inform clinical practice improvement. Methods We conducted a retrospective analysis using data from a prospectively observational registry of AF ablation procedures at our institution from 2015 to 2020. Patients were followed up for MACCE and AF recurrence. The risk factors of AF recurrence and MACCE were further explored. Results The study cohort consisted of 2,293 patients, including 1,441 males and 852 females, and had an average follow-up duration of 50.36 months. After catheter ablation, females exhibited a notably higher rate of recurrence compared to males, with a hazard ratio of 1.305 and a 95% confidence interval ranging from 1.101 to 1.547, which was statistically significant (p=0.0014). Gender differences in AF recurrence persisted regardless of early versus late intervention (both p<0.05). No significant difference in MACCE rates was observed between genders. Independent risk factors for AF recurrence included female gender, diabetes, left atrial diameter ≥40 mm. Conclusions Gender differences significantly impact the long-term outcomes of AF recurrence, but not MACCE rates post-catheter ablation. The study highlights the necessity to integrate gender considerations into AF management strategies.

Instruction Cessation of oral anticoagulation (OAC) is common after the first 3 months of catheter ablation of atrial fibrillation (AF); however, thromboembolic risk has not been defined in patients with and without AF recurrence (RAF vs. NRAF) post ablationMethods and Results We identified 796 patients who discontinued OAC at 3 months post AF ablation from January 2015 to May 2018 in our center. Regular follow-up was performed to detect RAF, collect medication management and thromboembolic and major bleeding events. CHA2DS2-VASc score was 1.79±1.50; 547 (68.7%) patients were at intermediate and high risk (i.e. CHA2DS2-VASc score ³1 in male patients, or ³2 in female patients); 169 (21.2%) were RAF. During 29.2±12.2 months follow-up, the incidence rate of thromboembolism was 1.62 per 100 patient-year (7 in 431 years) in RAF, 0.33 per 100 patient-year (5 in 1503 years) in NRAF. After adjusting for potential confounding factors, RAF was associated with more 3.5-fold higher rate of thromboembolism compared with NRAF (adjusting HR, 4.488; 95%CI, 1.381-14.586). Rate of thromboembolism was even higher in patients with intermediate and high risk (2.16 per 100 patient-year [7 in 323 years] versus 0.38 per 100 patient-year [4 in 1043 years], aHR, 5.807; 95%CI, 1.631-20.671). In multivariate logistic regression analysis, RAF was the only independent predictor of thromboembolism (4.837 [1.498-15.621], P=0.008).

Introduction：LAmbre occluder (Lifetech Scientific, Shenzhen, China), a new device for left atrial appendage (LAA) occlusion, is increasingly used, but the procedure for retrieval after dislodgement has rarely reported in human. Methods and Results：An 80-year-old male patient with permanent atrial fibrillation underwent the implantation of LAA occlusion device. The occluder dislodged to left atrium (LA) at the end of procedure. We failed to retrieve device in LA with a LASSO catheter and forceps with the 8.5F sheath. After it suddenly flowing into aortic arch, we successfully retrieved with a 14F flexible sheath and forceps. We also discussed reasons for the device dislodgment and reported experiences for device retrieval. Conclusion: Combination of the 14F flexible sheath and forceps could be used to retrieve the dislocation of LAA occlusion device.