Cardiac Arrhythmias: The Latest Strategies for Clinical Diagnosis and Treatment

Dear Colleagues,

Over the last decade, we have witnessed a true revolutionary era of new technologies in regard to ablations strategies. For most of these technologies, the focus is on generating a high-standard safety profile for patients and effective (ablation) strategies.

In regard to energy delivery, conventional radiofrequency ablations have been developed from primitive parameters as impedance drop or EGMs changes with ablations to the use of a forced time integral as a marker for effective lesions, and then moving them to the superior one of the ablation index parameters. Recently, there have been new developments in terms of short-duration, high-power RF ablation. There is no doubt that each technology provides a new horizon in order to improve efficacy, ensure safety, and improve procedures time, radiation exposure, etc.

Within the era of cryoablation, where electrical block lines are created through freezing the tissue to a certain degree to create ablated cells and damage cascade to create bidirectional electrical blocks, this technology showed itself to be superior in terms of saving time during the procedure at a slight cost of certain complications that are marginally higher than those experienced with radiofrequency ablation. However, many trials are needed to confirm the equal efficacy and safety of this method.

A novel pulse field ablation via the electroporation of cells is considered to be the future for ablations, where the beam of the electric shock wave will initiate a cascade for programmed cell death, hence the line of the block. The advantages include a very short duration procedure time and homogenous and intact ablation lesions and lines, with an overall improvement in the procedures time and impact on patient recovery. The potential side effects are almost similar to former technologies. The technical aspects for the best approach to use this new technology are evolving and are currently a source for future research.

Dr. Usama Boles
Dr. Andres Enriquez
Guest Editors

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• cardiac arrhythmias
• catheter ablation
• defibrillators
• pacemakers
• atrial fibrillation
• acute coronary syndrome