State of the Art: Mapping Strategies to Guide Ablation in Ischemic Heart Disease | JACC

Hosts Mitsuaki Sawano, MD, co-host Shun Kohsaka, MD, and Nobuhiro Ikemura, MD, welcome Tomohiko Taniguchi, MD, from Kobe City Medical Center General Hospital, to discuss findings from the CURRENT AS Registry-2 on low-gradient severe aortic stenosis (AS). Based on data from over 3,300 patients across 21 Japanese centers, the study categorized AS into four hemodynamic subtypes, revealing that low-gradient AS with reduced LVEF had the poorest prognosis, paradoxical LFLG AS was associated with high rates of atrial fibrillation and advanced cardiac damage despite low valve calcification, and normal-flow LG AS frequently exceeded guideline-based calcification thresholds despite being labeled as moderate. Dr. Taniguchi emphasizes the need to revise conventional illustrations of AS subtypes by incorporating cardiac damage and frailty and underscores the importance of proper statistical interpretation in subgroup analyses.

In this JACC Deep Dive episode, Editor-in-Chief Dr. Harlan Krumholz discusses a major study on sudden cardiac arrest in young competitive athletes, highlighting survival rates, causes, and racial disparities. The study shows that survival improves dramatically with immediate AED use and has increased over time, emphasizing the need for widespread emergency preparedness and health equity efforts.. While progress has been made, ensuring universal access to CPR training and AEDs remains critical to saving lives.

In this JACC Deep Dive episode, Dr. Harlan Krumholz reviews the ADVANTAGE-AF trial, which evaluated pulse field ablation (PFA) as a treatment for persistent atrial fibrillation. The study demonstrated that PFA is a safe and effective approach, with strong symptomatic outcomes and a low complication rate, though questions remain about long-term durability and the need for more rigorous follow-up. PFA represents a promising innovation, but further randomized studies and extended monitoring will be essential to fully define its role in clinical practice.

This special electrophysiology-themed issue of JACC, summarized by Dr. Valentin Fuster, dives into cutting-edge research on atrial fibrillation, pulsed field ablation, sudden cardiac arrest in athletes, and preventive strategies in congenital heart disease. From new therapies like finerenone to breakthrough mapping techniques, this episode captures the evolving sophistication and promise of arrhythmia management in modern cardiology.

This special electrophysiology-themed issue of JACC, summarized by Dr. Valentin Fuster, dives into cutting-edge research on atrial fibrillation, pulsed field ablation, sudden cardiac arrest in athletes, and preventive strategies in congenital heart disease. From new therapies like finerenone to breakthrough mapping techniques, this episode captures the evolving sophistication and promise of arrhythmia management in modern cardiology.

This special electrophysiology-themed issue of JACC, summarized by Dr. Valentin Fuster, dives into cutting-edge research on atrial fibrillation, pulsed field ablation, sudden cardiac arrest in athletes, and preventive strategies in congenital heart disease. From new therapies like finerenone to breakthrough mapping techniques, this episode captures the evolving sophistication and promise of arrhythmia management in modern cardiology.

This special electrophysiology-themed issue of JACC, summarized by Dr. Valentin Fuster, dives into cutting-edge research on atrial fibrillation, pulsed field ablation, sudden cardiac arrest in athletes, and preventive strategies in congenital heart disease. From new therapies like finerenone to breakthrough mapping techniques, this episode captures the evolving sophistication and promise of arrhythmia management in modern cardiology.

This special electrophysiology-themed issue of JACC, summarized by Dr. Valentin Fuster, dives into cutting-edge research on atrial fibrillation, pulsed field ablation, sudden cardiac arrest in athletes, and preventive strategies in congenital heart disease. From new therapies like finerenone to breakthrough mapping techniques, this episode captures the evolving sophistication and promise of arrhythmia management in modern cardiology.

This special electrophysiology-themed issue of JACC, summarized by Dr. Valentin Fuster, dives into cutting-edge research on atrial fibrillation, pulsed field ablation, sudden cardiac arrest in athletes, and preventive strategies in congenital heart disease. From new therapies like finerenone to breakthrough mapping techniques, this episode captures the evolving sophistication and promise of arrhythmia management in modern cardiology.

This special electrophysiology-themed issue of JACC, summarized by Dr. Valentin Fuster, dives into cutting-edge research on atrial fibrillation, pulsed field ablation, sudden cardiac arrest in athletes, and preventive strategies in congenital heart disease. From new therapies like finerenone to breakthrough mapping techniques, this episode captures the evolving sophistication and promise of arrhythmia management in modern cardiology.