Piotr Futyma, MD retweeted
Interesting responses to @drjohnm post of our study. Agree PF PWI is easier BUT 1) is it more durable than RF 2) does it improve outcomes? Every study to date says NO inc PIFPAF RCT with PF! What is this obsession of EPs with PWI?
Another sobering study in AF ablation. Melbourne group reports on 121 patients who have recurrent AF despite durable PVI. All have posterior wall isolation. [Because we can.]
The results are similar to the trials. Not good.
doi.org/10.1016/j.jace…
@peterkistler3
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Can somebody hide this case from @drjohnm please?
Intra-articular injection and left atrial appendage closure device infection: a case report and literature review
heartrhythmcasereports.com/article/S2214-…
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Peri-mitral flutter in a patient with prior PVI and PW isolation. Mitral block (even with PFA) still suboptimal (doi.org/10.1161/CIRCEP…). Will PF + RF using STSF DE be the answer? Block easy to achieve in this case. Need durability data. Excellent mapping by @mahummaps
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Piotr Futyma, MD retweeted
Another sobering study in AF ablation. Melbourne group reports on 121 patients who have recurrent AF despite durable PVI. All have posterior wall isolation. [Because we can.]
The results are similar to the trials. Not good.
doi.org/10.1016/j.jace…
@peterkistler3
The results are similar to the trials. Not good.
doi.org/10.1016/j.jace…
@peterkistler3
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Piotr Futyma, MD retweeted
Credit to the EP team in Bern for this excellent remapping study after either RF or PFA. Mandated remapping is much better than remapping for symptoms jacc.org/doi/10.1016/j.…
A) PFA no better than RF for durable PVI
B) Recapitulates GAP study showing that AF still occurs in one-third of durably isolated PVs and 72% of those with reconnected veins DID NOT have AF at one year
This is the crux of our problem in EP: we don't understand the pathophysiology of the condition. PVs get isolated because we can. @TobiasReichlin
A) PFA no better than RF for durable PVI
B) Recapitulates GAP study showing that AF still occurs in one-third of durably isolated PVs and 72% of those with reconnected veins DID NOT have AF at one year
This is the crux of our problem in EP: we don't understand the pathophysiology of the condition. PVs get isolated because we can. @TobiasReichlin
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Piotr Futyma, MD retweeted
13% would close a PFO based on patient request alone with no indication. Sobering.
A healthy 40-year old man was found to have a PFO on an otherwise normal echocardiogram (performed for palpitations . He has done research and wants it closed. Do you do it or refer for closure?
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It can sometimes still be ablated from the RVOT, with different energy though
academic.oup.com/ehjcr/article/…
academic.oup.com/ehjcr/article/…
Can RVOT PVCs with transition at V4 still be ablated from the left side? Despite local EGMs being much better on the right, RF resulted only in very late and brief suppression. RF from the left, opposite to the RV lesions immediately eliminated the ectopy.
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Kudos to Martin Ruwald et al. for the detailed remapping data. Worth noting though that these numbers come exclusively from:
1️⃣patients with clinical recurrence who returned for redo (not entire initial cohort) and
2️⃣after initial focal-monopolar PFA
This subset doesn’t fully represent durability in total monopolar-PFA population or the (more commonly used for PVI) bipolar PFA systems
1️⃣patients with clinical recurrence who returned for redo (not entire initial cohort) and
2️⃣after initial focal-monopolar PFA
This subset doesn’t fully represent durability in total monopolar-PFA population or the (more commonly used for PVI) bipolar PFA systems
🚩How durable is PVI after PFA when patients return for repeat ablation?
In @HRS_O2Journal , Ruwald et al. found:
• 48% complete durable PVI
• 79% of individual PVs remained isolated
• 76% of gaps clustered at the carina
• Organized AT was the main recurrence
The carina may be an important target for improving long-term PFA durability. #EPeeps
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Piotr Futyma, MD retweeted
Multivessel Coronary Microvascular Vasospasm Following Redo Pulmonary Vein Isolation with Left Atrial Roof Linear Ablation Using Pulsed Field Ablation for Persistent Atrial Fibrillation
heartrhythmcasereports.com/article/S2214-…
heartrhythmcasereports.com/article/S2214-…
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Bipolar ablation of VT during APHRS 2026 in Busan:
• Magdi Saba – Bipolar RF Ablation in NICM-VT: A Pre-recorded Case from Cleveland Clinic London
Thu 22 Oct, 14:10–14:25
• Takumi Yamada – Bipolar Ablation and Alternative Energy Delivery Strategies for Refractory Intramural :45
• Ayaka Takeo – Bipolar and Needle Ablation: How to and When to Use? Sat 24 Oct, 15:00–15:15
• Magdi Saba – Bipolar RF Ablation in NICM-VT: A Pre-recorded Case from Cleveland Clinic London
Thu 22 Oct, 14:10–14:25
• Takumi Yamada – Bipolar Ablation and Alternative Energy Delivery Strategies for Refractory Intramural :45
• Ayaka Takeo – Bipolar and Needle Ablation: How to and When to Use? Sat 24 Oct, 15:00–15:15
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Piotr Futyma, MD retweeted
@ftrae @lukaszzarebski1 I agree….
It mainly goes about precision and reproducibility… and this does not just concern lesion depth, but also lesion width.
It mainly goes about precision and reproducibility… and this does not just concern lesion depth, but also lesion width.
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Why? Because it allows precise and safe ablation close to the His bundle area. Our study using standard ablation catheters for focal PFA will be presented at #APHRS2026 by @lukaszzarebski1
Why rely on standard focal ablation catheters when you can count on the stability of the Sphere-9 ™ catheter lattice tip? Video from x vivo pre-clinical model at the visible heart lab.
Learn more: bit.ly/4wmvT8a
See risk info: bit.ly/4p6tqLq
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Piotr Futyma, MD retweeted
Amen:
“The EP community at-large, and other relevant stakeholders, have to be the arbiters of whether the right questions are being asked and whether the right studies are being done. This is why it is critical to ensure that we refocus training programs with this goal in mind.”
“The EP community at-large, and other relevant stakeholders, have to be the arbiters of whether the right questions are being asked and whether the right studies are being done. This is why it is critical to ensure that we refocus training programs with this goal in mind.”
Cardiac Electrophysiology at a Crossroads: Building on Dr. Josephson's 20 years of observations. Is EP science, procedure or both? What is the future of EP science?
authors.elsevier.com/a/1nzSl,siTgsT…
#EPeeps #CardioX @ACCinTouch @HRSonline
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This is a must-read.
Cardiac Electrophysiology at a Crossroads: Building on Dr. Josephson's 20 years of observations. Is EP science, procedure or both? What is the future of EP science?
authors.elsevier.com/a/1nzSl,siTgsT…
#EPeeps #CardioX @ACCinTouch @HRSonline
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Piotr Futyma, MD retweeted
A very thoughtful article by @DrJGoldberger
Investment in science and fostering careers of investigators continues to be extremely important! @Ed_Gerst @C_Meyer_MD @ACCinTouch @HRSonline
Investment in science and fostering careers of investigators continues to be extremely important! @Ed_Gerst @C_Meyer_MD @ACCinTouch @HRSonline
Cardiac Electrophysiology at a Crossroads: Building on Dr. Josephson's 20 years of observations. Is EP science, procedure or both? What is the future of EP science?
authors.elsevier.com/a/1nzSl,siTgsT…
#EPeeps #CardioX @ACCinTouch @HRSonline
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Piotr Futyma, MD retweeted
Cardiac Electrophysiology at a Crossroads: Building on Dr. Josephson's 20 years of observations. Is EP science, procedure or both? What is the future of EP science?
authors.elsevier.com/a/1nzSl,siTgsT…
#EPeeps #CardioX @ACCinTouch @HRSonline
authors.elsevier.com/a/1nzSl,siTgsT…
#EPeeps #CardioX @ACCinTouch @HRSonline
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Piotr Futyma, MD retweeted
@HeartOTXHeartMD John, you can ask @ftrae, normal rounds are like a Netflix show. It’s why I love this job so much. Real medicine hardly needs embellishing. It’s beautiful
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Piotr Futyma, MD retweeted
❓is there a difference between sandwich ablation and bipolar ablation❓
Answers from Google 🔍 for a general medicine docs.
@EPWaveDoc @ftrae
Answers from Google 🔍 for a general medicine docs.
@EPWaveDoc @ftrae
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Piotr Futyma, MD retweeted
Robimy z lekarzy (sami sobie to robimy) pokolenie płatków śniegu. Straszne warunki - dziki ! Turyści chodzą z małymi dziećmi po Krynicy Morskiej i się dzików nie boją, ale lekarze z Łodzi potrzebują transporterów opancerzonych i dlatego trzeba odebrać akredytację.
🔴200 pacjentów na lekarza i grasujące dziki. Szpital psychiatryczny w Łodzi może stracić akredytację
Centrum Medycznego Kształcenia Podyplomowego skontrolowało szpital psychiatryczny w Łodzi. Z raportu wynika, że jednostka nie spełnia wymogów akredytacyjnych. Jej wicedyrektorem jest konsultant krajowy w dziedzinie psychiatrii, prof. Piotr Gałecki.
🖋️@DariuszFaron & @jan_czura
wiadomosci.wp.pl/200-pacjentow-…
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Piotr Futyma, MD retweeted
#ResistTheUrge to ablate more
Proud of our TRIAD fellow Michel Abou Khalil @mabou_khalil for this important work in JCE!
In nearly 19,000 patients undergoing first ablation for paroxysmal #AFib, adding lesions beyond PVI was associated with more recurrence, repeat ablation, and atypical flutter.
An observational study, but an important reminder: more ablation does not necessarily mean better outcomes. Defining when—and for whom—to go beyond PVI remains critical.
@PrashSanders @Dr_Santangeli @S_NarayanMD @shivkumarmd @TinaBaykaner @JonHsuMD @peterkistler3 @DocOfHearts @drjohnm @EJSMD @AndreaRussoEP @Phiso_de @DrJasonAndrade
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