Idiopathic Premature Ventricular Contraction Catheter Ablation, Sedentary Population vs. Athlete's Populations: Outcomes and Resumption of Sports Activity.

There are no investigations about the outcomes of idiopathic PVC catheter ablation (CA) in athletes compared to the sedentary population. We conducted a prospective single-centre observational study. The primary and secondary procedural outcomes were the post-ablation reduction of premature ventricular contractions (PVCs) in an athletes vs. non-athletes group and in agonist vs. leisure-time athletes. The third was the evaluation of the resumption of physical activity and the improvement of symptoms in agonist and leisure-time athletes. From January 2020 to October 2022 we enrolled 79 patients with RVOT/LVOT/fascicular PVC presumed origin. The median percentage of decrease between the pre-procedure and post-procedure Holter monitoring in the non-athletes group was 96 (IQR 68-98) and 98 in the athletes group (IQR 92-99) (p = 0.08). Considering the athletes, the median percentage of decrease in the number of PVCs was 98 (IQR 93-99) and 98 (IQR 87-99), respectively, in leisure-time and agonistic athletes (p = 0.42). Sixteen (70%) leisure time and seventeen (90%) agonist athletes (p = 0.24) have resumed physical activity 3 months after PVC CA; among agonistic athletes, 59% have resumed competitive physical activity. Many leisure-time (88%) and agonist (70%) athletes experienced an improvement in symptoms after ablation. PVC CA was effective and safe in both groups, reducing symptoms and allowing a quick and safe return to sports activities in athletes.

The History of Atrial Flutter Electrophysiology, from Entrainment to Ablation: A 100-Year Experience in the Precision Electrocardiology.

Atrial flutter (AFL) is a regular supraventricular reentrant tachycardia generating a continuous fluttering of the baseline electrocardiography (ECG) at a rate of 250 to 300 beats per minute. AFL is classified based on the involvement of the cavo-tricuspid isthmus in the circuit. The "isthmic" (or type 1) AFL develops entirely in the right atrium; this circuit is commonly activated in a counter-clockwise direction, generating the common sawtooth ECG morphology in the inferior leads (slow descendent-fast ascendent). AFL can be nonisthmus dependent (type 2), often presenting with faster atrial rate and most commonly a left atrial location.