Background: Aortic coarctation is a congenital narrowing of the thoracic aorta that may present with upper-limb hypertension, lower-limb hypoperfusion, heart failure, or late vascular complications. Endovascular therapy has become an important treatment option, especially in adolescents and adults.

Objective: To evaluate procedural success, blood pressure improvement, complications, and mid-term outcomes after balloon angioplasty and stent implantation for aortic coarctation.

Methods: A prospective observational study was conducted among 96 patients with native or recurrent aortic coarctation treated endovascularly between January 2021 and December 2024. Clinical, imaging, procedural, and follow-up data were analyzed.

Results: Mean age was 19.8±8.7 years. Native coarctation was present in 72.9% and recoarctation in 27.1%. Stent implantation was performed in 78.1%, while balloon angioplasty alone was used in 21.9%. Technical success was achieved in 97.9%. Mean peak systolic gradient decreased from 48.6±15.4 mmHg to 8.7±5.6 mmHg. At 12 months, systolic blood pressure decreased from 156.8±18.9 mmHg to 128.4±12.7 mmHg. Major complications occurred in 4.2%.

Conclusion: Endovascular management of aortic coarctation is safe and effective, with high procedural success, marked gradient reduction, improved blood pressure control, and acceptable complication rates. Stent implantation is preferred in adolescents and adults with suitable anatomy.

Background

Persistent atrial fibrillation (AF) is associated with increased morbidity, mortality, stroke risk, heart failure, and reduced quality of life. Catheter ablation has emerged as an effective rhythm-control strategy; however, outcomes in persistent AF remain less favorable than in paroxysmal AF due to advanced atrial remodeling and complex arrhythmogenic substrates.

Objective

To evaluate procedural success, arrhythmia recurrence, quality-of-life improvement, and long-term clinical outcomes following catheter ablation in patients with persistent AF.

Methods

A prospective multicenter study enrolled 600 consecutive patients with persistent AF undergoing catheter ablation between January 2020 and December 2024. Clinical, procedural, and follow-up data were collected over a 24-month period. Primary endpoints included freedom from atrial arrhythmia recurrence, symptom improvement, hospitalization, stroke, and mortality.

Results

Pulmonary vein isolation (PVI) was successfully achieved in 98.5% of patients. At 12 months, freedom from atrial arrhythmia recurrence was 72.8%, increasing to 82.1% after repeat procedures. Significant improvements were observed in symptom burden, exercise capacity, and quality of life. Major complications occurred in 3.2% of patients.

Conclusion

Catheter ablation provides effective rhythm control and substantial clinical improvement in patients with persistent AF. Contemporary ablation techniques achieve high procedural success with acceptable complication rates and meaningful long-term benefits.

Abstract

Background: Leadless pacemakers are miniaturized intracardiac pacing devices designed to overcome complications associated with conventional transvenous pacemakers, including pocket infection, lead fracture, venous occlusion, and lead dislodgement.

Objective: To review the clinical outcomes, safety profile, procedural considerations, complications, and future directions of leadless pacemaker therapy.

Methods: This narrative review summarizes clinical trials, registries, observational studies, and contemporary electrophysiology practice recommendations regarding leadless cardiac pacing.

Results: Leadless pacemakers demonstrate high implantation success, stable pacing thresholds, low infection rates, and reduced lead- and pocket-related complications. Current use is strongest for patients requiring single-chamber ventricular pacing, particularly those with atrial fibrillation and bradycardia, high infection risk, limited venous access, or prior device infection.

Conclusion: Leadless pacemakers represent a major advancement in cardiac rhythm management. While they offer important safety advantages over conventional systems, careful patient selection, procedural expertise, and long-term surveillance remain essential.

Cardiac resynchronization therapy is an established device-based treatment for selected patients with heart failure and electrical dyssynchrony. By coordinating right and left ventricular contraction, CRT improves cardiac output, reverses adverse ventricular remodeling, reduces symptoms, and lowers hospitalization risk. The greatest benefit is observed in patients with reduced left ventricular ejection fraction, widened QRS duration, and left bundle branch block morphology. This article reviews indications, patient selection, procedural considerations, clinical outcomes, complications, and future directions of CRT in heart failure management.

Implantable cardioverter defibrillators are established therapies for prevention of sudden cardiac death in patients at high risk of malignant ventricular arrhythmias. However, outcomes in South Asian populations remain underrepresented in global device trials. This article reviews clinical indications, implantation patterns, complications, appropriate and inappropriate shock rates, survival outcomes, barriers to access, and future directions for ICD therapy in South Asian patients. 

Cardiac arrhythmias are a major cause of morbidity and mortality worldwide. Conventional electrocardiogram (ECG) interpretation remains the cornerstone of arrhythmia diagnosis; however, increasing volumes of ECG data generated from hospitals, ambulatory monitors, implantable devices, and wearable technologies present significant diagnostic challenges. Artificial intelligence (AI), particularly machine learning (ML) and deep learning (DL), has emerged as a promising tool for automated arrhythmia detection.

Objective

To evaluate the diagnostic accuracy, clinical utility, and implementation challenges of AI-assisted arrhythmia detection systems in contemporary cardiology practice.

Methods

A prospective observational study was conducted involving 1,200 patients undergoing ECG monitoring. AI-based ECG analysis was compared with interpretation by experienced electrophysiologists. Outcomes included sensitivity, specificity, diagnostic accuracy, time to diagnosis, and clinical impact.

Results

AI-assisted analysis demonstrated an overall diagnostic accuracy of 96.4%. Sensitivity for atrial fibrillation detection was 98.1%, while ventricular tachycardia detection reached 95.2%. Diagnostic reporting time decreased by 72% compared with conventional interpretation. AI-assisted systems significantly improved early arrhythmia identification and reduced missed diagnoses.

Conclusion

AI-assisted arrhythmia detection provides highly accurate and efficient ECG interpretation. Integration of AI into clinical workflows may improve diagnostic speed, patient outcomes, and healthcare efficiency while complementing clinician expertise.