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Background/Objectives: Pulmonary vein isolation (PVI) using radiofrequency catheter ablation with contact force (CF)-sensing technology has improved long-term outcomes in patients with atrial fibrillation. This prospective randomized study aimed to assess the efficacy and safety of CF-sensing technology for additional left atrial (LA) linear ablation of persistent AF (PerAF). Methods: After PVI, anteromitral (AM) line and roof line ablation were performed using a CF-sensing catheter. Patients were randomly assigned to either the CF-sensing (CFS) group or the CF-blind control (Blind) group. The primary endpoint was atrial arrhythmia recurrence. LA late gadolinium enhancement (LA-LGE) MRI was conducted at baseline and 1-year follow-up for long-term lesion evaluation. Results: A total of 62 patients with drug-refractory PerAF were enrolled (mean age: 58 ± 10 years; 77% male). The success rates of AM and roof line block were 97% and 100% in the CFS group (n = 33) and 93% and 90% in the Blind group (n = 29). The time to achieve block was reduced in the CFS group (AM: 36 ± 22 vs. 48 ± 28 min, p = 0.068; roof: 19 ± 14 vs. 27 ± 15 min, p = 0.031). The maximum CF for safety endpoints was significantly lower in the CFS group (AM: 42 vs. 69 g, p < 0.001; roof: 33 vs. 49 g, p = 0.003). Full linear LA-LGE formation on 1-year MRI did not differ significantly between the groups (AM: 17 vs. 36%; roof; 29 vs. 24%, both p = NS). Kaplan–Meier estimates of AF/AT-free survival after ablation procedures were 63.6% in the CFS group and 58.6% in the Blind group (log-rank p = 0.837). Conclusions: In patients with PerAF, additional LA linear ablation following PVI using CF-sensing technology improved procedural safety and reduced the time needed to achieve conduction block. However, it did not significantly influence clinical outcomes or the formation of permanent full linear lesions. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study investigated the relationship between spinal canal expansion and clinical outcomes in patients with myelopathy due to ossification of the posterior longitudinal ligament (OPLL) who underwent cervical open-door laminoplasty. Methods: A retrospective study was conducted on 36 OPLL patients who underwent open-door laminoplasty between 2009 and 2021. Preoperative and two-year postoperative radiologic parameters, including bony canal area (BCA) and spinal canal area (SCA), were measured. Clinical outcomes were assessed using the Numerical Rating Scale (NRS) for neck pain and radicular pain, the Neck Disability Index (NDI), and Japanese Orthopaedic Association (JOA) scores. Results: The mean expansion of BCA was 112.1 mm2 (47%) and SCA was 100.5 mm2 (64%). All clinical outcomes improved after surgery, although not statistically significant. JOA scores improved significantly in the severe group, while NDI and NRS-neck scores improved in the mild to moderate group. Significant correlations were found between improvements in NRS-neck and expansions of BCA (r = 0.533, p = 0.001) and SCA (r = 0.537, p = 0.001). NDI improvement was also associated with BCA expansion. No significant correlations were found between canal expansion and NRS-R, NRS-L, or JOA scores. Conclusions: Cervical open-door laminoplasty effectively increased the bony and spinal canal areas in patients with OPLL and myelopathy. In addition to improving myelopathy symptoms, this procedure may also improve neck pain and disability. Further research is needed to assess the long-term outcomes and to better understand these clinical improvements. [ABSTRACT FROM AUTHOR]

(1) Background: We hypothesized that female sex would have a differential impact on left atrial (LA) low-voltage areas (LVAs) according to CHA2DS2-VA scores. (2) Methods: This study included 553 patients who underwent radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF). LVAs were defined as regions with bipolar peak-to-peak voltages of <0.5 mV. The proportion of LVAs was calculated by dividing the total LVA by the LA surface area. (3) Results: There was no sex-related difference in LA LVAs among patients with a CHA2DS2-VA scores ≤ 2. The proportion of LVAs was significantly higher in females among patients with CHA2DS2-VA scores of 3 or 4 (10.1 (4.7–15.1)% vs. 15.8 (9.2–32.1)%; p = 0.027). Female sex was significantly associated with extensive LVAs (LVA proportion ≥ 30%). Females had odd ratios of 27.82 (95% confidence interval (CI) 3.33–756.8, p = 0.01), and 1.53 (95% CI 0.81–2.83, p = 0.184) for extensive LAVs in patients with CHA2DS2-VA scores ≥ 3 and CHA2DS2-VA scores < 3, respectively. In the multiple regression model, female patients with a CHA2DS2-VA ≥3 were significantly associated with a higher proportion of LVAs (β = 8.52, p = 0.039). (4) Conclusions: Female sex was significantly associated with extensive LVAs, particularly when their CHA2DS2-VA scores were ≥3. This result suggests that female sex has a differential effect on the extent of LVAs based on the presence of additional risk factors. [ABSTRACT FROM AUTHOR]