2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T764,Unlike the tremendous progress made in atrial fibrillation ablation, the greatest unmet clinical need is for innovative ablation treatments for scar-related ventricular tachycardia (VT), particularly given the thick, often fibrotic tissue characteristic of the scarred substrate. A focal pulsed field ablation (PFA) catheter with a novel waveform was designed: high voltage to provide tissue penetration and low energy (using short-duration pulses) to avoid tissue overheating. We present the outcomes of VCAS (Ventricular Catheter Ablation Study), a first-in-human study of this PFA catheter to ablate scar-related VT. An investigational 8.5F force-sensing PFA catheter was used for scar-VT ablation in ischemic or nonischemic substrates. Pulsed field lesions consisted of 5 applications, each <200 ms, of a high-voltage (>10 kV) monophasic waveform with QRS synchronization. The PFA catheter was localized by electrical impedance-based navigation. A subcohort of patients without previous cardiac surgery underwent epicardial ventricular mapping at baseline and after endocardial PFA to assess for transmurality of endocardial pulsed field lesions. Study end points included procedural efficiency, safety, and effectiveness to final follow-up of 6 months. At 2 centers, 26 patients underwent ablation: 66±9 years of age, 4% women, left ventricular ejection fraction 32±10%, VT storm 42%, previous VT ablation 42%. Acute procedural success, achieved in 24 (92%) patients, required 21 (interquartile range, 14-24) lesions per patient with a transpired ablation time of 31 minutes (19-42). Clinical VT was induced in 14 of 16 patients (88%) before ablation and 1 of 16 patients (6%, In this first-in-human study, the high-voltage PFA catheter efficiently delivered transmural ventricular lesions to treat scar-related VT. URL: https://www.clinicaltrials.gov; Unique identifier: NCT06203262.31:Teda, BACKGROUND: Unlike the tremendous progress made in atrial fibrillation ablation, the greatest unmet clinical need is for innovative ablation treatments for scar-related ventricular tachycardia (VT), particularly given the thick, often fibrotic tissue characteristic of the scarred substrate. A focal pulsed field ablation (PFA) catheter with a novel waveform was designed: high voltage to provide tissue penetration and low energy (using short-duration pulses) to avoid tissue overheating. We present the outcomes of VCAS (Ventricular Catheter Ablation Study), a first-in-human study of this PFA catheter to ablate scar-related VT. METHODS: An investigational 8.5F force-sensing PFA catheter was used for scar-VT ablation in ischemic or nonischemic substrates. Pulsed field lesions consisted of 5 applications, each <200 ms, of a high-voltage (>10 kV) monophasic waveform with QRS synchronization. The PFA catheter was localized by electrical impedance-based navigation. A subcohort of patients without previous cardiac surgery underwent epicardial ventricular mapping at baseline and after endocardial PFA to assess for transmurality of endocardial pulsed field lesions. Study end points included procedural efficiency, safety, and effectiveness to final follow-up of 6 months. RESULTS: At 2 centers, 26 patients underwent ablation: 66±9 years of age, 4% women, left ventricular ejection fraction 32±10%, VT storm 42%, previous VT ablation 42%. Acute procedural success, achieved in 24 (92%) patients, required 21 (interquartile range, 14–24) lesions per patient with a transpired ablation time of 31 minutes (19–42). Clinical VT was induced in 14 of 16 patients (88%) before ablation and 1 of 16 patients (6%, P <0.001) after ablation. High-density epi-endo voltage mapping was performed in 10 patients [42%]; of the 9 patients undergoing endocardial-only PFA, transmural tissue homogenization was observed in all 9 (100%) patients. Freedom from recurrent VT/ventricular fibrillation (VT/VF) or implantable cardioverter defibrillator shock was 81.8% (95% CI, 67.1–99.8). Regarding VT/VF burden, the incidence rate of postablation VT/VF significantly decreased from baseline to after PFA by 98% (median [IQR], 6 [1–11] versus 0 [0–0], respectively; P <0.001). Primary safety end points within 180 days occurred in 3 of 26 (11.5%) patients: cardiogenic shock, heart failure hospitalization, and retroperitoneal bleed. CONCLUSIONS: In this first-in-human study, the high-voltage PFA catheter efficiently delivered transmural ventricular lesions to treat scar-related VT. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT06203262. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Ventricular Tachycardia: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Ventricular Tachycardia (condition). Clinician-written summaries and actionable practice insights. 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Targeted ablation eliminated the targeted VT in 96% of cases and achieved non-inducibility of any VT in 79%.","limitations":"Single-center consecutive series with a small sample (n=28); non-inducibility endpoint applied to unstable VTs without direct termination confirmation; no long-term follow-up outcomes reported."}},{"doi":"10.1080/10903127.2026.2704728","pmid":"42467420","title":"Emergency Medical Services Physician-Led Activation for Extracorporeal Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest","journal_title":"Prehospital Emergency Care","journal_issn":"1090-3127","published_at":"2026-07-29T00:00:00.000Z","url":"https://doi.org/10.1080/10903127.2026.2704728","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-25T06:20:23.240Z","updated_at":"2026-08-25T06:20:23.240Z","tags":[{"paper_doi":"10.1080/10903127.2026.2704728","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2704728","tag_type":"category","value":"Emergency Medicine","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2704728","tag_type":"condition","value":"Out-of-Hospital Cardiac Arrest","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2704728","tag_type":"condition","value":"Ventricular Fibrillation","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2704728","tag_type":"condition","value":"Ventricular Tachycardia","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2704728","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2704728","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2704728","tag_type":"modality","value":"Extracorporeal Cardiopulmonary Resuscitation","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2704728","tag_type":"sample_size","value":"n=347","value_numeric":347},{"paper_doi":"10.1080/10903127.2026.2704728","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2704728","tag_type":"study_design","value":"Observational Cohort Study","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2704728","tag_type":"warning","value":"Comparison between the ECPR-activated and non-activated groups is informal; the non-activated group had higher unadjusted survival (60%), likely reflecting selection bias or unmeasured confounders.","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2704728","tag_type":"warning","value":"Only 15 patients were ECPR-eligible and 10 were activated, making outcome estimates highly imprecise — interpret survival rates with caution.","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2704728","tag_type":"warning","value":"Study conducted at a single urban academic center in North Carolina; protocol details (e.g., cannulation team availability) may not be reproducible across other EMS systems.","value_numeric":null}],"summaries":{"what_studied":"An observational cohort study evaluated an EMS physician-led prehospital ECPR activation protocol in a single urban third-service EMS agency and academic tertiary care center in North Carolina over one year (May 2024–May 2025), targeting adult OHCA patients aged 18–60 with witnessed, non-traumatic, bystander-CPR-assisted VT/VF refractory to ≥3 defibrillations.","key_result":"Of 347 non-traumatic OHCA patients, 4.3% (15/347) were ECPR-eligible; ECPR was activated in 66.7% (10/15), cannulation achieved in 50% (5/10), and survival to discharge with CPC-1 (good neurological outcome) occurred in 40% (4/10) of the activation group.","limitations":"Very small eligible cohort (n=15) at a single center limits generalizability; non-randomized design prevents causal inference; no direct comparison arm for ECPR vs. conventional resuscitation outcomes.","practice_takeaway":"An EMS physician-led prehospital ECPR protocol can identify and activate eligible refractory VT/VF OHCA patients, with 40% survival to discharge and all survivors at CPC-1 in the activated group. Larger multi-system studies are needed before broad adoption."}},{"doi":"10.1161/circep.125.014708","pmid":"41979465","title":"Automated Cardiac Arrest Detection Using Wrist-Worn Photoplethysmography: External Validation in Patients With Induced Shockable Cardiac Arrest (DETECT-1b)","journal_title":"Circulation: Arrhythmia and Electrophysiology","journal_issn":"1941-3149","published_at":"2026-04-14T00:00:00.000Z","url":"https://doi.org/10.1161/circep.125.014708","source_score":83,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-24T13:23:12.734Z","updated_at":"2026-05-24T13:23:12.734Z","tags":[{"paper_doi":"10.1161/circep.125.014708","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1161/circep.125.014708","tag_type":"brand","value":"CardioWatch","value_numeric":null},{"paper_doi":"10.1161/circep.125.014708","tag_type":"category","value":"Cardiac & Cardiovascular Systems","value_numeric":null},{"paper_doi":"10.1161/circep.125.014708","tag_type":"condition","value":"Cardiac Arrest","value_numeric":null},{"paper_doi":"10.1161/circep.125.014708","tag_type":"condition","value":"Ventricular Fibrillation","value_numeric":null},{"paper_doi":"10.1161/circep.125.014708","tag_type":"condition","value":"Ventricular Tachycardia","value_numeric":null},{"paper_doi":"10.1161/circep.125.014708","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1161/circep.125.014708","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1161/circep.125.014708","tag_type":"modality","value":"Wearable Photoplethysmography","value_numeric":null},{"paper_doi":"10.1161/circep.125.014708","tag_type":"sample_size","value":"n=49","value_numeric":49},{"paper_doi":"10.1161/circep.125.014708","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1161/circep.125.014708","tag_type":"study_design","value":"Prospective Multicenter Validation Study","value_numeric":null},{"paper_doi":"10.1161/circep.125.014708","tag_type":"warning","value":"Only 26 of 49 patients had inducible cardiac arrest events; the remaining 23 contributed only false-positive data, which may affect generalizability.","value_numeric":null},{"paper_doi":"10.1161/circep.125.014708","tag_type":"warning","value":"Study design is labeled 'prospective multicenter validation' but is not a randomized trial; level of evidence estimated at 3 accordingly.","value_numeric":null},{"paper_doi":"10.1161/circep.125.014708","tag_type":"warning","value":"The algorithm developer (Corsano Health) processed the PPG data blinded to events, but has a commercial interest — potential for industry bias should be noted.","value_numeric":null}],"summaries":{"what_studied":"External validation of a wrist-worn PPG algorithm (CardioWatch, Corsano Health) for automated cardiac arrest detection in 49 adult patients undergoing VT ablation or subcutaneous ICD implantation, during which shockable cardiac arrest (pulseless VT or VF) was induced; 59 total events in 26 patients were analyzed.","key_result":"Per-event sensitivity was 92% (54/59; 95% CI, 81%–97%), with 100% sensitivity for VF (9/9) and 90% for pVT (45/50); positive predictive value was 86% (54/63); only 9 true false-positive alerts occurred over 125.5 hours of PPG data.","limitations":"- Induced arrest episodes were brief, requiring a short 10-second detection window that may inflate false positives in real-world use.\n- Controlled, optimal sensor placement during a procedure may not reflect daily life wearable conditions.\n- Study did not include nonshockable cardiac arrest rhythms (e.g., PEA, asystole).","practice_takeaway":"A wrist PPG algorithm can detect shockable cardiac arrest with high sensitivity (92% per event, 100% for VF) and very few false alarms in a controlled setting — promising for future out-of-hospital cardiac arrest detection wearables. Real-world performance during daily use still needs validation."}},{"doi":"10.1161/circulationaha.125.077025","pmid":"41071961","title":"High-Voltage Focal Pulsed Field Ablation to Treat Scar-Related Ventricular Tachycardia: The First-in-Human VCAS Trial","journal_title":"Circulation","journal_issn":"0009-7322","published_at":"2025-10-10T00:00:00.000Z","url":"https://doi.org/10.1161/circulationaha.125.077025","source_score":121,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-12-20","doi":"10.1161/circulationaha.125.077025","days":"30","issn":"0009-7322","rank":"10","field":"Clinical Medicine","score":"121","category":"Cardiac & Cardiovascular Systems","categories":["Cardiac & Cardiovascular Systems"],"_categories":["Cardiac & Cardiovascular Systems"]},"pubmed":{"doi":"10.1161/CIRCULATIONAHA.125.077025","title":"High-Voltage Focal Pulsed Field Ablation to Treat Scar-Related Ventricular Tachycardia: The First-in-Human VCAS Trial.","journal":"Circulation","methods":"","results":"At 2 centers, 26 patients underwent ablation: 66±9 years of age, 4% women, left ventricular ejection fraction 32±10%, VT storm 42%, previous VT ablation 42%. Acute procedural success, achieved in 24 (92%) patients, required 21 (interquartile range, 14-24) lesions per patient with a transpired ablation time of 31 minutes (19-42). Clinical VT was induced in 14 of 16 patients (88%) before ablation and 1 of 16 patients (6%, ","abstract":"$30","keywords":["high-voltage","postmyocardial infarction","pulsed field ablation","scar-related","transmural","ventricular tachycardia"],"pubmed_id":"41071961","conclusions":"","publication_date":"2025-10-10T00:00:00"},"crossref":{"DOI":"10.1161/circulationaha.125.077025","URL":"https://doi.org/10.1161/circulationaha.125.077025","ISSN":["0009-7322","1524-4539"],"link":[{"URL":"https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.125.077025","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"1691-1704","type":"journal-article","issue":"24","score":1,"title":["High-Voltage Focal Pulsed Field Ablation to Treat Scar-Related Ventricular Tachycardia: The First-in-Human VCAS Trial"],"author":[{"given":"Vivek Y.","family":"Reddy","sequence":"first","affiliation":[{"name":"Helmsley Electrophysiology Center, Mount Sinai Fuster Heart Hospital, New York, NY (V.Y.R., J.S.K., K.W., M.N.)."}]},{"given":"Jacob S.","family":"Koruth","sequence":"additional","affiliation":[{"name":"Helmsley Electrophysiology Center, Mount Sinai Fuster Heart Hospital, New York, NY (V.Y.R., J.S.K., K.W., M.N.)."}]},{"given":"Petr","family":"Peichl","sequence":"additional","affiliation":[{"name":"Cardiology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic (P.P., J.K.)."}]},{"given":"Jan","family":"Petru","sequence":"additional","affiliation":[{"name":"Cardiology Department, Homolka Hospital, Prague, Czech Republic (J.P., M.F., J.S., P.N.)."}]},{"given":"Moritoshi","family":"Funasako","sequence":"additional","affiliation":[{"name":"Cardiology Department, Homolka Hospital, Prague, Czech Republic (J.P., M.F., J.S., P.N.)."}]},{"given":"Jan","family":"Skoda","sequence":"additional","affiliation":[{"name":"Cardiology Department, Homolka Hospital, Prague, Czech Republic (J.P., M.F., J.S., P.N.)."}]},{"given":"Keita","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Helmsley Electrophysiology Center, Mount Sinai Fuster Heart Hospital, New York, NY (V.Y.R., J.S.K., K.W., M.N.)."}]},{"given":"Moritz","family":"Nies","sequence":"additional","affiliation":[{"name":"Helmsley Electrophysiology Center, Mount Sinai Fuster Heart Hospital, New York, NY (V.Y.R., J.S.K., K.W., M.N.)."}]},{"given":"Josef","family":"Kautzner","sequence":"additional","affiliation":[{"name":"Cardiology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic (P.P., J.K.)."}]},{"given":"Petr","family":"Neuzil","sequence":"additional","affiliation":[{"name":"Cardiology Department, Homolka Hospital, Prague, Czech Republic (J.P., M.F., J.S., P.N.)."}]}],"funder":[{"name":"Field Medical 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