Background and Objectives: Leadless pacemakers provide an innovative alternative to traditional transvenous pacemakers for managing cardiac arrhythmias. The objective of this systematic review is to conduct a meta-analysis comparing acute complication and mortality rates associated with leadless pacemakers versus transvenous pacemaker placements using national-level data. Specifically, we aim to summarize the current evidence and calculate pooled odds ratios for acute overall complications, acute device-related complications, and acute mortality to assess the early safety outcomes of leadless pacemaker placement relative to traditional transvenous pacemakers. Materials and Methods: A systematic search of PubMed, Scopus, ScienceDirect, and Google Scholar was conducted by two independent researchers using a predefined search protocol. The search included articles published up to 10 October 2024, without limits on review depth. Studies were included if they provided national-level data comparing leadless pacemaker and traditional pacemaker recipients in terms of acute mortality, acute overall complications, and acute device-related complications. Outcomes were pooled to calculate odds ratios using a random-effects model in RStudio (version 2024.12.1+563). Results: A total of five studies met the eligibility criteria. The pooled odds ratio for acute mortality was 2.03 (95% CI: 0.65–6.34, I² = 99%; p < 0.01), for acute overall complications was 1.08 (95% CI: 0.45–2.61, I² = 99%; p < 0.01), and for acute device-related complications was 1.02 (95% CI: 0.23–4.44, I² = 99%; p < 0.01). Conclusions: The reviewed studies suggest that leadless pacemakers offer a promising alternative to transvenous pacemakers, offering a comparable short-term safety profile. Ongoing technological advancements may further enhance their applicability in clinical practice.

Background: Leadless pacemakers (LesPM) are a new safe alternative technology for pacing the right ventricle. However, not enough information is available on their potential benefits for quality of life (QoL) in patients with LesPM. The purpose of the study was the quality of life comparison of patients with LesPM and conventional pacemakers (ConvPM). Methods: The study included patients who underwent implantation of a single-chamber pacemaker from December 2018 to March 2023. We used the SF-36 Questionnaire to assess quality of life at baseline and after 12 and 24 months of follow-up. We also used a questionnaire consisting of 10 specific questions related to the implantation procedure. Results: Total of 50 patients were included (25 LesPM; 25 ConvPM). There were no differences in baseline characteristics between groups (LesPM vs. ConvPM), except for age (47.5 vs. 57.3 years; P = 0.012) and diabetes 28% vs. 21%; P = 0.021). Baseline SF-36 did not differ between groups. After 6 months of follow-up, patients in the LesPM group showed significantly higher scores on physical function (47 vs 32; P<0.001), physical role (53 vs 37; P=0.004) and mental health (67 vs 52; P=0.017), even after adjusting for covariates. Pacemaker-related discomfort and physical limitations were significantly lower in the LesPM group. Conclusion: LesPM is associated with a better quality of life than ConvPM, both in terms of physical and mental health. Patients who underwent LesPM implantation reported less procedure-related discomfort, physical limitations, and anxiety.

Accessory pathways (AP) of abnormal conduction are pathways between the ventricular and atrial myocardium that exist apart from the conduction system structures. Patients with AP of abnormal atrioventricular conduction may have ventricular tachycardia known as atrioventricular (AV) reciprocating tachycardia (AVRT). Orthodromic AVRT often occurs in the presence of AP. The pathological impulse passes antegrade via the normal AV conduction system, whereas retrograde conduction to the atria via AP. Rarely, conduction occurs in the opposite direction, resulting in antidromic AVRT. APs occur at all points of the AV ring and usually as isolated anomalies, although in some patients, congenital anomalies are observed. Most APs have non-decremental conduction properties and are conducted more rapidly than normal tissue with AV conduction. In many patients with AP, baseline ECG reveals clear preexcitation signs and special algorithms can be used to presume their localization. Electrophysiologic study in these patients is often performed with in the purpose of diagnosing, localizing, and determining AP’s functional characteristics. Drug therapy for AVRT prevention is useful for temporary control while waiting for drastic actions and, in some cases, for long-term treatment. Over the last few decades, a radical treatment option as catheter ablation has emerged in patient’s treatment with WPW syndrome.

Background/Objectives: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide, with inflammatory cytokines increasingly implicated in its development, persistence, and post-ablation recurrence. However, prospective perioperative cytokine data from Central Asia are lacking. The objective of the study is to evaluate temporal changes in inflammatory cytokines in AF patients undergoing catheter ablation and assess differences by AF type and recurrence status. Methods: In this prospective observational study conducted at the Syzganov National Scientific Center of Surgery, Almaty, Kazakhstan, 166 AF patients (mean age 66.1 ± 8.2 years; 57.8% male) were enrolled. Serum cytokines were measured using ELISA at baseline, immediately postablation, and at 6 months. Temporal changes were analysed using Friedman and Wilcoxon signed-rank tests, while between-group comparisons used Mann–Whitney U and Kruskal–Wallis tests. Results: IL-1β, IL-6, and IL-17A showed significant temporal changes (all p < 0.001). IL-6 increased immediately after ablation (0.088 to 0.122 pg/mL) before decreasing below baseline at 6 months (0.079 pg/mL). IL-17A progressively declined across all time points (0.073, 0.069, and 0.048 pg/mL). At 6 months, IL-1α levels were higher in primary versus recurrent AF (0.079 vs. 0.067 pg/mL; p = 0.047). Baseline IL-1β and IL-28A differed across AF subtypes (p = 0.040 and p = 0.014). No pre-operative cytokine independently predicted recurrence. Conclusions: AF ablation is associated with distinct cytokine trajectories, particularly for IL-1β, IL-6, and IL-17A. Cytokine profiles vary by AF type and recurrence, highlighting the potential role of immune monitoring in AF management. These findings should be regarded as exploratory and hypothesis-generating.

Background. Pulmonary vein isolation is the cornerstone of catheter-based treatment for atrial fibrillation. Cryoballoon ablation offers an effective and reproducible method for pulmonary vein isolation, yet recurrence of arrhythmias remains a challenge. Despite advances in catheter technologies, the role of altered pulmonary vein anatomy as a factor for atrial fibrillation recurrence is poorly studied. Materials and Methods. This prospective study included 465 patients with paroxysmal atrial fibrillation who underwent cryoballoon ablation. Pulmonary vein and left atrial anatomy were evaluated using multislice computed tomography. Patients were followed for 24–48 months to assess atrial fibrillation recurrence and anatomical risk factors. Cox proportional hazard modeling and Kaplan-Meier analysis were used to evaluate predictors of arrhythmia recurrence. Results. Complete Pulmonary vein isolation was achieved in all patients. During follow-up, 38% of patients experienced atrial fibrillation recurrence. Patients with altered pulmonary vein anatomy, particularly a left common pulmonary vein and additional pulmonary veins, showed a higher rate of recurrence. Cox regression analysis identified left atrial volume index >50 mL/m² and pathological pulmonary vein anatomy as independent risk factors for atrial fibrillation recurrence. Conclusion. Altered pulmonary vein anatomy is a significant risk factor for atrial fibrillation recurrence following cryoballoon ablation. Comprehensive imaging of the left atrial and pulmonary vein using multislice computed tomography can improve patient selection, reducing the recurrence risk and improving long-term outcomes.

Ambulatory cardiac monitoring is a rapidly expanding field of functional diagnostics. Today, the main direction of cardiac monitoring is outpatient monitoring of the electrocardiogram, an important diagnostic tool that is used daily by doctors in many specialties. Therefore, both wearable and subcutaneous technologies of electrocardiographic monitoring are now widely used. A number of devices can be placed under the patient’s skin and have the ability to wirelessly transmit data to home transmitters, which, in turn, then transmit data to the doctor via cloud interfaces, so that, they allow remote monitoring and monitoring of the patient’s condition. Such systems are widely used in various countries of the world, approved in the USA, and are also used for remote monitoring of patients in Europe and Kazakhstan, where their implementation is gaining momentum. This review presents the technical aspects of subcutaneous monitoring, provides a schematic representation of the operation of systems existing on the market, discusses the advantages of this method, as well as the disadvantages of existing implantable cardiac monitors. The issues of the future development of this technology and indications for the use of existing devices approved by the professional cardiological communities are considered.