Atrial fibrillation (AF) recurrence has become common in patients who have undergone catheter ablation. High neutrophil lymphocyte ratios (NLR) have been linked to an increased risk of recurrent AF. The research is, however, not conclusive. This meta‐analysis addressed the value of easily accessible and affordable pre‐ and postablation NLR levels as indicators of AF recurrence in patients who had undergone ablation. We searched PubMed, SCOPUS, and Google Scholar for pertinent studies through May 2023. Using random effects models, the aggregated odds ratio (OR) of pre‐ and post‐NLR and AF recurrence was estimated. Inter‐study heterogeneity was described using I² statistics and leave‐one‐out sensitivity analysis. A p‐value < .05 was considered statistically significant. The literature search yielded 270 studies, seven of which were included in this meta‐analysis of 1923 patients who experienced AF recurrence after undergoing ablation. There are five retrospective and two prospective studies with a mean follow‐up of 20.5 months. The unadjusted odds ratio (OR) of AF recurrence for preablation NLR was 1.33 (95% CI: 1.04–1.71, p < .01, I² = 95.49%), while the adjusted OR was 1.45 (95% CI: 0.87–2.43, p < .01, I² = 95.1%). The unadjusted odds ratio (OR) for postablation NLR was 1.21 (95% CI: 1.09–1.36, p < .01, I² = 85.9%), and the adjusted odds ratio (OR) was 1.28 (95% CI: 0.93–1.76), demonstrating significant heterogeneity (I² = 95.32%) with a p‐value < .01. NLR was significantly associated with AF recurrence prediction. To detect AF recurrence, we recommend that clinicians add a simple NLR blood test to their diagnostic modalities.

Background: Pulmonary hypertension (PH) can lead to cardiac failure, thereby significantly affecting life expectancy and quality of life. Due to inadequate disease surveillance and risk assessment, clinical challenges persist despite advances in diagnosis and treatment. We aimed to review the potential of high-sensitivity cardiac troponin (hs-cTn) as a biomarker for predicting outcomes in PH patients. Methods: A thorough examination of the PubMed and Google Scholar databases was conducted through March 2023. Studies involving adult PH patients and hsTn as a prognostic indicator of outcomes such as mortality, hospitalization, and disease progression were included, after screening their titles and abstracts. Two independent evaluators extracted data, with the quality assessed using the JBI critical appraisal tool. Results: This review uncovered eight studies that examined the prognostic value of hs-cTn in PH patients. Higher hs-cTn levels were associated with increased mortality and hospitalization rates, according to the studies. The severity of PH, cardiac dysfunction, right ventricular function, and systolic dysfunction were associated with hs-cTn. Multiple studies have demonstrated that hsTn has the potential to identify high-risk PH patients who could benefit from targeted therapies and increased clinical monitoring. Conclusions: This review suggests that hsTn may be a biomarker for PH risk stratification and prognosis. Across PH subtypes, elevated hsTn levels predict poor outcomes. However, large-scale prospective studies are needed to confirm hs-cTn’s function in diagnosing pulmonary hypertension and determine its potential value in treatment.

Background: Stroke and subclinical cerebral ischemia remain important neurological complications of transcatheter aortic valve replacement (TAVR). The Sentinel cerebral embolic protection (CEP) device is designed to capture embolic debris during TAVR, but its impact on clinical and imaging outcomes remains incompletely characterized. Methods: PubMed, Embase, and Cochrane databases were systematically searched for randomized controlled trials (RCTs) comparing Sentinel CEP versus no protection when TAVR was performed. Outcomes of interest included all stroke, disabling stroke, infarct volume by diffusion-weighted MRI in protected and unprotected areas, all-cause mortality, acute kidney injury, and major vascular complications. Risk ratios (RRs) and median differences with 95% confidence intervals (CIs) were calculated using random-effects models and trial sequential analysis (TSA) assessed evidence robustness. Results: Four RCTs including 10,986 patients were analyzed. Sentinel CEP did not significantly reduce clinical stroke (RR 0.88, 95% CI 0.69–1.12) or disabling stroke (RR 0.68, 95% CI 0.41–1.14). Pooled DW-MRI data showed a significant reduction in new ischemic lesion volume within Sentinel CEP-protected territories (difference in medians −75.7 mm³; 95% CI −130.4 to −21.0). Subgroup analyses in elderly, female, and high-surgical-risk patients revealed no benefit with Sentinel CEP. Additionally, TSA indicated that current data are underpowered for definitive conclusions. Conclusions: The Sentinel CEP device during TAVR did not significantly reduce clinical stroke but was associated with lower MRI-detected ischemic lesion volumes compared with no protection. Further adequately powered RCTs integrating clinical and imaging endpoints are needed to define its role in neuroprotection during TAVR.

Atrial fibrillation (AF) catheter ablation is safe and effective, though rare cases of takotsubo syndrome (TTS) have been observed without proven causation. This review synthesizes TTS following AF ablation case reports and series. Until October 2024, PubMed/Medline, SCOPUS, and Google Scholar were searched for AF ablation and TTS case reports and series. This study examines TTS incidence, clinical features, and prognosis after AF catheter ablation. Thirteen articles detailing 18 patients were included in the review. The study population had a mean age of 65 ± 9.18 years and 77.77% were female. Of the 18 patients, 6 patients (33.3%) underwent radiofrequency catheter ablation and 5 patients (27.7%) underwent cryoablation. All the patients developed TTS within 4 days of the procedure. Heart palpitations and breathlessness are predominant symptoms. Eight patients had T-wave inversion. Dyskinesia was the most prevalent echocardiography finding among the reported cases. Left ventricular ejection fraction was moderately reduced in 5 cases (35.7%) and severely reduced (left ventricular ejection fraction <30%) in 6 cases (42.8%). Of the 15 patients in whom a pattern of ballooning was reported, 13 patients had apical ballooning and 2 had atypical ballooning pattern. Of the 8 cases (44.44%) with complications, 1 had ventricular fibrillation and 2 patients had pulseless electrical activity. Left ventricular function is completely recovered among 17 patients whereas one patient died due to numerous cardiac electromechanical dissociation events. This systematic investigation highlights the need for TTS vigilance after AF ablation, especially in postmenopausal women having catheter ablation. More research is required to fully understand the prevalence, etiology, and risk factors of TTS after AF ablation.

Atrial fibrillation (AF) is prevalent among patients undergoing transcatheter aortic valve replacement (TAVR) and increases risks of thromboembolism and bleeding with chronic anticoagulation. Concomitant left atrial appendage occlusion (LAAO) during TAVR may reduce long-term stroke and bleeding risks. PubMed, Embase, and Cochrane databases were searched through May 2025 for studies comparing TAVR + LAAO versus TAVR + standard medical therapy in patients with atrial fibrillation. Random-effects models were used to pool risk ratios (RRs) or mean differences with 95% CIs. Four studies (2 randomized controlled trials, 2 observational; n = 563, mean age 82 years) were included; 279 patients (49.5%) underwent TAVR + LAAO. Thirty-day outcomes showed no differences in mortality (RR 0.91; 95% CI, 0.28-3.01), stroke/transient ischemic attack (RR 0.27; 95% CI, 0.04-1.66), or major bleeding (RR 0.27; 95% CI, 0.04-1.66). Over a 9.8-month to 2-year follow-up, all-cause mortality (RR 0.95; 95% CI, 0.68-1.32), cardiac death (RR 0.95; 95% CI, 0.60-1.50), stroke/transient ischemic attack (RR 1.33; 95% CI, 0.30-5.83), and major bleeding (RR 1.06; 95% CI, 0.71-1.59) remained similar. Contrast use and hospital length of stay were comparable. Concomitant TAVR plus LAAO appears feasible, with no statistically significant differences in short-term outcomes versus TAVR plus standard medical therapy; however, certainty is low, and findings are hypothesis-generating, warranting larger randomized trials and prospective registries.