The Year in Hungarian Cardiology 2024: Arrhythmias

In 2024, several remarkable scientific papers were published from Hungary in the field of cardiac arrhythmias. Among these were some interesting ECG case reports featured in prestigious journals. Significant findings were reported on intracardiac echocardiography guided atrioventricular node ablation, the routine use of 3D mapping systems, and the effects of a new antiarrhythmic drug in the management of atrial fibrillation. A novel cardiac MR sequence was investigated in patients with atrial fibrillation scheduled for ablation or electro-cardioversion. Details regarding pulmonary vein isolation ablation techniques enriched the scientific community’s understanding, including insight into using different mapping catheters, the feasibility of zero-fluoro point-by-point ablation, and a 90W versus 50W power setting comparison. It was demonstrated that short interruption of NOAC therapy is safe strategy before pulmonary vein isolation, if left atrial appendage thrombus is excluded with cardiac computed tomography. Research also confirmed that the risk of infection does not significantly differ between early and delayed lead repositioning strategies. A robust meta-analysis was performed on safety and efficacy of subcutaneous implantable cardioverter defibrillator (S-ICD) among obese pa­tients. We obtained valuable data on the benefit of single-lead ICD system with a floating atrial dipole (DX ICD) over single chamber ICDs in terms of enhanced atrial arrhythmia detection. In the field of cardiac resynchronization therapy (CRT), a substudy of the BUDAPEST-CRT showed that CRT-D upgrade reduces the risk of heart failure hospitalization and improves reverse remodelling in patients with atrial fibrillation, similar to those observed among patients in sinus rhythm.