BackgroundPulsed field ablation (PFA) has emerged as a promising therapy for atrial fibrillation. While general anesthesia (GA) is the standard to ensure catheter stability, using conscious or deep sedation (CS/DS) to streamline workflows is gaining interest. However, whether CS/DS provides comparable safety and efficacy to GA remains controversial and has lacked systematic evaluation.ObjectivesTo compare the clinical efficacy and safety of PFA for atrial fibrillation under GA vs. CS/DS.MethodsA literature search was conducted in PubMed, Cochrane Library, and Embase from inception to April 9, 2026. Studies were selected using predefined inclusion and exclusion criteria. The comparison of GA and CS/DS during PFA focused on the following clinical outcomes: procedural time, left atrial dwell time, fluoroscopy time, pulmonary vein isolation (PVI) success rate, and adverse event incidence. Heterogeneity was assessed with the I² statistic and Cochran's Q test; sensitivity analysis was performed if heterogeneity was high. Publication bias was evaluated using funnel plots and Egger's test.ResultsTen studies involving 3,692 atrial fibrillation patients were included. Compared to GA, CS/DS significantly shortened overall procedural time (WMD: −7.73 min, random-effects; 95% CI: −14.17 to −1.29; P = 0.019). However, there were no significant differences between the groups in left atrial dwell time (WMD: −2.59 min, random-effects; 95% CI: −9.74 to 4.57), fluoroscopy time (WMD: −2.52 min, random-effects; 95% CI: −5.31 to 0.28), acute PVI success (RR: 1.00, fixed-effects; 95% CI: 0.98 to 1.03), or major adverse events (RR: 1.57, fixed-effects; 95% CI: 0.81 to 3.05). CS/DS showed a borderline trend toward fewer minor adverse events (RR: 0.61, fixed-effects; 95% CI: 0.37 to 1.01; P = 0.053).ConclusionIn PFA for AF, CS/DS was associated with reduced overall procedural time compared with GA, while maintaining comparable acute PVI success rates and safety profiles. However, large-scale randomized controlled trials are still needed to confirm these findings.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251165071, identifier (CRD420251165071).
IntroductionThis study aims to investigate the short-term effect of early cardiac exercise rehabilitation on the recovery of cardiac function in patients who have undergone open heart surgery.MethodsA total of 120 patients who performed open heart surgery from January 2019 to December 2021 were divided into an experimental group (n = 60) and a control group (n = 60). The control group received standard nursing by nurses while the experimental group participated in early cardiac exercise rehabilitation training. The postoperative cardiac function (at discharge and 3 months after operation), gastrointestinal peristalsis recovery, infection rate, readmission rate, and patient satisfaction of both groups were assessed.ResultsThe experimental group demonstrated lower infection rate, reduced readmission rate, higher patient satisfaction, and better postoperative cardiac function at 3 months after operation than the control group (P < 0.05). There was no significant difference in the postoperative cardiac function at discharge and the recovery time of gastrointestinal peristalsis between two groups (p > 0.05).DiscussionIn conclusions, early cardiac exercise rehabilitation training during the perioperative period can help to improve the recovery of cardiac function in a short term for patients who have undergone open heart surgery. At the same time, early cardiac exercise rehabilitation also helped to reduce postoperative infections and readmission, and improve patient satisfaction..
IntroductionMinimally invasive surgery (MIS), including endovascular and robot-assisted procedures, is widely used for vascular pathologies but remains limited by technical complexity, cognitive workload, and postoperative complications. Artificial Intelligence (AI) may help address these challenges through predictive analysis, decision support, image analysis, and automation.MethodsA structured Google Scholar search was conducted from February 21, 2025, to January 1, 2026, and updated through September 2026. Peer-reviewed studies applying AI to vascular MIS were included, with additional targeted searches addressing clinical translation, deployment, regulation, and ethical considerations.ResultsThirty primary studies were analyzed, including eight on machine learning, nine on deep learning, four on natural language processing, and nine on robotics or reinforcement learning. Machine learning supported risk stratification and outcome prediction, deep learning enabled imaging and segmentation applications, natural language processing facilitated clinical information extraction, and robotic systems supported navigation and procedural assistance.DiscussionAI demonstrates substantial potential across the vascular MIS pathway, but broader clinical adoption requires stronger validation, prospective multicenter studies, standardized reporting, health-economic evaluation, and careful consideration of regulatory, liability, and accessibility challenges.
Despite advances in early recognition, aetiology-directed therapy, intensive cardiovascular care and short-term mechanical circulatory support (MCS), cardiogenic shock (CS) remains associated with high mortality and morbidity. MCS can restore systemic perfusion and stabilise patients as a bridge to recovery or advanced heart failure therapies, or as a bridge-to-decision when the final therapeutic destination remains uncertain. However, appropriate patient and device selection remains challenging. The optimal timing of support is uncertain, as both premature implantation and delayed use in advanced shock may limit benefit while increasing complications. Device selection should therefore be individualised according to the predominant patient phenotype, including left ventricular, right ventricular or biventricular failure, concomitant respiratory failure, vascular access and anatomical considerations. Randomised trials have focused predominantly on acute myocardial infarction-related CS, whereas data in heart failure-related and acute-on-chronic CS remain limited. Recent trials have also shown that greater haemodynamic support does not uniformly translate into improved survival, highlighting the importance of matching device physiology to shock phenotype and clinical trajectory. MCS is associated with clinically relevant complications, including major bleeding, haemolysis, limb ischaemia, stroke, thrombosis and vascular injury. Accordingly, its use should be considered within a strategy integrating reversibility, neurological prognosis, recovery potential, a realistic definitive therapeutic strategy, technical feasibility and anticipated complication risk. This Mini Review summarises contemporary indications, devices and complications of MCS in CS, with emphasis on phenotype-guided selection, timing, intensive care management and current evidence gaps.
Cardiovascular health is a key factor in human longevity, affecting not just lifespan but also the quality of aging. We synthesize evidence across four risk factor domains: genetic and epigenetic factors (APOE, FOXO3, telomere biology, epigenetic clocks); metabolic and vascular factors (hyperglycemia, dyslipidemia, obesity, arterial stiffness); lifestyle determinants (diet, physical activity, smoking, sleep, gut microbiome); and environmental exposure (air and noise pollution, climate stressors, ionizing radiation). These factors influence various biological processes such as oxidative stress, chronic low grade inflammation (inflammaging), mitochondrial dysfunction, metabolic disturbances, and changes in telomere length and epigenetics that collectively damage the endothelium, stiffen arteries, promote atherosclerosis, and contribute to overall cardiovascular decline with age. Understanding these processes helps explain why cardiovascular aging is such a strong predictor of mortality. We further summarize the principal intervention strategies with evidence for improving cardiovascular health and longevity, such as adherence to the American Heart Association's Life's Essential 8 construct, heart-healthy dietary patterns(Mediterranean, DASH), smoking cessation, sleep optimization, and reduction of environmental exposures. This narrative review distinguishes evidence derived from model organisms, human observational cohorts, and human interventional/genetic studies, since these evidence tiers differ substantially in their support for lifespan or longevity extending claims specifically, as opposed to cardiovascular risk reduction more broadly.
