Biomedical papers - Latest articles
Results 61 to 89 of 89:
Challenges with hippocampal MR spectroscopy as a surrogate for pre-radiotherapy assessment of neurocognitive impairment in patients with brain metastasisOriginal papers
Iveta Selingerova, Klara Holikova, Tomas Chodur, Ludmila Hynkova, Petr Pospisil, Martin Bulik, Renata Belanova, Kamila Siffelova, Ivana Kolouskova, Marek Slavik, Petr Burkon, Roman Hrstka, Radim Jancalek, Jiri Sana, Pavel Slampa, Tomas Kazda
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(3):206-215 | DOI: 10.5507/bp.2024.012 
Patients with multiple brain metastases (BM) benefit from hippocampal-avoiding whole brain radiotherapy (HA-WBRT), a less available form of WBRT. This study explores pre-radiotherapy (pre-RT) hippocampal magnetic resonance spectroscopy (MRS) as a tool for assessing neurocognitive functions (NCF) in order to identify which patients may benefit from HA-WBRT. 43 BM patients underwent pre-RT hippocampal MRS, correlating N-acetylaspartate (neuronal density surrogate) with NCF tests (HVLT and BVMT). Borderline statistically significant correlations were found with speculative interpretation underlying the challenges of hippocampal MRS as a surrogate for neurocognitive impairment. Further studies are needed to validate hippocampal MRS as a predictor for memory sparing radiotherapy benefit.
Interventions for increasing medication adherence in heart failure patients: A narrative reviewReviews
Libor Jelinek, Jan Vaclavik, Marie Lazarova
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(3):200-205 | DOI: 10.5507/bp.2024.022
Heart failure is one of the critical and most costly medical challenges of the 21st century. It is a chronic debilitating condition and adherence to medication, a precondition for successful treatment is often poor. There are various interventions for improving adherence. Depending on the goal of the intervention, these are roughly patient centric, healthcare provider centric and system centric. The authors provide an overview of these interventions with a focus on effectiveness and appropriateness in different clinical situations. Their use can lead to improved patient outcomes and reduced economic burden of the disease.
Chronic non-bacterial osteomyelitis (CNO) and chronic recurrent multifocal osteomyelitis (CRMO) with a focus on pamidronate therapyReviews
Katerina Bouchalova, Zuzana Pytelova
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(3):191-199 | DOI: 10.5507/bp.2024.007
CNO/CRMO is a rare autoinflammatory bone disease of unknown etiology. The authors review the etiology, epidemiology, clinical course, diagnostic criteria, development of classification criteria, diagnostic methods, association with other diseases, methods for disease activity evaluation, treatment and tasks for the future. Tables comparing different diagnostic criteria, recently developed RINBO index (radiologic index for nonbacterial osteomyelitis) and summary of studies on CNO/CRMO therapy using pamidronate are included.
Macrotroponins cause discrepancy in high-sensitivity examinationCase reports
Pavel Broz, Jaroslav Racek, Pavel Prokop, Jaroslav Novak, Daniel Rajdl, Ladislav Trefil
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(2):187-190 | DOI: 10.5507/bp.2023.001
This work presents two cases of a discrepancy between clinical presentation and falsely elevated cardiac troponins concentrations. Cases like this are well known to laboratory professionals, however, according to the experience of the authors, clinical professionals are often not. Presentation of such cases to the wider medical community can help avoid unnecessary investigation and possible harm to patients.
Bacillus Calmette-Guérin pneumonitis after intravesical instillation: Report of two cases and a review of the literatureCase reports
Martina Spisarova, Stanislav Losse, Petr Jakubec, Igor Hartmann, Milan Kral, Jiri Ehrmann, Marek Szkorupa, Hana Studentova, Bohuslav Melichar
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(2):181-186 | DOI: 10.5507/bp.2022.051
Two cases of BCG pneumonitis described in this study highlight the necessity to consider systemic BCG infection in patients after intravesical BCG therapy. Uncommon complications of bacillus Calmette-Guérin administration could be very serious and threaten the life of patients treated with this modality. Treatment with specific antituberculotic medication underlines the importance of correct diagnosis.
Robotic assisted living donor nephrectomy - the first in the Czech RepublicCase reports
Pavel Zemla, Igor Hartmann, Frantisek Hruska, Milan Kral, Jana Janeckova, Petr Utikal, Ales Vidlar, Karel Krejcí, Petr Bachleda
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(2):177-180 | DOI: 10.5507/bp.2023.034
This work describes the first robotic assisted living donor nephrectomy in the Czech Republic which was performed in June 2022. Worldwide, this operation was first carried out in 2001 and has now become common practice at many workplaces. It not only provides all the advantages of a laparoscopic operation but it also adds other technical improvements and minimizes intraoperative stress on the surgeon. The authors believe this breakthrough in the Czech Republic will trigger an increase in robotic assisted kidney harvesting. This paper also incorporates our ten-year experience in living donor nephrectomies, conducted using various techniques.
B cell subsets reconstitution and immunoglobulin levels in children and adolescents with B non-Hodgkin lymphoma after treatment with single anti CD20 agent dose included in chemotherapeutic protocols: single center experience and review of the literatureOriginal papers
Eva Hlavackova, Zdenka Krenova, Arpad Kerekes, Peter Slanina, Marcela Vlkova
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(2):167-176 | DOI: 10.5507/bp.2023.021
This is a retrospective one tertiary centre study which investigated the humoral and cellular immunity reconstitution and clinical impact of chemotherapeutic protocols that included a single rituximab dose in children and adolescents treated for non-Hodgkin Lymphoma. The proportion of IgG, IgM, and IgA hypogammaglobulinemia decreased over the follow-up period. The median for B cell reconstitution was 3 months after the end of lymphoma treatment. Transitional B lymphocyte subsets dominated at the time of B cell subset reconstitution. No secondary antibody deficiency needing immunoglobulin replacement therapy was found.
High incidence of acute and subacute ischaemic foci on brain MRI in patients with a diagnosis of acute pulmonary embolism and confirmed patent foramen ovaleOriginal papers
Radomir Nykl, Martin Hutyra, Eva Cechakova, Jan Precek, David Vindis, David Richter, Milos Taborsky
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(2):162-166 | DOI: 10.5507/bp.2023.005
The authors present an evaluation of 129 patients with a diagnosis of acute pulmonary embolism who were thoroughly examined (TTE, TEE, laboratory, brain MRI), They found a surprisingly high incidence of acute and subacute pathological findings on brain MRI in direct relation to the presence of PFO confirmed by TEE.
Utility of fine-needle aspiration biopsy (FNAB) in parotid pleomorphic adenoma diagnosis and managementOriginal papers
Alzbeta Fikova, Stepan Novak, David Kalfert, Martin Kuchar, Michal Zabrodsky, Lucie Dostalova, Jan Balko, Jan Plzak
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(2):156-161 | DOI: 10.5507/bp.2023.027
The results confirmed, that ultrasound-guided fine-needle aspiration biopsy (FNAB) is valuable in the diagnostic algorithm for patients with pleomorphic adenoma. Ultrasound-guided FNAB is simple, accurate and valuable in the diagnosis of plemorphic adenoma and provides results that can lead to the choice of less invasive operative treatment. For smaller tumours in favourable locations, extracapsular dissection is a safe and adequate surgical technique with minimal risk to the facial nerve or other local complications and without increased risk of recurrence.
Retinal microvascular abnormalities in major depressionOriginal papers
Evgenii Sadykov, Ladislav Hosak, Alexandr Stepanov, Jana Zapletalova, Jan Studnicka
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(2):147-155 | DOI: 10.5507/bp.2023.026
The authors detected significantly larger retinal arteriolar and venular calibres in a non-geriatric population with major depression compared with a population without depression. The finding may be useful for prevention as well as personalized treatment of this serious mental disorder.
High pre-transplant Mucosal Associated Invariant T Cell (MAIT) count predicts favorable course of myeloid aplasiaOriginal papers
Ivana Karlova Zubata, Jitka Smetanova Brozova, Tomas Karel, Barbora Bacova, Jan Novak
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(2):139-146 | DOI: 10.5507/bp.2023.011
MAIT cell abundance detected before myeloablative conditioning and autologous stem cell transplantation predicts the course of myeloid aplasia. The number of MAIT cells negatively correlated with peak C-reactive protein level and the amount of red blood cell transfusion units resulting in earlier discharge of patients with the most abundant MAIT cells.
Levels of retinol and retinoic acid in pancreatic cancer, type-2 diabetes and chronic pancreatitisOriginal papers
Pavel Hrabak, Miroslava Zelenkova, Tomas Krechler, Jan Soupal, Michal Vocka, Tomas Hanus, Lubos Petruzelka, Stepan Svacina, Ales Zak, Tomas Zima, Marta Kalousova
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(2):132-138 | DOI: 10.5507/bp.2023.049
There are still uncertainties about role of retinoids in pancreatic pathologies. The authors used high-performance liquid chromatography with UV detection to measure the serum the retinol and ATRA levels in 246 patients with PDAC, CHP, T2DM and healthy controls. The authors confirmed a significant decrease in retinol levels in PDAC compared to CHP and healthy controls, significant decrease of ATRA levels in PDAC compared to T2DM and healthy controls and they found a correlation between retinol, prealbumin and transferrin, and of ATRA and insulin-like growth factor binding protein-2.
Serum concentrations of 25-OH vitamin D and the pro-inflammatory interleukins IL-17, IL-23, and IL-18 in patients with plaque psoriasisOriginal papers
Maria Ganeva, Zhivka Tsokeva, Tanya Gancheva, Evgeniya Hristakieva, Vanya Tsoneva, Irena Manolova
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(2):124-131 | DOI: 10.5507/bp.2023.043
The IL-23/IL-17 pathogenic axis plays a key role in the pathogenesis of psoriasis. Vitamin D is thought to be involved in the development of many diseases by modulating the inflammatory process. The study established a moderate negative correlation between 25(OH)D levels and the PASI score suggesting participation of vitamin D in the pathogenesis of psoriasis. Significantly higher concentrations of pro-inflammatory IL-17A and IL-18 in individuals with cardio-metabolic diseases (CMDs) in the study cohort and elevated levels of these cytokines in psoriasis patients with CMDs were detected.
Novel approach to adherence assessment based on parent drug and metabolite pharmacokinetics: pilot study with spironolactoneOriginal papers
Alena Pilkova, Martin Sima, Jan Miroslav Hartinger, Thi Minh Phuong Nikrynova Nguyen, Vera Maresova, Ivana Kurcova, Ondrej Slanar, Jiri Widimsky
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(2):117-123 | DOI: 10.5507/bp.2022.048
Detection of drug or its metabolite in a blood sample without evaluation of serum concentration does not fully enable uncovering instances of improper drug use or white-coat adherence. Considering pharmacokinetic properties of the drug helps us to recognize if measured concentration refers to steady state, i. e. regular use, or is markedly reduced and therefore originates from irregular or single dose ingestion before sampling. Application of pharmacokinetic principles in the interpretation of serum concentrations of antihypertensive drugs leads to a more precise evaluation of a patient's behaviour.
Current trends in the management of out of hospital cardiac arrest (OHCA)Reviews
Michal Plodr, Eva Chalusova
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(2):105-116 | DOI: 10.5507/bp.2024.006
The last decade has seen the development of new procedures and technologies that have the potential to reverse the unfavourable prognosis of patients after OHCA. The early availability of AEDs in remote or sparsely populated destinations can be solved by deploying drones as AED carriers. Dispatchers will be able during an incoming emergency call to rely on the support of machine learning models or videocalls from the scene. The use of ECMO in patients after cardiac arrest is already an introduced method in the early in-hospital phase, and there are promising partial results from the pre-hospital area. The definition of input criteria for each method is a key factor in the misuse of forces and means and is a prerequisite to increasing the percentage of survival of OHCA with good neurological status.
Treatment adherence and the contemporary approach to treating type 2 diabetes mellitusReviews
Bela Kolars, Ivana Minakovic, Beata Grabovac, Dejan Zivanovic, Vesna Mijatovic Jovin
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(2):97-104 | DOI: 10.5507/bp.2024.009
This paper explores the modern approach to treating type 2 diabetes mellitus (T2D), emphasizing the importance of adherence for successful management. It reviews various components of T2D treatment, lifestyle modifications, including medical nutritional therapy and physical activity. Medications in contemporary treatment are discussed, each with specific benefits and potential risks. Factors influencing the adherence to the components of treatment are analysed. Even though adherence leads to a better disease outcome, it is often poor. The review concludes that addressing factors affecting adherence can significantly improve T2D outcomes and reduce costs.
Endoscopic treatment of pancreatic fluid collection in gastric heterotopic pancreas. A case reportCase reports
Ivana Mikoviny Kajzrlikova, Jan Kuchar, Petr Vitek, Barbora Horavova, Hana Vankova, Martin Chrostek
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(1):92-96 | DOI: 10.5507/bp.2022.043
This case report details the diagnostic work-up in a young woman with clinical presentation of heterotopic pancreas. Here, imaging and endoscopic findings of a newly diagnosed submucosal mass in the gastric antrum are well described. Technical issues of endosonographically-navigated drainage of symptomatic fluid collection in heterotopic pancreas with a plastic double pigtail stent under fluoroscopic control are also presented. Fluid collections after acute pancreatitis in heterotopic pancreas can be successfully managed by endoscopy.
Pediatric Cushing's disease: Case reports and retrospective reviewCase reports
Renata Pomahacova, Petra Paterova, Eva Nykodymova, Josef Sykora, Michal Krsek
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(1):85-91 | DOI: 10.5507/bp.2022.049
This article describes growth retardation and change in facial appearance with development of moon face as the first symptoms of CS. Growth retardation is prior to development of moon face. CRH test and BIPSS contribute to confirming the diagnosis of CD and excluding ectopic ACTH syndrome in children with invisible adenoma on MRI.
Disposition of levobupivacaine during intraoperative continuous caudal epidural analgesia in a preterm neonateCase reports
Jan Sipek, Pavla Pokorna, Martin Sima, Jitka Styblova, Vladimir Mixa
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(1):81-84 | DOI: 10.5507/bp.2023.047
The use of epidural analgesia in neonates raises concerns due to possible drug cumulation and toxicity. In general, studying PK and modelling using plasma concentrations of the used local anaesthetic (LA) in neonates is applicable in daily clinical practice because the intravenous blood volume is small, and the number of samples does not have to be large. To the best of their knowledge, this is the first case report of the pharmacokinetic profile of levobupivacaine (LA) achieving pharmacotherapy goals during epidural use in preterm neonates. A special adjustment of the laboratory method reduced the blood samples to 0.2-0.5 mL each. Although elimination of levobupivacaine was prolonged, no accumulation occurred and concentrations of total and free levobupivacaine were well below the toxicity threshold. Epidural analgesia at this age should be monitored and used with caution.
Prediction of live birth - selection of embryos using morphokinetic parametersOriginal papers
Katerina Tvrdonova, Silvie Belaskova, Tatana Rumpikova, David Rumpik, Alena Myslivcova Fucikova, Frantisek Malir
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(1):74-80 | DOI: 10.5507/bp.2022.052
The goal of this study was to use time-lapse monitoring to find key morphokinetic parameters in pre-implantation human embryos, which are essential for the identification of embryos with high developmental potential, specifically embryos leading to the birth of a healthy child.
DNA methylation of selected tumor suppressor genes in endometrial hyperplasiaOriginal papers
Ondrej Dvorak, Munachiso Ndukwe, Marcela Slavickova, Jan Laco, Jiri Spacek
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(1):68-73 | DOI: 10.5507/bp.2022.053
This research study was focused on changes in DNA methylation in specific tumor supressor genes in endometrial hyperplasia. The authors performed a retrospective study of endometrial tissue of 164 patients treated in their department from 2007 to 2014 dividing them into three subsets: atypical hyperplasia, hyperplasia without atypia and a control group with normal endometrial tissue. 25 selected genes using the methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) probe set were tested. Differences in DNA methylation among the groups were found in PTEN, CDH13, and MSH6 promoters. These genes appear to be involved in different stages of the development of endometrial hyperplasia.
The nociceptive response during adult cardiac surgery measured by the qNOX index: A feasibility studyOriginal papers
Vladislav Rogozov, Tomas Vanek, Marek Maly, Jan Rocek, Petr Kacer
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(1):62-67 | DOI: 10.5507/bp.2022.045
The "qNOX" index for the Conox monitor was predicted to be responsive to the probability of reaction to nociceptive stimulation during general anaesthesia. The results show that the qNOX index does not reflect development of detectable signs related to nociceptive stimulation during adult cardiac surgery and could be affected by simultaneous use of muscle relaxants.
Corneal stromal lenticule transplantation for the treatment of corneal ulcersOriginal papers
Yun Min Klimesova, Martina Nemcokova, Magdalena Netukova, Alina-Dana Baxant, Marcela Hlavackova, Jana Kacerovska, Pavel Studeny
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(1):55-61 | DOI: 10.5507/bp.2023.004
The possibility of using deep-frozen corneal stromal lenticules could significantly help in the treatment of corneal ulcers or even perforations, which is currently difficult due to the relative unavailability of corneal tissue donors, especially in developing countries.
Immunoablative therapy followed by autologous hematopoietic stem cell transplantation as the first-line disease-modifying therapy in patients with multiple sclerosisOriginal papers
Martin Lachnit, Kamila Zondra Revendova, Pavel Hradilek, Radovan Bunganic, Zdenek Koristek, Tomas Jelinek, Monika Skutova, Radim Piza, Ondrej Volny, Roman Hajek, Michal Bar
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(1):50-54 | DOI: 10.5507/bp.2023.023
Six multiple sclerosis (MS) patients with a rapid progression of disability underwent immunoablative therapy followed by autologous hematopoietic stem cell transplantation (AHSCT) as the first-line disease-modifying therapy, between 2018 and 2021. Four out of six patients showed disability progression after AHSCT, so the rapid progression of MS was just slowed down by AHSCT. One patient developed activity on magnetic resonance imaging and two patients experienced mild relapses after AHSCT. None of the patients developed grade 4 non-hematological toxicity.
Hypertension, hyperlipidaemia and thrombophilia as the most common risk factors for retinal vein occlusion in patients under 50 yearsOriginal papers
Zuzana Schreiberova, Jiri Rehak, Barbora Babkova, Martin Sin, Martina Rybarikova, Barbora Paskova, Irena Sinova, Petra Hubnerova, Miroslava Maluskova, Klara Maresova, Marta Karhanova
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(1):44-49 | DOI: 10.5507/bp.2022.036
The authors confirmed that the most common abnormalities leading to retinal vein occlusion (RVO) in patients under 50 years were systemic cardiovascular diseases, particularly arterial hypertension and hyperlipidaemia, and we found out that the risk factors for central RVO (CRVO), hemi-central RVO (HRVO) and branch RVO (BRVO) were similar. To the best of our knowledge, this is the only study to date which has examined the difference between RF presence in CRVO and HRVO patients compared to BRVO patients under the age of 50.
Mortality of hospitalized patients with COVID-19: Effects of treatment options (vitamin D, anticoagulation, isoprinosine, ivermectin) assessed by propensity score matching, retrospective analysisOriginal papers
Jiri Plasek, Jozef Dodulik, Petr Gai, Barbora Hrstkova, Jan Skrha, Lukas Zlatohlavek, Renata Vlasakova, Peter Danko, Petr Ondracek, Eva Cubova, Bronislav Capek, Marie Kollarova, Tomas Furst, Jan Vaclavik
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(1):35-43 | DOI: 10.5507/bp.2023.045
The main findings of this retrospective analysis on 790 unvaccinated patients with COVID-19 respiratory infection may be summarized as follows: Vitamin D supplementation had no meaningful effect on in-hospital mortality. Neither isoprinosine nor ivermectin had any effect on in-hospital mortality either. Prophylactic anticoagulation treatment was to some degree beneficial compared with the full dose anticoagulation. 35.7% of patients died in the hospital: 37.7% males and 33.3% females, and the difference between sexes was not significant (except for the age group 61-70 years)
The inhibitory effects of Xiao-Gao-Jiang-Zhuo-containing serum on adipogenesis in 3T3-L1 preadipocytesOriginal papers
Liang Chen, Yu Han, Jing Li, Chunpeng Feng, Chen Chen, Ting Ye
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(1):25-34 | DOI: 10.5507/bp.2023.016
XGJZ-containing serum was obtained from obese rats treated with the XGJZ formula. The authors confirmed that XGJZ-containing serum can inhibit the differentiation of 3T3-L1 adipocytes, reduce the expression of lipogenic transcription factors, lipid accumulation, and lipid metabolism-related enzyme activity in differentiated 3T3-L1 adipocytes, thereby improving the risk of obesity and obesity-related diseases. It provides evidence for the mechanism of obesity
DNA damage and arterial hypertension. A systematic review and meta-analysisReviews
Radka Hazukova, Martina Rezacova, Miloslav Pleskot, Zdenek Zadak, Eva Cermakova, Milos Taborsky
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(1):15-24 | DOI: 10.5507/bp.2023.044
DNA damage is increased in hypertensive pts compared with healthy controls and this is confirmed with meta-analysis (comet: 26.6±11.0 vs 11.7±4.07; P<0.05; 8OHdG: 13.1±4.12 vs 6.97±2,67; P<0.05, gammaH2AX: no data available). Greater DNA damage is identified in more adverse cases. DNA damage correlates strongly with serum glycosylated haemoglobin (r=0.670; P<0.05) and total antioxidant status (r=-0.670 to -0.933; P<0.05). This is the first systematic review with meta-analysis showing that oxidative DNA damage is increased in humans with arterial hypertension.
Catheter ablation for non-paroxysmal atrial fibrillation. A reviewReviews
Sabri Hassouna, Pavel Osmancik
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(1):1-14 | DOI: 10.5507/bp.2023.053
Atrial fibrillation (AF) is the most common cardiac arrhythmia and it is associated with increased morbidity and mortality. Catheter ablation is currently the most effective treatment for AF. PVI as a treatment for paroxysmal atrial fibrillation (AF) is associated with a high success rate; however, outcomes for treating persistent and long-standing persistent AF with PVI alone are substantially lower. Since pulmonary vein isolation by itself is rarely sufficient in the treatment of non-paroxysmal AF, a variety of techniques have been developed to increase the efficacy of CA for non-paroxysmal AF. Different approaches include PVI-only, PVI + linear ablations, and a stepwise approach, depending on the surgeon's skills, preference, and experience. New methods such as pulsed-field ablation, using ultra-short electrical pulses, appear to be very promising.