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In atrial fibrillation, Prof. Pappone has established a fundamental role of catheter ablation in the treatment of patients, developing “the Pappone approach”, a method now accepted worldwide. Subsequently, he identified the “rotors” as responsible for the persistence of atrial fibrillation and as a target of radiofrequency ablation, clarifying the anatomical and functional bases of this complex and common cardiac arrhythmia.

 

In heart failure, Prof. Pappone developed and used cardiac resynchronization therapy using innovative multipolar catheters in patients with refractory heart failure.

 

In Wolff-Parkinson-White Syndrome (WPW), he carried out pioneering studies demonstrating the possibility of identifying asymptomatic WPW patients at high risk of malignant arrhythmias. These results generated new recommendations in the guidelines, leading to treatment by ablation in asymptomatic patients with accessory pathways at risk of sudden death.

 

In Brugada Syndrome, he identified and characterized for the first time the arrhythmic substrate in affected patients, and was the first in the world to  devise and develop an innovative epicardial ablation of the arrhythmic substrate, which drastically reduces the occurrence of malignant arrhythmias in patients at risk of sudden death. To date, more than 600 patients suffering from Brugada syndrome have been subjected to ablation of the arrhythmic substrate, with the disappearance of the Brugada pattern and malignant ventricular arrhythmias in almost all cases.