Circulation. Arrhythmia and electrophysiology最新文献

{"title":"Reduction in Left Atrial Epicardial Adipose Tissue Following Catheter Ablation for Atrial Fibrillation.","authors":"Nadia Chamoun, Yaacoub Chahine, Ahmad Kassar, Hala Al Yasiri, Tori Hensley, Romanos Haykal, Patrick M Boyle, Nazem Akoum","doi":"10.1161/CIRCEP.124.013590","DOIUrl":"https://doi.org/10.1161/CIRCEP.124.013590","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013590"},"PeriodicalIF":9.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulsed Field Ablation of Small Vessel-Related Arrhythmias: A New Catheter and Methods.","authors":"Fengqi Xuan, Yunhao Li, Jie Zhang, Long Lin, Daoyang Zhang, Qi Zhang, Ping Zhang, Yujie Zhang, Wei Ma, Yaling Han, Zulu Wang, Ming Liang","doi":"10.1161/CIRCEP.124.013606","DOIUrl":"https://doi.org/10.1161/CIRCEP.124.013606","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013606"},"PeriodicalIF":9.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression of Atrial Cardiomyopathy Predicts Subsequent Stroke: An Analysis of Left Atrial Low-Voltage Areas in Patients With Atrial Fibrillation Ablation.","authors":"Yasuhiro Matsuda, Satoshi Kudo, Masaharu Masuda, Hiroyuki Uematsu, Ayako Sugino, Hirotaka Ooka, Subaru Fujii, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Takuya Tsujimura, Yosuke Hata, Sho Nakao, Masaya Kusuda, Wataru Ariyasu, Toshiaki Mano","doi":"10.1161/CIRCEP.124.013550","DOIUrl":"https://doi.org/10.1161/CIRCEP.124.013550","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013550"},"PeriodicalIF":9.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blanking Period After Catheter Ablation of Paroxysmal Atrial Fibrillation: Insights From Continuous Cardiac Monitoring.","authors":"Martin Aguilar, Laurent Macle, Sewanou H Honfo, Paul Khairy, Julia Cadrin-Tourigny, Aamiya Sidhu, Marc W Deyell, Nathaniel M Hawkins, Richard G Bennett, Jason G Andrade","doi":"10.1161/CIRCEP.124.013232","DOIUrl":"10.1161/CIRCEP.124.013232","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013232"},"PeriodicalIF":9.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxidative Stress Causes Mitochondrial and Electrophysiologic Dysfunction to Promote Atrial Fibrillation in <i>Pitx2^+/-</i> Mice.","authors":"Tuerdi Subati, Kyungsoo Kim, Zhenjiang Yang, Matthew B Murphy, Joseph C Van Amburg, Isis L Christopher, Owen P Dougherty, Kaylen K Woodall, Charles D Smart, Joyce E Johnson, Agnes B Fogo, Venkataraman Amarnath, Vineet Agrawal, Joey V Barnett, Jeffrey E Saffitz, Katherine T Murray","doi":"10.1161/CIRCEP.124.013199","DOIUrl":"10.1161/CIRCEP.124.013199","url":null,"abstract":"<p><strong>Background: </strong>The strongest genetic risk factors for atrial fibrillation (AF) are DNA variants on chromosome 4q25 near the transcription factor gene <i>PITX2</i> (Pitx2:Paired-like homeodomain transcription factor 2). Mice deficient in <i>Pitx2</i> (<i>Pitx2</i>^<i>+/-</i>) have increased AF susceptibility, although the molecular mechanism(s) remains controversial. <i>Pitx2</i> encodes a transcription factor that activates an antioxidant response to promote cardiac repair. Increased reactive oxygen species causing oxidation of polyunsaturated fatty acids generates reactive lipid dicarbonyl moieties that adduct to proteins and other macromolecules to promote cellular injury. We tested the hypothesis that oxidative stress, and specifically isolevuglandins, the most reactive lipid dicarbonyls identified, are increased in the setting of <i>Pitx2</i> deficiency to promote proarrhythmic remodeling and AF.</p><p><strong>Methods: </strong><i>Pitx2</i>^<i>+/-</i> and <i>Pitx2</i>^<i>+/+</i> wild-type littermate control mice were treated orally with vehicle, the lipid dicarbonyl scavenger 2-hydroxybenzylamine, or an inactive control compound at weaning, until study at age 16 to 18 weeks.</p><p><strong>Results: </strong><i>Pitx2</i>^<i>+/-</i> mice demonstrated increased P wave duration indicative of slowed atrial conduction, as well as increased inducible AF burden and sustained AF, compared with wild type, and these abnormalities were prevented by 2-hydroxybenzylamine. Both reactive oxygen species and isolevuglandin protein adducts were elevated in <i>Pitx2</i>^<i>+/-</i> atria with reduced expression of reactive oxygen species-protective genes. High-resolution respirometry demonstrated impaired mitochondrial function in <i>Pitx2</i>^<i>+/-</i> atria, with disruption of mitochondrial integrity and cell-cell junctions with connexin lateralization, as well as decreased mitochondrial biogenesis gene expression. Proarrhythmic ionic current remodeling in <i>Pitx2</i>^<i>+/-</i> atrial myocytes included elevated resting membrane potential, abbreviated action potential duration, and reduced maximum phase 0 upstroke velocity compared with wild type. Most of these abnormalities were ameliorated or prevented by 2-hydroxybenzylamine.</p><p><strong>Conclusions: </strong>These results demonstrate a critical role for lipid dicarbonyl mediators of oxidative stress in the proarrhythmic remodeling and AF susceptibility that occurs with <i>Pitx2</i> deficiency, implying the possibility of genotype-specific therapy to prevent AF.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013199"},"PeriodicalIF":9.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sane Approach to Optimizing the Workload in Remote Monitoring of Cardiovascular Implantable Electronic Devices.","authors":"Markus Sane, Toni Jäntti, Annukka Marjamaa, Elina Pennanen, Charlotte Aura, Eeva Torvinen, Leena Karjalainen, Pekka Raatikainen, Jarkko Karvonen","doi":"10.1161/CIRCEP.124.013078","DOIUrl":"10.1161/CIRCEP.124.013078","url":null,"abstract":"<p><strong>Background: </strong>Remote monitoring offers an effective and safe method for monitoring patients with cardiovascular implantable electronic devices. The downside of remote monitoring is the overflow of the data. Since many of the remote monitoring transmissions are nonactionable, optimizing alert transmissions could partly overcome this problem.</p><p><strong>Methods: </strong>We collected data on the number and the causes of all alert-, scheduled-, and patient-initiated transmissions as well as actions initiated by these transmissions in 2023. According to our strategy, all clinically nonrelevant alerts were turned off. The trend of alert transmissions and the proportion of actionable scheduled transmissions are presented. The patient safety was monitored by analyzing the premortem alerts and changes to alert settings in deceased patients, as well as the rate of actionable scheduled or patient-initiated transmissions during follow-up.</p><p><strong>Results: </strong>During the study period 8182 transmissions were generated from 3732 cardiovascular implantable electronic devices. Of these, 2306 (28%) were alert transmissions, of which 57% (n=1290) were considered clinically nonrelevant. The rate of alerts decreased by 44% from January to December (0.07 versus 0.04 per device per month, <i>P</i>=0.001). Of the 3335 scheduled transmissions, 11% (364) were actionable, and the proportion of actionable scheduled transmissions remained unchanged during the follow-up period (<i>P</i>=0.08). Notably, none of the deaths were linked to the adjustment of alert settings.</p><p><strong>Conclusions: </strong>Our data indicated that active evaluation of the clinical relevance of all alert transmissions and deactivation of clinically nonrelevant alerts reduce the remote monitoring workload. However, long-term follow-up is needed to ensure that patient safety is not compromised.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013078"},"PeriodicalIF":9.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Vivo Endocardial and Epicardial Mapping of Human Sinus Node: From Electrical Landmarks to Anatomical Landmarks.","authors":"Ivan Eltsov, Luigi Pannone, Dhanunjaya Lakkireddy, Andrea Sarkozy, Gian Battista Chierchia, Mark La Meir, Carlo de Asmundis","doi":"10.1161/CIRCEP.124.013533","DOIUrl":"10.1161/CIRCEP.124.013533","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013533"},"PeriodicalIF":9.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subcutaneous Implantable Defibrillators in Young Patients: Arrhythmias, Complications, and Physical Activity.","authors":"Pietro Francia, Matteo Ziacchi, Federico Migliore, Paolo De Filippo, Antonio Dello Russo, Stefano Viani, Antonio Rapacciuolo, Giulio Falasconi, Carmen Adduci, Giovanni Bisignani, Luca Checchi, Giuseppe Busacca, Luca Santini, Carlo Lavalle, Valeria Ilia Calvi, Antonio Curcio, Massimo Silvetti, Antonio Pangallo, Marco Carbonaro, Davide Giorgi, Raimondo Pittorru, Mariolina Lovecchio, Sergio Valsecchi, Mauro Biffi, Antonio D'Onofrio, Antonio Pelliccia","doi":"10.1161/CIRCEP.124.013365","DOIUrl":"10.1161/CIRCEP.124.013365","url":null,"abstract":"<p><strong>Background: </strong>The safety of subcutaneous implantable cardioverter defibrillator (S-ICD) recipients who lead active lifestyles and engage in recreational sports is unknown. We aimed to evaluate the association between lifestyle and recreational sports and the occurrence of arrhythmia- and device-related complications, appropriate and inappropriate shocks in S-ICD recipients.</p><p><strong>Methods: </strong>We assessed a cohort of young-adult (15-65 years) S-ICD patients, evaluated their physical activity with IPAQ (International Physical Activity Questionnaire), and assessed the association between lifestyle and recreational sports on S-ICD safety and shocks.</p><p><strong>Results: </strong>We enrolled 602 S-ICD recipients (77% men; age, 46±14 years). According to the IPAQ, patients were categorized as inactive subjects (26.4%), moderately active subjects (45.2%), or highly active subjects (28.4%). Among moderately/highly active subjects, 163 (27.1%) were recreational athletes. During follow-up (47.3 [interquartile range, 27.0-67.6] months), 23 patients (3.8%) reached the safety end point of arrhythmia- or device-related complications, with moderately and highly active subjects showing in multivariate analysis similar incidence compared with inactive subjects (<i>P</i>=0.59 and <i>P</i>=0.83, respectively). Forty-four patients had 87 appropriate shocks. In multivariate analysis, moderately and highly active subjects showed a nonsignificantly lower incidence of appropriate shocks compared with inactive subjects (<i>P</i>=0.12 and <i>P</i>=0.11, respectively). Consistently, there was a nonsignificant lower incidence of appropriate shocks in athletes versus nonathletes (<i>P</i>=0.06). Thirty-nine patients had 46 inappropriate shocks. Moderately and highly active subjects had similar incidence of inappropriate shocks compared with inactive subjects (<i>P</i>=0.92 and <i>P</i>=0.88, respectively).</p><p><strong>Conclusions: </strong>Young S-ICD patients often lead active lifestyles and participate in sports. Higher activity levels were not associated with increased implantable cardioverter defibrillator-related complications or increased risk of implantable cardioverter defibrillator shocks.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013365"},"PeriodicalIF":9.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harmonized Definitions and Nomenclature for Use in Pulsed Field Ablation.","authors":"Omar M Aldaas, Vivek Y Reddy, Atul Verma, Andrea Natale, Petr Peichl, Boris Schmidt, Hugh Calkins, Prashanthan Sanders, Moussa Mansour, Gregory K Feld, Jonathan C Hsu","doi":"10.1161/CIRCEP.124.013294","DOIUrl":"10.1161/CIRCEP.124.013294","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013294"},"PeriodicalIF":9.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Independent External Evaluation of Pediatric Hypertrophic Cardiomyopathy Risk Scores in Predicting Severe Ventricular Arrhythmias.","authors":"Marie Wilkin, Diala Khraiche, Elena Panaioli, Margaux Pontailler, Olivier Raisky, Eloi Marijon, Damien Bonnet, Victor Waldmann","doi":"10.1161/CIRCEP.124.012932","DOIUrl":"10.1161/CIRCEP.124.012932","url":null,"abstract":"<p><strong>Background: </strong>Sudden cardiac death is the most common cause of death in childhood hypertrophic cardiomyopathy (HCM). Recently, 2 risk scores have been developed to estimate the 5-year risk of sudden cardiac death. We aimed to assess their respective performances in an independent cohort.</p><p><strong>Methods: </strong>All patients with HCM aged <18 years from a single center were retrospectively included between 2003 and 2023. HCM Risk-Kids and PRIMaCY risk scores were calculated at diagnosis and during follow-up. The primary composite outcome included sustained ventricular arrhythmia, appropriate implantable cardioverter defibrillator (ICD) therapy, aborted cardiac arrest, or sudden cardiac death.</p><p><strong>Results: </strong>A total of 100 primary prevention children were included (7.1±5.6 years, 59.0% males), with a mean follow-up of 8.6±5.5 years. Overall, 13 (13.0%) patients experienced the primary composite outcome. When only considering events during the 5 first years, Harrel C index was 0.52 (95% CI, 0.27-0.77) for HCM Risk-Kids (≥6%) and 0.70 (95% CI, 0.59-0.80) for PRIMaCY (>8.3%), with 1 patient potentially treated by ICD for every 25 ICDs implanted for HCM Risk-Kids and 1 for every 14 ICDs implanted for PRIMaCY. When risk scores were repeated and all primary outcomes during follow-up were considered, 12 of 13 (92.3%) events were correctly identified using both risk scores, with 1 patient potentially treated by ICD for every 5.6 ICDs implanted for HCM Risk-Kids and 1 for every 5.3 ICDs implanted for PRIMaCY. Among 44 (44.0%) patients implanted with an ICD, all primary prevention patients who had ≥1 appropriate ICD therapy during follow-up had an HCM Risk-Kids ≥6% and PRIMaCY >8.3% at implantation.</p><p><strong>Conclusions: </strong>In this independent evaluation, our findings suggest imperfect discrimination between low and high-risk patients using the HCM Risk-Kids and PRIMaCY risk scores, with predicted risks tending to be overestimated compared with the actual observed events. The performance or risk scores was substantially improved by periodic reassessment during follow-up.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e012932"},"PeriodicalIF":9.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}