Circulation. Arrhythmia and electrophysiology最新文献

{"title":"The \"420\" Cannabis Celebration and Atrial Fibrillation.","authors":"Jean Jacques Noubiap, Gregory M Marcus","doi":"10.1161/CIRCEP.124.013566","DOIUrl":"10.1161/CIRCEP.124.013566","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013566"},"PeriodicalIF":9.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771214","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":"Long-Term Clinical Benefits of Pulsed Field Ablation in Paroxysmal Atrial Fibrillation: Subanalyses From the Multicenter inspIRE Trial.","authors":"Tom J R De Potter, Massimo Grimaldi, Mattias Duytschaever, Ante Anic, Johan Vijgen, Petr Neuzil, Hugo Van Herendael, Atul Verma, Allan Skanes, Daniel Scherr, Helmut Pürerfellner, Gediminas Rackauskas, Pierre Jais, Vivek Y Reddy","doi":"10.1161/CIRCEP.124.013465","DOIUrl":"10.1161/CIRCEP.124.013465","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013465"},"PeriodicalIF":9.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956776","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":"Marshall-Plan Ablation Strategy Versus Pulmonary Vein Isolation in Persistent AF: A Randomized Controlled Trial.","authors":"Nicolas Derval, Romain Tixier, Josselin Duchateau, Xavier Bouteiller, Timothé Loock, Arnaud Denis, Rémi Chauvel, Benjamin Bouyer, Marine Arnaud, Masaaki Yokoyama, Christopher Kowalewski, Cinzia Monaco, Ciro Ascione, Frédéric Sacher, Mélèze Hocini, Pierre Jaïs, Michel Haïssaguerre, Thomas Pambrun","doi":"10.1161/CIRCEP.124.013427","DOIUrl":"10.1161/CIRCEP.124.013427","url":null,"abstract":"<p><strong>Background: </strong>Beyond pulmonary vein (PV) isolation, the optimal ablation strategy for persistent atrial fibrillation (AF) remains poorly defined. The purpose of this study was to compare 2 ablation strategies in the treatment of patients with persistent AF: a comprehensive ablation strategy based on anatomic considerations versus PV isolation alone.</p><p><strong>Methods: </strong>The Marshall-Plan trial is a prospective, randomized, parallel-group, controlled clinical trial of superiority conducted at the Bordeaux University Hospital. Consecutive patients with symptomatic, documented persistent AF were included and randomized into 2 arms: Marshall-Plan consisting of PV isolation with additional ablation including vein of Marshall ethanol infusion, and lines of block at the mitral, dome, and cavotricuspid isthmuses versus PV isolation alone. The main outcome was the 1-year freedom from any arrhythmia (atrial fibrillation/atrial tachycardia >30 seconds) after a single ablation procedure with or without any antiarrhythmic medication at 12 months.</p><p><strong>Results: </strong>A total of 120 patients were included (age 65±8 years; 21 women). Two patients were excluded from analysis. All PVs were successfully isolated in both groups. In the Marshall-Plan group, vein of Marshall ethanol infusion was completed in 57 (97%) patients. Conduction block across linear lesions was obtained in 93%, 92%, and 93% of the mitral, dome, and cavotricuspid isthmuses, respectively. The full lesion set was successfully completed in 52 (88%) patients in the Marshall-Plan group and 59 (100%) patients in the PV isolation group. At 12 months, freedom from recurrence of atrial arrhythmia >30 seconds after 1 ablation procedure, with or without antiarrhythmic medication, had occurred in 51 of the 59 (86.4%) patients assigned to the Marshall-Plan approach, and 39 of the 59 (66.1%) patients assigned to PV isolation only (<i>P</i>=0.012).</p><p><strong>Conclusions: </strong>In this prospective randomized controlled trial, the Marshall-Plan strategy was significantly superior to a PV isolation strategy at 12 months.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT04206982.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":"18 5","pages":"e013427"},"PeriodicalIF":9.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109809","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":"Computational Modeling of Effects of <i>PKP2</i> Gene Therapy on Ventricular Conduction Properties in Arrhythmogenic Cardiomyopathy.","authors":"Alessio Ostini, André G Kléber, Yoram Rudy, Jeffrey E Saffitz, Jan P Kucera","doi":"10.1161/CIRCEP.124.013658","DOIUrl":"10.1161/CIRCEP.124.013658","url":null,"abstract":"<p><strong>Background: </strong>Patients with arrhythmogenic cardiomyopathy due to pathogenic variants in <i>PKP2</i>, the gene for the desmosomal protein plakophilin-2, are being enrolled in gene therapy trials designed to replace the defective allele via adeno-associated viral transduction of cardiac myocytes. Evidence from experimental systems and patients indicates that ventricular myocytes in <i>PKP2</i> arrhythmogenic cardiomyopathy have greatly reduced electrical coupling at gap junctions and reduced Na⁺ current density. In previous adeno-associated viral gene therapy trials, <50% of ventricular myocytes have generally been transduced.</p><p><strong>Methods: </strong>We used established computational models of ventricular cell electrophysiology to define the effects of varying levels of successful gene therapy on conduction in patients with <i>PKP2</i> arrhythmogenic cardiomyopathy. Conduction velocity and development of conduction block were analyzed in tissue constructs composed of cells with levels of electrical coupling and Na⁺ current density observed in experimental studies.</p><p><strong>Results: </strong>We observed a nonlinear relationship between conduction velocity and the proportion of transduced cells. Conduction velocity increased only modestly when up to 40% of myocytes were transduced. Conduction block did not occur in tissue constructs with moderate levels of uncoupling (0.10 or 0.15 of normal) as this degree of coupling was sufficient to allow electrotonic current to pass through diseased cells. Thus, low levels of transduction, likely to occur in phase 1 clinical trials, do not seem to pose a major safety concern. However, our models did not incorporate the potential effects of fibrosis and inflammation, both of which are presumably present in <i>PKP2</i> arrhythmogenic cardiomyopathy patients undergoing gene therapy and could impact arrhythmogenesis.</p><p><strong>Conclusions: </strong>The extent of successful ventricular myocyte transduction anticipated to be achieved in <i>PKP2</i> adeno-associated viral gene therapy trials will likely not restore conduction velocity to levels sufficient to decrease the risk of reentrant arrhythmias. Transduction efficiency of 60% to 80% would be required to restore conduction velocity to 50% of normal.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013658"},"PeriodicalIF":9.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810621","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":"Unraveling the Rhythm: Sex-Based Molecular Signatures of Sinus Node Function and Arrhythmia Susceptibility.","authors":"Takashi Ikenouchi, Thassio Mesquita, Eugenio Cingolani","doi":"10.1161/CIRCEP.125.013981","DOIUrl":"10.1161/CIRCEP.125.013981","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013981"},"PeriodicalIF":9.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966989","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":"Different Incidence and Size of Silent Strokes After Pulsed Field Ablation With Circular Shaped Ablation Catheters.","authors":"Shinsuke Miyazaki, Iwanari Kawamura, Yoshihiro Iwasa, Miho Negishi, Ryo Tateishi, Masaki Honda, Kentaro Goto, Takuro Nishimura, Kazuya Yamao, Susumu Tao, Masateru Takigawa, Tetsuo Sasano","doi":"10.1161/CIRCEP.125.013719","DOIUrl":"10.1161/CIRCEP.125.013719","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013719"},"PeriodicalIF":9.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985587","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":"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":"10.1161/CIRCEP.124.013590","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013590"},"PeriodicalIF":9.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005860/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Protein-Based Biomarkers of Out-of-hospital Sudden Cardiac Death After Myocardial Infarction.","authors":"Maomao Zhang, Zhonghua Tong, Naixin Wang, Kaiyang Lin, Yafei Zhang, Dongni Wang, Xiaoqi Wang, Penghe Wang, Qiannan Yang, Yingjin Kong, Mengdi Wang, Jingxuan Cui, Zhuozhong Wang, Muhua Cao, Lulu Li, Ying Liu, Zhaoying Li, Shaohong Fang, Fan Zhang, Zhenwei Pan, Jinwei Tian, Bo Yu","doi":"10.1161/CIRCEP.124.013217","DOIUrl":"10.1161/CIRCEP.124.013217","url":null,"abstract":"<p><strong>Background: </strong>Early identification of out-of-hospital high-risk sudden cardiac death (SCD) after acute myocardial infarction is crucial for timely therapeutic interventions. However, left ventricular ejection fraction as a standalone clinical stratification tool has major limitations, necessitating improved risk stratification strategies.</p><p><strong>Methods: </strong>Mass spectrometry measured 6592 peptides and 522 proteins, from which targeted proteomics identified the optimal protein combination to assess out-of-hospital SCD risk. ELISA validated its predictive value by comparing it with a clinical stratification tool (left ventricular ejection fraction ≤35%) and 2 reported models (risk score and out-of-hospital cardiac arrest score) in 3 case-control cohorts nested within diverse contemporary postinfarction populations.</p><p><strong>Results: </strong>In the discovery cohort (105 SCD cases and 105 survivors), mass spectrometry discovered 44 differential proteins associated with SCD, unveiling early circulating features characterized by inflammatory response and complement activation in out-of-hospital SCD cases. Targeted proteomics identified the optimal SCD-warning 3-protein combination, including coronin-1A, haptoglobin, and CFD (complement factor D), to assess out-of-hospital SCD risk. An ELISA-based SCD-warning 3-protein combination model significantly outperformed left ventricular ejection fraction alone (C statistic: 0.752 versus 0.548; <i>P</i><0.001) and improved their performance (ΔC statistic, 0.281; categorical net reclassification improvement, 0.095; continuous net reclassification improvement, 0.952; integrated discrimination improvement, 0.291). Similar incremental discrimination metrics were observed in 2 reported stratification models (risk score and out-of-hospital cardiac arrest score), particularly within the left ventricular ejection fraction-preserved population. These findings were repeatably validated in 2 independent cohorts (n=234 and 48, respectively). CFD inhibition protection for mortality and pro-malignant arrhythmias in acute myocardial infarction mice supported the biological plausibility of the critical protein in SCD-warning 3-protein combination.</p><p><strong>Conclusions: </strong>In high-risk individuals for out-of-hospital SCD, the SCD-warning 3-protein combination may contribute to enhanced early identification for timely intensive management. These findings suggest pivotal proteins for improving understanding SCD pathophysiology.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013217"},"PeriodicalIF":9.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718101","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":"(Doubts on) The Mechanistic Role of Pulmonary Veins Reconnection in Paroxysmal and Persistent Atrial Fibrillation: A Meta-Analysis of Mandatory Remapping Studies.","authors":"Marco Bergonti, Tardu Özkartal, Maria Luce Caputo, Giulio Conte","doi":"10.1161/CIRCEP.124.013456","DOIUrl":"10.1161/CIRCEP.124.013456","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013456"},"PeriodicalIF":9.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669435","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":"10.1161/CIRCEP.124.013606","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013606"},"PeriodicalIF":9.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005861/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}