Circulation. Arrhythmia and electrophysiology最新文献

筛选
英文 中文
Enormous Burden of Atrial Fibrillation in Older Patients With Congenital Heart Disease: Do Only Age and Underlying Heart Defect Matter? 先天性心脏病老年患者心房颤动负担沉重:只有年龄和潜在的心脏缺陷才重要吗?
IF 9.1 1区 医学
Circulation. Arrhythmia and electrophysiology Pub Date : 2024-09-01 Epub Date: 2024-08-21 DOI: 10.1161/CIRCEP.123.012690
Anna Kwiatek-Wrzosek, Mirosław Kowalski, Elżbieta K Biernacka, Piotr Hoffman, Ewa Kowalik
{"title":"Enormous Burden of Atrial Fibrillation in Older Patients With Congenital Heart Disease: Do Only Age and Underlying Heart Defect Matter?","authors":"Anna Kwiatek-Wrzosek, Mirosław Kowalski, Elżbieta K Biernacka, Piotr Hoffman, Ewa Kowalik","doi":"10.1161/CIRCEP.123.012690","DOIUrl":"10.1161/CIRCEP.123.012690","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e012690"},"PeriodicalIF":9.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008385","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}
引用次数: 0
FABP4 Enhances Lipidic and Fibrotic Cardiac Structural and Ca2+ Dynamic Changes. FABP4 可增强脂质和纤维化心脏结构及 Ca2+ 动态变化
IF 9.1 1区 医学
Circulation. Arrhythmia and electrophysiology Pub Date : 2024-09-01 Epub Date: 2024-08-30 DOI: 10.1161/CIRCEP.123.012683
Marinela Couselo-Seijas, Xocas Vázquez-Abuín, María Gómez-Lázaro, Laetitia Pereira, Ana M Gómez, Ricardo Caballero, Eva Delpón, Susana Bravo, José Ramón González-Juanatey, Sonia Eiras
{"title":"FABP4 Enhances Lipidic and Fibrotic Cardiac Structural and Ca<sup>2+</sup> Dynamic Changes.","authors":"Marinela Couselo-Seijas, Xocas Vázquez-Abuín, María Gómez-Lázaro, Laetitia Pereira, Ana M Gómez, Ricardo Caballero, Eva Delpón, Susana Bravo, José Ramón González-Juanatey, Sonia Eiras","doi":"10.1161/CIRCEP.123.012683","DOIUrl":"10.1161/CIRCEP.123.012683","url":null,"abstract":"<p><strong>Background: </strong>Adipocyte FABP4 (fatty acid-binding protein 4) is augmented in the epicardial stroma of patients with long-standing persistent atrial fibrillation. Because this molecule is released mainly by adipocytes, our objective was to study its role in atrial cardiomyopathy, focusing our attention on fibrosis, metabolism, and electrophysiological changes. These results might clarify the role of adiposity as a mediator of atrial cardiomyopathy.</p><p><strong>Methods: </strong>We used several preclinical cellular models, epicardial and subcutaneous stroma primary cell cultures from patients undergoing open heart surgery, human atrial fibroblasts, atrial cardiomyocytes derived from human induced pluripotent stem cells and isolated from adult mice, and Nav1.5 transfected Chinese hamster ovary cells. Fibrosis, glucose, mitochondrial and adipogenesis activity, gene expression, and proteomics were determined by wound healing, enzymatic, colorimetric, fluorescence assays, real-time quantitative polymerase chain reaction, and TripleTOF proteomics. Molecular changes were analyzed by Raman confocal microspectroscopy, calcium dynamics by confocal microscopy, and ion currents by patch clamp. Epicardial, subcutaneous, and atrial fibroblasts and cardiomyocytes were incubated with FABP4 at 100 ng/mL.</p><p><strong>Results: </strong>Our results showed that FABP4 induced fibrosis, glucose metabolism, and lipid accumulation on epicardial and subcutaneous stroma cells and atrial fibroblasts. Besides, it modified lipid content and calcium dynamics in atrial cardiomyocytes without effects on I<sub>Na</sub>.</p><p><strong>Conclusions: </strong>FABP4 exerts fibrotic and metabolic changes on epicardial stroma and modifies lipid content and calcium dynamic on atrial cardiomyocytes. These results suggest its possible role as an atrial cardiomyopathy mediator.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e012683"},"PeriodicalIF":9.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104880","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}
引用次数: 0
Classification of Premature Ventricular Contractions in Athletes During Routine Preparticipation Exams. 在常规赛前检查中对运动员室性早搏进行分类。
IF 9.1 1区 医学
Circulation. Arrhythmia and electrophysiology Pub Date : 2024-09-01 Epub Date: 2024-08-28 DOI: 10.1161/CIRCEP.124.012835
Sofia E Gomez, Marco V Perez, Matthew T Wheeler, David Hadley, Calvin E Hwang, Andrea Kussman, Daniel S Kim, Victor Froelicher
{"title":"Classification of Premature Ventricular Contractions in Athletes During Routine Preparticipation Exams.","authors":"Sofia E Gomez, Marco V Perez, Matthew T Wheeler, David Hadley, Calvin E Hwang, Andrea Kussman, Daniel S Kim, Victor Froelicher","doi":"10.1161/CIRCEP.124.012835","DOIUrl":"10.1161/CIRCEP.124.012835","url":null,"abstract":"<p><strong>Background: </strong>Large-scale data on incidental premature ventricular contraction (PVC) prevalence and morphologies have been lacking, leaving many providers without guidance on further cardiac testing for patients with incidental PVCs on ECG. Athletes offer an intriguing cohort to understand the clinical significance, prevalence, and common morphologies of incidental PVCs because they often undergo ECG screening during preparticipation exams.</p><p><strong>Methods: </strong>Digital ECGs were obtained from 10 728 screened athletes aged 14 to 35 years during mass screenings in schools and professional sports teams between 2014 and 2021. A retrospective analysis of ECGs with PVCs was performed using the simultaneous display of frontal (limb) and horizontal (precordial) plane leads. PVCs were coded for morphology and categorized as benign or nonbenign using recommended criteria.</p><p><strong>Results: </strong>Twenty-six athletes (0.24%) were found to have at least 1 PVC. Among these, 50% were female, 65% were White, 8% were Asian, 4% were Hispanic, and 23% were Black. Nineteen of the 26 (73%) ECGs had PVCs with a left bundle branch block pattern compared with 7 (27%) with a right bundle branch block pattern. Twenty-four ECGs (96%) had PVCs with benign patterns, including 18 with right ventricular outflow tract, 5 with left anterior fascicle, and 2 with left posterior fascicle morphology.</p><p><strong>Conclusions: </strong>There is a low prevalence of PVCs on routine ECG screening of young athletes, and most PVCs are of benign morphology in this population. This study highlights the value of using digital ECG recorders with simultaneous lead display to guide decision-making about further cardiac testing and referrals in young athletes with PVCs. Using our results and review of the literature, we propose methods and algorithms of PVC evaluation on screening ECGs to help guide many providers with risk stratification and decision-making about further cardiac testing and electrophysiology referrals in young athletes with PVCs.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e012835"},"PeriodicalIF":9.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11452187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079416","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}
引用次数: 0
Focal Pulsed Field Ablation for Premature Ventricular Contractions: A Multicenter Experience. 局部脉冲场消融治疗室性早搏:多中心经验
IF 9.1 1区 医学
Circulation. Arrhythmia and electrophysiology Pub Date : 2024-09-01 Epub Date: 2024-09-05 DOI: 10.1161/CIRCEP.124.012826
Domenico Giovanni Della Rocca, María Cespón-Fernández, Ahmad Keelani, Santi Raffa, Luigi Pannone, Alexandre Almorad, Erwin Ströker, Georgi Borisov, Gezim Bala, Juan Sieira, Giampaolo Vetta, Obaida Alothman, Antonio Sorgente, Charles Audiat, Ingrid Overeinder, Markus Frommhold, Alvise Del Monte, Mark La Meir, Andrea Natale, Gian-Battista Chierchia, J Christoph Geller, Carlo de Asmundis, Andrea Sarkozy
{"title":"Focal Pulsed Field Ablation for Premature Ventricular Contractions: A Multicenter Experience.","authors":"Domenico Giovanni Della Rocca, María Cespón-Fernández, Ahmad Keelani, Santi Raffa, Luigi Pannone, Alexandre Almorad, Erwin Ströker, Georgi Borisov, Gezim Bala, Juan Sieira, Giampaolo Vetta, Obaida Alothman, Antonio Sorgente, Charles Audiat, Ingrid Overeinder, Markus Frommhold, Alvise Del Monte, Mark La Meir, Andrea Natale, Gian-Battista Chierchia, J Christoph Geller, Carlo de Asmundis, Andrea Sarkozy","doi":"10.1161/CIRCEP.124.012826","DOIUrl":"10.1161/CIRCEP.124.012826","url":null,"abstract":"<p><strong>Background: </strong>Pulsed field ablation (PFA) is a novel technology for catheter-based atrial arrhythmia treatment. Evidence of its application for ventricular arrhythmia ablation is still limited. In this study, we describe the feasibility and efficacy of focal PFA for premature ventricular contraction (PVC) ablation.</p><p><strong>Methods: </strong>A prospective cohort of 20 patients referred for PVC ablation at 2 centers was enrolled, regardless of the presence of structural heart disease, PVC morphology, or previous ablation attempts. All procedures were performed using the CENTAURI System in combination with contact force sensing catheters and 3-dimensional electroanatomical mapping systems. Energy output and the number of applications were left to the operator's discretion.</p><p><strong>Results: </strong>Eleven (55%) procedures were conducted under general anesthesia, 6 (30%) under deep sedation, and 3 (15%) under light sedation. Muscular contraction was observed in one case (5%). Median procedural and fluoroscopy times were 95.5 and 6.55 minutes, respectively. The median number of PFA applications was 8 with a median contact force of 10<i>g</i>. A statistically significant (76%) reduction was observed in mean peak-to-peak bipolar electrogram voltage before and after ablation (0.707 versus 0.098 mV; <i>P</i>=0.008). Ventricular irritative firing was observed in 11 (55%) patients after PFA. The median follow-up was 120 days. Acute procedural success was achieved in 17 of 20 (85% [95% CI, 0.70-1]) patients. Two of the patients with procedural failure had late success with >80% clinical PVC burden suppression during follow-up, and 2 of 17 patients with acute success had late PVC recurrence, which accounts for a total of 17 of 20 (85% [95% CI, 0.70-1]) patients with chronic success. Transient ST-segment depression occurred in 1 patient, and the right bundle branch block was induced in 2 others (permanently only in one case).</p><p><strong>Conclusions: </strong>PVC ablation using a focal PFA is feasible, effective, and safe, with promising acute and long-term results in several ventricular locations. Irritative firing is frequently observed. Coronary evaluation should be considered when targeting the outflow tract.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e012826"},"PeriodicalIF":9.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132029","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}
引用次数: 0
Outcomes of Atrial Fibrillation Ablation in Heart Failure Subtypes. 心房颤动消融术在心衰亚型中的疗效。
IF 9.1 1区 医学
Circulation. Arrhythmia and electrophysiology Pub Date : 2024-09-01 Epub Date: 2024-08-28 DOI: 10.1161/CIRCEP.124.012926
Arwa Younis, Chadi Tabaja, Pasquale Santangeli, Hiroshi Nakagawa, Joseph Sipko, Ruth Madden, Patricia Bouscher, Tyler Taigen, Koji Higuchi, Katsuhide Hayashi, Abdel Hadi El Hajjar, Fatimah Chamseddine, Thomas Callahan, David O Martin, Shady Nakhla, Mohamed Kanj, Jakub Sroubek, Justin Z Lee, Walid I Saliba, Oussama M Wazni, Ayman A Hussein
{"title":"Outcomes of Atrial Fibrillation Ablation in Heart Failure Subtypes.","authors":"Arwa Younis, Chadi Tabaja, Pasquale Santangeli, Hiroshi Nakagawa, Joseph Sipko, Ruth Madden, Patricia Bouscher, Tyler Taigen, Koji Higuchi, Katsuhide Hayashi, Abdel Hadi El Hajjar, Fatimah Chamseddine, Thomas Callahan, David O Martin, Shady Nakhla, Mohamed Kanj, Jakub Sroubek, Justin Z Lee, Walid I Saliba, Oussama M Wazni, Ayman A Hussein","doi":"10.1161/CIRCEP.124.012926","DOIUrl":"10.1161/CIRCEP.124.012926","url":null,"abstract":"<p><strong>Background: </strong>Catheter ablation (CA) improves clinical outcomes in patients with atrial fibrillation (AF) and heart failure (HF) with reduced ejection fraction (HFrEF). We aimed to evaluate the impact of CA on clinical and quality-of-life outcomes across HF subtypes.</p><p><strong>Methods: </strong>All patients undergoing AF ablation at a tertiary center were enrolled in a prospective registry and included in this study (2013-2021). The primary end point was AF recurrence. Secondary end points included AF-related hospitalizations and quality-of-life outcomes. Patients were categorized according to their HF status: no HF, HFrEF, HF with mildly reduced ejection fraction (HFmrEF), and HF with preserved ejection fraction (HFpEF).</p><p><strong>Results: </strong>A total of 7020 patients were included (80% no HF, 8% HFrEF, 7% HFmrEF, and 5% HFpEF). Over 3 years, the cumulative incidence of AF recurrence after ablation was as follows: HFpEF (53%), HFmrEF (41%), HFrEF (41%), and no HF (34%); <i>P</i><0.01. Multivariable Cox analyses confirmed these findings using no HF group as reference (HFpEF: hazard ratio, 1.47 [95% CI, 1.21-1.78]; HFmrEF: hazard ratio, 1.23 [95% CI, 1.04-1.45]; and HFrEF: hazard ratio, 1.17 [95% CI, 1.01-1.37]; <i>P</i><0.05 for all). In all groups, CA resulted in a significant reduction of AF-related hospitalization (mean rate per 1 patient-years [before and after CA]; HFpEF [1.8 versus 0.3], HFmrEF [1.1 versus 0.2], HFrEF [1.1 versus 0.2], and no HF [1 versus 0.1]; <i>P</i><0.01 for each comparison) and significant improvement in quality of life as measured by both the AF symptom severity score and the AF burden score (<i>P</i><0.01 for the comparison between baseline and follow-up for each score when tested separately).</p><p><strong>Conclusions: </strong>AF recurrence rates after CA were higher in patients with HF compared with those without HF, with patients with HFpEF being at the highest risk of recurrence. Nonetheless, CA was associated with a significant reduction in AF symptoms, AF-related hospitalization, and HF symptoms in most patients irrespective of HF subtypes.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e012926"},"PeriodicalIF":9.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079420","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}
引用次数: 0
Whole-Heart Histological and Electroanatomic Assessment of Postinfarction Cardiac Magnetic Resonance Imaging Scar and Conducting Channels. 对梗死后心脏磁共振成像疤痕和传导通道的全心组织学和电解剖学评估
IF 9.1 1区 医学
Circulation. Arrhythmia and electrophysiology Pub Date : 2024-09-01 Epub Date: 2024-08-28 DOI: 10.1161/CIRCEP.124.012922
Kasun De Silva, Timothy Campbell, Richard G Bennett, Robert D Anderson, Chris Davey, Alexandra K O'Donohue, Aaron Schindeler, Samual Turnbull, Dinesh Selvakumar, Ashwin Bhaskaran, Yasuhito Kotake, Chi-Jen Hsu, James J H Chong, Eddy Kizana, Saurabh Kumar
{"title":"Whole-Heart Histological and Electroanatomic Assessment of Postinfarction Cardiac Magnetic Resonance Imaging Scar and Conducting Channels.","authors":"Kasun De Silva, Timothy Campbell, Richard G Bennett, Robert D Anderson, Chris Davey, Alexandra K O'Donohue, Aaron Schindeler, Samual Turnbull, Dinesh Selvakumar, Ashwin Bhaskaran, Yasuhito Kotake, Chi-Jen Hsu, James J H Chong, Eddy Kizana, Saurabh Kumar","doi":"10.1161/CIRCEP.124.012922","DOIUrl":"10.1161/CIRCEP.124.012922","url":null,"abstract":"<p><strong>Background: </strong>Cardiac magnetic resonance imaging (CMR)-defined ventricular scar and anatomic conduction channels (CMR-CCs) offer promise in delineating ventricular tachycardia substrate. No studies have validated channels with coregistered histology, nor have they ascertained the histological characteristics of deceleration zones (DZs) within these channels. We aimed to validate CMR scar and CMR-CCs with whole-heart histology and electroanatomic mapping in a postinfarction model.</p><p><strong>Methods: </strong>Five sheep underwent anteroseptal infarction. CMR (116±20 days post infarct) was postprocessed using ADAS-3D, varying pixel intensity thresholds (5545, 6040, 6535, and 7030). DZs were identified by electroanatomic mapping (129±12 days post infarct). Explanted hearts were sectioned and stained with Picrosirius red, and whole-heart histopathologic shells were generated. Scar topography as well as percentage fibrosis, adiposity, and remaining viable myocardium within 3 mm histological biopsies and within CMR-CCs were determined.</p><p><strong>Results: </strong>Using the standard 6040 thresholding, CMR had 83.8% accuracy for identifying histological scar in the endocardium (κ, 0.666) and 61.4% in the epicardium (κ, 0.276). Thirty-seven CMR-CCs were identified by varying thresholding; 23 (62%) were unique. DZs colocalized to 19 of 23 (83%) CMR-CCs. Twenty (87%) CMR-CCs were histologically confirmed. Within-channel histological fibrosis did not differ by the presence of DZs (<i>P</i>=0.242). Within-channel histological adiposity was significantly higher at sites with versus without DZs (24.1% versus 8.3%; <i>P</i><0.001).</p><p><strong>Conclusions: </strong>Postprocessed CMR-derived scars and channels were validated by histology and electroanatomic mapping. Regions of CMR-CCs at sites of DZs had higher adiposity but similar fibrosis than regions without DZs, suggesting that lipomatous metaplasia may contribute to arrhythmogenicity of postinfarction scar.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e012922"},"PeriodicalIF":9.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079421","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}
引用次数: 0
Substrate Characterization and Outcomes of Ventricular Tachycardia Ablation in Amyloid Cardiomyopathy: A Multicenter Study. 淀粉样心肌病室性心动过速消融的基质特征和疗效:一项多中心研究
IF 9.1 1区 医学
Circulation. Arrhythmia and electrophysiology Pub Date : 2024-09-01 Epub Date: 2024-08-22 DOI: 10.1161/CIRCEP.124.012788
Paolo Compagnucci, Antonio Dello Russo, Alessio Gasperetti, Marco Schiavone, Ojasav Sehrawat, Kanae Hasegawa, Sanghamitra Mohanty, Jackson J Liang, Suraj Kapa, Vincenzo Mirco La Fazia, Frank Bogun, William G Stevenson, Claudio Tondo, Konstantinos C Siontis, Harikrishna Tandri, Pasquale Santangeli, Andrea Natale, Michela Casella
{"title":"Substrate Characterization and Outcomes of Ventricular Tachycardia Ablation in Amyloid Cardiomyopathy: A Multicenter Study.","authors":"Paolo Compagnucci, Antonio Dello Russo, Alessio Gasperetti, Marco Schiavone, Ojasav Sehrawat, Kanae Hasegawa, Sanghamitra Mohanty, Jackson J Liang, Suraj Kapa, Vincenzo Mirco La Fazia, Frank Bogun, William G Stevenson, Claudio Tondo, Konstantinos C Siontis, Harikrishna Tandri, Pasquale Santangeli, Andrea Natale, Michela Casella","doi":"10.1161/CIRCEP.124.012788","DOIUrl":"10.1161/CIRCEP.124.012788","url":null,"abstract":"<p><strong>Background: </strong>Sustained ventricular tachycardia (VT) in cardiac amyloidosis is uncommon, and the substrate and outcomes of catheter ablation are not defined.</p><p><strong>Methods: </strong>We included 22 consecutive patients (mean age, 68±10 years; male sex, 91%) with cardiac amyloidosis (ATTR [transthyretin], n=16; light chain, n=6) undergoing catheter ablation for VT/ventricular fibrillation (VF) between 2013 and 2023 in a retrospective, observational, international study. The primary efficacy outcome was recurrent VT/VF during follow-up, while the primary safety end point included major procedure-related adverse events.</p><p><strong>Results: </strong>The indication for ablation was drug-refractory VT in 17 patients (77%), and premature ventricular complex-initiated polymorphic VT/VF in 5 patients (23%). Catheter ablation was performed using endocardial (n=17.77%) or endo-epicardial approaches (n=5.23%). Complete endocardial electroanatomical voltage maps of the left and right ventricles were obtained in 17 (77%) and 10 (45%) patients, respectively. Each patient had evidence of low-voltage areas, most commonly involving the interventricular septum (n=16); late potentials were recorded in 16 patients (73%). A median of 1 (1-2) VT was inducible per patient; 12 of the 26 mappable VTs (46%) originated from the interventricular septum. Complete procedural success was achieved in 16 patients (73%), with 4 (18%) major procedure-related adverse events. After a median follow-up of 32 (14-42) months, sustained VT/VF recurrence was observed in 9 patients (41%); survival free from VT/VF recurrence was 56% (95% CI, 36%-86%) at 36-month follow-up, and most patients remained on antiarrhythmic drugs. A significant reduction in per patient implantable cardioverter defibrillator therapies was noted in the 6-month period after ablation (before: 6 [4-9] versus after: 0 [0-0]; <i>P</i><0.001). In multivariable analysis, complete procedural success was associated with reduced risk of recurrent VT/VF (hazard ratio, 0.002; <i>P</i>=0.034).</p><p><strong>Conclusions: </strong>Catheter ablation can achieve control of recurrent VT/VF in more than half of patients with cardiac amyloidosis, and the reduction in VT/VF burden post-ablation may be relevant for quality of life. Septal substrate and risk of procedure-related complications challenge successful management of patients with cardiac amyloidosis and VT/VF.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e012788"},"PeriodicalIF":9.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016567","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}
引用次数: 0
Ethics of Wearable-Based Out-of-Hospital Cardiac Arrest Detection. 基于可穿戴设备的院外心脏骤停检测伦理。
IF 9.1 1区 医学
Circulation. Arrhythmia and electrophysiology Pub Date : 2024-09-01 Epub Date: 2024-08-22 DOI: 10.1161/CIRCEP.124.012913
Marijn Eversdijk, Mirela Habibović, Dick L Willems, Willem J Kop, M Corrette Ploem, Lukas R C Dekker, Hanno L Tan, Rik Vullings, Marieke A R Bak
{"title":"Ethics of Wearable-Based Out-of-Hospital Cardiac Arrest Detection.","authors":"Marijn Eversdijk, Mirela Habibović, Dick L Willems, Willem J Kop, M Corrette Ploem, Lukas R C Dekker, Hanno L Tan, Rik Vullings, Marieke A R Bak","doi":"10.1161/CIRCEP.124.012913","DOIUrl":"10.1161/CIRCEP.124.012913","url":null,"abstract":"<p><p>Out-of-hospital cardiac arrest is a major health problem, and immediate treatment is essential for improving the chances of survival. The development of technological solutions to detect out-of-hospital cardiac arrest and alert emergency responders is gaining momentum; multiple research consortia are currently developing wearable technology for this purpose. For the responsible design and implementation of this technology, it is necessary to attend to the ethical implications. This review identifies relevant ethical aspects of wearable-based out-of-hospital cardiac arrest detection according to four key principles of medical ethics. First, aspects related to beneficence concern the effectiveness of the technology. Second, nonmaleficence requires preventing psychological distress associated with wearing the device and raises questions about the desirability of screening. Third, grounded in autonomy are empowerment, the potential reidentification from continuously collected data, issues of data access, bystander privacy, and informed consent. Finally, justice concerns include the risks of algorithmic bias and unequal technology access. Based on this overview and relevant legislation, we formulate design recommendations. We suggest that key elements are device accuracy and reliability, dynamic consent, purpose limitation, and personalization. Further empirical research is needed into the perspectives of stakeholders, including people at risk of out-of-hospital cardiac arrest and their next-of-kin, to achieve a successful and ethically balanced integration of this technology in society.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e012913"},"PeriodicalIF":9.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11410148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016566","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}
引用次数: 0
Clinical Implications of Atrial Fibrillation Provoked by Acetylcholine. 乙酰胆碱诱发心房颤动的临床意义
IF 9.1 1区 医学
Circulation. Arrhythmia and electrophysiology Pub Date : 2024-09-01 Epub Date: 2024-08-21 DOI: 10.1161/CIRCEP.124.013015
Keita Shibata, Kohei Wakabayashi, Naoko Ikeda, Tomoyuki Ishinaga, Yuta Kusakabe, Asakawa Masaki, Naoki Aizawa, Suguru Shimazu, Takahiro Furuya, Yuya Nakamura, Chisato Sato, Tenjin Nishikura, Masaru Shiigai, Mitsunori Mutou, Junko Honye, Kaoru Tanno
{"title":"Clinical Implications of Atrial Fibrillation Provoked by Acetylcholine.","authors":"Keita Shibata, Kohei Wakabayashi, Naoko Ikeda, Tomoyuki Ishinaga, Yuta Kusakabe, Asakawa Masaki, Naoki Aizawa, Suguru Shimazu, Takahiro Furuya, Yuya Nakamura, Chisato Sato, Tenjin Nishikura, Masaru Shiigai, Mitsunori Mutou, Junko Honye, Kaoru Tanno","doi":"10.1161/CIRCEP.124.013015","DOIUrl":"10.1161/CIRCEP.124.013015","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e013015"},"PeriodicalIF":9.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008384","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}
引用次数: 0
Accuracy and Evolution of Large Language Models in Atrial Fibrillation-Related Queries: A Patient- and Provider-Centered Approach. 心房颤动相关查询中大型语言模型的准确性和演变:以患者和提供者为中心的方法。
IF 9.1 1区 医学
Circulation. Arrhythmia and electrophysiology Pub Date : 2024-09-01 Epub Date: 2024-08-21 DOI: 10.1161/CIRCEP.124.012919
Abdel Hadi El Hajjar, Joseph Kassab, Carl Ammoury, Shady Nakhla, Mohamed Kanj, Samir R Kapadia, Serge C Harb
{"title":"Accuracy and Evolution of Large Language Models in Atrial Fibrillation-Related Queries: A Patient- and Provider-Centered Approach.","authors":"Abdel Hadi El Hajjar, Joseph Kassab, Carl Ammoury, Shady Nakhla, Mohamed Kanj, Samir R Kapadia, Serge C Harb","doi":"10.1161/CIRCEP.124.012919","DOIUrl":"10.1161/CIRCEP.124.012919","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e012919"},"PeriodicalIF":9.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008383","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}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信