Circulation. Arrhythmia and electrophysiology最新文献

{"title":"Evaluating the Safety Profile and Learning Curve With a Pulsed Field Ablation Variable Loop Circular Catheter in Procedures for AF: Observations From the VARIPURE Prospective, Multicenter, Postmarket Study.","authors":"Francis Bessière, Mads Brix Kronborg, Philipp Sommer, Alexandre Almorad, Gustavo Rodrigues, Daniel Scherr, Frederic A Sebag, Tom De Potter, Massimo Grimaldi, Tobias Reichlin, Sebastien Knecht, Christian Sohns, Gian Battista Chierchia, Kévin Gardey, Sabine Ernst","doi":"10.1161/CIRCEP.125.014294","DOIUrl":"10.1161/CIRCEP.125.014294","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e014294"},"PeriodicalIF":9.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970936","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":"One-Year Outcomes of the First 1000 Patients Implanted With the Medtronic Micra AV Leadless Pacing System in France: The AV-CESAR Cohort Study.","authors":"Fawzi Kerkouri, Nicolas Clementy, Pascal Defaye, Mina Ait Said, Antoine Andorin, Frédéric Anselme, Warda Aoudjeghout, Marc Badoz, Nathalie Behar, Nazih Benhenda, Mouna Ben Kilani, Alexandre Bodin, Pierre Bordachar, Abdeslam Bouzeman, Olivier Citerne, Jean-Claude Deharo, Carine Dommerc, Mathieu Echivard, Fabrice Extramiana, Laurent Fauchier, Rodrigue Garcia, Edouard Gitenay, Charles Guenancia, Benoît Guy-Moyat, Peggy Jacon, Laurence Jesel, Christophe Juin, Ziad Khoueiry, Maciej Kubala, Christophe Leclercq, Vincent Mansourati, Christelle Marquié, Alexis Mechulan, Pierre Mondoly, Kumar Narayanan, Pierre Ollitrault, Jean-Luc Pasquié, Angelique Peret, Hervé Poty, Frederic Sebag, Olivier Villejoubert, Xavier Waintraub, Victor Waldmann, Serge Boveda, Jacques Mansourati, Eloi Marijon","doi":"10.1161/CIRCEP.126.014850","DOIUrl":"10.1161/CIRCEP.126.014850","url":null,"abstract":"<p><strong>Background: </strong>Evidence supporting the Micra AV leadless pacing system has largely derived from highly experienced centers, potentially limiting generalizability to routine clinical practice.</p><p><strong>Methods: </strong>The AV-CESAR study (French Cohort Evaluating the Effectiveness of Atrioventricular Synchrony by the micRa AV) is a nationwide retrospective cohort, including the first 1000 patients implanted with a Medtronic Micra AV leadless pacemaker in France (2020-2024). Mean follow-up was 13.4±10.6 months. Primary end points were early (in-hospital) and late (postdischarge) device-related major complications; pacemaker syndrome and need for implantation of a new pacing system were centrally adjudicated.</p><p><strong>Results: </strong>Among 1003 patients, device implantation was successful in 1000 (99.7%). Mean age was 72.0±15 years; 62.8% were men, 44.0% had ≥2 comorbidities, and 62.4% were unsuitable for transvenous pacemakers. The primary indication was permanent complete atrioventricular block with preserved sinus rhythm (78.0%). Early major complications occurred in 2.4%, including pericardial effusion (0.8%; 3 requiring surgery), access-site complications (0.8%), and thromboembolism (0.3%). Late major complications included pacemaker syndrome (2.5%), pacing-induced cardiomyopathy (1.2%), high thresholds (>4 V/0.24ms, 0.3%), and premature battery depletion (0.2%). No device infections or dislodgements were observed. Overall, 2.5% of patients required implantation of a new pacing system (pacing-induced cardiomyopathy n=11; pacemaker syndrome n=7; high threshold n=3; battery/software failure n=3; tricuspid regurgitation n=1) and 12.7% were permanently reprogrammed to ventricular paced/sensed, inhibited (VVI) mode. In pacing-dependent patients with ambulatory Holter monitoring (>3.4 million paced cycles), mean atrioventricular synchrony was 67.6±17.3% and correlated with device-reported AM-VP (74.8±17.1%; <i>R</i>²=0.92; <i>P</i><0.001). Atrioventricular synchrony declined at heart rates >90 beats per minute (5.6% of monitored time). All-cause mortality was 13.8%, with 0.2% directly device-related; 41.7% of deaths were cardiovascular.</p><p><strong>Conclusions: </strong>The Micra AV system is primarily used as an alternative when dual-chamber conventional pacemakers are not feasible. It demonstrated acceptable safety and clinical performance in a high-risk population. The marked reduction in atrioventricular synchrony at higher heart rates may suggest limited clinical benefit in patients with higher exertional heart rates.</p><p><strong>Registration: </strong>URL: https://clinicaltrials.gov/study/NCT05953558; Unique identifier: NCT05953558.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e014850"},"PeriodicalIF":9.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970900","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":"Influence of Cooling Agents on the Arrhythmogenic and Autonomic Effects of Electronic Cigarettes in an in vivo Model.","authors":"Cory Kucera, Anand R Ramalingam, Sean M Raph, Romith Paily, Shweta Srivastava, Pawel K Lorkiewicz, Aruni Bhatnagar, Matthew A Nystoriak, Alex P Carll","doi":"10.1161/CIRCEP.125.014253","DOIUrl":"10.1161/CIRCEP.125.014253","url":null,"abstract":"<p><strong>Background: </strong>Despite the growing popularity of electronic cigarettes, evidence is mounting that vaping induces autonomic nervous system imbalance, cardiac arrhythmia, and potentially even cardiac arrest. The ingredients menthol, WS-3, and WS-23 are cooling agents that enhance the appeal of electronic cigarettes (e-cigs) but bear unknown risks when inhaled.</p><p><strong>Methods: </strong>We systematically evaluated how these coolants influence the impacts of e-cigs on cardiac and cellular electrophysiology in mice and human induced pluripotent stem cell-derived cardiomyocytes, respectively. Mice were exposed by inhalation to e-cig aerosols generated from standard e-liquid solvents and 2.5% nicotine benzoate (vehicle), or from vehicle plus menthol, WS-3, or WS-23, at increasing concentrations throughout exposure. Telemetry-derived electrocardiograms were analyzed for changes in heart rate, heart rate variability, morphology, and ventricular premature beat arrhythmias. Human induced pluripotent stem cell-derived cardiomyocytes were evaluated for the effects of serially increasing coolant concentrations on beat rate, electric field potential duration, and rate-corrected field potential duration from a newly validated formula, in the absence and presence of norepinephrine to simulate basal physiology and nicotine-evoked sympathoexcitation.</p><p><strong>Results: </strong>Upon e-cig aerosol inhalation, all coolants acutely enhanced vehicle-induced autonomic imbalance, but only the synthetic coolants, WS-3 and WS-23, potentiated ventricular arrhythmogenesis. Ventricular premature beats during e-cig exposures correlated with sympathetic dominance and transient delays in ventricular repolarization measured by heart rate variability and rate-corrected QT interval, respectively; however, correlations were strongest for WS-23 despite no significant impact of coolants on nicotine intake. Conversely, in human induced pluripotent stem cell-derived cardiomyocytes, coolants did not affect basal physiology but slowed beat rate and shortened rate-corrected field potential duration during norepinephrine stimulation.</p><p><strong>Conclusions: </strong>Together, these data indicate that coolants dose-dependently enhance the arrhythmogenicity of e-cigs, likely through acute alterations in autonomic modulation and repolarization. Pending confirmation by human studies, these common non-nicotine additives may exacerbate e-cig cardiotoxicity and pose unique cardiovascular risks, particularly in those with arrhythmogenic susceptibility to sympathetic stimulation or slowed ventricular repolarization.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e014253"},"PeriodicalIF":9.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13271165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249246","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":"Leadless Pacemakers in the Setting of Surgical and Transcatheter Tricuspid Valve Procedures.","authors":"George Abou Deb, Fadi Abou Deb, Nikola Kozhuharov, Khaled Albouaini","doi":"10.1161/CIRCEP.126.015000","DOIUrl":"10.1161/CIRCEP.126.015000","url":null,"abstract":"<p><p>Transvenous pacing is increasingly recognized as problematic in patients with prior or concomitant tricuspid valve intervention, owing to risks of leaflet interference, prosthetic dysfunction, and progression of tricuspid regurgitation. Leadless pacemakers offer a valve-sparing alternative; however, their safety and performance in structurally altered right heart anatomy remain incompletely defined. We conducted a systematic review to evaluate procedural feasibility, electrical performance, device-valve interaction, and clinical outcomes of leadless pacemaker implantation in patients undergoing surgical or transcatheter tricuspid valve interventions. Thirty-four studies comprising 272 patients were included, encompassing surgical repair, bioprosthetic replacement, valve-in-valve procedures, transcatheter edge-to-edge repair, and transcatheter tricuspid valve replacement. Leadless pacemakers were implanted via transfemoral, transjugular, or direct surgical approaches, achieving a procedural success rate of 99.3%. Electrical performance was consistently favorable, with stable capture thresholds, sensing amplitudes, and impedance during follow-up. Device-valve interaction was infrequent and generally manageable. Leadless pacemaker-related complications were rare (1.1%), with no device-related mortality. Within the included studies of patients undergoing surgical or transcatheter tricuspid valve interventions, no study demonstrated worsening tricuspid regurgitation attributable to the leadless pacemaker or its delivery system. Across a broad spectrum of complex tricuspid anatomies, leadless pacemakers demonstrated excellent feasibility, durable electrical performance, and a low complication profile, supporting their role as a valve-sparing pacing strategy in this population. These findings support leadless pacing in patients with prior tricuspid intervention, although prospective comparative data are required to define its role relative to alternative pacing modalities.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e015000"},"PeriodicalIF":9.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970947","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":"Maximizing Lesion Depth With the Lattice-Tip Catheter: A Preclinical Comparison of Single, Double, and Mixed Pulsed-Field and Radiofrequency Applications.","authors":"Keita Watanabe, Masaya Shinohara, Fengyuan Yu, Vivek Y Reddy, Jacob S Koruth","doi":"10.1161/CIRCEP.125.014799","DOIUrl":"10.1161/CIRCEP.125.014799","url":null,"abstract":"<p><strong>Background: </strong>Combining radiofrequency (RF) and pulsed-field (PF) applications in various combinations, or repeating PF applications, has been reported to augment lesion size and depth. We compared lesion dimensions using single, double, and combined applications of PF and RF for the large-footprint lattice-tip catheter.</p><p><strong>Methods: </strong>Sixteen swine underwent endocardial ablation using the lattice-tip catheter. Four-second PF and 5-second, saline-irrigated, temperature-controlled RF energy were delivered in the ventricles using 1 of 5 different settings: single applications of PF (PF¹-only), single RF (RF¹-only), and 3 sequential settings: PF¹-PF² (2 consecutive PF applications at the same location), PF¹-RF¹ (PF followed by RF), and RF¹-PF¹ (RF followed by PF).</p><p><strong>Results: </strong>A total of 102 lesions (69 left and 33 right ventricles) were analyzed. Mean lesion depths were 6.8±0.3 mm (PF¹-PF²), 6.6±0.3 mm (RF¹-PF¹), 5.7±0.2 mm (PF¹-only), 5.0±0.3 mm (PF¹-RF¹), and 5.1±0.2 mm (RF¹-only). Mean lesion depths did not differ significantly between PF¹-PF² and either PF¹-only or RF¹-PF¹ (<i>P</i>=0.114 and <i>P</i>=0.986, respectively). However, the variability in depth was significantly smaller in the PF¹-PF² group compared with both PF¹-only and RF¹-PF¹ (<i>P</i>=0.017 and <i>P</i>=0.013, respectively). Only the PF¹-PF² setting produced significantly deeper lesions compared with the RF¹-only and PF¹-RF¹ settings (<i>P</i>=0.015 and <i>P</i>=0.012, respectively). RF lesions exhibited a prominent dark hemorrhagic core and a thin pale rim; PF lesions appeared uniformly pale; and combination lesions demonstrated a central dark zone surrounded by a pale rim of variable thickness.</p><p><strong>Conclusions: </strong>Repeating PF twice created the optimal combination of greatest depth and least variation compared with all other strategies. RF¹-PF¹ resulted in similar depth, but required toggling between settings and risked thermal adverse events.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e014799"},"PeriodicalIF":9.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764241","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":"Automated Cardiac Arrest Detection Using Wrist-Worn Photoplethysmography: External Validation in Patients With Induced Shockable Cardiac Arrest (DETECT-1b).","authors":"Roos Edgar, Niels T B Scholte, Kambiz Ebrahimkheil, Catharina E Jansen, Rypko J Beukema, Marc A Brouwer, Sing-Chien Yap, Masih Mafi-Rad, Reinoud E Knops, Eelko Ronner, Aysun Cetinyurek-Yavuz, Kevin Vernooy, Eric Boersma, Peter C Stas, Niels van Royen, Judith L Bonnes","doi":"10.1161/CIRCEP.125.014708","DOIUrl":"10.1161/CIRCEP.125.014708","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e014708"},"PeriodicalIF":9.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671038","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":"Initial Experience Using a Variable Loop Circular Pulsed Field Ablation Catheter to Treat Atrial Arrhythmias in Complex Congenital Heart Disease Patients.","authors":"Pierre-Olivier Veillette, Zachariah Hale, Elizabeth DeWitt, Douglas Mah, Thomas Tadros, Edward O'Leary","doi":"10.1161/CIRCEP.125.014619","DOIUrl":"10.1161/CIRCEP.125.014619","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e014619"},"PeriodicalIF":9.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764176","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":"Pace and Ablate or Pace Then Ablate: Defining the Risk of Concomitant AV Node Ablation and Pacemaker Implantation Using a Probability Based Approach.","authors":"Anthony J Preston, Justin Blackman, Andrew D Krahn, Darrel P Francis, Matthew T Bennett, James P Howard, Lyndon J Rebello, Martin van Zyl, Michael J Thibert, Laura Arbour, Markus B Sikkel","doi":"10.1161/CIRCEP.125.014790","DOIUrl":"10.1161/CIRCEP.125.014790","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e014790"},"PeriodicalIF":9.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811915","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":"Variability in Tissue Interface Temperature During Pulse Field Atrial Ablation: Implications for Real-Time Contact Assessment.","authors":"John R Power, Keita Watanabe, Masaya Shinohara, Fengyuan Yu, Srinivas Dukkipati, Daniel R Musikantow, William Whang, Joshua Lampert, Abhishek Maan, Maryam Saleem, Ariel Banai, Connor P Oates, Sai Krishna Reddy Seemala, Vivek Y Reddy, Jacob S Koruth","doi":"10.1161/CIRCEP.125.014310","DOIUrl":"10.1161/CIRCEP.125.014310","url":null,"abstract":"<p><strong>Background: </strong>Pulsed field ablation (PFA) can generate low-intensity catheter-tissue interface heating. Recently, a large-focal PFA catheter able to measure the tip-tissue interface temperature has become available. Accordingly, we aimed to characterize the electrode tip-tissue interface temperature dynamics during PFA.</p><p><strong>Methods: </strong>A retrospective single-center study evaluated PFA lesions in 41 consecutive patients undergoing atrial fibrillation ablation using the lattice-tip catheter. Lesions were grouped by anatomic location with interface temperatures measured via catheter tip thermocouples. The association of predictors with lesion temperatures was evaluated with a mixed-effects model. An analysis of lesion dimensions and interface temperatures was also performed in swine.</p><p><strong>Results: </strong>Among 41 patients, 2779 pulse field lesions were analyzed. Mean peak temperature was 41.7±2.2 °C (range, 37.2 °C-52.8 °C) and average temperature was 39.5±1.4 °C (range, 36.4 °C-46.9 °C). Temperatures exceeded 50 °C in 10 of 2779 (0.4%) lesions, most often in the anterosuperior left superior pulmonary vein (5/10). Univariate analysis showed peak temperature was positively associated with previous lesion temperature (<i>r</i>=0.65 [95% CI, 0.63-0.67]; <i>P</i><0.001) and had weak associations with time between lesions (<i>r</i>=-0.15 [-0.19 to -0.11]; <i>P</i><0.001) and percentage impedance drop (<i>r</i>=0.20 [95% CI, 0.16-0.23]; <i>P</i><0.001). Even after multivariable analysis, the peak temperature remained significantly lowest at the right carina (39.7 °C), anterosuperior right superior pulmonary vein (40.9 °C), and right superior pulmonary vein roof (40.5 °C) locations. Swine demonstrated a moderately strong association between lesion depth with peak temperature (<i>R</i>=0.53 [95% CI, 0.20-0.75]; <i>P</i>=0.003) and average temperature (<i>R</i>=0.49 [95% CI, 0.16-0.73]; <i>P</i>=0.007).</p><p><strong>Conclusions: </strong>Lattice-tip temperatures during PFA vary substantially, with right superior pulmonary vein sites often demonstrating a blunted temperature response compared with other sites. Peak and average temperatures correlated with lesion depth.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e014310"},"PeriodicalIF":9.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722017","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":"2026 ACC/AHA/HRS Advanced Training Statement on Clinical Cardiac Electrophysiology (Revision of the 2015 ACC/AHA/HRS Advanced Training Statement on Clinical Cardiac Electrophysiology): A Report of the ACC Competency Management Committee.","authors":"José A Joglar, Julia H Indik, Nadeen N Faza, Sana M Al-Khatib, Sumeet S Chugh, Edmond Cronin, James P Daubert, Jasneet Devgun, Mehak Dhande, David S Frankel, Zachary D Goldberger, Jodie L Hurwitz, Fred M Kusumoto, Dhanunjaya R Lakkireddy, Amgad N Makaryus, Joseph E Marine, Jeremy P Moore, Kristen K Patton, Dawn R Phoubandith, Andrea M Russo, Rachel Schreier, Stacy Westerman","doi":"10.1161/HAE.0000000000000094","DOIUrl":"10.1161/HAE.0000000000000094","url":null,"abstract":"","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":" ","pages":"e000094"},"PeriodicalIF":9.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764246","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}