Europace最新文献

{"title":"Late Arrhythmic Burden in Patients With Left Bundle Branch Block After TAVR With the Evolut Valve.","authors":"Silvia Mas-Peiro, Thibault Lhermusier, Marina Urena, Luis Nombela-Franco, Victoria Vilalta, Antonio Munoz-Garcia, Ignacio Amat-Santos, Felipe Atienza, Neal Kleiman, Chekrallah Chamandi, Vicenç Serra, Mark Deyell, Francisco Campelo-Parada, Pierre Mondoly, Gaspard Suc, Victoria Canadas-Godoy, Eduard Fernandez-Nofrerias, Javier Castrodeza, Jaime Elizaga, Pierre Baudinaud, Jaume Francisco Pascual, John G Webb, Emilie Pelletier-Beaumont, François Philippon, Josep Rodés-Cabau","doi":"10.1093/europace/euaf057","DOIUrl":"https://doi.org/10.1093/europace/euaf057","url":null,"abstract":"<p><strong>Background: </strong>Arrhythmic burden after discharge in patients with new-onset persistent left bundle branch block (NOP-LBBB) following transcatheter aortic valve replacement (TAVR) with Evolut devices remains largely unknown.</p><p><strong>Objectives: </strong>Assessing incidence and type of arrhythmias at 2-year follow-up in patients with NOP-LBBB post-TAVR.</p><p><strong>Methods: </strong>Prospective multicentre study including 88 patients with LBBB persisting for ≥3 days post-implantation. Before discharge, an implantable loop recorder (REVEAL XT/LINQ) was implanted; patients had continuous monitoring for 2 years. Arrhythmic events were adjudicated in a central core lab.</p><p><strong>Results: </strong>411 arrhythmic events were detected in 58 patients (65.9%; 2 [1-4] events per patient). Symptoms were reported in 12/58 (20.7%), and therapy was changed in 25/58 (43.1%). There were 101 bradyarrhythmic events in 33 patients (35 high grade atrioventricular block [HAVB], 66 severe bradycardia). HAVB incidence was higher in the early (4-week) phase and remained stable over time, whereas severe bradycardia increased after one year. Permanent pacemaker was required in 11 (12.5%) patients (6.8% and 5.7% in the first and second year, respectively). There were 310 tachyarrythmic events in 29 patients (120 AF/AFL, 111 AT, 72 SVT, 6 NSVT, 1 VT); its incidence decreased throughout the 2 years. New AF/AFL episodes occurred in 20/69 patients (29%; symptomatic in 2/20 [10%]).</p><p><strong>Conclusion: </strong>Patients with NOP-LBBB post-TAVR with Evolut devices exhibited a high burden of late arrhythmias, with events occurring in two thirds of patients, and leading to treatment changes in about half of them. These data should inform future studies on cardiac monitoring devices for follow-up and treatment optimization in this challenging population.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656574","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":"Pathophysiological aspects of carotid sinus massage Cardioinhibition and vasodepression occur independent, respond differently to massage duration and evoke corrective BP responses.","authors":"J Gert van Dijk, Boriana S Gagaouzova, Jelle S Y de Jong, Ineke A van Rossum, Marc J van Houwelingen, Fabian I Kerkhof, Robert H Reijntjes, Julian F R Paton, Frederik J de Lange, Roland D Thijs","doi":"10.1093/europace/euaf047","DOIUrl":"https://doi.org/10.1093/europace/euaf047","url":null,"abstract":"<p><strong>Background and aims: </strong>We studied the blood pressure (BP) decrease after carotid sinus massage to study cardioinhibition (CI) and arterial vasodepression (aVD), whether CI and aVD occur independent of one another, and how the BP decrease ends.</p><p><strong>Methods: </strong>We measured BP, heart rate (HR), stroke volume (SV) and total peripheral resistance (TPR) retrospectively in carotid sinus massage cohorts in two Dutch syncope centres. CI and aVD were defined as HR and TPR decreasing below 3 standard deviations under pre-massage baseline means. We used the logratio method to analyse changes relative to baseline, tested whether CI and aVD occurred together more often than through chance, and whether the responses depended on massage duration and on corrective BP-increases.</p><p><strong>Results: </strong>CI occurred in 48% and aVD in 30% of 244 massages of 90 persons. CI and aVD did not occur together more often than randomly. Compared to aVD, CI occurred more often, earlier, faster, and shorter with a larger maximal but similar overall BP-decreasing effect. Longer massage duration yielded a larger BP decrease through stronger aVD. The BP decrease evoked corrective increases of HR and TPR.</p><p><strong>Conclusion: </strong>CI appears as a phasic response to the onset of massage, independent of aVD, which is a more latent response sensitive to ongoing massage. BP corrections probably depend on the contralateral carotid sinus and aortic baroreceptors. The BP decrease after sinus massage may in part depend on the efficacy of corrective responses.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656590","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":"Feasibility of a 90-Watt, 3-Second Radiofrequency Application for Superior Vena Cava Isolation during Atrial Fibrillation Ablation.","authors":"Takashi Kaneshiro, Sadanori Murota, Minoru Nodera, Shinya Yamada, Masayoshi Oikawa, Yasuchika Takeishi","doi":"10.1093/europace/euaf056","DOIUrl":"https://doi.org/10.1093/europace/euaf056","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647755","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":"Characterization of ventricular tachycardia ablation in end-stage heart failure patients with left ventricular assist device (CHANNELED registry).","authors":"J-H van den Bruck, F Hohendanner, E Heil, K Albert, D Duncker, H Estner, T Deneke, A Parwani, E Potapov, K Seuthe, J Wörmann, A Sultan, J-H Schipper, L Eckardt, F Doldi, P Lugenbiel, H Servatius, G Thalmann, T Reichlin, M Khalaph, D Guckel, P Sommer, D Steven, J Lüker","doi":"10.1093/europace/euaf054","DOIUrl":"https://doi.org/10.1093/europace/euaf054","url":null,"abstract":"<p><strong>Background and aims: </strong>Patients with left-ventricular-assist-devices (LVAD) are at high risk for ventricular tachycardia (VT), data on VT ablation in LVAD patients is scarce. This multicentre registry assessed the mechanism of VT, procedural parameters, and outcome of VT ablation in LVAD patients (NCT06063811).</p><p><strong>Methods: </strong>Data of LVAD patients referred for VT ablation at 9 tertiary care centres were collected retrospectively. Parameters included VT mechanisms, procedural data, VT recurrence, and mortality.</p><p><strong>Results: </strong>Overall, 69 patients (90% male, mean age 60.7±8.4 years) undergoing 72 ablation procedures were included. Most procedures were conducted after intensification of antiarrhythmic drug (AAD) treatment (18/72; 25%) or a prior combination of ≥ 2 AADs (31/72; 43%). Endocardial low voltage areas were detected in all patients. The predominant VT mechanism was scar-related re-entry (76/96 VTs; 79%) and 19/96 VTs (20%) were related to the LVAD cannula. Non-inducibility of any VT was achieved in 28/72 procedures (39%). No LVAD related complication was observed. The extent of endocardial scar was associated with VT recurrence. The median follow-up was 283 days (IQR 70-587 days). A total of 3/69 patients were lost to follow-up, 10/69 (14%) were transplanted, 26/69 (38%) died, and 16/69 (23%) patients were free from VT.</p><p><strong>Conclusion: </strong>Although often a last resort, VT ablation in LVAD patients is feasible and safe when performed in experienced centres. These patients suffer from a high scar burden, and cardiomyopathy-associated rather than cannula-related scar seems to be the dominant substrate. VT recurrence is high despite extensive treatment, and the overall prognosis is limited.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656571","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":"Letter to the Editor: Carotid Sinus Massage in Clinical Practice.","authors":"Sebastian Stec, Marta Kornaszewska","doi":"10.1093/europace/euaf058","DOIUrl":"https://doi.org/10.1093/europace/euaf058","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656586","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":"Baseline and 10-year change in the number of ideal cardiovascular health metrics and sudden cardiac death in the community.","authors":"J P Empana, M C Perier, P E Warming, E Marijon, I van Valkengoed, Frederik N Ågesen, E Prescott, R Jabbari, R E Climie, P Elders, M T Blom, P J Schwartz, H L Tan, J Tfelt-Hansen, X Jouven","doi":"10.1093/europace/euaf046","DOIUrl":"https://doi.org/10.1093/europace/euaf046","url":null,"abstract":"<p><strong>Background and aims: </strong>adherence to an ideal cardiovascular health (CVH) might contribute to lower the burden of sudden cardiac death (SCD) in the community. We aimed to examine the association between the number of ideal CVH metrics at baseline and of its change over 10 years with the risk of SCD.</p><p><strong>Methods: </strong>the Copenhagen City Heart Study is a community based prospective cohort study. The number of ideal CVH metrics (range 0 to 6; non-smoking, and ideal level of body mass index, physical activity, untreated glucose, untreated systolic blood pressure and untreated total cholesterol levels) at baseline in 1991-94 and its 10y change thereof between 1981-83 and 1991-94 were evaluated. Definite SCD was defined as a death occurring within 1 hour (eye-witnessed case) or within 24 hours (non eye-witnessed) of symptoms onset, with the presence of confirmed ventricular tachycardia and the exclusion of non cardiac cause at autopsy. Fine and Gray sub distribution HRs (sHR) were calculated to account for competing risk.</p><p><strong>Results: </strong>the study population includes 8837 participants (57% women; mean age 57 years, +/- 15y) in 1991-94. After a median follow-up of 22.6 years from January 1st 1993 up to December 31th 2016, 56 definite SCD occurred. The risk of definite SCD decreased gradually with the number of ideal metrics in 1991-94 (sHR=0.58;95% CI: 0.44-0.75 per additional ideal metric) and with the change (i.e. improvement) in the number of ideal metrics between 1981-83 and 1991-94 (sHR=0.68; 0.50-0.93 per change in the number of ideal metrics). Effects size were lower for coronary death, all-cause mortality and coronary heart disease events.</p><p><strong>Conclusions: </strong>adherence to a higher number of ideal cardiovascular health was related to a substantial lower risk of definite SCD.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630261","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":"Clinical profile and outcomes among patients with cardiac implantable electronic device presenting as isolated pocket infection, pocket-related infective endocarditis or lead-related infective endocarditis.","authors":"Wojciech Jacheć, Anna Polewczyk, Dorota Nowosielecka, Andrzej Kutarski","doi":"10.1093/europace/euaf053","DOIUrl":"https://doi.org/10.1093/europace/euaf053","url":null,"abstract":"<p><strong>Aims: </strong>The clinical spectrum of cardiac implantable electronic device (CIED) infections includes isolated pocket infection (IPI), pocket infection complicated by infective endocarditis (PIRIE), and lead-related infective endocarditis (LRIE). The aim of this study was to assess the risk factors, clinical course and outcomes in patients with CIED infections and to demonstrate differences between PIRIE and LRIE.</p><p><strong>Methods and results: </strong>The retrospective analysis of data from 3847 patients undergoing transvenous lead extraction (TLE) for non-infectious (2640; 68.62%) and infectious (1207; 31.38%) indications including 361 (29.91%) IPI, 472 (39.11%) PIRIE and 374 (30.99%) LRIE showed some differences in risk factors, clinical course and outcomes between the subgroups. Unlike PIRIE, diabetes [HR=1.488; 95%CI(1.178÷1.879), P<0.001] and lead abrasion [HR=2.117 95%CI(1.665÷2.691), P<0.001] increased the risk of LRIE. The risk of pocket infection spread was greater with S. Aureus infection [HR=1.596; 95%CI(1.202-2.120), p<0.001). Compared to LRIE, patients with PIRIE had lower levels of inflammatory markers and lower prevalence of vegetations. Mortality in PIRIE compared to LRIE patients was lower (53.18% vs 62.30%; p<0.001) and comparable to IPI (50.69%; p=0.162) at long-term [median 1828 (815÷3139) days] follow-up.</p><p><strong>Conclusion: </strong>CIED infections share common risk factors, however, diabetes and intracardiac lead abrasion predispose to LRIE, whereas multiple leads and Staphylococcus aureus in pocket culture are risk factors for pocket infection spread. Compared to LRIE, the clinical course of PIRIE was milder and short- and long-term mortalities were lower, but comparable to IPI after more than one year. This may be an argument in favour of categorization into primary LRIE and secondary endocarditis, i.e. PIRIE.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624075","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":"Outcomes of Ventricular Tachycardia Ablation facilitated by Preprocedural Cardiac Imaging-derived Scar Characterization. A Prospective Multicenter International Registry.","authors":"Diego Penela, Giulio Falasconi, David Soto-Iglesias, Juan Fernández-Armenta, Giulio Zucchelli, Felipe Bisbal, Fatima Zaraket, Etelvino Silva, Matteo Parollo, Alessia Chiara Latini, Jose Alderete, Daniel Viveros, Aldo Bellido, Dario Turturiello, Chiara Valeriano, Paula Franco-Ocaña, Andrea Saglietto, Pietro Francia, Julio Martí-Almor, Antonio Berruezo","doi":"10.1093/europace/euaf051","DOIUrl":"https://doi.org/10.1093/europace/euaf051","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630264","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":"Identifying Extra Pulmonary Vein Targets for Persistent Atrial Fibrillation Ablation: Bridging Advanced and Conventional Mapping Techniques.","authors":"Alexander J Sharp, Michael T Pope, Andre Briosa E Gala, Richard Varini, Abhirup Banerjee, Timothy R Betts","doi":"10.1093/europace/euaf048","DOIUrl":"https://doi.org/10.1093/europace/euaf048","url":null,"abstract":"<p><strong>Background and aims: </strong>Advanced technologies such as charge density mapping (CDM) show promise in guiding adjuvant ablation in patients with persistent atrial fibrillation (AF); however, their limited availability restricts widespread adoption. We sought to determine whether regions of the left atrium containing CDM-identified pivoting and rotational propagation patterns during AF could also be reliably identified using more conventional contact mapping techniques.</p><p><strong>Methods: </strong>Twenty-two patients undergoing de novo ablation of persistent AF underwent both CDM and electroanatomic voltage mapping during AF and sinus rhythm with multiple pacing protocols. Though the use of a left atrium statistical shape model, the location of distinctive propagation patterns identified by CDM were compared with low-voltage areas (LVAs) and regions of slow conduction velocity (CV).</p><p><strong>Results: </strong>Neither LVA nor CV mapping during paced rhythms reliably identified regions containing CDM propagation patterns. CV mapping during AF did correlate with these regions (ρ = -0.63, p < 0.0001 for pivoting patterns; ρ = -0.54, p < 0.0001 for rotational patterns). These propagation patterns consistently occurred in two specific anatomical regions across patients: the anteroseptal and inferoposterior walls of the left atrium.</p><p><strong>Conclusion: </strong>Mapping techniques during paced rhythms do not reliably correspond with regions of CDM-identified propagation patterns in persistent AF. However, these propagation patterns are consistently observed in two specific anatomical regions, suggesting a predisposition to abnormal electrophysiological properties. While further research is needed, these regions may serve as promising targets for empirical ablation, potentially reducing the reliance on complex mapping techniques.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603854","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":"Time-dependent repolarization changes following left bundle branch area pacing vs. conventional biventricular pacing in patients with dyssynchronous heart failure.","authors":"Karin C Smits, Edoardo Bressi, Leonard M Rademakers, Jesse H J Rijks, Antonius M W van Stipdonk, Elien B Engels, Aaron Isaacs, Ben J M Hermans, Domenico Grieco, Justin G L M Luermans, Kevin Vernooy, Frits W Prinzen, Uyên Châu Nguyên","doi":"10.1093/europace/euaf034","DOIUrl":"10.1093/europace/euaf034","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425131","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}