{"title":"SCN5A variant type-dependent risk prediction in Brugada syndrome.","authors":"Takanori Aizawa, Takeru Makiyama, Hai Huang, Tomohiko Imamura, Megumi Fukuyama, Keiko Sonoda, Koichi Kato, Takashi Hisamatsu, Yuko Nakamura, Kenji Hoshino, Junichi Ozawa, Hiroshi Suzuki, Kazushi Yasuda, Hisaaki Aoki, Takashi Kurita, Yoko Yoshida, Tsugutoshi Suzuki, Yoshihide Nakamura, Yoshiharu Ogawa, Shintaro Yamagami, Hiroshi Morita, Shinsuke Yuasa, Masakazu Fukuda, Makoto Ono, Hidekazu Kondo, Naohiko Takahashi, Seiko Ohno, Yoshihisa Nakagawa, Koh Ono, Minoru Horie","doi":"10.1093/europace/euaf024","DOIUrl":"https://doi.org/10.1093/europace/euaf024","url":null,"abstract":"<p><strong>Aims: </strong>The variant in SCN5A with the loss of function (LOF) effect in the cardiac Na+ channel (Nav1.5) is the definitive cause for Brugada syndrome (BrS), and the functional analysis data revealed that LOF variants are associated with poor prognosis. However, which variant types (e.g. missense or non-missense) affect the prognoses of those variant carriers remain unelucidated.</p><p><strong>Methods and results: </strong>We defined SCN5A LOF variants as all non-missense and missense variants that produce peak INa less than 65% of wild type previously confirmed by patch-clamp studies. The study population consisted of 76 Japanese BrS patients (median age [IQR] at diagnosis: 28 [14-45] years, and 74% patients were male) with LOF type of SCN5A variants: 40 with missense and 36 with non-missense variants. Non-missense variant carriers presented significantly more severe cardiac conduction disorder compared to the missense variant carriers. During follow-up periods of 9.0 [5.0-14.0] years, compared to missense variants, non-missense variants were significant risk factors of lifetime lethal arrhythmia events (LAEs) (P = 0.023). When focusing only on the missense variants which produce no peak INa, these missense variant carriers exhibited the same clinical outcomes as those with non-missense (log-rank P = 0.325). After diagnosis, however, both variant types were comparable in risk of LAEs (P = 0.155).</p><p><strong>Conclusion: </strong>We identified, for the first time, that SCN5A non-missense variants were associated with higher probability of LAE than missense variants in BrS patients though it did not change significantly after diagnosis.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390574","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}
EuropacePub Date : 2025-02-05DOI: 10.1093/europace/euaf018
Ling Shi, Yu Duan, Ning Fang, Ning Zhang, Sen Yan, Kunna Wang, Te Hou, Zhiqi Wang, Xiaohui Jiang, Qianhui Gao, Song Zhang, Yue Li, Yun Zhang, Yongtai Gong
{"title":"Lactobacillus gasseri prevents ibrutinib-associated atrial fibrillation through butyrate.","authors":"Ling Shi, Yu Duan, Ning Fang, Ning Zhang, Sen Yan, Kunna Wang, Te Hou, Zhiqi Wang, Xiaohui Jiang, Qianhui Gao, Song Zhang, Yue Li, Yun Zhang, Yongtai Gong","doi":"10.1093/europace/euaf018","DOIUrl":"10.1093/europace/euaf018","url":null,"abstract":"<p><strong>Background: </strong>Ibrutinib, a widely used anti-cancer drug, is known to significantly increase the susceptibility to atrial fibrillation (AF). While it is recognized that drugs can reshape the gut microbiota, influencing both therapeutic effectiveness and adverse events, the role of gut microbiota in ibrutinib-induced AF remains largely unexplored.</p><p><strong>Method: </strong>Utilizing 16S rRNA gene sequencing, faecal microbiota transplantation, metabonomics, electrophysiological examination, and molecular biology methodologies, we sought to validate the hypothesis that gut microbiota dysbiosis promotes ibrutinib-associated AF and to elucidate the underlying mechanisms.</p><p><strong>Result: </strong>We found that ibrutinib administration pre-disposes rats to AF. Interestingly, ibrutinib-associated microbial transplantation conferred increased susceptibility to AF in rats. Notably, ibrutinib induced a significantly decrease in the abundance of Lactobacillus gasseri (L. gasseri), and oral supplementation of L. gasseri or its metabolite, butyrate (BA), effectively prevented rats from ibrutinib-induced AF. Mechanistically, BA inhibits the generation of reactive oxygen species, thereby ameliorating atrial structural remodelling. Furthermore, we demonstrated that ibrutinib inhibited the growth of L. gasseri by disrupting the intestinal barrier integrity.</p><p><strong>Conclusion: </strong>Collectively, our findings provide compelling experimental evidence supporting the potential efficacy of targeting gut microbes in preventing ibrutinib-associated AF, opening new avenues for therapeutic interventions.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002455","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}
EuropacePub Date : 2025-02-05DOI: 10.1093/europace/euaf014
Alessio Gasperetti, Luigi Di Biase
{"title":"Pulmonary vein reconnection rates after pulse field ablation: time for a reality check?","authors":"Alessio Gasperetti, Luigi Di Biase","doi":"10.1093/europace/euaf014","DOIUrl":"10.1093/europace/euaf014","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002608","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}
EuropacePub Date : 2025-02-05DOI: 10.1093/europace/euaf013
Marcos Clavero-Adell, Daniel Palanca-Arias, Vicent Modesto I Alapont
{"title":"Letter to the editor: exercise stress test as a screening tool for pre-excitation.","authors":"Marcos Clavero-Adell, Daniel Palanca-Arias, Vicent Modesto I Alapont","doi":"10.1093/europace/euaf013","DOIUrl":"10.1093/europace/euaf013","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002509","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}
EuropacePub Date : 2025-02-05DOI: 10.1093/europace/euaf010
Marco Schiavone, Luigi Di Biase
{"title":"Freeze the clock: earlier catheter ablation for atrial fibrillation delivers better outcomes.","authors":"Marco Schiavone, Luigi Di Biase","doi":"10.1093/europace/euaf010","DOIUrl":"10.1093/europace/euaf010","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002538","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}
EuropacePub Date : 2025-02-05DOI: 10.1093/europace/euae261
{"title":"Correction to: Acute and mid-term outcomes of ablation for atrial fibrillation with VISITAG SURPOINT: the Japan MIYABI registry.","authors":"","doi":"10.1093/europace/euae261","DOIUrl":"https://doi.org/10.1093/europace/euae261","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 2","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398724","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}
EuropacePub Date : 2025-02-05DOI: 10.1093/europace/euaf011
Matteo Ziacchi, Luca Ottaviano, Luca Checchi, Stefano Viani, Gerardo Nigro, Valter Bianchi, Silvana De Bonis, Paolo De Filippo, Pietro Francia, Antonio Rapacciuolo, Gennaro Vitulano, Giovanni Battista Perego, Vincenzo Schillaci, Carlo Lavalle, Federico Migliore, Ennio C L Pisanò, Paolo Compagnucci, Pietro Palmisano, Gianluca Botto, Roberto Rordorf, Mariolina Lovecchio, Sergio Valsecchi, Mauro Biffi
{"title":"The risk of failure of subcutaneous implantable cardioverter defibrillator therapy: from PRAETORIAN score to clinical practice.","authors":"Matteo Ziacchi, Luca Ottaviano, Luca Checchi, Stefano Viani, Gerardo Nigro, Valter Bianchi, Silvana De Bonis, Paolo De Filippo, Pietro Francia, Antonio Rapacciuolo, Gennaro Vitulano, Giovanni Battista Perego, Vincenzo Schillaci, Carlo Lavalle, Federico Migliore, Ennio C L Pisanò, Paolo Compagnucci, Pietro Palmisano, Gianluca Botto, Roberto Rordorf, Mariolina Lovecchio, Sergio Valsecchi, Mauro Biffi","doi":"10.1093/europace/euaf011","DOIUrl":"10.1093/europace/euaf011","url":null,"abstract":"<p><strong>Aims: </strong>The subcutaneous implantable cardioverter defibrillator (S-ICD) is an alternative to traditional ICDs. The PRAETORIAN score, based on chest radiographs, has been validated to predict the probability of successful S-ICD defibrillation testing by assessing factors like fat thickness between the coil and sternum and generator placement. This study evaluated the correlation between the PRAETORIAN score and clinical characteristics, as well as implantation variables.</p><p><strong>Methods and results: </strong>We retrospectively analysed data from 1253 patients who had undergone implantation of an S-ICD across 33 centres. The intermuscular positioning of the pulse generator was adopted in all patients. Post-implantation posterior-anterior and lateral chest radiographs were analysed to calculate the PRAETORIAN score. A total of 95.7% of patients had a PRAETORIAN score < 90, indicative of a low risk of conversion failure. Body mass index (BMI) was the only independent predictor of a score ≥ 90, and all patients with BMI < 25 kg/m2 (normal weight or underweight) had a score < 90. The intermuscular positioning technique resulted in optimal posterior placement of the device in all patients and significant sub-generator fat in only 3% of cases. A shock impedance value > 88 Ohm enabled to detect a PRAETORIAN score ≥ 90 with 98% (95% CI 97-99%) negative predictive value.</p><p><strong>Conclusion: </strong>In contemporary practice, the PRAETORIAN score can be simplified. By adopting an intermuscular approach, two of the three steps of the score-evaluating the adequate posterior positioning of the generator and measuring the sub-generator fat-become superfluous, and impedance may serve as a reliable surrogate of sub-coil fat thickness. Furthermore, our data suggest that for non-obese patients, a favourable PRAETORIAN score is assured, making the score evaluation potentially unnecessary.</p><p><strong>Clinical trial registration: </strong>URL: http://clinicaltrials.gov/ Identifier: NCT02275637.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002612","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}
EuropacePub Date : 2025-02-05DOI: 10.1093/europace/euaf023
{"title":"Correction to: Cardioneuroablation for the treatment of reflex syncope and functional bradyarrhythmias: A Scientific Statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS) and the Latin American Heart Rhythm Society (LAHRS).","authors":"","doi":"10.1093/europace/euaf023","DOIUrl":"10.1093/europace/euaf023","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 2","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398726","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}
EuropacePub Date : 2025-02-05DOI: 10.1093/europace/euaf020
Mengting Liu, Xiaohui Guo, Jun Qiao
{"title":"Global inequalities of atrial fibrillation/atrial flutter from 1990 to 2021: study based on Global Burden of Disease 2021.","authors":"Mengting Liu, Xiaohui Guo, Jun Qiao","doi":"10.1093/europace/euaf020","DOIUrl":"10.1093/europace/euaf020","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 2","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255226","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}
EuropacePub Date : 2025-02-05DOI: 10.1093/europace/euae294
Deni Kukavica, Gianluca Pili, Alessandro Trancuccio, Gala Giannini, Valerio Pergola, Mirella Memmi, Patrick Gambelli, Maira Marino, Massimo Morini, Raffaella Bloise, Carlo Napolitano, Andrea Mazzanti, Silvia G Priori
{"title":"Prognostic relevance of baseline exercise stress test in RYR2-related CPVT.","authors":"Deni Kukavica, Gianluca Pili, Alessandro Trancuccio, Gala Giannini, Valerio Pergola, Mirella Memmi, Patrick Gambelli, Maira Marino, Massimo Morini, Raffaella Bloise, Carlo Napolitano, Andrea Mazzanti, Silvia G Priori","doi":"10.1093/europace/euae294","DOIUrl":"10.1093/europace/euae294","url":null,"abstract":"<p><strong>Aims: </strong>Exercise stress test (EST) represents the gold standard for diagnosis of catecholaminergic polymorphic ventricular tachycardia (CPVT). We aimed to determine the relevance of exercise induced VT for the occurrence of LAE at follow-up.</p><p><strong>Methods and results: </strong>In RYR2-related CPVT patients who underwent a baseline EST, we assessed the incidence and severity of ventricular arrhythmias (VA). Data were analysed using logistic regression models and Cox proportional hazards models. The primary outcome was the occurrence of life-threatening arrhythmic event (LAE; composite of sudden cardiac death, aborted cardiac arrest, or hemodynamically non-tolerated VT) at follow-up. In 102 RYR2-related CPVT patients (65 females; median age 16 years, IQR: 11-36 years), exercise-induced VT (bidirectional in 64% of cases) was elicited in 56% patients. VT could not be induced in pre-school children. Lower basal heart rate, early onset VA (within the first step of EST) and heart rate at the first minute of recovery were associated with exercise-induced VT. Cox analyses showed that early onset VA (HR 6.0, 95% CI: 1.3-27.9, P = 0.022) and exercise-induced VT (HR 6.6, 95% CI: 1.5-29.1, P = 0.012) at baseline EST were significantly associated with the occurrence of LAE at follow-up, and remained associated even after correction for symptoms.</p><p><strong>Conclusion: </strong>Early onset VA and exercise-induced VT at baseline EST was associated with LAE at follow-up, allowing to identify a sub-set of patients at higher risk already at diagnosis.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 2","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188732","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}