Europace最新文献

{"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}

{"title":"How harmful is right ventricular pacing? The question revived by the BioPace trial.","authors":"Mads Brix Kronborg, Niraj Varma, Jens Cosedis Nielsen","doi":"10.1093/europace/euaf005","DOIUrl":"https://doi.org/10.1093/europace/euaf005","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 3","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656596","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":"Immune and non-immune congenital heart block: a tale of two very different entities.","authors":"Susan P Etheridge, Janette F Strasburger","doi":"10.1093/europace/euaf041","DOIUrl":"10.1093/europace/euaf041","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/PMC11919813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556302","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":"Late outcomes of congenital and childhood non-immune, isolated atrioventricular block: a French nationwide retrospective cohort study.","authors":"Florence Mycinski, Victor Waldmann, Florence Kyndt, Béatrice Guyomarch, Alice Maltret, Marie Wilkin, Caroline Ovaert, Guy Vaksmann, Jean-Benoit Thambo, Jean-Marc Sellal, Paul Padovani, Naychi Lwin, Solène Prigent, Oscar Werner, Julien Barc, Jean-Jacques Schott, Damien Bonnet, Vincent Probst, Alban-Elouen Baruteau","doi":"10.1093/europace/euaf040","DOIUrl":"10.1093/europace/euaf040","url":null,"abstract":"<p><strong>Aims: </strong>The natural history of congenital or childhood non-immune, isolated atrioventricular block (AVB) is poorly defined. We aimed at clarifying its long-term outcomes.</p><p><strong>Methods and results: </strong>We retrospectively studied 385 children with isolated, non-immune AVB diagnosed from in utero or up to 18 years of age, at 29 French medical centres, between 1980 and 2022. Patients with structural heart disease, endomyocardial fibrosis, or maternal antibodies were excluded. Atrioventricular block was asymptomatic in 314 (81.6%) and complete in 263 (68.3%) patients at the time of diagnosis. There was progression to complete AVB in 84/122 (68.8%) patients with incomplete AVB over 12 years (7-17). A total of 286/385 patients (74.3%) received a permanent pacemaker, implanted in the first year of life in 39 (14%) and before 10 years of age in 172 (60%) children. The pacing indication was prophylactic in 203 children (71%). Genetic screening was performed in 133/385 patients (34.5%), leading to the identification of a clinically actionable variant in 11 (8.3%) patients. After a median follow-up of 10 years (5-17), no patient died or developed endomyocardial fibrosis or dilated cardiomyopathy.</p><p><strong>Conclusion: </strong>In this large nationwide study, the long-term outcome of congenital or childhood non-immune, isolated AVB was excellent. Most children required pacemaker implantation over time, albeit often as a prophylactic measure.</p>","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/PMC11919819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604038","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":"Atrial fibrillation burden in clinical practice, research, and technology development: a clinical consensus statement of the European Society of Cardiology Council on Stroke and the European Heart Rhythm Association.","authors":"Wolfram Doehner, Giuseppe Boriani, Tatjana Potpara, Carina Blomstrom-Lundqvist, Rod Passman, Luciano A Sposato, Dobromir Dobrev, Ben Freedman, Isabelle C Van Gelder, Taya V Glotzer, Jeff S Healey, Theodore Karapanayiotides, Gregory Y H Lip, Jose Luis Merino, George Ntaios, Renate B Schnabel, Jesper H Svendsen, Emma Svennberg, Rolf Wachter, Karl Georg Haeusler, A John Camm","doi":"10.1093/europace/euaf019","DOIUrl":"10.1093/europace/euaf019","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is one of the most common cardiac diseases and a complicating comorbidity for multiple associated diseases. Many clinical decisions regarding AF are currently based on the binary recognition of AF being present or absent with the categorical appraisal of AF as continued or intermittent. Assessment of AF in clinical trials is largely limited to the time to (first) detection of an AF episode. Substantial evidence shows, however, that the quantitative characteristic of intermittent AF has a relevant impact on symptoms, onset, and progression of AF and AF-related outcomes, including mortality. Atrial fibrillation burden is increasingly recognized as a suitable quantitative measure of intermittent AF that provides an estimate of risk attributable to AF, the efficacy of antiarrhythmic treatment, and the need for oral anticoagulation. However, the diversity of assessment methods and the lack of a consistent definition of AF burden prevent a wider clinical applicability and validation of actionable thresholds of AF burden. To facilitate progress in this field, the AF burden Consensus Group, an international and multidisciplinary collaboration, proposes a unified definition of AF burden. Based on current evidence and using a modified Delphi technique, consensus statements were attained on the four main areas describing AF burden: Defining the characteristics of AF burden, the recording principles, the clinical relevance in major clinical conditions, and implementation as an outcome in the clinic and in clinical trials. According to this consensus, AF burden is defined as the proportion of time spent in AF expressed as a percentage of the recording time, undertaken during a specified monitoring duration. A pivotal requirement for validity and comparability of AF burden assessment is a continuous or near-continuous duration of monitoring that needs to be reported together with the AF burden assessment. This proposed unified definition of AF burden applies independent of comorbidities and outcomes. However, the disease-specific actionable thresholds of AF burden need to be defined according to the targeted clinical outcomes in specific populations. The duration of the longest episode of uninterrupted AF expressed as a time duration should also be reported when appropriate. A unified definition of AF burden will allow for comparability of clinical study data to expand evidence and to establish actionable thresholds of AF burden in various clinical conditions. This proposed definition of AF burden will support risk evaluation and clinical treatment decisions in AF-related disease. It will further promote the development of clinical trials studying the clinical relevance of intermittent AF. A unified approach on AF burden will finally inform the technology development of heart rhythm monitoring towards validated technology to meet clinical needs.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 3","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11901050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613689","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":"Thermal side effects during pulsed field ablation: an analysis using computer modelling.","authors":"Marcela Mercado-Montoya, Tatiana Gomez-Bustamante, Steven R Mickelsen, Erik Kulstad, Ana González-Suárez, Lawrence J Overzet","doi":"10.1093/europace/euaf035","DOIUrl":"10.1093/europace/euaf035","url":null,"abstract":"<p><strong>Aims: </strong>Pulsed field ablation (PFA) is described as non-thermal, but data from oncology and cardiology show thermal effects occur. The specific waveform parameters influencing thermal energy development during PFA are unclear. The aim of this study is to numerically evaluate the thermal effects of PFA on myocardial and oesophageal tissue at various peak voltage conditions.</p><p><strong>Methods and results: </strong>A three-dimensional computer model of the left atrium quantified thermal effects from PFA at peak voltages of 1, 1.5, and 2 kV. Energy was applied using a bipolar configuration with far-field and symmetry boundaries set as electrically insulating. A monophasic waveform with a 100 μs pulse width and a 1 s gap between pulses was applied for a total of 50 pulses, mimicking clinical conditions. Minimal temperature rise in the oesophagus was observed with 1 kV pulses (214.5 J). At 1.5 and 2 kV (570.3 and 1.23 kJ), temperatures reached 46.3°C and >62°C, respectively, after a single pulse train. These findings suggest that repeated applications could lead to even higher temperatures, especially if good tissue contact is obtained. These results align with data from other medical fields using pulsed field treatments.</p><p><strong>Conclusion: </strong>Thermal effects from PFA depend on the total energy deposited, with peak voltage being a significant factor. Current commercially available PFA systems have the potential to induce collateral thermal injury with repeated applications of pulsed field energy. This highlights the need for careful monitoring and adjustment of PFA parameters in clinical settings.</p>","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/PMC11879925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440392","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":"Biventricular vs. right ventricular pacing devices in patients anticipated to require frequent ventricular pacing (BioPace).","authors":"Reinhard C Funck, Hans-Helge Müller, Maurizio Lunati, Luc De Roy, Norbert Klein, Eckhard Meisel, Goran Milasinovic, Mark D Carlson, Michael Wittenberg, Gerhard Hindricks, Jean-Jacques Blanc","doi":"10.1093/europace/euaf029","DOIUrl":"https://doi.org/10.1093/europace/euaf029","url":null,"abstract":"<p><strong>Aims: </strong>Right ventricular (RV) pacing may promote left ventricular (LV) dysfunction. Particularly in patients with preserved LV ejection fraction (LVEF), narrow QRS, and anticipated high ventricular pacing burden (HVPB), evidence is missing that biventricular (BiV) pacing can improve clinical outcome. We therefore evaluated whether implantation of a BiV pacing device (BiVPD) compared with a RV pacing device (RVPD) may improve clinical outcome in predominantly this kind of patients.</p><p><strong>Methods and results: </strong>In the Biventricular Pacing for atrioventricular Block to Prevent Cardiac Desynchronization (BioPace) trial [multicentre, single-blinded (patients), randomized, parallel group], patients were equally allocated to either receive a BiVPD or a RVPD. Co-primary endpoints were (i) the composite of time to death or first heart failure hospitalization and (ii) survival time. We analysed 1810 randomized patients (median age: 73.5 years; female sex: 31.7%; mean LVEF 55.4%; mean QRS 118.4 ms), 902 to BiV and 908 to RV pacing. During mean follow-up of 68.8 months, the difference in the primary composite endpoint between both groups [346 vs. 363 events, hazard ratio (HR) 0.878; 95% confidence interval (CI) 0.756-1.020; P = 0.0882) or in mortality (305 vs. 307 deaths, HR 0.926; 95% CI 0.789-1.088; P = 0.3492) was smaller than 20%.</p><p><strong>Conclusion: </strong>In patients, predominantly with preserved LVEF, narrow QRS, and HVPB, superiority of implanting BiVPDs compared with RVPDs could not be proven. Right ventricular pacing may be less harmful for this kind of patients than often suggested and primary BiV pacing does not clearly improve their clinical outcome.</p><p><strong>Clinical trial registration: </strong>Registered in ClinicalTrials.gov, number NCT00187278 (https://clinicaltrials.gov/ct2/show/study/NCT00187278).</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 3","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656594","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":"Aggressive ablation vs. regular ablation for persistent atrial fibrillation: a multicentre real-world cohort study.","authors":"Kaige Li, Yangbin Shi, Xinhua Wang, Ping Ye, Bing Han, Weifeng Jiang, Yu Zhang, Qidong Zheng, Anjing Ji, Menghe Zhang, Yanzhe Wang, Shaohui Wu, Kai Xu, Mu Qin, Xu Liu, Xumin Hou","doi":"10.1093/europace/euaf045","DOIUrl":"10.1093/europace/euaf045","url":null,"abstract":"<p><strong>Aims: </strong>Current guidelines for the optimal ablation strategy for persistent atrial fibrillation (PerAF) remain unclear. While our previous RCT confirmed the favourable prognosis of aggressive ablation, real-world evidence is still lacking.</p><p><strong>Methods and results: </strong>Among 4833 PerAF patients undergoing catheter ablation at 10 centres, two groups were defined: regular ablation (PVI-only or PVI plus anatomical ablation) and aggressive ablation (anatomical plus electrogram-guided ablation), with 1560 patients each after propensity score (PS) matching. The primary endpoint was 12-month AF/atrial tachycardia (AT) recurrence-free survival off anti-arrhythmic drugs after a single procedure. Additional PS matching was performed within the regular group between PVI-only and anatomical ablation (n = 455 each). Furthermore, anatomical ablation from the regular group was independently matched with aggressive ablation (n = 1362 each). At 12 months, the aggressive group showed superior AF/AT-free survival (66.2% vs. 59.3%, P < 0.001; HR 0.745), similar AT recurrence (12.0% vs. 11.3%, P = 0.539), and significantly higher procedural AF termination (67.0% vs. 21.0%, P < 0.001) than regular group. Moreover, patients with AF termination had improved AF/AT-free survival (72.3% vs. 55.2%, P < 0.001). Safety endpoints did not differ significantly between the two groups. Both the ablation outcomes and AF termination rate showed increasing trends with the extent of ablation aggressiveness but declined with extremely aggressive ablation. After additional PS matching, within the regular group, no statistical differences were observed though AF/AT-free survival in the anatomical group was slightly higher than the PVI-only group (60.7% vs. 55.6%, P = 0.122); while aggressive ablation showed improved AF/AT-free survival compared to anatomical ablation alone from regular group (67.5% vs. 59.9%, P < 0.001).</p><p><strong>Conclusion: </strong>Aggressive ablation achieved more favourable outcomes than regular ablation, and moderately aggressive ablation may be associated with better clinical outcomes. AF termination is a reliable ablation endpoint.</p>","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/PMC11920505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572364","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":"Evaluation of a Second-Generation Intercostal Extravascular ICD Lead with a Pectoral Pulse Generator for Sensing, Defibrillation and Anti-tachycardia Pacing.","authors":"Shephal K Doshi, Reinoud E Knops, Adrian Ebner, Michael Husby, Alan Marcovecchio, Rick Sanghera, Don Scheck, Martin C Burke","doi":"10.1093/europace/euaf044","DOIUrl":"https://doi.org/10.1093/europace/euaf044","url":null,"abstract":"<p><strong>Background: </strong>Intercostal EV-ICD leads may work better inn contact with the pericardium thereby directing pacing and defibrillation energy toward excitable myocytes. We report three-month safety and performance outcomes with a second-generation intercostal EV-ICD lead paired with standard, commercially available ICD pulse generators (PGs).</p><p><strong>Methods: </strong>Subjects undergoing a transvenous ICD (TV-ICD) procedure received a concomitant intercostal EV-ICD lead system. The intercostal EV-ICD lead was connected sequentially to a PG in a left pectoral and then a left mid-axillary location. EV-ICD lead assessment included sensing and defibrillation of induced ventricular arrhythmias (IVA) and pacing capture. The intercostal EV-ICD system was followed in a \"recording only\" mode and the control TV-ICD system in \"therapy delivery\" mode to compare stored events. Devices were evaluated prior to hospital discharge, 2 weeks, 1 month, 2 months and 3 months post implant. Defibrillation testing was repeated prior to lead removal.</p><p><strong>Results: </strong>20/20(100%) were successfully implanted (median implant time of 9 minutes). Two major lead complications were reported over a mean of 82 days: (1) lead movement and (2) infection of both the TV-ICD and EV-ICD systems. Intraoperative pacing capture was achieved with the integrated bipolar configuration in 19 of 20 (95%) subjects. Pacing capture with the EV-ICD system was tolerated in all subjects, with over 90% feeling no pain after a one-month recovery from the procedure. Induced VF episodes were sensed in all subjects and defibrillated successfully in 17 of 17 patients (100%) with a left mid-axillary PG and 19 of 20 patients (95%) with a left pectoral PG. Sensing and defibrillation were successful in 18 of 18 (100%) tested prior to lead removal.</p><p><strong>Conclusions: </strong>In this pilot experience with a second generation intercostal EV-ICD lead implantation, sensing and defibrillation of induced VF was successful when paired with a standard ICD PG from either a left midaxillary or pectoral pocket.</p><p><strong>Study identifier: </strong>NCT Number: NCT05791032, URL: https://clinicaltrials.gov/study/NCT05791032.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556300","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":"Impact of the presence of sinus rhythm during cavotricuspid isthmus ablation for atrial flutter on the incidence of future new-onset atrial fibrillation: insights from an international multi-center registry.","authors":"Josip Katic, Patrick Badertscher, Ivan Zeljkovic, Peter Ammann, Tobias Reichlin, Sven Knecht, Philipp Krisai, Michael Kühne, Christian Sticherling","doi":"10.1093/europace/euaf039","DOIUrl":"https://doi.org/10.1093/europace/euaf039","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556303","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}