Europace最新文献

{"title":"Feasibility and Accuracy of Wearable ECG Monitoring in Adult Congenital Heart Disease.","authors":"Florine Runge, Jonas Brügger, Francisco Javier Ruperti-Repilado, Behnam Subin, Fabian Jordan, Corinne Isenegger, Christian Sticherling, Michael Kühne, Felix Mahfoud, Daniel Tobler, Patrick Badertscher","doi":"10.1093/europace/euaf247","DOIUrl":"https://doi.org/10.1093/europace/euaf247","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250168","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":"Atrial cardiomyopathy delays the endothelialization process of left atrial appendage occluders.","authors":"Xiangwei Ding, Hao Jiang, Xiaohai Jiang, Kexin Wang, Yi Lu, Chuanmeng Zhang, Yin Ren, Gecai Chen, Bo Zhang, Ming Chu, Zhongbao Ruan, Li Zhu, Minglong Chen","doi":"10.1093/europace/euaf227","DOIUrl":"10.1093/europace/euaf227","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12510309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091496","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":"Mapping and ablation outcomes of extra-pulmonary vein triggers in atrial fibrillation: single-centre retrospective study with consistent provocation protocol.","authors":"Seunghoon Cho, Daehoon Kim, Hanjin Park, Oh-Seok Kwon, Hee Tae Yu, Tae-Hoon Kim, Jae-Sun Uhm, Boyoung Joung, Moon-Hyoung Lee, Hui-Nam Pak","doi":"10.1093/europace/euaf225","DOIUrl":"10.1093/europace/euaf225","url":null,"abstract":"<p><strong>Aims: </strong>Extra-pulmonary vein triggers (ExPVTs) are recognized as important contributors to atrial fibrillation (AF) recurrence after radio-frequency catheter ablation (RFCA). This study aimed to investigate the clinical characteristics, diagnostic value, and prognostic implications of isoproterenol-induced ExPVTs in patients undergoing de novo RFCA with circumferential pulmonary vein isolation (CPVI).</p><p><strong>Methods and results: </strong>We analysed 2619 non-valvular AF patients (25.8% female, mean age 59.4 ± 10.9 years, 60.7% with paroxysmal AF) who underwent CPVI and standardized isoproterenol provocation testing; 98.2% also received empirical right atrial (RA) ablation. We evaluated the clinical and prognostic significance of ExPVTs for AF recurrence within 2 years, considering their anatomical location and targeted ablation status. ExPVTs were identified in 13.5% of patients. Lower mean left atrial (LA) voltage was independently associated with ExPVTs, irrespective of sex. Importantly, ExPVTs remained independently associated with AF recurrence [hazard ratio (HR) 1.81 (95% confidence interval 1.39-2.35)], alongside AF type, body mass index, LA volume index, and mean LA voltage as significant predictors. LA [HR 1.50 (1.04-2.17)] and septal [HR 1.51 (1.02-2.23)] triggers were significantly associated with recurrence, while RA triggers were not, given the high rate of empirical RA ablation (98.9%). Recurrence risk was highest in patients with multiple or unmappable triggers and in those without ExPVT-targeted ablation.</p><p><strong>Conclusion: </strong>ExPVTs are strongly associated with lower LA voltage and carry independent prognostic value for AF recurrence, with outcomes varying by anatomical location and targeted ablation status. These findings underscore the importance of systematic ExPVT assessment and selective targeting in individualized ablation strategies.</p><p><strong>Clinical trial registration: </strong>NCT02138695.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12510313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091502","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":"Correction to: Biventricular vs. right ventricular pacing devices in patients anticipated to require frequent ventricular pacing (BioPace).","authors":"","doi":"10.1093/europace/euaf253","DOIUrl":"10.1093/europace/euaf253","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 10","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12510310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257673","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":"Early substrate-based catheter ablation vs. antiarrhythmic drug therapy for ventricular tachyarrhythmias among patients with prior myocardial infarction: the MANTRA-VT randomized trial.","authors":"Pekka Raatikainen, Heikki Mäkynen, Juha Hartikainen, Mats Jensen Urstad, Leena Konkola, Niels C F Sandgaard, Peter Lukac, Arne Johannessen, Anders Jönsson, Peter Schuster, Carina Blomström-Lundqvist, Jussi Kuutti, Piia Lavikainen, Hannu Parikka","doi":"10.1093/europace/euaf236","DOIUrl":"10.1093/europace/euaf236","url":null,"abstract":"<p><strong>Aims: </strong>Ventricular tachyarrhythmias (VT/VF) are common among patients with prior myocardial infarction (MI). MANTRA-VT trial was designed to compare the efficacy and safety of early substrate-based radiofrequency catheter ablation (RFCA) to antiarrhythmic drug (AAD) therapy for ventricular tachyarrhythmias.</p><p><strong>Methods and results: </strong>We randomly assigned 58 AAD naïve post MI patients with implantable cardioverter defibrillator (ICD) and at least one documented VT/VF episode after the device implantation to an initial treatment strategy of substrate-based RFCA or AAD therapy. The primary endpoint was cumulative number of ventricular tachyarrhythmias (VT/VF burden) at 12 months. The secondary endpoints included all-cause mortality, hospitalization, adverse events, and VT/VF burden at 24 months. Analyses were performed on an intention-to-treat basis. The median number of VT/VF episodes at 12 months was zero in both the RFCA (range 0-3) and the AAD group (range 0-23) (P = 0.454), whereas the rate of appropriate ICD shocks was 7% and 30% in the RFCA and the AAD groups (P = 0.026), respectively. During the extended follow-up, 82% of the patients in the RFCA group and 63% in the AAD group had no ICD therapies (P = 0.012). There was no significant difference between the groups in total mortality (HR 1.02, 95% CI 0.20-5.11, P = 0.86) and hospitalization (HR 1.35, 95% CI 0.36-5.09. P = 0.66) at 24 months. Therapy-related adverse events occurred in 3.6% and 16.7% of the patients in the RFCA and the AAD groups (P = 0.10), respectively.</p><p><strong>Conclusion: </strong>Early substrate-based RFCA was associated with reduced risk of ICD therapies, but with no meaningful difference in VT/VF burden, mortality, hospitalization, and adverse events.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 10","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298790","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":"From fixed time points to personalized care: rethinking stroke risk management in atrial fibrillation patients.","authors":"Davide Antonio Mei, Jacopo Francesco Imberti, Giuseppe Boriani","doi":"10.1093/europace/euaf215","DOIUrl":"10.1093/europace/euaf215","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12509843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033033","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":"Towards smarter screening: refining ECG criteria for the youngest athletes.","authors":"Cheyenne M Beach, Rachel Lampert","doi":"10.1093/europace/euaf223","DOIUrl":"10.1093/europace/euaf223","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12510326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091489","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":"Application of peak frequency annotation after pulmonary vein isolation and its association with long-term atrial fibrillation recurrence.","authors":"Ming-Jen Kuo, Li-Wei Lo, Jin-Long Huang, Yenn-Jiang Lin, Yu-Cheng Hsieh, Shih-Lin Chang, Yu-Feng Hu, Fa-Po Chung, Cheng-Hung Li, Chin-Yu Lin, Ting-Yung Chang, Ling Kuo, Cheng-I Wu, Chih-Min Liu, Shin-Huei Liu, Yu-Shan Huang, Steven Kim, Shih-Ann Chen","doi":"10.1093/europace/euaf233","DOIUrl":"10.1093/europace/euaf233","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12510305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130193","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":"Controversy: the blanking period after atrial fibrillation ablation is needed and should be maintained.","authors":"Helmut Pürerfellner, Stylianos Tzeis, John Mandrola","doi":"10.1093/europace/euaf203","DOIUrl":"10.1093/europace/euaf203","url":null,"abstract":"<p><p>The concept of a post-ablation 'blanking period' (typically 90 days) has long served as a clinical and regulatory buffer during which atrial arrhythmia recurrences are not considered indicative of procedural failure. This period was originally justified by transient electrophysiological instability due to oedema, inflammation, and autonomic fluctuations. However, recent data-particularly in the era of continuous rhythm monitoring and novel energy sources such as pulsed field ablation-have challenged the biological and prognostic neutrality of early recurrences. Several studies now suggest that arrhythmia episodes within the blanking period, especially beyond the first 30 days, may strongly predict long-term recurrence, thereby questioning the utility of maintaining a fixed observational window. This EP Europace Controversy article presents opposing viewpoints on the necessity of the blanking period in modern practice. Dr Stelios Tzeis argues in favour of preserving the blanking period, citing its role in minimizing unnecessary re-intervention and ensuring standardized trial endpoints. Conversely, Dr John Mandrola advocates for shortening or abandoning the blanking period, proposing a more individualized approach guided by arrhythmia timing, symptom burden, and ablation modality. The introduction, authored by Prof. Helmut Pürerfellner, sets the stage by reviewing the historical rationale, emerging evidence, and practical implications of this ongoing debate. As ablation techniques evolve and data accrue, reassessing the blanking period becomes essential. This Controversy aims to inform clinical practice, future trial design, and shared decision-making by juxtaposing two expert perspectives on a timely and consequential topic in atrial fibrillation management.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947737","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":"Correction to: Atrial cardiomyopathy revisited-evolution of a concept: a clinical consensus statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), the Asian Pacific Heart Rhythm Society (APHRS), and the Latin American Heart Rhythm Society (LAHRS).","authors":"","doi":"10.1093/europace/euaf248","DOIUrl":"10.1093/europace/euaf248","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 10","pages":""},"PeriodicalIF":7.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12507087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250231","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}