Europace最新文献

{"title":"Management of patients with transvalvular right ventricular leads undergoing transcatheter tricuspid valve interventions: a scientific statement of the European Heart Rhythm Association and the European Association of Percutaneous Cardiovascular Interventions of the ESC endorsed by the Heart Rhythm Society, the Asian Pacific Heart Rhythm Society and the Canadian Heart Rhythm Society.","authors":"Jean-Claude Deharo, Julien Dreyfus, Maria-Grazia Bongiorni, Haran Burri, Pascal Defaye, Michael Glikson, Nigel Lever, Antonio Mangieri, Blandine Mondésert, Jens Cosedis Nielsen, Maully Shah, Christoph Thomas Starck, Archana Rao, Christophe Leclercq, Fabien Praz, Sergio Richter, Nicolas Amabile, Alexander Breitenstein, Óscar Cano, Karol Čurila, Jamie Manlucu, Robert D Schaller, Hung-Fat Tse, Christian Veltmann, Zachary Whinnett","doi":"10.1093/europace/euaf061","DOIUrl":"10.1093/europace/euaf061","url":null,"abstract":"<p><p>Up to one-third of patients referred for transcatheter tricuspid valve intervention (TTVI) have a transvalvular pacemaker (PPM) or implantable cardioverter-defibrillator (ICD) lead in place. Both the electrophysiology and interventional cardiology communities have been alerted to the complexity of decision-making in this situation due to potential interactions between the leads and the TTVI material, including the risk of jailing or damage to the leads. This document, commissioned by the European Heart Rhythm Association and the European Association of Percutaneous Cardiovascular Interventions of the ESC, reviews the scientific evidence to inform Heart Team discussions on the management of patients with a PPM or ICD who are scheduled for or have undergone TTVI.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751824","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":"Persistent atrial fibrillation with left atrial low-voltage area: who benefit from additional modification?","authors":"Hengzhi Zhang, Ning Chen, Qiuheng Bian, Mingchuan Yuan, Gang Yang, Youmei Shen, Hongwu Chen, Weizhu Ju, Mingfang Li, Kai Gu, Nan Wu, Hailei Liu, Minglong Chen","doi":"10.1093/europace/euaf095","DOIUrl":"10.1093/europace/euaf095","url":null,"abstract":"<p><strong>Aims: </strong>The presence of low-voltage areas (LVAs) is associated with increased recurrence rate following ablation of persistent atrial fibrillation (PeAF). However, the benefit of additional LVA modification remains controversial. This substudy of the STABLE-SR-II trial aims to explore the factors that influence the benefit of additional LVA ablation for PeAF patients with LVAs.</p><p><strong>Methods and results: </strong>In the STABLE-SR-II trial, PeAF patients with de novo ablation were randomized to receive either circumferential pulmonary vein isolation (CPVI, CPVI-alone group) or CPVI plus LVA ablation (CPVI-plus group). Patients with LVAs were included and analyzed in this substudy. The primary outcome was freedom from atrial arrhythmias 18 months after a single ablation procedure. LVAs were detected in 133 out of 276 PeAF patients (48%). Age and LVA burden were potential factors influencing the relative success of additional LVA ablation compared with CPVI alone in the univariable analysis. In multi-adjusted models, significant benefit from additional LVA ablation was found in patients aged ≥65 years [n = 50, hazard ratio (HR) 0.14, 95% confidence interval (CI) 0.02-0.83] or with LVA burden ≥ 15% (n = 18, HR 0.01, 95% CI: 0-0.44). LVA burden ≥15% was observed in 10 of 50 patients aged ≥65 years (20%) and in 8 of 83 patients aged <65 years (10%). Combined subgroup analysis demonstrated that LVA ablation was particularly beneficial for patients aged ≥65 years, regardless of LVA burden.</p><p><strong>Conclusion: </strong>LVA ablation following CPVI may provide additional benefits for older PeAF patients (≥65 years) in the first procedure.</p><p><strong>Clinical trial registration: </strong>NCT03448562 [CPVI Alone Versus CPVI Plus Electrophysiological Substrate Ablation in the LA During SR for the Treatment of Non-PAF (STABLE-SR_II)].</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 5","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993125","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":"GSTP1 inhibits angiotensin II-induced atrial fibrillation by regulating ferroptosis.","authors":"Han Li, Zhenyu Feng, Benke Li, Jie Bai, Qiu-Yue Lin, Xiaohong Yu, Ningning Zhang, Yunpeng Xie, Xiaolei Yang","doi":"10.1093/europace/euaf083","DOIUrl":"10.1093/europace/euaf083","url":null,"abstract":"<p><strong>Aims: </strong>Atrial fibrillation is the most common arrhythmia in clinical practice and increases the potential risk of stroke, thromboembolism, and death. Glutathione-S-transferases pi 1 (GSTP1), a key factor of ferroptosis, can participate in stress signal and cell damage pathway through its non-catalytic activity, and has the role of regulating and protecting cells from carcinogens and electrophilic compounds. However, the role and mechanism of GSTP1 in angiotensin II-induced atrial fibrillation have not been studied.</p><p><strong>Methods and results: </strong>We constructed a mouse model of atrial fibrillation using Ang II and identified key factors by proteome and ferroptosis PCR array. We investigated the role of GSTP1 in atrial remodelling and NRAMs by the ferroptosis inhibitor Ferrostatin-1 (Fer-1), AAV9-cTNT-GSTP1, and GSTP1 inhibitor Ezatiostat. The results showed that the ferroptosis pathway was significantly altered in atrial fibrillation by proteomics. The ferroptosis inhibitor Fer-1 demonstrated that inhibiting ferroptosis can intervene in Ang II-induced atrial fibrillation. The ferroptosis PCR array showed that the expression of GSTP1 was significantly decreased in atrial fibrillation, and it was verified in cells and human atrial tissues. In mice infected with AAV9-cTNT-GSTP1, it was found that overexpression of GSTP1 inhibited Ang II-induced atrial fibrillation. Overexpression of GSTP1 inhibited Ang II-induced myocardial injury, oxidative stress, and ferroptosis in vitro.</p><p><strong>Conclusion: </strong>Therefore, these results preliminarily demonstrate that GSTP1-mediated ferroptosis plays a crucial role in the Ang II-induced atrial fibrillation model and can be considered a potential therapeutic target for atrial fibrillation.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788193","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":"Re-recognized the Maintenance Mechanism of Persistent Atrial Fibrillation via Electrogram Analysis in Termination Regions.","authors":"Mu Qin, Le-Tian Wang, Shi-Yi Wang, Yu Zhang, Wei-Feng Jiang, Shao-Hui Wu, Kai Xu, Yang Liu, Xu-Min Hou, Xu Liu","doi":"10.1093/europace/euaf087","DOIUrl":"https://doi.org/10.1093/europace/euaf087","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987340","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":"State of the Art of Artificial Intelligence in Clinical Electrophysiology in 2025. A Scientific Statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), and the ESC Working Group in e-Cardiology.","authors":"E Svennberg, J K Han, E G Caiani, S Engelhardt, S Ernst, P Friedman, R Garcia, H Ghanbari, G Hindricks, S H Man, J Millet, S M Narayan, G A Ng, P A Noseworthy, F V Y Tjong, J Ramírez, J P Singh, N Trayanova, D Duncker","doi":"10.1093/europace/euaf071","DOIUrl":"https://doi.org/10.1093/europace/euaf071","url":null,"abstract":"<p><strong>Aim: </strong>Artificial Intelligence (AI) has the potential to transform cardiac electrophysiology (EP), particularly in arrhythmia detection, procedural optimization, and patient outcome prediction. However, a standardized approach to reporting and understanding AI-related research in EP is lacking. This scientific statement aims to develop and apply a checklist for AI-related research reporting in EP to enhance transparency, reproducibility and understandability in the field.</p><p><strong>Methods: </strong>An AI checklist specific to EP was developed with expert input from the writing group and voted on using a modified Delphi process, leading to the development of a 29-item checklist. The checklist was subsequently applied to assess reporting practices to identify areas where improvements could be made and provide an overview of the state of the art in AI-related EP research in three domains from May 2021 until May 2024: atrial fibrillation management, sudden cardiac death (SCD), and EP lab applications.</p><p><strong>Results: </strong>The EHRA AI checklist was applied to 31 studies in atrial fibrillation management, 18 studies in SCD, and 6 studies in EP lab applications. Results differed between the different domains, but in no domain reporting of a specific item exceeded 55 % of included papers. Key areas such as trial registration, participant details, data handling, and training performance were underreported (<20%). The checklist application highlighted areas where reporting practices could be improved to promote clearer, more comprehensive AI research in EP.</p><p><strong>Conclusion: </strong>The EHRA AI checklist provides a structured framework for reporting AI research in EP. Its use can improve understanding but also enhance the reproducibility and transparency of AI studies, fostering more robust and reliable integration of AI into clinical EP practice.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751739","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":"Multipoint pacing is associated with reduction of heart failure hospitalizations or death in patients who do not respond to cardiac resynchronization therapy. Results of the MORE-CRT MPP randomized trial.","authors":"Christophe Leclercq, Haran Burri, Leonardo Calò, Christopher Aldo Rinaldi, Johannes Sperzel, Bernard Thibault, Tim Betts, Pascal Defaye, Andreas Hain, Olivier Piot, Kwangdeok Lee, Wenjiao Lin, Annalisa Pollastrelli, Andrea Grammatico, Giuseppe Boriani","doi":"10.1093/europace/euaf070","DOIUrl":"https://doi.org/10.1093/europace/euaf070","url":null,"abstract":"<p><strong>Background and aims: </strong>Cardiac resynchronization therapy (CRT) via biventricular pacing (BIVP) is an effective treatment, but non-responders are at higher risk of death and heart failure (HF) hospitalizations compared with CRT responders. The MORE-CRT MPP trial aimed to evaluate whether CRT with multipoint pacing (MPP) is associated with improved clinical outcomes in CRT non-responders.</p><p><strong>Methods: </strong>CRT patients were treated with conventional BIVP for 6 months and then assessed for CRT response (left ventricular end-systolic volume relative reduction >15% vs. baseline). CRT non-responders were 1:1 randomized to BIVP or MPP and followed for 6 months. The main endpoint of this secondary analysis was HF hospitalizations or all-cause mortality.</p><p><strong>Results: </strong>Out of 3724 CRT patients (67±11 years, 1050 female) 1677 were non-responders and randomized to MPP or BIVP, of whom 1421 (722 MPP and 699 BIVP) had complete data. In a mean follow-up of 5±1 months after randomization, MPP was associated with a lower incidence of HF hospitalizations or all-cause mortality (48/722 (6.64%)) compared with BIVP (73/699 (10.44%), RRR=36% (95% CI=±4%), p=0.0107). At multivariable analysis, MPP was associated with a lower occurrence of the main endpoint (odds ratio=0.60, p=0.0124). At logistic regression analysis HF hospitalizations or all-cause death were lower with MPP vs. BIVP in the whole population and in many patients subgroups, e.g. ischemic patients and patients with long (>105 ms) interventricular electrical delay.</p><p><strong>Conclusion: </strong>In MORE-CRT MPP randomized trial, multipoint pacing was associated with a significant reduction of all-cause mortality and HF hospitalizations in prior non-responders to conventional biventricular pacing.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751736","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":"Practical Compendium of Antiarrhythmic Drugs: A Clinical Consensus Statement of the European Heart Rhythm Association of the ESC.","authors":"Jose L Merino, Juan Tamargo, Carina Blomström-Lundqvist, Giuseppe Boriani, Harry J G M Crijns, Dobromir Dobrev, Andreas Goette, Stefan H Hohnloser, Gerald V Naccarelli, James A Reiffel, Jacob Tfelt-Hansen, Marcel Martínez Cossiani, A John Camm","doi":"10.1093/europace/euaf076","DOIUrl":"https://doi.org/10.1093/europace/euaf076","url":null,"abstract":"<p><p>The EHRA Practical Compendium of Antiarrhythmic Drugs (AADs) offers advice on these drugs, focusing on their clinical use and the global impact of cardiac arrhythmias. This document aims to provide practical instructions to clinicians in arrhythmia management through pharmacological strategies. The compendium highlights persistent challenges in arrhythmia treatment, including clinical constraints, procedural risks, and the complexity of certain arrhythmias. Notably, atrial fibrillation is highly prevalent, and the demand for invasive treatment often surpasses the capacity of existing healthcare systems. As a result, pharmacological management remains essential. This is particularly relevant for patients with cardiac implantable electronic devices or channelopathies, where ablation is often not a suitable option. AADs play a pivotal role in these scenarios. The compendium introduces the ABC framework for AAD therapy: A (Appropriate therapy), for patients in whom AADs are the best therapeutic option, B (Backup therapy), as adjunctive treatment to invasive procedures, such as catheter ablation, and C (Complementary therapy), in combination with other therapies. The document provides detailed insights into the mechanisms of action, efficacy, safety profiles, and drug interactions of each class of AADs. Additionally, the compendium covers practical considerations, including initiation, combination strategies, monitoring, follow-up, special populations, and adverse effect management, with an emphasis on proarrhythmia risk mitigation. It also explores the integration of AADs with other therapeutic modalities, promoting a synergistic approach to optimize patient outcomes. In summary, this compendium serves as an indispensable resource for clinicians, offering practical advice and evidence-based insights to navigate the complexities of arrhythmia management effectively.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751737","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":"Patient selection, ventricular tachycardia substrate delineation, and data transfer for stereotactic arrhythmia radioablation: a clinical consensus statement of the European Heart Rhythm Association of the European Society of Cardiology and the Heart Rhythm Society.","authors":"Katja Zeppenfeld, Robert Rademaker, Amin Al-Ahmad, Corrado Carbucicchio, Christian De Chillou, Jakub Cvek, Micaela Ebert, Gordon Ho, Josef Kautzner, Pier Lambiase, Jose Luis Merino, Michael Lloyd, Satish Misra, Etienne Pruvot, John Sapp, Luis Schiappacasse, Marek Sramko, William G Stevenson, Paul C Zei, Dan Wichterle, Jonathan Chrispin, Claudia Herrera Siklody, Radek Neuwirth, Gemma Pelargonio, Tobias Reichlin, Clifford Robinson, Claudio Tondo","doi":"10.1093/europace/euae214","DOIUrl":"10.1093/europace/euae214","url":null,"abstract":"<p><p>Stereotactic arrhythmia radioablation (STAR) is a novel, non-invasive, and promising treatment option for ventricular arrhythmias (VAs). It has been applied in highly selected patients mainly as bailout procedure, when (multiple) catheter ablations, together with anti-arrhythmic drugs, were unable to control the VAs. Despite the increasing clinical use, there is still limited knowledge of the acute and long-term response of normal and diseased myocardium to STAR. Acute toxicity appeared to be reasonably low, but potential late adverse effects may be underreported. Among published studies, the provided methodological information is often limited, and patient selection, target volume definition, methods for determination and transfer of target volume, and techniques for treatment planning and execution differ across studies, hampering the pooling of data and comparison across studies. In addition, STAR requires close and new collaboration between clinical electrophysiologists and radiation oncologists, which is facilitated by shared knowledge in each collaborator's area of expertise and a common language. This clinical consensus statement provides uniform definition of cardiac target volumes. It aims to provide advice in patient selection for STAR including aetiology-specific aspects and advice in optimal cardiac target volume identification based on available evidence. Safety concerns and the advice for acute and long-term monitoring including the importance of standardized reporting and follow-up are covered by this document. Areas of uncertainty are listed, which require high-quality, reliable pre-clinical and clinical evidence before the expansion of STAR beyond clinical scenarios in which proven therapies are ineffective or unavailable.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035552","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":"Impact of myocardial phenotype on optimal atrioventricular delay settings during biventricular and left bundle branch pacing at rest and during exercise: insights from a virtual patient study.","authors":"Claudia A Manetti, Nick van Osta, Ahmed S Beela, Lieven Herbots, Frits W Prinzen, Tammo Delhaas, Joost Lumens","doi":"10.1093/europace/euaf082","DOIUrl":"10.1093/europace/euaf082","url":null,"abstract":"<p><strong>Aims: </strong>Previous studies have not examined the role of non-electrical myocardial disease substrates in determining the optimal atrio-ventricular delay (AVD) settings. We conducted virtual patient simulations to evaluate whether myocardial disease substrates influence the acute response to AVD optimization at rest and during exercise.</p><p><strong>Methods and results: </strong>The CircAdapt cardiovascular model was used to simulate various left ventricular (LV) remodelling found in cardiac resynchronization therapy candidates. We simulated electrical dyssynchrony, LV dilatation with preserved and reduced contractility, and increased LV passive stiffness. We simulated cardiac resynchronization following biventricular (BiVP) and non-selective LBB pacing (nsLBBP). The paced-AVD ranged from 220 to 40 ms. Cardiac output and heart rate were increased to simulate different levels of exercise. The optimal AVD was the one leading to the highest stroke volume (SV) and the lowest mean left atrial pressure (mLAP). At rest, in simulations with healthy myocardium the gain in SV by AVD optimization was larger compared to those with reduced contractility and stiff myocardium. However, mLAP was comparably decreased by AVD optimization in both healthy and diseased myocardium. During exercise, the optimal AVD shifted to shorter values, and mLAP was more sensitive to AVD, particularly in the presence of hypo-contractile and stiff myocardium.</p><p><strong>Conclusion: </strong>Simulations show that hypocontractility and stiffness reduce the effect of AVD optimization on SV but enhance its benefit in lowering mLAP. Notably, virtual patients with stiff ventricles experience greater benefits from AVD optimization during exercise compared to resting conditions. Furthermore, nsLBBP provides more favourable improvements in mLAP than BiVP.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802858","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":"Baseline and 10-year change in the number of ideal cardiovascular health metrics and sudden cardiac death in the community.","authors":"Jean-Philippe Empana, Marie-Cecile Perier, Peder Emile Warming, Eloi Marijon, Irene van Valkengoed, Frederik N Ågesen, Eva Prescott, Rezza Jabbari, Rachel E Climie, Petra Elders, Marieke T Blom, Peter J Schwartz, Hanno L Tan, J Tfelt-Hansen, Xavier Jouven","doi":"10.1093/europace/euaf046","DOIUrl":"10.1093/europace/euaf046","url":null,"abstract":"<p><strong>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 and results: </strong>The Copenhagen City Heart Study is a community-based prospective cohort study. The number of ideal CVH metrics (range 0-6; 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 10-year change thereof between 1981-83 and 1991-94 were evaluated. Definite SCD was defined as a death occurring within 1 h (eye-witnessed case) or within 24 h (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 (sHRs) were calculated to account for competing risk. The study population includes 8837 participants (57% women; mean age 57 years, ±15 years) in 1991-94. After a median follow-up of 22.6 years from 1 January 1993 up to 31 December 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% confidence interval (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). Effect size was lower for coronary death, all-cause mortality, and coronary heart disease events.</p><p><strong>Conclusion: </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":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953004/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}