Europace最新文献

{"title":"Novel systematic processing of cardiac magnetic resonance imaging identifies target regions associated with infarct-related ventricular tachycardia.","authors":"Alba Ramos-Prada, Andrés Redondo-Rodríguez, Ivo Roca-Luque, Andreu Porta-Sánchez, Rachel M A Ter Bekke, Jorge G Quintanilla, Javier Sánchez-González, Rafael Peinado, Jose Luis Merino, Matthijs Cluitmans, Robert J Holtackers, Manuel Marina-Breysse, Carlos Galán-Arriola, Daniel Enríquez-Vázquez, Sara Vázquez-Calvo, José Manuel Alfonso-Almazán, Gonzalo Pizarro, Borja Ibáñez, Juan José González-Ferrer, Ricardo Salgado-Aranda, Victoria Cañadas-Godoy, David Calvo, Julián Pérez-Villacastín, Nicasio Pérez-Castellano, David Filgueiras-Rama","doi":"10.1093/europace/euae244","DOIUrl":"10.1093/europace/euae244","url":null,"abstract":"<p><strong>Aims: </strong>There is lack of agreement on late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) imaging processing for guiding ventricular tachycardia (VT) ablation. We aim at developing and validating a systematic processing approach on LGE-CMR images to identify VT corridors that contain critical VT isthmus sites.</p><p><strong>Methods and results: </strong>This is a translational study including 18 pigs with established myocardial infarction and inducible VT undergoing in vivo characterization of the anatomical and functional myocardial substrate associated with VT maintenance. Clinical validation was conducted in a multicentre series of 33 patients with ischaemic cardiomyopathy undergoing VT ablation. Three-dimensional LGE-CMR images were processed using systematic scanning of 15 signal intensity (SI) cut-off ranges to obtain surface visualization of all potential VT corridors. Analysis and comparisons of imaging and electrophysiological data were performed in individuals with full electrophysiological characterization of the isthmus sites of at least one VT morphology. In both the experimental pig model and patients undergoing VT ablation, all the electrophysiologically defined isthmus sites (n = 11 and n = 19, respectively) showed overlapping regions with CMR-based potential VT corridors. Such imaging-based VT corridors were less specific than electrophysiologically guided ablation lesions at critical isthmus sites. However, an optimized strategy using the 7 most relevant SI cut-off ranges among patients showed an increase in specificity compared to using 15 SI cut-off ranges (70 vs. 62%, respectively), without diminishing the capability to detect VT isthmus sites (sensitivity 100%).</p><p><strong>Conclusion: </strong>Systematic imaging processing of LGE-CMR sequences using several SI cut-off ranges may improve and standardize procedure planning to identify VT isthmus sites.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282467","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":"Intermittent ventricular preexcitation in children: not always a low-risk condition.","authors":"Marie Laure Yammine, Pietro Paolo Tamborrino, Francesco Flore, Corrado Di Mambro, Vincenzo Pazzano, Sara Di Marzio, Fabrizio Drago","doi":"10.1093/europace/euae250","DOIUrl":"10.1093/europace/euae250","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344122","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: Outcomes of catheter ablation in high-risk patients with Brugada syndrome refusing an implantable cardioverter defibrillator implantation.","authors":"","doi":"10.1093/europace/euae249","DOIUrl":"10.1093/europace/euae249","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":"26 10","pages":""},"PeriodicalIF":7.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371306","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":"Transcatheter non-acute retrieval of the tine-based leadless ventricular pacemaker.","authors":"Moritoshi Funasako, Pavel Hála, Marek Janotka, Jan Šorf, Lucie Machová, Jan Petrů, Milan Chovanec, Jan Škoda, Lucie Šedivá, Jaroslav Šimon, Libor Dujka, Vivek Y Reddy, Petr Neužil","doi":"10.1093/europace/euae256","DOIUrl":"10.1093/europace/euae256","url":null,"abstract":"<p><strong>Aims: </strong>We report our single-centre experience of mid-term to long-term retrieval and reimplantation of a tine-based leadless pacemaker [Micra transcatheter pacing system (TPS)]. The TPS is a clinically effective alternative to transvenous single-chamber ventricular pacemakers. Whereas it is currently recommended to abandon the TPS at the end of device life, catheter-based retrieval may be favourable in specific scenarios.</p><p><strong>Methods and results: </strong>We report on nine consecutive patients with the implanted TPS who subsequently underwent transcatheter retrieval attempts. The retrieval system consists of the original TPS delivery catheter and an off-the-shelf single-loop 7 mm snare. The procedure was guided by fluoroscopy and intracardiac echocardiography. After an implantation duration of 3.1 ± 2.8 years (range 0.4-9.0), the overall retrieval success rate was 88.9% (8 of 9 patients). The mean procedure time was 89 ± 16 min, and the fluoroscopy time was 18.0 ± 6.6 min. No procedure-related adverse device events occurred. In the one unsuccessful retrieval, intracardiac echocardiography revealed that the TPS was partially embedded in the ventricular tissue surrounding the leadless pacemaker body in the right ventricle. After retrieval, three patients were reimplanted with a new TPS device. All implantations were successful without complications.</p><p><strong>Conclusion: </strong>A series of transvenous late retrievals of implanted TPS devices demonstrated safety and feasibility, followed by elective replacement with a new leadless pacing device or conventional transvenous pacing system. This provides a viable end-of-life management alternative to simple abandonment of this leadless pacemaker.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389084","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 effective refractory period personalization on arrhythmia vulnerability in patient-specific atrial computer models.","authors":"Patricia Martínez Díaz, Albert Dasí, Christian Goetz, Laura A Unger, Annika Haas, Armin Luik, Blanca Rodríguez, Olaf Dössel, Axel Loewe","doi":"10.1093/europace/euae215","DOIUrl":"10.1093/europace/euae215","url":null,"abstract":"<p><strong>Aims: </strong>The effective refractory period (ERP) is one of the main electrophysiological properties governing arrhythmia, yet ERP personalization is rarely performed when creating patient-specific computer models of the atria to inform clinical decision-making. This study evaluates the impact of integrating clinical ERP measurements into personalized in silico models on arrhythmia vulnerability.</p><p><strong>Methods and results: </strong>Clinical ERP measurements were obtained in seven patients from multiple locations in the atria. Atrial geometries from the electroanatomical mapping system were used to generate personalized anatomical atrial models. The Courtemanche M. et al. cellular model was adjusted to reproduce patient-specific ERP. Four modeling approaches were compared: homogeneous (A), heterogeneous (B), regional (C), and continuous (D) ERP distributions. Non-personalized approaches (A and B) were based on literature data, while personalized approaches (C and D) were based on patient measurements. Modeling effects were assessed on arrhythmia vulnerability and tachycardia cycle length, with sensitivity analysis on ERP measurement uncertainty. Mean vulnerability was 3.4 ± 4.0%, 7.7 ± 3.4%, 9.0 ± 5.1%, and 7.0 ± 3.6% for scenarios A-D, respectively. Mean tachycardia cycle length was 167.1 ± 12.6 ms, 158.4 ± 27.5 ms, 265.2 ± 39.9 ms, and 285.9 ± 77.3 ms for scenarios A-D, respectively. Incorporating perturbations to the measured ERP in the range of 2, 5, 10, 20, and 50 ms changed the vulnerability of the model to 5.8 ± 2.7%, 6.1 ± 3.5%, 6.9 ± 3.7%, 5.2 ± 3.5%, and 9.7 ± 10.0%, respectively.</p><p><strong>Conclusion: </strong>Increased ERP dispersion had a greater effect on re-entry dynamics than on vulnerability. Inducibility was higher in personalized scenarios compared with scenarios with uniformly reduced ERP; however, this effect was reversed when incorporating fibrosis informed by low-voltage areas. Effective refractory period measurement uncertainty up to 20 ms slightly influenced vulnerability. Electrophysiological personalization of atrial in silico models appears essential and requires confirmation in larger cohorts.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035551","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":"Lifetime cumulative activity burden is associated with symptomatic heart failure and arrhythmic risk in patients with arrhythmogenic right ventricular cardiomyopathy: a retrospective cohort study.","authors":"Leonhard Binzenhöfer, Sebastian Clauss, Katharina Strauß, Julia Höpler, Marie Kraft, Sabine Hoffmann, Stefan Brunner, Philipp Tomsits, Dominik Schüttler, Steffen Massberg, Stefan Kääb, Enzo Lüsebrink","doi":"10.1093/europace/euae236","DOIUrl":"10.1093/europace/euae236","url":null,"abstract":"<p><strong>Aims: </strong>Sports-related physical activity is associated with an increased risk of ventricular dysfunction and arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). However, there are currently no standardized strategies for activity assessment. Thresholds for harmful levels of physical activity suggested by previous studies vary substantially and neither lifetime activity burden nor continuous modelling approaches were considered.</p><p><strong>Methods and results: </strong>For this single-centre retrospective study, ARVC patients were interviewed to assess sports-related and non-sports-related physical activity between the age of 10 years and the last follow-up. Activity data were aggregated to the median metabolic equivalent of task-hours (METh) per week for each year. The association between cumulative physical activity burden and clinical study endpoints was investigated using Cox regression models. A total of 124 patients (median age: 39.5 years, 48% male) were included in the analysis, of whom 93 had been diagnosed with definite ARVC. Study participants reported a median overall activity of 202.3 METh/week, with 38.7 METh/week attributed to sports-related activity. In the continuous model, cumulative overall activity burden was associated with the occurrence of symptomatic heart failure [hazard ratio (HR) per 100 METh/week: 1.017, 95% CI (1.003, 1.032), P = 0.015], sustained ventricular tachycardia [HR: 1.021, 95% CI (1.006, 1.037), P = 0.007], and implantable cardioverter defibrillator interventions [HR: 1.017, 95%CI (1.000, 1.034), P = 0.048]. This finding was consistent when considering sports-related activity separately as a predictor variable, whereas the resulting hazard ratios did not show a significant association for non-sports-related physical activity.</p><p><strong>Conclusion: </strong>This study demonstrates for the first time that cumulative physical activity as a continuous predictor variable is associated with symptomatic heart failure and arrhythmic risk in ARVC patients. Collaborative research is required in larger cohorts to investigate the influence of potential confounders on event occurrence and to develop threshold recommendations for clinical practice.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282466","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 posterior mitral isthmus ablation in the absence of a vein of Marshall.","authors":"Clara François, Milad El Haddad, Benjamin De Becker, Maarten De Smet, Jean-Benoît Le Polain de Waroux, René Tavernier, Mattias Duytschaever, Sébastien Knecht","doi":"10.1093/europace/euae255","DOIUrl":"10.1093/europace/euae255","url":null,"abstract":"<p><strong>Aims: </strong>Achieving acute and durable mitral isthmus (MI) block remains challenging using radiofrequency (RF) catheter ablation alone. Vein of Marshall (VoM) ethanolization results in chemical damage along the MI resulting in the creation of a durable transmural lesion with a very high rate of procedural block. However, no studies have systematically assessed the efficacy of MI ablation alone when no anatomical VoM is present.</p><p><strong>Methods and results: </strong>Thirty seven patients without VoM evidenced after careful angiographic examination were included. Ablation parameters and result were compared with a matched control group in whom the posterior MI line was performed without assessing the presence of the VoM. Mitral isthmus block was achieved in 36 out of 37 patients without VoM (97%), with endocardial ablation only in 5/37 (14%) and combined endocardial and coronary sinus ablation in 32/37 patients (86%). There was a significant difference in the occurrence of block between patients without a VoM and the control group (97.3% vs. 65% respectively, P < 0.01), with a trend towards less needed RF {26 [interquartile range (IQR) 20-38] vs. 29 [IQR 19-40] tags [P = 0.8], 611 [IQR 443-805] vs. 746 [IQR 484-1193] seconds [P = 0.08]}.</p><p><strong>Conclusion: </strong>The absence of a VoM is associated with a very high rate of procedural block during posterior MI ablation. The higher rate of MI block in this specific population would also suggest the crucial role of the VoM (when present) in resistant MI block.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344120","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":"Smartphone app-based approximation of time spent with atrial fibrillation and symptoms in patients after catheter ablation: data from the TeleCheck-AF project.","authors":"Emma Sandgren, Astrid N L Hermans, Monika Gawalko, Konstanze Betz, Afzal Sohaib, Chi Ho Fung, Henrike A K Hillmann, Rachel M J van der Velden, Dominique Verhaert, Daniel Scherr, Arian Sultan, Daniel Steven, Ron Pisters, Martin Hemels, Piotr Lodziński, Sevasti-Maria Chaldoupi, Dhiraj Gupta, Henri Gruwez, Nikki A H A Pluymaekers, Jeroen M Hendriks, Malene Nørregaard, Martin Manninger, David Duncker, Dominik Linz","doi":"10.1093/europace/euae247","DOIUrl":"10.1093/europace/euae247","url":null,"abstract":"<p><strong>Aims: </strong>Reduction of atrial fibrillation (AF) burden is the preferred outcome measure over categorical AF rhythm recurrence after AF ablation. In this sub-analysis of the TeleCheck-AF project, we tested the feasibility of smartphone app-based approximation of time spent with AF and/or symptoms.</p><p><strong>Methods and results: </strong>Patients scheduled for at least one teleconsultation during the 12-month follow-up after AF ablation were instructed to use a smartphone photoplethysmography-based application for simultaneous symptom and rhythm monitoring three times daily for 1 week. Proxies of time spent with AF and/or symptoms (% recordings, load, and % days), temporal aggregation of AF and/or symptoms (density), and symptom-rhythm correlation (SRC) were assessed. In total, 484 patients (60% male, 62 ± 9.9 years) were included. Adherence, motivation, and patient satisfaction were high. %AF recordings, AF load, and %AF days (rs = 0.88-0.95) and %symptom recordings, symptom load, and %symptom days (rs = 0.95-0.98) showed positive correlations. The SRC correlated negatively with time spent with symptoms (rs = -0.65-0.90) and with time spent with AF (rs = -0.31-0.34). In patients with paroxysmal AF before ablation and AF during the monitoring period, 87% (n = 39/44) had a low-density score <50% ('paroxysmal AF pattern') while 5% (n = 2/44) had a high-density score >90% ('persistent AF pattern'). Corresponding numbers for patients with persistent AF before ablation were 48% (n = 11/23) and 43% (n = 10/23), respectively.</p><p><strong>Conclusion: </strong>On-demand, app-based simultaneous rhythm and symptom assessment provides objective proxies of time spent with AF and/or symptoms and SRC, which may assist in assessing AF and symptom outcomes after AF ablation.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344125","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":"Cavotricuspid isthmus ablation using a pentaspline pulsed field ablation catheter: feasibility and acute results.","authors":"Corentin Chaumont, Pierre Ollitrault, Arnaud Savoure, Raphael Al Hamoud, Jonaz Font, Helene Eltchaninoff, Paul Milliez, Laure Champ-Rigot, Frederic Anselme","doi":"10.1093/europace/euae262","DOIUrl":"https://doi.org/10.1093/europace/euae262","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":"26 10","pages":""},"PeriodicalIF":7.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497518","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":"SARS-CoV-2 ORF 3a-mediated currents are inhibited by antiarrhythmic drugs.","authors":"Felix Wiedmann, Emika Boondej, Megan Stanifer, Amelie Paasche, Manuel Kraft, Merten Prüser, Timon Seeger, Ulrike Uhrig, Steeve Boulant, Constanze Schmidt","doi":"10.1093/europace/euae252","DOIUrl":"https://doi.org/10.1093/europace/euae252","url":null,"abstract":"<p><strong>Aims: </strong>Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been linked to cardiovascular complications, notably cardiac arrhythmias. The open reading frame (ORF) 3a of the coronavirus genome encodes for a transmembrane protein that can function as an ion channel. The aim of this study was to investigate the role of the SARS-CoV-2 ORF 3a protein in COVID-19-associated arrhythmias and its potential as a pharmacological target.</p><p><strong>Methods and results: </strong>Human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM) and cultured human fibroblasts were infected with SARS-CoV-2. Subsequent immunoblotting assays revealed the expression of ORF 3a protein in hiPSC-CM but not in fibroblasts. After intracytoplasmic injection of RNA encoding ORF 3a proteins into Xenopus laevis oocytes, macroscopic outward currents could be measured. While class I, II, and IV antiarrhythmic drugs showed minor effects on ORF 3a-mediated currents, a robust inhibition was detected after application of class III antiarrhythmics. The strongest effects were observed with dofetilide and amiodarone. Finally, molecular docking simulations and mutagenesis studies identified key amino acid residues involved in drug binding.</p><p><strong>Conclusion: </strong>Class III antiarrhythmic drugs are potential inhibitors of ORF 3a-mediated currents, offering new options for the treatment of COVID-19-related cardiac complications.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"26 10","pages":""},"PeriodicalIF":7.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461059","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}