Europace最新文献

{"title":"Tissue characterization using cardiac magnetic resonance imaging and response to cardiac resynchronization therapy.","authors":"Se-Eun Kim, Jaewon Oh, Yoo Jin Hong, Daehoon Kim, Hee Tae Yu, Chan Joo Lee, Tae-Hoon Kim, Jae-Sun Uhm, Boyoung Joung, Hui-Nam Pak, Moon-Hyoung Lee, Young Jin Kim, Seok-Min Kang","doi":"10.1093/europace/euaf043","DOIUrl":"10.1093/europace/euaf043","url":null,"abstract":"<p><strong>Aims: </strong>Cardiac magnetic resonance (CMR) imaging for tissue characterization offers valuable insights for risk stratification among patients with cardiomyopathy. This study aimed to assess the prognostic value of CMR-based tissue characterization in predicting response to cardiac resynchronization therapy (CRT) in patients with non-ischaemic cardiomyopathy (NICM).</p><p><strong>Methods and results: </strong>Retrospective analysis was performed on CMR data from NICM patients before CRT implantation. Various CMR parameters, including the late gadolinium enhancement (LGE), native T1, T2, and extracellular volume (ECV), were analysed. Among the 101 patients (mean age: 66 years, male: 52.5%), 72 (71.3%) were CRT responders. The CRT responders had lower LGE burden (13.1 vs. 35.3%, P < 0.001), native T1 (1334.5 vs. 1371.6 ms, P = 0.012), T2 (42.2 vs. 45.7 ms, P < 0.001), and ECV (30.8 vs. 36.8%, P < 0.001) compared with CRT non-responders. After adjusting for other risk factors, LGE burden ≤ 20% [odds ratio (OR): 22.61, 95% confidence interval (CI): 4.73-176.68, P < 0.001], ECV ≤ 34% (OR: 15.93, 95% CI: 3.01-115.13, P = 0.002), and T2 ≤ 45 ms (OR: 8.10, 95% CI: 1.82-43.75, P = 0.008) were identified as predictors of good CRT response and favourable clinical outcomes (log-rank P < 0.001).</p><p><strong>Conclusion: </strong>Cardiac magnetic resonance-based tissue parameters effectively predict CRT response and clinical outcomes in patients with NICM, independently of conventional predictors.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 4","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11982015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004308","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":"Epicardial ventricular arrhythmia ablation: a clinical consensus statement of the European Heart Rhythm Association of the European Society of Cardiology and the Heart Rhythm Society, the Asian Pacific Heart Rhythm Society, the Latin American Heart Rhythm Society, and the Canadian Heart Rhythm Society.","authors":"Arash Arya, Luigi Di Biase, Victor Bazán, Antonio Berruezo, Andrea d'Avila, Paolo Della Bella, Andres Enriquez, Mélèze Hocini, Josef Kautzner, Hui-Nam Pak, William G Stevenson, Katja Zeppenfeld, Alireza Sepehri Shamloo, Christian Meyer, Christian de Chillou, Thomas Deneke, Marta de Riva, Andreu Porta-Sanchez, John Sapp, Boris Schmidt, Kalyanam Shivkumar, Philipp Sommer, Kyoko Soejima, Gregory E Supple, Arthur Wilde, Giulio Zucchelli","doi":"10.1093/europace/euaf055","DOIUrl":"10.1093/europace/euaf055","url":null,"abstract":"<p><p>Epicardial access during electrophysiology procedures offers valuable insights and therapeutic options for managing ventricular arrhythmias (VAs). The current clinical consensus statement on epicardial VA ablation aims to provide clinicians with a comprehensive understanding of this complex clinical scenario. It offers structured advice and a systematic approach to patient management. Specific sections are devoted to anatomical considerations, criteria for epicardial access and mapping evaluation, methods of epicardial access, management of complications, training, and institutional requirements for epicardial VA ablation. This consensus is a joint effort of collaborating cardiac electrophysiology societies, including the European Heart Rhythm Association, the Heart Rhythm Society, the Asia Pacific Heart Rhythm Society, the Latin American Heart Rhythm Society, and the Canadian Heart Rhythm Society.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 4","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751741","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":"Flecainide and atrial fibrillation cardioversion: what solutions at present and in the near future?","authors":"Marco Vitolo, Davide Antonio Mei, Giuseppe Boriani","doi":"10.1093/europace/euaf063","DOIUrl":"10.1093/europace/euaf063","url":null,"abstract":"","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/PMC11992564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751815","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":"External validation of a machine learning-based classification algorithm for ambulatory heart rhythm diagnostics in pericardioversion atrial fibrillation patients using smartphone photoplethysmography: the SMARTBEATS-ALGO study.","authors":"Jonatan Fernstad, Emma Svennberg, Peter Åberg, Katrin Kemp Gudmundsdottir, Anders Jansson, Johan Engdahl","doi":"10.1093/europace/euaf031","DOIUrl":"10.1093/europace/euaf031","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study was to perform an external validation of an automatic machine learning (ML) algorithm for heart rhythm diagnostics using smartphone photoplethysmography (PPG) recorded by patients with atrial fibrillation (AF) and atrial flutter (AFL) pericardioversion in an unsupervised ambulatory setting.</p><p><strong>Methods and results: </strong>Patients undergoing cardioversion for AF or AFL performed 1-min heart rhythm recordings pericardioversion at least twice daily for 4-6 weeks, using an iPhone 7 smartphone running a PPG application (CORAI Heart Monitor) simultaneously with a single-lead electrocardiogram (ECG) recording (KardiaMobile). The algorithm uses support vector machines to classify heart rhythm from smartphone-PPG. The algorithm was trained on PPG recordings made by patients in a separate cardioversion cohort. Photoplethysmography recordings in the external validation cohort were analysed by the algorithm. Diagnostic performance was calculated by comparing the heart rhythm classification output to the diagnosis from the simultaneous ECG recordings (gold standard). In total, 460 patients performed 34 097 simultaneous PPG and ECG recordings, divided into 180 patients with 16 092 recordings in the training cohort and 280 patients with 18 005 recordings in the external validation cohort. Algorithmic classification of the PPG recordings in the external validation cohort diagnosed AF with sensitivity, specificity, and accuracy of 99.7%, 99.7% and 99.7%, respectively, and AF/AFL with sensitivity, specificity, and accuracy of 99.3%, 99.1% and 99.2%, respectively.</p><p><strong>Conclusion: </strong>A machine learning-based algorithm demonstrated excellent performance in diagnosing atrial fibrillation and atrial flutter from smartphone-PPG recordings in an unsupervised ambulatory setting, minimizing the need for manual review and ECG verification, in elderly cardioversion populations.</p><p><strong>Clinical trial registration: </strong>Clinicaltrials.gov, NCT04300270.</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/PMC11965787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440388","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 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-centre 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":"10.1093/europace/euaf039","url":null,"abstract":"","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/PMC11983383/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical profile and outcomes among patients with cardiac implantable electronic device presenting as isolated pocket infection, pocket-related infective endocarditis, or lead-related infective endocarditis.","authors":"Wojciech Jacheć, Anna Polewczyk, Dorota Nowosielecka, Andrzej Kutarski","doi":"10.1093/europace/euaf053","DOIUrl":"10.1093/europace/euaf053","url":null,"abstract":"<p><strong>Aims: </strong>The clinical spectrum of cardiac implantable electronic device (CIED) infections includes isolated pocket infection (IPI), pocket infection complicated by infective endocarditis (PIRIE), and lead-related infective endocarditis (LRIE). The aim of this study was to assess the risk factors, clinical course, and outcomes in patients with CIED infections and to demonstrate differences between PIRIE and LRIE.</p><p><strong>Methods and results: </strong>The retrospective analysis of data from 3847 patients undergoing transvenous lead extraction for non-infectious (2640; 68.62%) and infectious (1207; 31.38%) indications, including 361 (29.91%) IPI, 472 (39.11%) PIRIE, and 374 (30.99%) LRIE, showed some differences in risk factors, clinical course, and outcomes between the subgroups. Unlike PIRIE, diabetes [hazard ratio (HR) = 1.488; 95% confidence interval (CI; 1.178-1.879), P < 0.001] and lead abrasion [HR = 2.117; 95% CI (1.665-2.691), P < 0.001] increased the risk of LRIE. The risk of pocket infection spread was greater with Staphylococcus aureus infection [HR = 1.596; 95% CI (1.202-2.120), P < 0.001]. Compared with LRIE, patients with PIRIE had lower levels of inflammatory markers and lower prevalence of vegetations. Mortality in PIRIE compared with LRIE patients was lower (53.18 vs. 62.30%; P < 0.001) and comparable to IPI (50.69%; P = 0.162) at long-term [median 1828 (815-3139) days] follow-up.</p><p><strong>Conclusion: </strong>Cardiac implantable electronic device infections share common risk factors; however, diabetes and intra-cardiac lead abrasion predispose to LRIE, whereas multiple leads and S. aureus in pocket culture are risk factors for pocket infection spread. Compared with LRIE, the clinical course of PIRIE was milder, and short- and long-term mortalities were lower, but comparable with IPI after >1 year. This may be an argument in favour of categorization into primary LRIE and secondary endocarditis, i.e. PIRIE.</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/PMC11982440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624075","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":"Feasibility of a 90-watt, 3-second radiofrequency application for superior vena cava isolation during atrial fibrillation ablation.","authors":"Takashi Kaneshiro, Sadanori Murota, Minoru Nodera, Shinya Yamada, Masayoshi Oikawa, Yasuchika Takeishi","doi":"10.1093/europace/euaf056","DOIUrl":"10.1093/europace/euaf056","url":null,"abstract":"","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/PMC11953002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647755","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":"Dronedarone provides effective early rhythm control: post-hoc analysis of the ATHENA trial using EAST-AFNET 4 criteria.","authors":"Paulus Kirchhof, A John Camm, Harry J G M Crijns, Jonathan P Piccini, Christian Torp-Pedersen, David S McKindley, Mattias Wieloch, Stefan H Hohnloser","doi":"10.1093/europace/euaf080","DOIUrl":"10.1093/europace/euaf080","url":null,"abstract":"<p><strong>Aims: </strong>This post-hoc analysis of the ATHENA trial assessed whether dronedarone (400 mg twice daily) improved cardiovascular outcomes compared with placebo in patients with early atrial fibrillation/atrial flutter (AF) and cardiovascular comorbidities, based on EAST-AFNET 4 inclusion criteria and outcomes.</p><p><strong>Methods and results: </strong>The co-primary outcomes were (i) a composite of cardiovascular death, stroke, or hospitalisation due to worsening of heart failure (HF) or acute coronary syndrome (ACS) and (ii) nights spent in hospital per year. Sinus rhythm (SR) at 12 months was a secondary outcome. The primary safety outcome was a composite of death, stroke, or pre-specified serious adverse events of special interest (AESIs) related to rhythm control therapy. 1810 patients with early AF were identified. Patients receiving dronedarone had fewer deaths from cardiovascular causes, strokes, or hospitalisations due to worsening of HF or ACS compared with patients receiving placebo [dronedarone (n = 924), 87 patients with ≥1 event; placebo (n = 886), 117 patients with ≥1 event; hazard ratio 0.71; 95% confidence interval 0.54-0.94; P = 0.014]. Number of nights spent in hospital did not differ between treatment groups. More patients receiving dronedarone (69.2%) were in SR at 12 months compared with placebo (60.8%). Primary safety events comprising death, stroke, or pre-specified serious AESIs related to rhythm control therapy were not different (dronedarone vs. placebo: 60 vs. 71 patients with ≥1 event).</p><p><strong>Conclusion: </strong>These data support the use of dronedarone for early rhythm control therapy in selected patients with early AF.</p><p><strong>Trial registration: </strong>ATHENA: ClinicalTrials.gov identifier NCT00174785. EAST-AFNET 4: ClinicalTrials.gov identifier NCT01288352.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"27 4","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980471","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":"Characterization of ventricular tachycardia ablation in end-stage heart failure patients with left ventricular assist device (CHANNELED registry).","authors":"Jan-Hendrik van den Bruck, Felix Hohendanner, Emanuel Heil, Karolin Albert, David Duncker, Heidi Estner, Thomas Deneke, Abdul Parwani, Evgenij Potapov, Katharina Seuthe, Jonas Wörmann, Arian Sultan, Jan-Hendrik Schipper, Lars Eckardt, Florian Doldi, Patrick Lugenbiel, Helge Servatius, Gregor Thalmann, Tobias Reichlin, Moneeb Khalaph, Denise Guckel, Philipp Sommer, Daniel Steven, Jakob Lüker","doi":"10.1093/europace/euaf054","DOIUrl":"10.1093/europace/euaf054","url":null,"abstract":"<p><strong>Aims: </strong>Patients with left ventricular assist devices (LVADs) are at high risk for ventricular tachycardia (VT), and data on VT ablation in patients with LVAD are scarce. This multicentre registry assessed the mechanism of VT, procedural parameters, and outcome of VT ablation in patients with LVAD (NCT06063811).</p><p><strong>Methods and results: </strong>Data of patients with LVAD referred for VT ablation at nine tertiary care centres were collected retrospectively. Parameters included VT mechanisms, procedural data, VT recurrence, and mortality. Overall, 69 patients (90% male, mean age 60.7 ± 8.4 years) undergoing 72 ablation procedures were included. Most procedures were conducted after intensification of antiarrhythmic drug (AAD) treatment (18/72; 25%) or a prior combination of ≥2 AADs (31/72; 43%). Endocardial low-voltage areas were detected in all patients. The predominant VT mechanism was scar-related re-entry (76/96 VTs; 79%), and 19/96 VTs (20%) were related to the LVAD cannula. Non-inducibility of any VT was achieved in 28/72 procedures (39%). No LVAD-related complication was observed. The extent of endocardial scar was associated with VT recurrence. The median follow-up was 283 days (interquartile range 70-587 days). A total of 3/69 patients were lost to follow-up, 10/69 (14%) were transplanted, 26/69 (38%) died, and 16/69 (23%) patients were free from VT.</p><p><strong>Conclusion: </strong>Although often a last resort, VT ablation in patients with LVAD is feasible and safe when performed in experienced centres. These patients suffer from a high scar burden, and cardiomyopathy-associated rather than cannula-related scar seems to be the dominant substrate. Ventricular tachycardia recurrence is high despite extensive treatment, and the overall prognosis is limited.</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/PMC11983390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656571","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":"Socio-economic position and sudden cardiac death: a Danish nationwide study.","authors":"Toke Stahl Jacobsen, Tobias Skjelbred, Lars Køber, Bo Gregers Winkel, Thomas Hadberg Lynge, Jacob Tfelt-Hansen","doi":"10.1093/europace/euaf001","DOIUrl":"10.1093/europace/euaf001","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study was to examine differences in incidence rates of all-cause mortality (ACM) and sudden cardiac death (SCD) in persons of differing socio-economic position (SEP).</p><p><strong>Methods and results: </strong>All deaths in Denmark from 1 January to 31 December 2010 (1 year) were included. Autopsy reports, death certificates, discharge summaries, and nationwide health registries were reviewed to identify cases of SCD. Socio-economic position was measured as either household income or highest achieved educational level and analysed separately. Hazard rates were calculated using univariate and multivariable Cox regression models adjusting for age, sex, and selected comorbidities. A total of 53 452 deaths were included, of which 6820 were classified as SCDs. Incidence rates of ACM and SCD increased with age and were higher in the lower SEP groups. The greatest difference in SCD incidence was found between the low and high education level groups, with an incidence rate ratio of 5.1 (95% confidence interval 3.8-6.8). The hazard ratios for ACM and SCD were significantly higher for low SEP groups, independent of comorbidities. Compared with the highest income group, the low-income group had adjusted hazard ratios of ACM and SCD that were 2.17 (2.01-2.34) and 1.72 (1.67-1.76), respectively.</p><p><strong>Conclusion: </strong>We observed an inverse association between both income and education level and the risk of ACM and SCD in the general population, which persisted independently of baseline comorbidities. Our results indicate a need for further research into the mechanisms behind socio-economic disparities in healthcare and targeted preventative strategies.</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/PMC11982016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002610","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}