Europace最新文献

{"title":"Algorithm-guided personalized pulsed field ablation for persistent atrial fibrillation: a prospective multicentre study with matched external comparison.","authors":"Frédéric Anselme, Decebal Gabriel Lațcu, Théo Méral, Arnaud Savoure, Serge Boveda, Pascal Defaye, Sandrine Venier, Grégoire Massoullié, Pierre Ollitrault, Olivier Thomas, Raphaël Al Hamoud, Maria-Alexandra Nicola, Corentin Chaumont","doi":"10.1093/europace/euag225","DOIUrl":"10.1093/europace/euag225","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839709","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":"COnCOmitaNt pulsed field ablation-based pUlmonary vein isolation and lefT atrial appendage closure: the COCONUT study.","authors":"Christian-Hendrik Heeger, Laurent Roten, Domenico Della Rocca, Vedran Velagić, Dhiraj Gupta, Tom De Potter, Christian Sticherling, Lukas Urbanek, Boris Schmidt, Abdul Shokor Parwani, Ignacio Garcia-Bolao, Rocco Arancio, Amr Nawar, Shibu Mathew, Jennifer Beney, Henning Rolfes, Kolya Sievert, Serge Boveda, Antoine Lepillier, Marjorie Niro, Reza Wakili, Alexander Steger, Ahmad Awada, Vedran Pasara, Grégoire Massoullié, Andrija Nekic, Maarten Vanhaverbeke, Alexandre Almorad, Romain Eschalier, Maxim Didenko, Marco Contarini, Lorenz Räber, Jan-Per Wenzel, Manuel Rattka, Daniel Scherr, Roland Richard Tilz, Martin W Bergmann","doi":"10.1093/europace/euag198","DOIUrl":"10.1093/europace/euag198","url":null,"abstract":"<p><strong>Aims: </strong>Atrial fibrillation (AF) ablation by pulmonary vein isolation (PVI) and left atrial appendage closure (LAAC) are increasingly performed as standalone procedures. Given that PVI and LAAC share the same access route, a combined approach of pulsed field ablation (PFA)-based PVI and LAAC might be beneficial. The COCONUT study focused on safety, efficacy, and outcomes combining PVI by PFA with LAAC in one procedure.</p><p><strong>Methods: </strong>This is a retrospective, multinational registry study. The primary endpoints were the following: (1) primary safety endpoint: serious adverse events; and (2) primary efficacy endpoint: success of PVI and LAA closure defined as the ability to isolate all pulmonary veins and the successful closure of the LAA. For secondary endpoints, peri-procedural data and follow-up data were collected.</p><p><strong>Results: </strong>A total of 155 patients from 22 centres of nine European countries were treated by concomitant pentaspline catheter PFA-based PVI and LAAC. The mean CHA2DS2-VA score was 3.1 ± 1.4. The primary efficacy endpoint was achieved at 97.4% with successful PVI at 100% and successful LAAC in 151/155 patients (97.4%). The primary safety endpoint was observed in 3/155 patients (1.9%). Transoesophageal echocardiography and/or CCTA 67 ± 26 days after the procedure showed no device embolization and no device-related thrombus, 24/151 (15.9%) patients showed peri-device gaps of <5 mm while gaps of >5 mm have been observed in 3/151 (2.0%). Among 137/155 patients with available arrhythmia, a follow-up >6 months at 78.1% showed sinus rhythm.</p><p><strong>Conclusion: </strong>In this large multicentre study, concomitant PFA-based AF ablation and LAA closure proved to be feasible, effective, and safe and overall procedure duration was short.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"28 9","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911240","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":"Amiodarone dose to treat ventricular tachycardia in Chagas cardiomyopathy.","authors":"Henrique Horta Veloso, Mauro Felippe Felix Mediano","doi":"10.1093/europace/euag142","DOIUrl":"10.1093/europace/euag142","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":"28 9","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988438","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":"Impaired sinus rate behaviour during ventricular arrhythmia is associated with adverse outcomes in implantable cardioverter-defibrillator recipients.","authors":"Maarten Blondeel, Stien Goris, Eva Goethals, Margot Vermeiren, Sebastian Ingelaere, Gábor Vörös, Thomas Rosseel, Christophe Garweg, Peter Haemers, Joris Ector, Rik Willems, Tomas Robyns, Tom De Potter, Bert Vandenberk","doi":"10.1093/europace/euag251","DOIUrl":"10.1093/europace/euag251","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886828","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":"Bleeding-related conditions, procedural safety, and mortality after left atrial appendage closure.","authors":"Grégoire Massoullié, Come Fleury, Emeline Tourret, Simon Berger, Catherine Basthier-Denis, Guillaume Clerfond, Pierre-Antoine Catalan, Aurélie Chalard, Clément Riocreux, Aurélien Lebreton, Bruno Pereira, Romain Eschalier","doi":"10.1093/europace/euag235","DOIUrl":"10.1093/europace/euag235","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886833","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":"The latest Fontan paradox: when less is more (difficult).","authors":"Jeremy P Moore, Thomas Paul, Susan P Etheridge","doi":"10.1093/europace/euag239","DOIUrl":"10.1093/europace/euag239","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":"28 9","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963208","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":"Identifying patients at low risk for atrial fibrillation after cryptogenic stroke: the PAVA score.","authors":"Baptiste Maille, Noémie Resseguier, Eloi Marijon, Nathalie Behar, Marc Badoz, Fabrice Vuillier, Cecile Malrain, Claire Grygorowicz, Victor Klein, Aymeric Menet, Maryam Dridi, Christelle Haddad, David Calvet, Laurent Suissa, Luciano A Sposato, Jean-Claude Deharo, Yannick Bejot, Charles Guenancia","doi":"10.1093/europace/euag183","DOIUrl":"10.1093/europace/euag183","url":null,"abstract":"<p><strong>Aims: </strong>Continuous cardiac monitoring with implantable loop recorders (ILRs) is recommended after cryptogenic stroke to detect occult atrial fibrillation (AF). We aimed to develop and validate a dedicated risk score for AF detection in patients undergoing ILR monitoring after cryptogenic stroke.</p><p><strong>Methods and results: </strong>This multicentre study enrolled 1002 consecutive patients (mean age 66.0 ± 12.3 years, 57.9% male) who received an ILR after cryptogenic stroke. The primary outcome was a first episode of AF or atrial tachycardia (AT). A score was developed in a randomly split development cohort and validated internally, accounting for competing risks, missing data imputation, and hazard ratio-based weighting. Among the 668 patients in the development cohort, cumulative incidences of AF/AT at 1, 2, and 3 years were 20.3%, 28.9%, and 33.0%, respectively. Four independent predictors were identified: premature atrial contractions > 200/24 h on Holter-ECG (2 points), age >58-78 years (3 points) or > 78 years (4 points), significant valvular heart disease (1 point), and left atrial dilatation (2 points), forming the PAVA (premature atrial contractions, age, significant valvular heart disease, and left atrial dilatation) score. Discrimination was good in both the development and validation cohorts (c-index 0.73 and 0.79, respectively). The 3-year areas under the curve were 0.800 and 0.905, respectively. A PAVA score ≤ 2, observed in 23.6% of patients, yielded negative predictive values of 89.2% and 100% in the development and validation cohorts. ROC-curve analysis confirmed superior clinical utility over existing scores (Brown ESUS-AF [Brown embolic stroke of undetermined source-atrial fibrillation], HAVOC).</p><p><strong>Conclusion: </strong>A PAVA score ≤ 2 demonstrates a high negative predictive value for AF/AT on ILR after cryptogenic stroke, offering a practical tool to optimize patient prioritization for ILR implantation.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"28 9","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905560","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":"Multicentre experience with the variable-loop circular catheter pulsed-field ablation system for atrial fibrillation ablation.","authors":"Antonio Dello Russo, Yari Valeri, Giuseppe Ciconte, Marco Schiavone, Paolo Compagnucci, Sara Poggi, Raffaele Salerno, Antonio Di Monaco, Lorenzo Gigli, Daniela Aschieri, Stefania Riva, Matteo Anselmino, Livio Bertagnolli, Luca Rossi, Patrizio Mazzone, Giuseppe Stabile, Michela Casella, Massimo Grimaldi, Claudio Tondo, Carlo Pappone","doi":"10.1093/europace/euag265","DOIUrl":"10.1093/europace/euag265","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976183","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":"Incidence and clinical implications of ventricular tachycardia: a population-based approach.","authors":"Peter Vibe Rasmussen, Anders Holt, Jacob Tønnesen, Charlotte Middelfart, Morten Lamberts, Jacob Tfelt-Hansen, Martin H Ruwald, Peter Karl Jacobsen, Morten Lock Hansen","doi":"10.1093/europace/euag234","DOIUrl":"10.1093/europace/euag234","url":null,"abstract":"","PeriodicalId":11981,"journal":{"name":"Europace","volume":" ","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886789","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":"Programmed ventricular stimulation for risk stratification in symptomatic athletes with nonischemic left ventricular scar and preserved ejection fraction.","authors":"Luigi Sciarra, Fabrizio Ricci, Elena Cavarretta, Zefferino Palamà, Alessio Borrelli, Mauro Di Roma, Leonardo Pignalosa, Federico Zanin, Daniele Falco, Giulia Renda, Cesare Mantini, Sabina Gallina, Francesco Brancati, Silvio Romano, Antonio Scarà","doi":"10.1093/europace/euag160","DOIUrl":"10.1093/europace/euag160","url":null,"abstract":"<p><strong>Aims: </strong>Non-ischaemic left ventricular (LV) scar is increasingly recognized in athletes with preserved left ventricular ejection fraction (LVEF) and may represent a substrate for malignant ventricular arrhythmias. The role of electrophysiological study (EPS) with programmed ventricular stimulation (PVS) for risk stratification in this population remains unclear. This study aimed to evaluate the prognostic value of inducibility at EPS in symptomatic athletes with non-ischaemic LV scar and preserved LVEF.</p><p><strong>Methods and results: </strong>We prospectively enrolled 72 consecutive athletes (mean age 48.9 ± 13.1 years; 66.7% male) with documented non-ischaemic LV scar, preserved LVEF (≥50%), and arrhythmic symptoms (tachycardic palpitations, syncope/presyncope, and/or exercise-related ventricular arrhythmias) undergoing EPS. Inducibility was defined as sustained ventricular arrhythmias during PVS. The primary endpoint was the occurrence of major arrhythmic events (MAE), including sudden cardiac death, sustained ventricular tachycardia/ventricular fibrillation, or appropriate implantable cardioverter-defibrillator therapy. Twenty-three athletes (31.9%) were inducible (EPS+), while 49 (68.1%) were non-inducible (EPS-). Baseline characteristics were largely comparable between groups, although QRS duration was longer in inducible athletes (104.6 ± 15.2 ms vs. 95.5 ± 14.3 ms; P = 0.019). Twenty-three inducible athletes underwent ICD implantation (18 transvenous and 5 subcutaneous devices), whereas 16 non-inducible athletes received an implantable loop recorder. During a median follow-up of 42 months, 11 major arrhythmic events occurred. Nine events occurred among inducible athletes and consisted of sustained ventricular arrhythmias (monomorphic VT, polymorphic VT, or ventricular fibrillation) successfully terminated by appropriate ICD therapy, whereas two major arrhythmic events occurred among non-inducible athletes and required successful resuscitation followed by ICD implantation. No arrhythmic deaths occurred during follow-up. Event-free survival at 50 months was 40.6% in inducible athletes and 95.9% in non-inducible athletes (log-rank P < 0.001).</p><p><strong>Conclusion: </strong>In symptomatic athletes with non-ischaemic LV scar and preserved LVEF, inducibility at EPS identifies a subgroup at higher risk of MAE, whereas non-inducibility is associated with a low event rate. EPS may represent a useful adjunctive tool for arrhythmic risk stratification in athletes, particularly in those without conventional high-risk features.</p>","PeriodicalId":11981,"journal":{"name":"Europace","volume":"28 9","pages":""},"PeriodicalIF":10.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905576","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}