Europace最新文献

{"title":"Minimized atrial pacing and atrial fibrillation burden in the DANPACE II trial.","authors":"Maria Hee Jung Park Frausing, Frederik Mikkelsen, Mads Brix Kronborg, Jacob Moesgaard Larsen, Katja Fiedler Holm, Andi Eie Albertsen, Lene Svendstrup, Ulrik Hintze, Ole Dyg Pedersen, Ulla Davidsen, Thomas Fischer, Jens Brock Johansen, Christian Gerdes, Jens Cosedis Nielsen","doi":"10.1093/europace/euag254","DOIUrl":"10.1093/europace/euag254","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/PMC13598333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891288","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":"Selective activation of tetrodotoxin-sensitive sodium channels by AaH-II drives arrhythmogenic late Na+ current in the heart.","authors":"Hugo Millet, Maureen Choteau-Bodor, Thomas Stervinou, Floriane Bibault, Sarah Godin, Pauline Belhumeur, Matthias Dereli, Agnès Hivonnait, Morteza Erfanian, Agnès Tessier, Aurore Girardeau, Guillaume Lamirault, Flavien Charpentier, Mikael Croyal, Nathalie Gaborit, Jérôme Montnach, Michel De Waard","doi":"10.1093/europace/euag249","DOIUrl":"10.1093/europace/euag249","url":null,"abstract":"<p><p>Increased late sodium current (INaL) is a central mechanism underlying both inherited and acquired cardiac arrhythmias. Although Nav1.5 is the dominant cardiac sodium channel, multiple tetrodotoxin-sensitive (TTX-S) Nav isoforms are also expressed in cardiomyocytes, particularly within transverse tubules, where they influence excitation-contraction coupling. Whether these channels contribute directly to pathological INaL and arrhythmogenesis remains unresolved, in part because available pharmacological tools lack isoform selectivity. Herein, our objective was to determine the contribution of TTX-S Nav channels to pathological cardiac INaL and arrhythmia and to establish selective pharmacological tools to dissect their role. Using automated patch-clamp and human Nav isoform profiling, we show that the reference INaL inducer ATX-II predominantly activates TTX-resistant Nav1.5 Nav channels. However, ATX-II lacks Nav isoform selectivity when inappropriately used, questioning the conclusions reached by numerous cardiac INaL studies. In contrast, AaH-II, a peptide from Androctonus australis hector scorpion venom, more selectively and potently enhances INaL through TTX-S Nav isoforms. In human iPS-derived cardiomyocytes, TTX-S INaL leads to action potential prolongation. In adult ventricular cardiomyocytes, AaH-II induces abnormal Ca2+ handling and spontaneous Ca2+ release events. In isolated hearts and in vivo, selective TTX-S INaL activation produces conduction abnormalities, QT prolongation, and ventricular proarrhythmic events, which are prevented by nanomolar tetrodotoxin concentrations that spare Nav1.5. These findings demonstrate that TTX-S sodium channels are sufficient to generate arrhythmogenic late Na+ current in the heart, independently of Nav1.5. AaH-II provides a powerful new tool to selectively probe TTX-S INaL and reveals these channels as previously underappreciated contributors to cardiac electrical instability. Targeting TTX-S Nav channels may therefore represent a novel and potentially safer strategy for antiarrhythmic therapy.</p>","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/PMC13598332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887050","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":"Sex-associated differences in lesion delivery and atrial fibrillation recurrence after cryoballoon ablation.","authors":"Emanuel Heil, Matthias Bock, Julia Knocks, Jan Paul Rudolph, Jin-Hong Gerds-Li, Frank Heinzel, Philipp Attanasio, Abdul Shokor Parwani, Hendrik Boldt, Florian Blaschke, Doreen Schöppenthau, Julia Christina Lueg, Till Althoff, Nikolaos Dagres, Verena Tscholl, Gerhard Hindricks, Felix Hohendanner","doi":"10.1093/europace/euag189","DOIUrl":"10.1093/europace/euag189","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/PMC13544113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891284","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 second beat matters: coupling intervals and sudden cardiac death risk in hypertrophic cardiomyopathy.","authors":"Rasmus Bork Dinesen, Vincent Probst, Jacob Tfelt-Hansen","doi":"10.1093/europace/euag246","DOIUrl":"10.1093/europace/euag246","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/PMC13581394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982335","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":"Wearable smartwatches for atrial fibrillation detection and burden estimation after ablation: comparison with continuous monitoring.","authors":"Martin Aguilar, Laurent Macle, Ralph Chamieh, Paul Khairy, Marc W Deyell, Richard G Bennett, Jason G Andrade","doi":"10.1093/europace/euaf280","DOIUrl":"10.1093/europace/euaf280","url":null,"abstract":"<p><strong>Aims: </strong>Wearable ECG-enabled smartwatches have been validated for atrial fibrillation (AF) screening, but their accuracy for monitoring AF recurrence and quantifying AF burden after catheter ablation is uncertain. To evaluate the simulated performance of three commercial smartwatch algorithms for AF recurrence detection and AF burden estimation compared with implantable cardiac monitors (ICMs).</p><p><strong>Methods and results: </strong>Using continuous ICM data from 346 patients in the CIRCA-DOSE trial, we simulated three smartwatch algorithms, assuming daytime wear (8:00 AM-10:00 p.m.). We also simulated commonly-used non-invasive intermittent rhythm monitoring strategies. Primary endpoints were sensitivity for arrhythmia recurrence and correlation with ICM-derived AF burden. Analyses were stratified by daily wear time and patient activity. AF recurrence occurred in 47.1% of patients. Simulated detection sensitivities were 82.2% (Apple Watch AF Burden), 70.6% (Apple Watch IRN), and 64.4% (Fitbit IHRD), compared with 15.8-64.6% for simulated intermittent AECG monitors. Wearables outperformed commonly-used Holter/patch monitoring strategies. AF burden correlation with ICM exceeded r = 0.97 for all algorithms. Among missed recurrences, median AF burden was <0.02%. Longer daily wear improved sensitivity (>90% with 24-hour use), whereas patient activity modestly reduced detection.</p><p><strong>Conclusion: </strong>Smartwatch-based AF detection algorithms demonstrate strong correlation with ICM-derived AF burden and clinically good sensitivity for recurrence detection, outperforming conventional non-invasive strategies. These findings support the integration of wearables as a scalable alternative for post-ablation rhythm monitoring.</p>","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/PMC13564214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145481166","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":"Human electrophysiologic mapping of transaortic pacing targets for valve-integrated pacemakers.","authors":"Iurii Karpenko, Andrei Ardashev, Jeremiah Wasserlauf, Evgeny Zhelyakov, Anna Lytchakov, Eric Rytkin, Igor R Efimov, Daniil P Aksenov","doi":"10.1093/europace/euag266","DOIUrl":"10.1093/europace/euag266","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/PMC13624274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982388","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":"Electrophysiological and histological comparisons of left bundle branch pacing vs. left ventricular septal pacing in canine self-controlled models.","authors":"Jie Zhang, Fan Zhang, Shaobo Fan, Le He, Dongyan Wu, Fengmin Lu, Jing Xu, Jun Ding, Yingchuan Yan, Fengqi Xuan, Wenjuan Zhang, Wei Ma","doi":"10.1093/europace/euag267","DOIUrl":"10.1093/europace/euag267","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/PMC13621800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012012","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":"Sex-specific trends in ventricular arrhythmias among European implantable cardioverter-defibrillator recipients.","authors":"Andrea Papa, Sing-Chien Yap, Michael Kühne, Christian Sticherling, Felix Mahfoud, Dominic A M J Theuns, Beat Schaer","doi":"10.1093/europace/euag268","DOIUrl":"10.1093/europace/euag268","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/PMC13621799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001553","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":"Essential antiarrhythmic drug accessibility worldwide: a multi-survey study and comprehensive evaluation of access and supply challenges.","authors":"Pieter G Postema, Niels D Reijnhout, Federico Ballacci, Evert A Manders, Wiert F Hoeksema, Mauro Toniolo, Jacob Tfelt-Hansen, Diego Penela, Piotr Futyma, Deirdre A Lane, Ruben Casado-Arroyo, Georgia Sarquella-Brugada, Nico A Blom, Arthur A M Wilde, Carla E M Hollak, Elena Arbelo","doi":"10.1093/europace/euag220","DOIUrl":"10.1093/europace/euag220","url":null,"abstract":"<p><strong>Aims: </strong>Antiarrhythmic drugs (AADs) are essential for preventing symptoms, morbidity, and mortality associated with cardiac arrhythmias. However, concerns are increasing about their accessibility. We aimed to assess insights into current access to AADs.</p><p><strong>Methods and results: </strong>Online surveys were distributed to members of the European Heart Rhythm Association, the Association for European Paediatric and Congenital Cardiology, the European Reference Network GUARD-Heart, and national heart rhythm societies. Responses were obtained from 558 respondents across 80 countries. Among countries included in the main analysis (≥5 respondents; 16 countries within and 7 outside the European Union, n = 298 respondents), only 16-59% of surveyed AADs were considered readily accessible. Accessibility varied substantially by drug: oral flecainide and propranolol were available in 88% of countries, whereas mexiletine solution was available in only 10%. Marked differences in accessibility were reported both between and within countries, with availability also changing over time. Higher-income countries generally reported better access and a greater number of market authorization holders than lower-income countries. National societies' perception was that limited access negatively affected patients' quality of life (72%) and life expectancy (35%), while 73% expected these challenges to persist or worsen in the coming years.</p><p><strong>Conclusion: </strong>Physicians worldwide frequently encounter problems accessing guideline-recommended antiarrhythmic drugs for their patients, which putatively impacts their patients' quality of life and life expectancy. This highlights systemic vulnerabilities that extend across national and institutional boundaries, urging close collaboration among clinicians, policymakers, manufacturers, and institutions to guarantee timely and equitable treatment for all patients.</p>","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/PMC13554807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873528","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":"Outcomes of Amulet occluder implantation following Watchman screen failure in the ADVANCE LAA study: a real-world analysis of procedural success and safety.","authors":"Dhanunjaya Lakkireddy, Jacqueline Saw, Akash Makkar, Dipak Shah, Ruby Satpathy, Muhamed Saric, Rahul Sharma, Frank Cuoco, Robert Percell, George Manoukian, Ryan Gage, Jordan A Anderson, Himanshu Agarwal","doi":"10.1093/europace/euag228","DOIUrl":"10.1093/europace/euag228","url":null,"abstract":"<p><strong>Aims: </strong>The Watchman device is widely used for left atrial appendage occlusion but may be unsuitable in patients with complex anatomies, resulting in screening failures. The Amulet occluder, with its dual-seal design, may overcome these limitations. The aim of this analysis is to evaluate procedural success, closure, and clinical outcomes of Amulet occluder implantation in patients who failed Watchman screening.</p><p><strong>Methods and results: </strong>This analysis from the ADVANCE LAA study included patients ineligible for Watchman (Screen Fail) compared to patients eligible for Amulet and Watchman (Device Eligible). Baseline characteristics, procedural details, cardiac imaging, and clinical events were assessed through 1 year. The safety endpoint composite was a composite of all-cause death, ischaemic stroke, systemic embolism, or device/procedure-related events requiring open cardiac surgery or major endovascular intervention within hospital discharge or 7 days post-implant. Independent core laboratory and clinical events committee adjudicated imaging and adverse events, respectively. A total of 609 patients underwent Amulet implantation (Screen Fail: n = 97; Device Eligible: n = 512). Screen Fail patients had more complex anatomy and higher CHA2DS2-VASc and HAS-BLED scores. Despite these differences, implant success was high (96.9% vs. 98.0%; P = 0.446). Clinically relevant closure on transoesophageal echocardiography (≤3 mm peri-device leak) was achieved in ≥97% of patients in both groups at implant and 1-3 months. The peri-procedural safety endpoint composite rate was similar in both groups [3.1% vs. 2.7%; OR: 1.14 (0.32, 4.03); P = 0.742]. One-year rates of stroke (1.1% vs. 1.0%), major bleeding (9.6% vs. 6.2%), cardiovascular/unknown death (2.1% vs. 5.2%), and all-cause death (6.3% vs. 6.6%) were similar between groups (P > 0.05).</p><p><strong>Conclusion: </strong>Amulet occluder implantation was feasible, safe, and effective in patients with or without failed Watchman screening, providing a viable option for both anatomically simple and complex anatomies.</p><p><strong>Clinical trial registration: </strong>URL https://clinicaltrials.gov Unique Identifier NCT05997446.</p>","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/PMC13554794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818052","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}