Europace最新文献

{"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":"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":"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":"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":"Identification of a new genetic locus associated with atrial fibrillation in the Taiwanese population by genome-wide and transcriptome-wide association studies.","authors":"Guan-Wei Lee, Jien-Jiun Chen, Chih-Hsien Wang, Sheng-Nan Chang, Fu-Chun Chiu, Pang-Shuo Huang, Su-Kiat Chua, Eric Y Chuang, Chia-Ti Tsai","doi":"10.1093/europace/euaf042","DOIUrl":"10.1093/europace/euaf042","url":null,"abstract":"<p><strong>Aims: </strong>Genome-wide association studies (GWASs) identified common single-nucleotide polymorphisms (SNPs) in more than 100 genomic regions associated with atrial fibrillation (AF). We aimed to identify novel AF genes in Taiwanese population by multi-stage GWAS.</p><p><strong>Methods and results: </strong>In exploratory stage, we did GWAS with whole-genome genotypes (4 512 191 SNPs) in 516 patients with AF from the National Taiwan University AF Registry and 5160 normal sinus rhythm controls from the Taiwan Biobank. Significant loci were replicated in 1002 independent patients and 2003 controls and in the UK Biobank. Expression quantitative trait locus (eQTL) mapping and transcriptome-wide association study (TWAS) were performed to implicate functional significance. Stage I GWAS revealed three loci associated with AF with a genome-wide significance level, including one close to PITX2 gene (chromosome 4q25, rs2723329, minor allele frequency [MAF] 0.50 vs. 0.41, P = 1.53 × 10-10), another close to RAP1A gene (also to previous KCND3; chromosome 1p13.2, rs7525578, MAF 0.17 vs. 0.07, P = 1.24 × 10-26), and one novel locus close to HNF4G gene (chromosome 8q21.13, rs2980218, MAF 0.44 vs. 0.35, P = 2.19 × 10-9). They were validated in Stage II population. The eQTL analyses showed significant colocalization of 1p13.2 locus with RAP1A gene expression in fibroblasts and 8q21.13 locus with HNF4G expression in lymphocytes. There is a significant association of RAP1A gene expression in fibroblasts and HNF4G in lymphocytes and brain with AF in TWAS.</p><p><strong>Conclusion: </strong>Genome-wide association study in Taiwan revealed PITX2 and RAP1A/KCND3 loci and novel AF locus (HNF4G) with the most significant locus in the RAP1A locus. RAP1A and HNF4G genes may implicate fibrosis, metabolic, and neurogenic pathways in pathogenesis of AF.</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/PMC11952963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556301","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":"European Society of Cardiology (ESC) clinical consensus statement on indications for conduction system pacing, with special contribution of the European Heart Rhythm Association of the ESC and endorsed by the Asia Pacific Heart Rhythm Society, the Canadian Heart Rhythm Society, the Heart Rhythm Society, and the Latin American Heart Rhythm Society.","authors":"Michael Glikson, Haran Burri, Amr Abdin, Oscar Cano, Karol Curila, Jan De Pooter, Juan C Diaz, Inga Drossart, Weijian Huang, Carsten W Israel, Marek Jastrzębski, Jacqueline Joza, Jarkko Karvonen, Daniel Keene, Christophe Leclercq, Wilfried Mullens, Margarida Pujol-Lopez, Archana Rao, Kevin Vernooy, Pugazhendhi Vijayaraman, Francesco Zanon, Yoav Michowitz, Jens Cosedis Nielsen, Lucas Boersma, Carina Blomström-Lundqvist, Mads Brix Kronborg, Mina K Chung, Hung Fat Tse, Habib Rehman Khan, Francisco Leyva, Ulises Rojel-Martinez, Marcin Ruciński, Niraj Varma","doi":"10.1093/europace/euaf050","DOIUrl":"10.1093/europace/euaf050","url":null,"abstract":"<p><p>Conduction system pacing (CSP) is being increasingly adopted as a more physiological alternative to right ventricular and biventricular pacing. Since the 2021 European Society of Cardiology pacing guidelines, there has been growing evidence that this therapy is safe and effective. Furthermore, left bundle branch area pacing was not covered in these guidelines due to limited evidence at that time. This Clinical Consensus Statement provides advice on indications for CSP, taking into account the significant evolution in this domain.</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/PMC11957271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751813","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":"Carotid sinus massage in clinical practice.","authors":"Sebastian Stec, Marta Kornaszewska","doi":"10.1093/europace/euaf058","DOIUrl":"10.1093/europace/euaf058","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/PMC11979326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656586","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 ventricular tachycardia ablation facilitated by pre-procedural cardiac imaging-derived scar characterization: a prospective multi-centre international registry.","authors":"Diego Penela, Giulio Falasconi, David Soto-Iglesias, Juan Fernández-Armenta, Giulio Zucchelli, Felipe Bisbal, Fatima Zaraket, Etelvino Silva, Matteo Parollo, Alessia Chiara Latini, Jose Alderete, Daniel Viveros, Aldo Bellido, Dario Turturiello, Chiara Valeriano, Paula Franco-Ocaña, Andrea Saglietto, Pietro Francia, Julio Martí-Almor, Antonio Berruezo","doi":"10.1093/europace/euaf051","DOIUrl":"10.1093/europace/euaf051","url":null,"abstract":"<p><strong>Aims: </strong>Pre-procedural imaging can facilitate scar-related ventricular tachycardia (VT) ablation, although only limited data have been reported. This prospective registry aimed to analyse procedural data and outcomes in a multi-centre setting of a pre-defined VT ablation strategy facilitated by the integration of pre-procedural imaging into the navigation system.</p><p><strong>Methods and results: </strong>Consecutive patients referred for scar-related left-sided VT ablation were prospectively enrolled at five European tertiary hospitals. Pre-procedural cardiac magnetic resonance (CMR)-derived scar maps and/or multi-detector computed tomography (MDCT)-derived wall thinning maps of the left ventricle (LV) were obtained and integrated into the navigation system. An endocardial or endoepicardial approach was chosen based on the scar distribution at pre-procedural imaging. The decision of performing a detailed electro-anatomical map (EAM) of the LV (image-aided) or to using the pre-procedural imaging for guiding the ablation without obtaining an EAM (image-guided) was left to the physician's discretion. One hundred and seventy-one patients (71% with ischaemic cardiomyopathy) were included. Cardiac magnetic resonance was integrated in 159 (93%), MDCT in 113 (66%), and both in 101 (59%) procedures. Procedure-related complications occurred in 9 (5%) patients. At a mean follow-up of 18 ± 19 months, the overall survival and VT recurrence-free survival were 91 and 74.4%, respectively. There were no significant differences in long-term ablation outcomes based on the type of cardiomyopathy (P = 0.88) or the pre-procedural imaging modality employed (P = 0.33). An image-guided approach appears feasible, safe, and faster, with reduced procedure, radiofrequency, and fluoroscopy times, without compromising efficacy.</p><p><strong>Conclusion: </strong>In a large multi-centre prospective cohort, VT ablation facilitated by pre-procedural imaging is associated with favourable long-term outcomes.</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/PMC11983391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630264","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}