Frontiers in Cardiovascular Medicine最新文献

{"title":"Real-time technical support for guiding remotely ICD/CRT-D implantation.","authors":"Antonio Curcio, Letizia R Romano, Florinda M Augusto, Giovanni Canino, Elisa Coluccio, Alberto Polimeni, Ciro Indolfi","doi":"10.3389/fcvm.2025.1525151","DOIUrl":"10.3389/fcvm.2025.1525151","url":null,"abstract":"<p><strong>Background: </strong>In the electrophysiologic (EP) lab, technical support for implantable cardioverter/defibrillators (ICD) and cardiac resynchronization therapy (CRT-D) procedures is often limited by the availability and costs of field clinical specialist (FCS) bioengineers.</p><p><strong>Methods: </strong>This study explores the viability of using remote support through an internet-based platform for ICD and CRT-D implantation procedures, aiming to enhance efficiency and overcome geographical or pandemic-related barriers. After preclinical phases, thirty patients underwent ICD/CRT-D guided either remotely or with on-site FCS implantation at two primary cardiac care centers, with ten procedures guided remotely and twenty cases with on-site FCS.</p><p><strong>Results: </strong>All procedures in both study arms were successfully completed (100% of cases). Procedural time was shorter in the telemedicine group (<i>P</i> = 0.031). Although fluoroscopic time was slightly reduced in the remote guided group, the difference did not reach statistical significance (<i>P</i> = 0.5). No major adverse events occurred.</p><p><strong>Conclusion: </strong>The study demonstrates the feasibility of remotely supported ICD and CRT-D implantation procedures.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1525151"},"PeriodicalIF":2.8,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Surgical correction of pulmonary artery sling causing tracheal obstruction in infancy: rapid and complete recovery.","authors":"Hüseyin Sicim, Daniel A Velez, Mohamad Alaeddine","doi":"10.3389/fcvm.2025.1558779","DOIUrl":"10.3389/fcvm.2025.1558779","url":null,"abstract":"<p><p>Pulmonary artery sling (PAS) is an uncommon congenital anomaly in which the left pulmonary artery (LPA) originates abnormally from the posterior aspect of the right pulmonary artery (RPA). The LPA then traverses between the trachea and esophagus, resulting in compression of the lower trachea. This compression can lead to respiratory symptoms, including wheezing and stridor, and in some cases, airway obstruction. In addition, bronchial compression-commonly affecting the right bronchus-can result in air trapping, pneumonia, and atelectasis. In this report, we present postoperative rapid relief of a symptomatic case in which LPA transection and reimplantation to the main pulmonary artery were performed successfully on cardiopulmonary bypass.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1558779"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of significant tricuspid regurgitation in atrial fibrillation: a meta-analysis.","authors":"Xiuxiu Zhang, Na Zhang, Jia Fu, Dapeng Yu","doi":"10.3389/fcvm.2025.1428964","DOIUrl":"10.3389/fcvm.2025.1428964","url":null,"abstract":"<p><strong>Aims: </strong>Significant tricuspid regurgitation (TR) in atrial fibrillation (AF) patients is becoming a global issue, as it can lead to progressive right ventricular enlargement and heart failure, thereby increasing morbidity and mortality. This study aimed to evaluate potential predictors of significant TR in AF patients using open databases.</p><p><strong>Methods: </strong>PubMed, EMBASE, the Cochrane Library, and Web of Science were searched for relevant studies from inception to September 2023. Using STATA 14.0 statistical software, hazard ratios (HRs) were calculated for data synthesis. The potential predictors included clinical characteristics, echocardiography parameters, and prior comorbidities. Evidence certainty was evaluated based on the GRADE system.</p><p><strong>Results: </strong>In total, 12 studies involving almost 16,000 patients were included in this review. Female sex (HR = 2.14; 95% CI: 1.84-2.49; I² = 0.0%; <i>p</i> = 0.430), persistent atrial fibrillation (HR = 2.99; 95% CI: 2.47-3.61; I² = 0.0%; <i>p</i> = 0.896), left ventricular ejection fraction [standard mean difference (SMD) = -0.16; 95% CI:-0.30 to -0.03; I² = 69.8%; <i>p</i> < 0.000], age (HR = 1.07; 95% CI: 1.04-1.09; I² = 72.3%; <i>p</i> = 0.013), heart failure (HR = 1.86; 95% CI: 1.45-2.39; I² = 9.0%; <i>p</i> = 0.348), age ≥65 years (HR = 2.30; 95% CI: 1.63-3.25; I² = 55.1%; <i>p</i> = 0.108), chronic lung disease (HR = 1.33; 95% CI: 1.02-1.74; I² = 0.0%; <i>p</i> = 0.882), right ventricle fractional area change (SMD = 0.18; 95% CI: 0.01-0.36; I² = 0.0%; <i>p</i> = 0.440), systolic pulmonary arterial pressure (SMD = 0.97; 95% CI: 0.76-1.19; I² = 41.5%; <i>p</i> = 0.181), and proper ventricular systolic pressure (SMD = 1.07; 95% CI: 0.54-1.59; I² = 92.4%; <i>p</i> < 0.000) may negatively influence significant TR.</p><p><strong>Conclusions: </strong>This meta-analysis identified a potential negative influence of several clinical characteristics, echocardiography parameters, and previous comorbidities on significant TR. However, due to the low level of certainty of evidence, our analysis can only provide some guidance to practitioners and researchers. Caution is advised, and further validation is needed.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1428964"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual-task training and cognitive performance in individuals with coronary artery disease and/or heart failure: a systematic review.","authors":"Talita Cezareti, Wallace Machado Magalhães de Souza, Andrea Camaz Deslandes, Tereza Cristina Felippe Guimarães, Daniel Arthur Barata Kasal, Luiz Fernando Rodrigues Junior, Mauro Felippe Felix Mediano","doi":"10.3389/fcvm.2025.1462385","DOIUrl":"10.3389/fcvm.2025.1462385","url":null,"abstract":"<p><strong>Introduction: </strong>Dual-task training (DTT) emerged as a promising intervention strategy to improve cognition in individuals with cardiovascular diseases (CVDs). The aim of this study is to describe the literature on the relationship between motor-cognitive DTT and cognitive performance (CP) in individuals with coronary artery disease (CAD) and/or heart failure (HF).</p><p><strong>Method: </strong>This systematic review includes intervention and observational studies that assessed motor-cognitive DTT on CP in individuals with CAD and/or HF. Searches were performed in the MEDLINE/Pubmed, Scielo, Lilacs, PEDro, and EMBASE databases. Methodological quality was assessed using the PEDro and ROBII scales for intervention studies and the Newcastle-Ottawa Scale for observational studies. The certainty of evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach<b>.</b></p><p><strong>Results: </strong>A total of 2,098 articles were retrieved, and 21 articles were selected for full reading. Among these, 16 were excluded according to pre-specified exclusion criteria, resulting in five studies conducted between 2018 and 2022, conducted in three countries (United States, Portugal, and Russia). The studies included 228 individuals, comprising one study with HF participants, one including women with CAD, two including individuals that underwent myocardial revascularization, and one with patients with CAD enrolled in a phase 2 of cardiac rehabilitation program. Each study used different combinations of motor and cognitive tasks, conducted sequentially (<i>n</i> = 2 studies) or simultaneously (<i>n</i> = 3 studies), with one study using virtual training. The overall certainty of evidence for CP was low according to GRADE approach. Reduction in postoperative cognitive dysfunction after myocardial revascularization was observed in two studies. Moreover, the results indicate that DTT may have a positive impact on memory, selective attention, and conflict resolution capacity.</p><p><strong>Conclusion: </strong>The studies reviewed indicate motor-cognitive DTT as a potential approach to improve CP in individuals with CAD and/or HF.</p><p><strong>Systematic review registration: </strong>www.crd.york.ac.uk/prospero/display_record.php?ID=CRD4202341516, identifier (CRD 4202341516).</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1462385"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between albumin-corrected calcium and all-cause mortality in patients with heart failure: a retrospective study.","authors":"Xiongda Yao, Yurong Leng, Junda Cao","doi":"10.3389/fcvm.2025.1552807","DOIUrl":"10.3389/fcvm.2025.1552807","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF), a global health challenge, is a leading cause of mortality in hospitalized patients. Early and accurate prognostic evaluation in these patients is vital for guiding clinical management. Our aim was to explore the association between albumin-corrected calcium (ACC) and mortality in hospitalized patients.</p><p><strong>Methods: </strong>This retrospective cohort study utilized data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients were stratified into three groups based on ACC levels. The association between ACC and clinical outcomes in HF patients was analyzed using Cox proportional hazards regression and restricted cubic spline models.</p><p><strong>Results: </strong>A total of 4,737 heart failure patients were included. Multifactorial Cox regression revealed that elevated ACC levels were significantly associated with increased 30-day and 180-day mortality. Restricted cubic spline analysis demonstrated a U-shaped relationship between ACC levels and mortality, with an inflection point at 9.18. Patients with ACC levels above 9.18 exhibited an 20.4% higher risk of 30-day mortality [Hazard ratio (HR): 1.204, 95% (Confidence interval) CI: 1.009-1.437] and a 20.8% higher risk of 180-day mortality (HR: 1.208, 95% CI: 1.019-1.431) compared to those with ACC below 9.18.</p><p><strong>Conclusions: </strong>The observed U-shaped association between ACC levels and 30- and 180-day mortality in HF patients highlights the potential utility of ACC as a prognostic marker.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1552807"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longer-term and landmark analysis of transcatheter vs. surgical aortic-valve implantation in severe aortic stenosis: a meta-analysis.","authors":"Yu Wang, Xiaowen Zhang, Xinlin Zhang, Wei Xu","doi":"10.3389/fcvm.2025.1479200","DOIUrl":"10.3389/fcvm.2025.1479200","url":null,"abstract":"<p><strong>Background: </strong>Previous reports of longer-term outcomes of transcatheter aortic valve implantation (TAVI) focus on higher risk patients and suggest potential temporal changes.</p><p><strong>Aims: </strong>To evaluate the longer-term and temporal performances of TAVI compared to surgical aortic valve replacement (SAVR).</p><p><strong>Methods: </strong>Randomized controlled trials reporting outcomes with at least 1-year follow-up. The primary outcome was the composite of all-cause death or disabling stroke.</p><p><strong>Results: </strong>We included 8 trials with 8,749 patients. TAVI was associated with a higher risk of longer-term (5-year) primary outcome compared to SAVR among higher-risk [odds ratio (OR), 1.25; 95% CI, 1.07-1.47] but not lower-risk participants [1.0 (0.77-1.29)]. However, a significant temporal interaction was detected in both risk profiles. TAVI with balloon-expandable valves was associated with a higher risk of longer-term primary outcome compared to SAVR [1.38 (1.2-1.6)], whereas no statistical difference was found with self-expanding valves [1.03 (0.89-1.19)]. There was a significant interaction between the two valve systems, and a temporal interaction was detected in both systems. Overall landmark analysis revealed a lower risk in TAVI within the initial 30 days [0.76 (0.6, 0.96)], comparable between 30 days to 2 years [1.04 (0.85, 1.28)], and higher beyond 2 years [1.36 (1.15-1.61)]. Analysis for all-cause death generated largely similar results.</p><p><strong>Conclusions: </strong>TAVI was associated with a higher longer-term risk of primary outcome compared to SAVR in higher-risk patients and with balloon-expandable valves. However, a characteristic temporal interaction was documented in all subgroups. Future studies are warranted to test these findings.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1479200"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal left ventricular ejection fraction variations and outcomes in wide population of cardiovascular patients with and without heart failure.","authors":"Radosław Szczerba, Wiktoria Żelazna, Jakub Sokołowski, Natalia Wyroba, Zuzanna Wydrych, Michał Wita, Małgorzata Cichoń, Michał Orszulak, Katarzyna Mizia-Stec, Krystian Wita, Maciej T Wybraniec","doi":"10.3389/fcvm.2025.1559258","DOIUrl":"10.3389/fcvm.2025.1559258","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure (HF) with improved ejection fraction (HFimpEF) was shown to be related with improved outcome but increase of left ventricular ejection fraction (LVEF) in patients without HF is of less known clinical significance. The aim of the study was to evaluate long-term prognosis in patients with different cardiovascular disorders, with and without HF, depending on temporal variations of LVEF.</p><p><strong>Methods: </strong>The study covered 31 920 patients (median age 71 years, 37.7% females) with different cardiovascular disorders and at least two measurements of LVEF separated by ≥1 month. Clinical parameters were acquired from database of Academic Repository of Clinical Cases of Medical University of Silesia. HFimpEF was defined by LVEF increase ≥10% in HF patients in relation to baseline value. The endpoints were all-cause mortality and Major Adverse Cardiac and Cerebrovascular Event (MACCE).</p><p><strong>Results: </strong>The median follow-up time was 51.5 months and LVEF was measured median 2 times. HF was diagnosed in 12 152 patients (38.1%), of which 2 843 (23.4%) experienced HFimpEF. MACCE occurrence was greater in HF than non-HF patients (12.78%/year vs. 6.07%/year, <i>p</i> < 0.001). In patients with HF, Kaplan-Meier survival curves showed significantly lower MACCE occurrence in HFimpEF and stable LVEF than in decreased LVEF (11.46%/year vs. 12.5%/year vs. 21.6%/year; log-rank <i>p</i> = 0.199 and <i>p</i> < 0.001) and HFimpEF constituted one of independent predictors of MACCE (HR = 0.84, 95% CI: 0.76-0.93). Conversely, in non-HF population patients with LVEF improvement had higher MACCE occurrence than patients with stable LVEF and lower than deteriorating LVEF (6.97%/year vs. 5.72%/year vs. 14.55%/year respectively; log-rank <i>p</i> = 0.001 and <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Temporal increase of LVEF corresponds with improved survival in patients with HF but not among non-HF patients.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1559258"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Dual-lumen microcatheter-facilitated wiring technique to correctly access a protruded aorto-ostial stent: a case series.","authors":"Seok Hyun Kim, Kook Jin Chun","doi":"10.3389/fcvm.2025.1467926","DOIUrl":"10.3389/fcvm.2025.1467926","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous coronary intervention (PCI) through the aorto-ostial coronary stent that is protruding into the aorta remains a technical challenge because of the poor coaxial alignment of the guiding catheter and the inability to advance the guidewire into the distal vessel through the stent's central lumen. In this article, we introduce a dual-lumen microcatheter-facilitated wiring technique performed on two patients to overcome this difficulty.</p><p><strong>Case summary: </strong>The first case was a 75-year-old man who presented with chest pain. He was diagnosed with an unstable angina, and coronary angiography showed near-total in-stent occlusion of the previously placed stent protruding into the aorta. Despite several attempts, the guidewire passed through the side strut of the stent instead of the central stent lumen. Thus, we placed the tip of the microcatheter proximally to the side strut, outside the stent. Then, a second wire was passed through the central lumen successfully. After confirming the wire's position via intravascular ultrasound, we inflated a drug-eluting balloon, subsequently obtaining a successful angiographic result. The second case was a 78-year-old woman diagnosed with non-ST segment elevation myocardial infarction. Coronary angiography revealed tight stenosis at the ostial left anterior descending artery with a previous stent deployed from the left main to the circumflex artery. Owing to the excessive overhanging stent into the aorta, the wire could not be advanced into the stent's central lumen. However, with the facilitation of a dual-lumen microcatheter, a second wire successfully passed through the stent's central lumen. Finally, the patient received a successful PCI with a stent.</p><p><strong>Conclusion: </strong>A dual-lumen microcatheter-facilitated wiring technique may be useful in overcoming wiring difficulty caused by the excessive protrusion of an aorto-ostial stent into the aorta.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1467926"},"PeriodicalIF":2.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: The second valve drag technique for managing acute total obstruction of the right coronary artery during transcatheter aortic valve replacement.","authors":"Yanbin Song, Xiaochun Zhang, Daxin Zhou, Wenzhi Pan","doi":"10.3389/fcvm.2025.1535890","DOIUrl":"10.3389/fcvm.2025.1535890","url":null,"abstract":"<p><strong>Introduction: </strong>Despite technological advancements and new generation devices availability, transcatheter aortic valve replacement (TAVR) for bicuspid aortic valve (BAV) stenosis still presents unique technical challenges.</p><p><strong>Methods and results: </strong>We report an uncommon but critical complication of acute right coronary artery occlusion resulting from valve dislocation during TAVR. For the first time, we employed novel approach, namely second valve dragging, to address mispositioned self-expanding valve. This implementation of novel and successful interventional treatment led to the rapid relief of coronary obstruction.</p><p><strong>Discussion: </strong>This innovative approach offers a promising avenue for further management of these patients in critical conditions.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1535890"},"PeriodicalIF":2.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The utility of 24-h electrocardiogram recordings for the prediction of a sufficient number of premature ventricular complexes and mapping strategy during catheter ablation.","authors":"Stine Aagaard-Nilsen, Lars Andreas Dejgaard, Ole-Gunnar Anfinsen, Erik Lyseggen, Torbjørn Holm, Trine S Fink, Hans Henrik Odland, Knut Sevre, Erik Kongsgård, Finn Hegbom, Mathis Korseberg Stokke","doi":"10.3389/fcvm.2025.1558130","DOIUrl":"10.3389/fcvm.2025.1558130","url":null,"abstract":"<p><strong>Background and aims: </strong>An insufficient number of premature ventricular complexes (PVCs) during catheter ablation (CA) may prohibit adequate mapping of the site of origin. Parameters to predict this situation have not been established. Our objective was to quantify the association between preprocedural information and the probability of a sufficient number of PVCs for adequate mapping and successful CA.</p><p><strong>Methods: </strong>Clinical characteristics and results from examinations and procedural data were collected retrospectively from health journals for patients admitted for CA of PVCs from 2011 to 2020.</p><p><strong>Results: </strong>In total, 46 of 332 patients (14%) had an insufficient number of PVCs to enable adequate electroanatomical mapping. Patients with a sufficient number of PVCs had nominally more PVCs in the 24-h electrocardiogram (ECG), with a strong statistical trend [16,007 (6,509-26,205) vs. 8,332 (3,066-20,974), <i>p</i> = 0.055]. The receiver operator curve for a sufficient number of PVCs in 24-h ECGs had an area under the curve of 0.610 (95% CI 0.498-0.722, <i>p</i> = 0.055). The best predictive values were found at >10,000 PVCs per 24-h, with a positive predictive value of 67% and a negative predictive value of 57%. Patients for whom activation mapping was used as the sole mapping method had more PVCs in the 24-h ECG than did patients for whom pace mapping was added or used as an alternative [19,769 (10,564-30,526) vs. 15,237 (6,000-25,033), <i>p</i> = 0.022]. Neither acute outcome nor procedure time depended on the mapping strategy.</p><p><strong>Conclusion: </strong>The number of PVCs in a 24-h ECG was moderately associated with the presence of a sufficient number of PVCs to perform electroanatomical mapping during CA. The presence of more PVCs in the preprocedural 24-h ECG was associated with the use of activation mapping as the sole mapping strategy.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"12 ","pages":"1558130"},"PeriodicalIF":2.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}