Heart rhythm最新文献

{"title":"Early versus delayed catheter ablation in atrial fibrillation and heart failure: A systematic review and meta-analysis","authors":"Mustafa Eray Kilic MD ,&nbsp;Mehmet Emin Arayici PhD, MPH, BBA ,&nbsp;Yigit Resit Yilancioglu MD ,&nbsp;Oguzhan Ekrem Turan MD ,&nbsp;Emin Evren Ozcan MD, PhD ,&nbsp;Mehmet Birhan Yilmaz MD","doi":"10.1016/j.hrthm.2025.06.012","DOIUrl":"10.1016/j.hrthm.2025.06.012","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation<span> (AF) and heart failure (HF) frequently coexist, worsening outcomes. Catheter ablation (CA) is an established therapy, but the optimal timing remains unclear.</span></div></div><div><h3>Objective</h3><div>This study aimed to evaluate the impact of early vs delayed CA on clinical outcomes in patients with AF and HF.</div></div><div><h3>Methods</h3><div>This International Prospective Register of Systematic Reviews–registered systematic review (CRD42025643686) adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Comparative studies enrolling adults with AF and HF were included. Early CA was defined as ablation performed within varying timeframes (often ≤12 months) after AF diagnosis or HF decompensation vs delayed CA beyond that period. Primary outcomes were AF recurrence, all-cause mortality, and HF hospitalizations. Random-effects meta-analyses were performed.</div></div><div><h3>Results</h3><div>Ten studies (n = 15,822) contributed to the meta-analyses. Early CA was associated with significantly reduced AF recurrence (k = 8, hazard ratio [HR] 0.63, 95% confidence interval [CI] 0.52–0.78, <em>P</em> &lt; .0001) and HF hospitalization (k = 5, HR 0.63, 95% CI 0.51–0.77, <em>P</em> &lt; .0001). A nonsignificant trend toward reduced all-cause mortality was observed (k = 4, HR 0.71, 95% CI 0.41–1.24, <em>P</em> = .23). Statistical heterogeneity was absent for HF hospitalization (I² = 0%), moderate for AF recurrence (I² = 67.6%), and high for mortality (I²<span> = 75.3%). Narrative synthesis included 2 additional randomized controlled trials comparing treatment strategies.</span></div></div><div><h3>Conclusion</h3><div>Evidence from pooled observational studies suggests early CA is associated with reduced AF recurrence and HF hospitalization in patients with AF and HF; a mortality benefit was not statistically confirmed. Interpretation warrants caution owing to reliance on observational data and methodological heterogeneity across studies.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e882-e893"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiarrhythmic drug continuation as “treatment failure” in persistent atrial fibrillation ablation studies","authors":"Laurent Fauchier MD,&nbsp;Thibault Lenormand MD,&nbsp;Lisa Lochon MD","doi":"10.1016/j.hrthm.2025.06.042","DOIUrl":"10.1016/j.hrthm.2025.06.042","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e1043-e1044"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2025 SCAI/HRS clinical practice guidelines on transcatheter left atrial appendage occlusion","authors":"Andrew M. Goldsweig MD, MS, FSCAI ,&nbsp;Michael Glikson MD ,&nbsp;Jacqueline Joza MD, FHRS ,&nbsp;Clifford J. Kavinsky MD, PhD, MSCAI ,&nbsp;Omar Khalique MD, FSCAI ,&nbsp;Dhanunjaya Lakkireddy MD, FHRS ,&nbsp;G. Burkhard Mackensen MD, PhD, FSCAI ,&nbsp;Gerald V. Naccarelli MD, FHRS ,&nbsp;Devi G. Nair MD, FHRS ,&nbsp;Jacqueline Saw MD, FSCAI ,&nbsp;Rahul Prakash Sharma MD, FSCAI ,&nbsp;Matthew Sherwood MD, FSCAI ,&nbsp;Molly Szerlip MD, FSCAI ,&nbsp;Yngve Falck-Ytter MD ,&nbsp;Rebecca L. Morgan PhD, MPH ,&nbsp;Chelsea Armah MPH ,&nbsp;Scott Firestone MS ,&nbsp;Angela Fix MPH, MWC ,&nbsp;Emily Senerth MS, MPH ,&nbsp;Christopher R. Ellis MD, FHRS","doi":"10.1016/j.hrthm.2025.05.048","DOIUrl":"10.1016/j.hrthm.2025.05.048","url":null,"abstract":"<div><h3>Background</h3><div>Left atrial appendage occlusion (LAAO) devices reduce the risk of atrial fibrillation-associated stroke relative to no oral anticoagulation. However, uncertainty and practice variation persist in the areas of patient selection, periprocedural imaging, adjunctive antithrombotic therapy, and management of peridevice leak (PDL) and device-related thrombus. The Society for Cardiovascular Angiography &amp; Interventions and Heart Rhythm Society developed these evidence-based guidelines to support clinicians, patients, and other stakeholders in management decisions regarding LAAO.</div></div><div><h3>Methods</h3><div>The Society for Cardiovascular Angiography &amp; Interventions and Heart Rhythm Society convened a balanced, multidisciplinary guideline panel with &lt;50% of members reporting significant conflicts of interest with the industry. Evidence Foundation, a registered 501(c)(3) nonprofit organization, provided methodological support for guideline development. The guideline panel formulated and prioritized clinical questions following the Grading of Recommendations Assessment, Development, and Evaluation approach in a population, intervention, comparison, outcome format. A technical review team of clinical and methodological experts conducted systematic reviews of the published evidence, synthesized data, and graded the certainty of evidence across outcomes. The guideline panel then developed recommendations and supporting statements informed by the technical review and using the Grading of Recommendations Assessment, Development, and Evaluation evidence-to-decision framework.</div></div><div><h3>Results</h3><div>The guideline panel developed 8 evidence-based recommendations to address variations in care related to LAAO. The panel also identified 2 knowledge gaps.</div></div><div><h3>Conclusions</h3><div>Key recommendations address patient selection for LAAO, periprocedural imaging, adjunctive antithrombotic therapy, and management of PDL and device-related thrombus. The panel also recommended necessary future research regarding the use of single antiplatelet therapy following LAAO and regarding the management of PDL.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e1048-e1063"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defibrillation pad positioning in refractory ventricular arrhythmias","authors":"Sheldon Cheskes MD, CCFP(EM), FCFP, DRCPSC ,&nbsp;DOSE VF Investigators","doi":"10.1016/j.hrthm.2025.06.051","DOIUrl":"10.1016/j.hrthm.2025.06.051","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e1045-e1046"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Localized reentrant ventricular tachycardia in the Purkinje network with 3 different exits after acute myocardial infarction","authors":"Haruka Matsuura MD ,&nbsp;Tsukasa Kamakura MD, PhD ,&nbsp;Kenzaburo Nakajima MD, PhD ,&nbsp;Kengo Kusano MD, PhD","doi":"10.1016/j.hrthm.2025.07.003","DOIUrl":"10.1016/j.hrthm.2025.07.003","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e1017-e1021"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144617167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning identifies arrhythmogenic features of QRS fragmentation in human cardiomyopathy: Implications for improving risk stratification","authors":"Cathy Ong Ly BSc ,&nbsp;Adrian M. Suszko MSc ,&nbsp;Nathan C. Denham BM, PhD ,&nbsp;Praloy Chakraborty MD ,&nbsp;Mahbod Rahimi MSc ,&nbsp;Chris McIntosh PhD ,&nbsp;Vijay S. Chauhan MD","doi":"10.1016/j.hrthm.2024.11.002","DOIUrl":"10.1016/j.hrthm.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Heterogeneous ventricular activation can provide the substrate for ventricular arrhythmias (VA), but its manifestation on the electrocardiogram (ECG) as a risk stratifier is not well-defined.</div></div><div><h3>Objective</h3><div>To characterize the spatiotemporal features of QRS peaks that best predict VA in patients with cardiomyopathy (CM) using machine learning (ML).</div></div><div><h3>Methods</h3><div>Prospectively enrolled CM patients with prophylactic defibrillators (n=95) underwent digital, high-resolution ECG recordings during intrinsic rhythm and ventricular pacing at 100 to 120 beats/min. Intra QRS peaks in the signal-averaged precordial leads were identified and their characteristics (amplitude, width, and timing within the QRS) were transformed into 4-bin histograms. Random forest models of these characteristics in each lead alongside clinical data were trained on 76 patients and tested on 19 patients with cross-validation to determine the features that predicted VA.</div></div><div><h3>Results</h3><div>Patients were followed up for 45 (22–48) months, and 21% had VA. The individual machine learning (ML) models determined (area under the receiver operating characteristic curve [AUROC]) intrinsic QRS peak amplitude (0.88), width (0.78), and location (0.84) to all predict VA. In a combined model including all QRS peak characteristics, peaks with amplitude &lt; 31 μV in V1, a width of 4 to 8 ms in V1, and location in the final quarter of the QRS of V1 were most predictive. Neither clinical data nor QRS peak characteristics assessed during ventricular pacing improved VA prediction when combined with intrinsic QRS peak characteristics.</div></div><div><h3>Conclusions</h3><div>Arrhythmogenic QRS fragmentation is characterized by narrow, low-amplitude peaks in the terminal QRS of lead V1. These features alone without clinical variables or ventricular pacing are sufficient to accurately risk stratify CM patients.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2457-2468"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A simplified cardiac implantable electronic device infection classification by combining key diagnostic criteria","authors":"Benedetta Brescia MD ,&nbsp;Lorenzo Bertolino MD ,&nbsp;Fabian Patauner MD ,&nbsp;Anna Maria Peluso MD ,&nbsp;Raffaella Gallo MD ,&nbsp;Fabio Luciano MD ,&nbsp;Gerardo Nigro MD, PhD ,&nbsp;Antonio D’Onofrio MD ,&nbsp;Emanuele Durante-Mangoni MD, PhD","doi":"10.1016/j.hrthm.2024.11.039","DOIUrl":"10.1016/j.hrthm.2024.11.039","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2729-2730"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing ventricular scar characterization in late-gadolinium enhancement cardiac MRI: Impact of thresholding techniques in magnitude and phase-sensitive reconstructed images","authors":"Janneke C. Burger BSc ,&nbsp;Luuk H.G.A. Hopman PhD ,&nbsp;Fernando O. Campos PhD ,&nbsp;Cornelis P. Allaart MD, PhD ,&nbsp;Pieter G. Postema MD, PhD ,&nbsp;Michiel J.B. Kemme MD, PhD ,&nbsp;Marco J.W. Götte MD, PhD ,&nbsp;Martin J. Bishop PhD ,&nbsp;Vokko P. van Halm MD, PhD ,&nbsp;Pranav Bhagirath MD, PhD","doi":"10.1016/j.hrthm.2025.03.1943","DOIUrl":"10.1016/j.hrthm.2025.03.1943","url":null,"abstract":"<div><h3>Background</h3><div>Late gadolinium enhancement (LGE) images, reconstructed using magnitude (MAG) or phase-sensitive inversion recovery (PSIR) sequences, differ in signal intensities because of their handling of longitudinal magnetization. These differences influence LGE quantification, which typically uses full-width at half maximum (FWHM) or standard deviation (n-SD) thresholding when predicting cardiac events.</div></div><div><h3>Objective</h3><div>This study assessed the impact of FWHM and n-SD on MAG- and PSIR-derived scar characteristics.</div></div><div><h3>Methods</h3><div>Patients with ischemic cardiomyopathy undergoing LGE imaging were retrospectively studied. Two reconstruction techniques (MAG vs PSIR) and 2 thresholding methods (FWHM vs n-SD) were evaluated. LGE images were postprocessed with commercially available software, using scar thresholds of 40%–60% of the maximum signal intensity for FWHM and 2–5 SDs above the mean for n-SD. Scar quantification was compared between patients with primary and secondary prevention implantable cardioverter-defibrillator.</div></div><div><h3>Results</h3><div>Of the 80 patients, 32 (40%) had an implantable cardioverter-defibrillator for primary prevention. PSIR imaging showed significantly larger scar metrics than did MAG using FWHM and n-SD thresholding, including larger border zone (16.43 ± 8.15 g vs 21.42 ± 10.72 g; <em>P</em>&lt;.001) and conduction corridor (CC) characteristics. MAG-based analysis revealed significant differences in scar and CC metrics. For PSIR, scar metrics were consistent across FWHM and n-SD. MAG-based analysis showed larger border zone and CC length in patients with primary prevention, with similar trends for PSIR.</div></div><div><h3>Conclusion</h3><div>This study demonstrates significant differences in myocardial scar metrics based on reconstruction and thresholding techniques. PSIR consistently provided robust scar characterization across methods, emphasizing its clinical potential to standardize LGE–cardiac magnetic resonance workflows and improve ventricular arrhythmia risk stratification.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2469-2476"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined pulsed field ablation and left atrial appendage occlusion: A multicenter comparative study","authors":"Mark T.K. Tam MBChB ,&nbsp;Pipin Kojodjojo MBBS ,&nbsp;Yat-Yin Lam MD ,&nbsp;Jeremy Chow MBBS ,&nbsp;Cliff Wong MBBS ,&nbsp;Kevin Ka-Ho Kam MBChB ,&nbsp;Geri Ling Na Wong MBChB ,&nbsp;Chin-Pang Chan MBChB, FHRS ,&nbsp;Joseph Y.S. Chan MBBS ,&nbsp;Kent Chak-yu So MBChB","doi":"10.1016/j.hrthm.2025.03.1968","DOIUrl":"10.1016/j.hrthm.2025.03.1968","url":null,"abstract":"<div><h3>Background</h3><div>Combining pulsed field ablation (PFA) and left atrial appendage occlusion (LAAO) to 1 procedure is appealing for the treatment of atrial fibrillation.</div></div><div><h3>Objective</h3><div>This study aimed to compare the outcome of combined and standalone procedures.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study of consecutive patients undergoing combined PFA and LAAO procedures in 3 centers in 2023. They underwent PFA pulmonary vein isolation (PVI) with Farapulse (Boston Scientific, Marlborough, MA), followed by LAAO with WATCHMAN FLX (Boston Scientific) guided by transesophageal echocardiogram (TEE). Pulmonary ridge thickness was measured at 45 degrees, 5 mm from tip of the ridge, before and after PFA. At 3 months, TEE or computed tomography was performed for patients with LAAO to assess occlusion results. Peridevice leak (PDL) of more than 3 mm was defined as significant. Consecutive PFA or LAAO standalone procedures served as controls.</div></div><div><h3>Results</h3><div>This cohort included 36 combined, 48 standalone LAAO, and 52 standalone PFA cases. Acute PVI was achieved in all combined and PFA standalone procedures. Successful LAAO implantation with WATCHMAN FLX was achieved in 97.2% combined procedures and all standalone LAAO procedures. In the combined cohort, pulmonary ridge thickness increased after ablation by 2.72 ± 1.19 mm (<em>P</em> &lt; .001) or 69.4% ± 51.4%. At 3 months, the rate of PDL did not differ between combined and standalone LAAO cohorts (26.7 vs 15.2%, <em>P</em> = .22). However, significant PDL (&gt; 3 mm) occurred more commonly in the combined cohort compared with the standalone LAAO cohort (20% vs 2.2%, <em>P</em> = .013).</div></div><div><h3>Conclusion</h3><div>Combined PFA and LAAO was feasible. However, we observed a mean 69.4% increase in pulmonary ridge thickness immediately following PFA. Significant PDL was more prevalent in combined procedure.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2579-2584"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective randomized trial of conduction system pacing vs right ventricular pacing for patients with atrioventricular block; Prague CSP trial","authors":"Karol Curila MD, MSc, PhD ,&nbsp;Jan Mizner MD, PhD ,&nbsp;Jan Morava MSc ,&nbsp;Radovan Smisek MSc, PhD ,&nbsp;Jana Vesela MSc ,&nbsp;Ondrej Sussenbek MD ,&nbsp;Petr Stros MD ,&nbsp;Jindrich Kupec MD ,&nbsp;Petr Waldauf MD, PhD ,&nbsp;Pavel Leinveber MSc, PhD ,&nbsp;Lukas Poviser MSc ,&nbsp;Laszlo Nagy MD, PhD ,&nbsp;Jan Cerny MSc ,&nbsp;Barbora Bitmanova MSc ,&nbsp;Pavel Jurak MSc, PhD ,&nbsp;Rostislav Polasek MD","doi":"10.1016/j.hrthm.2025.05.036","DOIUrl":"10.1016/j.hrthm.2025.05.036","url":null,"abstract":"<div><h3>Background</h3><div>Conduction system pacing (CSP) replaces right ventricular pacing (RVP) in bradycardia patients.</div></div><div><h3>Objective</h3><div>To compare CSP vs RVP in patients with pacemaker indication due to atrioventricular conduction disease.</div></div><div><h3>Methods</h3><div><span>This study randomized patients to CSP or RVP in 1:1 ratio and followed them for 12 months. CSP received either His bundle pacing or left bundle branch area pacing; The primary end point was a change in the </span>left ventricular ejection fraction (LVEF). The combined composite clinical end point consisted of cardiovascular death, cardiac resynchronization therapy upgrade, or hospitalization for heart failure.</div></div><div><h3>Results</h3><div><span>Of 249 patients, 125 were randomized to RVP and 124 to CSP; there were no differences between clinical parameters. In CSP, 10 patients received His bundle pacing, 96 left bundle branch area pacing, 15 deep septal pacing, and 3 RVP. Procedural and fluoroscopy times were longer in CSP vs RVP (63 vs 40 and 7 vs 3 minutes; </span><em>P &lt;</em> .001). In the intention-to-treat analysis, the LVEF decline in CSP was smaller than RVP (−2% vs −4%, <em>P</em> = .03), and a LVEF decrease ≥ 10% occurred more often in RVP 19 (16%) than CSP 6 (5%), <em>P</em> = .01. There was no difference in the composite clinical outcome between RVP and CSP (9 vs 4, <em>P</em> = .15). There was also no difference in procedural complications (9 in RVP vs 2 in CSP, <em>P</em> = .09).</div></div><div><h3>Conclusion</h3><div>In patients with severe conduction disease, CSP led to a smaller LVEF decline than RVP after 1 year of pacing. Both pacing methods had similar rates of clinical end points and procedural complications.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e894-e902"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}