Heart rhythm最新文献

{"title":"Therapeutic Benefits of Phenytoin in Calmodulinopathy: A Rare and Challenging Case Report.","authors":"Sakthi Saravanan, Navaneetha Sasikumar, Taniya Rachel Issacs, Raman Krishna Kumar, Arshad Jahangir, Praloy Chakraborty","doi":"10.1016/j.hrthm.2024.10.051","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.10.051","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545129","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":"Nonalcoholic fatty liver disease is associated with ventricular arrhythmias and major cardiovascular events in patients with implantable cardioverter-defibrillators.","authors":"Yuan Gao, Xiaoyao Li, Jiandu Yang, Zhuxin Zhang, Zhongli Chen, Sijin Wu, Xiang Cui, Xuan Ma, Xiaogang Guo, Ruohan Chen, Qi Sun, Yan Dai, Shu Zhang, Keping Chen","doi":"10.1016/j.hrthm.2024.10.050","DOIUrl":"10.1016/j.hrthm.2024.10.050","url":null,"abstract":"<p><strong>Background: </strong>Patients with nonalcoholic fatty liver disease (NAFLD) are at risk for cardiovascular diseases. Less is known about the relationship between NAFLD, ventricular arrhythmias (VAs), and cardiovascular events.</p><p><strong>Objective: </strong>We sought to evaluate the association between NAFLD and VAs and major cardiovascular events in patients with implantable cardioverter-defibrillators (ICDs).</p><p><strong>Methods: </strong>A total of 921 patients at high risk of sudden cardiac death who received ICDs were retrospectively analyzed. NAFLD is diagnosed by the presence of hepatic steatosis and lack of secondary causes of hepatic fat accumulation. The primary end points were VAs, defined as sustained ventricular tachycardia and ventricular fibrillation documented by the device. The secondary end points were cardiac mortality, heart transplantation, and rehospitalization for heart failure.</p><p><strong>Results: </strong>The prevalence of NAFLD in patients with ICDs was 24.2% (223/921). The mean age was 58.5 ± 12.7 years, and 25.7% were female. During the mean follow-up of 34.8 months, 272 (29.5%) patients achieved primary end points and 171 (18.6%) achieved secondary end points. Kaplan-Meier analysis revealed that NAFLD was associated with an increased risk of VAs (hazard ratio [HR], 3.90; 95% confidence interval [CI], 2.87-5.29; log-rank P < .0001) and secondary end points (HR, 2.04; 95% CI, 1.72-2.94; log-rank P < .0001). In adjusted Cox regression models, NAFLD was an independent risk factor for VAs (HR, 3.84; CI, 2.87-5.12; P < .001) and secondary end points (HR, 2.26; CI, 1.55-3.28; P < .001).</p><p><strong>Conclusion: </strong>In our retrospective cohort, NAFLD is significantly associated with VAs and major cardiovascular events in patients with ICDs.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567903","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":"Predictors of late recurrence after second catheter ablation for persistent atrial fibrillation.","authors":"Kohei Ukita, Yasuyuki Egami, Hiroaki Nohara, Shodai Kawanami, Akito Kawamura, Koji Yasumoto, Naotaka Okamoto, Yasuharu Matsunaga-Lee, Masamichi Yano, Masami Nishino","doi":"10.1016/j.hrthm.2024.10.053","DOIUrl":"10.1016/j.hrthm.2024.10.053","url":null,"abstract":"<p><strong>Background: </strong>Little has been reported on the predictors of late recurrence (LR) after second radiofrequency catheter ablation (RFCA) for persistent atrial fibrillation (AF).</p><p><strong>Objective: </strong>This study aimed to identify the predictors of LR after second RFCA in patients with persistent AF.</p><p><strong>Methods: </strong>We retrospectively analyzed 123 patients who underwent a second RFCA because of LR after the initial RFCA for persistent AF. LR was defined as a recurrence of atrial tachyarrhythmia >3 months after the ablation procedure. The initial RFCA included pulmonary vein isolation alone or pulmonary vein isolation plus cavotricuspid isthmus block. The predictors of LR were evaluated by the Cox proportional hazards model.</p><p><strong>Results: </strong>In the univariate analysis, elevated brain natriuretic peptide levels, absence of pulmonary vein reconnections at the beginning of the second RFCA, and presence of early recurrence (ER, defined as a recurrence of atrial tachyarrhythmia within 3 months) after the second RFCA were associated with LR (P = .025, P = .018, and P < .001, respectively). The multivariate analysis revealed that absence of pulmonary vein reconnections and presence of ER were independent predictors of LR after the second RFCA (P = .004 and P < .001, respectively).</p><p><strong>Conclusion: </strong>Absence of pulmonary vein reconnections and presence of ER were strongly associated with LR after the second RFCA in patients with persistent AF.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545127","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":"Risk of cardiac arrhythmias and outcomes with perioperative FLOT vs CROSS regimens for esophageal adenocarcinoma.","authors":"Aravinthasamy Sivamurugan, Stefano H Byer, Udhayvir S Grewal","doi":"10.1016/j.hrthm.2024.10.052","DOIUrl":"10.1016/j.hrthm.2024.10.052","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545128","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":"Global R-wave peak time for diagnosis of left bundle branch capture.","authors":"Grzegorz Kiełbasa, Paweł Moskal, Agnieszka Bednarek, Ignacy Jastrzębski, Patryk Stanisław Michel, Marek Rajzer, Marek Jastrzębski","doi":"10.1016/j.hrthm.2024.10.038","DOIUrl":"10.1016/j.hrthm.2024.10.038","url":null,"abstract":"<p><strong>Background: </strong>QRS axis deviation and rS configuration in V6 affect the ability of V6 R-wave peak time (RWPT) criterion to discriminate capture type during left bundle branch area pacing (LBBAP).</p><p><strong>Objective: </strong>We hypothesized that combining RWPTs from lateral leads: I, aVL, V5, and V6 may better reflect left ventricular activation time and that such a global RWPT may be insensitive to changes in QRS configuration.</p><p><strong>Methods: </strong>The analysis included 519 electrocardiograms (ECGs) with nonselective left bundle branch pacing (nsLBBP) and 176 ECGs with left ventricular septal pacing (LVSP). Optimal RWPT cutoffs and area under the receiver operating curve (AUC) were determined for each lead and combinations of leads, to find the best RWPT criterion for discriminating nsLBBP from LVSP. Values were reported separately for healthy and diseased left conduction system groups.</p><p><strong>Results: </strong>The highest AUC of 97.1/89.2% was obtained for the global RWPT, which combined leads I and V6. The AUC for single-lead RWPT, was highest for lead I, followed by V6, V5, and aVL with AUC of 95.1/87.4%, 93.6/87.1%, 93.0/86.5%, and 84.8/74.6%, respectively. The global RWPT criterion was not affected by variations in QRS configuration, as V6 and I RWPTs often showed opposite responses to changes in axis. In contrast, all single-lead RWPT criteria were sensitive to axis deviation and QRS configuration. Diagnostically optimal RWPT cutoffs for global RWPT and lead I RWPT were 162.5/187.5 ms, and 81.5/90.5 ms, respectively.</p><p><strong>Conclusion: </strong>The global RWPT criterion allows a more accurate diagnosis of LBBAP capture type independent of QRS configuration and axis.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567884","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":"Electrophysiologic characteristics and clinical correlation of right ventricular activation during left bundle branch area pacing (RV-LBBAP study).","authors":"Shunmuga Sundaram Ponnusamy, Vithiya Ganesan, Vadivelu Ramalingam, Saravana Kumar, Ramvivek Ramamoorthy, Kishore Ramu, Vaishnavi Nagarajan Bhuvaneshwari, Devisree Selvaraj, Avanthika Swisi Alagar, Jananie Dhanapal, Ranjitha Selvaraj, Mariann Diana, Selvaganesh Mariappan, Senthil Murugan, Mahesh Kumar, Pugazhendhi Vijayaraman","doi":"10.1016/j.hrthm.2024.10.049","DOIUrl":"10.1016/j.hrthm.2024.10.049","url":null,"abstract":"<p><strong>Background: </strong>Left bundle branch area pacing (LBBAP) results in a right bundle branch (RBB) delay pattern because of preexcitation of the left bundle. The mechanism of right ventricular (RV) activation during LBBAP is largely unknown.</p><p><strong>Objective: </strong>The aim of the study was to analyze the electrophysiologic characteristics of RV activation by mapping the RBB during LBBAP and its clinical correlation.</p><p><strong>Methods: </strong>Consecutive patients who underwent successful LBBAP were included. RBB block, RV paced rhythm, and suboptimal intracardiac electrograms were excluded. LBBAP was performed with continuous recording of His bundle (HB) and RBB electrograms. RV activation was classified into 3 types based on the intracardiac electrogram: type I, RBB mediated; type II, transseptal activation; and type III, fusion pattern.</p><p><strong>Results: </strong>Overall, 86 patients (94% left bundle branch pacing [LBBP]; 6% left ventricular septal pacing) were included. The mean age was 59.6 ± 12.8 years. Nonselective to selective capture transition was noted in 85% (n = 73). In patients with baseline normal QRS (n = 47), during selective LBBP (S-LBBP; n = 39), the most common pattern was type I (n = 35 [87%]), whereas during nonselective LBBP (NS-LBBP; n = 44), type III pattern (n = 40 [91%]) was common. In patients with left bundle branch block (n = 39), type III pattern was common during both S-LBBP and NS-LBBP. Type I pattern was noted only in patients with retrograde HB activation during S-LBBP. Left ventricular septal pacing showed type II activation in both groups. Patients without retrograde HB activation had higher left ventricular end-diastolic diameter, lower left ventricular ejection fraction, and prolonged HV interval compared with those with retrograde HB activation.</p><p><strong>Conclusion: </strong>Physiologic RBB-mediated (type I) activation of the right ventricle was the most common pattern observed during S-LBBP in patients with intact retrograde HB activation. Type III pattern was the most common pattern observed during NS-LBBP with fusion of multiple wavefronts from anterograde RBB activation, septal myocardial, and transverse interbundle connections.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567874","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":"Clinical outcomes of Asian patients with newly diagnosed atrial fibrillation and previously diagnosed atrial fibrillation: Insights from the CODE-AF registry.","authors":"JungMin Choi, So-Ryoung Lee, Tae-Hoon Kim, Hee Tae Yu, Junbeom Park, Jin-Kyu Park, Ki-Woon Kang, Jaemin Shim, Jae-Sun Uhm, Jun Kim, Hyung Wook Park, Jin-Bae Kim, Young Soo Lee, Boyoung Joung, Eue-Keun Choi","doi":"10.1016/j.hrthm.2024.10.046","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.10.046","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) may have different clinical features in its early phase.</p><p><strong>Objective: </strong>This study compared the characteristics and clinical outcomes of early-phase AF with later-phase AF using a large multicenter prospective registry (COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation [CODE-AF]).</p><p><strong>Methods: </strong>Patients enrolled between June 2016 and March 2021 were divided into two groups based on AF duration: (1) newly diagnosed (AF duration ≤90 days) and (2) previously diagnosed (AF duration >90 days). The baseline characteristics and clinical outcomes were compared.</p><p><strong>Results: </strong>Among the 10,001 study participants (mean age 67.0±14.5 years, and 64% men), 22% were defined as newly diagnosed and 78% as previously diagnosed. Newly diagnosed patients had fewer comorbidities and more unhealthy social behaviors. Despite lower prescription rates of oral anticoagulant, direct oral anticoagulants were more frequently used. The newly diagnosed group also had a higher composite clinical outcome risk within 90 days (adjusted HR 1.81, 95% CI 1.30-2.53, P<0.001) and revealed a higher risk of all bleeding and heart failure admission within 90 days. No significant differences remained between the groups over a 36-month follow-up.</p><p><strong>Conclusions: </strong>Patients with early-stage AF were younger and had fewer comorbidities. While there was a higher risk of heart failure admissions and minor bleeding, the risk of death, stroke, and major bleeding was not significantly increased. Structured monitoring and management during the initial months are essential to address these risks.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499179","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":"To the Editor - Validation and predictive performance of the PAT score.","authors":"Pattara Rattanawong, Dan Sorajja, Win-Kuang Shen","doi":"10.1016/j.hrthm.2024.10.047","DOIUrl":"10.1016/j.hrthm.2024.10.047","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499189","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":"Intraprocedural and postprocedural adverse events associated with a single-chamber atrial leadless pacemaker.","authors":"Jakrin Kewcharoen, Kuldeep Shah, Rahul Bhardwaj, Mohit K Turagam, Dhanunjaya Lakkireddy, Jalaj Garg","doi":"10.1016/j.hrthm.2024.10.043","DOIUrl":"10.1016/j.hrthm.2024.10.043","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499180","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":"An international physician survey of current ablation practices in atrial fibrillation: An AIM-AF substudy.","authors":"Sanjeev Saksena, April Slee, Jose L Merino, Andreas Goette, Giuseppe Boriani, Peter R Kowey, Jonathan P Piccini, James A Reiffel, Carina Blomström-Lundqvist, A John Camm","doi":"10.1016/j.hrthm.2024.10.044","DOIUrl":"10.1016/j.hrthm.2024.10.044","url":null,"abstract":"<p><strong>Background: </strong>Practice guidelines recommend ablation (ABL) in atrial fibrillation (AF) for rhythm control. Guidance for antiarrhythmic drugs (AADs) post-ABL is limited.</p><p><strong>Objective: </strong>The purpose of this study was to determine AAD and ABL practices in the United States and Europe.</p><p><strong>Methods: </strong>An online survey of experienced cardiologists (CDs) (n = 360) and interventional electrophysiologists (EPs) (n = 269) was conducted. AAD- and ABL-related survey questions and responses were analyzed.</p><p><strong>Results: </strong>ABL was preferred more often as first-line AF therapy (Rx) by US CDs/EPs (P ≤.001). ABL was selected to avoid AAD Rx by 46% (50% CDs, 40% EPs); to prevent AF progression by 41% (36% CDs, 47% EPs); and for superior efficacy by 28% (27% CDs, 30% EPs). ABL was used by 9% in asymptomatic AF (9% CDs, 10% EPs), by 14% in subclinical AF (13% CDs, 14% EPs), and by 17% for first AF event (15% CDs, 18% EPs). Primary ABL was preferred in heart failure by 38%. Comorbidities, age, and left atrial size were limitations for ABL by 48%, 40%, and 38%, respectively. AADs were used after ABL for AF/atrial tachycardia (AT) prophylaxis by 34% for 3-6 months and 29% for 1-2 months. AADs were given for a single AF recurrence by 34%, bridging to re-ABL by 32%, and long-term Rx by 34%. AF/AT post-ABL was most often managed with amiodarone (42%-48%).</p><p><strong>Conclusion: </strong>ABL was frequently preferred over AADs in symptomatic AF but notably also was used for asymptomatic and subclinical AF. Post-ABL AAD Rx for AF prophylaxis or recurrence was frequent, with empiric amiodarone being the most often selected AAD.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499174","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}