Heart rhythm最新文献

{"title":"Reply to the Editor - Validation and predictive performance of the PAT score.","authors":"Tsukasa Kamakura, Masahiko Takagi, Yuki Komatsu, Tetsuji Shinohara, Yoshiyasu Aizawa, Yukio Sekiguchi, Yasuhiro Yokoyama, Naohiko Aihara, Masayasu Hiraoka, Kazutaka Aonuma","doi":"10.1016/j.hrthm.2024.10.048","DOIUrl":"10.1016/j.hrthm.2024.10.048","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":"142499177","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":"Methods and Techniques to Optimize Energy Delivery Using the Circular Array Pulsed Field Ablation Catheter.","authors":"Stavros Mountantonakis, Nicholas Beccarino, Mark Abrams, Nikhil Sharma, Nicholas Skipitaris, Neil Bernstein, Kelly Jia, Kabir Bhasin, Takashi Kanda, Kordalis Athanasios, Dimitris Tsiachris, Kristie Coleman","doi":"10.1016/j.hrthm.2024.10.045","DOIUrl":"https://doi.org/10.1016/j.hrthm.2024.10.045","url":null,"abstract":"<p><p>Pulsed field ablation (PFA) is a novel method of cardiac ablation in which electrical fields are used to create microscopic pores in the cardiomyocyte cell membrane resulting in cell death. Unlike traditional thermal radiofrequency and cryoablation technologies, PFA is cardiomyocyte preferential, reducing the risk of collateral damage to the esophagus and phrenic nerve. However, achieving durable lesions with PFA is dependent on the proximity to the tissue and presently approved systems do not provide contact force sensing. The PulseSelect pulsed field ablation system is the first FDA approved/ CE marked/PMDA approved system for pulsed field ablation of atrial fibrillation, however there is no consensus on workflow and best practices. We present here real-world experience from our centers in the United States, Europe and Japan, and propose techniques and methods for incorporating fluoroscopy, electro-anatomical mapping, and intracardiac echocardiography to assure optimal lesion delivery and predictability.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499182","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":"Percutaneous biopsy and removal of a pacemaker lead-attached mass of unclear nature.","authors":"Eric Gnall, Sandra Abramson, Katie Hawthorne, Ali R Keramati, Colleen M Hanley, David Barry, Harish Jarrett, Zach Rozenbaum","doi":"10.1016/j.hrthm.2024.10.035","DOIUrl":"10.1016/j.hrthm.2024.10.035","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499185","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":"Multielectrode catheter-induced ectopy mapping: a novel technique for ablation of infrequent premature ventricular contractions.","authors":"Raphaël P Martins, Konstantinos Vlachos, Nuno Cortez-Dias, Pierre Groussin, Redwane Rakza, Nathalie Behar, Philippe Mabo, Christophe Leclercq, Dominique Pavin, Karim Benali","doi":"10.1016/j.hrthm.2024.10.039","DOIUrl":"10.1016/j.hrthm.2024.10.039","url":null,"abstract":"<p><strong>Background: </strong>Ablation of infrequent premature ventricular complexes (PVC) is challenging.</p><p><strong>Objectives: </strong>A novel mapping strategy for patients with infrequent PVCs, called multielectrode catheter-induced ectopy mapping (MECIE mapping) is described, aiming at performing a hybrid activation/template matching map by taking advantage of multielectrode catheter-induced arrhythmogenicity.</p><p><strong>Methods: </strong>Patients referred to 3 tertiary centers for PVC ablation were prospectively enrolled if they had infrequent PVCs (less than 1 PVC per minute) at onset of procedure, preventing the realization of an accurate activation map. A detailed MECIE map was created using the arrhythmogenic property of multielectrode catheters, corresponding to a local activation time (LAT) map generated by annotating LAT from mechanical PVCs. Selecting mechanical PVCs with ≥99% concordance with the clinical PVC spotted the site of origin at which ablation was delivered. The primary endpoint was long-term success, defined as an >80% reduction in PVC burden during follow-up.</p><p><strong>Results: </strong>A total of 29 patients were included, with 25 (interquartile range [IQR] 7-30) PVCs in the initial 30 minutes of procedure. During MECIE mapping, 67 (IQR 1-332) points with ≥99% concordance were acquired. The best LAT was 34.0 ± 9.5 ms before QRS onset. Pace mapping was 97.4 ± 3.1% compared with the clinical PVC. Ablation was locally performed. After 13.2 ± 5.1 months of follow-up, 27 patients (93.1 %) had 80% reduction in PVC burden, and only 2 patients had symptomatic recurrences.</p><p><strong>Conclusion: </strong>A detailed MECIE map taking advantage of multielectrode catheter arrhythmogenicity may be generated to spot the origin of PVCs, a strategy resulting in a good procedural success rate.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499183","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":"PVI-only is not enough for all patients with persistent AF: A FLOW-AF subgroup analysis.","authors":"Atul Verma, Steven Castellano, Melissa H Kong, Petr Neuzil, Tamas Szili-Torok, Stefan G Spitzer, Andreas Rillig, Vivek Y Reddy","doi":"10.1016/j.hrthm.2024.10.037","DOIUrl":"10.1016/j.hrthm.2024.10.037","url":null,"abstract":"<p><strong>Background: </strong>Since the Substrate and Trigger Ablation for Reduction of Atrial Fibrillation Trial Part II (STAR-AF II), there has been a trend toward pulmonary vein isolation (PVI)-only ablation strategies for persistent atrial fibrillation (PeAF). Electrographic flow (EGF) mapping can identify active sources of atrial fibrillation (AF) and estimate the electrographic flow consistency (EGFC) of wavefront propagation through substrate, revealing functional AF mechanisms.</p><p><strong>Objective: </strong>We sought to examine the success of a PVI-only ablation strategy for a redo PeAF/longstanding PeAF population.</p><p><strong>Methods: </strong>Electrographic Flow-Guided Ablation in Redo Patients With Persistent Atrial Fibrillation (FLOW-AF [NCT04473963]) prospectively enrolled patients with nonparoxysmal AF undergoing redo ablation at 4 centers. One-minute EGF recordings using 64-pole basket catheters were obtained both pre-PVI and post-PVI following a 20-minute wait and confirmation of electrical isolation of veins. Patients with EGF-identified sources were randomized 1:1 to EGF-guided source ablation vs PVI-only. Patients with no sources were not randomized and mostly received PVI only.</p><p><strong>Results: </strong>Study of 85 patients enrolled 24 with EGF-identified sources randomized to PVI only and 23 with no sources receiving PVI only. Of these 47 patients, those with sources (Group 2) had different clinical characteristics including older age and higher CHA₂DS₂-VASc scores compared with those with sources (Group 1). After PVI only, Group 1 had 70% (16 of 23) freedom from recurrent AF (FFAF) within 1 year vs Group 2 with 35% (8 of 23), P = .018. In addition, patients with high electrographic flow consistency (EGFC) indicative of healthy or normal substrate had 67% (10 of 15) FFAF vs 45% (14 of 31) in those with low EGFC suggestive of abnormal substrate, P = .011.</p><p><strong>Conclusion: </strong>Success rates in no-sources patients receiving PVI only are better than in those with sources randomized to PVI only. For the clinically heterogenous population of patients with PeAF, the presence of EGF-identified sources matters clinically, and PVI only will not be enough for all patients.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499188","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":"Procedural characteristics, safety, and clinical outcomes of pulsed-field ablation for pulmonary vein isolation in patients with a left common pulmonary vein.","authors":"Fabian Jordan, Sven Knecht, Corinne Isenegger, Rebecca Arnet, Nicolas Schaerli, Philipp Krisai, David Spreen, Felix Mahfoud, Christian Sticherling, Michael Kühne, Patrick Badertscher","doi":"10.1016/j.hrthm.2024.10.041","DOIUrl":"10.1016/j.hrthm.2024.10.041","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499187","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":"Value of multimodality imaging for ventricular tachycardia ablation in patients with structural heart disease.","authors":"Boldizsar Kovacs, Michael Ghannam, Jackson Liang, Amrish Deshmukh, Anil Attili, Hubert Cochet, Rakesh Latchamsetty, Krit Jongnarangsin, Fred Morady, Frank Bogun","doi":"10.1016/j.hrthm.2024.10.032","DOIUrl":"10.1016/j.hrthm.2024.10.032","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499190","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":"Atrial flutter and sick sinus syndrome.","authors":"Jean Jacques Noubiap, Thomas A Dewland, Jeffrey E Olgin, Janet J Tang, Catherine Lee, Gregory M Marcus","doi":"10.1016/j.hrthm.2024.10.033","DOIUrl":"10.1016/j.hrthm.2024.10.033","url":null,"abstract":"<p><strong>Background: </strong>Sick sinus syndrome (SSS) is a common condition resulting in reduced quality of life, syncope, and permanent pacemaker (PPM) implantation, but predictors have not been elucidated. Whereas atrial arrhythmias are frequently associated with SSS, we hypothesized that atrial flutter (AFL) would strongly predict SSS, given shared relationships with right atrial and particularly crista terminalis fibrosis.</p><p><strong>Objective: </strong>The study aimed to assess the impact of AFL on the occurrence of SSS and associated syncope and PPM implantation.</p><p><strong>Methods: </strong>Health care databases were used to identify adults aged ≥18 years receiving hospital-based care in California in 2005-2019. International Classification of Diseases codes were used to identify diagnoses and procedures. Patients were classified on the basis of the presence of AFL and atrial fibrillation (AF). Cox proportional hazards models adjusting for demographics and comorbidities were employed.</p><p><strong>Results: </strong>We included 29,357,609 individuals (54% female; mean age, 46 years), 101,243 with AFL alone, 1,674,680 with AF alone, and 284,547 with AF and AFL. After adjustment for age, sex, race and ethnicity, and comorbidities, AF, AFL, and both arrhythmias were each associated with increased risk of SSS and associated syncope and PPM implantation (all P < .001). In the population with AF, an additional AFL diagnosis conferred a higher risk for development of SSS (hazard ratio [HR],1.62; 95% confidence interval, 1.59-1.64), syncope (HR, 1.63; 1.54-1.72), and PPM implantation (HR, 1.74; 1.70-1.79).</p><p><strong>Conclusion: </strong>AFL is associated with an increased risk of incident SSS and its adverse consequences, especially in patients with coexisting AF. AFL may be useful for risk stratification strategies to predict, to prevent, and to treat SSS.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499176","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":"Atrial fibrillation's hidden compass: The left atrium and the future of risk stratification.","authors":"Christopher V DeSimone, Nicholas Y Tan, Abhishek J Deshmukh","doi":"10.1016/j.hrthm.2024.10.042","DOIUrl":"10.1016/j.hrthm.2024.10.042","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499175","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":"Personalized ablation strategies optimize first-pass isolation and minimize pulmonary vein reconnection during paroxysmal atrial fibrillation ablation.","authors":"Joey Junarta, Jessica Qiu, Austin V Cheng, Chirag R Barbhaiya, Lior Jankelson, Douglas Holmes, Alexander Kushnir, Robert J Knotts, Felix Yang, Scott A Bernstein, David S Park, Larry A Chinitz, Anthony Aizer","doi":"10.1016/j.hrthm.2024.10.036","DOIUrl":"10.1016/j.hrthm.2024.10.036","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499186","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}