Heart rhythm最新文献

{"title":"P-wave morphology of Bachmann bundle pacing based on electroanatomic mapping and intracardiac echocardiography.","authors":"Soichiro Yamashita, Mitsuru Takami, Kimitake Imamura, Mitsuaki Ito, Kenichi Tani, Wataru Fujimoto, Koji Kuroda, Junichi Imanishi, Masamichi Iwasaki, Takafumi Todoroki, Masanori Okuda, Akira Shimane, Koji Fukuzawa, Daniel L Lustgarten","doi":"10.1016/j.hrthm.2026.05.012","DOIUrl":"10.1016/j.hrthm.2026.05.012","url":null,"abstract":"<p><strong>Background: </strong>Optimal criteria for Bachmann bundle (BB) pacing have not been established with direct anatomic visualization of BB engagement.</p><p><strong>Objective: </strong>This study aimed to further characterize the optimal site for BB pacing incorporating local electrogram (EGM) and P-wave morphology.</p><p><strong>Methods: </strong>This study included 20 patients who underwent a catheter ablation for atrial fibrillation. First, the right atrial BB insertion (BBRA) was identified anatomically by electroanatomic mapping (EAM) and intracardiac echocardiography. Local EGMs at and surrounding the anatomically defined BB were analyzed using a multipolar planar mapping catheter. Second, pace mapping was performed at 5 areas around and within the BB, and their P-wave morphologies were analyzed.</p><p><strong>Results: </strong>In all cases, the echocardiographically identified BB was consistent with the BB determined by EAM. Local EGMs at the BBRA vary morphologically. In the P-wave morphology of the BBRA pacing, (1) the 12-lead P-wave axes recapitulated normal sinus rhythm (SR) P waves, (2) inferior P-wave amplitude increased with BB capture relative to the native SR P wave, (3) the P-wave duration was >10 ms shorter than that of the SR, and (4) there was no isoelectric interval pacing centrally at the right atrial BB breakout area. If all these 4 criteria are met, the BB can be predicted with 95% sensitivity and 86% specificity.</p><p><strong>Conclusion: </strong>Using a combined definition of the BB using EAM and intracardiac echocardiography, paced P-wave parameters were identified that can be used to confirm BB capture with high sensitivity and specificity, which could be useful when targeting the BB for permanent atrial pacing.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"e2914-e2922"},"PeriodicalIF":7.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147947580","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":"Subcutaneous ICD therapy in patients with prior sternotomy: feasibility and long-term outcomes in a propensity-matched analysis from a national registry.","authors":"Luca Checchi, Laura Perrotta, Matteo Ziacchi, Federico Migliore, Stefano Viani, Berardo Sarubbi, Paolo De Filippo, Giovanni Bisignani, Carlo Lavalle, Valter Bianchi, Valeria Rella, Ennio C Pisanò, Luca Santini, Giuseppe Mascia, Domenico Pecora, Roberta Brambilla, Giovanni Luca Botto, Luca Ottaviano, Roberto Rordorf, Massimo S Silvetti, Pietro Francia, Gerardo Nigro, Antonio Bisignani, Raimondo Pittorru, Mariolina Lovecchio, Sergio Valsecchi, Mauro Biffi, Giuseppe Ricciardi","doi":"10.1016/j.hrthm.2026.04.041","DOIUrl":"10.1016/j.hrthm.2026.04.041","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"e3051-e3053"},"PeriodicalIF":7.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814249","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":"Determinants and outcomes of late electrical storm in patients supported by left ventricular assist device.","authors":"Miloud Cherbi, Pierre Groussin, Vincent Galand, Erwan Flecher, Kerstin Bode, Elena Efimova, Alexey Dashkevich, Jackson Liang, John Larson, Blandine Mondesert, Jacinthe Boulet, Pierre-Emmanuel Noly, Paul Gautier, Clément Delmas, Raphael Martins","doi":"10.1016/j.hrthm.2026.05.046","DOIUrl":"10.1016/j.hrthm.2026.05.046","url":null,"abstract":"<p><strong>Background: </strong>Although ventricular arrhythmias (VAs) are frequent after left ventricular assist device (LVAD) implantation, the characteristics and prognostic significance of late electrical storm (ES) remain incompletely understood.</p><p><strong>Objective: </strong>This study aimed to assess the incidence and clinical impact of late ES in LVAD recipients.</p><p><strong>Methods: </strong>This international, multicenter, retrospective study included 1151 LVAD recipients implanted between 2006 and 2019. Late ES was defined as ≥ 3 sustained VA episodes within 24 hours occurring beyond 30 days after implantation. The primary outcome was 5-year all-cause mortality. The secondary endpoint was 5-year cardiac mortality.</p><p><strong>Results: </strong>Late ES occurred in 49 patients (4.3%), with a median onset at 9.2 months after implantation. Patients with late ES experienced significantly higher 5-year all-cause mortality (adjusted hazard ratio [aHR] 2.87 [1.81-4.54]; P < .01) and cardiac mortality (aHR 3.47 [2.14-5.62]; P < .01). Notably, late VA without ES showed no prognostic impact. Multivariable analysis identified 4 independent predictors of late ES: left ventricular end-diastolic diameter of ≥80 mm before LVAD implantation (aHR 2.47 [1.29-4.87]), nonischemic cardiomyopathy (aHR 2.20 [1.10-4.40]), history of VAs (aHR 2.35 [1.27-4.32]), and implantable cardioverter-defibrillator before LVAD implantation (aHR 4.80 [1.12-20.85]). The late ES-LVAD score, based on these variables, demonstrated good discrimination (C-statistic 0.76) and stratified patients into low- (score 0-1), intermediate- (score 2-3), and high-risk groups (score 4-5), with corresponding late ES rates of 1.0%, 3.9%, and 7.8%.</p><p><strong>Conclusion: </strong>Late ES, but not isolated late VAs, is independently associated with substantially worse long-term outcomes in LVAD recipients. The late ES-LVAD score enables practical risk stratification, facilitating targeted therapeutic interventions in high-risk patients.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"e2893-e2903"},"PeriodicalIF":7.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101393","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":"The predictive power of left atrial reservoir strain for long-term atrial fibrillation in the Atherosclerosis Risk in Communities study.","authors":"Daokun Sun, Lap Sum Chan, Faye L Norby, Riccardo M Inciardi, Elsayed Z Soliman, Alvaro Alonso, Scott D Solomon, Amil M Shah, Wei Pan, Lin Yee Chen","doi":"10.1016/j.hrthm.2025.10.029","DOIUrl":"10.1016/j.hrthm.2025.10.029","url":null,"abstract":"<p><strong>Background: </strong>Left atrial (LA) function measures from the 2-dimensional echocardiograms are linked to atrial fibrillation (AF) development, but their standalone predictive value remains unclear.</p><p><strong>Objective: </strong>This study assessed the standalone predictive power of LA function measures for long-term AF prediction (5 and 10 years).</p><p><strong>Methods: </strong>We analyzed 5442 older adults (median age 74) from the Atherosclerosis Risk in Communities study without previous AF. Participants were split into training and testing sets (7:3 ratio). We evaluated the standalone predictive performance of LA strain measures (reservoir, conduit, and contraction strain) with and without age for long-term AF. The performance was compared with that of the CHARGE-AF score and a machine learning-based predictive model that incorporates the most important routinely measured echocardiographic parameters with LA strain measures.</p><p><strong>Results: </strong>LA reservoir strain alone achieved a Harrell's C-index of 0.664 and 0.646 for 5- and 10-year AF prediction, improving to 0.677 and 0.663 when combined with age, which outperformed the CHARGE-AF score (0.667 and 0.655) and other LA strain measures. A better predictive performance was achieved by the machine learning-based predictive model, including LA reservoir strain, age, race, and 9 echocardiographic parameters; the C-indexes were 0.732 (0.686-0.777) for 5-year and 0.725 (0.693-0.757) for 10-year prediction.</p><p><strong>Conclusion: </strong>The standalone predictive performance of LA reservoir strain for long-term AF risk is comparable with the CHARGE-AF score (11 variables) and slightly lower than that of a machine learning-based model with 12 variables, highlighting the importance of LA reservoir in AF risk prediction.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"2298-2307"},"PeriodicalIF":7.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-sensitivity cardiac troponin I for enhanced risk stratification in primary prevention for sudden cardiac death in hypertrophic cardiomyopathy.","authors":"Zihao Lai, Xiaofei Li, Shuxin Fan, Hankun Yan, Haojie Zhu, Chen He, Yan Yao, Xiaohan Fan","doi":"10.1016/j.hrthm.2026.05.010","DOIUrl":"10.1016/j.hrthm.2026.05.010","url":null,"abstract":"<p><strong>Background: </strong>Risk stratification of sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM) remains challenging. High-sensitivity cardiac troponin I (hs-cTnI) specifically reflects myocardial damage whereas its relationship with SCD risk in HCM is unclear.</p><p><strong>Objective: </strong>This study aimed to investigate the prognostic value of hs-cTnI on enhancing SCD risk stratification in HCM.</p><p><strong>Methods: </strong>This cohort study consecutively enrolled 705 patients with confirmed diagnosis of HCM. The baseline and clinical follow-up data were collected. The primary end point was defined as SCD or SCD-equivalent events including witnessed arrhythmic cardiac arrest and sustained ventricular tachycardia or ventricular fibrillation requiring intervention.</p><p><strong>Results: </strong>The final analysis included 559 patients with a median age of 53.0 years, 66.2% male, 16.1% with an implantable cardioverter-defibrillator (ICD), and a median hs-cTnI level of 0.021 ng/mL. The mean follow-up was 862 days, with 51 patients (9.1%) experiencing SCD events. The hs-cTnI showed a significant nonlinear association with SCD risk and remained as an independent predictor (adjusted hazard ratio 2.93 [95% confidence interval 1.89‒4.54], P < .0001). The optimal threshold value of hs-cTnI for increased risk of SCD was 0.0405 ng/mL. The addition of hs-cTnI to the conventional risk score model significantly improved the predictive performance (C-statistic increased from 0.752 to 0.813; P = .007). Patients with both elevated risk score and hs-cTnI had the worst prognosis (P < .0001).</p><p><strong>Conclusion: </strong>The hs-cTnI could be an independent predictor of SCD risk for patients with HCM. Integrating hs-cTnI into SCD risk assessment may provide additional indication of ICD implantation for primary prevention.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"e2837-e2845"},"PeriodicalIF":7.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147947615","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":"Climate change comes to atrial fibrillation ablation: The heat wave is over, the ice age has ended.","authors":"Sohaib A Virk, Jonathan Kalman","doi":"10.1016/j.hrthm.2026.07.013","DOIUrl":"10.1016/j.hrthm.2026.07.013","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"e2692-e2694"},"PeriodicalIF":7.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148619721","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":"Epicardial assessment of transmural posterior wall isolation during endocardial pulsed field ablation in long-standing persistent atrial fibrillation.","authors":"Jordan Johnson, Nathan Shatz, Praneeth Katrapati, J Peter Weiss, Michael Zawaneh, Rong Bai, Wilber Su, Roderick Tung","doi":"10.1016/j.hrthm.2026.03.1959","DOIUrl":"10.1016/j.hrthm.2026.03.1959","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"e3041-e3042"},"PeriodicalIF":7.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645049","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 retrieval of embolized atrial leadless pacemakers: Early multicenter experience.","authors":"Syed M Zaidi, Gregory Supple, Francis E Marchlinski, Benjamin D'Souza, Eric Berkowitz, Eric Rashba, Michael Katz, David Feigenblum, Robert D Schaller","doi":"10.1016/j.hrthm.2026.07.025","DOIUrl":"10.1016/j.hrthm.2026.07.025","url":null,"abstract":"<p><strong>Background: </strong>Leadless dual-chamber pacemakers extend pacing into the atrium but introduce unique challenges related to fixation and stability. Atrial device embolization remains poorly characterized, with limited data beyond isolated case reports.</p><p><strong>Objectives: </strong>To describe the clinical features, procedural characteristics, and outcomes of embolized atrial leadless pacemakers, emphasizing warning signs and percutaneous retrieval strategies.</p><p><strong>Methods: </strong>We performed a retrospective multicenter case series of AVEIR AR embolization events across 6 United States electrophysiology centers between October 2024 and August 2025. Clinical, procedural, and imaging data were collected, including implant parameters, timing and location of embolization, and retrieval techniques.</p><p><strong>Results: </strong>Six embolization cases were identified (mean age, 71 ± 10 years, 50% women). All devices were implanted at the base of the right atrial appendage with reported minimal or absent current of injury (COI) at implantation. Embolization occurred intraprocedurally in 1 case and during the early postprocedural period in 5 cases, most commonly to the pulmonary arteries (5 of 6 cases). All devices embolized with the fixation helix oriented proximally. Percutaneous retrieval was successful in all cases using femoral access, deflectable sheaths, and snare-based techniques, without major complications. Reimplantation in 2 of 6 cases yielded a robust COI and favorable chronic electrical parameters.</p><p><strong>Conclusion: </strong>Atrial leadless pacemaker embolization, although uncommon, appears to occur early after implantation and is associated with suboptimal COI at implant. Despite unfavorable device orientation, percutaneous retrieval using standard electrophysiology tools is highly effective. Careful attention to fixation signals and adjunctive imaging may reduce embolization risk.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"2470-2475"},"PeriodicalIF":7.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497582","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":"Bidirectional temporal association of device-detected atrial fibrillation and sleep apnea.","authors":"Philipp Spitaler, Valentin Bilgeri, Gudrun Feuchtner, Patrick Rockenschaub, Fabian Barbieri, Birkan Tugrul, Agne Adukauskaite, Markus Stühlinger, Bernhard Erich Pfeifer, Peter Willeit, Axel Bauer, Wolfgang Dichtl","doi":"10.1016/j.hrthm.2026.07.026","DOIUrl":"10.1016/j.hrthm.2026.07.026","url":null,"abstract":"<p><strong>Background: </strong>The relationship between atrial fibrillation (AF) and sleep apnea (SA) is well established, but the day-to-day temporal direction of this association remains uncertain.</p><p><strong>Objective: </strong>This study aimed to examine the bidirectional day-to-day association between device-detected AF (DDAF) and device-detected SA (DDSA), while distinguishing DDAF episode onset from continuation of ongoing episodes.</p><p><strong>Methods: </strong>Data were obtained from the prospective ACaSA study in pacemaker patients undergoing continuous remote monitoring. Data collected from September 2020 to August 2025 were analyzed. Severe DDSA was defined as a respiratory disturbance index of ≥20 and a DDAF episode as a daily burden of ≥6 minutes. 3 day-level, time-stratified intraindividual case-crossover analyses were performed: pathway 1 related preceding-day DDAF burden to incident severe DDSA on the subsequent night, pathway 2 related preceding-night severe DDSA to incident DDAF episode onset the next day, and pathway 3 related preceding-night severe DDSA to continuation of an already active DDAF episode. Generalized linear mixed-effects models were used as secondary analyses.</p><p><strong>Results: </strong>A total of 112,242 patient-days from 218 patients were analyzed. Incident severe DDSA was preceded by higher odds of elevated DDAF burden on the previous day in a graded manner, with odds ratios (ORs) of 1.38 (95% confidence interval [CI], 1.10-1.74) for 6 minutes to 1 hour, 1.81 (95% CI, 1.52-2.15) for 1-12 hours, and 2.52 (95% CI, 1.97-3.22) for ≥12 hours (all P ≤ .005). Both incident DDAF episode onset and the continuation of ongoing DDAF episodes were preceded by higher odds of severe DDSA on the previous night (OR, 1.35; 95% CI, 1.10-1.64; P = .003, and OR, 2.39; 95% CI, 1.47-3.88; P < .001, respectively).</p><p><strong>Conclusion: </strong>Continuous monitoring identified a bidirectional temporal association between DDAF and DDSA. Incident severe DDSA was preceded by higher odds of elevated DDAF burden, whereas both incident DDAF episode onset and continuation of ongoing episodes were preceded by higher odds of severe DDSA.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"2342-2350"},"PeriodicalIF":7.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497547","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":"Spatial dissociation between atrial exit and the putative slow pathway substrate in atypical AVNRT.","authors":"Masao Takahashi, Yoshiaki Mizunuma, Takafumi Sasaki, Koichiro Yamaoka, Hirofumi Kujiraoka, Tomoyuki Arai, Rintaro Hojo, Seiji Fukamizu","doi":"10.1016/j.hrthm.2026.05.009","DOIUrl":"10.1016/j.hrthm.2026.05.009","url":null,"abstract":"<p><strong>Background: </strong>Atypical atrioventricular nodal reentrant tachycardia (AVNRT) is characterized by heterogeneous reentrant circuits, and substrate-oriented ablation targets remain incompletely defined because retrograde slow pathway atrial exits are spatially variable.</p><p><strong>Objective: </strong>This study aimed to explore the spatial relationship between sinus rhythm high-peak frequency (PF) regions and retrograde slow pathway atrial exits in atypical AVNRT and to evaluate the feasibility of a substrate-oriented ablation approach.</p><p><strong>Methods: </strong>11 patients with atypical AVNRT (8 fast-slow, 3 slow-slow) underwent catheter ablation guided by PF mapping during sinus rhythm. High-PF sites along the tricuspid annulus and atrial earliest activation sites during retrograde slow pathway conduction were mapped. Ablation was initially performed at the high-PF region, with additional atrial exit ablation when required.</p><p><strong>Results: </strong>High-PF sites were identified in all patients, most commonly near the 5-o'clock tricuspid annular position. No patient demonstrated spatial concordance between the high-PF and atrial earliest activation sites (mean distance 10.9 ± 4.1 mm). Ablation at the high-PF region alone eliminated retrograde slow pathway conduction in 9 of 11 patients (82%). Additional atrial exit ablation was required in 2 patients. Acute success was achieved in all patients, with no recurrences for 6 months.</p><p><strong>Conclusion: </strong>In atypical AVNRT, atrial exits were frequently spatially dissociated from a putative slow pathway substrate identified during sinus rhythm. These findings provide hypothesis-generating mechanistic insight and suggest that sinus rhythm high-PF mapping may represent a feasible substrate-oriented approach warranting validation in larger controlled studies.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"e2974-e2982"},"PeriodicalIF":7.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147947638","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}