Heart rhythm最新文献

{"title":"Causal inference in the field of arrhythmia: An introduction to mendelian randomization.","authors":"Eva Lukas, Margot van de Weijer, Jacob Bergstedt, Connie R Bezzina, Jorien L Treur","doi":"10.1016/j.hrthm.2024.07.015","DOIUrl":"10.1016/j.hrthm.2024.07.015","url":null,"abstract":"<p><p>Mendelian randomization (MR) uses genetic variants associated with an exposure (eg, high blood pressure) as instrumental variables to test causal effects on an outcome (eg, atrial fibrillation [AF]). By leveraging the random assortment of genetic variants during gamete formation, MR reduces biases like confounding and reverse causation. We screened 391 papers, examining 277 that applied MR to investigate arrhythmia and, in others, cardiovascular traits, lifestyle, behavioral traits, and body composition. Our analysis focused on MR studies of arrhythmia and cardiovascular traits. Key findings highlight high systolic blood pressure, low resting heart rate, elevated cardiac troponin I levels, coronary artery disease, and heart failure as risk factors for AF, whereas AF itself increases heart failure risk. As genetic data become more accessible, MR's relevance grows. Sensitivity analyses and integrating MR with other methodologies in a triangulation framework enhance the robustness of causal inferences by navigating different biases.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"203-216"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633177","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":"Focal aneurysm formation in a coronary bypass graft after permanent pacemaker implantation.","authors":"Benito Baldauf, Hendrik Bonnemeier","doi":"10.1016/j.hrthm.2024.07.018","DOIUrl":"10.1016/j.hrthm.2024.07.018","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"263-264"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633182","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 pacing outcomes in infants with heart block: Lead and device complications from a multicenter experience.","authors":"Edward T O'Leary, Shankar Baskar, Audrey Dionne, Kimberlee Gauvreau, Taylor S Howard, Lanier B Jackson, Robert D Whitehill, Douglas Y Mah","doi":"10.1016/j.hrthm.2024.07.014","DOIUrl":"10.1016/j.hrthm.2024.07.014","url":null,"abstract":"<p><strong>Background: </strong>Infants with complete heart block (CHB) require epicardial pacemaker (PM) insertion. Prior studies described epicardial pacing outcomes in infants and children, although they were limited by small or heterogeneous populations.</p><p><strong>Objective: </strong>This study aimed to explore patient- and procedure-level associations with device complications in infants with CHB who received a permanent PM.</p><p><strong>Methods: </strong>This was a multicenter, retrospective cohort study including infants receiving an epicardial PM between 2000 and 2021 for CHB. The primary outcome was time to device-related adverse event: lead failure requiring revision; pocket infection; exit block requiring increased pacing output; or lead-related coronary artery compression. Time-to-event analysis was performed by the Kaplan-Meier method with a multivariable Cox proportional hazards model.</p><p><strong>Results: </strong>There were 174 infants who received an epicardial PM (282 bipolar, 39 unipolar leads) for CHB. Median age and weight at PM were 93.5 days and 4.5 kg, respectively. Pacing indication was postoperative CHB in 63% and congenital CHB in 37%. The median follow-up was 2.1 years. The primary outcome occurred in 26 infants at a median time to event of 0.6 year. Age ≤90 days at PM implantation was the most significant risk factor for a device-related adverse event (hazard ratio, 7.02; P < .001), primarily driven by pocket infections. Lead failure occurred in 3% of leads with a 5- and 10-year freedom from failure of 93% and 83%, respectively.</p><p><strong>Conclusion: </strong>Device complications affect 15% of infants receiving a permanent PM for heart block. Age ≤90 days at PM implantation is especially associated with infectious complications. Epicardial lead durability appears similar to previously reported pediatric experiences.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"170-180"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619841","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":"Revised protocol for loop recorder implant, maximizing R-wave amplitude minimizes false-positive alarms.","authors":"Luigi Cocchiara, Benedetta Brescia, Alessandro Volpe, Daniele Faccenda, Alfonsomaria Salucci, Aldo Marrese, Valerio Pergola, Giuseppe Ammirati, Celeste Fonderico, Stefano Nardi, Riccardo Persico, Gianluigi Comparone, Lucio Addeo, Pasquale Visconti, Emanuele Parlato, Teresa Strisciuglio, Giovanni Esposito, Antonio Rapacciuolo","doi":"10.1016/j.hrthm.2024.07.025","DOIUrl":"10.1016/j.hrthm.2024.07.025","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"275-276"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727058","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":"Is electrical cardioversion independently associated with infarcts on brain magnetic resonance imaging or clinical outcomes in patients with atrial fibrillation?","authors":"Annina Stauber, Andreas Müller, Nikki Rommers, Stefanie Aeschbacher, Leo H Bonati, David Conen, Tobias Reichlin, Peter Ammann, Nicolas Rodondi, Marcello DiValentino, Giorgio Moschovitis, Helena Aebersold, Jürg Hans Beer, Tim Sinnecker, Raban V Jeger, David J Kurz, Claudia Liedtke, Michael Kühne, Stefan Osswald, Alain M Bernheim","doi":"10.1016/j.hrthm.2024.06.026","DOIUrl":"10.1016/j.hrthm.2024.06.026","url":null,"abstract":"<p><strong>Background: </strong>Electrical cardioversion (ECV) is frequently performed in symptomatic atrial fibrillation.</p><p><strong>Objective: </strong>This study aimed to assess the association of ECV with infarcts on brain magnetic resonance imaging (bMRI) and clinical outcomes.</p><p><strong>Methods: </strong>The Swiss Atrial Fibrillation Cohort Study included 2386 patients; 1731 patients were evaluated by bMRI. ECVs were recorded by questionnaire. Patients were assigned to categories by number of ECVs performed before enrollment (0, 1, ≥2). A bMRI study was conducted at baseline and after 2 years (n = 1227) and analyzed for large noncortical or cortical infarcts and small noncortical infarcts. Clinical outcomes were recorded during follow-up. Associations of ECV and outcome measures were assessed by multivariate analyses.</p><p><strong>Results: </strong>There was no independent association between the number of ECVs and infarct prevalence (large noncortical or cortical infarcts and small noncortical infarcts) on baseline bMRI (ECV 1 vs 0: odds ratio [OR], 0.95 [95% CI, 0.68-1.24]; ECV ≥2 vs 0: OR, 1.04 [0.72-1.44]) or between ECVs performed during follow-up and new infarcts on bMRI at 2 years (OR, 1.46 [0.54-3.31]). ECVs were not associated with overt stroke or transient ischemic attack (ECV 1 vs 0: hazard ratio [HR], 1.36 [0.88-2.10]; ECV ≥2 vs 0: HR, 1.53 [0.94-2.48]), hospitalization for heart failure (ECV 1 vs 0: HR, 1.06 [0.82-1.37]; ECV ≥2 vs 0: HR, 1.03 [0.77-1.38]), or death (ECV 1 vs 0: HR, 0.90 [0.70-1.15]; ECV ≥2 vs 0: HR, 0.91 [0.69-1.20]).</p><p><strong>Conclusion: </strong>There was no association between ECV performed before enrollment and cerebral infarcts on baseline bMRI or between ECV performed during follow-up and new infarcts at 2 years. Moreover, ECV was not associated with clinical events.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"6-12"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142034415","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":"HRS policy statement on catheter ablation of atrial fibrillation.","authors":"Christopher F Liu, Adam E Berman, Mina K Chung, Jonathan Dukes, Kenneth A Ellenbogen, Scott J Greenberg, Sabina Hadziabdulahovic, Arvindh N Kanagasundram, Timothy R Larsen, Sumeet K Mainigi, Molly Sachdev, Mark H Schoenfeld, David J Slotwiner, Amit Thosani, J Peter Weiss, Lisa Miller, Anne Marie Smith, Amit J Shanker","doi":"10.1016/j.hrthm.2024.09.048","DOIUrl":"10.1016/j.hrthm.2024.09.048","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"289-292"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345224","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":"Reply to the Editor- Revisiting the prognostic role of SCN5A in Brugada syndrome.","authors":"Ioannis Doundoulakis, Luigi Pannone, Pedro Brugada, Carlo de Asmundis","doi":"10.1016/j.hrthm.2024.06.023","DOIUrl":"10.1016/j.hrthm.2024.06.023","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"281"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436773","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":"Variations in threshold values for border zone and dense scar produce significant changes in scar parameters obtained by ADAS-3D.","authors":"Valentina Faga, Paolo D Dallaglio, Eduard Claver, Julian Rodriguez-García, Rodolfo San Antonio, Marcos Rodriguez, Cemirame Payan, Josep Comin-Colet, Ignasi Anguera, Andrea Di Marco","doi":"10.1016/j.hrthm.2024.06.055","DOIUrl":"10.1016/j.hrthm.2024.06.055","url":null,"abstract":"<p><strong>Background: </strong>ADAS-3D software elaborates cardiac magnetic resonance (CMR) images to obtain a quantitative evaluation of dense scar and border zone (BZ), including BZ channels, which can be useful for ventricular tachycardia ablation and risk stratification. However, most prior reports with ADAS-3D used flexible thresholds (60% ± 5% and 40% ± 5% of maximum pixel signal intensity) to define dense scar and BZ. The impact of such variations of the threshold values on the measurements obtained with ADAS-3D is unknown.</p><p><strong>Objective: </strong>This study aimed to quantify the degree of change in ADAS-3D measurements when different thresholds for dense scar and BZ are employed.</p><p><strong>Methods: </strong>A single-center retrospective observational cohort study including 87 consecutive patients with previous myocardial infarction who underwent CMR was conducted. ADAS-3D software semiautomatically processed CMR sequences. We compared the scar measurements obtained with the 9 possible combinations of thresholds (55%/60%/65% and 35%/40%/45% of maximum pixel signal intensity).</p><p><strong>Results: </strong>The overall comparison between thresholds showed highly significant differences (P < .001) in all scar parameters. Not a single patient maintained the same number of BZ channels with all the thresholds settings. A percentage difference of up to 200% in BZ channel numbers and channel mass was observed in all 36 comparisons. An absolute difference of up to 10 channels was also recorded. Of note, the highest median channel mass (obtained with the thresholds 35-65) was 59-fold higher compared with the lowest one (obtained with the 45-55 cutoffs).</p><p><strong>Conclusion: </strong>Variations in threshold values result in statistically significant and high-magnitude changes in the quantification of scar parameters by ADAS-3D.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"106-117"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497930","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":"Differences in coagulation responses to vascular injury between uninterrupted dabigatran and apixaban: A clinical prospective randomized study.","authors":"Yasuhiro Ikami, Daisuke Izumi, Shinya Fujiki, Hirotaka Sugiura, Sou Otsuki, Naomasa Suzuki, Yuta Sakaguchi, Takahiro Hakamata, Yuki Hasegawa, Nobue Yagihara, Kenichi Iijima, Takahiro Tanaka, Masahiro Ishizawa, Masaomi Chinushi, Tohru Minamino, Takayuki Inomata","doi":"10.1016/j.hrthm.2024.07.017","DOIUrl":"10.1016/j.hrthm.2024.07.017","url":null,"abstract":"<p><strong>Background: </strong>The coagulation response during vascular injury with uninterrupted administration of direct oral anticoagulants has not been elucidated.</p><p><strong>Objective: </strong>Our aim was to evaluate differences in coagulation responses after vascular injury between uninterrupted direct thrombin inhibitor and direct factor Xa inhibitor recipients.</p><p><strong>Methods: </strong>Patients scheduled for catheter ablation for atrial fibrillation were randomly assigned to receive dabigatran or apixaban in this prospective, randomized, comparative, parallel-group study. Venous blood was collected 3 times: 180 minutes after taking the anticoagulant on the day before the procedure, before vascular punctures of the ablation procedure, and 10-15 minutes after the start of vascular punctures.</p><p><strong>Results: </strong>Forty-two patients were enrolled. The prothrombin fragment 1+2 level, the primary end point, was much larger after vascular puncture in the uninterrupted dabigatran recipients (median, 83 pmol/L; interquartile range, 56-133 pmol/L) than in the uninterrupted apixaban recipients (median, 1 pmol/L; interquartile range, -3 to 19 pmol/L; P < .001). Antithrombin levels decreased after vascular puncture in dabigatran recipients, and both protein C and antithrombin levels decreased after vascular puncture in apixaban recipients.</p><p><strong>Conclusion: </strong>Unlike uninterrupted apixaban, uninterrupted dabigatran does not inhibit thrombin generation in response to vascular injury.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"21-28"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633179","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":"Management of anesthesia for procedures in the cardiac electrophysiology laboratory.","authors":"Bharath Rajagopalan, Dhanunjaya Lakkireddy, Amin Al-Ahmad, Jonathan Chrispin, Mitchell Cohen, Luigi Di Biase, Rakesh Gopinathannair, Viviane Nasr, Rachita Navara, Parin Patel, Pasquale Santangeli, Ronak Shah, Juan Sotomonte, Arun Sridhar, Wendy Tzou, Jim W Cheung","doi":"10.1016/j.hrthm.2024.06.048","DOIUrl":"10.1016/j.hrthm.2024.06.048","url":null,"abstract":"<p><p>The complexity of cardiac electrophysiology procedures has increased significantly during the past 3 decades. Anesthesia requirements of these procedures can differ on the basis of patient- and procedure-specific factors. This manuscript outlines various anesthesia strategies for cardiac implantable electronic devices and electrophysiology procedures, including preprocedural, procedural, and postprocedural management. A team-based approach with collaboration between cardiac electrophysiologists and anesthesiologists is required with careful preprocedural and intraprocedural planning. Given the recent advances in electrophysiology, there is a need for specialized cardiac electrophysiology anesthesia care to improve the efficacy and safety of the procedures.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":"217-230"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467551","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}