Heart rhythm最新文献

{"title":"Non-linear Relationship and Predictive Value of Systemic Immune-Inflammation Index for Atrial Fibrillation Recurrence After Catheter Ablation in Hypertensive Patients.","authors":"Zixi Zhang, Shunyi Li, Tao Tu, Chaoshuo Liu, Yongguo Dai, Cancan Wang, Qiuzhen Lin, Chan Liu, Yichao Xiao, Qiming Liu","doi":"10.1016/j.hrthm.2025.03.1958","DOIUrl":"https://doi.org/10.1016/j.hrthm.2025.03.1958","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a prevalent arrhythmia in hypertensive patients and significantly increases mortality. Chronic inflammation plays a critical role in the pathophysiology of AF.</p><p><strong>Objective: </strong>To evaluate the prognostic value of systemic immune-inflammation index (SII) in predicting AF recurrence after catheter ablation in hypertensive patients.</p><p><strong>Methods: </strong>This retrospective cohort study included 418 hypertensive patients with paroxysmal AF who underwent catheter ablation between January 2019 and January 2023. Cox proportional hazards models, restricted cubic spline (RCS) analysis, and receiver operating characteristic (ROC) curves were used to evaluate the association between SII and AF recurrence. The predictive performance of SII was compared with that of C-reactive protein (CRP) and high-sensitivity C-reactive protein (hsCRP). Sensitivity analyses were performed to assess the robustness of findings.</p><p><strong>Results: </strong>AF recurrence occurred in 17.94% of patients. SII was an independent predictor of recurrence (HR: 1.13, 95% CI: 1.09-1.19; P < 0.001). RCS analysis revealed a non-linear relationship with a threshold of 457.41 ×10⁹/L, above which the risk of recurrence increased markedly. ROC analysis demonstrated that SII had superior predictive performance compared to CRP and hsCRP (AUC: 0.688 vs. 0.510 and 0.542). Sensitivity analyses confirmed the robustness of SII across subgroups.</p><p><strong>Conclusions: </strong>SII is a valuable marker for predicting AF recurrence post-ablation in hypertensive patients. It supports inflammation-based risk assessments and should be considered in clinical risk stratification. Further research is needed to explore inflammation-targeted therapies.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663330","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-Attitudinally Appropriate Nomenclature.","authors":"Eduardo Back Sternick, Robert H Anderson, Rehan Mahmud, Jose Angel Cabrera, Demosthenes Katritsis, Jeronimo Farre, Justin T Tretter, Diane E Spicer, Andrew C Cook, Damian Sanchez-Quintana","doi":"10.1016/j.hrthm.2025.03.1949","DOIUrl":"10.1016/j.hrthm.2025.03.1949","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663172","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":"Letter to the Editor-Attitudinal Anatomy.","authors":"Martin J LaPage","doi":"10.1016/j.hrthm.2025.02.053","DOIUrl":"10.1016/j.hrthm.2025.02.053","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663242","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":"Modified electrocardiogram using only limb leads to record V1 and V6: A simplified approach for left bundle branch area pacing follow-up.","authors":"Alberto Spadotto, Valérian Valiton, Haran Burri","doi":"10.1016/j.hrthm.2025.03.1956","DOIUrl":"10.1016/j.hrthm.2025.03.1956","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663328","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":"Association of Air Pollution with Ventricular Arrhythmias and Physical Activity: A Natural Experiment from US Wildfires.","authors":"Krishna Pundi, Valentina Kutyifa, Jagmeet P Singh, Jim W Cheung, Gaurav A Upadhyay, Malini Madhavan, Camden Harrell, Steven Mullane, Mintu P Turakhia","doi":"10.1016/j.hrthm.2025.03.1953","DOIUrl":"https://doi.org/10.1016/j.hrthm.2025.03.1953","url":null,"abstract":"<p><strong>Background: </strong>The association between particulate matter (PM) air pollution and ventricular arrhythmias is not well established. In patients with cardiac implantable electronic devices (CIED), publicly available day-level air pollution data provide a unique opportunity to study acute and subacute effects of particulate matter pollution.</p><p><strong>Objective: </strong>To evaluate the association of air pollution with ventricular arrhythmias, physical activity, and CIED markers of heart failure.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using the CERTITUDE database of CIED patients. The primary predictors were Air Quality Index (AQI), PM<10μm in diameter (PM₁₀), and PM<2.5μm in diameter (PM_2.5). We cross-linked day-level air pollutant levels to patient zip codes. We determined the association of air pollution to CIED parameters using (1) a case-crossover analysis using a conditional logistic regression and (2) a time-varying exposure analysis using an Andersen-Gill model.</p><p><strong>Results: </strong>The study cohort included 28349 patients (32% female, age 72.8±11.9), of whom 17448 (61.6%) had pacemakers and 9079 (32%) had defibrillators. AQI and PM_2.5 were associated with significant changes in physical activity, heart rate, and thoracic impedance. When limiting to the 8687 patients living in Western US Fire States (AZ/CA/CO/NM/NV/OR/UT/WA), there was a strong association between PM_2.5 and PVC burden, with an odds ratio of 7.72 (95% confidence interval: 7.48-7.96; p<0.0001) for PM_2.5≥13.7. Multiple sensitivity analyses demonstrated the stability of our findings.</p><p><strong>Conclusion: </strong>In a large cohort of CIED patients, AQI and PM_2.5 had significant associations with PVC burden, physical activity and heart rate. These data also demonstrate the feasibility of linking environmental data with patient sensor data to evaluate exposure-outcome relationships.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663238","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":"Progressive splitting of the QRS complex during 2 decades.","authors":"Yuko Matsui, Satoshi Higuchi, Daigo Yagishita, Tsuyoshi Shiga, Morio Shoda, Junichi Yamaguchi","doi":"10.1016/j.hrthm.2025.02.054","DOIUrl":"10.1016/j.hrthm.2025.02.054","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663332","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, Luuk H G A Hopman, Fernando O Campos, Cornelis P Allaart, Pieter G Postema, Michiel J B Kemme, Marco J W Götte, Martin J Bishop, Vokko P van Halm, Pranav Bhagirath","doi":"10.1016/j.hrthm.2025.03.1943","DOIUrl":"10.1016/j.hrthm.2025.03.1943","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>This study assessed the impact of FWHM and n-SD on MAG- and PSIR-derived scar characteristics.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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; P<.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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-03-13","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":"Long-term weight change and transition of metabolic health status in middle life and the risk of atrial fibrillation.","authors":"Jiang Li, Xiaoqing Xu, Yuefeng Yu, Ying Sun, Lingli Cai, Wenqi Shen, Bin Wang, Xiao Tan, Yingli Lu, Ningjian Wang","doi":"10.1016/j.hrthm.2025.03.1942","DOIUrl":"10.1016/j.hrthm.2025.03.1942","url":null,"abstract":"<p><strong>Background: </strong>The association of long-term weight change with atrial fibrillation (AF) risk remains controversial, and evidence for the effect of metabolic health transition on AF is limited.</p><p><strong>Objective: </strong>The purpose of this study was to evaluate the effects of body mass index (BMI) change and transition in BMI-metabolic health status on AF.</p><p><strong>Methods: </strong>We conducted a prospective cohort study within the UK Biobank. Metabolic health was defined as having at least 4 of the 6 metabolically healthy (MH) criteria including blood pressure, C-reactive protein, triacylglycerols, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and glycated hemoglobin.</p><p><strong>Results: </strong>Of the 490,969 participants initially included for baseline BMI analysis, 33,297 AF cases were observed during a median follow-up of 14.0 years. Overweight (hazard ratio [HR] 1.12; 95% confidence interval [CI] 1.09-1.15) and obesity (1.74; 1.68-1.79) significantly increased the risk of AF. A BMI loss of >2% per year was associated with a lower risk of AF (0.75; 0.57-0.99), especially transitioning from obesity to overweight (0.74; 0.54-1.02), though without statistical significance. Compared with MH-normal weight, the HRs for MH-obesity and metabolically unhealthy (MU)-obesity were 1.74 (1.67-1.81) and 1.76 (1.69-1.83), respectively. The transition from MH-overweight/obesity to MU-overweight/obesity increased the risk of AF (1.35; 0.97-1.88).</p><p><strong>Conclusion: </strong>A BMI decrease of >2% per year was associated with a lower risk of AF, particularly in those changing from obesity to overweight. The transition from MH-overweight/obesity to MU-overweight/obesity increased the risk of AF. Weight management and maintenance of metabolic health should be recommended for primary prevention of AF.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633845","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":"Efficacy and safety of oral factor XI/XIa inhibitors in atrial fibrillation: A systematic review and meta-analysis of randomized controlled trials.","authors":"Milene Vitória Sampaio Sobral, Ivo Queiroz, Wellgner Fernandes Oliveira Amador, João Lucas de Magalhães Leal Moreira, Rafaela da Cunha Pirolla, Rodrigo Bettanim Menechini, Flávia Queiroga, Francis Lopes Pacagnelli, Camila Mota Guida","doi":"10.1016/j.hrthm.2025.02.052","DOIUrl":"10.1016/j.hrthm.2025.02.052","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633843","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":"Dual-chamber leadless pacemaker implant procedure outcomes: Insights from the AVEIR DR i2i study.","authors":"Rahul N Doshi, James E Ip, Pascal Defaye, Vivek Y Reddy, Derek V Exner, Robert Canby, Morio Shoda, Maria Grazia Bongiorni, Gerhard Hindricks, Petr Neuzil, Thomas Callahan, Sri Sundaram, Daniel F Booth, Louis-Philippe Richer, Nima Badie, Reinoud E Knops","doi":"10.1016/j.hrthm.2025.03.1941","DOIUrl":"10.1016/j.hrthm.2025.03.1941","url":null,"abstract":"<p><strong>Background: </strong>Initial results were recently reported for the AVEIR DR i2i study, which involved the percutaneous implantation of a novel dual-chamber leadless pacemaker (LP) system, with right atrial and right ventricular LPs delivering atrioventricular synchronous pacing.</p><p><strong>Objective: </strong>The purpose of this study was to evaluate procedural outcomes and learning curve for de novo implantation of the dual-chamber LP (AVEIR DR, Abbott, Abbott Park, IL).</p><p><strong>Methods: </strong>Implant procedure metrics collected during the study were analyzed, including procedural complications within 30 days of implantation. Procedural outcomes were evaluated according to implanter experience: 1-4 vs 9+ dual-chamber LP implant procedures (ie, initial vs advanced implant experience).</p><p><strong>Results: </strong>De novo dual-chamber LPs were successfully implanted in 446 of 452 patients (98.7%) by 126 physicians. Mean procedural duration metrics included 90±37 minutes of introducer sheath insertion-to-removal time, 74±32 minutes of dual-chamber procedure duration, 26±17 minutes of right ventricular LP procedure duration, 42±24 minutes of right atrial LP procedure duration, and 20±13 minutes of fluoroscopy duration; between initial and advanced implant experience, there were reductions of 19%-36% (P<.05) in these duration metrics. There were 62 procedural complications in 50 of 452 patients (11.1%) (ie, 88.9% complication free), predominantly involving cardiac arrhythmias (ie, atrial fibrillation/flutter or complete atrioventricular block; 16 of 452 [3.5%]). Freedom from complications significantly improved from 88.5% to 97.6% of patients (P<.05) when comparing initial and advanced implant experience.</p><p><strong>Conclusion: </strong>In a pivotal investigational study, implantation of a dual-chamber LP system was successful in 98.7% of patients. Advanced implant experience was accompanied by improvements in procedural outcomes including reduced procedural times (introducer sheath insertion to removal, dual-chamber procedure, ventricular LP and atrial LP procedures, and fluoroscopy) and improved freedom from complications.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT05252702.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633840","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}