Heart rhythm最新文献

{"title":"Electrical substrate of the right ventricle in valvular pulmonary stenosis: Early observations from electrophysiology studies before pulmonary valve replacement","authors":"Jeff Hong MD , Amr El-Bokl MD , Nicola Maschietto MD, PhD , Edward T. O’Leary MD","doi":"10.1016/j.hrthm.2024.10.075","DOIUrl":"10.1016/j.hrthm.2024.10.075","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2686-2688"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618808","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":"Slowly conducting anatomic isthmuses of tetralogy of Fallot: An opportunity for “prophylactic” ventricular tachycardia ablation","authors":"Bryce V. Johnson MD ,&nbsp;Mark Sonderman MD ,&nbsp;Matthew J. Magoon BS ,&nbsp;Andrew Pistner MD ,&nbsp;Bishoy Hanna MD ,&nbsp;Graham H. Bevan MD ,&nbsp;Rosemary McDonagh BS ,&nbsp;Patrick M. Boyle PhD, FHRS ,&nbsp;Melissa R. Robinson MD, FHRS ,&nbsp;Nazem Akoum MD, FHRS ,&nbsp;Neal A. Chatterjee MD, MSc ,&nbsp;Eric V. Krieger MD ,&nbsp;Babak Nazer MD","doi":"10.1016/j.hrthm.2024.10.073","DOIUrl":"10.1016/j.hrthm.2024.10.073","url":null,"abstract":"<div><h3>Background</h3><div><span>Patients with repaired tetralogy of Fallot<span><span> are at risk of ventricular tachycardia (VT) and </span>sudden cardiac death<span>. Most VTs arise from 5 slowly conducting anatomic isthmuses (SCAIs; conduction velocity ≤0.5 m/s) bound by the right ventriculotomy, ventricular septal defect patch, and tricuspid and pulmonic valves. Historically, </span></span></span>risk stratification electrophysiologic studies involved programmed ventricular stimulation with VT induction guiding implantable cardioverter-defibrillator (ICD) implantation or VT ablation.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate a “prophylactic” strategy of ablating SCAIs even in the absence of inducible VT to reduce ICD implantation and arrhythmic events and to compare this with the “historical” strategy.</div></div><div><h3>Methods</h3><div>This was a single-center, retrospective cohort study<span>. The historical cohort underwent programmed ventricular stimulation to guide ICD implantation or VT ablation. The prophylactic cohort underwent right ventricular electroanatomic mapping and ablation of SCAIs. A composite end point of arrhythmic death, cardiac arrest, sustained VT, and ICD complication was compared between the cohorts.</span></div></div><div><h3>Results</h3><div><span>Ninety-two patients with repaired tetralogy of Fallot had risk stratification electrophysiologic studies. Of 57 prophylactic patients, SCAIs were identified or ablated in 33 (58%), 16 (28%) had inducible VT before ablation, and 1 received ICD. Of 35 historical patients, 15 (43%) had inducible VT; 3 had cryoablation during pulmonic valve replacement and 11 received ICDs. No prophylactic patients met the composite end point during a median 21 months (interquartile range, 8–35 months) vs 10 (29%) historical patients during a median 125 months (interquartile range, 90–142 months; </span><em>P</em> = .017). There were no ablation-related complications.</div></div><div><h3>Conclusion</h3><div>Prophylactic SCAI ablation is associated with fewer ICD implantations and a reduction in incident arrhythmic events without ablation-related complications.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2669-2677"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675352","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":"Bloodstream infection in patients with cardiac implantable electronic devices and prosthetic heart valves: The role of PET-CT","authors":"Tardu Özkartal MD ,&nbsp;Marco Bergonti PhD, MD ,&nbsp;Maria Luce Caputo PhD, MD ,&nbsp;Luca Ceriani MD ,&nbsp;Giulio Conte PhD, MD","doi":"10.1016/j.hrthm.2024.11.024","DOIUrl":"10.1016/j.hrthm.2024.11.024","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2726-2728"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686901","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 recurrent ventricular tachyarrhythmia following the occurrence of a first ventricular arrhythmic event in patients with a primary prevention implantable cardioverter-defibrillator","authors":"Matthew Wang BS,&nbsp;Ilan Goldenberg MD,&nbsp;Arwa Younis MD,&nbsp;Ido Goldenberg MD,&nbsp;Michael Christof,&nbsp;David T. Huang MD, FHRS,&nbsp;Scott McNitt MS,&nbsp;Bronislava Polonsky MS,&nbsp;Valentina Kutyifa MD, PhD,&nbsp;Wojciech Zareba MD, PhD,&nbsp;Amole Ojo MD,&nbsp;Mehmet K. Aktaş MD, MBA, FHRS","doi":"10.1016/j.hrthm.2024.11.033","DOIUrl":"10.1016/j.hrthm.2024.11.033","url":null,"abstract":"<div><h3>Background</h3><div>There are limited data on clinical and arrhythmic outcomes after a first ventricular tachyarrhythmia (VTA) in heart failure (HF) patients who receive a primary prevention implantable cardioverter-defibrillator (ICD).</div></div><div><h3>Objective</h3><div>This study was designed to quantify the burden of and to identify risk factors for recurrent VTA in this population and to evaluate the risk of all-cause mortality associated with recurrent VTA.</div></div><div><h3>Methods</h3><div>The study comprised 789 patients who experienced VTA following primary prevention ICD implantation in 5 ICD trials (MADIT-II, MADIT-RISK, MADIT-CRT, MADIT-RIT, RAID). Landmark analysis was used to quantify the burden and to identify predictors of recurrent VTA. Time-dependent analysis was used to evaluate the association of VTA recurrence with subsequent mortality.</div></div><div><h3>Results</h3><div>The mean age of the study patients was 63 years, and 17% were women. The cumulative probability of experiencing at least 1 recurrent VTA episode at 3 years after a first VTA episode was 60%; the recurrent VTA burden after a first event during 3 years was 2.8 episodes per patient. The risk of recurrent VTA remained ≥56% at 3 years regardless of baseline clinical and echocardiographic risk factors. VTA recurrence was associated with a significant 2-fold increased risk of subsequent all-cause mortality.</div></div><div><h3>Conclusion</h3><div>Patients with a primary prevention ICD who experience an episode of VTA are at high risk of recurrent VTA, regardless of baseline risk factors. Recurrent VTA is associated with a pronounced increase in the risk of death. These findings suggest a need for early intervention after a first VTA in patients who receive a primary prevention ICD.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2651-2660"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709855","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 validation of the 2021 European Society of Cardiology guidelines on preexisting right bundle branch block in patients undergoing transcatheter aortic valve implantation","authors":"Marc Salis MD ,&nbsp;Patrick Badertscher MD ,&nbsp;Andrea Papa MD ,&nbsp;Sven Knecht DSc ,&nbsp;Teodor Serban MD ,&nbsp;Thomas Nestelberger MD ,&nbsp;Christoph Kaiser MD ,&nbsp;Gregor Leibundgut MD ,&nbsp;Beat Schaer MD ,&nbsp;Philipp Krisai MD ,&nbsp;Felix Mahfoud MD ,&nbsp;Michael Kühne MD ,&nbsp;Christian Sticherling MD","doi":"10.1016/j.hrthm.2024.11.030","DOIUrl":"10.1016/j.hrthm.2024.11.030","url":null,"abstract":"<div><h3>Background</h3><div>Risk stratification of patients with right bundle branch block (RBBB) undergoing transcatheter aortic valve implantation (TAVI) remains challenging.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the European Society of Cardiology (ESC) criteria for risk stratification of RBBB patients undergoing TAVI.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed prospectively enrolled patients with preexisting RBBB undergoing TAVI between 2011 and 2023. A surface 12-lead electrocardiogram was available before and after the procedure in all patients. The following ESC criteria were validated: ΔPR interval ≥20 ms, QRS axis change, and transient high-degree atrioventricular block (HAVB) &lt;24 hours after TAVI.</div></div><div><h3>Results</h3><div>Preexisting RBBB was documented in 107 of 1410 patients (7.6%) undergoing TAVI. Mean age was 83 ± 5 years, 34% were female, and 66% received self-expandable valves. Of those 107 patients with preexisting RBBB, 36 (34%) had persistent HAVB lasting longer than 24 hours and received permanent pacemaker therapy. Of the remaining 71 patients, 16 patients (23%) had delayed HAVB during 30 days of follow-up. The ESC criteria identified 81% of patients (13/16) with delayed HAVB during 30-day follow-up while missing 3 patients (19%; 2.8% of the overall cohort). This resulted in a sensitivity of 81% and a negative predictive value of 92%. Meeting the ESC criteria bore a 6-fold increase in the odds for development of HAVB during 30-day follow-up (odds ratio, 6.5; 95% confidence interval, 1.84–30.8; <em>P</em> = .007).</div></div><div><h3>Conclusion</h3><div>In this large cohort of patients with preexisting RBBB undergoing TAVI with contemporary prosthesis and implantation techniques, the ESC criteria—PR prolongation, QRS axis change, and transient HAVB—correctly identified 4 of 5 patients in whom HAVB developed during 30-day follow-up.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2625-2634"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709788","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":"Salvaged by the stylet: Procedural insights from difficult cases of left bundle branch area pacing","authors":"Anindya Ghosh MD ,&nbsp;Chenni S. Sriram MD, FHRS ,&nbsp;Ulhas M. Pandurangi MD","doi":"10.1016/j.hrthm.2024.11.053","DOIUrl":"10.1016/j.hrthm.2024.11.053","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2613-2615"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768332","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":"Predicting pacemaker implantation after TAVI in patients with right bundle branch block: One must imagine Sisyphus happy","authors":"Pasquale Santangeli MD, PhD ,&nbsp;Thomas Callahan MD ,&nbsp;Raphael Rosso MD","doi":"10.1016/j.hrthm.2025.01.043","DOIUrl":"10.1016/j.hrthm.2025.01.043","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e903-e905"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374093","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":"In search of a driver for atrial fibrillation","authors":"Lianne N. van Staveren MD ,&nbsp;Yannick J.H.J. Taverne MD, PhD ,&nbsp;Richard Hendriks PhD ,&nbsp;Natasja M.S. de Groot MD, PhD","doi":"10.1016/j.hrthm.2025.05.024","DOIUrl":"10.1016/j.hrthm.2025.05.024","url":null,"abstract":"<div><h3>Background</h3><div>Short atrial fibrillation cycle lengths (AFCLs) and regular activation patterns are associated with drivers of atrial fibrillation, although the relation with underlying patterns of activation is incompletely understood. Previous studies used automated assessment of electrograms to determine fast and regular fibrillatory rates.</div></div><div><h3>Objective</h3><div>We investigated the relation among AFCL, temporal variation in AFCL, and the occurrence of driver-like patterns of activation using high-density local activation time mapping.</div></div><div><h3>Methods</h3><div>High-density epicardial mapping of the right atrium and left atrial ventricular groove including Bachmann’s bundle was performed in 71 patients admitted for elective cardiac surgery. Recording sites with the shortest median AFCL or the smallest standard deviation of AFCL were identified. Patterns of activation included focal or rotational activation, smooth propagation, propagation with conduction block (CB), collision, and remnant activity.</div></div><div><h3>Results</h3><div>There was a higher number of fibrillation waves with CB (81% [interquartile range (IQR) 76%–85%] vs 74% [68%–76%]; <em>P</em> &lt; .001) and fractionated potentials (22% [12%–37%] vs 12% [9%–15%]; <em>P</em> &lt; .001) at shortest median AFCL than at other recording sites. Smallest standard deviation sites harbored more smoothly propagating waves (33% [24%–54%] vs 17% [11%–25%]; <em>P</em> &lt; .001) and a higher proportion of single potentials (76% [60%–89%] vs 59% [54%–65%]; <em>P</em> &lt; .001). Both highly regular and fastest reactivated sites did not correspond to the origin of (repetitive) focal fibrillation waves.</div></div><div><h3>Conclusion</h3><div>During extensive mapping, the fastest or most regularly activated areas are characterized by CB and smoothly propagating fibrillation waves instead of repetitive occurrence of focal or rotational activation patterns. This study rejects the concept of detecting drivers by identifying the fastest or most regularly activated recording sites.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e978-e989"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119341","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":"A delayed pacemaker recall","authors":"Robert G. Hauser MD, FHRS,&nbsp;Melanie Kapphahn-Bergs RN, CCDS,&nbsp;Ali Bahbah MD,&nbsp;Dawn Witt PhD, MPH,&nbsp;Jay N. Sengupta MD, FHRS","doi":"10.1016/j.hrthm.2025.03.1992","DOIUrl":"10.1016/j.hrthm.2025.03.1992","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2724-2725"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019666","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":"Out-of-hospital sudden death due to idiopathic ventricular fibrillation caught on multi-lead Holter recording","authors":"José Oscar Torres Jaimes MD ,&nbsp;Carlos Gayosso Chávez MD ,&nbsp;Luis Armando García Pedraza MD ,&nbsp;Erick Calderón Aranda MD, FASE ,&nbsp;Milton Ernesto Guevara Valdivia MD, FHRS ,&nbsp;María Catalina Salgado Solorio MD","doi":"10.1016/j.hrthm.2025.03.1962","DOIUrl":"10.1016/j.hrthm.2025.03.1962","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2722-2723"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669809","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}