Heart rhythmPub Date : 2025-10-01DOI: 10.1016/j.hrthm.2024.11.007
Zechuan Zhou MD , Bin Zheng MD
{"title":"Analysis of development trends in His bundle pacing research hotspots using bibliometrics","authors":"Zechuan Zhou MD , Bin Zheng MD","doi":"10.1016/j.hrthm.2024.11.007","DOIUrl":"10.1016/j.hrthm.2024.11.007","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2731-2732"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618779","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}
Heart rhythmPub Date : 2025-10-01DOI: 10.1016/j.hrthm.2024.11.027
Jeremy P. Moore MD, MS, FHRS
{"title":"Prophylactic electrophysiologic interventions in congenital heart disease: New insights and fresh controversy","authors":"Jeremy P. Moore MD, MS, FHRS","doi":"10.1016/j.hrthm.2024.11.027","DOIUrl":"10.1016/j.hrthm.2024.11.027","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e919-e920"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695290","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}
Heart rhythmPub Date : 2025-10-01DOI: 10.1016/j.hrthm.2024.12.019
Josep Rodés-Cabau MD, PhD , Luis Nombela-Franco MD, PhD , Guillem Muntané-Carol MD, PhD , Gabriela Veiga MD, PhD , Ander Regueiro MD, PhD , Tamim Nazif MD , Vicenç Serra MD , Lluis Asmarats MD, PhD , Henrique B. Ribeiro MD, PhD , Azeem Latib MD , Anthony Poulin MD , Asim N. Cheema MD , Pilar Jiménez-Quevedo MD, PhD , Joan Antoni Gomez-Hospital MD, PhD , Aritz Gil Ongay MD, PhD , Rami Gabani MD , Dabit Arzamendi MD , Michael Brener MD , Alvaro Calabuig MD , Andrea Scotti MD , François Philippon MD, FHRS
{"title":"Prospective validation of a prespecified algorithm for the management of conduction disturbances after transcatheter aortic valve replacement: The PROMOTE study","authors":"Josep Rodés-Cabau MD, PhD , Luis Nombela-Franco MD, PhD , Guillem Muntané-Carol MD, PhD , Gabriela Veiga MD, PhD , Ander Regueiro MD, PhD , Tamim Nazif MD , Vicenç Serra MD , Lluis Asmarats MD, PhD , Henrique B. Ribeiro MD, PhD , Azeem Latib MD , Anthony Poulin MD , Asim N. Cheema MD , Pilar Jiménez-Quevedo MD, PhD , Joan Antoni Gomez-Hospital MD, PhD , Aritz Gil Ongay MD, PhD , Rami Gabani MD , Dabit Arzamendi MD , Michael Brener MD , Alvaro Calabuig MD , Andrea Scotti MD , François Philippon MD, FHRS","doi":"10.1016/j.hrthm.2024.12.019","DOIUrl":"10.1016/j.hrthm.2024.12.019","url":null,"abstract":"<div><h3>Background</h3><div><span>There is a large variability in the management of conduction disturbances (CDs) after </span>transcatheter aortic valve replacement (TAVR).</div></div><div><h3>Objective</h3><div>This study aimed to validate a prespecified algorithm for managing CDs in patients undergoing TAVR.</div></div><div><h3>Methods</h3><div><span>This was a prospective multicenter study including consecutive patients without prior pacemaker undergoing TAVR. Patients were stratified in different groups according to the presence of prior right bundle branch block (RBBB) and the occurrence of CDs during the procedure: no prior RBBB and no CDs (group NCD), prior RBBB and no CDs (group RBBB-NCD), and occurrence of CDs (group CD). A management algorithm was prespecified for each group. </span>Permanent pacemaker (PPM) and mortality (overall, sudden cardiac death) at 30 days were the primary end points.</div></div><div><h3>Results</h3><div>A total of 2110 TAVR recipients were included. Patients were distributed in NCD (32.0%), RBBB-NCD (5.1%), and CD (62.9%) groups. A total of 329 patients (15.6%) received a PPM at 30 days, with a PPM rate of 5.5%, 15.9%, and 20.7% in the NCD, RBBB-NCD, and CD groups, respectively (<em>P</em><span><span> < .001). The PPM rate was 17.4% and 57.2% in patients with procedural new-onset left bundle branch block and high-degree atrioventricular block/complete heart block, respectively. There were no differences in 30-day all-cause mortality and </span>sudden cardiac death between groups (NCD group, 1.2% and 0.2%; RBBB-NCD group, 0% and 0%; CD group, 0.7% and 0.1%; </span><em>P</em> = .45 and <em>P</em><span> = .99 for all-cause mortality and sudden cardiac death, respectively).</span></div></div><div><h3>Conclusion</h3><div>A prespecified strategy for the management of CDs in contemporary TAVR recipients was feasible and safe, with no increased mortality and an extremely low rate of sudden cardiac death in patients with CDs. However, PPM rates remained high, and continued efforts for preventing the occurrence of CDs are warranted.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2635-2643"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853347","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}
Heart rhythmPub Date : 2025-10-01DOI: 10.1016/j.hrthm.2025.05.015
Chantal J.M. van Opbergen PhD , Lilian K. Gutierrez PhD , Giorgia Bertoli PhD , Mingliang Zhang PhD , Sarah Boyce BSc , Yan Deng MD, PhD , Michael Cammer MFA, MAT , Feng-Xia Liang PhD , Mario Delmar MD, PhD
{"title":"Exercise-induced dysregulation of the adrenergic response in a mouse model of PKP2-arrhythmogenic cardiomyopathy","authors":"Chantal J.M. van Opbergen PhD , Lilian K. Gutierrez PhD , Giorgia Bertoli PhD , Mingliang Zhang PhD , Sarah Boyce BSc , Yan Deng MD, PhD , Michael Cammer MFA, MAT , Feng-Xia Liang PhD , Mario Delmar MD, PhD","doi":"10.1016/j.hrthm.2025.05.015","DOIUrl":"10.1016/j.hrthm.2025.05.015","url":null,"abstract":"<div><h3>Background</h3><div><span>Plakophilin-2 (PKP2) is a component of the desmosome<span>. Pathogenic variants can lead to arrhythmogenic cardiomyopathy (PKP2-ACM). In patients with PKP2-ACM, exercise and </span></span>catecholamine<span> surges negatively impact arrhythmia incidence and severity.</span></div></div><div><h3>Objective</h3><div>The study aimed to characterize remodeling of the sympathetic input and adrenergic response in hearts of PKP2-deficient mice (PKP2cKO) subjected to endurance exercise.</div></div><div><h3>Methods</h3><div><span><span><span>We used expansion microscopy and structured illumination to characterize the abundance of beta 1-adrenergic receptors (β1-ARs) in the sarcolemma<span> in PKP2cKO-myocytes, sedentary or trained, and Cre-negative controls. We prevented endogenous catecholamine import by </span></span>short hairpin RNA<span> (shRNA)-mediated knockdown of its transporter [organic cation transporter 3 (OCT3)] and characterized differential effects of isoproterenol (membrane permeable) vs </span></span>norepinephrine (non-membrane permeable) on Ca</span><sup>2+</sup> transient dynamics. Separately, we evaluated the distribution of sympathetic terminals in PKP2cKO-trained hearts vs controls.</div></div><div><h3>Results</h3><div><span>Exercise led to “increased” abundance of sarcolemma β1-ARs in control, and “decreased” abundance in PKP2cKO-myocytes. OCT3 knockdown drastically reduced the response of trained PKP2cKO-myocytes to </span>norepinephrine<span> but not isoproterenol<span>, indicating preserved response to native catecholamines by intracellular (dyad-associated) receptors in the setting of a reduced sarcolemma pool. In tissue, we observed reduced abundance of sympathetic terminals and heterogeneous distribution across the myocardium.</span></span></div></div><div><h3>Conclusion</h3><div>Endurance exercise in PKP2-deficient myocytes leads to a reduced pool of functional β1-ARs in the sarcolemma and yet availability of intracellular receptors<span>, which can activate selected (and heterogeneous) routes of intracellular signaling cascades. We speculate that remodeling of nerve terminals affects sympathetic input distribution and hence, regional modulation of excitability and conduction. These changes can facilitate cell-generated triggered activity and heterogeneity of the underlying substrate, setting the stage for life-threatening arrhythmias.</span></div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e939-e950"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093441","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}
Heart rhythmPub Date : 2025-10-01DOI: 10.1016/j.hrthm.2025.07.015
Thomas A. Boyle MD, David S. Frankel MD, FHRS
{"title":"Severe acute kidney injury from limited pulsed field ablation","authors":"Thomas A. Boyle MD, David S. Frankel MD, FHRS","doi":"10.1016/j.hrthm.2025.07.015","DOIUrl":"10.1016/j.hrthm.2025.07.015","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Page e1043"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626053","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}
Heart rhythmPub Date : 2025-10-01DOI: 10.1016/j.hrthm.2025.07.023
Jeanne E. Poole MD, FHRS , Gust H. Bardy MD, FHRS
{"title":"SCD-HeFT","authors":"Jeanne E. Poole MD, FHRS , Gust H. Bardy MD, FHRS","doi":"10.1016/j.hrthm.2025.07.023","DOIUrl":"10.1016/j.hrthm.2025.07.023","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages 2445-2446"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183823","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}
Heart rhythmPub Date : 2025-10-01DOI: 10.1016/j.hrthm.2025.09.037
Jack W Samways, Timothy Cheng, Ji-Jian Chow, Matthew J Shun-Shin, Nadine Ali, Daniel Keene, James P Howard, Akriti Naraen, Keenan Saleh, Nandita Kaza, Chet Sharma, Jagdeep S Mohal, Rohin K Reddy, Marina Strocchi, Steven A Niederer, Nicholas S Peters, Nicholas W F Linton Meng, Prapa Kanagaratnam, Fu Siong Ng, Darrel P Francis, Zachary I Whinnett, Ahran D Arnold
{"title":"Ventricular repolarization is improved by His resynchronization therapy but not biventricular pacing.","authors":"Jack W Samways, Timothy Cheng, Ji-Jian Chow, Matthew J Shun-Shin, Nadine Ali, Daniel Keene, James P Howard, Akriti Naraen, Keenan Saleh, Nandita Kaza, Chet Sharma, Jagdeep S Mohal, Rohin K Reddy, Marina Strocchi, Steven A Niederer, Nicholas S Peters, Nicholas W F Linton Meng, Prapa Kanagaratnam, Fu Siong Ng, Darrel P Francis, Zachary I Whinnett, Ahran D Arnold","doi":"10.1016/j.hrthm.2025.09.037","DOIUrl":"10.1016/j.hrthm.2025.09.037","url":null,"abstract":"<p><strong>Background: </strong>Biventricular pacing (BVP) delivered cardiac resynchronization therapy (CRT) modestly improves activation synchrony in patients with heart failure and left bundle branch block (LBBB) but can trigger ventricular arrhythmias. His bundle pacing (HBP) can correct LBBB as an alternative CRT method, producing superior ventricular activation synchrony and hemodynamics.</p><p><strong>Objective: </strong>The aim of the study was to investigate the relative effects of HBP-CRT and BVP-CRT on ventricular repolarization.</p><p><strong>Methods: </strong>Patients with LBBB referred for BVP-CRT underwent intra-procedural non-invasive epicardial mapping during atrial pacing (intrinsic LBBB), BVP-CRT, and temporary HBP. When HBP corrected LBBB, changes from baseline (LBBB) in overall and left ventricular (LV) repolarization dispersion (ΔVRT, ΔLVRT), repolarization gradient (ΔVRG, ΔLVRG) and activation-recovery interval (ARI) dispersion (ΔVARI, ΔLVARI) were measured.</p><p><strong>Results: </strong>17 patients had full datasets. BVP-CRT had no effect on global repolarization dispersion, gradient steepness or ARI (ΔVRT -1.5 ms, 95% confidence interval [CI] -15.4 to +12.4, P = .82; ΔVRG -0.00549 ms/mm, -0.106 to +0.0954, P = .9; ΔVARI -5.0 ms, -24.3 to +14.3, P = .59) and worsened the parameters in the LV (ΔLVRT +14.5 ms, +0.05 to +28.9, P = .049; ΔLVRG +0.0931 ms/mm, -0.0635 to +0.25, P = .226, ΔLVARI +28.6 ms, 95% CI +6.0 to +51.2, P = .02). HBP-CRT significantly improved global repolarization dispersion, gradient steepness and ARI (ΔLVRT +14.5 ms, +0.05 to +28.9, P = .049; ΔLVRG +0.0931 ms/mm, -0.0635 to +0.25, P = .226; ΔVARI -49.5 ms, -69.0 to -29.9, P < .0001) and within the LV (ΔLVRT -38.2 ms, -48.7 to -27.6, P < .001; ΔLVRG -0.228 ms/mm, -0.334 to -0.122, P = .0003; ΔLVARI -37.2 ms, -59.4 to -15.0, P = .003).</p><p><strong>Conclusion: </strong>HBP-CRT improves LBBB-induced repolarization abnormalities through improved activation synchrony and ARI modulation. BVP-CRT does not improve, and appears to worsen, LV repolarization parameters.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225346","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}
Heart rhythmPub Date : 2025-10-01DOI: 10.1016/j.hrthm.2025.05.017
Júlia Aranyó MD , Daina Martínez-Falguera MSc , Albert Teis MD, PhD , Edgar Fadeuilhe MD , Oriol Rodríguez-Leor MD, PhD , Víctor Bazan MD, PhD , Axel Sarrias MD , Cristian Tebe MPH, PhD , Roger Villuendas MD, PhD , Victoria Delgado MD, PhD , Antoni Bayés-Genís MD, PhD , Carolina Gálvez-Montón DVM, PhD , Felipe Bisbal MD, PhD
{"title":"Tissue characteristics underlying endocardial local impedance subtypes in chronic myocardial infarction","authors":"Júlia Aranyó MD , Daina Martínez-Falguera MSc , Albert Teis MD, PhD , Edgar Fadeuilhe MD , Oriol Rodríguez-Leor MD, PhD , Víctor Bazan MD, PhD , Axel Sarrias MD , Cristian Tebe MPH, PhD , Roger Villuendas MD, PhD , Victoria Delgado MD, PhD , Antoni Bayés-Genís MD, PhD , Carolina Gálvez-Montón DVM, PhD , Felipe Bisbal MD, PhD","doi":"10.1016/j.hrthm.2025.05.017","DOIUrl":"10.1016/j.hrthm.2025.05.017","url":null,"abstract":"<div><h3>Background</h3><div>Local impedance (LI) mapping is feasible and provides additional tissue characterization<span> of the ventricular tachycardia substrate. Data on tissue composition underlying the LI spectrum are lacking.</span></div></div><div><h3>Objective</h3><div><span>To describe the tissue composition underlying different LI subtypes in a chronic myocardial infarction (MI) </span>swine model.</div></div><div><h3>Methods</h3><div><span><span>One month after non-reperfused anterior MI, 18 </span>Landrace<span> Large White pigs underwent delayed-enhancement </span></span>cardiac magnetic resonance<span><span> (DE-CMR) and endocardial left ventricular (LV) LI mapping. DE-CMR images were post-processed off-line to obtain </span>LV wall thickness, scar subtypes, and border zone (BZ) corridors, and were co-registered with LI maps. Tissue samples were obtained from abnormal LI sites.</span></div></div><div><h3>Results</h3><div>Low LI zones exhibited more pronounced wall thinning compared to intermediate LI tissue (2.8 ± 0.7 vs 3.8 ± 0.9 mm; <em>P <</em><span> .001) and correlated with DE-CMR dense endocardial scarring (91.4%) and with epicardial scarring (75% dense and 24% BZ tissue). Intermediate LI tissue exhibited predominantly subendocardial scarring, with more heterogeneous distribution (45% dense, 47% BZ, and 8% healthy tissue) and less epicardial involvement (73% healthy tissue). Most DE-CMR BZ corridors (75.6%) colocalized with intermediate LI tissue. Histologically, tissue from intermediate LI zones displayed less collagen I (</span><em>P</em> = .008), collagen III (<em>P</em> = .053), and collagen volume fraction (<em>P</em> = .021), and greater vascular density (<em>P</em> = .075), compared to low LI zones.</div></div><div><h3>Conclusions</h3><div>Areas of low LI had a higher proportion of dense, transmural scar and wall thinning compared to intermediate LI areas. DE-CMR BZ corridors colocalized with intermediate LI in most cases. LI subtypes showed distinctive histological composition.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 10","pages":"Pages e968-e977"},"PeriodicalIF":5.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093444","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}