Heart rhythm最新文献

{"title":"Prevalence and cardiac risk of familial ST depression syndrome: A study of 12 million electrocardiograms.","authors":"Rasmus Frosted, Kathrine Kold Sørensen, Mikkel Porsborg Andersen, Christoffer Polcwiartek, Chaoqun Zheng, Helle Collatz Christensen, Kristian Hay Kragholm, Claus Graff, Christian Torp-Pedersen, Alex Hørby Christensen","doi":"10.1016/j.hrthm.2025.02.048","DOIUrl":"10.1016/j.hrthm.2025.02.048","url":null,"abstract":"<p><strong>Background: </strong>Familial ST depression syndrome (Fam-STD) is a recently identified inherited cardiac disease characterized by a distinct electrocardiographic phenotype and occurrence of arrhythmias and heart failure.</p><p><strong>Objective: </strong>We aimed to investigate the electrocardiographic prevalence of the Fam-STD and its association with cardiac events in a large, nationwide cohort.</p><p><strong>Methods: </strong>We used a Danish nationwide electrocardiogram (ECG) database containing 11,952,430 ECGs from 2,485,987 unique individuals. We excluded ECGs from children <15 years and ECGs with likely secondary causes of ST-segment deviations. The Fam-STD phenotype prevalence was assessed according to the original (Fam-STD-2018) and revised (Fam-STD-2022 probands/relatives) proposed diagnostic criteria. Through linkage with national registries, we evaluated the risk of a composite cardiac end point (new-onset atrial fibrillation, ventricular arrhythmias, heart failure, cardiac device implantation) and all-cause mortality by Cox proportional hazards models.</p><p><strong>Results: </strong>A total of 6,352,104 ECGs (1,890,184 individuals; 55% female; 3.4 ECGs per individual) remained after application of the exclusion criteria. We found 56 (3/100,000) individuals fulfilling Fam-STD-2018, 173 (9/100,000) fulfilling Fam-STD-2022 probands, and 4975 (263/100,000) fulfilling Fam-STD-2022 relatives criteria. During a mean follow-up of 2.4 ± 3.4 years, we observed increased risks of the composite cardiac end point (hazard ratio, 4.4 [confidence interval, 1.2-15.9], 3.6 [2-6.5], 2.21 [2-2.5]) and all-cause mortality (hazard ratio, 6.2 [confidence interval, 3.6-10.6], 3.1 [1.7-1.9], 1.8 [1.7-1.9]) for Fam-STD-2018, Fam-STD-2022 probands, and Fam-STD-2022 relatives, respectively, compared with matched controls without ST deviation.</p><p><strong>Conclusion: </strong>The Fam-STD proband electrocardiographic phenotype is rare and has a prevalence in Denmark of 3-9/100,000, fairly similar to estimates of other inherited arrhythmia syndromes. The increased risk of cardiac events and mortality highlights the importance of early identification to allow preventive interventions.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572760","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":"Decisional conflict and defibrillator implantation choices among Black women and men with chronic systolic heart failure","authors":"Lonnie T. Sullivan II MD ,&nbsp;Andrew J. Maul MD, MBA ,&nbsp;Rebecca Young MS ,&nbsp;Brian C. Boursiquot MD, MS ,&nbsp;Apurva Khedagi MD ,&nbsp;Brooke Alhanti PhD ,&nbsp;Larry R. Jackson II MD, MHSc ,&nbsp;Kevin L. Thomas MD","doi":"10.1016/j.hrthm.2024.07.026","DOIUrl":"10.1016/j.hrthm.2024.07.026","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 3","pages":"Pages 627-628"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727055","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":"Late gadolinium enhancement in early repolarization syndrome","authors":"Hiroshi Morita MD, PhD ,&nbsp;Saori Asada MD, PhD ,&nbsp;Satoshi Nagase MD, PhD ,&nbsp;Akira Ueoka MD, PhD ,&nbsp;Takuro Masuda MD ,&nbsp;Masakazu Miyamoto MD, PhD ,&nbsp;Koji Nakagawa MD, PhD ,&nbsp;Nobuhiro Nishii MD, PhD ,&nbsp;Shinsuke Yuasa MD, PhD","doi":"10.1016/j.hrthm.2024.07.116","DOIUrl":"10.1016/j.hrthm.2024.07.116","url":null,"abstract":"<div><h3>Background</h3><div>In patients with Brugada syndrome, myocardial fibrosis can be identified through epicardial biopsy or cardiac magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE). However, the myocardial alterations in patients with early repolarization syndrome (ERS) remain poorly elucidated.</div></div><div><h3>Objective</h3><div>The objective of this study was to investigate the presence of myocardial fibrosis in patients with ERS by LGE in CMR.</div></div><div><h3>Methods</h3><div>We retrospectively evaluated 20 patients with ERS, all of whom exhibited J waves in the contiguous 2 leads. The location of J waves was classified as in the septum (V₁-V₂), anterior (V₃-V₄), lateral (I, aVL, V₅-V₆), inferior (II, III, aVF), or posterior (V₇-V₉) regions. To compare the distribution of LGE on CMR imaging with J waves, sections on short-axis view of the left ventricle (LV) were categorized as located in the septum, anterior, lateral, inferior, and posterior regions.</div></div><div><h3>Results</h3><div>Overall, 85% of ERS patients displayed LGE, which was more prevalent in the septum and posterior regions, followed by the inferior and lateral regions. The presence or absence of J waves and LGE coincided in 61% of LV areas, whereas discordance between the distributions of J waves and LGE was observed in 38%. LGE was most frequent in the septum (75%), where its reflection in J waves may be less robust. The appearance of LGE was not associated with symptoms, electrical storm, or ventricular fibrillation occurrence during follow-up.</div></div><div><h3>Conclusion</h3><div>LGE is common in patients with ERS, and the distribution of J waves and LGE coincides in approximately 60% of LV areas.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 3","pages":"Pages 767-775"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878571","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":"Detection of cardiac sarcoidosis with the artificial intelligence–enhanced electrocardiogram","authors":"Jose F. de Melo Jr. MD ,&nbsp;Kathryn E. Mangold PhD ,&nbsp;Julia Debertin MPH ,&nbsp;Andrew Rosenbaum MD ,&nbsp;John P. Bois MD ,&nbsp;Zachi I. Attia PhD ,&nbsp;Paul A. Friedman MD ,&nbsp;Abhishek J. Deshmukh MBBS ,&nbsp;Suraj Kapa MD ,&nbsp;Leslie T. Cooper MD ,&nbsp;Omar F. Abou Ezzeddine MD, MS ,&nbsp;Konstantinos C. Siontis MD","doi":"10.1016/j.hrthm.2024.08.013","DOIUrl":"10.1016/j.hrthm.2024.08.013","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 3","pages":"Pages 859-861"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912434","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 ultrarare inherited arrhythmia syndromes","authors":"Thomas M. Roston MD, PhD ,&nbsp;Vassilios J. Bezzerides MD, PhD ,&nbsp;Jason D. Roberts MAS, MD ,&nbsp;Dominic J. Abrams MBBS, MD, MBA","doi":"10.1016/j.hrthm.2024.08.023","DOIUrl":"10.1016/j.hrthm.2024.08.023","url":null,"abstract":"<div><div>Ultrarare inherited arrhythmia syndromes are increasingly diagnosed as a result of increased awareness as well as increased availability and reduced cost of genetic testing. Yet by definition, their rarity and heterogeneous expression make development of evidence-based management strategies more challenging, typically employing strategies garnered from similar genetic cardiac disorders. For the most part, reliance on anecdotal experiences, expert opinion, and small retrospective cohort studies is the only means to diagnose and to treat these patients. Here we review the management of specific ultrarare inherited arrhythmic syndromes together with the genetic and molecular basis, which will become increasingly important with the development of targeted therapies to correct the biologic basis of these disorders.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 3","pages":"Pages 832-843"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999785","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":"Incidence and outcomes of cardiovascular implantable electronic device infections in patients with end-stage kidney disease","authors":"Sania Jiwani MBBS ,&nbsp;Wan-Chi Chan MBBS ,&nbsp;Akshaya Gadre MBBS ,&nbsp;Seth Sheldon MD, FHRS ,&nbsp;Jinxiang Hu PhD ,&nbsp;Rhea Pimentel MD, FHRS ,&nbsp;Amit Noheria MBBS, SM ,&nbsp;Kamal Gupta MBBS","doi":"10.1016/j.hrthm.2024.09.016","DOIUrl":"10.1016/j.hrthm.2024.09.016","url":null,"abstract":"<div><h3>Background</h3><div>End-stage kidney disease (ESKD) patients are prone to bloodstream infections that may result in a higher risk of cardiac implantable electronic device (CIED) infections.</div></div><div><h3>Objective</h3><div>The objective of this study was to assess the incidence, risk predictors, management strategies, and long-term outcomes of CIED infections in ESKD patients undergoing de novo CIED implantation.</div></div><div><h3>Methods</h3><div>This is a retrospective study using the United States Renal Data System. ESKD patients with de novo CIED implantation between January 1, 2006, and September 30, 2014, were included. Patients were observed until death, kidney transplantation, end of Medicare coverage, or September 30, 2015, to assess incidence of CIED infection. Management approach was determined from procedure codes for lead extraction within 60 days of CIED infection diagnosis. Patients with CIED infection were observed until December 31, 2019, to assess long-term outcomes.</div></div><div><h3>Results</h3><div>Of 15,515 ESKD patients undergoing de novo CIED implantation, incidence of CIED infection was 4.8% during a median follow-up of 1.3 years. The presence of a defibrillator (adjusted hazard ratio [aHR], 1.48), higher body mass index (aHR, 1.01), and younger age (aHR, 0.96) were independent risk factors for CIED infection. Lead extraction occurred in only 50.71% of patients by 60 days. After propensity score matching, the 3-year mortality was higher in those who did not undergo lead extraction compared with those who did (80.3% vs 72.3%) and time to mortality was shorter (0.3 vs 0.6 year). Only 13.8% of patients underwent reimplantation with a new CIED after lead extraction.</div></div><div><h3>Conclusion</h3><div>CIED infections occur frequently in ESKD patients and are associated with a high mortality. Early lead extraction is not performed routinely but is associated with improved survival.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 3","pages":"Pages 744-751"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284507","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":"Early vs later non–vitamin K antagonist oral anticoagulants in patients with acute ischemic stroke and atrial fibrillation: A meta-analysis and systematic review of randomized trials","authors":"Linghua Fu MD, PhD ,&nbsp;Jinzhu Hu MD, PhD ,&nbsp;Pingping Yang MD, PhD ,&nbsp;Qi Chen MD, PhD","doi":"10.1016/j.hrthm.2024.12.008","DOIUrl":"10.1016/j.hrthm.2024.12.008","url":null,"abstract":"<div><h3>Background</h3><div>There are conflicting published data on the optimal timing of non–vitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients with acute ischemic stroke.</div></div><div><h3>Objective</h3><div>To compare the efficacy and safety of early initiation of NOACs with later initiation of NOACs in those patients, we conducted a meta-analysis of phase 3 or phase 4 randomized controlled trials.</div></div><div><h3>Methods</h3><div>We systematically searched the Cochrane Library, PubMed, and Embase databases. A random effects model was selected to pool the effect measurement estimates (risk ratios [RRs] and 95% confidence intervals [CIs]).</div></div><div><h3>Results</h3><div>Three randomized controlled trials with 6442 enrolled patients with AF and acute ischemic stroke were included. Compared with later NOAC therapy, early NOAC therapy was associated with nonsignificant reductions in the risk of primary outcomes (RR, 0.82; 95% CI, 0.65–1.05). Subgroup analysis found that in reducing risk of primary outcomes, early anticoagulation may benefit female patients more than male patients (0.54 [0.35–0.83] vs 0.97 [0.63–1.50]; <em>P</em> for interaction, .06). Numerically lower rates of recurrent ischemic stroke (RR, 0.80; 95% CI, 0.56–1.15), death (RR, 0.96; 95% CI, 0.81–1.15), and systemic embolism (RR, 0.43; 95% CI, 0.16–1.11) were observed in early initiation of NOACs in comparison with later initiation of NOACs. There was no difference in major bleeding (RR, 0.98; 95% CI, 0.55–1.74), symptomatic intracranial hemorrhage (RR, 0.93; 95% CI, 0.43–1.96), or major extracranial bleeding (RR, 0.73; 95% CI, 0.28–1.95) between groups.</div></div><div><h3>Conclusion</h3><div>In AF patients with acute ischemic stroke, early initiation of NOACs is not inferior to later initiation of NOACs in reducing composite events, without increased hazard of bleeding, especially in female patients.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 3","pages":"Pages 629-636"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822022","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":"Pulsed field ablation of atrial tachyarrhythmia originating from atrial septal aneurysm","authors":"Caijie Shen MD, PhD ,&nbsp;Tsai-Lin Chou MS ,&nbsp;Dalise Yidai Shatz BA ,&nbsp;Truc-Vy Lam BS ,&nbsp;Rong Bai MD, FHRS ,&nbsp;Wilber Su MD, FHRS","doi":"10.1016/j.hrthm.2024.07.108","DOIUrl":"10.1016/j.hrthm.2024.07.108","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 3","pages":"Pages 817-820"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878572","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":"Transcatheter neo–superior vena cava creation for placement of a cardiac defibrillator: Overcoming the limitation of chronic superior vena cava occlusion","authors":"Alan Sugrue MBBCh, MSc ,&nbsp;Abhishek Deshmukh MBBS, FHRS ,&nbsp;Ammar M. Killu MBBS, FHRS ,&nbsp;Jason Anderson MD","doi":"10.1016/j.hrthm.2024.07.117","DOIUrl":"10.1016/j.hrthm.2024.07.117","url":null,"abstract":"","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 3","pages":"Pages 752-755"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878574","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 impact of postoperative atrial fibrillation burden during 2.5 years of continuous rhythm monitoring after cardiac surgery: Results from the RACE V prospective cohort study","authors":"Martijn D. Gilbers MD ,&nbsp;Michal J. Kawczynski MD ,&nbsp;Elham Bidar MD, PhD ,&nbsp;Bart Maesen MD, PhD ,&nbsp;Aaron Isaacs PhD ,&nbsp;Joris Winters PhD ,&nbsp;Dominik Linz MD, PhD ,&nbsp;Michiel Rienstra MD, PhD ,&nbsp;Isabelle van Gelder MD, PhD ,&nbsp;Jos G. Maessen MD, PhD ,&nbsp;Ulrich Schotten MD, PhD","doi":"10.1016/j.hrthm.2024.08.014","DOIUrl":"10.1016/j.hrthm.2024.08.014","url":null,"abstract":"<div><h3>Background</h3><div>Early postoperative atrial fibrillation (POAF) is common after cardiac surgery and is associated with late-POAF recurrences. However, little is known about the burden of POAF and its potential impact on long-term outcomes after cardiac surgery, particularly on the risk for late-POAF recurrences.</div></div><div><h3>Objective</h3><div>The purpose of this study was to establish the distribution of POAF burden and to determine the association between early-POAF burden and late-POAF recurrences during 2.5 years of continuous rhythm monitoring after cardiac surgery in patients with and without preoperative history of atrial fibrillation (AF).</div></div><div><h3>Methods</h3><div>Patients undergoing cardiac surgery were prospectively enrolled and postoperatively continuously monitored with an implantable loop recorder for 2.5 years. All patients underwent extensive clinical assessment at baseline. During follow-up, all AF episodes were registered, and AF associated metrics, such as burden, were calculated for different time intervals. Early-POAF was defined as AF within first 90 postoperative days and late-POAF as AF after this interval.</div></div><div><h3>Results</h3><div>A total of 98 consecutive patients were included. POAF burden during the early postoperative phase was significantly higher compared to the late postoperative phase (<em>P</em> &lt;.001). The longest individual POAF episode was strongly associated with increased POAF burden after adjusting for age, sex, and AF history (standardized Beta: 0.91, <em>P</em> &lt;.001). Also, early-POAF burden was associated with late-POAF (re)occurrence after adjusting for age, sex, AF history (adjusted hazard ratio 1.93, 95% confidence interval 1.42–2.62, <em>P</em> &lt;.001).</div></div><div><h3>Conclusion</h3><div>POAF burden was significantly associated with the longest individual POAF episode duration. Additionally, greater early-POAF burden was associated with increased late-POAF incidence, highlighting its potential in estimating the risk for long-term POAF recurrences.</div></div>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":"22 3","pages":"Pages 647-660"},"PeriodicalIF":5.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912435","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}