JACC. Clinical electrophysiology最新文献

{"title":"Marshall-Related Atrial Ectopy After Previous Vein of Marshall Ethanol Infusion.","authors":"Francesco Notaristefano, Karim Benali, Benjamin Sacristan, Nicolas Johner, Allan Plant, Konstantinos Vlachos, Kinan Kneizeh, Geoffroy Ditac, John Fitzgerald, Laurens Verhaeghe, Cinzia Monaco, Josselin Duchateau, Frédéric Sacher, Michel Haïssaguerre, Pierre Jaïs, Nicolas Derval, Thomas Pambrun, Romain Tixier","doi":"10.1016/j.jacep.2025.06.032","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.06.032","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Clinical Significance of Atrial Fibrillation in Non-High-Risk Brugada Syndrome: The BruFib Study.","authors":"Marco Bergonti, Frederic Sacher, Bernard Belhassen, Georgia Sarquella-Brugada, Elena Arbelo, Avi Sabbag, Lia Crotti, Jacob Tfelt-Hansen, Daniele Faccenda, Michela Casella, Konstantinos P Letsas, Andrea Rossi, Peter J Schwartz, Cinzia Monaco, Esther Scheirlynck, Luigi Pannone, Vincenzo Russo, Leonardo Calò, Maria Luce Caputo, Paola Berne, Alessandro Vicentini, Tardu Oezkartal, Federico Migliore, Sergio Conti, Paolo Compagnucci, Chiara Scrocco, Pedro Brugada, Carlo de Asmundis, Claudio Tondo, Josep Brugada, Vincent Probst, Elijah R Behr, Giulio Conte","doi":"10.1016/j.jacep.2025.06.031","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.06.031","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) occurs in up to 20% of patients with Brugada syndrome (BrS), yet its risk factors and prognostic implications remain uncertain.</p><p><strong>Objectives: </strong>This study sought to identify risk factors for AF in patients with non-high-risk BrS and to evaluate the impact of AF on ventricular arrhythmias (VAs), sick sinus syndrome (SSS), and stroke in non-high-risk BrS.</p><p><strong>Methods: </strong>This was a multicenter, retrospective study conducted across 20 international centers. Non-high-risk BrS patients were stratified based on the presence or absence of AF. The primary endpoint was the occurrence of VAs, defined as sustained ventricular tachycardia, ventricular fibrillation, or arrhythmic sudden cardiac death.</p><p><strong>Results: </strong>A total of 686 BrS patients were analyzed (39.3 years of age, 33.1% female, 31.8% spontaneous type 1 electrocardiogram, 36.0% pathogenic/likely pathogenic SCN5A variant), including 280 with AF (40.8%). Proband status and older age were associated with AF at Cox regression analysis. Over a median follow-up of 48.8 months, the incidence of VAs was 0.26% per year, with no significant difference between patients with and without AF (HR: 0.67; P = 0.58). Early-onset AF (<20 years) was associated with significantly higher risk of VAs (P < 0.001). SSS was twice as prevalent in BrS patients with AF (10.0% vs 6.2%; P = 0.047), and stroke occurred exclusively in the AF group (2.5%), despite low CHA₂DS₂-VA (mean 0.5).</p><p><strong>Conclusions: </strong>The presence of AF in non-high-risk BrS does not identify patients with higher risk of VAs. However, early-onset AF (<20 years) defines a distinct subgroup with elevated risk. Patients with AF and BrS have a significantly higher risk of SSS and stroke.</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focal Pulsed Field Ablation for Atrial Tachycardia Adjacent to the Phrenic Nerve","authors":"Jakrin Kewcharoen MD,&nbsp;Thomas Dewland MD,&nbsp;Edward P. Gerstenfeld MD, MS","doi":"10.1016/j.jacep.2025.04.004","DOIUrl":"10.1016/j.jacep.2025.04.004","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 8","pages":"Pages 1888-1893"},"PeriodicalIF":7.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardioneural Ablation","authors":"Olujimi A. Ajijola MD, PhD,&nbsp;Kalyanam Shivkumar MD, PhD","doi":"10.1016/j.jacep.2025.04.019","DOIUrl":"10.1016/j.jacep.2025.04.019","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 8","pages":"Pages 1696-1698"},"PeriodicalIF":7.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Septal Intramyocardial Purkinje Network","authors":"Xiaoke Liu MD, PhD ,&nbsp;Siva K. Mulpuru MD, MPH ,&nbsp;Atta Behfar MD, PhD ,&nbsp;Matthew Hillestad PhD ,&nbsp;Ryan Mahlberg ,&nbsp;Christopher V. DeSimone MD, PhD ,&nbsp;Paul A. Friedman MD ,&nbsp;Yong-Mei Cha MD ,&nbsp;Samuel J. Asirvatham MD","doi":"10.1016/j.jacep.2025.03.030","DOIUrl":"10.1016/j.jacep.2025.03.030","url":null,"abstract":"<div><h3>Background</h3><div>Despite the growing use of left bundle branch<span> area pacing (LBBAP) to deliver conduction system pacing, the mechanism underlying the narrow QRS interval conferred by this pacing modality remains unclear.</span></div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the mechanism that provides a most plausible explanation of LBBAP physiology.</div></div><div><h3>Methods</h3><div>A cohort of 13 patients who had surface electrocardiographic (ECG) or intracardiac recording features not explainable by either selective or nonselective LBBAP were evaluated. Unique ECG patterns<span> and intracardiac recordings over the right interventricular septum were analyzed, as well as septal Purkinje fiber staining patterns in human cardiac tissue, to assess whether such findings can be attributed to the capture of the recently discovered intramyocardial Purkinje network.</span></div></div><div><h3>Results</h3><div>The following unexpected ECG and intracardiac recording patterns were observed during LBBAP: 1) alternating incomplete right bundle branch block<span> and left bundle branch block<span> in an output-independent and output-dependent fashion; 2) variable, instead of all-or-none, recruitment of both left and right bundle systems; 3) correction of baseline right bundle branch block<span> at low outputs; 4) paced QRS axis and duration closely matching the baseline narrow QRS interval in patients who underwent atrioventricular node<span> ablation; and 5) intracardiac recordings demonstrating rapid, apparently nonphysiological activation of the right ventricular septum. Additionally, extensive Purkinje tissue was identified deep inside the septal myocardium in the human heart near the usual location of the LBBAP lead.</span></span></span></span></div></div><div><h3>Conclusions</h3><div>These data suggest a potential physiological role of the intramyocardial Purkinje system. Direct capture of Purkinje fibers connected to both bundle branches to rapidly activate both ventricles could provide a unifying explanation for these counterintuitive findings.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 8","pages":"Pages 1835-1848"},"PeriodicalIF":7.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seeing the Forest for the Trees","authors":"Peter Hanna MD, PhD,&nbsp;Kalyanam Shivkumar MD, PhD","doi":"10.1016/j.jacep.2025.06.004","DOIUrl":"10.1016/j.jacep.2025.06.004","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 8","pages":"Pages 1736-1737"},"PeriodicalIF":7.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brugada Syndrome and the Need for Device-Specific ICD Indications","authors":"Pasquale Crea MD, PhD","doi":"10.1016/j.jacep.2025.06.038","DOIUrl":"10.1016/j.jacep.2025.06.038","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 8","pages":"Page 1887"},"PeriodicalIF":7.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcutaneous Electrical Vagus Nerve Stimulation to Suppress Premature Ventricular Contractions","authors":"Stefanos Zafeiropoulos MD, MBA ,&nbsp;Kristie Coleman MPH, RN ,&nbsp;Jonathan Kogan ,&nbsp;Dimitrios Varrias MD ,&nbsp;Jonas Leavitt BS ,&nbsp;Alexandra Bekiaridou MD ,&nbsp;Theodoros Zanos PhD ,&nbsp;Stavros Zanos PhD, MD ,&nbsp;Stavros Stavrakis PhD, MD ,&nbsp;Stavros Mountantonakis MD, MBA","doi":"10.1016/j.jacep.2025.04.011","DOIUrl":"10.1016/j.jacep.2025.04.011","url":null,"abstract":"<div><h3>Introduction</h3><div><span>The autonomic nervous system has been implicated in the genesis of idiopathic premature ventricular complexes (PVCs). </span>Antiadrenergic<span><span> effects have been shown noninvasively by low-level electrical stimulation of the </span>tragus (LLTS).</span></div></div><div><h3>Objectives</h3><div>This study evaluated the efficacy of LLTS in reducing PVC burden.</div></div><div><h3>Methods</h3><div>This 2-center, prospective, sham-controlled, single-blinded, crossover randomized clinical trial was conducted in patients with symptomatic PVCs with at least 5% daily PVC burden and who were refractory to medical therapy. Participants received two sequential, 10-day sessions of active LLTS (20 Hz, 1 mA below the discomfort threshold) and sham stimulation (earlobe stimulation). Each treatment was interrupted by an 8-day washout period. Randomization determined the order of treatment. All patients wore an extended Holter monitor (ePatch; Philips) for daily PVC count during the study period.</div></div><div><h3>Results</h3><div>Of the 36 randomized patients, 35 (19 [59.4%] male; mean age 58.0 ± 17.1 years) completed the study and were included in the analysis. The median baseline PVC burden was 12.00% (IQR: 11.4%). LLTS significantly reduced the median PVC burden by 13.4% compared with sham stimulation (10.5% [IQR: 14.4%] vs 8.59% [IQR: 8.45%]; <em>P</em> = 0.021). No significant differences in heart rate variability were observed between the 2 groups. Exploratory analyses revealed a more pronounced reduction in slow heart rate–dependent PVCs and a sustained decrease in PVC burden throughout the LLTS period.</div></div><div><h3>Conclusions</h3><div>LLTS effectively reduced PVC burden in patients with symptomatic PVCs refractory to medical therapy, highlighting its potential as an adjuvant therapeutic option. Larger, multicenter trials are warranted to confirm these findings and evaluate long-term outcomes [Non-invasive Vagal Stimulation for Frequent Premature Ventricular Complexes (NoVa-PVC); <span><span>NCT05341544</span><svg><path></path></svg></span>]</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 8","pages":"Pages 1699-1707"},"PeriodicalIF":7.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardioneural Ablation for Functional Bradycardia and Vasovagal Syncope","authors":"Roderick Tung MD ,&nbsp;Margarida Pujol-Lopez MD, PhD ,&nbsp;Andrew H. Locke MD ,&nbsp;Daniel M. Alyesh MD ,&nbsp;Sri Sundaram MD ,&nbsp;Anand D. Shah MD ,&nbsp;Vineet Kumar MD ,&nbsp;Guru Kowlgi MD ,&nbsp;Kapil Kumar MD ,&nbsp;Alexei Shvilkin MD, PhD ,&nbsp;Tolga Aksu MD ,&nbsp;Smit Vasaiwala MD ,&nbsp;J. Peter Weiss MD, MSc ,&nbsp;Michael Zawaneh MD ,&nbsp;Jeffrey R. Winterfield MD ,&nbsp;Leah A. John MD ,&nbsp;Pasquale Santangeli MD, PhD ,&nbsp;Christopher Woods MD, PhD ,&nbsp;Wendy S. Tzou MD ,&nbsp;Sunil Kapur MD ,&nbsp;Andre d’Avila MD, PhD","doi":"10.1016/j.jacep.2025.04.012","DOIUrl":"10.1016/j.jacep.2025.04.012","url":null,"abstract":"<div><h3>Background</h3><div>Cardioneural ablation (CNA) shows promise as a viable alternative to permanent cardiac pacing and pharmacotherapy for patients with symptomatic functional bradycardia and debilitating vasovagal syncope (VVS). The evidence supporting a potential therapeutic role for CNA is limited by relatively small sample sizes from predominantly single-center reports.</div></div><div><h3>Objectives</h3><div>This study sought to report the feasibility, safety, and clinical efficacy of CNA from a large, first-ever multicenter US registry.</div></div><div><h3>Methods</h3><div>A multicenter registry from 15 US sites was established by collecting data from consecutive patients undergoing CNA for recurrent VVS or symptomatic functional bradycardia (sinus bradycardia [SB] or atrioventricular block [AVB]) refractory to medical therapy and behavioral modification (2018-2024).</div></div><div><h3>Results</h3><div>A total of 205 patients who underwent 210 CNA procedures<span><span><span> were included. The mean age was 47 ± 17 years, 49% were female, and baseline left ventricular ejection fraction<span> was 60% ± 5%. The most common indication for CNA was syncope in 66.3% (VVS 61.5%, syncope related to AVB 4.9%), followed by SB in 31.2%, AVB in 1.5%, or both SB and AVB in 0.9%. An anatomical approach to target typical ganglionated plexus locations was implemented in all cases, with high-frequency stimulation in 47% of procedures. Endocardial<span> ablation targeting ganglionated plexuses was performed in both atria in 77%, with 697 ± 515 seconds of radiofrequency application. Vagal and sympathetic responses during ablation were observed in 52% and 73% of cases, respectively. The mean increase in heart rate immediately after ablation was 20 ± 15 beats/min. Complications were observed in 4.7% of procedures: 2 respiratory failures requiring </span></span></span>bilevel positive airway pressure<span>, 1 right diaphragmatic paralysis<span>, and 4 sinus node dysfunction, with a major adverse event rate of 1.4% (2 </span></span></span>hemopericardium<span>, 1 death). At a mean follow-up of 14 ± 11 months, 78% of patients with syncope remained free from recurrence, with a reduction in episodes from a median of 7 (4-15) episodes to a median of 0 (0-0) episodes. Overall, 97% of the cohort remained free from pacemaker implantation.</span></span></div></div><div><h3>Conclusions</h3><div>In the largest multicenter CNA experience to date, acceleration of baseline heart rate and a significant reduction in syncope burden were achieved with an acceptable rate of major procedural complications. These observational data pave the way for future randomized trials to evolve CNA indications beyond compassionate usage for managing functional bradycardia and reflex syncope.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 8","pages":"Pages 1683-1695"},"PeriodicalIF":7.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Response to Resynchronization Therapy","authors":"Margarida Pujol-López MD, PhD ,&nbsp;Freddy R. Graterol MD ,&nbsp;Roger Borràs MSc ,&nbsp;Cora Garcia-Ribas MD, PhD ,&nbsp;J. Baptiste Guichard MD, PhD ,&nbsp;Mariona Regany-Closa MSc ,&nbsp;Rafael Jiménez-Arjona MD ,&nbsp;Mireia Niebla RN ,&nbsp;Marina Poza RN ,&nbsp;Esther Carro RN ,&nbsp;M. Ángeles Castel MD, PhD ,&nbsp;Elena Arbelo MD, PhD ,&nbsp;Andreu Porta-Sánchez MD, PhD ,&nbsp;Marta Sitges MD, PhD ,&nbsp;Ivo Roca-Luque MD, PhD ,&nbsp;Adelina Doltra MD, PhD ,&nbsp;Eduard Guasch MD, PhD ,&nbsp;José M. Tolosana MD, PhD ,&nbsp;Lluís Mont MD, PhD","doi":"10.1016/j.jacep.2025.03.024","DOIUrl":"10.1016/j.jacep.2025.03.024","url":null,"abstract":"<div><h3>Background</h3><div>Randomized studies comparing conduction system pacing (CSP) with biventricular pacing (BiVP) are scarce and do not include clinical outcomes.</div></div><div><h3>Objectives</h3><div>The CONSYST-CRT (Conduction System Pacing vs Biventricular Resynchronization Therapy in Systolic Dysfunction and Wide QRS) trial aimed to test the noninferiority of CSP as compared with BiVP in patients with an indication for cardiac resynchronization therapy, with respect to a combined clinical endpoint at 1-year follow-up.</div></div><div><h3>Methods</h3><div>A total of 134 patients with cardiac resynchronization therapy indication were randomized to BiVP or CSP and followed up for 12 months. Crossover was allowed when the primary allocation procedure failed. The atrioventricular interval was optimized to obtain fusion with intrinsic conduction. The primary combined endpoint was all-cause mortality, cardiac transplant, heart failure hospitalization, or left ventricular ejection fraction (LVEF) improvement &lt;5 points at 12 months. Secondary endpoints were LVEF increase, LV end-systolic volume (LVESV) decrease, echocardiographic response (≥15% LVESV decrease), QRS shortening, septal flash correction, NYHA functional class improvement, and a combined endpoint of all-cause mortality, cardiac transplantation, and heart failure hospitalization.</div></div><div><h3>Results</h3><div>Sixty-seven patients were allocated to each group. Eighteen patients (26.9%) crossed from CSP to BiVP; 5 (7.5%) crossed over from BiVP to CSP. Noninferiority (NI) was observed for CSP compared with BiVP for the primary endpoint (23.9% vs 29.8%, respectively; mean difference −5.9; 95% CI: −21.1 to 9.2; <em>P</em> = 0.02) and for the combined endpoint of all-cause mortality, cardiac transplantation, and heart failure hospitalization (11.9% vs 17.9%; <em>P</em> &lt; 0.01 NI); echocardiographic response (66.6% vs 59.7%; <em>P</em> = 0.03 NI); NYHA functional class (<em>P</em> &lt; 0.001 NI); and QRS shortening (<em>P</em> &lt; 0.01). LVEF, LVESV, and septal flash endpoint values were similar, but noninferiority was not met (14.1% ± 10% vs 14.4% ± 10%, −27.9% ± 27% vs −27.9% ± 28%, −2.2 ± 2.7 mm vs −2.7 ± 2.4 mm, respectively).</div></div><div><h3>Conclusions</h3><div>CSP was noninferior to BiVP in achieving clinical and echocardiographic response, suggesting that CSP could be an alternative to BiVP. (Conduction System Pacing vs Biventricular Resynchronization Therapy in Systolic Dysfunction and Wide QRS [CONSYST-CRT]; <span><span>NCT05187611</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 8","pages":"Pages 1820-1831"},"PeriodicalIF":7.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}