JACC. Clinical electrophysiology最新文献

{"title":"Impact of Anterior Right Ventricular Outflow Tract Conduction Block on QRS Morphology in Repaired Tetralogy of Fallot","authors":"Jeremy P. Moore MD, MS , Katja Zeppenfeld MD, PhD","doi":"10.1016/j.jacep.2025.02.007","DOIUrl":"10.1016/j.jacep.2025.02.007","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 6","pages":"Pages 1360-1365"},"PeriodicalIF":8.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719333","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":"Beyond the Cautionary Tale","authors":"Uyanga Batnyam MD , Usha Tedrow MD, MSc","doi":"10.1016/j.jacep.2025.03.008","DOIUrl":"10.1016/j.jacep.2025.03.008","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 6","pages":"Pages 1171-1173"},"PeriodicalIF":8.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996885","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":"Simultaneous Right and Left Bundle Pacing","authors":"Rohan Trivedi DO, Pugazhendhi Vijayaraman MD","doi":"10.1016/j.jacep.2025.03.029","DOIUrl":"10.1016/j.jacep.2025.03.029","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 6","pages":"Pages 1349-1351"},"PeriodicalIF":8.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173814","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":"Nanosecond vs Microsecond Pulsed Field Ablation","authors":"Lei Ding MD ,&nbsp;Aikai Zhang MD ,&nbsp;Yang Sun MD ,&nbsp;Yuandong Liu MD ,&nbsp;Yingjie Qi MD ,&nbsp;Zihan Jiang MD ,&nbsp;Lijie Mi MD ,&nbsp;Fengyuan Yu MD ,&nbsp;Hongda Zhang MD ,&nbsp;Min Tang MD, PhD","doi":"10.1016/j.jacep.2025.01.017","DOIUrl":"10.1016/j.jacep.2025.01.017","url":null,"abstract":"<div><h3>Background</h3><div>A nanosecond pulsed field generator and a circular multielectrode catheter have been introduced.</div></div><div><h3>Objectives</h3><div>The aim of this study was to compare the durability, safety, and muscle contraction of ablation via microsecond or nanosecond pulsed field ablation (PFA) in canines.</div></div><div><h3>Methods</h3><div>Under general anesthesia without muscle relaxants, 24 canines were subjected to isolation of the superior vena cava (SVC) and pulmonary veins (PVs) using nanosecond or microsecond PFA. Repeat mapping was performed and the animals were sacrificed acutely (7 days, n = 9), subacutely (30 days, n = 9), or chronically (3 months, n = 6).</div></div><div><h3>Results</h3><div>All SVCs were isolated with durable isolation. A total of 161 sections from the SVC revealed transmural lesions in all sections, with a mean depth of 1.3 ± 0.7 mm. Similarly, all the PVs were isolated. Durable isolation was achieved in 23 (95.8%) of 24 PVs in nanosecond PFA and 22 (91.7%) of 24 PVs in microsecond PFA. Nanosecond PFA resulted in transmural lesions in 148 (97.4%) of 152 sections and a median lesion depth of 2.7 ± 1.2 mm. Microsecond PFA created transmural lesions in 155 (96.9%) of 160 sections with a median depth of 2.6 ± 1.0 mm. There were no significant differences in depth or transmurality between groups. Nanosecond PFA caused no, slight, and severe muscle contraction in 70.8%, 12.5%, and 16.7% PVs, respectively, and microsecond PFA resulted in no and severe muscle contraction in 29.2% and 70.8% PVs, respectively. Nanosecond PFA demonstrated a significantly lower incidence of severe muscle contraction (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Nanosecond PFA yields comparable lesion durability, safety, and significantly reduced muscle contractions to microsecond PFA, which may help enable PV isolation without general anesthesia.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 6","pages":"Pages 1218-1230"},"PeriodicalIF":8.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673858","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 Relevance of the Type of Ventricular Arrhythmia in Titin-Related Dilated Cardiomyopathy","authors":"Micaela Ebert MD ,&nbsp;Marta de Riva MD, PhD ,&nbsp;Adrianus P. Wijnmaalen MD, PhD ,&nbsp;Daniela Q.C.M. Barge-Schaapveld MD, PhD ,&nbsp;Marianne Bootsma MD, PhD ,&nbsp;Jarieke Hoogendoorn MD ,&nbsp;Daniela Husser MD ,&nbsp;J. Peter van Tintelen MD, PhD ,&nbsp;Jan D.H. Jongbloed MSc, PhD ,&nbsp;Sergio Richter MD ,&nbsp;Antonio Berruezo MD, PhD ,&nbsp;Gerhard Hindricks MD ,&nbsp;William G. Stevenson MD ,&nbsp;Katja Zeppenfeld MD, PhD","doi":"10.1016/j.jacep.2025.01.010","DOIUrl":"10.1016/j.jacep.2025.01.010","url":null,"abstract":"<div><h3>Background</h3><div>Truncating titin variants (<em>TTN</em>tvs) are the most prevalent cause of inherited dilated cardiomyopathy. Occurrence of different ventricular arrhythmia (VA) subtypes, including premature ventricular complexes (PVCs), nonsustained ventricular tachycardia (NSVT), and sustained monomorphic VT (SMVT), has been reported.</div></div><div><h3>Objectives</h3><div>The aim of this study was to analyze the prognostic relevance of distinct VA subtypes among <em>TTN</em>tv carriers and their underlying arrhythmogenic substrates.</div></div><div><h3>Methods</h3><div>Twenty-two <em>TTN</em>tv carriers referred for ablation of SMVT (n = 14) or frequent PVCs (n = 8) from 5 centers were included (mean age 56 ± 11 years; left ventricular ejection fraction 38% ± 13%; 77% male). Detailed phenotyping was performed, including Holter monitoring, cardiac imaging, and electroanatomical mapping. Patients were followed up for a median of 44 months.</div></div><div><h3>Results</h3><div>Demographic characteristics, including age, comorbidities, and left ventricular ejection fraction, were similar. NSVTs were frequent in both groups but faster in patients with SMVT (cycle length: 350 milliseconds [Q1-Q3: 315-403 milliseconds] vs 427 milliseconds [Q1-Q3: 395-469 milliseconds]). Although substrates for SMVT extended in a basal ring–like fashion with septal predominance, PVC sites of origin were limited to the basal anterior left ventricular segment. In the SMVT group, acute complete procedural success was achieved for 36%; during follow-up, 86% had recurrent VT, and 50% died of progressive heart failure. In the PVC group, complete abolition of PVCs was achieved in only 13%; at 3 months, median PVC burden was 1%, and there were no deaths or sustained VT during follow-up. VA subtype and NSVT cycle length were associated with mortality and poor VT-free survival.</div></div><div><h3>Conclusions</h3><div>In <em>TTN</em>tv carriers, SMVTs but not frequent PVCs are associated with high mortality due to heart failure. Occurrence of SMVT may identify a subgroup at risk for rapid, progressive adverse remodeling. The prognostic significance of different VA subtypes needs to be confirmed in a larger cohort.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 6","pages":"Pages 1193-1204"},"PeriodicalIF":8.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634016","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":"Procedure-Related Complications Associated With Catheter Ablation for Idiopathic Premature Ventricular Complexes","authors":"Sean DeAngelo DO ,&nbsp;Maryam Haghshomar MD ,&nbsp;Badri Aryal MD ,&nbsp;Muhammed Khawar Sana MD ,&nbsp;Robert D. Schaller DO","doi":"10.1016/j.jacep.2025.02.038","DOIUrl":"10.1016/j.jacep.2025.02.038","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 6","pages":"Pages 1334-1337"},"PeriodicalIF":8.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008708","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":"Extended Cardiac Rhythm Monitoring Detects More Arrhythmias in Myotonic Dystrophy Patients","authors":"Vincenzo Russo MD, PhD","doi":"10.1016/j.jacep.2025.03.041","DOIUrl":"10.1016/j.jacep.2025.03.041","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 6","pages":"Page 1347"},"PeriodicalIF":8.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144364945","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":"Turning Back Time","authors":"Rose Crowley BMed, MD ,&nbsp;Peter M. Kistler MBBS, PhD","doi":"10.1016/j.jacep.2025.04.005","DOIUrl":"10.1016/j.jacep.2025.04.005","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 6","pages":"Pages 1248-1250"},"PeriodicalIF":8.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366111","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":"Pulsed-Field vs Thermal Catheter Ablation of Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy","authors":"Samy Gribissa MD ,&nbsp;Thomas Kueffer PhD ,&nbsp;Sven Knecht PhD ,&nbsp;Xavier Waintraub MD ,&nbsp;Nicolas Badenco MD ,&nbsp;Philippe Charron MD, PhD ,&nbsp;Pauline Pinon MD ,&nbsp;Raphael King MSc ,&nbsp;Estelle Gandjbakhch MD, PhD ,&nbsp;Guillaume Duthoit MD ,&nbsp;Christian Sticherling MD ,&nbsp;Tobias Reichlin MD, PhD ,&nbsp;Mikael Laredo MD, PhD","doi":"10.1016/j.jacep.2025.01.009","DOIUrl":"10.1016/j.jacep.2025.01.009","url":null,"abstract":"<div><h3>Background</h3><div>Pulsed-field ablation (PFA) may be beneficial for the treatment of atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM).</div></div><div><h3>Objectives</h3><div>The goal of this study was to compare the safety and efficacy of PFA and thermal ablation in patients with HCM and AF.</div></div><div><h3>Methods</h3><div>From 2016 to 2024, patients with HCM undergoing a first AF ablation using PFA or thermal ablation (cryoballoon or radiofrequency) were retrospectively included from 3 French and Swiss centers. Freedom from atrial arrhythmia (AA) recurrence at the 12-month follow-up was assessed.</div></div><div><h3>Results</h3><div>Overall, 109 patients (median age 60 years; 68% male; 43% paroxysmal AF) with HCM underwent PFA (n = 58) or thermal ablation (n = 51) of AF. In addition to pulmonary vein (PV) isolation, extra-PV ablation was performed in 62% of PFA cases and in 18% of thermal cases. PFA was associated with shorter median procedure times than thermal ablation (81 minutes [Q1-Q3: 60-110 minutes] vs 132 minutes [Q1-Q3: 75-190 minutes]; <em>P</em> &lt; 0.0001) and with less postprocedural heart failure (n = 0 vs n = 4; <em>P</em> = 0.03). Freedom from AA recurrence was 57% (95% CI: 46%-67%) after 12 months. PFA was associated with less AA recurrence than thermal ablation (adjusted HR: 0.46; 95% CI: 0.23-0.91; <em>P</em> = 0.03). Extra-PV ablation was associated with more sustained AA recurrence with thermal ablation (HR: 3.07; 95% CI: 1.21-7.82; <em>P</em> = 0.02) but not with PFA (HR: 1.07; 95% CI: 0.35-3.27; <em>P</em> = 0.91).</div></div><div><h3>Conclusions</h3><div>In patients with HCM and AF, PFA seems to be associated with better safety and efficacy outcomes than thermal ablation.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 6","pages":"Pages 1205-1215"},"PeriodicalIF":8.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633955","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 Efficacy of Left Atrial vs Biatrial Cardioneuroablation in Patients With Vasovagal Syncope","authors":"Bin Tu MD, PhD ,&nbsp;Aiyue Chen MD ,&nbsp;Simin Cai MD ,&nbsp;Zhuxin Zhang MD ,&nbsp;Likun Zhou MD ,&nbsp;Zihao Lai MD ,&nbsp;Pakezhati Maimaitijiang MD ,&nbsp;Zhicheng Hu MD, PhD ,&nbsp;LingMin Wu MD, PhD ,&nbsp;Ligang Ding MD, PhD ,&nbsp;Lihui Zheng MD, PhD ,&nbsp;Yan Yao MD, PhD","doi":"10.1016/j.jacep.2025.01.019","DOIUrl":"10.1016/j.jacep.2025.01.019","url":null,"abstract":"<div><h3>Background</h3><div>Cardioneuroablation has been proposed to be effective in patients with vasovagal syncope, whereas the preferred ablation strategy is undetermined.</div></div><div><h3>Objectives</h3><div>This study aimed to determine the preferred ablation strategy of cardioneuroablation between the left atrial (LA) and the bilateral atrial (BiA) approach.</div></div><div><h3>Methods</h3><div>This study was a prospective randomized clinical trial to compare the efficacy of 2 ablation strategies for patients with vasovagal syncope. The participants were randomly assigned to either the LA or BiA ganglion plexus ablation group in a 1:1 ratio.</div></div><div><h3>Results</h3><div>Eighty participants (37 men [46.2%]; age 38 ±16 years) were enrolled, with 40 participants in each group. The efficacy was 87.5% in the LA group (95% CI: 76.8 to 98.2%) and 90% (95% CI: 80.7 to 99.7%) in the BiA group (<em>P</em> = 0.723; <em>P</em> for noninferiority = 0.001). Compared to the BiA group, LA group reduced the average procedure time by 13 minutes (95% CI: 6-20 minutes), the average x-ray dosage by 5.7 mGy (95% CI: 2.1-9.3 mGy), the average ablation lesions by 4 (95% CI: 2-6), and ablation time by 125 seconds (95% CI: 60-190 seconds). No significant difference was observed in presyncope recurrence rate (15% vs 10%; <em>P</em> = 0.498), quality of life (78.7 ± 13.6 vs 80.9 ± 10.6; <em>P</em> = 0.417), mean heart rate (79 ± 11 vs 77 ± 9; <em>P</em> = 0.391), and response to head-up tilt test (57.1% vs 62.2%; <em>P</em> = 0.664) between groups at 12 months.</div></div><div><h3>Conclusions</h3><div>The LA approach's efficacy was noninferior to the BiA approach, whereas the LA approach showed the added benefit of reduced procedure time, a smaller ablation lesion, and smaller x-ray dosage. (Different Catheter Ablation Strategy in Vasovagal Syncope; <span><span>NCT05573178</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 6","pages":"Pages 1265-1276"},"PeriodicalIF":8.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673866","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}