JACC. Clinical electrophysiology最新文献

{"title":"Left Superior Mahaim-Type Accessory Pathway With Latent Pre-Excitation: Diagnosis and Electrophysiological Characterization.","authors":"Nicolas Johner, Geoffroy Ditac, Konstantinos Vlachos, Kinan Kneizeh, Cinzia Monaco, Karim Benali, Allan Plant, John L Fitzgerald, Laurens Verhaeghe, Francesco Notaristefano, Jan Charton, Romain Tixier, Pierre Jaïs, Thomas Pambrun, Nicolas Derval","doi":"10.1016/j.jacep.2025.08.001","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.08.001","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080583","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":"Left Atrial Appendage Closure for Patients With a History of Ischemic Stroke Despite Oral Anticoagulant.","authors":"Tadatomo Fukushima, Masato Fukunaga, Akihiro Isotani, Miho Nakamura, Kenichi Ishizu, Shinichi Shirai, Masahiko Asami, Mitsuru Sago, Shuhei Tanaka, Ryuki Chatani, Daisuke Hachinohe, Toru Naganuma, Yohei Ohno, Tomoyuki Tani, Hideharu Okamatsu, Yusuke Watanabe, Masaki Izumo, Mike Saji, Shingo Mizuno, Hiroshi Ueno, Shunsuke Kubo, Masaki Nakashima, Masanori Yamamoto, Kenji Ando, Kentaro Hayashida","doi":"10.1016/j.jacep.2025.07.021","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.07.021","url":null,"abstract":"<p><strong>Background: </strong>Patients who have an ischemic stroke (IS) with an oral anticoagulant (OAC) have a high recurrence rate of IS. There is insufficient data on left atrial appendage closure (LAAC) for patients with nonvalvular atrial fibrillation (AF) who have had an IS despite OAC.</p><p><strong>Objectives: </strong>The objectives of this study were to compare the clinical outcomes of the patients after LAAC based on IS risk.</p><p><strong>Methods: </strong>This study was retrospective observational study from the OCEAN-LAAC (Optimized Catheter Valvular Intervention-Left Atrial Appendage Closure) registry. Nonvalvular AF patients who underwent LAAC were divided into 3 groups: a control group with no IS history, a group having a previous IS despite an OAC, and a group having a previous IS without OAC. The coprimary endpoints were cardiovascular (CV) death and IS.</p><p><strong>Results: </strong>We included 1,418 patients (median CHA₂DS₂-VASc 5.0, HAS-BLED 3.0) undergoing LAAC. The previous history of IS was noted in 503 (35.4%), and 346 patients were under an OAC. During the median follow-up period of 367 days, no differences in CV death rate were observed among the 3 groups (previous IS despite OAC, subdistribution HR [sHR]: 1.78; 95% CI: 0.87-3.64; previous IS without OAC, sHR: 1.45; 95% CI: 0.59-3.55). The incidence of IS after LAAC was predominantly higher in the previous IS despite OAC group (sHR: 2.62; 95% CI: 1.17-5.86; Gray's test: P = 0.02; previous IS without OAC: sHR: 1.24; 95% CI: 0.36-4.28; Gray's test: P = 0.70).</p><p><strong>Conclusions: </strong>The patients after LAAC who have had an IS despite OAC did not differ in CV death but were at higher risk of IS even after LAAC.</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080590","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":"Evaluating the Impact of Obesity and Epicardial Adiposity on the Presence of HFpEF in Patients With AF.","authors":"Jonathan P Ariyaratnam, Adrian D Elliott, Ricardo S Mishima, Jenelle K Dziano, Mehrdad Emami, Jackson O Howie, Melissa E Middeldorp, Prashanthan Sanders","doi":"10.1016/j.jacep.2025.08.011","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.08.011","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with preserved ejection fraction (HFpEF) is common in atrial fibrillation (AF). The mechanisms underlying HFpEF in AF remain unclear.</p><p><strong>Objectives: </strong>This study sought to assess the influence of obesity and epicardial adipose tissue (EAT) on the presence of HFpEF in AF.</p><p><strong>Methods: </strong>Consecutive patients with symptomatic AF and preserved ejection fraction undergoing an AF ablation procedure were recruited. Participants were classified as obese if body mass index (BMI) was ≥30 kg/m². Diagnosis of HFpEF was made according to invasive measurement of mean left atrial pressure (mLAP). Mean right atrial pressures (mRAP) were measured to assess extrinsic pericardial restraint. Left atrial function was assessed by means of electroanatomic mapping and transthoracic echocardiography. Total cardiac volumes (TCV) and EAT volumes (EATV) were assessed with the use of cardiac computed tomography scans.</p><p><strong>Results: </strong>Of 120 participants, 44 (36.7%) were obese and 76 (63.3%) were nonobese. Obese patients were younger than nonobese patients (P = 0.003). Obese patients demonstrated higher mLAP (P < 0.001) and were more likely to have HFpEF (P = 0.043). Obese patients also demonstrated higher mRAP (P < 0.001). However, there were no differences in global LA voltages (P = 0.186) or LA reservoir strain (P = 0.63). TCV (P = 0.001) and EATV (P < 0.001) were significantly greater in obese patients, and both correlated positively with mRAP (TCV: P = 0.013; EATV: P = 0.007).</p><p><strong>Conclusions: </strong>Obesity in AF is associated with worse hemodynamics and higher prevalence of HFpEF, underpinned by greater pericardial restraint due to cardiomegaly and increased EATV. Patients with obesity and increased EATV are therefore at increased risk of HF and may benefit from additional HFpEF and weight loss therapies to reduce this risk (Characterizing Left Atrial Function and Compliance in Atrial Fibrillation; ACTRN12620000639921).</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137683","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":"Acceleration of Left Ventricular Summit Arrhythmias Induced by Unsuccessful Radiofrequency Applications as a Guide to Origin.","authors":"Takumi Yamada, G Neal Kay","doi":"10.1016/j.jacep.2025.08.006","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.08.006","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137507","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":"Prophylactic Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement.","authors":"Quentin Fischer, Luis Nombela-Franco, Guillem Muntané-Carol, Gabriela Veiga, Ander Regueiro, Tamim Nazif, Vicenç Serra, Lluis Asmarats, Henrique B Ribeiro, Azeem Latib, Anthony Poulin, Asim N Cheema, Gabriela Tirado-Conte, Joan Antoni Gomez-Hospital, Aritz Gil Ongay, Rami Gabani, Dabit Arzamendi, Michael Brener, Alvaro Calabuig, Andrea Scotti, Marco Antonio S Gelain, Marino Labinaz, Pedro Cepas-Guillén, Mélanie Côté, Juan H Del Portillo, François Philippon, Josep Rodés-Cabau","doi":"10.1016/j.jacep.2025.07.028","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.07.028","url":null,"abstract":"<p><strong>Background: </strong>The management of patients developing new conduction disturbances after transcatheter aortic valve replacement (TAVR) remains largely debated.</p><p><strong>Objectives: </strong>The purpose of this study was to evaluate the incidence and clinical impact of prophylactic permanent pacemaker implantation (PPI) after TAVR.</p><p><strong>Methods: </strong>This was a prespecified subanalysis of the PROMOTE (PRospective Application of a Pre-Specified Scientific Expert Panel AlgOrithm for the Management of COnduction Disturbances Following Transcatheter Aortic Valve Replacement) trial, a prospective multicenter study including 2,110 consecutive patients without prior pacemaker undergoing TAVR. Prophylactic PPI was considered in case of enlarged QRS with active electrocardiogram changes (daily PR or QRS interval increase ≥20 ms during 2 consecutive days), or new-onset persistent with either QRS>150 ms or PR >240 ms.</p><p><strong>Results: </strong>A total of 329 patients with PPI post-TAVR were included, 80 (24.3%) of which had a prophylactic indication. The main indication (90%) of prophylactic PPI was new-onset persistent left bundle branch block with QRS >150 ms and/or PR >240 ms. The 30-day clinical outcomes were similar in prophylactic and nonprophylactic PPI patients, but the median rate of ventricular pacing percentage was significantly lower in the prophylactic PPI group (2% vs 73%; P < 0.001), with a higher rate of patients with ventricular pacing percentage <1% (42.6% vs 14.5%; P < 0.001). Prophylactic PPI after a positive electrophysiological study (His-Ventricle interval ≥70 ms) did not seem to impact the pacing burden at follow-up (median: 2.0% vs 1.9% in no electrophysiological study patients; P = 0.585).</p><p><strong>Conclusions: </strong>About one fourth of patients receiving PPI after TAVR had a prophylactic indication. Despite similar clinical outcomes, prophylactic PPI patients exhibited a very low pacing burden at 30 days. These findings would question the systematic use of prophylactic PPI after TAVR. (PRospective Application of a Pre-Specified Scientific Expert Panel AlgOrithm for the Management of COnducton Disturbances Following Transcatheter Aortic Valve Replacement [PROMOTE]; NCT04139616).</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080644","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":"Intracardiac Echocardiography for the Detection of Arrhythmogenic Periaortic Ventricular Tachycardia Substrate: Multimodality Core Lab Analysis.","authors":"Naohiko Sahara, Yasutoshi Shinoda, Beeletsega Yeneneh, Philip Gideon, Michael F Morris, Praneeth Katrapati, Nathaniel Shatz, Rong Bai, Jake Martinez, Yu Liao, Dalise Yi Shatz, Michael S Zawaneh, Wilber Su, J Peter Weiss, Roderick Tung","doi":"10.1016/j.jacep.2025.06.012","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.06.012","url":null,"abstract":"<p><strong>Background: </strong>There is no established imaging technique to detect and diagnose periaortic scar, an increasingly prevalent and challenging substrate referred for ventricular tachycardia (VT) ablation. We hypothesized that wall thinning detected with intracardiac echocardiography (ICE) can identify periaortic arrhythmogenic substrate (PAS) in patients with structural heart disease.</p><p><strong>Objectives: </strong>This study sought to validate a new method of identifying PAS using ICE in comparison with electro-anatomic mapping and cardiac magnetic resonance (CMR).</p><p><strong>Methods: </strong>A total of 84 VT ablation patients were analyzed (87% male, median age 72 years [Q1-Q3: 63-75 years], 61% with nonischemic cardiomyopathy) and categorized into 2 groups: PAS+ (n = 29) and PAS- (n = 55) based on voltage-defined scar and deceleration zones. Wall thickness of the basal anterior septum was measured by ICE and CMR at a standardized distance from the left ventricular ostium in diastole by an independent core lab. In 43 patients with CMR, correlation with late gadolinium enhancement (LGE) in the basal anterior septum was also assessed.</p><p><strong>Results: </strong>A significant difference in wall thickness measured at 1 cm from the left ventricular ostium with ICE was observed between PAS+ and PAS- patients (0.57 cm [Q1-Q3: 0.51-0.65 cm] vs 0.72 cm [Q1-Q3: 0.65-0.79 cm]; P < 0.001). Wall thickness by ICE had higher diagnostic performance than CMR, with only 50% of PAS+ patients exhibiting LGE. At a cutoff of <0.60 cm, the sensitivity and specificity of ICE predicting PAS+ were 58% and 87% (positive predictive value 71%, negative predictive value 80%) in comparison with 50% and 84% (positive predictive value 69%, negative predictive value 70%) with CMR-LGE, respectively.</p><p><strong>Conclusions: </strong>ICE-detected wall thinning may be a novel imaging technique to identify arrhythmogenic periaortic VT substrate in this challenging anatomic region, which often eludes diagnosis with CMR. The absence of LGE on CMR does not rule out the presence of periaortic substrate in patients presenting with outflow tract VT.</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080641","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":"Characteristics of Localized Re-Entrant Atrial Tachycardia Involving the Coronary Sinus in the Tachycardia Circuit.","authors":"Yosuke Nakatani, Thomas Pambrun, Takashi Nakashima, Masateru Takigawa, F Daniel Ramirez, Cyril Goujeau, Clémentine André, Konstantinos Vlachos, Aline Carapezzi, Ghassen Cheniti, Romain Tixier, Remi Chauvel, Josselin Duchateau, Frédéric Sacher, Meleze Hocini, Michel Haïssaguerre, Pierre Jaïs, Nicolas Derval","doi":"10.1016/j.jacep.2025.07.029","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.07.029","url":null,"abstract":"<p><strong>Background: </strong>Localized-re-entrant atrial tachycardias (ATs) involving the coronary sinus (CS) as a critical part of the circuit (CS-ATs) remain poorly characterized.</p><p><strong>Objectives: </strong>The goal of this study was to determine the prevalence, clinical characteristics, and electrophysiological properties of CS-ATs.</p><p><strong>Methods: </strong>CS-ATs were identified in a cohort of 545 consecutive patients with 775 ATs mapped by using a high-density mapping system.</p><p><strong>Results: </strong>Eight CS-ATs (1.0% of all ATs; 95% CI: 0.5%-2.0%) were identified in 8 patients (1.5% of all patients; 95% CI: 0.7%-2.9%). All had prior ablation in the inferior septum, bottom wall of the left atrium (LA), or CS, resulting in scar formation in either the inferior septum or bottom wall in 6 patients (75%). The mean tachycardia cycle length was 299 ± 70 milliseconds. The CS segment involved in the tachycardia circuit measured 28 ± 11 mm in length, with a conduction time of 58 ± 31 milliseconds (21% ± 13% of tachycardia cycle length). All CS-ATs exhibited a centrifugal activation pattern originating from the inferior part of the LA. CS-ATs were correctly diagnosed in only 2 patients. Ablation targeting the LA-CS connection successfully terminated CS-AT in 4 patients, and ethanol infusion into the vein of Marshall was required in 3 patients. CS-AT could not be terminated in 1 patient because of an inappropriate ablation strategy.</p><p><strong>Conclusions: </strong>CS-ATs are a rare cause of AT, typically occurring after ablation in the inferior part of the LA or CS. Diagnosing CS-ATs can be challenging. Ablation targeting the LA-CS connection is effective, and ethanol infusion into the vein of Marshall is a viable therapeutic option.</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137639","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":"Ventricular-Ventricular-Atrial Response After Ventricular Overdrive Pacing in Antidromic Nodoventricular Reciprocating Tachycardia.","authors":"Satoshi Sakai, Koichi Nagashima, Mitsunori Maruyama, Hajime Fujimoto, Akihiro Takitsume, Tsunenari Soeda, Hiroyuki Kawata, Taku Nishida, Shungo Hikoso","doi":"10.1016/j.jacep.2025.08.007","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.08.007","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137657","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 Unequivocal Role of the Implantable Cardioverter-Defibrillator in Sudden Cardiac Death Prevention.","authors":"Sana M Al-Khatib","doi":"10.1016/j.jacep.2025.07.023","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.07.023","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080626","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":"Premature Ventricular Contraction Location and Incident Heart Failure.","authors":"Thomas A Dewland, David G Rosenthal, Edward P Gerstenfeld, Melvin M Scheinman, Alvaro Alonso, Elsayed Z Soliman, Lin Yee Chen, David S Siscovick, Nona Sotoodehnia, John S Gottdiener, Bruce M Psaty, Susan R Heckbert, Phyllis K Stein, Gregory M Marcus","doi":"10.1016/j.jacep.2025.07.015","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.07.015","url":null,"abstract":"<p><strong>Background: </strong>The anatomical distribution of spontaneous ventricular ectopy and the risk of heart failure associated with premature ventricular contraction (PVC) location has not been studied outside the narrow group of individuals presenting for arrhythmia-related clinical care.</p><p><strong>Objectives: </strong>This study sought to describe the epidemiology of PVC site of origin and to determine whether PVC anatomical location is independently associated with incident heart failure risk.</p><p><strong>Methods: </strong>Ambulatory adults without prevalent heart failure were identified from the CHS (Cardiovascular Health Study) and the ARIC (Atherosclerosis Risk in Communities Study) cohorts. Anatomical PVC location was assessed by 2 expert reviewers using baseline 12-lead electrocardiogram (ECG) morphology.</p><p><strong>Results: </strong>Among 20,590 participants, 427 (2.1%) demonstrated at least 1 PVC on baseline ECG. Ventricular ectopy was localized to the left ventricle in 49% of participants, outflow tract in 27%, right ventricle in 22%, and epicardium in 2%. Over a mean follow-up of 19.2 years, ventricular ectopy on baseline ECG was associated with an increased adjusted risk of heart failure (HR: 1.43; 95% CI: 1.20 to 1.70; P < 0.001). Adjusted risk of incident heart failure was highest for PVCs arising from the epicardium (HR: 2.98; 95% CI: 1.12 to 7.95; P = 0.029) and the left ventricle (HR: 1.59; 95% CI: 1.30 to 1.94; P < 0.001).</p><p><strong>Conclusions: </strong>In a large population-based cohort, ventricular ectopy was most frequently localized to the left ventricle. Individuals with ectopy arising from the left ventricle and from epicardial locations experienced a higher likelihood of incident heart failure compared with those without PVCs or those with PVCs from other locations.</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080614","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}