JACC. Clinical electrophysiology最新文献

{"title":"Outcomes of Scar-Related Ventricular Tachycardia Ablation With Percutaneous Left Ventricular Assist Device Support.","authors":"Iwanari Kawamura, Jacob S Koruth, Shigeki Kusa, Jin Iwasawa, Jeff Lam, Betsy Ellsworth, Keita Watanabe, Moritz Nies, Joshua Lampert, Abhishek Maan, Daniel R Musikantow, Mohit K Turagam, Noah Moss, William Whang, Marc A Miller, Vivek Y Reddy, Srinivas Dukkipati","doi":"10.1016/j.jacep.2025.07.016","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.07.016","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous left ventricular assist devices (pLVADs) are often used in critically ill patients undergoing scar-related ventricular tachycardia (VT) ablation. However, there are no randomized controlled trials evaluating their benefits.</p><p><strong>Objectives: </strong>The goal of this study was to compare outcomes between pLVAD- and non-pLVAD-supported VT ablation using a propensity score matching analysis.</p><p><strong>Methods: </strong>This retrospective analysis comprised 481 scar-related VT patients who underwent catheter ablation (175 pLVAD and 306 non-pLVAD). A 1:1 propensity score matching was conducted to balance baseline characteristics for comparison of procedural and long-term outcomes.</p><p><strong>Results: </strong>A propensity score analysis generated 115 matched pairs in each group. Baseline characteristics of the matched cohorts were comparable (mean left ventricular ejection fraction 27%, 40% NYHA functional class ≥III, and 36% electrical storm). Compared with the non-pLVAD, more patients in the pLVAD group had at least 1 VT termination during ablation. Despite including a higher use of advanced ablation strategies and a longer procedure time, the pLVAD group had a postprocedural VT inducibility similar to that of the non-pLVAD group. The incidence of periprocedural major complications was higher among pLVAD patients (29.6% vs 13.9%; P = 0.004), largely driven by vascular complications requiring intervention and periprocedural heart failure. During a median follow-up of 326 days, Kaplan-Meier curves showed no statistically significant differences in composite outcome (hospitalization for VT or worsening heart failure requiring hospitalization, LVAD implantation, orthotopic heart transplantation, and all-cause mortality), and VT recurrence.</p><p><strong>Conclusions: </strong>The use of pLVADs during VT ablation is associated with longer procedures and higher procedural complications without any benefit in acute or long-term outcomes.</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040037","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":"Transatrial Epicardial Access Via Inadvertent Atrial Wall Puncture Enabling Ventricular Tachycardia Mapping and Ablation.","authors":"Muhieddine Omar Chokr, Ricardo Ferreira Silva, Ana Belén Guadalupe Saeteros, Mauricio Ibrahim Scanavacca","doi":"10.1016/j.jacep.2025.07.025","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.07.025","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040090","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":"Intermittent LBBB After Transcatheter Aortic Valve Replacement.","authors":"Ramanathan Velayutham, Anish Bhargav, Bhagwati Prasad Pant, Avinash Anantharaj, Raja J Selvaraj","doi":"10.1016/j.jacep.2025.07.013","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.07.013","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039624","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":"Mind Your \"A Game\".","authors":"Edward G Lakatta","doi":"10.1016/j.jacep.2025.07.020","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.07.020","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039697","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":"Detection and Significance of Nonsustained Ventricular Tachycardia in a Post-Stroke Population.","authors":"Pranav Rekapalli, Alireza Oraii, Jonathan Heintz, Sanjay Dixit, Andrew E Epstein, David S Frankel, Matthew Hyman, David Lin, Timothy Markman, Steven R Messé, Saman Nazarian, Brett Cucchiara, Robert D Schaller, Vincent Y See, Wei Yang, Scott E Kasner, Francis E Marchlinski, Rajat Deo","doi":"10.1016/j.jacep.2025.07.018","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.07.018","url":null,"abstract":"<p><strong>Background: </strong>Clinical guidelines recommend cardiac rhythm monitoring in post-stroke patients.</p><p><strong>Objectives: </strong>This study sought to assess the prevalence and significance of nonsustained ventricular tachycardia (NSVT) in patients who have had an ischemic stroke or transient ischemic attack (TIA).</p><p><strong>Methods: </strong>The CAMPS (Cardiac Ambulatory Monitoring Post Stroke) study was composed of post-stroke or TIA patients who were referred for ambulatory cardiac rhythm monitoring. Between 2019 and 2023, 752 patients completed cardiac monitoring within 1 year of the ischemic event. We evaluated the association between the presence of NSVT and the risk of subsequent stroke, cardiac events, or death.</p><p><strong>Results: </strong>Patients were monitored for a mean of 19 ± 7 days, and NSVT was observed in 164 patients (22%). Compared with patients who did not have NSVT, those with NSVT were older, more likely to be male, smoke, and have a higher prevalence of coronary heart disease. Patients with NSVT had a higher risk of subsequent stroke (HR: 2.65; 95% CI: [1.74-4.02]), cardiac events (HR: 2.25; 95% CI: [1.40-3.64]), and death (HR: 1.87; 95% CI: [1.12-3.15]). These estimates remained significant after adjustment for demographics and clinical factors: subsequent stroke (HR: 2.50; 95% CI: [1.59-3.93]), cardiac events (HR: 1.86; 95% CI: [1.11-3.11]), and death (HR: 1.90; 95% CI: [1.09-3.31]). In this exploratory analysis, a higher NSVT burden was associated with increased risk of adverse events.</p><p><strong>Conclusions: </strong>NSVT in patients with recent stroke or TIA is independently associated with a 2- to 3-fold increased risk of subsequent stroke, cardiac events, and death after controlling for demographics and clinical factors.</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040199","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":"Infant Electrocardiogram-Based Deep Learning Predicts Critical Congenital Heart Disease.","authors":"Joshua Mayourian, Donnchadh O'Sullivan, Katia Bravo-Jaimes, Malini Madhavan, Sunil Ghelani, Robert Geggel, John K Triedman","doi":"10.1016/j.jacep.2025.08.005","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.08.005","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039716","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 Tachycardia Ablation via the Right Atrium to Left Ventricle Access Using a Transseptal Needle.","authors":"Hailei Liu, Youmei Shen, Shumpei Mori, Weizhu Ju, Minglong Chen","doi":"10.1016/j.jacep.2025.07.024","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.07.024","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040102","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 Risk of Breakthrough Cardiac Events Associated With Psychiatric Medications in Patients With Diagnosed and Clinically Treated Long QT Syndrome.","authors":"Iuri Ferreira Felix, Vanessa Karlinski Vizentin, Raquel Neves, Sahej Bains, J Martijn Bos, John R Giudicessi, Michael J Ackerman","doi":"10.1016/j.jacep.2025.08.002","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.08.002","url":null,"abstract":"<p><strong>Background: </strong>Long QT syndrome (LQTS) is a potentially life-threatening genetic heart disease. Because many psychiatric medications have QT-prolonging potential, there is hesitation when prescribing them to LQTS patients with concomitant psychiatric disorders, which may lead to suboptimal mental health care.</p><p><strong>Objectives: </strong>This study sought to evaluate the incidence of breakthrough cardiac events (BCEs) in patients with diagnosed and clinically treated LQTS on QT-prolonging psychiatric medications.</p><p><strong>Methods: </strong>Review of LQTS patients seen at the Mayo Clinic between January 2000 and December 2023 with a concomitant psychiatric diagnosis requiring medications with a QT-prolonging potential was performed. Follow-up time was defined as time from first evaluation in our clinic to the last communication for any LQTS-associated BCEs.</p><p><strong>Results: </strong>Among 195 of 1,787 patients (11%) placed on psychiatric drugs (150 [76%] female, mean age at LQTS diagnosis 27 ± 18 years), the most common psychiatric disorders were depression (141 [71%]) and anxiety (120 [62%]). The most common prescribed medications were fluoxetine (53 [26%]), sertraline (27 [14%]) and escitalopram (22 [11%]). Before their first Mayo Clinic evaluation, 61 of 195 patients (31%) had at least 1 BCE. This occurred while on psychiatric medications for 7 patients (11%). Following their first Mayo Clinic evaluation, 14 of 195 patients (7%) had at least 1 BCE. This occurred while on psychiatric medications for 3 patients (21%). The 3 events happened in the setting of other known arrhythmia triggers including treatment noncompliance and electrolyte abnormalities.</p><p><strong>Conclusions: </strong>After correct diagnosis and treatment, LQTS patients with concomitant mental health issues may be safely and effectively treated with QT-prolonging psychiatric medications.</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000504","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":"Calmodulinopathies: The Need for a Registry.","authors":"Peter J Schwartz, Lia Crotti","doi":"10.1016/j.jacep.2025.08.004","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.08.004","url":null,"abstract":"<p><p>Calmodulinopathies are very rare genetic disorders associated with a high risk for sudden cardiac death. Disease-causing variants in 1 of the 3 identical CALM genes cause severe forms of long QT syndrome, catecholaminergic polymorphic ventricular tachycardia, or idiopathic ventricular fibrillation, and there are many unanswered questions concerning management and underlying mechanisms. What is currently known depends largely on the initial publications from the ICamR (International Calmodulinopathy Registry). However, progress is delayed because the accrual of patients in ICamR is slow. As we did long ago for long QT syndrome, this is a call for action, requesting doctors all over the world to enroll even their isolated cases in the Registry. This is the only way to obtain, for an adequate number of patients, the data necessary to define the spectrum of clinical manifestations and the genotype-phenotype correlation essential for an improved risk stratification and best therapeutic management. If you are willing to contribute, please contact us.</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954375","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":"Linear Ablation at the Mitral Isthmus Following Mitral Valve Surgery","authors":"Kinan Kneizeh MD ,&nbsp;Thomas Pambrun MD ,&nbsp;Allan Plant MBChB ,&nbsp;Karim Benali MD, PhD ,&nbsp;Xavier Bouteiller PhD ,&nbsp;Konstantinos Vlachos MD ,&nbsp;Nadir Moussaoui MD ,&nbsp;Cinzia Monaco MD ,&nbsp;Masaaki Yokoyama MD, PhD ,&nbsp;John Fitzgerald MBBS, PhD ,&nbsp;Laurens Verhaeghe MD ,&nbsp;Nicolas Johner MD ,&nbsp;Geoffroy Ditac MD ,&nbsp;Francesco Notaristefano MD ,&nbsp;Miruna Popa MD ,&nbsp;Benjamin Sacristan MD ,&nbsp;Marine Arnaud MD ,&nbsp;Benjamin Bouyer MD ,&nbsp;Romain Tixier MD ,&nbsp;Josselin Duchateau MD, PhD ,&nbsp;Nicolas Derval MD","doi":"10.1016/j.jacep.2025.05.009","DOIUrl":"10.1016/j.jacep.2025.05.009","url":null,"abstract":"<div><h3>Background</h3><div>Creating conduction block along the mitral isthmus can be challenging because of anatomical factors. Ethanol infusion into the vein of Marshall (EIVOM) effectively facilitates this process. Patients with prior mitral valve surgery<span> are at high risk for atrial fibrillation and atrial tachycardia. The feasibility and outcomes of EIVOM and mitral isthmus ablation in these patients remain unclear.</span></div></div><div><h3>Objectives</h3><div>The aim of this study was to evaluate the feasibility, safety, and durability of EIVOM and mitral isthmus ablation in patients with prior mitral valve surgery.</div></div><div><h3>Methods</h3><div>Consecutive mitral valve–operated patients undergoing EIVOM and mitral isthmus ablation were retrospectively included. Feasibility and outcomes were evaluated and compared with a propensity score–matched control group.</div></div><div><h3>Results</h3><div>The study group had a mean age of 64 ± 12 years and a mean left atrial volume index of 56 ± 18 mL/m²<span>; 53.7% of patients were male. Patients with mitral valve replacement (74.1%), 52.5% of whom received mechanical valves, were included. EIVOM was successful in 92.6% of patients, with the acute mitral isthmus block achieved in 88.9% of patients. Propensity-weighted analysis with a control group of patients with no history of mitral valve surgery (n = 72) showed similar EIVOM success rates between groups (91.5% vs 91.7%; </span><em>P</em> = 0.76) and comparable VOM dissection rates (6.4% vs 1.4%; <em>P</em> = 0.30). The proportion of acutely unblocked mitral isthmus was higher in the study group (12.8% vs 5.5%; <em>P</em> = 0.073). Freedom from atrial tachycardia/atrial fibrillation at 1 year was not statistically different (55.3% vs 73.6%; <em>P</em> = 0.12).</div></div><div><h3>Conclusions</h3><div>EIVOM and mitral isthmus ablation are feasible and acutely successful after mitral valve surgery.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 9","pages":"Pages 1992-2000"},"PeriodicalIF":7.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553572","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}