JACC. Clinical electrophysiology最新文献

{"title":"Junctions Speak in Volumes","authors":"Mario Delmar MD, PhD, Xianming Lin PhD","doi":"10.1016/j.jacep.2025.01.006","DOIUrl":"10.1016/j.jacep.2025.01.006","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 5","pages":"Pages 931-932"},"PeriodicalIF":8.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567132","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 “Cool Down, Then Ablate” Principle Guides the Treatment of Ventricular Tachycardias in Myocarditis","authors":"Giovanni Peretto MD, PhD , Cristina Basso MD, PhD , Antonio Esposito MD , Lorenzo Dagna MD , Paolo Della Bella MD","doi":"10.1016/j.jacep.2025.02.010","DOIUrl":"10.1016/j.jacep.2025.02.010","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 5","pages":"Pages 1044-1046"},"PeriodicalIF":8.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981141","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":"Empirical Coronary Venous Pacing or Endpoint-Based Cardiac Resynchronization Therapy?","authors":"Marek Jastrzębski MD, PhD","doi":"10.1016/j.jacep.2025.03.010","DOIUrl":"10.1016/j.jacep.2025.03.010","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 5","pages":"Pages 1009-1011"},"PeriodicalIF":8.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139434","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":"Atrial Fibrillation and Flutter in a Contemporary Cohort of Patients With Myotonic Muscular Dystrophy","authors":"Melissa A. Austin MD ,&nbsp;Gregory E. Supple MD ,&nbsp;Samuel Carrell MD, PhD ,&nbsp;Colin Quinn MD ,&nbsp;Lauren Elman MD ,&nbsp;Saman Nazarian MD, PhD","doi":"10.1016/j.jacep.2024.12.007","DOIUrl":"10.1016/j.jacep.2024.12.007","url":null,"abstract":"<div><h3>Background</h3><div>Literature on the prevalence and management of atrial arrhythmias in patients with myotonic muscular dystrophy type 1 (MMD1) or myotonic muscular dystrophy type 2 (MMD2) is limited.</div></div><div><h3>Objectives</h3><div>This study sought to describe incidence, prevalence, and predictors of atrial fibrillation (AF) and atrial flutter (AFL) in a contemporary cohort of patients with myotonic muscular dystrophy (MMD).</div></div><div><h3>Methods</h3><div>Associations between patient factors and incident AF/AFL were analyzed in patients with MMD referred for routine electrophysiology evaluation between January 2013 and September 2023.</div></div><div><h3>Results</h3><div>We identified 120 patients (96 MMD1, 24 MMD2) seen for new electrophysiology clinic visits for MMD cardiac evaluation. Median age at MMD diagnosis was 34.6 years (Q1-Q3: 21.8-51.0 years), with a younger age at diagnosis for MMD1 patients (<em>P</em> &lt; 0.001). AF or AFL was diagnosed in 31% of patients (31 of 96 MMD1 patients vs 6 of 24 MMD2 patients; <em>P</em> = 0.656) during the study period. AF occurred in 34 (28%) patients, AFL in 9 (8%), and 6 of 37 had both AF and AFL. Anticoagulation (AC) was prescribed at initial AF/AFL diagnosis in 41% (n = 15 of 37) of patients. The CHA₂DS₂-VASc score was higher in patients who received AC (<em>P</em> &lt; 0.001). Twelve (32%) patients underwent catheter ablation. One stroke occurred in the AF/AFL group (no AC, CHA₂DS₂-VASc score 0). Female MMD1 patients were less likely to develop AF/AFL (HR: 0.08). Diagnosis of MMD1 at a younger age (HR: 0.95 per year) and greater CTG nucleotide repeats (HR: 1.09 per 50 repeats) were associated with incident AF/AFL.</div></div><div><h3>Conclusions</h3><div>There was a high prevalence of AF/AFL in this single-institution MMD cohort. The CHA₂DS₂-VASc score may not be an effective tool in this population.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 5","pages":"Pages 933-941"},"PeriodicalIF":8.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023120","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":"Sudden Cardiac Death as First Manifestation of Cardiovascular Disease","authors":"Tobias Skjelbred MD ,&nbsp;Peder Emil Warming MD ,&nbsp;Johanna Krøll MD ,&nbsp;Mikkel Porsborg Andersen MScPH, PhD ,&nbsp;Christian Torp-Pedersen MD, DMSc ,&nbsp;Bo Gregers Winkel MD, PhD ,&nbsp;Jacob Tfelt-Hansen MD, DMSc ,&nbsp;Thomas Hadberg Lynge MD, PhD","doi":"10.1016/j.jacep.2024.12.012","DOIUrl":"10.1016/j.jacep.2024.12.012","url":null,"abstract":"<div><h3>Background</h3><div>Sudden cardiac death (SCD) is a significant public health problem. Knowledge on SCD victims without a history of cardiovascular disease (CVD) is limited, presenting challenges for future prevention efforts.</div></div><div><h3>Objectives</h3><div>This study aims to examine the differences between SCD cases with and without a known history of CVD.</div></div><div><h3>Methods</h3><div>All Danish citizens were followed from January 1, 2010, until death or the end of the year. All deaths in Denmark during this period were reviewed by ≥1 medical doctor to identify cases of SCD. Data were analyzed from March 2023 until March 2024.</div></div><div><h3>Results</h3><div>A total of 6,851 SCD cases were identified, of which 3,046 (44.5%) had no history of CVD. Incidence rates of SCD increased with age and were higher in cases with a history of CVD across all age groups. The difference in SCD incidence between individuals with and without a history of CVD decreased with age, with incidence rate ratios ranging from 21.6 (95% CI: 5.2-66.7) in those aged 0 to 19 years to 1.8 (95% CI: 1.7-1.9) in those aged &gt;90 years. Female sex and living alone were associated with a lower odds of having a CVD before SCD with ORs of 0.66 and 0.75, respectively.</div></div><div><h3>Conclusions</h3><div>The distribution of SCD cases is nearly equal between individuals with and without a history of CVD, although the risk remains higher in those with prior CVD. Future research should aim to uncover the distinct causes and mechanisms driving SCD in populations with a known CVD, as well as the general population.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 5","pages":"Pages 881-890"},"PeriodicalIF":8.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364784","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":"Atrial Fibrillation Ablation Strategies in Heart Failure Patients","authors":"Vanessa Sciacca MD,&nbsp;Philipp Sommer MD","doi":"10.1016/j.jacep.2025.02.009","DOIUrl":"10.1016/j.jacep.2025.02.009","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 5","pages":"Pages 953-955"},"PeriodicalIF":8.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970014","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":"Burden of Premature Ventricular Complexes and Risk of Cardiomyopathy","authors":"Sarah Slaven MD ,&nbsp;Lohit Garg MD ,&nbsp;Rafay Sabzwari MD ,&nbsp;Christopher Barrett MD ,&nbsp;Alexis Tumolo MD ,&nbsp;Lukasz Cerbin MD ,&nbsp;Amneet Sandhu MD ,&nbsp;Matthew Zipse MD ,&nbsp;Wendy Tzou MD ,&nbsp;Michael Rosenberg MD","doi":"10.1016/j.jacep.2025.01.004","DOIUrl":"10.1016/j.jacep.2025.01.004","url":null,"abstract":"<div><h3>Background</h3><div>The association between premature ventricular complexes (PVCs) and ventricular function has been described in several observational studies, where it has been implied that a higher burden of PVCs plays a causative role in reducing left ventricular ejection fraction (LVEF). To date, however, few studies have examined the association of PVCs and cardiomyopathy on a population level.</div></div><div><h3>Objectives</h3><div>In this treatment-agnostic, cross-sectional study, the authors examined the association of PVC burden with depressed LVEF.</div></div><div><h3>Methods</h3><div>We performed an analysis of &gt;30,000 ambulatory monitors obtained on patients from April 22, 2017, and February 20, 2023. Subjects with ≥24 hours of monitoring, a PVC burden of ≥5%, and a transthoracic echocardiogram performed within 3 months of monitoring were included. The presence of cardiomyopathy was defined as LVEF &lt;50%. Clinical factors including comorbidities and relevant medications were included and adjusted for.</div></div><div><h3>Results</h3><div>The included sample included a total of 1,451 patients, with age 68.2 ± 14.5 years, female sex in 39.6%. The average PVC burden was 12.4% ± 7.4% (5%-43.4%). Of 746 subjects with a transthoracic echocardiogram, the mean LVEF was 55.6% ± 9.2% (25%-76.8%), with 171 subjects (22.9%) having an LVEF &lt;50%. In both unadjusted and adjusted analyses, we found no significant association between percentage of PVCs and LVEF (<em>P</em> = 0.78), nor with PVC burden and depressed left ventricular function (<em>P</em> = 0.13).</div></div><div><h3>Conclusions</h3><div>We found no evidence that the PVC burden alone is an independent predictor of cardiomyopathy.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 5","pages":"Pages 894-903"},"PeriodicalIF":8.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407816","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":"Causal Machine Learning for Left Atrial Appendage Occlusion in Patients With Atrial Fibrillation","authors":"Che Ngufor PhD ,&nbsp;Nan Zhang PhD ,&nbsp;Holly K. Van Houten ,&nbsp;David R. Holmes Jr. MD ,&nbsp;Jonathan Graff-Radford MD ,&nbsp;Mohamad Alkhouli MD ,&nbsp;Paul A. Friedman MD ,&nbsp;Peter A. Noseworthy MD ,&nbsp;Xiaoxi Yao PhD","doi":"10.1016/j.jacep.2024.12.013","DOIUrl":"10.1016/j.jacep.2024.12.013","url":null,"abstract":"<div><h3>Background</h3><div>Transcatheter left atrial appendage occlusion (LAAO) is an alternative to lifelong anticoagulation, but optimal patient selection remains challenging.</div></div><div><h3>Objectives</h3><div>This study sought to apply a novel causal machine learning framework to identify patients who would benefit from LAAO vs a direct oral anticoagulant (DOAC).</div></div><div><h3>Methods</h3><div>We identified 744,190 adult patients with atrial fibrillation treated with either LAAO or DOAC between March 13, 2015, and December 31, 2019, using data from OptumLabs Data Warehouse. One-to-one propensity score matching was used to create a cohort where patients were similar in 107 baseline characteristics. A causal forest model was used to estimate the heterogeneous treatment effect for a composite outcome of ischemic stroke, systemic embolism, major bleeding, and all-cause mortality.</div></div><div><h3>Results</h3><div>In the matched cohort of 28,930 patients, the mean age was 76.8 ± 6.3 years; 5,818 patients (40%) were female, and the mean CHA₂DS₂-VASc score was 5.8. LAAO was associated with no difference with the primary composite outcome in comparison to NOAC early on (average treatment effect of −0.68% [−1.4%, 0.06%] at 1 year), but a lower risk at the end of 2 years (average treatment effect of −2.9% [−3.7%, −2.0%]). At the end of 2 years, 30.1% of the overall cohort were classified as potentially benefiting from LAAO, 69.7% were classified as neutral, and 1.4% were potentially harmed by LAAO.</div></div><div><h3>Conclusions</h3><div>Novel machine learning algorithms were developed to identify patients who are more likely to benefit from LAAO vs DOACs. This information can support clinical decision-making to determine which patients should be referred to subspecialists for further examination and discussion of LAAO.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 5","pages":"Pages 977-986"},"PeriodicalIF":8.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407830","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":"Catheter Ablation for Ventricular Tachycardia After Myocardial Infarction","authors":"Rohin K. Reddy MBBS ,&nbsp;Jack W. Samways MBChB ,&nbsp;James P. Howard MB BChir, PhD ,&nbsp;Yousif Ahmad MBBS, PhD ,&nbsp;Matthew J. Shun-Shin MBChB, PhD ,&nbsp;Keenan Saleh MBBS ,&nbsp;Akriti Naraen MBChB ,&nbsp;Prapa Kanagaratnam MB BChir, PhD ,&nbsp;Zachary I. Whinnett BMBS, PhD ,&nbsp;Ahran D. Arnold MBBS, PhD","doi":"10.1016/j.jacep.2025.02.039","DOIUrl":"10.1016/j.jacep.2025.02.039","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 5","pages":"Pages 1047-1050"},"PeriodicalIF":8.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996383","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":"Burden of Premature Ventricular Complexes and Risk of Cardiomyopathy","authors":"Zachary T. Yoneda MD,&nbsp;William G. Stevenson MD","doi":"10.1016/j.jacep.2025.02.034","DOIUrl":"10.1016/j.jacep.2025.02.034","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 5","pages":"Pages 904-906"},"PeriodicalIF":8.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012522","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}