JACC. Clinical electrophysiology最新文献

{"title":"The Importance of Following Treatment Guidelines in Long QT Syndrome Regardless of Genotype Status.","authors":"Elizabeth S Kaufman","doi":"10.1016/j.jacep.2024.09.007","DOIUrl":"https://doi.org/10.1016/j.jacep.2024.09.007","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620710","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":"Impact of Multidirectional Pacing on Activation and Repolarization Parameters to Localize Ischemic Ventricular Tachycardia Circuits.","authors":"Adam S C Dennis, Michele Orini, Eva Melis Hesselkilde, Arnela Saljic, Benedikt M Linz, Stefan M Sattler, James Williams, Jacob Tfelt-Hansen, Thomas Jespersen, Anthony W C Chow, Pier D Lambiase","doi":"10.1016/j.jacep.2024.07.028","DOIUrl":"https://doi.org/10.1016/j.jacep.2024.07.028","url":null,"abstract":"<p><strong>Background: </strong>In ventricular tachycardia (VT), optimal substrate mapping strategies identifying arrhythmogenic sites are not established.</p><p><strong>Objectives: </strong>This study sought to evaluate multidirectional pacing on the distribution of specific conduction and repolarization metrics to localize re-entrant VT sites in a porcine infarct model.</p><p><strong>Methods: </strong>Substrate maps were created in 13 pigs with chronic myocardial infarction using the Advisor HD Grid (Abbott) during right ventricular (RV), left ventricular, biventricular pacing (BIV), and sinus rhythm (SR). Critical VT sites of early-, mid-, and late-diastolic signals were delineated. Vulnerable sites to re-entry were defined as sites of latest activation timing within and post-QRS complex, largest activation and activation-recovery interval gradients. Distances between the 20 most vulnerable sites and diastolic VT points were measured, and identification of VT points was assessed using the area under the receiver-operating characteristic curve.</p><p><strong>Results: </strong>A total of 34 VTs were mapped, and 48 sinus and pacing maps were obtained (10 BIV, 13 left ventricular, 13 RV, 12 SR). Late potential mapping in SR was taken as the established clinical standard for comparison. Latest activation time with BIV pacing provided the closest localization for VT isthmus (median 5.5 mm; IQR: 7.15 mm; P < 0.005). The gradient of activation-recovery interval using RV pacing had closest localization for VT exit and entrance (median 10.6 mm; IQR: 5.0 mm; P < 0.005 and 9.4 mm; IQR: 8.0 mm; P < 0.05). Global sensitivity and specificity analysis showed that gradient of activation-recovery interval in SR achieved the highest area under the receiver-operating characteristic curve, with similar results from the gradient of activation timing.</p><p><strong>Conclusions: </strong>Multidirectional pacing in combination with conduction and repolarization parameters enables better localization of VT diastolic critical sites vs SR late potentials.</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500587","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":"AI and Personal Digital Health Tools: Pioneering the Future of Precision Health Care.","authors":"Hawkins C Gay, Rod S Passman","doi":"10.1016/j.jacep.2024.09.015","DOIUrl":"https://doi.org/10.1016/j.jacep.2024.09.015","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620669","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":"A Tale of 2 Troubling Tachycardias.","authors":"Shohei Kataoka, Haran Yogasundaram, Tomer Mann, Byron Lee, Ramanan Kumareswaran, Gregory E Supple, Henry H Hsia, David J Callans, Melvin M Scheinman","doi":"10.1016/j.jacep.2024.09.002","DOIUrl":"https://doi.org/10.1016/j.jacep.2024.09.002","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545468","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":"Emergent Ablation for Ventricular Tachycardia: Predictors of Prolonged Hospitalization and Mortality.","authors":"Shunsuke Uetake, Kanae Hasegawa, Masaaki Kurata, Giovanni Ernest Davogustto, Tiffany Ying Hu, Kara K Siergrist, Zachary Yoneda, Travis D Richardson, Arvindh N Kanagasundram, William G Stevenson, Harikrishna Tandri","doi":"10.1016/j.jacep.2024.08.017","DOIUrl":"https://doi.org/10.1016/j.jacep.2024.08.017","url":null,"abstract":"<p><strong>Background: </strong>Patients with ventricular tachycardia (VT) frequently present in unstable VT and are subject to urgent/high-risk ablation procedures. Clinical predictors of prolonged hospitalization and mortality are needed for optimal management of these patients.</p><p><strong>Objectives: </strong>This study seeks to identify factors associated with prolonged hospitalization and mortality in emergent unplanned VT ablation procedures.</p><p><strong>Methods: </strong>Fifty consecutive patients hospitalized emergently for VT with structural heart disease who underwent catheter ablation were prospectively followed up for outcomes and complications.</p><p><strong>Results: </strong>Of the 50 patients (mean ± SD age 67.6 ± 12.8 years), 86.0% were male, 62.0% had ischemic cardiomyopathy, and their median left ventricular ejection fraction was 28.5%. Hospital stay <7 days (median 3 days) occurred in 28 (56.0%) patients (Group 1) and >7 days (median 10 days) or death <7 days occurred in 22 (44.0%) patients (Group 2). PAINESD score and left ventricular ejection fraction were similar between the groups. Compared with Group 1, Group 2 had significantly worse NYHA functional class III or higher (25.0% vs 63.6%; P = 0.006), electrical storm (46.4% vs 77.3%; P = 0.027), and prior failed VT ablation (35.7% vs 68.2%; P = 0.023). Multivariable analysis showed that NYHA functional class III or higher and prior failed VT ablation were predictive of prolonged hospital stay. After ablation, compared with Group 1, Group 2 had worse heart failure (10.7% vs 54.5%; P = 0.001), VT recurrences (3.6% vs 68.2%; P < 0.001), and 7 deaths within 30 days.</p><p><strong>Conclusions: </strong>Patients undergoing emergent VT ablation are at high risk for prolonged hospital stay, which is predicted by NYHA functional class III or higher and a prior failed ablation. Early VT recurrences and worsening heart failure contribute to prolonged hospitalization and a high 30-day mortality.</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545469","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":"Genetic Testing in Younger Adults With Pacemakers","authors":"Elizabeth S. Kaufman MD","doi":"10.1016/j.jacep.2024.06.008","DOIUrl":"10.1016/j.jacep.2024.06.008","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"10 10","pages":"Pages 2261-2262"},"PeriodicalIF":8.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788057","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":"Coronary Vasospasm During Pulse-Field Focal Ablation of the Cavotricuspid Isthmus Observed With Intravascular Ultrasound","authors":"Cinzia Monaco MD ,&nbsp;Roberto Menè MD ,&nbsp;Masaaki Yokoyama MD, PhD ,&nbsp;Kinan Kneizeh MD ,&nbsp;Thomas Pambrun MD ,&nbsp;Pierre Coste MD, PhD ,&nbsp;Mélèze Hocini MD ,&nbsp;Pierre Jaïs MD, PhD ,&nbsp;Nicolas Derval MD","doi":"10.1016/j.jacep.2024.06.032","DOIUrl":"10.1016/j.jacep.2024.06.032","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"10 10","pages":"Pages 2293-2296"},"PeriodicalIF":8.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107443","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":"Outcomes of Pacemaker Implantation During Pregnancy","authors":"Vardhmaan Jain MD ,&nbsp;Abdul Mannan Khan Minhas MD ,&nbsp;Birju Rao MD, MSCR ,&nbsp;Stacy Westerman MD ,&nbsp;Neal K. Bhatia MD ,&nbsp;Mikhael F. El-Chami MD ,&nbsp;Kamala P. Tamirisa MD ,&nbsp;Faisal M. Merchant MD","doi":"10.1016/j.jacep.2024.06.033","DOIUrl":"10.1016/j.jacep.2024.06.033","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"10 10","pages":"Pages 2271-2273"},"PeriodicalIF":8.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145657","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":"Standard Defibrillator Leads for Left Bundle Branch Area Pacing","authors":"Guram Imnadze MD ,&nbsp;Thomas Fink MD ,&nbsp;Thomas Eitz MD ,&nbsp;Yuri Bocchini MD ,&nbsp;Lilit Antonyan MD ,&nbsp;Karen Harutyunyan MD ,&nbsp;Valérian Valiton MD ,&nbsp;Maxim Didenko MD ,&nbsp;Philipp Sommer MD ,&nbsp;Haran Burri MD","doi":"10.1016/j.jacep.2024.07.011","DOIUrl":"10.1016/j.jacep.2024.07.011","url":null,"abstract":"<div><div>The authors report for the first time to their knowledge, implantation of a standard implantable cardioverter-defibrillator lead for permanent delivery of left bundle branch area pacing. Implantation was successful and safe in 11 of 12 patients, with adequate defibrillation testing, good electrical and electrocardiographic parameters, and uneventful device-related short-term follow-up.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"10 10","pages":"Pages 2263-2268"},"PeriodicalIF":8.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rate-Dependent Pacemap Matching in Scar-Related Ventricular Tachycardia","authors":"Yasutoshi Shinoda MD ,&nbsp;Zenith A. Jameria MD ,&nbsp;Naohiko Sahara MD ,&nbsp;Gaurav A. Upadhyay MD ,&nbsp;Yu Liao MD ,&nbsp;Jake Martinez MD ,&nbsp;Praneeth Katrapati MD ,&nbsp;Rong Bai MD ,&nbsp;Michael Zawaneh MD ,&nbsp;J. Peter Weiss MD ,&nbsp;Wilber Su MD ,&nbsp;Roderick Tung MD","doi":"10.1016/j.jacep.2024.06.034","DOIUrl":"10.1016/j.jacep.2024.06.034","url":null,"abstract":"<div><h3>Background</h3><div>The impact of varying rates of pacemapping (PM) rates on QRS morphology and PM score matching in patients with scar-related ventricular tachycardia (VT) has not been systematically assessed.</div></div><div><h3>Objectives</h3><div>In this study, the authors sought to assess the variability in PM score matching at different pacing rates.</div></div><div><h3>Methods</h3><div>During substrate mapping for VT ablation, PM was performed at cycle lengths (CLs) of 600 ms, 500 ms, 400 ms, 300 ms, and VT CL. PM scores were compared for the entire QRS, the first half (H1) of QRS, and the second half (H2) of QRS to examine the influence of the preceding T-wave superimposed into the onset of paced QRS complex (TR fusion).</div></div><div><h3>Results</h3><div>A total of 269 PMs in 40 patients undergoing scar-related VT ablation were systematically analyzed. The PM score improved at rates closer to VT with a median difference of 6% (Q1-Q3: 4%-10%; range: 0%-33%) between the lowest and the highest PM scores at a given site. Greater slurring of the QRS onset was observed at faster-paced CL, corresponding to a superimposition of the preceding T-wave into QRS onset, with significant differences in H1 but not H2 of the QRS complex. At faster PM rates, 32% of overall sites developed pseudo delta wave and 69% of endocardial pacing sites fulfilled epicardial criteria.</div></div><div><h3>Conclusions</h3><div>The rate of pacemapping can significantly alter morphologic score matching, with the most optimal match observed closest to VT CL. The onset of QRS complex morphology is influenced by superimposition of the preceding T-wave at faster rates, resulting in an underrecognized TR fusion phenomenon that may confound epicardial electrocardiographic criteria predicated upon the initial QRS slope and vector.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"10 10","pages":"Pages 2132-2144"},"PeriodicalIF":8.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262302","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}