JACC. Clinical electrophysiology最新文献

{"title":"Full Issue PDF","authors":"","doi":"10.1016/S2405-500X(25)00289-0","DOIUrl":"10.1016/S2405-500X(25)00289-0","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 5","pages":"Pages I-CCXXI"},"PeriodicalIF":8.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138279","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":"Temporal Considerations and Equity in Left Atrial Appendage Occlusion Patient Selection","authors":"Rahul Chaudhary MD, MBA","doi":"10.1016/j.jacep.2025.02.046","DOIUrl":"10.1016/j.jacep.2025.02.046","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 5","pages":"Page 1043"},"PeriodicalIF":8.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139331","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":"Introducing the Fourth Left Atrial Appendage Occlusion Study","authors":"William F. McIntyre MD, PhD, Sanjit S. Jolly MD, MSc, Richard P. Whitlock MD, PhD, Jeff S. Healey MD, MSc","doi":"10.1016/j.jacep.2025.02.047","DOIUrl":"10.1016/j.jacep.2025.02.047","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 5","pages":"Page 1041"},"PeriodicalIF":8.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139571","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":"Benefits of Early Catheter Ablation in Patients With Atrial Fibrillation","authors":"Soonil Kwon MD ,&nbsp;So-Ryoung Lee MD, PhD ,&nbsp;Eue-Keun Choi MD, PhD ,&nbsp;Bongsung Kim MS ,&nbsp;Kyung-Do Han PhD ,&nbsp;JungMin Choi MD ,&nbsp;Kyung-Yeon Lee MD ,&nbsp;Hyo-Jeong Ahn MD ,&nbsp;Seil Oh MD, PhD ,&nbsp;Gregory Y.H. Lip MD","doi":"10.1016/j.jacep.2024.12.023","DOIUrl":"10.1016/j.jacep.2024.12.023","url":null,"abstract":"<div><h3>Background</h3><div>Although early rhythm control showed better clinical outcomes in patients with atrial fibrillation (AF), limited data exist on the relationship between the timing of atrial fibrillation catheter ablation (AFCA) and clinical outcomes.</div></div><div><h3>Objectives</h3><div>This study investigated the impact of early vs late AFCA on clinical outcomes.</div></div><div><h3>Methods</h3><div>Using the Korean claims database, 944,710 AF patients without previous AFCA were investigated. These patients were categorized into 3 groups based on the duration from their AF diagnosis to AFCA: &lt;1 year (early-AFCA), 1 to &lt;3 years (intermediate-AFCA), and ≥3 years (late-AFCA). The study outcomes included ischemic stroke, heart failure (HF) hospitalization, myocardial infarction, major adverse cardiovascular events (comprising the aforementioned three), all-cause mortality, a composite outcome (encompassing all mentioned outcomes), and AF recurrence.</div></div><div><h3>Results</h3><div>A total of 57,804 AF patients (38,536 without AFCA and 19,268 with AFCA; mean age 57.8 years; 73.5% men) were followed up for an average of 2.6 ± 1.5 years. AFCA was associated with lower risks across all study outcomes (HRs: 0.26-0.41 for all outcomes; all <em>P &lt;</em> 0.001). Compared with the early-AFCA group, the intermediate- and late-AFCA groups showed higher risks of HF hospitalization and all-cause mortality. Additionally, the late-AFCA group had higher risks of major adverse cardiovascular events, composite outcomes, and AF recurrence than those of the early- and intermediate-AFCA groups. After weighing the propensity scores, the results were largely consistent with the primary analysis.</div></div><div><h3>Conclusions</h3><div>Early AFCA showed improved clinical outcomes, primarily caused by decreased risk of HF hospitalization and AF recurrence.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 5","pages":"Pages 956-965"},"PeriodicalIF":8.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476143","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":"Advancing Risk Assessment in Myotonic Muscular Dystrophy Through Translational Research and Personalized Medicine","authors":"Carla Amarante-Cuadrado MD ,&nbsp;Ravi Vazirani MD","doi":"10.1016/j.jacep.2025.02.045","DOIUrl":"10.1016/j.jacep.2025.02.045","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 5","pages":"Page 1039"},"PeriodicalIF":8.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139435","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":"PVI With CF-Sensing Large-Tip Focal PFA Catheter With 3D Mapping for Paroxysmal AF: Omny-IRE 3-Month Results.","authors":"Mattias Duytschaever, Massimo Grimaldi, Tom De Potter, Atul Verma, Laurent Macle, Josef Kautzner, Dominik Linz, Ante Anic, Hugo Van Herendael, Gediminas Rackauskas, Petr Neuzil, Julian Chun, Boris Schmidt, Sebastien Knecht, Alexandre Almorad, Benjamin Berte, Vivek Y Reddy, Johan Vijgen","doi":"10.1016/j.jacep.2025.04.008","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.04.008","url":null,"abstract":"<p><strong>Background: </strong>Omny-IRE (A Study For Treatment of Paroxysmal Atrial Fibrillation [PAF] With the OMNYPULSE Catheter and the TRUPULSE Generator; NCT05971693) evaluated safety and effectiveness of a novel large-tip focal, multielectrode, contact force-sensing, pulsed field ablation catheter with electroanatomic mapping integration.</p><p><strong>Objectives: </strong>This study sought to assess 3-month safety and effectiveness of the platform for treating symptomatic paroxysmal atrial fibrillation.</p><p><strong>Methods: </strong>Pulmonary vein isolation (PVI) was performed using the OMNYPULSE Platform. Primary effectiveness was adenosine/isoproterenol-proof entrance block. Primary safety was occurrence of primary adverse events. Prespecified patient subsets underwent systematic brain imaging, esophageal endoscopy, cardiac computed tomography/magnetic resonance angiogram, and mandatory 3-month remapping for PVI durability assessment.</p><p><strong>Results: </strong>Of 188 patients enrolled, 136 were included in the per-protocol analysis. Primary effectiveness was 100% (136 of 136). Median (Q1-Q3) procedure, left atrial dwell, total ablation, and total fluoroscopy times were 105.5 (91.0-124.0), 70.0 (56.0-81.5), 46.9 (37.1-58.8), and 5.0 (3.1-9.8) minutes, respectively. The primary adverse event rate was 3.0% (4 of 135 patients with 3-month follow-up; 3 major vascular access complications, 1 pericarditis). Brain imaging (n = 30) revealed 1 patient (3.3%) with an asymptomatic silent cerebral event at discharge, which resolved at 1 month without neurological change. No esophageal injury was observed. Computed tomography/magnetic resonance angiogram imaging (n = 24) showed no incidences of pulmonary vein narrowing >70%. During remapping, PVI was durable in 84.5% (98 of 116) of veins and 62.1% (18 of 29) of patients. With an optimized workflow, PVI durability improved to 89.3% (75 of 84) and 71.4% (15 of 21) of veins and patients, respectively.</p><p><strong>Conclusions: </strong>The force-sensing, large-focal pulsed field ablation catheter with 3-dimensional electroanatomic mapping integration showed 100% acute success with a promising safety profile for treating paroxysmal atrial fibrillation. Prespecified remapping showed good PVI durability. (A Study For Treatment of Paroxysmal Atrial Fibrillation [PAF] With the OMNYPULSE Catheter and the TRUPULSE Generator; NCT05971693).</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010200","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":"Irrigation of Pulsed Field Ablation Electrodes Mitigates Joule Heating and the Heat Stacking Phenomena.","authors":"William H Sauer, Daniel Campos-Villarreal, Nathaniel A Steiger","doi":"10.1016/j.jacep.2025.04.018","DOIUrl":"10.1016/j.jacep.2025.04.018","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110645","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":"Use of High-Power, Short-Duration Radiofrequency Applications to Target Purkinje Tissue and Ablate Ventricular Fibrillation.","authors":"Robert N Kerley, Uyanga Batnyam, Babak Nazer, Esseim Sharma, Jorge E Romero, Usha B Tedrow, William H Sauer","doi":"10.1016/j.jacep.2025.04.014","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.04.014","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015799","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":"TraNscutaneOus Electrical VAgus Nerve Stimulation to Suppress Premature Ventricular Contractions: A Crossover, Randomized Clinical Trial (NoVa-PVC).","authors":"Stefanos Zafeiropoulos, Kristie Coleman, Jonathan Kogan, Dimitrios Varrias, Jonas Leavitt, Alexandra Bekiaridou, Theodoros Zanos, Stavros Zanos, Stavros Stavrakis, Stavros Mountantonakis","doi":"10.1016/j.jacep.2025.04.011","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.04.011","url":null,"abstract":"<p><strong>Introduction: </strong>The autonomic nervous system has been implicated in the genesis of idiopathic premature ventricular complexes (PVCs). Antiadrenergic effects have been shown noninvasively by low-level electrical stimulation of the tragus (LLTS).</p><p><strong>Objectives: </strong>This study evaluated the efficacy of LLTS in reducing PVC burden.</p><p><strong>Methods: </strong>This 2-center, prospective, sham-controlled, single-blinded, crossover randomized clinical trial was conducted in patients with symptomatic PVCs with at least 5% daily PVC burden and who were refractory to medical therapy. Participants received two sequential, 10-day sessions of active LLTS (20 Hz, 1 mA below the discomfort threshold) and sham stimulation (earlobe stimulation). Each treatment was interrupted by an 8-day washout period. Randomization determined the order of treatment. All patients wore an extended Holter monitor (ePatch; Philips) for daily PVC count during the study period.</p><p><strong>Results: </strong>Of the 36 randomized patients, 35 (19 [59.4%] male; mean age 58.0 ± 17.1 years) completed the study and were included in the analysis. The median baseline PVC burden was 12.00% (IQR: 11.4%). LLTS significantly reduced the median PVC burden by 13.4% compared with sham stimulation (10.5% [IQR: 14.4%] vs 8.59% [IQR: 8.45%]; P = 0.021). No significant differences in heart rate variability were observed between the 2 groups. Exploratory analyses revealed a more pronounced reduction in slow heart rate-dependent PVCs and a sustained decrease in PVC burden throughout the LLTS period.</p><p><strong>Conclusions: </strong>LLTS effectively reduced PVC burden in patients with symptomatic PVCs refractory to medical therapy, highlighting its potential as an adjuvant therapeutic option. Larger, multicenter trials are warranted to confirm these findings and evaluate long-term outcomes [Non-invasive Vagal Stimulation for Frequent Premature Ventricular Complexes (NoVa-PVC); NCT05341544].</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110655","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":"Effect of Anterior vs Posterior Dispersive Patch Placement on Radiofrequency Ablation Lesion Size in Swine.","authors":"Ramkumar V Venkateswaran, Shohei Kataoka, Chang Hee Kwon, Sung Ho Lee, Edward P Gerstenfeld","doi":"10.1016/j.jacep.2025.04.009","DOIUrl":"https://doi.org/10.1016/j.jacep.2025.04.009","url":null,"abstract":"<p><strong>Background: </strong>Ablation of ventricular tachycardia using radiofrequency (RF) energy can be challenging for deep circuits. Standard RF ablation is monopolar, with energy delivered between the catheter and a dispersive patch (DP). Aligning the DP with the direction of RF application may shift the RF field to create deeper lesions.</p><p><strong>Objectives: </strong>The authors sought to compare left ventricular lesion size with concordant (patch oriented in the direction of ablation) versus discordant DP placement in swine.</p><p><strong>Methods: </strong>An irrigated, contact force sensing RF catheter was used to apply lesions to the anterior and posterior left ventricles in swine. Two DPs were attached, and the ground was randomly chosen so that one-half of the lesions were concordant (eg, anterior RF/anterior DP) and one-half were discordant (eg, anterior RF/posterior DP). Ablation parameters otherwise remained constant.</p><p><strong>Results: </strong>A total of 77 lesions (38 concordant, 39 discordant) in 10 swine were analyzed. Contact force (18.0 ± 3.2 g vs 17.6 ± 3.5 g; P = 0.606) and baseline impedance (111.3 ± 7.5 Ω vs 110.9 ± 7.3 Ω; P = 0.782) were similar between groups. Lesions with concordant compared with discordant DP had greater lesion depth (7.4 ± 1.8 vs 6.1 ± 1.6 mm; P = 0.001) and area (72.5 ± 22.2 mm² vs 59.6 ± 17.5 mm²; P = 0.006).</p><p><strong>Conclusions: </strong>Placing the DP on the body surface concordant with the direction of RF ablation results in ∼20% increase in lesion depth. This simple modification can be used to enhance RF lesion size.</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996970","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}