JACC. Clinical electrophysiology最新文献_第5页

Sustained Improvement in Quality of Life Following Catheter Ablation for Persistent AF Beyond 3 Years 3年以上持续性房颤导管消融后生活质量的持续改善：这不是假的。

IF 7.7 1区医学

JACC. Clinical electrophysiology Pub Date : 2025-09-01 DOI: 10.1016/j.jacep.2025.05.010

Jeremy William MBBS , Sohaib Virk MD , Jonathan M. Kalman MBBS, PhD , Peter M. Kistler MBBS, PhD

{"title":"Sustained Improvement in Quality of Life Following Catheter Ablation for Persistent AF Beyond 3 Years","authors":"Jeremy William MBBS , Sohaib Virk MD , Jonathan M. Kalman MBBS, PhD , Peter M. Kistler MBBS, PhD","doi":"10.1016/j.jacep.2025.05.010","DOIUrl":"10.1016/j.jacep.2025.05.010","url":null,"abstract":"<div><h3>Background</h3><div><span><span>Catheter ablation (CA) is an effective treatment for </span>atrial fibrillation<span> (AF) that improves arrhythmia<span> burden and quality of life (QOL). However, there are limited data on long-term QOL outcomes in patients with </span></span></span>persistent AF (PsAF).</div></div><div><h3>Objectives</h3><div>This study sought to evaluate long-term QOL outcomes up to 3 years post-ablation for patients with PsAF in CAPLA (Catheter Ablation for Persistent Atrial Fibrillation: A Multicentre Randomized Trial of Pulmonary Vein Isolation vs PVI With Posterior Left Atrial Wall Isolation).</div></div><div><h3>Methods</h3><div>CAPLA was a large, multicenter, international trial that randomized patients with PsAF to an ablation strategy of either pulmonary vein isolation alone or in combination with posterior wall isolation. In this secondary analysis, QOL was assessed using the Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) questionnaire, evaluated before ablation and repeated at 6 months, 1 year, and 3 years post-ablation. Patients underwent intensive rhythm monitoring to calculate 3-year AF burden. Statistical significance was set at <em>P</em> <0.05.</div></div><div><h3>Results</h3><div>Of 338 patients randomized in CAPLA, 309 (91.4%) had complete QOL data at 3 years post-ablation. The mean AFEQT score rose from 53.7 ± 22.6 at baseline to 78.7 ± 20.1 at 12 months and further increased to 88.4 ± 14.8 at 3 years (<em>P</em> < 0.001). Significant improvements were noted across all AFEQT subdomains, including symptoms, activity limitations, and treatment concerns. A significant negative correlation was observed between AF burden and QOL at 3 years (<em>r</em> = −0.45; <em>P</em> < 0.001), with AF burden >5% associated with no significant improvement in QOL.</div></div><div><h3>Conclusions</h3><div>CA for PsAF resulted in a significant incremental improvement in QOL over long-term follow-up. The sustained nature of QOL improvement over 3 years following ablation argues against a placebo effect.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 9","pages":"Pages 1983-1991"},"PeriodicalIF":7.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553575","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}

引用次数: 0

Feasibility of Upfront Surgical Subxiphoid Epicardial Access for Hybrid Ablation of Ventricular Tachycardia 剑突下心外膜前路手术治疗室性心动过速的可行性。

IF 7.7 1区医学

JACC. Clinical electrophysiology Pub Date : 2025-09-01 DOI: 10.1016/j.jacep.2025.05.018

Kenji Hashimoto MD, PhD , Anunay Gupta MD, DM , Tai Chung So MD , Samual Turnbull BSc , Kasun De Silva MD , Ashwin Bhaskaran MBBS, MSc (Int Med) , Yasuhito Kotake MD, PhD , Timothy G. Campbell BSc, PhD , Nisal Perera MBBS , Saurabh Kumar MBBS, PhD

引用次数: 0

Age-Specific Mechanisms of Sudden Death Associated With Epilepsy 癫痫相关猝死的年龄特异性机制

IF 7.7 1区医学

JACC. Clinical electrophysiology Pub Date : 2025-09-01 DOI: 10.1016/j.jacep.2025.04.028

Lauri Holmstrom MD, PhD , Audrey Uy-Evanado MD , Arayik Sargsyan MD , Harpriya Chugh BS , Habiba Aziz MS , Vinicius F. Calsavara PhD , Alex A.T. Bui PhD , Angelo Salvucci MD , Jonathan Jui MD , Kyndaron Reinier PhD , Lisa M. Bateman MD , Sumeet S. Chugh MD

{"title":"Age-Specific Mechanisms of Sudden Death Associated With Epilepsy","authors":"Lauri Holmstrom MD, PhD , Audrey Uy-Evanado MD , Arayik Sargsyan MD , Harpriya Chugh BS , Habiba Aziz MS , Vinicius F. Calsavara PhD , Alex A.T. Bui PhD , Angelo Salvucci MD , Jonathan Jui MD , Kyndaron Reinier PhD , Lisa M. Bateman MD , Sumeet S. Chugh MD","doi":"10.1016/j.jacep.2025.04.028","DOIUrl":"10.1016/j.jacep.2025.04.028","url":null,"abstract":"<div><h3>Background</h3><div>Epilepsy is associated with an increased risk of sudden cardiac death<span> (SCD), which can occur at any age. Due to low numbers of SCD events in longitudinal cohort studies of epilepsy, studies of age-specific clinical profiles have not been performed.</span></div></div><div><h3>Objectives</h3><div>In this study, the authors investigated the detailed clinical characteristics of SCD associated with epilepsy in the general population, across all ages.</div></div><div><h3>Methods</h3><div>Individuals with a pre-SCD diagnosis of epilepsy were identified from all out-of-hospital SCD cases prospectively ascertained in Portland, Oregon since 2002 (catchment population ∼1 million) and Ventura County, California since 2015 (catchment population ∼850,000). Lifetime clinical records were evaluated for a detailed assessment of the clinical profile.</div></div><div><h3>Results</h3><div>From a total of 8,287 SCD cases, we identified 356 (4.3%) with a pre-SCD history of epilepsy. The proportion of previously diagnosed epilepsy in overall SCD cases was highest among younger subjects and progressively decreased with age (from 35.3% in 1 to 10 years to 2.5% in >80 years) (<em>P</em><span> < 0.001). There was a distinct shift in the clinical profile demarcated by the 50 to 60 years decade: Younger subjects had the highest prevalence of drug-resistant epilepsy and prearrest seizures (</span><em>P</em> < 0.001). Older subjects had a significantly higher prevalence of stroke and mood disorders, and these differences were specific for SCD in epilepsy (<em>P</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>There were significant clinical profile differences by age among individuals with epilepsy, which were observed to be specific for SCD. Age-specific mechanisms should facilitate the development of targeted prevention strategies for SCD in epilepsy.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 9","pages":"Pages 1936-1947"},"PeriodicalIF":7.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325700","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}

引用次数: 0

Periatrial Epicardial Fat and Atrial Fibrillation 心房周围心外膜脂肪与心房颤动。

IF 7.7 1区医学

JACC. Clinical electrophysiology Pub Date : 2025-09-01 DOI: 10.1016/j.jacep.2025.06.025

Nitesh Nerlekar MBBS (Hons), MPH, PhD , Francis J. Ha MBBS(Hons), BMedSc(Hons)

引用次数: 0

Pulmonary Edema After Extensive Pulsed Field Ablation in Elderly Patients 老年患者广泛脉冲场消融后肺水肿的研究

IF 7.7 1区医学

JACC. Clinical electrophysiology Pub Date : 2025-09-01 DOI: 10.1016/j.jacep.2025.05.033

Mauricio Ibrahim Scanavacca MD, PhD, Rodrigo Melo Kulchetscki MD, Carolina Isabel Silva Lemes MD, Tan Chen Wu MD, PhD

引用次数: 0

Full Issue PDF 完整版PDF

IF 7.7 1区医学

JACC. Clinical electrophysiology Pub Date : 2025-09-01 DOI: 10.1016/S2405-500X(25)00680-2

引用次数: 0

Focal Ablation With the Pentaspline Pulsed Field Catheter Using Novel Constrained Basket Configurations (“Olive” and “Powerball”) 使用新型约束篮结构（“Olive”和“Powerball”）的Pentaspline脉冲场导管进行局灶消融。

IF 7.7 1区医学

JACC. Clinical electrophysiology Pub Date : 2025-09-01 DOI: 10.1016/j.jacep.2025.05.013

Keita Watanabe MD, Masaya Shinohara MD, Fengyuan Yu MD, Vivek Y. Reddy MD, Jacob S. Koruth MD

引用次数: 0

3-Dimensional Mapping of Atrial Excitation Changes, Modulated by Pharmacologically Controlled Consciousness, Facilitates Atrial Lead Placement in Atrial Standstill 由药理学控制的意识调节的心房兴奋变化的三维映射，有助于心房静止时心房铅的放置。

IF 7.7 1区医学

JACC. Clinical electrophysiology Pub Date : 2025-09-01 DOI: 10.1016/j.jacep.2025.05.012

Kentaro Goto MD , Shinsuke Miyazaki MD , Yuriko Hiruma MD , Tetsuo Sasano MD

引用次数: 0

Development and Clinical Validation of a Cross-Sex Translator of ECG Drug Responses 心电药物反应的跨性别翻译器的开发与临床验证。

IF 7.7 1区医学

JACC. Clinical electrophysiology Pub Date : 2025-09-01 DOI: 10.1016/j.jacep.2025.05.015

Roshni Shetty MS , Stefano Morotti PhD , Vladimír Sobota PhD , Jason D. Bayer PhD , Haibo Ni PhD , Eleonora Grandi PhD

{"title":"Development and Clinical Validation of a Cross-Sex Translator of ECG Drug Responses","authors":"Roshni Shetty MS , Stefano Morotti PhD , Vladimír Sobota PhD , Jason D. Bayer PhD , Haibo Ni PhD , Eleonora Grandi PhD","doi":"10.1016/j.jacep.2025.05.015","DOIUrl":"10.1016/j.jacep.2025.05.015","url":null,"abstract":"<div><h3>Background</h3><div>Sex differences in cardiac electrophysiology critically affect arrhythmia risk and therapeutic responses. Female subjects are at a higher risk of drug-induced torsade de pointes and sudden cardiac death, largely due to longer QTc intervals, compared with male subjects. However, the underrepresentation of female subjects in both basic and clinical research creates biases that limit our understanding of sex-specific arrhythmia mechanisms, risk metrics, and treatment outcomes.</div></div><div><h3>Objectives</h3><div>The authors aimed to develop a quantitative tool that predicts ECG features in female subjects based on data from male subjects (and vice versa) by combining biophysical models of human ventricular electrophysiology and statistical regression models.</div></div><div><h3>Methods</h3><div>Male and female ventricular tissue models were constructed incorporating transmural heterogeneity and sex-specific parameterizations, and pseudo-ECGs were derived from these models. Multivariable lasso (least absolute shrinkage and selection operator) regression was used to generate sets of regression coefficients (a cross-sex translator) that map male ECG features to female ECG features.</div></div><div><h3>Results</h3><div>The translator successfully predicted drug-induced effects on simulated female ECG features using simulated male ECG data as input, with an average discrepancy <5%. In addition, a proof-of-concept clinical application using ECG data from age-matched male and female subjects showed that the translator predicted relative drug-induced changes in female ECG features from corresponding male data under various drug regimens with an average error <6%.</div></div><div><h3>Conclusions</h3><div>We propose our cross-sex ECG translator as a novel digital health tool that can facilitate sex-specific cardiac safety assessments, ensuring that pharmacotherapy is safe and effective across sexes, which is a major step forward in addressing disparities in cardiac treatment for female subjects.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"11 9","pages":"Pages 2014-2027"},"PeriodicalIF":7.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600420","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}

引用次数: 0

A Step Forward in Translating Sex-Specific Differences in Cardiac Electrophysiology 心脏电生理性别差异的研究进展。

IF 7.7 1区医学

JACC. Clinical electrophysiology Pub Date : 2025-09-01 DOI: 10.1016/j.jacep.2025.05.025

Seth H. Weinberg BS, PhD

引用次数: 0