JACC. Clinical electrophysiology最新文献

{"title":"Full Issue PDF","authors":"","doi":"10.1016/S2405-500X(24)00840-5","DOIUrl":"10.1016/S2405-500X(24)00840-5","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"10 10","pages":"Pages I-CXC"},"PeriodicalIF":8.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142534687","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":"Sex, Race, and Rural-Urban Disparities in Ventricular Tachycardia Ablations","authors":"Amber B. Tang MD ,&nbsp;Olumuyiwa P. Akinrimisi MD, MS ,&nbsp;Boback Ziaeian MD, PhD","doi":"10.1016/j.jacep.2024.05.033","DOIUrl":"10.1016/j.jacep.2024.05.033","url":null,"abstract":"<div><h3>Background</h3><div>Ventricular ablation may be clinically indicated for patients with recurrent ventricular tachycardia (VT) and has been shown to decrease risk of recurrence and overall morbidity. However, the existence of disparities among patients receiving ventricular ablation has not been well characterized.</div></div><div><h3>Objectives</h3><div>In this study, the authors examined patients hospitalized with VT to determine whether disparities exist among those receiving ablations.</div></div><div><h3>Methods</h3><div>The authors used the National Inpatient Sample to assess patients hospitalized with a primary diagnosis of VT in 2019 who did and did not receive catheter ablations. Multiple logistic regression was used to calculate risk factors for VT ablation based on age, sex, race/ethnicity, socioeconomic status, and hospital characteristics.</div></div><div><h3>Results</h3><div>After adjusting for baseline characteristics and comorbidities, female and Black patients hospitalized with VT had significantly lower odds of receiving ablations compared with male and White patients (OR: 0.835; 95% CI: 0.699-0.997; <em>P =</em> 0.047; and OR: 0.617; 95% CI: 0.457-0.832; <em>P =</em> 0.002, respectively). Additionally, patients at rural or nonteaching hospitals were significantly less likely to receive ablations compared with those at urban, teaching hospitals. No significant differences were noted based on income or insurance status in the adjusted models.</div></div><div><h3>Conclusions</h3><div>The authors identified significant disparities in the delivery of ventricular ablations among patients hospitalized with VT. Overall, patients who were female or Black as well as those who were hospitalized at rural or nonteaching hospitals were significantly less likely to receive VT ablations during hospitalization.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"10 10","pages":"Pages 2148-2154"},"PeriodicalIF":8.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901741","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":"Transcriptomic Profiling of Human Myocardium at Sudden Death to Define Vulnerable Substrate for Lethal Arrhythmias.","authors":"Arianne Caudal, Yu Liu, Paul D Pang, David P Maison, Kosuke Nakasuka, Jean Feng, H S Schwarzer-Sperber, Roland Schwarzer, Ellen Moffatt, Timothy J Henrich, Arun Padmanabhan, Andrew J Connolly, Joseph C Wu, Zian H Tseng","doi":"10.1016/j.jacep.2024.08.013","DOIUrl":"https://doi.org/10.1016/j.jacep.2024.08.013","url":null,"abstract":"<p><strong>Background: </strong>While some chronic pathological substrates for sudden cardiac death (SCD) are well known (eg, coronary artery disease and left ventricular [LV] dysfunction), the acute vulnerable myocardial state predisposing to fatal arrhythmia remains a critical barrier to near-term SCD prevention.</p><p><strong>Objectives: </strong>This study sought to define the distinct myocardial transcriptomic profile of autopsy-defined arrhythmic sudden deaths, compared to nonarrhythmic sudden deaths and trauma deaths, to determine the acute vulnerable state in the hours to days before SCD.</p><p><strong>Methods: </strong>We used autopsy to adjudicate arrhythmic from nonarrhythmic causes in 1,265 sudden deaths in San Francisco County from 2011 to 2018. We performed a degradation-tolerant transcriptomic evaluation of LVs sampled at the time of SCD from 245 consented cases using a curated panel of 448 gene probes with known or hypothesized association with SCD.</p><p><strong>Results: </strong>The targeted transcriptome of arrhythmic (n = 129) vs nonarrhythmic (n = 90 nonarrhythmic sudden deaths + 26 trauma deaths) LV samples revealed 31 differentially up-regulated and 36 down-regulated genes (adjusted P < 0.05) related to the collagen-containing extracellular matrix (up-regulation of FAP, FMOD, and LTBP2), regulation of ion transport (up-regulation of KCNA5 and KCNN3 and down-regulation of KCNJ8, KCNK1, and KCNJ5), and contraction (down-regulation of MYH6). Fibrosis-related genes showed the highest magnitude increased expression in arrhythmic vs nonarrhythmic deaths and vs published transcriptomes from end-stage heart failure. After molecular stratification by known markers for mature (COL1A1, COL1A2, COL3A1) and active (POSTN, MEOX1) fibrosis, cases with the highest expression of both had the largest proportion of arrhythmic cause of death (n = 27 of 36 [75%]) vs cases with low expression of both markers (n = 87 of 181 [38%]) (P = 0.006) or vs mature only (n = 10 of 14 [71%]) or active only (n = 5 of 14 [36%]). Activated fibroblast gene expression signature was enriched in arrhythmic female vs arrhythmic male cases, among other sex-specific differences in ion-channel and myosin (up-regulation of SCN4B, SCN8A, and KCNAB1 in females and KCNJ4 and MYH7B in males) expression.</p><p><strong>Conclusions: </strong>RNA profiling of the myocardium at SCD identifies active fibrosis, undetectable by conventional clinical methods, in the presence of fixed scar and selected ion-channel dysregulation (more pronounced among female cases) as an acute vulnerable substrate for fatal arrhythmias. These findings may represent novel directions to identify patients at elevated near-term risk for SCD and critical pathways for intervention to reduce acute lethal arrhythmias.</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638964","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":"Social Determinants of Health and Ventricular Tachycardia","authors":"Tarryn Tertulien MD, MSc ,&nbsp;Rajat Deo MD, MTR","doi":"10.1016/j.jacep.2024.06.030","DOIUrl":"10.1016/j.jacep.2024.06.030","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"10 10","pages":"Pages 2155-2157"},"PeriodicalIF":8.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107445","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":"Manual Chest PRESSURE During Direct Current Cardioversion for Atrial Fibrillation","authors":"David Ferreira BMed ,&nbsp;Philopatir Mikhail MBBS ,&nbsp;Joyce Lim MBBS ,&nbsp;Max Ray BMed ,&nbsp;Jovita Dwivedi MBBS ,&nbsp;Stephen Brienesse BMed ,&nbsp;Lloyd Butel-Simoes MBBS ,&nbsp;William Meere MBBS ,&nbsp;Adam Bland MBBS ,&nbsp;Niklas Howden MBBS ,&nbsp;Michael Malaty MBBS ,&nbsp;Mercy Kunda BNurs ,&nbsp;Amy Kelty BNurs ,&nbsp;Michael McGee MBBS ,&nbsp;Andrew Boyle PhD ,&nbsp;Aaron L. Sverdlov PhD ,&nbsp;Maged William MBBS ,&nbsp;John Attia PhD ,&nbsp;Nicholas Jackson MBBS ,&nbsp;Gwilym Morris PhD ,&nbsp;Bradley Wilsmore PhD","doi":"10.1016/j.jacep.2024.05.037","DOIUrl":"10.1016/j.jacep.2024.05.037","url":null,"abstract":"<div><h3>Background</h3><div>Direct current cardioversion is frequently used to return patients with atrial fibrillation (AF) to sinus rhythm. Chest pressure during cardioversion may improve the efficacy of cardioversion through decreasing transthoracic impedance and increasing cardiac energy delivery.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the efficacy and safety of upfront chest pressure during direct current cardioversion for AF with anterior-posterior pad positioning.</div></div><div><h3>Methods</h3><div>This was a multicenter, investigator-initiated, double-blinded, randomized clinical trial. Recruitment occurred from 2021 to 2023. Follow-up was until hospital discharge. Recruitment occurred across 3 centers in New South Wales, Australia. Inclusion criteria were age ≥18 years, referred for cardioversion for AF, and anticoagulation for 3 weeks or transesophageal echocardiography excluding left atrial appendage thrombus. Exclusion criteria were other arrhythmias requiring cardioversion, such as atrial flutter and atrial tachycardia. The intervention arm received chest pressure during cardioversion from the first shock. The primary efficacy outcome was total joules required per patient encounter. Secondary efficacy outcomes included first shock success, transthoracic impedance, cardioversion success, and sinus rhythm at 30 minutes post cardioversion.</div></div><div><h3>Results</h3><div>A total of 311 patients were randomized, 153 to control and 158 to intervention. There was no difference in total joules applied per encounter in the control arm vs intervention arm (355.0 ± 301 J vs 413.8 ± 347 J; <em>P</em> = 0.19). There was no difference in first shock success, total shocks provided, average impedance, and cardioversion success.</div></div><div><h3>Conclusions</h3><div>This study does not support the routine application of chest pressure for direct current cardioversion in atrial fibrillation (PRESSURE-AF [Investigating the Efficacy of Chest Pressure for Direct Current Cardioversion in Atrial Fibrillation: A Randomized Controlled Trial]; <span><span>ACTRN12620001028998</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"10 10","pages":"Pages 2207-2213"},"PeriodicalIF":8.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125716","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 Ablation Energy Source on Outcomes of Slow Pathway Modification for AVNRT in Children","authors":"Maully J. Shah MBBS ,&nbsp;Shankar Baskar MD ,&nbsp;Kevin F. Kennedy MS ,&nbsp;David S. Spar MD ,&nbsp;Shashank Behere MD ,&nbsp;Richard J. Czosek MD ,&nbsp;Christopher M. Janson MD","doi":"10.1016/j.jacep.2024.05.010","DOIUrl":"10.1016/j.jacep.2024.05.010","url":null,"abstract":"<div><h3>Background</h3><div>Selection of radiofrequency ablation (RF) or cryoablation (Cryo) for atrioventricular nodal re-entrant tachycardia (AVNRT) in children remains controversial due to a lack of contemporary comparison studies in this population.</div></div><div><h3>Objectives</h3><div>This study sought to compare outcomes of RF and Cryo for AVNRT in the pediatric population.</div></div><div><h3>Methods</h3><div>AVNRT ablation outcomes were retrospectively analyzed utilizing the National Cardiovascular Data Registry IMPACT (Improving Pediatric and Adult Congenital Treatment) Registry from April 2016 to March 2019. Data from subjects 1 to 21 years of age undergoing elective first-time slow pathway (SP) modification for AVNRT were included. Exclusion criteria included &lt;1 year of age, congenital heart disease, and &gt;1 ablation target. Cases were analyzed by ablation energy: 1) RF only; 2) Cryo only; 3) radiofrequency ablation switching to cryoablation (RF→Cryo); and 4) cryoablation switching to radiofrequency ablation (Cryo→RF). The primary outcome was acute ablation failure. Secondary outcomes included in-hospital adverse events.</div></div><div><h3>Results</h3><div>Among 2,448 patients (mean age 13.6 ± 3.4 years, 60% female), RF only was employed in 43% (n = 1,046), Cryo only in 49% (n = 1,201), RF→Cryo in 6% (n = 135), and Cryo→RF in 66 (3%). Acute ablation failure occurred in 1.3% (n = 33), with no difference by energy source (1% in RF only, 1.5% in Cryo only, 1.5% in RF→Cryo, 3% in Cryo→RF; <em>P</em> = 0.5). Atrioventricular (AV) block requiring permanent pacemaker did not occur in any group; transient AV block occurred in 0.4% of the cohort, with no difference by group.</div></div><div><h3>Conclusions</h3><div>In this largest pediatric study of AVNRT ablation, RF and Cryo demonstrated comparable high acute success and rare documentation of AV block that did not result in temporary or permanent pacing. Longitudinal data are important for further comparison of these modalities with regard to recurrence risk and late complications.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"10 10","pages":"Pages 2214-2223"},"PeriodicalIF":8.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788055","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 Catheter Ablation of Electrical Storm on Survival","authors":"Karim Benali MD ,&nbsp;Sandro Ninni MD, PhD ,&nbsp;Charles Guenancia MD, PhD ,&nbsp;Rayan Mohammed MD ,&nbsp;Donovan Decaudin MD ,&nbsp;Ophélie Bourdrel MD ,&nbsp;Alexandre Salaun MD ,&nbsp;Cédric Yvorel MD ,&nbsp;Pierre Groussin MD ,&nbsp;Dominique Pavin MD ,&nbsp;Konstantinos Vlachos MD ,&nbsp;Pierre Jaïs MD, PhD ,&nbsp;Jean-Baptiste Bouchet MD ,&nbsp;Jerome Morel MD, PhD ,&nbsp;François Brigadeau MD ,&nbsp;Gabriel Laurent MD, PhD ,&nbsp;Didier Klug MD, PhD ,&nbsp;Antoine Da Costa MD, PhD ,&nbsp;Michel Haissaguerre MD, PhD ,&nbsp;Raphael Martins MD, PhD","doi":"10.1016/j.jacep.2024.05.032","DOIUrl":"10.1016/j.jacep.2024.05.032","url":null,"abstract":"<div><h3>Background</h3><div>Electrical storm (ES) is a life-threatening condition, associated with substantial early and subacute mortality. Catheter ablation (CA) is a well-established therapy for ES. However, data regarding the impact of CA on the short-term and midterm survival of patients admitted for ES remain unclear.</div></div><div><h3>Objectives</h3><div>This multicenter study aimed to investigate the impact of CA of ES on survival outcomes, while accounting for key patient characteristics associated with treatment selection.</div></div><div><h3>Methods</h3><div>A propensity score–matching (PSM) analysis was performed on 780 consecutive patients admitted for ES in 4 tertiary centers. PSM (1:1) based on the main characteristics associated with the use of CA or medical therapy alone was performed, resulting in 2 groups of 288 patients.</div></div><div><h3>Results</h3><div>After PSM, patients who underwent CA (n = 288) and those treated with medical therapy alone (n = 288) did not present any significant differences in the main demographic characteristics, ES presentation, and management. Compared with medical therapy alone, CA was associated with a significantly lower rate of ES recurrence at 1 year (5% vs 26%; <em>P &lt;</em> 0.001). Similarly, CA was associated with a higher 1-year (91% vs 81%; <em>P &lt;</em> 0.001) and 3-year (78% vs 71%; <em>P =</em> 0.017) survival after discharge. In subgroup analyses, effect of ablation therapy remained consistent in patients older than 70 years of age (HR: 0.39; 95% CI: 0.24-0.66), with substantial efficacy in patients with a LVEF &lt;35% (HR: 0.39; 95% CI: 0.27-0.59).</div></div><div><h3>Conclusions</h3><div>In propensity-matched analyses, this large study shows that CA-based management of patients admitted for ES is associated with a reduction in mortality compared with medical treatment, particularly in patients with a low ejection fraction.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"10 10","pages":"Pages 2117-2128"},"PeriodicalIF":8.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874816","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":"Smoking Cessation and Incident Atrial Fibrillation in a Longitudinal Cohort","authors":"Justin T. Teraoka MD, MAS ,&nbsp;Janet J. Tang PhD, MPH ,&nbsp;Francesca N. Delling MD, MPH ,&nbsp;Eric Vittinghoff PhD ,&nbsp;Gregory M. Marcus MD, MAS","doi":"10.1016/j.jacep.2024.06.019","DOIUrl":"10.1016/j.jacep.2024.06.019","url":null,"abstract":"<div><h3>Background</h3><div>Although smoking heightens the risk of AF, it remains unknown if that risk is amenable to modification after smoking cessation.</div></div><div><h3>Objectives</h3><div>This study sought to evaluate the association between smoking cessation and atrial fibrillation (AF) risk in a large longitudinal cohort.</div></div><div><h3>Methods</h3><div>After excluding those with prevalent AF and no history of smoking at baseline, we evaluated 146,772 UK Biobank participants with serial smoking assessments. We compared AF risk between former smokers at baseline and those who quit smoking during the study to current smokers. Incident AF was ascertained from outpatient and inpatient encounters and identified using International Classification of Diseases codes. Cox models were used to compare the risk of incident AF among current and former smokers as well as those who quit smoking during the study while controlling for age, sex, race, body mass index, education, cardiovascular comorbidities, alcohol use, and pack-years.</div></div><div><h3>Results</h3><div>Among the 146,772 participants (48.3% female; age: 57.3 ± 7.9 years), 37,377 (25.5%) currently smoked; 105,429 (72.0%) were former smokers; and 3,966 (2.7%) quit smoking during the study. Over a mean 12.7 ± 2.0 years of follow-up, 11,214 (7.6%) participants developed AF. Compared to current smokers, the adjusted risk of AF was 13% lower in former smokers (HR: 0.87; 95% CI: 0.83-0.91) and 18% lower in those who quit smoking during the study (HR: 0.82; 95% CI: 0.70-0.95).</div></div><div><h3>Conclusions</h3><div>Compared to those who continue to smoke, smoking cessation was associated with a lower risk of AF.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"10 10","pages":"Pages 2198-2206"},"PeriodicalIF":8.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262488","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":"Taming the Tempest","authors":"Esseim Sharma MD ,&nbsp;Usha Tedrow MD","doi":"10.1016/j.jacep.2024.06.013","DOIUrl":"10.1016/j.jacep.2024.06.013","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"10 10","pages":"Pages 2129-2131"},"PeriodicalIF":8.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788026","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":"Imaging to Facilitate Ventricular Tachycardia Ablation","authors":"Godefroy Chery MD,&nbsp;Mirmilad Khoshknab MD,&nbsp;Saman Nazarian MD, PhD","doi":"10.1016/j.jacep.2024.08.003","DOIUrl":"10.1016/j.jacep.2024.08.003","url":null,"abstract":"<div><div>Catheter ablation is a well-established and effective strategy for the management of ventricular tachycardia (VT). However, the identification and characterization of arrhythmogenic substrates for targeted ablation remain challenging. Electrogram abnormalities and responses to pacing during VT provide the classical and most validated methods to identify substrates. However, the 3-dimensional nature of the myocardium, nonconductive tissue, and heterogeneous strands of conductive tissue at the border zones or through the nonconductive zones can prohibit easy electrical sampling and identification of the tissue critical to VT. Intracardiac echocardiography is critical for identification of anatomy, examination of catheter approach and contact, assessment of tissue changes during ablation, and even potential substrates as echogenic regions, but lacks specificity with regard to the latter compared with advanced modalities. In recent decades, cardiac magnetic resonance, computed tomography and positron emission tomography have emerged as valuable tools in the periprocedural evaluation of VT ablation. Cardiac magnetic resonance has unparalleled soft tissue and temporal resolution and excels at identification of expanded interstitial space caused by myocardial infarction, fibrosis, inflammation, or infiltrative myopathies. Computed tomography has excellent spatial resolution and is optimal for identification of anatomic variabilities including wall thickness, thrombus, and lipomatous metaplasia. Positron emission tomography excels at identification of substrates including amyloidosis, sarcoidosis, and other inflammatory substrates. These imaging modalities are vital for assessing arrhythmogenic substrates, guiding optimal access strategy, and assessing ablation efficacy. Although clearly beneficial in specific settings, further clinical trials are needed to enhance generalizability and optimize integration of cardiac imaging for VT ablation.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"10 10","pages":"Pages 2277-2292"},"PeriodicalIF":8.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371852","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}