JACC. Clinical electrophysiology最新文献

{"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}

{"title":"Left Bundle Branch Area Pacing With or Without Conduction System Capture in Heart Failure Models","authors":"","doi":"10.1016/j.jacep.2024.05.007","DOIUrl":"10.1016/j.jacep.2024.05.007","url":null,"abstract":"<div><h3>Background</h3><div>Left bundle branch area pacing includes left bundle branch pacing (LBBP) and left ventricular septal pacing (LVSP), which is effective in patients with dyssynchronous heart failure (DHF). However, the basic mechanisms are unknown.</div></div><div><h3>Objectives</h3><div>This study aimed to compare LBBP with LVSP and explore potential mechanisms underlying the better clinical outcomes of LBBP.</div></div><div><h3>Methods</h3><div><span>A total of 24 beagles<span> were assigned to the following groups: 1) control group; 2) DHF group, left bundle branch ablation followed by 6 weeks of AOO pacing at 200 ppm; 3) LBBP group, DHF for 3 weeks followed by 3 weeks of DOO pacing at 200 ppm; and 4) LVSP with the same interventions in the LBBP group. Metrics of electrocardiogram, echocardiography, </span></span>hemodynamics, and expression of left ventricular proteins were evaluated.</div></div><div><h3>Results</h3><div>Compared with LVSP, LBBP had better peak strain dispersion (44.67 ± 1.75 ms vs 55.50 ± 4.85 ms; <em>P &lt;</em> 0.001) and hemodynamic effect (dP/dtmax improvement: 27.16% ± 7.79% vs 11.37% ± 4.73%; <em>P &lt;</em> 0.001), whereas no significant differences in cardiac function were shown. The altered expressions of proteins in the lateral wall vs septum in the DHF group were partially reversed by LBBP and LVSP, which was associated with the contraction and adhesion process, separately.</div></div><div><h3>Conclusions</h3><div>The animal study demonstrated that LBBP offered better mechanical synchrony and improved hemodynamics than LVSP, which might be explained by the reversed expression of contraction proteins. These results supported the potential superiority of left bundle branch area pacing with the capture of the conduction system in DHF model.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"10 10","pages":"Pages 2234-2246"},"PeriodicalIF":8.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544830","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":"Long-Term Safety and Efficacy of Intraoperative Leadless Pacemaker Implantation During Valve Surgery","authors":"Connor P. Oates MD ,&nbsp;Karel T.N. Breeman MD ,&nbsp;Marc A. Miller MD ,&nbsp;Percy Boateng MD ,&nbsp;Aarti Patil MD ,&nbsp;Daniel R. Musikantow MD ,&nbsp;Elbert Williams MD ,&nbsp;Ismail El-Hamamsy MD ,&nbsp;Morgan L. Montgomery MD ,&nbsp;Benjamin S. Salter MD ,&nbsp;Chartaroon Rimsukcharoenchai MD ,&nbsp;Dimosthenis Pandis MD ,&nbsp;Menachem M. Weiner MD ,&nbsp;Srinivas R. Dukkipati MD ,&nbsp;Anelechi Anyanwu MD ,&nbsp;Vivek Y. Reddy MD ,&nbsp;David H. Adams MD ,&nbsp;Ahmed M. El-Eshmawi MD","doi":"10.1016/j.jacep.2024.06.018","DOIUrl":"10.1016/j.jacep.2024.06.018","url":null,"abstract":"<div><h3>Background</h3><div>Intraoperative implantation of leadless cardiac pacemakers (LCPs) under direct visualization during cardiac surgery is a novel strategy to provide pacing to patients with an elevated risk of postoperative conduction disorders or with a preexisting pacing indication undergoing valve surgery.</div></div><div><h3>Objectives</h3><div>This study sought to evaluate the long-term safety and efficacy of intraoperative LCP implantation in 100 consecutive patients.</div></div><div><h3>Methods</h3><div>Retrospective single-center cohort study of consecutive patients (n = 100) who underwent intraoperative LCP implantation during valve surgery. Safety and efficacy were assessed at implantation and follow-up visits.</div></div><div><h3>Results</h3><div>A total of 100 patients (age 68 ± 13 years, 47% female) underwent intraoperative LCP implantation. The surgery involved the tricuspid valve in 99 patients (99%), including tricuspid valve repair in 59 (59%) and tricuspid valve replacement in 40 (40%). Most of the patients (78%) underwent multivalve surgery. The indication for LCP implantation was elevated risk of postoperative atrioventricular block in 54% and preexisting bradyarrhythmias in 46%. LCP implantation was successful in all patients. During a median of 10.6 months (IQR: 2.0-22.7 months) of follow-up, no device-related complications occurred. At 12-month follow-up, the pacing thresholds were acceptable (≤2.0 V at 0.24 milliseconds) in 95% of patients.</div></div><div><h3>Conclusions</h3><div>Intraoperative LCP implantation under direct visualization is a safe strategy to provide permanent pacing in patients undergoing valve surgery, with a postoperative electrical performance comparable to percutaneously placed LCPs.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"10 10","pages":"Pages 2224-2233"},"PeriodicalIF":8.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995737","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":"Successful Implantation of Defibrillator Leads for Left Bundle Branch Pacing","authors":"Mary Pelling MD,&nbsp;Michael S. Lloyd MD","doi":"10.1016/j.jacep.2024.08.011","DOIUrl":"10.1016/j.jacep.2024.08.011","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"10 10","pages":"Pages 2269-2270"},"PeriodicalIF":8.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142534688","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}