Journal of Arrhythmia最新文献

{"title":"The signal quality of tripolar Laplacian electrogram compared to bipolar electrogram in cardiac electrophysiology","authors":"Soichiro Yamashita MD,&nbsp;Makoto Takemoto MD,&nbsp;Wataru Fujimoto MD,&nbsp;Koji Kuroda MD,&nbsp;Junichi Imanishi MD,&nbsp;Masamichi Iwasaki MD,&nbsp;Takafumi Todoroki MD,&nbsp;Masanori Okuda MD","doi":"10.1002/joa3.70101","DOIUrl":"https://doi.org/10.1002/joa3.70101","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The usefulness of tripolar Laplacian electrogram (TLE) in cardiac electrophysiology is unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We investigated the difference in the morphology, voltage amplitude, noise level, and far-field potential (FFP) between TLE and bipolar electrogram (BE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-two patients who underwent catheter ablation for atrial fibrillation were analyzed. TLE and BE were simultaneously obtained using 64-electrode basket catheters during atrial tachycardia or pacing. Local electrograms (EGMs) were analyzed at the locations of three activation patterns: normal conduction, wavefront collision, and slow conduction (SC). In addition, each activation pattern was analyzed at two different wavefront angles: horizontal and vertical, respectively. The voltage amplitude, duration, morphology, and deflection number were compared. The noise level and FFP amplitude were also analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>With all activation patterns and wavefront angles, the voltage amplitude was significantly lower on TLE than on BE, and the mean amplitude ratio of TLE/BE was 0.75. The duration and deflection number of EGM were comparable. The ventricular FFP amplitude was lower on TLE than on BE (0.04 mV vs. 0.40 mV, <i>p</i> = .01). TLE also had less noise than BE (0.08 mV vs. 0.15 mV, <i>p</i> = .02), with a noise reduction of 47%. At the SC area, low-voltage EGMs below the mean noise levels were more common with BE than with TLE (29% vs. 8%, <i>p</i> = .04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TLE has a lower voltage amplitude than BE for all activation patterns and wavefront angles, and it removes more noise and FFPs. TLE is useful for analyzing low-voltage and fractionated EGMs regardless of the wavefront angle.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70101","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opening the door to a new era: A dual-chamber leadless pacemaker","authors":"Miyo Nakano MD, PhD,&nbsp;Yusuke Kondo MD, PhD, FJCS,&nbsp;Richard H. Hongo MD, PhD, MD,&nbsp;Hiroyuki Takaoka MD, PhD, FJCS,&nbsp;Yoshio Kobayashi MD, PhD, FJCS","doi":"10.1002/joa3.70100","DOIUrl":"https://doi.org/10.1002/joa3.70100","url":null,"abstract":"<p>Dual-chamber leadless pacing with Aveir DR offers a breakthrough alternative for patients at high risk of infection or with limited vascular access. By enabling both atrial and ventricular pacing without transvenous leads, this technology improves AV synchrony and may revolutionize future cardiac rhythm management, including defibrillation and resynchronization therapies.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Entrapment of the PulseSelect™ catheter in the pulmonary vein: A rare complication due to soft tissue obstruction","authors":"Kohei Iwasa MD,&nbsp;Masato Okada MD,&nbsp;Mebae Mizutani BS,&nbsp;Yoshihiko Ikeda MD, PhD,&nbsp;Nobuaki Tanaka MD","doi":"10.1002/joa3.70098","DOIUrl":"https://doi.org/10.1002/joa3.70098","url":null,"abstract":"<p>We encountered a case in which a guidewire and PulseSelect™ catheter became entrapped within a pulmonary vein during atrial fibrillation ablation. Although careful manual traction allowed successful retrieval without complications, the maneuver carried a risk of serious adverse events. Operators should be aware of this rare but important complication and avoid excessive catheter advancement into a distal pulmonary vein to minimize the risk of entrapment.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to demonstrate the clinical implication of prophylactic implantable cardioverter–defibrillator in patients with advanced light chain amyloidosis","authors":"Naoya Kataoka MD PhD,&nbsp;Teruhiko Imamura MD PhD","doi":"10.1002/joa3.70099","DOIUrl":"https://doi.org/10.1002/joa3.70099","url":null,"abstract":"<p>The indication for implantable cardioverter–defibrillator (ICD) implantation in patients with cardiac amyloidosis remains a matter of ongoing debate. Although the incidence of sudden cardiac death in this population is reported to be approximately 10%–30%, the majority of these events appear to result from pulseless electrical activity, which is unresponsive to defibrillation. The authors observed that ventricular arrhythmias were frequently present in patients with advanced light chain (AL) amyloidosis, and that ICD therapy was effective in terminating sustained ventricular arrhythmias in this subgroup.<span>¹</span> However, several concerns warrant consideration.</p><p>The current study included only 10 patients with AL amyloidosis, most of whom appeared to exhibit heart failure with preserved ejection fraction.<span>¹</span> Generally, ICD implantation is not recommended for patients with preserved left ventricular ejection fraction, except for those with cardiac sarcoidosis.<span>²</span> Do the authors advocate ICD implantation in all patients with AL amyloidosis, irrespective of left ventricular function? The cost-effectiveness of such an approach merits careful evaluation.</p><p>Notably, 40% of the cohort received single-chamber ICDs.<span>¹</span> Given that patients with cardiac amyloidosis frequently develop supraventricular arrhythmias, such as atrial fibrillation, the potential for inappropriate ICD shocks cannot be overlooked.<span>³</span> It remains unclear whether inappropriate shocks occurred in this cohort.</p><p>Recent studies have highlighted the potential role of catheter ablation in managing ventricular arrhythmias in patients with cardiac amyloidosis.<span>⁴</span> In light of the authors' finding that appropriate shocks were commonly delivered,<span>¹</span> prophylactic catheter ablation may represent a viable alternative strategy. The influence of AL-directed chemotherapy on the incidence and burden of ventricular arrhythmias also deserves further investigation.</p><p>Authors declare no conflict of interests for this article.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2025 Japanese Heart Rhythm Society / Japanese Circulation Society Consensus Statement on the Appropriate Use of Ambulatory and Wearable Electrocardiographs","authors":"Takanori Ikeda MD,&nbsp;Takashi Ashihara MD,&nbsp;Yu-ki Iwasaki MD,&nbsp;Maki Ono MD,&nbsp;Nobuyuki Kagiyama MD,&nbsp;Takehiro Kimura MD,&nbsp;Kengo Kusano MD,&nbsp;Ritsuko Kohno MD,&nbsp;Keita Saku MD,&nbsp;Tetsuo Sasano MD,&nbsp;Keitaro Senoo MD,&nbsp;Seiji Takatsuki MD,&nbsp;Naohiko Takahashi MD,&nbsp;Mitsuru Takami MD,&nbsp;Yukiko Nakano MD,&nbsp;Kenichi Hashimoto MD,&nbsp;Katsuhito Fujiu MD,&nbsp;Tadashi Fujino MD,&nbsp;Atsushi Mizuno MD,&nbsp;Koichiro Yoshioka MD,&nbsp;Eiichi Watanabe MD,&nbsp;Wataru Shimizu MD,&nbsp;Koichi Node MD","doi":"10.1002/joa3.70059","DOIUrl":"https://doi.org/10.1002/joa3.70059","url":null,"abstract":"<p>Recently, some clinicians have been diagnosing and treating arrhythmias on the basis of electrocardiogram (ECG) devices with low accuracy. In Europe and the US, several statements on the use of ECGs have already been published by related academic societies. In addition, with the relaxation of regulations on media advertising ambulatory/wearable ECG devices, the frequency of use of simple ECG devices by the general public will increase in the future. Therefore, this statement describes the functions and features of non-invasive ambulatory or wearable ECG devices that have been approved as medical devices in Japan (and that can record ECGs remotely), as well as points to note when using them; provides an overview of data storage and security for ambulatory/wearable ECG devices and implantable loop recorders (ILRs), as well as discussing differences between their use and the use of non-invasive ambulatory/wearable ECG devices; and provides classes of recommendation for the use of these devices and their evaluation for each arrhythmia type or condition. We describe lead-based ambulatory ECG devices (classical 24-h Holter ECG monitoring), handheld ECG devices, handheld-based ECG devices using a smartphone, wearable ECG devices (smartwatch and garment ECG devices), and patch ECG devices. In addition, we provide information on methods that are not based on the original ECG, such as photoplethysmography and oscillometric blood pressure measurement, and describe the limitations of their use. We hope that the publication of this statement will lead to the appropriate use of ambulatory/wearable ECG devices in Japan.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144117989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross-tissue transcriptome-wide association study identifies novel susceptibility genes for atrial fibrillation","authors":"Yalin Yuan MM,&nbsp;Xin Zheng MD,&nbsp;Wenjing Zhang MD,&nbsp;Zhaoyu Ren MD,&nbsp;Bin Liang PhD","doi":"10.1002/joa3.70097","DOIUrl":"https://doi.org/10.1002/joa3.70097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atrial fibrillation (AF), the most common cardiac arrhythmia, has been linked to numerous loci identified by genome-wide association studies (GWAS). However, the causal genes and underlying mechanisms remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-tissue transcriptome-wide association studies (TWAS) using the unified test for molecular signatures (UTMOST), integrating genetic data from the FinnGen R11 cohort (287 805 individuals) with gene expression profiles from the genotype-tissue expression (GTEx) project. To enhance reliability, we applied functional summary-based imputation (FUSION), fine-mapping of causal gene sets (FOCUS), and multi-marker analysis of GenoMic annotation (MAGMA) for gene prioritization, followed by Mendelian randomization (MR) and colocalization analyses. GeneMANIA was used to explore gene functions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>By integrating four TWAS approaches, this study identified five novel susceptibility genes significantly associated with AF risk. MR analysis further revealed that the gene expression levels of FKBP7, CEP68, and CAMK2D were positively associated with AF risk, while SPATS2L exhibited a significant protective effect. Colocalization analysis demonstrated that CEP68 and SPATS2L share causal variants with AF. Through comprehensive evaluation of multidimensional functional annotations and existing biological evidence, this study highlighted SPATS2L and CEP68 as potential functional candidate genes in AF pathogenesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This cross-tissue TWAS identified five novel AF susceptibility genes (CAMK2D, SPAST2L, CEP68, FKBP7, and SHRMOO3). Elevated expression of FKBP7, CEP68, and CAMK2D increases AF risk, while SPATS2L showed a protective effect, with colocalization analysis implicating CEP68 and SPATS2L as prioritized candidates. The integration of multi-omics approaches effectively unravels AF's genetic mechanisms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144117966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in atrial fibrillation and flutter mortality associated with disorders of thyroid gland in the United States from 1999 to 2020","authors":"Shahzaib Ahmed MBBS,&nbsp;Shoaib Ahmad MD,&nbsp;Hamza Ashraf MBBS,&nbsp;Eeman Ahmad MBBS,&nbsp;Umar Akram MBBS,&nbsp;Abbas H. Mallick MD,&nbsp;Irfan Ullah MBBS, MPH,&nbsp;Raheel Ahmed MBBS, MRCP,&nbsp;Chadi Alraies MD, MPH, FACC, FSCAI,&nbsp;Gregg C. Fonarow MD, FACC, FAHA, FHFSA","doi":"10.1002/joa3.70096","DOIUrl":"https://doi.org/10.1002/joa3.70096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Thyroid gland disorders are a known risk factor for atrial fibrillation and flutter (AF/AFL). Despite being a well-established risk factor, most studies have primarily examined prevalence, comorbidities, and treatment patterns with little to no research on mortality trends for this association. Objective: We aimed to analyze the trends in AF/AFL-related mortality in patients with thyroid gland disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Age-adjusted mortality rates and crude rates per 100,000 population from 1999 to 2020 using the CDC WONDER database. Annual percent changes and their averages were calculated via Joinpoint regression. AF/AFL-related mortality trends in patients with thyroid disorders were compared with those in the general population using pairwise comparison.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the study period, a total of 7187 AF/AFL-related deaths were observed in individuals diagnosed with thyroid gland disorders. The age-adjusted mortality rates increased throughout the study period. The mortality rates in females remained consistently higher than those in males. Mortality rates did not vary substantially across regions (South: 0.09; Northeast: 0.09; Midwest: 0.10; West: 0.11). Furthermore, the annual percent change in females and South with thyroid disorders differed significantly from the general population. The states with the highest mortality rates were Oregon, Wyoming, and Nebraska. The mortality rates remained higher in nonmetropolitan regions (0.11) than in metropolitan regions (0.09).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>AF/AFL-related mortality trends associated with thyroid disorders increased from 1999 to 2020. Policies that target vulnerable populations and regions may be beneficial in mitigating the increasing AF/AFL-related mortality associated with disorders of the thyroid gland.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy and interpretability of smartwatch electrocardiogram for early detection of atrial fibrillation: A systematic review and meta-analysis","authors":"Dr. Muhammad Iqhrammullah M.Si., MKM,&nbsp;Prof. Asnawi Abdullah PhD,&nbsp;Dr. Hermansyah S.KM., M.PH,&nbsp;Fahmi Ichwansyah PhD,&nbsp;Prof. Dr. Ir. Hafnidar A. Rani,&nbsp;Meulu Alina S.Ked,&nbsp;Artha M. T. Simanjuntak,&nbsp;Derren D. C. H. Rampengan S.Ked,&nbsp;dr. Seba Talat Al-Gunaid,&nbsp;dr. Naufal Gusti MKM,&nbsp;dr. Arditya Damarkusuma M.Med (Clin Epi), Sp.JP(K),&nbsp;Edza Aria Wikurendra PhD","doi":"10.1002/joa3.70087","DOIUrl":"https://doi.org/10.1002/joa3.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The prevalence of atrial fibrillation (AFib) continues to increase globally, posing a significant risk for serious cardiovascular complications, such as ischemic stroke and thromboembolism. Smartwatch single-lead electrocardiogram (ECG) can be a practical and accurate early detection tool for AFib.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of this study was to fill the research gap in evaluating the accuracy and interpretability of smartwatch ECG for early AFib detection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data derived from indexed literature in the Scopus, Scilit, PubMed, Google Scholar, Web of Science, IEEE, and Cochrane Library databases (as of June 1, 2024) were systematically screened and extracted. The quantitative synthesis was performed using a two-level mixed-effects logistic regression model, as well as a proportional analysis with Freeman-Tukey double transformation on a restricted maximum-likelihood model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The sensitivity and specificity of smartwatch ECG in algorithmic readings were 86% and 94%, respectively. In manual readings, the sensitivity and specificity reached 96% and 95%, respectively. In a brand-specific subgroup analysis, the algorithmic reading reached a summary area under the curve (sAUC) of 96%, while another brand achieved the highest sAUC of 98% in manual reading. The level of manual interpretability was relatively high with Cohen's Kappa of 0.83, but 3% of ECG results were difficult to read manually.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study shows that smartwatch ECG is able to detect AFib with high accuracy, especially through manual reading by trained medical personnel.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> PROSPERO Registration</h3>\u0000 \u0000 <p>CRD42024548537 (May 29, 2024).</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic kidney disease and increased LAVI as risk factors of new-onset heart failure in atrial fibrillation: A case-control study","authors":"Resultanti Irwan Muin MD,&nbsp;Muhammad Yamin MD, PhD,&nbsp;Ika Prasetya Wijaya MD, PhD,&nbsp;Kuntjoro Harimurti MD, MSc, PhD,&nbsp;Hamzah Shatri MD, MCE, PhD,&nbsp;Cosphiadi Irawan MD, PhD,&nbsp;Pradana Soewondo MD, PhD","doi":"10.1002/joa3.70061","DOIUrl":"https://doi.org/10.1002/joa3.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atrial fibrillation (AF) increases heart failure (HF) risk and can eventually increase morbidity and mortality. Therefore, recognizing risk factors in AF patients is crucial to prevent heart failure. To date, there has been no research on this topic in Indonesia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine risk factors of new-onset HF in AF patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Case–control study was undertaken at Cipto Mangunkusumo Hospital using medical record data from January 2018 to May 2023. AF patients aged ≥18 years with new-onset HF were included in the case group, and AF patients of similar age without HF were included in the control group. Patients with moderate or severe valvular heart disease, congenital heart disease, pacemakers, or implantable cardioverter defibrillators (ICD), or incomplete data were excluded. Logistic regression was used to identify significant risk factors for new-onset HF in AF patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 132 subjects consisting of 44 cases and 88 controls were included. Bivariate analysis revealed that the significant risk factors for new-onset HF in AF patients were CAD [<i>p</i> = .037; OR 2.34 (95% CI 1.11–4.93)], CKD [<i>p</i> = .000; OR 7.78 (95% CI 3.45–17.53)], and LAVI [<i>p</i> = .002; OR 3.23 (95% CI 1.52–6.85)]. In multivariate analysis, CKD [<i>p</i> = .000; OR 6.31 (95% CI 2.69–14.77)] and LAVI [<i>p</i> = .000; OR 3.49 (95% CI 1.42–9.97)] retained their statistical significance as risk factors of new-onset HF in AF patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CKD and increased LAVI may increase the likelihood of new-onset HF in AF patients, while hypertension, diabetes, CAD, smoking, and obesity were not significant risk factors for new-onset HF in our study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144091851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic comparison between implantable cardioverter-defibrillator and amiodarone in cancer patients","authors":"Hirota Kida CE, MS, PhD,&nbsp;Toshitaka Morishima MD, PhD,&nbsp;Eiji Uza CE, MS,&nbsp;Hironori Yamamoto MD, PhD,&nbsp;Taku Yasui MD, PhD,&nbsp;Masashi Fujita MD, PhD,&nbsp;Isao Miyashiro MD, PhD","doi":"10.1002/joa3.70093","DOIUrl":"https://doi.org/10.1002/joa3.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Implantable cardioverter-defibrillator (ICD) has been demonstrated to improve survival outcomes compared to amiodarone. However, this effectiveness in cancer patients remains unclear. Given the complexity of cardiovascular management in this population, including cancer stage considerations, we evaluated the relative effectiveness of ICD versus amiodarone in cancer patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>We linked cancer registry data with administrative records to identify patients newly prescribed amiodarone or who underwent ICD implantation between 2010 and 2015 at 36 hospitals in Osaka Prefecture, Japan. Among 161,125 cancer patients, 339 met the inclusion criteria (amiodarone: <i>n</i> = 281; ICD: <i>n</i> = 58), with a median follow-up of 762 days. Kaplan–Meier analysis revealed that the ICD group had a significantly reduced risk of all-cause mortality compared to the Amiodarone group (Log-rank test, <i>p</i> &lt; .003). Multivariable Cox proportional hazard regression model showed that ICD was an independent prognostic factor (Hazard ratio: 0.47, 95% confidence interval: 0.29–0.79, <i>p</i> = .004). These results were confirmed in a propensity-matched analysis. Among patients with cancer stage: in situ or localized, no significant difference in survival risk was observed between the ICD and Amiodarone groups, and ICD was not significantly associated with all-cause death. Conversely, among patients with cancer stage: regional or distant, the ICD group had a significantly reduced risk of all-cause death compared to the Amiodarone group, and ICD was an independent prognostic factor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In cancer patients, ICD may improve long-term prognosis compared to amiodarone, especially in patients with advanced cancer stages.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70093","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}