Journal of Arrhythmia最新文献

{"title":"Management of device embolization following left atrial appendage closure: Two cases and a review of the literature","authors":"Ahmet Kivrak MD,&nbsp;Ahmet Hakan Ates MD,&nbsp;Ugur Canpolat MD,&nbsp;Mert Dogan MD,&nbsp;Cem Coteli MD,&nbsp;Hikmet Yorgun MD,&nbsp;Mehmet Levent Sahiner MD,&nbsp;Ergun Barıs Kaya MD,&nbsp;Kudret Aytemir MD","doi":"10.1002/joa3.70139","DOIUrl":"https://doi.org/10.1002/joa3.70139","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Device embolization (DE) following left atrial appendage closure (LAAC) is a severe but uncommon complication, and limited data address optimal management strategies for this condition. This review presents two cases of device embolization (DE) following LAAC and discusses risk factors, incidence, and management strategies through a literature-based approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature review was conducted, including studies focused on DE after LAAC, examining percutaneous and surgical retrieval techniques, procedural success, and patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results and Conclusion</h3>\u0000 \u0000 <p>DE incidence ranges from 0.6% to 1.5%, with improper device sizing and anatomical factors as primary risk factors. Percutaneous retrieval, through transseptal or transarterial approaches, demonstrates high procedural success rates, while surgical retrieval remains an option for complex cases. Our review suggests that with experienced operators, tailored percutaneous strategies effectively manage DE following LAAC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70139","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144751193","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":"Impact of the Distance From the Cavotricuspid Isthmus to the Right Coronary Artery on First-Pass Conduction Block During Cryoablation for Atrial Flutter","authors":"Minoru Nodera,&nbsp;Takashi Kaneshiro,&nbsp;Sadahiro Murota,&nbsp;Shinya Yamada,&nbsp;Masayoshi Oikawa,&nbsp;Yasuchika Takeishi","doi":"10.1002/joa3.70159","DOIUrl":"https://doi.org/10.1002/joa3.70159","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cryoablation is an alternative to radiofrequency ablation for the treatment of cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL). However, the anatomical features that make achieving a CTI conduction block using cryoablation challenging remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 100 consecutive patients who underwent CTI cryoablation for AFL. Patients were divided into two groups: the first-pass group, in which first-pass CTI conduction block was achieved (<i>n</i> = 72) and the non-first-pass group, in which it was not achieved (<i>n</i> = 28). We analyzed the anatomical features and the temperature changes of the catheter during the first sequential CTI cryoablation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The distance from the CTI to the right coronary artery (RCA) in the first-pass group was significantly longer than that in the non-first-pass group (<i>p</i> &lt; 0.001). The time to reach nadir freezing temperature in the ventricular side of the CTI was significantly shorter in the first-pass group than in the non-first-pass group (<i>p</i> &lt; 0.001). The time to reach nadir freezing temperature at the ventricular side of the CTI correlated inversely with the distance from the CTI to the RCA (<i>R</i> = −0.410, <i>p</i> &lt; 0.001). The distance from the CTI to the RCA was the only significant factor associated with achieving first-pass CTI conduction block (odds ratio, 4.801, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The distance from the CTI to the RCA was significantly associated with achieving first-pass CTI conduction block by cryoablation. The warming effect of the RCA blood flow might prevent the CTI conduction block during cryoablation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70159","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144751675","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":"Long-Term Follow-Up of Superior Vena Cava–Right Atrium Spontaneous Conduction Block Line Durability Using the White-Line Approach of Extended Early Meets-Late Rate Tools","authors":"Yoshiaki Mizunuma,&nbsp;Masao Takahashi,&nbsp;Takafumi Sasaki,&nbsp;Koichiro Yamaoka,&nbsp;Hirofumi Kujiraoka,&nbsp;Tomoyuki Arai,&nbsp;Rintaro Hojo,&nbsp;Seiji Fukamizu","doi":"10.1002/joa3.70161","DOIUrl":"https://doi.org/10.1002/joa3.70161","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Superior vena cava (SVC)–right atrium (RA) spontaneous conduction block occurs in some patients. We demonstrated a novel approach for SVC isolation using visualization of the SVC–RA conduction block line as a white line with the extended early meets-late (EEML) tool of the CARTO system. The long-term durability of SVC isolation using white line has not been investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Overall, 200 patients who underwent SVC isolation as atrial fibrillation therapy or additional procedures between May 2015 and April 2024 were included. We created an activation map of sinus rhythm, adjusted the EEML settings, and confirmed the white line. In the presence of a white line, we performed SVC isolation using the white line (block group); in its absence, we conducted encircling SVC isolation (nonblock group). If additional procedures were needed at follow-up, repeat sessions were performed to identify the treatment targets, and SVC–RA mapping was performed. SVC–RA block line durability was defined as the SVC isolated area by voltage map at the additional session, including the white line of the first session. The SVC reconduction number between the two groups was compared, and SVC–RA spontaneous block line durability was confirmed in the block group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-one of 200 patients underwent additional procedures and follow-up SVC–RA mapping. The chronic SVC reconduction ratio did not differ significantly between the two groups. SVC–RA spontaneous block line durability was maintained in all patients in the block line group (block group 12/12 [100%]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SVC–RA spontaneous block visualized by using the white-line approach of EEML tools had durability in the chronic phase.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144751676","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":"Impact of Breathing and Anatomical Constraints on Subxiphoid Epicardial Puncture: Insights From a Japanese Cohort","authors":"Natnicha Pongbangli,&nbsp;Hirotsugu Ikewaki,&nbsp;Kyoko Hoshida,&nbsp;Kyoko Soejima","doi":"10.1002/joa3.70157","DOIUrl":"https://doi.org/10.1002/joa3.70157","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The subxiphoid approach is increasingly utilized for epicardial interventions. Understanding the effect of respiration on the distance from the xiphoid process to the pericardium is essential for improving procedural safety and efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted on 51 patients undergoing preprocedural ultrasound imaging. Measurements were taken in the supine position during spontaneous breathing at end-inspiration and end-expiration, with the probe directed toward both the midline and the left shoulder. Differences between respiratory phases and probe orientations were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean xiphoid-to-pericardium distance increased significantly from inspiration to expiration for both probe orientations (midline: 42.2 ± 12.2 mm vs. 54.6 ± 14.1 mm, <i>p</i> &lt; 0.001; left shoulder: 40.5 ± 12.3 mm vs. 51.2 ± 14.2 mm, <i>p</i> &lt; 0.001). The expiration-inspiration difference was greater with the midline direction (mean difference: 12.4 mm) than toward the left shoulder (10.7 mm). Probe direction affected measurements during expiration (<i>p</i> = 0.012) but not during inspiration (<i>p</i> = 0.104). The distance to the pericardium showed a positive correlation with body weight (<i>r</i> = 0.561), body mass index (<i>r</i> = 0.675), and chest dimensions, including anteroposterior (AP) (<i>r</i> = 0.477) and lateral diameters (<i>r</i> = 0.451). In contrast, the chest wall size index (lateral/AP ratio) was negatively correlated (<i>r</i> = −0.365). No significant difference in this distance was found between patients with and without chronic obstructive pulmonary disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Respiratory phase and anthropometric parameters significantly influence the distance to the pericardium. These findings may guide safer planning of subxiphoid epicardial procedures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740206","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":"Impact of Ablation Targeting Atrial Drivers and Fragmented Potentials on Long-Standing Persistent Atrial Fibrillation: A Retrospective Study","authors":"Yuma Gibo,&nbsp;Morio Ono,&nbsp;Yui Koyanagi,&nbsp;Katsuya Yoshihiro,&nbsp;Soichiro Usumoto,&nbsp;Toshihiko Gokan,&nbsp;Toshitaka Okabe,&nbsp;Naoei Isomura,&nbsp;Mitunori Muto,&nbsp;Masaru Shiigai,&nbsp;Junko Honye,&nbsp;Masahiko Ochiai","doi":"10.1002/joa3.70160","DOIUrl":"https://doi.org/10.1002/joa3.70160","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Long-standing persistent atrial fibrillation (AF) often shows resistance to pulmonary vein isolation (PVI) alone. This study aimed to compare the outcomes of catheter ablation targeting electrophysiological substrates versus conventional PVI in patients with long-standing persistent AF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 105 patients with long-standing persistent AF who underwent initial catheter ablation between June 2021 and June 2023. After propensity score matching (<i>n</i> = 38 each), we compared conventional PVI (conventional group) with additional ablation targeting AF drivers and fragmented potentials (driver and fragmented potentials group). The primary endpoint was AF recurrence lasting &gt; 30 s occurring ≥ 3 months post-ablation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Procedure times were longer in the driver and fragmented potentials group (166.1 ± 35.9 vs. 140.7 ± 50.4 min, <i>p</i> = 0.01). Higher rotational activity was observed in the left atrial appendage and bottom regions in this group. Over a mean follow-up of 383.5 ± 21.1 days, AF recurrence was numerically lower in the driver and fragmented potentials group (21.1% vs. 36.8%, <i>p</i> = 0.13). Post-ablation premature atrial contractions were significantly fewer in the driver and fragmented potentials group (<i>p</i> &lt; 0.01). Multivariate analysis identified fragmented potentials and driver activity in the bottom region as independent predictors of AF recurrence (<i>p</i> = 0.02; 95% CI: 1.08–3.12).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ablation targeting atrial drivers and fragmented potentials demonstrated a trend toward improved clinical outcomes compared to conventional PVI alone, with reduced AF recurrence and PAC burden. The bottom region of the left atrium appears to be a significant therapeutic target for improving long-term success in long-standing persistent AF ablation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70160","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144716945","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":"Clinical and Electrophysiological Characteristics of Patients Developing Macroreentrant Atrial Tachyarrhythmias Following Cardiac Surgery: A Retrospective Cohort Study","authors":"Nayani Makkar,&nbsp;Sreevilasam P. Abhilash,&nbsp;Krishna Kumar Mohanan Nair,&nbsp;Mukund A. Prabhu,&nbsp;Saikiran Kakarla,&nbsp;Jyothi Vijay,&nbsp;Sudipta Mondal,&nbsp;Valaparambil Kumar Ajit,&nbsp;Narayanan Namboodiri","doi":"10.1002/joa3.70146","DOIUrl":"https://doi.org/10.1002/joa3.70146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Macroreentrant atrial tachycardias (MRAT) predominate the atrial arrhythmias in patients with operated heart disease, and advances in interventional electrophysiology and catheter ablation technology have pioneered a shift in their management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed clinical, procedural, and outcome data from a cohort of patients who had undergone radiofrequency (RF) ablation for MRAT (utilizing high-density atrial mapping) following cardiac surgery for congenital or acquired heart disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-one patients underwent ablation for a MRAT from 2016 to 2023. These patients had a mean age of 50.17 ± 11.71 years and had undergone cardiac surgical intervention a median of 18 years prior to first presentation with atrial tachyarrhythmia. The commonest repaired lesion was a surgically corrected atrial septal defect. None of the studied patients had a left-sided macro reentrant circuit. The patients were followed up for a median duration of 2 years following ablation. Twenty-five patients (60.9%) had CTI-dependent atrial flutter (AFl). Using a strategy of high-density activation and voltage mapping and entrainment mapping to define the tachycardia circuit, an acute success rate of 95.1% was noted. Our population continued to do well on medium-term follow-up, with 90.2% of patients tachycardia-free at 2 years. However, seven patients (17.1%) developed sinus bradycardia requiring pacing, and three patients (7.3%) developed incident atrial fibrillation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A meticulous approach to MRAT mapping utilizing a combination of newer high-density mapping catheters with entrainment mapping yields high rates of acute (95.1%) and medium-term success (90.2%) in patients with antecedent cardiac surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144716983","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 Novel Technique for Diaphragmatic Compound Motor Action Potential Monitoring Using the BeeAT Catheter During Cryoballoon Ablation for Atrial Fibrillation","authors":"Keigo Yamamoto,&nbsp;Takeshi Goto,&nbsp;Masaomi Kimura","doi":"10.1002/joa3.70155","DOIUrl":"https://doi.org/10.1002/joa3.70155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diaphragmatic compound motor action potential (CMAP) monitoring helps prevent phrenic nerve palsy during cryoballoon ablation (CBA) for atrial fibrillation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective analysis included 95 patients who had undergone CBA. Phrenic nerve pacing was performed via the distal electrode of a BeeAT catheter positioned in the right subclavian vein, with CMAPs recorded from the most proximal electrode in the subdiaphragmatic inferior vena cava.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CMAP amplitude was unaffected by patient body habitus (mean: 1.14 ± 0.58 mV; CMAP-to-ventricular wave ratio: 8.76).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This technique provides stable, well-defined signals with minimal artifacts, enhancing the reliability of CMAP monitoring during CBA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144716696","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":"Trajectories of Lipid Profile Changes and Cardiovascular Outcomes in Elderly Asian Patients With Atrial Fibrillation","authors":"Yu-Ting Wang,&nbsp;Yu-Hsuan Joni Shao,&nbsp;Chih-Chieh Huang,&nbsp;Jo-Hsin Chen,&nbsp;Gregory Y. H. Lip,&nbsp;Jong-Shiuan Yeh","doi":"10.1002/joa3.70151","DOIUrl":"https://doi.org/10.1002/joa3.70151","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The relationship between baseline total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and cardiovascular outcomes is well established, but their trajectories over time in elderly Asian patients with atrial fibrillation (AF) remain unexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>Using the Taipei Medical University Clinical Research Database from 2013 to 2020, we identified 823 AF patients aged above 75 with at least three annual lipid profile measurements. We used an accelerated failure time (AFT) model to examine the association of trajectories with the primary outcome of composite cardiovascular events (stroke, TIA, myocardial infarction, heart failure hospitalization and cardiovascular death).</p>\u0000 \u0000 <p>During follow-up, 308 patients developed events (61.33 per 100 person-years). Three total cholesterol trajectory groups were identified: low (group 1), decreasing (group 2), and middle (group 3). Compared with group 1, individuals in group 3 exhibited a significantly longer event-free survival, with a mean increase of 2.74 years (95% confidence interval [CI]: 1.05–7.12; <i>p</i> = 0.0394).</p>\u0000 \u0000 <p>For LDL trajectories, group 3 was associated with a mean increase of 2.35 years (95% CI: 1.11–4.98; <i>p</i> = 0.0252) in survival time from the primary outcome compared to group 1. Regarding HDL, participants in group 3—characterized by persistently higher HDL levels—had a 2.12-year longer survival time (95% CI: 1.01–4.43; <i>p</i> = 0.0456) compared to those in group 1. Triglyceride trajectories showed no significant association with the primary outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this hospital-based cohort study, total cholesterol, LDL, and HDL trajectories are associated with composite cardiovascular outcomes in elderly Asian AF patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70151","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714839","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":"High-frequency content within the QRS complex can predict ventricular tachyarrhythmias in hypertrophic cardiomyopathy","authors":"Takeshi Tsutsumi MD, PhD,&nbsp;Jun Yokomachi MD,&nbsp;Takafumi Nakajima MD,&nbsp;Kentaro Minami MD, PhD,&nbsp;Nami Takano MD, PhD,&nbsp;Kuniaki Iwasawa MD, PhD,&nbsp;Gaku Oguri MD, PhD,&nbsp;Shigeru Toyoda MD, PhD,&nbsp;Toshiaki Nakajima MD, PhD","doi":"10.1002/joa3.70130","DOIUrl":"https://doi.org/10.1002/joa3.70130","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Frequency analysis of the electrocardiographic QRS complex (QRS) was performed to evaluate the abnormal ventricular excitation in hypertrophic cardiomyopathy (HCM), from which we validated a risk stratification for lethal ventricular arrhythmias (L-VAs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We selected 32 patients with HCM and 60 control subjects from a population of 520 consecutive patients with syncopal seizures in a university hospital. We measured bipolar X, Y, and Z leads and calculated the frequency power using continuous wavelet transform (CWT). We compared frequency powers, ranging from 15 to 250 Hz, between patients with HCM with and without L-VAs. ROC curve analysis was applied to evaluate the differences between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The frequency powers of the QRS were increased in HCM in the wide frequency ranges, except for 49–62 Hz. The sum of the frequency power from 150 to 250 Hz was significantly higher in HCM with versus without L-VAs. The area under the ROC curve was 0.83. The occurrence of L-VAs could be predicted with a sensitivity of 0.92 and a specificity of 0.56.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The high-frequency power hidden in the QRS may be a valuable predictor of L-VAs in patients with HCM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70130","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714840","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":"Dual Chamber Open Window Mapping and High-Density Mapping for Atrioventricular Reentrant Tachycardia Associated With Atrioventricular Mahaim Fiber","authors":"Yuta Taomoto,&nbsp;Yuichi Ono,&nbsp;Ryota Ishida,&nbsp;Tatsuya Sakamoto,&nbsp;Kenichiro Otomo","doi":"10.1002/joa3.70154","DOIUrl":"https://doi.org/10.1002/joa3.70154","url":null,"abstract":"<p>Dual-chamber open-window mapping (OWM) combined with high-density mapping revealed early atrioventricular conduction on the lateral tricuspid annulus, consistent with a Mahaim fiber. Catheter ablation targeting the ventricular insertion site led to successful elimination of the accessory pathway and noninducibility of tachycardia.\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 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70154","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695791","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}