Journal of Arrhythmia最新文献

{"title":"Editorial to “Initial experiences and technical insights of pulmonary vein isolation with FARAPULSE pulsed field ablation in patients implanted with WATCHMAN left atrial appendage closure devices: The first report in Japan”","authors":"Masato Fukunaga MD","doi":"10.1002/joa3.70105","DOIUrl":"https://doi.org/10.1002/joa3.70105","url":null,"abstract":"<p>Editorial comment on “Initial experiences and technical insights of pulmonary vein isolation with FARAPULSE pulsed field ablation in patients implanted with WATCHMAN left atrial appendage closure devices: The first report in Japan.”<span><sup>1</sup></span></p><p>Pulsed field ablation (PFA) has recently emerged as a promising technique for atrial fibrillation (AF) ablation, rapidly gaining popularity due to its favorable safety and efficacy profile. Unlike conventional thermal ablation, PFA devices exhibit significant variation in catheter design, workflow, and clinical evidence—differences that may be even more pronounced across platforms. Notably, among current systems, only the FARAPULSE PFA system (Boston Scientific) can be used in patients with a preexisting left atrial appendage closure (LAAC) device, according to the instructions for use. While PFA can theoretically be applied in such settings, metallic interference between the PFA catheter and LAAC device remains a potential procedural challenge.</p><p>In a recent issue of the <i>Journal of Arrhythmia</i>, Chatani et al.<span><sup>1</sup></span> presented a small case series demonstrating the feasibility of PFA in patients with prior WATCHMAN device implantation (3 months–2 years postimplantation), under intracardiac echocardiography (ICE) guidance. In Case 2 of their report, catheter artifact interference was observed when the FARAWAVE catheter was configured in its flower formation. This issue was resolved by adjusting catheter depth and position posteriorly. The LAAC device in that case was implanted proximally, protruding 4.4 mm from the ridge of the left superior pulmonary vein. The authors also noted that the Amplatzer Amulet device may pose a higher risk of interference due to its design. Importantly, all cases were completed without procedural complications, supporting the feasibility of PFA in this population.</p><p>Despite this success, certain concerns persist. Metal artifact interference remains a technical hurdle, particularly in anatomically complex or combined procedures. The concept of a combined AF ablation and LAAC—often termed the “one-stop procedure”—has gathered increasing interest. The OPTION trial evaluated LAAC as an alternative to oral anticoagulation in patients post-AF ablation. The trial permitted both concomitant LAAC (within 10 days of ablation) and delayed LAAC (90–180 days postablation). Results demonstrated that LAAC was associated with a lower incidence of nonprocedure-related major or clinically relevant nonmajor bleeding, and it was noninferior to oral anticoagulation for a composite endpoint of all-cause death, stroke, or systemic embolism at 36 months.<span><sup>2</sup></span> While these findings have not yet led to widespread procedural changes, the combined approach remains appealing to both clinicians and patients.</p><p>The ongoing OPTION-A trial (NCT06686485), a prospective, single-arm, multicenter postmarket study, is the first to formally e","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144292283","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":"Slow–fast atrioventricular nodal reentrant tachycardia mimicking junctional tachycardia following atrial extrastimulation","authors":"Koki Yamaoka MD,&nbsp;Seiji Takatsuki MD, PhD,&nbsp;Terumasa Yamashita MD, PhD,&nbsp;Hideo Mitamura MD, PhD,&nbsp;Masaki Ieda MD, PhD","doi":"10.1002/joa3.70107","DOIUrl":"https://doi.org/10.1002/joa3.70107","url":null,"abstract":"<p>Intracardiac electrocardiograms were recorded during a narrow QRS supraventricular tachycardia following atrial extrastimulation. What is the mechanism?\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":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144292282","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":"Bi-peaked R wave in HRV: A technical pitfall or ventricular pathology","authors":"Anish Singhal MD,&nbsp;Billa Anala MD resident,&nbsp;Madhuri Taranikanti MD,&nbsp;Nitin Ashok John MD,&nbsp;Naveen Ravi MD","doi":"10.1002/joa3.70111","DOIUrl":"https://doi.org/10.1002/joa3.70111","url":null,"abstract":"<p>During routine heart rate variability recording in an elderly male, bi-peaked R waves were recorded consistently. Initially, it was thought to be because of technical issues, which were ruled out systematically; next, it was believed to have been caused by cardiac pathology, which was evaluated using ECG and echocardiography.\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":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273056","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":"Utility of key anatomical landmarks visualization using a radiopaque tape for successful extravascular implantable cardioverter defibrillator implantation","authors":"Satoshi Oka MD, PhD,&nbsp;Mitsuru Wada MD, PhD,&nbsp;Kohei Ishibashi MD, PhD,&nbsp;Nobuhiko Ueda MD, PhD,&nbsp;Kengo Kusano MD, PhD","doi":"10.1002/joa3.70112","DOIUrl":"https://doi.org/10.1002/joa3.70112","url":null,"abstract":"<p>Radiopaque tape offers a practical and effective solution to visualize key anatomical landmarks for safe implantation of extravascular implantable cardioverter defibrillator (EV-ICD).\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":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273057","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":"Quantitative analyses of the distal bipolar electrogram for focal premature ventricular contraction ablation","authors":"Sun Young Jeong MD, MPH,&nbsp;Nigel Gupta MD,&nbsp;Zhilin Qu PhD,&nbsp;Sen Ji MD, PhD","doi":"10.1002/joa3.70103","DOIUrl":"https://doi.org/10.1002/joa3.70103","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Accurate interpretation of the distal bipolar electrogram (bi-EGM) is essential for successful ablation of idiopathic focal PVC. Sharp, early, and fractionated bi-EGM is often considered to be near-field and targeted, but in an empiric fashion rather than by quantitative criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To quantify the distal bi-EGM with five parameters to elucidate quantitative criteria distinguishing near-field from far-field bi-EGM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The distal bi-EGM was quantified and analyzed using: half time of activation (<i>t</i>_½), slope factor (<i>S</i>, derived by fitting the Boltzmann equation), linear slope (<i>dV/dt</i>), time from onset of bi-EGM to surface ECG (<i>T</i>_s) and number of deflections (<i>De</i>#).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 41 patients, 26 were ablated successfully and 15 unsuccessfully. <i>t</i>_½ and <i>S</i>, defining the sharpness of the activation process, were significantly different between the two groups (3.2 ± 0.3 vs. 5.9 ± 0.6 ms, <i>p</i> &lt; 0.001 and 0.8 ± 0.1 vs. 4.8 ± 2.0, <i>p</i> = 0.01). <i>T</i>_s was earlier in the successful group (35.6 ± 1.3 vs. 25.8 ± 1.6 ms, <i>p &lt;</i> 0.01). <i>dV/dt</i> and <i>De#</i> were not statistically different (0.2 ± 0.04 vs. 0.1 ± 0.02 mV/ms, <i>p</i> = 0.06; and 2.7 ± 0.2 vs. 2.3 ± 0.3, <i>p</i> = 0.22). The 5 parameters showed indifference across anatomic locations. AUCs of ROC curve are &gt;0.8 (<i>t</i>_½ 0.85, <i>S</i> 0.85 and <i>T</i>_s 0.87).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p><i>t</i>_½, <i>S</i> and <i>T</i>_s are precise in quantifying the sharpness and earliness of distal bi-EGM; therefore, discriminating the near-field from far-field bi-EGM for guiding successful ablation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256354","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":"Reviewer summary for journal of arrhythmia","authors":"","doi":"10.1002/joa3.70090","DOIUrl":"https://doi.org/10.1002/joa3.70090","url":null,"abstract":"<p>The Editorial Board members of the Journal of Arrhythmia are grateful to the following reviewers who provided their expertise and knowledge to the journal.</p><p>Fukaya, Hidehira</p><p>Oginosawa, Yasushi</p><p>Nishii, Nobuhiro</p><p>Inden, Yasuya</p><p>Mukai, Yasushi</p><p>Ishibashi, Kohei</p><p>Joung, Boyoung</p><p>Yoshida, Kentaro</p><p>Kaneko, Yoshiaki</p><p>Kimura, Masaomi</p><p>Morishima, Itsuro</p><p>Nakahara, Shiro</p><p>Sato, Toshiaki</p><p>Wada, Mitsuru</p><p>Aizawa, Yoshiyasu</p><p>Ching, Chi Keong</p><p>Ikeda, Yoshifumi</p><p>Arimoto, Takanori</p><p>Kataoka, Naoya</p><p>Maruyama, Mitsunori</p><p>Nakai, Toshiko</p><p>Noda, Takashi</p><p>Tsutsui, Kenta</p><p>Chen, Wei-Ta</p><p>Hasegawa, Kanae</p><p>Hayashi, Tatsuya</p><p>Irie, Tadanobu</p><p>Kuroki, Kenji</p><p>Sasaki, Shingo</p><p>Shimojo, Masafumi</p><p>Shinohara, Tetsuji</p><p>Tobiume, Takeshi</p><p>Yanagisawa, Satoshi</p><p>Ejima, Koichiro</p><p>Fukuzawa, Koji</p><p>Higa, Satoshi</p><p>Kodani, Eitaro</p><p>Mizutani, Yoshiaki</p><p>Mori, Hitoshi</p><p>Nabeshima, Taisuke</p><p>Nagashima, Koichi</p><p>Naruse, Yoshihisa</p><p>Sekihara, Takayuki</p><p>Shiga, Tsuyoshi</p><p>Sobue, Yoshihiro</p><p>Yamasaki, Hiro</p><p>Aizawa, Yoshifusa</p><p>Canpolat, Uğur</p><p>Chang, Shih-Lin</p><p>Hachiya, Hitoshi</p><p>Inoue, Koichi</p><p>Iwasaki, Yuki</p><p>Kamakura, Tsukasa</p><p>Kanzaki, Yasunori</p><p>Komatsu, Yuki</p><p>Kondo, Yusuke</p><p>Matsunaga-Lee, Yasuharu</p><p>Miyazaki, Aya</p><p>Nakatani, Yosuke</p><p>Ogawa, Masahiro</p><p>Ohe, Masatsugu</p><p>Takenaka, Sou</p><p>Yodogawa, Kenji</p><p>Yokoshiki, Hisashi</p><p>Fukunaga, Masato</p><p>Hashimoto, Kenichi</p><p>Hayashi, Kentaro</p><p>Hori, Yuichi</p><p>Kabutoya, Tomoyuki</p><p>Kajiyama, Takatsugu</p><p>Kanaoka, Koshiro</p><p>Kaneko, Shinji</p><p>Kaneshiro, Takashi</p><p>Kumagai, Koji</p><p>Masuda, Masaharu</p><p>Matsumoto, Kazuhisa</p><p>Miyamoto, Koji</p><p>Nagase, Takahiko</p><p>Nakasuka, Kosuke</p><p>Nam, Gi-Byoung</p><p>Sakamoto, Yuichiro</p><p>Takahashi, Yoshihide</p><p>Tanno, Kaoru</p><p>Tonegawa-Kuji, Reina</p><p>Ueda, Akiko</p><p>Watanabe, Atsuyuki</p><p>Yagi, Tetsuo</p><p>Yamashita, Seigo</p><p>Calvert, Peter</p><p>Fukamizu, Seiji</p><p>Furusho, Hiroshi</p><p>Hayashi, Meiso</p><p>Higuchi, Satoshi</p><p>Inaba, Osamu</p><p>Kawaji, Tetsuma</p><p>Kawakami, Hiroshi</p><p>Kawamura, Mitsuharu</p><p>Kobori, Atsushi</p><p>Kusa, Shigeki</p><p>Lau, Dennis</p><p>Mari, Amino</p><p>Matsumoto, Katsumi</p><p>Murase, Yosuke</p><p>Nagase, Satoshi</p><p>Nakajima, Ikutaro</p><p>Nakamura, Tomofumi</p><p>Oka, Takafumi</p><p>Osanai, Hiroyuki</p><p>Sasano, Tetsuo</p><p>Shimamoto, Keiko</p><p>Suzuki, Hirohiko</p><p>Suzuki, Shinya</p><p>Suzuki, Tsugutoshi</p><p>Togashi, Ikuko</p><p>Tokuda, Michifumi</p><p>Wakamiya, Akinori</p><p>Yasuoka, Ryobun</p><p>Yokoyama, Yasuhiro</p><p>Yoshiga, Yasuhiro</p><p>Amaya, Naoki</p><p>An, Yoshimori</p><p>Asano, Taku</p><p>Ashihara, Takashi</p><p>Chinushi, Masaomi</p><p>Fujiu, Katsuhito</p><p>Goto, Koji</p><p>Hara, Satoshi</p","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213793","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":"Catheter ablation of uncommon epicardial accessory pathway sites: A single-center case series","authors":"Haikal Balweel MD,&nbsp;Rifqi Rizkani Eri MD,&nbsp;Novaro Adeneur Tafriend MD,&nbsp;Sania Zahrani MD,&nbsp;Agus Harsoyo MD, PhD","doi":"10.1002/joa3.70102","DOIUrl":"https://doi.org/10.1002/joa3.70102","url":null,"abstract":"<p>Uncommon sites of epicardial accessory pathways: coronary sinus, atrial appendage, aortic cusps.\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":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144206789","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":"Temporal trends and racial disparities in atrial fibrillation ablation: A 5-year study","authors":"Daniel Antwi-Amoabeng MD, MSc,&nbsp;Bryce D. Beutler MD,&nbsp;Vijay Neelam MD,&nbsp;T. David Gbadebo MD","doi":"10.1002/joa3.70104","DOIUrl":"https://doi.org/10.1002/joa3.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Racial disparities exist in access to cardiovascular interventions, including atrial fibrillation (AF) ablation. This study evaluates trends and disparities among racial and ethnic groups in the United States over a five-year period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional analysis using the National Inpatient Sample (NIS) database from 2016 to 2020. Hospitalized AF patients undergoing ablation were identified using ICD-10 codes. Trends in ablation were assessed across racial groups, and multivariable logistic regression models were used to evaluate the predictors of cardiac ablation utilization. Time-to-ablation disparities were further analyzed using Cox proportional hazards regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>White patients had the highest ablation rates (1.08%) followed by Native Americans (1.03%), while Black patients had the lowest ablation rates (0.9%). A significant 52.6% increase in ablation utilization was observed over the study period (<i>p</i> &lt; .001), yet racial disparities remained unchanged. Black (adjusted odds ratio (aOR) 0.61, 95% CI: 0.56–0.64) and Hispanic (aOR 0.83, 95% CI: 0.77–0.88) patients had significantly lower odds of undergoing AF ablation compared to White patients. Black patients with higher comorbid disease burden, severe obesity, and protein-calorie malnutrition were less likely to have AF ablation and experienced significant wait times (additional 1.3 days) before receiving ablation in time-to-procedure analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While the overall rate of AF ablation has increased over time, persistent racial disparities in procedure utilization remain. Hospital location and bed size, socioeconomic factors, and comorbid medical conditions contribute to these disparities, underscoring the need for targeted interventions to close the gap in AF care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197483","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":"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}