Journal of Arrhythmia最新文献

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Use of ivabradine in children with junctional ectopic tachycardia after pediatric cardiac surgery; two-centre experience 伊伐布雷定在小儿心脏手术后结性异位心动过速中的应用two-centre经验。
IF 2.2
Journal of Arrhythmia Pub Date : 2024-10-08 DOI: 10.1002/joa3.13155
Hacer Kamali MD, Erkut Öztürk MD, Mehtap Çiftçi MD, Hasan Candas Kafali MD, Gülhan Tunca Şahin MD, Sertaç Haydin MD, Ali Can Hatemi MD, İbrahim Cansaran Tanıdır MD, Alper Güzeltaş MD, Yakup Ergül MD
{"title":"Use of ivabradine in children with junctional ectopic tachycardia after pediatric cardiac surgery; two-centre experience","authors":"Hacer Kamali MD,&nbsp;Erkut Öztürk MD,&nbsp;Mehtap Çiftçi MD,&nbsp;Hasan Candas Kafali MD,&nbsp;Gülhan Tunca Şahin MD,&nbsp;Sertaç Haydin MD,&nbsp;Ali Can Hatemi MD,&nbsp;İbrahim Cansaran Tanıdır MD,&nbsp;Alper Güzeltaş MD,&nbsp;Yakup Ergül MD","doi":"10.1002/joa3.13155","DOIUrl":"10.1002/joa3.13155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Although amiodarone is traditionally used in the treatment of postoperative junctional ectopic tachycardia (JET), the search for new treatments is ongoing. We present our experience with ivabradine at two medical centers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Between January 2022 and January 2023, patients who developed JET after pediatric cardiac surgery were prospectively followed up and documented. The diagnosis of JET was made with the support of the electrophysiology team and treatment was based primarily on whether JET disrupted hemodynamics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study was conducted at two high-volume centers, which record a total of 1130 pediatric cardiac surgeries within a year. The study recruited 26 patients with median heart rate 180 beats per minute, and 10 (38%) patients had impaired hemodynamics. Out of the 26 study participants, 14 (54%) cases were treated with ivabradine alone, 10 (38%) cases were treated with amiodarone + ivabradine, and 2 patients (8%) with high heart rates and prolonged junctional arrhythmia were treated with ivabradine and flecainide. The median time to ventricular rate control was 12 h, and the median time to sinus rhythm conversion was 55.5 h. No ivabradine-related side effects were observed in any of the patients, and no patient experienced JET recurrence after discontinuing treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Ivabradine seems to be a safe and effective medical treatment that can be used as the primary treatment in patients with stable hemodynamics, as an adjunctive therapy to amiodarone in patients with impaired hemodynamics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1473-1480"},"PeriodicalIF":2.2,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818125","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}
引用次数: 0
Editorial to “Atrial standstill in a young patient with ischemic stroke associated with inheritance of a novel HCN4 mutation” “与一种新的HCN4突变遗传相关的年轻缺血性卒中患者心房静止”的社论。
IF 2.2
Journal of Arrhythmia Pub Date : 2024-10-07 DOI: 10.1002/joa3.13164
Hidekazu Kondo MD, PhD, Naohiko Takahashi MD, PhD
{"title":"Editorial to “Atrial standstill in a young patient with ischemic stroke associated with inheritance of a novel HCN4 mutation”","authors":"Hidekazu Kondo MD, PhD,&nbsp;Naohiko Takahashi MD, PhD","doi":"10.1002/joa3.13164","DOIUrl":"10.1002/joa3.13164","url":null,"abstract":"&lt;p&gt;Abhinav et al. reported a young patient with atrial standstill who was found to have an HCN4 genetic variant.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; This is the first report of an association between HCN4 genetic variant and atrial mechanical and electrical standstill, which is very significant. Several causative genes for familial progressive cardiac conduction disease (PCCD) have been reported, including the gene they reported. As they mentioned in the discussion, the SCN5A mutation is the most well-known PCCD-causing gene. LMNA, MYH6, and TRPM4 have also been reported as PCCD-causing genes in addition to SCN5A.&lt;span&gt;&lt;sup&gt;2-4&lt;/sup&gt;&lt;/span&gt; Furthermore, Ishikawa et al. reported that sick sinus syndrome patients with HCN4 genetic variant frequently present with atrial fibrillation (AF) and left ventricular noncompaction (LVNC), which means that genetic variant of HCN4 could be a cause of PCCD; the mechanism by which HCN4 genetic variant generate such atrial and ventricular structural and electrical abnormality is still unclear. Normally, HCN4 is expressed primarily in limited regions of the cardiac conduction system, particularly in the sinoatrial node. It plays a crucial role in slow diastolic depolarization involved in automaticity. However, during the course of early embryonic development, HCN4-positive cells also have been shown to give rise to primitive heart tubes, which eventually form most of the myocytes in the left ventricle and part of the atrium of the adult heart. Ishikawa et al. indicated that the genetic variant in HCN4 may disrupt the normal differentiation of progenitor cells in the primitive heart, resulting in disturbance of structural and electrical properties of the left ventricle and both atria, which may ultimately be a substrate for the development of AF and LVNC.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; This speculation could explain how the HCN4 genetic abnormality in this case could cause structural and electrical atrial dysfunction, resulting in the phenotype of atrial standstill.&lt;/p&gt;&lt;p&gt;We were worried about the penetrance of this unique genetic variant. Multidisciplinary genetic counselling needs to be performed in order to perform genetic testing of his sister, parents, and aunt at an appropriate time, which could assist with the performance of appropriate intervention. Particularly, if the author has the opportunity to see his sister, we will encourage the authors to recommend that she should take a genetic testing along with electrocardiogram, which may help her prevent the development of new stroke at a young age.&lt;/p&gt;&lt;p&gt;If the patient has the symptoms because of chronotropic incompetence, the indication for a cardiac implantable electrical device (CIED) should be considered. However, decisions on which CIED to be implanted should be made carefully. The present case developed the atrial standstill, which limits the benefit of a dual chamber pacemaker. Since the disadvantages of ventricular lead implantation at a young age have also been propo","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1523-1524"},"PeriodicalIF":2.2,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818019","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}
引用次数: 0
2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation 2024欧洲心律协会/心律协会/亚太心律协会/拉丁美洲心律协会关于房颤导管和手术消融的专家共识声明。
IF 2.2
Journal of Arrhythmia Pub Date : 2024-10-06 DOI: 10.1002/joa3.13082
Stylianos Tzeis MD, PhD, Edward P. Gerstenfeld MD, Jonathan Kalman MD, PhD, Eduardo B. Saad MD, Alireza Sepehri Shamloo MD, Jason G. Andrade MD, Chirag R. Barbhaiya MD, Tina Baykaner MD, MPH, Serge Boveda MD, PhD, Hugh Calkins MD, Ngai-Yin Chan MD, Minglong Chen MD, Shih-Ann Chen MD, Nikolaos Dagres MD, Ralph J. Damiano MD, Tom De Potter MD, Isabel Deisenhofer MD, Nicolas Derval MD, Luigi Di Biase MD, PhD, Mattias Duytschaever MD, PhD, Katia Dyrda MD, Gerhard Hindricks MD, Meleze Hocini MD, PhD, Young-Hoon Kim MD, Mark la Meir MD, PhD, Jose Luis Merino MD, PhD, Gregory F. Michaud MD, Andrea Natale MD, Isabelle Nault MD, Santiago Nava MD, Takashi Nitta MD, PhD, Mark O’Neill MD, Hui-Nam Pak MD, PhD, Jonathan P. Piccini MD, MHS, Helmut Pürerfellner MD, Tobias Reichlin MD, Luis Carlos Saenz MD, Prashanthan Sanders MD, PhD, Richard Schilling MD, Boris Schmidt MD, Dphil, Gregory E. Supple MD, Kevin L. Thomas MD, Claudio Tondo MD, PhD, Atul Verma MD, Elaine Y. Wan MD
{"title":"2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation","authors":"Stylianos Tzeis MD, PhD,&nbsp;Edward P. Gerstenfeld MD,&nbsp;Jonathan Kalman MD, PhD,&nbsp;Eduardo B. Saad MD,&nbsp;Alireza Sepehri Shamloo MD,&nbsp;Jason G. Andrade MD,&nbsp;Chirag R. Barbhaiya MD,&nbsp;Tina Baykaner MD, MPH,&nbsp;Serge Boveda MD, PhD,&nbsp;Hugh Calkins MD,&nbsp;Ngai-Yin Chan MD,&nbsp;Minglong Chen MD,&nbsp;Shih-Ann Chen MD,&nbsp;Nikolaos Dagres MD,&nbsp;Ralph J. Damiano MD,&nbsp;Tom De Potter MD,&nbsp;Isabel Deisenhofer MD,&nbsp;Nicolas Derval MD,&nbsp;Luigi Di Biase MD, PhD,&nbsp;Mattias Duytschaever MD, PhD,&nbsp;Katia Dyrda MD,&nbsp;Gerhard Hindricks MD,&nbsp;Meleze Hocini MD, PhD,&nbsp;Young-Hoon Kim MD,&nbsp;Mark la Meir MD, PhD,&nbsp;Jose Luis Merino MD, PhD,&nbsp;Gregory F. Michaud MD,&nbsp;Andrea Natale MD,&nbsp;Isabelle Nault MD,&nbsp;Santiago Nava MD,&nbsp;Takashi Nitta MD, PhD,&nbsp;Mark O’Neill MD,&nbsp;Hui-Nam Pak MD, PhD,&nbsp;Jonathan P. Piccini MD, MHS,&nbsp;Helmut Pürerfellner MD,&nbsp;Tobias Reichlin MD,&nbsp;Luis Carlos Saenz MD,&nbsp;Prashanthan Sanders MD, PhD,&nbsp;Richard Schilling MD,&nbsp;Boris Schmidt MD, Dphil,&nbsp;Gregory E. Supple MD,&nbsp;Kevin L. Thomas MD,&nbsp;Claudio Tondo MD, PhD,&nbsp;Atul Verma MD,&nbsp;Elaine Y. Wan MD","doi":"10.1002/joa3.13082","DOIUrl":"10.1002/joa3.13082","url":null,"abstract":"<p>In the last three decades, ablation of atrial fibrillation (AF) has become an evidence-based safe and efficacious treatment for managing the most common cardiac arrhythmia. In 2007, the first joint expert consensus document was issued, guiding healthcare professionals involved in catheter or surgical AF ablation. Mounting research evidence and technological advances have resulted in a rapidly changing landscape in the field of catheter and surgical AF ablation, thus stressing the need for regularly updated versions of this partnership which were issued in 2012 and 2017. Seven years after the last consensus, an updated document was considered necessary to define a contemporary framework for selection and management of patients considered for or undergoing catheter or surgical AF ablation. This consensus is a joint effort from collaborating cardiac electrophysiology societies, namely the European Heart Rhythm Association, the Heart Rhythm Society, the Asia Pacific Heart Rhythm Society, and the Latin American Heart Rhythm Society</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1217-1354"},"PeriodicalIF":2.2,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818055","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}
引用次数: 0
Clinical outcomes during and after wearable cardioverter defibrillator use in Japanese patients with heart failure: A single-center experience 日本心力衰竭患者使用可穿戴式心律转复除颤器期间和之后的临床疗效:单中心经验
IF 2.2
Journal of Arrhythmia Pub Date : 2024-10-04 DOI: 10.1002/joa3.13158
Noriko Kikuchi MD, Tsuyoshi Shiga MD, Yohei Sugawara MD, Atsushi Suzuki MD, Yoshiaki Minami MD, Hidetoshi Hattori MD, Morio Shoda MD, Nobuhisa Hagiwara MD, Junichi Yamaguchi MD
{"title":"Clinical outcomes during and after wearable cardioverter defibrillator use in Japanese patients with heart failure: A single-center experience","authors":"Noriko Kikuchi MD,&nbsp;Tsuyoshi Shiga MD,&nbsp;Yohei Sugawara MD,&nbsp;Atsushi Suzuki MD,&nbsp;Yoshiaki Minami MD,&nbsp;Hidetoshi Hattori MD,&nbsp;Morio Shoda MD,&nbsp;Nobuhisa Hagiwara MD,&nbsp;Junichi Yamaguchi MD","doi":"10.1002/joa3.13158","DOIUrl":"10.1002/joa3.13158","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A wearable cardioverter defibrillator (WCD) is indicated for a limited period in patients at high risk of sudden cardiac death (SCD). Nonischemic heart failure (HF) is common among Japanese patients with HF. The aim of this study was to evaluate the incidence of fatal arrhythmias during WCD use and the clinical outcomes after WCD withdrawal in Japanese patients with HF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively studied 105 hospitalized HF patients who were discharged with a WCD. The main outcome was SCD/ventricular arrhythmias during WCD use and the other outcomes were implantation of an implantable cardioverter-defibrillator (ICD), SCD/ventricular arrhythmias after WCD withdrawal, and changes in left ventricular ejection fraction (LVEF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-seven (83%) patients received a WCD for primary prevention of SCD, of whom 60 (69%) were new-onset HF patients with an LVEF ≤35%. The median daily wear time was 22.1 h. Two patients experienced sustained ventricular tachycardia and one patient experienced atrioventricular block with asystole while on WCD. After WCD withdrawal, 81 (77%) patients decided not to receive ICD implantation. The percentage of patients with an LVEF ≥35% increased from 20% at baseline to 70% at 1 year after discharge. During the median follow-up of 50 months, 78 (96%) of the 81 patients who did not have an ICD were free of SCD/ventricular arrhythmias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The use of a WCD is useful for determining the appropriate indication for ICD implantation in Japanese patients with new-onset HF, a low LVEF, and a risk of SCD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1462-1472"},"PeriodicalIF":2.2,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818108","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}
引用次数: 0
The response to adenosine tells all: What is the mechanism? 对腺苷的反应告诉我们:机制是什么?
IF 2.2
Journal of Arrhythmia Pub Date : 2024-10-04 DOI: 10.1002/joa3.13154
Shu Hirata MD, Koichi Nagashima MD, PhD, Yuji Wakamatsu MD, PhD, Ryuta Watanabe MD, PhD, Yasuo Okumura MD, PhD
{"title":"The response to adenosine tells all: What is the mechanism?","authors":"Shu Hirata MD,&nbsp;Koichi Nagashima MD, PhD,&nbsp;Yuji Wakamatsu MD, PhD,&nbsp;Ryuta Watanabe MD, PhD,&nbsp;Yasuo Okumura MD, PhD","doi":"10.1002/joa3.13154","DOIUrl":"10.1002/joa3.13154","url":null,"abstract":"<p>The surface electrocardiograms during a wide QRS complex tachycardia and during the injection of 10 mg of adenosine triphosphate. What is the mechanism of this wide QRS 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":"40 6","pages":"1497-1500"},"PeriodicalIF":2.2,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818069","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}
引用次数: 0
Cost-effectiveness of Micra™ VR leadless pacemaker in patients with bradycardia and atrial fibrillation in Australia Micra™ VR 无导线起搏器在澳大利亚心动过缓和心房颤动患者中的成本效益。
IF 2.2
Journal of Arrhythmia Pub Date : 2024-09-27 DOI: 10.1002/joa3.13145
Koji Makino MCom, Mia Mudge MMedSci, Michelle Hill PhD, Chelsea Zaunmayr MPH, Dominic Tilden MPH (Hons)
{"title":"Cost-effectiveness of Micra™ VR leadless pacemaker in patients with bradycardia and atrial fibrillation in Australia","authors":"Koji Makino MCom,&nbsp;Mia Mudge MMedSci,&nbsp;Michelle Hill PhD,&nbsp;Chelsea Zaunmayr MPH,&nbsp;Dominic Tilden MPH (Hons)","doi":"10.1002/joa3.13145","DOIUrl":"10.1002/joa3.13145","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Micra™ VR Transcatheter Pacing System (Micra VR) is a single-chamber transcatheter leadless pacemaker. Absence of leads and subcutaneous pocket reduces or completely eliminates the risk of complications associated with the conventional transvenous pacemakers (TVPM). When compared with TVPM, the leadless technology provides a quicker postimplantation recovery and causes less cosmetic concerns/discomfort providing better patient experiences in the long run. We performed a modeled cost-utility analysis of Micra VR versus TVPM for the management of patients with bradycardia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We developed a Markov model comparing Micra VR to TVPM over the device battery life of 17 years. Key data inputs were drawn from the MICRA Coverage with Evidence Development (CED) study. Costs were obtained from Australian sources. The analysis is from the perspective of the Australian healthcare system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The risks of complications, including device-related events, in real-world clinical practice were relatively low for TVPM. The magnitude of cost savings arising from risk reductions provided by Micra VR was however sizable, offsetting roughly a quarter of its additional device cost. Over the 17-year model period, Micra VR was associated with an estimated incremental cost of A$4277 and an incremental quality-adjusted life years (QALYs) of 0.09 when compared with TVPM, yielding an incremental cost-effectiveness ratio of A$47 379 per QALY gain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Micra VR is likely to offer a cost-effective alternative to the conventional TVPM technology for the management of patients with bradycardia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1481-1489"},"PeriodicalIF":2.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818077","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}
引用次数: 0
Identification of regions maintaining atrial fibrillation through cycle length and cycle length gradient mapping 通过周期长度和周期长度梯度映射识别维持心房颤动的区域。
IF 2.2
Journal of Arrhythmia Pub Date : 2024-09-27 DOI: 10.1002/joa3.13151
Masafumi Shimojo M.D., Yasuya Inden M.D., Ph.D., Satoshi Yanagisawa M.D., Ph.D., Ryota Yamauchi M.D., Kei Hiramatsu M.D., Tomoya Iwawaki M.D., Masaya Tachi M.D., Shun Kondo M.D., Takayuki Goto M.D., Yukiomi Tsuji M.D., Ph.D., Toyoaki Murohara M.D., Ph.D.
{"title":"Identification of regions maintaining atrial fibrillation through cycle length and cycle length gradient mapping","authors":"Masafumi Shimojo M.D.,&nbsp;Yasuya Inden M.D., Ph.D.,&nbsp;Satoshi Yanagisawa M.D., Ph.D.,&nbsp;Ryota Yamauchi M.D.,&nbsp;Kei Hiramatsu M.D.,&nbsp;Tomoya Iwawaki M.D.,&nbsp;Masaya Tachi M.D.,&nbsp;Shun Kondo M.D.,&nbsp;Takayuki Goto M.D.,&nbsp;Yukiomi Tsuji M.D., Ph.D.,&nbsp;Toyoaki Murohara M.D., Ph.D.","doi":"10.1002/joa3.13151","DOIUrl":"10.1002/joa3.13151","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Visualizing the specific regions where atrial fibrillation (AF) is maintained is crucial for effective treatment, but it remains challenging in clinical practice. We aimed to address this challenge by developing a mapping approach focused on the cycle length (CL) and its gradient (CL-gradient).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In 105 patients undergoing initial ablation for persistent AF, pre-ablation CARTOFINDER data were utilized to create maps based on three indicators: (1) CL, the atrial frequency during AF calculated using CARTOFINDER; (2) Short CL, encompassing CLs within 5 ms of the minimum CL; and (3) CL-gradient, the CL range within a 6 mm radius. We evaluated the association between the AF termination through ablation and the measured values and patterns in each map.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AF termination occurred in 17 patients. The AF termination group exhibited the significant large maximum CL-gradient (48.8 ms [interquartile range, 38.6–66.3], <i>p</i> &lt;.001) and the short distance between the minimum CL site and the maximum CL-gradient site (15.8 mm, [interquartile range, 6.0–23.2], <i>p</i> =.029). Of the 17 AF termination cases, 13 exhibited a CL distribution pattern characterized by a steep CL-gradient near the minimum CL site (SG-MCL), defined as the distance of less than 23.2 mm and the maximum CL-gradient greater than 33.1 ms. In these AF termination cases, SG-MCL was also correlated with the ablation area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The minimum CL area accompanied by significant CL gradients in the immediate vicinity may play a crucial role in sustaining AF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1389-1399"},"PeriodicalIF":2.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818054","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}
引用次数: 0
Editorial to “The incidence and risk factors of atrial high-rate episodes in patients with a dual-chamber pacemaker” 双腔起搏器患者心房高频率发作的发生率和风险因素 "的社论。
IF 2.2
Journal of Arrhythmia Pub Date : 2024-09-23 DOI: 10.1002/joa3.13153
Kenji Yodogawa
{"title":"Editorial to “The incidence and risk factors of atrial high-rate episodes in patients with a dual-chamber pacemaker”","authors":"Kenji Yodogawa","doi":"10.1002/joa3.13153","DOIUrl":"10.1002/joa3.13153","url":null,"abstract":"&lt;p&gt;Atrial fibrillation (AF) is the most common chronic supraventricular arrhythmia, which is associated with thromboembolic complications and heart failure. The early detection of AF is important to avoid those events, but difficult particularly in patients with asymptomatic AF.&lt;/p&gt;&lt;p&gt;Recently, continuous rhythm monitoring with cardiac implantable electronic devices has been used to diagnose brief episodes of arrhythmia, including paroxysmal AF, which are recorded as atrial high-rate episodes (AHRE). A recent systematic review and meta-analysis demonstrated that the overall AHRE incidence ratio was estimated to be 17.56 cases per 100 person-years. Although AHREs were not associated with a statistically significant increased mortality risk, patients with documented AHREs were 4.45 times more likely to develop clinical AF, and were associated with a 1.90-fold increased stroke risk.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Thus, early detection of AHRE is also crucial to improve prognosis in patients with cardiac implantable electronic devices.&lt;/p&gt;&lt;p&gt;Pastori et al. evaluated 496 consecutive patients with cardiac implantable electronic devices. They found that AHRE were recorded in 173 patients, and multivariable Cox regression analysis showed that age, prior AF, white cell count, and high C reactive protein were independently associated with AHRE. However, clinical scores using age, left atrial size, renal function, ejection fraction, metabolic syndrome, and cardiomyopathy were nonsignificantly associated with AHRE. Similar results were obtained for CHADS2 and CHA2DS2VASc score.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;P-wave dispersion (PWD) is an ECG parameter and predictor of AF, which is defined as the difference between the maximum and the minimum P-wave durations detected on the body surface 12-lead ECG. Nishinarita et al. reported that PWD was an independent predictor of new-onset AHRE. They showed a greater incidence of sick sinus syndrome and longer PWD were apparent in the AHRE than non-AHRE group. In logistic regression analysis, receiver-operating characteristic curve analysis (area under the curve 0.90; &lt;i&gt;p&lt;/i&gt; &lt; .001) suggested the best cutoff value for PWD was 48 mm (sensitivity 73.8%, specificity 77.9%).&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Recently, the four-dimensional automatic LA quantitative analysis (4D Auto LAQ) technology in real-time three-dimensional echocardiography (RT-3DE) has been developed. Using this technology, Wang et al. investigated predicting factors for AHRE. Left atrial contraction longitudinal strain (LASct) obtained by the technology, body surface area (BSA), and LA end-systolic volume (LAESV) were influencing factors for AHRE. Multivariate analysis revealed that LASct was an independent risk factor for the AHRE.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;In this study, the authors examined the prevalence and risk factors associated with the occurrence of AHRE in patients with a dual-chamber pacemaker. Left ventricular global longitudinal strain (G","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1355-1356"},"PeriodicalIF":2.2,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818034","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}
引用次数: 0
Atrial standstill in a young patient with ischemic stroke associated with inheritance of a novel HCN4 mutation 一名年轻缺血性中风患者的心房停搏与新型 HCN4 突变遗传有关。
IF 2.2
Journal of Arrhythmia Pub Date : 2024-09-20 DOI: 10.1002/joa3.13150
Abhinav B. Anand PDF, DM, Bhavik S. Shah DM, Girish R. Sabnis DM, Ajay U. Mahajan DM, FESC, FACC
{"title":"Atrial standstill in a young patient with ischemic stroke associated with inheritance of a novel HCN4 mutation","authors":"Abhinav B. Anand PDF, DM,&nbsp;Bhavik S. Shah DM,&nbsp;Girish R. Sabnis DM,&nbsp;Ajay U. Mahajan DM, FESC, FACC","doi":"10.1002/joa3.13150","DOIUrl":"10.1002/joa3.13150","url":null,"abstract":"<p>We present a case of HCN4 gene mutation presenting with atrial standstill and stroke in the young.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1519-1522"},"PeriodicalIF":2.2,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818088","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}
引用次数: 0
A case of pulmonary vein reconnection after long-term success of pulmonary vein isolation for atrial fibrillation 心房颤动肺静脉隔离术长期成功后的肺静脉再连接病例。
IF 2.2
Journal of Arrhythmia Pub Date : 2024-09-19 DOI: 10.1002/joa3.13149
Kohei Ukita MD, Yasuyuki Egami MD, Yasuharu Matsunaga-Lee MD, Masamichi Yano MD, PHD, Masami Nishino MD, PHD, FACC, FESC
{"title":"A case of pulmonary vein reconnection after long-term success of pulmonary vein isolation for atrial fibrillation","authors":"Kohei Ukita MD,&nbsp;Yasuyuki Egami MD,&nbsp;Yasuharu Matsunaga-Lee MD,&nbsp;Masamichi Yano MD, PHD,&nbsp;Masami Nishino MD, PHD, FACC, FESC","doi":"10.1002/joa3.13149","DOIUrl":"10.1002/joa3.13149","url":null,"abstract":"<p>We describe a case where right superior pulmonary vein was not reconnected at the beginning of the third radiofrequency catheter ablation (RFCA) for atrial fibrillation but was reconnected at the beginning of the fourth RFCA. This is a case of pulmonary vein reconnection in the chronic phase after successful pulmonary vein isolation.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1490-1493"},"PeriodicalIF":2.2,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818057","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}
引用次数: 0
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