Journal of Arrhythmia最新文献

{"title":"Repolarization time map in catheter ablation for scar-related reentrant ventricular tachycardia","authors":"Naoya Kataoka MD, PhD,&nbsp;Teruhiko Imamura MD, PhD, FESC, FAHA, FACC, FHFSA, FAPSC, FACP, FJCS, FJCC, FJSH,&nbsp;Takahisa Koi MD, PhD,&nbsp;Keisuke Uchida MD,&nbsp;Koichiro Kinugawa MD, PhD","doi":"10.1002/joa3.70070","DOIUrl":"https://doi.org/10.1002/joa3.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ventricular tachycardias (VTs) associated with scar tissue involve reentry mechanisms influenced by both conduction abnormalities and repolarization heterogeneity. However, existing mapping techniques have predominantly focused on conduction delay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study analyzed 33 consecutive cases of catheter ablation for sustained VT. The EnSite system was employed to measure repolarization time (RT) with a high-pass filter setting of 0.05 Hz. We compared the characteristics and concordance rates of short RT areas, defined as white or red-colored regions, with those identified through conventional mappings in relation to ablation targets. These short RT areas were defined based on the longest interval from the QRS onset to the maximal <i>dV</i>/<i>dt</i> point of unipolar potentials, which was divided into eight equal segments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 31 VTs across 26 cases, we found that 18 (58%) of the identified ablation targets corresponded to deceleration zones (DZs). Of them, 16 (89%) also overlapped with areas of short RTs. Notably, among the remaining 13 VTs without ablation targets corresponding to DZs, 9 (69%) had ablation targets located in areas with short RTs. The distribution analysis revealed that 84% of short RT regions were located near the exit site, whereas 75% of DZs were situated near the entrance site. The distance between the two was 16 mm (interquartile range: 6.5–27.5 mm).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study underscored the potential of RT mapping in identifying ablation targets in scar-related VTs. Incorporating both repolarization heterogeneity and conduction delay could significantly enhance the understanding of the intricate circuits involved in these arrhythmias.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831046","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":"Manifest type B Wolff-Parkinson-White syndrome complicated with slow/fast atrioventricular nodal reentrant tachycardia: A case report","authors":"Daiki Yamashita MD,&nbsp;Yoshihiko Kagawa MD, PhD,&nbsp;Shinichi Harada MD,&nbsp;Fumiya Uchida BHS,&nbsp;Kaoru Dohi MD, PhD","doi":"10.1002/joa3.70069","DOIUrl":"https://doi.org/10.1002/joa3.70069","url":null,"abstract":"<p>The unstable left-sided AP was a bystander in AVRT via the right-sided AP, and the right-sided AP was a bystander in AVNRT in this case. Interestingly, the right-sided AP was either part of the circuit or a bystander.\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 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831047","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 assess clinical implication of catheter ablation for ventricular tachycardia in patients with structural heart diseases","authors":"Sayaka Matsumoto,&nbsp;Naoya Kataoka MD, PhD,&nbsp;Teruhiko Imamura MD, PhD","doi":"10.1002/joa3.70064","DOIUrl":"https://doi.org/10.1002/joa3.70064","url":null,"abstract":"<p>Catheter ablation for ventricular tachycardia (VT) in patients with structural heart disease has increasingly become prevalent, primarily due to advancements in functional substrate mapping techniques. However, clinicians have expressed concern regarding potential procedure-related declines in cardiac function consequent to myocardial injury. The authors demonstrated that left ventricular ejection fraction (LVEF) remained preserved in the majority of patients postablation<span>¹</span>; nonetheless, several pertinent issues warrant consideration.</p><p>The PAINESD score serves as a valuable tool for stratifying the risk of ablation-related complications, including deterioration of cardiac function and the development of heart failure, with an LVEF of less than 25% constituting one of the key criteria.<span>²</span> In the current study, nearly half of the subjects exhibited preserved LVEF at baseline.<span>¹</span> Consequently, any minor procedural reductions in LVEF might exert minimal clinical significance within this specific subgroup. Refining their findings by excluding patients with preserved LVEF could potentially enhance the interpretability and applicability of the outcomes.</p><p>Numerous participants received comprehensive pharmacotherapy, commonly referred to as the “fantastic four” regimen.<span>¹</span> Approximately half of the participants presented with preserved LVEF. However, robust evidence supporting the necessity and efficacy of these medications in this particular population remains limited.<span>³</span> Notably, the present study identified the administration of renin-angiotensin system inhibitors as a risk factor associated with reduced cardiac function following ablation. Baseline LVEF levels may represent a confounding variable influencing this observation.</p><p>The clinical significance of observed improvements in LVEF among patients already exhibiting preserved ejection fraction remains ambiguous. Evaluating the reduction in low-voltage myocardial areas during postablation follow-up could provide critical insights into the genuine impact of catheter ablation procedures in this subset of patients.</p><p>Finally, delineating the optimal area for ablation remains a significant technical challenge. Recent literature indicates the length of VT isthmus averages approximately 17 mm,<span>⁴</span> typically necessitating only four to five ablation lesions using standard radiofrequency catheters. Such minimally invasive catheter ablation techniques theoretically minimize detrimental effects on cardiac function. Future research endeavors should focus on advancing mapping methodologies to precisely define optimal ablation targets, thereby potentially mitigating adverse effects on cardiac function.<span>⁵</span></p><p>Authors declare no conflict of interests for this article.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822218","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":"Indirect epicardial targeting of left atrial tachycardia using Bachmann's bundle: A case report of successful ablation from pulmonary artery","authors":"Yakup Yunus Yamanturk MD,&nbsp;Muhammed Emin Teker MD,&nbsp;Emre Ozerdem MD,&nbsp;Ahmet Lutfi Sertdemir MD,&nbsp;Basar Candemir","doi":"10.1002/joa3.70056","DOIUrl":"https://doi.org/10.1002/joa3.70056","url":null,"abstract":"<p>Successful rhythm control by standard endocardial methods may become quite challenging in some atrial tachycardia cases, very few of which may need extraordinarily different approaches after the initial failure of extensive endocardial ablation, such as epicardial ablation after subxiphoid puncture, or venous alcohol injection inside the vein of Marshall. With a good understanding of the structures nearby the LA, endocardially failed epicardial ATs can still be successfully ablated without directly entering the pericardial space.\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 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822214","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":"First clinical insights into pulsed field ablation for pulmonary vein stumps","authors":"Keigo Misonou MD,&nbsp;Masato Fukunaga MD,&nbsp;Jun Hirokami MD,&nbsp;Kenichi Hiroshima MD,&nbsp;Kenji Ando MD","doi":"10.1002/joa3.70067","DOIUrl":"https://doi.org/10.1002/joa3.70067","url":null,"abstract":"<p>It has been reported that pulmonary vein stumps after lung lobectomy can act as triggers for atrial fibrillation. These two cases represent the first report of successful pulmonary vein isolation by pulsed field ablation using the pentaspline catheter after pulmonary lobectomy under intracardiac echocardiography guidance.\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 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822215","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 safety and efficacy of subcutaneous implantable cardioverter-defibrillator compared with transvenous implantable cardioverter-defibrillator in propensity score-matched patients from Japan","authors":"Yuki Konno MD,&nbsp;Shingo Sasaki MD, PhD,&nbsp;Yuji Ishida MD, PhD,&nbsp;Yuichi Toyama MD, PhD,&nbsp;Kimitaka Nishizaki MD, PhD,&nbsp;Takahiko Kinjo MD, PhD,&nbsp;Taihei Itoh MD, PhD,&nbsp;Masaomi Kimura MD, PhD,&nbsp;Kazufumi Kato MD,&nbsp;Toshihiro Iwasaki MD,&nbsp;Hitoshi Umezaki MD,&nbsp;Shun Hirosawa MD,&nbsp;Hirofumi Tomita MD, PhD.","doi":"10.1002/joa3.70063","DOIUrl":"https://doi.org/10.1002/joa3.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Subcutaneous implantable cardioverter-defibrillator (S-ICD) has been reported to be non-inferior to transvenous ICD (TV-ICD) in terms of device-related complications and inappropriate shock (IAS). We aimed to evaluate the long-term clinical outcomes of S-ICD compared with TV-ICD in Japanese patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We studied 315 consecutive patients (TV-ICD, 167; S-ICD, 148) who underwent ICD implantation. A propensity score matching analysis was performed to select patient subgroups for comparison (104 patients in each group). Clinical outcomes, including appropriate and inappropriate ICD therapy, procedure- and lead-related complications, and mortality, were compared between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During follow-up (median, 1458 [interquartile range, 1353–1572] days), the cumulative incidence of appropriate shock therapy was 9.6% and 8.7% in the S-ICD and TV-ICD groups, respectively (<i>p</i> = 0.94). Although the S-ICD group tended to have a higher IAS than the TV-ICD group (5.8% vs. 1.9%), the difference was not significant (<i>p</i> = 0.19). Conversely, the cumulative incidence of procedural and lead-related complications was significantly lower in the S-ICD group (2.9% vs. 9.6%, <i>p</i> = 0.02). Notably, lead-related complications were more common in the TV-ICD group (<i>p</i> = 0.05). There was no difference in all-cause mortality between the two groups (<i>p</i> = 0.75), and heart failure exacerbation was the most common cause of death in both groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In propensity score-matched Japanese patients with S-ICD, the cumulative incidence of appropriate shock and mortality was comparable to those with TV-ICD. There was no significant difference in the rate of IAS. Notably, patients with S-ICD had fewer lead-related complications than those with TV-ICD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822217","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":"Performance of the novel ANTWERP score in predicting heart function improvement after atrial fibrillation ablation in Asian patients with heart failure","authors":"Ashfaq Ahmad,&nbsp;Mohamed Yasser El-mezayen,&nbsp;Farid Ullah,&nbsp;Javed Iqbal,&nbsp;Brijesh Sathian","doi":"10.1002/joa3.70062","DOIUrl":"https://doi.org/10.1002/joa3.70062","url":null,"abstract":"<p>I read the recent article by Ling et al.<span>¹</span> on the validation of the ANTWERP score for predicting left ventricular ejection fraction improvement after atrial fibrillation (AF) ablation in an Asian cohort of heart failure patients. The study provides meaningful information regarding risk stratification to select patients for AF ablation. However, I would like to make a few comments that may enhance its clinical applicability.</p><p>The study's retrospective design inherently raises concerns about selection bias, as patient follow-up and adherence to post-ablation management are not controlled prospectively. Such biases may affect outcome estimates and generalizability. Prospective, multicenter studies—like those suggested by Chen et al.<span>²</span> in their work on AF burden and the real-world evidence discussed by Andrade et al.<span>³</span> could help validate these findings in a more controlled setting.</p><p>While ANTWERP provides a helpful risk estimate, integrating other clinical parameters may improve prediction further. For instance, biomarkers, especially B-type natriuretic peptide and troponins, as well as sophisticated echocardiographic measures including global longitudinal strain, have emerged as promising candidates for assessing cardiac function in patients with AF.<span>⁴</span> Future studies may evaluate whether the addition of these markers would further enhance predictive accuracy when added to the ANTWERP score.</p><p>The study's exclusive focus on an Asian cohort raises important considerations regarding its applicability to other ethnic groups. Genetic and pathophysiological differences significantly influence AF progression and response to ablation, necessitating ethnicity-specific modifications. While recent work from Wong et al.<span>⁵</span> points out these differences, the importance of prospective validation in heterogeneous/ethnically diverse populations cannot be overstated, ensuring our work is relevant and can be utilized in wider clinical practice.</p><p>Furthermore, gender-difference factors related to AF, treatment response, and hormonal effects on cardiac re-modelling may also be relevant and merit future investigation.</p><p><b>Conclusion</b>: The authors' work is an important contribution to personalized medicine in the context of AF ablation for heart failure. Addressing the study's design limitations and exploring the additive value of other prognostic markers as well as confirming the score's performance in diverse populations could further enhance its clinical utility.</p><p>Authors declare no conflict of interests for this article.</p><p>The authors have nothing to disclose.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822311","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":"Pulsed-field ablation to isolate common inferior pulmonary veins in a patient with recurrent atrial fibrillation","authors":"Machiko Miyoshi MD, PhD,&nbsp;Kanae Hasegawa MD, PhD,&nbsp;Masato Shimada TR,&nbsp;Hiroshi Tada MD, PhD","doi":"10.1002/joa3.70058","DOIUrl":"https://doi.org/10.1002/joa3.70058","url":null,"abstract":"<p>This is the first report of a successful isolation of the common trunk of inferior pulmonary veins (PV) using pulsed-field ablation (PFA). PFA is easier and more reliable than conventional ablation methods for ablation in patients with PV anomalies and/or a small left atrium and for extensive ablation such as box isolation.\u0000 <figure>\u0000 <div><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801916","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 impact of very high-power-short-duration catheters on biomarkers after atrial fibrillation ablation","authors":"Andrea Bernardini MD,&nbsp;Alessandro Paoletti Perini MD, PhD,&nbsp;Cristiano Salvatore Zaccaria MD,&nbsp;Davide Ciliberti MD,&nbsp;Umberto Signorini MD,&nbsp;Francesco Grossi MD,&nbsp;Raffaele Martone MD, PhD,&nbsp;Serena Fatucchi MD,&nbsp;Alenja Bertini MD,&nbsp;Anna Arretini MD,&nbsp;Lisa Innocenti MD,&nbsp;Irene Capecchi MD,&nbsp;Margherita Padeletti MD, PhD,&nbsp;Massimo Milli MD,&nbsp;Andrea Giomi MD, PhD","doi":"10.1002/joa3.70060","DOIUrl":"https://doi.org/10.1002/joa3.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Very high-power short-duration (vHPSD) catheters are associated with less irrigation fluid load than standard (STD RF) ablation catheters. However, the impact of this fluid reduction on biomarkers in pulmonary vein isolation (PVI) for atrial fibrillation (AF) remains unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Aim</h3>\u0000 \u0000 <p>Biomarkers of heart failure, myocardial injury, and systemic inflammation status as Brain Natriuretic Peptide (BNP), high-sensitivity Troponin I (hsTnI), and C-reactive protein (CRP) were collected pre- and post-procedure of PVI for symptomatic AF. The study aimed to assess the impact of vHPSD catheter compared to an STD catheter (respectively irrigation of 8 vs. 15 mL/min during ablation) on biomarker alterations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 83 consecutive patients (59 males [71.1%], mean age 62.6 ± 11 years), with vHPSD catheters used in 53 cases (63.9%). No significant baseline differences were observed between groups.Fluid irrigation resulted in significantly lower with vHPSD catheter than STD RF (434.8 ± 105.6 vs. 806.6 ± 256.5 mL, <i>p</i> &lt; .001). Correspondingly, BNP variation was significantly lower in the vHPSD group than in the STD RF group, both in absolute change (12 [IQR −9–47] pg/mL vs. 44.5 [IQR 21–88.7] pg/mL, <i>p</i> = .002) and percentage change (16.3 [IQR −13.2–108.6] % vs. 84.1 [IQR 32.5–172.1] %, <i>p</i> = .012). When considering absolute values, a statistically significant increase in BNP was found only in the STD catheter group (from 52 [IQR 35.2–113.5] to 113 [IQR 66.7–189.5] pg/mL, <i>p</i> &lt; .001), whereas no significant increase was observed in the vHPSD group (<i>p</i> = .06). CRP levels increased post-PVI in both groups, but the delta was significantly lower in the vHPSD group (<i>p</i> = .025). No significant differences in post-procedural hsTnI were detected between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The use of a vHPSD catheter is associated with reduced fluid irrigation and a correspondingly smaller increase in BNP, a biomarker indicative of fluid overload and heart failure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801915","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":"Investigation of predictive parameters for recurrence in patients undergoing electrical cardioversion for atrial fibrillation","authors":"Levent Pay MD,&nbsp;Ozan Tezen MD,&nbsp;Tuğba Çetin MD,&nbsp;Ahmet Çağdaş Yumurtaş MD,&nbsp;Kıvanç Keskin MD,&nbsp;Şeyda Dereli MD,&nbsp;Ertan Arter MD,&nbsp;Yusuf Oflu MD,&nbsp;Faysal Şaylık MD,&nbsp;Berke Cenktug Korucu MD,&nbsp;Tufan Çınar MD,&nbsp;Mert İlker Hayıroğlu MD","doi":"10.1002/joa3.70053","DOIUrl":"https://doi.org/10.1002/joa3.70053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Electrical cardioversion (ECV) is a technique used to restore sinus rhythm in atrial fibrillation (AF), aiming to reduce AF-related symptoms. Various recurrence predictors, such as non-paroxysmal pattern, prolonged duration, chronic obstructive pulmonary disease, advanced age, or left atrial dilation, have been identified. Hence, the aim of our study was to determine the parameters that could predict AF recurrence in the long term in patients who underwent ECV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred seventy-two patients who underwent electrical cardioversion due to AF at our tertiary center were included in the study. Patients with recurrent AF after cardioversion were defined as the AF recurrence (+) group, and those with normal sinus rhythm were defined as the AF recurrence (−) group. Parameters that would predict AF recurrence were investigated between these two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AF recurrence was observed in 91 patients, while 81 patients did not experience any recurrence. The prediction model, constructed using multivariate Cox regression analysis, included six variables: non- high-density lipoprotein (HDL) cholesterol, free T3, mean corpuscular volume (MCV), left atrium anterior–posterior diameter, number of cardioversions, and oral anticoagulant use. ROC curve analysis demonstrated that our prediction model effectively distinguished between patients with arrhythmia relapse and those without, with an AUC value of 0.719 (<i>p</i> &lt; .05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study revealed that AF recurrence after ECV can be predicted by our prediction model consisting of patient characteristics, disease factors, and various biochemical parameters. The current study demonstrated a statistically significant association between the number of cardioversions and non-HDL cholesterol levels in patients with recurrent AF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749349","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}