Journal of Arrhythmia最新文献

{"title":"Editorial to “Efficacy and safety of pulsed-field versus conventional thermal ablation for atrial fibrillation: A systematic review and meta-analysis”","authors":"Kenji Kuroki MD, Akira Sato MD","doi":"10.1002/joa3.13138","DOIUrl":"https://doi.org/10.1002/joa3.13138","url":null,"abstract":"<p>We express our gratitude to Amin et al.<span><sup>1</sup></span> for their systematic review and meta-analysis comparing the efficacy and safety of pulsed field ablation (PFA) versus conventional thermal ablation (TA) for atrial fibrillation (AF). Pulsed field ablation represents an innovative energy source in ablation therapy, employing ultra-short pulse direct current to induce cell death via electroporation, creating pores in the cell membrane. This method offers several distinct advantages: (1) selectivity for cardiac tissue over other tissues such as nerves, smooth muscle, or red blood cells; (2) effectiveness dependent on electrode proximity to tissue, favoring deep lesions without requiring strong contact force; and (3) nonthermal mechanism, minimizing inflammation and being unaffected by blood flow cooling. These unique features suggest that PFA may offer safer ablation energy compared with TA, potentially enhancing efficacy by enabling more effective energy delivery. Despite accumulating clinical evidence of PFA, most studies remain single-arm or retrospective with limited sample sizes. Therefore, Amin et al.'s meta-analysis provides crucial insights into comparing the safety and efficacy of PFA versus TA.</p><p>In their study, Amin et al. analyzed 17 studies encompassing 2255 patients, focusing on AF recurrence and all atrial arrhythmia recurrence (AF, atrial tachycardia [AT], and atrial flutter [AFL]) separately during the follow-up. They found PFA was significantly reduced AF recurrence but did not show a significant difference in all atrial arrhythmia recurrence, potentially indicating higher recurrence of AT or AFL with PFA. Discussions by the authors suggested that extensive PVI using PFA might inadvertently create channels in the left atrial posterior wall, facilitating roof-dependent atrial tachycardia. Kawamura et al.<span><sup>2</sup></span> demonstrated that there was no significant difference between the PFA and TA cohorts in the nonablated posterior wall area, though the PFA cohort (<i>n</i> = 17) had a larger isolation area than radiofrequency ablation cohort (<i>n</i> = 17) in the left inferior pulmonary vein in the propensity score-matched analysis. This potential arrhythmogenic effect warrants further investigation using more larger cohorts.</p><p>Regarding complications, Amin et al. observed significantly fewer instances of phrenic nerve palsy and esophageal lesions with PFA, attributed to its tissue selectivity. However, they also noted an increased incidence of pericardial tamponade, which may partly stem from initial operator inexperience with PFA devices. If the rate of tamponade decreases, as more operators become accustomed to PFA devices in the near future, it would prove that operators' inexperience was the true reason. In fact, such a trend has already begun to emerge in a registry trial.<span><sup>3</sup></span> The MANIFEST-PF registry (<i>n</i> = 1568, initial experience of the MANIFEST-17 K registry), pu","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.13138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435764","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":"Editorial comments to “Increased interleukin-6 levels are associated with atrioventricular conduction delay in severe COVID-19 patients”","authors":"Bonpei Takase MD, PhD,&nbsp;Nobuyuki Masaki MD, PhD","doi":"10.1002/joa3.13135","DOIUrl":"https://doi.org/10.1002/joa3.13135","url":null,"abstract":"<p>Many cardiovascular diseases including atherosclerotic ischemic heart diseases, chronic heart failure, and cerebrovascular disorders are associated with chronic and acute inflammatory activation.<span>^{1, 2}</span> In mechanisms of developing arrhythmias, inflammation has recently been reported as one of the important pathogenic factors. In this important and a novel finding has also been recognized as the mechanism of rhythm disturbance complicated with COVID-19 infection.<span>³</span> Especially, Interleukin-6 has been focused because of possible influence to gap junction of connexin 40 or 43 which is important for the maintenance of normal heart rhythms.<span>^{4, 5}</span> In current issue of this journal, Accioli et al.<span>¹</span> reported the important role of Interleukin-6 of COVID-19 infection. The study is <i>for the first time</i> conducting prospective study on the role of Interleukin-6 for developing atrioventricular conduction disturbance, even if the numbers of study population was small of 33 patients. Since development of heart rhythm disturbance in patients of COVID-19 is sign for untoward outcome of COVID-19, clarifying the mechanism of atrioventricular conduction disturbance and founding Interleukin-6 possibly become treatment target is very important for treatment of long COVID-19 and severe COVID-19 patients. In this aspect, Accioli et al.'s findings should be confirmed in larger cohort.</p><p>Besides, COVID-19 infection, Interleukin-6 levels could be related with pathogenesis of HFpEF patients<span>²</span> or other cardiovascular disorders so that Accioli et al. study could be incentive for further advance in the research of the role of Interleukin-6 in the field of arrhythmia disease other than atrioventricular conduction disturbance.</p><p>Authors declare no conflict of interests for this article.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.13135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435837","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":"Transvenous extraction and reimplantation procedures for quadripolar left ventricular leads with an active fixation side helix","authors":"Takehiro Nomura MD,&nbsp;Tsuyoshi Isawa MD,&nbsp;Shigeru Toyoda MD, PhD,&nbsp;Kennosuke Yamashita MD, PhD, FJCC, FACC, FHRS,&nbsp;Taku Honda MD","doi":"10.1002/joa3.13134","DOIUrl":"https://doi.org/10.1002/joa3.13134","url":null,"abstract":"<p>Five ASQ extraction cases from our hospital were showed in this list. All leads were completely removed and there were no serious complications. Laser sheaths were used in four of the five cases. In cases 2 and 4, LV leads were successfully reimplanted after the removal of the ASQ, and the original target branches where the ASQ had been implanted remained patent.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.13134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435862","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":"Editorial to “Acute occlusion of the left main coronary artery following impedance rise after high-frequency catheter ablation”","authors":"Wei-Ta Chen MD, PhD","doi":"10.1002/joa3.13136","DOIUrl":"https://doi.org/10.1002/joa3.13136","url":null,"abstract":"&lt;p&gt;In this issue, Takafumi Koyama presented a case of frequent premature ventricular complexes (PVC).&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The authors performed radiofrequency ablation (RFA) for the PVCs near the left coronary cusp with an irrigated ablation catheter. The catheter impedance increased suddenly during ablation and the patient encountered acute left coronary artery occlusion. The situation was solved by coronary artery stenting and repeated balloon dilation.&lt;/p&gt;&lt;p&gt;Catheter impedance is a dynamic value that reflects the electrical resistance between the catheter tip and the surrounding tissue. As radiofrequency energy is delivered, the tissue adjacent to the catheter tip heats up. This heat causes changes in the tissue's electrical properties, leading to a decrease in impedance.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; A gradual decrease in impedance typically indicates effective tissue heating and lesion formation. However, abrupt changes in impedance can indicate several clinical situations. Steam pop, catheter movement, catheter fracture, tissue charring, and entry into a small vessel are conditions with sudden increase in catheter impedance. On the contrary, catheter tip erosion and tissue penetration may lead to a sudden drop in catheter impedance.&lt;/p&gt;&lt;p&gt;The type of catheter used, irrigated or nonirrigated, can also influence impedance measurements. Nonirrigated catheters rely solely on the conductive properties of the tissue for heat dissipation. As the tissue heats up, impedance tends to decrease more rapidly with irrigated catheters. There is a higher risk of steam pops and tissue damage due to the lack of cooling. For the irrigated catheters, the continuous saline delivery cools the area and improves heat dissipation. This results in a slower rate of impedance decrease. The risk of steam pops and tissue damage is reduced because of the cooling effect. While irrigated catheters generally provide better control over tissue temperature, impedance monitoring remains crucial for both types of catheters to optimize ablation and prevent complications.&lt;/p&gt;&lt;p&gt;In the presented case, the RFA was performed in the aorta near the left coronary artery ostium. During RFA, the catheter impedance once suddenly increased. The condition may indicate a catheter moving from the aorta into the coronary artery. Coronary arteries have a significantly lower blood flow rate compared with the aorta. This change in blood flow directly impacts the catheter's electrical environment. The narrower diameter of the coronary artery also leads to a smaller contact area between the catheter and the vessel wall. This reduced contact area alters the electrical properties of the system. The tissue composition of coronary arteries differs from that of the aorta, further influencing the electrical conductivity.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;\u0000 &lt;/p&gt;&lt;p&gt;When performing RFA near the coronary cusps, the rapid impedance increase serves as a strong indicator that the catheter has entered a coronar","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.13136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435771","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":"Paradoxical response during Para-Hisian pacing in a case with fasciculo-ventricular pathway: What is the mechanism?","authors":"Debabrata Bera DM,&nbsp;Calambur Narasimhan,&nbsp;Sanjeev S Mukherjee,&nbsp;Ayan Kar DNB,&nbsp;Joyanta Ghosh DM","doi":"10.1002/joa3.13133","DOIUrl":"https://doi.org/10.1002/joa3.13133","url":null,"abstract":"<p>Causes of paradoxical response include Pure His capture and inadvertent intermittent direct atrial capture. In the index case , we postulate that the likely mechanism of paradoxical prolongation could be due to decrement in the AV node due to the shortening of HH interval which happened as a result of a narrower H + Vc beat <i>following a wider Vc beat during decremetal pacing output</i>.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.13133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435892","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":"Validation of ablation site classification accuracy and trends in the prediction of potential reconnection sites for atrial fibrillation using the CARTONET® R12.1 model","authors":"Wataru Sasaki MD,&nbsp;Naomichi Tanaka MD, PhD,&nbsp;Kazuhisa Matsumoto MD, PhD,&nbsp;Daisuke Kawano MD,&nbsp;Masataka Narita MD,&nbsp;Tsukasa Naganuma MD,&nbsp;Kenta Tsutsui MD, PhD,&nbsp;Hitoshi Mori MD, PhD,&nbsp;Yoshifumi Ikeda MD, PhD,&nbsp;Takahide Arai MD, PhD,&nbsp;Kazuo Matsumoto MD, PhD,&nbsp;Ritsushi Kato MD, PhD","doi":"10.1002/joa3.13131","DOIUrl":"https://doi.org/10.1002/joa3.13131","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>CARTONET® enables automatic ablation site classification and reconnection site prediction using machine learning. However, the accuracy of the site classification model and trends of the site prediction model for potential reconnection sites are uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We studied a total of 396 cases. About 313 patients underwent pulmonary vein isolation (PVI), including a cavotricuspid isthmus (CTI) ablation (PVI group) and 83 underwent PVI and additional ablation (i.e., box isolation) (PVI+ group). We investigated the sensitivity and positive predictive value (PPV) for automatic site classification in the total cohort and compared these metrics for PV lesions versus non-PV lesions. The distribution of potential reconnection sites and confidence level for each site was also investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 29,422 points were analyzed (PV lesions [<i>n</i> = 22 418], non-PV lesions [<i>n</i> = 7004]). The sensitivity and PPV of the total cohort were 71.4% and 84.6%, respectively. The sensitivity and PPV of PV lesions were significantly higher than those of non-PV lesions (PV lesions vs. non-PV lesions, %; sensitivity, 75.3 vs. 67.5, <i>p</i> &lt; .05; PPV, 91.2 vs. 67.9, <i>p</i> &lt; .05). CTI and superior vena cava could not be recognized or analyzed. In the potential reconnection prediction model, the incidence of potential reconnections was highest in the posterior, while the confidence was the highest in the roof.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The automatic site classification of the CARTONET®R12.1 model demonstrates relatively high accuracy in pulmonary veins excluding the carina. The prediction of potential reconnection sites feature tends to anticipate areas with poor catheter stability as reconnection sites.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.13131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435400","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":"Microporous polysaccharide hemospheres for reducing pocket hematomas after cardiac device implantation in patients on antithrombotic therapy","authors":"Yuko Matsui MD,&nbsp;Satoshi Higuchi PhD,&nbsp;Fumiaki Mori PhD,&nbsp;Kao Takehisa MD,&nbsp;Kensuke Kikuchi MD,&nbsp;Haruka Kikuchi MD,&nbsp;Kohei Hirobe MD,&nbsp;Ryozo Maeda MD,&nbsp;Kei Tsukamoto PhD,&nbsp;Takashi Saito MD,&nbsp;Morio Shoda PhD,&nbsp;Junichi Yamaguchi PhD","doi":"10.1002/joa3.13130","DOIUrl":"https://doi.org/10.1002/joa3.13130","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Various surgical procedures have employed microporous polysaccharide hemosphere (MPH) hemostatic agents. However, data regarding their effectiveness in preventing pocket hematomas (PHs) during the implantation of cardiac implantable electronic devices (CIED) among the Asian population are limited. Therefore, this study aimed to investigate the potential benefits of using MPH hemostatic agents during CIED implantations as a preventive measure against post-procedural PHs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective, single-center, observational study involving 255 consecutive Japanese patients who underwent CIED implantation between November 2017 and April 2021. We compared PH occurrences within 28 days after CIED implantation between patients who received MPH hemostatic agents (<i>n</i> = 145) and those who did not (<i>n</i> = 110).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PH development was observed in nine (6.2%) patients who received MPH hemostatic agents and in 13 (11.8%) patients without MPH hemostatic (<i>p</i> = .111). Kaplan–Meier analysis of PH development revealed no significant difference between the two groups (log-rank <i>p</i> = .102). However, utilizing MPH hemostatic agents among patients taking antithrombotic drugs, including antiplatelet medications, direct oral anticoagulants, and warfarin, significantly reduced PH incidence (log-rank <i>p</i> = .03). The multivariate Cox proportional hazards model demonstrated that MPH hemostatic agent utilization independently correlated with a decreased PH risk (hazard ratio 0.22, 95% confidence interval 0.08–0.63, <i>p</i> = .004).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings of this study suggest that the incorporation of MPH hemostatic agents into standard practice may benefit to mitigate PH risk during CIED implantations in patients on antithrombotic therapy. This simple and practical measure may be valuable, especially in high-risk patients, such as those taking antithrombotic medications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.13130","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435414","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":"Editorial to “Acute occlusion of the left main coronary artery following impedance rise after high-frequency catheter ablation”: Prepare for a disastrous matter in the EP laboratory","authors":"Satoshi Higa MD, PhD, FHRS","doi":"10.1002/joa3.13132","DOIUrl":"https://doi.org/10.1002/joa3.13132","url":null,"abstract":"&lt;p&gt;In this issue of the &lt;i&gt;Journal of Arrhythmia&lt;/i&gt;, Koyama et al.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; reported a case of frequent premature ventricular contractions complicated with a left main coronary artery (LMCA) occlusion post-ablation in the left coronary cusp (LCC). Although they emergently performed angioplasty and implanted a drug-eluting stent, coronary angiography showed a 99% in-stent acute stenosis requiring repeat balloon dilatations. Intravascular ultrasound (IVUS) revealed intimal thickening and tissue protrusion within the stent. Finally, the in-stent restenosis completely resolved after additional balloon dilatations. The patient was successfully weaned from assisted circulation and was discharged on postoperative Day 7. During a 6-year long-term follow-up, the patient remained free of stent restenosis.&lt;/p&gt;&lt;p&gt;Current guidelines provide enough evidence of highly successful outcomes with overall cure rates of catheter ablation of idiopathic ventricular arrhythmias (VAs) and propose as a first-line therapy. However, successful ablation cannot be obtained in some populations due to anatomic limitations. For this particular reason, one of the most challenging issues that physicians may encounter in the EP laboratory is the approach to VAs originating from the left ventricular summit (LVS). Highly variable complex anatomies between the LVS and neighboring structures emphasizes the importance of a detailed characterization of the individual anatomy of this region and the use of 3D-anatomical reconstructions using image integration of ICE (intracardiac echocardiography) or a computed tomography for precise and safe mapping and ablation procedures. Although, the LVS can be accessed directly via an epicardial approach, the approach to this superior region usually is very limited due to the close proximity to the LMCA and thick fat layer. Practically, VAs originating from the epicardial aspect of the LVS can be targeted from the anterior interventricular vein (AIV)/great cardiac vein (GCV). On the other hand, the endocardial to intramural aspect of the LVS can be approached from the LCC, left ventricular outflow tract (LVOT) endocardium, or right ventricular outflow tract (RVOT) septal side. Due to the close proximity of multiple structures and nature of the preferential conduction around this region, the pace mapping method's efficacy for localizing VA origins may be poor. Therefore, activation mapping during spontaneous VAs is mandatory for localizing VA origins. In general, an earlier activation time in the distal GCV or proximal AIV than other sites within the RV/LVOT suggests epicardial LVS VAs. Regarding the ECG characteristics of the author's case, the previous algorithm using the aVL/aVR Q-wave ratio for LVS VAs supports a GCV/AIV region.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Furthermore, finding an earlier ventricular activation time preceding the QRS onset and unipolar electrogram morphology with a QS pattern also suggest a GCV/AIV origin. For more ac","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.13132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435146","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":"Antithrombotic management in atrial fibrillation patients following percutaneous coronary intervention: A clinical review","authors":"Yuichi Saito MD,&nbsp;Yoshio Kobayashi MD","doi":"10.1002/joa3.13128","DOIUrl":"10.1002/joa3.13128","url":null,"abstract":"<p>Patients with atrial fibrillation (AF) often develop acute coronary syndrome and undergo percutaneous coronary intervention (PCI), and vice versa. Acute coronary syndrome and PCI mandate the use of dual antiplatelet therapy, while oral anticoagulation is recommended in patients with AF to mitigate thromboembolic risks. Clinical evidence concerning antithrombotic treatment in patients with AF and PCI has been accumulated, but when combined, the therapeutic strategy becomes complex. Although triple therapy, a combination of oral anticoagulation with dual antiplatelet therapy, has been used for patients with AF undergoing PCI as an initial antithrombotic strategy, less intensive regimens may be associated with a lower rate of bleeding without an increased risk in thrombotic events. This narrative review article summarizes currently available evidence of antithrombotic therapy in patients with AF undergoing PCI.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.13128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141925840","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":"Atypical atrial resetting with ventricular extrastimulus during tachycardia: What is the mechanism?","authors":"Takashi Kobari MD,&nbsp;Yoshiaki Kaneko MD,&nbsp;Shuntaro Tamura MD,&nbsp;Hiroshi Hasegawa MD,&nbsp;Yosuke Nakatani MD","doi":"10.1002/joa3.13126","DOIUrl":"https://doi.org/10.1002/joa3.13126","url":null,"abstract":"<p>This atypical atrial resetting with ventricular extrastimulus delivered during supraventricular tachycardia is characterized by no capture of local ventricular deflection contralateral to the earliest atrial site and is a finding unmasking the presence of a nodoventricular pathway, the ventricular insertion of which is located apically, away from the mitral annulus.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.13126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435165","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}