Journal of Arrhythmia最新文献

{"title":"Precision in Action: Using Intracardiac Echocardiography for Targeted Removal of a Large Lead-Related Vegetation in a Patient With Infective Endocarditis","authors":"Muhammad Memon,&nbsp;Mohamad Sabra,&nbsp;Arfaat A. Khan","doi":"10.1002/joa3.70192","DOIUrl":"https://doi.org/10.1002/joa3.70192","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lead-related infective endocarditis is a serious complication of implantable cardioverter-defibrillators (ICDs), especially in patients with advanced heart failure who are poor surgical candidates. Management of large lead-associated vegetations remains a clinical challenge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We present the case of a 54-year-old woman with ischemic cardiomyopathy and recurrent ICD complications who developed bacteremia and infective endocarditis with vegetations on the aortic valve and a 1.5 × 1.3 cm mass on the right ventricular lead. Given her poor surgical candidacy due to worsening heart failure, a percutaneous approach was pursued.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The patient underwent successful intracardiac echocardiography (ICE)-guided catheter-based vegetation removal using a vacuum-assisted aspiration system, followed by transvenous lead extraction. The procedure was well tolerated, and the patient demonstrated clinical improvement post intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This case illustrates the utility of ICE-guided percutaneous aspiration and lead extraction for managing large lead-related vegetations in patients with infective endocarditis who are not candidates for surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038379","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":"Low Power Long Duration Ablation for High Impedance Left Ventricular Summit PVCs","authors":"Yutsuki Tsukagoshi,&nbsp;Keijiro Nakamura,&nbsp;Shoma Kitano,&nbsp;Naohiko Sahara,&nbsp;Hidehiko Hara","doi":"10.1002/joa3.70185","DOIUrl":"https://doi.org/10.1002/joa3.70185","url":null,"abstract":"<p>Low-power, long-duration (LPLD) ablation (≤ 25 W for ≥ 60 s with 30 mL/min irrigation) was applied to high-impedance (≥ 150 Ω) left ventricular summit PVC sites via the anterior interventricular vein. Power was escalated stepwise (10 W → 12 W → 15 W → 18 W) under strict safety criteria. Computer simulations demonstrated safe lesion formation at 20 W, whereas 30 W exceeded 100°C, predicting steam-pop risk. This approach achieved 66.7% acute success without complications, highlighting LPLD as a promising option for challenging high-impedance coronary venous ablation sites.\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 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145037785","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":"Reconsidering Sex-Specific Alcohol Guidelines for Atrial Fibrillation Prevention: Caution Against Premature Policy Change","authors":"Brijesh Sathian,&nbsp;Javed Iqbal,&nbsp;Syed Muhammad Ali","doi":"10.1002/joa3.70184","DOIUrl":"https://doi.org/10.1002/joa3.70184","url":null,"abstract":"<p>Matsunaga-Lee et al. are to be congratulated on the use of a large inpatient cohort to investigate the association between alcohol consumption and atrial fibrillation risk in men and women. Their results, especially the lack of a protective low-dose threshold in men, are thought-provoking and call into question the sex-specific drinking limits suggested by present guidelines. A number of methodological issues need to be addressed before conclusions can be firmly drawn for public health policy [<span>1</span>].</p><p>First, the cross-sectional design limits causal inference by nature. Prevalent compared to incident AF, it introduces survival bias and reverse causation. AF patients might reduce alcohol consumption following diagnosis, causing misclassification of exposure, a well-recognized limitation in lifestyle-disease epidemiology [<span>2</span>].</p><p>Second, the sole use of an inpatient sample creates issues with selection bias. Populations admitted to hospital settings are systematically different from community samples regarding comorbidity profiles, health behavior, and socioeconomic status [<span>3</span>]. These differences may interact with both sex and alcohol use and skew observed relationships.</p><p>Third, the lack of beverage-type information is a substantial limitation. Previous studies have established beverage-specific relationships, with AF beer and spirits tending to show greater risk than wine even at similar ethanol doses [<span>4, 5</span>]. Given the sex-related differences in beverage choice reported in Japanese and Western cohorts, failure to adjust for beverage type has the potential to confound the seeming sex interaction.</p><p>Fourth, even though the authors accounted for important clinical covariates, residual confounding is still possible. Important covariates like smoking, physical activity, socioeconomic status, and biomarkers (e.g., NT-proBNP, CRP) were not available. Without them, it is not easy to rule out other explanations for the observed association between low-level alcohol consumption and AF in men.</p><p>Lastly, the analysis seems to interpret the observed sex interaction as evidence of harmonious alcohol limits between the sexes at ≤ 20 g/day. Although this is an interesting hypothesis, it is too early on the basis of the study's design and the potential for differential misclassification by sex in self-reported alcohol consumption [<span>6</span>]. Prospective, population-based research with repeated, validated exposure measures is required to support these trends prior to updating national guidelines. Future studies should examine beverage types to determine whether some drinks are disproportionately linked to AF risk in both sexes, as well as cross-national comparisons to capture cultural and genetic variations. Stronger evidence for improving sex-specific guidelines would come from such methods.</p><p>In conclusion, Matsunaga-Lee et al. offer useful data, but the design, sampling, and exposure","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70184","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022265","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":"Right Atrial Ablation for Premature Ventricular Contractions Originating From the Posterior-Superior Process of the Left Ventricle: A Novel Therapeutic Approach","authors":"Yuki Kato,&nbsp;Yuichiro Sagawa,&nbsp;Kazuya Murata,&nbsp;Tetsuo Sasano,&nbsp;Yasuteru Yamauchi","doi":"10.1002/joa3.70186","DOIUrl":"https://doi.org/10.1002/joa3.70186","url":null,"abstract":"<p>We experienced a case of premature ventricular contractions originating from the posterior-superior process of the left ventricle that was successfully ablated from the right atrium where the A/V ratio was 5:1.\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 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012813","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":"Late Dislodgement of a Leadless Pacemaker: Potential Role of Impedance Decline as an Early Warning Sign","authors":"Toshihiko Goto,&nbsp;Masashi Yokoi,&nbsp;Kento Mori,&nbsp;Yoshihiro Seo","doi":"10.1002/joa3.70187","DOIUrl":"https://doi.org/10.1002/joa3.70187","url":null,"abstract":"<p>Pacing impedance declined rapidly 1 week after implantation, followed by a significant increase in threshold at the 2-week follow-up, resulting in pacing failure.\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 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70187","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012814","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":"Not Premature to Quantitatively Define the Near-Field Bipolar Electrogram for Premature Ventricular Contraction Ablation","authors":"Sen Ji,&nbsp;Nigel Gupta,&nbsp;Zhilin Qu","doi":"10.1002/joa3.70183","DOIUrl":"https://doi.org/10.1002/joa3.70183","url":null,"abstract":"<p>We are writing you to express our appreciation of the strong interest in our recent paper published in the <i>Journal</i> “Quantitative analyses of the distal bipolar electrogram for focal premature ventricular contractions [<span>1</span>]”, submitted by Sathian et al. [<span>2, 3</span>] in letters to the editor. We value their thoughtful opinions, many of which we have shared in the section of limitations of the study. However, some other critics are worthy of discussion.</p><p>Our study attempts to quantify the bipolar EGM numerically; undoubtedly, it is an overdue study moving forward from the long-held empirical approaches. Among the 5 parameters we have used, three (i.e., half time of the activation, <i>t</i>_½, slope factor obtained by fitting the Boltzmann equation, <i>S</i>, and time to the surface QRS, <i>T</i>_s) showed excellent performance in distinguishing the near-field bi-EGM from the far-field. These 3 parameters quantify the sharpness and the earliness of the bi-EGM—quantitative but consistent with the empirical approach we and other labs have been using in daily practice. Certainly, the performance of these parameters needs to be further validated with prospective multi-center studies. Thank you to the authors for supporting that idea.</p><p>When it comes to unipolar vs. bipolar mapping (uni- and bi-EGM), the experience of many years seems telling us that the uni-EGM helps us “get to the door, not into the house”. We certainly use uni-EGM embedded in commercial mapping software, as stated in the Methods section, to guide us for the initial localization of PVC foci. But uni-EGM appears to have a few intrinsic short comes to pin down the precise focus: (1) the “large bipolar nature” of the uni-EGM clearly falls short in distinguishing the difference of EGM at the millimeter scales; and (2) it is location-dependent, more useful at the sites where propagation of the activation wave front is rather uni-directional, such as bypass tract insertion site at the atrioventricular annuli and PVCs at the free wall (e.g., the free wall of the tricuspid/mitral annulus and the ventricular outflow tract), but not so at the sites where the propagation of the wave front is 4-directional, such as scar VT circuit or PVCs deeper embedded. The usefulness of the two has long been debated, that is beyond the scope of our current study. We consider that they are complementary, with the approach we proposed in Methods section [<span>1</span>].</p><p>For fractionation and successful ablation, it was a surprise to us that the fraction was not predictive for success in ablating focal PVCs as it has been long used in this setting. However, physiologically, it does make sense if the concept of that focal PVC is due to localized triggered activity or increased automaticity is correct [<span>4</span>]. Certainly, it needs further validation and more precise quantification such as frequency analyses. Additionally, our unpublished observat","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923331","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":"Revisiting Cryoablation for AVNRT: A Commentary on Safety, Recurrence, and Clinical Implications","authors":"Zubair Ahmed,&nbsp;Falak Naz,&nbsp;Muhammad Umar,&nbsp;Syed Ibad Ali,&nbsp;Fatima Laique","doi":"10.1002/joa3.70170","DOIUrl":"https://doi.org/10.1002/joa3.70170","url":null,"abstract":"<p>The article by Tachibana et al. [<span>1</span>] presents a comparative analysis of cryoablation versus radiofrequency ablation (RFA) in the context of the incidence of atrioventricular block (AVB) during slow pathway modification for atrioventricular nodal reentrant tachycardia (AVNRT). The attempt to compare the safety dynamics of the two ablation techniques is appreciable, particularly in the context of preserving AV nodal function, which is one of the major concerns in the treatment of AVNRT.</p><p>However, some methodological and interpretive aspects need to be explained further. Firstly, while the study reports a significantly higher incidence of transient AVB in the cryoablation group (24.1% vs. 6.4%, <i>p</i> &lt; 0.01), the authors state that cryoablation is safer due to its reversibility and the gradual development of AV conduction issues. However, the high rate of AVB events in the cryoablation group is a concern regarding procedural stability and real-time safety during the ablation procedures undertaken in proximity to the compact atrioventricular node, particularly in those with smaller Koch's triangles [<span>2</span>].</p><p>Second, although the later onset of atrioventricular block (AVB) following cryoablation (mean to AVB 6.6 ± 3.7 s) compared with radiofrequency ablation (RFA) (1.2 ± 0.3 s) is an intriguing observation, it is not clearly indicated how such a finding relates in particular to effective risk reduction or improved operator response. Although the potential for earlier detection to be beneficial with delayed evolution is attractive, unless supported by active procedural monitoring strategies, this benefit remains theoretical [<span>3</span>].</p><p>Third, AVNRT recurrence was more prevalent in the cryo group (9.5% vs. 3.4%, <i>p</i> &lt; 0.01) and challenges the precept of cryoablation's long-term effectiveness. The recurrence could be due to both lesion longevity and operator familiarity with ablation near the His bundle. The greater number of lesions ablated above the CS ostium in the cryo group lends support to this issue but is not addressed in detail. In addition, the research lacks adequate commentary on patient anatomy, lesion depth, or cooling dynamics, all of which are critical in the interpretation of energy delivery strategy results. Previous research has associated suboptimal cryo lesion formation with higher recurrence rates, especially in cases with delayed cooling or shallow lesion depth, issues that were not explored in this study.</p><p>Lastly, even though cryoablation showed no instances of permanent AVB in this cohort, the brief follow-up (median 221 days) and small sample size rule out conclusions about long-term AV nodal safety. Since certain AV nodal injuries may be delayed in presentation, longer follow-up and larger prospective trials would be required to confirm these results.</p><p>In conclusion, although the study indicates potential procedural safety of cryoablation in preventing perman","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70170","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144897810","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":"Efficacy and Safety of Second Sessions of Catheter Ablation for Idiopathic Premature Ventricular Contractions: From the Nationwide Japan Catheter Ablation Registry","authors":"Kentaro Goto,&nbsp;Shinsuke Miyazaki,&nbsp;Reina Tonegawa-Kuji,&nbsp;Koshiro Kanaoka,&nbsp;Seigo Yamashita,&nbsp;Tetsuo Sasano,&nbsp;Yoshitaka Iwanaga,&nbsp;Michikazu Nakai,&nbsp;Koichi Inoue,&nbsp;Yu-Ki Iwasaki,&nbsp;Koichi Nagashima,&nbsp;Kohki Nakamura,&nbsp;Masaharu Masuda,&nbsp;Koji Miyamaoto,&nbsp;Kazuhiro Satomi,&nbsp;Seiji Takatsuki,&nbsp;Kengo Kusano,&nbsp;Teiichi Yamane,&nbsp;Wataru Shimizu","doi":"10.1002/joa3.70181","DOIUrl":"https://doi.org/10.1002/joa3.70181","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The efficacy and safety of second catheter ablation (CA) sessions for idiopathic premature ventricular contractions (PVCs) from the same origin as the initial session remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>We analyzed 138 patients (median age 55 [43–68] years; 74 males [53.6%]) who underwent second CA sessions for idiopathic PVCs from the same origin category, using the Japanese Catheter Ablation Registry data collected between August 2017 and December 2020. PVC origins included 77 from the right ventricular outflow tract (RVOT) (55.8%), 8 from other right ventricular (RV) origins (5.8%), 23 from the left ventricular outflow tract (LVOT) (16.7%), and 30 from other left ventricular (LV) origins (21.7%). Acute success was achieved in 114 patients (82.6%), with significant variations by origins (RVOT: 83.1%, other RV: 75.0%, LVOT: 76.9%, other LV: 90.0%; <i>p</i> &lt; 0.01). In-hospital recurrence despite acute success occurred in 6 patients (5.3%), most frequently in other RV and LVOT sites. Success at discharge cases included more females (57.4% vs. 40.0%; <i>p</i> = 0.04) and were treated at higher-volume centers (median 304 vs. 234 cases/year; <i>p</i> &lt; 0.01). No significant predictors of success at discharge were identified in univariable or multivariable analyses. One patient (0.7%) experienced a cardiac tamponade.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Second CA sessions for idiopathic PVCs are generally safe and effective. However, additional efforts are needed to improve the LVOT and other RV origin efficacy.</p>\u0000 \u0000 <p><b>Trial Registration:</b> The J-AB registry has been registered in both the UMIN Clinical Trial Registry (UMIN000028288) and ClinicalTrials.gov (NCT03729232).</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70181","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144894302","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":"Automated Assessment to Predict Lethal Arrhythmias in Brugada Syndrome: Significance of R' in Lead III","authors":"Daiki Shako,&nbsp;Satoshi Nagase,&nbsp;Naoya Kataoka,&nbsp;Toshihiro Nakamura,&nbsp;Satoshi Oka,&nbsp;Yuichiro Miyazaki,&nbsp;Akinori Wakamiya,&nbsp;Kenzaburo Nakajima,&nbsp;Nobuhiko Ueda,&nbsp;Tsukasa Kamakura,&nbsp;Mitsuru Wada,&nbsp;Kohei Ishibashi,&nbsp;Yuko Inoue,&nbsp;Koji Miyamoto,&nbsp;Takeshi Aiba,&nbsp;Kengo Kusano","doi":"10.1002/joa3.70166","DOIUrl":"https://doi.org/10.1002/joa3.70166","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous investigations of predictors of sudden cardiac arrest (SCA) in Brugada syndrome (BrS) have been conducted using manual electrocardiogram (ECG) measurement, which lacks objectivity. This study aimed to examine predictive factors for SCA in BrS using automated ECG measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In 270 patients with BrS, ECGs were recorded using the same electrocardiograph when a Type 1 ECG was initially observed. The data were digitally acquired and analyzed using identical software. Right precordial leads in the upper one and two intercostal spaces were recorded in all patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a median follow-up of 88 months, 28 patients (10%) experienced SCA. Multivariate analysis showed that a history of SCA, history of syncope, R' duration ≥ 18 ms in lead III, and maximum corrected Tpeak-end interval ≥ 137 ms in right precordial leads were independent predictors of SCA. To simplify clinical verification, the presence of an R' wave in lead III was used as a cut-off surrogate. Visual evaluation confirmed that this R' wave remained an independent predictor of SCA in multivariate analysis. All seven patients with BrS who underwent epicardial mapping had fragmented potential at the base of the right ventricular inferior/inferolateral wall. This area corresponded to the most inferior and right-sided region of the ventricle, suggesting lead III may best reflect this region.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Automated ECG measurement revealed that an R' duration ≥ 18 ms in lead III predicted SCA in patients with BrS. Visual assessment also identified the R' wave in lead III as a novel predictor of SCA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70166","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144894304","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":"Optimization of Coronary Sinus Pacing Site Based on Cardiac Contractility Detected by a Right Atrial Lead–Embedded Accelerometer","authors":"Kosuke Muto,&nbsp;Yoshifumi Ikeda,&nbsp;Hitoshi Mori,&nbsp;Ritsushi Kato","doi":"10.1002/joa3.70182","DOIUrl":"https://doi.org/10.1002/joa3.70182","url":null,"abstract":"<p>A narrow QRS duration does not necessarily correlate with a high SonR value. To identify the optimal pacing site, comprehensive evaluation of all available parameters, including the use of MPP, may be necessary.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70182","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144894303","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}