Journal of Arrhythmia最新文献

{"title":"A simplified, fluoroless workflow for atrial fibrillation pulsed field electroporation","authors":"William K. Chan MD,&nbsp;Umjeet S. Jolly MD","doi":"10.1002/joa3.70057","DOIUrl":"https://doi.org/10.1002/joa3.70057","url":null,"abstract":"<p>We detail a streamlined workflow using intracardiac echocardiography that does not require internal jugular venous access, pre-procedural imaging, or additional multielectrode catheters. Overall, this may improve the efficiency and reduce the overall costs of PFA with a variable loop circular mapping catheter without necessarily compromising on efficacy or safety.\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":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749353","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":"Differential response of myocardium and His bundle to steroid therapy in a patient with cardiac sarcoidosis: A change of pacing threshold in His bundle pacing with cardiac sarcoidosis","authors":"Kenji Baba MD,&nbsp;Shogo Sakamoto MD, PhD,&nbsp;Moritoshi Irishio MD,&nbsp;Toru Kataoka MD, PhD,&nbsp;Daiju Fukuda MD, PhD","doi":"10.1002/joa3.70055","DOIUrl":"https://doi.org/10.1002/joa3.70055","url":null,"abstract":"<p>A patient with cardiac sarcoidosis who had introduced His bundle pacing and caused threshold deterioration was treated with steroid therapy, which resulted in lead threshold improvement and avoidance of lead replacement. Additionally, the thresholds of improvement with steroid therapy vary between the myocardium and His bundle in these patients.\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":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749331","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":"Radiofrequency or cryoablation or medical therapy for paroxysmal atrial fibrillation: An indirect comparison of effectiveness","authors":"Roberto Brunoro PharmD,&nbsp;Lorenzo Di Spazio PharmD,&nbsp;Melania Rivano PharmD,&nbsp;Luca Cancanelli PharmD,&nbsp;Chiara Nunzia Fasano Celentano PharmD,&nbsp;Daniele Mengato PharmD,&nbsp;Andrea Messori PharmD","doi":"10.1002/joa3.70054","DOIUrl":"https://doi.org/10.1002/joa3.70054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Paroxysmal atrial fibrillation (PAF) is commonly treated with pharmacological therapies, but these may be insufficient for symptom control. Radiofrequency and cryoballoon ablation have emerged as alternative strategies. This study aimed to compare the efficacy of cryoballoon ablation, radiofrequency ablation, and anti-arrhythmic drugs as initial therapies for symptomatic PAF based on randomized trial data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were extracted from randomized trials, and individual patient data were reconstructed from Kaplan–Meier curves using artificial intelligence techniques. Time-to-event analysis was performed to evaluate arrhythmia recurrence, with hazard ratios (HRs) as the primary measure of efficacy. A heterogeneity analysis was conducted to assess variability between studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five randomized trials were included in the analysis. Significant between-trial heterogeneity was observed. Both cryoballoon ablation (HR 0.48; 95% CI: 0.36–0.63; <i>p</i> &lt; .001) and radiofrequency ablation (HR 0.54; 95% CI: 0.37–0.80; <i>p</i> = .002) demonstrated superior efficacy compared to anti-arrhythmic drug therapy in reducing arrhythmia recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Cryoballoon and radiofrequency ablation are more effective than anti-arrhythmic drugs for initial therapy in symptomatic PAF. These findings support the use of ablation techniques as preferred interventions in this patient population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749332","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":"“A on V” tachycardia in a patient with diseased His bundle","authors":"Abhinav B. Anand DM,&nbsp;Yash Y. Lokhandwala DM","doi":"10.1002/joa3.70052","DOIUrl":"https://doi.org/10.1002/joa3.70052","url":null,"abstract":"<p>We present a case of narrow complex, near simultaneous “A on V” tachycardia in a patient with diseased His bundle (intrahisian delay:35 ms; HV: 72 ms) and describe response to adenosine, RV overdrive pacing and parahisian resetting to elucidate the tachycardia mechanism.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717385","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":"Does organized atrial tachycardia after a pulmonary vein isolation-only procedure portend better outcome of repeat ablation compared to recurrent atrial fibrillation?","authors":"Tamás János Riesz MD,&nbsp;Gábor Bencsik MD, PhD,&nbsp;László Sághy MD, PhD,&nbsp;Róbert Pap MD, PhD","doi":"10.1002/joa3.70049","DOIUrl":"https://doi.org/10.1002/joa3.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Better outcome has been suggested for repeat procedures after atrial fibrillation (AF) ablation, when recurrence presented as organized atrial tachycardia (OAT) compared to recurrent AF. However, this contradicts the finding of more advanced atrial remodeling in patients with OAT recurrence and may be related to iatrogenesis by substrate modification during the index procedure. Therefore, we examined the prognostic significance of the type of recurrent arrhythmia after pulmonary vein isolation (PVI) without additional substrate modification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included 185 patients (88 female, 64 ± 9 years) undergoing repeat ablation after index PVI for recurrent OAT (24%) or AF (76%). The recurrence rate, arrhythmia-free survival time, and the type of further recurrences were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was no difference in the rate and mean time of arrhythmia-free survival between patients with OAT versus AF recurrence after the first (49% vs. 52%, <i>p</i> = .72 and 51.08 ± 6.66 vs. 53.37 ± 4.75 months, <i>p</i> = .54, respectively) and last (60% vs. 58%, <i>p</i> = .80 and 63.2 ± 7.04 vs. 61.2 ± 5.32 months, <i>p</i> = .23, respectively) redo procedure. AF occurred in the majority of subsequently recurring patients in both groups. No significant difference was found in the outcome of redo procedures between patients with typical flutter and atypical OAT, but a higher rate of successful rhythm control was observed in those with paroxysmal, as compared to persistent AF recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>After a PVI-only index procedure, recurrent OAT is not associated with a better outcome of redo procedures compared to recurrent AF. After repeat ablations, both groups experience AF as the dominant further recurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690190","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 “Impact of intracardiac pattern matching settings on the activation map of accessory pathways using open window mapping”","authors":"Yosuke Nakatani MD, PhD","doi":"10.1002/joa3.70050","DOIUrl":"https://doi.org/10.1002/joa3.70050","url":null,"abstract":"&lt;p&gt;In the case report published in the Journal of Arrhythmia,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Morioku et al. evaluated the contribution of the intracardiac pattern matching (ICPM) algorithm, integrated within the CARTO3 system (Biosense Webster Inc., Diamond Bar, CA, USA), to the accuracy of annotations in open window mapping (OWM) for atrioventricular accessory pathway (AP). They compared the frequency of misannotations under various settings: without ICPM, based solely on atrial potentials, based solely on ventricular potentials, and based on both atrial and ventricular potentials. The results showed that ICPM reduced the frequency of misannotations, particularly when both atrial and ventricular potentials were utilized, demonstrating the greatest reduction in the misannotations (frequency of misannotations: without ICPM 0.75% vs. ICPM based on atrial and ventricular potentials 0.1%).&lt;/p&gt;&lt;p&gt;Recent advancements in 3D mapping systems have enabled high-density mapping, significantly enhancing the mapping accuracy. High-density mapping addresses the challenges of localizing accessory pathways using conventional methods, which involve point-by-point mapping to identify the connection sites of the AP to the atria or ventricle, or the site where the AP potential is recorded. The accuracy of 3D mapping improves with an increase in the mapping points. However, manually annotating local electrograms with a large number of mapping points can be challenging. Therefore, automatic annotation is necessary for high-density mapping, but a misannotation to the incorrect chamber could compromise the mapping accuracy. The issue of misannotations is particularly crucial in mapping atrioventricular APs as it necessitates mapping near the valvular annulus, where misannotations of far-field potentials from the ventricle during atrial mapping or from the atria during ventricular mapping can occur. To address this problem, OWM, which sets a mapping window that includes both atrial and ventricular potentials, was devised.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Two critical premises must be met to guarantee the accuracy of the OWM. The first is that the near-field potential is correctly annotated. OWM generally uses the dV/dt value in the unipolar signal to annotate near-field potentials. To enhance the accuracy of those annotations, it is essential to eliminate the influence of far-field potentials on the recorded potentials. A dedicated mapping catheter with a small electrode size and short inter-electrode distance can be useful in eliminating the influence of far-field potentials.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; We have reported that a multispline mapping catheter with closely spaced microelectrodes (OCTARAY, Biosense Webster) is beneficial for OWM.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The second premise is that OWM is performed during the correct rhythm. Ectopic beats are frequently induced by mechanical stimulation during contact mapping, leading to misannotations. However, this problem has not","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690191","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":"A new scoring system to predict the risk of late recurrence in extended follow-up after atrial fibrillation catheter ablation: APCEL score","authors":"Taner Ulus MD,&nbsp;Ahmet Şekip Ahmadi MD,&nbsp;Ertuğrul Çolak MD","doi":"10.1002/joa3.70048","DOIUrl":"https://doi.org/10.1002/joa3.70048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In studies where risk scores used to determine the risk of late recurrence after atrial fibrillation (AF) catheter ablation were defined, significant differences were observed in terms of parameters such as post-procedural follow-up time, pre-procedural AF time, energy sources used for ablation, and cut-off values of left atrium (LA) diameter. Considering all these factors, we aimed to develop a new recurrence risk score for prolonged follow-up after AF ablation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 206 patients who underwent index AF catheter ablation for paroxysmal or persistent AF. Independent predictors of late recurrence were identified at a median follow-up of 40 months (range: 21–57), and a risk score was created. The predictive ability of this score for late recurrence was compared with that of other risk scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Independent predictors of late recurrence development included pre-ablation AF duration &gt;19 months, persistent AF, early recurrence, chronic obstructive pulmonary disease, and LA volume index &gt;31 mL/m². The APCEL risk score, derived from these factors (Early recurrence: 3 points, AF duration &gt;19 months: 2 points, others: 1 point), demonstrated good predictive performance for late recurrence at 6th [AUC: 0.940, 95% CI: 0.896–0.983], 12th [AUC: 0.865, 95% CI: 0.796–0.932], 24th [AUC: 0.814, 95% CI: 0.743–0.885], and 36th months [AUC: 0.798, 95% CI: 0.726–0.868].</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The APCEL score, calculated at the end of the blanking period for patients who underwent AF ablation, can effectively identify those at high risk of late recurrence during extended follow-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689643","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":"Scrotal hematoma caused by femoral artery puncture during ablation","authors":"Kosuke Muto MD,&nbsp;Tsukasa Naganuma MD,&nbsp;Hitoshi Mori MD, PhD,&nbsp;Yoshifumi Ikeda MD, PhD,&nbsp;Ritsushi Kato MD, PhD","doi":"10.1002/joa3.70051","DOIUrl":"https://doi.org/10.1002/joa3.70051","url":null,"abstract":"<p>Scrotal hematoma is a rare complication of bleeding after femoral artery puncture. It often occurs without an associated inguinal hematoma, making it difficult to detect immediately after the procedure. Management of scrotal hematoma is usually conservative; however, surgical intervention or IVR may be necessary in cases of active bleeding.\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":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689735","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":"Leadless pacemaker implantation in real-world clinical practice: An Italian survey promoted by the AIAC (Italian Association of Arrhythmology and Cardiac Pacing)","authors":"Roberto Rordorf MD,&nbsp;Valentina De Regibus MD,&nbsp;Luca Bontempi MD,&nbsp;Guido De Ambroggi MD,&nbsp;Giosuè Mascioli MD,&nbsp;Patrizio Mazzone MD,&nbsp;Matteo Anselmino MD,&nbsp;Michela Casella MD,&nbsp;Maurilio Lauretti MD,&nbsp;Gemma Pelargonio MD,&nbsp;Vincenzo Russo MD,&nbsp;Manola Vilotta MD,&nbsp;Matteo Ziacchi MD,&nbsp;Giuseppe Boriani MD,&nbsp;Pietro Palmisano MD,&nbsp;Sakis Themistoclakis MD,&nbsp;Antonio D'Onofrio MD,&nbsp;Roberto De Ponti MD,&nbsp;the AIAC Ricerca Investigator Network","doi":"10.1002/joa3.70045","DOIUrl":"https://doi.org/10.1002/joa3.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Backgrounds</h3>\u0000 \u0000 <p>After a decade since the introduction of leadless pacemaker (L-PM), its use is still limited. The aim of this survey is to evaluate how this technology is perceived by electrophysiologist members of a National scientific society in clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A questionnaire with 22 questions was posted in the reserved area of the society website. The multiple-choice questions concerned the center's characteristics, patient selection criteria, limitations to the L-PM use, implant procedures, and follow-up. Additionally, non-implanting centers were also allowed to participate by completing the initial nine questions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-two responders participated in this survey: 59% implanted &lt;20 L-PM yearly and 31% did not implant L-PM. The three main reasons to choose an L-PM were anatomic contraindications to a transvenous pacemaker, the patient's high infective risk, and previous lead extraction, accounting for 78%, 74%, and 64% of the responses, respectively. Age &gt;60 years was indicated as more suitable by most of the responders. Among the implanting centers, the main limitation to a wider adoption was cost (49%), the lack of atrial pacing (28%), the absence of a dedicated extraction tool, and data on replacement (22%). The L-PM implant was performed with only local anesthesia in 77% of the centers and was associated with limited procedure duration and fluoroscopy time even in low-volume centers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although the L-PM implant is not a particularly complex procedure, these data confirm that its use is currently limited to selected patients of older age. Cost decreases and new developments might increase the adoption of this technology.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689734","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":"Risk stratification of elderly patients with Brugada syndrome: Results from a large Japanese cohort of idiopathic ventricular fibrillation","authors":"Tetsuji Shinohara MD, PhD,&nbsp;Masahiko Takagi MD, PhD,&nbsp;Tsukasa Kamakura MD, PhD,&nbsp;Yuki Komatsu MD, PhD,&nbsp;Yoshiyasu Aizawa MD, PhD,&nbsp;Yukio Sekiguchi MD, PhD,&nbsp;Yasuhiro Yokoyama MD, PhD,&nbsp;Naohiko Aihara MD,&nbsp;Masayasu Hiraoka MD, PhD,&nbsp;Kazutaka Aonuma MD, PhD,&nbsp;for the Japan Idiopathic Ventricular Fibrillation Study (J-IVFS) Investigators","doi":"10.1002/joa3.70047","DOIUrl":"https://doi.org/10.1002/joa3.70047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Brugada syndrome (BrS) is an inherited cardiac channelopathy associated with a high risk of sudden cardiac death (SCD) due to ventricular fibrillation (VF). Although implantable cardioverter-defibrillators (ICDs) are the primary therapy for SCD prevention, the risk stratification of elderly patients with BrS remains unclear. This study aimed to evaluate the incidence and risk factors of life-threatening arrhythmias in elderly patients with BrS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed 523 patients with BrS (mean age 51 ± 13 years, 497 men) enrolled in the multicenter prospective Japan Idiopathic Ventricular Fibrillation Study. Patients were categorized into the elderly (&gt;60 years, <i>n</i> = 150) and nonelderly (≤60 years, <i>n</i> = 373) groups. Clinical characteristics, programmed electrical stimulation (PES) results, and outcomes, including cardiac events (CEs: VF, fast ventricular tachycardia, or SCD), were compared. Statistical analyses were performed using Kaplan–Meier curves and Cox proportional hazard models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a mean follow-up of 106 ± 62 months, 59 patients (11%) experienced CE. The annual CE incidence was lower in the elderly group than in the nonelderly group (0.7% vs. 1.5%, <i>p</i> = 0.016). History of VF independently predicted CE occurrence in elderly patients (hazard ratio: 23.5, <i>p</i> &lt; 0.001). Asymptomatic elderly patients exhibited a negligible risk of CE. PES did not predict CE occurrence in the elderly group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Elderly patients with BrS have a better prognosis than nonelderly patients, particularly if they are asymptomatic. A history of VF is a key risk factor for life-threatening arrhythmias in elderly patients with BrS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689738","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}