Journal of Arrhythmia最新文献

{"title":"Editorial to “A critical analysis of online patient-directed resources on catheter ablation for ventricular arrhythmias”","authors":"Reina Tonegawa-Kuji MD, PhD","doi":"10.1002/joa3.70046","DOIUrl":"https://doi.org/10.1002/joa3.70046","url":null,"abstract":"<p>Catheter ablation is a critical treatment for managing life-threatening ventricular arrhythmias. To make informed decisions, patients need clear and accurate information about the procedure, its risks, and alternative treatment options. While healthcare providers explain these aspects during consultations, catheter ablation is a complex procedure, making it difficult for patients to fully understand everything in a single discussion. As a result, many turn to online resources for additional information. Reliable online information is crucial in helping patients navigate their treatment choices. In a recent study, “A Critical Analysis of Online Patient-Directed Resources on Catheter Ablation for Ventricular Arrhythmias,” Sood A et.al. evaluated the readability and quality of online patient materials.<span><sup>1</sup></span> The findings showed that among the 60 resources analyzed, not a single one met both the ideal readability and quality standards. Specifically, none of the reviewed resources met the readability standard recommended by the American Medical Association (AMA), which advises that patient-directed materials be written at a 6th-grade reading level or lower.<span><sup>2</sup></span> Furthermore, only one resource was written at or below the average American literacy level of 8th grade.<span><sup>3</sup></span> Additionally, only 27% of the resources scored as high quality based on the JAMA score.<span><sup>4</sup></span> The study also found no correlation between readability and quality. Beyond written materials, the study also examined videos as an alternative medium for patient education. While videos can be an effective tool for improving comprehension, the study found that only five (21%) of the 24 online videos included all the essential elements necessary for informed consent—clear explanations of the procedure, its risks, and available alternatives. This highlights a broader issue: not only are written resources too complex, but even multimedia formats fail to provide complete, accessible information.</p><p>There are several reasons why online medical information may not be tailored to patients' level of understanding. One key factor is the significant knowledge gap between healthcare providers and patients. When medical professionals attempt to explain procedures or treatments, they may unintentionally use overly complex language, simply because they do not realize how difficult these terms are for non-experts to understand. Additionally, many healthcare professionals are unaware that patient-directed materials should be written at a 6th-grade reading level or lower. When creating educational resources, it is common to simplify literature originally intended for medical professionals, such as guidelines from academic organizations. However, to make these materials truly accessible, greater emphasis must be placed on readability, ensuring that content is clear and easy for patients to understand.</p><p>Addressing this issu","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/joa3.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689736","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 of an alternative positioning of intracardiac defibrillation catheters in atrial fibrillation ablation","authors":"Jumpei Ohashi MD, PhD,&nbsp;Tatsuya Hayashi MD, PhD,&nbsp;Shingo Yamamoto MD,&nbsp;Yusuke Ugata MD, MPH,&nbsp;Kenichi Sakakura MD, PhD,&nbsp;Hideo Fujita MD, PhD","doi":"10.1002/joa3.70044","DOIUrl":"https://doi.org/10.1002/joa3.70044","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In pulmonary vein isolation (PVI) for atrial fibrillation (AF), intraoperative defibrillation is often required. Intracardiac defibrillation catheters (ICDCs) are most effective when positioned to enclose the heart between the coronary sinus (CS) and right atrium (RA) (CS/RA configuration). However, achieving this positioning via the inferior vena cava (IVC) can be challenging, and alternative configurations remain underexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included patients with paroxysmal or persistent AF who underwent cryoballoon ablation followed by intracardiac cardioversion using an ICDC via the IVC. The catheter was initially positioned with distal electrodes in the CS and proximal electrodes in the IVC (CS-only configuration). If cardioversion failed, the catheter was repositioned to place distal electrodes in the superior vena cava (SVC configuration). A maximum of 30 J of energy was used for all cardioversion attempts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 81 patients were included. Cardioversion in the CS-only configuration restored sinus rhythm in 11% (9/81) of patients. Repositioning to the SVC configuration achieved successful cardioversion in 93.1% (67/72) of the remaining cases without complications. Patients requiring the SVC configuration had a significantly higher prevalence of persistent AF (33.3% vs. 80.6%; <i>p</i> = 0.045). No adverse events were observed following cardioversion in the SVC configuration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While the CS-only configuration offers ease of placement, its efficacy is limited. Repositioning to the SVC configuration significantly enhances cardioversion success and represents a safer, more effective alternative for ICDC use during AF ablation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689217","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":"Impact of catheter ablation for ventricular tachycardia on left ventricular ejection fraction in patients with structural heart disease","authors":"Ashish Sood MBBS,&nbsp;Samual Turnbull BSc,&nbsp;Kasun De Silva MBBS,&nbsp;Ashwin Bhaskaran MBBS, MSc (Int Med),&nbsp;Richard G. Bennett BSc, MBChB, PhD,&nbsp;Timothy G. Campbell BSc, PhD,&nbsp;Liza Thomas MBBS, PhD,&nbsp;Saurabh Kumar MBBS, PhD","doi":"10.1002/joa3.70042","DOIUrl":"https://doi.org/10.1002/joa3.70042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Catheter ablation (CA) is efficacious for the treatment of ventricular tachycardia (VT) in patients with structural heart disease; however, heart failure contributes to long-term mortality in this cohort. Whether CA worsens left ventricular function requires investigation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 142 consecutive patients with structural heart disease undergoing CA for VT. Pre-ablation left ventricular ejection fraction (LVEF) was compared to LVEF postablation, predictors of change in LVEF were identified, and the relationship between change in LVEF and arrhythmic recurrence was assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with ischemic cardiomyopathy (ICM) had lower pre-ablation LVEF than patients with non-ischemic cardiomyopathy (NICM) (36.2 ± 14.3% vs. 50.8 ± 12.8%, <i>p</i> &lt; 0.001). There was no statistically significant change in LVEF following ablation for patients with ICM (<i>p</i> = 0.45) or NICM (<i>p</i> = 0.75). Patients with pre-ablation LVEF ≤20% experienced the largest recovery in LVEF, mean recovery 5.3% (95% CI: 0.6–10.1), <i>p</i> = 0.03, with LVEF recovery postablation similar in ICM and NICM patients (<i>p</i> = 0.69). Recovery of LVEF was associated with a decreased incidence of ventricular arrhythmia (VA) recurrence (<i>p</i> = 0.03) and an increased VA-recurrence-free survival (<i>p</i> = 0.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CA for VT does not cause a decline in LVEF among patients with structural heart disease. The subset of patients with severely impaired LVEF may experience an increase in LVEF following ablation and an associated reduction in VA recurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632831","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":"Oral Abstracts","authors":"","doi":"10.1002/joa3.70003","DOIUrl":"https://doi.org/10.1002/joa3.70003","url":null,"abstract":"","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622531","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":"Moderated Poster Abstracts","authors":"","doi":"10.1002/joa3.70001","DOIUrl":"https://doi.org/10.1002/joa3.70001","url":null,"abstract":"","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622297","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":"Best Poster Abstracts","authors":"","doi":"10.1002/joa3.70002","DOIUrl":"https://doi.org/10.1002/joa3.70002","url":null,"abstract":"","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622296","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":"Standard Poster Abstracts","authors":"","doi":"10.1002/joa3.70004","DOIUrl":"https://doi.org/10.1002/joa3.70004","url":null,"abstract":"","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622530","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 indicate implantable cardioverter-defibrillator in the aging population","authors":"Risako Orita,&nbsp;Naoya Kataoka MD, PhD,&nbsp;Teruhiko Imamura MD, PhD","doi":"10.1002/joa3.70038","DOIUrl":"https://doi.org/10.1002/joa3.70038","url":null,"abstract":"<p>To Editor,</p><p>The optimal indication for implantable cardioverter-defibrillator (ICD) implantation in the aging population remains a subject of debate, given the high incidence of nonarrhythmic mortality in this cohort. The authors have investigated the clinical outcomes of octogenarians undergoing ICD implantation for both primary and secondary prevention, with a focus on ICD therapies and the timing of mortality.<span>¹</span> Their findings suggest that while device utilization was infrequent, it preceded mortality by a significant margin. This may encourage clinicians to adopt a more aggressive approach to ICD implantation, even in elderly patients. However, several concerns warrant consideration.</p><p>A prior large-scale study evaluating the clinical implications of ICD generator replacement in the aging population reported that a substantial proportion of patients over 80 years of age succumbed before experiencing appropriate device utilization.<span>²</span> The discrepancy between these findings may stem from differences in baseline patient characteristics. Could the authors provide data on the proportion of patients who received guideline-directed medical therapy, which is known to mitigate arrhythmic events? Additionally, how many patients underwent catheter ablation for ventricular arrhythmias? Given that aggressive catheter ablation can reduce arrhythmic burden and thereby decrease the need for ICD intervention,<span>³</span> this information would be critical for contextualizing the study's findings.</p><p>Furthermore, the exclusion of patients with an observation period of fewer than 30 days raises concerns,<span>¹</span> as these individuals may be at particularly high risk for arrhythmic events. Their omission could potentially bias the results and limit the generalizability of the study.</p><p>In the present study, approximately 20% of patients received cardiac resynchronization therapy (CRT),<span>¹</span> which promotes cardiac reverse remodeling and may reduce the incidence of ventricular arrhythmias. The impact of CRT on preventing appropriate ICD utilization likely differs from that observed in patients with ICD implantation alone. Clarification on this point would enhance the interpretation of the findings.</p><p>Finally, the risk of device-related complications, including bleeding and infection, remains a significant concern, particularly in elderly patients with multiple comorbidities.<span>⁴</span> These risks must be carefully weighed against the potential benefits of ICD implantation in this population.</p><p>The authors declare no conflict of interest.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622732","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":"Advancements in BATTERY longevity of cardiac implantable electronic devices from real-world data: BATTERY study","authors":"Maiko Kuroda MD,&nbsp;Michio Nagashima MD,&nbsp;Masataka Narita MD,&nbsp;Wataru Sasaki MD,&nbsp;Naomichi Tanaka MD, PhD,&nbsp;Kazuhisa Matsumoto MD, PhD,&nbsp;Tsukasa Naganuma MD,&nbsp;Hitoshi Mori MD, PhD,&nbsp;Yoshifumi Ikeda MD, PhD,&nbsp;Kengo Korai MD,&nbsp;Masato Fukunaga MD,&nbsp;Kenichi Hiroshima MD,&nbsp;Kenji Ando MD,&nbsp;Ritsushi Kato MD, PhD","doi":"10.1002/joa3.70041","DOIUrl":"https://doi.org/10.1002/joa3.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Technological development has improved the battery longevity of cardiac implantable electronic devices (CIEDs). However, there have been no reports on the extent of the improvement in battery longevity in the real world.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who underwent CIED exchanges from February 2006 to June 2023 were included in this study. The actual battery longevity calculated from the implantation date to the battery replacement date and the predicted battery longevity based on manufacturer reports were investigated. All patients were divided into five groups according to their initial implantation dates. After excluding the first and last groups, the data among the middle three groups (P1, P2, P3) were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 3119 patients (pacemakers [PMs], 2138; ICDs, 477; cardiac resynchronization therapy pacemakers [CRTPs], 121; cardiac resynchronization therapy defibrillators [CRTDs], 383) were enrolled in this study. The predicted device longevity improved over time for all devices, but in recent analyses, it has been overestimated compared to the actual device longevity for PMs, ICDs, and CRTPs. The actual device longevity of PMs, ICDs, and CRTDs exhibited an extension in the early two periods (P1 vs. P2), but no extension was observed in the most recent two periods (P2 vs. P3). CRTPs showed no improvement in any of the periods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The battery longevity has improved by only about 1 year over the past nearly 15 years. Moreover, the discrepancy between the predicted and actual battery longevity suggests that a reevaluation of the methods for calculating the predicted battery longevity may be necessary.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622730","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":"Renal function decline in Asian patients with atrial fibrillation with warfarin and non-vitamin K antagonist oral anticoagulants: A report from the COOL-AF registry","authors":"Rungroj Krittayaphong MD,&nbsp;Sukrit Treewaree MD,&nbsp;Ahthit Yindeengam BSc,&nbsp;Gregory Y. H. Lip MD","doi":"10.1002/joa3.70037","DOIUrl":"https://doi.org/10.1002/joa3.70037","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The objective of this study was to compare the risk of estimated glomerular filtration rate (eGFR) decline between atrial fibrillation (AF) patients with direct oral anticoagulants (DOACs) and warfarin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We studied patients with nonvalvular AF from a prospective multicenter national AF registry in Thailand. Patients with missing eGFR data or eGFR less than 30 mL/min/1.73 m² were excluded. Follow-up data including eGFR were collected every 6 months until 3 years. eGFR decline was assessed by eGFR slope. We compared eGFR slope between patients who received DOACs and warfarin at baseline. In the warfarin group, we assessed the impact of good anticoagulation control by time in the therapeutic range (TTR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1708 patients were studied (mean age 68.1 years; 42.6% female). Patients with DOACs had a significantly slower rate of eGFR decline compared to warfarin. The eGFR slope was 2.32 mL/min/1.73 m² per year in the warfarin group (95% CI: 3.09 to 1.55), and 1.31 mL/min/1.73 m² per year in the DOAC group (95% CI: 1.97 to 0.64). The effect of OAC type on the eGFR slope remained significant even after the adjustment of baseline variables including baseline eGFR. There was no difference in GFR decline as reflected by eGFR slope when comparing warfarin patients with TTR &lt;65% and ≥65%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this prospective cohort of Asian patients with AF, DOACs were associated with a slower rate of eGFR decline when compared with warfarin. In the latter group, this was irrespective of the quality of anticoagulation control.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622731","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}