Journal of Arrhythmia最新文献

{"title":"Multimodality Imaging-Guided Pulsed Field Ablation for Atrial Fibrillation in Cor Triatriatum Sinister","authors":"Kazuya Murata,&nbsp;Yasuteru Yamauchi,&nbsp;Atsuhito Oda,&nbsp;Hirofumi Arai,&nbsp;Tetsuo Sasano","doi":"10.1002/joa3.70474","DOIUrl":"https://doi.org/10.1002/joa3.70474","url":null,"abstract":"<p>Multimodality imaging facilitated safe transseptal access and catheter navigation in a patient with cor triatriatum sinister. CARTO-integrated VARIPULSE pulsed-field ablation achieved pulmonary vein isolation without complications, demonstrating a feasible treatment strategy for atrial fibrillation in complex congenital left atrial anatomy.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70474","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149048378","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":"Genetically Predicted Gut Microbial Taxa and Inflammatory Proteins Associated With Atrial Fibrillation: A Bidirectional Mendelian Randomization and Colocalization Study","authors":"Chengcheng Yi,&nbsp;Wenyuan Zheng,&nbsp;Jing Zhao,&nbsp;Weiting Cai,&nbsp;Junqian Wang,&nbsp;Li Song,&nbsp;Ming Bai,&nbsp;Zheng Zhang","doi":"10.1002/joa3.70454","DOIUrl":"https://doi.org/10.1002/joa3.70454","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Observational studies have linked the gut microbiota and inflammatory proteins to atrial fibrillation (AF), but confounding, reverse causation, and instrument validity remain concerns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We evaluated 473 microbial traits and 91 inflammatory proteins in relation to AF using two GWAS datasets. Sensitivity analyses included instruments selected at <i>p</i> &lt; 5 × 10⁻⁸, MR-RAPS, <i>cis</i>/<i>trans</i>-stratified protein MR, reverse MR, and FGF-5 colocalization. Participants were predominantly of European ancestry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Under conventional IVW analysis, six associations were FDR-significant in the discovery analysis and remained FDR-significant when selectively evaluated in the second AF GWAS, with FDR correction applied across the six prioritized tests: Leptospirae (OR 0.605, 95% CI 0.457–0.800), Leptospirales (0.499, 0.371–0.673), leukemia inhibitory factor receptor (LIF-R; 0.905, 0.869–0.943), TWEAK (0.891, 0.856–0.927), FGF-5 (1.077, 1.051–1.103), and interleukin-6 (0.886, 0.834–0.942). At <i>p</i> &lt; 5 × 10⁻⁸, neither microbial trait had a harmonized instrument, whereas the protein estimates retained their directions. MR-RAPS supported LIF-R in both datasets, but support for the other signals varied. The prioritized proteins also differed in <i>cis</i>/<i>trans</i> genetic architecture. The FGF-5 <i>cis</i>-only estimates were based on two harmonized instruments and were therefore preliminary, while <i>cis</i>-region colocalization provided little evidence of a shared variant (PP.H4 = 0.0045).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The conventional IVW associations varied in robustness across alternative analyses. These findings prioritize hypotheses, not established causal pathways or clinical targets. Generalizability beyond predominantly European populations remains uncertain.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70454","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149048220","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 Special Muscle Fiber Surviving After Septal Line Ablation of Mitral-Isthmus Dependent Atrial Flutter","authors":"Takumi Yamada,&nbsp;Krittapoom Akrawinthawong,&nbsp;Yuichiro Miyazaki,&nbsp;Shumpei Mori","doi":"10.1002/joa3.70480","DOIUrl":"10.1002/joa3.70480","url":null,"abstract":"<p>Following unsuccessful supero-septal line ablation for mitral isthmus-dependent atrial flutter, a conduction gap may occur along the septoatrial bundle (SAB). In such cases, linear ablation extending perpendicularly to the supero-septal ablation line (SSL) toward Bachmann's bundle (BB) may achieve complete conduction block across the supero-septal ablation line.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038802","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":"Effectiveness of Bachmann's Bundle Pacing in a Patient With Severe Heart Failure and Refractory Atrial Fibrillation","authors":"Yosuke Murase,&nbsp;Yasuhiro Ogawa,&nbsp;Hajime Imai,&nbsp;Keita Mamiya,&nbsp;Katsuhiro Kawaguchi","doi":"10.1002/joa3.70466","DOIUrl":"10.1002/joa3.70466","url":null,"abstract":"<p>This case report highlights CRT-D with Bachmann's bundle pacing (BBP) in a patient with severe heart failure and refractory atrial fibrillation. BBP preserved atrioventricular conduction without PR prolongation, maintained left ventricular–only pacing, and was associated with suppression of atrial fibrillation and improvement in left atrial contractile function.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038744","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":"Prediction of Atrial Fibrillation Risk Through the Integration of Genetic Information and Artificial Intelligence-Based Electrocardiogram Data","authors":"Pil-Sung Yang,&nbsp;Hanjin Park,&nbsp;Oh-Seok Kwon,&nbsp;Je-Wook Park,&nbsp;Daehoon Kim,&nbsp;Hee Tae Yu,&nbsp;Tae-Hoon Kim,&nbsp;Jae-Sun Uhm,&nbsp;Boyoung Joung,&nbsp;Hui-Nam Pak","doi":"10.1002/joa3.70463","DOIUrl":"10.1002/joa3.70463","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Accurate prediction of atrial fibrillation (AF) is essential for prevention. The CHARGE-AF score, based on routinely available clinical factors, provides a practical tool for estimating AF risk but has limited predictive accuracy. This study aimed to improve AF risk prediction by integrating artificial intelligence (AI)–based electrocardiogram (ECG) analysis of age and sex with genetic information in addition to established clinical risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed 39 478 UK Biobank participants without prior AF. A polygenic risk score for AF (AF-PRS), the AI-ECG age gap (AI-ECG–predicted age minus chronological age), and AI-ECG–predicted sex mismatch were evaluated on top of the CHARGE-AF model. Model performance was compared across sequential prediction models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over a median follow-up of 2.7 years (interquartile range, 1.7–4.2; maximum, 6.7), 533 participants (1.3%) developed AF. AF-PRS (HR 1.61, 95% CI: 1.48–1.76) and the AI-ECG age gap (HR 1.37, 95% CI: 1.24–1.51) were independently associated with incident AF. Compared with CHARGE-AF alone (C-index 0.708, 95% CI: 0.686–0.730), adding AF-PRS improved discrimination (C-index 0.743; Δ0.035, 95% CI: 0.021–0.049; <i>p</i> &lt; 0.001). Adding traditional ECG parameters did not enhance performance, whereas incorporating AI-ECG features (age gap and sex mismatch) into the combined clinical and genetic model provided additional gain in discrimination (C-index 0.754; Δ0.045, 95% CI: 0.028–0.062), reclassification (net reclassification improvement 0.408), and discrimination improvement (0.007; all <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Integrating genetic risk and AI-ECG–derived features enhances AF prediction beyond an established clinical model, supporting the use of combined digital and genetic biomarkers for risk stratification.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038804","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":"Do Stimulants Promote Arrhythmic Risk: Insights From a Human-Induced Pluripotent Stem Cell-Derived Cardiomyocyte Model","authors":"Alia Arslanova,&nbsp;Samantha Wong,&nbsp;Sonia Franciosi,&nbsp;Glen F. Tibbits,&nbsp;Maksymilian Prondzynski,&nbsp;Shubhayan Sanatani","doi":"10.1002/joa3.70479","DOIUrl":"https://doi.org/10.1002/joa3.70479","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Stimulant medications are widely prescribed for ADHD. Although generally considered safe, their use in patients with underlying cardiac conditions remains a concern due to potential arrhythmic risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the effects of commonly prescribed stimulants on key electrophysiological parameters associated with arrhythmia risk in chamber-specific human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Atrial and ventricular hiPSC-CMs were plated on a multielectrode array (MEA) platform and exposed to clinically relevant plasma concentrations of methylphenidate, dextroamphetamine, atomoxetine, caffeine, or the β-agonist isoproterenol. Extracellular field potentials were recorded over 48 h to assess acute and prolonged effects on conduction velocity (CV), beat rate (BR), and corrected field potential duration (FPDc).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CV was largely preserved across all stimulant conditions in both atrial and ventricular hiPSC-CMs, while isoproterenol produced a modest early increase. All stimulants transiently elevated BR during the first hour of exposure, followed by a progressive decline over time. Isoproterenol and caffeine induced robust and sustained increases in BR, confirming model responsiveness. FPDc was prolonged by all stimulant compounds, most prominently by atomoxetine, consistent with its known I_Kr inhibitory properties. Isoproterenol produced a rate-dependent FPDc shortening, particularly in hiPSC-vCMs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>At clinically relevant plasma concentrations, stimulants modulated automaticity and repolarization but had minimal impact on conduction in hiPSC-CMs. The preservation of CV suggests that these compounds are unlikely to alter myocardial conduction at therapeutic doses. The observed effects on BR and FPDc warrant further mechanistic studies to understand how these changes may contribute to arrhythmia risk in susceptible populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70479","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149048095","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":"Association Between Temperature Management Using Passive Thermal Insulation and a Modified Aldrete Score During Cryoablation of Paroxysmal Atrial Fibrillation Under General Anesthesia","authors":"Arisa Yamaguchi,&nbsp;Masao Takemoto,&nbsp;Takuya Nagata,&nbsp;Reimi Goya,&nbsp;Yoshie Sadasue,&nbsp;Kaori Nagaoka,&nbsp;Norie Terauchi,&nbsp;Hijiri Inoue,&nbsp;Takahiro Mito,&nbsp;Michiko Kurachi,&nbsp;Takuya Tsuchihashi,&nbsp;Kyoko Matsuno,&nbsp;Tetsuji Okamoto","doi":"10.1002/joa3.70460","DOIUrl":"10.1002/joa3.70460","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Unintentional intraoperative hypothermia (core temperature &lt; 36°C), a common and frequently preventable complication in patients undergoing surgery under general anesthesia (GA), involves adverse effects on coagulation and prolonged recovery from GA. Thus, this study aimed to clarify the effect of passive thermal insulation (PTI) with a heat insulation blanket (HIB) on successful early recovery from GA in patients undergoing cryoablation for atrial fibrillation (AF) under GA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty-five patients undergoing cryoablation under GA for nonvalvular paroxysmal AF were prospectively assigned to the Blanket (<i>n</i> = 28) or Control (conventional towelettes; <i>n</i> = 27) group. The esophageal temperature was measured using an esophageal temperature probe before and after cryoablation. The esophageal hypothermia was defined as a temperature &lt; 36°C. The Δ in esophageal temperature was defined as the difference between the pre- and post-anesthesia temperature. The primary endpoint of this study was successful early recovery from GA, defined as a Modified Aldrete score (MAS) ≥ 9 at 2 h after the discontinuation of sedation/anesthesia in patients undergoing cryoablation under GA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study demonstrated that the PTI using HIBs significantly reduced the incidence of esophageal hypothermia from 93% to 68% and increased the rate of successful early recovery from GA from 37% to 64%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PTI using HIBs was associated with a smaller decline in esophageal temperature and a higher proportion of patients achieving MAS ≥ 9 at 2 h after discontinuation of anesthesia during cryoablation under GA. Larger studies using validated core temperature measurements and clinically meaningful recovery endpoints are warranted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>This study was registered in the University Hospital Medical Information Network Clinical Trial Registry of Japan (UMIN000057904)</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038829","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":"Bradycardia-Dependent Elevation of Atrial Pacing Threshold Mimicking Lead Failure Early After Pacemaker Implantation","authors":"Ayano Shibata,&nbsp;Rikitake Kogawa,&nbsp;Yukitoshi Ikeya,&nbsp;Toshiko Nakai,&nbsp;Yasuo Okumura","doi":"10.1002/joa3.70478","DOIUrl":"10.1002/joa3.70478","url":null,"abstract":"<p>Atrial pacing failure after pacemaker implantation does not always indicate lead malfunction. Non-invasive assessment can identify the underlying cause and may avoid unnecessary lead revision.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038763","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":"Glucagon-Like Peptide-1 Agonists and the Incidence of Atrial Fibrillation in Obese Patients With Heart Failure With Preserved Ejection Fraction and No Diabetes","authors":"Farah Rassam,&nbsp;Esteban Kosak Lopez,&nbsp;Sarah Sass,&nbsp;Thitiphan Srikulmontri,&nbsp;Evan Isaacs,&nbsp;John Malin,&nbsp;Phuuwadith Wattanachayakul,&nbsp;Olayinka Afolabi-Brown","doi":"10.1002/joa3.70455","DOIUrl":"10.1002/joa3.70455","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) reduce cardiovascular risk in obesity, but their effect on atrial fibrillation (AF) in heart failure with preserved ejection fraction (HFpEF) remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed TriNetX data comparing obese, non-diabetic HFpEF patients treated with GLP-1 RAs (<i>n</i> = 478) with untreated patients (<i>n</i> = 6887). Propensity matching yielded 470 patients per cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>GLP-1 RA therapy was not associated with reduced AF incidence (HR 0.86; 95% CI, 0.53–1.39; <i>p</i> = 0.543) but was associated with lower mortality (HR 0.42; 95% CI, 0.23–0.75; <i>p</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GLP-1 RAs may not reduce AF incidence in obese, HFpEF patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024861","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 60 W Versus 90 W, 4-s Radiofrequency Applications to the Esophagus-Adjacent Left Atrial Posterior Wall During Pulmonary Vein Isolation: A Pilot Study","authors":"Hideharu Okamatsu,&nbsp;Ken Okumura,&nbsp;Kakeru Tomaru,&nbsp;Junya Matsura,&nbsp;Kodai Negishi,&nbsp;Takuo Tsurugi,&nbsp;Yasuaki Tanaka,&nbsp;Masayoshi Uehara,&nbsp;Junjiro Koyama,&nbsp;Hirofumi Tomita","doi":"10.1002/joa3.70476","DOIUrl":"10.1002/joa3.70476","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In very high-power (51–90 W), short-duration (4 s) radiofrequency applications (QMODE+) using the QDOT MICRO catheter, the optimal power setting at the left atrial (LA) posterior wall adjacent to the esophagus for treating atrial fibrillation (AF) remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We evaluated the efficacy and safety of 60 W versus 90 W QMODE+ radiofrequency applications in the periesophageal region.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty AF patients were randomized into two groups based on the QMODE+ power applied to the periesophageal region: 60 W (<i>n</i> = 24) and 90 W (<i>n</i> = 26). We compared the incidence of residual conduction gaps in the periesophageal region and endoscopic esophageal lesions, as well as the 1-year atrial tachyarrhythmia (AT) recurrence rate between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median contact force was significantly higher in the 60 W group than in the 90 W group (12.9 g [IQR 10.2, 15.8] in the 60 W group and 10.9 g [IQR 8.4, 14.2] in the 90 W group, <i>p</i> &lt; 0.001). The rates of residual conduction gaps (8.3% and 11.5%, respectively, <i>p</i> = 1.00) and esophageal lesions (4.2% in each group) were similar between the two groups. The 1-year AT recurrence rate did not significantly differ between the two groups (20.8% vs. 7.7%, respectively, <i>p</i> = 0.24).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>60 W and 90 W QMODE+ RF applications for the periesophageal region achieved comparable rates of acute conduction block, endoscopy-detected esophageal injury, and 12-month AT recurrence-free survival, although contact force was significantly higher in the 60 W group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Japan Registry of Clinical Trials (jRCT); jRCT1072230115 (Registered on February 8, 2024)</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038790","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}