Journal of Arrhythmia最新文献

{"title":"Successful Ethanol Infusion of Vein of Marshall With Bridge Collateral Using the Double-Balloon Technique Incorporating a Wedged Berman Catheter","authors":"Yuhei Kasai,&nbsp;Takayuki Kitai,&nbsp;Junji Morita,&nbsp;Kei Murakami,&nbsp;Tsutomu Fujita","doi":"10.1002/joa3.70152","DOIUrl":"https://doi.org/10.1002/joa3.70152","url":null,"abstract":"<p>We describe a novel double-balloon technique incorporating a wedged Berman catheter to manage distal collateral drainage from the vein of Marshall (VOM) via a bridge collateral to the great cardiac vein, thereby enabling effective ethanol infusion. This technique may represent a viable alternative for anatomically challenging VOM ethanol infusion cases.\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":2.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70152","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144671999","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{"title":"WITHDRAWN: Clinical implication of the patient's disease awareness and adherence to medications in patients undergoing atrial fibrillation ablation","authors":"","doi":"10.1002/joa3.70135","DOIUrl":"https://doi.org/10.1002/joa3.70135","url":null,"abstract":"<p>\u0000 <b>WITHDRAWN</b>: <span>M. Sawada</span> MD, <span>N. Otsuka</span> MD, PhD, <span>K. Nagashima</span> MD, PhD, <span>R. Watanabe</span> MD, PhD, <span>Y. Wakamatsu</span> MD, PhD, <span>S. Hayashida</span> MD, PhD, <span>S. Hirata</span> MD, <span>M. Hirata</span> MD, <span>S. Kurokawa</span> MD, PhD, <span>Y. Okumura</span> MD, PhD, <span>Clinical implication of the patient's disease awareness and adherence to medications in patients undergoing atrial fibrillation ablation</span>, <i>Journal of Arrhythmia</i> <span>40</span>, no. <span>1</span> (<span>2023</span>): <span>57</span>-<span>66</span>, https://doi.org/10.1002/joa3.12965\u0000 </p><p>The above article, first published online on 6 December 2023, on Wiley Online Library (onlinelibrary.wiley.com), has been withdrawn by agreement between the authors, the Editors in Chief Kazuo Matsumoto and Young-Hoon Kim, the Japanese Heart Rhythm Society, and John Wiley and Sons Australia Ltd. The withdrawal has been made because the authors had not obtained permission to use the MMAS-8 scale reported in the article. The authors apologize for this error.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672951","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":"Technical Tips and Efficacy of Leadless Pacemaker Implantation in a Patient With Isolated Persistent Left Superior Vena Cava","authors":"Yuki Tokonami,&nbsp;Makoto Sano,&nbsp;Taro Narumi,&nbsp;Yoshihisa Naruse,&nbsp;Yuichiro Maekawa","doi":"10.1002/joa3.70149","DOIUrl":"https://doi.org/10.1002/joa3.70149","url":null,"abstract":"<p>Isolated persistent left superior vena cava (PLSVC) provides limited access during transvenous pacemaker implantation. We present a case of implantation of a leadless pacemaker for atrioventricular block with isolated PLSVC. A leadless pacemaker is an alternative strategy to a transvenous pacemaker; however, some technical tips are required: (1) the prevention of the mis-insertion in the dilated coronary sinus and (2) the pre-assessment of the anatomy of the right atrium and ventricle.\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":2.2,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144657698","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":"Critical Concerns Regarding the Conclusions of Pulmonary Vein Isolation's Impact on Cardiovascular Autonomic Reflexes","authors":"Zainab Haider Khan,&nbsp;Cheryl Vanessa Lewis,&nbsp;Chika Franklin Chilaka,&nbsp;Sahibzada Zumeran Jah,&nbsp;Mirza M. Hadeed Khawar","doi":"10.1002/joa3.70141","DOIUrl":"https://doi.org/10.1002/joa3.70141","url":null,"abstract":"&lt;p&gt;We have followed with great interest the research article by Malik et al., which investigates the impact of pulmonary vein isolation (PVI) on cardiovascular afferent autonomic reflexes in patients with atrial fibrillation [&lt;span&gt;1&lt;/span&gt;]. Although we are pleased that the authors systematically conducted their study regarding the assessment of autonomic function, we would like to present to the authors some significant flaws in their final results that undermine the validity and generalizability of their conclusions.&lt;/p&gt;&lt;p&gt;The most important limitation of the study is its highly underpowered design, as only nine patients completed pre- and post-PVI assessments. Modern statistical practices in heart rate variability research suggest that a modest or large effect size ranges from 0.25 to 0.9. In contrast, a recommended sample size of 25–64 participants in each group should provide the study with a power of 80%–90% [&lt;span&gt;2&lt;/span&gt;]. The size of the authors' sample lacks the statistical power to detect clinically significant changes in parameters of the autonomic nervous system.&lt;/p&gt;&lt;p&gt;The authors' conclusion that PVI does not have a direct impact on cardiovascular reflexes contradicts several other large-scale studies published over the last 5 years. The molecular markers related to CIRCA-DOSE examined 346 patients and found that PVI leads to meaningful, sustained changes in heart rate parameters [&lt;span&gt;3&lt;/span&gt;]. Specifically, patients who did not demonstrate arrhythmia recurrence had significantly faster daytime heart rates (11 ± 11 vs. 8 ± 12 bpm, &lt;i&gt;p&lt;/i&gt; = 0.001) and nighttime heart rates. The trial results essentially contradict the study's conclusion.&lt;/p&gt;&lt;p&gt;The authors acknowledge finding meaningful variations in the parameters of heart rate variability, which are associated with a reduction in total power (&lt;i&gt;p&lt;/i&gt; = 0.03) and very low-frequency components (&lt;i&gt;p&lt;/i&gt; = 0.03), but reject these as not being linked to afferent disruption. Such interpretation disagrees with what is known concerning physical physiology. According to several studies, significant correlations exist between baroreflex sensitivity and heart rate variability, with correlation coefficients ranging from 0.30 to 0.53 (&lt;i&gt;p&lt;/i&gt; &lt; 0.001–0.02) [&lt;span&gt;4&lt;/span&gt;]. The variant of autonomic function proposed by the authors is based on a compartmentalized interpretation, which is not entirely consistent with the context of cardiovascular autonomic regulation being viewed as an integrated process.&lt;/p&gt;&lt;p&gt;Recent comparative findings on pulsed field ablation (PFA) versus thermal ablation studies also raise doubts about the study's conclusions. The ADVENT study subanalysis also demonstrated a marked variation in the autonomic effect between ablation modalities, with thermal ablation causing a greater increase in heart rate (+8.8 vs. +5.2 bpm at 12 months, &lt;i&gt;p&lt;/i&gt; = 0.03) and decreased heart rate variability compared to PFA [&lt;span&gt;5&lt;/span&gt;]. Such results indicate that thermal PVI ","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647296","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":"Detailed Association Between Pulmonary Vein Isolation and Cardiovascular Reflex","authors":"Naoya Kataoka,&nbsp;Teruhiko Imamura","doi":"10.1002/joa3.70147","DOIUrl":"https://doi.org/10.1002/joa3.70147","url":null,"abstract":"<p>To Editor,</p><p>The authors demonstrated that pulmonary vein isolation (PVI) did not impair cardiovascular reflexes involving afferent baroreceptors [<span>1</span>]. While the findings are noteworthy, several concerns arise.</p><p>A previous study reported that ablation of the left atrial ganglionated plexi suppressed the recurrence of vasovagal syncope, likely due not only to the maintenance of heart rate through disruption of efferent fibers but also to the suppression of the Bezold–Jarisch reflex through disruption of afferent fibers [<span>2</span>]. How do the authors account for the discrepancy between that study and their own? One possible explanation is that the area of nerve fiber disruption caused by PVI is more limited compared to that of ganglionated plexi ablation. Additionally, the present study focused solely on volume-sensitive reflexes [<span>1</span>], whereas the previous study evaluated broader clinical outcomes, including heart rate responses and syncope events [<span>2</span>].</p><p>More than half of the participants in the present study were receiving beta-blockers [<span>1</span>], which may influence cardiac autonomic regulation. How do the authors consider the potential impact of beta-blockers on their findings?</p><p>Last, the anatomical basis for the preservation of afferent fibers after PVI remains unclear [<span>3</span>]. Since PVI primarily targets the endocardium of the left atrium, it is possible that afferent fibers are predominantly located in the epicardium. Alternatively, afferent pathways may primarily reside outside the left atrium, such as in the left ventricle.</p><p>The authors have nothing to report.</p><p>The authors have nothing to report.</p><p>The authors declare no conflicts of interest.</p><p>Malik V, Elliott AD, Thomas G et al., “Pulmonary Vein Isolation Does Not Alter Cardiovascular Afferent Autonomic Reflexes in Atrial Fibrillation,” <i>Journal of Arrhythmia</i> 41 (2025): e70119, https://doi.org/10.1002/joa3.70119.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647295","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":"Long-Term Safety of Extremely Low-Dose Amiodarone at 50 mg Daily in Patients With Persistent Atrial Fibrillation","authors":"Kentaro Yoshida,&nbsp;Yuta Okabe,&nbsp;Masako Baba,&nbsp;Ko Funabashi,&nbsp;Mami Narita,&nbsp;Shunsuke Kuchitsu,&nbsp;Akinori Sugano,&nbsp;Hideyuki Hasebe,&nbsp;Tomoko Ishizu,&nbsp;Noriyuki Takeyasu","doi":"10.1002/joa3.70150","DOIUrl":"https://doi.org/10.1002/joa3.70150","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Rhythm control of atrial fibrillation (AF) by pulmonary vein isolation alone is commonly difficult in this aging society, and the role of pharmacological therapy is being revisited. Identifying the lowest dose of amiodarone is important as this drug causes dose- and duration-related lung toxicity. Long-term safety of the use of extremely low-dose amiodarone in Japanese patients was retrospectively evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Included were 120 patients treated with extremely low-dose amiodarone (50 mg daily) for persistent AF. KL-6 level was systematically measured at baseline and every 3 months thereafter. The patients were classified into a different quartiles (Q) based on the KL-6 level measured at baseline (Q1, Q2, Q3, and Q4). Thyroid function was also evaluated at each follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a mean follow-up period of 51 months, KL-6 elevation (&gt; 700 U/mL) occurred in 7 (5.8%) patients with higher baseline KL-6 (Q1, 0 patients; Q2, 0 patients; Q3, 1 patient; and Q4, 6 patients; <i>p</i> = 0.0018). Interstitial pneumonia (IP) was diagnosed in 1 (0.8%) patient in Q3 who recovered without the use of steroids. ROC curve analysis showed a cut-off value for KL-6 of 283 U/mL for predicting the subsequent elevation. Approximately 70% of the patients were free from recurrence of AF, although electrical cardioversion was required to restore sinus rhythm in 58 (48%) of them.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Even an extremely low dose of amiodarone may potentially contribute to maintenance of sinus rhythm in highly selected patients with persistent AF. A low baseline KL-6 level may indicate patients at lower risk for amiodarone-related IP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647297","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 Patients With Malignancy","authors":"Naoya Kataoka,&nbsp;Teruhiko Imamura","doi":"10.1002/joa3.70148","DOIUrl":"https://doi.org/10.1002/joa3.70148","url":null,"abstract":"<p>The indication for cardiac implantable electronic devices in patients with malignancy remains a matter of ongoing debate. Current guidelines generally advocate for device implantation only in patients with an anticipated survival exceeding 1 year. Nevertheless, the authors report that implantable cardioverter-defibrillator (ICD) therapy conferred superior long-term survival compared to amiodarone in oncology patients, including those with advanced-stage cancer [<span>1</span>]. This finding raises several important concerns.</p><p>In Japan, prevailing guidelines explicitly discourage ICD implantation in patients whose life expectancy is less than 1 year, designating it as a Class III indication [<span>2</span>]. Accordingly, within the context of this Japan-based study, ICDs should have only been implanted in patients with an estimated survival beyond 1 year [<span>1</span>]. It is important to clarify whether patients with an expected life expectancy of &lt; 1 year were included in the study. In contrast, amiodarone prescription is not governed by such stringent prognostic thresholds. Consequently, the ICD cohort may have inherently comprised patients with more favorable baseline prognoses compared to those receiving amiodarone. It would be informative to clarify whether ICD intervention effectively averted sudden cardiac death in this population.</p><p>The therapeutic intent behind amiodarone administration in this study also warrants further elucidation. Notably, only 16.7% of patients in the amiodarone group had a documented history of ventricular arrhythmias [<span>1</span>]. It is likely that the remaining individuals were treated with amiodarone for rate or rhythm control in the context of supraventricular tachyarrhythmias [<span>3</span>]. Such arrhythmias are frequently refractory in patients with systemic deterioration, suggesting that amiodarone may have been preferentially used in individuals with more advanced or decompensated clinical status.</p><p>An emerging area of interest within the field of onco-cardiology involves cardiovascular toxicities associated with anticancer agents, most notably immune checkpoint inhibitors, anthracyclines, and fluoropyrimidines, including the development of cardiomyopathy [<span>4</span>]. The prophylactic utility of ICDs in this specific patient subset remains unclear. In the present study, 62% of ICD recipients underwent implantation for secondary prevention [<span>1</span>]. Among these patients, how many had a history of anticancer drug therapy?</p><p>The authors have nothing to report.</p><p>The authors have nothing to report.</p><p>The authors declare no conflicts of interest.</p><p>H. Kida, T. Morishima, E. Uza, et al., “Prognostic Comparison Between Implantable Cardioverter-Defibrillator and Amiodarone in Cancer Patients,” <i>Journal of Arrhythmia</i> 41 (2025): e70093, https://doi.org/10.1002/joa3.70093.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635246","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":"Pacing Pandemonium: The Unexpected Outcome of Temporary Pacing","authors":"Sudipta Mondal,&nbsp;Saikiran Kakarla,&nbsp;Narayanan Namboodiri","doi":"10.1002/joa3.70145","DOIUrl":"https://doi.org/10.1002/joa3.70145","url":null,"abstract":"<p>This case report describes the first occurrence of capture of the left bundle branch by a temporary pacing catheter that inadvertently perforated the interventricular septum during a transcatheter aortic valve implantation.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144646798","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":"Advancing Atrial Fibrillation Screening—Clinical Utility and Future Directions of Smartwatch ECG","authors":"Keitaro Senoo","doi":"10.1002/joa3.70143","DOIUrl":"https://doi.org/10.1002/joa3.70143","url":null,"abstract":"&lt;p&gt;Atrial fibrillation (AF) continues to rise globally and is well known to increase the risk of serious cardiovascular complications, such as ischemic stroke and thromboembolism. With the advent of an aging society, early detection and prevention of AF have become urgent challenges, not only for individual health but also from a healthcare economics perspective. In this context, smartwatch-based single-lead electrocardiograms (ECG) have attracted attention as a noninvasive and rapid method for acquiring ECG data during daily life.&lt;/p&gt;&lt;p&gt;The present study, “Accuracy and Interpretability of Smartwatch Electrocardiogram for Early Detection of Atrial Fibrillation,” [&lt;span&gt;1&lt;/span&gt;] focuses on the accuracy and interpretability of smartwatch ECG in detecting AF and evaluates its effectiveness through a quantitative meta-analysis. The authors systematically reviewed literature indexed in major databases, including Scopus, PubMed, and Web of Science, and performed meta-analyses using a two-level mixed-effects logistic regression model and a Freeman-Tukey double arcsine transformation.&lt;/p&gt;&lt;p&gt;The findings revealed promising results: algorithm-based automatic readings demonstrated a sensitivity of 86% and a specificity of 94%, while manual readings by healthcare professionals achieved even higher sensitivity and specificity of 96% and 95%, respectively. Notably, devices such as the Withings Scanwatch and Apple Watch showed particularly high clinical reliability, with summary area under the curve (sAUC) values of 96% and 98%, respectively. Furthermore, the interrater agreement for manual interpretation was substantial (Cohen's kappa = 0.83), with only 3% of ECG tracings deemed uninterpretable.&lt;/p&gt;&lt;p&gt;The significance of this study lies in its systematic and quantitative demonstration of the high diagnostic accuracy of smartwatch ECG in AF screening. Particularly in high-risk populations, a two-step approach—initial screening using smartwatch ECG followed by clinical confirmation for positive cases—presents a realistic and efficient strategy.&lt;/p&gt;&lt;p&gt;From the editorial perspective, we propose such a practical approach that may enhance the effectiveness of AF screening, particularly in high-risk populations. In this suggested workflow, the first step involves individuals recording ECGs through their smartwatches during routine self-monitoring. If the built-in algorithm detects a possible AF episode, a notification is issued. In the second step, the ECG data could be transmitted to a remote physician review service, where a clinical expert re-evaluates the tracing. Based on this review, triage decisions—such as “high likelihood of AF, recommend clinical consultation,” “unclear findings, suggest further testing,” or “no abnormality, continue observation”—can be made. This strategy may reduce unnecessary in-person visits while ensuring that those at risk receive timely and appropriate care. Such a two-step approach “a system comprising smartwatch ECG, remote review","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635249","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":"Prognostic relevance of arrhythmic and QTc burden in takotsubo cardiomyopathy: A systematic review and meta-analysis","authors":"Ankit Hanmandlu MD,&nbsp;Jyothik Varun Inampudi MD,&nbsp;Mohammad Hamza MD,&nbsp;Prakash Upreti MD,&nbsp;Abdul Rasheed Bahar MD,&nbsp;Jawad Basit BSc MBBS,&nbsp;Sivaram Neppala MD,&nbsp;Himaja Dutt Chigurupati MD,&nbsp;Rohit Goru BS,&nbsp;M. Chadi Alraies MD, MPH","doi":"10.1002/joa3.70138","DOIUrl":"https://doi.org/10.1002/joa3.70138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Takotsubo cardiomyopathy is characterized by stress-induced systolic dysfunction of the left ventricle that is largely reversible and not related to coronary ischemia. Patients with Takotsubo cardiomyopathy can often develop concurrent arrhythmias and prolonged QTc interval, which have been shown to contribute to significant morbidity and mortality in prior retrospective studies. Hence, we conducted a comprehensive systematic review and meta-analysis to characterize the risk of atrial arrhythmias, life-threatening arrhythmias, and QTc prolongation on clinical outcomes in patients with Takotsubo cardiomyopathy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched PubMed and EMBASE databases from inception to April 2024. A total of 13 studies were eligible for data collection across the three subgroups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Atrial and life-threatening arrhythmias in Takotsubo cardiomyopathy have an increased risk of in-hospital mortality and cardiogenic shock, a finding that was not observed in patients with prolonged QTc. Upon univariate analysis of the QTc subgroup, younger age and the presence of ST-Elevation were identified as additional negative prognostic indicators of adverse outcomes in Takotsubo cardiomyopathy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study demonstrates the increased risk of different arrhythmic profiles in Takotsubo cardiomyopathy. Further investigation is needed to identify pathophysiological mechanisms and tailored anti-arrhythmics to improve outcomes in this unique subset of Takotsubo patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144646797","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}