Journal of Arrhythmia最新文献

{"title":"Pre-Excited Atrial Fibrillation Degenerating Into Ventricular Fibrillation Captured by an Automated External Defibrillator","authors":"Mari Nakayama,&nbsp;Kodai Shinzato,&nbsp;Yuki Norita,&nbsp;Makoto Edayoshi,&nbsp;Takanori Yamaguchi","doi":"10.1002/joa3.70447","DOIUrl":"https://doi.org/10.1002/joa3.70447","url":null,"abstract":"<p>An automated external defibrillator (AED) captured the real-time transition from pre-excited atrial fibrillation to ventricular fibrillation in a previously undiagnosed patient with WPW syndrome. This case highlights the malignant potential of rapidly conducting accessory pathways.\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 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70447","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148753387","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":"Safety and Efficacy of Two Venous Closure Devices Compared With Manual Compression After Atrial Fibrillation Ablation","authors":"Satoko Shiomi,&nbsp;Kenichi Tokutake,&nbsp;Ui Takato,&nbsp;Ryutaro Sakurai,&nbsp;Yoshito Yamazaki,&nbsp;Takuya Matsumoto,&nbsp;Hidenori Sato,&nbsp;Hirotsuna Oseto,&nbsp;Masaaki Yokoyama,&nbsp;Seigo Yamashita,&nbsp;Teiichi Yamane,&nbsp;Michifumi Tokuda","doi":"10.1002/joa3.70442","DOIUrl":"https://doi.org/10.1002/joa3.70442","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>VASCADE MVP device has garnered attention as a novel femoral venous closure device. Manual compression (MC) is associated with prolonged bed rest and significant patient discomfort. Although Perclose ProGride/ProStyle device reduces bed rest duration, it can result in severe puncture site complications. The adoption of VASCADE MVP is anticipated to reduce the incidence of puncture site complications and facilitate early patient mobilization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 858 patients undergoing catheter ablation were included in this study (MC: <i>n</i> = 196; Perclose: <i>n</i> = 547; VASCADE: <i>n</i> = 115). Perclose device was introduced in January 2018, and VASCADE device in September 2024. Venous closure devices were employed for all suitable femoral puncture sheaths. In the MC group, compression was released after 7 h or the following morning; in the Perclose group after 4 h and in the VASCADE group after three or 4 h. Total post-procedure time and vascular complications were compared among the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The total post-procedure time was significantly shorter with VASCADE compared to Perclose and MC (22.6 ± 8.9 min vs. 29.6 ± 8.2 min and 30.4 ± 9.3 min, <i>p</i> &lt; 0.001). The incidence of re-bleeding was comparable between Perclose and VASCADE (11% vs. 13%, <i>p</i> = 0.787). No serious complications were observed in VASCADE group, whereas three patients (1%) in Perclose group experienced major complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The use of VASCADE devices safely reduced both total post-procedure time and bedrest times for complete hemostasis, without an associated increase in complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70442","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148753386","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":"Chronic but not Transient Anemia Is Associated With Atrial Fibrillation Recurrence After Catheter Ablation","authors":"Mikkel Guldberg Kasch,&nbsp;Númi Torpe Snæbjörnsson,&nbsp;Lise Da Riis-Vestergaard,&nbsp;Rogina Rached,&nbsp;Daniel Mølager Christensen,&nbsp;Casper Binding,&nbsp;Mariam Elmegaard,&nbsp;Mads Hashiba,&nbsp;Sebastian K. Nielsen,&nbsp;Morten Lambert,&nbsp;Christian Torp-Pedersen,&nbsp;Morten Schou,&nbsp;Gunnar Gislason,&nbsp;Abdullahi Ahmed Mohamed","doi":"10.1002/joa3.70445","DOIUrl":"https://doi.org/10.1002/joa3.70445","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Anemia is common in patients with atrial fibrillation (AF). Prior studies have associated anemia—based on a single pre-procedural hemoglobin measurement—with AF recurrence after catheter ablation. However, it remains unclear whether chronic anemia confers a different risk compared with transient anemia. This study evaluated the association between transient and chronic anemia and AF recurrence following first-time catheter ablation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this nationwide cohort study, we included 15 017 patients from the Danish National Ablation Database undergoing first-time AF ablation between 2010 and 2024 with available hemoglobin measurements within 12 months prior to the procedure. Patients were categorized as having no anemia, transient anemia, or chronic anemia based on repeated hemoglobin measurements. The primary outcome was AF recurrence within 1 year after a 90-day blanking period, defined as a composite of AF-related hospitalization, cardioversion, antiarrhythmic drug use, or repeat ablation. Associations were assessed using multivariable Cox proportional hazards models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 877 patients (5.8%) had chronic anemia and 1592 (10.6%) had transient anemia. During follow-up, 3445 patients (23.6%) experienced AF recurrence. The 1-year cumulative incidence of recurrence was highest in patients with chronic anemia (32.5%), followed by transient anemia (24.2%) and no anemia (23.0%). Compared with non-anemic patients, chronic anemia was independently associated with an increased risk of AF recurrence (adjusted hazard ratio [HR]: 1.36; 95% confidence interval [CI]: 1.18–1.56), whereas transient anemia was not (HR: 0.98; 95% CI: 0.87–1.10).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Chronic—but not transient—anemia prior to first-time catheter ablation was independently associated with a higher risk of AF recurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70445","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148753549","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":"Catheter Ablation for Atrial Fibrillation in Cardiac Amyloidosis: A Systematic Review and Meta-Analysis","authors":"Adivitch Sripusanapan,&nbsp;Natee Deepan,&nbsp;Bheem Pongsukvechkul,&nbsp;Suphatcha Kittiwongsopon,&nbsp;Min Choon Tan,&nbsp;Pattara Rattanawong,&nbsp;Dan Sorajja,&nbsp;Win-Kuang Shen,&nbsp;Ronpichai Chokesuwattanaskul,&nbsp;Narut Prasitlumkum","doi":"10.1002/joa3.70441","DOIUrl":"10.1002/joa3.70441","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atrial fibrillation (AF) is prevalent in cardiac amyloidosis (CA) and is associated with adverse clinical outcomes. Catheter ablation is increasingly used for rhythm control in this population, yet its clinical outcomes remain uncertain. We performed a systematic review and meta-analysis to evaluate arrhythmia recurrence and clinical outcomes following catheter ablation compared with medical therapy in patients with CA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We systematically searched MEDLINE, Embase, and Scopus from inception through December 2025 for studies evaluating catheter ablation of atrial arrhythmias in CA. Cohort studies reporting arrhythmia recurrence and/or clinical outcomes were included. The primary outcome was freedom from atrial arrhythmia (AA) following ablation. Secondary outcomes included all-cause mortality, heart failure hospitalization, and stroke. Random-effects models were used to pool event rates and odds ratios (ORs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirteen observational studies comprising 797 patients with CA and AF were included. The pooled rate of freedom from AA following catheter ablation was approximately 50% (95% CI 37%–63%; I² = 71.7%). The all-cause mortality analysis included 4 observational studies comprising 616 patients. Catheter ablation was associated with lower odds of all-cause mortality (OR 0.26, 95% CI 0.11–0.60; I² = 18.4%); however, this association should be interpreted with caution given the retrospective design and risk of bias. No statistically significant differences were observed for heart failure hospitalization or stroke.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In patients with CA, catheter ablation was associated with modest arrhythmia-free survival and lower odds of all-cause mortality. However, all contributing studies were observational cohorts. Randomized studies are needed to confirm these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711939","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":"Clinical Utility of HeartInsight Score Variability in the Management of Patients With Heart Failure","authors":"Takahiro Sekido,&nbsp;Hiroyasu Uzui,&nbsp;Natsuki Murata,&nbsp;Miku Takakura,&nbsp;Yuya Matunaka,&nbsp;Kazushi Hashiwaki,&nbsp;Shingo Horita,&nbsp;Mayumi Yoshikawa,&nbsp;Ryohei Nomura,&nbsp;Toshihiko Tsuji,&nbsp;Moe Mukai,&nbsp;Machiko Miyoshi,&nbsp;Kanae Hasegawa,&nbsp;Naoto Tama,&nbsp;Kentaro Ishida,&nbsp;Hiroshi Tada","doi":"10.1002/joa3.70426","DOIUrl":"10.1002/joa3.70426","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients with heart failure (HF) can be monitored remotely using cardiovascular implantable electronic devices (CIEDs). In Japan, the HeartInsight algorithm has been implemented in selected implantable cardioverter defibrillators and cardiac resynchronization therapy devices. This retrospective study investigated whether elevations above, and daily fluctuations in, the HeartInsight score threshold aid prediction of hospitalization for HF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 61 patients. Data were extracted from the BIOTRONIK Home Monitoring system; the number of days of HeartInsight score calculation, coefficient of variation, standard deviation, maximum value during the observation period, and mean values were analyzed. The primary endpoint was the first hospitalization for HF after CIED implantation. Patients were divided into two groups (HF hospitalization and non-HF hospitalization), and each parameter was compared between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The first hospitalization for HF after CIED implantation occurred in 10 of 61 patients (16%). Although the HF hospitalization group was younger than the non-HF hospitalization group, the two groups exhibited no differences in coronary risk factors, pharmacological therapies, or threshold elevation in HeartInsight scores. However, the HF hospitalization group demonstrated a tendency toward higher values, with significant differences observed in the maximum value and the difference between the maximum and mean values. Although few patients exhibited threshold elevation, greater daily variability was associated with a higher tendency toward HF hospitalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although predicting HF hospitalization based solely on threshold elevation is challenging, monitoring daily fluctuations may aid prediction. Evaluating score variability is important, even among patients without threshold elevation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148712288","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 of QRS Notch Resolution During LV-Only Fusion Pacing With Early Left Ventricular Reverse Remodeling After Cardiac Resynchronization Therapy","authors":"Junji Morita,&nbsp;Yuhei Kasai,&nbsp;Yumetsugu Munakata,&nbsp;Takayuki Kitai,&nbsp;Kei Murakami,&nbsp;Kazunari Mitsuishi,&nbsp;Daisuke Hachinohe,&nbsp;Yusuke Kondo","doi":"10.1002/joa3.70443","DOIUrl":"10.1002/joa3.70443","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cardiac resynchronization therapy (CRT) improves outcomes in patients with heart failure and left bundle branch block (LBBB); however, many patients remain non-responders. Identifying effective electrical resynchronization early remains an important clinical need.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the association between resolution of V5–V6 R-wave notching/slurring during left ventricular-only pacing (LV-only pacing), combined with an LV-only pacing percentage ≥ 50% at 1 month, and early left ventricular reverse remodeling in patients with complete LBBB (CLBBB) undergoing CRT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively studied 49 patients with CLBBB who underwent CRT. Patients with resolution of V5–V6 R-wave notching/slurring during LV-only pacing at implantation and an LV-only pacing percentage ≥ 50% at 1 month were classified as the R-Notch Resolution group; all others were classified as the Non–R-Notch Resolution group. The primary endpoint was left ventricular reverse remodeling at 1 month, defined as a ≥ 15% reduction in left ventricular end-systolic volume (LVESV) from baseline. Logistic regression analysis was performed to identify associated factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen patients were classified into the R-Notch Resolution group and 34 into the Non–R-Notch Resolution group. One-month left ventricular reverse remodeling occurred more frequently in the R-Notch Resolution group (80.0% vs. 47.1%). In multivariable logistic regression analysis, R-Notch Resolution group status remained independently associated with 1-month left ventricular reverse remodeling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Resolution of V5–V6 R-wave notching/slurring during LV-only pacing, combined with an LV-only pacing percentage ≥ 50% at 1 month, was independently associated with early left ventricular reverse remodeling after CRT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13454736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706552","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":"Pulsed Field Ablation Versus Thermal Ablation for First-Time Pulmonary Vein Isolation in Atrial Fibrillation: A Systematic Review and Meta-Analysis","authors":"Yousef Radwan Alnomani,&nbsp;Abdelaziz A. Awad,&nbsp;Ahmed Abdelaziz,&nbsp;Mazen Negmeldin Aly Yassin,&nbsp;Omnia Samy El-Sayed,&nbsp;Menna Marwan,&nbsp;Alaa Radwan Mady,&nbsp;Mahmoud Ali,&nbsp;Khaled Akil,&nbsp;Belal Hamed,&nbsp;Al-Hassan Soliman Wadan,&nbsp;Mohamed Abdelsalam","doi":"10.1002/joa3.70438","DOIUrl":"10.1002/joa3.70438","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>With over 60 million cases worldwide, atrial fibrillation (AF) is one of the most common cardiac arrhythmias in adults. Pulsed-field ablation (PFA) has emerged as a significant alternative to thermal ablation for pulmonary vein isolation (PVI). This systematic review and meta-analysis investigated the efficacy and safety of PFA versus thermal ablation in patients undergoing first-time PVI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We systematically searched PubMed, Scopus, Web of Science, and Cochrane Library from inception to 2025. Hazard ratios (HRs) with 95% confidence intervals (CIs) were derived from reconstructed Kaplan–Meier survival curves to compare atrial tachyarrhythmia recurrence between PFA and thermal ablation. Random-effects models were used to compare AF recurrence, durable PVI, redo procedures, phrenic nerve palsy (PNP), and other safety outcomes between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 27 studies comprising 8546 patients were included. Kaplan–Meier reconstruction from ten studies demonstrated higher 12-month arrhythmia-free survival with PFA compared with thermal ablation (78.4% [95% CI, 76.1–80.8] vs. 73.4% [95% CI, 71.5–75.4]). Thermal ablation was associated with a significantly higher risk of atrial tachyarrhythmia recurrence (HR 1.28, 95% CI 1.10–1.48; <i>p</i> = 0.001). Subgroup analyses demonstrated that PFA significantly reduced the recurrence risk in patients with paroxysmal AF (HR 1.63, 95% CI 1.31–2.03; <i>p</i> &lt; 0.001), whereas no significant difference was observed in those with persistent AF (HR 1.13, 95% CI 0.92–1.41; <i>p</i> = 0.25).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PFA was associated with lower rates of atrial tachyarrhythmia and AF recurrence rates than thermal ablation in patients undergoing first-time PVI; however, these findings should be interpreted cautiously, given the predominance of observational studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689322","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":"High-Density Electroanatomical Mapping of Alternating Short- and Long-RP Orthodromic Tachycardia With Identical Atrial Breakthrough","authors":"Alejandro Carta-Bergaz,&nbsp;Melanie Fernández-Caso,&nbsp;Esteban González-Torrecilla,&nbsp;Ángel Arenal","doi":"10.1002/joa3.70440","DOIUrl":"10.1002/joa3.70440","url":null,"abstract":"<p>High-density electroanatomical mapping during orthodromic tachycardia with alternating short- and long-VA conduction patterns demonstrated an identical earliest atrial breakthrough. Although this supports a common atrial insertion, it cannot distinguish functional longitudinal dissociation within a single accessory pathway from closely adjacent ventricular pathway components converging into a common atrial insertion.\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 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669448","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":"Improvement of Microvascular Ischemia by Atrioventricular Sequential Pacing in Non-Obstructive Hypertrophic Cardiomyopathy","authors":"Muthiah Subramanian,&nbsp;Radhika Manukonda,&nbsp;Sachin Yalagudri,&nbsp;Daljeet Kaur Saggu,&nbsp;Sridevi Chennapragda,&nbsp;Calambur Narasimhan","doi":"10.1002/joa3.70432","DOIUrl":"10.1002/joa3.70432","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Therapeutic options for symptomatic non-obstructive hypertrophic cardiomyopathy (nHCM) remain limited. We investigated whether right ventricular apical (RVA) pacing with optimal atrioventricular delay (AVD) can improve myocardial oxygen supply–demand mismatch, assessed using coronary sinus (CS) lactate as a marker of microvascular ischemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients underwent atrial pacing at 70% of target heart rate followed by AV sequential pacing at individually optimized AVD. CS lactate levels were measured at baseline, during atrial pacing, after washout, and during AV sequential pacing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline CS lactate was 0.55 ± 0.15 mmol/L and increased to 1.13 ± 0.29 mmol/L during atrial pacing. After washout, levels returned to near baseline (0.59 ± 0.21 mmol/L). During AV sequential pacing at optimal AVD (142.8 ± 20.6 ms), CS lactate decreased to 0.86 ± 0.31 mmol/L, showing a significant reduction compared to atrial pacing (<i>p</i> = 0.026). In 15 of 18 patients, CS lactate decreased during AV pacing compared with atrial pacing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>AV sequential pacing at optimized AVD reduces CS lactate during exertion in most patients with nHCM, suggesting improved myocardial oxygen balance and reduced microvascular ischemia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673598","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":"Clinical and Echocardiographic Factors Associated With AI-Estimated Atrial Fibrillation Likelihood During Sinus Rhythm in Patients With Documented Paroxysmal Atrial Fibrillation","authors":"Hiroki Sato,&nbsp;Akiko Baba,&nbsp;Yuki Kubota,&nbsp;Nozomi Kodama,&nbsp;Kei Hirota,&nbsp;Miho Miyoshi,&nbsp;Hidekazu Kondo,&nbsp;Akira Fukui,&nbsp;Tomoko Fukuda,&nbsp;Tetsuji Shinohara,&nbsp;Yasushi Teshima,&nbsp;Naohiko Takahashi","doi":"10.1002/joa3.70439","DOIUrl":"10.1002/joa3.70439","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Artificial intelligence-enabled electrocardiography (AI-ECG) has emerged as a promising tool for identifying patients with atrial fibrillation (AF) using sinus-rhythm ECGs. However, some patients with paroxysmal AF (PAF) may be assigned by AI-ECG to lower AF likelihood categories. Clinical and echocardiographic characteristics associated with AF likelihood assignment by AI-ECG remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center prospective study enrolled adults with documented PAF admitted for catheter ablation who were in sinus rhythm on the admission ECG. The four AF likelihood categories output by AI-ECG were dichotomized into higher and lower groups for analysis. Logistic regression was used to assess factors associated with assignment by AI-ECG to the higher AF likelihood group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 104 patients, 36 were categorized into the lower and 68 into the higher AF likelihood group. Hypertension was associated with lower odds of higher-group assignment (odds ratio [OR], 0.25; 95% confidence interval [CI], 0.10–0.66). In the echocardiographic model, higher left ventricular mass index (LVMI) was associated with lower (OR, 0.72 per 10 g/m² increase; 95% CI, 0.57–0.90) and mild or greater tricuspid regurgitation (TR) with higher (OR, 2.99; 95% CI, 1.14–7.87) odds of higher-group assignment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A lower AF likelihood assignment by AI-ECG was not uncommon among patients with documented PAF. Hypertension and higher LVMI were inversely associated with assignment to the higher AF likelihood group, whereas mild or greater TR showed a possible positive association. These findings suggest that AI-ECG-based AF likelihood assignment varies among patients with documented PAF during sinus rhythm.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669488","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}