Journal of Arrhythmia最新文献

{"title":"Implantable cardiac defibrillator outcomes in octogenarians","authors":"Bryan Stringer MD,&nbsp;Luke MacLeod MD,&nbsp;Fady Kaldas MD,&nbsp;Gayuni Krishnasamy BSc,&nbsp;Habib Rehman Khan MBBS FRCPUK PhD","doi":"10.1002/joa3.70012","DOIUrl":"https://doi.org/10.1002/joa3.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Implantable cardiac defibrillators (ICDs) are essential for preventing sudden cardiac death. Despite inclusion in national guidelines, older adults are often underrepresented in trials. Evaluating ICD use in the aging population, particularly with advancements in heart failure treatment, is crucial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study examines outcomes in octogenarians undergoing ICD implantation for primary and secondary prevention, focusing on ICD therapies and mortality timing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective observational study at a single Canadian academic center included patients ≥80 years old at ICD implantation, excluding those with &lt;30 days follow-up. Data on demographics, comorbidities, mortality, and ICD therapies were collected from electronic medical records. Clinical frailty was assessed using the Dalhousie Clinical Frailty Scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 143 patients (mean age 82.6 ± 2.2 years, 14% female) from May 2015 to October 2023. ICDs were implanted for primary prevention in 63 patients (44%) and secondary prevention in 80 patients (56%). Thirty-seven patients were excluded due to insufficient follow-up. ICD therapies occurred in 30 patients (25%) through anti-tachycardia pacing (ATP) and in 19 patients (18%) through shocks. The mean time to first ATP was 16.9 ± 21.0 months, and to first shock, 21.2 ± 23.6 months. Among 66 patients with mortality data, 19 (24%) died at 31.3 ± 30.4 months. Patients with non-ischemic cardiomyopathy experienced earlier shocks (7.7 vs. 32.2 months, <i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Elderly patients undergoing ICD implantation have multiple comorbidities and competing causes of mortality. Device use is overall infrequent but occurs well before observed mortality. Prospective clinical trials are needed to determine ICD benefits in this age cohort.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397151","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":"Successful radiofrequency ablation via transseptal approach for premature ventricular contractions originating from left ventricular outflow tract following self-expanding transcatheter aortic valve implantation","authors":"Yuhei Kasai MD, FHRS,&nbsp;Takayuki Kitai MD,&nbsp;Ryo Horita MD,&nbsp;Junji Morita MD,&nbsp;Daisuke Hachinohe MD","doi":"10.1002/joa3.70025","DOIUrl":"https://doi.org/10.1002/joa3.70025","url":null,"abstract":"<p>Transseptal catheter ablation resolved ventricular arrhythmias originating from the left ventricular outflow tract following transcatheter aortic valve implantation with a self-expanding Evolut valve. This report highlights the transseptal approach as a safe and effective alternative, overcoming the structural complexities of self-expanding valves while reducing procedural risks and preserving valve integrity.\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 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397152","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":"Managing a ventricular tachycardia storm: Looking beyond the horizon","authors":"Sanjai Pattu Valappil M.D. (internal medicine), DM (cardiology),&nbsp;Abhinav B. Anand DM cardiology,&nbsp;Prashanthan Sanders MBBS, PhD,&nbsp;Ramana Murugadass MBBS","doi":"10.1002/joa3.70018","DOIUrl":"https://doi.org/10.1002/joa3.70018","url":null,"abstract":"<p>The case highlights the possibility of nonischemic cardiomyopathy in patients with coronary artery disease and the complex nature of the isthmus with multiple entry and exit points. A combination of multiple strategies, that is, unipolar mapping, isochronal late activation mapping during sinus rhythm, and positioning of a multielectrode catheter at the putative isthmus during VT induction in the case of hemodynamically unstable VT, was used to achieve a successful outcome.\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 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397199","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 upgrade left bundle branch area pacing for right ventricular pacing-induced cardiomyopathy: Extra QRS shortening matters","authors":"Hao Huang,&nbsp;Xiaofeng Li,&nbsp;Tianxin Long,&nbsp;Yu Yu,&nbsp;Sijing Cheng,&nbsp;Xiaohui Ning,&nbsp;Xuhua Chen,&nbsp;Min Gu,&nbsp;Hongxia Niu,&nbsp;Wei Hua","doi":"10.1002/joa3.70017","DOIUrl":"https://doi.org/10.1002/joa3.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Left bundle branch area pacing (LBBAP) has developed as a strategy for patients with pacing-induced cardiomyopathy (PICM). We aimed to compare the upgrade effectiveness between LBBAP and traditional biventricular pacing (BVP) in PICM patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Consecutive PICM patients with successful device upgrades were enrolled. The primary outcome was the echocardiographic response, defined as absolute left ventricular ejection fraction (LVEF) improvement ≥5% at 6-month follow up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 92 patients were included. 61 underwent BVP and 31 underwent LBBAP. The median RVP burden was 96.8% (IQR: 93.0–99.0%). LBBAP achieved a shorter paced QRS duration (QRSd) compared with BVP (145.9 ± 22.4 ms vs. 157.5 ± 26.5 ms; <i>p</i> =.031). At 6 months, LBBAP had a higher echocardiographic response rate than BVP (67.7% vs. 39.3%, <i>p</i> =.019). LVEF increased from 37.8% ± 9.2% to 44.8% ± 10.2% (<i>p</i> &lt;.001) in LBBAP compared with an improvement from 35.7% ± 8.9% to 38.2% ± 12.1% (<i>p</i> &lt;.01) in BVP, with significantly greater change from baseline in LBBAP (7.0% ± 7.0% vs. 2.5% ± 8.7%; <i>p</i> =.024). Narrower pacing QRS after upgrade was associated with better echocardiographic response only in LBBAP but not in BVP. (<i>P</i> for interaction &lt;.05). Both groups had similar rates of composite clinical outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LBBAP improved echocardiographic response compared with BVP in PICM patients. The superior efficacy of LBBAP in reverse remodeling was dependent on improved electrical synchrony.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397149","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":"Can lead damage be ruled out using defibrillation threshold testing in patients with very high-impedance shock leads?","authors":"Masataka Narita MD,&nbsp;Yoshifumi Ikeda MD, PhD,&nbsp;Hitoshi Mori MD, PhD,&nbsp;Ritsushi Kato MD, PhD,&nbsp;Kazuo Matsumoto MD, PhD","doi":"10.1002/joa3.70014","DOIUrl":"https://doi.org/10.1002/joa3.70014","url":null,"abstract":"<p>This is the first report describing a shock lead whose functionality can be assessed using TSI measurement, even in cases where shock impedances derived from LVSM exceed 200 Ω. However, the lead exhibited high shock impedance after the DFT test, highlighting the need to monitor it closely.\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 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143396879","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":"Utilizing the lid of SL sheath packaging for a water-seal catheter insertion technique","authors":"Tatsuya Hayashi MD, PhD,&nbsp;Shingo Yamamoto MD,&nbsp;Jumpei Ohashi MD, PhD,&nbsp;Hideo Fujita MD, PhD","doi":"10.1002/joa3.70021","DOIUrl":"https://doi.org/10.1002/joa3.70021","url":null,"abstract":"<p>In the era of cryoablation and pulsed-field ablation, where large sheaths are commonly used, preventing air embolism is crucial. The lid from SL sheath packaging can be repurposed as a water-seal device for catheter insertion, thereby eliminating the need for additional equipment.\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 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362763","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":"Sex based disparities in hospitalization and readmission outcomes for complete atrioventricular block: Insights from United States readmission data","authors":"Nadhem Abdallah MD,&nbsp;Mohammed Samra MD,&nbsp;Momen Alsayed MBBS","doi":"10.1002/joa3.70013","DOIUrl":"https://doi.org/10.1002/joa3.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sex disparities in cardiovascular disorders are well-documented, but data on hospitalization and readmission outcomes in the context of sex for Complete Heart Block (CHB) remains limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed the 2016–2020 Nationwide Readmission Database to identify patients with a principal diagnosis of CHB. Men served as the control group, while women comprised the study cohort. The primary outcome was mortality. Secondary outcomes included odds of cardiac arrest, ventricular tachycardia, heart failure, mechanical ventilation use, all-cause 30-day readmission, total and early pacemaker use, length of stay (LOS), and total hospitalization charges (THC). Multivariate regression models adjusted for confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 175,257 patients with CHB, 45% were female. Female sex was associated with higher odds of mortality (adjusted OR [aOR] 1.42, 95% CI 1.3–1.55) compared to males. Additionally, females had higher odds of cardiac arrest (aOR 1.13, 95% CI 1.06–1.2), ventricular tachycardia (aOR 1.1, 95% CI 1.05–1.17), heart failure (aOR 1.18, 95% CI 1.14–1.22), mechanical ventilation use (aOR 1.1, 95% CI 1.03–1.17), and all-cause 30-day readmission (aOR 1.1, 95% CI 1.03–1.14). Women also had lower odds of total pacemaker use (aOR 0.92, 95% CI 0.88–0.96) and early pacemaker use (aOR 0.89, 95% CI 0.86–0.82). Female patients exhibited longer LOS (4.13 days vs. 3.86 days, <i>p</i> &lt; 0.001) but incurred lower THC ($89,908 vs. $94,590, <i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Female sex in CHB patients was associated with higher mortality and adverse events but lower pacemaker use compared to male patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362768","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":"Unusual left-sided variant orientation of the slow conduction zone in adenosine-sensitive atrial tachycardia","authors":"Shuhei Arai MD, PhD,&nbsp;Taku Asano MD, PhD,&nbsp;Yuki Takai MD,&nbsp;Yuya Nakamura MD, PhD,&nbsp;Toshiro Shinke MD, PhD","doi":"10.1002/joa3.70015","DOIUrl":"https://doi.org/10.1002/joa3.70015","url":null,"abstract":"<p>Adenosine-sensitive atrial tachycardia (AT) is typically associated with a slow conduction zone (SCZ) near the atrioventricular node or tricuspid annulus. We report an unusual case of adenosine-sensitive AT with a SCZ located between the left atrial appendage and the left atrial anterior septum, which was successfully ablated 9.2 mm from the left atrial earliest activation site. This case highlights the importance of advanced mapping and entrainment techniques in the identification and management of rare left-sided SCZ variants of adenosine-sensitive AT.\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 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362765","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 novel ablation strategy of slow/fast atrioventricular nodal reentrant tachycardia targeting the atrial activation focusing point at the inferior Koch's triangle: Identification of entrance site of slow pathway using high-resolution 3D mapping","authors":"Koji Sudo MD,&nbsp;Kenji Kuroki MD, PhD,&nbsp;Yasuteru Yamauchi MD, PhD,&nbsp;Akira Sato MD, PhD,&nbsp;Kazutaka Aonuma MD, PhD","doi":"10.1002/joa3.70019","DOIUrl":"https://doi.org/10.1002/joa3.70019","url":null,"abstract":"<p>This is the case of a 29-year-old female with sudden palpitations due to tachycardia. The atrial activation focusing point (AFP) was presumed to be the atrial entrance site within the reentry circuit of slow/fast atrioventricular nodal reentrant tachycardia by postpacing interval mapping. AFP is a novel ablation site because it is more distal to the His-bundle recording site and more atrial site compared to the conventional SP ablation site.\u0000 <figure>\u0000 <div><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362764","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":"Feasibility of left bundle branch area pacing with left axillary pacemaker implantation in a young female patient with heart failure","authors":"Hiroyuki Kato MD, PhD,&nbsp;Yuji Narita MD, PhD,&nbsp;Satoshi Yanagisawa MD, PhD,&nbsp;Yasuya Inden MD, PhD,&nbsp;Toyoaki Murohara MD, PhD","doi":"10.1002/joa3.70022","DOIUrl":"https://doi.org/10.1002/joa3.70022","url":null,"abstract":"<p>Device implantation with a generator pocket raises cosmetic concerns regarding external appearance. We present a case of successful left bundle branch area pacing and left axillary pacemaker generator implantation via a two-incision approach in a young female patient, resulting in favorable cardiac function and cosmetic satisfaction.\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 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362761","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}