Journal of Arrhythmia最新文献

{"title":"Parasympathetic Tone Selectively Modulates Electrogram Fragmentation and Spectral Properties in Right Atrial Ganglionated Plexi","authors":"Andrea Giomi,&nbsp;Andrea Bernardini,&nbsp;Alessandro Paoletti Perini,&nbsp;Margherita Padeletti,&nbsp;Cristiano Salvatore Zaccaria,&nbsp;Federica Michelotti,&nbsp;Umberto Signorini,&nbsp;Rossella Marcucci,&nbsp;Massimo Milli","doi":"10.1002/joa3.70424","DOIUrl":"https://doi.org/10.1002/joa3.70424","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>EGM fragmentation and spectral analysis have both been proposed to identify ganglionated plexi (GP) regions in the context of cardioneuroablation. However, their correlation has never been fully investigated, and it remains unclear whether these properties are related to structural or functional characteristics. The aim of this study is to evaluate how these features are related and modulated by parasympathetic tone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study population included 13 patients (mean age 34 ± 12 years, 69% male) undergoing an electrophysiological study. High-density right atrial mapping was performed using a multielectrode catheter during baseline conditions and after atropine administration. Spectral analysis of each point was obtained by fast Fourier transformation, deriving mean, median, and skewness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline maps showed fragmented EGM areas in the posterior-septal wall, corresponding to right atrial GP distribution. When compared to the remaining atrial myocardium, GP regions showed greater mean and median frequencies and lower skewness (<i>p</i> &lt; 0.001). Following atropine, only GP regions showed a significant decrease in mean (112.6 ± 13.9 to 101 ± 8.1 Hz, <i>p</i> = 0.02) and median frequency (<i>p</i> = 0.02), as well as an increase in skewness (0.03 ± 0.43 to 0.30 ± 0.27, <i>p</i> = 0.015), indicating a shift toward the spectral profile of compact myocardium. In non-GP locations, no significant spectral alterations were found.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EGM fragmentation and spectral properties are strongly correlated. Parasympathetic tone modulates both features exclusively in GP areas. The distinct signal pattern of GP regions may be a result of both local cholinergic release and structural cellular discontinuity with potential implications for a more precise targeting in the context of CNA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70424","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148616259","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":"Risk Stratification in Cardiovascular Medicine for Prognostic Assessment and Therapeutic Decision-Making: From Atrial Fibrillation to the Broader Disease Spectrum","authors":"Yuichi Saito,&nbsp;Kazuya Tateishi,&nbsp;Ken Kato,&nbsp;Hideki Kitahara,&nbsp;Yoshio Kobayashi","doi":"10.1002/joa3.70435","DOIUrl":"https://doi.org/10.1002/joa3.70435","url":null,"abstract":"<p>Risk stratification using validated scoring systems is fundamental to contemporary cardiovascular medicine, underpinning diagnosis, treatment selection, and prognostic assessment. This review provides a comprehensive overview of the major risk scores used across a broad spectrum of cardiovascular diseases, such as atrial fibrillation, acute coronary syndrome, and others, highlighting their development, clinical applications, and evolving roles in guideline-directed care. Importantly, predictive performance alone does not guarantee clinical benefit. We therefore examine evidence from randomized implementation trials evaluating whether risk score-guided management improves clinical outcomes and discuss the future role of artificial intelligence in reshaping cardiovascular risk assessment by integrating dynamic, individualized prediction with actionable clinical decision support.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70435","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148616204","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":"Electrocardiographic Predictors of Cardiac Reverse Remodeling After Left Bundle Branch Area Pacing in Atrioventricular Block: Emphasis on Post-Pacing QRS Duration","authors":"Fahmi Nur Hidayatullah,&nbsp;Giky Karwiky,&nbsp;Mohammad Rizki Akbar,&nbsp;Mohammad Iqbal,&nbsp;Vanny Febriana,&nbsp;Chaerul Achmad","doi":"10.1002/joa3.70425","DOIUrl":"https://doi.org/10.1002/joa3.70425","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Permanent pacing is essential for atrioventricular block, but conventional right ventricular pacing may cause electrical dyssynchrony and ventricular dysfunction. LBBAP offers a more physiological alternative, although response varies. This study aimed to identify electrocardiographic markers associated with reverse remodeling after LBBAP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This retrospective single-center study included 56 patients with atrioventricular block and reduced left ventricular ejection fraction who underwent LBBAP. Clinical, electrocardiographic, and echocardiographic data were assessed at baseline and 12-month follow-up. Reverse remodeling was defined as reduced LVESV with improved LVEF. Six post-pacing ECG parameters were evaluated: QRS duration, LVAT, V6–V1 interpeak interval, spatial QRS–T angle, Tp–Te interval, and R to Q ratio. Multivariable logistic regression evaluated variables associated with reverse remodeling, while ROC analysis assessed discriminative performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At 12 months, 40 patients (71.4%) achieved reverse remodeling. In univariable analysis, shorter post-pacing QRS duration, LVAT, and Tp-Te interval were associated with response. After multivariable adjustment, post-pacing QRS duration remained significantly associated with reverse remodeling (OR 0.87 per ms; 95% CI 0.80–0.95; <i>p</i> = 0.002), whereas optimal GDMT, LVAT, and Tp–Te interval were not statistically significant. Post-pacing QRS duration showed good discriminative performance (AUC 0.923).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Shorter post-pacing QRS duration was associated with reverse remodeling after LBBAP and may serve as a practical marker of electrical resynchronization. QRS duration may provide additional prognostic information for patient selection and pacing optimization.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70425","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148616337","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":"Diagnostic Accuracy of Electrocardiographic Criteria in Differentiating Arrhythmogenic Right Ventricular Cardiomyopathy From Idiopathic Outflow Tract Ventricular Arrhythmia: A Systematic Review and Meta-Analysis","authors":"Erika Maharani,&nbsp;Lucia Kris Dinarti,&nbsp;Dyah Wulan Anggrahini,&nbsp;Abida Hasna Laila,&nbsp;Nisrina Maulida Rozanti,&nbsp;Yoga Yuniadi","doi":"10.1002/joa3.70409","DOIUrl":"https://doi.org/10.1002/joa3.70409","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Differentiating arrhythmogenic right ventricular cardiomyopathy (ARVC) from idiopathic outflow tract ventricular arrhythmias (OT VA) remains a challenge due to overlapping electrocardiographic (ECG) features. However, their pathophysiology and prognosis differ. Given the limited accessibility of advanced imaging, ECG parameters could facilitate early diagnosis. This review and meta-analysis evaluate the diagnostic accuracy of ECG parameters in distinguishing ARVC from OT VA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic database search was conducted from inception to March 2025. Observational studies assessing ECG markers for differentiating ARVC from OT VA in adults were included. Diagnostic accuracy metrics (sensitivity, specificity, diagnostic odds ratio, and area under the receiver operating characteristic curve [AUC]) were synthesized using a bivariate random-effects model. Risk of bias was assessed using the QUADAS-2 tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ten studies enrolling 723 patients were included. T-wave inversion in V1–V3 was the most commonly assessed parameter, with a pooled sensitivity of 0.55 and specificity of 0.88 (AUC = 0.798). Epsilon waves demonstrated low sensitivity (0.12) but high specificity (0.98). Among depolarization-based parameters, QRS duration in V1–V3 (AUC = 0.832) and the ratio of QRS duration in precordial leads (AUC = 0.938) demonstrated strong diagnostic performance. S-wave upstroke and terminal activation delay also showed high specificity (0.95) but moderate sensitivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Several ECG parameters, particularly depolarization-based parameters, exhibit high specificity and moderate sensitivity in differentiating ARVC from OT VA. These findings support the use of ECG as a reliable and accessible diagnostic tool, particularly in settings without advanced imaging. A multi-marker ECG approach may enhance early recognition of patients with suspected ARVC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70409","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148616339","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":"Strategy-Specific Effects of Low-Voltage Area–Targeted Ablation Added to Pulmonary Vein Isolation: A Meta-Analysis of Randomized Controlled Trials","authors":"Akihiro Sunaga,&nbsp;Daisuke Sakamoto,&nbsp;Daisaku Nakatani,&nbsp;Katsuki Okada,&nbsp;Hirota Kida,&nbsp;Yuki Matsuoka,&nbsp;Hideaki Hasegawa,&nbsp;Tetsuhisa Kitamura,&nbsp;Masaharu Masuda,&nbsp;Yohei Sotomi,&nbsp;Yasushi Sakata","doi":"10.1002/joa3.70430","DOIUrl":"10.1002/joa3.70430","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Left atrial low-voltage areas (LVAs) represent an arrhythmogenic substrate in atrial fibrillation (AF). LVA-targeted ablation is increasingly used as an adjunct to pulmonary vein isolation (PVI), yet outcomes vary across randomized trials, potentially due to differences in ablation strategy. We performed a meta-analysis to evaluate the effectiveness of LVA-targeted ablation added to PVI and to assess whether treatment effects differ between LVA isolation and LVA homogenization strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following PRISMA, we systematically searched PubMed and CENTRAL for randomized controlled trials (RCTs). Eligible studies enrolled patients with any AF type undergoing voltage mapping and compared PVI plus LVA-targeted ablation (PVI + LVA) with PVI alone. The primary outcome was AF/atrial tachyarrhythmia recurrence during follow-up, as defined in each trial. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Subgroup analyses were performed according to the predominant LVA strategy (isolation vs. homogenization).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six RCTs involving 1565 patients (PVI + LVA, <i>n</i> = 780; PVI alone, <i>n</i> = 785) were included. Overall, PVI + LVA reduced recurrence compared with PVI alone (OR 0.72; 95% CI 0.54–0.96). In strategy-specific analyses, LVA isolation was associated with a significant reduction in recurrence (OR 0.57; 95% CI 0.38–0.87), whereas LVA homogenization showed a smaller and non-significant effect (OR 0.85; 95% CI 0.59–1.24). Between-strategy heterogeneity was substantial (<i>I</i>² = 90.4%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In RCTs of AF ablation, adding LVA-targeted ablation to PVI reduced arrhythmia recurrence. The treatment effect appeared more pronounced with LVA isolation than with homogenization; however, these strategy-specific findings should be considered exploratory and require confirmation in future randomized studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591695","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 Defibrillation After Conversion From Fixed-Tilt to Tuned-Duration Waveform","authors":"Yousaku Okubo,&nbsp;Hisayasu Matsuzaki,&nbsp;Shogo Miyamoto,&nbsp;Hiroshi Oe,&nbsp;Yukiko Nakano","doi":"10.1002/joa3.70436","DOIUrl":"10.1002/joa3.70436","url":null,"abstract":"<p>Fixed-tilt biphasic shocks may become ineffective in high-impedance states because phase-2 over-prolongation disrupts optimal charge neutralization. Waveform tuning based on membrane time constants, as implemented by DeFT Response, shortens phase durations to physiologic ranges and lowers the defibrillation threshold. This mechanism-based strategy may enhance the reliability of ICD therapy in patients with rising impedance or high DFTs.\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":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584517","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":"Artificial Intelligence Techniques in Cardiac Neuromodulation: Mechanisms, Applications, and Pathways to Clinical Translation","authors":"Kshitiz Pandey,&nbsp;Pratik Pandey,&nbsp;Sushmita Khanal,&nbsp;Ashish Panday","doi":"10.1002/joa3.70434","DOIUrl":"10.1002/joa3.70434","url":null,"abstract":"<p>Cardiac neuromodulation includes various methods, such as vagus nerve stimulation, baroreflex activation therapy, renal denervation, and stellate ganglion intervention, and targets the autonomic imbalance contributing to the pathophysiology of many cardiovascular diseases. Despite promising mechanistic evidence, several landmark trials, including INOVATE-HF, NECTAR-HF, and SYMPLICITY HTN-3, did not meet their primary clinical outcomes, with substantial numbers of non-responders observed across therapies. Variation in patient response is attributed to several unresolved issues, including insufficient stimulation dosing, off-target or non-selective fiber activation, and differences in autonomic phenotypes between patients. Both problems highlight the need for individualized approaches to patient selection, therapy delivery, and monitoring. Artificial intelligence (AI) offers tools to address these problems. In this narrative review, we describe seven families of AI techniques relevant to cardiac neuromodulation: supervised machine learning, deep learning, representation learning, reinforcement learning, multimodal fusion, digital twins with physics-informed AI, and explainable AI with federated learning. For each family, we summarize how the method works, the cardiac neuromodulation problem it addresses, and the available evidence in the field of cardiac electrophysiology. We then map these techniques to the three core problems of patient selection, real-time stimulation control, and longitudinal response monitoring. The strongest evidence to date supports representation learning for VNS responder identification, reinforcement learning for closed-loop VNS control, and digital twins for in silico testing of stimulation protocols. The opportunity for the field is to translate these methods, most of which were developed in adjacent fields, into prospective cardiac neuromodulation trials.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584429","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 Outcomes in Electrical Storm Versus Non–Electrical Storm Ventricular Tachycardia: A Systematic Review and Meta-Analysis","authors":"Ahmad Jalil,&nbsp;Fatima Rajab,&nbsp;Xuan Li,&nbsp;Abdulgafar Ibrahim,&nbsp;Arundhati Sawant,&nbsp;Michael Bashir,&nbsp;Varshitha Bandi,&nbsp;Karan Bhatt,&nbsp;Smit Mehta,&nbsp;Bilal Abaid,&nbsp;Arthur Alencar,&nbsp;Mahmoud Gomaa,&nbsp;Muhammad Afzal","doi":"10.1002/joa3.70366","DOIUrl":"10.1002/joa3.70366","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Electrical storm (ES) is a life-threatening manifestation of ventricular tachycardia (VT) associated with highmorbidity and mortality. Catheter ablation is an established therapy for VT, but the impact of ES on ablation outcomes remains uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and meta-analysis in accordance with PRISMA 2020 to compare VT ablation outcomes in patients with and without ES. PubMed, Cochrane Library, and ScienceDirect were searched from inception through January 2026. Eligible studies were comparative cohorts reporting periprocedural or long-term outcomes. Random-effects models were used to pool odds ratios (ORs), hazard ratios (HRs), and mean differences (MDs), with heterogeneity assessed using the I² statistic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six observational cohort studies including 3531 patients (1183 with ES and 2348 without ES) were included. Acute procedural endpoints, including post-ablation VT non-inducibility and residual inducible VT, were similar between groups. Periprocedural or in-hospital mortality was significantly higher in the ES group (OR 4.71, 95% CI 2.76–8.06), whereas complication rates, procedural duration, radiofrequency ablation time, and need for hemodynamic support did not differ significantly. During follow-up, ES was associated with higher all-cause mortality (OR 1.67, 95% CI 1.19–2.35) and greater VT recurrence in both arm-based (OR 1.45, 95% CI 1.11–1.91) and time-to-event analyses (HR 1.35, 95% CI 1.16–1.57).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>VT ablation showed comparable acute procedural success and procedural safety in patients with and without ES. However, ES was associated with higher early and long-term mortality and greater VT recurrence, supporting its role as a marker of adverse prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578792","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":"The Japanese Catheter Ablation Registry (J-AB): Annual Report in 2024","authors":"Kengo Kusano,&nbsp;Koichi Inoue,&nbsp;Koshiro Kanaoka,&nbsp;Koji Miyamoto,&nbsp;Yasuo Okumura,&nbsp;Yu-ki Iwasaki,&nbsp;Kazuhiro Satomi,&nbsp;Seiji Takatsuki,&nbsp;Kohki Nakamura,&nbsp;Seigo Yamashita,&nbsp;Masaharu Masuda,&nbsp;Yoshitaka Iwanaga,&nbsp;Shoko Chishaki-Kawabata,&nbsp;Teiichi Yamane,&nbsp;Wataru Shimizu,&nbsp;Hiroshi Tada,&nbsp;J-AB registry investigators","doi":"10.1002/joa3.70429","DOIUrl":"10.1002/joa3.70429","url":null,"abstract":"<p>The Japanese Catheter Ablation (J-AB) registry, started in August 2017, is a voluntary, nationwide, multicenter, prospective, observational registry performed by the Japanese Heart Rhythm Society (JHRS) in collaboration with the National Cerebral and Cardiovascular Center. From January 2022, the data registration system was changed from Research Electronic Data Capture (REDCap) system to Fountayn system. The purpose of this registry is to collect the details of target arrhythmias, the ablation procedures, including the types of target arrhythmias, outcomes, and acute complications in the real-world settings. During the year 2024, we have collected a total of 112 151 procedures (mean age of 67.5 years and 65.2% male) from 589 participant hospitals. Detailed data were shown in Figures and Tables.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549088","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":"Comparative Effectiveness of Antiarrhythmic Drugs on Early Atrial Tachyarrhythmias in the Blanking Period After Atrial Fibrillation Catheter Ablation","authors":"Asami Kashiwa,&nbsp;Yukio Hosaka,&nbsp;Yuka Hayashi,&nbsp;Komei Tanaka,&nbsp;Kazuyuki Ozaki,&nbsp;Masaomi Chinushi,&nbsp;Yoshifusa Aizawa,&nbsp;Kazuyoshi Takahashi","doi":"10.1002/joa3.70433","DOIUrl":"10.1002/joa3.70433","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Early recurrence of atrial tachyarrhythmia (ERAT) after ablation for atrial fibrillation (AF) is common during the blanking period; however, no standardized management approach exists. This study aimed to identify effective antiarrhythmic drugs (AADs) during the blanking period and to examine the association between AAD efficacy and long-term outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Initially, 497 patients who underwent catheter ablation for AF between April 2017 and December 2022 were included. Among these, patients who experienced ERAT after their first AF ablation were analyzed for this retrospective study. During the blanking period, the effectiveness of three AAD regimens, pilsicainide, bepridil, and bepridil plus aprindine, was compared. Patients were followed for 2 years after AAD discontinuation and stratified according to late recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 75 patients analyzed, ERAT was suppressed in 29.6% (8/27) with pilsicainide, 38.1% (8/21) with bepridil, and 77.8% (21/27) with bepridil plus aprindine (<i>p</i> = 0.0009). Among patients without late recurrence, ERAT suppression was higher with bepridil-based regimens: pilsicainide, 27.8% (5/18); bepridil, 66.7% (6/9); and bepridil plus aprindine, 89.5% (17/19) (<i>p</i> = 0.0006). Poor response to bepridil-based therapy was associated with a high late recurrence rate (73.7%, 14/19), whereas lack of response to pilsicainide was not (31.6%, 6/19) (<i>p</i> = 0.009).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Bepridil, particularly in combination with aprindine, was effective for managing ERAT after AF ablation. A poor response to bepridil or to bepridil plus aprindine during the blanking period may serve as a marker for identifying patients at higher risk of late recurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"42 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549025","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}