Journal of Arrhythmia最新文献

{"title":"How to demonstrate drug-induced Type 1 Brugada pattern electrocardiogram","authors":"Naoya Kataoka MD,&nbsp;Teruhiko Imamura MD, PhD","doi":"10.1002/joa3.13170","DOIUrl":"10.1002/joa3.13170","url":null,"abstract":"<p>Data on drug-induced Type 1 Brugada patterns remain limited. The authors' study examined the clinical characteristics and implications of drug-induced Type 1 Brugada patterns,<span>¹</span> raising several concerns.</p><p>During the follow-up period, 10% of patients exhibited a spontaneous Type 1 pattern,<span>¹</span> suggesting that Brugada syndrome may be a progressive disease. Recently, multiple syndromes, including Brugada syndrome, J-wave syndrome, and idiopathic ventricular fibrillation, have been postulated to represent the same underlying condition: subepicardial cardiomyopathy.<span>²</span> This condition is characterized by an arrhythmogenic substrate located in the epicardium with fibrosis and the progressive nature of Brugada syndrome lends support to this concept. Another critical concern is the identification of patients in whom a spontaneous Type 1 pattern develops. This cohort may demonstrate a higher prevalence of pathogenic variants and delayed enhancement on cardiac magnetic resonance imaging. The prognostic significance of these findings remains a topic of interest.</p><p>Due to the small number of events observed in patients with drug-induced Type 1 patterns, the authors did not advocate for routine sodium channel blocker challenge tests.<span>¹</span> However, the underlying mechanisms responsible for these findings remain unclear. The sodium channel blocker challenge test is typically performed to identify arrhythmogenic substrates, which are the therapeutic targets of catheter ablation in symptomatic Brugada syndrome patients.<span>³</span> Should we reconsider the necessity of this drug challenge test to ensure adequate catheter ablation?</p><p>The authors' study did not address the presence of early repolarization,<span>¹</span> which is often seen in patients with Brugada syndrome and constitutes a risk factor for arrhythmic events.<span>⁴</span> How many patients had concomitant early repolarization? The response to ajmaline in J-wave may vary depending on the presence of arrhythmic events or the specific location of early repolarization, an aspect that warrants further investigation.</p><p>Authors declare no conflict of interests for this article.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1535"},"PeriodicalIF":2.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818048","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":"Workflow of the zero-fluoro pulsed field ablation","authors":"Shu Hirata MD,&nbsp;Koichi Nagashima MD, PhD,&nbsp;Ryuta Watanabe MD, PhD,&nbsp;Yuji Wakamatsu MD, PhD,&nbsp;Moyuru Hirata MD,&nbsp;Sayaka Kurokawa MD, PhD,&nbsp;Naoto Otsuka MD, PhD,&nbsp;Masanaru Sawada MD,&nbsp;Yasuo Okumura MD","doi":"10.1002/joa3.13174","DOIUrl":"10.1002/joa3.13174","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Zero-fluoroscopic pulsed field ablation (PFA) is the next step in advancing pulmonary vein isolation (PVI) for atrial fibrillation (AF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A workflow incorporating a variable-loop circular PFA catheter, intracardiac echocardiography (ICE), and a visualized sheath was applied to 15 paroxysmal AF patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>It consisted of three steps: (1) positioning a non-magnetic mapping catheter in the coronary sinus after creating a right atrial matrix, (2) transseptal puncture with the sheath advancement to the left atrium under ICE guidance, and (3) PFA confirming catheter-tissue contact with tissue proximity indication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This zero-fluoro PFA workflow is feasible without advanced technique.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1529-1532"},"PeriodicalIF":2.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818129","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 implication of R wave in aVR during ventricular tachycardia or premature ventricular contraction","authors":"Naoya Kataoka MD,&nbsp;Teruhiko Imamura MD, PhD","doi":"10.1002/joa3.13171","DOIUrl":"10.1002/joa3.13171","url":null,"abstract":"<p>The authors identified that the presence of an R wave in lead aVR during wide QRS complex ventricular tachycardia (VT) or premature ventricular contraction (PVC) is a valuable observation in determining the origin of the arrhythmia.<span>¹</span> However, several concerns have been raised.</p><p>The authors concluded that their study could differentiate between supraventricular tachycardia with aberrancy and VT.<span>¹</span> Nonetheless, it is generally recommended to compare the QRS complex morphology during VT/PVC with that observed during sinus rhythm. The presence of an R wave in lead aVR alone may be insufficient for this differentiation.</p><p>The authors sought to distinguish the origins of VT/PVC between the basal region (Zone 1) and the apex (Zone 2).<span>¹</span> However, the method has already been established as a concordance pattern in the chest leads.<span>²</span> It is suggested that the authors compare their novel methodology with these conventional approaches.</p><p>It is unclear whether the authors have adequately differentiated between reentrant and automatic mechanisms.<span>¹</span> In cases of automaticity, the body surface electrocardiogram (ECG) is directly associated with guiding ablation targets. However, in cases of reentry, the body surface ECG merely identifies the exit site, necessitating further investigation to locate the critical isthmus. Notably, body surface ECG-guided ablation is ineffective for VTs involving the conduction system, such as fascicular VT.<span>³</span></p><p>The authors' methodology appears unable to distinguish between VT/PVC originating in the right ventricle versus the left ventricle.<span>¹</span> In right ventricular cases, the Brockenbrough technique is unnecessary, whereas in left ventricular cases, intracardiac ultrasonography is required. For instance, can the authors' methodology differentiate between right and left ventricular origins in cases of intraventricular septal arrhythmias?</p><p>Authors declare no conflict of interests for this article.</p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1534"},"PeriodicalIF":2.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818098","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":"An abrupt loss of capture during permanent His-bundle pacing: Assessment of mechanism underlying late capture threshold rise","authors":"Hiroyuki Kato MD, PhD,&nbsp;Satoshi Yanagisawa MD, PhD,&nbsp;Ryusuke Ota MD,&nbsp;Yasuya Inden MD, PhD,&nbsp;Toyoaki Murohara MD, PhD","doi":"10.1002/joa3.13165","DOIUrl":"10.1002/joa3.13165","url":null,"abstract":"<p>A His-bundle (HB) capture threshold rise is still a significant concern in permanent His-bundle pacing (HBP). We present a case where an abrupt increase in HB threshold and loss of capture occurred even after 3.5 years of stable permanent HBP for an atrioventricular block. The development of local fibrosis around the lead helix and the change in an insertion angle of the lead might adversely affect the HB capture threshold in the chronic phase.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1525-1528"},"PeriodicalIF":2.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818082","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":"Performance of the novel ANTWERP score in predicting heart function improvement after atrial fibrillation ablation in Asian patients with heart failure","authors":"Lo-Chieh Ling MD,&nbsp;Ting-Yung Chang MD,&nbsp;Yenn-Jiang Lin MD,&nbsp;Chin-Yu Lin MD,&nbsp;Shih-Lin Chang MD,&nbsp;Li-Wei Lo MD,&nbsp;Yu-Feng Hu MD,&nbsp;Fa-Po Chung MD,&nbsp;Shih-Ann Chen MD","doi":"10.1002/joa3.13162","DOIUrl":"10.1002/joa3.13162","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous research has demonstrated that atrial fibrillation (AF) ablation improves heart function variably among patients. We proposed that the ANTWERP score, which was validated in a European group of patients with low left ventricular ejection fraction (LVEF) who had AF ablation, would be valid in an Asian group as well. The purpose of the study is to examine how well a new scoring system (the ANTWERP score) can predict heart function improvement after atrial fibrillation ablation in Asian patients with heart failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review was conducted on patients (<i>n</i> = 84) undergoing AF ablation between January 2019 and June 2022. Initial diagnoses for impaired LV systolic function were confirmed by echocardiography. Patients meeting the “2021 Universal Definition of HF” criteria for LVEF recovery were classified as “responders.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Similarities were observed between responders and nonresponders regarding comorbidities, AF type, and LVEF, except for the left ventricular internal diameter in diastole. A higher percentage of responders had an ANTWERP score ≤2 (87.8%) compared to those with a score &gt;2 (55.6%). LVEF improvement was notably higher in the former group (+14.8% vs. +9.4%, <i>p</i> = .043). Atrial reverse remodeling and recurrent atrial arrhythmia rates were similar across groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The conclusion of the study was that the ANTWERP score effectively predicted LVEF improvement after atrial fibrillation ablation in the Asian population and that this scoring system could be used to guide clinical decisions and prognosis prediction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1359-1369"},"PeriodicalIF":2.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818097","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 spontaneous or pacing-induced transition from slow-fast atrioventricular nodal reentrant tachycardia to fast-slow type using a superior slow pathway","authors":"Hiroyuki Miyazawa MD,&nbsp;Itsuro Morishima MD, PhD,&nbsp;Yasunori Kanzaki MD,&nbsp;Kazuki Shimojo MD","doi":"10.1002/joa3.13157","DOIUrl":"10.1002/joa3.13157","url":null,"abstract":"<p>Wenckebach-periodic VA prolongation and abrupt shortening of HH interval during tachycardia indicate (i) a retrograde block at the upper common pathway that manifested a retrograde atrial activation via the superior slow pathway, and (ii) an antegrade return of a retrograde atrial activation to His bundle via the fast pathway.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1501-1504"},"PeriodicalIF":2.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818059","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":"Predictability of indicators in local activation time mapping of ablation success for premature ventricular contractions","authors":"Takahiko Nagase MD, PhD,&nbsp;Takafumi Kikuchi MD,&nbsp;Shun Akai MD,&nbsp;Masafumi Himeno MD,&nbsp;Ryo Ooyama MD,&nbsp;Yoshinori Yoshida MD,&nbsp;Chiyo Yoshino MD,&nbsp;Takafumi Nishida MD,&nbsp;Takahisa Tanaka MD,&nbsp;Mitsunori Ishino MD, PhD,&nbsp;Ryuichi Kato MD, PhD,&nbsp;Masao Kuwada MD","doi":"10.1002/joa3.13148","DOIUrl":"10.1002/joa3.13148","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Differences in predictability of ablation success for premature ventricular contractions (PVCs) between earliest isochronal map area (EIA), local activation time (LAT) differences on unipolar and bipolar electrograms (⊿LAT_Bi-Uni), LAT prematurity on bipolar electrograms (LAT_Bi), and unipolar morphology of QS or Q pattern remain unclear. We verified multiple statistical predictabilities of those indicators of ablation success on mapped cardiac surface.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty-five patients with multiple PVCs underwent catheter ablation after LAT mapping using multipolar mapping catheters with unipolar-based annotation. Patients were divided into success and failure groups based on ablation success on mapped cardiac surfaces. Discrimination ability, reclassification table, calibration plots, and decision curve analysis of 10 ms EIA (EIA_10ms), ⊿LAT_Bi-Uni, and LAT_Bi were validated. Unipolar morphology was compared between success and failure groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Right ventricular outflow tract, aortic cusp, and left ventricle were mapped in 17, 10, and 8 patients, respectively. In 14/35 (40%) patients, successful ablation was performed on mapped cardiac surfaces. Area under the curve of receiver-operating characteristic curve of EIA_10ms, ⊿LAT_Bi-Uni, and LAT_Bi were 0.874, 0.801, and 0.650, respectively (EIA_10ms vs. LAT_Bi, <i>p</i> =.014; ⊿LAT_Bi-Uni vs. LAT_Bi, <i>p</i> =.278; EIA_10ms vs. ⊿LAT_Bi-Uni, <i>p</i> =.464). EIA_10ms and ⊿LAT_Bi-Uni demonstrated better predictability, calibration, and clinical utility on reclassification table, calibration plots, and decision curve analysis than LAT_Bi. Unipolar morphology of QS or Q pattern did not correlate with ablation success (<i>p</i> =.518).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>EIA_10ms and ⊿LAT_Bi-Uni more accurately predict ablation success for PVCs on mapped cardiac surfaces than LAT_Bi and unipolar morphology.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1432-1441"},"PeriodicalIF":2.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818106","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":"Hydrodissection for pericardial adhesion in percutaneous epicardial ventricular tachycardia ablation","authors":"Yoshimi Onishi MD, PhD,&nbsp;Taku Asano MD, PhD,&nbsp;Shuhei Arai MD, PhD,&nbsp;Yuya Nakamura MD, PhD,&nbsp;Toshiro Shinke MD, PhD","doi":"10.1002/joa3.13159","DOIUrl":"10.1002/joa3.13159","url":null,"abstract":"<p>Epicardial ablation in patients with pericardial adhesions is challenging. This case is the first report of successful epicardial ventricular tachycardia ablation by combining hydrodissection with the previously reported blunt dissection techniques for pericardial adhesions. This approach demonstrates a promising technique for managing similar cases where traditional methods may fail, providing a safer and more effective solution for epicardial ablation in patients with pericardial adhesions.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1514-1518"},"PeriodicalIF":2.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818052","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":"Impact of anisotropic conduction and premature atrial contraction on the fractionated atrial potentials","authors":"Hideko Toyama MD, PhD,&nbsp;Koichiro Kumagai MD, PhD","doi":"10.1002/joa3.13161","DOIUrl":"10.1002/joa3.13161","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Fractionated atrial potential (FAP) during sinus rhythm (SR) may be a new target for ablation of atrial fibrillation (AF). However, the effects of the direction of activation and premature atrial contraction (PAC) on FAP is unknown. Therefore, we examined the impact of anisotropic conduction and PAC on the distribution and areas of FAP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>FAP map in the left atrium was created in 40 patients with AF before ablation. The distribution and areas of FAP were compared during SR, distal coronary sinus (CS) pacing (S1) and extrastimulus (S2), and paced PAC after SR. FAP was defined as a potential with four or more fragmented deflections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>FAPs during SR were found in the right and mid-anterior walls and septum in most patients. During S1 compared to SR, FAPs significantly decreased in the right and mid-anterior walls, appendage, septum, and right inferior wall, while significantly increased in the lateral wall. During S2 compared to S1, FAPs significantly increased in the mid anterior and right and mid posterior walls. During PAC compared to SR, FAPs significantly decreased in the right and mid anterior walls and roof, while significantly increased in the left anterior, left inferior and lateral walls. A rotational activation pattern at the FAP area during CS pacing was observed in 12 patients (30%), mostly in the left inferior wall.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The distribution and areas of FAP vary with anisotropic conduction and extrastimulus. Therefore, FAP should be evaluated not only during SR but also during extrastimulus from the distal CS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1381-1388"},"PeriodicalIF":2.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818063","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":"Utility of cardiac implantable electronic device algorithm for detecting severe sleep-disordered breathing in cardiomyopathy","authors":"Jiaqi Li MB BChir,&nbsp;Yingjuan Mok MBBS,&nbsp;Vern Hsen Tan MBBS,&nbsp;Hang Siang Wong MBBS,&nbsp;Yue Wang MD,&nbsp;Ying Zi Oh MD,&nbsp;Ai Ling Him RN,&nbsp;Sherida Syed Hamid BScN,&nbsp;Prunella Ting Lee BSc,&nbsp;Lisa Jie Ting Teo BSc,&nbsp;Leng Leng Lee CCDS,&nbsp;Andrew Kieran Ming Hui Chan MB BChir,&nbsp;Colin Yeo MBBS","doi":"10.1002/joa3.13156","DOIUrl":"10.1002/joa3.13156","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Half of patients with heart failure are estimated to have sleep-disordered breathing (SDB). However, many are undiagnosed as they do not report typical symptoms. This study aims to evaluate the implantable cardiac defibrillator (ICD) sleep-disordered breathing algorithm in a cohort of multi-racial Asian patients for detection of SDB against polysomnography (PSG).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospective pilot study, participants who fulfill the American College of Cardiology (ACC) indication for ICD were recruited. The ICD algorithm uses transthoracic impedance sensing to calculate respiratory disturbance index (RDI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-four patients were enrolled between August 2020 and December 2021. All patients underwent PSG exams and were followed up for up to 12 months. Eighteen participants completed the PSG study as of August 23, 2022. Severe SDB (defined as PSG-AHI ≥30 episodes/h) was diagnosed in 66.7% of the patients. No significant direct linear correlation was found between the PSG-AHI measurements and the RDI measurements (adjusted <i>r</i>² = .224, <i>r</i> = .473, <i>p</i> = .027). Applying a binary threshold cut-off RDI value of 32 episodes/h for the detection of severe SDB yielded a sensitivity of 91.7% and specificity of 16.7%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Transthoracic impedance sensing with an advanced inbuilt algorithm may be helpful as a screening test in detecting severe SDB in patients with heart failure and cardiomyopathy, potentially by applying a binary threshold cut-off value. This is the first study known to validate the algorithm in an exclusively multi-ethnic Asian population with heart failure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"40 6","pages":"1452-1459"},"PeriodicalIF":2.2,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818127","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}