Journal of Cardiovascular Electrophysiology最新文献

{"title":"Coronary Sinus Venoplasty Using Cutting Balloon for Left Ventricular Lead Placement.","authors":"Pooja Shah, Jyotika Gupta, Niraj Yadav, Anoop K Gupta","doi":"10.1111/jce.16765","DOIUrl":"https://doi.org/10.1111/jce.16765","url":null,"abstract":"<p><strong>Background: </strong>Coronary Sinus Venous stenosis is rare; however, it is often encountered during left ventricular (LV) lead implantation, which is the cornerstone of cardiac resynchronization therapy (CRT). Plain balloon angioplasty and anchor balloon technique have been described for LV lead implantation in patients with venous stenosis and tortuous anatomy. We investigate the efficacy of coronary vein angioplasty using a cutting balloon to facilitate the implantation of LV lead.</p><p><strong>Methods: </strong>452 patients who underwent standard CRT implantation from 2015 to 2024 were studied retrospectively. 21 patients (4.64%) had significant venous stenosis in the posterolateral vein, which required venous intervention to facilitate lead placement. Seven patients required cutting balloon dilatation for focal venous stenosis in which balloon dilation and anchor balloon technique failed.</p><p><strong>Results: </strong>All seven patients had successful LV lead implantation in the target vein following cutting balloon venoplasty. There was no complication during the procedure and long-term lead parameters were excellent.</p><p><strong>Conclusion: </strong>Coronary vein angioplasty using a cutting balloon is an effective and safe technique to facilitate LV pacing lead placement in case of target vein stenoses.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Absorbable Antibacterial Envelope Promotes Development of a Healthy Device Pocket: Results of the TYRX Pocket Health Study.","authors":"Francois Philippon, Elena Ladich, Renu Virmani, James E Ip, Jay Wright, H Andrew Hazlitt, Suneet Mittal, Mauro Biffi, Eric Johnson, Anna Ihrke, Jeff Lande, Aloke V Finn, Chiara Baldovini, Kiah Butler, Pauline J Beckmann, Christopher R Ellis","doi":"10.1111/jce.16766","DOIUrl":"https://doi.org/10.1111/jce.16766","url":null,"abstract":"<p><strong>Introduction: </strong>Creation of a pocket and implant of a cardiac implantable electronic device (CIED) elicits a foreign body response in the presence of the normal wound healing process. An absorbable antibacterial envelope (TYRX™, Medtronic Inc.) was developed to stabilize CIEDs and reduce infections. However, characterization of its impact on pocket healing is limited. We aimed to characterize histological and morphometric features of device capsules in patients previously implanted with an absorbable TYRX.</p><p><strong>Methods: </strong>The TYRX Pocket Health Study (NCT05356546) was a prospective, observational study conducted from June 2022 to July 2023 at 9 sites. The study evaluated characteristics in existing CIED pockets of patients previously implanted with an absorbable TYRX returning for device replacement. Tissue sections were obtained, stained, and evaluated for adhesions, capsule thickness, inflammation, neovascularization, and calcification and compared to a historical control.</p><p><strong>Results: </strong>The mean time between procedures was 6.8 years. TYRX pockets had significantly decreased adhesions (p < 0.05) with no clinically significant calcification. TYRX capsules contained predominantly Type I collagen and were significantly thinner (0.33 ± 0.16 mm TYRX, 0.8 ± 0.3 mm controls, p < 0.0001). TYRX pockets had low inflammation with 96% of TYRX pockets (26/27) having absent to mild inflammation.</p><p><strong>Conclusion: </strong>In this prospective evaluation of long-term pocket healing with an absorbable TYRX, reduced adhesions, low inflammation, and well-formed capsules were observed with no clinically significant calcification. This suggests that TYRX may promote creation of a well-healed pocket desirable for subsequent procedures.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concealed Interference: Stealth Device-Device Interaction With a Leadless Pacemaker System.","authors":"James E Ip","doi":"10.1111/jce.16771","DOIUrl":"https://doi.org/10.1111/jce.16771","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct Comparison of Two Commercially Available Pulsed Field Ablation Systems for Atrial Fibrillation; Procedure Characteristics and Acute Outcomes.","authors":"Bob G S Abeln, Marisa van der Graaf, Dan L Musat, Melanie A Gunawardene, Devi G Nair, Bradley P Knight, Bradley Wilsmore, Max Liebregts, Vincent F van Dijk, Maurits C E F Wijffels, Jippe C Balt, Suneet Mittal, Stephan Willems, Nishant Verma, Graham Peigh, Michael M Malaty, Lucas V A Boersma","doi":"10.1111/jce.16761","DOIUrl":"https://doi.org/10.1111/jce.16761","url":null,"abstract":"<p><strong>Background: </strong>There are few comparative studies on the everyday clinical outcomes of commercially available pulsed field ablation (PFA) systems for atrial fibrillation (AF).</p><p><strong>Objective: </strong>This study evaluates the acute efficacy and safety outcomes of the FARAPULSE™ (pentaspline catheter) and PulseSelect™ (circular catheter) system.</p><p><strong>Methods: </strong>International, multicenter, registry on patients with paroxysmal or persistent AF, undergoing a first ablation using either PFA system between January 29th, 2024 and September 1st, 2024. Primary endpoints were electrical isolation of ablation targets, procedural characteristics and freedom from major adverse events within 30 days postprocedure.</p><p><strong>Results: </strong>A total of 402 patients were enrolled at the six participating centers, of whom 56.5% were treated with the pentaspline ablation-catheter. Acute procedural efficacy was 100% for both groups. Use of the pentaspline ablation-catheter was associated with significantly shorter procedural times (36.0 min [IQR 31.0; 44.0] vs. 49.0 min [IQR 41.5;76.0]) compared to the circular ablation-catheter (p < 0.001). Major adverse events were scarce and not different between cohorts. Two patients (0.5%) experienced a stroke and one patient (0.2%) had a serious vascular access site complication. One patient had a transient ischemic attack (0.2%). Minor vascular access site complications were more common in the pentaspline catheter group (11.9% vs. 1.1%, p < 0.001).</p><p><strong>Conclusions: </strong>This study showed excellent acute efficacy and safety for both PFA-systems. Our findings reveal shorter procedural times with the pentaspline catheter, less minor access site complications with the circular catheter, and several procedural differences between the ablation systems, often driven by operator choice.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium-Glucose Cotransporter-2 Inhibitors and Stroke Risk in Patients With Atrial Fibrillation.","authors":"Ghee Kheng Lim, Ramzi Ibrahim, Xuan Ci Mee, Mahmoud Abdelnabi, Hoang Nhat Pham, Eiad Habib, Juan Farina, Justin Z Lee, Steven J Lester, Luis Scott, Dan Sorajja, Kwan Lee, Chadi Ayoub, Reza Arsanjani","doi":"10.1111/jce.16739","DOIUrl":"https://doi.org/10.1111/jce.16739","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter 2 inhibitors (SGLT2-Is) are primarily used to manage type 2 diabetes mellitus (T2DM) and heart failure (HF), but their impact on reducing stroke risk in patients with atrial fibrillation (AF) remains underexplored. We aimed to investigate the impact of SGLT2-Is for stroke risk mitigation in patients with AF.</p><p><strong>Methods: </strong>Using the TriNetX database, we performed a retrospective cohort study on patients ≥ 18 years with AF and on anticoagulation. These patients were then classified into two cohorts based on their use of SGLT2-Is. To balance the baseline demographics, comorbidities, and medication use, propensity score matching (PSM) was used. The primary outcome was ischemic and hemorrhagic strokes, and the secondary outcomes were all-cause mortality, all-cause hospitalizations, need for AF cardioversion or antiarrhythmic drug initiation, and cardiac arrest. Adjusted odds ratio (aORs) and hazard ratios (HRs) were estimated for both the primary and secondary outcomes.</p><p><strong>Results: </strong>A total of 152,778 patients with 76,389 patients were included in each cohort (SGLT2-Is users, and non-users) after PSM. The mean age of both SGLT2-Is users and non-users was 72.8 years. For the SGLT2-Is users, the mean follow-up period was 317 days, whereas the mean follow-up period for the non-users was 306 days. For the primary outcome, we found that SGLT2-Is users had a lower risk of ischemic stroke (aOR: 0.889; 95% CI: 0.857-0.923) and hemorrhagic stroke (aOR: 0.682; 95% CI: 0.620-0.749) compared to non-users. Regarding the secondary outcomes, SGLT2-Is users also had lower risk for all-cause mortality (aOR: 0.615; 95% CI: 0.595-0.636), all-cause hospitalizations (aOR: 0.599; 95% CI: 0.587-0.611), need of AF cardioversion (aOR: 0.846; 95% CI: 0.813-0.881), antiarrhythmic drug initiation (aOR: 0.790; 95% CI: 0.766-0.815), and cardiac arrest (aOR: 0.643; 95% CI: 0.601-0.688).</p><p><strong>Conclusions: </strong>SGLT2-I use in patients with AF is associated with lower risks of stroke and other cardiovascular and non-cardiovascular outcomes. Future prospective research is needed to validate these findings.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing Patients With Cold Drink-Triggered Atrial Fibrillation.","authors":"Daniel D DiLena, Jennifer Y Zhang, Adina S Rauchwerger, Mary E Reed, Gregory M Marcus, E Margaret Warton, David R Vinson","doi":"10.1111/jce.16753","DOIUrl":"https://doi.org/10.1111/jce.16753","url":null,"abstract":"<p><strong>Introduction: </strong>Atrial fibrillation (AF) is a common arrhythmia with significant health implications. Identifying modifiable lifestyle triggers is important in mitigating recurrence and improving patient outcomes. A subset of AF patients has reported cold drinks or foods as triggers, a phenomenon termed \"cold drink heart\" (CDH). Literature on CDH is scarce and primarily limited to case studies. We sought to characterize patient experiences with CDH and assess the effectiveness of cold trigger avoidance in reducing AF recurrence among affected patients.</p><p><strong>Methods and results: </strong>This was a mixed methods study employing a patient survey enhanced by chart review among patients who self-reported CDH. Participants were recruited during emergency department visits for AF or by contacting the principal investigator directly. The survey addressed demographics and clinical features. We compared those with CDH only and those with both CDH and non-CDH AF episodes. The cohort included 101 respondents (75% male). Median age of CDH onset was 44.5 years. More than half of respondents (51.5%) reported that their AF episodes occurred only following cold drink or food consumption. Rapid onset after ingestion was common, and many reported an association with recent physical exertion. Avoidance of cold ingestion was effective in reducing or eliminating AF episodes in 86.4% of cases, with greater success in CDH-only patients (100.0%). Physician awareness was low, with 52.4% of respondents reporting dismissive attitudes from one or more healthcare providers.</p><p><strong>Conclusion: </strong>CDH is poorly understood and has significant implications for AF prevention. Avoidance strategies may be highly effective, especially for CDH-only patients. Further research is needed to validate these findings and increase provider awareness.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes After Catheter Ablation in Cardiac Sarcoidosis and Idiopathic Nonischemic Cardiomyopathy.","authors":"Kenji Hashimoto, Samual Turnbull, Max Bickley, Ashwin Bhaskaran, Kaimin Huang, Kasun De Silva, Saurabh Kumar","doi":"10.1111/jce.16756","DOIUrl":"https://doi.org/10.1111/jce.16756","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiac sarcoidosis (CS) may present clinically with ventricular tachycardia (VT). Since the diagnosis is challenging, clinical manifestations and imaging findings are commonly used to identify probable CS in patients without histological diagnosis or extracardiac sarcoidosis. However, data on VT ablation with probable CS remains limited. We investigated the scar distribution and long-term outcomes of VT ablation in patients with at least probable CS and compared these with noninflammatory nonischemic cardiomyopathy (NICM) patients.</p><p><strong>Methods and results: </strong>Patients with at least probable CS and VT, who underwent catheter ablation were retrospectively included (the CS group), and compared with idiopathic NICM patients in whom focal inflammation was excluded via fluorodeoxyglucose-positron emission tomography (the noninflammatory NICM group). Procedural characteristics including scar distribution data along with postprocedural clinical outcomes were assessed. Twenty-three and 40 patients were included in the CS and noninflammatory NICM groups, respectively. Left and right ventricular substrate mapping was performed in 48% and 57% of CS patients, and in 68% and 38% of noninflammatory NICM patients. Right ventricular map revealed a broader bipolar low-voltage area and a more frequent unipolar low-voltage area in the septum in the CS group, whereas left ventricle map demonstrated no significant differences. At 1-year, ventricular arrhythmia-free survival (48% vs. 85%, p = 0.01, after multiple procedures) and death/transplant-free survival were lower in the CS group (54% vs. 97%, p < 0.01).</p><p><strong>Conclusion: </strong>CS patients exhibited significantly worse outcomes after VT ablation, compared to noninflammatory NICM patients, highlighting the importance of distinguishing CS from idiopathic NICM to optimize patient management.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Characteristics of Superior Vena Cava Impact After Pulsed-Field Ablation of the Right Pulmonary Veins.","authors":"Haruka Matsuura, Tsukasa Kamakura, Tsukasa Oshima, Toshihiro Nakamura, Satoshi Oka, Yuichiro Miyazaki, Akinori Wakamiya, Nobuhiko Ueda, Kenzaburo Nakajima, Mitsuru Wada, Kohei Ishibashi, Yuko Inoue, Koji Miyamoto, Takeshi Aiba, Kengo Kusano","doi":"10.1111/jce.16759","DOIUrl":"https://doi.org/10.1111/jce.16759","url":null,"abstract":"<p><strong>Introduction: </strong>Superior vena cava (SVC) conduction delay or isolation during right superior pulmonary vein (RSPV) ablation using thermal ablation technologies has been previously described because of the anatomical proximity of the SVC to the RSPV. We aimed to evaluate the impact of pulsed-field ablation (PFA) on the SVC.</p><p><strong>Methods: </strong>Sixty-eight consecutive patients who underwent pulmonary vein isolation (PVI) with PFA were enrolled: 17, Varipulse; 26, PulseSelect; 25, FARAPULSE. Right atrium mapping was performed before and after PVI to evaluate the impact of PFA on the SVC.</p><p><strong>Results: </strong>A low-voltage area (< 0.5 mV) of ≥ 0.5 cm² newly appeared in the SVC after PFA in 56 (82.4%) patients, including whole circumferential SVC impact in 10 (14.7%) patients. The incidence of SVC impact was significantly lower in patients treated with Varipulse catheters than in those treated with other PFA systems (Varipulse 52.9% vs. PulseSelect 96.2% vs. FARAPULSE 88.0%, p = 0.0009). The distance between the RSPV and SVC moderately correlated with SVC impact irrespective of the catheter used. Patients with SVC deformity, defined as a curve-shaped SVC with two narrow pointed ends resembling the moon (less than half of a circle), showed a significantly higher incidence of whole circumferential SVC impact than did those without (38.5% vs. 9.1%, p = 0.018).</p><p><strong>Conclusion: </strong>RSPV isolation with PFA can induce SVC impact regardless of the different PFA systems. SVC deformity and anatomical distance between the RSPV and SVC significantly correlated with SVC impact occurrence. Further studies are needed to confirm the clinical significance of this impact.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex, Race, and Socioeconomic Disparities in the Utilization of Transvenous Lead Removal for Patients Hospitalized With Cardiac Implantable Electronic Device Infections in the United States.","authors":"Siddharth Agarwal, Hossam Elbenawi, Harsh P Patel, Zain Ul Abideen Asad, Muhammad Bilal Munir, Gurukripa N Kowlgi, Justin Z Lee, Nicholas Y Tan, Alan Sugrue, Paul A Friedman, Samuel J Asirvatham, Daniel C DeSimone, Siva K Mulpuru, Yong-Mei Cha, Abhishek Deshmukh, Christopher V DeSimone","doi":"10.1111/jce.16758","DOIUrl":"https://doi.org/10.1111/jce.16758","url":null,"abstract":"<p><strong>Background: </strong>Transvenous lead removal (TLR) is a Class I indication for patients with cardiac implantable electronic device (CIED) infections. However, disparities in the utilization of TLR have not been fully explored, particularly concerning demographic and socioeconomic factors.</p><p><strong>Objectives: </strong>This study aims to examine whether disparities exist among patients hospitalized for CIED infections with respect to the utilization of TLR, focusing on sex, race, and income characteristics.</p><p><strong>Methods: </strong>We utilized the 2019 National Inpatient Sample (NIS) to assess patients hospitalized with CIED infections and identify those who underwent TLR. Multiple logistic regression was used to examine risk factors for TLR utilization, including age, sex, race/ethnicity, and socioeconomic characteristics.</p><p><strong>Results: </strong>A total of 56 709 patients were hospitalized for CIED infection in the United States in 2019, of which 9867 (17.4%) underwent TLR. On an adjusted analysis, females and Black patients were found to have lower odds of undergoing TLR compared to males and White patients (OR: 0.62; 95% CI: 0.59-0.78; p < 0.01; and OR: 0.47; 95% CI: 0.39-0.57; p < 0.01, respectively). Hispanic patients also had reduced odds of TLR (OR: 0.73; 95% CI: 0.58-0.93; p = 0.01). No significant associations were observed between income or insurance status and the likelihood of receiving TLR after adjustment.</p><p><strong>Conclusions: </strong>This study identified significant disparities in the utilization of TLR among patients hospitalized for CIED infections. Female, Black, and Hispanic patients were significantly less likely to receive TLR.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"Incidence and Economics of Transvenous ICD Lead Complications: Implications for Tricuspid Valve Function and Interventions\".","authors":"","doi":"10.1111/jce.16748","DOIUrl":"https://doi.org/10.1111/jce.16748","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}