Journal of Cardiovascular Electrophysiology最新文献

{"title":"Impact of Pulmonary Vein Isolation on Atrial Fibrillation Organisation: Correlation of Intracardiac and Surface Electrocardiogram Measures.","authors":"Nazifa Ahsan, Arunashis Sau, Joseph Barker, Rabiah Neerahoo, Norman Qureshi, Michael Koa-Wing, Daniel Keene, Louisa Malcolme-Lawes, David C Lefroy, Nicholas W F Linton, Phang Boon Lim, Amanda Varnava, Zachary I Whinnett, Prapa Kanagaratnam, Danilo P Mandic, Nicholas S Peters, Fu Siong Ng","doi":"10.1111/jce.70044","DOIUrl":"https://doi.org/10.1111/jce.70044","url":null,"abstract":"<p><strong>Introduction: </strong>Electrical activity in atrial fibrillation (AF) ranges from organized focal drivers to multiple wavelet re-entry. Understanding the effect of pulmonary vein isolation (PVI) on AF organization is clinically important, as it may optimize treatment strategies and outcomes. This study investigates the impact of PVI on AF organization and explores whether ventricular response regularity, measured from surface electrocardiograms (ECGs), reflects AF dynamics and electrophenotype.</p><p><strong>Methods: </strong>Patients undergoing first-time PVI at Imperial College Healthcare NHS Trust between 2014 and 2022 were assessed pre- and post-PVI. AF organization was quantified using Shannon entropy (ShEn) and Sample entropy (SampEn) from coronary sinus (CS) electrograms. Ventricular response regularity was evaluated using surface ECG RR interval (RRI) variability and SampEn.</p><p><strong>Results: </strong>PVI reduced ShEn and SampEn across all CS channels (e.g., SampEn CS 3-4: pre-ablation = 0.907 ± 0.512 vs. post-ablation = 0.790 ± 0.446, p < 0.001). Atrial ShEn and SampEn were correlated with ventricular response both pre- and post-ablation (e.g., correlations between atrial SampEn CS 3-4 and the following ventricular metrics: percentage of RRIs > 50 ms difference: r = 0.077, p = 0.008; normalized mean RRI difference: r = 0.144, p < 0.001; and normalized SampEn: r = 0.168, p < 0.001).</p><p><strong>Conclusion: </strong>The reduction in atrial ShEn and SampEn post-PVI indicates increased AF organization. The significant correlation between atrial entropy and ventricular variability suggests that AF organization affects ventricular response, assessed via surface ECG metrics. These findings highlight the potential of ECG-based measures as proxies for intracardiac AF organization.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794557","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":"Reply to \"Cardiopulmonary Exercise Testing-Guided Beta-Blocker Dosing in Long QT Syndrome: Genotype, Methodology, and Adherence Concerns\".","authors":"Iqbal El Assaad, Peter F Aziz","doi":"10.1111/jce.70047","DOIUrl":"https://doi.org/10.1111/jce.70047","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794558","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":"Age, Frailty, and Outcomes After Atrial Fibrillation Ablation: A Nationwide Cohort Study.","authors":"Olayiwola Bolaji, Olanrewaju Adabale, Yasemin Bahar, Blanche Echari, Vishnu Shenoy, Jaskomal Phagoora, Abdul Rasheed Bahar, M Chadi Alraies, Hakeem Ayinde, John N Catanzaro","doi":"10.1111/jce.70032","DOIUrl":"https://doi.org/10.1111/jce.70032","url":null,"abstract":"<p><strong>Background: </strong>Catheter ablation is a major treatment for atrial fibrillation (AF), but its outcomes in relation to age and frailty are not well understood, especially in an aging population.</p><p><strong>Methods: </strong>A retrospective analysis of the 2016-2021 National Inpatient Sample database identified patients undergoing catheter ablation for AF. Patients were categorized by age and frailty status (low, intermediate, high). Multivariable logistic regression and propensity score matching were used to examine outcomes.</p><p><strong>Results: </strong>Among 292,395 patients, 79.2% were aged 35-65 years, 15.7% were aged 66-79 years, and 5.1% were aged ≥ 80 years at the time of ablation. The proportion of patients aged ≥ 80 years increased from 11% in 2016% to 21.1% in 2021. Females comprised a higher proportion of the oldest age group (51.4%), but no sex differences were observed across frailty levels. In-hospital mortality was highest in the high frailty group. Patients over 80 years had higher odds of cardiac rhythm restoration and pacemaker implantation but lower risks of cardiogenic shock, mechanical circulatory support, heart failure, myocardial infarction, and major adverse cardiac and cerebrovascular events (MACCE). Higher frailty was associated with an increased risk of in-hospital mortality, complications, and MACCE.</p><p><strong>Conclusions: </strong>Catheter ablation is increasingly performed in older patients. Advanced age and higher frailty are independently associated with adverse outcomes. These factors should be considered when evaluating patients for this procedure, and strategies to mitigate these risks should be explored.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789245","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":"Correlation Between CRT Response and Patient-Regret Scores in Patients With Heart Failure With Reduced Ejection Fraction","authors":"Aritra Paul,&nbsp;Joe Demian,&nbsp;Niraj Varma,&nbsp;J. Emanuel Finet,&nbsp;Arshneel Kochar,&nbsp;Oussama Wazni,&nbsp;W. H. Wilson Tang,&nbsp;Feras Bader,&nbsp;John Rickard","doi":"10.1111/jce.16788","DOIUrl":"10.1111/jce.16788","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The correlation between CRT response and patient perception of the procedure is uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify whether patient-reported outcomes correlate with CRT response through a decision regret scale (DRS) in patients with heart failure with reduced ejection fraction (HFrEF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included 150 patients with HFrEF who underwent CRT implantation at the Cleveland Clinic from 2020 to 2022. Each patient was given a DRS questionnaire at 6 months post-CRT implant, and their CRT response status was assessed echocardiographically shortly thereafter. Response was defined as an improvement in LVEF &gt; 5% with a reduction in LVESV &gt; 10%. Patients were unaware of their response status at the time of filling out the questionnaire. The DRS Questionnaire asks patients whether they regret their decision to undergo a procedure. We grouped Questions 1, 3, and 5 from the DRS together for positive questions (higher is more regret), and Questions 2 and 4 were grouped for negative questions (lower is more regret). This data was compared between the two groups based on responder and nonresponder status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At 6 months post-CRT, the mean LVEF for responders compared to non-responders was 43% versus 27% <i>p</i> &lt; 0.001, respectively. The median IQR positive score was 3 (3–5), and 10 (8–10) for negative questions amongst all patients. There were no patients who voiced significant regret for having undergone device implant. In comparing the mean scores between responders and non-responders there was no difference (median IQR positive score 3 (3–6) in non-responders, 3 (3–4.5) in responders; <i>p</i> = 0.19; negative score 10 (8–10) non-responders, 10 (9–10) in responders; <i>p</i> = 0.44)).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with HFrEF undergoing CRT overwhelmingly do not regret their decision to undergo device implantation. The presence or absence of significant remodeling did not impact patient satisfaction and feelings toward the decision to undergo device implantation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 9","pages":"2366-2371"},"PeriodicalIF":2.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789253","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":"Efficacy and Safety of Spatiotemporal Electrogram Dispersion Ablation With Pulmonary Vein Isolation in Persistent Atrial Fibrillation: A Meta-Analysis.","authors":"Patavee Pajareya, Ponthakorn Kaewkanha, Boone Singtong, Noppachai Siranart, Somkiat Phutinart, Watsapon Chuanchai, Narut Prasitlumkum, Ronpichai Chokesuwattanaskul, Henry D Huang, Nithi Tokavanich","doi":"10.1111/jce.70036","DOIUrl":"https://doi.org/10.1111/jce.70036","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary vein isolation (PVI) is the mainstay treatment for rhythm control in patients with persistent atrial fibrillation (PsAF). However, due to the complex mechanisms of PsAF, the efficacy of PVI alone remains modest. Spatiotemporal electrogram dispersion (STED) ablation is a promising strategy to enhance outcomes. This study aims to evaluate the efficacy of STED ablation plus PVI versus PVI alone in PsAF ablation.</p><p><strong>Methods: </strong>A systematic search was conducted to identify studies published up to November 2024 comparing PVI plus STED ablation (PVI-STED group) versus PVI alone (PVI group) in patients with PsAF. The primary outcomes were AF recurrence and sinus rhythm (SR) conversion.</p><p><strong>Results: </strong>Eleven studies (three randomized controlled trials, three prospective cohorts, five retrospective cohorts) involving 1607 patients (mean age of 63.9 ± 9.3 years) were included. The PVI-STED group was significantly associated with a lower risk of AF recurrence (OR: 0.40, 95% CI: 0.27-0.59, I² = 25%) and a higher likelihood of SR conversion (OR: 7.04, 95% CI: 1.62-30.62, I² = 79%). No significant differences were observed in procedural time (MD: 27.61 min, 95% CI: -29.12 to 84.33, I² = 97%), ablation time (MD: 4.4 min, 95% CI: -11.3 to 20.0, I² = 98%), or fluoroscopy time (0.25 min, 95% CI: -3.4 to 3.9, I² = 95%). The overall rate of AEs in the PVI-STED group was 1% (95% CI: 1%-3%, I² = 0%).</p><p><strong>Conclusion: </strong>The PVI-STED approach demonstrated both efficacy and safety in treating PsAF, as evidenced by reduced AF recurrence and improved SR conversion rates.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775441","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, Predictors, and Outcomes With Ventricular Arrhythmias in Continuous Flow Left Ventricular Assist Device Recipients: A Multicenter Analysis.","authors":"Jobin Varghese, Jashan Gill, Rezwan Munshi, Henri Roukoz, Jaimin R Trivedi, Adarsh Bhan, Ashwin Ravichandran, Jennifer Cowger, Chirag Sandesara, Rahul Dhawan, Rajakrishnan Vijayakrishnan, Mark S Slaughter, Mustafa M Ahmed, Rakesh Gopinathannair","doi":"10.1111/jce.70033","DOIUrl":"https://doi.org/10.1111/jce.70033","url":null,"abstract":"<p><strong>Background: </strong>Ventricular arrhythmias (VAs) are common in patients with left ventricular assist devices (LVADs), but their prognostic impact remains uncertain. Prior studies have yielded conflicting results regarding their association with mortality and morbidity. We aimed to evaluate the incidence and clinical outcomes associated with VAs in a large, multicenter LVAD cohort.</p><p><strong>Methods: </strong>We analyzed 408 patients who underwent LVAD implantation across five centers between 2007 and 2015. VA was defined as sustained VAs lasting > 30 s or requiring ICD therapy. The effects of pre- and post-LVAD VA on clinical outcomes-including survival, hospitalizations, and ICD shocks-were assessed.</p><p><strong>Results: </strong>Of 408 patients, 254 (62%) had a history of pre-LVAD VA. Compared to those without prior VA, patients with pre-LVAD VA were more likely to be male (85% vs. 75%, p = 0.02), receive amiodarone (44% vs. 31%, p = 0.01), and have larger left ventricular end-diastolic dimension (LVEDD) (7.1 vs. 6.8 cm, p = 0.01). Postimplant, the pre-VA group had a significantly higher incidence of VA (73% vs. 37%, p < 0.0001), atrial arrhythmias (63% vs. 42%, p < 0.0001), ICD shocks (41% vs. 32%, p = 0.001), and cardiac hospitalizations (median 0.20 vs. 0.08 events/year, p = 0.0003). However, Kaplan-Meier survival analysis showed no significant difference in overall mortality (log-rank p = 0.10). On multivariate Cox regression, pre-LVAD VA predicted post-LVAD VA, but LVEDD was the only independent predictor of mortality.</p><p><strong>Conclusions: </strong>In this multicenter cohort, pre-LVAD VAs were strongly associated with postimplant arrhythmic burden and increased morbidity, but not with long-term mortality. These findings highlight the importance of structural factors such as LVEDD over arrhythmia history in survival outcomes and underscore the need for individualized arrhythmia surveillance and management strategies in LVAD recipients with prior VAs.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760193","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":"Step-By-Step: Subclavian Venoplasty to Facilitate Cardiac Implantable Electronic Device Upgrade.","authors":"Ikram U Haq, Robert C Ward, Siva K Mulpuru","doi":"10.1111/jce.16784","DOIUrl":"https://doi.org/10.1111/jce.16784","url":null,"abstract":"<p><strong>Introduction: </strong>Lead-related venous obstruction is a significant complication of chronic indwelling transvenous leads, which poses unique challenges during cardiac device upgrades.</p><p><strong>Background: </strong>The anatomical sequelae of venous occlusion are variable and carry important procedural implications. Occlusions can develop in any part of the venous system, but they most often occur in the subclavian and innominate veins, while the superior vena cava is less frequently affected.</p><p><strong>Methods: </strong>In this review, we describe approaches to lead-related venous occlusion providing step-by-step procedural guidance.</p><p><strong>Results: </strong>Venoplasty, neovascular channel creation are two main techniques for addressing lead-related venous obstruction.</p><p><strong>Conclusion: </strong>Venoplasty in the setting of an indwelling pacemaker or defibrillator leads can be performed safely and effectively. The difficulty of the procedure lies in crossing the obstruction. Familiarity with various tools is needed for a successful outcome.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760194","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":"On the Tip of a Needle: A Safer Route to Septal Reduction in HOCM?","authors":"Dana C. Johnson","doi":"10.1111/jce.70043","DOIUrl":"10.1111/jce.70043","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 9","pages":"2363-2365"},"PeriodicalIF":2.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753442","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":"Comparison of Left Atrium and Premature Ventricular Contraction Mapping Using OCTARAY and OPTRELL Catheters.","authors":"Jumpei Saito, Kato Daiki, Sato Hirotoshi, Toshihiko Matsuda, Yui Koyanagi, Katsuya Yoshihiro, Yuma Gibo, Soichiro Usumoto, Taro Kimura, Suguru Shimazu, Wataru Igawa, Seitaro Ebara, Toshitaka Okabe, Naoei Isomura, Masahiko Ochiai","doi":"10.1111/jce.70040","DOIUrl":"https://doi.org/10.1111/jce.70040","url":null,"abstract":"<p><strong>Introduction: </strong>Multielectrode mapping catheters, such as the OCTARAY and OPTRELL, are essential in creating myocardial electroanatomical mapping in arrhythmias. However, only a few studies have compared their performance, and in this study, we addressed this gap in knowledge by comparing their performance in left atrial (LA) mapping during atrial fibrillation (AF) ablation and premature ventricular contraction (PVC) mapping.</p><p><strong>Methods and results: </strong>Twenty patients (10 each for LA and PVC mapping) were enrolled. LA voltage mapping was performed twice, alternating between catheters post-AF ablation. Parameters compared included mapping time, mapping points, catheter-induced premature atrial contraction, tissue proximity indication (TPI), low voltage area, and fluoroscopy time. For PVC mapping, comparisons included mapping time, catheter-induced PVCs, earliest activation time measured from the onset of PVC QRS, earliest activation point, and fluoroscopy time. The mean voltage (0.192 mV [0.072, 0.48] vs. 0.126 mV [0.042, 0.378]; p = 0.001) and the percentage of TPI-positive electrodes (14.97% vs. 11.45%; p < 0.001) using the OPTRELL were significantly higher than those obtained using the OCTARAY. However, there were no significant differences in other LA parameters. In PVC mapping, catheter-induced PVCs using the OPTRELL were significantly fewer than when using the OCTARAY (100 [32, 337] vs. 247 [110, 745, p = 0.039), with fewer catheter induced PVCs per minute (15 [6, 23] vs. 35 [20, 71, p = 0.039). However, no significant differences were observed in other PVCs mapping parameters.</p><p><strong>Conclusion: </strong>In LA mapping, the OPTRELL showed higher mean voltage and TPI positivity and in PVC mapping it showed fewer catheter-induced PVCs compared to those of the OCTARAY catheters.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753441","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":"Left Atrial Slow-Conduction Channels Predict Pulmonary Vein Isolation Outcomes in Paroxysmal Atrial Fibrillation","authors":"Agustín Bortone,&nbsp;F. Daniel Ramirez,&nbsp;Eloi Marijon,&nbsp;Francesco Montereggi,&nbsp;Luca Rosario Limite","doi":"10.1111/jce.70023","DOIUrl":"10.1111/jce.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The mechanisms underlying recurrent atrial fibrillation (AF) despite durable pulmonary vein isolation (PVI) in patients with paroxysmal AF (PAF) remain unclear. This study investigates whether left atrial (LA) slow-conduction channels act as a substrate for recurrence following durable PVI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>High-density LA mapping was performed in 120 PAF patients. LA conduction velocities were calculated using the Local Velocity Vector algorithm. Channels were defined as narrow regions with slow conduction (&lt; 0.5 m/s) and fragmented electrograms. All patients underwent PVI using radiofrequency energy. One-year freedom from recurrent AF was compared based on baseline LA channel presence. A control group of five patients with atrioventricular reentrant tachycardia was included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 120 patients, 42 (35%) had 54 LA channels identified. Channels represented ~1% of total LA surface area, exhibited slow conduction (~0.23 m/s), were bordered by lines of block, displayed abnormal electrograms, and demonstrated decremental conduction, suggesting a potential role in reentry. Half were in low-voltage areas while the remainder were in regions with preserved voltage. At 1 year, 3 of 78 patients without channels (4%) had PAF recurrence, all due to PV reconnections, compared to 7 of 42 patients with channels (17%) who experienced recurrence (<i>p</i> = 0.02), 6 of whom had durably isolated PVs on repeat study. No channels were identified in controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The absence of LA channels may indicate a PAF phenotype with high PVI success. Conversely, patients with channels are less likely to respond to PVI. It remains unclear whether channels serve as risk indicators or targets for ablation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 9","pages":"2397-2409"},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742183","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}