Journal of Cardiovascular Electrophysiology最新文献

{"title":"The Role of RyR2 Mutations in Congenital Heart Diseases: Insights Into Cardiac Electrophysiological Mechanisms.","authors":"Tingting Lv, Siyuan Li, Qing Li, Lingbing Meng, Jing Yang, Lianfeng Liu, Changhua Lv, Ping Zhang","doi":"10.1111/jce.16569","DOIUrl":"https://doi.org/10.1111/jce.16569","url":null,"abstract":"<p><p>Ryanodine receptor 2 (RyR2) protein, a calcium ion release channel in the sarcoplasmic reticulum (SR) of myocardial cells, plays a crucial role in regulating cardiac systolic and diastolic functions. Mutations in RyR2 and its dysfunction are implicated in various congenital heart diseases (CHDs). Studies have shown that mutations in the RYR2 gene, which encodes the RyR2 protein, are linked to several cardiac arrhythmias, including catecholaminergic polymorphic ventricular tachycardia (CPVT), long QT syndrome (LQTS), calcium release deficiency syndrome (CRDS), and atrial fibrillation (AF). Additionally, RyR2 mutations have been associated with multiple genetic cardiomyopathies, such as left ventricular non-compaction cardiomyopathy (LVNC), arrhythmogenic right ventricular cardiomyopathy (ARVC), hypertrophic cardiomyopathy (HCM) and dilated cardiomyopathy (DCM). Through various cell and animal models, researchers have developed mutant RyR2 models demonstrated that these mutations often lead to calcium dysregulation, typically resulting in either a gain or loss of function. This comprehensive review delves into the current understanding of RyR2 mutations and their impact on cardiac electrophysiology, focusing on the molecular mechanisms linking these mutations to arrhythmias and cardiomyopathies-an essential step in advancing diagnostic and therapeutic strategies.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970913","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":"Six-Month Emergent Readmissions Following Hospitalization for Atrial Fibrillation Amid the Syrian Conflict: A Real-World Observational Cohort Study.","authors":"Ibrahim Antoun, Alkassem Alkhayer, Alamer Alkhayer, Khaled Yazji, Riyaz Somani, G André Ng, Mustafa Zakkar","doi":"10.1111/jce.16579","DOIUrl":"https://doi.org/10.1111/jce.16579","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is the most common arrhythmia worldwide. However, data regarding readmissions following index admission for AF in the developing world are not well described. This study assessed the rate, predictors, and trends of 6-month readmission after index admission for AF in Syria.</p><p><strong>Methods: </strong>We included adult patients who had an index admission with AF to Latakia's tertiary center between July 2021 and November 2023. Patients were monitored for readmission for 6 months after index discharge. Data were taken from the patient's medical notes.</p><p><strong>Results: </strong>A total of 649 patients were included in the final analysis, of which 320 (49%) were readmitted to the hospital within 6 months following index admission. Cardiac causes were the most common cause of readmission in 76% of patients, of which 70% were AF. Readmitted patients had a higher median age (64 vs. 58; p = 0.001) and fewer males (49% vs. 36%; p = 0.001). In multivariate analysis, factors that independently increased 6-month readmission risk were age ≥ 60 years (hazard ratio [HR]: 1.7, 95% CI: 1.4-2.2), females (HR: 2.2, 95% CI: 1.6-2.7), and congestive heart failure (CCF) (HR: 2.1, 95% CI: 1.4-2.6). Most cardiac readmissions (76%) happened during the first 60 days following index discharge.</p><p><strong>Conclusion: </strong>Almost half the patients were readmitted within 6 months after an index admission for AF. Females, CCF, and advancing age were independently associated with an increased risk of 6-month readmission.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970911","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":"A Short HV Interval Tachycardia Terminated by His-Refractory Premature Atrial Extra-Stimulation: What Is the Mechanism?","authors":"Chengye Di, Longyu Li, Qun Wang, Yanxi Wu, Yan Zhang, Wenhua Lin","doi":"10.1111/jce.16576","DOIUrl":"https://doi.org/10.1111/jce.16576","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970907","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":"Impact of Sodium-Glucose Co-Transporter 2 Inhibitors on Atrial Fibrillation Recurrence Post-Catheter Ablation Among Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.","authors":"Naser A Abdelhadi, Khaled Mohamed Ragab, Mohammed Elkholy, Jayanthi Koneru, Kenneth A Ellenbogen, Ajay Pillai","doi":"10.1111/jce.16544","DOIUrl":"https://doi.org/10.1111/jce.16544","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is the most common cause of arrhythmia-induced cardiomyopathy. Effective management strategies include medical therapy for rate and rhythm control, catheter ablation (CA), and goal-directed medical therapy. Sodium-glucose co-transporter 2 inhibitors (SGLT2i), a novel class of antidiabetic drugs, have shown a promising impact in reducing cardiovascular events in diabetic and nondiabetic heart failure (HF) patients. It is unclear what impact SGLT2i use may have on AF recurrence following CA. To evaluate the effects of SGLT2i on preventing AF recurrence following CA and its impact on other cardiovascular outcomes. We performed a comprehensive literature search through multiple search engines (PubMed, Scopus, Web of Science, and Cochrane) to include eligible studies using the appropriate keywords until 10 April 2024. Our search yielded nine eligible studies with 16 857 patients. Our analysis reveals a significant reduction in AF recurrence after CA among patients receiving SGLT2i compared to non-SGLT2i medications (RR = 0.72, 95% CI [0.67-0.78], p < 0.00001). Additionally, SGLT2i therapy was associated with decreased all-cause hospitalizations and reduced risk of ischemic stroke. However, no significant difference in all-cause mortality was observed between SGLT2i and non-SGLT2i groups. Our study found that SGLT2 inhibitors significantly reduced AF recurrence post-CA in diabetic patients. Moreover, SGLT2i use was associated with lowered hospitalization and ischemic stroke risk. Though no significant difference in mortality was noted, the decrease in hospitalization suggests a possible favorable effect on cardiovascular events.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948421","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":"Retrieval of an Aveir Leadless Pacemaker With a Standard Retrieval Catheter by Releasing the Wedged Docking Button Using a Loop Wire Technique.","authors":"Kensuke Yano, Masaya Shinohara, Hideto Sasaki, Takuto Suzuki, Hosei Kikushima, Ryo Wada, Shintaro Yao, Hideki Koike, Tadashi Fujino, Takanori Ikeda","doi":"10.1111/jce.16556","DOIUrl":"https://doi.org/10.1111/jce.16556","url":null,"abstract":"<p><strong>Introduction: </strong>The docking button of the Aveir leadless pacemaker (LP) is occasionally difficult to access due to its inappropriate position in the right ventricle (RV).</p><p><strong>Methods and results: </strong>We report a case where the Aveir LP was successfully retrieved by releasing the wedged docking button in the inferior wall of the RV using a loop wire technique.</p><p><strong>Conclusion: </strong>The loop wire technique may be useful to change the position of the Aveir LP. This may be helpful to retrieve the Aveir LP even in a case where the docking button is wedged in the inferior wall of the RV.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949349","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 Bundle Branch Area Pacing Versus Right Ventricular Pacing in Patients With Atrioventricular Block: A Systematic Review and Meta-Analysis.","authors":"Irfan Ahsan, Hussam Al Hennawi, Angad Bedi, Muhammad Khuzzaim Khan, Nikhil Duseja, Reginald T Ho","doi":"10.1111/jce.16548","DOIUrl":"https://doi.org/10.1111/jce.16548","url":null,"abstract":"<p><strong>Background: </strong>Left bundle branch area pacing (LBBAP) is a new technique for patients with atrioventricular block (AVB) and preserved left ventricular ejection fraction (LVEF), potentially offering better cardiac function than right ventricular pacing (RVP).</p><p><strong>Methods: </strong>We searched databases and registries for studies that compared LBBAP with RVP in patients with AVB and preserved LVEF. We extracted data on various outcomes and pooled the effect estimates using random-effects models.</p><p><strong>Results: </strong>Our meta-analysis included 14 studies (10 observational and 4 RCTs) involving 3062 patients with AVB. The analysis revealed that the QRS duration was significantly shorter in the LBBAP group compared to the RVP group [MD = -35.56 ms; 95% CI: (-39.27, -31.85), p < 0.00001]. Patients in the LBBAP group also exhibited a significant increase in left ventricular ejection fraction (LVEF) [MD = 5.48%; 95% CI: (4.07%, 6.89%), p < 0.00001], and a significant reduction in left ventricular end-diastolic diameter (LVEDD) compared to RVP [MD = -3.98 mm; 95% CI: (-5.88, -2.09 mm), p < 0.0001]. In terms of clinical outcomes, LBBAP was associated with a significantly lower risk of heart failure hospitalizations (HFHs) compared to RVP [OR = 0.26; 95% CI: (0.16, 0.44), p < 0.0001]. However, no significant differences were observed between the two groups in the implant success rate, pacing impedance, or pacing threshold. The RVP group demonstrated a significantly higher R-wave amplitude increase than the LBBAP group [MD = 0.85 mV; 95% CI: (0.23, 1.46), p = .007]. Lastly, there was no significant difference in the incidence of complications between the two groups [OR = 2.12; 95% CI: (0.29, 15.52), p = 0.46].</p><p><strong>Conclusion: </strong>LBBAP outperforms RVP in several cardiac function indicators, suggesting it may be a superior pacing method for AVB patients with preserved LVEF. However, the small sample size in studies and the result in heterogeneity call for more research to validate these findings and assess LBBAP's long-term effects.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948853","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":"Current Real-World Status of Off-Label Under- and Over-Dose of Direct Oral Anticoagulants After Atrial Fibrillation Ablation.","authors":"Tabito Kino, Akihiko Nogami, Kyoko Soejima, Kikuya Uno, Koichiro Kumagai, Takashi Kurita, Masayuki Fukuzawa, Atsushi Takita, Tomoko Ishizu, Kazutaka Aonuma","doi":"10.1111/jce.16560","DOIUrl":"https://doi.org/10.1111/jce.16560","url":null,"abstract":"<p><strong>Background: </strong>Off-label under- and overdosing of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) is not uncommon in real-world practice.</p><p><strong>Objective: </strong>This study aimed to identify efficacy and safety of off-label DOACs dose after AF ablation.</p><p><strong>Methods: </strong>The RYOUMA registry was a prospective multicenter study of Japanese patients who underwent AF ablation between 2017 and 2018. DOAC prescriptions were categorized into on-label standard dose, on-label reduced dose, off-label underdose, and off-label overdose.</p><p><strong>Results: </strong>The proportion of off-label doses among patients after AF ablation varied depending on the type of DOAC, ranging from 13.5% to 34.9%. Of 2821 patients, 366 (13.0%) were prescribed an off-label underdose and exhibited significantly higher CHADS₂, CHA₂DS₂-VASc, CHA₂DS₂-VA, HELT-E₂S₂, and HAS-BLED scores, age, concomitant use of antiplatelets, and lower weight when compared to the on-label standard dose (n = 1809). While the incidence of ischemic stroke after 1 year of off-label underdose was notably low (0.28%), the rate of major bleeding was relatively high (1.7%). Off-label overdose was prescribed to 134 patients (4.8%), who showed a significantly higher incidence of major bleeding (3.0%) compared to on-label standard dose (0.91%; p = 0.02). The off-label overdose group did not have any particular background and its thromboembolic risk was, conversely, low. The most likely cause of off-label overdose was clinicians potentially overlooking dose criteria, including advanced age, low body weight, and low creatinine clearance.</p><p><strong>Conclusions: </strong>In patients after AF ablation, off-label DOAC overdose was infrequent, but significantly associated with higher incidence of major bleeding during the remote period after AF ablation.</p><p><strong>Trial registration: </strong>The study was registered as UMIN000026092 (University Hospital Medical Information Network-Clinical Trial Registry).</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949416","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":"Physiological Pacing: Historical Review With an Eye to the Future.","authors":"Richard Sutton, Atul Prakash","doi":"10.1111/jce.16559","DOIUrl":"https://doi.org/10.1111/jce.16559","url":null,"abstract":"<p><p>This review provides a history of physiological pacing from inception to current practice and into the future. This review stems from personal experience and is not formally systematic. Physiological cardiac pacing is covered from 1960s to date. Concepts, and major milestones with their practical applications are reviewed including possible applications in the future. Huge strides have been made in the last 50 years, but consequences of developments have not always been well considered resulting in important adverse effects. The future requires deep electrophysiological thinking to achieve further benefits for our patients.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948957","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":"Association of Cardiac CT-Derived Epicardial Adipose Tissue With Atrial Fibrillation in Patients Without Left Atrial Fibrosis as Defined by Endocardial Voltage Mapping.","authors":"Aqeel Umar, Jeffrey Hocking, Sophia Z Massin, Adrian Suszko, Bernd J Wintersperger, Vijay S Chauhan","doi":"10.1111/jce.16566","DOIUrl":"https://doi.org/10.1111/jce.16566","url":null,"abstract":"<p><strong>Introduction: </strong>Epicardial adipose tissue (EAT) is often associated with atrial fibrosis, and both can provide the substrate for atrial fibrillation (AF). However, most AF patients have no evidence of left atrial (LA) fibrosis based on bipolar voltage mapping. We determined whether EAT differs in AF patients without LA fibrosis compared to matched controls without AF.</p><p><strong>Methods: </strong>Patients undergoing cardiac CT before first-time AF catheter ablation were prospectively enrolled. LA bipolar voltage mapping was performed, and patients were divided into -LVZ (LA low voltage zones < 5% of LA surface area; no fibrosis) and +LVZ (LA low voltage zones ≥ 5%; fibrosis). A control group without AF was matched to -LVZ patients. EAT was quantified on CT using standard signal thresholding to quantify total and regional volumes. AF patients were followed for 1-year postablation to assess atrial arrhythmia (AA) recurrence.</p><p><strong>Results: </strong>-LVZ (n = 50) had higher total EAT volumes than matched controls (n = 48) (79 [58-109] vs. 51 [37-73] cm³, p < 0.001), higher LA EAT (9 [6.3-12] vs. 4.2 [2.9-5.8] cm³, p < 0.001), higher posterior LA EAT (9.7 [6.4-12] vs. 5.9 [2.8-7.2] cm³, p < 0.001) and higher right atrial EAT (7.3 [5.1-9.9] vs. 4.8 [3.2-6.5] cm³, p < 0.001). These differences remained even after correcting EAT for BMI and LA volumes. There were no significant differences in EAT volumes between -LVZ and +LVZ (n = 25). There was no significant association between EAT and AF recurrence postablation.</p><p><strong>Conclusion: </strong>EAT volume is greater in AF patients without evidence of LA fibrosis compared to matched controls without AF. These findings support an association of EAT with AF pathogenesis even in the absence of LA fibrosis.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931931","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 \"Varipulse: A Step-by-Step Guide to Pulmonary Vein Isolation\".","authors":"","doi":"10.1111/jce.16522","DOIUrl":"10.1111/jce.16522","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"303"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864324","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}