Journal of Cardiovascular Electrophysiology最新文献

{"title":"Abandoning Non Invasive Risk Stratification in WPW: There Is no Such Thing as a Free Lunch.","authors":"Andrew Krumerman","doi":"10.1111/jce.70085","DOIUrl":"https://doi.org/10.1111/jce.70085","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199532","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":"Etripamil Nasal Spray to Keep the Doctor Away.","authors":"Graham Peigh, Bradley P Knight","doi":"10.1111/jce.70127","DOIUrl":"https://doi.org/10.1111/jce.70127","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199530","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":"Trends and Disparities in Ventricular Tachycardia-Related Mortality According to Cardiomyopathy Type in the United States.","authors":"Mohammad Ali Sheffeh, Jeanne du Fay de Lavallaz, Andres Estrada Magana, Konstantinos C Siontis, Jackson J Liang","doi":"10.1111/jce.70116","DOIUrl":"https://doi.org/10.1111/jce.70116","url":null,"abstract":"<p><strong>Background: </strong>Recent data show increased ventricular tachycardia (VT) related mortality. We aimed to investigate the trends and disparities of VT-related mortality according to cardiomyopathy subtypes.</p><p><strong>Methods: </strong>Mortality and demographic data were obtained from the CDC Wide-ranging Online Data for Epidemiologic Research database between 1999 and 2020. VT-related mortality was defined as the underlying cause of death and ischemic cardiomyopathy (ICM) or nonischemic cardiomyopathy (NICM) as the contributing cause of death. The direct method of standardization was utilized to estimate age-adjusted mortality rates (AAMRs). Temporal trends were evaluated using log-linear regression models.</p><p><strong>Results: </strong>A total of 15 888 deaths were related to both VT and ICM, and 16 777 were due to both VT and NICM. There was a significant increase in VT and ICM-related mortality between 2006 and 2020 with an APC of +1.38% (p < 0.05). Similarly, VT and NICM-related mortality increased between 2008 and 2020 with an APC of +0.60% (p < 0.05). ICM had a higher AAMR in males [6.23 (6.12-6.34)], Whites [3.49 (3.43-3.54)], Hispanics [2.11 (1.95-2.26)], and the Midwest region [3.73 (3.61-3.85)] compared to NICM. In contrast, NICM had a higher AAMR in females [1.57 (1.52-1.61)], Black or African Americans [5.02 (4.84-5.20)], and the South region [3.10 (3.03-3.18)]. p for all trend < 0.05.</p><p><strong>Conclusions: </strong>Real-world data show significant differences in VT-related mortality according to cardiomyopathy subtypes with prominent sex, race, and regional disparities. Clinical and public health strategies are needed to address inequities and improve outcomes.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185843","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":"Vein of Marshall Ethanol Ablation as a Strategy for Recurrent Persistent Atrial Fibrillation.","authors":"Brian C Hsia, Peter Zhang, Joey Junarta, Leonid Garber, Felix Yang, Michael Spinelli, Yury Malyshev, Alexander Kushnir, Lior Jankelson, Scott Bernstein, David Park, Chirag Barbhaiya, Douglas Holmes, Larry A Chinitz, Anthony Aizer","doi":"10.1111/jce.70114","DOIUrl":"https://doi.org/10.1111/jce.70114","url":null,"abstract":"<p><strong>Background: </strong>Vein of Marshall (VOM) ethanol ablation is effective in preventing recurrence in patients with persistent atrial fibrillation (AF) as a de novo strategy. There is minimal data on its use in recurrent AF.</p><p><strong>Objective: </strong>We investigated the efficacy of VOM ethanol ablation for recurrence despite initial AF ablation.</p><p><strong>Methods: </strong>Retrospective analysis was performed of persistent AF patients who underwent repeat ablation after an initial ablation for persistent AF. All patients had pulmonary vein isolation (PVI), posterior wall isolation (PWI), and cavotricuspid isthmus (CTI) during their previous ablation(s). At redo ablation, controls underwent confirmation and completion of previous ablation steps, substrate modification, and a search for non-PV triggers. Cases had additional VOM ethanol ablation combined with mitral isthmus ablation.</p><p><strong>Results: </strong>One hundred and seven patients (49 VOM, 60 control) were included. There was no difference in AF recurrence at 1-year comparing VOM patients (47%) and controls (38%), (p = 0.39). Within the VOM group, the mean AF burden decreased from 38% preablation to 10% 12-months post (p = 0.003). The proportion of recurrent persistent AF decreased from 65% preablation to 26% post (p = 0.004). There was no significant difference in reduction in AF burden or proportion of recurrent persistent AF when comparing VOM cases and controls. Six percent of VOM patients developed intraprocedural left atrial appendage (LAA) isolation.</p><p><strong>Conclusions: </strong>In patients with previous PVI, PWI, and CTI ablation, VOM ethanol ablation did not demonstrate a reduction in AF recurrence or burden when compared with a strategy of substrate modification and trigger ablation alone and increases the risk of LAA isolation.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185828","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":"Functional Gaps and Atrial Fibrosis as Predictors of Early Arrhythmia Recurrence After Robotic-Enhanced Hybrid Ablation for Persistent Atrial Fibrillation.","authors":"Eduardo Celentano, Ernesto Cristiano, Erika Bertella, Matteo Parrinello, Giovanni Albano, Barbara Ignatiuk, Martina Renda, Elena Bia, Anthea d'Amico, Raffaele Rainone, Ascanio Graniero, Laura Giroletti, Laura Polini, Mario Gasparri, Stefano Schena, Alfonso Agnino, Natasja M S De Groot","doi":"10.1111/jce.70117","DOIUrl":"https://doi.org/10.1111/jce.70117","url":null,"abstract":"<p><strong>Background: </strong>Robotic-enhanced hybrid ablation (RE-HA) is a promising strategy for persistent (PsAF) and long-standing persistent atrial fibrillation (LS-PsAF). The impact of post-epicardial conduction gaps and atrial fibrosis on early arrhythmia recurrence (EAR) is unclear.</p><p><strong>Objective: </strong>To assess whether conduction gaps and atrial fibrosis predict EAR within 3 months after the epicardial stage of RE-HA.</p><p><strong>Methods: </strong>Forty-two PsAF/LS-PsAF patients underwent RE-HA with left atrial appendage closure. High-density endocardial mapping at 3 months identified fixed (present in all maps) and functional (present in ≥1 but not all maps) conduction gaps. Atrial fibrosis was quantified by pre-procedural cardiac magnetic resonance (CMR).</p><p><strong>Results: </strong>Gaps were found in 18 patients (42.3%): functional in 10 (23.8%) and fixed in 13 (31.0%), with 5 (12%) showing both. EAR occurred in 12 patients (28.6%), AFL in 10/12 (83.3%). Gaps predicted AFL (OR 4.56; p = 0.003) and EAR (OR 3.50; p = 0.005). Left atrium LGE ≥ 10% independently predicted EAR (OR 7.50; p = 0.019) with no interaction with gap presence (p = 0.24). Total RF time was similar between groups despite more gaps in recurrence cases, reflecting procedural factors beyond gap count. Roof-line gaps predominated and colocalized with epicardial fat on CMR.</p><p><strong>Conclusion: </strong>Delayed high-density mapping after RE-HA reveals fixed and functional conduction gaps, especially at the roof line, that-together with pre-ablation fibrosis-independently predict EAR. These findings highlight distinct anatomical and electrophysiological risk domains and support substrate assessment with targeted endocardial completion in a staged workflow.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185920","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":"Beyond Catheter Design: The Overlooked Role of Fluids in Pulsed Field Ablation Hemolysis.","authors":"Jonathan Schilling, Ali Sovari","doi":"10.1111/jce.70118","DOIUrl":"https://doi.org/10.1111/jce.70118","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149048","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":"Wide QRS Complex Tachycardia With Alternating Bundle Branch Block Morphologies: What Is the Mechanism?","authors":"Firat Ozcan, Ozcan Ozeke, Idriz Merovci, Can Ozkan, Sona Huseynova, Meryem Kara, Elif Hande Ozcan Cetin, Duygu Kocyigit Burunkaya, Selin Yondem, Ahmet Korkmaz, Serkan Cay, Dursun Aras, Serkan Topaloglu","doi":"10.1111/jce.70123","DOIUrl":"https://doi.org/10.1111/jce.70123","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149056","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":"Authors' Reply: Three-Dimensional Left Atrial Function and Strain After PVI.","authors":"Elias N Andrade Cuellar, Juan Carlos Solis-Gómez, Rogelio Robledo-Nolasco","doi":"10.1111/jce.70120","DOIUrl":"https://doi.org/10.1111/jce.70120","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149106","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":"Long-Term Outcome of Radiofrequency Versus Pulsed-Field Ablation in Atrial Fibrillation Patients Aged More Than 60 Years Undergoing Their First Catheter Ablation.","authors":"Pamela Horton Embrey, Sanghamitra Mohanty, Prem Geeta Torlapati, Vincenzo Mirco La Fazia, Carola Gianni, Yaseen Eleyan, Bryan MacDonald, Angel Mayedo, Amin Al-Ahmad, John David Burkhardt, John Allison, Weeranun Bode, G J Gallinghouse, Rodney Horton, Andrea Natale","doi":"10.1111/jce.70101","DOIUrl":"https://doi.org/10.1111/jce.70101","url":null,"abstract":"<p><strong>Background: </strong>We evaluated the impact of pulsed-field (PFA) vs. radiofrequency ablation (RFA) on long-term ablation outcome in AF patients and whether the benefit was extended to all age groups, in a real-world population.</p><p><strong>Methods: </strong>Consecutive AF patients undergoing their first ablation procedure were classified based on their age at baseline; group 1: > 60 years and group 2: ≤ 60 years. Each group were then subclassified based on the energy modality used; group 1A or 2A: received RFA, and group 1B or 2B: underwent PFA. All patients received isolation of PVs and left atrial posterior wall.</p><p><strong>Results: </strong>A total of 1386 patients were included in group 1 (Gr 1A: 954; Gr 1B: 432) and 414 subjects in group 2 (Gr 2A: 284; Gr 2B: 130). Patients in group 1 were sicker with more comorbidities. At the end of 1-year follow-up, significantly higher recurrence rate was reported in group 1 patients receiving RFA compared to PFA (249 (26.1%) vs. 45 (10.4%), p < 0.001), whereas the recurrence rate was comparable between the two subgroups in group 2 (RFA: 69 (24.3%) vs. PFA: 22 (17%), p = 0.095). Mean time to recurrence was significantly longer in the Gr. 2B (PFA) population compared to RFA (7.21 ± 1.87 vs. 7.75 ± 2.03 months, p = 0.008) and comparable in Gr. 1 (RFA: 7.98 ± 1.29 vs. PFA: 8.12 ± 1.80 months, p = 0.531). After controlling for the variables in the multivariate model, PFA was associated with lower risk (OR = 0.378, 95% CI 0.265, 0.539; p-value < 0.001) and Persistent AF with higher risk of recurrence (OR = 1.745, 95% CI 1.562, 1.986; p-value = 0.040).</p><p><strong>Conclusion: </strong>PFA was associated with a significantly lower recurrence rate in patients > 60 years of age with more comorbidities compared to RFA. However, in patients aged ≤ 60 years, no difference in RFA vs. PFA in terms of recurrence rate was observed. Mean time to recurrence was comparable between PFA and RFA subgroups in the group 1 population, whereas it was significantly higher in group 2 PFA vs. RFA subgroup.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137738","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":"Visualization of Real-Time Esophageal Location Using Intracardiac Echocardiography on a Three-Dimensional Mapping System: Comparison of Esophageal Location Using Preoperative Computed Tomography and Investigation of Predictors for Esophageal Movement During Catheter Ablation.","authors":"Koji Sudo, Kenji Kuroki, Chisa Asahina, Maoko Atsumi, Kazuya Nakagawa, Tetsuya Asakawa, Tomoaki Hasegawa, Kazutaka Aonuma, Akira Sato","doi":"10.1111/jce.70096","DOIUrl":"https://doi.org/10.1111/jce.70096","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary vein isolation (PVI) using radiofrequency catheter ablation is an effective treatment for atrial fibrillation; however, esophageal-related complications remain a concern. The first objective of this study was to compare the feasibility of two techniques for visualizing real-time esophageal images: intracardiac echocardiography (ICE-Eso) and preoperative computed tomography (CT-Eso). The second objective was to clarify the predictors of esophageal movement on the day of catheter ablation.</p><p><strong>Methods and results: </strong>Eighty consecutive patients were included in this study. The esophageal location was measured at the centerline of each image on three equally separated imaging sections (upper, middle, and lower sites). Esophageal locations detected on ICE-Eso and CT-Eso were compared with those on contrast esophagography. We also investigated predictors of esophageal movement. A significant difference was found between the two distances in all three sections: upper site (ICE-Eso: 2.5 [interquartile range (IQR) 1.4-3.6] mm vs. CT-Eso: 5.2 [IQR 3.4-7.6] mm, p < 0.001), middle site (ICE-Eso: 2.7 [IQR 1.3-4.3] mm vs. CT-Eso: 5.4 [IQR 3.2-8.3] mm, p < 0.001), and lower site (ICE-Eso: 2.8 [IQR 1.2-5.2] mm vs. CT-Eso: 5.8 [IQR 3.1-10.3] mm, p < 0.001). Multivariate analysis revealed that eating a meal on the morning on the day of catheter ablation (non-fasting) was a predictor of esophageal movement. One patient (1.2%) experienced gastric hypomotility, which resolved completely with medical treatment.</p><p><strong>Conclusion: </strong>The results showed that ICE-Eso provided real-time, accurate esophageal location compared to CT-Eso. Therefore, ICE-Eso-guided PVI on the left atrial posterior wall near the esophagus may be a safe method. Additionally, non-fasting on the day of catheter ablation could help to predict esophageal movement.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086167","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}