{"title":"Unipolar Voltage for Better Characterizing Left Atrium Substrates: Comparing the Predictive Efficacy for Recurrence Post Atrial Fibrillation Ablation in a Post Hoc Analysis of STABLE-SR-III Trial.","authors":"Xiuyu Qi, Hongwu Chen, Gang Yang, Hailei Liu, Zidun Wang, Xiaohong Jiang, Chang Cui, Cheng Cai, Weizhu Ju, Minglong Chen","doi":"10.1111/jce.16490","DOIUrl":"10.1111/jce.16490","url":null,"abstract":"<p><strong>Background: </strong>While bipolar voltage (BV) is acknowledged as an indicator of viable cardiomyocyte activation, unipolar recording has emerged as an alternative technique due to its advantage of providing a wider field of view. This study aims to compare the efficacy of unipolar voltage (UV) versus BV in predicting ablation recurrence in atrial fibrillation patients.</p><p><strong>Methods: </strong>In Substrate Ablation in the Left Atrium during Sinus Rhythm Trial III, 375 patients completed the follow-up with preserved mapping data were included in the analysis. For each patient, the mean UV and BV was obtained from the electrograms sampled in left atrium (LA).</p><p><strong>Results: </strong>Totally 301 patients experience the primary endpoint within 23.0 ± 9.2 months. While both low UV and BV had significant associations with long-term recurrence of atrial tachyarrhythmia (ATa), only mean UV was independently associated with the outcome. The model by UV with ablation feature had higher discriminatory power to predict ATa recurrence compared with BV model (area under the curve [AUC]: 0.858 vs. 0.757, p < 0.001). In subgroup analysis, UV reveals more powerful predictive efficacy compared with BV, with the AUC 0.843 versus 0.751 (p < 0.001) in circumferential pulmonary vein isolation (CPVI) alone cohort and 0.882 versus 0.750 (p < 0.001) in CPVI plus cohort, respectively.</p><p><strong>Conclusion: </strong>UV exhibits higher efficacy for predicting long-term ATa recurrence after ablation compared with BV in elderly patients with atrial fibrillation regardless of whether the patient accepts substrate modification. The outcome suggests that unipolar recording may better characterize LA fibrosis by capturing more comprehensive transmural features than bipolar signals.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov; URL: https://www.</p><p><strong>Clinicaltrials: </strong>gov. Unique Identifier: NCT03462628.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"149-156"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604745","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}
Chengye Di, Qun Wang, Yanxi Wu, Longyu Li, Yan Zhang, Wenhua Lin
{"title":"Limitation of Unipolar Electrograms in Guiding Successful RFCA of Idiopathic Ventricular Arrhythmias Associated With Discrete Pre-Potential.","authors":"Chengye Di, Qun Wang, Yanxi Wu, Longyu Li, Yan Zhang, Wenhua Lin","doi":"10.1111/jce.16503","DOIUrl":"10.1111/jce.16503","url":null,"abstract":"<p><strong>Objectives: </strong>Activation mapping for idiopathic ventricular arrhythmias (IVAs) typically relies on identifying the earliest bipolar electrograms and unipolar electrograms characterized by an initial QS morphology preceding the intrinsic deflection. However, the utility of unipolar electrogram morphology, particularly when associated with discrete pre-potentials, in guiding IVA mapping is not well understood.</p><p><strong>Methods: </strong>We retrospectively analyzed 537 patients who underwent successful radiofrequency catheter ablation (RFCA) for IVAs between March 2016 and August 2023. Among them, 23 patients (4.3%) exhibited discrete bipolar pre-potentials with an isoelectric line between the end of the discrete pre-potential and the onset of the QRS complex during IVAs at the successful RFCA site. These cases were included in this study.</p><p><strong>Results: </strong>The time interval from the onset of the discrete pre-potential to the onset of the QRS complex was 66.4 ± 18.3 ms. The duration of the isoelectric line between the end of the discrete pre-potential and the onset of the QRS complex was 36.9 ± 13.6 ms. Unipolar electrograms associated with discrete pre-potentials exhibited an initial negative morphology in only 13 out of 23 patients (56.5%). In contrast, initial positive and isoelectric configurations in unipolar electrograms were observed in two patients (8.7%) and eight patients (34.8%), respectively. Perfect pace mapping was obtained in 21 patients (91.3%). RFCA was successful at the earliest site of the pre-potential within 3.5 ± 1.5 s in all 23 patients. During the 2.4 ± 1.2 years follow-up period, only one patient (4.3%) experienced a recurrence of clinical IVAs, with no complications reported during RFCA or follow-up.</p><p><strong>Conclusions: </strong>Unipolar electrograms show limited reliability in guiding the identification of IVAs origins compared to bipolar electrograms associated with discrete pre-potentials.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"235-245"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668044","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}
Joo Hee Jeong, So-Ryoung Lee, Il-Young Oh, Myung-Jin Cha, Hong Euy Lim, Hyoung-Seob Park, Pil-Sung Yang, Sung Ho Lee, Junbeom Park, Ki-Hun Kim, Jun-Hyung Kim, Jae-Sun Uhm, Jin Hee Ahn, Jumsuk Ko, Ju Youn Kim, Jaemin Shim
{"title":"Age and Clinically Actionable Events in Patients With Implantable Loop Recorders: Analysis of Multicenter Loop Recorder Registry.","authors":"Joo Hee Jeong, So-Ryoung Lee, Il-Young Oh, Myung-Jin Cha, Hong Euy Lim, Hyoung-Seob Park, Pil-Sung Yang, Sung Ho Lee, Junbeom Park, Ki-Hun Kim, Jun-Hyung Kim, Jae-Sun Uhm, Jin Hee Ahn, Jumsuk Ko, Ju Youn Kim, Jaemin Shim","doi":"10.1111/jce.16509","DOIUrl":"10.1111/jce.16509","url":null,"abstract":"<p><strong>Introduction: </strong>Little is known about age and clinical intervention after implantable loop recorder (ILR) insertion. This study investigated the association between age and clinical intervention after ILR implantation.</p><p><strong>Methods and results: </strong>Data were obtained from a multicenter registry of ILR in Korea (2017-2020, n = 795). ILRs were inserted with indications of unexplained syncope, recurrent palpitation, or cryptogenic stroke. The primary outcome was clinically actionable event that was a composite of the newly detected atrial fibrillation (AF), pacemaker or implantable cardioverter defibrillator (ICD) implantation, catheter ablation, and anticoagulation initiation. The mean age was 64.3 years, and the mean follow-up duration was 20.6 months. Clinically actionable events were observed in 322 (40.5%) patients. Compared to younger age (< 50 years), older age (≥ 50 years) showed higher prevalence of newly detected AF (3.7% vs. 15.8%; p = 0.001), pacemaker implantation (11.2% vs. 21.2%; p = 0.022), and initiation of anticoagulation (3.7% vs. 18.6%; p < 0.001). No significant differences were found in ICD implantation (1.9% vs. 1.3%; p = 0.996) or catheter ablation (3.8% vs. 6.0%; p = 0.512). The older age group more frequently experienced clinically actionable events compared to the younger age group (hazard ratio 2.52, 95% confidence interval: 1.86-3.41; p < 0.001). A significant association was found in the increase of age (per 1-year) and the risk of clinically actionable events (adjusted hazard ratio 1.03, 95% confidence interval 1.02-1.04; p < 0.001).</p><p><strong>Conclusion: </strong>Advanced age is a significant risk factor for clinical intervention after ILR insertion. ILR should be considered more actively in older patients requiring prolonged rhythm monitoring.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"266-275"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728925","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}
Yue Gao, Rui Jiang, Yan Liu, Zi-Xuan Li, Xin-He Xu, Shi-Jie Li, Xian-Jin Li, Bing Han
{"title":"Assessment of palpitations in patients with frequent premature ventricular contractions.","authors":"Yue Gao, Rui Jiang, Yan Liu, Zi-Xuan Li, Xin-He Xu, Shi-Jie Li, Xian-Jin Li, Bing Han","doi":"10.1111/jce.16476","DOIUrl":"10.1111/jce.16476","url":null,"abstract":"<p><strong>Introduction: </strong>In patients with frequent premature ventricular contractions (PVCs), palpitations may not always be directly caused by PVCs, and therefore, it is essential to establish symptom-rhythm correlations to determine the appropriate treatment. This study aims to analyze the palpitations and related factors in patients with frequent PVCs.</p><p><strong>Methods: </strong>The study enrolled patients with frequent PVCs who were not combined with other arrhythmias or structural heart disease. Through face-to-face consultation, patients were divided into symptomatic and asymptomatic groups. For symptomatic patients, the correlation between palpitations and PVC was further evaluated based on the temporal consistency of symptom onset and PVC occurrence. The demographic, clinical, and electrocardiogram features of the patients in each group were compared.</p><p><strong>Results: </strong>Of the 214 patients enrolled, 124(57.9%) experienced palpitations. Compared to the asymptomatic group, the symptomatic group had a higher proportion of females (63.7% vs. 47.8%; p = .020) and a higher proportion of subjects with anxiety (44.4% vs.14.4%; p = .000). Within the symptomatic patients, 72 (33.60%) who had palpitations that were clearly correlated with PVCs were classified as the PVC-relevant group. In this group, the PVC CI ratios were significantly lower (55% [52% -60%] vs. 62% [55% -67%]; p = .001) and the Post-PVC CI were longer (1170 [1027-1270] vs. 1083 [960-1180] ms; p = .018) than in the PVC-irrelevant group.</p><p><strong>Conclusion: </strong>A direct relationship between palpitations and PVCs could be established only in a minority of patients with frequent PVCs. PVCs with a relatively short PVC CI and a long post-PVC CI were more likely to cause palpitations, whereas palpitations lasting only a few seconds were more likely to be directly relevant to PVCs.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"32-41"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carlos Minguito-Carazo, Jesús Daniel Martínez-Alday, Javier García Seara, José Luis Martínez-Sande, Teba González-Ferrero, Oleksandr Shangutov, Juliana Elices-Teja, X Alberte Fernández López, José Ramón González-Juanatey, Moisés Rodríguez-Mañero
{"title":"Endocardial ablation of ganglionated plexus for the treatment of carotid sinus syndrome.","authors":"Carlos Minguito-Carazo, Jesús Daniel Martínez-Alday, Javier García Seara, José Luis Martínez-Sande, Teba González-Ferrero, Oleksandr Shangutov, Juliana Elices-Teja, X Alberte Fernández López, José Ramón González-Juanatey, Moisés Rodríguez-Mañero","doi":"10.1111/jce.16469","DOIUrl":"10.1111/jce.16469","url":null,"abstract":"<p><strong>Introduction: </strong>Carotid sinus syndrome (CSS), characterized by exaggerated vagal responses leading to asystolic pauses with carotid sinus massage (CSM), often necessitates pacemaker implantation. This study investigates cardioneuroablation (CNA) as an alternative strategy for CSS.</p><p><strong>Methods: </strong>Prospective study of consecutive patients referred for CNA due to CSS. All patients underwent CSM, atropine test and 24-h Holter monitoring before the procedure and at 6 months. The primary objective was the absence of any cardioinhibitory response to CSM following CNA. Secondary objectives included the combined endpoint of syncope and presyncope-free survival, pacemaker-free survival, differences in heart rate variation (HRV), as well as differences in the pre- and postprocedure atropine tests and in the SF-36 quality-of-life questionnaire.</p><p><strong>Results: </strong>A total of 13 consecutive patients (84.6% male, mean age 63.8 ± 12.3 years) were included. CSM revealed a symptomatic asystolic pause in all patients before CNA (7.3 [5.6-10.5] s). After the procedure, all the patients had a negative CSM, and only one patient (7.7%) had a positive CSM at 6 months. After a median follow-up of 11.2 (10.6-16.3) months, syncope or presyncope-free survival was 84.6%, and none required pacemaker implantation. There was an improvement in the energy and health change items in the SF-36 questionnaire. There was a reduction in HR increase in the atropine test at 6 months (pre-CNA: 66% [52-84] vs. post-CNA 26.0% (19.8-29.3]; p = .008) and in HRV parameters.</p><p><strong>Conclusions: </strong>In this proof-of-efficacy study, performed in patients affected by asystolic CSS, CNA was effective in reducing the rate of cardioinhibitory responses, suggesting a potential efficacy in also reducing syncopal recurrences. Controlled trials are warranted to corroborate clinical findings.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"7-16"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466299","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 of the peak frequency map for left atrial posterior wall isolation.","authors":"Shintaro Yamagami, Suguru Nishiuchi, Tomohiro Sato, Masaya Akiyama, Yuta Nakano, Kondo Hirokazu, Toshihiro Tamura","doi":"10.1111/jce.16477","DOIUrl":"10.1111/jce.16477","url":null,"abstract":"<p><strong>Introduction: </strong>Complete isolation of the left atrial posterior wall (LAPW) is challenging owing to overlapping epicardial conduction. Peak frequency (PF) is a novel parameter that focuses on near- and far-field electrogram components. In this study, we aimed to determine whether transmural block completion is related to the ablation site PF.</p><p><strong>Methods: </strong>We analyzed 44 consecutive patients undergoing initial LAPW isolation (LAPWI) between June 2023 and February 2024. Pre-LAPWI and PF maps were obtained using an HD-Grid catheter. In 17 of the 44 patients (Group-1), LAPWI was performed conventionally. In the remaining 27 patients (Group-2), PF-guided LAPWI was applied based on Group-1 results.</p><p><strong>Results: </strong>In Group-1, the left atrial (LA) roof and floor line success rates were 58.8% and 76.5%, respectively. The average PF value in the roof lines of patients with a completed block line was significantly higher than that of the remaining patients (286.6 ± 29.3 Hz vs. 236.1 ± 40.9 Hz, p = .012), but the floor lines were similar. In Group-2, relatively high PF values were targeted to achieve complete block of the LA roof and floor lines, following the results obtained in Group-1. The LA roof line success rates (92.6% vs. 58.8%, p = .007), total number of radiofrequency (RF) applications (22.7 ± 5.6 vs. 27.6 ± 8.5, p = .03), and procedural time (32.6 ± 18.3 vs. 47.9 ± 25.6 min, p = .03) differed between Group-1 and Group-2.</p><p><strong>Conclusion: </strong>Using a PF map for determining the optimal ablation line for LAPWI by RF catheter ablation is feasible.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"42-51"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501019","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}
Luke P Dawson, Jocasta Ball, Andrew Wilson, Lance Emerson, Aleksandr Voskoboinik, Ziad Nehme, Mark Horrigan, David Kaye, Dion Stub
{"title":"Association between temperature and air pollutants with atrial fibrillation presentations to emergency departments.","authors":"Luke P Dawson, Jocasta Ball, Andrew Wilson, Lance Emerson, Aleksandr Voskoboinik, Ziad Nehme, Mark Horrigan, David Kaye, Dion Stub","doi":"10.1111/jce.16475","DOIUrl":"10.1111/jce.16475","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding the impact of environmental exposures on disease incidence is important for environmental guidelines, health services management, and advising patients. We aimed to assess the relationship between daily mean temperature and common pollutants with atrial fibrillation (AF) presentations to emergency departments (EDs).</p><p><strong>Methods: </strong>The study included consecutive adult patients presenting with AF to EDs from 1/1/2014 to 31/12/2020 with linkage to hospital and emergency discharge diagnosis data. A time series quasi-Poisson regression with a distributed lag nonlinear model was fitted to assess the association between AF with mean air temperature and five common pollutants, overall and according to sex and region, with adjustment for season, day of the week, long-term trend, and co-pollutants.</p><p><strong>Results: </strong>In 82 575 AF presentations to EDs during the study period, mean (standard deviations [SD]) (SD) age was 69.6 (SD 14.7) years and 50.7% were female. AF presentations were associated with elevated levels of Particulate Matter (PM) 2.5 (≥57.7 µg/m<sup>3</sup>) and nitrous dioxide (NO2) (≥16.5 parts per billion), but not mean air temperature or other pollutants (carbon monoxide, sulphur dioxide, or ozone). The attributable fraction of AF presentations relating to above optimal NO2 and PM 2.5 levels was 7.24% and 3.81% resulting in 854 and 450 annual excess AF presentations, respectively.</p><p><strong>Conclusions: </strong>High levels of NO2 and PM 2.5 are associated with increased risk of AF presentations to EDs. These findings have important implications for environmental policies and advice to patients susceptible to AF presentations to EDs, especially in regions with higher baseline levels of PM 2.5 or NO2.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"71-80"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545697","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}
Julia Aranyó, Gladys Juncà, Axel Sarrias, Victor Bazan, Daniel Cea, Roger Villuendas, Carolina Gálvez-Montón, Eduard Fernandez-Nofrerias, Antoni Bayes-Genís, Victoria Delgado, Albert Teis, Felipe Bisbal
{"title":"Left Atrial Structure and Function Following Ethanol Infusion into Vein of Marshall (MR-SHALL Study).","authors":"Julia Aranyó, Gladys Juncà, Axel Sarrias, Victor Bazan, Daniel Cea, Roger Villuendas, Carolina Gálvez-Montón, Eduard Fernandez-Nofrerias, Antoni Bayes-Genís, Victoria Delgado, Albert Teis, Felipe Bisbal","doi":"10.1111/jce.16491","DOIUrl":"10.1111/jce.16491","url":null,"abstract":"<p><strong>Background: </strong>Ethanol infusion into the vein of Marshall (EI-VOM) is an adjunctive therapy to pulmonary vein isolation (PVI), which improves the efficacy of persistent atrial fibrillation (AF) ablation procedures. It is unknown how EI-VOM scar formation impacts left atrium (LA) structure and function.</p><p><strong>Objective: </strong>To characterize scar formation after EI-VOM, and its impact on LA function, by cardiac magnetic resonance (CMR).</p><p><strong>Methods: </strong>Consecutive patients referred for persistent AF ablation, or any repeat procedure, were included. Ablation strategy included PVI, EI-VOM and linear lesions when deemed necessary. LA was assessed by late gadolinium enhancement (LGE) CMR at baseline and 3-month follow-up. CMR was post-processed off-line with dedicated software. The LA was regionalized into 17 segments, and global and regional scarring were calculated. Strain parameters were analyzed-including LA reservoir, conduit, and booster strain; LA ejection fraction; and LA passive and active emptying function. Follow-up LGE-CMR reconstruction was coregistered with the voltage map, ablation RF points, and fluoroscopy to compare the scar location with the VOM trajectory.</p><p><strong>Results: </strong>This study included 21 patients (65 ± 8 years; 76% men; 57% ablation of persistent AF). After EI-VOM, 95% of patients presented new low-voltage areas, all of whom exhibited new LGE-CMR scarring at follow-up. Voltage map and LGE-CMR coregistration showed comparable scar areas (p = 0.287). LGE-CMR scarring frequently involved the whole VOM trajectory, predominantly affecting the LA ridge, mitral isthmus, and left posterior wall. LA volume was significantly reduced after ablation, without significant changes in LA functional parameters.</p><p><strong>Conclusion: </strong>EI-VOM causes permanent scarring at 3-month follow-up, with no adverse impact on CMR LA functional parameters.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"157-167"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604719","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}
Ziad Bulbul, Alaaeddine El Ghazawi, Alicia Khazzeka, Bernard Abi-Saleh, Hani Tamim, Maurice Khoury, Fadi Bitar, Mariam Arabi, Fatme Charafeddine, Marwan Refaat
{"title":"Cardiac Ablation in the Pediatric Population at a Tertiary Care Center in a Developing Country.","authors":"Ziad Bulbul, Alaaeddine El Ghazawi, Alicia Khazzeka, Bernard Abi-Saleh, Hani Tamim, Maurice Khoury, Fadi Bitar, Mariam Arabi, Fatme Charafeddine, Marwan Refaat","doi":"10.1111/jce.16489","DOIUrl":"10.1111/jce.16489","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to describe our experience and outcome of ablation therapy for arrhythmias in pediatrics at a tertiary care center.</p><p><strong>Methods: </strong>Data was collected retrospectively from the hospital medical records. All pediatrics presenting to AUBMC between 2000 and 2020 who underwent cardiac ablation were included. The data collected included type of arrhythmia, ablation technique, age and weight at ablation, procedure complications, medications used, and outcome assessment.</p><p><strong>Results: </strong>We had 67 patients who underwent cardiac ablation. Of those, 60% were males with a mean age of 15 years. Structural heart disease was present in 6% of patients. Wolff-Parkinson-White syndrome (WPW) was most prevalent at 31%, followed by atrioventricular nodal reentrant tachycardia (AVNRT) at 24%, atrioventricular reentrant tachycardia (AVRT) at 16%, ventricular tachycardia (VT) at 10%, atrial fibrillation (AF) at 3%, and atrial tachycardia (AT) at 1%. The remaining 15% of patients presented with less common types of arrhythmias, including other supraventricular tachycardias (SVTs), retrograde dual atrioventricular nodal reentry, and premature ventricular contractions (PVC). Antiarrhythmic medications were started before the procedure in 59% of our population. Medication regimens postablation included beta-blockers (68%), type 1c antiarrhythmics (25%), calcium channel blockers (3%), ivabradine (2%), and amiodarone (2%). The completed procedures showed a success rate of 93%.</p><p><strong>Conclusion: </strong>Ablation of arrhythmias in pediatrics is an effective procedure in the treatment of childhood arrhythmias. More studies are needed on cardiac ablation in this age group and those with structural heart disease in the Middle East region.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"144-148"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604710","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}