Journal of Cardiovascular Electrophysiology最新文献

{"title":"Critical Insights Into the Mechanisms of Catheter Ablation for Ventilatory Efficiency in AF-Mediated Cardiomyopathy.","authors":"Muhammad A Akhlaq, Aqsa Maqbool, Ahmed S Akhlaq, Fizzah Akhlaq, Javed Iqbal","doi":"10.1111/jce.16652","DOIUrl":"https://doi.org/10.1111/jce.16652","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663431","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":"One-Year Success Rates of a Stable, Low Pressure Cryoballoon for the Treatment of Paroxysmal Atrial Fibrillation: Results of the Prospective, International, Multicenter POLAR ICE Study.","authors":"Armin Luik, Ante Anic, Claire A Martin, Roland R Tilz, S C Yap, Carlo de Asmundis, Laure Champ-Rigot, Saverio Iacopino, Phillip Sommer, Elizabeth M Albrecht, Jonathan D Raybuck, Elizabeth Richards, Nele Cielen, Pascal Defaye","doi":"10.1111/jce.16645","DOIUrl":"https://doi.org/10.1111/jce.16645","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary vein isolation (PVI) using a cryoballoon is well-established for the treatment of paroxysmal atrial fibrillation (PAF). Compared to other available technologies, the usage of a stable, low-pressure cryoballoon (POLARx, Boston Scientific) has demonstrated lower nadir temperatures and longer thawing times. However, 1-year efficacy and safety still needs to be proven. The aim of the POLAR ICE Study was to evaluate 1-year efficacy and safety outcomes of cryoballoon ablation in patients with paroxysmal atrial fibrillation.</p><p><strong>Methods: </strong>POLAR ICE, a prospective, non-randomized, international, multicenter study to examine safety and efficacy of the novel cryoballoon for paroxysmal atrial fibrillation and de novo PVI, enrolled 399 patients across 19 centers, between August 2020 and May 2021, of which 11 were redo patients (previous treatment in the LA) and 10 were non-PAF patients.</p><p><strong>Results: </strong>This study treated 391 patients with the novel cryoballoon. After 12 months, freedom from atrial fibrillation could be demonstrated in 88.1% and freedom from any arrhythmia in 83.5%. Long-term primary composite safety events occurred in four (1.0%) patients, including one (0.26%) death (9.5 months post-index, cause unknown), one (0.26%) stroke, one (0.26%) myocardial infarction, and one (0.26%) persistent PNP (0.26%). AAD usage showed a significant decrease over the course of the study. Biophysical parameters nadir temperature (p = 0.008) and thaw time (p = 0.053) were predictive of 12-month freedom from recurrence.</p><p><strong>Conclusion: </strong>In this prospective, non-randomized, international, multicenter study, isolation of the pulmonary veins using a stable, low pressure cryoballoon was highly effective and safe in patients treated for paroxysmal atrial fibrillation.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663433","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":"Endo-Epicardial vs. Endocardial-Only Catheter Ablation of Ventricular Tachycardia in Patients With Ischemic Cardiomyopathy: The EPIC-VT Trial Design.","authors":"Raphaël P Martins, Pierre Groussin, Francis Bessière, Laure Champ-Rigot, Jean-Baptiste Gourraud, Sophie Lepage, Jacques Mansourati, Grégoire Massoulie, Philippe Maury, Sandro Ninni, Bertrand Pierre, Frédéric Sacher, Emilie Varlet, Xavier Waintraub, Clara Locher, Dominique Pavin, Philippe Mabo, Christophe Leclercq, Karim Benali","doi":"10.1111/jce.16630","DOIUrl":"https://doi.org/10.1111/jce.16630","url":null,"abstract":"<p><strong>Introduction: </strong>Radiofrequency ablation is a cornerstone therapy for patients with ischemic cardiomyopathy (ICM) presenting with ventricular tachycardia (VT). In this context, ablation is typically performed endocardially as a first-line approach. However, despite acute procedural success, the risk of recurrence remains high, potentially due to the presence of epicardial substrate. Several observational studies have suggested the potential benefits of a first-line endo-epicardial approach in decreasing recurrence. In this context, the EPIC-VT trial was designed to compare endocardial-only ablation versus combined endo-epicardial ablation as a first-line approach in ICM patients with VT.</p><p><strong>Methods: </strong>The EPIC-VT trial is a prospective, multicenter, controlled, randomized, open-label superiority trial with two parallel groups (endocardial-only approach vs. combined endo-epicardial approach) in a 1:1 ratio. The primary objective of this study is to demonstrate that a combined endo-epicardial approach reduces the risk of VT recurrence compared to an endocardial approach alone in patients with ICM. Patients will be followed for 2 years after the procedure.</p><p><strong>Results and conclusion: </strong>To date, only retrospective studies have compared VA recurrences in patients with ICM, depending on whether ablation was performed using an endocardial or an endo-epicardial approach, with conflicting results. A meta-analysis suggested an advantage of the endo-epicardial approach over the endocardial approach (odds ratio = 0.39 [95% CI: 0.18-0.83]). However, the level of evidence remains low, and no controlled randomized study has confirmed this hypothesis. If the EPIC-VT study confirms the superiority of a first-line endo-epicardial approach, such strategy could become the preferred option for VT ablation in ICM, thereby reducing the risk of VA recurrence.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656662","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":"Safety and Efficacy of a Novel Sealant-Based Vascular Closure Device Following Electrophysiology Procedures: ReliaSeal Trial.","authors":"John Summers, Vijay Swarup, Ian Parker, Joseph Bumgarner, Andrew Brenyo, Layth Saleh, Sadanandan, Javier Sanchez, Robert Beasley, Sanjaya Gupta","doi":"10.1111/jce.16623","DOIUrl":"https://doi.org/10.1111/jce.16623","url":null,"abstract":"<p><strong>Background: </strong>While manual compression (MC) remains the standard of care to achieve hemostasis, a novel vascular closure device (VCD) was designed to achieve faster hemostasis without compromising safety. The objective of the ReliaSeal trial was to evaluate the safety and effectiveness of the Mynx Control Venous VCD to close a single or multiple femoral venous access sites in one or both limbs in patients undergoing catheter-based procedures.</p><p><strong>Methods: </strong>The ReliaSeal trial was a prospective, randomized controlled trial comparing VCD to MC in patients undergoing catheter-based procedures requiring single or multiple access sites utilizing up to 12F sheaths. Endpoints included time to ambulation (TTA), time to hemostasis (TTH), time to discharge eligibility (TTDE), procedural/device success, and 30-day major and minor access site complications.</p><p><strong>Results: </strong>Two hundred and seventy subjects were randomized to the VCD or MC arm (n = 177 vs. n = 93) with a mean age of 66.7 ± 11.27 years. TTA, TTH, and TTDE were significantly reduced in VCD subjects compared to MC (TTA: 2.6 ± 1.03 vs. 5.1 ± 4.35 h, p < 0.001; TTH: 2.1 ± 1.79 vs. 11.4 ± 7.19 min, p < 0.001; TTDE: 3.1 ± 1.24 vs. 5.5 ± 4.58 h, p < 0.001, respectively). Procedural and device success was achieved in 100% of VCD subjects, compared to 98.9% of the MC group. No major or minor complications occurred in the VCD group; with a 5% minor complication rate in the MC group.</p><p><strong>Conclusion: </strong>The use of VCD resulted in significant reductions in TTA, TTH, and TTDE, with no major or minor complications and a high success rate.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648671","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":"Distribution Variance of Focal Atrial Tachycardia Foci and Long-Term Outcomes After Ablation: Experience From Two Chinese Centers.","authors":"Aikai Zhang, Xiaonan Dong, Fengyuan Yu, Lei Ding, Lijie Mi, Hongda Zhang, Lin Shi, Xiaomei Li, He Jiang, Min Tang","doi":"10.1111/jce.16595","DOIUrl":"https://doi.org/10.1111/jce.16595","url":null,"abstract":"<p><strong>Introduction: </strong>The distribution of the origin of focal atrial tachycardia (FAT) in patients with different ages have not been clearly elucidated. We aimed to evaluate age differences in foci and factors influencing recurrence after radiofrequency catheter ablation in adult and juvenile patients with FAT.</p><p><strong>Methods and results: </strong>A total of 323 consecutive FAT patients who underwent electrophysiological study and radiofrequency catheter ablation between January 2011 and March 2023 were selected for this study. We divided the patients into three groups according to the age of FAT onset: juvenile (< 18 years), young adult (≥ 18 and < 45 years), and middle-aged and old adult (≥ 45 years). Juvenile had a higher proportion of FAT originating from the left atrial appendage, the right atrial appendage, and the free or posterior wall of the right atrium. FAT in middle-aged and old adult patients was more likely to originate from the crista terminalis, tricuspid annulus, non-coronary cusp, and para-His. Young adults had a higher proportion of FAT originating from the superior vena cava and pulmonary veins. After a mean follow-up of 47.2 months, FAT recurred in 57 patients. Multivariate Cox regression analysis suggested that multifocal ablation (HR: 3.055, 95% CI: 1.476-6.323) and NT-proBNP (per standard deviation, HR: 1.367, 95% CI: 1.157-1.614) were independently associated with arrhythmia recurrence after ablation.</p><p><strong>Conclusion: </strong>Significant age differences were observed in the distribution of FAT foci. Multifocal AT and elevated NT-proBNP independently predicted FAT recurrence after ablation.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648660","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":"Factors Affecting the Impact of LBBBP on Ventricular Electrical Activation.","authors":"Erdi Babayigit, Gurbet Özge Mert, Bulent Gorenek","doi":"10.1111/jce.16642","DOIUrl":"https://doi.org/10.1111/jce.16642","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648663","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 Tachycardia With VA Dissociation: What Is the Mechanism?","authors":"José M Sánchez-Moreno, Torcuato Garrido-Arroquia Jurado, Pablo Sánchez-Millán, Luis Tercedor-Sánchez, Juan Jiménez-Jáimez","doi":"10.1111/jce.16653","DOIUrl":"https://doi.org/10.1111/jce.16653","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648674","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":"Introduction of the Low Voltage Bridge Mapping for the AVNRT RF Ablation in Children - Early Follow-Up Results.","authors":"Tomasz M Książczyk, Radosław Pietrzak, Klaudia Obsznajczyk, Magda Franke, Bożena Werner","doi":"10.1111/jce.16635","DOIUrl":"https://doi.org/10.1111/jce.16635","url":null,"abstract":"<p><strong>Background: </strong>Low voltage bridge mapping (LVBM) is an approach to atrio-ventricular nodal reentry tachycardia (AVNRT) ablation that has been postulated to facilitate the procedure. In our center, AVNRT ablations were performed with the traditional radio frequency current (RF) current approach using the CARTO mapping system. The use of LVBM in children has been well described with cryoablation but not with RF. LVBM was introduced in our center in April 2023 and is now routinely used for all AVNRT RF ablations. The aim of this study was to analyze how the introduction of the LVBM influenced the results of the pediatric AVNRT ablations using the RF current.</p><p><strong>Methods: </strong>We analyzed all AVNRT ablations performed between January 1, 2019 and June 30, 2024, and compared traditional and LVBM approaches.</p><p><strong>Results: </strong>The study group (LVBM) consisted of 40 and the control group of 61 children. Both groups did not differ significantly regarding age, body weight, and sex distribution. In the LVBM group, the total time of RF applications was significantly shorter (median of 120 s vs 191 s) and the number of RF applications was smaller than in the control group (median of: 4.5 vs 8). Total procedural time did not differ significantly between the groups. The success rate at 3 months follow-up was higher in the LVBM (92% vs 85%) group but failed to differ statistically. No complications were reported in either of groups.</p><p><strong>Conclusions: </strong>The introduction of the LVBM in RF AVNRT ablations in children allows for limiting the number and time of RF applications required, without prolonging the total procedure time. Our experience shows LVBM can also be effectively used in RF ablations of AVNRT.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648665","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":"Outcomes in Patients With Mitral Annular Disjunction and an Implantable-Cardioverter Defibrillator.","authors":"Fatima M Ezzeddine, Jee Won Jennifer Shin, Konstantinos C Siontis, Ammar M Killu, John Giudicessi, Michael J Ackerman, Abhishek J Deshmukh, Gurukripa N Kowlgi, Malini Madhavan, Christopher J McLeod, Samuel J Asirvatham, Freddy Del-Carpio Munoz","doi":"10.1111/jce.16612","DOIUrl":"https://doi.org/10.1111/jce.16612","url":null,"abstract":"<p><strong>Background: </strong>Mitral annular disjunction (MAD) carries an increased risk of complex ventricular arrhythmias, which can lead to sudden cardiac death. Many of these patients undergo implantable cardioverter defibrillator (ICD) implantation, but their ICD outcomes are not known.</p><p><strong>Objective: </strong>The aim of this study was to assess the outcomes of ICD implantation and the predictors of appropriate ICD therapies in patients with MAD.</p><p><strong>Methods: </strong>The study included patients with MAD who underwent ICD implantation. Clinical, electrocardiographic, cardiac imaging, and device therapy data were collected.</p><p><strong>Results: </strong>Forty-nine patients with MAD and ICD were included. Median age was 49 (21) years, and 29 (59%) were female. 13 (27%) patients underwent ICD implantation for primary prevention and 36 (73%) patients for secondary prevention. Over a median follow-up of 27.3 (35.3) months, 23 (47%) patients received ICD therapies. 18 (37%) patients had appropriate ICD therapies, and 5 (10%) patients had inappropriate ICD shocks. Median time to first appropriate therapy was 22.3 (63.3) months. In patients with a secondary prevention ICD indication, the rate of appropriate ICD therapies was 44%, while in patients with a primary prevention ICD indication, it was 15%. Among patients with appropriate ICD therapies, the first therapies were delivered for monomorphic ventricular tachycardia (VT) in 7 (39%) patients and polymorphic VT or ventricular fibrillation (VF) in 11 (61%) patients. Patients with appropriate ICD therapies were more likely to have a history of SCA (p = 0.003) and/or low left ventricular ejection fraction (LVEF) (p = 0.022) before ICD implantation as compared to patients without appropriate ICD therapies.</p><p><strong>Conclusions: </strong>In our cohort of patients with MAD and ICD, appropriate ICD therapies were common. Most appropriate ICD therapies were delivered for polymorphic VT or VF. Larger studies are needed to elucidate the mechanisms of VAs and refine risk stratification in MAD.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648668","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":"Concerns Regarding \"Echocardiographic Predictors of Ventricular Arrhythmias in Patients With Left Ventricular Assist Devices and Implantable Cardioverter-Defibrillator\".","authors":"Muhammad Nouman Javed, Muneeb Khawar, Javed Iqbal","doi":"10.1111/jce.16641","DOIUrl":"https://doi.org/10.1111/jce.16641","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648658","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}