Journal of Cardiovascular Electrophysiology最新文献

{"title":"Critical Evaluation of Capsule Floor Incision in CIED Generator Replacement.","authors":"Brijesh Sathian, Hanadi Al Hamad","doi":"10.1111/jce.16715","DOIUrl":"https://doi.org/10.1111/jce.16715","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101935","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 of Left Atrial Appendage Occlusion Treatment With Amulet After Unsuccessful Watchman FLX Device: A Multicenter Observational Study.","authors":"Arindam Bagga, Christian Sutherlin, Bhavya Makkar, Spencer Green, Lakshmi Laasya Vallabhaneni, Corinne Mitra, Mohamed Abdelrahman, Mahesh Balakrishnan, Jacob Hantla, Dhanunjaya Lakkireddy, Akash Makkar","doi":"10.1111/jce.16729","DOIUrl":"https://doi.org/10.1111/jce.16729","url":null,"abstract":"<p><strong>Introduction: </strong>Watchman FLX (W-FLX) is the most widely used left atrial appendage occlusion (LAAO) device to prevent atrial fibrillation (AF) related strokes in the United States. However, successful LAAO with W-FLX can be challenging in patients with complex left atrial appendage (LAA) anatomies. This analysis aimed to assess the procedural success rates of LAA occlusion (immediate and short-term outcomes) using the Amulet device, in patients with prior failed LAAO with W-FLX device.</p><p><strong>Methods and results: </strong>This was a multicentric retrospective analysis of 62 consecutive patients with unsuccessful LAAO with W-FLX, who subsequently underwent an attempted Amulet occluder placement. The primary endpoint was successful Amulet implantation. Secondary endpoints included peri-device leak (PDL) and device-related thrombus assessed by transesophageal echocardiography (TEE) at 45 days, safety end point through 7 days or hospital discharge (whichever was later) and major adverse events (MAEs) through 45 days. The Amulet occluder was successfully implanted in 98.38% of patients (n = 61/62). No clinically relevant PDL or device-related thrombus was noted at 45 days. There was one pericardial effusion noted a week after Amulet implant that underwent successful percutaneous pericardiocentesis. The reasons for W-FLX failure were all anatomical in nature. We identified five distinct anatomical patterns that posed challenges for W-FLX deployment but were amenable to successful Amulet implantation.</p><p><strong>Conclusion: </strong>The disc-lobe design of Amulet allows a high degree of successful LAAO in challenging anatomical variants (whale-tail, bilobed LAA, shallow vertical chicken-wing or seahorse, oval wide with posterior sloping trabeculations, and extensively trabeculated broccoli morphologies) with prior failed W-FLX implants. These findings may help guide device selection on pre-LAAO imaging, thereby enhancing resource utilization and contributing to more efficient and safer LAAO procedures.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101937","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":"Comments on \"High Power Short Duration Temperature-Controlled Radiofrequency Ablation for the Treatment of Outflow Tract Ventricular Arrhythmias\".","authors":"Mubariz Ali, Taimour Mushtaq, Abdullah Farooq, Brijesh Sathian, Javed Iqbal","doi":"10.1111/jce.16720","DOIUrl":"https://doi.org/10.1111/jce.16720","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078275","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 of Maternal Supraventricular Tachycardia During Pregnancy.","authors":"Benjamin W Furman, Jingwen Huang, Neal K Bhatia, Stacy B Westerman, Mikhael F El-Chami, Faisal M Merchant, Vardhmaan Jain","doi":"10.1111/jce.16730","DOIUrl":"https://doi.org/10.1111/jce.16730","url":null,"abstract":"<p><strong>Introduction: </strong>While supraventricular tachycardia (SVT) is generally considered benign, recent data suggest that SVT during pregnancy may be associated with adverse outcomes.</p><p><strong>Methods and results: </strong>We queried the National Inpatient Sample (NIS) from 2016 to 2021 to identify pregnancy-related hospitalizations with a diagnosis of SVT. Diagnoses, patient characteristics, and endpoints were ascertained using ICD-10 codes. Out of 23.5 million pregnancy-related hospitalizations, 30 215 (0.14%) included a diagnosis of SVT. Patients with SVT were older and had a higher prevalence of cardiovascular and non-cardiovascular comorbidities. In-hospital mortality was significantly higher in women with SVT (0.55 vs. 0.01%, p < 0.001). After adjustment for baseline differences, in-hospital mortality remained significantly higher in women with SVT (adjusted odds ratio [aOR] 4.68, 95% confidence interval [CI]: 2.94-7.46). Risk of cardiogenic shock (aOR 4.67, 95% CI: 3.12-7.00), need for mechanical circulatory support (aOR 4.93, 95% CI: 2.93-8.30) and incidence of pre-eclampsia or eclampsia (aOR 1.14, 95% CI: 1.04-1.24) were also greater in women with SVT. Of the 30 215 hospitalizations with SVT, only 190 women underwent ablation during hospitalization (0.63%). Among pregnant women undergoing ablation, the incidence of in-hospital mortality was too low to report per NIS guidelines (n < 10).</p><p><strong>Conclusions: </strong>A diagnosis of SVT was present in 0.14% of pregnancy-related hospitalizations and was associated with an increased risk of in-hospital mortality, cardiogenic shock, need for mechanical circulatory support, and pre-eclampsia/eclampsia.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078234","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":"Persistent Left Atrial Appendage Thrombus in Atrial Fibrillation Despite Anticoagulation.","authors":"Alexander Kushnir, Scott Bernstein, Chirag R Barbhaiya, Lior Jankelson, Douglas Holmes, Anthony Aizer, David Park, Michael Spinelli, Leonard Garber, Felix Yang, Larry A Chinitz","doi":"10.1111/jce.16718","DOIUrl":"https://doi.org/10.1111/jce.16718","url":null,"abstract":"<p><strong>Objectives: </strong>Assess the characteristics and management of patients with LAA thrombus despite compliance with oral anticoagulation (OAC).</p><p><strong>Background: </strong>Atrial fibrillation guidelines consider 4 weeks of uninterrupted OAC sufficient to avoid transesophageal echocardiography to rule out left atrial appendage thrombus. However, some patients may exhibit persistent thrombus despite compliance with OAC.</p><p><strong>Methods: </strong>Clinical history, management, and outcomes were reviewed for patients with LAA thrombus on preprocedural TEE presenting for an AF related procedure between 2021 and 2024.</p><p><strong>Results: </strong>Sixty-five (1.8%) of 3653 preprocedural TEEs exhibited LAA thrombus. OAC compliance of at least 4 week was documented in 39 (60%) of these patients, including Apixaban 64%, Rivaroxaban 23%, Warfarin 8%, Dabigatran 5%. Two of these patients (3%) experienced an embolic event and 8 (12%) died during the follow up period. Resolution of LAA thrombus was documented in 12/32 patients, 6 who switched to Dabigatran, 2 to Eliquis, 1 to Warfarin, and 3 remained on Eliquis. LAA-occlusion was successfully performed in seven patients with persistent LAA thrombus. CHADS-VASc 3 or greater, HFrEF, or valvular AF were present in 37/39 of these patients.</p><p><strong>Conclusion: </strong>For 3653 patients who underwent Preprocedural TEE, 39 exhibited LAA thrombus despite compliance with OAC. Switching OAC or maintaining the same agent for longer period of time resolved the thrombus in 31% of cases. LAA-O was effective in cases where the thrombus did not resolve. Patients with non-valvular AF, compliance with OAC > 4 weeks, CHADS-VASc ≤ 2, and normal EF exhibited the lowest probability for not having a thrombus on TEE.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078236","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":"Ventricular Tachycardia Ablation in Patients With Severely Decreased Left Ventricular Ejection Fraction.","authors":"Michael Ghannam, Nathanial Christian-Miller, Jackson Liang, Amrish Deshmukh, Kelly Arps, Rakesh Latchamsetty, Thomas Crawford, Krit Jongnarangsin, Hakan Oral, Fred Morady, Frank Bogun","doi":"10.1111/jce.16694","DOIUrl":"https://doi.org/10.1111/jce.16694","url":null,"abstract":"<p><strong>Background: </strong>Ablation of ventricular tachycardia (VT) is often performed in patients with structural heart disease. Procedural and delayed enhancement cardiac magnetic resonance imaging (DE-CMR) characteristics among patients with very severe cardiomyopathy (CM) and without left-ventricular assist devices (LVAD) have been incompletely described.</p><p><strong>Objectives: </strong>To examine procedural and imaging characteristics of patients with very severely decreased ejection fractions undergoing VT ablation procedures.</p><p><strong>Methods: </strong>Consecutive patients with a left ventricular ejection fraction (EF) < 20% and without LVADs who underwent VT ablation were included. A composite outcome of survival free from VT, LVAD, or transplant was examined.</p><p><strong>Results: </strong>Twenty-seven patients were included (64.1 ± 7.76 years; male n = 23, 88.5%; EF 12.8 ± 3%, LV end diastolic diameter 74 ± 11 mm, ischemic CM (n = 16, 60%), Nonischemic CM (n = 9, 52%), mixed CM (n = 2, 7%)). Twenty-five (93%) patients had failed amiodarone, 9 (33%) had a prior VT ablation, and 13 (48%) underwent ablation for VT storm. Scar was present in 22/23 patients with DE-CMR (intramural [n = 13], endocardial [n = 8], epicardial [n = 2], mixed components [n = 12]). DE-CMR scar corresponded to VT sites of origin in 18/22 patients (82%), excluding one patient with right ventricular VT, two with bundle-branch-reentry VT, and one-non-inducible patient. After 22 ± 19 months, VT occurred in 15/27(56%) patients, death 8/27(30%) and the composite outcome occurred in 22/27(82%) patients.</p><p><strong>Conclusion: </strong>Patients with very severe cardiomyopathy undergoing VT ablation represent a high risk population, experiencing high rates of VT recurrence and death on midterm follow up. Despite severe remodeling, DE-CMR provides localizing information on the arrhythmia site of origin.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997840","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: Tricuspid Regurgitation as a Marker or Therapeutic Target of Atrial Fibrillation Recurrence Following Pulmonary Vein Isolation.","authors":"Sebastian Weyand, Viola Adam, Paloma Biehler, Patricia Hägele, Simon Hanger, Stephanie Löbig, Andrei Pinchuk, Felix Ausbuettel, Christian Waechter, Peter Seizer","doi":"10.1111/jce.16726","DOIUrl":"https://doi.org/10.1111/jce.16726","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078238","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":"Electrocardiographic Characteristics of Ventricular Arrhythmias Originating From High Right Ventricular Outflow Tract and Pulmonary Artery.","authors":"Ming-Jen Kuo, Chin-Yu Lin, Jin-Long Huang, Yenn-Jiang Lin, Yu-Cheng Hsieh, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Fa-Po Chung, Cheng-Hung Li, Ting-Yung Chang, Ling Kuo, Cheng-I Wu, Chih-Min Liu, Shin-Huei Liu, Yu-Shan Huang, Shih-Ann Chen","doi":"10.1111/jce.16714","DOIUrl":"https://doi.org/10.1111/jce.16714","url":null,"abstract":"<p><strong>Background: </strong>Ventricular arrhythmias (VAs) may originate from the right ventricular outflow tract (RVOT) below the pulmonary sinus cusps (PSCs) or from the pulmonary artery (PA) above the PSCs. However, the electrocardiographic (ECG) characteristics of these VAs are not well defined.</p><p><strong>Objective: </strong>This study aimed to investigate the ECG characteristics of VAs originating from the high RVOT and PA.</p><p><strong>Methods: </strong>Patients who underwent catheter ablation for VAs originating from the RVOT or PA were retrospectively reviewed. Patients with VAs exhibiting a left bundle branch block pattern and an inferior axis on ECG, who also underwent pulmonary artery angiography, were included. Three-dimensional electroanatomic mapping was performed for all patients. The origin of the VAs, either below the pulmonary sinus cusps (Group 1: high RVOT group) or above the pulmonary sinus cusps (Group 2: PA group), was confirmed via PA angiography.</p><p><strong>Results: </strong>Thirty-seven patients were in Group 1, and 36 were in Group 2. In Group 2, significantly shorter R wave peak times (RWPT) were measured in leads II, III, and aVF on surface ECG during VAs. The cutoff values for RWPT were 66, 66, and 69 ms, respectively, with high area under the curve values of 0.944, 0.944, and 0.913, respectively.</p><p><strong>Conclusion: </strong>VAs originating from the PA exhibit shorter RWPT in leads II, III, and aVF on surface ECG, distinguishing them from VAs originating from the high RVOT. These findings can aid in preprocedural planning, facilitating the mapping and ablation of the supra-PSC region based on surface ECG characteristics.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078276","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":"Leadless Pacing: Past, Present, and Future.","authors":"Nishant Verma","doi":"10.1111/jce.16703","DOIUrl":"https://doi.org/10.1111/jce.16703","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078278","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":"Nonlinear Relationship Between Left Atrial Volume Measured by Computed Tomography and Recurrent Atrial Arrhythmias in Patients Undergoing Catheter Ablation for Atrial Fibrillation.","authors":"Aikai Zhang, Xiaofeng Li, Yuandong Liu, Min Tang","doi":"10.1111/jce.16717","DOIUrl":"https://doi.org/10.1111/jce.16717","url":null,"abstract":"<p><strong>Background: </strong>Left atrial remodeling is commonly believed to contribute to the recurrence of atrial arrhythmias following catheter ablation for atrial fibrillation (AF). However, the relationship between left atrial volume (LAV) assessed via left atrial computed tomography (LACT) and AF recurrence remains insufficiently explored.</p><p><strong>Aim: </strong>This study aimed to examine the association between LAV measured by LACT and the recurrence of AF.</p><p><strong>Methods: </strong>In this cohort study, 532 consecutive AF patients undergoing their first catheter ablation at Fuwai Hospital were enrolled. The primary outcome was the recurrence of atrial arrhythmias after a 90-day blanking period following the ablation procedure. Semi-automated software (Materialize Mimics) was utilized to analyze LACT data and estimate left atrial size.</p><p><strong>Results: </strong>After a median follow-up duration of 16.7 months, 189 patients experienced AF recurrence. Multivariate Cox regression revealed a significant positive association between LAV and recurrence risk (hazard ratio, 1.36; 95% confidence interval, 1.11-1.66, p = 0.003). Restrictive cubic spline analysis uncovered a U-shaped nonlinear association between LAV and AF recurrence, with an inflection point identified at 99.3 mL (P for nonlinear < 0.001, P for overall < 0.001). Kaplan-Meier survival analysis demonstrated significantly lower freedom from atrial arrhythmias in the 1st and 4th quartile compared to the 2nd quartile (Log-rank, p < 0.001).</p><p><strong>Conclusion: </strong>In AF patients undergoing initial catheter ablation, LAV was found to have a positive relationship with the risk of recurrent atrial arrhythmias, exhibiting a U-shaped nonlinear pattern. Both excessively high and low LAV levels were associated with an elevated risk of AF recurrence.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078232","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}