Journal of Cardiovascular Electrophysiology最新文献

{"title":"A Modular Approach for Leadless Pacing.","authors":"Wissam Mekary, Sonya Vijayvargiya, Celine Mouawad, Neal K Bhatia, Anand D Shah, Stacy B Westerman, Michael S Lloyd, Miguel A Leal, Faisal M Merchant, Mikhael F El-Chami","doi":"10.1111/jce.16740","DOIUrl":"https://doi.org/10.1111/jce.16740","url":null,"abstract":"<p><strong>Introduction: </strong>The AVEIR leadless pacemaker (LP) is a novel device that can function as a single atrial/ventricular or dual-chamber pacemaker. The introduction of single-chamber atrial LP has allowed electrophysiologists to treat patients with sinus node dysfunction with this device instead of implanting a dual-chamber transvenous pacemaker.</p><p><strong>Methods: </strong>We retrospectively identified all patients who underwent AVEIR LPs' implantation at Emory Healthcare between 2022 and 2025. Baseline characteristics, indications for pacing, and procedure outcomes were retrieved from electronic medical records. The device's electrical characteristics were reported from routine interrogations done at our device clinic.</p><p><strong>Results: </strong>Between 2022 and 2025, 89 patients underwent implantation of 37 single-chamber atrial AVEIR, 34 single-chamber ventricular AVEIR, and 18 dual-chamber devices. Patients were followed for a median duration of 4.7 months [2;9]. The rate of major complications was 3.4% and minor complications 1.1%. Two patients with ventricular LP required upgrade to cardiac resynchronization therapy-defibrillator (CRT-D) due to pacing-induced cardiomyopathy (2.3%). One patient (2.7%) with a standalone atrial LP developed atrial fibrillation with slow ventricular response requiring the addition of a ventricular LP 10 months postimplantation.</p><p><strong>Conclusion: </strong>In our center, we adopted a modular pacing approach for leadless pacing. This strategy focuses on minimizing the amount of hardware in the heart. This reduces complications such as perforation and dislodgment while optimizing battery longevity, which is affected by i2i communication.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127766","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":"Taking a Detour: Step-by-Step Alternative Approaches to Transseptal Access.","authors":"Worawan B Limpitikul, Vincent Wu, Kei Yamada, Gregory F Michaud, William J Hucker, Moussa Mansour, E Kevin Heist, Alan Hanley","doi":"10.1111/jce.16711","DOIUrl":"https://doi.org/10.1111/jce.16711","url":null,"abstract":"<p><p>Transseptal puncture via a femoral vein and inferior vena cava (IVC) is a commonly performed procedure in multiple electrophysiology studies that require access to the left atrium or left ventricle. However, the standard approach is impossible in certain anatomies with IVC obstruction, such as congenital IVC interruption with azygos continuation and acquired obstruction. Here, we describe a step-by-step approach to alternative methods for transseptal access, including the transhepatic approach and superior approach from either the internal jugular vein or axillary vein. With careful review of multi-modal imaging and multidisciplinary preprocedural planning, these methods are feasible and safe alternatives to transseptal access.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126203","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 Deep Learning-Based Multimodal Fusion Model for Recurrence Prediction in Persistent Atrial Fibrillation Patients.","authors":"Li Chen, Xujian Feng, Haonan Chen, Biqi Tang, Quan Fang, Taibo Chen, Cuiwei Yang","doi":"10.1111/jce.16733","DOIUrl":"https://doi.org/10.1111/jce.16733","url":null,"abstract":"<p><strong>Background: </strong>The long-term success rate of atrial fibrillation (AF) ablation remains a significant clinical challenge, particularly in patients with persistent atrial fibrillation (Persistent AF, PeAF). The recurrence risk in PeAF patients is influenced by various factors, which complicates the prediction of ablation outcomes. While clinical characteristics provide important references for risk assessment, the predictive accuracy of existing methods is limited and they fail to fully leverage the rich information contained in electrocardiogram (ECG) signals. Integrating clinical features with ECG signals holds promise for enhancing recurrence prediction accuracy and supporting personalized management.</p><p><strong>Methods: </strong>This study conducted a retrospective analysis of PeAF patients who underwent radiofrequency catheter ablation treatment between 2016 and 2019. A multimodal fusion framework based on a residual block network structure was proposed, integrating preprocedural AF rhythm 12-lead ECG signals, clinical scores, and baseline characteristics of the patients to construct a deep learning model for predicting the risk of postablation recurrence in PeAF patients. A fivefold cross-validation method was used to partition the data set for model training and testing.</p><p><strong>Results: </strong>The fusion model was evaluated on a cohort of 77 PeAF patients, achieving good predictive performance with an average AUC of 0.74, and a maximum of 0.82. It significantly outperformed traditional clinical scoring systems and single-modal models based solely on ECG signals. Additionally, the model demonstrated lower variance (0.08), reflecting its robustness and stability with small sample sizes.</p><p><strong>Conclusion: </strong>This study innovatively combines AF rhythm ECG signals with clinical characteristics to construct a deep learning model for predicting the recurrence risk in PeAF patients after radiofrequency catheter ablation. The results show that this method effectively improves prediction performance and provides support for personalized clinical decision-making, with significant potential for clinical application.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127764","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 Impact of GLP-1 Receptor Agonists on AF Recurrence After Ablation in Obese Patients.","authors":"Harsh Patel, Aakash Sheth, Ambica Nair, Bhavin Patel, Samarth Thakkar, Bharat Narasimhan, Nishaki Mehta, Zain Azad, Gurukripa N Kowlgi, Christopher V Desimone, Kostantinos Siontis, Sourbha S Dani, Mohammed Rafa Labedi, Abhishek J Deshmukh","doi":"10.1111/jce.16737","DOIUrl":"https://doi.org/10.1111/jce.16737","url":null,"abstract":"<p><strong>Background: </strong>Obesity is an important risk factor associated with atrial fibrillation (AF). The impact of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on recurrent AF among patients undergoing catheter ablation is not well described.</p><p><strong>Objective: </strong>This study aimed to evaluate the effect of GLP-1 RA on the recurrence of AF among obese patients after catheter ablation.</p><p><strong>Methods: </strong>Utilizing the TriNetX research network, we identified patients aged over 18 with obesity (BMI ≥ 30) who underwent AF ablation from January 1, 2015, to December 1, 2022, using Current Procedural Terminology codes. Patients were categorized based on their baseline GLP-1 RA use. Through propensity-score matching, each cohort comprised 1558 patients. The primary outcome encompassed a composite of cardioversion, initiation of new antiarrhythmic drug (AAD) therapy, or redo AF ablation. Additional outcomes during the 12-month follow-up included AF readmission, heart failure readmissions, readmissions due to ischemic stroke, and mortality, with a separate analysis done for patients with BMI > 40.</p><p><strong>Results: </strong>GLP-1 RA use in patients with obesity undergoing AF ablation was linked to a significantly reduced risk of cardioversion, new AAD therapy, and the need for redo AF ablation (hazard ratio [HR] 0.72 [0.65-0.80]; p < 0.001). At 12 months, individuals on GLP-1 agonists exhibited a lower likelihood of mortality (HR 0.61 [0.40-0.93]; p < 0.001). Although all other secondary outcomes were lower in the GLP-1 RA group, there was no significant difference in ischemic stroke between the groups. These results were consistent among patients with BMI > 40, although apart from ischemic stroke, there was no difference in mortality between the two groups.</p><p><strong>Conclusion: </strong>The utilization of GLP-1 RA in individuals with obesity is linked to a decreased likelihood of arrhythmia recurrence following AF ablation, leading to a reduced requirement for cardioversion, AAD therapy, or redo AF ablation.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127773","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":"Early Results of the New Pamira ICD Lead.","authors":"Adrian Bystriansky, Michael Ilan, Ulrich Gerk, Béla Merkely, Attila Kónyi, Martin Winterhalter, Jozsef Faluközy, Nicholas Jackson, Avishag Laish-Farkash, Nils Jenke, Lars Anneken","doi":"10.1111/jce.16724","DOIUrl":"https://doi.org/10.1111/jce.16724","url":null,"abstract":"<p><strong>Introduction: </strong>A new implantable cardioverter-defibrillator (ICD) lead with a polyurethane cover added for improved long-term reliance was investigated in a post-market study.</p><p><strong>Methods: </strong>The prospective BIO|MASTER Pamira study is designed to evaluate the new Pamira ICD lead in patients undergoing de-novo ICD or cardiac resynchronization therapy (CRT-D) implantation. We report first data from implantation and 6-month follow-up.</p><p><strong>Results: </strong>Despite its slightly larger diameter, the lead demonstrated similar or improved handling during implantation compared to its predecessor without polyurethane cover.</p><p><strong>Conclusion: </strong>All results from implantation and short-term follow-up aligned with expectations. To show an improved reliance, long-term data will be required.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127770","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":"The Cold Spark: A Novel Synergistic Paradigm With Pulsed Field Cryoablation","authors":"Leonid Maizels,&nbsp;Peter M. Kistler","doi":"10.1111/jce.16736","DOIUrl":"10.1111/jce.16736","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 6","pages":"1416-1418"},"PeriodicalIF":2.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110337","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":"Clinical Phenotypes in Relation to Outcomes in Heart Failure Patients With Cardiac Resynchronization Therapy and Defibrillators (CRT-D): An Unsupervised Cluster Analysis.","authors":"Luigi Gerra, Tommaso Bucci, Arnaud Bisson, Alexandre Bodin, Bertrand Pierre, Giuseppe Boriani, Gregory Y H Lip, Laurent Fauchier","doi":"10.1111/jce.16727","DOIUrl":"https://doi.org/10.1111/jce.16727","url":null,"abstract":"<p><strong>Background: </strong>Patients with heart failure undergoing cardiac resynchronization therapy (CRT) are a heterogenous and complex population.</p><p><strong>Objective: </strong>To identify different clusters of patients with CRT-D and to evaluate the associations with clinical outcomes, using cluster analysis (CAs).</p><p><strong>Methods: </strong>Three agglomerative hierarchical CAs were performed in CRT-D patients seen between 2010 and 2019 in French hospitals. Associations between clusters and death at 1 year and death during the whole follow-up (FU) were evaluated.</p><p><strong>Results: </strong>The study included 23 029 CRT-D patients, who were analyzed in three ways, as follows: the first group was a 50% random sample of all patients (n = 11 514), the second group included patients who were dead at 1 year (n = 1604) and the third group included those alive at 3 years FU (n = 14 228). A CA was performed on each group of patients. Four clusters were identified: Cluster 1 corresponded to the low-risk phenotype; Cluster 2 to patients with coronary artery disease (CAD) with few cardiovascular (CV) risk factors and comorbidities; Cluster 3 included patients with CV risk factors and comorbidities, but low CAD; Cluster 4 corresponded to clinically complex phenotype (CAD with CV risk factors and comorbidities). Compared with Cluster 1, Clusters 2, 3, and 4 were independently associated with an increased risk of all-cause death at 1-year FU and during the whole FU (Cluster 2: hazard ratio (HR) 1.21, 95% confidence interval (CI) 1.08-1.36; Cluster 3: HR 1.15, 95% CI 1.04-1.26; and Cluster 4: HR 1.79, 95% CI 1.65-1.96).</p><p><strong>Conclusion: </strong>CAs identified four statistically driven groups of CRT recipients, with specific clinical phenotypes and associated with different risks for all-cause death.</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":"144101934","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":"For Whom Does the Bell Toll? Outcomes of Catheter Ablation of Ventricular Tachycardia in Patients With Severe Left Ventricular Dysfunction.","authors":"Ioan Liuba, Pasquale Santangeli","doi":"10.1111/jce.16732","DOIUrl":"https://doi.org/10.1111/jce.16732","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":"144101936","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":"\"When Propensity Score Does Not Always Match?\" by Antoine Da Costa et al., Based on \"J. Hirokami, K. R. J. Chun, S. Bordignon, et al., Pulsed Field Ablation for Persistent Atrial Fibrillation in EU-PORIA Registry. Journal of Cardiovascular Electrophysiology (2025): 1-11.\"","authors":"Antoine Da Costa, Cedric Yvorel, Karim Benali","doi":"10.1111/jce.16731","DOIUrl":"https://doi.org/10.1111/jce.16731","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":"144101933","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":"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}