Journal of Cardiovascular Electrophysiology最新文献

{"title":"The Never Old-Fashioned Right Atrial Flutter Revisited.","authors":"Antoine Da Costa, Karim Benali","doi":"10.1111/jce.70082","DOIUrl":"https://doi.org/10.1111/jce.70082","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015455","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":"Idiopathic Premature Ventricular Complexes Originating From Right Ventricular False Tendons.","authors":"Jianwei Zhao, Jie Yang, Xia Wang, Jie Zheng, Bo Zhang, Yi Zhang, Yuanbin Song, Chuangye Wang, Ping Qu, Hu Tan","doi":"10.1111/jce.70079","DOIUrl":"https://doi.org/10.1111/jce.70079","url":null,"abstract":"<p><strong>Background and aims: </strong>Ablation for premature ventricular complexes (PVCs) originating from the right ventricular inflow tract (RVIT) is challenging. Few studies have identified the correlation between right ventricular false tendons (RVFTs) and RVIT PVCs. This study aimed to verify RVFTs as arrhythmogenic and electro-anatomical substrates for PVCs, and propose an enlightening mapping and ablation protocol to improve operative efficacy.</p><p><strong>Methods: </strong>We retrospectively analyzed 63 patients with PVCs originating from the RVIT and six were found to possess arrhythmogenic RVFTs. RVFTs were identified via the intracardiac echocardiography (ICE) imaging as fibrous or fibro-muscular bands traversing the right ventricle cavity with no connection to valvular cusps. ICE was used to reconstruct the geometry of the right ventricle, and verify the successful ablation target. Moreover, morphological and histological studies of RVFTs from swine hearts were performed to reveal potential arrhythmogenic mechanisms.</p><p><strong>Results: </strong>All RVFTs were found in the free wall of the right ventricle, with a similar connection from the subvalvular myocardium to the free wall, but with different spatial orientations, shapes, lengths, and thicknesses. Reconstruction of three-dimensional geometry with ICE was of immense benefit in terms of the location of the target spot and successful ablation. Despite variable morphology, the successful target site was consistently located at the subvalvular end of the RVFTs. Morphological and histological analysis of RVFTs from a swine heart demonstrated a component of cardiac muscles and fibrous tissues that may account for triggering activity, such as outflow tract PVCs.</p><p><strong>Conclusion: </strong>RVFTs may serve as arrhythmogenic and electro-anatomical substrates for RVIT PVCs. The \"culprit\" RVFTs can be identified and reconstructed in the three-dimensional system through ICE examinations, which may improve operative efficacy.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015505","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":"Leveraging Implantable Cardiac Defibrillator Remote Transmissions to Predict the Occurrence of Atrial Fibrillation.","authors":"Michael Scheid, Kristie M Coleman, Steven Mullane, Dimitrios Varrias, Emmanouil Mountantonakis, Gregg Husk, Kabir Bhasin, Nicholas Skipitaris, Laurence M Epstein, Theodoros P Zanos, Stavros E Mountantonakis","doi":"10.1111/jce.70072","DOIUrl":"https://doi.org/10.1111/jce.70072","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) and heart failure (HF) frequently coexist in patients, with the development of AF often preceding HF decompensation. We sought to evaluate whether daily remote monitoring of ICD parameters could predict AF occurrence using machine learning techniques in a real-world cohort.</p><p><strong>Methods: </strong>Data from patients with primary prevention ICDs transmitted daily to the Northwell centralized remote monitoring center between 2012 and 2021 were extracted. Using this data, an XGBoost model was trained to predict AF occurrence with a 3-day time horizon using a 14-day data collection sequence. Model predictive performance was validated retrospectively and prospectively, using mean ROC AUC and PR AUC across all folds. Feature importance was assessed using Shapley additive explanation (SHAP) values.</p><p><strong>Results: </strong>A total of 207 patients, 69.0% male, median age of 65.0 [57, 72] years, median ejection fraction of 30% [25, 40], 13.0% paroxysmal AF, and 35.7% with ischemic cardiomyopathy were monitored for over 36 months. Our model predicted AF occurrence within the following 3 days in 49 (23.7%) patients after a median of 36 months post-implant with an area under the receiver operating characteristic curve (AUROC) of 0.79 and an area under the precision-recall curve of 0.10 (AUPRC). The model has a specificity of 99% in the validation data set. Key variables included RV and RA sensing amplitudes as well as the pulse width. Validation was performed using K-fold cross-validation methods without a significant drop in performance metrics.</p><p><strong>Conclusion: </strong>This exploratory analysis suggests a machine learning approach has the potential to predict AF from daily remote monitoring of ICD parameters. This risk prediction algorithm requires external validation in a large-scale multi-center clinical trial.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015471","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":"Patient Comfort and Response Pattern Following Pulsed-Field Ablation Compared to Radiofrequency Ablation for Atrial Fibrillation.","authors":"Umar Hashim, Romil Patel, Hany Demo, Westby Fisher, Jose Nazari, Alex Ro, Mark Metzl, Jeremiah Wasserlauf","doi":"10.1111/jce.70077","DOIUrl":"https://doi.org/10.1111/jce.70077","url":null,"abstract":"<p><strong>Background: </strong>Pulsed-field ablation (PFA) for atrial fibrillation (AF) offers several advantages compared to thermal ablation, however direct comparisons of patient-reported outcomes after PFA and radiofrequency ablation (RFA) are limited. This study aimed to assess patient experience following PFA or RFA in AF ablation performed under general anesthesia.</p><p><strong>Methods: </strong>A retrospective study across a single integrated health system was conducted on consecutive patients who underwent PFA or RFA for AF under general anesthesia from March 2024 to December 2024. Data were collected from electronic medical records. Primary endpoints included postprocedural pain complaints and scores, need for postprocedure analgesic medication, and frequency of emergency department (ED) visits for procedure-related concerns.</p><p><strong>Results: </strong>Two hundred patients (100 PFA and 100 RFA) were analyzed (age 73.2 ± 9.2 y, 38% female). Patients undergoing RFA had a significantly higher rate of ED visits compared to those who underwent PFA (17% vs. 6%, p < 0.05). The most common complaints prompting RFA ED visits were shortness of breath (29% of RFA ED visits), palpitations (23% of RFA ED visits), dizziness (18% of RFA ED visits), and other (30% of RFA ED visits). There were no statistically significant differences in postprocedural pain scores (RFA 1.70 vs. PFA 1.57, p = 0.61), requests for analgesic medications in the recovery area (RFA 36% vs. PFA 27%, p = 0.26), nor encounters made to the care team within 4 weeks following the procedure (RFA 57% vs. PFA 44%, p = 0.20).</p><p><strong>Conclusion: </strong>In this retrospective study, patients undergoing PFA for AF under general anesthesia experienced fewer ED visits for procedure-related issues compared to those undergoing RFA. While these clinical endpoints potentially suggest improved procedural recovery with PFA compared to RFA, larger prospective studies using patient-reported outcome measures are warranted.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000592","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":"Letter to the Editor: Anticoagulation Risk Stratification and Methodological Considerations in Immediate Mobilization After Atrial Fibrillation Ablation.","authors":"XiRui Yang","doi":"10.1111/jce.70088","DOIUrl":"https://doi.org/10.1111/jce.70088","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955446","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: Sex-Specific Insights Into Tricuspid Regurgitation and AF Recurrence Post-PVI.","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.70091","DOIUrl":"10.1111/jce.70091","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955398","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":"Ethanol Infusion in the Vein of Marshall for Persistent Atrial Fibrillation Ablation: Evidence From Randomized Controlled Trials.","authors":"Carolina Saleiro, Sérgio Barra, Bárbara Oliveiros, Patrícia Alves, João Ferreira, Natália António, Luís Elvas, Lino Gonçalves, Miguel Valderrábano, Pedro A Sousa","doi":"10.1111/jce.70090","DOIUrl":"10.1111/jce.70090","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation (CA) for atrial fibrillation (AF), yet outcomes remain suboptimal in persistent AF patients. Ethanol infusion in the vein of Marshal (VoM), an embryological remnant implicated in AF pathogenesis, may enhance ablation efficacy.</p><p><strong>Objective: </strong>To evaluate the effectiveness of VoM ethanol infusion in patients with persistent AF.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials (RCT) comparing CA with versus without VoM ethanol infusion in patients undergoing first-time ablation of persistent AF. The primary endpoint was freedom from any atrial arrhythmia in a 12-month follow-up.</p><p><strong>Results: </strong>Four RCTs including 1045 patients were analyzed (VoM + CA-535 patients vs. CA alone-510 patients). Ethanol infusion in the VoM significantly increased freedom from atrial arrhythmias (RR 1.21; 95% CI 1.010-1.32; p < 0.0001, NNT 10) and reduced the need of a repeat procedure (RR 0.63; 95% CI 0.45-0.87; p = 0.005). Mitral isthmus (MI) block was more frequently achieved in the VoM group (RR 1.30; 95% CI 1.03-1.65; p = 0.03) There was no significant difference in the rate of major complications (2.8% vs. 3.5%, RR 0.72; 95% CI 0.37-1.43; p = 0.35, NNH 138), although overall complications were more frequent in the VoM ethanol infusion group (RR 2.25; 95% CI 1.08-4.70; p = 0.03).</p><p><strong>Conclusion: </strong>When added to CA, ethanol infusion in the VoM improves freedom from arrhythmia without increasing the risk of major complications. These findings may support its integration into ablation strategies for persistent AF.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955412","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":"Impact of Sodium-Glucose Cotransporter 2 Inhibitor on Recurrence After Catheter Ablation for Atrial Fibrillation in Patients With or Without Metabolic Syndrome.","authors":"Yang Xu, Zixu Zhao, Hui Xu, Chao Jiang, Xiao Wang, Zejun Yang, Wenyu Shao, Hang Guo, Liu He, Qi Guo, Caihua Sang, Deyong Long, Xin Du, Jianzeng Dong, Changsheng Ma","doi":"10.1111/jce.70073","DOIUrl":"https://doi.org/10.1111/jce.70073","url":null,"abstract":"<p><strong>Aims: </strong>The impact of sodium-glucose cotransporter-2 inhibitors (SGLT2i) on atrial fibrillation (AF) recurrence after catheter ablation is still inconclusive. Besides, their efficacy on AF recurrence stratified by metabolic syndrome (MetS) status remains unknown.</p><p><strong>Methods: </strong>Patients with AF undergoing initial catheter ablation between January 2017 and December 2023 from the China-AF Registry were included. Patients were 1:1 propensity score-matched by SGLT2i use at discharge and stratified by baseline MetS status. The main outcome was the AF recurrence after a 3-month blanking period.</p><p><strong>Results: </strong>After propensity score matching, 573 patients in the SGLT2i group and 573 in the non-SGLT2i group were included in the study. During the 20.5 ± 13.7 months follow-ups, AF recurrence occurred in 100 patients (17.5%) in the SGLT2i group and 168 patients (29.3%) in the non-SGLT2i group. SGLT2i was associated with lower AF recurrence (17.5% vs. 29.3%; HR 0.59, 95% CI: 0.46-0.75, p < 0.001), with consistent benefits in MetS (HR 0.61, 95% CI: 0.39-0.75, p = 0.03) and non-MetS subgroups (HR 0.58, 95% CI: 0.43-0.78, p < 0.001, P_interaction = 0.841). The effect of SGLT2i on the AF recurrence also remained consistent across the body mass index (BMI) spectrum (P_interaction = 0.740).</p><p><strong>Conclusion: </strong>SGLT2i was associated with a lower risk of AF recurrence after catheter ablation independently of MetS status or BMI spectrum.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955475","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":"Challenges to the Claimed Safety and Feasibility of Atrial Fibrillation Ablation and Left Atrial Appendage Occlusion Without Onsite Cardiothoracic Surgery.","authors":"Saad Sohail, Nouman Ahmed, Muhammad Ali Rana, Mohammad Hamza Abbas, Malik Sohail Riaz","doi":"10.1111/jce.70093","DOIUrl":"10.1111/jce.70093","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955341","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":"Expanding Access to Atrial Fibrillation Interventions: Patient Safety Must Remain the Priority.","authors":"Karen P Phillips","doi":"10.1111/jce.70094","DOIUrl":"https://doi.org/10.1111/jce.70094","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992747","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}