Journal of Cardiovascular Electrophysiology最新文献

{"title":"Limitations and Challenges of Three-Dimensional Echocardiography in Predicting Atrial Fibrillation Recurrence.","authors":"Mucahit Yetim, Abdullah Sarıhan, Macit Kalçık","doi":"10.1111/jce.70095","DOIUrl":"https://doi.org/10.1111/jce.70095","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":"144955406","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":"Cardiac Contractility Modulation- Making It Work.","authors":"Niraj Varma","doi":"10.1111/jce.70092","DOIUrl":"10.1111/jce.70092","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":"144955327","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":"Amusement Park Rides and Cardiac Devices: Heart Dropper or Device Stopper?","authors":"Mia Kassab, Alexander Johnson, Dania Kallas, Sonia Franciosi, Jeffrey Bone, Sakethram Saravu Vijayashankar, Shubhayan Sanatani","doi":"10.1111/jce.70087","DOIUrl":"https://doi.org/10.1111/jce.70087","url":null,"abstract":"<p><strong>Background: </strong>Cardiac implantable electronic devices (CIEDs) are essential for managing cardiac conditions, but may malfunction due to magnetic fields > 10,000 mG. Roller coasters using linear induction motors (LIMs) generate magnetic fields, yet their potential for electromagnetic interference (EMI) with CIEDs is unclear. This study assesses magnetic field exposure on amusement park rides and examines healthcare provider recommendations.</p><p><strong>Methods: </strong>Magnetic field strength was measured using gaussmeters placed at shoulder and abdomen levels, representing pediatric CIED sites. Rides at an amusement park were tested at least four times, recording median and maximum magnetic field strengths per second throughout the ride. Magnetic field strengths were compared between rides with health advisory messages (HAMs) and without (NHAMs). A survey was distributed to the Pediatric and Congenital Electrophysiology Society (PACES) and the Canadian Council of Cardiovascular Nurses to assess healthcare provider recommendations.</p><p><strong>Results: </strong>A total of 15 rides were sampled: 11 with HAMs and 4 with NHAM. The mean magnetic field strength was higher for HAM rides (2.9 mG) than NHAM rides (1.6 mG; p = 0.05). Maximum field strength was also greater in HAM rides (46.4 vs. 6.5 mG; p < 0.001), and in rides using LIMs (n = 2) compared to those using other mechanisms (211.7 vs. 7.8 mG; p < 0.001). Only 18.1% (n = 13) of healthcare providers relied on published resources for amusement park ride recommendations, while 58.3% (n = 42) advised patients to consider HAMs.</p><p><strong>Conclusion: </strong>Magnetic field strengths on all rides were clinically insignificant, posing minimal EMI risk for CIED patients. Further validation and standardized guidelines are needed to inform healthcare recommendations for patients with CIEDs.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955333","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":"High-Power Short-Duration Ablation Versus Conventional Power Ablation in Pulmonary Vein Isolation in Patients With Atrial Fibrillation: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"David C B I Cabral, André Rivera, Marcelo A P Braga, Bárbara M F Passos, Iuri Ferreira Felix, Caique M P Ternes, Alexandra R D Brigido, Guilherme Dagostin de Carvalho, Abhishek J Deshmukh, Christopher V DeSimone","doi":"10.1111/jce.16735","DOIUrl":"https://doi.org/10.1111/jce.16735","url":null,"abstract":"<p><strong>Background: </strong>High-power short-duration (HPSD) ablation has emerged as a promising alternative to conventional power delivery (CPD) for pulmonary vein isolation (PVI) among patients with atrial fibrillation (AF), though its efficacy, procedural efficiency, and safety profile remain uncertain.</p><p><strong>Aims: </strong>To evaluate and compare the efficacy, procedural efficiency, and safety of HPSD versus CPD ablation strategies for PVI in patients with AF through a systematic review and meta-analysis of randomized controlled trials (RCTs).</p><p><strong>Materials and methods: </strong>PubMed, Embase, Cochrane Library, and ClinicalTrials.Gov databases were systematically searched for RCTs comparing HPSD with CPD ablation for PVI in patients with AF. Random-effects models were used to pool hazard ratios (HR) and risk ratios (RR) with 95% confidence intervals (CI). R version 4.4.2 was used for statistical analysis.</p><p><strong>Results: </strong>Eight RCTs with 1094 patients (558 undergoing HPSD and 536 undergoing CPD ablation) were included. No significant differences were found in freedom from arrhythmia during the follow-up period (HR: 0.77; 95% CI: 0.41-1.45; p = 0.424). AF recurrence did not differ (RR: 0.83; 95% CI: 0.59-1.16; p = 0.268) between groups. HPSD had a significantly shorter procedural (mean difference [MD]: -21.93 min; 95% CI: -31.34, -12.53; p < 0.001) and RF ablation times (MD: -13.87 min; 95% CI: -19.46, -8.27; p < 0.001). No differences were observed in fluoroscopy time and first-pass isolation for right and left pulmonary veins. There was no difference in esophageal lesion rates, pericardial, or neurological complications, but there was a higher incidence of steam pops in HPSD (RR: 3.42; 95% CI: 1.45-8.09; p = 0.005).</p><p><strong>Discussion: </strong>Although HPSD ablation did not significantly improve freedom from arrhythmia or reduce AF recurrence compared to CPD, it demonstrated enhanced procedural efficiency, with shorter procedure and RF ablation times. Despite the higher rate of steam pops, the overall safety profile was similar between both groups.</p><p><strong>Conclusion: </strong>High-power short-duration ablation for pulmonary vein isolation in atrial fibrillation demonstrated comparable efficacy and safety to conventional power delivery, with the added benefit of shorter procedure and RF ablation times. However, HPSD ablation was associated with increased occurrence of steam pops.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955434","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":"Clarifying the Role of Intermittent Pre-Excitation in Risk Stratification: A Response to Abbas et al.","authors":"Antonio Gianluca Robles, Antonio Scarà, Luigi Sciarra","doi":"10.1111/jce.70089","DOIUrl":"https://doi.org/10.1111/jce.70089","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955378","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 Immunosuppressive Drugs on Patients With Percutaneous Left Atrial Appendage Occlusion.","authors":"Daisuke Togashi, Christopher R Ellis, Zachary T Yoneda, Jackon G Gregory, Shunsuke Uetake, Salah H Alahwany, Michael T Baker, Arvindh N Kanagasundram","doi":"10.1111/jce.70080","DOIUrl":"https://doi.org/10.1111/jce.70080","url":null,"abstract":"<p><strong>Introduction: </strong>Percutaneous left atrial appendage closure (LAAC) reduces the risk of thromboembolic stroke in patients with non-valvular atrial fibrillation who cannot tolerate long-term oral anticoagulation. However, outcomes after LAAC in patients requiring chronic immunosuppressive therapy (IMS) remain unknown. This study aimed to investigate the perioperative and long-term outcomes of percutaneous LAAC in patients receiving chronic IMS.</p><p><strong>Methods and results: </strong>Patients who underwent LAAC were retrospectively evaluated according to the presence of long-term IMS therapy. Perioperative complications, clinical outcomes, and device follow-up characteristics were evaluated. From November 2017 to March 2023, a total of 1172 patients who underwent LAAC were included (69.3% male, 74.8 years), of whom 74 were taking IMS. The most common reasons for IMS use were rheumatoid arthritis (50.0%), followed by kidney transplantation (17.6%). There were no significant differences in intraoperative complications between the IMS group and the non-IMS group. (1.4% vs. 1.3%, p = 0.943). During 617 [IQR: 373-1046] days, the incidence of systemic infections was higher in the IMS group (25.0% vs. 6.1%, p < 0.001). There were no significant differences in peri-device leak (PDL) or device-related thrombus, but the IMS group had a lower percentage of patients with improvement of PDL during follow-up (8.3% vs. 50.0%, p = 0.003).</p><p><strong>Conclusion: </strong>Successful LAAC in patients on IMS was achieved without increasing perioperative complications. Patients on chronic IMS did have an increased occurrence of systemic infections during long-term follow-up. The presence of IMS use was negatively associated with PDL improvement during follow-up.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955449","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":"Sex-Specific Insights Into Tricuspid Regurgitation and AF Recurrence Post-PVI.","authors":"Yidan Wang, Kun Fu, Feng Gan","doi":"10.1111/jce.70081","DOIUrl":"https://doi.org/10.1111/jce.70081","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955422","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":"AI to the Rescue: Fighting Atrial Fibrillation With Code.","authors":"Kathryn E Mangold, Linda Johnson, Abhishek Deshmukh","doi":"10.1111/jce.70084","DOIUrl":"https://doi.org/10.1111/jce.70084","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955271","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":"Difference in Microembolic Signals Between Flex-Tip Versus Non-Flex-Tip Type Catheters During High-Power Short-Duration Ablation.","authors":"Yoshiaki Mizutani, Satoshi Yanagisawa, Mizuki Ichikawa, Keisuke Nishio, Hiroya Sakai, Daishi Nonokawa, Yuichiro Makino, Hitomi Suzuki, Hitoshi Ichimiya, Yasuhiro Uchida, Junji Watanabe, Masaaki Kanashiro, Tomoya Iwawaki, Shun Kondo, Yuki Sato, Rei Shibata, Yasuya Inden, Toyoaki Murohara","doi":"10.1111/jce.70074","DOIUrl":"https://doi.org/10.1111/jce.70074","url":null,"abstract":"<p><strong>Introduction: </strong>A novel flex-tip ablation catheter has a distal tip with a unique design, especially for optimized irrigation flow against catheter contact. This study aimed to evaluate the microembolic signals (MESs) during high-power short-duration (HPSD) ablation between flex-tip and non-flex-tip catheters.</p><p><strong>Method and results: </strong>We retrospectively evaluated 70 patients (39 and 31 with flex-tip and non-flex-tip catheters, respectively) who underwent first-time HPSD radiofrequency ablation with a 50 W-power setting for atrial fibrillation at two institutions. All patients were clinically assessed for MESs using a novel carotid ultrasound-Doppler system throughout pulmonary vein isolation. The numbers of MESs were compared between the two types of catheters. In an experimental study, porcine heart pieces were ablated using two catheters to observe MESs using the same ultrasound evaluation. In the clinical study, 4913 points (2932 and 1981 points in the flex-tip and non-flex-tip groups, respectively) were analyzed. The numbers of MESs, MESs per point, and MESs per second were significantly lower in the flex-tip group than in the non-flex-tip group (123 ± 171 vs. 332 ± 256, p < 0.001; 1.8 ± 2.7 vs. 5.9 ± 4.3, p < 0.001; and 0.1 ± 0.1 vs. 0.2 ± 0.2, p < 0.001, respectively). After propensity score matching analysis in the clinical study with 19 patients in each group, the number of MESs was significantly lower in the flex-tip group than in the non-flex-tip group (152 ± 228 vs. 378 ± 300, p = 0.013), and the difference was most evident in bubble-type MESs (24 [16-96] vs. 185 [79-421], p = 0.023). In the experimental study with eight attempt ablations in each catheter, the number of MESs was significantly lower in the flex-tip group than in the non-flex-tip group (26 ± 14 vs. 58 ± 17, p = 0.002).</p><p><strong>Conclusions: </strong>Flex-tip catheter ablation significantly reduced MES detections, particularly in the bubble-type MESs, compared with the non-flex-tip catheter ablation at 50 W. This may indicate safe HPSD ablation with the flex-tip type catheter.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955426","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 Rare Presentation of Sense-B-Noise With High-Amplitude Signals in a Subcutaneous Implantable Cardioverter Defibrillator: Diagnostic Challenges and Management.","authors":"Yukihiro Uehara, Nobuhiko Ueda, Akinori Wakamiya, Kohei Ishibashi, Kengo Kusano","doi":"10.1111/jce.70076","DOIUrl":"https://doi.org/10.1111/jce.70076","url":null,"abstract":"<p><strong>Introduction: </strong>Sense-B-noise is a rare cause of inappropriate shock (IAS) of subcutaneous implantable cardioverter defibrillator (S-ICD), which is an oversensing of the vectors using the Sense B and a factor of noncardiac signal oversensing. High-amplitude signals in Sense-B-noise have not been reported previously.</p><p><strong>Methods: </strong>We present a case of a 47-year-old man, who experienced IAS of S-ICD due to sense-B-noise followed by intense noise of primary and alternate vectors.</p><p><strong>Results: </strong>Analysis of the extracted lead revealed a slight tear in the connection of the Sense B electrode, but the non-physiological signal was not reproducible and no functional defects were identified in the device.</p><p><strong>Conclusions: </strong>High-amplitude signals after an inappropriate shock due to sense-B-noise are another presentation of Sense-B-noise.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955202","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}