Journal of Cardiovascular Electrophysiology最新文献

{"title":"The Single-Delayed-Phase Contrast Computed Tomography Before Ablation to Reduce Radiation Exposure Without Compromising Diagnostic Pulmonary Vein Accuracy","authors":"Keishiro Yagyu,&nbsp;Yasushi Oginosawa,&nbsp;Takahiro Kobayashi,&nbsp;Yuki Nakamura,&nbsp;Nozomu Ishii,&nbsp;Taro Miyamoto,&nbsp;Katsuhide Hayashi,&nbsp;Hisaharu Ohe,&nbsp;Masaharu Kataoka","doi":"10.1111/jce.70002","DOIUrl":"10.1111/jce.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Early-phase contrast-enhanced CT (CCT) is often used to plan and guide catheter ablation for atrial fibrillation (AF), and delayed-phase images can be used to detect or exclude left atrial appendage (LAA) thrombosis. However, dual-phase CCT is associated with concerns about radiation exposure; hence, this study aimed to evaluate whether single-delayed-phase images can provide sufficient preoperative information while minimizing radiation exposure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>A total of 102 patients who underwent dual-phase CCT were analyzed for pulmonary vein (PV) anatomy and LAA thrombus detection. The decrease in image quality due to the difference between early and delayed phases in 3D reconstruction did not pose a problem regarding anatomical evaluation. The PV anatomy was classified as typical or atypical, and 399 PVs were analyzed. Atypical PVs included 17 cases, with consistent anatomical details across the early and delayed phases. The mean discrepancy in PV diameter between the two phases and the correlation coefficient for the coronal view was 0.78 ± 0.16 mm, <i>r</i> = 0.91, and for the axial view, 0.79 ± 0.15 mm, <i>r</i> = 0.93. The LAA thrombi were observed in three patients, and no thrombus was overestimated in the delayed phase. The total exposure dose was 2320.1 ± 1031.0 mGy-cm in the dual-phase, 1443.3 ± 578.5 mGy-cm in the single early phase, and 876.8 ± 526.6 mGy-cm in the single delayed phase. Radiation doses were significantly lower in single-phase imaging than in dual-phase.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The single-delayed-phase CCT provides accurate anatomical and thrombus evaluations while significantly reducing radiation exposure. This approach could be a safer alternative for pre-ablation assessment without compromising diagnostic reliability. <b>Trial Registration:</b> The University of Occupational and Environmental Health ethics committee approved the study (UOEHCRB22-067).</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 9","pages":"2341-2352"},"PeriodicalIF":2.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jce.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adding Non-Occlusive Cryoballoon Ablation in Case of Ostial-Level Pulmonary Vein Isolation or Carina Sparing Does Not Improve 1-Year Outcome After Cryoballoon Ablation (the NOCA-AF Study)","authors":"A. Strazdas,&nbsp;M. Tijskens,&nbsp;J. P. Abugattas,&nbsp;M. Wolf,&nbsp;B. Schwagten,&nbsp;Y. De Greef","doi":"10.1111/jce.70011","DOIUrl":"10.1111/jce.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Fixed-diameter cryoballoon ablation (CBA) can yield suboptimal ostial-level pulmonary vein isolation (PVI) and spare arrhythmogenic sites like the carina. The addition of non-occlusive cryoballoon ablation (NOCA) could overcome this limitation of CBA. We aimed to assess the need and effectiveness of NOCA and its impact on clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>One hundred AF patients (66 ± 10 years, 40 females) were prospectively randomized to CBA (Control group, <i>n</i> = 50) or CBA + NOCA if needed (Study group, <i>n</i> = 50). Ostial-level PVI and carina sparing was assessed by electroanatomic left atrial (LA) voltage mapping after CBA. Endpoint was documented AF/AFL/AT ( &gt; 30 s) at 12 months, with Holters at 6 and 12 months. After CBA, ostial PVI level was seen in 110 out of 392 veins (28%), with predominance of the left superior PV and carina sparing in 11 (11%) left PVs and 16 (16%) right PVs. Overall, voltage mapping displayed a potential NOCA need in 68 (68%) patients. Spatially, for both PV sides, preferential ostial-level PVI segments were situated at the posterior wall. NOCA was added in 38 (76%) study patients, confirmed effective in all by voltage remapping. At 1 year, AF/AFL/AT recurrence occurred in 12 (24%) Study and 6 (12%) control patients (<i>p</i> = 0.121).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ostial-level PVI and carina sparing occurs in a substantial amount of patients treated by CBA. Although NOCA proved effective in extending the lesion size to antral-level PVI or carina ablation, adding NOCA did not improve 1-year clinical outcome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 9","pages":"2330-2340"},"PeriodicalIF":2.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642654","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":"Commentary on “Sodium-Glucose Cotransporter-2 Inhibitors and Stroke Risk in Patients With Atrial Fibrillation”","authors":"Pouya Tayebi,&nbsp;Naghmeh Ziaie,&nbsp;Mohammad Barary,&nbsp;Ali Alizadeh Khatir,&nbsp;Mostafa Javanian,&nbsp;Soheil Ebrahimpour","doi":"10.1111/jce.70016","DOIUrl":"10.1111/jce.70016","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 8","pages":"2103-2104"},"PeriodicalIF":2.6,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637111","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":"Utility of Cardiopulmonary Exercise Testing in Assessing Beta-Blocker Efficacy in LQTS: Moving Away From One-Size-Fits-All","authors":"Iqbal El Assaad,&nbsp;Alison K. Heilbronner,&nbsp;Kenneth Zahka,&nbsp;Benjamin Hammond,&nbsp;Akash Patel,&nbsp;Peter F. Aziz","doi":"10.1111/jce.70001","DOIUrl":"10.1111/jce.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Currently, there is no specific standard to assess beta blocker efficacy in long QT syndrome (LQTS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe our institutional experience with utilizing cardiopulmonary exercise testing (CPET) to assess for chronotropic suppression and to compare frequency of life-threatening events (LTEs) on intentional “submaximal” treatment to those on maximal treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We queried our Inherited Arrhythmia Registry and identified patients with LQTS who were on “submaximal” beta blocker doses (nadolol &lt; 0.75-mg/kg/day &amp; propranolol &lt; 2 mg/kg/day) with at least 6 months follow up. Adequate beta blockade effect was defined as at least 15% decrease from maximal HR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 127 LQTS patients: 47% on maximal therapy, 43% on submaximal therapy, and 10% not receiving treatment. Thirty three percent of patients were on submaximal therapy due to side effects, none in patients less than 10 years of age. Baseline characteristics were similar between the groups. There was no significant difference in LTEs between maximal and submaximal therapy (8% vs. 5.4%, <i>p</i> = 0.72). During CPET, patients on maximal therapy were more likely to exhibit adequate chronotropic suppression (60% vs. 40%, <i>p</i> = 0.01). None of the patients on submaximal therapy with adequate chronotropic effect experienced LTEs during follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Adequate chronotropic suppression was achieved with “submaximal” beta blocker dose in 40%. Despite similar baseline risk profiles, LTEs were not significantly different in patients with submaximal versus maximal therapy. CPET may be a useful modality to devise an individualized treatment plan, especially in those who cannot tolerate the recommended guideline directed dose.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 9","pages":"2287-2295"},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jce.70001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isoproterenol for Unmasking Dormant Conduction and Non-Pulmonary Vein Triggers During Atrial Fibrillation Ablation: Prospective Multicenter Study","authors":"Saumil R. Oza,&nbsp;Daniela Hincapie,&nbsp;Manasvi Gupta,&nbsp;Allyson L. Varley,&nbsp;Christopher Thorne,&nbsp;Joshua R. Silverstein,&nbsp;Mohamed Gabr,&nbsp;Amit J. Thosani,&nbsp;Andres F. Miranda-Arboleda,&nbsp;Jose Osorio,&nbsp;Alejandro Velasco,&nbsp;Mohammad-Ali Jazayeri,&nbsp;Matthew C. Sackett,&nbsp;Alexandru Costea,&nbsp;Anthony Moretta,&nbsp;Richard Kuk,&nbsp;Jose M. Silva,&nbsp;Benjamin D'Souza,&nbsp;William Belden,&nbsp;Mark D. Metzl,&nbsp;Matthew Quin,&nbsp;Kent E. Morris,&nbsp;Jorge E. Romero,&nbsp;Nathaniel A. Steiger,&nbsp;William Sauer,&nbsp;Paul C. Zei","doi":"10.1111/jce.70007","DOIUrl":"10.1111/jce.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pulmonary vein (PV) reconnection and the onset of non-PV triggers are frequently the cause of atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA). The effectiveness of using isoproterenol for unmasking dormant conduction and non-PV-triggers during AF RFCA and its effect on improving procedural and clinical outcomes is still controversial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the effectiveness of isoproterenol for unmasking dormant conduction and non-PV triggers during RFCA for paroxysmal AF (PAF) and its effects on procedural and long-term clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospective multicenter cohort from the REAL-AF registry, patients who underwent RFCA for PAF with and without isoproterenol administration from January 2018 to May 2023 were included. The primary efficacy outcome was freedom from all-atrial arrhythmia at 12-month follow-up. Secondary outcomes included procedural and long-term clinical outcomes, and procedure-related complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1102 patients were included (isoproterenol = 325 vs. control = 777) (mean age 66.73 ± 10.19 years; 53.05% male). There were no differences in baseline characteristics between the groups. Dormant conduction/non-PV triggers with isoproterenol were observed in 10.2% of the patients. Isoproterenol administration was associated with increased procedural times (109 (83–137.5) vs. 96 (74–122), <i>p</i> = 0.002), and decreased rates of first-pass PV isolation (74.84% vs. 80.14%, <i>p</i> = 0.007). There were no differences in freedom from all-atrial arrhythmias (HR 0.87, 95% CI [0.61–1.24], <i>p</i> = 0.4) or long-term clinical outcomes at 12 months of follow-up between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients undergoing RFCA for PAF, the use of isoproterenol was associated with increased procedural times and more extensive ablation, without improved clinical outcomes at 12-month follow-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 9","pages":"2304-2317"},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626442","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 Limitations of Temporary Sinus Rhythm Restoration in Enhancing Catheter Ablation Outcomes for Longstanding Persistent Atrial Fibrillation","authors":"Zainab Haider Khan,&nbsp; Qura-tul-Ain,&nbsp;Jananiebarathy Amaranathan,&nbsp;Muneeb Khawar","doi":"10.1111/jce.70012","DOIUrl":"10.1111/jce.70012","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 9","pages":"2458-2459"},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626440","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-Based Differences in Symptomatology in the First Month Following Atrial Fibrillation Catheter Ablation","authors":"Mark T. Mills,&nbsp;Gregory Y. H. Lip,&nbsp;Vishal Luther,&nbsp;Dhiraj Gupta","doi":"10.1111/jce.70009","DOIUrl":"10.1111/jce.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Differences in baseline characteristics and clinical outcomes exist between female and male patients with atrial fibrillation (AF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess sex-specific symptoms within 1 month of AF catheter ablation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients undergoing AF ablation between 2000 and 2024 were identified from 57 healthcare organizations using a global federated research network. Female and male patients were 1:1 propensity score matched (PSM) based on baseline characteristics. Symptoms within a month of ablation were identified using ICD-10 codes and classified into major systems: cardiac (chest pain, palpitations), respiratory (dyspnea, cough), gastrointestinal (nausea, vomiting, heartburn, dysphagia, bloating, diarrhea, constipation, anorexia), neurological (headache, visual disturbance, speech disturbance, dizziness) and urological (urinary retention and dysuria).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After PSM, 69 244 patients were included (34 622 in each group). Female patients had a higher incidence of cardiac (female, 8.9% vs. male, 6.1%; <i>p</i> &lt; 0.001), respiratory (7.9% vs. 6.1%; <i>p</i> &lt; 0.001), gastrointestinal (3.4% vs. 2.2%; <i>p</i> &lt; 0.001) and neurological symptoms (3.1% vs. 2.5%; <i>p</i> &lt; 0.001) compared with male patients. Urological symptoms were more common in male patients (1.6% vs. 0.9%; <i>p</i> &lt; 0.001) due to a higher incidence of urinary retention (1.1% vs. 0.3%; <i>p</i> &lt; 0.001). All individual symptom components of cardiac, respiratory, gastrointestinal and neurological composites were more common in female patients, except from heartburn (0.1% vs. 0.1%; <i>p</i> = 0.49), bloating (0.2% vs. 0.2%; <i>p</i> &gt; 0.99), anorexia (0.1% vs. 0.1%; <i>p</i> = 0.79), and speech disturbance (0.2% vs. 0.2%; <i>p</i> = 0.51) which were similar between sexes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Compared with male patients, female patients experience higher rates of cardiac, respiratory, gastrointestinal, and neurological symptoms within 1 month of AF ablation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 9","pages":"2271-2278"},"PeriodicalIF":2.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jce.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kinetics and Disappearance of QRS Transition in Patients Undergoing Left Bundle Branch Pacing – A Novel Method for Classifying Microdislodgement","authors":"Márk Gémesi,&nbsp;Balázs Polgár,&nbsp;Zoltán Gingl,&nbsp;István Marczell,&nbsp;Előd János Zsigmond,&nbsp;Letícia Chityil–Papp,&nbsp;Péter Bógyi,&nbsp;Gábor Zoltán Duray","doi":"10.1111/jce.16779","DOIUrl":"10.1111/jce.16779","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>QRS transition during the threshold test is the gold standard for confirming direct capture of the Conduction System in patients with left bundle branch pacing (LBBP). Still, we have limited data on the kinetics of QRS transition over time. Microdislodgement is a known complication of left bundle branch area pacing (LBBAP); however, its true incidence depends on the thoroughness of follow-up. We aimed to evaluate the kinetics and disappearance of QRS transition in patients undergoing LBBP, assess the diagnostic yield of QRS transition at various time points, and characterize microdislodgement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective study included patients who underwent successful LBBP procedures at a tertiary center between January 2022 and February 2024. Based on the kinetics of QRS transition during intraoperative, postoperative, and follow-up threshold tests, microdislodgement was assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>LBB capture was confirmed in 118 of 155 LBBAP patients (76.1%), which defined our LBBP population. Intraoperative QRS transition was observed in 86.4%, which decreased significantly postoperatively (47.0%) and at follow-up (33.0%)—in 92.0% of LBBP patients' capture of LBB remained, while microdislodgement occurred only in 5.0% of LBBP cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study evaluates QRS transition kinetics in LBBAP patients, showing significant intraoperative detectability in patients with direct capture of LBB that decreases postoperatively and at first follow-up. Our classification of microdislodgement aids in understanding its impact on pacing outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 9","pages":"2254-2263"},"PeriodicalIF":2.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jce.16779","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accessory Pathway Antegrade Electrophysiologic Features Among Wolff–Parkinson–White Patients: The Risk in Relation to the Location","authors":"Salah Atta,&nbsp;Mohamed Aboelhassan,&nbsp;Mohamed Khairy Ibraheem,&nbsp;Salma Taha","doi":"10.1111/jce.70008","DOIUrl":"10.1111/jce.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Wolff–Parkinson–White (WPW) syndrome is a disorder characterized by presence of an accessory pathway (AP) which predisposes patients to tachyarrhythmia and sudden death. The aim of this study was to evaluate the prevalence of high-risk electrophysiologic AP features among WPW patients referred for electrophysiological study (EPS) and to explore whether the AP location can predict the high-risk nature of the AP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This descriptive observational study was carried out on 70 patients with WPW subjected to invasive EPS. All patients were subjected to determination of AP anterograde conduction properties [AP effective refractory period (APERP) and shortest pre-excited RR interval (SPERRI)], mapping for localization, and ablation attempts of the AP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-five patients (35.7%) had an AP antegrade refractory period (APERP) ≤ 240 ms. The shortest RR interval during pre-excited AF (SPERRI) was ≤ 250 ms in 17 patients. Thirty-two APs (45.7%) were classified as high-risk AP (having APERP ≤ 240 ms and/or SPERRI ≤ 250 ms). Radiofrequency ablation was successful in 59/63 patients (93.7%). The mean APERP was significantly lower in postero-septal than anteroseptal and mid-septal APs (<i>p</i> &lt; 0.003), and in left sided than right sided APs (<i>p</i> value = 0.001). Left non-septal APs (specially the left lateral APs) were significantly associated with the presence of high-risk than low-risk parameters. Septal APs (anterior, mid, and posterior) were significantly associated with the presence of low-risk than high-risk parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High-risk AP features as determined by the antegrade conduction properties are common among WPW patients. AP location may hold significance in predicting the presence of those high-risk electrophysiologic features.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 9","pages":"2264-2270"},"PeriodicalIF":2.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608458","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":"Cover Image, Volume 36, Issue 7","authors":"Ming-Jen Kuo,&nbsp;Chin-Yu Lin,&nbsp;Jin-Long Huang,&nbsp;Yenn-Jiang Lin,&nbsp;Yu-Cheng Hsieh,&nbsp;Shih-Lin Chang,&nbsp;Li-Wei Lo,&nbsp;Yu-Feng Hu,&nbsp;Fa-Po Chung,&nbsp;Cheng-Hung Li,&nbsp;Ting-Yung Chang,&nbsp;Ling Kuo,&nbsp;Cheng-I. Wu,&nbsp;Chih-Min Liu,&nbsp;Shin-Huei Liu,&nbsp;Yu-Shan Huang,&nbsp;Shih-Ann Chen","doi":"10.1111/jce.70017","DOIUrl":"https://doi.org/10.1111/jce.70017","url":null,"abstract":"<p>The cover image is based on the article <i>Electrocardiographic characteristics of ventricular arrhythmias originating from high right ventricular outflow tract and pulmonary artery</i> by Chin-Yu Lin et al., https://doi.org/10.1111/jce.16714\u0000 \u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jce.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144598580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}