Journal of Cardiovascular Electrophysiology最新文献

{"title":"Uncomplicated Extravascular Implantable Cardioverter-Defibrillator Extraction After 4 Years Dwell Time: A Case Report.","authors":"Jolien A de Veld, Kirsten M Kooiman, Reinoud E Knops","doi":"10.1111/jce.16530","DOIUrl":"10.1111/jce.16530","url":null,"abstract":"<p><p>The extravascular implantable cardioverter-defibrillator (EV-ICD) was developed to overcome complications associated with transvenous leads while being able to deliver anti-tachycardia pacing (ATP). The lead is implanted in the substernal space, which makes extraction a cautious procedure. We present a case of a 51-year-old women with a successful EV-ICD extraction after a lead dwell time of 4 years, which is the longest reported. The EV-ICD lead was extracted using simple traction after the removal of all adhesions at the xiphoidal site around the lead. We advise to only use extraction tools if the initial attempt is not successful and if no adhesions at the caudal part of the lead are visible anymore, as these tools could also damage the surrounding tissue and the lead.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"298-300"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854086","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":"Integrating Mapping and 4D Ultrasound-Is This the Dawn of a New ICE Age?","authors":"Rachel M Kaplan","doi":"10.1111/jce.16557","DOIUrl":"https://doi.org/10.1111/jce.16557","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909696","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":"Navigating the Trials and Tribulations of the First Year of an Electrophysiology Practice.","authors":"Abhishek Bose","doi":"10.1111/jce.16547","DOIUrl":"https://doi.org/10.1111/jce.16547","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909697","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":"Preclinical Experience Using 4D Intracardiac Echocardiography to Guide Cardiac Electrophysiology Procedures.","authors":"Colin J Blumenthal, Weihow Hsue, Tiffany Chen, David Zhang, Erez Brem, Fermin C Garcia, David J Callans, Francis E Marchlinski, Pasquale Santangeli, Cory M Tschabrunn","doi":"10.1111/jce.16531","DOIUrl":"https://doi.org/10.1111/jce.16531","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Intracardiac echocardiography (ICE) is an essential imaging modality for electrophysiology procedures, allowing intraprocedural monitoring, real-time catheter manipulation guidance, and visualization of complex anatomic structures. Four-dimentional (4D) ICE is the next stage in the evolution of the technology, permitting 360° rotation of the imaging plane, simultaneous multiplanar imaging, and volumetric acquisition, similar to transesophageal echocardiography (TEE). In this study, we report our experience with a novel 4D ICE catheter (NuVision, Biosense Webster) in structural electrophysiology procedures and difficult ventricular ablations in a swine preclinical model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;7 Yorkshire swine underwent 4D ICE (NuVision, Biosense Webster) imaging procedures and anatomical shells of the RV, LV, and LA were created on the CARTO mapping system. Ablation was performed on the RV moderator band and LV papillary muscles under imaging guidance with the 4D ICE catheter. Additional ICE images were obtained of the LAA to simulate placement of a left atrial appendage occlusion (LAAO) device. Triphenyl tetrazolium chloride was administered before euthanasia and hearts were harvested, fixed in formalin, and sectioned.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;CARTOSOUND reconstruction was completed using the novel multiplane imaging software platform, allowing for creation of anatomy with minimal movement of the ICE catheter. Maps generated were similar to 3D reconstruction acquired in pre-procedure CT. Ablation lesions were successfully delivered to the LV papillary muscles and RV moderator band with excellent correlation between gross pathology, electroanatomic mapping (EAM), and ICE images. 2D, multiplane, and 3D volumetric images were obtained of the LAA with minimal catheter movement to simulate use for an LAAO procedure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Intracardiac ultrasound has become an essential tool in the electrophysiology lab, especially for visualization of intracardiac structures in real time. 4D ICE is the natural progression of this technology, adding features previously only seen on TEE probes. In this preclinical study, 4D ICE was used to create CARTOSOUND shells with less catheter manipulation, which could decease procedural times and potentially decrease complications related to frequent manipulation of the ICE catheter. It was also placed in the left atrium to acquire multiplane and 3D rendered volumes of the left atrial appendage (LAA) similar to what would be required for an LAA occlusion procedure. This could be used as an alternative to TEE in LAAO procedures, potentially improving procedural efficiency and negating the need for general anesthesia. Additionally, it was used for real-time ablation guidance, specifically directly on the RV moderator band and LV papillary muscles. Multiplanar imaging allowed for more accurate catheter visualization and localization when targeting these","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909698","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":"Irregular Narrow QRS Tachycardia: What Is the Mechanism?","authors":"Haruka Matsuura, Tsukasa Kamakura, Mai Ishiwata, Kengo Kusano","doi":"10.1111/jce.16558","DOIUrl":"https://doi.org/10.1111/jce.16558","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907108","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":"In Response to: Reconsider the Indication of Implantable Cardioverter Defibrillator in Patients With Cardiac Amyloidosis.","authors":"Ojasav Sehrawat, William H Swain, Konstantinos C Siontis","doi":"10.1111/jce.16532","DOIUrl":"https://doi.org/10.1111/jce.16532","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909695","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":"Quantification of atrial cardiomyopathy disease severity by electroanatomic voltage mapping and cardiac magnetic resonance imaging.","authors":"Iain Sim, Jose Alonso Solis Lemus, Christopher O'Shea, Orod Razeghi, John Whitaker, Rahul Mukherjee, Daniel O'Hare, Noel Fitzpatrick, James Harrison, Ali Gharaviri, Louisa O'Neill, Irum Kotadia, Caroline H Roney, Neil Grubb, David E Newby, Marc R Dweck, Pier-Giorgio Masci, Matthew Wright, Amedeo Chiribiri, Steven Niederer, Mark O'Neill, Steven E Williams","doi":"10.1111/jce.16462","DOIUrl":"10.1111/jce.16462","url":null,"abstract":"<p><strong>Introduction: </strong>Atrial late gadolinium enhancement (Atrial-LGE) and electroanatomic voltage mapping (Atrial-EAVM) quantify the anatomical and functional extent of atrial cardiomyopathy. We aimed to explore the relationships between, and outcomes from, these modalities in patients with atrial fibrillation undergoing ablation.</p><p><strong>Methods: </strong>Patients undergoing first-time ablation had disease severities quantified using both Atrial-LGE and Atrial-EAVM. Correlations between modalities and their relationships with clinical features and arrhythmia recurrence were assessed.</p><p><strong>Results: </strong>In 123 atrial fibrillation patients (60 ± 10 years), Atrial-EAVM was moderately correlated with Atrial-LGE (r = .34, p < .001), with a mean fibrosis burden of 47.2% ± 14.91%. Agreement was strongest in the highest tertile of fibrosis burden (mean of differences 16.8% (95% CI = -24.4% to 57.9%, p = .433). Fibrosis burden was greater for Atrial-LGE than Atrial-EAVM (50.7% ± 10.7% vs. 13.7% ± 7.13%, p < .005) for patients in the lowest tertile who were younger, had smaller atria and a greater frequency of paroxysmal atrial fibrillation. Both Atrial EAVM and Atrial LGE were associated with recurrence of arrhythmia following ablation (Atrial-LGE HR = 1.02 (95% CI = 1.01-1.04), p = .047; Atrial-EAVM HR = 1.02 (95% CI = 1.005-1.03), p = .007). A low fibrosis burden (<15%) by Atrial-EAVM identified patients with very low arrhythmia recurrence. In contrast, a much higher fibrosis burden (>66%) by Atrial-LGE identified patients failing to respond to ablation.</p><p><strong>Conclusions: </strong>We demonstrate for the first time that the level of agreement between Atrial-EAVM and Atrial-LGE is dependent on the level of atrial cardiomyopathy disease severity. The functional consequences of atrial cardiomyopathy are most evident in patients with the highest anatomical extent of disease.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909699","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":"Syncope: Advances in Diagnosis and Treatment 2024.","authors":"Richard Sutton, Rose Anne Kenny, David G Benditt","doi":"10.1111/jce.16546","DOIUrl":"https://doi.org/10.1111/jce.16546","url":null,"abstract":"<p><strong>Aim: </strong>In light of many recent advances in the field of vasovagal syncope, a selective review has been undertaken of these developments.</p><p><strong>Methods: </strong>Recent publications on the following topics were reviewed; understanding of vasovagal syncope pathophysiology, tilt-testing methodology and interpretation, drug, ablation and pacemaker therapy.</p><p><strong>Results and conclusions: </strong>The vasovagal syncope field is very active in researching its pathophysiology, using it to gain better understanding of the process and applying this knowledge to therapy.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907120","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 the Individual Operator Experience and Learning Curve of a Novel Size Adjustable Cryoballoon.","authors":"Yosuke Hayashi, Shinsuke Miyazaki, Junichi Nitta, Osamu Inaba, Yuichiro Sagawa, Shinsuke Iwai, Yukio Sekiguchi, Yukihiro Inamura, Yasuteru Yamauchi, Kentaro Goto, Takuro Nishimura, Tetsuo Sasano","doi":"10.1111/jce.16526","DOIUrl":"https://doi.org/10.1111/jce.16526","url":null,"abstract":"<p><strong>Background: </strong>Cryoballoon ablation is less operator-dependent than radiofrequency ablation. Recently, size-adjustable cryoballoons (SA-CBs) have become available. We sought to analyze the individual baseline operator experience's impact on procedural results.</p><p><strong>Methods: </strong>This multicenter observational study included atrial fibrillation (AF) patients who underwent pulmonary vein (PV) isolation using SA-CBs capable of 28-mm or 31-mm balloon sizes. Experienced (E-group) or less experienced (LE-group) operators were defined as experiencing > 100 or ≤ 100 cryoballoon procedures, respectively.</p><p><strong>Results: </strong>Among 510 patients (67 ± 11 years, 355 men, 325 paroxysmal AF [PAF]) who underwent an SA-CB ablation, 240 and 270 were in the E-group and LE-group, respectively. All cryoballoon parameters were similar between the groups, except for a significantly higher 31-mm balloon isolation rate in the E-group than LE-group, especially for right superior PVs. Cryoballoon-related phrenic nerve injury occurred in 34 (6.7%) patients and tended to be higher in the LE-group than E-group (8.1% vs. 5.0%, p = 0.16). The AF freedom was comparable between the groups for both PAF and non-PAF patients. A total of 36(7.1%) patients underwent re-do procedures at 5.2 ± 2.6 months post-index procedure. The PV reconnection rate was significantly higher in the LE-group than E-group (27.1% vs. 8.9%, p < 0.01), and this trend was more pronounced for right PVs than left PVs.</p><p><strong>Conclusions: </strong>In AF ablation using SA-CBs, the overall procedural efficacy and safety were comparable between the E-group and LE-group. However, 100 CB procedures seemed to still be in the middle of a learning curve for selecting the balloon size and balloon position, especially for right PVs.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882050","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":"Machine Learning-Driven Identification of Distinct Persistent Atrial Fibrillation Phenotypes: A Cluster Analysis of DECAAF II.","authors":"Charbel Noujaim, Han Feng, Ghassan Bidaoui, Chao Huang, Hadi Younes, Ala Assaf, Mario Mekhael, Nour Chouman, Chanho Lim, Eoin Donnellan, Ghaith Shamaileh, Abdel Hadi El Hajjar, Daniel Nelson, Aneesh Dhore, Dan Li, Nassir Marrouche, Omar Kreidieh","doi":"10.1111/jce.16554","DOIUrl":"https://doi.org/10.1111/jce.16554","url":null,"abstract":"<p><strong>Introduction: </strong>Catheter ablation of persistent atrial fibrillation yields sub-optimal success rates partly due to the considerable heterogeneity within the patient population. Identifying distinct patient phenotypes based on post-ablation prognosis could improve patient selection for additional therapies and optimize treatment strategies.</p><p><strong>Methods: </strong>We studied all patients who underwent catheter ablation of persistent atrial fibrillation in the DECAAF II trial. Out of 44 participating centers, 25% were randomly chosen as a validation set. A Gradient Boosting Method determined essential features for arrhythmia recurrence prediction and the number of clusters was determined according to the average silhouette width. K-medoids cluster analysis identified subgroups based on these features, and Kaplan-Meier curves were further compared among different clusters.</p><p><strong>Results: </strong>Among 815 patients, 570 served as a training set and 245 as a validation set. Using the training set, the GBM model achieved an AUC of 0.874. K-medoids cluster analysis used LA volume, BMI, baseline fibrosis, and age, resulting in two clusters. Cluster 1 patients were older, had higher baseline fibrosis, higher BMI, and greater LA volume compared to Cluster 2. Atrial arrhythmia recurrence rates were significantly higher in Cluster 1 (51.7% vs. 35.0%, p = 0.0002), and survival analysis showed a significant difference in primary recurrence outcomes (HR = 1.71, p < 0.0001). The validation set confirmed these findings.</p><p><strong>Conclusion: </strong>Utilizing machine learning, we identified a high-risk cluster for procedural failure in catheter ablation of persistent atrial fibrillation within the DECAAF II trial population. The primary differentiating factors of this high-risk cluster include older age, high left atrial fibrosis, elevated BMI, and increased left atrial volume.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882118","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}