Journal of Cardiovascular Electrophysiology最新文献

{"title":"Para-Hisian Pacing in a Patient With Pre-Existing Right Bundle Branch Block: What Is the Mechanism?","authors":"Takashi Nakashima, Masaru Nagase, Yuya Suzumura, Takahiro Usui, Mikihito Morimoto, Kei Ando, Taro Shibahara, Daiju Ono, Takehiro Yamada, Keita Suzuki, Makoto Yamaura, Takahisa Ido, Shigekiyo Takahashi, Takuma Aoyama","doi":"10.1111/jce.16702","DOIUrl":"https://doi.org/10.1111/jce.16702","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009082","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":"Revisiting First-Line VoM Ablation in PeAF: Primum Non Nocere Matters.","authors":"Cem Çöteli","doi":"10.1111/jce.16687","DOIUrl":"https://doi.org/10.1111/jce.16687","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026176","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":"Conduction System Pacing \"How To\": Tips and Tricks.","authors":"Simone Valenza, Carmine De Lucia, Lina Marcantoni, Karim Mahfouz, Francesco Deluca, Carlo Colaiaco, Giorgio Porcelli, Fabrizio Ammirati, Luca Santini, Francesco Zanon","doi":"10.1111/jce.16690","DOIUrl":"https://doi.org/10.1111/jce.16690","url":null,"abstract":"<p><p>Conduction system pacing (CSP), encompassing His bundle pacing and left bundle branch area pacing, has emerged as a physiological pacing technique designed to activate the heart's intrinsic conduction system. CSP is a promising alternative to traditional right ventricular pacing for bradycardia and to biventricular pacing for cardiac resynchronization therapy. This article outlines key considerations for achieving successful CSP implantation, including procedural techniques, available tools, and programming strategies.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005520","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":"Outcomes of Exclusive 50 W High Power, 5 s Ablation Close to the Esophagus in Pulmonary Vein Isolation.","authors":"Yoshikazu Sato, Shigeki Kusa, Naoyuki Miwa, Satoshi Hara, Tadanori Nakata, Hidenori Hirano, Taiki Ishizawa, Tomohiro Tahara, Tetsuo Sasano, Hitoshi Hachiya","doi":"10.1111/jce.16678","DOIUrl":"https://doi.org/10.1111/jce.16678","url":null,"abstract":"<p><strong>Background: </strong>In pulmonary vein isolation (PVI) employing a high-power and short-duration (HP-SD) strategy, no consensus exists regarding the optimal settings for radiofrequency application (RFA) to the section of left atrium adjacent to the esophagus (esophageal area, EA).</p><p><strong>Objective: </strong>To evaluate (1) the efficacy and safety of HP-SD RFA with 50 W for 5 s on the EA, and (2) the predictive factors of esophageal thermal injury (ETI).</p><p><strong>Methods: </strong>We performed esophagogastroduodenoscopy on 85 patients who had undergone PVI with 50 W RFA. RFA duration was limited to 5 s on the EA.</p><p><strong>Results: </strong>Of the 85 patients, 16 (18.8%) developed asymptomatic thermal injury (1 mucosal injury, namely erosion and 15 gastric hypomotility). All of those were asymptomatic and transient, and any symptomatic or severe, esophageal or gastric complications was not observed. On the EA, conduction block was achieved after the first encircling in 82 (96.5%) patients. The number of RFA on the EA and the proportion of patients whose EA was located at the posterior wall of the right inferior PV (right-sided EA) were higher in the patients with ETI than without (9.0 [7.0-10.5] vs. 7.0 [5.0-9.0] p = 0.021, and 18.8% vs. 2.9%, p = 0.044, respectively). In multivariate analysis, the number of RFA on the EA (hazard ratio 1.32, p = 0.019) and RFA on the right-sided EA (hazard ratio, 13.50, p = 0.013) were identified as the predictors of ETI.</p><p><strong>Conclusion: </strong>RFA of 50 W for 5 s on the EA can be performed with a low incidence of esophageal mucosal injury while maintaining efficacy. RFA on the right-sided EA and the high number of RFA on the EA increase the risk of ETI.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001042","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 Case of Ventricular Premature Contractions With Multiple Morphologies Reproduced by a Single Ventricular Extrastimulus With Different Coupling Intervals.","authors":"Naoyuki Miwa, Tadanori Nakata, Satoshi Hara, Tomohiro Tahara, Taiki Ishizawa, Hidenori Hirano, Yoshikazu Sato, Shigeki Kusa, Hitoshi Hachiya","doi":"10.1111/jce.16684","DOIUrl":"https://doi.org/10.1111/jce.16684","url":null,"abstract":"<p><strong>Introduction: </strong>A 22-year-old male with no cardiovascular history presented with frequent symptomatic ventricular premature contractions (VPCs) with multiple QRS morphologies despite bisoprolol treatment.</p><p><strong>Results: </strong>The coupling intervals progressively increased from VPC1 to VPC3, and VPC2 was the most frequent. The earliest activation site was identified at the left-right coronary cusp junction. Single ventricular extrastimuli with variable coupling intervals from this site successfully reproduced QRS morphologies identical to VPC1-3.</p><p><strong>Conclusion: </strong>This case illustrated how a single focus VPC could exhibit multiform morphology due to varying fusion with intrinsic conduction and the importance of coupling interval-matched extrastimuli in identifying the origin.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017931","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":"Redo Ablation for Atrial Fibrillation Slows Mechanical Function Decrement From Atrial Fibrillation Progression.","authors":"Jiawei Dong, Ravi Ranjan","doi":"10.1111/jce.16693","DOIUrl":"https://doi.org/10.1111/jce.16693","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998740","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 Impact of the Incision of the Capsule Floor During Generator Replacement on Cardiac Implantable Electronic Device Infection Risk: A Single-Center Experience.","authors":"Umut Celikyurt, Burak Acar, Hacer Dogan, Ipek Celikyurt, Kaan Hanci, Ozlem Guler, Aysen Agacdiken, Ahmet Vural","doi":"10.1111/jce.16695","DOIUrl":"https://doi.org/10.1111/jce.16695","url":null,"abstract":"<p><strong>Introduction: </strong>The fibrous capsule around cardiac implantable electronic device (CIED) generators represents avascular tissue that could be colonized and provides the nidus for latent infection. The purpose of the study is to evaluate the effects of incision of the capsule floor at the lower and/or medial part at the time of generator replacement on the CIED infection and hematoma formation.</p><p><strong>Methods: </strong>This observational study with retrospective analysis of prospectively collected data included patients who underwent CIED generator replacement between January 2013 and January 2024. A total of 1059 consecutive patients were compared according to the incision of the capsule floor at the lower and/or medial part: 448 patients without (group 1) and 611 patients with an incision on the capsule floor (group 2).</p><p><strong>Results: </strong>Fifteen patients with CIED infection after generator replacement were identified. There were no significant differences between the two groups, except for a higher percentage of patients with number of previous procedures on pocket ≥ 2 (35% vs. 19.6%, p < 0.001), and NOAC use (10.6% vs. 6.7%, p = 0.027) in group 2. There was a lower infection rate in group 2 compared to group 1 (0.7% vs. 2.5%, p = 0.014). In multivariate analysis, independent predictors of CIED infection after generator replacement were replacement without an incision of the capsule floor (OR 4.384, 95% CI [1.355-14.189]; p = 0.014), and age< 65 years (OR 3.259, 95% CI [1.133-9.378]; p = 0.028).</p><p><strong>Conclusion: </strong>Generator replacement without incision of the capsule floor during generator replacement was associated with increased CIED infection risk. To minimize CIED infection risk, capsule floor incision could be considered during generator replacement.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018323","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":"Recurrence of Atrial Fibrillation After Cryoballoon Ablation in Women Is Less Pulmonary Vein Mediated as Compared to Men: Lessons From Repeat Ablation Procedures.","authors":"Maxime Tijskens, Juan Pablo Abugattas, Michael Wolf, Bruno Schwagten, Yves De Greef","doi":"10.1111/jce.16651","DOIUrl":"https://doi.org/10.1111/jce.16651","url":null,"abstract":"<p><strong>Background: </strong>Data on sex-related outcomes of pulmonary vein isolation (PVI) of cryoballoon ablation (CBA) in atrial fibrillation (AF) are sparse.</p><p><strong>Aim: </strong>To compare sex-differences in PV reconnection, strategy and outcome of repeat ablations after CBA.</p><p><strong>Methods: </strong>Repeat procedures were performed using radiofrequency ablation guided by 3D mapping. PV reconnection characteristics were compared in 229 patients (77 (33.6%) females). In durable PVI patients, we compared left atrial voltage maps, ablation strategy and 1-year outcome. Clinical success was defined as freedom of documented AF or atrial tachycardia (AT) > 30 s.</p><p><strong>Results: </strong>Female patients had a lower overall number of PV reconnections (0.8 ± 0.9 vs 1.2 ± 1.0, p < 0.001) driven by less reconnected left PVs: 13/77 (16.9%) vs 51/152 (33,6%), p = 0.008 and 7/77 (9.1%) vs 39/152 (25.7%), p = 0.003 for LSPV and LIPV, respectively. Durable PVI was more frequent in women (34/77 (44.1%) vs 37/152 (24.4%), p = 0.001). Female sex was the only independent predictor for durable PVI (HR = 2.003; 95% CI 1.090-3.682; p = 0.025). In durable PVI patients, substrate ablation was more frequently performed in women (21/35 (60%) vs 13/35 (37.1%), p = 0.044), mainly targeting the higher prevalent atrial low-voltage zones (21/35 (60.0%) vs 12/36 (33.3%), p = 0.017). At 1 year, recurrence of AF/AT did not differ between sexes: 6/35 (17.1%) versus 8/35 (22.9%), p = 0.591.</p><p><strong>Conclusions: </strong>The higher persistence of durable PVI in women points to a sex difference in AF recurrence driver after CBA. In durable PVI patients, a higher prevalence of low-voltage regions results in more substrate ablation in women. Despite sex differences in ablation strategy, 1-year outcome was similar.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025951","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":"Procedural and Clinical Outcomes of High-Frequency Low-Tidal Volume Ventilation Plus Rapid-Atrial Pacing in Paroxysmal Atrial Fibrillation Ablation.","authors":"Paul C Zei, Daniela Hincapie, Joan Rodriguez-Taveras, Jose Osorio, Isabella Alviz, Andres F Miranda-Arboleda, Mohamed Gabr, Christopher Thorne, Joshua R Silverstein, Amit J Thosani, Allyson L Varley, Fernando Moreno, Daniel A Zapata, Benjamin D'Souza, Anil Rajendra, Saumil Oza, R N Linda Justice, Ana Baranowski, Huy Phan, Alejandro Velasco, Charles C Te, Matthew C Sackett, Matthew J Singleton, Anthony R Magnano, David Singh, Richard Kuk, Nathaniel A Steiger, William H Sauer, Jorge E Romero","doi":"10.1111/jce.16661","DOIUrl":"https://doi.org/10.1111/jce.16661","url":null,"abstract":"<p><strong>Background: </strong>High-frequency low-tidal-volume (HFLTV) ventilation is a safe and cost-effective strategy that improves catheter stability, first-pass pulmonary vein isolation, and freedom from all-atrial arrhythmias during radiofrequency catheter ablation (RFCA) of paroxysmal and persistent atrial fibrillation (AF). However, the incremental value of adding rapid-atrial pacing (RAP) to HFLTV-ventilation has not yet been determined.</p><p><strong>Objective: </strong>To evaluate the effect of HFLTV-ventilation plus RAP during RFCA of paroxysmal AF on procedural and long-term clinical outcomes compared to HFLTV-ventilation alone.</p><p><strong>Methods: </strong>Patients from the REAL-AF prospective multicenter registry, who underwent RFCA of paroxysmal AF using either HFLTV + RAP (500-600 msec) or HFLTV ventilation alone from April 2020 to February 2023 were included. The primary outcome was freedom from all-atrial arrhythmias at 12-month follow-up. Secondary outcomes included procedural characteristics, long-term clinical outcomes, and procedure-related complications.</p><p><strong>Results: </strong>A total of 545 patients were included in the analysis (HFLTV + RAP = 327 vs. HFLTV = 218). There were no significant differences in baseline characteristics between the groups. No differences were observed in procedural (HFLTV + RAP 74 [57-98] vs. HFLTV 66 [53-85.75] min, p = 0.617) and RF (HFLTV + RAP 15.15 [11.22-21.22] vs. HFLTV 13.99 [11.04-17.13] min, p = 0.620) times. Both groups showed a similar freedom from all-atrial arrhythmias at 12-month follow-up (HFLTV + RAP 82.68% vs. HFLTV 86.52%, HR = 1.43, 95% CI [0.94-2.16], p = 0.093). There were no significant differences in freedom from AF-related symptoms (HFLTV + RAP 91.4% vs. HFLTV 93.1%, p = 0.476) or AF-related hospitalizations (HFLTV + RAP 98.5% vs. HFLTV 97.2%, p = 0.320). Procedure-related complications were low in both groups (HFLTV + RAP 0.6% vs. HFLTV 0%, p = 0.247).</p><p><strong>Conclusion: </strong>In patients undergoing RFCA for paroxysmal AF, adding RAP to HFLTV-ventilation was not associated with improved procedural and long-term clinical outcomes.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018329","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 Corticosteroid Therapy and Its Effect on Ventricular Tachyarrhythmia Recurrence in Cardiac Sarcoidosis: A 10-Year Longitudinal Multicenter Study.","authors":"Akiko Ueda, Koji Nakagawa, Koji Miyamoto, Reina Tonegawa-Kuji, Miyako Igarashi, Kenji Okubo, Akihiko Nogami, Kengo Kusano, Kyoko Soejima","doi":"10.1111/jce.16685","DOIUrl":"https://doi.org/10.1111/jce.16685","url":null,"abstract":"<p><strong>Introduction: </strong>The role of corticosteroids in the management of ventricular tachyarrhythmia (VA) in cardiac sarcoidosis (CS) remains controversial. This study assessed the effect of early steroid initiation on VA recurrence rates in patients with CS and evaluated VA frequency before and after steroid therapy.</p><p><strong>Methods: </strong>From a registry of 137 patients with CS with arrhythmias, those with VA and more than 60 days of follow-up were included. Patients were categorized into three groups: previous-on-steroid, those using corticosteroids at the time of the first VA (n = 15); early-steroid, those with steroid initiation within 60 days (n = 21); and no-or-delayed-steroid, those without steroid use at 60 days from the first VA (n = 35). The VA recurrence and timing were analyzed.</p><p><strong>Results: </strong>The median age at the first VA was 60 years. Over a median follow-up period of 81 (range: 4-345) months, 43 patients experienced VA recurrence. The median time to recurrence was 101, 33, and 17 months in the early-steroid, no-or-delayed steroid, and previous-on-steroid groups, respectively. Corticosteroid use at 60 days was an independent predictor of VA recurrence at 120 months (hazard ratio: 2.257; p = 0.045 in the no-or-delayed steroid group and hazard ratio: 3.155; p = 0.021 in the previous-on-steroid group vs. the early-steroid group). Low left ventricular ejection fraction (LVEF) was associated with frequent VA episodes. Corticosteroid initiation did not increase early VA episodes.</p><p><strong>Conclusion: </strong>Early corticosteroid initiation after VA onset reduced the long-term recurrence without increasing early episodes. Cases of repetitive VA were common in those with low LVEF.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002388","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}