Journal of Cardiovascular Electrophysiology最新文献

{"title":"A Quality Improvement Initiative to Optimize Follow-Up in the New England Area for Pediatric Patients With Cardiovascular Implantable Electronic Devices","authors":"Zoe Schefter,&nbsp;William P. Knapp,&nbsp;Elsie Helou,&nbsp;Kathleen Jay,&nbsp;Michael R. Epstein,&nbsp;Edward O'Leary,&nbsp;Felicia Tam,&nbsp;Shailendra Upadhyay,&nbsp;Bridget Boss,&nbsp;Niels Giddins,&nbsp;Audrey Dionne,&nbsp;Kerry Burke,&nbsp;Kathleen M. Rotondo,&nbsp;Elizabeth S. DeWitt,&nbsp;David Kane,&nbsp;Anna Tsirka,&nbsp;Douglas Y. Mah","doi":"10.1111/jce.16594","DOIUrl":"10.1111/jce.16594","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The use of cardiac implantable electronic devices (CIEDs) continues to grow. Despite the presence of implanted hardware, patient compliance with in-clinic visits and remote transmissions is poor. We performed a quality improvement (QI) initiative to assess and optimize CIED follow-up in the New England area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A regional network of eight pediatric institutions was created. All patients with CIEDs were identified starting in 2016. Noncompliance was defined as: no in-person evaluation within 1 year, or no remote transmission within 6 months. Interventions performed included automated texts/emails, certified letters, and personal phone calls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 612 patients were identified, with the total number of patients increasing over the 5-year QI period as patients had devices implanted and removed. Initial noncompliance with in-person annual follow-up was 29%. If patients were noncompliant, a personal phone call was made, reminding them to return to clinic. If the patient could not be reached for 3 months, a certified letter was sent. The noncompliance rate decreased to 5% over the first year and remained around this level over the QI period (3%–9%). For remote transmissions, 54% of patients were noncompliant. Interventions were performed on subgroups of patients. Automated texts/emails were trialed in 126; after 6 months, 41% of these patients remained noncompliant. Phone calls were then trialed on 87 patients. Over 6 months, noncompliance decreased to 11%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with CIEDs have poor compliance with regular follow-up. Patients have a limited response to automated measures (texts/emails). Personal phone calls had the greatest impact in improving compliance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 4","pages":"842-847"},"PeriodicalIF":2.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391007","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":"Predictors of Right Ventricular Pacing in Patients Undergoing Implantable Defibrillator Placement","authors":"James P. Hummel,&nbsp;Zhou Lan,&nbsp;Paul W. Jones,&nbsp;Rohan Khera,&nbsp;Kenneth Stein,&nbsp;Jeptha P. Curtis,&nbsp;Joseph G. Akar","doi":"10.1111/jce.16570","DOIUrl":"10.1111/jce.16570","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Identifying patients who will develop a need for right ventricular (RV) pacing after defibrillator (ICD) placement would help inform appropriate device selection, specifically to identify patients who might be more suitable for dual chamber or biventricular transvenous defibrillators versus single-chamber or subcutaneous devices which do not provide pacing. We sought to determine predictors of RV pacing in patients who did not have a pacing indication at the time of initial ICD implant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This observational study assessed single-chamber ICD recipients implanted from 2006 to 2016 from Boston Scientific's ALTITUDE database and linked to the NCDR® ICD Registry. The study population (<i>n</i> = 11 044) of ICDs (programmed VVI mode at 40 bpm), and without a clinical indication for pacing. was randomly divided into training and validation cohorts (70/30) and characteristics associated with RV pacing were identified using logistic regression. The outcome was defined as the development of &gt; 20% RV pacing averaged over any continuous 90-day period within 24 months after the ICD implant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients who developed &gt; 20% RV pacing (<i>n</i> = 148, 1.3%) had a higher likelihood of being older, male, and with a history of syncope, ventricular tachycardia or cardiac arrest, hypertension, previous or ongoing AF, and longer PR, QRS duration and BUN level (<i>p</i> &lt; 0.01). After adjustment, PR &gt; 230 ms, history of AF, ongoing AF at time of implant, history of VT or cardiac arrest, and age &gt; 70 were independently associated with RV pacing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study provides insight into predictors of RV pacing in ICD recipients without pacing needs at baseline.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 4","pages":"807-812"},"PeriodicalIF":2.3,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390360","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":"Catheter Ablation for Atrial Fibrillation in Octogenarians—Outcome and Impact for Future Same Day Discharge Strategies","authors":"Rahin Wahedi,&nbsp;Stephan Willems,&nbsp;Mario Jularic,&nbsp;Jens Hartmann,&nbsp;Omar Anwar,&nbsp;Jannis Dickow,&nbsp;Tim Harloff,&nbsp;Philipp Bengel,&nbsp;Peter Wohlmuth,&nbsp;Andreas Metzner,&nbsp;Nele Gessler,&nbsp;Melanie A. Gunawardene","doi":"10.1111/jce.16600","DOIUrl":"10.1111/jce.16600","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Catheter ablation (CA) for atrial fibrillation (AF) in the elderly poses a growing challenge. Outcome data regarding CA in these patients are scarce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Octogenarians with AF or consecutive atrial tachycardia undergoing index or re-ablation (pulmonary vein isolation [PVI] and ablation beyond PVI with different energy sources) in a single center, were analyzed. Study endpoints were efficacy as well as procedural safety. Secondary endpoints included periprocedural complications and predictors for prolonged hospital stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 301 patients (82.1 ± 1.9 years, paroxysmal AF <i>n</i> = 94 [31.2%], CHA₂DS₂-VASc-Score 4.2 ± 1.2) undergoing index ablation (<i>n</i> = 172/301, 57.1% [PVI only <i>n</i> = 156/172, radiofrequency <i>n</i> = 92, cryoballoon <i>n</i> = 59, pulsed-field ablation <i>n</i> = 5]) and re-ablation (<i>n</i> = 129/301 [42.9%]) were included. Arrhythmia-free survival at 1 year was 72.6%. Complication rates were low (groin site <i>n</i> = 2/301 [0.7%], tamponade <i>n</i> = 2/301 [0.7%] and stroke <i>n</i> = 1/301 [0.3%]). However concomitant infections (pneumonia <i>n</i> = 5/301 [1.7%], urinary-tract-infections <i>n</i> = 4/301, [1.3%]) and pacemaker-implantation <i>n</i> = 6/301 (2%) occurred more commonly. Hospital stay after CA was 2.3 ± 2 nights. Predictors for prolonged hospitalization were complications (odds ratio: 3.1), infections (odds ratio: 2.1), female sex (odds ratio: 1.15) and frailty assessed by Barthel index (odds ratio: 1.02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CA for AF in octogenarians shows low procedural complications and reasonable efficacy. However, concomitant infections and pacemaker implantations occur in this cohort. Due to prolonged hospitalization after CA, especially in female and frail octogenarians, same-day discharge may not be suitable for this specific patient cohort.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 4","pages":"832-841"},"PeriodicalIF":2.3,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389944","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":"The Atrial Fibrillation Registry (The FLOW-AF Registry): Insights From the United Arab Emirates—Patient Characteristics, Treatment, and One-Year Outcomes","authors":"Moutaz El Kadri,&nbsp;Khalid AlMuti,&nbsp;Amrish Agrawal,&nbsp;Nooshin Bazargani,&nbsp;Mohamed Fathy Soliman Gamaleldin,&nbsp;Haytham Mohamed Ahmed,&nbsp;Omneya Hassanain,&nbsp;Natasha Khalife,&nbsp;Ghazi Radaideh,&nbsp;Mohamed Magdy,&nbsp;Wael A. Almahmeed","doi":"10.1111/jce.16598","DOIUrl":"10.1111/jce.16598","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The epidemiological landscape and treatment efficacy of atrial fibrillation (AF) in the Middle East, notably in the United Arab Emirates (UAE), remain under-explored, presenting a distinct demographic and clinical pattern compared to Western populations. The FLOW-AF Registry aimed to bridge this knowledge gap by examining the characteristics, treatment patterns, clinical outcomes, and healthcare resource utilization (HCRU) of newly diagnosed non-valvular atrial fibrillation (NVAF) patients in the UAE, contributing to the scant literature on NVAF management in the region.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter, prospective observational study enrolled patients diagnosed with NVAF across six sites in the UAE. Data were collected on demographics, medical history, treatment decisions, clinical outcomes, and HCRU over a 12-month observation period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 198 patients were enrolled, with a mean age of 63.44 years. Mean CHA₂DS₂-VASc and HAS-BLED scores at baseline were 2.95 and 1.76, respectively. Most patients (55.77%) were prescribed non-vitamin K antagonist oral anticoagulants (NOACs). One-year incidence rates for major clinical events were 6.7% for all-cause mortality, 2.8% for bleeding complications, and 0.6% for myocardial infarction. No strokes were reported during the study period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The FLOW-AF Registry provides valuable insights into NVAF management in the UAE, demonstrating a distinct patient profile and a preference for NOACs. The NVAF cohort in the UAE was characterized by a younger demographic with lower risk scores and lower rate of clinical events relative to global counterparts. The findings underscore the evolving approach to AF management in the UAE, suggestive of a shift towards NOAC use but also highlights the need for ongoing research to fully understand long-term outcomes and validate current treatment paradigms in the UAE.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 4","pages":"813-823"},"PeriodicalIF":2.3,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jce.16598","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390468","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":"Contemporary Study of New Onset Atrial Fibrillation Treatment Strategies at a Large Academic Tertiary Care Center","authors":"Tarek Zghaib,&nbsp;Mirmilad Khoshknab,&nbsp;Timothy M. Markman,&nbsp;Francis E. Marchlinski,&nbsp;Andrew E. Epstein,&nbsp;Saman Nazarian","doi":"10.1111/jce.16599","DOIUrl":"10.1111/jce.16599","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Early rhythm-control after atrial fibrillation (AF) incidence is associated with improved cardiovascular outcomes. Moreover, AF ablation provides more effective rhythm-control than antiarrhythmic drugs (AADs). The extent of adoption of contemporary trials and guidelines for the management of new onset AF is unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>In this observational retrospective study, we sought to evaluate treatment pathways for new onset AF at a large tertiary academic medical center within the last 6 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a systematic search within our institutional TriNetX database to identify adult patients who (1) had new onset AF between January 2018 and January 2023, (2) did not have surgery or thyrotoxicosis within 1 month of incident AF diagnosis, and (3) had at least one visit at our center &gt; 6 months after initial AF diagnosis. Patients with prior AF diagnosis were excluded. We identified the initial three lines of treatment administered following AF diagnosis, including rate- or rhythm-control strategies with AADs or ablation therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort included 24 990 patients (mean age at diagnosis 69.8 ± 13.1 years, 58% male). During follow-up, 7130 (29%) received rhythm-control, 9760 (39%) received rate-control, and 8100 (32%) received neither. Rhythm-control consisted of AADs in 4610 (18%) and AF ablation in 2530 (10%). As first line therapy, 12 055 (48%) patients received rate-control, 3919 (16%) received AADs and 916 (4%) underwent AF ablation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Most contemporary patients with incident AF at a large US academic tertiary center either received no rate or rhythm intervention or only rate-control.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 4","pages":"824-829"},"PeriodicalIF":2.3,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390123","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":"Retrograde P Wave With Short RP Interval During Long RP' Tachycardia: What Is the Mechanism?","authors":"Yasuhiro Shirai,&nbsp;Mihoko Kawabata,&nbsp;Tatsuaki Kamata,&nbsp;Kaoru Okishige,&nbsp;Tetsuo Sasano,&nbsp;Kenzo Hirao","doi":"10.1111/jce.16601","DOIUrl":"10.1111/jce.16601","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 4","pages":"883-886"},"PeriodicalIF":2.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255583","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":"How to Demonstrate the Clinical Impact of Off-Label Use of Direct Oral Anticoagulants in Patients With Atrial Fibrillation","authors":"Naoya Kataoka,&nbsp;Teruhiko Imamura","doi":"10.1111/jce.16591","DOIUrl":"10.1111/jce.16591","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 4","pages":"909-910"},"PeriodicalIF":2.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255578","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":"Implantable Loop Recorder Services Reimagined: Embracing the Nonphysician Model Across Europe","authors":"Christopher Monkhouse","doi":"10.1111/jce.16604","DOIUrl":"10.1111/jce.16604","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 4","pages":"760-761"},"PeriodicalIF":2.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255579","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":"Déjà vu All Over Again: Pacing the Left Bundle Branch Area With Defibrillator Leads","authors":"Vardhmaan Jain,&nbsp;Michael S. Lloyd","doi":"10.1111/jce.16603","DOIUrl":"10.1111/jce.16603","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 3","pages":"663-664"},"PeriodicalIF":2.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255575","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":"Dual Uncommon Atrioventricular Connections in a Patient With Wolff-Parkinson-White Syndrome","authors":"Devendra Singh Bisht,&nbsp;Kamal Kishor","doi":"10.1111/jce.16596","DOIUrl":"10.1111/jce.16596","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Accessory pathways (APs) from the atrial appendage are uncommon and primarily described on the right side. Furthermore, connections involving the left atrial appendage (LAA) are even rarer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>This case report describes a 27-year-old female with recurrent supraventricular tachycardia (SVT) due to Wolff-Parkinson-White (WPW) syndrome. Electrophysiological evaluation identified dual atrioventricular (AV) connections: one from the LAA and another from the left coronary cusp (LCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The electrical characteristics of WPW syndrome need a deeper understanding. The retrograde conduction can persist even after successfully eliminating the antegrade conduction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 4","pages":"900-904"},"PeriodicalIF":2.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255577","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}