Journal of Cardiovascular Electrophysiology最新文献

{"title":"Anatomical Determinants of the Left Atrial Electrograms: Wall Thickness and Myocardial Fat Infiltration.","authors":"Cecilia Granata, Nicola Pierucci, Lorenzo Mazzocchi, Raimondo Pittorru, Roger Borras, Jean-Baptiste Guichard, Mariona Regany-Closa, Jana Reventos-Presmanes, Laia Llorca, Rosa Maria Figueras I Ventura, Jose Maria Tolosana, Adelina Doltra, Susana Prat, Blanca Domenech-Ximenos, Rosario Jesus Perea-Palazon, Till Althoff, Lluís Mont, Eduard Guasch, Marta Sitges, Ana Garcia-Alvarez, Ivo Roca-Luque, Andreu Porta-Sanchez","doi":"10.1111/jce.70491","DOIUrl":"https://doi.org/10.1111/jce.70491","url":null,"abstract":"<p><strong>Introduction: </strong>Electrogram peak-to-peak voltage depends on atrial wall structure and mapping configuration. We evaluated the relationship between computed tomography-derived atrial wall thickness, intramyocardial fat, myocardial muscle thickness, and electrogram voltage obtained with omnipolar, bipolar, and unipolar mapping.</p><p><strong>Methods: </strong>Consecutive patients undergoing left atrial mapping during atrial fibrillation or atypical atrial flutter ablation were retrospectively included. Pre-procedural contrast-enhanced CT was processed with ADAS 3D to quantify left atrial wall thickness and intramyocardial fat infiltration, from which myocardial muscle thickness was derived. High-density electroanatomical maps were spatially co-registered with CT. Associations between anatomical parameters and peak-to-peak voltage were assessed, stratifying by rhythm stability.</p><p><strong>Results: </strong>Twenty patients were included. In stable rhythms, left atrial wall thickness correlated positively with voltage for all configurations, strongest for unipolar (β = 0.38) and omnipolar (β = 0.23) vs. bipolar mapping (β = 0.13) (BP-UP p < 0.0001; BP-OT p < 0.01). Intramyocardial fat showed the strongest inverse association with omnipolar (β = -0.39), compared with bipolar (β = -0.14) and unipolar (β = -0.01; p ≤ 0.02). After excluding fat, muscle thickness correlated positively with OT (β = 0.30) and UP (β = 0.30), exceeding BP (β = 0.14; p < 0.0001). In unstable rhythms, associations were attenuated but OT remained most responsive to fat (β = -0.20) and muscle thickness (β = 0.11) (both p < 0.01).</p><p><strong>Conclusions: </strong>Myocardial muscle thickness is the main determinant of local atrial voltage, while intramyocardial fat contributes to voltage attenuation. OT provides the most consistent assessment of atrial wall composition, particularly under rhythm instability.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955994","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":"Large Language Models for PVC Localization: Proof of Concept or Clinical Tool?","authors":"Alexander Siotis, Gurukripa N Kowlgi, Abhishek J Deshmukh","doi":"10.1111/jce.70499","DOIUrl":"https://doi.org/10.1111/jce.70499","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912157","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":"Time-Dependent Diagnostic Yield and Therapeutic Impact of Implantable Loop Recorders, Brugada Syndrome as the Exception.","authors":"Luigi Cocchiara, Benedetta Brescia, Procolo Marchese, Stefano Nardi, Luigi Argenziano, Gianmarco Arabia, Marco Micillo, Francesca Gennaro, Giovanni Mazzotta, Lucio Addeo, Alessandro Landolfi, Emiliano Calvi, Manuel Cerini, Alessio Nicolai, Teresa Strisciuglio, Pasquale Vergara, Giovanni Esposito, Antonio Rapacciuolo","doi":"10.1111/jce.70469","DOIUrl":"https://doi.org/10.1111/jce.70469","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal duration of implantable loop recorder (ILR) monitoring remains uncertain and may differ according to the indication for implantation. We evaluated whether the time-dependent diagnostic yield and clinical relevance of ILR-detected arrhythmias differ among patients implanted for syncope, palpitations, cryptogenic stroke, or Brugada syndrome.</p><p><strong>Objective: </strong>This study sought to define the time-dependent diagnostic yield of ILRs across clinical indications and to assess whether early and late diagnoses differed in their impact on clinical management.</p><p><strong>Methods and results: </strong>We retrospectively analyzed 1734 consecutive patients undergoing ILR implantation at 5 Italian centers for unexplained syncope, palpitations, cryptogenic stroke, or Brugada syndrome. Diagnosis of interest was defined according to the implant indication: pauses for syncope, supraventricular tachycardia or atrial fibrillation for palpitations, atrial fibrillation for cryptogenic stroke, and ventricular tachycardia or pauses for Brugada syndrome. Median follow-up was 34 months. Maximally selected rank statistics identified 26 months as the global threshold separating early from late diagnoses, while indication-specific optimal diagnostic windows were 14 months for syncope, 13 months for palpitations, 16 months for cryptogenic stroke, and 55 months for Brugada syndrome. In syncope and palpitations, most actionable diagnoses occurred early, and diagnostic efficiency declined markedly after 26 months, with late findings often less clearly related to the index presentation. In cryptogenic stroke, atrial fibrillation detection was most frequent early but could still lead to changes in antithrombotic management later, supporting an individualized \"gray-zone\" approach to prolonged monitoring. By contrast, Brugada syndrome showed sustained diagnostic yield over extended follow-up, with late ventricular arrhythmias or pauses retaining major prognostic and therapeutic implications, including implantable cardioverter-defibrillator implantation and device-type selection.</p><p><strong>Conclusions: </strong>The value of ILR monitoring is strongly time- and indication-dependent. Prolonged routine monitoring or reimplantation appears to have limited incremental value in syncope and palpitations when early follow-up is unrevealing, whereas extended surveillance may remain justified in Brugada syndrome and should be individualized after cryptogenic stroke. These observations support indication-driven ILR follow-up strategies rather than a uniform approach based on device longevity alone.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900684","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 On-Site Cardiothoracic Surgery Availability on Outcomes of Catheter Ablation for Atrial Fibrillation in the United States.","authors":"Siddharth Agarwal, Harsh Patel, Zain Ul Abideen Asad, Muhammad Bilal Munir, Freddy Del-Carpio Munoz, Christopher V DeSimone, Abhishek Deshmukh","doi":"10.1111/jce.70495","DOIUrl":"10.1111/jce.70495","url":null,"abstract":"<p><strong>Background: </strong>Catheter ablation is an established rhythm control strategy for atrial fibrillation (AF) but carries a small risk of serious complications that may require emergent surgical intervention. Historically, the availability of on-site cardiothoracic surgery (CTS) has been considered an important safety requirement. However, contemporary advances in ablation techniques and peri-procedural care have improved procedural safety, and real-world data evaluating the impact of on-site CTS availability in current practice remain limited.</p><p><strong>Methods: </strong>We analyzed the National Readmissions Database (NRD) from 2016 to 2021 to identify adults undergoing catheter ablation for AF. Hospitals were classified based on the presence of on-site CTS, defined by the performance of coronary artery bypass graft surgery. Baseline characteristics were compared between groups. Multivariable logistic regression was used to assess the association between on-site CTS availability and in-hospital complications, mortality, discharge disposition, and 30-day all-cause readmissions, adjusting for demographic and clinical covariates.</p><p><strong>Results: </strong>Among 81 471 patients undergoing AF ablation, 3.3% were treated at centers without on-site CTS and 96.7% at centers with CTS. Patients treated at centers without CTS were older, more frequently female, and had a higher comorbidity burden, including greater thromboembolic risk. After multivariable adjustment, on-site CTS availability was not independently associated with in-hospital mortality, cardiac perforation, pericardiocentesis, need for open heart surgery, vascular, pulmonary, or neurological complications, discharge to home, or 30-day readmissions.</p><p><strong>Conclusion: </strong>In this large, contemporary national cohort, the availability of on-site cardiothoracic surgery was not independently associated with improved peri-procedural or short-term outcomes following AF ablation.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"2124-2128"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887495","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":"Pooled Efficacy and Safety of Left Atrial Appendage Occlusion Versus Direct Oral Anticoagulants or Antiplatelets: A Meta-Analysis of the Landmark Randomized Trials.","authors":"Leonardo M Knijnik, Birju Rao, David B DeLurgio","doi":"10.1111/jce.70493","DOIUrl":"10.1111/jce.70493","url":null,"abstract":"<p><strong>Background: </strong>Landmark randomized controlled trials (RCTs) comparing left atrial appendage occlusion (LAAO) against direct oral anticoagulants (DOACs) are individually underpowered for small but clinically meaningful differences. We performed a pooled meta-analysis to provide more precise efficacy and safety data.</p><p><strong>Methods: </strong>Utilizing random-effects models, we pooled data from 5890 patients across four landmark RCTs (PRAGUE-17, CLOSURE-AF, OPTION, and CHAMPION-AF) at their longest follow-up.</p><p><strong>Results: </strong>There were no significant differences between LAAO and antithrombotics in cardiovascular mortality (5.3% vs. 4.8%, p = 0.33), all-cause stroke (3.3% vs. 2.8%, p = 0.31), systemic embolism (0.2% vs. 0.1%, p = 0.68), or major bleeding (6.6% vs. 6.8%, p = 0.85). Non-procedural bleeding was significantly lower with LAAO (9.2% vs. 16.7%; RR 0.55; 95% CI 0.47-0.64; p < 0.0001), though there was a numerical trend toward more ischemic stroke events (2.7% vs. 2.0%; RR 1.35; 95% CI 0.97-1.88; p = 0.08).</p><p><strong>Conclusion: </strong>LAAO offers similar overall efficacy and safety to modern antithrombotics. It represents a clinical trade-off: accepting a known upfront procedural risk for a robust, long-term reduction in non-procedural bleeding, potentially at the cost of a slight numerical increase in ischemic stroke.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"2122-2123"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887567","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":"Acute Termination of Atrial Fibrillation During Ablation of a Left Atrial Slow-Conduction Channel.","authors":"Agustín Bortone, Ziad Khoueiry, Luca Rosario Limite, Alberto Musella","doi":"10.1111/jce.70456","DOIUrl":"10.1111/jce.70456","url":null,"abstract":"<p><strong>Introduction: </strong>Left atrial (LA) slow-conduction channels (SCCs) may represent active drivers of persistent AF, but human evidence is lacking.</p><p><strong>Methods and results: </strong>A 77-year-old patient with persistent AF developed LA flutter during PVI, which subsequently degenerated into AF. Activation mapping identified the flutter isthmus as an anterior LA SCC. The first radiofrequency application at this channel abruptly slowed and terminated AF, restoring SR. The patient remains arrhythmia-free at 4 months.</p><p><strong>Conclusion: </strong>This case provides the first human evidence suggesting that LA SCCs may actively sustain AF. However, further experimental and clinical studies are required to confirm these preliminary findings.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"2143-2146"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497508","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":"\"Left Atrial Appendage Closure Versus Medical Therapy in Atrial Fibrillation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials\".","authors":"Ali Alsajad Hussein Al-Janabi, Ali Saad Al-Shammari, Ahmed W Hageen, Abdullah Zeyad Hameed Al-Tuaama, Abdullah Muataz Taha Al-Ibraheem, Muhammad Shahzaib, Diya Rathi, Khadeeja Ali Hamzah, Mohammedsadeq A Shweliya, Yousif Hameed Kurmasha, Mohamed Wagdy, Marwan M Refaat","doi":"10.1111/jce.70486","DOIUrl":"10.1111/jce.70486","url":null,"abstract":"<p><p>We aim to compare the impact of left atrial appendage closure vs. medical therapy on clinical outcomes in patients with atrial fibrillation, focusing on key clinical outcomes relevant to thromboembolic prevention. We conducted a PRISMA-guided systematic review and meta-analysis of studies comparing LAAC with medical therapy in AF adults. PubMed, Embase, Scopus, ClinicalTrial. gov, and Cochrane Library were searched from inception to March 2026. Outcomes included all-cause mortality, any stroke, ischemic stroke, hemorrhagic stroke, major bleeding, systemic embolism and cardiac death. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using random-effects models. Reconstructed individual patient-level survival data from published Kaplan-Meier curves were used for time-to-event analyses. Trial sequential analysis (TSA) assessed the conclusiveness of cumulative evidence. Six randomized controlled trials involving 7004 patients were included. LAAC demonstrated comparable outcomes to medical therapy for all-cause mortality, any stroke, major bleeding, systemic embolism, and cardiac death. There was a non-significant trend toward increased ischemic stroke and reduced hemorrhagic stroke with LAAC. Reconstructed time-to-event analyses showed similar cumulative incidence of stroke and bleeding outcomes over follow-up. TSA demonstrated that the required information size was not reached for any major endpoint, indicating that current evidence remains underpowered and additional randomized trials are needed. LAAC provides similar overall efficacy and safety compared with medical therapy for stroke prevention in AF but should currently remain reserved for selected patients rather than replacing oral anticoagulation broadly. Further adequately powered trials with longer follow-up are required.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"2097-2111"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860260","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":"Intraprocedural Fibrin Clot Formation During Pulmonary Vein Isolation With a Lattice-Tip Ablation Catheter.","authors":"Nicholas Roma, Lindsey Magid, Nasir Siddique, Steven Stevens","doi":"10.1111/jce.70443","DOIUrl":"10.1111/jce.70443","url":null,"abstract":"<p><strong>Introduction: </strong>Pulsed-field ablation with a lattice-tip catheter has emerged as a promising technology for pulmonary vein isolation. We report a case of intraprocedural catheter malfunction with fibrin deposition potentially leading to a transient neurological deficit during ablation despite optimal anticoagulation.</p><p><strong>Case: </strong>A 39-year-old man with symptomatic atrial fibrillation and tachycardia-mediated cardiomyopathy underwent pulmonary vein isolation using the Affera mapping system and Sphere-9 lattice tip catheter. During the procedure, despite uninterrupted oral anticoagulation and heparin given to meet manufacturer-recommended activated clotting times, the catheter malfunctioned, and when removed, there was a white solid substance that was seen within the lattice tip. The procedure was stopped prematurely with incomplete pulmonary vein isolation. A pathologist confirmed the white substance was fibrin inside the lattice tip. The patient had symptoms of transient ischemic attack postoperatively and also suffered early recurrence of atrial fibrillation.</p><p><strong>Conclusion: </strong>This case demonstrates fibrin deposition and possible embolic events using the Sphere-9 lattice tip catheter despite stringent anticoagulation protocols. This highlights the importance of meticulous catheter inspection as well as provides a post-market complication utilizing this catheter.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"2129-2133"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411864","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":"Idiopathic Ventricular Fibrillation Triggered by Purkinje-Related Extrasystoles: State-of-the-Art and Novel Therapeutic Approaches.","authors":"Giacomo Mugnai, Davide Genovese, Francesco Santoro, Luigi Di Biase, Fengwei Zou, Luca Tomasi, Carlo de Asmundis, Flavio Ribichini, Pedro Brugada, Gian-Battista Chierchia","doi":"10.1111/jce.70457","DOIUrl":"10.1111/jce.70457","url":null,"abstract":"<p><p>Ventricular fibrillation (VF) is the primary arrhythmia causing sudden cardiac death. While typically linked to structural heart disease, a significant subset of VF episodes-especially in younger individuals-is triggered by focal ectopy from the His-Purkinje system (HPS). The HPS possesses distinct electrophysiological properties that make it inherently susceptible to arrhythmogenesis. It serves a dual role, acting as both a primary source of initiating premature ventricular complexes through abnormal automaticity and triggered activity (early and delayed afterdepolarizations), and as a critical substrate maintaining VF via micro-re-entrant circuits. This narrative review comprehensively synthesizes current knowledge on Purkinje-triggered VF, from its epidemiology and clinical setting to its underlying pathophysiological and ionic mechanisms of arrhythmia initiation and perpetuation. Finally, we critically evaluate contemporary diagnostic and management strategies, contrasting conventional focal trigger-based ablation with evolving substrate-based approaches such as Purkinje \"de-networking.\"</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"2083-2096"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497685","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":"Early-Stage Esophago-Mediastinal Fistula After Atrial Fibrillation Radiofrequency Ablation Successfully Treated With Endoscopic Vacuum Therapy.","authors":"Rodrigo Melo Kulchetscki, Bruno da Costa Martins, Alberto Pereira Ferraz, Luan Vieira Rodrigues, Gabrieli Melissa Oissa, Muhieddine Omar Chokr, Carina Abgail Hardy, Esteban Wisnivesky Rocca Rivarola, Cristiano Faria Pisani, Maurício Scanavacca","doi":"10.1111/jce.70473","DOIUrl":"10.1111/jce.70473","url":null,"abstract":"<p><strong>Background: </strong>Esophageal injury is a rare but potentially fatal complication of atrial fibrillation ablation, predominantly associated with thermal energy sources.</p><p><strong>Case summary: </strong>A 37-year-old man developed an esophago-mediastinal fistula after radiofrequency ablation for atrial fibrillation. An esophageal ulcer detected on routine post-ablation endoscopy progressed despite conservative management. Endoscopic vacuum therapy was instituted for 5 days, followed by endoscopic clip closure, resulting in complete healing without surgical intervention.</p><p><strong>Conclusion: </strong>This case underscores the value of post-ablation esophageal surveillance and demonstrates endoscopic vacuum therapy as an effective, minimally invasive option for managing esophageal perforation after radiofrequency ablation.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"2147-2151"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678767","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}