Sandeep K. Goyal, Carlo Pappone, Massimo Grimaldi, Sung W. Lee, Stavros Mountantonakis, J. Brian DeVille, Venkata S. Sagi, Chen-Yang Jiang, Haseeb Jafri, Alan P. Wimmer, Li-Qun Wu, Srinivas Dukkipati, Haroon Rashid, Hugh Calkins, Moussa Mansour, Javier Roman-Gonzalez, Andrea Natale, Giuseppe Ciconte, Arash Aryana, STELLAR investigators
{"title":"Multielectrode Radiofrequency Balloon Catheter for Paroxysmal Atrial Fibrillation: Results From the Global, Multicenter, STELLAR Study","authors":"Sandeep K. Goyal, Carlo Pappone, Massimo Grimaldi, Sung W. Lee, Stavros Mountantonakis, J. Brian DeVille, Venkata S. Sagi, Chen-Yang Jiang, Haseeb Jafri, Alan P. Wimmer, Li-Qun Wu, Srinivas Dukkipati, Haroon Rashid, Hugh Calkins, Moussa Mansour, Javier Roman-Gonzalez, Andrea Natale, Giuseppe Ciconte, Arash Aryana, STELLAR investigators","doi":"10.1111/jce.16524","DOIUrl":"10.1111/jce.16524","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The safety and efficacy of paroxysmal atrial fibrillation (PAF) ablation with the HELIOSTAR multielectrode radiofrequency (RF) balloon catheter have been demonstrated in European studies; data from elsewhere are lacking. This prospective, multicenter study conducted in the United States, Italy, and China investigated the safety and efficacy of pulmonary vein isolation (PVI) using HELIOSTAR in drug-refractory symptomatic PAF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The primary effectiveness endpoint (PEE) was 12-month freedom from documented atrial fibrillation/atrial flutter/atrial tachycardia plus freedom from acute procedural failure, nonstudy catheter failure, repeat ablation failure, direct current cardioversion (DCCV), and Class I/III antiarrhythmic drug (AAD) failure. The primary safety endpoint was the occurrence of early-onset primary adverse events (PAEs). Cerebral magnetic resonance imaging (MRI) and cardiac computed tomography were performed in a patient subset to assess silent cerebral lesions (SCLs) and severe pulmonary vein (PV) stenosis, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across 36 centers, 257 eligible subjects in the main phase had the study catheter inserted. Acute PVI was achieved in all subjects, with the majority (94.1%) using the balloon catheter only. In 67.7% and 92.2% of subjects, respectively, PEE and freedom from repeat ablation were met; clinical success rate was 77.7%. The PAE rate was 5.1%. One of 15 (6.7%) subjects with MRI showed a new SCL at 1 month postablation, which resolved at 3 months. Clinically meaningful improvements in Atrial Fibrillation Effect on QualiTy-of-life scores were seen at 3 months and were sustained to 12 months postablation, and accompanied with reduction of Class I/III AAD use and DCCV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>STELLAR confirmed the safety and efficacy of the HELIOSTAR catheter for PVI, with clinically meaningful improvements in quality of life in patients with drug-refractory symptomatic PAF. Most PVIs were achieved without focal touch-up, and > 90% of patients were free from repeat ablation at 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov Identifier: NCT03683030.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 2","pages":"376-386"},"PeriodicalIF":2.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jce.16524","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836386","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}
Elena Efimova, Samira Zeynalova, Sandra Eifert, Alexey Dashkevich, Michael Andrew Borger, Anna L. Meyer, Jens Garbade, Angeliki Darma, Kerstin Bode, Arash Arya
{"title":"Echocardiographic Predictors of Ventricular Arrhythmias in Patients With Left Ventricular Assist Devices and Implantable Cardioverter-Defibrillator","authors":"Elena Efimova, Samira Zeynalova, Sandra Eifert, Alexey Dashkevich, Michael Andrew Borger, Anna L. Meyer, Jens Garbade, Angeliki Darma, Kerstin Bode, Arash Arya","doi":"10.1111/jce.16539","DOIUrl":"10.1111/jce.16539","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the predictive value of preoperative echocardiographic parameters for occurrence of VAs in patients with preexisting ICD undergoing LVAD implantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>All consecutive patients (<i>n</i> = 264) with previous ICD who underwent LVAD surgery between May 2011 and December 2019 at our institution were included. The patients were predominantly male (89%) with NICM (59%) and a mean age of 59 ± 10 years. All LVADs were continuous flow device (154 HVAD, 21 HeartMate II, and 89 HeartMate 3). A total of 102 (39%) patients had VAs in the first year after LVAD implantation. We compared echocardiographic parameters in patients with and without VAs before LVAD, at 1 month and 1 year after LVAD implantation. Increased pre-LVEDD ≥ 72 mm predicted the occurrence of VAs after LVAD implantation for ICM patients (HR: 2.9, 95% confidence interval (CI): [1.3–6.6], <i>p</i> = 0.012), while a larger pre-RVEDD ≥ 46 mm was predictive in NICM patients (HR: 2.8, (CI): [1.4–5.9], <i>p</i> = 0.004). Moreover, a larger RVEDD at 1 year after LVAD was highly associated with VAs in the first year after LVAD implantation (50 ± 10 vs. 45 ± 8 mm, <i>p</i> = 0.001). All patients demonstrated a significant decrease in LVEDD as well as a reduction in severity of mitral and tricuspid regurgitation during 1 year after LVAD implantation, reflecting left ventricular unloading through the LVAD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Larger left and right ventricular diameters before LVAD predict the occurrence of VAs after LVAD implantation in ICM and NICM patients. Persistent RV remodeling post-LVAD is also associated with VAs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 2","pages":"387-395"},"PeriodicalIF":2.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jce.16539","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836025","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":"A Supraventricular Tachycardia With the Atrial Interval Variability: What Is the Mechanism?","authors":"Atsushi Doi, Kazuya Sugioka, Takuya Tsukamoto, Sawa Tanaka, Naoko Takaoka, Toshiharu Iwamura, Takahiko Kawarabayashi, Daiju Fukuda","doi":"10.1111/jce.16536","DOIUrl":"10.1111/jce.16536","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 2","pages":"517-520"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813298","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 Giant Left Atrial Appendage Aneurysm With Incessant Atrial Tachycardia","authors":"Hui-Qiang Wei, Yumei Xue, Shulin Wu, Hongtao Liao","doi":"10.1111/jce.16529","DOIUrl":"10.1111/jce.16529","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Left atrial appendage aneurysm (LAAA) is a rare congenital cardiac anomaly that involves the progressive dilatation of the left atrial appendage (LAA), predisposing the patient to serious complications such as atrial tachyarrhythmias, life-threatening systemic thromboembolism, and cardiac dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>We described a case of a 36-year-old woman with incessant atrial tachycardia (AT) originating from LAAA, which surgical intervention successfully terminated AT after attempted ablation failed. The AT terminated after the LAA was excised. There was no recurrence at the follow-up period of 3 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We present and discuss the management of rare incessant AT arising from giant LAAA where the localization was confirmed on electroanatomic mapping. LAA resection via video-assisted thoracoscopic surgery is minimally invasive approach to manage the LAAA AT, uniformly considered safe and successful.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 2","pages":"531-534"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813296","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":"Efficacy and Safety of High-Power Short-Duration Ablation for Cavo-Tricuspid Isthmus With a Flexible-Tip Temperature-Controlled Power Regulation Catheter Performed by Electrophysiology Trainees","authors":"Hidehiro Iwakawa, Masateru Takigawa, Kosuke Nakada, Tasuku Yamamoto, Takashi Ikenouchi, Mayumi Masumura, Miho Negishi, Iwanari Kawamura, Kentaro Goto, Takatoshi Shigeta, Takuro Nishimura, Tomomasa Takamiya, Susumu Tao, Shinsuke Miyazaki, Masahiko Goya, Hiroyuki Watanabe, Tetsuo Sasano","doi":"10.1111/jce.16516","DOIUrl":"10.1111/jce.16516","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The suitability of high-power short-duration (HPSD) cavo-tricuspid isthmus ablation (CTI-Abl) for electrophysiology (EP) trainees, as well as the underlying mechanisms of its efficacy, remain unknown. The aim of this study was to clarify the efficacy and safety of HPSD CTI-Abl performed by EP trainees and assess lesion characteristics between HPSD and moderate-power long duration (MPLD) ablations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Study 1: CTI-Abl was performed by first- to fourth-year EP trainees in consecutive 113 patients (67 ± 11 years, 27.2% female). Study cohort was historically divided into three groups: MPLD (30–35 W for up to 30 s) using TactiCath (TC-MPLD, <i>N</i> = 38) and MPLD and HPSD (50 W for 12 s) using TactiFlex (TF-MPLD, <i>N</i> = 23; TF-HPSD, <i>N</i> = 52). Primary endpoint was first-pass bidirectional isthmus block (BIB). Study 2: lesion geometries created by each ablation strategy were compared using an ex-vivo model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Study 1: TF-HPSD ablation strategy demonstrated a higher success rate of first-pass BIB than MPLD protocol (TC-MPLD, 58%; TF-MPLD, 48%; TF-HPSD, 94%, <i>p</i> < 0.001), without any complications. TF-HPSD group was associated with shorter total procedure and RF application times, as well as fewer ablation points and gaps, compared to the MPLD groups. Study 2: TF-HPSD created greater lesion surface length, width, and area than MPLD strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HPSD CTI-Abl performed by EP trainees using TactiFlex SE catheter demonstrated a higher first-pass BIB rate, shorter total procedure and RF application times, and fewer ablation points and gaps compared to the conventional method, without increasing complication rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 2","pages":"367-375"},"PeriodicalIF":2.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813300","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}
Ahmad Keelani, Obaida Alothman, Georgi Borisov, Markus Frommhold, Lorenzo Bartoli, Hytham Abdelwahab, Gabriele D'Ambrosio, Sultan Al Shehri, Santi Raffa, J. Christoph Geller
{"title":"Feasibility and Clinical Efficacy of Focal Pulsed Field Ablation in Patients With Non-Pulmonary Vein Triggered Atrial Arrhythmia From the Superior Caval Vein","authors":"Ahmad Keelani, Obaida Alothman, Georgi Borisov, Markus Frommhold, Lorenzo Bartoli, Hytham Abdelwahab, Gabriele D'Ambrosio, Sultan Al Shehri, Santi Raffa, J. Christoph Geller","doi":"10.1111/jce.16510","DOIUrl":"10.1111/jce.16510","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In patients with atrial arrhythmias originating from the superior vena cava (SVC), the use of radiofrequency energy to isolate the SVC is associated with a significant risk of injury both to the phrenic nerve and the sinus node. Pulsed field ablation (PFA) may overcome the disadvantages of thermal energy and improve both ablation efficacy and safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We report the feasibility, safety, and clinical efficacy of focal monopolar PFA in patients with the origin of their atrial arrhythmia in the SVC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nine patients (7 men, age 66 ± 8 years) with SVC-induced paroxysmal AF (<i>n</i> = 3), persistent AF (<i>n</i> = 5), or frequent premature atrial beats (<i>n</i> = 1) underwent SVC isolation using focal monopolar PFA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Acute circumferential SVC isolation was achieved in all cases, using 22 Ampere (A) or 25 A in areas with or without phrenic capture, respectively. The safety profile was excellent: two patients had transient sinus arrest and two had transient phrenic nerve stunning. Sinus node and phrenic nerve function recovered during the procedure, and no permanent damage was observed at follow-up. Coronary vasospasm occurred (and quickly resolved after injection of nitroglycerin) in one patient during additional ablation of a focal atrial tachycardia at the coronary sinus ostium. Kidney function remained stable before and after ablation in all patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this patient cohort with SVC-triggered atrial arrhythmia, isolation using focal monopolar PFA was feasible, effective, and safe. No permanent injury to the phrenic nerve or sinus node was observed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 2","pages":"359-366"},"PeriodicalIF":2.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800903","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":"Brugada Phenocopy Induced by BRAF and MEK Inhibitors in a Lung Adenocarcinoma","authors":"Leonardo Portolan, Alessandro Ruzzarin, Francesca Vassanelli, Flavio Ribichini, Giacomo Mugnai","doi":"10.1111/jce.16533","DOIUrl":"10.1111/jce.16533","url":null,"abstract":"<div>\u0000 \u0000 <p>Management of patients with drug-induced type 1 Brugada pattern is complex and controversial. We report the case of a 66-year-old man affected by metastatic lung adenocarcinoma with type 1 Brugada phenocopy at electrocardiogram (ECG) after initiation of an oncological therapy with BRAF and MEK inhibitors.</p></div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 2","pages":"528-530"},"PeriodicalIF":2.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800898","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}
Justin Pieper, Sapan Bhuta, Michael Poliner, Brian J Hansen, Chad C Ward, Salvatore J Savona, Ralph S Augostini, Steven J Kalbfleisch, Muhammad R Afzal, Mahmoud Houmsse, Emile G Daoud, John D Hummel
{"title":"Incidence and Predictors of Adverse Events Among Patients Awaiting Left Atrial Appendage Closure.","authors":"Justin Pieper, Sapan Bhuta, Michael Poliner, Brian J Hansen, Chad C Ward, Salvatore J Savona, Ralph S Augostini, Steven J Kalbfleisch, Muhammad R Afzal, Mahmoud Houmsse, Emile G Daoud, John D Hummel","doi":"10.1111/jce.16502","DOIUrl":"https://doi.org/10.1111/jce.16502","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of data regarding the optimal timing of left atrial appendage closure (LAAC) and whether scheduling delays increase the risk for adverse outcomes.</p><p><strong>Objectives: </strong>This study sought to assess the incidence and predictors of adverse events among patients awaiting LAAC.</p><p><strong>Methods: </strong>This single-center retrospective study assessed all patients who underwent LAAC from January 2017 to March 2020. The primary study endpoints were the rate and characteristics of adverse events occurring from the time of initial shared decision to pursue LAAC until the time of LAAC. Adverse events were defined as clinically significant bleeding or anemia, thromboembolic complications, or death. Patients were censored after successful closure or the first adverse event.</p><p><strong>Results: </strong>Two hundred and sixty-five patients underwent LAAC with demographics notable for age 73.5 ± 8.1 years, 98 (37%) females, left ventricular ejection fraction 52.3% ± 10.4%, CHA<sub>2</sub>DS<sub>2</sub>-VASc 4.8 ± 1.4, and HAS-BLED 3.2 ± 1.2. Median time from shared decision to insurance approval and insurance approval to LAAC were 18 (IQR 28) and 44 (IQR 40) days, respectively. Seventeen (6%) patients suffered an adverse event, including 15 (88%) cases of bleeding or anemia and 2 (12%) cases of thromboembolism. Multivariate analysis demonstrated that increased time to LAAC (odds ratio [OR] 1.31, 95% confidence interval [CI] [1.15, 1.50], p < 0.001) and higher HAS-BLED score (OR 1.67, CI [1.11, 2.59], p = 0.017) were associated with significantly increased risk for adverse events.</p><p><strong>Conclusion: </strong>Prolonged time to LAAC and higher HAS-BLED score portend an increased risk for adverse events while awaiting LAAC. Expedited closure is warranted in high-risk patients.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800819","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":"Unique Feature of Catheter Ablation for Tachyarrhythmia in Pediatric Patients","authors":"Naoya Kataoka, Teruhiko Imamura","doi":"10.1111/jce.16527","DOIUrl":"10.1111/jce.16527","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 2","pages":"550-551"},"PeriodicalIF":2.3,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794745","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}