Journal of Interventional Cardiac Electrophysiology最新文献

{"title":"Reduction in atrial and ventricular electrical heterogeneity following pulmonary vein isolation in patients with atrial fibrillation.","authors":"Guilherme L Fialho, Bruce D Nearing, Jonathan W Waks, Timothy R Maher, John-Ross Clarke, Alyssa Shepherd, Andre D'Avila, Richard L Verrier","doi":"10.1007/s10840-023-01543-7","DOIUrl":"10.1007/s10840-023-01543-7","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary vein isolation (PVI) modulates the intrinsic cardiac autonomic nervous system and reduces atrial fibrillation (AF) recurrence.</p><p><strong>Methods: </strong>In this retrospective analysis, we investigated the impact of PVI on ECG interlead P-wave, R-wave, and T-wave heterogeneity (PWH, RWH, TWH) in 45 patients in sinus rhythm undergoing clinically indicated PVI for AF. We measured PWH as a marker of atrial electrical dispersion and AF susceptibility and RWH and TWH as markers of ventricular arrhythmia risk along with standard ECG measures.</p><p><strong>Results: </strong>PVI acutely (16 ± 8.9 h) reduced PWH by 20.7% (from 31 ± 1.9 to 25 ± 1.6 µV, p < 0.001) and TWH by 27% (from 111 ± 7.8 to 81 ± 6.5 µV, p < 0.001). RWH was unchanged after PVI (p = 0.068). In a subgroup of 20 patients with longer follow-up (mean = 47 ± 3.7 days after PVI), PWH remained low (25 ± 1.7 µV, p = 0.01), but TWH partially returned to the pre-ablation level (to 93 ± 10.2, p = 0.16). In three individuals with early recurrence of atrial arrhythmia in the first 3 months after ablation, PWH increased acutely by 8.5%, while in patients without early recurrence, PWH decreased acutely by 22.3% (p = 0.048). PWH was superior to other contemporary P-wave metrics including P-wave axis, dispersion, and duration in predicting early AF recurrence.</p><p><strong>Conclusion: </strong>The rapid time course of decreased PWH and TWH after PVI suggests a beneficial influence likely mediated via ablation of the intrinsic cardiac nervous system. Acute responses of PWH and TWH to PVI suggest a favorable dual effect on atrial and ventricular electrical stability and could be used to track individual patients' electrical heterogeneity profile.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"335-346"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9752362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stellate ganglia stimulation counteracts vagal stimulation by significantly increasing heart rate and blood pressure.","authors":"Ammar M Killu, Mei Yang, Niyada Naksuk, Jason Tri, Xuping Li, Roshini Asirvatham, Samuel J Asirvatham, Yong-Mei Cha","doi":"10.1007/s10840-023-01516-w","DOIUrl":"10.1007/s10840-023-01516-w","url":null,"abstract":"<p><strong>Background: </strong>Vasovagal syncope (VVS) is the leading cause of syncope. The most frequent mechanism is that of a cardioinhibitory response, vasodepressor response, or mixture of both. Neural stimulation that negates or overcomes the effects of vagal tone may be used as a treatment strategy for VVS.</p><p><strong>Methods: </strong>Six male canines were studied. Stimulation (10-Hz, 2 ms pulse duration, 2 min duration) of the cervical vagus (CV), thoracic vagus (TV), and stellate ganglia (SG) was performed using needle electrodes at 3 V, 5 V, and 10 V output. SG stimulation at an output of 10 V overlaying TV stimulation at the same output was performed. Heart rate (HR), blood pressure (BP), and cardiac output (CO) were measured before, during, and after stimulation.</p><p><strong>Results: </strong>Right cervical vagal stimulation was associated with significant hemodynamic changes. HR, SBP, and DBP were reduced (107 ± 16 vs. 78 ± 15 bpm [P < 0.0001], 116 ± 24 vs. 107 ± 28 mmHg [P = 0.002] and 71 ± 18 vs. 58 ± 20 mmHg [P < 0.0001]), respectively, while left cervical vagal stimulation had minimal changes. CV stimulation was associated with greater hemodynamic changes than TV stimulation. Left and right SG stimulation significantly increased systolic blood pressure (SBP), diastolic blood pressure (DBP), and HR at 5 V and 10 V, which could be observed within 30 s after stimulation. An output-dependent increase in hemodynamic parameters was seen with both left and right SG stimulation. No difference between left and right SG stimulation was seen. SG stimulation overlay significantly increased HR, BP, and CO from baseline vagal stimulation bilaterally.</p><p><strong>Conclusions: </strong>Stellate ganglia stimulation leads to increased HR and BP despite significant vagal stimulation. This may be exploited therapeutically in the management of vasovagal syncope.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"219-231"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9085426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative meta-analysis of addition of ganglionic plexus ablation versus no ganglionic plexus ablation to pulmonary vein isolation for atrial fibrillation.","authors":"Ashish Kumar, Mariam Shariff, Jose Carlos Pachon, Juan C Zerpa Acosta, Christopher V DeSimone, John Stulak, Malini Madhavan, Abhishek J Deshmukh, Gurukripa N Kowlgi","doi":"10.1007/s10840-024-01945-1","DOIUrl":"10.1007/s10840-024-01945-1","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"347-350"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stellate ganglion block for refractory ventricular arrhythmias: an updated systematic review.","authors":"Yong Hao Yeo, Jia Yean Thong, Min-Choon Tan, Justin Z Lee, Jian Liang Tan, Timothy Markman, Pattara Rattanawong","doi":"10.1007/s10840-025-02009-8","DOIUrl":"10.1007/s10840-025-02009-8","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"427-431"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focal pulsed field ablation for guiding and assessing the acute effect of cardioneuroablation.","authors":"Ivan Sikiric, Zrinka Jurisic, Toni Breskovic, Marina Juric-Paic, Nina Berovic, Josip Kedzo, Ivan Pletikosic, Tolga Aksu, Ante Anic","doi":"10.1007/s10840-023-01716-4","DOIUrl":"10.1007/s10840-023-01716-4","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"479-481"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139570558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-procedural inappropriate sinus tachycardia after cardioneural ablation for malignant swallow syncope.","authors":"Nikhila Chelikam, Aashish Katapadi, Naga Venkata K Pothineni, Rakesh Gopinathannair, Rajesh Kabra, Rangarao Tummala, Andrea Yang, Dhanunjaya Lakkireddy, Douglas Darden","doi":"10.1007/s10840-024-01893-w","DOIUrl":"10.1007/s10840-024-01893-w","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"277-279"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of cardiac sympathetic denervation for ventricular arrhythmias: an updated systematic review and meta-analysis.","authors":"Daniel B Hanna, Ahmadreza Karimianpour, Nicole Mamprejew, Chris Fiechter, Dhiran Verghese, Viviana Navas, Dinesh Sharma","doi":"10.1007/s10840-025-01997-x","DOIUrl":"10.1007/s10840-025-01997-x","url":null,"abstract":"<p><strong>Introduction: </strong>The role of the sympathetic nervous system in the initiation and continuation of ventricular tachyarrhythmias (VTA) is well established. However, whether CSD reduces implantable cardioverter-defibrillator (ICD) shocks and recurrent VTA is still uncertain.</p><p><strong>Methods: </strong>A comprehensive literature search was performed at Medline and Embase until March 2023. The primary outcome was the rate of ICD shocks and VTA per patient-year in our pooled analysis of all included articles. Analyses were conducted using Comprehensive Meta-Analysis software.</p><p><strong>Results: </strong>Initial search yielded 1324 scientific studies with a total of 15 studies fitting our inclusion criteria. ICD shocks at 1 year post-CSD revealed an event rate of 69.8% (95% CI, 56.4-80.4% with 50% heterogeneity) (I² statistic). ICD shocks at 6 months had an event rate of 59.1% (95% CI, 46.9-70.4%; 47 I²). Analysis of our pooled studies showed that 64.3% of individuals achieved freedom from VTA at 1 year post-CSD (95% CI, 42.3-81.5%; 26% I²), while 62.3% were free from recurrent VTA 6 months post-CSD (95% CI, 51.2-72.2%; 40% I²). Time to mortality directly caused by recurrent VTA post-CSD was subdivided into short-term (0-30 days), intermediate-term (31-364 days), and long-term (≥ 365). Mortality for the short-term tertile was 8.9% (95% CI, 5.0-15.4%; 0% I²), medium-term was 5.3% (95% CI, 2.4-11.3%; 0% I²), and long-term 5.2% (95% CI, 2.4-10.9%; 0% I²).</p><p><strong>Conclusion: </strong>CSD seems to be promising as an acceptable treatment strategy for recurrent VTA refractory to traditional pharmacological or ablation therapy.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"415-425"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining cardiac care: the promising horizon of epicardial pulse field ablation for postoperative atrial fibrillation.","authors":"Juan Carlos Zerpa Acosta, Gurukripa N Kowlgi","doi":"10.1007/s10840-024-01806-x","DOIUrl":"10.1007/s10840-024-01806-x","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"475-477"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of immediate catheter ablation of ventricular arrhythmias in patients admitted via the emergency department.","authors":"Jannis Dickow, Nele Gessler, Omar Anwar, Johannes Feldhege, Tim Harloff, Jens Hartmann, Mario Jularic, Rahin Wahedi, Borislav Dinov, Peter Wohlmuth, Stephan Willems, Melanie Gunawardene","doi":"10.1007/s10840-025-02020-z","DOIUrl":"https://doi.org/10.1007/s10840-025-02020-z","url":null,"abstract":"<p><strong>Background: </strong>In patients with ventricular arrhythmias (VA) admitted via the emergency department (ED), immediate catheter ablation (CA-VA) might be indicated to stabilize patients. However, the unstable condition of these patients may increase periprocedural risk. This study evaluated the periprocedural safety of immediate CA-VA in patients admitted via the ED.</p><p><strong>Methods and results: </strong>In total, 223 ED patients who underwent immediate CA-VA from 01/2017 to 12/2022 (mean age 66 ± 13 years, 19% female, 55% heart failure, 59% coronary artery disease) were analyzed in terms of in-hospital outcomes (periprocedural death, pericardial tamponade, thromboembolic events, major bleedings). To address differences to elective patients, ED patients were compared with 784 elective CA-VA patients (mean age 59 ± 15 years, 34% female, 20% heart failure, 33% coronary artery disease, all p < 0.001): ED patients experienced higher rates of periprocedural complications (6.3% vs. 2.0%, p = 0.002) driven by thromboembolic events (2.2% vs. 0.4%, p = 0.02). Life-threatening complications were not different between groups (cardiac tamponade: 2.2% vs. 1.4%, p = 0.56; stroke: 0.9% vs. 0.4%, p = 0.67). Seven ED patients (3.1%) died unrelated to the procedure during hospitalization vs. none in the elective CA-VA group. Emergency admission (OR 3.07, 95% CI 1.48-6.38), age (OR 2.12, 95% CI 1.22-3.70), and heart failure (OR 1.99, 95% CI 0.96-4.15) were independently associated with periprocedural complications and overall death during hospitalization.</p><p><strong>Conclusion: </strong>Patients with VA admitted via the ED were older, sicker, and more often presented with ventricular tachycardia than elective CA-VA patients. Immediate CA-VA was associated with higher rates of periprocedural complications, driven by thromboembolic events; however, no procedure-related death occurred.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of atrial fibrillation ablation in kidney transplant patients.","authors":"Ahmad Keelani, Lorenzo Bartoli, Alessio Gasperetti, Sorin Popescu, Marco Schiavone, Anna Traub, Huong-Lan Phan, Marcel Feher, Thomas Fink, Vanessa Sciacca, Martin Nitschke, Julia Vogler, Charlotte Eitel, Giovanni Forleo, Christian-H Heeger, Roland R Tilz","doi":"10.1007/s10840-025-02006-x","DOIUrl":"https://doi.org/10.1007/s10840-025-02006-x","url":null,"abstract":"<p><strong>Introduction: </strong>Managing atrial fibrillation in kidney transplant patients poses a challenge for both nephrologists and cardiologists. Data regarding the safety and efficacy of catheter ablation in this patient's cohort is scarce.</p><p><strong>Methods and results: </strong>In this two-center prospective study, we included all consecutive kidney transplant patients who underwent atrial fibrillation ablation between April 2017 and March 2022. A 1:3 propensity score matching created a control group of non-transplant AF patients undergoing ablation. We included 16 kidney transplant patients and 48 matched controls. Ablation was successful in all patients. The periprocedural complication rate (6.3% in the kidney transplant group vs. 6.3% in the control group, p value = 1) did not differ between the two groups. One transplant patient experienced graft dysfunction after a complication. At 18 months, AF recurrence-fee rates were 69% in the transplant group and 70.1% in controls (p = 0.95). By the last follow-up, all transplant patients had discontinued antiarrhythmic drugs, while 19.6% of the patients in the control group were treated with antiarrhythmic drugs (p = 0.09). Kidney function in the transplant group remained stable (eGFR 32 [23.8, 40.5] ml/min/1.73 m² before vs. 34 [29.8, 38] ml/min/1.73 m² at last follow up, p = 0.93).</p><p><strong>Conclusions: </strong>This study demonstrates that catheter ablation is a viable option for treating AF in kidney transplant patients, with comparable outcomes to non-transplanted individuals. Discontinuing antiarrhythmic drugs reduces drug interaction risks, but minimizing procedural complications remains critical to preserving graft function.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}