Journal of Interventional Cardiac Electrophysiology最新文献

{"title":"Association between left atrial slow conduction velocity and recurrence of atrial fibrillation: a prospective study based on high-density mapping.","authors":"Dan Qi, Xiaonan Guan, Xiaoqing Liu, Lifeng Liu, Zheng Liu, Jianjun Zhang","doi":"10.1007/s10840-025-02052-5","DOIUrl":"https://doi.org/10.1007/s10840-025-02052-5","url":null,"abstract":"<p><strong>Background: </strong>The level of atrial remodeling is closely related to the recurrence of atrial fibrillation (AF). Although structural remodeling has been extensively evaluated, methods for assessing atrial electrical remodeling have not been established. The purpose of our study is to investigate the relationship between atrial conduction velocity and the recurrence of atrial fibrillation (AF) following radiofrequency ablation with pulmonary vein isolation.</p><p><strong>Methods and results: </strong>We prospectively enrolled 155 patients with paroxysmal atrial fibrillation who underwent their first AF ablation at our center. High-density bipolar voltage mapping was conducted during sinus rhythm in all patients. A coherent mapping was constructed to accurately evaluate the total conduction time, distance, and left atrial conduction velocity (LACV) on the anterior, posterior, and septal routes between the earliest and latest activation sites during sinus rhythm. Out of the patients, 24 experienced a recurrence of AF. The LACV was significantly lower in the patients with AF recurrence compared to those without (anterior, 0.81 ± 0.03 vs. 1.07 ± 0.02 m/s, p < 0.01; posterior, 1.06 ± 0.05 vs. 1.32 ± 0.03 m/s, p < 0.01; septal, 0.91 ± 0.05 vs. 1.13 ± 0.02 m/s, p < 0.01). A multivariate logistic analysis, which included age, left atrial diameter (LAD), LA low-voltage area, P-wave duration, and LA conduction velocity, demonstrated that a slow anterior left atrial conduction velocity (LACV) was an independent predictor of AF recurrence with an adjusted odds ratio of 1.64 (95% confidence interval [CI]: 1.24-3.78, p < 0.01). ROC curve analysis confirmed that the anterior LACV was the most accurate predictor of AF recurrence after pulmonary vein isolation (PVI) with a cut-off value of 0.83 m/s, a sensitivity of 93.9%, and a specificity of 70.8%. Anterior LACV was lower in patients with low-voltage areas than in those without low-voltage areas (0.81 ± 0.03 vs. 1.09 ± 0.02 cm/s, p < 0.01).</p><p><strong>Conclusion: </strong>An anterior LACV < 0.83 m/s was identified as a strong independent predictor of AF recurrence after PVI in patients with paroxysmal AF.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028945","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":"Unintended isolation of the left atrial appendage: a rare complication of pulsed-field ablation.","authors":"Yuki Takai, Yuya Nakamura, Taku Asano, Toshiro Shinke","doi":"10.1007/s10840-025-02055-2","DOIUrl":"https://doi.org/10.1007/s10840-025-02055-2","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011404","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":"Right bundle branch block pattern with right ventricular pacing in arrhythmogenic right ventricular cardiomyopathy.","authors":"Adrian M Petzl, Michael I Gurin, Francis E Marchlinski","doi":"10.1007/s10840-025-02051-6","DOIUrl":"https://doi.org/10.1007/s10840-025-02051-6","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013858","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":"Feasibility of deep sedation for catheter ablation of atrial fibrillation using pulsed field ablation.","authors":"Romil Patel, Riya Sam, Lavisha Singh, Westby Fisher, Mark Metzl, Jose Nazari, Alex Ro, Hany Demo, Jeremiah Wasserlauf","doi":"10.1007/s10840-025-02050-7","DOIUrl":"https://doi.org/10.1007/s10840-025-02050-7","url":null,"abstract":"<p><strong>Introduction: </strong>Pulsed field ablation (PFA) is a non-thermal energy source for catheter ablation associated with shorter procedure time, less risk of esophageal injury, and less dependence on absolute catheter stability compared with radiofrequency ablation. Limited data are available on performing the procedure with deep sedation (DS) as an alternative to general anesthesia (GA) utilizing endotracheal intubation.</p><p><strong>Methods: </strong>Patients who underwent PFA using DS between March and August 2024 were retrospectively included. DS was administered by anesthesia staff, consisting of propofol, dexmedetomidine, fentanyl, and midazolam, at the discretion of the practitioner. The primary endpoint was the rate of airway complications or requirement for conversion to GA. Secondary endpoints were the rate of acute procedural success, total time in the EP lab, procedure time, and non-procedure time.</p><p><strong>Results: </strong>A total of 100 patients (mean age 71.9 ± 11.6 years, BMI 30.1 ± 7.1, 51% females) were included in the analysis. There were no instances of airway complications or conversion from DS to GA. There was a 100% rate of acute isolation of pulmonary veins. The average total time in the lab was 149.7 ± 44.7 min, consisting of a mean procedure time of 98.3 ± 40.5 min and a non-procedure time of 51.4 ± 12.2 min.</p><p><strong>Conclusions: </strong>In this study conducted at a single health system, DS for PFA was feasible and associated with no instances of airway complications nor conversion to GA. The findings may not apply to patients with moderate or severe obstructive sleep apnea or other pulmonary diseases.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027124","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":"Comparing efficacy and safety between pulsed field ablation, cryoballoon ablation and high-power short duration radiofrequency ablation in atrial fibrillation: a systematic review and network meta-analysis.","authors":"Natee Deepan, Adivitch Sripusanapan, Narut Prasitlumkum, Noppachai Siranart, Ronpichai Chokesuwattanaskul, Leenhapong Navaravong, Jakrin Kewcharoen, Patavee Pajareya, Nithi Tokavanich","doi":"10.1007/s10840-025-02033-8","DOIUrl":"https://doi.org/10.1007/s10840-025-02033-8","url":null,"abstract":"<p><strong>Background: </strong>Pulsed field ablation (PFA) and high-power short-duration radiofrequency ablation (HPSD) are emerging techniques for treating atrial fibrillation (AF), offering promising results compared to cryoballoon ablation (CBA). This network meta-analysis aims to evaluates the efficacy and safety of PFA, HPSD, and CBA.</p><p><strong>Method: </strong>PubMed, Scopus and Cochrane Central Register of Controlled Trials were systematically searched for relevant studies until October 2024. The primary outcome is freedom from atrial arrhythmia. A random-effects model was used for data synthesis, and P-scores were employed for outcome ranking. Point estimation (odd ratios) was calculated for comparisons.</p><p><strong>Results: </strong>Eighteen studies were included in our network meta-analysis, involving 7,071 atrial fibrillation patients. Among them, 2,023 (29%), 3,725 (53%), and 1,323 (18%) patients underwent PFA, CBA, and HPSD, respectively. PFA demonstrated a higher freedom from atrial arrhythmia, with an odds ratio (OR) of 3.63 (95% CI: 2.95-4.46) compared to CBA and 1.89 (95% CI: 1.47-2.43) compared to HPSD. However, PFA was associated with a higher risk of complications (OR = 6.54, 95% CI: 2.13-20.00) compared to CBA, while HPSD showed an insignificant association with a lower risk of complications compared to CBA (OR = 0.61, 95% CI: 0.15-2.42). PFA had the shortest procedural time (P-score: 100%), while HPSD had the longest (P-score: 0%). In contrast, HPSD had the shortest fluoroscopic time, with P-scores of 100%, 46%, and 3% for HPSD, PFA, and CBA, respectively.</p><p><strong>Conclusion: </strong>PFA demonstrated higher efficacy but also a higher risk of complications compared to HPSD and CBA. HPSD showed greater efficacy with comparable safety to CBA.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017642","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":"Pulsed field ablation-based pulmonary vein isolation utilizing a simplified approach or a standard approach-insights from the fast and furious PFA study.","authors":"Christian-H Heeger, Leonie Zetzsch, Charlotte Eitel, Jan-Per Wenzel, Sorin Ștefan Popescu, Henning Rolfes, Sascha Hatahet, Behnam Subin, Karl-Heinz Kuck, Roland R Tilz","doi":"10.1007/s10840-025-02046-3","DOIUrl":"https://doi.org/10.1007/s10840-025-02046-3","url":null,"abstract":"<p><strong>Background: </strong>Pulsed field ablation (PFA) is a novel non-thermal energy source. Recently, we developed a tailored and streamlined pulmonary vein isolation (PVI) approach utilizing a pentaspline PFA catheter via a single access, single catheter approach. This study was aimed at comparing safety, efficacy, and follow-up of this approach with a conventional approach.</p><p><strong>Methods and results: </strong>Fifty consecutive patients with atrial fibrillation (AF) underwent first-time PVI via PFA under deep sedation. The first 25 patients were treated with a conventional approach utilizing two femoral vein access sheath inclusive utilization of 3D mapping and a coronary sinus catheter (conventional approach, control group). The second 25 patients were treated via a simplified single venous, single transseptal puncture, single catheter approach utilizing a vascular closure system (Fast and Furious PFA approach, FAST group). A total of 194 PVs were identified and isolated with PFA only (100%). The median procedural time was 26 (25, 30) min (FAST) and 65 (59, 72) min (control), respectively (P < 0.0001). The median fluoroscopy time was 5 (4, 7) min (FAST) and 12 (10, 14) min (control), respectively (P < 0.001). Freedom from AF recurrence at 12 months was 77% for the FAST group (vs.</p><p><strong>Control: </strong>81%, P = 0.856, and overall: 79%).</p><p><strong>Conclusion: </strong>The combination of a single venous puncture, single transseptal puncture approach utilizing PFA and vascular closure device resulted in a 100% rate of acute PVI and fast procedure with comparable safety, acute efficacy and 12-month outcome to the conventional approach.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028946","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":"Incidence of pacing-induced cardiomyopathy: left bundle branch area pacing versus leadless pacing.","authors":"Maya Chopra, Ji-Cheng Hsieh, William Mueller, Eric D Braunstein, Stuart Beldner, Raman L Mitra, Laurence M Epstein, Jonathan Willner, James K Gabriels","doi":"10.1007/s10840-025-02048-1","DOIUrl":"https://doi.org/10.1007/s10840-025-02048-1","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic right ventricular (RV) pacing are at risk for developing pacing-induced cardiomyopathy (PICM). Data regarding the incidence of PICM when pacing the RV septum using a leadless pacemaker (LP) are limited. Left bundle branch area pacing (LBBAP) has emerged as a viable alternative to RV pacing with a low incidence of PICM.</p><p><strong>Methods: </strong>All patients who received either a LP capable of providing atrioventricular (AV) synchronous pacing or a permanent pacemaker (PPM) with a LBBAP lead (lumenless or stylet-driven leads) for AV block between January 2021 and January 2023 at a single center were screened. Patients were included in the final analysis if they had both a pre- and post-operative transthoracic echocardiogram, pre- and post-operative electrocardiograms, and a pacing burden of ≥ 20%. The incidence of PICM, defined as a decrease in the left ventricular ejection fraction (LVEF) by ≥ 20% and to a value < 50% after a follow-up of at least six months, was compared between LBBAP and LP groups.</p><p><strong>Results: </strong>Over the study period, 533 PPMs were implanted for AV block. Of these, 95 patients met the inclusion criteria; 70 underwent LBBAP and 25 received LPs. The average age of the population was 75 ± 13 years; 64 (63%) were men. There was no difference in the mean pre-operative LVEF (57% ± 16% vs. 61% ± 10%; p = 0.25) or QRS duration (123 ± 33ms vs. 130 ± 29ms) between the LBBAP and LP groups. There was a high burden of ventricular pacing in both groups (90% ± 19% vs. 92% ± 13%; p = 0.52). After a follow-up of 14 ± 8 months, the incidence of PICM was significantly lower in the LBBAP group compared to the LP group (4.3% vs. 24%; p = 0.0039).</p><p><strong>Conclusion: </strong>In patients who are not candidates for cardiac resynchronization, who require a high burden of ventricular pacing, LBBAP may lead to a lower incidence of PICM than right ventricular septal pacing with a LP.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986008","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":"Preoperative skin antiseptics for the prevention of cardiac implantable electronic device infections: chlorhexidine-alcohol versus povidone-iodine-alcohol.","authors":"Antoine Da Costa, Lucas Ovache, Sarah Chellali, Jean Baptiste Guichard, Cécile Romeyer, Cedric Yvorel, Karim Benali","doi":"10.1007/s10840-025-02049-0","DOIUrl":"https://doi.org/10.1007/s10840-025-02049-0","url":null,"abstract":"<p><strong>Background: </strong>Skin antisepsis plays a key role in the prevention of cardiac implantable electronic device (CIED) infections. Moreover, skin antisepsis by chlorhexidine-alcohol has not yet been fully evaluated.</p><p><strong>Objectives: </strong>This single-center controlled study sought (1) to conduct a prospective observational analysis comparing two antiseptic skin preparations over two similar consecutive time periods, one conducted over a 1-year period using a povidone-iodine-alcohol solution (group I) and the other over the following year with a chlorhexidine-alcohol solution (group II) and (2) to determine real-life CIED infection predictive factors using the Prevention of Arrhythmia Device Infection Trial (PADIT) score.</p><p><strong>Methods and results: </strong>CIED implantations were performed in 1689 patients. A total of 17 patients (1.01%) developed a CIED infection. Long-term follow-up (16 ± 13 months) revealed no significant differences between groups: infections were observed in 9/844 patients (1.07%) in group I versus 8/845 patients (0.95%) in group II (p = 0.99). Univariate and multivariate logistic regression analyses were performed to identify infectious risk factors. Adjusted odds ratios (ORs) and hazard ratios (HRs) were calculated. Univariate analyses revealed that infection occurrence was positively correlated with acute heart failure (OR: 3.55; 95%CI [1.24-9.37]; p = 0.01 and HR: 3.37; 95% CI [1.28-8.87]; p = 0.014), renal failure (OR: 2.71; 95% CI [0.88-8.42]; p = 0.08 and HR: 2.99; 95% CI [0.97-9.17]; p = 0.05), use of temporary pacing before the implantation procedure (OR: 4.45; 95% CI [1.003-20.3]; p = 0.04 and HR: 4.35; 95% CI [0.99-19.05]; p = 0.05), PADIT score (OR: 1.3; 95% CI [1.064-1.54]; p = 0.009 and HR: 1.27; 95% CI [1.052-1.53]; p = 0.013), and PADIT score ≥ 5 (OR: 4.185; 95% CI [1.6-10.9]; p = 0.003 and HR: 3.91; 95% CI [1.51-10.149]; p = 0.005). No clear significant difference was found regarding the antiseptic skin preparation choice (OR: 0.88; 95% CI [0.34-2.3]; p = 0.8 and HR: 1.11; 95% CI [0.416-2.98]; p = 0.82). In multivariate analysis, the PADIT score ≥ 5 (OR: 3.18; 95% CI [1.125-8.99]; p = 0.003 and HR: 3.052; 95% CI [1.089-8.55]; p = 0.034) and use of temporary pacing before the implantation procedure (OR: 8.44; 95% CI [1.68-42.34]; p = 0.01 and HR: 8.49; 95% CI [1.732-41.69]; p = 0.008) were negatively correlated with the device infection risk.</p><p><strong>Conclusion: </strong>This study found that chlorhexidine-alcohol and povidone-iodine-alcohol solutions displayed similar antiseptic effects regarding CIED infection prevention. Both use of temporary pacing before the implantation procedure and PADIT score ≥ 5 correlated with the device infection risk.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028075","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":"Integration of automated peak frequency annotation with voltage mapping for identifying ventricular tachycardia ablation sites.","authors":"Sukriye Ebru Onder, Tumer Erdem Guler, Serdar Bozyel, Metin Cagdas, Sadiye Nur Dalgic, Abdulcebbar Sipal, Samet Gecer, Emre Kılıc, Pasquale Santangeli, Tolga Aksu","doi":"10.1007/s10840-025-02045-4","DOIUrl":"https://doi.org/10.1007/s10840-025-02045-4","url":null,"abstract":"<p><strong>Background: </strong>Peak frequency (PF) analysis has emerged as a novel tool for identifying arrhythmogenic substrates in ventricular tachycardia (VT) ablation, particularly when combined with traditional substrate mapping techniques such as voltage mapping and Isochronal Late Activation Mapping (ILAM). This study evaluates the utility of PF analysis in scarred myocardial regions, with a focus on areas containing manually annotated late potentials (LPs).</p><p><strong>Methods: </strong>Electroanatomical mapping using the EnSite X™ system was performed in 20 patients undergoing VT ablation. PF analysis was applied to scarred regions with voltages < 1.5 mV, with and without LPs, to identify zones of high-frequency activity. PF zones (PFZs) were compared to voltage maps and ILAM to assess spatial correlation with deceleration zones (DZs) and their role in defining ablation targets.</p><p><strong>Results: </strong>Peak frequency distributions differed significantly across myocardium conditions (H = 254.92, p < 0.0001). The median peak frequency was 120.0 Hz (77.3-179.0 Hz) in normal voltage myocardium, 145.0 Hz (100.0-194.3 Hz) in low-voltage myocardium without LPs, and 291.0 Hz (190.3-380.3 Hz) in low-voltage myocardium with LPs. Pairwise comparisons showed significant differences: normal voltage vs. low voltage without LPs (U = 46,455.0; p = 0.0019), normal voltage vs. low voltage with LPs (U = 20,935.5; p < 0.0001), and low voltage without LPs vs. low voltage with LPs (U = 19,548.0; p < 0.0001). PFZs exhibited strong colocalization with DZs identified via ILAM, with > 50% spatial overlap in most cases. The automated peak frequency annotation algorithm demonstrated high reproducibility, significantly reducing operator dependency compared to manual annotation.</p><p><strong>Conclusion: </strong>PF analysis provides a robust and reproducible method for identifying arrhythmogenic substrates in VT ablation. When integrated with voltage mapping and ILAM, it facilitates precise localization of critical ablation targets, particularly in regions with LPs. These findings highlight the potential of PF analysis to enhance the efficacy of substrate-based ablation strategies.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970048","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":"Clinical phenotypes and outcomes associated with improved left ventricular ejection fraction after biventricular pacing.","authors":"Sameer A Kunte, Lurdes Y T Inoue, William T Abraham, John G F Cleland, Anne B Curtis, Daniel J Friedman, Michael R Gold, Valentina Kutyifa, Cecilia Linde, Anthony S Tang, Gillian D Sanders, Sana M Al-Khatib","doi":"10.1007/s10840-025-02040-9","DOIUrl":"https://doi.org/10.1007/s10840-025-02040-9","url":null,"abstract":"<p><strong>Background: </strong>In some patients who receive a cardiac resynchronization therapy (CRT) device, the left ventricular ejection fraction (LVEF) does not improve.</p><p><strong>Methods: </strong>We analyzed patients enrolled in the REVERSE, MADIT-CRT, and BLOCK-HF trials, restricting the analysis to those who received CRT. Characteristics of patients with or without improved LVEF were compared using two sample t-tests and Pearson's chi-square tests. Kaplan-Meier survival curves were constructed to display time-to-event data. A log-rank test was used to compare event rates for patients with or without improved LVEF. Mixed effects Cox Proportional-Hazards models adjusting for covariates were used to analyze time to death or heart failure hospitalization (HFH) and time to death.</p><p><strong>Results: </strong>Of 1065 included patients, 75% (802) were men, 87% (793) were White, 11% (118) were Black, and 7% (72) were Hispanic. LVEF improved in 910 (85%) patients and did not in 155 (15%). Patients with an improved LVEF were less likely to have ischemic cardiomyopathy (ICM) (54% vs 76%; p = 0.004), more likely to have LBBB (73% vs 53%; p = < 0.001), and had longer QRS duration (159 vs 150 ms; p = < 0.001). In adjusted analyses, improved LVEF was associated with a longer time to HFH or death (HR 0.40; 95% CI 0.26-0.62; p < 0.001) or death alone (HR 0.27; 95% CI 0.15-0.48; p < 0.001).</p><p><strong>Conclusions: </strong>Patients with improvement in LVEF post-CRT implantation are less likely to have ICM and more likely to have LBBB and a longer QRS interval. Improvement in LVEF was associated with better outcomes.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011464","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}