Journal of Interventional Cardiac Electrophysiology最新文献

{"title":"Correction: Management of atrial fibrillation: two decades of progress - a scientific statement from the European Cardiac Arrhythmia Society.","authors":"Samuel Lévy, Gerhard Steinbeck, Luca Santini, Michael Nabauer, Diego Penela, Bharat K Kantharia, Sanjeev Saksena, Riccardo Cappato","doi":"10.1007/s10840-025-02025-8","DOIUrl":"https://doi.org/10.1007/s10840-025-02025-8","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663542","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":"Correction: Ablation catheter with high-density mapping system in patients with atrial fibrillation.","authors":"Ruggero Maggio","doi":"10.1007/s10840-025-02028-5","DOIUrl":"https://doi.org/10.1007/s10840-025-02028-5","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649237","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":"Developing a simple clinical risk score for ibrutinib-associated atrial fibrillation.","authors":"Tyler A Jacobson, Graham Peigh, Ruchi Patel, Ramzy P Issa, Nausheen Akhter","doi":"10.1007/s10840-025-01990-4","DOIUrl":"https://doi.org/10.1007/s10840-025-01990-4","url":null,"abstract":"<p><strong>Background: </strong>Ibrutinib, a Bruton's tyrosine kinase (BTK) inhibitor, is used in the treatment of B-cell malignancies (e.g., chronic lymphocytic leukemia [CLL]). Initial risk stratification of ibrutinib-associated atrial fibrillation (IAAF) may inform atrial fibrillation (AF) surveillance strategies. The performance of existing AF risk scores to predict incident AF among patients newly treated with ibrutinib is unknown.</p><p><strong>Methods: </strong>We conducted a single-center retrospective study of all patients without a history of AF who were treated with ibrutinib (2012-2016). Patient demographics were compared between cohorts by the presence of IAAF within 24 months of treatment initiation. First, the predictive ability of established AF risk models was assessed. Secondly, univariate and multivariate analyses were used to create a new IAAF risk model which was compared to established AF risk models by area under the curve (AUC) analysis.</p><p><strong>Results: </strong>Of 167 patients (66 ± 11 years, 70% male), 24 (14.4%) developed incident IAAF (mean time to IAAF, 7.1 ± 6.3 months). Univariate analysis showed that hypertension (HTN), diabetes (DM), systolic heart failure (HFrEF), and obstructive sleep apnea (OSA) were associated with IAAF. Logistic regression analysis of variables of interest and those with p < 0.1 on univariate analysis demonstrated that left atrial diameter (LAD) > 43 mm and obstructive sleep apnea were independently associated with IAAF. Existing AF risk scores had reasonable performance (AUC, 0.68-0.72). A new simple clinical risk score was developed: OSA 5 points, HFrEF 3 points, DM 2 points, and hyperlipidemia 2 points. This simple IAAF risk score achieved a numerically greater AUC than that of established risk models (AUC = 0.77). There was no statistically significant difference in the AUC performance between risk scores.</p><p><strong>Conclusion: </strong>Among 167 ibrutinib naïve patients, risk factors for incident AF development resemble those of the general population. However, common AF risk models have moderate predictive ability. Large validation studies are needed to confirm the superior IAAF predictive ability of this simple risk score and investigate the incremental predictive value of echocardiographic variables.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649244","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":"\"Double Capture\" - a technique to differentiate narrow complex Supraventricular Tachycardias.","authors":"Elizabeth Woollard, Timothy Ryan, David Yun, Nikola Stoyanov, Vincent Paul, Rafeeq Samie, Anne Powell, Timothy Gattorna, Krishnakumar Nair, Benjamin King","doi":"10.1007/s10840-024-01929-1","DOIUrl":"https://doi.org/10.1007/s10840-024-01929-1","url":null,"abstract":"<p><strong>Background: </strong>There are various diagnostic manoeuvres to distinguish between atrial tachycardia (AT), atrio-ventricular nodal re-entrant tachycardia (AVNRT) and orthodromic re-entrant tachycardia (ORT) when assessing a narrow complex supraventricular tachycardia (SVT) in the electrophysiology (EP) laboratory. These manoeuvres are commonly used in combination to come to a diagnosis due to the inability of a single test to be able to reliably differentiate between the arrhythmias.</p><p><strong>Objective: </strong>To determine whether a single captured His-synchronous simultaneous extra-stimulus in the atrium and ventricle (\"Double Capture\") can reliably distinguish the mechanism of a narrow complex SVT.</p><p><strong>Methods: </strong>At a single institution, we reviewed the data on patients in whom this maneuver was performed as part of their routine electrophysiology study and analyzed the intracardiac recordings. There were 44 patients who underwent routine electrophysiology studies for narrow complex SVTs and the maneuver was attempted. If the simultaneous extra-stimuli was delivered when the His was refractory and captured both the atrium (A) and ventricle (V), the earliest signal was assessed to attempt to differentiate the mechanism.</p><p><strong>Results: </strong>Double Capture was attempted in 44 patients of which six were excluded due to incorrect timing or inadequate electrogram recordings. Of the 38 remaining patients who either had AVNRT or ORT (no atrial tachycardias were included), \"Double Capture\" was achieved in 29 patients (76%). In patients in whom \"Double Capture\" occurred, reproducible termination of the tachyarrhythmia with \"Double Capture\" corresponded with ORT (n = 7). In patients with \"Double Capture\" with a His signal as the first signal post, and ongoing tachycardia, this typically corresponded with a diagnosis of AVNRT (n = 20), though there were two exceptions with ORT (n = 2).</p><p><strong>Conclusion: </strong>In this small study, \"Double Capture\" of the A and V during a sustained narrow complex SVT without change to the tachycardia or His interval timings was able to confirm AVNRT with a specificity of 78% and ORT with a specificity of 100%. This maneuver may be especially helpful to confirm bystander pathways or assess septal pathways.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615600","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":"Transcatheter repair of inferior vena cava baffle stenosis for delivery of intracardiac devices in congenital heart disease.","authors":"Robert N Kerley, Kevin Walsh","doi":"10.1007/s10840-025-02024-9","DOIUrl":"https://doi.org/10.1007/s10840-025-02024-9","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615677","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":"Impact of catheter ablation on atrial fibrillation outcomes in various cardiomyopathies: findings from LGE-MRI quantified atrial fibrosis analysis.","authors":"Ahmad Kassar, Nadia Chamoun, Romanos Haykal, Yaacoub Chahine, Hala Al Yasiri, Tori Hensley, David Owens, Nazem Akoum","doi":"10.1007/s10840-025-02027-6","DOIUrl":"10.1007/s10840-025-02027-6","url":null,"abstract":"<p><strong>Background: </strong>Cardiomyopathy (CM) is associated with atrial remodeling and atrial fibrillation (AF), often complicating rhythm management. Ventricular dysfunction contributes to AF through pressure and volume overload, while AF worsens ventricular function via tachycardia and irregular activation. Evidence suggests catheter ablation improves outcomes in CM patients, though success is influenced by the extent of atrial and ventricular remodeling.</p><p><strong>Methods: </strong>Patients undergoing their first catheter ablation for AF were divided into hypertrophic (HCM), ischemic (ICM), non-ischemic (NICM), and no-CM groups. Pre-ablation late-gadolinium enhancement cardiac magnetic imaging (LGE-MRI) was used to assess left atrial (LA) fibrosis burden and anatomical distribution. Patients were followed prospectively for arrhythmia recurrence.</p><p><strong>Results: </strong>A total of 552 patients, 39 HCM (69% obstructive), 39 ICM, 115 with NICM, and 359 without CM were included between January 2015 and December 2022. LA fibrosis was significantly higher in patients with CM (19.1 ± 7.5% vs. 16.5 ± 6.9%; P = 0.01). HCM and ICM had the greatest LA fibrosis among the different CM subtypes (21.3 ± 8.7% and 21.9 ± 9.1%, respectively). There was no significant difference in the regional distribution of fibrosis among the various groups. AF recurrence was observed in 321 (58.2%) after 456 (175-1204) days. Multivariate analysis revealed that compared to no CM, HCM was associated with a three-fold increase in AF recurrence (HR = 3.07, 95% CI 2.06-4.58, P < 0.001), followed by ICM (HR 1.61, 95%, CI 0.95-2.72; P = 0.07) and NICM (HR of 1.53, 95% CI 1.14-2.06; P = 0.05). LA fibrosis and volume index were independently associated with recurrence (HR = 1.03, 95% CI 1.01-1.06, P = 0.01 and HR = 1.02, 95% CI 1.01-1.03, P = 0.01). Genetic testing revealed key distinctions between HCM and NICM, with MYBPC3 and MYH7 as prominent genes in HCM and a heterogeneous genetic basis in NICM.</p><p><strong>Conclusion: </strong>Hypertrophic cardiomyopathy is associated with the highest risk of AF recurrence followed by ischemic and non-ischemic cardiomyopathy after catheter ablation. LA fibrosis regional patterns did not differ between cardiomyopathy types, while overall fibrosis and volume predicted recurrence.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582273","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":"Correction: Ablation of slow activation areas in addition to pulmonary vein isolation improves the maintenance of the sinus rhythm in patients with persistent atrial fibrillation.","authors":"Li Shu, Zhen Yuan, Yi Lu, Shenghui Ma, Chunhui Liu, Zhejun Cai","doi":"10.1007/s10840-025-02026-7","DOIUrl":"10.1007/s10840-025-02026-7","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572348","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":"Redo ablation procedures to treat recurrent atrial arrhythmias via a pentaspline pulsed field ablation catheter: a prospective, multicenter experience.","authors":"María Cespón-Fernández, Domenico G Della Rocca, Michele Magnocavallo, Andrés Betancur, Ilenia Lombardo, Luigi Pannone, Giampaolo Vetta, Antonio Sorgente, Marco Polselli, Charles Audiat, Alvise Del Monte, Stéphane Combes, Lorenzo Marcon, Ingrid Overeinder, Kazutaka Nakasone, Sahar Mouram, Sanghamitra Mohanty, Stefano Bianchi, Alexandre Almorad, Juan Sieira, Gezim Bala, Erwin Ströker, Pietro Rossi, Andrea Sarkozy, Serge Boveda, Andrea Natale, Carlo de Asmundis, Gian-Battista Chierchia","doi":"10.1007/s10840-025-02021-y","DOIUrl":"https://doi.org/10.1007/s10840-025-02021-y","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing atrial fibrillation (AF) catheter ablation may require redo procedures involving pulmonary vein (PV) re-isolation and/or ablation of extra-PV sites. Pulsed field ablation (PFA) offers a highly selective energy source for cardiac tissue, with the potential to reduce collateral damage to adjacent structures. This study aimed to evaluate the feasibility and efficacy of redo ablation using a pentaspline PFA system.</p><p><strong>Methods: </strong>Patients undergoing redo procedures with a pentaspline PFA system at three international centers were enrolled. A workflow was established based on rhythm at presentation: sinus rhythm (Group 1), atrial flutter/atrial tachycardia (Group 2), or AF (Group 3). Propensity score matching was used for comparison between PFA- and RF-based redo ablations.</p><p><strong>Results: </strong>A total of 117 patients were included (Group 1: 64, Group 2: 18, Group 3: 35). PV re-isolation was required in 71.9% and 72.2% of Group 1 and 2 patients, respectively. PFA terminated all cases of non-cavotricuspid isthmus dependent flutter and 45.7% of cases of AF. One major complication (0.9%; frontal cerebral hematoma) was documented. Freedom from atrial tachyarrhythmias at 12 months was 78.3% (95% CI 69.6-84.8%) without statistically significant differences among groups (Group 1: 85.7%; Group 2: 77%; Group 3: 65.5%; p = 0.053). PFA led to similar arrhythmia freedom compared to RF, but with significantly shorter procedural and dwelling times.</p><p><strong>Conclusion: </strong>The adoption of a pentaspline PFA system for repeat ablation procedures was feasible, safe, and effective at 1-year follow-up. No clinical differences were observed between PFA and RF; however, redo PFA cases were significantly shorter.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557157","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":"An approach to electroanatomical mapping with a pentaspline pulsed field catheter to guide atrial fibrillation ablation.","authors":"Mark T Mills, Peter Calvert, Calum Phenton, Nicole Worthington, Derick Todd, Simon Modi, Reza Ashrafi, Richard Snowdon, Dhiraj Gupta, Vishal Luther","doi":"10.1007/s10840-025-01980-6","DOIUrl":"https://doi.org/10.1007/s10840-025-01980-6","url":null,"abstract":"<p><strong>Background: </strong>Pulsed field ablation (PFA) of atrial fibrillation (AF) using a pentaspline multi-electrode catheter is commonly performed under fluoroscopic guidance. No data exist on the integration of this catheter within a three-dimensional electroanatomical mapping (3D-EAM) system for left atrial voltage and activation mapping, posterior wall isolation (PWI), or redo ablation. This technical report reviews an approach whereby mapping is performed using the pentaspline PFA catheter itself within an open architectural impedance-based 3D-EAM system.</p><p><strong>Methods: </strong>Cases involved mapping with the PFA catheter itself, with real-time visualisation of the guidewire tip and catheter within the 3D-EAM system. In certain cases, additional 3D-EAM was performed with a grid-style high-density mapping catheter for comparison.</p><p><strong>Results: </strong>In a series of 22 patients (45% female, mean age 63 ± 13 years, 55% paroxysmal AF, 27% redo procedures), mapping increased procedural times (mean 108 min vs. 68 min in fluoroscopy-only controls), without reducing fluoroscopy times. Three potential advantages of mapping with the PFA catheter were identified: (1) The technique helped identify sleeves of incomplete pulmonary vein isolation after index applications. (2) In the four cases mapped with both the PFA and grid-style catheters, voltage maps appeared concordant. (3) The technique helped facilitate robust PWI and identify inadvertent partial PWI.</p><p><strong>Conclusions: </strong>3D-EAM with a pentaspline PFA catheter itself is feasible, without the need for high-density mapping catheters. This approach has potential advantages over fluoroscopic-only guidance, although its long-term efficacy and cost-effectiveness require formal assessment.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542298","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}