Journal of Interventional Cardiac Electrophysiology最新文献

{"title":"The second Latin American catheter ablation registry (\"II LAHRS EP registry\").","authors":"Ulises Rojel Martinez, José Llorente, Nestor López Cabanillas, Luis Ignacio Mondragon, Mauricio Ibrahim Scanavacca, Juan Carlos Zerpa Acosta, William Fernando Bautista Vargas, María Eugenia Santillan, Dulce María García Frias, Armando Perez Silva, Leonardo Onetto, Alexander Dal Forno, Hermes Leonel Morales Molina, Mauricio Abello, Enrique Monjes, Richard Soto Becerra, Alberto Alfie, Juan Carlos Diaz Martinez, Diego Andres Rodríguez Guerrero, Manuel Felipe Patete Ayala, Januário de Pardo Mêo Neto, Silvano Diangelo, Jefferson Jaber, Luis Alberto Wayar Caballero, Edgardo Alfredo Rodriguez Salazar, Gustavo Tortajada, Carina Hardy, Fernando Vidal Bett, Hael Lizandro Fernandez Prado, Elibet Chavez Gonzalez, Luis Fernando Pava, José Enrique Vives Rodríguez, Mauricio Contreras, Lenin Rene Bulnes Garcia, Eric Karabut, Ramón Antonio Requena Dugun, Roberto Keegan","doi":"10.1007/s10840-024-01942-4","DOIUrl":"10.1007/s10840-024-01942-4","url":null,"abstract":"<p><strong>Background: </strong>Patient's clinical characteristics, technical resources, center and operator volume, and operator experience and training are known variables impacting outcomes. Although international standards have been agreed to maximize the benefits of this therapy, regional and global differences still exist. Latin American information has not been updated in the last 10 years. This study aimed to analyze current information on operators, centers, and CA in Latin America.</p><p><strong>Methods: </strong>Observational, retrospective study collecting Latin American information on operators and centers participating in CA, and procedures performed in 2023, from January 1 to December 31.</p><p><strong>Results: </strong>Electrophysiologists 178 (18 countries). Mean age 46,8 ± 9,2 (28-74) years. Male 86,5%. AFib, VT, and cardioneuroablation were performed by 80,2%, 70,9%, and 35,5% of operators respectively. Centers 175 (17 countries). Private 79,4% and academic 44,0%. Low volume (< 50/year) represented 36,6% and 38,3% performed ≥ 100 ablations/year. Procedures 7.595 (8.284 arrhythmias, 17 countries, 134 centers, 76 electrophysiologists). Patients mean age 51,5 ± 19,3 (1-95) years, male 55,3%, and 77,5% had a structurally normal heart. RF was the energy in 95,6% of procedures, cryoablation in 4,7%, and PFA in 0,2%. The most frequently treated arrhythmias were AFib (28,2%), AVNRT (20,9%), APs (15,8%), and PVC/NSVT (8,3%). Global success and complication rates were 93,6% and 3,0%, respectively and mortality 0,05%.</p><p><strong>Conclusion: </strong>II LAHRS EP Registry brings new and interesting data related to EP in Latin America. Electrophysiologists showed acceptable levels of experience, skills, and qualification. Although centers revealed an under-ideal availability of infrastructure and technical resources, the results of CA were comparable to other registries worldwide.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"597-612"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622008","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 pulsed field ablation with very high-power and high-power short-duration radiofrequency ablation for atrial fibrillation: a systematic review and meta-analysis.","authors":"Elísio Bulhões, Roberto A S V Mazetto, Antunes L Vanio, Maria L R Defante, Luanna Feitoza, Camila Guida, Henry Huang","doi":"10.1007/s10840-024-01970-0","DOIUrl":"10.1007/s10840-024-01970-0","url":null,"abstract":"<p><strong>Background: </strong>Catheter ablation is a key treatment for atrial fibrillation (AF), with high-power, very high-power short-duration and pulsed field ablation (PFA) being efficient options. However, direct comparisons between these techniques are lacking.</p><p><strong>Objective: </strong>We performed a systematic review and meta-analysis, which included predominantly observational studies (four retrospective and one prospective study), to compare PFA and High-power short-duration (HPSD) and very high-power short-duration (vHPSD) radiofrequency (RF) ablation in patients with AF.</p><p><strong>Methods: </strong>We searched PubMed, Embase and Cochrane Central. Outcomes of interest included: Arrhythmia-free survival (AF, atrial flutter, and atrial tachycardia recurrences 30 s during follow-up after a 1-month blanking period), procedure time, fluoroscopy time, fluoroscopy dose, complications overall. Statistical analysis was performed using the R program (version 4.3.2). Heterogeneity was assessed with I² statistics.</p><p><strong>Results: </strong>Our meta-analysis included 1,255 patients from 5 studies, with a mean age ranging from 63 to 68 years. Among them, 554 (45.2%) underwent pulsed field ablation (PFA) and 701 (55.8%) received high/very high potential short-duration ablation. PFA improved arrhythmia-free survival (RR 1.05; 95% CI 1.002-1.120; P = 0.004; I² = 0%) and reduced procedure time (MD -29.95 min; 95% CI -30.90 to -29.00; P < 0.01; I² = 0%). However, PFA increased fluoroscopy time (MD 6.33 min; 95% CI 1.65 to 11.01; P < 0.01; I² = 98%) and showed no significant difference in overall complications (RR 0.88; 95% CI 0.38-2.02; P = 0.756; I² = 47%), cardiac tamponade (RR 1.62; 95% CI 0.27-9.85; P = 0.599; I² = 40%), or stroke/transient ischemic attack (TIA) incidence (RR 0.64; 95% CI 0.15-2.80; P = 0.555; I² = 0%). PFA was associated with a reduced need for redo procedures (RR 0.66; 95% CI 0.45-0.97; P = 0.036; I² = 0%) and did not significantly affect the fluoroscopy dose (MD 896.86 mGy·cm²; 95% CI -1269.44 to 3063.15; P = 0.42; I² = 39%).</p><p><strong>Conclusion: </strong>In this meta-analysis, PFA was associated with improved arrhythmia-free survival and reduced procedure time, although it resulted in increased fluoroscopy time. PFA and high/very high power short-duration ablation yielded similar outcomes regarding overall complications, cardiac tamponade, and stroke/TIA incidence. Both techniques demonstrated comparable efficacy in treating atrial fibrillation.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"691-700"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909734","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":"Treatment of inappropriate sinus tachycardia using endocardial sinus node modification with epicardial phrenic nerve deviation.","authors":"Zeba Hashmath, Aditi Naniwadekar","doi":"10.1007/s10840-023-01697-4","DOIUrl":"10.1007/s10840-023-01697-4","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"509-511"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460376","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":"Mid-term clinical outcomes and cardiac function in patients receiving cardiac contractility modulation.","authors":"Andrew Deak, Syed M Zaidi, Chethan Gangireddy, Edmond Cronin, Eman Hamad, Carly Fabrizio, Sanjana Bhatia-Patel, Val Rakita, Isaac R Whitman","doi":"10.1007/s10840-024-01900-0","DOIUrl":"10.1007/s10840-024-01900-0","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the mid-term clinical and functional cardiac contractility modulation therapy (CCM) recipients in an urban population with heart failure.</p><p><strong>Background: </strong>CCM is a non-excitatory electrical therapy for patients with systolic heart failure with NYHA class III symptoms and ejection fraction (EF) 25-45%. How CCM affects a broad range of clinical measures, including diastolic dysfunction (DD) and weight change, is unexplored.</p><p><strong>Methods: </strong>We reviewed 31 consecutive patients at our center who underwent CCM implant. NYHA class, hospitalizations, ejection fraction (EF), diastolic function, and weight were compared pre- and post-CCM implant.</p><p><strong>Results: </strong>Mean age and follow-up time was 63 ± 10 years and 1.4 ± 0.8 years, respectively. Mean NYHA class improved by 0.97 functional classes (p < 0.001), and improvement occurred in 68% of patients. Mean annualized hospitalizations improved (0.8 ± 0.8 vs. 0.4 ± 1.0 hospitalizations/year, p = 0.048), and after exclusion of a single outlier, change in annualized days hospitalized also improved (total cohort 3.8 ± 4.7 vs. 3.7 ± 14.8 days/year; p = 0.96; after exclusion, 3.8 ± 4.7 vs. 1.1 ± 1.9 days/year, p < 0.001). Mean EF improved by 8% (p = 0.002), and among those with DD pre-CCM, mean DD improvement was 0.8 \"grades\" (p < 0.001). Mean weight change was 8.5 pounds lost, amounting to 4% of body weight (p = 0.002, p = 0.002, respectively), with 77% of patients having lost weight after CCM. Five patients (16%) experienced procedural complications; incidence skewed toward early implants.</p><p><strong>Conclusion: </strong>In an observational cohort, CCM therapy resulted in improvement in NYHA class, hospitalizations, systolic and diastolic function, and weight.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"579-588"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108199","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":"Image quality assessment and automation in late gadolinium-enhanced MRI of the left atrium in atrial fibrillation patients.","authors":"Benjamin Orkild, K M Arefeen Sultan, Eugene Kholmovski, Eugene Kwan, Erik Bieging, Alan Morris, Greg Stoddard, Rob S MacLeod, Shireen Elhabian, Ravi Ranjan, Ed DiBella","doi":"10.1007/s10840-024-01971-z","DOIUrl":"10.1007/s10840-024-01971-z","url":null,"abstract":"<p><strong>Background: </strong>Late gadolinium-enhanced (LGE) MRI has become a widely used technique to non-invasively image the left atrium prior to catheter ablation. However, LGE-MRI images are prone to variable image quality, with quality metrics that do not necessarily correlate to the image's diagnostic quality. In this study, we aimed to define consistent clinically relevant metrics for image and diagnostic quality in 3D LGE-MRI images of the left atrium, have multiple observers assess LGE-MRI image quality to identify key features that measure quality and intra/inter-observer variabilities, and train and test a CNN to assess image quality automatically.</p><p><strong>Methods: </strong>We identified four image quality categories that impact fibrosis assessment in LGE-MRI images and trained individuals to score 50 consecutive pre-ablation atrial fibrillation LGE-MRI scans from the University of Utah hospital image database. The trained individuals then scored 146 additional scans, which were used to train a convolutional neural network (CNN) to assess diagnostic quality.</p><p><strong>Results: </strong>There was excellent agreement among trained observers when scoring LGE-MRI scans, with inter-rater reliability scores ranging from 0.65 to 0.76 for each category. When the quality scores were converted to a binary diagnostic/non-diagnostic, the CNN achieved a sensitivity of <math><mrow><mn>0.80</mn> <mo>±</mo> <mn>0.06</mn></mrow> </math> and a specificity of <math><mrow><mn>0.56</mn> <mo>±</mo> <mn>0.10</mn></mrow> </math> .</p><p><strong>Conclusion: </strong>The use of a training document with reference examples helped raters achieve excellent agreement in their quality scores. The CNN gave a reasonably accurate classification of diagnostic or non-diagnostic 3D LGE-MRI images of the left atrium, despite the use of a relatively small training set.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"667-679"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872226","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":"Trends and outcomes of inpatient cardiac implantable electronic device transvenous lead extractions: a nationwide analysis.","authors":"Charl Khalil, Sorin Lazar, Michael Megaly, Raktham Mekritthikrai, Sharath C Vipparthy, Rami Doukky, Mohammad E Mortada, Henry D Huang, Parikshit S Sharma","doi":"10.1007/s10840-024-01891-y","DOIUrl":"10.1007/s10840-024-01891-y","url":null,"abstract":"<p><strong>Background: </strong>Higher rates of CIED implantations have been associated with an increased rate of lead failures and complications resulting in higher rates of transvenous lead extractions (TLE).</p><p><strong>Objective: </strong>To assess the trends TLE admissions and evaluate the patient related predictors of safety outcomes.</p><p><strong>Methods: </strong>National Readmission Database was queried to identify patients who underwent TLE from January 2016 to December 2019. We conducted a multivariate regression analysis to identify variables associated with in-hospital mortality in patients undergoing TLE. Additionally, we compared trends and outcomes of TLE among patients with prior sternotomy versus those without prior sternotomy and analyzed sex-based differences among patients undergoing TLE.</p><p><strong>Results: </strong>We identified 30,128 hospitalizations for TLE. The index admission in-hospital mortality rate was 3.21% with cardiac tamponade happening in 1.46% of the admissions. Age, infective endocarditis, CKD, congestive heart failure and anemia were associated with higher in-hospital mortality rates. There was a lower rate of in-hospital mortality in patients with history of prior sternotomy versus patients without (OR 0.72, CI: 0.59-0.87, p-value < 0.001). There was no difference in in-hospital mortality rate between males and females. Females had a shorter length and a higher cost of stay when compared to male gender.</p><p><strong>Conclusion: </strong>TLE admissions continue to increase. Overall rates of mortality and complications are relatively low. Patients with prior sternotomy had better outcomes and less complications when compared to those without prior sternotomy. Female gender is associated with higher rates of cardiac tamponade, yet shorter length of stay with lower cost.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"557-566"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893583","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 and economic outcomes with rivaroxaban versus warfarin in patients with nonvalvular atrial fibrillation and obstructive sleep apnea: retrospective analysis of US healthcare claims.","authors":"Andrea Natale, Sanghamitra Mohanty, Cindy Chen, Yuan Zhao, Alicia K Campbell, Brahim Bookhart, Veronica Ashton","doi":"10.1007/s10840-024-01940-6","DOIUrl":"10.1007/s10840-024-01940-6","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) and obstructive sleep apnea (OSA) are often comorbid and associated with increased risk of cardiovascular events such as stroke. We evaluated the effectiveness, safety, healthcare resource utilization, and costs of rivaroxaban versus warfarin in patients with nonvalvular AF (NVAF) and comorbid OSA.</p><p><strong>Methods: </strong>We used the IQVIA PharMetrics^® Plus adjudicated claims database to evaluate patients with NVAF, OSA, and moderate-to-severe stroke risk who initiated rivaroxaban or warfarin between November 2011 and December 2022. We adjusted for potential confounders with propensity score overlap weighting. Primary endpoints were evaluated based on intent-to-treat (ITT) and on-treatment follow-up to compare stroke or systemic embolism risk, major bleeding risk, all-cause healthcare resource utilization (inpatient hospitalizations, emergency department visits, outpatient visits, and pharmacy fills), and costs (per patient per year [PPPY]) by treatment cohort.</p><p><strong>Results: </strong>In total, 14,765 patients were included (9133 received rivaroxaban; 5632 received warfarin). Rivaroxaban significantly reduced stroke or systemic embolism versus warfarin by 26% (ITT-hazard ratio, 0.74 [95% CI 0.60-0.91]; P = 0.004) and 30% (on-treatment-hazard ratio, 0.70 [95% CI 0.55-0.89]; P = 0.004). Major bleeding was not significantly different between rivaroxaban and warfarin in either analysis. All-cause healthcare resource utilization was significantly reduced with rivaroxaban versus warfarin, leading to significantly reduced PPPY costs.</p><p><strong>Conclusions: </strong>Among patients with NVAF and OSA, rivaroxaban was associated with a significant reduction in stroke or systemic embolism risk versus warfarin with no difference in major bleeding. Rivaroxaban significantly reduced healthcare resource utilization and costs compared with warfarin, providing support for the use of rivaroxaban in this population.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"613-624"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710222","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":"Ultrasound-guided versus fluoroscopy-guided axillary vein puncture for cardiac implantable electronic device implantation: a meta-analysis enrolling 1257 patients.","authors":"Giampaolo Vetta, Antonio Parlavecchio, Jennifer Wright, Michele Magnocavallo, Lorenzo Marcon, Ioannis Doundoulakis, Roberto Scacciavillani, Antonio Sorgente, Luigi Pannone, Alexandre Almorad, Juan Sieira, Charles Audiat, Kazutaka Nakasone, Gezim Bala, Erwin Ströker, Ingrid Overeinder, Pietro Rossi, Andrea Sarkozy, Gian-Battista Chierchia, Carlo de Asmundis, Domenico Giovanni Della Rocca","doi":"10.1007/s10840-024-01932-6","DOIUrl":"10.1007/s10840-024-01932-6","url":null,"abstract":"<p><strong>Introduction: </strong>Ultrasound-guided (Echo-AVP) and Fluoroscopy-guided Axillary Vein Puncture (Fluoro-AVP) are both acknowledged as safe and effective techniques for transvenous implantation of leads for cardiac implantable electronic devices (CIEDs). Nonetheless, it is still debated which of the two techniques has a better safety and efficacy profile. Therefore, we performed a meta-analysis to evaluate the efficacy and safety of Echo-AVP versus Fluoro-AVP for CIEDs implantation.</p><p><strong>Methods: </strong>We systematically searched Medline, Embase and Cochrane electronic databases up to May 15th, 2024, for studies that evaluated the efficacy and safety of Echo-AVP and Fluoro-AVP reporting at least one clinical outcome of interest. The primary efficacy endpoint was acute procedural success and the primary safety endpoint was a composite endpoint of pneumothorax, pocket hematoma/bleeding, pocket infection and inadvertent arterial puncture. The effect size was estimated using a random-effect model as Odds Ratio (OR) and Mean Difference (MD) with relative 95% Confidence Interval (CI).</p><p><strong>Results: </strong>Overall, 4 studies were included, which enrolled 1257 patients (Echo-AVP: 373 patients; Fluoro-AVP: 884 patients). Echo-AVP led to a significant reduction in the primary safety endpoint (OR: 0.41; p = 0.0009), risk of inadvertent arterial puncture (OR: 0.29; p = 0.003) and fluoroscopy time ( MD: -105.02; p = 0.008). No differences were found between Echo-AVP and Fluoro-AVP for acute procedural success (OR: 0.77; p = 0.27), pneumothorax (OR: 0.66; p = 0.60), pocket hematoma/bleeding (OR: 0.68; p = 0.30), pocket infection (OR: 0.66; p = 0.60), procedural time (MD: 1.99; p = 0.65), success rate at first attempt (OR: 1.25; p = 0.34) and venous access time (MD: -0. 25; p = 0.99).</p><p><strong>Conclusion: </strong>Echo-AVP proved to reduce significantly the primary safety endpoint, inadvertent arterial puncture and fluoroscopy time compared to Fluoro-AVP.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"589-596"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502166","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 new-onset atrial fibrillation in patients with ST-segment elevation myocardial infarction.","authors":"Judith Minder, Diego Mannhart, Sarah Brunner, Gianluca Di Bari, Sven Knecht, Philipp Krisai, Thomas Nestelberger, Jasper Boeddinghaus, Gregor Leibundgut, Christoph Kaiser, Christian Mueller, Stefan Osswald, Christian Sticherling, Michael Kühne, Patrick Badertscher","doi":"10.1007/s10840-024-01941-5","DOIUrl":"10.1007/s10840-024-01941-5","url":null,"abstract":"<p><strong>Background: </strong>New-onset atrial fibrillation (NOAF) complicating ST-segment elevation myocardial infarction (STEMI) remains clinically challenging. The aim of this study was to assess the incidence of NOAF, identify risk factors for the development of atrial fibrillation (AF), and analyze the impact on patient care, therapy, and outcomes during long-term follow-up.</p><p><strong>Methods: </strong>This retrospective single-center study reviewed consecutive patients undergoing coronary angiography (CAG) for acute STEMI between May 2015 and September 2023. Patients were stratified in NOAF, defined as AF diagnosed during the index hospitalization or within 12 months of follow-up, AF prior to the hospitalization for STEMI, and patients with no AF.</p><p><strong>Results: </strong>We analyzed 1301 consecutive patients undergoing CAG for STEMI. NOAF was detected in 112 patients (9.8%), and 68 patients (5.2%) had prior AF. NOAF patients were 74% males, with a mean age of 69 ± 11 years. During a median follow-up of 683 days, the rates of stroke were 10% in patients with NOAF compared to 3.8% (p = 0.001) in patients without AF. Major bleeding occurred in 7% vs. 1.7%, p = 0.001, and death in 16% vs. 6.8%, p < 0.001 of patients with NOAF vs. no AF.</p><p><strong>Conclusion: </strong>NOAF was detected in almost 1 out of 10 STEMI patients and was associated with a higher rate of stroke, major bleeding, and death as in patients with no AF and with similar rates compared with prior AF. Future studies assessing optimal anticoagulation therapy in this challenging patient population are warranted.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"655-665"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807141","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":"A new insight into the anatomical ablation approach at R-L ILT for VAs with a left ventricular summit origination: electrophysiological characteristics and catheter ablation.","authors":"Yang Pang, Ye Xu, Kuan Cheng, Chaofeng Chen, Qingxing Chen, Yunlong Ling, Guijian Liu, Junbo Ge, Wenqing Zhu","doi":"10.1007/s10840-024-01974-w","DOIUrl":"10.1007/s10840-024-01974-w","url":null,"abstract":"<p><strong>Background: </strong>Ventricular arrhythmia (VA) originating from the left ventricular summit (LVS) poses particular challenges, with higher rates of ablation failure.</p><p><strong>Objective: </strong>To further evaluate the anatomical ablation approach from the subaortic region for LVS VAs and their electrophysiological characteristics.</p><p><strong>Method: </strong>The study enrolled 27 consecutive patients with sympatomatic VAs originating from LVS and who received an anatomical ablation approach from R-L ILT in our center.</p><p><strong>Results: </strong>Three different mapping results were obtained as the earliest activation sites (EAS) were observed in the RVOT region (group 1), R-L ILT (group 2), and epicardial region (group 3), respectively. A higher percentage of rS/QS patterns in lead I was observed in Groups 1 and 3. A narrower QRS duration was observed in Group (1) A presystolic potential was recorded at R-L ILT for most VAs in group (2) All VAs were successfully ablated at R-L ILT in groups 1 and 2, though poor pace mapping results were observed at R-L ILT. 4/7 VAs in group 3 ultimately failed after an ablation in both the endocardial and epicardial regions.</p><p><strong>Conclusion: </strong>An anatomical ablation approach at R-L ILT was effective for most VAs with an LVS origin. Different ECG and electrophysiological characteristics could be observed in VAs with different EAS. Poor pace mapping results in all regions with an EAS in the epicardial region had predictive value for the failure of the ablation procedure.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"709-720"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950218","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}