Journal of Interventional Cardiac Electrophysiology最新文献

{"title":"How to manage new-onset atrial fibrillation following ST-segment elevation myocardial infarction.","authors":"Naoya Kataoka, Teruhiko Imamura","doi":"10.1007/s10840-025-01985-1","DOIUrl":"10.1007/s10840-025-01985-1","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"505-506"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006826","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":"Undersensing of polymorphic VT by S-ICD, detected by an insertable cardiac monitor: two is company.","authors":"Naga Venkata K Pothineni, Emily Perovich, Christian S Yacono, Gregory E Supple","doi":"10.1007/s10840-023-01563-3","DOIUrl":"10.1007/s10840-023-01563-3","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"507-508"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9492312","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":"Ventricular activation pattern of left ventricular septal pacing in a canine model.","authors":"Feiyu Wei, Xiaohui Kuang, Xi Zhang, Peng Wu, Jie Fan","doi":"10.1007/s10840-024-01903-x","DOIUrl":"10.1007/s10840-024-01903-x","url":null,"abstract":"<p><strong>Background: </strong>Left bundle branch pacing (LBBP) is a feasible and effective physiological pacing technique. The QRS morphology of left ventricular septal pacing (LVSP) is similar to that of LBBP. The ventricular activation pattern of LBBP is well-known, whereas the pattern of LVSP still needs further investigation. The present study aimed to determine ventricular activation pattern difference between LVSP and LBBP in a canine model.</p><p><strong>Method: </strong>All six canines underwent successful LBBP and LVSP through trans-ventricular septum using intracardiac echocardiography and intracardiac electrogram. Their hearts were isolated and stained with Lugol's iodine to determine the position of the pacing lead. The activation sequences of the left ventricular myocardium and His-Purkinje system were recorded by placing multiple electrode catheters.</p><p><strong>Results: </strong>First, the left His-Purkinje system in LVSP was activated simultaneously from apical and basal regions to the left ventricular middle septal region, whereas the left ventricular septal myocardium was activated from the apical to basal region. The left His-Purkinje system activation in LBBP occurred in the direction of the apex from the pacing lead, but the left ventricular septal myocardium was activated in the apical to basal direction. Furthermore, the left intraventricular electrical synchrony was similar between LVSP and LBBP as determined by mapping the left ventricular septal to free wall activation time (46.7 ± 1.8 ms vs. 45.0 ± 1.4 ms, p = 0.11).</p><p><strong>Conclusion: </strong>The ventricular activation sequence of LVSP was similar to LBBP. LVSP can capture LBB due to the wide distribution of LBB. These findings suggest a rationale for clinical application of LVSP.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"567-577"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982477","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":"Identifying non-responders to cardiac resynchronization therapy in the non-left bundle branch block.","authors":"Toshihiro Nakamura, Kohei Ishibashi, Nobuhiko Useda, Satoshi Oka, Yuichiro Miyazaki, Akinori Wakamiya, Kenzaburo Nakajima, Tsukasa Kamakura, Mitsuru Wada, Yuko Inoue, Koji Miyamoto, Satoshi Nagase, Takeshi Aiba, Kengo Kusano","doi":"10.1007/s10840-024-01972-y","DOIUrl":"10.1007/s10840-024-01972-y","url":null,"abstract":"<p><strong>Background: </strong>Non-response to cardiac resynchronization therapy (CRT) is an important issue in the treatment of heart failure with reduced ejection fraction (HFrEF) and non-left bundle branch block (LBBB). Electrocardiogram-gated myocardial perfusion single-photon emission computed tomography imaging (G-MPI SPECT) is typically used to assess left ventricular (LV) dyssynchrony. This study aimed to determine whether G-MPI parameters are associated with non-responsiveness to CRT.</p><p><strong>Methods: </strong>Between January 2021 and December 2022, 128 patients underwent CRT, of whom 73 with preoperative evaluation using G-MPI were selected. Forty-three patients with non-LBBB (21 and 22 CRT responders and non-responders, respectively) and 30 patients with LBBB were analyzed.</p><p><strong>Results: </strong>Among patients with non-LBBB, CRT responders and non-responders exhibited no significant differences in baseline characteristics, except for the LV dimension. A receiver operating characteristic curve analysis identified 108° and 27.7° as the optimal cutoff values for the bandwidth and phase standard deviation (SD), respectively, to predict non-responsiveness to CRT (area under the curve [AUC] = 0.762; 95% confidence interval [CI] 0.601-0.923 and AUC = 0.742; 95% CI 0.576-0.909, respectively). A multivariate analysis revealed that a cutoff bandwidth of ≥ 108° and phase SD of ≥ 27.7° are independent predictors of non-responsiveness to CRT in patients with non-LBBB (hazard ratio 5.65; 95% CI 1.53-20.9; P = 0.009). In contrast, there were no significant associations between G-MPI parameters and non-responsiveness to CRT in patients with LBBB.</p><p><strong>Conclusions: </strong>Preoperative G-MPI might be associated with non-responsiveness to CRT in patients with non-LBBB, indicating that identifying potential non-responders can improve patient management.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"701-708"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921900","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":"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":"515-536"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","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":"Very high-power short-duration radiofrequency ablation in patients with typical atrial flutter: rationale and design of the FASD-HP randomized trial.","authors":"Laura Valverde Soria, Jorge Toquero, Thomas Brouzet, Laura García Cano, Ana García Barrios, Melodie Segura Domínguez, Gloria A Hermón Ramírez, Raquel Ajo Ferrer, María Ajo Ferrer, Celia María Andreu Concha, Vicente Arrarte Esteban, Angel Sánchez Barbié, Juan Gabriel Martínez-Martínez, Alicia Ibáñez Criado, José Luis Ibáñez Criado","doi":"10.1007/s10840-024-01969-7","DOIUrl":"10.1007/s10840-024-01969-7","url":null,"abstract":"<p><strong>Background: </strong>The aim of cavotricuspid isthmus (CTI)-dependent flutter ablation is the bidirectional conduction block of the CTI. Very-high-power short-duration (vHPSD) radiofrequency ablation aims to minimize conductive heating and increase resistive heating to create shallower but wider lesions in a very short time, while reducing the risk of collateral tissue damage. Experimental studies have shown that it produces effective transmural lesions with an equal or better safety profile compared to conventional parameters. There are published and ongoing trials studying long-term outcomes of this technique for pulmonary vein isolation, but there is a lack of evidence regarding its use in flutter ablation.</p><p><strong>Methods and results: </strong>Multicenter 1:1 randomized, single-blind study. Two CTI ablation strategies are compared: (1) conventional treatment arm consisting of 25-40-W applications of unlimited duration until reaching the minimum value of one of the currently accepted lesion markers (Ablation Index > 500 at the anterior half of the CTI and > 400 at the posterior half with CARTO3 system); (2) experimental treatment arm consisting of CTI block using point-by-point applications of very-high-power (90 W) short duration (4 s). The primary objective is to evaluate the non-inferiority of the efficacy and safety of vHPSD ablation in patients undergoing typical flutter ablation. Secondary objectives include comparison of total radiofrequency time, number of applications, number of steam pops, percentage of reconnections, procedure duration, pain during the procedure, and time to flutter recurrence.</p><p><strong>Conclusions: </strong>The FASD-HP trial is the first clinical trial to investigate the non-inferiority of CTI ablation with vHPSD in patients with typical atrial flutter.</p><p><strong>Clinical trial registration number: </strong>The study was registered at http://www.</p><p><strong>Clinicaltrials: </strong>gov (NCT05777850) on March 21, 2023.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"497-503"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872235","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":"Aborted coumel sign: a novel diagnostic marker for arrhythmia mechanism recognition.","authors":"Alberto Alfie, Gustavo Costa","doi":"10.1007/s10840-024-01937-1","DOIUrl":"10.1007/s10840-024-01937-1","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"513-514"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545882","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":"Combined Use of S-ICD and Absorbable Antibacterial Envelopes: A Proof-of-concept Study.","authors":"Alessio Gasperetti, Marco Schiavone, Matteo Ziacchi, Simone Zanchi, Leonida Lombardi, Maurizio Viecca, Carmelo La Greca, Simone Gulletta, Carlo Lavalle, Mauro Biffi, Giovanni B Forleo","doi":"10.1007/s10840-022-01222-z","DOIUrl":"10.1007/s10840-022-01222-z","url":null,"abstract":"<p><strong>Background: </strong>Absorbable antibacterial envelopes (AAEs) are currently recommended in patients undergoing a transvenous ICD implantation in cases at high risk of infection, who are now preferably implanted with a subcutaneous ICD (S-ICD). Nevertheless, experiences using a combined approach with S-ICD and AAE have not been reported. The aim of our study was to evaluate this strategy in patients at very high risk of infection.</p><p><strong>Methods: </strong>Twenty-five patients were implanted with the S-ICD+AAE using our combined approach, restricted to patients who would fit our decisional flow algorithm identifying very high-risk patients. Patients were followed up 1 month after discharge and every 6 months thereafter. Complications were defined as device-related events requiring medical or surgical intervention for resolution and/or device reprogramming.</p><p><strong>Results: </strong>Twenty-five patients (92% males, mean age 58.5±14.1 years) were implanted with the S-ICD device and the AAE using our combined approach. The most common high-infective risk factors were diabetes requiring insulin treatment (80%) and CKD requiring hemodialysis (48%), with 7 (28%) patients presenting with more than 2 risk factors. A single mild early post-operative hematoma was observed that was managed conservatively with a spontaneous resolution. Despite a very high-risk cohort, only a single late pocket infection was detected and solved conservatively with antibiotic therapy.</p><p><strong>Conclusions: </strong>The preliminary data of this proof-of-concept study show how a combined deployment of AAE and S-ICD in selected patients at very high risk of infection is a safe and feasible technique and may offer a reliable treatment option in specific and selected clinical settings.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":"1 1","pages":"537-543"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49513211","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":"Electrophysiological predictors of susceptible atrial substrate for the onset and recurrence of atrial fibrillation.","authors":"Cevher Ozcan, Zaid Aziz, Michael Mayer, Amrish Deshmukh, Hatem Al Kassem, Gaurav Upadhyay, Andrew Beaser, Maryam Emami","doi":"10.1007/s10840-024-01956-y","DOIUrl":"10.1007/s10840-024-01956-y","url":null,"abstract":"<p><strong>Background: </strong>The atrial electroanatomic substrate is an essential component in the pathogenesis of atrial fibrillation (AF). However, the electrophysiological markers of susceptible atria for AF are not well-characterized. This study aimed to assess atrial conduction indices on surface electrocardiogram (ECG) and intracardiac electrogram (EGM) as predictors of initiation and recurrence of AF after successful ablation.</p><p><strong>Methods: </strong>We studied all consecutive patients who underwent electrophysiological study and catheter ablation for AF (study group) or atrioventricular nodal reentrant tachycardia (AVNRT) (control group) from 2013 to 2018. Atrial conduction indices were measured on ECG and EGM during the electrophysiology study. Clinical data was obtained from the medical record.</p><p><strong>Results: </strong>A total of 387 patients with AF (mean age 63 years, 31% female) were studied and compared to 94 patents in control group. The initiation of AF was associated with significant prolongation of atrial conduction indices on ECG and EGM (p < 0.05). During a mean follow up of 5 ± 2 years, recurrence of AF (48%) after successful ablation occurred in patients with prolonged P wave duration, left atrial (LA) conduction interval, proximal to distal coronary sinus (pCS-dCS) interval, and P wave to dCS interval (p < 0.05). Machine learning modeling determined that pCS-dCS interval, QRS duration, and LA duration in leads V1 and II are most impactful conduction indices in association with AF recurrence.</p><p><strong>Conclusion: </strong>Prolonged atrial conduction intervals, particularly LA (pCS-dCS), indicate susceptible substrate for the onset and the recurrence of AF after ablation. LA conduction indices can facilitate early detection and management of AF.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"635-642"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750955","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":"Open window mapping with extended early meets late algorithm vs. conventional mapping for accessory pathway ablation.","authors":"Jose Luis Martínez Sande, Carlos Minguito-Carazo, Laila González Melchor, Moisés Rodríguez-Mañero, Javier García Seara, Xesus Alberte Fernández López, Rubén Bergel García, Federico García-Rodeja Arias, Jose Ramón González Juanatey","doi":"10.1007/s10840-024-01943-3","DOIUrl":"10.1007/s10840-024-01943-3","url":null,"abstract":"<p><strong>Background: </strong>Catheter ablation of accessory pathway is the treatment of choice for patients with symptomatic Wolff-Parkinson-White (WPW) syndrome. Accessory pathway (AP) identification relies on point-by-point mapping, raising the need for more precise and efficient methods. High-density open window mapping (OWM) combined with the extended early meets late (EEML) algorithm, utilizing 3D electroanatomic mapping systems, is a promising alternative. However, its role in clinical practice lacks comprehensive investigation, necessitating a comparison with conventional mapping.</p><p><strong>Methods: </strong>A prospective cohort study of patients referred for AP ablation evaluated the OWM strategy, comparing it with a retrospective cohort using conventional mapping. Procedure variables, including radiofrequency (RF), fluoroscopy, mapping and procedure times along with total mapping points were compared. Long-term recurrence rates were assessed.</p><p><strong>Results: </strong>42 patients in the OWM group and 34 in the conventional group were included. The OWM strategy exhibited a significantly lower total mapping time (p = 0.030) despite acquiring more points (p < 0.001) than the conventional group. OWM was associated with reduced fluoroscopy time (12.0 (9.0-16) vs. 19 (11-30) minutes, p = 0.009) and RF time (p = 0.021). Long-term recurrence rates were comparable between groups (7.1% OWM vs. 17.7% conventional mapping, p = 0.284). At a median follow-up of 16.2 (4.6-39.4) months there were not significant differences in recurrence-free survival (p = 0.509).</p><p><strong>Conclusion: </strong>OWM with the EEML algorithm is a feasible tool for precise AP location and ablation, associated with less fluoroscopy time, RF time, and total mapping time. Long-term recurrence rates were similar to conventional mapping. Prospective studies are warranted for further validation.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"643-653"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769685","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}