Journal of Interventional Cardiac Electrophysiology最新文献

{"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":"1455-1464"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","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":"Deep learning-based insights on T:R ratio behaviour during prolonged screening for S-ICD eligibility.","authors":"Mohamed ElRefai, Mohamed Abouelasaad, Benedict M Wiles, Anthony J Dunn, Stefano Coniglio, Alain B Zemkoho, Paul R Roberts","doi":"10.1007/s10840-022-01245-6","DOIUrl":"10.1007/s10840-022-01245-6","url":null,"abstract":"<p><strong>Background: </strong>A major predictor of eligibility of subcutaneous implantable cardiac defibrillators (S-ICD) is the T:R ratio. The eligibility cut-off of the T:R ratio incorporates a safety margin to accommodate for fluctuations of ECG signal amplitudes. We introduce a deep learning-based tool that accurately measures the degree of T:R ratio fluctuations and explore its role in S-ICD screening.</p><p><strong>Methods: </strong>Patients were fitted with Holters for 24 h to record their S-ICD vectors. Our tool was used to assess the T:R ratio over the duration of the recordings. Multiple T:R ratio cut-off values were applied, identifying patients at high risk of T-wave oversensing (TWO) at each of the proposed values. The purpose of our study is to identify the ratio that recognises patients at high risk of TWO while not inappropriately excluding true S-ICD candidates.</p><p><strong>Results: </strong>Thirty-seven patients (age 54.5 + / - 21.3 years, 64.8% male) were recruited. Fourteen patients had heart-failure, 7 hypertrophic cardiomyopathy, 7 had normal hearts, 6 had congenital heart disease, and 3 had prior inappropriate S-ICD shocks due to TWO. 54% of patients passed the screening at a T: R of 1:3. All patients passed the screening at a T: R of 1:1. The only subgroup to wholly pass the screening utilising all the proposed ratios are the participants with normal hearts.</p><p><strong>Conclusion: </strong>We propose adopting prolonged screening to select patients eligible for S-ICD with low probability of TWO and inappropriate shocks. The appropriate T:R ratio likely lies between 1:3 and 1:1. Further studies are required to identify the optimal screening thresholds.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":"1 1","pages":"1387-1397"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46740939","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":"Acute outcomes and learning curve from the initial patients treated with the PulseSelect system: a real-world multicenter experience of pulsed field ablation.","authors":"Giulio Molon, Stefano Nardi, Gianfranco Mitacchione, Antonio Dello Russo, Danilo Ricciardi, Roberto Mantovan, Luca Bontempi, Alessandro Costa, Luigi Argenziano, Edoardo Casali, Vincenzo Turco, Giuseppe Boriani","doi":"10.1007/s10840-025-02036-5","DOIUrl":"10.1007/s10840-025-02036-5","url":null,"abstract":"<p><strong>Introduction: </strong>Catheter ablation is a cornerstone in managing patients with symptomatic, drug-refractory atrial fibrillation (AF), and while effective, traditional thermal ablation techniques are associated with rare but significant complications due to a non-selective thermal energy transfer to all biologic tissues. Pulsed field ablation (PFA) offers a non-thermal approach, targeting myocardial tissue selectively while sparing adjacent structures. The PulseSelect system is a novel PFA platform, and this analysis examines the procedural outcomes, acute complications, and the learning curve associated with introduction of the PulseSelect system in six European centers.</p><p><strong>Methods: </strong>The One Shot to Pulmonary Vein Isolation (1STOP) project prospectively included 131 patients with paroxysmal or persistent AF treated with the PulseSelect system across six centers. Procedural data, patient characteristics, and acute outcomes were summarized. Additionally, sedation protocols, fluoroscopic times, and acute success rates were reported.</p><p><strong>Results: </strong>Patients (mean age 61.7 ± 9.7 years; 31.3% female) had predominantly paroxysmal AF (80.9%). Median procedural and fluoroscopy times were 55.0 and 16.0 min, respectively. General anesthesia was used in 75.5% of cases, while in the remaining 24.5% moderate sedation protocols allowed procedures (even in 15.1% without an anesthesiologist). Acute PVI success was 100%, and no major complications were observed. A short learning curve was noted, with significant reductions in procedural times after the initial 2-3 cases at each center.</p><p><strong>Conclusion: </strong>The PulseSelect system showed short procedural times, with a rapid learning curve, thus leading with high procedural efficiency. In 1 out of 4 cases general anesthesia was not applied, and no major complications were observed.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1475-1485"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780379","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":"Long-term outcomes of catheter ablation for atrial fibrillation in octogenarians.","authors":"Nikola Kozhuharov, Nabeela Karim, Antonio Creta, Lisa W M Leung, Rick Veasey, Armin Osmanagic, Anna Kefala, Mike Pope, Apostolos Vouliotis, Sven Knecht, Philipp Krisai, Pierre Jaïs, Claire Martin, Christian Sticherling, Matthew Ginks, Waqas Ullah, Richard Balasubramaniam, Manish Kalla, Mark M Gallagher, Ross J Hunter, Tom Wong, Dhiraj Gupta","doi":"10.1007/s10840-024-01879-8","DOIUrl":"10.1007/s10840-024-01879-8","url":null,"abstract":"<p><strong>Background and aims: </strong>Catheter ablation is superior to pharmacological therapy in controlling atrial fibrillation (AF). There are few data on the long-term outcome of AF ablation in octogenarian patients. This analysis aims to evaluate the outcome of AF ablation in octogenarians vs. younger patients.</p><p><strong>Methods: </strong>In this retrospective study in 13 centres in the UK, France, and Switzerland, the long-term outcomes of 473 consecutive octogenarian patients undergoing ablation for AF were compared to 473 matched younger controls (median age 81.3 [80.0, 83.0] vs. 64.4 [56.5, 70.7] years, 54.3% vs. 35.1% females; p-value for both < 0.001). The primary endpoint was the recurrence of atrial arrhythmia after a blanking period of 90 days within 365 days of follow-up.</p><p><strong>Results: </strong>Acute ablation success as defined as isolation of all pulmonary veins was achieved in 97% of octogenarians. Octogenarians experienced more procedural complications (11.4% vs 7.0%, p = 0.018). The median follow-up time was 281 [106, 365] days vs. 354 [220, 365] days for octogenarians vs. non-octogenarians (p < 0.001). Among octogenarians, 27.7% (131 patients) experienced a recurrence of atrial arrhythmia, in contrast to 23.5% (111 patients) in the younger group (odds ratio 1.49; 95% confidence interval 1.16-1.92; p = 0.002). In a multivariable regression model including gender, previous AF ablation, vascular disease, chronic kidney disease, CHA2DS2-VASc score, left atrial dilatation, and indwelling cardiac implantable electronic device, age above 80 remained an independent predictor of recurrence of arrhythmia.</p><p><strong>Conclusion: </strong>Ablation for AF is effective in octogenarians, but is associated with slightly higher procedural complication rate and recurrence of atrial arrhythmia than in younger patients.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1513-1522"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975841","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":"Ablation catheter with high-density mapping system in patients with atrial fibrillation.","authors":"Ruggero Maggio","doi":"10.1007/s10840-024-01954-0","DOIUrl":"10.1007/s10840-024-01954-0","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1375-1376"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755148","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":"Consumer-grade wearable devices in arrhythmia diagnostics for clinicians: where we are and where we are going.","authors":"Eric Rytkin, Irina Zotova, Rod Passman, Andrey Ardashev, Gregory Trachiotis, Igor Efimov, Bradley P Knight","doi":"10.1007/s10840-025-01994-0","DOIUrl":"10.1007/s10840-025-01994-0","url":null,"abstract":"<p><p>Atrial arrhythmias, including atrial fibrillation (AF), are a major contributor to cardiovascular morbidity and mortality. Early detection and effective management are critical to mitigating adverse outcomes such as stroke, heart failure, and overall mortality. Wearable devices have emerged as promising tools for monitoring, detecting, and managing atrial arrhythmias near-continuously. This comprehensive analysis explores these wearable technologies' current role and capabilities for clinicians' daily practice. Despite challenges related to data accuracy, privacy, patient compliance, and integration with healthcare systems, ongoing advancements hold significant promise for the future. Continued research and development are essential to fully realize the potential of wearables in improving clinical outcomes for patients with atrial arrhythmias.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1531-1541"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039594","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-balloon distal protection for vein of Marshall ethanol infusion in presence of persistent left superior vena cava.","authors":"Javier Ramos Jiménez, Lorena Gómez Burgueño, Nicolás Maneiro Melón, Fernando Arribas Ynsaurriaga, Rafael Salguero Bodes, Daniel Rodríguez Muñoz","doi":"10.1007/s10840-024-01957-x","DOIUrl":"10.1007/s10840-024-01957-x","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1379-1380"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729673","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":"Performance of a new respiratory compensated stability algorithm during radiofrequency ablation for atrial fibrillation.","authors":"Benjamin Berte, Chiara Valeriano, Sophie Rissotto, Alona Sigal, Ofer Klemm, Saagar Mahida, Tom De Potter, Helmut Pürerfellner, Richard Kobza","doi":"10.1007/s10840-025-02031-w","DOIUrl":"10.1007/s10840-025-02031-w","url":null,"abstract":"<p><strong>Background: </strong>Short-duration radiofrequency ablation is designed to enhance efficiency of pulmonary vein isolation (PVI). We investigated the performance of a novel stability algorithm (STABILITY +).</p><p><strong>Methods: </strong>In a prospective, single-center study, consecutive patients undergoing first-time PVI were included. Patients were categorized into four groups: Group 1, Hybrid (anterior, 50 W, 550 AI; posterior, 90 W 4 s) using Viistag; Group 2, Hybrid using STABILITY + ; Group 3, 90 W (anterior and posterior, 90 W 4 s) using Visitag; Group 4, 90 W using STABILITY + . Clinical, procedural and follow-up data were systematically collected.</p><p><strong>Results: </strong>A total of 268 patients were included. In total, 130 patients had Hybrid ablation while 138 underwent 90-W ablation. Procedure time was comparable in Groups 1, 2, and 3 however was lower in Group 4 (65 min, 65 min, 70 min, 54 min, p < 0.001). RF-time was longer in Group 1 and 2 vs 3 and 4 (11.6 min, 9.7 min, 4.5 min, 5.2 min, p < 0.001). First-pass isolation rates were comparable between all 4 groups (88%, 91%, 83.9%, 90%, p = 0.480). Freedom from arrhythmia at 6 months was also comparable (9%, 9%, 16.6%, 10.4%, p = 0.341). Complications were comparable and low and restricted to vascular access-related complications (2%, 1%, 0%, 2%, p = 0.388).</p><p><strong>Conclusions: </strong>Irrespective of the mode of ablation, the novel STABILITY + algorithm can be used in PVI ablations without compromising safety and efficiency and has the potential to improve first-pass isolation using 90-W HPSD ablation.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1465-1474"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730389","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":"Insights from optimal high-power ablation settings for anterior pulmonary vein wall isolation-A-Q-RATE POWER Trial.","authors":"Piotr Gardziejczyk, Roman Piotrowski, Martyna Skrzyńska-Kowalczyk, Marta Skowrońska, Ewa Wlazłowska-Struzik, Michał Niedźwiedź, Piotr Kułakowski, Jakub Baran","doi":"10.1007/s10840-025-02022-x","DOIUrl":"10.1007/s10840-025-02022-x","url":null,"abstract":"<p><strong>Background: </strong>The radiofrequency (RF) lesions obtained using very high-power short-duration (vHPSD) are shallower compared to high-power sort-duration (HPSD) or conventional ablation settings. Thus, there is a possibility that vHPSD RF applications may not achieve transmurality at thick parts of the anterior aspects of the pulmonary vein (PV)-left atrial (LA) wall junction. The aim of the study was to compare acute efficacy of pulmonary vein isolation (PVI) using vHPSD versus HPSD guided by AI ablation at the anterior aspects of PV in patients undergoing atrial fibrillation (AF) ablation.</p><p><strong>Methods: </strong>The A-Q-RATE POWER Trial was a prospective, dual-center, randomized study. Patients were assigned to receive vHPSD versus HPSD ablation delivered at the anterior aspects of PV. In both arms, the posterior parts of PV were ablated with vHPSD. The primary outcome was the need for additional RF applications at the anterior aspect of PVs to achieve complete PVI.</p><p><strong>Results: </strong>Seventy patients were randomly assigned to vHPSD (n = 35) or HPSD (n = 35). The vHPSD group required more touch-up RF applications at the anterior aspects of PV than the HPSD group (46% vs 19%, p < 0.001), especially at the right PVs (57% vs 20%, p = 0.001) compared to the left PVs (34% vs 17%, p = 0.1). The median duration of the procedure, LA dwell time, and fluoroscopy time were similar in both groups (112 [IQR 90-130] min vs 107 [90-125] min, p = 0.58; 95 [70-106] min vs 90 [71-100] min, p = 0.55; and 28 [IQR 14-69] s vs 46 [IQR 0-89] s, p = 0.97,respectively).</p><p><strong>Conclusion: </strong>The proposed hybrid strategy is associated with a significantly lower need for additional touch-up RF applications than vHPSD only, without extending procedural and fluoroscopy duration.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1447-1454"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458295","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":"Acute mitral block: pulse field ablation plus radiofrequency ablation when compared to radiofrequency ablation plus ethanol injection of vein of Marshall.","authors":"Alexander Cubberley, Amir A Ahmadian-Tehrani, Medhansh Kashyap, Taylor Pickering, Mustafa Dohadwala","doi":"10.1007/s10840-024-01963-z","DOIUrl":"10.1007/s10840-024-01963-z","url":null,"abstract":"<p><p>This retrospective study evaluated two groups: patients receiving RFA for PVI, posterior wall isolation, mitral isthmus, and coronary sinus (CS) ablation with adjunctive VOM ethanol injection (VOM/RFA ALL (N = 53)), and patients receiving PVI with PFA using pentaspline catheter followed by mitral isthmus and CS ablation with RFA (PFA PV + PW/RFA MITRAL (N = 12)). We hypothesized that PFA for pulmonary vein isolation (PVI) facilitates mitral block without adjunctive vein of Marshall (VOM) ethanol injection. Mitral block was achieved in 92.5% of VOM/RFA ALL patients and 83.3% of the PFA PV + PW/RFA MITRAL group (p = 0.31). Endocardial ablation time of the mitral isthmus and RF applications required to achieve a complete block were significantly shorter in the VOM/RFA ALL group (208 s vs 356 s, p < 0.01 and 14.5 vs 24.0, p < 0.01, respectively). Adjunctive VOM ethanol injection appears to still have a role for facilitation of mitral isthmus block in the new era of PFA.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1497-1500"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780308","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}