Journal of Interventional Cardiac Electrophysiology最新文献

{"title":"Safety and efficacy of atrial fibrillation ablation in kidney transplant patients.","authors":"Ahmad Keelani, Lorenzo Bartoli, Alessio Gasperetti, Sorin Popescu, Marco Schiavone, Anna Traub, Huong-Lan Phan, Marcel Feher, Thomas Fink, Vanessa Sciacca, Martin Nitschke, Julia Vogler, Charlotte Eitel, Giovanni Forleo, Christian-H Heeger, Roland R Tilz","doi":"10.1007/s10840-025-02006-x","DOIUrl":"10.1007/s10840-025-02006-x","url":null,"abstract":"<p><strong>Introduction: </strong>Managing atrial fibrillation in kidney transplant patients poses a challenge for both nephrologists and cardiologists. Data regarding the safety and efficacy of catheter ablation in this patient's cohort is scarce.</p><p><strong>Methods and results: </strong>In this two-center prospective study, we included all consecutive kidney transplant patients who underwent atrial fibrillation ablation between April 2017 and March 2022. A 1:3 propensity score matching created a control group of non-transplant AF patients undergoing ablation. We included 16 kidney transplant patients and 48 matched controls. Ablation was successful in all patients. The periprocedural complication rate (6.3% in the kidney transplant group vs. 6.3% in the control group, p value = 1) did not differ between the two groups. One transplant patient experienced graft dysfunction after a complication. At 18 months, AF recurrence-fee rates were 69% in the transplant group and 70.1% in controls (p = 0.95). By the last follow-up, all transplant patients had discontinued antiarrhythmic drugs, while 19.6% of the patients in the control group were treated with antiarrhythmic drugs (p = 0.09). Kidney function in the transplant group remained stable (eGFR 32 [23.8, 40.5] ml/min/1.73 m² before vs. 34 [29.8, 38] ml/min/1.73 m² at last follow up, p = 0.93).</p><p><strong>Conclusions: </strong>This study demonstrates that catheter ablation is a viable option for treating AF in kidney transplant patients, with comparable outcomes to non-transplanted individuals. Discontinuing antiarrhythmic drugs reduces drug interaction risks, but minimizing procedural complications remains critical to preserving graft function.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1017-1026"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523693","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":"Intermuscular two-incision technique for implantation of the subcutaneous implantable cardioverter defibrillator: a 3-year follow-up.","authors":"Federico Migliore, Raimondo Pittorru, Enrico Giacomin, Pietro Bernardo Dall'Aglio, Pasquale Valerio Falzone, Emanuele Bertaglia, Sabino Iliceto, Dario Gregori, Manuel De Lazzari, Domenico Corrado","doi":"10.1007/s10840-023-01478-z","DOIUrl":"10.1007/s10840-023-01478-z","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the present study was to evaluate the outcome of patients underwent subcutaneous implantable cardioverter defibrillator (S-ICD) implantation with the intermuscular (IM) two-incision technique during 3-year follow-up.</p><p><strong>Methods: </strong>the study population consisted of 105 consecutive patients (79 male; median 50 [13-77] years) underwent S-ICD implantation with the IM two-incision technique. The composite primary end point of the study consisted of device-related complications and inappropriate shocks (IAS). Secondary end points included the individual components of the primary end point, death from any cause, appropriate therapy, major adverse cardiac events, hospitalization for heart failure, and heart transplantation.</p><p><strong>Results: </strong>According to the PRAETORIAN score, the risk of conversion failure was classified as low in 99 patients (94.3%), intermediate in 6 (5.7%).Ventricular fibrillation was successfully converted at ≤65 J in 97.4% of patients. During a median follow-up of 39 (16-53) months, 10 patients (9.5%) experienced device-related complications, and 9 (8.5%) patients reported IAS. Lead-associated complications were the most common (5 patients, 4.7%), including 2 cases of lead failure (1.9%). Pocket complications were reported in 2 patients (1.9%). Extra-cardiac oversensing (3.8%) represented the leading cause of IAS. No T-wave oversensing episodes were recorded. Twelve patients (11.4%) experienced appropriate shocks. Eight patients (7.6%) died during follow-up. IAS or device-related complications did not impact on mortality.</p><p><strong>Conclusions: </strong>The overall device-related complications and IAS rates over 3 years of follow-up were 9.5% and 8.5%, respectively. According to our findings, the IM two-incision technique allows for optimal positioning of the device achieving a low PRAETORIAN score with a high conversion rate. IM two-incision technique allows low incidence of pocket complications, shifting the type of complications towards lead-related complications, which represent the most common complications. The IM two-incision technique would not seem to impact the occurrence of IAS. Management of complications are safe without impact on the outcome.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1109-1119"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9101307","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":"Pulsed field ablation of atrial fibrillation in the setting of pulmonary vein stents: a case report.","authors":"Cyrus M Nouraee, Jason D Engelmann, Konstantinos C Siontis","doi":"10.1007/s10840-025-02005-y","DOIUrl":"10.1007/s10840-025-02005-y","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"953-956"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080253","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":"Ultrasound-guided puncture of femoral veins versus standard palpation approach in patients undergoing pulmonary vein isolation.","authors":"Lucio Addeo, Chiara Valeriano, Stefano Valcher, Vincenza Abbate, Raffaella Mistrulli, Dimitri Buytaert, Peter Geelen, Peter Peytchev, Koen De Schouwer, Tom De Potter","doi":"10.1007/s10840-024-01977-7","DOIUrl":"10.1007/s10840-024-01977-7","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1129-1130"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932135","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":"A new horizon in persistent atrial fibrillation ablation? Evaluating selective CFAE ablation guided by fractionation mapping.","authors":"Bogdan Enache, Decebal Gabriel Lațcu","doi":"10.1007/s10840-024-01950-4","DOIUrl":"10.1007/s10840-024-01950-4","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"971-972"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950215","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":"Prevalence of high ventricular pacing burden in patients requiring permanent pacemaker post TAVR.","authors":"Joseph Ibrahim, Brent S Medoff, Jianhui Zhu, Floyd Thoma, Derek Serna-Gallegos, David West, Amber Makani, N A Mark Estes, Catalin Toma, Ibrahim Sultan, Dustin Kliner","doi":"10.1007/s10840-024-01958-w","DOIUrl":"10.1007/s10840-024-01958-w","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve replacement (TAVR) is occasionally complicated by high degree atrioventricular block (AVB) requiring permanent pacemaker (PPM) placement. Newer valve design, delivery platform evolution, and deployment technique refinement have lowered this risk. Ventricular pacing ≥ 30% has been previously identified as a predictor for worse clinical outcomes in this population. This study aims to assess the prevalence of high long-term pacing burden in this cohort.</p><p><strong>Methods: </strong>This is a retrospective study to evaluate patients from 2019 to 2023 who required PPM for high degree AVB following TAVR. Baseline demographics, clinical characteristics, procedural details were obtained. Ventricular pacing (VP) percentages were collected from PPM interrogations at 1, 6 and 12 months.</p><p><strong>Results: </strong>138 patients had PPM placement post-TAVR. Approximately one third of patients demonstrated ventricular pacing less than 25% at 1 month, 6 months, and 12 months (Fig. 1). Roughly 50% of patients had > 75% ventricular pacing at 1 month, 6months and 12 months. There was no difference in baseline demographics or EKG characteristics at 1 month. In a univariable logistic regression analysis, there were no statistically significant predictors of VP ≥ 30%. Although, balloon expandable valves and lower STS scores demonstrated an association with lower risk of VP ≥ 30%.</p><p><strong>Conclusions: </strong>Our study suggests that a significant portion of patients with PPM for high degree AVB after TAVR have low pacing burden at 6-12 months. Further investigation is needed to assess valve-specific predictors and alternative pacing approaches of AVB management.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1045-1051"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449299","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":"A new stepwise approach to minimize phrenic nerve injury during cryoballoon pulmonary vein isolation.","authors":"K Phkhaladze, H Omran, T Fink, V Sciacca, D Guckel, M Khalaph, M Braun, M El Hamriti, J Thale, G Nölker, J Vogt, C Sohns, P Sommer, G Imnadze","doi":"10.1007/s10840-024-01953-1","DOIUrl":"10.1007/s10840-024-01953-1","url":null,"abstract":"<p><strong>Background: </strong>A phrenic nerve injury (PNI) during cryoballoon (CB) pulmonary vein isolation (PVI) continues to represent a limitation of this technique. The objective of this study was to develop a novel technique with the aim of reducing the incidence of PNI.</p><p><strong>Methods: </strong>We performed a retrospective analysis of data from two hospitals in patients with symptomatic, drug-resistant atrial fibrillation (AF) over 7 years to evaluate the incidence and clinical characteristics of PNI during cryoballoon PVI. Patients in the intervention group were treated with a new technique consisting of the following consecutive steps: (A) phrenic nerve stimulation near stimulation threshold instead of 10 V stimulation; (B) advanced ablation to the right superior pulmonary vein (PV) using a pre-freezing technique; (C) \"pulling away\" of the CB after vein isolation and/or after reaching - 40 °C for both right PVs. Two subtypes of PNI were studied: persistent (no recovery to discharge) and transient (recovery to discharge) PNI.</p><p><strong>Results: </strong>Nine hundred patients with a mean age of 62.3 (± 10.9) years (38% female) were analyzed. Transient PNI occurred in 8/250 patients (3.2%) in the intervention group compared to 39/750 patients (6%) in the control group (p = 0.09). Persistent PNI occurred in one patient (0.4%) in the intervention group compared to 18 (2.8%) in the control group (p = 0.03). Any PNI occurred in 9 patients in the intervention group (3.6%) compared to 57 patients (8.8%) in the control group (p = 0.008).</p><p><strong>Conclusion: </strong>In this retrospective analysis, a new cryo-PVI technique significantly reduces the incidence of PNI, particularly persistent PNI.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1087-1093"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864535","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":"Clinical relevance of left atrial structural remodeling and non-pulmonary vein foci in atrial fibrillation.","authors":"Atsuhiko Yagishita, Susumu Sakama, Kazuma Iimura, Kyong Hee Lee, Kengo Ayabe, Mari Amino, Yuji Ikari, Koichiro Yoshioka","doi":"10.1007/s10840-024-01931-7","DOIUrl":"10.1007/s10840-024-01931-7","url":null,"abstract":"<p><strong>Background: </strong>The mechanistic role of left atrial (LA) structural remodeling as a non-pulmonary vein (PV) trigger in the initiation of atrial fibrillation (AF) remains uncertain. This study is aimed at prospectively evaluating the association between non-PV triggers and LA structural remodeling.</p><p><strong>Methods: </strong>A total of 517 patients undergoing catheter ablation for AF were included. After PV isolation, a standardized protocol was implemented to reveal non-PV triggers, which included burst pacing into AF followed by cardioversion during isoproterenol infusion. If pacing-induced atrial tachycardia (AT) was observed, mapping and catheter ablation were performed.</p><p><strong>Results: </strong>The mean percentage of LA low-voltage area (LVA) < 0.5 mV incrementally increased during right atrial pacing among the no induction (n = 470), AF (n = 21), and AT (n = 26) groups (2.6 ± 5.7%, 5.5 ± 6.4%, and 18.0 ± 21.5%, respectively; P < 0.001). In the AF induction group, non-PV foci originated from the left atrium in 13 of 25 foci (52%), and 8 of 13 LA non-PV foci (62%) were located in the septal region. All except 1 focus originated from the non-LVA < 0.5 mV (8%), but 8 of the 13 LA foci originated from the LVA < 1.0 mV (62%). There were no differences in AF recurrence among the groups (log-rank, P = 0.160).</p><p><strong>Conclusion: </strong>The majority of non-PV foci in the LA originated outside regions with advanced structural remodeling, thus suggesting the limited effectiveness of adjunctive ablation guided by the LVA < 0.5 mV during sinus rhythm in eliminating non-PV triggers.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"977-983"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467635","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":"Peak frequency drop: a novel intraprocedural parameter predicting acute conduction gaps post-pulmonary vein isolation.","authors":"Yoshiaki Mizutani, Yuma Matsumoto, Keisuke Nishio, Hiroya Sakai, Gen Fujiwara, Daishi Nonokawa, Yuichiro Makino, Hitomi Suzuki, Hitoshi Ichimiya, Yasuhiro Uchida, Junji Watanabe, Masaaki Kanashiro, Satoshi Yanagisawa, Yasuya Inden, Toyoaki Murohara","doi":"10.1007/s10840-025-02019-6","DOIUrl":"10.1007/s10840-025-02019-6","url":null,"abstract":"<p><strong>Background: </strong>The identification of potential gap sites after pulmonary vein isolation (PVI) and prevention of these warning points during ablation are crucial. We evaluated the changes in peak frequency (PF) on electrograms and examined the relationship between its value and the residual pulmonary vein (PV) gap after PVI.</p><p><strong>Methods: </strong>We included patients with a PV gap after PVI with a power setting of 50 W using a novel irrigated-tip catheter (TactiFlex, Abbott). The PF on bipolar electrograms in the ablation catheter was recorded immediately before and after ablation at all available ablation points, using Omnipolar technology near field. We compared the pre- and post-PF values, changes in PF, contact force, and impedance drop between points with and without a PV gap following PVI.</p><p><strong>Results: </strong>A total of 695 ablation points in 13 patients were analyzed. There were 19 and 676 points with and without the PV gap, respectively. The PV gap group demonstrated significantly lower PF drop and contact force (-14 ± 43 Hz vs. 61 ± 57 Hz, p < 0.001; and 8 [7-10] g vs. 10 [4-14] g, p = 0.039), and higher post-PF (226 ± 49 Hz vs. 176 ± 47 Hz, p < 0.001) than in the non-PV gap group. The PF drop had the highest area under the curve of 0.878 (95% confidence interval: 0.791-0.964) on receiver operating characteristic curve analysis for predicting the PV gap, with a cutoff value of 10.5 Hz (sensitivity, 81.8%; specificity, 89.5%).</p><p><strong>Conclusion: </strong>PF drop during PVI is a useful parameter for predicting the non-PV gap with a high probability.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1035-1044"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449296","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 outcome after ablation of persistent atrial fibrillation in patients with postprocedurally unmasked sinus node disease.","authors":"Verena Kantenwein, Elisabeth Martini, Bernhard Haller, Marta Telishevska, Felix Bourier, Tilko Reents, Marc Kottmaier, Sarah Lengauer, Isabel Deisenhofer, Christof Kolb","doi":"10.1007/s10840-025-01998-w","DOIUrl":"10.1007/s10840-025-01998-w","url":null,"abstract":"<p><strong>Background: </strong>About three percent of patients with persistent atrial fibrillation (AF) additionally suffer from a concealed sinus node disease (SND). We sought to determine the success of ablation one year after ablation of persistent AF in patients with postprocedurally unmasked SND.</p><p><strong>Methods and results: </strong>In total, 2539 patients with an ablation of persistent AF at our centre were screened for a postprocedurally unmasked SND, which made acute cardiac pacing necessary within one week after ablation. In a propensity score-matched case-control study (1:2 matching), the long-term ablation success of 51 patients (mean age 73 ± 8 years, 59% male) with unmasked SND after ablation of persistent AF was compared to that of 102 patients without SND after ablation of persistent AF. Controls were matched to cases based on the propensity score considering age, body mass index, left ventricular ejection fraction, gender, blood pressure, diabetes mellitus, atrial low voltage, previous number of ablations, and method of ablation. One year after ablation of persistent AF, 20 (39%) patients with postprocedurally unmasked SND and 61 (60%) patients without postprocedurally unmasked SND were in sinus rhythm (OR 0.43, 95% CI 0.22 to 0.90, p = 0.017). The number of repeat ablation procedures within the follow-up year did not differ significantly between cases and controls (mean 0.60 ± 0.68 vs 0.53 ± 0.80, rate ratio 1.14, 95% CI 0.72 to 1.78, p = 0.566).</p><p><strong>Conclusion: </strong>In patients with a postprocedurally unmasked SND after ablation of persistent AF, long-term ablation success seems to be worse compared to patients without postprocedurally unmasked SND.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"985-993"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188863","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}