Journal of Interventional Cardiac Electrophysiology最新文献

{"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":"https://doi.org/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":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-03","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":"Safety, efficacy, and quality of life outcomes of pulsed field ablation in Japanese patients with atrial fibrillation: results from the PULSED AF trial.","authors":"Teiichi Yamane, Tetsuo Sasano, Hirofumi Tomita, Daisetsu Aoyama, Shinsuke Miyazaki, Masateru Takigawa, Masaomi Kimura, Taihei Itoh, Seigo Yamashita, Jada M Selma, Jeffrey Cerkvenik, Atul Verma, Hiroshi Tada","doi":"10.1007/s10840-024-01912-w","DOIUrl":"10.1007/s10840-024-01912-w","url":null,"abstract":"<p><strong>Background: </strong>Pulsed field ablation (PFA), a novel treatment for atrial fibrillation (AF), has yet to be evaluated in a Japanese cohort.</p><p><strong>Methods: </strong>In this sub-analysis of the PULSED AF trial, 12-month outcomes of paroxysmal AF (PAF) and persistent AF (PsAF) patients treated with PFA in four Japan centers were assessed. After a 90-day blanking period, primary efficacy was determined via freedom from a composite endpoint of acute procedural failure, arrhythmia recurrence, or antiarrhythmic drug escalation over 1 year. Patient improvement was evaluated via two quality of life (QoL) surveys (AFEQT and EQ-5D) at baseline and 12 months.</p><p><strong>Results: </strong>The analysis included 32 patients, 16 PAF and 16 PsAF, with PAF patients averaging 61.1 ± 10.6 years and PsAF patients averaging 62.8 ± 11.5 years of age. Females made up 31% of PAF and 25% of PsAF cohorts. Acute pulmonary vein isolation was achieved in 100% of both cohorts. The primary efficacy success rate at 12 months was 75.0% for PAF and 56.3% for PsAF patients. No primary safety events occurred. The mean AFEQT score significantly increased for both PAF (25.9 points, p < 0.0001) and PsAF (13.2 points, p = 0.0002) patients, while the EQ-5D-5L score improved significantly for PAF (0.12 points, p = 0.048) patients but not for PsAF (0.04 points, p = 0.08) patients.</p><p><strong>Conclusions: </strong>Similar to outcomes in the global cohort, ablation with the PulseSelect™ PFA catheter was efficient, effective, and safe in a Japanese population, resulting in improved QoL for PAF and PsAF patients.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov Identifier: NCT04198701.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"149-157"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145793","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":"Noninvasive programmed stimulation after ventricular tachycardia ablation: gazing into a crystal ball to predict recurrences?","authors":"Jeanne du Fay de Lavallaz, Jackson J Liang","doi":"10.1007/s10840-024-01898-5","DOIUrl":"10.1007/s10840-024-01898-5","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"27-28"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072956","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":"Inappropriate shocks due to P-wave oversensing in a patient with a subcutaneous implantable cardioverter-defibrillator.","authors":"Fatima M Ezzeddine, Ammar M Killu, Abhishek J Deshmukh, Freddy Del-Carpio Munoz","doi":"10.1007/s10840-023-01625-6","DOIUrl":"10.1007/s10840-023-01625-6","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"1-4"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10162562","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":"Hybrid ablation for persistent/long-standing persistent atrial fibrillation: a meta-analysis and trial sequential analysis of randomized controlled trials.","authors":"André Rivera, Marcelo Antonio Pinheiro Braga, Caique M P Ternes, Douglas Mesadri Gewehr, Felipe Villa Martignoni, Alexander Dal Forno, Andrew H Locke, André d'Avila","doi":"10.1007/s10840-024-01839-2","DOIUrl":"10.1007/s10840-024-01839-2","url":null,"abstract":"<p><p>The efficacy and safety of hybrid ablation (HA) for patients with non-paroxysmal atrial fibrillation (AF) remain unclear. PubMed, Embase, Cochrane, and ClinicalTrials.gov were searched for randomized controlled trials (RCTs) comparing HA (endo-epicardial ablation) versus endocardial ablation (EA) for patients with persistent/long-standing persistent AF. Risk ratios (RRs) and 95% confidence intervals (CIs) were pooled. Our meta-analysis included 3 RCTs comprising 358 patients, of whom 233 (65.1%) were randomized to HA. Compared with EA, HA reduced the recurrence of atrial tachyarrhythmias (RR 0.53; 95% CI 0.41-0.69; p < 0.01) but had no subgroup interaction according to AF type (p = 0.90). There was no significant difference in major adverse events (RR 1.22; 95% CI 0.46-3.25; p = 0.68). Trial sequential analysis indicates that the observed effects can be deemed conclusive. In conclusion, in patients with persistent/long-standing persistent AF, HA substantially reduced the recurrence of atrial tachyarrhythmias. Notably, patients with long-standing persistent AF may benefit more from this ablation strategy.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"159-163"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436946","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":"Localized three-dimensional reentrant ventricular tachycardia visualized by high-density mapping in arrhythmogenic right ventricular cardiomyopathy.","authors":"Tetsuma Kawaji, Saki Yamano, Misaki Naka, Masashi Kato, Takafumi Yokomatsu, Shinji Miki","doi":"10.1007/s10840-024-01892-x","DOIUrl":"10.1007/s10840-024-01892-x","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"21-22"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897575","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":"Pulsed-field ablation of atrial fibrillation using the Farapulse system through the jugular vein: a case series of two patients.","authors":"Alex Scripcariu, Serge Boveda, Robin Richard-Vitton, Stephane Combes, Jean Paul Albenque, Nicolas Combes, Quentin Voglimacci-Stephanopoli","doi":"10.1007/s10840-024-01949-x","DOIUrl":"10.1007/s10840-024-01949-x","url":null,"abstract":"<p><p>We present two cases of patients with inaccessible femoral veins referred for ablation of paroxysmal atrial fibrillation (AF) who underwent Jugular access pulmonary vein isolation (PVI) with the pentaspline pulsed field ablation system. To our knowledge, there is only one other case reported of usage of this system via a superior approach by Mol et al. (Journal of Interventional Cardiac Electrophysiology (2023) 66:835-836).</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"5-8"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687143","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":"Peri-procedural anesthesia and patient pain experience in pulmonary vein isolation by means of very high-power short-duration radiofrequency ablation.","authors":"Poggi Sara, Strisciuglio Teresa, Iuliano Assunta, Spiniello Giorgio, Schillaci Vincenzo, Arestia Alberto, Shopova Gergana, Salito Armando Mariano, Marano Giovanni, La Rocca Vincenzo, Agresta Alessia, Ricciolino Riccardo, Cosimo Damiano Di Candia, Tommaso Infusino, Marco Micillo, De Simone Antonio, Solimene Francesco, Stabile Giuseppe","doi":"10.1007/s10840-024-01913-9","DOIUrl":"10.1007/s10840-024-01913-9","url":null,"abstract":"<p><strong>Background: </strong>Very high-power short-duration (vHPSD) temperature-controlled radiofrequency ablation (vHPSD) may reduce ablation times and improve patient tolerability, permitting pulmonary vein (PV) isolation under mild conscious sedation. We evaluated of the anesthetic drugs use and patients' pain experience during vHPSD PV isolation.</p><p><strong>Methods: </strong>Fifty-eight patients, with paroxysmal and persistent atrial fibrillation (AF), treated with QDot Micro catheter and vHPSD (90 w for 4 s) (vHPSD group), were compared with the last 33 patients treated with a surround flow contact force-sensing catheter guided by the ablation index (450 anteriorly at 50 W, 330 posteriorly at 40 W) (AI group). Anesthetic drugs use was compared as well as pain experience, measured using a 0-10 scale.</p><p><strong>Results: </strong>All PVs were acutely isolated. Procedural time (78 ± 10 min vs 84 ± 12 min, p = 0.012), fluoroscopy time (369 ± 139 s vs 441 ± 172 s, p = 0.03), and RF time in the vHPSD group (8.3 ± 2.1 min) were shorter than in the AI group (25 ± 11 min, p < 0.001). Only 4 patients experienced an access site-related vascular complication (groin hematoma). Midazolam was required in 36 (62%) vHPSD group patients vs 31 (94%) AI group patients (p < 0.001). Fentanyl was required in 4 (7%) vHPSD group patients vs 25 (76%) AI group patients (p < 0.001). No patients required general anesthesia. Twenty-two (38%) vHPSD group patients underwent PV isolation without any anesthetic drug. Pain experience was significantly lower in vHPSD group (4.9 ± 2 vs 6.6 ± 1.8, p < 0.001).</p><p><strong>Conclusions: </strong>vHPSD radiofrequency ablation for PVI can be performed under conscious sedation using only benzodiazepine in most of patients without compromising patient pain experience.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"141-147"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108201","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":"Targeting pulmonary vein myocardial sleeves with omnipolar mapping can reduce radiofrequency applications and procedure time: a proof-of-concept study.","authors":"Alejandro Vidal Margenat, Som Prabh Singh, Sarah Kondrach, Ellen Condoure, Jeremy Russell, Ramesh Hariharan","doi":"10.1007/s10840-024-01888-7","DOIUrl":"10.1007/s10840-024-01888-7","url":null,"abstract":"<p><strong>Background: </strong>There remains an imperative need to accurately map the left atrium in the setting of atrial fibrillation. While the pulmonary vein segmental ostial isolation plays a significant role in atrial fibrillation, clinical attempts to selectively ablate near the pulmonary vein myocardial sleeves have demonstrated a higher recurrence rate of arrhythmia given less precise mapping modalities. However, novel omnipolar mapping technology coupled with Advisor™ HD Grid Mapping Catheter may provide an advantageous profile to map and selectively ablate near the myocardial sleeves.</p><p><strong>Methods: </strong>This retrospective cohort underwent ablation targeting the pulmonary vein myocardial sleeves with the use of omnipolar mapping technology and later wide area circumferential ablation (WACA) was performed.</p><p><strong>Results: </strong>The findings of this study demonstrated a few number of lesions were required to achieve all PVI targeting PVMS at 36 (95% CI 32-41) compared to WACA at 81 (95% CI 73-90). PVMS radiofrequency time was shorter at 314 s (95% CI 278-350 s) compared to 799 s (95% CI 692-906 s) for WACA. Mean procedure time to complete PVMS was 59 min (95% CI 53-65) and to complete WACA was 90 min (95% CI 80-100).</p><p><strong>Conclusion: </strong>Precision ablation near PVMS coupled with omnipolar technology may provide a superior profile in reducing procedure time and number of ablative lesions compared to WACA in the setting of atrial fibrillation with possible similar results. Future investigation using randomized controlled trials can help further support these findings.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"83-91"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897577","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":"Vein of Marshall ethanol infusion for recurrent atrial fibrillation in patients with durably isolated pulmonary veins.","authors":"Gregory Cunn, Apoor Patel, Kristie Coleman, Eric Dulmovits, Nicholas Skipitaris, Laurence Epstein, Stavros Mountantonakis, Stuart Beldner","doi":"10.1007/s10840-024-01877-w","DOIUrl":"10.1007/s10840-024-01877-w","url":null,"abstract":"<p><strong>Background: </strong>Vein of Marshall (VoM) ethanol ablation has a proven benefit in patients with persistent atrial fibrillation (AF) undergoing index procedure; however, its role in repeat ablation is unknown. We sought to evaluate the benefit of empiric VoM ethanol ablation in addition to posterior wall isolation (PWI) during the repeat procedure in patients with durable pulmonary vein (PV) isolation from prior ablation.</p><p><strong>Methods: </strong>Twenty-three patients (age 67.1 + / - 7.4, 74% males) who received empiric VoM ethanol infusion in addition to PWI were matched for age, gender, ejection fraction, and left atrial size with forty-six patients receiving empiric PWI alone. All patients in the study group underwent additional ablation on mitral isthmus to complete the lateral mitral isthmus line. Additional ablation was based on program and trigger stimulation. Primary outcome was freedom from AF after a blanking period of 3 months by qualification of symptoms, EKG, wearable, or implantable monitor or device.</p><p><strong>Results: </strong>The study group had a higher average BMI (35.07 + / - 8.98 vs. 30.85 + / - 5.65, p = 0.033) and rate of persistent AF (83.0% vs. 54.3%, p = 0.029) versus the control. The 1-year AF-free survival for the study and control groups was 20 (86.96%) and 28 (60.1%) patients (p = 0.027). Cox proportional hazard regression analysis showed a significant reduction in AF recurrence in the study group (HR 0.25, 95% CI 0.073-0.843, p = 0.026).</p><p><strong>Conclusion: </strong>Among patients undergoing repeat catheter ablation for recurrent AF with durably isolated PVs, the addition of VoM ethanol infusion increased the likelihood of remaining free from AF at 12 months.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"65-71"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792651","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}