Journal of Interventional Cardiac Electrophysiology最新文献

{"title":"Usefulness of empiric superior vena cava isolation in paroxysmal atrial fibrillation ablation: a meta-analysis of randomized clinical trials.","authors":"Marco Valerio Mariani, Marta Palombi, Jean Pierre Jabbour, Nicola Pierucci, Pietro Cipollone, Agostino Piro, Cristina Chimenti, Fabio Miraldi, Carmine Dario Vizza, Carlo Lavalle","doi":"10.1007/s10840-024-01867-y","DOIUrl":"10.1007/s10840-024-01867-y","url":null,"abstract":"<p><strong>Background: </strong>The long-term success rate of pulmonary vein isolation (PVI) is suboptimal due to the presence of non-pulmonary vein (PV) foci that can trigger atrial fibrillation (AF) in up to 11%. Among non-PV triggers, the superior vena cava (SVC) is a major site of origin of ectopic beats initiating AF.</p><p><strong>Objective: </strong>To compare data from randomized controlled trials (RCTs) assessing PVI + empiric SVC isolation (SVCI) versus PVI alone in terms of AF recurrence, procedure-related complications, and fluoroscopic and procedural times.</p><p><strong>Methods: </strong>A search of online scientific libraries (from inception to April 1, 2024) was performed. Four RCTs were considered eligible for the meta-analysis totaling 600 patients of whom 287 receiving PVI + SVCI and 313 receiving PVI alone.</p><p><strong>Results: </strong>In the overall population, SVCI + PVI was associated with a non-significant reduction of AF recurrence at follow-up (0.66 [0.43;1.00], p = 0.05, I² 0%). In patients with paroxysmal AF (PAF), a significant reduction of AF recurrence was related to SVCI + PVI (11.7%) as compared to PVI alone (19.9%) (0.54 [0.32;0.92], p = 0.02, I² 0%). No statistical differences were found among the groups in terms of fluoroscopic (3.31 [- 0.8;7.41], p = 0.11, I² = 91%), procedural times (5.69 [- 9.78;21.16], p = 0.47, I² = 81%), and complications (1.06 [0.33;3.44], p = 0.92, I² = 0%).</p><p><strong>Conclusion: </strong>The addition of SVCI to PVI in patients in PAF is associated with a significant lower rate of AF recurrence at follow-up, without increasing complication rates and procedural and fluoroscopy times.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"93-100"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906736","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":"Prognostic value of non-invasive programmed ventricular stimulation after VT ablation to predict VT recurrences.","authors":"Julian Müller, Ivaylo Chakarov, Karin Nentwich, Artur Berkovitz, Sebastian Barth, Felix Ausbüttel, Christian Wächter, Heiko Lehrmann, Thomas Deneke","doi":"10.1007/s10840-024-01883-y","DOIUrl":"10.1007/s10840-024-01883-y","url":null,"abstract":"<p><strong>Background: </strong>The prognostic value of (non)-invasive programmed ventricular stimulation (NIPS) to predict recurrences of ventricular tachycardia (VT) is under discussion. Optimal endpoints of VT ablation are not well defined, and optimal timepoint of NIPS is unknown. The goal of this study was to evaluate the ability of programmed ventricular stimulation at the end of the VT ablation procedure (PVS) and NIPS after VT ablation to identify patients at high risk for VT recurrence.</p><p><strong>Methods: </strong>Between January 2016 and February 2022, consecutive patients with VT and structural heart disease undergoing first VT ablation and consecutive NIPS were included. In total, 138 patients were included. All patients underwent NIPS through their implanted ICDs after a median of 3 (1-5) days after ablation (at least 2 drive cycle lengths (500 and 400 ms) and up to four right ventricular extrastimuli until refractoriness). Clinical VT was defined by comparison with 12-lead electrocardiograms and stored ICD electrograms from spontaneous VT episodes. Patients were followed for a median of 37 (13-61) months.</p><p><strong>Results: </strong>Of the 138 patients, 104 were non-inducible (75%), 27 were inducible for non-clinical VTs (20%), and 7 for clinical VT (5%). In 107 patients (78%), concordant results of PVS and NIPS were observed. After 37 ± 20 months, the recurrence rate for any ventricular arrhythmia was 40% (normal NIPS 29% vs. inducible VT during NIPS 66%; log-rank p = 0.001) and for clinical VT was 3% (normal NIPS 1% vs. inducible VT during NIPS 9%; log-rank p = 0.045). Positive predictive value (PPV) and negative predictive value (NPV) of NIPS were higher compared to PVS (PPV: 65% vs. 46% and NPV: 68% vs. 61%). NIPS revealed the highest NPV among patients with ICM and LVEF > 35%. Patients with inducible VT during NIPS had the highest VT recurrences and overall mortality. Patients with both negative PVS and NIPS had the lowest any VT recurrence rates with 32%. Early re-ablation of patients with recurrent VTs during index hospitalization was feasible but did not reveal better long-term VT-free survival.</p><p><strong>Conclusions: </strong>In patients after VT ablation and structural heart disease, NIPS is superior to post-ablation PVS to stratify the risk of VT recurrences. The PPV and NPV of NIPS at day 3 were superior compared to PVS at the end of the procedure to predict recurrent VT, especially in patients with ICM.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"101-110"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988113","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":"Upstream targeting for the prevention of atrial fibrillation: Targeting Risk Interventions and Metformin for Atrial Fibrillation (TRIM-AF)-rationale and study design.","authors":"Sojin Y Wass, John Barnard, Hyun Su Kim, Han Sun, William Telfer, Taylor Schilling, Benico Barzilai, Dennis Bruemmer, Leslie Cho, Julie Huang, Ayman Hussein, Sangeeta R Kashyap, Luke Laffin, Reena Mehra, Chris Moravec, Walid Saliba, Prashanthan Sanders, Steven Nissen, Niraj Varma, Jonathan Smith, David Van Wagoner, Mina K Chung","doi":"10.1007/s10840-024-01955-z","DOIUrl":"10.1007/s10840-024-01955-z","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in ablation and other therapies for AF, progression of atrial fibrillation (AF) remains a significant clinical problem, associated with worse prognosis and worse treatment outcomes. Upstream therapies targeting inflammatory or antifibrotic mechanisms have been disappointing in preventing AF progression, but more recently genetic and genomic studies in AF suggest novel cellular and metabolic stress targets, supporting prior studies of lifestyle and risk factor modification (LRFM) for AF. However, while obesity is a significant risk factor, weight loss and risk factor modification have not been successfully applied in a US population with AF. Metformin, a common drug that targets metabolic stress pathways, has demonstrated potential in reducing the burden of AF.</p><p><strong>Methods: </strong>The Targeting Risk Interventions and Metformin for Atrial Fibrillation (TRIM-AF, NCT03603912) is a randomized clinical trial designed to examine reduction of AF burden and progression, targeting metabolic upstream therapies. This single center trial, at the Cleveland Clinic, is designed as a prospective randomized open-label blinded endpoint (PROBE) 2 × 2 factorial study of metformin extended release up to 750 mg twice daily and lifestyle and risk factor modification (LRFM) in patients with a cardiovascular implantable electronic device (CIED) that have had at least one ≥ 5-min episode of atrial fibrillation (AF) over the prior 3 months. Randomization is stratified by pacemaker vs. ICD and rhythm at enrollment (sinus rhythm/atrial paced vs. AF).</p><p><strong>Conclusion: </strong>TRIM-AF trial aims to determine if metformin, lifestyle, and risk factor modification (LRFM) reduce AF burden and its progression and assess whether combined therapy outperforms individual treatments.</p><p><strong>Trial registration: </strong>URL: https://clinicaltrials.gov/ ; Unique Identifier: NCT03603912.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"9-19"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818337","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":"The impact of peri-procedural imaging on safety and efficacy of atrial fibrillation ablation: insights from the Israeli AF Catheter Ablation Registry (ICAR).","authors":"Ibrahim Marai, Adi Elias, Guy Rozen, Roy Beinart, Eyal Nof, Yoav Michowitz, Michael Glikson, Yuval Konstantino, Moti Haim, David Luria, Alexander Omelchenko, Avishag Laish-Farkash, Mahmoud Suleiman","doi":"10.1007/s10840-024-01887-8","DOIUrl":"10.1007/s10840-024-01887-8","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary vein isolation (PVI) is the most effective therapy to achieve rhythm control in atrial fibrillation (AF). Peri-procedural imaging is used in many but not all centers. However, the impact of imaging on safety and efficacy of PVI is not clear. The Israeli Catheter Ablation Registry (ICAR) is a great opportunity to explore this issue in real-world practice.</p><p><strong>Aim: </strong>To describe the real-world utilization of peri-procedural imaging technologies in a large cohort of patients undergoing ablation for AF.</p><p><strong>Methods: </strong>A prospective-multicenter cohort of AF patients who underwent PVI during the years 2019-2021. Peri-procedural imaging (CT, ICE, TEE) was utilized based on the center and operator discretion. The study endpoints were peri-procedural complications and AF recurrence at 12 months follow-up among patients with and without peri-procedural imaging.</p><p><strong>Results: </strong>Between January 2019 and December 2021, a total of 921 patients underwent PVI. Peri-procedural imaging (at least 1 modality of CT, TEE, and or ICE) was utilized in 753 (81.8%) and no imaging among 168 (18.2%) patients. Cryoablation was the dominant energy used for PVI in both groups (92.3% of the non-imaging group, and 95.3% among imaging group), while RF was used in the rest of the patients. Fluoroscopy time was not different between the 2 groups; however, procedure duration was longer among the imaging group (90 min) compared to the non-imaging group (74.5 min, p = 0.006). By 12 months, the incidence of AF recurrence and repeated ablation were not different between the groups. Complications and re-hospitalization for cardiocerebrovascular reasons were not different among the 2 groups. Cox regression model demonstrated no association between preprocedural imaging and the risk of AF recurrence after ablation.</p><p><strong>Conclusion: </strong>This real-world multicenter prospective registry study demonstrated that the rate of complications and the rate of recurrence of AF during 1 year follow-up were not different among patients who had PVI either with or without peri-procedural imaging.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"73-81"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878857","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 right ventricular pacing site on the subcutaneous ICD sensing-a step towards personalised device therapy?","authors":"Mohamed ElRefai, Mohamed Abouelasaad, Christina Menexi, John Morgan, Paul R Roberts","doi":"10.1007/s10840-022-01218-9","DOIUrl":"10.1007/s10840-022-01218-9","url":null,"abstract":"<p><strong>Background: </strong>Patients with an existing subcutaneous implantable cardiac defibrillator (S-ICD) may develop a pacing indication. When transvenous pacing is not feasible, combining an S-ICD and a leadless pacemaker (LP) can be a reasonable option. There are reports of concomitant use of both devices. However, the effect of pacing on the S-ICD sensing is not well studied. We hypothesise that pacing changes R and T-wave amplitudes, causing changes in R:T ratios as perceived by a S-ICD, increasing the risk for T wave oversensing (TWO) during paced rhythm with a subsequent risk of inappropriate shocks.</p><p><strong>Methods: </strong>This is a prospective study in patients undergoing electrophysiological studies. Participants were fitted with a Holter®, and the leads were placed to correspond to the vectors of an S-ICD. The right ventricle was paced at four positions for 10 beats each at 8 mA/2 ms. The Holter® traces were analysed, using two-way analysis of variance (ANOVA) to assess the effect of pacing on the R:T ratio.</p><p><strong>Results: </strong>Forty-seven patients (age 56.02 ± 16.02, 72% male) were enrolled (81% structurally normal heart, 15% dilated cardiomyopathy, 2% ischaemic cardiomyopathy, and 2% adult congenital heart disease). Age, sex, and aetiology had no effect on the R:T ratio. Pacing caused significant changes in the R:T ratio. There was no significant difference in the R:T ratios between the pacing sites (p < 0.001).</p><p><strong>Conclusions: </strong>Pacing alters the R:T ratio significantly in most patients, theoretically increasing the risk for TWO and inappropriate shocks. Tailored programming for both devices is important for concomitant use of LPs and S-ICDs.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":"1 1","pages":"31-42"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47002629","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":"Correction: Implantation of a permanent pacemaker following orthotopic heart transplantation: a systematic review and meta-analysis.","authors":"Patavee Pajareya, Sathapana Srisomwong, Noppachai Siranart, Ponthakorn Kaewkanha, Yanisa Chumpangern, Narut Prasitlumkum, Jakrin Kewcharoen, Ronpichai Chokesuwattanaskul, Nithi Tokavanich","doi":"10.1007/s10840-024-01944-2","DOIUrl":"10.1007/s10840-024-01944-2","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"179"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622004","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":"Is day-case surgical procedure safe for MICRA leadless pacemaker implantation?","authors":"Lin-Thiri Toon, Mohammed ElRefai, Mohamed Abouelasaad, Roopa Patil, John Paisey, Arthur Yue, Paul Roberts","doi":"10.1007/s10840-024-01907-7","DOIUrl":"10.1007/s10840-024-01907-7","url":null,"abstract":"<p><strong>Background: </strong>MICRA implantation is not commonly done as a day-case procedure. Elective leadless pacemakers are implanted routinely in our centre.</p><p><strong>Objective: </strong>To assess whether the day-case MICRA procedure is safe.</p><p><strong>Methods: </strong>We retrospectively collected data from all patients undergoing elective MICRA implantation at our centre between May 2014 and Nov 2022 (n = 81). Two patient groups were stratified: those planned to be discharged on the same day (SD, n = 52) and those planned to be observed overnight after the procedure (ON, n = 29). Patient demographics, size of the sheath used, type of MICRA device, and rate of complications were recorded. In patients with successful implants (n = 80), device function at discharge and first routine follow-up were evaluated.</p><p><strong>Results: </strong>There were 58% males in the SD group and 45% in the ON group. Median age was 49 years in the SD and 67 years in the ON. Among patients who were planned as a day case, 8 patients had to stay in the hospital but for < 48 h: 2 due to minor groin bleeding, 1 due to patient's request despite fit to discharge, 4 due to the procedure carried out later in the day, and 1 for observation due to procedural complexity. MICRA implantation was successful in 80 patients. The rate of the major complications was 2% in the SD group and 7% in the ON group (p = 0.223), and none of the co-morbidities assessed showed an association with any complications. Device parameters at the follow-up were available in 76 patients. The rate of patients with low and stable PCT at follow-up was also 98% in the SD group and 96% in the ON group.</p><p><strong>Conclusions: </strong>Day case MICRA procedure can be performed safely in an appropriately selected patient population.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"117-123"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004420","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":"Mid-term clinical outcomes of left bundle branch area pacing compared to accurate right ventricular septal pacing.","authors":"Yousaku Okubo, Takumi Sakai, Shogo Miyamoto, Yukimi Uotani, Naoto Oguri, Motoki Furutani, Shunsuke Miyauchi, Sho Okamura, Takehito Tokuyama, Yukiko Nakano","doi":"10.1007/s10840-024-01890-z","DOIUrl":"10.1007/s10840-024-01890-z","url":null,"abstract":"<p><strong>Background: </strong>Although left bundle branch area pacing (LBBAP) reportedly results in fewer adverse outcomes after implantation than conventional stylet-guided right ventricular septal pacing (RVSP), previous studies have not compared LBBAP with accurate RVSP using a delivery catheter. The aim of this study was to compare clinical outcomes between LBBAP and accurate RVSP among patients with atrioventricular block (AVB).</p><p><strong>Methods: </strong>This single-center observational study enrolled 160 patients requiring RV pacing due to symptomatic AVB between September 2018 and December 2021. Primary composite outcomes included all-cause death, hospitalization due to heart failure (HF), and upgrading to biventricular pacing. Secondary composite outcomes included any procedural and postprocedural complications.</p><p><strong>Results: </strong>Overall, 160 patients were analyzed (LBBAP, n = 81; RVSP, n = 79). No significant differences in baseline characteristics were observed between the two groups. The RV pacing burden at 1 year after implantation was 90.8% ± 20.4% and 86.2% ± 22.6%, respectively (p = 0.21). During a mean follow-up of 840 ± 369 days, the incidence of the primary outcome was significantly lower with LBBAP (4.9%) compared to RVSP (22.8%) (Log-rank p = 0.02). There was no significant difference in the incidence of the secondary outcome between the two groups (3.7% vs. 5.1%, p = 0.65). In the multivariate analysis, baseline QRS duration, RV pacing burden, and LBBAP were independently associated with the primary outcome (baseline QRS duration: hazard ratio [HR], 1.01; 95% confidence interval [CI], 1.00-1.02; p < 0.001; RV pacing burden: HR, 1.01; 95% CI, 1.00-1.02; p < 0.001; LBBAP: HR, 0.45; 95% CI, 0.31-0.64; p < 0.001).</p><p><strong>Conclusion: </strong>In patients requiring frequent RV pacing, LBBAP was associated with reduced adverse clinical outcome compared to accurate RVSP using a delivery catheter.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"55-63"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788345","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 outcomes of conduction system pacing compared to biventricular pacing in patients with mid-range ejection fraction.","authors":"Jiaojiao Tang, Nathan W Kong, Andrew Beaser, Zaid Aziz, Srinath Yeshwant, Cevher Ozcan, Roderick Tung, Gaurav A Upadhyay","doi":"10.1007/s10840-024-01882-z","DOIUrl":"10.1007/s10840-024-01882-z","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of data comparing conduction system pacing (CSP) to biventricular pacing (BiVP) in patients with heart failure (HF) with mid-range left ventricular ejection fraction (LVEF).</p><p><strong>Objective: </strong>Compare the clinical outcomes of patients with mid-range LVEF undergoing CSP versus BiVP.</p><p><strong>Methods: </strong>Patients with mid-range LVEF (> 35 to 50%) undergoing CSP or BiVP were retrospectively identified. Lead performance, LVEF, HF hospitalization, and clinical composite outcome including upgrade to cardiac resynchronization therapy and mortality were compared.</p><p><strong>Results: </strong>A total of 36 patients (20 BiVP, 16 CSP--14 His bundle pacing, 4 left bundle branch area pacing) were analyzed. The mean age was 73 ± 15, 44% were female, and the mean LVEF was 42 ± 5%. Procedural and fluoroscopy time was comparable between the two groups. QRS duration was significantly shorter for the CSP group compared to the BiVP group (P < 0.001). During a mean follow-up of 47 ± 36 months, no significant differences were found in thresholds or need for generator change due to early battery depletion. LVEF improved in both groups (41.5 ± 4.5% to 53.9 ± 10.9% BiVP, P < 0.001; 41.6 ± 5.3% to 52.5 ± 8.3% CSP, P < 0.001). There were no significant differences in HF hospitalizations (P = 0.71) or clinical composite outcomes (P = 0.07).</p><p><strong>Conclusion: </strong>Among patients with HF with moderately reduced ejection fraction, CSP appears associated with similar improvements in LVEF and had similar clinical outcomes as BiVP in mid-term follow-up.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"111-116"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995862","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":"Implantation of a permanent pacemaker following orthotopic heart transplantation: a systematic review and meta-analysis.","authors":"Patavee Pajareya, Sathapana Srisomwong, Noppachai Siranart, Ponthakorn Kaewkanha, Yanisa Chumpangern, Narut Prasitlumkum, Jakrin Kewcharoen, Ronpichai Chokesuwattanaskul, Nithi Tokavanich","doi":"10.1007/s10840-024-01909-5","DOIUrl":"10.1007/s10840-024-01909-5","url":null,"abstract":"<p><strong>Background: </strong>Orthotopic heart transplant (OHT) is among the final armamentariums for end-stage heart disease. Many patients who have had OHT require a post-transplant permanent pacemaker (PPM) implantation due to an abnormal conduction system. We aimed to evaluate the risk of mortality and acute rejection in patients with OHT who had received PPM compared to patients without PPM and to determine predictors for PPM placement in this population.</p><p><strong>Methods: </strong>We comprehensively searched for studies from MEDLINE, EMBASE, and Cochrane databases from inception to September 2023. Inclusion criteria focused on patients who had undergone OHT and PPM implantation post-transplant. Data from each study were combined using a random-effects model. Results were expressed as relative risk (RR) or odd ratios (OR) with a 95% confidence interval (CI).</p><p><strong>Results: </strong>A total of 9 studies were included in this meta-analysis incorporating a total of 54,848 patients (3.3% had PPM). The pooled all-cause mortality rate among patients with PPM post-OHT was 26% (95% CI: 19-33%, I² = 1%). There were no differences between post-heart transplant patients with PPM and those without PPM in risk of all-cause mortality (RR 0.76, 95% CI: 0.43-1.34; I² = 45%) and acute rejection (RR 1.22, 95% CI: 0.74-2.00, I² = 59%). Bi-atrial anastomosis was associated with an increased risk of PPM implantation post-OHT (OR 7.74, 95% CI: 3.55-16.91, I² = 0%), while pre-OHT mechanical circulatory support (MCS) was associated with a decreased risk of PPM implantation post-OHT (OR 0.45, 95% CI 0.27-0.76, I² = 0%).</p><p><strong>Conclusion: </strong>There were no significant differences in all-cause mortality or acute rejection between post-OHT recipients who required PPM compared to those who did not receive PPM. Further, bi-atrial anastomosis portended the need for PPM implantation, while MCS was associated with a decreased occurrence of PPM.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"167-177"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072955","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}