Heart Rhythm O2最新文献

{"title":"Associations between atrial fibrillation symptom clusters and major adverse cardiovascular events following catheter ablation","authors":"","doi":"10.1016/j.hroo.2024.08.013","DOIUrl":"10.1016/j.hroo.2024.08.013","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global voices on atrial fibrillation care in China","authors":"","doi":"10.1016/j.hroo.2024.08.004","DOIUrl":"10.1016/j.hroo.2024.08.004","url":null,"abstract":"<div><div>An aging population, coupled with the high prevalence of physical inactivity, obesity, dyslipidemia, hypertension, and diabetes mellitus, has led to a significant increase in the incidence and prevalence of atrial fibrillation (AF) in China. Managing clinical complexity of AF patients poses significant challenges. Current guidelines advocate for holistic or integrated management using the ABC (Atrial fibrillation Better Care) pathway. Compliance with the ABC pathway has demonstrated promising benefit in improving clinical outcomes. The mAFA II trial (the mHealth technology for improved screening, patient involvement, and optimized integrated care in Atrial Fibrillation) explores the potential of a mobile health technology–supported integrated care approach in reducing the risks of rehospitalization and clinical adverse events. However, disparities persist between urban and rural areas, with the likelihood of rural older individuals by themselves using intelligent devices being extremely low. Therefore, the application prospects of the mobile AF application strategy in rural areas are greatly limited. The ongoing MIRACLE-AF trial (A Novel Model of Integrated Care of Older Patients With Atrial Fibrillation in Rural China) aims to address unique healthcare challenges faced by rural older patients with AF through a novel integrated care model, which is led by village doctors and supported by a digital health platform. In conclusion, innovative integrated care approaches using digital technologies offer promising solutions to enhance AF care across diverse settings in China, catering to the needs of both urban and rural populations.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethanol infusion into the vein of Marshall reduced atrial tachyarrhythmia recurrence during catheter ablation: A systematic review and meta-analysis","authors":"","doi":"10.1016/j.hroo.2024.08.011","DOIUrl":"10.1016/j.hroo.2024.08.011","url":null,"abstract":"<div><h3>Background</h3><div>Ethanol infusion into the vein of Marshall (EIVoM) may increase mitral isthmus bidirectional block (MIBB) and cause local autonomic denervation that may improve outcome.</div></div><div><h3>Objective</h3><div>This meta-analysis aimed to investigate whether the addition of EIVoM to atrial fibrillation (AF) ablation led to a better outcome.</div></div><div><h3>Methods</h3><div>Systematic literature search was performed using PubMed, Scopus, ScienceDirect, and Europe PMC for studies that compared the addition of EIVoM during AF ablation with radiofrequency ablation. The primary outcome was <em>atrial tachyarrhythmia</em> (ATa) recurrence, defined as AF/atrial flutter/atrial tachycardia after the blanking period.</div></div><div><h3>Results</h3><div>There were 2821 patients from 11 studies, and EIVoM was successful in 77% (95% confidence interval [CI] 62%–92%). ATa recurrence was 27% (95% CI 20%–34%) in the EIVoM group and 42% (95% CI 33%–51%) in ablation-only group. EIVoM reduced ATa recurrence (odds ratio [OR] 0.52; 95% CI 0.36–0.76; <em>P</em> &lt; .001; I² = 76.92). The rate of MIBB was 85% (95% CI 77%–94%) in the EIVoM group and 73% (95% CI 61%–85%) in the ablation-only group, which was significantly higher (OR 3.87; 95% CI 1.46–10.28; <em>P</em> &lt; .001; I² = 83.68). The mitral isthmus reconnection rate (OR 0.44; 95% CI 0.15–1.29; <em>P</em> = .14; I² = 63.6) and repeat procedure rate (OR 0.76; 95% CI 0.53–1.08; <em>P</em> = .12; I² = 48) were similar; however, a leave-one-out sensitivity analysis showed <em>P</em> &lt; .05 for both. The benefits of EIVoM were not affected by age, left atrial diameter, and left ventricular ejection fraction (<em>P</em> &gt; .05). Age (<em>P</em> = .029) and left atrial diameter (<em>P</em> = .042) were inversely associated with EIVoM benefits in terms of repeat ablation and mitral isthmus reconnection (age; <em>P</em> = .003).</div></div><div><h3>Conclusion</h3><div>The addition of EIVoM to ablation increased MIBB and reduced ATa recurrence.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142534953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double Perclose increases the efficiency of leadless pacemaker implantation: A propensity score–matched analysis","authors":"","doi":"10.1016/j.hroo.2024.07.018","DOIUrl":"10.1016/j.hroo.2024.07.018","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of atypical AVNRT in a patient with Ebstein anomaly","authors":"","doi":"10.1016/j.hroo.2024.08.005","DOIUrl":"10.1016/j.hroo.2024.08.005","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left atrial posterior wall isolation in addition to pulmonary vein isolation using a pentaspline catheter in pulsed-field ablation for atrial fibrillation: A systematic review and meta-analysis","authors":"","doi":"10.1016/j.hroo.2024.08.006","DOIUrl":"10.1016/j.hroo.2024.08.006","url":null,"abstract":"<div><h3>Background</h3><div>Persistent atrial fibrillation (AF) may require extensive ablation strategies. Left atrial posterior wall isolation (LAPWI) might address potential substrates for recurrence during pulsed-field ablation (PFA).</div></div><div><h3>Objective</h3><div>This meta-analysis aimed to investigate the feasibility and effectiveness of LAPWI in addition to pulmonary vein isolation (PVI) using a pentaspline catheter in PFA for AF.</div></div><div><h3>Methods</h3><div>Comprehensive search was conducted using PubMed, SCOPUS, ScienceDirect, and EuropePMC for studies reporting LAPWI+PVI using a pentaspline catheter in PFA ablation for AF. The primary outcome was atrial tachyarrhythmia (ATa) recurrence, defined as AF/atrial flutter/atrial tachycardia after blanking period.</div></div><div><h3>Results</h3><div>There were 882 patients from 7 studies. The success rate of LAPWI was 100% using mean/median of 16 to 20 added PFA applications with no reported acute left atrial posterior wall reconnection and esophageal complications. In mean follow-up of 240 ± 91 days, ATa recurrence was 21% (95% CI 13%–29%; I² = 84.8%) in the LAPWI+PVI group. Meta-regression analysis showed that age, left ventricular ejection fraction, and repeat procedure did not significantly influence ATa recurrence (<em>P</em> &gt; .05). Each 1-mm increase in left atrial diameter, increases the chance of ATa recurrence by 6% (R² = 100%, <em>P</em> &lt; .001, I² = 0%). Meta-analysis showed no difference in terms of ATa recurrence among LAPWI+PVI patients compared with those without LAPWI (odds ratio 0.78, 95% confidence interval 0.50–1.21, <em>P</em> = .27; I² = 0%, <em>P</em> = .86). Procedure time and fluoroscopy time did not significantly differ (<em>P</em> &gt; .05).</div></div><div><h3>Conclusion</h3><div>LAPWI using a pentaspline catheter during PFA was feasible and did not prolong the procedure/fluoroscopy but did not reduce ATa recurrence. LAPWI may be considered during PFA, although the benefit is uncertain.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare professionals’ perspective on the acceptance of gene therapy","authors":"","doi":"10.1016/j.hroo.2024.07.019","DOIUrl":"10.1016/j.hroo.2024.07.019","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventricular stimulation in patients with myotonic dystrophy type 1 may not predict future ventricular arrhythmias","authors":"","doi":"10.1016/j.hroo.2024.08.001","DOIUrl":"10.1016/j.hroo.2024.08.001","url":null,"abstract":"<div><h3>Background</h3><div>Myotonic dystrophy type 1 (DM1) is associated with progressive conduction disease. Furthermore, DM1 patients are at risk ventricular arrhythmias (VAs), although prediction remains difficult. The 2022 Heart Rhythm Expert Consensus Statement gives a IIb recommendation to the use of electrophysiology study (EPS) to risk-stratify patients for VAs. The utility of EPS in predicting the development of VAs, however, has not been explored in this patient population.</div></div><div><h3>Objective</h3><div>The study sought to examine the natural history of DM1 patients with positive and negative ventricular stimulation (v-stim) during EPS.</div></div><div><h3>Methods</h3><div>Patients with a history of DM1 undergoing EPS with associated v-stim from 2008 to present were retrospectively identified.</div></div><div><h3>Results</h3><div>From 2008 to 2022, 26 consecutive DM1 patients presented for EPS with v-stim. Four v-stim protocols were positive for sustained or hemodynamically significant ventricular tachycardia (VT), one of which was induced with 600 doubles, the others with triple extrastimuli. A total of 22 of 26 subjects received a device implant, with 18 receiving permanent pacemakers and 4 implantable cardioverter-defibrillators. All 4 of the patients with positive v-stims underwent ICD implantation. After a mean of 5.7 years of follow-up, 7 patients had sustained VT, 6 of whom had negative v-stims. Of the 4 patients with positive v-stims, only 1 developed sustained VT in follow-up. Other than baseline QT interval at time of EPS, no baseline characteristics were significantly different between patients with and without subsequent VT.</div></div><div><h3>Conclusion</h3><div>In this single center, v-stim in DM1 patients did not predict clinical VAs, as a vast majority of DM1 patients who developed VAs had negative v-stims.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression of myocardial dysfunction and prediction of arrhythmic events in patients with exercise-induced arrhythmogenic cardiomyopathy","authors":"","doi":"10.1016/j.hroo.2024.08.003","DOIUrl":"10.1016/j.hroo.2024.08.003","url":null,"abstract":"<div><h3>Background</h3><div>Several reports exist of an acquired exercise-induced arrhythmogenic cardiomyopathy. Little is known about myocardial disease progression and arrhythmia prediction in this population.</div></div><div><h3>Objective</h3><div>The study sought to explore the evolution of myocardial function and structure and its relation to incident life-threatening ventricular arrhythmias (VA), to identify markers of impending events.</div></div><div><h3>Methods</h3><div>We included athletes (individuals with exercise doses &gt;24 metabolic equivalent of task hours per week, &gt;6 consecutive years, participating in organized and competitive sports) who had VA, absence of family history and known genetic variants associated with cardiac disease, and no other identified etiology, in a tertiary referral single-center, longitudinal cohort study of patients with exercise-induced arrhythmogenic cardiomyopathy (EiAC). Evolution of myocardial function and structure was assessed by repeated echocardiographic examinations during long-term follow-up. Life-threatening VA were assessed at baseline and during long-term follow-up.</div></div><div><h3>Results</h3><div>Forty-one EiAC patients (15% women, age 45 ± 13 years) were followed for 80 (interquartile range 48–115) months. There were no changes in myocardial function or structure in the overall population during follow-up. We observed high incidence rate and high recurrence rate of life-threatening VA in EiAC patients. Subtle deterioration of right ventricular function was strongly associated with subsequent first-time VA (odds ratio 1.12, 95% confidence interval 1.01–1.25, <em>P =</em> .031, per 1% deterioration of right ventricular free wall longitudinal strain).</div></div><div><h3>Conclusion</h3><div>There were no clear changes in myocardial function or structure during follow-up in the overall population, but there was a high incidence rate and high recurrence rate of life-threatening VA. Subtle right ventricular deterioration by free wall longitudinal strain was a strong predictor of impending first-time life-threatening VA during follow-up.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global voices on atrial fibrillation management: Brazil","authors":"","doi":"10.1016/j.hroo.2024.06.010","DOIUrl":"10.1016/j.hroo.2024.06.010","url":null,"abstract":"<div><div>Atrial fibrillation (AF) and stroke are prevalent conditions worldwide, and the AF burden is expected to concentrate in low- and middle-income countries like Brazil. The National Institute for Health and Care Excellence–funded Global Health Research Group on Atrial Fibrillation Management (GHRG-AF) had a Brazilian arm that addressed AF epidemiology and care in Brazil. GHRG-AF analyzed data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a long-term cohort of 15,105 middle-aged adults in Brazil, focused on cardiovascular disease and diabetes. Additionally, the GHRG-AF used data from the Brazilian Study of Stroke Mortality and Morbidity (EMMA) study to understand AF impact on this cohort of 1863 stroke survivors, all admitted to a community hospital. The GHRG-AF also surveyed healthcare practices and the pathways of individuals who live with AF, interviewing health professionals and patients treated in different healthcare units in São Paulo. Despite these multiple approaches, those data were restricted to individuals living in large urban centers. Approximately 70% of the Brazilian territory comprises sparsely populated cities (&lt;10 inhabitants/km<span><span>²</span></span>), which, as a group, are home to 15 million individuals. In a new step, the GHRG-AF collaborators aim to improve cardiovascular research capacity in distant locations of the Brazilian Amazon, develop patient-centered protocols, empower community health agents in the region, and intensify collaboration with other research groups in remote parts of the country.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141707742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}