Heart Rhythm O2最新文献

{"title":"Ventricular tachycardia: Focal pulsed field electroporation as a rescue therapy","authors":"Rita Reis Santos MD, Mariana Sousa Paiva MD, Rita Amador MD, Daniel Matos MD, Pedro Carmo MD, Pedro Adragão MD, PhD","doi":"10.1016/j.hroo.2024.09.016","DOIUrl":"10.1016/j.hroo.2024.09.016","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 11","pages":"Pages 839-841"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704655","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":"Cost savings associated with extended battery longevity in cardiac resynchronization therapy defibrillators","authors":"Jeffrey L. Williams MD, MS, FACC, FHRS ,&nbsp;Ryoko Sato PhD ,&nbsp;Caroline M. Jacobsen MPhil","doi":"10.1016/j.hroo.2024.09.008","DOIUrl":"10.1016/j.hroo.2024.09.008","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac resynchronization therapy-defibrillators (CRT-D) are devices established as treatment for symptomatic heart failure patients at risk of sudden cardiac death. Battery depletion poses a significant clinical and economic burden; extended service life may reduce costs because of generator changes and associated complications.</div></div><div><h3>Objective</h3><div>This study estimated cost-savings associated with extended battery longevity in Medicare patients receiving CRT-D implantation.</div></div><div><h3>Methods</h3><div>A decision tree was used to explore 3 battery capacities: 1.0 ampere-hours (Ah), 1.6Ah, and 2.1Ah. Yearly risk of all-cause mortality, device-related complications, and end of battery life were estimated. Over 6 years, estimated costs included device implantation, replacement, follow-up appointments, and complications.</div></div><div><h3>Results</h3><div>The average total costs to Medicare over 6 years were $41,527, $48,515, and $56,647 per person (USD 2023) for the 2.1 Ah, 1.6 Ah, and 1.0 Ah, respectively. The total per-person replacement cost for the 1.0-Ah devices was more than 4 times that of the 2.1-Ah devices ($20,126 vs $5,006). When extrapolated to the total number of CRT-D implants over a 6-year period, the difference in costs between 2.1-Ah and 1.0-Ah battery capacity exceeded $500 million.</div></div><div><h3>Conclusion</h3><div>Extended longevity CRT-D batteries demonstrate significant cost savings to Medicare over 6 years. These data indicate long-term economic considerations should be included in device selection.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 11","pages":"Pages 755-761"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704739","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":"Needle-free atrial transseptal access: A safe and reproducible alternative for left atrial catheterization","authors":"Alex D. Pacheco-Bouthillier MD ,&nbsp;Jorge Javier Miguel-González MD ,&nbsp;Adriana González-Martínez MD, PhD ,&nbsp;Anna G. Everding-Rodríguez MD ,&nbsp;Silvia S. Gómez-Delgadillo MD ,&nbsp;Ángel E. Chávez-Torres MD ,&nbsp;Angélica Fregoso-Sánchez MD ,&nbsp;Benigno Ferreira-Piña MD ,&nbsp;Óscar S. Lomelí-Sánchez MD, MSc ,&nbsp;Hugo E. Coutiño-Moreno MD, PhD ,&nbsp;Vitelio A. Mariona-Montero MD","doi":"10.1016/j.hroo.2024.09.005","DOIUrl":"10.1016/j.hroo.2024.09.005","url":null,"abstract":"<div><h3>Background</h3><div>Left atrial catheterization is a common procedure in electrophysiology labs to treat arrhythmogenic substrates on the left side of the heart. Needle transseptal puncture is the standard approach, but it can lead to complications related to device design or operator technique. To reduce these complications, needle-free alternatives have been explored.</div></div><div><h3>Objective</h3><div>This study aims to report the first multicenter application of the needle-free transseptal access (NeFTA) approach, assessing its safety and efficacy in patients undergoing electrophysiological procedures.</div></div><div><h3>Methods</h3><div>This retrospective, observational multicenter study evaluated the safety and efficacy of the NeFTA approach in patients undergoing ablation of left arrhythmogenic substrates across 3 electrophysiology centers in Mexico. NeFTA uses only a guidewire, without a needle or sharp guidewire. The sheath, with a dilator, is guided into the fossa ovalis under fluoroscopic guidance, using anterior force and clockwise torque to allow the guidewire to puncture the septum with minimal risk.</div></div><div><h3>Results</h3><div>The NeFTA technique was used in 366 patients. Most sheaths were deflectable, with nondeflectable sheaths in 43.4% of cases. Left atrial access via NeFTA was successful in 96.18% of cases, with pericardial effusion as the only complication (0.55% rate).</div></div><div><h3>Conclusion</h3><div>This technique was reproducible and safe, achieving successful access on the first or second attempt in 96.18% of cases, regardless of the operator.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 11","pages":"Pages 788-795"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704647","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":"Unexpected implantation of cardiac resynchronization therapy: Its characteristics and prognosis","authors":"Naoya Kataoka MD, PhD,&nbsp;Teruhiko Imamura MD, PhD,&nbsp;Koichiro Kinugawa MD, PhD","doi":"10.1016/j.hroo.2024.09.004","DOIUrl":"10.1016/j.hroo.2024.09.004","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 11","pages":"Pages 825-827"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704738","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 bundle branch area pacing guided by intracardiac echocardiography imaging","authors":"Fatima M. Ezzeddine MD,&nbsp;Ammar M. Killu MBBS, FHRS,&nbsp;Siva K. Mulpuru MD, FHRS,&nbsp;Paul Friedman MD, FHRS,&nbsp;Yong-Mei Cha MD, FHRS","doi":"10.1016/j.hroo.2024.08.012","DOIUrl":"10.1016/j.hroo.2024.08.012","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 11","pages":"Pages 842-843"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704657","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":"Myeloperoxidase and N-terminal proatrial natriuretic peptide as predictors for atrial fibrillation recurrence in patients undergoing redo ablation","authors":"Marwin Bannehr MD ,&nbsp;Christian Georgi MD ,&nbsp;Christoph Edlinger MD ,&nbsp;Vera Paar PhD ,&nbsp;Paulina Jankowska MD ,&nbsp;Michael Lichtenauer MD ,&nbsp;Anja Haase-Fielitz PhD ,&nbsp;Martin Seifert MD ,&nbsp;Christian Butter MD","doi":"10.1016/j.hroo.2024.09.003","DOIUrl":"10.1016/j.hroo.2024.09.003","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) is a progressively developing arrhythmia. Electroanatomic remodeling may play an important role, both in the development of the disease and in the perpetuation and thus in the recurrence of AF.</div></div><div><h3>Objective</h3><div>This study aimed to investigate potential biomarkers myeloperoxidase (MPO), N-terminal proatrial natriuretic peptide (NT-proANP), intercellular adhesion molecule-1, and matrix metalloproteinase-2 and their predictive value for AF recurrence in patients undergoing redo ablation.</div></div><div><h3>Methods</h3><div>In this single-center prospective cohort study, 50 consecutive patients underwent ultra high-density mapping and redo ablation. Biomarkers were determined before ablation and at 6-month follow-up. Seven-day Holter was conducted to check for AF recurrence (&gt;30 seconds).</div></div><div><h3>Results</h3><div>Eleven (22%) patients showed AF recurrence after redo ablation. Receiver-operating characteristic curve analysis revealed venous MPO and NT-proANP (area under the curve [AUC] 0.755, 95% CI 0.599–0.912, <em>P =</em> .010; and AUC 0.752, 95% CI 0.551–0.953, <em>P =</em> .011) as acceptable predictors for intermediate AF recurrence, whereas matrix metalloproteinase-2, intercellular adhesion molecule-1, and established cardiovascular biomarkers such as N-terminal pro–B-type natriuretic peptide, troponin T, and C-reactive protein were not (all AUC &lt;0.600). MPO and NT-proANP correlated with AF burden (ρ = 0.365, <em>P =</em> .005; and ρ = 0.362, <em>P =</em> .005). While MPO was associated with atrial fibrosis in the endocardial map (ρ = 0.280, <em>P =</em> .024), NT-proANP correlated with left atrial volume index (ρ = 0.256, <em>P =</em> .037). There were no significant differences in biomarkers concentrations with regard to venous and coronary sinus samples.</div></div><div><h3>Conclusion</h3><div>MPO and NT-proANP are of predictive value for AF recurrence in patients undergoing redo ablation. While MPO correlated with endocardial fibrosis, NT-proANP was associated with left atrial volume.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 11","pages":"Pages 770-777"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704744","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":"Time-dependent improvements in pacing thresholds with lumenless leads placed in the right atrium","authors":"Yasumasa Nohno MD ,&nbsp;Ryosuke Kozu MD ,&nbsp;Shusaku Maruyama MD ,&nbsp;Tomoya Hasegawa MD ,&nbsp;Hiromi Tsuchiya MD ,&nbsp;Takahiro Tachibana MD ,&nbsp;Hikaru Kimura MD ,&nbsp;Yoshikazu Yazaki MD, PhD ,&nbsp;Katsuhito Fujiu MD, PhD","doi":"10.1016/j.hroo.2024.09.009","DOIUrl":"10.1016/j.hroo.2024.09.009","url":null,"abstract":"<div><h3>Background</h3><div>Traditional pacemaker implantation often poses risks, such as perforation when positioning atrial leads at the right atrial appendage (RAA). Recent advancements in delivery catheters have enabled atrial lead placement in the right atrial septum, potentially mitigating RAA-related complications. However, the performance of lumenless leads in this context remains unclear.</div></div><div><h3>Objective</h3><div>This study was performed to assess the performance of lumenless leads as atrial leads.</div></div><div><h3>Methods</h3><div>Forty-four consecutive patients undergoing pacemaker implantation with lumenless atrial leads were enrolled. Lead implantation was performed using a 3830 SelectSecure lead and C315HIS-sheath. Pacing parameters were collected immediately after screwing, 3 and 5 minutes later, at the end of the procedure, and at every 6-month follow-up.</div></div><div><h3>Results</h3><div>Lead parameters including P-wave, pacing threshold, and impedance significantly improved over time. The threshold levels from 2.00 ± 0.72 V/0.4 msec immediately after screwing to 1.45 ± 0.57 V/0.4 msec at 5 minutes, 0.95 ± 0.38 V/0.4 msec at the end of the procedure, and 0.78 ± 0.39 V/0.4 msec at discharge. Initially, threshold levels were &gt;2.5 V/0.4 msec in 15 cases; however, they decreased to &lt;2 V/0.4 msec by the end of the procedure. At discharge, 13 of the 15 cases showed a threshold decrease to &lt;1 V/0.4 msec. During follow-up, no threshold increase (&gt;1 V), lead revision, or battery depletion was observed.</div></div><div><h3>Conclusion</h3><div>Lumenless lead placement in the right atrium results in threshold decrease over time. Therefore, allowing a waiting period instead of immediately repositioning the lead may be more effective when thresholds are high after screwing.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 11","pages":"Pages 764-769"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704743","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":"Sudden arrhythmic death in patients with syncope and implantable cardiac monitor","authors":"Pilar Cabanas Grandío MD, PhD ,&nbsp;Bertrand Pierre MD ,&nbsp;Giovanni Bisignani MD ,&nbsp;Alessandro Cuneo MD ,&nbsp;Roland Papp MD ,&nbsp;Jürgen Schrader PhD ,&nbsp;Dennis H. Lau MBBS, PhD, FHRS","doi":"10.1016/j.hroo.2024.09.002","DOIUrl":"10.1016/j.hroo.2024.09.002","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 11","pages":"Pages 821-824"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704741","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":"Temporal changes in device-derived daily activity related to ventricular arrhythmias from the CERTITUDE registry","authors":"Valentina Kutyifa MD, PhD ,&nbsp;Michael Christof ,&nbsp;Steven Mullane MS ,&nbsp;Camden Harrell MS ,&nbsp;Jagmeet Singh MD ,&nbsp;Larry Chinitz MD ,&nbsp;Niraj Varma MD ,&nbsp;Jonathan P. Piccini MD, MHS ,&nbsp;Mintu P. Turakhia MD, MAS ,&nbsp;Spencer Z. Rosero MD, MS","doi":"10.1016/j.hroo.2024.07.020","DOIUrl":"10.1016/j.hroo.2024.07.020","url":null,"abstract":"<div><h3>Background</h3><div>There have been limited data examining the temporal relationship between device-derived daily activity and ventricular arrhythmias (VAs).</div></div><div><h3>Objective</h3><div>We aimed to assess whether activity predicted VAs or VAs predicted changes in activity.</div></div><div><h3>Methods</h3><div>The CERTITUDE registry includes over 55,000 implanted devices active on Home Monitoring. Daily data on activity are captured by a 1-axis accelerometer. Temporal changes in activity during treated VAs were analyzed using the first event and 7-day activity windows (baseline, pre-event, and postevent). Baseline period was defined as 31 to 38 days prior to VA. VAs were categorized by heart rate (≤200 beats/min, &gt;200 beats/min) and treatment (shock or antitachycardia pacing). Differences were assessed using the binomial proportion test and case-crossover analysis.</div></div><div><h3>Results</h3><div>A total of 5631 devices (3688 implantable cardioverter-defibrillators, 1943 cardiac resynchronization therapy defibrillators) were analyzed with a cumulative follow-up duration of 18,354 years (5.6 million days). Patients with VA events &gt;200 beats/min with shock (n = 593) had a significant decline in activity post-VA with a median –8.7% reduction (interquartile range –24.6% to 7.3%, <em>P &lt;</em> 0.001). However, there was no reduction in activity before VA events &gt;200 beats/min (<em>P =</em> .690) or before or after VA events &gt;200 beats/min with antitachycardia pacing. However, VA events ≤200 beats/min with shock had reductions in activity following the event (–5.8%, interquartile range –29.5% to 12.3%, <em>P =</em> .003). Case-crossover analyses confirmed lower activity rates following for VA events &gt;200 beats/min with shock.</div></div><div><h3>Conclusion</h3><div>In the CERTITUDE registry, we have shown a temporal decline in device-derived activity following VA events &gt;200 beats/min and for VA events &lt;200 beats/min treated with a shock, but we did not find changes in activity preceding a shock event.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 11","pages":"Pages 805-812"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704649","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 arrhythmias after atrial fibrillation electrical cardioversion: A multicenter study","authors":"Oholi Tovia-Brodie MD ,&nbsp;Yoav Michowitz MD ,&nbsp;Feras Bayya MD ,&nbsp;Stepan Havranek MD ,&nbsp;Milan Dusik MD ,&nbsp;Luigi Rivetti MD ,&nbsp;Roberto Mantovan MD ,&nbsp;Avi Sabbag MD ,&nbsp;Eyas Massalha MD ,&nbsp;Pietro Enea Lazzerini MD ,&nbsp;Iacopo Bertolozzi MD ,&nbsp;Giovanni Malanchini MD ,&nbsp;Christoffer Tobias Witt MD ,&nbsp;Óscar Cano MD, PhD ,&nbsp;Ziv Dadon MD ,&nbsp;Michael Ilan MD ,&nbsp;Pieter G. Postema MD, PhD ,&nbsp;Michael Glikson MD ,&nbsp;Moshe Rav Acha MD, PhD","doi":"10.1016/j.hroo.2024.08.009","DOIUrl":"10.1016/j.hroo.2024.08.009","url":null,"abstract":"<div><h3>Background</h3><div>Ventricular arrhythmias (VAs) after atrial fibrillation (AF) electrical cardioversion (ECV) have been reported.</div></div><div><h3>Objective</h3><div>We sought to assess incidence, timing, and clinical characteristics of patients with post-AF ECV-related VAs.</div></div><div><h3>Methods</h3><div>Multicenter observational retrospective study including 13 centers, incorporating patients with VAs or sudden cardiac death within 10 days of ECV. The total number of ECVs performed during the collecting period was provided. Patients with pre-ECV VAs were excluded.</div></div><div><h3>Results</h3><div>Twenty-three patients with VAs were identified out of 11,897 AF ECVs performed in 13 centers during a median 2-year period, suggesting post-ECV VA incidence of 0.2%. The patients’ mean age was 71 ± 11 years, and 13 (56.5%) were female. AF duration prior to ECV was 71 ± 54 days. Congestive heart failure and hypertension were both found in 17 (74%) patients. QT-prolonging drugs were used by 17 (74%). Index VA occurred 28.5 (interquartile range 5.5–72) hours post-ECV, including torsades de pointes, nonsustained polymorphic ventricular tachycardia, and sudden cardiac death in 17 (74%), 5 (22%), and 1 (4%) patient, respectively. Post-ECV heart rate was slower and QT duration longer compared with pre-ECV (57 ± 11 beats/min vs 113 ± 270 beats/min; <em>P &lt;</em> .001; QT duration 482 ± 61 ms vs 390 ± 60 ms; <em>P &lt;</em> .001). VAs reoccurred in 9 (39%) patients, 11 (interquartile range 3–13.5) hours post–index VA. Two patients had an arrhythmic death within 72 hours post-ECV.</div></div><div><h3>Conclusion</h3><div>VAs post-AF ECV are rare, occur within 3 to 72 hours post-ECV, and are potentially fatal. Our study gives a signal of caution favoring prolonged monitoring in small subset of patients as congestive heart failure patients treated with class III antiarrhythmic drugs, with post-ECV bradycardia, especially (but not exclusively) when QT prolongation noted.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 11","pages":"Pages 813-820"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704654","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}