Heart Rhythm O2最新文献

{"title":"Genetic cardiomyopathy and significant systolic heart failure treated with cardiac contractility modulation therapy","authors":"Aaron B. Hesselson MD, BSEE, FACC, FHRS, CCDS, Gaurang Vaidya MD, Andrew Kolodziej MD","doi":"10.1016/j.hroo.2024.06.008","DOIUrl":"10.1016/j.hroo.2024.06.008","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 8","pages":"Pages 592-596"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501824001879/pdfft?md5=e2ee920079c7071517e861c148051750&pid=1-s2.0-S2666501824001879-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142021066","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":"The Alliance Against Sudden Death, a 17-year journey for an original initiative of the Inter-American Society of Cardiology","authors":"Manlio F. Márquez-Murillo MD , Adela Bazbaz MD , Felipe Hernández RN , Jesús Antonio González-Hermosillo MD, FACC","doi":"10.1016/j.hroo.2024.05.006","DOIUrl":"10.1016/j.hroo.2024.05.006","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 8","pages":"Pages 515-519"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266650182400151X/pdfft?md5=3e8dacbf2b338ab3ccc61b493c787940&pid=1-s2.0-S266650182400151X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142021163","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":"Repeat ablation of atrial fibrillation using electrogram dispersion to identify additional areas of mechanistic significance","authors":"Junaid A.B. Zaman MA (Oxon), BMBCh, FRCP (Edin), PhD ,&nbsp;Abdulhaseeb Khan MS ,&nbsp;Jan Nielsen MD, PhD ,&nbsp;Steen B. Kristiansen MD, PhD ,&nbsp;Mads B. Kronborg MD, DMSc, PhD ,&nbsp;Christoffer T. Witt MD, PhD ,&nbsp;Christian Gerdes MD, PhD ,&nbsp;Jens Kristensen MD, PhD ,&nbsp;Henrik K. Jensen MD, PhD ,&nbsp;Peter Lukac MD, PhD ,&nbsp;Sharad C. Agarwal MBBS","doi":"10.1016/j.hroo.2024.07.007","DOIUrl":"10.1016/j.hroo.2024.07.007","url":null,"abstract":"<div><h3>Background</h3><p>Electrogram dispersion identifies putative atrial fibrillation (AF) drivers in first time ablation procedures, with high acute termination rates and long-term outcomes akin to extensive ablation approaches. Its use in a population that had undergone repeat ablation is unknown, particularly where the pulmonary veins are already isolated.</p></div><div><h3>Objective</h3><p>This purpose of this study was to assess electrogram dispersion mapping during repeat ablation procedures for persistent AF.</p></div><div><h3>Methods</h3><p>One hundred sixty-seven patients from the United Kingdom and Denmark, all with persistent AF recurrence after prior ablation procedure(s), were mapped using a five splined catheter for electrogram dispersion before ablation. Areas were manually tagged on biatrial electroanatomic maps and ablated once pulmonary vein isolation was confirmed or reisolated if required. All patients had 12-month continuous monitoring, with most of the cohort having follow-up beyond 24 months.</p></div><div><h3>Results</h3><p>Of the 167 patients [53 (32%) female; mean age 66 ± 8 years; mean left atrial (LA) diameter 4.8 cm; mean ejection fraction 53%], 108 had pulmonary veins already isolated. Dispersion sites occurred in both atria (3.2 LA, 1.4 right atrium). Acute termination to sinus rhythm occurred in 71 (42%) of the cohort patients, with a further 73 (44%) terminating to atrial tachycardia/flutter. At 12-month follow-up, 95% of patients were free of AF, with 74% overall freedom from all atrial arrhythmias. Heart failure and severely enlarged LA predicted recurrence, and termination to sinus improved freedom from all atrial arrhythmias.</p></div><div><h3>Conclusion</h3><p>Dispersion mapping is a promising approach at repeat ablation procedures for persistent AF, with high acute termination rates and good clinical outcomes. Further prospective randomized trials are needed to evaluate this approach in a population that had undergone repeat ablation.</p></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 8","pages":"Pages 543-550"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501824002265/pdfft?md5=23760e28c25abc1f687de0dba8897bab&pid=1-s2.0-S2666501824002265-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141694357","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":"Comparing outcomes after pulmonary vein isolation in patients with systolic and diastolic heart failure","authors":"Ahmad B. Allaw MD,&nbsp;Jeremy Treger MD, PhD,&nbsp;Jia Guo MD,&nbsp;Dipayon Roy MD,&nbsp;Amulya Gampa MD,&nbsp;Swati Rao MD,&nbsp;Stephanie A. Besser MSAS,&nbsp;Andrew D. Beaser MD,&nbsp;Zaid Aziz MD,&nbsp;Cevher Ozcan MD,&nbsp;Srinath Yeshwant MD,&nbsp;Gaurav A. Upadhyay MD","doi":"10.1016/j.hroo.2024.07.003","DOIUrl":"10.1016/j.hroo.2024.07.003","url":null,"abstract":"<div><h3>Background</h3><p>The benefit of pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) is well established; its efficacy in patients with heart failure preserved ejection fraction (HFpEF) is less clear.</p></div><div><h3>Objective</h3><p>The objective of the study was to compare AF and heart failure (HF) rehospitalizations after PVI in patients with HFpEF vs HFrEF.</p></div><div><h3>Methods</h3><p>The IBM MarketScan Database was used to identify patients undergoing PVI for AF. Patients were categorized by HF status: absence of HF, presence of HFrEF, or presence of HFpEF. Primary outcomes were HF and arrhythmia hospitalizations after PVI.</p></div><div><h3>Results</h3><p>A total of 32,524 patients were analyzed: 27,900 with no HF (86%), 2948 with HFrEF (9%), and 1676 with HFpEF (5%). Compared with those with no HF, both patients with HFrEF and HFpEF were more likely to be hospitalized for HF (hazard ratio [HR] 7.27; <em>P</em> &lt; .01 for HFrEF and HR 9.46; <em>P</em> &lt; .01 for HFpEF) and for AF (HR 1.17; <em>P</em> &lt; .01 for HFrEF and HR 1.74; <em>P</em> &lt; .01 for HFpEF) after PVI. In matched analysis, 23% of patients with HFrEF and 24% patients with HFpEF demonstrated a reduction in HF hospitalizations (<em>P</em> = .31) and approximately one-third demonstrated decreased arrhythmia rehospitalizations (<em>P</em> = .57) in the 6 months after PVI. Compared with those with HFrEF in longer-term follow-up (&gt;1 year), patients with HFpEF were more likely to have HF (HR 1.30; <em>P</em> &lt; .01) and arrhythmia (HR 1.19; <em>P</em> &lt; .01) rehospitalizations.</p></div><div><h3>Conclusion</h3><p>Reductions in HF and arrhythmia hospitalizations are observed early after PVI across all patients with HF, but patients with HFpEF demonstrate higher HF rehospitalization and arrhythmia recurrence in longer-term follow-up than do patients with HFrEF.</p></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 8","pages":"Pages 529-537"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501824002204/pdfft?md5=26837dd8c6c28577aaa0bd77679ef9db&pid=1-s2.0-S2666501824002204-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141700485","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 multimodal deep learning tool for detection of junctional ectopic tachycardia in children with congenital heart disease","authors":"","doi":"10.1016/j.hroo.2024.04.014","DOIUrl":"10.1016/j.hroo.2024.04.014","url":null,"abstract":"<div><h3>Background</h3><p>Junctional ectopic tachycardia (JET) is a prevalent life-threatening arrhythmia in children with congenital heart disease. It has a marked resemblance to normal sinus rhythm, often leading to delay in diagnosis and management.</p></div><div><h3>Objective</h3><p>The study sought to develop a novel multimodal automated arrhythmia detection tool that outperforms existing JET detection tools.</p></div><div><h3>Methods</h3><p>This is a cohort study performed on 40 patients with congenital heart disease at Texas Children’s Hospital. Electrocardiogram and central venous pressure waveform data produced by bedside monitors are captured by the Sickbay platform. Convolutional neural networks (CNNs) were trained to classify each heartbeat as either normal sinus rhythm or JET based only on raw electrocardiogram signals.</p></div><div><h3>Results</h3><p>Our best model improved the area under the curve from 0.948 to 0.952 and the true positive rate at 5% false positive rate from 71.8% to 80.6%. Using a 3-model ensemble further improved the area under the curve to 0.953 and the true positive rate at 5% false positive rate to 85.2%. Results on a subset of data show that adding central venous pressure can significantly improve area under the receiver-operating characteristic curve from 0.646 to 0.825.</p></div><div><h3>Conclusion</h3><p>This study validates the efficacy of deep neural networks to notably improve JET detection accuracy. We have built a performant and reliable model that can be used to create a bedside alarm that diagnoses JET, allowing for precise diagnosis of this life-threatening postoperative arrhythmia and prompt intervention. Future validation of the model in a larger cohort is needed.</p></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 7","pages":"Pages 452-459"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501824001508/pdfft?md5=f857b3f4fcd966c7a1300356e5fcc40b&pid=1-s2.0-S2666501824001508-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141047083","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":"Concerns on digital health from a cardiac implantable electrical device remote monitoring clinic perspective: results from an international survey","authors":"","doi":"10.1016/j.hroo.2024.06.001","DOIUrl":"10.1016/j.hroo.2024.06.001","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 7","pages":"Pages 479-482"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266650182400179X/pdfft?md5=187e8d414e45c9317fb8e4ff03c1b3c6&pid=1-s2.0-S266650182400179X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141398694","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":"Short- and long-term patient-reported outcomes of subcutaneous implantable cardioverter-defibrillator therapy: Results from the RHYTHM DETECT Registry","authors":"","doi":"10.1016/j.hroo.2024.05.009","DOIUrl":"10.1016/j.hroo.2024.05.009","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 7","pages":"Pages 474-478"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501824001788/pdfft?md5=a64b26f9e46b87058610a43be77d6a22&pid=1-s2.0-S2666501824001788-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141406323","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":"Integrating the quantitative with the qualitative: findings from a mixed methods cardiac rehabilitation exercise trial","authors":"","doi":"10.1016/j.hroo.2024.06.003","DOIUrl":"10.1016/j.hroo.2024.06.003","url":null,"abstract":"<div><h3>Background</h3><p>Cardiac rehabilitation is a core component of cardiovascular disease management. Eastern Corridor Medical Engineering–Cardiac Rehabilitation is a digital health platform for online cardiac rehabilitation exercise. We conducted a mixed methods pilot trial to evaluate Eastern Corridor Medical Engineering–Cardiac Rehabilitation.</p></div><div><h3>Objective</h3><p>The study sought to examine the difference between objectively measured outcomes and participant perceptions of benefits and improvements gained from participation in a cardiac rehabilitation exercise program.</p></div><div><h3>Methods</h3><p>Seventeen participants (14 male, 3 female; 69.5 ± 7.3 years of age) took part and were allocated to 1 of 2 groups; an online exercise group (n = 8), or an in-person exercise (n = 9) group. Due to the COVID-19 pandemic, a pragmatic approach to group allocation was adopted. Objective outcomes were assessed at baseline and repeated following the intervention period, with the primary outcome being 6-minute walk test distance. In addition to clinical outcome measurements, we undertook qualitative interviews with participants.</p></div><div><h3>Results</h3><p>Only 5 participants demonstrated a clinically meaningful improvement in 6-minute walk test distance, following the 8-week exercise program. The main theme emerging from the qualitative interviews was the valued benefits of the cardiac rehabilitation exercise program. Despite the lack of measurable physical change, participants self-defined a range of benefits they valued and attributed directly to participation in the cardiac rehabilitation exercise program.</p></div><div><h3>Conclusion</h3><p>The findings from this study may offer a useful starting point for further study of community-based cardiac rehabilitation exercise and also highlight the benefit of adopting a mixed methods approach that considers both the objective outcomes measured as well as the subjective reports obtained from participants.</p></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 7","pages":"Pages 443-451"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501824001818/pdfft?md5=3082e6fc81e0fff5fbdf350ac98d8bdb&pid=1-s2.0-S2666501824001818-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141410370","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":"Arrhythmogenic right ventricular dysplasia: A case of ventricular tachycardia and right ventricular failure","authors":"Laura Bradel DO ,&nbsp;Jude ElSaygh MD ,&nbsp;Gioia Turitto MD","doi":"10.1016/j.hroo.2024.04.013","DOIUrl":"10.1016/j.hroo.2024.04.013","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 7","pages":"Pages 487-489"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501824001466/pdfft?md5=6109d863811305f12605cfcc593c559c&pid=1-s2.0-S2666501824001466-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141729693","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":"Contributions of France to the field of clinical cardiac electrophysiology and pacing","authors":"Bernard Belhassen MD ,&nbsp;Nicolas Lellouche MD ,&nbsp;Robert Frank MD","doi":"10.1016/j.hroo.2024.02.005","DOIUrl":"10.1016/j.hroo.2024.02.005","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 7","pages":"Pages 490-514"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266650182400031X/pdfft?md5=ddba01c8251624cf0de8bdb63cbbfda6&pid=1-s2.0-S266650182400031X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141729694","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}