Heart Rhythm O2最新文献

{"title":"Pulsed field ablation for atrial fibrillation in a patient with cor triatriatum sinister using a single-shot mapping-integrated catheter","authors":"Panteleimon E. Papakonstantinou MD, MSc, PhD, Gabor Szeplaki MD, PhD, Zoi Kotsialou MD, MSc","doi":"10.1016/j.hroo.2026.01.018","DOIUrl":"10.1016/j.hroo.2026.01.018","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 4","pages":"Pages 799-801"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147714658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zero- or minimal-fluoroscopy vs conventional fluoroscopy in catheter ablation of supraventricular tachycardias: An updated systematic review and meta-analysis","authors":"Ayan Khalid MBBS ,&nbsp;Zaid Abdul Samad MBBS ,&nbsp;Areej Iftikhar MBBS ,&nbsp;Muhammad Ibrahim MBBS ,&nbsp;Shaikh Muhammad Daniyal MBBS ,&nbsp;Anas Rasool MBBS ,&nbsp;Fauzaan Ahmed Siddiqui MBBS ,&nbsp;Burhan Mazhar Baig MBBS ,&nbsp;Hafiz Muhammad Faizan Abid MBBS ,&nbsp;Muhammad Asfandyar Nadir MBBS ,&nbsp;Danish Ali Ashraf MBBS ,&nbsp;Ibrahim Nagmeldin Hassan MBBS ,&nbsp;Raheel Ahmed MBBS, MRCP, PhD","doi":"10.1016/j.hroo.2026.01.008","DOIUrl":"10.1016/j.hroo.2026.01.008","url":null,"abstract":"<div><h3>Background</h3><div>Catheter ablation is the treatment of choice for supraventricular tachycardias. Conventional fluoroscopy (CF) enables real-time guidance but exposes patients and staff to ionizing radiation. Zero- (ZF) or minimal-fluoroscopy (MF) approaches are primarily enabled by electroanatomic mapping, with adjunctive tools such as intracardiac echocardiography used selectively when clinically indicated, to reduce radiation.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the efficacy and safety of ZF/MF ablation compared with CF for supraventricular tachycardias.</div></div><div><h3>Methods</h3><div>We performed a systematic review and meta-analysis of randomized controlled trials and observational studies comparing ZF/MF with CF ablation. The primary outcomes were acute and long-term success. Long-term success was defined as the absence of arrhythmia recurrence during the follow-up period.</div></div><div><h3>Results</h3><div>34 studies (5 randomized controlled trials, 29 observational; 11,635 patients) were included. Acute success was similar (risk ratio [RR] 1.00; 95% confidence interval [CI] 0.99–1.01; <em>P</em> = .94), whereas long-term success favored ZF/MF (RR 1.02; 95% CI 1.00–1.03; <em>P</em> = .023). Complications were comparable (RR 0.65; 95% CI 0.26–1.61; <em>P</em> = .35). ZF/MF significantly reduced fluoroscopy time (mean difference [MD] −13.75 minutes; 95% CI −16.49 to −11.02; <em>P</em> &lt; .01) and dose–area product (MD −1511.98 cGy·cm²; 95% CI −2358.44 to −665.53; <em>P</em> &lt; .01). Procedure duration was slightly longer with ZF/MF (MD +4.47 minutes; 95% CI 0.19–8.75; <em>P</em> = .04).</div></div><div><h3>Conclusion</h3><div>ZF/MF ablation provides equivalent acute efficacy, marginal improvement in long-term success, and markedly reduces radiation exposure without increasing complications. These findings support ZF/MF as a safe and effective alternative to CF, with particular relevance for minimizing radiation exposure in vulnerable populations.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 4","pages":"Pages 664-674"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147714740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inferior vena cava angiography through the protective sleeve for right-heart visualization in helix-fixation ventricular leadless pacemaker implantation","authors":"Xianhao Wu MD ,&nbsp;Yun Cai MS ,&nbsp;Ziming Ou MS ,&nbsp;Zhaohui Qiu MD, PhD, FHRS","doi":"10.1016/j.hroo.2026.01.029","DOIUrl":"10.1016/j.hroo.2026.01.029","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 4","pages":"Pages 807-809"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147709439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular outcomes with diltiazem vs verapamil in permanent atrial fibrillation","authors":"Laurent Fauchier MD, PhD,&nbsp;Lisa Lochon MD,&nbsp;Dylan Pereira MD,&nbsp;Thibault Lenormand MD","doi":"10.1016/j.hroo.2026.01.027","DOIUrl":"10.1016/j.hroo.2026.01.027","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 4","pages":"Pages 813-816"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147714603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to isolate the superior vena cava using balloon-in-basket pulsed field ablation system: Standardized workflow and initial results","authors":"Roland Richard Tilz MD, FESC, FEHRA, FHRS ,&nbsp;Kohei Ukita MD ,&nbsp;Charlotte Eitel MD ,&nbsp;Karl-Heinz Kuck MD, PhD, FESC ,&nbsp;Sascha Hatahet MD ,&nbsp;Jan-Per Wenzel MD","doi":"10.1016/j.hroo.2026.01.014","DOIUrl":"10.1016/j.hroo.2026.01.014","url":null,"abstract":"<div><h3>Background</h3><div>Superior vena cava (SVC) is one of the most important non–pulmonary vein (PV) foci in patients with atrial fibrillation (AF), but ablation at this site carries risks of phrenic nerve injury and sinus node dysfunction. Balloon-in-basket (BiB)-pulsed field ablation (PFA) is a novel nonthermal system offering stable wall contact and simultaneous mapping, yet its use for SVC isolation has not been well established.</div></div><div><h3>Objective</h3><div>This study described a standardized workflow and initial results of SVC isolation using the BiB-PFA system.</div></div><div><h3>Methods</h3><div>We included patients who underwent de novo PV isolation and SVC isolation using the BiB-PFA system. SVC isolation was performed using a standardized workflow including electroanatomic mapping, phrenic nerve pacing, selective voltage adjustment (1800 or 1400 V), and systematic remapping. Baseline characteristics, procedural details, and acute safety outcomes were evaluated.</div></div><div><h3>Results</h3><div>A total of 10 patients (median age 78 years, 4 women, and 2 with paroxysmal AF) were analyzed. Acute PV isolation and SVC isolation were achieved in all patients. 1 patient developed transient sinus node arrest immediately after the first application for SVC, which resolved with isoprenaline without pacemaker implantation. No persistent sinus node dysfunction or phrenic nerve palsy occurred.</div></div><div><h3>Conclusion</h3><div>We described a standardized, reproducible strategy for SVC isolation using the BiB-PFA system. In this initial experience, the strategy was feasible and safe, with acute success in all patients and only 1 transient adverse event. These findings suggest that the BiB-PFA system may represent a promising tool for adjunctive SVC ablation in AF.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 4","pages":"Pages 706-712"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147714657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploratory assessment of field-tag–based catheter-tissue contact and acute lesion surrogates during pulsed field ablation","authors":"Shu Hirata MD,&nbsp;Koichi Nagashima MD, FHRS,&nbsp;Ryuta Watanabe MD,&nbsp;Yuji Wakamatsu MD,&nbsp;Yuji Saito MD,&nbsp;Naoto Otsuka MD,&nbsp;Moyuru Hirata MD,&nbsp;Masanaru Sawada MD,&nbsp;Hikaru Masuda MD,&nbsp;Yasuo Okumura MD, FHRS","doi":"10.1016/j.hroo.2026.02.003","DOIUrl":"10.1016/j.hroo.2026.02.003","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 4","pages":"Pages 817-819"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147714660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity promotes atrial fat deposition independent of myocardial infarction in Göttingen minipigs","authors":"Johs Dannesboe MSc ,&nbsp;Caroline Eggert Eggertsen MSc ,&nbsp;Karina Poulsdóttir Debes DVM, PhD ,&nbsp;Mette Flethøj DVM, PhD ,&nbsp;Lisbeth Høier Olsen DVM, PhD ,&nbsp;Jacob Eifer Møller MD, PhD ,&nbsp;Jeppe Egedal Kirchhoff PhD ,&nbsp;Torkel Falk DVM ,&nbsp;Nienke Anna Maria van Rooij BSc ,&nbsp;Trine Pagh Ludvigsen PhD ,&nbsp;Thomas Jespersen PhD ,&nbsp;Arnela Saljic PhD","doi":"10.1016/j.hroo.2026.01.022","DOIUrl":"10.1016/j.hroo.2026.01.022","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation often follows myocardial infarction (MI) and is associated with increased risks of adverse cardiovascular outcomes. Obesity is a potent risk factor for both MI and atrial fibrillation.</div></div><div><h3>Objective</h3><div>This study aimed to understand whether MI and obesity have a synergistic impact on atrial remodeling.</div></div><div><h3>Methods</h3><div>Lean (sham n = 3; MI n = 12) and obese (sham n = 3; MI n = 9) Göttingen minipigs (MI group) underwent a 120-minute balloon occlusion of the left anterior descending coronary artery. After 8 weeks, myocardial tissue was collected from 4 distinct left and right atrial sites for histologic analysis.</div></div><div><h3>Results</h3><div>Obese animals have a significantly higher amount of atrial adipose tissue than lean animals at all 4 sites (right atrium [RA] <em>P</em> = .0008; RA appendage [RAA] <em>P</em> = .002; left atrium [LA] <em>P</em> = .04; LA appendage [LAA] <em>P</em> = .0002). Obese animals also showed a higher level of intramyocardial adipose tissue in the LA and both appendages (RAA <em>P</em> = .03; LA <em>P</em> = .004; LAA <em>P</em> = .001). No significant fibrotic remodeling was detected under any condition or atrial site. MI pigs exhibited a trend toward smaller epicardial adipocytes, whereas obesity was associated with larger adipocytes in the RAA and free wall. Finally, obesity significantly increased PR interval duration by 13.7% in MI pigs (<em>P</em> = .037).</div></div><div><h3>Conclusion</h3><div>Obesity is the primary driver of atrial adipose tissue remodeling both in and around the atria. MI had no effect on atrial remodeling at any site in either lean or obese animals.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 4","pages":"Pages 725-736"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147714654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying hidden medical complexity in cardiovascular care: A large language model approach to evaluation and management coding and documentation","authors":"Victor A. Abrich MD, FHRS ,&nbsp;Richard Abrich MASc","doi":"10.1016/j.hroo.2026.01.017","DOIUrl":"10.1016/j.hroo.2026.01.017","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 4","pages":"Pages 771-773"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147714659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-supervised contrastive learning enables robust electrocardiogram-based cardiac classification","authors":"Deekshith Dade MS ,&nbsp;Jake A. Bergquist PhD ,&nbsp;Rob S. MacLeod PhD ,&nbsp;Benjamin A. Steinberg MD, MHS, FHRS ,&nbsp;Tolga Tasdizen PhD","doi":"10.1016/j.hroo.2026.01.016","DOIUrl":"10.1016/j.hroo.2026.01.016","url":null,"abstract":"<div><h3>Background</h3><div>Self-supervised contrastive learning has emerged as a powerful paradigm for learning generalizable representations from unlabeled data. In the context of electrocardiogram (ECG) analysis, such pre-training can significantly enhance classification performance, especially when labeled data is scarce.</div></div><div><h3>Objective</h3><div>We aimed to investigate and improve contrastive self-supervised learning techniques for ECGs by systematically combining recent methodological advances in augmentation design, contrastive loss formulation, and encoder architectures.</div></div><div><h3>Methods</h3><div>We implemented a contrastive pre-training framework combining vectorcardiography (VCG)-based physiologically-inspired augmentations, interlead, intersegment, contrastive loss, and patient-aware positive sampling. In addition, we developed a dual-stream architecture, extending the TemporalNet model by processing grouped ECG leads independently. Pretraining was conducted on a large corpus of approximately 1 million unlabeled ECGs. We evaluated performance on 2 downstream classification tasks—low left ventricular ejection fraction (LVEF) and high serum potassium chloride—using various levels of labeled supervision (1%, 5%, 10%, 50%, and 100%). The pre-trained models were compared with the randomly initialized models under both frozen and finetuned conditions.</div></div><div><h3>Results</h3><div>Contrastive pre-training consistently improved performance across all supervision levels. In low-label settings (1%–10% supervision), the pre-trained model achieved 3%–4% higher area under the receiver operator curve on the LVEF task and 5%–7% higher area under the receiver operator curve on the potassium chloride task compared with the baseline. The performance gap narrowed with increased supervision but remained favorable toward pre-trained models.</div></div><div><h3>Conclusion</h3><div>Our findings demonstrate that contrastive pre-training can substantially enhance ECG classification, especially when labeled data is limited. By unifying and extending ideas from recent literature into a scalable framework trained on 1 million ECGs, we provide practical guidance and architectural innovations for building strong ECG foundation models applicable to a broad range of clinical prediction tasks.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 4","pages":"Pages 757-770"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147714663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's Reply to “Considerations on phrenic nerve and sinus node safety during superior vena cava isolation using a balloon-in-basket pulsed field ablation system”","authors":"Kohei Ukita MD ,&nbsp;Roland Richard Tilz MD, FESC, FEHRA, FHRS","doi":"10.1016/j.hroo.2026.02.008","DOIUrl":"10.1016/j.hroo.2026.02.008","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 4","pages":"Page 821"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147709438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}