Heart Rhythm O2最新文献

{"title":"Clinical validation of a novel catheter–tissue contact algorithm in atrial fibrillation ablation using pulsed field ablation","authors":"Ankur Shah DO, Saanvi Billakanty BA, Andrew E. Volio DO, Allyson Farrah PA, Andrea Robinson RN, Katelyn R. Bennett DO, Arun K. Tewari PhD, Auroa Badin MD, David Nemer MD, Eugene Fu MD, FHRS, Jaret Tyler MD, FHRS, Anish K. Amin MD, FHRS, Nagesh Chopra MD, FHRS","doi":"10.1016/j.hroo.2026.06.016","DOIUrl":"10.1016/j.hroo.2026.06.016","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 10","pages":"Pages 2057-2059"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219215","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":"Methodological considerations in evaluating socioeconomic outcomes after atrial fibrillation ablation","authors":"Muhammad Fayyaz Riaz MBBS, Umema Saindad MBBS","doi":"10.1016/j.hroo.2026.07.019","DOIUrl":"10.1016/j.hroo.2026.07.019","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 10","pages":"Page 2061"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219247","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":"Single-chamber retrievable leadless pacemaker in adult congenital heart disease: A single-center experience","authors":"Giovanni Domenico Ciriello MD, Diego Colonna MD, Anna Correra MD, Giovanni Papaccioli MD, Emanuele Romeo MD, PhD, Berardo Sarubbi MD, PhD","doi":"10.1016/j.hroo.2026.07.002","DOIUrl":"10.1016/j.hroo.2026.07.002","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 10","pages":"Pages 2037-2041"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219218","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":"Refining cardiac resynchronization therapy selection in borderline QRS duration patients","authors":"Haoran Jiang MS,&nbsp;Zak Loring MD, MHS, FHRS,&nbsp;Niraj Varma MD, PhD,&nbsp;Robert Schaller DO, FHRS,&nbsp;Casey Gilles BS,&nbsp;Kasper Emerek MD,&nbsp;Peter Søgaard MD,&nbsp;Christoffer Polcwiartek MD, PhD,&nbsp;Claus Graff PhD,&nbsp;Marat Fudim MD,&nbsp;Joseph Kisslo MD,&nbsp;Daniel J. Friedman MD","doi":"10.1016/j.hroo.2026.06.018","DOIUrl":"10.1016/j.hroo.2026.06.018","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac resynchronization therapy (CRT) improves outcomes in heart failure patients with left bundle branch block (LBBB) and QRS of ≥150 ms, but benefits with borderline QRS (120–149 ms) remain uncertain. Electrical (ED) and mechanical dyssynchrony (MD) may refine patient selection, although reliable predictors are lacking.</div></div><div><h3>Objective</h3><div>To examine clinical predictors of dyssynchrony in patients with borderline QRS duration (QRSd) undergoing CRT.</div></div><div><h3>Methods</h3><div>We retrospectively studied 336 CRT recipients (2006–2015). Vectorcardiograms quantified QRS area (QRSa), with ED defined as QRSa of ≥95 μVs. MD was assessed via speckle-tracking echocardiography. Logistic regression identified predictors of dyssynchrony. QRSa indexed to left ventricular end-diastolic volume (QRSa/LVEDV) was evaluated in logistic and Cox models, stratified by a QRSd of 150 ms threshold.</div></div><div><h3>Results</h3><div>ED and MD were present in 53.0% and 74.4% of patients. Shorter height was independently associated with ED, while female sex predicted MD. Among patients with QRSd of &lt;150 ms, ED and MD were less prevalent, and height was the sole independent predictor of ED. Over a median follow-up of 28.3 months, 241 patients (71.7%) experienced a composite endpoint, with similar event rates between QRS subgroups. QRSa/LVEDV was the strongest predictor of MD (odds ratio: 26.83; <em>P</em> = .0004) and reduced risk of adverse outcomes (hazard ratio: 0.172; <em>P</em> = .0006) in the &lt;150-ms subgroup, outperforming QRSd and sex. When MD was added, the QRSa/LVEDV association attenuated (hazard ratio: 0.35; <em>P</em> = .07).</div></div><div><h3>Conclusion</h3><div>Among LBBB patients with borderline QRSd, QRSa/LVEDV was more strongly associated with MD and outcomes than QRSd or other factors, supporting its potential role in refining patient selection.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 10","pages":"Pages 1979-1989"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219205","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":"Preclinical and benchtop evaluation of a dedicated tool for insertable cardiac monitor explantation","authors":"Bryan Gonzalez BSE,&nbsp;Vanessa Ogueri MD,&nbsp;Devon Guerrelli PhD,&nbsp;Justin D. Opfermann PhD,&nbsp;Mischa Cho,&nbsp;Charles I. Berul MD, FHRS,&nbsp;Ryan P. O’Hara PhD","doi":"10.1016/j.hroo.2026.07.003","DOIUrl":"10.1016/j.hroo.2026.07.003","url":null,"abstract":"<div><h3>Background</h3><div>Insertable cardiac monitors (ICMs) are widely used for long-term rhythm surveillance, yet explantation can be challenging because of fibrotic encapsulation, tissue variability, and device migration. Current removal typically relies on general surgical instruments, and no dedicated tool exists for difficult ICM explants.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the performance of a purpose-built cardiac monitor extraction tool (CM-eX) compared with standard removal technique using benchtop and chronic animal models.</div></div><div><h3>Methods</h3><div>The CM-eX was designed and fabricated. Benchtop testing used a 2-layer synthetic gel model simulating fibrotic encapsulation and subcutaneous tissue. 80 ICM removals were performed using CM-eX, standard instruments, or direct wire pullout. Metrics included removal time and peak insertion and removal forces. Electromyography was recorded as a measure of operator demand. Chronic animal testing was performed in 9 rats implanted bilaterally with ICMs and explanted after a 3-month survival period, with each animal serving as its own control.</div></div><div><h3>Results</h3><div>In benchtop models, removal time was similar between the CM-eX and standard instruments (<em>P</em> = .40), whereas the CM-eX required significantly lower removal force than direct pullout (<em>P</em> &lt; .0001). Overall EMG activity was similar between methods. In the chronic animal model, the CM-eX was associated with faster explant in 8 of 9 paired comparisons, with a mean reduction of 28% vs standard instruments. No device slippage or procedural complications were observed.</div></div><div><h3>Conclusion</h3><div>In preclinical testing, the CM-eX demonstrated feasible ICM removal with reduced extraction force in benchtop models and directional improvements in explant time in an animal model. These findings support its potential to facilitate more controlled and consistent ICM explantation.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 10","pages":"Pages 1990-1996"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219209","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 multicenter randomized controlled study to evaluate the efficacy of an artificial intelligence–based electrocardiography for the detection of atrial fibrillation in patients with suspected symptoms (DEEP-AF)","authors":"Ki-Jeung Lee MD,&nbsp;Chang-Ok Seo MD,&nbsp;Joo Hee Jeong MD, PhD,&nbsp;Yeji Kim MD, PhD,&nbsp;Kyung-Yeon Lee MD,&nbsp;Hanjin Park MD,&nbsp;Hyoung Seok Lee MD,&nbsp;Ji-Hun Jang MD,&nbsp;Dae-Young Kim MD,&nbsp;Seong Huan Choi MD,&nbsp;Daehoon Kim MD,&nbsp;Do Young Kim MD, PhD,&nbsp;Je-Wook Park MD,&nbsp;Hee Tae Yu MD, PhD,&nbsp;Pil-Sung Yang MD, PhD,&nbsp;Kwang-No Lee MD, PhD,&nbsp;Yun Gi Kim MD, PhD,&nbsp;Seung-Young Roh MD, PhD,&nbsp;You-Mi Hwang MD, PhD,&nbsp;Chan-Hee Lee MD, PhD,&nbsp;Dae-Hyeok Kim MD, PhD","doi":"10.1016/j.hroo.2026.07.009","DOIUrl":"10.1016/j.hroo.2026.07.009","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) is frequently paroxysmal and asymptomatic, leading to delayed diagnosis and missed opportunities for stroke prevention. Artificial intelligence (AI) applied to 12-lead electrocardiograms (ECGs) obtained during sinus rhythm may enable risk stratification and more efficient allocation of rhythm-monitoring resources.</div></div><div><h3>Objective</h3><div>The purpose of this study is to determine whether an AI-ECG–guided strategy improves detection of newly diagnosed AF compared with usual care in patients with symptoms suggestive of AF and no prior AF diagnosis.</div></div><div><h3>Methods</h3><div>DEEP-AF (A Prospective, Multi-center, Randomized Clinical Trial to Evaluate the Detection of Atrial Fibrillation Using Artificial Intelligence-Enhanced Electrocardiography (SmartECG-AFrisk) Compared With Usual Care in Patients with Suspected Atrial Fibrillation) is a prospective, multicenter, randomized controlled superiority trial conducted at 13 tertiary hospitals in South Korea. A total of 1230 adults 30 years or older with symptoms suggestive of AF and no AF on screening 12-lead ECG will be randomized 1:1 to an AI-ECG–guided strategy or usual care. In the AI-ECG group, the SmartECG-AFrisk algorithm will generate a risk score (high risk: AI score ≥50; low risk: AI score &lt;50) to support clinician-directed rhythm monitoring within guideline-concordant practice. Usual care will follow standard clinical evaluation without access to the AI score.</div></div><div><h3>Results</h3><div>The primary outcome is the incidence of newly diagnosed AF within 6 months, confirmed on standard ECG modalities. Secondary outcomes include time to AF diagnosis, AF detection according to AI risk strata, health care resource utilization and diagnostic efficiency, initiation and timing of anticoagulation or antiplatelet therapy, AF burden, detection of other clinically relevant arrhythmias, arrhythmia-related procedures, clinical events, and patient satisfaction.</div></div><div><h3>Conclusion</h3><div>DEEP-AF will provide pragmatic randomized evidence on whether AI-ECG–guided risk stratification can improve AF detection and diagnostic efficiency in routine care.</div></div><div><h3>Trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> Identifier: <span><span>NCT07173673</span><svg><path></path></svg></span></div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 10","pages":"Pages 2006-2013"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219211","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":"Methodological considerations in comparing left bundle branch pacing and right ventricular pacing for atrial fibrillation outcomes","authors":"Muhammad Fayyaz Riaz MBBS,&nbsp;Suhail Ahmed MBBS,&nbsp;Hayat Asghar MBBS","doi":"10.1016/j.hroo.2026.06.029","DOIUrl":"10.1016/j.hroo.2026.06.029","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 10","pages":"Page 2060"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219246","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":"Ultrasound-guided peripheral regional anesthesia vs local infiltration anesthesia for cardiac device implantation: A propensity score–matched prospective observational cohort study","authors":"Riyong Zhou PhD,&nbsp;Ziyi Ni BMed,&nbsp;Yaoxue Zang BMed,&nbsp;Hao Zhou PhD,&nbsp;Lan Su PhD,&nbsp;Zhengzheng Li PhD,&nbsp;Zhiting Wang MS,&nbsp;Lingling Zheng BMed,&nbsp;Shengjie Wu PhD,&nbsp;Yinuo Lin PhD,&nbsp;Xiao Chen PhD","doi":"10.1016/j.hroo.2026.05.026","DOIUrl":"10.1016/j.hroo.2026.05.026","url":null,"abstract":"<div><h3>Background</h3><div>Conventional local infiltration anesthesia (LIA) may not consistently provide adequate analgesia during cardiac device implantation.</div></div><div><h3>Objective</h3><div>This study aimed to compare the analgesic efficacy of ultrasound-guided peripheral regional anesthesia (PRA) with LIA during cardiac device implantation.</div></div><div><h3>Methods</h3><div>We conducted a single-center prospective observational cohort study including patients undergoing first-time cardiac device implantation. Data were collected in real time during routine clinical care. Patients received PRA or LIA according to routine clinical practice, as determined by the treating clinicians. Propensity score matching was performed to reduce selection bias, resulting in 48 matched patients per group. Pain intensity was assessed using a Numerical Rating Scale at predefined intraoperative procedural steps and postoperative time points, as part of standardized periprocedural care. Additional anesthetic supplementation, pain-related movement, and adverse events were recorded.</div></div><div><h3>Results</h3><div>Among the matched patients (n = 96), pain scores at all 7 procedural steps were significantly lower in the PRA group than in the LIA group (all <em>P</em> &lt; .01). In the LIA group, pain intensity peaked during pocket creation (all <em>P</em> &lt; .05), whereas pain scores remained relatively consistent across procedural steps in the PRA group. Postoperative Numerical Rating Scale scores at 2–24 hours were significantly lower in the PRA group (all <em>P</em> &lt; .05). Pain-related movement and additional anesthetic supplementation were less frequent in the PRA group. Adverse events were infrequent and comparable between groups.</div></div><div><h3>Conclusion</h3><div>In this propensity score–matched prospective observational cohort study, ultrasound-guided PRA was associated with improved periprocedural analgesia without an observed increase in adverse events.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 10","pages":"Pages 1963-1970"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219276","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":"3D mapping-guided cardioneuroablation as a pacemaker-sparing strategy in refractory cardioinhibitory vasovagal syncope: A brief report","authors":"Jaouad Nguadi MD,&nbsp;Hicham Bouzelmat MD,&nbsp;Mehdi Guedira MD,&nbsp;Damien Poindron MD,&nbsp;Nicolas Lellouche MD, PhD,&nbsp;Zouhair Lakhal MD,&nbsp;Aatif Benyass MD,&nbsp;Cyrus Moini MD","doi":"10.1016/j.hroo.2026.05.018","DOIUrl":"10.1016/j.hroo.2026.05.018","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 10","pages":"Pages 2032-2036"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219217","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":"Pharmacist management of oral anticoagulation for atrial fibrillation in the community: The APOTHECARY AF study","authors":"Ciantel Adair Blyler PharmD,&nbsp;Elizabeth M. Jones PharmD,&nbsp;Brian S. Mittman PhD,&nbsp;Steven W. Chen PharmD,&nbsp;Christine M. Albert MD, MPH, FHRS,&nbsp;Roopinder K. Sandhu MD, MPH, FHRS","doi":"10.1016/j.hroo.2026.07.012","DOIUrl":"10.1016/j.hroo.2026.07.012","url":null,"abstract":"<div><h3>Background</h3><div>We developed a novel, community pharmacy-based, pharmacist-driven atrial fibrillation (AF) stroke prevention model involving pharmacist prescription of oral anticoagulants (OAC) in Alberta, Canada. Generalizability to healthcare systems outside Canada is unknown.</div></div><div><h3>Objective</h3><div>We recruited 5 California pharmacies for a proof-of-concept pilot study aimed at evaluating the prevalence of “actionable” AF and the feasibility, safety, and barriers to implementing a pharmacist OAC prescription program.</div></div><div><h3>Methods</h3><div>Before implementation, pharmacist and physician stakeholders were surveyed to identify potential barriers. Pharmacists identified adults aged ≥60 years with a CHA2DS2-VASc score of ≥2 (men) or ≥3 (women), and “actionable” AF, defined as (1) untreated, (2) sub-optimally treated, or (3) inappropriately treated. Participants were enrolled in a 3-month intervention in which pharmacists optimized OAC. Participant satisfaction was assessed at 3 months. Safety endpoints were assessed at 6, 9, and 12 months. Pharmacist-reported implementation barriers were assessed at 1 and 3 months.</div></div><div><h3>Results</h3><div>“Actionable” AF prevalence ranged from 14% to 41%. A total of 14 participants were enrolled. At baseline, 50% of participants were untreated, whereas 50% were sub-optimally treated. At 3 months, 91% of participants were on guideline-concordant OAC therapy. There were no major bleeding events and no prescription overrides. Participants reported high satisfaction with pharmacist services. Perceived barriers reflected reported the following implementation challenges: (1) lack of time, (2) insufficient access to medical records, and (3) adequate reimbursement.</div></div><div><h3>Conclusion</h3><div>Community-based, pharmacist-driven OAC prescription offers an opportunity to effectively close gaps in stroke risk reduction therapy for patients with AF. Scalability in the United States will depend on policy and infrastructure changes that address implementation challenges.</div></div><div><h3>Trial Registration</h3><div>ClinicalTrials.gov Identifier: NCT04907825</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 10","pages":"Pages 1923-1932"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219270","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}