Heart Rhythm O2最新文献

{"title":"Association between quality of life and redo procedures after pulmonary vein isolation in atrial fibrillation patients: Data from the Netherlands Heart Registration","authors":"Mileen R.D. van de Kar MD ,&nbsp;Gijs J. van Steenbergen MD, PhD ,&nbsp;Jasper R. Vermeer MD ,&nbsp;Jeroen F. van der Heijden MD, PhD ,&nbsp;Jippe F. Balt MD, PhD ,&nbsp;Justin G.L.M. Luermans MD, PhD ,&nbsp;Yuri Blaauw MD, PhD ,&nbsp;Niki M. Medendorp Msc ,&nbsp;Daniela N. Veldman-Schulz PhD ,&nbsp;Lukas R.C. Dekker MD, PhD ,&nbsp;Dennis van Veghel PhD ,&nbsp;Ablation Registration Committee of the Netherlands Heart Registration","doi":"10.1016/j.hroo.2025.03.017","DOIUrl":"10.1016/j.hroo.2025.03.017","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) significantly impacts quality of life (QoL), necessitating effective therapeutic interventions such as pulmonary vein isolation (PVI). Although PVI’s success is often measured by freedom from arrhythmia, clinical practice emphasizes symptom freedom and patient comfort, as captured by QoL tools such as the Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire.</div></div><div><h3>Objective</h3><div>This study investigates the association between baseline QoL, changes in QoL, and redo PVI, aiming to align patient-centered outcomes with clinical decision-making.</div></div><div><h3>Methods</h3><div>Data from 3336 AF patients undergoing first-time PVI between 2018 and 2021 in Dutch heart centers were analyzed. Patients with baseline and 1-year follow-up QoL scores were categorized into quartiles based on pre-PVI AFEQT scores, and redo PVI rates were assessed within 1 year.</div></div><div><h3>Results</h3><div>Redo PVI was performed in 16.0% of patients within 1 year. Significant differences in left atrial volume index, left ventricular ejection fraction, and AF type were observed between redo and no-redo groups. Median AFEQT scores improved significantly: from 53.9 to 71.3 in redo patients and from 57.4 to 88.0 in others (<em>P</em> &lt; .001). Higher baseline QoL scores correlated with lower redo rates: odds ratios for redo PVI were 0.93 (Q2, <em>P</em> =.52), 0.74 (Q3, <em>P</em> =.05), and 0.62 (Q4, <em>P</em> =.001) compared with Q1. Redo PVI rates varied significantly between heart centers, reflecting practice variation.</div></div><div><h3>Conclusion</h3><div>Lower baseline QoL is associated with a higher likelihood of redo PVI, emphasizing the role of patient-reported outcomes in AF management. Integrating QoL assessments into routine practice may support individualized care, create risk stratification, and contribute to standardizing clinical decision-making.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 6","pages":"Pages 745-752"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321319","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":"Current practices in managing patients with cardiac implantable electronic devices: Results of an international survey","authors":"James Allred MD, FHRS ,&nbsp;Amber Seiler NP, MSN, FHRS, CEPS, CCDS ,&nbsp;Mark Lyons BSc ,&nbsp;Paul Roberts MD ,&nbsp;Angela Tsiperfal MSN ,&nbsp;Laura van Heel BSN ,&nbsp;Catherina Meijer MSc ,&nbsp;Emmanuelle Nicolle MD ,&nbsp;David Lanctin MPH ,&nbsp;Eimo Martens MD","doi":"10.1016/j.hroo.2025.02.019","DOIUrl":"10.1016/j.hroo.2025.02.019","url":null,"abstract":"<div><h3>Background</h3><div>Managing patients with cardiac implantable electronic devices (CIEDs) is increasingly complicated with expanding populations and evolving technologies. While the 2023 Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society consensus on management of remote device clinics provides recommendations, the adoption of these practices in real-world practice is unknown.</div></div><div><h3>Objective</h3><div>This survey of device clinic staff characterized the adoption and variability of CIED follow-up practices.</div></div><div><h3>Methods</h3><div>A Delphi panel composed of U.S. and European Union clinical experts guided the research objectives, structure, and content of the survey. Once consensus was reached, the online survey (Qualtrics) was deployed in partnership with HRS through e-mail, social media posts, and at the HRX conference. An available case analysis was performed to handle missing data.</div></div><div><h3>Results</h3><div>A total of 471 responses were collected from 44 countries, including 310 in the United States, 88 in Europe, and 73 in other regions. Broad representation was achieved with respect to staff role, years of experience, and clinic ownership. Most (71%) respondents reported being aware of the 2023 consensus statement. While the majority (77%–83%, depending on device type) reported using hybrid in-person and remote management for patients with therapeutic CIEDs, 89% to 91% reported scheduling routine office visits at least once per year, depending on device type, respectively. Only 50% of respondents reported a hybrid approach for insertable cardiac monitor patients, with 35% reporting remote-only follow-up.</div></div><div><h3>Conclusion</h3><div>Variable adoption was found for many practices recommended in the 2023 Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society consensus. Future research should focus on optimal implementation of recommended practices.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 6","pages":"Pages 781-788"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321322","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":"Exploring serum and glucocorticoid-regulated kinase 1: A promising target for COVID-19 and atrial fibrillation treatment","authors":"Jamal E-Fatima PhD ,&nbsp;Faez Iqbal Khan PhD ,&nbsp;Dakun Lai PhD","doi":"10.1016/j.hroo.2025.02.015","DOIUrl":"10.1016/j.hroo.2025.02.015","url":null,"abstract":"<div><div>Serum and glucocorticoid-regulated kinase 1 (SGK1) is a serine/threonine kinase that is involved in various cellular pathways, such as ion transport, cell survival, proliferation, and immune responses. Dysregulation of this enzyme is increasingly being associated with the progression of 2 prominent types of diseases, namely viral infections, such as COVID-19, and cardiovascular disorders, such as atrial fibrillation (AF), positioning it as a potential therapeutic target. With regard to coronavirus 2019 (COVID-19), SGK1 detrimentally affects inflammatory pathways and modulates the cytokine storm, leading to lung tissue damage. Considering this dysregulation, researchers are exploring SGK1 inhibition as a potential strategy for mitigating severe COVID-19 outcomes. SGK1 also regulates pumps and ion channels, significantly affecting cardiac performance in AF. This protein is responsible for promoting fibrosis and inflammation in the cardiac tissue, making it a potential target for reducing atrial fibrillation. SGK1 inhibition offers a new avenue for therapeutic targets against both COVID-19 and AF. This review is aimed at providing a comprehensive overview of SGK1 dysregulation in both diseases, underscoring the urgent need for more preclinical and clinical trials to evaluate effective SGK1 inhibitors for patients with coexisting COVID-19 and AF.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 5","pages":"Pages 720-732"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089137","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":"Pulsed field ablation for paroxysmal atrial fibrillation in a dextrocardia case: A first-in-human experience","authors":"Tongshuai Chen PhD ,&nbsp;Kai Zhang PhD ,&nbsp;Bing Rong MD ,&nbsp;Mingjie Lin PhD ,&nbsp;Jingquan Zhong PhD, MD, FHRS","doi":"10.1016/j.hroo.2025.03.013","DOIUrl":"10.1016/j.hroo.2025.03.013","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 5","pages":"Pages 736-738"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089139","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":"Vein of Marshall ethanol infusion improves ablation outcomes in patients with persistent atrial fibrillation","authors":"Mohammed Al-Sadawi MB BCH,&nbsp;Rushil N. Shah MBBS, DNB, MHS,&nbsp;Amrish Deshmukh MD,&nbsp;Jackson J. Liang DO,&nbsp;Krit Jongnarangsin MD,&nbsp;Fred Morady MD,&nbsp;Hakan Oral MD,&nbsp;Aman Chugh MD,&nbsp;Michael Ghannam MD","doi":"10.1016/j.hroo.2025.01.020","DOIUrl":"10.1016/j.hroo.2025.01.020","url":null,"abstract":"<div><h3>Background</h3><div>Vein of Marshall ethanol infusion (VoMEI) may improve outcomes among patients with persistent atrial fibrillation (AF) undergoing catheter ablation procedures. Prior investigations used heterogeneous ablation strategies, limiting the understanding of VoMEI utility.</div></div><div><h3>Objective</h3><div>The study sought to examine the safety and efficacy of a uniform ablation approach utilizing VoMEI compared with patients undergoing pulmonary vein isolation (PVI) only or PVI and posterior wall isolation (PWI).</div></div><div><h3>Methods</h3><div>Patients undergoing first-time ablation for persistent AF utilizing VoMEI with PVI, PWI, and ablation of induced macro–re-entry arrhythmias were included. Two propensity-matched control groups (PVI only and PVI + PWI) were identified with 2:1 matching. Safety and efficacy rates between the groups were examined.</div></div><div><h3>Results</h3><div>A total of 155 patients were included (VoMEI, n = 31; PVI, n = 62; PVI + PWI, n = 62), consisting of 98 (63%) males 66 ± 10 years of age, with left atrial diameter 49 ± 7 mm, ejection fraction 50 ± 16%, and follow-up time 3.2 ± 2.2 years, with no demographic differences between the groups (<em>P &gt;</em> .05). The 1-year rate of freedom from atrial arrhythmias after a single procedure was 84%, 67%, and 54% for patients undergoing VoMEI, PVI only, and, PVI + PWI, respectively (log rank <em>P</em> = .021). Patients who underwent VoMEI had improved outcomes compared with patients who did not (hazard ratio 0.32, 95% confidence interval 0.12–0.78, <em>P =</em> .01), with fewer repeat procedures (10% vs 37%, <em>P &lt;</em> .01). Procedure, radiofrequency, and fluoroscopy times were greater in the VoMEI groups (<em>P &gt;</em> .05).</div></div><div><h3>Conclusion</h3><div>Among patients with persistent AF, an ablation strategy incorporating VoMEI improved long-term ablation outcomes compared with groups of propensity-matched patients undergoing PVI only or PVI + PWI.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 5","pages":"Pages 598-605"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089031","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":"Is a single lethal electric field threshold sufficient to characterize the lesion size in computational modeling of cardiac pulsed-field ablation?","authors":"Argyrios Petras PhD ,&nbsp;Gerard Amoros Figueras PhD ,&nbsp;Zoraida Moreno Weidmann MD ,&nbsp;Tomás García-Sánchez PhD ,&nbsp;David Viladés Medel MD, PhD ,&nbsp;Antoni Ivorra PhD ,&nbsp;Jose M. Guerra MD, PhD ,&nbsp;Luca Gerardo-Giorda PhD","doi":"10.1016/j.hroo.2025.02.014","DOIUrl":"10.1016/j.hroo.2025.02.014","url":null,"abstract":"<div><h3>Background</h3><div>Pulsed-field ablation (PFA) is a novel cardiac ablation technology based on irreversible electroporation (IRE). PFA computational models rely on identification of a lethal electric field threshold to predict the IRE area. However, the predicted lesion anisotropy ratios (width over depth) vary extensively among recent studies, and these discrepancies remain a subject of discussion.</div></div><div><h3>Objective</h3><div>This work aims to evaluate the predicted lesion anisotropy ratios using a PFA computational model by applying it to an open-chest in vivo porcine model geometry.</div></div><div><h3>Methods</h3><div>Six domestic swine underwent epicardial PFA applications using a previously described waveform protocol. Animals were killed at least 3 hours after the last ablation, and lesions were assessed using triphenyltetrazolium chloride (TTC) staining. Numeric simulations were performed on a segmented and meshed porcine thoracic computed tomography (CT) scan, mimicking the open-chest experimental setup.</div></div><div><h3>Results</h3><div>The maximum width of all simulated lesions was observed at the epicardial surface. The anisotropy ratios (AR) of the experimental lesions were smaller than the simulated ones (AR experimental vs simulated, 1.0–1.7 vs 2–2.7; Q1–Q3 quartiles). Increasing the peak voltage resulted in larger lesions; however, the computational model clearly underestimated the increase in lesion depth compared with the experimental data.</div></div><div><h3>Conclusion</h3><div>Our computational model shows that a single lethal electric field threshold is insufficient to accurately predict both lesion depth and width in cardiac PFA. Our study suggests that for the given PFA waveforms, a threshold between 270 and 500 V/cm provides satisfactory lesion depth estimations, and a higher threshold between 790 and 1000 V/cm better captures the lesion width.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 5","pages":"Pages 671-677"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089230","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":"A machine learning–based risk prediction model for atrial fibrillation in critically ill patients","authors":"Laith Alomari MD ,&nbsp;Yaman Jarrar MD ,&nbsp;Zaid Al-Fakhouri MD ,&nbsp;Emmanuel Otabor MBBS ,&nbsp;Justin Lam MD ,&nbsp;Jana Alomari","doi":"10.1016/j.hroo.2025.02.008","DOIUrl":"10.1016/j.hroo.2025.02.008","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) in critically ill patients increases morbidity, hospital stays, and costs. Existing prediction tools are limited in intensive care unit (ICU) settings.</div></div><div><h3>Objective</h3><div>This study developed a machine learning–based model to enable early AF risk identification and prevention.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, adult patients admitted to the ICU were identified from the MIMIC-IV (Medical Information Mart for Intensive Care-IV) database, including 47 clinical and laboratory variables. The primary outcome was AF within the first 48 hours of admission. Multiple machine learning models were trained to predict AF, with the top-performing model undergoing hyperparameter tuning. A compact model was developed using 15 variables and 2 novel features—one identifying patients 70 years of age or older with sepsis and another representing a composite score of pre-existing cardiac risk factors. Model performance was evaluated using accuracy, area under the receiver-operating characteristic curve (AUROC), and predictive values. SHAP (Shapley Additive exPlanations) analysis interpreted individual feature contributions to the model's predictions.</div></div><div><h3>Results</h3><div>The cohort comprised 46,266 ICU patients, with 4.6% developing AF within 48 hours. The CatBoost classifier model achieved an AUROC of 0.850 on the test set, while the compact model with new features yielded an AUROC of 0.820. SHAP analysis highlighted total serum magnesium, age, and the newly created features as key predictors of AF development.</div></div><div><h3>Conclusion</h3><div>This study demonstrates the potential of machine learning models in predicting AF development in ICU patients. The compact model, with a satisfactory AUROC, can be a valuable tool for identifying high-risk patients and facilitating timely interventions.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 5","pages":"Pages 652-660"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089228","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":"Long-term outcomes of triple-site versus dual-site cardiac resynchronization therapy using temporary pacing to guide individualized implantation","authors":"Michio Ogano MD, PhD ,&nbsp;Yu-ki Iwasaki MD, PhD ,&nbsp;Jun Tanabe MD ,&nbsp;Wataru Shimizu MD, PhD, FHRS ,&nbsp;Kuniya Asai MD, PhD","doi":"10.1016/j.hroo.2025.02.013","DOIUrl":"10.1016/j.hroo.2025.02.013","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac resynchronization therapy (CRT) is an effective treatment for chronic heart failure, but dual-site (2V) pacing may not fully eliminate electrical dyssynchrony. Triple-site (3V) pacing, adding an additional left ventricle (LV) pacing site, may enhance CRT outcomes.</div></div><div><h3>Objective</h3><div>This study examines the long-term effects of 2V vs 3V CRT, using temporary pacing to individualize lead placement.</div></div><div><h3>Methods</h3><div>From 2010 to 2016, 92 patients with New York Heart Association (NYHA class II-IV heart failure, left ventricular ejection fraction (LVEF) &lt; 35%, and QRS duration &gt; 120 ms received CRT guided by temporary pacing. Patients underwent invasive pacing studies to measure electrical and hemodynamic improvements between 2V and 3V configurations. Based on QRS narrowing and LV dP/dtmax improvements, 27 patients were assigned to the 3V group and 65 to the 2V group. Clinical outcomes, including the clinical composite score (CCS), NYHA class, QRS duration, heart failure (HF) events, and mortality, were followed up over an average 8.3 years.</div></div><div><h3>Results</h3><div>At 1 year, the 3V group had significantly better CCS outcomes compared with the 2V group (<em>P</em> = .018). Long-term follow-up showed a significantly lower HF event rate in the 3V group (<em>P</em> = .002), although overall mortality did not differ. Multivariate analysis identified 3V pacing as an independent predictor of reduced HF events (hazard ratio [HR] = 0.275; <em>P</em> = .018). Despite shorter battery life in the 3V group, device replacement rates were similar.</div></div><div><h3>Conclusion</h3><div>Temporary pacing-guided 3V CRT provides significant long-term benefits over 2V CRT by reducing HF events. These findings support the necessity of individualized assessment and approach to eliminate electrical dyssynchrony when considering multi-site pacing CRT.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 5","pages":"Pages 557-565"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089015","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":"Left bundle branch area pacing in patients with severe interventricular septal hypertrophy: A multicenter study assessing feasibility, safety, and outcomes of lumenless and stylet-driven leads","authors":"Sanjai Pattu Valappil MD, DM ,&nbsp;Abhinav B. Anand MD, DM ,&nbsp;Anindya Ghosh MD, DM ,&nbsp;Krishnaswamy Subramanyan MD, DM ,&nbsp;Pramod Jaiswal MD, DM ,&nbsp;Krishnan Jayanthi MD, DNB ,&nbsp;Golla N. Prasad MD, DNB ,&nbsp;Tirupattur S. Srinath MD, DNB ,&nbsp;Shilpa Menon MD, DM ,&nbsp;Sharan Shreedhar MD ,&nbsp;Karthikeyan D DMRD, DNB, Radiology ,&nbsp;Velayudhan Bashi MS, MCH ,&nbsp;Justin Paul MD, DNB, DM ,&nbsp;Elangovan Elavarasi Manimegalai MD, DM ,&nbsp;Immanuel Sathiakumar Arunkumar MD (General Medicine), DM (Cardiology) ,&nbsp;Sriram Veeraraghavan MD, DM ,&nbsp;Saran G. Kumar BSc ,&nbsp;Soli Rajaram Ramkumar MD, DM ,&nbsp;Raniya Palliyedath MBBS ,&nbsp;Shaima Hafeez MBBS ,&nbsp;Ulhas M. Pandurangi MD, DM","doi":"10.1016/j.hroo.2025.02.018","DOIUrl":"10.1016/j.hroo.2025.02.018","url":null,"abstract":"<div><h3>Background</h3><div>There has been limited success using left bundle branch area pacing (LBBAP) in patients with severe interventricular septal hypertrophy (IVSH).</div></div><div><h3>Objective</h3><div>This study assesses the feasibility, safety, and outcome of LBBAP in patients with severe IVSH.</div></div><div><h3>Methods</h3><div>19 adult patients with severe IVSH who underwent LBBAP were enrolled. Baseline patient characteristics, procedural data, and postprocedural results were collected. The feasibility of LBBAP in patients with severe IVSH using the lumenless leads (LLL) and stylet-driven leads (SDL) were analyzed.</div></div><div><h3>Results</h3><div>19 IVSH and 529 normal septal thickness (NST) patients underwent LBBAP. Implant success was achieved in 497 patients with NST (93.9%) and 14 patients with severe IVSH (73.6%). Among the 19 patients with severe IVSH, 7 patients underwent attempted LBBAP using LLL, with successful outcomes in 4 (57.1%). The remaining 12 patients underwent LBBAP with SDL, of which 10 were successful (83.3%). Mean septal thickness (20 ± 1.9 vs 21 ± 2.2), paced QRS duration (123 ± 17 vs 121 ± 9), and left ventricular activation time (LVAT) (75 ± 6 vs 74 ± 9) were comparable in the LLL and SDL groups. The lead thresholds (0.8 ± 0.3) remained stable over the mean follow-up duration of 36 ± 28.67 months without any lead-related complications.</div></div><div><h3>Conclusion</h3><div>LBBAP in patients with severe IVSH is safe and feasible. Although the overall success rates in this subgroup were lower (73.6%) compared with patients with NST, this was not significantly different with the use of SDL (83.3%) (<em>P</em> = .15).</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 5","pages":"Pages 588-597"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144088940","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":"Retrograde aortic access for ventricular arrhythmia ablation: A novel plug and suture strategy for vascular closure","authors":"Rebecca Arnet MD ,&nbsp;Sven Knecht DSc ,&nbsp;Behnam Subin MD ,&nbsp;Philipp Krisai MD ,&nbsp;Nicolas Schärli MD ,&nbsp;Felix Mahfoud MD ,&nbsp;Christian Sticherling MD ,&nbsp;Michael Kühne MD ,&nbsp;Patrick Badertscher MD","doi":"10.1016/j.hroo.2025.02.009","DOIUrl":"10.1016/j.hroo.2025.02.009","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 5","pages":"Pages 733-735"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089138","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}