Heart Rhythm O2最新文献

{"title":"Utility of short-term heart rate variability metrics in heart failure with reduced ejection fraction","authors":"Michiaki Nagai MD, PhD ,&nbsp;Sunny S. Po MD, PhD, FHRS ,&nbsp;Benjamin J. Scherlag PhD, FHRS ,&nbsp;Tarun W. Dasari MD, MPH","doi":"10.1016/j.hroo.2025.06.023","DOIUrl":"10.1016/j.hroo.2025.06.023","url":null,"abstract":"<div><h3>Background</h3><div>Recently, reduced sympathetic nervous system (SNS) activity measured by 10-minute electrocardiogram (ECG)-based heart rate (HR) variability (HRV) was associated with heart failure (HF) with recovered ejection fraction (EF) (HFrecEF). However, there are no studies on the optimal ECG recording time to indicate HFrecEF in short-term HRV.</div></div><div><h3>Objective</h3><div>In this study, the optimal ECG intervals and time-domain metrics to elucidate indicators for HFrecEF were investigated in HF with reduced EF (HFrEF).</div></div><div><h3>Methods</h3><div>HRV analyses based on 2-, 4.5-, and 9-minute ECG intervals were performed in 4 groups: patients with persistent HFrEF (n = 40), HFrecEF (n = 41), and stage A HF (n = 73) and healthy controls (n = 40).</div></div><div><h3>Results</h3><div>Mean HR and triangular and SNS indexes were significantly different across all of the 2-, 4.5-, and 9-minute ECG intervals among the 4 groups. In the logistic regression analysis adjusted for age, gender, body mass index, and mean HR, only the triangular index was significantly associated with recovery across all time intervals, whereas the SNS index at 2- and 9-minute ECG intervals was associated with recovery in EF (all <em>P</em> &lt; .05). Receiver operating characteristic analysis showed that the SNS index at a 9-minute ECG interval had the highest area under the curve, followed by the triangular index at a 2-minute ECG interval for the recovered EF group (0.724 and 0.718, respectively).</div></div><div><h3>Conclusion</h3><div>In this study, a higher 2-minute triangular index and a lower 9-minute SNS index indicated functional EF recovery in HFrEF. Further prospective studies are needed to confirm the utility of short-term indexes to predict myocardial recovery after HF treatment.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 9","pages":"Pages 1382-1390"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098811","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":"Atrial fibrillation in the emergency department: Predictors of admission and discharge—A nationwide analysis","authors":"Alexandra C. Millhuff MD ,&nbsp;Katarina Leyba MD ,&nbsp;Ishan Garg MD ,&nbsp;Hassan Khalid MD ,&nbsp;Aman Goyal MD ,&nbsp;Amir Humza Sohail MD, MSc ,&nbsp;Karthik Gangu MD ,&nbsp;Mohamed Daoud MD ,&nbsp;Shazib Sagheer MD ,&nbsp;Abu Baker Sheikh MD","doi":"10.1016/j.hroo.2025.06.017","DOIUrl":"10.1016/j.hroo.2025.06.017","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) is a commonly encountered cardiac arrhythmia. Its presentation in the emergency department (ED) has significant clinical and economic implications, warranting further investigation.</div></div><div><h3>Objective</h3><div>The purpose of this study was to analyze predictors of disposition and identify disparities among patients presenting to US EDs with AF.</div></div><div><h3>Methods</h3><div>In this retrospective study, we analyzed data from patient visits to the ED with a primary diagnosis of AF using the Nationwide Emergency Department Sample from January 1, 2016, to December 31, 2020. We compared demographic characteristics, comorbidities, and disposition status for these patients.</div></div><div><h3>Results</h3><div>A total of 699,680,000 adult ED visits were recorded, of which 3,070,240 were for AF. Nearly half (48.4%) of patients with AF in the ED required inpatient admission, while ED mortality was extremely low (0.03%). Patients aged 80 years or older (compared with those aged 18–44 years) were more likely to be admitted than discharged home (odds ratio 1.15; 95% confidence interval 1.07–1.24; <em>P</em> &lt; .001), and women were more likely to be admitted than men (odds ratio 1.12; 95% confidence interval 1.10–1.13; <em>P</em> &lt; .001). Comorbidities such as chronic pulmonary disease, essential hypertension, obesity, renal failure, liver disease, neurologic disorders, iron deficiency anemia, hypothyroidism, valvular disease, and hyperlipidemia, along with lifestyle factors such as smoking, alcohol consumption, or recreational drug use, also increased the likelihood of hospital admission.</div></div><div><h3>Conclusion</h3><div>Our study reveals that older age, female sex, and certain comorbidities significantly increase the likelihood of hospital admission for patients with AF in the ED.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 9","pages":"Pages 1306-1315"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098858","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":"R-wave amplitude changes in lead aVL predict outcomes in cardiac resynchronization therapy: Exploring the role of papillary muscle dyssynchrony and mitral regurgitation","authors":"Csilla A. Eötvös MD ,&nbsp;Teodora Avram MD ,&nbsp;Iulia G. Zehan MD ,&nbsp;Madalina P. Moldovan MD ,&nbsp;Adriana D. Sârb MD ,&nbsp;Roxana D. Lazar MD ,&nbsp;Giorgia Coșeriu MD ,&nbsp;Patricia Șchiop-Țentea MD ,&nbsp;Eric Daniel Blendea ,&nbsp;Diana L. Mocan-Hognogi MD, PhD ,&nbsp;Roxana Chiorescu MD, PhD ,&nbsp;Gabriel Gușetu MD, PhD ,&nbsp;Sorin Pop MD ,&nbsp;Craig A. McPherson MD ,&nbsp;E. Kevin Heist MD, PhD, FHRS ,&nbsp;Jagmeet P. Singh MD, DPhil, FHRS ,&nbsp;Dan Blendea MD, PhD, FHRS","doi":"10.1016/j.hroo.2025.06.004","DOIUrl":"10.1016/j.hroo.2025.06.004","url":null,"abstract":"<div><h3>Background</h3><div>Reduction in R-wave amplitude in lead aVL (RaVL) is often noted after cardiac resynchronization therapy (CRT), together with a shorter QRS duration and reduced mitral regurgitation (MR). Given that lead aVL reflects electrical activity in the anterolateral left ventricular wall, where the anterolateral papillary muscle (PM) resides, opposing the posteromedial one, we hypothesized that these electrocardiographic changes may reflect improved electrical resynchronization of the PMs, contributing to MR reduction.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the relationship between post-CRT changes in RaVL and MR severity and assess whether RaVL can serve as a surface electrocardiographic marker of PM dyssynchrony and a predictor of clinical response and long-term survival.</div></div><div><h3>Methods</h3><div>We analyzed 231 patients who underwent CRT implantation and were followed for a median of 41 months (interquartile range 29–55); 88 patients died during this period.</div></div><div><h3>Results</h3><div>Baseline RaVL correlated with QRS duration (<em>r</em> = 0.20, <em>P</em> = .0018) and aVL–aVF intrinsicoid deflection difference (<em>r</em> = 0.36, <em>P</em> &lt; .0001), supporting its role as a marker of electrical dyssynchrony. RaVL significantly decreased after CRT (0.66 ± 0.42 mV to 0.41 ± 0.41 mV, <em>P</em> &lt; .0001) and independently predicted MR response in multivariable logistic regression. Patients who experienced a reduction in RaVL or a decrease in QRS duration after CRT had significantly better survival than those whose corresponding parameters remained unchanged or increased. Both variables independently predicted survival in multivariable Cox regression.</div></div><div><h3>Conclusion</h3><div>A decrease in RaVL after CRT predicts MR improvement and survival, likely reflecting improved PM synchronization and mechanical resynchronization.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 9","pages":"Pages 1324-1334"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098860","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":"Bleeding risk in East Asian patients with atrial fibrillation: Validation of the DOAC score in a Japanese multicenter registry","authors":"Takahiko Nishiyama MD, PhD ,&nbsp;Shun Kohsaka MD ,&nbsp;Ryo Nakamaru MD, PhD ,&nbsp;Yoshinori Katsumata MD, PhD ,&nbsp;Takehiro Kimura MD, PhD, FHRS ,&nbsp;Ikuko Ueda PhD ,&nbsp;Yasuyuki Shiraishi MD, PhD ,&nbsp;Tomohiko Ono MD, PhD ,&nbsp;Kojiro Tanimoto MD, PhD ,&nbsp;Seiji Takatsuki MD, PhD, FHRS ,&nbsp;Masaki Ieda MD, PhD","doi":"10.1016/j.hroo.2025.06.003","DOIUrl":"10.1016/j.hroo.2025.06.003","url":null,"abstract":"<div><h3>Background</h3><div>Bleeding events remain relatively frequent in patients with atrial fibrillation (AF), posing significant clinical challenges in routine patient management. The recently developed direct oral anticoagulant (DOAC) score shows promise in predicting bleeding risk; however, its performance in East Asian patients is not well characterized.</div></div><div><h3>Objective</h3><div>This study aimed to assess the performance of the DOAC score in a contemporary outpatient-based registry of Japanese patients with AF and evaluate potential modifications to enhance its predictive accuracy.</div></div><div><h3>Methods</h3><div>The Keio Interhospital Cardiovascular Studies-Atrial Fibrillation registry is a multicenter prospective database designed according to international standards for newly diagnosed AF. Adjudicated bleeding events were prospectively collected, and we assessed each bleeding risk score’s predictive capacity using the C-index and calibration analysis. Performance was evaluated at 1- and 5-year intervals.</div></div><div><h3>Results</h3><div>Among 2101 patients (median age of 70 years; 67.9% men), the overall 1- and 5-year bleeding incidence was 2.1% and 4.7%, respectively. The DOAC score demonstrated acceptable discrimination at 1 year (C-index 0.704, 95% confidence interval [CI] 0.634–0.774), which was maintained over the extended 5-year follow-up (C-index 0.690, 95% CI 0.640–0.741). Calibration analysis showed acceptable performance across validation datasets. Notably, modifying antiplatelet scoring by distinguishing aspirin (2 points) from other antiplatelets (1 point) improved the performance (C-index 0.707, 95% CI 0.637–0.777).</div></div><div><h3>Conclusion</h3><div>The DOAC score proved valuable for long-term bleeding risk assessment in Japanese patients with AF, with enhanced performance through antiplatelet stratification. These findings support its implementation in East Asian populations for individualized clinical decision making.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 9","pages":"Pages 1289-1295"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098921","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":"PATIENT WITH CONGENITALLY CORRECTED TRANSPOSITION OF GREAT ARTERIES WITH A SLOW ATRIAL FLUTTER","authors":"Moses Kiwanuka Ssebuliba,&nbsp;Isaac Ssinabulya,&nbsp;Brain Kiggundu,&nbsp;Doreen Nakagaayi","doi":"10.1016/j.hroo.2025.08.019","DOIUrl":"10.1016/j.hroo.2025.08.019","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 9","pages":"Page 1480"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094939","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":"ID: 4310783 ROBUST ECG ANALYSIS ACROSS HOLTER AND PATCH DEVICES: A DEVICE-AGNOSTIC APPROACH","authors":"Jordan Diven,&nbsp;Jonathan Francey,&nbsp;Joshua Wiseman,&nbsp;Adrian Deery,&nbsp;Maeve McKeever,&nbsp;Niamh McCallan","doi":"10.1016/j.hroo.2025.07.040","DOIUrl":"10.1016/j.hroo.2025.07.040","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 9","pages":"Pages S8-S9"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989511","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":"ID: 4346892 DESIGNING PATIENT-FACING AI TOOLS: USABILITY EVALUATION OF A SMARTPHONE APP DISPLAYING CARDIAC IMPLANTABLE DEVICE DATA","authors":"Meghan Turchioe,&nbsp;So Hyeon Bang,&nbsp;Afra Shamnath,&nbsp;Stephanie Lai,&nbsp;Natalie Yee,&nbsp;Julie Lindmark,&nbsp;Jessica Federak,&nbsp;Viktoria Averina,&nbsp;David J. Slotwiner","doi":"10.1016/j.hroo.2025.07.078","DOIUrl":"10.1016/j.hroo.2025.07.078","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 9","pages":"Page S31"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144987841","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":"ID: 4349863 DIRECT-FROM-ECG DYNAMIC VENTRICULAR DYSSYCHRONY-GUIDED BIV PACING AND ADAPTIVE CRT OPTIMIZATION TO IMPROVE OUTCOMES IN HEART FAILURE PATIENTS","authors":"Sandeep Gulati,&nbsp;Joseph Yu,&nbsp;Nicholas T. Skipitaris,&nbsp;Andrea Natale,&nbsp;Sameer Jamal,&nbsp;Frank Mazzola,&nbsp;Dale DuBois,&nbsp;Brian Kolski","doi":"10.1016/j.hroo.2025.07.079","DOIUrl":"10.1016/j.hroo.2025.07.079","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 9","pages":"Pages S31-S32"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144987842","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":"ID: 4349496 HIGH IMPEDANCE ALERT IN A HYBRID PACEMAKER SYSTEM","authors":"Siddharth Agarwal,&nbsp;Abhishek J. Deshmukh,&nbsp;Ammar M. Killu,&nbsp;Alan M. Sugrue","doi":"10.1016/j.hroo.2025.07.044","DOIUrl":"10.1016/j.hroo.2025.07.044","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 9","pages":"Pages S10-S11"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144987929","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":"ID: 4348732 AI-BASED FRAMEWORK FOR EXPERT-LEVEL DIAGNOSIS OF PERITRICUSPID FLUTTER","authors":"Amanda Kremer,&nbsp;Thomas Demarcy,&nbsp;Santiago Silva,&nbsp;Léandre Genin,&nbsp;Edouard Gitenay,&nbsp;Elisa Martinez,&nbsp;Patrick Khanoyan,&nbsp;Jacques Billé,&nbsp;Jean-Baptiste Vignalou,&nbsp;Olivier Com,&nbsp;Hind Regragui,&nbsp;Andrea Ballatore,&nbsp;Francesco Figus,&nbsp;Florian Baptiste,&nbsp;Alexandre Maluski,&nbsp;Aicha Fofana,&nbsp;Clement Bars,&nbsp;Julien Seitz","doi":"10.1016/j.hroo.2025.07.092","DOIUrl":"10.1016/j.hroo.2025.07.092","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 9","pages":"Pages S38-S39"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988565","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}