Heart Rhythm O2最新文献

{"title":"Leadless pacemaker dislodgment: Difficulty in release as a predictor for dislodgment and tools for successful retrieval","authors":"Mohammad I. Amin MD, FHRS, Seham Saif MD, Sadananda Shivappa MD, Husam Noor MD","doi":"10.1016/j.hroo.2024.08.010","DOIUrl":"10.1016/j.hroo.2024.08.010","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 10","pages":"Pages 739-740"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535020","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 global burden of atrial fibrillation: Voices from Asia and Brazil","authors":"Gregory Y.H. Lip MD , Uma N. Srivatsa MBBS, MAS , Jeanne E. Poole MD","doi":"10.1016/j.hroo.2024.08.007","DOIUrl":"10.1016/j.hroo.2024.08.007","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 10","pages":"Pages 677-678"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535014","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":"Considerations regarding safety with pulsed field ablation for atrial fibrillation","authors":"Alan Sugrue MBBCh, MSc ,&nbsp;Samuel Shabtaie MD ,&nbsp;Nicholas Y. Tan MD, MS ,&nbsp;Elad Maor MD ,&nbsp;Suraj Kapa MD ,&nbsp;Samuel J. Asirvatham MD","doi":"10.1016/j.hroo.2024.08.002","DOIUrl":"10.1016/j.hroo.2024.08.002","url":null,"abstract":"<div><p>The introduction of pulsed field ablation (PFA) in electrophysiology marks a significant advancement, promising efficacy comparable to thermal ablation methods while potentially providing safety advantages. Despite a generally favorable safety profile in human trials and postmarket registries, cautious evaluation of PFA's safety is essential. This review provides a comprehensive overview of key safety considerations as we discuss a myriad of considerations ranging from thermal effects, gaseous microbubble formation, muscle contractions, and proarrhythmia to procedural techniques. We explore specific safety concerns with phrenic nerve injury, cerebral lesions, coronary artery spasm, hemolysis and pulmonary bleeding. Vigilance in safety monitoring, coupled with advancements in procedural techniques and understanding of PFA's unique effects, is crucial for optimizing the safe and effective use of PFA.</p></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 9","pages":"Pages 655-661"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501824002617/pdfft?md5=d7e12bb800ab1a21c10d904cab849131&pid=1-s2.0-S2666501824002617-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271264","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":"Outcomes of patients with malignancy undergoing catheter ablation for ventricular tachycardia in the United States","authors":"Siddharth Agarwal MD ,&nbsp;Charu Debnath MD ,&nbsp;Zain Ul Abideen Asad MD, MS ,&nbsp;Muhammad Bilal Munir MD ,&nbsp;Abhishek Deshmukh MD ,&nbsp;Christopher V. DeSimone MD, PhD","doi":"10.1016/j.hroo.2024.07.011","DOIUrl":"10.1016/j.hroo.2024.07.011","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 9","pages":"Pages 672-675"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501824002307/pdfft?md5=8359bc8c38c982b73e4015f1f9b3cf95&pid=1-s2.0-S2666501824002307-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141842461","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":"Risk factors and incidence of new-onset heart failure with conventional pacemaker implant: A nationwide study","authors":"Maiwand Farouq MD ,&nbsp;Cecilia Rorsman MD ,&nbsp;Sofia Marinko ,&nbsp;David Mörtsell MD, PhD ,&nbsp;Uzma Chaudhry MD, PhD ,&nbsp;Lingwei Wang MD, PhD ,&nbsp;Pyotr Platonov MD, PhD ,&nbsp;Rasmus Borgquist MD, PhD","doi":"10.1016/j.hroo.2024.07.012","DOIUrl":"10.1016/j.hroo.2024.07.012","url":null,"abstract":"<div><h3>Background</h3><p>Studies have shown that the risk of new-onset heart failure (HF) is higher postimplantation for patients receiving right ventricular pacing.</p></div><div><h3>Objective</h3><p>This study aimed to investigate incidence, risk factors, and implications for long-term prognosis of new-onset HF in patients after pacemaker implantation.</p></div><div><h3>Methods</h3><p>Patients without pre-existing HF who received a pacemaker in Sweden during the period of 2005 to 2020 were identified via the nationwide Pacemaker Registry. Data were crossmatched with the population registry and national disease registries. The primary outcome was new-onset HF within 5 years, and a risk score for this was developed and validated.</p></div><div><h3>Results</h3><p>In all, 65,579 patients met the inclusion criteria (10,351 single-chamber ventricular and 55,228 dual-chamber pacemakers). A total of 13,792 (21.0%) patients were diagnosed with HF within 5 years postimplantation. Of these, 6244 (45.3%) were hospitalized for HF. Patients with new-onset HF were more likely to die within 5 years (41.2% vs 19.7%, <em>P</em> &lt; .0001). Risk factors for new-onset HF included increasing age, male sex, hypertension, diabetes, atrial fibrillation, chronic lung and kidney disease, ischemic heart disease, and atrioventricular block. In a combined score using these variables, patients in the highest risk-score quartile had a hazard ratio of 5.36 (95% CI 4.91–5.86, <em>P</em> &lt; .001) and an absolute risk of 32% for developing HF.</p></div><div><h3>Conclusion</h3><p>Pacemaker therapy is associated with &gt;20% risk of new-onset HF within 5 years, and we identified 9 risk factors associated with the diagnosis of new-onset HF. The proposed score based on these variables can be used to identify patients at high risk for new-onset HF.</p></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 9","pages":"Pages 623-630"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501824002319/pdfft?md5=f4bd3c7ed40e19ea0e6aad4ea60c42f8&pid=1-s2.0-S2666501824002319-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839747","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":"Performance of off-the-shelf machine learning architectures and biases in low left ventricular ejection fraction detection","authors":"Jake A. Bergquist PhD ,&nbsp;Brian Zenger MD, PhD ,&nbsp;James Brundage ,&nbsp;Rob S. MacLeod PhD ,&nbsp;T. Jared Bunch MD ,&nbsp;Rashmee Shah MD, MS ,&nbsp;Xiangyang Ye PhD ,&nbsp;Ann Lyons PhD ,&nbsp;Michael Torre PhD ,&nbsp;Ravi Ranjan MD, PhD ,&nbsp;Tolga Tasdizen PhD ,&nbsp;Benjamin A. Steinberg MD, MHS","doi":"10.1016/j.hroo.2024.07.009","DOIUrl":"10.1016/j.hroo.2024.07.009","url":null,"abstract":"<div><h3>Background</h3><p>Artificial intelligence–machine learning (AI-ML) has demonstrated the ability to extract clinically useful information from electrocardiograms (ECGs) not available using traditional interpretation methods. There exists an extensive body of AI-ML research in fields outside of cardiology including several open-source AI-ML architectures that can be translated to new problems in an “off-the-shelf” manner.</p></div><div><h3>Objective</h3><p>We sought to address the limited investigation of which if any of these off-the-shelf architectures could be useful in ECG analysis as well as how and when these AI-ML approaches fail.</p></div><div><h3>Methods</h3><p>We applied 6 off-the-shelf AI-ML architectures to detect low left ventricular ejection fraction (LVEF) in a cohort of ECGs from 24,868 patients. We assessed LVEF classification and explored patient characteristics associated with inaccurate (false positive or false negative) LVEF prediction.</p></div><div><h3>Results</h3><p>We found that all of these network architectures produced LVEF detection area under the receiver-operating characteristic curve values above 0.9 (averaged over 5 instances per network), with the ResNet 18 network performing the highest (average area under the receiver-operating characteristic curve of 0.917). We also observed that some patient-specific characteristics such as race, sex, and presence of several comorbidities were associated with lower LVEF prediction performance.</p></div><div><h3>Conclusions</h3><p>This demonstrates the ability of off-the-shelf AI-ML architectures to detect clinically useful information from ECGs with performance matching contemporary custom-build AI-ML architectures. We also highlighted the presence of possible biases in these AI-ML approaches in the context of patient characteristics. These findings should be considered in the pursuit of efficient and equitable deployment of AI-ML technologies moving forward.</p></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 9","pages":"Pages 644-654"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501824002289/pdfft?md5=70091853d69b920d35ca322b9f124330&pid=1-s2.0-S2666501824002289-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141852736","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":"Remarkably high and accelerating failure rate of a widely used implantable cardioverter-defibrillator lead: A large-scale manufacturer-independent multicenter study with long accurate follow-up","authors":"Erik F.J. Oosterwerff MD ,&nbsp;Dominic A.M.J. Theuns MD, PhD ,&nbsp;Alexander H. Maass MD, PhD ,&nbsp;Lieselot van Erven MD, PhD","doi":"10.1016/j.hroo.2024.07.010","DOIUrl":"10.1016/j.hroo.2024.07.010","url":null,"abstract":"<div><h3>Background</h3><p>A high annual failure rate of the Linox family defibrillator lead was reported in various small single-center studies. No independent multicenter long-term performance information exists for this lead.</p></div><div><h3>Objective</h3><p>Our aim was to assess the longevity of the Linox family leads and to evaluate clinical variables and adverse events associated with failure.</p></div><div><h3>Methods</h3><p>This 4-center study included adults &gt;18 years of age who received Linox family leads for the prevention of sudden cardiac death. From November 2006 to November 2016, a total of 3993 high-voltage leads of the Linox family were implanted and followed up on.</p></div><div><h3>Results</h3><p>The absolute failure rate was 10.6% (dwell time to lead failure of 6.3 ± 3.4 years). Multivariate analysis confirmed younger age (for every 5 years younger than 65 years) (hazard ratio 1.09, 95% confidence interval 1.05–1.14, <em>P</em> &lt; .001) and subclavian access (hazard ratio 1.46, 95% confidence interval 1.18–1.81, <em>P</em> &lt; .001) as independent risk factors for lead failure. Patients frequently presented themselves with inappropriate shocks (20% in patients with lead failure) due to detection of nonphysiologic high-rate signals/noise.</p></div><div><h3>Conclusion</h3><p>This is the largest physician-driven multicenter study on the very long-term performance of Linox family leads. Our data report a remarkably high failure rate of these leads. Our findings have significant implications for the management of patients. Monitoring by remote care should be available for all active Linox family leads.</p></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 9","pages":"Pages 614-622"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501824002290/pdfft?md5=7b9d531350602dfa6f590ba3f98bd4a0&pid=1-s2.0-S2666501824002290-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141847896","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":"Left ventricular pacing through coronary sinus after tricuspid valve replacement: A case report and review of the literature","authors":"Xiaoya Wang MD ,&nbsp;Han Chen MD, PhD ,&nbsp;Youqi Fan MD, PhD","doi":"10.1016/j.hroo.2024.07.017","DOIUrl":"10.1016/j.hroo.2024.07.017","url":null,"abstract":"<div><p>In patients with a mechanical tricuspid prosthetic valve, the transvenous position of a ventricular lead through the coronary sinus (CS) is a good alternative option to right ventricular or epicardial lead implantation. In cardiac resynchronization therapy, pacing the left ventricular lateral wall was considered the best site for the CS lead. However, for patients without a left bundle branch block, the best position of CS leads remains controversial. Here, we present a case of placing CS lead in the anterior interventricular vein. Measurements at implantation and 2 years’ follow-up reported low pacing thresholds with good sensing thresholds. The electrocardiograph showed narrow QRS complexes (120 ms) and follow-up echocardiography at 2 years presented left ventricular ejection fraction 58.9%.</p></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 9","pages":"Pages 662-667"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501824002575/pdfft?md5=cdcece7a77baa1cc48bab48faa09459f&pid=1-s2.0-S2666501824002575-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271348","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 prospective, multicenter, randomized controlled trial comparing VDD-ICD with VVI-ICD in detecting subclinical atrial fibrillation in patients with ICDs: The Dx-AF trial","authors":"Mohammed Shurrab MD, MSc, PhD ,&nbsp;Amir K. Janmohamed MD ,&nbsp;Felix A. Ayala-Paredes MD ,&nbsp;Marcio Sturmer MD ,&nbsp;Satish C. Toal MD ,&nbsp;Jean-Francois Sarrazin MD ,&nbsp;Kevin E. Thorpe MMath ,&nbsp;Laurence D. Sterns MD ,&nbsp;Jeff S. Healey MD, MSc ,&nbsp;Eugene Crystal MD","doi":"10.1016/j.hroo.2024.07.014","DOIUrl":"10.1016/j.hroo.2024.07.014","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 9","pages":"Pages 668-671"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501824002332/pdfft?md5=faa2b074d119926a002637030d44c433&pid=1-s2.0-S2666501824002332-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838518","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":"Monitoring for arrhythmia in transthyretin cardiac amyloidosis with noninvasive ambulatory patch devices","authors":"Samuel L. Bruce MD ,&nbsp;Margaret Cuomo MS, FNP-C ,&nbsp;Hirad Yarmohammadi MD, MPH, FHRS ,&nbsp;Elaine Y. Wan MD, FHRS ,&nbsp;Deepak Saluja MD, FHRS ,&nbsp;Robert Sciacca EngScD ,&nbsp;Hasan Garan MD, MS ,&nbsp;Jan M. Griffin MD ,&nbsp;Mathew S. Maurer MD ,&nbsp;Angelo B. Biviano MD, MPH, FHRS","doi":"10.1016/j.hroo.2024.07.013","DOIUrl":"10.1016/j.hroo.2024.07.013","url":null,"abstract":"<div><h3>Background</h3><p>Transthyretin cardiac amyloidosis (ATTR-CA) is associated with an increased incidence of arrhythmias. We hypothesized that 2-week noninvasive ambulatory cardiac rhythm monitoring of patients with ATTR-CA would detect high rates of atrial fibrillation/atrial flutter (AF/AFL) and nonsustained ventricular tachycardia (NSVT).</p></div><div><h3>Objective</h3><p>The study sought to characterize arrhythmia in patients with ATTR-CA on 2-week, noninvasive cardiac rhythm monitors.</p></div><div><h3>Methods</h3><p>A total of 38 patients with ATTR-CA who underwent 2-week remote external patch monitoring were included in this single-center retrospective study. An age-matched control group included 38 patients who underwent the same cardiac rhythm monitoring as part of neurological workup.</p></div><div><h3>Results</h3><p>Of the ATTR-CA cohort, 26.3% had AF/AFL and 81.6% had NSVT. ATTR-CA was associated with higher rates of AF/AFL and NSVT compared with the control group. At a median follow-up of 45 weeks, there was no association between the presence of AF/AFL or NSVT on remote monitor in the ATTR-CA group and a composite of adverse clinical outcome.</p></div><div><h3>Conclusion</h3><p>ATTR-CA was associated with an elevated rate of AF/AFL and an even higher rate of NSVT on noninvasive ambulatory monitors. While evidence regarding the management of arrhythmias, particularly NSVT/ventricular tachycardia, in ATTR-CA remains limited, 2-week noninvasive cardiac monitoring can be considered to aid in risk stratification for both atrial and ventricular arrhythmias.</p></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 9","pages":"Pages 631-638"},"PeriodicalIF":2.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501824002320/pdfft?md5=66d40346e2b44844b8ac0b869ec50618&pid=1-s2.0-S2666501824002320-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141852042","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}