Heart Rhythm O2最新文献

{"title":"Impact of fat on the left atrial roof identified using intracardiac echocardiography during pulmonary vein isolation procedures","authors":"Yuhi Hasebe MD, PhD ,&nbsp;Takashi Noda MD, PhD ,&nbsp;Makoto Nakano MD, PhD ,&nbsp;Takahiko Chiba MD, PhD ,&nbsp;Hiroyuki Sato MD ,&nbsp;Nobuhiko Yamamoto MD, PhD ,&nbsp;Tomohiro Ito MD ,&nbsp;Koji Kumagai MD, PhD ,&nbsp;Satoshi Yasuda MD, PhD","doi":"10.1016/j.hroo.2024.11.001","DOIUrl":"10.1016/j.hroo.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have reported the presence of fat between the septopulmonary bundle and the septoatrial bundle on the left atrial (LA) roof. This fat may increase the wall thickness and protect the septopulmonary bundle from radiofrequency energy, potentially leading to conduction gaps.</div></div><div><h3>Objective</h3><div>This study aimed to determine whether fat on the LA roof can be identified using intracardiac echocardiography (ICE) and whether its presence affects the procedural outcomes of pulmonary vein isolation (PVI).</div></div><div><h3>Methods</h3><div>We evaluated 94 patients undergoing first-time radiofrequency catheter ablation for atrial fibrillation (60 men [63.8%]; mean age 65.7±10.7 years; 46 with paroxysmal atrial fibrillation [48.9%]) between February 2021 and September 2023. ICE was used to visualize the LA roof, and hypoechoic regions suggestive of fat were marked within the CARTOSOUND map (Biosense Webster, Irvine, CA). PVI was then performed with a personalized isolation line, avoiding fat regions when feasible.</div></div><div><h3>Results</h3><div>Fat on the LA roof was identified in 35 of 94 patients (37.2%). Conduction gaps on the left pulmonary vein roof were observed in 7 of 35 patients with fat (20.0%) and 1 of 59 patients without fat (1.7%) (<em>P</em>=.004). Among patients with conduction gaps, 7 of 8 (87.5%) had a PVI line that crossed a fat region. No significant differences were noted in conduction gaps in other areas between the 2 groups.</div></div><div><h3>Conclusion</h3><div>The findings indicate that the presence of fat on the LA roof, as identified using ICE, may be associated with a higher incidence of conduction gaps after PVI.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 1","pages":"Pages 3-10"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179269","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":"Cardiac venous system mapping for ventricular arrhythmia localization","authors":"Matthew Hanson MD ,&nbsp;Carli Peters MD ,&nbsp;Andres Enriquez MD ,&nbsp;Fermin Garcia MD","doi":"10.1016/j.hroo.2024.10.008","DOIUrl":"10.1016/j.hroo.2024.10.008","url":null,"abstract":"<div><div>The coronary venous system offers a route for mapping and ablation of ventricular arrhythmias with suspected epicardial or intramural origins. Coronary venous mapping helps the operator to select the best ablation approach, decide when percutaneous epicardial access may be necessary and provides an opportunity for therapeutic interventions, including radiofrequency application inside the coronary veins or ethanol infusion. In this article we review the anatomy of the coronary venous system, the scenarios in which coronary venous mapping can be helpful and the technical aspects involved in coronary venous mapping.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 1","pages":"Pages 70-77"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179275","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":"Electrocardiogram sampling frequency for the optimal performance of complexity analysis and machine learning models: Discrimination between patients with and without paroxysmal atrial fibrillation using sinus rhythm electrocardiograms","authors":"Steven Creasy MMath ,&nbsp;Vadim Alexeenko PhD ,&nbsp;Gregory Y.H. Lip MD, DFM ,&nbsp;Gary Tse BA, MBBS, MA, MPH, PhD, MFPH ,&nbsp;Philip J. Aston PhD, BSc ,&nbsp;Kamalan Jeevaratnam DAHP, DVM, MMedSc, PhD","doi":"10.1016/j.hroo.2024.11.002","DOIUrl":"10.1016/j.hroo.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>The current clinical practice to diagnose atrial fibrillation (AF) requires repeated episodic monitoring and significantly underperform in their ability to detect AF episodes.</div></div><div><h3>Objective</h3><div>There is therefore potential for artificial intelligence–based methods to assist in the detection of AF. Better understanding of the optimal parameters for this detection can potentially improve the sensitivity for detecting AF.</div></div><div><h3>Methods</h3><div>Ten-second, 12-lead electrocardiogram signals were analyzed using complexity algorithms combined with machine learning techniques to predict patients who had a previously detected AF episode but had since returned to normal sinus rhythm. An investigation was performed into the impact of the sampling frequency of the electrocardiogram signal on the accuracy of the machine learning models used.</div></div><div><h3>Results</h3><div>Using a single complexity algorithm showed a peak accuracy of 0.69 when using signals sampled at 125 Hz. In particular, it was noted that improved accuracy occurred when using lead V₆ compared with other available leads.</div></div><div><h3>Conclusion</h3><div>Based on these results, there is potential for 12-lead electrocardiogram signals to be recorded at 125 Hz as standard and used in conjunction with complexity analysis to aid in the detection of patients with AF.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 1","pages":"Pages 48-57"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180307","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":"Safety profile of pulsed field ablation regarding phrenic nerve function","authors":"Pierre Ollitrault MD ,&nbsp;Corentin Chaumont MD, PhD ,&nbsp;Jonaz Font MD ,&nbsp;Laure Champ-Rigot MD, PhD ,&nbsp;Frédéric Anselme MD, PhD ,&nbsp;Paul Milliez MD, PhD","doi":"10.1016/j.hroo.2024.11.013","DOIUrl":"10.1016/j.hroo.2024.11.013","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 1","pages":"Page 110"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180536","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":"Radiofrequency catheter ablation of persistent atrial fibrillation in a patient with cor triatriatum sinister","authors":"Hideyuki Hasebe MD ,&nbsp;Yoshitaka Furuyashiki MD ,&nbsp;Kentaro Yoshida MD","doi":"10.1016/j.hroo.2024.10.021","DOIUrl":"10.1016/j.hroo.2024.10.021","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 1","pages":"Pages 103-107"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180540","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":"Novel vs established cryoballoon ablation system for atrial fibrillation: A systematic review and meta-analysis","authors":"Jeanne du Fay de Lavallaz MD, PhD ,&nbsp;Sven Knecht MSc ,&nbsp;Tobias Reichlin MD ,&nbsp;Philipp Krisai MD ,&nbsp;Diego Mannhart MD ,&nbsp;Teodor Serban MD ,&nbsp;Laurent Roten MD ,&nbsp;Rebecca Arnet MD ,&nbsp;Corinne Isenegger MD ,&nbsp;Judith Minder MD ,&nbsp;Fabian Jordan MD ,&nbsp;Christian Sticherling MD ,&nbsp;Michael Kühne MD ,&nbsp;Patrick Badertscher MD","doi":"10.1016/j.hroo.2024.10.022","DOIUrl":"10.1016/j.hroo.2024.10.022","url":null,"abstract":"<div><h3>Background</h3><div>Recently, a novel cryoballoon ablation system (POLARx) for the treatment of atrial fibrillation has been introduced.</div></div><div><h3>Objective</h3><div>We aimed at systematically reviewing the efficacy and safety of the POLARx compared with the ArcticFront system.</div></div><div><h3>Methods</h3><div>Structured systematic database search for articles published between 2021 and 2024 reporting the efficacy and/or safety of the POLARx system for atrial fibrillation ablation. The co-primary endpoints were the long-term efficacy and safety of the POLARx system.</div></div><div><h3>Results</h3><div>Of the 24 studies with 5364 patients (weighted mean age 62.4 years) included, 15 compared the POLARx system (1746 patients) with the ArcticFront system (2282 patients). Despite significantly lower temperatures at isolation (POLARx –46.3 °C, ArcticFront –31.6 °C, <em>P</em> &lt; .01) and nadir temperatures (POLARx –56.5 °C, ArcticFront –47.8 °C, <em>P</em> &lt; .01), the POLARx system did not show a better acute (98.9% and 99.2% successfully ablated patients and 99.5% and 99.8% successfully ablated pulmonary veins in the POLARx and ArcticFront groups, respectively) or long-term (after a weighted mean follow-up of 12.6 months, the success rate was 69.5% with POLARx and 60.2% with ArcticFront, <em>P</em> = .98) efficacy. While most complications were similar between the POLARx and ArcticFront groups, the incidence of phrenic nerve palsies in the pooled cohorts (all POLARx vs all ArcticFront control patients) differed (2.7% vs 1.6% in the POLARx vs ArcticFront groups; odds ratio 1.79, 95% confidence interval 1.14–2.83, <em>P</em> = .01).</div></div><div><h3>Conclusion</h3><div>The novel POLARx system provided similar efficiency and acute/long-term efficacy but showed a higher incidence of phrenic nerve palsies compared with the ArcticFront system.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 1","pages":"Pages 21-31"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179272","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":"Catheter ablation for atrial fibrillation and risk of neurologic disease","authors":"Mohammed Al-Sadawi MBBCh,&nbsp;Nithi Tokavanich MD,&nbsp;Jasneet Devgun MD,&nbsp;Michael Ghannam MD,&nbsp;Rakesh Latchamsetty MD,&nbsp;Krit Jongsarangsin MD,&nbsp;Hakan Oral MD","doi":"10.1016/j.hroo.2024.11.004","DOIUrl":"10.1016/j.hroo.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Catheter ablation (CA) of atrial fibrillation (AF) has been proven to benefit patients with symptomatic AF and heart failure. However, the data on neurological outcomes including cerebrovascular accidents (CVA) and dementia remain controversial.</div></div><div><h3>Objective</h3><div>We aimed to determine the effect of CA on neurological events during long-term follow-up.</div></div><div><h3>Methods</h3><div>We performed a systematic review and meta-analysis of patients with AF who underwent CA of AF. The MEDLINE, EMBASE, and Web of Science databases were comprehensively searched from inception to January 2024. Studies that reported incidence of CVA and dementia in patients with AF were. Data from each study were combined by a random-effects model. The results were reported in risk ratios with 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>A total of 29 studies and 379,993 patients (mean age 58 ± 4 years, 30% women) were included in the analysis. Mean follow-up was 36 ± 23 months (range 12–120 months). Patients who underwent CA of AF had a lower risk of developing CVA compared with medical management (odds ratio [OR] 0.54, 95% CI 0.42–0 69, I² = 91%). Moreover, the risk of dementia was lower in the CA group compared with medical management (OR 0.51, 95% CI 0.4–0.66, I² = 74%). The incidence of CVA in the CA group was 1% (95% CI 1%–2%, I² = 97%), and the incidence of dementia was 2% (95% CI 2%–8%, I² = 97%).</div></div><div><h3>Conclusion</h3><div>CA of AF resulted in lower risk of CVA and dementia compared with medical management alone at long-term follow-up.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 1","pages":"Pages 32-38"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179274","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":"Sex differences in global electrical heterogeneity: The Hispanic Community Health Study/Study of Latinos","authors":"Larisa G. Tereshchenko MD, PhD ,&nbsp;Kazi T. Haq PhD ,&nbsp;Stacey J. Howell MD ,&nbsp;Evan C. Mitchell MD ,&nbsp;Jessica Hyde BS ,&nbsp;Jesús Martínez BS, BA ,&nbsp;Cassandra A. Ahmed MD ,&nbsp;Genesis Briceno MD ,&nbsp;Hetal Patel MSc ,&nbsp;Jose Pena MD ,&nbsp;Akram Khan MD ,&nbsp;Elsayed Z. Soliman MD, MSc, MS ,&nbsp;João A.C. Lima MD, MBA ,&nbsp;Samir R. Kapadia MD ,&nbsp;Anita D. Misra-Hebert MD, MPH ,&nbsp;Mayank M. Kansal MD ,&nbsp;Martha L. Daviglus MD, PhD ,&nbsp;Robert Kaplan PhD","doi":"10.1016/j.hroo.2024.11.019","DOIUrl":"10.1016/j.hroo.2024.11.019","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 1","pages":"Pages 97-102"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180539","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":"Reply: Safety profile of pulsed field ablation regarding phrenic nerve function","authors":"Alan Sugrue MBBCh, MSc,&nbsp;Samuel J. Asirvatham MD","doi":"10.1016/j.hroo.2024.11.014","DOIUrl":"10.1016/j.hroo.2024.11.014","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 1","pages":"Pages 110-111"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180542","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":"Current state of arrhythmia care in Latin America: A statement from the Latin American Heart Rhythm Society","authors":"Ulises Rojel MD, FHRS (LAHRS Co-Chair) ,&nbsp;Juan C. Diaz MD ,&nbsp;Marcio Jansen de Oliveira Figueiredo MD (LAHRS Co-Chair) ,&nbsp;Luigi Di Biase MD, FHRS (HRS Co-Chair) ,&nbsp;Eduardo Saad MD, FHRS (HRS Co-Chair) ,&nbsp;Luis Aguinaga-Arrascue MD ,&nbsp;Floreal Cueto MD ,&nbsp;Juan Cruz Lopez Diez MD ,&nbsp;Remberto Torres-Molina MD ,&nbsp;Cristiano F. Pisani MD ,&nbsp;Fatima Dumas Cintra MD ,&nbsp;Luis Quininir MD ,&nbsp;Armando Pérez-Silva MD, PhD ,&nbsp;Jorge Marin MD ,&nbsp;Federico Malavassi MD ,&nbsp;Elibet Chavez-Gonzalez MD ,&nbsp;Fernando A. Vidal-Bett MD ,&nbsp;Eliany Mejia-Lopez MD ,&nbsp;Jose Llorente MD ,&nbsp;Jorge Arbaiza MD ,&nbsp;Nestor Lopez-Cabanillas MD (LAHRS Co-Chair)","doi":"10.1016/j.hroo.2024.11.010","DOIUrl":"10.1016/j.hroo.2024.11.010","url":null,"abstract":"<div><h3>Background</h3><div>On May 18, 2023, the Latin American Heart Rhythm Society and the Heart Rhythm Society convened a meeting of leaders committed to arrhythmia care in Latin America to discuss clinical and health care policy issues and the barriers to delivering world-class standards in electrophysiology (EP) services, discuss potential future solutions, and share experiences and best practices.</div></div><div><h3>Methods</h3><div>A questionnaire on clinical arrhythmia problems, access to EP procedures, annual numbers of arrhythmia and device implantation procedures, and the largest medical issues that face each country was sent to 15 Latin American Heart Rhythm Society representatives from 15 different countries of the 20 that make up Latin America and was completed by all of them before the meeting. The event was organized as a series of individual reports, provided by the representatives as well as 11 regional leaders, followed by open discussion among the chair and meeting participants.</div></div><div><h3>Results</h3><div>Atrial fibrillation is the major clinical arrythmia–related problem throughout the region, followed by Chagas disease in some countries. There is significant variability in access to advanced arrhythmia care (ranging from 5 ablation procedures and 16 device implantation procedures per million inhabitants [PMIs] in Venezuela to 189 ablation procedures and 617 device implantation procedures PMIs in Uruguay) due to differences in workforce availability (ranging from 0.36 electrophysiologists PMIs in Cuba to 13.03 electrophysiologists PMIs in Argentina), resources (ranging from 0.74 EP centers PMIs in Brazil to 4.68 EP centers PMIs in Uruguay), technology (ranging from 0 operational and new generation 3D mapping systems PMIs in Cuba, Bolivia, and El Salvador to 1.98 operational and new generation 3D mapping systems PMIs in Argentina), drug availability, and national health policies. Collaboration in the area already occurs on an individual country basis, but no systematic regional efforts for working together is present.</div></div><div><h3>Conclusion</h3><div>Although atrial fibrillation is the most common arrhythmia problem, Chagas disease is highly prevalent in several countries of Latin America. Although there are significant variations concerning the practice of EP (including differences in policies and access to technology, drugs, and devices), overall there is limited access to implantable cardiac defibrillators, complex ablation procedures, resources (including 3-dimensional mapping systems, intracardiac echocardiography, and remote monitoring), trained physicians, and centers of excellence; thus, access to adequate health care is limited.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 1","pages":"Pages 112-126"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180543","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}