Indian Pacing and Electrophysiology Journal最新文献

{"title":"Catheter Ablation versus Medical Therapy for Ventricular Tachycardia in Patients with Ischemic Heart Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Ubaid Khan, Yehya Khlidj, Ahmed A Ibrahim, Ahmad Mazen Amin, Mohamed Saad Rakab, Majd M AlBarakat, Muhammad Haris Khan, Zuhair Majeed, Muhammad Imran, Junaid Ali, Chet RanaBhat, Wajeeh Ur Rehman, Justin Brilliant, Kashif Chaudhary","doi":"10.1016/j.ipej.2025.03.004","DOIUrl":"https://doi.org/10.1016/j.ipej.2025.03.004","url":null,"abstract":"<p><strong>Background: </strong>Ventricular tachycardia (VT) is a common chronic complication of ischemic heart disease (IHD), even in the era of contemporary coronary intervention. The use of implantable cardioverter-defibrillators (ICDs) has reduced mortality, but ICD shocks can be painful and traumatizing. Catheter ablation has been posited to reduce VT incidence and is commonly used in IHD patients when antiarrhythmic drugs do not suppress VT.</p><p><strong>Purpose: </strong>We aim to review the clinical efficacy and safety of catheter ablation vs medical therapy in patients with IHD.</p><p><strong>Methods: </strong>We conducted comprehensive searches across PubMed, CENTRAL, WOS, Scopus, and EMBASE until Feb 2024. Pooled data were reported using risk ratio (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes. This systematic review and meta-analysis was registered with PROSPERO ID: CRD42024551760.</p><p><strong>Results: </strong>We included Eight RCTs with a total of 1,252 patients. Patients who underwent ablation had a lower risk of VT storm compared to those who received medical therapy [RR: 0.74 with 95% CI: (0.60, 0.91), P =0.005), Compared to medical treatment, the catheter ablation group also required less appropriate ICD therapy [RR: 0.72 with 95% CI (0.57, 0.90), P < 0.01), and fewer appropriate ICD shocks [RR: 0.75 with 95% CI (0.57, 0.0.99), P = 0.04). However, there was no significant difference in VT/VF recurrence [RR: 0.94 with 95% CI (0.83, 1.04), P = 0.33) and all-cause mortality [RR: 0.87 with 95% CI (0.70, 1.09), P = 0.22).</p><p><strong>Conclusion: </strong>Catheter ablation is associated with a reduction in ventricular storms, ICD therapy, and ICD shocks while demonstrating similar safety in managing VT in IHD patients compared to medical therapy alone.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587558","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":"Tachycardia induced cardiomyopathy due to ectopic atrial tachycardia originating from the atrial appendage: A case series and review of literature.","authors":"Abhinav Aggarwal, Anil Yadav, Ankit Jain, Anunay Gupta","doi":"10.1016/j.ipej.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.ipej.2025.03.001","url":null,"abstract":"<p><p>This case series describes four cases of tachycardia-induced cardiomyopathy due to incessant ectopic atrial tachycardias from the atrial appendage (three from the right atrial appendage, one from the left). P wave morphology changes on surface 12-lead electrocardiogram can be used to diagnose this relatively rare subset of tachycardias and localise the site of origin. Tachycardia induced cardiomyopathy is relatively more common in atrial tachycardias from the atrial appendage as compared to tachycardia from other site s^1,2. Radiofrequency ablation is the treatment of choice and is associated with a high success rate. Oral ivabradine is another treatment option for cases where ablation is unsuccessful or if the patient is unwilling for ablation. For rare cases refractory to other treatment measures, surgical excision of the atrial appendage may be needed.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587572","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":"\"Transvenous Lead Extraction: Experience from a Northern State of India - The Srinagar Extraction Registry\".","authors":"Ajaz A Lone, Mohd Iqbal Dar, Jan Mohd Sheikh, Sheikh Mohamad Tahir, Waseem Rashid, Imran Hafeez, Hilal A Rather, Syed Bilal","doi":"10.1016/j.ipej.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.ipej.2025.03.002","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587557","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":"Lead fracture in stylet driven left bundle area pacing following exercise: Coincidence!","authors":"Jyotika Gupta, Pooja Shah, Anoop K Gupta","doi":"10.1016/j.ipej.2025.02.002","DOIUrl":"10.1016/j.ipej.2025.02.002","url":null,"abstract":"<p><p>Lumen less leads (LLLs) and stylet-driven leads (SDL) are widely used for left bundle branch area pacing (LBBAP) and has become standard practice. The incidence of lead fracture is very rare with both leads. We report a case of delayed fracture in stylet driven lead producing syncope following exercise.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524750","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":"Early rhythm control compared to rate control in atrial fibrillation - A systematic review, meta-analysis, and meta-regression.","authors":"Katherine Hermanto, Raymond Pranata, Hawani Sasmaya Prameswari, Giky Karwiky, Chaerul Achmad, Mohammad Iqbal","doi":"10.1016/j.ipej.2025.02.003","DOIUrl":"10.1016/j.ipej.2025.02.003","url":null,"abstract":"<p><strong>Background: </strong>This meta-analysis aimed to compare the effectiveness of early rhythm control to rate control, and whether catheter ablation derived more benefit compared to other methods of rhythm control.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted on PubMed, SCOPUS, and EuropePMC up to July 2, 2024. The primary outcome of this study was major adverse cardio-cerebrovascular events (MACCE), defined as a composite of mortality, stroke/systemic embolism, heart failure hospitalization (HFH), and acute coronary syndrome (ACS) during the follow-up period. Outcome measures were adjusted hazard ratios (aHR).</p><p><strong>Results: </strong>A total of 504,124 patients from 11 studies were included in this systematic review and meta-analysis. Early rhythm control was significantly associated with reduction in MACCE (aHR 0.85 [95 % CI 0.80, 0.90], p < 0.001; I²: 23 %), stroke (aHR 0.79 [95 % CI 0.72, 0.86], p < 0.001; I²: 25 %), HFH (aHR 0.87 [95 % CI 0.78, 0.96], p = 0.008; I²: 48 %), and ACS (aHR 0.80 [95 % CI 0.66, 0.96], p = 0.018; I²: 40 %). No mortality benefit (aHR 0.93 [95 % CI 0.85, 1.01], p = 0.066; I²: 67 %) was observed; however, mortality benefit became evident (aHR 0.87 [95 % CI 0.85, 0.89], p < 0.001) upon removal of a study during a leave-one-out sensitivity analysis. Meta-regression analysis showed that the benefits of early rhythm control in terms of MACCE were more pronounced with ablation (coefficient -0.004, p = 0.010, R²: 100 %).</p><p><strong>Conclusion: </strong>Early rhythm control was associated with better outcomes compared to rate control in AF, with a more pronounced benefit observed for ablation.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426422","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":"Cryoablation as an alternative strategy for bidirectional cavotricuspid isthmus block following multiple failed sessions of radiofrequency ablation due to epicardial-endocardial breakthrough: A case report.","authors":"Yuhei Kasai, Takayuki Kitai, Junji Morita, Tsutomu Fujita","doi":"10.1016/j.ipej.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.ipej.2025.02.004","url":null,"abstract":"<p><p>Cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL) is difficult to manage with antiarrhythmic drugs, with radiofrequency (RF) ablation being the standard treatment. However, achieving a bidirectional CTI block can be challenging due to complex anatomy and epicardial-endocardial breakthrough (EEB). This case report illustrates that cryoablation can serve as an effective bail-out strategy to achieve a permanent CTI block when RF ablation fails, particularly in cases complicated by EEB. We present the case of a 66-year-old woman who underwent multiple catheter ablations for persistent atrial fibrillation (AF) and CTI-dependent AFL. Despite two prior sessions of RF-based CTI ablation, a durable bidirectional block was not achieved. During her fourth ablation, recurrent AFL persisted despite extensive RF applications. Cryothermal ablation, utilizing a Freezor MAX catheter with point-by-point freezing along the CTI line, successfully terminated the AFL and created a durable bidirectional CTI block. While RF ablation remains the primary treatment for CTI-dependent AFL, the formation of a durable bidirectional CTI block can be challenging due to complex CTI anatomy, EEB, and tissue edema. Cryothermal ablation offers a viable alternative in these difficult cases. The enhanced tissue adhesion and improved catheter stability provided by cryoablation, along with the reduced risk of steam pops, allow for more consistent lesion formation. This case underscores the utility of cryoablation as a bail-out strategy when RF ablation alone is insufficient.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426420","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":"Spatial displacement on three-dimensional maps caused by rhythm differences in premature ventricular contraction ablation.","authors":"Yusuke Sakamoto, Hiroyuki Osanai, Yoshihito Nakashima, Hiroshi Asano","doi":"10.1016/j.ipej.2025.01.004","DOIUrl":"10.1016/j.ipej.2025.01.004","url":null,"abstract":"<p><strong>Introduction: </strong>Three-dimensional (3D) maps are useful for premature ventricular contraction (PVC) ablation. However, positional information changes compared with sinus rhythm when PVCs appear, rendering ablation difficult. We aimed to understand the spatial displacement characteristics of PVC ablation in 3D maps and the therapeutic effect after correction using the LAT-Hybrid function.</p><p><strong>Methods: </strong>Thirty-two consecutive patients who underwent PVC ablation from 2022 to 2024 were included. Parallel mapping was used to analyze the LAT-Hybrid function. Ablation was performed at the best Hybrid-LAT location. Characteristics according to PVC origin (right ventricular outflow tract, ventricular septum, and left ventricular outflow tract/left ventricular summit) were compared. Efficacy was evaluated by acute response and clinical outcome on 24-h Holter after 6 months.</p><p><strong>Results: </strong>In all cases, the PVC origin was spatially displaced by 5.6 ± 1.9 (right ventricular outflow tract, 6.0 ± 1.8; ventricular septum, 4.0 ± 1.4; left ventricular outflow tract/left ventricular summit, 6.0 ± 1.7) mm, and the septum area was significantly smaller. The voltage of origin was 60 % in the low voltage-transitional zone, which coincided with 80 % of the origin determined from the ripple map. The pace map at the location analyzed with LAT-Hybrid was high at 95.4 % ± 3.6 %, and ablation was successful in 96.9 % at the same site. The clinical outcome was good 6 months after ablation.</p><p><strong>Conclusion: </strong>Spatial displacement of the 3D map caused by differences in excitation propagation can lead to misidentification of the origin. PVC ablation corrects spatial displacement and obtains accurate positional information, leading to successful ablation.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068505","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":"Real-world single-center preliminary experience of radiofrequency balloon pulmonary vein ablation for atrial fibrillation.","authors":"Andrea Dell'Aquila, Carmelo La Greca, Amedeo Prezioso, Simone Zanchi, Joseph Antoine Kheir, Domenico Pecora","doi":"10.1016/j.ipej.2025.01.003","DOIUrl":"10.1016/j.ipej.2025.01.003","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is the most common cardiac arrhythmia and pulmonary vein isolation (PVI) by percutaneous transcatheter ablation is its pivotal treatment. Nowadays, several techniques using different energy sources are used, such as radiofrequency (RF), cryoablation and laser ablation. A new technology that combines the strengths of different techniques has been developed, in particular having both the speed of one-shot techniques and the selectivity and precision of point-by-point RF: the RF balloon (RFB). Recent clinical studies^1-3 have demonstrated its efficacy and safety, with good results in terms of first pass isolation, procedural duration and fluoroscopy time. However, real-world data regarding RFB ablation is scarce, therefore with this study we aimed to describe the experience of our center with this technology (one of the first adopting it in our country). We prospectively enrolled in a single-center a total of 20 consecutive patients who underwent AF ablation with RFB. The primary endpoint, i.e. PVI defined as stable absence of any electrical conduction from and into the veins, was met by 18 patient (90 %). Mean procedural and fluoroscopy times were 79 ± 30.68 min and and 15.36 ± 6.57 min, respectively, dwelling time was 30.3 ± 8.09 min. The only complication reported was a single case mild pericardial effusion 24 h after the procedure, likely of inflammatory nature, which was treated conservatively and resolved before discharge. With this study we demonstrated that PVI with RFB appears to be an effective and safe technique in a real world setting, with many upsides and a reduced atrial dwelling time that theoretically could reduce the risk of thromboembolic complications. Further studies on larger number of patients are needed to confirm the results we obtained.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047332","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":"Conduction disease in cardiac amyloidosis patients: A case series suggesting a role for left bundle branch area pacing.","authors":"Ojas H Mehta, Keyrian Louis Le Gratiet, Markus Sikkel, Laurence D Sterns","doi":"10.1016/j.ipej.2025.01.001","DOIUrl":"10.1016/j.ipej.2025.01.001","url":null,"abstract":"<p><p>Transthyretin Cardiac amyloidosis (ATTR-CA) is an increasingly recognised cause of heart failure in our elderly patients with preserved ejection fraction. Patients with ATTR-CA who require permanent pacemaker implantation often have preserved ejection fraction and do not meet the clinical indication for cardiac resynchronization therapy (CRT). In these patients, left bundle branch area pacing (LBBAP) can be a reasonable option to maximise physiological activation of the left ventricle. We describe a series of three patients with cardiac amyloidosis who have undergone LBBAP with the use of lumenless leads and successful capture of the myocardium and left bundle branch region.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928331","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":"Spatial relationship between evoked delayed potentials and deceleration zones of an isochronal late activation map in a patient with sarcoid-related ventricular tachycardia","authors":"Tomomasa Takamiya ,&nbsp;Takashi Miyamoto ,&nbsp;Shinsuke Miyazaki ,&nbsp;Tetsuo Sasano","doi":"10.1016/j.ipej.2024.10.007","DOIUrl":"10.1016/j.ipej.2024.10.007","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 1","pages":"Pages 54-56"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591718","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}