Indian Pacing and Electrophysiology Journal最新文献

{"title":"Left Bundle Branch Block in Non-Ischemic Cardiomyopathy: Does LOT-CRT offer incremental benefit compared to LBBP?","authors":"Syeda Atiqa Batul MD, Pugazhendhi Vijayaraman MD","doi":"10.1016/j.ipej.2026.02.018","DOIUrl":"10.1016/j.ipej.2026.02.018","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"26 2","pages":"Pages 121-122"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310715","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 cardiac resynchronization therapy versus left bundle optimized cardiac resynchronization therapy","authors":"Chinmay Parale,&nbsp;Suresh Kumar Sukumaran,&nbsp;Dinakar Bootla,&nbsp;K.E. Sivavignesh,&nbsp;Ashish Jain,&nbsp;Sridhar Balaguru,&nbsp;Santhosh Satheesh,&nbsp;Avinash Anantharaj,&nbsp;A Shaheer Ahmed,&nbsp;Raja Selvaraj","doi":"10.1016/j.ipej.2026.02.009","DOIUrl":"10.1016/j.ipej.2026.02.009","url":null,"abstract":"<div><h3>Background</h3><div>In patients undergoing left bundle branch area pacing for cardiac resynchronization therapy (LB-CRT), addition of a coronary sinus lead i.e. Left bundle optimized CRT (LOT-CRT) might confer additional benefit.</div></div><div><h3>Objectives</h3><div>To compare echocardiographic and clinical characteristics between LB-CRT and LOT-CRT at a 6 month follow up.</div></div><div><h3>Materials and methods</h3><div>This single center randomized controlled trial included patients with non-ischemic cardiomyopathy and left bundle branch block with left ventricular ejection fraction (LVEF) &lt; 35% who underwent implantation of an atrial lead, a left bundle lead and a coronary sinus lead. Patients were randomized to LB-CRT or LOT-CRT 48 h after implant and followed-up for 6 months. LVEF, LV end systolic volume (LVESV), NYHA class, 6-min walk distance (6MWD) and response rates were compared between the two pacing modalities.</div></div><div><h3>Results</h3><div>26 patients (12 in the LB-CRT group and 14 in the LOT-CRT group) were recruited in the study. The mean QRS duration of the population was 169.8 ± 20.6 ms and the mean LVEF was 21 ± 6.6%. Change in LVEF at 6 months (delta LVEF) in the LB-CRT group (15.7 ± 12.8%) was not significantly different from that in the LOT-CRT group (11.4 ± 14.2%; p = 0.43). Response rate in LB-CRT group (72.7%%), was comparable to that in the LOT-CRT group (71.4%; p = 0.94). LVESV, change in LVESV and 6MWD were also not significantly different between the two modalities.</div></div><div><h3>Conclusions</h3><div>In patients with non-ischemic cardiomyopathy and LBBB, there was no additional benefit with LOT-CRT compared to LB-CRT.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"26 2","pages":"Pages 114-120"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207913","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":"P wave oversensing and rate-related bundle branch block with T wave oversensing leading to inappropriate S-ICD therapies in cardiac sarcoidosis: A case report","authors":"Ohanian Antranik ,&nbsp;Barake Hassan","doi":"10.1016/j.ipej.2026.01.014","DOIUrl":"10.1016/j.ipej.2026.01.014","url":null,"abstract":"<div><div>Subcutaneous implantable cardioverter defibrillators (S-ICDs) are increasingly implanted devices to prevent sudden cardiac death (SCD), whether as a primary or secondary prevention strategies especially in patients who are at risk of developing complications related to transvenous implantable cardioverter defibrillators (TV-ICDs) and without an indication for cardiac pacing. However, S-ICDs can deliver inappropriate shocks due to sensing abnormalities, despite the applied strategies to prevent this complication. We present a case of a 56-year-old patient with cardiac sarcoidosis who experienced inappropriate shocks due to T wave oversensing (TWOS) secondary to rate related aberrancy and P wave oversensing. To the best of our knowledge, this is the first reported case of inappropriate S-ICD therapy in cardiac sarcoidosis, which highlights the necessity of closely monitoring the patient to prevent sensing abnormalities as the pre-implant screening cannot accurately predict future QRS alterations that might lead to oversensing and inappropriate shocks.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"26 2","pages":"Pages 166-170"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229007","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":"India-specific cardiogenetic aspects: Focus on cardiomyopathies and inherited arrhythmia syndromes","authors":"Priya Chockalingam ,&nbsp;Rajaram Anantharaman","doi":"10.1016/j.ipej.2026.02.001","DOIUrl":"10.1016/j.ipej.2026.02.001","url":null,"abstract":"<div><div>India is a land of diversity with its deep evolutionary history, demographic shifts, archaic and recent gene flow events and a high level of endogamy resulting in a unique genetic structure and variation. Yet, very little knowledge exists about population-specific and disease susceptibility variants in the country as Indian populations remain underrepresented in genomic studies. This review article, the final in the Cardiogenetic series, aims to highlight the India-specific knowledge on cardiomyopathies and inherited arrhythmia syndromes, enumerate the best practices and future directions, and emphasize the need for a nationwide database for cardiogenetic diseases. The genotype-phenotype correlations for HCM, DCM, ACM, LQTS, CPVT, sodium channelopathies and sudden cardiac death are outlined while touching upon the growing need for incorporating phenotype-guided genetic testing modalities in the management protocol of affected individuals and their families. The already functioning multidisciplinary cardiogenetic centres with dedicated healthcare teams comprised of cardiologists, electrophysiologists, geneticists, genetic counsellors and specialized nurses could be used as a model to scale-up and establish further facilities across the country and fill the existing gap in meting out comprehensive care to patients and their families.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"26 2","pages":"Pages 171-176"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120478","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":"Zero sheath exchange with VersaCross RF wire and FlexCath in cryoballoon AF ablation: A comparative study on procedural efficiency and safety","authors":"Apurva Popat ,&nbsp;Sweta Yadav ,&nbsp;Param Sharma ,&nbsp;Weijia Wang","doi":"10.1016/j.ipej.2026.01.001","DOIUrl":"10.1016/j.ipej.2026.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Catheter ablation for atrial fibrillation (AF) typically involves transseptal puncture (TSP) to access the left atrium. Traditional TSP requires sheath upsizing and exchanges, increasing procedural complexity, time, and risks. We evaluated the efficiency and safety of zero-exchange technique using the FlexCath Advance™ sheath combined with the VersaCross™ RF wire compared to the traditional method involving initial puncture with Agilis™ NxT sheath and Baylis RF needle, followed by sheath exchange.</div></div><div><h3>Methods</h3><div>This retrospective observational study included 109 patients undergoing their first cryoballoon AF ablation between June 2023 to June 2024 at Marshfield Medical Center. Procedural efficiency (time from venous access to TSP, time to first ablation, total procedural time), safety outcomes (pericardial effusion, bleeding, stroke/TIA, phrenic nerve injury, esophageal injury), and fluoroscopy exposure were compared between zero-exchange (n = 50) and traditional (n = 59) groups. Linear regression analyses were adjusted for age, sex, BMI, left ventricular ejection fraction (LVEF), and open-heart surgery history.</div></div><div><h3>Results</h3><div>The zero-exchange approach significantly improved procedural efficiency, with shorter time from venous access to TSP (20 ± 9 vs. 28 ± 12 min; p &lt; 0.01), time to first ablation (36 ± 9 vs. 48 ± 16 min; p &lt; 0.01), and total procedure duration (107 ± 31 vs. 129 ± 51 min; p &lt; 0.01). Adjusted regression analyses confirmed these reductions (all p &lt; 0.01). Fluoroscopy time was substantially lower with zero-exchange (8.4 ± 4 min vs. 19.9 ± 8.2 min; p &lt; 0.01). No significant complications occurred in either group.</div></div><div><h3>Conclusion</h3><div>The zero-exchange transseptal puncture technique using FlexCath Advance™ and VersaCross™ RF wire significantly enhances procedural efficiency and reduces radiation exposure without compromising patient safety, supporting its adoption in AF ablation procedures.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"26 2","pages":"Pages 135-139"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946089","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":"Inappropriate defibrillator discharge despite evident atrial flutter on stored device electrogram having significant RR variability – What is the mechanism?","authors":"Amit Varshney ,&nbsp;Amira Shaik ,&nbsp;Sanjeev S. Mukherjee ,&nbsp;Debabrata Bera","doi":"10.1016/j.ipej.2026.02.017","DOIUrl":"10.1016/j.ipej.2026.02.017","url":null,"abstract":"<div><div>It is crucial to analyze device stored electrograms (EGMs) to decipher whether the therapies were appropriate or inappropriate. We report a case of an inappropriate defibrillator therapy delivered during an obvious atrial tachyarrhythmia despite the dual chamber SVT discriminators being appropriately programmed for underlying rhythm abnormality. The therapy was delivered even though the tachycardia clearly satisfied V &lt; A rate branch along with significant RR interval variability. The morphology match was misleading possibly due to malalignment of the peaks. On the other hand, the Abbott algorithm decides stability delta based on 2nd shortest and longest RR interval. This delta was &lt;40 ms in spite of a irregular rhythm. The Atrio-Ventricular Association (AVA) algorithm, a second check-post designed for such situations, also got deceived due to variation of AV intervals. These led to fulfilment of stringent ‘ALL’ criteria programmed to make a diagnosis of VT and delivered therapy inappropriately.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"26 2","pages":"Pages 184-187"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318648","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":"Lifting the curtain on ventricular tachycardia substrate with cardiac MRI: Path to enhance ablation outcomes","authors":"Poojita Shivamurthy M.D.","doi":"10.1016/j.ipej.2026.03.004","DOIUrl":"10.1016/j.ipej.2026.03.004","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"26 2","pages":"Pages 133-134"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366706","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":"Catheter ablation of ventricular tachycardia via the coronary veins","authors":"Shumpei Mori ,&nbsp;Justin H. Hayase ,&nbsp;Yuichiro Miyazaki ,&nbsp;Shintaro Yamagami ,&nbsp;Tetsuma Kawaji ,&nbsp;Kalyanam Shivkumar","doi":"10.1016/j.ipej.2026.02.011","DOIUrl":"10.1016/j.ipej.2026.02.011","url":null,"abstract":"<div><div>Ventricular arrhythmias, either idiopathic or those associated with organic heart diseases, may originate from the epicardial side of the ventricular myocardium. Therefore, mapping and ablation via the coronary venous system offers a convenient, feasible, and effective option in such cases, considering the convenience of the epicardial location of the coronary venous system. Among epicardial idiopathic ventricular arrhythmias, the left ventricular summit is by far major region of interest closely associated with the coronary venous system. In this setting, the great cardiac vein/anterior interventricular vein or their tributaries serve as a convenient and practical route for the epicardial or intramural mapping of ventricular arrhythmias originating from this region, via endocardial access through the coronary sinus. In limited cases, where these veins are incidentally close enough to the arrhythmogenic focus and distant enough from the left coronary arteries, radiofrequency or ethanol ablation via these veins is also feasible and effective. Devices and techniques have been improved to facilitate transvenous epicardial and intramural mapping and ablation. Wide individual variations exist in terms of three-dimensional orientation of these veins relative to the left ventricular summit, coronary arteries, pulmonary root, and left atrial appendage. Therefore, discerning case-specific anatomy through careful review of periprocedural image findings is fundamental for estimating feasibility of transvenous epicardial procedures. In this review, comprehensive anatomy of the coronary venous system around the left ventricular summit as well as current clinical implications are summarized from the electrophysiologist's perspective.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"26 2","pages":"Pages 142-154"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310769","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":"Zero-exchange transseptal access in atrial fibrillation ablation: Improving efficiency without compromising safety","authors":"Srisa Prasanna Boddupalli ,&nbsp;Jayesh Gohil","doi":"10.1016/j.ipej.2026.03.005","DOIUrl":"10.1016/j.ipej.2026.03.005","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"26 2","pages":"Pages 140-141"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366764","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":"Exercise induced irregular wide QRS tachycardia with right bundle branch block morphology and extreme QRS axis deviation","authors":"Eliyahu Kalfon ,&nbsp;Tsafrir Or ,&nbsp;Bernard Belhassen","doi":"10.1016/j.ipej.2026.02.016","DOIUrl":"10.1016/j.ipej.2026.02.016","url":null,"abstract":"<div><div>A 29-year-old active woman was referred for evaluation following the development of an irregular wide complex tachycardia with right bundle branch morphology and extreme QRS axis during exercise stress testing. Two main alternative diagnoses are discussed: a) atrial fibrillation with either aberrancy or pre-excitation; b) left ventricular tachycardia originating from the Purkinje system including left posterior fascicle versus posteromedial papillary muscle.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"26 2","pages":"Pages 192-194"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436472","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}