Indian Pacing and Electrophysiology Journal最新文献

{"title":"Unexpected atrial preexcitation by a His refractory PVC. What is the diagnosis?","authors":"Ramanathan Velayutham, Anish Bhargav, Raja J Selvaraj","doi":"10.1016/j.ipej.2025.06.004","DOIUrl":"10.1016/j.ipej.2025.06.004","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303106","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":"Natural courses of atrial fibrillation following cryptogenic stroke: A systematic review and meta-analysis.","authors":"Patavee Pajareya, Somkiat Phutinart, Noppachai Siranart, Suwit Paksin, Priabprat Jansem, Prakit Anukoolwittaya, Piyoros Lertsanguansinchai, Narut Prasitlumkum, Ronpichai Chokesuwattanaskul, Nithi Tokavanich","doi":"10.1016/j.ipej.2025.06.006","DOIUrl":"10.1016/j.ipej.2025.06.006","url":null,"abstract":"<p><strong>Background: </strong>Cryptogenic stroke (CS) presents challenges in management and increases risk of stroke recurrence. The clinical relevance of atrial fibrillation detected after stroke (AFDAS) remains equivocal.</p><p><strong>Methods: </strong>Our study was conducted in a meta-analysis design, including all observational studies and utilizing random-effects model. The objectives were to explore the association between predictors and AFDAS incidence, and clinical differences between AF and non-AF patients following CS.</p><p><strong>Results: </strong>This meta-analysis included 59 studies with 18,683 patients with CS. AFDAS incidence was 20.8 %. In univariable analysis, significant predictors of AFDAS were age >75 years (OR 6.94, 95 % CI: 3.12-15.43, I² = 0 %) and hypertension (OR 2.16, 95 % CI: 1.28-3.63, I² = 0.0 %). In comparison to non-AF group, individuals with AF showed significantly higher levels of left atrial volume index (MD 7.50 mL/m², 95 % CI: 6.20-8.80, I² = 0.0 %), left atrial diameter (MD 0.17 cm, 95 % CI: 0.02-0.32, I² = 48.6 %), D-dimer (MD 0.20 mg/L, 95 % CI: 0.05-0.36, I² = 0.0 %), CHA₂DS₂VASc score (MD 0.76 point, 95 % CI: 0.53-0.98, I² = 64.2 %), and P-wave duration (MD 9.49 ms, 95 % CI: 0.75-18.23, I² = 30.4 %). Significantly lower levels were observed in left atrial contractile strain (MD -5.68 %, 95 % CI: 7.45 to -3.91, I² = 58.0 %) and left atrial reservoir strain (MD -9.05 %, 95 % CI: 12.2 to -5.91, I² = 71.9 %). The mean time from CS to AF detection was 162 days and from cardiac monitoring to AF detection was 49 days.</p><p><strong>Conclusion: </strong>Our study highlighted the potential link between certain comorbidities and demonstrated the delay in AF detection following CS. The significant parameters identified should be considered as new recommendations to the guideline for extended cardiac monitoring in CS patients. It is time to change the level of surveillance in this population.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303105","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":"Successful epicardial ablation of incessant left atrial tachycardia in a child with arrhythmia induced cardiomyopathy.","authors":"Vijay Yadav, Daljeet Kaur Saggu, Jasvinder Singh, Calambur Narasimhan","doi":"10.1016/j.ipej.2025.06.003","DOIUrl":"10.1016/j.ipej.2025.06.003","url":null,"abstract":"<p><p>Incessant supraventricular tachycardias leading to arrhythmia induced cardiomyopathy (AIC) is not uncommon. We report one such case of an incessant multidrug resistant focal left atrial tachycardia (AT) in a child who presented with AIC. During electrophysiology study this tachycardia was localized to the left atrial appendage (LAA) but, endocardial ablation at this site caused only temporary suppression of arrhythmia. The epicardial ablation at the site adjacent to the endocardial area proficiently terminated the tachycardia and improved the left ventricular function within the first 48 hours itself. Thus, this case report emphasizes the epicardial ablation of rare epicardial AT arising from LAA.</p>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286658","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":"Optimal strategy for very high-power short-duration atrial fibrillation ablation: Acute efficacy and safety of pulmonary vein and box isolation","authors":"Yusuke Sakamoto,&nbsp;Hiroyuki Osanai,&nbsp;Yoshihito Nakashima,&nbsp;Hiroshi Asano,&nbsp;Masayoshi Ajioka","doi":"10.1016/j.ipej.2025.04.007","DOIUrl":"10.1016/j.ipej.2025.04.007","url":null,"abstract":"<div><h3>Introduction</h3><div>The optimal strategy for very high-power short-duration (vHPSD) ablation for atrial fibrillation (AF) is unclear. Data regarding the application of box isolation (BOXI) and its complications, particularly, pulmonary vein stenosis (PVS), remain scarce. We aimed to determine the optimal strategy for vHPSD in AF ablation by focusing on pulmonary vein isolation (PVI) and BOXI and assessing the acute efficacy and safety.</div></div><div><h3>Methods</h3><div>Patients with drug-refractory AF (n = 97) were divided into two groups: Strategy 1 (n = 50; 90 W for 4 s with PVI for the bottom line and 50 W with an ablation index [AI] of 450 for the roof line) and Strategy 2 (n = 47; based on the outcomes of Strategy 1, using AI-guided ablation). The acute efficacy and safety were compared between the groups. Pre- and post-ablation imaging was conducted to assess PVS.</div></div><div><h3>Results</h3><div>Strategy 1 yielded first-pass isolation (FPI) rates of 62.5 % (PVI) and 72 % (BOXI). The weak points were the thick parts of the atrial wall and the parts with epicardial connections. Strategy 2, which was improved by AI guidance, increased the FPI rates to 97.5 % (PVI) and 95 % (BOXI) and reduced the procedural and fluoroscopy times, respectively. Follow-up imaging showed that the PVS incidence remained low and did not significantly differ between the strategies.</div></div><div><h3>Conclusion</h3><div>AI-guided ablation enhanced the efficacy of vHPSD for PVI and BOXI in Strategy 2. Furthermore, our assessment of PVS demonstrated that vHPSD maintains a favorable safety profile with a low PVS incidence.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 3","pages":"Pages 136-145"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042034","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":"Irregular narrow QRS tachycardia: Chaos is order yet undeciphered","authors":"Yash Lokhandwala","doi":"10.1016/j.ipej.2025.05.001","DOIUrl":"10.1016/j.ipej.2025.05.001","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 3","pages":"Pages 191-195"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180378","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":"Co-existence of RBM20 and KCNQ1 gene mutations in a patient with long QT syndrome and dilated cardiomyopathy. “Which came first: Chicken or the egg?”","authors":"Jithin S. Panicker,&nbsp;Sam Jacob Chiramel","doi":"10.1016/j.ipej.2025.03.005","DOIUrl":"10.1016/j.ipej.2025.03.005","url":null,"abstract":"<div><div>A 60-year-old female patient was taken to the emergency department with a history of syncope. ECG revealed polymorphic ventricular tachycardia which necessitated recurrent DC cardioversion. Post-reversion ECG showed sinus rhythm with prolonged corrected QTc. Bedside transthoracic echocardiogram revealed features suggestive of dilated cardiomyopathy (DCM) with severe left ventricular dysfunction. Next reversion to VT was managed with intravenous propranolol and DC cardioversion after which she remained in sinus rhythm. After the initiation of beta-blocker, she developed sinus bradycardia followed by complete heart block.</div><div>The concern we had while managing this case was whether the DCM caused the VT {then why long QTc?} OR was the long QTc causing DCM {due to same gene mutation}. Genetic analysis revealed the simultaneous occurrence of KCNQ1 and RBM20 mutation.</div><div>Regarding the treatment given to our patient, we continued beta-blocker, left bundle branch optimized implantable cardioverter defibrillator {LOT – Dx ICD} was done with atrial sensing, the right ventricular coil as the defibrillator, and left bundle branch area pacing.</div><div>In our patient, any of the two mutations could explain the occurrence of both DCM and long QTc. However genetic analysis revealed the simultaneous presence of both RBM20 and KCNQ1 mutation. To the best of our knowledge, this is the first report in the medical literature on the co-existence of RBM20 and KCNQ1 mutation.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 3","pages":"Pages 171-174"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754864","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":"Contralateral pneumothorax, pneumomediastinum, and pneumopericardium after dual-chamber pacemaker implantation","authors":"Mariana Pereira Santos ,&nbsp;André Alexandre ,&nbsp;Maria João Sousa ,&nbsp;Severo Torres","doi":"10.1016/j.ipej.2025.05.005","DOIUrl":"10.1016/j.ipej.2025.05.005","url":null,"abstract":"<div><div>We present a rare case of a 79-year-old man who developed contralateral pneumothorax, pneumomediastinum, and pneumopericardium following dual-chamber pacemaker implantation for symptomatic second-degree atrioventricular block. The procedure itself was uneventful, with appropriate lead placement and good electrical parameters.</div><div>However, 30 minutes post-procedure, the patient developed right-sided pleuritic chest pain and dyspnea. Imaging revealed a right-sided pneumothorax, pleural effusion, pneumomediastinum, and pneumopericardium. A chest drain was inserted due to the significant pneumothorax volume, leading to symptom resolution. Electrocardiographic changes and inflammatory marker elevation suggested pericarditis, which was successfully treated with ibuprofen and colchicine. The patient was discharged after 13 days and remained stable at a 1-year follow-up.</div><div>The suspected mechanism of injury was atrial lead perforation, although other causes, such as pleural puncture or superior vena cava injury, were considered. Management of such cases varies, with lead revision being unnecessary in this patient due to stable pacing parameters. This case highlights an unusual complication of pacemaker implantation and underscores the importance of prompt diagnosis and individualized management.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 3","pages":"Pages 162-166"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151842","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":"A subtle pre-excitation playing hide and seek","authors":"Ramanathan Velayutham,&nbsp;Anish Bhargav,&nbsp;Raja J. Selvaraj","doi":"10.1016/j.ipej.2025.05.003","DOIUrl":"10.1016/j.ipej.2025.05.003","url":null,"abstract":"<div><div>24 years female presented with recurrent palpitations for one year. Sinus ECG showed preexcitation pattern suggestive of a posteroseptal accessory pathway. During the electrophysiology study, atrioventricular reciprocating tachycardia was induced with an atrial extra stimulus. Successful ablation was done in posteroseptal region. Post ablation, there was subtle preexcitation on alternate beats with mid septal pattern which showed short and fixed HV. Short fixed HV and preexcitation morphology remained the same both during atrial pacing and junctional beats. This case highlights the unusual finding of intermittent conduction in fasciculoventricular pathway.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 3","pages":"Pages 132-135"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120999","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":"Unusual “crosstalk” phenomenon between right pulmonary veins observed during cryoballoon ablation","authors":"Yuhei Kasai,&nbsp;Takayuki Kitai,&nbsp;Junji Morita,&nbsp;Tsutomu Fujita","doi":"10.1016/j.ipej.2025.04.001","DOIUrl":"10.1016/j.ipej.2025.04.001","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 3","pages":"Pages 159-161"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789273","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":"Cardiogenetics: Closing the knowledge gap in India","authors":"Priya Chockalingam,&nbsp;Arthur A.M. Wilde","doi":"10.1016/j.ipej.2025.05.006","DOIUrl":"10.1016/j.ipej.2025.05.006","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 3","pages":"Pages 175-176"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175070","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}