Indian Pacing and Electrophysiology Journal最新文献

{"title":"Edoxaban for stroke prevention in patients with atrial fibrillation: Of randomized and real-world evidence","authors":"Joris R. de Groot","doi":"10.1016/j.ipej.2025.11.014","DOIUrl":"10.1016/j.ipej.2025.11.014","url":null,"abstract":"<div><div>Atrial fibrillation (AF) is the most common chronic arrhythmia worldwide. AF related complications include ischemic stroke, which can be prevented for largely by the use of direct oral anticoagulants. This review focuses on the randomized trial and large registries on edoxaban, a direct factor Xa inhibitor.</div><div>The ENGAGE-AF TIMI 48 study demonstrated that edoxaban 60/30 mg was non-inferior to warfarin for stroke or systemic embolism (SEE) prevention, while superior with regard to major bleeding. In ELDERCARE-AF, the non-approved dose of edoxaban 15 mg versus placebo resulted in a lower risk of stroke/SEE and a numerically higher major bleeding risk in elderly patients from Japan with a contraindication for anticoagulation.</div><div>These results are echoed in many sub analyses, generally showing preserved efficacy and safety of edoxaban versus warfarin, in patients with varying absolute risk for clinical outcomes. Asian patients with AF, who have a different risk profile than non-Asian patients, and edoxaban proved an effective and safe anticoagulant in Asian patients too. In the ETNA-AF Global registry, comprising patients from Europe and Asia, as well as in other non-randomized real-world studies, the efficacy and safety of edoxaban was confirmed.</div><div>In conclusion, edoxaban is an effective and safe direct anticoagulant for stroke prevention in AF. The large evidence base in Asian patients, in patients with cardiovascular and non-cardiovascular comorbidities and with different dosing regimens provide clinicians with a valuable option for stroke prevention in their patients with AF.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"26 1","pages":"Pages 61-67"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670136","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":"Cardiovascular screening of athletes","authors":"Sarandeep Marwaha,&nbsp;Sanjay Sharma","doi":"10.1016/j.ipej.2025.11.012","DOIUrl":"10.1016/j.ipej.2025.11.012","url":null,"abstract":"<div><div>The sudden death of an athlete causes grave concern among the medical, sporting, and lay communities, considering athletes epitomise the healthiest segment of society. Most decedents are asymptomatic, therefore screening to identify vulnerable individuals seems appropriate, particularly since most aetiologies can be detected during life and several therapeutic interventions can be implemented to minimise the risk. Given the diversity of conditions implicated in exercise related SCD, no single test will detect all disorders. Furthermore, the low incidence of SCD allows for a cost-effective approach using the simplest and most readily available tools. The 12-lead electrocardiogram has emerged as the most effective tool for detecting electrical diseases and raising suspicion of cardiomyopathy. The international recommendations for ECG interpretation allows for physiological remodelling, substantially reducing false positive rates. Nonetheless, the challenge remains, since the ECG will fail to identify up to 20 % of diseases implicated in young sudden cardiac death and is of limited value in middle-aged and older athletes, in whom atherosclerotic coronary artery disease dominates. Therefore, mitigation of risk extends beyond screening to encompass timely resuscitation, universal defibrillator access, and education in cardiac awareness. The future of screening for cardiovascular disease in athletes is likely to combine traditional evaluation with artificial intelligence, including the use of wearable monitoring, and equal access for effective screening worldwide.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"26 1","pages":"Pages 53-58"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670125","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 for atrial fibrillation: biophysics and a contemporary step-by-step approach","authors":"Jyothi Vijay,&nbsp;Narayanan Namboodiri","doi":"10.1016/j.ipej.2026.02.002","DOIUrl":"10.1016/j.ipej.2026.02.002","url":null,"abstract":"<div><div>Cryoablation has become the standard of care for treating atrial fibrillation (AF). Over the past two decades, significant advances have been made in this field. This review discusses the evidence-based practical aspects and recent advances in cryoablation for AF, with a focus on biophysics, procedural techniques, and evidence for cryoballoon-based pulmonary vein isolation (CBA).</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"26 1","pages":"Pages 5-12"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133281","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":"Developmental, normal, and abnormal anatomy of the coronary sinus","authors":"Robert H. Anderson ,&nbsp;Diane E. Spicer ,&nbsp;Damian Sanchez-Quintana","doi":"10.1016/j.ipej.2025.12.013","DOIUrl":"10.1016/j.ipej.2025.12.013","url":null,"abstract":"<div><div>The coronary sinus is the persisting remnant of the left horn of the developing systemic venous sinus. During the fifth week of human development, the channel is incorporated, with its own walls, into the left atrioventricular groove. Sprouts from the newly formed sinus then provide the basis for formation of the great, middle, and small cardiac veins.</div><div>Postnatally, the sinus provides drainage of the greater part of the venous return from the heart. The left superior caval vein itself largely regresses, with only its terminal part persisting as the oblique vein of the left atrium. Union of the oblique vein and the great cardiac vein serves to mark the distal extent of the sinus, with its proximal boundary formed at its entrance to the right atrium, guarded by the Thebesian valve. The great cardiac vein itself forms the base of the left ventricular summit, with this area initially described as a triangle by Brocq and Mouchet. In the setting of congenital persistence of the left superior caval vein, the sinus, and its right atrial orifice, are usually dilated. An imperforate Thebesian valve produces atresia of the sinus, with the persisting left superior caval vein then providing a conduit for retrograde passage of cardiac venous return to the right atrium. Rarer malformations are so-called \"unroofing\" of the sinus, and aneurysmal dilation to form diverticulums in the inferior wall of the ventricular mass. The sinus can also be abnormal, or absent, in the setting of isomerism.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 6","pages":"Pages 417-424"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678958","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":"Signature ECG part 4: A 6 year-old with an irregular pulse","authors":"Arthur AM. Wilde,&nbsp;Priya Chockalingam","doi":"10.1016/j.ipej.2025.11.006","DOIUrl":"10.1016/j.ipej.2025.11.006","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 6","pages":"Pages 449-450"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589274","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":"Electrocardiographic abnormalities in Duchenne muscular dystrophy patients and its relation to LV function and other factors","authors":"Y.J. Kulkarni ,&nbsp;Y. Sangeetha ,&nbsp;M. Thomas ,&nbsp;J.R. Jacob ,&nbsp;A. Manickavasagam ,&nbsp;S.C. Srinath ,&nbsp;A. Sivadasan ,&nbsp;Danda","doi":"10.1016/j.ipej.2025.12.006","DOIUrl":"10.1016/j.ipej.2025.12.006","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 6","pages":"Page 471"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145802040","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":"Cardiac Sympathetic Denervation for Inherited Channelopathies: Our experience","authors":"G.K. Mittal ,&nbsp;C. Mahajan ,&nbsp;P. Barwad ,&nbsp;Y. Lokhandwala","doi":"10.1016/j.ipej.2025.12.010","DOIUrl":"10.1016/j.ipej.2025.12.010","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 6","pages":"Page 472"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145802044","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":"Dual-chamber leadless pacemaker implant via the RIJ after failed femoral vein implant in a 65-year-old patient with symptomatic bradycardia, with left IJ port and right-sided AV fistula","authors":"Shivani Lawa ,&nbsp;Ghania Aizad ,&nbsp;Charles Bingham ,&nbsp;Daniel Cortez","doi":"10.1016/j.ipej.2025.09.009","DOIUrl":"10.1016/j.ipej.2025.09.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Sinus node dysfunction (SND) is a disorder defined by abnormal initiation and conduction of electrical signals from the sinoatrial node. The preferred first-line treatment for a patient with symptomatic SND is a permanent pacemaker implant. We describe the implantation of an Aveir dual-chamber leadless pacemaker through the right internal jugular vein in a 65-year-old female patient with inaccessible femoral veins and a chemotherapy port in the left internal jugular vein.</div></div><div><h3>Methods</h3><div>A retrospective review was performed at the University of California at Davis of the dual-chamber leadless pacemaker (Aveir DR) procedure.</div></div><div><h3>Results</h3><div>A 65-year-old female with a history of chronic dialysis use and chemotherapy, with persistence of left internal jugular vein port, presented with symptomatic bradycardia. After a failed attempt at an outside institution, she presented for a dual-chamber leadless pacemaker implant at our institution. Via the right internal jugular vein, the Aveir VR was deployed with stable thresholds, impedance, and sensing into the ventricular septum, with a subsequent atrial device being deployed with stable thresholds, impedance, and sensing into the right atrial appendage. Follow-up at 8 days demonstrated a ventricular threshold of 0.75V at 0.2 ms, impedance of 440 Ohms, and sensing of 9.9 mV. Follow-up atrial threshold of 0.75V at 0.2 ms, impedance of 400 Ohms, and P wave sensing of 0.8 mV.</div></div><div><h3>Conclusion</h3><div>Placement of the Aveir dual chamber leadless pacemaker is safe in an adult patient without any complications.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 6","pages":"Pages 433-437"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226153","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":"Cold front hits southern India: Cryoballoon AF ablation reaches India's tip","authors":"Melanie A. Gunawardene MD ,&nbsp;Boris Schmidt ,&nbsp;K.R. Julian Chun MD","doi":"10.1016/j.ipej.2025.12.015","DOIUrl":"10.1016/j.ipej.2025.12.015","url":null,"abstract":"","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 6","pages":"Pages 404-405"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696501","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":"Indian experience with cryoablation for paroxysmal and persistent atrial fibrillation","authors":"Sudipta Mondal ,&nbsp;Nayani Makkar ,&nbsp;Usnish Adhikari ,&nbsp;Kakarla Saikiran ,&nbsp;Jyothi Vijay ,&nbsp;Sreevilasam P. Abhilash ,&nbsp;Sabari Saravanan ,&nbsp;Narayanan Namboodiri","doi":"10.1016/j.ipej.2025.11.016","DOIUrl":"10.1016/j.ipej.2025.11.016","url":null,"abstract":"<div><h3>Background</h3><div>While the safety and efficacy of cryoablation procedures have been well-established in <em>Western populations</em>, data regarding these outcomes in the subcontinent remain limited.</div></div><div><h3>Methods</h3><div>This retrospective observational study included patients with paroxysmal atrial fibrillation (PAF) or persistent atrial fibrillation (PsAF) treated with cryoballoon catheter ablation according to standard clinical practice. The primary efficacy endpoints (mean follow-up of 15.3 months) were freedom from AF/atrial flutter (AFL)/atrial tachycardia (AT) lasting ≥30 s. The primary safety endpoint was the occurrence of serious procedure-related adverse events within 30 days of the procedure.</div></div><div><h3>Results</h3><div>The study population included 66 consecutive patients with recurrent symptomatic atrial fibrillation despite medications and underwent the cryoablation procedure for rhythm control. The cohort had a mean age of 55 ± 14 years, was 77 % male, had a CHA2DS2-VASc score of 1.63 ± 1.53, and had been diagnosed with AF for a mean of 2.93 ± 3.25 years before cryoablation. Patients with PAF comprised 75.8 % of the total cohort. The PsAF subgroup had a significantly larger mean left atrial (LA) diameter (42 mm vs. 36 mm; <em>p</em> &lt; 0.01), lower LVEF (57 % vs 63 %; <em>p</em> = 0.016), fewer presyncope episodes (6 % vs. 30 %; <em>p</em> = 0.048), and higher amiodarone use within last one year (69 % vs. 22 %; <em>p</em> &lt; 0.01). Two serious procedure-related events (3.03 %) occurred (phrenic nerve injury), both of which resolved within 3 months’ follow-up. Freedom from recurrence of atrial arrhythmia at 12 months was 71 % (95 % CI 55–81 %), with a significant difference between PAF 84 % (95 % CI 68–92 %) and PsAF 34 % (95 % CI 10–60 %) groups. Presence of atrial arrhythmia at the beginning of the study (87 % vs 51 %) and failure to terminate it after completion of ablative procedure, requiring electrical cardioversion, impose a higher risk (83 % vs 28 %) of recurrence<strong>.</strong> No difference was found between the PVI and PVI + groups<strong>.</strong></div></div><div><h3>Conclusions</h3><div>Cryoballoon ablation demonstrated efficiency, safety, and effectiveness in treating patients with paroxysmal and persistent AF. 12-month atrial arrhythmia-free survival rates were significantly higher in patients with PAF compared to those with PsAF. Pre-procedural atrial arrhythmias and post-procedural atrial arrhythmias requiring cardioversion are associated with a higher risk of recurrence. Major procedural adverse effects were comparable to those reported in global standards.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 6","pages":"Pages 397-403"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696491","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}