Indian Pacing and Electrophysiology Journal最新文献_第8页

Spatial displacement on three-dimensional maps caused by rhythm differences in premature ventricular contraction ablation 室性早搏消融中节律差异引起的三维地图空间位移。

Indian Pacing and Electrophysiology Journal Pub Date : 2025-03-01 DOI: 10.1016/j.ipej.2025.01.004

Yusuke Sakamoto, Hiroyuki Osanai, Yoshihito Nakashima, Hiroshi Asano

{"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":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 2","pages":"Pages 76-81"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","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}

引用次数: 0

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 由于心外膜-心内膜突破，射频消融多次失败后，冷冻消融作为双向腔尖瓣峡部阻断的替代策略：1例报告。

Indian Pacing and Electrophysiology Journal Pub Date : 2025-03-01 DOI: 10.1016/j.ipej.2025.02.004

Yuhei Kasai, Takayuki Kitai, Junji Morita, Tsutomu Fujita

{"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":"10.1016/j.ipej.2025.02.004","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 2","pages":"Pages 118-121"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","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}

引用次数: 0

Left lateral pathway AVRT causing overdrive suppression of SA node and reversible cardiomyopathy: A case report 左外侧通道AVRT引起窦房结过度抑制和可逆性心肌病1例报告。

Indian Pacing and Electrophysiology Journal Pub Date : 2025-01-01 DOI: 10.1016/j.ipej.2024.12.004

Avinash Jeewooth , Atul Kaushik , Aparna Jaswal , Vikas Kumar

引用次数: 0

Targeting deep substrates with radiofrequency: Unipolar with half-normal saline irrigation vs. Bipolar with normal saline irrigation 射频靶向深部基质：单极与半生理盐水冲洗vs双极与生理盐水冲洗。

Indian Pacing and Electrophysiology Journal Pub Date : 2025-01-01 DOI: 10.1016/j.ipej.2025.01.002

Alessio Gasperetti MD PhD , Pasquale Santangeli MD PhD

引用次数: 0

Spatial relationship between evoked delayed potentials and deceleration zones of an isochronal late activation map in a patient with sarcoid-related ventricular tachycardia 一名肉瘤相关性室性心动过速患者的诱发延迟电位与等时后期激活图减速区之间的空间关系。

Indian Pacing and Electrophysiology Journal Pub Date : 2025-01-01 DOI: 10.1016/j.ipej.2024.10.007

Tomomasa Takamiya , Takashi Miyamoto , Shinsuke Miyazaki , Tetsuo Sasano

引用次数: 0

The importance of inflammation in atrial fibrillation recurrence in patients with atrial fibrillation treated with Cryo balloon ablation 低温球囊消融治疗心房颤动患者中炎症在房颤复发中的重要性。

Indian Pacing and Electrophysiology Journal Pub Date : 2025-01-01 DOI: 10.1016/j.ipej.2024.12.005

Deniz Elcik , Aydin Tuncay , Mustafa Fehmi Bireciklioglu , Mehmet Tugrul İnanc

{"title":"The importance of inflammation in atrial fibrillation recurrence in patients with atrial fibrillation treated with Cryo balloon ablation","authors":"Deniz Elcik , Aydin Tuncay , Mustafa Fehmi Bireciklioglu , Mehmet Tugrul İnanc","doi":"10.1016/j.ipej.2024.12.005","DOIUrl":"10.1016/j.ipej.2024.12.005","url":null,"abstract":"<div><h3>Aim/background</h3><div>Although atrial fibrillation is the most common rhythm problem, the results of treatment to restore sinus rhythm are still not satisfactory. Nearly half of patients undergoing ablation relapse within one year. Therefore, triggered activities may not be the only cause. Inflammation is quite common in AF. In this study, we investigated the effect of PIV, an inflammatory marker, on recurrence.</div></div><div><h3>Methods</h3><div>A total of 157 patients who underwent ablation with cryo balloon were included in the study. One-year follow-up was evaluated for causes of recurrence.</div></div><div><h3>Results</h3><div>When the inflammatory parameters between the two groups are analyzed, CRP (5.9 [5.0–6.9] vs 9.7 [7.6–11.9], p < 0.001), NL ratio (2.8 [2.5–3.0] vs 6.4 [5.0–6.8], p < 0.001), SII2 (618.5 [557.1–679.9] vs 1798.9 [1305.8–2292.1], p < 0.001), PIV (355.9 [313.4–398.4] vs 1832 [1317.8–2347.1], p < 001) were significantly higher in the AF recurrence group. ROC analysis showed that PIV had the best sensitivity and specificity.</div></div><div><h3>Conclusions</h3><div>Inflammation has been found to be a cause of AF recurrence and PIV is one of the best markers for this.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 1","pages":"Pages 14-19"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923582","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}

引用次数: 0

Lesion characteristics of long application time ablation using unipolar half-normal saline irrigation and bipolar normal saline irrigation 使用单极半生理盐水灌注和双极生理盐水灌注进行长应用时间消融的病变特征。

Indian Pacing and Electrophysiology Journal Pub Date : 2025-01-01 DOI: 10.1016/j.ipej.2024.11.003

Takumi Kasai , Osamu Saitoh , Ayaka Oikawa , Naomasa Suzuki , Yasuhiro Ikami , Yuki Hasegawa , Sou Otsuki , Takayuki Inomata , Hiroshi Furushima , Masaomi Chinushi

{"title":"Lesion characteristics of long application time ablation using unipolar half-normal saline irrigation and bipolar normal saline irrigation","authors":"Takumi Kasai , Osamu Saitoh , Ayaka Oikawa , Naomasa Suzuki , Yasuhiro Ikami , Yuki Hasegawa , Sou Otsuki , Takayuki Inomata , Hiroshi Furushima , Masaomi Chinushi","doi":"10.1016/j.ipej.2024.11.003","DOIUrl":"10.1016/j.ipej.2024.11.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Unipolar radiofrequency (RF) ablation using half-normal saline irrigation (UNIP-HNS) and bipolar RF ablation using normal saline irrigation (BIP-NS) are effective to treat arrhythmias from inside thick myocardium. However, differences between these two ablations when using a long application time had not fully been studied.</div></div><div><h3>Methods</h3><div>UNIP-HNS, BIP-NS and unipolar RF ablation using normal saline irrigation (UNIP-NS) were applied for 120 s (30 W and 20-g contact) to porcine endocardial wall (≧15.0 mm thickness).</div></div><div><h3>Results</h3><div>All ablations (30 applications each in UNIP-HNS and BIP-NS, and 20 applications in UNIP-NS) were successfully accomplished without steam-pop. Total impedance decline was largest in BIP-NS followed by UNIP-HNS and UNIP-NS. UNIP-HNS created larger surface lesions and greater maximum lesion width under the surface than those by UNIP-NS and BIP-NS. Endocardial lesion depth in UNIP-HNS and BIP-NS were deeper than that in UNIP-NS, but with no difference between UNIP-HNS and BIP-NS, when selecting non-transmural lesions. Similar results were obtained when all lesions (non-transmural and transmural) were included and endocardial lesion depth of the transmural lesions (13/30 applications of BIP-NS) was estimated as 50 % of the myocardial thickness. Lesion length in the transverse myocardial wall (endocardial plus epicardial lesions) was greatest in BIP-NS.</div></div><div><h3>Conclusions</h3><div>Longer application time ablation (30 W) targeting the thick myocardium was performable in UNIP-HNS and BIP-NS. Since a transmural lesion and/or a deeper lesion into the myocardial wall are created, BIP-NS is preferable if two ablation catheters can be positioned on either side of the target.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 1","pages":"Pages 2-11"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644086","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}

引用次数: 0

Two distinct stages and mechanisms of ST-elevation during cryothermal cavotricuspid isthmus ablation guided by intracardiac echocardiography: A case report 在心内超声心动图引导下进行低温腔静脉峡部消融术时ST段抬高的两个不同阶段和机制：病例报告。

Indian Pacing and Electrophysiology Journal Pub Date : 2025-01-01 DOI: 10.1016/j.ipej.2024.10.002

Yuhei Kasai, Kizuku Iitsuka, Junji Morita, Takayuki Kitai

{"title":"Two distinct stages and mechanisms of ST-elevation during cryothermal cavotricuspid isthmus ablation guided by intracardiac echocardiography: A case report","authors":"Yuhei Kasai, Kizuku Iitsuka, Junji Morita, Takayuki Kitai","doi":"10.1016/j.ipej.2024.10.002","DOIUrl":"10.1016/j.ipej.2024.10.002","url":null,"abstract":"<div><div>Radiofrequency (RF) catheter ablation is the primary treatment for cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL), with cryothermal energy as an alternative. While cryoablation offers comparable effectiveness and safety to RF ablation, it poses a risk of coronary artery spasm leading to ST-elevation. This case report presents a 65-year-old man with drug-refractory atrial fibrillation (AF) and AFL undergoing cryothermal CTI ablation guided by intracardiac echocardiography (ICE). During the procedure, two distinct ST-elevation episodes were observed. The first episode coincided with the pull-down of the cryoablation catheter, potentially resulting in coronary compression, as indicated by ICE, and was rapidly resolved by discontinuing the freezing process. The second episode, occurring without active freezing, was attributed to coronary artery spasm and resolved with intracoronary nitroglycerin administration. During the second episode, emergent right coronary angiography confirmed total occlusion in the segment 4 AV adjacent to the region where cryoablation was performed, which fully resolved post-nitroglycerin. This report underscores the dual mechanisms of ST-elevation—coronary artery compression and spasm—during cryothermal CTI ablation, highlighting the critical role of ICE in enhancing procedural safety.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 1","pages":"Pages 32-36"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381819","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}

引用次数: 0

Left internal jugular vein approach to right atrial appendage base implantation of the Aveir AR leadless pacemaker 左颈内静脉入路至右心房附件基底植入Aveir AR无铅起搏器。

Indian Pacing and Electrophysiology Journal Pub Date : 2025-01-01 DOI: 10.1016/j.ipej.2024.11.004

Howard Liu, Daniel Cortez

{"title":"Left internal jugular vein approach to right atrial appendage base implantation of the Aveir AR leadless pacemaker","authors":"Howard Liu, Daniel Cortez","doi":"10.1016/j.ipej.2024.11.004","DOIUrl":"10.1016/j.ipej.2024.11.004","url":null,"abstract":"<div><h3>Introduction</h3><div>There is no prior report of an Aveir leadless pacemaker implantation into the atrial appendage via the internal jugular vein.</div></div><div><h3>Case</h3><div>A 44-year-old female patient with history of multiple ablations for sinus node dysfunction presented with symptomatic bradycardia. The patient had femoral veins <9mm, chronic pain at the femoral vein insertion sites, as well as a recent car accident with persistent leg pain due to femoral fractures. Placement of a leadless pacemaker was decided based on patient discretion. An Abbott Aveir AR leadless pacemaker was implanted via left internal jugular vein access without complication. Post device implantation showed threshold of 0.75V @0.4 ms, impedance of 340 Ω, Pwave of 4.4 mV. Six-month follow-up demonstrated a threshold of 0.5 V @0.2 milliseconds, impedance of 300 Ω and Pwave of 7.2 mV with 92 % pacing and predicted longevity of 12.7 years.</div></div><div><h3>Discussion</h3><div>The follow-up showed no complications in the patient. A similar approach may be feasible for other patients needing atrial leadless pacing, in which the transfemoral approach is not preferred.</div></div><div><h3>Conclusion</h3><div>Implantation of the Aveir AR leadless pacemaker into the right atrial appendage is feasible via the left internal jugular vein.</div></div>","PeriodicalId":35900,"journal":{"name":"Indian Pacing and Electrophysiology Journal","volume":"25 1","pages":"Pages 25-27"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814271","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}

引用次数: 0

Appropriate implantable cardioverter-defibrillator therapy triggered by heat stroke 适当的植入式心律转复除颤器治疗引发中暑。

Indian Pacing and Electrophysiology Journal Pub Date : 2025-01-01 DOI: 10.1016/j.ipej.2024.12.001

Carlos Fernando Paz Mamani , Mauricio Arce Carreón , Francisco Femenia , Josep Brugada

引用次数: 0