Journal of Innovations in Cardiac Rhythm Management最新文献

Impacts of Premature Atrial Contractions and Biochemical Markers Early After Cryoballoon Versus Radiofrequency Ablation on the Late Recurrence of Atrial Fibrillation. 低温球囊消融与射频消融后早期心房早搏及生化指标对房颤晚期复发的影响。

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-04-15 eCollection Date: 2025-04-01 DOI: 10.19102/icrm.2025.16043

Kenichi Sasaki, Daisuke Togashi, Akira Kasagawa, Ikutaro Nakajima, Takumi Higuma, Tomoo Harada, Yoshihiro J Akashi

{"title":"Impacts of Premature Atrial Contractions and Biochemical Markers Early After Cryoballoon Versus Radiofrequency Ablation on the Late Recurrence of Atrial Fibrillation.","authors":"Kenichi Sasaki, Daisuke Togashi, Akira Kasagawa, Ikutaro Nakajima, Takumi Higuma, Tomoo Harada, Yoshihiro J Akashi","doi":"10.19102/icrm.2025.16043","DOIUrl":"https://doi.org/10.19102/icrm.2025.16043","url":null,"abstract":"We sought to clarify the impacts of premature atrial contractions (PACs) and biochemical markers early after cryoballoon (CB) versus radiofrequency (RF) ablation for atrial fibrillation (AF) on the late recurrence of AF (LRAF). The study population included 138 patients who underwent first-time ablation for paroxysmal AF with CB (n = 69) or RF (n = 69). We compared the levels of the PAC burden on Holter monitoring, myocardial-bound creatine kinase (CK-MB), troponin T (TnT), and C-reactive protein (CRP) the day after ablation, and we assessed the incidence of LRAF, which was defined as AF after a 3-month blanking period. The postprocedural PAC burden was not significantly different between the CB and RF groups (P = .35), whereas the CK-MB and CRP levels were significantly higher in the CB group (both P < .01); the TnT levels of the groups were similar (P = .63). Among these, only a higher PAC burden was significantly associated with LRAF in both the CB (top quartile [≥2.16%]: 58% vs. others: 17%; log-rank P = .01) and RF (top quartile [≥3.05%]: 36% vs. others: 9%; log-rank P < .01) groups. A Cox regression analysis revealed two significant predictors of LRAF: in-hospital recurrence (CB group: hazard ratio [HR], 3.55 [1.67-11.80]; P = .04; RF group: HR, 7.55 [1.67-34.20]; P = .01) and a higher postprocedural PAC burden (CB: HR, 1.54 [1.06-2.22]; P = .02; RF: HR, 1.90 [1.16-3.35]; P = .01). In conclusion, irrespective of the ablation modality, the next-day PAC burden (but not the biochemical markers examined herein) is useful for predicting LRAF. Early AF recurrence should be considered a future risk even at the beginning of the blanking period.","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 4","pages":"6251-6259"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040180","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

Risk Factors Associated with Unsuccessful Dofetilide Initiation Due to Excessive QT Interval Prolongation: A Retrospective Study. 由于QT间期过长导致多非利特起始治疗失败的危险因素：一项回顾性研究。

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-04-15 eCollection Date: 2025-04-01 DOI: 10.19102/icrm.2025.16042

Johnathon Rast, Grant Whitebloom, Omar M Makram, Priyanshu Nain, Lakshya Seth, Nathaniel Wayne, Patrick Houlihan, Alexander Warner, Daniel Sohinki

{"title":"Risk Factors Associated with Unsuccessful Dofetilide Initiation Due to Excessive QT Interval Prolongation: A Retrospective Study.","authors":"Johnathon Rast, Grant Whitebloom, Omar M Makram, Priyanshu Nain, Lakshya Seth, Nathaniel Wayne, Patrick Houlihan, Alexander Warner, Daniel Sohinki","doi":"10.19102/icrm.2025.16042","DOIUrl":"https://doi.org/10.19102/icrm.2025.16042","url":null,"abstract":"Dofetilide is a class III anti-arrhythmic medication approved for patients with atrial fibrillation to maintain sinus rhythm. Excessive QTc interval prolongation, a potential side effect of dofetilide, increases the risk of torsades de pointes. This risk is mitigated by closely monitoring the QTc interval during an inpatient initiation protocol for the first five doses. Prior studies have demonstrated that dofetilide can be safely used in patients with heart failure after completing the initiation protocol. However, no studies have investigated risk factors associated with dofetilide-induced excessive QTc interval prolongation, resulting in discontinuation of the medicine. This single-center retrospective cohort study analyzed the association between dofetilide-associated excessive QTc prolongation during medication initiation and pertinent medical comorbidities as well as various echocardiographic values of interest. Risk factors found to be significantly associated with excessive QTc prolongation during dofetilide initiation included a clinical history of heart failure, reduced left ventricular ejection fraction, increased left ventricular end-diastolic diameter, increased left atrial diameter, and reduced right ventricular systolic function. Although some studies have demonstrated the safety of dofetilide use in patients with heart failure, our findings suggest that these patients are less likely to tolerate initiation of the medication due to excessive QTc prolongation.","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 4","pages":"6240-6246"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022553","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

Dual-morphology Bundle Branch Re-entrant Ventricular Tachycardia in Non-dilated Cardiomyopathy. 非扩张型心肌病双形态束支再入性室性心动过速。

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-04-15 eCollection Date: 2025-04-01 DOI: 10.19102/icrm.2025.16045

Ibrahim Alshaghdali, Tyler Alderson, Hakan Paydak, John Paul Mounsey, Subodh Devabhaktuni

{"title":"Dual-morphology Bundle Branch Re-entrant Ventricular Tachycardia in Non-dilated Cardiomyopathy.","authors":"Ibrahim Alshaghdali, Tyler Alderson, Hakan Paydak, John Paul Mounsey, Subodh Devabhaktuni","doi":"10.19102/icrm.2025.16045","DOIUrl":"https://doi.org/10.19102/icrm.2025.16045","url":null,"abstract":"Bundle branch re-entrant (BBR) tachycardia is an uncommon form of ventricular tachycardia (VT). This arrhythmia typically occurs in patients with a structural heart disease, especially dilated cardiomyopathy, and significant conduction system impairment, although affected patients with a structurally normal heart or normal conduction system have been reported. The QRS morphology during tachycardia can vary; it typically has a left bundle branch block (LBBB) morphology in which the antegrade conduction is over the right bundle and the retrograde limb is over the left bundle. The reverse of this circuit results in a right bundle branch block (RBBB) QRS morphology. A re-entrant circuit also can utilize interfascicular conduction, such as antegrade conduction over the left anterior fascicle and retrograde conduction up the left posterior fascicle or vice versa. Although there are reports of BBR tachycardia and interfascicular VT occurring in the same patient, to our knowledge, there are no prior reports of BBR tachycardia that has both LBBB and RBBB morphologies in the same patient. This case illustrated a BBR tachycardia with both left bundle and right bundle branch morphologies occurring in a patient with a non-dilated left ventricle.","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 4","pages":"6260-6267"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054240","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

Letter from the Editor in Chief. 总编辑的来信。

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-04-15 eCollection Date: 2025-04-01 DOI: 10.19102/icrm.2025.16046

Devi Nair

引用次数: 0

Digoxin Dilemma: Diagnosing Toxicity Amidst Dementia. 地高辛困境：诊断痴呆中的毒性。

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-04-15 eCollection Date: 2025-04-01 DOI: 10.19102/icrm.2025.16041

Parth Sushil Bajoria, Vinod Nookala

{"title":"Digoxin Dilemma: Diagnosing Toxicity Amidst Dementia.","authors":"Parth Sushil Bajoria, Vinod Nookala","doi":"10.19102/icrm.2025.16041","DOIUrl":"https://doi.org/10.19102/icrm.2025.16041","url":null,"abstract":"Digoxin, a cardiac glycoside and sodium-potassium adenosine triphosphatase inhibitor, has a narrow therapeutic index and is primarily prescribed for conditions such as systolic heart failure and atrial fibrillation. This narrow window increases the risk of toxicity, especially among susceptible populations. Although digoxin use has declined in recent decades and cases of toxicity have become less frequent, clinicians must remain vigilant, particularly with geriatric patients, who are more susceptible due to polypharmacy and reduced renal function. Here, we present a case of a 77-year-old woman with dementia who exhibited elevated digoxin levels and was successfully treated with digoxin immune Fab. While the use of immune Fab in chronic toxicity cases remains uncertain, our retrospective review of similar cases, managed both with and without immune Fab, provides insights into its role and limitations. We further underscore the importance of regular digoxin monitoring rather than checking the levels only during toxic episodes, as consistent monitoring can prevent fatal cases and reduce overall mortality.","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 4","pages":"6235-6238"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053378","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 Septal Fascicular Block Following Left Bundle Branch Area Pacing. 左束支区起搏后左间隔束束阻滞。

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-04-15 eCollection Date: 2025-04-01 DOI: 10.19102/icrm.2025.16044

Ahmet Lutfu Sertdemir, Ahmet Taha Sahin, Andrés Ricardo Pérez-Riera, Enes Elvin Gul, Adrian Baranchuk

引用次数: 0

The Rhythms of the Moon: Can the Moon Affect Cardiac Arrhythmias? 月亮的节奏：月亮会影响心律失常吗？

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-03-15 eCollection Date: 2025-03-01 DOI: 10.19102/icrm.2025.16034

Athanasios Ziakos, Armin Sause, Melchior Seyfarth

{"title":"The Rhythms of the Moon: Can the Moon Affect Cardiac Arrhythmias?","authors":"Athanasios Ziakos, Armin Sause, Melchior Seyfarth","doi":"10.19102/icrm.2025.16034","DOIUrl":"10.19102/icrm.2025.16034","url":null,"abstract":"Diagnosing paroxysmal cardiac arrhythmias early poses a challenge, yet it holds paramount significance. Certain patients hold strong beliefs regarding the moon's impact on cardiac arrhythmias. This study aims to examine the potential correlation. In our emergency room, each patient presentation is assigned an \"admission diagnosis.\" An analysis was conducted on admission diagnoses from 2012-2020 (before the coronavirus disease 2019 pandemic). The frequency of rhythmological diagnoses was investigated, both collectively and separately, as well as categorized by the underlying pathomechanism, in relation to the lunar phase and the moon's proximity to the Earth at the time of admission. Moreover, the impacts of sex, age, and weight were evaluated. A total of 58,230 patient presentations were recorded, with 16.9% coded with rhythmological diagnoses. No significant differences were found in the distribution of cardiac arrhythmias concerning lunar phases or the moon-Earth distance. Sex, age, and weight did not influence this distribution, except in a small group of underweight patients (<55 kg), where a statistically significant difference was observed with greater moon distance. To verify this result, we investigated all existing Holter records of underweight patients presenting to the emergency room between 2017 and 2020. In 195 24-h Holter recordings, a uniform burden of supraventricular extrasystoles and atrial fibrillation/flutter irrespective of the moon's distance from the Earth was observed. Contrary to patients' beliefs, the moon does not seem to affect the presentations with rhythmological complaints and diagnoses in our single-center analysis, irrespective of age, sex, or the arrhythmia type. The moon cannot aid in diagnosing paroxysmal arrhythmias.","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 3","pages":"6220-6222"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693813","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

Letter from the Editor in Chief. 总编辑的来信。

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-03-15 eCollection Date: 2025-03-01 DOI: 10.19102/icrm.2025.16038

Devi Nair

引用次数: 0

"Optimizing" the Anesthetic for Cardiac Contractility Modulation Devices. “优化”心脏收缩调节装置的麻醉剂。

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-03-15 eCollection Date: 2025-03-01 DOI: 10.19102/icrm.2025.16032

Samit Ghia, Ashanay Allen, Ranjit Suri, Himani Bhatt

{"title":"\"Optimizing\" the Anesthetic for Cardiac Contractility Modulation Devices.","authors":"Samit Ghia, Ashanay Allen, Ranjit Suri, Himani Bhatt","doi":"10.19102/icrm.2025.16032","DOIUrl":"10.19102/icrm.2025.16032","url":null,"abstract":"We present a case report of a patient undergoing implantation of a cardiac contractility modulation (CCM) device. The Optimizer® Smart Implantable Pulse Generator (Impulse Dynamics, Orangeburg, NY, USA) provides electrical energy to the right ventricular septum to modulate cardiac contractility and improve cardiac function in heart failure patients. The non-excitatory electrical signals are delivered by transvenous leads during the refractory period. Anesthetic administration during implantation can affect appropriate lead positioning. Propofol at high doses can attenuate diaphragmatic contraction and discomfort from inappropriate lead positioning, resulting in diaphragm stimulation. Therefore, local or conscious sedation is preferred during CCM device implantation. In patients undergoing procedures with this CCM device in situ, the Optimizer® activity causes upward deflections of the RS segment on the electrocardiogram. Also, strong electromagnetic fields can disrupt device function. This case report reviews the novel CCM device and its major anesthetic considerations.","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 3","pages":"6223-6228"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693818","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

Immune Checkpoint Inhibitor-induced Myocarditis: A Case Report of Complete Heart Block and Challenges in a Patient on Pembrolizumab. 免疫检查点抑制剂诱导的心肌炎：1例使用派姆单抗的患者完全性心脏传导阻滞和挑战

Journal of Innovations in Cardiac Rhythm Management Pub Date : 2025-03-15 eCollection Date: 2025-03-01 DOI: 10.19102/icrm.2025.16033

Viraj Panchal, Elina Momin, Shubhika Jain, Anaiya Singh, Guntas Ghuman, Vijaywant Brar

{"title":"Immune Checkpoint Inhibitor-induced Myocarditis: A Case Report of Complete Heart Block and Challenges in a Patient on Pembrolizumab.","authors":"Viraj Panchal, Elina Momin, Shubhika Jain, Anaiya Singh, Guntas Ghuman, Vijaywant Brar","doi":"10.19102/icrm.2025.16033","DOIUrl":"10.19102/icrm.2025.16033","url":null,"abstract":"Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment by modulating immune responses, leading to enhanced anti-tumor activity. ICIs, including agents targeting cytotoxic T-lymphocyte antigen 4, programmed cell death 1, and programmed cell death ligand, are now widely used in various malignancies, either as monotherapy or in combination with chemotherapy, radiotherapy, or targeted therapies. However, ICIs are associated with immune-related adverse events, affecting multiple organ systems, with myocarditis emerging as a rare but potentially fatal complication. We present a 67-year-old man with a history of prostate and renal cell carcinoma treated with pembrolizumab and lenvatinib, who developed myocarditis secondary to ICI therapy. The patient initially presented with generalized fatigue and bradycardia, later progressing to more severe symptoms, including sinus bradycardia and elevated troponin levels. An electrocardiogram revealed a sinus rhythm with first-degree atrioventricular block, non-specific intraventricular conduction delay, and elevated high-sensitivity troponin levels progressively increasing to 50,000 pg/mL. A comprehensive diagnostic workup ruled out ischemic causes, leading to the diagnosis of ICI-induced myocarditis. The patient was treated with high-dose corticosteroids, intravenous immunoglobulin, and temporary pacemaker insertion, resulting in clinical improvement. This case highlights the need for vigilance and prompt intervention in patients receiving ICI therapy, as early recognition and treatment of myocarditis are crucial to optimizing patient outcomes in this high-risk population.","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 3","pages":"6215-6219"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693787","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