Journal of Innovations in Cardiac Rhythm Management最新文献

{"title":"Snaring via a Femoral Approach to Facilitate Transvenous Lead Extraction of an Infected Right Ventricular Lead Jailed by a Bioprosthetic Tricuspid Valve.","authors":"Sapan Bhuta, Sena Colak, Aleena I Arif, Muhammad R Afzal","doi":"10.19102/icrm.2024.15105","DOIUrl":"10.19102/icrm.2024.15105","url":null,"abstract":"<p><p>An 85-year-old woman presented with <i>Corynebacterium</i> bacteremia complicated by infective endocarditis with vegetations on the prosthetic mitral valve and right ventricular (RV) lead. The patient had a single-chamber permanent pacemaker with two RV leads, one of which was previously trapped or \"jailed\" after a bioprosthetic tricuspid valve replacement. Complete transvenous lead extraction including the chronically retained jailed RV lead was achieved via laser extraction assisted by concomitant traction from a superior left subclavian and inferior right femoral venous approach.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 10","pages":"6066-6069"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584474","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}

{"title":"Comparative Efficacy and Safety of Direct Oral Anticoagulants Versus Warfarin in Atrial Fibrillation Patients with Chronic Liver Disease: A Systematic Review and Meta-analysis.","authors":"Syed Muhammad IbnE Ali Jaffari, Fnu Karishma, Syeda Urooba Shah, Robish Kishore, Avinash Kumar, Fnu Kajal, Maira Khalid, Avesh Kumar, Huda Anum, Zarmina Ali, Rimsha Irfan, Muhammad Ahsan Naseer Khan, Abdul Rehman Saleem, Hamza Islam, Rabia Islam","doi":"10.19102/icrm.2024.15103","DOIUrl":"10.19102/icrm.2024.15103","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is a prevalent cardiac arrhythmia. Direct oral anticoagulants (DOACs), with superior efficacy and safety, have emerged as a promising alternative to warfarin. This systematic review and meta-analysis aimed to compare the safety and efficacy of DOACs and warfarin in patients with AF and chronic liver disease (CLD). A systematic search was undertaken in PubMed, the Cochrane Library, and Google Scholar to identify studies comparing the effectiveness of DOACs and warfarin in patients diagnosed with AF and CLD. Subsequent analyses were carried out using the random-effects model. This meta-analysis included eight studies involving 20,684 participants; baseline characteristics indicated a prevalent male presence (56.7%), with an average age of 61.63 ± 9 years. Primary outcomes demonstrated that DOACs were associated with significantly reduced all-cause mortality (relative risk [RR], 0.73; 95% confidence interval [CI], 0.56-0.95; <i>I</i> ² = 84%; <i>P</i> = .02) and ischemic stroke risk (RR, 0.62; 95% CI, 0.45-0.86; <i>I</i> ² = 61%; <i>P</i> = .004). Secondary outcomes revealed a significantly reduced risk of major bleeding with DOACs compared to warfarin, while gastrointestinal bleeding showed a non-significant decrease. Intracranial hemorrhage risk was significantly lower with DOACs compared to warfarin. DOACs demonstrate superior safety and efficacy compared to warfarin, evidenced by reduced rates of all-cause death, ischemic stroke, severe bleeding, and cerebral hemorrhage. Further randomized controlled trials are essential to enhance the evidence base for DOACs across diverse patient populations.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 10","pages":"6052-6061"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584467","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}

{"title":"Implantation of an Extravascular Implantable Defibrillator Using a Substernal Lead in a Patient with Previous Cardiac Surgery.","authors":"Alexander Breitenstein, Jean-Yves Delaite, Nicolas Dayal","doi":"10.19102/icrm.2024.15104","DOIUrl":"10.19102/icrm.2024.15104","url":null,"abstract":"<p><p>We present the case of a 52-year-old man suffering from malignant mitral valve prolapse syndrome. He underwent a right-sided thoracotomy for mitral valve repair but required implantable cardioverter-defibrillator (ICD) implantation 4 years later. He chose the option of a substernal ICD, which was implanted successfully without any complications and good electrical parameters.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 10","pages":"6062-6065"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584468","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}

{"title":"Permanent Pacing Reduces Blood Pressure in Older Patients with Drug-resistant Hypertension: A New Pacing Paradigm?","authors":"Bich Lien Nguyen, Michael H Burnam, Francesco Accardo, Angela Angione, Roberto Scacciavillani, Carly Pierson, Eli S Gang","doi":"10.19102/icrm.2024.15091","DOIUrl":"10.19102/icrm.2024.15091","url":null,"abstract":"<p><p>Hypertension (HTN) is a major contributor to cardiovascular mortality. Many patients with drug-resistant hypertension (DRH) also require permanent pacing (PP). This large retrospective study evaluated the effect of PP for conventional PP indications in older patients with DRH. We reviewed the charts of 176 patients with dual-chamber PP and DRH. The effects of PP on systolic and diastolic blood pressure (sBP and dBP), the number of HTN-related medications, and left ventricular ejection fraction (LVEF) were assessed at 6 months post-implantation and compared with pre-implantation values. Patients were followed up with for ≥72 months. Patients with a decline of >5 mmHg in sBP and decrease in at least one anti-HTN medication were defined as responders (126/176; <i>P</i> < .01). The mean decline in sBP was 9 mmHg, while that in dBP was 3 mmHg (<i>P</i> < .001 for both). Among responders, optimal reductions in sBP, dBP, and medications were seen at a stratification of >50% atrial pacing and <40% ventricular pacing (-12, -6.3, and -1.6, respectively). When right ventricular pacing of <50% was used for dichotomizing, the optimal atrial/ventricular pacing stratification was atrial pacing > 50% and ventricular pacing < 40% (-11.3, -6.3, and -1.6, respectively). A relationship between increasing atrial pacing and a decline in sBP was noted but did not reach statistical significance. However, of those responders who had a >10-mmHg decline in sBP, the majority were paced between 60%-100% in the atria. The LVEF did not change post-PP in either group. In conclusion, PP results in significant improvement in BP control. The observed association warrants further investigation.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 9","pages":"6014-6021"},"PeriodicalIF":0.0,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381847","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}

{"title":"Efficacy and Safety of Intravenous Diltiazem Versus Metoprolol in the Management of Atrial Fibrillation with Rapid Ventricular Response in the Emergency Department: A Comprehensive Umbrella Review of Systematic Reviews and Meta-analyses.","authors":"Fnu Jaya, Maria Afzal, Fnu Anusha, Muskan Kumari, Ajay Kumar, Saqib Saleem, Aman Kumar, Vishal Bhatia, Rabia Islam, Manoj Kumar, Rameet Kumar, Hamza Islam, Muhammad Ali Muzammil, Satesh Kumar, Mahima Khatri","doi":"10.19102/icrm.2024.15095","DOIUrl":"10.19102/icrm.2024.15095","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is the most common cardiac arrhythmia in the United States, affecting 2.7-6.1 million people. AF can cause symptoms, but when it triggers a rapid ventricular response (RVR), most patients suffer from decompensation. Therefore, we performed an umbrella review of systematic reviews and meta-analyses comparing intravenous (IV) metoprolol and diltiazem to identify discrepancies, fill in knowledge gaps, and develop standardized decision-making guidelines for physicians to manage AF with RVR. A comprehensive search was conducted in PubMed, the Cochrane Library, and Scopus to identify studies for this umbrella review. The overall certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation method, while the quality of the included reviews was evaluated using AMSTAR 2, the Cochrane Collaboration tool, and the Newcastle-Ottawa scale. This study comprehensively analyzed four meta-analyses covering 11 randomized controlled trials and 19 observational studies. The analysis showed that IV diltiazem treatment was significantly more successful in rate control for AF with rapid ventricular response (RVR) than IV metoprolol (risk ratio [RR], 1.30; 95% confidence interval [CI], 1.09-1.56; <i>I</i> ² = 0%; <i>P</i> = .003). IV diltiazem also led to a significantly greater reduction in ventricular rate (mean difference, -14.55; 95% CI, -16.93 to -12.16; <i>I</i> ² = 72%; <i>P</i> < .00001), particularly at 10 min. The analysis also revealed a significantly increased risk of hypotension associated with treatment with IV diltiazem (RR, 1.43; 95% CI, 1.14-1.79; <i>I</i> ² = 0%; <i>P</i> = .002). In conclusion, IV diltiazem therapy achieved better rate control and ventricular rate decrease than metoprolol therapy in AF with RVR. Future clinical trials should compare calcium channel blockers and β-blockers for heart rate control efficacy and safety, considering adverse events.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 9","pages":"6022-6036"},"PeriodicalIF":0.0,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381846","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}

{"title":"Pacing-facilitated Short-long-short Sequences Leading to Ventricular Tachyarrhythmias: A Brief Report.","authors":"Hafez Golzarian, Mohammad Shaikh, Fayaz A Hakim","doi":"10.19102/icrm.2024.15093","DOIUrl":"10.19102/icrm.2024.15093","url":null,"abstract":"<p><p>Pacing-induced recurrent short-long-short sequences constitute an important yet overlooked mechanism for triggering ventricular tachyarrhythmias in patients with cardiovascular implantable electric devices. A careful and thorough retrospective analysis of patients' electrograms allows for a timely diagnosis with appropriate management.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 9","pages":"6011-6013"},"PeriodicalIF":0.0,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142383308","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}

{"title":"Sequential Isolation of Persistent Left Superior Vena Cava and Right Superior Vena Cava Using Pulsed-field Ablation with a Pentaspline Catheter for Recurrent Persistent Atrial Fibrillation.","authors":"Amulya Gupta, Murtaza Sundhu, Madhu Reddy, Seth H Sheldon, Amit Noheria","doi":"10.19102/icrm.2024.15092","DOIUrl":"10.19102/icrm.2024.15092","url":null,"abstract":"<p><p>Pulsed-field ablation (PFA) is a novel technology for atrial fibrillation (AF) ablation that can deliver energy precisely with a lower risk of damage to the surrounding organs. Persistent left superior vena cava (PLSVC) is a congenital variant that can act as a driver of AF, and its isolation may be required in recurrent persistent AF. We describe a case where PFA was used for isolation of the right superior vena cava, PLSVC, and posterior wall of the left atrium.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 9","pages":"6004-6010"},"PeriodicalIF":0.0,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381848","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}

{"title":"Letter from the Editor in Chief.","authors":"Devi Nair","doi":"10.19102/icrm.2024.15096","DOIUrl":"https://doi.org/10.19102/icrm.2024.15096","url":null,"abstract":"","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 9","pages":"A7-A8"},"PeriodicalIF":0.0,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142383307","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}

{"title":"Detection of Ventricular Tachycardia by an Implantable Cardiac Monitor 8 Months Post-myocardial Infarction.","authors":"Mario Volpicelli, Michele Capasso, Saverio Ambrosino, Orlando Munciguerra, Antonella Laezza, Ciro Pirozzi, Luigi Sena, Francesco Terracciano, Pasquale Merone, Carlo Carbone, Luigi Nunziata, Andrea Spadaro Guerra, Daniele Giacopelli, Luigi Caliendo","doi":"10.19102/icrm.2024.15094","DOIUrl":"10.19102/icrm.2024.15094","url":null,"abstract":"<p><p>Following a non-ST-elevation myocardial infarction (MI), a 68-year-old hypertensive, severely obese woman with 45% left ventricular ejection fraction underwent an implantable cardiac monitor (ICM) insertion. After 8 months, the ICM remotely transmitted multiple non-sustained ventricular tachycardia episodes. Symptomatic during these events, the patient underwent an invasive electrophysiologic stimulation, which induced ventricular arrhythmia. Subsequently, implantable cardioverter-defibrillator implantation was recommended. Continuous remote monitoring via an ICM detected critical arrhythmias in this post-MI patient, facilitating timely intervention.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 9","pages":"6037-6040"},"PeriodicalIF":0.0,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381845","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}

{"title":"Comparative Analysis of Clinical Outcomes of High-power, Short-duration Ablation versus Low-power, Long-duration Ablation Strategy in Patients with Atrial Fibrillation: A Comprehensive Umbrella Review of Meta-analyses.","authors":"Peddi Pavani, Olusegun Abiola Olanrewaju, Raja Subhash Sagar, Monika Bai, Jai Chand, Vishal Bhatia, Fnu Sagar, Fnu Karishma, Hamza Islam, Aman Kumar, Fnu Versha, Rabia Islam, Taha Nadeem","doi":"10.19102/icrm.2024.15083","DOIUrl":"10.19102/icrm.2024.15083","url":null,"abstract":"<p><p>Atrial fibrillation (AF) affects around 33 million people worldwide, rendering it a common cardiac arrhythmia. Catheter ablation (CA) has evolved as a leading therapeutic intervention for symptomatic AF. This umbrella review systematically evaluates existing systematic reviews and meta-analyses to assess the safety, efficacy, and potential of high-power, short-duration (HPSD) ablation as an alternative therapy option for AF. A thorough exploration was undertaken across PubMed, the Cochrane Library, and Embase to identify pertinent studies for inclusion in this umbrella review. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method was employed to assess the overall certainty of the evidence comprehensively, and the quality of the incorporated reviews was meticulously evaluated through use of the AMSTAR 2 tool, the Cochrane Collaboration tool, and the Newcastle-Ottawa scale. In this study, we initially identified 35 systematic reviews and meta-analyses, narrowing them down to a final selection of 11 studies, which collectively integrated data from 6 randomized controlled trials and 26 observational studies. For primary efficacy outcomes, the HPSD approach led to a non-significant decrease in the risk of atrial tachyarrhythmia recurrence (risk ratio [RR], 0.88; 95% confidence interval [CI], 0.70-1.12; <i>I</i> ² = 90%; <i>P</i> = .31) and a significantly reduced risk of AF recurrence (RR, 0.53; 95% CI, 0.42-0.67; <i>I</i> ² = 0%; <i>P</i> < .00001) compared to the low-power, long-duration (LPLD) approach. In terms of primary safety outcomes, the HPSD approach significantly reduced the risk of esophageal thermal injury (ETI) (RR, 0.71; 95% CI, 0.61-0.83; <i>I</i> ² = 0%; <i>P</i> < .00001) and facilitated a non-significant decrease in the risk of other major complications (RR, 0.87; 95% CI, 0.73-1.03; <i>I</i> ² = 0%; <i>P</i> = .10). In conclusion, HPSD therapy is safer and more effective than LPLD therapy, facilitating decreased AF recurrence rates along with reductions in ETI, total procedure duration, ablation number, ablation time, fluoroscopy time, and acute pulmonary vein reconnection.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"15 8","pages":"5963-5980"},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082051","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}