Journal of Innovations in Cardiac Rhythm Management最新文献

{"title":"Ablating Left-sided Atrioventricular Accessory Pathways in Young Patients with Persistent Left Superior Vena Cava: Start in the Coronary Sinus.","authors":"Soham Dasgupta, Christopher Johnsrude","doi":"10.19102/icrm.2025.16121","DOIUrl":"10.19102/icrm.2025.16121","url":null,"abstract":"<p><p>While hemodynamically insignificant, a persistent left superior vena cava (PLSVC) draining to the coronary sinus (CS) may have important implications during an electrophysiology study and catheter ablation. Specifically, ablation of left-sided accessory pathways (APs) poses a special challenge secondary to the potential distortion of the mitral valve annulus (MVA) and the possibility of the AP comprising a discrete epicardial trunk involving CS musculature. Ablation of such pathways is more likely accomplished from within the CS rather than on the MVA after a transseptal puncture. We describe two pediatric cases with a PLSVC draining to a dilated CS in whom successful ablation of left-sided APs was accomplished from within the CS after failed ablation attempts on the MVA. Initial mapping and ablation in the CS after a careful evaluation of the coronary artery proximity may obviate the need for a transseptal puncture with its potential challenges.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 12","pages":"6520-6524"},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12772929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918790","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":"Tachycardia Termination Without Global Propagation: Is the Pacing Site In or Out?","authors":"Ozcan Ozeke, Dursun Aras, Serkan Topaloglu","doi":"10.19102/icrm.2025.16123","DOIUrl":"10.19102/icrm.2025.16123","url":null,"abstract":"<p><p>Ventricular tachycardia termination by pacing with non-global capture is a specific criterion for identifying a critical component of the re-entrant circuit, regardless of whether concealed entrainment can be demonstrated at that site. It is usually observed almost by chance, but it can also be intentionally demonstrated by introducing a single extrastimulus during tachycardia.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 12","pages":"6525-6528"},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12772931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918811","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":"Enhanced Detection of Atrial Fibrillation and Tachyarrhythmia Differentiation Using Atrial Electrograms in Single-chamber Implantable Cardioverter-defibrillators: A Retrospective Analysis.","authors":"Nithin Kumar Konanur Srinivasa, Canan Dilay Dirican, Atul Prakash","doi":"10.19102/icrm.2025.16122","DOIUrl":"10.19102/icrm.2025.16122","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is a common comorbidity among patients with implantable cardioverter-defibrillators (ICDs). The presence of AF in this patient population is associated with increased mortality and morbidity. Dual-chamber ICDs allow for atrial arrhythmia detection; however, they have higher complication rates of implantation compared to single-chamber ICDs. Recent advances have enabled single-chamber ICDs to incorporate atrial electrogram (AEGM) sensing via a floating atrial dipole, potentially improving AF detection and arrhythmia discrimination. This study evaluates the effectiveness of AEGM-enabled single-chamber ICDs in detecting AF and differentiating tachyarrhythmias compared to single-chamber ICDs without AEGM and subcutaneous ICDs (S-ICDs). A retrospective analysis was done on 128 patients who received single-chamber ICDs between 2015 and 2024. Patients were stratified into three groups: (1) ICDs with AEGM, (2) ICDs without AEGM, and (3) S-ICDs. Baseline characteristics, comorbidities, arrhythmia events, and device data were collected. Numbers of ventricular tachycardia (VT), supraventricular tachycardia (SVT), and AF events were evaluated in all three devices. Outcomes measured included the detection of new and prior AF, tachycardia classification, initiation of anticoagulation, anticoagulants, AF ablation, congestive heart failure exacerbations, hospital admissions, and mortality. Statistical comparisons were made using logistic regression analysis. ICDs with AEGM (group 1, n = 69) detected AF in 42% (n = 29) of patients, including 13% (n = 9) with newly diagnosed, asymptomatic AF. In contrast, ICDs without AEGM (group 2, n = 34) detected AF only in patients with a prior history (n = 11), with no new cases identified. S-ICDs (group 3, n = 25) detected one new AF case, confirmed by external monitoring. The detection rate of new-onset subclinical AF was significantly higher in group 1 compared to groups 2 and 3 (<i>P</i> < .05). Among nine new AF patients in group 1, anticoagulation was started in four patients, anti-arrhythmics were initiated in four patients, two patients underwent AF ablation, and one patient underwent direct current cardioversion. VT events in all groups were analyzed, and the appropriateness of the therapy was confirmed in group 1 with the availability of AEGM and in groups 2 and 3 with EGM morphology and irregularity of the R-R intervals. There was no statistical difference among the groups with VT management (<i>P</i> > .05). In conclusion, single-chamber ICDs equipped with AEGM capabilities significantly enhance the detection of asymptomatic and new-onset AF. This has important implications for the management and prevention of AF-related complications in high-risk populations. Though there was no difference in VT defibrillation among all three groups, the validation of VT/SVT/AF was much more decisive in ICDs with AEGM.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 12","pages":"6551-6556"},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12772930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918813","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":"State-of-the-art Laser Ablation for Cardiac Arrhythmias: Development and Future Perspective-A State-of-the-art Review.","authors":"Helmut Weber, Lutz Ruprecht, Michaela Sagerer-Gerhardt","doi":"10.19102/icrm.2025.16124","DOIUrl":"10.19102/icrm.2025.16124","url":null,"abstract":"<p><p>Cardiovascular laser application (CVLA) is an innovative approach in the field of cardiology aimed at treating various cardiovascular diseases, including cardiac arrhythmias, cardiomyopathies, systemic and pulmonary resistant hypertension, and varicose leg veins, by using a key technology, the laser. Tissue-selective photon absorption of the 1064-nm wavelength induces tissue-selective irreversible lesions of arrhythmogenic myocardium, modulation of retrocardiac ganglion plexi, and renal and pulmonary perivascular innervation. This review summarizes the development and the experimental and clinical results of the CVLA, highlighting its potential advantages over other catheter ablation methods. Based on its unique characteristics, laser treatment has the potential to become an all-pervasive, safe, and effective procedure for the benefit of countless patients.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 12","pages":"6529-6550"},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12772932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918820","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.2025.16125","DOIUrl":"10.19102/icrm.2025.16125","url":null,"abstract":"","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 12","pages":"A7-A8"},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12772928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918762","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":"Cardiac Implantable Electronic Device Placement in the Era of Transcatheter Tricuspid Replacement: Approaches and Challenges.","authors":"Robert D Schaller, Mikhael F El-Chami","doi":"10.19102/icrm.2025.16112","DOIUrl":"10.19102/icrm.2025.16112","url":null,"abstract":"<p><p>Transcatheter tricuspid valve (TV) interventions (TTVIs), which include transcatheter TV replacement (TTVR) and transcatheter tricuspid edge-to-edge repair (T-TEER), represent a natural evolution in percutaneous valve therapy. However, TTVIs face distinct challenges, chief among them being the frequent presence of transvenous cardiac implantable electronic device (CIED) leads crossing the TV. This review investigates contemporary CIED strategies that eliminate the need for transvenous leads crossing the TV, thereby facilitating safer and more durable integration of device therapy with emerging TTVI technologies.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 11","pages":"6478-6487"},"PeriodicalIF":0.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12694895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744953","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":"Short- and Mid-term Outcomes of the Extravascular Implantable Cardioverter-defibrillator in Pediatric and Adolescent Patients: A Single-center Experience.","authors":"Nikola Dragisic, Emily R Backes, Lindsey Malloy-Walton, Edo K Bedzra, William J Gibson, Philip M Chang","doi":"10.19102/icrm.2025.16113","DOIUrl":"10.19102/icrm.2025.16113","url":null,"abstract":"<p><p>Experience with the Aurora extravascular (EV) implantable cardioverter-defibrillator (ICD) (Medtronic, Minneapolis, MN, USA) remains limited among pediatric centers in contrast to its broader implantation in adults. We evaluated our single-center experience with the EV ICD as part of our standard ICD options for treatment of malignant ventricular arrhythmias in pediatric subjects. Following approval for EV ICD implantation at our center, five consecutive adolescent patients underwent implantation over a 7-month period. Patient characteristics, qualification for EV ICD placement, nuances in EV ICD implantation in each patient, and post-implant follow-up were reviewed. A total of six out of eight consecutive ICD candidates were identified as potential EV ICD candidates, with five patients undergoing eventual EV ICD implantation (average age, 16.8 years [range, 14-19 years]; four males). Indications for ICD included genetic arrhythmias (n = 3) and hypertrophic cardiomyopathy (n = 2). All patients underwent successful implantation without intraoperative or early postoperative complications. No lead dislodgement, device migration, infection, or inappropriate shocks were observed. All patients demonstrated appropriate R-wave sensing and stable lead parameters at early (4- to 6-week) and mid-term (>3- to 6-month) follow-up. Post-implant exercise testing in two patients showed no significant P- or T-wave oversensing. EV ICD implantation is feasible and well tolerated in appropriately selected pediatric patients. Most pediatric ICD referrals were candidates for EV ICD implant when integrating the EV ICD in regular practice. Implant indications differ among pediatric versus adult EV ICD recipients. While early outcomes are favorable, long-term performance and applicability in smaller patients require further investigation.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 11","pages":"6488-6495"},"PeriodicalIF":0.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12694893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745039","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.2025.16115","DOIUrl":"10.19102/icrm.2025.16115","url":null,"abstract":"","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 11","pages":"A7-A8"},"PeriodicalIF":0.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12694891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745049","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":"The Integral Role of Cardiac Imaging in the Electrophysiology Field.","authors":"Sunu Budhi Raharjo, Andi Muhammad Zharfan","doi":"10.19102/icrm.2025.16111","DOIUrl":"10.19102/icrm.2025.16111","url":null,"abstract":"<p><p>Cardiac imaging is crucial in the electrophysiology field, not only as a diagnostic tool but also to expand and guide interventional cardiac electrophysiology procedures. With this consideration in mind, this article aims to review the critical role of cardiac imaging in stratifying patients' risk profiles and assisting the electrophysiological procedure in various scenarios. This article also highlights the future direction within the cardiac electrophysiology field with digital twins, which incorporate cardiac imaging and clinical data to build physiologically accurate cardiac replicas to assist electrophysiological procedural planning.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 11","pages":"6496-6508"},"PeriodicalIF":0.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12694894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744332","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":"Anxiety and Depression in Heart Failure.","authors":"Maria Polikandrioti, Athanasia Tsami","doi":"10.19102/icrm.2025.16114","DOIUrl":"10.19102/icrm.2025.16114","url":null,"abstract":"<p><p>Patients with heart failure (HF) may experience depression or anxiety due to various reasons associated with their or caregivers' characteristics. The purpose of this study was to explore patients' and caregivers' characteristics associated with hospitalized HF patients' anxiety and depression. A total of 300 hospitalized HF patients with their caregivers were enrolled in the study. Data were collected using the Hospital Anxiety and Depression Scale, which also included patients' and caregivers' characteristics. The statistical significance level was set at <i>P</i> < .05. A statistically significant association was observed between patients' anxiety and age (<i>P</i> = .044), level of education (<i>P</i> = .015), type of diagnosis (<i>P</i> = .001), New York Heart Association (NYHA) class (<i>P</i> = .001), prior hospitalization within the current year (<i>P</i> = .013), current smoking (<i>P</i> = .001), frequency of physical exercise (<i>P</i> = .001), and their self-reported ability for symptom management after hospital discharge (<i>P</i> = .001). A statistically significant association was observed between patients' depression and age (<i>P</i> = .018), type of diagnosis (<i>P</i> = .001), NYHA class (<i>P</i> = .001), prior hospitalization within the current year (<i>P</i> = .004), current smoking (<i>P</i> = .001), occasional alcohol consumption (<i>P</i> = .026), frequency of physical exercise (<i>P</i> = .001), and their self-reported ability for symptom management after hospital discharge (<i>P</i> = .001). In terms of caregivers' characteristics, a statistically significant association was observed between patients' anxiety/depression and the relationship with caregivers (<i>P</i> = .006 and <i>P</i> = .001, respectively), whether caregivers declared added responsibilities among family members (<i>P</i> = .041 and <i>P</i> = .002, respectively), and whether they felt uncertain about patients' clinical outcome (<i>P</i> = .001 and <i>P</i> = .001, respectively). Finally, a statistically significant association was observed between patients' depression and the occupation of their caregivers (<i>P</i> = .038). Patients' characteristics associated with anxiety/depression were demographic and clinical, while caregivers' characteristics associated with patients' anxiety/depression were their self-reports and demographic characteristics. Knowledge of factors that influence anxiety and depression can enable health care professionals to offer appropriate interventions tailored to their needs.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 11","pages":"6509-6519"},"PeriodicalIF":0.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12694892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745008","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}