Journal of Innovations in Cardiac Rhythm Management最新文献

{"title":"A Novel Three-dimensional Mapping Device to Guide Lead Placement for Left Bundle Branch Area Pacing.","authors":"Mahmoud Ali, Lynn Erickson, Sisir Siddamsetti, Tarek Ajam, Mohammed Djelmami-Hani, Imran K Niazi","doi":"10.19102/icrm.2025.16104","DOIUrl":"10.19102/icrm.2025.16104","url":null,"abstract":"<p><p>Navik 3D (APN Health, Waukesha, WI, USA) is a navigation software program that uses two-dimensional (2D) fluoroscopy images to provide three-dimensional (3D) information. Left bundle branch area (LBBA) pacing (LBBAP) is a novel physiologic pacing technique where the lead is placed in the right ventricular (RV) basal septum to capture the left bundle branch (LBB). Precise lead placement in this region can be challenging using 2D fluoroscopy. We studied the feasibility of using Navik 3D to identify the location, plane, and depth of the lead in the septum to assist with LBBAP procedures. This observational, prospective single-center study included 14 patients undergoing LBBAP. Navik 3D was used to identify the LBBA, RV septum, RV apex, and lead position in three dimensions using two orthogonal 2D views. The 3D images were overlaid on real-time, gated fluoroscopic images for navigation of the lead. Images of the 3D locations and successful or unsuccessful lead locations were projected onto 2D fluoroscopic images, allowing for repositioning if necessary. All attempted patients had successful LBBA lead implants. An LBB potential was recorded in 61.5% of the patients. Selective LBBAP was achieved in 85% of the patients. The mean QRS duration postimplant was 129.8 ± 13.1 ms. The mean left ventricular activation time (stimulus R-wave peak in V6) postimplant was 75 ± 12 ms. No acute complications were recorded. 3D localization of the LBBA using the Navik 3D mapping system was feasible and may assist with more appropriate LBBA lead placement.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 10","pages":"6449-6454"},"PeriodicalIF":0.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12588583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460226","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.2025.16105","DOIUrl":"10.19102/icrm.2025.16105","url":null,"abstract":"","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 10","pages":"A7-A8"},"PeriodicalIF":0.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12588581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460415","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":"Speckle Tracking Echocardiography in Pediatric and Congenital Heart Disease Patients with the Micra™ Leadless Pacemaker.","authors":"Natalia Betancourt-Guzman, Jeremy Markowitz, Erick Jimenez, Daniel Cortez, Brenda Dugas, Daniel Peck, Matthew Ambrose, Bradley C Clark","doi":"10.19102/icrm.2025.16103","DOIUrl":"10.19102/icrm.2025.16103","url":null,"abstract":"<p><p>Right ventricular pacing can cause electrical and mechanical dyssynchrony, potentially leading to pacemaker-induced cardiomyopathy (PICM). This pilot study evaluates speckle tracking echocardiography for the early detection of subclinical left ventricular dysfunction in pediatric and congenital heart disease patients with Micra™ leadless pacemakers (Medtronic, Minneapolis, MN, USA). We analyzed echocardiograms of eight patients (mean age, 15 years; 63% women) with Micra™ pacemakers at implant and 1 month and 1 year post-implant. Data of interest included demographics, pacemaker position, ejection fraction (EF), shortening fraction, and global longitudinal strain (GLS). The pacing percentages varied from <0.1% to 100%, with three patients having burdens of >20%. The mean GLS was -17.99, and the mean EF was 59.6%. A higher EF correlated mildly with more-negative GLS values (<i>r</i> = 0.288; <i>P</i> = .218), and greater pacing percentages correlated with poorer GLS values (<i>r</i> = -0.381; <i>P</i> = .097). In summary, GLS has the potential to identify myocardial dyssynchrony, which may have the potential to support the early detection of PICM. Further research with larger cohorts and longer follow-up is needed to validate these findings.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 10","pages":"6473-6477"},"PeriodicalIF":0.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12588584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460422","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":"Impact of Coronavirus Disease 2019 on Sick Sinus Syndrome: Trends in Incidence and Pacemaker Implantation.","authors":"Dharmindra Dulal, Ahmed Maraey, Blair Grubb","doi":"10.19102/icrm.2025.16102","DOIUrl":"10.19102/icrm.2025.16102","url":null,"abstract":"<p><p>Sick sinus syndrome (SSS) is a cardiac conduction disorder that often necessitates pacemaker implantation, especially in older adults. Emerging evidence suggests a potential association between coronavirus disease 2019 (COVID-19) infection and SSS, but the impact on SSS trends and permanent pacemaker (PPM) implantation rates remains unclear. This study compares the pre- and post-COVID-19 trends in SSS incidence and PPM implantation rates. Using the TriNetX Research Network, we analyzed the monthly incidence rate (IR) of SSS and the rate of PPM implantation in the overall population from January 2018 to December 2023. Additionally, we conducted a subgroup analysis focusing on patients >50 years of age to examine trends in IR and PPM implantations during the same period. To evaluate changes before and after COVID-19, we used interrupted time series analysis, with March 1, 2020, as the cutoff. In the overall SSS population, the IR increased significantly post-COVID-19 (IR, 1.80 cases/100,000 person-years [PY] per month; <i>P</i> < .001), which was accompanied by a significant rise in PPM implantation rates (119.16 cases/100,000 PY per month; <i>P</i> < .001). Among patients <50 years of age, the IR increased post-COVID-19 (IR, 0.355 cases/100,000 PY per month; <i>P</i> < .001), but PPM implantation rates in this subgroup remained unchanged (<i>P</i> = .897). Our findings suggest an increase in SSS incidence across all age groups post-COVID-19. However, the lack of increased PPM implantation in younger patients may reflect either a more transient disease course or a higher threshold for device implantation in this age group. Further research is needed to determine the prognosis of SSS in the recent era.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 10","pages":"6456-6462"},"PeriodicalIF":0.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12588589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460362","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":"Totally Fluoroless Versus Limited Fluoroscopy-assisted Implantation: Identifying the Role of Fluoroscopy During Subcutaneous Implantable Cardioverter-defibrillator Implantation.","authors":"Stefanos Archontakis, Evangelos Oikonomou, Panagiotis Dourvas, Nikias Milaras, Damianos Kolios, Tzonatan Klogkeri, Epameinondas Triantafyllou, Christos Nikolaros, Anastasios Markakos, Artemis Papadima, Dimitra Tyrovola, Dimitrios Venetsanos, Dimitrios Sirseloudis, Sotirios Tsalamandris, Skevos Sideris","doi":"10.19102/icrm.2025.16101","DOIUrl":"10.19102/icrm.2025.16101","url":null,"abstract":"<p><p>The subcutaneous implantable cardioverter-defibrillator (S-ICD) has emerged as an alternative to conventional ICD systems. Although not considered mandatory, short-time fluoroscopy is used in clinical practice, both preprocedurally and intraoperatively. The aim of this study was to compare totally fluoroless versus limited fluoroscopy-assisted S-ICD implantation in terms of clinical and technical efficacy and safety. In this non-randomized, single-center study, 49 patients (24.5% women; mean age, 43.2 ± 18.4 years) at high risk for arrhythmic cardiac death underwent S-ICD implantation in the context of either primary or secondary prevention between May 2016 and June 2024 with at least 6 months of follow-up thereafter. Patients were allocated to group A (n = 25), where a totally fluoroless implantation strategy was followed (January 2023-June 2024), or group B, where a limited fluoroscopy-guided S-ICD implantation process (first 24 cases) was followed. Following implantation, a pre-discharge chest X-ray confirmed an anatomically acceptable lead position in all cases. Further, our data revealed similar acute and long-term clinical efficacy with both approaches: the success rate of defibrillation testing at 60 J was 100%, the appropriate shock rate was low (8.2%) with defibrillation therapy successful in all cases, the mean PRAETORIAN score remained in the low-risk category, and no arrhythmic deaths were recorded. The rate of inappropriate shocks was similar between groups (8% vs. 8.3%; <i>P</i> = .97 for groups A and B, respectively). Finally, no major periprocedural complications were recorded with either approach. Compared to the limited fluoroscopy-guided technique, totally fluoroless S-ICD implantation showed comparable efficacy, reliability, and safety in the present study.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 10","pages":"6463-6472"},"PeriodicalIF":0.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12588590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460481","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":"Brugadaphobia.","authors":"Laszlo Littmann, William C Bock","doi":"10.19102/icrm.2025.16091","DOIUrl":"10.19102/icrm.2025.16091","url":null,"abstract":"<p><p>We present the case of a young man with cocaine intoxication whose electrocardiogram (ECG) on presentation showed a typical type 1 Brugada pattern. The patient had no personal or family history of unexplained syncope or sudden cardiac death. The ECG quickly normalized, and follow-up ECGs continued to be normal. Nevertheless, the patient and family members insisted on implantation of a cardioverter-defibrillator. The purpose of this case report is to discuss the somewhat unfounded fear of sudden cardiac death of asymptomatic patients with Brugada-type ECGs that has been termed \"brugadaphobia\" and to highlight the difficult and controversial decision-making process that should include discussions about the possible benefits and harms of an overly active diagnostic and therapeutic approach.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 9","pages":"6420-6423"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12513726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281358","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":"Successful Cardiac Resynchronization Therapy Defibrillator Implantation via the Vein of Marshall in a Patient with Coronary Sinus Ostial Occlusion.","authors":"Farid Aliyev, Emin Karimli, Aytan Hajili","doi":"10.19102/icrm.2025.16094","DOIUrl":"10.19102/icrm.2025.16094","url":null,"abstract":"<p><p>Cardiac resynchronization therapy (CRT) is a well-established treatment for patients with heart failure and wide QRS complexes. Successful left ventricular (LV) lead implantation is typically achieved through the coronary sinus (CS). However, congenital anomalies such as CS ostial atresia can complicate the procedure. We report a case of a 65-year-old man with a history of aortic valve replacement and heart failure who underwent successful CRT-defibrillator implantation. During the procedure, CS ostial atresia was unexpectedly encountered, preventing standard venous access. The LV lead was successfully implanted via the vein of Marshall.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 9","pages":"6445-6448"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12513728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281334","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":"Tips and Tricks to Perform a Successful Vein of Marshall Alcohol Ablation.","authors":"Aashish Katapadi, Mahmoud Gomaa, Rayyan Bhutta, Aleena Arif, Emile Daoud, Muhammad R Afzal","doi":"10.19102/icrm.2025.16092","DOIUrl":"10.19102/icrm.2025.16092","url":null,"abstract":"<p><p>Marshall bundle ablation via retrograde ethanol infusion into the vein of Marshall (VoM) is one of the few adjunctive approaches complementary to the success of pulmonary vein (PV) isolation during catheter ablation for persistent atrial fibrillation (AF). VoM ablation also increases the success and durability of mitral isthmus block for the management of peri-mitral flutter. Despite its promise, the adoption of VoM ablation is limited due to anatomical variations that result in a steep learning curve. Successful Marshall bundle ablation requires accurate identification and successful cannulation of the VoM with an appropriate-size balloon to achieve adequate occlusion, followed by non-traumatic ethanol infusion. VoM ablation is often performed before wide-area circumferential ablation of the left-sided PVs. Mitral isthmus ablation to achieve mitral annular block is always recommended after VoM ablation to minimize the risk of peri-mitral flutter. This paper discusses a step-by-step approach for successful Marshall bundle ablation with tips and tricks for difficult cases based upon the performance of over 500 cases performed at the Ohio State University Medical Center.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 9","pages":"6424-6437"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12513730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281396","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":"A Case of Epicardial Ablation of the Sinus Node for the Treatment of Inappropriate Sinus Tachycardia.","authors":"Mahmoud Eldesouky, Noha Elbanhawy, Shajil Chalil, Khalid Abozguia","doi":"10.19102/icrm.2025.16093","DOIUrl":"10.19102/icrm.2025.16093","url":null,"abstract":"<p><p>Despite advancements in medical therapy, managing symptomatic inappropriate sinus tachycardia (IST) remains challenging. The role of catheter ablation in addressing this condition remains ambiguous according to multiple cardiac society guidelines. In this case study, we illustrate the efficacy of a hybrid approach involving sinus node modification and ablation in a patient with refractory symptoms, while also addressing the associated challenges and safety considerations of this procedure. A 58-year-old female patient was troubled with recurrent palpitations secondary to IST. Due to the proximity of the target ablation site to the phrenic nerve, this area was not amenable to complete ablation endocardially. To alleviate symptoms, an ablation procedure was planned, aiming for epicardial sinus node modification and displacement of the phrenic nerve from the target site. The procedure was completed under general anesthesia. The conventional subxiphoid technique was deemed challenging even with a surgical approach due to the patient's body habitus and significantly increased body mass index; hence, she underwent a 5-cm right anterior thoracotomy to establish access to the pericardium. The sinoatrial (SA) node was ablated surgically by direct application under vision of the right atrium around the area of the SA node to avoid the phrenic nerve. Modification and ablation of the sinus node in patients exhibiting features of IST may be considered to help alleviate patients' symptoms. Further follow-up and assessments with large cohorts and powered randomized controlled studies are needed. Our case represents an example where a hybrid invasive approach resulted in a safe procedure with immediate symptomatic benefit.</p>","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 9","pages":"6438-6444"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12513729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281339","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.2025.16095","DOIUrl":"10.19102/icrm.2025.16095","url":null,"abstract":"","PeriodicalId":36299,"journal":{"name":"Journal of Innovations in Cardiac Rhythm Management","volume":"16 9","pages":"A7-A8"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12513727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281388","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}