Journal of Arrhythmia最新文献

{"title":"Relationship between the atrial‐activation pattern around the triangle of Koch and successful ablation sites in slow‐fast atrioventricular nodal reentrant tachycardia","authors":"Tomonori Watanabe, Hitoshi Hachiya, Hiroaki Watanabe, Kazunori Anno, Takafumi Okuyama, Tomohiko Harunari, Ayako Yokota, Masashi Kamioka, T. Komori, Yuko Torigoe‐Kurosu, Hisaki Makimoto, T. Kabutoya, Y. Kimura, Y. Imai, K. Kario","doi":"10.1002/joa3.12999","DOIUrl":"https://doi.org/10.1002/joa3.12999","url":null,"abstract":"The precise details of atrial activation around the triangle of Koch (ToK) remain unknown. We evaluated the relationship between the atrial‐activation pattern around the ToK and success sites for slow‐pathway (SP) modification ablation in slow‐fast atrioventricular reentrant tachycardia (AVNRT).Thirty patients with slow‐fast AVNRT who underwent successful ablation were enrolled. Atrial activation around the ToK during sinus rhythm was investigated using ultra‐high‐density mapping pre‐ablation. The relationships among features of atrial‐activation pattern and success sites were examined.Of 30 patients (22 cryoablation; 8 radiofrequency ablation), 26 patients had a collision site of two wavefronts of delayed atrial activation within ToK, indicating a success site. The activation‐search function of Lumipoint software, which highlights only atrial activation with a spatiotemporal consistency, showed non‐highlighted area on the tricuspid‐annulus side of ToK. In 23 of the patients, a spiky potential was recorded at that collision site outside the Lumipoint‐highlighted area. Fifteen cryoablation patients with a success site coincident with a collision site outside the Lumipoint‐highlighted area had significantly more frequent disappearances of SP after initial cryoablation (46.7% vs. 0%, p = .029), fewer cryoablations (3.7 ± 1.8 vs. 5.3 ± 1.3, p = .045), and shorter procedure times (170 ± 57 vs. 228 ± 91 min, p = .082) compared to the seven cryoablation patients without such sites. Four patients had transient AV block by ablation inside the Lumipoint‐highlighted area with fractionated signals, but no patient developed permanent AV block or recurrence post‐procedure (median follow‐up: 375 days).SP modification ablation at the collision site of atrial activation of the tricuspid‐annulus side along with a spiky potential could provide a better outcome.","PeriodicalId":503071,"journal":{"name":"Journal of Arrhythmia","volume":"197 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139848759","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}

{"title":"Scores predicting atrial fibrillation after mitral valve surgery: Do we need a more specific score?","authors":"Monirah A. Albabtain, Elham A. Almathami, Haneen Alghosoon, Faisal F. Alsubaie, Ibrahim M. Abdelaal, Huda H. Ismail, Adam I. Adam, Amr A. Arafat","doi":"10.1002/joa3.13002","DOIUrl":"https://doi.org/10.1002/joa3.13002","url":null,"abstract":"Atrial fibrillation after cardiac surgery (POAF) is associated with increased morbidity and mortality. Several scores were used to predict POAF, with variable results. Thus, this study assessed the performance of several scoring systems to predict POAF after mitral valve surgery. Additionally, we identified the risk factors for POAF in those patients.This retrospective cohort included 1381 recruited from 2009 to 2021. The patients underwent mitral valve surgery, and POAF occurred in 233 (16.87%) patients. The performance of CHADS2, CHA2DS2‐VASc, POAF, EuroSCORE II, and HATCH scores was evaluated.The median age was higher in patients who developed POAF (60 vs. 54 years; p < .001). CHA2‐DS2‐VASc, POAF, EuroSCORE II, and HATCH scores significantly predicted POAF, with areas under the curve of the receiver operator curve (AUCROC) of 0.56, 0.61, 0.58, and 0.54, respectively. We identified age > 58 years, body mass index > 28 kg/m2, creatinine clearance < 90 mL/min, reoperative surgery, and preoperative inotropic and intra‐aortic balloon pump use as predictors of POAF. We constructed a score from these variables (PSCC‐AF). A score > 2 significantly predicted POAF (p < .001). The AUCROC of this score was 0.67, which was significantly higher than the AUCROC of the POAF score (p = .009).POAF after mitral valve surgery can be predicted based on preoperative patient characteristics. The new PSCC‐AF score significantly predicted POAF after mitral valve surgery and can serve as a bedside diagnostic tool for POAF risk screening. Further studies are needed to validate the PSCC‐AF‐mitral score externally.","PeriodicalId":503071,"journal":{"name":"Journal of Arrhythmia","volume":"356 14‐15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139796364","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}

{"title":"Clinical advantage of multidetector computed tomography‐guided trans‐septal puncture","authors":"Naoya Kataoka, T. Imamura","doi":"10.1002/joa3.13004","DOIUrl":"https://doi.org/10.1002/joa3.13004","url":null,"abstract":"","PeriodicalId":503071,"journal":{"name":"Journal of Arrhythmia","volume":"16 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139805500","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}

{"title":"Postural orthostatic tachycardia syndrome and other autonomic dysfunctions following COVID‐19: Incidence, characteristics, and associated factors","authors":"C. Tanking, C. Lakkananurak, C. Srisakvarakul, A. Jitpreeda, K. Threechod, D. Sukitpunyaroj","doi":"10.1002/joa3.13001","DOIUrl":"https://doi.org/10.1002/joa3.13001","url":null,"abstract":"Long‐COVID syndrome has become a new health concern. Many major clinical centers have experienced more patients with symptoms suggestive of autonomic dysfunction, especially postural orthostatic tachycardia syndrome (POTS) following COVID‐19. However, there is a lack of information regarding the incidence and associated factors in Asian population.A retro‐prospective study was conducted to evaluate patients with symptoms suggestive of POTS or other autonomic dysfunctions. These symptoms last at least 3 months after PCR‐proven COVID‐19. Exclusion criteria were age under 18 years old, pregnancy, and pre‐COVID‐19 autonomic dysfunction symptoms. Patients with a symptom severity score greater than two were assessed with blood tests, 24‐h Holter, 24‐h ambulatory blood pressure, echocardiogram, and head‐up tilt table (HUTT).Seven hundred ninety‐three patients were interviewed at 146 ± 37 days after COVID‐19. The majority of patients were middle‐aged females (53%). Of those, 15 patients had the symptom severity score greater than 2. Out of those 15 patients, 12 had positive HUTT (1 demonstrating POTS, 10 neurocardiogenic syncope, and 1 orthostatic hypotension). Among those with positive HUTT patients, C‐reactive protein (CRP) was significantly higher (OR 1.01; p‐value 0.041). Fatigue and dyspnea on exertion were the two most complaint symptoms.This study shows the incidence of autonomic dysfunction and POTS is 1.5% (12/793) and 0.1% POTS (1/793), respectively, in a primary care setting (among general post‐COVID‐19 patients). The most common symptoms for these patients were fatigue and dyspnea.","PeriodicalId":503071,"journal":{"name":"Journal of Arrhythmia","volume":"20 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139805757","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}

{"title":"Impact of age on hospital outcomes after catheter ablation for ventricular tachycardia","authors":"Mingliang Tan, Y. H. Yeo, Q. Ang, Chrystina Kiwan, O. Fatunde, Justin Z. Lee, Aneesh Tolat, D. Sorajja","doi":"10.1002/joa3.12998","DOIUrl":"https://doi.org/10.1002/joa3.12998","url":null,"abstract":"The real‐world data on the safety profile of ventricular tachycardia (VT) ablation among elderly patients is not well‐established. This study aimed to evaluate the procedural outcomes among those aged 18–64 years versus those aged ≥65 years who underwent catheter ablation of VT.Using the Nationwide Readmissions Database, our study included patients aged ≥18 years who underwent VT catheter ablation between 2017 and 2020. We divided the patients into non‐elderly (18–64 years old) and elderly age groups (≥65 years old). We then analyzed the in‐hospital procedural outcome and 30‐day readmission between these two groups.Our study included 2075 (49.1%) non‐elderly patients and 2153 (50.9%) elderly patients who underwent VT ablation. Post‐procedurally, elderly patients had significantly higher rates of prolonged index hospitalization (≥7 days; 35.5% vs. 29.3%, p < .01), non‐home discharge (13.4% vs. 6.0%, p < .01), 30‐day readmission (17.0% vs. 11.4%, p < .01), and early mortality (5.5% vs. 2.4%, p < .01). There was no significant difference in the procedural complications between two groups, namely vascular complications, hemopericardium/cardiac tamponade, cerebrovascular accident (CVA), major bleeding requiring blood transfusion, and systemic embolization. Through multivariable analysis, the elderly group was associated with higher odds of early mortality (OR: 7.50; CI 1.86–30.31, p = .01), non‐home discharge (OR: 2.41; CI: 1.93–3.00, p < .01) and 30‐day readmission (OR: 1.58; CI 1.32–1.89, p < .01).Elderly patients have worse in‐hospital outcome, early mortality, non‐home discharge, and 30‐day readmission following catheter ablation for VT. There was no significant difference between elderly and non‐elderly groups in the procedural complications.","PeriodicalId":503071,"journal":{"name":"Journal of Arrhythmia","volume":"26 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139805488","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}