Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing最新文献

{"title":"Safety of ventricular tachycardia ablation under deep sedation with propofol and fentanyl.","authors":"Vera Maslova, Sophie Lange, Tim Kannenberg, Augustin Uckermark, Julius Nebendahl, Arne Clüver, Sami Srouji, Yara Scherkus, Adrian Zaman, Fabian Moser, Derk Frank, Evgeny Lian","doi":"10.1007/s10840-025-02081-0","DOIUrl":"https://doi.org/10.1007/s10840-025-02081-0","url":null,"abstract":"<p><strong>Background: </strong>There is no current standard of anaesthetic management for CA of VT. Data on VT ablation under deep sedation with propofol and fentanyl are limited.</p><p><strong>Objective: </strong>The aim was to evaluate the feasibility and safety of CA of VT under deep sedation with propofol and fentanyl.</p><p><strong>Methods: </strong>Data from 134 procedures in 106 patients undergoing CA for VT under sedation with propofol and fentanyl were prospectively included. Three groups were defined and compared: group 1 (no VT induction, n=36); group 2 (induction of hemodynamically unstable VT, n=42), and group 3 (induction of hemodynamically stable VT, n=56).</p><p><strong>Results: </strong>Median age was 64 years, 84% were male, and 97% had structural heart disease. Group 2 had a higher proportion of patients with DCM (p=0.04) and severely reduced LVEF (p=0.024). Unipolar RF ablation was performed in 95% of procedures, bipolar in 12%, and alcohol ablation in 4%. Epicardial access was utilized in 18%. Radiation dose was higher in group 2 (p=0.04), while post-ablation non-inducibility was more frequently achieved in group 3 (p=0.045). There were no cases of profound hypotension or intubation associated with sedation. CPR was performed in seven procedures due to PEA, all in group 2 (p<0.001) with ROSC achieved in all cases within 3 min. No differences were observed in complication rates or hospital stay.</p><p><strong>Conclusion: </strong>CA for VT under deep sedation with propofol and fentanyl in patients with structural heart disease is feasible and safe, irrespective of VT induction, mapping, and ablation approach. Hemodynamic instability, hypotension, and desaturation can be effectively managed.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304404","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":"Safety and performance of the Medtronic 3830 lead in His-bundle and Left bundle branch area pacing: A single-center experience.","authors":"Alejandro Sanchez-Nadales, Abdullah Sarkar, Jose Sleiman, Andres Sanchez-Nadales, Mileydis Alonso, John Bibawy, Marcelo Helguera, Sergio Pinski, Jose Baez-Escudero","doi":"10.1007/s10840-025-02070-3","DOIUrl":"https://doi.org/10.1007/s10840-025-02070-3","url":null,"abstract":"<p><strong>Background: </strong>Conduction system pacing (CSP) using His Bundle Pacing (HBP) and Left Bundle Branch Area Pacing (LBAP) is an evolving alternative to traditional right ventricular pacing (RVP), promising better physiological outcomes. This study evaluates the safety, feasibility, and performance of HBP and LBAP with Medtronic SelectSecure 3830 leads.</p><p><strong>Methods: </strong>We conducted a single-center retrospective analysis of 490 patients undergoing HBP or LBAP. The study assessed implant success rates, pacing thresholds, device longevity, and complication rates over an average follow-up of 28 months for HBP and 14 months for LBAP.</p><p><strong>Results: </strong>The implantation success rate was 85% for HBP and 97.4% for LBAP. LBAP demonstrated lower and more stable pacing thresholds, with initial values of 0.8V at 0.5 ms rising slightly to 0.9V at 0.5 ms, and fewer device revisions compared to HBP, whose initial pacing threshold of 1.3V at 0.8ms increased to 1.68 V at 0.7ms. Complications were minimal and similar across both groups. The need for fewer device revisions and potential for prolonged device life highlighted LBAP as potentially more cost-effective. Cardiac function measured by LVEF remained stable across both groups.</p><p><strong>Conclusions: </strong>Both HBP and LBAP are safe and feasible with comparable safety profiles. LBAP may offer advantages in terms of stability, fewer revisions, and extended device longevity. The study underscores the need for further research into optimal lead positioning and long-term outcomes of CSP, particularly for LBAP.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295617","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":"A systematic review and meta-analysis of artificial intelligence ECGs performance in the diagnosis of Brugada Syndrome.","authors":"Lucas M Barbosa, Roberto Mazetto, Maria L R Defante, Vânio L J Antunes, Vinicius Martins Rodrigues Oliveira, Douglas Cavalcante, Luanna Paula Garcez de Carvalho Feitoza, Ivo Queiroz, André Luiz Carvalho Ferreira, Guilherme Almeida, Elísio Bulhões, Maria do Carmo P Nunes, Mauricio Ibrahim Scanavacca, Francisco Darrieux, Josep Brugada","doi":"10.1007/s10840-025-02075-y","DOIUrl":"https://doi.org/10.1007/s10840-025-02075-y","url":null,"abstract":"<p><strong>Background: </strong>Brugada syndrome (BrS) is a serious condition linked to sudden cardiac death in individuals who are otherwise healthy. Notably, drug-induced BrS accounts for 50% to 70% of all documented cases. The utilization of artificial intelligence (AI) models in the analysis of electrocardiograms (ECGs) represents a promising approach for the detection of BrS.</p><p><strong>Purpose: </strong>This meta-analysis aims to evaluate the effectiveness of AI models in diagnosing BrS through ECG analysis.</p><p><strong>Methods: </strong>We conducted a systematic search across PubMed, Embase, and Cochrane databases, focusing on AI-based models for ECG analysis related to BrS detection. Key outcomes measured included sensitivity, specificity, and the summary receiver operating characteristic (SROC) curve. Pooled proportions were calculated using a random-effects model with 95% confidence intervals (CIs), and heterogeneity was using Zhou and Dendukuri I² approach. Additionally, a leave-one-out sensitivity analysis was performed to evaluate the impact of each one of the included studies on the pooled results and heterogeneity. All statistical analyses were conducted using R version 4.4.2.</p><p><strong>Results: </strong>Our analysis included six studies encompassing ECG data from 2,179 patients, all employing AI algorithms for ECG interpretation. The quantitative analysis revealed an area under the curve (AUC) of 0.898, a sensitivity of 78.9% (95% CI: 69.6 to 85.9), and a specificity of 87.7% (95% CI: 79.9 to 92.7). Notably, the sensitivity analysis without Zanchi et al., significantly reduced the heterogeneity (I² = 0%). However, the other analyses corroborated with our general findings.</p><p><strong>Conclusion: </strong>AI-driven ECG interpretation demonstrates to be a viable option in detecting BrS.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218511","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":"Optimal power settings have major impact on procedural efficiency in pulmonary vein isolation guided by robotic magnetic navigation.","authors":"Rita B Gagyi, Ioan A Minciuna, Tamas Geczy, Attila Nemes, Tamas Szili-Torok","doi":"10.1007/s10840-025-02058-z","DOIUrl":"https://doi.org/10.1007/s10840-025-02058-z","url":null,"abstract":"<p><strong>Introduction: </strong>Early reports on pulmonary vein isolation (PVI) for atrial fibrillation (AF) guided by robotic magnetic navigation (RMN) show comparable results to manual radiofrequency (RF) or cryoballoon ablation; however, lengthy procedures were reported. This could be due to suboptimal lesion formation caused by a lack of user experience and defined best practices. Operators performed RMN-guided RF ablation with lower power settings, presumably leading to longer procedures. In this study, we aimed to re-evaluate safety and efficiency of RMN-guided PVI for AF based on delivered radiofrequency power.</p><p><strong>Methods: </strong>Patients undergoing RMN-guided ablation were screened, and consecutive patients with AF undergoing PVI-only between 2008 and 2023 were retrospectively enrolled. Patients were grouped by the power settings utilized during the PVI procedure (group 1-25-30W, group 2-30-35W, group 3-35-40W, group 4-40-45W, group 5-45-50W, and group 6-50-55W). We collected and analyzed demographic data: age, sex, and AF type; safety data: intra- and post-procedural complications; procedural data: procedure duration, fluoroscopy time, RF ablation time, RF application number, and success rate; and follow-up data: AF recurrence and number of redo procedures.</p><p><strong>Results: </strong>From the total number of 3398 screened patients, 238 patients met the inclusion criterion of undergoing PVI-only procedure (mean age 60.4 ± 9.9 years, 63.8% male). Throughout the 15 years only five patients had major (2.2%) and 15 patients had minor complications (6.6%), without differences between the patient groups (p = 0.40 and p = 0.63). The mean procedure duration was progressively decreased with the use of higher RF power (273.9 ± 97.0, 179.8 ± 104.0, 134.9 ± 55.3, 134.0 ± 39.5, 118.1 ± 41.3, and 110.9 ± 39.0 min, respectively; p < 0.001). Median fluoroscopy time was 19.5 min (IQR 13.0-35.5), progressively decreasing within the power groups (58.2 ± 20.5, 40.5 ± 26.2, 15.9 ± 6.6, 17.8 ± 8.1, 17.4 ± 7.5, and 19.8 ± 9.3 min; p < 0.001). We found differences between the power groups in RF application number (p < 0.001) and RF application duration (p = 0.003). Successful PVI was achieved in 238 patients (100.0%). Twenty-one patients with paroxysmal AF (17.1%) and 31 patients with persistent AF (40.7%) had documented recurrence during the 12-month follow-up. We found no differences in AF recurrence between the patient groups (p = 0.18 and 0.66).</p><p><strong>Conclusions: </strong>RMN-guided PVI-only for AF is safe and feasible. In contrast to early reports, procedure times and fluoroscopy use gradually decreased during the years, when increasing RF power was applied. Higher power settings during robotically-guided PVI did not compromise the safety of the procedures.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228400","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":"Pulsed-field ablation beyond pulmonary vein for persistent atrial fibrillation: efficacy and impact on left atrial function.","authors":"Wael Zaher, Lorenzo Marcon, Domenico G Della Rocca, Kathleen Thayse, Emmanuel Tran-Ngoc, Klaus-Richard Ebinger, Giampaolo Vetta, Luigi Pannone, Serge Boveda, Carlo de Asmundis, Gian-Battista Chierchia, Antonio Sorgente","doi":"10.1007/s10840-025-02080-1","DOIUrl":"https://doi.org/10.1007/s10840-025-02080-1","url":null,"abstract":"<p><strong>Background: </strong>Pulsed field ablation (PFA) is a novel, non-thermal energy for atrial fibrillation (AF) catheter ablation that selectively targets cardiomyocytes with minimal to no risk of collateral damage. Among ablation strategies in persistent AF (PersAF), targeting sites other than the pulmonary veins (PVs) remains controversial, with concerns on improved success without increasing the risk of periprocedural complications and stiff left atrium (LA) syndrome. This study evaluates the impact of an ablation strategy beyond PVs using PFA on arrhythmia freedom and LA function in PersAF patients.</p><p><strong>Methods: </strong>This study included 93 patients with PersAF undergoing first-time PFA targeting PVs and other extra-PV targets. AF-related symptoms, adverse events, electrocardiograms, and transthoracic echocardiograms were assessed at follow-up visits at 1, 6, and 12 months.</p><p><strong>Results: </strong>Extra-PV targets included posterior wall (100%), anterior roof (50.5%), mitral isthmus (22.6%), anterior wall (36.6%), and right atrium applications (8.6%). No serious procedure-related adverse events were reported. At 1-year follow-up, 82.8% of patients were free from atrial arrhythmias. PFA significantly reduced A-wave velocity of mitral inflow and altered the E/A ratio but did not change LA compliance markers (e.g., LA strain reservoir and LA stiffness index (LASI)). LASI and left ventricular ejection fraction significantly improved from baseline in the PersAF > 3-month group.</p><p><strong>Conclusions: </strong>One-year atrial arrhythmia freedom in PersAF patients after extensive PFA by means of a multielectrode catheter was high. Extra-PV ablation was safe, did not alter LA compliance but promoted a positive reverse remodeling with improved LA compliance and left ventricular systolic function.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210729","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":"How to assess the impact of adjunct posterior wall isolation on left atrial function.","authors":"Naoya Kataoka, Teruhiko Imamura","doi":"10.1007/s10840-025-02056-1","DOIUrl":"https://doi.org/10.1007/s10840-025-02056-1","url":null,"abstract":"","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163903","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":"Differentiation of cardiac sarcoidosis from idiopathic dilated cardiomyopathy beyond patterns: a potential new quantitative CMR tool?","authors":"Nithi Tokavanich, Boldizsar Kovacs","doi":"10.1007/s10840-025-02069-w","DOIUrl":"https://doi.org/10.1007/s10840-025-02069-w","url":null,"abstract":"","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153287","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":"Phased RF ablation with PVAC gold: evolution favors only the strong.","authors":"David B De Lurgio","doi":"10.1007/s10840-022-01323-9","DOIUrl":"https://doi.org/10.1007/s10840-022-01323-9","url":null,"abstract":"","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":"349-350"},"PeriodicalIF":1.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40677809","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":"Autonomic cardiogastric neural interaction after pulmonary vein isolation in patients with atrial fibrillation.","authors":"Shinya Yamada,&nbsp;Takashi Kaneshiro,&nbsp;Naoko Hijioka,&nbsp;Kazuaki Amami,&nbsp;Yukiko Horikoshi,&nbsp;Yukio Yamadera,&nbsp;Takuto Hikichi,&nbsp;Akiomi Yoshihisa,&nbsp;Yasuchika Takeishi","doi":"10.1007/s10840-021-01004-z","DOIUrl":"https://doi.org/10.1007/s10840-021-01004-z","url":null,"abstract":"<p><strong>Purpose: </strong>Clinical significance of reduced vagal activity following pulmonary vein isolation (PVI) for atrial fibrillation (AF) remains unclear. Periesophageal vagal nerve injury following PVI may be a powerful contributing factor of decreased vagal tone.</p><p><strong>Methods: </strong>Drug-refractory 51 AF patients (31 males, 64 ± 11 years), who underwent successful PVI, were enrolled. We performed esophagogastroduodenoscopy 2 days after PVI and assessed delayed gastric emptying (DGE). Additionally, the coefficient of variance of R-R interval (CVRR) as a surrogate for vagal tone was measured before PVI, as well as at 1 day and 3 months after PVI. The patients were divided into two groups, patients with DGE and patients without DGE, and changes in CVRR were compared.</p><p><strong>Results: </strong>After PVI, 12 out of 51 patients (23.5%) had DGE. The baseline CVRR did not differ between the patients with (n = 12) and those without (n = 39) DGE (median 3.13%, interquartile range 1.69-5.13 vs. median 3.76%, interquartile range 2.96-5.90, P = 0.297). However, CVRR at 1 day after PVI was significantly lower in the patients with DGE than in those without (median 1.49%, interquartile range 0.90-2.19 vs. median 2.59%, interquartile range 1.58-3.86, P = 0.035), and then CVRR at 3 months became similar between the two groups, suggesting that the two groups had different changes in vagal tone after PVI. The recurrence of AF was similar at 3-6 months after PVI between the two groups.</p><p><strong>Conclusions: </strong>A significantly decreased CVRR immediately after PVI is a sign of DGE incidence, implying collateral damage to the esophagus.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":"357-364"},"PeriodicalIF":1.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10840-021-01004-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38954186","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":"Rhythmia zero-fluoroscopy workflow with high-power, short-duration ablation: retrospective analysis of procedural data.","authors":"Jose R Cuellar-Silva,&nbsp;Elizabeth M Albrecht,&nbsp;Brad S Sutton","doi":"10.1007/s10840-022-01283-0","DOIUrl":"https://doi.org/10.1007/s10840-022-01283-0","url":null,"abstract":"<p><strong>Background: </strong>Fluoroscopy is commonly used during atrial fibrillation (AF) ablation to guide catheter navigation and placement. Technology improvements have significantly reduced fluoroscopy time, and subsequent radiation dose, necessary to perform successful ablations. However, there is still no amount of radiation exposure known to be completely safe. The aim of this manuscript is to describe a detailed zero-fluoroscopy RHYTHMIA HDx workflow for AF ablation.</p><p><strong>Methods: </strong>This was an observational, single-center experience to describe the technique, acute procedural success, and safety using a novel zero-fluoroscopy workflow with the RHYTHMIA HDx mapping system and intracardiac echocardiography (ICE). Seventy-two consecutive patients undergoing de novo or redo AF ablation were retrospectively analyzed. Venous access was guided with ultrasound. ICE combined with the mapping system's magnetic tracking and sheath detection was used for precise catheter placement in the coronary sinus, at the transseptal puncture, and in the left atrium. A high-power, short-duration ablation strategy guided by local impedance was used. Pulmonary vein isolation was performed or touched up for all patients with additional lines added at the operator's discretion.</p><p><strong>Results: </strong>Using this zero-fluoroscopy workflow, all patients achieved acute isolation with no significant procedure-related complications. Average procedure time was 73.7 ± 16.2 min, which included persistent (58%) and paroxysmal (42%) AF cases, and no procedures required conversion to fluoroscopy.</p><p><strong>Conclusions: </strong>In this experience, a zero-fluoroscopy workflow using the RHYTHMIA HDx mapping system combined with ICE was feasible and safe for ablation in a heterogenous AF population. This approach, in the appropriate patient population, can eliminate radiation exposure to patients and staff.</p>","PeriodicalId":520675,"journal":{"name":"Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing","volume":" ","pages":"499-507"},"PeriodicalIF":1.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9640468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40407021","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}