Pacing and clinical electrophysiology : PACE最新文献

{"title":"Risk of Symptomatic Pulmonary Vein Stenosis After Atrial Fibrillation Ablation With High-Power Short-Duration Approach.","authors":"Pietro Palmisano, Zefferino Palamà, Antonio L Bartorelli, Salvatore Bonanno, Giuseppe Tricarico, Pasquale Crea, Giovanni Coluccia","doi":"10.1111/pace.70040","DOIUrl":"10.1111/pace.70040","url":null,"abstract":"<p><strong>Background: </strong>Symptomatic pulmonary vein stenosis (sPVS) is a rare but severe complication of transcatheter atrial fibrillation (AF) ablation. High-power, short-duration (HPSD) and very HPSD (vHPSD) approaches for radiofrequency (RF) AF ablation have been shown to improve procedural efficiency, with effectiveness and a short-term safety profile comparable to conventional standard-power long-duration (SPLD) ablation. Findings from some previous reports suggest that HPSD may be a risk factor for the development of sPVS. The aim of this multicenter, observational analysis was to compare the incidence of sPVS after AF ablation with HPSD, vHPSD, and SPLD.</p><p><strong>Methods: </strong>Data from 436 consecutive patients (63.1 ± 9.5 years, 66.5% male, 70.9% with paroxysmal AF) undergoing RF AF ablation were reviewed: 64 were ablated with HPSD, 71 with vHPSD, and 301 with SPLD. The incidence of sPVS during follow-up was assessed.</p><p><strong>Results: </strong>There were no significant differences in baseline characteristics between the three groups. During a median follow-up of 20 months, 9 cases of sPVS were identified: 7 (10.9%) in HPSD group, 1 (1.4%) in vHPSD group, and 1 (0.3%) in SPLD group (p < 0.001). The use of HPSD approach was an independent predictor of sPVS (hazard ratio, 20.226; 95% confidence interval, 20.49-164.59; p = 0.005) on multivariable analysis. Seven of 9 patients underwent percutaneous PVs angioplasty and stent implantation (3 veins in 4 patients, 2 veins in 2 patients, 1 vein in 1 patient).</p><p><strong>Conclusions: </strong>The results of this observational analysis suggest that RF AF ablation using HPSD approach may be associated with an increased risk of sPVS.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1191-1195"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035102","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":"The Postoperative S Wave in Lead V₅ and/or V₆ Predicts Better Clinical Outcomes in Heart Failure Patients With Left Bundle Branch Area Pacing.","authors":"Kailun Zhu, Chen He, Haojie Zhu, Chuangshi Wang, Xiaofei Li, Xiaohan Fan","doi":"10.1111/pace.70031","DOIUrl":"10.1111/pace.70031","url":null,"abstract":"<p><strong>Background: </strong>S wave in lead V_5/6 has been reported as a marker indicated for successful left bundle branch (LBB) capture. This study aimed to evaluate the value of the S wave in lead V_5/6 in predicting the long-term clinical outcomes in heart failure (HF) patients treated with left bundle area pacing (LBBAP).</p><p><strong>Methods: </strong>Consecutive HF patients receiving LBBAP were prospectively enrolled and followed at least 2 years. ECG were analyzed to identify the S wave in lead V_5/6. The composite end point was all-cause mortality, HF hospitalization, and malignant ventricular arrhythmias. Non-response to LBBAP delivered cardiac resynchronization therapy (CRT) was defined as left ventricular ejection fraction improvement <5% at 6 months after implantation.</p><p><strong>Results: </strong>A total of 57 patients were included with the mean age of 59.90 ± 12.57 years and 39 (68.42%) males. S wave in V_5/6 was observed in 38 patients. During a mean follow up of 29.84 ± 12.51 months, Kaplan-Meier curves showed a 77.8% reduction in risk of composite end point for V_5/6 with S (HR 0.222; 95% CI 0.065, 0.756; log-rank, p = 0.0069). Multivariate Cox regression analysis revealed that V_5/6 with S was associated with a lower risk of the composite end point by 69.0% (adjusted HR 0.31; 95% CI 0.09, 1.05; p = 0.041). The non-response rate of LBBAP was 22.58% in V_5/6 with S and 58.82% in V_5/6 without S (p = 0.012).</p><p><strong>Conclusion: </strong>S wave in lead V₅ and/or V₆ after LBBAP predicts better clinical outcomes, and has a better response rate of LBBAP for CRT in HF patients.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1077-1085"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986885","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":"Near-Zero Fluoroscopy Ablation Workflow With a Circular Multielectrode Pulsed-Field Ablation Catheter.","authors":"Kennosuke Yamashita, Yohei Kikuchi, Keita Yoshiyama, Daiki Kumazawa, Yosuke Mizuno, Kosuke Onodera, Takehiro Nomura","doi":"10.1111/pace.70046","DOIUrl":"10.1111/pace.70046","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary vein isolation (PVI) using pulsed field ablation (PFA) is effective for treating atrial fibrillation (AF) but often requires fluoroscopy, posing risks of radiation exposure. Using a circular multi-electrode PulseSelect catheter along with 3D electroanatomical mapping (3D-EAM) and intracardiac echocardiography (ICE) enables pulmonary vein isolation (PVI) with near-zero fluoroscopy.</p><p><strong>Methods: </strong>All procedures were managed under general anesthesia. Following transseptal puncture, pre-mapping was conducted using a multi-electrode catheter. Based on these initial mappings, the PulseSelect catheter and guiding wire were visualized on the 3D-EAM to perform PVI. After the procedure, post-mapping was carried out to confirm that there was no electrical reconnection in the treated areas.</p><p><strong>Results: </strong>The median times for isolation of the left and right pulmonary veins were 9.0 and 11.0 min, respectively. Total procedure time averaged 48.5 min, with fluoroscopy time limited to 0.1 min for initial registration. Pre- and post-mapping indicated minimal deviations in catheter positioning, demonstrating controlled ablation without significant procedural complications. Holter monitoring at three months showed a low recurrence rate of atrial arrhythmias.</p><p><strong>Conclusion: </strong>The near-zero fluoroscopy PFA workflow using the PulseSelect catheter, combined with 3D-EAM and ICE, significantly reduces radiation exposure, enhances procedural safety, and maintains efficacy in AF ablation. This approach confirms the feasibility of reducing reliance on fluoroscopy while ensuring accurate and safe ablation outcomes.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1196-1202"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071609","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 Noteworthy Case of Device Detected Dual Tachycardia.","authors":"Thaïs Pittet, Etienne Delacrétaz, Denis Graf, Hari Vivekanantham","doi":"10.1111/pace.70034","DOIUrl":"10.1111/pace.70034","url":null,"abstract":"","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1103-1105"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986787","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":"From Clinic to Cloud: Efficacy of AI-Assisted Remote Monitoring of Patients With Implantable Cardiac Devices.","authors":"Cheyenne S L Chiu, Willem Gerrits, Marco Guglielmo, Maarten J Cramer, Pim van der Harst, René van Es, Mathias Meine","doi":"10.1111/pace.70036","DOIUrl":"10.1111/pace.70036","url":null,"abstract":"<p><p>The integration of telehealth, particularly remote monitoring (RM), has profoundly improved the care of patients with cardiac implantable electronic devices (CIEDs). The recent COVID-19 pandemic has further accelerated the adoption of RM systems. The implementation of RM to standard clinical care has been accompanied by a surge of device transmissions. Especially unscheduled transmissions have resulted in an overwhelming workload for clinicians. As the number of device transmissions is expected to increase further while clinical resources remain limited, workflow optimization is crucial. Artificial intelligence (AI) presents a promising solution. This review outlines recent advances in RM and AI applications for CIEDs. It explores the potential of AI to streamline RM workflows, reduce clinician workload, and enhance heart failure care by enabling early detection of clinical deterioration and timely intervention. In addition, key barriers to implementation are addressed, including data standardization and regulatory considerations. Beyond improving monitoring efficiency and patient outcomes, AI-supported RM may also help expand access to care through more effective resource allocation and contribute to a more sustainable, future-proof healthcare system.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1106-1113"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986815","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":"Successful Implantation of New Coronary Sinus Lead Using Angioplasty for Lead-Related Vein Occlusion in a CRT-D Patient.","authors":"Ramazan Gunduz, Bekir Serhat Yildiz","doi":"10.1111/pace.70011","DOIUrl":"10.1111/pace.70011","url":null,"abstract":"<p><p>This case is a rare occurrence of atrial and coronary sinus (CS) lead dislocation 5 years post cardiac resynchronization therapy-defibrillator (CRT-D) implantation, thus necessitating a unique approach. The previous lead-related vein occlusion was dilated with a balloon using methods typically employed in coronary procedures to address stenosis at the lateral branch of the CS, followed by insertion of a new lead. Materials and techniques used in coronary artery interventional procedures can also be applied in cases of CS vein branch stenosis encountered during CRT-D implantation. This case represents one of the rare procedures performed in this manner.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1073-1076"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986910","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":"Racial Differences in Length of Stay After Atrial Fibrillation Ablation.","authors":"Waseem Nosair, Yasmina Sirgi, Evan Czulada, Nebu Alexander, Jamal Smith, Sarahfaye Dolman, Apostolos Tsimploulis, Athanasios Thomaides, David Strouse, Zayd Eldadah, Sung Lee, Morgana Mongraw-Chaffin, William S Weintraub","doi":"10.1111/pace.70029","DOIUrl":"10.1111/pace.70029","url":null,"abstract":"<p><strong>Background: </strong>Racial and sex disparities in catheter ablation (CA) utilization for atrial fibrillation (AF) have been documented. Less is known about race and sex differences in comorbidity burden and quality of care outcomes after CA.</p><p><strong>Objectives: </strong>We sought to characterize racial and sex differences in patient and procedural characteristics and their impact on prolonged length of stay (LOS) after CA for AF.</p><p><strong>Methods: </strong>A retrospective cohort of patients that received CA for AF between 2018 and 2024 was developed from our single center NCDR registry. The analysis was restricted to non-Hispanic White (NHW) and non-Hispanic Black (NHB) patients due to small sample sizes for other groups. The association between race, sex, and prolonged LOS was evaluated using a multivariable stepwise regression model. A sensitivity analysis was performed with the composite outcome of complications given its sparsity. Causal mediation analysis was performed to assess whether race differences in prolonged LOS were mediated by complications.</p><p><strong>Results: </strong>Between 2018 and 2024, 3345 patients were included in the cohort. NHB patients were younger and more likely to have Medicaid insurance, higher BMI, higher comorbidity burden, history of atrial flutter, prolonged LOS, and complications after ablation. They were less likely to have prior CA. Female patients were older, less likely to have private insurance and prior CA, and more likely to have paroxysmal AF, transient ischemic attack, and chronic lung disease. NHB race [aOR 1.90 (95% CI: 1.24-2.88), p = 0.003] and a composite outcome of procedural complications [aOR 156 (95% CI: 72.5-377), p < 0.001], but not sex, were independently associated with prolonged LOS. The effect of race on prolonged LOS was partially mediated by higher comorbidity burden and obesity among NHB, but not by complications, Medicaid status, or AF type.</p><p><strong>Conclusion: </strong>Prolonged LOS was more frequent among NHB patients undergoing CA. The higher odds of prolonged LOS among NHB patients was not mediated by a higher incidence of complications, suggesting that other factors like comorbidity burden and social determinants of health (SDOH) are more significant contributors. Policies focused on improving comorbidity management and addressing sociocultural disparities may reduce prolonged hospitalizations after CA for AF.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1148-1156"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986888","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":"Initial Experience With Implantation Left Bundle Branch Pacing Leads Without a Dedicated Three-Dimensional Sheath.","authors":"Cord-Friedrich Niehaus, Guram Imnadze, Thomas Eitz, Heinrich Weglage, Vanessa Sciacca, Philipp Lucas, Lilit Antonyan, Sebastian E Beyer, Ersan Akkaya, Elias Waezsada, Yuri Bocchini, Mustapha El Hamriti, Stephan Winnik, Denise Guckel, Maxim Didenko, Moneeb Khalaph, Christian Sohns, Philipp Sommer, Thomas Fink","doi":"10.1111/pace.70039","DOIUrl":"10.1111/pace.70039","url":null,"abstract":"<p><strong>Aims: </strong>Left bundle branch area pacing (LBBAP) has emerged as an alternative to cardiac stimulation via right ventricular pacing and cardiac resynchronization therapy using coronary sinus leads. The approach utilizes dedicated three-dimensional guiding catheters for lead placement. Our objective was to evaluate the feasibility and safety of a simplified approach of implantation of an LBBAP electrode without a dedicated guiding catheter.</p><p><strong>Methods: </strong>This was a prospective single-center proof-of-concept evaluation. Patients with an indication for dual-chamber pacemaker implantation were consecutively enrolled. All patients received ventricular lead placement with a commercially available stylet-driven pacemaker lead. LBBAP was attempted without the use of a dedicated guiding catheter but with the help of a manually three-dimensionally pre-curved stylet.</p><p><strong>Results: </strong>A total of 24 patients were analyzed. Procedure and fluoroscopy durations were 61 ± 12 min and 7.4 ± 3.9 min, while LBBAP lead placement was successful in 19 patients (79%). In these patients, the V6-R-wave peak time was 74 ± 11 ms, the V1V6 interpeak interval was 51 ± 11 ms, and QRS width during unipolar stimulation was 123 ± 14 ms. No complications attributed to the transseptal route of the pacing lead occurred. After a mean follow-up of 104 ± 20 days, there was no significant change in QRS widths (123 ± 15 ms, p = 0.94), V6-R wave peak time (70 ± 11 ms, p = 0.3), and V1V6 interpeak interval (45 ± 10 ms; p = 0.12).</p><p><strong>Conclusion: </strong>Implantation of an LBBAP electrode without the use of a dedicated three-dimensional sheath is feasible and safe in a high proportion of patients. Further studies are necessary to define the impact of this technique for potential use in clinical routine.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1086-1093"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071602","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 Persistent Left Superior Vena Cava on Outcomes With Atrial Fibrillation Ablation.","authors":"Claire Sorensen, Ahmed Shahab, Jinxiang Hu, Raghu Dendi, Martin Emert, Amit Noheria, Rhea Pimentel, Rigoberto Ramirez, Y Madhu Reddy, Seth H Sheldon","doi":"10.1111/pace.70047","DOIUrl":"10.1111/pace.70047","url":null,"abstract":"<p><strong>Background: </strong>A persistent left superior vena cava (PLSVC) can be a trigger for atrial fibrillation (AF).</p><p><strong>Objective: </strong>We aimed to compare post-ablation 1-year freedom from recurrent atrial tachycardia (AT)/AF in PLSVC patients with a matched population without PLSVC (n-PLSVC).</p><p><strong>Methods: </strong>A single-center, retrospective, case-control study between 2008 and 2022. Pre-ablation imaging identified patients with PLSVC. Propensity score matching for age, sex, BMI, type of AF, AF ablation energy type, left atrial volume, and year of ablation was performed to identify five controls for each PLSVC patient. We excluded patients who had less than 1 year of follow-up post-ablation or underwent prior surgical ablation.</p><p><strong>Results: </strong>There were 90 total patients including 15 PLSVC patients and 75 matched controls (60 ± 10 years old, 31% women, 58% paroxysmal, 62% radiofrequency). One-year freedom from AF was lower with PLSVC (27%) than n-PLSVC (59%, p = 0.02). The PLSVC was targeted for ablation in 5/15 patients (33%), all of whom had recurrent AT/AF within 1 year. Redo AF ablations were performed in 40% (6/15) of PLSVC patients. Freedom from AF at last follow-up (median 2.1, IQR 0.5-4.0 years) was 83% in PLSVC patients who underwent redo ablation. The only complication was right atrial lead dysfunction post-ablation requiring lead revision.</p><p><strong>Conclusion: </strong>Although the post-ablation freedom from AF is lower in patients with PLSVC than n-PLSVC, repeat ablation can result in a high freedom from AF in patients with PLSVC. Further study is necessary to determine the optimal methods and role for PLSVC ablation (including the role for pulse-field ablation).</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1176-1183"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126972","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":"Efficacy of Delivery Catheter for the Right Ventricular Septal Placement of a Defibrillator Lead.","authors":"Hiroyuki Kato, Koudai Yamazaki, Taku Sakurai, Shinji Yamazoe, Kazuhito Tsuzuki, Kazumasa Suga, Tomoyuki Ota, Hisashi Murakami, Kenji Kada, Naoya Tsuboi, Satoshi Yanagisawa, Yasuya Inden, Toyoaki Murohara","doi":"10.1111/pace.70060","DOIUrl":"https://doi.org/10.1111/pace.70060","url":null,"abstract":"<p><strong>Background: </strong>Right ventricular (RV) septal placement of implantable cardioverter-defibrillator (ICD) leads has been proposed as an alternative to conventional apical placement. However, optimal techniques for accurate septal defibrillator lead implantation remain to be established.</p><p><strong>Methods: </strong>This single-center, retrospective study analyzed 37 patients with cardiomyopathy who underwent ICD implantation with intended RV septal defibrillator lead placement. Patients were categorized into two groups based on the implantation technique: delivery catheter (n = 7) or stylet system (n = 30). Myocardial current of injury (COI) monitoring was used in the delivery catheter group to guide lead fixation. The lead position was assessed by cardiac computed tomography, and procedural outcomes were compared.</p><p><strong>Results: </strong>Accurate RV septal lead placement was achieved in 100% of the delivery catheter group compared to 60% in the stylet group (p = 0.047). The delivery catheter group also demonstrated significantly shorter lead implantation time (median 9 vs. 17 min, p = 0.016) and total fluoroscopy time (median 15 vs. 29 min, p = 0.009). Lead parameters and complication rates were comparable. A subclinical pericardial effusion was identified in one patient from the stylet group, in whom the lead was positioned in the RV free wall.</p><p><strong>Conclusion: </strong>The use of the delivery catheter with COI monitoring significantly enhanced the accuracy and efficiency of RV septal defibrillator lead implantation without compromising safety. This technique may offer procedural advantages over conventional stylet-based methods in patients with cardiomyopathy. Prospective studies are needed to establish more definitively the usefulness and safety of this approach.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145153141","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}