Pacing and clinical electrophysiology : PACE最新文献

{"title":"Association Between Micra Transcatheter Pacing System Curvature and Capture Threshold During Implantation.","authors":"Qiang Xing, Zukela Tuerhong, Renqing Guo, Jiasuoer Xiaokereti, Jianghua Zhang, Yaodong Li, Xianhui Zhou, Baopeng Tang","doi":"10.1111/pace.70279","DOIUrl":"10.1111/pace.70279","url":null,"abstract":"<p><strong>Background: </strong>No previous studies have examined the relationship between Micra transcatheter pacing system (TPS) curvature and acceptable thresholds during implantation. This study aimed to evaluate the association between Micra TPS curvature and pre-deployment capture thresholds.</p><p><strong>Methods: </strong>The Micra TPS was successfully implanted with the assistance of right ventriculography in 180 patients. The curvature of the Micra TPS prior to deployment was analyzed using archived right anterior oblique (RAO) images from the first deployment, with the aid of Origin software (OriginLab Corporation, USA), while electrical parameters were recorded from 0 to 30 min at 10-min intervals.</p><p><strong>Results: </strong>Among 159 eligible patients, 126 (79.2%) demonstrated acceptable thresholds with a mean curvature of 0.58 ± 0.18. The high-threshold group (n = 33, 20.8%) exhibited significantly greater curvature (1.36 ± 0.64). Receiver operating characteristic analysis indicated that Micra TPS curvature ≤0.799 predicted acceptable thresholds with 90.9% sensitivity and 91.3% specificity (area under the curve = 0.958, 95% confidence interval: 0.924-0.992), with stable thresholds maintained in the acceptable group. No procedural complications occurred.</p><p><strong>Conclusions: </strong>A curvature of ≤0.799 in the RAO view of the Micra TPS prior to deployment reliably indicates acceptable capture thresholds. Combining curvature assessment with right ventriculography enhances the procedural safety of Micra implantation.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1588-1594"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147960656","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":"Bipolar Radiofrequency Ablation of Atrial Tachycardia Originating From RAA via Pericardium Pathway-A Case Report.","authors":"Liang Xiong, Lili Qiu, Xiaowen Xie, Dandan Wang, Juan Hua, Qinmei Xiong, Jinzhu Hu, Qi Chen","doi":"10.1111/pace.70242","DOIUrl":"10.1111/pace.70242","url":null,"abstract":"<p><p>Atrial tachycardia originating from the right atrial appendage was first reported more than a decade ago, which had been observed to occur more frequently in younger populations. Radiofrequency catheter ablation of this type of tachycardia often yielded suboptimal success rates, largely attributable to the complex anatomical structure of the right atrial appendage. In this report, we presented a successful case of bipolar radiofrequency ablation for atrial tachycardia arising from the right atrial appendage, which might offer a promising approach for the treatment of similar cases in the future.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1559-1562"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597733","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":"Left Bundle Branch Area Pacing Reverts Electromechanical Window Negativity to a Similar Extent as Biventricular Pacing.","authors":"Florien Klein, Metra Daliry, Karin C Smits, Edoardo Bressi, Peter M Deissler, Johan van Koll, Jesse H J Rijks, Antonius M W van Stipdonk, Rachel M A Ter Bekke, Domenico Grieco, Chiara Manfuro, Giorgia Spiridigliozzi, Annalisa Casalese, Justin G L M Luermans, Frits W Prinzen, Roel Meiburg, Leonard M Rademakers, Kevin Vernooy, Uyên Châu Nguyên","doi":"10.1111/pace.70250","DOIUrl":"10.1111/pace.70250","url":null,"abstract":"<p><strong>Background: </strong>Cardiac resynchronization therapy (CRT) through left bundle branch area pacing (LBBAP) has been associated with reduced arrhythmogenic risk compared to biventricular pacing (BiVP). Electromechanical window (EMW) is a marker of electromechanical instability, and a negative EMW is associated with ventricular arrhythmias. We hypothesized that LBBA-CRT increases EMW at least as much as BiVP-CRT does.</p><p><strong>Methods: </strong>129 CRT recipients (LBBAP: n = 63; BiVP: n = 66) were included. EMW and echocardiographic reverse remodeling were evaluated before and 6-12 months after CRT implantation in the entire cohort and in a subgroup of patients with a negative EMW at baseline. EMW is calculated by subtracting the QT interval from the time interval of QRS onset to the aortic valve closure artifact (QAoC) using CW-Doppler echocardiography.</p><p><strong>Results: </strong>EMW measurements were feasible in 67% of patients (n = 86). No significant difference in ΔEMW was observed between LBBAP and BiVP. In patients with a negative EMW at baseline, both CRT strategies led to significant EMW increase (LBBAP: n = 21, ΔEMW +13 ms (IQR -1 to 70), p = 0.003; BiVP: n = 36, ΔEMW +26 ms (IQR -2 to 54), p = 0.006). There was no significant difference between CRT groups (p = 0.779). Left ventricular ejection fraction improved by 10% ± 11% and end-diastolic volume decreased by 37 ± 51 mL (<0.001), with no significant differences between LBBAP and BiVP. In multivariable analysis, a negative EMW at baseline, but not echocardiographic reverse remodeling, was the only independent predictor of EMW increase.</p><p><strong>Conclusion: </strong>In CRT patients with a negative EMW at baseline, LBBAP and BiVP revert EMW to a similar degree.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1464-1472"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680225","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":"QT Interval Evaluation in Right Ventricular Pacing: Validation of a Novel Formula.","authors":"Amr Abdin, Alhasan Almasri, Ibrahim Antoun, Charles Gieres, Christian Werner, Yvonne Bewarder, Christian Ukena, Igor Schwantke, Michael Böhm, Saarraaken Kulenthiran","doi":"10.1111/pace.70239","DOIUrl":"10.1111/pace.70239","url":null,"abstract":"<p><strong>Background: </strong>QT interval measurement in the presence of right ventricular pacing (RVP) represents a clinical challenge. We therefore aimed to derive and validate a formula for QT estimation during RVP in a large cohort of pacemaker patients.</p><p><strong>Methods and results: </strong>We prospectively enrolled 100 patients in a derivation cohort and 487 in a validation cohort. Eligible patients had implanted pacemakers or implantable cardioverter-defibrillators, preserved atrioventricular conduction, and a narrow native QRS. Standardized 12-lead ECGs were recorded during intrinsic rhythm, atrial pacing (AP), and RVP at matched heart rates. Linear regression of QT during non-paced rhythm against paced QT yielded the equation: QT_non-paced = 139.23 + 0.55 × QT_paced. In the validation cohort (mean age 71 ± 13 years, 72% male), application of the formula showed a significant correlation between predicted and observed QT values (r = 0.50, p < 0.001). Bland-Altman analysis demonstrated a modest mean overestimation of 15 ms, with consistent accuracy across subgroups defined by sex, device type, and lead position. Compared directly with the Bogossian method, our formula showed superior performance, with a lower mean absolute deviation (26.2 vs. 39.9).</p><p><strong>Conclusion: </strong>This novel, heart rate-independent formula provides a reliable method for estimating the intrinsic QT interval from paced measurements. It represents a practical tool to improve QT assessment and arrhythmic risk evaluation in patients with RVP, with potential implications for clinical decision-making and drug safety monitoring.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1455-1463"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611575","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":"Safety and Performance of INVICTA DF4 Ventricular Defibrillation Lead: Results From APOLLO Prospective Multicenter Study.","authors":"Klaus K Witte, Juan Gabriel Martínez, Mário M Oliveira, Alberto Barrera, Maite Izquierdo, Cosimo Mandurino, Maria Emilce Trucco, José Juan García Salvador, Antoine Dompnier, Frédéric Jean, Pablo J Sánchez Millán, Carsten Israel, Maria Martino, Pedro Marques","doi":"10.1111/pace.70286","DOIUrl":"10.1111/pace.70286","url":null,"abstract":"<p><strong>Background: </strong>Implantable cardioverter-defibrillator (ICD) therapy relies on reliable right ventricular leads for pacing, sensing, and defibrillation. The INVICTA DF4 lead is an active-fixation, quadripolar design intended to optimize implant workflow and long-term safety and performance.</p><p><strong>Methods: </strong>APOLLO was a prospective, multicenter, single-arm, observational study enrolling adults across Europe with guideline-based indications for de novo ICD or Cardiac Resynchronization Therapy Defibrillator (CRT-D) implantation who received an INVICTA DF4 lead (single- or dual-coil; 58 or 68 cm). The co-primary endpoints focused on safety and performance at 3 months, while secondary endpoints included long-term electrical variables, arrhythmia termination, and lead-related complications through 24 months.</p><p><strong>Results: </strong>Between June 4, 2021, and October 19, 2022, 446 patients were implanted across 45 sites in 8 European countries. The INVICTA lead was successfully implanted in 100% of the 446 enrolled patients. Leads were positioned either in the apex in 57.2% or right ventricle (RV) septum in 42.8%. Electrical variables stabilized after discharge and remained stable up to 24 months (M24 mean pacing threshold 0.85 ± 0.33 V at 0.5 ms; sensing 13.39 ± 3.17 mV; pacing impedance 525.5 ± 94.2 Ohms; right ventricular (RV) coil continuity 427.8 ± 82.7 Ohms). Of 86 arrhythmic episodes requiring defibrillation, 97.7% were successfully terminated. Lead-related complication free rate was 97.5% at 30 days, 98.9% at 31-730 days, and 96.4% overall. Mortality was 8.5% (38/446) at two years, of which 63% was due to cardiovascular causes.</p><p><strong>Conclusions: </strong>In a large, contemporary European cohort, the INVICTA DF4 ventricular lead demonstrated high implant success, durable electrical performance, effective arrhythmia termination, and low complication rates through 24 months. A trend toward less complication in septal positioning was observed compared to apical placement, with comparable electrical performance.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1595-1603"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959381","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 Leadless Pacemaker Implantation Position on Subclinical Right Ventricular Perforation.","authors":"Young Shin Lee, Jae-Sun Uhm, Je-Wook Park, Seung-Jung Park, Ye Chan Kim, In-Soo Kim, Hye-Jeong Lee, Moon-Hyun Kim, Hanjin Park, Daehoon Kim, Hee Tae Yu, Tae-Hoon Kim, Jin-Bae Kim, Jong-Youn Kim, Boyoung Joung, Hui-Nam Pak, Moon-Hyoung Lee","doi":"10.1111/pace.70218","DOIUrl":"10.1111/pace.70218","url":null,"abstract":"<p><strong>Introduction: </strong>Leadless pacemakers are typically implanted in the mid-septum of the right ventricle (RV) to mitigate the risk of perforation. However, reports on the precise location of these implants are limited. This study aimed to elucidate tine-based leadless pacemaker position and presence of subclinical RV perforation through computed tomography (CT) imaging, along with the associated prognosis.</p><p><strong>Methods: </strong>Patients who underwent heart, chest or abdomen CT after leadless pacemaker implantation were consecutively included. Two cardiologists and one radiologist reviewed the CT images to assess the position of tines and to detect RV perforation. The implantation position was categorized as the septum, RV free wall, junction of septum and RV free wall, moderator band, and RV apex. Subclinical perforation was defined as the tines of a leadless pacemaker beyond the outer myocardial contour without symptoms, pericardial effusion, hemodynamic instability, or pacemaker malfunction.</p><p><strong>Results: </strong>A total of 88 patients (age, 72.9 ± 12.1 years; 42 males) were included. The interval between procedure and CT scanning was 8.6 ± 9.2 months. In 68 patients (77.3%), the leadless pacemaker was implanted at the junction of the septum and the RV free wall. Subclinical RV perforation occurred in 15 patients (17.0%). Among patients with RV perforation, the most common implantation site was the junction of the septum and the RV free wall. None of the patients with RV perforation experienced any adverse events for 12.4 ± 12.3 months.</p><p><strong>Conclusions: </strong>The most common leadless pacemaker implantation site is the junction of the septum and the RV free wall. Subclinical RV perforation is not uncommon and not associated with overt adverse outcomes.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1447-1454"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577667","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":"How Long Should We Wait? Revisiting the Observation Period After Drug-Related Advanced Atrioventricular Block.","authors":"Yalcin Velibey, Erkan Kahraman, Edibe Betul Borklu, Rengin Cetin Guvenc, Tolga Sinan Guvenc, Osman Bolca","doi":"10.1111/pace.70431","DOIUrl":"10.1111/pace.70431","url":null,"abstract":"","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1657-1661"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901799","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":"Same-Day Discharge After Cardiac Device Generator Replacement: Safety and Patient Acceptability.","authors":"Luigi Cocchiara, Benedetta Brescia, Mario Vaccariello, Gianluigi Comparone, Raffaele Mauriello, Lucio Addeo, Stefano Nardi, Procolo Marchese, Francesca Gennaro, Alfonso Varriale, Luigi Argenziano, Teresa Strisciuglio, Giovanni Esposito, Antonio Rapacciuolo","doi":"10.1111/pace.70459","DOIUrl":"https://doi.org/10.1111/pace.70459","url":null,"abstract":"<p><strong>Background: </strong>Same-day discharge after cardiac implantable electronic device generator replacement may reduce hospital resource use, but evidence regarding its safety and patient acceptability remains limited. We evaluated the feasibility, safety, and patient-reported acceptability of a day-surgery pathway for isolated generator replacement.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective observational study of consecutive adults undergoing isolated cardiac implantable electronic device generator replacement between February 2017 and October 2024. Procedures requiring lead revision, upgrade, extraction, or repositioning were excluded. Patients were managed either through a day-surgery pathway with same-day discharge or through an ordinary-setting pathway. The primary endpoint was device-related infection within 365 days. Secondary outcomes included pocket hematoma, patient preference, and recalled preprocedural anxiety assessed using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and the Anaesthesia and Surgery-dependent Preoperative Anxiety (ASPA) scale, administered during follow-up after the procedure. A hypothetical projection of bed-day cost savings was also performed.</p><p><strong>Results: </strong>A total of 416 procedures were analyzed: 216 in the day-surgery group and 200 in the ordinary-setting group. Within 365 days, device-related infection occurred in 4 patients in the day-surgery group and 5 in the ordinary-setting group (1.9% vs. 2.5%; p = 0.743). One pocket hematoma occurred in the day-surgery group and was managed conservatively without subsequent infection. Preference for day surgery was reported by 93.8% of evaluable patients in the day-surgery group and 76.0% in the ordinary-setting group (p < 0.001). Recalled preprocedural APAIS and ASPA scores were significantly lower in the day-surgery group. Using published Italian hospital micro-costing data as an illustrative benchmark, the 216 day-surgery procedures corresponded to a hypothetical reduction in hospital resource consumption of approximately €159,808.</p><p><strong>Conclusions: </strong>Same-day discharge after isolated generator replacement was feasible and well accepted and was not associated with a detectable increase in device-related infection within 365 days. Recalled preprocedural anxiety scores were lower among patients managed through the day-surgery pathway, although these assessments were obtained retrospectively during follow-up. Same-day discharge may represent a resource-saving organizational pathway for selected patients, but its economic impact requires assessment in a formal health-economic analysis.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122955","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":"Affordable and Efficient Anatomy Mapping for LBBAP in Dextrocardia With Complete Heart Block.","authors":"Chanadda Rutnuntamongkon, Ronpichai Chokesuwattanaskul","doi":"10.1111/pace.70443","DOIUrl":"https://doi.org/10.1111/pace.70443","url":null,"abstract":"<p><p>We reported the case of a 77-year-old woman with dextrocardia and complete heart block, demonstrating the effectiveness of simplified anatomical mapping imaging and modified catheter techniques to achieve selective left bundle branch pacing (LBBP).</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083776","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":"Lead-to-Vein Ratio and Long-Term Vascular Safety After Transvenous Pacing in Children Weighing ≤15 Kg.","authors":"Michel Cabrera Ortega, Juan Carlos Ramiro Novoa, Osmin Castañeda Chirino, Adel Eladio González Morejón, Giselle Serrano Ricardo, Yoel Coto Hernández, Mabel Elena Dominguez Gonzalez, Liz Coto Pérez, Agustín Fernández-Cisnal","doi":"10.1111/pace.70454","DOIUrl":"https://doi.org/10.1111/pace.70454","url":null,"abstract":"<p><strong>Background: </strong>Transvenous pacing in low-weight children is technically feasible, but its clinical use depends on long-term venous patency, system performance, and ventricular function. We aimed to describe imaging-defined venous abnormalities and clinically overt vascular events after first transvenous pacemaker implantation and to explore whether the lead-to-vein ratio provides anatomical information beyond body weight.</p><p><strong>Methods: </strong>This prospective observational cohort included 35 children weighing ≤15 kg undergoing first transvenous pacemaker implantation between 2010 and 2020. The primary vascular endpoint was imaging-defined venous thrombosis, occlusion, or stenosis ≥50%; clinical impact was recorded separately. Device-related safety, minimum venous diameter, lead-to-vein ratio, ventricular function, synchrony, and paced QRS duration were analyzed using non-parametric, exact, and exploratory univariable tests.</p><p><strong>Results: </strong>Median follow-up was 6.7 [4.5-8.2] years. Eleven patients weighed <10 kg and 3 weighed <5 kg. The imaging-defined vascular endpoint occurred in 6/35 patients; 5 were asymptomatic surveillance findings and 1 was clinically symptomatic. The lead-to-vein ratio was higher in patients with the endpoint than in those without events (0.59 [0.55-0.63] vs. 0.47 [0.43-0.51]; p = 0.003). A ratio >0.55 was associated with more frequent imaging-defined endpoints (4/8 vs. 2/27; odds ratio 12.5; 95% confidence interval 1.7-92.3). Left ventricular ejection fraction remained preserved.</p><p><strong>Conclusion: </strong>During the first transvenous system lifespan, imaging-defined venous abnormalities were relatively frequent but mostly asymptomatic, whereas clinically overt vascular complications were uncommon. The lead-to-vein ratio may support anatomical pre-implant risk stratification, although multicenter validation and follow-up beyond generator replacement are required.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077512","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}