Herzschrittmachertherapie und Elektrophysiologie最新文献_第2页

[Basics in the EP lab-how and when to pace?] [基础在EP实验室-如何和何时节奏？］

Herzschrittmachertherapie und Elektrophysiologie Pub Date : 2026-09-01 Epub Date: 2026-05-13 DOI: 10.1007/s00399-026-01153-6

Ann-Kathrin Kahle, Christian Meyer

{"title":"[Basics in the EP lab-how and when to pace?]","authors":"Ann-Kathrin Kahle, Christian Meyer","doi":"10.1007/s00399-026-01153-6","DOIUrl":"10.1007/s00399-026-01153-6","url":null,"abstract":"Electrical stimulation is a central tool in the evaluation and management of arrhythmias in the electrophysiological laboratory. Targeted atrial and ventricular pacing maneuvers allow induction, mechanistic characterization, and termination of arrhythmias. This provides important insights into the involved conduction pathways, anatomical location, and the underlying arrhythmogenic substrate, thereby forming the basis for a tailored ablation strategy. A structured approach even prior to the first stimulation maneuver establishes the foundation for successful diagnosis and therapy (ensuring stable catheter positions, optimal signal quality, and reliable capture). Understanding fundamental principles such as incremental, programmed, burst and overdrive stimulation is essential for accurate interpretation of electrophysiological responses. The consolidation of knowledge over the past three decades has helped ensure that, today, a few key maneuvers are usually sufficient to enable a rapid and reliable diagnosis. These play a key role in differentiating regular narrow-complex tachycardias, distinguishing wide-complex tachycardias, and identifying reentrant vs. nonreentrant mechanisms. They are also indispensable for assessing procedural endpoints after ablation, including confirmation of noninducibility of the clinical tachycardia or successful pulmonary vein isolation. The present review further outlines practical solutions to common challenges such as inconsistent pacing responses, far-field signals, and nonreproducible arrhythmia induction. Overall, systematic application of pacing maneuvers enables precise mechanistic classification of tachycardias and significantly contributes to safe, efficient, and individualized electrophysiological therapy.","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"338-351"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935464","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}

引用次数: 0

Differential diagnosis of wide-complex tachycardia: ventricular or supraventricular? 宽复杂性心动过速的鉴别诊断：室性还是室上性？

Herzschrittmachertherapie und Elektrophysiologie Pub Date : 2026-09-01 Epub Date: 2026-08-05 DOI: 10.1007/s00399-026-01163-4

Stefano Bordignon, Boris Rudic, Alexander Langanke Kohls, Nils Malte Sönksen, Sara Würfel, Benedikt Götsch, Ulrich Hink

引用次数: 0

[AI-Assisted ECG diagnostics : Classical test statistics still apply]. 【人工智能辅助心电图诊断：经典检验统计仍然适用】。

Herzschrittmachertherapie und Elektrophysiologie Pub Date : 2026-09-01 Epub Date: 2026-06-23 DOI: 10.1007/s00399-026-01158-1

Wilhelm Haverkamp, Gerhard Hindricks, Nils Strodthoff

引用次数: 0

Value of the 12-lead ECG to localize the origin of ventricular tachycardia. 12导联心电图对室性心动过速病因定位的价值。

Herzschrittmachertherapie und Elektrophysiologie Pub Date : 2026-09-01 Epub Date: 2026-08-10 DOI: 10.1007/s00399-026-01167-0

Zoe Vogel, Carmen Kolokowsky, Roman Michalski, Daniel Sedding, Arash Arya

{"title":"Value of the 12-lead ECG to localize the origin of ventricular tachycardia.","authors":"Zoe Vogel, Carmen Kolokowsky, Roman Michalski, Daniel Sedding, Arash Arya","doi":"10.1007/s00399-026-01167-0","DOIUrl":"10.1007/s00399-026-01167-0","url":null,"abstract":"The 12-lead electrocardiogram (ECG) recorded during ventricular tachycardia (VT) remains a simple, universally available tool for VT localization. In idiopathic VT, QRS morphology and polarity often reflect the site of earliest activation and can facilitate targeted mapping. In patients with structural heart disease, however, the surface ECG predominantly represents the VT exit region rather than the critical diastolic isthmus; thus, its main clinical value lies in regionalization and in planning ablation strategy and access. A pragmatic stepwise interpretation integrating V1 morphology, precordial transition (V1-V6), and the frontal plane axis can localize VT in most cases, although accuracy is influenced by scar size, conduction abnormalities, antiarrhythmics, and variable exit sites. Emphasis is placed on estimating epicardial or intramural involvement using interval- and morphology-based criteria-especially in nonischemic cardiomyopathy-and on integrating ECG findings with cardiac scar imaging. Key disease-specific ECG patterns are highlighted. Electrocardiographic imaging, automated ECG analysis, and artificial intelligence (AI)-based localization approaches may further improve VT localization.","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"288-300"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702646","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}

引用次数: 0

In memoriam Dr. Heinz Friedrich Pitschner. 纪念Heinz Friedrich Pitschner博士。

Herzschrittmachertherapie und Elektrophysiologie Pub Date : 2026-09-01 Epub Date: 2026-07-21 DOI: 10.1007/s00399-026-01162-5

Jörg Neuzner, Ulrich Michel

引用次数: 0

Imaging phenotypes and substrates in ventricular tachycardia. 室性心动过速的影像学表型和底物。

Herzschrittmachertherapie und Elektrophysiologie Pub Date : 2026-09-01 Epub Date: 2026-07-23 DOI: 10.1007/s00399-026-01161-6

Pranav Bhagirath, Ivo Roca-Luque

{"title":"Imaging phenotypes and substrates in ventricular tachycardia.","authors":"Pranav Bhagirath, Ivo Roca-Luque","doi":"10.1007/s00399-026-01161-6","DOIUrl":"10.1007/s00399-026-01161-6","url":null,"abstract":"Ventricular tachycardia (VT) remains challenging, as the underlying substrate is heterogeneous and not adequately described by scar burden alone. Imaging is increasingly used to identify structural heart disease, characterize myocardial abnormality, and support VT ablation planning. Distinct imaging findings reflect specific myocardial phenotypes and substrate architectures, such as ischemic scar, nonischemic fibrosis, inflammatory injury, and fibrofatty remodelling. These phenotypes do not represent the same arrhythmic substrate and do not carry the same implications for mechanism, procedural strategy, or follow-up. This review discusses VT in terms of imaging phenotype and substrate rather than scar alone. It also summarizes how imaging can define substrate location, depth, tissue composition, and spatial distribution, and how this may improve understanding of the arrhythmic ventricle. The therapeutic implications of this framework are then discussed, including relevance for treatment planning, interpretation of treatment effect, and assessment of recurrence. Finally, current limitations and future directions of imaging-based substrate assessment in VT are addressed.","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"312-320"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563534","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}

引用次数: 0

[Ablation of an atrioventricular nodal reentrant tachycardia and a focal left atrial tachycardia in azygos continuation]. [消融房室结折返性心动过速和局灶性左房心动过速在奇期持续中的应用]。

Herzschrittmachertherapie und Elektrophysiologie Pub Date : 2026-09-01 Epub Date: 2026-02-18 DOI: 10.1007/s00399-026-01134-9

K Weipert, K Roussopoulos, M Tsiakou, A Schuster, D Gündüz, D Erkapic

引用次数: 0

Pseudo-pacemaker syndrome triggered by atrioventricular hysteresis algorithm activation in a patient with left bundle branch area pacing: a case report. 左束支区起搏患者房室迟滞算法激活引发伪起搏器综合征1例。

Herzschrittmachertherapie und Elektrophysiologie Pub Date : 2026-08-26 DOI: 10.1007/s00399-026-01166-1

Luca Nolte, Corinna Lenz, Max Olav Schrage, Hinrich Schroer

引用次数: 0

[The role of psychosocial risk factors in the development and course of atrial fibrillation]. [心理社会危险因素在房颤的发展和过程中的作用]。

Herzschrittmachertherapie und Elektrophysiologie Pub Date : 2026-08-17 DOI: 10.1007/s00399-026-01170-5

Karl-Heinz Ladwig, Andreas Götte, Luise Ankerhold, Karoline Lukaschek

{"title":"[The role of psychosocial risk factors in the development and course of atrial fibrillation].","authors":"Karl-Heinz Ladwig, Andreas Götte, Luise Ankerhold, Karoline Lukaschek","doi":"10.1007/s00399-026-01170-5","DOIUrl":"https://doi.org/10.1007/s00399-026-01170-5","url":null,"abstract":"Background: Psychosocial risk factors are well established in the development of cardiovascular disease. However, their role in the onset and progression of atrial fibrillation (AF) has not yet been systematically summarised.Objective: To present the current evidence on psychosocial risk factors associated with the development and course of AF.Methods: A scoping review of epidemiological and population-based studies as well as relevant meta-analyses was conducted. Studies addressing psychosocial risk factors, including social, occupational, and psychological stressors, sleep disturbances, depression, anxiety disorders, and stress-related disorders were included.Results: Consistent associations were reported particularly for depression, insomnia, and work-related stress. For depression, risk increases ranging from 15% to 58% were reported. Large population-based cohort studies consistently demonstrated risk increases of 26% to 36% for insomnia. In addition, associations were observed for adverse childhood experiences, anxiety disorders, and post-traumatic stress disorder. Evidence regarding loneliness and social isolation was inconsistent. Proposed underlying mechanisms include autonomic, endocrine, and inflammatory pathways.Conclusion: Available evidence suggests that psychosocial factors make a relevant contribution to the development and maintenance of AF. Consideration of psychosocial stressors may complement current approaches to AF risk stratification and prevention. The existing evidence supports a stronger integration of psychosocial risk factors into future epidemiological research and clinical care concepts.","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801472","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}

引用次数: 0

[33 years of pacemaker longevity-an unusual case]. [33年的心脏起搏器寿命——一个不寻常的案例]。

Herzschrittmachertherapie und Elektrophysiologie Pub Date : 2026-08-11 DOI: 10.1007/s00399-026-01164-3

Martin Koval, Timur Kyashif, Torsten Doenst

引用次数: 0