Herzschrittmachertherapie und Elektrophysiologie最新文献

{"title":"Determining the QRS axis: visual estimation is equal to calculation.","authors":"Johanna Mueller-Leisse, Giulia Syrbius, Henrike Aenne Katrin Hillmann, Joerg Eiringhaus, Stephan Hohmann, Christos Zormpas, Nizar Karfoul, David Duncker, Christian Veltmann","doi":"10.1007/s00399-025-01065-x","DOIUrl":"10.1007/s00399-025-01065-x","url":null,"abstract":"<p><strong>Background: </strong>The QRS axis of the electrocardiogram (ECG) is often considered in clinical practice, but its determination is frequently limited to a rough estimation, such as \"normal\", with left or right deviation, and superior or inferior in the case of premature ventricular complexes (PVCs). However, a more exact determination of the QRS axis may be warranted in certain scenarios, such as to determine the origin of PVCs more precisely, and is attainable by visual estimation using the hexaxial reference system.</p><p><strong>Objectives: </strong>The aim of this study was to determine how well such an estimation of the QRS axis would correlate with the axis calculated by formulas.</p><p><strong>Materials and methods: </strong>A PVC database from 2012-2020 was used to extract 12-lead ECGs of patients with outflow tract PVCs and analyze the QRS axes of regularly conducted beats as well as PVCs. QRS axes were determined visually by two physicians with the help of the hexaxial reference system to an accuracy of 10° on the one hand, and were calculated using three previously described formulas based on QRS voltages on the other.</p><p><strong>Results: </strong>A total of 216 QRS complexes from 108 patients were analyzed (108 regularly conducted beats and 108 PVCs). Estimated QRS axes of regularly conducted beats and PVCs were 39 ± 40° and 88 ± 15°, respectively. Calculated QRS axes of regularly conducted beats according to the three formulas were 37 ± 40°, 36 ± 40° and 35 ± 38°, respectively. Calculated QRS axes of PVCs according to the three formulas were 87 ± 15°, 87 ± 14° and 86 ± 16°, respectively. Correlation coefficients showed strong correlations between the estimated and the three calculated values for regularly conducted beats (0.98, 0.97 and 0.98) and PVCs (0.94, 0.94 and 0.94).</p><p><strong>Conclusions: </strong>A sophisticated visual estimation of the QRS axis correlates well with voltage-based calculations and can therefore be considered sufficient for most purposes.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"70-74"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054260","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":"[Role of ventricular tachycardia ablation in patients with systolic heart failure].","authors":"M Ebert, Y Thomsen, S Richter","doi":"10.1007/s00399-024-01064-4","DOIUrl":"10.1007/s00399-024-01064-4","url":null,"abstract":"<p><p>Patients with systolic heart failure (HF) and structural heart disease often suffer from ventricular tachycardias (VTs), which lead to increased morbidity and mortality. Despite advancements in pharmacological therapy and the use of implantable cardioverter-defibrillators, treatment options are limited due to side effects and decreased effectiveness. Catheter ablation (CA) has emerged as a promising therapy for drug-refractory VTs, especially in patients with structural heart disease. This article reviews current knowledge on the indications, efficacy, and long-term prognosis of CA in patients with HF. Additionally, it discusses the importance of preprocedural planning, risk stratification, and emerging therapeutic strategies such as mechanical circulatory support and stereotactic arrhythmia radioablation. The complex relationship between VT and HF, as well as potential risks like acute hemodynamic decompensation, are also addressed.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"10-20"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025743","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":"[SVT in the EP lab: electrograms don't always show the reentry circuit].","authors":"Harilaos Bogossian, Sebastian Robl, Nana-Yaw Bimpong-Buta, Konstantinos Iliodromitis","doi":"10.1007/s00399-024-01039-5","DOIUrl":"10.1007/s00399-024-01039-5","url":null,"abstract":"","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"334-337"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114669","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":"Challenges in the terminology of second-degree atrioventricular block.","authors":"S Serge Barold, Carsten W Israel, Bengt Herweg","doi":"10.1007/s00399-024-01055-5","DOIUrl":"10.1007/s00399-024-01055-5","url":null,"abstract":"<p><p>The terminology of second-degree atrioventricular block has evolved over time, thereby creating some confusion and misinterpretations. Strict adherence to standard terminology and the appropriate use of eponyms are important to avoid diagnostic errors.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"324-326"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649502","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":"[Pulsed-field ablation-is it the only energy source for ablation in the future? : Pro/Contra].","authors":"Melanie Gunawardene, Thomas Arentz","doi":"10.1007/s00399-024-01035-9","DOIUrl":"10.1007/s00399-024-01035-9","url":null,"abstract":"<p><p>Pulsed field ablation (PFA) is a nonthermal energy source used for cardiac ablation procedures. Cell death during PFA occurs via electroporation: ultrarapid (micro- to nanosecond) electrical pulses are applied to destabilize cell membranes causing irreversible pores. PFA leads to preferential ablation of myocardiocytes, sparing adjacent tissue like the esophagus or phrenic nerve. Preliminary clinical studies show high efficacy and a good safety profile in atrial fibrillation patients undergoing pulmonary vein isolation. The question remains, however, whether this new technology will replace well-known and established thermal energy sources like radiofrequency current or cryoablation within the next 5 years.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"263-267"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121151","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 ablation of atrial fibrillation-Is pulmonary vein isolation sufficient? : Pro and contra].","authors":"Kyoung-Ryul Julian Chun, Sascha Rolf","doi":"10.1007/s00399-024-01044-8","DOIUrl":"10.1007/s00399-024-01044-8","url":null,"abstract":"<p><p>Pulmonary vein isolation (PVI) is currently the gold standard for the ablation of atrial fibrillation (AF). Although this procedure shows good success rates, the recurrence rates after PVI alone are significantly higher in advanced AF and in the presence of comorbidities. Therefore, it is important to consider additional arrhythmogenic mechanisms outside the pulmonary veins, depending on the individual case, in order to improve the patients' outcome.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"268-273"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332179","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":"[Controversies in rhythmology].","authors":"Victoria Johnson, Philipp Sommer","doi":"10.1007/s00399-024-01048-4","DOIUrl":"10.1007/s00399-024-01048-4","url":null,"abstract":"","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"255"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480448","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":"[(LV)EF is a poor predictor of sudden cardiac death : Pro/Contra].","authors":"Christian Butter, Gerd Hindricks","doi":"10.1007/s00399-024-01041-x","DOIUrl":"10.1007/s00399-024-01041-x","url":null,"abstract":"<p><p>For more than two decades the left ventricular ejection fraction (LVEF) has been utilized with practically uncritical absolutism for the risk stratification of patients with ischemic and, historically, also nonischemic cardiomyopathy, in order to identify patients who could be threatened by sudden cardiac death. Based on historical data and in the absence of other better predictive parameters, the LVEF continues to appear in the guidelines unchanged, with cut-off values that lie in the region of the measurement accuracy of LVEF as determined by echocardiography. The basic identification of high-risk patients who then really benefit from an implantable cardioverter defibrillator (ICD) must be re-evaluated under the aspect of a meaningfully altered interventional and pharmaceutical treatment of heart failure.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"282-285"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300607","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":"[Atrial fibrillation in combination with severe mitral regurgitation : Which should be treated first, the atrial fibrillation or the mitral valve?]","authors":"Nora Köpcke, Fabian Barbieri, Mario Kasner, Markus Reinthaler, Ulf Landmesser, Martin Huemer, Philipp Attanasio","doi":"10.1007/s00399-024-01045-7","DOIUrl":"10.1007/s00399-024-01045-7","url":null,"abstract":"<p><strong>Background: </strong>The primary therapeutic approach for severe secondary mitral regurgitation (MR) in combination with atrial fibrillation is often not clear.</p><p><strong>Objectives/methods: </strong>To create a therapeutic guideline for daily clinical practice based on a case report as well as basic literature.</p><p><strong>Results: </strong>If a functional component is suspected, restoration of sinus rhythm may lead to a significant improvement in MR. The extent of the improvement and the time required to achieve this improvement are often difficult to predict.</p><p><strong>Conclusions: </strong>The involvement of an electrophysiologist is recommended in order to assess the likelihood of successful long-term rhythm control aimed at improving MR. In unclear cases, cardioversion combined with short-term administration of antiarrhythmic medication may be useful to demonstrate potential improvement of MR in sinus rhythm.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"303-311"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332178","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":"[Everyone over the age of 65 years should wear a smartwatch : Pro and contra].","authors":"V Johnson, L Eckardt","doi":"10.1007/s00399-024-01058-2","DOIUrl":"10.1007/s00399-024-01058-2","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is one of the most common cardiac arrhythmias and has far-reaching consequences not only for patients, but also for our healthcare system. The prevalence of this condition is expected to double in the coming decades. On the one hand, this is due to our aging population, the increasing number of comorbidities, and the improved technical possibilities for detection. A major complication of AF is stroke, whereby at-risk patients can be protected by oral anticoagulation if AF is diagnosed. The extent to which continuous screening for AF in patients with an increased risk of thromboembolic events should be carried out using wearables remains an important point in the current debate.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"290-295"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711587","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}