Pace-Pacing and Clinical Electrophysiology最新文献

{"title":"Long-Term Follow-Up of the S-ICD: A 10-Years Follow-Up Study of a Large Single Center Cohort.","authors":"Gerrit Frommeyer, Florian Reinke, Benjamin Rath, Julian Wolfes, Kevin Willy, Felix K Wegner, Julia Köbe, Lars Eckardt","doi":"10.1111/pace.15173","DOIUrl":"10.1111/pace.15173","url":null,"abstract":"<p><strong>Background: </strong>The subcutaneous implantable defibrillator (S-ICD) is an alternative to transvenous implantable defibrillators. The present analysis presents real-world data from patients with S-ICD and a follow-up duration of 10 years or more.</p><p><strong>Methods and results: </strong>Between July 2010 and November 2013 76 S-ICD systems were implanted. After a follow-up duration of 10 years, data from 67 patients (88.1%) was available. Mean follow-up duration was 10.7 ± 1.3 years. Forty-seven patients (70.2%) were still alive with active S-ICD therapy. Eight patients (11.9%) died during follow-up. In eight patients (11.9%), conversion to a transvenous ICD system was necessary. This was either due to heart failure with indication for biventricular pacing (n = 2), bradycardia (n = 3), oversensing that could not be solved (n = 2), or pocket infection (n = 1). In four patients (6%), the S-ICD system was explanted without replacement for individual reasons. Sixteen patients already underwent two generator replacements, while one generator replacement was performed in the rest of the cohort. Therefore, generator longevity was documented to be within the predicted values. In 10 patients (14.9%), appropriate therapy delivery for ventricular arrhythmias was delivered. In 12 patients (17.9%), inappropriate shock delivery due to oversensing occurred. Of note, this could be resolved in all but two patients. Furthermore, the majority of these episodes occurred in the early years before the implementation of the Smart Pass algorithm.</p><p><strong>Conclusion: </strong>S-ICD therapy can be successfully maintained over a long time. Incidence of oversensing significantly decreased with the implementation of novel algorithms and the new S-ICD generation. However, the present data also points out that in selected individuals conversion to transvenous systems is required.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"443-446"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lead Performance and Echocardiographic Outcomes for Delayed Bundle Capture Loss During Conduction System Pacing.","authors":"Shengjie Wu, Lan Su, Yuchao Fang, Wenxuan Shang, Xinxin Wang, Junwei Wang, Lei Xu, Songjie Wang, Weijian Huang","doi":"10.1111/pace.15178","DOIUrl":"10.1111/pace.15178","url":null,"abstract":"<p><strong>Background: </strong>Conduction system pacing (CSP) is increasingly recognized for mitigating the adverse hemodynamic effects commonly associated with conventional ventricular pacing. However, there is limited data on the lead performance and echocardiographic outcomes for delayed bundle capture loss during CSP.</p><p><strong>Objective: </strong>To evaluate the rate of complete loss of bundle capture/correction during CSP and assess the subsequent clinical outcomes.</p><p><strong>Method: </strong>Patients who underwent successful CSP lead implantation with indications for ventricular pacing or cardiac resynchronization therapy (CRT) were screened. The reasons for complete loss of capture or failed LBBB correction were identified, and subsequent clinical outcomes were analyzed.</p><p><strong>Result: </strong>Out of 2636 patients screened, nine experienced complete loss of bundle capture or LBBB correction during follow-up. Loss of capture was attributed to unexplained causes (n = 6), near-complete electrode dislodgement (n = 1), surgical damage (n = 1), and electrode malfunction (n = 1). The six patients with CRT indication and declining cardiac function underwent lead revision, with left ventricular ejection fraction (LVEF) improving from 40.6 ± 17.3% to 59.1 ± 6.0% at the last follow-up with the bundle capture threshold of 0.63 ± 0.14 V/0.5 ms. The remaining 3 atrioventricular block patients with stable cardiac function did not undergo lead revision and the local myocardium threshold of 0.58± 0.31 V/0.5 ms.</p><p><strong>Conclusion: </strong>The incidence of complete capture loss during CSP is low recapturing/recorrecting the bundle significantly improves cardiac function in patients with CRT indications.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"369-376"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superior Mesenteric Artery Syndrome Resulting From Gastric Dilatation After Catheter Ablation of Atrial Fibrillation.","authors":"Jichun Liu, Yang Ling, Ping Fang, Youquan Wei, Jinfeng Wang, Hao Yang, Xianghai Wang","doi":"10.1111/pace.15152","DOIUrl":"10.1111/pace.15152","url":null,"abstract":"<p><p>Catheter ablation (CA) is a recognized treatment for people experiencing symptomatic paroxysmal or persistent atrial fibrillation (AF). Pulmonary vein isolation (PVI) is the predominant therapeutic intervention for AF globally. According to PVI, some individuals may require supplementary ablation interventions. Literature has shown that the closeness of the esophagus to the posterior wall of the left atrium might result in injury to the vagal nerve branches during CA, causing conditions such as \"gastroparesis\" or \"pyloric spasms.\" This report details a case of superior mesenteric artery compression syndrome following AF ablation, which did not improve with conservative management and was ultimately addressed by surgical procedure.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"418-421"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progressive Anatomical Evolution Leading to Loss of S-ICD Eligibility in Hypertrophic Cardiomyopathy: A Case Report.","authors":"Luca Avolio, Paolo Zappulla, Daniela Dugo, Maria Teresa Cannizzaro, Angelo Di Grazia, Davide Capodanno","doi":"10.1111/pace.15169","DOIUrl":"10.1111/pace.15169","url":null,"abstract":"<p><p>Subcutaneous implantable cardioverter defibrillators (S-ICDs) are designed to avoid complications from transvenous leads, but patient selection requires careful screening, especially in conditions like hypertrophic cardiomyopathy (HCM) with frequent conduction abnormalities. A 27-year-old male with HCM underwent S-ICD implantation in 2015 after successful screening. In 2020, inappropriate shocks due to T-wave oversensing led to vector adjustments. By 2022, further shocks and failed re-screening revealed ineligibility for S-ICD due to low R/T ratios in multiple vectors. Imaging and ECG comparisons from 2015 to 2022 showed disease progression, with increased fibrosis and conduction abnormalities. As a result, a transvenous ICD was implanted. This case underscores how HCM progression, associated with fibrosis and ECG changes, can render S-ICD unsuitable over time. It highlights the importance of periodic reassessment in high-risk patients, as disease progression can compromise S-ICD eligibility, necessitating alternative solutions for inappropriate shocks.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"422-426"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulsed Field Versus High-Power Short-Duration Radiofrequency Ablation in Atrial Fibrillation: A Meta-Analysis.","authors":"Muhammad Hassan Waseem, Zain Ul Abideen, Ayesha Ahmed, Barka Sajid, Ameer Haider Cheema, Noor Ul Huda Ramzan, Amina Tahir, Sania Aimen","doi":"10.1111/pace.15166","DOIUrl":"10.1111/pace.15166","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation, which has increased in prevalence by 33% over the past two decades, affects 59 million people worldwide. It is treated using thermal and nonthermal techniques like radiofrequency, cryoballoon, laser, and pulsed-field ablation (PFA). This meta-analysis is the first to compare PFA with high-power short-duration radiofrequency ablation (HPSD-RFA).</p><p><strong>Methods: </strong>We comprehensively searched PubMed, Cochrane Central, and ScienceDirect from inception to August 2024. In Review Manager 5.4.1, we pooled risk ratios (RRs) and weighted mean difference (WMD) along with 95% confidence intervals for dichotomous and continuous outcomes, respectively, and employed a random effects model. Study quality was assessed via the Newcastle-Ottawa Scale, and funnel plots were used to evaluate the risk of publication bias.</p><p><strong>Results: </strong>Seven studies with a total of 1538 patients were analyzed in this meta-analysis. PFA was associated with a shorter total procedural time (MD = -36.39 min; 95% CI: [-46.23, -26.55]; p < 0.00001; I² = 90%), left atrial dwell time (MD = -33.22 min; 95% CI: [-53.21, -13.23]; p = 0.001; I² = 93%), and a longer fluoroscopy time compared to the HPSD-RFA (MD = 9.06 min; 95% CI: [6.13, 11.99]; p < 0.00001; I² = 96%). Other outcomes were comparable between the two arms.</p><p><strong>Conclusion: </strong>PFA outperforms HPSD ablation in terms of procedural efficiency outcomes except for the total fluoroscopy time. Still, both techniques are comparable regarding safety and arrhythmia control outcomes.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"402-413"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progressed Atrioventricular Block in Immune Checkpoint Inhibitor Induced Myocarditis: A Case Report.","authors":"Dongmei Xie, Ting Yan, Xin Zhang, Xingbin Liu","doi":"10.1111/pace.15155","DOIUrl":"10.1111/pace.15155","url":null,"abstract":"<p><p>Immune checkpoint inhibitor (ICI) has demonstrated promising results in treating various cancers, but its associated cardiotoxicity, especially ICI-associated myocarditis, presents a serious concern. We reported a case of a 63-year-old male who complained of progressive dyspnea after tislelizumab, a novel humanized anti-PD-1 monoclonal antibody, for hepatocellular carcinoma. Upon diagnosing ICI-related myocarditis, corticosteroid therapy was initiated immediately. The elevated biomarkers quickly decreased, but the atrioventricular block progressed from first-degree to third-degree, necessitating pacemaker implantation. This is the first report of complete AVB consecutive to tislelizumab-induced myocarditis, highlighting the importance of early corticosteroid therapy and continuous electrocardiography monitoring.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"414-417"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late Sustained Ventricular Arrhythmias After Left Ventricular Assist Device Implantation: Outcomes and Predictors.","authors":"Suganya Karikalan, Justin Z Lee, Min-Choon Tan, Nan Zhang, Ammar M Killu, Abhishek J Deshmukh, Christopher J McLeod, Dan Sorajja, Hicham El-Masry, Siva K Mulpuru, Yong-Mei Cha, Luis Scott","doi":"10.1111/pace.15158","DOIUrl":"10.1111/pace.15158","url":null,"abstract":"<p><strong>Background: </strong>The factors contributing to sustained ventricular arrhythmias (VAs) >30 days after left ventricular assist device (LVAD) implantation are not well-established.</p><p><strong>Objectives: </strong>This study aimed to predict the factors associated with late sustained VAs after LVAD implantation and develop a predictive score to identify patients with an increased risk of late sustained VAs after the procedure.</p><p><strong>Methods: </strong>We performed a retrospective cohort study on a training cohort of 623 patients and a validation cohort of 157 patients who underwent LVAD implantation at the Mayo Clinic (Rochester, Phoenix, and Jacksonville) from January 1, 2000, to December 30, 2020. Late sustained VAs were defined as ventricular tachycardia (VT) and ventricular fibrillation (VF) occurring >30 days after the LVAD procedure. Detailed chart reviews of the electronic health records within the Mayo Clinic and outside medical records were performed.</p><p><strong>Results: </strong>A total of 780 patients were included in our study. Late sustained VAs occurred in 30% (n = 232) of the patients. The significant factors associated with late sustained VAs after LVAD were the history of VAs prior to LVAD (34.1% vs. 23.0%, p < 0.01), implantable cardiac defibrillator (ICD) (87.9% vs. 77.6%, p < 0.01) or cardiac resynchronization therapy (CRT) in situ (43.5% vs. 33.6%, p = 0.008), VT ablation prior to LVAD (5.2% vs. 1.8%, p = 0.010), use of amiodarone (49.1% vs. 38.7%, p = 0.007), use of mexiletine (15.5% vs. 5.7%, p < 0.01), and higher left ventricular end-diastolic diameter (LVEDD) on echocardiography prior to LVAD implantation (71.4 vs. 68.7 mm, p = 0.002). During follow-up, the patients who developed late sustained VAs after LVAD had lower survival than those who did not (HR = 1.96, 95% CI:156-2.4, p < 0.001). The average time from LVAD to orthotopic heart transplant was longer among late sustained VAs patients (23 vs. 14 months, p < 0.01). The \"VIN\" risk score was created to identify four risk groups: low (scores 0), intermediate (score 1), high (score 2), and very high (score 3). The rates of late VA's in the training cohort at 1 year were 9.5%, 14%, 18%, and 25% which was almost similar to the risk of late VA's at validation cohort 10%, 12%, 20%, and 63%, respectively.</p><p><strong>Conclusions: </strong>Late sustained VAs occurred in 30% of the patients who received LVAD and were associated with lower survival. The VIN risk score was developed and validated to stratify patients into low, intermediate, high, and very high risk of late sustained VAs.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"386-393"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Automated Subcutaneous Implantable Cardioverter-Defibrillator Screening in Patients With Leadless Pacemakers.","authors":"Maciej Dyrbuś, Joanna Machowicz, Anna Kurek, Mariusz Gąsior, Mateusz Tajstra","doi":"10.1111/pace.15165","DOIUrl":"10.1111/pace.15165","url":null,"abstract":"<p><strong>Background: </strong>The number of leadless pacemakers (LPMs) implantations has seen a major growth in recent years. Indications for LPMs often overlap with indications for subcutaneous implantable cardioverter-defibrillators (sICDs), as they are mostly recommended in patients in whom transvenous devices are deemed ineligible or contraindicated. Before sICD implantation, the patient should pass screening to verify the stability of QRS morphology in intrinsic and paced rhythms. The aim of this study was to evaluate the percentage of positive sICD screening in patients with a previously implanted LPM and evaluate the concordance between the vectors during the intrinsic and paced rhythm.</p><p><strong>Methods: </strong>Twenty-two patients who underwent implantation of the ventricular LPM from May to October 2024 were included in the present study. After the implantation, automated sICD screening was performed using the dedicated system, across 2-4 body positions, both during intrinsic and paced rhythms, in nominal, and emergency output.</p><p><strong>Results: </strong>All patients had the devices implanted in the interventricular septal location. Screening for QRS indicated that 94.1% of patients fulfilled the criterion for implantation of sICD in at least one vector during intrinsic rhythm, while only 23.8% and 28.5% passed screening during nominal and emergency pacing outputs, respectively. Positive screening concordance in at least one vector was observed in 23.5% of patients.</p><p><strong>Conclusions: </strong>Despite almost all patients having undergone successful screening during intrinsic rhythm, the low rates of positive QRS assessment were observed during pacing, what might raise potential concerns for an optimal coexistence of LPM and sICD in daily clinical practice.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"464-468"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implantation and Follow-Up of an Extravascular ICD After a Challenging Transvenous System Extraction: A Case Report.","authors":"Domenico M Carretta, Rossella Troccoli, Gianluca Epicoco, Ilenia Pastore, Nicola Di Bari, Carlo D'Agostino, Tomaso Bottio","doi":"10.1111/pace.15170","DOIUrl":"10.1111/pace.15170","url":null,"abstract":"<p><p>The Extravascular ICD (EV-ICD) is implanted outside of the patient's heart and vascular system. The defibrillation lead is tunneled in the substernal space, very close to the surface of the heart, thus allowing for additional pacing capabilities such as Post Shock Pacing, Anti-Tachycardia Pacing (ATP), and Pause Prevention Pacing. Early studies demonstrated the safety and efficacy profile of the EV-ICD, but patients with previous or existing cardiac devices or leads were excluded. In this case report we describe the implantation of an EV-ICD in a 68-year-old male patient, who had undergone a challenging extraction of a previous transvenous system due to infection and screened negative for a subcutaneous ICD (S-ICD). Given the lack of upper and lower venous accesses, it was also necessary to implant an epicardial bipolar lead connected to a single-chamber pacemaker as a backup during extraction, which also remained in place chronically. Follow-up was uneventful through the following 10 months, with stable system parameters and no infection relapse.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"427-432"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of Atrial Fibrillation and Atrial Flutter From 1990 to 2021 in China: Global Burden of Disease Study 2021 Update.","authors":"Xiangyi Kong, Mingxiao Li, Liu He, Yiwei Lai, Jue Wang, Sitong Li, Xiaodong Peng, Manlin Zhao, Qifan Li, Zixu Zhao, Le Zhou, Zejun Yang, Ting Shen, Meiqi Zhao, Zhixian Wang, Enze Li, Yize Zhao, Wenyu Wang, Shijun Xia, Chao Jiang, Xueyuan Guo, Ning Zhou, Xin Du, Caihua Sang, Jianzeng Dong, Changsheng Ma","doi":"10.1111/pace.15175","DOIUrl":"10.1111/pace.15175","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) and atrial flutter (AFL) represent increasingly significant health burden globally. We aimed to systematically evaluate the status and trends of AF/AFL burden and attributable risk factors in China.</p><p><strong>Methods: </strong>We assessed the burden of AF/AFL measured as prevalence, incidence, mortality, and disability-adjusted life years (DALYs), by sex and age groups in China based on the Global Burden of Diseases Study (GBD) 2021 project.</p><p><strong>Results: </strong>In China, there were 10,775.72 thousand AF/AFL prevalent cases, 916.18 thousand AF/AFL incident cases, and 64.73 thousand AF/AFL mortality cases, contributing to 1653.12 thousand DALYs due to AF/AFL in 2021. Trend analysis indicated that the AAPC of number and crude rates of prevalence, incidence, mortality, and DALYs all escalated from 1990 to 2021. The current AF/AFL burden and temporal trend between 1990 and 2021 displayed heterogeneity based on sex and age groups. The spectrum for risk factors attributed for DALYs due to AF/AFL presented sex- and age-specific manifestation. High systolic blood pressure served as the emerging leading contributor to DALYs due to AF/AFL in China.</p><p><strong>Conclusion: </strong>A significant increase in the burden of AF/AFL underscores the enduring public health burden of AF/AFL in China, marked by profound sex and age-related variations. There is a pressing imperative to adopt tailored strategies to attenuate increasing burden of AF/AFL and combat alongside high complication burden due to AF/AFL in China.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"447-454"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}