Pace-Pacing and Clinical Electrophysiology最新文献

{"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":1.3,"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":"Intermediate Atrial Tachycardia During Persistent Atrial Fibrillation Ablation: A Sub-analysis of the Extent-AF Trial.","authors":"Kaige Li, Bosheng Xu, Yang Liu, Xinhua Wang, Bing Han, Ping Ye, Weifeng Jiang, Shaohui Wu, Kai Xu, Zheng Qidong, Yanzhe Wang, Mu Qin, Xu Liu, Xumin Hou","doi":"10.1111/pace.15180","DOIUrl":"10.1111/pace.15180","url":null,"abstract":"<p><strong>Background: </strong>The evidence supporting additional linear ablation for persistent atrial fibrillation (PerAF) remains limited. This study investigates the mechanisms of intermediate atrial tachycardia (AT), a transient state between PerAF and sinus rhythm (SR), during PerAF termination by catheter ablation, and provides evidence for these mechanisms.</p><p><strong>Methods: </strong>We analyzed 136 patients who converted to organized AT after PerAF termination in the Extent-AF study. Bi-atrial activation mapping combined with entrainment mapping was used to identify the mechanisms and critical isthmus of these ATs.</p><p><strong>Results: </strong>A total of 164 ATs were identified in 136 patients (average 1.2 per patient), with 143 (87%) ATs successfully mapped in 113 patients (average 1.3 per patient). The mechanisms of intermediate ATs included macro-reentry in 110 (77%), micro-reentry in 21 (15%), and focal AT in 12 (8%). Among the macro-reentrant ATs, the most common were perimitral ATs (PM-AT) in 52 (47%), followed by roof-dependent ATs (RF-AT) in 40 (36%) and typical atrial flutter (AFL) in 18 (16%). A total of 98 (72%) patients successfully underwent ablation for intermediate ATs. Of these, 88 (90%) required at least one of the perimitral line, roofline, or peritricuspid line to finally restore SR. After 12 months of follow-up, 63 (64.3%) of the patients with successfully ablated ATs were remained free of arrhythmia.</p><p><strong>Conclusions: </strong>The majority of intermediate ATs after PerAF termination were macro-reentrant ATs. Linear ablation targeting the mitral isthmus, roof, and tricuspid isthmus was crucial for restoring SR in up to 90% of patients, suggesting the importance of additional linear ablation in PerAF ablation.</p><p><strong>Trial registration: </strong>Optimization of intervention strategies for persistent atrial fibrillation: ChiCTR2200060075; chictr.org.cn.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"455-463"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626941","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":1.3,"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":1.3,"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}

{"title":"Feasibility and Safety of Pulsed-Field Ablation for Persistent Atrial Fibrillation: A Prospective Study.","authors":"Guocai Chen, Mingyang Gao, Yiwei Lai, Lihong Huang, Shijun Xia, Song Zuo, Xueyuan Guo, Nian Liu, Deyong Long, Jianzeng Dong, Liu He, Xin Du, Songnan Li, Caihua Sang, Changsheng Ma","doi":"10.1111/pace.15162","DOIUrl":"10.1111/pace.15162","url":null,"abstract":"<p><strong>Introduction: </strong>Pulsed-field ablation (PFA) is a novel nonthermal ablation approach using rapid electrical pulses to cause cardiac cell apoptosis via electroporation. Our study aims to investigate the feasibility and safety of PFA for persistent atrial fibrillation (PeAF).</p><p><strong>Methods: </strong>Thirty-two consecutive patients diagnosed with PeAF were enrolled in our study. All patients underwent PFA treatment using the strategy including pulmonary vein isolation (PVI), left atrial posterior wall (LAPW) isolation, cavotricuspid isthmus (CTI) block, and mitral isthmus (MI) block. Acute and follow-up procedure outcomes were evaluated, and adverse events related to the ablation procedure were also observed.</p><p><strong>Results: </strong>One-year survival free from atrial tachyarrhythmia post-ablation was 65.6%. Acute success rates for PVI, LAPW isolation, CTI block, and MI block were 100%, 100%, 96.9%, and 81.3%, respectively. Eleven cases (34.4%) experienced atrial tachyarrhythmia recurrence, with eight cases being atrial fibrillation (AF) recurrence and three cases being atrial flutter recurrence. Three patients underwent repeat ablation. Minor complications were encountered in four patients with asymptomatic cerebral lesions. Vagal responses were commonly observed during the procedure. No severe coronary vasospasm or severe hemolysis occurred in our cohort.</p><p><strong>Conclusion: </strong>PFA with the strategy including PVI, LAPW isolation, CTI block, and MI block is feasible, safe, and associated with a high rate of freedom from atrial tachyarrhythmia recurrence at 1 year in patients with PeAF.</p><p><strong>Trial registration: </strong>This study registered at the Chinese Clinical Trial Registry (ChiCTR2300068980).</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"302-310"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257412","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":"Advanced Atrioventricular Block in a Young Patient: Pacemaker Implantation Is No Longer the Only Choice.","authors":"Bruna Miers May, Eduardo Bartholomay, Adriano Nunes Kochi, Karina de Andrade, Thaís Coutinho Nicola, Giulia Bonatto Reichert","doi":"10.1111/pace.15153","DOIUrl":"10.1111/pace.15153","url":null,"abstract":"<p><p>A 40-year-old woman with symptomatic advanced atrioventricular (AV) block underwent cardioneuroablation (CNA) for the treatment of functional bradyarrhythmia, following the exclusion of reversible causes and intrinsic disease of the conduction system. Selective ablation of ganglia related to the AV node, performed exclusively in the left atrium, restored AV conduction, which has remained unchanged with 2 years of follow-up. CNA is a viable and effective option with low risk for the treatment of functional bradyarrhythmias, regardless of their severity.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"325-328"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257408","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":"Transseptal Sheath Perfused With High Concentration Heparinized Saline for Reducing Sheath-Associated Thrombus.","authors":"Juan Xu, Shi Peng, Yuanjun Sun, Zhenning Nie, Ya Zhen, Xiaomeng Yin, Xiaofeng Lu, Yan Liu, Xiaoyu Zhang, Dayang Huang, Shuai Guo, Yong Wei, Genqing Zhou, Yunlong Xia, Jun Li, Shaowen Liu, Songwen Chen","doi":"10.1111/pace.15115","DOIUrl":"10.1111/pace.15115","url":null,"abstract":"<p><strong>Background: </strong>Transseptal catheterization is critical for atrial fibrillation (AF) ablation but risks thromboembolism. Transseptal sheaths (TSS) were suggested for continuous heparinized saline solution flush. The safety and effectiveness of a simple TSS management to reduce sheath-associated thrombus development risk was investigated.</p><p><strong>Methods: </strong>AF patients who underwent radiofrequency ablation with the simple TSS management were studied under a retrospective multi-center observation study and a prospective single-center observation study. TSS and dilators were washed and perfused with high concentration heparinized saline (20 u/mL). Immediately after two successful transseptal punctures, activated clotting time ≥300 s was maintained by heparin infusion. TSS aspiration with negative suction and re-perfusion with high concentration heparinized saline (20 u/mL) was performed for the remaining procedure before and after catheter withdrawal.</p><p><strong>Results: </strong>A total of 4765 AF patients underwent 5367 ablation procedures were enrolled in the retrospective study, involving 156 (2.9% per procedure) complications. No acute stroke occurred during all the procedures. Perioperative thromboembolic complications occurred in 10 (0.21%) patients and in 10 (0.19%) procedures. Thromboembolic complications occurred within 24 h, between 24-48 h, and after 48 h post-procedure in six, two, and two patients, respectively. In the prospective observation study, neither sheath- nor catheter-associated thrombus were detected by the intracardiac echocardiography during all 127 procedures, without any perioperative thromboembolic complications. No hemorrhagic cerebrovascular complication was encountered in both observational studies.</p><p><strong>Conclusion: </strong>For AF radiofrequency ablation, it was safe and effective for TSS high concentration heparinized saline infusion only. This approach could avoid sheath-associated thrombus for interventional procedures.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"334-342"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803518","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":"Radiofrequency Versus Cryoballoon 180-Day Mortality Risk After Atrial Fibrillation Ablation: An 8-Year Analysis.","authors":"Michal Orczykowski, Marcin Kowalski, Maciej Bak, Anna Jargielo, Filip Machaj, Michal Swierczewski, Krystyna Guzek, Magdalena Topczewska, Piotr Urbanek, Bodalski Robert, Andrzej Glowniak, Pawel Derejko, Maciej Sterlinski, Maria Bilinska, Lukasz Szumowski","doi":"10.1111/pace.15164","DOIUrl":"10.1111/pace.15164","url":null,"abstract":"<p><strong>Introduction: </strong>Catheter ablation (CA) is a preferred treatment for atrial fibrillation (AF), often outperforming antiarrhythmic medications in maintaining sinus rhythm and managing symptoms. One of the most important features of any treatment method, alongside its effectiveness, is its safety.</p><p><strong>Methods: </strong>This study evaluates 180-day all-cause mortality rates post-ablation using data from the National Health Fund in Poland (NHF-P), encompassing over 99% of AF CAs and 100% of deaths in Poland from 2012 to 2019.</p><p><strong>Results: </strong>Our analysis, which included 31,214 ablations on 26,767 patients (34.8% female), compared cryoballoon and radiofrequency (RF) ablation techniques and assessed mortality rates and risk factors. The study revealed a 180-day mortality rate of 0.56%, with the highest rate observed in patients over 80 years old (2.67%) and the lowest in those aged 18-34 years (0.29%). Mortality did not significantly differ between cryoballoon (0.48%) and RF ablation (0.65%; p = 0.072). The risk of mortality did not differ between patients undergoing a first-time ablation and those having subsequent procedures (p = 0.90, OR 0.92). Significant risk factors for increased mortality included male sex, kidney disease, heart failure, diabetes, prior myocardial infarction, and a history of malignancy.</p><p><strong>Conclusion: </strong>The 180-day mortality rate after AF ablation procedure reached 0.56%, with no significant difference between cryoballoon and RF ablation. Further research, including matched control groups and extended follow-up periods, is essential to better understand the benefits and risks of CA for AF, particularly in the oldest patient groups.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"363-366"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441978","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":"Leadless Pacemaker Implantation Following Lead Extraction in a Patient With Recent Percutaneous Tricuspid Valve Repair.","authors":"Luca Segreti, Marco Torre, Matteo Parollo, Lorenzo Pistelli, Andrea Di Cori, Giulio Zucchelli","doi":"10.1111/pace.15150","DOIUrl":"10.1111/pace.15150","url":null,"abstract":"<p><p>This case details the successful implantation of a leadless pacemaker following the extraction of transvenous leads in a 72-year-old female patient with a complex cardiovascular history. The patient had undergone a series of cardiac interventions, including a recent percutaneous tricuspid valve repair with a metal clip implant due to severe regurgitation. After presenting with an infection at the pacemaker site, methicillin-resistant Staphylococcus hominis was identified, necessitating the removal of the entire pacing system. A leadless pacemaker was subsequently implanted without complications, despite the recent tricuspid valve repair. This case highlights the efficacy and safety of leadless pacemakers in complex clinical scenarios, especially when traditional transvenous systems are no longer viable due to infections or other complications. The report underscores the importance of personalized management strategies for cardiac device infections, illustrating that leadless pacemakers offer a feasible and safe alternative even in patients with previous valvular interventions.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"320-324"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048495","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":"External DC Shocks of Symptomatic Supraventricular Tachycardia During Screw-In Leadless Pacemaker Implant: A Case Report.","authors":"Mattia Liccardo, Ersilia Cipolletta, Emma Arezzi, Monica Sicuranza, Maria Rea, Pietro Ricciardi, Giovanni Napolitano","doi":"10.1111/pace.15134","DOIUrl":"10.1111/pace.15134","url":null,"abstract":"<p><p>We present the case of a 64-year-old man who, during the implantation of an active-fixation leadless pacemaker (LP, Aveir VR, Abbott, USA), underwent several external defibrillation shocks up to 240 Joules, due to symptomatic sustained supraventricular tachycardia at 160 bpm. The shocks, delivered both before and after the screwing of the device in the low interventricular septum, did not cause any technical damage to the device, and no complications were observed. The device was then deployed successfully. To our knowledge, this is the first documented case of external cardioversion (ECV) in a patient with an active-fixation LP. The results suggest that ECV in these patients appears to be safe and feasible.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"315-319"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959081","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}