Pace-Pacing and Clinical Electrophysiology最新文献

{"title":"Lower Risk of New-Onset Atrial Fibrillation in Conduction System Pacing Compared With Right Ventricular Pacing.","authors":"Feng Li, You Zhang, Jian Huang, Si-Liang Peng, Meng-Chao Jin, Chi Geng, Venkatesh Ravi, Parikshit S Sharma, Pugazhendhi Vijayaraman, Hui Li","doi":"10.1111/pace.15121","DOIUrl":"10.1111/pace.15121","url":null,"abstract":"<p><strong>Background: </strong>Conduction system pacing (CSP) has been reported to improve clinical outcomes in comparison of right ventricular pacing (RVP). However, the performance between CSP and RVP on the risk of new-onset atrial fibrillation (AF) remains elusive.</p><p><strong>Methods: </strong>Four online databases were systematically searched up to July 1, 2024. Studies comprising the rate/risk of new-onset AF between CSP and RVP group were included. Subgroup analysis was performed to screen the potential determinants for the new-onset AF risk for CSP therapy. The pooled risk of new-onset AF based on ventricular pacing burden (Vp) between CSP and RVP group were evaluated.</p><p><strong>Results: </strong>A total of six studies including 1577 patients requiring pacing therapy were eligible. The pooled new-onset AF rates for CSP and RVP group were 0.09 and 0.27, respectively. Compared with RVP group, CSP group showed a lower pooled risk (risk ratio [RR] 0.38, p = 0.000) and adjusted risk (hazard ratio [HR] 0.32, p = 0.000) of new-onset AF. Meanwhile, a significant intervention-covariate interaction for the adjusted risk of new-onset AF between CSP and RVP group was identified with Vp < 20% and Vp ≥ 20%.</p><p><strong>Conclusions: </strong>Our study suggests that CSP is associate with a significantly lower occurrence of new-onset AF compared with RVP. The Vp ≥ 20% may be the key determinant on the lower risk of new-onset AF with CSP therapy.</p><p><strong>Trial registration: </strong>https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023492551, identifier (CRD42023492551).</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"202-215"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985359","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":"Inappropriate Shocks in Brugada Syndrome Patients With a Subcutaneous Implantable Cardioverter Defibrillator.","authors":"Masaya Watanabe, Tadafumi Nanbu, Yuki Ishidoya, George Suzuki, Akihiko Yotsukura, Izumi Yoshida, Yoshitaka Tanaka, Kazushige Inoue, Junko Mitsuishi, Tomomi Kanno, Masayuki Sakurai, Toshihisa Anzai","doi":"10.1111/pace.15151","DOIUrl":"10.1111/pace.15151","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare inappropriate shock (IAS) rates between subcutaneous implantable cardioverter-defibrillator (S-ICD) and transvenous ICD (TV-ICD) in Brugada syndrome (BrS) patients and identify risk factors for IAS in S-ICD use.</p><p><strong>Methods: </strong>We enrolled consecutive patients with BrS who underwent ICD implantation between 2013 and 2023. Data on clinical characteristics, S-ICD screening test data, and IAS occurrence were retrospectively analyzed.</p><p><strong>Results: </strong>In total, 74 patients (40 with S-ICDs and 34 with TV-ICD) were enrolled in the study. During a median follow-up of 4.6 years, IAS occurred in nine S-ICD and three TV-ICD patients, exhibiting a non-statistically significant trend (log-rank p = 0.103) toward a higher incidence in the S-ICD group. The incidence of IAS related to non-atrial tachyarrhythmia (non-AT) causes was significantly higher in the S-ICD group than in the TV-ICD group (log-rank p = 0.014). Fewer electrocardiography (ECG) sensing vectors passing the screening test at both the baseline and exercise test (hazard ratio [HR] 0.31, 95% confidence interval [CI] 0.09-0.85; p = 0.21) and detection of ATs (HR 5.25, 95% CI 1.15-24.05; p = -0.048) were associated with IAS in patients with S-ICD.</p><p><strong>Conclusion: </strong>No significant difference was observed in the overall incidence of IAS between the S-ICD and TV-ICD groups; however, IAS due to non-AT causes occurred more frequently in the S-ICD group. Fewer ECG sensing vectors passing screening were significantly correlated with the IAS when exercise test results were considered. Therefore, ECG screening, including exercise testing, is preferable for S-ICD candidates.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"160-168"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054217","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":"Early Improvement in Cardiac Function and Dyssynchrony After Physiological Upgrading in Pacing-Induced Cardiomyopathy.","authors":"María Teresa Moraleda-Salas, Emilio Amigo-Otero, Irene Esteve-Ruiz, Álvaro Arce-León, José Miguel Carreño-Lineros, Elena Izaga Torralba, Francisco Navarro Roldan, Pablo Moriña-Vázquez","doi":"10.1111/pace.15126","DOIUrl":"10.1111/pace.15126","url":null,"abstract":"<p><strong>Background: </strong>Interventricular dyssynchrony derived from the classic non-physiological stimulation (n-PS) of the right ventricle (RV) is a known cause of left ventricular dysfunction (LVDys).</p><p><strong>Methods: </strong>This was a prospective descriptive single-center study. We analyzed patients who develop LVDys with n-PS, and the results after upgrading to conduction system pacing (CSP). Ultra-high frequency electrocardiogram (UHF-ECG) was performed pre and post-implantation of the last patients included. ECG recordings in 16 frequency bands (150-1000 Hz) were used to create maps of ventricular depolarization. The maximum time difference between the centers of mass of the complex UHF QRS of leads V1-V6 (electrical dyssynchrony [DYS-e] 16) and V1-V8 (DYS-e 18) defined ventricular dyssynchrony. Data were expressed as mean ± standard deviation.</p><p><strong>Results: </strong>27 patients were upgraded to CSP from January 2022 to January 2024 after developing LVDys. Permanent His bundle pacing (p-HBP) was achieved in 63% (n = 17); in the other 10 patients left bundle branch area pacing (LBBAp) was performed. The average baseline LVEF improved from 34.5% (27-42) to 47.6% (38.2-57), p < 0.001. Telediastolic left ventricle diameter as well as QRS width also decreased. Thresholds remained stable at 6-month follow-up. The last eight patients included were studied in terms of ventricular synchrony parameters by UHF-ECG (VDI Technologies), both His bundle pacing (HBP) and the LBBAp achieved significant improvement with respect to baseline parameters.</p><p><strong>Conclusions: </strong>LVEF improved in patients with previous n-PS-induced cardiomyopathy after upgrading to CSP. LVDys due to dyssynchronopathy is frequent and probably underdiagnosed. UHF-ECG provides useful new information about ventricular activation and will likely improve patient selection for cardiac resynchronization therapy (CRT).</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"256-261"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900486","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":"Meta-Analysis of Pulsed-Field Ablation Versus- High-Power Short-Duration Ablation for Atrial Fibrillation.","authors":"Jun Xue, Qunying Huang, Fuling Yu, Yinjun Mao","doi":"10.1111/pace.15141","DOIUrl":"10.1111/pace.15141","url":null,"abstract":"<p><strong>Purpose: </strong>To optimize the effectiveness and safety of pulmonary vein isolation, pulsed-field ablation (PFA) and high-power short-duration ablation (HPSD) have recently been incorporated into clinical practice. The objective of this study is to conduct a comparative analysis, focusing on the efficacy, safety, and procedural efficiency of PFA and HPSD in the treatment of atrial fibrillation (AF).</p><p><strong>Methods: </strong>A thorough search was performed across multiple databases to identify trials that compared PFA with HPSD for AF from their inception until July 2024. The odds ratio (OR) and mean difference (MD), accompanied by a 95% confidence interval (CI), were employed as indicators of treatment efficacy.</p><p><strong>Results: </strong>The analysis included six eligible trials, encompassing a total enrollment of 1382 patients. No statistically significant disparities were observed in terms of freedom from any atrial arrhythmia (OR 1.10; 95% CI 0.75, 1.63) or periprocedural complications (OR 1.04; 95% CI 0.52, 2.09) between the two ablation techniques. The likelihood of requiring a repeat ablation procedure was significantly reduced with PFA compared to HPSD (OR 0.63; 95% CI 0.41-0.97); however, there was no significant difference in the incidence of PV reconnection between patients initially treated with HPSD and those using PFA (OR 0.83; 95% CI 0.53-1.30). The PFA technique demonstrated significantly shorter procedure time (MD -34.58; 95% CI -45.20, -23.96) and left atrium (LA) dwell time (MD -34.52; 95% CI -58.42, -10.61), but longer fluoroscopy time (MD 8.81; 95% CI 6.25, 11.37). The subgroup analyses revealed that PFA continued to exhibit superior procedure time and LA dwell time but inferior fluoroscopy time.</p><p><strong>Conclusion: </strong>The efficacy and safety profiles of both PFA and HPSD are comparable in patients undergoing ablation therapy for AF; however, PFA is associated with shorter procedural time and longer fluoroscopy time.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"180-191"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933683","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":"Managing a Mental Disorder With New Technologies: TheLeadless Pacemaker in Reel's Syndrome, a Case Report.","authors":"P L Magliano, F Scotto Di Uccio, R Persico, C Provvisiero, P Ricciardi, V Ducceschi","doi":"10.1111/pace.15131","DOIUrl":"10.1111/pace.15131","url":null,"abstract":"<p><p>Reel's syndrome (RS) is an unusual cause of pacemaker lead dislodgement. We present the case of a 59-year-old female patient with Down syndrome (DS) implanted with a dual-chamber endovascular pacemaker due to symptomatic sinus node disfunction, reporting several syncopal episodes in last days and showing abnormal electrical parameters at the 2-months follow-up due to RS. The malfunctioning device was removed and an endocardial leadless pacing system was implanted.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"235-238"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900489","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 Long-Term Outcomes of Inactive Pacemaker Lead Abandonment in Children and Dramatic Observation of Complications.","authors":"Agnieszka Nowosielecka, Dorota Nowosielecka, Wojciech Jacheć, Radosław Pietura, Tomasz Smyk, Janusz Gozdek, Andrzej Kutarski","doi":"10.1111/pace.15137","DOIUrl":"10.1111/pace.15137","url":null,"abstract":"<p><p>Transvenous extraction of the leads in children is associated with a higher risk of serious complications, that is why it is reluctantly performed. Unfortunately, this conservative approach has been associated with secondary complications (tricuspid valve dysfunction and bilateral venous obstruction), adverse events during lead removal procedure and recanalization and stenting of chest veins. We present a case of a 27-year-old female with a pacemaker and insertion of two new leads on the opposite side of the chest leaving the old ones in place.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"239-244"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900493","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":"Improved Cardiac Physiological Pacing Implantation by Probe Method: A Case Report.","authors":"Yuhang Yang, Xinmiao Huang, Zhaojun Wang","doi":"10.1111/pace.15123","DOIUrl":"10.1111/pace.15123","url":null,"abstract":"","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"245-248"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907926","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":"Dual Chamber Aveir Retrievable Leadless Pacemaker Implant via the Right Internal Jugular Vein in a 13-Year-Old With Congenital Complete Heart Block.","authors":"Daniel Cortez","doi":"10.1111/pace.15129","DOIUrl":"10.1111/pace.15129","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital complete heart block is a condition where there is a risk of Stokes Adam's attacks and sudden death may occur. Once the escape rate is too low, or other high-risk factors occur, these patients ultimately need pacemakers placed. Epicardial or transvenous pacemakers have typically been in employed dependent on size of the patient and other circumstances. We describe the first case of an implant via internal jugular vein (right) of a dual chamber leadless pacemaker implant in a symptomatic pediatric patient with congenital complete heart block.</p><p><strong>Methods: </strong>The study was approved by the University of California and consent was waived due to retrospective nature of this case report.</p><p><strong>Case: </strong>A 13-year-old presented with presyncope at rest after years of being followed for her congenital complete heart block. Her average rate on Holter monitoring was below 50 bpm, which coincided with her recent symptoms. After discussion with family, and our own cardiology/surgical team, she had a dual chamber leadless pacemaker implanted. Stable 3-month atrial parameters included an impedance of 340 Ω, sensing of 3.2 mV, and threshold of 0.25 V at 0.2 ms, while ventricular parameters showed an impedance of 780 Ω, sensing of 14.2  mV, and threshold of 0.5 V at 0.2 ms.</p><p><strong>Conclusion: </strong>Dual chamber leadless pacemaker implant is feasible via right internal jugular vein access and in a pediatric patient.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"224-226"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848360","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":"Impact of Procedural Aspects on Early Complications After Permanent Cardiac Implantable Device Implantations.","authors":"Joanna Popiolek-Kalisz, Tomasz Chrominski, Marcin Szczasny, Piotr Błaszczak","doi":"10.1111/pace.15124","DOIUrl":"10.1111/pace.15124","url":null,"abstract":"<p><strong>Background: </strong>Cardiac implantable devices (CIED) such as pacemakers, implantable cardioverter-defibrillators, or cardiac resynchronization devices are implanted in selected patients with bradyarrhythmia and advanced heart failure. The invasive character of these procedures poses a risk of early complications such as pneumothorax, bleeding, infections, or dislocations.</p><p><strong>Aims: </strong>There are no available data that analyzed the impact of the organization of procedures on the early complications risk after permanent pacing procedures. The aim of this study was to investigate if organizational aspects can impact early complications risk in CIED implantations.</p><p><strong>Methods: </strong>This retrospective study analyzed the medical records of 1673 patients who underwent CIED implantation at the Department of Cardiology of Cardinal Wyszynski Hospital in the years 2016-2020 (before the conduction system pacing era).</p><p><strong>Results: </strong>The regression analysis revealed the predictive value of the number of leads on complication risk overall (β = 0.65, p < 0.001). Even though the significant differences in complications count were also observed for the consecutive days of the week (p = 0.002) and procedure order within the same day (p = 0.01), the regression analysis did not confirm their predictive value on complications' risk. However, the subgroup analysis regarding the device type revealed the significant predictive value of procedure order on complications in the single-chamber pacemaker subgroup (β = 1.10, p = 0.01). Moreover, the subgroup analysis confirmed the predictive value of the number of leads on pneumothorax (β = 0.89, p = 0.04) and dislocation (β = 0.67, p = 0.01), age of the patient, and the assist with the less experienced operator on hemopericardium (β = 0.11, p = 0.02, and β = 2.34, p = 0.04, respectively).</p><p><strong>Conclusion: </strong>The study showed that the number of leads is the main factor of early complications after CIED implantations. In the simplest devices such as single-chamber pacemakers, the order of the procedure within the same day can also play a role in early complications risk.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"249-255"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883663","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":"In Vivo Tissue Temperature Characteristics of Contact Force Catheter With a Mesh-Shaped Irrigation Tip: A Porcine Study.","authors":"Masanaru Sawada, Naoto Otsuka, Koichi Nagashima, Ryuta Watanabe, Yuji Wakamatsu, Satoshi Hayashida, Shu Hirata, Moyuru Hirata, Sayaka Kurokawa, Yasuo Okumura, Kenta Uto, Hiroyuki Hao, Rie Takahashi, Yoshiki Taniguchi","doi":"10.1111/pace.15147","DOIUrl":"10.1111/pace.15147","url":null,"abstract":"<p><strong>Background: </strong>Neither the actual in vivo tissue temperatures reached with a novel contact force sensing catheter with a mesh-shaped irrigation tip (TactiFlex SE, Abbott) nor the safety profile has been elucidated.</p><p><strong>Methods: </strong>In a porcine model (n = 8), thermocouples were implanted epicardially in the superior vena cava, right pulmonary vein, and esophagus close to the inferior vena cava following a right thoracotomy. After chest closure, endocardial ablation was conducted near the thermocouples under fluoroscopic guidance. We compared tissue temperatures during 50 W/13-s high-power short-duration (HPSD) and 30 W/30-s standard ablation.</p><p><strong>Results: </strong>No steam pops were observed in 34 HPSD and 35 standard ablation applications. Tmax (maximum tissue temperature when the thermocouple was located ≤5 mm from the catheter tip) was modestly higher in HPSD compared to standard ablation (60.1°C ± 12.4°C vs. 57.8°C ± 12.9°C; p = 0.46). The peak tissue temperature correlated inversely with the catheter tip-to-thermocouple distance (HPSD: r = -0.40; standard: r = -0.57). Lethal temperatures (≥50°C) were reached faster with HPSD (6.5 ± 3.2 s vs. 10.3 ± 8.6 s; p = 0.04) and the distance from the catheter tip achieving a lethal tissue temperature ≥50°C (indicative of the lesion depth) was slightly shallower with HPSD (4.2 and 4.8 mm, respectively). The esophageal injury occurred superficially in both settings (0.98 ± 0.22 mm vs. 1.16 ± 0.18 mm; p = 0.29).</p><p><strong>Conclusions: </strong>HPSD ablation produced a modestly higher and more rapid increase in the tissue temperature around the veno-atrial junction with a shorter catheter tip-to-thermocouple distance required to reach lethal temperatures. This data contributes to understanding effective lesion creation and collateral injury prevention with the TactiFlex catheter.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"270-279"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048488","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}