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Extended Period Outcomes of Posterior Box Isolation in 4 Randomized Atrial Fibrillation Catheter Ablation Trials 4项随机心房颤动导管消融试验中后箱隔离的延长期结局
JACC. Asia Pub Date : 2025-02-01 DOI: 10.1016/j.jacasi.2024.12.002
Sang Jun Lee MD, Hee Tae Yu MD, PhD, Sung Hwa Choi MD, Daehoon Kim MD, Tae-Hoon Kim MD, Jae-Sun Uhm MD, PhD, Boyoung Joung MD, PhD, Moon-Hyoung Lee MD, PhD, Hui-Nam Pak MD, PhD
{"title":"Extended Period Outcomes of Posterior Box Isolation in 4 Randomized Atrial Fibrillation Catheter Ablation Trials","authors":"Sang Jun Lee MD,&nbsp;Hee Tae Yu MD, PhD,&nbsp;Sung Hwa Choi MD,&nbsp;Daehoon Kim MD,&nbsp;Tae-Hoon Kim MD,&nbsp;Jae-Sun Uhm MD, PhD,&nbsp;Boyoung Joung MD, PhD,&nbsp;Moon-Hyoung Lee MD, PhD,&nbsp;Hui-Nam Pak MD, PhD","doi":"10.1016/j.jacasi.2024.12.002","DOIUrl":"10.1016/j.jacasi.2024.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Catheter-based electrical posterior box isolation (POBI) and circumferential pulmonary vein isolation (CPVI) do not improve the rhythmic outcomes of atrial fibrillation catheter ablation in previous studies with 12 to 24 months of follow-up.</div></div><div><h3>Objectives</h3><div>The authors analyzed the long-term rhythm outcomes of our 4 previously conducted randomized controlled trials comparing CPVI alone vs CPVI plus additional POBI using the intention-to-treat principle.</div></div><div><h3>Methods</h3><div>The authors analyzed 575 AF patients included in our 4 previous randomized controlled trials. We compared clinical recurrence defined as recurrent atrial arrhythmia after the index procedure. In patients who underwent a repeat procedure because of recurrence after the index procedure, the mechanism of recurrence was analyzed.</div></div><div><h3>Results</h3><div>After a median follow-up of 48 months, there were no significant differences in the clinical recurrence or major adverse cardiac events between the CPVI alone and CPVI plus POBI groups. The procedure time was significantly longer, and the atrial tachycardia recurrence rate was higher in the CPVI plus POBI group. In the patients who experienced clinical recurrence, there were no significant differences in the rates of cardioversion or need for repeat procedures between the groups. In patients who underwent a repeat procedure because of recurrence after the index procedure (n = 64), the pulmonary vein reconnection rate did not differ, but re-entrant atrial tachycardia was more common in the CPVI plus POBI group, while extrapulmonary vein triggers were more common in the CPVI alone group.</div></div><div><h3>Conclusions</h3><div>The addition of POBI to CPVI did not improve the long-term rhythm outcomes in patients undergoing atrial fibrillation catheter ablation. (The Evaluation for Prognostic Factors After Catheter Ablation of Atrial Fibrillation, <span><span>NCT02138695</span><svg><path></path></svg></span>; Evaluation of Proper Radiofrequency Catheter Ablation Strategy for the Patients Who Were Changed to Paroxysmal Atrial Fibrillation From Persistent Atrial Fibrillation, <span><span>NCT02176616</span><svg><path></path></svg></span>; Comparison of Circumferential Pulmonary Vein Isolation Alone Versus Linear Ablation in Addition to Circumferential Pulmonary Vein Isolation for Catheter Ablation in Persistent Atrial Fibrillation: Prospective Randomized Controlled Trial, <span><span>NCT02721121</span><svg><path></path></svg></span>; Comparison of Circumferential Pulmonary Vein Isolation and Complex Pulmonary Vein Isolation Additional Linear Ablation for Recurred Atrial Fibrillation After Previous Catheter Ablation: Prospective Randomized Trial [RILI Trial]; <span><span>NCT02747498</span><svg><path></path></svg></span></div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 285-295"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150855","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}
引用次数: 0
30-Day Transcatheter Aortic Valve Replacement Outcomes in Severe Symptomatic Aortic Stenosis Chinese Patients 中国重度症状性主动脉瓣狭窄患者30天经导管主动脉瓣置换术的疗效
JACC. Asia Pub Date : 2025-02-01 DOI: 10.1016/j.jacasi.2024.10.011
Mao Chen MD , Xianbao Liu MD, PhD , Yujie Zhou MD , Yundai Chen MD , Yuan Feng MD , Sarah Verdoliva Boatman MSc , Jianan Wang MD, PhD
{"title":"30-Day Transcatheter Aortic Valve Replacement Outcomes in Severe Symptomatic Aortic Stenosis Chinese Patients","authors":"Mao Chen MD ,&nbsp;Xianbao Liu MD, PhD ,&nbsp;Yujie Zhou MD ,&nbsp;Yundai Chen MD ,&nbsp;Yuan Feng MD ,&nbsp;Sarah Verdoliva Boatman MSc ,&nbsp;Jianan Wang MD, PhD","doi":"10.1016/j.jacasi.2024.10.011","DOIUrl":"10.1016/j.jacasi.2024.10.011","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 318-321"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150944","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}
引用次数: 0
Extremely Small 20-mm Versus Standard-Size Balloon-Expandable Transcatheter Heart Valves 极小20毫米与标准尺寸球囊可扩张经导管心脏瓣膜比较
JACC. Asia Pub Date : 2025-02-01 DOI: 10.1016/j.jacasi.2024.09.005
Taishi Okuno MD , Masaki Izumo MD , Kai Takahiko MD , Shingo Kuwata MD , Masashi Koga MD , Yoshihiro J. Akashi MD , Shinichi Shirai MD , Yusuke Watanabe MD , Toru Naganuma MD , Norio Tada MD , Futoshi Yamanaka MD , Masahiko Noguchi MD , Hiroshi Ueno MD , Yohei Ohno MD , Hidetaka Nishina MD , Kensuke Takagi MD , Masahiko Asami MD , Kazuki Mizutani MD , Fumiaki Yashima MD , Toshiaki Otsuka MD , Kentaro Hayashida MD
{"title":"Extremely Small 20-mm Versus Standard-Size Balloon-Expandable Transcatheter Heart Valves","authors":"Taishi Okuno MD ,&nbsp;Masaki Izumo MD ,&nbsp;Kai Takahiko MD ,&nbsp;Shingo Kuwata MD ,&nbsp;Masashi Koga MD ,&nbsp;Yoshihiro J. Akashi MD ,&nbsp;Shinichi Shirai MD ,&nbsp;Yusuke Watanabe MD ,&nbsp;Toru Naganuma MD ,&nbsp;Norio Tada MD ,&nbsp;Futoshi Yamanaka MD ,&nbsp;Masahiko Noguchi MD ,&nbsp;Hiroshi Ueno MD ,&nbsp;Yohei Ohno MD ,&nbsp;Hidetaka Nishina MD ,&nbsp;Kensuke Takagi MD ,&nbsp;Masahiko Asami MD ,&nbsp;Kazuki Mizutani MD ,&nbsp;Fumiaki Yashima MD ,&nbsp;Toshiaki Otsuka MD ,&nbsp;Kentaro Hayashida MD","doi":"10.1016/j.jacasi.2024.09.005","DOIUrl":"10.1016/j.jacasi.2024.09.005","url":null,"abstract":"<div><h3>Background</h3><div>The 20-mm balloon-expandable transcatheter heart valve (THV) represents the smallest available option for transcatheter aortic valve replacement (TAVR). Its current underutilization stems from concerns regarding prosthesis-patient mismatch, durability, and potential adverse outcomes.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to compare the long-term outcomes between the 20-mm balloon-expandable THVs and standard-size balloon-expandable THVs.</div></div><div><h3>Methods</h3><div>Patients who underwent transfemoral TAVR with SAPIEN THVs were sourced from the OCEAN-TAVI (Optimized Transcatheter Valvular Intervention) registry, an ongoing, multicenter cohort study that has enrolled over 7,000 TAVR patients in Japan. A 1:3 propensity-matched analysis, based on 24 baseline clinical and echocardiographic variables, was used to contrast the 20-mm with &gt;20-mm balloon-expandable THVs.</div></div><div><h3>Results</h3><div>Of 5,086 eligible patients, 284 (5.6%) received the 20-mm balloon-expandable THV. After propensity-matching, the 20-mm THV group (n = 276) and the &gt;20-mm THV group (n = 828) demonstrated balanced baseline characteristics, with an absolute standardized difference &lt;0.10. The average follow-up duration for patients who were alive was 955 ± 512 days, and the average time to death was 584 ± 543 days. The 20-mm group showed a higher frequency of prosthesis-patient mismatch (PPM) (moderate PPM: 29.2% vs 10.8%; severe PPM: 4.9% vs 1.5%; <em>P &lt;</em> 0.001). Over a 5-year period, all-cause mortality and heart failure rehospitalization rates were comparable between the 2 groups (all-cause mortality: 34.2% vs 38.0%; HR: 1.01; 95% CI: 0.74-1.37; <em>P =</em> 0.970; heart failure rehospitalization: 15.2% vs 16.3%; HR: 0.81; 95% CI: 0.50-1.29; <em>P =</em> 0.371).</div></div><div><h3>Conclusions</h3><div>This registry-based study suggests that the initially observed inferior forward hemodynamics associated with the 20-mm THV do not translate into heightened long-term mortality or heart failure rehospitalization risks. (The OCEAN-TAVI registry [Optimized Transcatheter Valvular Intervention-Transcatheter Aortic Valve Implantation]; <span><span>UMINID:000020423</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 245-254"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150950","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}
引用次数: 0
Protruding and Ulcerated Aortic Atheromas as Predictors of Periprocedural Ischemic Stroke Post-Transcatheter Aortic Valve Replacement 经导管主动脉瓣置换术后围手术期缺血性卒中的预测因素:突出和溃疡性主动脉粥样硬化
JACC. Asia Pub Date : 2025-02-01 DOI: 10.1016/j.jacasi.2024.10.020
Shinnosuke Kikuchi MD , Antonin Trimaille MD , Adrien Carmona MD , Dinh Phi Truong MD , Kensuke Matsushita MD, PhD , Benjamin Marchandot MD , Amandine Granier MD , Antje Reydel MD , Manh Cuong Vu MD , Franck Zheng MD , Zoe Heyberger MD , Julien Tse Sik Sun MD , Florian Loizon MD , Paul Knellwolf MD , Dorian Recht MD , Baudouin Koenig MD , Mickael Ohana MD, PhD , Kiyoshi Hibi MD, PhD , Patrick Ohlmann MD, PhD , Olivier Morel MD, PhD
{"title":"Protruding and Ulcerated Aortic Atheromas as Predictors of Periprocedural Ischemic Stroke Post-Transcatheter Aortic Valve Replacement","authors":"Shinnosuke Kikuchi MD ,&nbsp;Antonin Trimaille MD ,&nbsp;Adrien Carmona MD ,&nbsp;Dinh Phi Truong MD ,&nbsp;Kensuke Matsushita MD, PhD ,&nbsp;Benjamin Marchandot MD ,&nbsp;Amandine Granier MD ,&nbsp;Antje Reydel MD ,&nbsp;Manh Cuong Vu MD ,&nbsp;Franck Zheng MD ,&nbsp;Zoe Heyberger MD ,&nbsp;Julien Tse Sik Sun MD ,&nbsp;Florian Loizon MD ,&nbsp;Paul Knellwolf MD ,&nbsp;Dorian Recht MD ,&nbsp;Baudouin Koenig MD ,&nbsp;Mickael Ohana MD, PhD ,&nbsp;Kiyoshi Hibi MD, PhD ,&nbsp;Patrick Ohlmann MD, PhD ,&nbsp;Olivier Morel MD, PhD","doi":"10.1016/j.jacasi.2024.10.020","DOIUrl":"10.1016/j.jacasi.2024.10.020","url":null,"abstract":"<div><h3>Background</h3><div>Aortic atherosclerosis can affect the strategy and outcomes of transcatheter aortic valve replacement (TAVR). Limited investigation exists into how aortic atheroma morphology influences outcomes post-TAVR.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the influence of protruding and ulcerated aortic atheromas on periprocedural ischemic stroke post-TAVR.</div></div><div><h3>Methods</h3><div>This analysis included 977 patients who underwent TAVR between February 2010 and May 2019, with available contrast-enhanced computed tomography data. Protruding aortic atheroma was defined as atheroma of ≥3 mm thickness with protruding components. Ulcerated aortic atheroma was defined as atheroma with ulcer-like intimal disruption. The primary endpoint was periprocedural ischemic stroke within 30 days post-TAVR.</div></div><div><h3>Results</h3><div>In total, 43 (4.4%) experienced periprocedural ischemic stroke. Patients with protruding or ulcerated aortic atheroma had a significantly higher incidence of periprocedural stroke compared with those without (8.0% [95% CI: 4.9%-12.2%] vs 3.2% [95% CI: 2.1%-4.8%]; <em>P =</em> 0.003). Protruding or ulcerated atheroma (adjusted OR [aOR]: 2.55 [95% CI: 1.37-4.74]), particularly in the aortic arch (aOR: 3.86 [95% CI: 1.69-8.83]), independently increased periprocedural stroke risk. Among patients undergoing transfemoral TAVR with self-expandable valves (n = 315, 32%), protruding or ulcerated atheroma in the aortic arch was independently associated with periprocedural stroke (aOR: 9.04 [95% CI: 1.59-51.4]), whereas it was not among those with balloon-expandable valves (n = 580, 59%) (aOR: 2.85 [95% CI: 0.92-8.84]).</div></div><div><h3>Conclusions</h3><div>Protruding and ulcerated aortic atheromas are associated with a higher risk of periprocedural ischemic stroke post-TAVR. Careful selection of TAVR strategy, including valve type and procedural approach, is essential for patients with such aortic lesions.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 258-269"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150952","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}
引用次数: 0
Selecting the Proper Transcatheter Aortic Valve Replacement Device in East Asians With a Small Aortic Annulus 东亚小主动脉环患者经导管主动脉瓣置换术的选择
JACC. Asia Pub Date : 2025-02-01 DOI: 10.1016/j.jacasi.2024.11.002
Ying-Hwa Chen MD, PhD , Howard C. Herrmann MD
{"title":"Selecting the Proper Transcatheter Aortic Valve Replacement Device in East Asians With a Small Aortic Annulus","authors":"Ying-Hwa Chen MD, PhD ,&nbsp;Howard C. Herrmann MD","doi":"10.1016/j.jacasi.2024.11.002","DOIUrl":"10.1016/j.jacasi.2024.11.002","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 322-326"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150945","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}
引用次数: 0
Posterior Wall Box Isolation in Atrial Fibrillation Catheter Ablation 房颤导管消融后壁盒隔离术
JACC. Asia Pub Date : 2025-02-01 DOI: 10.1016/j.jacasi.2025.01.001
David Chieng MBBS, PhD , Peter M. Kistler MBBS, PhD
{"title":"Posterior Wall Box Isolation in Atrial Fibrillation Catheter Ablation","authors":"David Chieng MBBS, PhD ,&nbsp;Peter M. Kistler MBBS, PhD","doi":"10.1016/j.jacasi.2025.01.001","DOIUrl":"10.1016/j.jacasi.2025.01.001","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 296-298"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150940","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}
引用次数: 0
Novel Applications of the Hybrid IVUS-OCT Imaging System 混合IVUS-OCT成像系统的新应用
JACC. Asia Pub Date : 2025-02-01 DOI: 10.1016/j.jacasi.2024.11.022
Masaru Ishida MD, PhD
{"title":"Novel Applications of the Hybrid IVUS-OCT Imaging System","authors":"Masaru Ishida MD, PhD","doi":"10.1016/j.jacasi.2024.11.022","DOIUrl":"10.1016/j.jacasi.2024.11.022","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 242-244"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150949","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}
引用次数: 0
Effect of Renal Impairment on Clinical Outcomes After Mitral Valve Transcatheter Edge-to-Edge Repair 经导管二尖瓣边缘修复术后肾功能损害对临床预后的影响
JACC. Asia Pub Date : 2025-02-01 DOI: 10.1016/j.jacasi.2024.10.025
Kazuki Tanaka MD , Junichi Yamaguchi MD , Masafumi Yoshikawa MD , Eiji Shibahashi MD , Hisao Otsuki MD , Takanori Kawamoto MD , Chihiro Koyanagi MD , Yusuke Inagaki MD , Tomohito Kogure MD , Masanori Yamamoto MD , Mike Saji MD , Masahiko Asami MD , Masaki Nakashima MD , Yusuke Enta MD , Shinichi Shirai MD , Masaki Izumo MD , Shingo Mizuno MD , Yusuke Watanabe MD , Makoto Amaki MD , Kazuhisa Kodama MD , Kentaro Hayashida MD
{"title":"Effect of Renal Impairment on Clinical Outcomes After Mitral Valve Transcatheter Edge-to-Edge Repair","authors":"Kazuki Tanaka MD ,&nbsp;Junichi Yamaguchi MD ,&nbsp;Masafumi Yoshikawa MD ,&nbsp;Eiji Shibahashi MD ,&nbsp;Hisao Otsuki MD ,&nbsp;Takanori Kawamoto MD ,&nbsp;Chihiro Koyanagi MD ,&nbsp;Yusuke Inagaki MD ,&nbsp;Tomohito Kogure MD ,&nbsp;Masanori Yamamoto MD ,&nbsp;Mike Saji MD ,&nbsp;Masahiko Asami MD ,&nbsp;Masaki Nakashima MD ,&nbsp;Yusuke Enta MD ,&nbsp;Shinichi Shirai MD ,&nbsp;Masaki Izumo MD ,&nbsp;Shingo Mizuno MD ,&nbsp;Yusuke Watanabe MD ,&nbsp;Makoto Amaki MD ,&nbsp;Kazuhisa Kodama MD ,&nbsp;Kentaro Hayashida MD","doi":"10.1016/j.jacasi.2024.10.025","DOIUrl":"10.1016/j.jacasi.2024.10.025","url":null,"abstract":"<div><h3>Background</h3><div>Renal impairment is associated with poor clinical outcomes in patients with cardiovascular diseases. Some studies have revealed the impact of renal impairment on the clinical outcomes of patients who underwent mitral valve transcatheter edge-to-edge repair (M-TEER). However, limited data are available regarding the impact of baseline renal impairment after M-TEER in Asian-Pacific patients with heart failure and severe mitral regurgitation.</div></div><div><h3>Objectives</h3><div>This study sought to examine the effect of renal impairment on clinical outcomes after M-TEER using a large-scale nationwide registry in Japan.</div></div><div><h3>Methods</h3><div>A total of 2,150 patients enrolled in the OCEAN-Mitral (Optimized Catheter Valvular Intervention) registry were divided into 3 groups according to the estimated glomerular filtration rate (eGFR) before M-TEER: normal eGFR (≥60 mL/min/1.73 m<sup>2</sup>) (n = 291), renal impairment (&lt;60 mL/min/1.73 m<sup>2</sup>) (n = 1,746), and dialysis (n = 113). The impact of renal impairment and dialysis on major adverse cardiovascular events (MACE) (a composite of all-cause death and hospitalization for heart failure) was examined.</div></div><div><h3>Results</h3><div>Kaplan-Meier analysis revealed that the renal impairment and dialysis groups had a significantly higher incidence of MACE (survival rates at 2 years: normal eGFR, 74.2% [95% CI: 66.9%-80.1%] vs renal impairment, 63.9% [95% CI: 61.0%-66.6%] vs dialysis, 50.9% [95% CI: 38.2%-62.2%]; <em>P &lt;</em> 0.001). Multivariate Cox regression analysis identified dialysis as the strongest independent predictor of MACE (HR: 1.95; 95% CI: 1.33-2.85; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Renal impairment was associated with an increased incidence of major adverse events, and dialysis was the strongest independent predictor of poor clinical outcomes after M-TEER in Asian-Pacific patients.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 273-282"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150938","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}
引用次数: 0
Electrocardiographic Characteristics and Ablation Outcomes Associated With Para-Hisian Ventricular Arrhythmias 与旁心性室性心律失常相关的心电图特征和消融结果
JACC. Asia Pub Date : 2025-02-01 DOI: 10.1016/j.jacasi.2024.11.012
Anugrah Nair DM , Jenish P. Shroff DM , Lukah Q. Tuan BSc , Adriana Tokich BSc , Deep Chandh Raja DM , Abhinav Mehta BSc , Walter P. Abhayaratna MBBS, PhD , Prashanthan Sanders MBBS, PhD , Francis E. Marchlinski MD , Kalyanam Shivkumar MD, PhD , Rajeev K. Pathak MBBS, PhD
{"title":"Electrocardiographic Characteristics and Ablation Outcomes Associated With Para-Hisian Ventricular Arrhythmias","authors":"Anugrah Nair DM ,&nbsp;Jenish P. Shroff DM ,&nbsp;Lukah Q. Tuan BSc ,&nbsp;Adriana Tokich BSc ,&nbsp;Deep Chandh Raja DM ,&nbsp;Abhinav Mehta BSc ,&nbsp;Walter P. Abhayaratna MBBS, PhD ,&nbsp;Prashanthan Sanders MBBS, PhD ,&nbsp;Francis E. Marchlinski MD ,&nbsp;Kalyanam Shivkumar MD, PhD ,&nbsp;Rajeev K. Pathak MBBS, PhD","doi":"10.1016/j.jacasi.2024.11.012","DOIUrl":"10.1016/j.jacasi.2024.11.012","url":null,"abstract":"<div><h3>Background</h3><div>Ventricular arrhythmias (VAs) near the His-bundle comprise 9% of unexplained VAs and present challenges for ablation caused by the risk of atrioventricular block.</div></div><div><h3>Objectives</h3><div>The authors studied the electrocardiographic (ECG) and electrophysiological characteristics of Para-Hisian (PH) VAs, comparing them with septal right ventricular outflow tract VAs.</div></div><div><h3>Methods</h3><div>From 210 patients with VAs between 2018 and 2024, 31 (14.7%) with PH-VAs and 23 (10.9%) with septal right ventricular outflow tract VAs were included. ECG characteristics of both were compared, and features differentiating left and right PH and supra- and infra-Hisian VAs were identified.</div></div><div><h3>Results</h3><div>Of 31 patients, 15 had VAs from the right PH site and 16 from the left. Median follow-up was 15 months (Q1-Q3: 14-21 months) for left infra-Hisian, 16 months (Q1-Q3: 14-20 months) for left supra-Hisian, and 14 months (Q1-Q3: 14-16 months) for right infra-Hisian and right supra-Hisian VAs (Q1-Q3: 14-15 months). PH-VAs had narrower QRS complexes (134 ± 19.6 ms vs 169 ± 24 ms; <em>P</em> &lt; 0.05), R-wave in lead aVL (100% [31 of 31] vs 4.3% [1 of 23]; <em>P</em> &lt; 0.001), and earlier R-wave transition at or before lead V<sub>3</sub> (80.6% [25 of 31] vs 47.8% [11 of 23]; <em>P</em> &lt; 0.05). Left PH-VAs had earlier R-wave transition at lead V<sub>2</sub> (50% [8 of 16] vs 20% [3 of 15]; <em>P =</em> 0.036). Right PH VAs had deeper S-wave relative to the preceding sinus beat in lead V<sub>1</sub> (73.3% [11 of 15] vs 37.5% [6 of 16]; <em>P =</em> 0.04) and lead aVR (80% [12 of 15] vs 56.3% [9 of 16]; <em>P =</em> 0.01). Postprocedure heart block occurred in 1 patient.</div></div><div><h3>Conclusions</h3><div>PH-VAs exhibit unique ECG features based on their origins, and can be effectively treated without affecting atrioventricular conduction.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 299-312"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150941","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}
引用次数: 0
Management of Chronic Coronary Syndrome 慢性冠状动脉综合征的治疗
JACC. Asia Pub Date : 2025-02-01 DOI: 10.1016/j.jacasi.2024.12.004
Yao Xie MD, PhD, MPH, Jun Jiang MD, PhD, Jian’an Wang MD, PhD
{"title":"Management of Chronic Coronary Syndrome","authors":"Yao Xie MD, PhD, MPH,&nbsp;Jun Jiang MD, PhD,&nbsp;Jian’an Wang MD, PhD","doi":"10.1016/j.jacasi.2024.12.004","DOIUrl":"10.1016/j.jacasi.2024.12.004","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 327-331"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150954","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}
引用次数: 0
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