Annals of Noninvasive Electrocardiology最新文献

{"title":"CHA2DS2-VASc Score as a Predictor for Atrial Fibrillation Recurrence and Clinical Outcomes Following Pulmonary Vein Isolation","authors":"Mustafa Gabarin,&nbsp;Mahmoud Suleiman,&nbsp;Adi Elias,&nbsp;Ibrahim Marai,&nbsp;Roy Beinart,&nbsp;Eyal Nof,&nbsp;Yoav Michowitz,&nbsp;Michael Glikson,&nbsp;Yuval Konstantino,&nbsp;Moti Haim,&nbsp;David Luria,&nbsp;David Pereg,&nbsp;Avishag Laish-Farkash,&nbsp;Alexander Omelchenko,&nbsp;the Israeli Working Group on Pacing Electrophysiology","doi":"10.1111/anec.70088","DOIUrl":"https://doi.org/10.1111/anec.70088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults, associated with serious cardiovascular complications such as ischemic stroke, heart failure, and myocardial infarction. Pulmonary vein isolation (PVI) is an established rhythm-control strategy for AF. Although the CHA₂DS₂-VASc score is primarily used to estimate stroke risk in patients with AF, its potential utility in predicting AF recurrence after PVI has not been fully explored in contemporary, real-world multicenter settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the association between the CHA₂DS₂-VASc score and both AF recurrence and adverse clinical outcomes following PVI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study using the Israeli Catheter Ablation Registry (ICAR), including 860 patients undergoing their first PVI for AF. Patients were grouped by CHA₂DS₂-VASc score (0–1, 2–4, &gt; 5). The primary endpoint was AF recurrence within 12 months. Secondary endpoints included re-hospitalization, major adverse cardiovascular events (MACE), and all-cause mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AF recurrence occurred in 32% of patients. Recurrence rates were 25.7%, 31.4%, and 51% across the low, intermediate, and high CHA₂DS₂-VASc score groups, respectively. A higher score was independently associated with increased recurrence risk (HR = 2.88; 95% CI, 1.75–4.74; <i>p</i> &lt; 0.001). Elevated CHA₂DS₂-VASc scores also correlated with higher MACE and re-hospitalization rates. No significant difference in all-cause mortality was observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The CHA₂DS₂-VASc score is an independent predictor of AF recurrence and adverse outcomes after PVI. Its simplicity, availability, and routine use make it a clinically useful tool to support preprocedural risk stratification in AF patients undergoing ablation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143919658","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":"Cardiac Adverse Events in Patients Receiving Immune Checkpoint Inhibitors in the Adjuvant Setting: An FDA Pooled Analysis","authors":"Asma Dilawari,&nbsp;Mori J. Krantz,&nbsp;Ilynn Bulatao,&nbsp;Hee-Koung Joeng,&nbsp;Marc Neilson,&nbsp;Suparna Wedam,&nbsp;Xin Gao,&nbsp;Mallorie H. Fiero,&nbsp;Abhilasha Nair,&nbsp;Marc Theoret,&nbsp;Laleh Amiri-Kordestani","doi":"10.1111/anec.70087","DOIUrl":"https://doi.org/10.1111/anec.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment. By releasing blocks (checkpoints) on the immune system, they elicit powerful antitumor effects. Despite improving survival, ICIs are associated with serious cardiac toxicities. Previous reports have focused on advanced cancer; cardiotoxicity data are therefore limited in the curative setting. We evaluated ICI cardiotoxicity in the non-metastatic setting, where long-term cardiac safety is a growing public health concern.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>ICIs approved in the adjuvant setting were pooled and trials with combination chemotherapy were excluded. Cardiac adverse events (AEs) and emerging cardio-metabolic risks (hyperglycemia, weight gain, hypothyroidism) were assessed. The relative risk (RR) of cardiotoxicity was assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ten randomized controlled trials of atezolizumab, ipilimumab, nivolumab, and pembrolizumab in multiple solid tumors were evaluated; among 9244 patients, 5338 received ICIs. No trial performed routine cardiac monitoring. Six percent of ICI patients vs. 4.6% in placebo (RR 1.24, 95% CI 1.04, 1.49) had a cardiac AE and 13 (0.2%) of ICI patients experienced a fatal cardiac AE (RR 4.76, 95% CI 1.07, 21.06). Older age and male sex were associated with a higher risk for cardiac fatality. Arrhythmia was the most common cardiac AE; hypothyroidism was more frequent (14% vs. 2.5%) among ICI-treated patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the largest pooled analysis of cardiac AEs associated with ICIs in the adjuvant setting. Despite no formalized testing for subclinical cardiotoxicity, ICI treatment increased cardiac AEs. These findings are relevant for long-term cancer survivors, clinicians, and particularly in new drug development, where cardiotoxicity may be substantially underestimated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143919632","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":"Identifying Demographic Factors Affecting the ECG Duration Collected Using a Single-Lead ECG Patch Device","authors":"Dillon J. Dzikowicz,&nbsp;Mehmed Aktas,&nbsp;Betty Mykins,&nbsp;Xiaojuan Xia,&nbsp;Wojciech Zareba,&nbsp;Jean-Phillippe Couderc","doi":"10.1111/anec.70068","DOIUrl":"https://doi.org/10.1111/anec.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Atrial fibrillation (AF), affecting 3% of the US adults, is the most common arrhythmia. While ambulatory electrocardiogram (ECG) monitoring is essential for AF detection, conventional technologies have diagnostic limitations due to AF's sporadic nature. ECG patches offer extended monitoring periods, though their effectiveness is primarily limited by deteriorating skin-electrode contact rather than battery or memory constraints.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This analysis reports our experience with the Zio ECG patch (iRhythm, San Francisco, CA) in 256 AF patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We analyzed human and technical factors and their association with ECG recording duration using previously recorded data which employed the ECG patch as a reference. Descriptive statistics and logistic regression were used to identify associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Body mass index (BMI) was found to be an independent predictor of poorer compliance in a dose-dependent manner (<i>B</i> = −0.046, OR = 0.955, 95% CI: 0.916–0.996, <i>p</i> = 0.033). Loss of adhesive was the primary reason for poor compliance (<i>n</i> = 25; 11%). These findings can guide researchers and clinicians in determining the appropriateness of a 14-day ECG patch based on expected wear time and patient compliance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>BMI significantly impacts ECG patch compliance, primarily through adhesive failures. These findings indicate the need for improved adhesive technologies for higher BMI patients. Future device development should prioritize maintaining electrode-skin contact across diverse patient populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov Identifier: NCT04267133</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904928","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":"Narrowed Right Bundle Branch Block Pattern in Tachycardia","authors":"Zhi Luo,&nbsp;Yi Liu,&nbsp;Yuwei Chen,&nbsp;Xiaobo Pu,&nbsp;Xiangbin Xiao","doi":"10.1111/anec.70072","DOIUrl":"https://doi.org/10.1111/anec.70072","url":null,"abstract":"<p>A 66-year-old man with 5-year intermittent palpitation underwent an electrophysiologic (EP) study. Electrocardiograms (ECGs) on admission showed sinus rhythm with right bundle branch block (RBBB). During palpitation, regular tachycardia with RBBB occurred. Through detailed analysis, the diagnosis of Wolff-Parkinson-White (WPW) syndrome with orthodromic atrio-ventricular reentry tachycardia (AVRT) was established. The case emphasizes the significance of comparing sinus rhythm and tachycardia ECGs for accurate diagnosis.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883952","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":"A Case Report: Electrotonic Modulation-Related T-Wave Over-Sensing After Left Bundle Branch Pacing","authors":"Linlin Li,&nbsp;Manxin Lin,&nbsp;Jincun Guo,&nbsp;Qiang Li,&nbsp;Fanqi Meng,&nbsp;Xinyi Huang,&nbsp;Simei Chen,&nbsp;Binni Cai","doi":"10.1111/anec.70083","DOIUrl":"https://doi.org/10.1111/anec.70083","url":null,"abstract":"<p>A 66-year-old male patient diagnosed with dilated cardiomyopathy, heart failure with reduced EF (32%), and complete left bundle branch block (CLBBB) received cardiac resynchronization therapy (CRT)-D implantation. Left bundle branch pacing (LBBP) was successfully performed, but during the follow-up 6 weeks later, the electrocardiogram (ECG) showed a sinus rhythm tracked by ventricular pacing with a ratio of approximately 2:1 due to T-wave over-sensing, which might be caused by the changes in T-wave morphology due to electrotonic modulation and hyperkalemia or by the lower sensitivity threshold set by the auto sensing algorithm of the ICD. Shortening post-ventricular atrial refractory period (PVARP) restored the ventricular pacing tracking of the atrium, and the T-wave changes improved as time went by.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879947","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":"Evaluatıon of Depressıon and Anxıety Status in Patıents After Cardıac Devıce Implantatıon","authors":"Murat Özmen,&nbsp;Onur Altunkaya,&nbsp;Selim Aydemir,&nbsp;Sidar Şiyar Aydın,&nbsp;Faruk Aydınyılmaz,&nbsp;Emrah Aksakal,&nbsp;Emre Alkan","doi":"10.1111/anec.70085","DOIUrl":"https://doi.org/10.1111/anec.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Implantable cardioverter defibrillator (ICD) and pacemaker (PM) implantation may lead to anxiety and depression, which may reduce patients' quality of life. The aim of our study was to compare depression and anxiety following device implantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective study was conducted on 202 patients admitted to our hospital with ICD and PM implants between January 2024 and January 2025.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of anxiety in PM and ICD recipients was 25.9% and 38.8%, respectively. There was a significant difference in anxiety in ICD patients (&lt; 0.001). In terms of depression, the results in the PM and ICD groups were 18.9 and 38.9, respectively. The results showed a significant difference in the prevalence of depression between PM and ICD recipients. The tendency toward depression was statistically significant in both device recipients (PM; <i>p</i> = 0.008, ICD; <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Considering the prevalence of anxiety and depression, it seems necessary to pay closer attention to the anxiety and depression states of patients who have been treated with PM and ICD devices and to provide more widespread education to these patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871640","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":"Transesophageal Atrial Pacing for the Evaluation of Accessory Atrioventricular Pathways in Wolff-Parkinson-White Syndrome: A Pediatric Case Report and Literature Review","authors":"Jing Chen,&nbsp;Ping Zuo,&nbsp;Xiaoyun Yang,&nbsp;Bei Wang","doi":"10.1111/anec.70084","DOIUrl":"https://doi.org/10.1111/anec.70084","url":null,"abstract":"<p>Arrhythmia induction and identifying the functional characteristics of accessory pathways in Wolff-Parkinson-White (WPW) syndrome typically requires an invasive electrophysiological study. This case reports a 13-year-old boy with a five-year history of paroxysmal palpitations, where transesophageal atrial pacing (TEAP) was used to identify accessory pathways. TEAP revealed multiple tachycardia forms, differentiating orthodromic atrioventricular reentrant tachycardia with narrow and wide QRS complexes. EPS confirmed two pathways, diagnosing WPW syndrome. TEAP effectively assessed accessory pathways' functional characteristics and their roles in tachycardia, showcasing its potential as a minimally invasive diagnostic tool for this condition.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861865","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":"Tracing Visual Expertise in ECG Interpretation: An Eye-Tracking Pilot Study","authors":"Alessandro Bortolotti,&nbsp;Fabrizio Ricci,&nbsp;Carmelita Cieri,&nbsp;Federica Cocco,&nbsp;Chiara Martini,&nbsp;Marcello Panunzi,&nbsp;Davide Rossi,&nbsp;Anna Sorella,&nbsp;Silvio Saraullo,&nbsp;Davide Scordo,&nbsp;Giulia Renda,&nbsp;Sabina Gallina,&nbsp;Riccardo Palumbo","doi":"10.1111/anec.70082","DOIUrl":"https://doi.org/10.1111/anec.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Visual expertise is pivotal for accurate ECG interpretation. We aimed to identify and measure expertise-based differences in visual search patterns, cognitive load, and diagnostic accuracy during ECG analysis using eye-tracking technology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>First- to third-year residents and board-certified expert cardiologists interpreted ECGs of patients with suspected acute coronary syndrome, while eye-tracking glasses recorded fixation count, duration, and pupil dilation. Diagnostic accuracy and cognitive load via NASA Task Load Index were analyzed. Heatmaps illustrated relationships between cognitive load, perceived workload, and self-assessed performance across experience levels and ECG task complexities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Expert readers interpreted ECGs significantly faster than residents (107.6 ± 32.8 vs. 205.31 ± 57.43 s; <i>p</i> &lt; 0.001) and demonstrated higher diagnostic accuracy across all levels of task difficulty (<i>p</i> &lt; 0.001). Eye-tracking analysis revealed that experts exhibited fewer fixations (67.7 ± 25.7 vs. 143.7 ± 29.9; <i>p</i> &lt; 0.001) and longer fixation durations (3.9 ± 0.7 vs. 3.2 ± 1 s; <i>p</i> = 0.032) than residents. Experts also showed lower pupil dilation changes (4.8% ± 2% vs. 10.5% ± 4.2%; <i>p</i> = 0.015). Increased task difficulty was associated with greater pupil dilation, particularly among novices (mean pupil dilation for difficult tasks 13.4% ± 4.1% vs. 7.3% ± 2.3% for easy tasks; <i>p</i> = 0.008), indicating higher cognitive demand. Experts maintained superior self-assessed performance (8 ± 0 vs. 7 ± 1.2; <i>p</i> = 0.009) and reported lower perceived negative workload (4.5 ± 1.45 vs. 6 ± 0.55; <i>p</i> = 0.041).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this pilot study, expert readers achieved faster and more accurate diagnoses, exhibiting more efficient visual search patterns and lower cognitive load. Pending external validation, our findings suggest that ECG training programs should focus on developing targeted visual techniques, cognitive efficiency, and adaptive coping strategies to enhance accurate interpretation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70082","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143845926","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":"The Effect of Sacubitril/Valsartan on Supraventricular and Ventricular Arrhythmias in Patients With Heart Failure","authors":"Alireza Arzhangzadeh,&nbsp;Mohammad Hossein Nikoo,&nbsp;Majid Haghjoo,&nbsp;Fatemeh Rasekh,&nbsp;Shayan Shojaei,&nbsp;Asma Mousavi,&nbsp;Salma Nozhat,&nbsp;Roozbeh Narimani-Javid,&nbsp;Helia Bazroodi,&nbsp;Sana Neisi,&nbsp;Mitra Mojibpour,&nbsp;Mohammad Abedini,&nbsp;Saghi Eslamzadeh,&nbsp;Hamed Bazrafshan Drissi,&nbsp;Sasan Shafiei","doi":"10.1111/anec.70081","DOIUrl":"https://doi.org/10.1111/anec.70081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients with heart failure with reduced ejection fraction (HFrEF) frequently experience electrical disturbances, such as ventricular or atrial fibrillation (AF). Sacubitril/Valsartan (SV) therapy has been linked to lower rates of mortality, ventricular tachycardia (VT), and ventricular fibrillation (VF), with decreased reliance on implantable cardioverter-defibrillator (ICD) therapy. However, studies on the antiarrhythmic effects of SV in patients with ICD or cardiac resynchronization therapy defibrillator (CRT-D) devices are limited. This study aimed to evaluate the impact of SV therapy on antiarrhythmic pacing, defibrillation shock occurrences, and the burden of ventricular arrhythmias in patients with HFrEF who have ICD or CRT-D devices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This study was conducted at a HF outpatient clinic involving patients with HFrEF treated with SV. Primary outcomes included the incidence of VT, VF, non-sustained VT (NsVT), supraventricular tachycardia (SVT), and related interventions such as antiarrhythmic pacing (ATP) and defibrillation shocks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>A total of 181 HFrEF patients completed at least 12 months of follow-up, with a mean age of 63.39 ± 12 years; 36.5% were male, and 60.8% had an ICD. Device interrogation revealed a significant reduction in VF incidents (7 vs. 15, <i>p</i> = 0.025) and a decrease in the combined outcome of VT and VF (17 vs. 24, <i>p</i> = 0.047). The need for ICD interventions such as ATP and shocks also significantly decreased following the initiation of SV therapy (10 vs. 24, <i>p</i> = 0.012).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SV therapy significantly reduces the incidence of cardiac arrhythmias, particularly VT and VF, while decreasing the need for clinical interventions related to implanted devices.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835773","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":"Predicting Ventricular Tachyarrhythmias in Patients With Left Ventricular Ejection Fraction Improvement Following Cardiac Resynchronization Therapy","authors":"Adam Visca,&nbsp;Saadia Sherazi,&nbsp;Ilan Goldenberg,&nbsp;Scott McNitt,&nbsp;Nikhila Rao,&nbsp;Nilesh Rao,&nbsp;Ahmed Shah,&nbsp;Mehmet Aktas,&nbsp;Valentina Kutyifa,&nbsp;Wojciech Zareba,&nbsp;Krishna Rao","doi":"10.1111/anec.70059","DOIUrl":"https://doi.org/10.1111/anec.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients undergoing cardiac resynchronization therapy with a defibrillator (CRT-D) often experience improvements in the left ventricular ejection fraction (LVEF). This study aimed to identify predictors of ventricular tachyarrhythmias (VTA) in patients with CRT-D devices and LVEF improvement beyond guideline recommendations for a defibrillator.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients randomized to the CRT-D arm of the Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy trial who improved their LVEF to &gt; 35% at 12 months following CRT-D implant were included in this analysis (<i>N</i> = 651). Predictors of an appropriate implantable cardioverter defibrillator (ICD) Rx VTA were evaluated by Cox proportional hazards regression modeling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified three predictors of VTA among patients treated with CRT-D subsequent to LVEF improvement &gt; 35%: Lower range improvement in LVEF 36%–40% versus improvement to &gt; 40% (HR, 1.97; 95% CI, 1.21–3.20; <i>p</i> = 0.006); Baseline non-LBBB ECG morphology (hazard ratio [HR], 1.93; 95% confidence interval [CI], 1.23–3.04; <i>p</i> = 0.004); Occurrence of VTA during the first year post-CRT-D (HR, 4.91; 95% CI, 2.99–8.07; <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We identified a sub-group of patients with risk factors who remain at high risk of VTA despite improvement in LVEF following CRT implant. These patients require close monitoring despite improvement in LVEF beyond guideline recommendations for an ICD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793338","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}