Annals of Noninvasive Electrocardiology最新文献

{"title":"Digitalis Therapy Is Associated With an Increased Risk of ICD Shock Delivery and Device Revision","authors":"Gerrit Frommeyer,&nbsp;Philipp S. Lange,&nbsp;Thomas Kleemann,&nbsp;Christoph Stellbrink,&nbsp;Hüseyin Ince,&nbsp;Johannes Brachmann,&nbsp;Thorsten Lewalter,&nbsp;Matthias Hochadel,&nbsp;Jochen Senges,&nbsp;Lars Eckardt","doi":"10.1111/anec.70080","DOIUrl":"https://doi.org/10.1111/anec.70080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Digitalis glycosides are employed for rate control of atrial fibrillation and treatment of heart failure. Previous studies suggested potential harmful effects of digitalis therapy. The aim of the present study was to assess the prevalence and potential impact of digitalis therapy on outcomes in patients with systolic failure who were implanted with an ICD- or CRT-ICD system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>The German Device Registry is a nationwide, prospective registry with a 1-year follow-up investigating 4384 patients receiving either ICD or CRT systems in 52 German centers. The present analysis focused on the presence of digitalis therapy in 3826 patients undergoing device implantation. Patients receiving digitalis therapy (<i>n</i> = 800) presented a more severely impaired left ventricular function, higher NYHA class, and an increased incidence of left bundle branch block. Consequently, the implantation of CRT systems was more common in this group. One-year mortality did not significantly differ between both groups (9.1% vs. 7.4%, <i>p</i> = 0.14). Similar results were obtained for the combined endpoint, including death, myocardial infarction, and stroke. ICD shock delivery (19.7% vs. 15.0%, <i>p</i> = 0.006) and device revision (11.4% vs. 7.5%, <i>p</i> &lt; 0.004) were more common in digitalis-treated patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this study in patients undergoing ICD or CRT implantation, an association of digitalis therapy with an increased risk of device revision was observed. Of note, mortality or severe cardiovascular events did not differ between both groups. Furthermore, an increased risk of ICD shock delivery was observed in digitalis-treated patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786702","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":"Left Bundle Branch Pacing Improved the Outcome of End-Stage Hypertrophic Cardiomyopathy: A Case Report","authors":"Manxin Lin,&nbsp;Shufen Huang,&nbsp;Xinyi Huang,&nbsp;Linlin Li,&nbsp;Binni Cai","doi":"10.1111/anec.70073","DOIUrl":"https://doi.org/10.1111/anec.70073","url":null,"abstract":"<p>Patients with hypertrophic cardiomyopathy (HCM) enter the terminal stage when developed left ventricle enlargement and ejection fraction (EF) reduction. The concomitant complete left bundle branch block (LBBB) is considered an important factor related to poor outcome. Previous research suggested that biventricular pacing has limited effects on such patients. We report a case with end-stage hypertrophic cardiomyopathy who had a miraculous recovery after receiving successful left bundle branch pacing (LBBP).</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769997","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":"Assessment of Long-Term Use Versus Discontinuation of Direct Oral Anticoagulant After Catheter Ablation for Atrial Fibrillation—RYOUMA Registry Subanalysis","authors":"Yuka Oda,&nbsp;Akihiko Nogami,&nbsp;Yuki Komatsu,&nbsp;Kyoko Soejima,&nbsp;Itsuro Morishima,&nbsp;Kenichi Hiroshima,&nbsp;Ritsushi Kato,&nbsp;Satoru Sakagami,&nbsp;Fumiharu Miura,&nbsp;Keisuke Okawa,&nbsp;Masayuki Fukuzawa,&nbsp;Atsushi Takita,&nbsp;Kikuya Uno,&nbsp;Koichiro Kumagai,&nbsp;Takashi Kurita,&nbsp;Masahiko Gosho,&nbsp;Tomoko Ishizu,&nbsp;Kazutaka Aonuma,&nbsp;the RYOUMA Investigators","doi":"10.1111/anec.70067","DOIUrl":"https://doi.org/10.1111/anec.70067","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The relationship between oral anticoagulant (OAC) status after catheter ablation (CA) for atrial fibrillation (AF) and the risks of ischemic stroke or major bleeding events is still unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a subanalysis of the RYOUMA registry, a prospective multicenter observational study of Japanese patients who underwent CA for AF in 2017–2018.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 2844 patients, the rate of DOAC continuation was 48.1%, 69.6%, and 80.9% in patients with a CHADS2 score of 0–1, 2, and 3–6, respectively. Among the patients taking DOACs with a CHADS2 score of 0–1 and 2, the incidence rates of major bleeding were significantly higher than those of ischemic stroke or systemic embolic events (SEEs) (1.3%/year [95% CI, 0.6–2.1] vs. 0.3%/year [95% CI, 0.0–0.7], <i>p</i> = 0.019; 1.8%/year [95% CI, 0.6–3.0] vs. 0.2%/year [95% CI, 0.0–0.6], <i>p</i> = 0.018, respectively). However, there was no difference between the incidence rates of major bleeding events and ischemic stroke or SEEs in patients taking DOACs with a CHADS2 score of 3–6 (1.6%/year [95% CI, 0.2–3.0] vs. 1.0%/year [95% CI, 0.0–2.1], <i>p</i> = 0.474).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In patients with a CHADS2 score of 2, those who continued taking DOACs had a higher incidence rate of major bleeding events compared to ischemic stroke/SEEs, similar to those with a CHADS2 score of 0–1. Conversely, in patients with a CHADS2 score of 3–6, the incidence rates of both ischemic stroke/SEEs and major bleeding were similarly high.</p>\u0000 \u0000 <p><b>Trial Registration:</b> The study was registered as UMIN000026092 (University Hospital Medical Information Network-Clinical Trial Registry)</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762158","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 Narrow QRS Tachycardia With Alternating R-R Interval","authors":"Fenglin Wu,&nbsp;Lijun Zeng,&nbsp;Xiaobo Pu","doi":"10.1111/anec.70075","DOIUrl":"https://doi.org/10.1111/anec.70075","url":null,"abstract":"<p>We report a case of a 21-year-old female manifesting narrow QRS complex tachycardia and alternating R-R intervals. The fixed RP interval suggested ventriculoatrial conduction via an accessory pathway (AP). The alternating PR intervals indicated anterograde conduction through the fast and slow nodal pathways, respectively. The coexistence of AP and dual atrioventricular nodal pathways is not rare, with most of them exhibiting as atrioventricular reentry tachycardia (AVRT) using the fast or slow nodal pathway exclusively as the anterograde limb. We propose that alternating dual nodal pathway AVRT may occur when the fast pathway's effective refractory period is between the cycle lengths of fast-nodal-pathway AVRT and slow-nodal-pathway AVRT.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762157","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":"Serendipitous Supernormality","authors":"Behzad B. Pavri,&nbsp;Eitan Frankel","doi":"10.1111/anec.70069","DOIUrl":"https://doi.org/10.1111/anec.70069","url":null,"abstract":"<p>We describe a patient who underwent AV node modification to create complete heart block in the setting of incessant, ablation-and-drug-refractory, symptomatic atypical atrial flutter. His dual chamber defibrillator (previously implanted for resuscitated cardiac arrest) was programmed to the VVIR mode at a faster pacing rate of 85 bpm. Serendipitously, this rate was an almost exact factorial of his flutter rate of 250–260 bpm. This resulted in every 6th flutter wave falling in the supernormal period, resulting in fixed-coupled supraventricular bigeminy and trigeminy in the setting of complete heart block. Reprogramming the pacing rate to 75 bpm abolished bigeminy and trigeminy.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770167","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":"Clinical and Electrocardiographic Characteristics in NSTEMI Patients With Acute Total Occlusion of Culprit Left Circumflex Artery","authors":"Yongshi Wei,&nbsp;Doudou Pei,&nbsp;Jiang Deng,&nbsp;Bryan Richard Sasmita,&nbsp;Lijun Mao,&nbsp;Fengpeng Jia","doi":"10.1111/anec.70070","DOIUrl":"https://doi.org/10.1111/anec.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Complete blockage of the culprit coronary artery is associated with 30% of NSTEMI (non-ST-segment elevation myocardial infarction) patients. The culprit vessel in the left circumflex artery (LCX) is more prevalent in this subset of individuals. These people's clinical features and ischemia alterations on electrocardiography (ECG) are unknown. The goals of this study were to examine clinical features and identify predicted ECG abnormalities in NSTEMI patients with complete blockage of the culprit LCX.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study enrolled 5215 consecutive NSTEMI patients' data. A total of 180 people were diagnosed with acute total occlusion of the culprit artery (ATOCA). Based on the culprit vessel, the patients were classified into three groups:ATOCA in the LAD (<i>n</i> = 46), ATOCA in the RCA (<i>n</i> = 38) and ATOCA in the LCX (<i>n</i> = 96). Furthermore, basic clinical data, ECG alterations, and the occurrence of major adverse cardiac events (MACEs) were gathered and examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this single-center investigation, we discovered that ATOCA was more prevalent in patients with NSTEMI in the LCX group. Patients with culprit LCX were more prone to having multivessel coronary disease (<i>p</i> = 0.015), poorer LVEF (<i>p</i> = 0.040), and a lower revascularization success rate (<i>p</i> = 0.019) during hospitalization, although there were no significant differences in MACEs in short and long follow-up. STV5 + STV6 ≥ 2.5 mm (OR = 2.595, 95% CI: 1.297 ~ 5.192) and T-wave imbalance (defined as an upright T-wave in V1 with an amplitude larger than V6 (T1–T6 ≥ 1 mm) recorded from the P-R interval)(OR = 3.871, 95% CI: 1.820 ~ 8.231) were shown to be independent predictors of NSTEMI patients with acute complete blockage of the culprit LCX in multivariate regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The LCX is the most prevalent culprit vessel with acute complete occlusion in NSTEMI patients, yet it has little effect on clinical outcomes. This subset of patients may be predicted by STV5 + STV6 ≥ 2.5 mm and T-wave imbalance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762156","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":"Active Compression During External Cardioversion of Atrial Fibrillation: A Meta-Analysis of Randomized Controlled Trials","authors":"Hosam I. Taha,&nbsp;Abubakar Nazir,&nbsp;Ahmed A. Ibrahim,&nbsp;Mohamed S. Elgendy,&nbsp;Abdalhakim Shubietah,&nbsp;Hazem Reyad Mansour,&nbsp;Sherif Sary,&nbsp;Moataz Maged,&nbsp;Mustafa Turkmani,&nbsp;Mohamed Abuelazm","doi":"10.1111/anec.70074","DOIUrl":"https://doi.org/10.1111/anec.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Direct current cardioversion (DCCV) is commonly used for atrial fibrillation, but there is uncertainty about whether active chest compression improves its effectiveness. This meta-analysis evaluates the impact of active compression on cardioversion outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis synthesizing evidence from randomized controlled trials (RCTs) retrieved from PubMed, Scopus, WOS, Embase, and Cochrane Library till September 2024. Statistical analysis was performed using R software (version 4.3.1), applying risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, with 95% confidence intervals (CI). PROSPERO ID: CRD42024595499.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four RCTs with 737 patients were included. When compared to the no-compression approach, active compression during DCCV was not associated with any significant difference in cardioversion success (RR: 1.10; 95% CI [0.96, 1.25], <i>p</i> = 0.16), first shock success (RR: 1.62; 95% CI [0.94, 2.81], <i>p</i> = 0.08), number of shocks (MD: -0.32; 95% CI [−1.01, 0.36], <i>p</i> = 0.36), or crossover success (MD: 0.76; 95% CI [0.33, 1.77], <i>p</i> = 0.52). However, active compression was associated with a reduced successful shock energy (MD: -23.97 J; 95% CI [−26.84, −21.10], <i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Active compression during DCCV does not significantly improve cardioversion success but may reduce the energy required for successful cardioversion, suggesting potential safety benefits. However, further studies are needed to determine its clinical relevance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741421","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":"Overestimated Myocardial Ischemia","authors":"Hang Lv,&nbsp;Ming Liu","doi":"10.1111/anec.70064","DOIUrl":"https://doi.org/10.1111/anec.70064","url":null,"abstract":"<p>We introduced a case of a 69-year-old female patient with mitral valve prolapse with severe regurgitation who was transferred from the ICU to a regular ward after undergoing mitral valve replacement surgery. Routine ECG examination showed that the precordial leads were affected by the apical pulsation, leading to pseudo-ST segment depression and prolonged QT interval. In clinical practice, ECG artifacts caused by apical pulsation, if not carefully distinguished, may lead to unnecessary examinations and treatments for patients. Our case emphasizes the importance of accurately identifying ECG artifacts.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717150","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 Impact of Antiretroviral Therapy on Electrocardiographic Parameters in Human Immundeficiency Virus-Positive Patients","authors":"Ahmet Anıl Başkurt,&nbsp;Yusuf Demir,&nbsp;Oktay Şenöz","doi":"10.1111/anec.70058","DOIUrl":"https://doi.org/10.1111/anec.70058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Antiretroviral therapy (ART) has revolutionized the management of human immunodeficiency virus (HIV) infection by transforming it into a chronic but manageable condition. Despite its effectiveness in viral suppression and immune restoration, concerns remain regarding ART's potential impact on cardiovascular health, particularly on electrocardiographic (ECG) parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study investigated the effects of ART on ECG parameters in HIV-infected patients by analyzing pre- and post-therapy data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 83 HIV-positive patients were enrolled and evaluated for ECG parameters before and 3 months after ART initiation. Key parameters, including QRS duration, QT duration corrected by the Bazett formula (QTc interval), QRS-T angle, morphology in inferior leads, voltage in lead 1, and P-wave duration (MVP) score, were manually assessed. Statistical analyses compared pre- and post-ART values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No statistically significant changes were observed in ECG parameters post-ART. For example, QRS duration remained stable (pre-ART: 89.08 ± 12.01 ms; post-ART: 88.94 ± 10.00 ms, <i>p</i> = 0.849), as did QTc interval (pre-ART: 403.51 ± 22.22 ms; post-ART: 404.84 ± 14.91 ms, <i>p</i> = 0.563) and MVP ECG score (pre-ART: 3.02 ± 0.95; post-ART: 2.98 ± 0.87, <i>p</i> = 0.882). The QRS-T angle also showed no significant difference (<i>p</i> = 0.675).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ART does not appear to significantly affect ECG parameters in HIV-infected patients, supporting its favorable cardiac safety profile. These findings highlight the importance of regular ECG monitoring to ensure cardiovascular safety in patients undergoing ART.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698984","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":"Distribution Patterns of Paroxysmal Atrial Fibrillation Triggers and Catheter Ablation Success Rates","authors":"Dongsheng Zhao,&nbsp;Yan Dong,&nbsp;Qiushi Chen,&nbsp;Fengxiang Zhang,&nbsp;Koulong Zheng","doi":"10.1111/anec.70065","DOIUrl":"https://doi.org/10.1111/anec.70065","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Investigate the distribution of triggers in paroxysmal atrial fibrillation (PAF) patients and assess the efficacy of circumferential pulmonary vein isolationI (CPVI) combined with non-pulmonary veins (PV) trigger ablation over 1 year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective study included 130 PAF patients undergoing initial catheter ablation. A standardized protocol was applied before CPVI, followed by ablation targeting non-PV triggers. Ablation success was marked by the inability to induce atrial fibrillation (AF) or related arrhythmias. Patients underwent Holter monitoring at intervals post-surgery, culminating in a 7-day exam at 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Atrial fibrillation (AF) was induced in 88 patients (67.0%), with 94 foci identified. The left pulmonary vein was a common source, but the superior vena cava emerged as the most prevalent non-PV site. The 1-year success rate was 86.0%, with no significant differences in success rates among trigger types. However, non-PV triggers were linked to lower recurrence rates post-surgery (HR 0.27, 95% CI 0.08–0.96, <i>p</i> = 0.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study found that the combination of drug stimulation and high-frequency atrial stimulation before CPVI significantly boosted AF induction rates and revealed a high incidence of non-PV triggers. Effective intraoperative induction and accurate identification of non-PV triggers, particularly in the superior vein cava (SVC), contributed to a substantial reduction in postoperative recurrence rates. This approach suggests a potential strategy for improving outcomes in PAF treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"30 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689824","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}