European heart journal open最新文献

{"title":"Comparison between no fasting vs. fasting in patients undergoing cardiac catheterization laboratory procedures: a systematic review and meta-analysis.","authors":"Pedro Segura-Saldaña, Mayita Alvarez-Vargas, Victor Ludeña-Meléndez, Juan Llaja-Socorro, Carlos Davila-Paredes, José Sánchez-Cárdenas, Estefani Galvez-Rodriguez, Arón Santillán-Rodríguez, Carlos Cabrera-Cruzado, Pedro Guerra-Canchari, Carlos Diaz-Arocutipa","doi":"10.1093/ehjopen/oeaf123","DOIUrl":"https://doi.org/10.1093/ehjopen/oeaf123","url":null,"abstract":"<p><strong>Aims: </strong>Fasting prior to procedures in the cardiac catheterization laboratory is an established indication in clinical practice. However, the evidence supporting this recommendation is uncertain.</p><p><strong>Objectives: </strong>The aim of this systematic review and meta-analysis was to evaluate the impact of non-fasting vs. fasting before cardiac catheterization.</p><p><strong>Methods and results: </strong>PubMed, Embase, Scopus, and Web of Science databases were searched until September 2024. Randomized controlled trials comparing both strategies were included. Outcomes were hypoglycaemia, aspiration pneumonia, contrast-induced acute kidney injury (AKI), nausea/vomiting, hypotension, and patient satisfaction. Risk of bias was assessed using the RoB 2.0 tool. All meta-analyses were performed using a random-effects model. Six studies were included (<i>n</i> = 2736). The mean age ranged from 62 to 70 years, and 31% were female. There was no significant difference in the risk of hypoglycaemia [risk ratio (RR) 0.82, 95% confidence interval (CI) 0.49-1.38], aspiration pneumonia (RR 1.31, 95% CI 0.28-6.05), nausea/vomiting (RR 0.95, 95% CI 0.58-1.55), contrast-induced AKI (RR 1.87, 95% CI 0.94-3.72) between the non-fasting and fasting groups. In contrast, patients in the non-fasting group had a lower risk of hypotension (RR 0.57, 95% CI 0.38-0.86) and higher satisfaction scores (standardized mean difference -1.53, 95% CI -2.11 to -0.96) compared with the fasting group. The risk of bias was judged as some concerns in three of four studies.</p><p><strong>Conclusion: </strong>Our results suggest that in patients who underwent cardiac catheterization procedures, non-fasting was a safe strategy and provoked higher satisfaction compared to fasting.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 2","pages":"oeaf123"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824940","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}

{"title":"Beyond the conventional risk factors in the management of atherosclerosis in women: a call to action for careful consideration of obesity and inflammation.","authors":"Mirvat Alasnag, Antonia Sambola, Izabella Uchmanowicz, Marta Kaluzna, Pierre François Sabouret, Laura Serrano, Valeria Paradies, Biljana Parapid, Shrilla Banerjee, Anne Bachelot, Martine Gilard, Michał Hawranek, Vijay Kunadian, Alaide Chieffo, Roxana Mehran, Stephane Manzo Silberman","doi":"10.1093/ehjopen/oeag055","DOIUrl":"https://doi.org/10.1093/ehjopen/oeag055","url":null,"abstract":"<p><p>Conventional risk factors do not completely explain the burden of atherosclerotic cardiovascular disease (ASCVD) in women. Obesity and chronic low-grade inflammation are recognized as important contributors to atherosclerotic risk. This viewpoint explains the role of obesity-driven inflammation in the development and management of atherosclerosis in women. Abdominal obesity promotes a proinflammatory and prothrombotic environment that accelerates atherogenesis. Women with higher inflammatory biomarker levels and experience sex-specific risk-modifying stages, such as polycystic ovary syndrome, pregnancy-related conditions, and menopause, have higher risk for cardiovascular events, including atherosclerosis. We review evidence for antiobesity and anti-inflammatory therapies. Integrating obesity and inflammation into ASCVD care in women requires targeted screening, risk assessment, and sex-stratified research approaches. This viewpoint highlights the relation between obesity and atherosclerosis.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 2","pages":"oeag055"},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792928","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}

{"title":"Physician-led telemedical care enhances blood pressure control in hypertension: a randomized-controlled pilot study (REMOTE-control-HTN).","authors":"Paula Sagmeister, Natalie Fischer, Diana Eckert, Luise Mentzel, Parham Shahidi, Charlotte Wolff, Holger Thiele, Karl Fengler","doi":"10.1093/ehjopen/oeag061","DOIUrl":"https://doi.org/10.1093/ehjopen/oeag061","url":null,"abstract":"<p><strong>Aims: </strong>Despite advances in antihypertensive therapy, blood pressure (BP) control remains inadequate in many patients due to limited follow-up and insufficient medication titration.</p><p><strong>Methods and results: </strong>This single-centre, randomized controlled pilot trial was conducted at a tertiary academic hospital in Germany between December 2023 to September 2024. Sixty adults with uncontrolled hypertension (office BP >140/90 mmHg despite antihypertensive medication) were randomized 1:1 to standard care or physician-led telemedical care. All participants performed home BP measurements twice daily using validated telemedical devices. The intervention group received structured biweekly calls for BP review and medication optimization. The control group continued care with their general practitioners. The primary endpoint was time in target range (TTR) over 6 months, defined as the percentage of home BP readings below guideline thresholds (<130/80 mmHg for age <65, <140/90 mmHg for age ≥65). Group comparisons used <i>t</i>-tests. The study was registered at CinlicalTrials.gov Identifier [NCT07049289]. Fifty-six patients completed 6-month follow-up (mean age 61 ± 13 years, 61% male). Baseline BP was 161 ± 17/97 ± 12 mmHg. At 6 months, systolic BP decreased by -15.0 ± 9.8 mmHg in the intervention group vs. -4.0 ± 8.7 mmHg in the control group (<i>P</i> < 0.001). Mean systolic TTR was significantly higher in the telemedical care group (52.2 ± 24.2% vs. 36.0 ± 29.2%, <i>P</i> = 0.028), as was diastolic TTR (59.0 ± 31.0% vs. 37.1 ± 34.4%, <i>P</i> = 0.016), and total TTR (42.9 ± 27.5% vs. 24.8 ± 29.7%, <i>P</i> = 0.021). Measurement adherence was superior in the intervention group (83.2 ± 15.4% vs. 70.5 ± 25.9%, <i>P</i> = 0.033).</p><p><strong>Conclusion: </strong>Physician-supported telemedical care significantly improved BP control and measurement adherence over 6 months. Larger trials are needed to assess long-term clinical outcomes.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 2","pages":"oeag061"},"PeriodicalIF":0.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824938","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}

{"title":"Evaluation after delayed and repeated intervention in the VIPVIZA-extended randomized controlled trial: beneficial results 6 years after baseline.","authors":"Margareta Norberg, Patrik Wennberg, Per Wester, Anders Själander, Per Liv","doi":"10.1093/ehjopen/oeag047","DOIUrl":"https://doi.org/10.1093/ehjopen/oeag047","url":null,"abstract":"<p><strong>Aims: </strong>The Västerbotten Intervention Programme VIsualiZation of subclinical Atherosclerosis (VIPVIZA) pragmatic randomized controlled trial (RCT) previously reported reduced cardiovascular disease (CVD) risk 3 years after colour-coded information about subclinical atherosclerosis based on carotid ultrasonography and facilitated by nurse-led motivational dialogue. This report evaluated the development of CVD risk and clinical risk factors following the 3-year follow-up, at which point the control group received their first delayed intervention and the intervention group received a repeated VIPVIZA intervention.</p><p><strong>Methods and results: </strong>Participants (<i>n</i> = 3532) were recruited during 2013-2016 and randomized into two groups. Routine primary care managed preventive treatments. At the 6-year follow-up, group differences in CVD risk factors, the European Systematic Coronary Risk Evaluation 2 (SCORE2), and Framingham Risk Score (FRS) were statistically tested. Trajectories of the outcomes in both groups were graphically assessed. The participation rate after 6 years was 75.4%. No significant differences were found between groups in levels of SCORE2, FRS, clinical risk factors, anthropometrics, smoking, or diabetes-except for systolic blood pressure, which was lower in the original intervention group. Risk scores and systolic blood pressure increased in both groups in parallel, while LDL levels decreased and converged. The higher the baseline risk was, the stronger the decrease of LDL cholesterol.</p><p><strong>Conclusion: </strong>When the delayed VIPVIZA intervention was provided to the control group after 3 years, the beneficial effect appeared similar as previously reported for the intervention group. After 6 years, any differences between groups in CVD risk were no longer seen. Cholesterol levels were greatly reduced in both groups.</p><p><strong>Registration: </strong>The VIPVIZA trial is registered with www.clinicaltrials.gov (NCT01849575).</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 2","pages":"oeag047"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694303","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}

{"title":"On the provenance of spontaneous coronary artery dissection.","authors":"Robert M Graham, Sharonne N Hayes, Lucy McGrath-Cadell, Siiri E Iismaa, Eleni Giannoulatou, Jason C Kovacic","doi":"10.1093/ehjopen/oeag066","DOIUrl":"https://doi.org/10.1093/ehjopen/oeag066","url":null,"abstract":"<p><p>Spontaneous coronary artery dissection is an unusual, but increasingly recognized, cause of acute coronary syndrome. It is a potentially fatal disorder that predominantly (>90% of cases) affects women, who are about 20 years younger (age 45-52 years) than those presenting with an acute coronary syndrome due to atherosclerotic coronary artery disease, and is the commonest cause of myocardial infarction associated with pregnancy. With the advent of improved coronary artery imaging modalities, including invasive coronary angiography, intravascular ultrasonography (IVUS), and optical coherence tomography (OCT), spontaneous coronary artery dissection is being increasingly diagnosed. It is typically due to a spontaneous bleed in the tunica media of an epicardial coronary artery, with or without an intimal tear, that results in an intramural haematoma; the latter, in turn causing a separation or dissection of the lamellae formed by the layers of smooth muscle cells of the tunica media, which can propagate longitudinally. Although coronary artery dissection can be due to atherosclerotic disease that may, in fact, present spontaneously, or to trauma, or guidewire-induced intimal injury, the understanding that the entity now known as <i>spontaneous coronary artery dissection</i> is an idiopathic disorder that is not associated with atherosclerosis or trauma, and is not iatrogenic, is one that has emerged only relatively recently (last 10-15 years). This raises the question, what is the provenance of spontaneous coronary artery dissection as it is now defined and understood? Here, this issue is addressed by a detailed consideration of the medical literature from 1800.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 2","pages":"oeag066"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792901","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}

{"title":"Ablation of visually identified spatiotemporal dispersion plus pulmonary vein isolation in persistent atrial fibrillation.","authors":"Eduardo Franco, Cristina Lozano-Granero, Sonia Antonana-Ugalde, Roberto Matía, Antonio Hernández-Madrid, José Luis Zamorano, Javier Moreno","doi":"10.1093/ehjopen/oeag063","DOIUrl":"https://doi.org/10.1093/ehjopen/oeag063","url":null,"abstract":"<p><strong>Aims: </strong>Pulmonary vein isolation (PVI) provides limited efficacy in persistent atrial fibrillation (AF). We performed PVI plus ablation of areas with visually detected spatiotemporal dispersion (STD) in consecutive patients with persistent AF, and compared them with a 1:1 propensity score-matched cohort of patients treated with a PVI-only approach.</p><p><strong>Methods and results: </strong>STD was visually identified using conventional high-density mapping catheters (IntellaMap ORION, PentaRay NAV, or Advisor HD Grid), without dedicated software. Areas with STD showing fractionated continuous electrograms (FCEs), if present, were ablated first, and other areas with STD were ablated in cases without AF conversion during ablation of FCEs. The right atrium was treated only in cases without AF conversion during left atrial ablation in which the AF cycle length was faster at the right atrium. Hundred patients were treated with each ablation strategy (PVI + STD or PVI-only) (63.9 ± 10.1 years, 28% females). Thirty-five patients from the PVI + STD group showed areas with FCEs, which were ablated first, achieving AF termination in nine patients. In the remaining 91 patients, 221 areas with STD were ablated. The right atrium was treated in 48 patients. Globally, AF conversion was achieved in 33 patients. The PVI + STD group showed lower atrial arrhythmia recurrences at 18-month follow-up (30% vs. 53%, <i>P</i> < 0.001) and after a median follow-up of 45 [26-66] months (44% vs. 71%, <i>P</i> < 0.001), and less progression to permanent AF (14% vs. 41%, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Ablation of areas with visually identified STD, added to PVI, reduced atrial arrhythmia recurrences and decreased progression to permanent AF.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 2","pages":"oeag063"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792880","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}

{"title":"Effect of high-intensity interval training on peak oxygen uptake, quality of life, and ventricular arrhythmias in patients with an implantable cardioverter defibrillator: a randomized controlled trial.","authors":"Mathias Nyman, Ole Christian Mjølstad, Ane Cecilie Dale, Brage Høyem Amundsen, Ole Rossvoll, Ulrik Wisløff, Jan Pål Loennechen","doi":"10.1093/ehjopen/oeag058","DOIUrl":"https://doi.org/10.1093/ehjopen/oeag058","url":null,"abstract":"<p><strong>Aims: </strong>Exercise is effective in preventing and treating cardiovascular disease. High-intensity interval training (HIIT) has shown promising effects on cardiorespiratory fitness and quality of life (QoL). However, evidence of risks and beneficial effects of HIIT in patients at high risk of ventricular arrhythmias (VA) is limited. This study evaluated the effects of HIIT on peak oxygen uptake (VO₂peak), QoL, and the burden of VA in patients with an implantable cardioverter defibrillator (ICD).</p><p><strong>Methods and results: </strong>Fifty-six ICD patients with coronary artery disease (CAD) or non-ischaemic dilated cardiomyopathy (DCM) were randomized to a 12-week supervised HIIT programme with intervals at 85-95% of maximum heart rate, or to usual activity (control). Primary outcomes were changes in VO₂peak and QoL. Secondary outcomes included changes in VA burden, with or without ICD therapy. High-intensity interval training increased VO₂peak by 7.0% vs. no change in the control group, with a between-group difference of 1.7 mL/kg/min (95% confidence interval, 0.7-2.6; <i>P</i> < 0.001). After correction for multiple testing, HIIT improved QoL on the SF-36 health change domain, while most other domains showed favourable but non-significant trends. Clinically relevant VA occurred in two patients during baseline exercise testing and in two patients during HIIT. Sustained ventricular tachycardia incidence was lower in the HIIT group (<i>P</i> = 0.037), although the number of events was small and unevenly distributed.</p><p><strong>Conclusion: </strong>In ICD patients with CAD or non-ischaemic DCM, a supervised 12-week HIIT programme significantly improved exercise capacity and QoL. However, its overall impact on VA remains inconclusive, and the risk of exercise-induced arrhythmias remains a concern.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 2","pages":"oeag058"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725137","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}

{"title":"Acute atrial fibrillation and flutter treated electively: rationale and design of the randomized controlled AFFELECT trial.","authors":"Jani Rankinen, Leo-Pekka Lyytikäinen, Juuso Järventie, Markus Hautamäki, Anna Numminen, Matilda Hurskainen, Markku Rantanen, Antti Muuronen, Juho Tynkkynen, Jussi Hernesniemi","doi":"10.1093/ehjopen/oeag060","DOIUrl":"https://doi.org/10.1093/ehjopen/oeag060","url":null,"abstract":"<p><strong>Aims: </strong>Cardioversion (CV) is commonly used in the emergency department (ED) to treat recent-onset atrial fibrillation (AF) or flutter (AFL).</p><p><strong>Design: </strong>The AFFELECT trial (NCT04267159) is an investigator-initiated, prospective, unblinded randomized controlled non-inferiority trial comparing experimental delayed rhythm control (elective CV performed within 5-9 days after the index visit) to standard acute rhythm control (CV performed in ED) in patients with recent-onset (duration <48 h) symptomatic AF/AFL suitable for rhythm control. A total of 500 patients are randomized in a 2:3 ratio to the acute and delayed groups, respectively, accounting for a possible one-third unplanned early CV rate in the delayed group due to higher symptom burden. Unplanned early CV means that patients with unbearable symptoms are offered the option for an earlier CV (before the 5-9 days target timeline) if needed. Patients randomized to delayed group are discharged immediately after adequate heart rate control (heart rate <110 bpm) and anticoagulation and are scheduled an appointment for delayed CV at a cardiology outpatient clinic (in transoesophageal echocardiography guidance if required). Patients randomized to acute CV undergo cardioversion in the ED within 48 h of arrhythmia onset and are assigned to a cardiologic outpatient clinic visit also within 5-9 days. The primary end-point is the presence of sinus rhythm on electrocardiogram at 4 weeks after the outpatient clinic visit.</p><p><strong>Conclusion: </strong>The AFFELECT trial tests whether delayed management of recent-onset AF/AFL is a non-inferior alternative to acute CV, aiming to reduce ED burden, number of needed CVs, and redirect care to specialized arrhythmia units.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 2","pages":"oeag060"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824929","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}

{"title":"Impact of left ventricular ejection fraction on clinical outcomes following ventricular tachycardia ablation: a propensity-matched analysis from a large multicentre database.","authors":"Dharmindra Dulal, Ahmed Maraey, Paul Chacko, Tarvinder Dhanjal, Abhishek Maan, E Kevin Heist","doi":"10.1093/ehjopen/oeag057","DOIUrl":"https://doi.org/10.1093/ehjopen/oeag057","url":null,"abstract":"<p><strong>Aims: </strong>Ventricular tachycardia (VT) ablation is an established therapy for patients with structural heart disease and recurrent VT. However, the impact of left ventricular function on peri-procedural and long-term outcomes remains incompletely understood. We evaluated the association of left ventricular ejection fraction (LVEF) on clinical outcomes after VT ablation.</p><p><strong>Methods and results: </strong>We conducted a retrospective cohort study using the TriNetX Research Network (2010-21) to evaluate outcomes after VT ablation, stratifying patients by LVEF (>30 vs. ≤30%). Propensity score matching (1:1) was used to balance baseline characteristics. The primary outcome was a 30-day composite safety endpoint defined as all-cause mortality, acute kidney injury (AKI), mechanical circulatory support (MCS) use, or cardiac tamponade. Secondary outcomes included 3-year all-cause mortality, ventricular arrhythmia recurrence, and rehospitalization. The individual components of the 30-day composite were evaluated in exploratory analyses. Among 2549 patients who underwent VT ablation, 623 were matched in each subgroup. The 30-day composite safety endpoint was significantly lower in patients with LVEF >30% (17.9 vs. 26.3%; <i>P</i> = 0.0004). In exploratory analyses, patients with LVEF ≤30% had higher 30-day mortality, AKI, and MCS use, while tamponade rates were similar between groups. At 3-year follow-up, all-cause mortality (15.2 vs. 28.7%) and rehospitalization (31.6 vs. 44.1%) remained significantly lower (<i>P</i> < 0.01) in the higher LVEF group. Ventricular tachycardia recurrence rates were high in both groups (71 vs. 67%) without a significant difference.</p><p><strong>Conclusion: </strong>In this large real-world study, patients with LVEF >30% undergoing VT ablation experienced significantly better peri-procedural and long-term outcomes.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 2","pages":"oeag057"},"PeriodicalIF":0.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824922","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}

{"title":"Cardiac autonomic function in elderly patients with and without atrial fibrillation.","authors":"Peter Hämmerle, Johannes Schier, Konstantinos D Rizas, Vincent Schlageter, Emel Kaplan, Stefanie Aeschbacher, Marius Rast, Philipp Krisai, Michael Coslovsky, Tobias Reichlin, Julia B Bardoczi, Nicolas Rodondi, Andreas S Müller, Alain M Bernheim, Giorgio Moschovitis, Maria Luisa De Perna, David Conen, Christian Sticherling, Stefan Osswald, Axel Bauer, Felix Mahfoud, Michael Kühne, Christine S Zuern","doi":"10.1093/ehjopen/oeag056","DOIUrl":"10.1093/ehjopen/oeag056","url":null,"abstract":"<p><strong>Aims: </strong>Cardiac autonomic dysfunction is associated with an adverse prognosis in patients with atrial fibrillation (AF). However, the association of AF itself with cardiac autonomic function (CAF) remains unclear. We aimed to investigate whether CAF, assessed by heart rate variability (HRV), differs across patients with and without AF.</p><p><strong>Methods and results: </strong>We enrolled patients from a prospective multicentre study (Swiss-AF) with a 5-min resting ECG recording in SR or AF without pacing. Cardiac autonomic function was quantified by periodic repolarization dynamics (PRD), a marker of sympathetic activity, and by conventional HRV parameters. We included 2289 patients, 807 (35%) SR patients, 932 (41%) AF patients with SR ECGs (AF-SR), and 550 (24%) AF patients with AF ECGs (AF-AF). Mean age was 74 vs. 70 vs. 75 years; 37%, 31%, and 24% were female. Median PRD was 4.8 deg (IQR 2.6-6.7) in the SR group, 5.1 deg (IQR 2.9-6.9) in the AF-SR group, and 7.0 deg (IQR 5.8-8.4) in the AF-AF group (<i>P</i> < 0.001). After full adjustment (SR group = reference group), the AF-AF group showed a stronger association with elevated PRD (β-coefficient 2.10, 95% CI 1.79-2.41, <i>P</i> < 0.001) than the AF-SR group (β-coefficient 0.36, 95% CI 0.08-0.64, <i>P</i> = 0.011). Most other HRV parameters indicated greater autonomic impairment in the AF-SR group compared to the SR group.</p><p><strong>Conclusion: </strong>Atrial fibrillation was associated with increased sympathetic activity, with the greatest impairment observed in patients during AF, independent of cardiovascular risk factors. Periodic repolarization dynamics may represent a useful marker for the assessment of CAF in AF patients.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 2","pages":"oeag056"},"PeriodicalIF":0.0,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725132","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}