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Cardiac Perforation During High-Power Radiofrequency Ablation of the Left Lateral Ridge Using QDOT MICRO. 使用 QDOT MICRO 对左侧脊进行高功率射频消融时的心脏穿孔。
IF 8.4 1区 医学 Q1 Medicine Pub Date : 2024-04-17 DOI: 10.1161/CIRCEP.123.012643
C. Gianni, Matthew Dare, Javier E. Sanchez, A. Al‐Ahmad, J. Zagrodzky, G. Gallinghouse, J. Burkhardt, Robert C Neely, Andrea Natale
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引用次数: 0
Sinus Rhythm Atrial Electrocardiographic Imaging in Patients With Mitral Regurgitation: Clues to the Substrate for Atrial Fibrillation. 二尖瓣反流患者的窦性心律心房心电图成像:心房颤动基底的线索。
IF 8.4 1区 医学 Q1 Medicine Pub Date : 2024-04-17 DOI: 10.1161/CIRCEP.123.012666
Matthew R. Schill, Ramya Vijayakumar, Tari-Ann Yates, M. McGilvray, Christian W Zemlin, R. Schuessler, Yoram Rudy, Ralph J. Damiano
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引用次数: 0
Differential Pacing Maneuver From the Vein of Marshall. 来自马歇尔静脉的差分起搏手法。
IF 8.4 1区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-02-23 DOI: 10.1161/CIRCEP.123.012420
Naohiko Kawaguchi, Yasuaki Tanaka, Kenji Okubo, Shinichi Tachibana, Emiko Nakashima, Katsumasa Takagi, Hiroyuki Hikita, Tetsuo Sasano, Atsushi Takahashi

Background: Bidirectional mitral isthmus (MI) block is conventionally verified by differential pacing from the coronary sinus (CS) and its sequence change. This study aimed to evaluate the ability of differential pacing from the vein of Marshall (VOM) to detect epicardial MI connections.

Methods: Radiofrequency and VOM ethanol MI ablation were performed with a VOM electrode catheter inserted to the septal side of the ablation line. MI block was verified using conventional CS pacing. To perform differential VOM pacing analysis, initial pacing was delivered from a distal VOM bipole closer to the block line, and then from a proximal VOM bipole. The intervals from pacing stimulus during different VOM pacing sites to the electrogram recorded through the CS catheter on the opposite side of the line were compared. When the interval during distal VOM pacing was longer than that during proximal VOM pacing, it indicated a VOM connection block; however, if the former interval was shorter, the connection through the VOM was considered persistent.

Results: Overall, 50 patients were evaluated. According to CS pacing, MI ablation was incomplete in 9 patients, in whom the analysis indicated persistent VOM connection. Among 41 patients with complete MI block, confirmed by CS finding, in 30 (73%) patients, the interval during distal VOM pacing was longer than that during proximal VOM pacing by 11±5 ms. However, in 11 patients (27%) the former interval was revealed to be shorter than the latter by 16±8 ms, indicating residual VOM connection. Conduction time across the line was significantly shorter in 11 patients than in the other 30 (166±21 versus 197±36 ms; P<0.01). Ten successful reevaluated analyses after VOM ethanol and further radiofrequency ablation of the connection indicated VOM block achievement.

Conclusions: Differential VOM pacing maneuver reflects the VOM conduction status. This maneuver can uncover residual epicardial connections that are missing with CS pacing.

背景:双向二尖瓣峡部(MI)阻滞传统上是通过冠状窦(CS)的不同起搏及其序列变化来验证的。本研究旨在评估从马歇尔静脉(VOM)进行差分起搏检测心外膜 MI 连接的能力:方法:将 VOM 电极导管插入消融线的室间隔侧,进行射频和 VOM 乙醇 MI 消融。使用常规 CS 起搏验证 MI 阻滞。为了进行差异 VOM 起搏分析,首先从靠近阻滞线的远端 VOM 双极进行起搏,然后再从近端 VOM 双极进行起搏。比较从不同 VOM 起搏部位的起搏刺激到通过阻滞线另一侧的 CS 导管记录到的电图的时间间隔。如果远端 VOM 起搏时的间隔长于近端 VOM 起搏时的间隔,则表明 VOM 连接阻滞;但如果前者的间隔较短,则认为通过 VOM 的连接持续存在:共对 50 名患者进行了评估。根据 CS,9 名患者的起搏 MI 消融不完全,分析表明这些患者的 VOM 连接持续存在。在 41 例经 CS 结果证实的完全 MI 阻滞患者中,有 30 例(73%)患者的远端 VOM 起搏间期比近端 VOM 起搏间期长 11±5 毫秒。然而,在 11 名患者(27%)中,前者的间期比后者短 16±8 毫秒,这表明 VOM 连接残留。11 名患者的跨线传导时间明显短于其他 30 名患者(166±21 对 197±36 毫秒;PC 结论:差异 VOM 起搏操作反映了 VOM 的传导状态。该操作可发现 CS 起搏时缺失的残余心外膜连接。
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引用次数: 0
Genetic Testing in Brugada Syndrome: A 30-Year Experience. Brugada 综合征的基因检测:30 年的经验
IF 8.4 1区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-03-01 DOI: 10.1161/CIRCEP.123.012374
Luigi Pannone, Antonio Bisignani, Randy Osei, Anaïs Gauthey, Antonio Sorgente, Cinzia Monaco, Domenico Giovanni Della Rocca, Alvise Del Monte, Antanas Strazdas, Joerelle Mojica, Maysam Al Housari, Vincenzo Miraglia, Sahar Mouram, Giampaolo Vetta, Gaetano Paparella, Robbert Ramak, Ingrid Overeinder, Gezim Bala, Alexandre Almorad, Erwin Ströker, Gudrun Pappaert, Juan Sieira, Thomy de Ravel, Mark La Meir, Andrea Sarkozy, Pedro Brugada, Gian Battista Chierchia, Sonia Van Dooren, Carlo de Asmundis

Background: A pathogenic/likely pathogenic variant can be found in 20% to 25% of patients with Brugada syndrome (BrS) and a pathogenic/likely pathogenic variant in SCN5A is associated with a worse prognosis. The aim of this study is to define the diagnostic yield of a large gene panel with American College of Medical Genetics and Genomics variant classification and to assess prognosis of SCN5A and non-SCN5A variants.

Methods: All patients with BrS, were prospectively enrolled in the Universitair Ziekenhuis Brussel registry between 1992 and 2022. Inclusion criteria for the study were (1) BrS diagnosis; (2) genetic analysis performed with a large gene panel; (3) classification of variants following American College of Medical Genetics and Genomics guidelines. Patients with a pathogenic/likely pathogenic variant in SCN5A were defined as SCN5A+. Patients with a reported variant in a non-SCN5A gene or with no reported variants were defined as patients with SCN5A-. All variants were classified as missense or predicted loss of function.

Results: A total of 500 BrS patients were analyzed. A total of 104 patients (20.8%) were SCN5A+ and 396 patients (79.2%) were SCN5A-. A non-SCN5A gene variant was found in 75 patients (15.0%), of whom, 58 patients (77.3%) had a missense variant and 17 patients (22.7%) had a predicted loss of function variant. At a follow-up of 84.0 months, 48 patients (9.6%) experienced a ventricular arrhythmia (VA). Patients without any variant had higher VA-free survival, compared with carriers of a predicted loss of function variant in SCN5A+ or non-SCN5A genes. There was no difference in VA-free survival between patients without any variant and missense variant carriers in SCN5A+ or non-SCN5A genes. At Cox analysis, SCN5A+ or non-SCN5A predicted loss of function variant was an independent predictor of VA.

Conclusions: In a large BrS cohort, the yield for SCN5A+ is 20.8%. A predicted loss of function variant carrier is an independent predictor of VA.

背景:20%至25%的布鲁格达综合征(BrS)患者可能存在致病性/可能致病性变异,而SCN5A的致病性/可能致病性变异与较差的预后有关。本研究的目的是根据 ACMG 变异分类确定大型基因面板的诊断率,并评估 SCN5A 和非 SCN5A 变异的预后:方法:1992 年至 2022 年间,所有 BrS 患者均在 UZB 登记处进行了前瞻性登记。研究的纳入标准为:(1)确诊为 BrS;(2)使用大型基因面板进行遗传分析;(3)根据 ACMG 指南对变异进行分类。SCN5A中存在致病/可能致病变异的患者被定义为SCN5A+。非 SCN5A 基因变异或无变异报告的患者被定义为 SCN5A- 患者。所有变异均被归类为错义或预测功能缺失:共分析了 500 名 BrS 患者。共有 104 名患者(20.8%)为 SCN5A+,396 名患者(79.2%)为 SCN5A-。在 75 名患者(15.0%)中发现了非 SCN5A 基因变异,其中 58 名患者(77.3%)为错义变异,17 名患者(22.7%)为预测功能缺失变异。在84.0个月的随访中,48名患者(9.6%)出现了室性心律失常(VA)。与SCN5A+或非SCN5A基因的预测功能缺失变异携带者相比,没有任何变异的患者无VA生存率更高。没有任何变异的患者与SCN5A+或非SCN5A基因的错义变异携带者之间的无VA生存率没有差异。在Cox分析中,SCN5A+或非SCN5A预测功能缺失变异是VA的独立预测因子:结论:在一个大型 BrS 队列中,SCN5A+ 的发病率为 20.8%。预测的功能缺失变异携带者是VA的独立预测因子。
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引用次数: 0
Harnessing Data Insights for Improved Patient Care in LAAO: A Novel Approach to Personalized Risk Assessment at the Bedside. 利用数据洞察力改善 LAAO 患者护理:床旁个性化风险评估的新方法。
IF 8.4 1区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-03-28 DOI: 10.1161/CIRCEP.124.012845
Jaya Chandrasekhar, Jacqueline Saw
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引用次数: 0
Comparative Evaluation of Activity Sensing Rate Responses of a Leadless Pacemaker Using Intracardiac Accelerometer Versus Traditional Activity Sensing Pacemaker. 使用心内加速计的无引线起搏器与传统活动感应起搏器的活动感应速率响应比较评估。
IF 8.4 1区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-03-18 DOI: 10.1161/CIRCEP.123.012616
Jo Jo Hai, Chu-Pak Lau, Hung-Fat Tse
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引用次数: 0
Development of the NOCSAE Standard to Reduce the Risk of Commotio Cordis. 制定 NOCSAE 标准以降低脐带损伤风险。
IF 8.4 1区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-02-23 DOI: 10.1161/CIRCEP.123.011966
Nathan Dau, Cynthia Bir, Elizabeth McCalley, David Halstead, Mark S Link

Background: Commotio cordis, sudden cardiac death (SCD) caused by relatively innocent impact to the chest, is one of the leading causes of SCD in sports. Commercial chest protectors have not been demonstrated to mitigate the risk of these SCDs.

Methods: To develop a standard to assess chest protectors, 4 phases occurred. A physiological commotio cordis model was utilized to assess variables that predicted for SCD. Next, a surrogate model was developed based on data from the physiological model, and the attenuation in risk was assessed. In the third phase, this model was calibrated and validated. Finally, National Operating Committee on Standards for Athletic Equipment adopted the standard and had an open review process with revision of the standard over 3 years.

Results: Of all variables, impact force was the most robust at predicting SCD. Chest wall protectors which could reduce the force of impact to under thresholds were predicted to reduce the risk of SCD. The correlation between the experimental model and the mechanical surrogate ranged from 0.783 with a lacrosse ball at 30 mph to 0.898 with a baseball at 50 mph. The standard was licensed to National Operating Committee on Standards for Athletic Equipment which initially adopted the standard in January 2018, and finalized in July 2021.

Conclusions: An effective mechanical surrogate based on physiological data from a well-established model of commotio cordis predicts the reduction in SCD with chest protectors. A greater reduction in force provides a great degree of protection from commotio cordis. This new National Operating Committee on Standards for Athletic Equipment standard for chest protectors should result in a significant reduction in the risk of commotio cordis on the playing field.

背景:心源性猝死(Commotio cordis),即胸部受到相对无害的撞击而导致的心脏性猝死(SCD),是导致运动中心源性猝死的主要原因之一。商业胸部保护器尚未被证明能降低这些 SCD 的风险:为了制定评估胸部保护器的标准,我们进行了四个阶段的研究。首先,利用生理学脐带损伤模型来评估预测 SCD 的变量。接下来,根据生理模型的数据开发了一个替代模型,并对风险的衰减进行了评估。在第三阶段,对该模型进行了校准和验证。最后,国家运动装备标准操作委员会通过了该标准,并对该标准进行了为期 3 年的公开审查和修订:结果:在所有变量中,冲击力对 SCD 的预测最为准确。据预测,能将冲击力降至阈值以下的胸壁保护器可降低 SCD 风险。实验模型与机械替代物之间的相关性从每小时 30 英里的长曲棍球的 0.783 到每小时 50 英里的棒球的 0.898 不等。该标准已授权给国家运动装备标准操作委员会,该委员会于 2018 年 1 月初步通过了该标准,并于 2021 年 7 月最终确定了该标准:基于一个成熟的脊髓损伤模型的生理数据,一个有效的机械替代物可以预测使用胸部保护器后 SCD 的减少情况。更大的力量减少可在很大程度上防止脊髓损伤。国家运动装备标准操作委员会关于护胸的新标准应能显著降低运动场上发生脊髓损伤的风险。
{"title":"Development of the NOCSAE Standard to Reduce the Risk of Commotio Cordis.","authors":"Nathan Dau, Cynthia Bir, Elizabeth McCalley, David Halstead, Mark S Link","doi":"10.1161/CIRCEP.123.011966","DOIUrl":"10.1161/CIRCEP.123.011966","url":null,"abstract":"<p><strong>Background: </strong>Commotio cordis, sudden cardiac death (SCD) caused by relatively innocent impact to the chest, is one of the leading causes of SCD in sports. Commercial chest protectors have not been demonstrated to mitigate the risk of these SCDs.</p><p><strong>Methods: </strong>To develop a standard to assess chest protectors, 4 phases occurred. A physiological commotio cordis model was utilized to assess variables that predicted for SCD. Next, a surrogate model was developed based on data from the physiological model, and the attenuation in risk was assessed. In the third phase, this model was calibrated and validated. Finally, National Operating Committee on Standards for Athletic Equipment adopted the standard and had an open review process with revision of the standard over 3 years.</p><p><strong>Results: </strong>Of all variables, impact force was the most robust at predicting SCD. Chest wall protectors which could reduce the force of impact to under thresholds were predicted to reduce the risk of SCD. The correlation between the experimental model and the mechanical surrogate ranged from 0.783 with a lacrosse ball at 30 mph to 0.898 with a baseball at 50 mph. The standard was licensed to National Operating Committee on Standards for Athletic Equipment which initially adopted the standard in January 2018, and finalized in July 2021.</p><p><strong>Conclusions: </strong>An effective mechanical surrogate based on physiological data from a well-established model of commotio cordis predicts the reduction in SCD with chest protectors. A greater reduction in force provides a great degree of protection from commotio cordis. This new National Operating Committee on Standards for Athletic Equipment standard for chest protectors should result in a significant reduction in the risk of commotio cordis on the playing field.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139930336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predicting Major Adverse Events in Patients Undergoing Transcatheter Left Atrial Appendage Occlusion. 预测接受经导管左房阑尾闭塞术患者的主要不良事件
IF 8.4 1区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-02-23 DOI: 10.1161/CIRCEP.123.012424
Kamil F Faridi, Emily L Ong, Sarah Zimmerman, Paul D Varosy, Daniel J Friedman, Jonathan C Hsu, Fred Kusumoto, Bobak J Mortazavi, Karl E Minges, Lucy Pereira, Dhanunjaya Lakkireddy, Christina Koutras, Beth Denton, Julie Mobayed, Jeptha P Curtis, James V Freeman

Background: The National Cardiovascular Data Registry Left Atrial Appendage Occlusion Registry (LAAO) includes the vast majority of transcatheter LAAO procedures performed in the United States. The objective of this study was to develop a model predicting adverse events among patients undergoing LAAO with Watchman FLX.

Methods: Data from 41 001 LAAO procedures with Watchman FLX from July 2020 to September 2021 were used to develop and validate a model predicting in-hospital major adverse events. Randomly selected development (70%, n=28 530) and validation (30%, n=12 471) cohorts were analyzed with 1000 bootstrapped samples, using forward stepwise logistic regression to create the final model. A simplified bedside risk score was also developed using this model.

Results: Increased age, female sex, low preprocedure hemoglobin, no prior attempt at atrial fibrillation termination, and increased fall risk most strongly predicted in-hospital major adverse events and were included in the final model along with other clinically relevant variables. The median in-hospital risk-standardized adverse event rate was 1.50% (range, 1.03%-2.84%; interquartile range, 1.42%-1.64%). The model demonstrated moderate discrimination (development C-index, 0.67 [95% CI, 0.65-0.70] and validation C-index, 0.66 [95% CI, 0.62-0.70]) with good calibration. The simplified risk score was well calibrated with risk of in-hospital major adverse events ranging from 0.26% to 3.90% for a score of 0 to 8, respectively.

Conclusions: A transcatheter LAAO risk model using National Cardiovascular Data Registry and LAAO Registry data can predict in-hospital major adverse events, demonstrated consistency across hospitals and can be used for quality improvement efforts. A simple bedside risk score was similarly predictive and may inform shared decision-making.

背景:美国国家心血管数据登记处和左心房阑尾闭塞(LAAO)登记处包括了在美国实施的绝大多数经导管 LAAO 手术。本研究的目的是建立一个模型,预测使用 Watchman FLX 进行 LAAO 患者的不良事件:2020年7月至2021年9月期间使用Watchman FLX进行的41001例LAAO手术数据被用于开发和验证院内主要不良事件预测模型。随机选取开发组群(70%,n=28 530)和验证组群(30%,n=12 471),使用前向逐步逻辑回归建立最终模型,并对1000个引导样本进行分析。利用该模型还开发了简化的床边风险评分:结果:年龄增大、性别为女性、术前血红蛋白偏低、之前未尝试过房颤终止术以及跌倒风险增加最能预测院内重大不良事件,这些因素与其他临床相关变量一起被纳入最终模型。院内风险标准化不良事件发生率的中位数为1.50%(范围为1.03%-2.84%;四分位间范围为1.42%-1.64%)。该模型显示出适度的区分度(开发 C 指数为 0.67 [95% CI,0.65-0.70],验证 C 指数为 0.66 [95% CI,0.62-0.70])和良好的校准性。简化风险评分校准良好,0至8分的院内主要不良事件风险分别为0.26%至3.90%:使用美国国家心血管数据登记处和LAAO登记处数据建立的经导管LAAO风险模型可以预测院内重大不良事件,在不同医院具有一致性,可用于质量改进工作。简单的床边风险评分也具有类似的预测能力,可为共同决策提供参考。
{"title":"Predicting Major Adverse Events in Patients Undergoing Transcatheter Left Atrial Appendage Occlusion.","authors":"Kamil F Faridi, Emily L Ong, Sarah Zimmerman, Paul D Varosy, Daniel J Friedman, Jonathan C Hsu, Fred Kusumoto, Bobak J Mortazavi, Karl E Minges, Lucy Pereira, Dhanunjaya Lakkireddy, Christina Koutras, Beth Denton, Julie Mobayed, Jeptha P Curtis, James V Freeman","doi":"10.1161/CIRCEP.123.012424","DOIUrl":"10.1161/CIRCEP.123.012424","url":null,"abstract":"<p><strong>Background: </strong>The National Cardiovascular Data Registry Left Atrial Appendage Occlusion Registry (LAAO) includes the vast majority of transcatheter LAAO procedures performed in the United States. The objective of this study was to develop a model predicting adverse events among patients undergoing LAAO with Watchman FLX.</p><p><strong>Methods: </strong>Data from 41 001 LAAO procedures with Watchman FLX from July 2020 to September 2021 were used to develop and validate a model predicting in-hospital major adverse events. Randomly selected development (70%, n=28 530) and validation (30%, n=12 471) cohorts were analyzed with 1000 bootstrapped samples, using forward stepwise logistic regression to create the final model. A simplified bedside risk score was also developed using this model.</p><p><strong>Results: </strong>Increased age, female sex, low preprocedure hemoglobin, no prior attempt at atrial fibrillation termination, and increased fall risk most strongly predicted in-hospital major adverse events and were included in the final model along with other clinically relevant variables. The median in-hospital risk-standardized adverse event rate was 1.50% (range, 1.03%-2.84%; interquartile range, 1.42%-1.64%). The model demonstrated moderate discrimination (development C-index, 0.67 [95% CI, 0.65-0.70] and validation C-index, 0.66 [95% CI, 0.62-0.70]) with good calibration. The simplified risk score was well calibrated with risk of in-hospital major adverse events ranging from 0.26% to 3.90% for a score of 0 to 8, respectively.</p><p><strong>Conclusions: </strong>A transcatheter LAAO risk model using National Cardiovascular Data Registry and LAAO Registry data can predict in-hospital major adverse events, demonstrated consistency across hospitals and can be used for quality improvement efforts. A simple bedside risk score was similarly predictive and may inform shared decision-making.</p>","PeriodicalId":10319,"journal":{"name":"Circulation. Arrhythmia and electrophysiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11021146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139930338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pulsed Field Ablation Index-Guided Ablation for Lesion Formation: Impact of Contact Force and Number of Applications in the Ventricular Model. 脉冲场消融指数引导的病变形成消融:心室模型中接触力和应用次数的影响
IF 8.4 1区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-02-23 DOI: 10.1161/CIRCEP.123.012717
Luigi Di Biase, Jacopo Marazzato, Assaf Govari, Andreas Altman, Christopher Beeckler, Joe Keyes, Tushar Sharma, Vito Grupposo, Fengwei Zou, Masafumi Sugawara, Atsushi Ikeda, Farshad Raissi, Rahul Bhardwaj, Jonathan C Hsu, Mark Lee, Rajesh Banker, Sanghamitra Mohanty, Andrea Natale, Qi Chen, Paras Parikh, Xiaodong Zhang, Hiroshi Nakagawa

Background: The effect of contact force (CF) on lesion formation is not clear during pulsed field ablation (PFA). The aim of this study was to evaluate the impact of CF, PFA, and their interplay through the PFA index (PF index) formula on the ventricular lesion size in swine.

Methods: PFA was delivered through the CF-sensing OMNYPULSE catheter. Predefined PFA applications (×3, ×6, ×9, and ×12) were delivered maintaining low (5-25 g), high (26-50 g), and very high (51-80 g) CFs. First, PFA lesions were evaluated on necropsy in 11 swine to investigate the impact of CF/PFA-and their integration in the PF index equation-on lesion size (study characterization). Then, 3 different PF index thresholds-300, 450, and 600-were tested in 6 swine to appraise the PF index accuracy to predict the ventricular lesion depth (study validation).

Results: In the study characterization data set, 111 PFA lesions were analyzed. CF was 32±17 g. The average lesion depth and width were 3.5±1.2 and 12.0±3.5 mm, respectively. More than CF and PFA dose alone, it was their combined effect to impact lesion depth through an asymptotically increasing relationship. Likewise, not only was the PF index related to lesion depth in the study validation data set (r2=0.66; P<0.001) but it also provided a prediction accuracy of the observed depth of ±2 mm in 69/73 lesions (95%).

Conclusions: CF and PFA applications play a key role in lesion formation during PFA. Further studies are required to evaluate the best PFA ablation settings to achieve transmural lesions.

背景:在脉冲场消融(PFA)过程中,接触力(CF)对病变形成的影响尚不明确。本研究旨在通过 PFA 指数(PF 指数)公式评估 CF、PFA 及其相互作用对猪心室病灶大小的影响:方法:通过CF感应OMNYPULSE导管输送PFA。在维持低(5-25 克)、高(26-50 克)和极高(51-80 克)CF 的情况下,使用预定义的 PFA 应用(×3、×6、×9 和×12)。首先,对 11 头猪的尸体解剖进行了 PFA 病变评估,以研究 CF/PFA 及其在 PF 指数方程中的整合对病变大小的影响(研究特征)。然后,在 6 头猪身上测试了 3 种不同的 PF 指数阈值--300、450 和 600,以评估 PF 指数预测心室病变深度的准确性(研究验证):在研究特征数据集中,分析了 111 个 PFA 病变。平均病变深度和宽度分别为 3.5±1.2 mm 和 12.0±3.5 mm。与单独的 CF 和 PFA 剂量相比,它们的共同作用通过渐近递增关系影响了病变深度。同样,在研究验证数据集中,PF 指数不仅与病变深度相关(r2=0.66;PConclusions:CF和PFA的应用在PFA过程中的病变形成中起着关键作用。需要进一步的研究来评估实现透壁病变的最佳 PFA 消融设置。
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引用次数: 0
The Science Behind the Standardization of Chest Protectors: Is Marketing Alone Enough to Sell Chest Protectors?... Not Anymore! 护胸标准化背后的科学依据:仅靠营销就能销售护胸产品吗?不再是了
IF 8.4 1区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-03-18 DOI: 10.1161/CIRCEP.124.012844
Camila Trejo-Paredes, Rachel Lampert
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引用次数: 0
期刊
Circulation. Arrhythmia and electrophysiology
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