JACC. Clinical electrophysiology最新文献

{"title":"Association Between Slowly Conducting Anatomical Isthmuses and Ventricular Tachycardia Inducibility in Tetralogy of Fallot","authors":"Victor Waldmann MD, PhD ,&nbsp;Jeremy P. Moore MD, MS ,&nbsp;Francis Bessière MD, PhD ,&nbsp;Nawel Babouri MD ,&nbsp;Mitchell I. Cohen MD ,&nbsp;Edward T. O’Leary MD ,&nbsp;Nimesh S. Patel MD ,&nbsp;Babak Nazer MD ,&nbsp;Weiyi Tan MD ,&nbsp;Frank A. Fish MD ,&nbsp;Aarti Dalal MD ,&nbsp;Elisabetta Mariucci MD, PhD ,&nbsp;Reina B. Tan MD ,&nbsp;Michael S. Lloyd MD ,&nbsp;Christopher J. McLeod MBChB, PhD ,&nbsp;Charles C. Anderson MD ,&nbsp;Ronald J. Kanter MD ,&nbsp;Bryce V. Johnson MD ,&nbsp;Bo Wang MD ,&nbsp;Philip M. Chang MD ,&nbsp;Paul Khairy MD, PhD","doi":"10.1016/j.jacep.2025.08.008","DOIUrl":"10.1016/j.jacep.2025.08.008","url":null,"abstract":"<div><h3>Background</h3><div>Catheter ablation of sustained monomorphic ventricular tachycardia (SMVT) guided by the identification of slowly conducting anatomical isthmuses (SCAIs) has been proposed to mitigate the risk of ventricular tachycardia in tetralogy of Fallot (TOF). However, the prevalence and clinical significance of SCAI remain uncertain.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the association between SCAI and SMVT inducibility in patients with TOF.</div></div><div><h3>Methods</h3><div>A multicenter international cohort with retrospective (2017-2021) and prospective (commencing 2021) components enrolled patients with TOF referred for electrophysiological study before transcatheter pulmonary valve replacement. The proportion with SCAI and its association with SMVT inducibility were analyzed.</div></div><div><h3>Results</h3><div>A total of 162 patients (mean age 39.5 ± 14.2 years; 57.4% male) were included. SMVT was induced in 42 (25.9%) patients, and ≥1 SCAI was present in 76 (46.9%) patients. The prevalence of SCAI was higher in patients with inducible SMVT (78.6% vs 31.1%; <em>P</em> &lt; 0.001). However, 21.4% of patients with inducible SMVT had normally conducting anatomical isthmus (14.3%) or a non–anatomical isthmus substrate (7.1%). The area under the curve of SCAI in predicting SMVT inducibility was 0.71 (sensitivity 78.6%; specificity 64.2%). Although SCAI was independently associated with SMVT (OR: 6.4; 95% CI: 2.6-18.2), the association with other clinical parameters improved prediction of SMVT inducibility.</div></div><div><h3>Conclusions</h3><div>SCAI is highly prevalent in patients with TOF and is associated with inducible SMVT. However, the proportion of SCAI in noninducible patients is substantial, and some inducible patients have no SCAI. These findings suggest that SCAI alone is insufficient for arrhythmia management decisions, highlighting the need for an integrative approach combining electrophysiological study with other clinical parameters.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"12 1","pages":"Pages 31-40"},"PeriodicalIF":7.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080618","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}

{"title":"Elimination of Ventricular Tachycardia and Premature Ventricular Contractions by Ablation of Oppositely Directed Re-Entrant Circuits","authors":"Ryuichi Usui MD ,&nbsp;Yuka Oda MD, PhD ,&nbsp;Yuki Komatsu MD, PhD ,&nbsp;Kikuya Uno MD, PhD ,&nbsp;Akihiko Nogami MD, PhD","doi":"10.1016/j.jacep.2025.09.001","DOIUrl":"10.1016/j.jacep.2025.09.001","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"12 1","pages":"Pages 217-226"},"PeriodicalIF":7.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274662","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}

{"title":"Electrode Thermal Profile During Ventricular RF Ablation","authors":"Daisuke Togashi MD,&nbsp;Yumi Katsume MD,&nbsp;Salah H. Alahwany MD,&nbsp;Giovanni E. Davogustto MD,&nbsp;Zachary T. Yoneda MD,&nbsp;Travis D. Richardson MD,&nbsp;Jay A. Montgomery MD,&nbsp;Sharon Shen MD,&nbsp;Juan C. Estrada MD,&nbsp;Arvindh N. Kanagasundram MD,&nbsp;Harikrishna Tandri MD,&nbsp;William G. Stevenson MD","doi":"10.1016/j.jacep.2025.09.008","DOIUrl":"10.1016/j.jacep.2025.09.008","url":null,"abstract":"<div><h3>Background</h3><div>Electrode–tissue contact and orientation influence radiofrequency (RF) ablation heating, lesion size, and steam pops, and is not easily assessed. A catheter with 6 distal electrode temperature sensors provides thermal profiles that may help clarify electrode–tissue interactions.</div></div><div><h3>Objectives</h3><div>The aim of this study was to evaluate the relationships between thermal profiles, catheter orientation, impedance fall, steam pops, and discordant temperature–impedance changes during ventricular RF ablation.</div></div><div><h3>Methods</h3><div>We analyzed 2,085 RF applications in 100 patients, titrating power to a maximum temperature &lt;50 °C and impedance fall &gt;10 Ω. Stable thermal profiles were classified as embedded, central, or peripheral. Catheter orientation from the force vector was classified as perpendicular, oblique, or parallel.</div></div><div><h3>Results</h3><div>The thermal profile aligned with the force vector at 60.9% of stable sites, with 72.1% of peripheral profiles being oblique/parallel and 80.4% of central profiles being perpendicular. Impedance fall was discordant with temperature at 890 (42.7%) sites. Catheter orientation and thermal profiles differed for low temperature-high impedance fall, compared with high temperature-low impedance fall discordant sites (<em>P</em> &lt; 0.001). An embedded thermal profile (all sensors ≥45 °C) most often occurred with perpendicular or oblique orientations, had the greatest impedance falls, and had the highest incidence of steam pops (8.6% vs 1.3%; <em>P</em> &lt; 0.001). No steam pops occurred with impedance falls &lt;14 Ω or maximum temperature &lt;45.8 °C, or when impedance fall and temperature were discordant.</div></div><div><h3>Conclusions</h3><div>Electrode thermal profiles provide information complementary to force vector and impedance, reflecting electrode–tissue interactions that are also related to discrepancies in impedance fall and temperature during RF ablation. They can potentially help optimize RF ablation lesion size while avoiding steam pops.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"12 1","pages":"Pages 1-12"},"PeriodicalIF":7.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354771","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}

{"title":"From Silence to Storm","authors":"Xiao Liu MD, PhD,&nbsp;Peng-Sheng Chen MD","doi":"10.1016/j.jacep.2025.09.031","DOIUrl":"10.1016/j.jacep.2025.09.031","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"12 1","pages":"Pages 59-61"},"PeriodicalIF":7.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458236","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}

{"title":"Ultra-Low Temperature Cryoablation Combined With Pulsed Field Ablation in a Swine Ventricular Infarct Model","authors":"Thomas A. Dewland MD,&nbsp;Ramkumar Venkateswaran MD,&nbsp;Satoshi Higuchi MD,&nbsp;Chanhee Lee MD,&nbsp;Edward P. Gerstenfeld MD","doi":"10.1016/j.jacep.2025.09.017","DOIUrl":"10.1016/j.jacep.2025.09.017","url":null,"abstract":"<div><h3>Background</h3><div>Treatment of ventricular arrhythmias with radiofrequency catheter ablation can be challenging due to insufficient ablation efficacy in scar. The performance of ultra-low temperature cryoablation (ULTC) and combined ULTC + pulsed field ablation (PFA) has not been studied in ventricular tissue.</div></div><div><h3>Objectives</h3><div>This study sought to compare ventricular lesion size between ULTC alone and combined ULTC+PFA.</div></div><div><h3>Methods</h3><div>A total of 5 swine underwent chronic infarction via 120-minute balloon occlusion of the left anterior descending coronary artery. Three ablation approaches were tested: single 2-minute freeze (ULTC-1), 2 sequential 2-minute freezes delivered in a freeze-thaw-freeze cycle (ULTC-2), and a single 2-minute freeze with 8 PFA trains (ULTC-1+PFA).</div></div><div><h3>Results</h3><div>A total of 36 lesions (7 ULTC-1, 14 ULTC-2, 15 ULTC-1+PFA lesions) were applied to the left ventricular endocardium in 5 swine. Median (Q1-Q3) width was 9 (7-13) mm in healthy tissue and 11 (9-14) mm in scar (<em>P</em> = 0.18). In both healthy and scar tissue, lesion width was larger with ULTC-2 and with ULTC-1+PFA when compared with ULTC-1 alone. Lesion depth was 11 (9-15) mm in healthy tissue and 11 (8-13) mm in scar (<em>P</em> = 0.57). Lesion depth trended deeper with ULTC-2 and with ULTC-1+PFA. Within scar, zero of the ULTC-1, 13% of the ULTC-2 lesions, and 67% of the ULTC-1+PFA lesions were transmural.</div></div><div><h3>Conclusions</h3><div>ULTC resulted in clinically substantial lesions in healthy and infarcted ventricular myocardium. The addition of PFA to ULTC allowed for larger and more transmural lesions compared with a single ULTC ablation alone while avoiding the longer ablation times associated with 2 successive freezes.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"12 1","pages":"Pages 62-70"},"PeriodicalIF":7.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145700966","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}

{"title":"Full Issue PDF","authors":"","doi":"10.1016/S2405-500X(25)01073-4","DOIUrl":"10.1016/S2405-500X(25)01073-4","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"12 1","pages":"Pages I-CCLIV"},"PeriodicalIF":7.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146045290","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}

{"title":"Evaluating the Impact of Obesity and Epicardial Adiposity on the Presence of HFpEF in Patients With AF","authors":"Jonathan P. Ariyaratnam MB BChir, PhD ,&nbsp;Adrian D. Elliott PhD ,&nbsp;Ricardo S. Mishima MD, PhD ,&nbsp;Jenelle K. Dziano BClinExPhys (Hons) ,&nbsp;Mehrdad Emami MD, PhD ,&nbsp;Jackson O. Howie MClinExPhys ,&nbsp;Melissa E. Middeldorp MPH, PhD ,&nbsp;Prashanthan Sanders MBBS, PhD","doi":"10.1016/j.jacep.2025.08.011","DOIUrl":"10.1016/j.jacep.2025.08.011","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure with preserved ejection fraction (HFpEF) is common in atrial fibrillation (AF). The mechanisms underlying HFpEF in AF remain unclear.</div></div><div><h3>Objectives</h3><div>This study sought to assess the influence of obesity and epicardial adipose tissue (EAT) on the presence of HFpEF in AF.</div></div><div><h3>Methods</h3><div>Consecutive patients with symptomatic AF and preserved ejection fraction undergoing an AF ablation procedure were recruited. Participants were classified as obese if body mass index (BMI) was ≥30 kg/m². Diagnosis of HFpEF was made according to invasive measurement of mean left atrial pressure (mLAP). Mean right atrial pressures (mRAP) were measured to assess extrinsic pericardial restraint. Left atrial function was assessed by means of electroanatomic mapping and transthoracic echocardiography. Total cardiac volumes (TCV) and EAT volumes (EATV) were assessed with the use of cardiac computed tomography scans.</div></div><div><h3>Results</h3><div>Of 120 participants, 44 (36.7%) were obese and 76 (63.3%) were nonobese. Obese patients were younger than nonobese patients (<em>P</em> = 0.003). Obese patients demonstrated higher mLAP (<em>P</em> &lt; 0.001) and were more likely to have HFpEF (<em>P</em> = 0.043). Obese patients also demonstrated higher mRAP (<em>P</em> &lt; 0.001). However, there were no differences in global LA voltages (<em>P</em> = 0.186) or LA reservoir strain (<em>P</em> = 0.63). TCV (<em>P</em> = 0.001) and EATV (<em>P</em> &lt; 0.001) were significantly greater in obese patients, and both correlated positively with mRAP (TCV: <em>P</em> = 0.013; EATV: <em>P</em> = 0.007).</div></div><div><h3>Conclusions</h3><div>Obesity in AF is associated with worse hemodynamics and higher prevalence of HFpEF, underpinned by greater pericardial restraint due to cardiomegaly and increased EATV. Patients with obesity and increased EATV are therefore at increased risk of HF and may benefit from additional HFpEF and weight loss therapies to reduce this risk (Characterizing Left Atrial Function and Compliance in Atrial Fibrillation; <span><span>ACTRN12620000639921</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"12 1","pages":"Pages 96-107"},"PeriodicalIF":7.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137683","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}

{"title":"Prevalence of Peridevice Leak in Patients With Left Atrial Appendage-Occlusion vs Without Electrically Isolated Left Atrial Appendage","authors":"Sanghamitra Mohanty MD, MS ,&nbsp;Prem Geeta Torlapati MD, MPH ,&nbsp;Vincenzo Mirco La Fazia MD ,&nbsp;Rashi Sharma MD ,&nbsp;Carola Gianni MD, PhD ,&nbsp;Amin Al-Ahmad MD ,&nbsp;John D. Burkhardt MD ,&nbsp;G.J. Gallinghouse MD ,&nbsp;Rodney Horton MD ,&nbsp;John Allison MD ,&nbsp;Weeranun Bode MD ,&nbsp;Luigi Di Biase MD, PhD ,&nbsp;Andrea Natale MD","doi":"10.1016/j.jacep.2025.08.027","DOIUrl":"10.1016/j.jacep.2025.08.027","url":null,"abstract":"<div><h3>Background</h3><div>Peridevice leak (PDL) is commonly observed after Watchman implantation for left atrial appendage occlusion (LAAO) in atrial fibrillation (AF). Because the LAA is actively contractile, it is fair to assume that some degree of device shifting could occur because of LAA contraction during the initial period of device implantation.</div></div><div><h3>Objectives</h3><div>This study examined PDL prevalence in Watchman patients with vs without electrical isolation of LAA that consequentially leads to loss of contractility of the appendage.</div></div><div><h3>Methods</h3><div>Consecutive patients with AF undergoing the Watchman procedure were included in the study and prospectively followed up. Based on prior LAA isolation (LAAI), patients were divided into Group 1 (prior LAAI) and Group 2 (no LAAI). In all patients in Group 1, electroanatomical mapping and transesophageal echocardiogram (TEE) were used to confirm LAAI and absence of contractility of the appendage before the Watchman implantation. Repeat TEE was scheduled at 45 to 60 days’ post-Watchman implantation to assess for PDL on color Doppler. The leaks were reassessed by computed tomography imaging at 6 months. If leaks were detected during the first follow-up TEE, another TEE/computed tomography imaging was performed at 12 months to exclude persistent leak.</div></div><div><h3>Results</h3><div>A total of 495 patients were included in Group 1 and 810 in Group 2. Baseline characteristics were comparable between groups. At the first follow-up TEE at 45 to 60 days, leaks of any size were noted in 90 (18.2%) patients in Group 1 and 199 (24.6%) patients in Group 2 (<em>P</em> = 0.007). The majority of the leaks in Group 2 were ≥3 mm in size (Group 1: 26 [28.9%] vs Group 2: 109 [54.8%]; <em>P</em> &lt; 0.001). Prior LAAI was found to be an independent predictor (OR: 0.662; 95% CI: 0.488-0.900; <em>P</em> = 0.008) of lower risk of leaks.</div></div><div><h3>Conclusions</h3><div>In this large prospective series of real-world patients, prior LAAI was seen to be associated with a lower risk of PDL in patients with AF and a Watchman device in situ.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"12 1","pages":"Pages 108-115"},"PeriodicalIF":7.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307940","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}

{"title":"Ultrasound-Based Renal Sympathetic Denervation as Adjunctive Upstream Therapy During Atrial Fibrillation Ablation","authors":"William Whang MD ,&nbsp;Devi Nair MD ,&nbsp;Rahul Bhardwaj MD ,&nbsp;Marc Lahiri MD ,&nbsp;Dinesh Sharma MD ,&nbsp;Taisei Kobayashi MD ,&nbsp;Shephal K. Doshi MD ,&nbsp;Andrea Natale MD ,&nbsp;Craig Moskowitz MD ,&nbsp;Moussa Mansour MD ,&nbsp;Vijay Swarup MD ,&nbsp;Mohit K. Turagam MD ,&nbsp;Srinivas Dukkipati MD ,&nbsp;Matthew C. Hyman MD, PhD ,&nbsp;Sanghamitra Mohanty MD, MS ,&nbsp;Jeff Lam MS ,&nbsp;Ugur Gurol BS ,&nbsp;Carla Perdomo Silva BA ,&nbsp;Vivek Y. Reddy MD","doi":"10.1016/j.jacep.2025.08.028","DOIUrl":"10.1016/j.jacep.2025.08.028","url":null,"abstract":"<div><h3>Background</h3><div>During atrial fibrillation (AF) ablation, adjunctive renal denervation (RDN), by virtue of its effect on the sympathetic/renin-angiotensin-aldosterone axis, has improved AF control. However, patients in these studies mostly had uncontrolled hypertension.</div></div><div><h3>Objectives</h3><div>The aim of this study was to assess the effect of RDN using an ultrasound catheter to improve rhythm outcomes in patients with hypertension (including controlled hypertension) undergoing AF ablation.</div></div><div><h3>Methods</h3><div>This investigator-initiated, sham-controlled, single-blind randomized controlled U.S. Food and Drug Administration trial included first-ever paroxysmal or persistent AF ablation patients with histories of hypertension receiving ≥1 antihypertensive medication. Post–AF ablation randomization was 1:1 to RDN using a circumferential ultrasound system or sham control; patients with ineligible renal arterial anatomy were screen failures. The primary endpoint was 12-month freedom from AF or atrial flutter (AFL) (≥30 seconds) off antiarrhythmic medications after 90-day blanking.</div></div><div><h3>Results</h3><div>At 9 centers, 107 patients were randomized; excluding 7 screen failures, the 100-patient cohort (mean age 66 ± 9 years, 35% women, paroxysmal and persistent AF in 86% and 14%) underwent radiofrequency ablation (55%) or cryoablation (45%) for AF. The 1-year Kaplan-Meier estimates for freedom from AF or AFL were 49% for sham vs 67% for RDN (log-rank <em>P</em> = 0.17). In a Cox analysis adjusted for age, sex, and persistent AF, the HR for recurrent AF or AFL with RDN was 0.65 (95% CI: 0.32-1.31; <em>P</em> = 0.23). There were no RDN-related adverse events.</div></div><div><h3>Conclusions</h3><div>In this AF ablation cohort, adjunctive RDN was safe and reduced AF and AFL recurrence by 35%, an effect not reaching statistical significance in this pilot trial. A fully powered randomized trial is warranted to define the impact of RDN among patients planned for AF ablation.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"12 1","pages":"Pages 71-81"},"PeriodicalIF":7.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421796","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}

{"title":"Irregular A-H-V-H-V Pattern Arrhythmia","authors":"Atsushi Doi MD ,&nbsp;Kazuki Moriwaki MD ,&nbsp;Takuya Oshita MD ,&nbsp;Takuya Tsukamoto MD ,&nbsp;Naoko Takaoka MD ,&nbsp;Toshiharu Iwamura MD ,&nbsp;Takahiko Kawarabayashi MD ,&nbsp;Daiju Fukuda MD","doi":"10.1016/j.jacep.2025.09.002","DOIUrl":"10.1016/j.jacep.2025.09.002","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":"12 1","pages":"Pages 203-216"},"PeriodicalIF":7.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146045289","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}