首页 > 最新文献

JACC. Clinical electrophysiology最新文献

英文 中文
Effects of Implantable Cardioverter-Defibrillator Leads on the Tricuspid Valve and Right Ventricle 植入式心律转复除颤器导线对三尖瓣和右心室的影响:随机试验
IF 8 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 DOI: 10.1016/j.jacep.2024.04.034

Background

There are no randomized data to inform the extent to which transvenous cardiac leads cause tricuspid regurgitation (TR).

Objectives

This study sought to determine the effect of a transvenous implantable cardioverter-defibrillator (TV-ICD) on TR severity, and secondarily, on right ventricular (RV) size and function.

Methods

We evaluated TR severity before and 6 months after implantable cardioverter-defibrillator insertion in a post hoc analysis of adults randomized to receive a transvenous (n = 252) or subcutaneous implantable cardioverter-defibrillator (S-ICD) (n = 251) device. TR and RV size and systolic function were assessed by echocardiographic images analyzed in a core laboratory.

Results

At baseline, at least mild TR was present in 30% of individuals. At 6 months, the proportion of participants with any TR in the TV-ICD group was 42% vs 19% in the S-ICD group (P < 0.001). The proportion with moderate or severe TR was 7% in the TV-ICD group vs 2% in the S-ICD group (P = 0.021). At 6 months, the OR of at least 1 grade worsening of TR in the TV-ICD group as compared with the S-ICD group was 7.2 (95% CI: 3.3-15.8; P < 0.001). There were no differences between groups with respect to RV size or systolic function.

Conclusions

Six months following TV-ICD insertion, there was a 7-fold increase in the risk of at least 1 grade worsening of TR, with 7% of individuals having TR that was moderate or severe. There was no detectable difference in RV size or function; however, longer follow-up is needed.
背景:目前还没有随机数据说明经静脉心导管导致三尖瓣反流(TR)的程度:本研究旨在确定经静脉植入式心律转复除颤器(TV-ICD)对三尖瓣反流严重程度的影响,其次是对右心室(RV)大小和功能的影响:我们对随机接受经静脉(n = 252)或皮下植入式心律转复除颤器(S-ICD)(n = 251)装置的成人进行了事后分析,评估了植入式心律转复除颤器之前和之后 6 个月的 TR 严重程度。TR 和 RV 的大小及收缩功能由核心实验室分析的超声心动图进行评估:基线时,30%的人至少存在轻度TR。6 个月时,TV-ICD 组有任何 TR 的参与者比例为 42%,而 S-ICD 组为 19%(P < 0.001)。TV-ICD组出现中度或重度TR的比例为7%,而S-ICD组为2%(P = 0.021)。6 个月时,TV-ICD 组与 S-ICD 组相比,TR 至少恶化 1 级的 OR 为 7.2 (95% CI: 3.3-15.8; P < 0.001)。各组在 RV 大小或收缩功能方面没有差异:插入 TV-ICD 6 个月后,TR 至少恶化 1 级的风险增加了 7 倍,其中 7% 的人的 TR 为中度或重度。在 RV 大小或功能方面没有可检测到的差异;但是,还需要更长时间的随访。
{"title":"Effects of Implantable Cardioverter-Defibrillator Leads on the Tricuspid Valve and Right Ventricle","authors":"","doi":"10.1016/j.jacep.2024.04.034","DOIUrl":"10.1016/j.jacep.2024.04.034","url":null,"abstract":"<div><h3>Background</h3><div>There are no randomized data to inform the extent to which transvenous cardiac leads cause tricuspid regurgitation (TR).</div></div><div><h3>Objectives</h3><div>This study sought to determine the effect of a transvenous implantable cardioverter-defibrillator (TV-ICD) on TR severity, and secondarily, on right ventricular (RV) size and function.</div></div><div><h3>Methods</h3><div>We evaluated TR severity before and 6 months after implantable cardioverter-defibrillator insertion in a post hoc analysis of adults randomized to receive a transvenous (n = 252) or subcutaneous implantable cardioverter-defibrillator (S-ICD) (n = 251) device. TR and RV size and systolic function were assessed by echocardiographic images analyzed in a core laboratory.</div></div><div><h3>Results</h3><div>At baseline, at least mild TR was present in 30% of individuals. At 6 months, the proportion of participants with any TR in the TV-ICD group was 42% vs 19% in the S-ICD group (<em>P</em> &lt; 0.001). The proportion with moderate or severe TR was 7% in the TV-ICD group vs 2% in the S-ICD group (<em>P</em> = 0.021). At 6 months, the OR of at least 1 grade worsening of TR in the TV-ICD group as compared with the S-ICD group was 7.2 (95% CI: 3.3-15.8; <em>P</em> &lt; 0.001). There were no differences between groups with respect to RV size or systolic function.</div></div><div><h3>Conclusions</h3><div>Six months following TV-ICD insertion, there was a 7-fold increase in the risk of at least 1 grade worsening of TR, with 7% of individuals having TR that was moderate or severe. There was no detectable difference in RV size or function; however, longer follow-up is needed.</div></div>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405500X24003694/pdfft?md5=59aa8c6d5a656d1ef377e6ab669c56af&pid=1-s2.0-S2405500X24003694-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603645","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
Delayed Intradevice Leak Due to Torn Left Atrial Appendage Occlusion Device Membrane 左心房阑尾闭塞装置膜撕裂导致的延迟性装置内泄漏。
IF 8 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 DOI: 10.1016/j.jacep.2024.05.020
{"title":"Delayed Intradevice Leak Due to Torn Left Atrial Appendage Occlusion Device Membrane","authors":"","doi":"10.1016/j.jacep.2024.05.020","DOIUrl":"10.1016/j.jacep.2024.05.020","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603644","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
Atrial Fibrillation Burden on a 14-Day ECG Monitor: Findings From the GUARD-AF Trial Screening Arm 14 天心电图监护仪上的心房颤动负担:GUARD-AF 试验筛查组的研究结果
IF 7 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 DOI: 10.1016/j.jacep.2024.08.010
Daniel E. Singer MD, Steven J. Atlas MD MPH, Alan S. Go MD, Steven A. Lubitz MD MPH, David D. McManus MD MSc, Rowena J. Dolor MD MHS, Ranee Chatterjee MD MPH, Michael B. Rothberg MD MPH, David R. Rushlow MD, Lori A. Crosson PhD MS, Ronald S. Aronson MD, Donna Mills RN, Michael Patlakh BS, Dianne Gallup MS, Emily C. O’Brien PhD, Renato D. Lopes MD PhD MHS
The “burden” of atrial fibrillation (AF) detected by screening likely influences stroke risk, but the distribution of burden is not well described. This study aims to determine the frequency of AF and the distribution of AF burden found when screening individuals ≥70 years of age with a 14-day electrocardiograph monitor. This is a cohort study of the screening arm of a randomized AF screening trial among those ≥70 years of age without a prior AF diagnosis (between 2019 and 2021). Screening was performed with a 14-day continuous electrocardiogram patch monitor. Analyzable patches were returned by 5,684 (95%) of screening arm participants; the median age was 75 years (Q1-Q3: 72-78 years), 57% were female, and the median CHADS-VASc score was 3 (Q1-Q3: 2-4). AF was detected in 252 participants (4.4%); 29 (0.5%) patients had continuous AF and 223 (3.9%) had paroxysmal AF. Among those with paroxysmal AF, the average indices of AF burden were of low magnitude with right-skewed distributions. The median percent time in AF was 0.46% (Q1-Q3: 0.02%-2.48%), or 75 (Q1-Q3: 3-454) minutes, and the median longest episode was 38 (Q1-Q3: 2-245) minutes. The upper quartile threshold of 2.48% time in AF corresponded to 7.6 hours. Age greater than 80 years was associated with screen-detected AF in our multivariable model (OR: 1.46; 95% CI: 1.06-2.02). Most AF detected in these older patients was very low burden. However, one-quarter of those with AF had multiple hours of AF, raising concern about stroke risk. These findings have implications for targeting populations for AF screening trials and for responding to heart rhythm alerts from mobile devices (Guard AF [A Study to Determine if Identification of Undiagnosed Atrial Fibrillation in People at least 70 Years of Age Reduces the Risk of Stroke]; )
通过筛查发现的心房颤动(房颤)"负担 "可能会影响中风风险,但负担的分布尚未得到很好的描述。本研究旨在确定使用 14 天心电图监测仪对年龄≥70 岁的人进行筛查时发现的房颤频率和房颤负荷的分布情况。这是一项针对既往未确诊房颤的≥70 岁人群(2019 年至 2021 年)的房颤随机筛查试验筛查组的队列研究。筛查使用 14 天连续心电图贴片监测仪进行。5684名(95%)筛查组参与者交回了可分析的贴片;年龄中位数为75岁(Q1-Q3:72-78岁),57%为女性,CHADS-VASc评分中位数为3分(Q1-Q3:2-4分)。有 252 名参与者(4.4%)检测到房颤;29 名患者(0.5%)为持续性房颤,223 名患者(3.9%)为阵发性房颤。在阵发性房颤患者中,房颤负担的平均指数较低,呈右斜分布。心房颤动时间百分比的中位数为 0.46%(1-Q3:0.02%-2.48%),或 75(1-Q3:3-454)分钟,最长发作时间的中位数为 38(1-Q3:2-245)分钟。房颤时间的上四分位数阈值为 2.48%,相当于 7.6 小时。在我们的多变量模型中,年龄大于 80 岁与筛查出的房颤有关(OR:1.46;95% CI:1.06-2.02)。在这些老年患者中检测到的大多数房颤负担都很轻。然而,四分之一的房颤患者有多个小时的房颤,这引起了人们对中风风险的关注。这些发现对心房颤动筛查试验的目标人群以及响应移动设备的心律警报具有重要意义(Guard AF [A Study to Determine if Identification of Undiagnosed Atrial Fibrillation in People at least 70 Years of Agees Reduces the Risk of Stroke]; )
{"title":"Atrial Fibrillation Burden on a 14-Day ECG Monitor: Findings From the GUARD-AF Trial Screening Arm","authors":"Daniel E. Singer MD, Steven J. Atlas MD MPH, Alan S. Go MD, Steven A. Lubitz MD MPH, David D. McManus MD MSc, Rowena J. Dolor MD MHS, Ranee Chatterjee MD MPH, Michael B. Rothberg MD MPH, David R. Rushlow MD, Lori A. Crosson PhD MS, Ronald S. Aronson MD, Donna Mills RN, Michael Patlakh BS, Dianne Gallup MS, Emily C. O’Brien PhD, Renato D. Lopes MD PhD MHS","doi":"10.1016/j.jacep.2024.08.010","DOIUrl":"https://doi.org/10.1016/j.jacep.2024.08.010","url":null,"abstract":"The “burden” of atrial fibrillation (AF) detected by screening likely influences stroke risk, but the distribution of burden is not well described. This study aims to determine the frequency of AF and the distribution of AF burden found when screening individuals ≥70 years of age with a 14-day electrocardiograph monitor. This is a cohort study of the screening arm of a randomized AF screening trial among those ≥70 years of age without a prior AF diagnosis (between 2019 and 2021). Screening was performed with a 14-day continuous electrocardiogram patch monitor. Analyzable patches were returned by 5,684 (95%) of screening arm participants; the median age was 75 years (Q1-Q3: 72-78 years), 57% were female, and the median CHADS-VASc score was 3 (Q1-Q3: 2-4). AF was detected in 252 participants (4.4%); 29 (0.5%) patients had continuous AF and 223 (3.9%) had paroxysmal AF. Among those with paroxysmal AF, the average indices of AF burden were of low magnitude with right-skewed distributions. The median percent time in AF was 0.46% (Q1-Q3: 0.02%-2.48%), or 75 (Q1-Q3: 3-454) minutes, and the median longest episode was 38 (Q1-Q3: 2-245) minutes. The upper quartile threshold of 2.48% time in AF corresponded to 7.6 hours. Age greater than 80 years was associated with screen-detected AF in our multivariable model (OR: 1.46; 95% CI: 1.06-2.02). Most AF detected in these older patients was very low burden. However, one-quarter of those with AF had multiple hours of AF, raising concern about stroke risk. These findings have implications for targeting populations for AF screening trials and for responding to heart rhythm alerts from mobile devices (Guard AF [A Study to Determine if Identification of Undiagnosed Atrial Fibrillation in People at least 70 Years of Age Reduces the Risk of Stroke]; )","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142180648","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
Sharpening the Spear 磨砺长矛:我们能用心肌肌钙蛋白 T 完善心脏性猝死预测吗?
IF 8 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 DOI: 10.1016/j.jacep.2024.05.039
{"title":"Sharpening the Spear","authors":"","doi":"10.1016/j.jacep.2024.05.039","DOIUrl":"10.1016/j.jacep.2024.05.039","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901742","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
Termination Without Global Propagation in Re-Entrant Ventricular Tachycardia: Electrophysiologic Characteristics and 3D-Electroanatomical Mapping Analysis. 再入型室性心动过速中无全局传播的终止:电生理学特征和三维电子解剖图分析
IF 8 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-31 DOI: 10.1016/j.jacep.2024.08.004
Yumi Katsume, Kanae Hasegawa, Sarawuth Limprasert, Akiko Ueda, Arvindh N Kanagasundram, Travis D Richardson, William G Stevenson, Kyoko Soejima

Background: Termination of ventricular tachycardia (VT) by a pacing stimulus that does not generate a QRS complex (termination without global propagation [TWGP]) can be a marker for a critical re-entry circuit isthmus. However, the electrophysiologic and anatomic features of these sites and their relation to VT substrate defined by 3-dimensional electroanatomical maps (3D-EAM) remain unknown.

Objectives: This retrospective study aimed to characterize TWGP sites and their relation to VT substrate identified by 3D-EAM.

Methods: A total of 632 consecutive cases of catheter ablation for scar-related VT at 2 University medical centers were reviewed to identify TWGP.

Results: TWGP was observed 12 times at 11 different sites in 10 patients (5 ischemic cardiomyopathy). The TWGP stimulus fell immediately before or synchronous with the QRS in all cases, and evidence of local capture despite absence of a QRS complex was observed 6 times. In 5 sites, pacing after VT termination produced a QRS different than the VT. Four sites were in dense scar areas (<0.1 mV), and 6 in abnormal low voltage zone (0.1-1.5 mV). Additional mapping or ablation that abolished VT were consistent with the TWGP site being in a VT isthmus. A substrate marker for VT of late potentials, evoked delayed potentials, or slow conduction was present at 6 of 11 TWGP sites.

Conclusions: TWGP may be a marker for detecting a re-entry circuit isthmus that has escaped detection based on electrogram or pace mapping-based substrate mapping.

背景:通过起搏刺激终止室性心动过速(VT)但不产生 QRS 波群(无全波传播终止[TWGP])可作为关键再入电路峡部的标志。然而,这些部位的电生理学和解剖学特征及其与三维电解剖图(3D-EAM)所定义的 VT 基底的关系仍不清楚:这项回顾性研究旨在确定 TWGP 位点的特征及其与 3D-EAM 确定的 VT 基底的关系:方法: 对两所大学医疗中心的 632 例连续瘢痕相关 VT 导管消融病例进行回顾性研究,以确定 TWGP:在 10 名患者(5 名缺血性心肌病患者)的 11 个不同部位观察到 12 次 TWGP。在所有病例中,TWGP 刺激均落在 QRS 之前或与 QRS 同步,尽管没有 QRS 波群,但仍有 6 次观察到局部捕获的证据。在 5 个部位,VT 终止后起搏产生的 QRS 与 VT 不同。其中 4 个部位位于密集疤痕区(结论:TWGP 可能是 VT 的标志物):TWGP 可能是检测再入路峡部的标志物,而基于电图或起搏图的基底图无法检测到这种峡部。
{"title":"Termination Without Global Propagation in Re-Entrant Ventricular Tachycardia: Electrophysiologic Characteristics and 3D-Electroanatomical Mapping Analysis.","authors":"Yumi Katsume, Kanae Hasegawa, Sarawuth Limprasert, Akiko Ueda, Arvindh N Kanagasundram, Travis D Richardson, William G Stevenson, Kyoko Soejima","doi":"10.1016/j.jacep.2024.08.004","DOIUrl":"https://doi.org/10.1016/j.jacep.2024.08.004","url":null,"abstract":"<p><strong>Background: </strong>Termination of ventricular tachycardia (VT) by a pacing stimulus that does not generate a QRS complex (termination without global propagation [TWGP]) can be a marker for a critical re-entry circuit isthmus. However, the electrophysiologic and anatomic features of these sites and their relation to VT substrate defined by 3-dimensional electroanatomical maps (3D-EAM) remain unknown.</p><p><strong>Objectives: </strong>This retrospective study aimed to characterize TWGP sites and their relation to VT substrate identified by 3D-EAM.</p><p><strong>Methods: </strong>A total of 632 consecutive cases of catheter ablation for scar-related VT at 2 University medical centers were reviewed to identify TWGP.</p><p><strong>Results: </strong>TWGP was observed 12 times at 11 different sites in 10 patients (5 ischemic cardiomyopathy). The TWGP stimulus fell immediately before or synchronous with the QRS in all cases, and evidence of local capture despite absence of a QRS complex was observed 6 times. In 5 sites, pacing after VT termination produced a QRS different than the VT. Four sites were in dense scar areas (<0.1 mV), and 6 in abnormal low voltage zone (0.1-1.5 mV). Additional mapping or ablation that abolished VT were consistent with the TWGP site being in a VT isthmus. A substrate marker for VT of late potentials, evoked delayed potentials, or slow conduction was present at 6 of 11 TWGP sites.</p><p><strong>Conclusions: </strong>TWGP may be a marker for detecting a re-entry circuit isthmus that has escaped detection based on electrogram or pace mapping-based substrate mapping.</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287387","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
Improvement of Erectile Dysfunction After Atrial Fibrillation Ablation: A Medication Dependency Analysis. 心房颤动消融术后勃起功能障碍的改善:药物依赖性分析
IF 7 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-30 DOI: 10.1016/j.jacep.2024.08.002
Vincenzo Mirco La Fazia,Gianluca Massaro,Sanghamitra Mohanty,Carola Gianni,Domenico Giovanni Della Rocca,Prem Geeta Torlapati,Rodney Horton,Amin Al-Ahmad,Luigi Di Biase,Andrea Natale
{"title":"Improvement of Erectile Dysfunction After Atrial Fibrillation Ablation: A Medication Dependency Analysis.","authors":"Vincenzo Mirco La Fazia,Gianluca Massaro,Sanghamitra Mohanty,Carola Gianni,Domenico Giovanni Della Rocca,Prem Geeta Torlapati,Rodney Horton,Amin Al-Ahmad,Luigi Di Biase,Andrea Natale","doi":"10.1016/j.jacep.2024.08.002","DOIUrl":"https://doi.org/10.1016/j.jacep.2024.08.002","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262301","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
New-Onset Left Ventricular Dysfunction After Left Bundle Branch Pacing. 左束支起搏后新发左心室功能障碍
IF 8 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-30 DOI: 10.1016/j.jacep.2024.07.019
Shunmuga Sundaram Ponnusamy, Vithiya Ganesan, Sudharshana Nagalingam, Vadivelu Ramalingam, Selvaganesh Mariappan, Habibullah Moghal, Senthil Murugan, Mahesh Kumar, Riya Joseph, Pugazhendhi Vijayaraman

Background: Left bundle branch pacing (LBBP) provides stable pacing parameters and has been suggested as an alternative for right ventricular pacing and cardiac resynchronization therapy.

Objectives: The aim of the study was to assess the incidence and etiology of new-onset left ventricular dysfunction (NOLVD) following LBBP in patients with baseline normal left ventricular (LV) function and cardiomyopathy patients with normalized LV function.

Methods: Patients undergoing successful LBBP for symptomatic bradyarrhythmia or as an alternative to cardiac resynchronization therapy were included. Normalization of LV function was defined as improvement in LV ejection fraction to ≥50%. Patients with baseline normal LV function and those with recovered LV function after LBBP constituted the study group. Loss of conduction system capture (LOCSC) was defined as complete or partial loss of right bundle branch delay pattern along with inability to demonstrate capture transition during threshold assessment.

Results: A total of 426 patients were included; 59% (n = 250) had baseline normal LV function (group I) and 41% (n = 176) had recovered LV function after LBBP (group II). Mean follow-up duration of 28.3 ± 16.7 months. NOLVD was noted in 3.75% (n = 16; group I = 5 and group II = 11) of patients. The etiologies for NOLVD were LOCSC in 62.5% (n = 10), suboptimal atrioventricular (AV) delay in 18.7% (n = 3), atrial fibrillation in 6.3% (n = 1), and idiopathic in 12.5% (n = 2). LOCSC occurred at a mean interval of 9.2 ± 6.4 months after the initial implantation. Reinterventions (n = 6) including lead repositioning, AV delay optimization, and AV junction ablation resulted in renormalization of LV function in all 6 patients.

Conclusions: Periodic assessment in device clinic is required because NOLVD from reversible causes can occur during follow-up in patients after LBBP.

背景:左束支起搏(LBBP)可提供稳定的起搏参数,已被建议作为右心室起搏和心脏再同步化治疗的替代方法:研究旨在评估左束支起搏后新发左心室功能障碍(NOLVD)的发生率和病因,研究对象为基线左心室(LV)功能正常的患者和左心室功能正常的心肌病患者:方法:纳入因症状性缓慢性心律失常或作为心脏再同步化治疗的替代方案而成功接受 LBBP 的患者。左心室功能正常化的定义是左心室射血分数改善到≥50%。基线左心室功能正常的患者和 LBBP 后左心室功能恢复的患者组成研究组。传导系统捕获丧失(LOCSC)的定义是右束支延迟模式完全或部分丧失,以及在阈值评估中无法显示捕获转换:共纳入 426 名患者;59%(n = 250)的患者左心室功能基线正常(I 组),41%(n = 176)的患者在 LBBP 后左心室功能恢复(II 组)。平均随访时间为 28.3 ± 16.7 个月。3.75%的患者(n = 16;I 组 = 5,II 组 = 11)出现 NOLVD。NOLVD的病因包括:62.5%的患者为LOCSC(10例),18.7%的患者为房室延迟不达标(3例),6.3%的患者为心房颤动(1例),12.5%的患者为特发性(2例)。LOCSC 发生在首次植入后的平均间隔时间为 9.2 ± 6.4 个月。重新干预(n = 6)包括导联重新定位、房室延迟优化和房室交界处消融,所有 6 名患者的左心室功能均恢复正常:需要在设备诊所进行定期评估,因为 LBBP 患者在随访期间可能会出现由可逆原因引起的 NOLVD。
{"title":"New-Onset Left Ventricular Dysfunction After Left Bundle Branch Pacing.","authors":"Shunmuga Sundaram Ponnusamy, Vithiya Ganesan, Sudharshana Nagalingam, Vadivelu Ramalingam, Selvaganesh Mariappan, Habibullah Moghal, Senthil Murugan, Mahesh Kumar, Riya Joseph, Pugazhendhi Vijayaraman","doi":"10.1016/j.jacep.2024.07.019","DOIUrl":"https://doi.org/10.1016/j.jacep.2024.07.019","url":null,"abstract":"<p><strong>Background: </strong>Left bundle branch pacing (LBBP) provides stable pacing parameters and has been suggested as an alternative for right ventricular pacing and cardiac resynchronization therapy.</p><p><strong>Objectives: </strong>The aim of the study was to assess the incidence and etiology of new-onset left ventricular dysfunction (NOLVD) following LBBP in patients with baseline normal left ventricular (LV) function and cardiomyopathy patients with normalized LV function.</p><p><strong>Methods: </strong>Patients undergoing successful LBBP for symptomatic bradyarrhythmia or as an alternative to cardiac resynchronization therapy were included. Normalization of LV function was defined as improvement in LV ejection fraction to ≥50%. Patients with baseline normal LV function and those with recovered LV function after LBBP constituted the study group. Loss of conduction system capture (LOCSC) was defined as complete or partial loss of right bundle branch delay pattern along with inability to demonstrate capture transition during threshold assessment.</p><p><strong>Results: </strong>A total of 426 patients were included; 59% (n = 250) had baseline normal LV function (group I) and 41% (n = 176) had recovered LV function after LBBP (group II). Mean follow-up duration of 28.3 ± 16.7 months. NOLVD was noted in 3.75% (n = 16; group I = 5 and group II = 11) of patients. The etiologies for NOLVD were LOCSC in 62.5% (n = 10), suboptimal atrioventricular (AV) delay in 18.7% (n = 3), atrial fibrillation in 6.3% (n = 1), and idiopathic in 12.5% (n = 2). LOCSC occurred at a mean interval of 9.2 ± 6.4 months after the initial implantation. Reinterventions (n = 6) including lead repositioning, AV delay optimization, and AV junction ablation resulted in renormalization of LV function in all 6 patients.</p><p><strong>Conclusions: </strong>Periodic assessment in device clinic is required because NOLVD from reversible causes can occur during follow-up in patients after LBBP.</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346826","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
Ambulatory Rhythm Monitoring in People Living With HIV: A Cross-Sectional Analysis From a Comparative Cohort. 艾滋病病毒感染者的动态心律监测:来自比较队列的横断面分析。
IF 8 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-30 DOI: 10.1016/j.jacep.2024.07.013
Cody Cichowitz, Godfrey A Kisigo, Salama P Fadhil, Grace Ruselu, Nikola Fajkis-Zajączkowska, Eva Mujuni, Megan A Willkens, Priscilla Hsue, Robert N Peck
{"title":"Ambulatory Rhythm Monitoring in People Living With HIV: A Cross-Sectional Analysis From a Comparative Cohort.","authors":"Cody Cichowitz, Godfrey A Kisigo, Salama P Fadhil, Grace Ruselu, Nikola Fajkis-Zajączkowska, Eva Mujuni, Megan A Willkens, Priscilla Hsue, Robert N Peck","doi":"10.1016/j.jacep.2024.07.013","DOIUrl":"https://doi.org/10.1016/j.jacep.2024.07.013","url":null,"abstract":"","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287383","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
Ablation for Atrial Fibrillation in Patients With Rare Pathogenic Variants in Cardiomyopathy and Arrhythmia Genes. 心肌病和心律失常基因罕见致病变异患者心房颤动的消融治疗。
IF 8 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-20 DOI: 10.1016/j.jacep.2024.06.035
Majd A El-Harasis, Zachary T Yoneda, Katherine C Anderson, Fei Ye, Joseph A Quintana, J Roberto Martinez-Parachini, Gregory G Jackson, Bibin T Varghese, Diane M Crawford, Lili Sun, Hollie L Williams, Matthew J O'Neill, Giovanni E Davogustto, James L Laws, Brittany S Murphy, Kelsey Tomasek, Yan Ru Su, Emily McQuillen, Emma Metz, Carly Smith, Doug Stubbs, Dakota D Grauherr, Quinn S Wells, Gregory F Michaud, Pablo Saavedra, Juan Carlos Estrada, Travis D Richardson, Sharon T Shen, Arvindh N Kanagasundram, Jay A Montgomery, Harikrishna Tandri, Christopher R Ellis, George H Crossley, Prince J Kannankeril, Lynne W Stevenson, William G Stevenson, Steven A Lubitz, Patrick T Ellinor, Dan M Roden, M Benjamin Shoemaker

Background: Patients with rare, pathogenic cardiomyopathy (CM) and arrhythmia variants can present with atrial fibrillation (AF). The efficacy of AF ablation in these patients is unknown.

Objective: This study tested the hypotheses that: 1) patients with a pathogenic variant in any CM or arrhythmia gene have increased recurrence following AF ablation; and 2) patients with a pathogenic variant associated with a specific gene group (arrhythmogenic left ventricular CM [ALVC], arrhythmogenic right ventricular CM, dilated CM, hypertrophic CM, or a channelopathy) have increased recurrence.

Methods: We performed a prospective, observational, cohort study of patients who underwent AF catheter ablation and whole exome sequencing. The primary outcome measure was ≥30 seconds of any atrial tachyarrhythmia that occurred after a 90-day blanking period.

Results: Among 1,366 participants, 109 (8.0%) had a pathogenic or likely pathogenic (P/LP) variant in a CM or arrhythmia gene. In multivariable analysis, the presence of a P/LP variant in any gene was not significantly associated with recurrence (HR 1.15; 95% CI 0.84-1.60; P = 0.53). P/LP variants in the ALVC gene group, predominantly LMNA, were associated with increased recurrence (n = 10; HR 3.75; 95% CI 1.84-7.63; P < 0.001), compared with those in the arrhythmogenic right ventricular CM, dilated CM, hypertrophic CM, and channelopathy gene groups. Participants with P/LP TTN variants (n = 46) had no difference in recurrence compared with genotype-negative-controls (HR 0.93; 95% CI 0.54-1.59; P = 0.78).

Conclusions: Our results support the use of AF ablation for most patients with rare pathogenic CM or arrhythmia variants, including TTN. However, patients with ALVC variants, such as LMNA, may be at a significantly higher risk for arrhythmia recurrence.

背景:罕见的致病性心肌病(CM)和心律失常变异患者可能会出现心房颤动(AF)。这些患者的房颤消融疗效尚不清楚:本研究测试了以下假设1) 任何 CM 或心律失常基因中存在致病变异的患者在房颤消融术后复发率都会增加;以及 2) 与特定基因组(致心律失常左心室 CM [ALVC]、致心律失常右心室 CM、扩张型 CM、肥厚型 CM 或通道病)相关的致病变异患者复发率都会增加:我们对接受房颤导管消融术和全外显子组测序的患者进行了一项前瞻性、观察性、队列研究。主要结果指标是在90天空白期后发生≥30秒的任何房性快速心律失常:在1366名参与者中,109人(8.0%)的CM或心律失常基因存在致病或可能致病(P/LP)变异。在多变量分析中,任何基因中出现 P/LP 变异与复发均无明显关系(HR 1.15;95% CI 0.84-1.60;P = 0.53)。与致心律失常右室CM、扩张型CM、肥厚型CM和通道病变基因组相比,ALVC基因组(主要是LMNA)中的P/LP变异与复发率升高有关(n = 10;HR 3.75;95% CI 1.84-7.63;P < 0.001)。与基因型阴性对照组相比,P/LP TTN 变体参与者(n = 46)的复发率没有差异(HR 0.93;95% CI 0.54-1.59;P = 0.78):我们的研究结果支持对大多数具有罕见致病性 CM 或心律失常变异(包括 TTN)的患者使用房颤消融术。然而,ALVC 变异(如 LMNA)患者的心律失常复发风险可能明显更高。
{"title":"Ablation for Atrial Fibrillation in Patients With Rare Pathogenic Variants in Cardiomyopathy and Arrhythmia Genes.","authors":"Majd A El-Harasis, Zachary T Yoneda, Katherine C Anderson, Fei Ye, Joseph A Quintana, J Roberto Martinez-Parachini, Gregory G Jackson, Bibin T Varghese, Diane M Crawford, Lili Sun, Hollie L Williams, Matthew J O'Neill, Giovanni E Davogustto, James L Laws, Brittany S Murphy, Kelsey Tomasek, Yan Ru Su, Emily McQuillen, Emma Metz, Carly Smith, Doug Stubbs, Dakota D Grauherr, Quinn S Wells, Gregory F Michaud, Pablo Saavedra, Juan Carlos Estrada, Travis D Richardson, Sharon T Shen, Arvindh N Kanagasundram, Jay A Montgomery, Harikrishna Tandri, Christopher R Ellis, George H Crossley, Prince J Kannankeril, Lynne W Stevenson, William G Stevenson, Steven A Lubitz, Patrick T Ellinor, Dan M Roden, M Benjamin Shoemaker","doi":"10.1016/j.jacep.2024.06.035","DOIUrl":"https://doi.org/10.1016/j.jacep.2024.06.035","url":null,"abstract":"<p><strong>Background: </strong>Patients with rare, pathogenic cardiomyopathy (CM) and arrhythmia variants can present with atrial fibrillation (AF). The efficacy of AF ablation in these patients is unknown.</p><p><strong>Objective: </strong>This study tested the hypotheses that: 1) patients with a pathogenic variant in any CM or arrhythmia gene have increased recurrence following AF ablation; and 2) patients with a pathogenic variant associated with a specific gene group (arrhythmogenic left ventricular CM [ALVC], arrhythmogenic right ventricular CM, dilated CM, hypertrophic CM, or a channelopathy) have increased recurrence.</p><p><strong>Methods: </strong>We performed a prospective, observational, cohort study of patients who underwent AF catheter ablation and whole exome sequencing. The primary outcome measure was ≥30 seconds of any atrial tachyarrhythmia that occurred after a 90-day blanking period.</p><p><strong>Results: </strong>Among 1,366 participants, 109 (8.0%) had a pathogenic or likely pathogenic (P/LP) variant in a CM or arrhythmia gene. In multivariable analysis, the presence of a P/LP variant in any gene was not significantly associated with recurrence (HR 1.15; 95% CI 0.84-1.60; P = 0.53). P/LP variants in the ALVC gene group, predominantly LMNA, were associated with increased recurrence (n = 10; HR 3.75; 95% CI 1.84-7.63; P < 0.001), compared with those in the arrhythmogenic right ventricular CM, dilated CM, hypertrophic CM, and channelopathy gene groups. Participants with P/LP TTN variants (n = 46) had no difference in recurrence compared with genotype-negative-controls (HR 0.93; 95% CI 0.54-1.59; P = 0.78).</p><p><strong>Conclusions: </strong>Our results support the use of AF ablation for most patients with rare pathogenic CM or arrhythmia variants, including TTN. However, patients with ALVC variants, such as LMNA, may be at a significantly higher risk for arrhythmia recurrence.</p>","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145655","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
Mechanisms of Mitral Isthmus Reconnection After Ablation With and Without Vein of Marshall Ethanol Infusion. 注入或不注入马歇尔静脉乙醇消融后二尖瓣峡部重新连接的机制
IF 7 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-19 DOI: 10.1016/j.jacep.2024.07.009
Paul Schurmann,Akanibo Da-Wariboko,Armen Kocharian,Adi Lador,Apoor Patel,Nilesh Mathuria,Amish S Dave,Miguel Valderrábano
BACKGROUNDReconnection of the mitral isthmus (MI) is common after radiofrequency ablation (RFA). Vein of Marshall ethanol infusion (VOMEI) expedites MI ablation, but long-term results are unclear.OBJECTIVESThis study sought to determine anatomic substrates of failed MI ablation, with and without VOMEI.METHODSConsecutive VOMEI procedures were included (n = 231; of which 140 were de novo ablations and 91 were prior RFA failures (rescue VOMEI). MI conduction mechanisms were studied with vein of Marshall (VOM) electrograms obtained with a 2-F octapolar catheter, mapping, and differential pacing.RESULTSIn rescue VOMEI, intact VOM electrograms showed epicardial connections, epi-endocardial dissociation, and VOM conduction in pseudo-MI block. After VOMEI, after a follow-up of 725 ± 455 days, 78 patients (33.7%) experienced recurrence. Of those, 36 (46%) had evidence of MI reconnection and 42 had other mechanisms. Of the 36 patients with MI reconnection, endocardial radiofrequency (RF) at the annular MI restored block in 16 (45%), and coronary sinus (CS) RF was required in 20 (55%). Post-VOMEI recurrence mechanisms included CS connection-dependent arrhythmias: CS-mediated perimitral flutter, CS-to-left atrium (LA) and CS ostial re-entry, and CS focal activity. Intraprocedural factors associated with MI reconnection included volume of ethanol delivered ≥4 mL (OR: 0.74; P = NS), CS ablation at VOMEI (OR: 4.05; P = 0.003), and age (OR: 1.06; P = 0.011).CONCLUSIONSMI reconnections after RFA are due to epicardial connections from VOM. Recurrences after VOMEI are due to incomplete annular MI RFA and CS arrhythmogenesis including CS-mediated perimitral flutter, CS-to-LA re-entry and CS focal activity. Adding complete CS disconnection to VOMEI may prevent recurrences.
背景二尖瓣峡部(MI)的连接在射频消融(RFA)后很常见。马歇尔静脉乙醇灌注(VOMEI)可加速二尖瓣峡部消融,但长期效果尚不明确。方法纳入连续的 VOMEI 手术(n = 231;其中 140 例为全新消融,91 例为之前的 RFA 失败(救援 VOMEI))。用 2-F 八极导管获得的马歇尔静脉 (VOM) 电图、绘图和差分起搏研究了 MI 的传导机制。结果 在抢救性 VOMEI 中,完整的 VOM 电图显示心外膜连接、心外膜与心内膜分离以及假性 MI 阻滞中的 VOM 传导。VOMEI 后,经过 725 ± 455 天的随访,78 名患者(33.7%)复发。其中,36 例(46%)有 MI 再连接的证据,42 例有其他机制。在 36 名有 MI 再连接的患者中,16 人(45%)的心内膜射频(RF)在环形 MI 恢复了阻滞,20 人(55%)需要冠状窦射频(CS)。VOMEI 后复发机制包括 CS 连接依赖性心律失常:CS 介导的瓣周扑动、CS 至左心房(LA)和 CS 室间隔再入以及 CS 局灶活动。与 MI 再连接相关的术中因素包括乙醇输送量≥4 mL(OR:0.74;P = NS)、VOMEI 时的 CS 消融(OR:4.05;P = 0.003)和年龄(OR:1.06;P = 0.011)。VOMEI术后复发的原因是不完全的环形MI RFA和CS心律失常发生,包括CS介导的窦周扑动、CS至LA再入路和CS局灶活动。在 VOMEI 中加入完全的 CS 切断可防止复发。
{"title":"Mechanisms of Mitral Isthmus Reconnection After Ablation With and Without Vein of Marshall Ethanol Infusion.","authors":"Paul Schurmann,Akanibo Da-Wariboko,Armen Kocharian,Adi Lador,Apoor Patel,Nilesh Mathuria,Amish S Dave,Miguel Valderrábano","doi":"10.1016/j.jacep.2024.07.009","DOIUrl":"https://doi.org/10.1016/j.jacep.2024.07.009","url":null,"abstract":"BACKGROUNDReconnection of the mitral isthmus (MI) is common after radiofrequency ablation (RFA). Vein of Marshall ethanol infusion (VOMEI) expedites MI ablation, but long-term results are unclear.OBJECTIVESThis study sought to determine anatomic substrates of failed MI ablation, with and without VOMEI.METHODSConsecutive VOMEI procedures were included (n = 231; of which 140 were de novo ablations and 91 were prior RFA failures (rescue VOMEI). MI conduction mechanisms were studied with vein of Marshall (VOM) electrograms obtained with a 2-F octapolar catheter, mapping, and differential pacing.RESULTSIn rescue VOMEI, intact VOM electrograms showed epicardial connections, epi-endocardial dissociation, and VOM conduction in pseudo-MI block. After VOMEI, after a follow-up of 725 ± 455 days, 78 patients (33.7%) experienced recurrence. Of those, 36 (46%) had evidence of MI reconnection and 42 had other mechanisms. Of the 36 patients with MI reconnection, endocardial radiofrequency (RF) at the annular MI restored block in 16 (45%), and coronary sinus (CS) RF was required in 20 (55%). Post-VOMEI recurrence mechanisms included CS connection-dependent arrhythmias: CS-mediated perimitral flutter, CS-to-left atrium (LA) and CS ostial re-entry, and CS focal activity. Intraprocedural factors associated with MI reconnection included volume of ethanol delivered ≥4 mL (OR: 0.74; P = NS), CS ablation at VOMEI (OR: 4.05; P = 0.003), and age (OR: 1.06; P = 0.011).CONCLUSIONSMI reconnections after RFA are due to epicardial connections from VOM. Recurrences after VOMEI are due to incomplete annular MI RFA and CS arrhythmogenesis including CS-mediated perimitral flutter, CS-to-LA re-entry and CS focal activity. Adding complete CS disconnection to VOMEI may prevent recurrences.","PeriodicalId":14573,"journal":{"name":"JACC. Clinical electrophysiology","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262486","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
期刊
JACC. Clinical electrophysiology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1