Journal of Arrhythmia最新文献_第4页

A Novel Multiparametric Model Integrating Aortoseptal Angle to Predict the Origin of Outflow Tract Ventricular Arrhythmias 结合主动脉间隔角的多参数模型预测流出道室性心律失常的起源。

IF 1.7 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Arrhythmia

Pub Date : 2026-01-13 DOI: 10.1002/joa3.70269

Sunu Budhi Raharjo, Charles Saputra, Andre Tritansa Faizal, Dony Yugo Hermanto, Dicky Armein Hanafy, Ario Soeryo Kuncoro, Amiliana Mardiani Soesanto, Rina Ariani, Estu Rudiktyo, Daniel Valentino Chrismara, Andi Muhammad Zharfan, Yoga Yuniadi

Background

Localizing the site of origin of outflow tract ventricular arrhythmias (OTVA) before ablation remains challenging despite existing ECG algorithms. Anatomical alterations of the aortic root associated with left ventricular outflow tract (LVOT) origin can be visualized through aortoseptal angle measurement. This study investigated the aortoseptal angle for predicting LVOT origin and improving the predictive power of current ECG algorithms.

Methods

Patients undergoing successful OTVA ablation at a national cardiovascular referral hospital were enrolled. Transthoracic echocardiography measured the aortoseptal angle before ablation. Patients with structural abnormalities, multifocal arrhythmias, reduced ejection fraction, unsuccessful ablation, or non-inducible VAs were excluded. Multivariable logistic regression was used to develop a diagnostic model.

Results

Forty-eight patients were included (44.9 ± 12.2 years, 79.8% female). Patients with LVOT origin (17.1%) had higher hypertension prevalence (71.4% vs. 17.6%; p < 0.001) and smaller aortoseptal angles (128.0 ± 6.2 vs. 136.7 ± 5.8; p < 0.001) than right ventricular outflow tract (RVOT) origin. The aortoseptal angle demonstrated good diagnostic performance (AUC 85.5%), comparable to ECG algorithms (V2 transition ratio 90.3%, V2S/V3R index 81.4%). Multivariable analysis identified three independent predictors: hypertension (OR 10.35; 95% CI: 1.07–99.87; p = 0.043), aortoseptal angle (OR 0.79; 95% CI: 0.65–0.96; p = 0.033), and V2 transition ratio (OR 12.12; 95% CI: 1.03–141.48; p = 0.026). The integrated model substantially improved performance (AUC 0.966, sensitivity 92.31%, specificity 88.24%).

Conclusions

Aortoseptal angle measurement by echocardiography effectively identifies LVOT origin. Integration with hypertension status and V2 transition ratio substantially enhances diagnostic accuracy, supporting the use in pre-ablation assessment.

背景：尽管现有的ECG算法，在消融前定位流出道室性心律失常（OTVA）的起源位置仍然具有挑战性。主动脉根部与左心室流出道（LVOT）起源相关的解剖改变可以通过主动脉间隔角测量可视化。本研究探讨了主动脉间隔角对LVOT起源的预测，提高了当前心电算法的预测能力。方法：选取在某国家级心血管转诊医院成功行OTVA消融术的患者。经胸超声心动图测量消融前主动脉间隔角。排除结构异常、多灶性心律失常、射血分数降低、消融不成功或非诱导性VAs的患者。采用多变量logistic回归建立诊断模型。结果：纳入48例患者（44.9±12.2岁，女性79.8%）。LVOT起源患者（17.1%）高血压患病率（71.4% vs. 17.6%; p p p = 0.043）、主动脉间隔角（OR 0.79; 95% CI: 0.65 ~ 0.96; p = 0.033）和V2转换比（OR 12.12; 95% CI: 1.03 ~ 141.48; p = 0.026）较高。综合模型显著提高了诊断效果（AUC 0.966，灵敏度92.31%，特异度88.24%）。结论：超声心动图测量主动脉间隔角能有效识别左室血栓的起源。结合高血压状态和V2转换比大大提高了诊断准确性，支持在消融前评估中的应用。

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引用次数: 0

Wild Type Transthyretin Amyloid Cardiomyopathy Hidden Under Ablation-Refractory Atrial Arrhythmias and the Potential Contribution of Tafamidis in Rhythm Control 隐藏在消融难治性心房心律失常下的野生型转甲状腺蛋白淀粉样心肌病和他法非底斯在心律控制中的潜在作用。

IF 1.7 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Arrhythmia

Pub Date : 2026-01-13 DOI: 10.1002/joa3.70271

Tomoki Horie, Yasutoshi Nagata, Toshihiro Nozato, Shinsuke Miyazaki, Takashi Ashikaga

An octogenarian man with a history of multiple catheter ablation failures for atrial fibrillation and tachycardia was diagnosed with transthyretin amyloid cardiomyopathy. After 1 year of tafamidis therapy, the patient experienced spontaneous restoration of sinus rhythm, and follow-up image of 99mTc-pyrophosphate scintigraphy revealed a marked decrease of tracer accumulation.

一位80多岁的男性，有多次导管消融失败的房颤和心动过速的历史，被诊断为甲状腺素淀粉样蛋白心肌病。经1年他法底斯治疗后，患者窦性心律自然恢复，随访99mtc焦磷酸盐显像显示示踪剂积累明显减少。

引用次数: 0

Cardiac Resynchronization Therapy: Reconsidering Its Essence as a Treatment for Electrical Dyssynchrony in Heart Failure 心脏再同步化治疗：重新考虑其作为心力衰竭电非同步化治疗的本质。

IF 1.7 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Arrhythmia

Pub Date : 2026-01-09 DOI: 10.1002/joa3.70268

Michio Ogano, Yu-ki Iwasaki, Jun Tanabe, Wataru Shimizu, Kuniya Asai

Cardiac resynchronization therapy (CRT) essentially targets electrical dyssynchrony, one of the key drivers in heart failure (HF). Its efficacy depends on both the quality (QRS morphology) and quantity (QRS duration) of dyssynchrony, requiring individualized patient selection. While drug therapy for HF has a limited effect on this substrate, early implantation of CRT can prevent irreversible remodeling and facilitate optimization of medical therapy. CRT should be recognized as an essential component within a comprehensive strategy for HF management in patients with appropriate indications.

心脏再同步化治疗（CRT）主要针对电非同步化，这是心力衰竭（HF）的关键驱动因素之一。其疗效取决于非同步运动的质量（QRS形态学）和数量（QRS持续时间），需要个体化患者选择。虽然HF药物治疗对该底物的影响有限，但早期植入CRT可以防止不可逆重构，促进药物治疗的优化。CRT应被认为是有适当适应症患者心衰管理综合策略的重要组成部分。

引用次数: 0

Atrial Tram Tracks and Ventricular Step Ladder: Decoding the Dot Plot 心房电轨与心室阶梯：点阵图解码。

IF 1.7 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Arrhythmia

Pub Date : 2026-01-09 DOI: 10.1002/joa3.70266

Ramanathan Velayutham, Anish Bhargav, Barathkrishnan Janarthanan, Raja J. Selvaraj

Falsely detected atrial tachycardia episode in a patient with CRT-P due to FFRW oversensing resulting in ventricular sensed response triggered BiV pacing and auto adjusting sensitivity phenomenon.

1例CRT-P患者因FFRW过感而误检房性心动过速，导致心室感测反应触发BiV起搏及自动调节敏感性现象。

引用次数: 0

Novel Echocardiographic Index for Risk Stratification of Ventricular Arrhythmias and Mortality Based on Right Ventricular Function 基于右室功能的室性心律失常和死亡率危险分层的新型超声心动图指数。

IF 1.7 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Arrhythmia

Pub Date : 2026-01-08 DOI: 10.1002/joa3.70244

Toshinori Chiba, Takatsugu Kajiyama, Yusuke Kondo, Hiroyuki Takaoka, Noriko Suzuki-Eguchi, Masahiro Nakano, Miyo Nakano, Satoko Ryuzaki, Yukiko Takanashi, Yuya Komai, Yusei Nishikawa, Yoshio Kobayashi

Background

Right ventricular (RV) dysfunction is independently predictive of sudden cardiac death. This study aimed to compare the performance of different risk stratification methods for death and appropriate implantable cardioverter-defibrillator (ICD) therapy using echocardiography and cardiac magnetic resonance imaging (CMR) to quantify RV function.

Methods

Consecutive patients undergoing ICD implantations who had completed both preprocedural echocardiography and CMR were retrospectively enrolled. Patients with channelopathies or arrhythmogenic right ventricular disease were excluded. The RV fractional area change (RVFAC) and estimated pulmonary artery pressure (EPAP) were calculated from echocardiography. The contraction pressure index (CPI) was defined as the quotient of the RVFAC divided by the EPAP. Both metrics were used to predict the composite endpoint of death and an appropriate ICD therapy. RV dysfunction was defined by either RVFAC < 35% or RV ejection fraction (RVEF) < 45%.

Results

In total, 88 patients (60.4 ± 14.7 years, 61 males) including 15 with ischemic cardiomyopathy were retrospectively enrolled. Forty-two patients received ICDs as secondary prevention. The mean RVFAC, CPI, and RVEF were 35.9% ± 9.22%, 1.4% ± 0.7%/mmHg, and 39.5% ± 14.4%, respectively. Regarding the composite endpoint, the best cut-off value of the CPI was 1.59 (specificity 0.45, sensitivity 0.96, ROC-AUC 0.68). The hazard ratio of a low RVFAC was 3.28 (95% CI: 1.39–7.77, p = 0.007, concordance = 0.622), a low CPI, 14.2 (95% CI: 1.91–104.9, p = 0.010, c = 0.665), and a low RVEF, 3.44 (95% CI: 1.17–10.1, p = 0.003, c = 0.620).

Conclusion

Both CMR-derived RVEF and the echocardiographic CPI predicted appropriate ICD therapy and death. The CPI may provide superior risk stratification.

背景：右心室功能障碍是心源性猝死的独立预测因素。本研究旨在比较使用超声心动图和心脏磁共振成像（CMR）量化RV功能的不同死亡风险分层方法和适当的植入式心律转复除颤器（ICD）治疗的性能。方法：回顾性纳入连续接受ICD植入并完成术前超声心动图和CMR的患者。排除有通道病变或致心律失常的右心室疾病的患者。超声心动图计算右心室分数面积变化（RVFAC）和肺动脉压（EPAP）。收缩压力指数（CPI）定义为RVFAC除以EPAP的商。这两个指标被用来预测死亡的复合终点和适当的ICD治疗。结果：共纳入88例患者（60.4±14.7岁，61例男性），包括15例缺血性心肌病患者。42例患者接受icd作为二级预防。RVFAC、CPI、RVEF平均值分别为35.9%±9.22%、1.4%±0.7%/mmHg、39.5%±14.4%。综合终点CPI的最佳临界值为1.59（特异性0.45，敏感性0.96,ROC-AUC 0.68）。低RVFAC的风险比为3.28 (95% CI: 1.39 ~ 7.77, p = 0.007，一致性= 0.622)，低CPI的风险比为14.2 (95% CI: 1.91 ~ 104.9, p = 0.010, c = 0.665)，低RVEF的风险比为3.44 （95% CI: 1.17 ~ 10.1, p = 0.003, c = 0.620）。结论：cmr衍生的RVEF和超声心动图CPI均可预测适当的ICD治疗和死亡。CPI可以提供更好的风险分层。

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引用次数: 0

Inpatient Outcomes of Atrial Fibrillation in Patients With Acute Pancreatitis: Insights From the TriNetX Database 急性胰腺炎患者心房颤动的住院结果：来自TriNetX数据库的见解

IF 1.7 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Arrhythmia

Pub Date : 2026-01-07 DOI: 10.1002/joa3.70264

Obaid Ur Rehman, Waqas Rasheed, Adeena Jamil, Eeshal Fatima, Tariq Jamal Siddiqi, Raheel Ahmed, Matthew G. D. Bates, Naser Yamani, Ahsan Alam, Jishanth Mattumpuram

Background

Research regarding the adverse outcomes of atrial fibrillation (AF) in patients with acute pancreatitis (AP) is limited. We hypothesize that the presence of AF is associated with worse inpatient outcomes, including increased mortality and complications in patients admitted with AP.

Methods

In this cohort study, de-identified patient data from the US Collaborative Network in TriNetX was used to assess the risk of all-cause mortality and adverse events in patients with AP having AF compared to those without AF within 30 days of the index event from January 1, 2010 to July 6, 2024. Analyses were performed before and after propensity score matching, with risks expressed as odds ratios (OR) with 95% confidence intervals (95% CI), and Kaplan–Meier curves were generated for outcomes.

Results

A total of 267 429 patients with AP were identified, of whom 44 621 had a diagnosis of AF. Patients with AP having AF presented with higher comorbidity burdens compared to the non-AF cohort before propensity score matching. After matching, patients with AF exhibited increased risks of all-cause mortality (OR, 1.24; 95% CI, 1.18–1.3), acute kidney injury (OR, 1.17; 95% CI, 1.14–1.2), deep venous thrombosis (OR, 1.33; 95% CI, 1.27–1.39), hemorrhage (OR, 1.06; 95% CI, 1.01–1.11), severe sepsis (OR, 1.3; 95% CI, 1.25–1.35), and requiring critical care services (OR, 1.19; 95% CI, 1.16–1.23).

Conclusion

Our results suggest that AF significantly increases the risk of mortality in patients with AP, even after accounting for confounding etiological, comorbid, and pharmacological factors.

背景：关于急性胰腺炎（AP）患者心房颤动（AF）不良结局的研究有限。我们假设房颤的存在与更糟糕的住院结果相关，包括房颤患者死亡率和并发症的增加。方法：在这项队列研究中，使用来自美国TriNetX协作网络的未识别患者数据来评估2010年1月1日至2024年7月6日指标事件发生后30天内，AP合并房颤患者与非房颤患者的全因死亡率和不良事件风险。在倾向评分匹配之前和之后进行分析，风险以95%置信区间（95% CI）的优势比（OR）表示，并生成Kaplan-Meier曲线。结果：共有267 429例AP患者被确定，其中44 621例被诊断为房颤。在倾向评分匹配前，AP合并房颤的患者比非房颤患者表现出更高的合并症负担。匹配后，房颤患者表现出全因死亡率（OR, 1.24; 95% CI, 1.18-1.3）、急性肾损伤（OR, 1.17; 95% CI, 1.14-1.2）、深静脉血栓形成（OR, 1.33; 95% CI, 1.27-1.39）、出血（OR, 1.06; 95% CI, 1.01-1.11）、严重脓毒症（OR, 1.3; 95% CI, 1.25-1.35）和需要重症监护服务（OR, 1.19; 95% CI, 1.16-1.23）的风险增加。结论：我们的研究结果表明，即使在考虑了混杂的病因、合并症和药理学因素后，AF显著增加了AP患者的死亡风险。

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引用次数: 0

A Case of VF Misclassification Corrected by VF Therapy Assurance: Implications for ICD Programming VF治疗保证纠正的VF错误分类一例：对ICD规划的影响。

IF 1.7 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Arrhythmia

Pub Date : 2026-01-07 DOI: 10.1002/joa3.70265

Naoki Matsumoto, Kenji Shimeno, Masanori Matsuo, Yukio Abe, Daiju Fukuda

Implantable cardioverter-defibrillator undersensing may delay therapy in ventricular fibrillation with low-amplitude signals. Ventricular fibrillation therapy assurance (VFTA) detected persistent VF after initial shock failure, enabling timely shock delivery and successful resuscitation. VFTA may help optimize device programming by preventing misclassification and treatment delay in life-threatening arrhythmias.

植入式心律转复除颤器感应不足可能延迟心室颤动的低振幅信号治疗。心室颤动治疗保证（VFTA）检测到初始休克失败后持续的心室颤动，使休克及时递送和成功复苏。VFTA可能有助于优化设备规划，防止误诊和治疗延误危及生命的心律失常。

引用次数: 0

A Rare Case of RNRVAS Termination and Re-Initiation Visualized on a 12-Lead ECG 1例罕见的12导联心电图显示RNRVAS终止和重新启动。

IF 1.7 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Arrhythmia

Pub Date : 2026-01-05 DOI: 10.1002/joa3.70270

Tomoyoshi Morioku, Yasuyuki Egami, Yasuharu Matsunaga-Lee, Masamichi Yano, Masami Nishino

This case illustrates both termination and re-initiation of repetitive non-reentrant ventriculoatrial synchrony (RNRVAS) visualized on a standard 12-lead ECG. It highlights how pacemaker algorithms such as VIP and PVC response, together with abnormal atrial refractoriness, can trigger or terminate RNRVAS.

本病例在标准12导联心电图上显示重复性非再入性室房同步（RNRVAS）的终止和重新开始。它强调了起搏器算法，如VIP和PVC反应，以及异常的心房难治性，如何触发或终止RNRVAS。

引用次数: 0

Comment on “The Crucial Role of Physical Activity Index in Predicting the Incidence of Pacemaker Syndrome” 对“身体活动指数在预测心脏起搏器综合征发生率中的重要作用”的评论

IF 1.7 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Arrhythmia

Pub Date : 2026-01-02 DOI: 10.1002/joa3.70261

Ahmet Yılmaz

<p>I read with great interest the article by Malekrah et al., entitled “The Crucial Role of Physical Activity Index in Predicting the Incidence of Pacemaker Syndrome,” published in the Journal of Arrhythmia. The study makes a noteworthy contribution by addressing the potential role of physical activity in the pathogenesis of pacemaker syndrome (PMS). However, several important limitations in methodological design and parameter selection restrict the clinical generalizability of the findings.</p><p>First, implanting dual-chamber devices in all patients and reprogramming them to VVIR mode at discharge does not reflect clinical practice. Large randomized trials (PASE, CTOPP, MOST) have typically performed mode changes only in symptomatic cases or for comparative analysis [<span>1-3</span>]. Routinely implanting dual-chamber devices but programming them in single-chamber mode lacks clinical justification and creates a non-physiological environment of AV dyssynchrony. Therefore, the reported incidence of PMS was obtained under a protocol different from real-life practice and should be interpreted with caution.</p><p>Second, the study population being limited to individuals under 65 years of age, with left ventricular ejection fraction (LVEF) ≥ 50% and sinus rhythm, excludes the highest-risk groups for PMS. The current ESC Guidelines on Cardiac Pacing and CRT [<span>4</span>] and the HRS/APHRS/LAHRS Guideline on Cardiac Physiologic Pacing [<span>5</span>] emphasize that hemodynamic intolerance related to PMS is more pronounced in patients with low EF and atrial fibrillation (AF). The exclusion of these patients limits the applicability of the results to a narrow group of “young, active, normal EF, and sinus rhythm” individuals.</p><p>Third, many key parameters essential for understanding PMS pathophysiology were not evaluated in this study. Recent PMS studies have focused on hemodynamic indicators (blood pressure, stroke volume, cardiac output), electrophysiological variables (% ventricular pacing, AV interval, retrograde VA conduction time), and particularly mechanical synchrony parameters (global longitudinal strain, intraventricular dyssynchrony, mitral inflow patterns) [<span>6-9</span>]. None of these parameters were reported in the work of Malekrah et al.</p><p>Fourth, the study demonstrated an increased incidence of PMS among individuals with high levels of physical activity. However, this finding may reflect increased symptom awareness or greater perception of effort-related symptoms rather than a causal relationship. Physical activity level was assessed using the self-reported IPAQ questionnaire, which carries a risk of measurement bias. Moreover, the study did not report whether higher activity actually led to greater ventricular pacing rates since parameters such as true pacing burden (%V-pacing), AV interval, and rate-adaptive sensor settings were not provided; the hemodynamic mechanism remains unsupported.</p><p>In conclusion, the study at

我怀着极大的兴趣阅读了Malekrah等人发表在《心律失常杂志》上的一篇文章，题为“身体活动指数在预测起搏器综合征发生率中的关键作用”。该研究通过解决身体活动在起搏器综合征（PMS）发病机制中的潜在作用做出了值得注意的贡献。然而，在方法设计和参数选择上的一些重要限制限制了研究结果的临床推广。首先，在所有患者中植入双腔装置并在出院时将其重新编程为VVIR模式并不符合临床实践。大型随机试验（PASE、CTOPP、MOST）通常仅在有症状的病例或用于比较分析时才进行模式改变[1-3]。常规植入双室装置，但将其编程为单室模式缺乏临床依据，并造成房室不同步的非生理环境。因此，报告的经前综合症发病率是在不同于现实实践的方案下获得的，应谨慎解释。其次，研究人群限于65岁以下、左室射血分数(LVEF)≥50%和窦性心律的个体，排除了经前综合征的最高风险群体。目前的ESC心脏起搏和CRT指南[4]和HRS/APHRS/LAHRS心脏生生性起搏指南[5]强调，与PMS相关的血流动力学不耐受在低EF和房颤（AF）患者中更为明显。排除这些患者限制了结果在“年轻，活跃，正常EF和窦性心律”个体的狭窄群体中的适用性。第三，许多理解经前综合症病理生理的关键参数在本研究中没有得到评估。最近的PMS研究主要集中在血流动力学指标（血压、卒中量、心输出量）、电生理变量（心室起搏百分比、房室间期、逆行心室传导时间），特别是机械同步参数（整体纵向应变、室内非同步化、二尖瓣流入模式）[6-9]。这些参数在Malekrah等人的研究中都没有报道。第四，该研究表明，高水平体力活动的个体经前综合症的发病率增加。然而，这一发现可能反映了症状意识的增强或对努力相关症状的更大感知，而不是因果关系。使用自我报告的IPAQ问卷评估身体活动水平，该问卷存在测量偏倚的风险。此外，由于没有提供诸如真实起搏负荷（% v -起搏）、房室间隔和速率自适应传感器设置等参数，该研究没有报告较高的活动是否真的导致更高的心室起搏率；其血流动力学机制仍未得到支持。综上所述，本研究试图通过一个变量——身体活动指数来解释经前综合症的多因素性质。一个不能同时评估机械、电生理和临床参数的模型不能准确地代表经前综合征的真实病理生理。未来的研究应包括低EF患者、更广泛的年龄范围和各种起搏模式；客观运动测试和先进超声心动图测量支持的分析方法将提高这一问题的科学清晰度。作者声明无利益冲突。

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引用次数: 0

Safety and Efficacy of Pulsed Field Ablation for Atrial Fibrillation in Elderly Patients 脉冲场消融治疗老年心房颤动的安全性和有效性。

IF 1.7 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Arrhythmia

Pub Date : 2026-01-02 DOI: 10.1002/joa3.70267

Federico Follesa, Alix Prévot, Samy Gribissa, Xavier Waintraub, Marine Thuillot, Nicolas Badenco, Guillaume Duthoit, Estelle Gandjbakhch, Mikael Laredo

Background

Pulsed-field ablation (PFA) is increasingly used for catheter ablation of atrial fibrillation (AF), but older patients remain underrepresented in clinical trials. This study aimed to compare procedural outcomes and mid-term effectiveness of PFA in patients aged ≤ 75 and > 75 years.

Methods

In this retrospective single-center cohort, 479 consecutive patients underwent PFA for AF between January 2022 and April 2024. Patients were grouped by age (≤ 75 vs. > 75 years at ablation). Procedural parameters and acute complications were compared. Arrhythmia-free survival was assessed with Kaplan–Meier analysis after an 8-weeks blanking period, and predictors of recurrence were evaluated using Cox regressions.

Results

Of 479 patients (mean age 65.0 ± 12.1 years; 73.6% males), 104 (21.7%) were > 75 years at ablation. Patients > 75 years had more comorbidities, including hypertension and impaired renal function. Pulmonary vein isolation was achieved in 99.8% of cases. Acute complication rates were similar between groups (7.7% in > 75 vs. 8.5% in ≤ 75, p = 1.00), with low rates of tamponade (1.5%) and stroke (1.3%). Kaplan–Meier analysis showed no difference in arrhythmia-free survival. At 6 months, freedom from atrial arrhythmia was 81.4% in the > 75 group and 83.8% in the ≤ 75 group (p = 0.57); corresponding rates at 12 months were 60.1% and 68.6%. Age was not an independent predictor of recurrence. At last follow-up, 75.7% of patients were off antiarrhythmic drugs.

Conclusions

PFA in patients > 75 years is associated with low complication rates and favorable rhythm outcomes, comparable to those in younger patients. These findings support the use of PFA in elderly patients with AF.

背景：脉冲场消融（PFA）越来越多地用于房颤（AF）的导管消融，但老年患者在临床试验中的代表性仍然不足。本研究旨在比较≤75岁和≤75岁患者PFA的手术结果和中期疗效。方法：在这项回顾性单中心队列研究中，479名连续患者在2022年1月至2024年4月期间接受了房颤PFA治疗。患者按年龄分组（≤75岁vs.消融时为75岁）。比较手术参数及急性并发症。8周空白期后，采用Kaplan-Meier分析评估无心律失常生存率，并采用Cox回归评估复发预测因子。结果：479例患者（平均年龄65.0±12.1岁，男性占73.6%）中，104例（21.7%）患者在消融时的年龄为50 ~ 75岁。年龄在75岁以下的患者有更多的合并症，包括高血压和肾功能受损。99.8%的病例实现了肺静脉隔离。两组间急性并发症发生率相似（bbb75组为7.7%，≤75组为8.5%,p = 1.00），压塞发生率低（1.5%），卒中发生率低（1.3%）。Kaplan-Meier分析显示无心律失常生存率无差异。6个月时，bbb75组房性心律失常发生率为81.4%，≤75组为83.8% (p = 0.57)；12个月的相应比率分别为60.1%和68.6%。年龄不是复发的独立预测因子。最后随访时，75.7%的患者停用抗心律失常药物。结论：与年轻患者相比，年龄在0 ~ 75岁的PFA患者并发症发生率低，心律结果良好。这些发现支持PFA在老年房颤患者中的应用。

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引用次数: 0