Journal of Cardiovascular Electrophysiology最新文献

{"title":"Catheter Ablation of Idiopathic Left Anterior Fascicular Ventricular Arrhythmias: Predicting Origin Sites via Mapping and Electrocardiography","authors":"Zhi-Xiang Zhou,&nbsp;Wu-Ming Hu,&nbsp;Jia-Sheng Yu,&nbsp;Ze-Chao Hong,&nbsp;Yu Yan,&nbsp;Yu Shen,&nbsp;Jin Li,&nbsp;Jia-Xuan Lin,&nbsp;Yi-Fan Chen,&nbsp;Lucia D'Angelo,&nbsp;Shea Michaela James,&nbsp;Mei-ling Gao,&nbsp;Jia-Feng Lin,&nbsp;Cheng Zheng","doi":"10.1111/jce.16549","DOIUrl":"10.1111/jce.16549","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Idiopathic ventricular arrhythmias (VAs) arising from the left anterior fascicle (LAF) are uncommonly seen, and their characteristics still need to be sufficiently investigated. This study aimed to conclude these VAs' characteristics and explore efficient ablation strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were analyzed from 118 patients undergoing successful catheter ablation for LAF VAs. Patients were divided into three groups based on target sites in LAF: proximal-LAF group (<i>n</i> = 30, from the common trunk of the left bundle branch to the LAF below the right coronary cusp (RCC), middle-LAF group (<i>n</i> = 35, the LAF below the RCC and left coronary cusp (LCC), distal-LAF group (<i>n</i> = 53, the LAF below LCC to the LAF terminal).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From proximal- to distal-LAF, VAs showed a gradually decreased Purkinje-ventricular (PV) and His-ventricular (HV) interval. For proximal-LAF VAs, a distance from the sites recorded with the earliest Purkinje potential to RCC of 4.08 ± 1.03 mm predicted successful ablation in RCC. There are significant differences among the three groups in QRS duration, R/S ratio in V6, and Lead I. Using these three ECG characteristics as a panel to predict the origin of LAF VAs, the area under curve (AUC) was 0.96% and 95% confidence interval (CI) was 0.916–1.0 in the proximal- and middle-LAF group, the AUC was 0.998 and 95% CI was 0.994–1.0 in the middle- and distal-LAF group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>When LAF is anatomically divided into proximal, middle, and distal segments, QRS duration and R/S ratio in Leads V6 and I are available to predict the origin and promote a successful catheter ablation. In addition, combining these three ECG characteristics as a panel can better facilitate the prediction of LAF-VA origin.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 2","pages":"449-456"},"PeriodicalIF":2.3,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Anemia on Clinical Outcomes in Atrial Fibrillation Patients on Oral Anticoagulants: A Prognostic Meta-Analysis","authors":"Ahmed Mazen Amin,&nbsp;Hossam Elbenawi,&nbsp;Ramez M. Odat,&nbsp;Mohamed Elgebaly,&nbsp;Ali Saad Al-shammari,&nbsp;AlMothana Manasrah,&nbsp;Michael Nakhla,&nbsp;Dina Ayman,&nbsp;Mohamed Ahmed Ali,&nbsp;Ahmed Helmi,&nbsp;Mohamed Abuelazm,&nbsp;Caique M. P. Ternes,&nbsp;Basel Abdelazeem,&nbsp;Irfan Zeb,&nbsp;Abhishek J. Deshmukh,&nbsp;Christopher V. DeSimone,&nbsp;Andre d'Avila","doi":"10.1111/jce.16537","DOIUrl":"10.1111/jce.16537","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Anemia is frequently observed as a comorbidity in atrial fibrillation (AF), especially in elderly patients and in those on anticoagulation. This has been associated with poor clinical outcomes. We aim to investigate the impact of anemia on clinical outcomes in patients with AF on oral anticoagulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We comprehensively searched PubMed, WOS, SCOPUS, EMBASE, and CENTRAL through March 2024 and conducted a prognostic systematic review and meta-analysis. All analyses were performed using R V. 4.3.1. This meta-analysis was registered at PROSPERO (CRD42024556023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 23 studies comprising 286,781 patients for analysis. Anemia had a significant association with an 84% increase in risk of major bleeding (HR: 1.84 with 95% CI [1.59, 2.13], <i>p</i> &lt; 0.01), a 32% increase in the risk of intracranial hemorrhage (HR: 1.32 with 95% CI [1.10, 1.58], <i>p</i> &lt; 0.01), a 98% increase in the risk of gastrointestinal bleeding (HR: 1.98 with 95% CI [1.67, 2.35], <i>p</i> &lt; 0.01), and a 91% increase in the risk of all-cause mortality (HR: 1.91 with 95% CI [1.46, 2.51], <i>p</i> &lt; 0.01). However, the impact of anemia did not significantly affect the risk of stroke, transient ischemic stroke (TIA), or systemic embolism (HR: 1.07 with 95% CI [0.93, 1.22], <i>p</i> = 0.36).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Anemia was significantly associated with an increased risk of major bleeding, intracranial hemorrhage, gastrointestinal bleeding, and all-cause mortality. However, anemia did not significantly impact stroke, TIA, or systemic embolism.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 2","pages":"430-448"},"PeriodicalIF":2.3,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Varipulse: A Step-by-Step Guide to Pulmonary Vein Isolation”","authors":"","doi":"10.1111/jce.16522","DOIUrl":"10.1111/jce.16522","url":null,"abstract":"<p>Nair DG, Gomez T, De Potter T. VARIPULSE: A step-by-step guide to pulmonary vein isolation. <i>J Cardiovasc Electrophysiol</i>. 2024;35:1817-1827. doi:10.1111/jce.16366</p><p>In Figure 4 the image of the catheter for “Step 4: Second antral position, repositioned” is incorrect. The correct image is shown in the Figure below. In addition, the captions to Figures 1, 2, 4, 5, 6, 7, 8, and 9 should include the following copyright statement: “Images courtesy of ©Biosense Webster Inc., part of Johnson &amp; Johnson MedTech. All rights reserved.”</p><p>We apologize for this error.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 1","pages":"303"},"PeriodicalIF":2.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jce.16522","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Atrial Substrate Mapping During Atrial Pacing and Its Impact on the Omnipolar Voltage and the Peak-Frequency of Electrograms","authors":"Takatoshi Shigeta,&nbsp;Masateru Takigawa,&nbsp;Takashi Ikenouchi,&nbsp;Miho Negishi,&nbsp;Tasuku Yamamoto,&nbsp;Kentaro Goto,&nbsp;Takuro Nishimura,&nbsp;Susumu Tao,&nbsp;Shinsuke Miyazaki,&nbsp;Masahiko Goya,&nbsp;Tetsuo Sasano","doi":"10.1111/jce.16514","DOIUrl":"10.1111/jce.16514","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Atrial pacing maps are often used as substitutes for sinus rhythm (SR) maps to expedite mapping procedures. However, the impact of this method on electrophysiological parameters has not been systematically examined. This study aimed to elucidate the advantages and limitations of atrial pacing maps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>In 21 patients undergoing catheter ablation for atrial fibrillation, left atrial (LA) substrate maps using an HD-grid catheter were performed during SR, and pacing from the sinus-node region with cycle lengths (CLs) of 300 ms (SN-P300) and 600 ms (SN-P600). Mapping time, omnipolar voltage, peak-frequency of electrograms, and global LA activation time were compared among the three maps. The SR-map more frequently required automap-setting changes (<i>p</i> &lt; 0.01), and one SR-map was not completed due to CL-fluctuation. Compared to SR, mapping time significantly decreased (833 [702–1097] seconds for SR vs. 615 [530–700] seconds for SN-P600 and 463 [404–542] seconds for SN-P300, <i>p</i> &lt; 0.01). Mean voltage and peak-frequency of electrograms significantly decreased in SN-P600 and SN-P300 (mean voltage: 2.5 [2.1–3.2] mV for SR vs. 2.3 [2.1–2.8] mV for SN-P600 and 2.2 [2.0–2.7] mV for SN-P300, <i>p</i> &lt; 0.01; mean peak-frequency: 308 [299–325] Hz for SR vs. 303 [288–314] Hz for SN-P600 and 281 [258–295] Hz for SN-P300, <i>p</i> &lt; 0.01). The wavefront collision site shifted in 3/20 (15%) between SR and SN-P600, remaing within 30° along the mitral annulus, but this shift reached 9/20 (45%) between SR and SN-P300, including one patient showing a shift up to 60°.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SN-P maps provide faster, higher-resolution substrate maps, but the amplitude and frequency of electrograms may be reduced as the CL shortens. Maps with SN-P600 may be acceptable, maintaining electrophysiological information in SR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 2","pages":"411-421"},"PeriodicalIF":2.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncomplicated Extravascular Implantable Cardioverter-Defibrillator Extraction After 4 Years Dwell Time: A Case Report","authors":"Jolien A. de Veld,&nbsp;Kirsten M. Kooiman,&nbsp;Reinoud E. Knops","doi":"10.1111/jce.16530","DOIUrl":"10.1111/jce.16530","url":null,"abstract":"<p>The extravascular implantable cardioverter-defibrillator (EV-ICD) was developed to overcome complications associated with transvenous leads while being able to deliver anti-tachycardia pacing (ATP). The lead is implanted in the substernal space, which makes extraction a cautious procedure. We present a case of a 51-year-old women with a successful EV-ICD extraction after a lead dwell time of 4 years, which is the longest reported. The EV-ICD lead was extracted using simple traction after the removal of all adhesions at the xiphoidal site around the lead. We advise to only use extraction tools if the initial attempt is not successful and if no adhesions at the caudal part of the lead are visible anymore, as these tools could also damage the surrounding tissue and the lead.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 1","pages":"298-300"},"PeriodicalIF":2.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cover Image, Volume 35, Issue 12","authors":"Thomas J. McGarry,&nbsp;T. Jared Bunch,&nbsp;Ravi Ranjan,&nbsp;Gregory J. Stoddard","doi":"10.1111/jce.16555","DOIUrl":"https://doi.org/10.1111/jce.16555","url":null,"abstract":"<p>The cover image is based on the article <i>Five Criteria Predict Induction and Ablation of Supraventricular Tachycardia</i> by Thomas J. McGarry et al., https://doi.org/10.1111/jce.16496\u0000 \u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"35 12","pages":"i"},"PeriodicalIF":2.3,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jce.16555","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142861521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Wave-speed Mapping Method for Visualizing Accessory Pathways in Wolff–Parkinson–White Syndrome","authors":"Koji Sudo,&nbsp;Kenji Kuroki,&nbsp;Tetsuya Asakawa,&nbsp;Kazuya Nakagawa,&nbsp;Chisa Asahina,&nbsp;Yuya Tanaka,&nbsp;Tomoaki Hasegawa,&nbsp;Kazutaka Aonuma,&nbsp;Akira Sato","doi":"10.1111/jce.16545","DOIUrl":"10.1111/jce.16545","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Catheter ablation (CA) is the first-line treatment with a high success rate for patients with symptomatic Wolff–Parkinson–White syndrome, while three-dimensional (3D) mapping systems enable the identification of accessory pathways (APs). We aimed to develop a novel mapping method using wave-speed mapping (WSM) to determine AP locations and CA outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>This study included 19 patients diagnosed with atrioventricular (AV) reciprocating tachycardia. We compared local activation time (LAT) mapping and WSM, and analyzed the relationship between the “high-speed islets” in WSM and successful ablation sites. Sixteen APs were located on the left, three on the septum, and one on the right side. The median number of mapping points and mapping time were 1451 points and 14.6 min, respectively. All 20 APs in the 19 patients were eliminated using “high-speed islets” in WSM. Eleven APs (55%) were eliminated after the first ablation application. One patient with an anteroseptal AP close to the AV node underwent cryoablation to avoid an AV block. The AP width in the 3D mapping system was significantly narrower in WSM than in LAT mapping (5.8 ± 4.0 mm vs. 10.4 ± 3.2 mm, <i>p</i> &lt; .001). One patient experienced an AP recurrence, successfully eliminated using WSM-guided CA in a repeat procedure. During 13.1 ± 8.3 months of follow-up, all patients remained free of any supraventricular tachycardias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>WSM is a novel mapping method for visualizing APs as “high-speed islets” and guides a more precise ablation site than LAT mapping.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 2","pages":"401-410"},"PeriodicalIF":2.3,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-Wave Oversensing by the Implantable Cardiac Monitor During Paroxysmal Atrioventricular Block: What Is the Mechanism?","authors":"Yuhei Kasai,&nbsp;Junji Morita,&nbsp;Takayuki Kitai,&nbsp;Kizuku Iitsuka,&nbsp;Yumetsugu Munakata,&nbsp;Jungo Kasai,&nbsp;Tsutomu Fujita","doi":"10.1111/jce.16550","DOIUrl":"10.1111/jce.16550","url":null,"abstract":"&lt;p&gt;An implantable cardiac monitor (ICM) is a device that is placed subcutaneously for the continuous monitoring of a patient's cardiac rhythm for up to several years [&lt;span&gt;1&lt;/span&gt;]. This device is particularly valuable for identifying the cause of unexplained syncope, and it offers long-term cardiac monitoring to determine any correlations between symptoms and cardiac rhythm [&lt;span&gt;2, 3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In this report, we describe a case in which P-wave oversensing (PWOS) by the ICM prevented episodes of bradycardia or pauses from being detected during episodes of syncope.&lt;/p&gt;&lt;p&gt;A 78-year-old male patient experienced multiple episodes of syncope following palpitations.&lt;/p&gt;&lt;p&gt;He underwent an extensive diagnostic evaluation, which included echocardiography, Holter monitoring, and computed tomography of the brain and coronary arteries. However, these examinations did not yield a conclusive diagnosis. After obtaining written informed consent, an ICM (LINQ II; Medtronic, Minneapolis, MN, US) was implanted in the fourth intercostal space at an angle of 45°.&lt;/p&gt;&lt;p&gt;Twenty-four days after ICM implantation, the patient experienced another episode of syncope and activated the patient assist device function. Upon reviewing the remote monitoring data, it was confirmed that the ICM had not detected any pauses or bradycardia. However, the waveform recorded by the patient assist device indicated paroxysmal atrioventricular block (AVB), leading to a false-negative diagnosis owing to PWOS by the ICM, and no recordings of pauses or bradycardia were preserved (Figure 1). The R-wave amplitude at the time of ICM implantation was 1.0 mV. In accordance with the R- and P-wave amplitudes, the minimum sensitivity of the R-wave was adjusted from the nominal value of 0.035–0.2 mV using the remote programming system, which enabled us to remotely reprogram device alert settings without in-office patient visits. [&lt;span&gt;4&lt;/span&gt;]. Postadjustment, the paroxysmal AVB episodes were accurately captured without false negatives (Figure 2). Subsequently, a leadless pacemaker (Micra AV2; Medtronic) was implanted in the lower portion of the interventricular septum without any complications. Given the patient's active lifestyle (with hobbies including swimming and golf) and strong preference for a leadless pacemaker, the we chose Micra AV2. Although the patient currently presents with paroxysmal AVB, the potential for progression to permanent AVB necessitated choosing a device capable of maintaining AV synchrony. The ICM was then removed with no recurrence of syncope. What is the mechanism behind the occurrence of PWOS?&lt;/p&gt;&lt;p&gt;ICMs are valuable tools for patients requiring long-term cardiac monitoring [&lt;span&gt;5&lt;/span&gt;]. This report describes a rare case where PWOS was detected through remote monitoring, which was triggered by the patient's activation of the patient assist device function immediately after experiencing syncope.&lt;/p&gt;&lt;p&gt;As shown in Figure 1, two instances of PWOS occurred in th","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 2","pages":"512-516"},"PeriodicalIF":2.3,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jce.16550","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Approach to Identifying Appropriate Candidates for Transvenous Lead Extraction","authors":"Nicholas J. Beccarino,&nbsp;Saimanoj Guntaka,&nbsp;Brandon Needelman,&nbsp;Rachel Thangavelu,&nbsp;James K. Gabriels,&nbsp;Laurence M. Epstein","doi":"10.1111/jce.16534","DOIUrl":"10.1111/jce.16534","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The need for transvenous lead extractions (TLEs) in the setting of cardiac implantable electronic device-(CIED) related infections continues to rise. Delays in referral for TLE in this setting are common and are associated with increased mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe the outcomes of a comprehensive approach, including an electronic medical record (EMR)-based notification algorithm designed to identify patients with active CIED-related infections to facilitate timely TLE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following an interdepartmental education initiative at a high-volume extraction center, an EMR based notification algorithm generated alerts for all inpatients with a CIED who received intravenous antibiotics or had positive blood cultures between September 2022 and February 2024. Patients deemed to be high risk underwent an electrophysiology consultation and were managed at the discretion of the treating electrophysiologist. Demographics, procedural details, and clinical outcomes were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>1829 notifications were screened over the study period. Thirty-nine consults were generated (2%). Of these patients, 18 TLEs were performed (46%). Patients who underwent TLE had MSSA (56%), MRSA (22%), enterococcus (11%), Serratia (5.6%), or S. gallolyticus (5.6%) bacteremia. The median time from the review to consultation was 1 day (IQR: 0, 1 days) and review to TLE was 2 days (IQR: 1, 2.75 days). Survival in the extraction group was 67% after a median follow-up period of 133 days (IQR: 59, 223 days).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A comprehensive approach, including an EMR-based notification algorithm allowed for the early identification of patients who were appropriate candidates for TLE due to CIED-related infections. Use of this algorithm facilitated timely TLEs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 2","pages":"396-400"},"PeriodicalIF":2.3,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two Distinct Atrial Breakthroughs During Fast-Slow Atrioventricular Nodal Reentrant Tachycardia","authors":"Shuntaro Tamura,&nbsp;Yosuke Nakatani,&nbsp;Hiroshi Hasegawa,&nbsp;Takashi Kobari,&nbsp;Yoshiaki Kaneko,&nbsp;Hideki Ishii","doi":"10.1111/jce.16535","DOIUrl":"10.1111/jce.16535","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The slow atrioventricular nodal pathway (SP) typically has a single atrial breakthrough site.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>We report a case of fast-slow type AVNRT with two distinct atrial breakthrough sites during tachycardia. The earliest atrial activation site (EAAS) was at the right inferior septum, followed by the inferolateral wall of the tricuspid annulus. Ablation at the EAAS shifted it to the inferolateral wall.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case demonstrates two distinct atrial breakthrough sites from a single SP in AVNRT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":"36 2","pages":"535-539"},"PeriodicalIF":2.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}