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Successful ablation of Purkinje-related ventricular ectopy leading to ventricular fibrillation in Emery-Dreifuss dilated cardiomyopathy. 艾默-德雷弗斯扩张型心肌病患者浦金氏相关性心室异位导致心室颤动的成功消融。
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-16 DOI: 10.1007/s10840-025-01983-3
Laura Valverde Soria, Pablo J Sanchez-Millan, José Antonio Fernandez-Sanchez, Rosa Macías-Ruiz, Juan Jimenez-Jaimez, Luis Tercedor

Introduction: Mutations in EMD are related to an increased risk of ventricular arrhythmias and sudden cardiac death. There is a lack of data concerning ventricular arrhythmia ablation in Emery-Dreifuss patients.

Methods and results: We present a case of successful ablation of a short-coupled ventricular ectopy (VE) triggering recurrent ventricular fibrillation (VF) episodes in a EMD patient with an intraseptal substrate. Our approach combined substrate ablation with ICD-guided pacemapping.

Conclusion: VF ablation of Purkinje triggers may be an alternative treatment for patients with dilated cardiomyopathy and recurrent ICD shocks due to VF induced by monomorphic VE.

简介:EMD突变与室性心律失常和心源性猝死的风险增加有关。关于Emery-Dreifuss患者室性心律失常消融术的资料缺乏。方法和结果:我们提出了一例成功的消融短偶联心室异位(VE)引发复发性心室颤动(VF)发作的EMD患者与脑室内底物。我们的方法结合了基底消融和icd引导的心脏起搏。结论:浦肯野触发器的VF消融可能是扩张型心肌病和复发性ICD休克患者的替代治疗方法。
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引用次数: 0
Right ventricular subclinical dysfunction in high-burden idiopathic outflow tract premature ventricular contraction population. 高负荷特发性流出道室性早搏人群右心室亚临床功能障碍。
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-15 DOI: 10.1007/s10840-024-01976-8
Dicky Armein Hanafy, Putri Reno Indrisia, Amiliana Mardiani Soesanto, Dony Yugo Hermanto, Yoga Yuniadi, Aditya Agita Sembiring, Vidya Gilang Rejeki, Muhammad Rizky Felani, Emir Yonas, Sunu Budhi Raharjo, Amin Al-Ahmad

Background: The relationship between premature ventricular contractions (PVC) and right ventricular (RV) function is not widely known. Left ventricular (LV) dysfunction due to PVC is known as PVC-induced cardiomyopathy (PIC) and suppressing the PVC substrate would improve LV function. The effect of PVC ablation on changes in RV function in patients with subtle RV subclinical dysfunction remains unknown.

Objective: Understanding the alterations in RV function parameters after PVC ablation.

Method: Basic and speckle-tracking echocardiography has been performed on 42 individuals with symptomatic idiopathic outflow tract PVC before and 1 month after a successful ablation.

Result: At the baseline of the study, there were 26 patients with RV subclinical dysfunction and 16 patients without RV dysfunction. Patients with RV subclinical dysfunction exhibited significantly higher PVC burden and QRS complex duration than those with normal RV function (p < 0.05). A PVC burden ≥ 21% (OR 9.11, 1.54-53.87, p = 0.015) and a QRS complex duration ≥ 138 ms (OR 5.74, 1.07-30.90, p = 0.042) were independently associated with RV subclinical dysfunction. In both groups, measurements of RV subclinical function before and after ablation, specifically by free wall longitudinal strain (FWLS) and global longitudinal strain (GLS), demonstrated significant changes. These improvements were more pronounced in the group with RV dysfunction (FWLS 9.7 ± 4.0, p < 0.001; GLS 7.5 ± 4.2, p < 0.001). Lower initial FWLS and GLS before ablation emerged as significant parameters in the multivariate analysis for the improvement of RV function post-ablation.

Conclusion: Patients with RV subclinical dysfunction had higher PVC burden and wider QRS duration. Patients with idiopathic outflow tract PVC with RV subclinical dysfunction may experience improvements in RV function after successful PVC ablation.

背景:室性早搏(PVC)与右心室(RV)功能之间的关系尚不清楚。由PVC引起的左室(LV)功能障碍被称为PVC诱导的心肌病(PIC),抑制PVC底物可改善左室功能。对于有轻微右心室亚临床功能障碍的患者,PVC消融术对右心室功能改变的影响尚不清楚。目的:了解PVC消融术后右室功能参数的变化。方法:对42例有症状的特发性流出道PVC患者在消融前和消融成功后1个月进行了基础超声心动图和斑点追踪超声心动图检查。结果:在研究基线时,有26例右心室亚临床功能障碍患者和16例无右心室功能障碍患者。右心室亚临床功能障碍患者的PVC负担和QRS持续时间明显高于右心室功能正常患者(p)。结论:右心室亚临床功能障碍患者的PVC负担更高,QRS持续时间更长。特发性流出道PVC伴右室亚临床功能障碍的患者在成功的左室消融术后可能会改善右室功能。
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引用次数: 0
Unicentric Brazilian registry of cardiac sympathetic denervation for control of ventricular arrhythmias. 控制室性心律失常的单中心巴西心脏交感神经去支配登记。
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-14 DOI: 10.1007/s10840-024-01975-9
Rodrigo M Kulchetscki, Paulo Henrique Peitl Gregório, Gabrielle D 'Arezzo Pessente, Cristiano F Pisani, Muhieddine O Chokr, Carina A Hardy, Luciana Sacilotto, Francisco Carlos da Costa Darrieux, Denise Hachul, Mauricio I Scanavacca, Paulo M Pêgo-Fernandes
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引用次数: 0
US National trends in mortality related to ventricular tachycardia/ ventricular fibrillation. 美国与室性心动过速/室颤相关的死亡率趋势。
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-13 DOI: 10.1007/s10840-025-01979-z
Alireza Ghajar, Maeve M Sargeant, John N Catanzaro, Binu Philips, Fabrizio R Assis, Rajasekhar Nekkanti, Samuel F Sears, Ghanshyam Shantha
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引用次数: 0
Optimized workflow with hybrid (very) high-power short-duration radiofrequency ablation renders point-by-point pulmonary vein isolation as fast and effective as cryoballoon ablation. 混合(非常)高功率短时间射频消融优化工作流程,逐点肺静脉隔离与低温球囊消融一样快速有效。
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-11 DOI: 10.1007/s10840-025-01982-4
Marco Fusaroli, Mark G Hoogendijk, Rohit E Bhagwandien, Sip A Wijchers, Nick van Boven, Bakthawar K Mahmoodi, Sing-Chien Yap

Introduction: A hybrid approach with very high-power short-duration (vHPSD) posteriorly and ablation-index guided HPSD (50 W) anteriorly seems to be an optimal balance between efficiency and effectiveness for point-by-point pulmonary vein isolation (PVI). The aim of the current study is to compare vHPSD/HPSD ablation to cryoballoon ablation (CBA) in patients with symptomatic atrial fibrillation (AF).

Methods and results: In this retrospective single-center study, we identified 110 consecutive patients who underwent their first PVI with either vHPSD/HPSD (n = 54) or CBA (n = 56). We compared procedural efficacy, efficiency, safety, and long-term outcomes. Baseline characteristics of both groups were comparable; however, patients in the vHPSD/HPSD group had larger left atrial volume index (35, IQR 27-45 vs. 28, IQR 21-36 ml/m2, P = 0.005). Complete PVI was achieved in all patients except two CBA cases (100% vs. 96.4%, P = 0.50). First-pass isolation rate was 79.6% in the hybrid group. Procedure times were similar between groups (53, IQR 47-63 vs. 55, IQR 49-65 min, P = 0.35), but fluoroscopy time was shorter in the vHPSD/HPSD group (3.9 [2.7, 5.6] vs. 11.9 [9.3, 14.9] min, P < 0.001). There were 3 temporary phrenic nerve palsies (5.4%) in the CBA group which resolved within 1 year. The 1-year freedom from any atrial tachyarrhythmias after a single procedure was similar between groups (68.5% vs. 73.2%, P = 0.56). During repeat procedure, the durability of PVI was comparable.

Conclusions: The use of vHPSD/HPSD ablation renders point-by-point PVI as fast and effective as CBA. Furthermore, it has lower radiation exposure compared to CBA.

介绍:对于逐点肺静脉隔离(PVI)来说,高功率短时间(vHPSD)后路和消融指数引导的HPSD (50 W)前路的混合入路似乎是效率和效果之间的最佳平衡。本研究的目的是比较vHPSD/HPSD消融与低温球囊消融(CBA)在症状性心房颤动(AF)患者中的应用。方法和结果:在这项回顾性单中心研究中,我们确定了110例连续接受首次PVI的vHPSD/HPSD患者(n = 54)或CBA患者(n = 56)。我们比较了手术疗效、效率、安全性和长期结果。两组的基线特征具有可比性;而vHPSD/HPSD组左房容积指数较大(35,IQR 27-45 vs 28, IQR 21-36 ml/m2, P = 0.005)。除2例CBA病例外,所有患者均达到完全PVI (100% vs. 96.4%, P = 0.50)。杂交组的一次过分离率为79.6%。两组间手术时间相似(53,IQR 47-63 vs. 55, IQR 49-65 min, P = 0.35),但vHPSD/HPSD组透视时间更短(3.9 [2.7,5.6]vs. 11.9 [9.3, 14.9] min, P结论:使用vHPSD/HPSD消融使PVI逐点消融与CBA一样快速有效。此外,与CBA相比,它的辐射暴露更低。
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引用次数: 0
A new horizon in persistent atrial fibrillation ablation? Evaluating selective CFAE ablation guided by fractionation mapping. 持续性房颤消融的新前景?评价选择性CFAE消融引导下的分流成像。
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-10 DOI: 10.1007/s10840-024-01950-4
Bogdan Enache, Decebal Gabriel Lațcu
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引用次数: 0
Outcomes of catheter ablation in cardiac sarcoidosis patients with ventricular tachycardia: a propensity score-matched retrospective analysis. 心脏结节病合并室性心动过速患者导管消融的结果:倾向评分匹配的回顾性分析。
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-09 DOI: 10.1007/s10840-025-01986-0
Haider Al Taii, Ritika Saxena, Ramez Morcos, Ali Saad Al-Shammari, Kassem Farhat, Ahmed Sermed Al Sakini, Ameer Al-Wssawi, Diann Gaalema, Arun Naraynan, Dean Sabayon, Aiham Albani, Hani Jneid
<p><strong>Background: </strong>Ventricular tachycardia (VT) in patients with cardiac sarcoidosis (CS) can lead to sudden cardiac death. The role of ventricular tachycardia ablation (VTA) in CS has been investigated in a few small, single-center, and larger observational studies, but the evidence still needs to be provided. This study aimed to investigate the clinical outcomes of VTA in patients with CS admitted with a diagnosis of VT.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using the TriNetX database: US collaborative network from 2010 to 2024. Patients undergoing ablation for VT with and without CS were identified. Two groups were created for propensity score analysis matching a history of hypertension, diabetes, obesity, peripheral vascular diseases, heart failure, ischemic heart diseases, atrial fibrillation, and chronic kidney disease. The primary outcome was the incidence of death, cardiogenic shock, heart failure, acute myocardial infarction, hemorrhagic stroke, ischemic stroke, and ventricular tachycardia within 1 year from the date of the index procedure.</p><p><strong>Results: </strong>Out of 15,958 patients who underwent catheter ablation for VT, 778 patients had CS. After propensity matching, the mean age of patients with VT and CS who underwent ablation was 58.6 (SD = 11.3), compared to 59.5 (SD = 13) in patients with VT without CS (p-value = 0.07). The propensity-matched analysis showed no significant differences in procedure-related complications between those with cardiac sarcoidosis (CS) and those without. Both cohorts had 10 events each for cardiac tamponade (p = 0.195), groin hematoma requiring transfusion (p = 0.102), pneumothorax (p = 0.317), and sepsis (p = 0.654). Cardiogenic shock occurred in 13 patients in the non-CS group versus 12 in the CS group (p = 0.840). At the 1-year follow-up, there was no significant difference in the mortality rate between the two groups (HR = 1.228, 95% CI 0.834-1.809, p = 0.298). Cardiogenic shock was also similar, with 13 events in the non-CS group and 12 in the CS group (HR = 0.879, 95% CI 0.636-1.213, p = 0.430). However, CS was associated with a higher risk of acute exacerbation of heart failure (314 in non-CS vs. 378 in CS, HR = 0.823, 95% CI 0.709-0.956, p = 0.010) and a lower risk of acute myocardial infarction (96 in non-CS vs. 74 in CS, HR = 1.389, 95% CI 1.026-1.881, p = 0.033). There was no significant difference in ICD shock (147 in non-CS vs. 185 in CS, HR = 0.817, 95% CI 0.658-1.014, p = 0.066), ischemic stroke (10 cases each, HR = 0.941, 95% CI 0.382-2.316, p = 0.895), or hemorrhagic stroke (10 cases each, HR = 1.455, 95% CI 0.326-6.501, p = 0.620). However, CS was associated with a higher risk of pericarditis (91 in non-CS vs. 151 in CS, HR = 0.593, 95% CI 0.457-0.769, p < 0.05). At the 5-year follow-up, CS was associated with a lower risk of mortality (123 deaths in non-CS vs. 104 in CS, HR = 1.341, 95% CI 1.033-1.741, p = 0.027) and a lower ris
背景:心脏结节病(CS)患者室性心动过速(VT)可导致心源性猝死。室性心动过速消融(VTA)在CS中的作用已经在一些小型、单中心和大型观察性研究中进行了研究,但仍需要提供证据。本研究旨在探讨诊断为VTA的CS患者的VTA的临床结果。方法:回顾性分析2010 - 2024年TriNetX数据库:美国协作网络。对伴有和不伴有CS的VT患者进行消融。创建两组进行倾向评分分析,以匹配高血压、糖尿病、肥胖、周围血管疾病、心力衰竭、缺血性心脏病、心房颤动和慢性肾脏疾病的病史。主要终点是自指标手术之日起1年内死亡、心源性休克、心力衰竭、急性心肌梗死、出血性卒中、缺血性卒中和室性心动过速的发生率。结果:在15958例接受导管消融治疗VT的患者中,778例患者发生CS。倾向匹配后,行消融术的VT和CS患者的平均年龄为58.6岁(SD = 11.3),而无CS的VT患者的平均年龄为59.5岁(SD = 13) (p值= 0.07)。倾向匹配分析显示,心脏结节病(CS)患者和非CS患者在手术相关并发症方面没有显著差异。两个队列各有10例心包填塞(p = 0.195)、腹股沟血肿需要输血(p = 0.102)、气胸(p = 0.317)和脓毒症(p = 0.654)。非CS组发生心源性休克13例,CS组12例(p = 0.840)。随访1年时,两组患者死亡率差异无统计学意义(HR = 1.228, 95% CI 0.834-1.809, p = 0.298)。心源性休克也相似,非CS组有13例,CS组有12例(HR = 0.879, 95% CI 0.636-1.213, p = 0.430)。然而,CS与心力衰竭急性加重的高风险相关(非CS组为314,CS组为378,HR = 0.823, 95% CI 0.709-0.956, p = 0.010),急性心肌梗死的风险较低(非CS组为96,CS组为74,HR = 1.389, 95% CI 1.026-1.881, p = 0.033)。ICD休克(非CS组147例,CS组185例,HR = 0.817, 95% CI 0.658-1.014, p = 0.066)、缺血性脑卒中(各10例,HR = 0.941, 95% CI 0.382-2.316, p = 0.895)、出血性脑卒中(各10例,HR = 1.455, 95% CI 0.326-6.501, p = 0.620)的发生率差异无统计学意义。然而,CS与心包炎的高风险相关(非CS组为91,CS组为151,HR = 0.593, 95% CI 0.457-0.769, p)。结论:心脏结节病对导管消融患者围手术期即时并发症的影响与非心脏结节病相当。然而,它与心包炎、1年和5年急性心力衰竭加重以及5年ICD休克的发生率增加有关。这些发现支持VT消融作为心脏结节病患者的一种合理、安全的治疗选择。操作人员应该准备好应对这一人群的独特挑战,包括潜在的后续并发症及其管理。需要进一步的前瞻性和多中心研究来验证这些发现并优化临床结果。
{"title":"Outcomes of catheter ablation in cardiac sarcoidosis patients with ventricular tachycardia: a propensity score-matched retrospective analysis.","authors":"Haider Al Taii, Ritika Saxena, Ramez Morcos, Ali Saad Al-Shammari, Kassem Farhat, Ahmed Sermed Al Sakini, Ameer Al-Wssawi, Diann Gaalema, Arun Naraynan, Dean Sabayon, Aiham Albani, Hani Jneid","doi":"10.1007/s10840-025-01986-0","DOIUrl":"https://doi.org/10.1007/s10840-025-01986-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Ventricular tachycardia (VT) in patients with cardiac sarcoidosis (CS) can lead to sudden cardiac death. The role of ventricular tachycardia ablation (VTA) in CS has been investigated in a few small, single-center, and larger observational studies, but the evidence still needs to be provided. This study aimed to investigate the clinical outcomes of VTA in patients with CS admitted with a diagnosis of VT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted using the TriNetX database: US collaborative network from 2010 to 2024. Patients undergoing ablation for VT with and without CS were identified. Two groups were created for propensity score analysis matching a history of hypertension, diabetes, obesity, peripheral vascular diseases, heart failure, ischemic heart diseases, atrial fibrillation, and chronic kidney disease. The primary outcome was the incidence of death, cardiogenic shock, heart failure, acute myocardial infarction, hemorrhagic stroke, ischemic stroke, and ventricular tachycardia within 1 year from the date of the index procedure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Out of 15,958 patients who underwent catheter ablation for VT, 778 patients had CS. After propensity matching, the mean age of patients with VT and CS who underwent ablation was 58.6 (SD = 11.3), compared to 59.5 (SD = 13) in patients with VT without CS (p-value = 0.07). The propensity-matched analysis showed no significant differences in procedure-related complications between those with cardiac sarcoidosis (CS) and those without. Both cohorts had 10 events each for cardiac tamponade (p = 0.195), groin hematoma requiring transfusion (p = 0.102), pneumothorax (p = 0.317), and sepsis (p = 0.654). Cardiogenic shock occurred in 13 patients in the non-CS group versus 12 in the CS group (p = 0.840). At the 1-year follow-up, there was no significant difference in the mortality rate between the two groups (HR = 1.228, 95% CI 0.834-1.809, p = 0.298). Cardiogenic shock was also similar, with 13 events in the non-CS group and 12 in the CS group (HR = 0.879, 95% CI 0.636-1.213, p = 0.430). However, CS was associated with a higher risk of acute exacerbation of heart failure (314 in non-CS vs. 378 in CS, HR = 0.823, 95% CI 0.709-0.956, p = 0.010) and a lower risk of acute myocardial infarction (96 in non-CS vs. 74 in CS, HR = 1.389, 95% CI 1.026-1.881, p = 0.033). There was no significant difference in ICD shock (147 in non-CS vs. 185 in CS, HR = 0.817, 95% CI 0.658-1.014, p = 0.066), ischemic stroke (10 cases each, HR = 0.941, 95% CI 0.382-2.316, p = 0.895), or hemorrhagic stroke (10 cases each, HR = 1.455, 95% CI 0.326-6.501, p = 0.620). However, CS was associated with a higher risk of pericarditis (91 in non-CS vs. 151 in CS, HR = 0.593, 95% CI 0.457-0.769, p &lt; 0.05). At the 5-year follow-up, CS was associated with a lower risk of mortality (123 deaths in non-CS vs. 104 in CS, HR = 1.341, 95% CI 1.033-1.741, p = 0.027) and a lower ris","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
A new insight into the anatomical ablation approach at R-L ILT for VAs with a left ventricular summit origination: electrophysiological characteristics and catheter ablation. 以左心室峰顶为起始点的输精管,解剖消融入路的新见解:电生理特征和导管消融。
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-08 DOI: 10.1007/s10840-024-01974-w
Yang Pang, Ye Xu, Kuan Cheng, Chaofeng Chen, Qingxing Chen, Yunlong Ling, Guijian Liu, Junbo Ge, Wenqing Zhu

Background: Ventricular arrhythmia (VA) originating from the left ventricular summit (LVS) poses particular challenges, with higher rates of ablation failure.

Objective: To further evaluate the anatomical ablation approach from the subaortic region for LVS VAs and their electrophysiological characteristics.

Method: The study enrolled 27 consecutive patients with sympatomatic VAs originating from LVS and who received an anatomical ablation approach from R-L ILT in our center.

Results: Three different mapping results were obtained as the earliest activation sites (EAS) were observed in the RVOT region (group 1), R-L ILT (group 2), and epicardial region (group 3), respectively. A higher percentage of rS/QS patterns in lead I was observed in Groups 1 and 3. A narrower QRS duration was observed in Group (1) A presystolic potential was recorded at R-L ILT for most VAs in group (2) All VAs were successfully ablated at R-L ILT in groups 1 and 2, though poor pace mapping results were observed at R-L ILT. 4/7 VAs in group 3 ultimately failed after an ablation in both the endocardial and epicardial regions.

Conclusion: An anatomical ablation approach at R-L ILT was effective for most VAs with an LVS origin. Different ECG and electrophysiological characteristics could be observed in VAs with different EAS. Poor pace mapping results in all regions with an EAS in the epicardial region had predictive value for the failure of the ablation procedure.

背景:起源于左心室峰顶(LVS)的室性心律失常(VA)提出了特殊的挑战,具有较高的消融失败率。目的:进一步探讨主动脉下解剖消融入路治疗LVS输精管的电生理特点。方法:本研究连续招募了27例来自LVS的交感静脉输注患者,这些患者在我们中心接受了R-L ILT的解剖消融入路。结果:分别在RVOT区(1组)、R-L ILT区(2组)和心外膜区(3组)观察到最早激活位点(EAS),得到3个不同的作图结果。第1组和第3组ⅰ型铅rS/QS型比例较高。(1)组QRS持续时间较短。(2)组中大多数VAs在R-L ILT处记录了收缩前电位。(1)组和2组所有VAs在R-L ILT处均成功消融,但在R-L ILT处观察到较差的起搏制图结果。3组4/7的VAs在心内膜和心外膜区域消融后最终失效。结论:解剖消融入路对大多数LVS源性输精管是有效的。不同EAS的VAs心电图及电生理特征不同。心外膜区域有EAS的所有区域的心律标测结果都很差,这对消融手术的失败具有预测价值。
{"title":"A new insight into the anatomical ablation approach at R-L ILT for VAs with a left ventricular summit origination: electrophysiological characteristics and catheter ablation.","authors":"Yang Pang, Ye Xu, Kuan Cheng, Chaofeng Chen, Qingxing Chen, Yunlong Ling, Guijian Liu, Junbo Ge, Wenqing Zhu","doi":"10.1007/s10840-024-01974-w","DOIUrl":"https://doi.org/10.1007/s10840-024-01974-w","url":null,"abstract":"<p><strong>Background: </strong>Ventricular arrhythmia (VA) originating from the left ventricular summit (LVS) poses particular challenges, with higher rates of ablation failure.</p><p><strong>Objective: </strong>To further evaluate the anatomical ablation approach from the subaortic region for LVS VAs and their electrophysiological characteristics.</p><p><strong>Method: </strong>The study enrolled 27 consecutive patients with sympatomatic VAs originating from LVS and who received an anatomical ablation approach from R-L ILT in our center.</p><p><strong>Results: </strong>Three different mapping results were obtained as the earliest activation sites (EAS) were observed in the RVOT region (group 1), R-L ILT (group 2), and epicardial region (group 3), respectively. A higher percentage of rS/QS patterns in lead I was observed in Groups 1 and 3. A narrower QRS duration was observed in Group (1) A presystolic potential was recorded at R-L ILT for most VAs in group (2) All VAs were successfully ablated at R-L ILT in groups 1 and 2, though poor pace mapping results were observed at R-L ILT. 4/7 VAs in group 3 ultimately failed after an ablation in both the endocardial and epicardial regions.</p><p><strong>Conclusion: </strong>An anatomical ablation approach at R-L ILT was effective for most VAs with an LVS origin. Different ECG and electrophysiological characteristics could be observed in VAs with different EAS. Poor pace mapping results in all regions with an EAS in the epicardial region had predictive value for the failure of the ablation procedure.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Ultrasound-guided puncture of femoral veins versus standard palpation approach in patients undergoing pulmonary vein isolation. 超声引导下股静脉穿刺与标准触诊入路在肺静脉隔离患者中的比较。
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-06 DOI: 10.1007/s10840-024-01977-7
Lucio Addeo, Chiara Valeriano, Stefano Valcher, Vincenza Abbate, Raffaella Mistrulli, Dimitri Buytaert, Peter Geelen, Peter Peytchev, Koen De Schouwer, Tom De Potter
{"title":"Ultrasound-guided puncture of femoral veins versus standard palpation approach in patients undergoing pulmonary vein isolation.","authors":"Lucio Addeo, Chiara Valeriano, Stefano Valcher, Vincenza Abbate, Raffaella Mistrulli, Dimitri Buytaert, Peter Geelen, Peter Peytchev, Koen De Schouwer, Tom De Potter","doi":"10.1007/s10840-024-01977-7","DOIUrl":"https://doi.org/10.1007/s10840-024-01977-7","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Identifying non-responders to cardiac resynchronization therapy in the non-left bundle branch block. 在非左束支阻滞中识别对心脏再同步化治疗无反应的患者。
IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-03 DOI: 10.1007/s10840-024-01972-y
Toshihiro Nakamura, Kohei Ishibashi, Nobuhiko Useda, Satoshi Oka, Yuichiro Miyazaki, Akinori Wakamiya, Kenzaburo Nakajima, Tsukasa Kamakura, Mitsuru Wada, Yuko Inoue, Koji Miyamoto, Satoshi Nagase, Takeshi Aiba, Kengo Kusano

Background: Non-response to cardiac resynchronization therapy (CRT) is an important issue in the treatment of heart failure with reduced ejection fraction (HFrEF) and non-left bundle branch block (LBBB). Electrocardiogram-gated myocardial perfusion single-photon emission computed tomography imaging (G-MPI SPECT) is typically used to assess left ventricular (LV) dyssynchrony. This study aimed to determine whether G-MPI parameters are associated with non-responsiveness to CRT.

Methods: Between January 2021 and December 2022, 128 patients underwent CRT, of whom 73 with preoperative evaluation using G-MPI were selected. Forty-three patients with non-LBBB (21 and 22 CRT responders and non-responders, respectively) and 30 patients with LBBB were analyzed.

Results: Among patients with non-LBBB, CRT responders and non-responders exhibited no significant differences in baseline characteristics, except for the LV dimension. A receiver operating characteristic curve analysis identified 108° and 27.7° as the optimal cutoff values for the bandwidth and phase standard deviation (SD), respectively, to predict non-responsiveness to CRT (area under the curve [AUC] = 0.762; 95% confidence interval [CI] 0.601-0.923 and AUC = 0.742; 95% CI 0.576-0.909, respectively). A multivariate analysis revealed that a cutoff bandwidth of ≥ 108° and phase SD of ≥ 27.7° are independent predictors of non-responsiveness to CRT in patients with non-LBBB (hazard ratio 5.65; 95% CI 1.53-20.9; P = 0.009). In contrast, there were no significant associations between G-MPI parameters and non-responsiveness to CRT in patients with LBBB.

Conclusions: Preoperative G-MPI might be associated with non-responsiveness to CRT in patients with non-LBBB, indicating that identifying potential non-responders can improve patient management.

背景:心脏再同步化治疗(CRT)无反应是治疗心力衰竭伴射血分数降低(HFrEF)和非左束分支阻滞(LBBB)的一个重要问题。心电图门控心肌灌注单光子发射计算机断层成像(G-MPI SPECT)通常用于评估左心室(LV)非同步化。本研究旨在确定G-MPI参数是否与CRT无反应性相关。方法:于2021年1月至2022年12月对128例患者行CRT,其中73例术前行G-MPI评估。43例非LBBB患者(分别为21例和22例CRT反应者和无反应者)和30例LBBB患者进行了分析。结果:在非lbbb患者中,CRT应答者和无应答者在基线特征上没有显著差异,除了左室尺寸。接收机工作特性曲线分析确定108°和27.7°分别为带宽和相位标准差(SD)的最佳截止值,以预测对CRT的无响应性(曲线下面积[AUC] = 0.762;95%置信区间[CI] 0.601 ~ 0.923, AUC = 0.742;95% CI分别为0.576-0.909)。一项多变量分析显示,截止带宽≥108°和SD期≥27.7°是非lbbb患者对CRT无反应的独立预测因子(风险比5.65;95% ci 1.53-20.9;p = 0.009)。相比之下,LBBB患者的G-MPI参数与对CRT无反应性之间没有显著关联。结论:术前G-MPI可能与非lbbb患者对CRT无反应相关,表明识别潜在的无反应者可以改善患者管理。
{"title":"Identifying non-responders to cardiac resynchronization therapy in the non-left bundle branch block.","authors":"Toshihiro Nakamura, Kohei Ishibashi, Nobuhiko Useda, Satoshi Oka, Yuichiro Miyazaki, Akinori Wakamiya, Kenzaburo Nakajima, Tsukasa Kamakura, Mitsuru Wada, Yuko Inoue, Koji Miyamoto, Satoshi Nagase, Takeshi Aiba, Kengo Kusano","doi":"10.1007/s10840-024-01972-y","DOIUrl":"https://doi.org/10.1007/s10840-024-01972-y","url":null,"abstract":"<p><strong>Background: </strong>Non-response to cardiac resynchronization therapy (CRT) is an important issue in the treatment of heart failure with reduced ejection fraction (HFrEF) and non-left bundle branch block (LBBB). Electrocardiogram-gated myocardial perfusion single-photon emission computed tomography imaging (G-MPI SPECT) is typically used to assess left ventricular (LV) dyssynchrony. This study aimed to determine whether G-MPI parameters are associated with non-responsiveness to CRT.</p><p><strong>Methods: </strong>Between January 2021 and December 2022, 128 patients underwent CRT, of whom 73 with preoperative evaluation using G-MPI were selected. Forty-three patients with non-LBBB (21 and 22 CRT responders and non-responders, respectively) and 30 patients with LBBB were analyzed.</p><p><strong>Results: </strong>Among patients with non-LBBB, CRT responders and non-responders exhibited no significant differences in baseline characteristics, except for the LV dimension. A receiver operating characteristic curve analysis identified 108° and 27.7° as the optimal cutoff values for the bandwidth and phase standard deviation (SD), respectively, to predict non-responsiveness to CRT (area under the curve [AUC] = 0.762; 95% confidence interval [CI] 0.601-0.923 and AUC = 0.742; 95% CI 0.576-0.909, respectively). A multivariate analysis revealed that a cutoff bandwidth of ≥ 108° and phase SD of ≥ 27.7° are independent predictors of non-responsiveness to CRT in patients with non-LBBB (hazard ratio 5.65; 95% CI 1.53-20.9; P = 0.009). In contrast, there were no significant associations between G-MPI parameters and non-responsiveness to CRT in patients with LBBB.</p><p><strong>Conclusions: </strong>Preoperative G-MPI might be associated with non-responsiveness to CRT in patients with non-LBBB, indicating that identifying potential non-responders can improve patient management.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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
Journal of Interventional Cardiac Electrophysiology
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