Pub Date : 2025-01-14DOI: 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
{"title":"Unicentric Brazilian registry of cardiac sympathetic denervation for control of ventricular arrhythmias.","authors":"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","doi":"10.1007/s10840-024-01975-9","DOIUrl":"https://doi.org/10.1007/s10840-024-01975-9","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978946","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}
Pub Date : 2025-01-13DOI: 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
{"title":"US National trends in mortality related to ventricular tachycardia/ ventricular fibrillation.","authors":"Alireza Ghajar, Maeve M Sargeant, John N Catanzaro, Binu Philips, Fabrizio R Assis, Rajasekhar Nekkanti, Samuel F Sears, Ghanshyam Shantha","doi":"10.1007/s10840-025-01979-z","DOIUrl":"https://doi.org/10.1007/s10840-025-01979-z","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971203","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}
Pub Date : 2025-01-11DOI: 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。
{"title":"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.","authors":"Marco Fusaroli, Mark G Hoogendijk, Rohit E Bhagwandien, Sip A Wijchers, Nick van Boven, Bakthawar K Mahmoodi, Sing-Chien Yap","doi":"10.1007/s10840-025-01982-4","DOIUrl":"https://doi.org/10.1007/s10840-025-01982-4","url":null,"abstract":"<p><strong>Introduction: </strong>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).</p><p><strong>Methods and results: </strong>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/m<sup>2</sup>, 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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964694","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}
Pub Date : 2025-01-09DOI: 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":"<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","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}
Pub Date : 2025-01-08DOI: 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.
{"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}
Pub Date : 2025-01-06DOI: 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}
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.
{"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}
Pub Date : 2025-01-01Epub Date: 2024-09-07DOI: 10.1007/s10840-024-01912-w
Teiichi Yamane, Tetsuo Sasano, Hirofumi Tomita, Daisetsu Aoyama, Shinsuke Miyazaki, Masateru Takigawa, Masaomi Kimura, Taihei Itoh, Seigo Yamashita, Jada M Selma, Jeffrey Cerkvenik, Atul Verma, Hiroshi Tada
Background: Pulsed field ablation (PFA), a novel treatment for atrial fibrillation (AF), has yet to be evaluated in a Japanese cohort.
Methods: In this sub-analysis of the PULSED AF trial, 12-month outcomes of paroxysmal AF (PAF) and persistent AF (PsAF) patients treated with PFA in four Japan centers were assessed. After a 90-day blanking period, primary efficacy was determined via freedom from a composite endpoint of acute procedural failure, arrhythmia recurrence, or antiarrhythmic drug escalation over 1 year. Patient improvement was evaluated via two quality of life (QoL) surveys (AFEQT and EQ-5D) at baseline and 12 months.
Results: The analysis included 32 patients, 16 PAF and 16 PsAF, with PAF patients averaging 61.1 ± 10.6 years and PsAF patients averaging 62.8 ± 11.5 years of age. Females made up 31% of PAF and 25% of PsAF cohorts. Acute pulmonary vein isolation was achieved in 100% of both cohorts. The primary efficacy success rate at 12 months was 75.0% for PAF and 56.3% for PsAF patients. No primary safety events occurred. The mean AFEQT score significantly increased for both PAF (25.9 points, p < 0.0001) and PsAF (13.2 points, p = 0.0002) patients, while the EQ-5D-5L score improved significantly for PAF (0.12 points, p = 0.048) patients but not for PsAF (0.04 points, p = 0.08) patients.
Conclusions: Similar to outcomes in the global cohort, ablation with the PulseSelect™ PFA catheter was efficient, effective, and safe in a Japanese population, resulting in improved QoL for PAF and PsAF patients.
{"title":"Safety, efficacy, and quality of life outcomes of pulsed field ablation in Japanese patients with atrial fibrillation: results from the PULSED AF trial.","authors":"Teiichi Yamane, Tetsuo Sasano, Hirofumi Tomita, Daisetsu Aoyama, Shinsuke Miyazaki, Masateru Takigawa, Masaomi Kimura, Taihei Itoh, Seigo Yamashita, Jada M Selma, Jeffrey Cerkvenik, Atul Verma, Hiroshi Tada","doi":"10.1007/s10840-024-01912-w","DOIUrl":"10.1007/s10840-024-01912-w","url":null,"abstract":"<p><strong>Background: </strong>Pulsed field ablation (PFA), a novel treatment for atrial fibrillation (AF), has yet to be evaluated in a Japanese cohort.</p><p><strong>Methods: </strong>In this sub-analysis of the PULSED AF trial, 12-month outcomes of paroxysmal AF (PAF) and persistent AF (PsAF) patients treated with PFA in four Japan centers were assessed. After a 90-day blanking period, primary efficacy was determined via freedom from a composite endpoint of acute procedural failure, arrhythmia recurrence, or antiarrhythmic drug escalation over 1 year. Patient improvement was evaluated via two quality of life (QoL) surveys (AFEQT and EQ-5D) at baseline and 12 months.</p><p><strong>Results: </strong>The analysis included 32 patients, 16 PAF and 16 PsAF, with PAF patients averaging 61.1 ± 10.6 years and PsAF patients averaging 62.8 ± 11.5 years of age. Females made up 31% of PAF and 25% of PsAF cohorts. Acute pulmonary vein isolation was achieved in 100% of both cohorts. The primary efficacy success rate at 12 months was 75.0% for PAF and 56.3% for PsAF patients. No primary safety events occurred. The mean AFEQT score significantly increased for both PAF (25.9 points, p < 0.0001) and PsAF (13.2 points, p = 0.0002) patients, while the EQ-5D-5L score improved significantly for PAF (0.12 points, p = 0.048) patients but not for PsAF (0.04 points, p = 0.08) patients.</p><p><strong>Conclusions: </strong>Similar to outcomes in the global cohort, ablation with the PulseSelect™ PFA catheter was efficient, effective, and safe in a Japanese population, resulting in improved QoL for PAF and PsAF patients.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov Identifier: NCT04198701.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"149-157"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2024-08-27DOI: 10.1007/s10840-024-01898-5
Jeanne du Fay de Lavallaz, Jackson J Liang
{"title":"Noninvasive programmed stimulation after ventricular tachycardia ablation: gazing into a crystal ball to predict recurrences?","authors":"Jeanne du Fay de Lavallaz, Jackson J Liang","doi":"10.1007/s10840-024-01898-5","DOIUrl":"10.1007/s10840-024-01898-5","url":null,"abstract":"","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":"27-28"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072956","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}
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