Heart Rhythm O2最新文献

{"title":"Contemporary practice about cardiac implantable electronic device infections prevention: A French multicenter survey","authors":"Antoine Da Costa MD, PhD ,&nbsp;Marc Goralski MD ,&nbsp;Aurélie Guiot MD ,&nbsp;Isabelle Lecardonnel MD ,&nbsp;Jean Claude Deharo MD, PhD","doi":"10.1016/j.hroo.2025.10.009","DOIUrl":"10.1016/j.hroo.2025.10.009","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac implantable electronic device infections remain a major complication. Preventive measures include antiseptic skin preparation, systemic antibiotic prophylaxis, and more recently the use of the absorbable TYRX antibiotic-eluting envelope (AEE). Despite explicit international recommendations, real-world adherence to guidelines is insufficiently documented.</div></div><div><h3>Objective</h3><div>This study aimed to assess infection prevention practices across French hospital centers, with a particular focus on the recent European Society of Cardiology recommendations regarding AEE use.</div></div><div><h3>Methods</h3><div>Data were collected from 33 French centers (51.3% private, 21.2% academic, 27.3% general hospitals). Each practitioner reported data for 5 patients. A structured questionnaire, validated by 2 international experts, addressed key prevention strategies with specific emphasis on AEE.</div></div><div><h3>Results</h3><div>Infectious risk assessment was systematically performed, occasionally using risk scores (Prevention of Arrhythmia Device Infection Trial 12.1%; Charlson 3%). Annual infection incidence was most often tracked on a case-by-case basis (54.5%). Screening for <em>Staphylococcus aureus</em> carriage was infrequent (18.2%), whereas systematic C-reactive protein measurement was more common (63.6%). Intravenous antibiotic prophylaxis was reported in 93.9% of cases, administered within 1 hour before implantation in 77.4%. Skin preparation with 2% alcoholic chlorhexidine and pocket irrigation with physiological saline were both used in 39.4% of cases. AEE was not systematically applied in reimbursed indications (42.4%), with an overall adherence rate to recommendations of 59.5%.</div></div><div><h3>Conclusion</h3><div>This multicenter French survey highlights substantial gaps in physicians’ knowledge and application of cardiac implantable electronic device infection prevention practices, despite the availability of clear European Society of Cardiology guidelines.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 88-94"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-initiated transmissions in remote monitoring of cardiac implantable electronic devices: Evaluating volume, clinical value, and short message service-based strategy to reduce unnecessary transmissions","authors":"Jaakko Huovinen MD,&nbsp;Jarkko Karvonen MD, PhD,&nbsp;Aapo Aro MD, PhD,&nbsp;Markus Sane MD, PhD","doi":"10.1016/j.hroo.2025.10.011","DOIUrl":"10.1016/j.hroo.2025.10.011","url":null,"abstract":"<div><h3>Background</h3><div>Remote monitoring (RM) has been shown to improve clinical outcomes compared with traditional in-office follow-up and has seen rapid adoption. However, most RM transmissions are nonactionable, contributing to clinical workload. Many cardiac implantable electronic devices (CIEDs) allow patient-initiated transmissions, which are frequently nonactionable. More efficient strategies are needed to manage this burden without compromising patient safety.</div></div><div><h3>Objective</h3><div>This study aimed to describe the reasons behind patient-initiated transmissions in RM of CIEDs and assess the impact of a simple short message service (SMS)-based intervention to reduce unnecessary transmissions.</div></div><div><h3>Methods</h3><div>At Helsinki University Hospital in 2024, each RM transmission was evaluated for its cause and resulting clinical action. Patient-initiated transmissions were analyzed for indications and outcomes. Beginning in June 2024, patients who sent transmissions without a clear medical reason received an SMS explaining RM procedures and device functionality. The effect of this intervention on transmission volume was measured.</div></div><div><h3>Results</h3><div>4020 CIEDs produced 8182 RM transmissions. Of the 8182 transmissions, 2268 (27.7%) were patient initiated, with an average of 0.049 transmissions per device per month. Among 1234 transmissions triggered by symptoms or unknown reasons, 85.0% were clinically nonactionable. Only 3.6% led to an in-office visit. After implementing the SMS intervention, the frequency of asymptomatic patient-initiated transmissions decreased by 31.2% (<em>P</em> = .008).</div></div><div><h3>Conclusion</h3><div>Patient-initiated transmissions significantly contribute to RM workload, although most do not lead to clinical action. A simple SMS-based strategy effectively reduced nonactionable transmissions, enhancing the efficiency of RM workflows.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 95-102"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic status does not influence quality of life and mood outcomes after catheter ablation for atrial fibrillation: A call for equitable access","authors":"Youlin Koh MBBS, FRACP ,&nbsp;Laura Chen BNurs ,&nbsp;Lisa Lu BNurs ,&nbsp;Aisling Green BSc ,&nbsp;Souvik Das MBBS, FRACP ,&nbsp;Louise Segan MBBS, FRACP ,&nbsp;Rose Crowley MBBS, FRACP ,&nbsp;Hariharan Sugumar MBBS, FRACP, PhD ,&nbsp;Sandeep Prabhu MBBS, FRACP, PhD ,&nbsp;Aleksandr Voskoboinik MBBS, FRACP, PhD ,&nbsp;David Chieng MBBS, FRACP, PhD ,&nbsp;Ahmed Al-Kaisey MBChB, FRACP, PhD ,&nbsp;Joseph Morton MBBS, FRACP, PhD ,&nbsp;Peter Kistler MBBS, FRACP, PhD ,&nbsp;Christopher Davey MBBS, GDipJourn, FRANZCP, PhD ,&nbsp;Jonathan Kalman MBBS, FRACP, PhD ,&nbsp;Michael Wong MBBS, FRACP, PhD","doi":"10.1016/j.hroo.2025.10.014","DOIUrl":"10.1016/j.hroo.2025.10.014","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies indicate that socioeconomic status (SES) is a determinant of successful rhythm control in atrial fibrillation (AF). However, data relating specifically to ablation outcomes are lacking.</div></div><div><h3>Objective</h3><div>We sought to investigate the relationship between SES and AF ablation outcomes.</div></div><div><h3>Methods</h3><div>Participants enrolled in 2 multicenter randomized trials evaluating AF ablation outcomes were invited to participate in an SES survey. SES indicators collected included cultural and linguistic diversity, education, occupational skill, weekly income, and the Household, Income and Labour Dynamics in Australia index of social support. The impact of SES on AF-related quality of life (QoL) (primary outcome) and mood was evaluated with regression methods.</div></div><div><h3>Results</h3><div>159 patients provided consent and answers to the SES survey. The mean age was 62.8 ± 9.4 years, and 78% were male. In this cohort, 56.6% were treated in a public hospital; 40% completed a certificate, diploma, or degree; and 40% were in a highly skilled occupation. The interquartile range of weekly income was $850–$2307. Median social support index was 59/70. Principal component analysis divided the cohort into SES quartiles. Mean 12-month change in standardized QoL score was 22.4 ± 30.4 (maximum score 100). There was a reduction in the 12-month anxiety/depression score of −4.8 ± 7.01 (maximum score 21). Median AF burden was 0% (0%–1.9%). These changes did not differ across SES quartiles.</div></div><div><h3>Conclusion</h3><div>Across a wide spectrum of SES, AF ablation was highly effective for improvements in AF-related QoL and anxiety/depression. These improvements correlated with low AF burden after ablation.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 46-52"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined assessment of nonalcoholic fatty liver disease fibrosis score and B-type natriuretic peptide for predicting atrial fibrillation recurrence after catheter ablation: A multicenter study","authors":"Kyoko Koyama MD ,&nbsp;Naoaki Hashimoto MD ,&nbsp;Takanori Arimoto MD ,&nbsp;Daisuke Kutsuzawa MD ,&nbsp;Ken Watanabe MD ,&nbsp;Yuta Kobayashi MD ,&nbsp;Mashu Toyoshima MD ,&nbsp;Daisuke Kinoshita MD ,&nbsp;Masahiro Wanezaki MD ,&nbsp;Yoichiro Otaki MD ,&nbsp;Shigehiko Kato MD ,&nbsp;Harutoshi Tamura MD ,&nbsp;Tetsu Watanabe MD ,&nbsp;Shunsuke Netsu MD ,&nbsp;Nobuyuki Kiribayashi MD ,&nbsp;Tomonori Aono MD ,&nbsp;Satoshi Aita MD ,&nbsp;Akio Fukui MD ,&nbsp;Yuji Saito MD ,&nbsp;Taku Toshima MD ,&nbsp;Masafumi Watanabe MD","doi":"10.1016/j.hroo.2025.11.003","DOIUrl":"10.1016/j.hroo.2025.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Combined assessment of the left and right atrial overload has been associated with atrial fibrillation recurrence after catheter ablation.</div></div><div><h3>Objective</h3><div>This study aimed to investigate whether liver fibrosis scores are associated with right atrial remodeling and evaluate the prognostic value of combining these scores with B-type natriuretic peptide (BNP) levels.</div></div><div><h3>Methods</h3><div>This study included a retrospective single-center cohort (n = 212) and a prospective multicenter validation cohort (n = 250) of patients who underwent first-time ablation for atrial fibrillation. Liver fibrosis scores, including the nonalcoholic fatty liver disease fibrosis score (NFS), fibrosis-4 index, and aspartate aminotransferase–to–platelet ratio index, were calculated before the procedure. The right atrial volume was assessed using 3-dimensional computed tomography.</div></div><div><h3>Results</h3><div>NFS was significantly associated with atrial arrhythmia recurrence after catheter ablation, whereas the fibrosis-4 index and aspartate aminotransferase–to–platelet ratio index were not. Adding NFS to BNP further enhanced risk prediction. The patients were stratified into 3 groups based on the median NFS and BNP values to ensure balanced group sizes. Patients with elevated levels of both (group C) exhibited the worst clinical profiles and the highest recurrence rates. Group C was independently associated with atrial arrhythmia recurrence (hazard ratio, 3.07; 95% confidence interval, 1.07–8.77; <em>P</em> &lt; .05). These findings were validated in the multicenter cohort, where group C similarly had the worst clinical characteristics and remained an independent predictor of recurrence (hazard ratio, 2.27; 95% confidence interval, 1.17–4.40; <em>P</em> &lt; .05).</div></div><div><h3>Conclusion</h3><div>The combined assessment of NFS and BNP enables noninvasive risk stratification by capturing biatrial overload and may help identify high-risk patients.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 70-80"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulsed field ablation for ventricular arrhythmias: From mechanistic foundations to clinical translation","authors":"Hongxi Li MD ,&nbsp;Han Zhang MD ,&nbsp;Menglin Tian MD ,&nbsp;Sen Yang MD ,&nbsp;Xiaohua Zhao MD ,&nbsp;Qiwei Liao MD ,&nbsp;Shaolong Li MD ,&nbsp;Dong Yang MD ,&nbsp;Fuding Guo MD, PhD","doi":"10.1016/j.hroo.2025.08.027","DOIUrl":"10.1016/j.hroo.2025.08.027","url":null,"abstract":"<div><div>Ventricular arrhythmias (VAs), particularly scar-related ventricular tachycardia, remain a leading cause of sudden cardiac death in patients with structural heart disease. Although radiofrequency ablation is the current standard of care, its efficacy is limited in complex myocardial substrates. Pulsed field ablation (PFA), a non-thermal and cell-selective technique based on irreversible electroporation, has emerged as a promising alternative. This review provides a comprehensive overview of the mechanistic rationale, preclinical validation, and early clinical experiences of PFA in VAs. It primarily discusses potential challenges in the clinical treatment of ventricular tachycardia. Furthermore, we highlight emerging catheter systems and the possible synergistic value of functional substrate mapping, preprocedural imaging, and parameter optimization in improving the precision and safety of PFA. As a promising ablation technology, PFA holds strong potential for treating VAs.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 171-182"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life-threatening events in patients with LQT3 on and off beta-blockers: Insights from a case series","authors":"Alexis Hermida MD, PhD ,&nbsp;Jean-Baptiste Gourraud MD, PhD ,&nbsp;Isabelle Denjoy MD ,&nbsp;Adrien Bloch MD ,&nbsp;Vincent Probst MD, PhD ,&nbsp;Fabrice Extramiana MD, PhD","doi":"10.1016/j.hroo.2025.11.005","DOIUrl":"10.1016/j.hroo.2025.11.005","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 193-195"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does obesity affect atrial fibrillation ablation outcomes? Insights from a national atrial fibrillation catheter ablation registry: One-year follow-up","authors":"Avia Bar-Moshe MD ,&nbsp;Gal Tsaban MD ,&nbsp;Ido Dan MSc ,&nbsp;Ibrahim Marai MD ,&nbsp;Yoav Michowitz MD ,&nbsp;Michael Glikson MD ,&nbsp;David Luria MD ,&nbsp;Alexander Omelchenko MD ,&nbsp;Avishag Laish-Farkash MD, PhD ,&nbsp;Mahmoud Suleiman MD ,&nbsp;Sergiy Bereza MD ,&nbsp;Eyal Nof MD ,&nbsp;Roy Beinart MD ,&nbsp;Moti Haim MD ,&nbsp;Yuval Konstantino MD","doi":"10.1016/j.hroo.2025.10.008","DOIUrl":"10.1016/j.hroo.2025.10.008","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) is the most common sustained arrhythmia in adults and is associated with significant morbidity and mortality. Obesity is a known risk factor for AF, but its impact on the success of AF ablation and the risk of recurrence remains inconclusive.</div></div><div><h3>Objective</h3><div>This study evaluated the safety and efficacy of AF ablation across different obesity subgroups.</div></div><div><h3>Methods</h3><div>This prospective, nationwide, multicenter registry study included 878 patients who underwent AF ablation between January 2019 and December 2021. Participants were categorized into nonobese and obesity classes I–III (body mass index [BMI] ≥30 kg/m²) per the World Health Organization classification. Procedural characteristics, clinical outcomes, and adverse events were collected. Primary endpoints were AF recurrence and rehospitalization within 1 year.</div></div><div><h3>Results</h3><div>AF recurrence at 1 year occurred in 23% of patients, with no significant differences among BMI groups. In multivariable analysis, none of the obesity subgroups were independently associated with recurrent AF or need for reablation. Female gender, systolic pulmonary artery pressure, and left atrium size were significant predictors of AF recurrence. Rehospitalization rates were higher in obesity classes I (adjusted hazard ratio 2.2; <em>P</em> = .02) and II (adjusted hazard ratio 3.9; <em>P</em> &lt; .001). Diabetes was also an independent predictor of rehospitalization. Procedural safety was comparable across BMI categories, with no significant differences in major complications.</div></div><div><h3>Conclusion</h3><div>This study suggests that although obesity is associated with a higher rate of rehospitalization, it does not significantly affect the 12-month efficacy or safety of AF ablation. These findings support the continued use of AF ablation in obese patients, regardless of obesity class.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 27-36"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying independent risk factors of mortality among patients receiving a leadless pacemaker: A longitudinal retrospective study in a single center","authors":"Shreya Srivastava MD, MPH ,&nbsp;Humail Patel MD ,&nbsp;Riya George MD ,&nbsp;Sai Guntaka MD ,&nbsp;Ji-Cheng Hsieh MD ,&nbsp;Raman Mitra MD, PhD, FHRS","doi":"10.1016/j.hroo.2025.10.007","DOIUrl":"10.1016/j.hroo.2025.10.007","url":null,"abstract":"<div><h3>Background</h3><div>In certain high-risk subgroups, leadless pacemakers (LPs) have lower 2-year complications and reintervention rates than transvenous-VVI pacing. Despite this, other studies have reported higher all-cause in-hospital mortality and complications in the LP group. Many of these studies are based on claims data, which have inherent limitations. We conducted a single-center, detailed, retrospective study to examine clinical factors, including the Charlson comorbidity index (CCI), associated with higher mortality among patients receiving an LP.</div></div><div><h3>Objective</h3><div>This study aimed to examine clinical factors, including the CCI, associated with higher mortality among patients receiving an LP.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted among 574 patients who received an LP between 2018 and 2022 at a quaternary care hospital. CCI was generated for each patient, and a multivariable Cox regression analysis was performed to obtain associated hazard ratios. Furthermore, we conducted logistic regression analyses to identify unique factors that affect the odds of 30-day mortality.</div></div><div><h3>Results</h3><div>The mean CCI score in the study population was 5.30 (standard deviation 2.03). The total mortality in the study population was 26.6% (n = 146). Patients who had a CCI of &gt;4 points had a 3-fold increase in risk of mortality compared with those who had a CCI of ≤4 points (hazard ratio 3.04; 95% confidence interval [CI] 1.70–5.42). Moreover, there was a decreased odds of survival within the first 30 days among those with a CCI of &gt;4. Low left ventricular ejection fraction (odds ratio [OR] 2.62; 95% CI 1.05–6.56), hemoglobin (OR 2.29; 95% CI 1.10–4.77), and advanced age (OR 2.28; 95% CI 1.20–4.34) were identified as independent risk factors of early mortality.</div></div><div><h3>Conclusion</h3><div>CCI has previously been demonstrated to be a significant predictor of mortality in patients receiving pacemakers or implantable defibrillators. In our study, we found that a CCI of &gt;4 was independently associated with mortality. In addition, our study highlights that low left ventricular ejection fraction, hemoglobin, and advanced age are key risk factors that may predict early mortality among LP patients.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 81-87"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial fibrosis predicts sudden cardiac death in patients with hypertrophic cardiomyopathy after cardiac electronic device implantation: Insights from cardiovascular magnetic resonance imaging","authors":"Bingqi Fu MD ,&nbsp;Xinqiao Lian MD ,&nbsp;Hao Huang MD ,&nbsp;Tianxin Long MD ,&nbsp;Juwei Yang MD ,&nbsp;Yu Jiang MD ,&nbsp;Xiaohui Ning MD ,&nbsp;Xuhua Chen MD ,&nbsp;Hongxia Niu MD ,&nbsp;Minjie Lu MD ,&nbsp;Wei Hua MD, FHRS","doi":"10.1016/j.hroo.2025.10.012","DOIUrl":"10.1016/j.hroo.2025.10.012","url":null,"abstract":"<div><h3>Background</h3><div>Patients with hypertrophic cardiomyopathy (HCM) face an increased risk of sudden cardiac death (SCD), and myocardial fibrosis is predictive of ventricular arrhythmias.</div></div><div><h3>Objective</h3><div>This study aimed to determine whether the location, pattern, and quantification of myocardial fibrosis predict SCD in patients with HCM after cardiac implantable electronic device (CIED) implantation.</div></div><div><h3>Methods</h3><div>This study included patients with HCM who completed cardiovascular magnetic resonance and received CIED between June 2017 and January 2023. The primary outcome was SCD or SCD-equivalent events (composite of SCD, resuscitated cardiac arrest, sustained ventricular tachycardia or ventricular fibrillation, or appropriate implantable cardioverter-defibrillator therapy).</div></div><div><h3>Results</h3><div>88 patients were included (age 52.3 ± 15.3 years; 67.0% male). Over a median follow-up period of 38.1 months, 27 SCD events (30.6%) were recorded. Fibrosis in the inferior wall, transmural pattern, total fibrosis, and gray zone fibrosis (GZF) were all significantly associated with SCD risk. Stepwise regression analyses identified the transmural fibrosis pattern (hazard ratio 3.15; 95% confidence interval [CI] 1.22–8.14; <em>P</em> = .018) and increased GZF_6SD (hazard ratio 3.49; 95% CI 1.31–9.25; <em>P</em> = .012) as independent predictors of SCD risk. Incorporating both transmural fibrosis and GZF_6SD of ≥21.00% into the HCM 5-year SCD risk model significantly improved predictive value from 0.69 (95% CI 0.54–0.84) to 0.76 (95% CI 0.62–0.89; <em>P</em> for comparison = .002). The net reclassification improvement was 0.35 (95% CI 0.13–0.57; <em>P</em> = .002), and the integrated discrimination improvement was 0.04 (95% CI 0.02–0.06; <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>Transmural fibrosis and elevated GZF_6SD are predictors of SCD in patients with HCM after CIED implantation and provide additional value to the existing risk scoring system.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 119-129"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First catheter ablation in Fiji: Innovative use of a pacemaker programmer as a recording system","authors":"Bridget McIlraith PGDipMedTech, CCP, CCDS ,&nbsp;Anil Jayendrappa BSc, CCDS, CEPIA ,&nbsp;Tracey Cumming BSc ,&nbsp;Jennifer Youard NZCS ,&nbsp;Jamie Voss MBChB, FRACP ,&nbsp;Geoffrey Clare MBChB, FRACP ,&nbsp;Matthew Webber MBChB, FRACP ,&nbsp;Andrew Martin MBChB, CCDS, FRACP ,&nbsp;Pacific Islands Pacemaker Services","doi":"10.1016/j.hroo.2025.11.006","DOIUrl":"10.1016/j.hroo.2025.11.006","url":null,"abstract":"<div><div>Wolff-Parkinson-White syndrome is a potentially life-threatening condition for which catheter ablation is considered first-line therapy, yet electrophysiology (EP) services remain unavailable in many low- and middle-income countries. We describe the innovative use of a pacemaker programmer as an EP recording system for the first catheter ablation procedures performed in Fiji. 2 patients with symptomatic Wolff-Parkinson-White underwent ablation using a repurposed pacemaker programmer for intracardiac signal recording in combination with an IBI-1500T9 radiofrequency generator for energy delivery. Both procedures were successful, achieving elimination of accessory pathway conduction and complete resolution of symptoms without complications. These cases demonstrate that repurposing readily available cardiac device equipment can enable lifesaving EP procedures in resource-limited settings and establish a foundation for future service development.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"7 1","pages":"Pages 152-155"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145969368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}