Pub Date : 2025-11-01DOI: 10.1016/j.hroo.2025.07.104
Lane A. McLendon MD , Madhuri S. Mulekar PhD , Lynn A. Batten MD
Background
Sudden cardiac death in young athletes is a devastating event unparalleled in the sports community. The debate over electrocardiogram (ECG) screening of young athletes has been ongoing for many years and recommendations vary widely.
Objective
We prospectively studied students in coastal Alabama to compare the detection rate of life-threatening cardiac pathology using a 12-lead ECG vs a preparticipation questionnaire.
Methods
A total of 2604 students in coastal Alabama aged 5–22 years (median age, 15 years) were included between 2014 and 2019. They completed the American Heart Association (AHA) 14-point preparticipation questionnaire and underwent a 12-lead ECG.
Results
Of participants answering the questionnaire, 60.2% were men, 81.4% were White, and 10.7% were Black. There were 306 (11.9%) of 2565 students who reported symptoms that would have triggered referral to a cardiologist, with the most common (88.2%) being chest pain, shortness of breath, and palpitations. Of 2604 ECGs, 86 (3.3%) were abnormal, with the most frequent findings (54.7%) being T wave inversions and pathologic Q waves. The AHA screening questionnaire had a sensitivity of 33.0% and specificity of 78.7%, while the ECG screening had 100% sensitivity and 97.0% specificity. Three students (0.1%) were found to have conditions associated with sudden cardiac arrest which were detected by ECG, although only 1 of these students reported symptoms on the questionnaire which would have prompted a referral.
Conclusion
The 14-point AHA questionnaire raised suspicion for unnecessary referrals while missing 66.0% of the life-threatening pathologies detected with ECG.
{"title":"Preparticipation electrocardiogram screening in a Gulf Coast community: A prospective study","authors":"Lane A. McLendon MD , Madhuri S. Mulekar PhD , Lynn A. Batten MD","doi":"10.1016/j.hroo.2025.07.104","DOIUrl":"10.1016/j.hroo.2025.07.104","url":null,"abstract":"<div><h3>Background</h3><div>Sudden cardiac death in young athletes is a devastating event unparalleled in the sports community. The debate over electrocardiogram (ECG) screening of young athletes has been ongoing for many years and recommendations vary widely.</div></div><div><h3>Objective</h3><div>We prospectively studied students in coastal Alabama to compare the detection rate of life-threatening cardiac pathology using a 12-lead ECG vs a preparticipation questionnaire.</div></div><div><h3>Methods</h3><div>A total of 2604 students in coastal Alabama aged 5–22 years (median age, 15 years) were included between 2014 and 2019. They completed the American Heart Association (AHA) 14-point preparticipation questionnaire and underwent a 12-lead ECG.</div></div><div><h3>Results</h3><div>Of participants answering the questionnaire, 60.2% were men, 81.4% were White, and 10.7% were Black. There were 306 (11.9%) of 2565 students who reported symptoms that would have triggered referral to a cardiologist, with the most common (88.2%) being chest pain, shortness of breath, and palpitations. Of 2604 ECGs, 86 (3.3%) were abnormal, with the most frequent findings (54.7%) being T wave inversions and pathologic Q waves. The AHA screening questionnaire had a sensitivity of 33.0% and specificity of 78.7%, while the ECG screening had 100% sensitivity and 97.0% specificity. Three students (0.1%) were found to have conditions associated with sudden cardiac arrest which were detected by ECG, although only 1 of these students reported symptoms on the questionnaire which would have prompted a referral.</div></div><div><h3>Conclusion</h3><div>The 14-point AHA questionnaire raised suspicion for unnecessary referrals while missing 66.0% of the life-threatening pathologies detected with ECG.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 11","pages":"Pages 1761-1766"},"PeriodicalIF":2.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145546467","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}
Pub Date : 2025-11-01DOI: 10.1016/j.hroo.2025.07.105
Iris van der Schaaf MD , Manon Kloosterman MSc , Anton P.M. Gorgels MD, PhD , Anneline S.J.M. te Riele MD, PhD , Peter M. van Dam PhD , Peter Loh MD, PhD
Background
Carriers of (likely) Plakophilin-2 pathogenic variants (PKP2-(L)PV) are at risk of developing arrhythmogenic cardiomyopathy. Early disease detection is crucial because life-threatening arrhythmias may occur early. CineECG is a novel electrocardiogram (ECG) analysis tool that reconstructs the average trajectory of ventricular electrical activity.
Objective
The study aimed to describe the electrical depolarization and repolarization CineECG trajectories in PKP2-(L)PV carriers with a normal ECG as per evaluation of 2 cardiologists, who meet no Task Force Criteria other than their PV.
Methods
PKP2-(L)PV carriers were 2:1-matched to control subjects, who had atrioventricular nodal reentry tachycardia but no other cardiac abnormalities. Sinus rhythm ECGs of controls were used to create a normal distribution of trajectories. PKP2-(L)PV carriers’ trajectories were compared with the normal distribution. A trajectory was considered abnormal if it fell less than 95% within the normal distribution.
Results
Overall, 104 subjects were included (age 24 years [19–36], 43% men): 37 PKP2-(L)PV carriers and 67 controls. Depolarization and repolarization trajectories were abnormal in 51% and 24% of carriers, respectively. In carriers with abnormal depolarization trajectories, significant differences were observed in the direction of the initial depolarization trajectory when compared with controls in the inferior-superior axis (P = .005) and posterior-anterior axis (P = .020). In the left-right axis, the direction significantly differed from carriers with a normal trajectory (P = .020).
Conclusion
Abnormal electrical activity was identified in over half of preclinical PKP2-(L)PV carriers with a normal ECG. CineECG could be a sensitive tool to unveil early, subtle abnormalities in ventricular electrical activity that would otherwise not be detected.
{"title":"CineECG detects abnormal electrical activity in the 12-lead ECG of preclinical plakophilin-2 variant carriers","authors":"Iris van der Schaaf MD , Manon Kloosterman MSc , Anton P.M. Gorgels MD, PhD , Anneline S.J.M. te Riele MD, PhD , Peter M. van Dam PhD , Peter Loh MD, PhD","doi":"10.1016/j.hroo.2025.07.105","DOIUrl":"10.1016/j.hroo.2025.07.105","url":null,"abstract":"<div><h3>Background</h3><div>Carriers of (likely) Plakophilin-2 pathogenic variants (<em>PKP2</em>-(L)PV) are at risk of developing arrhythmogenic cardiomyopathy. Early disease detection is crucial because life-threatening arrhythmias may occur early. CineECG is a novel electrocardiogram (ECG) analysis tool that reconstructs the average trajectory of ventricular electrical activity.</div></div><div><h3>Objective</h3><div>The study aimed to describe the electrical depolarization and repolarization CineECG trajectories in <em>PKP2</em>-(L)PV carriers with a normal ECG as per evaluation of 2 cardiologists, who meet no Task Force Criteria other than their PV.</div></div><div><h3>Methods</h3><div><em>PKP2</em>-(L)PV carriers were 2:1-matched to control subjects, who had atrioventricular nodal reentry tachycardia but no other cardiac abnormalities. Sinus rhythm ECGs of controls were used to create a normal distribution of trajectories. <em>PKP2</em>-(L)PV carriers’ trajectories were compared with the normal distribution. A trajectory was considered abnormal if it fell less than 95% within the normal distribution.</div></div><div><h3>Results</h3><div>Overall, 104 subjects were included (age 24 years [19–36], 43% men): 37 <em>PKP2</em>-(L)PV carriers and 67 controls. Depolarization and repolarization trajectories were abnormal in 51% and 24% of carriers, respectively. In carriers with abnormal depolarization trajectories, significant differences were observed in the direction of the initial depolarization trajectory when compared with controls in the inferior-superior axis (<em>P</em> = .005) and posterior-anterior axis (<em>P</em> = .020). In the left-right axis, the direction significantly differed from carriers with a normal trajectory (<em>P</em> = .020).</div></div><div><h3>Conclusion</h3><div>Abnormal electrical activity was identified in over half of preclinical <em>PKP2</em>-(L)PV carriers with a normal ECG. CineECG could be a sensitive tool to unveil early, subtle abnormalities in ventricular electrical activity that would otherwise not be detected.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 11","pages":"Pages 1786-1795"},"PeriodicalIF":2.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145546589","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}
Pub Date : 2025-11-01DOI: 10.1016/j.hroo.2025.07.022
Michela Casella MD, PhD , Yari Valeri MD , Paolo Compagnucci MD, PhD , Luca Finori MD , Giovanni Volpato MD , Laura Cipolletta MD , Quintino Parisi MD , Riccardo Grandin MD , Francesca Campanelli MD , Leonardo D’Angelo MD , Giorgio Giacomini MD , Francesco Cardinali MD , Giacomo Castellucci MD , Enrico Rita MD , Loredana Messano MD , Giuseppe Ciliberti MD , Maurizio Malacrida MSc , Antonio Dello Russo MD, PhD
Background
There is a lack of data on the temporal dynamics of cardiac biomarkers after radiofrequency and pulsed field ablation (PFA) catheter ablation of atrial fibrillation.
Objective
To evaluate the kinetics of release of several biomarkers following pulmonary vein isolation (PVI).
Methods
All patients underwent baseline and regular post-procedural blood sampling (at 3, 24, and 48 hours) to assess major markers of myocardial injury (troponin I, creatinine kinase-MB, and myoglobin) and inflammatory (C-reactive protein [CRP]). The population was stratified into 3 groups according to the ablation system: radiofrequency (RF) ablation catheter (RF group), pentaspline FarapulseTM PFA system (PFA-FAR group), and variable-loop VaripulseTM PFA system (PFA-VAR group).
Results
A total of 186 patients were included: 79 RF (42.5%), 69 PFA-FAR (37.1%), and 38 PFA-VAR (20.4%). A greater extent of myocardial injury was noticed in the PFA groups vs RF, and cellular electroporation via pentaspline PFA resulted in a greater biomarker increase compared with loop-variable PFA. Kinetics of biomarkers of inflammation increase following PVI with both PFA technologies and RF. However, both PFA systems resulted in a faster CRP biomarker recovery compared with RF, while CRP continued to increase beyond 24 hours post-ablation only in the RF group. PVI was achieved in all patients (100%) using only PFA or RF.
Conclusion
Cellular electroporation induced by pentaspline PFA was associated with a significantly greater elevation in these cardiac biomarkers compared with variable-loop PFA and RF. After an initial increase, both PFA systems were associated with a more rapid decline in CRP levels compared with RF.
{"title":"Cardiac biomarker temporal dynamics after radiofrequency and pulsed field catheter ablation of atrial fibrillation","authors":"Michela Casella MD, PhD , Yari Valeri MD , Paolo Compagnucci MD, PhD , Luca Finori MD , Giovanni Volpato MD , Laura Cipolletta MD , Quintino Parisi MD , Riccardo Grandin MD , Francesca Campanelli MD , Leonardo D’Angelo MD , Giorgio Giacomini MD , Francesco Cardinali MD , Giacomo Castellucci MD , Enrico Rita MD , Loredana Messano MD , Giuseppe Ciliberti MD , Maurizio Malacrida MSc , Antonio Dello Russo MD, PhD","doi":"10.1016/j.hroo.2025.07.022","DOIUrl":"10.1016/j.hroo.2025.07.022","url":null,"abstract":"<div><h3>Background</h3><div>There is a lack of data on the temporal dynamics of cardiac biomarkers after radiofrequency and pulsed field ablation (PFA) catheter ablation of atrial fibrillation.</div></div><div><h3>Objective</h3><div>To evaluate the kinetics of release of several biomarkers following pulmonary vein isolation (PVI).</div></div><div><h3>Methods</h3><div>All patients underwent baseline and regular post-procedural blood sampling (at 3, 24, and 48 hours) to assess major markers of myocardial injury (troponin I, creatinine kinase-MB, and myoglobin) and inflammatory (C-reactive protein [CRP]). The population was stratified into 3 groups according to the ablation system: radiofrequency (RF) ablation catheter (RF group), pentaspline Farapulse<sup>TM</sup> PFA system (PFA-FAR group), and variable-loop Varipulse<sup>TM</sup> PFA system (PFA-VAR group).</div></div><div><h3>Results</h3><div>A total of 186 patients were included: 79 RF (42.5%), 69 PFA-FAR (37.1%), and 38 PFA-VAR (20.4%). A greater extent of myocardial injury was noticed in the PFA groups vs RF, and cellular electroporation via pentaspline PFA resulted in a greater biomarker increase compared with loop-variable PFA. Kinetics of biomarkers of inflammation increase following PVI with both PFA technologies and RF. However, both PFA systems resulted in a faster CRP biomarker recovery compared with RF, while CRP continued to increase beyond 24 hours post-ablation only in the RF group. PVI was achieved in all patients (100%) using only PFA or RF.</div></div><div><h3>Conclusion</h3><div>Cellular electroporation induced by pentaspline PFA was associated with a significantly greater elevation in these cardiac biomarkers compared with variable-loop PFA and RF. After an initial increase, both PFA systems were associated with a more rapid decline in CRP levels compared with RF.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 11","pages":"Pages 1688-1695"},"PeriodicalIF":2.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145546943","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}
Pub Date : 2025-11-01DOI: 10.1016/j.hroo.2025.07.021
Laura T. Derry MD, MBA , Mary A. Whooley MD , Merritt H. Raitt MD, FHRS , Thomas L. Rotering MPH , Hui Shen MS , Gary Tarasovsky BS , Sanket S. Dhruva MD, MHS
Background
Traditionally, patients with cardiovascular implantable electronic devices (CIEDs) (pacemakers and implantable cardioverter-defibrillators) attend routine in-person evaluations at least annually, paired with remote monitoring (RM). Because similar data can be obtained through RM and in-person evaluations, it is unclear whether routine in-person evaluations are necessary.
Objective
This study aimed to compare major adverse cardiac events (MACE) in patients who did vs did not receive in-person CIED care while participating in RM.
Methods
We classified patients who received their CIED care within the Veterans Health Administration and sent ≥1 RM transmission between July 1, 2020, and June 30, 2021, into 2 groups based on clinician evaluation type for their CIED care: (1) at least 1 in-person evaluation or (2) remote-only evaluations. The primary outcome was MACE, a composite of all-cause mortality, stroke, and cardiac hospitalization, in the following year (July 1, 2021, to June 30, 2022). We performed multivariable logistic regression, adjusting for patient- and device-related characteristics.
Results
Of 40,367 patients, 38,213 (94.7%) had at least 1 in-person evaluation for CIED care. The mean patient age was 72.8 years and 97.4% were male. There were 11,248 total MACEs (27.9%), 10,777 (28.2%) among patients who had at least 1 in-person evaluation and 471 (21.9%) among those with remote-only evaluations for CIED care. After multivariable adjustment, there was no significant difference in MACE (odds ratio 1.11; 95% confidence interval 0.98–1.25) between patients who had any in-person evaluation and those who had remote-only evaluations for CIED care.
Conclusion
Among patients engaged in RM, the odds of MACE were similar regardless of whether patients had any in-person evaluations vs remote-only evaluations for CIED care.
{"title":"Outcomes associated with remote monitoring without in-person evaluations for patients with cardiovascular implantable electronic devices","authors":"Laura T. Derry MD, MBA , Mary A. Whooley MD , Merritt H. Raitt MD, FHRS , Thomas L. Rotering MPH , Hui Shen MS , Gary Tarasovsky BS , Sanket S. Dhruva MD, MHS","doi":"10.1016/j.hroo.2025.07.021","DOIUrl":"10.1016/j.hroo.2025.07.021","url":null,"abstract":"<div><h3>Background</h3><div>Traditionally, patients with cardiovascular implantable electronic devices (CIEDs) (pacemakers and implantable cardioverter-defibrillators) attend routine in-person evaluations at least annually, paired with remote monitoring (RM). Because similar data can be obtained through RM and in-person evaluations, it is unclear whether routine in-person evaluations are necessary.</div></div><div><h3>Objective</h3><div>This study aimed to compare major adverse cardiac events (MACE) in patients who did vs did not receive in-person CIED care while participating in RM.</div></div><div><h3>Methods</h3><div>We classified patients who received their CIED care within the Veterans Health Administration and sent ≥1 RM transmission between July 1, 2020, and June 30, 2021, into 2 groups based on clinician evaluation type for their CIED care: (1) at least 1 in-person evaluation or (2) remote-only evaluations. The primary outcome was MACE, a composite of all-cause mortality, stroke, and cardiac hospitalization, in the following year (July 1, 2021, to June 30, 2022). We performed multivariable logistic regression, adjusting for patient- and device-related characteristics.</div></div><div><h3>Results</h3><div>Of 40,367 patients, 38,213 (94.7%) had at least 1 in-person evaluation for CIED care. The mean patient age was 72.8 years and 97.4% were male. There were 11,248 total MACEs (27.9%), 10,777 (28.2%) among patients who had at least 1 in-person evaluation and 471 (21.9%) among those with remote-only evaluations for CIED care. After multivariable adjustment, there was no significant difference in MACE (odds ratio 1.11; 95% confidence interval 0.98–1.25) between patients who had any in-person evaluation and those who had remote-only evaluations for CIED care.</div></div><div><h3>Conclusion</h3><div>Among patients engaged in RM, the odds of MACE were similar regardless of whether patients had any in-person evaluations vs remote-only evaluations for CIED care.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 11","pages":"Pages 1752-1760"},"PeriodicalIF":2.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145546466","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}
Pub Date : 2025-11-01DOI: 10.1016/j.hroo.2025.08.034
Jackeline P. Vajta Gomez MD , Michele M. Pelter RN, PhD , Geoffrey H. Tison MD, MPH , David Mortara PhD , Fabio Badilini PhD , Yumiko Abe-Jones MS , Sandra Oreper MPH , Margaret C. Fang MD, MPH , Priya A. Prasad PhD, MPH
{"title":"Association of ventricular tachycardia burden with 30-day in-hospital mortality in an intensive care unit cohort","authors":"Jackeline P. Vajta Gomez MD , Michele M. Pelter RN, PhD , Geoffrey H. Tison MD, MPH , David Mortara PhD , Fabio Badilini PhD , Yumiko Abe-Jones MS , Sandra Oreper MPH , Margaret C. Fang MD, MPH , Priya A. Prasad PhD, MPH","doi":"10.1016/j.hroo.2025.08.034","DOIUrl":"10.1016/j.hroo.2025.08.034","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 11","pages":"Pages 1769-1772"},"PeriodicalIF":2.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145546469","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}
Pub Date : 2025-11-01DOI: 10.1016/j.hroo.2025.08.040
William H. Swain MD , John R. Giudicessi MD, PhD , Jeffrey B. Geske MD , Darrell B. Newman MD , J. Martijn Bos MD, PhD , Shahid Karim MBChB , Peter A. Noseworthy MD, MBA , Zachi I. Attia PhD , Paul A. Friedman MD , Adelaide M. Arruda-Olson MD, PhD , Michael J. Ackerman MD, PhD , Steve R. Ommen MD , Konstantinos C. Siontis MD
Background
The characteristics of patients with hypertrophic cardiomyopathy (HCM) who present with sudden cardiac arrest as the initial manifestation of the disease are not well known.
Objective
The purpose of this study was to evaluate artificial intelligence–enhanced electrocardiography (AI-ECG) and sudden cardiac death (SCD) risk factors in patients with HCM presenting with sudden cardiac arrest (SCA).
Methods
We identified patients within the Mayo Clinic enterprise (2001–2022) who were newly diagnosed with HCM after surviving SCA. Index clinical, electrocardiographic, and imaging characteristics were documented. Risk models for SCD in HCM were retrospectively applied. An AI-ECG algorithm designed for the detection of HCM was also applied to the patients’ first ECG obtained at our institution.
Results
Twenty-seven patients met the inclusion criteria. Eight patients (30%) had documented cardiac symptoms preceding SCA. Twenty-four patients (89%) had an abnormal electrocardiogram at index evaluation, and 16 (59%) had ≥1 SCD risk factor that could have qualified them for an implantable cardioverter-defibrillator if HCM had been diagnosed before SCA. Retrospective application of the European Society of Cardiology 5-year HCM Risk-SCD tool yielded a median score of 4.6% (interquartile range 3.2%–7.2%), with 12 patients (44%) having an estimated SCD risk of <4%, implying a low risk. AI-ECG indicated a high prediction score for HCM in 26 patients (96%), suggesting its potential utility as an early detector of the disease if applied before SCA.
Conclusion
Among patients with SCA who were then newly diagnosed with HCM, conventional SCD risk factors were common but not universal in this post hoc assessment. AI-ECG may facilitate the early detection of HCM.
{"title":"Artificial intelligence–enhanced electrocardiography and sudden death risk factors in cardiac arrest survivors diagnosed with hypertrophic cardiomyopathy","authors":"William H. Swain MD , John R. Giudicessi MD, PhD , Jeffrey B. Geske MD , Darrell B. Newman MD , J. Martijn Bos MD, PhD , Shahid Karim MBChB , Peter A. Noseworthy MD, MBA , Zachi I. Attia PhD , Paul A. Friedman MD , Adelaide M. Arruda-Olson MD, PhD , Michael J. Ackerman MD, PhD , Steve R. Ommen MD , Konstantinos C. Siontis MD","doi":"10.1016/j.hroo.2025.08.040","DOIUrl":"10.1016/j.hroo.2025.08.040","url":null,"abstract":"<div><h3>Background</h3><div>The characteristics of patients with hypertrophic cardiomyopathy (HCM) who present with sudden cardiac arrest as the initial manifestation of the disease are not well known.</div></div><div><h3>Objective</h3><div>The purpose of this study was to evaluate artificial intelligence–enhanced electrocardiography (AI-ECG) and sudden cardiac death (SCD) risk factors in patients with HCM presenting with sudden cardiac arrest (SCA).</div></div><div><h3>Methods</h3><div>We identified patients within the Mayo Clinic enterprise (2001–2022) who were newly diagnosed with HCM after surviving SCA. Index clinical, electrocardiographic, and imaging characteristics were documented. Risk models for SCD in HCM were retrospectively applied. An AI-ECG algorithm designed for the detection of HCM was also applied to the patients’ first ECG obtained at our institution.</div></div><div><h3>Results</h3><div>Twenty-seven patients met the inclusion criteria. Eight patients (30%) had documented cardiac symptoms preceding SCA. Twenty-four patients (89%) had an abnormal electrocardiogram at index evaluation, and 16 (59%) had ≥1 SCD risk factor that could have qualified them for an implantable cardioverter-defibrillator if HCM had been diagnosed before SCA. Retrospective application of the European Society of Cardiology 5-year HCM Risk-SCD tool yielded a median score of 4.6% (interquartile range 3.2%–7.2%), with 12 patients (44%) having an estimated SCD risk of <4%, implying a low risk. AI-ECG indicated a high prediction score for HCM in 26 patients (96%), suggesting its potential utility as an early detector of the disease if applied before SCA.</div></div><div><h3>Conclusion</h3><div>Among patients with SCA who were then newly diagnosed with HCM, conventional SCD risk factors were common but not universal in this post hoc assessment. AI-ECG may facilitate the early detection of HCM.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 11","pages":"Pages 1807-1814"},"PeriodicalIF":2.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145546470","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}
Pub Date : 2025-11-01DOI: 10.1016/j.hroo.2025.08.036
Jose Eric M. Lacsa, Doctor in Religious, Values Education
{"title":"Can safety and innovation coexist in the global expansion of laser balloon ablation?","authors":"Jose Eric M. Lacsa, Doctor in Religious, Values Education","doi":"10.1016/j.hroo.2025.08.036","DOIUrl":"10.1016/j.hroo.2025.08.036","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 11","pages":"Page 1858"},"PeriodicalIF":2.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145546471","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}
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