Heart Rhythm O2最新文献

{"title":"Real-world use of insertable cardiac monitor remote programming: A multicenter European experience","authors":"Samir Fareh MD ,&nbsp;Stefano Nardi MD ,&nbsp;Luigi Argenziano MD ,&nbsp;Luca Poggio MD ,&nbsp;Alessandro Costa MD ,&nbsp;Fernando Scala MD ,&nbsp;Alessandro Diamante MD ,&nbsp;Giovanni Luzzi MD ,&nbsp;Carlo Lavalle MD ,&nbsp;Luca Checchi MD ,&nbsp;Michele Magnocavallo MD ,&nbsp;Massimo Stefano Silvetti MD ,&nbsp;Daniele Porcelli MD ,&nbsp;Domenico Gianfrancesco MD ,&nbsp;Andrea Boncompagni MD ,&nbsp;Paul Charles MD ,&nbsp;Vittoria Marino MD ,&nbsp;Monica Campari MS ,&nbsp;Sergio Valsecchi PhD ,&nbsp;Giulio Conte PhD, MD","doi":"10.1016/j.hroo.2025.08.035","DOIUrl":"10.1016/j.hroo.2025.08.035","url":null,"abstract":"<div><h3>Background</h3><div>Insertable cardiac monitors (ICMs) enable continuous arrhythmia monitoring but generate high transmission volumes, increasing clinical workload. The LUX-Dx ICM (Boston Scientific) allows remote reprogramming of device alert settings, potentially reducing in-office visits.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the real-world use of remote reprogramming after its initial commercialization in Europe and its impact on transmission burden.</div></div><div><h3>Methods</h3><div>Deidentified data were collected from 697 consecutive patients across 23 European centers between 2022 and 2024.</div></div><div><h3>Results</h3><div>Syncope (48%) was the most frequent indication for ICM implantation. Patients were followed for a median of 9 months (25th–75th percentile 4–13). A total of 401 reprogramming events (0.8 per patient-year) occurred in 230 ICMs, with 38% (95% confidence interval 34–43) of devices reprogrammed within 1 year. Of these, 156 (39%) were performed remotely. The overall transmission rate was 3.0 per patient-month (95% confidence interval 2.9–3.1): alert transmissions (64%), scheduled transmissions (31%), patient-initiated interrogations (4%), and clinician-initiated interrogations (1%). The rate of recorded episodes varied significantly by indication (<em>P</em> &lt; .001), with bradycardia the most frequent across groups. Reprogramming significantly reduced transmission rates (median 57%; 25th–75th percentile 4–86), alerts (78%; 25th–75th percentile 11–96), and recorded episodes (91%; 25th–75th percentile 47–99) (all <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>ICM reprogramming plays a key role in optimizing device performance and reducing remote monitoring burden. Currently used in 39% of cases, remote reprogramming holds potential for broader adoption to minimize in-office visits. Efficiency may be further improved by transitioning to an alert-based monitoring strategy and eliminating scheduled transmissions.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 11","pages":"Pages 1735-1742"},"PeriodicalIF":2.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145546953","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":"Artificial intelligence and real-time directional guidance in arrhythmia management","authors":"Sanjiv M. Narayan MD, PhD, FHRS","doi":"10.1016/j.hroo.2025.08.025","DOIUrl":"10.1016/j.hroo.2025.08.025","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 11","pages":"Pages 1681-1682"},"PeriodicalIF":2.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145546940","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":"Real-world comparison of variable vs fixed-loop circular pulsed field ablation catheters: Acute outcomes including non-pulmonary vein ablation","authors":"Joerg Yogarajah MD ,&nbsp;Julie Hutter MD ,&nbsp;Patrick Kahle MD ,&nbsp;Marko Tomic MD ,&nbsp;Mirlinda Lüsebrink MD ,&nbsp;Andreas Hain MD ,&nbsp;Samuel Sossalla MD ,&nbsp;Malte Kuniss MD ,&nbsp;Thomas Neumann MD","doi":"10.1016/j.hroo.2025.08.030","DOIUrl":"10.1016/j.hroo.2025.08.030","url":null,"abstract":"<div><h3>Background</h3><div>Pulsed field ablation (PFA) is an emerging non-thermal approach for pulmonary vein isolation (PVI) in atrial fibrillation (AF). Comparative real-world data between variable-loop circular catheter (VLCC; VARIPULSE™, Biosense Webster, Inc) and fixed-loop circular catheter (FLCC; PulseSelect™, Medtronic) catheters, including non-PVI ablation, are limited.</div></div><div><h3>Objective</h3><div>To compare acute efficacy, procedural characteristics, and safety of PVI, and adjunctive ablations performed with VLCC vs FLCC during clinical implementation.</div></div><div><h3>Methods</h3><div>Overall, 90 consecutive patients were studied (first 45 VLCC and 45 FLCC cases). FLCC procedures used fluoroscopic guidance; VLCC was integrated with 3-dimensional mapping, reflecting standard real-world use of each catheter. Additional ablations were performed at the operator’s discretion. Acute outcomes and complications were analyzed.</div></div><div><h3>Results</h3><div>Acute PVI success was 100% in both groups. Additional ablations (cavotricuspid isthmus [CTI], roof lines, posterior wall, superior vena cava [SVC]) were performed in 17 (VLCC) and 15 (FLCC) patients, achieving bidirectional block without Radiofrequency touch-ups. In PVI-only cases, FLCC was associated with shorter median procedure time (67.2 vs 76 min, <em>P</em> &lt; .001), whereas VLCC had reduced fluoroscopy time (8.3 vs 11.4 min, <em>P</em> &lt; .001). Major complication rates were low and comparable (2.2% vs 0%, <em>P</em> = 1).</div></div><div><h3>Conclusion</h3><div>This first clinical comparison demonstrated high acute efficacy and favorable safety profiles, with notable procedural differences reflecting their distinct workflows of 2 circular PFA catheter systems for AF ablation. Likewise, this includes the first reported successful CTI, SVC and mitral isthmus ablation using VLCC reflecting its versatility for ablation. Further research is warranted to assess long-term outcomes and lesion durability.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 11","pages":"Pages 1706-1715"},"PeriodicalIF":2.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145546945","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":"Beyond the electrocardiogram: Equity, access, and real-world barriers to preventive cardiac screening for young athletes","authors":"Lane A. McLendon MD ,&nbsp;Madhuri S. Mulekar PhD ,&nbsp;Lynn A. Batten MD","doi":"10.1016/j.hroo.2025.08.026","DOIUrl":"10.1016/j.hroo.2025.08.026","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 11","pages":"Pages 1767-1768"},"PeriodicalIF":2.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145546468","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":"Erratum to “ID: 4348379 MAPPING THE INVISIBLE: SPATIAL ERP MAPPING AS A TARGETABLE MARKER OF ARRHYTHMOGENIC SUBSTRATE”, Volume 6, Issue 9S, pS41, September 2025","authors":"","doi":"10.1016/j.hroo.2025.10.001","DOIUrl":"10.1016/j.hroo.2025.10.001","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 11","pages":"Page 1860"},"PeriodicalIF":2.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145546473","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":"Early is on time: Minimizing implantable cardioverter-defibrillator shocks through expedited antitachycardia pacing","authors":"Steven Mullane MS ,&nbsp;Camden Harrell MS ,&nbsp;Valentina Kutyifa MD, PhD ,&nbsp;Luigi Di Biase MD, PhD ,&nbsp;Malini Madhavan MBBS ,&nbsp;Gaurav A. Upadhyay MD ,&nbsp;Jim W. Cheung MD","doi":"10.1016/j.hroo.2025.07.023","DOIUrl":"10.1016/j.hroo.2025.07.023","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 11","pages":"Pages 1722-1724"},"PeriodicalIF":2.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145546951","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":"Increased lipoprotein(a) levels independently predict a higher incidence of ventricular arrhythmias: A comprehensive retrospective cohort study","authors":"Maryam M. Sani MD, MPH,&nbsp;Tarek Harb MD,&nbsp;Thorsten M. Leucker MD, PhD,&nbsp;Jonathan Chrispin MD","doi":"10.1016/j.hroo.2025.07.001","DOIUrl":"10.1016/j.hroo.2025.07.001","url":null,"abstract":"<div><h3>Background</h3><div>Lipoprotein(a) (Lp(a)) is a causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and has been linked to ventricular arrhythmias (VA). Beyond its role in cholesterol metabolism, Lp(a) promotes endothelial dysfunction, thrombogenesis, and inflammation, which may contribute to arrhythmogenesis independent of ASCVD.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the association between Lp(a) levels and the incidence of VA in a large, population-based cohort.</div></div><div><h3>Methods</h3><div>Adults aged ≥18 years with available Lp(a) measurements were identified from the TriNetX research network. Patients were stratified into low (≤75 nmol/L) and high Lp(a) groups (&gt;75 nmol/L). The primary outcome was the incidence of VA, defined as ventricular tachycardia, fibrillation, flutter, or cardiac arrest owing to cardiac causes. Propensity score matching was used to adjust for demographics, ASCVD risk factors, and comorbidities. Kaplan-Meier survival analysis and Cox proportional hazards models were performed after matching.</div></div><div><h3>Results</h3><div>Before propensity score matching, 75,655 patients were in the low Lp(a) group and 40,860 in the high Lp(a) group. After matching, each cohort included 39,414 patients. VA occurred in 889 patients in the low and 718 in the high Lp(a) cohort. Mean follow-up was 3.35 years [low Lp(a)] and 1.90 years [high Lp(a)]. The high Lp(a) group had lower VA-free survival (84.30% vs 86.06%, <em>P</em> &lt; .01). High Lp(a) was associated with increased VA risk (hazard ratio 0.855, 95% confidence interval 0.771–0.922, <em>P</em> = .045).</div></div><div><h3>Conclusion</h3><div>Elevated Lp(a) levels are independently associated with a higher incidence of VA, even after adjusting for ASCVD and its downstream consequences. Future research should explore mechanisms and therapeutic implications.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 10","pages":"Pages 1646-1651"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145327032","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":"Simplified left cardiac sympathetic denervation as an acute strategy for recurrent ventricular tachycardia in multimorbid patients with structural heart disease: A case series","authors":"Konstantin Krieger MD ,&nbsp;Innu Park MD ,&nbsp;Thomas Kemper MD ,&nbsp;Christoph Lösel MD ,&nbsp;Beate Schädlich MD ,&nbsp;Raphael Spittler MD, MSc ,&nbsp;Maren Kirchhöfer MD ,&nbsp;Christina Lohrenz MD ,&nbsp;Stefan Meierling MD ,&nbsp;Boris Alexander Hoffmann MD, BSc","doi":"10.1016/j.hroo.2025.07.009","DOIUrl":"10.1016/j.hroo.2025.07.009","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac sympathetic denervation as a treatment for drug-refractory ventricular arrhythmias (VAs) involves video-assisted thoracoscopic removal of the stellate ganglion (SG) and thoracic ganglia. A simplified approach sparing the SG and targeting left T2–T4 ganglia (left cardiac sympathetic denervation [LCSD]) may offer a less invasive alternative.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the efficacy and safety of simplified SG-sparing LCSD as a bailout procedure for multimorbid patients with structural heart disease and recurrent VAs refractory to antiarrhythmic drugs and/or catheter ablation.</div></div><div><h3>Methods</h3><div>All patients undergoing SG-sparing LCSD at our institution between June 2023 and June 2024 were included in this single-center retrospective study. Baseline demographics, procedural complications, and arrhythmia outcomes were analyzed.</div></div><div><h3>Results</h3><div>LCSD was performed in 7 patients (mean age 75.9 ± 6.7 years, mean LVEF 30.7 ± 10.9%) with structural heart disease (nonischemic cardiomyopathy, n = 3; ischemic cardiomyopathy, n = 4) mostly 1 day (interquartile range 1–21) after admission with a procedure duration of 20.7 ± 5.3 minutes. Initially, 4 patients (57.1%) had electrical storm. Apart from 1 pleural effusion requiring drainage, no major complications or Horner’s syndrome occurred. During a follow-up of 7 ± 2.6 months, median VA episodes requiring implantable cardioverter-defibrillator therapy decreased from 14 to 2 (<em>P</em> = .021) and median implantable cardioverter-defibrillator shocks from 1.5 to 0 (<em>P</em> = .034). Three patients remained free of sustained VAs; 1 patient died of coronavirus disease 2019.</div></div><div><h3>Conclusion</h3><div>In this case series of 7 patients, SG-sparing LCSD demonstrated promising results in terms of safety and efficacy for reducing VAs. Further studies are warranted to confirm long-term outcomes with this approach.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 10","pages":"Pages 1652-1658"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145327043","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":"Leveraging artificial intelligence for risk stratification of inherited cardiomyopathies in under-resourced settings","authors":"Salah H. Alahwany MD, PhD ,&nbsp;Omnia Kamel MD ,&nbsp;Amir Abdelghany MD ,&nbsp;Ahmed Ammar MD","doi":"10.1016/j.hroo.2025.07.020","DOIUrl":"10.1016/j.hroo.2025.07.020","url":null,"abstract":"<div><div>Inherited cardiomyopathies are a significant global cause of sudden cardiac death, particularly among younger individuals and those in under-resourced regions. Despite progress in diagnostics and therapeutics, screening and risk stratification remain challenging due to genetic complexity, variable clinical presentation, and the interpretive limitations of current electrophysiological and imaging tools. Artificial intelligence (AI)—particularly machine learning, deep learning, and natural language processing offers transformative potential by enabling large-scale analysis of complex data and detecting subtle disease patterns which could potentially improve diagnostic accuracy and cost-effectiveness, particularly in low-resource environments. This review evaluates the limitations of existing risk models, synthesizes disease-specific AI applications within a unified framework, and explores the role of AI in advancing personalized care and risk prediction in underserved populations.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 10","pages":"Pages 1659-1667"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145327044","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":"Improved spatial stability with a flexible tip ablation catheter in atrial fibrillation ablation","authors":"Michael A. Hoffer-Hawlik MD, MBA ,&nbsp;Lior Jankelson MD, PhD ,&nbsp;Elizabeth Rosinski BS ,&nbsp;Yan Huo MD, PhD ,&nbsp;Isaac Shai BS ,&nbsp;Anthony Aizer MD, FHRS ,&nbsp;Douglas Holmes MD ,&nbsp;Larry A. Chinitz MD, FHRS ,&nbsp;Chirag R. Barbhaiya MD, FHRS","doi":"10.1016/j.hroo.2025.07.015","DOIUrl":"10.1016/j.hroo.2025.07.015","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"6 10","pages":"Pages 1676-1678"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145327047","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}