Heart Rhythm O2最新文献

{"title":"Impact of implantation depth and calcium burden on infranodal conduction delay after transcatheter aortic valve replacement","authors":"Andrea Papa MD,&nbsp;Teodor Serban MD,&nbsp;Ivo Strebel PhD,&nbsp;Sven Knecht DSc, PhD,&nbsp;Corinne Isenegger MMed,&nbsp;Thomas Nestelberger MD,&nbsp;Christoph Kaiser MD,&nbsp;Gregor Leibundgut MD,&nbsp;Philipp Haaf MD,&nbsp;Beat Schaer MD,&nbsp;Philipp Krisai MD,&nbsp;Stefan Osswald MD,&nbsp;Christian Sticherling MD,&nbsp;Michael Kühne MD,&nbsp;Patrick Badertscher MD","doi":"10.1016/j.hroo.2023.12.003","DOIUrl":"10.1016/j.hroo.2023.12.003","url":null,"abstract":"<div><h3>Background</h3><p>Infranodal conduction disorders are common after transcatheter aortic valve replacement (TAVR). Risk factors are incompletely understood.</p></div><div><h3>Objective</h3><p>The purpose of this study was to assess the impact of valve implantation depth and calcium burden of the device landing zone on infranodal conduction intraprocedure pre- and post-TAVR.</p></div><div><h3>Methods</h3><p>In all patients undergoing TAVR between June 2020 and June 2021, the His-ventricle (HV) interval was measured pre- and post-valve deployment. The difference between the 2 measurements defined delta HV, whereas infranodal conduction delay was defined as HV interval &gt;55 ms. Valve implantation depth was measured as the distance between the aortic annular plane and the ventricular prosthesis end. Calcium burden was quantified as the volume of calcium in 6 regions of interest: the non-, right, and left coronary cusps (NCC, RCC, and LCC, respectively) and the corresponding regions of the left ventricular outflow tract (LVOT) underlying each cusp (LVOT_NCC, LVOT_RCC, LVOT_LCC, respectively).</p></div><div><h3>Results</h3><p>Of 101 patients (mean age 81 ± 5.7 years; 47% women), 37 demonstrated infranodal conduction delay intraprocedure post-TAVR. Overall, mean implantation depth was 5 ± 3.1 mm, median calcium volume was 2080 mm³ [interquartile range 632–2400]. Delta HV showed no correlation with implantation depth or calcium burden (r = –0.08 and r = 0.12, respectively). However, LVOT_NCC calcification was a significant predictor for infranodal conduction delay post-valve deployment in a multivariable logistic regression model (odds ratio 1.62 per 100-mm³ increase (95% confidence interval 1.06–2.69; <em>P</em> = .04).</p></div><div><h3>Conclusion</h3><p>Assessment of LVOT_NCC calcification may identify patients at risk for infranodal conduction delay after TAVR, whereas implantation depth did not predict infranodal conduction delay.</p></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501823003331/pdfft?md5=e6605a3bc18bceee3c6128c0d47a4664&pid=1-s2.0-S2666501823003331-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139017485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing cardiac contractile motion for noninvasive radioablation of ventricular tachycardia","authors":"Bryan Wu MD ,&nbsp;Todd Atwood PhD, DABR ,&nbsp;Arno J. Mundt MD ,&nbsp;Jennifer Karunamuni MD ,&nbsp;Paul Stark MD ,&nbsp;Albert Hsiao MD, PhD ,&nbsp;Frederick Han MD ,&nbsp;Jonathan C. Hsu MD MAS ,&nbsp;Kurt Hoffmayer MD PharmD ,&nbsp;Farshad Raissi MD ,&nbsp;Ulrika Birgersdotter-Green MD ,&nbsp;Gregory Feld MD ,&nbsp;David E. Krummen MD ,&nbsp;Gordon Ho MD","doi":"10.1016/j.hroo.2023.12.006","DOIUrl":"10.1016/j.hroo.2023.12.006","url":null,"abstract":"<div><h3>Background</h3><p>Respiratory motion management strategies are used to minimize the effects of breathing on the precision of stereotactic ablative radiotherapy for ventricular tachycardia, but the extent of cardiac contractile motion of the human heart has not been systematically explored.</p></div><div><h3>Objective</h3><p>We aim to assess the magnitude of cardiac contractile motion between different directions and locations in the heart.</p></div><div><h3>Methods</h3><p>Patients with intracardiac leads or valves who underwent 4-dimensional cardiac computed tomography (CT) prior to a catheter ablation procedure for atrial or ventricular arrhythmias at 2 medical centers were studied retrospectively. The displacement of transvenous right atrial appendage, right ventricular (RV) implantable cardioverter-defibrillator, coronary sinus lead tips, and prosthetic cardiac devices across the cardiac cycle were measured in orthogonal 3-dimensional views on a maximal-intensity projection CT reconstruction.</p></div><div><h3>Results</h3><p>A total of 31 preablation cardiac 4-dimensional cardiac CT scans were analyzed. The LV lead tip had significantly greater motion compared with the RV lead in the anterior-posterior direction (6.0 ± 2.2 mm vs 3.8 ± 1.7 mm; <em>P =</em> .01) and superior-inferior direction (4.4 ± 2.9 mm vs 3.5 ± 2.0 mm; <em>P =</em> .049). The prosthetic aortic valves had the least movement of all fiducials, specifically compared with the RV lead tip in the left-right direction (3.2 ± 1.2 mm vs 6.1 ± 3.8 mm, <em>P =</em> .04) and the LV lead tip in the anterior-posterior direction (3.8 ± 1.7 mm vs 6.0 ± 2.2 mm, <em>P =</em> .03).</p></div><div><h3>Conclusion</h3><p>The degree of cardiac contractile motion varies significantly (1 mm to 15.2 mm) across different locations in the heart. The effect of contractile motion on the precision of radiotherapy should be assessed on a patient-specific basis.</p></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501823003367/pdfft?md5=2949eb2bc7066c6e2844bf7355d4008d&pid=1-s2.0-S2666501823003367-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139191839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in the 30-year span of Noninfectious Cardiovascular Implantable Electronic Device Complications in Olmsted County","authors":"Gurukripa N. Kowlgi, Vaibhav Vaidya, Mingyan Dai, Pragyat Futela, Rahul Mishra, David O. Hodge, Abhishek J. Deshmukh, S. Mulpuru, Paul A. Friedman, Yong- Mei Cha","doi":"10.1016/j.hroo.2024.02.001","DOIUrl":"https://doi.org/10.1016/j.hroo.2024.02.001","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139816704","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":"Ultrasound-guided Explant Technique for Implantable Loop Recorder in Patients with High Body Mass Index: A Practical Approach","authors":"Chokanan Thaitirarot, Shirley Sze, Sue Armstrong, Riyaz Somani","doi":"10.1016/j.hroo.2024.01.009","DOIUrl":"https://doi.org/10.1016/j.hroo.2024.01.009","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139823704","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":"Outcomes and Care Quality Metrics for People Living with Rheumatic Heart Disease and Atrial Fibrillation in Uganda","authors":"Chinonso C. Opara, Roy H. Lan, J. Rwebembera, E. Okello, David Watkins, Andrew Y Chang, Chris T Longenecker","doi":"10.1016/j.hroo.2024.02.002","DOIUrl":"https://doi.org/10.1016/j.hroo.2024.02.002","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139831431","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":"A pilot study of longitudinal changes in neurocognition, white matter hyperintensities, and cortical thickness in atrial fibrillation patients following catheter ablation vs medical management","authors":"Hannah Schwennesen MD ,&nbsp;Jeffrey N. Browndyke PhD ,&nbsp;Mary Cooter Wright MS ,&nbsp;Marat Fudim MD, MHS ,&nbsp;James P. Daubert MD, FHRS ,&nbsp;Mark F. Newman MD ,&nbsp;Joseph P. Mathew MD, MHS, MBA ,&nbsp;Jonathan P. Piccini MD, MHS, FHRS","doi":"10.1016/j.hroo.2024.01.002","DOIUrl":"10.1016/j.hroo.2024.01.002","url":null,"abstract":"<div><h3>Background</h3><p>Cerebral microembolization and atrophy complicate atrial fibrillation (AF).</p></div><div><h3>Objectives</h3><p>We aimed to compare changes in neuroimaging findings between AF patients treated with catheter ablation and those treated with medical therapy.</p></div><div><h3>Methods</h3><p>In this pilot study, we evaluated differences in the change in regional white matter hyperintensity burden (WMHb) and cognitive function from baseline to 6 weeks and 1 year in patients treated with AF ablation (n = 12) and patients treated with medical management alone (n = 11). Change in cortical thickness over time in Alzheimer’s disease (AD) risk, aging-associated, and shared AD risk/aging regions was also compared between groups.</p></div><div><h3>Results</h3><p>The mean age was 69.7 ± 5.0 years, 78% of patients were male, 39% had persistent AF, and all received oral anticoagulation. There were no significant differences between groups in the change in cognitive function. At 6 weeks, there were no significant differences in periventricular WMHb changes between groups (0.00 vs 0.04, <em>P =</em> .12), but changes in attention/concentration were inversely correlated with periventricular (<em>P =</em> .01) and total (<em>P =</em> .03) WMHb. Medical management patients demonstrated significantly greater cortical thinning in AD risk regions from baseline to 1 year (<em>P =</em> .003).</p></div><div><h3>Conclusions</h3><p>AF patients who underwent ablation demonstrated less cortical thinning in regions associated with AD risk than patients treated with medical therapy. Larger, prospective studies are needed to better understand the relationship between AF therapies and the development of cognitive decline.</p></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501824000023/pdfft?md5=638b81a1abf749ab009bbdfe43b1335d&pid=1-s2.0-S2666501824000023-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139455632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherent skin barrier drape use is associated with a reduced risk of cardiac implantable device infection: Results from a prospective study of 14,225 procedures","authors":"Mehrdad Golian MD ,&nbsp;Nicolas M. Berbenetz MD ,&nbsp;Roupen Odabashian MD ,&nbsp;Mouhannad M. Sadek MD ,&nbsp;Vicente Corrales-Medina MD ,&nbsp;Alper Aydin MD ,&nbsp;Darryl R. Davis MD ,&nbsp;Martin S. Green MD ,&nbsp;Andres Klein MD ,&nbsp;Girish M. Nair MBBS, MSc ,&nbsp;Pablo B. Nery MD ,&nbsp;F. Daniel Ramirez MD ,&nbsp;Calum Redpath MBChB, PhD ,&nbsp;Simon P. Hansom MBBS ,&nbsp;David H. Birnie MBChB, MD","doi":"10.1016/j.hroo.2023.12.002","DOIUrl":"10.1016/j.hroo.2023.12.002","url":null,"abstract":"<div><h3>Background</h3><p>Cardiac implantable electronic device (CIED) infection is a costly and highly morbid complication. Perioperative interventions, including the use of antibiotic pouches and intensified perioperative antibiotic regimens, have demonstrated marginal efficacy at reducing CIED infection. Additional research is needed to identify additional interventions to reduce infection risk.</p></div><div><h3>Objective</h3><p>We sought to evaluate whether adherent skin barrier drape use is associated with a reduction in CIED infection.</p></div><div><h3>Methods</h3><p>A prospective registry of all CIED implantation procedures was established at our institution in January 2007. The registry was established in collaboration with our hospital infection prevention team with a specific focus on prospectively identifying all potential CIED infections. All potential CIED infections were independently adjudicated by 2 physicians blinded to the use of an adherent skin barrier drape.</p></div><div><h3>Results</h3><p>Over a 13-year period, 14,225 procedures were completed (mean age 72 ± 14 years; female 4,918 (35%); new implants 10,005 (70%); pulse generator changes 2585 (18%); upgrades 1635 (11%). Of those, 2469 procedures (17.4%) were performed using an adherent skin barrier drape. There were 103 adjudicated device infections (0.73%). The infection rate in patients in the barrier use groups was 8 of 2469 (0.32%) as compared with 95 of 11,756 (0.8%) in the nonuse group (<em>P</em> = .0084). In multivariable analysis, the use of an adherent skin barrier drape was independently associated with a reduction in infection (odds ratio 0.32; 95% confidence interval 0.154–0.665; <em>P</em> = .002).</p></div><div><h3>Conclusion</h3><p>The use of an adherent skin barrier drape at the time of cardiac device surgery is associated with a lower risk of subsequent infection.</p></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266650182300332X/pdfft?md5=7ae2e56093fbccce9a00a935104edd69&pid=1-s2.0-S266650182300332X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138993096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pericarditis prophylactic therapy after sinus node–sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia","authors":"Carlo de Asmundis MD, PhD ,&nbsp;Lorenzo Marcon MD ,&nbsp;Luigi Pannone MD ,&nbsp;Domenico Giovanni Della Rocca MD, PhD ,&nbsp;Dhanunjaya Lakkireddy MD ,&nbsp;Thomas M. Beaver MD ,&nbsp;Chad R. Brodt MD ,&nbsp;Cinzia Monaco MD ,&nbsp;Antonio Sorgente MD, PhD ,&nbsp;Charles Audiat MD ,&nbsp;Giampaolo Vetta MD ,&nbsp;Robbert Ramak MSc ,&nbsp;Ingrid Overeinder MD ,&nbsp;Rani Kronenberger MD ,&nbsp;Gezim Bala MD, PhD ,&nbsp;Alexandre Almorad MD ,&nbsp;Erwin Ströker MD, PhD ,&nbsp;Juan Sieira MD, PhD ,&nbsp;Andrea Sarkozy MD, PhD ,&nbsp;Pedro Brugada MD, PhD ,&nbsp;Mark La Meir MD, PhD","doi":"10.1016/j.hroo.2024.01.001","DOIUrl":"10.1016/j.hroo.2024.01.001","url":null,"abstract":"<div><h3>Background</h3><p>Pericarditis is the most common complication following hybrid sinus node–sparing ablation for inappropriate sinus tachycardia (IST)/postural orthostatic tachycardia syndrome (POTS).</p></div><div><h3>Objective</h3><p>The study sought to evaluate the association of prophylaxis therapy on the risk of symptomatic pericarditis following hybrid IST/POTS ablation.</p></div><div><h3>Methods</h3><p>All consecutive patients undergoing to hybrid ablation of symptomatic IST/POTS refractory or intolerant to drugs were retrospectively analyzed. Pharmacological prophylaxis therapy was based on acetylsalicylic acid and colchicine started on the day of the ablation and continued for at least 3 months. The primary endpoint was occurrence of symptomatic pericarditis. The secondary endpoint was occurrence of pericarditis-related complications, including the following: duration of pericarditis &gt;3 months, hospitalization for pericarditis, postpericardiectomy pleuro-pericarditis, and pericardiectomy.</p></div><div><h3>Results</h3><p>A total of 220 patients undergone to hybrid IST/POTS ablation were included and 44 (20%) underwent prophylaxis therapy. Pericarditis occurred in 101 (45.9%) patients, with 97 (96%) in the first 5 days. At survival analysis, prophylaxis was associated with higher rate of freedom from pericarditis (81.9% vs 47.2%, log-rank <em>P &lt;</em> .001). Pericarditis-related complications were low, occurring in 7 (3.2%) patients. There was no difference in pericarditis-related complications between the patients who underwent prophylaxis therapy and patients who did not. At Cox multivariate analysis, predictors of pericarditis were IST (vs POTS) (hazard ratio 0.61, 95% confidence interval0.39-0.99, <em>P =</em> .04) and prophylaxis therapy (hazard ratio 0.27, 95% confidence interval 0.13-0.55, <em>P &lt;</em> .001).</p></div><div><h3>Conclusion</h3><p>In a large cohort of patients undergoing hybrid ablation for IST/POTS, a prophylaxis therapy with acetylsalicylic acid and colchicine was associated with a lower rate of symptomatic pericarditis.</p></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501824000011/pdfft?md5=9f46165f344d67d969191d2a71433634&pid=1-s2.0-S2666501824000011-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139454731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of Sports for Patients with Subcutaneous Implantable Cardioverter Defibrillator (SPORT S-ICD): Study rationale and protocol","authors":"E. Chorin, Rachel Lampert, Nick R. Bijsterveld, R. Knops, A. A. Wilde, Hein Heidbuchel, Andrew Krahn, Ilan Goldenberg, Raphael Rosso, D. Viskin, Shir Frydman, Lior Lupu, Sami Viskin","doi":"10.1016/j.hroo.2024.01.007","DOIUrl":"https://doi.org/10.1016/j.hroo.2024.01.007","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139831234","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":"Only the strong survive: The impact of frailty on patients undergoing leadless pacemaker implantation","authors":"Marye J. Gleva MD,&nbsp;Karen Joynt Maddox MD, MPH","doi":"10.1016/j.hroo.2024.01.003","DOIUrl":"10.1016/j.hroo.2024.01.003","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666501824000047/pdfft?md5=7fcf83db98f7b0afb5272b3d6219639d&pid=1-s2.0-S2666501824000047-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139639575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}