Indian Pacing and Electrophysiology Journal最新文献_第9页

Navigating the complex relationship between COPD severity and AF recurrence: Correspondence 导航COPD严重程度与房颤复发之间的复杂关系：对应关系。

Q3 Medicine

Indian Pacing and Electrophysiology Journal

Pub Date : 2025-09-01 DOI: 10.1016/j.ipej.2025.09.001

Parth Aphale, Shashank Dokania, Himanshu Shekhar

引用次数: 0

Chronic obstructive pulmonary disease is associated with higher recurrence rates of atrial fibrillation following catheter ablation 慢性阻塞性肺疾病与导管消融后房颤复发率升高相关

Q3 Medicine

Indian Pacing and Electrophysiology Journal

Pub Date : 2025-09-01 DOI: 10.1016/j.ipej.2025.09.006

Ree Lu , Devin Skoll , Ahmed Y. Gasmelseed , Geoffrey A. Rubin , Elaine Y. Wan , Amardeep S. Saluja , Jose M. Dizon , Angelo B. Biviano , Hasan Garan , Hirad Yarmohammadi

Background

Patients with atrial fibrillation (AF) and chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular mortality compared to patients with AF alone. Consequently, employing rhythm control strategies such as AF catheter ablation could offer substantial benefits to patients with COPD. However, the impact of COPD on AF ablation outcomes is not well established.

Methods

In this single-center case control study, we retrospectively analyzed 200 patients with AF and COPD, 52 of whom underwent AF catheter ablation. Those who underwent ablation were matched with a control group of patients with AF but without COPD who underwent ablation. Ablation outcomes were compared between the groups. Univariate and multivariable analysis were conducted for prediction of AF recurrence.

Results

Compared to the controls, cases with COPD were more likely to have AF recurrence following catheter ablation (OR 13.42, P-value = 0.0001). Multivariable analysis revealed predictors of AF recurrence following catheter ablation included decreased use of loop diuretics and amiodarone. Patients with severe or very severe COPD were more likely to have left atrial enlargement than patients with mild or moderate COPD (OR 2.28, P-value = 0.026).

Conclusion

Patients with AF and COPD were more likely than patients with AF but without COPD to experience AF recurrence following catheter ablation. Predictors of AF recurrence included decreased use of loop diuretics and amiodarone. Our study demonstrates that while ablation in patients with COPD is safe, ablation in patients with COPD is associated with higher AF recurrence rates.

背景：合并心房颤动（AF）和慢性阻塞性肺疾病（COPD）的患者与单独合并心房颤动（AF）的患者相比，心血管死亡风险增加。因此，采用心律控制策略，如房颤导管消融可以为COPD患者提供实质性的益处。然而，COPD对房颤消融结果的影响尚未得到很好的证实。方法：在这项单中心病例对照研究中，我们回顾性分析了200例房颤合并COPD患者，其中52例接受房颤导管消融治疗。接受消融术的患者与接受消融术的AF但无COPD的对照组患者相匹配。比较两组消融结果。单因素和多因素分析预测房颤复发。结果：与对照组相比，COPD患者导管消融后房颤复发的可能性更大（OR 13.42， p值=0.0001）。多变量分析显示，导管消融后房颤复发的预测因素包括环形利尿剂和胺碘酮的使用减少。重度或极重度COPD患者左房扩大发生率高于轻、中度COPD患者（or 2.28， p值=0.026）。结论：房颤合并慢性阻塞性肺病患者比房颤合并慢性阻塞性肺病患者在导管消融后房颤复发的可能性更大。房颤复发的预测因素包括减少环形利尿剂和胺碘酮的使用。我们的研究表明，虽然慢性阻塞性肺病患者的消融是安全的，但慢性阻塞性肺病患者的消融与更高的房颤复发率相关。

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引用次数: 0

ECG Challenge: Focal atrial tachycardia mimicking flutter: Diagnosis clarified by ladder diagrams 心电图挑战：局灶性房性心动过速模拟扑动：通过梯形图明确诊断。

Q3 Medicine

Indian Pacing and Electrophysiology Journal

Pub Date : 2025-09-01 DOI: 10.1016/j.ipej.2025.07.014

Erick Sánchez-Rodriguez, Jose Luis Morales-Velázquez, Pio Iran Coria Sandoval, Hugo Enrique Coutiño Moreno

We present the case of a 75-year-old man with a history of hypertension, type 2 diabetes, and concentric left ventricular hypertrophy who presented with palpitations. The initial electrocardiogram suggested atrial flutter; however, detailed analysis using a ladder diagram revealed a focal atrial tachycardia with alternating 2:1 and 3:1 conduction. Some deflections initially interpreted as flutter waves were identified as T waves, highlighting the importance of differentiating true atrial activity from ventricular repolarization. The presence of exit block further supported a focal origin. This case underscores the value of ladder diagrams in accurately interpreting complex supraventricular arrhythmias.

我们提出的情况下，一个75岁的男性高血压病史，2型糖尿病和同心性左心室肥厚谁提出心悸。初步心电图提示心房扑动；然而，使用阶梯图的详细分析显示局灶性房性心动过速交替2:1和3:1传导。一些最初被解释为扑动波的偏转被确定为T波，突出了区分真正的心房活动和心室复极的重要性。出口块的存在进一步支持了震源。本病例强调了阶梯图在准确解释复杂室上性心律失常中的价值。

引用次数: 0

Atrial fibrillation ablation: Is the Ice Age definitively over? 心房颤动消融：冰河时代已经结束了吗？

Q3 Medicine

Indian Pacing and Electrophysiology Journal

Pub Date : 2025-09-01 DOI: 10.1016/j.ipej.2025.08.001

Ahmad Awada MD , Carlo de Asmundis MD PhD , Gian-Battista Chierchia MD PhD

引用次数: 0

A regular wide QRS tachycardia with right bundle branch block morphology and left QRS axis deviation 右束支阻滞形态和左QRS轴偏离的规则宽QRS心动过速。

Q3 Medicine

Indian Pacing and Electrophysiology Journal

Pub Date : 2025-09-01 DOI: 10.1016/j.ipej.2025.09.003

Yotam Kolben , Marianna Vander , Bernard Belhassen

A 76-year-old male called an emergency medical service after his smartwatch detected rapid heart rate. ECG obtained on ambulance recorded a regular, wide QRS tachycardia (150 bpm) having a morphology of right bundle branch block and left QRS axis. Two main diagnoses were discussed: a) any type of supraventricular tachycardia associated with ventricular aberration; b) ventricular tachycardia originating close to the posterior fascicle of the left ventricle. The final diagnosis was made after performing carotid sinus massage.

一名76岁的男性在智能手表检测到心率加快后拨打了紧急医疗服务电话。在救护车上获得的心电图记录了一个规则的，宽QRS心动过速（150 bpm），具有右束分支阻滞和左QRS轴的形态。讨论了两种主要诊断：a)任何类型的室上性心动过速与心室畸变相关；B)起源于左心室左后束附近的室性心动过速。在颈动脉窦按摩后做出最终诊断。

引用次数: 0

Is Ischemia really the crux of the matter? 缺血真的是问题的关键吗？

Q3 Medicine

Indian Pacing and Electrophysiology Journal

Pub Date : 2025-09-01 DOI: 10.1016/j.ipej.2025.10.003

Samual Turnbull BSc. , Saurabh Kumar BSc(Med)/MBBS, PhD

引用次数: 0

Chronic Obstructive Pulmonary Disease is Associated with Higher Recurrence Rates of Atrial Fibrillation Following Catheter Ablation. 慢性阻塞性肺疾病与导管消融后房颤复发率升高相关

Q3 Medicine

Indian Pacing and Electrophysiology Journal

Pub Date : 2025-08-28 DOI: 10.1016/j.ipej.2025.08.009

Ree Lu, Devin Skoll, Ahmed Y Gasmelseed, Geoffrey A Rubin, Elaine Y Wan, Amardeep S Saluja, Jose M Dizon, Angelo B Biviano, Hasan Garan, Hirad Yarmohammadi

Background: Patients with atrial fibrillation (AF) and chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular mortality compared to patients with AF alone. Consequently, employing rhythm control strategies such as AF catheter ablation could offer substantial benefits to patients with COPD. However, the impact of COPD on AF ablation outcomes is not well established.

Methods: In this single-center case control study, we retrospectively analyzed 200 patients with AF and COPD, 52 of whom underwent AF catheter ablation. Those who underwent ablation were matched with a control group of patients with AF but without COPD who underwent ablation. Ablation outcomes were compared between the groups. Univariate and multivariable analysis were conducted for prediction of AF recurrence.

Results: Compared to the controls, cases with COPD were more likely to have AF recurrence following catheter ablation (OR 13.42, P-value=0.0001). Multivariable analysis revealed predictors of AF recurrence following catheter ablation included decreased use of loop diuretics and amiodarone. Patients with severe or very severe COPD were more likely to have left atrial enlargement than patients with mild or moderate COPD (OR 2.28, P-value=0.026).

Conclusion: Patients with AF and COPD were more likely than patients with AF but without COPD to experience AF recurrence following catheter ablation. Predictors of AF recurrence included decreased use of loop diuretics and amiodarone. Our study demonstrates that while ablation in patients with COPD is safe, ablation in patients with COPD is associated with higher AF recurrence rates.

背景：合并心房颤动（AF）和慢性阻塞性肺疾病（COPD）的患者与单独合并心房颤动（AF）的患者相比，心血管死亡风险增加。因此，采用心律控制策略，如房颤导管消融可以为COPD患者提供实质性的益处。然而，COPD对房颤消融结果的影响尚未得到很好的证实。方法：在这项单中心病例对照研究中，我们回顾性分析了200例房颤合并COPD患者，其中52例接受房颤导管消融治疗。接受消融术的患者与接受消融术的AF但无COPD的对照组患者相匹配。比较两组消融结果。单因素和多因素分析预测房颤复发。结果：与对照组相比，COPD患者导管消融后房颤复发的可能性更大（OR 13.42， p值=0.0001）。多变量分析显示，导管消融后房颤复发的预测因素包括环形利尿剂和胺碘酮的使用减少。重度或极重度COPD患者左房扩大发生率高于轻、中度COPD患者（or 2.28， p值=0.026）。结论：房颤合并慢性阻塞性肺病患者比房颤合并慢性阻塞性肺病患者在导管消融后房颤复发的可能性更大。房颤复发的预测因素包括减少环形利尿剂和胺碘酮的使用。我们的研究表明，虽然慢性阻塞性肺病患者的消融是安全的，但慢性阻塞性肺病患者的消融与更高的房颤复发率相关。

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引用次数: 0

Theory and Practice of Present Clinical Use of Quinidine in the Management of Cardiac Arrhythmias. 奎尼丁治疗心律失常临床应用的理论与实践。

Q3 Medicine

Indian Pacing and Electrophysiology Journal

Pub Date : 2025-08-02 DOI: 10.1016/j.ipej.2025.07.018

Bernard Belhassen, Anat Milman

At the beginning of the last century, quinidine had been shown to be highly effective in the management of atrial fibrillation and soon after of ventricular arrhythmias. At the end of the same century, quinidine was quickly abandoned, and its manufacturing ceased, resulting in limited accessibility across numerous countries. Paradoxically, this decline in use occurred alongside accumulating evidence supporting quinidine's therapeutic benefit in managing rare, life-threatening ventricular arrhythmias occurring in patients with no organic heart disease (Idiopathic ventricular fibrillation, Brugada syndrome, Early repolarization syndrome, Short QT syndrome, Multifocal ectopic Purkinje-related premature contractions), as well as those with organic heart disease involving the Purkinje network such as those occurring after acute myocardial infarction or in patients with hypertrophic cardiomyopathy. The present review will extensively deal with all these topics.

在上个世纪初，奎尼丁已被证明对房颤和室性心律失常的治疗非常有效。在同一世纪末，奎尼丁很快被放弃，其生产停止，导致许多国家的可及性有限。矛盾的是，在使用量下降的同时，越来越多的证据支持奎尼丁在治疗非器质性心脏病（特发性心室颤动、Brugada综合征、早期复极综合征、短QT期综合征、多灶异位浦肯病相关性早搏）患者中发生的罕见、危及生命的室性心律失常方面的治疗益处。以及那些涉及浦肯野网络的器质性心脏病，如急性心肌梗死后或肥厚性心肌病患者。本文将广泛讨论所有这些问题。

引用次数: 0

Long-term outcomes of ventricular tachycardia ablation in ischemic and non-ischemic cardiomyopathy patients: Data from a single center ablation registry 缺血性和非缺血性心肌病患者室性心动过速消融的长期结果：来自单中心消融登记的数据

Q3 Medicine

Indian Pacing and Electrophysiology Journal

Pub Date : 2025-07-01 DOI: 10.1016/j.ipej.2025.07.002

Reza Khosravi , Farzad Kamali , Saba Simiyari , Zahra Ghaffarinejad , Mahta Arbabi , Mozhgan Hadavi Bavil , Amin Entezari , Majid Haghjoo , Amir Farjam Fazelifar , Shabnam Madadi , Zahra Emkanjoo

Objective

Catheter ablation is effective in the treatment of ventricular tachycardia (VT). However, long-term outcomes after VT ablation in non-ischemic cardiomyopathy are sparsely described. We aimed to compare the outcomes of VT ablation between patients with ischemic cardiomyopathy (ICMP) and non-ischemic cardiomyopathy (NICMP).

Methods

Acute procedural and long-term outcomes of 212 consecutive patients (ICMP, 135; NICMP, 77) who were ablated for sustained VT and followed for a median of 36 months were gathered and analyzed.

Results

Compared with patients with NICMP, patients with ICM were older, more likely to be men, had lower LVEF, more comorbidities, and had a higher number of inducible VTs. Complete procedure success was higher in patients from the NICMP group (88.3 % in NICMP compared to 79.3 % in ICMP). VT recurrence occurred in 54.8 % of ICMP compared to 38.9 % of NICMP (P value = 0.026). The overall mortality rate was 22 % in the ICMP group, compared to 7 % in the NICMP group (P value = 0.007). Additionally, cardiac mortality occurred significantly more in the ICMP group than in the NICMP group (19 % vs. 6 %) (P value = 0.011).

Conclusion

VT ablation in patients with NICMP was found to be an effective and safe approach, achieving acute procedural success in a noticeable number of patients using the currently available catheter mapping and ablation techniques with acceptable low procedural complications. Overall, procedural failures were significantly more frequent in ICMP patients than in NICMP and were consistent with unhealthier long-term outcomes.

目的：导管消融是治疗室性心动过速的有效方法。然而，对于非缺血性心肌病室间隔消融术后的长期预后，报道较少。我们的目的是比较缺血性心肌病（ICMP）和非缺血性心肌病（NICMP）患者VT消融的结果。方法：连续212例患者的急性手术和长期预后(ICMP, 135；NICMP, 77)，因持续VT而消融，中位随访36个月的患者被收集和分析。结果：与NICMP患者相比，ICM患者年龄更大，男性更容易，LVEF更低，合并症更多，诱导性室性血栓数量更多。NICMP组患者的手术成功率更高（NICMP组为88.3%，而ICMP组为79.3%）。ICMP组的室速复发率为54.8%，NICMP组为38.9% （P值= 0.026）。ICMP组的总死亡率为22%，而NICMP组为7% （P值= 0.007）。此外，ICMP组的心脏死亡率明显高于NICMP组（19% vs. 6%）（P值= 0.011）。结论：VT消融在NICMP患者中是一种有效且安全的方法，使用目前可用的导管定位和消融技术，在可接受的低手术并发症的情况下，在相当数量的患者中获得了急性手术成功。总的来说，ICMP患者的手术失败明显比NICMP患者更频繁，并且与不健康的长期预后一致。

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引用次数: 0

Erratum regarding missing Ethical statements in previously published articles 关于先前发表的文章中缺少伦理声明的勘误。

Q3 Medicine

Indian Pacing and Electrophysiology Journal

Pub Date : 2025-07-01 DOI: 10.1016/j.ipej.2025.07.007

引用次数: 0