IJC Heart and Vasculature最新文献

{"title":"Fibrinogen-to-albumin ratio as a novel biomarker for risk assessment in clinically suspected acute myocarditis","authors":"Lihi Levi-Gofman ,&nbsp;Shaul Atar ,&nbsp;Gassan Moady","doi":"10.1016/j.ijcha.2025.101791","DOIUrl":"10.1016/j.ijcha.2025.101791","url":null,"abstract":"<div><h3>Background</h3><div>Acute myocarditis typically follows a benign course, but fatal complications may occur in fulminant cases. Evaluation is based on clinical, laboratory, and imaging parameters. We aimed to assess the prognostic value of the fibrinogen-to-albumin ratio (FAR) in patients with clinically suspected myocarditis.</div></div><div><h3>Methods</h3><div>Echocardiographic, laboratory, and clinical parameters were obtained from patients with clinically suspected myocarditis. We assessed the correlations between troponin, albumin, fibrinogen, FAR, left ventricular ejection fraction (LVEF), and complications during the index hospitalization. Repeat echocardiography was performed in patients with reduced LVEF. Several potential factors were tested for their ability to predict LVEF recovery.</div></div><div><h3>Results</h3><div>A total of 118 patients were included (80 % male; median age, 35 years; mean LVEF, 55 %). Median troponin level was 2558 ng/L, and the median fibrinogen-to-albumin ratio (FAR) was 120. In 38 patients (32 %), LVEF was reduced; among them, 15 (39 %) had persistently reduced LVEF on repeat echocardiography. Troponin levels and FAR were inversely correlated with reduced LVEF (r = –0.28, p = 0.002 and r = –0.31, p = 0.001, respectively). FAR remained an independent factor after adjustment for age and sex. Neither troponin nor FAR was associated with persistently reduced LVEF on follow-up echocardiography. In addition, high FAR was not correlated with longer length of stay (LOS) (p = 0.07), readmissions (p = 0.29), or complications during hospitalization (p = 0.22).</div></div><div><h3>Conclusion</h3><div>FAR is associated with reduced LVEF and may reflect disease severity in clinically suspected myocarditis; however, it does not appear to be useful for long-term prediction.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101791"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007676","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":"Use of the novel virtual myectomy in guiding thoracoscopic myectomy for patients with hypertrophic obstructive cardiomyopathy","authors":"Peijian Wei ,&nbsp;Tong Tan ,&nbsp;Shengwen Wang ,&nbsp;Jiexu Ma ,&nbsp;Guanyu Lu ,&nbsp;Haozhong Liu ,&nbsp;Hanxiang Xie ,&nbsp;Wei Zhu ,&nbsp;Jian Zhuang ,&nbsp;Jian Liu ,&nbsp;Huiming Guo","doi":"10.1016/j.ijcha.2025.101795","DOIUrl":"10.1016/j.ijcha.2025.101795","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate the efficacy of a novel virtual myectomy procedure in guiding thoracoscopic <em>trans</em>-mitral myectomy.</div></div><div><h3>Methods and Results</h3><div>Clinical data from 37 patients who underwent thoracoscopic <em>trans</em>-mitral septal myectomy guided by virtual myectomy between April 2019 and October 2021 were retrospectively analyzed. Enhanced cardiac CT images were imported into Mimics software to perform virtual myectomy. The short-axis two-chamber plane, perpendicular to the interventricular septum (IVS), was marked for each segment from the basal septum to the apex. IVS thickness was continuously measured at each marked segment, and a figurative digital model determined the resection extent. The cohort consisted of 22 women (59.46 %) with a mean age of 53.14 ± 13.62 years. No deaths or permanent pacemaker implantations occurred. Septal thickness decreased significantly from 20.49 ± 3.85 to 11.28 ± 2.53 mm (P &lt; 0.001), resulting in a marked reduction in obstruction (90.84 ± 28.78 to 11.59 ± 11.06 mmHg, P &lt; 0.001). Twelve patients (32.43 %) underwent mitral valve replacement. The virtual resection’s length, width, thickness, and volume showed strong positive correlations with the actual resection (R = 0.76–0.89). The virtual model’s septal thickness was moderately correlated with the actual resection volume (R = 0.51, P &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>Virtual myectomy effectively guided septal myectomy, with favorable outcomes in selected patients. This approach, combined with preoperative 3D simulation and printing, enables precise planning for complex cases<strong>.</strong></div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101795"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118217","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":"Mental stress is associated with coronary endothelial dysfunction in women with chest pain and non-obstructive coronary artery disease","authors":"Jaskanwal Deep S Sara ,&nbsp;Nazanin Rajai ,&nbsp;Scott Breitinger ,&nbsp;Betsy Medina-Inojosa ,&nbsp;Lilach O Lerman ,&nbsp;Amir Lerman","doi":"10.1016/j.ijcha.2025.101802","DOIUrl":"10.1016/j.ijcha.2025.101802","url":null,"abstract":"<div><h3>Objective</h3><div>We evaluate the association between chronic mental stress (MS) and coronary endothelial function in patients with chest pain and nonobstructive coronary artery disease (CAD) separately in males and females.</div></div><div><h3>Methods</h3><div>Patients with nonobstructive CAD (stenosis &lt;40 %) at coronary angiography underwent an invasive assessment for coronary endothelial dysfunction (CED). Macrovascular CED was defined as a percentage change in coronary artery diameter<!--> <!-->to acetylcholine (%ΔCADAch) ≤ −10 % and microvascular CED was defined as a percentage change in coronary blood flow<!--> <!-->to acetylcholine (%ΔCBFAch) ≤−50 %. Patients completed a questionnaire within 2 years of the index procedure that included questions regarding chronic MS. The frequency of macrovascular, microvascular and any type of CED was compared across groups. Logistic regression analyses were performed to assess the association between MS and CED.</div></div><div><h3>Results</h3><div>Between January 2017 and December 2022, 211 patients (mean (sd) age 54.4 (13.6) yrs, 71.0 % female) were included. One hundred forty-two (67.3 %)<!--> <!-->patients had any type of CED. In females with significant MS there was a higher proportion of individuals with any type of CED compared to without CED (43 (42.6 %) vs. 12 (24.5 %), p = 0.0362). In a multivariable analysis<!--> <!-->MS was associated with any type of CED in females: OR (95 % CI) 2.70 (1.24–6.25); p = 0.0156.</div></div><div><h3>Conclusion</h3><div>Chronic MS is associated with CED in females with chest pain and nonobstructive CAD. Chronic MS may<!--> <!-->underly the mechanism for chest pain in these patients<!--> <!-->and<!--> <!-->may play a contributory<!--> <!-->to<!--> <!-->cardiovascular disease through its association with<!--> <!-->endothelial dysfunction.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101802"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118221","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":"Sex-related differences in myocardial fibrosis among patients with aortic stenosis: A systematic review and meta-analysis","authors":"Paul C. Onyeji ,&nbsp;Shivank Dani ,&nbsp;Sonise Momplaisir-Onyeji ,&nbsp;Miguel C. Lenzi ,&nbsp;Paweł Łajczak ,&nbsp;Felipe S. Passos ,&nbsp;Leo Consoli ,&nbsp;Hristo Kirov ,&nbsp;Torsten Doenst ,&nbsp;Tulio Caldonazo","doi":"10.1016/j.ijcha.2025.101814","DOIUrl":"10.1016/j.ijcha.2025.101814","url":null,"abstract":"<div><h3>Background</h3><div>Aortic stenosis (AS) leads to pathological myocardial remodeling, particularly fibrosis, which contributes to adverse outcomes including heart failure, arrhythmias, and mortality. Evidence suggests sex-specific differences in fibrotic response, but individual studies are underpowered for definitive conclusions. This <em>meta</em>-analysis aimed to evaluate sex-related differences in myocardial fibrosis using cardiac magnetic resonance (CMR) parameters.</div></div><div><h3>Methods</h3><div>Three databases were searched for studies comparing male and female patients with AS reporting CMR-derived measures. The primary outcomes were late gadolinium enhancement (LGE%), infarct-related and non-infarct-related LGE, extracellular volume (ECV) and Septal E/e′. Effect sizes were expressed as risk ratios (RR) for binary outcomes and mean differences (MD) for continuous outcomes, each with 95% confidence intervals (CI), using random-effects models. Study quality was appraised with the Newcastle–Ottawa Scale, and certainty of evidence was graded using the GRADE framework.</div></div><div><h3>Results</h3><div>Seven studies (n = 2,105; 1,246 males) were included. No significant difference was observed in LGE% (MD 0.13; 95 %CI −0.93 to 1.18; p = 0.770), and risks of infarct-related LGE between sexes (RR 1.61; 95 %CI 0.90 to 2.89; p = 0.080). Males had higher risk of non-infarct LGE (RR 1.51; 95 %CI 1.34 to 1.70; p = 0.002). There were no significant differences in ECV (MD −0.45; 95 %CI −2.34 to 1.44; p = 0.506) and Septal E/e′ between sexes (MD −1.87; 95 %CI −4.05 to 0.32; p = 0.072).</div></div><div><h3>Conclusion</h3><div>This <em>meta</em>-analysis shows sex-related differences in myocardial fibrosis in AS, with men exhibiting more focal replacement fibrosis and women a tendency toward diffuse interstitial fibrosis. These patterns highlight the relevance of incorporating sex-specific factors into diagnosis and management.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101814"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220595","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":"High-sensitivity C-reactive protein is associated with altered cardiac structure and function in psoriasis: The PSOCADIA study","authors":"Maria Dons ,&nbsp;Morten Sengeløv ,&nbsp;Kristoffer Grundtvig Skaarup ,&nbsp;Niklas Dyrby Johansen ,&nbsp;Mats C.H. Lassen ,&nbsp;Sofie Bøgh-Sørensen ,&nbsp;Julie I.H. Borchsenius ,&nbsp;Filip Soeskov Davidovski ,&nbsp;Nino E. Landler ,&nbsp;Christoffer V. Nissen ,&nbsp;Peter Riis Hansen ,&nbsp;Brittany N. Weber ,&nbsp;Claus Zachariae ,&nbsp;Lone Skov ,&nbsp;Tor Biering-Sørensen","doi":"10.1016/j.ijcha.2025.101832","DOIUrl":"10.1016/j.ijcha.2025.101832","url":null,"abstract":"<div><h3>Background</h3><div>High sensitivity C-reactive protein (hsCRP) is a biomarker of systemic inflammation that may be associated with cardiovascular risk in psoriasis. We assessed the relationship between hsCRP levels and cardiac structure and function in a large cross-sectional cohort study of individuals with psoriasis.</div></div><div><h3>Methods</h3><div>Adults with psoriasis underwent hsCRP testing and transthoracic echocardiography. Myocardial dysfunction was defined as left ventricular ejection fraction &lt; 50 % and/or global longitudinal strain (GLS) &lt; 16 %. Diastolic dysfunction followed standard echocardiographic guidelines. Associations between hsCRP tertiles, cardiometabolic risk factors, and cardiac structure and function were evaluated. Logistic regression assessed odds of myocardial dysfunction with hsCRP &gt; 2 mg/L.</div></div><div><h3>Results</h3><div>972 adults with psoriasis were prospectively included (median age 54 years, 44.9 % women, 75.2 % moderate-to-severe psoriasis). Median hsCRP was 1.14 mg/L. Lower hsCRP levels were linked to greater biologic therapy use. Higher hsCRP was associated with older age, female sex, increased body mass index, and greater cardiometabolic risk factor burden.</div><div>The highest hsCRP tertile had greater rates of myocardial dysfunction (28.8 %) and diastolic dysfunction (31.3 %) compared to the lowest tertile (17.6 % and 21.8 %, respectively, p &lt; 0.05 for both). After multivariable adjustment, increasing hsCRP was associated with impaired GLS and LVEF, and an hsCRP &gt; 2 mg/L was independently associated with a 45 % increased odds of myocardial dysfunction (OR 1.45, 95 % CI: 1.02 – 2.07, p = 0.042).</div></div><div><h3>Conclusions</h3><div>In psoriasis, elevated hsCRP was independently associated with impaired systolic function, reflected by reduced GLS and LVEF. These findings suggest systemic inflammation may be involved in early myocardial dysfunction in this population.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101832"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465379","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":"Association of complete revascularization with safety and outcomes in elderly patients with multi-vessel coronary artery disease: a systematic review and meta-analysis","authors":"David T. Zhang ,&nbsp;Matt Raven ,&nbsp;Manasa Dondapati ,&nbsp;Ravi Masson ,&nbsp;Puja B. Parikh ,&nbsp;Travis Bench ,&nbsp;John P. Reilly ,&nbsp;Michael Tao","doi":"10.1016/j.ijcha.2025.101825","DOIUrl":"10.1016/j.ijcha.2025.101825","url":null,"abstract":"<div><h3>Background</h3><div>The utility of complete revascularization has been well defined in young patients with acute coronary syndrome (ACS) and multivessel coronary artery disease (CAD). However, the clinical benefit in elderly patients remains unclear with current literature has yielded conflicting results. This meta-analysis aims to evaluate the association of complete versus culprit-only coronary revascularization with mortality in elderly patients with multivessel CAD.</div></div><div><h3>Methods</h3><div>A literature search was conducted for studies reporting on outcomes after complete versus culprit-only revascularization in elderly patients with multivessel CAD presenting with ACS. The primary endpoint was all-cause mortality. The main secondary endpoint was cardiovascular (CV) mortality. The search included the following databases: PubMed, EMBASE, and Web of Science. The search was not restricted to time or publication status.</div></div><div><h3>Results</h3><div>14 studies with 11,994 elderly patients (7,236 with culprit-only, 4,758 with complete revascularization) met inclusion criteria. Mean follow-up duration was 29.0 months (range 12–56 months), mean age was 79.5 years old, 56.9% of patients were men, and mean left ventricular ejection fraction was 54.3%. Patients who underwent complete revascularization had significantly lower all-cause and CV mortality compared to culprit-only revascularization (OR 1.75, 95% CI 1.40–2.18; p &lt; 0.001; OR 1.75, 95% CI 1.14–2.68; p = 0.01). Subgroup analysis demonstrated this association to be statistically significant for studies with cohorts presenting with non-ST segment elevation myocardial infarction (NSTEMI) and mixed cohorts that included NSTEMI and ST segment elevation myocardial infarction (STEMI) patients. However, there was no significant difference in risk of all-cause mortality with complete versus culprit-only revascularization in studies of only STEMI patients (OR 1.03, 95% CI 0.61–1.72; p = 0.92).</div></div><div><h3>Conclusion</h3><div>Complete coronary revascularization is associated with lower risk of all-cause and CV mortality in elderly patients with multivessel CAD presenting with NSTEMI. However, there does not appear to be a difference in outcomes in patients presenting with STEMI.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101825"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145362285","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":"Evaluating artificial intelligence-enabled medical tests in cardiology: Best practice","authors":"Jonas L. Isaksen ,&nbsp;Malene Nørregaard ,&nbsp;Martin Manninger ,&nbsp;Dobromir Dobrev ,&nbsp;Thomas Jespersen ,&nbsp;Ben Hermans ,&nbsp;Jordi Heijman ,&nbsp;Gernot Plank ,&nbsp;Daniel Scherr ,&nbsp;Thomas Pock ,&nbsp;Vajira Thambawita ,&nbsp;Michael A. Riegler ,&nbsp;Jørgen K. Kanters ,&nbsp;Dominik Linz","doi":"10.1016/j.ijcha.2025.101783","DOIUrl":"10.1016/j.ijcha.2025.101783","url":null,"abstract":"<div><div>Machine learning methods are increasingly used in cardiovascular research. In order to highlight opportunities and challenges of the evaluation of studies applying machine learning, we use examples from cardiac electrophysiology, a field characterized by large and often imbalanced amounts of data. We provide recommendations and guidance on evaluating and presenting supervised machine learning studies. We recommend proper cohort selection, keeping training and testing data strictly separate, and comparing results to a reference model without machine learning as basic principles to ensure the quality of studies using machine learning methods. We furthermore recommend specific metrics and plots when reporting on machine learning including on models for multi-channel time series or images. This Best Practice paper represents a possible blueprint to help evaluate machine learning-based medical tests in cardiac electrophysiology and beyond.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101783"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917731","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":"Recent highlights from the International Journal of Cardiology Heart and Vasculature: cardio-oncology","authors":"Anke Fender ,&nbsp;Florian Bruns ,&nbsp;Dobromir Dobrev","doi":"10.1016/j.ijcha.2025.101780","DOIUrl":"10.1016/j.ijcha.2025.101780","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101780"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902504","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-assisted CCTA quantifies sex differences in coronary atherosclerotic burden at low atheroma volumes","authors":"Zoee D’Costa ,&nbsp;Ronald P. Karlsberg ,&nbsp;Geoffrey W. Cho","doi":"10.1016/j.ijcha.2025.101758","DOIUrl":"10.1016/j.ijcha.2025.101758","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery disease (CAD) manifests differently between sexes, with data suggesting females develop more non-calcified plaques that traditional calcium-centric tools may not detect.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of 100 individuals with low total atheroma volume (TAV) &lt; 250 mm³ using artificial intelligence (AI)-enabled coronary computed tomography angiography (CCTA) to assess sex-based differences in coronary plaque composition. Plaque subtypes included calcified, non-calcified, and low-density non-calcified atheroma volumes.</div></div><div><h3>Results</h3><div>Females had significantly lower total (p = 0.018) and non-calcified plaque (p &lt; 0.001) burden compared to males. Calcified (p = 0.52) and low-density non-calcified (p = 0.16) plaque volumes did not differ significantly. Age was a consistent predictor of plaque volume across most subtypes.</div></div><div><h3>Conclusions</h3><div>Despite low overall plaque burden, males demonstrated a higher non-calcified plaque burden than females. This finding contrasts with previous literature and underscores the potential of AI-enabled CCTA to detect subclinical coronary disease, particularly in low-risk cohorts. These results support the use of comprehensive plaque profiling in both sexes to improve early risk stratification.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101758"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714136","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":"Comparison of clinical outcomes between catheter ablation and permanent pacemaker implantation in Tachycardia-Bradycardia Syndrome patients: a meta-analysis","authors":"Sunu Budhi Raharjo ,&nbsp;Emir Yonas ,&nbsp;Sarah Naura Irbah ,&nbsp;Dicky Armein Hanafy ,&nbsp;Muhammad Rizky Felani ,&nbsp;Aldo Ferly ,&nbsp;Fa Po Chung","doi":"10.1016/j.ijcha.2025.101767","DOIUrl":"10.1016/j.ijcha.2025.101767","url":null,"abstract":"<div><h3>Introduction</h3><div>Tachycardia-Bradycardia Syndrome (TBS) is a clinical disorder resulting from complications associated with sick sinus syndrome (SSS). In patients with SSS, TBS is marked by alternating episodes of tachycardia and bradycardia. This <em>meta</em>-analysis aims to evaluate and compare the differences in clinical outcomes between ablation and pacemaker treatments for TBS.</div></div><div><h3>Methods</h3><div>We performed a systematic search on libraries, including PubMed, EuropePMC, SCOPUS, Cochrane Central, and medRxiv, for preprint studies. The search terms used were “Tachycardia Bradycardia Syndrome,” “Pacing,” and “Ablation” between the pacing and ablation groups in TBS patients. Review Manager Software Version 5.4 (Cochrane Collaboration) was used to perform the <em>meta</em>-analysis.</div></div><div><h3>Results</h3><div>We identified 1,138 potential articles from our search, and 521 duplicates were removed. After screening the titles and abstracts of the remaining 662 articles, we obtained 23 potentially relevant articles. Finally, we included the remaining eight studies in our qualitative synthesis and <em>meta</em>-analysis, which comprised 1,266 patients.</div><div>Catheter ablation was associated with a lower incidence of AF recurrence (OR of 0.09 [0.04, 0.22; p &lt; 0.001], with moderate heterogeneity (I² = 76 %, p &lt; 0.001), stroke (OR of 0.28 [0.14, 0.53; p &lt; 0.001] low heterogeneity I² = 0 %, p = 0.99 favouring the ablation group.) and lower mortality (OR of 0.37 [0.17, 0.80; p0.01] low heterogeneity I² = 0 %, p = 0.84 favouring the ablation group), compared to those who underwent pacemaker implantation in patients with TBS.</div></div><div><h3>Conclusion</h3><div>Catheter ablation resulted in a lower incidence of AF recurrence, stroke, and mortality compared to the pacemaker in TBS patients. There was no difference between groups regarding procedure-related complications and cardiovascular rehospitalization.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"60 ","pages":"Article 101767"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144813975","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}