Annals of Noninvasive Electrocardiology最新文献

{"title":"Metabolic Syndrome and Atrial Cardiomyopathy on the Risk of Stroke Mortality in the General Population","authors":"Yaodongqin Xia,&nbsp;Xuan Lu,&nbsp;Minglong Chen,&nbsp;Mingfang Li","doi":"10.1111/anec.70148","DOIUrl":"10.1111/anec.70148","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Metabolic syndrome (MetS) and atrial cardiomyopathy (AtCM) are recognized as risk factors for cardiovascular disease, including stroke. We aimed to determine the combined impact of MetS and AtCM on stroke mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were selected from the Third National Health and Nutrition Examination (NHANES III) Survey. MetS was defined according to the Adult Treatment Panel III, while AtCM was defined as deep terminal negativity of the P wave in V1 (DTNPV1). Survey-weighted Firth penalized Cox analysis was performed to determine the adjusted HRs and 95% CIs of stroke mortality by MetS-AtCM status, including metabolically healthy without AtCM (MHNA; reference), metabolically unhealthy without AtCM (MUNA), metabolically healthy with AtCM (MHA), metabolically unhealthy with AtCM (MUA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 4315 participants were included in the analysis. Throughout the follow-up, the rates of stroke mortality increased across the MetS-AtCM status categories: 1.56, 2.78, 4.68, and 8.24 per 1000 person-years in MHNA, MUNA, MHA, and MUA groups, respectively. Compared to the MHNA participants, MUA were at a higher risk of stroke mortality (HR = 3.33, 95% CI 1.24–8.94, <i>p</i> = 0.018). Stroke mortality showed a non-significant upward trend in both MUNA (HR = 1.57, 95% CI 0.96–2.59, <i>p</i> = 0.074) and MHA (HR = 1.61, 95% CI 0.52–5.00, <i>p</i> = 0.401) groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest a potential joint association of MetS and AtCM on stroke mortality. Further RCTs are warranted to evaluate the efficacy of anticoagulation in preventing ischemic stroke and reducing stroke mortality among individuals with both MetS and AtCM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12754273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145861659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Ventricular Ejection Fraction and Incident Cardiac Conduction Dysfunction: Exploring the Mediating Effects of Electrophysiological Parameters","authors":"Qie Zhang,&nbsp;Feilong Zhang,&nbsp;Yuhao Hu,&nbsp;Jinfeng Wang,&nbsp;Xinlin Yang,&nbsp;Zhou Du,&nbsp;Yuting Chen,&nbsp;Jiran Shen,&nbsp;Ronghui Yu","doi":"10.1111/anec.70146","DOIUrl":"10.1111/anec.70146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Population-based evidence on the predictive role of left ventricular ejection fraction (LVEF) in incident Cardiac Conduction Dysfunction (CCD) and the mediating effects of electrophysiological parameters remains understudied. This study aimed to characterize the relationship between LVEF and incident CCD and explore the potential mediating effects of electrophysiological parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective cohort study included 32,398 participants (96.6% White ethnicity) from the UK Biobank with analyzable LVEF and electrocardiogram data. Incident CCD was defined as the first occurrence of atrioventricular block, left bundle branch block, or other conduction disorders. Stepwise backward Cox regression and sensitivity analyses evaluated the association between LVEF and CCD. Additionally, mediation analysis was performed to examine QRS duration, PQ interval, and corrected QT interval as potential mediators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a mean follow-up of 6.96 ± 1.63 years, 484 incident CCD cases were identified. LVEF was an independent predictor of incident CCD, with each 1-standard deviation increase in LVEF associated with a 17% reduction in risk (adjusted hazard ratio, 0.83; 95% confidence interval, 0.77–0.89; <i>p</i> &lt; 0.001). Sensitivity analyses across LVEF thresholds, competing risks, and exclusion of early events confirmed the robustness of these findings. Mediation analysis showed that PQ interval mediated 6% (<i>p</i> &lt; 0.001), QRS duration mediated 17% (<i>p</i> &lt; 0.001), and corrected QT interval mediated −3% (<i>p</i> = 0.002) of the total effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LVEF is independently associated with incident CCD, with electrophysiological parameters potentially explaining part of this association. These findings underscore the clinical relevance of myocardial mechano-electrical coupling in large-scale population settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12744959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145848752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Voltage: Independent Validation of the SV3 + SV4 Criterion for LVH Detection","authors":"Fernando De la Garza Salazar","doi":"10.1111/anec.70147","DOIUrl":"10.1111/anec.70147","url":null,"abstract":"&lt;p&gt;We read with great interest the study by Yoosefi et al. proposing the SV3 + SV4 voltage sum—defined as the algebraic addition of the S-wave amplitudes in leads V3 and V4—as a new ECG criterion for left ventricular hypertrophy (LVH) and exploring whether age, sex, and hypertension improve diagnostic performance (Yoosefi et al. &lt;span&gt;2025&lt;/span&gt;). Using their thresholds, the authors reported a sensitivity of 0.609 and specificity of 0.669 overall; with sex-specific cutoffs, performance reached 0.500/0.809 in women and 0.556/0.910 in men (Yoosefi et al. &lt;span&gt;2025&lt;/span&gt;). These values represent a modest improvement over traditional voltage criteria but still illustrate limited sensitivity, especially in women.&lt;/p&gt;&lt;p&gt;To assess generalizability, we externally validated SV3 + SV4 in a Mexican cohort (&lt;i&gt;n&lt;/i&gt; = 664) using both the global and sex-specific thresholds. The non–sex-specific cutoff achieved an AUC of 0.685 (95% CI 0.644–0.726), accuracy 0.654, and sensitivity 0.606. Applying sex-specific thresholds increased specificity to 0.879 but reduced sensitivity to 0.412, indicating that the anticipated benefit of separate cutoffs did not translate into improved diagnostic balance.&lt;/p&gt;&lt;p&gt;We compared these findings with our recently published Marcos VCG-ECG model, a clinically interpretable, signal-only algorithm that integrates electrocardiographic and vectorcardiographic features through a rule-based C5.0 classifier (De la Garza Salazar and Egenriether &lt;span&gt;2025&lt;/span&gt;). Developed and validated against echocardiographic LVH, this model achieved an AUC of 0.779 (95% CI 0.715–0.844), accuracy 0.755, sensitivity 0.731, and specificity 0.775—outperforming SV3 + SV4 while maintaining full interpretability through explicit rule sets grounded in physiologic P-QRS-T wave and vector-loop relationships. Consistent with Yoosefi et al., adding demographic variables did not improve discrimination.&lt;/p&gt;&lt;p&gt;The authors also present an SVM analysis that achieved an F1-score of 0.714 in men (Yoosefi et al. &lt;span&gt;2025&lt;/span&gt;). While encouraging, this estimate derives from a small dataset (&lt;i&gt;n&lt;/i&gt; = 159; LVH 14.5%), which increases the risk of optimistic performance. Some feature combinations showed near-zero sensitivity but perfect specificity—formally “high-performing,” yet clinically uninformative. These results highlight the importance of class-balance awareness and transparent reporting of class-wise metrics in small ML datasets.&lt;/p&gt;&lt;p&gt;Taken together, three practical messages arise. (1) External validation remains essential, as SV3 + SV4 performance decreased outside the derivation cohort. (2) Voltage-only summation may have reached its diagnostic ceiling, given persistent sensitivity–specificity trade-offs (Faggiano et al. &lt;span&gt;2024&lt;/span&gt;). (3) Interpretable, multiparametric ECG/VCG models may offer a better diagnostic equilibrium while preserving transparency and physiologic traceability (De la Garza Salazar and Egenriether &lt;span&gt;2025&lt;/span&gt;; Huang et al.","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145848811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Function and Atrial Remodeling: Interpreting Voltage-Mapping Limitations","authors":"Mücahit Aker,&nbsp;Macit Kalçık,&nbsp;Lütfü Bekar","doi":"10.1111/anec.70144","DOIUrl":"10.1111/anec.70144","url":null,"abstract":"&lt;p&gt;We read with interest the recent article by Deng et al., which explored the association between renal function and left atrial low-voltage area (LVA) burden in patients with atrial fibrillation (Deng et al. &lt;span&gt;2025&lt;/span&gt;). The authors report increased LVA prevalence among individuals with reduced estimated glomerular filtration rate (eGFR), suggesting a link between renal dysfunction and atrial substrate remodeling. Although the research addresses an important clinical question, several methodological considerations limit the strength of the conclusions.&lt;/p&gt;&lt;p&gt;A primary issue concerns the heterogeneity and intrinsic variability of bipolar voltage mapping. Voltage measurements are highly sensitive to catheter contact, mapping density, electrode configuration, and rhythm status during acquisition. The study does not clarify mapping stability parameters or point density across participants, factors known to influence LVA quantification and potentially introduce systematic misclassification (Huang et al. &lt;span&gt;2022&lt;/span&gt;). Without standardized acquisition protocols, observed differences in LVA burden may partly reflect procedural variability rather than true substrate differences.&lt;/p&gt;&lt;p&gt;Another limitation arises from the distribution of renal function within the cohort. Only a small minority of subjects appear to have eGFR values in ranges typically associated with structural atrial remodeling. Prior studies have demonstrated that meaningful electrophysiologic atrial alterations are most evident in moderate-to-severe renal impairment, rather than in mild reductions of eGFR (Lee et al. &lt;span&gt;2021&lt;/span&gt;). The limited representation of lower renal-function strata raises concerns regarding statistical power and the generalizability of the renal–atrial substrate association.&lt;/p&gt;&lt;p&gt;The multivariable models also may not sufficiently account for confounders that influence atrial fibrosis and LVA burden. Duration of atrial fibrillation, left atrial volume, hypertension severity, glycemic status, and systemic inflammatory markers are independently associated with voltage reduction and may overlap mechanistically with renal dysfunction. Omitting several of these parameters risks attributing substrate differences to renal function while partially reflecting unmeasured cardiac and metabolic remodeling pathways (Karakasis et al. &lt;span&gt;2024&lt;/span&gt;).&lt;/p&gt;&lt;p&gt;Finally, the causal interpretability of the findings warrants caution. Atrial LVA represents a complex composite of fibrosis, anisotropy, and conduction heterogeneity, whereas renal dysfunction reflects systemic microvascular, neurohormonal, and inflammatory alterations. Although these processes may coexist, current evidence supports correlation rather than directional causality. The study would benefit from integration of imaging-based fibrosis quantification or biomarkers of extracellular matrix turnover to substantiate mechanistic claims (Pegoraro et al. &lt;span&gt;2025&lt;/span&gt;). As it stands, the prognostic","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12719601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145802994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of P-Wave Parameters With Left Atrial Hemodynamics in Atrial Cardiomyopathy","authors":"Melissa Kazantzi,&nbsp;Aljoscha Mohr,&nbsp;Ruth Schneider,&nbsp;Adnan Labedi,&nbsp;Niklas Bach,&nbsp;Johann Rößler,&nbsp;Stephan Salmen,&nbsp;Ralf Gold,&nbsp;Arash Haghikia,&nbsp;Fabienne Kreimer,&nbsp;Michael Gotzmann","doi":"10.1111/anec.70145","DOIUrl":"10.1111/anec.70145","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>P-wave parameters, readily obtainable from standard 12-lead ECGs, have been associated with atrial fibrillation (AF), ischemic stroke, and other cardiovascular conditions. Left atrial cardiomyopathy (AtCM), characterized by atrial fibrosis and functional impairment, is considered a central substrate in the development of AF and embolic stroke of undetermined source. This study examines the relationship between P-wave parameters and left atrial hemodynamics and evaluates their potential diagnostic utility in identifying AtCM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a monocentric, prospective study in hospitalized patients. Inclusion criteria were sinus rhythm and age ≥ 18 years. P-wave parameters were assessed in conjunction with echocardiographic measures of left atrial function. Statistical analyses compared patients with and without pathological P-wave parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 416 patients were included. Pathological P-wave parameters were highly prevalent, with 55% of patients exhibiting ≥ 3 abnormalities. Advanced interatrial block (IAB) showed a robust association with impaired left atrial hemodynamics, whereas other parameters, such as PTFV1, demonstrated only weak correlations. Patients with advanced IAB exhibited significant alterations in left atrial size, function, and NT-proBNP levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Advanced IAB emerged as the most reliable P-wave parameter for detecting left atrial dysfunction in AtCM, whereas other P-wave indices, including PTFV1, were less informative. These findings highlight the diagnostic value of advanced IAB in identifying AtCM, particularly in patients with embolic stroke of undetermined source, and emphasize the need for more refined diagnostic criteria in future investigations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12715353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ablation of Atrial Tachycardia in a Budd-Chiari Syndrome Patient via Inferior Vena Cava–Azygos–Superior Vena Cava Approach","authors":"Yuwei Chen,&nbsp;Yi Liu,&nbsp;Xiangbin Xiao,&nbsp;Xiaobo Pu","doi":"10.1111/anec.70136","DOIUrl":"10.1111/anec.70136","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Catheter ablation for atrial tachycardia (AT) in Budd-Chiari syndrome (BCS) presents unique challenges due to altered venous anatomy. This case demonstrates an innovative approach to overcome complete inferior vena cava (IVC) occlusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 24-year-old female with BCS underwent catheter ablation via an innovative femoral vein–IVC–azygos–SVC approach, guided by preprocedural CT angiography and 3D electroanatomical mapping.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Successful ablation was achieved at the anterior interatrial septum with no arrhythmia recurrence during the 3-month follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case demonstrates the successful use of an IVC-azygos-SVC approach guided by CT angiography and 3D mapping for atrial tachycardia ablation in Budd-Chiari syndrome, offering a viable solution for patients with complex venous obstruction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12709648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Diagnostic Clues in a Rare Case of Ventricular Preexcitation Masking Occlusive Myocardial Infarction of the Left Anterior Descending Artery","authors":"Honglin Ni,&nbsp;Xiaoli Zhang,&nbsp;Zhicheng Gao","doi":"10.1111/anec.70142","DOIUrl":"10.1111/anec.70142","url":null,"abstract":"<p>Acute occlusive myocardial infarction (OMI) complicated by ventricular pre-excitation can present diagnostic challenges. This case describes a 78-year-old male with an 11-h history of chest tightness. A reduction was observed in the extent of localized ventricular pre-excitation, accompanied by secondary ST–T segment abnormalities in leads V1–V3. Emergency coronary angiography revealed occlusion of the left anterior descending artery. This case highlights that a decrease in the extent of local ventricular pre-excitation in R–wave–dominant leads, combined with inference of the accessory pathway location and its potential correlation with the occluded vessel, may facilitate early identification of OMI.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Isoproterenol Treatment for Ventricular Fibrillation Storm in Early Repolarization Syndrome With SCN5A Mutation","authors":"Sung Soo Kim,&nbsp;Jeong Tae Byoun,&nbsp;Donghyeon Joo,&nbsp;Jum Suk Ko,&nbsp;Nam Ho Kim,&nbsp;Hyung Ki Jeong","doi":"10.1111/anec.70143","DOIUrl":"10.1111/anec.70143","url":null,"abstract":"<p>A 58-year-old man experienced a ventricular fibrillation storm with prominent inferolateral J waves and was diagnosed with early repolarization syndrome. Initial coronary angiography showed no significant stenosis and the other evaluations for ventricular fibrillation were unremarkable. Despite conventional therapy for ventricular fibrillation, it recurred. Isoproterenol infusion suppressed the J wave and successfully mitigated ventricular fibrillation episodes. This case highlights the role of isoproterenol in managing early repolarization syndrome-related ventricular fibrillation storms and the possible pathogenic link between SCN5A mutations and J wave syndromes.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12703576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Intravenous Normal Saline Infusion Pre-Cardiac Implantable Electronic Devices Versus No Infusion in Fasting","authors":"Muhammad Hanzla Umair,&nbsp;Shahab Saidullah,&nbsp;Sadaf Shabeer,&nbsp;Roha Daneyal,&nbsp;Neha Kumar,&nbsp;Priyanka Shetiya,&nbsp;Hina Ahmed Siddiqi,&nbsp;Haresh Kumar,&nbsp;Anjali Bai,&nbsp;Raja Sadam Mehmood,&nbsp;Abida Perveen,&nbsp;F. N. U. Abdullah,&nbsp;Jahanzeb Malik","doi":"10.1111/anec.70139","DOIUrl":"10.1111/anec.70139","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Venous puncture failure during cardiac implantable electronic device (CIED) implantation is a significant procedural challenge, particularly in fasting patients. Pre-procedural intravenous normal saline (NS) infusion may enhance venous filling and improve procedural outcomes, but evidence in this setting is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study at Abbas Institute of Medical Sciences, including 2852 patients undergoing CIED implantation. Patients were divided into two groups: those who received intravenous NS infusion prior to the procedure (<i>n</i> = 1130) and those who did not (<i>n</i> = 1722). Baseline demographics, procedural details, and outcomes—including venous puncture failure, arterial puncture, site change, and acute kidney injury (AKI)—were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The NS group demonstrated a significantly lower rate of venous puncture failure (4.6% vs. 8.9%, <i>p</i> &lt; 0.001) and arterial puncture failure (1.6% vs. 2.8%, <i>p</i> = 0.03). AKI occurred less frequently in the NS group, although this difference was not statistically significant (1.8% vs. 2.6%, <i>p</i> = 0.09). Predictors of venous puncture failure included absence of NS infusion (OR 2.1, 95% CI 1.5–3.0), BMI ≥ 30, and CKD. ROC analysis demonstrated good model discrimination (AUC = 0.81).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pre-procedural NS infusion significantly improves venous puncture success in fasting patients undergoing CIED implantation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12703552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Supraclavicular Access in Temporary Pacemaker Implantation","authors":"Abdulkarim Jamal Abdunnaser Ben Yezza,&nbsp;Mubashir Hussain,&nbsp;Hafiz Muhammad Hashim Butt,&nbsp;Qurban Hussain Khan,&nbsp;Aadarsh Kumar Ramani,&nbsp;Abida Perveen,&nbsp;Muhammad Zeeshan Khan,&nbsp;FNU Abdullah,&nbsp;Jahanzeb Malik","doi":"10.1111/anec.70132","DOIUrl":"10.1111/anec.70132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Temporary pacemaker (TPM) implantation is a critical intervention for managing symptomatic bradyarrhythmias. While infraclavicular access via subclavian or internal jugular veins is commonly used, the supraclavicular approach has emerged as a promising alternative with potential benefits in safety and procedural efficiency. However, data comparing these approaches, particularly in resource-limited settings, remain limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective observational study at a tertiary care center, evaluating all patients who underwent TPM implantation via either supraclavicular or infraclavicular venous access between January 2020 and December 2024. Baseline characteristics, procedural success, complications, and outcomes were compared. Multivariate logistic regression identified predictors of complications. A ROC curve and Kaplan–Meier analysis were used to evaluate model performance and complication-free survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 3569 patients, 1644 received supraclavicular access and 1925 received infraclavicular access. The supraclavicular group had a significantly lower overall complication rate (9.3% vs. 14.8%, <i>p</i> &lt; 0.001), including fewer arterial punctures, pneumothoraces, lead dislodgements, and hematomas. First-attempt success (89.4% vs. 83.2%, <i>p</i> &lt; 0.001) and mean procedure time (24.6 ± 7.8 min vs. 29.1 ± 9.4 min, <i>p</i> &lt; 0.001) were also better with supraclavicular access. On multivariate analysis, supraclavicular access was independently associated with fewer complications (adjusted OR 0.59, <i>p</i> &lt; 0.001). Kaplan–Meier analysis showed longer complication-free survival in the supraclavicular group (log-rank <i>p</i> = 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Supraclavicular venous access for TPM implantation is associated with fewer complications, greater procedural efficiency, and improved patient outcomes compared to infraclavicular access. Wider adoption may improve safety in high-volume or resource-limited settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145720706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}