Arrhythmia and Electrophysiology Review

Syncope is defined by transient and spontaneous loss of consciousness with rapid recovery. Vasovagal syncope (VVS) is the most common form of syncope and is strongly associated with hypervagotonia. There is, however, a lack of effective therapies for VVS. Cardioneuroablation (CNA) is an emerging and promising intervention for VVS with favourable outcomes. CNA has been shown to suppress excessive excitation of vagal activity through ablating the cardiac ganglionated plexi. CNA in the management of VVS requires more structured and comprehensive studies and several issues concerning patient selection, selection of ablation targets, ablation endpoints and the long-term effect of CNA are yet to be determined. This review describes its clinical applications and future directions based on current research data and the authors' own experiences.

Le Li

Sunny Po

Yan Yao

Arrhythmia & Electrophysiology Review

Cardioneuroablation for Treating Vasovagal Syncope: Current Status and Future Directions

心脏神经消融治疗血管迷走性晕厥：现状与未来方向

Background: AF is a common complication of an acute MI (AMI) and goes along with adverse events. Nevertheless, the therapeutical guidelines and pharmacological possibilities have improved over the past years. Therefore, this contemporary study aimed to clarify the effect of AF on long-term mortality in patients with incident AMI. Methods: This study included 2,313 patients aged 25–84 years with initial AMI that occurred from 2009 until 2017, documented within the population-based Augsburg Myocardial Infarction Registry. Patients were monitored from hospital admission, with a median follow-up duration of 4.5 years (interquartile range 4.4 years). Survival analysis and multivariable Cox regression analysis were conducted to explore the relationship between AF and long-term all-cause and cardiovascular disease mortality. Results: Altogether, 156 individuals had AF on their admission ECG, while the remaining 2,157 presented with sinus rhythm (SR). Patients with AF were significantly older, more frequently had arterial hypertension, non-ST-segment elevation MI, worse kidney function, smaller AMIs, and were more often former and non-smokers. An increased long-term all-cause mortality was observed among the AF group. (AF patients 39.1%, SR group 16.7%), Upon multivariable adjustment, a HR of 1.40 (95% CI [1.05–1.87]; p=0.023) was calculated when comparing the AF with SR patients. Conclusion: An independently increased risk of long-term mortality for patients with AF compared with patients with SR in case of incident AMI was identified. Therefore, AF should be considered as a serious risk factor in AMI patients, and must be treated aggressively to reduce mortality risk.

Ferdinand Bauke

Christa Meisinger

Philip Raake

Jakob Linseisen

Timo Schmitz

Association Between Atrial Fibrillation and Long-term Mortality in Acute MI Patients

急性心肌梗死患者心房颤动与长期死亡率的关联

Background: Extensive research has been devoted to ICDs, but there is still a significant gap in the literature regarding phantom shocks (PSs). Understanding the frequency, predictors, risk factors, management and health implications of PSs is essential. This review aimed to comprehensively investigate PSs in patients with ICDs up to the present day. Specifically, the review explores the incidence of PSs, identifies risk factors that may increase their likelihood and determines predictive factors to help anticipate their occurrence. By addressing these points, the study aimed to enhance the understanding and management of PSs in ICD patients. Methods: This study reviewed central databases from their inception up to March 2024. The primary objective was to examine the occurrence of PSs in patients with ICDs. Data were gathered on patient demographics, incidence rates, and various risk factors and predictors that might affect the occurrence of PSs. Then, a detailed analysis of the collected data was conducted to identify significant associations between these risk factors, predictors and the incidence of PSs. Results: This review identified a significant association between prior ICD shocks, defibrillation threshold testing, the presence of depression and anxiety for the occurrence of PS in patients with ICDs. This underscores the importance of thoroughly evaluating and managing these factors to improve the care of individuals with ICDs. Conclusion: PSs are often associated with various factors, such as previous shock therapy, defibrillation threshold testing, depression, anxiety and higher levels of education. It is crucial for healthcare providers to acknowledge these correlations and provide personalised care to patients experiencing PSs.

Khaled Elenizi

Rasha Alharthi

Incidence, Risk Factors and Predictors of Phantom Shocks in Patients with Implantable Cardioverter Defibrillators: State-of-the-art Review

植入式心脏复律除颤器患者中幻觉电击的发生率、危险因素及预测因素：最新综述

Permanent cardiac pacing in children with congenital complete atrioventricular block (CCAVB) and/or congenital heart disease (CHD) is challenging. Conduction system pacing (CSP) represents a novel pacing strategy aiming to preserve physiological ventricular activation. Patients with CCAVB or CHD are at high risk of developing pacing-induced cardiomyopathy with chronic conventional right ventricular myocardial pacing. CSP may be a valuable pacing modality in this particular setting because it can preserve ventricular synchrony. In this review, we summarise implantation techniques, the available clinical evidence and future directions related to CSP in CCAVB and CHD.

Óscar Cano

Jeremy P Moore

Conduction System Pacing in Children and Congenital Heart Disease

儿童及先天性心脏病中的传导系统起搏

In this review, we summarise the ongoing debate surrounding the anatomy of the atrioventricular conduction axis and its relevance to pacing. We highlight previous disagreements and emphasise the importance of understanding the anatomical location of the axis. We give credit and support to the initial descriptions by His and Tawara, in particular their attention to the relationship of the atrioventricular conduction axis with the membranous septum. We express our disagreements with recent diagrams that incorrectly, in our opinion, depict the left bundle and right bundle branches. We offer our own latest understanding of the location and relationships of the atrioventricular conduction axis, including details of its development, and differences between human and animal hearts. We also emphasise the importance of understanding the relationship between the inferior pyramidal space and the inferoseptal recess so as appropriately to place the axis within the heart. We conclude by emphasising the need to consider the heart in the context of the body, describing its component parts by using attitudinally appropriate nomenclature.

Robert H Anderson

Damián Sánchez-Quintana

Diane E Spicer

Yolanda Macías

Andrew C Cook

José-Angel Cabrera

Rehan Mahmud

Eduardo Back Sternick

Justin T Tretter

Revisiting the Atrioventricular Conduction Axis for the 21st Century

重温21世纪的房室传导轴

During catheter ablation of post-infarct ventricular tachycardia (VT), substrate mapping is used when VT is non-inducible or poorly tolerated. Substrate mapping aims to identify regions of slowly conducting myocardium (borderzone) within and surrounding myocardial scar for ablation. Historically, these tissue types have been identified using bipolar voltage mapping, with areas of low bipolar voltage (&lt;0.50 mV) defined as scar, and areas with voltages between 0.50 mV and 1.50 mV as borderzone. In the era of high-density mapping, studies have demonstrated slow conduction within areas of bipolar voltage &lt;0.50 mV, suggesting that this historical cut-off is outdated. While electrophysiologists often adapt voltage cut-offs to account for this, the optimal scar-borderzone threshold is not known. In this review, we discuss dynamic voltage mapping, a novel substrate mapping technique we have developed, which superimposes data from both activation and voltage maps, to help delineate the post-infarct VT circuit through identification of the optimal scar-borderzone voltage threshold.

Mark T Mills

Peter Calvert

Justin Chiong

Dhiraj Gupta

Vishal Luther

Dynamic Voltage Mapping of the Post-infarct Ventricular Tachycardia Substrate: A Practical Technique to Help Differentiate Scar from Borderzone Tissue

梗死后室性心动过速基质的动态电压映射：一种有助于区分瘢痕与边界区组织的实用技术

短名	Arrhythm Electrophysiol Rev
Journal Impact	2.67
国际分区	CARDIAC & CARDIOVASCULAR SYSTEMS(Q2)

ISSN	2050-3369, 2050-3377
h-index	30

涉及主题	医学内科学心脏病学生物心房颤动工程类心理学航空航天工程烧蚀导管消融病理外科麻醉重症监护医学神经科学放射科物理
出版信息	出版商: Radcliffe Group Ltd.，出版周期: ，期刊类型: journal，开源期刊: 是
基本数据	创刊年份: 2015，原创研究文献占比: 26.32%，自引率:7.70%， Gold OA占比: 100.00%
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平均审稿周期	网友分享经验：7 Weeks

Arrhythmia and Electrophysiology Review

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Cardioneuroablation for Treating Vasovagal Syncope: Current Status and Future Directions

Association Between Atrial Fibrillation and Long-term Mortality in Acute MI Patients

Incidence, Risk Factors and Predictors of Phantom Shocks in Patients with Implantable Cardioverter Defibrillators: State-of-the-art Review

Conduction System Pacing in Children and Congenital Heart Disease

Revisiting the Atrioventricular Conduction Axis for the 21st Century

Revisiting the Atrioventricular Conduction Axis for the 21st Century

Conduction System Pacing in Children and Congenital Heart Disease

Association Between Atrial Fibrillation and Long-term Mortality in Acute MI Patients

Incidence, Risk Factors and Predictors of Phantom Shocks in Patients with Implantable Cardioverter Defibrillators: State-of-the-art Review

Dynamic Voltage Mapping of the Post-infarct Ventricular Tachycardia Substrate: A Practical Technique to Help Differentiate Scar from Borderzone Tissue