JACC-Clinical ElectrophysiologyJACC临床电生理学
JACC-Clinical Electrophysiology(英文缩写 JACC-CLIN ELECTROPHY),ISSN 2405-500X,eISSN 2405-5018,中文译名:JACC临床电生理学 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-10-01 至 2026-09-30，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 6.124 | Q2 |
| 2022 | 7.000 | Q1 |
| 2023 | 8.000 | Q1 |
| 2024 | 7.700 | Q1 |
| 2025 | 7.200 | Q1 |
JACC-Clinical Electrophysiology 最新收录文献
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1. The Lazarus Protocol: Rescue Catheter Ablation of Incessant Ventricular Fibrillation by Purkinje Substrate Denetworking in Critically Ill Patients With Ischemic Cardiomyopathy.
PMID:日期:2026-09-30We report a case series of 3 critically ill patients with refractory incessant ventricular fibrillation (VF) who underwent catheter ablation using high-density mapping of the Purkinje system during ongoing VF, combined with targeted Purkinje denetworking and myocardial substrate modification. All patients were supported with advanced mechanical circulatory support, including venoarterial extracorporeal membrane oxygenation or venoarterial extracorporeal membrane oxygenation with Impella support, and procedures were guided by electroanatomic mapping with multimodality imaging integration. Purkinje potentials and abnormal electrograms within infarcted and border-zone myocardium were targeted, resulting in restoration and maintenance of sinus rhythm with no inducible ventricular arrhythmias after ablation. These findings suggest that, in carefully selected patients, combined Purkinje-targeted ablation and substrate modification may provide a life-saving rescue strategy for otherwise refractory incessant VF.
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3. Impact of Interelectrode Spacing on Ventricular Tachycardia Substrate Mapping: Insights Into 3-Dimensional Characteristics of the Arrhythmogenic Substrate.
PMID:日期:2026-09-24Re-entrant ventricular tachycardia (VT) circuits often involve 3-dimensional activation across the endocardium, epicardium, and mid-myocardium, highlighting the importance of comprehensive substrate assessment. Wider interelectrode spacing may incorporate broader-field electrical components that are less apparent on conventional closely spaced recordings. This study sought to investigate the electrophysiological impact of interelectrode spacing on substrate mapping and its potential implications for 3-dimensional features of VT substrate. Sixty-eight high-density substrate maps from 35 patients undergoing catheter ablation for scar-related VT were retrospectively analyzed. Closely spaced (2-mm) and widely spaced (8-mm) bipolar electrograms were simultaneously acquired using a decapolar catheter and used to generate closely and widely spaced bipolar electrode maps (CEM and WEM). Compared with CEM, WEM, which incorporates a greater contribution of far-field components, demonstrated higher bipolar amplitudes, a greater prevalence of multicomponent electrograms, and a lower prevalence of split potentials (all P < 0.01). Lines of block delineated by split potentials on CEM were frequently attenuated or no longer apparent on WEM because the corresponding electrograms appeared fragmented and lacked a distinct split configuration. In an exploratory analysis of 6 VTs with evaluable activation maps, activation gaps were larger with closely than widely spaced bipolar mapping (32.5% vs 20.0%; P = 0.03). In 4 VTs, widely spaced recordings identified diastolic or presystolic far-field potentials not evident with closely spaced recordings. Widely spaced bipolar electrograms may provide complementary functional information beyond that obtained with conventional near-field recordings by incorporating broader-field electrical components, thereby offering additional insight into the potential 3-dimensional characteristics of the arrhythmogenic substrate.
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4. Programmed Ventricular Stimulation for Risk Stratification in Nonischemic Cardiomyopathy With Preserved or Mildly Reduced LVEF.
PMID:日期:2026-09-23A substantial proportion of sudden cardiac deaths occur in patients with nonischemic cardiomyopathy (NICM) and left ventricular ejection fraction (LVEF) ≥40% who do not meet current criteria for implantable cardioverter-defibrillator (ICD) implantation. This study sought to evaluate programmed ventricular stimulation (PVS) for arrhythmic risk stratification in patients with NICM, cardiac magnetic resonance-confirmed myocardial scar, and LVEF ≥40%. Consecutive patients with NICM, LVEF ≥40%, late gadolinium enhancement on cardiac magnetic resonance, and frequent premature ventricular complexes (PVCs; >5%) or nonsustained ventricular tachycardia who underwent PVS at a tertiary center (2014-2025) were included. The primary outcome was a major arrhythmic event (MAE): sustained ventricular tachycardia/fibrillation, appropriate ICD therapy, or sudden cardiac death. Among 182 patients (median aged 62 years; 33% women), PVS was positive in 45 (25%). Over a median 3.5-year follow-up, MAE occurred in 13 of 45 PVS-positive (29%) vs 2 of 137 PVS-negative patients (1.5%; P < 0.001), yielding a negative predictive value of 98.5%. Additional MAE predictors included multifocal PVCs/nonsustained ventricular tachycardia (HR: 6.6; 95% CI: 1.8-24.4), family history of sudden cardiac death (HR: 16.7; 95% CI: 4.5-62.3), QRS ≥100 milliseconds (HR: 5.2; 95% CI: 1.4-19.2), and LVEF ≤50% (HR: 4.4; 95% CI: 1.4-13.4; all P < 0.05). A noninvasive risk score incorporating these 4 variables yielded an optimism-corrected C-statistic of 0.892 (95% CI: 0.805-0.957). PVS represents a useful tool for risk stratification of arrhythmic events in patients with NICM, myocardial scar and preserved or mildly reduced LVEF, identifying those who may benefit from primary prevention ICD implant.
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5. Abrupt Wall Thickness Transitions Amid Ischemic Re-Entrant Ventricular Tachycardia.
PMID:日期:2026-09-23该文献暂无摘要。
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6. Pediatric Catecholaminergic Polymorphic Ventricular Tachycardia: Clinical Characteristics, Genetic Spectrum, and Outcomes in a Multicenter Cohort.
PMID:日期:2026-09-22Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inherited arrhythmia with a high risk of life-threatening ventricular arrhythmias in childhood. This study sought to characterize pediatric CPVT and evaluate contemporary therapeutic outcomes, including left cardiac sympathetic denervation (LCSD) and bilateral cardiac sympathetic denervation (BCSD). This retrospective multicenter study included 92 pediatric patients with CPVT from 3 tertiary centers in Türkiye between 2012 and 2025. Arrhythmic events included aborted cardiac arrest, sudden cardiac death, appropriate implantable cardioverter-defibrillator shocks, arrhythmic syncope, and ventricular tachycardia. Paired preprocedural and postprocedural event rates were compared in patients with an adequate preprocedural observation period. Median age at symptom onset was 9.25 years (IQR: 5.88-12.0), and median age at diagnosis was 11.6 years (IQR: 8.64-14.41). Among 87 genetically tested patients, 74 (85.1%) had a pathogenic or likely pathogenic variant; ryanodine receptor 2 and calsequestrin 2 variants were identified in 41 (47.1%) and 24 (27.6%), respectively. Fifty patients underwent sympathetic denervation (LCSD, n = 25; BCSD, n = 25). In the paired cohort (n = 35), median arrhythmic event rate decreased from 3.20 events/year (IQR: 1.74-8.76) before LCSD/BCSD to 0.00 events/year (IQR: 0.00-1.35) during the first 2 postprocedural years (P < 0.001). First 2-year event rates did not differ significantly between procedures. Seven patients died; documented treatment nonadherence was present in all. LCSD/BCSD was associated with a substantial reduction in arrhythmic burden, but observational treatment allocation and center-specific management preclude conclusions regarding comparative effectiveness. Sustained treatment adherence remains essential.
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7. Stellate Ganglion Block Reduces the Incidence of Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting.
PMID:日期:2026-09-21Postoperative atrial fibrillation (POAF) is associated with sympathetic overactivity. Stellate ganglion is a potential target for intervention. The aim of this study was to examine the efficacy of preemptive left stellate ganglion block (SGB) in reducing POAF in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass. Patients were randomized to the SGB group or the control group. The primary endpoint was the incidence of POAF within 5 days postoperatively. Secondary endpoints included POAF-associated characteristics and recovery indicators. A total of 124 patients underwent initial randomization, with 108 in modified intention-to-treat and 98 in per-protocol analysis. In modified intention-to-treat analysis, POAF occurred in 18.5% of the SGB group and 44.4% of the control group (OR: 0.288; 95% CI: 0.106-0.731; P = 0.007). Per-protocol analysis yielded consistent results. SGB group showed significantly lower POAF burden, shorter duration of first POAF episode, fewer POAF episodes and antiarrhythmic treatments, decreased C-reactive protein, interleukin-6, high-sensitivity cardiac troponin T, and creatine kinase-MB on certain postoperative time points, and decreased postoperative hospitalization than the control group (all P < 0.05). Exploratory subgroup analyses suggested that the association between SGB pretreatment and lower POAF incidence was more pronounced among patients without diabetes (OR: 0.10; 95% CI: 0.019-0.480; P = 0.004) and those at lower baseline risk of POAF (OR: 0.10; 95% CI: 0.005-0.642; P = 0.040). In patients undergoing coronary artery bypass grafting with cardiopulmonary bypass, preemptive left SGB was associated with a reduced incidence of POAF within 5 postoperative days. Exploratory subgroup analyses suggested a potentially greater association among patients without diabetes and those at lower risk of POAF.
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8. Left Stellate Ganglion Pulsed Radiofrequency Suppresses Ischemic Ventricular Arrhythmias: A Translational Study.
PMID:日期:2026-09-18Cardiac sympathetic hyperactivity originating from the left stellate ganglion (LSG) drives ischemic ventricular arrhythmias (VAs). Stellate ganglion block provides only transient relief, whereas surgical denervation is invasive and irreversible. A minimally invasive approach with potentially sustained effects is needed. This study sought to investigate whether pulsed radiofrequency (PRF) of the LSG-a nonthermal neuromodulatory technique-safely suppresses ischemic VAs, and to characterize its mechanism using integrated neural and cardiac transcriptomics. Safety was first assessed in healthy rats (n = 15) randomized to control, LSG-PRF (42 °C, 2 Hz, 20 milliseconds), or surgical LSG excision. In a rat myocardial infarction (MI) model (n = 24; Sham, MI, MI + PRF), cardiac sympathetic nerve activity, programmed electrical stimulation, echocardiography, and histology were evaluated, complemented by bulk RNA-seq of the LSG and single-cell RNA-seq of cardiac tissue. Translational feasibility was tested in 4 patients with drug-refractory electrical storm using ultrasound-guided LSG-PRF. In contrast to LSG excision, PRF produced only transient Horner's syndrome and did not cause hypotension. In MI rats, PRF reduced cardiac sympathetic nerve activity, attenuated ventricular tachycardia/ventricular fibrillation inducibility and duration on programmed stimulation, lowered serum norepinephrine and angiotensin II, improved left ventricular function, and reduced myocardial fibrosis. LSG transcriptomics showed down-regulation of inflammation- and sprouting-related genes including S100a9 and Ngf. Single-cell analysis of the infarcted heart revealed attenuation of a proinflammatory Grik2 Schwann cell subset, with computationally inferred reductions in neuro-immune signaling. In all 4 patients, no sustained ventricular tachycardia recurrence was observed during a median follow-up of 12 months. LSG-PRF is a minimally invasive neuromodulatory strategy associated with suppression of sympathetic hyperactivity and post-MI VAs, accompanied by attenuated ganglionic inflammation and modulated cardiac neuro-immune signaling. Preliminary clinical experience supports feasibility and warrants prospective trials.
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10. Sex-Specific Temporal Trends in the Incidence of Heart Failure Among Patients With Atrial Fibrillation: A Population-Based Study.
PMID:日期:2026-09-18Although there is evidence linking women to a higher risk of ischemic stroke in AF, it remains uncertain whether there are sex differences in the hazards of HF. This study sought to evaluate sex differences in the temporal trend of incident heart failure (HF) among patients with atrial fibrillation (AF). Using a territory-wide clinical registry in Hong Kong, patients newly diagnosed with AF between 1997 and 2021 were studied. Annual incidence rate (IR) and incidence rate ratio were estimated by Poisson regression analysis. Multivariate adjusted Fine-Gray regression models were performed to examine the subdistribution hazard ratio between women and HF, accounting for all-cause mortality as a competing event. We included 130,132 individuals with newly diagnosed AF (median age: 76.6 years; IQR: 60.4-92.8; 48.6% female). Between 1997 and 2021, the annual IR (per 1000 person-years) of HF declined from 69.6 to 16.7 in women and from 44.5 to 13.7 in men over the years. Women maintained a higher IR than men for the entire follow-up period (IR: 25.3 vs 19.3 per 1000 person-years) and were associated with a higher risk of HF than men (incidence rate ratio [95% CI]: 1.34 [1.31-1.37]). When compared with men, women were older at the time of diagnosis of AF, had higher baseline CHADS-VASc scores, and were more likely to be prescribed reduced doses of direct oral anticoagulants. Despite an overall decrease in the risk of HF among AF patients over two decades of follow-up, women retained elevated residual adjusted HF risk after full adjustment for time-varying comorbidities.