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Mansour M, Mohanty S, Natale A. Quest for safe and feasible isolation of superior vena cava by pulsed-field ablation: are we there yet? Europace 2024; 26:euae159. [PMID: 38874397 PMCID: PMC11252501 DOI: 10.1093/europace/euae159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 06/15/2024] Open
Affiliation(s)
- Moussa Mansour
- Electrophysiology, Harvard Medical School, Boston, MA, USA
| | - Sanghamitra Mohanty
- Texas Cardiac Arrhythmia Institute, St. David’s Medical Center, 3000 N. I-35, Suite 720, Austin, TX 78705, USA
| | - Andrea Natale
- Texas Cardiac Arrhythmia Institute, St. David’s Medical Center, 3000 N. I-35, Suite 720, Austin, TX 78705, USA
- Interventional Electrophysiology, Scripps Clinic, 10666 N Torrey Pines Rd, La Jolla, CA 92037, USA
- Department of Internal Medicine, Metro Health Medical Center, Case Western Reserve University School of Medicine, 2500 Metrohealth Dr, Cleveland, OH 44109, USA
- Department of Biomedicine and Prevention, Division of Cardiology, University of Tor Vergata, Via Montpellier, 1, Rome 00133, Italy
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Sekihara T, Oka T, Ozu K, Sakata Y. Complete free wall isolation of arrhythmogenic persistent left superior vena cava. J Cardiovasc Electrophysiol 2024; 35:862-866. [PMID: 38323745 DOI: 10.1111/jce.16207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/22/2023] [Accepted: 01/19/2024] [Indexed: 02/08/2024]
Abstract
INTRODUCTION Persistent left superior vena cava (PLSVC) is one of the major sources of triggers and drivers of atrial fibrillation (AF). There has been no established PLSVC ablation procedure to eliminate the arrhythmogenicity along the entire length of PLSVC. METHODS AND RESULTS A 70-year-old woman with a history of two previous catheter ablations for AF, mitral valvuloplasty, and an unroofed coronary sinus-type atrial septal defect closure underwent the redo AF ablations. The AF trigger and driver were identified within the patient's enlarged PLSVC. The AF was treated by complete PLSVC free wall isolation. CONCLUSION Complete PLSVC free wall isolation may be an effective ablation method to eliminate the arrhythmogenicity along the entire length of the PLSVC.
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Affiliation(s)
- Takayuki Sekihara
- Department of Cardiology, Faculty of Medical Sciences, University of Osaka, Osaka, Japan
| | - Takafumi Oka
- Department of Cardiology, Faculty of Medical Sciences, University of Osaka, Osaka, Japan
| | - Kentaro Ozu
- Department of Cardiology, Faculty of Medical Sciences, University of Osaka, Osaka, Japan
| | - Yasushi Sakata
- Department of Cardiology, Faculty of Medical Sciences, University of Osaka, Osaka, Japan
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Repp ML, Chinyere IR. Opportunities and Challenges in Catheter-Based Irreversible Electroporation for Ventricular Tachycardia. PATHOPHYSIOLOGY 2024; 31:32-43. [PMID: 38251047 PMCID: PMC10801500 DOI: 10.3390/pathophysiology31010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/22/2023] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
The use of catheter-based irreversible electroporation in clinical cardiac laboratories, termed pulsed-field ablation (PFA), is gaining international momentum among cardiac electrophysiology proceduralists for the non-thermal management of both atrial and ventricular tachyrhythmogenic substrates. One area of potential application for PFA is in the mitigation of ventricular tachycardia (VT) risk in the setting of ischemia-mediated myocardial fibrosis, as evidenced by recently published clinical case reports. The efficacy of tissue electroporation has been documented in other branches of science and medicine; however, ventricular PFA's potential advantages and pitfalls are less understood. This comprehensive review will briefly summarize the pathophysiological mechanisms underlying VT and then summarize the pre-clinical and adult clinical data published to date on PFA's effectiveness in treating monomorphic VT. These data will be contrasted with the effectiveness ascribed to thermal cardiac ablation modalities to treat VT, namely radiofrequency energy and liquid nitrogen-based cryoablation.
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Affiliation(s)
| | - Ikeotunye Royal Chinyere
- Department of Medecine, Banner University Medicine, Tucson, AZ 85724, USA
- Sarver Heart Center, University of Arizona, 1501 North Campbell Avenue, Room 6154, Tucson, AZ 85724, USA
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4
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Menè R, Sousonis V, Combes S, Maltret A, Albenque JP, Combes N. Pulsed field ablation of a persistent left superior vena cava in recurrent paroxysmal atrial fibrillation and its effect on the mitral isthmus: A case report. HeartRhythm Case Rep 2024; 10:6-10. [PMID: 38264100 PMCID: PMC10800993 DOI: 10.1016/j.hrcr.2023.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Affiliation(s)
- Roberto Menè
- Heart Rhythm Management Department, Clinique Pasteur, Toulouse, France
- Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | | | - Stéphane Combes
- Heart Rhythm Management Department, Clinique Pasteur, Toulouse, France
| | - Alice Maltret
- Department of Pediatric Cardiology and Congenital Heart Diseases, Marie Lannelongue Hospital, Groupe Hospitalier Paris Saint Joseph, Le Plessis-Robinson, France
| | | | - Nicolas Combes
- Heart Rhythm Management Department, Clinique Pasteur, Toulouse, France
- Department of Pediatric Cardiology and Congenital Heart Diseases, Marie Lannelongue Hospital, Groupe Hospitalier Paris Saint Joseph, Le Plessis-Robinson, France
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5
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Chen S, Chun JKR, Bordignon S, Tohoku S, Urbanek L, Schaack D, Ebrahimi R, Schulte-Hahn B, Schmidt B. Pulsed field ablation-based pulmonary vein isolation in atrial fibrillation patients with cardiac implantable electronic devices: practical approach and device interrogation (PFA in CIEDs). J Interv Card Electrophysiol 2023; 66:1929-1938. [PMID: 36481833 PMCID: PMC10570236 DOI: 10.1007/s10840-022-01445-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Shaojie Chen
- Cardioangiologisches Centrum Bethanien (CCB), Frankfurt Academy For Arrhythmias (FAFA), Kardiologie, Medizinische Klinik III, Agaplesion Markus Krankenhaus, Akademisches Lehrkrankenhaus der Goethe-Universität Frankfurt am Main, Frankfurt Am Main, Germany.
- Die Sektion Medizin, Universität Zu Lübeck, Lübeck, Germany.
| | - Julian K R Chun
- Cardioangiologisches Centrum Bethanien (CCB), Frankfurt Academy For Arrhythmias (FAFA), Kardiologie, Medizinische Klinik III, Agaplesion Markus Krankenhaus, Akademisches Lehrkrankenhaus der Goethe-Universität Frankfurt am Main, Frankfurt Am Main, Germany
- Die Sektion Medizin, Universität Zu Lübeck, Lübeck, Germany
| | - Stefano Bordignon
- Cardioangiologisches Centrum Bethanien (CCB), Frankfurt Academy For Arrhythmias (FAFA), Kardiologie, Medizinische Klinik III, Agaplesion Markus Krankenhaus, Akademisches Lehrkrankenhaus der Goethe-Universität Frankfurt am Main, Frankfurt Am Main, Germany
| | - Shota Tohoku
- Cardioangiologisches Centrum Bethanien (CCB), Frankfurt Academy For Arrhythmias (FAFA), Kardiologie, Medizinische Klinik III, Agaplesion Markus Krankenhaus, Akademisches Lehrkrankenhaus der Goethe-Universität Frankfurt am Main, Frankfurt Am Main, Germany
| | - Lukas Urbanek
- Cardioangiologisches Centrum Bethanien (CCB), Frankfurt Academy For Arrhythmias (FAFA), Kardiologie, Medizinische Klinik III, Agaplesion Markus Krankenhaus, Akademisches Lehrkrankenhaus der Goethe-Universität Frankfurt am Main, Frankfurt Am Main, Germany
| | - David Schaack
- Cardioangiologisches Centrum Bethanien (CCB), Frankfurt Academy For Arrhythmias (FAFA), Kardiologie, Medizinische Klinik III, Agaplesion Markus Krankenhaus, Akademisches Lehrkrankenhaus der Goethe-Universität Frankfurt am Main, Frankfurt Am Main, Germany
| | - Ramin Ebrahimi
- Cardioangiologisches Centrum Bethanien (CCB), Frankfurt Academy For Arrhythmias (FAFA), Kardiologie, Medizinische Klinik III, Agaplesion Markus Krankenhaus, Akademisches Lehrkrankenhaus der Goethe-Universität Frankfurt am Main, Frankfurt Am Main, Germany
| | - Britta Schulte-Hahn
- Cardioangiologisches Centrum Bethanien (CCB), Frankfurt Academy For Arrhythmias (FAFA), Kardiologie, Medizinische Klinik III, Agaplesion Markus Krankenhaus, Akademisches Lehrkrankenhaus der Goethe-Universität Frankfurt am Main, Frankfurt Am Main, Germany
| | - Boris Schmidt
- Cardioangiologisches Centrum Bethanien (CCB), Frankfurt Academy For Arrhythmias (FAFA), Kardiologie, Medizinische Klinik III, Agaplesion Markus Krankenhaus, Akademisches Lehrkrankenhaus der Goethe-Universität Frankfurt am Main, Frankfurt Am Main, Germany
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Schaack D, Schmidt B, Tohoku S, Bordignon S, Urbanek L, Ebrahimi R, Hirokami J, Efe TH, Chen S, Chun KRJ. Pulsed Field Ablation for Atrial Fibrillation. Arrhythm Electrophysiol Rev 2023; 12:e11. [PMID: 37427302 PMCID: PMC10326665 DOI: 10.15420/aer.2022.45] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 01/31/2023] [Indexed: 07/11/2023] Open
Abstract
Catheter ablation is a widely used, effective and safe treatment for AF. Pulsed field ablation (PFA), as a novel energy source for cardiac ablation, has been shown to be tissue selective and is expected to decrease damage to non-cardiac tissue while providing high efficacy in pulmonary vein isolation. The FARAPULSE ablation system (Boston Scientific) follows the idea of single-shot ablation and is the first device approved for clinical use in Europe. Since its approval, multiple high-volume centres have performed increasing numbers of PFA procedures in patients with AF and have published their experiences. This review summarises the current clinical experience regarding the use of PFA for AF using the FARAPULSE system. It provides an overview of its efficacy and safety.
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Affiliation(s)
- David Schaack
- Cardioangiologisches Centrum Bethanien, Frankfurt, Germany
| | - Boris Schmidt
- Cardioangiologisches Centrum Bethanien, Frankfurt, Germany
- Universitätsklinikum Frankfurt, Medizinische Klinik 3 – Klinik für Kardiologie, Frankfurt, Germany
| | - Shota Tohoku
- Cardioangiologisches Centrum Bethanien, Frankfurt, Germany
| | | | - Lukas Urbanek
- Cardioangiologisches Centrum Bethanien, Frankfurt, Germany
| | - Ramin Ebrahimi
- Cardioangiologisches Centrum Bethanien, Frankfurt, Germany
| | - Jun Hirokami
- Cardioangiologisches Centrum Bethanien, Frankfurt, Germany
| | - Tolga Han Efe
- Cardioangiologisches Centrum Bethanien, Frankfurt, Germany
| | - Shaojie Chen
- Cardioangiologisches Centrum Bethanien, Frankfurt, Germany
- Die Sektion Medizin, Universität zu Lübeck, Lübeck, Germany
| | - KR Julian Chun
- Cardioangiologisches Centrum Bethanien, Frankfurt, Germany
- Die Sektion Medizin, Universität zu Lübeck, Lübeck, Germany
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Reddy VY, Petru J, Funasako M, Kopriva K, Hala P, Chovanec M, Janotka M, Kralovec S, Neuzil P. Coronary Arterial Spasm During Pulsed Field Ablation to Treat Atrial Fibrillation. Circulation 2022; 146:1808-1819. [PMID: 36134574 DOI: 10.1161/circulationaha.122.061497] [Citation(s) in RCA: 79] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Pulsed field ablation (PFA) has a unique safety profile when used to treat atrial fibrillation, largely related to its preferentiality for myocardial tissue ablation, in particular, esophageal sparing. A pentaspline catheter was the first such PFA system studied clinically for atrial fibrillation ablation; in these initial regulatory trials, the catheter was used for pulmonary vein isolation and left atrial posterior wall ablation. Since its regulatory approval in Europe, in clinical practice, physicians have ablated beyond pulmonary vein isolation and left atrial posterior wall ablation to expanded lesion sets in closer proximity to coronary arteries. This is an unstudied important issue because preclinical and clinical data have raised the potential for coronary arterial spasm. Herein, we studied the vasospastic potential of PFA lesion sets, both remote from and adjacent to coronary arteries. METHODS During routine atrial fibrillation ablation using the pentaspline PFA catheter, coronary angiography was performed before, during, and after pulsed field applications. The lesion sets studied included: (1) those remote from the coronary arteries such as pulmonary vein isolation (n=25 patients) and left atrial posterior wall ablation (n=5), and (2) ablation of the cavotricuspid isthmus (n=20) that is situated adjacent to the right coronary artery. RESULTS During pulmonary vein isolation and left atrial posterior wall ablation, coronary spasm did not occur, but cavotricuspid isthmus ablation provoked severe subtotal vasospasm in 5 of 5 (100%) consecutive patients, and this was relieved by intracoronary nitroglycerin in 5.5±3.5 minutes. ST-segment elevation was not observed. However, no patient (0%, P=0.004) had severe spasm if first administered parenteral nitroglycerin, either intracoronary (n=5) or intravenous (n=10), before treatment. CONCLUSIONS Coronary vasospasm was not provoked during PFA at locations remote from coronary arteries, but when the energy is delivered adjacent to a coronary artery, PFA routinely provokes subclinical vasospasm. This phenomenon is attenuated by nitroglycerin, administered either post hoc to treat spasm or as prophylaxis.
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Affiliation(s)
- Vivek Y Reddy
- Homolka Hospital, Prague, Czech Republic (V.Y.R., J.P., M.F., K.K., P.H., M.C., M.J., S.K., P.N.).,Icahn School of Medicine at Mount Sinai, New York (V.Y.R.)
| | - Jan Petru
- Homolka Hospital, Prague, Czech Republic (V.Y.R., J.P., M.F., K.K., P.H., M.C., M.J., S.K., P.N.)
| | - Moritoshi Funasako
- Homolka Hospital, Prague, Czech Republic (V.Y.R., J.P., M.F., K.K., P.H., M.C., M.J., S.K., P.N.)
| | - Karel Kopriva
- Homolka Hospital, Prague, Czech Republic (V.Y.R., J.P., M.F., K.K., P.H., M.C., M.J., S.K., P.N.)
| | - Pavel Hala
- Homolka Hospital, Prague, Czech Republic (V.Y.R., J.P., M.F., K.K., P.H., M.C., M.J., S.K., P.N.)
| | - Milan Chovanec
- Homolka Hospital, Prague, Czech Republic (V.Y.R., J.P., M.F., K.K., P.H., M.C., M.J., S.K., P.N.)
| | - Marek Janotka
- Homolka Hospital, Prague, Czech Republic (V.Y.R., J.P., M.F., K.K., P.H., M.C., M.J., S.K., P.N.)
| | - Stepan Kralovec
- Homolka Hospital, Prague, Czech Republic (V.Y.R., J.P., M.F., K.K., P.H., M.C., M.J., S.K., P.N.)
| | - Petr Neuzil
- Homolka Hospital, Prague, Czech Republic (V.Y.R., J.P., M.F., K.K., P.H., M.C., M.J., S.K., P.N.)
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Unrue EL, Hopper W, Evans W, Thurston BC, Mount MG. Double Superior Vena Cava Due to Persistent Left Superior Vena Cava Incidentally Identified on Central Venous Catheterization: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2022; 23:e936628. [PMID: 36442847 PMCID: PMC9677566 DOI: 10.12659/ajcr.936628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Persistent left superior vena cava (PLSVC) results in a double superior vena cava (SVC), and although it is rare, this is the most common venous anomaly of the thorax. PSLVC arises from the junction of the left subclavian and internal jugular veins. It is identified on the left side of the mediastinum adjacent to the aortic arch, and it usually drains into the right atrium through the coronary sinus. This report presents the case of a 40-year-old man with an incidental finding of double SVC due to PSLVC identified on hospital admission following a motor vehicle collision. CASE REPORT A 40-year-old man was found to have a double SVC due to PLSVC upon chest radiography during hospital admission for injuries related to motor vehicle trauma. The discovery was made following placement of a central venous catheter (CVC) down the left-sided SVC and into the coronary sinus. The patient suffered no harm as a result. The diagnosis was made by chest radiography and confirmed by computed tomography angiography. CONCLUSIONS PSLVC is an uncommon condition that can complicate common procedures and therefore must be well-understood by physicians across many medical and surgical specialties. Although PLSVC may be asymptomatic, as in this case, in some patients PLSVC presents as atrial fibrillation or with nonspecific cardiac symptoms. Therefore, all patients identified with PLSVC should be investigated to exclude associated cardiac abnormalities and arrythmias, and before the placement of central venous access devices.
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Affiliation(s)
- Emily L. Unrue
- Department of Surgery, Edward Via College of Osteopathic Medicine, Spartanburg, SC, USA,Corresponding Authors: Emily L. Unrue, e-mail: , Wade Hopper, e-mail;
| | - Wade Hopper
- Department of Surgery, Edward Via College of Osteopathic Medicine, Spartanburg, SC, USA,Corresponding Authors: Emily L. Unrue, e-mail: , Wade Hopper, e-mail;
| | - Warren Evans
- Department of Surgery, Spartanburg Medical Center, Spartanburg, SC, USA
| | - Brian C. Thurston
- Department of Surgery, Spartanburg Medical Center, Spartanburg, SC, USA
| | - Michael G. Mount
- Department of Surgery, Spartanburg Medical Center, Spartanburg, SC, USA
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Gao M, Bian Y, Huang L, Zhang J, Li C, Liu N, Liu X, Zuo S, Guo X, Wang W, Zhao X, Long D, Sang C, Tang R, Li S, Dong J, Ma C. Catheter ablation for atrial fibrillation in patients with persistent left superior vena cava: Case series and systematic review. Front Cardiovasc Med 2022; 9:1015540. [PMID: 36337869 PMCID: PMC9632661 DOI: 10.3389/fcvm.2022.1015540] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/30/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Persistent left superior vena cava (PLSVC) is the most common form of thoracic venous abnormality. Catheter ablation (CA) for atrial fibrillation (AF) can be complicated by the existence of PLSVC, which could act as an important arrhythmogenic mechanism in AF. Methods and results We reported a case series of patients with PLSVC who underwent CA for AF at our center between 2018 and 2021. A systematic search was also performed on PubMed, EMBASE, and Web of Science for research reporting CA for AF in patients with PLSVC. Sixteen patients with PLSVC were identified at our center. Ablation targeting PLSVC was performed in 5 patients in the index procedures and in four patients receiving redo procedures. One patient experienced acute procedure failure. After a median follow-up period of 15 months, only 6 (37.5%) patients remained free from AF/atrial tachycardia (AT) after a single procedure. In the systematic review, 11 studies with 167 patients were identified. Based on the included studies, the estimated prevalence of PLSVC in patients undergoing CA for AF was 0.7%. Ablation targeting PLSVC was performed in 121 (74.7%) patients. Major complications in patients with PLSVC receiving AF ablation procedure included four cases of cardiac tamponades (2%), three cases of cardiac effusion (1.5%), one case of ischemic stroke, and three cases of phrenic nerve injury (1.5%) (one left phrenic nerve and two right phrenic nerve). Pooled analysis revealed that after a median follow-up period of 15.6 months (IQR 12.0–74.0 months), the long-term AF/AT-free rate was 70.6% (95% CI 62.8–78.4%, I2 = 0.0%) (Central illustration). Different ablation strategies for PLSVC were summarized and discussed in the systematic review. Conclusion In patients with PLSVC, recurrence of atrial arrhythmia after CA for AF is relatively common. Ablation aiming for PLSVC isolation is necessitated in most patients. The overall risk of procedural complications was within an acceptable range.
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Affiliation(s)
- Mingyang Gao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yang Bian
- Department of Cardiology, Baoji Hospital Affiliated to Xi’an Medical University, Baoji, Shaanxi, China
| | - Lihong Huang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jingrui Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Changyi Li
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Nian Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiaoxia Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Song Zuo
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xueyuan Guo
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Wei Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xin Zhao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Deyong Long
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Caihua Sang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Ribo Tang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Songnan Li
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- *Correspondence: Songnan Li,
| | - Jianzeng Dong
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Changsheng Ma
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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