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Tokuda M, Yamashita S, Shiomi S, Sakurai R, Sato H, Oseto H, Yokoyama M, Tokutake K, Kato M, Narui R, Tanigawa SI, Yoshimura M, Yamane T. Pulmonary Vein Stenosis After Catheter Ablation of Atrial Fibrillation Using a Cryoballoon, Hot Balloon, or Laser Balloon. Circ J 2023; 87:1711-1719. [PMID: 37258224 DOI: 10.1253/circj.cj-23-0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Pulmonary vein stenosis (PVS) after PV isolation (PVI) for atrial fibrillation (AF) is a severe complication that requires angioplasty. This study aimed to compare the reduction of the cross-sectional PV area (PVA) and the incidence of PVS after cryoballoon (CB)-PVI, hot balloon (HB)-PVI, or laser balloon (LB)-PVI.Methods and Results: A total of 320 patients who underwent an initial catheter ablation procedure for AF using a CB, HB, or LB in 2 hospitals were included. They underwent contrast-enhanced multidetector CT before and 3 months after the procedure. In all 4 PVs, the reduction in PVA was more significant in the LB group than in the CB or HB groups, respectively. Moderate (50-75%) and severe (>75%) PVS were observed in 5.3% and 0.5% of the PVs, respectively. Although moderate PVS was more frequently observed in the LB group than in the CB or HB groups (8.2%, 3.8%, and 5.0%; P=0.03), the incidence of severe PVS was similar in the LB, CB, and HB groups (0.3%, 0.5%, and 1.0%; P=0.46). Symptomatic PVS requiring intervention occurred in 1 (0.3%) patient. CONCLUSIONS Although the reduction in cross-sectional PVA and the incidence of moderate PVS after LB-PVI was more significant than after CB-PVI or HB-PVI, it rarely led to severe PVS. Symptomatic PVS requiring intervention was rare after the balloon ablation of AF.
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Affiliation(s)
- Michifumi Tokuda
- Department of Cardiology, The Jikei University School of Medicine
- Department of Cardiology, Jikei Katsushika Medical Center
| | - Seigo Yamashita
- Department of Cardiology, The Jikei University School of Medicine
| | - Satoko Shiomi
- Department of Cardiology, Jikei Katsushika Medical Center
| | - Ryutaro Sakurai
- Department of Cardiology, The Jikei University School of Medicine
| | - Hidenori Sato
- Department of Cardiology, Jikei Katsushika Medical Center
| | - Hirotsuna Oseto
- Department of Cardiology, The Jikei University School of Medicine
| | - Masaaki Yokoyama
- Department of Cardiology, The Jikei University School of Medicine
| | - Kenichi Tokutake
- Department of Cardiology, The Jikei University School of Medicine
| | - Mika Kato
- Department of Cardiology, The Jikei University School of Medicine
| | - Ryohsuke Narui
- Department of Cardiology, The Jikei University School of Medicine
| | | | | | - Teiichi Yamane
- Department of Cardiology, The Jikei University School of Medicine
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Tokuda M, Yamashita S, Sato H, Tokutake K, Yoshimura M, Yamane T. Raise-up technique to achieve better stability and contact with the roof line during cryoballoon ablation. HeartRhythm Case Rep 2023; 9:646-648. [PMID: 37746556 PMCID: PMC10511938 DOI: 10.1016/j.hrcr.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Affiliation(s)
- Michifumi Tokuda
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
- Department of Cardiology, Jikei Katsushika Medical Center, Tokyo, Japan
| | - Seigo Yamashita
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hidenori Sato
- Department of Cardiology, Jikei Katsushika Medical Center, Tokyo, Japan
| | - Kenichi Tokutake
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Michihiro Yoshimura
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Teiichi Yamane
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
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Okumura Y, Nagashima K, Watanabe R, Yokoyama K, Kato T, Fukaya H, Hayashi H, Nakahara S, Shimizu W, Iwasaki YK, Fujimoto Y, Mukai Y, Ejima K, Otsuka T, Suzuki S, Murakami M, Kimura M, Harada M, Koyama J, Okamatsu H, Yamane T, Yamashita S, Tokuda M, Narui R, Takami M, Shoda M, Harada T, Nakajima I, Fujiu K, Hiroshima K, Tanimoto K, Fujino T, Nakamura K, Kumagai K, Okada A, Kobayashi H, Hayashi T, Watari Y, Hatsuno M, Tachibana E, Iso K, Sonoda K, Aizawa Y, Chikata A, Sakagami S, Inoue M, Minamiguchi H, Makino N, Satomi K, Yazaki Y, Aoyagi H, Ichikawa M, Haruta H, Hiro T, Okubo K, Arima K, Tojo T, Kihara H, Miyanaga S, Fukuda Y, Oiwa K, Fujiishi T, Akabane M, Ishikawa N, Kusano K, Miyamoto K, Tabuchi H, Shiozawa T, Miyamoto K, Mase H, Murotani K. Registry for Evaluating Healthy Life Expectancy and Long-Term Outcomes after Catheter Ablation of Atrial Fibrillation in the Very Elderly (REHEALTH AF) study: rationale and design of a prospective, multicentre, observational, comparative study. BMJ Open 2023; 13:e068894. [PMID: 36792334 PMCID: PMC9933749 DOI: 10.1136/bmjopen-2022-068894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
INTRODUCTION Data are lacking on the extent to which patients with non-valvular atrial fibrillation (AF) who are aged ≥80 years benefit from ablation treatment. The question pertains especially to patients' postablation quality of life (QoL) and long-term clinical outcomes. METHODS AND ANALYSIS We are initiating a prospective, registry-based, multicentre observational study that will include patients aged ≥80 years with non-valvular AF who choose to undergo treatment by catheter ablation and, for comparison, such patients who do not choose to undergo ablation (either according to their physician's advice or their own preference). Study subjects are to be enrolled from 52 participant hospitals and three clinics located throughout Japan from 1 June 2022 to 31 December 2023, and each will be followed up for 1 year. The planned sample size is 660, comprising 220 ablation group patients and 440 non-ablation group patients. The primary endpoint will be the composite incidence of stroke/transient ischaemic attack (TIA) or systemic embolism (SE), another cardiovascular event, major bleeding and/or death from any cause. Other clinical events such as postablation AF recurrence, a fall or bone fracture will be recorded. We will collect standard clinical background information plus each patient's Clinical Frailty Scale score, AF-related symptoms, QoL (Five-Level Version of EQ-5D) scores, Mini-Mental State Examination (optional) score and laboratory test results, including measures of nutritional status, on entry into the study and 1 year later, and serial changes in symptoms and QoL will also be secondary endpoints. Propensity score matching will be performed to account for covariates that could affect study results. ETHICS AND DISSEMINATION The study conforms to the Declaration of Helsinki and the Ethical Guidelines for Clinical Studies issued by the Ministry of Health, Labour and Welfare, Japan. Results of the study will be published in one or more peer-reviewed journals. TRIAL REGISTRATION NUMBER UMIN000047023.
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Affiliation(s)
- Yasuo Okumura
- Department of Cardiology, Nihon University Itabashi Hospital, Itabashi-ku, Tokyo, Japan
| | - Koichi Nagashima
- Department of Cardiology, Nihon University Itabashi Hospital, Itabashi-ku, Tokyo, Japan
| | - Ryuta Watanabe
- Department of Cardiology, Nihon University Itabashi Hospital, Itabashi-ku, Tokyo, Japan
| | - Katsuaki Yokoyama
- Department of Cardiology, Nihon University Hospital, Chiyoda-ku, Tokyo, Japan
| | - Takeshi Kato
- Department of Cardiovascular and Internal Medicine, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan
| | - Hidehira Fukaya
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Hidemori Hayashi
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate Schoool of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Shiro Nakahara
- Department of Cardiology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School Hospital, Bunkyo-ku, Tokyo, Japan
| | - Yu-ki Iwasaki
- Department of Cardiovascular Medicine, Nippon Medical School Hospital, Bunkyo-ku, Tokyo, Japan
| | - Yuhi Fujimoto
- Department of Cardiovascular Medicine, Nippon Medical School Hospital, Bunkyo-ku, Tokyo, Japan
| | - Yasushi Mukai
- Department of Cardiovascular Medicine, Japanese Red Cross Fukuoka Hospital, Fukuoka City, Fukuoka, Japan
| | - Koichiro Ejima
- Department of Cardiology, Minamino Cardiovascular Hospital, Hachioji, Tokyo, Japan
| | - Takayuki Otsuka
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Minato-ku, Tokyo, Japan
| | - Shinya Suzuki
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Minato-ku, Tokyo, Japan
| | - Masato Murakami
- Division of Cardiology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan
| | - Masaomi Kimura
- Divison of Cardiology, Pulmonary Medicine and Nephrology, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan
| | - Masahide Harada
- Department of Cardiology, Fujita Health University, Toyoake, Aichi, Japan
| | - Junjiroh Koyama
- Cardiovascular Center, Saiseikai Kumamoto Hospital, Kumamoto City, Kumamoto, Japan
| | - Hideharu Okamatsu
- Cardiovascular Center, Saiseikai Kumamoto Hospital, Kumamoto City, Kumamoto, Japan
| | - Teiichi Yamane
- Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Seigo Yamashita
- Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Michifumi Tokuda
- Division of Cardiology, Department of Internal Medicine, The Jikei University Katsushika Medical Center, Katsushika-ku, Tokyo, Japan
| | - Ryohsuke Narui
- Division of Cardiology, Department of Internal Medicine, The Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan
| | - Mitsuru Takami
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Morio Shoda
- Department of Cardiology, Tokyo Women's Medical University Hospital, Shinjuku-ku, Tokyo, Japan
| | - Tomoo Harada
- Department of Cardiology, St.Marianna University School of Medicine Hospital, Kawasaki, Kanagawa, Japan
| | - Ikutaro Nakajima
- Department of Cardiology, St.Marianna University School of Medicine Hospital, Kawasaki, Kanagawa, Japan
| | - Katsuhito Fujiu
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Kenichi Hiroshima
- Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Fukuoka, Japan
| | - Kojiro Tanimoto
- Deparatment of Cardiology, National Hospital Organisation Tokyo Medical Center, Meguro-ku, Tokyo, Japan
| | - Tadashi Fujino
- Department of Cardiovascular Medicine, Toho University Graduate School of Medicine, Ota-ku, Tokyo, Japan
| | - Keijiro Nakamura
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Meguro-ku, Tokyo, Japan
| | - Koji Kumagai
- Department of Cardiovascular Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan
| | - Ayako Okada
- Department of Cardiovascular Medicine, Shinshu University Hospital, Matsumoto, Nagano, Japan
| | - Hideki Kobayashi
- Department of Cardiovascular Medicine, Shinshu University Hospital, Matsumoto, Nagano, Japan
| | - Tatsuya Hayashi
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Omiya, Saitama, Japan
| | - Yuji Watari
- Department of Cardiology, Teikyo University Hospital, Itabashi-ku, Tokyo, Japan
| | - Mina Hatsuno
- Department of Cardiology, Teikyo University Hospital, Itabashi-ku, Tokyo, Japan
| | - Eizo Tachibana
- Division of Cardiology, Kawaguchi Municipal Medical Center, Kawaguchi, Saitama, Japan
| | - Kazuki Iso
- Division of Cardiology, Kawaguchi Municipal Medical Center, Kawaguchi, Saitama, Japan
| | - Kazumasa Sonoda
- Division of Cardiology, Department of Medicine, Tokyo Rinkai Hospital, Edogawa-ku, Tokyo, Japan
| | - Yoshiyasu Aizawa
- Department of Cardiology, International University of Health and Welfare Narita Hospital, Narita, Chiba, Japan
| | - Akio Chikata
- Department of Cardiology, Toyama Prefectural Central Hospital, Toyama City, Toyama, Japan
| | - Satoru Sakagami
- Department of Cardiology, National Hospital Organization, Kanazawa Medical Center, Kanazawa, Ishikawa, Japan
| | - Masaru Inoue
- Department of Cardiology, National Hospital Organization, Kanazawa Medical Center, Kanazawa, Ishikawa, Japan
| | | | - Nobuhiko Makino
- Department of Cardiology, Osaka Police Hospital, Osaka City, Osaka, Japan
| | - Kazuhiro Satomi
- Department of Cardiology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Yoshinao Yazaki
- Department of Cardiology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Hideshi Aoyagi
- Department of Cardiovascular Medicine, St Luke's International University, Chuo-ku, Tokyo, Japan
| | - Makoto Ichikawa
- Department of Cardiology, Sekishin Clinic, Kawagoe, Saitama, Japan
| | - Hironori Haruta
- Department of Cardiology, TMG Asaka Medical Center, Asaka, Saitama, Japan
| | - Takafumi Hiro
- Circulatory medicine, Akabane Central General Hospital, Kita-ku, Tokyo, Japan
| | - Kimie Okubo
- Department of Cardiology, Itabashi Medical Association Hospital, Itabashi-ku, Tokyo, Japan
| | - Ken Arima
- Department of Cardiology, Kasukabe Medical Center, Kasukabe, Saitama, Japan
| | - Taiki Tojo
- Department of Cardiovascular medicine, Kitasato University Kitasato Institute Hospital, Minato-ku, Tokyo, Japan
| | - Hajime Kihara
- Department of Internal Medicine, Kihara Cardiovascular Clinic, Asahikawa, Hokkaido, Japan
| | - Satoru Miyanaga
- Division of Cardiology, Department of Internal Medicine, The Jikei University Daisan Hospital, Komae, Tokyo, Japan
| | - Yoshiaki Fukuda
- Department of Cardiology, Higashi Saitama General Hospital, Satte, Saitama, Japan
| | - Koji Oiwa
- Cardiology, Japan Community Health are Organization, Yokohama Chuo Hospital, Yokohama, Kanagawa, Japan
| | - Tamami Fujiishi
- Department of Cardiology, JCHO Sagamino Hospital, Sagamihara, Kanagawa, Japan
| | - Masashi Akabane
- Department of Cardiology, Akabane Clinic, Outawara, Tochigi, Japan
| | - Norikazu Ishikawa
- Department of Cardiology, Zengyodanchi Ishikawa Clinic, Fujisawa, Kanagawa, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Haruna Tabuchi
- Department of Cardiology, Juntendo University Nerima Hospital, Nerima-ku, Tokyo, Japan
| | - Tomoyuki Shiozawa
- Department of Cardiology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - Kenjiro Miyamoto
- Department of Cardiology, Sapporo Shiroishi Memorial Hospital, Hokkaido, Sapporo, Japan
| | - Hiroshi Mase
- Department of Cardiology, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan
| | - Kenta Murotani
- Biostatistics Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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Yuzawa-Tsukada N, Tokuda M, Miyamoto T, Yoshimura M. Percutaneous transluminal septal myocardial ablation was effective in hypertrophic obstructive cardiomyopathy with anomalous mitral papillary muscles: a case report. Eur Heart J Case Rep 2023; 7:ytac493. [PMID: 36694877 PMCID: PMC9856278 DOI: 10.1093/ehjcr/ytac493] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/10/2022] [Accepted: 12/30/2022] [Indexed: 01/09/2023]
Abstract
Background Abnormalities of the mitral subvalvular apparatus are not uncommon in hypertrophic obstructive cardiomyopathy (HOCM). Where invasive treatment is indicated in these patients to reduce left ventricular outflow tract (LVOT) obstruction, surgical myectomy with mitral valve repair is recommended. Case summary In this report, we describe the case of a patient with HOCM and anomalous papillary muscle anatomy, successfully treated by percutaneous transluminal septal myocardial ablation (PTSMA). Discussion PTSMA effectively reduced septal myocardial thickness and LVOT gradient, with only mild residual systolic anterior motion and mitral regurgitation despite anomalous papillary muscle anatomy. Upon careful anatomical evaluation, PTSMA may be a suitable therapeutic option for patients with LVOT obstruction and mitral valve abnormalities who are poor surgical candidates.
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Affiliation(s)
| | - Michifumi Tokuda
- Division of Cardiology, Department of Internal Medicine, The Jikei University Katsushika Medical Center, 6-41-2 Aoto, Katsushika-ku, Tokyo 125-8506, Japan
| | - Takashi Miyamoto
- Division of Cardiology, Saitama Cardiovascular Respiratory Center, Kumagaya, Saitama, Japan
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Tsuda T, Kato T, Usuda K, Kusayama T, Usui S, Sakata K, Hayashi K, Kawashiri MA, Yamagishi M, Takamura M, Otsuka T, Suzuki S, Hirata A, Murakami M, Takami M, Kimura M, Fukaya H, Nakahara S, Shimizu W, Iwasaki YK, Hayashi H, Harada T, Nakajima I, Okumura K, Koyama J, Tokuda M, Yamane T, Momiyama Y, Tanimoto K, Soejima K, Nonoguchi N, Ejima K, Hagiwara N, Harada M, Sonoda K, Inoue M, Kumagai K, Hayashi H, Satomi K, Yazaki Y, Watari Y, Arai M, Watanabe R, Yokoyama K, Matsumoto N, Nagashima K, Okumura Y. Effect of Catheter Ablation for Atrial Fibrillation in Heart Failure With Mid-Range or Preserved Ejection Fraction ― Pooled Analysis of the AF Frontier Ablation Registry and Hokuriku-Plus AF Registry ―. Circ J 2022. [DOI: 10.1253/circj.cj-22-0461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- Toyonobu Tsuda
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | - Takeshi Kato
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | | | - Takashi Kusayama
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | - Soichiro Usui
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | - Kenji Sakata
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | - Kenshi Hayashi
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | | | | | - Masayuki Takamura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | | | - Shinya Suzuki
- Department of Cardiology, The Cardiovascular Institute
| | - Akio Hirata
- Cardiovascular Division, Osaka Police Hospital
| | | | | | - Masaomi Kimura
- Division of Cardiology, Pulmonary Medicine and Nephrology, Hirosaki University School of Medicine
| | | | | | | | | | | | - Tomoo Harada
- St. Marianna University School of Medicine Hospital
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- Division of Cardiology, Nihon University Itabashi Hospital
| | - Ryuta Watanabe
- Division of Cardiology, Nihon University Itabashi Hospital
| | | | | | | | - Yasuo Okumura
- Division of Cardiology, Nihon University Itabashi Hospital
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Shiomi S, Tokuda M, Yamashita S, Ogawa T, Yamane T, Yoshimura M. Successful bail-out of a massive air embolism during catheter ablation for atrial fibrillation. HeartRhythm Case Rep 2022; 9:148-151. [PMID: 36970380 PMCID: PMC10030301 DOI: 10.1016/j.hrcr.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Tokuda M, Yamashita S, Hachisuka E, Sato H, Oseto H, Yokoyama M, Tokutake K, Yokoyama K, Kato M, Narui R, Tanigawa SI, Yoshimura M, Yamane T. A 15-year follow-up study of Radiofrequency Catheter Ablation for Atrial Fibrillation in Patients with Tachycardia-Bradycardia Syndrome. J Cardiovasc Electrophysiol 2022; 33:2100-2103. [PMID: 35842800 DOI: 10.1111/jce.15628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/29/2022] [Accepted: 07/09/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Catheter ablation for atrial fibrillation (AF) in patients with tachycardia-bradycardia syndrome (TBS) can be major therapeutic option to replace permanent pacemaker implantation (PMI). However, the very long-term outcome more than 15 years in these patients has not been elucidated. METHODS From 2002 to 2008, 25 consecutive TBS patients (62 ± 7.9 years old, 68% male) with both AF and symptomatic sinus pauses (>3.0 sec) were performed radiofrequency AF ablation. These patients were followed for 15 ± 2.7 years. RESULTS The median longest sinus pause before ablation procedure was 6.0 (4.4-8.0) seconds. Following 1.6±0.8 ablation procedures, 18(72%) patients remained free from AF. Three (12%) patients died due to non-cardiovascular causes, and 7(28%) patients underwent PMI due to symptomatic sinus pause after recurrent AF in 5 patients and progression of sinus node dysfunction in 2 patients. The median duration from the first AF ablation to PMI was 6.3 years (range 9 days to 11.0 years). Five and 2 patients required PMI more than 5 and 10 years after the first ablation procedure, respectively. CONCLUSIONS AF ablation prevented PMI in the 72% of TBS patients for 15 years follow up. However, in consideration of long duration to PMI, a continuous careful long-term follow-up was warranted. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Michifumi Tokuda
- Department of Cardiology, The Jikei University School of Medicine
| | - Seigo Yamashita
- Department of Cardiology, The Jikei University School of Medicine
| | - Eri Hachisuka
- Department of Cardiology, The Jikei University School of Medicine
| | - Hidenori Sato
- Department of Cardiology, The Jikei University School of Medicine
| | - Hirotsuna Oseto
- Department of Cardiology, The Jikei University School of Medicine
| | - Masaaki Yokoyama
- Department of Cardiology, The Jikei University School of Medicine
| | - Kenichi Tokutake
- Department of Cardiology, The Jikei University School of Medicine
| | - Kenichi Yokoyama
- Department of Cardiology, The Jikei University School of Medicine
| | - Mika Kato
- Department of Cardiology, The Jikei University School of Medicine
| | - Ryohsuke Narui
- Department of Cardiology, The Jikei University School of Medicine
| | | | | | - Teiichi Yamane
- Department of Cardiology, The Jikei University School of Medicine
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Yokoyama M, Tokuda M, Tokutake K, Sato H, Oseto H, Yokoyama K, Kato M, Narui R, Tanigawa SI, Yamashita S, Yoshimura M, Yamane T. Effect of air removal with extracorporeal balloon inflation on incidence of asymptomatic cerebral embolism during cryoballoon ablation of atrial fibrillation: A prospective randomized study. IJC Heart & Vasculature 2022; 40:101020. [PMID: 35434257 PMCID: PMC9010628 DOI: 10.1016/j.ijcha.2022.101020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/21/2022] [Accepted: 03/28/2022] [Indexed: 11/04/2022]
Abstract
Background It was previously reported, based on a retrospective study, that preliminary removal of air bubbles in heparinized saline water with extracorporeal balloon inflation reduced the incidence of asymptomatic cerebral embolism (ACE). The present study aims to compare the incidence of ACE between a conventional and pre-inflation method during cryoballoon ablation in a prospective randomized controlled study. Methods A total of 98 atrial fibrillation patients were enrolled and randomized into conventional and pre-inflation groups. Patients in the pre-inflation group received balloon massaging with preliminary extracorporeal balloon inflation in saline water before the cryoballoon was inserted into the body. Results The baseline characteristics were similar between the two groups. Post-procedural 3-Tesla MRI revealed CE in 27.6% of patients. Symptomatic CE only occurred in two patients in the pre-inflation group. One patient had transient dysarthria and mild muscle weakness in one hand; the other patient complained of transient left upper limb weakness, left lower limb paresthesia and dysarthria. The incidence of ACE detected by cerebral MRI did not differ between the two groups to a statistically significant extent (conventional vs. pre-inflation; 22.9% vs. 29.2%; P = 0.49). In the multivariable analysis, eGFR was independently associated with the presence of ACE (odds ratio 0.95; 95% confidence interval 0.907–0.995; P = 0.03). Conclusion In this prospective randomized study, the preliminary removal of air bubbles in heparinized saline water with extracorporeal balloon inflation had no impact on the incidence of ACE.
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Tokuda M, Yamashita S, Kato M, Sato H, Oseto H, Yokoyama M, Tokutake K, Narui R, Yoshimura M, Yamane T. Cerebral Embolism During Catheter Ablation of Atrial Fibrillation Using Radiofrequency Catheter, Cryoballoon, Hotballoon, or Laserballoon. JACC Clin Electrophysiol 2022; 8:255-257. [PMID: 35210086 DOI: 10.1016/j.jacep.2021.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/14/2021] [Indexed: 11/20/2022]
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Yamashita S, Tokuda M, Mahida S, Sato H, Ikewaki H, Oseto H, Yokoyama M, Isogai R, Tokutake K, Yokoyama K, Narui R, Kato M, Tanigawa SI, Sugimoto KI, Yoshimura M, Yamane T. Very long term outcome after linear versus electrogram guided ablation for persistent atrial fibrillation. Sci Rep 2021; 11:23591. [PMID: 34880293 PMCID: PMC8654861 DOI: 10.1038/s41598-021-02935-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 11/22/2021] [Indexed: 11/10/2022] Open
Abstract
The optimal ablation strategy for persistent atrial fibrillation (PsAF) remains to be defined. We sought to compare very long-term outcomes between linear ablation and electrogram (EGM)-guided ablation for PsAF. In a retrospective analysis, long-term arrhythmia-free survival compared between two propensity-score matched cohorts, one with pulmonary vein isolation (PVI) and linear ablation including roof/mitral isthmus line (LINE-group, n = 52) and one with PVI and EGM-guided ablation (EGM-group; n = 52). Overall, 99% of patients underwent successful PVI. Complete block following linear ablation was achieved for 94% of roof lines and 81% of mitral lines (both lines blocked in 75%). AF termination by EGM-guided ablation was accomplished in 40% of patients. Non-PV foci were targeted in 7 (13%) in the LINE-group and 5 (10%) patients in the EGM-group (p = 0.76). During 100 ± 28 months of follow-up, linear ablation was associated with superior arrhythmia-free survival after the initial and last procedure (1.8 ± 0.9 procedures) compared with EGM-group (Logrank test: p = 0.0001 and p = 0.045, respectively). In multivariable analysis, longer AF duration and EGM-guided ablation remained as independent predictors of atrial arrhythmia recurrence. Linear ablation might be a more effective complementary technique to PVI than EGM-guided ablation for PsAF ablation.
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Affiliation(s)
- Seigo Yamashita
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan.
| | - Michifumi Tokuda
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | - Saagar Mahida
- Department of Cardiac Electrophysiology, Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Hidenori Sato
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | - Hirotsugu Ikewaki
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | - Hirotsuna Oseto
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | - Masaaki Yokoyama
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | - Ryota Isogai
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | - Kenichi Tokutake
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | - Kenichi Yokoyama
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | - Ryohsuke Narui
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | - Mika Kato
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | - Shin-Ichi Tanigawa
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | - Ken-Ichi Sugimoto
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | - Michihiro Yoshimura
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | - Teiichi Yamane
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
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11
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Watanabe R, Nagashima K, Wakamatsu Y, Otsuka N, Yokoyama K, Matsumoto N, Otsuka T, Suzuki S, Hirata A, Murakami M, Takami M, Kimura M, Fukaya H, Nakahara S, Kato T, Hayashi H, Iwasaki YK, Shimizu W, Nakajima I, Harada T, Koyama J, Okumura K, Tokuda M, Yamane T, Tanimoto K, Momiyama Y, Nonoguchi N, Soejima K, Ejima K, Hagiwara N, Harada M, Sonoda K, Inoue M, Kumagai K, Hayashi H, Yazaki Y, Satomi K, Watari Y, Okumura Y. Different Determinants of the Recurrence of Atrial Fibrillation and Adverse Clinical Events in the Mid-Term Period After Atrial Fibrillation Ablation. Circ J 2021; 86:233-242. [PMID: 34219078 DOI: 10.1253/circj.cj-21-0326] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND It is unclear whether there are differences in the clinical factors between atrial fibrillation (AF) recurrence and adverse clinical events (AEs), including stroke/transient ischemic attack (TIA), major bleeding, and death, after AF ablation.Methods and Results:We examined the data from a retrospective multicenter Japanese registry conducted at 24 cardiovascular centers between 2011 and 2017. Of the 3,451 patients (74.1% men; 63.3±10.3 years) who underwent AF ablation, 1,046 (30.3%) had AF recurrence and 224 (6.5%) suffered AEs (51 strokes/TIAs, 71 major bleeding events, and 36 deaths) over a median follow-up of 20.7 months. After multivariate adjustment, female sex, persistent and long-lasting persistent AF (vs. paroxysmal AF), and stepwise increased left atrial diameter (LAd) quartiles were significantly associated with post-ablation recurrences. A multivariate analysis revealed that an age ≥75 years (vs. <65 years), body weight <50 kg, diabetes, vascular disease, left ventricular (LV) ejection fraction <40% (vs. ≥50%), Lad ≥44 mm (vs. <36 mm), and creatinine clearance <50 mL/min were independently associated with AE incidences, but not with recurrences. CONCLUSIONS This study disclosed different determinants of post-ablation recurrence and AEs. Female sex, persistent AF, and enlarged LAd were determinants of post-ablation recurrence, whereas an old age, comorbidities, and LV and renal dysfunction rather than post-ablation recurrence were AEs determinants. These findings will help determine ablation indications and post-ablation management.
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Affiliation(s)
- Ryuta Watanabe
- Division of Cardiology, Nihon University Itabashi Hospital.,Department of Cardiology, Nihon University Hospital
| | | | - Yuji Wakamatsu
- Division of Cardiology, Nihon University Itabashi Hospital
| | - Naoto Otsuka
- Division of Cardiology, Nihon University Itabashi Hospital
| | | | | | | | - Shinya Suzuki
- Department of Cardiology, The Cardiovascular Institute
| | - Akio Hirata
- Cardiovascular Division, Osaka Police Hospital
| | | | | | | | - Hidehira Fukaya
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
| | | | | | | | | | | | | | - Tomoo Harada
- St. Marianna University School of Medicine Hospital
| | | | | | | | - Teiichi Yamane
- Division of Cardiology, The Jikei University School of Medicine
| | | | | | | | | | | | | | | | | | | | | | - Hidemori Hayashi
- Department of Cardiology, Juntendo University School of Medicine
| | | | | | - Yuji Watari
- Department of Cardiology, Teikyo University School of Medicine
| | - Yasuo Okumura
- Division of Cardiology, Nihon University Itabashi Hospital
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12
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Sato H, Tokuda M, Oseto H, Yokoyama M, Ikewaki H, Isogai R, Tokutake K, Yokoyama K, Kato M, Narui R, Tanigawa S, Yamashita S, Matsuo S, Yoshimura M, Yamane T. Transition of the heart rate and atrial premature complex after cryoballoon vs. radiofrequency ablation for paroxysmal atrial fibrillation. Heart Vessels 2021; 37:110-114. [PMID: 34216250 DOI: 10.1007/s00380-021-01894-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/18/2021] [Indexed: 11/25/2022]
Abstract
The temporal changes in ambulatory monitoring findings after cryoballoon (CB) ablation of atrial fibrillation (AF) have not been well elucidated. This study aims to compare the details of ambulatory monitoring after CB and radiofrequency catheter (RFC) ablation for AF. Of 724 consecutive AF patients who underwent initial ablation using a CB or RFC, 508 (254 pairs) were selected using propensity score matching. Ambulatory monitoring was performed at 1, 3, 6, 12, 24 and 36 months after the procedure. After 1, 3 and 6 months, the number of total heart beats (THBs) was larger in the CB group than in the RFC group. It gradually decreased and became significantly similar by 12 months after ablation. THBs significantly increased 1, 3, 6 and 12 months after ablation in both the RFC and CB groups and became statistically similar by 24 months after ablation. The atrial premature contraction burden was higher in the RFC group than in the CB group at 3 months after ablation. THB and APC burden after AF ablation were significantly different between the RF and CB groups. THBs returned to statistically similarity by 2 years after ablation in both groups.
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Affiliation(s)
- Hidenori Sato
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Michifumi Tokuda
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Hirotsuna Oseto
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Masaaki Yokoyama
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hirotsugu Ikewaki
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ryota Isogai
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenichi Tokutake
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenichi Yokoyama
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Mika Kato
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ryohsuke Narui
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shinichi Tanigawa
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Seigo Yamashita
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Seiichiro Matsuo
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Michihiro Yoshimura
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Teiichi Yamane
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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13
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Wakamatsu Y, Nagashima K, Watanabe R, Arai M, Yokoyama K, Matsumoto N, Otsuka T, Suzuki S, Hirata A, Murakami M, Takami M, Kimura M, Fukaya H, Nakahara S, Kato T, Hayashi H, Iwasaki YK, Shimizu W, Nakajima I, Harada T, Koyama J, Okumura K, Tokuda M, Yamane T, Tanimoto K, Momiyama Y, Nonoguchi N, Soejima K, Ejima K, Hagiwara N, Harada M, Sonoda K, Inoue M, Kumagai K, Hayashi H, Yazaki Y, Satomi K, Watari Y, Okumura Y. Clinical Outcomes of Off-Label Underdosing of Direct Oral Anticoagulants After Ablation for Atrial Fibrillation. Int Heart J 2020; 61:1165-1173. [DOI: 10.1536/ihj.20-335] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Yuji Wakamatsu
- Division of Cardiology, Nihon University Itabashi Hospital
| | | | - Ryuta Watanabe
- Division of Cardiology, Nihon University Itabashi Hospital
| | - Masaru Arai
- Division of Cardiology, Nihon University Itabashi Hospital
| | | | | | | | - Shinya Suzuki
- Department of Cardiology, The Cardiovascular Institute
| | - Akio Hirata
- Cardiovascular Division, Osaka Police Hospital
| | | | | | | | | | | | | | | | | | | | | | - Tomoo Harada
- St. Marianna University School of Medicine Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Yasuo Okumura
- Division of Cardiology, Nihon University Itabashi Hospital
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14
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Iso K, Nagashima K, Arai M, Watanabe R, Yokoyama K, Matsumoto N, Otsuka T, Suzuki S, Hirata A, Murakami M, Takami M, Kimura M, Fukaya H, Nakahara S, Kato T, Hayashi H, Iwasaki YK, Shimizu W, Nakajima I, Harada T, Koyama J, Okumura K, Tokuda M, Yamane T, Tanimoto K, Momiyama Y, Nonoguchi N, Soejima K, Ejima K, Hagiwara N, Harada M, Sonoda K, Inoue M, Kumagai K, Hayashi H, Yazaki Y, Satomi K, Watari Y, Okumura Y. Clinical outcomes of ablation versus non-ablation therapy for atrial fibrillation in Japan: analysis of pooled data from the AF Frontier Ablation Registry and SAKURA AF Registry. Heart Vessels 2020; 36:549-560. [PMID: 33236221 DOI: 10.1007/s00380-020-01721-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/23/2020] [Indexed: 11/27/2022]
Abstract
Whether ablation for atrial fibrillation (AF) is, in terms of clinical outcomes, beneficial for Japanese patients has not been clarified. Drawing data from 2 Japanese AF registries (AF Frontier Ablation Registry and SAKURA AF Registry), we compared the incidence of clinically relevant events (CREs), including stroke/transient ischemic attack (TIA), major bleeding, cardiovascular events, and death, between patients who underwent ablation (n = 3451) and those who did not (n = 2930). We also compared propensity-score matched patients (n = 1414 in each group). In propensity-scored patients who underwent ablation and those who did not, mean follow-up times were 27.2 and 35.8 months, respectively. Annualized rates for stroke/TIA (1.04 vs. 1.06%), major bleeding (1.44 vs. 1.20%), cardiovascular events (2.15 vs. 2.49%) were similar (P = 0.96, 0.39, and 0.35, respectively), but annualized death rates were lower in the ablation group than in the non-ablation group (0.75 vs.1.28%, P = 0.028). After multivariate adjustment, the risk of CREs was statistically equivalent between the ablation and non-ablation groups (hazard ratio [HR] 0.89, 95% confidence interval [CI] 0.71-1.11), but it was significantly low among patients who underwent ablation for paroxysmal AF (HR 0.68 [vs. persistent AF], 95% CI 0.49-0.94) and had a CHA2DS2-VASc score < 3 (HR 0.66 [vs. CHA2DS2-VASc score ≥ 3], 95% CI 0.43-0.98]). The 2-year risk reduction achieved by ablation may be small among Japanese patients, but AF ablation may benefit those with paroxysmal AF and a CHA2DS2-VASc score < 3.
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Affiliation(s)
- Kazuki Iso
- Division of Cardiology, Department of Medicine, Itabashi Hospital, Nihon University School of Medicine, Ohyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Koichi Nagashima
- Division of Cardiology, Department of Medicine, Itabashi Hospital, Nihon University School of Medicine, Ohyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Masaru Arai
- Division of Cardiology, Department of Medicine, Itabashi Hospital, Nihon University School of Medicine, Ohyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Ryuta Watanabe
- Division of Cardiology, Department of Medicine, Itabashi Hospital, Nihon University School of Medicine, Ohyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | | | - Naoya Matsumoto
- Department of Cardiology, Nihon University Hospital, Tokyo, Japan
| | - Takayuki Otsuka
- Department of Cardiology, The Cardiovascular Institute, Tokyo, Japan
| | - Shinya Suzuki
- Department of Cardiology, The Cardiovascular Institute, Tokyo, Japan
| | - Akio Hirata
- Cardiovascular Division, Osaka Police Hospital, Osaka, Japan
| | - Masato Murakami
- Divison of Cardiology, Shonan-Kamakura General Hospital, Kanagawa, Japan
| | | | - Masaomi Kimura
- Department of Cardiology, Hirosaki University Hospital, Aomori, Japan
| | | | - Shiro Nakahara
- Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | | | | | | | | | - Ikutaro Nakajima
- St. Marianna University School of Medicine Hospital, Kanagawa, Japan
| | - Tomoo Harada
- St. Marianna University School of Medicine Hospital, Kanagawa, Japan
| | | | - Ken Okumura
- Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Michifumi Tokuda
- Tokyo Jikei University School of Medicine Hospital, Tokyo, Japan
| | - Teiichi Yamane
- Tokyo Jikei University School of Medicine Hospital, Tokyo, Japan
| | - Kojiro Tanimoto
- National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | | | | | | | | | | | | | | | - Masaru Inoue
- Ishikawa Prefectural Central Hospital, Ishikawa, Japan
| | | | | | | | | | | | - Yasuo Okumura
- Division of Cardiology, Department of Medicine, Itabashi Hospital, Nihon University School of Medicine, Ohyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.
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15
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Yamashita S, Tokuda M, Matsuo S, Mahida S, Sato H, Oseto H, Yokoyama M, Isogai R, Tokutake K, Yokoyama K, Narui R, Kato M, Tanigawa S, Miyanaga S, Sugimoto K, Yoshimura M, Yamane T. Risk of Coronary Sinus Stenosis After Epicardial Radiofrequency Ablation for Mitral Isthmus Linear Ablation. Circ Arrhythm Electrophysiol 2020; 13. [PMID: 32755378 DOI: 10.1161/circep.120.008388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Seigo Yamashita
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Michifumi Tokuda
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Seiichiro Matsuo
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Saagar Mahida
- Department of Cardiac Electrophysiology, Liverpool Heart and Chest Hospital & Liverpool Centre for Cardiovascular Science, Liverpool, United Kingdom
| | - Hidenoti Sato
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Hirotsuna Oseto
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Masaaki Yokoyama
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryota Isogai
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Tokutake
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Yokoyama
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryohsuke Narui
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Mika Kato
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Shinichi Tanigawa
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Satoru Miyanaga
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Sugimoto
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Michihiro Yoshimura
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Teiichi Yamane
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
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16
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Yokoyama M, Yamashita S, Tokuda M, Mahida S, Yoshimura M, Yamane T. Supraventricular bigeminy originating from the mitral annulus: What is the mechanism? J Cardiovasc Electrophysiol 2020; 31:2222-2225. [PMID: 32608049 DOI: 10.1111/jce.14645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/12/2020] [Accepted: 06/26/2020] [Indexed: 11/29/2022]
Abstract
We present a case of a 67-year-old female with a previous history of pulmonary vein isolation for paroxysmal atrial fibrillation who presented with supraventricular bigeminy with a constant coupling interval. The supraventricular bigeminy originated from the anterior mitral annulus with initial mapping suggestive of a focal mechanism. However detailed mapping using an ultrahigh resolution mapping system (with the manual shifting of the annotation window) revealed very low amplitude potentials connecting the previous sinus beat with continuous activation along the mitral annulus. Our observations were indicative of a re-entry mechanism underlying the supraventricular bigeminy.
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Affiliation(s)
- Masaaki Yokoyama
- Department of Internal Medicine, Division of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Seigo Yamashita
- Department of Internal Medicine, Division of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Michifumi Tokuda
- Department of Internal Medicine, Division of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Saagar Mahida
- Department of Cardiac Electrophysiology, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom.,Liverpool Centre for Cardiovascular Science, Liverpool, United Kingdom
| | - Michihiro Yoshimura
- Department of Internal Medicine, Division of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Teiichi Yamane
- Department of Internal Medicine, Division of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
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17
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Okumura Y, Nagashima K, Arai M, Watanabe R, Yokoyama K, Matsumoto N, Otsuka T, Suzuki S, Hirata A, Murakami M, Takami M, Kimura M, Fukaya H, Nakahara S, Kato T, Shimizu W, Iwasaki YK, Hayashi H, Harada T, Nakajima I, Okumura K, Koyama J, Tokuda M, Yamane T, Momiyama Y, Tanimoto K, Soejima K, Nonoguchi N, Ejima K, Hagiwara N, Harada M, Sonoda K, Inoue M, Kumagai K, Hayashi H, Satomi K, Yazaki Y, Watari Y. Current Status and Clinical Outcomes of Oral Anticoagulant Discontinuation After Ablation for Atrial Fibrillation in Japan ― Findings From the AF Frontier Ablation Registry ―. Circ J 2019; 83:2418-2427. [DOI: 10.1253/circj.cj-19-0602] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yasuo Okumura
- Division of Cardiology, Nihon University Itabashi Hospital
| | | | - Masaru Arai
- Division of Cardiology, Nihon University Itabashi Hospital
| | - Ryuta Watanabe
- Division of Cardiology, Nihon University Itabashi Hospital
| | | | | | | | - Shinya Suzuki
- Department of Cardiology, The Cardiovascular Institute
| | - Akio Hirata
- Cardiovascular Division, Osaka Police Hospital
| | | | | | - Masaomi Kimura
- Divison of Cardiology, Pulmonary Medicine and Nephrology, Hirosaki University School of Medicine
| | | | | | | | | | | | | | - Tomoo Harada
- St. Marianna University School of Medicine Hospital
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18
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Tokutake K, Tokuda M, Yamashita S, Sato H, Ikewaki H, Okajima E, Oseto H, Yokoyama M, Isogai R, Yokoyama K, Kato M, Narui R, Tanigawa S, Matsuo S, Miyanaga S, Sugimoto K, Yoshimura M, Yamane T. Anatomical and Procedural Factors of Severe Pulmonary Vein Stenosis After Cryoballoon Pulmonary Vein Ablation. JACC Clin Electrophysiol 2019; 5:1303-1315. [DOI: 10.1016/j.jacep.2019.08.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 07/30/2019] [Accepted: 08/01/2019] [Indexed: 11/29/2022]
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19
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Yamashita S, Tokuda M, Matsuo S, Mahida S, Hachisuka EO, Sato H, Ikewaki H, Oseto H, Yokoyama M, Isogai R, Tokutake K, Yokoyama K, Narui R, Kato M, Tanigawa S, Sugimoto K, Yoshimura M, Yamane T. Comparison of atrial arrhythmia recurrence after persistent atrial fibrillation ablation between patients with or without tachycardia‐induced cardiomyopathy. J Cardiovasc Electrophysiol 2019; 30:2310-2318. [DOI: 10.1111/jce.14144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/09/2019] [Accepted: 08/20/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Seigo Yamashita
- Division of Cardiology, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Michifumi Tokuda
- Division of Cardiology, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Seiichiro Matsuo
- Division of Cardiology, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Saagar Mahida
- Department of Cardiac Electrophysiology Liverpool Heart and Chest Hospital Liverpool UK
| | - Eri Okajima Hachisuka
- Division of Cardiology, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Hidenori Sato
- Division of Cardiology, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Hirotsugu Ikewaki
- Division of Cardiology, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Hirotsuna Oseto
- Division of Cardiology, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Masaaki Yokoyama
- Division of Cardiology, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Ryota Isogai
- Division of Cardiology, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Kenichi Tokutake
- Division of Cardiology, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Kenichi Yokoyama
- Division of Cardiology, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Ryohsuke Narui
- Division of Cardiology, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Mika Kato
- Division of Cardiology, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Shinichi Tanigawa
- Division of Cardiology, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Kenichi Sugimoto
- Division of Cardiology, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Michihiro Yoshimura
- Division of Cardiology, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
| | - Teiichi Yamane
- Division of Cardiology, Department of Internal Medicine The Jikei University School of Medicine Tokyo Japan
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20
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Tokuda M, Yamashita S, Matsuo S, Kato M, Sato H, Oseto H, Okajima E, Ikewaki H, Yokoyama M, Isogai R, Tokutake K, Yokoyama K, Narui R, Tanigawa SI, Yoshimura M, Yamane T. Clinical significance of early recurrence of atrial fibrillation after cryoballoon vs. radiofrequency ablation-A propensity score matched analysis. PLoS One 2019; 14:e0219269. [PMID: 31265482 PMCID: PMC6605651 DOI: 10.1371/journal.pone.0219269] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 06/19/2019] [Indexed: 11/30/2022] Open
Abstract
Objectives One of the mechanisms of early recurrence of atrial fibrillation (ERAF) after AF ablation is considered to be the inflammatory reaction of the atrial tissue. The aim of this study is to compare the clinical significance of ERAF at each stage for true AF recurrence between cryoballoon (CB) and radiofrequency (RF) ablation. Methods Among 798 paroxysmal AF patients who underwent an initial ablation, 460 patients (CB, n = 230; RF, n = 230) were selected by propensity score matching. Very ERAF (VERAF), ERAF-1M, ERAF-3M and true AF recurrence were defined as AF recurrence at 0–2, 3–30, 31–90 days and more than 90 days after the procedure, respectively. Results The patient characteristics of the two groups were similar. ERAF was observed 21% and 27% in the CB and RF groups, respectively. In both the CB and RF group, VERAF, ERAF-1M and ERAF-3M were more frequently observed in patients with true AF recurrence than in those without. In a multivariable analysis, ERAF-1M and ERAF-3M were found to be independent predictors of true AF recurrence in both the CB (P = 0.04 and P<0.001, respectively) and RF groups (P = 0.02 and P = 0.001, respectively). However, while VERAF was associated with true AF recurrence after RF ablation (P = 0.03), it was not associated with true AF recurrence after CB ablation (P = 0.19). Conclusion The relationship between ERAF and true AF recurrence differed between the RF and CB ablation groups. While VERAF was associated with true AF recurrence after RF ablation, it was not a predictor of true AF recurrence after CB ablation.
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Affiliation(s)
- Michifumi Tokuda
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
- * E-mail:
| | - Seigo Yamashita
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Seiichiro Matsuo
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Mika Kato
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hidenori Sato
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hirotsuna Oseto
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Eri Okajima
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hidetsugu Ikewaki
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Masaaki Yokoyama
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryota Isogai
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Tokutake
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Yokoyama
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryohsuke Narui
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shin-ichi Tanigawa
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Michihiro Yoshimura
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Teiichi Yamane
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
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21
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Yamashita S, Takigawa M, Denis A, Derval N, Sakamoto Y, Masuda M, Nakamura K, Miwa Y, Tokutake K, Yokoyama K, Tokuda M, Matsuo S, Naito S, Soejima K, Yoshimura M, Haïssaguerre M, Jaïs P, Yamane T. Pulmonary vein-gap re-entrant atrial tachycardia following atrial fibrillation ablation: an electrophysiological insight with high-resolution mapping. Europace 2019; 21:1039-1047. [DOI: 10.1093/europace/euz034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 03/07/2019] [Indexed: 11/13/2022] Open
Abstract
Aims
The circuit of pulmonary vein-gap re-entrant atrial tachycardia (PV-gap RAT) after atrial fibrillation ablation is sometimes difficult to identify by conventional mapping. We analysed the detailed circuit and electrophysiological features of PV-gap RATs using a novel high-resolution mapping system.
Methods and results
This multicentre study investigated 27 (7%) PV-gap RATs in 26 patients among 378 atrial tachycardias (ATs) mapped with Rhythmia™ system in 281 patients. The tachycardia cycle length (TCL) was 258 ± 52 ms with P-wave duration of 116 ± 28 ms. Three types of PV-gap RAT circuits were identified: (A) two gaps in one pulmonary vein (PV) (unilateral circuit) (n = 17); (B) two gaps in the ipsilateral superior and inferior PVs (unilateral circuit) (n = 6); and (C) two gaps in one PV with a large circuit around contralateral PVs (bilateral circuit) (n = 4). Rhythmia™ mapping demonstrated two distinctive entrance and exit gaps of 7.6 ± 2.5 and 7.9 ± 4.1 mm in width, respectively, the local signals of which showed slow conduction (0.14 ± 0.18 and 0.11 ± 0.10m/s) with fragmentation (duration 86 ± 27 and 78 ± 23 ms) and low-voltage (0.17 ± 0.13 and 0.17 ± 0.21 mV). Twenty-two ATs were terminated (mechanical bump in one) and five were changed by the first radiofrequency application at the entrance or exit gap. Moreover, the conduction time inside the PVs (entrance-to-exit) was 138 ± 60 ms (54 ± 22% of TCL); in all cases, this resulted in demonstrating P-wave with an isoelectric line in all leads.
Conclusion
This is the first report to demonstrate the detailed mechanisms of PV-gap re-entry that showed evident entrance and exit gaps using a high-resolution mapping system. The circuits were variable and Rhythmia™-guided ablation targeting the PV-gap can be curative.
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Affiliation(s)
- Seigo Yamashita
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | | | - Arnaud Denis
- CHU Bordeaux, IHU Lyric, Université de Bordeaux, Bordeaux, France
| | - Nicolas Derval
- CHU Bordeaux, IHU Lyric, Université de Bordeaux, Bordeaux, France
| | - Yuichiro Sakamoto
- Department of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Aichi, Japan
| | | | - Kohki Nakamura
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Gunma, Japan
| | - Yosuke Miwa
- Department of Cardiology, Kyorin University Hospital, Tokyo, Japan
| | - Kenichi Tokutake
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | - Kenichi Yokoyama
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | - Michifumi Tokuda
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | - Seiichiro Matsuo
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | - Shigeto Naito
- Division of Cardiology, Gunma Prefectural Cardiovascular Center, Gunma, Japan
| | - Kyoko Soejima
- Department of Cardiology, Kyorin University Hospital, Tokyo, Japan
| | - Michihiro Yoshimura
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
| | | | - Pierre Jaïs
- CHU Bordeaux, IHU Lyric, Université de Bordeaux, Bordeaux, France
| | - Teiichi Yamane
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-19-18 Nishishinbashi, Minato-ku, Tokyo, Japan
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22
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Tokuda M, Yamashita S, Matsuo S, Kato M, Sato H, Oseto H, Okajima E, Ikewaki H, Isogai R, Tokutake K, Yokoyama K, Narui R, Tanigawa SI, Inada K, Yoshimura M, Yamane T. Radiofrequency needle for transseptal puncture is associated with lower incidence of thromboembolism during catheter ablation of atrial fibrillation: propensity score-matched analysis. Heart Vessels 2018; 33:1238-1244. [DOI: 10.1007/s00380-018-1159-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/30/2018] [Indexed: 11/24/2022]
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23
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Narui R, Yamane T, Tokuda M, Ikewaki H, Okajima E, Sato H, Oseto H, Isogai R, Tokutake K, Yokoyama K, Kato M, Ito K, Tanigawa SI, Yamashita S, Inada K, Matsuo S, Miyanaga S, Sugimoto K, Yoshimura M. Atrial fibrillation diagnosed by a medical checkup is associated with a poor outcome of catheter ablation. Heart Vessels 2018; 33:770-776. [PMID: 29357093 DOI: 10.1007/s00380-017-1115-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 12/22/2017] [Indexed: 11/30/2022]
Abstract
Atrial fibrillation (AF), especially asymptomatic cases, is often detected by medical checkups. We investigated the outcome of AF ablation in cases detected by medical checkups. We reviewed the data of 735 patients with AF (56 ± 10 years, paroxysmal: 441 patients) who underwent initial catheter ablation. All patients were divided into two groups based on their AF being diagnosed either by a medical checkup (group M) or not (group NM). AF was diagnosed by medical checkups in 263 (36%) patients. In Group M, the age was younger, time from the diagnosis to ablation shorter, left atrium dimension larger, and left ventricular ejection fraction lower than in Group NM. Male gender, persistent AF, and asymptomatic AF were more frequently seen in Group M than in Group NM. A mean of 13 ± 11 months after the initial ablation procedure, AF recurrence was more frequently observed in group M compared to group NM (P = 0.018). While the AF recurrence rate was similar in both groups in persistent AF patients (P = 0.87), it was more frequently observed in Group M than in Group NM in paroxysmal AF patients (P = 0.005). AF diagnosed by medical checkups was often associated with a worse outcome of catheter ablation, especially in paroxysmal AF patients.
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Affiliation(s)
- Ryohsuke Narui
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Teiichi Yamane
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Michifumi Tokuda
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hirotsugu Ikewaki
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Eri Okajima
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hidenori Sato
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hirotsuna Oseto
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ryota Isogai
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenichi Tokutake
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenichi Yokoyama
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Mika Kato
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Keiichi Ito
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shin-Ichi Tanigawa
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Seigo Yamashita
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Keiichi Inada
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Seiichiro Matsuo
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Satoru Miyanaga
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenichi Sugimoto
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Michihiro Yoshimura
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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24
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Fujii A, Nagashima K, Kumar S, Tanigawa S, Baldinger SH, Michaud GF, John RM, Koplan BA, Tokuda M, Inada K, Tedrow UB, Stevenson WG. Significance of Inducible Nonsustained Ventricular Tachycardias After Catheter Ablation for Ventricular Tachycardia in Ischemic Cardiomyopathy. Circ Arrhythm Electrophysiol 2017; 10:CIRCEP.117.005005. [PMID: 29237608 DOI: 10.1161/circep.117.005005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 11/20/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Noninducibility of sustained monomorphic ventricular tachycardia (SMVT) postablation does not insure absence of later recurrence in patients with ischemic cardiomyopathy. This study aims to determine the relation between inducible nonsustained VT postablation and VT recurrences. METHODS AND RESULTS One hundred sixty-five consecutive patients (156 male; age 68±9 years) underwent ablation for SMVT because of ischemic cardiomyopathy; 44 patients who did not have induction testing or in whom only ventricular fibrillation was induced after ablation were excluded. In 38 patients (23%), SMVT was inducible (group C). Of the 83 patients without inducible SMVT after ablation, nonsustained VT defined as ≥5 beats lasting for <30 s, was induced in 34 patients (group B, 21%), whereas the remaining 49 patients had no VT induced by the induction test (group A, 30%). Over a median follow-up of 18.7 months, freedom from recurrent VT at 24 months was 60% in group A, 45% in group B (P=0.017 versus group A), and 38% in group C (P=0.005 versus group A). In patients without inducible SMVT, inducible nonsustained VT and left ventricular ejection fraction was independently associated with VT recurrence (hazard ratio, 3.66 and 1.07; 95% CI, 1.3-11.1 and 1.01-1.14). CONCLUSIONS Inducible nonsustained VT postablation suggests the continued presence of functional arrhythmia substrate. Further trials are needed to assess whether additional ablation would improve outcome in this group.
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Affiliation(s)
- Akira Fujii
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.F., S.K., S.T., S.H.B., G.F.M., R.M.J., B.A.K., M.T., K.I., U.B.T., W.G.S.); and Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan (K.N.).
| | - Koichi Nagashima
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.F., S.K., S.T., S.H.B., G.F.M., R.M.J., B.A.K., M.T., K.I., U.B.T., W.G.S.); and Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan (K.N.)
| | - Saurabh Kumar
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.F., S.K., S.T., S.H.B., G.F.M., R.M.J., B.A.K., M.T., K.I., U.B.T., W.G.S.); and Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan (K.N.)
| | - Shinichi Tanigawa
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.F., S.K., S.T., S.H.B., G.F.M., R.M.J., B.A.K., M.T., K.I., U.B.T., W.G.S.); and Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan (K.N.)
| | - Samuel H Baldinger
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.F., S.K., S.T., S.H.B., G.F.M., R.M.J., B.A.K., M.T., K.I., U.B.T., W.G.S.); and Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan (K.N.)
| | - Gregory F Michaud
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.F., S.K., S.T., S.H.B., G.F.M., R.M.J., B.A.K., M.T., K.I., U.B.T., W.G.S.); and Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan (K.N.)
| | - Roy M John
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.F., S.K., S.T., S.H.B., G.F.M., R.M.J., B.A.K., M.T., K.I., U.B.T., W.G.S.); and Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan (K.N.)
| | - Bruce A Koplan
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.F., S.K., S.T., S.H.B., G.F.M., R.M.J., B.A.K., M.T., K.I., U.B.T., W.G.S.); and Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan (K.N.)
| | - Michifumi Tokuda
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.F., S.K., S.T., S.H.B., G.F.M., R.M.J., B.A.K., M.T., K.I., U.B.T., W.G.S.); and Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan (K.N.)
| | - Keiichi Inada
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.F., S.K., S.T., S.H.B., G.F.M., R.M.J., B.A.K., M.T., K.I., U.B.T., W.G.S.); and Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan (K.N.)
| | - Usha B Tedrow
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.F., S.K., S.T., S.H.B., G.F.M., R.M.J., B.A.K., M.T., K.I., U.B.T., W.G.S.); and Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan (K.N.)
| | - William G Stevenson
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.F., S.K., S.T., S.H.B., G.F.M., R.M.J., B.A.K., M.T., K.I., U.B.T., W.G.S.); and Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan (K.N.).
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25
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Tokutake K, Tokuda M, Matsuo S, Isogai R, Yokoyama K, Kato M, Narui R, Tanigawa S, Yamashita S, Miyanaga S, Yoshimura M, Yamane T. Dissociated pulmonary vein activity after cryoballoon ablation and radiofrequency ablation for atrial fibrillation: a propensity score-matched analysis. Heart Vessels 2017; 33:529-536. [PMID: 29147788 DOI: 10.1007/s00380-017-1083-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 11/10/2017] [Indexed: 10/18/2022]
Abstract
Cryoballoons (CBs) have proven to be effective for achieving pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF). Dissociated PV activity (DPVA) after successful radiofrequency PVI is sometimes observed inside the PV and has been found to prove the achievement of electrical disconnection from the left atrium. However, little is known about the incidence or characteristics of DPVA after CB-PVI. The aim of this study was to compare the incidence and characteristics of DPVA in patients undergoing CB and radiofrequency (RF) ablation for AF. Two hundred and ninety-four propensity score-matched patients from 440 consecutive patients who underwent initial catheter ablation for paroxysmal AF were included in the present study (CB-PVI 147, RF-PVI 147). DPVA was more frequently observed after CB-PVI than after RF-PVI (32 vs. 19% of the PVs, P < 0.001), especially in the left superior PV (52 vs. 29%, P < 0.001) and left inferior PV (22 vs. 7%, P < 0.001). The AF-free rate after the initial ablation in the patients with and without DPVA was similar in both the CB (P = 0.23) and RF (P = 0.39) groups. During repeat ablation procedures for recurrent AF, PV reconnection was similarly observed in PVs with and without DPVA during the initial procedure, both in the CB (30 vs. 44%, P = 0.29) and RF (65 vs. 58%, P = 0.41) groups. DPVA was more frequently observed after CB-PVI than after RF-PVI. The presence of DPVA was not related to the ablation outcome or chronic PV reconnection following CB-PVI.
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Affiliation(s)
- Kenichi Tokutake
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Michifumi Tokuda
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Seiichiro Matsuo
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ryota Isogai
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenichi Yokoyama
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Mika Kato
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ryohsuke Narui
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shinichi Tanigawa
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Seigo Yamashita
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Satoru Miyanaga
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Michihiro Yoshimura
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Teiichi Yamane
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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Yokoyama K, Tokuda M, Matsuo S, Isogai R, Tokutake K, Kato M, Narui R, Tanigawa S, Yamashita S, Inada K, Yoshimura M, Yamane T. Pulmonary vein re-mapping after cryoballoon ablation for atrial fibrillation. Europace 2017; 20:943-948. [DOI: 10.1093/europace/eux129] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 04/18/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- Kenichi Yokoyama
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Michifumi Tokuda
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Seiichiro Matsuo
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Ryota Isogai
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Kenichi Tokutake
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Mika Kato
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Ryohsuke Narui
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Shinichi Tanigawa
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Seigo Yamashita
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Keiichi Inada
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Michihiro Yoshimura
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Teiichi Yamane
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
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Narui R, Tokuda M, Matsushima M, Isogai R, Tokutake K, Yokoyama K, Hioki M, Ito K, Tanigawa SI, Yamashita S, Inada K, Shibayama K, Matsuo S, Miyanaga S, Sugimoto K, Yoshimura M, Yamane T. Incidence and Factors Associated With the Occurrence of Pulmonary Vein Narrowing After Cryoballoon Ablation. Circ Arrhythm Electrophysiol 2017. [DOI: 10.1161/circep.116.004588] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ryohsuke Narui
- From the Department of Cardiology (R.N., M.T., R.I., K.T., K.Y., M.H., K.Ito, S.T., S.Y., K.Inada, K.Shibayama, S.Matsuo, S.Miyanaga, K.Sugimoto, M.Y., T.Y.) and Division of Clinical Epidemiology (M.M.), The Jikei University School of Medicine, Tokyo, Japan
| | - Michifumi Tokuda
- From the Department of Cardiology (R.N., M.T., R.I., K.T., K.Y., M.H., K.Ito, S.T., S.Y., K.Inada, K.Shibayama, S.Matsuo, S.Miyanaga, K.Sugimoto, M.Y., T.Y.) and Division of Clinical Epidemiology (M.M.), The Jikei University School of Medicine, Tokyo, Japan
| | - Masato Matsushima
- From the Department of Cardiology (R.N., M.T., R.I., K.T., K.Y., M.H., K.Ito, S.T., S.Y., K.Inada, K.Shibayama, S.Matsuo, S.Miyanaga, K.Sugimoto, M.Y., T.Y.) and Division of Clinical Epidemiology (M.M.), The Jikei University School of Medicine, Tokyo, Japan
| | - Ryota Isogai
- From the Department of Cardiology (R.N., M.T., R.I., K.T., K.Y., M.H., K.Ito, S.T., S.Y., K.Inada, K.Shibayama, S.Matsuo, S.Miyanaga, K.Sugimoto, M.Y., T.Y.) and Division of Clinical Epidemiology (M.M.), The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Tokutake
- From the Department of Cardiology (R.N., M.T., R.I., K.T., K.Y., M.H., K.Ito, S.T., S.Y., K.Inada, K.Shibayama, S.Matsuo, S.Miyanaga, K.Sugimoto, M.Y., T.Y.) and Division of Clinical Epidemiology (M.M.), The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Yokoyama
- From the Department of Cardiology (R.N., M.T., R.I., K.T., K.Y., M.H., K.Ito, S.T., S.Y., K.Inada, K.Shibayama, S.Matsuo, S.Miyanaga, K.Sugimoto, M.Y., T.Y.) and Division of Clinical Epidemiology (M.M.), The Jikei University School of Medicine, Tokyo, Japan
| | - Mika Hioki
- From the Department of Cardiology (R.N., M.T., R.I., K.T., K.Y., M.H., K.Ito, S.T., S.Y., K.Inada, K.Shibayama, S.Matsuo, S.Miyanaga, K.Sugimoto, M.Y., T.Y.) and Division of Clinical Epidemiology (M.M.), The Jikei University School of Medicine, Tokyo, Japan
| | - Keiichi Ito
- From the Department of Cardiology (R.N., M.T., R.I., K.T., K.Y., M.H., K.Ito, S.T., S.Y., K.Inada, K.Shibayama, S.Matsuo, S.Miyanaga, K.Sugimoto, M.Y., T.Y.) and Division of Clinical Epidemiology (M.M.), The Jikei University School of Medicine, Tokyo, Japan
| | - Shin-ichi Tanigawa
- From the Department of Cardiology (R.N., M.T., R.I., K.T., K.Y., M.H., K.Ito, S.T., S.Y., K.Inada, K.Shibayama, S.Matsuo, S.Miyanaga, K.Sugimoto, M.Y., T.Y.) and Division of Clinical Epidemiology (M.M.), The Jikei University School of Medicine, Tokyo, Japan
| | - Seigo Yamashita
- From the Department of Cardiology (R.N., M.T., R.I., K.T., K.Y., M.H., K.Ito, S.T., S.Y., K.Inada, K.Shibayama, S.Matsuo, S.Miyanaga, K.Sugimoto, M.Y., T.Y.) and Division of Clinical Epidemiology (M.M.), The Jikei University School of Medicine, Tokyo, Japan
| | - Keiichi Inada
- From the Department of Cardiology (R.N., M.T., R.I., K.T., K.Y., M.H., K.Ito, S.T., S.Y., K.Inada, K.Shibayama, S.Matsuo, S.Miyanaga, K.Sugimoto, M.Y., T.Y.) and Division of Clinical Epidemiology (M.M.), The Jikei University School of Medicine, Tokyo, Japan
| | - Kenri Shibayama
- From the Department of Cardiology (R.N., M.T., R.I., K.T., K.Y., M.H., K.Ito, S.T., S.Y., K.Inada, K.Shibayama, S.Matsuo, S.Miyanaga, K.Sugimoto, M.Y., T.Y.) and Division of Clinical Epidemiology (M.M.), The Jikei University School of Medicine, Tokyo, Japan
| | - Seiichiro Matsuo
- From the Department of Cardiology (R.N., M.T., R.I., K.T., K.Y., M.H., K.Ito, S.T., S.Y., K.Inada, K.Shibayama, S.Matsuo, S.Miyanaga, K.Sugimoto, M.Y., T.Y.) and Division of Clinical Epidemiology (M.M.), The Jikei University School of Medicine, Tokyo, Japan
| | - Satoru Miyanaga
- From the Department of Cardiology (R.N., M.T., R.I., K.T., K.Y., M.H., K.Ito, S.T., S.Y., K.Inada, K.Shibayama, S.Matsuo, S.Miyanaga, K.Sugimoto, M.Y., T.Y.) and Division of Clinical Epidemiology (M.M.), The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Sugimoto
- From the Department of Cardiology (R.N., M.T., R.I., K.T., K.Y., M.H., K.Ito, S.T., S.Y., K.Inada, K.Shibayama, S.Matsuo, S.Miyanaga, K.Sugimoto, M.Y., T.Y.) and Division of Clinical Epidemiology (M.M.), The Jikei University School of Medicine, Tokyo, Japan
| | - Michihiro Yoshimura
- From the Department of Cardiology (R.N., M.T., R.I., K.T., K.Y., M.H., K.Ito, S.T., S.Y., K.Inada, K.Shibayama, S.Matsuo, S.Miyanaga, K.Sugimoto, M.Y., T.Y.) and Division of Clinical Epidemiology (M.M.), The Jikei University School of Medicine, Tokyo, Japan
| | - Teiichi Yamane
- From the Department of Cardiology (R.N., M.T., R.I., K.T., K.Y., M.H., K.Ito, S.T., S.Y., K.Inada, K.Shibayama, S.Matsuo, S.Miyanaga, K.Sugimoto, M.Y., T.Y.) and Division of Clinical Epidemiology (M.M.), The Jikei University School of Medicine, Tokyo, Japan
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Narui R, Matsuo S, Isogai R, Tokutake K, Yokoyama K, Kato M, Ito K, Tanigawa SI, Yamashita S, Tokuda M, Inada K, Shibayama K, Miyanaga S, Sugimoto K, Yoshimura M, Yamane T. Impact of deep sedation on the electrophysiological behavior of pulmonary vein and non-PV firing during catheter ablation for atrial fibrillation. J Interv Card Electrophysiol 2017; 49:51-57. [PMID: 28285382 DOI: 10.1007/s10840-017-0238-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 02/23/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE Catheter ablation for atrial fibrillation is performed with and without deep sedation, which could affect the arrhythmogenic activity during the procedure. We investigated the impact of sedation on electrophysiological properties in patients with AF who underwent catheter ablation. METHODS This study consisted of 255 consecutive patients with atrial fibrillation (229 males, persistent: 105 patients) who underwent a single-catheter ablation procedure. The patients were divided into the following two groups according to the depth of sedation during the procedure: group M (mild sedation with flunitrazepam in 138 patients) and group D (deep sedation with propofol in 117 patients). Peripheral oxygen saturation was continuously monitored via pulse oximetry throughout the procedure. RESULTS A spontaneous dissociated pulmonary vein activity after pulmonary vein isolation occurred more frequently in group M than in group D (29.1 vs 15.7%, P < 0.01). Adenosine-induced dormant pulmonary vein conduction was more frequently observed in group M than in group D (19.2 vs 13.0% P = 0.01). There were no significant differences in the incidence of non-pulmonary vein triggers between groups M and D (15.2 vs 11.1%, P = 0.53). The atrial fibrillation recurrence rate following the single procedure did not differ between the two groups (29.0 vs 26.5%, in groups M and D, P = 0.85). CONCLUSIONS Although deep sedation reduced the incidence of a dissociated pulmonary vein activity and dormant pulmonary vein conduction following pulmonary vein isolation, it did not affect the recurrence rate for atrial fibrillation after the procedure.
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Affiliation(s)
- Ryohsuke Narui
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Seiichiro Matsuo
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Ryota Isogai
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenichi Tokutake
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenichi Yokoyama
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Mika Kato
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Keiichi Ito
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shin-Ichi Tanigawa
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Seigo Yamashita
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Michifumi Tokuda
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Keiichi Inada
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenri Shibayama
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Satoru Miyanaga
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenichi Sugimoto
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Michihiro Yoshimura
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Teiichi Yamane
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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Yokoyama K, Yamashita S, Tokutake K, Narui R, Kato M, Tanigawa S, Tokuda M, Inada K, Matsuo S, Shibayama K, Miyanaga S, Yoshimura M, Yamane T. Total absence of pulmonary vein potentials in a patient with paroxysmal atrial fibrillation: was it really isolated? Heart Vessels 2017; 32:501-505. [PMID: 28054100 DOI: 10.1007/s00380-016-0928-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 11/25/2016] [Indexed: 11/30/2022]
Abstract
We herein present a case (72 years, male) with total absence of pulmonary veins (PVs) potentials at the beginning of the first procedure for paroxysmal atrial fibrillation (AF), demonstrating dormant conduction between the left atrium and all PVs revealed by adenosine triphosphate provocation with relation to the incidence of AF. He was free from atrial arrhythmias during 1 year follow-up after complete PV isolation with the elimination of multiple transient dormant conductions by circular mapping catheter guide ablation.
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Affiliation(s)
- Kenichi Yokoyama
- Department of Cardiology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, Japan
| | - Seigo Yamashita
- Department of Cardiology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, Japan.
| | - Kenichi Tokutake
- Department of Cardiology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, Japan
| | - Ryohsuke Narui
- Department of Cardiology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, Japan
| | - Mika Kato
- Department of Cardiology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, Japan
| | - Shinichi Tanigawa
- Department of Cardiology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, Japan
| | - Michifumi Tokuda
- Department of Cardiology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, Japan
| | - Keiichi Inada
- Department of Cardiology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, Japan
| | - Seiichiro Matsuo
- Department of Cardiology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, Japan
| | - Kenri Shibayama
- Department of Cardiology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, Japan
| | - Satoru Miyanaga
- Department of Cardiology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, Japan
| | - Michihiro Yoshimura
- Department of Cardiology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, Japan
| | - Teiichi Yamane
- Department of Cardiology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, Japan
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Tokutake K, Tokuda M, Ogawa T, Matsuo S, Yoshimura M, Yamane T. Pulmonary vein stenosis after second-generation cryoballoon ablation for atrial fibrillation. HeartRhythm Case Rep 2016; 3:36-39. [PMID: 28491764 PMCID: PMC5420014 DOI: 10.1016/j.hrcr.2016.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Kenichi Tokutake
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Michifumi Tokuda
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Takayuki Ogawa
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Seiichiro Matsuo
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Michihiro Yoshimura
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Teiichi Yamane
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
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31
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Tokuda M, Matsuo S, Isogai R, Uno G, Tokutake K, Yokoyama K, Kato M, Narui R, Tanigawa S, Yamashita S, Inada K, Yoshimura M, Yamane T. Adenosine testing during cryoballoon ablation and radiofrequency ablation of atrial fibrillation: A propensity score-matched analysis. Heart Rhythm 2016; 13:2128-2134. [PMID: 27520540 DOI: 10.1016/j.hrthm.2016.08.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND The infusion of adenosine triphosphate after radiofrequency (RF) pulmonary vein (PV) isolation (PVI), which may result in acute transient PV-atrium reconnection, can unmask dormant conduction. OBJECTIVE The purpose of this study was to compare the incidence and characteristics of dormant conduction after cryoballoon (CB) and RF ablation of atrial fibrillation (AF). METHODS Of 414 consecutive patients undergoing initial catheter ablation of paroxysmal AF, 246 (59%) propensity score-matched patients (123 CB-PVI and 123 RF-PVI) were included. RESULTS Dormant conduction was less frequently observed in patients who underwent CB-PVI than in those who underwent RF-PVI (4.5% vs 12.8% of all PVs; P < .0001). The incidence of dormant conduction in each PV was lower in patients who underwent CB-PVI than in those who underwent RF-PVI in the left superior PV (P < .0001) and right superior PV (P = .001). The site of dormant conduction was mainly located around the bottom of both inferior PVs after CB-PVI. Multivariable analysis revealed that a longer time to the elimination of the PV potential (odds ratio 1.018; 95% confidence interval 1.001-1.036; P = .04) and the necessity of touch-up ablation (odds ratio 3.242; 95% confidence interval 2.761-7.111; P < .0001) were independently associated with the presence of dormant conduction after CB-PVI. After the elimination of dormant conduction by additional ablation, the AF-free rate was similar in patients with and without dormant conduction after both CB-PVI and RF-PVI (P = .28 and P = .73, respectively). CONCLUSION The results of the propensity score-matched analysis showed that dormant PV conduction was less frequent after CB ablation than after RF ablation and was not associated with ablation outcomes.
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Affiliation(s)
- Michifumi Tokuda
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan.
| | - Seiichiro Matsuo
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryota Isogai
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Goki Uno
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Tokutake
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Yokoyama
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Mika Kato
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryohsuke Narui
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shinichi Tanigawa
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Seigo Yamashita
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Keiichi Inada
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Michihiro Yoshimura
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Teiichi Yamane
- Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan
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33
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Hioki M, Matsuo S, Tokutake K, Yokoyama K, Narui R, Ito K, Tanigawa S, Tokuda M, Yamashita S, Anan I, Inada K, Sakuma T, Sugimoto KI, Yoshimura M, Yamane T. Filling defects of the left atrial appendage on multidetector computed tomography: their disappearance following catheter ablation of atrial fibrillation and the detection of LAA thrombi by MDCT. Heart Vessels 2016; 31:2014-2024. [PMID: 26936451 DOI: 10.1007/s00380-016-0819-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 02/19/2016] [Indexed: 01/08/2023]
Abstract
Filling defects of the left atrial appendage (LAA) on multidetector computed tomography (MDCT) are known to occur, not only due to LAA thrombi formation, but also due to the disturbance of blood flow in the LAA of patients with atrial fibrillation (AF). The purpose of this study was to evaluate the impact of the maintenance of sinus rhythm via ablation on the incidence of LAA filling defects on MDCT in patients with AF. A total of 459 consecutive patients were included in the present study. Prior to ablation, MDCT and transesophageal echocardiography (TEE) were performed. AF ablation was performed in patients without LAA thrombi confirmed on TEE. The LAA filling defects were evaluated on MDCT at 3 months after ablation. LAA filling defects were detected on MDCT in 51 patients (11.1 %), among whom the absence of LAA thrombi was confirmed in 42 patients using TEE. The LAA Doppler velocity in patients with LAA filling defects was lower than that of patients without filling defects (0.61 ± 0.19 vs. 0.47 ± 0.21 m/s; P < 0.0001). The sensitivity, specificity and negative predictive value of MDCT in the detection of thrombi were 100, 91 and 100 %, respectively. No LAA filling defects were observed on MDCT at 3 months after ablation in any of the patients, including the patients in whom filling defects were noted prior to the procedure. MDCT is useful for evaluating the presence of LAA thrombi and the blood flow of the LAA. The catheter ablation of AF not only suppresses AF, but also eliminates LAA filling defect on MDCT suggesting the improvement of LAA blood flow.
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Affiliation(s)
- Mika Hioki
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Seiichiro Matsuo
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Kenichi Tokutake
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenichi Yokoyama
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ryohsuke Narui
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Keiichi Ito
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shinichi Tanigawa
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Michifumi Tokuda
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Seigo Yamashita
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ikuko Anan
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Keiichi Inada
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Toru Sakuma
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ken-Ichi Sugimoto
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Michihiro Yoshimura
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Teiichi Yamane
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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34
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Tanigawa SI, Tokuda M, Yoshimura M, Yamane T. Isolation of an arrhythmogenic roof vein with the guide of a circular mapping catheter in a case with paroxysmal atrial fibrillation. HeartRhythm Case Rep 2016; 2:202-203. [PMID: 28491669 PMCID: PMC5412607 DOI: 10.1016/j.hrcr.2015.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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35
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Tokuda M, Yamane T, Sadaoka S, Tokutake K, Yokoyama K, Hioki M, Narui R, Tanigawa S, Inada K, Matsuo S, Yoshimura M. Percutaneous retrieval of a radiolucent anchoring sleeve embolized in pulmonary artery during pacemaker implantation. Heart Vessels 2015; 31:1402-4. [PMID: 26391679 DOI: 10.1007/s00380-015-0747-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 09/09/2015] [Indexed: 10/23/2022]
Abstract
An 85-year-old female presented to our institution with symptomatic sick sinus syndrome. During pacemaker implantation, an anchoring sleeve in the right ventricular lead was embolized in the left pulmonary artery. Although the anchoring sleeve was radiolucent, digital subtraction angiography revealed an angiographic filling defect in the lower branch of the left pulmonary artery, and a snare catheter enabled the anchoring sleeve to be grasped and extracted.
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Affiliation(s)
- Michifumi Tokuda
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Teiichi Yamane
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shunichi Sadaoka
- Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Tokutake
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenichi Yokoyama
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Mika Hioki
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ryohsuke Narui
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shinichi Tanigawa
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Keiichi Inada
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Seiichiro Matsuo
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Michihiro Yoshimura
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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36
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Yamane T, Matsuo S, Tokuda M, Yoshimura M. Conjunction of Three Pulmonary Veins in Patients With Atrial Fibrillation: Images of Two Cases. J Cardiovasc Electrophysiol 2015; 26:1381-2. [PMID: 26086471 DOI: 10.1111/jce.12740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Teiichi Yamane
- Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Seiichiro Matsuo
- Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Michifumi Tokuda
- Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Michihiro Yoshimura
- Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
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37
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Tokuda M, Fujisawa M, Miyashita K, Kawakami Y, Morimoto-Yamashita Y, Torii M. Involvement of TRPV1 and AQP2 in hypertonic stress by xylitol in odontoblast cells. Connect Tissue Res 2015; 56:44-9. [PMID: 25372661 DOI: 10.3109/03008207.2014.984804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
AIM To examine the responses of mouse odontoblast-lineage cell line (OLC) cultures to xylitol-induced hypertonic stress. METHODOLOGY OLCs were treated with xylitol, sucrose, sorbitol, mannitol, arabinose and lyxose. Cell viability was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium assay. The expression of transient receptor potential vanilloids (TRPV) 1, 3 and 4 was detected using a reverse transcriptase-polymerase chain reaction (RT-PCR) assay. The expression of aquaporin (AQP) 2 was detected using immunofluorescence and Western blotting analysis. The expression of interleukin-6 (IL-6) under xylitol-induced hypertonic stress was assessed using an enzyme-linked immunosorbent assay (ELISA). Small interfering ribonucleic acid (siRNA) for AQP-2 was used to inhibition assay. RESULTS Xylitol-induced hypertonic stress did not decrease OLC viability, unlike the other sugars tested. OLCs expressed TRPV1, 3 and 4 as well as AQP2. Xylitol inhibited lipopolysaccharide (LPS)-induced IL-6 expression after 3 h of hypertonic stress. TRPV1 mRNA expression was upregulated by xylitol. Costimulation with HgCl2 (AQP inhibitor) and Ruthenium red (TRPV1 inhibitor) decreased cell viability with xylitol stimulation. OLCs treated with siRNA against TRPV1 exhibited decreased cell viability with xylitol stimulation. CONCLUSION OLCs have high-cell viability under xylitol-induced hypertonic stress, which may be associated with TRPV1 and AQP2 expressions.
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Affiliation(s)
- M Tokuda
- Department of Restorative Dentistry and Endodontology, Kagoshima University Graduate School of Medical and Dental Sciences , Kagoshima , Japan
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38
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Inada K, Matsuo S, Tokutake KI, Yokoyama KI, Hioki M, Narui R, Ito K, Tanigawa SI, Yamashita S, Tokuda M, Shibayama K, Miyanaga S, Sugimoto KI, Yoshimura M, Yamane T. Predictors of ectopic firing from the superior vena cava in patients with paroxysmal atrial fibrillation. J Interv Card Electrophysiol 2014; 42:27-32. [PMID: 25398210 DOI: 10.1007/s10840-014-9954-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 10/07/2014] [Indexed: 01/26/2023]
Abstract
PURPOSE Although catheter ablation targeting the pulmonary vein (PV) is a well-known therapy for patients with paroxysmal atrial fibrillation (PAF), ectopic firings from the superior vena cava (SVC) can initiate PAF. The purpose of this study was to investigate predictors of SVC firing. METHODS The subjects included 336 consecutive PAF patients (278 males, age 56.1 ± 10.8 years) undergoing atrial fibrillation (AF) ablation. The appearance of SVC firing was monitored throughout the procedure using a decapolar catheter with multiple electrodes to record electrograms of the coronary sinus and SVC. In addition to PV isolation, SVC isolation was performed only in patients with documented SVC firing. RESULTS SVC firing was observed in 43/336 (12.8 %) of the patients, among whom complete isolation of the SVC was achieved in 40/43 (93 %) patients. A lower body mass index (BMI) (22.8 ± 2.8 vs 24.1 ± 3.1 kg/m(2), p = 0.007) and higher prevalence of prior ablation procedures (58 vs 18 %, p = 0.0001) were related to the presence of SVC firing. In a multivariate analysis, a lower BMI (p = 0.012; odds ratio 0.83, 95 % CI 0.72 to 0.96) and history of prior ablation procedures (p < 0.0001; odds ratio 5.37, 95 % CI 2.71 to 10.63) were found to be independent predictors of the occurrence of SVC firing. Among 96 patients undergoing repeat ablation procedures, less PV-left atrial re-conduction was observed in patients with SVC firing than in those without (2.7 ± 1.2 vs 3.2 ± 0.8, p = 0.02). CONCLUSIONS The presence of SVC firing in patients with PAF is associated with a history of repeat ablation procedures and lower BMI values.
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Affiliation(s)
- Keiichi Inada
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8471, Japan,
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39
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Nagashima K, Choi EK, Lin KY, Kumar S, Tedrow UB, Koplan BA, Michaud GF, John RM, Epstein LM, Tokuda M, Inada K, Couper GS, Stevenson WG. Ventricular Arrhythmias Near the Distal Great Cardiac Vein. Circ Arrhythm Electrophysiol 2014; 7:906-12. [DOI: 10.1161/circep.114.001615] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Catheter ablation for ventricular arrhythmia (VA) near the distal great cardiac vein (GCV) is often challenging, and data are limited.
Methods and Results—
Analysis was performed in 30 patients (19 men; age, 52.8±15.5 years) who underwent catheter ablation for focal VA (11 ventricular tachycardia and 19 premature contractions) with early activation in the GCV (36.7±8.0 ms pre-QRS). Angiography in 27 patients showed earliest GCV site within 5 mm of a coronary artery in 20 (74%). Ablation was performed in the GCV in 15 patients and abolished VA in 8. Ablation was attempted at adjacent non-GCV sites in 19 patients and abolished VA in 5 patients (4 from the left ventricular endocardium and 1 from the left coronary cusp); all success had VA with an initial r wave in lead I and activation ≤7 ms after the GCV (GCV–non-GCV interval). In 13 patients, percutaneous epicardial mapping was performed, but because of adjacent coronaries only 2 received radiofrequency application with VA elimination in 1. Surgical cryoablation was performed in 3 patients and abolished VA in 2. Overall acute success was achieved in 16 (53%) patients. After a median of 2.8 months, 13 patients remained free of VA. Major complications occurred in 4 patients, including coronary injury requiring stenting.
Conclusions—
Ablation for this arrhythmia is challenging and often limited by the adjacent coronary vessels. Success of anatomically guided endocardial ablation may be identified by a short GCV–non-GCV interval and r wave in lead I.
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Affiliation(s)
- Koichi Nagashima
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Eue-Keun Choi
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Kaity Y. Lin
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Saurabh Kumar
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Usha B. Tedrow
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Bruce A. Koplan
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Gregory F. Michaud
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Roy M. John
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Laurence M. Epstein
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Michifumi Tokuda
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Keiichi Inada
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Gregory S. Couper
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - William G. Stevenson
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
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40
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Nagashima K, Choi EK, Tedrow UB, Koplan BA, Michaud GF, John RM, Epstein LM, Tokuda M, Inada K, Kumar S, Lin KY, Barbhaiya CR, Chinitz JS, Enriquez AD, Helmbold AF, Stevenson WG. Correlates and Prognosis of Early Recurrence After Catheter Ablation for Ventricular Tachycardia due to Structural Heart Disease. Circ Arrhythm Electrophysiol 2014; 7:883-8. [DOI: 10.1161/circep.114.001461] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Catheter ablation for ventricular tachycardia (VT) from structural heart disease has a significant risk of recurrence, but the optimal duration for in-hospital monitoring is not defined. This study assesses the timing, correlates, and prognostic significance of early VT recurrence after ablation.
Methods and Results—
Of 370 patients (313 men; aged 63.0±13.2 years) who underwent a first radiofrequency ablation for sustained monomorphic VT associated with structural heart disease from 2008 to 2012, sustained VT recurred in 81 patients (22%) within 7 days. In multivariable analysis, early recurrence was associated with New York Heart Association classification ≥III (odds ratio [OR] 1.90, 95% confidence interval [CI] 1.03–3.48;
P
=0.04), dilated cardiomyopathy (OR 1.93, 95% CI 1.03–3.57;
P
=0.04), prevalence of VT storm before the procedure (OR 2.62, 95% CI 1.48–4.65;
P
=0.001), a greater number of induced VTs (OR 1.24, 95% CI 1.07–1.45;
P
=0.006), and acute failure or no final induction test (OR 1.88, 95% CI 1.03–3.40;
P
=0.04). During a median of 2.5 (1.2, 4.0) years of follow-up, early VT recurrence was an independent correlates of mortality (hazard ratio 2.59, 95% CI 1.52–4.34;
P
=0.0005).
Conclusions—
Patients who have early recurrences of VT after ablation are a high risk group who may be identifiable from their clinical profile. Further study is warranted to define the optimal treatment strategies for this patient group.
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Affiliation(s)
- Koichi Nagashima
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Eue-Keun Choi
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Usha B. Tedrow
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Bruce A. Koplan
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Gregory F. Michaud
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Roy M. John
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Laurence M. Epstein
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Michifumi Tokuda
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Keiichi Inada
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Saurabh Kumar
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Kaity Y. Lin
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Chirag R. Barbhaiya
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Jason S. Chinitz
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Alan D. Enriquez
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Alan F. Helmbold
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - William G. Stevenson
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
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41
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Tokuda M, Yamane T, Matsuo S, Tokutake K, Yokoyama K, Hioki M, Narui R, Tanigawa SI, Yamashita S, Inada K, Yoshimura M. Paradoxical responses to pacing maneuvers differentiating atrioventricular node reentrant tachycardia and junctional tachycardia. Heart Vessels 2014; 31:256-60. [PMID: 25223535 DOI: 10.1007/s00380-014-0579-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 09/05/2014] [Indexed: 10/24/2022]
Abstract
A 40-year-old female presented at our hospital because of heart palpitations. During an electrophysiological study, atrioventricular (AV) conduction showed dual AV nodal physiology. Three types of supraventricular tachycardia (SVT) were induced. The initiation of SVT was reproducibility dependent on a critical A-H interval prolongation. An early premature atrial contraction during SVT repeatedly advanced the immediate His potential with termination of the tachycardia, indicating AV node reentrant tachycardia (AVNRT). However, after atrial overdrive pacing during SVT without termination of the tachycardia, the first return electrogram resulted in an AHHA response, consistent with junctional tachycardia. The mechanism of paradoxical responses to pacing maneuvers differentiating AVNRT and junctional tachycardia was discussed.
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Affiliation(s)
- Michifumi Tokuda
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Teiichi Yamane
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Seiichiro Matsuo
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenichi Tokutake
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenichi Yokoyama
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Mika Hioki
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ryohsuke Narui
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shin-Ichi Tanigawa
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Seigo Yamashita
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Keiichi Inada
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Michihiro Yoshimura
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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42
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Tokuda M, Manlucu J, Brancato S, Nagashima K, Matsuo S, Yamane T, Tedrow UB, Stevenson WG. Catheter ablation of ventricular tachycardia beneath an endoventricular patch. Circulation 2014; 130:801-2. [PMID: 25156917 DOI: 10.1161/circulationaha.114.010595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Michifumi Tokuda
- From the Arrhythmia Service, Cardiovascular Division of Brigham and Women's Hospital, Harvard Medical School, Boston, MA (M.T., J.M., S.B., K.N., U.B.T., W.G.S.); and the Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan (S.M., T.Y.).
| | - Jaimie Manlucu
- From the Arrhythmia Service, Cardiovascular Division of Brigham and Women's Hospital, Harvard Medical School, Boston, MA (M.T., J.M., S.B., K.N., U.B.T., W.G.S.); and the Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan (S.M., T.Y.)
| | - Scott Brancato
- From the Arrhythmia Service, Cardiovascular Division of Brigham and Women's Hospital, Harvard Medical School, Boston, MA (M.T., J.M., S.B., K.N., U.B.T., W.G.S.); and the Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan (S.M., T.Y.)
| | - Koichi Nagashima
- From the Arrhythmia Service, Cardiovascular Division of Brigham and Women's Hospital, Harvard Medical School, Boston, MA (M.T., J.M., S.B., K.N., U.B.T., W.G.S.); and the Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan (S.M., T.Y.)
| | - Seiichiro Matsuo
- From the Arrhythmia Service, Cardiovascular Division of Brigham and Women's Hospital, Harvard Medical School, Boston, MA (M.T., J.M., S.B., K.N., U.B.T., W.G.S.); and the Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan (S.M., T.Y.)
| | - Teiichi Yamane
- From the Arrhythmia Service, Cardiovascular Division of Brigham and Women's Hospital, Harvard Medical School, Boston, MA (M.T., J.M., S.B., K.N., U.B.T., W.G.S.); and the Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan (S.M., T.Y.)
| | - Usha B Tedrow
- From the Arrhythmia Service, Cardiovascular Division of Brigham and Women's Hospital, Harvard Medical School, Boston, MA (M.T., J.M., S.B., K.N., U.B.T., W.G.S.); and the Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan (S.M., T.Y.)
| | - William G Stevenson
- From the Arrhythmia Service, Cardiovascular Division of Brigham and Women's Hospital, Harvard Medical School, Boston, MA (M.T., J.M., S.B., K.N., U.B.T., W.G.S.); and the Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan (S.M., T.Y.)
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Nagashima K, Tedrow UB, Koplan BA, Michaud GF, John RM, Epstein LM, Tokuda M, Inada K, Reichlin TR, Ng JP, Barbhaiya CR, Nof E, Tadros TM, Stevenson WG. Reentrant Ventricular Tachycardia Originating From the Periaortic Region in the Absence of Overt Structural Heart Disease. Circ Arrhythm Electrophysiol 2014; 7:99-106. [DOI: 10.1161/circep.113.000870] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
In the absence of overt structural heart disease, most left ventricular outflow tract ventricular tachycardias (VTs) have a focal origin and are benign. We hypothesized that multiple morphologies (MMs) of inducible left ventricular outflow tract VT may indicate a scar-related VT that can mimic idiopathic VT.
Methods and Results—
Of 54 consecutive patients referred for ablation of sustained outflow tract VT without overt structural heart disease, 24 had left ventricular outflow tract VT, 10 had MM VT, and 14 had a single VT (SM). The MM group were older (70.3±4.3 versus 53.9±15.9 years;
P
=0.004), had more hypertension (100% versus 29%;
P
=0.0006), and had longer PR intervals and QRS durations compared with the SM group. In contrast to the SM group, the MM group VTs had features consistent with reentry, including induction by programmed stimulation without isoproterenol, entrainment in some, and abnormal electrograms in the periaortic area. Periaortic region voltages suggested scar in the MM group, but not in the SM group. MRI in 2 MM patients was consistent with scar, but not in 10 SM patients. Longer radiofrequency applications were required in the MM group than in the SM group. At a median follow-up of 9.7 (3.0–32.0) months, recurrences tended to be more frequent in the MM group than in the SM group (70% versus 22%;
P
=0.07).
Conclusions—
VTs from small regions of periaortic scar can mimic idiopathic VT but are suggested by multiple VT morphologies and are more difficult to ablate. Whether these patients are at greater risk, as feared for other scar-related VTs, warrants further study.
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Affiliation(s)
- Koichi Nagashima
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Usha B. Tedrow
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Bruce A. Koplan
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Gregory F. Michaud
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Roy M. John
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Laurence M. Epstein
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Michifumi Tokuda
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Keiichi Inada
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Tobias R. Reichlin
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Justin P. Ng
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Chirag R. Barbhaiya
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Eyal Nof
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - Thomas M. Tadros
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
| | - William G. Stevenson
- From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women’s Hospital, Boston, MA
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Hashimoto T, Ajimura S, Beer G, Bhang H, Bragadireanu M, Buehler P, Busso L, Cargnelli M, Choi S, Curceanu C, Enomoto S, Faso D, Fujioka H, Fujiwara Y, Fukuda T, Guaraldo C, Hayano RS, Hiraiwa T, Iio M, Iliescu M, Inoue K, Ishiguro Y, Ishikawa T, Ishimoto S, Ishiwatari T, Itahashi K, Iwai M, Iwasaki M, Kato Y, Kawasaki S, Kienle P, Kou H, Ma Y, Marton J, Matsuda Y, Mizoi Y, Morra O, Nagae T, Noumi H, Ohnishi H, Okada S, Outa H, Piscicchia K, Poli Lener M, Romero Vida A, Sada Y, Sakaguchi A, Sakuma F, Sato M, Scordo A, Sekimoto M, Shi H, Sirghi D, Sirghi F, Suzuki K, Suzuki S, Suzuki T, Tanida K, Tatsuno H, Tokuda M, Tomono D, Toyoda A, Tsukada K, Vazquez Doce O, Widmann E, Wuenschek BK, Yamaga T, Yamazaki T, Yim H, Zhang Q, Zmeska J. A search for the K−ppbound state in the 3He( K−in-flight, n) reaction at J-PARC. EPJ Web of Conferences 2014. [DOI: 10.1051/epjconf/20146609008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sada Y, Ajimura S, Beer G, Bhang H, Bragadireanu M, Buehler P, Busso L, Cargnelli M, Choi S, Curceanu C, Enomoto S, Faso D, Fujioka H, Fujiwara Y, Fukuda T, Guaraldo C, Hashimoto T, Hayano RS, Hiraiwa T, Iio M, Iliescu M, Inoue K, Ishiguro Y, Ishikawa T, Ishimoto S, Ishiwatari T, Itahashi K, Iwai M, Iwasaki M, Kato Y, Kawasaki S, Kienle P, Kou H, Ma Y, Marton J, Matsuda Y, Mizoi Y, Morra O, Nagae T, Noumi H, Ohnishi H, Okada S, Outa H, Piscicchia K, Poli Lener M, Romero Vidal A, Sakaguchi A, Sakuma F, Sato M, Scordo A, Sekimoto M, Shi H, Sirghi D, Sirghi F, Suzuki K, Suzuki S, Suzuki T, Tanida K, Tatsuno H, Tokuda M, Tomono D, Toyoda A, Tsukada K, Vazquez Doce O, Widmann E, Weunschek BK, Yamaga T, Yamazaki T, Yim H, Zhang Q, Zmeskal J. Search for the K−ppbound state via the in-flight 3He( K−, n) reaction. EPJ Web of Conferences 2014. [DOI: 10.1051/epjconf/20148102016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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47
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Tokuda M, Martins M, Izar P. Transferability of microsatellites for studies on the social behavior of the tufted capuchin monkey (genus Sapajus). Genet Mol Res 2014; 13:9910-4. [DOI: 10.4238/2014.november.27.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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48
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Sarkozy A, Tokuda M, Tedrow UB, Sieria J, Michaud GF, Couper GS, John R, Stevenson WG. Epicardial Ablation of Ventricular Tachycardia in Ischemic Heart Disease. Circ Arrhythm Electrophysiol 2013; 6:1115-22. [DOI: 10.1161/circep.113.000467] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Andrea Sarkozy
- From the Cardiology Department, University Hospital of Antwerp, University of Antwerp, Antwerp, Belgium (A.S.); Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (M.T., U.B.T., G.F.M., R.J., W.G.S.); Fundacion Barrie, Galicia, Spain (J.S.); Beca de Postgrado en el extranjero, 2012, UZ Brussel, VUB, Brussels, Belgium (J.S.); and Department of Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (G.S.C.)
| | - Michifumi Tokuda
- From the Cardiology Department, University Hospital of Antwerp, University of Antwerp, Antwerp, Belgium (A.S.); Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (M.T., U.B.T., G.F.M., R.J., W.G.S.); Fundacion Barrie, Galicia, Spain (J.S.); Beca de Postgrado en el extranjero, 2012, UZ Brussel, VUB, Brussels, Belgium (J.S.); and Department of Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (G.S.C.)
| | - Usha B. Tedrow
- From the Cardiology Department, University Hospital of Antwerp, University of Antwerp, Antwerp, Belgium (A.S.); Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (M.T., U.B.T., G.F.M., R.J., W.G.S.); Fundacion Barrie, Galicia, Spain (J.S.); Beca de Postgrado en el extranjero, 2012, UZ Brussel, VUB, Brussels, Belgium (J.S.); and Department of Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (G.S.C.)
| | - Juan Sieria
- From the Cardiology Department, University Hospital of Antwerp, University of Antwerp, Antwerp, Belgium (A.S.); Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (M.T., U.B.T., G.F.M., R.J., W.G.S.); Fundacion Barrie, Galicia, Spain (J.S.); Beca de Postgrado en el extranjero, 2012, UZ Brussel, VUB, Brussels, Belgium (J.S.); and Department of Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (G.S.C.)
| | - Gregory F. Michaud
- From the Cardiology Department, University Hospital of Antwerp, University of Antwerp, Antwerp, Belgium (A.S.); Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (M.T., U.B.T., G.F.M., R.J., W.G.S.); Fundacion Barrie, Galicia, Spain (J.S.); Beca de Postgrado en el extranjero, 2012, UZ Brussel, VUB, Brussels, Belgium (J.S.); and Department of Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (G.S.C.)
| | - Gregory S. Couper
- From the Cardiology Department, University Hospital of Antwerp, University of Antwerp, Antwerp, Belgium (A.S.); Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (M.T., U.B.T., G.F.M., R.J., W.G.S.); Fundacion Barrie, Galicia, Spain (J.S.); Beca de Postgrado en el extranjero, 2012, UZ Brussel, VUB, Brussels, Belgium (J.S.); and Department of Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (G.S.C.)
| | - Roy John
- From the Cardiology Department, University Hospital of Antwerp, University of Antwerp, Antwerp, Belgium (A.S.); Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (M.T., U.B.T., G.F.M., R.J., W.G.S.); Fundacion Barrie, Galicia, Spain (J.S.); Beca de Postgrado en el extranjero, 2012, UZ Brussel, VUB, Brussels, Belgium (J.S.); and Department of Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (G.S.C.)
| | - William G. Stevenson
- From the Cardiology Department, University Hospital of Antwerp, University of Antwerp, Antwerp, Belgium (A.S.); Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (M.T., U.B.T., G.F.M., R.J., W.G.S.); Fundacion Barrie, Galicia, Spain (J.S.); Beca de Postgrado en el extranjero, 2012, UZ Brussel, VUB, Brussels, Belgium (J.S.); and Department of Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (G.S.C.)
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49
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Blankstein R, Osborne M, Naya M, Waller A, Kim CK, Murthy VL, Kazemian P, Kwong RY, Tokuda M, Skali H, Padera R, Hainer J, Stevenson WG, Dorbala S, Di Carli MF. Cardiac positron emission tomography enhances prognostic assessments of patients with suspected cardiac sarcoidosis. J Am Coll Cardiol 2013; 63:329-36. [PMID: 24140661 DOI: 10.1016/j.jacc.2013.09.022] [Citation(s) in RCA: 471] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 09/12/2013] [Accepted: 09/16/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study sought to relate imaging findings on positron emission tomography (PET) to adverse cardiac events in patients referred for evaluation of known or suspected cardiac sarcoidosis. BACKGROUND Although cardiac PET is commonly used to evaluate patients with suspected cardiac sarcoidosis, the relationship between PET findings and clinical outcomes has not been reported. METHODS We studied 118 consecutive patients with no history of coronary artery disease, who were referred for PET, using [(18)F]fluorodeoxyglucose (FDG) to assess for inflammation and rubidium-82 to evaluate for perfusion defects (PD), following a high-fat/low-carbohydrate diet to suppress normal myocardial glucose uptake. Blind readings of PET data categorized cardiac findings as normal, positive PD or FDG, positive PD and FDG. Images were also used to identify whether findings of extra-cardiac sarcoidosis were present. Adverse events (AE)-death or sustained ventricular tachycardia (VT)-were ascertained by electronic medical records, defibrillator interrogation, patient questionnaires, and telephone interviews. RESULTS Among the 118 patients (age 52 ± 11 years; 57% males; mean ejection fraction: 47 ± 16%), 47 (40%) had normal and 71 (60%) had abnormal cardiac PET findings. Over a median follow-up of 1.5 years, there were 31 (26%) adverse events (27 VT and 8 deaths). Cardiac PET findings were predictive of AE, and the presence of both a PD and abnormal FDG (29% of patients) was associated with hazard ratio of 3.9 (p < 0.01) and remained significant after adjusting for left ventricular ejection fraction (LVEF) and clinical criteria. Extra-cardiac FDG uptake (26% of patients) was not associated with AE. CONCLUSIONS The presence of focal PD and FDG uptake on cardiac PET identifies patients at higher risk of death or VT. These findings offer prognostic value beyond Japanese Ministry of Health and Welfare clinical criteria, the presence of extra-cardiac sarcoidosis and LVEF.
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Affiliation(s)
- Ron Blankstein
- Noninvasive Cardiovascular Imaging Program, Department of Medicine (Cardiovascular Division) and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts.
| | - Michael Osborne
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Masanao Naya
- Noninvasive Cardiovascular Imaging Program, Department of Medicine (Cardiovascular Division) and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Alfonso Waller
- Noninvasive Cardiovascular Imaging Program, Department of Medicine (Cardiovascular Division) and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Chun K Kim
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Venkatesh L Murthy
- Noninvasive Cardiovascular Imaging Program, Department of Medicine (Cardiovascular Division) and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts
| | - Pedram Kazemian
- Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts
| | - Raymond Y Kwong
- Noninvasive Cardiovascular Imaging Program, Department of Medicine (Cardiovascular Division) and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts
| | - Michifumi Tokuda
- Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts
| | - Hicham Skali
- Noninvasive Cardiovascular Imaging Program, Department of Medicine (Cardiovascular Division) and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts
| | - Robert Padera
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jon Hainer
- Noninvasive Cardiovascular Imaging Program, Department of Medicine (Cardiovascular Division) and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - William G Stevenson
- Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts
| | - Sharmila Dorbala
- Noninvasive Cardiovascular Imaging Program, Department of Medicine (Cardiovascular Division) and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Marcelo F Di Carli
- Noninvasive Cardiovascular Imaging Program, Department of Medicine (Cardiovascular Division) and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts; Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
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50
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Tokuda M, Tedrow UB, Inada K, Reichlin T, Michaud GF, John RM, Epstein LM, Stevenson WG. Direct comparison of adjacent endocardial and epicardial electrograms: implications for substrate mapping. J Am Heart Assoc 2013; 2:e000215. [PMID: 24113324 PMCID: PMC3835221 DOI: 10.1161/jaha.113.000215] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background Analysis of unipolar voltage maps has been used to detect epicardial scar, but data to define optimal parameters to identify scar remote from the recording site is limited. This study compares the characteristics of electrograms at endocardial sites adjacent to abnormal epicardial sites. Methods and Results Data obtained from endocardial and epicardial electroanatomical maps of 31 patients with scar‐related ventricular tachycardia were reviewed. Five hundred twenty‐three pairs of endo‐ and epicardial points were selected according to predefined criteria. The endocardial points adjacent to epicardial scar (bipolar voltage <1.5 mV) had smaller unipolar voltage than those distant from epicardial scar (P<0.001). In multivariable analysis, unipolar voltage was the only endocardial electrogram predictor of epicardial scar (P<0.001, OR 0.94, 95% CI 0.93 to 0.97). An endocardial unipolar amplitude <4.4 mV in the right ventricular (RV) (sensitivity 93%, specificity 76%) and <5.1 mV in the left ventricular (LV) (sensitivity 91%, specificity 75%) was the optimal cutoff predicting epicardial scar. Applying these thresholds to electroanatomical maps, revealed a good match between endocardial unipolar abnormality and epicardial scar for 67% of LV and 75% of RV maps, respectively, but notably poor matches occurred in 8 (29%) maps (7 with nonischemic cardiomyopathy). Site‐by‐site correlations were better for ischemic than nonischemic cardiomyopathy. Conclusions This study supports the contention that unipolar electrograms are capable of indicating overlying epicardial scar during endocardial mapping, but illustrates limitations that appear to differ with nonischemic as compared to ischemic cardiomyopathy. The presence of epicardial arrhythmia substrate cannot be excluded by analysis of unipolar endocardial maps in some patients.
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Affiliation(s)
- Michifumi Tokuda
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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