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Morita H, Asada S, Ueoka A, Mizuno T, Masuda T, Miyamoto M, Kawada S, Nakagawa K, Nishii N, Yuasa S. Risk Stratification for the Occurrence of Ventricular Fibrillation in Patients with Early Repolarization Syndrome. Heart Rhythm 2024:S1547-5271(24)02535-9. [PMID: 38710349 DOI: 10.1016/j.hrthm.2024.04.101] [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: 11/30/2023] [Revised: 04/21/2024] [Accepted: 04/27/2024] [Indexed: 05/08/2024]
Abstract
(BACKGROUND) Several signs of malignant early repolarizations (ERs) have been proposed in patients with ER syndrome (ERS). However, recent reports have challenged the efficacy of these signs in predicting future ventricular fibrillation (VF) in patients with ERS. (OBJECTIVE) To assess the predictive value of various electrocardiograms (ECG) in predicting future VF events among ERS patients. (METHODS) We retrospectively evaluated the clinical characteristics of 44 ERS patients to identify risk factors for VF during follow-up. (RESULTS) Following the initial event, 16 patients experienced VF (VF group), while 28 did not (non-VF group). The VF group had a longer QRS interval, more fragmented QRS (fQRS), and a higher T/R voltage ratio than the non-VF group. Wide J-waves were more prevalent in the VF group; however, other J-wave markers did not differ between the groups. Positive late potentials (LPs) recorded on signal-averaged ECGs were more frequent in the VF group. While none of the patients showed spontaneous Brugada on ECG, the VF group frequently exhibited pilsicainide-induced ST-segment elevation. These ECG markers were significantly associated with the occurrence of VF during follow-up. Patients with multiple ECG factors: including QRS abnormalities (wide QRS or fQRS), wide J waves, and a high T/R ratio, had a worse prognosis than patients without multiple factors, effectively stratifying patient risk. (CONCLUSIONS) The occurrence of VF in patients with ERS may be associated with conduction abnormalities such as QRS widening, fQRS, high T/R ratio, positive LPs, and pilsicainide test results. Therefore, ECG factors could be useful in identifying high-risk patients.
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Affiliation(s)
- Hiroshi Morita
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
| | - Saori Asada
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama 700-8558, Japan
| | - Akira Ueoka
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama 700-8558, Japan
| | - Tomofumi Mizuno
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama 700-8558, Japan
| | - Takuro Masuda
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama 700-8558, Japan
| | - Masakazu Miyamoto
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama 700-8558, Japan
| | - Satoshi Kawada
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama 700-8558, Japan
| | - Koji Nakagawa
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama 700-8558, Japan
| | - Nobuhiro Nishii
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Shinsuke Yuasa
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama 700-8558, Japan
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Morita H, Ueoka A, Mizuno T, Masuda T, Asada S, Ejiri K, Miyamoto M, Kawada S, Nakagawa K, Nishii N, Yuasa S. Clinical characteristics of electrical storm in patients with early repolarization syndrome. Heart Rhythm 2024; 21:562-570. [PMID: 38242221 DOI: 10.1016/j.hrthm.2024.01.016] [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] [Received: 10/20/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND Early repolarization syndrome (ERS) is an idiopathic ventricular fibrillation (VF) associated with inferolateral J waves. While electrical storm (ES) in ERS is not rare, their characteristics and risk factors are not fully understood. OBJECTIVE This study aimed to clarify the significance of ES in ERS. METHODS We evaluated 44 patients with ERS who experienced VF/sudden cardiac death or arrhythmic syncope. We assessed clinical characteristics to identify the risk factors for ES. RESULTS In total, 13 patients (30%) experienced ES (ES group). Of these, 11 patients (85%) experienced ES during the acute phase of initial VF episodes and 2 patients (2%) experienced ES during follow-up. VF associated with ES occurred during therapeutic hypothermia in 6 of 13 patients (46%). The J-wave voltage during therapeutic hypothermia was higher in the ES group than that in the patients without ES. Isoproterenol was used in 5 patients (38%), which decreased J-wave voltage and relieved ES. Among the clinical markers, shorter QT and QTp intervals (the interval from QRS onset to the peak of T wave), pilsicainide-induced ST elevation, and high scores on the Shanghai Score System were associated with ES. Although pilsicainide induced ST elevation in 6 of 34 patients (18%), spontaneous Brugada electrocardiographic patterns did not appear to be associated with VF. Therapeutic hypothermia was also a risk factor for acute phase ES. CONCLUSION Patients with ERS in the ES group frequently had short QT and QTp intervals, pilsicainide-induced ST elevations, and high Shanghai Score System scores. Therapeutic hypothermia was also associated with acute phase ES.
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Affiliation(s)
- Hiroshi Morita
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Okayama, Japan.
| | - Akira Ueoka
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama City, Okayama, Japan
| | - Tomofumi Mizuno
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama City, Okayama, Japan
| | - Takuro Masuda
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama City, Okayama, Japan
| | - Saori Asada
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama City, Okayama, Japan
| | - Kentaro Ejiri
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama City, Okayama, Japan
| | - Masakazu Miyamoto
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama City, Okayama, Japan
| | - Satoshi Kawada
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama City, Okayama, Japan
| | - Koji Nakagawa
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama City, Okayama, Japan
| | - Nobuhiro Nishii
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Okayama, Japan
| | - Shinsuke Yuasa
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama City, Okayama, Japan
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Morita H, Nakagawa K, Ueoka A, Mizuno T, Masuda T, Asada S, Miyamoto M, Kawada S, Nishii N, Nakamura K. Significant delayed conduction and characteristic ventricular tachycardias in patients with cardiac sarcoidosis and electrical storm. J Cardiovasc Electrophysiol 2024; 35:307-316. [PMID: 38105352 DOI: 10.1111/jce.16156] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION Electrical storm (ES) of ventricular tachyarrhythmias (VTAs) is an important cause of sudden death in patients with cardiac sarcoidosis (CS). VTAs in CS are associated with myocardial scarring and inflammation. However, little is known about the risk factors of ES in patients with CS and VTAs. The objective of this study is to clarify the characteristics and risk factors for the development of ES in patients with CS. METHODS The study population included consecutive 52 patients with CS and sustained VTA. Twenty-five out of 52 patients experienced ES. We evaluated clinical characteristics, imaging modalities, and electrocardiogram (ECG) parameters to determine the risk factors associated with ES. RESULTS Half of the patients experienced VTAs as the initial symptom of sarcoidosis, and eight patients had ES as the initial VTA episode. There were no differences in cardiac imaging abnormalities between patients with and without ES. Among ECG markers, significant QRS fragmentation (odds ratio [OR]: 7.9, p = .01) and epsilon waves (OR: 12.24, p = .02) were associated with ES. Among the ventricular tachycardia (VT) characteristics, multiple morphologies of monomorphic VTs (OR: 10.9, p < .01), short VT cycle lengths (OR: 12.5, p < .01), and polymorphic VT (OR: 13.5, p < .01) were associated with ES. Bidirectional VTs were detected in 10 patients with ES and one patient without ES. Immunosuppressive therapy relieved ES in some patients. CONCLUSIONS ES was common in patients with CS and VTAs. Significant depolarization abnormalities that appeared as QRS fragmentation, epsilon waves, and specific VT characteristics were associated with ES.
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Affiliation(s)
- Hiroshi Morita
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Koji Nakagawa
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
| | - Akira Ueoka
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
| | - Tomofumi Mizuno
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
| | - Takuro Masuda
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
| | - Saori Asada
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
| | - Masakazu Miyamoto
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
| | - Satoshi Kawada
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
| | - Nobuhiro Nishii
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazufumi Nakamura
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
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Miyamoto M, Morita H, Mizuno T, Masuda T, Ueoka A, Asada S, Kawada S, Nakagawa K, Nishii N. Significance of left posterior extension of early repolarization in patients with J-wave syndrome. Heart Rhythm 2023; 20:1729-1736. [PMID: 37634559 DOI: 10.1016/j.hrthm.2023.08.032] [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] [Received: 06/09/2023] [Revised: 08/22/2023] [Accepted: 08/22/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND J waves in the inferior or lateral leads are characteristic electrocardiographic (ECG) changes in patients with early repolarization syndrome (ERS). However, the presence of J waves in the left posterior region has not yet been evaluated. OBJECTIVE The purpose of this study was to clarify the significance of J waves in the posterior left ventricle using leads V7-V9 and a body surface mapping (BSM) system. METHODS Forty patients diagnosed with ERS were included. All patients exhibited J waves in either the contiguous inferior, lateral, or posterior leads. We evaluated the incidence of J waves in the inferolateral and posterior leads using a 15-lead ECG with synthesized V7-V9 and an 87-lead BSM. Additionally, we assessed the arrhythmogenicity of the posterior regions based on the morphology of the premature ventricular complexes (PVCs) associated with ventricular fibrillation (VF). RESULTS J waves were observed in the lateral, inferior, and posterior leads of 26 (65%), 31 (78%), and 39 (97%) patients, respectively. J waves were found only in the posterior leads of 5 patients. BSM was evaluated in 9 patients, all of whom exhibited a positive area on the posterior region. PVCs associated with VF were recorded in 5 patients. Among patients with inferolateral and posterior J waves, all except 1 patient who displayed left bundle branch block morphology showed PVCs originating from the posterior left ventricular region. CONCLUSION Posterior J waves are common in ERS patients. This abnormality can be detected using leads V7-V9 and the BSM system and may be associated with arrhythmogenesis.
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Affiliation(s)
- Masakazu Miyamoto
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
| | - Hiroshi Morita
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | - Tomofumi Mizuno
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
| | - Takuro Masuda
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
| | - Akira Ueoka
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
| | - Saori Asada
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
| | - Satoshi Kawada
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
| | - Koji Nakagawa
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
| | - Nobuhiro Nishii
- Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan; Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Asada S, Morita H, Mizuno T, Masuda T, Ueoka A, Miyamoto M, Kawada S, Nakagawa K, Nishii N. Syncope and loss of consciousness after implantation of a cardioverter-defibrillator in patients with Brugada syndrome: Prevalence and characteristics in long-term follow-up. Heart Rhythm O2 2023; 4:641-649. [PMID: 37936673 PMCID: PMC10626187 DOI: 10.1016/j.hroo.2023.09.007] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023] Open
Abstract
Background Syncope is a significant prognostic factor in patients with Brugada syndrome (BrS). However, the risk of ventricular arrhythmia in patients with nonarrhythmic loss of consciousness (LOC) is similar to that in asymptomatic patients. LOC events after implantable cardioverter-defibrillator (ICD) implantation may provide insights into underlying causes of the initial LOC episode. Objective The purpose of this study was to examine LOC characteristics following ICD implantation. Methods We retrospectively analyzed 112 patients with BrS (mean age 47 years; 111 men) who were treated with an ICD. The patients were classified into 3 groups based on symptoms at implantation: asymptomatic (35 patients); LOC (46 patients); and ventricular tachyarrhythmia (VTA) (31 patients). We evaluated the incidence and cause of LOC during long-term follow-up after ICD implantation. Results During mean follow-up of 12.2 years, 41 patients (37%) experienced LOC after ICD implantation. Arrhythmic LOC occurred in 5 asymptomatic patients, 14 LOC patients, and 16 patients with VTA. Nonarrhythmic LOC, similar to the initial episode, occurred after ICD implantation in 6 patients with prior LOC (2 with neurally mediated syncope and 4 with epilepsy). Most epileptic patients experienced LOC during rest or sleeping, and did not show an abnormal encephalogram during initial evaluation of the LOC episodes. Conclusion After ICD implantation, 13% of patients had nonarrhythmic LOC similar to the initial episode. Accurate classification of LOC based on a detailed medical history is important for risk stratification, although distinguishing arrhythmic LOC from epilepsy-related LOC episodes can be challenging depending on the circumstances and characteristics of the LOC event.
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Affiliation(s)
- Saori Asada
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroshi Morita
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Tomofumi Mizuno
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Takuro Masuda
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Akira Ueoka
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masakazu Miyamoto
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Satoshi Kawada
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Koji Nakagawa
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Nobuhiro Nishii
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Miyamoto M, Nakamura K, Nakagawa K, Nishii N, Kawada S, Ueoka A, Asada S, Watanabe A, Morita H, Ito H. Prevalence and Treatment of Arrhythmias in Patients With Transthyretin and Light-Chain Cardiac Amyloidosis. Circ Rep 2023; 5:298-305. [PMID: 37431518 PMCID: PMC10329899 DOI: 10.1253/circrep.cr-23-0022] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/22/2023] [Accepted: 05/29/2023] [Indexed: 07/12/2023] Open
Abstract
Background: Various types of arrhythmia are observed in patients with cardiac amyloidosis, but the prevalence of arrhythmia has not been fully investigated. This study investigated the prevalence and treatment of arrhythmias in patients with cardiac amyloidosis before the introduction of new agents for amyloidosis, such as tafamidis. Methods and Results: Of 53 patients who were histologically diagnosed with cardiac amyloidosis at 10 centers in western Japan between 2009 and 2021, 43 who were diagnosed on the basis of immunohistochemical staining were evaluated in this study. Of these 43 patients, 13 had immunoglobulin light-chain (AL) amyloidosis and 30 had transthyretin (ATTR) amyloidosis; further, 27 had atrial tachyarrhythmia, 13 had ventricular tachyarrhythmia, and 17 had bradyarrhythmia. Atrial fibrillation (AF) was the most common arrhythmia in patients with cardiac amyloidosis (n=24; 55.8%), especially among those with ATTR amyloidosis (70.0% of ATTR vs. 23.1% of AL). Eleven (25.6%) patients were treated with a cardiac implantable device. All 3 patients with pacemakers were alive at the last follow-up (median 76.7 months; interquartile range [IQR] 4.8-146.4 months). Of the 8 patients who underwent AF ablation, there was no recurrence in 6 (75%) after a median of 39.3 months (IQR 19.8-59.3 months). Conclusions: The prevalence of various arrhythmias was high in patients with cardiac amyloidosis. AF occurred most frequently in patients with cardiac amyloidosis, especially among patients with ATTR.
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Affiliation(s)
- Masakazu Miyamoto
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Kazufumi Nakamura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Koji Nakagawa
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Nobuhiro Nishii
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Satoshi Kawada
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Akira Ueoka
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Saori Asada
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Atsuyuki Watanabe
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
- Department of Cardiology, National Hospital Organization Okayama Medical Center Okayama Japan
| | - Hiroshi Morita
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
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Morimoto Y, Morita H, Ejiri K, Mizuno T, Masuda T, Ueoka A, Asada S, Miyamoto M, Kawada S, Nakagawa K, Nishii N, Nakamura K, Ito H. Significant Delayed Activation on the Right Ventricular Outflow Tract Represents Complete Right Bundle-Branch Block Pattern in Brugada Syndrome. J Am Heart Assoc 2023; 12:e028706. [PMID: 37158059 DOI: 10.1161/jaha.122.028706] [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] [Indexed: 05/10/2023]
Abstract
Background The appearance of complete right bundle-branch block (CRBBB) in Brugada syndrome (BrS) is associated with an increased risk of ventricular fibrillation. The pathophysiological mechanism of CRBBB in patients with BrS has not been well established. We aimed to clarify the significance of a conduction delay zone associated with arrhythmias on CRBBB using body surface mapping in patients with BrS. Methods and Results Body surface mapping was recorded in 11 patients with BrS and 8 control patients both with CRBBB. CRBBB in control patients was transiently exhibited by unintentional catheter manipulation (proximal RBBB). Ventricular activation time maps were constructed for both of the groups. We divided the anterior chest into 4 areas (inferolateral right ventricle [RV], RV outflow tract [RVOT], intraventricular septum, and left ventricle) and compared activation patterns between the 2 groups. Excitation propagated to the RV from the left ventricle through the intraventricular septum with activation delay in the entire RV in the control group (proximal RBBB pattern). In 7 patients with BrS, excitation propagated from the inferolateral RV to the RVOT with significant regional activation delay. The remaining 4 patients with BrS showed a proximal RBBB pattern with the RVOT activation delay. The ventricular activation time in the inferolateral RV was significantly shorter in patients with BrS without a proximal RBBB pattern than in control patients. Conclusions The CRBBB morphology in patients with BrS consisted of 2 mechanisms: (1) significantly delayed conduction in the RVOT and (2) proximal RBBB with RVOT conduction delay. Significant RVOT conduction delay without proximal RBBB resulted in CRBBB morphology in patients with BrS.
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Affiliation(s)
- Yoshimasa Morimoto
- Department of Cardiovascular Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
- Department of Cardiovascular Medicine Fukuyama City Hospital Hiroshima Japan
| | - Hiroshi Morita
- Department of Cardiovascular Therapeutics Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Kentaro Ejiri
- Department of Cardiovascular Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | - Tomofumi Mizuno
- Department of Cardiovascular Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Takuro Masuda
- Department of Cardiovascular Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Akira Ueoka
- Department of Cardiovascular Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Saori Asada
- Department of Cardiovascular Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Masakazu Miyamoto
- Department of Cardiovascular Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Satoshi Kawada
- Department of Cardiovascular Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Koji Nakagawa
- Department of Cardiovascular Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Nobuhiro Nishii
- Department of Cardiovascular Therapeutics Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Kazufumi Nakamura
- Department of Cardiovascular Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
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Ueoka A, Sung YL, Liu X, Rosenberg C, Chen Z, Everett TH, Rubart M, Tisdale JE, Chen PS. Testosterone does not shorten action potential duration in Langendorff-perfused rabbit ventricles. Heart Rhythm 2022; 19:1864-1871. [PMID: 35716858 PMCID: PMC10081443 DOI: 10.1016/j.hrthm.2022.06.012] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 06/03/2022] [Accepted: 06/08/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Women have longer baseline QT intervals than men. Because previous studies showed that testosterone and 5α-dihydrotestosterone shorten the ventricular action potential duration (APD) in animal models, differential testosterone concentrations may account for the sex differences in QT interval. OBJECTIVE The purpose of this study was to test the hypothesis that testosterone shortens the APD in Langendorff-perfused rabbit ventricles. METHODS We performed optical mapping studies in hearts with or without testosterone administration. Acute studies included 26 hearts using 2 different protocols, including 17 without and 9 with atrioventricular (AV) block. For chronic studies, we implanted testosterone pellets subcutaneously in 7 female rabbits for 2-3 weeks before optical mapping studies during complete AV block. Six rabbits without pellet implantation served as controls. RESULTS The hearts in the acute studies were paced with a pacing cycle length (PCL) of 200-300 ms and mapped at baseline and after administration of 1 nM, 10 nM, 100 nM, and 3 μM of testosterone. There was no shortening of APD80 at any PCL. Instead, a lengthening of APD80 was noted at higher concentrations. There were no sex differences in testosterone responses. In chronic studies, heart rates were 136 ± 5 bpm before and 148 ± 9 bpm after (P = .10) while QTc intervals were 314 ± 9 ms before and 317 ± 99 ms after (P = .69) testosterone pellet implantation, respectively. Overall, ventricular APD80 in the pellet group was longer than in the control group at 300- to 700-ms PCL. CONCLUSION Testosterone does not shorten ventricular repolarization in rabbit hearts.
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Affiliation(s)
- Akira Ueoka
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Yen-Ling Sung
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Xiao Liu
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Carine Rosenberg
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Zhenhui Chen
- The Krannert Cardiovascular Research Center and Division of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Thomas H Everett
- The Krannert Cardiovascular Research Center and Division of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Michael Rubart
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - James E Tisdale
- College of Pharmacy, Purdue University, Indianapolis, Indiana; Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Peng-Sheng Chen
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
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9
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Ueoka A, Nagase S, Nakagawa K, Morita H, Ito H. Intermittent orthodromic capture of the earliest activation site during atrial pacing in a case with reentrant atrial tachycardia originating from the atrioventricular node vicinity. J Arrhythm 2022; 38:473-477. [PMID: 35785376 PMCID: PMC9237296 DOI: 10.1002/joa3.12702] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 02/26/2022] [Accepted: 03/13/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Akira Ueoka
- Department of Cardiovascular Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Satoshi Nagase
- Department of Advanced Arrhythmia and Translational Medical Science National Cerebral and Cardiovascular Center Suita Japan
| | - Koji Nakagawa
- Department of Cardiovascular Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Hiroshi Morita
- Department of Cardiovascular Therapeutics Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
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10
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Liu X, Yuan Y, Wong J, Meng G, Ueoka A, Woiewodski LM, Chen LS, Shen C, Li X, Lin SF, Everett TH, Chen PS. The frequency spectrum of sympathetic nerve activity and arrhythmogenicity in ambulatory dogs. Heart Rhythm 2020; 18:465-472. [PMID: 33246037 DOI: 10.1016/j.hrthm.2020.11.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/02/2020] [Accepted: 11/14/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Sympathetic nerve activity, heart rate (HR), and blood pressure (BP) all have very low frequency (VLF), low frequency (LF), and high frequency (HF) oscillations. OBJECTIVE The purpose of this study was to test the hypothesis that the frequency spectra of subcutaneous nerve activity (ScNA), stellate ganglion nerve activity (SGNA), HR, and BP are important to cardiac arrhythmogenesis. METHODS We used radiotransmitters to record SGNA, ScNA, HR, and BP in 6 ambulatory dogs and determined the dominant frequency and paroxysmal atrial tachyarrhythmias (PATs) episodes in 3-minute windows over a 24-hour period. RESULTS The frequency spectra determined in ScNA reflected that in SGNA. HF oscillations were present in both ScNA and SGNA at all time but could be overshadowed by the much larger LF and VLF burst activities. The dominant frequency could occur in any of the 3 frequency bands. There were circadian variations with more frequent occurrences of HF oscillations at night. HF oscillations in HR and BP matched HF oscillations in SGNA and ScNA. PATs occurred only when dominant frequencies of SGNA and ScNA were in the LF and VLF bands. CONCLUSION HF oscillations in BP and HR correlate with HF oscillations in sympathetic nerve activity and are present at all time. HF oscillations can be overshadowed by the much larger LF and VLF burst activities. PATs occur only when LF or VLF, but not when HF, is the dominant frequency. The frequency spectra determined in ScNA reflect that in SGNA.
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Affiliation(s)
- Xiao Liu
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Cedars-Sinai Medical Center, Los Angeles, California
| | - Yuan Yuan
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Johnson Wong
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Guannan Meng
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Akira Ueoka
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Leanne M Woiewodski
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Lan S Chen
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Changyu Shen
- Richard and Susan Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Xiaochun Li
- Department of Biostatistics, Indiana University School of Medicine & Richard M. Fairbanks School of Public Health, Indianapolis, Indiana
| | - Shien-Fong Lin
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Institute of Biomedical Engineering, National Chiao-Tung University, Hsin-Chu, Taiwan
| | - Thomas H Everett
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Peng-Sheng Chen
- Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Cedars-Sinai Medical Center, Los Angeles, California.
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11
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Fei YD, Chen M, Guo S, Ueoka A, Chen Z, Rubart-von der Lohe M, Everett TH, Qu Z, Weiss JN, Chen PS. Simultaneous activation of the small conductance calcium-activated potassium current by acetylcholine and inhibition of sodium current by ajmaline cause J-wave syndrome in Langendorff-perfused rabbit ventricles. Heart Rhythm 2020; 18:98-108. [PMID: 32763429 DOI: 10.1016/j.hrthm.2020.07.036] [Citation(s) in RCA: 5] [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] [Received: 12/14/2019] [Revised: 07/24/2020] [Accepted: 07/30/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Concomitant apamin-sensitive small conductance calcium-activated potassium current (IKAS) activation and sodium current inhibition induce J-wave syndrome (JWS) in rabbit hearts. Sudden death in JWS occurs predominantly in men at night when parasympathetic tone is strong. OBJECTIVE The purpose of this study was to test the hypotheses that acetylcholine (ACh), the parasympathetic transmitter, activates IKAS and causes JWS in the presence of ajmaline. METHODS We performed optical mapping in Langendorff-perfused rabbit hearts and whole-cell voltage clamp to determine IKAS in isolated ventricular cardiomyocytes. RESULTS ACh (1 μM) + ajmaline (2 μM) induced J-point elevations in all (6 male and 6 female) hearts from 0.01± 0.01 to 0.31 ± 0.05 mV (P<.001), which were reduced by apamin (specific IKAS inhibitor, 100 nM) to 0.14 ± 0.02 mV (P<.001). More J-point elevation was noted in male than in female hearts (P=.037). Patch clamp studies showed that ACh significantly (P<.001) activated IKAS in isolated male but not in female ventricular myocytes (n=8). Optical mapping studies showed that ACh induced action potential duration (APD) heterogeneity, which was more significant in right than in left ventricles. Apamin in the presence of ACh prolonged both APD at the level of 25% (P<.001) and APD at the level of 80% (P<.001) and attenuated APD heterogeneity. Ajmaline further increased APD heterogeneity induced by ACh. Ventricular arrhythmias were induced in 6 of 6 male and 1 of 6 female hearts (P=.015) in the presence of ACh and ajmaline, which was significantly suppressed by apamin in the former. CONCLUSION ACh activates ventricular IKAS. ACh and ajmaline induce JWS and facilitate the induction of ventricular arrhythmias more in male than in female ventricles.
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Affiliation(s)
- Yu-Dong Fei
- Krannert Institute of Cardiology, Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiology, XinHua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mu Chen
- Krannert Institute of Cardiology, Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiology, XinHua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuai Guo
- Krannert Institute of Cardiology, Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Akira Ueoka
- Krannert Institute of Cardiology, Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Zhenhui Chen
- Krannert Institute of Cardiology, Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Michael Rubart-von der Lohe
- Department of Pediatrics, Riley Heart Research Center, Indiana University School of Medicine, Indianapolis, Indiana
| | - Thomas H Everett
- Krannert Institute of Cardiology, Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Zhilin Qu
- Department of Medicine (Cardiology) and Physiology, University of California, Los Angeles, California
| | - James N Weiss
- Department of Medicine (Cardiology) and Physiology, University of California, Los Angeles, California
| | - Peng-Sheng Chen
- Krannert Institute of Cardiology, Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Cedars-Sinai Medical Center, Los Angeles, California.
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12
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Matsumi H, Nakamura K, Eguchi E, Miyoshi T, Nakagawa K, Nishii N, Watanabe A, Ueoka A, Yoshida M, Tokunaga N, Amioka N, Yamada N, Saito D, Morita H, Ogino K, Ito H. Low Consultation Rate of General Population with Atrial Fibrillation. Int Heart J 2019; 60:1303-1307. [PMID: 31735770 DOI: 10.1536/ihj.19-062] [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] [Indexed: 11/18/2022]
Abstract
In order to prevent ischemic stroke, it is important to identify and treat patients with atrial fibrillation (AF) who do not consult a doctor in a medical institution. The aim of this study was to determine the consultation rate at medical institutions for patients with AF in group medical examinations conducted in a city in western Japan. Of 6101 examinees of group medical examinations (40 years of age or older) conducted in Ibara City, Okayama Prefecture, Japan, from 2012 to 2014, 4338 participants (71.1%) who were evaluated by electrocardiogram (ECG) gave written informed consent and responded to surveys in the form of questionnaires through a personal interview conducted by nurses were included in the Ibara-AF study. A cumulative total of 82 subjects were diagnosed as having AF by ECG (prevalence of AF = 1.89%), and 51 individuals had AF during the three-year period.15 (29.4%) of the 51 patients with AF did not regularly visit medical institutions. Among them, 46.7% (n = 7) and 53.3% (n = 8) of the patients were symptomatic and asymptomatic, respectively, and 73.3% of the patients had a CHADS2 score of more than one point. There were no significant differences in patients' characteristics between regular and non-regular visit groups. In conclusion, about one-third of the patients with AF did not regularly see a doctor in a medical institution and most of them had a CHADS2 score of more than one point in a Japanese rural area. Educating the public about the risks of AF is required.
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Affiliation(s)
- Hiroaki Matsumi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Kazufumi Nakamura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Eri Eguchi
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.,Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Toru Miyoshi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Koji Nakagawa
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Nobuhiro Nishii
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.,Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Atsuyuki Watanabe
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Akira Ueoka
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Masashi Yoshida
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Naoto Tokunaga
- Department of Cardiovascular Medicine, Ibara City Hospital
| | - Naofumi Amioka
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.,Department of Cardiovascular Medicine, Ibara City Hospital
| | | | - Daiji Saito
- Department of Cardiovascular Medicine, Ibara City Hospital
| | - Hiroshi Morita
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.,Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Keiki Ogino
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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13
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Ueoka A, Morita H, Watanabe A, Morimoto Y, Kawada S, Tachibana M, Miyamoto M, Nakagawa K, Nishii N, Ito H. Prognostic Significance of the Sodium Channel Blocker Test in Patients With Brugada Syndrome. J Am Heart Assoc 2018; 7:JAHA.118.008617. [PMID: 29748178 PMCID: PMC6015319 DOI: 10.1161/jaha.118.008617] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 11/24/2022]
Abstract
Background A drug provocation test using a sodium channel blocker (SCB) can unmask a type 1 ECG pattern in patients with Brugada syndrome. However, the prognostic value of the results of an SCB challenge is limited in patients with non–type 1 ECG. We investigated the associations of future risk for ventricular fibrillation with SCB‐induced ECG changes and ventricular tachyarrhythmias (VTAs). Methods and Results We administered intravenous pilsicainide to 245 consecutive patients with Brugada syndrome (181 patients with spontaneous type 1 ECG, 64 patients with non–type 1 ECG). ECG parameters before and after the test and occurrence of drug‐induced VTAs were evaluated. During a mean follow‐up period of 113±57 months, fatal VTA events occurred in 31 patients (sudden death: n=3, ventricular tachycardia/ventricular fibrillation: n=28). Symptomatic patients and spontaneous type 1 ECG were associated with future fatal arrhythmic events. Univariable analysis of ECG parameters after the test showed that long PQ and QRS intervals, high ST level, and SCB‐induced VTAs were associated with later VTA events during follow‐up. Multivariable analysis showed that symptomatic patients, high ST level (V1) ≥0.3 mV after the test, and SCB‐induced VTAs were independent predictors for future fatal arrhythmic events (hazard ratios: 3.28, 2.80, and 3.62, 95% confidence intervals: 1.54–7.47, 1.32–6.35, and 1.64–7.75, respectively; P<0.05). Conclusions SCB‐induced VTAs and ST‐segment augmentation are associated with an increased risk of the development of ventricular tachycardia/ventricular fibrillation events during follow‐up in patients with Brugada syndrome.
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Affiliation(s)
- Akira Ueoka
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroshi Morita
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Atsuyuki Watanabe
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshimasa Morimoto
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Satoshi Kawada
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Motomi Tachibana
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masakazu Miyamoto
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Koji Nakagawa
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Nobuhiro Nishii
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
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14
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Goto K, Kinoshita Y, Zaima S, Ueoka A, Kobayashi K, Kikuta Y, Sato K, Taniguchi M, Hiramatsu S, Takebayashi H, Haruta S. The Association between Renal Congestion on Admission and Clinical Course in Acute Decompensated Heart Failure. J Card Fail 2017. [DOI: 10.1016/j.cardfail.2017.08.246] [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: 11/28/2022]
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15
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Tachibana M, Morita H, Ueoka A, Miyoshi A, Tsushima S, Sugiyama H, Nakagawa K, Watanabe A, Nishii N, Nakamura K, Ito H. 177-02: QRS widening and fragmented QRS rise a risk of cardiac sarcoidosis in complete right bundle branch block patients. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i181b] [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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16
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Ueoka A, Morita H, Watanabe A, Nakagawa K, Nishii N, Nagase S, Ohe T, Ito H. Activation Pattern of the Polymorphic Ventricular Tachycardia and Ventricular Fibrillation on Body Surface Mapping in Patients With Brugada Syndrome. Circ J 2016; 80:1734-43. [DOI: 10.1253/circj.cj-16-0124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 11/09/2022]
Affiliation(s)
- Akira Ueoka
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine and Dentistry
| | - Hiroshi Morita
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine and Dentistry
| | - Atsuyuki Watanabe
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine and Dentistry
| | - Koji Nakagawa
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine and Dentistry
| | - Nobuhiro Nishii
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine and Dentistry
| | - Satoshi Nagase
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine and Dentistry
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Tohru Ohe
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine and Dentistry
- Department of Cardiovascular Medicine, Cardiovascular Center Sakakibara Hospital
| | - Hiroshi Ito
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine and Dentistry
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17
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Abdovic E, Abdovic S, Hristova K, Hristova K, Katova T, Katova T, Gocheva N, Gocheva N, Pavlova M, Pavlova M, Gurzun MM, Ionescu A, Canpolat U, Yorgun H, Sunman H, Sahiner L, Kaya E, Ozer N, Tokgozoglu L, Kabakci G, Aytemir K, Oto A, Gonella A, D'ascenzo F, Casasso F, Conte E, Margaria F, Grosso Marra W, Frea S, Morello M, Bobbio M, Gaita F, Seo H, Lee S, Lee J, Yoon Y, Park E, Kim H, Park S, Lee H, Kim Y, Sohn D, Nemes A, Domsik P, Kalapos A, Orosz A, Lengyel C, Forster T, Enache R, Muraru D, Popescu B, Calin A, Nastase O, Botezatu D, Purcarea F, Rosca M, Beladan C, Ginghina C, Canpolat U, Aytemir K, Ozer N, Yorgun H, Sahiner L, Kaya E, Oto A, Muraru D, Piasentini E, Mihaila S, Padayattil Jose' S, Peluso D, Ucci L, Naso P, Puma L, Iliceto S, Badano L, Cikes M, Jakus N, Sutherland G, Haemers P, D'hooge J, Claus P, Yurdakul S, Oner F, Direskeneli H, Sahin T, Cengiz B, Ercan G, Bozkurt A, Aytekin S, Osa Saez AM, Rodriguez-Serrano M, Lopez-Vilella R, Buendia-Fuentes F, Domingo-Valero D, Quesada-Carmona A, Miro-Palau V, Arnau-Vives M, Palencia-Perez M, Rueda-Soriano J, Lipczynska M, Piotr Szymanski P, Anna Klisiewicz A, Lukasz Mazurkiewicz L, Piotr Hoffman P, Kim K, Cho S, Ahn Y, Jeong M, Cho J, Park J, Chinali M, Franceschini A, Matteucci M, Doyon A, Esposito C, Del Pasqua A, Rinelli G, Schaefer F, Kowalik E, Klisiewicz A, Rybicka J, Szymanski P, Biernacka E, Hoffman P, Lee S, Kim W, Yun H, Jung L, Kim E, Ko J, Ruddox V, Norum I, Edvardsen T, Baekkevar M, Otterstad J, Erdei T, Edwards J, Braim D, Yousef Z, Fraser A, Melcher A, Reiner B, Hansen A, Strandberg L, Caidahl K, Wellnhofer E, Kriatselis C, Gerd-Li H, Furundzija V, Thnabalasingam U, Fleck E, Graefe M, Park Y, Moon J, Ahn T, Baydar O, Kadriye Kilickesmez K, Ugur Coskun U, Polat Canbolat P, Veysel Oktay V, Umit Yasar Sinan U, Okay Abaci O, Cuneyt Kocas C, Sinan Uner S, Serdar Kucukoglu S, Ferferieva V, Claus P, Rademakers F, D'hooge J, Le TT, Wong P, Tee N, Huang F, Tan R, Altman M, Logeart D, Bergerot C, Gellen B, Pare C, Gerard S, Sirol M, Vicaut E, Mercadier J, Derumeaux GA, Park TH, Park JI, Shin SW, Yun SH, Lee JE, Makavos G, Kouris N, Keramida K, Dagre A, Ntarladimas I, Kostopoulos V, Damaskos D, Olympios C, Leong D, Piers S, Hoogslag G, Hoke U, Thijssen J, Ajmone Marsan N, Schalij M, Bax J, Zeppenfeld K, Delgado V, Rio P, Branco L, Galrinho A, Cacela D, Abreu J, Timoteo A, Teixeira P, Pereira-Da-Silva T, Selas M, Cruz Ferreira R, Popa BA, Zamfir L, Novelli E, Lanzillo G, Karazanishvili L, Musica G, Stelian E, Benea D, Diena M, Cerin G, Fusini L, Mirea O, Tamborini G, Muratori M, Gripari P, Ghulam Ali S, Cefalu' C, Maffessanti F, Andreini D, Pepi M, Mamdoo F, Goncalves A, Peters F, Matioda H, Govender S, Dos Santos C, Essop M, Kuznetsov VA, Yaroslavskaya EI, Pushkarev GS, Krinochkin DV, Kolunin GV, Bennadji A, Hascoet S, Dulac Y, Hadeed K, Peyre M, Ricco L, Clement L, Acar P, Ding W, Zhao Y, Lindqvist P, Nilson J, Winter R, Holmgren A, Ruck A, Henein M, Illatopa V, Cordova F, Espinoza D, Ortega J, Cavalcante J, Patel M, Katz W, Schindler J, Crock F, Khanna M, Khandhar S, Tsuruta H, Kohsaka S, Murata M, Yasuda R, Tokuda H, Kawamura A, Maekawa Y, Hayashida K, Fukuda K, Le Tourneau T, Kyndt F, Lecointe S, Duval D, Rimbert A, Merot J, Trochu J, Probst V, Le Marec H, Schott J, Veronesi F, Addetia K, Corsi C, Lamberti C, Lang R, Mor-Avi V, Gjerdalen GF, Hisdal J, Solberg E, Andersen T, Radunovic Z, Steine K, Maffessanti F, Gripari P, Tamborini G, Muratori M, Fusini L, Ferrari C, Caiani E, Alamanni F, Bartorelli A, Pepi M, D'ascenzi F, Cameli M, Iadanza A, Lisi M, Reccia R, Curci V, Sinicropi G, Henein M, Pierli C, Mondillo S, Rekhraj S, Hoole S, Mcnab D, Densem C, Boyd J, Parker K, Shapiro L, Rana B, Kotrc M, Vandendriessche T, Bartunek J, Claeys M, Vanderheyden M, Paelinck B, De Bock D, De Maeyer C, Vrints C, Penicka M, Silveira C, Albuquerque E, Lamprea D, Larangeiras V, Moreira C, Victor Filho M, Alencar B, Silveira A, Castillo J, Zambon E, Iorio A, Carriere C, Pantano A, Barbati G, Bobbo M, Abate E, Pinamonti B, Di Lenarda A, Sinagra G, Salemi VMC, Tavares L, Ferreira Filho J, Oliveira A, Pessoa F, Ramires F, Fernandes F, Mady C, Cavarretta E, Lotrionte M, Abbate A, Mezzaroma E, De Marco E, Peruzzi M, Loperfido F, Biondi-Zoccai G, Frati G, Palazzoni G, Park TH, Lee JE, Lee DH, Park JS, Park K, Kim MH, Kim YD, Van 'T Sant J, Gathier W, Leenders G, Meine M, Doevendans P, Cramer M, Poyhonen P, Kivisto S, Holmstrom M, Hanninen H, Schnell F, Betancur J, Daudin M, Simon A, Carre F, Tavard F, Hernandez A, Garreau M, Donal E, Calore C, Muraru D, Badano L, Melacini P, Mihaila S, Denas G, Naso P, Casablanca S, Santi F, Iliceto S, Aggeli C, Venieri E, Felekos I, Anastasakis A, Ritsatos K, Kakiouzi V, Kastellanos S, Cutajar I, Stefanadis C, Palecek T, Honzikova J, Poupetova H, Vlaskova H, Kuchynka P, Linhart A, Elmasry O, Mohamed M, Elguindy W, Bishara P, Garcia-Gonzalez P, Cozar-Santiago P, Bochard-Villanueva B, Fabregat-Andres O, Cubillos-Arango A, Valle-Munoz A, Ferrer-Rebolleda J, Paya-Serrano R, Estornell-Erill J, Ridocci-Soriano F, Jensen M, Havndrup O, Christiansen M, Andersen P, Axelsson A, Kober L, Bundgaard H, Karapinar H, Kaya A, Uysal E, Guven A, Kucukdurmaz Z, Oflaz M, Deveci K, Sancakdar E, Gul I, Yilmaz A, Tigen MK, Karaahmet T, Dundar C, Yalcinsoy M, Tasar O, Bulut M, Takir M, Akkaya E, Jedrzejewska I, Braksator W, Krol W, Swiatowiec A, Dluzniewski M, Lipari P, Bonapace S, Zenari L, Valbusa F, Rossi A, Lanzoni L, Molon G, Canali G, Campopiano E, Barbieri E, Rueda Calle E, Alfaro Rubio F, Gomez Gonzalez J, Gonzalez Santos P, Cameli M, Lisi M, Focardi M, D'ascenzi F, Solari M, Galderisi M, Mondillo S, Pratali L, Bruno RM, Corciu A, Comassi M, Passera M, Gastaldelli A, Mrakic-Sposta S, Vezzoli A, Picano E, Perry R, Penhall A, De Pasquale C, Selvanayagam J, Joseph M, Simova II, Katova TM, Kostova V, Hristova K, Lalov I, D'ascenzi F, Pelliccia A, Natali B, Cameli M, Alvino F, Zorzi A, Corrado D, Bonifazi M, Mondillo S, Rees E, Rakebrandt F, Rees D, Halcox J, Fraser A, O'driscoll J, Lau N, Perez-Lopez M, Sharma R, Lichodziejewska B, Goliszek S, Kurnicka K, Kostrubiec M, Dzikowska Diduch O, Krupa M, Grudzka K, Ciurzynski M, Palczewski P, Pruszczyk P, Gheorghe L, Castillo Ortiz J, Del Pozo Contreras R, Calle Perez G, Sancho Jaldon M, Cabeza Lainez P, Vazquez Garcia R, Fernandez Garcia P, Chueca Gonzalez E, Arana Granados R, Zhao X, Xu X, Bai Y, Qin Y, Leren I, Hasselberg N, Saberniak J, Leren T, Edvardsen T, Haugaa K, Daraban AM, Sutherland G, Claus P, Werner B, Gewillig M, Voigt J, Santoro A, Ierano P, De Stefano F, Esposito R, De Palma D, Ippolito R, Tufano A, Galderisi M, Costa R, Fischer C, Rodrigues A, Monaco C, Lira Filho E, Vieira M, Cordovil A, Oliveira E, Mohry S, Gaudron P, Niemann M, Herrmann S, Strotmann J, Beer M, Hu K, Bijnens B, Ertl G, Weidemann F, Baktir A, Sarli B, Cicek M, Karakas M, Saglam H, Arinc H, Akil M, Kaya H, Ertas F, Bilik M, Yildiz A, Oylumlu M, Acet H, Aydin M, Yuksel M, Alan S, O'driscoll J, Gravina A, Di Fino S, Thompson M, Karthigelasingham A, Ray K, Sharma R, De Chiara B, Russo C, Alloni M, Belli O, Spano' F, Botta L, Palmieri B, Martinelli L, Giannattasio C, Moreo A, Mateescu A, La Carrubba S, Vriz O, Di Bello V, Carerj S, Zito C, Ginghina C, Popescu B, Nicolosi G, Antonini-Canterin F, Malev E, Omelchenko M, Vasina L, Luneva E, Zemtsovsky E, Cikes M, Velagic V, Gasparovic H, Kopjar T, Colak Z, Hlupic L, Biocina B, Milicic D, Tomaszewski A, Kutarski A, Poterala M, Tomaszewski M, Brzozowski W, Kijima Y, Akagi T, Nakagawa K, Ikeda M, Watanabe N, Ueoka A, Takaya Y, Oe H, Toh N, Ito H, Bochard Villanueva B, Paya-Serrano R, Fabregat-Andres O, Garcia-Gonzalez P, Perez-Bosca J, Cubillos-Arango A, Chacon-Hernandez N, Higueras-Ortega L, De La Espriella-Juan R, Ridocci-Soriano F, Noack T, Mukherjee C, Ionasec R, Voigt I, Kiefer P, Hoebartner M, Misfeld M, Mohr FW, Seeburger J, Daraban AM, Baltussen L, Amzulescu M, Bogaert J, Jassens S, Voigt J, Duchateau N, Giraldeau G, Gabrielli L, Penela D, Evertz R, Mont L, Brugada J, Berruezo A, Bijnens B, Sitges M, Yoshikawa H, Suzuki M, Hashimoto G, Kusunose Y, Otsuka T, Nakamura M, Sugi K, Ruiz Ortiz M, Mesa D, Romo E, Delgado M, Seoane T, Martin M, Carrasco F, Lopez Granados A, Arizon J, Suarez De Lezo J, Magalhaes A, Cortez-Dias N, Silva D, Menezes M, Saraiva M, Santos L, Costa A, Costa L, Nunes Diogo A, Fiuza M, Ren B, De Groot-De Laat L, Mcghie J, Vletter W, Geleijnse M, Toda H, Oe H, Osawa K, Miyoshi T, Ugawa S, Toh N, Nakamura K, Kohno K, Morita H, Ito H, El Ghannudi S, Germain P, Samet H, Jeung M, Roy C, Gangi A, Orii M, Hirata K, Yamano T, Tanimoto T, Ino Y, Yamaguchi T, Kubo T, Imanishi T, Akasaka T, Sunbul M, Kivrak T, Oguz M, Ozguven S, Gungor S, Dede F, Turoglu H, Yildizeli B, Mutlu B, Mihaila S, Muraru D, Piasentini E, Peluso D, Cucchini U, Casablanca S, Naso P, Iliceto S, Vinereanu D, Badano L, Rodriguez Munoz D, Moya Mur J, Becker Filho D, Gonzalez A, Casas Rojo E, Garcia Martin A, Recio Vazquez M, Rincon L, Fernandez Golfin C, Zamorano Gomez J, Ledakowicz-Polak A, Polak L, Zielinska M, Kamiyama T, Nakade T, Nakamura Y, Ando T, Kirimura M, Inoue Y, Sasaki O, Nishioka T, Farouk H, Sakr B, Elchilali K, Said K, Sorour K, Salah H, Mahmoud G, Casanova Rodriguez C, Cano Carrizal R, Iglesias Del Valle D, Martin Penato Molina A, Garcia Garcia A, Prieto Moriche E, Alvarez Rubio J, De Juan Bagua J, Tejero Romero C, Plaza Perez I, Korlou P, Stefanidis A, Mpikakis N, Ikonomidis I, Anastasiadis S, Komninos K, Nikoloudi P, Margos P, Pentzeridis P. Poster session Thursday 12 December - AM: 12/12/2013, 08:30-12:30 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet203] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kijima Y, Akagi T, Nakagawa K, Taniguchi M, Ueoka A, Deguchi K, Toh N, Oe H, Kusano K, Sano S, Ito H. Catheter closure of patent foramen ovale in patients with cryptogenic cerebrovascular accidents: initial experiences in Japan. Cardiovasc Interv Ther 2013; 29:11-7. [DOI: 10.1007/s12928-013-0193-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 06/14/2013] [Indexed: 10/26/2022]
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Kijima Y, Akagi T, Nakagawa K, Ueoka A, Toh N, Kusano K, Ito H. NEW THERAPEUTIC STRATEGIES FOR PATIENTS WITH ATRIAL SEPTAL DEFECT AND SEVERE PULMONARY ARTERIAL HYPERTENSION: COMBINATION OF ADVANCED MEDICAL THERAPY AND CATHETER INTERVENTION. J Am Coll Cardiol 2013. [DOI: 10.1016/s0735-1097(13)61914-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Sakatani T, Ueoka A, Maruyama N, Shimoda Y, Kishita E, Tsubakimoto Y, Matsuo A, Inoue K, Fujita H, Kitamura M, Nishimura T. [Clinical characteristics of patients diagnosed as high cardiac event probability by "Heart Risk View"]. Kaku Igaku 2011; 48:419-423. [PMID: 22338909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
"Heart Risk View" is the software to evaluate the cardiac event probability, and it is based on the results of the prospective cohort study (J-ACCESS). We examined the usefulness of this software. Study population consisted of 83 patients, who were diagnosed that cardiac event probability was over 20% by "Heart Risk View." During the follow-up period (596 +/- 356 days), cardiac event occurred in 23 patients (27.7%), including 7 patients death. No significant differences were observed in the ejection fraction by Quantitative Gated SPECT, total defect score calculated from SPECT, and the percentage of stress perfusion abnormality detected by SPECT between event and non-event groups. However, the percentage of cardiac revascularization therapy based on the SPECT was significantly lower in the event group (9 vs. 38%, p = 0.03). In conclusion, cardiac event probability calculated by "Heart Risk View" was reliable in our study cohort. Cardiac event strongly depended on the cardiac ischemia, for which the therapy was difficult because of lesion complexity or combined diseases.
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Matsuo A, Fujita H, Ueoka A, Maruyama N, Shimoda Y, Kishita E, Tsubakimoto Y, Sakatani T, Inoue K, Kitamura M, Nishimura M. Importance of measuring the fractional flow reserve in patients receiving hemodialysis. Cardiovasc Interv Ther 2011; 26:215-21. [DOI: 10.1007/s12928-011-0061-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2010] [Accepted: 03/06/2011] [Indexed: 11/30/2022]
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Poster Session 3. Europace 2011. [DOI: 10.1093/europace/eur229] [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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Sakatani T, Inoue K, Tanigaki T, Ueoka A, Shimonaga T, Tsubakimoto Y, Kimura S, Matsuo A, Fujita H, Kitamura M. The Association between Electrocardiographic Characteristics and Clinical Outcome in Cardiac Resynchronization Therapy. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.pj3_034] [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: 11/11/2022] Open
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Inoue K, Tanigaki T, Ueoka A, Shimonaga T, Tsubakimoto Y, Sakatani T, Kimura S, Matsuo A, Fujita H, Kitamura M. Prognostic Value of Plasma Aldosterone Levels on the Future Risk of New-Onset Atrial Fibrillation. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.op24_1] [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: 11/11/2022] Open
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