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Miyazaki Y, Ishibashi K, Ueda N, Oka S, Wakamiya A, Shimamoto K, Nakajima K, Kamakura T, Wada M, Inoue Y, Miyamoto K, Nagase S, Aiba T, Kusano K. Evaluation of synchronized left ventricular pacing rate over biventricular pacing in cardiac resynchronization therapy. J Cardiol 2024:S0914-5087(24)00080-7. [PMID: 38679318 DOI: 10.1016/j.jjcc.2024.04.007] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/13/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND The adaptive cardiac resynchronization therapy (aCRT) algorithm enables synchronized left ventricular pacing (sLVP) to achieve fusion with intrinsic right ventricular activation. Although sLVP presents benefits over biventricular pacing, the adequate sLVP rate for better clinical outcomes remains unclear. We aimed to assess the association between sLVP rates and clinical outcomes. METHODS Our study cohort included 271 consecutive patients, who underwent CRT implantation between April 2016 and August 2021. RESULTS We evaluated 63 patients on whom we applied the aCRT algorithm [48 men, mean age: 64 ± 14 years; median follow-up period: 316 days (interquartile range: 212-809 days)]. At the 6-month follow-up after CRT implantation, the frequency of CRT responders was 71 % (n = 45). The sLVP rate was significantly higher in responders than in non-responders (75 ± 30 % vs. 47 ± 40 %, p = 0.003). Receiver operating characteristics curve analysis revealed that the optimal cut-off value during the sLVP rate was 59.4 % for the prediction of CRT responders (area under the curve, 0.70; sensitivity, 80 %; specificity, 61 %; positive predictive value, 84 %; and negative predictive value, 55 %). Kaplan-Meier analysis demonstrated that the higher-sLVP group (sLVP ≧59.4 %, n = 43) had a better prognosis (cardiac death and heart failure hospitalization) than the lower-sLVP group (sLVP <59.4 %, n = 20) (log-rank p < 0.001). Multivariate Cox hazard analysis revealed that a higher sLVP rate was associated with a good prognosis (p < 0.001). CONCLUSIONS sLVP was associated with CRT response, and a higher sLVP rate (≧59.4 %) was important for good prognosis in patients with aCRT.
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Affiliation(s)
- Yuichiro Miyazaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
| | - Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Satoshi Oka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Akinori Wakamiya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Keiko Shimamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuko Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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Miyazaki Y, Ishibashi K, Ueda N, Nakamura T, Oka S, Wakamiya A, Nakajima K, Wada M, Aiba T, Kusano K. Right Atrial Septal Lead Enhances the Favorable Effects of the Adaptive Cardiac Resynchronization Therapy Algorithm. JACC Asia 2024; 4:335-338. [PMID: 38660108 PMCID: PMC11035932 DOI: 10.1016/j.jacasi.2024.01.010] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/10/2024] [Accepted: 01/26/2024] [Indexed: 04/26/2024]
Abstract
The adaptive cardiac resynchronization therapy (CRT) algorithm provides synchronized left ventricular pacing (sLVP). However, ensuring a high sLVP rate is challenging. We assessed the association between the sLVP rate and pacing sites in the right atrium. We evaluated 71 patients who underwent CRT and in whom the adaptive CRT algorithm was applied (53 men; mean age, 66 ± 14 years; median follow-up period, 301 days; IQR: 212-596 days). The atrial pacing leads were positioned in the right atrial (RA) septum in 17 patients (septal group) and in the RA appendage in 54 patients (RA appendage group), with significantly higher sLVP rates in the septal group compared with the RA appendage group (81% ± 30% vs 63% ± 37%; P = 0.045). In patients with first-degree atrioventricular blocks, the sLVP rates tended to be higher in the septal group. Therefore, RA septal pacing increased sLVP rates in patients undergoing CRT.
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Affiliation(s)
- Yuichiro Miyazaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Toshihiro Nakamura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Satoshi Oka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Akinori Wakamiya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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Wada M, Compton C, Hickson R, Bingham P. Development of LIME-NZ: a generic tool for prompt estimation of economic impacts of disease for New Zealand livestock. N Z Vet J 2024; 72:79-89. [PMID: 38252956 DOI: 10.1080/00480169.2023.2294792] [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] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/03/2023] [Indexed: 01/24/2024]
Abstract
AIMS To develop a simple and robust generic tool to measure the impacts of livestock diseases on New Zealand dairy, beef and sheep farms using enterprise gross margin models. METHODS The most recent (2018-2020) livestock production benchmarking data was extracted from industry-led economic surveys. Gross margin models were built for each enterprise type, accounting for 11 dairy farm types and 16 farm types for beef and sheep. Disease parameters, including changes in mortality, reproduction performance, milk yield, price of animals and culling rate, as well as additional expenses for veterinary intervention, were applied to the infected compartment of the herd/flock using the assumed annual within-herd disease incidence. Farm-level disease impacts were estimated as the difference in annual profit between the baseline and infected farm. The baseline gross margin models were validated against the industry data. The disease impact models were validated using a recently published study on bovine viral diarrhoea (BVD). The impact assessment tool, LIME-NZ, was developed using the statistical software R and implemented in the web-based R package Shiny. The input parameters can be varied interactively to obtain a range of disease impacts for uncertain disease parameters. RESULTS The baseline gross margin models demonstrated reasonable accuracy with a mean percentage error of <14% when compared with the industry reports. The estimated annual impacts of BVD were comparable to those reported in the BVD study, NZ$38.5-140.4 thousand and $0.9-32.6 thousand per farm per year for dairy and beef enterprises, respectively. CONCLUSIONS LIME-NZ can be used to rapidly obtain the likely economic impacts of diseases that are endemic, recently introduced or at increased risk of introduction in the New Zealand context. This will aid communication and decision-making among government agencies and the livestock industry, including veterinarians and livestock producers, about the management of diseases, until refined information becomes available to improve decision-making.
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Affiliation(s)
- M Wada
- EpiCentre, Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - C Compton
- EpiCentre, Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - R Hickson
- Farmherd Innovation, Pahiatua, New Zealand
| | - P Bingham
- Diagnostic, Surveillance and Science Directorate, Operations Branch, Ministry for Primary Industries, Wallaceville, New Zealand
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Ueda N, Ishibashi K, Noda T, Oka S, Miyazaki Y, Shimamoto K, Wakamiya A, Nakajima K, Kamakura T, Wada M, Inoue Y, Miyamoto K, Nagase S, Aiba T, Kanzaki H, Izumi C, Noguchi T, Kusano K. Implications of ventricular arrhythmia after cardiac resynchronization therapy. Heart Rhythm 2024; 21:163-171. [PMID: 37739199 DOI: 10.1016/j.hrthm.2023.09.014] [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: 06/28/2023] [Revised: 09/02/2023] [Accepted: 09/16/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Conflicting data are available on whether ventricular arrhythmia (VA) or shock therapy increases mortality. Although cardiac resynchronization therapy (CRT) reduces the risk of VA, little is known about the prognostic value of VA among patients with CRT devices. OBJECTIVES The purpose of this study was to evaluate the implications of VA as a prognostic marker for CRT. METHODS We investigated 330 CRT patients within 1 year after CRT device implantation. The primary endpoint was the composite endpoint of all-cause death or hospitalization for heart failure. RESULTS Forty-three patients had VA events. These patients had a significantly higher risk of the primary endpoint, even among CRT responders (P = .009). Fast VA compared to slow VA was associated with an increased risk of the primary endpoint (hazard ratio [HR] 2.14; 95% confidence interval [CI] 1.06-4.34; P = .035). Shock therapy was not associated with a primary endpoint (shock therapy vs antitachycardia pacing: HR 1.49; 95% CI 0.73-3.03; P = .269). The patients with VA had a lower prevalence of response to CRT (23 [53%] vs 202 [70%]; P = .031) and longer left ventricular paced conduction time (174 ± 23 ms vs 143 ± 36 ms; P = .003) than the patients without VA. CONCLUSION VA occurrence within 1 year was related to paced electrical delay and poor response to CRT. VA could be associated with poor prognosis among CRT patients.
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Affiliation(s)
- Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Satoshi Oka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yuichiro Miyazaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Keiko Shimamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Akinori Wakamiya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yuko Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Hideaki Kanzaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
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Ueda N, Noda T, Kanaoka K, Miyazaki Y, Wakamiya A, Nakajima K, Kamakura T, Wada M, Yamagata K, Ishibashi K, Inoue Y, Miyamoto K, Nagase S, Aiba T, Kanzaki H, Izumi C, Noguchi T, Yasuda S, Kusano K. Clinical Significance of Atrial Tachyarrhythmia Duration for Ventricular Arrhythmia in Patients With Cardiac Resynchronization Therapy. Circ J 2023:CJ-23-0547. [PMID: 38057103 DOI: 10.1253/circj.cj-23-0547] [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: 12/08/2023]
Abstract
BACKGROUND Atrial tachyarrhythmias (ATAs) are reportedly associated with ventricular arrhythmias (VAs). However, little is known about the association between ATA duration and the risk of VA. We investigated the relationship between ATA duration and subsequent VA in patients with a cardiac resynchronization therapy defibrillator (CRT-D).Methods and Results: We investigated associations between the longest ATA duration during the first year after cardiac resynchronization therapy (CRT) implantation and VA and VA relevant to ATA (VAATA) in 160 CRT-D patients. ATAs occurred in 63 patients in the first year. During a median follow-up of 925 days from 1 year after CRT implantation, 40 patients experienced 483 VAs. Kaplan-Meier analysis showed a significantly higher risk of VA in patients with than without ATA in the first year (log rank P=0.0057). Hazard ratios (HR) of VA (HR 2.36, 2.10, and 3.04 for ATA >30s, >6 min and >24 h, respectively) and only VAATA (HR 4.50, 5.59, and 11.79 for ATA >30s, >6 min and >24 h, respectively) increased according to the duration of ATA. In multivariate analysis, ATA >24 h was an independent predictor of subsequent VA (HR 2.42; P=0.02). CONCLUSIONS Patients with ATA >24 h in the first year after CRT had a higher risk of subsequent VA and VAATA. The risk of VA, including VAATA, increased with the longest ATA duration.
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Affiliation(s)
- Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Koshiro Kanaoka
- Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
| | - Yuichiro Miyazaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Akinori Wakamiya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yuko Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hideaki Kanzaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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Ueda N, Kataoka N, Miyazaki Y, Shimamoto K, Wakamiya A, Nakajima K, Kamakura T, Wada M, Ishibashi K, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Aiba T, Kinugawa K, Minamino N, Kusano K. N-terminal pro atrial natriuretic peptide as a prognostic marker of cardiac resynchronization therapy recipients. Int J Cardiol Heart Vasc 2023; 49:101282. [PMID: 37908624 PMCID: PMC10613895 DOI: 10.1016/j.ijcha.2023.101282] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 11/02/2023]
Abstract
Background Although the dynamic changes of atrial natriuretic peptide (ANP) expressions in a failing heart are well-documented, the clinical implications of detailed measurements of each ANP molecular form processed from proANP remain unclear. Methods Patients screening was conducted on patients who were eligible for cardiac resynchronization therapy (CRT) between 2014 and 2019 in our institution. Blood samples and echocardiographic parameters were collected on the day before and six months after implantation. Total ANP, proANP, and N-terminal fragment of proANP (NT-proANP) were examined as predictive biomarkers for cardiac death, left ventricular assist device implantation, and heart failure hospitalization following CRT implantation. Results A total of 86 subjects (mean age 70 years, 64 males) who underwent successful CRT implantation were enrolled. Plasma levels of total ANP, proANP, and NT-proANP were not normally distributed [25.8 pM (interquartile range: 11.1-53.1), 2.2 pM (1.0-5.4), and 4.1 nM (2.4-7.1), respectively]. Over a median follow-up of 2.7 years, 31 patients (2 deaths and 29 heart failure hospitalizations) reached the endpoints. Among the different ANP forms, only NT-proANP emerged as an independent predictor of the composite outcome (adjusted odds ratio of 2.542 in those with levels above vs. below the median, 95 % confidence interval 1.151-5.615, p = 0.021). NT-proANP levels were associated with left atrial volume and left diastolic functional parameters and decreased in response to echocardiographic improvements at six months post-implantation (16 ± 44 % decrease in responders vs 18 ± 60 % increase in non-responders, p = 0.005). Conclusion Pre-implantation NT-proANP levels could serve as a predictive factor for clinical outcomes in recipients of CRT.
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Affiliation(s)
- Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Naoya Kataoka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
- Second Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Yuichiro Miyazaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Keiko Shimamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Akinori Wakamiya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yuko Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Koichiro Kinugawa
- Second Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Naoto Minamino
- National Cerebral and Cardiovascular Center Research Institute, Suita, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
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Kamakura T, Ueda N, Wada M, Ishibashi K, Kusano K. Proarrhythmic Effect of Antitachycardia Pacing: Is Only the Pacing Algorithm to be Blamed? JACC Clin Electrophysiol 2023; 9:2169-2170. [PMID: 37879800 DOI: 10.1016/j.jacep.2023.07.026] [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: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 10/27/2023]
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Kamakura T, Kamoshida J, Toda K, Wayama K, Wada M, Kusano K. Ventricular fibrillation initiated by reentry involving the Purkinje network in a patient with after myocardial infarction. HeartRhythm Case Rep 2023; 9:618-623. [PMID: 37746568 PMCID: PMC10511930 DOI: 10.1016/j.hrcr.2023.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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)
- Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Junichi Kamoshida
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kojiro Toda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Keima Wayama
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
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9
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Oka S, Ueda N, Ishibashi K, Noda T, Miyazaki Y, Wakamiya A, Shimamoto K, Nakajima K, Kamakura T, Wada M, Inoue Y, Miyamoto K, Nagase S, Aiba T, Kanzaki H, Izumi C, Kusano K. Significance of effective cardiac resynchronization therapy pacing for clinical responses: An analysis based on the effective cardiac resynchronization therapy algorithm. Heart Rhythm 2023; 20:1289-1296. [PMID: 37307884 DOI: 10.1016/j.hrthm.2023.06.005] [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: 02/04/2023] [Revised: 05/30/2023] [Accepted: 06/07/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND High percent ventricular pacing maximizes cardiac resynchronization therapy (CRT) response. An effective CRT algorithm classifies each left ventricular (LV) pace as effective or ineffective on the basis of the detection of QS or QS-r morphology on the electrogram; however, the relationship between percent effective CRT pacing (%e-CRT) and responses is unclear. OBJECTIVE We aimed to clarify the association between %e-CRT and clinical outcomes. METHODS Of the 136 consecutive CRT patients, 49 using the adaptive and effective CRT algorithm with percent ventricular pacing > 90% were evaluated. The primary and secondary outcomes were heart failure (HF) hospitalization and prevalence of CRT responders, defined as patients with an improvement in LV ejection fraction of ≥10% or a reduction in LV end-systolic volume of ≥15% after CRT device implantation, respectively. RESULTS We divided the patients into the effective group (n = 25) and the less effective group (n = 24) by the median value of %e-CRT (97.4% [93.7%-98.3%]). During the median follow-up period of 507 days (interquartile range 335-730 days), the effective group had a significantly lower risk of HF hospitalization than the less effective group as revealed by Kaplan-Meier analysis (log-rank, P = .016). Univariate analysis revealed %e-CRT ≥ 97.4% (hazard ratio 0.12; 95% confidence interval 0.01-0.95; P = .045) as a predictor of HF hospitalization. The effective group had a higher prevalence of CRT responders than the less effective group (23 [92%] vs 9 [38%]; P < .001). Univariate analysis revealed that %e-CRT ≥ 97.4% (odds ratio 19.20; 95% confidence interval 3.63-101.00; P < .001) was a predictor of CRT response. CONCLUSION High %e-CRT is associated with high CRT responder prevalence and low HF hospitalization risk.
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Affiliation(s)
- Satoshi Oka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yuichiro Miyazaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Akinori Wakamiya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Keiko Shimamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuko Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Hideaki Kanzaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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10
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Wada M, Inoue YY, Nakai M, Sumita Y, Tonegawa-Kuji R, Miyazaki Y, Wakamiya A, Shimamoto K, Ueda N, Nakajima K, Kamakura T, Yamagata K, Ishibashi K, Miyamoto K, Nagase S, Aiba T, Iwanaga Y, Miyamoto Y, Kusano K. Transvenous lead extraction versus surgical lead extraction or conservative treatment for cardiac implantable electronic device infections: Propensity score-weighted analyses of a nationwide claim-based database. Pacing Clin Electrophysiol 2023; 46:833-839. [PMID: 37485704 DOI: 10.1111/pace.14789] [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: 04/14/2023] [Revised: 06/13/2023] [Accepted: 07/03/2023] [Indexed: 07/25/2023]
Abstract
INTRODUCTION Infection is one of the most important complications associated with cardiac implantable electronic device (CIED) therapy. The number of reports comparing the outcomes of transvenous lead extraction (TLE), surgical lead extraction, and conservative treatment for CIED infections using a real-world database is limited. This study investigated the association between the treatment strategies for CIED infections and their outcomes. METHODS We performed a retrospective analysis of 3605 patients with CIED infections admitted to 681 hospitals using a nationwide claim-based database collected between April 2012 and March 2018. RESULTS We divided the 3605 patients into TLE (n = 938 [26%]), surgical lead extraction (n = 182 [5.0%]), and conservative treatment (n = 2485 [69%]) groups. TLE was performed more frequently in younger patients and at larger hospitals (p for trend < .001 for both). The rate of TLE increased during the study period, whereas that of surgical lead extraction decreased (p for trend < .001 for both). TLE was associated with lower in-hospital mortality (vs. surgical lead extraction: odds ratio [OR], 0.20; 95% CI, 0.06-0.70; vs. conservative treatment: OR, 0.45; 95% CI: 0.22-0.94) and lower 30-day readmission rates (vs. surgical lead extraction: OR, 0.18; 95% CI: 0.06-0.56; vs. conservative treatment: OR, 0.06; 95% CI, 0.03-0.13) in propensity score-weighted analyses. CONCLUSIONS Only 26% of patients hospitalized for CIED infections received TLE. TLE was associated with significantly lower in-hospital mortality and 30-day recurrence rates than surgical lead extraction and conservative treatment, suggesting that TLE should be more widely recommended as a first-line treatment for CIED infections.
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Affiliation(s)
- Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuko Y Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Michikazu Nakai
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoko Sumita
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Reina Tonegawa-Kuji
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yuichiro Miyazaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Akinori Wakamiya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Keiko Shimamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoshitaka Iwanaga
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoshihiro Miyamoto
- Open Innovation Center, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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11
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Ideishi A, Yamagata K, Nishii T, Miyanooi H, Miyazaki Y, Wakamiya A, Shimamoto K, Ueda N, Nakajima K, Wada M, Kamakura T, Ishibashi K, Inoue Y, Miyamoto K, Noda T, Nagase S, Aiba T, Kusano K. Interference of cardiac implantable electronic devices and computed tomography imaging in the current era with a phantom model. J Arrhythm 2023; 39:580-585. [PMID: 37560271 PMCID: PMC10407191 DOI: 10.1002/joa3.12853] [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: 12/27/2022] [Revised: 03/20/2023] [Accepted: 04/02/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Cardiac implantable electronic devices are used in patients with cardiac rhythm disorders. Computed tomography irradiation is not prohibited for patients with cardiac implantable electronic devices, despite adverse events being reported. Hence, appropriate preparation and knowledge are required before computed tomography irradiation can be carried out in these patients. Since there is limited knowledge or literature about the influence of computed tomography irradiation in cases with recent cardiac implantable electronic devices, we aimed to evaluate the adverse events and elucidate the necessary and sufficient safety measures associated with this therapy. METHODS AND RESULTS We placed cardiac implantable electronic devices on an anthropomorphic phantom model and observed their electrical activity in electrograms, while various protocols of computed tomography irradiation were implemented and adverse events evaluated. Oversensing with pauses of up to 3.2 s was observed in standard computed tomography protocols, but ventricular tachyarrhythmia or other clinically significant events could not be confirmed. Oversensing with pauses of up to 8.0 s was observed and ventricular tachyarrhythmia was detected in the maximum-dose protocols. However, treatments such as antitachycardia pacing or shock therapy for ventricular tachyarrhythmia were not observed because of their absence. CONCLUSION Computed tomography irradiation for patients using cardiac implantable electronic devices is highly unlikely to cause clinically significant adverse events with the device settings and computed tomography protocols currently being used. Changing or monitoring the device settings routinely before computed tomography irradiation is not necessarily required for most patients.
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Affiliation(s)
- Akihito Ideishi
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
- Department of CardiologyFukuoka University School of MedicineFukuokaJapan
| | - Kenichiro Yamagata
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Tatsuya Nishii
- Department of RadiologyNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Hideto Miyanooi
- Department of RadiologyNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Yuichiro Miyazaki
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Akinori Wakamiya
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Keiko Shimamoto
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Nobuhiko Ueda
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Kenzaburo Nakajima
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Mitsuru Wada
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Tsukasa Kamakura
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Kohei Ishibashi
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Yuko Inoue
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Koji Miyamoto
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Takashi Noda
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Satoshi Nagase
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
- Department of Advanced Arrhythmia and Translational Medical ScienceNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Takeshi Aiba
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Kengo Kusano
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
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12
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Niwase T, Watanabe YX, Hirayama Y, Mukai M, Schury P, Andreyev AN, Hashimoto T, Iimura S, Ishiyama H, Ito Y, Jeong SC, Kaji D, Kimura S, Miyatake H, Morimoto K, Moon JY, Oyaizu M, Rosenbusch M, Taniguchi A, Wada M. Discovery of New Isotope ^{241}U and Systematic High-Precision Atomic Mass Measurements of Neutron-Rich Pa-Pu Nuclei Produced via Multinucleon Transfer Reactions. Phys Rev Lett 2023; 130:132502. [PMID: 37067317 DOI: 10.1103/physrevlett.130.132502] [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] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/26/2023] [Accepted: 02/16/2023] [Indexed: 06/19/2023]
Abstract
The new isotope ^{241}U was synthesized and systematic atomic mass measurements of nineteen neutron-rich Pa-Pu isotopes were performed in the multinucleon transfer reactions of the ^{238}U+^{198}Pt system at the KISS facility. The present experimental results demonstrate the crucial role of the multinucleon transfer reactions for accessing unexplored neutron-rich actinide isotopes toward the N=152 shell gap in this region of nuclides.
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Affiliation(s)
- T Niwase
- Wako Nuclear Science Center, Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - Y X Watanabe
- Wako Nuclear Science Center, Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - Y Hirayama
- Wako Nuclear Science Center, Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - M Mukai
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - P Schury
- Wako Nuclear Science Center, Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - A N Andreyev
- School of Physics, Engineering and Technology, University of York, York YO10 5DD, United Kingdom
| | - T Hashimoto
- Institute for Basic Science, 70, Yuseong-daero 1689-gil, Yusung-gu, Daejeon 43000, Korea
| | - S Iimura
- Department of Physics, Rikkyo University, Tokyo 171-8501, Japan
| | - H Ishiyama
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - Y Ito
- Advanced Science Research Center, Japan Atomic Energy Agency, Ibaraki 319-1195, Japan
| | - S C Jeong
- Wako Nuclear Science Center, Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - D Kaji
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - S Kimura
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - H Miyatake
- Wako Nuclear Science Center, Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - K Morimoto
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - J-Y Moon
- Institute for Basic Science, 70, Yuseong-daero 1689-gil, Yusung-gu, Daejeon 43000, Korea
| | - M Oyaizu
- Wako Nuclear Science Center, Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - M Rosenbusch
- Wako Nuclear Science Center, Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - A Taniguchi
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, Kumatori, Osaka 590-0494, Japan
| | - M Wada
- Wako Nuclear Science Center, Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
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13
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Agnes P, Albuquerque IFM, Alexander T, Alton AK, Ave M, Back HO, Batignani G, Biery K, Bocci V, Bonivento WM, Bottino B, Bussino S, Cadeddu M, Cadoni M, Calaprice F, Caminata A, Campos MD, Canci N, Caravati M, Cargioli N, Cariello M, Carlini M, Cataudella V, Cavalcante P, Cavuoti S, Chashin S, Chepurnov A, Cicalò C, Covone G, D'Angelo D, Davini S, De Candia A, De Cecco S, De Filippis G, De Rosa G, Derbin AV, Devoto A, D'Incecco M, Dionisi C, Dordei F, Downing M, D'Urso D, Fairbairn M, Fiorillo G, Franco D, Gabriele F, Galbiati C, Ghiano C, Giganti C, Giovanetti GK, Goretti AM, Grilli di Cortona G, Grobov A, Gromov M, Guan M, Gulino M, Hackett BR, Herner K, Hessel T, Hosseini B, Hubaut F, Hungerford EV, Ianni A, Ippolito V, Keeter K, Kendziora CL, Kimura M, Kochanek I, Korablev D, Korga G, Kubankin A, Kuss M, La Commara M, Lai M, Li X, Lissia M, Longo G, Lychagina O, Machulin IN, Mapelli LP, Mari SM, Maricic J, Messina A, Milincic R, Monroe J, Morrocchi M, Mougeot X, Muratova VN, Musico P, Nozdrina AO, Oleinik A, Ortica F, Pagani L, Pallavicini M, Pandola L, Pantic E, Paoloni E, Pelczar K, Pelliccia N, Piacentini S, Pocar A, Poehlmann DM, Pordes S, Poudel SS, Pralavorio P, Price DD, Ragusa F, Razeti M, Razeto A, Renshaw AL, Rescigno M, Rode J, Romani A, Sablone D, Samoylov O, Sandford E, Sands W, Sanfilippo S, Savarese C, Schlitzer B, Semenov DA, Shchagin A, Sheshukov A, Skorokhvatov MD, Smirnov O, Sotnikov A, Stracka S, Suvorov Y, Tartaglia R, Testera G, Tonazzo A, Unzhakov EV, Vishneva A, Vogelaar RB, Wada M, Wang H, Wang Y, Westerdale S, Wojcik MM, Xiao X, Yang C, Zuzel G. Search for Dark-Matter-Nucleon Interactions via Migdal Effect with DarkSide-50. Phys Rev Lett 2023; 130:101001. [PMID: 36962014 DOI: 10.1103/physrevlett.130.101001] [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] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/23/2022] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Dark matter elastic scattering off nuclei can result in the excitation and ionization of the recoiling atom through the so-called Migdal effect. The energy deposition from the ionization electron adds to the energy deposited by the recoiling nuclear system and allows for the detection of interactions of sub-GeV/c^{2} mass dark matter. We present new constraints for sub-GeV/c^{2} dark matter using the dual-phase liquid argon time projection chamber of the DarkSide-50 experiment with an exposure of (12 306±184) kg d. The analysis is based on the ionization signal alone and significantly enhances the sensitivity of DarkSide-50, enabling sensitivity to dark matter with masses down to 40 MeV/c^{2}. Furthermore, it sets the most stringent upper limit on the spin independent dark matter nucleon cross section for masses below 3.6 GeV/c^{2}.
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Affiliation(s)
- P Agnes
- Department of Physics, Royal Holloway University of London, Egham TW20 0EX, United Kingdom
| | - I F M Albuquerque
- Instituto de Física, Universidade de São Paulo, São Paulo 05508-090, Brazil
| | - T Alexander
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - A K Alton
- Physics Department, Augustana University, Sioux Falls, South Dakota 57197, USA
| | - M Ave
- Instituto de Física, Universidade de São Paulo, São Paulo 05508-090, Brazil
| | - H O Back
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - G Batignani
- INFN Pisa, Pisa 56127, Italy
- Physics Department, Università degli Studi di Pisa, Pisa 56127, Italy
| | - K Biery
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - V Bocci
- INFN Sezione di Roma, Roma 00185, Italy
| | | | - B Bottino
- Physics Department, Università degli Studi di Genova, Genova 16146, Italy
- INFN Genova, Genova 16146, Italy
| | - S Bussino
- INFN Roma Tre, Roma 00146, Italy
- Mathematics and Physics Department, Università degli Studi Roma Tre, Roma 00146, Italy
| | - M Cadeddu
- INFN Cagliari, Cagliari 09042, Italy
| | - M Cadoni
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - F Calaprice
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | | | - M D Campos
- Physics, Kings College London, Strand, London WC2R 2LS, United Kingdom
| | - N Canci
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | | | | | | | - M Carlini
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- Gran Sasso Science Institute, L'Aquila 67100, Italy
| | - V Cataudella
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - P Cavalcante
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- Virginia Tech, Blacksburg, Virginia 24061, USA
| | - S Cavuoti
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - S Chashin
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, Moscow 119234, Russia
| | - A Chepurnov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, Moscow 119234, Russia
| | - C Cicalò
- INFN Cagliari, Cagliari 09042, Italy
| | - G Covone
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - D D'Angelo
- Physics Department, Università degli Studi di Milano, Milano 20133, Italy
- INFN Milano, Milano 20133, Italy
| | - S Davini
- INFN Genova, Genova 16146, Italy
| | - A De Candia
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - S De Cecco
- INFN Sezione di Roma, Roma 00185, Italy
- Physics Department, Sapienza Università di Roma, Roma 00185, Italy
| | - G De Filippis
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - G De Rosa
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - A V Derbin
- Saint Petersburg Nuclear Physics Institute, Gatchina 188350, Russia
| | - A Devoto
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - M D'Incecco
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - C Dionisi
- INFN Sezione di Roma, Roma 00185, Italy
- Physics Department, Sapienza Università di Roma, Roma 00185, Italy
| | - F Dordei
- INFN Cagliari, Cagliari 09042, Italy
| | - M Downing
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - D D'Urso
- Chemistry and Pharmacy Department, Università degli Studi di Sassari, Sassari 07100, Italy
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
| | - M Fairbairn
- Physics, Kings College London, Strand, London WC2R 2LS, United Kingdom
| | - G Fiorillo
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - D Franco
- APC, Université de Paris, CNRS, Astroparticule et Cosmologie, Paris F-75013, France
| | | | - C Galbiati
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- Gran Sasso Science Institute, L'Aquila 67100, Italy
| | - C Ghiano
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - C Giganti
- LPNHE, CNRS/IN2P3, Sorbonne Université, Université Paris Diderot, Paris 75252, France
| | - G K Giovanetti
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - A M Goretti
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | | | - A Grobov
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - M Gromov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, Moscow 119234, Russia
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - M Guan
- Institute of High Energy Physics, Beijing 100049, China
| | - M Gulino
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
- Engineering and Architecture Faculty, Università di Enna Kore, Enna 94100, Italy
| | - B R Hackett
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - K Herner
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - T Hessel
- APC, Université de Paris, CNRS, Astroparticule et Cosmologie, Paris F-75013, France
| | | | - F Hubaut
- Centre de Physique des Particules de Marseille, Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - E V Hungerford
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - An Ianni
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | | | - K Keeter
- School of Natural Sciences, Black Hills State University, Spearfish, South Dakota 57799, USA
| | - C L Kendziora
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Kimura
- AstroCeNT, Nicolaus Copernicus Astronomical Center, 00-614 Warsaw, Poland
| | - I Kochanek
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - D Korablev
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - G Korga
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - A Kubankin
- Radiation Physics Laboratory, Belgorod National Research University, Belgorod 308007, Russia
| | - M Kuss
- INFN Pisa, Pisa 56127, Italy
| | - M La Commara
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - M Lai
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - X Li
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - M Lissia
- INFN Cagliari, Cagliari 09042, Italy
| | - G Longo
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - O Lychagina
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, Moscow 119234, Russia
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - I N Machulin
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - L P Mapelli
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - S M Mari
- INFN Roma Tre, Roma 00146, Italy
- Mathematics and Physics Department, Università degli Studi Roma Tre, Roma 00146, Italy
| | - J Maricic
- Department of Physics and Astronomy, University of Hawai'i, Honolulu, Hawaii 96822, USA
| | - A Messina
- INFN Sezione di Roma, Roma 00185, Italy
- Physics Department, Sapienza Università di Roma, Roma 00185, Italy
| | - R Milincic
- Department of Physics and Astronomy, University of Hawai'i, Honolulu, Hawaii 96822, USA
| | - J Monroe
- Department of Physics, Royal Holloway University of London, Egham TW20 0EX, United Kingdom
| | - M Morrocchi
- INFN Pisa, Pisa 56127, Italy
- Physics Department, Università degli Studi di Pisa, Pisa 56127, Italy
| | - X Mougeot
- Université Paris-Saclay, CEA, List, Laboratoire National Henri Becquerel (LNE-LNHB), F-91120 Palaiseau, France
| | - V N Muratova
- Saint Petersburg Nuclear Physics Institute, Gatchina 188350, Russia
| | - P Musico
- INFN Genova, Genova 16146, Italy
| | - A O Nozdrina
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - A Oleinik
- Radiation Physics Laboratory, Belgorod National Research University, Belgorod 308007, Russia
| | - F Ortica
- Chemistry, Biology and Biotechnology Department, Università degli Studi di Perugia, Perugia 06123, Italy
- INFN Perugia, Perugia 06123, Italy
| | - L Pagani
- Department of Physics, University of California, Davis, California 95616, USA
| | - M Pallavicini
- Physics Department, Università degli Studi di Genova, Genova 16146, Italy
- INFN Genova, Genova 16146, Italy
| | - L Pandola
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
| | - E Pantic
- Department of Physics, University of California, Davis, California 95616, USA
| | - E Paoloni
- INFN Pisa, Pisa 56127, Italy
- Physics Department, Università degli Studi di Pisa, Pisa 56127, Italy
| | - K Pelczar
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- M. Smoluchowski Institute of Physics, Jagiellonian University, 30-348 Krakow, Poland
| | - N Pelliccia
- Chemistry, Biology and Biotechnology Department, Università degli Studi di Perugia, Perugia 06123, Italy
- INFN Perugia, Perugia 06123, Italy
| | | | - A Pocar
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - D M Poehlmann
- Department of Physics, University of California, Davis, California 95616, USA
| | - S Pordes
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S S Poudel
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - P Pralavorio
- Centre de Physique des Particules de Marseille, Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - D D Price
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - F Ragusa
- Physics Department, Università degli Studi di Milano, Milano 20133, Italy
- INFN Milano, Milano 20133, Italy
| | - M Razeti
- INFN Cagliari, Cagliari 09042, Italy
| | - A Razeto
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - A L Renshaw
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | | | - J Rode
- APC, Université de Paris, CNRS, Astroparticule et Cosmologie, Paris F-75013, France
- LPNHE, CNRS/IN2P3, Sorbonne Université, Université Paris Diderot, Paris 75252, France
| | - A Romani
- Chemistry, Biology and Biotechnology Department, Università degli Studi di Perugia, Perugia 06123, Italy
- INFN Perugia, Perugia 06123, Italy
| | - D Sablone
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - O Samoylov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - E Sandford
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - W Sands
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - S Sanfilippo
- INFN Roma Tre, Roma 00146, Italy
- Mathematics and Physics Department, Università degli Studi Roma Tre, Roma 00146, Italy
| | - C Savarese
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - B Schlitzer
- Department of Physics, University of California, Davis, California 95616, USA
| | - D A Semenov
- Saint Petersburg Nuclear Physics Institute, Gatchina 188350, Russia
| | - A Shchagin
- Radiation Physics Laboratory, Belgorod National Research University, Belgorod 308007, Russia
| | - A Sheshukov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - M D Skorokhvatov
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - O Smirnov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - A Sotnikov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | | | - Y Suvorov
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
| | - R Tartaglia
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | | | - A Tonazzo
- APC, Université de Paris, CNRS, Astroparticule et Cosmologie, Paris F-75013, France
| | - E V Unzhakov
- Saint Petersburg Nuclear Physics Institute, Gatchina 188350, Russia
| | - A Vishneva
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | | | - M Wada
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
- AstroCeNT, Nicolaus Copernicus Astronomical Center, 00-614 Warsaw, Poland
| | - H Wang
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - Y Wang
- Institute of High Energy Physics, Beijing 100049, China
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - S Westerdale
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - M M Wojcik
- M. Smoluchowski Institute of Physics, Jagiellonian University, 30-348 Krakow, Poland
| | - X Xiao
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - C Yang
- Institute of High Energy Physics, Beijing 100049, China
| | - G Zuzel
- M. Smoluchowski Institute of Physics, Jagiellonian University, 30-348 Krakow, Poland
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14
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Agnes P, Albuquerque IFM, Alexander T, Alton AK, Ave M, Back HO, Batignani G, Biery K, Bocci V, Bonivento WM, Bottino B, Bussino S, Cadeddu M, Cadoni M, Calaprice F, Caminata A, Campos MD, Canci N, Caravati M, Cargioli N, Cariello M, Carlini M, Cataudella V, Cavalcante P, Cavuoti S, Chashin S, Chepurnov A, Cicalò C, Covone G, D'Angelo D, Davini S, De Candia A, De Cecco S, De Filippis G, De Rosa G, Derbin AV, Devoto A, D'Incecco M, Dionisi C, Dordei F, Downing M, D'Urso D, Fiorillo G, Franco D, Gabriele F, Galbiati C, Ghiano C, Giganti C, Giovanetti GK, Goretti AM, Grilli di Cortona G, Grobov A, Gromov M, Guan M, Gulino M, Hackett BR, Herner K, Hessel T, Hosseini B, Hubaut F, Hungerford EV, Ianni A, Ippolito V, Keeter K, Kendziora CL, Kimura M, Kochanek I, Korablev D, Korga G, Kubankin A, Kuss M, La Commara M, Lai M, Li X, Lissia M, Longo G, Lychagina O, Machulin IN, Mapelli LP, Mari SM, Maricic J, Messina A, Milincic R, Monroe J, Morrocchi M, Mougeot X, Muratova VN, Musico P, Nozdrina AO, Oleinik A, Ortica F, Pagani L, Pallavicini M, Pandola L, Pantic E, Paoloni E, Pelczar K, Pelliccia N, Piacentini S, Pocar A, Poehlmann DM, Pordes S, Poudel SS, Pralavorio P, Price DD, Ragusa F, Razeti M, Razeto A, Renshaw AL, Rescigno M, Rode J, Romani A, Sablone D, Samoylov O, Sands W, Sanfilippo S, Sandford E, Savarese C, Schlitzer B, Semenov DA, Shchagin A, Sheshukov A, Skorokhvatov MD, Smirnov O, Sotnikov A, Stracka S, Suvorov Y, Tartaglia R, Testera G, Tonazzo A, Unzhakov EV, Vishneva A, Vogelaar RB, Wada M, Wang H, Wang Y, Westerdale S, Wojcik MM, Xiao X, Yang C, Zuzel G. Search for Dark Matter Particle Interactions with Electron Final States with DarkSide-50. Phys Rev Lett 2023; 130:101002. [PMID: 36962032 DOI: 10.1103/physrevlett.130.101002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 01/06/2023] [Indexed: 06/18/2023]
Abstract
We present a search for dark matter particles with sub-GeV/c^{2} masses whose interactions have final state electrons using the DarkSide-50 experiment's (12 306±184) kg d low-radioactivity liquid argon exposure. By analyzing the ionization signals, we exclude new parameter space for the dark matter-electron cross section σ[over ¯]_{e}, the axioelectric coupling constant g_{Ae}, and the dark photon kinetic mixing parameter κ. We also set the first dark matter direct-detection constraints on the mixing angle |U_{e4}|^{2} for keV/c^{2} sterile neutrinos.
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Affiliation(s)
- P Agnes
- Department of Physics, Royal Holloway University of London, Egham TW20 0EX, United Kingdom
| | - I F M Albuquerque
- Instituto de Física, Universidade de São Paulo, São Paulo 05508-090, Brazil
| | - T Alexander
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - A K Alton
- Physics Department, Augustana University, Sioux Falls, South Dakota 57197, USA
| | - M Ave
- Instituto de Física, Universidade de São Paulo, São Paulo 05508-090, Brazil
| | - H O Back
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - G Batignani
- INFN Pisa, Pisa 56127, Italy
- Physics Department, Università degli Studi di Pisa, Pisa 56127, Italy
| | - K Biery
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - V Bocci
- INFN Sezione di Roma, Roma 00185, Italy
| | | | - B Bottino
- Physics Department, Università degli Studi di Genova, Genova 16146, Italy
- INFN Genova, Genova 16146, Italy
| | - S Bussino
- INFN Roma Tre, Roma 00146, Italy
- Mathematics and Physics Department, Università degli Studi Roma Tre, Roma 00146, Italy
| | - M Cadeddu
- INFN Cagliari, Cagliari 09042, Italy
| | - M Cadoni
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - F Calaprice
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | | | - M D Campos
- Physics, Kings College London, Strand, London WC2R 2LS, United Kingdom
| | - N Canci
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | | | | | | | - M Carlini
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- Gran Sasso Science Institute, L'Aquila 67100, Italy
| | - V Cataudella
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - P Cavalcante
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- Virginia Tech, Blacksburg, Virginia 24061, USA
| | - S Cavuoti
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - S Chashin
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, Moscow 119234, Russia
| | - A Chepurnov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, Moscow 119234, Russia
| | - C Cicalò
- INFN Cagliari, Cagliari 09042, Italy
| | - G Covone
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - D D'Angelo
- Physics Department, Università degli Studi di Milano, Milano 20133, Italy
- INFN Milano, Milano 20133, Italy
| | - S Davini
- INFN Genova, Genova 16146, Italy
| | - A De Candia
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - S De Cecco
- INFN Sezione di Roma, Roma 00185, Italy
- Physics Department, Sapienza Università di Roma, Roma 00185, Italy
| | - G De Filippis
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - G De Rosa
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - A V Derbin
- Saint Petersburg Nuclear Physics Institute, Gatchina 188350, Russia
| | - A Devoto
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - M D'Incecco
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - C Dionisi
- INFN Sezione di Roma, Roma 00185, Italy
- Physics Department, Sapienza Università di Roma, Roma 00185, Italy
| | - F Dordei
- INFN Cagliari, Cagliari 09042, Italy
| | - M Downing
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - D D'Urso
- Chemistry and Pharmacy Department, Università degli Studi di Sassari, Sassari 07100, Italy
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
| | - G Fiorillo
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - D Franco
- APC, Université de Paris, CNRS, Astroparticule et Cosmologie, Paris F-75013, France
| | | | - C Galbiati
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- Gran Sasso Science Institute, L'Aquila 67100, Italy
| | - C Ghiano
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - C Giganti
- LPNHE, CNRS/IN2P3, Sorbonne Université, Université Paris Diderot, Paris 75252, France
| | - G K Giovanetti
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - A M Goretti
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | | | - A Grobov
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - M Gromov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, Moscow 119234, Russia
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - M Guan
- Institute of High Energy Physics, Beijing 100049, China
| | - M Gulino
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
- Engineering and Architecture Faculty, Università di Enna Kore, Enna 94100, Italy
| | - B R Hackett
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - K Herner
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - T Hessel
- APC, Université de Paris, CNRS, Astroparticule et Cosmologie, Paris F-75013, France
| | | | - F Hubaut
- Centre de Physique des Particules de Marseille, Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - E V Hungerford
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - An Ianni
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | | | - K Keeter
- School of Natural Sciences, Black Hills State University, Spearfish, South Dakota 57799, USA
| | - C L Kendziora
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M Kimura
- AstroCeNT, Nicolaus Copernicus Astronomical Center, 00-614 Warsaw, Poland
| | - I Kochanek
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - D Korablev
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - G Korga
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - A Kubankin
- Radiation Physics Laboratory, Belgorod National Research University, Belgorod 308007, Russia
| | - M Kuss
- INFN Pisa, Pisa 56127, Italy
| | - M La Commara
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - M Lai
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - X Li
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - M Lissia
- INFN Cagliari, Cagliari 09042, Italy
| | - G Longo
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - O Lychagina
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, Moscow 119234, Russia
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - I N Machulin
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - L P Mapelli
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - S M Mari
- INFN Roma Tre, Roma 00146, Italy
- Mathematics and Physics Department, Università degli Studi Roma Tre, Roma 00146, Italy
| | - J Maricic
- Department of Physics and Astronomy, University of Hawai'i, Honolulu, Hawaii 96822, USA
| | - A Messina
- INFN Sezione di Roma, Roma 00185, Italy
- Physics Department, Sapienza Università di Roma, Roma 00185, Italy
| | - R Milincic
- Department of Physics and Astronomy, University of Hawai'i, Honolulu, Hawaii 96822, USA
| | - J Monroe
- Department of Physics, Royal Holloway University of London, Egham TW20 0EX, United Kingdom
| | - M Morrocchi
- INFN Pisa, Pisa 56127, Italy
- Physics Department, Università degli Studi di Pisa, Pisa 56127, Italy
| | - X Mougeot
- Université Paris-Saclay, CEA, List, Laboratoire National Henri Becquerel (LNE-LNHB), F-91120 Palaiseau, France
| | - V N Muratova
- Saint Petersburg Nuclear Physics Institute, Gatchina 188350, Russia
| | - P Musico
- INFN Genova, Genova 16146, Italy
| | - A O Nozdrina
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - A Oleinik
- Radiation Physics Laboratory, Belgorod National Research University, Belgorod 308007, Russia
| | - F Ortica
- Chemistry, Biology and Biotechnology Department, Università degli Studi di Perugia, Perugia 06123, Italy
- INFN Perugia, Perugia 06123, Italy
| | - L Pagani
- Department of Physics, University of California, Davis, California 95616, USA
| | - M Pallavicini
- Physics Department, Università degli Studi di Genova, Genova 16146, Italy
- INFN Genova, Genova 16146, Italy
| | - L Pandola
- INFN Laboratori Nazionali del Sud, Catania 95123, Italy
| | - E Pantic
- Department of Physics, University of California, Davis, California 95616, USA
| | - E Paoloni
- INFN Pisa, Pisa 56127, Italy
- Physics Department, Università degli Studi di Pisa, Pisa 56127, Italy
| | - K Pelczar
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
- M. Smoluchowski Institute of Physics, Jagiellonian University, 30-348 Krakow, Poland
| | - N Pelliccia
- Chemistry, Biology and Biotechnology Department, Università degli Studi di Perugia, Perugia 06123, Italy
- INFN Perugia, Perugia 06123, Italy
| | | | - A Pocar
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - D M Poehlmann
- Department of Physics, University of California, Davis, California 95616, USA
| | - S Pordes
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S S Poudel
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - P Pralavorio
- Centre de Physique des Particules de Marseille, Aix Marseille Univ, CNRS/IN2P3, CPPM, Marseille, France
| | - D D Price
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - F Ragusa
- Physics Department, Università degli Studi di Milano, Milano 20133, Italy
- INFN Milano, Milano 20133, Italy
| | - M Razeti
- INFN Cagliari, Cagliari 09042, Italy
| | - A Razeto
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - A L Renshaw
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | | | - J Rode
- APC, Université de Paris, CNRS, Astroparticule et Cosmologie, Paris F-75013, France
- LPNHE, CNRS/IN2P3, Sorbonne Université, Université Paris Diderot, Paris 75252, France
| | - A Romani
- Chemistry, Biology and Biotechnology Department, Università degli Studi di Perugia, Perugia 06123, Italy
- INFN Perugia, Perugia 06123, Italy
| | - D Sablone
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - O Samoylov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - W Sands
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - S Sanfilippo
- INFN Roma Tre, Roma 00146, Italy
- Mathematics and Physics Department, Università degli Studi Roma Tre, Roma 00146, Italy
| | - E Sandford
- The University of Manchester, Manchester M13 9PL, United Kingdom
| | - C Savarese
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - B Schlitzer
- Department of Physics, University of California, Davis, California 95616, USA
| | - D A Semenov
- Saint Petersburg Nuclear Physics Institute, Gatchina 188350, Russia
| | - A Shchagin
- Radiation Physics Laboratory, Belgorod National Research University, Belgorod 308007, Russia
| | - A Sheshukov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - M D Skorokhvatov
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - O Smirnov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | - A Sotnikov
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | | | - Y Suvorov
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
| | - R Tartaglia
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | | | - A Tonazzo
- APC, Université de Paris, CNRS, Astroparticule et Cosmologie, Paris F-75013, France
| | - E V Unzhakov
- Saint Petersburg Nuclear Physics Institute, Gatchina 188350, Russia
| | - A Vishneva
- Joint Institute for Nuclear Research, Dubna 141980, Russia
| | | | - M Wada
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
- AstroCeNT, Nicolaus Copernicus Astronomical Center, 00-614 Warsaw, Poland
| | - H Wang
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - Y Wang
- Institute of High Energy Physics, Beijing 100049, China
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - S Westerdale
- INFN Cagliari, Cagliari 09042, Italy
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - M M Wojcik
- M. Smoluchowski Institute of Physics, Jagiellonian University, 30-348 Krakow, Poland
| | - X Xiao
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - C Yang
- Institute of High Energy Physics, Beijing 100049, China
| | - G Zuzel
- M. Smoluchowski Institute of Physics, Jagiellonian University, 30-348 Krakow, Poland
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15
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Miyazaki Y, Yamagata K, Wakamiya A, Shimamoto K, Ueda N, Nakajima K, Kamakura T, Wada M, Ishibashi K, Inoue Y, Miyamoto K, Nagase S, Aiba T, Kusano K. Adding interactive face-to-face lectures to passive lectures effectively reduces radiation exposure during atrial fibrillation ablation. J Cardiol 2023; 81:464-468. [PMID: 36822546 DOI: 10.1016/j.jjcc.2023.02.005] [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: 10/20/2022] [Revised: 01/24/2023] [Accepted: 02/07/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND Radiation exposure remains a major concern for electrophysiologists and patients. This study aimed to investigate the effect of altering awareness of radiation exposure during atrial fibrillation ablation using interactive face-to-face (FTF) lectures compared to passive lectures. METHODS Patients who underwent their first catheter ablation with radiofrequency energy for atrial fibrillation between January 2014 and December 2020 were included in this study. All operators attended an e-learning lecture on radiation exposure before catheter ablation. The addition of FTF lectures to this lecture was introduced in 2018. The effect on radiation exposure was compared between the pre-FTF and FTF periods by comparing fluoroscopy time and radiation dose. RESULTS A total of 896 patients [mean age, 66 ± 11 years; 603 men (67 %)] were included in this study. For pre-FTF (n = 345), only pulmonary vein isolation (PVI) was performed in 112 patients and PVI with additional ablation in 233 patients. For FTF lectures (n = 551), PVI-only was performed in 302 patients and PVI with additional ablation in 249 patients. Fluoroscopy time, cumulative air kerma, and cumulative air kerma per time significantly reduced after FTF introduction in both PVI-only group [pre-FTF and FTF; 37 ± 15 min and 16 ± 10 min (p < 0.0001), 477 ± 582 mGy and 108 ± 156 mGy (p < 0.0001), 11 ± 12 mGy/min, and 5 ± 6 mGy/min (p < 0.0001), respectively] and PVI with additional ablation group [pre-FTF and FTF; 48 ± 17 min and 15 ± 13 min (p < 0.0001), 613 ± 483 mGy and 68 ± 96 mGy (p < 0.0001), 12 ± 10 mGy/min, and 4 ± 4 mGy/min (p < 0.0001), respectively]. There were no significant differences in intraoperative complications between the two periods. CONCLUSIONS FTF lectures can reduce radiation exposure.
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Affiliation(s)
- Yuichiro Miyazaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
| | - Akinori Wakamiya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Keiko Shimamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yuko Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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16
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Tonegawa-Kuji R, Inoue YY, Nakai M, Kanaoka K, Sumita Y, Miyazaki Y, Wakamiya A, Shimamoto K, Ueda N, Nakajima K, Wada M, Kamakura T, Yamagata K, Ishibashi K, Miyamoto K, Nagase S, Aiba T, Miyamoto Y, Iwanaga Y, Kusano K. Differences in patient characteristics, clinical practice and outcomes of cardiac implantable electric device therapy between Japan and the USA: a cross-sectional study using data from nationally representative administrative databases. BMJ Open 2023; 13:e068124. [PMID: 36639209 PMCID: PMC9843182 DOI: 10.1136/bmjopen-2022-068124] [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: 01/15/2023] Open
Abstract
OBJECTIVES To identify differences in patient characteristics, clinical practice and outcomes of cardiac implantable electronic device (CIED) therapy between Japan and the USA. DESIGN A cross-sectional study. SETTING Nationally representative administrative databases from Japan and the USA containing hospitalisations with first-time implantations of pacemakers, implantable cardioverter-defibrillators (ICD) and cardiac-resynchronisation therapy with or without defibrillators (CRTP/CRTD). PARTICIPANTS Patients hospitalised with first-time implantations of CIEDs. OUTCOME MEASURES In-hospital mortality, in-hospital complication and 30-day readmission rates. RESULTS Overall, 107 339 (median age 78 (71-84), 48 415 women) and 295 584 (age 76 (67-83), 127 349 women) records with CIED implantations were included from Japan and the USA, respectively. Proportion of women in defibrillator recipients was lower in Japan than in the USA (ICD, 21% vs 28%, p<0.001; CRTD, 24% vs 29%, p<0.001). Length of stay after CIED implantation was longer in Japan than in the USA for all device types (conventional pacemaker, 8(7-11) vs 1 (1-3) days, p<0.001; leadless pacemaker, 5 (3-9) vs 2 (1-5) days, p<0.001; ICD, 8 (7-11) vs 1 (1-3) days, p<0.001, CRTP, 9 (7-13) vs 2 (1-4) days, p<0.001; CRTD, 9 (8-14) vs 2 (1-4) days, p<0.001). In-hospital mortality after CIED implantation was similar between Japan and the USA ((OR) (95% CI), conventional pacemaker 0.58 (0.83 to 1.004); ICD 0.77 (0.57 to 1.03); CRTP 0.85 (0.51 to 1.44); CRTD 1.11 (0.81 to 1.51)), except that after leadless pacemaker implantation in Japan was lower than that in the USA (0.32 (0.23 to 0.43)). 30-day readmission rates were lower in Japan than in the USA for all device types (conventional pacemaker 0.55 (0.53 to 0.57); leadless pacemaker 0.50 (0.43 to 0.58); ICD 0.54 (0.49 to 0.58); CRTP 0.51 (0.42 to 0.62); CRTD 0.57 (0.51 to 0.64)). CONCLUSIONS International variations in patient characteristics, practice and outcomes were observed. In-hospital mortality after CIED implantation was similar between Japan and the USA, except in cases of leadless pacemaker recipients.
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Affiliation(s)
- Reina Tonegawa-Kuji
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yuko Y Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Michikazu Nakai
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Koshiro Kanaoka
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yoko Sumita
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yuichiro Miyazaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Akinori Wakamiya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Keiko Shimamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kohei Ishibashi
- 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
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yoshihiro Miyamoto
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yoshitaka Iwanaga
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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Iimura S, Rosenbusch M, Takamine A, Tsunoda Y, Wada M, Chen S, Hou DS, Xian W, Ishiyama H, Yan S, Schury P, Crawford H, Doornenbal P, Hirayama Y, Ito Y, Kimura S, Koiwai T, Kojima TM, Koura H, Lee J, Liu J, Michimasa S, Miyatake H, Moon JY, Naimi S, Nishimura S, Niwase T, Odahara A, Otsuka T, Paschalis S, Petri M, Shimizu N, Sonoda T, Suzuki D, Watanabe YX, Wimmer K, Wollnik H. Study of the N=32 and N=34 Shell Gap for Ti and V by the First High-Precision Multireflection Time-of-Flight Mass Measurements at BigRIPS-SLOWRI. Phys Rev Lett 2023; 130:012501. [PMID: 36669221 DOI: 10.1103/physrevlett.130.012501] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
The atomic masses of ^{55}Sc, ^{56,58}Ti, and ^{56-59}V have been determined using the high-precision multireflection time-of-flight technique. The radioisotopes have been produced at RIKEN's Radioactive Isotope Beam Factory (RIBF) and delivered to the novel designed gas cell and multireflection system, which has been recently commissioned downstream of the ZeroDegree spectrometer following the BigRIPS separator. For ^{56,58}Ti and ^{56-59}V, the mass uncertainties have been reduced down to the order of 10 keV, shedding new light on the N=34 shell effect in Ti and V isotopes by the first high-precision mass measurements of the critical species ^{58}Ti and ^{59}V. With the new precision achieved, we reveal the nonexistence of the N=34 empirical two-neutron shell gaps for Ti and V, and the enhanced energy gap above the occupied νp_{3/2} orbit is identified as a feature unique to Ca. We perform new Monte Carlo shell model calculations including the νd_{5/2} and νg_{9/2} orbits and compare the results with conventional shell model calculations, which exclude the νg_{9/2} and the νd_{5/2} orbits. The comparison indicates that the shell gap reduction in Ti is related to a partial occupation of the higher orbitals for the outer two valence neutrons at N=34.
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Affiliation(s)
- S Iimura
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, Graduate School of Science, Osaka University, 1-1 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
- Department of Physics, College of Science, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Tokyo 171-8501, Japan
| | - M Rosenbusch
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - A Takamine
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - Y Tsunoda
- Center for Computational Sciences, University of Tsukuba, Tsukuba 305-8577, Japan
| | - M Wada
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - S Chen
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - D S Hou
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- University of Chinese Academy of Sciences, Beijing 100049, China
- School of Nuclear Science and Technology, Lanzhou University, Lanzhou 730000, China
| | - W Xian
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - H Ishiyama
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - S Yan
- Institute of Mass Spectrometry and Atmospheric Environment, Jinan University, Guangzhou 510632, China
| | - P Schury
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - H Crawford
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94523, USA
| | - P Doornenbal
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - Y Hirayama
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - Y Ito
- Advanced Science Research Center, Japan Atomic Energy Agency, Ibaraki 319-1195, Japan
| | - S Kimura
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - T Koiwai
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - T M Kojima
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - H Koura
- Advanced Science Research Center, Japan Atomic Energy Agency, Ibaraki 319-1195, Japan
| | - J Lee
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - J Liu
- Department of Physics, The University of Hong Kong, Pokfulam, Hong Kong, China
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - S Michimasa
- Center of Nuclear Study (CNS), The University of Tokyo, Bunkyo 113-0033, Japan
| | - H Miyatake
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - J Y Moon
- Institute for Basic Science, 70, Yuseong-daero 1689-gil, Yusung-gu, Daejeon 305-811, Korea
| | - S Naimi
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - S Nishimura
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - T Niwase
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
- Kyushu University, Hakozaki, Higashi-ku, Fukuoka 812-8581, Japan
| | - A Odahara
- Department of Physics, Graduate School of Science, Osaka University, 1-1 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
| | - T Otsuka
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Advanced Science Research Center, Japan Atomic Energy Agency, Ibaraki 319-1195, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - S Paschalis
- School of Physics, Engineering, and Technology, University of York, York YO10 5DD, United Kingdom
| | - M Petri
- School of Physics, Engineering, and Technology, University of York, York YO10 5DD, United Kingdom
| | - N Shimizu
- Center for Computational Sciences, University of Tsukuba, Tsukuba 305-8577, Japan
| | - T Sonoda
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - D Suzuki
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
| | - Y X Watanabe
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - K Wimmer
- RIKEN Nishina Center for Accelerator-Based Science, Wako, Saitama 351-0198, Japan
- Department of Physics, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - H Wollnik
- New Mexico State University, Las Cruces, New Mexico 88001, USA
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18
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Kamakura T, Ueda N, Wada M, Ishibashi K, Kusano K. Efficacy of intrinsic antitachycardia pacing for ventricular tachycardia refractory to conventional burst pacing: A case series. J Cardiovasc Electrophysiol 2023; 34:225-228. [PMID: 36511471 DOI: 10.1111/jce.15773] [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: 10/21/2022] [Revised: 12/03/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022]
Abstract
Intrinsic antitachycardia pacing (iATP) is a novel automated ventricular ATP algorithm that designs ATP sequences based on the analysis of prior failed ATP. Real-world data on the efficacy and safety of iATP are lacking. Among 124 ventricular tachycardia (VT) episodes in 130 consecutive patients (mean age at implantation: 63.8 ± 14.9 years; sex, 95 male and 35 female) for whom implantable cardioverter defibrillator or cardiac resynchronization therapy defibrillator equipped with iATP algorithm was implanted, we investigated the efficacy and safety of iATP for VT refractory to conventional burst pacing. Eight patients had a total of 17 episodes of iATP therapy after failed conventional burst pacing within 11.2 ± 6.6 months of follow-up. Eleven VT episodes (64.7%) in seven patients (87.5%) were successfully terminated by iATP, and only one patient (12.5%) experienced VT acceleration. iATP might be useful for VTs refractory to conventional burst pacing with a low risk of VT acceleration.
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Affiliation(s)
- Tsukasa Kamakura
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Nobuhiko Ueda
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Mitsuru Wada
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kohei Ishibashi
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kengo Kusano
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
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Tonegawa-Kuji R, Inoue YY, Nakai M, Kanaoka K, Sumita Y, Miyazaki Y, Wakamiya A, Shimamoto K, Ueda N, Nakajima K, Kataoka N, Wada M, Yamagata K, Ishibashi K, Miyamoto K, Nagase S, Aiba T, Miyamoto Y, Iwanaga Y, Kusano K. Clinical Predictors of Pacing Device Implantation in Implantable Cardiac Monitor Recipients for Unexplained Syncope. CJC Open 2022; 5:259-267. [PMID: 37124961 PMCID: PMC10140738 DOI: 10.1016/j.cjco.2022.12.007] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Background Implantable cardiac monitors (ICMs) help investigate the cause of unexplained syncope, but the probability and predictors of needing a pacing device thereafter remain unclear. Methods We retrospectively analyzed the data of patients who received ICM insertion for unexplained syncope with suspected arrhythmic etiology. The data were obtained from a nationwide database obtained between April 1, 2012 and March 31, 2020. Multivariable mixed-effects survival analysis was performed to identify predictors of pacing device implantation (PDI), and a risk score model was developed accordingly. Results In total, 2905 patients (age: 72 years [range: 60-78]) implanted with ICMs to investigate the cause of syncope were analyzed. During the median follow-up period of 128 days (range: 68-209) days, 473 patients (16%) underwent PDI. Older age, history of atrial fibrillation, bundle branch block (BBB), and diabetes were independent predictors of PDI in multivariable analysis. A risk score model was developed with scores ranging from 0 to 32 points. When patients with the lowest quartile score (0-13 points) were used as a reference, those with higher quartiles had a higher risk of PDI (second quartile: 14-15 points, hazard ratio [HR]: 3.86, 95% confidence interval [CI]: 2.62-5.68; third quartile: 16-18 points, HR: 4.67, 95% CI: 3.14-6.94; fourth quartile: 19-32 points, HR: 6.59, 95% CI: 4.47-9.71). Conclusions The 4 identified predictors are easily assessed during the initial evaluation of patients with syncope. They may help identify patients with a higher risk of requiring permanent PDI.
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Miyamoto K, Kanaoka K, Ohta Y, Yoh M, Takahashi H, Tonegawa‐Kuji R, Miyazaki Y, Shimamoto K, Wakamiya A, Ueda N, Nakajima K, Kamakura T, Wada M, Ishibashi K, Inoue Y, Nagase S, Aiba T, Narai A, Nakase T, Koga M, Fukuda T, Kataoka N, Takagi M, Kusano K. A multicenter prospective randomized study comparing the incidence of periprocedural cerebral embolisms caused by catheter ablation of atrial fibrillation between cryoballoon and radiofrequency ablation (Embo-Abl study): Study design. Clin Cardiol 2022; 46:214-222. [PMID: 36413635 PMCID: PMC9933100 DOI: 10.1002/clc.23949] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 10/03/2022] [Accepted: 10/30/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Although catheter ablation (CA) has become a standard therapeutic approach to atrial fibrillation (AF), it imposes a low but relevant risk of thromboembolic complications of around 0.5%-1%, including ischemic strokes, and has an additional risk of clinically silent cerebral embolisms (SCEs) of 10%-40%. Both cryoballoon (CB) and radiofrequency (RF) ablation are routinely used clinically worldwide, yet there are few prospective data comparing the incidence of cerebral embolism after CA of AF between CB and RF ablation. METHODS The aim of the Embo-Abl study will be to compare the incidence of cerebral embolisms on 3 T diffusion-weighted image magnetic resonance imaging (MRI) after CA of AF between CB and RF ablation in patients with AF in a prospective, multicenter, open-label, controlled, randomized fashion. The primary endpoint of the Embo-Abl study will be the occurrence of MRI-detected SCE 1-3 days after CA. The patients will be registered and randomly assigned to either the CB or RF ablation group in a 1:1 ratio. The study cohort will include 230 patients with AF from a multicenter in Japan. RESULTS The results of this study are currently under investigation. CONCLUSION The Embo-Abl study will be the first to compare the incidence of periprocedural cerebral embolisms caused by CA of AF between CB and RF ablation in a prospective, multicenter, randomized, controlled fashion.
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Affiliation(s)
- Koji Miyamoto
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Koshiro Kanaoka
- Center for Cerebral and Cardiovascular Disease Information, Open Innovation CenterNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Yasutoshi Ohta
- Department of RadiologyNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Masue Yoh
- Department of Medicine IIKansai Medical UniversityMoriguchiJapan
| | - Hiroki Takahashi
- Department of Medicine IIKansai Medical UniversityMoriguchiJapan
| | - Rena Tonegawa‐Kuji
- Center for Cerebral and Cardiovascular Disease Information, Open Innovation CenterNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Yuichiro Miyazaki
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Keiko Shimamoto
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Akinori Wakamiya
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Nobuhiko Ueda
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Kenzaburo Nakajima
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Tsukasa Kamakura
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Mitsuru Wada
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Kohei Ishibashi
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Yuko Inoue
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Satoshi Nagase
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Takeshi Aiba
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Akihisa Narai
- New Development GroupHashimoto Electronic Industry Co., LtdMatsusakaJapan
| | - Tomohiro Nakase
- New Development GroupHashimoto Electronic Industry Co., LtdMatsusakaJapan
| | - Masatoshi Koga
- Department of Cerebrovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Tetsuya Fukuda
- Department of RadiologyNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Naoya Kataoka
- Second Department of Internal MedicineUniversity of ToyamaToyamaJapan
| | - Masahiko Takagi
- Department of Medicine IIKansai Medical UniversityMoriguchiJapan
| | - Kengo Kusano
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
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Suzuki M, Kotani K, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Wada M, Abe M, Akao M, Hasegawa K, Wada H. Serum amyloid A-low-density-lipoprotein complex and mortality in patients with suspected or known coronary artery disease: the ANOX study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1161] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Serum amyloid A-low-density-lipoprotein (SAA-LDL) is a complex formed from the oxidative interaction between SAA and LDLs. A relatively small-scale study has shown that circulating SAA-LDL levels may serve as a prognostic marker in patients with stable coronary artery disease (CAD). However, the prognostic value of SAA-LDL should be confirmed in a larger-scale cohort study.
Methods
Using data from a multicenter, prospective cohort of 2416 patients with suspected or known CAD enrolled in the ANOX (Development of Novel Biomarkers Related to Angiogenesis or Oxidative Stress to Predict Cardiovascular Events) study, we assessed the prognostic value of serum levels of SAA-LDL. The primary outcome was all-cause death. The secondary outcomes were cardiovascular death and major adverse cardiovascular events (MACE) defined as a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke. Patients were followed up over 3 years.
Results
Stepwise regression analysis including baseline data on potential clinical confounders (i.e., age, sex, body mass index, hypertension, dyslipidemia, diabetes, current smoking, estimated glomerular filtration rate, the Gensini score, previous myocardial infarction, previous stroke, previous heart failure hospitalization, atrial fibrillation, malignancies, anemia, antihypertensive drug use, statin use, and aspirin use) and established cardiovascular biomarkers (i.e., N-terminal pro-brain natriuretic peptide, high-sensitivity cardiac troponin I [hs-cTnI], and high-sensitivity C-reactive protein [hs-CRP]) revealed that independent determinants of SAA-LDL levels were female sex, dyslipidemia, the Gensini score, absence of statin use, hs-cTnI, and hs-CRP. After adjusting for potential clinical confounders and established cardiovascular biomarkers, the highest quartile of SAA-LDL levels (vs. the lowest quartile) was significantly associated with the incidence of all-cause death (hazard ratio [HR], 1.51; 95% confidence interval [CI], 1.02–2.26), but not with that of cardiovascular death (HR, 1.11; 95% CI, 0.59–2.10) or MACE (HR, 1.57; 95% CI, 0.97–2.57). Stratified analyses revealed that this association was pronounced in patients with low hs-cTnI (<75th percentile) (HR, 1.85; 95% CI, 1.06–3.30) and in patients with low hs-CRP levels (≤1.0 mg/L) (HR, 2.30; 95% CI, 1.17–4.79).
Conclusions
Elevated SAA-LDL levels were independently associated with the risk of all-cause death in patients with suspected or known CAD. The SAA-LDL level appears to serve as a prognostic biomarker for risk stratification in relatively low-risk patients with low hs-cTnI (<75th percentile) or low hs-CRP (≤1.0 mg/L).
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): The ANOX study is supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization.
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Affiliation(s)
- M Suzuki
- National Hospital Organization Saitama Hospital , Wako , Japan
| | - K Kotani
- Jichi Medical University , Shimotsuke , Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center , Kure , Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center , Yokohama , Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center , Sendai , Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center , Kanazawa , Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital , Hakodate , Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center , Kobe , Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center , Toon , Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center , Sapporo , Japan
| | - M Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - H Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
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22
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Kamada H, Mori K, Ueda N, Wakamiya A, Nakajima K, Kamakura T, Wada M, Ishibashi K, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Noda T, Izumi C, Noguchi T, Kusano K, Aiba T. Impact of Pre-Ablation Direct Current Cardioversion for Persistent Atrial Fibrillation to Predict Recurrence of Atrial Fibrillation after Catheter Ablation. Int Heart J 2022; 63:828-836. [DOI: 10.1536/ihj.22-135] [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: 11/18/2022]
Affiliation(s)
- Hiroyuki Kamada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kazuki Mori
- Department of Cardiovascular Medicine, Hyogo Prefectural Amagasaki General Medical Center
| | - Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Akinori Wakamiya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yuko Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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23
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Kida T, Matsuzaki K, Yokota I, Kawase N, Masatoshi K, Inoue H, Yuji K, Kaneshita S, Inoue T, Wada M, Kohno M, Kawahito Y, Iwami T. POS0875 LATENT TRAJECTORY MODELING OF PULMONARY ARTERY PRESSURE IN SYSTEMIC SCLEROSIS: A RETROSPECTIVE COHORT STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2192] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundSystemic sclerosis (SSc) is an autoimmune disease that is characterized by systemic vasculopathy and fibrosis. Pulmonary hypertension (PH), defined as elevated pulmonary arterial pressure (PAP), is one of the leading causes of death of SSc1. In recent years, various therapies have been developed to target each of the pathogenesis of SSc – autoimmunity, vasculopathy, and fibrosis. Accordingly, treatment strategies based on risk stratification for PH progression are aspired; however, prediction of changes in PAP in diverse patients with SSc has not been established2.ObjectivesTo visualize the patterns of PAP elevation in SSc and to identify the clinical characteristics of each trajectory, by applying latent trajectory modeling for PAP measured repeatedly by echocardiography.MethodsThis was a multicenter, retrospective cohort study conducted at four referral hospitals in Kyoto, Japan. Patients with SSc who visited the study site between April 2008 and March 2021 and had at least three echocardiographic measurements of systolic pulmonary arterial pressure (sPAP) were included in this study. Follow-up concluded in March 2021. A group-based trajectory model3 was applied to the change in sPAP over time, and individual patients were classified into distinct subgroups that followed similar trajectories. The number and shape of the trajectories were estimated based on adequacy, goodness of fit, parsimony, and interpretability of the model. Clinical plausibility was assessed by comparing PH-free survival, i.e., time to either PH or death, for each trajectory. Multinomial logistic regression analysis was performed for baseline clinical characteristics associated with trajectory assignment.ResultsA total of 236 patients with a total of 1097 sPAP measurements were included. We identified five trajectories following the quadratic function as “rapid progression (n=9, 3.8%)”, “early elevation (n=30, 12.7%)”, “mid elevation (n=54, 22.9%)”, “late elevation (n=24, 10.2%)”, and “low stable (n=119, 50.4%)”. Each trajectory, in this order, showed earlier elevation of sPAP and shorter PH-free survival (Figure 1). In the multinomial logistic regression (with the “low stable” as reference), cardiac involvement was associated with the “rapid progression” (adjusted odds ratio [OR] 28.9, 95% confidence interval [CI] 3.21–259.5), diffuse cutaneous SSc was associated with the “early elevation” (OR 4.08, 95% CI 1.27–13.1), anti-centromere antibody positive was associated with the “mid elevation” (OR 4.50, 95% CI 1.11–18.2), and older age of onset was associated with the above three trajectories.ConclusionThe pattern of changes in pulmonary artery pressure over time in SSc can be classified into five distinct trajectories. Each trajectory differed in baseline clinical characteristics and outcomes.References[1]Pokeerbux MR, et al. Survival and prognosis factors in systemic sclerosis: data of a French multicenter cohort, systematic review, and meta-analysis of the literature. Arthritis Res Ther. 2019;21(1):86.[2]Denton CP, et al. Systemic sclerosis. Lancet. 2017;390(10103):1685-1699.[3]Nagin DS, et al. Group-based trajectory modeling in clinical research. Annu Rev Clin Psychol. 2010;6:109-38.Disclosure of InterestsNone declared
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24
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Ueda N, Noda T, Ideishi A, Wada M, Yamagata K, Ishibashi K, Inoue Y, Miyamoto K, Yasuda S, Kusano K. Clinical Impacts and Insights Into Mechanisms of Paced Fragmented QRS in Cardiac Resynchronization Therapy Patients. JACC Clin Electrophysiol 2022; 8:681-684. [PMID: 35589183 DOI: 10.1016/j.jacep.2022.01.004] [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] [Received: 11/01/2021] [Revised: 12/21/2021] [Accepted: 01/01/2022] [Indexed: 11/24/2022]
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25
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Nakasuka K, Ishibashi K, Hattori Y, Mori K, Nakajima K, Nagayama T, Kamakura T, Wada M, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Takaya Y, Isobe M, Terasaki F, Ohte N, Kusano K. Sex-related differences in the prognosis of patients with cardiac sarcoidosis treated with cardiac resynchronization therapy. Heart Rhythm 2022; 19:1133-1140. [DOI: 10.1016/j.hrthm.2022.02.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/19/2022] [Accepted: 02/25/2022] [Indexed: 11/04/2022]
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26
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Shimamoto K, Ohno S, Kato K, Takayama K, Sonoda K, Fukuyama M, Makiyama T, Okamura S, Asakura K, Imanishi N, Kato Y, Sakaguchi H, Kamakura T, Wada M, Yamagata K, Ishibashi K, Inoue Y, Miyamoto K, Nagase S, Kusano K, Horie M, Aiba T. Impact of cascade screening for catecholaminergic polymorphic ventricular tachycardia type 1. Heart 2022; 108:840-847. [PMID: 35135837 PMCID: PMC9120385 DOI: 10.1136/heartjnl-2021-320220] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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] [Received: 08/23/2021] [Accepted: 12/30/2021] [Indexed: 11/06/2022] Open
Abstract
Objective Human cardiac ryanodine receptor 2 (RYR2) shows autosomal-dominant inheritance in catecholaminergic polymorphic ventricular tachycardia type 1 (CPVT1); however, de novo variants have been observed in sporadic cases. Here, we investigated CPVT1-related RYR2 variant inheritance and its clinical significance between familial and de novo cases. Methods We enrolled 82 independent CPVT1 probands (median age: 10.0 (7.0–13.0) years; 45 male) carrying the RYR2 variants and whose biological origin could be confirmed by parental genetic analysis: assured familial inheritance (familial group: n=24) and de novo variants (de novo group: n=58). We examined the clinical characteristics of the probands and their family members carrying the RYR2 variants. Results In the de novo group, the RYR2 variants were more likely located in the C-terminus domain and less likely in the N-terminus domain than those in the familial group. The cumulative incidence of the first cardiac events (syncope and cardiac arrest (CA) or CA only) of the probands at the age of 5 and 10 years was higher in the de novo group than in the familial group. Nearly half of the probands in both groups experienced CA events before diagnosis. Only 37.5% of their genotype-positive parents had symptoms; however, at least 66.7% of the genotype-positive siblings were symptomatic. Conclusions CPVT1 probands harbouring de novo RYR2 variants showed an earlier onset of symptoms than those with assured familial inheritance. Cascade screening may enable early diagnosis, risk stratification and prophylactic therapeutic intervention to prevent sudden cardiac death of probands and potential genotype-positive family members.
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Affiliation(s)
- Keiko Shimamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Seiko Ohno
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Koichi Kato
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Koichiro Takayama
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Keiko Sonoda
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Megumi Fukuyama
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Takeru Makiyama
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satomi Okamura
- Department of Data Science, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Koko Asakura
- Department of Data Science, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Noriaki Imanishi
- Department of Genomic Care, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoshiaki Kato
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Heima Sakaguchi
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yuko Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Minoru Horie
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan .,Department of Clinical Laboratory and Genetics, National Cerebral and Cardiovascular Center, Suita, Japan
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27
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Yokoyama Y, Kataoka N, Nakai M, Matsuo A, Fujiwara A, Wakamiya A, Ueda N, Nakajima K, Kamakura T, Wada M, Yamagata K, Ishibashi K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Takahama H, Izumi C, Kinugawa K, Minamino N, Kusano K. A new biomarker of cardiac resynchronization therapy response: cGMP to mature BNP ratio. J Cardiol 2022; 79:727-733. [PMID: 35016810 DOI: 10.1016/j.jjcc.2021.12.015] [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: 09/20/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Biomarkers that can predict cardiac resynchronization therapy (CRT) response have not yet been identified. The purpose of this study was to assess whether individual measurements of four brain/B-type natriuretic peptide (BNP) forms, coupled with cyclic guanosine monophosphate (cGMP) might contribute to the prediction of echocardiographic CRT responders. METHODS A BNP precursor (proBNP) and total BNP (= proBNP + mature BNP) were measured with newly developed kits, while an N-terminal fragment of proBNP (NT-proBNP) and cGMP were measured with commercial kits on the day before CRT implantation. Estimated mature BNP (emBNP = total BNP-proBNP), and the ratio of cGMP to each BNP form, as well as the concentrations of three other BNP forms, were prospectively investigated for their capability in predicting a response to CRT. A CRT responder was defined as an improvement in left ventricular ejection fraction >10% and/or a reduction in left ventricular end-systolic volume >15% at 6-month follow-up. RESULTS Out of 77 patients, 46 (60%) were categorized as CRT responders. Among the measurement parameters, only the highest quartile of the cGMP to emBNP ratio was an independent predictor of CRT responders (odds ratio 4.87, 95% confidence interval 1.25-18.89, p = 0.02). The cGMP to emBNP ratio was associated with the cumulative events of heart failure hospitalization within one year following CRT implantation (log-rank p = 0.029). CONCLUSIONS The cGMP to emBNP ratio could be utilized as a predictive biomarker of CRT responders. (Clinical Study on Responder Prediction in Cardiac Resynchronization Therapy Using Individual Molecular Measurement of Natriuretic Peptide: UMIN R000038927).
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Affiliation(s)
- Yasuhiro Yokoyama
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Naoya Kataoka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan; Second Department of Internal Medicine, University of Toyama, Toyama, Japan.
| | - Michikazu Nakai
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Ayaka Matsuo
- Omics Research Center, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Akihiro Fujiwara
- Department of Clinical Chemistry, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Akinori Wakamiya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yuko Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Takashi Noda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hiroyuki Takahama
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Koichiro Kinugawa
- Second Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Naoto Minamino
- Omics Research Center, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
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28
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Shimamoto K, Yamagata K, Wakamiya A, Ueda N, Kamakura T, Wada M, Inoue-Yamada Y, Miyamoto K, Nagase S, Kusano KF. Zero-fluoroscopy ablation in patients with cardiac electronic implantable devices. J Cardiovasc Electrophysiol 2021; 33:423-429. [PMID: 34921701 DOI: 10.1111/jce.15332] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/02/2021] [Accepted: 12/11/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Utilizing a three-dimensional (3-D) mapping system and intracardiac echocardiography (ICE) has allowed ablation procedures with less or without fluoroscopy; however, there is limited data for patients with cardiac electronic implantable device (CIED) leads regarding the suspected risk of lead injury. Therefore, we sought to explore technics to perform safe trans-septal approach and catheter manipulation technique in patients with CIED leads. METHODS AND RESULTS This study comprised 49 consecutive patients (59% males, median 73 years old) with CIED who underwent catheter ablation for supraventricular tachycardia requiring the trans-septal approach, 15 without fluoroscopy (zero-fluoro group), and 34 with fluoroscopy (conventional-fluoro group), between July 2019 and April 2021. All procedures were performed under a 3-D mapping system and ICE guidance. We compared the differences in treatment and development of complications between the two groups. The procedures were for atrial fibrillation (82%) and atrial tachycardia (76%). Coronary sinus catheter insertion and the trans-septal procedure were successfully performed in all patients. The median time from venipuncture to trans-septal procedure (zero-fluoro vs. conventional-fluoro group: 28 [18-37] min vs. 24 [21-31] min, p = .70), total procedure time (231 [142-274] min vs. 175 [163-225] min, p = .63), and the acute procedural success rate (100% vs. 97%, p = 1.00) did not differ between both groups. No patient showed lead-related complications in both groups. CONCLUSION This is the first study to show zero-fluoro ablation for supraventricular arrhythmia using 3-D mapping and ICE in patients with CIED leads was feasible under careful catheter manipulation.
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Affiliation(s)
- Keiko Shimamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Akinori Wakamiya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yuko Inoue-Yamada
- 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
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kengo F Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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29
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Yamagata K, Ishibashi K, Wakamiya A, Shimamoto K, Ueda N, Kamakura T, Wada M, Inoue Y, Miyamoto K, Noda T, Nagase S, Aiba T, Kusano K. Comparison Between Septal Pacing With the Catheter Delivery System and Apical Pacing With the Stylet Delivery System for Ventricular Lead Placement: A Randomized Controlled Trial. Circ Arrhythm Electrophysiol 2021; 14:e010362. [PMID: 34689568 DOI: 10.1161/circep.121.010362] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Akinori Wakamiya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Keiko Shimamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yuko Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
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30
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Aiba T, Ishibashi K, Hattori K, Wada M, Ueda N, Miyazaki Y, Wakamiya A, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Kusano K. Frequent Premature Ventricular Contraction and Non-Sustained Ventricular Tachycardia After the SARS-CoV-2 Vaccination in Patient With Implantable Cardioverter Defibrillator Due to Acquired Long-QT Syndrome. Circ J 2021; 85:2117. [PMID: 34275963 DOI: 10.1253/circj.cj-21-0515] [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: 11/09/2022]
Affiliation(s)
- Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kazuko Hattori
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yuichiro Miyazaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Akinori Wakamiya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yuko Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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Suzuki K, Miyamoto K, Wakamiya A, Ueda N, Nakajima K, Kamakura T, Wada M, Yamagata K, Ishibashi K, Inoue Y, Noda T, Nagase S, Aiba T, Yambe T, Kusano K. Impact of nocturnal hypoxemia on the recurrence of atrial tachyarrhythmia after catheter ablation of atrial fibrillation. Heart Vessels 2021; 37:794-801. [PMID: 34677657 DOI: 10.1007/s00380-021-01969-x] [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: 06/22/2021] [Accepted: 10/15/2021] [Indexed: 11/25/2022]
Abstract
Factors causing atrial tachyarrhythmia recurrence after catheter ablation (CA) of atrial fibrillation (AF) remain undetermined. This study aimed to investigate the effect of nocturnal hypoxemia on the recurrence of atrial tachyarrhythmia after CA of AF. Among 594 patients with AF who underwent an ambulatory sleep study at the National Cerebral and Cardiovascular Center, Suita, Osaka, Japan (2014-2019), 365 underwent CA of AF; 290 patients who underwent CA were followed up for > 3 months. Multivariate Cox regression analysis was used to calculate hazard ratios (HRs) using clinical variables, to identify the independent predictors of atrial tachyarrhythmia recurrence after the final CA. Atrial tachyarrhythmia recurred in 45 of 290 (15.5%) patients during the median follow-up period of 479 days (interquartile range 225-1002). On the performing multivariate analysis of the data of patients who did not receive continuous positive airway pressure (CPAP), severe nocturnal hypoxemia [defined as the percentage of sleep time spent with SaO2 of < 90% (T90) over 20%] [HR 8.53, 95% confidence interval (CI) 1.872-38.814; P < 0.01] and an 1 mL/m2 increase in the left atrial volume index (HR 1.02, 95% CI 1.004-1.044; P = 0.02) were found to be independently associated with the recurrence of atrial tachyarrhythmia. In addition, the rates of freedom from atrial tachyarrhythmia after the final AF ablation with CPAP were significantly lower in the group with more severe nocturnal hypoxemia (Log-rank P = 0.03). In conclusion, it is necessary to consider both, AHI and nocturnal hypoxia while performing an ambulatory sleep apnea study. CA may be less effective in patients with more severe nocturnal hypoxia, despite the administration of CPAP.
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Affiliation(s)
- Keisuke Suzuki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
- Department of Medical Engineering and Cardiology, Institute of Development Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Akinori Wakamiya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yuko Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Tomoyuki Yambe
- Department of Medical Engineering and Cardiology, Institute of Development Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
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32
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Ueda N, Nagase S, Kataoka N, Nakajima K, Kamakura T, Wada M, Yamagata K, Ishibashi K, Inoue Y, Miyamoto K, Noda T, Aiba T, Izumi C, Noguchi T, Ohno S, Kusano K. Prevalence and characteristics of the Brugada electrocardiogram pattern in patients with arrhythmogenic right ventricular cardiomyopathy. J Arrhythm 2021; 37:1173-1183. [PMID: 34621416 PMCID: PMC8485808 DOI: 10.1002/joa3.12628] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/29/2021] [Accepted: 08/20/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Despite distinct pathophysiology, arrhythmogenic right ventricular cardiomyopathy (ARVC) and Brugada syndrome (BrS) exhibit overlapping phenotypes. We investigated the prevalence and characteristics of the Brugada electrocardiogram (ECG) pattern in ARVC patients. METHODS A total of 114 ARVC patients fulfilling the revised Task Force Criteria were enrolled. The Brugada ECG pattern was evaluated according to the consensus report on right precordial leads, and 1141 ECGs (median, 1; interquartile range, 1-16 ECGs/patient) were analyzed. RESULTS Five patients (4%) showed a Brugada ECG pattern, which disappeared in four patients with ECGs recorded more than 2 years afterward. ARVC patients with the Brugada ECG pattern had a longer PQ interval (220 ± 62 ms vs 180 ± 35 ms, P = .02) and longer QRS duration (138 ± 25 ms vs 102 ± 23 ms, P < .001) than patients without the pattern. During follow-up (median, 11.4; interquartile range, 5.5-17.1 years), 19 ARVC patients experienced cardiac death and 29 experienced heart failure (HF) hospitalization. Kaplan-Meier analysis determined that the Brugada ECG pattern increased the risk of cardiac death and HF hospitalization (log-rank; P < .001, P < .001 respectively). The mean J-point and S-wave amplitudes of the Brugada ECG pattern were 0.29 ± 0.05 mV and 0.34 ± 0.21 mV, respectively, which were significantly lower than those of 26 age-matched BrS patients with a previous ventricular fibrillation episode (0.66 ± 0.33 mV, P < .001 and 0.67 ± 0.39 mV, P = .02 respectively). CONCLUSION The Brugada ECG pattern was infrequently encountered, was transient in ARVC patients, and was associated with a longer PQ interval, longer QRS duration, and cardiac events.
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Affiliation(s)
- Nobuhiko Ueda
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Satoshi Nagase
- Department of Advanced Arrhythmia and Translational Medical Science National Cerebral and Cardiovascular Center Suita Japan
| | - Naoya Kataoka
- Second Department of Internal Medicine University of Toyama Toyama Japan
| | - Kenzaburo Nakajima
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Tsukasa Kamakura
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Mitsuru Wada
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Kenichiro Yamagata
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Kohei Ishibashi
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Yuko Inoue
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Koji Miyamoto
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Takashi Noda
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Takeshi Aiba
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Chisato Izumi
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Teruo Noguchi
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Seiko Ohno
- Department of Bioscience and Genetics National Cerebral and Cardiovascular Center Suita Japan
| | - Kengo Kusano
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
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33
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Subharat S, Wada M, Sutar A, Abila R, Khounsy S, Heuer C. Livestock movement patterns in the main livestock production provinces of Lao PDR. Transbound Emerg Dis 2021; 69:e322-e335. [PMID: 34435463 DOI: 10.1111/tbed.14303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/23/2021] [Indexed: 11/27/2022]
Abstract
Foot-and-mouth disease (FMD) is a highly infectious transboundary disease that is endemic and affects the livelihood of smallholder farmers in Lao People's Democratic Republic (PDR). Knowledge about livestock movement patterns is important for preventing the spread of FMD between villages. This study describes the livestock movement patterns in Champasak, Savannakhet and Xiangkhouang provinces of Lao PDR. Face-to-face interviews were conducted with randomly selected villagers (n = 195) and traders (n = 169) in 115 villages between February and March 2019. Livestock owners commonly purchased (mainly breeding) animals from other smallholders (81%) and sold (mainly slaughter) animals to traders (76%) or other smallholders (16%), typically within the same district and province. The median inter-village trade distance was 20-30 km, with an average frequency of 4 trades per village per month. Traders purchased animals from smallholders (71%) and middlemen (25%) located within their district. It was common for many traders (74%) to retain animals at their property before selling, typically a median of 4 beef cattle per trader. Local trades within the district were far more common (72%) than distant trades. The movements of grazing/fattening large ruminants between villages were reported in 30% of the villages in all three provinces and occurred mostly within the same district or province in short distance (6 km). Social Network Analysis has identified animal movement hubs in the three provinces which could be targeted for FMD control and surveillance. Movements of animals for further use (fattening/ reproduction), long-distance movements and frequent local movements described in this area have important implications for FMD circulation. The findings from the study will inform FMD spread simulation models for Lao PDR. The knowledge gained from these data will also help the Lao PDR authorities understand the patterns of animal movements associated with disease spread.
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Affiliation(s)
- S Subharat
- EpiCentre, School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - M Wada
- EpiCentre, School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - A Sutar
- OIE Sub-Regional Representation for Southeast Asia, Bangkok, Thailand
| | - R Abila
- OIE Sub-Regional Representation for Southeast Asia, Bangkok, Thailand
| | - S Khounsy
- Department of Livestock and Fisheries, Vientiane, Lao PDR
| | - C Heuer
- EpiCentre, School of Veterinary Science, Massey University, Palmerston North, New Zealand
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Yokoyama Y, Aiba T, Miyamoto K, Kanzaki H, Ueda N, Nakajima K, Kamakura T, Wada M, Yamagata K, Ishibashi K, Inoue Y, Nagase S, Noda T, Izumi C, Kusano K. Pulmonary Vein Isolation and Pacemaker Implantation in a Patient with Dextrocardia Situs Inversus. Int Heart J 2021; 62:927-931. [PMID: 34276015 DOI: 10.1536/ihj.20-804] [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
A 70-year-old female with dextrocardia with situs inversus (DSI) totalis and inferior vena cava occlusion underwent radiofrequency catheter ablation because she had symptomatic paroxysmal atrial fibrillation (AF). Careful preoperative examination made successful pulmonary vein isolation through the left jugular vein approach. One-year later, however, AF recurred, and symptomatic sinus bradycardia or junctional bradycardia often occurred. Then, the pacemaker was implanted. We here reported a rare case of congenital abnormality, DSI with inferior vena cava occlusion who had undergone successful pulmonary vein isolation and pacemaker implantation without any complications.
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Affiliation(s)
- Yasuhiro Yokoyama
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hideaki Kanzaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yuko Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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35
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Yokoyama Y, Miyamoto K, Nakai M, Sumita Y, Ueda N, Nakajima K, Kamakura T, Wada M, Yamagata K, Ishibashi K, Inoue Y, Nagase S, Noda T, Aiba T, Miyamoto Y, Yasuda S, Kusano K. Complications Associated With Catheter Ablation in Patients With Atrial Fibrillation: A Report From the JROAD-DPC Study. J Am Heart Assoc 2021; 10:e019701. [PMID: 34041920 PMCID: PMC8483553 DOI: 10.1161/jaha.120.019701] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Aging is one of the major concerns and determinants of the indications for catheter ablation (CA) for atrial fibrillation. This study aimed to assess the safety of CA in older patients with atrial fibrillation undergoing CA. Methods and Results The JROAD-DPC (Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure Combination) is a nationwide claims database using data from the Japanese Diagnosis Procedure Combination/Per Diem Payment System. Among 6 632 484 records found between April 2012 and March 2018 from 1058 hospitals, 135 299 patients with atrial fibrillation (aged 65±10 years, 38 952 women) who underwent CA in 456 hospitals were studied and divided into the following age groups: <60, 60 to 64, 65 to 69, 70 to 74, 75 to 79, 80 to 84, and ≥85 years. The overall in-hospital complication rate was 3.4% (cardiac tamponade 1.2%), and in-hospital mortality was 0.04%. Older patients had a higher prevalence of women, lower body mass index, and a higher burden of comorbidities such as hypertension, and all of those characteristics were predictors for complications in multivariate analysis. A multivariate adjusted odds ratio revealed that increased age was independently and significantly associated with overall complications (60-64 years, 1.19; 65-69 years, 1.29; 70-74 years, 1.57; 75-79 years, 1.63; 80-84 years, 1.90; and ≥85 years, 2.86; the reference was <60 years). Conclusions The nationwide JROAD-DPC database demonstrated that the frequency of complications following CA in patients with atrial fibrillation increased according to age.
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Affiliation(s)
- Yasuhiro Yokoyama
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Koji Miyamoto
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Michikazu Nakai
- Center for Cerebral and Cardiovascular Disease Information National Cerebral and Cardiovascular Center Suita Japan
| | - Yoko Sumita
- Center for Cerebral and Cardiovascular Disease Information National Cerebral and Cardiovascular Center Suita Japan
| | - Nobuhiko Ueda
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Mitsuru Wada
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Yuko Inoue
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Satoshi Nagase
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Takashi Noda
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Takeshi Aiba
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
| | - Yoshihiro Miyamoto
- Center for Cerebral and Cardiovascular Disease Information National Cerebral and Cardiovascular Center Suita Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan.,Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
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Shimamoto K, Yamagata K, Nakajima K, Kamakura T, Wada M, Inoue Y, Miyamoto K, Noda T, Nagase S, Kusano KF. An anatomical approach to determine the location of the sinoatrial node during catheter ablation. J Cardiovasc Electrophysiol 2021; 32:1320-1327. [PMID: 33600020 DOI: 10.1111/jce.14961] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 02/09/2021] [Accepted: 02/16/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The sinoatrial node (SAN) should be identified before superior vena cava (SVC) isolation to avoid SAN injury. However, its location cannot be identified without restoring sinus rhythm. This study evaluated the usefulness of the anatomically defined SAN by comparing it with the electrically confirmed SAN (e-SAN) to predict the top-most position of e-SAN and thus establish a safe and more efficient anatomical reference for SVC isolation than the previously reported reference of the right superior pulmonary vein (RSPV) roof. METHODS AND RESULTS The e-SAN was identified as the earliest activation site in the electroanatomical map obtained during sinus rhythm. The anatomically defined SAN, the cranial edge of the crista terminalis (CT) visualized with intracardiac echocardiography (CT top), and the RSPV roof, which was obtained from the overlaid electroanatomical image of SVC and RSPV, were tagged on one map. The distance from the e-SAN to each reference was measured. Among 77 patients, the height of the e-SAN from the CT top was a median (interquartile range) of -2.0 (-8.0 to 4.0) mm. The e-SAN existed from 10 mm above the CT top or lower in 74 (96%) patients and from the RSPV roof or below in 73 (95%) patients. The reference of 10 mm above the CT top is more proximal to the right atrium than the RSPV roof and can provide longer isolatable SVC sleeves (30.0 [20.0-35.0] vs. 24.0 [18.0-30.0] mm, p < .001). The e-SAN tended to be found above the CT top when the heart rate during mapping was faster (adjusted odds ratio [95% confidence interval] per 10-bpm increase: 1.71 [1.20-2.43], p < .01). CONCLUSION The CT top is useful for predicting the upper limit of the e-SAN and can provide a better reference for SVC isolation than the RSPV roof.
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Affiliation(s)
- Keiko Shimamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.,Department of Molecular Imaging in Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yuko Inoue
- 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
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kengo F Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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Liu D, Dai S, Wada M, Yang K, Chen J, Liu D, Cherenda N, Wang D. Modelling of hydrogen atoms reflection from an annealed tungsten fuzzy surfaces. Nuclear Materials and Energy 2021. [DOI: 10.1016/j.nme.2021.100909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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38
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Abba A, Accorsi C, Agnes P, Alessi E, Amaudruz P, Annovi A, Desages FA, Back S, Badia C, Bagger J, Basile V, Batignani G, Bayo A, Bell B, Beschi M, Biagini D, Bianchi G, Bicelli S, Bishop D, Boccali T, Bombarda A, Bonfanti S, Bonivento WM, Bouchard M, Breviario M, Brice S, Brown R, Calvo-Mozota JM, Camozzi L, Camozzi M, Capra A, Caravati M, Carlini M, Ceccanti A, Celano B, Cela Ruiz JM, Charette C, Cogliati G, Constable M, Crippa C, Croci G, Cudmore S, Dahl CE, Dal Molin A, Daley M, Di Guardo C, D'Avenio G, Davignon O, Del Tutto M, De Ruiter J, Devoto A, Diaz Gomez Maqueo P, Di Francesco F, Dossi M, Druszkiewicz E, Duma C, Elliott E, Farina D, Fernandes C, Ferroni F, Finocchiaro G, Fiorillo G, Ford R, Foti G, Fournier RD, Franco D, Fricbergs C, Gabriele F, Galbiati C, Garcia Abia P, Gargantini A, Giacomelli L, Giacomini F, Giacomini F, Giarratana LS, Gillespie S, Giorgi D, Girma T, Gobui R, Goeldi D, Golf F, Gorel P, Gorini G, Gramellini E, Grosso G, Guescini F, Guetre E, Hackman G, Hadden T, Hawkins W, Hayashi K, Heavey A, Hersak G, Hessey N, Hockin G, Hudson K, Ianni A, Ienzi C, Ippolito V, James CC, Jillings C, Kendziora C, Khan S, Kim E, King M, King S, Kittmer A, Kochanek I, Kowalkowski J, Krücken R, Kushoro M, Kuula S, Laclaustra M, Leblond G, Lee L, Lennarz A, Leyton M, Li X, Liimatainen P, Lim C, Lindner T, Lomonaco T, Lu P, Lubna R, Lukhanin GA, Luzón G, MacDonald M, Magni G, Maharaj R, Manni S, Mapelli C, Margetak P, Martin L, Martin S, Martínez M, Massacret N, McClurg P, McDonald AB, Meazzi E, Migalla R, Mohayai T, Tosatti LM, Monzani G, Moretti C, Morrison B, Mountaniol M, Muraro A, Napoli P, Nati F, Natzke CR, Noble AJ, Norrick A, Olchanski K, Ortiz de Solorzano A, Padula F, Pallavicini M, Palumbo I, Panontin E, Papini N, Parmeggiano L, Parmeggiano S, Patel K, Patel A, Paterno M, Pellegrino C, Pelliccione P, Pesudo V, Pocar A, Pope A, Pordes S, Prelz F, Putignano O, Raaf JL, Ratti C, Razeti M, Razeto A, Reed D, Refsgaard J, Reilly T, Renshaw A, Retriere F, Riccobene E, Rigamonti D, Rizzi A, Rode J, Romualdez J, Russel L, Sablone D, Sala S, Salomoni D, Salvo P, Sandoval A, Sansoucy E, Santorelli R, Savarese C, Scapparone E, Schaubel T, Scorza S, Settimo M, Shaw B, Shawyer S, Sher A, Shi A, Skensved P, Slutsky A, Smith B, Smith NJT, Stenzler A, Straubel C, Stringari P, Suchenek M, Sur B, Tacchino S, Takeuchi L, Tardocchi M, Tartaglia R, Thomas E, Trask D, Tseng J, Tseng L, VanPagee L, Vedia V, Velghe B, Viel S, Visioli A, Viviani L, Vonica D, Wada M, Walter D, Wang H, Wang MHLS, Westerdale S, Wood D, Yates D, Yue S, Zambrano V. The novel Mechanical Ventilator Milano for the COVID-19 pandemic. Phys Fluids (1994) 2021; 33:037122. [PMID: 33897243 PMCID: PMC8060010 DOI: 10.1063/5.0044445] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 02/14/2021] [Indexed: 06/12/2023]
Abstract
This paper presents the Mechanical Ventilator Milano (MVM), a novel intensive therapy mechanical ventilator designed for rapid, large-scale, low-cost production for the COVID-19 pandemic. Free of moving mechanical parts and requiring only a source of compressed oxygen and medical air to operate, the MVM is designed to support the long-term invasive ventilation often required for COVID-19 patients and operates in pressure-regulated ventilation modes, which minimize the risk of furthering lung trauma. The MVM was extensively tested against ISO standards in the laboratory using a breathing simulator, with good agreement between input and measured breathing parameters and performing correctly in response to fault conditions and stability tests. The MVM has obtained Emergency Use Authorization by U.S. Food and Drug Administration (FDA) for use in healthcare settings during the COVID-19 pandemic and Health Canada Medical Device Authorization for Importation or Sale, under Interim Order for Use in Relation to COVID-19. Following these certifications, mass production is ongoing and distribution is under way in several countries. The MVM was designed, tested, prepared for certification, and mass produced in the space of a few months by a unique collaboration of respiratory healthcare professionals and experimental physicists, working with industrial partners, and is an excellent ventilator candidate for this pandemic anywhere in the world.
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Affiliation(s)
- A. Abba
- Nuclear Instruments S.R.L., Como 22045, Italy
| | - C. Accorsi
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - P. Agnes
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - E. Alessi
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | - P. Amaudruz
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A. Annovi
- INFN Sezione di Pisa, Pisa 56127, Italy
| | - F. Ardellier Desages
- APC, Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - S. Back
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | - C. Badia
- Gran Sasso Science Institute, L'Aquila 67100, Italy
| | - J. Bagger
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - V. Basile
- Istituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato, CNR STIIMA, Milano 20133, Italy
| | | | - A. Bayo
- LSC, Laboratorio Subterráneo de Canfranc, Canfranc-Estación 22880, Spain
| | - B. Bell
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | | | - D. Biagini
- Dipartimento di Chimica e Chimica Industriale, Università di Pisa, Pisa 56124, Italy
| | - G. Bianchi
- Istituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato, CNR STIIMA, Milano 20133, Italy
| | - S. Bicelli
- Camozzi Group S.p.A., Brescia BS 25126, Italy
| | - D. Bishop
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | | | - A. Bombarda
- Dipartimento di Ingegneria Gestionale, dell'Informazione e della Produzione, Università di Bergamo, Bergamo, 24129, Italy
| | - S. Bonfanti
- Dipartimento di Ingegneria Gestionale, dell'Informazione e della Produzione, Università di Bergamo, Bergamo, 24129, Italy
| | | | - M. Bouchard
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - M. Breviario
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - S. Brice
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R. Brown
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - J. M. Calvo-Mozota
- LSC, Laboratorio Subterráneo de Canfranc, Canfranc-Estación 22880, Spain
| | - L. Camozzi
- Camozzi Group S.p.A., Brescia BS 25126, Italy
| | - M. Camozzi
- Camozzi Group S.p.A., Brescia BS 25126, Italy
| | - A. Capra
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - M. Caravati
- INFN Sezione di Cagliari, Cagliari 09042, Italy
| | - M. Carlini
- Gran Sasso Science Institute, L'Aquila 67100, Italy
| | | | - B. Celano
- INFN Sezione di Napoli, Napoli 80126, Italy
| | - J. M. Cela Ruiz
- CIEMAT, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - C. Charette
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - G. Cogliati
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - M. Constable
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - C. Crippa
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - G. Croci
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - S. Cudmore
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - A. Dal Molin
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - M. Daley
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - C. Di Guardo
- Dipartimento di Scienze Economiche ed Aziendali, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - G. D'Avenio
- National Center for Innovative Technologies in Public Health, ISS (Italy National Institute of Health), Roma 00161, Italy
| | - O. Davignon
- Laboratoire Leprince Ringuet, École Polytechnique, Palaiseau, Cedex 91128, France
| | - M. Del Tutto
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J. De Ruiter
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - A. Devoto
- Dipartimento di Fisica, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | | | - F. Di Francesco
- Dipartimento di Chimica e Chimica Industriale, Università di Pisa, Pisa 56124, Italy
| | - M. Dossi
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - E. Druszkiewicz
- Department of Physics and Astronomy, University of Rochester, Rochester, New York 14627, USA
| | - C. Duma
- INFN-CNAF, Bologna 40127, Italy
| | - E. Elliott
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - D. Farina
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | | | | | | | | | - R. Ford
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | | | | | - D. Franco
- APC, Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | | | - F. Gabriele
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | | | - P. Garcia Abia
- CIEMAT, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - A. Gargantini
- Dipartimento di Ingegneria Gestionale, dell'Informazione e della Produzione, Università di Bergamo, Bergamo, 24129, Italy
| | - L. Giacomelli
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | | | | | | | - S. Gillespie
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - D. Giorgi
- Camozzi Group S.p.A., Brescia BS 25126, Italy
| | - T. Girma
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - R. Gobui
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | | | - F. Golf
- Department of Physics and Astronomy, University of Nebraska-Lincoln, Lincoln, Nebraska 68508, USA
| | - P. Gorel
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | - G. Gorini
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - E. Gramellini
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G. Grosso
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | - F. Guescini
- Max-Planck-Institut für Physik (Werner-Heisenberg-Institut), 80805 München, Germany
| | - E. Guetre
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - G. Hackman
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - T. Hadden
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - K. Hayashi
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A. Heavey
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G. Hersak
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - N. Hessey
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - G. Hockin
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - K. Hudson
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - A. Ianni
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - C. Ienzi
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - C. C. James
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - C. Kendziora
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S. Khan
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - E. Kim
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - M. King
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - S. King
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - A. Kittmer
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - I. Kochanek
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - J. Kowalkowski
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - M. Kushoro
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - S. Kuula
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | | | - G. Leblond
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - L. Lee
- Department of APT, Faculty of Medicine, University of British Columbia, Vancouver V5Z 1M9, Canada
| | - A. Lennarz
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - M. Leyton
- INFN Sezione di Napoli, Napoli 80126, Italy
| | - X. Li
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | | | - C. Lim
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - T. Lindner
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - T. Lomonaco
- Dipartimento di Chimica e Chimica Industriale, Università di Pisa, Pisa 56124, Italy
| | - P. Lu
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - R. Lubna
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - G. A. Lukhanin
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G. Luzón
- CAPA (Centro de Astropartículas y Física de Altas Energías), Universidad de Zaragoza, Zaragoza 50009, Spain
| | - M. MacDonald
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - G. Magni
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - R. Maharaj
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - S. Manni
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - C. Mapelli
- Dipartimento di Meccanica, Politecnico di Milano, Milano 20156, Italy
| | - P. Margetak
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - L. Martin
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - S. Martin
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | | | - N. Massacret
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - P. McClurg
- Department of Respiratory and Anaesthesia Technology, Vanier College, Montréal, Quebec H4L 3X9, Canada
| | | | - E. Meazzi
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | | | - T. Mohayai
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - L. M. Tosatti
- Istituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato, CNR STIIMA, Milano 20133, Italy
| | - G. Monzani
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - C. Moretti
- Dipartimento di Pediatria, Sapienza Università di Roma, Roma 00185, Italy
| | | | | | - A. Muraro
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | - P. Napoli
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - F. Nati
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - C. R. Natzke
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | | | - A. Norrick
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - K. Olchanski
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A. Ortiz de Solorzano
- CAPA (Centro de Astropartículas y Física de Altas Energías), Universidad de Zaragoza, Zaragoza 50009, Spain
| | - F. Padula
- School of Civil and Mechanical Engineering, Curtin University, Perth (Washington), Australia
| | | | - I. Palumbo
- Azienda Ospedaliera San Gerardo, Monza 20900, Italy
| | - E. Panontin
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - N. Papini
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | | | | | - K. Patel
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - A. Patel
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - M. Paterno
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | | | | | - A. Pocar
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - A. Pope
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - S. Pordes
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - F. Prelz
- INFN Sezione di Milano, Milano 20133, Italy
| | - O. Putignano
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - J. L. Raaf
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - C. Ratti
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - M. Razeti
- INFN Sezione di Cagliari, Cagliari 09042, Italy
| | - A. Razeto
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - D. Reed
- Equilibar L.L.C., Fletcher, North Carolina 28732, USA
| | - J. Refsgaard
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - T. Reilly
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - A. Renshaw
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - F. Retriere
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - E. Riccobene
- Dipartimento di Informatica, Universitá degli Studi di Milano, Milano 20122, Italy
| | - D. Rigamonti
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | | | | | - J. Romualdez
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - L. Russel
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - D. Sablone
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - S. Sala
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | | | - P. Salvo
- Istituto di Fisiologia Clinica del CNR, IFC-CNR, Pisa 56124, Italy
| | | | - E. Sansoucy
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - R. Santorelli
- CIEMAT, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - C. Savarese
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | | | - T. Schaubel
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - S. Scorza
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | - M. Settimo
- SUBATECH, IMT Atlantique, Université de Nantes, CNRS-IN2P3, Nantes 44300, France
| | - B. Shaw
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - S. Shawyer
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - A. Sher
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A. Shi
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - A. Slutsky
- St. Michael's Hospital, Unity Health Toronto, Ontario M5B 1W8, Canada
| | - B. Smith
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | | | - A. Stenzler
- 12th Man Technologies, Garden Grove, California 92841, USA
| | - C. Straubel
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - P. Stringari
- MINES ParisTech, PSL University, CTP-Centre of Thermodynamics of Processes, 77300 Fontainebleau, France
| | - M. Suchenek
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Warsaw 00-614, Poland
| | - B. Sur
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - L. Takeuchi
- Department of Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - M. Tardocchi
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | - R. Tartaglia
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - E. Thomas
- Arthur B. McDonald Canadian Astroparticle Research Institute, Kingston, Ontario K7L 3N6, Canada
| | - D. Trask
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - J. Tseng
- Department of Physics, University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom
| | - L. Tseng
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - L. VanPagee
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - V. Vedia
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - B. Velghe
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | | | - A. Visioli
- Dipartimento di Ingegneria Meccanica e Industriale, Università degli Studi di Brescia, Brescia 25123, Italy
| | - L. Viviani
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - D. Vonica
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - M. Wada
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Warsaw 00-614, Poland
| | - D. Walter
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - H. Wang
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - M. H. L. S. Wang
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - D. Wood
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - D. Yates
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - S. Yue
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - V. Zambrano
- CAPA (Centro de Astropartículas y Física de Altas Energías), Universidad de Zaragoza, Zaragoza 50009, Spain
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Suzuki K, Miyamoto K, Ueda N, Nakajima K, Kamakura T, Wada M, Yamagata K, Ishibashi K, Inoue Y, Noda T, Nagase S, Aiba T, Yambe T, Kakuta T, Tadokoro N, Fukushima S, Fujita T, Kusano K. Relationship between electrical gaps after Maze procedure and atrial tachyarrhythmias and ablation outcomes after cardiac surgery and concomitant Maze procedure. Heart Vessels 2021; 36:675-685. [PMID: 33580804 DOI: 10.1007/s00380-020-01737-3] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/20/2020] [Indexed: 10/22/2022]
Abstract
Atrial tachycardia (AT) and atrial fibrillation (AF) commonly occur after cardiac surgeries (CSs). This study investigated the mechanisms and long-term outcomes of AT and AF ablation after various Maze procedures, particularly whether atrial tachyarrhythmias after the Maze procedure occur due to gaps in the Maze lines. We analyzed 37 consecutive cases with atrial tachyarrhythmias after the Maze procedures and concomitant CSs between 2007 and 2019. Fifty-nine atrial tachyarrhythmias were induced in 37 consecutive cases, and 49 of those atrial tachyarrhythmias were mappable ATs. Forty ATs were related to the Maze procedures in the 49 mappable ATs (81.6%). All 37 consecutive cases had residual electrical conductions (gaps) in the Maze lines (88 gaps; 2.4 ± 1.2 gaps/patient). Forty of 88 gaps (45.5%) were associated with gap-related ATs. The common ATs in this study were 1. peri-mitral atrial flutter due to gaps at pulmonary vein isolation (PVI) line to mitral valve annulus (MVA) (20 cases), and 2. peri-tricuspid atrial flutter due to gaps at right atrial incision to the tricuspid valve annulus (TVA) (10 cases). Forty-seven of 49 ATs (95.9%) were successfully ablated at the first session, and there were no complications. The mean follow-up period after ablation was 3.6 ± 3.2 (median, 2.1; interquartile range, 0.89-6.84) years. The Kaplan-Meier analysis of freedom from recurrent atrial tachyarrhythmias after Maze procedure was 82.7% at 1-year follow-up and 75.5% at 4-year follow-up after a single procedure. Reentry was the main mechanism of ATs after Maze procedures and concomitant CSs, and ATs were largely related to the gaps on the Maze lines between the PVI line and the MVA or those on the lines between right atrial incision to the TVA. Long-term follow-up data suggest that catheter ablation of atrial tachyarrhythmias after various Maze procedures is effective and safe.
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Affiliation(s)
- Keisuke Suzuki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.,Institute of Development Aging and Cancer, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yuko Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Tomoyuki Yambe
- Institute of Development Aging and Cancer, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Takashi Kakuta
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Naoki Tadokoro
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Satsuki Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Tomoyuki Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
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Miyazaki Y, Wada M, Yoshitake K, Mochizuki H, Ishibashi K, Noda T, Fukushima N, Kusano K. Leadless pacemaker implantation in a patient with a fully magnetically levitated left ventricular assist device. Pacing Clin Electrophysiol 2021; 44:1126-1129. [PMID: 33521993 DOI: 10.1111/pace.14182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/01/2021] [Accepted: 01/18/2021] [Indexed: 11/27/2022]
Abstract
Left ventricular assist device (LVAD) therapy is increasingly used in patients with end-stage heart failure. However, LVADs are associated with challenges, especially in the presence of a cardiac implantable electronic device. Although a leadless pacemaker (PM), the Micra™ Transcatheter Pacing System, can be used with LVADs, data regarding HeartMate 3™ LVAD are limited. In this report, we present a patient with a HeartMate 3™ LVAD who underwent successful leadless PM implantation after the removal of an infected cardiac resynchronization therapy defibrillator.
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Affiliation(s)
- Yuichiro Miyazaki
- Division of Arrhythmia and Electrophysiology, Department of Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Mitsuru Wada
- Division of Arrhythmia and Electrophysiology, Department of Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Koichi Yoshitake
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hiroki Mochizuki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kohei Ishibashi
- Division of Arrhythmia and Electrophysiology, Department of Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Takashi Noda
- Division of Arrhythmia and Electrophysiology, Department of Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Norihide Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kengo Kusano
- Division of Arrhythmia and Electrophysiology, Department of Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
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41
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Fujino M, Miyazaki A, Furukawa O, Somura J, Yoshida Y, Hayama Y, Kamakura S, Negishi J, Wada M, Kusano K, Ohuchi H. Electrocardiographic features of arrhythmogenic right ventricular cardiomyopathy in school-aged children. Heart Vessels 2021; 36:863-873. [PMID: 33511492 DOI: 10.1007/s00380-020-01754-2] [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: 08/26/2020] [Accepted: 12/04/2020] [Indexed: 11/28/2022]
Abstract
It can be difficult to distinguish children with early-stage arrhythmogenic right ventricular cardiomyopathy (ARVC) from those with benign premature ventricular contraction (PVC). We retrospectively evaluated six school-aged children with ARVC and compared with those of 20 with benign PVC. The median age at initial presentation was 11.4 and 10.2 years in ARVC and benign PVC, respectively. None of the ARVC patients fulfilled the diagnostic criteria of ARVC at initial presentation. At ARVC diagnosis, the treadmill exercise test and Holter monitoring showed provoked PVC during exercise and pleomorphic PVC in all ARVC cases, respectively. During the observation period, terminal activation duration (TAD) was prolonged in all ARVC patients. In addition, ΔTAD (5.5 [3-10] ms) were significantly longer than those with benign PVC (p < 0.001). A new notched S-wave in V1 appeared in four (67%) ARVC patients, who had myocardial abnormalities in the right ventricle, and in zero benign PVC. Our electrocardiographic findings, such as provoked PVC during exercise, pleomorphic PVC, prolonged TAD, and a new notched S-wave in V1 could contribute to the early detection of ARVC in school-aged children.
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Affiliation(s)
- Mitsuhiro Fujino
- Department of Pediatric Cardiology, The National Cerebral Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan.,Department of Pediatric Cardiology, The Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka, 534-0021, Japan
| | - Aya Miyazaki
- Department of Pediatric Cardiology, The National Cerebral Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan. .,Department of Congenital Heart Disease, Division of Transitional Medicine, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi-ku, Shizuoka city, Shizuoka, 420-8527, Japan.
| | - Ouki Furukawa
- Department of Pediatrics, The Shiga University of Medical Science, Seta Tsukinowa-Cho, Otsu, Shiga, 520-2192, Japan
| | - Junpei Somura
- Department of Pediatrics, The Shiga University of Medical Science, Seta Tsukinowa-Cho, Otsu, Shiga, 520-2192, Japan
| | - Yoko Yoshida
- Department of Pediatric Electrophysiology, The Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka, 534-0021, Japan
| | - Yohsuke Hayama
- Department of Pediatric Cardiology, The National Cerebral Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Shiro Kamakura
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, The National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Jun Negishi
- Department of Pediatric Cardiology, The National Cerebral Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Mitsuru Wada
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, The National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Kengo Kusano
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, The National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Hideo Ohuchi
- Department of Pediatric Cardiology, The National Cerebral Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
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42
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Kamakura T, Sacher F, Katayama K, Ueda N, Nakajima K, Wada M, Yamagata K, Ishibashi K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Nakatani Y, Ramirez FD, André C, Nakashima T, Krisai P, Takagi T, Tixier R, Chauvel R, Cheniti G, Duchateau J, Pambrun T, Derval N, Hocini M, Jais P, Haïssaguerre M, Kamakura S, Kusano K. High-risk atrioventricular block in Brugada syndrome patients with a history of syncope. J Cardiovasc Electrophysiol 2021; 32:772-781. [PMID: 33428312 DOI: 10.1111/jce.14876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/01/2020] [Revised: 12/25/2020] [Accepted: 01/02/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Determining the etiology of syncope is challenging in Brugada syndrome (BrS) patients. Implantable cardioverter defibrillator placement is recommended in BrS patients who are presumed to have arrhythmic syncope. However, arrhythmic syncope in BrS patients can occur in the setting of atrioventricular block (AVB), which should be managed by cardiac pacing. The clinical characteristics of BrS patients with high-risk AVB remain unknown. METHODS This study included 223 BrS patients with a history of syncope from two centers. The clinical characteristics of patients with high-risk AVB (Mobitz type II second-degree AVB, high-degree AVB, or third-degree AVB) were investigated. RESULTS During the 99 ± 78 months of follow-up, we identified six BrS patients (2.7%) with high-risk AVB. Three of the six patients (50%) with AVB presented with syncope associated with prodromes or specific triggers. Four patients (67%) were found to have paroxysmal third-degree AVB during the initial evaluation for BrS and syncope, while two patients developed third-degree AVB during the follow-up period. The incidence of first-degree AVB was significantly higher in AVB patients than in non-AVB patients (83% vs. 15%; p = .0005). There was no significant difference in the incidence of ventricular fibrillation between AVB and non-AVB patients (AVB [17%], non-AVB [12%]; p = .56). CONCLUSION High-risk AVB can occur in BrS patients with various clinical presentations. Although rare, the incidence is worth considering, especially in BrS patients with first-degree AVB.
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Affiliation(s)
- Tsukasa Kamakura
- Department of Cardiovascular Medicine, Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan.,Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Hospital (CHU), University of Bordeaux, Pessac-Bordeaux, France
| | - Frederic Sacher
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Hospital (CHU), University of Bordeaux, Pessac-Bordeaux, France
| | | | - Nobuhiko Ueda
- Department of Cardiovascular Medicine, Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine, Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yuko Inoue
- Department of Cardiovascular Medicine, Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Takashi Noda
- Department of Cardiovascular Medicine, Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yosuke Nakatani
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Hospital (CHU), University of Bordeaux, Pessac-Bordeaux, France
| | - F Daniel Ramirez
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Hospital (CHU), University of Bordeaux, Pessac-Bordeaux, France
| | - Clémentine André
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Hospital (CHU), University of Bordeaux, Pessac-Bordeaux, France
| | - Takashi Nakashima
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Hospital (CHU), University of Bordeaux, Pessac-Bordeaux, France
| | - Philipp Krisai
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Hospital (CHU), University of Bordeaux, Pessac-Bordeaux, France
| | - Takamitsu Takagi
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Hospital (CHU), University of Bordeaux, Pessac-Bordeaux, France
| | - Romain Tixier
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Hospital (CHU), University of Bordeaux, Pessac-Bordeaux, France
| | - Remi Chauvel
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Hospital (CHU), University of Bordeaux, Pessac-Bordeaux, France
| | - Ghassen Cheniti
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Hospital (CHU), University of Bordeaux, Pessac-Bordeaux, France
| | - Josselin Duchateau
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Hospital (CHU), University of Bordeaux, Pessac-Bordeaux, France
| | - Thomas Pambrun
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Hospital (CHU), University of Bordeaux, Pessac-Bordeaux, France
| | - Nicolas Derval
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Hospital (CHU), University of Bordeaux, Pessac-Bordeaux, France
| | - Mélèze Hocini
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Hospital (CHU), University of Bordeaux, Pessac-Bordeaux, France
| | - Pierre Jais
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Hospital (CHU), University of Bordeaux, Pessac-Bordeaux, France
| | - Michel Haïssaguerre
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Hospital (CHU), University of Bordeaux, Pessac-Bordeaux, France
| | - Shiro Kamakura
- Department of Cardiovascular Medicine, Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center, Osaka, Japan
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Nishikawa T, Aiba T, Ueda N, Nakajima K, Yamada-Inoue Y, Kamakura T, Wada M, Yamagata K, Ishibashi K, Tateishi E, Kiso K, Ikeda Y, Ishibashi-Ueda H, Miyamoto K, Nagase S, Noda T, Kusano K. Unusual Overlapping Cardiac Sarcoidosis and Long-QT Type 3 Induced Ventricular Fibrillation. Intern Med 2021; 60:85-89. [PMID: 33390472 PMCID: PMC7835453 DOI: 10.2169/internalmedicine.5018-20] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 54-year-old woman had been resuscitated after ventricular fibrillation and her electrocardiogram showed a QT prolongation (QTc=510 ms), and genetic screening revealed a missense variant, R1644C, in the SCN5A gene. She was therefore diagnosed with congenital long-QT syndrome (LQTS) type 3. However, the patient had left ventricular dysfunction, and based on the findings of cardiac magnetic resonance imaging, positron emission tomography and pathological examinations, she was diagnosed with cardiac sarcoidosis. Although both are rare diseases, their overlapping presence in this case may have led to an increased cardiovascular risk compared with either alone. Thus, not only genetic but comprehensive clinical examinations are important for making a correct diagnosis.
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Affiliation(s)
- Tatsuya Nishikawa
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Takeshi Aiba
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Nobuhiko Ueda
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Kenzaburo Nakajima
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Yuko Yamada-Inoue
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Tsukasa Kamakura
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Mitsuru Wada
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Kenichiro Yamagata
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Kohei Ishibashi
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Emi Tateishi
- Department of Radiology, National Cerebral and Cardiovascular Center, Japan
| | - Keisuke Kiso
- Department of Radiology, National Cerebral and Cardiovascular Center, Japan
| | - Yoshihiko Ikeda
- Department of Pathology, National Cerebral and Cardiovascular Center, Japan
| | | | - Koji Miyamoto
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Satoshi Nagase
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Takashi Noda
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Kengo Kusano
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
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44
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Tonegawa R, Miyamoto K, Ueda N, Nakajima K, Wada M, Yamagata K, Ishibashi K, Inoue Y, Noda T, Nagase S, Ota M, Aiba T, Nakajima T, Fukuda T, Kusano K. Ventricular tachycardia in cardiac sarcoidosis -prognosis, characterization of ventricular substrates and outcomes of treatment-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2141] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The prognosis, the underlying substrate and clinical outcomes of treatment are unclear in patients with cardiac sarcoidosis (CS)-related ventricular tachycardia (VT).
Objective
This study investigated the prognosis and the relationship between electroanatomical mapping (EAM) and imaging findings in patients with CS-related VT.
Methods
A total of 203 CS patients (Age 68.1±11.6 years, 87 males) were enrolled at two tertiary care medical centers between 2000 and 2018. All met the 2016 Japanese Circulation Society guidelines for diagnosis of CS. They were followed for a composite of major adverse cardiac events (MACE) including cardiac death, heart transplantation, unscheduled hospitalization for heart failure, and life-threatening ventricular arrhythmias. Distribution of late gadolinium enhancement (LGE) on cardiac MRI (CMR) and/or an abnormal myocardial 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography at diagnosis were examined. The relationship between EAM and the image findings were also analyzed in patients with radiofrequency ablation (RFA) for VT.
Results
During a median follow-up of 53 months, 87 of the 203 patients (43%) experienced a MACE. Baseline factors associated with MACE were presence of sustained VT (HR, 2.43, 95% CI 1.54–3.85, P<0.001), left ventricular ejection fraction below 50% (HR, 1.95 95% CI 1.07–3.56, P=0.029), and abnormal myocardial FDG uptake (HR, 2.42 95% CI 1.04–5.61, P=0.039). Overall, 69 of the 203 patients (34%) experienced sustained VT. Abnormal myocardial FDG uptake was significantly more prevalent in patients with VT than in those without (92.7% vs. 78.5%, P=0.02). A total of 25 patients (9.9%) required RFA for CS-related VT (Age 64.0±8.7 years, 12 males, 1.32±0.56 RFAs per patient). Abnormal electrocardiograms (EGM) were observed in 22 of the 25 patients (88%). LGE was more frequent than abnormal FDG uptake in areas with an abnormal EGM (77% vs. 41%; P=0.002). Over a mean follow-up period of 67-months, 13 of the 25 patients with RFA (52%) remained free of VT episodes (Figure). VT recurred in nine of the 12 patients with RFA and in 17 of the 47 patients without RFA, but was suppressed by intensive pharmacologic therapy such as the combined use of amiodarone and sotalol. In patients with CS-related VT, survival without experiencing a MACE did not differ in participants with or without RFA.
Conclusions
In our 203 CS patients, sustained VT and abnormal FDG uptake were associated with worse cardiac outcomes. The prevalence of abnormal FDG uptake was significantly higher in patients with CS-related VT, LGE on CMR was more frequent within localized areas of an abnormal EGM, suggesting that both scar itself and the associated inflammation were involved in the pathogenesis of CS-related VT. Successful RFA of CS-related VT is still challenging, and recurrence is common. Preprocedural CMR can be useful in detecting abnormal EGMs that are potential targets for substrate ablation.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- R Tonegawa
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Kumamoto University, Department of Advanced Cardiovascular Medicine, Kumamoto, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - M Ota
- National Cerebral & Cardiovascular Center, Department of Radiology, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - T Nakajima
- Saitama Cardiovascular and Respiratory Center, Department of Cardiology, Kumagaya, Japan
| | - T Fukuda
- National Cerebral & Cardiovascular Center, Department of Radiology, Suita, Japan
| | - K.F Kusano
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Kumamoto University, Department of Advanced Cardiovascular Medicine, Kumamoto, Japan
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Nakashima T, Usami S, Aiba T, Oishi S, Kimura Y, Kawakami S, Yamada-Inoue Y, Ogata S, Ueda N, Nakajima K, Kamakura T, Wada M, Yamagata K, Ishibashi K, Miyamoto K, Noda T, Nagase S, Kanzaki H, Izumi C, Yasuda S, Kamakura S, Takaki H, Sugimachi M, Kusano K. Novel Non-Invasive Index for Prediction of Responders in Cardiac Resynchronization Therapy Using High-Resolution Magnetocardiography. Circ J 2020; 84:2166-2174. [PMID: 33162489 DOI: 10.1253/circj.cj-20-0325] [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: 11/09/2022]
Abstract
BACKGROUND Approximately one-third of patients with advanced heart failure (HF) do not respond to cardiac resynchronization therapy (CRT). We investigated whether the left ventricular (LV) conduction pattern on magnetocardiography (MCG) can predict CRT responders.Methods and Results:This retrospective study enrolled 56 patients with advanced HF (mean [±SD] LV ejection fraction [LVEF] 23±8%; QRS duration 145±19 ms) and MCG recorded before CRT. MCG-QRS current arrow maps were classified as multidirectional (MDC; n=28) or unidirectional (UDC; n=28) conduction based on a change of either ≥35° or <35°, respectively, in the direction of the maximal current arrow after the QRS peak. Baseline New York Heart Association functional class and LVEF were comparable between the 2 groups, but QRS duration was longer and the presence of complete left bundle branch block and LV dyssynchrony was higher in the UDC than MDC group. Six months after CRT, 30 patients were defined as responders, with significantly more in the UDC than MDC group (89% vs. 14%, respectively; P<0.001). Over a 5-year follow-up, Kaplan-Meyer analysis showed that adverse cardiac events (death or implantation of an LV assist device) were less frequently observed in the UDC than MDC group (6/28 vs. 15/28, respectively; P=0.027). Multivariate analysis revealed that UDC on MCG was the most significant predictor of CRT response (odds ratio 69.8; 95% confidence interval 13.14-669.32; P<0.001). CONCLUSIONS Preoperative non-invasive MCG may predict the CRT response and long-term outcome after CRT.
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Affiliation(s)
- Takahiro Nakashima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Shunsuke Usami
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Shogo Oishi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yoshitaka Kimura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Shoji Kawakami
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yuko Yamada-Inoue
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center
| | - Nobuhiko Ueda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kenzaburo Nakajima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Tsukasa Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Mitsuru Wada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kenichiro Yamagata
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Satoshi Nagase
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hideaki Kanzaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Shiro Kamakura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hiroshi Takaki
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center
| | - Masaru Sugimachi
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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46
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Walker PM, Hirayama Y, Lane GJ, Watanabe H, Dracoulis GD, Ahmed M, Brunet M, Hashimoto T, Ishizawa S, Kondev FG, Litvinov YA, Miyatake H, Moon JY, Mukai M, Niwase T, Park JH, Podolyák Z, Rosenbusch M, Schury P, Wada M, Watanabe XY, Liang WY, Xu FR. Properties of ^{187}Ta Revealed through Isomeric Decay. Phys Rev Lett 2020; 125:192505. [PMID: 33216598 DOI: 10.1103/physrevlett.125.192505] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
Mass-separated ^{187}Ta_{114} in a high-spin isomeric state has been produced for the first time by multinucleon transfer reactions, employing an argon gas-stopping cell and laser ionization. Internal γ rays revealed a T_{1/2}=7.3±0.9 s isomer at 1778±1 keV, which decays through a rotational band with perturbations associated with the approach to a prolate-oblate shape transition. Model calculations show less influence from triaxiality compared to heavier elements in the same mass region. The isomer-decay reduced E2 hindrance factor f_{ν}=27±1 supports the interpretation that axial symmetry is approximately conserved.
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Affiliation(s)
- P M Walker
- Department of Physics, University of Surrey, Guildford, GU2 7XH, United Kingdom
| | - Y Hirayama
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - G J Lane
- Department of Nuclear Physics, RSPhys, Australian National University, Canberra, Australian Capital Territory 2601, Australia
| | - H Watanabe
- School of Physics, and International Research Center for Nuclei and Particles in Cosmos, Beihang University, Beijing 100191, China
- Nishina Center for Accelerator-Based Science, RIKEN, Wako, Saitama 351-0198, Japan
| | - G D Dracoulis
- Department of Nuclear Physics, RSPhys, Australian National University, Canberra, Australian Capital Territory 2601, Australia
| | - M Ahmed
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
- University of Tsukuba, Tsukuba, Ibaraki 305-0006, Japan
| | - M Brunet
- Department of Physics, University of Surrey, Guildford, GU2 7XH, United Kingdom
| | - T Hashimoto
- Rare Isotope Science Project, Institute for Basic Science (IBS), Daejeon 305-811, Republic of Korea
| | - S Ishizawa
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
- Nishina Center for Accelerator-Based Science, RIKEN, Wako, Saitama 351-0198, Japan
- Graduate School of Science and Engineering, Yamagata University, Yamagata 992-8510, Japan
| | - F G Kondev
- Physics Division, Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - Yu A Litvinov
- GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany
| | - H Miyatake
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - J Y Moon
- Rare Isotope Science Project, Institute for Basic Science (IBS), Daejeon 305-811, Republic of Korea
| | - M Mukai
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
- Nishina Center for Accelerator-Based Science, RIKEN, Wako, Saitama 351-0198, Japan
- University of Tsukuba, Tsukuba, Ibaraki 305-0006, Japan
| | - T Niwase
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
- Nishina Center for Accelerator-Based Science, RIKEN, Wako, Saitama 351-0198, Japan
- Department of Physics, Kyushu University, Nishi-ku, Fukuoka 819-0395, Japan
| | - J H Park
- Rare Isotope Science Project, Institute for Basic Science (IBS), Daejeon 305-811, Republic of Korea
| | - Zs Podolyák
- Department of Physics, University of Surrey, Guildford, GU2 7XH, United Kingdom
| | - M Rosenbusch
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - P Schury
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - M Wada
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
- University of Tsukuba, Tsukuba, Ibaraki 305-0006, Japan
| | - X Y Watanabe
- Wako Nuclear Science Center (WNSC), Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Wako, Saitama 351-0198, Japan
| | - W Y Liang
- School of Physics and State Key Laboratory of Nuclear Physics and Technology, Peking University, Beijing 100871, China
| | - F R Xu
- School of Physics and State Key Laboratory of Nuclear Physics and Technology, Peking University, Beijing 100871, China
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47
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Kamada H, Ishibashi K, Nakajima K, Ueda N, Kamakura T, Wada M, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Isobe M, Terasaki F, Kusano K. Cardiac function at diagnosis is important prognostic factor in patients with cardiac sarcoidosis -from Japanese nationwide questionnaire survey-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2130] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Sarcoidosis is a systemic non-caseating granulomatous disease of unknown etiology. Cardiac involvement (cardiac sarcoidosis, CS) has been reported to be an important prognostic factor in this disease because of heart failure and/or ventricular arrhythmia, and corticosteroid therapy is usually prescribed to prevent cardiac events. However, little is known about the relationship of cardiac function and concomitant corticosteroid therapy on later cardiac events in CS.
Objective
We evaluated the relationship between prognosis and left ventricular ejection fraction (LVEF) at the time of diagnosis in CS patients from the Japanese nationwide questionnaire survey.
Methods
Total of 757 Japanese patients from 57 hospitals who diagnosed CS were examined. Patients who unsatisfied the criteria of the Japanese new guidelines, or who underwent cardiac transplantations were excluded, and 420 patients (287 females, mean age 60±13 years old, median follow-up periods 1864 days [interquartile range: 845–3159 days]) were analyzed. The relationship of adverse events (all-cause death, cardiovascular death, and appropriate ICD [Implantable Cardioverter Defibrillator] discharge) and LVEF (with corticosteroid 84%) (low LVEF: LVEF≤35% n=98 [with corticosteroid in 78%], moderate LVEF: LVEF 35–50% n=104 [with corticosteroid in 93%], normal LVEF: 50≤LVEF n=218 [with corticosteroid in 83%]) were evaluated respectively.
Results
89 CS patients developed all-cause death (n=50), cardiovascular death (n=30) or appropriate ICD discharge (n=48). The frequency of corticosteroid therapy was not different in the each LVEF group, but Kaplan-Meier analysis revealed that all-cause death, cardiovascular death, and all cardiovascular adverse events were more observed in lower LVEF group (log-rank p<0.0001). Furthermore, multivariate Cox hazard analysis revealed that LVEF was a most important independent prognostic factor in CS.
Conclusion
This Japanese nationwide questionnaire survey data showed that initial LVEF was an independent and strong prognostic predictor in CS, therefore primary prevention would be needed even after starting corticosteroid in patients with decreased cardiac function.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Kamada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Kamakura
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Isobe
- Tokyo Medical and Dental University, Tokyo, Japan
| | | | - K Kusano
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
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48
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Ueda N, Noda T, Nakajima I, Ishibashi K, Nakajima K, Kamakura T, Wada M, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Aiba T, Kiso K, Kanzaki H, Izumi C, Noguchi T, Yasuda S, Kusano K. Clinical impact of left ventricular paced conduction disturbance in cardiac resynchronization therapy. Heart Rhythm 2020; 17:1870-1877. [DOI: 10.1016/j.hrthm.2020.05.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 05/14/2020] [Accepted: 05/19/2020] [Indexed: 11/29/2022]
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49
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Kamada H, Ishibashi K, Nakajima K, Ueda N, Kamakura T, Wada M, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Isobe M, Terasaki F, Kusano K. Long time clinical course of cardiac sarcoidosis with corticosteroid therapy -from Japanese nationwide questionnaire survey-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2109] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Sarcoidosis is a systemic inflammatory syndrome of unknown etiology and cardiac involvement has been reported to be an important prognostic factor in this disease. An autopsy study has reported that the frequency of this cardiac involvement (cardiac sarcoidosis: CS) varies in the different countries and races and very frequent in Japanese patients. We therefore performed the nationwide questionnaire survey and try to clarify the clinical characteristics and corticosteroid effect in CS, especially focused on arrhythmic events in this disease.
Methods
Total of 757 Japanese patients from 57 hospitals who diagnosed CS were examined. Patients who unsatisfied the criteria of the Japanese new guidelines, or who underwent cardiac transplantations were excluded, and 420 patients (287 females, median follow-up periods 1864 days [interquartile range: 845–3159 days]) were analyzed. The clinical outcome and corticosteroid effect were evaluated.
Results
Clinical characteristics at diagnosis was as follows: female dominant (68%), mean age of 60±13 years old, mean left ventricular ejection fraction was 49±16%. Arrhythmic events were very frequently observed as an initial cardiac manifestation in 263 patients (62%) of CS, of which atrioventricular block (AVB) in 174 (41%), ventricular tachycardia (VT) in 73 (17%) and AVB with VT in 17 (4%) (Figure 1A). Pacemaker was implanted in 166 patients (40%) and defibrillators was 137 patients (33%). Corticosteroid was prescribed in 144 (83%) of 174 patients with AVB and in 62 (85%) of 73 patients with VT. Initial dose was mean 47.9 mg and maintenance dose of mean 7.3 mg. Corticosteroid improved VT as good as AVB (27% vs. 29%). However, corticosteroid sometimes worsened VT events compared with AVB (10% vs. 2%) (Figure 1B). During the course of follow-up, 32 patients were needed to increase corticosteroid in 23 of AVB and 10 of VT cases. However, there were no difference in mortality between the groups, whether or not to increase corticosteroid. All survival rate was 92% (5-year mortality), 83% (10-year mortality) and free from all cause death and defibrillator charge was 81% (5 year), 71% (10 year).
Conclusion
Fatal arrhythmia is commonly observed in CS as a primary symptom. Corticosteroid sometimes worsen ventricular arrhythmia and appropriate defibrillator discharge was common. Thus, careful attention for activating ventricular arrhythmia would be needed during the follow-up period even after corticosteroid therapy.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Kamada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Kamakura
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Isobe
- Tokyo Medical and Dental University, Tokyo, Japan
| | | | - K Kusano
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
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50
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Yokoyama Y, Aiba T, Ueda N, Nakajima K, Kamakura T, Wada M, Yamagata K, Ishibashi K, Inoue Y, Miyamoto K, Nagase S, Noda T, Yasuda S, Shimizu W, Kusano K. Subcutaneous and transvenous implantable cardioverter defibrillator in high-risk long-QT syndrome type 3 associated with Val411Met mutation in SCN5A. J Cardiol Cases 2020; 22:238-241. [DOI: 10.1016/j.jccase.2020.07.007] [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] [Received: 04/28/2020] [Revised: 06/20/2020] [Accepted: 06/25/2020] [Indexed: 10/23/2022] Open
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