Fractionated non-pulmonary vein triggers contribute to spontaneous activity and initiating and maintaining paroxysmal atrial fibrillation: A case report.

Unlabelled: Pulmonary vein (PV) antrum isolation (PVAI) that involves electrically isolating PV foci is a useful treatment strategy for atrial fibrillation (AF). However, non-PV triggers during/after the PVAI are observed in approximately 30 % of AF cases, contributing to AF recurrence. We present the case of an 84-year-old woman who underwent ablation of recurrent symptomatic paroxysmal AF in our hospital.

Bidirectional Association Among the Type of Atrial Fibrillation, Sleep-Disordered Breathing Severity, Heart Failure Progression, and Left Atrial Enlargement, in Patients with Atrial Fibrillation.

This study aimed to clarify (1) the association among the atrial fibrillation (AF) type, sleep-disordered breathing (SDB), heart failure (HF), and left atrial (LA) enlargement, (2) the independent predictors of LA enlargement, and (3) the effects of ablation on those conditions in patients with AF. The study's endpoint was LA enlargement (LA volume index [LAVI] ≥ 78 mL/m).Of 423 patients with nonvalvular AF, 236 were enrolled.

Role of Sleep-Disordered Breathing and Epicardial Connections in the Recurrence of Atrial Fibrillation.

The presence of epicardial connections (ECs) between the pulmonary veins (PVs) and atrium may contribute to atrial fibrillation (AF) recurrence. This study aimed to determine the impact of sleep-disordered breathing (SDB) on the presence of ECs and the interplay between SDB and ECs on AF recurrence.We retrospectively reviewed 400 consecutive non-valvular AF patients.

Fibroblast-Derived Lysyl Oxidase Increases Oxidative Phosphorylation and Stemness in Cholangiocarcinoma.

Background & Aims: Metabolic and transcriptional programs respond to extracellular matrix-derived cues in complex environments, such as the tumor microenvironment. Here, we demonstrate how lysyl oxidase (LOX), a known factor in collagen crosslinking, contributes to the development and progression of cholangiocarcinoma (CCA).

Methods: Transcriptomes of 209 human CCA tumors, 143 surrounding tissues, and single-cell data from 30 patients were analyzed.

Discovery of NSD2-Degraders from Novel and Selective DEL Hits.

NSD2 is a histone methyltransferase predominantly catalyzing di-methylation of histone H3 on lysine K36. Increased NSD2 activity due to mutations or fusion-events affecting the gene encoding NSD2 is considered an oncogenic event and a driver in various cancers, including multiple myelomas carrying t(4;14) chromosomal translocations and acute lymphoblastic leukemia's expressing the hyperactive NSD2 mutant E1099 K. Using DNA-encoded libraries, we have identified small molecule ligands that selectively and potently bind to the PWWP1 domain of NSD2, inhibit NSD2 binding to H3K36me2-bearing nucleosomes, but do not inhibit the methyltransferase activity.

Geriatric nutritional risk index as the prognostic factor in older patients with fragility hip fractures.

Unlabelled: This study investigated the long-term survival and incidence of secondary fractures after fragility hip fractures. The 5-year survival rate was 62%, and the mortality risk was seen in patients with GNRI < 92. The 5-year incidence of secondary fracture was 22%, which was significantly higher in patients with a BMI < 20.

The administrative burden on physicians and technicians for organizing international telemedicine conferences: utility of a shared program management system in an international telemedicine network.

Background: The use of international telemedicine conferences for doctor-to-doctor education has increased following the coronavirus disease 2019 pandemic to ensure health and safety. Previous studies have shown that administrative tasks are an obstacle to promoting international telemedicine conferences but have not identified the type of system needed to alleviate this burden.

Objective: The Asia-Pacific Advanced Network Medical Working Group (APAN-MWG) is an international telemedicine network that includes 1171 medical institutions and 3653 members as of July 21, 2021.

Epicardial Connections After a Conventional Pulmonary Vein Antrum Isolation in Patients With Atrial Fibrillation.

Background: The existence of epicardial connection(s) (ECs) between the pulmonary veins (PVs) and atrium may hinder establishing a complete PV antrum isolation (AI) (PVAI) in patients with atrial fibrillation (AF). Thus, the purpose of this study was to determine the prevalence and location of ECs inside the conventional PVAI lines.

Methods and results: Three-hundred consecutive patients with non-valvular AF were evaluated.

Atrial Fibrillation in a Patient with Heparin-induced Thrombocytopenia Successfully Treated by Radiofrequency Catheter Ablation Using a Direct Thrombin Inhibitor.

A 74-year-old man was admitted to our hospital to undergo radiofrequency catheter ablation (RFCA) of persistent atrial fibrillation (AF). We found that he had a history of heparin-induced thrombocytopenia (HIT). Thus, a direct thrombin inhibitor, Argatroban Hydrate (Argatroban), was used instead of heparin as anticoagulation therapy during the RFCA procedure.

Mesenchymal-epithelial crosstalk shapes intestinal regionalisation via Wnt and Shh signalling.

Organs are anatomically compartmentalised to cater for specialised functions. In the small intestine (SI), regionalisation enables sequential processing of food and nutrient absorption. While several studies indicate the critical importance of non-epithelial cells during development and homeostasis, the extent to which these cells contribute to regionalisation during morphogenesis remains unexplored.

Efficacy and Safety of Nepcell S in Achieving Hemostasis After Removal of a 15-Fr Femoral Venous Sheath in Patients Undergoing Cryoballoon Ablation for Atrial Fibrillation.

Hemostasis at the femoral venous access site after cryoballoon ablation (CA) for atrial fibrillation (AF) is often prolonged because of aggressive anticoagulation and the use of 15-Fr-caliber sheaths. The Nepcell S (NC) is a newly developed hemostatic pad made of fibrosed calcium alginate extracted from natural seaweed. The calcium ions from the NC accelerate the clotting cascade.

Importance of the length of the myocardial sleeve in the superior vena cava in patients with atrial fibrillation.

Background: Pulmonary vein (PV) antrum isolation (PVAI) has proven to be a useful strategy for radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) worldwide. However, non-PV foci, especially from the superior vena cava (SVC), play an important role in initiating and maintaining AF.

Methods: In all, 427 consecutive patients with non-valvular AF who were admitted to our hospitals to undergo RFCA of AF using an EnSite system were evaluated.

Influence of Serum Cholinesterase Levels on Patients Suspected of Having Stable Coronary Artery Disease.

Objective The serum cholinesterase (ChE) level has been used for the evaluation of the nutritional status in daily practice. It has been reported that the serum ChE level is significantly more elevated in patients with three-vessel coronary disease than in normal subjects. Thus, the aim of this study was to assess the influence of serum ChE levels in patients suspected of having stable coronary artery disease (CAD).

A Case of a Figure of Eight Atrial Tachycardia after a Pulmonary Vein Antrum Isolation of Atrial Fibrillation.

A 66-year-old female, whom received a pulmonary vein (PV) isolation (PVAI) with linear ablation of the carina lines between the superior and inferior PVs of both the right and left PVs for atrial fibrillation (AF), was admitted to receive a radiofrequency catheter ablation (RFCA) of symptomatic drug-refractory atrial tachycardia (AT). The EnSite analysis by the Advisor HD Grid catheter during the AT could easily detect that the carina between the right superior and inferior PVs exhibited a low voltage area (< 0.5 mV), in addition to the fact that the electrical activation turned around the right PVs in a figure 8, even though mapping was performed during AT.

Radiofrequency catheter ablation of premature ventricular contractions from the mitral annulus in patients without structural heart disease.

Introduction: We previously reported the clinical benefits of radiofrequency catheter ablation (RFCA) of premature ventricular contractions (PVCs) from the right ventricular outflow tract or near the His-bundle, which can often deteriorate the clinical status. PVCs from the mitral valve (MA-PVCs) also often deteriorate the patients' clinical status. This study aimed to evaluate the effect of ablating MA-PVCs with RFCA from a trans-interatrial septal approach on the clinical status in symptomatic patients with frequent MA-PVCs without structural heart disease.

Evaluation of Coronary Artery Disease in Patients with Atrial Fibrillation by Cardiac Computed Tomography for Catheter Ablation: CADAF-CT Trial 2.

Objective We recently reported that routine cardiac computed tomography (CT) scans for radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) could steadily detect coronary artery lesions (CALs) and could accurately detect myocardial ischemia in 9% of patients with AF who underwent RFCA of AF. The aim of this study was to identify the independent risk factor (s) of myocardial ischemia in those patients. Methods Patient characteristics, blood test, CALs, Ordinal coronary calcium scoring (OCCS), and myocardial Ischemia (MI) were evaluated in 757 consecutive patients who underwent RFCA of AF.

Evaluation of coronary artery disease in patients with atrial fibrillation by cardiac computed tomography for catheter ablation: CADAF-CT trial.

Almost all institutions routinely perform cardiac computed tomography (CT) before radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) to evaluate the cardiac anatomy. The ideal timing of the CT image acquisition is different between for RFCA of AF and for evaluation of coronary artery lesions (CALs). Thus, the aim of this study was to assess whether 64- or 320-line routine cardiac CT scans before RFCA of AF could evaluate both coronary artery lesions and pulmonary veins (LA-PVs) anatomy at the timing of the image acquisition of the LA-PVs in patients with AF who underwent RFCA of AF.

Tracing the cellular dynamics of sebaceous gland development in normal and perturbed states.

The sebaceous gland (SG) is an essential component of the skin, and SG dysfunction is debilitating. Yet, the cellular bases for its origin, development and subsequent maintenance remain poorly understood. Here, we apply large-scale quantitative fate mapping to define the patterns of cell fate behaviour during SG development and maintenance.

Radiofrequency catheter ablation of premature ventricular contractions from near the His-bundle.

Objective: This study aimed to investigate the effects of radiofrequency catheter ablation (RFCA) and clinical and electrophysiological characteristics in symptomatic patients with premature ventricular contractions (PVCs) from near the His-bundle (His-PVCs).

Methods: The patient characteristics, prevalence of complications with any life style related disease (ALSRD) including hypertension, dyslipidemia, or diabetes mellitus, and/or cardiovascular disease (CVD) including coronary artery disease, cerebrovascular disease, renal dysfunction, or cardiomyopathy, clinical status, frequency of PVCs evaluated by 24hour Holter monitoring, echocardiography including the left ventricular diastolic dysfunction (LVDD) parameters, and electrophysiological findings were evaluated in 14 consecutive symptomatic patients with His-PVCs.

Results: The prevalence of males, being elderly and/or slightly obese, current and/or history of smoking, ALSRD or CVD related complications, and LVDD probably resulting from ALSRD and/or CVD complications were higher in patients with His-PVCs.