Predictors of the "Crosstalk" Phenomenon During Cryoballoon Ablation in Patients with Atrial Fibrillation.

Second-generation cryoballoon (CB) ablation is effective in achieving pulmonary vein (PV) isolation (PVI) in atrial fibrillation (AF) patients. The "crosstalk" (CST) phenomenon has been reported to reduce unnecessary applications during CB ablation. Nevertheless, it is unclear under what conditions the CST phenomenon occurs.

Relationship between D-dimer level upon emergency room arrival and the duration of cardiac arrest in patients with witnessed out-of-hospital cardiac arrest.

In patients with out-of-hospital cardiac arrest (OHCA), the probability of resuscitation is strongly influenced by the duration of cardiac arrest, which activates the blood coagulation-fibrinolysis system. Because plasma D-dimer levels reflect activity of blood coagulation and fibrinolysis, they should increase with the duration of cardiac arrest. We evaluated 222 consecutive non-traumatic witnessed OHCA patients who underwent measurement of plasma D-dimer levels on arrival in the emergency room.

The clinical impact of the left atrial posterior wall lesion formation by the cryoballoon application for persistent atrial fibrillation: Feasibility and clinical implications.

Introduction: The left atrial (LA) posterior wall (LAPW) has been targeted to improve the clinical outcomes in patients with persistent atrial fibrillation (PersAF). This study aimed to investigate the feasibility, safety, and clinical implications of cryoballoon (CB) applications on the LAPW to accomplish electrical isolation (EI) of the LAPW with CB.

Methods: A total of 100 patients (males, 84; mean age, 64 ± 10 years) with PersAF were enrolled.

Impact of chronic kidney disease on long-term clinical outcomes of everolimus-eluting stent implantation: A subanalysis of the Tokyo-MD PCI registry.

Objective: The aim of the study was to investigate the impact of chronic kidney disease (CKD) on the 5-year clinical outcomes of everolimus-eluting stent (EES) implantation.

Background: Recent studies have demonstrated the safety and efficacy of EES. However, limited information exists on the long-term clinical outcomes associated with CKD.

Clinical investigation of esophageal injury from cryoballoon ablation of persistent atrial fibrillation.

Background: The cryoballoon (CB) can be utilized for extra pulmonary vein (PV) ablation such as for a left atrial (LA) posterior wall (LAPW) isolation. However, scrutiny of the esophageal injuries during the LAPW isolation has never been performed. We sought to thoroughly investigate the esophageal lesions (ELs) and gastric hypomotility (GH) caused by an LAPW isolation using a CB.

"Clinical Impact of the Cryoballoon Temperature and Occlusion Status on the Success of Pulmonary Vein Isolation".

Background: Complete occlusion of the pulmonary veins (PVs) with the cryoballoon (CB) is considered to be the crucial factor for a successful PV isolation (PVI). We investigated whether a complete occlusion was indispensable for a successful CB based PVI of every PV.

Methods And Results: Atrial fibrillation patients (n=123, 97; paroxysmal) undergoing a de novo PVI were enrolled.

Clinical assessment of cryoballoon ablation in cases with atrial fibrillation and a left common pulmonary vein.

Introduction: Pulmonary vein isolation (PVI) using a cryoballoon (CB) is a useful tool for treating atrial fibrillation (AF); however, the clinical efficacy of the CB has never been fully investigated in patients with a left common pulmonary vein (LCPV).

Methods And Results: Three hundred twenty-four consecutive paroxysmal AF patients underwent PVI with a CB. Three-dimensional computed tomography was performed in all patients before the ablation.

Ultra-long acting calcium channel blockers may decrease accuracy of the acetylcholine provocation test.

Background: When drug-induced coronary spasm provocation tests are performed, a washout period of >48h for calcium channel blockers (CCBs) is uniformly recommended. However, each CCB has a distinct half-life, and little is known about the influence of prior oral administration of CCBs on acetylcholine provocation test to evaluate coronary vasomotor reaction.

Methods And Results: We examined 245 consecutive patients with suspected vasospastic angina who had undergone acetylcholine provocation test.

Fatal delayed rupture of the subclavian artery in a patient with first-rib fracture caused by blunt trauma.

This case highlights the probable association of significantly displaced posterior first-rib fracture and jagged edges of the fracture line following blunt chest trauma with delayed ipsilateral subclavian artery rupture. Early angiography and first-rib repair should promptly be considered under such circumstances.

Comparative study of hemorrhagic and ischemic complications among anticoagulants in patients undergoing cryoballoon ablation for atrial fibrillation.

Objective: Few data exist to evaluate the safety and efficacy of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) undergoing cryoballoon ablation (CB-A). This study is aimed to clarify the usefulness of DOACs in patients undergoing CB-A.

Methods: The patients (average age; 65.

Novel method for earlier detection of phrenic nerve injury during cryoballoon applications for electrical isolation of pulmonary veins in patients with atrial fibrillation.

Background: Diaphragmatic electrogram recording during cryoballoon ablation (CB-A) of atrial fibrillation is commonly used to predict phrenic nerve palsy (PNP).

Objective: The purpose of this study was to investigate a novel method for predicting PNP at an earlier stage to prevent sustained PNP.

Methods: A total of 197 patients undergoing CB-A were enrolled.

Diagnostic utility of unenhanced computed tomography for acute aortic syndrome.

Background: The diagnostic value of unenhanced computed tomography (CT) for diagnosing acute aortic dissection (AAD) and ruptured thoracic aortic aneurysm (TAA) remains unclear.

Methods And Results: We examined 219 consecutive patients who visited the emergency room with suspected acute aortic syndrome (AAS) because of chest or back pain and who underwent both unenhanced and contrast-enhanced 64-row multi-detector CT. The unenhanced CT findings were evaluated by the cardiologist on duty who was blind to the findings of contrast-enhanced CT.

Cardiopulmonary arrest caused by coronary spasm after coronary vasodilator withdrawal during the peri-operative period of gastrectomy.

Calcium antagonists, nicorandil and long-acting nitrates are highly effective for preventing coronary spasm. The withdrawal of coronary vasodilators, especially calcium antagonists, is risky in cases of vasospastic angina. We herein present a case of cardiopulmonary arrest that occurred due to coronary spasm triggered by the discontinuation of coronary vasodilators during the peri-operative period of gastrectomy.

Coexistence of left-sided atrioventricular accessory pathways with a common inferior pulmonary vein ostium.

Background: As the technique for radiofrequency catheter ablation for atrial fibrillation (AF) has progressed, so has our knowledge of both normal and abnormal anatomy of the left atrium and pulmonary veins (PV). We treated several AF patients with accessory conduction pathways (ACP) who were also found to have a common ostium of inferior PVs (CIPV), a relatively rare PV anomaly. No relation between ACP and PV anomalies has ever been reported, and the aim of our study was to study this association.

Ambulatory ECG-based T-wave alternans and heart rate turbulence predict high risk of arrhythmic events in patients with old myocardial infarction.

Background: Few studies have explored risk stratification of arrhythmic events in patients with ischemic heart diseases according to T-wave alternans (TWA) using modified moving average (MMA) method and heart rate turbulence (HRT).

Methods And Results: A retrospective analysis of 63 patients who underwent MMA-based TWA and HRT divided the patients into 3 groups: group-C of 21 controls, group-O of 21 patients with old myocardial infarction (OMI) showing no episodes of sustained ventricular tachyarrhythmia (SVT), and group-V of 21 OMI patients with episodes of SVT who received an implantable cardioverter-defibrillator. Among the 3 groups, positive TWA (>or=65 microV) and impaired HRT were observed most frequently in group-V (P<0.