Publications by authors named "Chih Min Liu"

Background: Undetected atrial fibrillation (AF) poses a significant risk of stroke and cardiovascular mortality. However, diagnosing AF in real-time can be challenging as the arrhythmia is often not captured instantly. To address this issue, a deep-learning model was developed to diagnose AF even during periods of arrhythmia-free windows.

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Background: Predicting premature ventricular contraction (PVC) origin pre-ablation is a fundamental step, as right ventricular outflow tract (RVOT) PVC often leads to higher success rates.

Objective: To compare nine published ECG criteria to differentiate between RVOT and non-RVOT origins of PVCs and develop a stepwise algorithm using those criteria to better determine PVC origin to predict ablation success.

Methods: Two centers were involved in this study, the derivation group and the validation group.

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Background: Although significant research has explored the digital phenotype in mood disorders, the time-lagged and bidirectional relationship between mood and global positioning system (GPS) mobility remains relatively unexplored. Leveraging the widespread use of smartphones, we examined correlations between mood and behavioral changes, which could inform future scalable interventions and personalized mental health monitoring.

Objective: This study aims to investigate the bidirectional time lag relationships between passive GPS data and active ecological momentary assessment (EMA) data collected via smartphone app technology.

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Background: The recurrence rate of strokes associated with atrial fibrillation (AF) can be substantially reduced through the administration of oral anticoagulants. However, previous studies have not demonstrated a clear benefit from the universal application of oral anticoagulants in patients with embolic stroke of undetermined source. Timely detection of AF remains a challenge in patients with stroke.

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  • A study examined the effects of QT prolongation in cancer patients, analyzing ECG data from 59,568 patients in Taiwan to understand its impact on cardiovascular (CV) mortality.* -
  • The research found that while QT prolongation (measured by QTcB) was related to a slight increase in CV mortality risk, comorbidities were more significant factors influencing these outcomes.* -
  • Ultimately, the study concluded that the presence of comorbidities, rather than just prolonged QT intervals, played a larger role in determining CV mortality in cancer patients.*
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  • A study was done to see if lowering the dose of antipsychotic medication for patients in remission could still work well, using blood tests to check drug levels.
  • Researchers watched 126 patients over 2 years, measuring their blood drug levels after they reduced their medication doses in a careful way.
  • They found that many patients could stay healthy on lower medication doses, suggesting that it's possible to reduce medication without more problems, even if different groups of people might react differently to the drug.
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  • The study investigates post-stroke antithrombotic therapy patterns in patients with atrial fibrillation and how these treatments impact outcomes after ischemic stroke.
  • Among patients who were not taking anticoagulants before their stroke, many continued to forgo anticoagulation or only received antiplatelet medications, resulting in higher rates of recurrent strokes and mortality compared to those on non-vitamin K antagonist oral anticoagulants (NOACs).
  • Continuing the same NOAC after a stroke was linked to better outcomes, while switching NOACs increased the risk of ischemic stroke, indicating that maintaining consistency in anticoagulant therapy may be crucial for patient safety and recovery.
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  • - The study investigated the relationship between the distance from the descending aorta to the left inferior pulmonary vein (Dao-LIPV) and the presence of triggers and drivers in atrial fibrillation (AF) during ablation procedures.
  • - A total of 886 patients with drug-refractory AF were analyzed; 63 were found to have LIPV triggers or drivers, with Dao-LIPV distance proving to be a strong predictor for these occurrences.
  • - The research developed a risk score model indicating that patients with a Dao-LIPV distance of 2.5 mm or less and persistent AF have a significantly higher risk of LIPV triggers or drivers, which can help electrophysiologists plan ablation treatments more effectively.*
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Background: Ibrutinib, a Bruton's tyrosine kinase inhibitor used in cancer therapy, exerts ventricular proarrhythmic effects; however, the underlying mechanisms remain unclear. Excitation-contraction coupling (E-C) disorders are pivotal for the genesis of ventricular arrhythmias (VAs), which arise mainly from the right ventricular outflow tract (RVOT). In this study, we aimed to comprehensively investigate whether ibrutinib regulates the electromechanical activities of the RVOT, leading to enhanced arrhythmogenesis, and explore the underlying mechanisms.

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Background: Recent studies have shown that dexmedetomidine may improve microcirculation and prevent organ failure. However, most evidence was obtained from experimental animals and patients receiving cardiac surgery with cardiopulmonary bypass. This study aimed to investigate the effect of dexmedetomidine on microcirculation and organ injuries in critically ill general surgical patients.

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  • Signal-averaged electrocardiography (SAECG) was studied in patients with nonischemic cardiomyopathies (NICMs) to determine its diagnostic and prognostic value regarding ventricular arrhythmia (VA).
  • In a study of 58 NICM patients, those who met at least one SAECG criterion showed larger areas of scar tissue and more frequently had extremely low-voltage zones than those who did not meet the criteria.
  • The findings suggest that a positive SAECG indicates a greater risk for arrhythmogenic issues in NICM patients, although it did not significantly correlate with long-term recurrence of ventricular arrhythmias.
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Background: Early detection of dysphagia is important for preventing aspiration pneumonia. Although videofluoroscopy is currently the primary diagnostic tool for dysphagia, access to this tool may be limited because of radiation exposure risk, high cost, and other factors.

Purpose: In this study, a meta-analysis was used to determine the strength of the correlation between dysphagia detection outcomes obtained using subjective questionnaires and videofluoroscopy.

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  • Reduced-dose apixaban is recommended for atrial fibrillation patients who meet specific criteria, but the optimal dose for Asian patients with certain kidney function levels is unclear.
  • A study analyzed 13,508 patients to compare outcomes of low-dose vs. standard-dose apixaban and warfarin in those with low serum creatinine and kidney function.
  • Patients taking low-dose apixaban had a significantly lower risk of mortality and major complications compared to those on warfarin, but standard-dose apixaban showed similar risks to warfarin.
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Background: Examining patients with first-episode psychosis (FEP) provides opportunities to better understand the mechanism underlying these illnesses. By incorporating quantitative measures in FEP patients, we aimed to (1) determine the baseline distribution of clinical features; (2) examine the impairment magnitude of the quantitative measures by comparing with external controls and then the counterparts of schizophrenia patients of different familial loadings; and (3) evaluate whether these quantitative measures were associated with the baseline clinical features.

Methods: Patients with FEP were recruited from one medical center, two regional psychiatric centers, and two private clinics in northern Taiwan with clinical features rated using the Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance (PSP) scale.

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  • This study investigates how AI and pre-ablation CT images can predict the recurrence of atrial fibrillation (AF) after catheter ablation, relying on clinical data and imaging for better accuracy.
  • Researchers analyzed data from 638 patients and designed machine learning models using CT images and clinical variables, achieving varying predictive performance for AF recurrence.
  • The best results came from an ensemble model combining both AI-driven imaging and selected clinical variables, yielding a predictive accuracy (AUC) of 0.76.
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Background: The aim of this study was to build an auto-segmented artificial intelligence model of the atria and epicardial adipose tissue (EAT) on computed tomography (CT) images, and examine the prognostic significance of auto-quantified left atrium (LA) and EAT volumes for AF.

Methods and results: This retrospective study included 334 patients with AF who were referred for catheter ablation (CA) between 2015 and 2017. Atria and EAT volumes were auto-quantified using a pre-trained 3-dimensional (3D) U-Net model from pre-ablation CT images.

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Introduction: Catheter ablation is an effective and safe strategy for treating atrial fibrillation patients. Nevertheless, studies on the long-term outcomes of catheter ablation in patients with dilated cardiomyopathy are limited. This study aimed to assess the electrophysiological characteristics of atrial fibrillation patients with dilated cardiomyopathy and compare the long-term clinical outcomes between patients undergoing catheter ablation and medical therapy.

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Objective: This study measured normal ranges of microcirculatory parameters in healthy individuals and investigated differences in parameters by age and sex.

Methods: Participants were enrolled into three groups with equal numbers of male and female: young (20-39 years), middle-aged (40-59 years), and elderly (60-79 years). Sublingual microcirculation images were obtained using the incident dark field (IDF).

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  • A study was conducted to evaluate whether a new mapping technique, PRISM, could improve catheter ablation outcomes for patients with persistent atrial fibrillation (AF) when combined with traditional methods.
  • The trial involved 170 patients and showed that those who underwent the PRISM-guided procedure had a significantly higher success rate in maintaining normal heart rhythm after 12 months compared to the conventional approach.
  • The findings suggest that PRISM mapping may enhance the precision of AF treatment and reduce the recurrence of atrial arrhythmias, making it a promising alternative for persistent AF management.
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  • The study examines how catheter ablation (CA) of atrial fibrillation (AF) affects the severity of mitral regurgitation (MR) in patients who have both conditions, analyzing data from 2011 to 2021.
  • Of the 50 patients analyzed, those with improved MR after CA (group 1) had fewer risk factors like hypertension and diabetes, and less scar tissue in the left atrium compared to those with refractory MR (group 2).
  • The results indicate that while most patients experience improved MR post-ablation, the presence of scar tissue in the posterior bottom of the left atrium predicts a poorer outcome in terms of MR recovery.
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  • The study investigates the occurrence of Carina breakthrough (CB) at the right pulmonary vein (RPV) after a specific ablation procedure in atrial fibrillation patients.
  • Out of 62 patients, 33.87% experienced RPV CB, and those affected had lower contact force (CF) at lesions near the RPV carina compared to those who did not.
  • The research found that a CF of less than 10.5 grams is a potential predictor of RPV CB, suggesting that higher CF during ablation could help reduce this complication.
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  • This study compares the effectiveness of circumferential pulmonary vein isolation (CPVI) and segmental pulmonary vein isolation (SPVI) in patients undergoing redo ablations for recurrent atrial fibrillation (AF).
  • 543 patients who had AF ablation were analyzed, with 141 included in the final assessment; the results showed similar AF-free survival rates for both techniques, but a significant difference in atrial flutter recurrence favoring CPVI.
  • The findings suggest that while SPVI and CPVI are comparable for AF recurrence, SPVI has a higher rate of atrial flutter, potentially linked to more residual pulmonary vein gaps over time.
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Background: Modifying the autonomic system after catheter ablation may prevent the recurrence of atrial fibrillation (AF). Evaluation of skin sympathetic nerve activity (SKNA) is a noninvasive method for the assessment of sympathetic activity. However, there are few studies on the effects of different energy settings on SKNA.

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  • A study investigated why some patients with paroxysmal atrial fibrillation (PAF) progress to persistent atrial fibrillation (PersAF) despite catheter ablation, focusing on predictors of this progression.
  • The study included 400 PAF patients, categorizing them into three outcome groups, and monitored them for 3 years post-ablation to assess AF recurrence and progression.
  • Key findings showed that a larger left atrial diameter, presence of non-pulmonary vein triggers, and a history of thyroid disease were significant predictors for both recurrence of AF and progression to PersAF.*
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