Publications by authors named "Hee Yu"

Background: There is limited information on protective factors related to atrioventricular (AV) block.

Objective: This study examines the association between accelerometer-derived moderate-to-vigorous physical activity (MVPA) and AV block in healthy elderly individuals.

Methods: A total of 23,590 UK Biobank participants ≥60 years involved in a wrist-worn accelerometer study with no history of hypertension, diabetes mellitus, dyslipidemia, and coronary heart disease were analyzed.

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This study utilized a genome-wide association study (GWAS) to investigate the genetic variations linked to the risk of hepatitis B virus (HBV) reactivation in patients who have undergone liver transplantation (LT), aiming to enhance understanding and improve clinical outcomes. Genotyping performed on a selected patients from the Korean Organ Transplantation Registry (KOTRY) data using high-throughput platforms with the Axiom Korea Biobank array 1.1.

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Aims: Determining elevated left atrial (LA) pressure is crucial in patients with atrial fibrillation (AF), yet non-invasive estimation using echocardiography remains unclear. This study aimed to identify useful echocardiographic indices for identifying elevated LA pressure in patients with AF.

Methods And Results: Patients with paroxysmal or persistent AF referred for catheter ablation at two tertiary hospitals were prospectively enrolled.

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Background: Pulmonary vein isolation (PVI) alone is less effective in patients with persistent atrial fibrillation (AF) compared with those with paroxysmal AF. We investigate whether additional linear ablation from the superior vena cava to the right atrial septum and cavotricuspid isthmus ablation improves the rhythm outcome of patients with persistent AF undergoing cryoballoon PVI (Cryo-PVI).

Methods: In this investigator-initiated, multicenter, randomized clinical trial, 289 patients with persistent AF refractory to antiarrhythmic drug therapy were randomized 1:1 to either Cryo-PVI with additional right atrium (RA) linear ablation or Cryo-PVI alone.

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Background And Aims: Artificial intelligence (AI) algorithms in 12-lead electrocardiogram (ECG) provides promising age prediction methods. This study investigated whether the discrepancy between ECG-derived AI-predicted age (AI-ECG age) and chronological age, termed electrocardiographic aging (ECG aging), is associated with atrial fibrillation (AF) risk.

Methods: An AI-ECG age prediction model was developed using a large-scale dataset (1 533 042 ECGs from 689 639 participants) and validated with six independent and multi-national datasets (737 133 ECGs from 330 794 participants).

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Background: The determination of left ventricular diastolic function (LVDF) in patients with significant (≥moderate) mitral regurgitation (MR) poses a complex challenge. We recently validated an artificial intelligence-enabled electrocardiogram (AI-ECG) algorithm to estimate LVDF.

Objectives: This study sought to evaluate the risk of all-cause mortality across AI-ECG LVDF-derived myocardial disease (MD) grades in MR.

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Aims: Whether adjusting the duration of ablation based on left atrial wall thickness (LAWT) provides extra benefits for pulmonary vein (PV) isolation for atrial fibrillation (AF) is uncertain. We studied the safety and efficacy of tailored cryoballoon PV isolation (CB-PVI) based on LAWT for paroxysmal AF.

Methods And Results: Two hundred seventy-seven patients with paroxysmal AF refractory to anti-arrhythmic drug were randomized 1:1 to either LAWT-guided CB-PVI (n = 135) and empirical CB-PVI (n = 142).

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Introduction: End-stage lung disease causes cardiac remodeling and induces electrocardiogram (ECG) changes. On the other way, whether lung transplantation (LTx) in end-stage lung disease patients are associated with ECG change is unknown. The object of this study was to investigate ECG changes before and after LTx in end-stage lung disease patients and whether these changes had clinical significance.

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Background: Atrial fibrillation (AF) may have different clinical features in its early phase.

Objective: The purpose of this study was to compare the characteristics and clinical outcomes of early-phase AF with later-phase AF using a large multicenter prospective registry (CODE-AF [COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation]).

Methods: Patients enrolled between June 2016 and March 2021 were divided into 2 groups based on AF duration: (1) newly diagnosed (AF duration ≤90 days); and (2) previously diagnosed (AF duration >90 days).

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It would be clinically valuable if the efficacy of antiarrhythmic drugs could be simulated in advance. We developed a digital twin to predict amiodarone efficacy in high-risk atrial fibrillation (AF) patients post-ablation. Virtual left atrium models were created from computed tomography and electroanatomical maps to simulate AF and evaluate its response to varying amiodarone concentrations.

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Background: The role of anti-arrhythmic drugs (AADs) in recurrent atrial fibrillation (AF) after catheter ablation (CA) is not fully understood. The aim of this study was to explore the effects of AADs in patients who recurred after AFCA depending on extra-pulmonary vein triggers (ExPVTs) and post-ablation heart rate variability (HRV) parameters.

Methods: We analyzed 2,036 patients who underwent de-novo AFCA and 486 patients with post-AFCA recurrence who underwent rhythm control with AADs.

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Background: New digital technology-based rehabilitation may be a viable option for patients after anterior cruciate ligament reconstruction (ACLR), with advantages such as easy access to treatment and learning as well as cost-effectiveness.

Purpose: To investigate the effects of an augmented reality (AR)-based, telerehabilitation system in patients after ACLR compared with a brochure-based rehabilitation program in terms of patient-reported outcomes and functional performance measures.

Study Design: Randomized controlled trial; Level of evidence, 2.

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Article Synopsis
  • This study looked at how to successfully use a new heart procedure called left bundle branch area pacing (LBBAP) and what makes it work better.
  • They tried this procedure on 119 patients, mostly with heart problems, and found out it worked well in most cases.
  • They discovered that fewer attempts to put in the heart leads meant better success, and that certain heart conditions, like intraventricular conduction delay (IVCD) and a larger heart part called the right atrium, made the procedure harder.
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Background: The ideal long-term antithrombotic strategy for patients after successful catheter-based atrial fibrillation (AF) ablation is still uncertain. Presently, practices vary, and the advantages of oral anticoagulation (OAC) for the post-ablation population are not clearly established. To date, no randomized trials have addressed this therapeutic question.

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  • Atrial fibrillation (AF) is linked to kidney problems, and this study aimed to see if rhythm control (using medications or procedures to restore normal heart rhythm) is better for kidney function compared to rate control (slowing the heart rate).
  • Researchers analyzed data from 20,886 AF patients to compare rates of major kidney issues between those receiving rhythm control and those receiving rate control over several years.
  • Results showed that rhythm control significantly reduced the risk of kidney-related problems in patients with chronic kidney disease (CKD), while there was no difference in outcomes for patients without significant CKD.
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  • The study investigates how artificial intelligence (AI) can analyze 12-lead ECGs to predict a patient's age and its link to atrial fibrillation (AF) recurrence post-ablation.
  • Researchers validated an AI model on multiple datasets to estimate AI-ECG age among patients undergoing AF catheter ablation, focusing on those on anti-arrhythmic drugs.
  • Findings reveal that a larger gap between AI-ECG age and chronological age (10 years or more) significantly raises the risk of AF recurrence, regardless of actual age or heart size, highlighting the AI-ECG's prognostic value.
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  • Increased left atrial pressure (LAP) is linked to dyspnea and heart failure with preserved ejection fraction (HFPEF) in patients with atrial fibrillation (AF), and this study aimed to compare LAP between paroxysmal AF (PAF) and persistent AF patients.
  • The study involved 1,369 participants who underwent AF catheter ablation, measuring LAP across different heart rates and rhythms, revealing that persistent AF had consistently higher LAP than PAF, especially during faster pacing.
  • Findings suggest that PAF patients have lower baseline LAP but show more significant increases during rapid pacing, calling for updated HFPEF assessments and better rhythm control strategies in PAF management.
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  • This study looked into how delaying catheter ablation for atrial fibrillation (AF) affects outcomes in patients not responding to antiarrhythmic drugs (AAD) by analyzing data from 1,038 persistent AF patients.
  • Results indicated that patients who didn't respond to AAD had a higher likelihood of experiencing AF recurrence after ablation, especially those with longer diagnosis-to-ablation times (DAT).
  • The optimal DAT cutoff for better outcomes was identified as 22 months, suggesting that waiting longer than this period for ablation could be detrimental for certain patients, particularly those whose condition improved on AAD therapy.
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Background: Atrial fibrillation (AF) is an indicator of frailty in old patients. This study aimed to investigate the effect of frailty on the use of oral anticoagulants (OAC) and clinical outcomes in a nationwide cohort of patients with new-onset AF.

Methods: This study included 451,368 participants without AF from the Korea National Health Insurance Service-Health Screening cohort between 2002 and 2009.

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Background: Polypharmacy is commonly observed in atrial fibrillation (AF) and is associated with poorer clinical outcomes. Our study aimed to elucidate the polypharmacy prevalence, its associated risk factors, and its relationship with adverse clinical outcomes using a 'real-world' database.

Methods: This study included 451,368 subjects without prior history of AF (median age, 54 [interquartile range, 48.

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Background: Hypertrophic cardiomyopathy (HCM) is frequently associated with atrial fibrillation (AF). We compared clinical, echocardiographic, and electrophysiological parameters between HCM subtypes and those without HCM at AF catheter ablation (AFCA) and analyzed post-AFCA reverse remodeling and AF recurrence based on HCM presence and subtype.

Methods: Among 5161 consecutive patients who underwent de novo AFCA, we included HCM patients and control patients who were age-, gender-, and AF type-matched.

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An ischemic stroke, one of the leading causes of morbidity and mortality, is caused by ischemia and hemorrhage resulting in impeded blood supply to the brain. According to many studies, blueberries have been shown to have a therapeutic effect in a variety of diseases. Therefore, in this study, we investigated whether blueberry-treated mesenchymal stem cell (MSC)-derived extracellular vesicles (B-EVs) have therapeutic effects in in vitro and in vivo stroke models.

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Background: Data on off-label reduced dose risk among patients with atrial fibrillation (AF) who qualify for a single-dose reduction of apixaban is scarce.

Objectives: We prospectively assessed apixaban dosing and clinical characteristics in AF patients meeting a dose reduction criterion.

Methods: The multicentre, prospective cohort study, the efficAcy and Safety of aPixaban In REal-world practice in Korean frail patients with AF (ASPIRE), encompasses patients with AF who met the criteria for a single-dose reduction of apixaban and were given varying doses of apixaban, either the on-label standard dose or the off-label reduced dose.

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The evidence about the associations of leukocyte telomere length (LTL) and intermediary cardiovascular phenotypes with adverse cardiovascular outcomes is inconclusive. This study assessed these relationships with cardiovascular imaging, electrocardiography, and the risks of sudden cardiac death (SCD), coronary events, and heart failure (HF) admission. We conducted a cross-sectional analysis of UK Biobank participants enrolled between 2006 and 2010.

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Background: The reason for higher incidence of atrial fibrillation (AF) in Europe compared with East Asia is unclear. We aimed to investigate the association between modifiable lifestyle factors and lifetime risk of AF in Europe and East Asia, along with race/ethnic similarities and disparities.

Methods: 1:1 propensity score matched pairs of 242,763 East Asians and 242,763 White Europeans without AF were analyzed.

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