Ectopic cycle length estimation from the quantified distribution patterns of ventricular bigeminy and trigeminy.

Background: Ectopic cycle length (ECL) and the distribution patterns of ventricular bigeminy and trigeminy, expressed as their postextrasystolic intervals (PEIs) and interectopic intervals (IEIs), have been poorly pursued.

Objective: Based on modulation theory, we hypothesized that the PEIs of bigeminy and trigeminy determine their IEIs and ECL.

Methods: Ambulatory electrocardiograms of 1290 patients with ventricular premature complexes (≥3000/day) were studied.

Characteristics and catheter ablation of focal atrial tachycardia originating from the interatrial septum.

Background: Ablation of focal atrial tachycardia (AT) originating from the interatrial septum (IAS) is challenging because of its complex anatomy.

Methods: We studied the electrocardiographic and electrophysiologic characteristics of focal, septal AT in seven patients who underwent successful ablation.

Results: The site of successful ablation was at the site of earliest activation on the right side of the IAS in three patients and on the left side in four patients, >1cm away from the centre of the fossa ovalis in the septum secundum.

Impact of left atrial appendage ridge ablation on the complex fractionated electrograms in persistent atrial fibrillation.

Background: The left atrial appendage (LAA) is a possible key contributor to the maintenance of persistent atrial fibrillation (PsAF). The effect of LAA ostial ablation on global left atrial higher-frequency sources remains unclear.

Methods: Complex fractionated electrograms (CFEs) and dominant frequency (DF) maps acquired with a NavX system in 58 PsAF patients were enrolled and examined before and after LAA posterior ridge ablation, which followed a stepwise linear ablation.

Sudden cardiac arrest recorded during Holter monitoring: prevalence, antecedent electrical events, and outcomes.

Background: Causative arrhythmias of sudden cardiac arrest (SCA) are changing in this age of improved coronary care.

Objective: The purpose of this study was to examine the frequency of terminal arrhythmias and the electrical events prior to SCA.

Methods: We analyzed 24-hour Holter recordings of 132 patients enrolled from 41 institutions who either died (n = 88) or had an aborted death (n = 44).

Epicardial adipose tissue-based defragmentation approach to persistent atrial fibrillation: its impact on complex fractionated electrograms and ablation outcome.

Background: Increased epicardial adipose tissue (EAT) volume is associated with atrial fibrillation (AF). However, the efficacy of EAT-based left atrial (LA) ablation for persistent AF (PsAF) is unclear.

Objective: The purpose of this study was to assess whether EAT-based LA ablation is effective for PsAF.

Substrate modification by adding ablation of localized complex fractionated electrograms after stepwise linear ablation in persistent atrial fibrillation.

Purpose: Linear left atrial (LA) ablation in patients with persistent atrial fibrillation (PsAF) resulting in the elimination of most complex fractionated electrogram (CFE) sites has been demonstrated. This study was designed to evaluate the impact of a localized CFE ablation in addition to a representative linear LA ablation in patients with PsAF.

Methods: A total of 40 consecutive patients with PsAF underwent construction of CFE and dominant frequency (DF) maps using NavX.

Strong modulation of ectopic focus as a mechanism of repetitive interpolated ventricular bigeminy with heart rate doubling.

Background: Repetitive interpolated ventricular bigeminy (RIVB) can introduce a doubling of the ventricular rate.

Objective: To clarify the mechanism of RIVB, we hypothesized that it was introduced by a strong modulation of the ventricular automatic focus.

Methods: RIVB, defined as more than 7 bigeminy events, was detected by instantaneous heart rate and bigeminy interval (BI) tachograms in 1450 successive patients with frequent ventricular premature contractions (≥3000 per day).

Spatial relationship between high-dominant-frequency sites and the linear ablation line in persistent atrial fibrillation: its impact on complex fractionated electrograms.

Aims: Complex fractionated electrograms (CFEs) and high-dominant-frequency (DF) sites theoretically represent abnormal substrates and targets for atrial fibrillation (AF) ablation. The relationship between the high-DF sites in the left atrium (LA) and commonly used linear ablation line to the distribution of the CFEs in patients with persistent AF is unknown.

Methods And Results: This study enrolled 62 persistent AF patients who underwent construction of LA CFE and DF maps (>350 points/map).

Catheter ablation of ventricular tachycardia originating from the left posterior papillary muscle guided by the shadow of a multipolar catheter.

A 62-year-old man without structural heart disease underwent electrophysiological testing for ventricular tachycardia (VT). Hemodynamically unstable VT was induced after isoproterenol (ISP) provocation. Electroanatomical mapping using a multipolar catheter identified the earliest activation originating from the posterior papillary muscle (PPM) where prepotentials preceding the local ventricular electrogram were observed.

Determinants of serum high molecular weight (HMW) adiponectin levels in patients with coronary artery disease: associations with cardio-renal-anemia syndrome.

Objective: A low serum adiponectin level is associated with a high incidence of coronary artery disease (CAD) in the healthy population. Paradoxically, serum adiponectin is elevated in patients with severe CAD or chronic heart failure. We investigated the determinants of serum high molecular weight (HMW) adiponectin in patients with CAD.

A unique iatrogenic organized left atrial tachycardia with a gap conduction in previously ablated lesions.

This case concerns a 57-year-old woman with an organized left atrial tachycardia (AT) after pulmonary vein (PV) isolation. The left inferior PV (LIPV) exhibited a figure of eight tachycardia around the LIPV ostium with one loop at the anterior aspect and another at the posterior aspect, which corresponded to regular surface P waves. Although a gap ablation of fractionated electrograms changed the LIPV sequence, the atrial potentials were organized with a shortened cycle length accompanied by the same surface P-wave morphology.

Effects of losartan on serum total and high-molecular weight adiponectin concentrations in hypertensive patients with metabolic syndrome.

High-molecular weight (HMW) adiponectin may have the most biologic activity among several isoforms. We investigated long-term effects of losartan on serum concentrations of total and HMW adiponectin in hypertensive patients with metabolic syndrome (MS) by serial measurements over 6 months. Forty hypertensive patients first received 50 mg of losartan.

A case of persistent atrial fibrillation cured by focal ablation in a young patient.

We present a case of a 25-year-old man who had persistent atrial fibrillation (AF) lasting for three months. The persistent AF was terminated by a 20-mg bolus infusion of adenosine triphosphate. Frequent and repetitive episodes of ectopic atrial tachycardia (EAT) emerged from the mid-portion of the saddle between the left superior and inferior pulmonary veins.

Effects of statins on restenosis after coronary stent implantation.

Experimental data and preliminary clinical studies suggest that lipid-lowering drugs might have a beneficial effect on restenosis after coronary angioplasty. Recently, statins have been focused on prevention of restenosis after coronary stent implantation. However, their benefit has not yet been established.

Comparison of serum high-molecular weight (HMW) adiponectin with total adiponectin concentrations in type 2 diabetic patients with coronary artery disease using a novel enzyme-linked immunosorbent assay to detect HMW adiponectin.

Adiponectin (Acrp30), an adipocyte-derived protein, exists in serum as a trimer, a hexamer, and a high-molecular weight (HMW) form, including 12-18 subunits. Because HMW adiponectin may be biologically active, we measured it in serum using a novel enzyme-linked immunosorbent assay (ELISA) confirmed by gel filtration chromatography that the ELISA detected mainly adiponectin with 12-18 subunits, and we compared HMW with total adiponectin concentration in patients with type 2 diabetes. We next investigated the relationship between serum HMW and coronary artery disease (CAD) in 280 consecutive type 2 diabetic patients, including 59 patients with angiographically confirmed CAD.

Identification of stimulation site of pacemaker lead using tissue tracking method.

Purpose: We aimed to identify the electrical stimulation sites of pacemaker leads using a tissue tracking method of tissue Doppler imaging.

Methods: The study group consisted of 30 patients who had undergone permanent pacemaker implantation. During tissue Doppler imaging, the initial contraction site was seen as a red area stimulated by the pacemaker lead.

Variation in parasystolic cycle length.

At the time of the first visit to our clinic, an electrocardiographic examination of a 73-year-old female patient revealed ventricular premature contractions (VPCs) with variable coupling intervals that were diagnosed as parasystole. Characteristically many of the parasystoles had no sinus contractions between two consecutive VPCs, which we referred to as pure parasystole. We first repeatedly examined variations in the length of the parasystolic cycles between January 6, 1997 and March 2, 2003 using electrocardiography.

Long-term benefits of monteplase before coronary angioplasty in acute myocardial infarction.

Patients with acute myocardial infarction were randomly assigned to receive direct percutaneous coronary intervention (PCI) or pretreatment with intravenous monteplase followed by PCI. Although the combination of monteplase and PCI did not alter mortality compared with direct PCI, there was a dramatic reduction in the cardiac event rate over a 2-year follow-up compared with direct PCI.

[Primary malignant pericardial mesothelioma temporarily reduced by radiation therapy: a case report].

A 47-year-old woman was referred to our hospital because of cardiomegaly and pericardial effusion. She complained of a cough. Computed tomography, echocardiography, and magnetic resonance imaging showed a mass on the pericardium.

Isolated noncompaction of the left ventricular myocardium in an elderly patient.

Noncompaction of the ventricular myocardium (NVM) is a rare disorder of endomyocardial morphogenesis characterized by numerous, prominent trabeculations and deep intertrabecular recesses. It is commonly associated with congenital heart disease, but the isolated form (INVM) is not associated with other structural heart diseases. Clinical reports of INVM have been limited to a few case reports and small series of pediatric patients.

Model of bidirectional modulated parasystole as a mechanism for cyclic bursts of ventricular premature contractions.

Cyclic bursts of ventricular premature contractions (VPC) coming at minute-order intervals have been discerned by analyzing ambulatory ECG recordings, and their mechanism has not been clarified. The present study simulates this phenomenon by constructing a bidirectional modulated parasystole model. With Ts and Te as the intrinsic periods of the sinus and ectopic pacemakers, there are distinct and initial condition-dependent solutions in the model with Ts / Te values close to 1, 1/2, 1/4, etc.

Circulating matrix metalloproteinase-1 and -3 in patients with an acute coronary syndrome.

To elucidate the diagnostic value of serum matrix metalloproteinase (MMP) levels, we measured MMP-1 and MMP-3 by a 1-step sandwich enzyme immunoassay. The transcardiac gradients of both MMPs were greater in patients with unstable angina and acute myocardial infarction than in patients with stable effort angina or control patients. Serum MMP levels appear to be a marker of plaque instability in patients with acute coronary syndrome.

Prediction of short-term progression or regression of atherosclerotic coronary artery disease by lipoprotein (a): a quantitative coronary angiographic study.

This study assessed whether progression of coronary artery atherosclerotic lesions could be predicted in the short term using various lipid profiles. In 37 patients (61.9 +/- 9.

Fluvastatin attenuates nitrate tolerance in patients with ischemic heart disease complicating hypercholesterolemia.

Background: Long-term administration of nitrates results in the development of tolerance. Nitrate tolerance is considered to occur in association with oxidative stress, although its underlying mechanisms are multi-factorial. Fluvastatin, a newly developed statin, is considered to have not only a cholesterol-lowering effect but also anti-oxidative properties.