Publications by authors named "Kengo Kusano"

Unlabelled: The modified bicaval anastomosis technique is an orthotopic heart transplantation technique that preserves the posterior wall of the right atrium as a bridging tissue, creating a dual structure of the recipient and donor hearts between the superior and inferior venae cavae. In this report, we present a case with unique electrophysiological findings following heart transplantation using this technique. The patient, who had persistent atrial fibrillation before the procedure, achieved a maintained sinus rhythm afterward.

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[Arrhythmia].

No Shinkei Geka

November 2024

Article Synopsis
  • The main goals in treating atrial fibrillation (AF) are to prevent strokes using anticoagulants, manage heart rhythm and rate with medications, and explore non-drug therapies like catheter ablation.* -
  • Catheter ablation, which helps improve life quality by addressing AF symptoms, has advanced significantly, with new methods such as balloon ablation and pulsed-field ablation showing fewer complications.* -
  • Surgical methods for treating AF are also becoming less invasive, with innovations like robotic surgery and the Wolf-Ohtsuka procedure, highlighting the need for improved collaboration among heart care teams in future research.*
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Article Synopsis
  • * AAs were the first symptom of IAS in 52% of patients, and nearly a quarter had multiple AAs documented.
  • * The study found a moderate incidence of severe outcomes, including a yearly primary endpoint rate of 1.4%, with younger patients experiencing higher risks and other complications affecting some patients as well.
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Background: Although the MADIT-ICD benefit score (MBS) helps select suitable implantable cardioverter defibrillator (ICD) candidates, optimal indicators for cardiac resynchronization therapy (CRT) remain uncertain. Evaluating the applicability of the MBS in Japanese CRT patients is imperative.

Methods And Results: This multicenter study assessed the cumulative incidence of ventricular tachycardia/fibrillation (VT/VF) and non-arrhythmic mortality (AM) in CRT patients grouped according to potential benefit (lowest, highest, and intermediate).

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Sudden cardiac death (SCD) is responsible for 15%-20% of deaths globally/year, predominantly due to ventricular arrhythmias (VA) caused by vulnerable cardiac substrate. Identifying those at risk has proved difficult with several limitations of current methods. We evaluated the evidence for magnetocardiography (MCG) in predicting SCD events.

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Background: We aimed to quantify the incidence of atrial fibrillation (AF) in patients with cryptogenic stroke globally, as well as separately in patients in and outside of Japan, using an implantable loop recorder from a prospective, observational, Reveal LINQ Registry.

Methods And Results: Patients developing cryptogenic stroke and monitored by implantable loop recorder for searching AF were studied. The primary end point was incidence of AF within 36 months after insertion.

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Article Synopsis
  • The Japanese Catheter Ablation (J-AB) registry, launched in August 2017, is a nationwide voluntary study led by the Japanese Heart Rhythm Society focused on collecting data about catheter ablation procedures.
  • In January 2022, the registry's data collection system shifted from REDCap to the Fountayn system to improve data management.
  • By the end of 2022, the registry compiled data from 90,042 procedures across 614 hospitals, highlighting the types of arrhythmias, outcomes, and complications, with participants averaging 66.7 years old and 65.9% being male.
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Article Synopsis
  • About 15% to 20% of long QT syndrome (LQTS) patients are genotype-negative (GEN-), leading to uncertainties in their risk and treatment compared to genotype-positive (GEN+) patients.
  • The study evaluated 832 LQTS patients in Japan and Italy, finding that GEN- patients had more cardiac events and less family history of LQTS, especially in Japan.
  • Despite some differences, the study concluded that the arrhythmic risk and clinical outcomes were similar for both GEN+ and GEN- patients, suggesting they should be managed the same way.
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  • The study explored the timing for surgery in patients with asymptomatic or slightly symptomatic chronic severe aortic regurgitation but with normal heart function, involving 210 patients to assess treatment plans and outcomes.
  • In two distinct studies, one group (Study A) followed a watchful waiting approach, revealing that survival rates matched those of the general population, while another group (Study B) evaluated surgical outcomes after aortic valve replacement, highlighting certain risks associated with heart chamber size.
  • The findings suggest that watchful waiting is a safe option, but left ventricular size over 45 mm before surgery is a key indicator of poor postoperative results, potentially guiding future treatment decisions.
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Article Synopsis
  • Patients with improved left ventricular ejection fraction (LVEF >35%) after cardiac resynchronization therapy (CRT) have a lower risk of ventricular arrhythmia (VA) compared to those with low LVEF.
  • The study involved 352 CRT patients, measuring serum B-type natriuretic peptide (BNP) levels after 6 months, showing that lower BNP levels correlate with a reduced risk of VA.
  • High post-CRT BNP levels could indicate a greater risk of VA in patients who have improved LVEF, making BNP a useful predictor for VA risk in these patients.
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Article Synopsis
  • - This study focused on the safety and effectiveness of catheter ablation for treating atrial fibrillation (AF) in elderly patients, analyzing data from 170,017 procedures over four years.
  • - Despite an increase in procedures for patients aged 80 and older, the overall complications rate was 2.8%, with higher risks as age increased, especially for those 85 and older.
  • - Recurrence rates of AF after ablation were consistent across different age groups, indicating that with proper patient selection, AF ablation is a viable treatment option for older adults.
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Background: The SMART Pass algorithm for subcutaneous implantable cardioverter-defibrillator prevents inappropriate shocks due to oversensing. The mechanisms and significance of SMART Pass deactivation remain unclear.

Objective: The objective of this study was to assess whether SMART Pass deactivation is associated with inappropriate shocks and to elucidate the underlying mechanism.

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Background: Predicting the origin of premature ventricular contraction (PVC) from the preoperative electrocardiogram (ECG) is important for catheter ablation therapies. We propose an explainable method that localizes PVC origin based on the semantic segmentation result of a 12-lead ECG using a deep neural network, considering suitable diagnosis support for clinical application.

Methods: The deep learning-based semantic segmentation model was trained using 265 12-lead ECG recordings from 84 patients with frequent PVCs.

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Article Synopsis
  • An implantable loop recorder (ILR) is used to help diagnose unexplained syncope, especially in patients with inherited arrhythmia syndromes, like long-QT syndrome (LQTS), even though its effectiveness in detecting arrhythmias in LQTS is still debated.
  • A case study of a 19-year-old female with LQTS type 1 showed that despite being on beta-blocker therapy, she continued to experience syncope without documented arrhythmias, leading to the decision to use the ILR for continuous monitoring.
  • After two years, the ILR successfully recorded critical heart activity during a syncopal episode, revealing significant QT interval prolongation and T-wave alternance, thus emphasizing the potential of
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Background: This study compared the stability of the Medtronic Attain Stability Quad (ASQ), a novel quadripolar active fixation left ventricular (LV) lead with a side helix, to that of conventional quadripolar leads with passive fixation (non-ASQ) and evaluated their LV lead performance.

Methods And Results: In all, 183 consecutive patients (69 ASQ, 114 non-ASQ) who underwent cardiac resynchronization therapy (CRT) between January 2018 and June 2021 were enrolled. Complications, including elevated pacing capture threshold (PCT) levels, phrenic nerve stimulation (PNS), and LV lead dislodgement, were analyzed during the postimplantation period until the first outpatient visit after discharge.

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Background: Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of hospitalization for heart failure and cardiovascular death with type 2 diabetes; however, their effect on arrhythmias is unclear. The purpose of this study was to investigate the effects of empagliflozin on ventricular arrhythmias in patients with type 2 diabetes.

Methods: A total of 150 patients with type 2 diabetes who were treated with an implantable cardioverter-defibrillator or cardiac resynchronization therapy defibrillator (ICD/CRT-D) were randomized to once-daily empagliflozin or placebo for 24 weeks.

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