Publications by authors named "Kohei Ukita"
It is unclear whether the impact of pre-reperfusion unloading on improving survival is sustained throughout all periods from the onset in patients with ST-segment-elevation myocardial infarction (STEMI). This study is a post-hoc analysis of the J-PVAD registry. Among all patients registered in J-PVAD between February 2020 and December 2021, patients with STEMI complicated with cardiogenic shock and treated with Impella alone support were selected.
View Article and Find Full Text PDFWe describe a case where right superior pulmonary vein was not reconnected at the beginning of the third radiofrequency catheter ablation (RFCA) for atrial fibrillation but was reconnected at the beginning of the fourth RFCA. This is a case of pulmonary vein reconnection in the chronic phase after successful pulmonary vein isolation.
View Article and Find Full Text PDFBackground: Little has been reported on the predictors of late recurrence (LR) after second radiofrequency catheter ablation (RFCA) for persistent atrial fibrillation (AF).
Objective: This study aimed to identify the predictors of LR after second RFCA in patients with persistent AF.
Methods: We retrospectively analyzed 123 patients who underwent a second RFCA because of LR after the initial RFCA for persistent AF.
Introduction: The impact of combining ablation index (AI)-guided and very high-power short-duration (vHPSD) ablation on procedural factors at the posterior wall near the esophagus is unclear.
Methods: Atrial fibrillation patients who underwent initial ablation using three-dimensional mapping were enrolled. Patients were classified into two groups: those who underwent only AI-guided pulmonary vein isolation (PVI) (AI group) and those who underwent vHPSD ablation at the posterior wall adjacent to the esophagus in addition to AI-guided PVI (AI + vHPSD group).
Article Synopsis
- Heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) are associated with serious health risks, but maintaining sinus rhythm (SR) post-catheter ablation (CA) has shown benefits over standard medical treatment.
- A study of 244 AF patients with HFpEF compared outcomes between those maintaining SR after their first CA and those after a repeat CA, finding similar rates of adverse health events over three years.
- The results indicate that maintaining SR after a repeat CA does not offer additional benefits compared to maintaining SR after the initial CA, suggesting both approaches are equally effective in managing these patients.
Article Synopsis
- The study investigates the impact of P-wave morphology (specifically duration and vector magnitude) on health outcomes in patients with acute anterior myocardial infarction (MI) caused by blockage in the left anterior descending artery.
- Researchers enrolled 426 patients and found a significant cut-off value for predicting complications like heart failure hospitalization and death, using specific P-wave measurements.
- Results showed that patients with high P-wave duration/vector magnitude had a greater risk of adverse outcomes, while age and performance of the heart also played critical roles in predicting these outcomes.
Risk factors for tachycardia-induced cardiomyopathy due to atrial fibrillation.
Pacing Clin Electrophysiol
August 2024
Background: Tachycardia-induced cardiomyopathy (TIC) is a reversible cardiomyopathy with ventricular dysfunction caused by tachyarrhythmias. Notably, atrial fibrillation (AF) is the most common causal arrhythmia leading to TIC. However, the risk factors for the development of TIC due to AF remain unclear.
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- The study analyzed the effects of coronary angioscopy (CAS) findings after the implantation of two types of stents: a polymer-free biolimus A9-coated stent (PF-BCS) and a durable polymer everolimus-eluting stent (DP-EES) in 99 patients, with evaluations done at 1 and 12 months post-implantation.
- Results showed a decrease in thrombi and yellow plaque from 1 month to 12 months, with no new thrombi but some new yellow plaque observed in patients with DP-EES.
- Key factors affecting thrombi development included management of diabetes, stent area, and stent coverage, highlighting that polymer
Aims: Catheter ablation (CA) of atrial fibrillation (AF) improves left ventricular ejection fraction (LVEF) in patients with heart failure with reduced ejection fraction (HFrEF). The impact of ST-segment depression before CA on LVEF recovery and clinical outcomes remains unknown. In the present study, we aimed to investigate the relationship between ST-segment depression during AF rhythm before CA and improvement in the LVEF and clinical outcomes in persistent atrial fibrillation (PerAF) patients with HFrEF.
View Article and Find Full Text PDFChanges in QRS morphology during antidromic atrioventricular reentrant tachycardia.
Pacing Clin Electrophysiol
November 2024
Article Synopsis
- A 44-year-old male experienced symptomatic supraventricular tachycardia (SVT) with a wide QRS complex and underwent an electrophysiological study to diagnose the condition.
- The SVT was identified as antidromic atrioventricular reentrant tachycardia (AVRT) involving an accessory pathway, with a noticeable change in QRS morphology during the episode before it resolved spontaneously.
- Successful mapping and radiofrequency treatment eliminated the accessory pathway, making the tachycardia episodes unable to occur again, marking a unique case in clinical findings.
Background: It has not been fully elucidated which patients with persistent atrial fibrillation (PerAF) should undergo substrate ablation plus pulmonary vein isolation (PVI). This study aimed to identify PerAF patients who required substrate ablation using intraprocedural assessment of the baseline rhythm and the origin of atrial fibrillation (AF) triggers.
Methods and results: This was a post hoc subanalysis using extended data of the EARNEST-PVI trial, a prospective multicenter randomized trial comparing PVI-alone and PVI-plus (i.
Drug-eluting stents have significantly contributed to reducing mortality in patients with ST-segment elevation myocardial infarctions (STEMIs), but slow-flow/no-reflow phenomenon (SFNR) and in-stent restenosis are still clinical problems. In contrast, perfusion balloons (PBs) can compress thrombi and ruptured plaque for long inflation without ischemia and can be used as a delivery device for infusion of nitroprusside to distal risk area during ballooning. We conducted a Reduction of risk bY perfUsion balloon for ST-segment Elevated myocardial Infarction (RYUSEI) study to evaluate whether PBs before stenting are more effective than conventional stenting for STEMIs.
View Article and Find Full Text PDFSuccessful catheter ablation of atrial tachycardia initiated with orthodromic capture of superior vena cava potentials.
Herzschrittmacherther Elektrophysiol
June 2024
A case of successful catheter ablation of paroxysmal atrial fibrillation and atrial tachycardia is reported. After pulmonary vein isolation, atrial tachycardia was induced by the use of isoproterenol and burst pacing from the catheter in the right atrium. An attempt was made to create a three-dimensional (3D) map of the atrial tachycardia, but the atrial tachycardia was terminated in the middle of the mapping.
View Article and Find Full Text PDFBackground: Residual non-pulmonary vein (PV) foci are significantly associated with atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). However, we previously reported among patients with non-PV foci induced only once, none experienced AF recurrence. Thus, we aimed to investigate the correlation between the residual induction number of non-PV foci and ablation outcome in paroxysmal AF patients.
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- Pulmonary vein isolation (PVI) changes P-wave parameters in patients, but differences between radiofrequency catheter ablation (RFCA) and cryoballoon ablation (CBA) regarding P-wave vector magnitude (Pvm) are not fully understood.
- * The study analyzed 426 patients, showing that ΔPvm (change in Pvm) was significantly larger in the CBA group compared to the RFCA group, indicating better outcomes with CBA.
- * Additionally, lower ΔPvm values were linked to a higher risk of late arrhythmia recurrence in both RFCA and CBA groups, suggesting that monitoring ΔPvm could be crucial for patient prognosis.*
Article Synopsis
- The study investigates how low LDL cholesterol, anemia, and low platelet levels affect outcomes in heart failure patients with preserved ejection fraction (HFpEF).
- Using data from 1021 hospitalized patients, they created a scoring system (LEP score) to evaluate the risk of all-cause death and heart failure readmission based on these factors.
- The findings showed that higher LEP scores correlated with an increased risk of negative outcomes, highlighting the importance of monitoring these three components in managing HFpEF patients.
Article Synopsis
- The study investigates how the duration of atrial fibrillation (AF) affects the success of catheter ablation in patients with long-standing AF (LsAF).
- It found that patients with LsAF lasting 1-2.4 years have similar outcomes to those with persistent AF (PerAF), but those with LsAF over 2.4 years face a higher risk of arrhythmia recurrence.
- Additionally, patients with LsAF over 2.4 years might benefit more from a combined ablation strategy (PVI-plus) than from a standard approach (PVI-alone).
Article Synopsis
- The study examined factors affecting 30-day survival rates after urgent coronary interventions for patients experiencing life-threatening heart rhythm issues linked to heart attacks.
- 55 patients were analyzed, grouped by whether they survived beyond 30 days (survival group) or died within that timeframe (death group), focusing on their characteristics and medical procedures.
- Key findings revealed that immediate cardiopulmonary resuscitation (CPR) and having single-vessel coronary artery disease significantly predicted better survival outcomes, while absence of diabetes and low arterial lactate also correlated positively with survival.
Heart failure (HF) readmission post-transcatheter aortic valve implantation (TAVI) is common; however, its anatomical predictors remain unclear. This study identified a small systolic left ventricular inflow-outflow (LVIO) angle, evaluated using computed tomography, as a potential anatomical predictor associated with HF readmission post-TAVI. Patients with a small systolic LVIO angle may require close follow-up post-TAVI.
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- The study investigates how P-wave morphology affects clinical outcomes and arrhythmia recurrence in patients with paroxysmal atrial fibrillation after undergoing cryoballoon ablation.
- A total of 269 patients were analyzed, focusing on P-wave duration and vector magnitude, with a significant correlation found between higher values and late recurrence of atrial fibrillation (LRAF).
- Results indicated that those with higher P-wave metrics had lower myocardial injury markers and a higher likelihood of developing atrial tachycardia, suggesting the P-wave characteristics can be key predictors in post-ablation outcomes.
The impact of cryoballoon ablation (CBA) for atrial fibrillation (AF) in patients with enlarged left atrium (E-LA) has not been sufficiently clarified. A total of 306 patients underwent an initial CBA for paroxysmal AF between February 2017 and March 2022 in our hospital. These patients were categorized into 2 groups according to the preprocedural left atrium (LA) diameter (LAD): E-LA group with LAD ≥40 mm and normal LA (N-LA) group with LAD <40 mm.
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