Publications by authors named "Mitsuru Takami"

Atrial fibrillation (AF) is strongly associated with strokes, heart failure, and increased mortality. This study aims to identify the monocyte-macrophage heterogeneity and interactions of these cells with non-immune cells, and to identify functional biomarkers in patients with AF. Therefore, we assess the single cell landscape of left atria (LA), using a combination of single cell and nucleus RNA-seq.

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Aims: Several algorithms can differentiate inferior axis premature ventricular contractions (PVCs) originating from the right side and left side on 12-lead electrocardiograms (ECGs). However, it is unclear whether distinguishing the origin should rely solely on PVC or incorporate sinus rhythm (SR). We compared the dual-rhythm model (incorporating both SR and PVC) to the PVC model (using PVC alone) and quantified the contribution of each ECG lead in predicting the PVC origin for each cardiac rotation.

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The 88Annual Scientific Meeting of the Japanese Circulation Society (JCS2024) was held from Friday, March 8to Sunday, March 10in Kobe, Japan. The main theme of this 3-day meeting was "The Future of Cardiology: Challenges in Overcoming Cardiovascular Disease". As COVID-19 has been finally conquered, with revision of its categorization under the Infectious Disease Control Law and relaxation of infection prevention measures, it was once again possible to have face-to-face presentations and lively discussion.

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Background: Despite the positive impact of implantable cardioverter defibrillators (ICDs) and wearable cardioverter defibrillators (WCDs) on prognosis, their implantation is often withheld especially in Japanese heart failure patients with reduced left ventricular ejection fraction (HFrEF) who have not experienced ventricular tachycardia (VT) or ventricular fibrillation (VF) for uncertain reasons. Recent advancements in heart failure (HF) medications have significantly improved the prognosis for HFrEF. Given this context, a critical reassessment of the treatment and prognosis of ICDs and WCDs is essential, as it has the potential to reshape awareness and treatment strategies for these patients.

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Article Synopsis
  • Atrioventricular nodal reentrant tachycardia (AVNRT) can return even after successful ablation of the slow pathway, prompting a study on recurrence reasons in 46 patients.
  • The study found that while many patients initially had successful RF ablation targeting the rightward inferior extension (RIE), some still experienced recurrent AVNRT, with various types showing up in follow-up cases.
  • Most recurrences were treated successfully again within the RIE area, and notably, the new successful ablation sites were often higher than where the initial procedure targeted.
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There is a strong demand for remote monitoring systems to gather health data. This study investigated the safety, usefulness, and patient satisfaction in outpatient care using telehealth with real-time electrocardiogram (ECG) monitoring after catheter ablation. In all, 38 patients who underwent catheter ablation were followed up using telehealth.

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Introduction: Intermuscular implantations of subcutaneous implantable cardioverter-defibrillators (S-ICD) have been recommended, but the position of the anterior border of the latissimus dorsi muscle (LDM) has not previously been evaluated in establishing an incision line to facilitate the intermuscular approach. The objective of this study is to evalua the position and trend of the anterior border of the LDM in patients who are candidates for implantable cardioverter-defibrillators.

Methods: The distance from the back to the anterior border of the LDM (A) and the anterior-posterior width of the chest wall (B) were measured on computed tomography retrospectively, and the ratio (=A/B) was used as the position of the anterior border of the LDM.

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Knowing the vascular anatomy of the common femoral artery bifurcation and ultrasound-guided puncture, including doppler, is helpful in recognizing anatomic variations and avoiding complications.

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Introduction: Data are lacking on the extent to which patients with non-valvular atrial fibrillation (AF) who are aged ≥80 years benefit from ablation treatment. The question pertains especially to patients' postablation quality of life (QoL) and long-term clinical outcomes.

Methods And Analysis: We are initiating a prospective, registry-based, multicentre observational study that will include patients aged ≥80 years with non-valvular AF who choose to undergo treatment by catheter ablation and, for comparison, such patients who do not choose to undergo ablation (either according to their physician's advice or their own preference).

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Article Synopsis
  • VT non-inducibility after radiofrequency (RF) ablation is generally linked to a lower chance of ventricular tachycardia (VT) recurrence, but its routine use as an endpoint is debated.
  • A study analyzed 62 patients who did not achieve VT non-inducibility post-ablation, finding that 35% experienced VT recurrences over two years.
  • Key factors influencing lower VT recurrence included a left ventricular ejection fraction (LVEF) of 35% or higher and the successful elimination of clinical VT during the procedure.
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Background: Lesion gaps assessed by late-gadolinium enhancement magnetic resonance imaging (LGE-MRI) are associated with the atrial fibrillation (AF) recurrence after pulmonary vein isolation. Animal studies have demonstrated that the catheter-contact force (CF), stability, and orientation are strongly associated with lesion formation. However, the impact of those procedural factors on the lesion characteristics associated with AF recurrence has not been well discussed.

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Background: It is uncertain whether cardiac resynchronization therapy with a defibrillator (CRT-D) provides better survival benefits than a CRT-pacemaker (CRT-P) in heart failure patients with a reduced ejection fraction (≦35%, HFrEF) treated with contemporary HF therapy.

Methods: We retrospectively analyzed the ventricular arrhythmia (VAs; sustained ventricular tachycardia/fibrillation) events in HFrEF patients who underwent CRT without a prior history of VAs or aborted sudden cardiac death before the CRT implantation. Between January/2010 and December/2020, a CRT device was implanted in 79 HFrEF patients (mean age: 69 ± 12 years, male: 57, ischemic cardiomyopathy: 16).

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The management of heart rhythm disorders in patients with adult congenital heart disease and limited vascular access is challenging. We present the case of a 38-year-old woman with Ebstein's anomaly who underwent implantation of a combination of a leadless pacemaker and a subcutaneous implantable cardioverter-defibrillator to manage fatal arrhythmias. ().

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Article Synopsis
  • Recent research indicates that catheter ablation significantly lowers the risk of death or hospitalization for heart failure in patients with atrial fibrillation (AF) and heart failure with mid-range or preserved ejection fraction, contrasting with medical therapy.
  • A study involving 899 AF patients showed that those who underwent catheter ablation (525) had better outcomes compared to those who received medical treatment (374), with notable reductions in serious cardiovascular events.
  • With a follow-up period of about 24.6 months, the ablation group had a 68% lower risk (hazard ratio of 0.32) for the combined outcomes of cardiovascular death and heart failure hospitalizations compared to the medical therapy group.
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Article Synopsis
  • - The study investigates why atrial fibrillation (AF) recurrence rates differ between sexes, focusing on the roles of non-pulmonary vein (PV) foci and epicardial adipose tissue (EAT).
  • - Data from 304 patients revealed that females had more non-PV foci and less EAT around the atrium compared to males, with specific patterns observed in the left atrial wall.
  • - Key predictors for AF recurrence included female sex, presence of non-PV foci, left atrial diameter, and septal EAT, with notable differences in predictors between males and females.
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Article Synopsis
  • * After a median follow-up of 14.2 months, the study found that 20.7% of patients experienced AF recurrence, and only those in the successful group had significant improvements in left atrial (LA) distensibility and stroke volume index post-procedure.
  • * Key independent predictors of AF recurrence included the left ventricular ejection fraction and the baseline Δ LA expansion index, making the latter a reliable marker for assessing RFCA success and indicating improved cardiac
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Background: Corticosteroids are widely used in patients with cardiac sarcoidosis (CS). In addition, upgrading to cardiac resynchronization therapy (CRT) is sometimes needed. This study aimed to investigate the impact of corticosteroid use on the clinical outcomes following CRT upgrades.

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Introduction: The skin overlying cardiovascular implantable electronic devices (CIEDs) sometimes becomes very thin after implantations, which could cause a device erosion. The factors related to the skin thickness of device pockets have not been elucidated. This study aimed to evaluate the skin thickness of CIED pockets and search for the factors associated with the thickness.

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Background: Several algorithms have been proposed for differentiating the right and left outflow tracts (RVOT/LVOT) arrhythmia origins from 12-lead electrocardiograms (ECGs); however, the procedure is complicated. A deep learning (DL) model, a form of artificial intelligence, can directly use ECGs and depict the importance of the leads and waveforms. This study aimed to create a visualized DL model that could classify arrhythmia origins more accurately.

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Background: Some of atrial fibrillation (AF) drivers are found in normal/mild late-gadolinium enhancement (LGE) areas, as well as moderate ones. The atrial wall thickness (AWT) has been reported to be important as a possible AF substrate. However, the AWT and degree of LGEs as an AF substrate has not been fully validated in humans.

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