Publications by authors named "Moonhyoung Lee"
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.
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).
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).
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.
View Article and Find Full Text PDFBackground: 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.
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.
Renal Outcomes of Rhythm Control in Patients Recently Diagnosed With Atrial Fibrillation.
JACC Clin Electrophysiol
November 2024
Article Synopsis
- 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.
Article Synopsis
- 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.
Article Synopsis
- 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.
Article Synopsis
- 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.
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.
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.
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.
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.
View Article and Find Full Text PDFBackground: 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.
Article Synopsis
- The study investigates how radiofrequency catheter ablation (RFCA) affects right ventricular (RV) function in patients with different types of atrial fibrillation (AF).
- Researchers measured various RV function parameters before and after the procedure in patients with paroxysmal AF (PAF), persistent AF (PeAF), and long-standing persistent AF (LSPeAF).
- Results showed that patients with PeAF saw significant improvements in RV function after RFCA, while those with LSPeAF had more severe impairment and less improvement compared to the other groups.
Background: A study was designed to investigate whether the coronary artery disease polygenic risk score (CAD-PRS) may guide lipid-lowering treatment initiation as well as deferral in primary prevention beyond established clinical risk scores.
Methods And Results: Participants were 311 799 individuals from the UK Biobank free of atherosclerotic cardiovascular disease, diabetes, chronic kidney disease, and lipid-lowering treatment at baseline. Participants were categorized as statin indicated, statin indication unclear, or statin not indicated as defined by the European and US guidelines on statin use.
Article Synopsis
- The study investigates the relationship between extra-pulmonary vein triggers (ExPVTs) and low-voltage scar areas (LVAs) in patients with atrial fibrillation (AF) after catheter ablation.
- Out of 2255 patients, 181 (10.7%) had ExPVTs, with a significant association between the presence of ExPVTs and lower mean left atrial voltage.
- Patients with ExPVTs experienced higher recurrence rates of AF post-ablation, but the location of these triggers did not influence rhythm outcomes.
Article Synopsis
- A study examined whether adjusting radiofrequency (RF) energy based on left atrial wall thickness (LAWT) during circumferential pulmonary vein isolation (CPVI) improved outcomes for patients with paroxysmal atrial fibrillation (PAF).
- 212 patients were divided into two groups: one received LAWT-guided CPVI while the other underwent conventional CPVI, both using specific RF delivery protocols.
- After an average follow-up of 13.4 months, results showed no significant differences in clinical recurrence rates, major complications, and other procedural outcomes between the two groups, indicating that the tailored approach did not enhance safety or efficacy.
Article Synopsis
- The study investigated how gaps in pulmonary vein isolation (PVI) affect the recurrence of atrial fibrillation (AF) using a digital model of human AF.
- It included 50 patients, primarily with persistent AF, and analyzed the relationship between PVI gaps, final rhythm status, and other factors across 600 AF episodes.
- Findings showed that antral PVI led to a lower rate of AF recurrence compared to ostial PVI, and more PVI gaps were associated with higher AF recurrence rates, especially when extra-PV induction was involved.
Background: This study aimed to evaluate racial differences in the incidence of stroke by conducting an ecological epidemiological study using UK Biobank and Korean nationwide data.
Methods: This study used individual data from the Korean National Health Insurance Service-Health Screening and UK Biobank, which included participants who underwent health examinations between 2006 and 2010. We included 112,750 East Asians (50.
Background: This study aimed to evaluate racial differences in bleeding incidence by conducting an ecological epidemiological study using data from Korea and the United Kingdom.
Methods: We included healthy participants from the Korean National Health Insurance Service-Health Screening and the UK Biobank who underwent health examinations between 2006 and 2010 and had no comorbidities or history of medication use. Finally, 112,750 East Asians (50.
Background: Although successful atrial fibrillation (AF) ablation can maintain sinus rhythm and reduce the left atrial (LA) dimension, blunted LA reverse remodeling can be observed in patients with atrial myopathy. We explored the potential mechanisms and long-term outcomes in patients with blunted LA reverse remodeling after successful AF catheter ablation.
Methods And Results: We included 1685 patients who underwent baseline and 1-year follow-up echocardiograms, had a baseline LA dimension ≥40 mm, and did not have a recurrence of AF within a year.