Early repolarization and myocardial scar predict poorest prognosis in patients with coronary artery disease.

Purpose: Recent studies show positive association of early repolarization (ER) with the risk of life-threatening arrhythmias in patients with coronary artery disease (CAD). This study was to investigate the relationships of ER with myocardial scarring and prognosis in patients with CAD.

Materials And Methods: Of 570 consecutive CAD patients, patients with and without ER were assigned to ER group (n=139) and no ER group (n=431), respectively.

Complex fractionated atrial electrograms related to left atrial wall thickness.

Introduction: The mechanism of complex fractionated atrial electrogram (CFAE) in patients with atrial fibrillation (AF) remains controversial. This study investigated the relationship between CFAE and left atrial (LA) wall thickness.

Methods And Results: LA muscular wall thickness (excluding fat) was measured by cardiac computed tomography in 31 patients with AF (12 paroxysmal, 19 persistent) prior to catheter ablation procedures.

Short stature and ischemic stroke in nonvalvular atrial fibrillation: new insight into the old observation.

Background: For decades, repeated epidemiologic observations have been made regarding the inverse relationship between stature and cardiovascular disease, including stroke. However, the concept has not been fully evaluated in patients with atrial fibrillation (AF). We investigated whether patient's height is associated with ischemic stroke in patients with nonvalvular AF and attempted to ascertain a potential mechanism.

Fragmented QRS as a candidate marker for high-risk assessment in hypertrophic cardiomyopathy.

Background: The relationship between a fragmented QRS complex (fQRS) on 12-lead ECG and fatal arrhythmic events in hypertrophic cardiomyopathy (HCM) remains unclear.

Objective: The purpose of this study was to investigate whether fQRS is associated with ventricular arrhythmic events (VAEs) in HCM patients.

Methods: Of an initial cohort of 273 patients (57% male, mean age 55 years) diagnosed with HCM, 167 patients were included and divided into 2 groups: those with fQRS (n = 67) and those without fQRS (n = 100).

Paced QT interval is a better predictor of mortality than the intrinsic QT interval: long-term follow-up study.

Background: Prolongation of the corrected QT (QTc) interval on 12-lead electrocardiogram is related to total mortality and sudden cardiac death. The value of the paced QTc interval in predicting mortality has not been investigated.

Objective: To evaluate the relationship between the paced QTc interval and mortality.

First-degree atrioventricular block is associated with advanced atrioventricular block, atrial fibrillation and left ventricular dysfunction in patients with hypertension.

Objectives: Clinical significance of first-degree atrioventricular block (AVB) have not been known in patients with hypertension. This study was performed to elucidate long-term prognosis of first-degree AVB in patients with hypertension.

Methods: We included 3816 patients (mean age, 61.

New-onset atrial fibrillation predicts long-term newly developed atrial fibrillation after coronary artery bypass graft.

Background: New-onset postoperative atrial fibrillation (POAF) is associated with poor short- and long-term outcomes after isolated coronary artery bypass graft (CABG). This study evaluated whether new-onset POAF is independently associated with long-term (>1 year) atrial fibrillation (AF) and mortality.

Methods: Among 1,171 consecutive patients who had undergone CABG, AF and mortality were compared between patients with POAF (POAF group, n = 244) and those without POAF (no-POAF group, n = 927) after propensity score matching.

Transvenous pacemaker lead removal in pacemaker lead endocarditis with large vegetations: a report of two cases.

Pacemaker lead endocarditis is treated with total removal of the infected device and proper antibiotics. The outcomes of patients undergoing percutaneous lead extraction for large vegetations (>2 cm) have not yet been shown. In this case report, we present two patients with pacemaker lead endocarditis with large vegetations of maximum diameter 2.

Atrial tachycardia originating from the aortomitral junction.

Atrial tachycardia (AT) originating from the aortomitral junction is a very rare and challenging disease. Its arrhythmic characteristics have not been described in detail compared with the descriptions of the arrhythmic characteristics of AT originating from the other locations. Only a few case reports have documented successful ablation of this type of AT using transaortic or transseptal approaches.

Effect of hypoxic paracrine media on calcium-regulatory proteins in infarcted rat myocardium.

Background And Objectives: An increase in intracellular calcium concentration due to loss of Ca(2+) homeostasis triggers arrhythmia or cardiac cell death in the heart. Paracrine factors released from stem cells have beneficial cardioprotective effects. However, the mechanism of modulation of Ca(2+) homeostasis by paracrine factors in ischemic myocardium remains unclear.

Multidetector computed tomography may be an adequate screening test to reduce periprocedural stroke in atrial fibrillation ablation: a multicenter propensity-matched analysis.

Background: Whether routine transesophageal echocardiography (TEE) in addition to multidetector computed tomography (MDCT) has incremental value in preventing periprocedural stroke before atrial fibrillation (AF) ablation is unclear.

Objective: The purpose of this study was to evaluate whether screening with MDCT is sufficient for preventing periprocedural stroke.

Methods: From 4 tertiary centers, we enrolled 1147 patients (902 males, age 57 ± 11 years) with optimal anticoagulation and preserved left ventricular ejection function who had undergone MDCT and routine TEE (group 1, n = 678) or selective TEE (group 2, n = 469) as screening tests before AF ablation.

Impact of increased orifice size and decreased flow velocity of left atrial appendage on stroke in nonvalvular atrial fibrillation.

The structural and functional characteristics of left atrial appendage (LAA) in patients with atrial fibrillation (AF) with previous stroke remain incompletely elucidated. This study investigated whether a larger LAA orifice is related to decreased LAA flow velocity and stroke in nonvalvular AF. The dimension, morphology, and flow velocity of LAA were compared in patients with nonvalvular AF with (stroke group, n = 67, mean age 66 ± 9 years) and without ischemic stroke (no-stroke group, n = 151, mean age 56 ± 10 years).

An electrocardiography algorithm combined with clinical features could localize the origins of focal atrial tachycardias in adjacent structures.

Aims: It is difficult to differentiate the origins of focal atrial tachycardias (ATs) in adjacent structures by electrocardiography (ECG) alone. The aim of this study was to evaluate whether the clinical features of these ATs may help differentiate their origins.

Methods And Results: One hundred and ninety-four patients (mean age, 43.

Distinct prognostic impacts of both atrial volumes on outcomes after radiofrequency ablation of nonvalvular atrial fibrillation: three-dimensional imaging study using multidetector computed tomography.

Background: Left atrial (LA) enlargement is associated with atrial fibrillation (AF) recurrence after radiofrequency ablation (RFA). However, impact of right atrial (RA) size on outcomes after RFA is unclear.

Methods: Patients who underwent RFA of AF (n=242, 197 men, 57 ± 11 years) were enrolled (159 paroxysmal [PaAF] and 83 persistent [PeAF]).

Chronic amiodarone therapy impairs the function of the superior sinoatrial node in patients with atrial fibrillation.

Background: The mechanisms underlying amiodarone-induced sinoatrial node (SAN) dysfunction remain unclear, so we used 3-dimensional endocardial mapping of the right atrium (RA) to investigate.

Methods And Results: In a matched-cohort design, 18 patients taking amiodarone before atrial fibrillation (AF) ablation (amiodarone group) were matched for age, sex and type of AF with 18 patients who had undergone AF ablation without taking amiodarone (no-amiodarone group). The amiodarone group had a slower heart rate than the no-amiodarone group at baseline and during isoproterenol infusion.

Post-shock sinus node recovery time is an independent predictor of recurrence after catheter ablation of longstanding persistent atrial fibrillation.

Background: Electro-anatomical remodeling of the atria has been reported to be associated with sinus node dysfunction in patients with atrial fibrillation (AF). We hypothesized that post-shock sinus node recovery time (PS-SNRT: the time from cardioversion to the earliest sinus node activation) is related to the degree of left atrial (LA) remodeling and the clinical outcome of radiofrequency catheter ablation (RFCA) in patients with longstanding persistent AF (L-PeAF).

Methods And Results: We included 117 patients with L-PeAF (82.

Routine preprocedural transesophageal echocardiography might not be necessary for stroke prevention evaluation in AF patients on anticoagulation therapy.

Background: Preprocedural transesophageal echocardiography (TEE) is used to reduce the stroke during atrial fibrillation (AF) ablation. This study evaluated whether routine preprocedural TEE in addition to multidetector computed tomography (MDCT) is necessary to prevent periprocedural stroke in AF ablation.

Methods: Each patient underwent MDCT and TEE (group 1, n=247) or MDCT alone (group 2, n=103) for the initial evaluation before AF ablation.

Alpha B-crystallin prevents the arrhythmogenic effects of particulate matter isolated from ambient air by attenuating oxidative stress.

Ca(2+)/calmodulin-dependent protein kinase II (CaMKII) is activated by particulate matter (PM) isolated from ambient air and linked to prolonged repolarization and cardiac arrhythmia. We evaluated whether alpha B-crystallin (CryAB), a heat shock protein, could prevent the arrhythmogenic effects of PM by preventing CaMKII activation. CryAB was delivered into cardiac cells using a TAT-protein transduction domain (TAT-CryAB).

Prolonged atrial effective refractory periods in atrial fibrillation patients associated with structural heart disease or sinus node dysfunction compared with lone atrial fibrillation.

Backgrounds: Atrial fibrillation (AF) is commonly associated with structural heart disease (SHD) or sinus node dysfunction (SND). We hypothesized that regional atrial effective refractory period (ERP) is different in patients with SHD/SND from lone AF.

Methods: We included 648 patients with AF (age, 56.

Fate of preoperative atrial fibrillation after correction of atrial septal defect.

Background: Atrial fibrillation (AF) is common among adult patients with an atrial septal defect (ASD). Catheter ablation or the Maze procedure can be considered for AF before or concurrently with ASD closure. However, the fate of preoperative AF is not well established.

Effect of a single bolus injection of low-dose hydrocortisone for prevention of atrial fibrillation recurrence after radiofrequency catheter ablation.

Background: The transient use of corticosteroid shortly after atrial fibrillation (AF) ablation might prevent immediate and mid-term AF recurrence; however, the effective dosage for preventing AF recurrence has not been determined. In this study, we evaluated whether low-dose hydrocortisone is effective for the prevention of AF recurrence after radiofrequency catheter ablation (RFCA).

Methods And Results: We enrolled 89 AF patients (70 males, 55.