Deep Learning-Based Recurrence Prediction of Atrial Fibrillation After Catheter Ablation.

Background: Radiofrequency catheter ablation (RFCA) is an effective therapy for atrial fibrillation (AF). However, it the problem of AF recurrence remains. This study investigates whether a deep convolutional neural network (CNN) can accurately predict AF recurrence in patients with AF who underwent RFCA, and compares CNN with conventional statistical analysis.

Safety and feasibility of implanting a transvenous implantable cardioverter defibrillator (TV-ICD) in the left axilla.

Background: Transvenous implantable cardioverter defibrillator (TV-ICD) systems are commonly implanted in the left anterior chest because of an easier implantation and better defibrillation threshold. This study aimed to evaluate the safety and feasibility of left axillary implantations of TV-ICD systems.

Methods: We performed left axillary TV-ICD implantations and compared that to the major complication rate and operation time of the conventional TV-ICD implantation site (left anterior chest).

Impact of right atrial structural remodeling on recurrence after ablation for atrial fibrillation.

Background: Recurrence of atrial fibrillation (AF) after pulmonary vein isolation (PVI) is associated with left atrial (LA) remodeling; however, its association with right atrial (RA) remodeling remains unclear.

Objective: This study aimed to identify whether RA structural remodeling could predict recurrence of AF after PVI.

Methods: This study prospectively analyzed 245 patients with AF who had undergone PVI.

Impact of atrial mitral and tricuspid regurgitation on atrial fibrillation recurrence after ablation.

Background: Atrial fibrillation (AF) induces functional mitral regurgitation (FMR) and tricuspid regurgitation (FTR) during atrial remodeling. FMR and FTR are associated with AF prognosis, but the effects for AF recurrence after ablation have not been determined conclusively.

Methods: Two hundred thirty nine patients who underwent AF ablation were enrolled.

Lesion size and adjacent tissue damage assessment with high power and short duration radiofrequency ablation: comparison to conventional radiofrequency ablation power setting.

There is increased interest in creating high-power short duration (HPSD) ablation lesions in the field of atrial fibrillation (AF) radiofrequency ablation (RFA). We evaluated the lesion characteristics and collateral damage using two separate RFA protocols setting (HPSD: 50 W and 7 s vs control: 25 W and 30 s) in vitro model. Sixteen freshly killed porcine hearts were obtained, and the atrium and ventricle slabs were harvested for ablation.

The Association of Cardio-Ankle Vascular Index (CAVI) with Biatrial Remodeling in Atrial Fibrillation.

Aim: Arterial stiffness results in elevated left ventricular filling pressure and can promote atrial remodeling due to chronic pressure overload. However, the impact of arterial stiffness on the process of atrial remodeling in association with atrial fibrillation (AF) has not been fully evaluated.

Methods: We enrolled 237 consecutive patients diagnosed with AF who had undergone ablation; data from 213 patients were analyzed.

The impact of sleep apnea on right atrial structural remodeling with atrial fibrillation.

Background: Atrial remodeling associated with atrial fibrillation (AF) and sleep apnea is well known. Although sleep apnea is known to be associated with left atrial (LA) remodeling, its association with right atrial (RA) remodeling remains unclear. The study aimed to investigate the effect of sleep apnea on RA remodeling.

Analysis of Financial Factors Which Driving the Operating Margins of 880 Public Hospitals in Japan Using a Business Intelligence System.

Management improvement was strongly required at public hospital and Local Incorporated Administrative Agency hospitals in Japan. We analysed financial statements of 880 public hospitals using Business Intelligence System. In order to raise the efficiency of management, it is important to have patients with a high profitability (seriously ill patients) at municipal hospitals; whereas, in Local Incorporated Administrative Agency hospitals, avoiding producing ordinary losses and not incurring excessive expenses will be important for management improvement.

Paget-Schroetter Syndrome Resulting from Thoracic Outlet Syndrome and KAATSU Training.

A 29-year-old woman who worked as a KAATSU (a type of body exercise that involves blood flow restriction) instructor visited our emergency room with a chief complaint of swelling and left upper limb pain. Chest computed tomography (CT) showed non-uniform contrast images corresponding to the site from the left axillary vein to the left subclavian vein; vascular ultrasonography of the upper limb revealed a thrombotic obstruction at the same site, leading to a diagnosis of Paget-Schroetter syndrome (PSS). We herein report our experience with a case of PSS derived from thoracic outlet syndrome (TOS), in a patient who was a KAATSU instructor.

A case of transient apical hypertrophy associated with coronary vasospasm.

A 49-year-old woman was admitted to our hospital because of repeated loss of consciousness. On arrival, she was in cardiopulmonary arrest associated with arrhythmia of Torsades de pointes, and recovered from it after cardiopulmonary resuscitation and defibrillation. The administration of a β-blocker and amiodarone was initiated to prevent ventricular tachycardia.

Decreased Defibrillation Threshold and Minimized Myocardial Damage With Left Axilla Implantable Cardioverter Defibrillator Implantation.

Background: To reduce myocardial damage caused by implantable cardioverter defibrillator (ICD) shock, the left axilla was studied as an alternative pulse generator implantation site, and compared with the traditional implantation site, the left anterior chest.

Methods and results: Computer simulation was used to study the defibrillation conduction pattern and estimate the simulated defibrillation threshold (DFT) and myocardial damage when pulse generators were placed in the left axilla and left anterior chest, respectively; pulse generators were also newly implanted in the left axilla (n=30) and anterior chest (n=40) to compare the corresponding DFT. On simulation, when ICD generators were implanted in the left axilla, compared with the left anterior chest, the whole heart may be defibrillated with a lower defibrillation energy (left axilla 6.

Efficacy and Myocardial Injury With Subcutaneous Implantable Cardioverter Defibrillators - Computer Simulation of Defibrillation Shock Conduction.

Background: Subcutaneous implantable cardiac defibrillator (S-ICD) systems have a lower invasiveness than traditional ICD systems, and expand the indications of ICD implantations. The S-ICD standard defibrillation shock output energy, however, is approximately 4 times that of the traditional ICD system. This raises concern about the efficacy of the defibrillation and myocardial injury.

Evaluation of defibrillation safety and shock reduction in implantable cardioverter-defibrillator patients with increased time to detection: A randomized SANKS study.

Background: The need for ways to minimize the number of implantable cardioverter-defibrillator (ICD) shocks is increasing owing to the risk of its adverse effects on life expectancy. Studies have shown that a longer detection time for ventricular tachyarrhythmia reduces the safety of therapies, in terms of syncope and mortality, but not substantially in terms of the success rate. We aimed to evaluate the effects of increased number of intervals to detect (NID) VF on the safety of ICD shock therapy and on the reduction of inappropriate shocks.

Left axillary pacemaker generator implantation with a direct puncture of the left axillary vein.

Background: Pacemaker generators are routinely implanted in the anterior chest. However, where to place the generator may need to be considered from the mental, functional, and cosmetic standpoints.

Methods: In this study, we performed the left axillary pacemaker generator implantation with a direct puncture of the left axillary vein in 40 consecutive patients, and evaluated the late safety and efficacy of this implantation.