Publications by authors named "Yuki Komatsu"

Article Synopsis
  • Presacral epidermoid cysts are uncommon benign tumors that can turn malignant; a case study reports a 66-year-old woman whose cyst transformed into squamous cell carcinoma (SCC) that spread to her mesopharynx.
  • After the diagnosis, the patient underwent extensive surgery, including total pelvic exenteration, and received adjuvant radiotherapy, but developed a new mesopharyngeal carcinoma four years later.
  • She was treated with neoadjuvant chemotherapy and surgery, ultimately showing no signs of tumor recurrence 1.5 years after her operations, highlighting the rarity of metastatic mesopharyngeal carcinoma from other sites.
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  • The study evaluates the effectiveness of the Predicting Arrhythmic evenT (PAT) score in predicting future ventricular fibrillation (VF) events in patients with Brugada syndrome (BrS), particularly those without prior VF.
  • Researchers analyzed 413 patients from 59 hospitals in Japan over a follow-up period of about 107 months, finding that while 13.1% experienced VF events, the PAT score didn't effectively differentiate risk in those without a history of VF.
  • Overall, the study concluded that the PAT score is not a reliable tool for predicting future VF events in BrS patients without previous VF, indicating a need for further validation of risk stratification models.
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Background: Ventricular arrhythmia (VA) is a life-threatening condition associated with cardiac sarcoidosis (CS). Right bundle branch block (RBBB) is a common conduction disorder in CS; however, its association with VA remains unknown.

Objectives: This study aimed to investigate the relationship between RBBB and VA in patients with CS.

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Article Synopsis
  • Conventional antipsychotic drugs are ineffective for about one-third of schizophrenia patients, highlighting the need for non-dopaminergic treatment options.
  • A systematic review of recent phase II and III clinical trials identified 16 promising compounds for schizophrenia treatment, including both monotherapies and add-on therapies.
  • Several of these compounds showed efficacy for various symptoms of schizophrenia, suggesting new, targeted treatment strategies that differ from traditional antipsychotics.*
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Background: A rotational activation pattern (RAP) around the localized line of a conduction block often correlates with sites specific to the critical zones of ventricular tachycardia (VT). The wavefront direction during substrate mapping affects manifestation of the RAP and line of block.

Objective: The purpose of this study was to investigate the most optimal cardiac rhythm for identifying RAP and line of block in substrate mapping.

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Introduction: Most patients with Brugada syndrome (BrS) are first diagnosed in their 40s, with sudden cardiac death (SCD) often occurring in their 50s. Ventricular fibrillation (VF) may occur in some patients with BrS despite having been asymptomatic for a long period. This study aimed to assess the incidence and risk factors for late life-threatening arrhythmias in patients with BrS.

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We herein report a 37-year-old man who experienced recurrence of metastatic cardiac rhabdomyosarcoma along with intractable ventricular tachycardia (VT) 7 years after resection of rhabdomyosarcoma in his right elbow. At 36 years old, he developed VT unresponsive to radiofrequency catheter ablation (RFCA). Initially, the cardiac tumor was not detected, but it gradually grew in size at the RFCA site.

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Background: There are few data on ventricular fibrillation (VF) initiation in patients with inferolateral J waves.

Objectives: This multicenter study investigated the characteristics of triggers initiating spontaneous VF in inferolateral J-wave syndrome.

Methods: A total of 31 patients (age 37 ± 14 years, 24 male) with spontaneous VF episodes associated with inferolateral J waves were evaluated to determine the origin and characteristics of triggers.

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Unlabelled: In patients with a history of antithrombin deficiency, a direct thrombin inhibitor may be considered as an alternative to intraprocedural anticoagulation. A 55-year-old woman with antithrombin deficiency and prior myocardial infarction suffered from electrical storm and appropriate defibrillator shocks. Substrate mapping guided left ventricular endocardial and epicardial ablations were successfully performed.

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Of the monomorphic ventricular tachycardias, there are 4 specific tachycardias related to the Purkinje system: 1) idiopathic verapamil-sensitive fascicular ventricular tachycardia (FVT); 2) non-re-entrant FVT; 3) bundle branch re-entry and interfascicular re-entry; and 4) Purkinje-mediated VT in structural heart disease. Verapamil-sensitive FVT is classified into 4 types according to the location of the circuit: 1) left posterior type; 2) left anterior type; 3) left upper septal type;and 4) reverse type. And, in the left anterior and posterior types, there are septal and papillary muscle subtypes.

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Background: Atrial fibrillation (AF) is the most common arrhythmia and often recurs despite catheter ablation. The recurrence of AF is often underdiagnosed by standard 24-hour electrocardiogram (ECG) because of its transient and silent nature. A garment-style ECG with a highly conductive textile electrode made of poly(3,4-ethylenedioxythiophene) poly(styrenesulfonate)(PEDOTPSS) and nanofiber (Garment ECG) has been developed that can provide longer-term continuous monitoring.

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The therapeutic strategy for sustained ventricular tachycardia (VT) during left ventricular assist device usage remains unclear. We encountered a patient with durable left ventricular assist device who presented sustained VT. Electrophysiological mapping was able to be established appropriately owing to the robust mechanical hemodynamics support despite inter-device interference.

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We report a case of palliative surgery in a 73-year-old patient with metastatic plantar sarcoma. The patient underwent resection and irradiation of an undifferentiated spindle cell sarcoma in the right plantar region. The wound was not closed and systemic metastases were observed.

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: Holter electrocardiogram (ECG) is the gold standard for ambulatory monitoring of atrial fibrillation (AF) but it is insufficient because of its limited recording time. Although several consumer ECG devices provide longer recording time, they generally do not undergo the regulatory process for medical use. Furthermore, current medical-grade devices for longer ECG monitoring are not continuous or too invasive for AF monitoring.

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Article Synopsis
  • - The study investigates whether catheter ablation as a first-line treatment for ventricular tachycardia (VT) during implantable cardioverter defibrillator (ICD) implantation is more effective than standard medical therapy plus ICD in patients with cardiomyopathy.
  • - The trial involved 180 patients and found that those in the ablation group showed lower recurrence rates of VT and required fewer ICD shocks compared to the control group over an average follow-up period of 31 months.
  • - Results suggest that early ablation may offer significant benefits in reducing VT recurrence and hospitalizations for patients with nonischemic cardiomyopathy, potentially filling a current gap in clinical guidelines.
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  • * In a study of 13 DHCM patients, 23 ablation procedures were performed, revealing that a majority of the arrhythmogenic substrate was found in the basal regions, particularly the epicardial and intramural areas.
  • * Despite the challenges in ablation due to the substrate locations, 55% of patients experienced VT recurrence, though most could manage their episodes with anti-tachycardia pacing instead of requiring further ablation.
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Phosphatidylinositol 3-kinase (PI3K) signaling promotes the differentiation and proliferation of regulatory B (Breg) cells, and the lipid phosphatase phosphatase and tensin homolog deleted on chromosome 10 (PTEN) antagonizes the PI3K-Akt signaling pathway. We previously demonstrated that cardiac Akt activity is increased and that restraint stress exacerbates hypertension and both heart and adipose tissue (AT) inflammation in DS/obese rats, an animal model of metabolic syndrome (MetS). We here examined the effects of restraint stress and pharmacological inhibition of PTEN on heart and AT pathology in such rats.

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Background: Recent advancements in a 3-dimensional mapping system allow for the assessment of detailed conduction properties during sinus rhythm and thus the establishment of a strategy targeting functionally abnormal regions in scar-related ventricular tachycardia (VT). We hypothesized that a rotational activation pattern (RAP) observed in maps during baseline rhythm was associated with the critical location of VT.

Methods: We retrospectively examined the pattern of wavefront propagation during sinus rhythm in patients with scar-related VT.

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