Collaboration between dyspnea clinic and primary care physicians to identify heart failure with preserved ejection fraction in the community: Results from the Maebashi City HF project.

Background: Despite increasing awareness in general practice, heart failure with preserved ejection fraction (HFpEF) remains under-diagnosed in the community due to diagnostic difficulties. Dedicated dyspnea clinics are responsible for diagnosing HFpEF and efficient referral from primary care physicians is the key to enhance its role.

Methods: This retrospective analysis was performed to assess the effectiveness of a one-year collaborative project between our dyspnea clinic and the Maebashi Medical Association.

Optimal Intravascular Ultrasound-Guided Percutaneous Coronary Intervention in Patients With Multivessel Disease and Chronic Kidney Disease.

There is a scarcity of data on clinical outcomes after intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in patients with multivessel disease and chronic kidney disease (CKD). The Optimal Intravascular Ultrasound (OPTIVUS)-Complex PCI study multivessel cohort was a prospective multicenter single-arm trial enrolling 1,015 patients who underwent multivessel IVUS-guided PCI including left anterior descending coronary artery target with an intention to meet the prespecified OPTIVUS criteria for optimal stent expansion. We compared the clinical outcomes between patients with and without CKD.

[Ortner Syndrome Complicated with Giant Myxoma:Report of a Case].

A 68-year-old woman were admitted with chief complaints of persistent hoarseness, dysphagia and dyspnea on effort. She was found to have a left atrial myxoma with obstruction of mitral inflow on echo-cardiogram. The tumor was extensively attached to the atrial septum and left atrium.

Clinical advantages of reduced expiratory positive airway pressure setting in adaptive servo-ventilation therapy.

The clinical ramifications of adaptive servo-ventilation (ASV) therapy have stirred debate within the medical community. Given the potential detrimental effect of elevated expiratory positive airway pressure (EPAP) on cardiac output, we hypothesized that relatively lower EPAP may be recommended for successful ASV therapy. In-hospital patients with congestive heart failure refractory to medical therapy were included in the prospective cohort study of ASV therapy on prognosis in repeatedly hospitalized patients with chronic heart failure: longitudinal observational study of effects on readmission and mortality (SAVIOR-L) study.

[Ruptured Stanford Type A Acute Aortic Dissection Accompanying Persistent Sciatic Artery Aneurysm: Report of a Case].

Persistent sciatic artery( PSA) is a rare congenital anomaly and often results in aneurismal or occlusive changes. A 82-year-old woman was reffered with diagnosis of Stanford type A acute aortic dissection complicated cardiac tamponade. Emergent aortic arch replacement was performed.

Authors reply regarding "A-V-V-A response to single atrial premature depolarization in a narrow QRS tachycardia: What is the mechanism?".

We respond to a letter by Dr. A. Goyal.

Catheter ablation approach targeting epicardial connections to the right pulmonary vein antrum detected before pulmonary vein isolation.

Background: Epicardial connections from surrounding structures to the right pulmonary vein (PV) antrum impede PV isolation.

Objective: This study aimed to evaluate the efficacy of an ablation approach targeting epicardial connections for right PV isolation.

Methods: We prospectively enrolled 124 patients with atrial fibrillation undergoing initial PV isolation.

Characteristics of radiofrequency lesions in patients with symptomatic periesophageal vagal nerve injury after pulmonary vein isolation.

Background: Periesophageal vagal nerve injury (PNI) is an unpredictable and serious complication of atrial fibrillation (AF) ablation. We aimed to identify the factors associated with symptomatic PNI.

Methods: This study included 1391 patients who underwent ablation index-guided pulmonary vein isolation (PVI) using the CARTO system.

Lower extremity artery thromboembolism during removal of Impella after repair for ventricular septal rupture: A case report.

Although the anticoagulant complications of Impella are well known, the timing of heparin administration when using Impella immediately after open heart surgery has not been established. We report a case of a 59-year-old man with Impella-assisted repair of a ventricular septal perforation after acute myocardial infarction who developed thromboembolism of the lower extremity arteries after removal of Impella.

A randomized controlled trial of the size-adjustable cryoballoon vs conventional cryoballoon for paroxysmal atrial fibrillation: The CONTRAST-CRYO II trial rationale and design.

Background: Pulmonary vein isolation (PVI) with cryoballoon technology is a well-established therapy for treatment of atrial fibrillation (AF). Recently, a size-adjustable cryoballoon (POLARx FIT) that enables delivery in a standard 28-mm or an expanded 31-mm size was introduced.

Objective: The purpose of this study was to perform a randomized clinical trial to evaluate the safety and efficacy of this novel cryoballoon compared to the conventional cryoballoon.

Angiotensin Receptor-Neprilysin Inhibitor Suppresses Renin-Angiotensin-Aldosterone System Activation After Cardiac Surgery Using Cardiopulmonary Bypass.

Background: Sacubitril/valsartan, being both a neprilysin inhibitor and angiotensin receptor blocker, exhibits a renin-angiotensin-aldosterone system (RAAS) inhibitory effect. However, no study has investigated the administration of sacubitril/valsartan in patients early after surgery using cardiopulmonary bypass.

Methods And Results: This was a prospective observational study of 63 patients who underwent open heart surgery and were treated with sacubitril/valsartan.

Novel automated atrial pacemapping technique based on intracardiac pattern matching to identify the location of ectopic atrial activity.

Atrial ectopy from the pulmonary veins and non-pulmonary vein foci can trigger atrial fibrillation. In addition, the elimination of atrial ectopy is important to prevent recurrence. The intracardiac pattern matching technique has been reported as a useful method to manually visualize the location of triggers regardless of their frequency.

Detection of dynamic lung hyperinflation using cardiopulmonary exercise testing and respiratory function in patients with stable cardiac disease: a multicenter, cross-sectional study.

Background: Many patients with heart disease potentially have comorbid chronic obstructive pulmonary disease (COPD); however, there are not enough opportunities for screening, and the qualitative differentiation of shortness of breath (SOB) has not been well established. We investigated the detection rate of SOB based on a visual and qualitative dynamic lung hyperinflation (DLH) detection index during cardiopulmonary exercise testing (CPET) and assessed potential differences in respiratory function between groups.

Methods: We recruited 534 patients with heart disease or patients who underwent simultaneous CPET and spirometry (369 males, 67.

Narrow QRS ectopy with concealed connections from a para-Hisian origin to the proximal left fascicles.

Introduction: Catheter ablation of ectopy originating from the vicinity of the His bundle can be challenging.

Methods And Results: We report a case of a 33-year-old man with narrow QRS ectopy with preferential conduction from a para-Hisian origin to the proximal left fascicles, which was successfully eliminated by radiofrequency ablation in the right coronary cusp, guided by ultrahigh-resolution mapping of the His bundle, bundle branch, and fascicular electrograms.

Conclusion: Some narrow QRS ectopy may originate from the vicinity of the conduction system, instead of the "true" conduction system, and have concealed connections from its origin to the conduction system.