Sex differences in atrial fibrillation ablation outcomes: insights from a large-scale multicentre registry.

Aim: The impact of sex differences on the clinical outcomes of radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) is controversial. We investigated the sex differences regarding the efficacy and clinical outcomes of RFCA of AF.

Methods And Results: We conducted a large-scale, prospective, multicentre, observational study (Kansai Plus Atrial Fibrillation Registry).

Impact of peripheral artery disease on prognosis after myocardial infarction: The J-MINUET study.

Background: Patients with peripheral artery disease (PAD) are at high risk of cardiovascular events, including myocardial infarction (MI), stroke, and cardiovascular death. However, the impact of PAD on prognosis in Japanese patients with acute MI remains unclear.

Methods: The Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET) is a prospective multicenter registry that registered 3283 patients with acute MI.

Long-Term Prognosis of Patients with Myocardial Infarction Type 1 and Type 2 with and without Involvement of Coronary Vasospasm.

While prognoses in relation to myocardial infarction (MI) type have been elucidated in past reports, the results were not consistent, perhaps due to occurrence of Type 2 MI with CVS and its mortality. The Japanese registry of acute Myocardial Infarction diagnosed by Universal Definition (J-MINUET) is a prospective multicenter registry in Japan. In contrast to thromboembolic event-related Type 1 myocardial infarction (MI), clinical features of Type 2 MI, including coronary vasospasm (CVS), are varied due to the heterogeneous nature of its development.

Evaluation of an Integrated Device Diagnostics Algorithm to Risk Stratify Heart Failure Patients - Results From the SCAN-HF Study.

Background: Integrated device diagnostics, Triage-HF, is useful in risk stratifying patients with heart failure (HF), but its performance for Japanese patients remains unknown. This is a prospective study of Japanese patients treated with a cardiac resynchronization therapy defibrillator (CRT-D), with a Medtronic OptiVol 2.0 feature.

An analysis of factors influencing pulmonary artery catheter passage through the tricuspid and pulmonary valves.

Purpose: A pulmonary artery catheter (PAC) has to pass the tricuspid and pulmonary valves for its proper placement. Although several factors were reported to hinder the placement, there have been no reports to identify the factors that prolong the individual time for passing through each valve.

Method: We individually measured the time required for a PAC to pass through the tricuspid and pulmonary valves.

Restrictive mitral annuloplasty with or without coronary artery bypass grafting in ischemic mitral regurgitation.

Aims: In patients with ischaemic mitral regurgitation (MR), the impact of mitral valve surgery with concomitant coronary artery bypass grafting (CABG) on post-operative survival and left ventricular (LV) reverse remodelling remains unknown. Therefore, we investigated these outcomes following restrictive mitral annuloplasty (RMA) with and without CABG in those patients.

Methods And Results: This study included 309 patients with chronic MR and ischaemic cardiomyopathy for whom concomitant CABG was indicated (n = 225) or not indicated (n = 84) with RMA.

Scoring System for Identification of "Survival Advantage" after Successful Percutaneous Coronary Intervention in Patients with Chronic Total Occlusion.

Background: Percutaneous coronary intervention (PCI) is widely used in patients with chronic total occlusion (CTO), but its benefit in improving long-term outcomes is controversial. We aimed to develop a prediction score for grading "survival advantage" conferred by successful results of CTO-PCI and a scoring system for prediction of the influence of CTO-PCI results on major adverse cardiac and cerebrovascular events (MACCEs).

Methods: Follow-up data of 2625 patients who underwent CTO-PCI at 65 Japanese centers were analyzed.

An analysis of prior experience influencing quality of pulmonary artery catheter placement in residents.

Background: Prior experience may be important for successful placement of a pulmonary artery catheter (PAC). However, there is no report about the minimum number of the placement to reach acceptable technique for the catheter placement during residency.

Aims: This study was designed to examine quality of the catheter placement and to assess the effect of prior experience.

Burden and Long Firing of Premature Atrial Contraction Early After Catheter Ablation Predict Late Recurrence of Atrial Fibrillation.

Background: Associations between characteristics of premature atrial contraction (PAC) 6 months after catheter ablation (CA) and later recurrence are not known. We investigated the effects of PAC characteristics on long-term outcomes of initially successful atrial fibrillation (AF) ablation.

Methods and results: In all, 378 patients (mean age 61 years, 21% female, 67% paroxysmal AF) who underwent initial radiofrequency CA for AF without recurrence up to 24-h Holter monitoring 6 months after the procedure were reviewed retrospectively.

Admission During Off-Hours Does Not Affect Long-Term Clinical Outcomes of Japanese Patients with Acute Myocardial Infarction.

Discordant results have been reported on outcomes of acute myocardial infarction (AMI) patients who present during off-hours.We investigated 3283 consecutive patients with AMI who were selected from the prospective, nationwide, multicenter registry (J-MINUET) database comprising 28 institutions in Japan between July 2012 and March 2014 to determine the current impact of off-hours presentation (defined as weekends, holidays, and weekdays from 8:01 PM to 7:59 AM) at hospitals on long-term clinical outcomes. The primary endpoint was a composite of all-cause death, non-fatal MI, non-fatal stroke, cardiac failure, and urgent revascularization for unstable angina for up to 3 years from the index event.

Guideline adherence and long-term clinical outcomes in patients with acute myocardial infarction: a Japanese Registry of Acute Myocardial Infarction Diagnosed by Universal Definition (J-MINUET) substudy.

Background: The association between guideline adherence and long-term outcomes in patients with acute myocardial infarction in real-world clinical practice remains unclear.

Methods: We investigated 3283 consecutive patients with acute myocardial infarction who were selected from a prospective, nation-wide, multicentre registry (J-MINUET) database covering 28 institutions in Japan between July 2012 and March 2014. Among the 2757 eligible patients, we evaluated the use of seven guideline-recommended therapies, including urgent revascularisation, door-to-balloon time of 90 minutes or less, and five discharge medications (P2Y12 inhibitors on aspirin, beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, statins, lipid-lowering drugs).

Impact of IVUS-Derived Vessel Size on Midterm Outcomes After Stent Implantation in Femoropopliteal Lesions.

To identify intravascular ultrasound (IVUS) findings that predict midterm stent patency in femoropopliteal (FP) lesions. A retrospective analysis was undertaken of 335 de novo FP lesions in 274 consecutive patients (mean age 72.4±8.

Risk Factors of In-Hospital Lethal Arrhythmia Following Acute Myocardial Infarction in Patients Undergoing Primary Percutaneous Coronary Intervention - Insight From the J-MINUET Study.

Lethal arrhythmias including ventricular tachycardia and fibrillation (VT/VF) are common complications of acute myocardial infarction (AMI). Predictors of in-hospital VT/VF after AMI, however, have not been thoroughly investigated. In this study, we sought to elucidate the predictors of in-hospital VT/VF events after AMI in the Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET).

Tip Detection Method Using the New IVUS Facilitates the 3-Dimensional Wiring Technique for CTO Intervention.

Objectives: This study assessed the efficacy of the tip detection method during intravascular ultrasound (IVUS)-based 3-dimensional (3D) wiring with a new chronic total occlusion (CTO)-specific IVUS system (AnteOwl IVUS [AO-IVUS]) for CTO percutaneous coronary intervention (PCI).

Background: The study developed angiography-based 3D wiring for CTO-PCI. Previously, the authors produced a short-tip CTO-specific IVUS system (Navifocus WR IVUS [Navi-IVUS]), which has been upgraded into the AO-IVUS system by adding a pullback transducer system for IVUS-based 3D wiring.

Outcomes After Atrial Fibrillation Ablation in Patients With Premature Atrial Contractions Originating From Non-Pulmonary Veins.

Objectives: The aim of this study was to examine the relationship between residual premature atrial contractions (PACs) originating from non-pulmonary veins (PVs), which do not initiate atrial fibrillation (AF), and AF recurrence after ablation.

Background: Residual atrial ectopic beats that trigger AF from non-PVs (non-PV AF triggers) after catheter ablation are among the major causes of AF recurrence. However, little is known about the impact of non-PV PACs on AF recurrence.

Absorb GT1 Bioresorbable Vascular Scaffold System - 1-Year Post-Marketing Surveillance in Japan.

Background: The Japan post-marketing surveillance (PMS) for the Absorb GT1 bioresorbable vascular scaffold (BVS) mandated an intracoronary imaging-guided implantation technique.

Methods and results: We enrolled 135 patients who were planned to undergo PCI with THE Absorb GT1. Adequate lesion preparation, imaging-guided appropriate sizing, and high-pressure post-dilatation using a noncompliant balloon to minimize final diameter stenosis were recommended.

Heart failure in patients with type 2 diabetes mellitus: assessment with echocardiography and effects of antihyperglycemic treatments.

Heart failure is one of the major cardiovascular complications in patients with type 2 diabetes mellitus (T2DM) and increases the risk of morbidity and mortality. Although active management for heart failure is needed in patients with T2DM, traditional treatment and some new class of antihyperglycemic drugs, such as glucagon-like peptide-1 receptor agonists or dipeptidyl peptidase-4 inhibitors, could not reduce the risk of heart failure. Recent major trials demonstrated sodium-glucose co-transporter-2 (SGLT2) inhibitors improve prognosis of T2DM patients through prevention of heart failure.

Impact of baseline left atrial function on long-term outcome after catheter ablation for paroxysmal atrial fibrillation.

Background: Left atrial (LA) size is an established predictor of recurrence after catheter ablation for paroxysmal atrial fibrillation (PAF). We investigated the impact of baseline LA function on recurrence after PAF ablation and compared the predictive values of LA function with those of LA size.

Methods: We retrospectively investigated 292 consecutive patients who underwent PAF ablation (median follow-up: 3.

HAS-BLED score as a predictor of bleeding complications from catheter ablation of atrial fibrillation: A subanalysis of the Japanese Anti-Coagulation Regimen Exploration in AF Catheter Ablation Registries.

Background: The ATRIA, Outcomes Registry for Better Informed Treatment (ORBIT), and modified (m) HAS-BLED (excluding a labile international normalized ratio element from the HAS-BLED score) scores are currently used to predict the bleeding risk in atrial fibrillation (AF) patients receiving oral anticoagulant treatment. We assessed the usefulness of these scores in estimating the catheter ablation (CA)-related bleeding risk in AF patients from the Japanese Anti-Coagulation Regimen Exploration in AF Catheter Ablation Registry (JACRE).

Methods: We investigated 1322 consecutive patients enrolled in the prospective, multicenter JACRE registry of AF patients receiving CA.

Effect of combination of non-slip element balloon and drug-coating balloon for in-stent restenosis lesions (ELEGANT study).

Background: In-stent restenosis (ISR) remains a problematic issue of coronary intervention. The non-slip element balloon (NSE) is a balloon catheter with 3 longitudinal nylon elements which are attached proximally and distally to the balloon component. The expectation is that this design of balloon is able to achieve a larger lumen area due to the elements, as well as reducing balloon slippage.

Guide catheter extension lock enables the strongest backup force during the antegrade approach in percutaneous coronary intervention.

Sufficient guide catheter backup is crucial for successful percutaneous coronary intervention (PCI). We have developed a new technique for locking a small child catheter to the vessel wall by balloon dilatation outside the child catheter at the proximal site of the main branch. We call this the "guide catheter extension lock" ("Kiwami lock", Kiwami child catheter, Terumo Corp.

Association of onset-season with characteristics and long-term outcomes in acute myocardial infarction patients: results from the Japanese registry of acute myocardial infarction diagnosed by universal definition (J-MINUET) substudy.

It is known that incidence and short-term mortality rate of acute myocardial infarction (AMI) tend to be higher in the cold season. The aim of our study was to investigate the association of onset-season with patient characteristics and long-term prognosis of AMI. This was a prospective, multicenter, Japanese investigation of 3,283 patients with AMI who were hospitalized within 48 h of symptom onset between July 2012 and March 2014.

Multiple Shifts of the Earliest Retrograde Atrial Activation Site Along the Tricuspid Annulus During the Fast-Slow Form of Atrioventricular Nodal Reentrant Tachycardia by Radiofrequency Modification.

A 70-year-old woman was admitted for treatment of supraventricular tachycardia. Ventriculoatrial conduction was revealed through programmed ventricular stimulation; the coronary sinus ostium (CSos) was the earliest atrial activation site. The fast-slow forms of atrioventricular nodal reentrant tachycardia (AVNRT) were induced by ventricular extra-stimuli.

Study design of nationwide Japanese Catheter Ablation Registry: Protocol for a prospective, multicenter, open registry.

Background: Catheter ablation has become a popular interventional treatment for cardiac tachyarrhythmias and the number has been on the rise year by year. However, little is known about its efficacy and safety in the real-world settings.

Method: Japanese Catheter Ablation (J-AB) Registry is a nationwide, multicenter, observational registry, performed by Japanese Heart Rhythm Society (JHRS), collaborated with National Cerebral and Cardiovascular Center.