Supplement of Clinical Practice Guidelines for Endovenous Thermal Ablation for Varicose Veins: Overuse for the Inappropriate Indication.

While endovenous thermal ablation (ETA) become first choice of treatment for varicose veins, overuse of ETA for the inappropriate indication is growing problem. ETA is performed not only on varicose cases without symptom but also non diseased cases with segmental reflux of saphenous veins or no reflux. Indications of ETA was demonstrated in "the Clinical Practice Guidelines for ETA for Varicose Veins 2019" by Japanese Society of Phlebology.

Cardiac Tamponade During Tocilizumab Therapy in a Patient with Rheumatoid Arthritis and Anti-DNA Antibody Positivity.

Drug-induced lupus (DIL) is a drug-mediated immune reaction with the same symptoms as that of lupus erythematosus. We herein report the first case of tocilizumab-induced lupus syndrome presenting with cardiac tamponade. A 65-year-old man presented with cough, exertional dyspnea, and chest pain after 2 months of tocilizumab therapy for rheumatoid arthritis.

The coronary artery calcium score correlates with left atrial low-voltage area: Sex differences.

Introduction: In patients with coronary artery disease, a high coronary artery calcium score (CACS) correlates with atrial fibrillation (AF); however, the association between left atrial (LA) remodeling progression and coronary arteriosclerosis is unclear. This study aimed to evaluate the relationship between LA remodeling progression and the CACS.

Methods: This retrospective study enrolled 148 patients with AF (paroxysmal AF, n = 94) who underwent catheter ablation.

Comparison of touch-up ablation rate and pulmonary vein isolation durability between hot balloon and cryoballoon.

Introduction: This study aimed to compare touch-up ablation (TUA) rates and pulmonary vein isolation (PVI) durability of hot balloon ablation (HBA) and cryoballoon ablation (CBA) in paroxysmal atrial fibrillation (PAF) patients.

Methods: In total, 137 PAF patients were enrolled in the study. Among them, 59 underwent two HBA procedures at 6-month intervals and 78 patients underwent two CBA sessions, both regardless of atrial fibrillation recurrence.

Long-Term Outcomes of Endovascular Stenting for Blunt Renal Artery Injuries with Stenosis: A Report of Five Consecutive Cases.

Background: Renal artery stenting is performed for renal artery injuries to preserve renal function and prevent renovascular hypertension. However, its indications are controversial and its long-term prognosis remains unknown. Here, we evaluate the characteristics and long-term outcomes of renal artery stenting for blunt renal artery injuries at our institution.

Characteristics of ventricular intracardiac electrograms of ventricular tachycardias originating from the epicardia in patients with an implantable cardioverter defibrillator.

Introduction: While characteristic waveforms of 12-lead electrocardiograms have been reported to predict the epicardial origin of ventricular tachycardia (VT), it has not been fully examined whether ventricular intracardiac electrograms (VEGMs) recorded from the implantable cardioverter defibrillator (ICD) via telemetry can determine the origin of VT or not. The aim of this study was to investigate the VEGM characteristics of VT originating from the epicardia.

Method And Results: Intracardiac VEGMs of the induced VTs, with detected sites of origin during the VT study, were recorded in 15 (23 VTs) of the 46 patients.

The relationship between obstructive sleep apnea and recurrence of atrial fibrillation after pulmonary vein isolation using a contact force-sensing catheter.

Purpose: Our aim was to elucidate the relationship between obstructive sleep apnea (OSA) and atrial fibrillation (AF) recurrence after repeated pulmonary vein isolation (PVI).

Methods: We conducted a non-randomized observational study, with the data prospectively collected. One hundred patients (paroxysmal AF, n = 89) underwent PVI using a contact force-sensing catheter.

Ventricular Fibrillation Induced by Coronary Vasospasm in a Patient with Early Repolarization and Hyperthyroidism.

Vasospastic angina (VSA) has been recognized as a cause of ventricular fibrillation (VF) degenerating into sudden cardiac death. We experienced a case of VSA with hyperthyroidism in which VF was provoked with an augmented J-wave amplitude in the inferior leads. The patient underwent insertion of an implantable cardioverter-defibrillator for the secondary prevention of VF in addition to taking Ca-channel antagonists.

Gastric syphilis: The great imitator in the stomach.

Syphilis is resurging worldwide. Here, we present the case of a 33-year-old heterosexual man who presented with a 3-week history of epigastric pain, nausea, emesis, and 8 kg weight loss. He was subsequently diagnosed with gastric syphilis, based on reactive syphilis serological testing and Treponema pallidum found in gastric biopsy specimens.

Development of Nonpulmonary Vein Foci Increases Risk of Atrial Fibrillation Recurrence After Pulmonary Vein Isolation.

Objectives: The aim of this paper was to clarify the impact of nonpulmonary vein foci (NPVF) on atrial fibrillation (AF) recurrence after pulmonary vein (PV) isolation.

Background: NPVF are considered contributing factors for the recurrence of AF after PV isolation, but their exact role remains unclear.

Methods: We retrospectively reviewed 216 patients (paroxysmal AF, n = 172; persistent AF, n = 44) who underwent a second electrophysiological study 6 months after the original PV isolation.

Ventricular tachycardia storm originating from interventricular septum successfully treated with surgical cryoablation with electroanatomic and electrophysiological mapping before dual valve replacement.

A 58-year-old man with dilated cardiomyopathy was admitted with heart failure. He had a history of two catheter ablation procedures for ventricular tachycardia (VT) originating from the intraventricular septum (IVS). Before dual valve replacement (DVR), he suffered a VT storm.

Successful catheter ablation of ventricular premature complexes from the right atrial side of the atrioventricular septum with good contact force.

The acquisition of good contact force for radiofrequency catheter ablation of ventricular premature complexes (VPCs) originating from the basal septum of the left ventricle (LV) is often difficult. We describe a case of VPCs originating from the basal septum of the LV, which were successfully eliminated by applying radiofrequency at the right atrium (RA) side of the atrioventricular septum (AVS) without causing any significant impairment of atrioventricular conduction because the ablation catheter could obtain better contact force through the RA approach. Moreover, intracardiac echocardiography (ICE) and RA angiography effectively demonstrated the AVS.

Usefulness of epicardial impedance evaluation for epicardial mapping and determination of epicardial ablation site for ventricular tachycardia: A pilot study.

Background: During epicardial mapping, determination of appropriate ablation sites in low voltage areas (LVA) is challenging because of large epicardial areas covered by adipose tissue.

Objective: To evaluate the impedance difference between epicardial fat and the epicardial LVA using multiple detector computed tomography (MDCT).

Methods: We enrolled patients who underwent ventricular tachycardia (VT) ablation via the epicardial approach after endocardial ablation failure.

Combination of drug-coated balloon angioplasty and excimer laser coronary angioplasty ablation for coronary restenosis of Kawasaki disease: A case report.

Coronary aneurysm is a well-known sequela of Kawasaki disease. Although ischemic heart disease often becomes problematic due to coronary aneurysm and severe calcification, there is no consensus on how to treat ischemic lesions in those with Kawasaki disease. We describe a case of successful percutaneous coronary intervention of the restenosis lesion within a coronary artery aneurysm accompanied by Kawasaki disease by using an excimer laser coronary angioplasty ablation technique followed by drug-coated balloon angioplasty.

Long-term efficacy of catheter ablation for paroxysmal atrial fibrillation in patients with Brugada syndrome and an implantable cardioverter-defibrillator to prevent inappropriate shock therapy.

Background: In patients with an implantable cardioverter-defibrillator (ICD) and Brugada syndrome (BrS), the long-term efficacy of catheter ablation for preventing inappropriate shock therapy due to paroxysmal atrial fibrillation (PAF) has not been elucidated.

Objective: To evaluate the efficacy of atrial fibrillation (AF) ablation for PAF for prevention of inappropriate ICD therapy over a longer follow-up period.

Methods: We enrolled 76 men with BrS and an ICD, with a mean age of 46.

An isolated spontaneous dissecting celiac artery aneurysm with successful endovascular treatment using stenting and coil embolization.

Isolated spontaneous dissecting celiac artery aneurysm (DCAA) is a rare event. We report the case of a 50-year-old Japanese man with sudden post-prandial epigastric pain. He was diagnosed as having an isolated DCAA based on the results of contrast-enhanced multi-slice computed tomography (CT).

Peri-Mitral Atrial Tachycardia Using the Marshall Bundle Epicardial Connections.

Objectives: The aim of this study was to determine whether re-entrant circuits were associated with the ligament of Marshall (LOM).

Background: Peri-mitral atrial tachycardias (PMATs) following pulmonary vein isolation (PVI) or mitral valve surgery are common.

Methods: Six PMATs involving epicardial circuits were identified from 38 patients.

Transient sinus node dysfunction following sinus node artery occlusion due to radiofrequency catheter ablation of the septal superior vena cava-right atrium junction.

We performed catheter ablation to septal superior vena cava (SVC)-right atrium (RA) junction rapid firing in a 57-year-old man with paroxysmal atrial fibrillation. He later experienced transient sinus node dysfunction resulting from injury to the sinus node artery (SNA), which branched only from the proximal region of the left circumflex artery. The direction of the SNA should be considered during catheter ablation at the septal SVC-RA junction, especially if the sinus node is supplied by only one SNA from the right coronary artery or the left circumflex artery.

Early repolarization pattern and its day-to-day dynamic change as markers for ventricular fibrillation in patients with vasospastic angina.

Aims: An early repolarization (ER) pattern is a risk factor for ventricular fibrillation (VF) in certain diseases. However, it is unclear whether this association holds for patients with vasospastic angina (VSA). Moreover, the reported long-term follow-up of implantable cardioverter defibrillator (ICD) therapy for VSA patients is limited to 3 years.

Simultaneous nephrotic syndrome and hepatitis in secondary syphilis: case report and review of the literature.

A 66-year-old man presented with a penile ulcer, an acute clinical onset of nephrotic syndrome and hepatitis. Secondary syphilis was diagnosed on the basis of the history of rash and the result of strongly positive serological test for syphilis. A renal biopsy demonstrated membranous glomerulonephritis with subepithelial electron-dense deposits.