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.

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.

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.

Early repolarization and positive T-wave alternans as risk markers for life-threatening arrhythmias in patients with vasospastic angina.

Background: Several arrhythmogenic markers have been suggested as predictors for risk of life-threatening arrhythmias during symptom-free periods in vasospastic angina (VSA), but no definite conclusion has been drawn.

Objective: To investigate prevalence of fatal ventricular tachyarrhythmia in VSA and its relation to appearance of early repolarization (ER) and positive T wave alternans (p-TWA) in patients with VSA during symptom-free periods.

Methods: We studied 116 consecutive patients with chest pain who underwent an acetylcholine provocation test for VSA diagnosis.

Long-term prognosis in patients with Brugada syndrome based on Class II indication for implantable cardioverter-defibrillator in the HRS/EHRA/APHRS Expert Consensus Statement: multicenter study in Japan.

Background: The HRS/EHRA/APHRS Expert Consensus Statement for implantable cardioverter-defibrillator (ICD) in Brugada syndrome (BrS) has recently been published. However, the validity of the Class II indication for ICD in BrS patients is still unknown.

Objective: The purpose of this study was to evaluate the validity of the Class II indication for ICD implantation in the Consensus Statement with a large Japanese cohort of BrS.