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  • Ovid Technologies (Wolters Kluwer Health)  (3)
  • Okamura, Hideo  (3)
  • 1
    Online Resource
    Online Resource
    Significance of Coronary Artery Spasm Diagnosis in Patients With Early Repolarization Syndrome
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Journal of the American Heart Association Vol. 7, No. 4 ( 2018-02-20)
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    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 7, No. 4 ( 2018-02-20)
    Abstract: Previously described patients with early repolarization syndrome ( ERS ) may have experienced silent coronary artery spasm ( CAS ) because the diagnosis of CAS was mainly based on symptoms or coronary angiography findings, without performing a spasm provocation test. This study investigated the significance of CAS diagnosis and evaluated the incidence of silent CAS in patients with possible ERS (ie, idiopathic ventricular fibrillation [ VF ] and inferolateral J wave). Methods and Results The study included 34 patients with idiopathic VF and inferolateral J wave. Thirteen patients (38%) were diagnosed as having CAS on the basis of coronary angiography with spasm provocation test (n=8) and documentation of spontaneous ST elevation (n=5). Of the 13 patients with CAS , 5 (38%) did not experience chest symptoms before and during VF , and were diagnosed as having silent CAS . The remaining 21 patients (62%), with a negative provocation test result and absence of chest symptoms, were considered to have ERS. During the 92 months of follow‐up, patients with CAS receiving appropriate medical treatment with antianginal drugs showed a favorable outcome. In contrast, 4 of 21 patients with ERS (19%) had VF recurrences. The use of monotherapy or combination therapy, consisting of quinidine, cilostazol, and bepridil, in the 4 patients with ERS, was effective in suppressing VF . Conclusions Approximately 40% of patients with CAS with documented VF and inferolateral J wave did not experience chest symptoms at the first VF , and could have been misdiagnosed as having ERS . The use of the spasm provocation test is considered essential to differentiate patients for optimal medical treatment.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.117.007942
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2653953-6
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  • 2
    Online Resource
    Online Resource
    Long-Term Prognosis of Probands With Brugada-Pattern ST-Elevation in Leads V 1 –V 3
    Ovid Technologies (Wolters Kluwer Health) ; 2009
    In:  Circulation: Arrhythmia and Electrophysiology Vol. 2, No. 5 ( 2009-10), p. 495-503
    Details
    In: Circulation: Arrhythmia and Electrophysiology, Ovid Technologies (Wolters Kluwer Health), Vol. 2, No. 5 ( 2009-10), p. 495-503
    Abstract: Background— The prognosis of patients with saddleback or noncoved type (non–type 1) ST-elevation in Brugada syndrome is unknown. The purpose of this study was to clarify the long-term prognosis of probands with non–type 1 ECG and those with coved (type 1) Brugada-pattern ECG. Methods and Results— A total of 330 (123 symptomatic, 207 asymptomatic) probands with a coved or saddleback ST-elevation ≥1 mm in leads V 1 –V 3 were divided into 2 ECG groups—type 1 (245 probands) and non–type 1 (85 probands)—and were prospectively followed for 48.7�15.0 months. The absence of type 1 ECG was confirmed by drug provocation test and multiple recordings. The ratio of individuals with a family history of sudden cardiac death (14%) was lower than previous studies. Clinical profiles and outcomes were not notably different between the 2 groups (annual arrhythmic event rate of probands with ventricular fibrillation; type 1: 10.2%, non–type 1: 10.6%, probands with syncope; type 1: 0.6%, non–type 1: 1.2%, and asymptomatic probands; type 1: 0.5%, non–type 1: 0%). Family history of sudden cardiac death at age 〈 45 years and coexistence of inferolateral early repolarization with Brugada-pattern ECG were independent predictors of fatal arrhythmic events (hazard ratio, 3.28; 95% confidence interval, 1.42 to 7.60; P =0.005; hazard ratio, 2.66; 95% confidence interval, 1.06 to 6.71; P =0.03, respectively, by multivariate analysis), although spontaneous type 1 ECG and ventricular fibrillation inducibility by electrophysiological study were not reliable parameters. Conclusions— The long-term prognosis of probands in non–type 1 group was similar to that of type 1 group. Family history of sudden cardiac death and the presence of early repolarization were predictors of poor outcome in this study, which included only probands with Brugada-pattern ST-elevation.
    Type of Medium: Online Resource
    ISSN: 1941-3149 , 1941-3084
    URL: Article
    DOI: 10.1161/CIRCEP.108.816892
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2009
    detail.hit.zdb_id: 2425487-3
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  • 3
    Online Resource
    Online Resource
    Abstract 11668: High Resolution Magnetocardiography as a Novel Noninvasive Tool to Distinguish Between Benign and Malignant Early Repolarization Pattern
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 132, No. suppl_3 ( 2015-11-10)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 132, No. suppl_3 ( 2015-11-10)
    Abstract: Introduction: Most of the early repolarization patterns (ERP) in electrocardiography (ECG) are benign but some of them are associated with ventricular fibrillation (VF). We evaluated whether or not a high spatio-temporal resolution magnetocardiography (MCG) could non-invasively detect malignant types of ERP. Methods: Sixty four-channel MCG, standard 12-lead ECG, and signal averaged ECG (SAECG) were recorded in 120 patients with inferolateral ERP in ECG without any major structural heart diseases; 13 of them had a history of VF (VF(+)-group) and the remaining 107 had no VF (VF(-)-group). We evaluated the following novel MCG indexes: MCG-QRS (msec), root mean square of terminal 40 msec magnetic field (MCG-RMS) (msec), and the duration under 10% of maximal amplitude (MCG-LAS) (msec) of the highest amplitude channel. Results: The amplitude and distribution of the J-wave, ST-T morphology in ECG, parameters of SAECG were not significantly different, whereas MCG-QRS and MCG-LAS were significantly longer and MCG-RMS was smaller in ERP-VF(+) compared with ERP-VF(-) group (107(SD=24) vs 84(13) msec, P 〈 0.01, 8(22) vs 22(11) msec, P 〈 0.01, 0.10(0.08) vs 0.28(0.19) msec, P 〈 0.01, respectively). In the multivariate logistic regression model, only MCG-QRS remained significant among the MCG indexes and the existing predictors (odds ratio (OR) 1.08, 95%CI 1.01 to1.17). The predictive ability of VF was significantly higher using MCG-QRS when the c-statistic was compared with that of the existing ECG measure (0.82 vs 0.56, P 〈 0.01, Figure). When cut-offs were set by the least squares method at MCG-QRS 100 msec, MCG-RMS 0.24 msec, MCG-LAS 27 msec, corresponding ORs were calculated as 12.7, 95%CI 3.6 to 45.0, 6.1, 95%CI 1.7 to 21.2, 6.2, 95%CI 1.8 to 20.8, respectively. Conclusions: MCG-QRS 〉 100 msec was a simple and effective criterion for prediction of high risk ERP subjects, thus MCG analysis is an useful screening tool to detect malignant ERP out of the numerous benign ones.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.132.suppl_3.11668
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 1466401-X
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