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  • 2020-2024  (694)
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  • 1
    Online Resource
    Online Resource
    Clinical impact of applying strategic programming in patients with implantable cardioverter-defibrillators beyond reducing inappropriate shocks
    Springer Science and Business Media LLC ; 2020
    In:  International Journal of Arrhythmia Vol. 21, No. 1 ( 2020-12)
    Details
    In: International Journal of Arrhythmia, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2020-12)
    Abstract: The incidence of inappropriate shocks remains high at 30% in patients with implantable cardioverter-defibrillators (ICDs). This retrospective study sought to examine the efficacy of strategic programming (ICD programming with a long detection interval and high-rate cutoff) in reducing electrical storm, inappropriate shocks, and unexpected hospital visits in patients with ICDs with/without cardiac resynchronization therapy with defibrillator (CRT-Ds). Methods This was a single tertiary center retrospective study, evaluating the clinical outcomes, especially regarding inappropriate therapies in patients with ICDs or CRT-Ds. Enrolled patients underwent ICD or CRT-D implantations from January 2008 to May 2016. Clinical information was attained by a thorough chart review. Results We analyzed 155 defibrillator patients from January 2008 to May 2016 (124 patients had ICDs and 31 had CRT-Ds). Since we adopted this strategic programming as a default programming from 2015 implanted ICDs and CRT-Ds, we divided the patients into two groups: devices implanted before 2015 (group A, n  = 94) versus implanted after 2015 (group B, n  = 61). During a median of 1289 days of follow-up, electrical storms occurred in three patients (eight events) in group B versus 11 (28 events) in group A ( P  = 0.18); appropriate therapies were delivered in 27 patients (56 events) in group A versus 7 (15 events) in group B ( P  = 0.72); inappropriate therapies were delivered in 15 patients (21 events) in group A versus 1 with 1 episode in group B ( P  = 0.03); and 5 unexpected hospitalizations occurred in four patients in group B versus 36 in 24 patients in group A ( P  = 0.02). Conclusion The clinical application of strategic programming reduced inappropriate shocks and unexpected hospitalizations in ICD and CRT-D patients.
    Type of Medium: Online Resource
    ISSN: 2466-1171
    URL: Article
    DOI: 10.1186/s42444-020-00012-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 3007034-X
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  • 2
    Online Resource
    Online Resource
    QRS complex characteristics and patient outcomes in out-of-hospital pulseless electrical activity cardiac arrest
    BMJ ; 2021
    In:  Emergency Medicine Journal Vol. 38, No. 1 ( 2021-01), p. 53-58
    Details
    In: Emergency Medicine Journal, BMJ, Vol. 38, No. 1 ( 2021-01), p. 53-58
    Abstract: Pulseless electrical activity (PEA) is increasingly observed in out-of-hospital cardiac arrest (OHCA), but outcomes are still poor. We aimed to assess the relationship between QRS characteristics and outcomes of patients with OHCA with initial PEA (OHCA-P). Methods This prospective observational study included patients aged at least 18 years who developed OHCA-P between 1 January 2016 and 31 December 2018, and were enrolled in the Daegu Emergency Medical Services registry, South Korea. We performed multivariable logistic regression analyses to identify the associations between QRS characteristics and OHCA-P outcomes, in which QRS complexes were considered separately (model 1) and simultaneously (model 2). The primary outcome was survival to hospital discharge and the secondary outcome was a favourable neurological outcome. Results Of the 3659 patients with OHCA, 576 were enrolled (median age 73 years; 334 men). A higher QRS amplitude was associated with survival to hospital discharge and a favourable neurological outcome in model 1 (adjusted OR (aOR) 1.077 and 1.106, respectively; 95% CI 1.021 to 0.136 and 1.029 to 1.190, respectively) and model 2 (aOR 1.084 and 1.123, respectively; 95% CI 1.026 to 1.145 and 1.036 to 1.216, respectively). A QRS width of 〈 120 ms was associated with survival to hospital discharge and a favourable neurological outcome in model 1 (aOR 3.371 and 4.634, respectively; 95% CI 1.633 to 6.960 and 1.562 to 13.144, respectively) and model 2 (aOR 3.213 and 5.103, respectively; 95% CI 1.568 to 6.584 and 1.682 to 15.482, respectively). Survival to hospital discharge and neurological outcome were not associated with QRS frequency. Conclusion OHCA-P outcomes were better when the initial QRS complex showed a higher amplitude or narrower width.
    Type of Medium: Online Resource
    ISSN: 1472-0205 , 1472-0213
    URL: Article
    DOI: 10.1136/emermed-2020-209623
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2027092-6
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  • 3
    Online Resource
    Online Resource
    Usefulness of cardiac magnetic resonance images for prediction of sudden cardiac arrest in patients with mitral valve prolapse: a multicenter retrospective cohort study
    Springer Science and Business Media LLC ; 2021
    In:  BMC Cardiovascular Disorders Vol. 21, No. 1 ( 2021-12)
    Details
    In: BMC Cardiovascular Disorders, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: An association has been identified between mitral valve prolapse (MVP) and sudden cardiac arrest (SCA), and ventricular arrhythmias (VA). This study aimed to elucidate predictive factors for SCA or VA in MVP patients. Methods MVP patients who underwent cardiac magnetic resonance (CMR) were retrospectively included. Patients with other structural heart disease or causes of aborted SCA were excluded. Clinical characteristics (sex, age, body mass index, histories of diabetes, hypertension, and dyslipidemia) and electrocardiographic (PR interval, QRS duration, corrected QT interval, inverted T wave in the inferior leads, bundle branch block, and atrial fibrillation), echocardiographic [mitral regurgitation grade, prolapsing mitral leaflet, and right ventricular systolic pressure (RVSP)], and CMR [left atrial volume index, both ventricular ejection fractions, both ventricular end-diastolic and systolic volume indexes, prolapse distance, mitral annular disjunction, systolic curling motion, presence of late gadolinium enhancement (LGE), LGE volume and proportion] parameters were analyzed. Results Of the 85 patients [age, 54.0 (41.0–65.0) years; 46 men], seven experienced SCA or VA. Younger age and wide QRS complex were observed more often in the SCA/VA group than in the no-SCA/VA group. The SCA/VA group exhibited lower RVSP, more systolic curling motion and LGE, greater LGE volume, and higher LGE proportion. The presence of LGE [hazard ratio (HR), 19.8; 95% confidence interval (CI) 2.65–148.15; P  = 0.004], LGE volume (HR 1.08; 95% CI 1.02–1.14; P = 0.006) and LGE proportion (HR 1.32; 95% CI 1.08–1.60; P = 0.006) were independently associated with higher risk of SCA or VA in MVP patients together with systolic curling motion in each model. Conclusions The presence of systolic curling motion, high LGE volume and proportion, and the presence of LGE on CMR were independent predictive factors for SCA or VA in MVP patients.
    Type of Medium: Online Resource
    ISSN: 1471-2261
    URL: Article
    DOI: 10.1186/s12872-021-02362-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2059859-2
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  • 4
    Online Resource
    Online Resource
    Long-term Clinical Outcomes of Radiofrequency Catheter Ablation versus Permanent Pacemaker Implantation in Patients with Tachycardia-Bradycardia Syndrome
    XMLink ; 2020
    In:  Korean Circulation Journal Vol. 50, No. 11 ( 2020), p. 998-
    Details
    In: Korean Circulation Journal, XMLink, Vol. 50, No. 11 ( 2020), p. 998-
    Type of Medium: Online Resource
    ISSN: 1738-5520 , 1738-5555
    URL: Article
    DOI: 10.4070/kcj.2020.0065
    Language: English
    Publisher: XMLink
    Publication Date: 2020
    detail.hit.zdb_id: 2528698-5
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  • 5
    Online Resource
    Online Resource
    External validation of multimodal termination of resuscitation rules for out-of-hospital cardiac arrest patients in the COVID-19 era
    Springer Science and Business Media LLC ; 2021
    In:  Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Vol. 29, No. 1 ( 2021-12)
    Details
    In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Springer Science and Business Media LLC, Vol. 29, No. 1 ( 2021-12)
    Abstract: Futile resuscitation for out-of-hospital cardiac arrest (OHCA) patients in the coronavirus disease (COVID)-19 era can lead to risk of disease transmission and unnecessary transport. Various existing basic or advanced life support (BLS or ALS, respectively) rules for the termination of resuscitation (TOR) have been derived and validated in North America and Asian countries. This study aimed to evaluate the external validation of these rules in predicting the survival outcomes of OHCA patients in the COVID-19 era. Methods This was a multicenter observational study using the WinCOVID-19 Daegu registry data collected during February 18–March 31, 2020. The subjects were patients who showed cardiac arrest of presumed cardiac etiology. The outcomes of each rule were compared to the actual patient survival outcomes. The sensitivity, specificity, false positive value (FPV), and positive predictive value (PPV) of each TOR rule were evaluated. Results In total, 170 of the 184 OHCA patients were eligible and evaluated. TOR was recommended for 122 patients based on the international basic life support termination of resuscitation (BLS-TOR) rule, which showed 85% specificity, 74% sensitivity, 0.8% FPV, and 99% PPV for predicting unfavorable survival outcomes. When the traditional BLS-TOR rules and KoCARC TOR rule II were applied to our registry, one patient met the TOR criteria but survived at hospital discharge. With regard to the FPV (upper limit of 95% confidence interval  〈  5%), specificity (100%), and PPV ( 〉  99%) criteria, only the KoCARC TOR rule I, which included a combination of three factors including not being witnessed by emergency medical technicians, presenting with an asystole at the scene, and not experiencing prehospital shock delivery or return of spontaneous circulation, was found to be superior to all other TOR rules. Conclusion Among the previous nine BLS and ALS TOR rules, KoCARC TOR rule I was most suitable for predicting poor survival outcomes and showed improved diagnostic performance. Further research on variations in resources and treatment protocols among facilities, regions, and cultures will be useful in determining the feasibility of TOR rules for COVID-19 patients worldwide.
    Type of Medium: Online Resource
    ISSN: 1757-7241
    URL: Article
    DOI: 10.1186/s13049-021-00834-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2455990-8
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  • 6
    Online Resource
    Online Resource
    Clinical outcomes after pulmonary vein isolation using an automated tagging module in patients with paroxysmal atrial fibrillation
    Springer Science and Business Media LLC ; 2020
    In:  International Journal of Arrhythmia Vol. 21, No. 1 ( 2020-12)
    Details
    In: International Journal of Arrhythmia, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2020-12)
    Abstract: An automated tagging module (VISITAG™; Biosense Webster, Irvine, CA) allows objective demonstration of energy delivery. However, the effect of VISITAG™ on clinical outcomes remains unclear. This study evaluated (1) clinical outcome after AF ablation using VISITAG™ and (2) the prevalence of gaps in the ablation line. Methods This retrospective analysis included 157 consecutive patients (mean age, 56.7 years; 73.2% men) with paroxysmal atrial fibrillation who underwent successful PVI between 2013 and 2016. Outcomes after the index procedure were compared between those using the VISITAG™ module (VISITAG group, n  = 62) and those not using it (control group, n  = 95). The primary outcome was recurrence of AF or atrial tachycardia after a blanking period of 3 months. Results The VISITAG group showed significantly shorter overall procedure time (172.2 ± 37.6 min vs. 286.9 ± 66.7 min, P   〈  0.001), ablation time (49.8 ± 9.7 min vs. 82.8 ± 28.2 min, P   〈  0.001), and fluoroscopy time (11.8 ± 5.3 min vs. 34.2 ± 30.1 min, P   〈  0.001) compared with controls. The 1-year recurrence-free survival rate was not statistically different between the groups (70.8% in the VISITAG group vs. 79.2% in the control group, P  = 0.189). Gaps in the VISITAG line were common in the both carina and left side pulmonary veins. Patients without gaps (≥ 5 mm) by the criteria emphasizing catheter stability ( 〉  15 s, 〈  4 mm range, 〉  60% force over time, 〉  6 g contact force) showed higher recurrence-free survival rate compared with those with gaps (borderline statistical significance, 91.7% vs. 66.0%, P  = 0.094). Conclusion Use of the VISITAG™ module significantly reduced procedure, ablation, and fluoroscopic times with a similar AF/AT recurrence rate compared with the conventional ablation. Clinical implications of minimizing gaps along the ablation line should be evaluated further in the future prospective studies.
    Type of Medium: Online Resource
    ISSN: 2466-1171
    URL: Article
    DOI: 10.1186/s42444-020-00021-9
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
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  • 7
    Online Resource
    Online Resource
    The shape of the left lateral ridge as a predictor of long-term outcome of catheter ablation for atrial fibrillation based on clinical and experimental data
    Elsevier BV ; 2021
    In:  International Journal of Cardiology Vol. 329 ( 2021-04), p. 91-98
    Details
    In: International Journal of Cardiology, Elsevier BV, Vol. 329 ( 2021-04), p. 91-98
    Type of Medium: Online Resource
    ISSN: 0167-5273
    URL: Article
    DOI: 10.1016/j.ijcard.2020.12.055
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 1500478-8
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  • 8
    Online Resource
    Online Resource
    Natural Course of New‐Onset Postoperative Atrial Fibrillation after Noncardiac Surgery
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Journal of the American Heart Association Vol. 10, No. 7 ( 2021-04-06)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 10, No. 7 ( 2021-04-06)
    Abstract: Postoperative atrial fibrillation (POAF) is common after cardiac surgery, but little is known about its incidence and natural course after noncardiac surgery. We evaluated the natural course and clinical impact of POAF and the long‐term impact of anticoagulation therapy in patients without a history of atrial fibrillation (AF) undergoing noncardiac surgery. Methods and Results We retrospectively analyzed the database of Asan Medical Center (Seoul, Korea) to identify patients who developed new‐onset POAF after undergoing noncardiac surgery between January 2006 and January 2016. The main outcomes were AF recurrence, thromboembolic event, and major bleeding during follow‐up. Of 322 688 patients who underwent noncardiac surgery, 315 patients (mean age, 66.4 years; 64.4% male) had new‐onset POAF with regular rhythm monitoring after discharge. AF recurred in 53 (16.8%) during 2 years of follow‐up. Hypertension (hazard ratio, 2.12; P =0.02), moderate‐to‐severe left atrial enlargement (hazard ratio, 2.33; P =0.007) were independently associated with recurrence. Patients with recurrent AF had higher risks of thromboembolic events (11.2% versus 0.8%; P 〈 0.001) and major bleeding (26.9% versus 4.1%; P 〈 0.001) than those without recurrence. Patients with recurrent AF and without anticoagulation were especially predisposed to thromboembolic events ( P 〈 0.001). Overall, anticoagulation therapy was not significantly associated with thromboembolic events (1.4% versus 2.5%, P =0.95). Conclusions AF recurred in 16.8% of patients with POAF after noncardiac surgery. AF recurrence was associated with higher risks of adverse clinical outcomes. Considering the high risk of anticoagulation‐related bleeding, the benefits of routine anticoagulation should be carefully weighed in this population. Active surveillance for AF recurrence is warranted.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.120.018548
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2653953-6
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  • 9
    Online Resource
    Online Resource
    Clinical Implications of Ventricular Repolarization Parameters on Long-Term Risk of Atrial Fibrillation　― Longitudinal Follow-up Data From a General Ambulatory Korean Population ―
    Japanese Circulation Society ; 2020
    In:  Circulation Journal Vol. 84, No. 7 ( 2020-6-25), p. 1067-1074
    Details
    In: Circulation Journal, Japanese Circulation Society, Vol. 84, No. 7 ( 2020-6-25), p. 1067-1074
    Type of Medium: Online Resource
    ISSN: 1346-9843 , 1347-4820
    URL: Article
    DOI: 10.1253/circj.CJ-19-1151
    Language: English
    Publisher: Japanese Circulation Society
    Publication Date: 2020
    detail.hit.zdb_id: 2084830-4
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  • 10
    Online Resource
    Online Resource
    Esophageal Thermal Injury after Catheter Ablation for Atrial Fibrillation with High-Power (50 Watts) Radiofrequency Energy
    XMLink ; 2021
    In:  Korean Circulation Journal Vol. 51, No. 2 ( 2021), p. 143-
    Details
    In: Korean Circulation Journal, XMLink, Vol. 51, No. 2 ( 2021), p. 143-
    Type of Medium: Online Resource
    ISSN: 1738-5520 , 1738-5555
    URL: Article
    DOI: 10.4070/kcj.2020.0323
    Language: English
    Publisher: XMLink
    Publication Date: 2021
    detail.hit.zdb_id: 2528698-5
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