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Journal of Arrhythmia
   Full-text available via subscription Subscription journal
     ISSN (Print) 1880-4276 - ISSN (Online) 1883-2148
     Published by Elsevier Homepage  [2563 journals]   [H-I: 1]
  • Editorial Board
    • Pages: iii - iv
      Citation: Journal of Arrhythmia 30, 3 (2014)
      PubDate: 2014-06-01
      DOI: 10.1016/S1880-4276(14)00084-2
      Issue No: Vol. 30, No. 3 (2014)
  • Magnesium sulfate-induced blocked premature atrial contractions resulting
           in fetal bradyarrhythmia
    • Authors: Takekazu Miyoshi; Wataru Shimizu, Takashi Noda, Yoshinari Kobayashi, Chizuko A. Kamiya, Kaoru Yamanaka, Reiko Neki, Jun Yoshimatsu, Shiro Kamakura
      Pages: 201 - 203
      Abstract: Abstract: Here, we present a rare case of fetal bradyarrhythmia following magnesium sulfate therapy for preterm labor. After we switched treatment from ritodrine hydrochloride to magnesium sulfate at 25 weeks' gestation, the fetal heart rate dropped from 150bpm to 80–100bpm. Fetal echocardiography and magnetocardiography indicated bigeminy and trigeminy of blocked premature atrial contractions. It is well known that magnesium sulfate decreases the baseline and variability of fetal heart rate. Studies have reported a substantial decrease of 2–15bpm in the baseline fetal heart rate, and magnesium has various effects on fetal heart rate patterns with a lower baseline fetal heart rate within the normal range of 110–160bpm. This is the first report of magnesium sulfate-induced fetal bradyarrhythmia by prolongation of the refractory period of the atrioventricular node in the case of blocked premature atrial contractions. Clinicians should consider fetal bradyarrhythmia when the baseline fetal heart rate drops to
      Citation: Journal of Arrhythmia 30, 3 (2014)
      PubDate: 2014-01-02
      DOI: 10.1016/j.joa.2013.11.002
      Issue No: Vol. 30, No. 3 (2014)
  • Cardiac arrhythmias during long-duration spaceflights
    • Authors: Tagayasu Anzai; Mary Anne Frey, Akihiko Nogami
      Pages: 139 - 149
      Abstract: Abstract: Few studies have investigated cardiac arrhythmias during spaceflight. Atrial and ventricular premature contractions, short-duration atrial fibrillation, and non-sustained ventricular tachycardia were reported by previous spaceflight programs. Some of these arrhythmias occurred following extravehicular activity in space. Arrhythmias during spaceflight are related with hypokalemia, microgravity, changes in the autonomic nervous system, and physical stress. Some astronauts have needed radiofrequency catheter ablation for atrial arrhythmias. Future long-duration spaceflights beyond the Earth's orbit may expose astronauts to significant levels of radiation that affect the coronary arteries. Genetic tests for arrhythmias might be added to the present cardiac screening examinations in the future.
      Citation: Journal of Arrhythmia 30, 3 (2014)
      PubDate: 2013-10-17
      DOI: 10.1016/j.joa.2013.07.009
      Issue No: Vol. 30, No. 3 (2013)
  • The effects of nifekalant hydrochloride on the spatial dispersion of
           repolarization after direct current defibrillation in patients with oral
           amiodarone and β-blocker therapy
    • Authors: Keiko Maeda; Masahiko Takagi, Hiroaki Tatsumi, Eiichiro Nakagawa, Minoru Yoshiyama
      Pages: 150 - 156
      Abstract: Abstract: Background: Although nifekalant hydrochloride (NIF) has been demonstrated to suppress ventricular tachyarrhythmias, especially electrical storms, the mechanism by which it does so is still unclear. We examined the effects of NIF on the spatial dispersion of repolarization (SDR) after implantable cardioverter-defibrillator (ICD) shock.Methods and Results: In 35 patients with oral amiodarone and β-blocker therapy, and an ICD, we recorded the 87-lead electrocardiogram during sinus rhythm (CONTROL-1 group) under general anesthesia, and just after the termination of induced ventricular fibrillation (VF) by ICD shock, with or without NIF administration. In all recordings, the corrected QT interval (QTc) was measured in each lead. The dispersion of QTc (QTc-D; maximum QTc minus minimum QTc) was also measured. Compared with that in the CONTROL-1 group, the QTc-D exhibited significant deterioration after ICD shock (61±14 and 90±19ms1/2, respectively; p
      Citation: Journal of Arrhythmia 30, 3 (2014)
      PubDate: 2013-07-19
      DOI: 10.1016/j.joa.2013.05.009
      Issue No: Vol. 30, No. 3 (2013)
  • Hydralazine inhibits ventricular tachyarrhythmias in an acquired long QT
           rabbit model
    • Authors: Kenta Tsutsui; MD, Satoshi Yamagishi, MD, Tomoyuki Kunishima, MD, Noriyuki Hayami, MD, Yuji Murakawa, MD
      Pages: 157 - 160
      Abstract: Abstract: Background: Some cardioactive vasodilating agents inhibit ventricular tachyarrhythmias (VT) associated with acquired long QT syndrome (LQT). We tested whether a vasodilator without direct cardiac effect can eliminate abnormal repolarization-related VT.Methods: The effect of hydralazine on the occurrence of VT was assessed in a methoxamine-sensitized rabbit model of acquired LQT. To verify that VTs in this animal model are triggered by early afterdepolarization (EAD), monophasic action potential (MAP) on the left ventricular surface was recorded in open-chest rabbits.Results: In control rabbits, combined administration of methoxamine and nifekalant frequently induced VTs (16/20, 80%). In contrast, VT occurred only in 2 out of 14 rabbits treated with hydralazine (14.3%, P
      Citation: Journal of Arrhythmia 30, 3 (2014)
      PubDate: 2013-07-18
      DOI: 10.1016/j.joa.2013.06.002
      Issue No: Vol. 30, No. 3 (2013)
  • A rare KCNE1 polymorphism, D85N, as a genetic modifier of long QT syndrome
    • Authors: Kanae Hasegawa; Seiko Ohno, Hideki Itoh, Takeru Makiyama, Takeshi Aiba, Yasutaka Nakano, Wataru Shimizu, Hiroshi Matsuura, Naomasa Makita, Minoru Horie
      Pages: 161 - 166
      Abstract: Abstract: Background: The gene KCNE1 encodes the β-subunit of cardiac voltage-gated K+ channels and causes long QT syndrome (LQTS). LQTS is characterized by the prolongation of QT interval and lethal arrhythmias such as torsade de pointes (TdP). A KCNE1 polymorphism, D85N, has been shown to modify the phenotype of LQTS through a loss-of-function effect on both KCNQ1 and KCNH2 channels when co-expressed and reconstituted in a heterologous expression system.Methods: A screening for the D85N polymorphism was performed in 355 LQTS families with mutations in KCNQ1, KCNH2, or SCN5A. Among the probands who had a heterozygous status with the polymorphism, we focused on a family with a KCNH2 mutation (E58K), a N-terminal missense mutation, and examined the clinical significance of this polymorphism. We also conducted biophysical assays to analyze the effect of the polymorphism in mammalian cells.Results: In 355 probands, we found 14 probands (3.9%) who had a heterozygous compound status with the D85N polymorphism. In the family with a KCNE1-D85N polymorphism and a KCNH2-E58K mutation, the proband and her daughter carried both the KCNH2 mutation and the KCNE1-D85N polymorphism. They experienced repetitive syncope and TdP. Two sons of the proband had either KCNH2-E58K mutation or KCNE1-D85N, but were asymptomatic. Biophysical assays of KCNE1-D85N with KCNH2-E58K variants produced a larger reduction in the reconstituted IKr currents compared to co-expression with wild-type KCNE1.Conclusions: The KCNE1-D85N polymorphism modified the clinical features of LQTS patients.
      Citation: Journal of Arrhythmia 30, 3 (2014)
      PubDate: 2013-10-28
      DOI: 10.1016/j.joa.2013.08.004
      Issue No: Vol. 30, No. 3 (2013)
  • Rhythm and rate control effects of intravenous amiodarone for atrial
           fibrillation complicated by acutely decompensated heart failure
    • Authors: Daisuke Horiuchi; Shingo Sasaki, Takahiko Kinjo, Yuji Ishida, Taihei Itoh, Kenichi Sasaki, Shingen Owada, Masaomi Kimura, Ken Okumura
      Pages: 167 - 172
      Abstract: Abstract: Background: Atrial fibrillation (AF) often occurs in the acute phase of heart failure (AHF), and is usually associated with a rapid ventricular response. No drug with proven efficacy in the treatment of AF in the setting of AHF has been approved in Japan. We prospectively investigated the efficacy and safety of intravenous amiodarone injection in patients with AHF using a unified protocol.Methods: The study included 20 consecutive patients (15 males; mean age, 67±8 years) admitted for AHF accompanied by AF with rapid ventricular response (mean, 137±15beats/min). Eleven patients had recent-onset/transient/paroxysmal AF, and the other 9 had persistent/long-standing persistent AF. Amiodarone injection was administered for 24h under continuous ECG monitoring according to a protocol used for ventricular tachyarrhythmias in Japan.Results: In 10 of the 11 patients with recent-onset/transient/paroxysmal AF, AF was converted to sinus rhythm at a mean of 5.8h after initiation of intravenous amiodarone. In these patients, the heart rate during AF was reduced from 132±15 to 101±20beats/min (P
      Citation: Journal of Arrhythmia 30, 3 (2014)
      PubDate: 2013-11-18
      DOI: 10.1016/j.joa.2013.09.005
      Issue No: Vol. 30, No. 3 (2013)
  • Relationship between cardiopulmonary exercise testing parameters and heart
           failure risk (H2ARDD score) in atrial fibrillation
    • Authors: Shinya Suzuki; Akira Koike, Koichi Sagara, Takayuki Otsuka, Hiroto Kano, Shunsuke Matsuno, Hideaki Takai, Tokuhisa Uejima, Yuji Oikawa, Kazuyuki Nagashima, Hajime Kirigaya, Junji Yajima, Hiroaki Tanabe, Hitoshi Sawada, Tadanori Aizawa, Takeshi Yamashita
      Pages: 173 - 179
      Abstract: Abstract: Background: A novel risk scoring system (H2ARDD) for estimating the incidence of heart failure (HF) events in atrial fibrillation (AF) has been developed, which represents points assigned for organic heart disease (2 points), anemia (1 point), renal dysfunction (1 point), diabetes (1 point), and diuretic use (1 point). We aimed to clarify whether H2ARDD score is related to cardiopulmonary exercise testing (CPX) parameters in patients with AF.Methods: The study population included 344 consecutive patients with AF who underwent CPX as initial screening between June 2004 and March 2012. The association between 4 CPX parameters and the incidence of HF events was analyzed by using multiple linear regression models.Results: The peak O2 uptake (peak O2), anaerobic (gas exchange) threshold (AT), and ratio of the increase in O2 to the increase in work rate (ΔO2/ΔWR) were lower and the slope of the increase in ventilation to the increase in CO2 output (E–CO2 slope) was higher in patients with than in those without each H2ARDD score component. Accordingly, the parameters significantly increased or decreased according to H2ARDD score. With the multiple linear regression models, H2ARDD score was independently associated with each CPX parameter even after adjustment for various cofactors.Conclusions: H2ARDD score was independently associated with the well-established CPX parameters in patients with AF, suggesting a potential pathophysiological basis for a risk stratification system for predicting HF events in patients with AF.
      Citation: Journal of Arrhythmia 30, 3 (2014)
      PubDate: 2013-11-18
      DOI: 10.1016/j.joa.2013.09.002
      Issue No: Vol. 30, No. 3 (2013)
  • Systematic review of the use of intravenous amiodarone and nifekalant for
           cardiopulmonary resuscitation in Japan
    • Authors: Mari Amino; Koichiro Yoshioka, Shigetaka Kanda, Yoshiaki Deguchi, Mari Nakamura, Yoshinori Kobayashi, Sadaki Inokuchi, Teruhisa Tanabe, Yuji Ikari
      Pages: 180 - 185
      Abstract: Abstract: Background: Intravenous amiodarone is considered to be the first-line drug for the treatment of ventricular tachycardia or fibrillation. However, in Japan, nifekalant had been used before the introduction of amiodarone; therefore, most clinical studies on amiodarone use have been small-scale studies. The aim of the present study was to review the literature concerning the actual use of amiodarone and nifekalant in order to evaluate the effects of both drugs and the most appropriate mode of administration.Methods: The Japan Medical Abstracts Society, PubMed, and Scopus databases were used to identify the reports. The resulting data were used for a systematic review focusing on the effectiveness of amiodarone in comparison with that of nifekalant and the dose differential effect of amiodarone.Results: The search returned 9 studies, including 310 patients, that compared the effectiveness of amiodarone and nifekalant, as well as 3 studies, including 108 patients, that analyzed the effectiveness of treatment according to amiodarone dose. Of 418 patients, 187 in whom amiodarone was used for cardiopulmonary resuscitation (CPR) were included in a review that compared the doses recommended by Japanese guidelines 2009 (125mg intravenous [i.v.] over 10min) and the American Heart Association guidelines (300mg bolus i.v.). Amiodarone and nifekalant were equally effective in preventing electrical storm (67% vs. 67%). The defibrillation effect for CPR was also equal in the 2 groups (60% vs. 54%). Hypotension and bradycardia were recorded as adverse effects in the amiodarone group (9.5% and 5.3%), whereas torsades de pointes was observed in the nifekalant group (1.4%). In the analysis of the dose-differential effect of amiodarone, the rates of successful return of spontaneous circulation and discharge survival were higher in the 125-mg slow i.v. group than in the 300-mg bolus i.v. group (76% vs. 53% and 54% vs. 26%, respectively).Conclusions: Amiodarone and nifekalant were equivalent in their prophylactic and defibrillation efficacy. Concerning the initial amiodarone dose, the 125mg intravenous [i.v.] over 10min seemed to be more appropriate for the Japanese population.
      Citation: Journal of Arrhythmia 30, 3 (2014)
      PubDate: 2013-12-20
      Issue No: Vol. 30, No. 3 (2013)
  • Impact of atrial fibrillation on long-term clinical outcomes in
           outpatients with heart failure
    • Authors: Hidehiro Kaneko; Shinya Suzuki, Hiroto Kano, Shunsuke Matsuno, Takayuki Otsuka, Hideaki Takai, Tokuhisa Uejima, Yuji Oikawa, Junji Yajima, Akira Koike, Kazuyuki Nagashima, Hajime Kirigaya, Koichi Sagara, Hiroaki Tanabe, Hitoshi Sawada, Tadanori Aizawa, Takeshi Yamashita
      Pages: 186 - 191
      Abstract: Abstract: Background: Atrial fibrillation (AF) is a common arrhythmia in patients with heart failure (HF); however, its impact on unselected outpatients with HF remains unclear.Methods: We followed 2024 symptomatic outpatients with HF who visited the Cardiovascular Institute Hospital (The Shinken Database: 2004–2011, N=17,517). We examined the prevalence, clinical characteristics, and outcomes of AF in these outpatients with HF.Results: AF was observed in 310 of the patients (15%). Patients with AF were older; more likely to be female; and had lower rates of hypertension, diabetes mellitus, and ischemic heart disease. However, they also had higher rates of New York Heart Association grades III/IV, lower left ventricular ejection fraction (EF), renal dysfunction, and dilated cardiomyopathy. The use of cardiovascular drugs including beta-blockers, renin-angiotensin-system inhibitors, diuretics, digitalis, and antiarrhythmic drugs was more common in patients with AF. Kaplan–Meier curves revealed that the incidences of all-cause death, cardiovascular disease death, and HF-related admission were significantly higher in patients with AF. Kaplan–Meier curves and an unadjusted Cox regression analysis showed that AF was associated with a significantly higher risk of all-cause death, cardiovascular death, and HF-related admission. However, the adjusted Cox regression model showed that AF was no longer an independent risk factor for all-cause death, cardiovascular death, and HF death but remained an independent risk factor of HF-related admission (hazard ratio, 1.781; 95% confidence interval, 1.172–2.704; p=0.007).Conclusions: AF was frequently observed in outpatients with HF. AF was not associated with long-term mortality but was independently associated with HF-related admission in this outpatient population.
      Citation: Journal of Arrhythmia 30, 3 (2014)
      PubDate: 2013-12-26
      Issue No: Vol. 30, No. 3 (2013)
  • A case of premature ventricular contractions originating from the
           papillary muscle in the right ventricle
    • Authors: Keitaro Senoo; Takayuki Otsuka, Shinya Suzuki, Koichi Sagara, Takeshi Yamashita
      Pages: 192 - 196
      Abstract: Abstract: A 45-year-old man with premature ventricular contractions (PVCs) underwent electrophysiological studies. Activation mapping using a noncontact electroanatomical mapping system indicated that the septal mid-apical region in the right ventricle was activated earliest. However, pace mapping did not match the activation mapping. Although the PVCs were successfully eliminated by applying radiofrequency current to the prepotential site preceding their QRS onset, a recurrence of PVCs with the same QRS morphology was observed at the 2-month follow-up examination, necessitating a second procedure. During the second procedure, echocardiography-guided electroanatomic mapping revealed centrifugal activation from the right ventricular mid-apical region on the septal portion of the anterior papillary muscle, but perfect pace mapping was not obtained at that site. With intracardiac echocardiography confirming good contact between the ablation catheter and papillary muscle, an irrigated radiofrequency current successfully eliminated the PVCs. This case indicates that the use of a guidance system may be feasible and useful for catheter ablation of PVCs originating from the right ventricular papillary muscle when there are discrepancies between activation mapping and pace mapping.
      Citation: Journal of Arrhythmia 30, 3 (2014)
      PubDate: 2013-09-18
      DOI: 10.1016/j.joa.2013.08.002
      Issue No: Vol. 30, No. 3 (2013)
  • Adenosine-sensitive atrial tachycardia originating from the mitral
           annulus–aorta junction
    • Authors: Naoto Kino; Toshiya Kurotobi, Daisuke Tonomura, Kentaro Yano, Keiichi Furubayashi, Takao Tsuchida, Yoshihisa Shimada, Hitoshi Fukumoto
      Pages: 197 - 200
      Abstract: Abstract: Here we report a case of adenosine-sensitive focal atrial tachycardia that was successfully ablated from the left atrium at a site located adjacent to the posterior site of the left coronary cusp in spite of failed ablations from the superior-septal right atrium and non-coronary aortic cusp. In the case of an unsuccessful ablation from the right superoseptum and non-coronary aortic sinus, the left atrial septum represents a potential optional site for ablation.
      Citation: Journal of Arrhythmia 30, 3 (2014)
      PubDate: 2013-11-18
      DOI: 10.1016/j.joa.2013.09.006
      Issue No: Vol. 30, No. 3 (2013)
  • Monophasic action potential duration alternans after abrupt shortening of
           the cardiac cycle in humans
    • Authors: Kazumasa Sonoda; Ichiro Watanabe, Yasuo Okumura, Naoko Sasaki, Rikitake Kogawa, Keiko Takahashi, Hiroaki Mano, Masayoshi Kofune, Kimie Ohkubo, Toshiko Nakai, Satoshi Kunimoto, Atsushi Hirayama
      Pages: 204 - 207
      Abstract: Abstract: Background: Action potential alternans may be important in causing ventricular arrhythmias.Methods and results: We recorded monophasic action potentials from the right ventricular endocardium in patients with persistent atrial fibrillation who underwent internal atrial defibrillation during rapid ventricular pacing. In 3 of 45 patients, monophasic action potential duration alternans was observed at a pacing cycle length ≤350ms.Conclusion: Action potential alternans is not a rare phenomenon (6.6%) in humans.
      Citation: Journal of Arrhythmia 30, 3 (2014)
      PubDate: 2013-09-16
      DOI: 10.1016/j.joa.2013.06.005
      Issue No: Vol. 30, No. 3 (2013)
  • A curious alliance: Sinus nodal dysfunction precipitating atrioventricular
    • Authors: Sreekanth Yerram; MD, Chandramohan Ramasamy, MD, Jayaraman Balachander, MD, DM, Raja J. Selvaraj, MD, DNB
      Pages: 208 - 210
      Abstract: Abstract: An elderly woman presented with recurrent syncope. Sinus bradycardia and sinoatrial block were seen on the electrocardiogram; however, PR interval prolongation after sinus pauses suggested atrioventricular conduction system disease. The occurrence of complete atrioventricular block after a pause during the electrophysiological study confirmed a diagnosis of paroxysmal atrioventricular block precipitated by sinus pauses secondary to sinus nodal disease.
      Citation: Journal of Arrhythmia 30, 3 (2014)
      PubDate: 2013-09-19
      DOI: 10.1016/j.joa.2013.07.007
      Issue No: Vol. 30, No. 3 (2013)
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