Journal Detail Information

1

Cite

Share

Implantable Cardioverter-Defibrillator of Korean Patients in a Single Center Registry.

Jin Kyung HWANG ; Hye Bin GWAG ; Seung Jung PARK ; Kyoung Min PARK ; June Soo KIM ; Young Keun ON

International Journal of Arrhythmia.2017;18(4):155-167. doi:10.18501/arrhythmia.2017.026

BACKGROUND AND OBJECTIVES: The safety and efficacy of implantable cardioverter-defibrillator (ICD) for Korean is unclear. We investigated the clinical characteristics and outcomes of Korean patients undergoing ICD for primary or secondary prevention. MATERIALS AND METHODS: From October 1999 to December 2016, 396 cases (365 patients) of ICD implantation were performed: Baseline characteristics, procedural findings, and clinical outcome data were collected retrospectively from our ICD registry. The primary outcome was composite of cardiac death, appropriate shock or antitachycardia pacing. RESULTS: Among 365 patients, 91 patients (25.9%) had ICD for primary prevention and 274 patients (75.1%) were for secondary prevention (51.2±17.10 years, male was 80.8%). The median follow-up period was 3.1 years (interquartile range: 1.6–6.0 days). The most prevalent etiology was dilated cardiomyopathy (46.2%) in the primary prevention and idiopathic ventricular tachycardia or fibrillation (24.4%) in the secondary prevention. The primary outcome was noted in 28.6% of the primary prevention and 33.2% of the secondary prevention (P=0.44). The rate of cardiac death was 2.2% in the primary prevention and 1.8% in the secondary prevention (P=1.00). The hospitalization due to heart failure was higher in the primary prevention compared with the secondary prevention (23.1% versus 13.5%, P=0.03). ICD therapy occurred in 134 patients (36.7%). Among them, 60 patients (44.8% of ICD therapy) experienced inappropriate shock. The most common cause of inappropriate shock was atrial fibrillation of flutter (AF/AFL). CONCLUSION: The clinical efficacy and safety of ICD in Korean is consistent with the data from Western countries.
Atrial Fibrillation ; Cardiomyopathy, Dilated ; Death ; Defibrillators, Implantable* ; Follow-Up Studies ; Heart Failure ; Hospitalization ; Humans ; Male ; Primary Prevention ; Retrospective Studies ; Secondary Prevention ; Shock ; Tachycardia, Ventricular ; Treatment Outcome

2

Cite

Share

Full-Body Magnetic Resonance Imaging in Patients with an Implantable Cardioverter-Defibrillator: Primary Results of a Randomized Study..

Boyoung JOUNG

International Journal of Arrhythmia.2016;17(3):156-157. doi:10.18501/arrhythmia.2016.026

No abstract available.
Defibrillators, Implantable* ; Humans ; Magnetic Resonance Imaging*

3

Cite

Share

New Technologies for Magnetic Resonance Imaging Compatible Device of Boston Scientific.

Ji Woon JUNG

International Journal of Arrhythmia.2016;17(3):150-155. doi:10.18501/arrhythmia.2016.025

The use of both magnetic resonance imaging (MRI) and pacing devices has vastly increased worldwide in recent years. A significant number of implanted patients will likely need monitoring using magnetic resonance imaging (MRI) over the course of the lifetime of their device. Some studies have demonstrated that with appropriate precautions, MRI can be safely performed in patients with selected implantable pacemakers. However, MRI is still contraindicated in patients with pacemakers. Recently, new pacing systems have been specifically designed for safe use in the MRI environment. The first reported experience suggests that the technology is safe and may allow patients with these new pacemakers to undergo MRI. This review will describe the outstanding issues and controversies surrounding the safety of MRI in patients with pacemakers, and the potential benefits of the new MRI-conditional technology. We will also discuss how to decide whether an MRI-conditional system should be implanted, and highlight key issues that warrant further studies.
Humans ; Magnetic Resonance Imaging*

4

Cite

Share

Efforts of the Past 20 Years for Proved Magnetic Resonance Imaging Safety of Medtronic Implantable Cardiac Devices.

Jisuk LEE

International Journal of Arrhythmia.2016;17(3):144-149. doi:10.18501/arrhythmia.2016.024

Magnetic resonance imaging (MRI) is increasingly becoming a standard of care and hence, an unmatched and irreplaceable diagnostic method. However, patients with implantable cardiac devices have not been guaranteed safety when exposed to the MRI environment. For this reason, Medtronic has taken the initiative and developed SureScan™ devices, which are MRI compatible devices for patients that would enable them to undergo MRI scans safely. The current technological developments in magnetic resonance (MR) and their clinical applications are discussed.
Cardiology ; Humans ; Magnetic Resonance Imaging* ; Methods ; Safety Management ; Standard of Care

5

Cite

Share

Basic Cardiac Magnetic Resonance Physics for Clinicians - a Clinician's Point of View.

Sang Chol LEE

International Journal of Arrhythmia.2016;17(3):135-143. doi:10.18501/arrhythmia.2016.023

Gaining a complete understanding of the physics of magnetic resonance imaging (MRI) is a daunting task. However, as cardiac MRI is being increasingly used in cardiovascular medicine, understanding the basics of MRI physics has become necessary for appropriate assessment of the images and correct interpretation of the findings. MRI is an imaging modality that utilizes the magnetic potential of the body. When the body is placed inside an extremely strong magnetic field, the protons of the water molecules inside the body align along the field, after which, the proton spins are exposed to a radiofrequency pulse with a frequency that matches the precession frequency of the protons in the body. This causes the precession of the protons to resonate and increase in amplitude. Simultaneously, three-dimensional magnetic gradients are applied for targeting specific slices of the body and discriminating the two-dimensional orientation of the organs; this is followed by emission of electromagnetic pulses generated by the resonance with varying frequencies and phases from various parts of the body. As soon as the input pulse has ceased, the machine starts absorbing the electromagnetic pulses that are being emitted by the body. These waves are mathematically converted into images of the internal organs and are visualized through rapid computer processing. To improve the contrast between tissues and abnormal structures, specific pulse sequences and weighting of the images are applied. This review summarizes the principles of MRI physics for clinicians who lack an understanding of fundamental physics.
Magnetic Fields ; Magnetic Resonance Imaging ; Magnets ; Protons ; Water

6

Cite

Share

4q25 and ZFHX3 Single Nucleotide Polymorphisms are Associated with Electroanatomical Characteristics of Left Atrium and Clinical Outcomes of Radiofrequency Catheter Ablation in Patients with Atrial Fibrillation.

Jaemin SHIM ; Jae Sun UHM ; Boyoung JOUNG ; Moon Hyoung LEE ; Hui Nam PAK

International Journal of Arrhythmia.2016;17(3):118-134. doi:10.18501/arrhythmia.2016.022

BACKGROUND AND OBJECTIVES: Previous studies have demonstrated an association between several single nucleotide polymorphisms and atrial fibrillation (AF). We hypothesized that the phenotypes of AF patients were associated with common AF susceptibility alleles. SUBJECTS AND METHODS: A total of 659 patients (57±9 years, 76% male) with AF who underwent catheter ablation and 659 age, and sex-matched controls were genotyped for the common AF susceptibility alleles rs2200733 and rs6843082 at 4q25, rs2106261 at ZFHX3, and rs13376333 at KCNN3. The phenotypes of AF patients, including electroanatomical characteristics of the left atrium and recurrence after ablation, were compared. RESULTS: The rs2200733 variant allele carriers have larger left atrium volume (128.5±40.7 vs. 113.5±29.2 mL, p=0.020), longer PR interval (185.9±32.6 vs. 174.8±21.9 ms, p=0.018), and higher amplitude of negative P-wave terminal force in Lead V₁ (0.07±0.04 vs. 0.05±0.04 mV, p=0.015) on electrocardiography than those without the variant allele. When the patients were assigned to three groups according to the number of variant alleles (Group A: no variant, n=15; Group B: 1 variant, n=158; Group C: 2 variants, n=439), incremental prognostic value, according to the number of variant alleles, was demonstrated (Log Rank p=0.015). Multivariate Cox regression analysis showed that persistent AF (OR 1.677, 95% CI 1.176-2.381, p=0.004) and the number of variants (OR 1.552, 95% CI 1.099-2.222, p=0.015) were independent predictors for recurrence of AF. CONCLUSION: This study showed the common AF susceptibility alleles at 4q25 and ZFHX3 are associated with electroanatomical characteristics of the left atrium and the clinical outcomes of catheter ablation in Korean patients with AF.
Alleles ; Atrial Fibrillation* ; Catheter Ablation* ; Electrocardiography ; Heart Atria* ; Humans ; Phenotype ; Polymorphism, Single Nucleotide* ; Recurrence

7

Cite

Share

Bradyarrhythmia Can Increase the Plasma Level of N-Terminal Pro-Brain Natriuretic Peptide.

Young Soo LEE

International Journal of Arrhythmia.2016;17(3):112-117. doi:10.18501/arrhythmia.2016.021

BACKGROUND AND OBJECTIVES: Myocardial wall stretch is the main trigger for pro-brain natriuretic peptide (pro-BNP) secretion. The reduced heart rate associated with bradyarrhythmia increases stroke volume, resulting in increased wall tension. Therefore, we propose that bradyarrhythmia could increase plasma N-terminal pro-BNP (NT-pro-BNP) levels. SUBJECTS AND METHODS: We enrolled 125 patients who received a temporary pacemaker because they had sinus node dysfunction (SND) or atrioventricular blocks (AVBs). Patients with renal dysfunction, hyperkalemia, reduced left ventricular systolic function (left ventricular ejection fraction [LVEF], <40%), and atrial fibrillation were excluded. Heart failure (HF) was defined as an NT-pro-BNP level of >300 pg/mL. We evaluated history of hypertension, diabetes mellitus, and ischemic heart disease, plasma NT-pro-BNP levels, body mass index (BMI), LVEF, left atrial diameter (LAD), and escape rhythm rate. RESULTS: The log plasma NT-pro-BNP level of the patients with AVBs was significantly increased compared to that of the patients with SND (3.17±0.55 vs. 2.93±0.64 pg/mL, respectively; p=0.03). The incidence of HF was 72.5% (106 patients; 44 male patients). Further, the incidence of HF was significantly higher among patients with AVBs than among patients with SND. The type of bradyarrhythmia was found to be the only predictor of HF after adjusting for age, history of hypertension, LAD, and LVEF. The LVEF, LAD, and ventricular rate were similar between the 2 groups. CONCLUSION: As in the case of patients with tachyarrhythmia, bradyarrhythmia may increase plasma NT-pro-BNP levels, leading to HF. Therefore, the possibility of HF should be considered in patients with bradyarrhythmia.
Arrhythmias, Cardiac ; Atrial Fibrillation ; Atrioventricular Block ; Body Mass Index ; Bradycardia* ; Diabetes Mellitus ; Heart Failure ; Heart Rate ; Humans ; Hyperkalemia ; Hypertension ; Incidence ; Male ; Myocardial Ischemia ; Plasma* ; Sick Sinus Syndrome ; Stroke Volume ; Tachycardia ; United Nations

8

Cite

Share

Two Cases of Transhepatic Implantation of Cardiac Implantable Electronic Device: All Roads lead to Rome.

Myung Jin CHA ; Jae Sun UHM ; Tae Hoon KIM ; Eue Keun CHOI ; Boyoung JOUNG ; Hui Nam PAK ; Seil OH ; Moon Hyoung LEE

International Journal of Arrhythmia.2017;18(4):209-214. doi:10.18501/arrhythmia.2017.032

Lead insertion for cardiac implantable electronic devices requires venous access into the right side of the heart. The access route commonly used is from the axillary vein, through the subclavian vein and the superior vena cava. However, in patients with congenital heart malformations or those with vascular stenosis, and/or those who have undergone previous cardiac surgery, the passage of leads might be difficult, and the implantation procedure would show restricted scope. In such cases, insertion of leads through the hepatic vein is known to be a safe procedure. We report 2 cases of patients with limited vascular access who underwent lead implantation using the transhepatic approach—1 patient who underwent placement of an implantable cardioverter defibrillator and the other who underwent placement of a permanent pacemaker.
Axillary Vein ; Constriction, Pathologic ; Defibrillators ; Defibrillators, Implantable ; Heart ; Hepatic Veins ; Humans ; Subclavian Vein ; Thoracic Surgery ; Vena Cava, Superior

9

Cite

Share

Radiofrequency Catheter Ablation of Persistent Atrial Fibrillation with Myotonic Dystrophy and Achalasia-like Esophageal Dilatation.

Bong Joon KIM ; Tae Joon CHA

International Journal of Arrhythmia.2017;18(4):205-208. doi:10.18501/arrhythmia.2017.031

Myotonic dystrophy, a multi-systemic disease with cardiac involvement, is the most common inherited neuromuscular disease. Here, we report the results of radiofrequency catheter ablation of persistent atrial fibrillation in a patient with myotonic dystrophy and achalasia-like esophageal dilatation.
Atrial Fibrillation* ; Catheter Ablation* ; Dilatation* ; Humans ; Myotonic Dystrophy* ; Neuromuscular Diseases

10

Cite

Share

Prevalence of Atrial Fibrillation in Korean Population.

So Ryoung LEE ; Eue Keun CHOI

International Journal of Arrhythmia.2017;18(4):195-204. doi:10.18501/arrhythmia.2017.030

Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice and has been a major public health problem. The prevalence of AF globally has been reported to range from 0.4% to 2% in the adult population; however, the prevalence widely varies depending on the study population. Although AF prevalence in Asian population is about 1% lower than that in European and North American population, the number of AF patients in Asia is rapidly increasing concomitant with the increased aging of the population. However, previous studies that reported AF epidemiology in the Korean population are limited. According to a recent report based on the national health claims database, prevalence of AF in 2015 was 0.7% in the entire Korean adult population and showed a continuous increase with population aging. Additionally, among patients with AF, mean CHA2DS2-VASc score was significantly increased and the number of high thromboembolic risk patients has increased over time. Although oral anticoagulation (OAC) prescription in AF patients increased from 35% to 51%, especially after introduction of non-vitamin K antagonist anticoagulants, a substantial proportion of Korean patients with AF still remain undertreated. In this review, we aimed to summarize temporal changes in the prevalence and incidence of AF and to evaluate the thromboembolic risk in patients with AF. In addition, we also discussed the utilization of OAC therapy in patients with AF in Korean population.
Adult ; Aging ; Anticoagulants ; Arrhythmias, Cardiac ; Asia ; Asian Continental Ancestry Group ; Atrial Fibrillation* ; Epidemiology ; Humans ; Incidence ; Prescriptions ; Prevalence* ; Public Health ; Stroke

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share