2021/10/20 更新

写真a

イイジマ ケンイチ
飯嶋 賢一
IIJIMA Kenichi
所属
医歯学総合病院 循環器内科 助教
職名
助教
外部リンク

学位

  • 博士(医学) ( 2010年10月   新潟大学 )

研究キーワード

  • 心臓電気生理学

  • 循環器内科学

研究分野

  • ライフサイエンス / 循環器内科学

経歴(researchmap)

  • 新潟大学医歯学総合病院   循環器内科   助教

    2019年2月 - 現在

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  • 新潟大学医歯学総合病院   循環器内科   特任助教

    2016年4月 - 2019年1月

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  • 新潟大学大学院医歯学総合研究科   循環器内科学   医員

    2015年4月 - 2016年3月

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  • アラバマ大学バーミングハム校   医用工学部   博士研究員

    2013年10月 - 2015年4月

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  • 新潟大学医学部   循環器内科   医員

    2006年4月 - 2013年9月

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経歴

  • 新潟大学   医歯学総合病院 循環器内科   助教

    2019年2月 - 現在

  • 新潟大学   医歯学総合病院 循環器内科   特任助教

    2016年4月 - 2019年1月

学歴

  • 新潟大学大学院   医歯学総合研究科

    2006年4月 - 2010年9月

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  • 新潟大学   医学部   医学科

    1996年4月 - 2003年3月

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所属学協会

 

論文

  • Right ventricular insertion promotes reinitiation of ventricular fibrillation in defibrillation failure. 国際誌

    Kenichi Iijima, Hanyu Zhang, Matthew T Strachan, Jian Huang, Gregory P Walcott, Jack M Rogers

    Heart rhythm   2021年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Shocks near defibrillation threshold (nDFT) strength commonly extinguish all ventricular fibrillation (VF) wavefronts, but a train of rapid, well-organized postshock activations (PAs) typically appears before sinus rhythm ensues. If one of the PA waves undergoes partial propagation block (wavebreak), reentry may be induced, causing VF to reinitiate and the shock to fail. OBJECTIVE: The purpose of this study was to determine whether wavebreak leading to VF reinititation following nDFT shocks occurs preferentially at the right ventricular insertion (RVI), which previous studies have identified as a key site for wavebreak. METHODS: We used panoramic optical mapping to image the ventricular epicardium of 6 isolated swine hearts during nDFT defibrillation episodes. After each experiment, the hearts were fixed and their geometry scanned with magnetic resonance imaging (MRI). The MRI and mapping datasets were spatially coregistered. For failed shocks, we identified the site of the first wavebreak of a PA wave during VF reinitiation. RESULTS: We recorded 59 nDFT failures. In 31 of these, the first wavebreak event occurred within 1 cm of the RVI centerline, most commonly on the anterior side of the right ventricular insertion (aRVI) (23/31). The aRVI region occupies 16.8% ± 2.5% of the epicardial surface and would be expected to account for only 10 wavebreaks if they were uniformly distributed. By χ2 analysis, aRVI wavebreaks were significantly overrepresented. CONCLUSION: The anterior RVI is a key site in promoting nDFT failure. Targeting this site to prevent wavebreak could convert defibrillation failure to success and improve defibrillation efficacy.

    DOI: 10.1016/j.hrthm.2021.01.022

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  • Regional Disparities in Adherence to Guidelines for the Treatment of Chronic Heart Failure.

    Yuji Matsuo, Fumitoshi Yoshimine, Katsuya Fuse, Kazuo Suzuki, Takuya Sakamoto, Kenichi Iijima, Kazuyuki Ozaki, Tohru Minamino

    Internal medicine (Tokyo, Japan)   60 ( 4 )   525 - 532   2021年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Objective The incidence of chronic heart failure (CHF) is likely to keep increasing in Japan as the population ages, placing increased burdens on medical facilities, particularly on the limited numbers of rural hospitals. We explored the appropriateness of CHF treatment in rural areas in Japan. Methods We compared rates of adherence to therapeutic guidelines for CHF between residents with a left ventricular ejection fraction <35% living in urban areas (n = 207) and those in rural areas (n = 180). Treatments included pharmacological [beta-blockers, angiotensin-converting enzyme inhibitors (ACEi)/angiotensin II receptor blocker (ARB), mineralocorticoid receptor antagonist (MRA) and anticoagulants for atrial fibrillation] and non-pharmacological [implantable cardioverter defibrillator (ICD)/cardiac resynchronization therapy (CRT), cardiac rehabilitation and HF education] approaches. Patients This study included 387 patients with CHF, prior myocardial infarction or cardiomyopathy, and a left ventricular ejection fraction (LVEF) <35% as determined by echocardiography. Results The respective rates of treatments administered in urban and rural areas were as follows: beta-blockers, 91.3% vs. 61.7% (p<0.05); ACEi/ARB, 86.5% vs. 68.3% (p<0.05); MRA, 74.4% vs. 59.4% (p<0.01); anticoagulants, 100% vs. 86.5%, (p<0.05); ICD/CRT, 45.4% vs. 5.0% (p<0.05); cardiac rehabilitation, 32.4% vs. 13.3% (p<0.05) and HF education, 33.3% vs. 32.8% (p=0.75). Conclusion Regional disparities in treatment for CHF persist, even in Japan. Improvements in the use of guideline-directed treatment in rural areas might improve the outcomes for CHF patients.

    DOI: 10.2169/internalmedicine.4660-20

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  • J point elevation in high precordial leads associated with risk of ventricular fibrillation. 国際誌

    Yuki Hasegawa, Hiroshi Watanabe, Yasuhiro Ikami, Sou Otsuki, Kenichi Iijima, Nobue Yagihara, Daisuke Izumi, Tohru Minamino

    Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc   e12820   2020年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: The significance of high precordial electrocardiograms in idiopathic ventricular fibrillation (IVF) is unknown. METHOD: This study included 50 consecutive patients (48 men; age, 42 ± 18 years) who had spontaneous ventricular fibrillation not linked to structural heart disease and received implantable cardiac defibrillator therapy. IVF was diagnosed in 35 patients and Brugada syndrome was diagnosed in other 15 patients. Electrocardiograms in high intercostal space were compared between 35 patients with IVF and 105 age- and sex-matched healthy controls (patient: control ratio, 1:3). RESULTS: The frequency of J point elevation ≥ 0.1 mV in the 4th intercostal spaces was similar between patients with IVF (14%) and healthy controls (7%). However, the frequency of J point elevation ≥ 0.1 mV in the 3rd intercostal space was higher in patients with IVF (40%) than controls (11%) (p < .01). J point elevation was present only in the 3rd intercostal space but not in the 4th intercostal space in 30% of patients with IVF but only in 6% of controls (p < .01). During follow-up, the recurrence of ventricular fibrillation was higher in patients with IVF who had J point elevation in the 3rd intercostal space (36%) and Brugada syndrome(40%) than those with IVF who did not have J point elevation in the 3rd intercostal space(11%) (p < .05 for both). CONCLUSION: J point elevation in the 3rd intercostal space was associated with IVF and recurrences of ventricular fibrillation. Electrocardiogram recordings in the high intercostal space may be useful to identify risk of sudden death.

    DOI: 10.1111/anec.12820

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  • Placebo-Controlled, Double-Blind Study of Empagliflozin (EMPA) and Implantable Cardioverter-Defibrillator (EMPA-ICD) in Patients with Type 2 Diabetes (T2DM): Rationale and Design. 国際誌

    Shinya Fujiki, Kenichi Iijima, Masaaki Okabe, Shinichi Niwano, Kenichi Tsujita, Shigeto Naito, Kenji Ando, Kengo Kusano, Ritsushi Kato, Junichi Nitta, Tetsuji Miura, Takeshi Mitsuhashi, Kazuomi Kario, Yusuke Kondo, Masaki Ieda, Nobuhisa Hagiwara, Toyoaki Murohara, Kazuyoshi Takahashi, Hirofumi Tomita, Yasuchika Takeishi, Toshihisa Anzai, Wataru Shimizu, Masafumi Watanabe, Yoshihiro Morino, Takeshi Kato, Hiroshi Tada, Yoshihisa Nakagawa, Masafumi Yano, Koji Maemura, Takeshi Kimura, Hisako Yoshida, Keiko Ota, Takahiro Tanaka, Nobutaka Kitamura, Koichi Node, Yoshifusa Aizawa, Ippei Shimizu, Daisuke Izumi, Kazuyuki Ozaki, Tohru Minamino

    Diabetes therapy : research, treatment and education of diabetes and related disorders   11 ( 11 )   2739 - 2755   2020年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: Type 2 diabetes (T2DM) is associated with cardiovascular death, including sudden cardiac death due to arrhythmias. Patients with an implantable cardioverter-defibrillator (ICD) are also at high risk of developing a clinically significant ventricular arrhythmia. It has been reported that sodium-glucose cotransporter 2 (SGLT2) inhibitors can reduce cardiovascular deaths; however, the physiological mechanisms of this remain unclear. It is, however, well known that SGLT2 inhibitors increase blood ketone bodies, which have been suggested to have sympatho-suppressive effects. Empagliflozin (EMPA) is an SGLT2 inhibitor. The current clinical trial titled "Placebo-controlled, double-blind study of empagliflozin (EMPA) and implantable cardioverter-defibrillator (EMPA-ICD) in patients with type 2 diabetes (T2DM)" was designed to investigate the antiarrhythmic effects of EMPA. METHODS: The EMPA-ICD study is a prospective, multicenter, placebo-controlled, double-blind, randomized, investigator-initiated clinical trial currently in progress. A total of 210 patients with T2DM (hemoglobin A1c 6.5-10.0%) will be randomized (1:1) to receive once-daily placebo or EMPA, 10 mg, for 24 weeks. The primary endpoint is the number of clinically significant ventricular arrhythmias for 24 weeks before and 24 weeks after study drug administration, as documented by the ICD. The secondary endpoints of the study are the change from baseline concentrations in blood ketone and catecholamine 24 weeks after drug treatment. CONCLUSION: The EMPA-ICD study is the first clinical trial to assess the effect of an SGLT2 inhibitor on clinically significant ventricular arrhythmias in patients with T2DM and an ICD. TRIAL REGISTRATION: Unique trial number, jRCTs031180120 ( https://jrct.niph.go.jp/latest-detail/jRCTs031180120 ).

    DOI: 10.1007/s13300-020-00924-9

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  • Suppression of cardiac memory-related severe form of torsades de pointes by landiolol in a patient with congenital long QT syndrome type 2. 国際誌

    Sou Otsuki, Daisuke Izumi, Yuki Hasegawa, Nobue Yagihara, Kenichi Iijima, Tohru Minamino

    HeartRhythm case reports   6 ( 7 )   407 - 410   2020年7月

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  • Replacement of an Implantable Cardioverter-Defibrillator (ICD) with a New Standard Subcutaneous ICD System in a Patient with Jervell and Lange-Nielsen Syndrome. 査読

    Akinori Sato, Yuki Hasegawa, Hisanori Haniu, Shuichi Shiraishi, Nobue Yagihara, Kenichi Iijima, Daisuke Izumi, Tohru Minamino

    International heart journal   60 ( 5 )   1206 - 1210   2019年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A 7-year-old female suffering from syncope attacks and deafness was genetically diagnosed with Jervell and Lange-Nielsen syndrome (JLNS). A transvenous-designed shock lead and implantable cardioverter-defibrillator (ICD) were atypically implanted subcutaneously, because the patient's body was small. Six years after implantation, we confirmed the patient's eligibility for a subcutaneous ICD (S-ICD) based on electrocardiogram screening. The implanted ICD system was replaced with a new standard S-ICD system. Implantation of the S-ICD may be considered a reliable and safe option in young patients with JLNS, even if their electrocardiograms show remarkable prolongation of the QT interval and T-wave alternans.

    DOI: 10.1536/ihj.19-076

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  • Early repolarization and risk of lone atrial fibrillation. 査読 国際誌

    Yuki Hasegawa, Hiroshi Watanabe, Yasuhiro Ikami, Sou Otsuki, Kenichi Iijima, Nobue Yagihara, Akinori Sato, Daisuke Izumi, Tohru Minamino

    Journal of cardiovascular electrophysiology   30 ( 4 )   565 - 568   2019年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: Early repolarization syndrome is a recently proposed condition characterized by an early repolarization pattern in the electrocardiogram (ECG) and ventricular fibrillation in the absence of structural heart abnormalities. Although some studies have suggested that early repolarization is associated with frequency of atrial fibrillation, the association of early repolarization with atrial fibrillation is not well known. HYPOTHESIS: Early repolarization indicates the substrate for atrial fibrillation in addition to that for ventricular fibrillation. METHOD: This study included 79 patients (57 men [72%]; age, 45 ± 12 years) aged less than 60 years who had paroxysmal lone atrial fibrillation and 395 age- and sex-matched healthy controls (patient:control ratio, 1:5). Patients who had structural heart disease, hypertension, diabetes, hyperthyroidism, history of successful resuscitation, or the Brugada type ECG were excluded. ECGs recorded during sinus rhythm were compared between patients with atrial fibrillation and healthy controls. RESULTS: Early repolarization in the inferior and/or lateral leads was more common in patients with atrial fibrillation (25%) than controls (10%; P = 0.001). The location and magnitude of early repolarization were similar between the two groups. Other electrocardiographic measurements were not different between the two groups. Among patients with atrial fibrillation, there was no difference in clinical characteristics including age at atrial fibrillation development, sex, and body mass index between patients with early repolarization and those without early repolarization. Electrocardiographic measurements were not different between patients with early repolarization and those without early repolarization. CONCLUSION: Early repolarization was associated with lone atrial fibrillation. Early repolarization may indicate increased susceptibility to atrial fibrillation.

    DOI: 10.1111/jce.13848

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  • A Steam Pop Detected by Intracardiac Echocardiography During Catheter Ablation of the Left Ventricular Papillary Muscle. 査読

    Akinori Sato, Nobue Yagihara, Yuki Hasegawa, Sou Otuki, Kenichi Iijima, Daisuke Izumi, Tohru Minamino

    International heart journal   60 ( 1 )   199 - 203   2019年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A 60-year-old female with premature ventricular contractions (PVCs) originating from the bottom of the posteromedial papillary muscle of the left ventricle underwent radiofrequency catheter ablation (RFCA) using an irrigated-tip catheter. During ablation of the PVCs, a loud steam pop was observed. Intracardiac echocardiography (ICE) revealed a growing, hyperechogenic intramyocardial microbubble formation around the catheter tip. The formation disappeared slowly and completely, leaving an endocardial laceration without pericardial effusion. ICE imaging is valuable during a difficult RFCA procedure, because ICE reveals the exact anatomical position of the catheter and thus allows rapid evaluation of the occurrence of steam popping and any possible subsequent complication.

    DOI: 10.1536/ihj.18-136

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  • Clinical Predictors of Recurrent Ventricular Arrhythmias in Secondary Prevention Implantable Cardioverter Defibrillator Recipients With Coronary Artery Disease - Lower Left Ventricular Ejection Fraction and Incomplete Revascularization. 査読

    Toshiki Takano, Komei Tanaka, Kazuyuki Ozaki, Akinori Sato, Kenichi Iijima, Takao Yanagawa, Daisuke Izumi, Takuya Ozawa, Koichi Fuse, Masahito Sato, Naohito Tanabe, Tohru Minamino

    Circulation journal : official journal of the Japanese Circulation Society   82 ( 12 )   3037 - 3043   2018年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The implantable cardioverter defibrillator (ICD) is a standard prevention therapy for patients at high risk for sudden cardiac death (SCD) due to life-threatening ventricular arrhythmia (VA), that is, ventricular fibrillation and ventricular tachycardia. However, clinical predictors of recurrent VA in secondary prevention ICD recipients with coronary artery disease (CAD) remain unknown. Methods and Results: We followed up 96 consecutive patients with CAD undergoing ICD implantation for secondary prevention of SCD. Long-term rates and clinical predictors of appropriate ICD therapy (ICD-Tx) for VA were analyzed. Appropriate ICD-Tx occurred in 41 (42.7%) patients during a median follow-up of 2.4 years (interquartile range, 0.9-6.1). These patients had significantly greater left ventricular end-diastolic diameter (62.3±1.3 vs. 54.6±1.1 mm, P<0.001), lower left ventricular ejection fraction (LVEF; 36.3±2.0% vs. 45.7±1.8%, P<0.001), and more incomplete revascularization (ICR; 70.7% vs. 45.5%, P=0.014) than those without appropriate ICD-Tx. Multivariable analysis showed that LVEF (hazards ratio [HR], 0.950; 95% CI: 0.925-0.975; P<0.001) and ICR (HR, 2.293; 95% CI: 1.133-4.637; P=0.021) were significant predictors of appropriate ICD-Tx for VA. CONCLUSIONS: Lower LVEF and ICR were independent predictors of recurrent VA in secondary prevention ICD recipients with CAD.

    DOI: 10.1253/circj.CJ-18-0646

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  • Effects of Direct Oral Anticoagulants at the Peak Phase, Trough Phase, and After Vascular Injury. 査読 国際誌

    Sou Otuki, Daisuke Izumi, Masayoshi Suda, Akinori Sato, Yuki Hasegawa, Nobue Yagihara, Kenichi Iijima, Masaomi Chinushi, Ichiro Fuse, Tohru Minamino

    Journal of the American College of Cardiology   71 ( 1 )   102 - 104   2018年1月

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  • Inappropriate inhibition of biventricular pacing due to diaphragmatic myopotentials amplified by the selectable sensing filter 査読

    Kenichi Iijima, Naoko Ishida, Daisuke Izumi, Tohru Minamino

    EUROPACE   19 ( 12 )   2014 - 2014   2017年12月

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    記述言語:英語   出版者・発行元:OXFORD UNIV PRESS  

    DOI: 10.1093/europace/euw372

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  • The effects of pure potassium channel blocker nifekalant and sodium channel blocker mexiletine on malignant ventricular tachyarrhythmias 査読

    Sou Otuki, Kanae Hasegawa, Hiroshi Watanabe, Goro Katsuumi, Nobue Yagihara, Kenichi Iijima, Akinori Sato, Daisuke Izumi, Hiroshi Furushima, Masaomi Chinushi, Yoshifusa Aizawa, Tohru Minamino

    JOURNAL OF ELECTROCARDIOLOGY   50 ( 3 )   277 - 281   2017年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS  

    Background: Patients with repetitive ventricular tachyarrhythmias so-called electrical storm frequently require antiarrhythmic drugs. Amiodarone is widely used for the treatment of electrical storm but is ineffective in some patients. Therefore, we investigated the efficacy of stepwise administration of nifekalant, a pure potassium channel blocker, and mexiletine for electrical storm.
    Methods: This study included 44 patients with repetitive ventricular tachyarrhythmias who received stepwise therapy with nifekalant and mexiletine for electrical storm. Nifekalant was initially administered, and mexiletine was subsequently added if nifekalant failed to control ventricular tachyarrhythmias.
    Results: Nifekalant completely suppressed recurrences of ventricular arrhythmias in 28 patients (64%), including 6 patients in whom oral amiodarone failed to control arrhythmias. In 9 of 16 patients in whom nifekalant was partially effective but failed to suppress ventricular arrhythmias, mexiletine was added. The addition of mexiletine prevented recurrences of ventricular tachyarrhythmias in 5 of these 9 patients (56%). There was no death associated with electrical storm. In total, the stepwise treatment with nifekalant and mexiletine was effective in preventing ventricular tachyarrhythmias in 33 of 44 patients (75%). There was no difference in cycle length of the ventricular tachycardia, QRS interval, QT interval, or left ventricular ejection fraction between patients who responded to antiarrhythmic drugs and those who did not. During follow-up, 8 patients had repetitive ventricular tachyarrhythmia recurrences, and the stepwise treatment was effective in 6 of these 8 patients (75%).
    Conclusions: The stepwise treatment with nifekalant and mexiletine was highly effective in the suppression of electrical storm. (C) 2016 Published by Elsevier Inc.

    DOI: 10.1016/j.jelectrocard.2016.09.005

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  • Malignant Form of Idiopathic Ventricular Arrhythmia Originating from the Right Ventricular Outflow Tract 査読

    Keiko Sonoda, Hiroshi Watanabe, Masaomi Chinushi, Kanae Hasegawa, Nobue Yagihara, Kenichi Iijima, Akinori Sato, Daisuke Izumi, Hiroshi Furushima, Yoshifusa Aizawa

    journal of arrhythmia   27 ( 4 )   316   2017年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: Idiopathic ventricular fibrillation (VF) and/or polymorphic VT are occasionally initiated by VT or premature ventricular contraction (PVC) originating from the RVOT. Methods: Among 56 patients without structural heart disease in whom EPS was conducted for idiopathic VT arising from the RVOT, we examined the clinical characteristics in 5 patients with VF or polymorphic VT initiated by PVC originating from RVOT. Results: Episodes of VF were documented in 1 patient and polymorphic VT in 4 patients including one with a family history of aborted sudden death. In holter recording, there was no PVC/VT with short coupling interval in any patients. In Treadmill test, there were no patient with VT/VF inducted by exercise. 2 patients had J waves. The morphologies of PVC triggering polymorphic VT or VF were various:QS pattern was seen in the lead? in 3 patients, RS pattern was seen in the remaining. Conclusion: In this study, we found that the lack of inducibility by exercise and the absence of family history of cardiac disease were not always benign factor in the RVOT-VT/PVC. There were not any special feature in the form of PVC triggering VT/VF. Our findings may be useful to treat the patients with history of syncope and episodes of RVOT VT/VPC. © 2011, Japanese Heart Rhythm Society. All rights reserved.

    DOI: 10.4020/jhrs.27.PJ2_085

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  • Electrical stimulation-based evaluation for functional modification of renal autonomic nerve activities induced by catheter ablation 査読

    Masaomi Chinushi, Katsuya Suzuki, Osamu Saitoh, Hiroshi Furushima, Kenichi Iijima, Daisuke Izumi, Akinori Sato, Mika Sugai, Mitsuya Iwafuchi

    HEART RHYTHM   13 ( 8 )   1707 - 1715   2016年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE INC  

    BACKGROUND Catheter ablation of the renal artery can be performed without apparent angiographic stenosis. This suggests that renal nerve function can be attenuated with minor structural damage to the renal artery.
    OBJECTIVE To clarify this hypothesis, we examined the relationship between electrical nerve stimulation (ENS)-induced blood pressure (BP) response and severity of histological injury of the renal artery using an acute canine model of renal artery ablation.
    METHODS An irrigation catheter was inserted into the renal arteries of 8 dogs, and radiofrequency current was delivered at 15, 20, or 25 W. ENS was applied to each artery before and after ablation.
    RESULTS Before ablation, ENS increased the BP and heart rate from 145 15/86 13 to 189 21/111 19 mm Hg and from 116 9 to 130 6 beats/min, respectively. Heart rate variability indices and serum catecholamine levels were elevated concomitantly. After ablation, the ENS -induced increase in BP and heart rate were markedly attenuated after 15 W ablation and those were nearly completely inhibited after 20 or 25 W ablation. An increase in heart rate variability indices and serum catecholamine levels became insignificant regardless of the applied energy. Renal artery angiograms revealed stenotic lesions only after 25 W ablation procedures. Histological studies showed mild to moderate injury of the arterial wall and autonomic nerves caused by 20 and 25 W ablation procedures, whereas only minor changes caused by 15 W ablation.
    CONCLUSION Functional renal autonomic nerve ablation is potentially performable with the guidance of ENS.

    DOI: 10.1016/j.hrthm.2016.04.021

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  • Optical Mapping of Membrane Potential and Epicardial Deformation in Beating Hearts 査読

    Hanyu Zhang, Kenichi Iijima, Jian Huang, Gregory P. Walcott, Jack M. Rogers

    BIOPHYSICAL JOURNAL   111 ( 2 )   438 - 451   2016年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:CELL PRESS  

    Cardiac optical mapping uses potentiometric fluorescent dyes to image membrane potential (V-m). An important limitation of conventional optical mapping is that contraction is usually arrested pharmacologically to prevent motion artifacts from obscuring V-m signals. However, these agents may alter electrophysiology, and by abolishing contraction, also prevent optical mapping from being used to study coupling between electrical and mechanical function. Here, we present a method to simultaneously map V-m and epicardial contraction in the beating heart. Isolated perfused swine hearts were stained with di-4-ANEPPS and fiducial markers were glued to the epicardium for motion tracking. The heart was imaged at 750 Hz with a video camera. Fluorescence was excited with cyan or blue LEDs on alternating camera frames, thus providing a 375-Hz effective sampling rate. Marker tracking enabled the pixel(s) imaging any epicardial site within the marked region to be identified in each camera frame. Cyan-and blue-elicited fluorescence have different sensitivities to V-m, but other signal features, primarily motion artifacts, are common. Thus, taking the ratio of fluorescence emitted by a motion-tracked epicardial site in adjacent frames removes artifacts, leaving V-m (excitation ratiometry). Reconstructed V-m signals were validated by comparison to monophasic action potentials and to conventional optical mapping signals. Binocular imaging with additional video cameras enabled marker motion to be tracked in three dimensions. From these data, epicardial deformation during the cardiac cycle was quantified by computing finite strain fields. We show that the method can simultaneously map V-m and strain in a left-sided working heart preparation and can image changes in both electrical and mechanical function 5 min after the induction of regional ischemia. By allowing high-resolution optical mapping in the absence of electromechanical uncoupling agents, the method relieves a long-standing limitation of optical mapping and has potential to enhance new studies in coupled cardiac electromechanics.

    DOI: 10.1016/j.bpj.2016.03.043

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  • 血圧調整における左右腎交感神経興奮の役割 (実験モデルの神経電気刺激と高周波アブレーション)

    池主 雅臣, 鈴木 克弥, 齋藤 修, 大矢 佳奈, 飯嶋 賢一, 佐藤 光希, 和泉 大輔, 須貝 美佳, 古嶋 博司

    心臓   48 ( 6 )   608 - 616   2016年6月

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    記述言語:日本語   出版者・発行元:公益財団法人 日本心臓財団  

    腎動脈アブレーションでは両側腎動脈に高周波通電が行われているが, その根拠は明らかにされていない. 高周波通電が両側腎動脈に行われる理由を検証するため動物実験を行った. ビーグル犬を用いて血圧調整における左右腎交感神経興奮の効果を, 腎動脈高周波アブレーション前後の神経電気刺激の昇圧反応から検討した. 腎動脈にイリゲーションカテーテルを挿入して高周波通電を片側腎動脈に行い, 先端電極からの神経電気刺激をアブレーション前後で施行した. アブレーション前の神経電気刺激で昇圧速脈反応が左右腎動脈で同程度に誘発され, 心拍変動解析の交感神経指標と血中カテコラミン値も上昇した. アブレーションを施行した腎動脈では神経電気刺激による昇圧速脈反応は観察されなくなったが, アブレーションをしなかった腎動脈の神経電気刺激では, アブレーション前と同等の昇圧速脈反応が再度誘発された. 腎交感神経刺激による全身交感神経緊張は左右腎動脈で同等に生じ, 一側腎動脈アブレーションは, 対側腎動脈刺激の昇圧速脈誘発に影響を与えなかった. 腎動脈アブレーションで成果を得るには, 両側腎動脈通電が望まれることを支持する所見と思われる.&lt;/p&gt;

    DOI: 10.11281/shinzo.48.608

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  • Effects of combination therapy with nifekalant and mexiletine on electrical storm 査読

    Otuki S, Hasegawa K, Watanabe H, Yagihara N, Iijima K, Sato A, Izumi D, Furushima H, Chinushi M, Minamino T

    EUROPEAN HEART JOURNAL   36   1068   2015年8月

  • Frequency Characteristics and Associations with the Defibrillation Threshold of Ventricular Fibrillation in Patients with Implantable Cardioverter Defibrillators 査読

    Kenichi Iijima, Masaomi Chinushi, Osamu Saitoh, Kanae Hasegawa, Keiko Sonoda, Nobue Yagihara, Akinori Sato, Daisuke Izumi, Hiroshi Watanabe, Hiroshi Furushima, Yoshifusa Aizawa, Tohru Minamino

    INTERNAL MEDICINE   54 ( 10 )   1175 - 1182   2015年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPAN SOC INTERNAL MEDICINE  

    Objective The dominant frequency (DF) in frequency analyses is considered to represent the objective cycle length and complexity of activation under conditions of ventricular fibrillation (VF). However, knowledge regarding the mechanisms determining the DF in human VF is limited. We studied the characteristics of the DF of human VF and relationship between DF and the defibrillation threshold.
    Methods Seventy-two implantable cardioverter-defibrillator patients and 211 VF were studied. Using defibrillation tests, we performed a frequency analysis with fast Fourier transformation. The correlations between DF and clinical characteristics, including the defibrillation threshold, were assessed.
    Results The mean DF of all induced VFs was 5.2 +/- 0.8 Hz. The patients were divided into two groups according to DF: the low-DF (DF &lt;5.2 Hz, n=32) and high-DF (DF &gt;= 5.2 Hz, n=40) groups. The frequency of structural heart disease was significantly higher in the low-DF group. In addition, the QRS duration, QT interval and effective refractory period of the right ventricle (RV-ERP) were significantly longer in the low-DF group. A multivariate analysis showed RV-ERP to be the only independent predictor of DF. Excluding patients receiving group III anti-arrhythmic drugs, which are known to have potent defibrillation threshold effects, the defibrillation threshold was significantly lower in the low-DF group (p=0.026).
    Conclusion We found that the DF of human VF is associated with underlying heart disease, the cardiac function, cardiac conduction, ventricular refractoriness and defibrillation threshold. Our findings may be useful for identifying and managing patients with a high defibrillation threshold.

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  • Short-coupling premature ventricular complexes from the left ventricle triggered isoproterenol-resistant electrical storm in a patient with Brugada syndrome 査読

    Masaomi Chinushi, Kenichi Iijima, Akinori Sato, Hiroshi Furushima

    HEART RHYTHM   10 ( 6 )   916 - 920   2013年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE INC  

    DOI: 10.1016/j.hrthm.2013.01.020

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  • Suppression of Storms of Ventricular Tachycardia by Epicardial Ablation of Isolated Delayed Potential in Noncompaction Cardiomyopathy 査読

    Masaomi Chinushi, Kenichi Iijima, Hiroshi Furushima, Daisuke Izumi, Akinori Sato, Nobue Yagihara, Kanae Hasegawa, Hiroshi Watanabe, Kyoko Soejima, Yoshifusa Aizawa

    PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY   36 ( 4 )   e115 - e119   2013年4月

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    記述言語:英語   出版者・発行元:WILEY-BLACKWELL  

    A 65-year-old recipient of an implantable cardioverter defibrillator suffering from ventricular noncompaction developed storms of ventricular tachycardia (VT). Epicardial voltage mapping revealed the presence of a large low-voltage area in the left ventricular apical and inferoposterior wall, and isolated delayed potential was recorded over 1.5 cm in the posterior border between low and normal myocardial voltage. Pacemapping at the delayed potential recording site produced two different QRS depending on pacing output strength, and these two QRS morphologies were similar to clinically documented VTs. During one of the VTs, a mid-diastolic potential was recorded from the site with the delayed potential, and rapid pacing produced concealed entrainment. After epicardial radiofrequency ablation of the isolated delayed potential, VTs were noninducible and the VT storm was suppressed. (PACE 2013; 36:e115-e119)

    DOI: 10.1111/j.1540-8159.2010.02999.x

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  • Blood pressure and autonomic responses to electrical stimulation of the renal arterial nerves before and after ablation of the renal artery 査読

    Masaomi Chinushi, Daisuke Izumi, Kenichi Iijima, Katsuya Suzuki, Hiroshi Furushima, Osamu Saitoh, Yui Furuta, Yoshifusa Aizawa, Mitsuya Iwafuchi

    Hypertension   61 ( 2 )   450 - 456   2013年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Radiofrequency (RF) catheter ablation of the renal artery is therapeutic in patients with drug-refractory essential hypertension. This study was designed to examine the role of the renal autonomic nerves and of RF application from inside the renal artery in the regulation of blood pressure (BP). An open irrigation catheter was inserted into either the left or right renal artery in 8 dogs. RF current (17±2 watts) was delivered to one renal artery. Electrical autonomic nerve stimulation was applied to each renal artery before and after RF ablation. BP, heart rate, indices of heart rate variability, and serum catecholamines were analyzed. Before RF ablation, electrical autonomic nerve stimulation of either renal artery increased BP from 150±16/ 92±15 to 173±21/105±16 mm Hg. After RF ablation, BP increased similarly when the nonablated renal artery was electrically stimulated, although the rise in BP was attenuated when the ablated renal artery was stimulated. Serum catecholamines and sympathetic nerve indices of heart rate variability increased when electrical autonomic nerve stimulation was applied before RF ablation and to the nonablated renal artery after RF ablation, although it changed minimally when the ablated renal artery was stimulated, suggesting interconnectivity between afferent renal nerve stimulation and systemic sympathetic activity. Renal artery angiogram showed no apparent injury after RF ablation. In conclusion, electrical stimulation of the renal arterial autonomic nerves increases BP via an increase in central sympathetic nervous activity. This response might be used to determine the target ablation site and end point of renal artery RF ablation. © 2012 American Heart Association, Inc.

    DOI: 10.1161/HYPERTENSIONAHA.111.00095

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  • Correlation between Defibrillation Threshold and Dominant Frequency of Ventricular Fibrillation 査読

    Kenichi Iijima, Akinori Sato, Daisuke Izumi, Hiroshi Watanabe, Hiroshi Furushima, Masaomi Chinushi

    CIRCULATION   126 ( 21 )   2012年11月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • Hemodynamic Responses and Histological Effects of Radiofrequency Catheter Ablation to Renal Artery Sympathetic Nerve 査読

    Masaomi Chinushi, Daisuke Izumi, Kenichi Iijima, Katuya Suzuki, Hiroshi Furushima, Yoshifusa Aizawa, Mitsuya Iwafuchi

    CIRCULATION   126 ( 21 )   2012年11月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • Radiofrequency Catheter Ablation to Ventricular Tachycardia with Tetoralogy of Fallot Usefulness of Ablation to Narrow Channel of Macroreentrant Circuit Around Ventricular Septal Patch 査読

    Hiroshi Furushima, Masaomi Chinushi, Hiroshi Watanabe, Daisuke Izumi, Akinori Sato, Kenichi Iijima

    CIRCULATION   126 ( 21 )   2012年11月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • Exercise-Related QT Interval Shortening with a Peaked T Wave in a Healthy Boy with a Family History of Sudden Cardiac Death 査読

    Masaomi Chinushi, Akinori Sato, Kenichi Iijima, Katuya Suzuki, Furushima Hiroshi, Daisuke Izumi, Hiroshi Watanabe, Hasegawa Kanae, Yoshifusa Aizawa

    PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY   35 ( 8 )   e239 - e242   2012年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL  

    An asymptomatic 15-year-old boy, who had a family history of sudden cardiac death, was referred for screening for cardiac disease. The 12-lead electrocardiogram at rest showed a short QT/QTc(Bazett)/QTc(Fredericia) interval of 320/388/364 ms, but the intervals were further shortened to 200/339/284 ms after the treadmill test concomitant with appearance of a peaked T wave. Other conventional cardiac examinations were normal, but effective refractory period was less than 180 ms in both ventricles, and double ventricular extrastimulation reproducibly induced nonsustained polymorphic ventricular tachycardia. Intravenous administration of epinephrine also induced a short QT interval and a peaked T wave, and a hump was manifested on the T wave of the first postpacing beat with a longer preceding RR interval. Furthermore, a couple of premature ventricular complexes originated from a similar timing as the hump. Genetic analysis did not show the mutation in KCNQ1, KCNH2, KCNE1, KCNE2, KCNJ2, SCN5A genes but revealed single nucleotide polymorphism (C5457T) in SCN5A gene. (PACE 2012; 35:e239e242)

    DOI: 10.1111/j.1540-8159.2012.03363.x

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  • Characteristics of J Wave-Associated Idiopathic Ventricular Fibrillation: Role of Drugs 査読

    Masaomi Chinushi, Kanae Hasegawa, Kenichi Iijima, Hiroshi Furushima, Daisuke Izumi, Akinori Sato, Yoshifusa Aizawa

    PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY   35 ( 8 )   e226 - e230   2012年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL  

    A storm of J wave-associated idiopathic ventricular fibrillation (VF) was observed in a 49-year-old man. Multiform premature ventricular complexes initiated the episodes of VF. Intravenous isoproterenol attenuated the J wave and suppressed the VF storm. After the implantation of a cardioverter defibrillator, VF was induced by programmed electrical stimulation at baseline, and it was terminated by a 25-J shock after an unsuccessful 15-J shock. During oral treatment with quinidine sulfate, 600 mg daily, the J wave was attenuated and VF became noninducible by programmed electrical stimulation. VF induced by a shock delivered on the T wave was terminated by a single 10-J shock. Mean F-F interval and dominant frequency of the VF were 162 ms and 6.8 Hz at baseline, and 210 ms and 5.0 Hz during the quinidine sulfate treatment. (PACE 2012; 35:e226e230)

    DOI: 10.1111/j.1540-8159.2011.03066.x

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  • Recurrence of ventricular fibrillation in a patient with non-type 1 Brugada electrocardiographic morpholog 査読

    Minoru Tagawa, Masaomi Chinushi, Yuichi Nakamura, Yukie Ochiai, Akinori Sato, Kenichi Iijima, Hiroko Uchiyama, Hiroshi Furushima, Yoshifusa Aizawa

    Journal of Cardiology Cases   6 ( 1 )   e17 - e19   2012年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A healthy 25-year-old man suffered from loss of consciousness due to ventricular fibrillation (VF). Emergency services required multiple cardioversion to restore sinus rhythm. Repeated electrocardiographic (ECG) recordings after admission showed non-type 1 Brugada ST-segment elevation in V1 and V2. Intravenous pilsicainide infusion augmented the ST-segment elevation but its morphology did not represent type-1 ECG. Intravenous administration of isoproterenol normalized the ST-segment elevation, and programmed electrical stimulation induced VF. Spontaneous VF recurred 1 year after introduction of implantable cardioverter defibrillator. Non-type 1 ST-segment elevation, to which pharmacological responses are similar to Brugada syndrome, may be used as a hallmark of ventricular tachyarrhythmia. © 2012 Japanese College of Cardiology.

    DOI: 10.1016/j.jccase.2012.03.008

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  • Epicardial and endocardial mapping determine most successful site of ablation for ventricular tachyarrhythmias originating from left ventricular summit 査読

    Kenichi Iijima, Masaomi Chinushi, Hiroshi Furushima, Yoshifusa Aizawa

    EUROPACE   14 ( 6 )   911 - 912   2012年6月

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    記述言語:英語   出版者・発行元:OXFORD UNIV PRESS  

    A 34-year-old woman presented with idiopathic premature ventricular complex (PVC) and ventricular tachycardia (VT) originating from the area called the left ventricular summit. Radiofrequency (RF) application both through the coronary sinus and to the epicardial surface transiently suppressed the VT/PVC. Radiofrequency with sufficient energy was only applicable from the endocardial site, and the VT/PVC was successfully eliminated.

    DOI: 10.1093/europace/eur382

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  • The peak-to-end of the T wave in the limb ECG leads reflects total spatial rather than transmural dispersion of ventricular repolarization in an anthopleurin-A model of prolonged QT interval 査読

    Daisuke Izumi, Masaomi Chinushi, Kenichi Iijima, Hiroshi Furushima, Yukio Hosaka, Kanae Hasegawa, Yoshifusa Aizawa

    HEART RHYTHM   9 ( 5 )   796 - 803   2012年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE INC  

    BACKGROUND Previous studies have showed that the interval between the peak and the end of the T wave (Tp-e) is a marker of transmural dispersion of ventricular repolarization.
    OBJECTIVE We studied the relationship between (a) the Tp-e on local pseudo transmural electrograms (pseudo transmural Tp-e) or limb leads of body surface electrocardiogram (surface Tp-e) and (b) the intracardiac left ventricular (LV) repolarization during a drug-induced QT-interval prolongation.
    METHODS Using open-chested canine intact hearts treated by anthopleurin-A, transmural LV electrograms were recorded via needle electrodes placed in the basoanterior, midanterior, apicoanterior, basolateral, midlateral, and apicolateral LV wall. Recovery time (RT) was calculated as an index of local repolarization at each transmural unipolar electrode.
    RESULTS This model showed slower heart rate-dependent heterogeneous distribution of ventricular repolarization both along the basal to apical axis and along the transmural axis. RT was longer at the LV apex than at the base and longer in the lateral than in the anterior wall during the slower heart rate. A high correlation was found between surface Tp-e and total LV dispersion. In contrast, pseudo transmural Tp-e correlated with transmural RT dispersion. The shortest RT in the heart roughly corresponded to the peak, as did the longest RT with the end of the T wave on the surface electrocardiogram.
    CONCLUSION During drug-induced QT-interval prolongation with a large apicobasal and anterolateral dispersion of ventricular repolarization, the Tp-e in the limb leads expresses spatial (total) distribution of repolarization in the whole left ventricle.

    DOI: 10.1016/j.hrthm.2011.11.046

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  • Epicardial Scar in a Patient with no Apparent Heart Disease 査読

    Masaomi Chinushi, Daisuke Izumi, Hiroshi Furushima, Akinori Sato, Kenichi Iijima, Kanae Hasegawa, Yoshifusa Aizawa

    PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY   35 ( 5 )   e136 - e139   2012年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL  

    A 35-year-old man, who had an episode of aborted sudden cardiac death due to ventricular fibrillation, suffered from multiple storms of ventricular tachycardia (VT). Conventional cardiac examinations did not reveal any structural heart diseases, and he had been treated by an implantable cardioverter defibrillator since 2007. At the latest admission, epicardial but not endocardial voltage mapping revealed a small area of low voltage at the left ventricular (LV) postero-lateral wall where a delayed potential was recorded during sinus rhythm. Excellent pacemapping with a prolonged stimulus to QRS interval was obtained from the area, and a mid-diastolic potential was recorded during the VT. Radiofrequency application terminated the VT and any VT became noninducible after the ablation. In some patients diagnosed as LV-VT with no apparent heart disease, arrhythmogenic substrate may exist on the epicardial surface of the ventricle. (PACE 2012; 35:e136e139)

    DOI: 10.1111/j.1540-8159.2011.03142.x

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  • Analysis of J waves during myocardial ischaemia 査読

    Akinori Sato, Yasuhiko Tanabe, Masaomi Chinushi, Yuka Hayashi, Tsuyoshi Yoshida, Eiichi Ito, Daisuke Izumi, Kenichi Iijima, Nobue Yagihara, Hiroshi Watanabe, Hiroshi Furushima, Yoshifusa Aizawa

    EUROPACE   14 ( 5 )   715 - 723   2012年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:OXFORD UNIV PRESS  

    The aim of this study was to investigate the relationship between J-wave dynamics and arrhythmias during myocardial ischaemia in patients with vasospastic angina (VSA).
    Sixty-seven consecutive patients diagnosed with VSA by a provocation test for coronary spasm were grouped according to whether they had a J wave in the baseline electrocardiograms or not (VSA-JW group, n 14; VSA-non-JW group: n 53). We retrospectively studied the associations between J-wave and ST-segment dynamics and induced ventricular fibrillations (VFs) during coronary spasm. In the VSA-JW group, 7 of the 14 patients showed changes in J-wave morphology and/or gains in J-wave voltage, followed by VF in 4 patients. Compared with patients without VF, the four patients with VF showed similar maximal voltage in the baseline J waves but a higher voltage during induced coronary spasms (0.57 0.49 vs. 0.30 0.11 mV; P 0.011). In three patients with VF, J waves progressively increased and were accompanied by the characteristic coved-type or lambda-shaped ST-segment elevations. In the VSA-non-JW group, only four patients showed new appearances of J waves during coronary spasms and another patient without a distinct J wave developed VF. Ventricular fibrillations were induced more frequently in the VSA-JW group than in the VSA-non-JW group [4/14 (29) vs. 1/53 (2); P 0.012].
    J-wave augmentations were caused by myocardial ischaemia during coronary spasms. The presence and augmentation of J waves, especially prominent J waves with the characteristic ST-elevation patterns, were associated with VF.

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  • Is the coexistence of sustained ST-segment elevation and abnormal Q waves a risk factor for electrical storm in implanted cardioverter defibrillator patients with structural heart diseases? 査読

    Hiroshi Furushima, Masaomi Chinushi, Kenichi Iijima, Kanae Hasegawa, Akinori Sato, Daisuke Izumi, Hiroshi Watanabe, Yoshifusa Aizawa

    EUROPACE   14 ( 5 )   675 - 681   2012年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:OXFORD UNIV PRESS  

    The aim of this study was to determine whether or not the coexistence of sustained ST-segment elevation and abnormal Q waves (STe-Q) could be a risk factor for electrical storm (ES) in implanted cardioverter defibrillator (ICD) patients with structural heart diseases.
    In all, 156 consecutive patients received ICD therapy for secondary prevention of sudden cardiac death and/or sustained ventricular tachyarrhythmias were included. Electrical storm was defined as epsilon 3 separate episodes of ventricular tachycardia (VT) and/or ventricular fibrillation (VF) terminated by ICD therapies within 24 h. During a mean follow-up of 1825 1188 days, 42 (26.9) patients experienced ES, of whom 12 had coronary artery disease, 15 had idiopathic dilated cardiomyopathy, 6 had hypertrophic cardiomyopathy, 4 had arrhythmogenic right ventricular cardiomyopathy, 4 had cardiac sarcoidosis, and 1 had valvular heart disease. Sustained ST-segment elevation and abnormal Q waves in epsilon 2 leads on the 12-lead electrocardiography was observed in 33 (21) patients. On the KaplanMeier analysis, patients with STe-Q had a markedly higher risk of ES than those without STe-Q (P 0.0001). The multivariate Cox proportional hazards regression model indicated that STe-Q and left ventricular ejection fraction (LVEF) (30) were independent risk factors associated with the recurrence of VT/VF (STe-Q: HR 1.962, 95 CI 1.243.12, P 0.004; LVEF: HR 1.860, 95 CI 1.202.89, P 0.006), and STe-Q was an independent risk factor associated with ES (HR 4.955, 95 CI 2.699.13, P 0.0001).
    Sustained ST-segment elevation and abnormal Q waves could be a risk factor of not only recurrent VT/VF but also ES in patients with structural heart diseases.

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  • Relationship between electroanatomical voltage mapping characteristics and breakout site of ventricular activation in idiopathic ventricular tachyarrhythmia originating from the right ventricular outflow tract septum 査読

    Hiroshi Furushima, Masaomi Chinushi, Kenichi Iijima, Daisuke Izumi, Yukio Hosaka, Yoshifusa Aizawa

    JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY   33 ( 2 )   135 - 141   2012年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    Objective To assess the electrophysiological characteristics of the breakout site of ventricular activation using electroanatomical voltage mapping (EVM) and its relation to the optimal ablation site in idiopathic ventricular tachyarrhythmias originating from the outflow tract of the (RVOT) septum.
    Methods Twenty-eight patients with symptomatic drug-refractory premature ventricular complexes (PVCs) and/or ventricular tachycardia (VT) originating from the RVOT septum and 5 control subjects with WPW syndrome were included. Low-voltage areas (LVAs) were defined as signal amplitudes between 0.1 and 1.5 mV. The borderline between the normal area and the LVA was defined as "border," and the distance from the LVA to the border (length of LVA) was measured.
    Results In all 28 patients and control subjects, there was an LVA below the pulmonary valve. There was no significant difference in length of LVA between patients with idiopathic ventricular arrhythmias and control subjects (2.0+/-0.6 vs. 1.9+/-0.1 cm). In 19 of the 28 patients, the optimal ablation site was identical to the border area. In all 11 patients who had pre-potentials at the successful ablation site, there were two cases with polymorphic VT and/or ventricular fibrillation associated with PVCs. In these two cases, length of LVA was longer than in other patients (4.0 and 3.9 cm vs. 1.8+/-0.5 cm (n=26)), and the optimal ablation site was located at the border area.
    Conclusion The border area, including the LVA, tends to be the breakout site and/or origin of ventricular arrhythmias in idiopathic ventricular tachyarrhythmia originating from the RVOT septum.

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  • Intramural inflammation as a cause of transient ST-segment elevation in a patient of cardiac sarcoidosis 査読

    Kenichi Iijima, Masaomi Chinushi, Hiroshi Furushima, Yoshifusa Aizawa

    EUROPACE   14 ( 2 )   300 - 302   2012年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:OXFORD UNIV PRESS  

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  • The prevalence of early repolarization in Wolff-Parkinson-White syndrome with a special reference to J waves and the effects of catheter ablation 査読

    Nobue Yagihara, Akinori Sato, Kenichi Iijima, Daisuke Izumi, Hiroshi Furushima, Hiroshi Watanabe, Tadanobu Irie, Yoshiaki Kaneko, Masahiko Kurabayashi, Masaomi Chinushi, Masahito Satou, Yoshifusa Aizawa

    JOURNAL OF ELECTROCARDIOLOGY   45 ( 1 )   36 - 42   2012年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS  

    We determined the prevalence of J waves in the electrocardiograms (ECG) of 120 patients with Wolff-Parkinson-White syndrome in comparison with J-wave prevalence in a control group of 1936 men and women with comparable demographic and ECG characteristics and with normal atrioventricular conduction. J waves were present only during manifest preexcitation in 22 of 120 patients (18.3%), disappearing after catheter ablation and suggesting that J waves were associated with the presence of preexcitation. J waves were present in 19 (15.8%) of 120 patients only after ablation, apparently having been masked by early depolarization of the preexcited myocardial region, and in 22 patients (18.3%), J waves were not altered significantly by preexcitation. Thus, the overall J-wave prevalence was 52.5% (63/120) and, excluding those apparently due to preexcitation, 34.8% (41/120), both substantially higher than the prevalence (11.5%) in the control group (P &lt; .001 for both). The patients with J waves appearing only during preexcitation were younger, predominantly females. The presence of J waves after ablation was associated with a history of atrial fibrillation and shorter ventricular effective refractory period. It is concluded that the prevalence of J waves is high in patients with Wolff-Parkinson-White syndrome and is influenced by manifest preexcitation. (C) 2012 Elsevier Inc. All rights reserved.

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  • Long QT Syndrome with Nocturnal Cardiac Events Caused by a KCNH2 Missense Mutation (G604S) 査読

    Akinori Sato, Masaomi Chinushi, Hiroshi Suzuki, Fujito Numano, Takanori Hanyu, Kenichi Iijima, Hiroshi Watanabe, Hiroshi Furushima

    INTERNAL MEDICINE   51 ( 14 )   1857 - 1860   2012年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPAN SOC INTERNAL MEDICINE  

    An 8-year-old boy suffered from an unconsciousness attack and torsade de pointes arrhythmia during sleep or at rest. His electrocardiogram showed prolonged QT intervals, but the T wave morphology was atypical for type 1, 2 or 3 congenital long-QT syndrome (LQTS). Intravenous epinephrine slightly prolonged the QT interval whereas mexiletine infusion shortened the QT interval. Although these clinical characteristics might suggest type 3 LQTS, a genetic analysis identified the G604S-KCNH2 mutation (type 2 LQTS). Because mismatches between the genotype and phenotype of LQTS are possible, genetic analysis of LQTS is important to identify the most appropriate therapeutic option and risk stratification.

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  • Insulation Defects in Riata Implantable Cardioverter-defibrillator Leads 査読

    Akinori Sato, Masaomi Chinushi, Kenichi Iijima, Daisuke Izumi, Hiroshi Furushima

    INTERNAL MEDICINE   51 ( 19 )   2689 - 2694   2012年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPAN SOC INTERNAL MEDICINE  

    Background The structures composing implantable cardioverter-defibrillator (ICD) leads have become more complicated and thinner with technological advances. Silicon insulation defects with and without clinically manifested electrical abnormalities have been reported in Riata leads (St. Jude Medical).
    Objective The aim of this study was to assess the incidence and clinical implications of insulation defects in Riata leads implanted at our hospital.
    Methods The subjects included 10 consecutive patients who received 8-French Riata ICD leads with dual-coil conductors (model 1580 or 1581) between 2006 and 2010 at our hospital. Operative records, chest X-rays and interrogation data were reviewed.
    Results In all cases, Atlas+ (St. Jude Medical) was used as an ICD generator and the Riata leads were implanted transvenously and fixed to the right ventricular apex. During a mean follow-up period of 52 +/- 9 (36-70) months, chest X-rays revealed insulation defects in Riata leads and conductor wires projecting from the bodies of the Riata leads in two of 10 (20%) patients. One of the patients received inappropriate ICD therapies due to T-wave oversensing based on attenuation of R waves and augmentation of T waves 41 months after implantation. In the other patient, an insulation defect without any clinically manifested electrical troubles was detected 50 months after implantation.
    Conclusion Riata leads have a high incidence of insulation defects, which may be occasionally accompanied by inappropriate ICD discharges. For patients with Riata leads, careful observation of any changes in the lead-electrical measurements and a routine chest X-ray follow-up are necessary.

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  • Ventricular Tachycardia Due to Intramyocardial Fibroma 査読

    Kenichi Iijima, Masaomi Chinushi, Daisuke Izumi, Yoshifusa Aizawa

    JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY   22 ( 7 )   825 - 826   2011年7月

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    記述言語:英語   出版者・発行元:WILEY-BLACKWELL  

    DOI: 10.1111/j.1540-8167.2010.01974.x

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  • Rate Control Is a Better Initial Treatment for Patients With Atrial Fibrillation and Heart Failure - Rhythm Control vs. Rate Control: Which Is Better in the Management of Atrial Fibrillation? (Rate-Side) 査読

    Masaomi Chinushi, Kenichi Iijima

    CIRCULATION JOURNAL   75 ( 4 )   970 - 978   2011年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPANESE CIRCULATION SOC  

    Congestive heart failure (CHF) and atrial fibrillation (AF) often coexist, and each increase the morbidity and mortality associated with the other. Until now, many studies have reported that a strategy of rate control, in combination with anticoagulation in patients at risk of thromboembolic events, appears to be at least equivalent to a strategy of maintaining sinus rhythm with currently available pharmacological therapeutic options. As compared to rhythm control therapy, rate control treatment is simple and relatively easy. Therefore, pharmacological rate control should be considered initially in patients with AF associated with CHF. However, cardiac symptoms associated with AF may continue after achieving reasonable ventricular rate control. Either pharmacological or non-pharmacological rhythm control needs to be considered at that time. Amiodarone is the only recommended antiarrhythmic drug in the recent therapeutic guidelines for CHF, and can be used for both rhythm and rate control of AF. However, there is no question that some patients require early non-pharmacological rhythm control instead of long-lasting rate control. Catheter ablation (CA) can be applicable even in AF associated with CHF, but the results of CA are closely associated with the clinical and electrophysiological characteristics in each patient, as well as with the experience with this procedure in each institution. Indications for and the appropriate period of CA need to be carefully examined in each individual. (Circ J 2011; 75: 970-978)

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  • An Appropriate Defibrillation Threshold Obtained by the Combined Connection Between Two Shock Leads and ICD Generator 査読

    Akinori Sato, Masaomi Chinushi, Kenichi Iijima, Hiroshi Watanabe, Daisuke Izumi, Hiroshi Furushima, Keiko Sonoda, Kanae Hasegawa, Nobue Yagihara, Yoshifusa Aizawa

    INTERNAL MEDICINE   50 ( 22 )   2815 - 2818   2011年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPAN SOC INTERNAL MEDICINE  

    A 60-year-old man with arrhythmogenic right ventricular cardiomyopathy was readmitted for the battery exchange of his implantable cardioverter-defibrillator (ICD). Since (i) he had been treated with a dual-coil shock lead (Sprint Fidelis, Medtronic) and (ii) pre-operative venography showed mild collateral flow to the left subclavian vein, a single-coil lead was additionally implanted. However, the single-coil defibrillation system was unable to terminate the induced ventricular fibrillation (VF), thus dual defibrillation shock pathways were created using the connection to the superior vena cava coil of the Fidelis lead. The combined connections of the two shock leads provided an appropriate margin of the defibrillation threshold.

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  • Association of J-Wave with Atrial Fibrillation in Wolff-Parkinson-White Syndrome 査読

    Nobue Yagihara, Masaomi Chinushi, Hiroshi Furushima, Hiroshi Watanabe, Daisuke Izumi, Akinori Sato, Kenichi Iijima, Tadanori Irie, Yoshiaki Kaneko, Masahiko Kurabayashi, Masahito Sato, Yoshifusa Aizawal

    Journal of Arrhythmia   27   2011年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: J-waves are considered to reflect early repolarization. We have previously reported the disappearance of J waves after catheter ablation of an accessory pathway in patients with Wolff-Parkinson-White syndrome. Here, we further studied the association of an accessory pathway on J-waves with Wolff-Parkinson-White syndrome. Methods: We included 124 patients with Wolff-Parkinson-White syndrome who underwent catheter ablation, and 1936 controls without structural heart disease or ECG abnormalities. Results: The prevalence of J-waves was higher in patients with Wolff-Parkinson-White syndrome (n=69, 56%) than the controls (n=222, 11.5%). After successful ablation of the Wolff-Parkinson-White patients, J-waves disappeared in 22 patients, while J-waves were still apparent or after ablation in 21 patients. The prevalence of atrial fibrillation was higher in patients with J-waves (n=31, 45%) after ablation than those without (n=15, 33%). The ventricular and atrial refractory period tended to be shorter in patients with J-waves, after ablation than those without such waves. Conclusion: J-waves were frequently observed and were affected by ablation of an accessory pathway in patients with Wolff-Parkinson-White syndrome although the exact nature of this association is still undetermined. © 2011, Japanese Heart Rhythm Society. All rights reserved.

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  • Incidence and Management for Trouble-Shooting Associated with the Sprint-Fidelis ICD Lead 査読

    Kenichi Iijima, Masaomi Chinushi, Akinori Sato, Yukio Hosaka, Daisuke Izumi, Hiroshi Furushima, Hiroshi Watanabe, Masahito Sato, Katsuya Ebe, Hiroshi Shimizu, Kazuyoshi Takahashi, Yoshifusa Aizawa

    Journal of Arrhythmia   27   2011年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Method: We investigated the outcomes of 136 patients with Sprint-Fidelis in 5 centers in Niigata Prefecture. Results. Incidence: Lead troubles occurred in 9 patients (6.6%). The mean period before the trouble was 31 months (16-57 months). Implantation: Among these 9 patients, the lead was implanted using a cut-down technique in 4, an extra-thoracic approach in 4 and a subclavian approach in 1. Discovery: The lead troubles in 5 were discovered at regular clinics. The other 4 patients emergently visited because of the lead integrity alert (LIA) or inappropriate ICD discharges. In the 9 patients, the average sensing integrity counter was 338/day and mean F-F interval, of which was recognized as NST, was less than 200ms. The LIA: The LIA had been programmed in 7, and 5 of the patients visited before inappropriate ICD discharges. However, the other 2 elderly patients couldn't notice the alert sound. Extraction: Lead extraction was attempted in 6 and 5 leads were removable without any complications. Conclusions: The incidence of troubles with Sprint-Fidelis is high, and it occurs in the relatively late phase. The LIA is useful to detect the lead problems but its efficacy may be limited in elderly patients. © 2011, Japanese Heart Rhythm Society. All rights reserved.

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  • Characteristics of Ventricular Tachycardia in Drug-Refractory Electrical Storm in ICD Patients with Structural Heart Disease 査読

    Hiroshi Furushima, Masaomi Chinushi, Keiko Sonoda, Kanae Hasegawa, Nobue Yagihara, Kenichi Iijima, Akinori Sato, Daisuke Izumi, Hiroshi Watanabe, Yoshifusa Aizawa

    journal of arrhythmia   27   194   2011年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Objective: The aim of the present study was to assess characteristics of ventricular tachycardia (VT) of electrical storm (ES) in ICD patients with structural heart disease. Methods: We included 156 consecutive patients who implanted ICD due to secondary prevention. ES was defined as the occurrence of at least 3 episodes of VT/VF within 24-hours. Basic treatment for ES was as follows
    sedation, β-blockers, and class I and/or III antiarrhythmic drugs. We defined that elimination of ES for 2 weeks after basic treatment was drug effective (DE), if not, drug refractory (DR). Results: During a mean follow-up period of 54 ± 37 months, ES occurred in 42 patients (OMI in 12, DCM in 15, HCM in 6, ARVC in 5, cardiac sarcoidosis in 4). Patients with DE and DR were 30 and 12 patients, respectively. There were no significant differences in age, sex, and LVEF. However, cycle length of VT (VTCL) was significantly longer in patients with DR than with DE (384 ± 16 vs. 305 ± 10 ms, p&lt
    0.05). All 12 patients with DE required for Catheter ablation. Conclusion: Longer VTCL in ES was related to drug refractoriness, which might be caused by stability of reentry circuit in spite of antiarrhythmic therapy. © 2011, Japanese Heart Rhythm Society. All rights reserved.

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  • Endocardial Arrhythmogenic Mechanisms of Torsades de Pointes in Patients with the Congenital Long QT Syndrome 査読

    Masaomi Chinushi, Hiroshi Furushima, Yukio Hosaka, Satoru Komura, Akinori Sato, Kenichi Iijima, Yoshifusa Aizawa

    INTERNAL MEDICINE   50 ( 16 )   1695 - 1702   2011年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPAN SOC INTERNAL MEDICINE  

    We injected acetylcholine (Ach) into the coronary artery to ascertain whether coronary vasospasm contributed to the syncopal events or chest oppression suffered by 3 patients with long QT syndrome (LQTS). During the test, a quadripolar electrode catheter was placed in the right ventricle and the activation-recovery interval was reanalyzed from the stored data. Intracoronary Ach transiently prolonged the QT intervals in all 3 patients without inducing coronary vasospasm. The Ach-induced QT prolongation was associated with enhanced spatial and temporal dispersion of intra-ventricular repolarization. The electrophysiological abnormalities were consistent with the putative arrhythmogenic mechanisms identified in experimental studies of LQTS.

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  • Inappropriate Pacing Inhibition Triggered by QT Prolongation due to T Wave Oversensing in an ICD Recipient Presenting with Long QT Syndrome 査読

    Kenichi Iijima, Masaomi Chinushi, Kanae Hasegawa, Daisuke Izumi, Yukio Hosaka, Hiroshi Furushima, Yoshifusa Aizawa

    INTERNAL MEDICINE   50 ( 9 )   1021 - 1024   2011年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPAN SOC INTERNAL MEDICINE  

    Inappropriate inhibition of atrial pacing due to T-wave oversensing (TWOS) was observed in a patient presenting with congenital long QT syndrome, treated with an implantable cardioverter defibrillator (ICD) and beta-adrenergic blocker. Development of TWOS was associated with further QT interval prolongation in the absence of amplitude changes in the intracardiac T and R waves. Replacement of the ICD generator with a sensing filter designed to attenuate the intracardiac T wave suppressed TWOS and normalized the pacing functions.

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  • Ventricular Tachyarrhythmia Associated with Hypertrophic Cardiomyopathy: Incidence, Prognosis, and Relation to Type of Hypertrophy 査読

    Hiroshi Furushima, Masaomi Chinushi, Kenichi Iijima, Akiko Sanada, Daisuke Izumi, Yukio Hosaka, Yoshifusa Aizawa

    JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY   21 ( 9 )   991 - 999   2010年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY  

    Patients: The study consisted of 66 consecutive patients with HCM who were admitted to Niigata University Hospital between 1992 and 2005. Their clinical characteristics and ECG morphology were investigated according to the type of HCM.
    Results: The type of HCM was asymmetric hypertrophy (ASH) in 34 patients (51%), obstructive HCM (HOCM) in 9 (14%), apical HCM (ApHCM) in 14 (21%), and midventricular obstruction (MVO) in 9 (14%). The cause of admission was ventricular tachyarrhythmia in 25 patients (38%), unexplained syncope in 11 (17%), and heart failure in 30 (45%). Sustained monomorphic ventricular tachycardia (SMVT) occurred in 19 patients and ventricular fibrillation in 6. In the 19 patients with SMVT, 12 had MVO and 3 of these had previous apHCM. Six of the 19 patients with SMVT had ASH, and 3 had abnormal apical wall motion. In 14 patients, the SMVT appeared to originate from the apical aneurysm based on the morphology of the tachycardia. Ventricular tachyarrhythmia recurred in 14 of the 25 patients (56%), and 4 of the 18 patients with an ICD had electrical storm. ASH with abnormal wall motion of the LV apex or MVO was recognized in the 4 patients with electrical storm; they commonly had abnormal Q waves and ST elevation in leads V4-V6.
    Conclusion: Ventricular tachyarrhythmia was responsible for 38% of hospitalizations in HCM, and SMVT occurred in patients with MVO and/or with abnormal wall motion of the LV apex. Electrical storm was more common in patients with ST elevation in precordial leads V4-V6. (J Cardiovasc Electrophysiol, Vol. 21, pp. 991-999, September 2010).

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  • Effects of Bepridil Versus E-4031 on Transmural Ventricular Repolarization and Inducibility of Ventricular Tachyarrhythmias in the Dog 査読

    Daisuke Izumi, Masaomi Chinushi, Kenichi Iijima, Shizue Ahara, Satoru Komura, Hiroshi Furushima, Yukio Hosaka, Akiko Sanada, Nobue Yagihara, Yoshifusa Aizawa

    PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY   33 ( 8 )   950 - 959   2010年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL  

    Methods: We used plunge needle electrode to record transmural left ventricular (LV) repolarization and activation-recovery interval (ARI) to estimate local repolarization. The correlation between paced cycle length and ARI was separately examined in the LV endocardium, mid-myocardium (Mid), and epicardium. Attempts to induce VTA were made during bradycardia and sympathetic stimulation.
    Results: Bepridil and E-4031 prolonged QT interval and ARI in all LV layers, though the magnitude of prolongation was greatest in Mid, increasing the transmural ARI dispersion, particularly during bradycardia. Compared with E-4031, bepridil caused mild, reverse use-dependent changes in ventricular repolarization, and less ARI dispersion than E-4031 during slow ventricular pacing. Both drugs increased ARI(max) and cycle length at 50% of ARI(max), though the changes were smaller after bepridil than after E-4031 administration. Bradycardia after the administration of each drug induced no VTA; however, sympathetic stimulation induced sustained polymorphic VTA in two of five dogs treated with E-4031 versus no dog treated with bepridil.
    Conclusions: Unlike the pure I(kr) blocker, E-4031, bepridil exhibited weak properties of reverse use-dependency and protected against sympathetic stimulation-induced VTA. It may be an effective supplemental treatment for recipients of implantable cardioverter defibrillator. (PACE 2010; 950-959).

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  • Efficacy of Procainamide and Lidocaine in Terminating Sustained Monomorphic Ventricular Tachycardia - Retrospective Case Series 査読

    Satoru Komura, Masaomi Chinushi, Hiroshi Furushima, Yukio Hosaka, Daisuke Izumi, Kenichi Iijima, Hiroshi Watanabe, Nobue Yagihara, Yoshifusa Aizawa

    CIRCULATION JOURNAL   74 ( 5 )   864 - 869   2010年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPANESE CIRCULATION SOC  

    Background: The efficacy of antiarrhythmic drugs in terminating sustained monomorphic ventricular tachycardia (SMVT) was assessed in a retrospective manner to provide a basis for recommending their use.
    Methods and Results: The 90 patients were included in this study to evaluate the efficacy to terminate SMVT using procainamide or lidocaine. All patients were alert and responsive. The mean systolic blood pressure was 91 +/- 25 mmHg (range, 40-150 mmHg). SMVT was diagnosed from ECG recordings and later in an electrophysiologic study. VTs with a cycle length of 329 +/- 55 and 324 +/- 61 ms were treated with the mean doses of 358 +/- 50 mg and 81 +/- 30 mg of procainamide and lidocaine and were terminated in 53/70 (75.7%) and in 7/20 (35.0%) respectively. The drugs were discontinued if there was no rise in blood pressure after slowing of the tachycardia rate or if there were signs of impending deterioration in consciousness. Though procainamide was effective, blood pressure was often low and DC shock should be available at all times during administration of the drug.
    Conclusions: Procainamide, the relatively older drug, was more effective than lidocaine in terminating SMVT associated with structural heart diseases. This is a retrospective analysis but can form the basis for formulating guidelines for initial management of SMVT. (Circ J 2010; 74: 864-869)

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  • Effect of Bepridil in Atrial Fibrillation Inducibility Facilitated by Vagal Nerve Stimulation - Prevention of Vagal Nerve Activation-Induced Shortening of the Atrial Action Potential Duration 査読

    Kenichi Iijima, Masaomi Chinushi, Daisuke Izumi, Shizue Ahara, Hiroshi Furushima, Satoru Komura, Yukio Hosaka, Akiko Sanada, Akinori Sato, Yoshifusa Aizawa

    CIRCULATION JOURNAL   74 ( 5 )   895 - 902   2010年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPANESE CIRCULATION SOC  

    Background: Because bepridil blocks multiple myocardial ionic channels, including the muscarinic acetylcholine receptor-operated potassium current (I(KAch)), bepridil is expected to suppress atrial fibrillation (AF) mediated by vagal nerve stimulation (VNS).
    Methods and Results: The therapeutic effects of bepridil were studied with a special focus on heart rate variability (HRV) in a canine model of AF. During VNS, AF was induced in 9 of 9 experiments before, vs 3 of 9 experiments after administration of bepridil (P&lt;0.01). During 350 ms atrial pacing, VNS shortened the right and left atrial monophasic action potentials at 90% repolarization (MAP90) by -31 +/- 8% and -22 +/- 12%, respectively, vs -10 +/- 13% and -6 +/- 8%, respectively, after bepridil (P&lt;0.01, N=9). Bepridil prolonged the sinus cycle length, although it had no significant effect on the conduction time measured at 300 ms pacing. Statistically insignificant change was observed in the VNS-induced slowing of the sinus cycle length and in the VNS-induced increase in high frequency amplitude of HRV before (1.2 +/- 0.7 to 5.3 +/- 4.0 ms) vs after (1.7 +/- 0.8 to 5.4 +/- 2.3 ms) bepridil administration.
    Conclusions: Bepridil prevented the VNS-induced shortening of atrial MAP90 and suppressed the inducibility of AF during VNS in two-thirds of the experiments. As far as this study shows, it may be possible that inhibition of I(KAch) played a part in this antifibrillatory effect. (Circ J 2010; 74: 895-902)

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  • Delayed Pericardial Effusion Due to Perforation of the Right Ventricular Outflow Tract by an ICD Lead 査読

    Masaomi Chinushi, Yukio Hosaka, Shinsuke Okada, Kenichi Iijima, Hiroshi Furushima, Yoshifusa Aizawa

    INTERNAL MEDICINE   49 ( 5 )   389 - 392   2010年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPAN SOC INTERNAL MEDICINE  

    A delayed pericardial effusion developed in a recipient of a cardioverter defibrillator (ICD). After an uneventful implant procedure and postoperative recovery, the patient suffered loss of appetite and fatigue, and was re-admitted to the hospital 48 days later. Her vital signs were stable and cardiac silhouette on chest roentgenogram was normal. However, blood cell counts and chemistry revealed the presence of anemia and liver dysfunction, an echocardiogram showed a diffuse pericardial effusion, and computed tomography suggested that the ICD lead, screwed in the right ventricular outflow tract, had perforated the wall. In order to make a prompt diagnosis and initiate timely corrective treatment, the physician in charge of long-term follow-up should remember that a pericardial effusion can be delayed and accumulate in the absence of typical signs of cardiac tamponade after ICD lead implantation.

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  • Significance of Early Onset and Progressive Increase of Activation Delay During Premature Stimulation in Brugada Syndrome 査読

    Hiroshi Furushima, Masaomi Chinushi, Kenichi Iijima, Daisuke Izumi, Yukio Hosaka, Yoshifusa Aizawa

    CIRCULATION JOURNAL   73 ( 8 )   1408 - 1415   2009年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPANESE CIRCULATION SOC  

    Background: The relationship between the activation delay during programmed stimulation and the inducibility of ventricular fibrillation (VF) and filtered QRS duration on signal-averaged ECG (SAECG) were assessed in patients with Brugada syndrome (BS).
    Methods and Results: The activation delay was assessed using the interval between the stimulus and the QRS complex during programmed stimulation in 25 patients with BS and 10 with idiopathic ventricular tachycardia (controls). The mean increase of delay (MID) was used to characterize the conduction curves. The filtered QRS duration (fQRSd) in leads V(2) (RfQRSd) and V(5) (LfQRSd) were also evaluated using SAECG. Both MIDs at the right ventricular outflow tract (RVOT) were significantly greater in symptomatic and asymptomatic BS patients than in the control group (symptomatic, 7.1 +/- 2.7 ms vs control, 2.5 +/- 1.2 ms, P&lt;0.001, asymptomatic, 7.3 +/- 3.3 ms vs control, P&lt;0.001, respectively). The MID correlated with the His-ventricular interval; however, there were no significant correlations between the MID and RfQRSd or RfQRSd-LfQRSd.
    Conclusions: The MID, which indicates an increase of the St-QRS during premature stimulation, was much greater in patients with BS (regardless of clinical symptoms) than in the control group, especially in the RVOT, which might be related to the easy inducibility of VF from the RVOT. (Circ J 2009; 73: 1408-1415)

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  • Effects of verapamil on anterior ST segment and ventricular fibrillation cycle length in patients with Brugada syndrome 査読

    Masaomi Chinushi, Kenichi Iijima, Minoru Tagawa, Satoru Komura, Hiroshi Furushima, Yoshifusa Aizawa

    JOURNAL OF ELECTROCARDIOLOGY   42 ( 4 )   367 - 373   2009年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS  

    Purpose: This Study examined the effects of verapamil (5-10 mg intravenous) on the cardiac electrical activity of 10 Brugada syndrome (BS) patients having vasospastic angina, atrial fibrillation, and/or hypertension.
    Results: Verapamil showed no significant change ill the ST-segment elevation. Likewise, there was no significant change in the lengths of QRS complex, HV and corrected QT intervals, or effective refractory period at the right ventricle, The conduction time between right ventricular apex and Outflow tract, measured at 400-millisecond pacing, was mildly prolonged by verapamil. At baseline, induced ventricular fibrillation (VF) was terminated by a 200-J shock in all patients. After verapamil, VF was reinduced in 7, was noninducible in 2, and self-terminated in 1 patient. Mean F-F interval was shorter after than before verapamil, and a 360-J shock was required in 2 of the 7 patients.
    Conclusion: In some BS patients, calcium channel blockade may modify the electrical characteristics of VF. (c) 2009 Elsevier Inc. All rights reserved.

    DOI: 10.1016/j.jelectrocard.2009.03.009

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  • Ventricular Fibrillation Triggered during and after Radiofrequency Energy Delivery to the Site of Origin of Idiopathic Right Ventricular Outflow Tract Arrhythmia 査読

    Kenichi Iijima, Masaomi Chinushi, Hiroshi Furushima, Yukio Hosaka, Daisuke Izumi, Yoshifusa Aizawa

    PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY   32 ( 3 )   406 - 409   2009年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL PUBLISHING, INC  

    We observed a case of idiopathic ventricular arrhythmias originating from the right ventricular outflow tract (RVOT). The origin of target premature ventricular contraction (PVC) and nonsustained ventricular tachycardia (VT) was within a wide low-voltage area around the RVOT. During radiofrequency (RF) application to the site of arrhythmia origin, polymorphic VT and ventricular fibrillation were repeatedly triggered by new PVC that had developed near the site of ablation. This electrical storm persisted &gt; 30 minutes after cessation of RF current delivery, and was suppressed by additional RF applications to the site of origin of the new PVC.
    (PACE 2009; 32:406-409).

    DOI: 10.1111/j.1540-8159.2008.02253.x

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  • Correlation between Surface and Intracardiac Electrocardiogram in a Patient with Inappropriate Defibrillation Shocks Due to Hyperkalemia 査読

    Yukio Hosaka, Masaomi Chinushi, Kenichi Iijima, Akiko Sanada, Hiroshi Furushima, Yoshifusa Aizawa

    INTERNAL MEDICINE   48 ( 13 )   1153 - 1156   2009年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPAN SOC INTERNAL MEDICINE  

    A 39-year-old man received implantable cardioverter defibrillator (ICD) shocks during sinus rhythm, triggered by an increase in amplitude and oversensing of intracardiac T waves, caused by hyperkalemia. After treatment of hyperkalemia, the T wave morphology normalized, and oversensing and inappropriate ICD shocks were eliminated. Alteration of the intracardiac electrogram was well correlated to the surface electrocardiogram (ECG) changes. Intracardiac T waves can be altered by hyperkalemia and it seems that this alteration can be estimated by surface ECG analysis.

    DOI: 10.2169/internalmedicine.48.2139

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  • Preservation of Renal Function in Response to Cardiac Resynchronization Therapy 査読

    Shinpei Kimura, Masahiro Ito, Masaomi Chinushi, Komei Tanaka, Yasutaka Tanabe, Yukio Hosaka, Satoru Komura, Shinsuke Okada, Kenichi Iijima, Hiroshi Furushima, Koichi Fuse, Masahito Sato, Yoshifusa Aizawa

    CIRCULATION JOURNAL   72 ( 11 )   1794 - 1799   2008年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPANESE CIRCULATION SOC  

    Background Cardiac resynchronization therapy (CRT) has recently been introduced as a new option for patients with severe heart failure, but its effect on renal function remains unclear.
    Methods and Results Twenty-three patients receiving CRT were studied. Responders were those who showed &gt; 0% increase in left ventricular ejection fraction after CRT by echocardiography. Clinical parameters, echocardiographic measurement, renal function, and prescriptions were examined before and 3 months after CRT, and the relationship between the response to CRT and renal function was examined. The responders had a better prognosis than the non-responders (p &lt; 0.05). There was a significant difference in the change in the estimated glomerular filtration rate between the responders and non-responders (p &lt; 0.05), even in patients with renal dysfunction before CRT (p &lt; 0.01). Prescriptions of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB) were 100% in the CRT responders and 60% in the non-responders (p &lt; 0.05). Up-titration of blockers could be significantly achieved in the CRT responders compared with the non-responders (p &lt; 0.05).
    Conclusions Preservation of renal function was observed in the responders to CRT, even in patients with renal dysfunction. Prescription of ACEI/ARB and up-titration of beta-blockers increased in the CRT responders. These results may contribute to the beneficial effects of CRT. (Circ J 2008; 72: 1794-1799)

    DOI: 10.1253/circj.cj-08-0424

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  • Automatic R-wave and impedance testing with the modern patient alert system to reduce inappropriate implantable cardioverter defibrillator shocks due to lead fracture 査読

    Masaomi Chinushi, Yukio Hosaka, Noboru Ikarashi, Kenichi Iijima, Hiroshi Furushima, Yoshifusa Aizawa

    EUROPACE   10 ( 6 )   738 - 740   2008年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:OXFORD UNIV PRESS  

    DOI: 10.1093/europace/eun095

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  • A post-QRS potential in Brugada syndrome its relation to electrocardiographic pattern and possible genesis 査読

    Yoshifusa Aizawa, Masaomi Chinushi, Minoru Tagawa, Hiroshi Furushima, Shinsuke Okada, Kenichi Iijima, Daisuke Izumi, Hiroshi Watanabe, Satoru Komura

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   51 ( 17 )   1720 - 1721   2008年4月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE INC  

    DOI: 10.1016/j.jacc.2008.01.031

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  • Antiarrhythmic vs. pro-arrhythmic effects depending on the intensity of adrenergic stimulation in a canine anthopleurin-A model of type-3 long QT syndrome 査読

    Masaomi Chinushi, Daisuke Izumi, Kenichi Iijima, Shizue Ahara, Satoru Komura, Hiroshi Furushima, Yukio Hosaka, Yoshifusa Aizawa

    EUROPACE   10 ( 2 )   249 - 255   2008年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:OXFORD UNIV PRESS  

    Aims The effects of adrenergic activity and beta-blockade were studied in a canine experimental model of type-3 tong QT syndrome (LQT3) induced by application of anthopleurin-A.
    Methods and results Boluses of epinephrine at 0.5 and/or 1.0 mu g/kg were administered before and after propranolol, 0.3 mg/kg, and the distribution of the ventricular repolarization and the development of polymorphic ventricular tachyarrhythmia (VA) were assessed. Using needle electrodes, transmural unipolar electrograms were recorded across the left ventricle (W) and right ventricle (RV). Activation-recovery interval (ARI) was measured in each electrogram to estimate local repolarization during RV pacing at the cycle length of 750 ms after the creation of complete atrioventricular block. Before propranolol, epinephrine, 0.5 mu g/kg, did not induce VA in any experiment. However, a dose of 1.0 mu g/kg induced polymorphic VA following multiple premature ventricular complex (PVC) in four of six experiments. Epinephrine, 0.5 mu g/kg, shortened ARI at all sites and lessened LV transmural ARI dispersion. Neither ARI nor its dispersion could be determined after 1.0 mu g/kg of epinephrine because of the induction of PVC, polymorphic VA, or both. Propranolol (i) prevented epinephrine-induced PVC and polymorphic VA in all experiments, (ii) slightly prolonged ARI at all sites, along with a decrease in IV transmural. ARI dispersion, and (iii) reversed the epinephrine-induced shortening of ARI.
    Conclusion In this LQT3 model, an increase in adrenergic activity by epinephrine had dose-dependent, opposite effects on ventricular electrical stability. Since beta-adrenergic blockade suppressed epinephrine-induced PVC and polymorphic VA, it might be considered for supplemental therapy to suppress VA in patients presenting with LQT3.

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  • Comparison of conduction delay in the right ventricular outflow tract between Brugada syndrome and right ventricular cardiomyopathy: investigation of signal average ECG in the precordial leads 査読

    Hiroshi Furushima, Masaomi Chinushi, Kazuki Okamura, Kenichi Iijima, Satoru Komura, Yasutaka Tanabe, Shinsuke Okada, Daisuke Izumi, Yoshifusa Aizawa

    EUROPACE   9 ( 10 )   951 - 956   2007年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:OXFORD UNIV PRESS  

    Background In both Brugada syndrome (BS) and arrhythmogenic right ventricular cardiomyopathy (ARVC), electrical abnormalities in the right ventricular outflow tract (RVOT) are important for arrhythmogenesis.
    Objectives The aim of this study was to compare conduction delay in the right ventricular in BS with that in ARVC using the signal-averaged electrocardiogram.
    Methods Twenty patients with BS (18 men and 2 women; 55 +/- 12 years old; 9 symptomatic and 11 asymptomatic) and eight patients with ARVC (six men and two women; 53 +/- 16 years old) were included. We assessed the presence of late potentials (LPs) and the filtered QRS duration (fQRSd) in V-2 and V-5 using a high-pass filter of 40 Hz (fQRSd:40) and 100 Hz (fQRSd:100).
    Results In ARVC, there was no significant difference in fQRSd:40 between V2 and V5 (158 +/- 19 vs. 145 +/- 17 ms, respectively): however, in BS, fQRSd:40 in V2 was significantly longer than fQRSd:40 in V5 (147 +/- 15 vs. 125 +/- 10 ms, P &lt; 0.001). In ARVC, there was no significant difference between fQRSdA0 and fQRSd:100 in V-2 and V-5 (158 +/- 19 vs. 142 +/- 23 ms and 145 +/- 17 vs. 132 +/- 9 ms, respectively). In contrast, in BS, fQRSd:100 was significantly shorter than fQRSd:40 in V2 (110 +/- 8 ms vs. 147 +/- 15, P &lt; 0.001). The relative decrease in fQRSd: 100 compared with fQRSd:40 in V2 was significantly greater in BS than in ARVC.
    Conclusion The dominant prolongation of the fQRSd in the right precordial. lead in BS was different from the characteristics of ARVC, which may be caused by the conduction delay due to fibro-fatty replacement in RV.

    DOI: 10.1093/europace/eum128

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  • Prevention of postprandial hypotension-related syncope by caffeine in a patient with long-standing diabetes mellitus.

    Kazuo Furukawa, Tatsuro Suzuki, Hajime Ishiguro, Hiroshi Morikawa, Keiko Sonoda, Kenichi Iijima, Masahiro Ito, Osamu Hanyu, Hirohito Sone

    Endocrine journal   67 ( 6 )   585 - 592   2020年6月

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    記述言語:英語  

    A 74-year-old man who had type 2 diabetes mellitus of a duration of 20 years was admitted for syncope after eating a high carbohydrate meal. Although he had had episodes of pallor or syncope after carbohydrate-rich meals, such as with large amounts of white rice, several times within a year and he had been taken to hospitals emergently, the etiology of these episodes had remained unclear despite his undergoing several studies. Studies did show severe orthostatic hypotension during the head-up tilt test and a decrease in the coefficient of variation of the R-R interval (CVR-R) on resting electrocardiogram, suggesting severe autonomic nervous dysfunction. Because of the episodes of syncope after eating a carbohydrate-rich meal, we investigated whether he had postprandial hypotension (PPH). The 75 g oral glucose tolerance test revealed a significant decrease in his postprandial blood pressure by about 40 mmHg, leading to the diagnosis of PPH. The carbohydrate-rich meal test induced syncope with systolic blood pressure under 40 mmHg. Then 150 mg caffeine was administered before a second carbohydrate-rich meal. The marked decline in postprandial blood pressure was suppressed and plasma noradrenaline levels were gradually increased over a period of 60 minutes. Caffeine could be useful for prevention of postprandial hypotension-related syncope.

    DOI: 10.1507/endocrj.EJ19-0370

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  • 心室細動を生じ、冠攣縮および器質的冠動脈狭窄を合併した右冠動脈左冠尖起始の一例

    布施 拓也, 松尾 聖, 高野 俊樹, 大久保 健志, 萱森 裕美, 八木原 伸江, 飯嶋 賢一, 保屋野 真, 柳川 貴央, 和泉 大輔, 小澤 拓也, 柏村 健, 尾崎 和幸, 南野 徹

    日本心臓病学会学術集会抄録   66回   EP - 060   2018年9月

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    記述言語:日本語   出版者・発行元:(一社)日本心臓病学会  

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  • 高位肋間におけるJ点上昇と致死性不整脈リスクに関する検討

    長谷川 祐紀, 渡部 裕, 大槻 総, 飯嶋 賢一, 八木原 伸江, 佐藤 光希, 和泉 大輔, 南野 徹

    日本心臓病学会学術集会抄録   66回   O - 078   2018年9月

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    記述言語:日本語   出版者・発行元:(一社)日本心臓病学会  

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  • 下壁由来の心室期外収縮が心室細動のトリガーと考えられたBrugada症候群の1例

    久保田 直樹, 長谷川 祐紀, 佐藤 光希, 松尾 聖, 八木原 伸江, 飯嶋 賢一, 和泉 大輔, 南野 徹

    心臓   50 ( Suppl.1 )   75 - 82   2018年8月

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    記述言語:日本語   出版者・発行元:(公財)日本心臓財団  

    52歳男性。早朝に胸部不快のため受診し心房細動を指摘された。観察中に下方軸の心室期外収縮(PVC)から心室細動(VF)をきたし心肺蘇生を受けた。心電図では下壁誘導と左胸部誘導に広くJ波を認めた。器質的心疾患はなく、冠動脈造影では有意狭窄や冠攣縮誘発性は認めなかった。Pilsicainide負荷で右胸部誘導のCoved型ST上昇を認め、Brugada症候群と診断した。皮下植込み型除細動器の植込み術直後とその3週間後に、今度は上方軸のPVCからVFをきたした。Isoproterenol負荷、Propofol鎮静刺激、Pilsicainide負荷ではPVCは誘発されなかった。心臓電気生理検査では右室からの単発期外刺激にて容易にVFが誘発され3度の体外直流通電でようやく停止した。VF再発予防としてBepridilを開始し、その後VFの再発を認めていない。Brugada症候群では右室流出路における不整脈基質の存在が想定され、VFに先行するPVCは左脚ブロック・下方軸型が多い。本例のようなJ波を合併したBrugada症候群では、広範な不整脈基質の存在が下壁由来のPVCの発生やVFの易誘発性に寄与していた可能性があった。J波を合併したBrugada症候群においてVFに先行するPVCを評価した報告は乏しく、貴重な症例と考えられ報告する。(著者抄録)

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  • 各種抗凝固療法における血管損傷時の凝固系の反応の検討

    大槻 総, 和泉 大輔, 須田 将吉, 佐藤 光希, 長谷川 祐紀, 八木原 伸江, 飯嶋 賢一, 池主 雅臣, 南野 徹

    日本内科学会雑誌   107 ( Suppl. )   163 - 163   2018年2月

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    記述言語:日本語   出版者・発行元:(一社)日本内科学会  

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  • 早期再分極における心房細動発症リスクの検討

    長谷川 祐紀, 渡部 裕, 大槻 総, 飯嶋 賢一, 八木原 伸江, 佐藤 光希, 和泉 大輔, 南野 徹

    日本内科学会雑誌   107 ( Suppl. )   203 - 203   2018年2月

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    記述言語:日本語   出版者・発行元:(一社)日本内科学会  

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  • テストステロン減少が病態の顕性化に寄与したと考えられた高齢発症のQT延長症候群の1例

    長谷川 祐紀, 坂口 裕太, 大槻 総, 飯嶋 賢一, 八木原 伸江, 佐藤 光希, 和泉 大輔, 池主 雅臣, 南野 徹

    心臓   49 ( Suppl.1 )   43 - 49   2017年8月

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    記述言語:日本語   出版者・発行元:(公財)日本心臓財団  

    27歳時に片側睾丸摘出の既往がある61歳男性。母親とその姉妹2人が20歳頃に突然死している。失神や多形性心室頻拍(TdP)の既往はなかったが、50歳頃より検診でQT延長を指摘されていた。今回、運転中に初めて失神し搬送された。この際、著明なQT延長(QTc=666ms)とTdP頻発を認めた。器質的心疾患は認めず、家族歴から先天性QT延長症候群と考えられたが、本例では60歳代での心原性失神の初発であった。検診心電図では、QT延長は段階的に顕性化していた。本例では数日前からエフェドリン含む感冒薬の内服歴がありTdP発症の要因となったと考えられた。さらに本例では明らかなテストステロン低値を認めており、QT延長症候群の高齢での顕性化に寄与したと考えられた。QT延長例や潜在的素因を持つ例に内分泌的異常や薬剤など幅広い修飾因子が加わることで、高齢で初回発作をきたす例があり注意を要する。(著者抄録)

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  • 断線によるCRT左室リード留置部位の変更で異なる臨床経過を呈した3例

    長谷川 祐紀, 和泉 大輔, 大槻 総, 飯嶋 賢一, 八木原 伸江, 佐藤 光希, 池主 雅臣, 南野 徹

    心臓   48 ( Suppl.2 )   179 - 186   2016年12月

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    記述言語:日本語   出版者・発行元:(公財)日本心臓財団  

    CRT-D植込み後、左室リード断線による心不全悪化をきたし、冠静脈狭窄のため異なる部位への再留置を余儀なくされた3症例を経験した。3例とも左室リードは単純牽引で用手的抜去可能であった。症例1:68歳女性。拡張型心筋症(DCM、EF=37%、QRS=132ms、NYHAIII)、徐脈性心房細動、心室頻拍のためCRT-Dを植込み、NYHAIIに改善した。植込み8年2月後に左室リード断線をきたした。後側壁側から側壁側への再留置となり、その後初回留置後より利尿剤の減量が可能となった。症例2:71歳男性。DCM(EF=32%、QRS=180ms、NYHAIII)のためCRT-Dを植込み、NYHAIIに改善した。2年3ヵ月後に左室リード断線をきたした。心室刺激閾値高値や横隔神経捕捉のため目標領域への留置が困難であり、中心静脈経由で後側壁側に再留置したが、心不全は改善せず術後54日目に死亡した。症例3:57歳女性。DCM(EF=17%、QRS=190ms、NYHAIII)のためCRT-Dを植込みNYHAIIに改善した。4年7ヵ月後に左室リード断線をきたした。前側壁側から前壁側への再留置となり、その後心不全が悪化した(NYHAIII)。結語:左室リードの再留置時には、同部位への留置が困難となる可能性、他部位への留置によりCRTの効果が異なる可能性を考慮する必要がある。(著者抄録)

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  • クラリスロマイシン内服中に徐脈を契機に多形性心室頻拍をきたした高齢者QT延長症候群の1例

    長谷川 祐紀, 和泉 大輔, 大槻 総, 八木原 伸江, 飯嶋 賢一, 佐藤 光希, 池主 雅臣, 南野 徹

    心臓   48 ( Suppl.1 )   155 - 155   2016年8月

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    記述言語:日本語   出版者・発行元:(公財)日本心臓財団  

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  • 左室基部後壁起源の心室性期外収縮により心室細動を繰り返した特発性心室細動の1例

    勝海 悟郎, 古嶋 博司, 和泉 大輔, 大槻 総, 長尾 智美, 飯嶋 賢一, 佐藤 光希, 小田 雅人, 渡部 裕, 池主 雅臣, 南野 徹

    心臓   46 ( Suppl.2 )   56 - 61   2014年8月

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    記述言語:日本語   出版者・発行元:(公財)日本心臓財団  

    生来健康の27歳男性。父親が57歳時に突然死している。深夜飲酒中に心室細動をきたし当院に搬送された。心肺蘇生、低体温療法を施行し、後遺症なく回復した。心エコー、心臓MRI、冠動脈CTで器質的心疾患は認めなかった。Type 3 Brugada型心電図を認めたが、ICD植え込み後に施行したピルシカイニド負荷試験ではtype 1様波形変化が1誘導のみであり、特発性心室細動と診断した。また、同検査中に右脚ブロック、左軸偏位型の心室性期外収縮を認めた。運動負荷試験後の夜間から早朝にこの心室性期外収縮より心室細動が惹起され、ショック作動を繰り返した。心臓電気生理検査では左室基部後壁心外膜側に心室性期外収縮の起源を認め、心内膜側から焼灼を試みたが、完全には抑制されなかった。その後、ベプリジル内服により心室性期外収縮、心室細動は抑制され、以後9ヵ月間再発なく経過している。心室細動を惹起する心室性期外収縮の起源が同定され、bepridilが奏功した特発性心室細動症例を経験したので文献的考察を加えて報告する。(著者抄録)

    DOI: 10.11281/shinzo.46.S2_56

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  • 右室流出路起源の期外収縮をトリガーとする多形性心室頻拍が見られた潜在性type2-QT延長症候群の1例

    佐藤 光希, 園田 桂子, 飯嶋 賢一, 八木原 伸江, 和泉 大輔, 渡部 裕, 古嶋 博司, 南野 徹, 阿部 晃, 池主 雅臣

    心臓   45 ( Suppl.3 )   135 - 135   2013年12月

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    記述言語:日本語   出版者・発行元:(公財)日本心臓財団  

    DOI: 10.11281/shinzo.45.S3_135

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  • 神経電気刺激と高周波通電による腎動脈自律神経興奮への介入

    池主 雅臣, 鈴木 克弥, 斉藤 修, 飯嶋 賢一, 和泉 大輔, 佐藤 光希, 古嶋 博司, 南野 徹, 岩渕 三哉

    心電図   33 ( Suppl.4 )   S - 4   2013年9月

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    記述言語:日本語   出版者・発行元:(一社)日本不整脈心電学会  

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  • 多形性心室頻拍の契機となるLV summit領域の心室性期外収縮にカテーテルアブレーションが奏功した1例

    勝海 悟郎, 池主 雅臣, 飯嶋 賢一, 佐藤 光希, 和泉 大輔, 渡部 裕, 古嶋 博司, 南野 徹

    心臓   45 ( Suppl.2 )   19 - 19   2013年8月

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    記述言語:日本語   出版者・発行元:(公財)日本心臓財団  

    DOI: 10.11281/shinzo.45.S2_19

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  • 脳膿瘍を合併した感染性心内膜炎の1例

    勝海 悟郎, 柏村 健, 飯嶋 賢一, 小幡 裕明, 塙 晴雄, 小玉 誠, 南野 徹

    新潟医学会雑誌   127 ( 6 )   330 - 330   2013年6月

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    記述言語:日本語   出版者・発行元:新潟医学会  

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  • 救命できたaborted sudden deathの集計

    林 由香, 藤木 伸也, 萱森 裕美, 渡辺 達, 園田 桂子, 飯嶋 賢一, 小田 雅人, 佐藤 光希, 小幡 裕明, 和泉 大輔, 小澤 拓也, 渡部 裕, 柏村 健, 伊藤 正洋, 古嶋 博司, 廣野 暁, 池主 雅臣, 塙 晴雄, 小玉 誠, 柳川 貴央, 本多 忠幸, 遠藤 裕

    新潟医学会雑誌   126 ( 5 )   269 - 269   2012年5月

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    記述言語:日本語   出版者・発行元:新潟医学会  

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  • Ventricular Tachyarrhythmias Associated with Congestive Heart Failure (Therapeutic Roles of Antiarrhythmic Drugs and Catheter Ablation)

    Masaomi Chinush, Hiroshi Furushima, Daisuke Izumi, Kenichi Iijima, Yoshifusa Aizawa

    JOURNAL OF CARDIAC FAILURE   17 ( 9 )   S126 - S126   2011年9月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS  

    Web of Science

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  • 当院における冠動脈バイパス術後心房細動の発症危険因子/予防因子についての検討

    八木原 伸江, 池主 雅臣, 古嶋 博司, 長谷川 奏恵, 真田 明子, 飯嶋 賢一, 和泉 大輔, 保坂 幸男, 渡部 裕, 伊藤 正洋, 廣野 暁, 菊地 千鶴男, 竹久保 賢, 林 純一, 相澤 義房

    新潟医学会雑誌   125 ( 1 )   49 - 49   2011年1月

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    記述言語:日本語   出版者・発行元:新潟医学会  

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  • リンパ腫の心筋内浸潤によりT波の陰性化を生じた2症例

    真田 明子, 池主 雅臣, 富田 任, 鈴木 友康, 飯嶋 賢一, 佐藤 光希, 和泉 大輔, 保坂 幸男, 伊藤 正洋, 古嶋 博司, 相澤 義房

    心電図   28 ( 5 )   471 - 471   2008年10月

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    記述言語:日本語   出版者・発行元:(一社)日本不整脈心電学会  

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  • U波の交代現象と変動を認めた原発性不整脈疾患の3例

    保坂 幸男, 池主 雅臣, 古嶋 博司, 相澤 義泰, 和泉 大輔, 佐藤 光希, 飯嶋 賢一, 真田 明子, 相澤 義房

    心電図   28 ( 5 )   471 - 471   2008年10月

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    記述言語:日本語   出版者・発行元:(一社)日本不整脈心電学会  

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▶ 全件表示

共同研究・競争的資金等の研究

  • 心室細動の発症、維持、再発に関与する解剖学的基盤を標的とした新たな治療法の開発

    研究課題/領域番号:20K08419  2020年4月 - 2023年3月

    日本学術振興会  科学研究費助成事業 基盤研究(C)  基盤研究(C)

    飯嶋 賢一, 和泉 大輔, 八木原 伸江, 南野 徹

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    配分額:4290000円 ( 直接経費:3300000円 、 間接経費:990000円 )

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  • 心室細動の発症・再発に関わる解剖学的因子を標的とした新たな心室細動治療戦略の開発

    2016年4月 - 2018年3月

    日本学術振興会  科学研究費助成事業(科研費)基盤C 

    飯嶋 賢一

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    担当区分:研究代表者  資金種別:競争的資金

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  • 心室細動波の周波数特性と臨床指標との関連

    2013年4月 - 2013年9月

    日本学術振興会  科学研究費助成事業(科研費)若手B 

    飯嶋 賢一

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    担当区分:研究代表者  資金種別:競争的資金

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