198 results on '"Sung Il Im"'
Search Results
2. Real-time heart rate variability according to ambulatory glucose profile in patients with diabetes mellitus
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Sung Il Im, Su Hyun Bae, Soo Jin Kim, Bong Joon Kim, Jung Ho Heo, Su kyoung Kwon, Sung Pil Cho, Hun Shim, Jung Hwan Park, Hyun Su Kim, and Chul Ho Oak
- Abstract
BackgroundAutonomic neuropathy commonly occurs as a long-term complication of diabetes mellitus (DM) and can be diagnosed based on heart rate variability (HRV), calculated from electrocardiogram (ECG) recordings. There are limited data on HRV using real-time ECG and ambulatory glucose monitoring in patients with DM.Methods and ResultsA total of 43 patients (66.3±7.5 years) with DM underwent continuous real-time ECG monitoring (225.7±107.3 hours) for HRV and ambulatory glucose monitoring using a remote monitoring system. We compared the HRV according to the ambulatory glucose profile. Data were analyzed according to the target in glucose range (TIR). There were no significant differences in the baseline characteristics of the patients according to the TIR. During monitoring, we checked ECG and ambulatory glucose levels (a total of 15,090 times) simultaneously for all patients. Both time- and frequency-domain HRVs were lower when the patients had poorly controlled glucose levels (>200 mg/dL) and TIR70%. In addition, heart and respiratory rates increased with real-time glucose levels (PConclusionsPoorly controlled glucose levels were independently associated with lower HRV in patients with DM. This was further substantiated by the independent continuous association between real-time measurements of hyperglycemia and lower HRV. These data strongly suggest that cardiac autonomic dysfunction is caused by elevated blood sugar levels.
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- 2023
3. Postoperative effects of bariatric surgery on heart rate recovery and heart rate variability
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Han Su Park, Kyungwon Seo, Hyeon Soo Kim, Sung il Im, Bong Joon Kim, Bu Kyung Kim, and Jung Ho Heo
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Background: Several studies have reported associations between obesity and autonomic dysfunction. However, little research has investigated the effect of bariatric surgery on heart rate recovery (HRR) in the treadmill test and heart rate variability (HRV) in 24-hour Holter monitoring. We investigated the effects of bariatric surgery on HRR and HRV, which are parameters related to autonomic dysfunction. Methods: We retrospectively investigated patients who underwent bariatric surgery in 2019. The treadmill test, 24-hour Holter monitoring, and echocardiography were performed before and 6 months after surgery. We compared the changes in HRR in the treadmill test and HRV parameters such as the time domain and spectral domain in 24-hour Holter monitoring before and after surgery. Results: Of the 40 patients who underwent bariatric surgery, 25 patients had the treadmill test or 24-hour Holter monitoring both before and after surgery. Body weight and body mass index significantly decreased after surgery (112.86±24.37 kg vs. 89.10±20.26 kg, p
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- 2022
4. How to write case reports in medicine
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Sung il Im
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Medical research has become an important part of providing care to patients. Case reports published in medical journals can communicate information to the medical community about rare or unreported features, conditions, complications, or interventions. Case reports are generally short, focusing on key components such as a summary and introduction, case presentation, and discussion. Authors now have access to free, continuously updated case reports of different types from multiple journals. This review introduces the process and mechanisms for how and when to prepare a case report. We briefly review the editorial process of each of these complementary journals, along with author anecdotes, hoping to inspire authors to write and continue writing case reports; and discusses the essentials of a case report, aiming to provide guidelines for improving medical writing skills.
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- 2022
5. Pulsed Field Ablation of Left Ventricular Myocardium in a Swine Infarct Model
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Sung Il, Im, Satoshi, Higuchi, Adam, Lee, Carol, Stillson, Eric, Buck, Blake, Morrow, Kit, Schenider, Molly, Speltz, and Edward P, Gerstenfeld
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Cicatrix ,Swine ,Myocardium ,Catheter Ablation ,Myocardial Infarction ,Tachycardia, Ventricular ,Animals ,Humans - Abstract
Pulsed field ablation (PFA) leads to cell death by irreversible electroporation. There are limited data about PFA lesion characteristics in the ventricle, particularly in the presence of myocardial scar.This study sought to evaluate the lesion characteristics of PFA and radiofrequency energy (RFA) in healthy and infarcted left ventricular (LV) myocardium in swine.Swine (n = 10) underwent either: 1) 120-minute left anterior descending coronary artery balloon occlusion myocardial infarction and survived for 6 to 8 weeks (n = 8); or 2) served as healthy control subjects (n = 2). PFA or RFA was delivered to the LV endocardium in regions of healthy myocardium or scar identified with electroanatomical mapping. Bipolar, biphasic PFA was delivered for 2.5 seconds × 4 applications/site using 2 different catheters: linear quadripolar (FOCAL) or multispline 8-pole catheter (BASKET). Gross and histologic measurements of lesion size were performed.In the PFA group, 21 lesions were delivered to healthy LV and 20 to areas of scar. Overall, there was no significant difference in lesion depth between catheter groups (FOCAL linear vs BASKET; P = 0.740), whereas lesion width was greater for BASKET (10.6 ± 2.4 mm vs 13.3 ± 3.3 mm; P = 0.007). In myocardial scar, lesion depth was not significantly different between PFA catheters (P = 0.235). However, lesion depth for PFA was greater than for RFA (PFA vs RFA; 6.1 ± 1.7 mm vs 3.8 ± 1.7 mm; P = 0.005).PFA allows rapid, safe, and effective ablation of surviving islands of myocardium within and around infarcted LV substrate. This technology holds promise for treating infarct-related ventricular tachycardia in humans.
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- 2022
6. PO-455617-18 SHORT COUPLED PREMATURE ATRIAL COMPLEXES LEAD TO ADVERSE ATRIAL REMODELING AND ATRIAL FIBRILLATION IN A SWINE MODEL
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Satoshi Higuchi, Sung Il Im, Ramkumar Venkateswaran, Chanhee Lee, Jeffrey E. Olgin, Carol Stillson, Dwight Bibby, Theodore P. Abraham, and Edward P. Gerstenfeld
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
7. Does post-STEMI CMR play a role in prognostication?
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Sung Il Im
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Pharmacology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Elevated native T1 values are independent predictors of obstructive Non-IR artery in ST elevation MI patients. These results suggest the presence of concomitant remote myocardial impairment in the non-infarct territories wit obstructive CAD. The fact that there is a correlation between the presence of obstructive coronary artery and high native T1 values might support the performance of complete revascularization early after STEMI without postponing and waiting for the results of perfusion studies. As opposed to myocardial perfusion imaging, native T1 evaluation can be performed safely early post STEMI, not exposing patients to pharmacologic or physiologic stress. Therefore, larger and more comprehensive studies are needed to clarify the usefulness of revascularization of elevated T1 areas early after MI.
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- 2023
8. Disseminated Staphylococcus aureus infection and acute bacterial pericarditis: a case report
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Su Hyun Bae, Song-Hyun Lee, Joon-Young Choi, Bong-Joon Kim, Soo-Jin Kim, Sung-Il Im, Hyun-Su Kim, and Jung-Ho Heo
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- 2022
9. PO-455617-17 PIRFENIDONE MITIGATES THE DEVELOPMENT OF ARRHYTHMOGENIC ATRIAL FIBROSIS DUE TO PREMATURE ATRIAL COMPLEXES IN A SWINE MODEL
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Satoshi Higuchi, Ramkumar Venkateswaran, Chanhee Lee, Sung Il Im, Jeffrey E. Olgin, Carol Stillson, Dwight Bibby, Theodore P. Abraham, and Edward P. Gerstenfeld
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
10. PO-01-161 PIRFENIDONE MITIGATES THE DEVELOPMENT OF ARRHYTHMOGENIC ATRIAL FIBROSIS DUE TO PREMATURE ATRIAL COMPLEXES IN A SWINE MODEL
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Satoshi Higuchi, Ramkumar Venkateswaran, Chanhee Lee, Sung Il Im, Jeffrey E. Olgin, Carol Stillson, Dwight Bibby, Theodore P. Abraham, and Edward P. Gerstenfeld
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
11. Predictors of long‐term success after catheter ablation of premature ventricular complexes
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Vasanth Vedantham, Joshua D. Moss, Edward P. Gerstenfeld, Zian H. Tseng, Gregory M. Marcus, Satoshi Higuchi, Henry H. Hsia, Kyoung-Min Park, Byron K. Lee, Aleksandr Voskoboinik, Melvin M. Scheinman, Adam Lee, Randall J. Lee, and Sung Il Im
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Adult ,Male ,medicine.medical_specialty ,Heart Ventricles ,medicine.medical_treatment ,Catheter ablation ,030204 cardiovascular system & hematology ,Electrocardiography ,03 medical and health sciences ,QRS complex ,0302 clinical medicine ,Physiology (medical) ,Diabetes mellitus ,Internal medicine ,Late Recurrence ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Aged ,Premature ventricular complexes ,business.industry ,Medical record ,Middle Aged ,medicine.disease ,Ventricular Premature Complexes ,Treatment Outcome ,Radiofrequency catheter ablation ,Catheter Ablation ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
INTRODUCTION Some patients have late recurrence after acutely successful radiofrequency catheter ablation (RFCA) of premature ventricular complexes (PVCs). The aim of this study was to evaluate predictors of long-term success following acutely successful PVC RFCA. METHODS We identified consecutive patients at our institution with frequent PVCs undergoing RFCA and reviewed procedural data and medical records. Acute success was defined as elimination of targeted PVCs for at least 30-min after RFCA. Long-term success was defined as absence of targeted PVCs during all follow-up visits and PVC-burden
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- 2021
12. Eosinophilic Esophagitis with Angina Pectoris
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Seun Ja Park, Min Young Son, Moo In Park, Gil-Soon Choi, Won Moon, Sung Eun Kim, Sung Il Im, Jae Hyun Kim, and Kyoungwon Jung
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medicine.medical_specialty ,chest pain ,medicine.diagnostic_test ,Esophagogastroduodenoscopy ,business.industry ,lcsh:R ,lcsh:Medicine ,General Medicine ,Esophageal Disorder ,Chest pain ,medicine.disease ,Dysphagia ,Gastroenterology ,Angina ,eosinophilic esophagitis ,angina pectoris ,Left coronary artery ,Internal medicine ,medicine.artery ,medicine ,proton pump inhibitors ,medicine.symptom ,Eosinophilic esophagitis ,business ,Asthma - Abstract
Eosinophilic esophagitis (EoE) is an immune or antigen-mediated chronic inflammatory esophageal disorder that is relatively rare in Asian countries. The main symptoms of EoE are dysphagia and food impaction. Although chest pain is a symptom of EoE, it is also a symptom of coronary heart disease. This paper reports a case of EoE with angina pectoris in a 45-year-old male who was referred to the authors’ hospital for chest pain. He was diagnosed with angina pectoris because of mild stenosis in the left coronary artery on coronary angiography. On the other hand, the symptoms did not improve with angina medication therapy. Therefore, he underwent a chest CT scan, which revealed esophageal thickening. Esophagogastroduodenoscopy was performed. His endoscopic findings showed linear furrows with edema, and >90 eosinophils existed per high-power field on the histology findings. He was diagnosed with EoE. Through additional examinations, he was also diagnosed with asthma. The patient was treated with a proton pump inhibitor and a fluticasone inhaler. His symptoms and abnormal endoscopic findings disappeared after eight weeks of treatment. This case shows that physicians should consider the possibility of the symptoms for EoE when unexplained chest pain persists.
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- 2020
13. Predictors of adverse outcome in patients with frequent premature ventricular complexes: The ABC-VT risk score
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Sung Il Im, Hansu Park, Christina Alhede, Kyoung-Min Park, Vasanth Vedantham, Melvin M. Scheinman, Henry H. Hsia, Zian H. Tseng, Edward P. Gerstenfeld, Alexios Hadjis, Eric Vittinghoff, Byron K. Lee, Gregory M. Marcus, Randall J. Lee, Aleksandr Voskoboinik, and Joshua D. Moss
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Male ,medicine.medical_specialty ,030204 cardiovascular system & hematology ,Ventricular tachycardia ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Ventricular remodeling ,Adverse effect ,Aged ,Retrospective Studies ,Framingham Risk Score ,Ventricular Remodeling ,business.industry ,Hazard ratio ,Odds ratio ,medicine.disease ,Ventricular Premature Complexes ,Confidence interval ,Echocardiography ,Cohort ,Catheter Ablation ,Electrocardiography, Ambulatory ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Background No independently validated score currently exists for risk stratification of patients with frequent premature ventricular complexes (PVCs). Objectives The purpose of this study was to develop a risk score to predict adverse events in patients with frequent PVCs. Methods We analyzed consecutive patients between 2012 and 2017 undergoing 14-day continuous monitoring with frequent PVCs (>5%) and concurrent echocardiography. We performed binary logistic regression to determine multivariate predictors of adverse left ventricular remodeling (left ventricular ejection fraction [LVEF] 75 mL/m2). A risk score was created using the log(odds ratio (OR)) of these predictors and validated prospectively to determine the risk of future adverse events in those with baseline LVEF >45%. An adverse event was defined as LVEF decline by 10%, heart failure hospitalization, or cardiovascular mortality. Two validation cohorts were used: follow-up from the original derivation cohort (cohort 1) and an independent Korean PVC registry (cohort 2). Results The derivation cohort comprised 206 patients with a mean PVC burden of 11.6% ± 6.2% and considerable daily fluctuation (minimum burden 7.3% ± 6.2% vs maximum 17.9% ± 8.0%). Independent predictors of adverse remodeling were as follows: superiorly directed PVC axis (OR 2.7; 1 point), PVC burden 10%–20% (OR 3.5; 2 points) and >20% (OR 4.4; 3 points), PVC coupling interval >500 ms (OR 4.7; 4 points), nonsustained ventricular tachycardia (OR 5.3; 4 points), which form the ABC-VT risk score. This score predicted future adverse events in both validation cohorts: cohort 1, hazard ratio 1.43; 95% confidence interval 1.19–1.73; P Conclusion The ABC-VT score is a simple tool that predicts adverse left ventricular remodeling and future clinical deterioration in patients with frequent PVCs.
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- 2020
14. What Is Better Predictor of Late Recurrence after Radiofrequency Catheter Ablation for Atrial Fibrillation?
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Kyoung-Min Park and Sung il Im
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Internal Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2022
15. CA-534-01 PULSED FIELD ABLATION COMPARED TO RADIOFREQUENCY ABLATION OF LEFT VENTRICULAR MYOCARDIUM IN A SWINE INFARCT MODEL
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Sung Il Im, Satoshi Higuchi, and Edward P. Gerstenfeld
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2022
16. PO-653-04 FREQUENT DYSSYNCHRONOUS PREMATURE ATRIAL CONTRACTIONS LEAD TO ADVERSE REMODELING AND ATRIAL FIBRILLATION IN A SWINE MODEL
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Satoshi Higuchi, Aleksandr Voskoboinik, Sung Il Im, Dwight Bibby, Carol Stillson, Adam C. Lee, Gregory M. Marcus, Jeffrey E. Olgin, Dolkun Rahmutula, Eric Vittinghoff, Theodore P. Abraham, and Edward P. Gerstenfeld
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2022
17. Association between Ischemic Electrocardiographic Changes during Acetylcholine Provocation Test and Long-Term Clinical Outcomes in Patients with Vasospastic Angina
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Jin Won Kim, Hong Seog Seo, Jin Oh Na, Eung Ju Kim, Seung-Woon Rha, Byoung Geol Choi, Chang Gyu Park, Cheol Ung Choi, Sung Il Im, and Hong Euy Lim
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medicine.medical_specialty ,Vasospastic angina ,business.industry ,Provocation test ,Internal medicine ,Cardiology ,Medicine ,In patient ,sense organs ,cardiovascular diseases ,business ,Association (psychology) ,Acetylcholine ,medicine.drug - Abstract
Objectives Intracoronary injection of acetylcholine (Ach) has been shown to induce significant coronary artery spasm (CAS) in patients with vasospastic angina. Clinical significance and angiographic characteristics of patients with ischemic electrocardiogram (ECG) changes during the Ach provocation test are not clarified yet. Methods A total 4,418 consecutive patients underwent coronary angiography with Ach provocation tests from 2004 to 2012 were enrolled. Ischemic ECG changes were defined as transient ST-segment depression or elevation ( > 1 mm) and T inversion with/without chest pain. Finally, a total 2,293 patients (28.5% of total subjects) proven CAS were enrolled for this study. Results A total 119 patients (5.2%) showed ECG changes during Ach provocation tests. The baseline clinical and procedural characteristics are well balanced between the two groups. Ischemic ECG change group showed more frequent chest pain, higher incidence of baseline spasm, severe vasospasm, multi-vessel involvement, and more diffuse spasm ( > 30 mm) than those without ischemic ECG changes. At 5 years, the incidences of death, major adverse cardiac events (MACE) and major adverse cardiac and cerebral events (MACCE) were higher in the ischemic ECG change group despite of optimal medical therapy. Conclusions The patients with ischemic ECG changes during Ach provocation tests were associated with more frequent chest pain, baseline spasm, diffuse, severe and multi-vessel spasm than patients without ischemic ECG changes. At 5-years, the incidences of death, MACE and MACCE were higher in the ischemic ECG change group, suggesting more intensive medical therapy with close clinical follow up will be required.
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- 2019
18. PO-625-01 FIBROSIS AND SLOW CONDUCTION PERSIST AFTER RECOVERY OF PREMATURE ATRIAL CONTRACTION INDUCED ATRIAL MYOPATHY IN A SWINE MODEL
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Satoshi Higuchi, Sung Il Im, Dwight Bibby, Carol Stillson, Adam C. Lee, Gregory M. Marcus, Jeffrey E. Olgin, Theodore P. Abraham, and Edward P. Gerstenfeld
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2022
19. DH-575-02 IDENTIFICATION OF SUPRAVENTRICULAR TACHYCARDIA MECHANISMS WITH SURFACE ELECTROCARDIOGRAMS USING A DEEP NEURAL NETWORK
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Satoshi Higuchi, Roland Li, Sean Abreau, L. Bing Liem, Edward P. Gerstenfeld, Sung Il Im, Joshua Barrios, Geoff Tison, and Melvin M. Scheinman
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2022
20. B-AB04-02 FREQUENT PREMATURE ATRIAL CONTRACTIONS LEAD TO ADVERSE ATRIAL REMODELING AND ATRIAL FIBRILLATION IN A SWINE MODEL
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Eric Vittinghoff, Sung Il Im, Satoshi Higuchi, Dolkun Rahmutula, Dwight Bibby, Jeffrey E. Olgin, Theodore P. Abraham, Aleksandr Voskoboinik, Gregory M. Marcus, Edward P. Gerstenfeld, and Adam Lee
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medicine.medical_specialty ,business.industry ,Premature atrial contraction ,Physiology (medical) ,Internal medicine ,Cardiology ,Medicine ,Atrial fibrillation ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease ,Lead (electronics) ,Atrial Remodeling - Published
- 2021
21. B-PO02-140 EFFECT OF ATRIAL ECTOPY COUPLING INTERVAL ON ATRIAL STRUCTURAL REMODELLING AND ATRIAL FIBRILLATION IN A SWINE MODEL
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Adam Lee, Gregory M. Marcus, Satoshi Higuchi, Aleksandr Voskoboinik, Jeffrey E. Olgin, Dwight Bibby, Theodore P. Abraham, Edward P. Gerstenfeld, and Sung Il Im
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Coupling (electronics) ,Atrial ectopy ,medicine.medical_specialty ,business.industry ,Physiology (medical) ,Internal medicine ,Cardiology ,medicine ,Interval (graph theory) ,Atrial fibrillation ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease - Published
- 2021
22. Abstract 12935: Predictors of Long-term Success After Catheter Ablation of Premature Ventricular Complexes
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Byron K. Lee, Adam Lee, Melvin M. Scheinman, Henry H. Hsia, Edward P. Gerstenfeld, Gregory M. Marcus, Randall J. Lee, Aleksandr Voskoboinik, Vasanth Vedantham, Joshua D. Moss, Satoshi Higuchi, Zian H. Tseng, and Sung Il Im
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Premature ventricular complexes ,medicine.medical_specialty ,medicine.diagnostic_test ,Radiofrequency ablation ,business.industry ,medicine.medical_treatment ,Catheter ablation ,law.invention ,Radiofrequency catheter ablation ,law ,Physiology (medical) ,Internal medicine ,Late Recurrence ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Electrocardiography - Abstract
Introduction: Some patients(pts) have late recurrence after acutely successful radiofrequency catheter ablation(RFCA) of premature ventricular complexes (PVC). Hypothesis: The aim of this study was to evaluate predictors of long term success following acutely successful PVC ablation. Methods: From 2016-19, we identified consecutive pts at our institution with frequent PVCs undergoing RFCA and reviewed procedural data and medical records. Earliest local activation on the intracardiac bipolar and unipolar electrogram was measured using digital calipers. Acute success was defined as elimination of targeted PVC for at least 30 mins after RFCA. Long term success was defined as absence of PVC on 12 lead ECG during all follow up (f/u) visits and PVC burden reduction >80% or PVC burden Results: Among 241 pts, 161 (66.8%) pts had long term success with mean f/u of 17.6±5.8 months.In univariate analysis, diabetes mellitus and alcohol use were associated with PVC recurrence while age, female sex, acute success, ablation time, right ventricular PVC origin, single PVC morphology (sPVC), and earliest bipolar activation>24msec pre-QRS were associated with long-term success. In multivariate analysis, female sex, sPVC and earliest activation >24 msec preQRS were independent predictors of long term success at 1 year. The positive predictive value of earliest bipolar onset preQRS of PVC>24msec for long term success was 0.77(P Conclusions: Female gender, sPVC, and earliest onset of bipolar electrogram preQRS>24msec were predictors of long term success in patients with PVC undergoing RFCA. If local onset is
- Published
- 2020
23. Two P waves followed by 1 QRS complex: What is the mechanism?
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Satoshi Higuchi, Sung Il Im, Melvin M. Scheinman, and Edward P. Gerstenfeld
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Male ,Bundle of His ,medicine.medical_specialty ,Mechanism (biology) ,business.industry ,medicine.disease ,Electrocardiography ,QRS complex ,Atrioventricular nodal tachycardia ,Physiology (medical) ,Internal medicine ,medicine ,Cardiology ,Humans ,Tachycardia, Atrioventricular Nodal Reentry ,Ectopic rhythm ,Cardiology and Cardiovascular Medicine ,business ,Atrioventricular block ,Junctional rhythm ,Aged - Published
- 2021
24. Changes in QRS Duration Are Associated with a Therapeutic Response to Sacubitril-valsartan in Heart Failure with Reduced Ejection Fraction
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Kyoung Im Cho, Hyun Su Kim, Tae Joon Cha, Sung Il Im, Jung Ho Heo, Bong Joon Kim, and Han Su Park
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medicine.medical_specialty ,Angiotensin receptor ,QRS duration ,QRS complex ,Internal medicine ,Heart failure reduced ejection fraction ,Medicine ,Radiology, Nuclear Medicine and imaging ,In patient ,cardiovascular diseases ,Ventricular dyssynchrony ,Cardiac remodeling ,Ejection fraction ,business.industry ,Sacubitril–valsartan ,medicine.disease ,Left ventricular synchrony ,Heart failure ,Cardiology ,cardiovascular system ,Original Article ,Cardiology and Cardiovascular Medicine ,business ,Ischemic heart ,Sacubitril, Valsartan ,circulatory and respiratory physiology - Abstract
BACKGROUND Recent studies have demonstrated that angiotensin receptor neprilysin inhibitors (ARNIs) can reverse the cardiac remodeling effects that occur in heart failure with reduced ejection fraction (HFrEF). These studies have also suggested that ARNIs have favorable effects on ventricular dyssynchrony. We assessed the changes in QRS duration associated with ARNIs in patients with HFrEF. METHODS We retrospectively investigated patients with HFrEF (defined by a left ventricular ejection fraction [LVEF] ≤ 35%) who were treated with ARNIs for at least six months. We divided the patients into QRS shortening and non-QRS shortening groups according to their electrocardiogram (ECG) findings. We also compared changes in echocardiographic parameters between the groups. RESULTS A total of 68 patients with HFrEF were included (mean age: 62.5 years, 74.6% male). Twenty-one patients had significant ischemic heart disease (IHD). Thirty-five patients exhibited QRS-duration shortening on follow-up ECGs (mean change: -7.8 msec), and 33 patients showed no changes or increased QRS duration (mean change: 5.1 msec). The QRS shortening group exhibited significant improvement in LVEF (12.5 ± 15.3% vs. 1.7 ± 9.5%; p < 0.001) when compared with the non-QRS shortening group. The QRS shortening group also had significantly lower LV end-diastolic dimension (LVEDD), LV end-systolic dimension (LVESD) and LV mass index (LVMI) than did the non-QRS shortening group. The change in QRS duration was significantly correlated with the change in LVEF (r = -0.329, p = 0.011) and LVESD (r = 0.298, p = 0.022). CONCLUSIONS Among patients with HFrEF treated with ARNIs, the QRS shortening group showed favorable LV systolic function recovery, and reversal of cardiac remodeling compared to those of the non-QRS shortening group. Change in the QRS duration, which reflects LV synchrony, may be associated with response to ARNIs in patients with HFrEF.
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- 2020
25. Usefulness of an Implantable Loop Recorder in Diagnosing Unexplained Syncope and Predictors for Pacemaker Implantation
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Ki Woon Kang, Jong Chun Nah, Seongwook Han, Tae Hoon Kim, Sung Ho Lee, Jong Il Choi, Yong Seog Oh, June Soo Kim, Sung Il Im, Seil Oh, and Jin Bae Kim
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Male ,Pacemaker, Artificial ,medicine.medical_specialty ,Cardiovascular Disorders ,medicine.medical_treatment ,Bundle-Branch Block ,Catheter ablation ,Syncope ,03 medical and health sciences ,0302 clinical medicine ,Implantable Loop Recorder ,Recurrence ,Risk Factors ,Internal medicine ,Republic of Korea ,Implantable loop recorder ,medicine ,Humans ,030212 general & internal medicine ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Aged, 80 and over ,biology ,Bundle branch block ,Proportional hazards model ,business.industry ,Hazard ratio ,Syncope (genus) ,Arrhythmias, Cardiac ,General Medicine ,Middle Aged ,biology.organism_classification ,medicine.disease ,Unexplained Syncope ,Confidence interval ,Electrodes, Implanted ,Pacemaker ,Electrocardiography, Ambulatory ,Cardiology ,Female ,Original Article ,business ,Atrioventricular block - Abstract
Background An implantable loop recorder (ILR) is an effective tool for diagnosing unexplained syncope (US). We examined the diagnostic utility of an ILR in detecting arrhythmic causes of US and determining which clinical factors are associated with pacemaker (PM) implantation. Methods This retrospective, multicenter, observational study was conducted from February 2006 to April 2018 at 11 hospitals in Korea. Eligible patients with recurrent US received an ILR to diagnose recurrent syncope and document arrhythmia. Results A total of 173 US patients (mean age, 67.6 ± 16.5 years; 107 men [61.8%]) who received an ILR after a negative conventional workup were enrolled. During a mean follow-up of 9.4 ± 11.1 months, 52 patients (30.1%) had recurrent syncope, and syncope-correlated arrhythmia was confirmed in 34 patients (19.7%). The ILR analysis showed sinus node dysfunction in 24 patients (70.6%), supraventricular tachyarrhythmia in 4 (11.8%), ventricular arrhythmia in 4 (11.8%), and sudden atrioventricular block in 2 (5.9%). Overall, ILR detected significant arrhythmia in 99 patients (57.2%) irrespective of syncope. Among patients with clinically relevant arrhythmia detected by ILR, PM implantation was performed in 60 (34.7%), an intra-cardiac defibrillator in 5 (2.9%), and catheter ablation in 4 (2.3%). In a Cox regression analysis, history of paroxysmal atrial fibrillation (PAF) (hazard ratio [HR], 2.34; 95% confidence interval [CI], 1.33–4.12; P < 0.01) and any bundle branch block (BBB) (HR, 2.52; 95% CI, 1.09–5.85; P = 0.03) were significantly associated with PM implantation. Conclusion ILR is useful for detecting syncope-correlated arrhythmia in patients with US. The risk of PM is high in US patients with a history of PAF and any BBB., Graphical Abstract
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- 2020
26. Effects of Empagliflozin on Diuretics Reduction in Outpatient Heart Failure Patients
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Soo-Jin Kim, Bong-Joon Kim, Sung-Il Im, Hyun-Su Kim, and Jung-Ho Heo
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Inhibitors of sodium-glucose cotransporter 2 (SGLT2i) reduce the risk of hospitalization for heart failure (HF). We aimed to examine the effect of empagliflozin on change of diuretics dose in outpatient HF patients.We retrospectively reviewed the medical records of 612 patients who were treated using both empagliflozin and diuretics. We excluded patients who did not meet the criteria for HF. Dose and duration of empagliflozin and diuretics were measured.Of 612 patients, a total of 251 was analyzed and followed for a mean 430.0±175.4 days. The mean age was 69.3, 51.8% were female, and 93.2% had type 2 diabetes. The distribution of initial diuretics type when starting empagliflozin showed that furosemide comprised 24.7%, spironolactone 20.7%, thiazide 36.9%, and others. Total 23.1% of patients reduced diuretic dose, 13.1% increased diuretic dose, 41.4% continued at the same diuretic dose, and 22.3% switched to different diuretics. Among patients who were using furosemide, 36.0% reduced diuretics dose. There was a diuretic reduction in 22.6% of HF preserved ejection fraction (HFpEF, left ventricular ejection fraction [LVEF] ≥50%) and in 26.5% of HF reduced EF (HFrEF, LVEF50%). The average doses furosemide at the start of empagliflozin decreased from 16.3mg/day to 8.5mg/day at the time of follow-up.Among outpatient clinic HF patients treated with both diuretics and empagliflozin, 23.1% of patients had their diuretics reduced, and the mean dose of furosemide was reduced by about half. This suggests that empagliflozin has clinical advantages in managing outpatient HF patients.
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- 2022
27. What Regional Disparity Trends of Cardiovascular Mortality Have Changed in 2019 Compared to the 1980s?
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Sung il Im
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Internal Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2022
28. Increased Right Ventricular Pressure as a Predictor of Acute Decompensated Heart Failure in End-Stage Renal Disease Patients on Maintenance Hemodialysis
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Bong-Joon Kim, Soo-Jin Kim, Sung-Il Im, Hyun-Su Kim, Jung-Ho Heo, Ho Sik Shin, Ye Na Kim, Yeonsoon Jung, and Hark Rim
- Abstract
Many patients with end-stage renal disease (ESRD) on hemodialysis (HD) have reduced vascular compliance and are likely to develop heart failure (HF). This study aimed to determine the factors associated with acute decompensation events among ESRD patients undergoing HD.We retrospectively investigated ESRD patients on HD using a medical record review. We divided the patients into those admitted to hospital due to acute decompensated heart failure (ADHF) and those who were not. We compared the medical histories, electrocardiograms, and echocardiographic and laboratory data between the two groups.Of the 188 ESRD patients on HD, 87 were excluded, and 101 were enrolled (mean age: 63.7 years; 52.1% male). Thirty patients (29.7%) were admitted due to ADHF. These patients exhibited similar left ventricular ejection fraction (LVEF), left ventricular (LV) mass index, and E/E' values compared to the non-ADHF group. However, the ADHF group exhibited significantly higher tricuspid regurgitation (TR) jet velocity (2.9±0.6 vs. 2.5±0.4 m/s; p=0.004) and right ventricular systolic pressure (RVSP) (43.5±17.2 vs. 34.2±9.9 mmHg; p=0.009) than the non-ADHF group, respectively. A multivariate logistic regression analysis demonstrated that the TR jet velocity (odds ratio, 8.356; 95% confidence interval, 1.806-38.658; p=0.007) was an independent predictor of ADHF after adjusting for age and sex, while the LVEF and E/E' were not.Our data showed that an increased TR jet velocity was an independent predictor of ADHF events in ESRD patients on HD, but the LVEF and E/E' were not.
- Published
- 2022
29. Identification of Markers Associated With Development of Stroke in 'Clinically Low‐Risk' Atrial Fibrillation Patients
- Author
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Jaemin Shim, Jun Hyung Kim, Hong Euy Lim, Yae Min Park, Jinhee Ahn, Seung Yong Shin, Eun Mi Lee, Sung Il Im, Sang Jin Han, Gregory Y.H. Lip, and Jin Seok Kim
- Subjects
Adult ,medicine.medical_specialty ,ABCD score ,risk stratification ,risk score ,Risk Assessment ,Risk Factors ,Internal medicine ,Atrial Fibrillation ,Ischaemic stroke ,medicine ,Humans ,atrial fibrillation ,Stroke ,Aged ,Retrospective Studies ,Original Research ,Ischemic Stroke ,Framingham Risk Score ,stroke, ischemic ,ABCD² score ,business.industry ,Atrial fibrillation ,Middle Aged ,medicine.disease ,Risk stratification ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Stroke and thromboembolic events may still occur in “clinically low‐risk” atrial fibrillation ( AF ) patients as categorized by CHA 2 DS 2 ‐ VAS c score. Our aim was to assess the proportion of “clinically low‐risk” patients using a nongender CHA 2 DS 2 ‐ VAS c (ie, CHA 2 DS 2 ‐ VA ) score of 0 to 1 among patients who experienced AF ‐associated stroke and to identify markers associated with stroke in “clinically low‐risk” patients. Methods and Results We retrospectively recruited nonvalvular AF patients who experienced embolic stroke between 2013 and 2016 from 9 institutes in Korea. AF patients with CHA 2 DS 2 ‐ VA score of 0 to 1 at the time of stroke were analyzed and compared with “clinically low‐risk” AF patients without stroke. A total of 3033 subjects with AF ‐associated stroke were recruited. Of these, 583 patients (19.2%) had CHA 2 DS 2 ‐ VA score of 0 to 1. On multivariate analysis, age (≥60 years), N‐terminal pro B‐type natriuretic peptide (≥300 pg/mL), creatinine clearance (ABCD score) to the “clinically low‐risk” patients, the c‐index was 0.858 (95% CI 0.838–0.877; P Conclusions The present study suggests a new insight into how additional use of markers can further refine stroke risk differentiation among AF patients initially classified as “clinically low‐risk.” Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 03147911.
- Published
- 2019
30. B-AB03-03 PULSED FIELD ABLATION OF LEFT VENTRICULAR MYOCARDIUM IN A SWINE INFARCT MODEL
- Author
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Eric Buck Blake Morrow, Satoshi Higuchi, Adam Lee, Sung Il Im, Carol Stillson, and Edward P. Gerstenfeld
- Subjects
medicine.medical_specialty ,Field (physics) ,business.industry ,Physiology (medical) ,Internal medicine ,medicine.medical_treatment ,Cardiology ,medicine ,Left ventricular myocardium ,Cardiology and Cardiovascular Medicine ,Ablation ,business - Published
- 2021
31. Risk factor algorithm used to predict frequent premature ventricular contraction-induced cardiomyopathy
- Author
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Young Keun On, Kyoung-Min Park, Sung Il Im, June Soo Kim, and Seung-Jung Park
- Subjects
Male ,medicine.medical_specialty ,Cardiomyopathy ,030204 cardiovascular system & hematology ,Risk Assessment ,Group A ,Asymptomatic ,Ventricular Function, Left ,Group B ,03 medical and health sciences ,QRS complex ,0302 clinical medicine ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,Republic of Korea ,medicine ,Palpitations ,Humans ,030212 general & internal medicine ,Risk factor ,Retrospective Studies ,business.industry ,Incidence ,Incidence (epidemiology) ,Stroke Volume ,Middle Aged ,medicine.disease ,Ventricular Premature Complexes ,Electrocardiography, Ambulatory ,Cardiology ,Female ,medicine.symptom ,Cardiomyopathies ,Cardiology and Cardiovascular Medicine ,business ,Algorithm ,Algorithms ,Follow-Up Studies - Abstract
Premature ventricular contraction (PVC) QRS duration (QRSd) and high PVCs burden are known as a risk factor of PVC-induced cardiomyopathy (CMP). The aim of this study is to find useful algorithm to predict PVC-induced CMP.180 patients (99 males, 51±14years) with frequent PVCs (10%/24h), who underwent successful PVC ablation, were studied. Typical PVC-related symptoms were defined as the presence of palpitations or dropped beats during PVC. Group A (n=144) was symptomatic and Group B (n=36) was asymptomatic.The incidence of CMP was significantly higher in group B (group A=19%, group B=66%, p0.001). In group A, there were significant differences, between the patients with normal EF and CMP, in terms of sex (p=0.005), daily PVC burden (p=0.012), distribution of PVCs with a LV site (p0.009), and PVC QRSd (p0.001). In group B, the PVC QRSd was significantly wider in patients with CMP. Multivariate analysis showed that PVC QRSd (p0.001), PVC burden (p=0.022), and LV site (p=0.043) were risk factors for CMP.Using our scoring algorithm for this patient sample, we are able to predict the development of PVC-induced CMP with 80% sensitivity, 81% specificity, 64% positive predictive value, and 91% negative predictive value.
- Published
- 2017
32. Changes in Left Atrial Transport Function in Patients Who Maintained Sinus Rhythm After Successful Radiofrequency Catheter Ablation for Atrial Fibrillation: A 1-Year Follow-Up Multislice Computed Tomography Study
- Author
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Seong Hwan Kim, Chun Hwang, Jin Oh Na, Dong Joo Oh, Jin-Seok Kim, Seung-Woon Rha, Jun Hyuk Kang, Eung Ju Kim, Hong Seog Seo, Chang Gyu Park, Sung Il Im, Seung Yong Shin, Young-Hoon Kim, Hwan Seok Yong, Cheol Ung Choi, and Hong Euy Lim
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Left atrium ,Catheter ablation ,Atrial fibrillation ,030204 cardiovascular system & hematology ,medicine.disease ,Ablation ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Radiofrequency catheter ablation ,Physiology (medical) ,Internal medicine ,medicine ,Cardiology ,Atrial Ablation ,In patient ,Sinus rhythm ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Functional remodeling of left atrium (LA) after radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) has not been fully elucidated. This study aimed to determine the impact of RFCA on LA transport function in patients who maintained sinus rhythm (SR) after AF ablation. Methods and Results A total of 96 patients [paroxysmal AF (PAF) = 52] who maintained SR during 1 year after AF ablation were enrolled. Multi-slice computed tomography was performed to determine LA volume (LAV) and LA emptying fraction (LAEF) at pre-RFCA and 1-year post-RFCA. Creatine kinase-MB (CK-MB) and troponin-T levels were analyzed one-day post-RFCA. At 1-year post-RFCA, mean LAV and LAEF decreased in overall patients. Based on LAEF change (ΔLAEF) cut off of 5.0%, LAEF reduced in 41 patients (worsened group) and improved or showed no change in 55 patients (preserved group). Compared with preserved group, worsened group had a higher proportion of PAF, higher levels of CK-MB and troponin-T, and additional LA ablation. ΔLAEF was inversely correlated with CK-MB and troponin-T levels. Subgroup analysis showed that LAEF significantly decreased in PAF patients who underwent additional LA ablation. Multivariate analysis revealed that high baseline LAEF and additional LA ablation were independent predictors for worsened LAEF. Conclusions Although SR was maintained for 1 year after AF ablation, LAEF as well as LAV decreased. The extent of LAEF deterioration was significantly associated with the amount of iatrogenic myocardial damage. Our data indicate that extensive atrial ablation may lead to LA functional deterioration, especially in patients with PAF. This article is protected by copyright. All rights reserved
- Published
- 2016
33. New electrocardiographic criteria for predicting successful ablation of premature ventricular contractions from the right coronary cusp
- Author
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Sung Il Im, June Soo Kim, Young Keun On, Kyoung-Min Park, and Seung-Jung Park
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Catheter ablation ,030204 cardiovascular system & hematology ,Electrocardiography ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,Republic of Korea ,medicine ,Humans ,Ventricular outflow tract ,Left coronary cusp ,030212 general & internal medicine ,Lead (electronics) ,Right coronary cusp ,Aged ,medicine.diagnostic_test ,business.industry ,Middle Aged ,Ablation ,Ventricular Premature Complexes ,Predictive value of tests ,Catheter Ablation ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background ECG features for predicting successful ablation sites of outflow tract (OT) premature ventricular complex (PVCs) have been previously presented, but effective predictors of right coronary cusp (RCC) remain elusive. Methods 106 patients (59 males, 56±14years) who underwent successful PVC ablation were studied. Various ECG patterns and measurements were analyzed to identify the unique features of RCC PVC origins. The R-wave duration index (RWDI) was calculated as a percentage by dividing the QRS complex duration by the longest R-wave duration in lead V 1 or V 2 . Results Successful ablation sites were the RCC in 18 patients, the left coronary cusp (LCC) in 20, the RCC/LCC junction (RLJ) in 22, the AIV/GCV in 11 and the right ventricular outflow tract in 35. Forty-seven patients had dominantly positive forces in lead I. Among these 47 patients, 19 were ablated from the RCC (18/18, 100%), eighteen from the RVOT (18/35, 51%), five from the LCC (5/20, 25%), and five from the RLJ (6/22, 27%). The S-wave amplitude in lead aV L was significantly smaller in RCC than LCC or RLJ PVCs (0.1±0.3mV vs. 1.1±0.5mV, p 1–2 RWDI was significantly greater in RCC than RVOT PVCs (51.8±20.5% vs. 30.8±13.9%, p 43.6% for R-wave duration index in V 1 or V 2 (AUC: 0.83, p Conclusions The presence of a dominant positive lead I, RWDI >43.6% and S-wave amplitude in aV L
- Published
- 2016
34. Heart rate recovery and blood pressure response during exercise testing in patients with microvascular angina
- Author
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Sung Il Im, Hyun-Su Kim, Bong Joon Kim, Kyoung-Im Cho, Jung Ho Heo, and Eun-Ah Jo
- Subjects
lcsh:Internal medicine ,medicine.medical_specialty ,Cardiac autonomic function ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Chest pain ,Angina ,Coronary artery disease ,03 medical and health sciences ,Microvascular angina ,0302 clinical medicine ,Internal medicine ,Heart rate ,Internal Medicine ,medicine ,030212 general & internal medicine ,lcsh:RC31-1245 ,Angiology ,ST depression ,business.industry ,Research ,lcsh:R ,Odds ratio ,medicine.disease ,Heart rate recovery ,Blood pressure ,Cardiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Angina pectoris with a normal coronary angiogram, termed microvascular angina (MVA), is an important clinical entity; however, its causes remain unclear. Autonomic dysfunction is one of the possible causes. Therefore, this study aimed to investigate parasympathetic dysfunction assessed by heart rate recovery (HRR) and increased sympathetic activity assessed by exaggerated blood pressure (BP) response (EBPR) to exercise in MVA. Methods The study participants were consecutive patients with anginal chest pain who underwent both coronary angiography with an ergonovine provocation test and a treadmill exercise test between January 2008 and February 2015. Patients with significant coronary artery disease (coronary artery stenosis ≥50%) or significant coronary artery spasm (≥90%) were excluded. Based on the treadmill exercise test, patients were categorized into the microvascular angina (MVA) group (patients with uniform ST depression ≥1 mm) and the control group. HRR was defined as peak heart rate minus heart rate after a 1 min recovery; blunted HRR was defined as ≤12 beats/min. EBPR was defined as a peak exercise systolic BP ≥210 mmHg in men and ≥ 190 mmHg in women. These parameters were compared between patients with MVA and the controls. Results Among the 970 enrolled patients (mean age 53.1 years; female 59.0%), 191 (20.0%) were diagnosed with MVA. In baseline characteristics, the MVA group had older participants, female predominance, and a higher prevalence of hypertension. The MVA group showed significantly lower HRR 1 min (24.9 ± 15.9 vs. 31.3 ± 22.7, p
- Published
- 2019
35. Editorial for 'Declaration of the known facts in myopathy: Pacing in order to capture future occurrence of PVC‐induced myopathy?'
- Author
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Sung Il Im, June Soo Kim, Kyoung-Min Park, Youngjun Park, Young Keun On, Seung-Jung Park, and Hye Bin Gwag
- Subjects
medicine.medical_specialty ,business.industry ,Order (business) ,medicine ,Declaration ,General Medicine ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Intensive care medicine ,business ,Myopathy - Published
- 2019
36. Interatrial septal thickness as a marker of structural and functional remodeling of the left atrium in patients with atrial fibrillation
- Author
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Eung Ju Kim, Sung Il Im, Dong Joo Oh, Chang Gyu Park, Seung-Woon Rha, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Hong Seog Seo, Seong Hwan Kim, Jin Won Kim, Seong Woo Han, and Chun Hwang
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Paroxysmal atrial fibrillation ,medicine.medical_treatment ,Cardiology ,Left atrium ,Action Potentials ,Catheter ablation ,Predictive Value of Tests ,Recurrence ,Risk Factors ,Internal medicine ,Atrial Fibrillation ,Multidetector Computed Tomography ,medicine ,Humans ,In patient ,Sinus rhythm ,Prospective Studies ,Aged ,Univariate analysis ,Chi-Square Distribution ,Ejection fraction ,Atrial Septum ,business.industry ,Heart atria ,Atrial fibrillation ,Atrial Remodeling ,Middle Aged ,medicine.disease ,Echocardiography, Doppler ,Treatment Outcome ,medicine.anatomical_structure ,ROC Curve ,Area Under Curve ,Multivariate Analysis ,Catheter Ablation ,Linear Models ,Original Article ,Atrial Function, Left ,Female ,Electrophysiologic Techniques, Cardiac ,business - Abstract
BACKGROUND/AIMS There have been reports that interatrial septal (IAS) thickness is increased in patients with atrial fibrillation (AF). This study was performed to investigate whether IAS thickness determined by transthoracic echocardiography (TTE) represents the amount of left atrium (LA) structural and functional remodeling. METHODS The study population consisted of 104 consecutive patients who underwent catheter ablation (CA) for AF (paroxysmal atrial fibrillation [PAF], 82; persistent atrial fibrillation [PeAF], 22). IAS thickness and left atrium volume (LAV) using TTE, and LA voltage (LA(VOL)) using 3-dimensional electroanatomical mapping system were assessed during sinus rhythm. RESULTS IAS thickness was significantly correlated with maximal LAV (LAV(max)) (r = 0.288, p = 0.003), mean LA(VOL) (r = -0.537, p < 0.001), total left atrium emptying fraction (LAEF(total); r = -0.213, p = 0.030), and active LAEF (LAEF(active); r = -0.249, p = 0.014). IAS thickness was greater in the high-risk group (≥ 2) compared to other groups according to CHA2DS2-VASc score (p = 0.019). During a follow-up of 19.6 months, 23 subjects (22.1%; PAF, 17; PeAF, 6) had recurrence of arrhythmia. Univariate analysis showed that LAV(max), minimal LAV, mean LA(VOL), LVEF(total), LVEF(active), and IAS thickness were associated with recurrence of arrhythmia. However, on multivariate analysis, only mean LA(VOL) and LAEF(active) were independent risk factors for recurrence. CONCLUSIONS Although IAS thickness showed significant correlations with parameters for LA structural and functional remodeling, this parameter alone could not independently predict recurrence of arrhythmia after CA for AF.
- Published
- 2015
37. Absolute change in fasting plasma glucose over 12months is associated with 2-year and 5-year major adverse cardiovascular events in patients with drug-eluting stent implants
- Author
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Eung Ju Kim, Sung Il Im, Sun Ki Lee, Chang Gyu Park, Cheol Ung Choi, Byung Geol Choi, Eun Mi Lee, Jin Oh Na, Ji Park Kim, Jin Won Kim, Hong Euy Lim, Dong Oh Kang, Dong Joo Oh, Hong Seog Seo, and Seung-Woon Rha
- Subjects
Blood Glucose ,Male ,medicine.medical_specialty ,Time Factors ,Statin ,medicine.drug_class ,medicine.medical_treatment ,Subgroup analysis ,Cohort Studies ,Percutaneous Coronary Intervention ,Risk Factors ,Diabetes mellitus ,Internal medicine ,medicine ,Humans ,Prospective Studies ,cardiovascular diseases ,Risk factor ,Aged ,business.industry ,Incidence (epidemiology) ,Percutaneous coronary intervention ,Drug-Eluting Stents ,Fasting ,Middle Aged ,medicine.disease ,Surgery ,Treatment Outcome ,Cardiovascular Diseases ,Drug-eluting stent ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Mace ,Follow-Up Studies - Abstract
Background Major adverse cardiovascular events (MACEs) in patients with or without cardiovascular disease (CVD) are greatly affected by various factors associated with metabolism and inflammation. Objective To determine which clinical parameters at treatment are associated with the development of 2-year and 5-year MACEs in high-risk patients with CVD who have undergone drug-eluting stent (DES) implantation. Method The present study involved a total of 432 patients who underwent percutaneous coronary intervention with DES. Variables representing the average and absolute amount of change in clinical parameters over the 12-month follow-up were assessed for association with 2-year and 5-year development of MACE. The study population was divided into quartiles for the variable showing the highest correlation to MACE development. Estimated incidence of 2-year and 5-year MACEs for each of the quartiles was determined by survival curve analysis, and subgroup analysis was performed for patients with diabetes and statin users. Results Absolute change in fasting plasma glucose (FPG) over 12months showed the highest correlation with 2-year and 5-year MACE development. The estimated incidence of MACE increased with increasing quartiles for absolute change in FPG. The association between absolute change in FPG and MACE development exhibited a stronger relationship for the specific subgroups of patients with diabetes and statin users. Increases and decreases in FPG had a comparable contribution to MACE development. Conclusion A greater absolute change in FPG over 12months post-PCI is an independent risk factor for 2-year and 5-year MACE development in DES-implanted patients, especially in the diabetes and statin users.
- Published
- 2015
38. Gap junction remodelling by chronic pressure overload is related to the increased susceptibility to atrial fibrillation in rat heart
- Author
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Sang Wook Kim, Wang Soo Lee, Jee Eun Kwon, Seung Yong Shin, Hong Euy Lim, Sung Il Im, Won Min Jo, Chee Jeong Kim, Tae-Ho Kim, Dae Hyun Song, Kwang Je Lee, Byoung Kwon Kim, Too Jae Min, and Seong Hyeop Hyeon
- Subjects
Male ,medicine.medical_specialty ,Diastole ,Cardiomyopathy ,Blood Pressure ,Left ventricular hypertrophy ,Connexins ,Muscle hypertrophy ,Rats, Sprague-Dawley ,Physiology (medical) ,Internal medicine ,Atrial Fibrillation ,medicine ,Animals ,cardiovascular diseases ,Pressure overload ,Ischemic cardiomyopathy ,business.industry ,Gap Junctions ,Dilated cardiomyopathy ,Atrial fibrillation ,medicine.disease ,Rats ,Chronic Disease ,cardiovascular system ,Cardiology ,Hypertrophy, Left Ventricular ,Disease Susceptibility ,Cardiomyopathies ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims Left atrial (LA) fibrosis caused by various pathological stimuli is a common finding. However, the difference of atrial remodelling via haemodynamic change in diverse cardiomyopathy has not been elucidated. Methods and results Male Sprague-Dawley rats (6–8 weeks, n = 180) were randomly assigned to three groups and corresponding sham control groups: (i) ischaemic cardiomyopathy, (ii) left ventricular hypertrophy (LVH), and (iii) dilated cardiomyopathy. At 12 weeks after operation, atrial fibrillation (AF) inducibility and duration were assessed by in vivo burst transoesophageal pacing. Using the Langendorff apparatus, left ventricular (LV) function and pressure were measured. The expression of connexin-43 (Cx43) and alpha-smooth muscle actin (α-SMA) in atrial tissues was assessed by quantitative real-time polymerase chain reaction and immunohistochemical staining. Fibrosis was analysed by Masson's trichrome staining. Compared with controls, the LA weight/heart weight ratio was increased in the LVH group alone, and was significantly correlated with AF duration ( P < 0.001, R = 0.388). Atrial fibrillation inducibility and duration were higher and longer only in the LVH group ( P = 0.002, 0.079, respectively), and isolated LV diastolic dysfunction and elevated LV pressure were observed. Although α-SMA expression and fibrosis were increased in all three cardiomyopathy models, down-regulation of Cx43 expression in the LA was observed in the LVH group alone. Conclusion Chronic pressure overload in the absence of LV systolic dysfunction resulted in LA hypertrophy and increased susceptibility to AF, which might be related to conduction abnormality via decreased expression and lateral distribution of Cx43 as well as interstitial fibrosis.
- Published
- 2014
39. Does the amount of atrial mass reduction improve clinical outcomes after radiofrequency catheter ablation for long-standing persistent atrial fibrillation? Comparison between linear ablation and defragmentation
- Author
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Seong Woo Han, Sung Il Im, Jin Won Kim, Seung Yong Shin, Seong Hwan Kim, Cheol Ung Choi, Eung Ju Kim, Seung-Woon Rha, Hong Seog Seo, Dong Joo Oh, Jin Oh Na, Chang Gyu Park, Hong Euy Lim, and Chun Hwang
- Subjects
Adult ,Male ,medicine.medical_specialty ,Mass reduction ,medicine.medical_treatment ,Catheter ablation ,Pulmonary vein ,Internal medicine ,Atrial Fibrillation ,medicine ,Humans ,Heart Atria ,Prospective Studies ,business.industry ,Atrial fibrillation ,Middle Aged ,medicine.disease ,Ablation ,Treatment Outcome ,Radiofrequency catheter ablation ,Persistent atrial fibrillation ,Catheter Ablation ,Cardiology ,Female ,Electrophysiologic Techniques, Cardiac ,Cardiology and Cardiovascular Medicine ,business ,Linear ablation ,Follow-Up Studies - Abstract
Background Although a large isolated surface area of the left atrium (LA) may improve the success rate of catheter ablation (CA) for paroxysmal atrial fibrillation (AF), little is known about the relation between clinical outcomes and the amount of atrial mass reduction (AMR: ratio of total isolated and ablated areas to LA surface area) in different ablation strategies for patients with long-standing persistent AF (L-PeAF). Methods We randomly assigned 119 consecutive L-PeAF patients to adjunctive linear ablation ( n =60) or complex fractionated atrial electrogram (CFAE)-guided ablation ( n =59) after circumferential antral pulmonary vein isolation (PVI). Linear lesions included roof and anterior lines with conduction block. LA defragmentation was performed with an automated CFAE-detection algorithm. Cavotricuspid isthmus block was performed in all patients. Creatine kinase-MB (CK-MB) and troponin-T levels were measured 1day post-CA. Results CK-MB and troponin-T levels were higher, ablation time was longer, and AMR was greater in the CFAE-guided ablation group than in the linear ablation group. AF termination during CA was more frequently observed in the linear ablation group than in the CFAE-guided ablation group ( P =0.031). Twelve months after a single procedure, recurrence occurred in 16 (26.7%) patients with linear ablation and 27 (45.8%) patients with CFAE-guided ablation ( P =0.023). On multivariate analysis, LA volume and ablation method were the only independent risk factors for arrhythmia recurrence. Conclusion Conduction block through linear lines+PVI was an efficient ablation strategy for L-PeAF, whereas the AMR amount did not influence clinical outcomes.
- Published
- 2014
40. Effect of StentBoost imaging guided percutaneous coronary intervention on mid-term angiographic and clinical outcomes
- Author
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Eung Ju Kim, Jin Won Kim, Cheol Ung Choi, Sung Il Im, Seung-Woon Rha, Hong Seog Seo, Chang Gyu Park, Jin Oh Na, Hong Euy Lim, Dong Joo Oh, Sun Won Kim, and Seong Woo Han
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Coronary Artery Disease ,Coronary Angiography ,Coronary artery disease ,Percutaneous Coronary Intervention ,Restenosis ,Internal medicine ,Intravascular ultrasound ,medicine ,Humans ,Prospective Studies ,Registries ,Prospective cohort study ,Ultrasonography, Interventional ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Percutaneous coronary intervention ,Stent ,Drug-Eluting Stents ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Treatment Outcome ,Fluoroscopy ,Conventional PCI ,Cardiology ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Introduction The gold standard for evaluating stent expansion after percutaneous coronary intervention (PCI) is intravascular ultrasound (IVUS). However, the routine use of this modality is costly and time consuming. StentBoost is a new imaging technique that improves fluoroscopy-based assessments of stent expansion. The purpose of this study was to evaluate the effect of StentBoost imaging-guided PCI on mid-term angiographic and clinical outcomes. Methods and results A total of 870 consecutive patients were recruited (mean age: 64.34±11.61; men: 64.5%), all of whom underwent PCI with drug-eluting stents (DESs). The subjects were divided into a no StentBoost group (n=569 patients) and a StentBoost group (n=301 patients). The 6-month angiographic and 12-month clinical outcomes were compared between the two groups. At 1month, clinical outcomes were similar between the two groups. At 6months, the StentBoost group had significantly lower rates of late loss (0.32±0.40 vs. 0.48±0.59; p=0.005) and binary restenosis (1.2% vs. 8.3%; p=0.029) compared with the no-StentBoost group. At 12months, StentBoost group had significantly lower the incidence of target lesion revascularization (TLR) (1.7% vs. 7%; p=0.034) and TLR-major adverse cardiac events (6% vs. 13.2%; p=0.037) compared with the no-StentBoost group. Conclusion We conclude that the routine clinical use of StentBoost during PCI can be useful, and results in better medium-term angiographic and clinical outcomes.
- Published
- 2013
41. Extracellular fluid adjusted for body size is contracted in hypertension
- Author
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Jin Oh Na, Hong Seog Seo, Jin Won Kim, Eung Ju Kim, Cheol Ung Choi, Chang Gyu Park, Sun Won Kim, Sung Il Im, Hong Euy Lim, and Seung-Woon Rha
- Subjects
Male ,medicine.medical_specialty ,Waist ,Physiology ,Body Mass Index ,Cohort Studies ,Internal medicine ,Extracellular fluid ,Electric Impedance ,Internal Medicine ,Intravascular volume status ,medicine ,Body Size ,Humans ,Aged ,business.industry ,Extracellular Fluid ,Fluid compartments ,Odds ratio ,Middle Aged ,Blood pressure ,Endocrinology ,Case-Control Studies ,Relative risk ,Hypertension ,Body Composition ,Cardiology ,Regression Analysis ,Female ,Cardiology and Cardiovascular Medicine ,business ,Body mass index - Abstract
Extracellular fluid (ECF) is associated with blood pressure, but reports on the status of the ECF volume in hypertension have been inconsistent. The aim of this study was to assess the ECF volume status in hypertensives with regard to body size in a large cohort. We performed a single-center case-control observation study for patients who visited the outpatient hypertension clinic and health examination center. For all eligible participants, we examined the body composition, including fluid compartments, using a noninvasive bioimpedance analysis. Of 2934 subjects (women 1365, 57.5 ± 12.2 years), 1166 subjects were normotensive and 1768 subjects were hypertensive. The ECF volume was larger in female hypertensives than in normotensives but was not different between the male groups. However, the relative ECF, defined as the ratio of ECF to body mass index (BMI), was significantly lower in hypertensives of both genders (P
- Published
- 2013
42. Contents Vol. 125, 2013
- Author
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Eung Ju Kim, Peijun Liu, Sun Won Kim, Satz Mengensatzproduktion, Chang Gyu Park, Feng Bai, Richard W. Smalling, Hao Hu, Abid Assali, Hong Euy Lim, William H. Barry, Byoung Geol Choi, James Amirian, André Vincentelli, Hong Seog Seo, Xiu Q. Zhang, Longquan Yang, Xueping Du, David Brosh, Sophie Tamareille, Karin Rupp, Muthiah Vaduganathan, Druck Reinhardt Druck Basel, Sung Il Im, Patricia Felli, Hana Vaknin-Assa, Pierre Vladimir Ennezat, Matthew D. Terwelp, M. Viigimaa, V. Papademetriou, Bin Nie, Peter Alter, Christian Noel, Eldad Rechavia, Ming Yang, Pascal Meier, Alon Eisen, Jing Yu, Kang Gao, Seung-Woon Rha, Jin Oh Na, Isabelle Tillie-Leblond, Mehmet Gungor Kaya, Alexander Battler, Cheol Ung Choi, Se Yeon Choi, Eli I. Lev, Zhe Fang, Zhaoxia Yin, M. Doumas, Feng Zhao, Jin Won Kim, Dong Joo Oh, Katia Orvin, Thierry H. Le Jemtel, Heinz Rupp, Xin Lin, Ruixin Ma, Tamir Bental, Alexandra J. Lansky, Georg M. Fröhlich, Thomas Philipp Rupp, and Ran Kornowski
- Subjects
Traditional medicine ,business.industry ,Medicine ,Pharmacology (medical) ,Cardiology and Cardiovascular Medicine ,business - Published
- 2013
43. Association between right ventricular systolic function and electromechanical delay in patients with right bundle branch block
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Kyoung Im Cho, Jeong Ho Heo, Bong Joon Kim, Hyun Su Kim, Dong Hyun Park, Ga In You, Yoon Kyung Kim, and Sung Il Im
- Subjects
Cardiac function curve ,Male ,medicine.medical_specialty ,Systole ,Bundle-Branch Block ,Volume overload ,030204 cardiovascular system & hematology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,QRS complex ,Electrocardiography ,0302 clinical medicine ,Internal medicine ,Medicine ,Humans ,Aged ,Bundle branch block ,medicine.diagnostic_test ,business.industry ,Right bundle branch block ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Ventricle ,Echocardiography ,Cardiology ,Ventricular Function, Right ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Elevated right ventricle (RV) pressure and/or volume can place stress on the right bundle branch block (RBBB) and its associated Purkinje network, which can affect its electrical properties, resulting in conduction delay or block. We hypothesized that prolonged R′ wave duration in lead V1 would extend the later portion of the QRS complex and can act as an indicator of reduced RV function in patients with RBBB. Method Kosin University Gospel Hospital echocardiography and electrocardiography (ECG) database was reviewed to identify patients with complete RBBB between 2013 and 2015. ECGs recorded closest to the time of the echocardiography were carefully reviewed, and QRS and R′ wave duration were measured. RV systolic dysfunction was defined as an RV fractional area change (FAC) less than 35%, as indicated by echocardiography guidelines. Results Compared to patients with normal RV function (n = 241), patients with RV dysfunction (n = 123) showed prolonged QRS duration (145.3 ± 19.3 ms vs. 132.2 ± 13.4 ms, p
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- 2016
44. Changes in Left Atrial Transport Function in Patients Who Maintained Sinus Rhythm After Successful Radiofrequency Catheter Ablation for Atrial Fibrillation: A 1-Year Follow-Up Multislice Computed Tomography Study
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Jin-Seok, Kim, Sung Il, Im, Seung Yong, Shin, Jun Hyuk, Kang, Jin Oh, Na, Cheol Ung, Choi, Seong Hwan, Kim, Eung Ju, Kim, Seung-Woon, Rha, Chang Gyu, Park, Hong Seog, Seo, Dong Joo, Oh, Chun, Hwang, Young-Hoon, Kim, Hwan Seok, Yong, and Hong Euy, Lim
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Male ,Chi-Square Distribution ,Time Factors ,Action Potentials ,Middle Aged ,Cicatrix ,Logistic Models ,Treatment Outcome ,Heart Rate ,Predictive Value of Tests ,Risk Factors ,Atrial Fibrillation ,Multidetector Computed Tomography ,Multivariate Analysis ,Catheter Ablation ,Humans ,Atrial Function, Left ,Female ,Heart Atria ,Prospective Studies ,Aged - Abstract
Functional remodeling of left atrium (LA) after radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) has not been fully elucidated. This study aimed to determine the impact of RFCA on LA transport function in patients who maintained sinus rhythm (SR) after AF ablation.A total of 96 patients (paroxysmal AF [PAF] = 52) who maintained SR during 1 year after AF ablation were enrolled. Multislice computed tomography was performed to determine LA volume (LAV) and LA emptying fraction (LAEF) at pre-RFCA and 1-year post-RFCA. Creatine kinase-MB (CK-MB) and troponin-T levels were analyzed 1-day post-RFCA. At 1-year post-RFCA, mean LAV and LAEF decreased in overall patients. Based on LAEF change (ΔLAEF) cutoff of 5.0%, LAEF reduced in 41 patients (worsened group) and improved or showed no change in 55 patients (preserved group). Compared with preserved group, worsened group had a higher proportion of PAF, higher levels of CK-MB and troponin-T, and additional LA ablation. ΔLAEF was inversely correlated with CK-MB and troponin-T levels. Subgroup analysis showed that LAEF significantly decreased in PAF patients who underwent additional LA ablation. Multivariate analysis revealed that high baseline LAEF and additional LA ablation were independent predictors for worsened LAEF.Although SR was maintained for 1 year after AF ablation, LAEF as well as LAV decreased. The extent of LAEF deterioration was significantly associated with the amount of iatrogenic myocardial damage. Our data indicate that extensive atrial ablation may lead to LA functional deterioration, especially in patients with PAF.
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- 2016
45. Aorta-Right Atrial Tunnel: Is Surgical Correction Mandatory?
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Sung Il Im, Sunki Lee, Sun Won Kim, Jin Oh Na, Cheol Ung Choi, Hwan Seok Yong, and Hong Euy Lim
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Aortic valve ,Adult ,Heart Defects, Congenital ,Male ,medicine.medical_specialty ,Aortography ,Vascular Malformations ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Physiology (medical) ,medicine.artery ,Internal medicine ,Aortic sinus ,medicine ,Humans ,Heart Atria ,Cardiac Surgical Procedures ,Aorta ,Cardiac catheterization ,medicine.diagnostic_test ,business.industry ,Coronary arteries ,medicine.anatomical_structure ,Parasternal line ,Heart murmur ,Cardiology ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
An asymptomatic 31-year-old man with chronic hepatitis B and a 7-year history of lamivudine use was referred to our hospital for evaluation of a heart murmur. The patient had no family history of congenital heart disease or collagen vascular disease. Cardiac auscultation revealed a grade 3/6 continuous murmur at the right parasternal border. Transthoracic echocardiography revealed a round, tunnel-like structure from the left aortic sinus to the right atrium (RA; Figure 1A and 1B, arrows, and Movie IA and IB in the online-only Data Supplement) without any evidence of RA or right ventricular enlargement. Modified parasternal short-axis view (Figure 1C and Movie II in the online-only Data Supplement) of the aortic valve level demonstrated an anastomosis site to the RA with continuous turbulent flow on color Doppler examination. Continuous-wave Doppler obtained from the shunt indicated a high flow velocity with systolic and diastolic pattern at the anastomosis site to the RA (Figure 1D). Cardiac catheterization showed a normal pulmonary artery pressure (systolic/diastolic, 24/7 mm Hg) and normal mean RA pressure (4 mm Hg), and the Qp/Qs ratio was 1.3:1. Aortography confirmed a large tunnel beginning in the left aortic sinus and ending in the RA (Figure 2, asterisk, and Movie III in the online-only Data Supplement), with normal-looking left coronary arteries arising independently from different proximal portions of the tunnel. Importantly, no coronary myocardial branches originated from the tunnel, which is the …
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- 2016
46. Impact of low-dose aspirin on coronary artery spasm as assessed by intracoronary acetylcholine provocation test in Korean patients
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Kanhaiya L. Poddar, Seong Woo Han, Hong Seog Seo, Hong Euy Lim, Ji Young Park, Cheol Ung Choi, Amro Elnagar, Byoung Geol Choi, Yong Jian Li, Jae Woong Choi, Sang Hyun Park, Sun Won Kim, Sureshkumar Ramasamy, Chang Gyu Park, Sung Il Im, Songree Park, Jin Won Kim, Eung Ju Kim, Kang Yin Chen, Dong Joo Oh, Seung-Woon Rha, Jin Oh Na, and Sung Kee Ryu
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Myocardial bridge ,Male ,medicine.medical_specialty ,Provocation test ,Coronary Vasospasm ,Hyperlipidemias ,Coronary artery spasm ,Coronary Angiography ,Coronary artery disease ,Diabetes Complications ,Sex Factors ,Diabetes mellitus ,Internal medicine ,medicine ,Humans ,Aspirin ,business.industry ,Age Factors ,Odds ratio ,Middle Aged ,medicine.disease ,Confidence interval ,Acetylcholine ,Hypertension ,Cardiology ,Female ,Ischemic chest pain ,business ,Cardiology and Cardiovascular Medicine ,medicine.drug - Abstract
High-dose aspirin has been reported to aggravate coronary artery spasm (CAS). However, it is unknown whether low-dose aspirin (LDA; 100mg) has deleterious impact on CAS. We assessed the impact of LDA on CAS induced by intracoronary acetylcholine (ACh) provocation test. A total of 2789 consecutive patients without significant coronary artery disease who underwent ACh test between November 2004 and March 2010 were enrolled. The patients were divided into two groups: the aspirin group taking LDA before ACh test (n=221) and the no aspirin group not taking aspirin (n=2568). At baseline, the prevalence of old age, diabetes mellitus, hypertension, and hyperlipidemia were higher in the aspirin group. During the ACh test, the incidence of significant CAS, ischemic chest pain, as well as severe and multivessel spasm was higher in the aspirin group. The response rate to lower ACh dose was higher in the aspirin group. Multivariate analysis showed that the previous use of LDA was an independent predictor of CAS (adjusted odds ratio, 1.6, 95% confidence interval, 1.0–2.3; p=0.031). However, it is likely that the association of LDA and CAS that we have observed is not causal but may be hypothesis generating due to significant baseline differences. Further, male gender, old age, lipid-lowering drugs, baseline spasm, and myocardial bridge were independent predictors of CAS. LDA was more frequently associated with CAS and ischemic symptoms, as well as severe and multivessel spasm, suggesting the patients who have received LDA would require more intensive medical therapies and close follow up.
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- 2012
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47. Abstract 18503: Geranylgeranylacetone (gga) And Gga-derivatives Inhibit Acetylcholine-activated K+ Current In Mouse Atrial Cardiomyocyte ; Possible Mechanism For Af Suppression
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Eun Kyoung Choi, Hye Jin Yun, Sung Il Im, Ga-In Yu, Bianca J. J. M. Brundel, and Tae-Joon Cha
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Tachycardia ,medicine.medical_specialty ,business.industry ,Atrial fibrillation ,Inflammation ,Pharmacology ,medicine.disease_cause ,medicine.disease ,Endocrinology ,Physiology (medical) ,Internal medicine ,Heat shock protein ,Medicine ,Teprenone ,Inducer ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Acetylcholine ,Oxidative stress ,medicine.drug - Abstract
Atrial fibrillation (AF) is the most common sustained arrhythmia. AF is caused by inflammation, oxidative stress, and various structural heart diseases. An important key factor in AF promotion is that atrial cardiomyocytes have constitutively active acetylcholine-activated K+ (IKACh) current that is enhanced by the tachycardia. Furthermore, it is known that heat shock proteins (HSPs) are involved in the protection against different forms of cellular stress and recent investigators reported that the HSP inducing compound geranylgeranylacetone (GGA, also known as teprenone) prevents atrial remodeling and attenuates the promotion of AF. Whether GGA and GGA-derivatives prevent the acetylcholine-activated K+ current is unknown. Methods: We examined the effect of HSP inducer GGA and 5 derivatives on IKACh current in mouse atrial cardiomyocytes. In the present study, the IKACh current was recorded using a nystatin-perforated whole cell patch-clamp technique following activation by acetylcholine (10 μM for 2 min). After the measurement of the baseline IKACh current, atrial cardiomyocytes were treated with GGA 10μM or a derivative of GGA (NYK9274, NYK9308, NYK9354, NYK9356 or NYK9376) for 10min and the IKACh current was re-measured. Results: IKACh current in mouse atrial cardiomyocyte treated with acetylcholine (10 μM) was significantly increased, which was markedly attenuated by GGA 10μM treatment (n=5, peak; 54±11.2%, quasi-steady-state; 58±11.4%, p Conclusion: This study provides important evidences that the HSP inducer GGA facilitates its potent antiarrhythmic effect by inhibiting IKAch, which underlies electrical remodeling in mammalian atrial cardiomyocytes. Furthermore, two GGA derivatives, NYK9308 and NYK9356, with improved pharma-chemical properties compared to GGA, reveal similar protective effects compared to GGA, and provide important background information for the use of GGA and GGA-like compounds in patients with AF.
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- 2015
48. Impact of periodontitis as representative of chronic inflammation on long-term clinical outcomes in patients with atrial fibrillation
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Bong Joon Kim, Hyun Su Kim, Kyoung-Im Cho, Jinho Heo, Jung Ho Heo, Sung Il Im, and Jin Yong Hwang
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Periodontitis ,medicine.medical_specialty ,Multivariate analysis ,Clinical events ,business.industry ,Inflammation ,Atrial fibrillation ,medicine.disease ,inflammation ,Left atrial ,Internal medicine ,medicine ,atrial fibrillation ,In patient ,cardiovascular diseases ,Arrhythmias and Sudden Death ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,arrhythmias ,Mace - Abstract
Objectives Relationship between atrial fibrillation (AF) and inflammation was shown in previous studies. However, there was limited data about the association between the periodontitis and AF in the long-term follow-up. The aim of this study was to evaluate the impact of periodontitis on long-term clinical outcomes in patients with AF. Methods The Kosin University echocardiography, ECG and periodontitis database were reviewed from 2013 to 2015 to identify patients with AF. Those patients were divided into two groups according to the presence of periodontitis and clinical events including any arrhythmic attack, thromboembolic and bleeding and death were collected during a median of 18 months. Results Among 227 patients with AF, 47 (20.7%) patients had periodontitis. Major adverse cardiac events (MACE) were significantly higher in patients with periodontitis compared with those without periodontitis (p
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- 2018
49. P1186Impact of Helicobacter pylori recurrence on long-term clinical outcomes in patients with atrial fibrillation
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Sung Il Im and Kim Se Kim
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medicine.medical_specialty ,biology ,business.industry ,Atrial fibrillation ,Helicobacter pylori ,medicine.disease ,biology.organism_classification ,Gastroenterology ,Term (time) ,Physiology (medical) ,Internal medicine ,medicine ,In patient ,Cardiology and Cardiovascular Medicine ,business - Published
- 2018
50. IMPACT OF ALFA AND BETA BLOCKER, CARVEDILOL ON THE LONG TERM CLINICAL OUTCOMES IN PATIENTS WITH BENIGN PROSTATIC HYPERTROPHY
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Sung Il Im
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medicine.medical_specialty ,medicine.drug_class ,business.industry ,Urology ,Mean age ,urologic and male genital diseases ,Gospel Hospital ,Muscle hypertrophy ,medicine ,In patient ,Cardiology and Cardiovascular Medicine ,business ,Beta blocker ,Carvedilol ,medicine.drug - Abstract
There was limited data about the impact of alfa- and beta-blocker(BB), Carvedilol on the long-term clinical outcomes with benign prostatic hypertrophy(BPH). A total of 448 patients with BPH were consecutively enrolled(mean age; 69.2±10.9 years) at Kosin university gospel hospital from 2013 to 2016
- Published
- 2018
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