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Background: Patients with subcutaneous implantable cardioverter‐defibrillators (S‐ICDs) experience an oversensing episode (OS) more frequently than those with transvenous ICDs. However, no established electrocardiography (ECG) parameters can accurately detect an OS. This study aimed to evaluate the incidence of an OS in real‐world clinical practice and the association of synthesized 18‐lead ECG (syn18‐ECG) parameters with an OS. Methods: We retrospectively included 21 consecutive patients who underwent S‐ICD implantation and collected syn18‐ECG parameters. We placed the generator in a deep posterior position and defined an OS as an inappropriate charging episode caused by cardiac or noncardiac signals. A SMART pass filter and two tachyarrhythmia zones were programed. Results: The most frequent underlying heart disease was Brugada/J wave syndrome (n = 7). During a median follow‐up period of 1188 days, an OS was observed in six patients (28.6%). The QRS amplitude in synthesized V7 lead (synV7) was significantly lower in the OS group than in the non‐OS group (0.59 ± 0.17 vs. 0.91 ± 0.35 mV, p = 0.019). The optimal cutoff value of synV7 QRS amplitude was 0.61 mV, with a sensitivity of 80.0% and a specificity of 83.7% for predicting an OS. Univariate logistic analysis showed that a synV7 QRS amplitude of <0.61 mV was only associated with an OS (odd ratio, 20.0; 95% confidence interval, 1.66–241.72; p = 0.018). Conclusions: In patients with S‐ICDs, an OS was not a rare complication during long‐term follow‐up. A low synV7 QRS amplitude was associated with a high OS incidence. [ABSTRACT FROM AUTHOR]

Objectives: Oral health problems are common and are associated with various geriatric conditions in older adults. The importance of oral health has not been fully highlighted in the assessment and management of patients with heart failure. Here, we investigated the association between oral health status and the decline in physical function during hospitalization in elderly patients with acute heart failure. Materials and Methods: We evaluated oral health using the revised oral assessment guide in 77 patients aged 65 years or older who were admitted to hospital for acute heart failure. Oral health problems were defined as a revised oral assessment guide score ≥9. Results: Oral health problems were identified in 66.2% of the patients. Patients with oral health problems had high prevalence of decreased physical function, undernutrition, and cognitive impairment. A reduction in the Barthel Index, as an indicator of activities of daily living during hospitalization, was significant in the enrolled patients. The Barthel Index decreased more in patients with oral health problems than those with normal oral health. Furthermore, the revised oral assessment guide score on admission was found to be the only independent predictor of changes in the Barthel Index during hospitalization in the multivariate analyses. Conclusions: Oral assessment using the revised oral assessment guide during hospitalization could provide useful information for the management of elderly heart failure patients. [ABSTRACT FROM AUTHOR]

Aim: The number of hospitalized super‐elderly patients with heart failure (HF) has increased with aging of the population. These patients are associated with poor clinical outcomes with the advance of age; however, few reports regarding acute HF have compared the clinical outcomes of nonagenarians with those of octogenarians. Methods: This study enrolled 683 patients aged ≥80 years who were admitted to our institution for acute HF between 2016 and 2020. The outcomes of interest were the 1‐year all‐cause mortality, incidence of cardiac events (cardiac‐related death or HF‐related readmission), and physical function during hospitalization of patients with survival‐to‐discharge. Physical function was evaluated using the Barthel index. Results: Post‐discharge all‐cause mortality, particularly non‐cardiac mortality, was significantly higher in nonagenarians than octogenarians. Conversely, the incidence of cardiac death or rehospitalization for HF after discharge was comparable between the two groups. On admission, the Barthel index score was significantly lower in nonagenarians than octogenarians, and further decreased during hospitalization. Nonagenarians required social support at discharge more often than octogenarians (67.4% vs. 44.4%; P < 0.001). Conclusions: The current study demonstrated that nonagenarians have poorer non‐cardiac outcomes and were more vulnerable regarding physical activities than octogenarians among patients with acute HF. Holistic medical care, including palliative care and social support, will be increasingly required with increasing age. Geriatr Gerontol Int 2023; 23: 227–233. [ABSTRACT FROM AUTHOR]

Aim: Sarcopenia is a geriatric condition characterized by progressive loss of skeletal muscle mass and function. The definition and diagnosis of sarcopenia is inconsistent between different populations and is still evolving. Herein, we investigated the prevalence and clinical implications of severe sarcopenia using the Asian Working Group for Sarcopenia (AWGS) 2019 criteria in Japanese patients with acute heart failure (HF). Methods: Overall, 272 patients admitted for acute HF were evaluated for sarcopenia using the AWGS 2019 criteria. Results: There were 46 patients with severe sarcopenia, accounting for approximately 75% of patients who were diagnosed as having sarcopenia. A Kaplan–Meier analysis showed that patients with severe sarcopenia had a higher incidence of cardiac death or rehospitalization for HF 1 year post‐discharge than those with non‐severe sarcopenia or without sarcopenia (log‐rank P = 0.006). A multivariate Cox regression analysis showed that severe sarcopenia was independently correlated with the occurrence of cardiac death or rehospitalization for HF after adjusting for other prognostic factors (hazard ratio 2.580, 95% confidence interval: 1.404–4.740, P = 0.002). Conclusions: Severe sarcopenia constituted most sarcopenia diagnoses using the AWGS 2019 cut‐off values, and was independently associated with 1‐year incidence of cardiac death or rehospitalization for HF post‐discharge in Japanese patients with acute HF. The assessment of sarcopenia may provide useful information for HF management. Geriatr Gerontol Int 2022; 22: 477–482. [ABSTRACT FROM AUTHOR]

Abstract: Background: There are limited data on uninterrupted anticoagulation with direct oral anticoagulants during catheter ablation for atrial fibrillation (AF), particularly in Japan. We planned a subgroup analysis of the RE‐CIRCUIT study, comparing the use of uninterrupted dabigatran therapy with warfarin therapy during catheter ablation among the Japanese subgroup and with that in the total population. Methods: The RE‐CIRCUIT study utilized a prospective, randomized, open‐label, blinded endpoint design, and the primary endpoint was the incidence of major bleeding events (MBEs). Patients were randomized to uninterrupted dabigatran 150 mg twice daily or warfarin. In this study, we analyzed the results in Japanese patients. Results: Of 704 enrolled patients in the study, 112 Japanese patients were randomized to dabigatran (n = 65) or warfarin (n = 47). MBEs were experienced by two patients: one in the dabigatran group (1.6%, cardiac tamponade) and one in the warfarin group (2.2%, groin hematoma) (risk difference vs warfarin −0.6%; 95% CI −5.8, 4.7). Within the Japanese subgroup, there were no thromboembolic events in both groups. Conclusion: While not designed to show statistical difference between two treatment groups, our results from the Japanese subgroup supported those from the overall population. Furthermore, this study provided clinical information regarding MBE, especially cardiac tamponade, in Japanese patients. [ABSTRACT FROM AUTHOR]

To assess the effects of right ventricular (RV) pacing on body surface QRST distributions, we recorded QRST isointegral mops (I-maps) during sinus rhythm and RV pacing in 25 patients with anterior myocardial infarction (Ml), 19 with inferior MI, and 14 without MI. The QRST values at each lead point recorded during sinus rhythm and RV pacing with an 87-lead system were analyzed with a paired t-test in each patient. An abnormal decrease in the QRST value of the I-map was assessed by the difference map, which indicated a "-2SD area," where the QRST integral value was less than the normal range (mean — 2SD) calculated from 608 normal individuals. The I-maps were similar during the two activation sequences in patients with and without MI. However, during RV pacing, QHST values significantly decreased over the upper right anterior chest and increased over the lower left anterior chest and back. The ΣDMs (sum of QRST integral values below the normal range) for both activation sequences were strongly correlated in patients with anterior MI and with inferior Ml (r = 0.91 and r = 0.92, respectively; P < 0.001). Although small but significant changes in QRST values were detected, the distribution of the " - 2SD area" and the ΣDM were similar during both activation sequences in patients with prior MI. Thus, these findings demonstrate that an altered activation sequence produces small but significant changes in QRST values but that I-maps still provide information that is useful for the diagnosis of MI during RV pacing. [ABSTRACT FROM AUTHOR]