337 results on '"Jaemin Shim"'
Search Results
52. The Impact of Personal Thoracic Impedance on Electrical Cardioversion in Patients with Atrial Arrhythmias
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Seung-Young Roh, Jinhee Ahn, Kwang-No Lee, Yong-Soo Baek, Dong-Hyeok Kim, Dae-In Lee, Jaemin Shim, Jong-Il Choi, and Young-Hoon Kim
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cardioversion ,heart failure ,atrial fibrillation ,atrial tachycardia ,thoracic impedance ,Medicine (General) ,R5-920 - Abstract
Background and Objectives: Direct current cardioversion (DCCV) is a safe and useful treatment for atrial tachyarrhythmias. In the past, the energy delivered in DCCV was decided upon empirically, based only on the type of tachyarrhythmia. This conventional method does not consider individual factors and may lead to unnecessary electrical damage. Materials and Methods: We performed DCCV in patients with atrial tachyarrhythmias. The impedance and electrical current at the moment of shock were measured. The human thoracic impedance between both defibrillator patches and the electric current that was used were measured. Results: A total of 683 DCCVs were performed on 466 atrial tachyarrhythmia patients. The average impedance was 64 ± 11 Ω and the average successful current was 23 ± 6 mA. The magnitude of the electrical current that was successful depended upon the human impedance (linear regression, B = −0.266, p < 0.001) and the left atrial diameter (B = 0.092, p < 0.001). Impedance was directly proportional to body mass index (BMI) (B = 1.598, p < 0.001) and was higher in females than in males (77 ± 15 Ω vs. 63 ± 11 Ω, p < 0.001). Notably, the high-impedance (>70 Ω) group had a higher BMI (27 ± 4 kg/m2 vs. 25 ± 3 kg/m2, p < 0.001) and a higher proportion of females (37% vs. 9%, p < 0.001) than the low-impedance group (Conclusions: Human thoracic impedance was one of the factors that impacted the level of electrical current required for successful DCCV in patients with atrial arrhythmias. In the future, it will be helpful to consider individual predictors, such as BMI and gender, to minimize electrical damage during DCCV.
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- 2021
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53. Identification of Markers Associated With Development of Stroke in 'Clinically Low‐Risk' Atrial Fibrillation Patients
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Seung Yong Shin, Sang‐Jin Han, Jin‐Seok Kim, Sung Il Im, Jaemin Shim, Jinhee Ahn, Eun Mi Lee, Yae Min Park, Jun Hyung Kim, Gregory Y. H. Lip, and Hong Euy Lim
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ABCD score ,atrial fibrillation ,risk score ,risk stratification ,stroke, ischemic ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Stroke and thromboembolic events may still occur in “clinically low‐risk” atrial fibrillation (AF) patients as categorized by CHA2DS2‐VASc score. Our aim was to assess the proportion of “clinically low‐risk” patients using a nongender CHA2DS2‐VASc (ie, CHA2DS2‐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 CHA2DS2‐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 CHA2DS2‐VA score of 0 to 1. On multivariate analysis, age (≥60 years), N‐terminal pro B‐type natriuretic peptide (≥300 pg/mL), creatinine clearance (
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- 2019
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54. Different influence of cardiac hemodynamics on thromboembolic events in patients with paroxysmal and non-paroxysmal atrial fibrillation.
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Yun Gi Kim, Jaemin Shim, Ki Yung Boo, Do Young Kim, Suk-Kyu Oh, Kwang-No Lee, Jong-Il Choi, and Young-Hoon Kim
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Medicine ,Science - Abstract
Blood stasis in left atrium (LA) or LA appendage (LAA) is thought to be the main cause of thrombus formation and systemic embolism in atrial fibrillation (AF) patients. Paroxysmal and non-paroxysmal AF differ significantly in various aspects. Impact of cardiac hemodynamics on systemic embolism might also differ between the 2 distinct AF entities. This study was performed to evaluate the influence of cardiac hemodynamics on systemic embolism in both paroxysmal and non-paroxysmal AF. Consecutive AF patients undergoing radiofrequency catheter ablation (RFCA) in Korea University Medical Center Anam Hospital between June 1998 and February 2018 were analyzed. Among 2,801 patients who underwent first-time RFCA, a total of 231 patients had either previous ischemic stroke, transient ischemic attack, or arterial embolism. In paroxysmal AF, LA diameter, LA volume (measured with magnetic resonance imaging), left ventricular (LV) ejection fraction, E/e', LAA flow velocity, and prevalence of spontaneous echocontrast (SEC) and dense SEC were significantly different between patients with and without thromboembolic events. However, only E/e' was different between patients with and without thromboembolic events in non-paroxysmal AF. The influence of LA diameter, LA volume, LV EF, LAA flow velocity, and dense SEC on thromboembolic events was significantly moderated by the type of AF. In conclusion, paroxysmal and non-paroxysmal AF might have a different mechanism responsible for thrombus formation and consequent embolic events. Relative contribution of hemodynamic parameters and other factors such as atrial myopathy to thromboembolic events in paroxysmal versus non-paroxysmal AF needs further evaluation.
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- 2019
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55. Ischemic stroke risk during long-term follow up in patients with successful catheter ablation for atrial fibrillation in Korea.
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Dong-Hyeok Kim, Dae-In Lee, Jinhee Ahn, Kwang-No Lee, Seung-Young Roh, Jaemin Shim, Jong-Il Choi, and Young-Hoon Kim
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Medicine ,Science - Abstract
The interruption of oral anticoagulation therapy (OAC) after CA of atrial fibrillation (AF) is controversial. The purpose of this study was to evaluate the relationship between successful long-term outcomes of catheter resection and SR maintenance and ischemic stroke risk in Korea. We studied 1,548 consecutive patients who were followed up for more than 2 years after CA of AF. We investigated the incidence of ischemic stroke during long-term follow-up. Compared to the AF recurrence group (n = 619), the sinus rhythm (SR) maintenance group (n = 929) had more paroxysmal AF (74.6% versus 44.4%, p
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- 2018
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56. Non-vitamin K antagonist oral anticoagulants versus warfarin for the prevention of spontaneous echo-contrast and thrombus in patients with atrial fibrillation or flutter undergoing cardioversion: A trans-esophageal echocardiography study.
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Yun Gi Kim, Jong-Il Choi, Mi-Na Kim, Dong-Hyuk Cho, Suk-Kyu Oh, Hyungdon Kook, Hee-Soon Park, Kwang No Lee, Yong-Soo Baek, Seung-Young Roh, Jaemin Shim, Seong-Mi Park, Wan Joo Shim, and Young-Hoon Kim
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Medicine ,Science - Abstract
Spontaneous echo-contrast (SEC) and thrombus observed in trans-esophageal echocardiography (TEE) is known as a strong surrogate marker for future risk of ischemic stroke in patients with atrial fibrillation (AF) or atrial flutter (AFL). The efficacy of non-vitamin K antagonist oral anticoagulants (NOAC) compared to warfarin to prevent SEC or thrombus in patients with AF or AFL is currently unknown. AF or AFL patients who underwent direct current cardioversion (DCCV) and pre-DCCV TEE evaluation from January 2014 to October 2016 in a single center were analyzed. The prevalence of SEC and thrombus were compared between patients who received NOAC and those who took warfarin. NOAC included direct thrombin inhibitor and factor Xa inhibitors. Among 1,050 patients who were considered for DCCV, 424 patients anticoagulated with warfarin or NOAC underwent TEE prior to DCCV. Eighty patients who were anticoagulated for less than 21 days were excluded. Finally, 344 patients were included for the analysis (180 warfarin users vs. 164 NOAC users). No significant difference in the prevalence of SEC (44.4% vs. 43.9%; p = 0.919), dense SEC (13.9% vs. 15.2%; p = 0.722), or thrombus (2.2% vs. 4.3%; p = 0.281) was observed between the warfarin group and the NOAC group. In multivariate analysis, there was no association between NOAC and risk of SEC (odds ratio [OR]: 1.4, 95% CI: 0.796-2.297, p = 0.265) or thrombus (OR: 3.4, 95% CI: 0.726-16.039, p = 0.120). In conclusion, effectiveness of NOAC is comparable to warfarin in preventing SEC and thrombus in patients with AF or AFL undergoing DCCV. However, numerical increase in the prevalence of thrombus in NOAC group warrants further evaluation.
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- 2018
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57. Feasibility and accuracy of a new mobile electrocardiography device, ER-2000®, in the diagnosis of arrhythmia
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Yae Min Park, Dae In Lee, Hwan Cheol Park, Jaemin Shim, Jong-Il Choi, Hong Euy Lim, Sang Weon Park, and Young-Hoon Kim, MD
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Arrhythmia ,ER-2000® ,12-Lead electrocardiogram (ECG) ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: We performed this study to evaluate the feasibility and accuracy of a new mobile electrocardiography (ECG) device, ER-2000®, in detecting cardiac arrhythmia, by comparing it to a 12-lead ECG used as the gold standard. Methods: Mode 1 of ER-2000® was recorded using three electrodes with cables attached to the anterior chest wall, and mode 2 was recorded using the side chest channel and finger channel. Standard 12-lead ECG was used to record with a speed of 25 mm/s, simultaneously. Results: Seventeen patients with complaints of palpitation were enrolled. Twelve-lead ECG revealed normal sinus rhythm in three patients, sinus tachycardia in one, atrial fibrillation (AF) in two, atrial tachycardia (AT) in one, first degree atrioventricular block in one, pacing rhythm in two patients who underwent permanent pacemaker implantation, AF with intermittent ventricular pacing in one, complete right bundle branch block in one, J-wave elevation in one, narrow QRS tachycardia in one, atrial premature beat (APB) in one, ventricular premature beat (VPB) in one, and narrow QRS tachycardia with intermittent aberrant conduction in one. Rhythm diagnosis obtained by the two different modes of ER-2000® was correlated with that obtained by the 12-lead ECG in all patients except in one in whom ER-2000® showed one APB while 12-lead ECG showed sinus rhythm. R-R interval was accurately recorded despite the detailed morphology of QRS, and T-wave was somewhat modified with the use of ER-2000®. A pacing blip detected by 12-lead ECG was not detected by ER-2000® despite a similar wide QRS duration in the paced QRS. Conclusions: A rhythm strip obtained using ER-2000® is accurate in diagnosing arrhythmia, despite some differences in the detailed morphology of the QRS and T-wave, and the pacing spike compared to those obtained by the 12-lead ECG.
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- 2015
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58. Virtual In-Silico Modeling Guided Catheter Ablation Predicts Effective Linear Ablation Lesion Set for Longstanding Persistent Atrial Fibrillation: Multicenter Prospective Randomized Study
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Jaemin Shim, Minki Hwang, Jun-Seop Song, Byounghyun Lim, Tae-Hoon Kim, Boyoung Joung, Sung-Hwan Kim, Yong-Seog Oh, Gi-Byung Nam, Young Keun On, Seil Oh, Young-Hoon Kim, and Hui-Nam Pak
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atrial fibrillation ,catheter ablation ,virtual ablation ,in-silico modeling ,recurrence ,Physiology ,QP1-981 - Abstract
Objective: Radiofrequency catheter ablation for persistent atrial fibrillation (PeAF) still has a substantial recurrence rate. This study aims to investigate whether an AF ablation lesion set chosen using in-silico ablation (V-ABL) is clinically feasible and more effective than an empirically chosen ablation lesion set (Em-ABL) in patients with PeAF.Methods: We prospectively included 108 patients with antiarrhythmic drug-resistant PeAF (77.8% men, age 60.8 ± 9.9 years), and randomly assigned them to the V-ABL (n = 53) and Em-ABL (n = 55) groups. Five different in-silico ablation lesion sets [1 pulmonary vein isolation (PVI), 3 linear ablations, and 1 electrogram-guided ablation] were compared using heart-CT integrated AF modeling. We evaluated the feasibility, safety, and efficacy of V-ABL compared with that of Em-ABL.Results: The pre-procedural computing time for five different ablation strategies was 166 ± 11 min. In the Em-ABL group, the earliest terminating blinded in-silico lesion set matched with the Em-ABL lesion set in 21.8%. V-ABL was not inferior to Em-ABL in terms of procedure time (p = 0.403), ablation time (p = 0.510), and major complication rate (p = 0.900). During 12.6 ± 3.8 months of follow-up, the clinical recurrence rate was 14.0% in the V-ABL group and 18.9% in the Em-ABL group (p = 0.538). In Em-ABL group, clinical recurrence rate was significantly lower after PVI+posterior box+anterior linear ablation, which showed the most frequent termination during in-silico ablation (log-rank p = 0.027).Conclusions: V-ABL was feasible in clinical practice, not inferior to Em-ABL, and predicts the most effective ablation lesion set in patients who underwent PeAF ablation.
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- 2017
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59. Effectiveness of beta-blockers depending on the genotype of congenital long-QT syndrome: A meta-analysis.
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Jinhee Ahn, Hyun Jung Kim, Jong-Il Choi, Kwang No Lee, Jaemin Shim, Hyeong Sik Ahn, and Young-Hoon Kim
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Medicine ,Science - Abstract
Beta-blockers are first-line therapy in patients with congenital long-QT syndrome (LQTS).This study sought to determine the differences in effectiveness of beta-blockers on risk reduction according to LQTS genotype.We searched MEDLINE, EMBASE, and CENTRAL databases to investigate the use of beta-blockers (atenolol, nadolol, propranolol, and metoprolol) in patients with LQTS. Hazard ratio (HR) and relative risk (RR) were extracted or calculated from studies reporting cardiac events (syncope, aborted cardiac arrest (ACA), or sudden cardiac death (SCD)).Among 2,113 articles searched, 10 studies (7 registry-based cohort studies (Cohort) and 3 interrupted time series studies (ITS)) involving 9,727 patients were included. In a meta-analysis using a random-effect model, the use of beta-blocker was associated with significant risk reduction of all cardiac events (HR 0.49, p
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- 2017
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60. Right Ventricular Compression Mimicking Brugada-Like Electrocardiogram in a Patient with Recurrent Pectus Excavatum
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Jinhee Ahn, Jong-Il Choi, Jaemin Shim, Sung Ho Lee, and Young-Hoon Kim
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Pectus excavatum (PE), the most common skeletal anomaly of chest wall, sometimes requires a surgical correction but recurrent PE is not uncommon. PE usually has a benign course; however, this chest deformity may be associated with symptomatic tachyarrhythmias due to mechanical compression. We report a case of a patient with recurrent PE after surgical correction presenting with palpitation and electrocardiogram (ECG) showing ST-segment elevation on the right precordial leads, which could be mistaken for a Brugada syndrome (BrS).
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- 2017
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61. Radiofrequency Catheter Ablation Improves the Quality of Life Measured with a Short Form-36 Questionnaire in Atrial Fibrillation Patients: A Systematic Review and Meta-Analysis.
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Yun Gi Kim, Jaemin Shim, Jong-Il Choi, and Young-Hoon Kim
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Medicine ,Science - Abstract
BACKGROUND:The main purpose of performing radiofrequency catheter ablation (RFCA) in atrial fibrillation (AF) patients is to improve the quality of life (QoL) and alleviate AF-related symptoms. We aimed to determine the qualitative and quantitative effects of RFCA on the QoL in AF patients. METHODS:We performed a systemic review and meta-analysis using a random effects model. We searched for the studies that reported the physical component summary score (PCS) and mental component summary score (MCS) of the short form-36, a validated system to assess and quantify the QoL, before and after RFCA in AF patients. PCS and MCS are T-scores with a mean of 50 and standard deviation of 10. RESULTS:Of the 470 studies identified through systematic search, we included 13 studies for pre-RFCA vs. the post-RFCA analysis and 5 studies for treatment success vs. AF recurrence analyses. In the pre-RFCA vs. post-RFCA analysis, RFCA was associated with a significant increase in both the PCS (weighted mean difference [WMD] = 6.33 [4.81-7.84]; p < 0.001) and MCS (WMD = 7.80 [6.15-9.44]; p < 0.001). The ΔPCS (post-RFCA PCS-pre-RFCA PCS) and ΔMCS values were used for the treatment success vs. AF recurrence analysis. Patients with successful ablation had a higher ΔPCS (WMD = 7.46 [4.44-10.49]; p < 0.001) and ΔMCS (WMD = 7.59 [4.94-10.24]; p < 0.001). CONCLUSIONS:RFCA is associated with a significant increase in the PCS and MCS in AF patients. Patients without AF recurrence after RFCA had a better improvement in the PCS and MCS than patients who had AF recurrence.
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- 2016
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62. Rhythm Control and Cardiovascular or Cerebrovascular Outcomes in Patients with Atrial Fibrillation: A Study of the CODE-AF Registry
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Joung, Ho-Gi Chung, Junbeom Park, Jin-Kyu Park, Ki-Woon Kang, Jaemin Shim, Jin-Bae Kim, Jun Kim, Eue-Keun Choi, Hyung Wook Park, Young Soo Lee, and Boyoung
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rhythm control ,atrial fibrillation ,oral anticoagulation ,prognosis - Abstract
Background: It is not clear whether the data regarding rhythm control during atrial fibrillation (AF) contained in AF registries is prognostically significant. Thus, this study investigated the relationship between rhythm control and cardiovascular outcomes in patients in contemporary AF registries. Methods: This study was conducted using data from 6670 patients with AF receiving oral anticoagulation in the CODE-AF registry. We used propensity overlap weighting to account for differences in baseline characteristics between the rhythm control and rate control groups. The primary outcome was a composite of the rate of death due to cardiovascular causes, stroke, acute coronary syndrome, and heart failure. The secondary outcomes were individual components of the primary outcome. Results: In the CODE-AF registry, 5407 (81.1%) patients were enrolled three months after AF diagnosis. During a median follow-up period of 973 days (interquartile range: 755–1089 days), a primary outcome event occurred in 72 patients in the rhythm control group (1.4 events per 100 person-years) and in 211 patients in the rate control group (1.8 events per 100 person-years). However, after overlap weighting, the incidence rates were 1.4 and 1.5 events per 100 person-years, respectively. No significant difference was found in either the primary outcome (weighted HR: 0.87; 95% CI: 0.66–1.17; p = 0.363) or secondary outcomes between the rhythm control and rate control groups. Conclusion: In a prospective AF registry in which most of the population was enrolled at least three months after AF diagnosis, no difference in the risk of cardiovascular or cerebrovascular outcomes was found between the rhythm control and rate control groups, suggesting the early rhythm control should be considered to improve the outcome of patients.
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- 2023
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63. GARFIELD-AF: risk profiles, treatment patterns and 2-year outcomes in patients with atrial fibrillation in Germany, Austria and Switzerland (DACH) compared to 32 countries in other regions worldwide
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Sylvia, H, John A, C, Darius, H, Jan, S, Saverio, V, Karen, P, Marianne, B, Sebastian, S, Frank, M, Gloria, K, Kakkar, A, Bassand, J, John Camm, A, Fitzmaurice, D, Fox, K, Gersh, B, Goldhaber, S, Goto, S, Haas, S, Hacke, W, Mantovani, L, Misselwitz, F, Pieper, K, Turpie, A, van Eickels, M, Verheugt, F, Gersh, K, Lucas Luciardi Harry Gibbs, H, Brodmann, M, Cools, F, Carlos Pereira Barretto, A, Connolly, S, Eikelboom, J, Corbalan, R, Jing, Z, Jansky, P, Dalsgaard Nielsen, J, Ragy, H, Raatikainen, P, Le Heuzey, J, Keltai, M, Pal Singh Sawhney, J, Agnelli, G, Ambrosio, G, Koretsune, Y, Jerjes Sánchez Díaz, C, Ten Cate, H, Atar, D, Stepinska, J, Panchenko, E, Wei Lim, T, Jacobson, B, Oh, S, Viñolas, X, Rosenqvist, M, Steffel, J, Angchaisuksiri, P, Oto, A, Parkhomenko, A, Al Mahmeed, W, Hu Kangning Chen, D, Zhao, Y, Zhang, H, Chen, J, Cao, S, Wang, D, Yang, Y, Li, W, Li, H, Yin, Y, Tao, G, Yang, P, Chen, Y, He, S, Wang, Y, Fu, G, Li, X, Wu, T, Cheng, X, Yan, X, Zhao, R, Chen, M, Xiong, L, Chen, P, Jiao, Y, Guo, Y, Xue, L, Yang, Z, Jadhavm Raghava Sarma, P, Kulkarni, G, Chandwani, P, Atulbhai Pothiwala, R, Padinhare Purayil, M, Chawla, K, Annasaheb Kothiwale, V, Raghuraman, B, Madan Vijan, V, Sawhney, J, Bantwal, G, Khan, A, Meena, R, Chopada, M, Abraham, S, Bisne, V, Vijayaraghavan, G, Roy, D, Durgaprasad, R, Ravi Shankar, A, Kumar, S, Jain, D, Bhargava, K, Kumar, V, Madappa Nagamalesh, U, Kumar Rajput, R, Koretsune Seishu Kanamori, Y, Yamamoto, K, Kumagai, K, Katsuda, Y, Yoshida, K, Toyota, F, Mizuno, Y, Misumi, I, Noguchi, H, Ando, S, Suetsugu, T, Minamoto, M, Oda, H, Adachi, S, Chiba, K, Norita, H, Tsuruta, M, Koyanagi, T, Ando, H, Higashi, T, Okada, M, Azakami, S, Komaki, S, Kumeda, K, Murayama, T, Matsumura, J, Oba, Y, Sonoda, R, Goto, K, Minoda, K, Haraguchi, Y, Suefuji, H, Miyagi, H, Kato, H, Nakamura, T, Nandate, H, Zaitsu, R, Fujiura, Y, Yoshimura, A, Numata, H, Ogawa, J, Kamogawa, Y, Murakami, K, Wakasa, Y, Yamasawa, M, Maekawa, H, Abe, S, Kihara, H, Tsunoda, S, Saito, K, Tachibana, H, Oba, I, Kuwahata, T, Higa, S, Gushiken, M, Eto, T, Chibana, H, Fujisawa, K, Shiga, Y, Sumi, H, Nagatomo, T, Atsuchi, Y, Nagoshi, T, Sanno, K, Hoshino, F, Yokota, N, Kameko, M, Tabuchi, T, Ishizawa, M, Ikeda, D, Seto, T, Iwao, T, Ishioka, N, Oshiro, K, Tsuchida, K, Hatori, Y, Takeuchi, M, Takezawa, H, Nagano, S, Iwaki, M, Nakamura, Y, Miyamoto, N, Taguchi, T, Ashida, K, Yoshizawa, N, Agata, J, Matsukawa, S, Arasaki, O, Fukuoka, S, Murakami, H, Mishima, K, Hata, Y, Sakuma, I, Obunai, K, Takamura, I, Akutsu, M, Unoki, T, Go, Y, Ikemura, M, Morii, S, Marusaki, S, Doi, H, Tanaka, M, Kusumoto, T, Kakinoki, S, Ogurusu, C, Murata, K, Shimoyama, M, Nakatsuka, M, Kitami, Y, Oyama, R, Ageta, M, Mita, T, Nagao, K, Mito, T, Minami, J, Abe, M, Fujii, M, Okawa, M, Fujito, T, Taniguchi, T, Ko, T, Kubo, H, Imamaki, M, Akiyama, M, Ueda, T, Odakura, H, Inagaki, M, Katsube, Y, Nakata, A, Tomimoto, S, Shibuya, M, Nakano, M, Ito, K, Matsuta, M, Ishiguro, M, Minagawa, T, Wada, M, Mukawa, H, Mizuguchi, M, Okuda, F, Kimura, T, Taga, K, Techigawara, M, Igarashi, M, Watanabe, H, Seo, T, Hiramitsu, S, Hosokawa, H, Hoshiai, M, Hibino, M, Miyagawa, K, Horie, H, Sugishita, N, Soma, A, Neya, K, Yoshida, T, Akahane, K, Takanaka, C, Matsui, S, Kanda, H, Kaneko, M, Nagasaka, S, Taguchi, A, Toru, S, Miyashita, A, Sasaguri, H, Nariyama, J, Hatsuno, T, Iwase, T, Sato, K, Kawai, K, Kotani, T, Tsuji, T, Sakai, H, Nishino, K, Ikeda, K, Maeda, K, Shinozuka, T, Inoue, T, Kawakami, K, Kitazumi, H, Takagi, T, Hamaoka, M, Kojima, J, Sasaki, A, Tsuchiya, Y, Betsuyaku, T, Higuchi, K, Honda, M, Hasegawa, K, Baba, T, Mineoi, K, Koeda, T, Hirasawa, K, Kumazaki, T, Nakagomi, A, Otaki, E, Shindo, T, Hirayama, H, Sugimoto, C, Yamagishi, T, Mizuguchi, I, Sezaki, K, Niwa, I, Takenaka, K, Iiji, O, Taya, K, Kitazawa, H, Ueda, S, Kakuda, H, Ono, T, Oriso, S, Kamata, J, Nanke, T, Maeda, I, Matsuura, Y, Teragawa, H, Maruyama, Y, Takei, K, Kito, T, Asano, H, Matsushita, K, Nakamura, M, Washizuka, T, Sawano, M, Arima, S, Arai, H, Shinohara, H, Takai, H, Furukawa, N, Ota, A, Aoki, K, Yamamoto, T, Kasai, T, Suzuki, S, Shibata, N, Watanabe, M, Nishihata, Y, Arino, T, Okuyama, M, Wakiyama, T, Kato, T, Sasagawa, Y, Tana, T, Hayashi, Y, Hirota, S, Abe, Y, Saito, Y, Uchiyama, H, Takeda, H, Ono, H, Tohyo, S, Hanazono, N, Miyajima, S, Shimono, H, Aoyama, T, Shozawa, Y, Niijima, Y, Murai, O, Inaba, H, Nomura, K, Nozoe, M, Suzuki, K, Furukawa, T, Shiraiwa, T, Ito, N, Nagai, S, Nakahara, S, Shimoyama, Y, Ohara, N, Kozuka, T, Okita, H, Endo, M, Goto, T, Hirose, M, Nagata, E, Nakanishi, N, Mori, T, Seki, S, Okamoto, K, Moriai, O, Emura, Y, Fukuda, T, Date, H, Kawakami, S, Ueyama, Y, Fudo, T, Imaizumi, M, Ogawa, T, Take, S, Ikeda, H, Nishioka, H, Sakamoto, N, Ikeoka, K, Wakaki, N, Doiuchi, J, Kira, T, Tada, M, Tsuzaki, K, Miura, N, Fujisawa, Y, Furumoto, W, Fujisawa, A, Nakamura, R, Komatsu, H, Fujiki, R, Kawano, S, Nishizawa, K, Kato, Y, Azuma, J, Yasui, K, Amano, T, Sekine, Y, Honzawa, T, Koshibu, Y, Sakamoto, Y, Seta, Y, Miyaguchi, S, Morishita, K, Samejima, Y, Sasaki, T, Iseki, F, Kobayashi, T, Kano, H, Kim, J, Yamaguchi, H, Takagi, Y, Onuki Pearce, Y, Suzuki, Y, Fukui, T, Nakayama, T, Kanai, H, Kawano, Y, Ino, T, Miyoshi, H, Miyamoto, Y, Shigekiyo, M, Ono, S, Okamoto, Y, Ubukata, S, Kodera, K, Oriuchi, T, Matsumoto, N, Inagaki, K, Iseki, A, Goda, T, Katsuki, T, Sato, A, Mori, E, Tsubokura, T, Shudo, H, Fujimoto, S, Katsuya, T, Furukawa, Y, Narumi, J, Owari, M, Inakura, T, Anno, T, Shirakawa, K, Keong Ching Toon Wei Lim, C, Foo, D, Wong, K, Yuyang, T, Oh Hui Nam Park, S, Kim, W, Lee, H, Jang, S, Hyeok Kim, D, Ryu, D, Shim, J, Kim, D, Ju Choi, D, Seog Oh, Y, Cho, M, Kim, H, Jeon, H, Shin, D, Weon Park, S, Ki Park, H, Han, S, Hoon Sung, J, Park, H, Nam, G, Keun On, Y, Euy Lim, H, Kwak, J, Cha, T, Jong Hong, T, Hoon Park, S, Han Yoon, J, Kim, N, Kim, K, Chun Jung, B, Hwang, G, Kim, C, Rungaramsin Peerapat Katekangplu, S, Khunrong, P, Bunyapipat, T, Wongcharoen, W, 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Ravi Shankar, Sunil Kumar, Dinesh Jain, Kartikeya Bhargava, Vinay Kumar, Udigala Madappa Nagamalesh, Rajeeve Kumar Rajput, Yukihiro Koretsune Seishu Kanamori, Kenichi Yamamoto, Koichiro Kumagai, Yosuke Katsuda, Keiki Yoshida, Fumitoshi Toyota, Yuji Mizuno, Ikuo Misumi, Hiroo Noguchi, Shinichi Ando, Tetsuro Suetsugu, Masahiro Minamoto, Hiroyuki Oda, Susumu Adachi, Kei Chiba, Hiroaki Norita, Makoto Tsuruta, Takeshi Koyanagi, Kunihiko Yamamoto, Hiroshi Ando, Takayuki Higashi, Megumi Okada, Shiro Azakami, Shinichiro Komaki, Kenshi Kumeda, Takashi Murayama, Jun Matsumura, Yurika Oba, Ryuji Sonoda, Kazuo Goto, Kotaro Minoda, Yoshikuni Haraguchi, Hisakazu Suefuji, Hiroo Miyagi, Hitoshi Kato, Tsugihiro Nakamura, Tadashi Nakamura, Hidekazu Nandate, Ryuji Zaitsu, Yoshihisa Fujiura, Akira Yoshimura, Hiroyuki Numata, Jun Ogawa, Yasuyuki Kamogawa, Kinshiro Murakami, Yutaka Wakasa, Masanori Yamasawa, Hiromitsu Maekawa, Sumihisa Abe, Hajime Kihara, Satoru Tsunoda, Katsumi Saito, Hiroki Tachibana, Ichiro Oba, Takashi Kuwahata, Satoshi Higa, Masamichi Gushiken, Takuma Eto, Hidetoshi Chibana, Kazuaki Fujisawa, Yuhei Shiga, Hirokuni Sumi, Toshihisa Nagatomo, Yoshihiko Atsuchi, Toshiro Nagoshi, Kazuhisa Sanno, Fumihiro Hoshino, Naoto Yokota, Masahiro Kameko, Toshifumi Tabuchi, Munesumi Ishizawa, Yoshitake Fujiura, Daisuke Ikeda, Taku Seto, Tetsu Iwao, Norio Ishioka, Koichi Oshiro, Keizo Tsuchida, Yutaka Hatori, Motoshi Takeuchi, Hiroto Takezawa, Shinjiro Nagano, Masaaki Iwaki, Yuichiro Nakamura, Naomasa Miyamoto, Toshifumi Taguchi, Ko Ashida, Naoto Yoshizawa, Jun Agata, Seishiro Matsukawa, Osamu Arasaki, Shuji Fukuoka, Hirofumi Murakami, Kazuya Mishima, Yoshiki Hata, Ichiro Sakuma, Kotaro Obunai, Ichiro Takamura, Mitsuyuki Akutsu, Toshihide Unoki, Yoshinori Go, Makoto Ikemura, Shoji Morii, Shigeru Marusaki, Hideo Doi, Mitsuru Tanaka, Takaaki Kusumoto, Shigeo Kakinoki, Chiga Ogurusu, Kazuya Murata, Masaki Shimoyama, Masami Nakatsuka, Yutaka Kitami, Yoichi Nakamura, Hiroshi Oda, Rikimaru Oyama, Masato Ageta, Teruaki Mita, Kazuhiko Nagao, Takafumi Mito, Junichi Minami, Mitsunori Abe, Masako Fujii, Makoto Okawa, Tsuneo Fujito, Toshiya Taniguchi, Tenei Ko, Hiroshi Kubo, Mizuho Imamaki, Masahiro Akiyama, Takashi Ueda, Hironori Odakura, Masahiko Inagaki, Yoshiki Katsube, Atsuyuki Nakata, Shinobu Tomimoto, Mitsuhiro Shibuya, Masayuki Nakano, Kenichiro Ito, Masahiro Matsuta, Motoyuki Ishiguro, Taro Minagawa, Masamichi Wada, Hiroaki Mukawa, Masato Mizuguchi, Fumio Okuda, Teruaki Kimura, Kuniaki Taga, Masaaki Techigawara, Morio Igarashi, Hiroshi Watanabe, Toshihiko Seo, Shinya Hiramitsu, Hiroaki Hosokawa, Mitsumoto Hoshiai, Michitaka Hibino, Koichi Miyagawa, Hideki Horie, Nobuyoshi Sugishita, Yukio Shiga, Akira Soma, Kazuo Neya, Tetsuro Yoshida, Kunio Akahane, Sen Adachi, Chiei Takanaka, Saori Matsui, Hirofumi Kanda, Masanori Kaneko, Shiro Nagasaka, Atsushi Taguchi, Shuta Toru, Kazuyuki Saito, Akiko Miyashita, Hiroki Sasaguri, Jin Nariyama, Taketo Hatsuno, Takash Iwase, Kazuki Sato, Kazuya Kawai, Tomobumi Kotani, Tsuyoshi Tsuji, Hirosumi Sakai, Kiyoshi Nishino, Kenichi Ikeda, Kazuo Maeda, Tomohiro Shinozuka, Takeshi Inoue, Koichi Kawakami, Hiromichi Kitazumi, Tsutomu Takagi, Mamoru Hamaoka, Jisho Kojima, Akitoshi Sasaki, Yoshihiro Tsuchiya, Tetsuo Betsuyaku, Koji Higuchi, Masaaki Honda, Koichi Hasegawa, Takao Baba, Kazuaki Mineoi, Toshihiko Koeda, Kunihiko Hirasawa, Toshihide Kumazaki, Akira Nakagomi, Eiji Otaki, Takashi Shindo, Hiroyoshi Hirayama, Chikako Sugimoto, Takashi Yamagishi, Ichiro Mizuguchi, Kazunori Sezaki, Isamu Niwa, Ken Takenaka, Osamu Iiji, Koichi Taya, Hitoshi Kitazawa, samu Ueda, Hirokazu Kakuda, Takuya Ono, Seizo Oriso, Junya Kamata, Toshihiko Nanke, Itaru Maeda, Yoshifusa Matsuura, Hiroki Teragawa, Yasuyuki Maruyama, Kazuo Takei, Hajime Horie, Tetsutaro Kito, Hiroshi Asano, Koji Matsushita, Masaichi Nakamura, Takashi Washizuka, Tomoki Yoshida, Masato Sawano, Shinichi Arima, Hidekazu Arai, Hisanori Shinohara, Hiroyuki Takai, Nobufusa Furukawa, Akira Ota, Kentaro Yamamoto, Kenji Aoki, Taku Yamamoto, Takeaki Kasai, Shunji Suzuki, Shu Suzuki, Nitaro Shibata, Masayuki Watanabe, Yosuke Nishihata, Toru Arino, Masaki Okuyama, Tetsushi Wakiyama, Tomoko Kato, Yasuo Sasagawa, Takeshi Tana, Yoshihito Hayashi, Shinichi Hirota, Yukihiko Abe, Yoshihiro Saito, Hirohide Uchiyama, Hiroshi Takeda, Hiroshi Ono, Shuichi Tohyo, Naoto Hanazono, Seiichi Miyajima, Hisashi Shimono, Takuma Aoyama, Yasunobu Shozawa, Yawara Niijima, Osamu Murai, Hideko Inaba, Katsumasa Nomura, Masatsugu Nozoe, Kazuo Suzuki, Toshiyuki Furukawa, Toshihiko Shiraiwa, Nobuhisa Ito, Shunichi Nagai, Kiyoharu Sato, Shiro Nakahara, Yujin Shimoyama, Naoko Ohara, Teruhiko Kozuka, Hideaki Okita, Masato Endo, Tsutomu Goto, Makoto Hirose, Emiko Nagata, Noriyuki Nakanishi, Toshizumi Mori, Shuichi Seki, Katsuhiro Okamoto, Osamu Moriai, Yoko Emura, Tsuyoshi Fukuda, Haruhiko Date, Shuichi Kawakami, Sho Nagai, Yuya Ueyama, Tetsuro Fudo, Mitsuru Imaizumi, Takuo Ogawa, Shunsuke Take, Hideo Ikeda, Hiroaki Nishioka, Norihiko Sakamoto, Kiyomitsu Ikeoka, Nobuo Wakaki, Masatake Abe, Junji Doiuchi, Tetsuya Kira, Masato Tada, Ken Tsuzaki, Naoya Miura, Yasuaki Fujisawa, Wataru Furumoto, Susumu Suzuki, Akinori Fujisawa, Ryosai Nakamura, Hiroyasu Komatsu, Rei Fujiki, Shuichi Kawano, Keijiro Nishizawa, Yoji Kato, Junya Azuma, Kiyoshi Yasui, Toshio Amano, Yasuhiro Sekine, Tatsuo Honzawa, Yuichiro Koshibu, Yasuhide Sakamoto, Yukihiro Seta, Shingo Miyaguchi, Kojuro Morishita, Yasuko Samejima, Toyoshi Sasaki, Fumiko Iseki, Toshiyuki Kobayashi, Hiroshi Kano, Jaeyoung Kim, Hiroshi Yamaguchi, Yoichi Takagi, Yoko Onuki Pearce, Yasuyuki Suzuki, Takayuki Fukui, Toru Nakayama, Hideaki Kanai, Yoshiyuki Kawano, Tetsuji Ino, Hironori Miyoshi, Yasufumi Miyamoto, Masahito Shigekiyo, Shimato Ono, Yutaka Okamoto, Satoshi Ubukata, Kojiro Kodera, Tatsuo Oriuchi, Naoki Matsumoto, Koichi Inagaki, Atsushi Iseki, Tomohiro Yoshida, Toshihiro Goda, Tsukasa Katsuki, Atsushi Sato, Etsuo Mori, Toshio Tsubokura, Hiroshi Shudo, Shunichi Fujimoto, Tomohiro Katsuya, Yoshiyuki Furukawa, Hiroshi Hosokawa, Jun Narumi, Kiichiro Yamamoto, Masaki Owari, Takuya Inakura, Takafumi Anno, Kazuyuki Shirakawa, Chi Keong Ching Toon Wei Lim, David Foo, Kelvin Wong, Tan Yuyang, Seil Oh Hui Nam Park, Woo-Shik Kim, HyeYoung Lee, Sung-Won Jang, Dae Hyeok Kim, Jun Kim, DongRyeol Ryu, Jaemin Shim, Dae-Kyeong Kim, Dong Ju Choi, Yong Seog Oh, Myeong-Chan Cho, Hack-Lyoung Kim, Hui-Kyung Jeon, Dong-Gu Shin, Sang Weon Park, Hoon Ki Park, Sang-Jin Han, Jung Hoon Sung, Hyung-Wook Park, Gi-Byoung Nam, Young Keun On, Hong Euy Lim, JaeJin Kwak, Tae-Joon Cha, Taek Jong Hong, Seong Hoon Park, Jung Han Yoon, Nam-Ho Kim, Kee-Sik Kim, Byung Chun Jung, Gyo-Seung Hwang, Chong-Jin Kim, Sakda Rungaramsin Peerapat Katekangplu, Porames Khunrong, Thanita Bunyapipat, Wanwarang Wongcharoen, Pinij Kaewsuwanna, Khanchai Siriwattana, Waraporn Tiyanon, Supalerk Pattanaprichakul, Khanchit Likittanasombat, Doungrat Cholsaringkarl, Warangkana Boonyapisit, Sirichai Cheewatanakornkul, Songkwan Silaruks, Pisit Hutayanon, Seksan Chawanadelert, Pairoj Chattranukulchai, Boonsert Chatlaong, Yingsak Santanakorn, Khompiya Kanokphatcharakun, Piya Mongkolwongroj, Sasivimon Jai-Aue, Ongkarn Komson, Armagan Altun Ali Aydinlar, Ramazan Topsakal, Zeki Ongen, Sadik Acikel, Durmus Yildiray Sahin, Ozcan Yilmaz, Mehmet Birhan Yilmaz, Hasan Pekdemir, Mesut Demir, Murat Sucu, Levent Sahiner, Murat Ersanli, Ertugrul Okuyan, Dursun Aras, Florencia Rolandi Adrian Cesar Ingaramo, Gustavo Alberto Sambadaro, Vanina Fernandez Caputi, Hector Luciardi, Sofia Graciela Berman, Pablo Dragotto, Andres Javier Kleiban, Nestor Centurion, Rodolfo Andres Ahuad Guerrero, Leonel Adalberto Di Paola, Ricardo Dario Dran, Javier Egido, Matias Jose Fosco, Victor Alfredo Sinisi, Luis Rodolfo Cartasegna, Oscar Gomez Vilamajo, Jose Luis Ramos, Sonia Sassone, Gerardo Zapata, Diego Conde, Guillermo Giacomi, Alberto Alfredo Fernandez, Mario Alberto Berli, Fabian Ferroni, Dário Celestino Sobral Filho Jefferson Jaber, Luciana Vidal Armaganijan, Costantino Roberto Frack Costantini, André Steffens, Weimar Kunz Sebba Barroso de Souzaem, João David de Souza Neto, José Márcio Ribeiro, Marcelo Silveira Teixeira, Paulo Rossi, Leonardo Pires, Daniel Moreira, José Carlos Moura Jorge, Adalberto Menezes Lorga Filho, Luiz Bodanese, Marcelo Westerlund Montera, Carlos Henrique Del Carlo, Jamil Abdalla Saad, Fernando Augusto Alves da Costa, Renato Lopes, Gilson Roberto de Araújo, Euler Roberto Manenti, Jose Francisco Kerr Saraiva, João Carlos Ferreira Braga, Alexandre Negri, Carlos Moncada, Dalton Precoma, Fernando Roquette, Gilmar Reis, Roberto Álvaro Ramos Filho, Estêvão Lanna Figueiredo, Roberto Vieira Botelho, Cláudio Munhoz da Fontoura Tavares, Helius Carlos Finimundi, Adriano Kochi, César Cássio Broilo França, Fábio Alban, Guido Bernardo Aranha Rosito, João Batista de Moura Xavier Moraes Junior, Rogério Tadeu Tumelero, Lilia Maia, Roberto Simões de Almeida, Ney Carter do Carmo Borges, Luís Gustavo Gomes Ferreira, Ramón Corbalán Benjamin Aleck Joseh Stockins Fernandez, Humberto Montecinos, Fernando Lanas, Martín Larico Gómez, Carlos Astudillo, Carlos Conejeros, Patricio Marin Cuevas, Alejandro Forero, Claudio Bugueño Gutiérrez, Juan Aguilar, Sergio Potthoff Cardenas, German Eggers, Cesar Houzvic, Carlos Rey, Germán Arriagada, Gustavo Charme Vilches, Carlos Jerjes Sanchez Diaz Jesus Jaime Illescas Diaz, Raul Leal Cantu, Maria Guadalupe Ramos Zavala, Ricardo Cabrera Jardines, Nilda Espinola Zavaleta, Enrique Lopez Rosas, Guillermo Antonio Llamas Esperón, Gerardo Pozas, Ernesto Cardona Muñoz, Norberto Matadamas Hernandez, Adolfo Leyva Rendon, Norberto Garcia Hernandez, Manuel de los Rios Ibarra, Luis Ramon Virgen Carrillo, David Lopez Villezca, Carlos Hernandez Herrera, Juan Jose Lopez Prieto, Rodolfo Gaona Rodriguez, Efrain Villeda Espinosa, David Flores Martinez, Jose Velasco Barcena, Omar Fierro Fierro, Ignacio Rodriguez Briones, Jose Luis Leiva Pons, Humberto Alvarez Lopez, Rafael Olvera Ruiz, Carlos Gerardo Cantu Brito, Eduardo Julian Jose Roberto Chuquiure Valenzuela, Roxana Reyes Sanchez, Alberto Esteban Bazzoni Ruiz, Oscar Martin Lopez Ruiz, Roberto Arriaga Nava, Jesus David Morales Cerda, Pedro Fajardo Campos, Mario Benavides Gonzalez, Marianne Brodmann Kurt Lenz, Claus Hagn, Johannes Foechterle, Heinz Drexel, Kurt Huber, Andrea Podczeck-Schweighofer, Michael Winkler, Bruno Schneeweiss, Alfons Gegenhuber, Wilfried Lang, Sabine Eichinger-Hasenauer, Peter Kaserer, Josef Sykora, Heribert Rasch, Bernhard Strohmer, Luc Capiau Geert Vervoort, Bart Wollaert, Geert Hollanders, Jan Vercammen, Dirk Faes, Yohan Balthazar, Marc Delforge, Olivier Xhaet, Harry Striekwold, John Thoeng, Kurt Hermans, Georges Mairesse, Wim Anné, Ivan Blankoff, Michel Beutels, Stefan Verstraete, Peter Vandergoten, Philippe Purnode, Pascal Godart, Tim Boussy, Philippe Desfontaines, Alex Heyse, Joeri Voet, Axel De Wolf, Eva Zidkova Petr Jansky, Rudolf Spacek, Vilma Machova, Ondrej Ludka, Josef Olsr, Lubos Kotik, Blazej Racz, Richard Ferkl, Jan Hubac, Ilja Kotik, Zdenek Monhart, Hana Burianova, Ondrej Jerabek, Jana Pisova, Iveta Petrova, Vratislav Dedek, Michaela Honkova, Petr Podrazil, Petr Reichert, Jindrich Spinar, Miroslav Novak, Vaclav Durdil, Katarina Plocova, Jiri Lastuvka, Jørn Nielsen Steen Husted, Helena Dominguez, Ulrik Hintze, Søren Rasmussen, Næstved Sygehus, Arne Bremmelgaard, John Markenvard, Jan Børger, Jorgen Solgaard, Ebbe Eriksen, Thomas Løkkegaard, Michael Bruun, Jacob Mertz, Morten Schou, Michael Olsen, Pekka Raatikainen Carmela Viitanen, Franck Paganelli Joël Ohayon, Frédéric Casassus, Michel Galinier, Yannick Gottwalles, Philippe Loiselet, Jean-Joseph Muller, Mohamed Bassel Koujan, André Marquand, Sylvain Destrac, Olivier Piot, Nicolas Delarche, Jean-Pierre Cebron, Maxime Guenoun, Dominique Guedj-Meynier, A. G. Lokesh, Mathieu Zuber, Pierre Amarenco, Emmanuel Ellie, James Kadouch, Pierre-Yves Fournier, Jean-Pierre Huberman, Nestor Lemaire, Gilles Rodier, Xavier Vandamme, Igor Sibon, Jean-Philippe Neau, Marie Hélène Mahagne, Antoine Mielot, Marc Bonnefoy, Jean-Baptiste Churet, Vincent Navarre, Frederic Sellem, Gilles Monniot, Jean-Paul Boyes, Bernard Doucet, Michel Martelet, Désiré Obadia, Bernard Crousillat, Joseph Mouallem, Etienne Bearez, Jean Philippe Brugnaux, Alain Fedorowsky, Pierre Nazeyrollas, Jean-Baptiste Berneau, Frédéric Chemin, Sebastien Schellong Harald Darius, Georg Koeniger, Andreas Kopf, Uwe Gerbaulet, Bernd-Thomas Kellner, Thomas Schaefer, Jan Purr, Enno Eißfeller, Heinz-Dieter Zauzig, Peter Riegel, Christoph Axthelm, Gerd-Ulrich Heinz, Holger Menke, Andreas Pustelnik, Stefan Zutz, Wolfgang Eder, Guenter Rehling, Dirk Glatzel, Norbert Ludwig, Petra Sandow, Henning Wiswedel, Cosmas Wildenauer, Steffen Schoen, Toralf Schwarz, Adyeri Babyesiza, Maximilian Kropp, Hans-Hermann Zimny, Friedhelm Kahl, Andreas Caspar, Sabine Omankowsky, Torsten Laessig, Hermann-Josef Hartmann, Gunter Lehmann, Hans-Walter Bindig, Gunter Hergdt, Dietrich Reimer, Joachim Hauk, Holger Michel, Praxis Dres. Werner Erdle, Wilfried Dorsch, Janna Dshabrailov, Karl-Albrecht Rapp, Reinhold Vormann, Thomas Mueller, Peter Mayer, Uwe Horstmeier, Volker Eissing, Heinz Hey, Heinz Leuchtgens, Volker Lilienweiss, Heiner Mueller, Christian Schubert, Herrmann Lauer, Thomas Buchner, Gunter Brauer, Susanne Kamin, Karsten Mueller, Sylvia Baumbach, Muwafeg Abdel-Qader, Hans-Holger Ebert, Carsten Schwencke, Peter Bernhardt, Laszlo Karolyi, Britta Sievers, Wilhelm Haverkamp, Jens-Uwe Roehnisch, Andras Vertes Gabor Szantai, Andras Matoltsy, Nikosz Kanakaridisz, Zoltan Boda, Erno Kis, Balazs Gaszner, Ferenc Juhasz, Gizella Juhasz, Sandor Kancz, Zoltan Laszlo, Zsolt May, Bela Merkely, Ebrahim Noori, Tamas Habon, Peter Polgar, Gabriella Szalai, Sandor Vangel, Andras Nagy, Gabriella Engelthaler, Judit Ferenczi, Mihaly Egyutt, Giuliana Martini Leone Maria Cristina, Eros Tiraferri, Rita Santoro, Sophie Testa, Giovanni Di Minno, Marco Moia, Teresa Maria Caimi, Maria Tessitori, Roberto Cappelli, Daniela Poli, Roberto Quintavalla, Franco Cosmi, Raffaele Fanelli, Vincenzo Oriana, Raffaele Reggio, Roberto Santi, Leonardo Pancaldi, Raimondo De Cristofaro, Giuliana Guazzaloca, Angelo De Blasio, Jorge Salerno Uriate, Flavia Lillo, Enrico Maria Pogliani, Grzegorz Bilo, Michele Accogli, Antonio Mariani, Mauro Feola, Arturo Raisaro, Luciano Fattore, Andrea Mauric, Fabrizio Germini, Luca Tedeschi, Maria Settimi, Sergio Nicoli, Paolo Ricciarini, Antonio Argena, Paolo Ronchini, Claudio Bulla, Filippo Tradati, Massimo Volpe, Maria D’Avino, Maria Grazia Bongiorni, Silva Severi, Alessandro Capucci, Corrado Lodigiani, Enrico Salomone, Gaetano Serviddio, Claudio Tondo, Paolo Golino, Carmine Mazzone, Saverio Iacopino, Hugo ten Cate J. H. Ruiter, Andreas Lucassen, Henk Adriaansen, Maarten Bongaerts, Mathijs Pieterse, Coen van Guldener, Johannes Herrman, S. H. K. P. R. Nierop, Pieter Hoogslag, Walter Hermans, B. E. Groenemeijer, W. Terpstra, Cees Buiks, L. V. A. Boersma, Eivind Berge Per Anton Sirnes, Erik Gjertsen, Torstein Hole, Knut Erga, Arne Hallaråker, Gunnar Skjelvan, Anders Østrem, Beraki Ghezai, Arne Svilaas, Peter Christersson, Torbjørn Øien, Svein Høegh Henrichsen, Jan Erik Otterstad, Jan Berg-Johansen, Janina Stepinska Andrzej Gieroba, Malgorzata Biedrzycka, Michal Ogorek, Beata Wozakowska-Kaplon, Krystyna Loboz-Grudzien, Wieslaw Supinski, Jerzy Kuzniar, Roman Zaluska, Jaroslaw Hiczkiewicz, Lucyna Swiatkowska-Byczynska, Lech Kucharski, Marcin Gruchala, Piotr Minc, Maciej Olszewski, Grzegorz Kania, Malgorzata Krzciuk, Zbigniew Lajkowski, Bozenna Ostrowska-Pomian, Jerzy Lewczuk, Elzbieta Zinka, Agnieszka Karczmarczyk, Malgorzata Chmielnicka-Pruszczynska, Iwona Wozniak-Skowerska, Grzegorz Opolski, Marek Bronisz, Marcin Ogorek, Grazyna Glanowska, Piotr Ruszkowski, Grzegorz Skonieczny, Ryszard Sciborski, Boguslaw Okopien, Piotr Kukla, Krzysztof Galbas, Krzysztof Cymerman, Jaroslaw Jurowiecki, Pawel Miekus, Waldemar Myszka, Stanislaw Mazur, Roman Lysek, Jacek Baszak, Teresa Rusicka-Piekarz, Grzegorz Raczak, Ewa Domanska, Jadwiga Nessler, Jozef Lesnik, Vera Eltishcheva Roman Libis, Gadel Kamalov, Dmitry Belenky, Liudmila Egorova, Alexander Khokhlov, Eduard Yakupov, Dmitry Zateyshchikov, Olga Barbarash, Olga Miller, Evgeniy Mazur, Konstantin Zrazhevskiy, Tatyana Novikova, Yulia Moiseeva, Elena Polkanova, Konstantin Sobolev, Maria Rossovskaya, Yulia Shapovalova, Alla Kolesnikova, Konstantin Nikolaev, Oksana Zemlianskaia, Anna Zateyshchikova, Victor Kostenko, Sergey Popov, Maria Poltavskaya, Anton Edin, Elena Aleksandrova Oksana Drapkina, Alexander Vishnevsky, Oleg Nagibovich, Petr Chizhov, Svetlana Rachkova, Mikhail Sergeev, Borys Kurylo, Alexey Ushakov, Xavier Vinolas Pere Alvarez Garcia, Maria Fernanda Lopez Fernandez, Luis Tercedor Sanchez, Salvador Tranche Iparraguirre, Pere Toran Monserrat, Emilio Marquez Contreras, Jordi Isart Rafecas, Juan Motero Carrasco, Pablo Garcia Pavia, Casimiro Gomez Pajuelo, Luis Miguel Rincon Diaz, Luis Fernando Iglesias Alonso, Angel Grande Ruiz, Jordi Merce Klein, Jose Ramon Gonzalez Juanatey, Ines Monte Collado, Herminia Palacin Piquero, Carles Brotons Cuixart, Esther Fernandez Escobar, Joan Bayo i Llibre, Cecilia Corros Vicente, Manuel Vida Gutierrez, Francisco Epelde Gonzalo, Carlos Alexandre Almeida Fernandez, Encarnacion Martinez Navarro, Juan Jose Montero Alia, Maria Barreda Gonzalez, Maria Angels Moleiro Oliva, Jose Iglesias Sanmartin, Mercedes Jimenez Gonzalez, Maria del Mar Rodriguez Alvarez, Juan Herreros Melenchon, Tomas Ripoll Vera, Manuel Jimenez Navarro, Maria Vazquez Caamano, Maria Fe Arcocha Torres, Gonzalo Marcos Gomez, Andres Iniguez Romo, Miguel Angel Prieto Diaz, Mårten Rosenqvist Alexander Wirdby, Jan Lindén, Kerstin Henriksson, Micael Elmersson, Arnor Egilsson, Ulf Börjesson, Gunnar Svärd, Bo Liu, Anders Lindh, Lars-Bertil Olsson, Mikael Gustavsson, Lars Andersson, Lars Benson, Claes Bothin, Ali Hajimirsadeghi, Björn Martinsson, Marianne Ericsson, Åke Ohlsson, Håkan Lindvall, Peter Svensson, Katarina Thörne, Hans Händel, Pyotr Platonov, Fredrik Bernsten, Ingar Timberg, Milita Crisby, Jan-Erik Karlsson, Agneta Andersson, Lennart Malmqvist, Johan Engdahl, Jörgen Thulin, Aida Hot-Bjelak, Steen Jensen, Per Stalby, Jan Steffel Johann Debrunner, Juerg H. Beer, Dipen Shah, Iurii Rudyk Vira Tseluyko, Oleksandr Karpenko, Svitlana Zhurba, Igor Kraiz, Oleksandr Parkhomenko, Iryna Kupnovytska, Nestor Seredyuk, Yuriy Mostovoy, Oleksiy Ushakov, Olena Koval, Igor Kovalskiy, Yevgeniya Svyshchenko, Oleg Sychov, Mykola Stanislavchuk, Andriy Yagensky, Susanna Tykhonova, Ivan Fushtey, Will Murdoch Naresh Chauhan, Daryl Goodwin, Louise Lumley, Ramila Patel, Philip Saunders, Bennett Wong, Alex Cameron, Niranjan Patel, P. Jhittay, Andrew Ross, M. S. Kainth, Karim Ladha, Kevin Douglas, Gill Pickavance, Joanna McDonnell, Laura Handscombe, Trevor Gooding, Helga Wagner, Colin Bradshaw, Catherine Bromham, Kevin Jones, Shoeb Suryani, Richard Coates, Bhupinder Sarai, W. Willcock, S. Sircar, John Cairns, A. Gilliand, Roman Bilas, E. Strieder, Peter Hutchinson, Anne Wakeman, Michael Stokes, Graham Kirby, Bhaskhar Vishwanathan, Nigel Bird, Paul Evans, M. Clark, John Bisatt, Jennifer Litchfield, E. 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Iwase, Kazuki Sato, Kazuya Kawai, Tomobumi Kotani, Tsuyoshi Tsuji, Hirosumi Sakai, Kiyoshi Nishino, Kenichi Ikeda, Kazuo Maeda, Tomohiro Shinozuka, Takeshi Inoue, Koichi Kawakami, Hiromichi Kitazumi, Tsutomu Takagi, Mamoru Hamaoka, Jisho Kojima, Akitoshi Sasaki, Yoshihiro Tsuchiya, Tetsuo Betsuyaku, Koji Higuchi, Masaaki Honda, Koichi Hasegawa, Takao Baba, Kazuaki Mineoi, Toshihiko Koeda, Kunihiko Hirasawa, Toshihide Kumazaki, Akira Nakagomi, Eiji Otaki, Takashi Shindo, Hiroyoshi Hirayama, Chikako Sugimoto, Takashi Yamagishi, Ichiro Mizuguchi, Kazunori Sezaki, Isamu Niwa, Ken Takenaka, Osamu Iiji, Koichi Taya, Hitoshi Kitazawa, samu Ueda, Hirokazu Kakuda, Takuya Ono, Seizo Oriso, Junya Kamata, Toshihiko Nanke, Itaru Maeda, Yoshifusa Matsuura, Hiroki Teragawa, Yasuyuki Maruyama, Kazuo Takei, Hajime Horie, Tetsutaro Kito, Hiroshi Asano, Koji Matsushita, Masaichi Nakamura, Takashi Washizuka, Tomoki Yoshida, Masato Sawano, Shinichi Arima, Hidekazu Arai, Hisanori Shinohara, Hiroyuki Takai, Nobufusa Furukawa, Akira Ota, Kentaro Yamamoto, Kenji Aoki, Taku Yamamoto, Takeaki Kasai, Shunji Suzuki, Shu Suzuki, Nitaro Shibata, Masayuki Watanabe, Yosuke Nishihata, Toru Arino, Masaki Okuyama, Tetsushi Wakiyama, Tomoko Kato, Yasuo Sasagawa, Takeshi Tana, Yoshihito Hayashi, Shinichi Hirota, Yukihiko Abe, Yoshihiro Saito, Hirohide Uchiyama, Hiroshi Takeda, Hiroshi Ono, Shuichi Tohyo, Naoto Hanazono, Seiichi Miyajima, Hisashi Shimono, Takuma Aoyama, Yasunobu Shozawa, Yawara Niijima, Osamu Murai, Hideko Inaba, Katsumasa Nomura, Masatsugu Nozoe, Kazuo Suzuki, Toshiyuki Furukawa, Toshihiko Shiraiwa, Nobuhisa Ito, Shunichi Nagai, Kiyoharu Sato, Shiro Nakahara, Yujin Shimoyama, Naoko Ohara, Teruhiko Kozuka, Hideaki Okita, Masato Endo, Tsutomu Goto, Makoto Hirose, Emiko Nagata, Noriyuki Nakanishi, Toshizumi Mori, Shuichi Seki, Katsuhiro Okamoto, Osamu Moriai, Yoko Emura, Tsuyoshi Fukuda, Haruhiko Date, Shuichi Kawakami, Sho Nagai, Yuya Ueyama, Tetsuro Fudo, Mitsuru Imaizumi, Takuo Ogawa, Shunsuke Take, Hideo Ikeda, Hiroaki Nishioka, Norihiko Sakamoto, Kiyomitsu Ikeoka, Nobuo Wakaki, Masatake Abe, Junji Doiuchi, Tetsuya Kira, Masato Tada, Ken Tsuzaki, Naoya Miura, Yasuaki Fujisawa, Wataru Furumoto, Susumu Suzuki, Akinori Fujisawa, Ryosai Nakamura, Hiroyasu Komatsu, Rei Fujiki, Shuichi Kawano, Keijiro Nishizawa, Yoji Kato, Junya Azuma, Kiyoshi Yasui, Toshio Amano, Yasuhiro Sekine, Tatsuo Honzawa, Yuichiro Koshibu, Yasuhide Sakamoto, Yukihiro Seta, Shingo Miyaguchi, Kojuro Morishita, Yasuko Samejima, Toyoshi Sasaki, Fumiko Iseki, Toshiyuki Kobayashi, Hiroshi Kano, Jaeyoung Kim, Hiroshi Yamaguchi, Yoichi Takagi, Yoko Onuki Pearce, Yasuyuki Suzuki, Takayuki Fukui, Toru Nakayama, Hideaki Kanai, Yoshiyuki Kawano, Tetsuji Ino, Hironori Miyoshi, Yasufumi Miyamoto, Masahito Shigekiyo, Shimato Ono, Yutaka Okamoto, Satoshi Ubukata, Kojiro Kodera, Tatsuo Oriuchi, Naoki Matsumoto, Koichi Inagaki, Atsushi Iseki, Tomohiro Yoshida, Toshihiro Goda, Tsukasa Katsuki, Atsushi Sato, Etsuo 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Simões de Almeida, Ney Carter do Carmo Borges, Luís Gustavo Gomes Ferreira, Ramón Corbalán Benjamin Aleck Joseh Stockins Fernandez, Humberto Montecinos, Fernando Lanas, Martín Larico Gómez, Carlos Astudillo, Carlos Conejeros, Patricio Marin Cuevas, Alejandro Forero, Claudio Bugueño Gutiérrez, Juan Aguilar, Sergio Potthoff Cardenas, German Eggers, Cesar Houzvic, Carlos Rey, Germán Arriagada, Gustavo Charme Vilches, Carlos Jerjes Sanchez Diaz Jesus Jaime Illescas Diaz, Raul Leal Cantu, Maria Guadalupe Ramos Zavala, Ricardo Cabrera Jardines, Nilda Espinola Zavaleta, Enrique Lopez Rosas, Guillermo Antonio Llamas Esperón, Gerardo Pozas, Ernesto Cardona Muñoz, Norberto Matadamas Hernandez, Adolfo Leyva Rendon, Norberto Garcia Hernandez, Manuel de los Rios Ibarra, Luis Ramon Virgen Carrillo, David Lopez Villezca, Carlos Hernandez Herrera, Juan Jose Lopez Prieto, Rodolfo Gaona Rodriguez, Efrain Villeda Espinosa, David Flores Martinez, Jose Velasco Barcena, Omar Fierro Fierro, Ignacio Rodriguez Briones, Jose Luis Leiva Pons, Humberto Alvarez Lopez, Rafael Olvera Ruiz, Carlos Gerardo Cantu Brito, Eduardo Julian Jose Roberto Chuquiure Valenzuela, Roxana Reyes Sanchez, Alberto Esteban Bazzoni Ruiz, Oscar Martin Lopez Ruiz, Roberto Arriaga Nava, Jesus David Morales Cerda, Pedro Fajardo Campos, Mario Benavides Gonzalez, Marianne Brodmann Kurt Lenz, Claus Hagn, Johannes Foechterle, Heinz Drexel, Kurt Huber, Andrea Podczeck-Schweighofer, Michael Winkler, Bruno Schneeweiss, Alfons Gegenhuber, Wilfried Lang, Sabine Eichinger-Hasenauer, Peter Kaserer, Josef Sykora, Heribert Rasch, Bernhard Strohmer, Luc Capiau Geert Vervoort, Bart Wollaert, Geert Hollanders, Jan Vercammen, Dirk Faes, Yohan Balthazar, Marc Delforge, Olivier Xhaet, Harry Striekwold, John Thoeng, Kurt Hermans, Georges Mairesse, Wim Anné, Ivan Blankoff, Michel Beutels, Stefan Verstraete, Peter Vandergoten, Philippe Purnode, Pascal Godart, Tim Boussy, Philippe Desfontaines, Alex Heyse, Joeri Voet, Axel De Wolf, Eva Zidkova Petr Jansky, Rudolf Spacek, Vilma Machova, Ondrej Ludka, Josef Olsr, Lubos Kotik, Blazej Racz, Richard Ferkl, Jan Hubac, Ilja Kotik, Zdenek Monhart, Hana Burianova, Ondrej Jerabek, Jana Pisova, Iveta Petrova, Vratislav Dedek, Michaela Honkova, Petr Podrazil, Petr Reichert, Jindrich Spinar, Miroslav Novak, Vaclav Durdil, Katarina Plocova, Jiri Lastuvka, Jørn Nielsen Steen Husted, Helena Dominguez, Ulrik Hintze, Søren Rasmussen, Næstved Sygehus, Arne Bremmelgaard, John Markenvard, Jan Børger, Jorgen Solgaard, Ebbe Eriksen, Thomas Løkkegaard, Michael Bruun, Jacob Mertz, Morten Schou, Michael Olsen, Pekka Raatikainen Carmela Viitanen, Franck Paganelli Joël Ohayon, Frédéric Casassus, Michel Galinier, Yannick Gottwalles, Philippe Loiselet, Jean-Joseph Muller, Mohamed Bassel Koujan, André Marquand, Sylvain Destrac, Olivier Piot, Nicolas Delarche, Jean-Pierre Cebron, Maxime Guenoun, Dominique Guedj-Meynier, A. G. Lokesh, Mathieu Zuber, Pierre Amarenco, Emmanuel Ellie, James Kadouch, Pierre-Yves Fournier, Jean-Pierre Huberman, Nestor Lemaire, Gilles Rodier, Xavier Vandamme, Igor Sibon, Jean-Philippe Neau, Marie Hélène Mahagne, Antoine Mielot, Marc Bonnefoy, Jean-Baptiste Churet, Vincent Navarre, Frederic Sellem, Gilles Monniot, Jean-Paul Boyes, Bernard Doucet, Michel Martelet, Désiré Obadia, Bernard Crousillat, Joseph Mouallem, Etienne Bearez, Jean Philippe Brugnaux, Alain Fedorowsky, Pierre Nazeyrollas, Jean-Baptiste Berneau, Frédéric Chemin, Sebastien Schellong Harald Darius, Georg Koeniger, Andreas Kopf, Uwe Gerbaulet, Bernd-Thomas Kellner, Thomas Schaefer, Jan Purr, Enno Eißfeller, Heinz-Dieter Zauzig, Peter Riegel, Christoph Axthelm, Gerd-Ulrich Heinz, Holger Menke, Andreas Pustelnik, Stefan Zutz, Wolfgang Eder, Guenter Rehling, Dirk Glatzel, Norbert Ludwig, Petra Sandow, Henning Wiswedel, Cosmas Wildenauer, Steffen Schoen, Toralf Schwarz, Adyeri Babyesiza, Maximilian Kropp, Hans-Hermann Zimny, Friedhelm Kahl, Andreas Caspar, Sabine Omankowsky, Torsten Laessig, Hermann-Josef Hartmann, Gunter Lehmann, Hans-Walter Bindig, Gunter Hergdt, Dietrich Reimer, Joachim Hauk, Holger Michel, Praxis Dres. Werner Erdle, Wilfried Dorsch, Janna Dshabrailov, Karl-Albrecht Rapp, Reinhold Vormann, Thomas Mueller, Peter Mayer, Uwe Horstmeier, Volker Eissing, Heinz Hey, Heinz Leuchtgens, Volker Lilienweiss, Heiner Mueller, Christian Schubert, Herrmann Lauer, Thomas Buchner, Gunter Brauer, Susanne Kamin, Karsten Mueller, Sylvia Baumbach, Muwafeg Abdel-Qader, Hans-Holger Ebert, Carsten Schwencke, Peter Bernhardt, Laszlo Karolyi, Britta Sievers, Wilhelm Haverkamp, Jens-Uwe Roehnisch, Andras Vertes Gabor Szantai, Andras Matoltsy, Nikosz Kanakaridisz, Zoltan Boda, Erno Kis, Balazs Gaszner, Ferenc Juhasz, Gizella Juhasz, Sandor Kancz, Zoltan Laszlo, Zsolt May, Bela Merkely, Ebrahim Noori, Tamas Habon, Peter Polgar, Gabriella Szalai, Sandor Vangel, Andras Nagy, Gabriella Engelthaler, Judit Ferenczi, Mihaly Egyutt, Giuliana Martini Leone Maria Cristina, Eros Tiraferri, Rita Santoro, Sophie Testa, Giovanni Di Minno, Marco Moia, Teresa Maria Caimi, Maria Tessitori, Roberto Cappelli, Daniela Poli, Roberto Quintavalla, Franco Cosmi, Raffaele Fanelli, Vincenzo Oriana, Raffaele Reggio, Roberto Santi, Leonardo Pancaldi, Raimondo De Cristofaro, Giuliana Guazzaloca, Angelo De Blasio, Jorge Salerno Uriate, Flavia Lillo, Enrico Maria Pogliani, Grzegorz Bilo, Michele Accogli, Antonio Mariani, Mauro Feola, Arturo Raisaro, Luciano Fattore, Andrea Mauric, Fabrizio Germini, Luca Tedeschi, Maria Settimi, Sergio Nicoli, Paolo Ricciarini, Antonio Argena, Paolo Ronchini, Claudio Bulla, Filippo Tradati, Massimo Volpe, Maria D’Avino, Maria Grazia Bongiorni, Silva Severi, Alessandro Capucci, Corrado Lodigiani, Enrico Salomone, Gaetano Serviddio, Claudio Tondo, Paolo Golino, Carmine Mazzone, Saverio Iacopino, Hugo ten Cate J. H. Ruiter, Andreas Lucassen, Henk Adriaansen, Maarten Bongaerts, Mathijs Pieterse, Coen van Guldener, Johannes Herrman, S. H. K. P. R. Nierop, Pieter Hoogslag, Walter Hermans, B. E. Groenemeijer, W. Terpstra, Cees Buiks, L. V. A. Boersma, Eivind Berge Per Anton Sirnes, Erik Gjertsen, Torstein Hole, Knut Erga, Arne Hallaråker, Gunnar Skjelvan, Anders Østrem, Beraki Ghezai, Arne Svilaas, Peter Christersson, Torbjørn Øien, Svein Høegh Henrichsen, Jan Erik Otterstad, Jan Berg-Johansen, Janina Stepinska Andrzej Gieroba, Malgorzata Biedrzycka, Michal Ogorek, Beata Wozakowska-Kaplon, Krystyna Loboz-Grudzien, Wieslaw Supinski, Jerzy Kuzniar, Roman Zaluska, Jaroslaw Hiczkiewicz, Lucyna Swiatkowska-Byczynska, Lech Kucharski, Marcin Gruchala, Piotr Minc, Maciej Olszewski, Grzegorz Kania, Malgorzata Krzciuk, Zbigniew Lajkowski, Bozenna Ostrowska-Pomian, Jerzy Lewczuk, Elzbieta Zinka, Agnieszka Karczmarczyk, Malgorzata Chmielnicka-Pruszczynska, Iwona Wozniak-Skowerska, Grzegorz Opolski, Marek Bronisz, Marcin Ogorek, Grazyna Glanowska, Piotr Ruszkowski, Grzegorz Skonieczny, Ryszard Sciborski, Boguslaw Okopien, Piotr Kukla, Krzysztof Galbas, Krzysztof Cymerman, Jaroslaw Jurowiecki, Pawel Miekus, Waldemar Myszka, Stanislaw Mazur, Roman Lysek, Jacek Baszak, Teresa Rusicka-Piekarz, Grzegorz Raczak, Ewa Domanska, Jadwiga Nessler, Jozef Lesnik, Vera Eltishcheva Roman Libis, Gadel Kamalov, Dmitry Belenky, Liudmila Egorova, Alexander Khokhlov, Eduard Yakupov, Dmitry Zateyshchikov, Olga Barbarash, Olga Miller, Evgeniy Mazur, Konstantin Zrazhevskiy, Tatyana Novikova, Yulia Moiseeva, Elena Polkanova, Konstantin Sobolev, Maria Rossovskaya, Yulia Shapovalova, Alla Kolesnikova, Konstantin Nikolaev, Oksana Zemlianskaia, Anna Zateyshchikova, Victor Kostenko, Sergey Popov, Maria Poltavskaya, Anton Edin, Elena Aleksandrova Oksana Drapkina, Alexander Vishnevsky, Oleg Nagibovich, Petr Chizhov, Svetlana Rachkova, Mikhail Sergeev, Borys Kurylo, Alexey Ushakov, Xavier Vinolas Pere Alvarez Garcia, Maria Fernanda Lopez Fernandez, Luis Tercedor Sanchez, Salvador Tranche Iparraguirre, Pere Toran Monserrat, Emilio Marquez Contreras, Jordi Isart Rafecas, Juan Motero Carrasco, Pablo Garcia Pavia, Casimiro Gomez Pajuelo, Luis Miguel Rincon Diaz, Luis Fernando Iglesias Alonso, Angel Grande Ruiz, Jordi Merce Klein, Jose Ramon Gonzalez Juanatey, Ines Monte Collado, Herminia Palacin Piquero, Carles Brotons Cuixart, Esther Fernandez Escobar, Joan Bayo i Llibre, Cecilia Corros Vicente, Manuel Vida Gutierrez, Francisco Epelde Gonzalo, Carlos Alexandre Almeida Fernandez, Encarnacion Martinez Navarro, Juan Jose Montero Alia, Maria Barreda Gonzalez, Maria Angels Moleiro Oliva, Jose Iglesias Sanmartin, Mercedes Jimenez Gonzalez, Maria del Mar Rodriguez Alvarez, Juan Herreros Melenchon, Tomas Ripoll Vera, Manuel Jimenez Navarro, Maria Vazquez Caamano, Maria Fe Arcocha Torres, Gonzalo Marcos Gomez, Andres Iniguez Romo, Miguel Angel Prieto Diaz, Mårten Rosenqvist Alexander Wirdby, Jan Lindén, Kerstin Henriksson, Micael Elmersson, Arnor Egilsson, Ulf Börjesson, Gunnar Svärd, Bo Liu, Anders Lindh, Lars-Bertil Olsson, Mikael Gustavsson, Lars Andersson, Lars Benson, Claes Bothin, Ali Hajimirsadeghi, Björn Martinsson, Marianne Ericsson, Åke Ohlsson, Håkan Lindvall, Peter Svensson, Katarina Thörne, Hans Händel, Pyotr Platonov, Fredrik Bernsten, Ingar Timberg, Milita Crisby, Jan-Erik Karlsson, Agneta Andersson, Lennart Malmqvist, Johan Engdahl, Jörgen Thulin, Aida Hot-Bjelak, Steen Jensen, Per Stalby, Jan Steffel Johann Debrunner, Juerg H. Beer, Dipen Shah, Iurii Rudyk Vira Tseluyko, Oleksandr Karpenko, Svitlana Zhurba, Igor Kraiz, Oleksandr Parkhomenko, Iryna Kupnovytska, Nestor Seredyuk, Yuriy Mostovoy, Oleksiy Ushakov, Olena Koval, Igor Kovalskiy, Yevgeniya Svyshchenko, Oleg Sychov, Mykola Stanislavchuk, Andriy Yagensky, Susanna Tykhonova, Ivan Fushtey, Will Murdoch Naresh Chauhan, Daryl Goodwin, Louise Lumley, Ramila Patel, Philip Saunders, Bennett Wong, Alex Cameron, Niranjan Patel, P. Jhittay, Andrew Ross, M. S. Kainth, Karim Ladha, Kevin Douglas, Gill Pickavance, Joanna McDonnell, Laura Handscombe, Trevor Gooding, Helga Wagner, Colin Bradshaw, Catherine Bromham, Kevin Jones, Shoeb Suryani, Richard Coates, Bhupinder Sarai, W. Willcock, S. Sircar, John Cairns, A. Gilliand, Roman Bilas, E. Strieder, Peter Hutchinson, Anne Wakeman, Michael Stokes, Graham Kirby, Bhaskhar Vishwanathan, Nigel Bird, Paul Evans, M. Clark, John Bisatt, Jennifer Litchfield, E. Fisher, Tim Fooks, Richard Kelsall, Neil Paul, Elizabeth Alborough, Michael Aziz, C. Ramesh, Pete Wilson, Simon Franklin, Sue Fairhead, Julian Thompson, Hasan Chowan, Gary Taylor, Dawn Tragen, Matt Parfitt, Claire Seamark, Carolyn Paul, Mark Richardson, Angus Jefferies, Helen Sharp, Hywel Jones, Claire Giles, Matthew Bramley, Philip Williams, Jehad Aldegather, Simon Wetherell, William Lumb, Phil Evans, Frances Scouller, Neil Macey, Stephen Rogers, Yvette Stipp, Richard West, Philip Pinney, Paul Wadeson, John Matthews, Preeti Pandya, Andrew Gallagher, T. Railton, Emyr Davies, Jonathan McClure, Marc Jacobs, Claire Hutton, R. Thompson, Bijoy Sinha, Keith Butter, Susan Barrow, Helen Little, David Russell, Ulka Choudhary, Ikram Haq, Paul Ainsworth, Claire Jones, Phil Weeks, Jane Eden, Lisa Gibbons, Janet Glencross, Alison MacLeod, K. Poland, Conor Mulolland, A. Warke, Paul Conn, D. Burns, R. Smith, R. Kamath, Jonathan Webster, Ian Hodgins, Stephen Vercoe, Paul Roome, Hilary Pinnock, Jayesh Patel, Amar Ali, Nigel Hart, Richard Davies, Nigel De-Sousa, Catherine Neden, Mark Danielsen, Purnima Sharma, Sophia Galloway, Charlotte Hawkins, Raife Oliver, Martin Aylward, Mira Pattni, Gordon Irvine, Shahid Ahmad, Catherine Rothwell, Fiaz Choudhary, Sabrina Khalaque, Stephanie Short, Sharon Peters, Warwick Coulson, Neil Roberts, Amy Butler Steven Coates, Ben Ward, Daniel Jackson, Steve Walton, Diane Shepherd, Toh Wong, Mark Boon, Melanie Deacon, David Cornelius, Sarah Davies, Ben Frankel, Nick Hargreaves, Henry Choi, Jon Sumner, Tim Myhill, Salah Estifanos, Diane Geatch, Justin Wilkinson, Richard Veale, Karen Forshaw, Rob Hirst, Kashif Zaman, Catherine Liley, Rebecca Wastling, Paul McEleny, Andre Beattie, Philip Cooke, Mike Wong, Mark Pugsley, Chaminda Dooldeniya, Greg Rogers, James Bennett, Polly Jacobs, Rajesh Muvva, Matthew Adam, Robin Fox, Nicolas Thomas, Simon Cartwright, Rory Reed, Simon Randfield, Christine A’Court, Ann Flynn, Andrew Halpin, Simon Dobson, Louise Lomax, Minnal Nadaph, Iain Munro, Jane Goram, Helen Stoddart, Phil Simmons, John Shewring, Emma Bowen-Simpkins, Mark Rickenbach, Adam Blenkhorn Bhuwanendu Singh, Penny Astridge, William van Gaal, Walter Abhayaratna, Philip Thomson, Ron Lehman, Jens Kilian, David Coulshed, Andrei Catanchin, David Colquhoun, Hosen Kiat, David Eccleston, John French, Bronte Ayres, Peter Blombery, Thanh Phan, James Rogers, David O’Donnell, Sang Cheol Bae, Harry Gibbs, Patrick Carroll, Greg Starmer, Margaret Arstall, Maurits Binnekamp, Astin Lee, John Eikelboom Robert Luton, Milan Gupta, Amritanshu Shekhar Pandey, Stephen Cheung, Rolland Leader, Philippe Beaudry, Félix Ayala-Paredes, Joseph Berlingieri, John Heath, Germain Poirier, Miranda du Preez, Bradley Schweitzer, Reginald Nadeau, Ripple Dhillon, Tomasz Hruczkowski, Andrea Lavoie, Ratika Parkash, James Cha, Benoit Coutu, Paul MacDonald, Brian Ramjattan, Jorge Bonet, Saul Vizel, Paul Angaran, Sameh Fikry, Ahmed Mowafy Azza Katta, Mazen Tawfik, Moustafa Nawar, Mohamed Sobhy, Seif Kamal Abou Seif, Tarek Khairy, Ahmed Abd El-Aziz, Nasser Taha, Ashraf Reda, Atef Elbahry, Mohamed Setiha, Mohamed Gamal El Din, Magdi Elkhadem, Adel El-Etreby, David Kettles Junaid Bayat, Heidi Siebert, Adrian Horak, Ynez Kelfkens, Riaz Garda, Thayabran Pillay, Michele Guerra, Louis van Zyl, Hendrik Theron, Andrew Murray, Rikus Louw, Deon Greyling, Pindile Mntla, Siddique Ismail, Fayzal Ahmed, Johannes Engelbrecht, Shambu Maharajh, Wessel Oosthuysen, Rehana Loghdey, Veronica Ueckermann, Wael AlAl Mahmeed AbdullahNaeemi, Ghazi Yousef, Nooshin Bazargani, Munther AlOmairi, Rajan Maruthanayagam, Rupesh Singh, Ahmed Naguib, Mohamed Ibrahim, Amrish Agrawal, Mukesh Nathani, Ehab M. Esheiba, Adel Wassef, Rajeev Gupta, Michael Cox Scott Beach, Peter Duffy, Stephen Falkowski, Kevin Ferrick, Miguel Franco, W. Michael Kutayli, Annette Quick, Niraj Sharma, Vance Wilson, Stephen Miller, Mark Alberts, Edwin Blumberg, Roddy Canosa, Ted Gutowski, Rodney Ison, Jorge Garcia, Paul Mullen, Howard Noveck, Pamela Rama, Rajneesh Reddy, Marcus Williams, Daniel Nishijima, Keith Ferdinand, Ihsan Haque, Robert Mendelson, Sridevi Pitta, Daniel Theodoro, Charles Treasure, Moustafa Moustafa, Cas Cader, Walter Pharr, Alisha Oropallo, George Platt, Jaspal Gujral, James Welker, and Firas Koura
- Abstract
Background: The Global Anticoagulant Registry in the FIELD–Atrial Fibrillation (GARFIELD-AF) is a worldwide non-interventional study of stroke prevention in patients with non-valvular AF. Methods and results: 52,080 patients with newly diagnosed AF were prospectively enrolled from 2010 to 2016. 4121 (7.9%) of these patients were recruited in DACH [Germany (n = 3567), Austria (n = 465) and Switzerland (n = 89) combined], and 47,959 patients were from 32 countries in other regions worldwide (ORW). Hypertension was most prevalent in DACH and ORW (85.3% and 75.6%, respectively). Diabetes, hypercholesterolaemia, carotid occlusive disease and vascular disease were more prevalent in DACH patients vs ORW (27.6%, 49.4%, 5.8% and 29.0% vs 21.7%, 40.9%, 2.8% and 24.5%). The use of non-vitamin K antagonist oral anticoagulants (NOACs) increased more in DACH over time. Management of vitamin K antagonists was suboptimal in DACH and ORW (time in therapeutic range of INR ≥ 65% in 44.6% and 44.4% of patients or ≥ 70% in 36.9% and 36.0% of patients, respectively). Adjusted rates of cardiovascular mortality and MI/ACS were higher in DACH while non-haemorrhagic stroke/systemic embolism was lower after 2-year follow-up. Conclusions: Similarities and dissimilarities in AF management and clinical outcomes are seen in DACH and ORW. The increased use of NOAC was associated with a mismatch of risk-adapted anticoagulation (over-and-undertreatment) in DACH. Suboptimal control of INR requires educational activities in both regional groups. Higher rates of cardiovascular death in DACH may reflect the higher risk profile of these patients and lower rates of non-haemorrhagic stroke could be associated with increased NOAC use. Graphical abstract: [Figure not available: see fulltext.].
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- 2023
64. Obesity Is Indirectly Associated with Sudden Cardiac Arrest through Various Risk Factors
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Yun Gi Kim, Joo Hee Jeong, Seung-Young Roh, Kyung-Do Han, Yun Young Choi, Kyongjin Min, Jaemin Shim, Jong-Il Choi, and Young-Hoon Kim
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sudden cardiac arrest ,body-mass index ,waist circumference ,central obesity ,General Medicine - Abstract
Although obesity is a well-established risk factor of cardiovascular event, the linkage between obesity and sudden cardiac arrest (SCA) is not fully understood. Based on a nationwide health insurance database, this study investigated the impact of body weight status, measured by body-mass index (BMI) and waist circumference, on the SCA risk. A total of 4,234,341 participants who underwent medical check-ups in 2009 were included, and the influence of risk factors (age, sex, social habits, and metabolic disorders) was analyzed. For 33,345,378 person-years follow-up, SCA occurred in 16,352 cases. The BMI resulted in a J-shaped association with SCA risk, in which the obese group (BMI ≥ 30) had a 20.8% increased risk of SCA compared with the normal body weight group (18.5 ≤ BMI < 23.0) (p < 0.001). Waist circumference showed a linear association with the risk of SCA, with a 2.69-fold increased risk of SCA in the highest waist circumference group compared with the lowest waist circumference group (p < 0.001). However, after adjustment of risk factors, neither BMI nor waist circumference was associated with the SCA risk. In conclusion, obesity is not independently associated with SCA risk based on the consideration of various confounders. Rather than confining the findings to obesity itself, comprehensive consideration of metabolic disorders as well as demographics and social habits might provide better understanding and prevention of SCA.
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- 2023
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65. Combined epicardial and endocardial approach for redo radiofrequency catheter ablation in patients with persistent atrial fibrillation: a randomized clinical trial
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Kwang No Lee, Do Young Kim, Ki Yung Boo, Yun Gi Kim, Seung Young Roh, Jaemin Shim, Jong Il Choi, and Young Hoon Kim
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Male ,Treatment Outcome ,Physiology (medical) ,Atrial Fibrillation ,Catheter Ablation ,Tachycardia, Supraventricular ,Humans ,Female ,Middle Aged ,Cardiology and Cardiovascular Medicine ,Pericardium ,Endocardium - Abstract
Aims An epicardial approach is an effective means to detect and eliminate residual potentials in non-transmural lesions created during prior endocardial ablation. We sought to determine the impact of a combined epicardial and endocardial approach compared with a conventional endocardial approach, on recurrence-free survival after redo ablation. Methods and results Participants with recurred persistent atrial fibrillation after prior endocardial ablation were randomized (1:1) to undergo treatment with the combined approach (epicardial followed by endocardial ablation) for the treatment group or conventional approach (endocardial ablation only) for the control group. The primary outcome was the time to recurrence of atrial fibrillation or atrial tachycardia following a 90-day blanking period within 12 months after the procedure. The secondary safety outcome was the occurrence of procedure-related complications within 24 h after the procedure. Of 100 randomized participants {median age, 59.0 [(interquartile range (IQR): 53.8–64.3] years, including 16% women, with one prior ablation (IQR: 1–1)}, 93 (93%) completed the trial. Events relevant to the primary outcome occurred in 16 patients in the treatment group and in 21 patients in the control group {Kaplan–Meier estimator percentages, 32 vs. 42%; hazard ratio, 0.71 [95% confidence interval (CI): 0.37–1.37]}. The periprocedural complication rate was lower in the treatment group [2 vs. 16%; odds ratio, 0.11 (95% CI: 0.00–0.87)] with similar achievement of the procedural endpoint in the two groups. Conclusion In the redo procedure for persistent atrial fibrillation, the combined approach had no significant difference of recurrence-free survival and a lower procedural complication rate compared with the conventional approach.
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- 2022
66. 2021 Korean Heart Rhythm Society Guidelines for Catheter or Surgical Ablation of Atrial Fibrillation
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Woo-Hyun Lim, Jaemin Shim, Ji-Hyun Lee, and Boyoung Joung
- Abstract
Rhythm control therapy is used in atrial fibrillation (AF) management to improve AF-related symptoms along with rate control. AF catheter ablation is effective in maintaining sinus rhythm and has an acceptable complication rate. Compared with antiarrhythmic drugs, AF catheter ablation is superior with respect to arrhythmia-free survival and improvement in the quality of life. Therefore, AF ablation is recommended for rhythm control after the failure of antiarrhythmic drugs and is sometimes considered a first-line therapy for AF patients. Radiofrequency and cryoballoon ablation show similar efficacy, with slightly different complication profiles. Surgery for AF is also an effective rhythm control therapy and should be considered in patients undergoing cardiac surgery or in those with failed catheter ablation. For patients undergoing AF catheter ablation, performing ablation under uninterrupted warfarin or non-vitamin K oral anticoagulant treatment is recommended for periprocedural stroke risk management. Here, we review existing data and discuss the general principles of AF catheter and surgical ablation in patients with AF.
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- 2022
67. Overpromising Social Welfare Benefits? Electoral Competition and Welfare Politics in Taiwan
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Jaemin Shim
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Economics and Econometrics ,Sociology and Political Science ,Political Science and International Relations ,Development - Abstract
Drawing insights from legislative, electoral and welfare studies, the article investigates whether and to what extent electoral competition affects incumbent politicians’ overpromising of social welfare benefits. For this, Taiwan is chosen as the case and the article examines the fate of elite-level social welfare legislative proposals in the period between 1992 and 2016. Findings drawn from quantitative bill sponsorship patterns demonstrate that political elites tend to propose failure-prone social welfare bills during election periods. Moreover, this tendency grew even more clearly in tandem with the rising levels of electoral democracy. The article argues that the overpromising of social welfare benefits is likely due to cognitive biases on the voter side allowing politicians to make promises without necessarily facing the negative consequences of under-delivery. The article contributes to the comparative welfare state literature by adding much-needed nuance to the existing debates on the relationship between democratic deepening, electoral competition, and the development of welfare politics.
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- 2022
68. Being Underweight Is Associated with Increased Risk of Sudden Cardiac Death in People with Diabetes Mellitus
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Yun Gi Kim, Kyung-Do Han, Seung-Young Roh, Joo Hee Jeong, Yun Young Choi, Kyongjin Min, Jaemin Shim, Jong-Il Choi, and Young-Hoon Kim
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underweight ,diabetes mellitus ,General Medicine ,sudden cardiac death - Abstract
Background: Diabetes mellitus (DM) can cause various atherosclerotic cardiovascular disease including sudden cardiac death (SCD). The impact of being underweight on the risk of SCD in people with DM remains to be revealed. We aimed to evaluate the risk of SCD according to body-mass index (BMI; kg/m2) level in DM population. Methods: We used a nationwide healthcare insurance database to conduct this study. We identified people with DM among those who underwent nationwide health screening during 2009 to 2012. Medical follow-up data was available until December 2018. Results: A total of 2,602,577 people with DM with a 17,851,797 person*year follow-up were analyzed. The underweight group (BMI < 18.5) showed 2.4-fold increased risk of SCD during follow-up (adjusted-hazard ratio [HR] = 2.40; 95% confidence interval [CI] = 2.26–2.56; p < 0.001). When normal-BMI group (18.5 ≤ BMI < 23) was set as a reference, underweight group (adjusted-HR = 2.01; 95% CI = 1.88–2.14) showed even higher risk of SCD compared with the obesity group (BMI ≥ 30; adjusted-HR = 0.89; 95% CI = 0.84–0.94). When BMI was stratified by one unit, BMI and SCD risk showed a U-curve association with the highest risk observed at low BMI levels. The lowest risk was observed in 27 ≤ BMI < 28 group. The association between being underweight and increased SCD risk in DM people was maintained throughout various subgroups. Conclusions: Being underweight is significantly associated with an increased risk of SCD in the DM population. A steep rise in the risk of SCD was observed as the BMI level decreased below 23. The lowest risk of SCD was observed in 27 ≤ BMI < 28 group.
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- 2023
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69. PO-05-165 COMPARATIVE BLEEDING RISK IN PATIENTS WITH ATRIAL FIBRILLATION WITH CANCER VERSUS WITHOUT CANCER FROM NATIONWIDE PROSPECTIVE COHORT: CODE-AF REGISTRY
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KI-WOON KANG, David Shin, Seung Young Shin, Jun Kim, Eue-Keun Choi, Myung-Jin Cha, Jung Myung Lee, Jin-bae Kim, junbeom Park, Jin-Kyu Park, Tae-Hoon Kim, Jae-Sun Uhm, Jaemin Shim, Young Soo Lee, Hyung Wook Park, Changsoo Kim, and Boyoung Joung
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
70. Atrial fibrillation is associated with increased risk of lethal ventricular arrhythmias
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Jong Il Choi, Ha Young Choi, Yun Young Choi, Kyongjin Min, Jaemin Shim, Younghoon Kim, Kyungdo Han, and Yun Gi Kim
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medicine.medical_specialty ,Databases, Factual ,Science ,Population ,Cardiology ,Kaplan-Meier Estimate ,Ventricular tachycardia ,Risk Assessment ,Article ,Electrocardiography ,Medical research ,Internal medicine ,Atrial Fibrillation ,Republic of Korea ,medicine ,Humans ,education ,education.field_of_study ,Multidisciplinary ,business.industry ,Incidence (epidemiology) ,Atrial fibrillation ,medicine.disease ,Prognosis ,Ventricular flutter ,Increased risk ,Risk factors ,Heart failure ,Ventricular fibrillation ,Heart Function Tests ,Ventricular Fibrillation ,Medicine ,Disease Susceptibility ,business ,Biomarkers - Abstract
Atrial fibrillation (AF) is associated with various major adverse cardiac events such as ischemic stroke, heart failure, and increased overall mortality. However, its association with lethal ventricular arrhythmias such as ventricular tachycardia (VT), ventricular flutter (VFL), and ventricular fibrillation (VF) is controversial. We conducted this study to determine whether AF can increase the risk of VT, VFL, and VF. We utilized the Korean National Health Insurance Service database for this nationwide population-based study. This study enrolled people who underwent a nationwide health screen in 2009 for whom clinical follow-up data were available until December 2018. Primary outcome endpoint was the occurrence of VT, VFL, or VF in people who were and were not diagnosed with new-onset AF in 2009. We analyzed a total of 9,751,705 people. In 2009, 12,689 people were diagnosed with new-onset AF (AF group). The incidence (events per 1000 person-years of follow-up) of VT, VFL, and VF was 2.472 and 0.282 in the AF and non-AF groups, respectively. After adjustment for covariates, new-onset AF was associated with 4.6-fold increased risk (p
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- 2021
71. A prospective, observational study of rivaroxaban for stroke prevention in atrial fibrillation: the XANAP Korea
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Seung-Woon Rha, Nam-Ho Kim, Young Hoon Kim, Keun-Sik Hong, Gi-Byoung Nam, Dong-Gu Shin, Jaemin Shim, Moon Hyoung Lee, Young Keun On, Pierre Amarenco, Joung-Ho Rha, Sun U. Kwon, and Hyung Wook Park
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Male ,medicine.medical_specialty ,Asia ,Population ,korea ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Republic of Korea ,medicine ,Humans ,atrial fibrillation ,Prospective Studies ,education ,Stroke ,rivaroxaban ,Aged ,Rivaroxaban ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Anticoagulants ,Atrial fibrillation ,medicine.disease ,stroke ,Treatment Outcome ,Editorial ,Stroke prevention ,Medicine ,030211 gastroenterology & hepatology ,Observational study ,business ,Factor Xa Inhibitors ,medicine.drug ,Cohort study - Abstract
Background/Aims Atrial fibrillation (AF)-related stroke accounts for 20% of ischemic strokes. Rivaroxaban use in AF patients for preventing stroke and systemic embolism was approved in 2013 in Korea. This study was to investigate the safety and effectiveness of rivaroxaban use in Korean patients with non-valvular AF in a real-world setting. Methods This was an analysis of the Korean patients in Xarelto for Prevention of Stroke in Patients with Atrial Fibrillation in Asia-Pacific (XANAP), which was a prospective, observational cohort study including patients with non-valvular AF starting rivaroxaban treatment to prevent stroke or non-central nervous system systemic embolism (non-CNS SE), conducted in 10 Asian countries. Results A total of 844 patients were enrolled in the Korean portion of the XANAP study. In XANAP Korea, the mean age was 70.1 years and 62.6% were males. The mean CHADS2 score was 2.5 and the mean CHA2DS2-VASc score was 3.8. 47% of the patients had experienced prior stroke or non-CNS SE or transient ischemic attack. 73.6% of the patients had CHADS2 score ≥ 2. Incidence proportions of 0.8% of the patients (1.1 per 100 patient-years) developed adjudicated treatment-emergent major bleeding. Death was observed in 1.2% of the patients. The incidence of non-major bleeding as well as thromboembolic event were 8.4% (11.6 per 100 patient-years) and 1.5% (2.0 per 100 patient-years), respectively. Conclusions This study reaffirmed the consistent safety profile of rivaroxaban. We found consistent results with overall XANAP population for rivaroxaban in terms of safety in non-valvular AF patients for the prevention of stroke and non-CNS SE.
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- 2021
72. Clinical Significance of Adenosine-Induced Atrial Fibrillation after Complete Pulmonary Vein Isolation
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Yun Young Choi, Jaemin Shim, Yun Gi Kim, Kyongjin Min, Seung-Young Roh, Jin Seok Kim, Jong-Il Choi, and Young-Hoon Kim
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General Medicine ,atrial fibrillation ,adenosine ,recurrence ,radiofrequency catheter ablation - Abstract
Background: Adenosine can cause dormant electrical conduction between the pulmonary vein and left atrium after pulmonary vein isolation (PVI). Adenosine can also induce atrial fibrillation (AF) during catheter ablation. However, the clinical outcomes and effects of additional ablation for the trigger sites of adenosine-induced AF (AIAF) are unknown. This study therefore aimed to evaluate the clinical significance of AIAF. Methods: Between January 2010 and September 2019, we analyzed 616 consecutive patients with paroxysmal AF (PAF) who underwent radiofrequency catheter ablation (RFCA), including wide-area circumferential pulmonary vein isolation (PVI) and post-PVI adenosine testing. Results: Among 616 patients, 134 (21.7%) and 34 (5.5%) showed dormant conduction and AIAF, respectively. Eight patients (1.3%) had both dormant conduction and AIAF. The AF recurrence rate was not significantly different between patients with and without AIAF (16.7% vs. 18.6%, log-rank p = 0.827) during a mean follow-up period of 17.9 ± 18 months. Additional RFCA for the trigger site was attempted in 10 patients with AIAF; however, the recurrence rate of atrial arrhythmias was also not different between the groups with and without additional ablation (20% vs. 16.7%, log-rank p = 0.704). Conclusions: AIAF after PVI was not clinically associated with recurrence during long-term follow-up. Ablation of the trigger site in AIAF did not improve the clinical outcomes.
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- 2022
73. A Watch-Type Electrocardiography Is a Reliable Tool for Detecting Paroxysmal Cardiac Arrhythmias
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Yun Gi Kim, Jong-Il Choi, Hee-Jung Kim, Kyongjin Min, Yun Young Choi, Jaemin Shim, Ho Sung Son, and Young-Hoon Kim
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arrhythmia ,wearable device ,electrocardiography ,smartwatch ,watch-type ECG ,cardiovascular system ,General Medicine ,cardiovascular diseases - Abstract
Background: A substantial proportion of cardiac arrhythmias are paroxysmal in nature, and 12-lead electrocardiography (ECG) and Holter monitoring often fail to detect paroxysmal arrhythmias. We designed and evaluated a watch-type, electrocardiograph-recording, wearable device (w-ECG) to overcome the limitations of 12-lead ECG and Holter monitoring. Methods: We prospectively enrolled 96 patients with symptoms assumed to be related to cardiac arrhythmias. Electrocardiography recording was performed with both the w-ECG and Holter monitoring. Detection of any arrhythmia was the primary outcome endpoint and was compared between the w-ECG and Holter monitoring. Results: Any arrhythmia was detected in 51 (53.1%) and 27 (28.1%) patients by the w-ECG and Holter monitoring, respectively (odds ratio (OR) = 2.9, p < 0.001). The w-ECG was superior to Holter monitoring for the detection of clinically significant arrhythmias (excluding atrial premature contraction, ventricular premature contraction, and non-sustained atrial tachyarrhythmia) (OR = 2.34, p = 0.018). In 27 (28.1%) patients, cardiac arrhythmias were detected only by the w-ECG, with atrial fibrillation being the most frequent case (13 patients). Based on ECGs recorded by using the w-ECG, 17 patients (17.7%) received therapeutic interventions, including radiofrequency catheter ablation. Conclusions: The w-ECG is capable of recording ECGs of good quality, with a discernable P wave and distinguishable QRS morphology. The ability of the w-ECG to detect cardiac arrhythmias was significantly better than that of Holter monitoring, and a significant proportion of patients received therapeutic intervention based on ECGs recorded by the w-ECG.
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- 2022
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74. The Politicization of Social Investment in the Media and Legislature in North East Asia
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Jaemin Shim
- Abstract
This chapter examines the agenda-setting politics of social investment issues in Japan, South Korea, and Taiwan since 1990, based on newspaper articles and bill sponsorship records. The findings reveal that, in all three countries, social investment issues have increasingly gained legislative and media saliency and presented mostly as a problem-driven valence issue, for example, in tackling an aging society and the low-fertility crisis. However, cross-national differences do exist in terms of the primary function that social investment serves as well as the extent to which the legislature mirrors the media. The chapter’s second half examines the effect of partisanship on social investment agenda-setting in the legislature. The results demonstrate that, on the one hand, partisanship is not an important factor in deciding whether a social investment bill is introduced. On the other hand, the effect of partisanship is visibly related to the choice of the type of social investment strategy.
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- 2022
75. Different Influence of Blood Pressure on New-Onset Atrial Fibrillation in Pre- and Postmenopausal Women
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Kyungdo Han, Do Young Kim, Ha Young Choi, Younghoon Kim, Jin Seok Kim, Jaemin Shim, Yun Young Choi, Yun Gi Kim, Jong Il Choi, and Seung Young Roh
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medicine.medical_specialty ,Blood Pressure ,030204 cardiovascular system & hematology ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Atrial Fibrillation ,Internal Medicine ,Humans ,Medicine ,Aged ,Postmenopausal women ,business.industry ,Atrial fibrillation ,Middle Aged ,medicine.disease ,Health Surveys ,New onset atrial fibrillation ,Postmenopause ,Population based study ,Menopause ,Blood pressure ,Hypertension ,Cardiology ,Female ,business ,030217 neurology & neurosurgery - Abstract
The characteristics of hypertension in pre- and postmenopausal women are different. Hypertension is a known risk factor for new-onset atrial fibrillation (AF), but its interaction with the menopause state is not fully established. We investigated whether menopause influences the adverse impact of high blood pressure on new-onset AF using a nationwide population-based cohort in Korea. People who underwent both a national health check-up and national cancer screening program were included in this study. A total of 3 280 834 women were assessed with 23 781 070 person*year follow-up data. Menopause was observed in 1 439 161 women. The risk of new-onset AF and blood pressure showed a linear relationship in premenopausal women ( P P for interaction
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- 2021
76. Stroke and systemic embolism in patients with atrial fibrillation and heart failure according to heart failure type
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Jaemin Shim, Ki Woon Kang, Jung Myung Lee, Junbeom Park, Nak Hoon Son, Jae Sun Uhm, Hee Tae Yu, Eue Keun Choi, Myung Jin Cha, Jun Kim, Hyung Wook Park, Boyoung Joung, Jin Bae Kim, Ji Eun Mun, Young Soo Lee, Jin-Kyu Park, So Ryoung Lee, Changsoo Kim, and Tae Hoon Kim
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Male ,medicine.medical_specialty ,Ejection fraction ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Embolism ,Heart failure ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Original Research Articles ,medicine ,Humans ,Cumulative incidence ,030212 general & internal medicine ,Original Research Article ,Risk factor ,Stroke ,Aged ,business.industry ,Incidence (epidemiology) ,Hazard ratio ,Bleeding ,Atrial fibrillation ,Stroke Volume ,Middle Aged ,medicine.disease ,Prognosis ,lcsh:RC666-701 ,Cardiology ,Systemic embolism ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims This study aimed to elucidate the risk for stroke and systemic embolism (SE) in patients with atrial fibrillation and heart failure (HF) according to HF type. Methods and results A total of 10 780 patients with atrial fibrillation were enrolled in a multicentre prospective registry and divided according to HF type: no‐HF, HF with preserved ejection fraction (EF) (HFpEF), HF with mid‐range EF (HFmrEF), and HF with reduced EF (HFrEF). Each group included 237 age‐matched and sex‐matched patients (age, 69.0 ± 10.3 years; men, 69.6%). The baseline characteristics, cumulative incidence, and hazard ratios for stroke/SE and major bleeding were compared across the groups. Patients with HF accounted for 10.3% of the total population; HFpEF, HFmrEF, and HFrEF represented 43.7%, 23.6%, and 32.7% of the patients with HF, respectively. The CHA2DS2‐VASc score was significantly higher in the HFpEF, HFmrEF, and HFrEF groups than in the no‐HF group. The annual stroke/SE incidence rates were 2.8%, 0.7%, 1.1%, and 0.9% in the HFpEF, HFmrEF, HFrEF, and no‐HF groups, respectively. The cumulative incidence of stroke/SE was significantly highest in the HFpEF group at 22.8 ± 10.0 months (P = 0.020). The stroke/SE risk was higher in the HFpEF group than in the HFmrEF and HFrEF groups (hazard ratio, 3.192; 95% confidence interval, 1.039–9.810; P = 0.043). E/e' value was an independent risk factor for stroke/SE. There were no significant differences in the incidence of major bleeding across the groups. Conclusions The stroke/SE risk was the highest in the HFpEF group and comparable between the HFmrEF and HFrEF groups.
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- 2021
77. Impact of carotid atherosclerosis in CHA2DS2-VASc-based risk score on predicting ischemic stroke in patients with atrial fibrillation
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Jimi Choi, Yun Gi Kim, Dong-Hyuk Cho, Suk Kyu Oh, Young Hoon Kim, Hyungdon Kook, Seong Mi Park, Jong Il Choi, Wan Joo Shim, Jaemin Shim, and Kwang No Lee
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Carotid Artery Diseases ,medicine.medical_specialty ,Diastole ,Cardiology ,Carotid Intima-Media Thickness ,Brain Ischemia ,Risk Factors ,Internal medicine ,medicine ,Humans ,atrial fibrillation ,cardiovascular diseases ,Risk factor ,Stroke ,Ischemic Stroke ,Framingham Risk Score ,business.industry ,Vascular disease ,Hazard ratio ,risk assessment ,Atrial fibrillation ,medicine.disease ,carotid stenosis carotid intima media thickness ,stroke ,Blood pressure ,cardiovascular system ,Medicine ,Original Article ,business - Abstract
Background/Aims Vascular disease is an established risk factor for stroke in patients with atrial fibrillation (AF), which is included in CHA2DS2-VASc score. However, the role of carotid atherosclerosis remains to be determined. Methods Three hundred-ten patients with AF who underwent carotid sonography were enrolled. Results During a median follow-up of 31 months, 18 events (5.8%) of stroke were identified. Patients with stroke had higher carotid intima-media thickness (CIMT) (1.16 ± 0.33 mm vs. 0.98 ± 0.25 mm, p = 0.017). CIMT was significantly increased according to the CHA2DS2-VASc score (p < 0.001) and it was correlated with left ventricular mass index and early diastolic mitral annular velocity (e’), a ratio of early transmitral flow velocity to e’ (E/e’) and pulmonary artery systolic pressure (all p < 0.05). Cox regression using multivariate models showed that carotid plaque was associated with the risk of stroke (hazard ratio, 3.748; 95% confidence interval [CI], 1.107 to 12.688; p = 0.034). C-statistics increased from 0.648 (95% CI, 0.538 to 0.757) to 0.716 (95% CI, 0.628 to 0.804) in the CHA2DS2-VASc score model after the addition of CIMT and carotid plaque as a vascular component (p = 0.013). Conclusions Increased CIMT and presence of carotid plaque are associated with a high risk of ischemic stroke, and CIMT is related to myocardial remodeling and diastolic dysfunction, suggesting that carotid atherosclerosis can improve risk prediction of stroke in patients with AF, when included under vascular disease in the CHA2DS2-VASc scoring system.
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- 2021
78. PO-03-225 ALCOHOL AND THE RISK OF ALL-CAUSE DEATH, ATRIAL FIBRILLATION, VENTRICULAR ARRHYTHMIA, AND SUDDEN CARDIAC ARREST
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Jong-Il Choi, Yun Gi Kim, Hyoung Seok Lee, JOO HEE JEONG, Yun Young Choi, Jaemin Shim, Young-Hoon Kim, and KYONGJIN MIN
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
79. PO-05-123 UNUSUAL VENTRICULAR ENTRAINMENT RESPONSE IN ATYPICAL ATRIOVENTRICULAR NODAL REENTRANT TACHYCARDIA (AVNRT): WHAT’S THE MECHANISM?
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Man Wah, Amy Chu, Jaemin Shim, Hyoung Seok Lee, JOO HEE JEONG, Jue Seong Lee, Yun Young Choi, Yun Gi Kim, Jong-Il Choi, and Young-Hoon Kim
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
80. PO-01-176 ASSOCIATION BETWEEN LOW-DENSITY LIPOPROTEIN CHOLESTEROL AND SUDDEN CARDIAC ARREST IN PEOPLE WITH DIABETES MELLITUS
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Joo Hee Jeong, Yun Gi Kim, Kyongjin Min, Hyoung Seok Lee, Yun Young Choi, Seung-Young Roh, Jaemin Shim, Kyung-Do Han, Young-Hoon Kim, and Jong-Il Choi
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
81. Comparative occurrence of ischemic stroke with the rhythm versus rate control strategy in a national prospective cohort of atrial fibrillation
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Myung Jin Cha, Jin-Kyu Park, Ki Woon Kang, Jun Kim, Tae Hoon Kim, Junbeom Park, Jin Bae Kim, Boyoung Joung, Changsoo Kim, Eue Keun Choi, Hyung Wook Park, Young Soo Lee, Jung Myung Lee, Jae Sun Uhm, Jae Guk Kim, and Jaemin Shim
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Male ,medicine.medical_specialty ,Cardiology ,Lower risk ,Risk Assessment ,rhythm ,Brain Ischemia ,03 medical and health sciences ,0302 clinical medicine ,Rhythm ,Risk Factors ,Internal medicine ,Republic of Korea ,medicine ,Humans ,atrial fibrillation ,Prospective Studies ,Prospective cohort study ,Stroke ,Aged ,Ischemic Stroke ,business.industry ,Rate control ,Anticoagulants ,Atrial fibrillation ,Middle Aged ,medicine.disease ,stroke ,rate ,Propensity score matching ,Ischemic stroke ,Medicine ,030211 gastroenterology & hepatology ,Original Article ,business - Abstract
Background/Aims: Comparative occurrence of ischemic stroke for rhythm versus rate control strategy in patients with non-valvular atrial fibrillation (NVAF) is still inconclusive. The purpose of this study was to investigate whether the rhythm control strategy is associated with a lower risk of ischemic stroke compared to the rate control strategy in NVAF patients. Methods: The CODE-AF registry prospectively enrolled 6,280 consecutive pa tients who were treated for NVAF at 10 tertiary referral centers in South Korea. Of these, 2,513 NVAF patients (age, 67 ± 10 years; male, 61.8%) were clinically followed up for over 1-year and divided into rate and rhythm control groups. Results: Those treated with the rhythm control strategy were younger and had less proportions of underlying disease compared to those treated with the rate control strategy. After the propensity matching analysis, those treated with the rhythm control strategy had similar baseline characteristics including the CHA2DS2-VASC score compared to those treated with the rate control strategy. The rate of oral anticoagulation, all bleeding, and hospitalization were also simi larly between the two groups. The incidence rate of ischemic stroke in the rhythm control group was significantly lower than in the rate control group (0.7 vs. 6.9 per 1,000 person-years, p = 0.011). Conclusions: The rhythm control strategy demonstrated a beneficial effect to lower the risk of ischemic stroke during a 1-year follow-up compared to the rate control strategy.
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- 2021
82. Prevalence and Predictors of Clinically Relevant Atrial High-Rate Episodes in Patients with Cardiac Implantable Electronic Devices
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Jaemin Shim, Hyung Seob Park, Il Young Oh, Boyoung Joung, Min Kim, Junbeom Park, Hee Tae Yu, Ki Woon Kang, Tae Hoon Kim, Young Soo Lee, Eue Keun Choi, and Jung Hoon Sung
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medicine.medical_specialty ,Left atrium ,Sick sinus syndrome ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Internal medicine ,Internal Medicine ,medicine ,In patient ,030212 general & internal medicine ,Original Research ,medicine.diagnostic_test ,business.industry ,Atrial fibrillation ,Odds ratio ,medicine.disease ,Confidence interval ,medicine.anatomical_structure ,Pacemaker, artificial ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Electrocardiography ,Arrhythmia - Abstract
Background and objectives Atrial high-rate episodes (AHREs) can be continuously detected by cardiovascular implantable electronic devices (CIEDs); however, the predictors of clinically relevant AHREs are unclear. Methods This prospective multicenter study monitored 816 patients (median age 73 years, 40.4% male) without atrial fibrillation (AF) from September 2017 to July 2020. AHREs was defined as a programmed atrial detection rate >220 beats/min. The reference values of 6 minutes and 6 hours were set to analyze clinical implication of AHREs based on previously published data that the 6 minutes excluded most episodes of oversensing. Results During a median follow-up of 18 months (interquartile interval 9-26 months), AHREs with the longest durations of >15 seconds, >6 minutes, and >6 hours and clinically documented AF by electrocardiography were noted in 246 (30.1%), 112 (13.7%), 49 (6.0%), and 24 (2.9%) patients, respectively. Among patients developing AHREs >6 minutes, 102 (91.1%) of 112 patients were identified at the 6-month visit. Patients with AHREs >6 minutes had higher proportions of sick sinus syndrome, subjects with atrial premature beat >1% on Holter monitoring, and larger left atrium (LA) size than patients with AHREs ≤6 minutes. Multivariable logistic regression analysis showed that LA diameter >41 mm (odds ratio [OR], 2.08; 95% confidence interval [95% CI], 1.25-3.45), and sick sinus syndrome (OR, 3.22; 95% CI, 1.91-5.43) were associated with AHREs >6 minutes. Conclusions In patients with LA diameter >41 mm, and sick sinus syndrome before CIEDs implantation is associated with risk of developing AHREs >6 minutes. Trial registration ClinicalTrials.gov Identifier: NCT03303872.
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- 2020
83. Sex-Related Differences in Left Atrial Low-Voltage Areas According to CHA2DS2-VA Scores among Patients with Atrial Fibrillation
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Do Young Kim, Yun Gi Kim, Ha Young Choi, Yun Young Choi, Ki Yung Boo, Kwang-No Lee, Seung-Young Roh, Jaemin Shim, Jong-Il Choi, and Young-Hoon Kim
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atrial fibrillation ,catheter ablation ,female ,sex ,electro-anatomical remodeling ,low voltage area ,General Medicine - Abstract
(1) Background: We hypothesized that female sex would have a differential impact on left atrial (LA) low-voltage areas (LVAs) according to CHA2DS2-VA scores. (2) Methods: This study included 553 patients who underwent radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF). LVAs were defined as regions with bipolar peak-to-peak voltages of
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- 2022
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84. Metabolic Syndrome, Gamma-Glutamyl Transferase, and Risk of Sudden Cardiac Death
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Yun Gi Kim, Kyungdo Han, Joo Hee Jeong, Seung-Young Roh, Yun Young Choi, Kyongjin Min, Jaemin Shim, Jong-Il Choi, and Young-Hoon Kim
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congenital, hereditary, and neonatal diseases and abnormalities ,hemic and lymphatic diseases ,General Medicine ,gamma-glutamyl transferase ,metabolic syndrome ,sudden cardiac death - Abstract
Background: Metabolic syndrome is associated with a significantly increased risk of sudden cardiac death (SCD). However, whether temporal changes in the metabolic syndrome status are associated with SCD is unknown. We aimed to determine whether metabolic syndrome and gamma-glutamyl transferase (ɣ-GTP), including their temporal changes, are associated with the risk of SCD. Methods: We performed a nationwide population-based analysis using the Korean National Health Insurance Service. People who underwent a national health check-up in 2009 and 2011 were enrolled. The influence of metabolic syndrome and ɣ-GTP on SCD risk was evaluated. Results: In 2009, 4,056,423 (848,498 with metabolic syndrome) people underwent health screenings, 2,706,788 of whom underwent follow-up health screenings in 2011. Metabolic syndrome was associated with a 50.7% increased SCD risk (adjusted hazard ratio (aHR) = 1.507; p < 0.001). The SCD risk increased linearly as the metabolic syndrome diagnostic criteria increased. The ɣ-GTP significantly impacted the SCD risk; the highest quartile had a 51.9% increased risk versus the lowest quartile (aHR = 1.519; p < 0.001). A temporal change in the metabolic syndrome status and ɣ-GTP between 2009 and 2011 was significantly correlated with the SCD risk. Having metabolic syndrome in 2009 or 2011 indicated a lower SCD risk than having metabolic syndrome in 2009 and 2011 but a higher risk than having no metabolic syndrome. People with a ≥20-unit increase in ɣ-GTP between 2009 and 2011 had an 81.0% increased SCD risk versus those with a change ≤5 units (aHR = 1.810; p < 0.001). Conclusions: Metabolic syndrome and ɣ-GTP significantly correlated with an increased SCD risk. SCD was also influenced by temporal changes in the metabolic syndrome status and ɣ-GTP, suggesting that appropriate medical treatment and lifestyle modifications may reduce future SCD risk.
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- 2022
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85. Effect of alcohol consumption on the risk of adverse events in atrial fibrillation: from the COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation (CODE-AF) registry
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Jun Kim, Tae Hoon Kim, Junbeom Park, Hee Tae Yu, Jae Sun Uhm, Jin Bae Kim, Hyung Wook Park, So Ryoung Lee, Boyoung Joung, Jin-Kyu Park, Young Soo Lee, Ki Woon Kang, Jung Myung Lee, Eue Keun Choi, Myung Jin Cha, Chewan Lim, and Jaemin Shim
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medicine.medical_specialty ,Alcohol Drinking ,Population ,030204 cardiovascular system & hematology ,Risk Assessment ,Brain Ischemia ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Physiology (medical) ,Internal medicine ,Atrial Fibrillation ,medicine ,Humans ,Registries ,Adverse effect ,education ,Stroke ,education.field_of_study ,business.industry ,Hazard ratio ,Anticoagulants ,Atrial fibrillation ,medicine.disease ,Confidence interval ,Pharmaceutical Preparations ,Heart failure ,Propensity score matching ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
Aims The aim of this study is to determine the relationship between alcohol consumption and atrial fibrillation (AF)-related adverse events in the AF population. Methods and results A total of 9411 patients with nonvalvular AF in a prospective observational registry were categorized into four groups according to the amount of alcohol consumption—abstainer-rare, light ( Conclusion Our findings suggest that heavy alcohol consumption increases the risk of adverse events in patients with AF, whereas light or moderate alcohol consumption does not.
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- 2020
86. Non-genetic risk factors for atrial fibrillation are equally important in both young and old age: A nationwide population-based study
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Jaemin Shim, Jong Il Choi, Yun Gi Kim, Yun Young Choi, Younghoon Kim, Yong Gyu Park, Jin Seok Kim, Kwang No Lee, Do-Young Kim, Ha Young Choi, Ki Yung Boo, and Kyungdo Han
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Male ,Pediatrics ,medicine.medical_specialty ,Epidemiology ,030204 cardiovascular system & hematology ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Diabetes mellitus ,Primary prevention ,Atrial Fibrillation ,Diabetes Mellitus ,Humans ,Medicine ,030212 general & internal medicine ,Genetic risk ,business.industry ,Incidence ,Atrial fibrillation ,medicine.disease ,Obesity ,Population based study ,Hypertension ,Cardiology and Cardiovascular Medicine ,business ,Alcohol consumption - Abstract
Aims There are several non-genetic risk factors for new-onset atrial fibrillation, including age, sex, obesity, hypertension, diabetes, and alcohol consumption. However, whether these non-genetic risk factors have equal significance among different age groups is not known. We performed a nationwide population-based analysis to compare the clinical significance of non-genetic risk factors for new-onset atrial fibrillation in various age groups. Methods and results A total of 9,797,409 people without a prior diagnosis of atrial fibrillation who underwent a national health check-up in 2009 were included. During 80,130,090 person-years of follow-up, a total of 196,136 people were diagnosed with new-onset atrial fibrillation. The impact of non-genetic risk factors on new-onset atrial fibrillation was examined in different age groups. Obesity, male sex, heavy alcohol consumption, smoking, hypertension, diabetes and chronic kidney disease were associated with an increased risk of new-onset atrial fibrillation. With minor variations, these risk factors were consistently associated with the risk of new-onset atrial fibrillation among various age groups. Using these risk factors, we created a scoring system to predict future risk of new-onset atrial fibrillation in different age groups. In receiver operating characteristic curve analysis, the predictive value of these risk factors ranged between 0.556 and 0.603, and no significant trends were observed. Conclusions Non-genetic risk factors for new-onset atrial fibrillation may have a similar impact on different age groups. Except for sex, these non-genetic risk factors can be modifiable. Therefore, efforts to control non-genetic risk factors might have relevance for both the young and old.
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- 2020
87. Differences in anticoagulation strategy and outcome in atrial fibrillation patients with chronic kidney disease: a CODE-AF registry study
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Jin-Kyu Park, Boyoung Joung, Jung-Myung Lee, Myung Jin Cha, Changsoo Kim, Ki-Woon Kang, Tae Hoon Kim, Young Soo Lee, Jun Kim, Jin Bae Kim, Jae Sun Uhm, Junbeom Park, Jaemin Shim, Yeon-Jik Choi, Eue Keun Choi, and Hyung Wook Park
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medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Renal function ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,Dabigatran ,03 medical and health sciences ,Anticoagulation ,0302 clinical medicine ,Internal medicine ,medicine ,030212 general & internal medicine ,Stroke ,Aspirin ,Rivaroxaban ,Kidney diseases ,business.industry ,Atrial fibrillation ,General Medicine ,medicine.disease ,lcsh:RC666-701 ,Apixaban ,business ,medicine.drug ,Kidney disease - Abstract
PurposeDose reduction of non-vitamin K antagonist oral anticoagulants (NOACs) is indicated in patients with atrial fibrillation (AF) with renal impairment. This study investigated anticoagulation patterns and outcomes in patients with chronic kidney disease (CKD).Materials and methodsIn a prospective observational registry (CODE-AF), 3445 patients with non-valvular AF including 1129 with CKD (estimated glomerular filtration rate ≤ 60 mL min−1 1.73 m−2) were identified between June 1, 2016, and July 3, 2017.ResultsCompared with patients with no-CKD, patients with CKD more frequently had a high stroke risk (94.9% vs. 67.0%,p p p = 0.001) and rivaroxaban (0% vs. 79.5%,p = 0.001) were lower in patients with RIDR. However, the underdose rate of apixaban was not different (62.5% vs. 53.9%,p = 0.089). The overdose rate of dabigatran (7.5% vs. 0%) and rivaroxaban (13.7% vs. 0%) was higher in RIDR than in no-RIDR patients. Stroke/transient ischemic attack was significantly higher in CKD patients (1.4 vs. 0.6 per 100 person-years,p = 0.045). Aspirin significantly increased minor bleeding in CKD patients compared with controls (p = 0.037).ConclusionCKD patients might have a high stroke risk and NOAC usage rate. The underdose rate of NOACs decreased in CKD patients, except for apixaban. Aspirin significantly increased minor bleeding in CKD patients.
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- 2020
88. Gender Politics and Legislative Networks in Taiwan: An Analysis of Women-Bill Co-Sponsorship and Bill Success
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Jaemin Shim
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Sociology and Political Science ,05 social sciences ,Substantive representation ,Legislature ,Public administration ,Legislative process ,050601 international relations ,0506 political science ,Odds ,Politics ,Political science ,050602 political science & public administration ,Democratization ,Law ,Legislator - Abstract
This article examines how legislative networks can be utilised to further the interests of female voters. Specifically, I investigate how legislators’ gender and partisanship within co-sponsorship networks are related to the successful passage of women bills. For this goal, the article focusses on Taiwan—where both women’s descriptive and substantive representations have improved dramatically since democratisation and, at the same time, co-sponsoring bills have been a legislative process of the ongoing significance. The article utilises an original bill co-sponsorship dataset that consists of 232,734 co-sponsors related to all bills submitted between 2005 and 2016. By comparing women and non-women bills, the article demonstrates that the legislative effectiveness on women bills varied by legislator’s gender and affiliated party. That is, the proportion of male legislators in the co-sponsorship network did not effect on women bill success, while it turned out to be positively related to non-women bill success. Moreover, the proportion of right-leaning party legislators in the co-sponsorship network decreased the odds of women bill passage while increasing the chance of non-women bill ones. Despite the increasing participation of male legislators and right-leaning party legislators in co-sponsoring women’s issues in Taiwan, the results demonstrate that their role was limited on the success of women bills.
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- 2020
89. Stroke and Systemic Embolism and Other Adverse Outcomes of Heart Failure With Preserved and Reduced Ejection Fraction in Patients With Atrial Fibrillation (from the COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation [CODE-AF])
- Author
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Jun Kim, Jin Bae Kim, Boyoung Joung, Ki Woon Kang, Changsoo Kim, Seyong Chung, Myung Jin Cha, Young Soo Lee, Eue Keun Choi, Jae Sun Uhm, Tae Hoon Kim, Hyung Wook Park, Jin-Kyu Park, Jung Myung Lee, Junbeom Park, and Jaemin Shim
- Subjects
Male ,medicine.medical_specialty ,Heart Ventricles ,Embolism ,Administration, Oral ,030204 cardiovascular system & hematology ,Risk Assessment ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Atrial Fibrillation ,Republic of Korea ,medicine ,Humans ,Cumulative incidence ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Stroke ,Aged ,Heart Failure ,Ejection fraction ,business.industry ,Incidence ,Hazard ratio ,Anticoagulants ,Stroke Volume ,Atrial fibrillation ,Middle Aged ,Prognosis ,medicine.disease ,Survival Rate ,Echocardiography ,Heart failure ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,Complication ,business ,Follow-Up Studies - Abstract
It is unknown whether heart failure (HF) with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF) carry a similar risk of stroke or systemic embolism (SE) and other outcomes in patients with nonvalvular atrial fibrillation (AF). A prospective, multicenter outpatient registry with echocardiographic data which enrolled 10,589 patients from June 2016 to May 2019 was analyzed. In this registry, 935 (8.8%) patients had HF, and the proportions of patients with HFpEF and HFrEF were 43.2% and 56.8%, respectively. During follow-up over 1.33 years, 11 (2.07 per 100 person-years [PYR]) and 5 (0.76 per 100 PYR) patients had stroke/SE in the HFpEF and HFrEF groups, respectively, whereas 102 patients (0.84 per 100 PYR) had these sequelae in the no-HF group. The HFpEF group had a significantly higher cumulative incidence of stroke/SE (p = 0.004) and risk of stroke/SE (adjusted hazard ratio [HR] 2.23, 95% confidence interval [CI] 1.19 to 4.18) than the no-HF group. The risk of stroke/SE in the HFpEF group compared with that in the no-HF group was consistently increased even in patients on oral anticoagulation therapy (adjusted HR 2.55, 95% CI 1.31 to 4.96). There was a correlation between larger left atrial size and risk of stroke/SE (adjusted HR 1.53, 95% CI 1.03 to 2.29), but not between reduced left ventricular ejection fraction and this risk. In conclusion, these results suggest that strict oral anticoagulation therapy helps reduce the risk of stroke/SE in patients with nonvalvular AF and HFpEF, especially in those with a larger left atrial size.
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- 2020
90. A prospective survey of the persistence of warfarin or NOAC in nonvalvular atrial fibrillation: a COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation (CODE-AF)
- Author
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Junbeom Park, Jun Kim, Young Soo Lee, Changsoo Kim, Jin Bae Kim, Hyeongsoo Kim, Eue Keun Choi, Jung Myung Lee, Jaemin Shim, Hyung Wook Park, Boyoung Joung, Myung Jin Cha, Tae Hoon Kim, Jae Sun Uhm, Jin-Kyu Park, and Ki Woon Kang
- Subjects
Chronic bronchitis ,medicine.medical_specialty ,Cardiology ,Administration, Oral ,Dabigatran ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Rivaroxaban ,Edoxaban ,Internal medicine ,Republic of Korea ,medicine ,Humans ,Apixaban ,Prospective Studies ,Stroke ,Aged ,business.industry ,Warfarin ,Anticoagulants ,Atrial fibrillation ,Middle Aged ,medicine.disease ,Pharmaceutical Preparations ,chemistry ,Medicine ,Female ,Original Article ,030211 gastroenterology & hepatology ,business ,medicine.drug - Abstract
Background/Aims: Efforts to reduce stroke in patients with atrial fibrillation (AF) have focused on increasing physician adherence to oral anticoagulant (OAC) guidelines; however, the high early discontinuation rate of vitamin K antagonists (VKAs) is a lim itation. Although non-VKA OACs (NOACs) are more convenient to administer than warfarin, their lack of monitoring may predispose patients to nonpersistence. We com pared the persistence of NOAC and VKA treatment for AF in real-world practice. Methods: In a prospective observational registry (COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation [CODE-AF] regis try), 7,013 patients with nonvalvular AF (mean age 67.2 ± 10.9 years, women 36.4%) were consecutively enrolled between June 2016 and June 2017 from 10 tertiary hospitals in Korea. This study included 3,381 patients who started OAC 30 days before enrollment (maintenance group) and 572 patients who newly started OAC (new-starter group). The persistence rate of OAC was evaluated. Results: In the maintenance group, persistence to OAC declined during 6 months, to 88.3% for VKA and 95.5% for NOAC (p < 0.0001). However, the persistence rate was not different among NOACs. In the new-starter group, persistence to OAC declined during 6 months, to 78.9% for VKA and 92.1% for NOAC (p < 0.0001). The persistence rate was lower for rivaroxaban (83.7%) than apixaban (94.6%) and edoxaban (94.1%, p < 0.001). In the new-starter group, diabetes, valve disease, and cancer were related to nonper sistence of OAC. Conclusions: Nonpersistence was significantly lower with NOAC than VKA in both the maintenance and new-starter groups. In only the new-starter group, apixaban or edox aban showed higher persistence rates than rivaroxaban.
- Published
- 2020
91. Association of Depression With Atrial Fibrillation in South Korean Adults
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Yun Gi Kim, Kwang-No Lee, Kyung-Do Han, Kyu-Man Han, Kyongjin Min, Ha Young Choi, Yun Young Choi, Jaemin Shim, Jong-Il Choi, and Young-Hoon Kim
- Subjects
Adult ,Male ,Depression ,Incidence ,Research ,Cardiology ,General Medicine ,Middle Aged ,Cohort Studies ,Young Adult ,Online Only ,Atrial Fibrillation ,Republic of Korea ,Humans ,Female ,Aged ,Original Investigation - Abstract
This cohort study uses data from the Korean National Health Insurance Service database to assess the association of depression with the development of new-onset atrial fibrillation., Key Points Question Is depression associated with increased risk of new-onset atrial fibrillation (AF)? Findings In this cohort study of 5 031 222 individuals with a follow-up of 43 115 042 person-years, depression was associated with a higher cumulative incidence of new-onset AF. Recurrent episodes of depression were associated with an even higher risk of new-onset AF, and young age and female sex had a significant interaction with depression. Meaning Results of this study suggest that depression is associated with an increased risk of new-onset AF, suggesting the need for adequate screening for AF in people with depression., Importance The risk of atrial fibrillation (AF) in people with depression is not fully known. Depression is associated with sympathetic activation and emotional stress, which might increase the risk of new-onset AF. Objective To assess the incidence of new-onset AF in those with and without depression using data from a nationwide health care database. Design, Setting, and Participants This cohort study obtained data from the Korean National Health Insurance Service database and enrolled people who underwent a nationwide health checkup in 2009. People younger than 20 years and those with a history of heart valve surgery, previous diagnosis of mitral stenosis, or who were diagnosed with AF between January 1, 2002 and December 31, 2008 were excluded. The risk of new-onset AF (occurring between 2009 and 2018) was compared in people who were and were not diagnosed with depression within a year before the 2009 nationwide health checkup. Data were analyzed between August 1, 2020 and October 31, 2020. Exposure Previous diagnosis of depression. Main Outcomes and Measures Cumulative incidence and risk of new-onset AF between 2009 and 2018 in participants with and without depression. Kaplan-Meier analysis was conducted to assess incidence of AF, and Cox proportional hazards regression was used to calculate adjusted and unadjusted hazard ratios (HRs) and 95% CIs. Results A total of 5 031 222 individuals with a mean (SD) age of 46.99 (14.06) years (2 771 785 men [55.1%]) were included in the analysis; of these individuals, 148 882 (3.0%) had a diagnosis of depression in the year before the 2009 health checkup and 4 882 340 (97%) did not. People with depression vs those without depression were older (aged 56.7 vs 46.7 years) and more likely to be women (96 472 [64.8%] vs 2 162 965 [44.3%]). Prevalence of hypertension, diabetes, dyslipidemia, and heart failure was higher in the depression group. The cumulative incidence of new-onset AF was significantly higher in people with depression vs without depression in the Kaplan-Meier analysis and showed steady divergence throughout 10 years of follow-up (cumulative incidence, 4.44% vs 1.92%; log-rank P
- Published
- 2022
92. Cardiac MRI Based Left Atrial Radiomics for Assessing Persistent Atrial Fibrillation and Catheter Ablation Outcomes
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Soojung Park, Yongwon Cho, Guan Yang, kyungsang Kim, Yu-Whan Oh, Yun Gi Kim, Jaemin Shim, Jong-Il Choi, Young-Hoon Kim, and Sung Ho Hwang
- Subjects
History ,Polymers and Plastics ,Business and International Management ,Industrial and Manufacturing Engineering - Published
- 2022
93. Substantive representation of women and policy-vote trade-offs: does supporting women's issue bills decrease a legislator's chance of reelection?
- Author
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Jaemin Shim
- Subjects
Politik ,women's policy ,Far East ,representation ,Politikwissenschaft ,political influence ,0211 other engineering and technologies ,Taiwan ,election ,02 engineering and technology ,Wahl ,legislation ,regression analysis ,Geschlechterpolitik ,Political science ,050602 political science & public administration ,Gesetzgebung ,Frau ,Political Process, Elections, Political Sociology, Political Culture ,Social sciences, sociology, anthropology ,Abstimmung ,Repräsentation ,politische Willensbildung, politische Soziologie, politische Kultur ,Ostasien ,021110 strategic, defence & security studies ,Sozialwissenschaften, Soziologie ,05 social sciences ,Trade offs ,Substantive representation ,Frauenpolitik ,politischer Einfluss ,0506 political science ,Interessenvertretung ,Frauen- und Geschlechterforschung ,Regressionsanalyse ,gender policy ,Political economy ,voting ,Political Science and International Relations ,ddc:320 ,woman ,ddc:300 ,Women's Studies, Feminist Studies, Gender Studies ,representation of interests ,politics ,Law ,Legislator - Abstract
The paper investigates how parliamentary efforts to represent the interests of female electorates influence the legislators' re-election chances. Taiwan is chosen as the case study and, for empirical analysis, I utilise an original bill co-sponsorship dataset that consists of roughly 400,000 cosponsors for all bills submitted between 1992 and 2016. The findings, based on regression analyses, show that making more legislative effort on women's issues - by prioritising them over other issues - results in electoral losses, and this negative effect is more pronounced among female legislators. The paper contributes to the gender politics literature by theorising and testing a hitherto underexplored relationship between two representational processes: how the substantive representation women by female legislators affects their descriptive representation. It also contributes to legislative and electoral studies by demonstrating that legislators' policy-vote trade-offs are policy-sensitive and gendered, thus calling for a more nuanced approach to be taken in future research. Supplemental data for this article can be accessed at https://doi.org/10.1080/13572334.2021.1902645.
- Published
- 2022
94. Efficient Segmentation for Left Atrium With Convolution Neural Network Based on Active Learning in Late Gadolinium Enhancement Magnetic Resonance Imaging
- Author
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Yongwon Cho, Hyungjoon Cho, Jaemin Shim, Jong-Il Choi, Young-Hoon Kim, Namkug Kim, Yu-Whan Oh, and Sung Ho Hwang
- Subjects
Contrast Media ,Humans ,Gadolinium ,Heart Atria ,Neural Networks, Computer ,General Medicine ,Magnetic Resonance Imaging - Abstract
To propose fully automatic segmentation of left atrium using active learning with limited dataset in late gadolinium enhancement in cardiac magnetic resonance imaging (LGE-CMRI).An active learning framework was developed to segment the left atrium in cardiac LGE-CMRI. Patients (n = 98) with atrial fibrillation from the Korea University Anam Hospital were enrolled. First, 20 cases were delineated for ground truths by two experts and used for training a draft model. Second, the 20 cases from the first step and 50 new cases, corrected in a human-in-the-loop manner after predicting using the draft model, were used to train the next model; all 98 cases (70 cases from the second step and 28 new cases) were trained. An additional 20 LGE-CMRI were evaluated in each step.The Dice coefficients for the three steps were 0.85 ± 0.06, 0.89 ± 0.02, and 0.90 ± 0.02, respectively. The biases (95% confidence interval) in the Bland-Altman plots of each step were 6.36% (-14.90-27.61), 6.21% (-9.62-22.03), and 2.68% (-8.57-13.93). Deep active learning-based annotation times were 218 ± 31 seconds, 36.70 ± 18 seconds, and 36.56 ± 15 seconds, respectively.Deep active learning reduced annotation time and enabled efficient training on limited LGE-CMRI.
- Published
- 2022
95. The Association between Alcohol Consumption and Subclinical Atrial Fibrillation
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Ga-In Yu, Daehoon Kim, Hee Tae Yu, Tae-Hoon kim, Il-Young Oh, Jong Sung Park, Hyoung-Seob Park, Junbeom Park, Young Soo Lee, Ki-Woon Kang, Jaemin Shim, Jung-Hoon Sung, Eue-Keun Choi, and Boyoung Joung
- Published
- 2022
96. Oral Anticoagulation Therapy in Atrial Fibrillation Patients with Advanced Chronic Kidney Disease: CODE-AF Registry
- Author
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Hanjin Park, Hee Tae Yu, Tae-Hoon Kim, Junbeom Park, Jin-Kyu Park, Ki-Woon Kang, Jaemin Shim, Jin-Bae Kim, Jun Kim, Eue-Keun Choi, Hyung Wook Park, Young Soo Lee, and Boyoung Joung
- Subjects
Stroke ,Atrial Fibrillation ,Embolism ,Myocardial Infarction ,Humans ,Anticoagulants ,Kidney Failure, Chronic ,Administration, Oral ,Hemorrhage ,Warfarin ,Registries ,General Medicine ,Renal Insufficiency, Chronic - Abstract
Advanced chronic kidney disease (CKD), including end-stage renal disease (ESRD) on dialysis, increases thromboembolic risk among patients with atrial fibrillation (AF). This study examined the comparative safety and efficacy of direct-acting oral anticoagulant (DOAC) compared to warfarin or no oral anticoagulant (OAC) in AF patients with advanced CKD or ESRD on dialysis.Using data from the COmparison study of Drugs for symptom control and complication prEvention of AF (CODE-AF) registry, 260 non-valvular AF patients with advanced CKD (defined as estimated glomerular filtration rate30 mL/min per 1.73/m²) or ESRD on dialysis were enrolled from June 2016 to July 2020. The study population was categorized into DOAC, warfarin, and no OAC groups; and differences in major or clinically relevant non-major (CRNM) bleeding, stroke/systemic embolism (SE), myocardial infarction/critical limb ischemia (CLI), and death were assessed.During a median 24 months of follow-up, major or CRNM bleeding risk was significantly reduced in the DOAC group compared to the warfarin group [hazard ratio (HR) 0.11, 95% confidence interval (CI) 0.01 to 0.93,Among AF patients with advanced CKD or ESRD on dialysis, DOAC was associated with a lower risk of major or CRNM bleeding compared to warfarin and a lower risk of composite adverse clinical outcomes compared to no OAC. ClinicalTrials.gov (NCT02786095).
- Published
- 2023
97. The extent of complex fractionated atrial electrograms in the left atrium reflects age‐related electrical remodeling in patients with persistent atrial fibrillation
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Jong Il Choi, Younghoon Kim, Yae Min Park, Hwan Cheol Park, Jaemin Shim, Sang Weon Park, and Dae In Lee
- Subjects
complex fractionated atrial electrograms (CFAEs) ,medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_treatment ,Left atrium ,Atrial structure ,Catheter ablation ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Age related ,Medicine ,Electrical Remodeling ,In patient ,030212 general & internal medicine ,business.industry ,aging ,Mean age ,medicine.anatomical_structure ,lcsh:RC666-701 ,atrial fibrillation (AF) ,Persistent atrial fibrillation ,Cardiology ,Original Article ,Cardiology and Cardiovascular Medicine ,business - Abstract
Backgrounds Alterations in the atrial structure and function associated with aging result in electric remodeling of the left atrium (LA) in patients with persistent atrial fibrillation (AF). We performed this study to evaluate the influence of age on electric remodeling as assessed by the extent of complex fractionated atrial electrograms (CFAEs) in the LA. Methods A total of 122 patients (mean age, 55.9 ± 10.4 years; range, 31‐79; 106 males) who underwent catheter ablation for drug‐refractory persistent AF were included in the study. The extent of CFAE was measured by CFAE area and its index (CFAE area/LA surface area × 100) using three‐dimensional automated software of NavX system. Results The mean value of CFAE extent was significantly different among age groups; the CFAE area decreased significantly with increasing age (30 seconds [43.2 ± 14.5 mm2] vs 40 seconds [28.6 ± 6.0 mm2] vs 50 seconds [22.8 ± 3.4 mm2] vs 60 seconds [15.3 ± 2.6 mm2] vs 70 seconds [10.3 ± 3.2 mm2]; P = .010). A similar significant decrease was observed in the CFAE area index (30 seconds [22.9 ± 7.4] vs 40 seconds [14.9 ± 3.4] vs 50 seconds [10.4 ± 1.6] vs 60 seconds [6.9 ± 1.2] vs 70 seconds [4.6 ± 1.4]; P = .002). Age had a significantly negative correlation with the CFAE area (r = −0.322, P, With increasing age, a significant reduction in complex fractionated atrial electrogram (CFAE) area reflects age‐related electric remodeling, whereas an increase in the LA size and volume reflect anatomic remodeling in patients with persistent AF.
- Published
- 2019
98. Machine Learning-Predicted Progression to Permanent Atrial Fibrillation After Catheter Ablation
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Je-Wook Park, Oh-Seok Kwon, Jaemin Shim, Inseok Hwang, Yun Gi Kim, Hee Tae Yu, Tae-Hoon Kim, Jae-Sun Uhm, Jong-Youn Kim, Jong Il Choi, Boyoung Joung, Moon-Hyoung Lee, Young-Hoon Kim, and Hui-Nam Pak
- Subjects
machine learning ,RC666-701 ,catheter ablation ,Diseases of the circulatory (Cardiovascular) system ,atrial fibrillation ,progression ,risk score ,Cardiology and Cardiovascular Medicine - Abstract
IntroductionWe developed a prediction model for atrial fibrillation (AF) progression and tested whether machine learning (ML) could reproduce the prediction power in an independent cohort using pre-procedural non-invasive variables alone.MethodsCohort 1 included 1,214 patients and cohort 2, 658, and all underwent AF catheter ablation (AFCA). AF progression to permanent AF was defined as sustained AF despite repeat AFCA or cardioversion under antiarrhythmic drugs. We developed a risk stratification model for AF progression (STAAR score) and stratified cohort 1 into three groups. We also developed an ML-prediction model to classify three STAAR risk groups without invasive parameters and validated the risk score in cohort 2.ResultsThe STAAR score consisted of a stroke (2 points, p = 0.003), persistent AF (1 point, p = 0.049), left atrial (LA) dimension ≥43 mm (1 point, p = 0.010), LA voltage p = 0.004), and PR interval ≥196 ms (1 point, p = 0.001), based on multivariate Cox analyses, and it had a good discriminative power for progression to permanent AF [area under curve (AUC) 0.796, 95% confidence interval (CI): 0.753–0.838]. The ML prediction model calculated the risk for AF progression without invasive variables and achieved excellent risk stratification: AUC 0.935 for low-risk groups (score = 0), AUC 0.855 for intermediate-risk groups (score 1–3), and AUC 0.965 for high-risk groups (score ≥ 4) in cohort 1. The ML model successfully predicted the high-risk group for AF progression in cohort 2 (log-rank p < 0.001).ConclusionsThe ML-prediction model successfully classified the high-risk patients who will progress to permanent AF after AFCA without invasive variables but has a limited discrimination power for the intermediate-risk group.
- Published
- 2021
99. Malnutrition and Risk of Procedural Complications in Patients With Atrial Fibrillation Undergoing Catheter Ablation
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Jae Sun Uhm, Hui Nam Pak, Younghoon Kim, Jaemin Shim, Moon Hyoung Lee, Daehoon Kim, Tae Hoon Kim, Boyoung Joung, Yun Gi Kim, Hee Tae Yu, and Jong Il Choi
- Subjects
medicine.medical_specialty ,rhythm outcome ,business.industry ,complication ,Atrial fibrillation ,malnutrition ,Odds ratio ,Cardiovascular Medicine ,medicine.disease ,Confidence interval ,Malnutrition ,RC666-701 ,Internal medicine ,catheter ablation ,Cohort ,medicine ,Diseases of the circulatory (Cardiovascular) system ,Population study ,atrial fibrillation ,Cardiology and Cardiovascular Medicine ,Complication ,business ,Body mass index ,Original Research - Abstract
Background: Little is known about the prognostic value of nutritional status among patients undergoing atrial fibrillation (AF) catheter ablation (AFCA). We compared the risk of procedure-related complications and long-term rhythm outcomes of AFCA according to nutritional status.Methods: We included 3,239 patients undergoing de novo AFCA in 2009-2020. Nutritional status was assessed using the controlling nutritional status (CONUT) score. The association between malnutrition and the risk of AFCA complications or long-term rhythm outcomes was evaluated. We validated the effects of malnutrition using an external cohort of 360 patients undergoing AFCA in 2013-2016.Results: In the study population (26.8% women, median age: 58 years), 1,005 (31.0%) had malnutrition (CONUT scores ≥ 2); 991 (30.6%) had mild (CONUT 2–4) and 14 (0.4%) had moderate-to-severe (CONUT ≥ 5) malnutrition. The overall complication rates after AFCA were 3.3% for normal nutrition, 4.2% for mild malnutrition, and 21.4% for moderate-to-severe malnutrition. Moderate-to-severe malnutrition [odds ratio (OR) 6.456, 95% confidence interval (CI) 1.637-25.463, compared with normal nutrition], older age (OR 1.020 per 1-year increase, 95% CI 1.001-1.039), female sex (OR 1.915, 95% CI 1.302-2.817), and higher systolic blood pressure (OR 1.013 per 1-mmHg increase, 95% CI 1.000-1.026) were independent predictors for the occurrence of complications. In the validation cohort, malnutrition (CONUT ≥ 2) was associated with a 2.87-fold higher risk of AFCA complications (95% CI 1.174-7.033). The association between malnutrition and a higher risk of AFCA complications was consistently observed regardless of body mass index and sex. Malnutrition did not affect rhythm outcomes during the median follow-up of 40 months (clinical recurrence: 37.0% in normal nutrition vs. 36.5% in malnutrition).Conclusion: Malnutrition, which is common in patients undergoing AFCA, was associated with a substantially higher risk for complications after AFCA.
- Published
- 2021
100. Clinical Implications of Heart Rate Control in Heart Failure With Atrial Fibrillation: Multi-Center Prospective Observation Registry (CODE-AF Registry)
- Author
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Shinjeong Song, Jum-Suk Ko, Hye Ah Lee, Eue-Keun Choi, Myung-Jin Cha, Tae-Hoon Kim, Jin-Kyu Park, Jung-Myung Lee, Ki-Woon Kang, Jaemin Shim, Jae-Sun Uhm, Jun Kim, Changsoo Kim, Jin-Bae Kim, Hyung Wook Park, Boyoung Joung, and Junbeom Park
- Subjects
Cardiology and Cardiovascular Medicine - Abstract
BackgroundAtrial fibrillation (AF) is treated by heart rate (HR) control. However, the optimal HR target in AF patients with heart failure (HF) remains unclear. To evaluate the clinical implication of the resting HR in AF patients with HF accompanied by preserved, mid-range, or reduced ejection fraction (HFpEF, HFmrEF, or HFrEF, respectively).MethodsEchocardiographic data from June 2016 to April 2020 in a prospective, multicenter, observational registry from 11,104 patients were analyzed. The follow-up duration was 2.2 years. The main outcome was composite of death and hospitalization. We categorized patients according to the HF type and resting HR: ≤ 60 bpm, 61–80 bpm, 81–110 bpm, and >110 bpm.ResultsA total of 1,421 patients were enrolled in the study: 582 in the HFpEF group, 506 in the HFmrEF group, and 333 in the HFrEF group. The patients had a mean age of 69 ± 11 years and consisted of 872 (61.4%) men. Primary endpoint rates among HFpEF patients with 60 < HR ≤ 110 bpm were lower than those with HR ≤ 60 bpm (61–80 bpm group: hazard ratio, 0.66; 95% CI, 0.46–0.94; p = 0.021; 81–110 bpm group: hazard ratio, 0.60; 95% CI, 0.40–0.90; p = 0.013). Especially, HFpEF patients with HR 81–110 bpm had a lower incidence of hospitalization caused by HF aggravation than those with other HR strata (HR ≤ 80bpm strata or HR >110 bpm strata). In HFmrEF and HFrEF patients, the survival rates did not differ significantly among patients in the three groups with HR ≤ 110 bpm. Moreover, the event rates increased significantly in HFmrEF patients with HR >110 bpm (hazard ratio, 1.91; 95% CI, 1.16-3.14, p = 0.011).ConclusionIn patients with AF and HFpEF, the resting HR has U-shaped associations with the overall primary endpoint. A lower or higher resting HR is associated with increased cardiovascular outcomes, especially in patients with HFpEF and AF.
- Published
- 2021
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