Search

Introduction: Intermuscular implantations of subcutaneous implantable cardioverter‐defibrillators (S‐ICD) have been recommended, but the position of the anterior border of the latissimus dorsi muscle (LDM) has not previously been evaluated in establishing an incision line to facilitate the intermuscular approach. The objective of this study is to evalua the position and trend of the anterior border of the LDM in patients who are candidates for implantable cardioverter‐defibrillators. Methods: The distance from the back to the anterior border of the LDM (A) and the anterior–posterior width of the chest wall (B) were measured on computed tomography retrospectively, and the ratio (=A/B) was used as the position of the anterior border of the LDM. In addition, the variability and factors affecting the values were evaluated. Results: An analysis was performed on 78 patients, and the position of the anterior border of the LDM (=A/B) exhibited a normal distribution, with a mean value of 0.53 ± 0.062 (0.41–0.69). The position of the anterior border of the LDM tended to be more anterior in younger, taller, male, primary prevention, nonheart failure, low brain natriuretic peptide level, and nondiabetic patients. Conclusion: The position of the anterior border of the LDM varied from case to case with variable results. Conventional incisions on the midaxillary line may be inappropriate for intermuscular implantations, and the position of the anterior border of the LDM should be evaluated in each individual case to establish the incision line. [ABSTRACT FROM AUTHOR]

Background: Ventricular tachycardia (VT) non‐inducibility at the end of ablation is associated with a less likely VT recurrence. However, it is not clear whether we should use VT non‐inducibility as a routine end point of VT ablation. The aim of this study was to evaluate VT recurrence in patients in whom VT non‐inducibility was not achieved at the end of the radiofrequency (RF) ablation and the factors attributing to the VT recurrence. Methods: We analyzed that 62 patients in whom VT non‐inducibility was not achieved at the end of the RF ablation were studied. Results: Over 2 years, 22 (35%) of the cases had VT recurrences. A multivariate analysis showed that an LVEF ≥35% (HR: 0.19; 95% CI: 0.06–0.49; p <.01) and elimination of the clinical VT as an acute ablation efficacy (HR: 0.23; 95% CI: 0.04–0.81; p =.02) were independent predictors of fewer VT recurrences. RF ablation was associated with a 91.1% reduction in VT episodes. Conclusion: Even if VT non‐inducibility was not achieved, patients with an LVEF ≥35% or in whom the clinical VT could be eliminated might be prevented from having VT recurrences. The validity of the VT non‐inducibility of any VT should be evaluated considering each patient's background and the results of the procedure. [ABSTRACT FROM AUTHOR]

Background: There is a strong demand for remote monitoring systems to gather health data. This study investigated the safety, usefulness, and patient satisfaction in outpatient care using telehealth with real-time electrocardiogram (ECG) monitoring after catheter ablation. Methods and Results: In all, 38 patients who underwent catheter ablation were followed up using telehealth. At the 3- and 6-month follow-up, a self-fitted Duranta ECG monitoring device was sent to the patient's home before the online consultation. Patients attached the devices themselves, and the doctors viewed the patients by video chat and performed real-time ECG monitoring. The frequency of hospital visits and the ECG monitoring duration were compared with conventional in-person follow-up data (n=102). The completion rate for telehealth follow-up was 32 of 38 patients (84%). The number of hospital visits during the 6 months was significantly lower with telehealth follow-up than with conventional follow-up (median [interquartile range] 1 [1-1] vs. 5 [3-5]; P<0.0001). However, the ECG monitoring duration was approximately 4-fold longer for the telehealth follow-up (median [interquartile range] 89 [64-117] vs. 24 [0.1-24] h; P<0.0001). No major adverse events were observed during the telehealth follow-up. Patient surveys showed high satisfaction with telehealth follow-up due to reduced hospital visits. Conclusions: A combination of telehealth follow-up with real-time ECG monitoring increased the ECG monitoring duration and patient satisfaction without any adverse events., Competing Interests: The Section of Arrhythmia is supported by endowments from Abbott JAPAN, Medtronic JAPAN, and Boston Scientific JAPAN. The Section of Arrhythmia has received a scholarship fund from Biotronik JAPAN. K.H. chairs the Section, and K.F. and K.I. belong to the Section. However, none of the authors declare any conflicts of interest regarding this manuscript’s contents., (Copyright © 2023, THE JAPANESE CIRCULATION SOCIETY.)