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We report a case of a 44‐year‐old male who underwent an electrophysiological study for symptomatic supraventricular tachycardia (SVT) with wide QRS complex. The SVT was diagnosed as an antidromic atrioventricular reentrant tachycardia (AVRT) via antegrade conduction of left‐sided accessory pathway (AP). However, the QRS morphology changed during the SVT, and then the SVT was terminated spontaneously. The mapping of AP was performed during sinus rhythm, and the radiofrequency application successfully eliminated the AP, which rendered tachycardias non‐inducible. This was a rare case of antidromic AVRT during which the QRS morphology changed. [ABSTRACT FROM AUTHOR]

Background: Tachycardia‐induced cardiomyopathy (TIC) is a reversible cardiomyopathy with ventricular dysfunction caused by tachyarrhythmias. Notably, atrial fibrillation (AF) is the most common causal arrhythmia leading to TIC. However, the risk factors for the development of TIC due to AF remain unclear. This study aimed to identify the associated factors of TIC due to AF. Methods: Persistent AF patients with heart rate (HR) ≥100 beats per minute who underwent initial catheter ablation were enrolled in this study. TIC was diagnosed as left ventricular ejection fraction (LVEF) < 50% during AF rhythm, which was recovered after the restoration of sinus rhythm. Non‐TIC was defined as LVEF ≥ 50% despite AF rhythm. The patient backgrounds were compared between the TIC group and the non‐TIC group to reveal the contributing factors of TIC. Results: The TIC group comprised 57 patients, while the non‐TIC group consisted of 101 patients. The TIC group was younger than the non‐TIC group (median 64 vs. 70, p = 0.006). Male sex was more frequent in the TIC group than the non‐TIC group (82.5% vs. 58.4%, p = 0.003). HR was higher in the TIC group than in the non‐TIC group (median 130 bpm vs. 111 bpm, p < 0.001). The number of smokers was significantly higher in the TIC group than in the non‐TIC group (p < 0.001). Multivariable analysis demonstrated that higher HR (odds ratio [OR]: 1.74; 95% confidence interval [CI]: 1.37–2.21; p < 0.001) and current smokers (OR: 5.27; 95% CI: 1.60–17.4; p = 0.006) were the independent factors leading to TIC. Conclusion: Higher HR and current smokers were independent risk factors for the development of TIC due to AF. [ABSTRACT FROM AUTHOR]

Background Methods. Genotyping was carried out, with a tetra-primer polymerase chain reaction (PCR) method, for 659 DNA specimens from 438 healthy volunteers and 221 patients with UC. Genotype distribution between cases and controls and the association of patients’ genotypes with clinical parameters were statistically evaluated. Results. No significant difference in genotype distribution was found between UC patients and healthy controls. However, when the relation of the C/C genotype to clinical parameters in UC patients was evaluated by Fisher’s exact test, it was found that the frequency of the C/C genotype was higher in patients with pancolitis type than in those with other types restricted to the distal or left-sided colon (odds ratio [OR], 10.781; 95% confidence interval [CI], 1.342–86.619; P = 0.0074). Conclusions. These data suggest that the MIF -173 G/C polymorphism may be related to the extent of disease in UC in a Japanese population. Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine and has been shown to be involved in the development of chronic murine colitis. In the +173 G/C polymorphism of the MIF gene, the presence of C creates the binding motif of activator protein 4. This study explored the association of this polymorphism with ulcerative colitis (UC). [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion The impact of combining ablation index (AI)‐guided and very high‐power short‐duration (vHPSD) ablation on procedural factors at the posterior wall near the esophagus is unclear.Atrial fibrillation patients who underwent initial ablation using three‐dimensional mapping were enrolled. Patients were classified into two groups: those who underwent only AI‐guided pulmonary vein isolation (PVI) (AI group) and those who underwent vHPSD ablation at the posterior wall adjacent to the esophagus in addition to AI‐guided PVI (AI + vHPSD group). Differences in myocardial injury, inflammation, procedural characteristics, and pulmonary vein (PV) reconnection patterns were assessed between the two groups.This study included 167 patients (AI group, 83 patients; AI+vHPSD group, 84 patients). No significant differences in high‐sensitive troponin I or changes in inflammatory markers between pre‐ and Postablation were observed in either group. Total application time and total application energy were significantly lower in the AI+vHPSD group than in the AI group (p < 0.001 for both) despite no significant difference in the total number of applications between the groups. The incidence of esophagus temperature ≥40 degrees was significantly lower in the AI+vHPSD group than in the AI group (p = 0.036). However, the incidence of PV reconnections near the esophagus was significantly higher in the AI+vHPSD group than in the AI group (11.9% vs 3.6%, p = 0.046), despite no significant difference in the incidence of PV reconnections overall.The combination of AI‐guided PVI and vHPSD adjacent to the esophagus demonstrated reduced application energy requirements and maintained safety and effectiveness during the perioperative period. [ABSTRACT FROM AUTHOR]

Background Methods and Results Conclusions Heart failure (HF) with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) are associated with high morbidity and mortality. Recently, sinus rhythm (SR) maintenance (SRM) after catheter ablation (CA) of AF (AFCA) in HFpEF has shown to reduce adverse events as compared to medical treatment. However, it remains unclear whether SRM after a repeat CA for recurrent AF has the same effect as SRM after the initial CA in patients with AF and HFpEF.We studied 244 AF patients with HFpEF who maintained SR after repeat AFCA (repeat CA‐SRM group, n = 54) and initial AFCA (initial CA‐SRM group, n = 190). HFpEF were defined as HFA‐PEFF score of 5 or 6 and left ventricular ejection fraction ≥ 50% before the initial CA. The primary endpoint was a composite of all‐cause mortality, HF hospitalizations, or strokes within 3 years after the initial or repeat CA. The incidence of the primary endpoint was similar between the repeat CA‐SRM and initial CA‐SRM groups (3 of 54 [5.6%] vs. 8 of 190 [4.2%], p = .423 by a log‐rank test). There was no significant difference in the 12‐month HFA‐PEFF score and the proportion of a 12‐month HFA‐PEFF score <5 between the repeat CA‐SRM and the initial CA‐SRM groups (5 [4,6] vs. 5 [4,6], p = .915, and 46% vs. 35%, p = .426, respectively).In patients with AF and HFpEF diagnosed by HFA‐PEFF score, the primary endpoint of all‐cause mortality, HF hospitalizations, and strokes was similar between the repeat CA‐SRM and initial CA‐SRM groups. [ABSTRACT FROM AUTHOR]

Background: Coronary angioscopy (CAS) has 2 unique abilities: direct visualization of thrombi and plaque color. However, in the recent drug-eluting stent (DES) era, serial CAS findings after DES implantation have not been fully elucidated. We investigated the impact of CAS findings after implantation of a polymer-free biolimus A9-coated stent (PF-BCS) or durable polymer everolimus-eluting stent (DP-EES)., Methods and Results: We investigated serial CAS and optical coherence tomography (OCT) findings at 1 and 12 months in 99 patients who underwent PF-BCS or DP-EES implantation. We evaluated factors correlated with angioscopic thrombi and yellow plaque, and the clinical impact of both thrombi and yellow plaque at 12 months (BTY). The BTY group included 17 (22%) patients. The incidence and grade of thrombi and yellow plaque decreased from 1 to 12 months. Although no patients had newly appearing thrombi at 12 months, 2 DP-EES patients had newly appearing yellow plaque at 12 months. Multivariable analysis revealed HbA1c, minimum stent area, and adequate strut coverage were significant factors correlated with 12-month angioscopic thrombi, and DP-EESs were significantly correlated with 12-month yellow plaque. However, BTY was not correlated with clinical events., Conclusions: The management of diabetes, stent area, and adequate stent coverage are important for intrastent thrombogenicity and polymer-free stents are useful for stabilizing plaque vulnerability.