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1. Impact of sinus rhythm maintenance on major adverse cardiac and cerebrovascular events after catheter ablation of atrial fibrillation: insights from AF frontier ablation registry

Author

Usuda, Keisuke, Kato, Takeshi, Tsuda, Toyonobu, Tada, Hayato, Niwa, Satoru, Usui, Soichiro, Sakata, Kenji, Hayashi, Kenshi, Furusho, Hiroshi, Kawashiri, Masaaki, Takamura, Masayuki, Otsuka, Takayuki, Suzuki, Shinya, Hirata, Akio, Murakami, Masato, Takami, Mitsuru, Kimura, Masaomi, Fukaya, Hidehira, Nakahara, Shiro, Shimizu, Wataru, Iwasaki, Yu-ki, Hayashi, Hiroshi, Harada, Tomoo, Nakajima, Ikutaro, Okumura, Ken, Koyama, Junjiroh, Tokuda, Michifumi, Yamane, Teiichi, Momiyama, Yukihiko, Tanimoto, Kojiro, Soejima, Kyoko, Nonoguchi, Noriko, Ejima, Koichiro, Hagiwara, Nobuhisa, Harada, Masahide, Sonoda, Kazumasa, Inoue, Masaru, Kumagai, Koji, Hayashi, Hidemori, Satomi, Kazuhiro, Yazaki, Yoshinao, Watari, Yuji, Arai, Masaru, Watanabe, Ryuta, Yokoyama, Katsuaki, Matsumoto, Naoya, Nagashima, Koichi, and Okumura, Yasuo

Published
2022
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2. Safety and Performance of the Micra VR Leadless Pacemaker in a Japanese Cohort ― Comparison With Global Studies ―

Author

Ando, Kenji, primary, Inoue, Kanki, additional, Harada, Tomoo, additional, Shizuta, Satoshi, additional, Yoshida, Yukihiko, additional, Kusano, Kengo, additional, Onuki, Tatsuya, additional, Watari, Yuji, additional, Fukui, Akio, additional, Sasaki, Shingo, additional, Shoda, Morio, additional, Nishii, Nobuhiro, additional, Shiose, Akira, additional, Hosoda, Junya, additional, Okai, Chie, additional, Stromberg, Kurt, additional, Murphy, Jeffrey, additional, Holmes, Thomas R, additional, and Soejima, Kyoko, additional

Published
2023
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3. The proportion of asymptomatic recurrence after catheter ablation of atrial fibrillation in patients with a pacemaker for sick sinus syndrome

Author

Osaka, Yuki, Takigawa, Masateru, Takahashi, Atsushi, Kuwahara, Taishi, Okubo, Kenji, Takahashi, Yoshihide, Tanaka, Yasuaki, Kawaguchi, Naohiko, Yamao, Kazuya, Watari, Yuji, Nakashima, Emiko, Nakajima, Jun, Takagi, Katsumasa, Fujino, Tadashi, Kimura, Shigeki, Hikita, Hiroyuki, Hirao, Kenzo, and Isobe, Mitsuaki

Published
2017
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5. Registry for Evaluating Healthy Life Expectancy and Long-Term Outcomes after Catheter Ablation of Atrial Fibrillation in the Very Elderly (REHEALTH AF) study: rationale and design of a prospective, multicentre, observational, comparative study

Author

Okumura, Yasuo, primary, Nagashima, Koichi, additional, Watanabe, Ryuta, additional, Yokoyama, Katsuaki, additional, Kato, Takeshi, additional, Fukaya, Hidehira, additional, Hayashi, Hidemori, additional, Nakahara, Shiro, additional, Shimizu, Wataru, additional, Iwasaki, Yu-ki, additional, Fujimoto, Yuhi, additional, Mukai, Yasushi, additional, Ejima, Koichiro, additional, Otsuka, Takayuki, additional, Suzuki, Shinya, additional, Murakami, Masato, additional, Kimura, Masaomi, additional, Harada, Masahide, additional, Koyama, Junjiroh, additional, Okamatsu, Hideharu, additional, Yamane, Teiichi, additional, Yamashita, Seigo, additional, Tokuda, Michifumi, additional, Narui, Ryohsuke, additional, Takami, Mitsuru, additional, Shoda, Morio, additional, Harada, Tomoo, additional, Nakajima, Ikutaro, additional, Fujiu, Katsuhito, additional, Hiroshima, Kenichi, additional, Tanimoto, Kojiro, additional, Fujino, Tadashi, additional, Nakamura, Keijiro, additional, Kumagai, Koji, additional, Okada, Ayako, additional, Kobayashi, Hideki, additional, Hayashi, Tatsuya, additional, Watari, Yuji, additional, Hatsuno, Mina, additional, Tachibana, Eizo, additional, Iso, Kazuki, additional, Sonoda, Kazumasa, additional, Aizawa, Yoshiyasu, additional, Chikata, Akio, additional, Sakagami, Satoru, additional, Inoue, Masaru, additional, Minamiguchi, Hitoshi, additional, Makino, Nobuhiko, additional, Satomi, Kazuhiro, additional, Yazaki, Yoshinao, additional, Aoyagi, Hideshi, additional, Ichikawa, Makoto, additional, Haruta, Hironori, additional, Hiro, Takafumi, additional, Okubo, Kimie, additional, Arima, Ken, additional, Tojo, Taiki, additional, Kihara, Hajime, additional, Miyanaga, Satoru, additional, Fukuda, Yoshiaki, additional, Oiwa, Koji, additional, Fujiishi, Tamami, additional, Akabane, Masashi, additional, Ishikawa, Norikazu, additional, Kusano, Kengo, additional, Miyamoto, Koji, additional, Tabuchi, Haruna, additional, Shiozawa, Tomoyuki, additional, Miyamoto, Kenjiro, additional, Mase, Hiroshi, additional, and Murotani, Kenta, additional

Published
2023
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6. Zero-contrast Imaging Guided Transcatheter Aortic Valve Replacement in Patients with Severe Chronic Kidney Disease: A Feasibility and Outcome Study

Author

Yukimitsu, Nozomu, primary, Watanabe, Yusuke, additional, Kataoka, Akihisa, additional, Hioki, Hirofumi, additional, Ishibashi, Ruri, additional, Katayama, Taiga, additional, Takamura, Shintaro, additional, Nagura, Fukuko, additional, Kawashima, Hideyuki, additional, Yamamoto, Hirosada, additional, Watari, Yuji, additional, Konno, Kumiko, additional, Yokoyama, Naoyuki, additional, and Kozuma, Ken, additional

Published
2023
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11. Incidences of esophageal injury during esophageal temperature monitoring: a comparative study of a multi-thermocouple temperature probe and a deflectable temperature probe in atrial fibrillation ablation

Author

Kuwahara, Taishi, Takahashi, Atsushi, Takahashi, Yoshihide, Okubo, Kenji, Takagi, Katsumasa, Fujino, Tadashi, Kusa, Shigeki, Takigawa, Masateru, Watari, Yuji, Yamao, Kazuya, Nakashima, Emiko, Kawaguchi, Naohiko, Hikita, Hiroyuki, Sato, Akira, and Aonuma, Kazutaka

Published
2014
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22. Impact of Sinus Rhythm Maintenance on Major Adverse Cardiac and Cerebrovascular Events after Catheter Ablation of Atrial Fibrillation: Insights from AF Frontier Ablation Registry

Author

Usuda, Keisuke, primary, Kato, Takeshi, additional, Tsuda, Toyonobu, additional, Tada, Hayato, additional, Niwa, Satoru, additional, Usui, Soichiro, additional, Sakata, Kenji, additional, Hayashi, Kenshi, additional, Furusho, Hiroshi, additional, Kawashiri, Masa-aki, additional, Takamura, Masayuki, additional, Otsuka, Takayuki, additional, Hirata, Akio, additional, Murakami, Masato, additional, Takami, Mitsuru, additional, Kimura, Masaomi, additional, Fukaya, Hidehira, additional, Nakahara, Shiro, additional, Shimizu, Wataru, additional, Harada, Tomoo, additional, Okumura, Ken, additional, Yamane, Teiichi, additional, Momiyama, Yukihiko, additional, Soejima, Kyoko, additional, Hagiwara, Nobuhisa, additional, Harada, Masahide, additional, Sonoda, Kazumasa, additional, Inoue, Masaru, additional, Kumagai, Koji, additional, Hayashi, Hidemori, additional, Satomi, Kazuhiro, additional, Watari, Yuji, additional, Matsumoto, Naoya, additional, Nagashima, Koichi, additional, and Okumura, Yasuo, additional

Published
2021
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26. Clinical Outcomes of Off-Label Underdosing of Direct Oral Anticoagulants After Ablation for Atrial Fibrillation

Author

Wakamatsu, Yuji, primary, Nagashima, Koichi, additional, Watanabe, Ryuta, additional, Arai, Masaru, additional, Yokoyama, Katsuaki, additional, Matsumoto, Naoya, additional, Otsuka, Takayuki, additional, Suzuki, Shinya, additional, Hirata, Akio, additional, Murakami, Masato, additional, Takami, Mitsuru, additional, Kimura, Masaomi, additional, Fukaya, Hidehira, additional, Nakahara, Shiro, additional, Kato, Takeshi, additional, Hayashi, Hiroshi, additional, Iwasaki, Yu-ki, additional, Shimizu, Wataru, additional, Nakajima, Ikutaro, additional, Harada, Tomoo, additional, Koyama, Junjiroh, additional, Okumura, Ken, additional, Tokuda, Michifumi, additional, Yamane, Teiichi, additional, Tanimoto, Kojiro, additional, Momiyama, Yukihiko, additional, Nonoguchi, Noriko, additional, Soejima, Kyoko, additional, Ejima, Koichiro, additional, Hagiwara, Nobuhisa, additional, Harada, Masahide, additional, Sonoda, Kazumasa, additional, Inoue, Masaru, additional, Kumagai, Koji, additional, Hayashi, Hidemori, additional, Yazaki, Yoshinao, additional, Satomi, Kazuhiro, additional, Watari, Yuji, additional, and Okumura, Yasuo, additional

Published
2020
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27. Simple and novel technique to confirm complete mitral isthmus block

Author

Takigawa, Masateru, primary, Takahashi, Atsushi, additional, Tanaka, Yasuaki, additional, Martin, Claire A., additional, Nakashima, Emiko, additional, Yamao, Kazuya, additional, Sagawa, Yuichiro, additional, Kuwahara, Taishi, additional, Okubo, Kenji, additional, Takahashi, Yoshihide, additional, Watari, Yuji, additional, Nakajima, Jun, additional, Takagi, Katsumasa, additional, Fujino, Tadashi, additional, Kimura, Shigeki, additional, Hikita, Hiroyuki, additional, and Hirao, Kenzo, additional

Published
2018
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29. Airway support using a pediatric intubation tube in adult patients with atrial fibrillation: A simple and unique method to prevent heart movement during catheter ablation under continuous deep sedation

Author

Takigawa, Masateru, primary, Takahashi, Atsushi, additional, Kuwahara, Taishi, additional, Okubo, Kenji, additional, Nakashima, Emiko, additional, Watari, Yuji, additional, Yamao, Kazuya, additional, Nakajima, Jun, additional, Tanaka, Yasuaki, additional, Takagi, Katsumasa, additional, Kimura, Shigeki, additional, Hikita, Hiroyuki, additional, Hirao, Kenzo, additional, and Isobe, Mitsuaki, additional

Published
2017
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30. Impact of Alcohol Consumption on the Outcome of Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation

Author

Takigawa, Masateru, primary, Takahashi, Atsushi, additional, Kuwahara, Taishi, additional, Takahashi, Yoshihide, additional, Okubo, Kenji, additional, Nakashima, Emiko, additional, Watari, Yuji, additional, Nakajima, Jun, additional, Yamao, Kazuya, additional, Osaka, Yuki, additional, Tanaka, Yasuaki, additional, Kimura, Shigeki, additional, Takagi, Katsumasa, additional, Hikita, Hiroyuki, additional, Hirao, Kenzo, additional, and Isobe, Mitsuaki, additional

Published
2016
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31. Impact of anteroinferior transseptal puncture on creation of a complete block at the mitral isthmus in patients with atrial fibrillation

Author

Okubo, Kenji, primary, Kuwahara, Taishi, additional, Takigawa, Masateru, additional, Tanaka, Yasuaki, additional, Nakajima, Jun, additional, Watari, Yuji, additional, Nakashima, Emiko, additional, Yamao, Kazuya, additional, Sagawa, Yuichiro, additional, Takagi, Katsumasa, additional, Fujino, Tadashi, additional, Tsutsui, Hiroyuki, additional, and Takahashi, Atsushi, additional

Published
2016
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32. Adherence Rates of Guideline-Recommended Therapies for Heart Failure in Outpatients: Primary Results of the IMPROVE HF Japan Pilot Study

Author

Momomura, Shin-Ichi, primary, Nakamura, Akihiro, additional, Doi, Masayuki, additional, Kadokami, Toshiaki, additional, Nakashima, Hitoshi, additional, Fujiwara, Yasukazu, additional, Atsuchi, Nobuhimo, additional, Watari, Yuji, additional, Nozoe, Masatsugu, additional, Hirahara, Taishi, additional, Koga, Narumi, additional, Furukawa, Toshihito, additional, Inomata, Takayuki, additional, and Sonoda, Masahiro, additional

Published
2016
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35. Long-Term Follow-Up After Catheter Ablation of Paroxysmal Atrial Fibrillation

Author

Takigawa, Masateru, primary, Takahashi, Atsushi, additional, Kuwahara, Taishi, additional, Okubo, Kenji, additional, Takahashi, Yoshihide, additional, Watari, Yuji, additional, Takagi, Katsumasa, additional, Fujino, Tadashi, additional, Kimura, Shigeki, additional, Hikita, Hiroyuki, additional, Tomita, Makoto, additional, Hirao, Kenzo, additional, and Isobe, Mitsuaki, additional

Published
2014
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36. Late-Phase Thromboembolism After Catheter Ablation for Paroxysmal Atrial Fibrillation

Author

Takigawa, Masateru, primary, Takahashi, Atsushi, additional, Kuwahara, Taishi, additional, Takahashi, Yoshihide, additional, Okubo, Kenji, additional, Nakashima, Emiko, additional, Watari, Yuji, additional, Nakajima, Jun, additional, Takagi, Katsumasa, additional, Yamao, Kazuya, additional, Fujino, Tadashi, additional, Sugiyama, Tomoyo, additional, Kimura, Shigeki, additional, Hikita, Hiroyuki, additional, Irioka, Takashi, additional, Hirao, Kenzo, additional, and Isobe, Mitsuaki, additional

Published
2014
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37. Takotsubo cardiomyopathy in siblings

Author

Ikutomi, Masayasu, primary, Yamasaki, Masao, additional, Matsusita, Masashiro, additional, Watari, Yuji, additional, Arashi, Hiroyuki, additional, Endo, Goro, additional, Yamaguchi, Jun-ichi, additional, and Ohnishi, Satoshi, additional

Published
2013
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39. Japanese Journal of Electrocardiology

Author

Yamakawa, Takeshi, primary, Watari, Yuji, additional, Nagaoka, Kensuke, additional, Ueno, Yasunari, additional, Motoyoshi, Kentaro, additional, Ishikawa, Shuichi, additional, Furukawa, Taiji, additional, and Isshiki, Takaaki, additional

Published
2007
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40. Japanese Journal of Electrocardiology

Author

Furukawa, Taiji, primary, Sagawa, Toshio, additional, Watari, Yuji, additional, Oga, Kyoji, additional, Watanabe, Suguru, additional, Koganesawa, Satoshi, additional, Honda, Mitsuyoshi, additional, and Isshiki, Takaaki, additional

Published
2005
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41. Outcomes after stepwise ablation for persistent atrial fibrillation in patients with heart failure

Author

Takahashi, Yoshihide, Takahashi, Atsushi, Kuwahara, Taishi, Okubo, Kenji, Takagi, Katsumasa, Watari, Yuji, Takigawa, Masateru, Nakashima, Emiko, Kawaguchi, Naohiko, Yamao, Kazuya, Hirao, Kenzo, and Isobe, Mitsuaki

Abstract

There is limited data regarding the outcomes after stepwise ablation for persistent atrial fibrillation (AF) in patients with heart failure (HF). Patients without structural heart disease undergoing stepwise ablation for persistent AF (continuous AF=1 year) were studied (n=108; age, 61±10 years) and 32 patients had a history of HF. The HF patients were further grouped on the basis of left ventricular ejection fraction (LVEF)=45% (n=15) and >45% (n=17). During a median follow-up period of 2.2 years, repeated ablations were necessary in 65 patients. The proportion of patients that were arrhythmia free 1 year after the last ablation was 67% in patients with LVEF=45%, 86% in LVEF>45%, and 91% in no HF (p=0.0009). In patients with LVEF=45%, the AF burden was reduced to less than one paroxysmal episode per month, and patients with and without recurrences both showed significant increases in LVEF over the follow-up period (38±7% to 60±10% and 37±6% to 53±10%, respectively). HF patients with LVEF=45% had lower chances to remain free from arrhythmias after stepwise ablation for persistent AF than those with LVEF>45%. Nevertheless, LVEF also improved in patients with recurrences, reflecting the observed reduction in AF burden and emphasizing the benefits of ablation.

Published
2012
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43. Effect of Catheter Ablation for Atrial Fibrillation in Heart Failure With Mid-Range or Preserved Ejection Fraction　- Pooled Analysis of the AF Frontier Ablation Registry and Hokuriku-Plus AF Registry.

Author

Tsuda T, Kato T, Usuda K, Kusayama T, Usui S, Sakata K, Hayashi K, Kawashiri MA, Yamagishi M, Takamura M, Otsuka T, Suzuki S, Hirata A, Murakami M, Takami M, Kimura M, Fukaya H, Nakahara S, Shimizu W, Iwasaki YK, Hayashi H, Harada T, Nakajima I, Okumura K, Koyama J, Tokuda M, Yamane T, Momiyama Y, Tanimoto K, Soejima K, Nonoguchi N, Ejima K, Hagiwara N, Harada M, Sonoda K, Inoue M, Kumagai K, Hayashi H, Satomi K, Yazaki Y, Watari Y, Arai M, Watanabe R, Yokoyama K, Matsumoto N, Nagashima K, and Okumura Y

Subjects
Humans, Male, Aged, Female, Stroke Volume, Treatment Outcome, Registries, Atrial Fibrillation complications, Atrial Fibrillation surgery, Heart Failure therapy, Catheter Ablation adverse effects
Abstract

Background: A recent randomized trial demonstrated that catheter ablation for atrial fibrillation (AF) in patients with heart failure with reduced ejection fraction (EF) is associated with a reduction in death or heart failure. However, the effect of catheter ablation for AF in patients with heart failure with mid-range or preserved EF is unclear., Methods and results: We screened 899 AF patients (72.4% male, mean age 68.4 years) with heart failure and left ventricular EF ≥40% from 2 Japanese multicenter AF registries: the Atrial Fibrillation registry to Follow the long-teRm Outcomes and use of aNTIcoagulants aftER Ablation (AF Frontier Ablation Registry) as the ablation group (525 patients who underwent ablation) and the Hokuriku-Plus AF Registry as the medical therapy group (374 patients who did not undergo ablation). Propensity score matching was performed in these 2 registries to yield 106 matched patient pairs. The primary endpoint was a composite of cardiovascular death and hospitalization for heart failure. At 24.6 months, the ablation group had a significantly lower incidence of the primary endpoint (hazard ratio 0.32; 95% confidence interval 0.13-0.70; P=0.004) than the medical therapy group., Conclusions: Compared with medical therapy, catheter ablation for AF in patients with heart failure and mid-range or preserved EF was associated with a significantly lower incidence of cardiovascular death or hospitalization for heart failure.

Published
2023
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44. Different Determinants of the Recurrence of Atrial Fibrillation and Adverse Clinical Events in the Mid-Term Period After Atrial Fibrillation Ablation.

Author

Watanabe R, Nagashima K, Wakamatsu Y, Otsuka N, Yokoyama K, Matsumoto N, Otsuka T, Suzuki S, Hirata A, Murakami M, Takami M, Kimura M, Fukaya H, Nakahara S, Kato T, Hayashi H, Iwasaki YK, Shimizu W, Nakajima I, Harada T, Koyama J, Okumura K, Tokuda M, Yamane T, Tanimoto K, Momiyama Y, Nonoguchi N, Soejima K, Ejima K, Hagiwara N, Harada M, Sonoda K, Inoue M, Kumagai K, Hayashi H, Yazaki Y, Satomi K, Watari Y, and Okumura Y

Subjects
Aged, Female, Hemorrhage etiology, Humans, Male, Recurrence, Retrospective Studies, Treatment Outcome, Atrial Fibrillation, Catheter Ablation adverse effects, Catheter Ablation methods, Ischemic Attack, Transient etiology, Stroke etiology
Abstract

Background: It is unclear whether there are differences in the clinical factors between atrial fibrillation (AF) recurrence and adverse clinical events (AEs), including stroke/transient ischemic attack (TIA), major bleeding, and death, after AF ablation., Methods and results: We examined the data from a retrospective multicenter Japanese registry conducted at 24 cardiovascular centers between 2011 and 2017. Of the 3,451 patients (74.1% men; 63.3±10.3 years) who underwent AF ablation, 1,046 (30.3%) had AF recurrence and 224 (6.5%) suffered AEs (51 strokes/TIAs, 71 major bleeding events, and 36 deaths) over a median follow-up of 20.7 months. After multivariate adjustment, female sex, persistent and long-lasting persistent AF (vs. paroxysmal AF), and stepwise increased left atrial diameter (LAd) quartiles were significantly associated with post-ablation recurrences. A multivariate analysis revealed that an age ≥75 years (vs. <65 years), body weight <50 kg, diabetes, vascular disease, left ventricular (LV) ejection fraction <40% (vs. ≥50%), Lad ≥44 mm (vs. <36 mm), and creatinine clearance <50 mL/min were independently associated with AE incidences, but not with recurrences., Conclusions: This study disclosed different determinants of post-ablation recurrence and AEs. Female sex, persistent AF, and enlarged LAd were determinants of post-ablation recurrence, whereas an old age, comorbidities, and LV and renal dysfunction rather than post-ablation recurrence were AEs determinants. These findings will help determine ablation indications and post-ablation management.

Published
2022
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45. Clinical outcomes of ablation versus non-ablation therapy for atrial fibrillation in Japan: analysis of pooled data from the AF Frontier Ablation Registry and SAKURA AF Registry.

Author

Iso K, Nagashima K, Arai M, Watanabe R, Yokoyama K, Matsumoto N, Otsuka T, Suzuki S, Hirata A, Murakami M, Takami M, Kimura M, Fukaya H, Nakahara S, Kato T, Hayashi H, Iwasaki YK, Shimizu W, Nakajima I, Harada T, Koyama J, Okumura K, Tokuda M, Yamane T, Tanimoto K, Momiyama Y, Nonoguchi N, Soejima K, Ejima K, Hagiwara N, Harada M, Sonoda K, Inoue M, Kumagai K, Hayashi H, Yazaki Y, Satomi K, Watari Y, and Okumura Y

Subjects
Aged, Atrial Fibrillation complications, Female, Follow-Up Studies, Humans, Incidence, Japan epidemiology, Male, Middle Aged, Recurrence, Risk Factors, Stroke epidemiology, Stroke etiology, Time Factors, Treatment Outcome, Anticoagulants therapeutic use, Atrial Fibrillation therapy, Catheter Ablation methods, Propensity Score, Registries, Risk Assessment methods, Stroke prevention & control
Abstract

Whether ablation for atrial fibrillation (AF) is, in terms of clinical outcomes, beneficial for Japanese patients has not been clarified. Drawing data from 2 Japanese AF registries (AF Frontier Ablation Registry and SAKURA AF Registry), we compared the incidence of clinically relevant events (CREs), including stroke/transient ischemic attack (TIA), major bleeding, cardiovascular events, and death, between patients who underwent ablation (n = 3451) and those who did not (n = 2930). We also compared propensity-score matched patients (n = 1414 in each group). In propensity-scored patients who underwent ablation and those who did not, mean follow-up times were 27.2 and 35.8 months, respectively. Annualized rates for stroke/TIA (1.04 vs. 1.06%), major bleeding (1.44 vs. 1.20%), cardiovascular events (2.15 vs. 2.49%) were similar (P = 0.96, 0.39, and 0.35, respectively), but annualized death rates were lower in the ablation group than in the non-ablation group (0.75 vs.1.28%, P = 0.028). After multivariate adjustment, the risk of CREs was statistically equivalent between the ablation and non-ablation groups (hazard ratio [HR] 0.89, 95% confidence interval [CI] 0.71-1.11), but it was significantly low among patients who underwent ablation for paroxysmal AF (HR 0.68 [vs. persistent AF], 95% CI 0.49-0.94) and had a CHA 2 DS 2 -VASc score  < 3 (HR 0.66 [vs. CHA 2 DS 2 -VASc score ≥ 3], 95% CI 0.43-0.98]). The 2-year risk reduction achieved by ablation may be small among Japanese patients, but AF ablation may benefit those with paroxysmal AF and a CHA 2 DS 2 -VASc score < 3.

Published
2021
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46. Current Status and Clinical Outcomes of Oral Anticoagulant Discontinuation After Ablation for Atrial Fibrillation in Japan　- Findings From the AF Frontier Ablation Registry.

Author

Okumura Y, Nagashima K, Arai M, Watanabe R, Yokoyama K, Matsumoto N, Otsuka T, Suzuki S, Hirata A, Murakami M, Takami M, Kimura M, Fukaya H, Nakahara S, Kato T, Shimizu W, Iwasaki YK, Hayashi H, Harada T, Nakajima I, Okumura K, Koyama J, Tokuda M, Yamane T, Momiyama Y, Tanimoto K, Soejima K, Nonoguchi N, Ejima K, Hagiwara N, Harada M, Sonoda K, Inoue M, Kumagai K, Hayashi H, Satomi K, Yazaki Y, and Watari Y

Subjects
Administration, Oral, Aged, Anticoagulants adverse effects, Atrial Fibrillation diagnosis, Atrial Fibrillation mortality, Drug Administration Schedule, Female, Hemorrhage chemically induced, Humans, Incidence, Ischemic Attack, Transient diagnosis, Ischemic Attack, Transient mortality, Japan epidemiology, Male, Middle Aged, Registries, Retrospective Studies, Risk Assessment, Risk Factors, Stroke diagnosis, Stroke mortality, Time Factors, Treatment Outcome, Anticoagulants administration & dosage, Atrial Fibrillation therapy, Catheter Ablation adverse effects, Catheter Ablation mortality, Ischemic Attack, Transient prevention & control, Stroke prevention & control
Abstract

Background: The safety of discontinuing oral anticoagulant (OAC) after ablation for atrial fibrillation (AF) in Japanese patients has not been clarified., Methods and results: A study based on the Atrial Fibrillation registry to Follow the long-teRm Outcomes and use of aNTIcoagulants aftER Ablation (AF Frontier Ablation Registry) was conducted. Data were collected from 3,451 consecutive patients (74.1% men; age, 63.3±10.3 years) who had undergone AF ablation at any of 24 cardiovascular centers in Japan between August 2011 and July 2017. During a 20.7-month follow-up period, OAC therapy was discontinued in 1,836 (53.2%) patients; 51 patients (1.5%) suffered a stroke/transient ischemic attack (TIA), 71 (2.1%) suffered major bleeding, and 36 (1.0%) died. Patients in whom OAC therapy was discontinued were significantly younger than those in whom OACs were continued, and their CHA 2 DS 2 -VASc scores were significantly lower. The incidences of stroke/TIA, major bleeding, and death were significantly lower among these patients. Upon multivariate adjustment, stroke events were independently associated with relatively high baseline CHA 2 DS 2 -VASc scores but not with OAC status., Conclusions: Although the incidences of stroke/TIA, major bleeding, and death were relatively low among patients for whom OAC therapy was discontinued, stroke/TIA occurrence was strongly associated with a high baseline stroke risk rather than with OAC status. Thus, discontinuation of OAC therapy requires careful consideration, especially in patients with a high baseline stroke risk.

Published
2019
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47. Simultaneous isolation of superior and inferior pulmonary veins on both the left and right sides could yield better outcomes in patients with paroxysmal atrial fibrillation.

Author

Takigawa M, Kuwahara T, Takahashi A, Okubo K, Takahashi Y, Nakashima E, Yamao K, Watari Y, Nakajima J, Takagi K, Fujino T, Kimura S, Hikita H, Hirao K, and Isobe M

Subjects
Action Potentials, Aged, Atrial Fibrillation diagnosis, Atrial Fibrillation physiopathology, Catheter Ablation adverse effects, Disease-Free Survival, Electrophysiologic Techniques, Cardiac, Female, Heart Conduction System physiopathology, Humans, Male, Middle Aged, Pulmonary Veins physiopathology, Recurrence, Retrospective Studies, Time Factors, Treatment Outcome, Atrial Fibrillation surgery, Catheter Ablation methods, Heart Conduction System surgery, Pulmonary Veins surgery
Abstract

Aims: This study investigated whether disappearance patterns of pulmonary vein (PV) potentials (PVPs) during PV isolation (PVI) affect the outcome of catheter ablation (CA) in patients with paroxysmal atrial fibrillation (PAF)., Methods and Results: Extensive PVI was performed in 1149 PAF patients (age, 61 ± 10 years). Clinical and demographic characteristics, ablation data, and follow-up outcomes were prospectively collected. During an initial CA, simultaneous disappearance of superior and inferior PVPs in both right and left PVs was observed in 464 (40.4%) patients (Group S). Atrial fibrillation-recurrence free rates at 1, 3, and 5 years after the initial CA in Group S were 78.9, 71.9, and 68.1%, respectively, which were higher than those in Group Non-S (P = 0.004). However, those were similar after the final CA between both groups. The incidence of PV-left atrium (LA) electrical reconnection was significantly lower in Group S than in Group Non-S in the second (Group S, 65.6% vs. Group Non-S, 82.1%; P = 0.004) and third (Group S, 8.3% vs. Group Non-S, 47.6%; P = 0.03) CAs. Furthermore, the reconnections more frequently occurred on the side of PVs where simultaneous PVP elimination had not been achieved at the initial CA. Simultaneous disappearance of superior and inferior PVPs in both right and left PVs independently reduced the risk of AF recurrence after the initial CA by 26%., Conclusions: The simultaneous disappearance of superior and inferior PVPs in both right and left PVs is associated with less frequent PV-left atrium reconnection and may yield a better clinical outcome after the initial CA., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.)

Published
2015
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