Long-Term Anticoagulation Discontinuation After Catheter Ablation for Atrial Fibrillation: The ALONE-AF Randomized Clinical Trial.

Importance: Data from randomized clinical trials on a long-term anticoagulation strategy for patients after catheter-based ablation for atrial fibrillation (AF) are lacking.

Objective: To evaluate whether discontinuing oral anticoagulant therapy provides superior clinical outcomes compared with continuing oral anticoagulant therapy in patients without documented atrial arrhythmia recurrence after catheter ablation for AF.

Design, Setting, And Participants: A randomized clinical trial including 840 adult patients (aged 19-80 years) who were enrolled and randomized from July 28, 2020, to March 9, 2023, at 18 hospitals in South Korea.

A Social History of Seoul National University Hospital: The National Health Insurance, Three-Minute Consultation, and the Convoluted Legacy of American Aid for a Postcolonial Medical Institution in South Korea.

The author traces the evolution of Seoul National University Hospital (SNUH) and its predecessors, focusing on their transformation from the 1960s to the 1980s. Starting as an impoverished governmental hospital of a postcolonial country, it grew into a major South Korean biomedical corporation with many faculty members with American training, a new main building with the latest technologies, and a larger independent budget supported by the National Health Insurance (NHI). However, this evolution accompanied multiple issues stemming from overcrowding, which resulted in short and skimpy consultations, a poor environment, staff exploitation, and various minor crimes.

Adherence to the ABC (atrial fibrillation better care) pathway and risk of adverse outcomes in patients with chronic kidney disease: a report from the prospective APHRS-AF registry.

Background: Limited data exist on the effectiveness of the ABC (Atrial Fibrillation Better Care) pathway in reducing adverse events in Asian patients with atrial fibrillation (AF) and chronic kidney disease (CKD).

Methods: A post-hoc analysis of the prospective APHRS AF Registry. Patients were divided into CKD (eGFR < 60 ml/min) and non-CKD (eGFR ≥ 60 ml/min) groups.

Apixaban outcomes in atrial fibrillation patients with a single-dose reduction criterion: ASPIRE 1-year results.

Aims: This study, using a prospective cohort, evaluated the effectiveness and safety of off-label reduced-dose apixaban vs. the on-label dose in atrial fibrillation (AF) patients meeting a single-dose reduction criterion.

Methods And Results: The efficAcy and Safety of aPixaban In REal-world practice in Korean frail patients with AF (ASPIRE) study is a multicentre, prospective observational cohort involving AF patients who met a single-dose reduction criterion of apixaban.

Post-Implant Global Longitudinal Strain as a Predictor of Pacing-Induced Cardiomyopathy in Patients with Preserved Ejection Fraction Undergoing Pacemaker Placement.

Background: Right ventricular (RV) pacing exacerbates heart failure and increases cardiac mortality in patients with reduced ejection fraction (EF). However, its impact on left ventricular dysfunction in patients with preserved EF remains inconclusive. This study investigates the relationship between RV pacing, global longitudinal strain (GLS), and EF in patients with preserved EF.

Artemisinin-Quinidine Combination for Suppressing Ventricular Tachyarrhythmia in an Ex Vivo Model of Brugada Syndrome.

Background: The ionic mechanism underlying Brugada syndrome (BrS) arises from an imbalance in transient outward current flow between the epicardium and endocardium. Previous studies report that artemisinin, originally derived from a Chinese herb for antimalarial use, inhibits the Ito current in canines. In a prior study, we showed the antiarrhythmic effects of artemisinin in BrS wedge preparation models.

Clinical outcomes of Asian patients with newly diagnosed atrial fibrillation and previously diagnosed atrial fibrillation: Insights from the CODE-AF Registry.

Background: Atrial fibrillation (AF) may have different clinical features in its early phase.

Objective: The purpose of this study was to compare the characteristics and clinical outcomes of early-phase AF with later-phase AF using a large multicenter prospective registry (CODE-AF [COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation]).

Methods: Patients enrolled between June 2016 and March 2021 were divided into 2 groups based on AF duration: (1) newly diagnosed (AF duration ≤90 days); and (2) previously diagnosed (AF duration >90 days).

Impact of Atrial Fibrillation with Rapid Ventricular Response on Atrial Fibrillation Recurrence: From the CODE-AF Registry.

: Relatively little has been established about the association of rapid ventricular response (RVR) with further recurrence of atrial fibrillation (AF). This study investigated the impact of RVR on the recurrence of AF. : Data were obtained from a multicenter, prospective registry of non-valvular AF patients.

Multifunctional Magnetic Muscles for Soft Robotics.

Despite recent advancements, artificial muscles have not yet been able to strike the right balance between exceptional mechanical properties and dexterous actuation abilities that are found in biological systems. Here, we present an artificial magnetic muscle that exhibits multiple remarkable mechanical properties and demonstrates comprehensive actuating performance, surpassing those of biological muscles. This artificial muscle utilizes a composite configuration, integrating a phase-change polymer and ferromagnetic particles, enabling active control over mechanical properties and complex actuating motions through remote laser heating and magnetic field manipulation.

The anticoagulation one year after ablation of atrial fibrillation in patients with atrial fibrillation (ALONE-AF) trial: Study protocol.

Background: The ideal long-term antithrombotic strategy for patients after successful catheter-based atrial fibrillation (AF) ablation is still uncertain. Presently, practices vary, and the advantages of oral anticoagulation (OAC) for the post-ablation population are not clearly established. To date, no randomized trials have addressed this therapeutic question.

New Insights into Pacing Induced Cardiomyopathy.

Pacing induced cardiomyopathy (PICM) can occur as a complication due to pacing the right ventricle. Its precise definition varies across different studies, leading to uncertainty as to the best approach for managing this entity. More than 10% of patients who undergo chronic right ventricular pacing develop PICM.

Clinical characteristics of apixaban prescription in AF patients with single dose-reduction criterion: the ASPIRE (efficAcy and safety of aPixaban in rEal-world practice in Korean frail patients with atrial fibrillation) study.

Background: Data on off-label reduced dose risk among patients with atrial fibrillation (AF) who qualify for a single-dose reduction of apixaban is scarce.

Objectives: We prospectively assessed apixaban dosing and clinical characteristics in AF patients meeting a dose reduction criterion.

Methods: The multicentre, prospective cohort study, the efficAcy and Safety of aPixaban In REal-world practice in Korean frail patients with AF (ASPIRE), encompasses patients with AF who met the criteria for a single-dose reduction of apixaban and were given varying doses of apixaban, either the on-label standard dose or the off-label reduced dose.

Reinforcement of a Subcutaneous Pocket for Implantable Cardioverter Defibrillator Insertion Using Acellular Dermal Matrix: A Case Report.

Pediatric patients who undergo implant insertion into the chest wall face a high risk of implant exposure to the external environment. Five months after an 8-year-old boy underwent implantable cardioverter-defibrillator (ICD) implantation in a subcutaneous pocket in the left anterolateral chest wall to manage long QT syndrome, ICD replacement became necessary owing to exposure risk from distal and lateral thinning of the ICD pocket. Pocket rupture and exposure would increase the risk of infection; therefore, we performed ICD removal and primary pocket closure.

Educational status and the risk of adverse outcomes in Asian patients with atrial fibrillation: a report from the prospective APHRS-AF Registry.

Background: The aim of this study was to evaluate the impact of educational status (ES) on the clinical course of Asian patients with atrial fibrillation (AF).

Methods: We used data from the prospective APHRS-AF Registry. ES was classified as follows: low (primary school), medium (secondary), and high (University).

Case Report: Comprehensive evaluation of ECG phenotypes and genotypes in a family with Brugada syndrome carrying .

Background: Brugada syndrome (BrS) is a channelopathy that can lead to sudden cardiac death in the absence of structural heart disease. Patients with BrS can be asymptomatic or present with symptoms secondary to polymorphic ventricular tachycardia or ventricular fibrillation. Even though BrS can exhibit autosomal dominant inheritance, it is not easy to identify the phenotype and genotype in a family thoroughly.

Association Between Atrial Fibrillation Symptoms and Clinical Outcomes: A Prospective Multicenter Registry Study.

The presence of symptoms plays an important role in determining whether to focus on rhythm control or rate control when treating atrial fibrillation (AF). Previous comparative studies on the clinical outcomes of symptomatic and asymptomatic AF have yielded inconsistent results, and a link between AF symptoms and left atrial (LA) remodeling is not established. Patients selected from the COmparison study of Drugs for symptom control and complication prEvention of AF (CODE-AF) registry, which is a prospective, multicenter study consisting of patients with non-valvular AF, were grouped into 2 groups: symptomatic and asymptomatic.

Modified application of SAMe-TT2R2 scoring system in Asian patients with atrial fibrillation for the selection of oral anticoagulants.

Background/aims: The SAMe-TT2R2 score is used for assessing anticoagulation control (AC) quality with warfarin. However, it is hard to apply SAMe-TT2R2 score in Asian patients with atrial fibrillation (AF), because it has not been proven in those populations. This study aimed to validate the SAMe-TT2R2 score in Asian patients with AF and suggest a modified SAMe- TT2R2 score for this population.

Identification of concealed cardiomyopathy using next-generation sequencing-based genetic testing in Korean patients initially diagnosed with idiopathic ventricular fibrillation.

Aims: Idiopathic ventricular fibrillation (IVF) is a disease in which the cause of ventricular fibrillation cannot be identified despite comprehensive clinical evaluation. This study aimed to investigate the clinical yield and implications of genetic testing for IVF.

Methods And Results: This study was based on the multi-centre inherited arrhythmia syndrome registry in South Korea from 2014 to 2017.

Sex-related differences in presentation, treatment, and outcomes of Asian patients with atrial fibrillation: a report from the prospective APHRS-AF Registry.

We aimed to investigate the sex-related differences in the clinical course of patients with Atrial Fibrillation (AF) enrolled in the Asia-Pacific-Heart-Rhythm-Society Registry. Logistic regression was utilized to investigate the relationship between sex and oral anticoagulant, rhythm control strategies and the 1-year chance to maintain sinus rhythm. Cox-regression was utilized to assess the 1-year risk of all-cause, and cardiovascular death, thromboembolic events, acute coronary syndrome, heart failure, and major bleeding.

Low-dose non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation.

In the last decade, non-vitamin K antagonist oral anticoagulants (NOACs), a new generation of OACs, were introduced to prevent thromboembolism in patients with atrial fibrillation. Although vitamin K-dependent anticoagulants have long been used as OACs, their inherent disadvantage of considerable bleeding complications has limited their use. NOACs demonstrate similar or superior clinical outcomes to those of warfarin.

Clinical and Genetic Features of Korean Inherited Arrhythmia Probands.

Background And Objectives: Inherited arrhythmia (IA) is a more common cause of sudden cardiac death in Asian population, but little is known about the genetic background of Asian IA probands. We aimed to investigate the clinical characteristics and analyze the genetic underpinnings of IA in a Korean cohort.

Methods: This study was conducted in a multicenter cohort of the Korean IA Registry from 2014 to 2017.