Publications by authors named "Takashi Nakashima"

We report reversible severe infranodal conduction disturbances that followed COVID-19 vaccination in a young woman. Right and left bundle branch conduction were impaired and recovered at different times, resulting in reversible paroxysmal complete atrioventricular block.

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Article Synopsis
  • - The study reveals that myogenic stem satellite cell activator HGF experiences nitration due to peroxynitrite, leading to its diminished binding to the receptor c-met, which disrupts muscle health as we age.
  • - A specific rat anti-HGF monoclonal antibody, 1H41C10, effectively protects HGF from nitration at critical tyrosine sites (Y198 and Y250), maintaining its function to activate satellite cells.
  • - The findings suggest that 1H41C10 could be significant in developing treatments for age-related muscle loss and conditions like sarcopenia by preventing HGF dysfunction.
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We described a premature ventricular contraction arising from the left coronary sinus cusp, in which we discussed about the interpretations of the signals recorded there. Our case provided further insights into the interpretation of signals recorded at the coronary sinus cusp during premature ventricular contraction ablation.

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  • A study investigated the prevalence and predictors of complete atrioventricular block (C-AVB) that can occur after internal electrical cardioversion (IEC) during atrial fibrillation (AF) ablation.
  • Of 124 patients undergoing the procedure, 88% had their AF terminated, and transient C-AVB occurred in 13% of those where AF was terminated, with longer ventricular pauses observed in those with C-AVB.
  • Key predictors for experiencing transient C-AVB included a larger left atrial diameter and preexisting intraventricular conduction abnormalities.
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We described the differential ventricular overdrive pacing during long RP' supraventricular tachycardia and discussed about its response leading to the dianosis.

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Mechanical perturbation triggers activation of resident myogenic stem cells to enter the cell cycle through a cascade of events including hepatocyte growth factor (HGF) release from its extracellular tethering and the subsequent presentation to signaling-receptor c-met. Here, we show that with aging, extracellular HGF undergoes tyrosine-residue (Y) nitration and loses c-met binding, thereby disturbing muscle homeostasis. Biochemical studies demonstrated that nitration/dysfunction is specific to HGF among other major growth factors and is characterized by its locations at Y198 and Y250 in c-met-binding domains.

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  • The study investigates the relationship between abnormal atrial potentials (AAPs) and reentrant atrial tachycardia (AT), focusing on how AAPs can indicate areas of slow conduction that support AT circuits.
  • Analysis of 123 ATs in 104 patients shows a significant overlap (93±13%) between AAP areas during sinus rhythm and regions of slow conduction during AT, with variations in AAP distribution based on the type of AT.
  • Findings suggest that AAPs may help identify AT circuit characteristics, particularly in challenging mapping situations, with localized-reentrant ATs having smaller AAP areas compared to macro-reentrant ATs.
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  • Substrate abnormalities can change how atrial tachycardias (ATs) activate, affecting their wave patterns on electrocardiograms.
  • This study examined high-density activation maps of 126 ATs to determine factors influencing periods of no electrical activity (isoelectric intervals) during these complex activation patterns.
  • Results showed that smaller activated areas and larger low-voltage regions were significant predictors of these isoelectric intervals, with specific metrics indicating a strong ability to predict the presence of these intervals during atrial tachycardias.
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In the setting of structural heart disease, ventricular tachycardia (VT) is typically associated with a re-entrant mechanism. In patients with hemodynamically tolerated VTs, activation and entrainment mapping remain the gold standard for the identification of the critical parts of the circuit. However, this is rarely accomplished, as most VTs are not hemodynamically tolerated to permit mapping during tachycardia.

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  • The study explores unidirectional block during AI-guided pulmonary vein isolation in patients with atrial fibrillation, specifically focusing on the entrance and exit blocks in the pulmonary veins (PVs).
  • A total of 441 PVs from 113 patients were analyzed, finding that while entrance block was successfully achieved, only 2% demonstrated unidirectional blocks, with some cases requiring additional treatment to establish bidirectional block.
  • The findings suggest that using entrance block as the main endpoint for pulmonary vein isolation is adequate due to the low occurrence of unidirectional block in this context.
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Background: Bipolar voltage is widely used to characterize the atrial substrate but has been poorly validated, particularly during clinical tachycardias.

Objective: The purpose of this study was to evaluate the diagnostic performance of voltage thresholds for identifying regions of slow conduction during reentrant atrial tachycardias (ATs).

Methods: Thirty bipolar voltage and activation maps created during reentrant ATs were analyzed to (1) examine the relationship between voltage amplitude and conduction velocity (CV), (2) measure the diagnostic ability of voltage thresholds to predict CV, and (3) identify determinants of AT circuit dimensions.

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We describe atrial activation sequence changes during ventricular overdrive pacing in a patient with a concealed left-sided accessory pathway and discuss its potential mechanism.

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Protein tyrosine residue (Y) nitration, a post-translational chemical-modification mode, has been associated with changes in protein activity and function; hence the accumulation of specific nitrated proteins in tissues may be used to monitor the onset and progression of pathological disorders. To verify the possible impact of nitration on postnatal muscle growth and regeneration, a pilot study was designed to examine the nitration/dysfunction of hepatocyte growth factor (HGF), a key ligand that is released from the extracellular tethering and activates myogenic stem satellite cells to enter the cell cycle upon muscle stretch and injury. Exposure of recombinant HGF (a hetero-dimer of α- and β-chains) to peroxynitrite induces Y nitration in HGF α-chain under physiological conditions.

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We described a type 1 Brugada electrocardiogram and discussed about the potential diagnostic electrocardiographic indicators to differentiate true Brugada syndrome and Brugada phenocopy.

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Introduction: Systematic and quantitative descriptions of vein of Marshall (VOM)-induced tissue ablation are lacking. We sought to characterize the distribution of low voltage observed in the left atrium (LA) after VOM ethanol infusion.

Methods And Results: The distribution of ethanol-induced low voltage was evaluated by comparing high-density maps performed before and after VOM ethanol infusion in 114 patients referred for atrial fibrillation ablation.

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Introduction: The optimal strategy after a failed ablation for persistent atrial fibrillation (perAF) is unknown. This study evaluated the value of an anatomically guided strategy using a systematic set of linear lesions with adjunctive ethanol infusion into the vein of Marshall (Et-VOM) in patients referred for second perAF ablation procedures.

Methods And Results: Patients with perAF who underwent a second procedure were grouped according to the two strategies.

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Introduction: Due to changes in esophageal position, preoperative assessment of the esophageal location may not mitigate the risk of esophageal injury in catheter ablation for atrial fibrillation (AF). This study aimed to assess esophageal motion and its impact on AF ablation strategies.

Methods And Results: Ninety-seven AF patients underwent two computed tomography (CT) scans.

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