Impact of renal function on the efficacy of low-voltage area ablation after pulmonary vein isolation: A sub-analysis of the SUPPRESS-AF trial.

Background And Aims: The SUPPRESS-AF trial showed that pulmonary vein isolation (PVI) plus low-voltage area (LVA) ablation may reduce atrial fibrillation (AF) recurrence in some subgroups. Renal dysfunction is a cause of LVAs due to atrial cardiomyopathy and is also a risk factor for AF recurrence after catheter ablation. The aim of this study was to investigate the efficacy of LVA ablation after PVI stratified by renal function.

Long-term prognosis after acute coronary syndrome due to de novo coronary artery lesions and stent thrombosis in patients on hemodialysis.

Percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) undergoing hemodialysis (HD) remains challenging, with limited long-term outcome data. We investigated the long-term prognosis of ACS due to de novo coronary artery lesions and stent thrombosis (ST) in patients with and without HD. We analyzed 187 patients with ACS from the Osaka Cardiovascular Conference Long ST registry, a retrospective, multicenter registry of definite ST, and 1,856 patients with ACS due to de novo coronary artery lesions at Kansai Rosai Hospital.

Long-Term Outcomes Following Percutaneous Coronary Intervention With Rotational Atherectomy for Severely Calcified Lesions.

Background: While severe calcification is associated with unfavorable clinical outcomes, rotational atherectomy (RA) has been used for lesion modification of severely calcified lesions. However, long-term outcomes after percutaneous coronary intervention (PCI) with RA have not yet been fully investigated.

Methods And Results: We enrolled 301 patients with 334 lesions, which were treated using PCI with RA.

Late stent thrombosis six months after ultrathin-strut covered stent implantation in lesion with calcified nodule.

Unlabelled: A 72-year-old woman undergoing hemodialysis presented with effort angina pectoris due to severe stenosis with calcified nodules in the right coronary artery. Percutaneous coronary intervention was performed using an excimer laser coronary angioplasty and an ultrathin-strut covered stent (CS) was implanted due to coronary perforation. An additional durable-polymer everolimus-eluting stent (DP-EES) was implanted because of protrusions in the proximal edge of the CS.

Impact of quantitative flow ratio on outcomes after percutaneous coronary intervention for chronic total occlusion.

The clinical implication of a post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) in coronary artery disease (CAD) patients with chronic total occlusion (CTO) remains insufficiently explored. This single-center retrospective observational study analyzed 195 CTO lesions from 195 CAD patients who underwent successful PCI with drug-eluting stent implantation and were assessed for post-PCI QFR. The primary end point was target lesion revascularization (TLR) at 3 years.

Serial Change and Clinical Impact of Irregular Protrusion in Lesions With Chronic Coronary Syndrome.

Background: The changes over time and effects on long-term clinical outcomes beyond 1 year of irregular protrusion (IP) in chronic coronary syndrome (CCS) remains unclear.

Aims: This study aimed to assess the time-dependent change and long-term clinical impact of IP in CCS lesions.

Methods: This study was a post hoc analysis of COLLABORATION study, which was a multicenter, prospective, observational study conducted from July 2018 to February 2020, assessing 1- and 12-month serial vessel responses after stent implantation using OCT and coronary angioscopy.

Comparison of Vessel Responses Following Combined Sirolimus-Eluting and Endothelial Progenitor Cell Stent and Ultra-Thin Sirolimus-Eluting Stent Implantation by Serial Optical Coherence Tomography and Coronary Angioscopy: A Multicenter Observational Study.

A dual-therapy sirolimus-eluting and CD34+ antibody-coated Combo Stent (DTS) has been developed to enhance endothelization and capture endothelial progenitor cells; however, vessel responses following DTS implantation remain unclear. Therefore, we evaluated early- and mid-term intravascular characteristics of DTS using intravascular imaging modalities. This multicenter, prospective, observational study enrolled 88 patients (95 lesions) who underwent DTS (43 patients, 48 lesions) or sirolimus-eluting Orsiro stent (SES, 45 patients, 47 lesions) implantation.

Association between body size and atrial myopathy: Investigation using the prevalence of left atrial low-voltage areas.

Background: Left atrial low-voltage areas (LVAs) are known to be associated with atrial myopathy and atrial fibrillation (AF) recurrence after catheter ablation. However, the association between body size and prevalence of LVAs has not been fully elucidated. The purpose of this study was to clarify the association between body size and the prevalence of LVAs in patients with AF ablation.

Factors associated with recurrence after drug-coated balloon therapy for femoropopliteal in-stent restenosis.

Purpose: To evaluate the impact of intravascular ultrasound (IVUS)-evaluated tissue morphology on recurrence following drug-coated balloon (DCB) angioplasty for the treatment of femoropopliteal in-stent restenosis (FP-ISR).

Methods: This study was a single-center, retrospective, observational study. Study subjects were 65 FP-ISR lesions (mean lesion length: 165 ± 88 mm, occlusive restenosis: 25%) in 53 patients (age: 76 ± 8, diabetes mellitus: 66%) who underwent DCB angioplasty and whose IVUS data of tissue morphology were available.

Incidence of Angiographic Deterioration Following Inframalleolar Angioplasty and Its Impact on Outcomes in Patients With Chronic Limb-Threatening Ischemia Requiring Repeat Intervention.

Background: Clinical impact of inframalleolar (IM) angioplasty in patients with chronic limb-threatening ischemia (CLTI) is still controversial.

Methods And Results: This single-center, retrospective study included 168 patients with CLTI and tissue loss who underwent angioplasty for IM lesions. Angiographic follow up was performed at reintervention between April 2010 and December 2020.

A hospital lipid-lowering protocol improves 2-year clinical outcomes in patients with acute coronary syndrome.

Background: Although mortality after acute coronary syndrome (ACS) has improved in the acute phase, cardiovascular events occur at a certain frequency in the chronic phase. A hospital lipid-lowering protocol (HLP) could be effective in providing optimal lipid-lowering therapy to improve long-term clinical outcomes after ACS.

Aims: This study investigated the impact of HLP on clinical outcomes in patients with ACS.

Impact of Cilostazol Administration on Prevention of Aspiration Pneumonia in Patients With Chronic Limb-Threatening Ischemia.

Background: Cilostazol has reported effectiveness for preventing aspiration pneumonia in patients with ischemic stroke, but whether it is similarly beneficial for patients with chronic limb-threatening ischemia (CLTI) is unclear.

Methods And Results: This retrospective single-center study enrolled 1,368 CLTI patients treated with endovascular therapy (EVT). In the multivariate analysis, predictors for aspiration pneumonia were age (hazard ratio [HR] 1.

Impact of Immunosuppressive Therapy on Lead Dislodgement After Cardiac Implantable Electronic Device Implantation.

Backgrounds: Lead dislodgement is a severe complication in cardiac implantable electronic device (CIED) implantation. Inflammation after CIED implantation results in the development of adhesions between lead and tissues, resulting in the lead becoming fixed in the body. In patients with immunosuppressive therapy, however, adhesion is inhibited by anti-inflammatory effects.

Left atrial low voltage areas and heart failure in patients with atrial fibrillation: Implication of the atrial myopathy.

Aims: Atrial fibrillation (AF) and heart failure (HF) affect each other and are often co-morbid. The fact that HF development is not uncommon even after ablation suggests that we need a deeper understanding of the pathology of these conditions. Atrial myocardial degeneration is an underlying factor in AF patients and may be associated with HF development after ablation.

Impact of wall thickness on the tissue cooling effect of cryoballoon ablation.

Aims: Understanding of the tissue cooling properties of cryoballoon ablation during pulmonary vein (PV) isolation is lacking. The purpose of this study was to delineate the depth of the tissue cooling effect during cryoballoon freezing at the pulmonary venous ostium.

Methods And Results: A left atrial-PV model was constructed using a three-dimensional printer with data from a patient to which porcine thigh muscle of various thicknesses could be affixed.

Impact of baseline yellow plaque assessed by coronary angioscopy on vascular response after stent implantation.

Background: The relationship between baseline yellow plaque (YP) and vascular response after stent implantation has not been fully investigated.

Methods: This was a sub-analysis of the Collaboration-1 study (multicenter, retrospective, observational study). A total of 88 lesions from 80 patients with chronic coronary syndrome who underwent percutaneous coronary intervention were analyzed.

Atrial Functional Substrates for the Prediction of Atrial Fibrillation Recurrence After Pulmonary Vein Isolation.

Low-voltage areas have been used as atrial structural substrates in estimating fibrotic degeneration in patients with atrial fibrillation (AF). The high-resolution maps obtained by recently developed mapping catheters allow the visualization of several functional abnormalities. We investigated the association between left atrial (LA) functional abnormal findings on a high-resolution substrate map and AF recurrence in patients who underwent pulmonary vein isolation without any additional LA substrate ablation.

Impact of diabetes mellitus and poor glycemic control on the prevalence of left atrial low-voltage areas and rhythm outcome in patients with atrial fibrillation ablation.

Introduction: Left atrial low-voltage areas (LVAs) are known to be correlated with atrial scarring and atrial fibrillation (AF) recurrence after ablation. However, the association between LVAs and glycemic status before ablation has not been fully clarified. The purpose of this study was to investigate associations among the prevalence of diabetes mellitus (DM), glycemic control, and the prevalence of LVAs in patients with AF ablation.

Prognostic impact of atrial cardiomyopathy: Long-term follow-up of patients with and without low-voltage areas following atrial fibrillation ablation.

Background: Atrial cardiomyopathy is known as an underlying pathophysiological factor in the majority of patients with atrial fibrillation (AF). Left atrial low-voltage areas (LVAs) are reported to coincide with fibrosis and likely represent atrial cardiomyopathy.

Objective: The purpose of this study was to delineate differences in the long-term prognosis of patients stratified by the size of LVAs.

Two-year real world clinical outcomes after intravascular imaging device guided percutaneous coronary intervention with ultrathin-strut biodegradable-polymer sirolimus-eluting stent.

Background: There are little clinical data on imaging-guided percutaneous coronary intervention (PCI) 1 year after the biodegradable-polymer sirolimus-eluting stents (BP-SES) implantation, when the polymer disappears.

Methods: We retrospectively analyzed 2455 patients who underwent successful PCI with BP-SES or durable-polymer everolimus-eluting stents (DP-EES) between September 2011 and March 2021, and compared 2-year clinical outcomes of BP-SES (n = 459) with DP-EES (n = 1996). The outcome measures were target lesion revascularization (TLR) and major adverse cardiac events (MACE), defined as a composite of cardiac death, myocardial infarction, target vessel revascularization, and stent thrombosis.

Comparison of voltage maps using OCTARAY catheter and PENTARAY catheter.

Background: Recently, a new OCTARAY mapping catheter was commercially launched. The catheter is designed to enable high-density mapping and precise signal recording via 48 small electrodes arranged on eight radiating splines. The purpose of this study was to compare bipolar voltage and low-voltage-area size, and mapping efficacy between the OCTARAY catheter and the PENTARAY catheter METHODS: Twelve consecutive patients who underwent initial and second ablations for persistent atrial fibrillation within 2 years were considered for enrollment.