Publications by authors named "Yu-Cheng Hsieh"
2025 THRS Expert Consensus of Imaging Assessment in Atrial Fibrillation. .
Acta Cardiol Sin
July 2025
Atrial fibrillation (AF) is the most common form of cardiac arrhythmia in the elderly population with a high lifetime risk after the age of 45 years, leading to a major impact on the public health from elicited left atrial (LA) thrombogenesis and cardioembolic stroke. Imaging in the AF population plays a crucial role, not only in assessing LA size but also in delineating the underlying cardiac structural and functional features to reach a more specific diagnosis. Contemporary clinical practice guideline recommended anticoagulation therapy based on annual thromboembolic event risk using a validated clinical risk score.
View Article and Find Full Text PDFIncorporating pharmacogenetics into clinical practice promises to improve therapeutic outcomes by optimizing drug selection and dosage based on genetic factors affecting drug response. A key advantage of PGx-guided therapy is to decrease the likelihood of adverse events. To evaluate the clinical impact of PGx risk variants, we performed a retrospective study using genetic and clinical data from the largest Han Chinese cohort, comprising 486,956 individuals, assembled by the Taiwan Precision Medicine Initiative.
View Article and Find Full Text PDFIntroduction: Data on the long-term outcomes and procedural details of the lesion size index-guided high-power ablation strategy (HP-LSI) are limited.
Methods: Eighty patients were retrospectively assigned to the high-power with time-restricted ablation strategy (fixed at 10 s per lesion), while 67 patients were assigned to the high power LSI-guided strategy (anterior wall LSI at least 5.0, posterior wall LSI 4.
Electrocardiographic Characteristics of Ventricular Arrhythmias Originating From High Right Ventricular Outflow Tract and Pulmonary Artery.
J Cardiovasc Electrophysiol
July 2025
Background: Ventricular arrhythmias (VAs) may originate from the right ventricular outflow tract (RVOT) below the pulmonary sinus cusps (PSCs) or from the pulmonary artery (PA) above the PSCs. However, the electrocardiographic (ECG) characteristics of these VAs are not well defined.
Objective: This study aimed to investigate the ECG characteristics of VAs originating from the high RVOT and PA.
Background: Apolipoprotein A1 (ApoA1) is a major component of high-density lipoprotein cholesterol and plays a critical role in reverse cholesterol transport. Dynamic changes in ApoA1 levels may be associated with major adverse cardiovascular events. This study aimed to evaluate the impact of ApoA1 trajectories over three early assessments.
View Article and Find Full Text PDFSGLT2i and Cardiovascular Events in Patients With Concomitant Atrial Fibrillation and Diabetes: A TriNetX Cohort Study.
J Clin Endocrinol Metab
August 2025
Aims: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) enhance cardiovascular outcomes in individuals with type 2 diabetes mellitus (T2DM). Whether such effects also occur in T2DM patients with atrial fibrillation (AF) remains unknown. We aimed to investigate SGLT2i use on cardiovascular outcomes in patients with concomitant AF and T2DM.
View Article and Find Full Text PDFArticle Synopsis
- Edoxaban, a non-vitamin K oral anticoagulant, is approved for stroke prevention in atrial fibrillation (AF) patients in many Asian countries, but its long-term effectiveness and safety had limited data in Taiwan prior to this study.
- The Global ETNA-AF registry analyzed two-year outcomes in Taiwan and three other Asian countries, revealing that edoxaban users in Taiwan were generally older with lower kidney function but showed comparable low rates of clinical events across regions.
- The study concluded that despite some variations in patient characteristics, the low rates of cardiovascular death and major bleeding events indicate that edoxaban is effective and safe for routine clinical use among AF patients in Taiwan and other Asian countries.
Background: Atrial fibrillation (AF) increases the risks of stroke and mortality. It remains unclear whether rhythm control reduces the risk of stroke in patients with AF concomitant with hypertrophic cardiomyopathy (HCM).
Methods: We identified AF patients with HCM who were ≥ 18 years old in the Taiwan National Health Insurance Database.
Article Synopsis
- Differentiating left ventricular hypertrophy (LVH) from conditions like hypertrophic cardiomyopathy (HCM) and Fabry disease is complex and often requires input from various specialists, which leads to inconsistent diagnoses.
- *A new AI-based tool called the MRI short-axis view left ventricular hypertrophy classifier (MSLVHC) has been developed to accurately distinguish HCM from Fabry disease using MRI cine images and has shown high accuracy and strong performance metrics.
- *The model not only demonstrated reliability in tests at two hospitals but also holds potential to enhance the diagnostic process for specialists dealing with LVH-related conditions.
Article Synopsis
- This study introduces a novel approach for multi-level storage using via RRAM in conjunction with standard FinFET CMOS logic processes.
- It highlights the achievement of multiple resistance states by carefully managing current compliance during the set operations.
- Additionally, the research proposes new setting circuits to enhance stability and manage resistance control amidst process variations, leading to improved performance in multi-level state distributions.
Article Synopsis
- This study investigates how AI and pre-ablation CT images can predict the recurrence of atrial fibrillation (AF) after catheter ablation, relying on clinical data and imaging for better accuracy.
- Researchers analyzed data from 638 patients and designed machine learning models using CT images and clinical variables, achieving varying predictive performance for AF recurrence.
- The best results came from an ensemble model combining both AI-driven imaging and selected clinical variables, yielding a predictive accuracy (AUC) of 0.76.
Aims: The effectiveness of sodium-glucose co-transporter-2 inhibitors (SGLT2i) on incident dementia in patients with diabetes and atrial fibrillation (AF) remains unknown. This study aimed to investigate the association between SGLT2i and the risk of incident dementia in diabetic patients with AF, and to explore the interactions with oral anticoagulants or dipeptidyl peptidase-4 inhibitors (DPP4i).
Materials And Methods: We conducted a cohort study using Taiwan's National Health Insurance Research Database.
Catheter Ablation With Morphologic Repetitiveness Mapping for Persistent Atrial Fibrillation.
JAMA Netw Open
November 2023
Article Synopsis
- A study was conducted to evaluate whether a new mapping technique, PRISM, could improve catheter ablation outcomes for patients with persistent atrial fibrillation (AF) when combined with traditional methods.
- The trial involved 170 patients and showed that those who underwent the PRISM-guided procedure had a significantly higher success rate in maintaining normal heart rhythm after 12 months compared to the conventional approach.
- The findings suggest that PRISM mapping may enhance the precision of AF treatment and reduce the recurrence of atrial arrhythmias, making it a promising alternative for persistent AF management.
Article Synopsis
- The study investigates the occurrence of Carina breakthrough (CB) at the right pulmonary vein (RPV) after a specific ablation procedure in atrial fibrillation patients.
- Out of 62 patients, 33.87% experienced RPV CB, and those affected had lower contact force (CF) at lesions near the RPV carina compared to those who did not.
- The research found that a CF of less than 10.5 grams is a potential predictor of RPV CB, suggesting that higher CF during ablation could help reduce this complication.
Article Synopsis
- This study compares the effectiveness of circumferential pulmonary vein isolation (CPVI) and segmental pulmonary vein isolation (SPVI) in patients undergoing redo ablations for recurrent atrial fibrillation (AF).
- 543 patients who had AF ablation were analyzed, with 141 included in the final assessment; the results showed similar AF-free survival rates for both techniques, but a significant difference in atrial flutter recurrence favoring CPVI.
- The findings suggest that while SPVI and CPVI are comparable for AF recurrence, SPVI has a higher rate of atrial flutter, potentially linked to more residual pulmonary vein gaps over time.
Article Synopsis
- This study looked at new-onset dementia in patients with atrial fibrillation (AF) and how catheter ablation might affect dementia risk.
- Using a large database from Taiwan, researchers followed over 136,000 patients for about 6.6 years and found that those with AF had a significantly higher risk of developing dementia, especially Alzheimer's disease.
- The results showed that patients with AF who underwent catheter ablation had a lower overall risk of dementia, although this did not apply to vascular dementia types.
Article Synopsis
- Amiodarone is a medicine used during therapeutic hypothermia (cooling the body) after a heart stops working because of abnormal heart rhythms.
- Scientists did experiments on pigs to see how this medicine affects heart electricity when the pigs are cooled down.
- The results showed that using amiodarone during cooling makes heart signals uneven and increases the risk of dangerous heart rhythms compared to just cooling down.
Atrial fibrillation as a contributor to the mortality in patients with dementia: A nationwide cohort study.
Front Cardiovasc Med
April 2023
Article Synopsis
- This study investigates how atrial fibrillation (AF) affects death risks in patients who also have dementia, using data from Taiwan's National Health Insurance Research Database.
- The research shows that patients with both dementia and AF have a higher likelihood of dying from all causes and specifically from cardiovascular issues compared to those with dementia alone.
- It emphasizes the need for managing AF in dementia patients, as certain medications may help lower their risk of mortality.
Background: Therapeutic hypothermia (TH) increases the susceptibility to ventricular arrhythmias (VAs) by prolonging action potential duration (APD) and facilitating arrhythmogenic spatially discordant alternans (SDA). Levosimendan, a calcium sensitizer, has been reported to shorten APD by enhancing the adenosine triphosphate (ATP)-sensitive K current.
Objective: The purpose of this study was to test the hypothesis that, during TH, levosimendan shortens the already prolonged APD, attenuates SDA, and prevents VA.
Article Synopsis
- Propafenone, a class IC antiarrhythmic drug, is a standard treatment for paroxysmal atrial fibrillation (AF) in Taiwan, and this study investigates the effectiveness and safety of its generic version (Rhynorm) compared to the brand name (Rytmonorm).
- The study involved 76 patients with AF, using a wearable ECG to track AF episodes over 24 weeks, focusing on the frequency of significant AF occurrences and any adverse effects.
- The results showed that Rhynorm is as effective and safe as Rytmonorm for treating AF, with no significant differences between the two groups, confirming Rhynorm's noninferiority.
Article Synopsis
- The Improve SCA trial highlights the underutilization of implantable cardioverter-defibrillators (ICDs) in regions like Asia, Latin America, and Africa, showing their potential benefits for patients with ischemic (ICM) and non-ischemic cardiomyopathy (NICM) who are at risk of sudden cardiac arrest (SCA).
- Out of 1848 non-ischemic and 581 ischemic cardiomyopathy patients, those who received ICDs had significantly lower all-cause mortality rates at 3 years compared to those without the devices, indicating a strong mortality benefit.
- The study concludes that ICD implantation is crucial for improving survival in primary prevention patients and that the rate of appropriate device therapy is
(1) Background: Catheter ablation (CA) is an accepted treatment option for drug-refractory ventricular tachycardia (VT) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). This study investigates the effect of amiodarone on ablation outcomes in ARVC. (2) Methods: The study enrolled patients with ARVC undergoing CA of sustained VT.
View Article and Find Full Text PDFBackground: The substrate and ablation outcome in arrhythmogenic right ventricular cardiomyopathy (ARVC) with or without right ventricular (RV) dysfunction is unclear.
Objective: We aimed to investigate ablation outcome and substrate in ARVC patients with or without RV dysfunction.
Methods: We retrospectively studied ARVC patients with (group 1) or without RV dysfunction (group 2) undergoing substrate mapping/ablation.
Article Synopsis
- Atypical atrial flutter (aAFL) is common after cardiac surgeries or procedures for atrial fibrillation, and this study aimed to improve ablation techniques using a new mapping algorithm.
- Researchers studied 15 patients with 20 cases of aAFL, finding that the ablation sites identified by analyzing global activation histograms (GAH) were highly effective in targeting reentry circuits.
- The use of the Lumipoint algorithm facilitated better identification of slow conduction areas, leading to quicker aAFL termination and improved patient outcomes.
Background: The presence of ventricular tachycardia (VT) is associated with higher mortality. The annual incidence of VT after a diagnosis of amyloidosis and the associated cardiovascular (CV) outcomes have not been well assessed in a large cohort.
Methods: A total of 12,139 amyloidosis patients were identified from the Taiwan National Health Insurance Research Database.