- 著者
- Atsushi Suzuki Ryudo Fujiwara Hiroyuki Asada Kohei Iwasa Tomohiro Miyata Woo Hyung Song Kotaro Higuchi Hidenobu Seo Yuki Sakamoto Masahiro Shimizu Fumitaka Soga Hiroyuki Shibata Amane Kozuki Ryoji Nagoshi H. Immo Lehmann Yoichi Kijima Junya Shite
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-21-0423, (Released:2021-07-30)
- 参考文献数
- 17
- 被引用文献数
- 4
Background:The use of iodine contrast agents is one possible limitation in cryoballoon ablation (CBA) for atrial fibrillation (AF). This study investigated intracardiac echography (ICE)-guided contrast-free CBA.Methods and Results:The study was divided into 2 phases. First, 25 paroxysmal AF patients (Group 1) underwent CBA, and peri-balloon leak flow velocity (PLFV) was assessed using ICE and electrical pulmonary vein (PV) lesion gaps were assessed by high-density electroanatomical mapping. Then, 24 patients (Group 2) underwent ICE-guided CBA and were compared with 25 patients who underwent conventional CBA (historical controls). In Group 1, there was a significant correlation between PLFV and electrical PV gap diameter (r=–0.715, P<0.001). PLFV was higher without than with an electrical gap (mean [±SD] 127.0±28.6 vs. 66.6±21.0 cm/s; P<0.001) and the cut-off value of PLFV to predict electrical isolation was 105.7 cm/s (sensitivity 0.700, specificity 0.929). In Group 2, ICE-guided CBA was successfully performed with acute electrical isolation of all PVs and without the need for “rescue” contrast injection. Atrial tachyarrhythmia recurrence at 6 months did not differ between ICE-guided and conventional CBA (3/24 [12.5%] vs. 5/25 [20.0%], respectively; P=0.973, log-rank test).Conclusions:PLFV predicted the presence of an electrical PV gap after CBA. ICE-guided CBA was feasible and safe, and could potentially be performed completely contrast-free without a decrease in ablation efficacy.
- 著者
- Takamichi Yamamoto Seung Bong Hong Masahiro Shimizu Katsuaki Sato Yotaro Numachi
- 出版者
- 日本てんかん学会
- 雑誌
- Epilepsy & Seizure (ISSN:18825567)
- 巻号頁・発行日
- vol.7, no.1, pp.55-65, 2014-08-15 (Released:2014-08-15)
- 参考文献数
- 12
- 被引用文献数
- 5
Purpose: To evaluate the efficacy and safety of lamotrigine monotherapy in patients with newly diagnosed partial seizures including secondarily generalized seizures or generalized tonic-clonic seizures, and those with recurrent seizures in Japan and South Korea.Methods: The study was a multi-center, open-label, evaluation of lamotrigine monotherapy in patients with newly diagnosed epilepsy or epilepsy with recurrent seizures. The primary endpoint was the seizure-free rate in the maintenance phase.Results: A total of 67 patients were enrolled; 52 patients completed 6 weeks of treatment (the escalation phase) and 42 patients completed 30 weeks of treatment (the escalation phase and the maintenance phase). The seizure-free rate in the maintenance phase for all seizure types was 43.1%. Adverse events (AEs) were reported in 82% (53/65) of patients. The most common AEs were headache (14/65, 22%), nasopharyngitis (12/65, 18%) and rash (7/65, 11%).Conclusion: The seizure-free rate with lamotrigine monotherapy in the maintenance phase was 43.1% for all seizure types. Lamotrigine monotherapy appears to be effective in patients with newly diagnosed epilepsy and those with recurrent seizures in Japan and South Korea. The safety profile of lamotrigine in this monotherapy study was similar to that observed in patients with adult bipolar disorder treated with lamotrigine monotherapy.