Japanese Journal of Electrocardiology
Online ISSN : 1884-2437
Print ISSN : 0285-1660
ISSN-L : 0285-1660
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Volume 30, Issue 3
Displaying 1-15 of 15 articles from this issue
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Editorial
  • The Change in Atrial ST Level in Unipolar Lead during Pulmonary Vein Isolation
    Hisa Shimojima, Yukei Higashi, Sayaka Yamaya, Daisuke Wakatsuki, Ayaka ...
    2010 Volume 30 Issue 3 Pages 209-214
    Published: 2010
    Released on J-STAGE: February 03, 2011
    DOIhttps://doi.org/10.5105/jse.30.209
    JOURNAL FREE ACCESS
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    Background and Aim : There has been little information available on the significance of the changes in the STa level in the unipolar electrogram during pulmonary vein isolation (PVI). We examined whether the elevation of the STa in PVI is an indicator of atrial injury. Methods : The study was performed in the 11 cases of atrial fibrillation (AF) undergoing PVI. The unipolar electrogram from the ablation (ABL) catheter tip was recorded during PVI, and the variation in the STa during and after the radiofrequency application was analyzed and compared with the variation in the amplitude of bipolar electrogram. An 8mm tip catheter was used, and the RF power and the tip temperature were set at 30-35 watts and 50 degrees for 30-45 seconds, respectively. Results : The 68 applications were analyzed. The STa elevation occurred just after the ABL, reached the peak at 10-20 seconds after ABL, and improved thereafter, and the STa level at 1 minute after termination of ABL was 88.7%of the level at the peak. The bipolar electrogram amplitude after ABL was 57.8% of the control level, and a morphology change. Conclusion : The STa elevation during PVI was thought to be an indicator of efficient ABL.
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  • Cost-effectiveness Analysis of Event Recorder as Compared with Holter Monitoring in Patients with Suspected Arrhythmias
    Gen Nakaji, Masahiko Fujihara, Mitsuhiro Fukata, Shioto Yasuda, Keita ...
    2010 Volume 30 Issue 3 Pages 216-224
    Published: 2010
    Released on J-STAGE: February 03, 2011
    DOIhttps://doi.org/10.5105/jse.30.216
    JOURNAL FREE ACCESS
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    Background : Although self-activating cardiac event recorders are available, the cost-effectiveness of such event recorders remains unclear in this country. Objectives : This study was performed for cost-effectiveness analysis of event recorder (EP-202, Parama-Tech Co. Ltd., Japan) as compared with conventional Holter monitoring (cardiomemory EMC, Nihon Kohden, Japan). Methods : Consecutive 107 patients with suspected arrhythmias were enrolled in this study from 2007 to 2009. They underwent either event recorder (n=44) or Holter ECG (n=48) at the discretion of treating physicians, after recording standard 12-lead ECG. Diagnostic cost was calculated as 1,500 points for the Holter ECG and 150 points for the event recorder according to the health insurance system. Effectiveness was evaluated as number of patients whose arrhythmias were diagnosed by either ECG modality and were indicative of pharmacologic or nonpharmacologic therapies. Results : The average cost in patients undergoing Holter ECG was higher than that of the event recorder by about one-order (p<0.001), whereas these modalities yielded equivalent diagnostic abilities of 39.6%and 56.8%, respectively (p = 0.39). Conclusions : Event recorder is more cost-effective than Holter monitoring for arrhythmia detection, especially in the case of symptomatic and infrequent paroxysms of various kinds of arrhythmias.
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  • A Case of WPW Syndrome with Coronary Sinus Musculature Potential
    Kohei Sawasaki, Makoto Saito, Masahiro muto
    2010 Volume 30 Issue 3 Pages 227-233
    Published: 2010
    Released on J-STAGE: February 03, 2011
    DOIhttps://doi.org/10.5105/jse.30.227
    JOURNAL FREE ACCESS
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    A 67 year-old man with WPW syndrome, who had frequent paroxysmal supraventricular tachycardia, underwent radiofrequency catheter ablation. Atrioventricular tachycardia (AVRT) was easily inducible by either atrial or ventricular extrastimulation. During AVRT, atrial potential was divided. The first component was dull and the second component was sharp. The earliest activation of the first component was at coronary sinus (CS) 4-5 and the second component was at CS 7-8. Ventriculo-atrial (V-A) conduction in ventricular pacing was similar, too. We speculated that activation of the first component was left atrial potential and the second component was CS musculature potential. The earliest retrograde atrial potential was recorded by ablation catheter at CS 4-5 above the mitral annulus via the retrograde aortic approaches. The accessory pathway conduction was completely eliminated 6 seconds after the first application. After successful ablation, atrioventricular nodal conduction appeared. We speculated that fusion potential of left atrium and CS musculature was revealed. After the ablation, the patient has been free from palpitation for 6months.
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