[in Japanese]

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[in Japanese]

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The modalities currently available for treatment and prevention of life-threatening ventricular tachyarrhythmias (VT/VF) are various antiarrhythmic drugs, catheter ablation and implantable cardioverter defibrillator (ICD) . However, the usefulness of these therapeutic options is limited by either low efficiency, intolerable side effects, or reduced quality of life (QOL) of the recipient. Fundamentally innovative antiarrhythmic strategies are, therefore, a matter of great concern to cardiologists.
We have investigated the possibility of radiotherapy in the prevention of fatal ventricular arrhythmias in rabbit model, to develop future strategies for preventing sudden cardiac mortalities. We previously reported that targeted external heavy ion irradiation (THIR, 15 Gy) applied to rabbit hearts upregulates connexin43 (Cx43) for 2 weeks thereafter, and reduces ventricular vulnerability in association with an improvement in the spatial homogeneity of repolarization. A single application of THIR to normal rabbit hearts causes upregulation and altered cellular distribution of Cx43 in LV tissue for at least 1 year. This long-lasting effect on gap junctional intercellular communication (GJIC) may bring this technique closer to becoming a therapy for the abolishment of ventricular arrhythmias associated with structural heart disease.

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Background : The aim of this study was to evaluate the safe and effective dose and blood concentration (BC) of bepridil. Methods : We measured BC by high-performance liquid chromatography (HPLC) in a total of 112 patients (80 male, mean age 64.3±12.5 years old) with arrhythmias who received oral bepridil therapy. BC was compared with the clinical features, ECG parameters, effectiveness on arrhythmias, and adverse events. Results : The mean dose of bepridil was 128±34mg/day and the mean BC was 751±462ng/ml. BC was significantly higher in patients who received 200mg/day than in those who received 100mg/day and 150mg/day (1,093±721ng/ml vs. 702±433ng/ml, p=0.02, vs. 759±408ng/ml, p=0.049) . During the mean follow up period of 899 days, sinus rhythm was maintained in 14 out of 109 patients with atrial tachyarrhythmias and 57 patients showed significant improvement in their symptoms. BCs were significantly higher in patients with symptomatic improvement than those without (866±541ng/ml vs. 622±329ng/ml, p=0.006) . BCs were also elevated in 10 patients with QTc interval>0.48 seconds and 6 patients with bradycardia < 50/min compared to those without these side effects (QTc prolongation : 1,086±471ng/ml vs. no side effects : 703±438ng/ml, p=0.005, Bradycardia : 1,056±522ng/ml vs. no side effects : 703±438ng/ml, p=0.03) . No patients have developed torsade de pointes or sudden cardiac death. Conclusions : It was considered that the appropriate dose of bepridil was less than or equal to 150mg/day for Japanese, and that the optimal BC, which brings about symptomatic improvement and fewer adverse events, was between 600 and 1,000ng/ml.

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Although much has been researched about the benefits of continuous speech recognition (CSR) in various fields such as radiology and electronic medical records, little evidence is available on the efficacy of CSR in cardiovascular medicine. In the present study, we compared conventional typing with a commercially available CSR system, AmiVoice(R) (Advanced Media, Inc., Tokyo, Japan) in making ambulatory electrocardiographic (AECG) reports. Report turnaround time by CSR contains additional time for correction of recognition errors. A total of 278 AECG reports generated between December 2009 and March 2010 were assessed. One hundred thirty-nine (50.0%) were dictated using CSR system and the same number of reports were generated by typing. Reporting time by CSR was statistically shorter than that by typing (median : 764 sec vs. 883 sec, p<0.001, Mann-Whitney U test) , although there was no significant difference in patient characteristics, total character counts or appreciable findings in reports between the two methods. Furthermore, this tendency still existed regardless of the number of reported findings associated with significant arrhythmia and myocardial ischemia. In conclusion, CSR dictation for AECG reporting, even considering the additional time required for corrections, may be a favorable alternative to conventional typing with the promise of time reduction in AECG report production.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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