Japanese Journal of Electrocardiology
Online ISSN : 1884-2437
Print ISSN : 0285-1660
ISSN-L : 0285-1660
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Volume 33, Issue 5
Displaying 1-8 of 8 articles from this issue
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  • Implantable Cardioverter-Defibrillator Shocks ; A Marker of Poor Prognosis but Themselves Do Not Affect Mortality
    Akira Shimane, Katsunori Okajima, Kunihiko Kiuchi, Kiminobu Yokoi, Jin ...
    2014 Volume 33 Issue 5 Pages 421-428
    Published: 2014
    Released on J-STAGE: July 27, 2015
    DOIhttps://doi.org/10.5105/jse.33.421
    JOURNAL FREE ACCESS
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    Implantable cardioverter-defibrillator (ICD) therapy has been proven to reduce mortality in patient with high risk for sudden cardiac death. However, recent studies suggest that ICD shocks, even inappropriate shocks, are associated with an increased risk of mortality. To clarify the prognostic implication of ICD shocks, consecutive 253 patients with ICD (79% men, 63±11 years, 36% primary prevention, left ventricular ejection fraction [LVEF]38±14%) were analyzed with respect to ICD shocks and death. During a median follow up period of 1428 days, appropriate and inappropriate shocks occurred in 62 (24.5%) patients each. A total of 55 patients (31 cardiac deaths) among the 253 patients died. In a Cox proportional-hazards model adjusted for baseline prognostic factors, age (HR : 1.044, p=0.007), LVEF (HR : 0.969, p=0.011), serum creatinine (HR : 1.867, p<0.001), a history of atrial fibrillation or atrial tachycardia (HR : 2.093, p=0.012), and appropriate shocks (HR : 2.777, 95%CI : 1.514-5.096, p=0.001) were associated with all-cause mortality. However, inappropriate shocks did not affect the mortality.
    ICD shocks themselves do not contribute to the increased risk of mortality. Appropriate shocks are adverse prognostic marker indicating recurrence or new onset of ventricular tachyarrhythmia.
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  • Effects of the Great East Japan Earthquake on the Holter Electrocardiogram
    Hiromi Matsuda, Haruki Itoh, Hiroko Tsuchida, Kanae Takahashi, Ayano F ...
    2014 Volume 33 Issue 5 Pages 429-436
    Published: 2014
    Released on J-STAGE: July 27, 2015
    DOIhttps://doi.org/10.5105/jse.33.429
    JOURNAL FREE ACCESS
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    On March 11, 2011, the Great East Japan Earthquake occurred. We investigated the effects of the earthquake on Holter ECG parameters retrospectively. The data from 30 patients who had been monitored by Holter ECG across the time of the earthquake's occurrence were analyzed. The data analyzed were heart rate (HR), ST change, and frequency domain heart rate variability (HRV), namely a total-frequency component (TF), a high-frequency component (HF), a low-frequency component / high-frequency component ratio (L/H), and a very-low-frequency component (VLF). ST changes were evaluated visually. HR and HRV parameters were calculated for 5, 10, and 30 minutes before and just after the earthquake and the differences according to sex and age were also investigated. As a result of the earthquake, HR increased and the ST segment was depressed. Compared with the values of HRV before earthquake, TF increased, HF decreased in younger subjects and increased in older subjects, L/H increased in younger and decreased in older subjects, and VLF showed a tendency to increase after the earthquake. In older subjects, HF increased because of increased parasympathetic nervous activity, which may be due to the “near pre-syncope state” or “startle response” reaction to the earthquake.
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