JACC. Asia最新文献

{"title":"Para-Hisian Ventricular Arrhythmias","authors":"Mitsunori Maruyama MD, PhD","doi":"10.1016/j.jacasi.2024.11.018","DOIUrl":"10.1016/j.jacasi.2024.11.018","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 313-314"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Frontiers in Antegrade Wiring From the Asia Pacific Chronic Total Occlusion Club","authors":"Eugene B. Wu MD ,&nbsp;Shunsuke Matsuno MD ,&nbsp;Wataru Nagamatsu MD ,&nbsp;Arun Kalyanasundaram MD ,&nbsp;Scott A. Harding MD, PhD ,&nbsp;Sidney Lo MD ,&nbsp;Soo Teik Lim MD ,&nbsp;Lei Ge MD ,&nbsp;Ji-Yan Chen MD ,&nbsp;Henry J.F. Luo MD ,&nbsp;Jie Quan MD ,&nbsp;Seung-Whan Lee MD, PhD ,&nbsp;Hsien-Li Kao MD ,&nbsp;Etsuo Tsuchikane MD PhD","doi":"10.1016/j.jacasi.2024.12.009","DOIUrl":"10.1016/j.jacasi.2024.12.009","url":null,"abstract":"<div><div>Antegrade wiring (AW) is the prevailing chronic total occlusion (CTO) crossing technique. For proximal cap ambiguity, the Global CTO consensus group uses the “anatomy dictates strategy” method: 1) intravascular ultrasound; 2) move the cap; or 3) retrograde. For CTO body crossing, anatomy dictates 4 strategies: 1) CTOs with tapered stump—loose tissue tracking; 2) CTOs with clear intimal path—intentional intimal tracking with 3-dimensional (3D) wiring; 3) CTOs without a clear intimal path—intentional intimal tracking with intermediate penetration wire; and 4) the “long plus CTOs”—intentional subintimal wiring. The new angiographic 3D antegrade puncture technique from the APCTO (Asia Pacific Chronic Total Occlusion) Club is presented for distal cap puncture. angiographic 3D antegrade puncture technique can be used as a 3D wiring technique as well as an antegrade dissection and re-entry technique. Based on these new frontiers, we have updated our APCTO algorithm in this paper. This update can form a basis for research and training.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 219-230"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extended Period Outcomes of Posterior Box Isolation in 4 Randomized Atrial Fibrillation Catheter Ablation Trials","authors":"Sang Jun Lee MD,&nbsp;Hee Tae Yu MD, PhD,&nbsp;Sung Hwa Choi MD,&nbsp;Daehoon Kim MD,&nbsp;Tae-Hoon Kim MD,&nbsp;Jae-Sun Uhm MD, PhD,&nbsp;Boyoung Joung MD, PhD,&nbsp;Moon-Hyoung Lee MD, PhD,&nbsp;Hui-Nam Pak MD, PhD","doi":"10.1016/j.jacasi.2024.12.002","DOIUrl":"10.1016/j.jacasi.2024.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Catheter-based electrical posterior box isolation (POBI) and circumferential pulmonary vein isolation (CPVI) do not improve the rhythmic outcomes of atrial fibrillation catheter ablation in previous studies with 12 to 24 months of follow-up.</div></div><div><h3>Objectives</h3><div>The authors analyzed the long-term rhythm outcomes of our 4 previously conducted randomized controlled trials comparing CPVI alone vs CPVI plus additional POBI using the intention-to-treat principle.</div></div><div><h3>Methods</h3><div>The authors analyzed 575 AF patients included in our 4 previous randomized controlled trials. We compared clinical recurrence defined as recurrent atrial arrhythmia after the index procedure. In patients who underwent a repeat procedure because of recurrence after the index procedure, the mechanism of recurrence was analyzed.</div></div><div><h3>Results</h3><div>After a median follow-up of 48 months, there were no significant differences in the clinical recurrence or major adverse cardiac events between the CPVI alone and CPVI plus POBI groups. The procedure time was significantly longer, and the atrial tachycardia recurrence rate was higher in the CPVI plus POBI group. In the patients who experienced clinical recurrence, there were no significant differences in the rates of cardioversion or need for repeat procedures between the groups. In patients who underwent a repeat procedure because of recurrence after the index procedure (n = 64), the pulmonary vein reconnection rate did not differ, but re-entrant atrial tachycardia was more common in the CPVI plus POBI group, while extrapulmonary vein triggers were more common in the CPVI alone group.</div></div><div><h3>Conclusions</h3><div>The addition of POBI to CPVI did not improve the long-term rhythm outcomes in patients undergoing atrial fibrillation catheter ablation. (The Evaluation for Prognostic Factors After Catheter Ablation of Atrial Fibrillation, <span><span>NCT02138695</span><svg><path></path></svg></span>; Evaluation of Proper Radiofrequency Catheter Ablation Strategy for the Patients Who Were Changed to Paroxysmal Atrial Fibrillation From Persistent Atrial Fibrillation, <span><span>NCT02176616</span><svg><path></path></svg></span>; Comparison of Circumferential Pulmonary Vein Isolation Alone Versus Linear Ablation in Addition to Circumferential Pulmonary Vein Isolation for Catheter Ablation in Persistent Atrial Fibrillation: Prospective Randomized Controlled Trial, <span><span>NCT02721121</span><svg><path></path></svg></span>; Comparison of Circumferential Pulmonary Vein Isolation and Complex Pulmonary Vein Isolation Additional Linear Ablation for Recurred Atrial Fibrillation After Previous Catheter Ablation: Prospective Randomized Trial [RILI Trial]; <span><span>NCT02747498</span><svg><path></path></svg></span></div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 285-295"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"30-Day Transcatheter Aortic Valve Replacement Outcomes in Severe Symptomatic Aortic Stenosis Chinese Patients","authors":"Mao Chen MD ,&nbsp;Xianbao Liu MD, PhD ,&nbsp;Yujie Zhou MD ,&nbsp;Yundai Chen MD ,&nbsp;Yuan Feng MD ,&nbsp;Sarah Verdoliva Boatman MSc ,&nbsp;Jianan Wang MD, PhD","doi":"10.1016/j.jacasi.2024.10.011","DOIUrl":"10.1016/j.jacasi.2024.10.011","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 318-321"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extremely Small 20-mm Versus Standard-Size Balloon-Expandable Transcatheter Heart Valves","authors":"Taishi Okuno MD ,&nbsp;Masaki Izumo MD ,&nbsp;Kai Takahiko MD ,&nbsp;Shingo Kuwata MD ,&nbsp;Masashi Koga MD ,&nbsp;Yoshihiro J. Akashi MD ,&nbsp;Shinichi Shirai MD ,&nbsp;Yusuke Watanabe MD ,&nbsp;Toru Naganuma MD ,&nbsp;Norio Tada MD ,&nbsp;Futoshi Yamanaka MD ,&nbsp;Masahiko Noguchi MD ,&nbsp;Hiroshi Ueno MD ,&nbsp;Yohei Ohno MD ,&nbsp;Hidetaka Nishina MD ,&nbsp;Kensuke Takagi MD ,&nbsp;Masahiko Asami MD ,&nbsp;Kazuki Mizutani MD ,&nbsp;Fumiaki Yashima MD ,&nbsp;Toshiaki Otsuka MD ,&nbsp;Kentaro Hayashida MD","doi":"10.1016/j.jacasi.2024.09.005","DOIUrl":"10.1016/j.jacasi.2024.09.005","url":null,"abstract":"<div><h3>Background</h3><div>The 20-mm balloon-expandable transcatheter heart valve (THV) represents the smallest available option for transcatheter aortic valve replacement (TAVR). Its current underutilization stems from concerns regarding prosthesis-patient mismatch, durability, and potential adverse outcomes.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to compare the long-term outcomes between the 20-mm balloon-expandable THVs and standard-size balloon-expandable THVs.</div></div><div><h3>Methods</h3><div>Patients who underwent transfemoral TAVR with SAPIEN THVs were sourced from the OCEAN-TAVI (Optimized Transcatheter Valvular Intervention) registry, an ongoing, multicenter cohort study that has enrolled over 7,000 TAVR patients in Japan. A 1:3 propensity-matched analysis, based on 24 baseline clinical and echocardiographic variables, was used to contrast the 20-mm with &gt;20-mm balloon-expandable THVs.</div></div><div><h3>Results</h3><div>Of 5,086 eligible patients, 284 (5.6%) received the 20-mm balloon-expandable THV. After propensity-matching, the 20-mm THV group (n = 276) and the &gt;20-mm THV group (n = 828) demonstrated balanced baseline characteristics, with an absolute standardized difference &lt;0.10. The average follow-up duration for patients who were alive was 955 ± 512 days, and the average time to death was 584 ± 543 days. The 20-mm group showed a higher frequency of prosthesis-patient mismatch (PPM) (moderate PPM: 29.2% vs 10.8%; severe PPM: 4.9% vs 1.5%; <em>P &lt;</em> 0.001). Over a 5-year period, all-cause mortality and heart failure rehospitalization rates were comparable between the 2 groups (all-cause mortality: 34.2% vs 38.0%; HR: 1.01; 95% CI: 0.74-1.37; <em>P =</em> 0.970; heart failure rehospitalization: 15.2% vs 16.3%; HR: 0.81; 95% CI: 0.50-1.29; <em>P =</em> 0.371).</div></div><div><h3>Conclusions</h3><div>This registry-based study suggests that the initially observed inferior forward hemodynamics associated with the 20-mm THV do not translate into heightened long-term mortality or heart failure rehospitalization risks. (The OCEAN-TAVI registry [Optimized Transcatheter Valvular Intervention-Transcatheter Aortic Valve Implantation]; <span><span>UMINID:000020423</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 245-254"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protruding and Ulcerated Aortic Atheromas as Predictors of Periprocedural Ischemic Stroke Post-Transcatheter Aortic Valve Replacement","authors":"Shinnosuke Kikuchi MD ,&nbsp;Antonin Trimaille MD ,&nbsp;Adrien Carmona MD ,&nbsp;Dinh Phi Truong MD ,&nbsp;Kensuke Matsushita MD, PhD ,&nbsp;Benjamin Marchandot MD ,&nbsp;Amandine Granier MD ,&nbsp;Antje Reydel MD ,&nbsp;Manh Cuong Vu MD ,&nbsp;Franck Zheng MD ,&nbsp;Zoe Heyberger MD ,&nbsp;Julien Tse Sik Sun MD ,&nbsp;Florian Loizon MD ,&nbsp;Paul Knellwolf MD ,&nbsp;Dorian Recht MD ,&nbsp;Baudouin Koenig MD ,&nbsp;Mickael Ohana MD, PhD ,&nbsp;Kiyoshi Hibi MD, PhD ,&nbsp;Patrick Ohlmann MD, PhD ,&nbsp;Olivier Morel MD, PhD","doi":"10.1016/j.jacasi.2024.10.020","DOIUrl":"10.1016/j.jacasi.2024.10.020","url":null,"abstract":"<div><h3>Background</h3><div>Aortic atherosclerosis can affect the strategy and outcomes of transcatheter aortic valve replacement (TAVR). Limited investigation exists into how aortic atheroma morphology influences outcomes post-TAVR.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the influence of protruding and ulcerated aortic atheromas on periprocedural ischemic stroke post-TAVR.</div></div><div><h3>Methods</h3><div>This analysis included 977 patients who underwent TAVR between February 2010 and May 2019, with available contrast-enhanced computed tomography data. Protruding aortic atheroma was defined as atheroma of ≥3 mm thickness with protruding components. Ulcerated aortic atheroma was defined as atheroma with ulcer-like intimal disruption. The primary endpoint was periprocedural ischemic stroke within 30 days post-TAVR.</div></div><div><h3>Results</h3><div>In total, 43 (4.4%) experienced periprocedural ischemic stroke. Patients with protruding or ulcerated aortic atheroma had a significantly higher incidence of periprocedural stroke compared with those without (8.0% [95% CI: 4.9%-12.2%] vs 3.2% [95% CI: 2.1%-4.8%]; <em>P =</em> 0.003). Protruding or ulcerated atheroma (adjusted OR [aOR]: 2.55 [95% CI: 1.37-4.74]), particularly in the aortic arch (aOR: 3.86 [95% CI: 1.69-8.83]), independently increased periprocedural stroke risk. Among patients undergoing transfemoral TAVR with self-expandable valves (n = 315, 32%), protruding or ulcerated atheroma in the aortic arch was independently associated with periprocedural stroke (aOR: 9.04 [95% CI: 1.59-51.4]), whereas it was not among those with balloon-expandable valves (n = 580, 59%) (aOR: 2.85 [95% CI: 0.92-8.84]).</div></div><div><h3>Conclusions</h3><div>Protruding and ulcerated aortic atheromas are associated with a higher risk of periprocedural ischemic stroke post-TAVR. Careful selection of TAVR strategy, including valve type and procedural approach, is essential for patients with such aortic lesions.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 258-269"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selecting the Proper Transcatheter Aortic Valve Replacement Device in East Asians With a Small Aortic Annulus","authors":"Ying-Hwa Chen MD, PhD ,&nbsp;Howard C. Herrmann MD","doi":"10.1016/j.jacasi.2024.11.002","DOIUrl":"10.1016/j.jacasi.2024.11.002","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 322-326"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior Wall Box Isolation in Atrial Fibrillation Catheter Ablation","authors":"David Chieng MBBS, PhD ,&nbsp;Peter M. Kistler MBBS, PhD","doi":"10.1016/j.jacasi.2025.01.001","DOIUrl":"10.1016/j.jacasi.2025.01.001","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 296-298"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Applications of the Hybrid IVUS-OCT Imaging System","authors":"Masaru Ishida MD, PhD","doi":"10.1016/j.jacasi.2024.11.022","DOIUrl":"10.1016/j.jacasi.2024.11.022","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 242-244"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Renal Impairment on Clinical Outcomes After Mitral Valve Transcatheter Edge-to-Edge Repair","authors":"Kazuki Tanaka MD ,&nbsp;Junichi Yamaguchi MD ,&nbsp;Masafumi Yoshikawa MD ,&nbsp;Eiji Shibahashi MD ,&nbsp;Hisao Otsuki MD ,&nbsp;Takanori Kawamoto MD ,&nbsp;Chihiro Koyanagi MD ,&nbsp;Yusuke Inagaki MD ,&nbsp;Tomohito Kogure MD ,&nbsp;Masanori Yamamoto MD ,&nbsp;Mike Saji MD ,&nbsp;Masahiko Asami MD ,&nbsp;Masaki Nakashima MD ,&nbsp;Yusuke Enta MD ,&nbsp;Shinichi Shirai MD ,&nbsp;Masaki Izumo MD ,&nbsp;Shingo Mizuno MD ,&nbsp;Yusuke Watanabe MD ,&nbsp;Makoto Amaki MD ,&nbsp;Kazuhisa Kodama MD ,&nbsp;Kentaro Hayashida MD","doi":"10.1016/j.jacasi.2024.10.025","DOIUrl":"10.1016/j.jacasi.2024.10.025","url":null,"abstract":"<div><h3>Background</h3><div>Renal impairment is associated with poor clinical outcomes in patients with cardiovascular diseases. Some studies have revealed the impact of renal impairment on the clinical outcomes of patients who underwent mitral valve transcatheter edge-to-edge repair (M-TEER). However, limited data are available regarding the impact of baseline renal impairment after M-TEER in Asian-Pacific patients with heart failure and severe mitral regurgitation.</div></div><div><h3>Objectives</h3><div>This study sought to examine the effect of renal impairment on clinical outcomes after M-TEER using a large-scale nationwide registry in Japan.</div></div><div><h3>Methods</h3><div>A total of 2,150 patients enrolled in the OCEAN-Mitral (Optimized Catheter Valvular Intervention) registry were divided into 3 groups according to the estimated glomerular filtration rate (eGFR) before M-TEER: normal eGFR (≥60 mL/min/1.73 m²) (n = 291), renal impairment (&lt;60 mL/min/1.73 m²) (n = 1,746), and dialysis (n = 113). The impact of renal impairment and dialysis on major adverse cardiovascular events (MACE) (a composite of all-cause death and hospitalization for heart failure) was examined.</div></div><div><h3>Results</h3><div>Kaplan-Meier analysis revealed that the renal impairment and dialysis groups had a significantly higher incidence of MACE (survival rates at 2 years: normal eGFR, 74.2% [95% CI: 66.9%-80.1%] vs renal impairment, 63.9% [95% CI: 61.0%-66.6%] vs dialysis, 50.9% [95% CI: 38.2%-62.2%]; <em>P &lt;</em> 0.001). Multivariate Cox regression analysis identified dialysis as the strongest independent predictor of MACE (HR: 1.95; 95% CI: 1.33-2.85; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Renal impairment was associated with an increased incidence of major adverse events, and dialysis was the strongest independent predictor of poor clinical outcomes after M-TEER in Asian-Pacific patients.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 2","pages":"Pages 273-282"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}