Tonegawa

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The usefulness of carotid endarterectomy (CEA) for carotid artery stenosis has been established even in the era of endovascular treatment. Digital subtraction angiography (DSA) and three-dimensional computed tomography angiography (3D-CTA) are used for preoperative evaluation of CEA; however, contrast agents cannot be used in patients with renal dysfunction or contrast agent allergy. Since the introduction of a three-dimensional image analysis software, SYNAPSE VINCENT (Fujifilm, Tokyo, Japan) in February 2016, we initially fused cervical CT, carotid three-dimensional time-of-flight magnetic resonance angiography, and carotid plaque imaging using 1...

Since subarachnoid hemorrhage (SAH) due to the re-rupture of cerebral aneurysms severely worsens the prognosis, an accurate initial diagnosis is essential. Computed tomography (CT) and magnetic resonance imaging (MRI) usually detect aneurysmal subarachnoid hemorrhage (aSAH). However, in rare cases, its identification on CT- and MRI scans is difficult, and a cerebrospinal fluid (CSF) examination is required. We present preoperative imaging and intraoperative findings in patients whose aSAH detection necessitated a CSF examination...

The protein C (PC) pathway involves physiological anticoagulant factors (PC, protein S [PS], and factor V) and performs major anticoagulant functions in adults. Variations in overall PC pathway function due to dynamic changes in PC and PS in early childhood are poorly understood. We aimed to evaluate the contributions of PC pathway function during early childhood by measuring changes in plasma thrombin generation (TG) after administration of the PC activator protac. We evaluated correlations between anticoagulant factors and percentage of protac-induced coagulation inhibition (PiCi%)...

BACKGROUND AND AIMS: Few recent large-scale studies have evaluated the risks and benefits of continuing oral anticoagulant (OAC) therapy after catheter ablation (CA) for atrial fibrillation (AF). This study evaluated the status of continuation of OAC therapy and the association between continuation of OAC therapy and thromboembolic and bleeding events according to the CHADS2 score. METHODS: This retrospective study included data from the Japanese nationwide administrative claims database of patients who underwent CA for AF between April 2014 and March 2021...

The Japanese Catheter Ablation (J-AB) registry, started in August 2017, is a voluntary, nationwide, multicenter, prospective, observational registry, performed by the Japanese Heart Rhythm Society (JHRS) in collaboration with the National Cerebral and Cardiovascular Center using a Research Electronic Data Capture system. The purpose of this registry is to collect the details of target arrhythmias, the ablation procedures, including the type of target arrhythmias, outcomes, and acute complications in the real-world settings...

INTRODUCTION: Infection is one of the most important complications associated with cardiac implantable electronic device (CIED) therapy. The number of reports comparing the outcomes of transvenous lead extraction (TLE), surgical lead extraction, and conservative treatment for CIED infections using a real-world database is limited. This study investigated the association between the treatment strategies for CIED infections and their outcomes. METHODS: We performed a retrospective analysis of 3605 patients with CIED infections admitted to 681 hospitals using a nationwide claim-based database collected between April 2012 and March 2018...

Lamb waves and meteotsunamis generated by the Tonga volcanic eruption in 2022 were observed worldwide. Here, we show a distinct spectral peak at approximately 3.6 millihertz in the air and seafloor pressures of those waves. The peak in the air pressure represents resonant coupling between Lamb and thermospheric gravity waves. To reproduce the observed spectral structure up to 4 millihertz, an upward-moving pressure source with a duration of 1500 seconds should be placed at altitudes of 58 to 70 kilometers, which are slightly higher than the overshooting plume top of 50 to 57 kilometers...

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BACKGROUND: Implantable cardiac monitors (ICMs) help investigate the cause of unexplained syncope, but the probability and predictors of needing a pacing device thereafter remain unclear. METHODS: We retrospectively analyzed the data of patients who received ICM insertion for unexplained syncope with suspected arrhythmic etiology. The data were obtained from a nationwide database obtained between April 1, 2012 and March 31, 2020. Multivariable mixed-effects survival analysis was performed to identify predictors of pacing device implantation (PDI), and a risk score model was developed accordingly...

Diphenyl ethers (DEs), which are widely used in the agricultural and chemical industries, have become hazardous contaminants in the environment. Although several DE-degrading bacteria have been reported, discovering new types of such microorganisms could enhance understanding of the degradation mechanism in the environment. In this study, we used a direct screening method based on detection of ether bond-cleaving activity to screen for microorganisms that degrade 4,4'-dihydroxydiphenyl ether (DHDE) as a model DE...

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BACKGROUND: Cardiac tamponade is a potentially fatal complication of catheter ablation for atrial fibrillation (AF). OBJECTIVES: This study aimed to evaluate the impact of body mass index (BMI) on cardiac tamponade during AF ablation. METHODS: Patients who underwent catheter ablation for AF between April 1, 2016 and March 31, 2018 were analyzed using a Japanese nationwide claims database. Mixed-effects multivariable Poisson regression analysis was performed to investigate the association between BMI and cardiac tamponade...

INTRODUCTION: The superior vena cava (SVC) is the most common source of non-pulmonary vein foci in atrial fibrillation (AF); therefore, predicting the existence of non-pulmonary vein foci before the catheter ablation procedure helps construct a proper ablation strategy in preparation for SVC isolation. This study aimed to clarify the structural characteristics of patients with SVC foci initiating AF. METHODS: We enrolled 331 consecutive patients with AF who underwent cardiac computed tomography imaging before radiofrequency catheter ablation treatment, and they were divided into SVC (+) and (-) groups based on the presence or absence of SVC foci initiating AF...

OBJECTIVES: To identify differences in patient characteristics, clinical practice and outcomes of cardiac implantable electronic device (CIED) therapy between Japan and the USA. DESIGN: A cross-sectional study. SETTING: Nationally representative administrative databases from Japan and the USA containing hospitalisations with first-time implantations of pacemakers, implantable cardioverter-defibrillators (ICD) and cardiac-resynchronisation therapy with or without defibrillators (CRTP/CRTD)...

BACKGROUND: Although catheter ablation (CA) has become a standard therapeutic approach to atrial fibrillation (AF), it imposes a low but relevant risk of thromboembolic complications of around 0.5%-1%, including ischemic strokes, and has an additional risk of clinically silent cerebral embolisms (SCEs) of 10%-40%. Both cryoballoon (CB) and radiofrequency (RF) ablation are routinely used clinically worldwide, yet there are few prospective data comparing the incidence of cerebral embolism after CA of AF between CB and RF ablation...

The Japanese Catheter Ablation (J-AB) registry, started in August 2017, is a voluntary, nationwide, multicenter, prospective, observational registry, performed by the Japanese Heart Rhythm Society (JHRS) in collaboration with the National Cerebral and Cardiovascular Center using a Research Electronic Data Capture system. The purpose of this registry is to collect the details of target arrhythmias, the ablation procedures, including the type of target arrhythmias, outcomes, and acute complications in real-world settings...

Polyrotaxanes (PRXs) containing acetylated α-cyclodextrins exhibit a temperature-dependent phase transition in aqueous solutions across their lower critical solution temperature (LCST) of approximately 26.6 °C. To gain insights into the interactions of acetylated PRXs (Ac-PRXs) with biological components, thermoresponsive supramolecular surfaces were prepared by coating tissue culture polystyrene (TCPS) surfaces with Ac-PRX triblock copolymers, and their surface properties across the LCST were evaluated. The wettability and protein adsorption of Ac-PRX-coated surfaces changed significantly between 10 and 37 °C, whereas the uncoated TCPS and unmodified PRX-coated surfaces did not alter the wettability and protein adsorption at 10 and 37 °C...

Real-world data (RWD) are observational data obtained by collecting, structuring, and accumulating patient information among the medical big data. RWD are derived from a variety of patient medical care and health information outside of conventional research data, and include electronic health records, claims data, registry data of disease, drug and device, health check-up data, and more recently, patient information data from wearable devices. They are currently being utilized in various forms for optimal medical care and real-world evidence (RWE) is constructed through a process of hypothesis generation and verification based on the RWD research...

BACKGROUND: This study aimed to provide real-world data on the rates, trends, and predictors of in-hospital complications and 30-day readmission following leadless pacemaker (LP) implantation. METHODS: We analyzed leadless or conventional pacemaker implantations using the all-payer, nationally representative Nationwide Readmissions Database between 2017 and 2019. The national trends of in-hospital mortality, in-hospital complications, and 30-day readmission rates after pacemaker implantation were analyzed...