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Article: What Does Atrial Fibrillation Mean in Patients With Cardiac Implantable Electronic Devices?

Uhm, Jae-Sun

2024 Volume 54, Issue 1, Page(s) 28–29

Language	English
Publishing date	2024-01-10
Publishing country	Korea (South)
Document type	Editorial
ZDB-ID	2557464-4
ISSN	1738-5520
ISSN	1738-5520
DOI	10.4070/kcj.2023.0302
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Article: Rare and Elusive Arrhythmia: Atrial Tachycardia From Noncoronary Aortic Cusp During Catheter Ablation for Atrial Fibrillation.

Uhm, Jae-Sun

Korean circulation journal

2022 Volume 52, Issue 7, Page(s) 527–528

Language	English
Publishing date	2022-07-05
Publishing country	Korea (South)
Document type	Editorial
ZDB-ID	2557464-4
ISSN	1738-5520
ISSN	1738-5520
DOI	10.4070/kcj.2022.0137
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Article ; Online: Changes in the Circadian Rhythm of High-Frequency Heart Rate Variability Associated With Depression.

Lee, Deokjong / Han, Changho / Kim, Hyungjun / Uhm, Jae-Sun / Yoon, Dukyong / Park, Jin Young

Journal of Korean medical science

2023 Volume 38, Issue 19, Page(s) e142

Abstract: Background: Heart rate variability (HRV) extracted from electrocardiogram measured for a short period during a resting state is clinically used as a bio-signal reflecting the emotional state. However, as interest in wearable devices increases, greater ... ...

Abstract	Background: Heart rate variability (HRV) extracted from electrocardiogram measured for a short period during a resting state is clinically used as a bio-signal reflecting the emotional state. However, as interest in wearable devices increases, greater attention is being paid to HRV extracted from long-term electrocardiogram, which may contain additional clinical information. The purpose of this study was to examine the characteristics of HRV parameters extracted through long-term electrocardiogram and explore the differences between participants with and without depression and anxiety symptoms. Methods: Long-term electrocardiogram was acquired from 354 adults with no psychiatric history who underwent Holter monitoring. Evening and nighttime HRV and the ratio of nighttime-to-evening HRV were compared between 127 participants with depressive symptoms and 227 participants without depressive symptoms. Comparisons were also made between participants with and without anxiety symptoms. Results: Absolute values of HRV parameters did not differ between groups based on the presence of depressive or anxiety symptoms. Overall, HRV parameters increased at nighttime compared to evening. Participants with depressive symptoms showed a significantly higher nighttime-to-evening ratio of high-frequency HRV than participants without depressive symptoms. The nighttime-to-evening ratio of HRV parameters did not show a significant difference depending on the presence of anxiety symptoms. Conclusion: HRV extracted through long-term electrocardiogram showed circadian rhythm. Depression may be associated with changes in the circadian rhythm of parasympathetic tone.
MeSH term(s)	Humans ; Male ; Female ; Adult ; Middle Aged ; Circadian Rhythm/physiology ; Heart Rate/physiology ; Electrocardiography, Ambulatory ; Depression ; Anxiety
Language	English
Publishing date	2023-05-15
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	639262-3
ISSN	1598-6357 ; 1011-8934
ISSN (online)	1598-6357
ISSN	1011-8934
DOI	10.3346/jkms.2023.38.e142
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Article: Corrigendum: Effect of epicardial fat volume on outcomes after left atrial posterior wall isolation in addition to pulmonary vein isolation in patients with persistent atrial fibrillation.

Kim, Daehoon / Yu, Hee Tae / Kwon, Oh-Seok / Kim, Tae-Hoon / Uhm, Jae-Sun / Joung, Boyoung / Lee, Moon-Hyoung / Pak, Hui-Nam

Frontiers in cardiovascular medicine

2023 Volume 10, Page(s) 1220717

Abstract: This corrects the article DOI: 10.3389/fcvm.2022.1005760.]. ...

Abstract	[This corrects the article DOI: 10.3389/fcvm.2022.1005760.].
Language	English
Publishing date	2023-06-02
Publishing country	Switzerland
Document type	Published Erratum
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2023.1220717
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Article: Association of extra-pulmonary vein triggers with low-voltage area and clinical recurrence in patients with atrial fibrillation undergoing catheter ablation.

Park, In Jae / Kim, Daehoon / Yu, Hee Tae / Kim, Tae-Hoon / Uhm, Jae-Sun / Joung, Boyoung / Lee, Moon-Hyoung / Hwang, Chun / Pak, Hui-Nam

Journal of arrhythmia

2024 Volume 40, Issue 2, Page(s) 278–288

Abstract: Background and objectives: Although extra-pulmonary vein (PV) triggers (ExPVTs) play a role in atrial fibrillation (AF) recurrence after catheter ablation (AFCA), the mechanism is unknown. We explored whether the locations of ExPVTs were associated with ...

Abstract	Background and objectives: Although extra-pulmonary vein (PV) triggers (ExPVTs) play a role in atrial fibrillation (AF) recurrence after catheter ablation (AFCA), the mechanism is unknown. We explored whether the locations of ExPVTs were associated with low-voltage scar areas (LVAs). Methods: Among 2255 consecutive patients who underwent a de novo AFCA, 1696 (male 72.1%, median 60 years old, paroxysmal 64.7%) were included who underwent isoproterenol provocation and voltage mapping of the left atrium (LA) during their procedures. We investigated the associations between ExPVTs and their mean LA voltage and colocalization of ExPVTs within LVAs (<0.2 mV). Results: We observed ExPVTs in 181 (10.7%) patients (60 in the LA, 99 in the right atrium [RA], 16 biatrial, and 6 unmappable). A lower mean LA voltage was independently associated with the existence of ExPVTs (OR 0.77 per 1 SD mV increase, 95% CI 0.60-0.99, Conclusions: The presence of ExPVTs was associated with low LA voltage and poor rhythm outcome post-AFCA, but the colocalization of ExPVTs and LVA in LA did not affect rhythm outcome.
Language	English
Publishing date	2024-02-18
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2696593-8
ISSN	1883-2148 ; 1880-4276
ISSN (online)	1883-2148
ISSN	1880-4276
DOI	10.1002/joa3.13003
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Article: The Effects of Radiofrequency Catheter Ablation for Atrial Fibrillation on Right Ventricular Function.

Kim, Minkwan / Uhm, Jae-Sun / Park, Je-Wook / Bae, SungA / Jung, In Hyun / Heo, Seok-Jae / Kim, Daehoon / Yu, Hee Tae / Kim, Tae-Hoon / Joung, Boyoung / Lee, Moon-Hyoung

Korean circulation journal

2024 Volume 54, Issue 4, Page(s) 203–217

Abstract: Background and objective: The effects of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) on right ventricular (RV) function are not well known.: Methods: Patients who underwent RFCA for AF and underwent pre- and post-procedural ... ...

Abstract	Background and objective: The effects of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) on right ventricular (RV) function are not well known. Methods: Patients who underwent RFCA for AF and underwent pre- and post-procedural echocardiography were enrolled consecutively. Fractional area change (FAC), RV free-wall longitudinal strain (RVFWSL), and RV 4-chamber strain including the ventricular septum (RV4CSL) were measured. Changes in FAC, RVFWSL, and RV4CSL before and after RFCA were compared among paroxysmal AF (PAF), persistent AF (PeAF), and long-standing persistent AF (LSPeAF) groups. Results: A total of 164 participants (74 PAF, 47 PeAF, and 43 LSPeAF; age, 60.8 ± 9.8 years; men, 74.4%) was enrolled. The patients with PeAF and LSPeAF had worse RV4CSL (p<0.001) and RVFWSL (p<0.001) than those with PAF and reference values. Improvements in RVFWSL and RV4CSL after RFCA were significant in the PeAF group compared with the PAF and LSPeAF groups (ΔRV4CSL, 8.4% [5.1, 11.6] in PeAF vs. 1.0% [-1.0, 4.1] in PAF, 1.9% [-0.2, 4.4] in LSPeAF, p<0.001; ΔRVFWSL, 9.0% [6.9, 11.5] in PeAF vs. 0.9% [-1.4, 4.9] in PAF, 1.0% [-1.0, 3.6] in LSPeAF, p<0.001). In patients without recurrence, improvements in RVFWSL and RV4CSL after RFCA were significant in the PeAF group compared to the LSPeAF group. Conclusions: RV systolic function is more impaired in patients with PeAF and LSPeAF than in those with PAF. RV systolic function is more improved after RFCA in patients with PeAF than in those with PAF or LSPeAF.
Language	English
Publishing date	2024-04-23
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2557464-4
ISSN	1738-5520
ISSN	1738-5520
DOI	10.4070/kcj.2023.0312
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Article ; Online: Sex difference in atrial fibrillation recurrence after catheter ablation and antiarrhythmic drugs.

Park, Yoon Jung / Park, Je-Wook / Yu, Hee Tae / Kim, Tae-Hoon / Uhm, Jae-Sun / Joung, Boyoung / Lee, Moon-Hyoung / Pak, Hui-Nam

Heart (British Cardiac Society)

2023 Volume 109, Issue 7, Page(s) 519–526

Abstract: Objective: The risk of recurrence after atrial fibrillation (AF) catheter ablation (AFCA) is higher in women than in men. However, it is unknown whether a sex difference exists in antiarrhythmic drug (AAD) responsiveness among patients with recurrence.!# ...

Abstract	Objective: The risk of recurrence after atrial fibrillation (AF) catheter ablation (AFCA) is higher in women than in men. However, it is unknown whether a sex difference exists in antiarrhythmic drug (AAD) responsiveness among patients with recurrence. Methods: Among 2999 consecutive patients (26.5% women, 58.3±10.9 years old, 68.1% paroxysmal AF) who underwent de novo AFCA, we compared and evaluated the sex differences in rhythm outcome in 1094 patients with recurrence and in 788 patients who subsequently underwent rhythm control with AAD. Results: During a follow-up of 48.2±34.9 months, 1094 patients (36.5%) had AF recurrence after AFCA, and 508 of 788 patients (64.5%) had AF recurrence under AAD. Although the rhythm outcome of a de novo AFCA was worse (log-rank p=0.041, HR 1.28, 95% CI 1.02 to 1.59), p=0.031) in women, AAD response after postprocedural recurrences was better in women than in men (log-rank p=0.003, HR 0.75, 95% CI 0.59 to 0.95, p=0.022), especially in women older than 60 years old (log-rank p=0.003). In 249 patients who underwent repeat procedure after AAD use, the pulmonary vein (PV) reconnection rate (62.7% vs 76.8%, p=0.048) was lower in women than in men but not the existence of extra-PV trigger (37.8% vs 25.4%, p=0.169). Conclusions: Although women showed worse rhythm outcomes than men after AFCA, the post-AFCA AAD response was better in elderly women than in men. Trial registration number: NCT02138695.
MeSH term(s)	Aged ; Female ; Humans ; Male ; Middle Aged ; Anti-Arrhythmia Agents/therapeutic use ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/drug therapy ; Atrial Fibrillation/surgery ; Catheter Ablation/adverse effects ; Catheter Ablation/methods ; Pulmonary Veins/surgery ; Recurrence ; Sex Characteristics ; Treatment Outcome
Chemical Substances	Anti-Arrhythmia Agents
Language	English
Publishing date	2023-03-10
Publishing country	England
Document type	Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1303417-0
ISSN	1468-201X ; 1355-6037
ISSN (online)	1468-201X
ISSN	1355-6037
DOI	10.1136/heartjnl-2021-320601
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Article ; Online: Anti- and pro-fibrillatory effects of pulmonary vein isolation gaps in human atrial fibrillation digital twins.

Jin, Ze / Hwang, Taehyun / Kim, Daehoon / Lim, Byounghyun / Kwon, Oh-Seok / Kim, Sangbin / Kim, Moon-Hyun / Park, Je-Wook / Yu, Hee Tae / Kim, Tae-Hoon / Uhm, Jae-Sun / Joung, Boyoung / Lee, Moon-Hyoung / Pak, Hui-Nam

NPJ digital medicine

2024 Volume 7, Issue 1, Page(s) 81

Abstract: Although pulmonary vein isolation (PVI) gaps and extrapulmonary vein triggers contribute to recurrence after atrial fibrillation (AF) ablation, their precise mechanisms remain unproven. Our study assessed the impact of PVI gaps on rhythm outcomes using a ...

Abstract	Although pulmonary vein isolation (PVI) gaps and extrapulmonary vein triggers contribute to recurrence after atrial fibrillation (AF) ablation, their precise mechanisms remain unproven. Our study assessed the impact of PVI gaps on rhythm outcomes using a human AF digital twin. We included 50 patients (76.0% with persistent AF) who underwent catheter ablation with a realistic AF digital twin by integrating computed tomography and electroanatomical mapping. We evaluated the final rhythm status, including AF and atrial tachycardia (AT), across 600 AF episodes, considering factors including PVI level, PVI gap number, and pacing locations. Our findings revealed that antral PVI had a significantly lower ratio of AF at the final rhythm (28% vs. 56%, p = 0.002) than ostial PVI. Increasing PVI gap numbers correlated with an increased ratio of AF at the final rhythm (p < 0.001). Extra-PV induction yielded a higher ratio of AF at the final rhythm than internal PV induction (77.5% vs. 59.0%, p < 0.001). In conclusion, our human AF digital twin model helped assess AF maintenance mechanisms. Clinical trial registration: https://www.clinicaltrials.gov Unique identifier: NCT02138695.
Language	English
Publishing date	2024-03-26
Publishing country	England
Document type	Journal Article
ISSN	2398-6352
ISSN (online)	2398-6352
DOI	10.1038/s41746-024-01075-y
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Article: Using computed tomogram atrial myocardial thickness maps in high-power short-duration radiofrequency pulmonary vein isolation: UTMOST AF.

Hwang, Taehyun / Kwon, Oh-Seok / Yu, Hee Tae / Yang, Song-Yi / Kim, Daehoon / Kim, Tae-Hoon / Uhm, Jae-Sun / Joung, Boyoung / Lee, Moon-Hyoung / Hwang, Chun / Pak, Hui-Nam

Journal of arrhythmia

2024 Volume 40, Issue 2, Page(s) 267–277

Abstract: Background: High-power short-duration (HPSD) ablation creates wide, shallow lesions using radiofrequency (RF) heating. It is uncertain if adjusting RF energy based on atrial wall thickness provides extra benefits. We studied the safety and effectiveness ...

Abstract	Background: High-power short-duration (HPSD) ablation creates wide, shallow lesions using radiofrequency (RF) heating. It is uncertain if adjusting RF energy based on atrial wall thickness provides extra benefits. We studied the safety and effectiveness of tailored HPSD energy based on left atrial (LA) wall thickness (LAWT) for circumferential pulmonary vein isolation (CPVI) in patients with paroxysmal atrial fibrillation (PAF). Methods: We enrolled 212 patients (68.4% male, mean age: 59.5 ± 11.0 years) and randomly assigned them to two groups: LAWT-guided CPVI (WT, Results: After a mean follow-up of 13.4 ± 7.0 months, the WT and control groups showed no significant difference regarding clinical recurrence rate (13.9% vs. 5.8%, respectively; Conclusions: The LAWT-guided energy titration strategy did not result in improved procedural safety and efficacy compared to the conventional 50-60 W-HPSD CPVI in patients with PAF.
Language	English
Publishing date	2024-03-01
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2696593-8
ISSN	1883-2148 ; 1880-4276
ISSN (online)	1883-2148
ISSN	1880-4276
DOI	10.1002/joa3.13008
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Article ; Online: Clinical Characteristics and Rhythm Outcomes in Patients With Atrial Myopathy After Successful Catheter Ablation of Atrial Fibrillation.

Kim, Moon-Hyun / Kim, Tae-Hoon / Hwang, Inseok / Park, Je-Wook / Yu, Hee Tae / Uhm, Jae-Sun / Joung, Boyoung / Lee, Moon-Hyoung / Hwang, Chun / Pak, Hui-Nam

Journal of the American Heart Association

2024 Volume 13, Issue 3, Page(s) e030818

Abstract: Background: Although successful atrial fibrillation (AF) ablation can maintain sinus rhythm and reduce the left atrial (LA) dimension, blunted LA reverse remodeling can be observed in patients with atrial myopathy. We explored the potential mechanisms ... ...

Abstract	Background: Although successful atrial fibrillation (AF) ablation can maintain sinus rhythm and reduce the left atrial (LA) dimension, blunted LA reverse remodeling can be observed in patients with atrial myopathy. We explored the potential mechanisms and long-term outcomes in patients with blunted LA reverse remodeling after successful AF catheter ablation. Methods and results: We included 1685 patients who underwent baseline and 1-year follow-up echocardiograms, had a baseline LA dimension ≥40 mm, and did not have a recurrence of AF within a year. The patients were divided into tertile groups according to the delta value of the change in LA dimension on the preprocedure and 1-year postprocedure echocardiography. After propensity score matching for age, sex, AF type, and LA dimension, 1272 patients were finally included in the analyses (424 in each group; the least/blunted, moderate, and the most reverse remodeling group). The patients in the T1 group (blunted LA reverse remodeling) were independently associated with higher left ventricular mass index (odds ratio [OR], 1.014 [95% CI, 1.005-1.022], Conclusions: Blunted LA reverse remodeling after AF catheter ablation, which is suggestive of atrial myopathy, was independently associated with a larger ventricular epicardial adipose tissue volume and worsening of H
MeSH term(s)	Humans ; Aged ; Atrial Fibrillation ; Treatment Outcome ; Heart Atria ; Echocardiography/methods ; Catheter Ablation/adverse effects ; Catheter Ablation/methods ; Recurrence ; Atrial Remodeling
Language	English
Publishing date	2024-01-31
Publishing country	England
Document type	Journal Article
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.123.030818
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