arrhythmia news 014

Tsu-Juey Wu

(Taiwan Heart Rhythm Society)

10041 50 22 26

886-2-23821530

886-2-23821528

www.thrs.org.tw

I S S N 2 2 2 3 - 0 1 3 0

Yenn-Jiang Lin Kuo-Hung Lin

Shih-Tsung Cheng

Cheng-Hung Li Wen-Chin Tsa

Hung-Yu Chang Tze-Fan Chao

Shuenn-Nan Chiu Shih-Chung Huang

Jan-Yow Chen Po-Ching Chi

Bien-Hsien Huang Wei-Hua Tang

Shan-Huei Huang Hung-Ta Wo

Jun. 2014 VOL. 014Arrhythmia News

1994 Cazeau PACE four chamber

pacing dilated cardiomyopathy left bundle

branch block (LBBB)

(Cardiac Resynchronization Therapy, CRT) 20

CRT

(algorithm)

P1P1P3P5P7 -

P9 EKG of the month

P10P13P16P17 HRS

P18 2014 HRS

2011 Effectiveness of cardiac resynchronization

therapy by QRS morphology in the Multicenter Automatic

Defibrillator Implantation Trial-Cardiac Resynchronization

Therapy (MADIT-CRT). Circulation 2011;123:1061-72

CRT-D( defibrillation

CRT) QRS

2.4 CRT-D 34%

41%

(LBBB)

NEJM Survival with Cardiac-

Resynchronization Therapy in Mild Heart Failure, N Engl J

Med 2014; 370:1694-1701 (MADIT-CRT)

MADIT-CRT 1820

EF<30%, NYHA class I II 3:2

CRT-D ICD

guideline ICD MADIT-CRT 2004 12

22 2009 6 22 1691

2010 9 10 (post trial phase I) 854

2013 9 (post trial phase 2)

QRS

LBBB LBBB

LBBB CRT-D

ICD 41% (hazard

ratio of 0.59) 62% (hazard ratio of

0.38) subgroup

Ta iwan Hear t Rhythm Soc ie ty 103 6THRS VOL.0142

QRS 150 <150ms CRT-D

LBBB (RBBB intraventricular conduction

delay)

(NYHA class

III and IV) CRT-D

MADIT-CRT the Resynchronization Reverses

Remodeling in Systolic Left Ventricular Dysfunction

(REVERSE) trial 2 CRT-D

The

Resynchronization–Defibrillation for Ambulatory Heart

Failure Trial (RAFT) CRT-D

(NYHA class I ~ III)

MEDIT-CRT CRT-D LBBB

(NYHA I II)

(EF<30%) LBBB CRT-D

CRT-D LBBB

Reference1. Goldenberg I, Kutyifa V, Klein HU, et al. Survival with Cardiac-

Resynchronization Therapy in Mild Heart Failure, N Engl J Med

2014; 370:1694-1701.

2. Zareba W, Klein H, Cygankiewicz I, et al. Effectiveness of cardiac

resynchronization therapy by QRS morphology in the Multicenter

Therapy (MADIT-CRT). Circulation 2011;123:1061-72.

3. Tang AS, Wells GA, Talajic M, et al. Cardiac-resynchronization

therapy for mild-to-moderate heart failure. N Engl J Med

2010;363:2385-95.

Survival with Cardiac-Resynchronization Therapy in Mild

Heart Failure, N Engl J Med 2014; 370:1694-1701 LBBB

CRT-D ICD

LBBB CRT-D

Survival with Cardiac-Resynchronization Therapy in Mild Heart Failure, N Engl J Med 2014;

370:1694-1701 LBBB QRS

EF>25% or EF<25% CRT-D ICD

Ta iwan Hear t Rhythm Soc ie ty 103 6VOL.014 3THRS

( )

Cardiac Resynchronization Therapy (CRT)

QRS left bundle branch

block(LBBB)

MADIT-CRT

7

(Ischemic cardiomyopathy NYHA Fc I-II; Non-Ischemic

Cardiomyopathy Fc II) CRT-de brillator (CRT-D)1

CRT

(LV reversed remodeling)

1/3 (non-responder)2,3

non-responders4

CRT non-responder

AV interval VV interval

AV interval

LBBB

CRT

CRT

(synchronized LV pacing, sLVP)

5

AdaptivCRT®

sLVP

CRT (Biventricular pacing, BVP)

(LVP)

LVP PR 200msec BVP6

100 BPM BVP LVP7

LVP

LVP AV delay AV interval

70% RV 30-90mesc8,9

BVP BVP

AV delay P 30msec RV

50msec9,10

AdaptivCRT®

( )

Adaptive CRT trial 522 2:1

AdaptivCRT®

6 AdaptivCRT®

11

AdaptivCRT®

RV

pacing 44% sLVP sLVP 50%

sLVP 50% sLVP 50%

12

AdaptivCRT®

48%


(P=0.044)12

46%13

MIRACLE MIRACLE ICD InSync III Marquis

PROSPECT

CRT AdaptivCRT®

12%14

CRT

(phrenic nerve stimulation, PNS)

PNS

CRT CRT

(Cardiac Vein)

7015

PNS

(QuartetTM

by St. Jude Medical Attain®

Performa®

by Medtronic)

RV 10

CRT

non-responder PNS

St.

Jude Medical VectSelect QuartetTM

CRT

Medtronic

Vector Express®

16

CRT non-responder

St Jude Medical

MultiPointTM

Pacing (MPP) ( ( ))

BVP

LV dP/dtmax16,17

tissue Doppler

imaging (TDI) BVP18

CRT

References

1. Goldenborg I, et al. NEJM. 2014:370;1694-1701.

2. Abraham WT, et al. NEJM. 2002;346:1845-1853.

3. Abraham WT, et al. Circulation. 2004;110:2864-2868.

4. Mullens W, et al. JACC. 2009;53:765-773.

5. Van Gelder BM, et al. JACC. 2005;46:2305-2310.

6. Kurzidim K, et al. PACE. 2005;28:754-761.

7. Vollman D, et al. Circulation. 2006;113:953-959.

8. Khaykin Y, et al. Europace. 2011;13:1464-1470.

9. Bailey R, et al. JACC. 2008;1022-1101. (Abstract)

10. Jones RC, et al. JC. 2012;21:1226-1232.

11. Martin DO, et al. Heart Rhythm. 2012;9:1807-1814.

12. Birnie D, et al. Heart Rhythm. 2013;9:1368-1374.

13. Martin OD, et al. Circulation. 2013;128:A17740. (Abstract)

14. Singh JP, et al. Europace. 2013;15:1622-1628.

15. Randhawa A, et al. PACE. 2013;36:94-102.

16. Thibault B, et al. Europace. 2013;15:984-991.

17. Pappone C, et al. Heart Rhythm. 2014;11:394-401.

18. Rinaldo CA, et al. J Cardiac Fail. 2013;19:731-738.

( )


11%

3% 1.6% 0.8%

0.5%

CS

2.9 10.6

1.

(transseptal puncture)

1

2. WiCSw®

-LV

system (EBR Systems Inc.; Battery model

3000; Pulse generator model 4000)

Plavix 3

WiSE-CRT2

WiCSw®

-LV system


(A): W i C S - L V ( P i e z o e l e c t r i c

transducers)

LV

(B): WICS-LV

1. pacemaker

2. pulse generatior

3. pulse generator

(C): X (trans-

aortic approach )

( )

3.

Medtronic 20066

4Fr

3

1. Rademakers LM, et al. Heart Rhythm. 2014;11:609-613.

2. Auricchio A, et al. Europace. 2014;16:681-688.

3. Yee R, et al. Heart Rhythm. 2014 (Epub ahead of print)


(AF)

51

AF2,3

24

35

AF

2050 1200 -1500

AF6-8

2006~2008

(TSR) 16.5%

(transient ischemic attack, TIA) AF AF

28%

AF9

CHA2DS2-VASc score AF

CHA2DS2-VASc score 210,11

aspirin anticoagulant

ESC HAS-BLED score

HAS-BLED score 312

K

(VKAs) warfarin

( INR

2-3 INR

)

onset/offset

AF13

optimal INR

( ) Warfarin

NOACS

(NOACs)

ROCKET-AF (CHADS2

score 3.5) /TIA (

55%) Rivaroxaban ( )

warfarin (ITT on-treatment

warfarin 21% )14

(RELY ARISTOTLE)

ROCKET-AF CHADS2 score

2.1 /TIA 20%14

warfarin

415

ROCKET-AF East

Asia Cohort

AF Rivaroxaban

warfarin Rivaroxaban

(HR=0.28 72% )

(HR=0.24 76% )

(HR=0.54)

(HR=0.14)16

double blind, double dummy J-ROCKET

( 15mg/QD CrCl

30-49 mL/min 10mg/QD) warfarin

17

NOACs warfarin

Dabigatran 80%

( )18

RELY ( 75 )

(CrCl 30-50 mL/min) Dabigatran warfarin

Dabigatran ( )

11-12% FDA

(HR=1.41 [95% CI, 1.28-1.55]; P <

.001)19

ATLAS2 TIMI 22

Rivaroxaban (ACS)20

ACS

Rivaroxaban

Rivaroxaban AF

Dabigatran AF21,22

Rivaroxaban 24

Dabigatran 24 36

4823

BID QD


23% TID 30%24

Rivaroxaban QD25

AF NOACs

warfarin John Camn

CAD

Rivaroxaban26

Reference:1. Wolf PA, et al. Stroke. 1991;22:983-988.

2. Lin HJ, et al. Stroke. 1996;27:1760-1764.

3. Jørgensen HS, et al. Stroke. 1996;10:1765-1769.

4. Benjamin EJ, et al. Circulation. 1998;98:946-952.

5. Stewart S, et al. Am J Med. 2002;113:359-364.

6. Miyasaka Y, et al. Circulation. 2006;114:119-125.

7. Go AS, et al. JAMA. 2001;285:2370-2375.

8. United Nations. Available at: http://www.un.org/esa/population/

publications/WPA2009/WPA2009-report.pdf. Accessed July 2011.

9. Hsieh FI & Taiwan Stroke Registry Investigators. Circulation.

2010;122:1116-1123.

10. Olesen JB, et al. BMJ. 2011;342 ePublication – do.

11. Camm AJ, et al. Eur Heart J. 2010;31:2369-2429.

12. Pisters R, et al. Chest. 2010;138:1093-1100.

13. ACC/AHA/ESC Guidelines, Eur Heart J. 2006.

14. Patel MR, et al. N Engl J Med. 2011;365:883-891.

15. Shen AY, et al. J Am Coll Cardiol. 2007;50:309-315.

16. Wong KS, et al. Stroke. 2014 (Epub ahead of print)

17. Hori M, et al. Circ J. 2012;76:2104-2111.

18. Mavrakanas T, et al. Pharmacol Ther. 2011;130:46-58.

19. FDA Safety Announcement http://www.fda.gov/Drugs/DrugSafety/

ucm396470.htm.

20. Mega JL, et al. Lancet. 2009;374:29-38.

21. Chatterjee S, et al. presented at AHA 2012.

22. Artang R, et al. Am J Cardiol. 2013;112:1973-1979.

23. EHRA practical guide for use of the new oral anticoagulants.

Europace. 2013;15:625-651.

24. Coleman CI, et al. Curr Med Res Opin. 2012;28:669-680.

25. Rivaroxaban ; .

26. Savelieval I, et al. Clin. Cardiol. 2014;37:32-47.


E K G C a s e o f t h e M o n t h

4 0

Brugada syndrome ( ) ICD ICD

right ventricular outflow tract

epicardium delay potential fragmented

potential potential

V1-3 ST elevation ( )

right bundle branch block (RBBB)

VT VF

Brugada Syndrome V1-3 RSR

dynamic J wave and ST elevation RBBB

V1-3 RSR V5-6 slurred S wave

Yoshiyasu Aizawa Circulation

11 RBBB Brugada syndrome

Brugada RBBB

mask Brugada

right bundle

conduction typical RBBB pattern

Brugada syndrome

ST segment J point

provocation test dynamic change

V1-3 ST elevation

dynamic ST change

Brugada syndrome

Brugada Syndrome

Brugada Syndrome RBBB

benign

dynamic J point and ST change


1.

Study nds common test of ICD patients to be unnecessaryMay 9, 2014 | By Varun Saxenahttp://www. ercemedicaldevices.com/story/study- nds-common-test-

icd-patients-be-unnecessary/2014-05-09

(defibrillation test)

Shockless Implant Evaluation 2500

5

8.3% (no-test

group) 7.22 95

(no-test group)

5.4 v.s. 6.5

2. (CardioMEMS system)

FDA

CardioMEMS HF System for Pulmonary Pressure

Monitoring in Heart Failure Patients Approved by FDA

(VIDEO)by EDITORS on May 29, 2014

http://www.medgadget.com/cardiac_surgery

24

FDA

( CardioMEMS System)

24

CardioMEMS HF

3. FDA (CRT)

FDA Approves Medtronic CRT Devices for Mild HF With

AV Block

April 10, 2014

http://www.medscape.com/viewarticle/823485

FDA (CRT-D

and CRT-P)

BLOCK-

HF

CRT-D CRT-P

35%(LVEF <35 ) QRS

130 BLOCK-HF

NYHA 1-3 50

691

CRT-D CRT-P

(primary endpoint)

(primary endpoint)

LV end-systolic

volume index, LVESVI 15

LVESVI

4. (Biotronik) ProMRI

3T

1.5T

BIOTRONIK’s ProMRI Technology Cleared for 3 Tesla

MRI Scans and Full-Body at 1.5 Tesla

by EDITORS on May 22, 2014 3:05 pmhttp://www.medgadget.com/2014/05/biotroniks-promri-technology-

cleared-for-3-tesla-mri-scans-and-full-body-at-1-5-tesla.html

BIOTRONIK ProMRI

MRI

3T 1.5T

3T

BIOTRONIK 2011

(ICD) CE

(ICD) 1.5T

BIOTRONIK


CRT-P CRT-D

5. (St. Jude Medical)

FDA

Three New Pacemakers f rom SJM, Inc lud ing a

Quadripolar, Approved in U.S.

by EDITORS on Mar 24, 2014 2:29 pmhttp://www.medgadget.com/2014/03/three-new-pacemakers-from-

sjm-including-a-quadripolar-approved-in-u-s.html

(St. Jude Medical) Allure Quadra

CRT-P Assurity Endurity

FDA

Allure Quadra

Assurity Endurity

Assurity Endurity

Assurity

Endurity

Allure Quadra CRT-P Assurity Endurity

2013 03 CE

2014

6. (MRI)

Medtronic snags EU approval for an MRI-safe ICD

http://www.fiercemedicaldevices.com/story/medtronic-snags-eu-

approval-mri-safe-icd/2014-04-09

(Metronic Inc.) MRI (ICD)

(CE mark)

63% (ICD)

(MRI) MRI

St. Jude Medical

Biotronik Evera MRI (ICD)

MRI Evera MRI

SmartShock

30%

7. LifeBot / /

LifeBot Releases World’s Lightest Advanced Cardiac

by EDITORS on May 19, 2014 3:57 pmhttp://www.medgadget.com/2014/05/lifebot-releases-worlds-lightest-

advanced-cardiac-monitorde brillatorpacer.html


LifeBot

2.8

1.27 4.5 8.35 2.5 11.43 21 6.35

LifeBot

8. Biosense Webster CARTOSOUND Module

(ICE)

CAROSOUND Module SOUNDSTAR

(ICE)

( ICE)

SOUNDSTAR Biosense Webster

CARTO3 System CARTOSOUND Module

SOUNDSTAR CARTO3 System

(ICE)

CARTOSOUND Module

Biosense Webster

9. Boston Scientific launches the Rhythmia™

Mapping System in HRS 2014

Boston Scienti c HRS 2014 Rhythmia™ Mapping

System

Boston Scientific 2012 10 Rhythmia

Medical Inc., 2013 Rhythmia™ Mapping

System FDA CE Mark 2014

(HRS 2014)

6 4

IntellaMap Orion™ High Resolution Mapping

Catheter

Rhythmia™ Mapping System

2016


Atrial Fibrillation News

Heart Rhythm. 2014 May

The Impact of Atrial Fibrillation Termination Mode

during Catheter Ablation Procedure on Maintenance

of Sinus Rhythm. (Faustino M. et al.)

(AAD)

(AT)

(cardioversion)

persistent longstanding

persistent AF

(prospective) 400

persistent AF (

62.7 7.2 ) AF

135 AT 195

70

Holter

72.6% (direct to SR) 80.0% (through AT

into SR) 28.6% (by DC cardioversion) (p<0.001)

(direct to SR)

Hazard ratios (HRs) DC

(HR=0.54, p<0.001) AT SR

(HR=1.69; p=0.027) 104

AT SR SR

(HR=6.25 p=0.001)

AT SR

1 SR direct to SR

SR

Heart. 2014 May

Prediction of stroke or TIA in patients without

atrial brillation using CHADS2 and CHA2DS2-VASc

scores. (Mitchell LB. et al, for the APPROACH

investigators)

AF AFL

CHADS2 CHA2DS2-VASc TIA

20970

AF APPROACH (Alberta Provincial Project

for Outcomes Assessment in Coronary Heart disease)

2005 2011

(ACS) TIA

4.1 453 (2.2%)

(297 ) TIA(156 ) 1903 (9.0%)

TIA risk score

(p<0.001) CHADS2 3 CHA2DS2-VASc 4

TIA 1% CHADS2 CHA2DS2-

VASc (C-statistic

0.68 0.71) CHADS2 CHA2DS2-VASc

(p<0.0001)

ACS AF CHADS2

CHA2DS2-VASc TIA

non-valvular AF

(ACS without AF ) TIA

CHADS2 CHA2DS2-

VASc thromboembolic risk

Pacing Clin Electrophysiol. 2014 May

Left Ventricular Hypertrophy and Antiarrhythmic

Drugs in Atrial Fibrillation: Impact on Mortality.

(Chung R. et al.)

AF guideline

amiodarone AF LVH

persistent AF LVH amiodarone

(AAD) amiodarone

(observation cohort analysis) AF

(cardioversion)

LVH ( LV wall

thickness 1.4cm)

AAD (LVEF)

( Social Security Death Index ) Kaplan-Meier

Cox proportional hazards models

AAD 3926

1399 LV wall thickness (

66.8 11.8 67% LVEF 46 15%

septum 1.3 0.4cm 1.2 0.2cm)

LVH( 1.4cm) 537 (38%) 537

LVH 67.5 11.7 76.4%

LVEF 48.3 13.3% LVEF

CAD (p=0.023) Amiodarone

(log rank p=0.001) propensity-score matched

cohort AF LVH AAD (no drug)

amiodarone AAD (non-AADs) amiodarone (

65 ) amiodarone

(p=0.05)

Pers i s ten t AF LVH

amiodarone AAD amiodarone

amiodarone

AF LVH

Heart Rhythm. 2014 May


Mortality and Cerebrovascular Events After

Radiofrequency Catheter Ablation of Atrial

Fibrillation. (Ghanbari H. et al Michigan group)

AF

10

(Cardiovascular events

CVEs)

3,058 ( 58 10 )

paroxysmal AF (1,888 ) persistent AF (1,170 )

11,347 - (patient-year) Time-dependent

rhythm status CVEs (cardiac &

all-cause mortality) multivariant Cox models

baseline time-dependent

high arrhythmia burden

independent predictor ( coefficient: 0.017/10years;

95% CI: 0.006-0.029, p=0.003) LA diameter ( coef cient:

0.044/5mm; 95% CI: 0.034-0.055, p<0.0001) persistent

AF ( coef cient: 0.174; 95% CI: 0.147-0.201, p<0.0001)

CVEs 71 (2.3%)

33 (1.1%) 111 (3.6%)

(HR:0.41 95% CI:0.20-0.84

p=0.015)

(HR:0.86; 95% CI:0.58-1.29 p=0.48) CVEs

(HR:0.79; 95% CI:0.48-1.29 p=0.34)

J Am Coll Cardiol. 2014 Apr.

Antithrombotic treatment in patients with heart

failure and associated with atrial fibrillation and

vascular disease: A nationwide cohort study.

(Lamberts M. et al.)

1997 2009 (

CAD PAD) AF

status incident AF no AF

AF time-dependent Cox regression models(HR

with 95% CI) Thromboembolism(TE)

(MI) 37,464

( 74.5 10.7 36.3% )

20.7% prevalent AF 17.2%

incident AF prevalent AF VKA (Vitamin

K antagonist) VKA anti-platelet

TE (HR 0.91[0.73-1.12]) MI (HR 1.11[0.96-1.28])

(HR 1.31[1.09-1.57])

incident AF VKA anti-platelet

VKA TE (HR 0.77[0.56-1.06])

MI(HR 1.07[0.89-1.28])

(HR 1.71[1.33-2.21]) AF

TE MI

VKA alone

single anti-platelet agent

AF VKA

anti-platelet

(TE or MI)

Circ Res. 2014 Apr.

The clinical profile and pathophysiology of atrial

fibrillation: relationships among clinical features,

epidemiology, and mechanisms (Andrade J. et al.)

(estimated lifetime

risk 22-26%) AF

AF risk

factors

(predisposing gene

variant)

AF

AF

ectopic firing reentrant 4 (1) ion

channel dysfunction (2) Ca2+

-handling abnormalities (3)

structural remodeling (4) autonomic neural dysregulation

structural remodeling

(prior atrial infarction) Ca2+

-handling

abnormalities DAD/trigger activity focal

ectopic firing Neural dysregulation

atrial arrhythmogenesis

(Monogenic) AF

ion channel dysfunction arrhythmia

Af (polygenic)

polygenic AF

AF

AF

Ventricular Tachycardia / Device News

Int J Cardiol. 2014 Apr.

Safety of mid-septal electrode placement in

implantable cardioverter defibrillator recipients

- Results of the SPICE (Septal Positioning of

ventricular ICD Electrodes) study (Kolb C. et al.)

(RV apical pacing)

( [RV mid-septum])

ICD (mid-septal position)


299 ICD (79%

65.2 12.1 83% primary

prevention) ICD

(mid-septum) (n = 145) ICD

(RV apical location) Event-free

(primary end point) (secondary end point)

events (lead revision)

(suboptimal RV electrode performance

de brillation thresholds > 25J)

event free survival

80.6% 72.3% 82.2%

72.1% P 0.726 0.969 non-

inferiority High

de brillation thresholds 7 (5.0%)

3 (2.2%) p 0.209

ICD (mid-septum)

(RV apex) survival free of lead revision,

suboptimal right ventricular electrode performance or non-

randomized lead position

non-inferiority

Pacing Clin Electrophysiol. 2014 May

Safety and Outcomes of Magnetic Resonance

Imaging in Patients with Abandoned Pacemaker and

De brillator Leads (John V. Higgins et al.)

(abandoned cardi-

ovascular implantable electronic device [CIED])

(MRI)

(radiofrequency filed)

(endocardial heating) CIED

MRI

MRI device

generators MRI

pacing threshold generator

threshold 19 (11

8 ) 19 85 MRI

1.63

MRI ICD dual

coil 35 MRI 31

MRI

MRI generator

pacing

threshold

CIED

MRI MRI

cardiac device

Circulation. 2014 May

Ef cacy of Long Detection Interval ICD Settings in

Secondary Prevention Population: Data from the

Advance III Trial. (Kloppe A. et al.)

Advance III long detection

window primary prevention secondary prevention

ICD 1902

477 primary prevention 248

long detection setting (30/40 intervals)

299 (18/24 intervals)

cycle length 320ms 85%

65 12 37% (VF)

38% 13% ICD 37% 47%

16% 12

25% (115.6 rate per 100/pts

years vs 86.8; IRR: 0.75 95%Cl: 0.61-0.93, p=0.008)

34% (51.2 rate per 100 pts year vs 38.1; IRR

0.66; 95%Cl: 0.48-0.89, p=0.007) (89.7 vs 67.7;

IRR: 0.77 95%Cl: 0.60-0.97, p=0.029) (37.1 vs

28.1; IRR: 0.64 95%Cl: 0.45-0.93, P=0.018)

Advance III ICD long detection windows

primary prevention secondary prevention

secondary prevention

secondary prevention

long detection with ATP during charging

Circ Arrhythm Electrophysiol. 2014 Feb.

High-density mapping of ventricular scar: a

comparison of ventricular tachycardia (VT)

supporting channels with channels that do not

support VT (Nayyar S. et al.)

(channels that support VT circuit)

22

NavX system PentaRay mapping

matching pacemap stimulus-to-QRS 40ms

matching pacemap to the VT morphology

entrainment mappinng

238 57

(97% versus 82%, p=0.036)

(mean SEM,

53 5 versus 33 4mm) stimulus-to-QRS (130 12

versus 82 12ms) (103 14 versus

43 13ms) (0 .87 0.23 versus

1.39 0.21m/s) fractionated, late

very late potentials

21% 26% 29% mapping

potentials


1 2014 6 7 13:30-17:35/

(Post HRS Highlight

Symposium)/ 2 /

2 2 0 1 4 6 8 0 9 : 0 0 - 1 5 : 2 0 /

(Peripheral Vascular intervention: form basic to

advance)/ 6F /

/

3 2014 6 14 13:30-17:40/ -

(CIEDs Training Program - Part III :

CRT)/TICC /

/

4 2014 6 14 13:30-1740/ -

(CIEDs Training Program - Part III :

CRT)/ 14 /

/ /

5 2014 7 5-6 / Asia Paci c Thrombosis Management

Meeting- -

/ / Bayer

APAC, https://www.thrombosismanagement.com/apac

6 2014 9 12-14 / (APSC 2014)/

/ /

7 2014 9 27 / THRS /

/

8 2014 10 4 13:30-17:30 10 5 08:50-17:00/

2014 / 101-104 /

1 2014 6 18-21 / 2014-

(Cardiostim 2014)/ - (Nice, France )

2 2014 6 27-28 / -

(2nd International Europa-Park Symposium

on Cardiac Arrhythmia)/ Europa-Park Rust,

(Europa-Park Rust, Germany)

3 2013 8 30 -9 3 / 2014 (ESC

Congress 2014 )/ - (Barcelona , Spain)

4 2014 10 5-8 / 2014 (Heart Rhythm

Congress)/ - (Birmingham, UK)

5 2014 10 15-17 / -

(10th International Symposium on Catheter Ablation

Techniques (ISCAT))/ - ( Paris, France)

6 2014 10 29 -11 1 /

(The 7th Asia-Paci c Heart Rhythm Scienti c Session)/

- (New Delhi, India)

7 2 0 1 4 1 1 9 - 1 0 /

-(Europe AF -The 7th conference)/ -

(London, UK)

8 2014 12 2-5 / -

(XVI International Symposium on

Progress in Clinical Pacing)/ - (Rome, Italy)


HRS

35 (Heart Rhythm Society, HRS)

2014 Moscone Center

8

4 HRS

HRS

IL-17

(Rhodiola Crenulate Down-regulated Proin ammatory

Cytokine IL-17 to Reduce Ventricular Arrhythmia in Failing

Heart) ,

IL-17

Th17

IL-17 IL-17

(salidroside) H9C2 /

Th1- Th2

IL-10

IL-17

IL-17

IL-17

RNA (microRNA)

microRNA 20~25

microRNA

miR-1 -133 -328 -499

microRNA

microRNA

HRS

microRNA

miR-106b

miR-

106b ryanodine receptor type-2(RyR2)

miR-106b

circulating microRNA, c-miR-1, 21, 29b and -133a

pulmonary vein isolation (PVI)

microRNA

microRNA

HSR MOSCONE CENTER HRS


2014 HRS

(Heart Rhythm Society, HRS)

(2011 HRS) HRS

Moscone center

30 oral poster presentation

summit AF

summit VT/VF summit Lead and Device management

summit

case (AF) (VT)

(Contact Force catheter)

mapping

Mapping

(low voltage zone area: 25% without CF vs. 13% with CF,

and late potential area: 2.3% without CF vs. 5.8% with CF)

20% lesion

MRI

lesion

non-randoized study

SMART AF randomized study TOCCASTAR

safety efficacy (75.9% vs. 58.1% 1

year freedom form arrhythmia)

(cryoballoon) STOP-AF

trial

98% acute

success rate 73% freedom for AF 5

53% freedom for AF (Arctic Front

AdvanceTM) Flexible

surface temperature gradient

80-84% 1 year freedom

from AF

direct

tissue observation (Compliant Laser Balloon

Catheter) Low-

intensity collimated ultrasound

( PV ositum ) 3D

anatomy

non-invasive ablation

3D

100

2010 Noninvasive stereotactic

radiosurgery(CyberHeartTM)

CTI ablation

late breaking trial

device ICD

(Defibrillation testing) SIMPLE trial (A

randomized trial of defibrillation testing at the time of ICD

implantation)

ineffective shock (3.03% vs. 2.17%)

(5.83% vs. 5.21%) Leadless

ICD LEADLESS trial

33 device migration/infection/

mechanical failure/pro-arrhythmia

(adenosine testing) ADVICE trial

(Adenosine-guided pulmonary vein isolation for the treatment

of paroxysmal atrial fibrillation)

dormant conduction 1 year freedom

from arrhythmia (65.3% vs. 39.4%, p<0.0001)

The Cryo versus RF trial (Point by point

RF ablation versus the cryoballoon or a novel combined

approach)

1year free from arrhythmia (76% with combine

vs. 67% with cryoballoon alone, and 47% with RF alone)

CTI

pulmonary vein isolation

PReVENT trial (Prophylactic pulmonary vein isolation

during isthmus ablation for atrial utter)

pulmonary vein isolation 21%

SVT sudden cardiac death

arrhythmia news 014

Health & Medicine

maditcrt maditcrt

crtd defibrillation

i s s n

qrs morphology

mild heart failure

lbbb nejm survival

n engl j med

month p10 p13 p16 p17