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YASUOKA Ryobun

    Department of Medicine　Lecturer
Last Updated :2024/04/25

Researcher Information

Degree

  • phd（2008/03 Kindai University）

J-Global ID

Research Areas

  • Other / Other

Published Papers

  • Tomoya Nagano; Ryobun Yasuoka; Motohide Tanaka; Masahiro Maruyama; Gaku Nakazawa; Takashi Kurita
    Journal of cardiology 79 (2) 283 - 290 2022/02 
    BACKGROUND: Direct oral anticoagulants (DOACs) have been used to prevent cardiogenic embolism in patients with atrial fibrillation (AF). No evidence has been established for the follow-up renal function evaluation intervals. We hypothesized that a proposed follow-up interval of renal function can be estimated by patient's baseline characteristics including creatinine clearance (CCr). METHODS: We conducted a single-center retrospective study at Kindai University Hospital from May 2011 to December 2017. Patients were screened and they were enrolled if baseline CCr of ≥50 mL/min. To provide a periodical synchronization for measurements of CCr in all patients, these were evaluated at four different time points (approximately at 3, 6, 9, and 12 months). Primary endpoint was defined as a CCr value of <50 mL/min during the follow-up period. We analyzed associations between the cumulative risk for renal endpoint and baseline characteristics by the Kaplan-Meier method and the Cox proportional hazards model. RESULTS: Renal endpoint was associated with age (95% CI: 0.07 to 0.21, p<0.01), body weight (95% CI: -0.09 to -0.01, p<0.01), CCr (95% CI: -0.18 to -0.07, p<0.01), and CHA2DS2-VASc score (95% CI: 0.14 to 0.63, p<0.01). Combining baseline CCr of <60 mL/min and other risk factors, acceptable intervals for 5% risk levels were 78 days (age ≥75 years old), 100 days (CHA2DS2-VASc score of> 4 points), and 90 days (body weight <60kg), respectively. Under conditions of baseline CCr of <60 mL/min, age ≥75 years old, CHA2DS2-VASc score of> 4 points, or body weight <60 kg, an increased risk of renal endpoints is 4.85, 3.29, 1.24, 2.44 fold, respectively. CONCLUSIONS: We propose a risk-stratified follow-up interval for renal evaluation in patients with AF and DOACs therapy according to a combination of baseline CCr and other risk factors.
  • Motohide Tanaka; Ryobun Yasuoka; Tomoya Nagano; Yasuhito Kotake; Masahiro Maruyama; Hiromi Yamamoto; Yoshitaka Iwanaga; Yutaka Hirano; Gaku Nakazawa; Takashi Kurita
    International journal of cardiology. Heart & vasculature 36 100866 - 100866 2021/10 
    Background: Transesophageal echocardiography (TEE) is currently the gold standard technique for diagnosing left atrial appendage (LAA) thrombi. Cardiac computed tomography (CT) has been expected to become an alternative method to TEE; however, a reliable quantitative evaluation method has not been established. Methods and results: We enrolled 177 patients with persistent atrial fibrillation who underwent both cardiac CT and TEE before catheter ablation. The patients were classified into two groups according to the TEE results: the thrombus group (13 patients) and non-thrombus group (164 patients). The Hounsfield unit (HU) density at the proximal LAA (LAAp) and distal LAA (LAAd) was measured on cardiac CT images. The LAAd/LAAp HU ratio and standard deviation of HU density (HU-SD) at the LAAd were evaluated. We created an algorithm by decision tree analysis to predict LAA thrombus formation using the HU ratio and HU-SD. Definite absence of LAA thrombus (Category-I) was diagnosed for 139 patients by combining the first and second branching of the decision tree (Category-Ia: HU ratio of ≥0.26, Category-Ib: HU ratio of <0.26, HD-SD of ≥26.94). Definite presence of LAA thrombus (Category-Ⅱ) was diagnosed for 3 patients using the third branching of the decision tree (Category-Ⅱ: HU ratio of <0.26 and HU-SD of <13.85). Highly possibility of LAA thrombus (Category-III), but not definite, was diagnosed for the remaining 35 patients; therefore, these patients required diagnostic TEE. The diagnostic accuracy of this algorithm was 0.95. Conclusion: We have proposed a reliable algorithm to diagnose LAA thrombus formation using the HU ratio and HU-SD.
  • Masahiro Maruyama; Ryobun Yasuoka; Tomoya Nagano; Gaku Nakazawa; Takashi Noda; Takashi Nitta; Yoshifusa Aizawa; Tohru Ohe; Takashi Kurita
    Journal of cardiology 78 (3) 244 - 249 2021/09 
    BACKGROUND: Implantable cardioverter-defibrillator and cardiac resynchronization therapy using a defibrillator (ICD/CRT-D) are established means of reducing mortality due to ventricular arrhythmia. Although atrial fibrillation/flutter (AF) is the most common cardiac arrhythmia in patients with heart disease, the impact of AF on the prognosis of patients with ICD/CRT-D remains controversial. METHODS AND RESULTS: We analyzed data from the Nippon Storm Study, a prospective observational study of 1570 patients that was conducted at 48 Japanese ICD centers. We allocated 1549 participants to AF and non-AF groups, compared their clinical data at the time of enrollment, and monitored the incidences of mortality, hospitalization, and appropriate and inappropriate ICD/CRT-D therapy during a median 28 months. When the AF (n = 257, 16.6%) and non-AF-(n = 1292, 83.4%) groups were compared, the AF group was older (67.7 vs. 61.4 years; p<0.0001), and had lower left ventricular ejection fraction (38.0 ± 17.0% vs. 43.5 ± 18.9%; p<0.0001). During follow up, mortality was significantly higher in the AF than the non-AF group (p<0.0001). In multivariate analysis, AF was significantly associated with all-cause mortality [p = 0.013; hazard ratio (HR)=1.62]. Inappropriate ICD/CRT-D therapy occurred in 40/257 patients (15.6%) and AF was associated with a higher prevalence of inappropriate ICD/CRT-D therapy (p<0.0001; HR=2.25). CONCLUSION: The presence of AF at ICD/CRT-D implantation carries subsequent independent risks of 1.62-fold for death and 2.25-fold for inappropriate therapy.
  • Yoshiaki Kubota; Wan Ting Tay; Tiew-Hwa Katherine Teng; Kuniya Asai; Takashi Noda; Kengo Kusano; Atsushi Suzuki; Nobuhisa Hagiwara; Shinji Hisatake; Takanori Ikeda; Ryobun Yasuoka; Takashi Kurita; Wataru Shimizu
    ESC heart failure 8 (5) 3791 - 3799 2021/06 
    AIMS: The number of patients with both chronic obstructive pulmonary disease (COPD) and heart failure (HF) is increasing in Asia, and these conditions often coexist. We previously revealed a tendency of beta-blocker underuse among patients with HF with reduced ejection fraction (HFrEF) and COPD in Asian countries other than Japan. Here, we evaluated the impact of cardio-selective beta-blocker use on the long-term outcomes of patients with HF and COPD. METHODS AND RESULTS: Among the 5232 patients with HFrEF (left ventricular ejection fraction of <40%) prospectively enrolled from 11 Asian regions in the ASIAN-HF registry, 412 (7.9%) had a history of COPD. We compared the clinical characteristics and long-term outcomes of the patients with HF and COPD according to the use and type of beta-blockers used: cardio-selective beta-blockers (n = 149) vs. non-cardio-selective beta-blockers (n = 124) vs. no beta-blockers (n = 139). The heart rate was higher, and the outcome was poorer in the no beta-blocker group than in the beta-blocker groups. The 2 year all-cause mortality was significantly lower in the non-cardio-selective beta-blocker group than in the no beta-blocker group. Further, the cardiovascular mortality significantly decreased in the non-cardio-selective beta-blocker group before (hazard ratio: 0.36; 95% confidence interval: 0.18-0.73; P = 0.004) and after adjustments (hazard ratio: 0.37; 95% confidence interval: 0.19-0.73; P = 0.005), but not in the cardio-selective beta-blocker group. CONCLUSIONS: Beta-blockers reduced the all-cause mortality of patients with HFrEF and COPD after adjusting for age and heart rate, although the possibility of selection bias could not be completely excluded due to multinational prospective registry.
  • Yasuhito Kotake; Ryobun Yasuoka; Motohide Tanaka; Takashi Noda; Takashi Nitta; Yoshifusa Aizawa; Tohru Ohe; Gaku Nakazawa; Takashi Kurita
    IJC Heart & Vasculature Elsevier BV 32 100704 - 100704 2352-9067 2021/02
  • Toru Takase; Yoshitaka Iwanaga; Yugo Yamashita; Takeshi Morimoto; Yusuke Yoshikawa; Hidewo Amano; Seiichi Hiramori; Kitae Kim; Maki Oi; Yohei Kobayashi; Yuji Nishimoto; Heitaro Watanabe; Kenji Yamaji; Ryobun Yasuoka; Masafumi Ueno; Kazuhiro Kobuke; Takeshi Kimura; Shunichi Miyazaki
    European journal of internal medicine 82 2020/12 
    BACKGROUND: There is a paucity of data comparing the long-term outcomes after inferior vena cava (IVC) filters placement for patients with acute venous thromboembolism (VTE) between those with and without active cancer. METHODS: In the COMMAND VTE Registry, we evaluated the effects of IVC filter use on the long-term clinical outcomes stratified by the presence and absence of active cancer. RESULTS: Among 2,626 patients with acute symptomatic VTE, there were 604 patients with active cancer, and 2022 patients without active cancer. IVC filters were placed and not retrieved in 455 patients (17%) in the entire cohort, in 150 patients (24.8%) in the active cancer stratum, and in 305 patients (15.1%) in the non-cancer stratum. In the entire cohort, non-retrieved IVC filter placement was not associated with a lower adjusted risk for PE recurrence (HR 0.59, 95% CI 0.30-1.15, P = 0.122), but with an increased adjusted risk for DVT recurrence (HR 2.27, 95% CI 1.43-3.60, P<0.001). In the non-cancer stratum, the non-retrieved IVC filter placement was associated with a decreased risk for PE (HR 0.29, 95% CI 0.09-0.93, P = 0.037), but not with an increased risk for DVT (HR 1.73, 95% CI 0.89-3.38, P = 0.108), while in the active cancer stratum, it was associated with an increased risk for DVT (HR 2.47, 95% CI 1.24-4.91, P = 0.010), but not with a decreased risk for PE (HR 0.82, 95% CI 0.34--1.96, P = 0.650). CONCLUSIONS: There were some differences in the risk-benefit balance between VTE patients with and without active cancer.
  • 慢性閉塞性肺疾患を合併したうっ血性心不全患者の長期転帰にβ遮断薬が及ぼす影響 ASIAN HF Registry(Impact of Β-blocker on Long-term Outcomes in Congestive Heart Failure Patients with Chronic Obstructive Pulmonary Disease: ASIAN HF Registry)
    久保田 芳明; Wan Ting Tay; 浅井 邦也; 野田 崇; 草野 研吾; 鈴木 敦; 萩原 誠久; 久武 真二; 池田 隆徳; 安岡 良文; 栗田 隆志; Tiew-Hwa Katherine Teng; Inder Anand; Lam Carolyn S.P.; 清水 渉
    日本循環器学会学術集会抄録集 (一社)日本循環器学会 84回 OJ24 - 2 2020/07
  • 慢性閉塞性肺疾患を合併したうっ血性心不全患者の長期転帰にβ遮断薬が及ぼす影響 ASIAN HF Registry(Impact of Β-blocker on Long-term Outcomes in Congestive Heart Failure Patients with Chronic Obstructive Pulmonary Disease: ASIAN HF Registry)
    久保田 芳明; Wan Ting Tay; 浅井 邦也; 野田 崇; 草野 研吾; 鈴木 敦; 萩原 誠久; 久武 真二; 池田 隆徳; 安岡 良文; 栗田 隆志; Tiew-Hwa Katherine Teng; Inder Anand; Lam Carolyn S.P.; 清水 渉
    日本循環器学会学術集会抄録集 (一社)日本循環器学会 84回 OJ24 - 2 2020/07
  • Komatsu Y; Hocini M; Nogami A; Maury P; Peichl P; Iwasaki YK; Masuda K; Denis A; Voglimacci-Stephanopoli Q; Wichterle D; Kawamura M; Fukamizu S; Yokoyama Y; Mukai Y; Harada T; Yoshida K; Yasuoka R; Igawa M; Ohira K; Shimizu W; Aonuma K; Kautzner J; Haïssaguerre M; Ieda M
    Circulation 139 (20) 2315 - 2325 0009-7322 2019/05 [Refereed]
  • 植込み型除細動器使用患者において心房細動が死亡に及ぼす影響 NIPPON Storm試験からのサブ解析(Impact of Atrial Fibrillation on Mortality in Patients with Implantable Cardioverter Defibrillators: Sub-analysis from the NIPPON Storm Study)
    丸山 将広; 安岡 良文; 栗田 隆志; 野田 崇; 新田 隆; 相澤 義房; 大江 透
    日本循環器学会学術集会抄録集 (一社)日本循環器学会 83回 OJ35 - 6 2019/03
  • 日本における下大静脈フィルターの使用の現状 COMMAND VTEレジストリからの報告(Current Use of Inferior Vena Cava Filters in Japan: Reports from the COMMAND VTE Registry)
    高瀬 徹; 岩永 善高; 山下 侑吾; 藤田 晃輔; 渡邉 平太郎; 山治 憲司; 安岡 良文; 上野 雅史; 小夫家 和宏; 天野 秀生; 平森 誠一; 金 基泰; 東儀 圭則; 木村 剛; 宮崎 俊一
    日本循環器学会学術集会抄録集 (一社)日本循環器学会 83回 OJ01 - 8 2019/03
  • Maruyama M; Kurita T; Kotake Y; Hashiguchi N; Yasuoka R; Ueno M; Iwanaga Y; Miyazaki S
    Journal of cardiology cases 19 (2) 66 - 69 2019/02 [Refereed]
  • Takashi Kurita; Ryobun Yasuoka
    Catheter Ablation: A Current Approach on Cardiac Arrhythmias Springer Singapore 269 - 281 2018/01 [Refereed]
  • Ryobun Yasuoka; Takashi Kurita; Yasuhito Kotake; Yuzuru Akaiwa; Naotaka Hashiguchi; Koichiro Motoki; Hiromi Yamamoto; Kazuhiro Kobuke; Yoshitaka Iwanaga; Yutaka Hirano; Shunichi Miyazaki
    HEART AND VESSELS SPRINGER 32 (7) 893 - 901 0910-8327 2017/07 [Refereed]
     
    Low blood flow velocity in the left atrial appendage (LAA) indicates a high risk of thromboembolism. Although transesophageal echocardiography (TEE) has been the standard method with which to evaluate the LAA blood flow velocity, a clinically noninvasive method is desired. We hypothesized that the ratio of the Hounsfield unit (HU) density at two distinct points within the LAA represents the blood flow velocity in the LAA. We retrospectively investigated 60 consecutive patients with atrial fibrillation (paroxysmal type, n = 29) who underwent enhanced computed tomography (CT) and TEE. The peak emptying flow velocity in the LAA (LAAPV) was evaluated using TEE. HU density was measured at proximal and distal sites of the LAA (LAAp and LAAd) on CT images. The LAAd/LAAp ratio was correlated with the LAAPV (P < 0.01, r = 0.69). Among several indices, the HU ratio was the most significant parameter associated with the LAAPV (beta = 0.469, CI 28.602-68.286, P < 0.001). Receiver-operating characteristic analysis (area under the curve, 0.91) demonstrated that an HU density ratio cutoff of 0.32 discriminated a low LAAPV (< 25 cm/s) with sensitivity of 90% and specificity of 84%. Flow velocity of the LAA can be estimated by the HU density ratio at distal and proximal sites within the LAA. Our method might be a feasible substitution for TEE to discriminate patients with a reduced LAAPV.
  • Ryobun Yasuoka; Takashi Kurita; Yasuhito Kotake; Naotaka Hashiguchi; Koichiro Motoki; Kazuhiro Kobuke; Yoshitaka Iwanaga; Shunichi Miyazaki
    CIRCULATION JOURNAL JAPANESE CIRCULATION SOC 81 (5) 668 - 674 1346-9843 2017/05 [Refereed]
     
    Background: The CRYO-Japan PMS study indicated that cryoballoon ablation (Cryo-Abl) has a lower acute success rate of pulmonary vein isolation (PVI) for the right and left inferior PVs (RIPV and LIPV, respectively) than for the superior PVs. This study aimed to determine if the orientation and position of the inferior PVs are related to the difficulty of acute success of PVI. Methods and Results: We investigated 30 consecutive patients who underwent Cryo-Abl. A "difficult PV" was defined as the requirement for >2 cooling applications and/or touch-up ablation to achieve PVI. We measured the ventral angle between the vertical line and the direction of each PV trunk (PV angle) on the transverse plane of enhanced CT images. PV position was defined as the difference in the levels between the bottom of the RIPVs and the non-coronary cusp of the aorta. PV angle <105 and PV position <1.250 mm were independent factors of difficult RIPV isolation (PV angle: odds ratio (OR)=23.80, confidence interval (Cl) 3.15528 to -0.53622, P=0.002; PV position: OR=12.14, Cl -2.77301 to -0.23160, P=0.014). PV position <16.875mm was also related to the difficulty of LIPV isolation (OR=5.78, CI -1.77095 to -0.09474, P=0.027). Conclusions: RIPV with ventral orientation may require difficult maneuvers to advance an ablation system towards it. Low take-off of the inferior PVs may cause non-coaxial configuration of balloon catheters towards the direction of these veins.
  • 橋口 直貴; 小竹 康仁; 赤岩 譲; 安岡 良文; 元木 康一郎; 栗田 隆志; 宮崎 俊一
    心臓 (公財)日本心臓財団 48 (Suppl.2) 64 - 64 0586-4488 2016/12
  • Ryobun Yasuoka; Takashi Kurita; Yasuhito Kotake; Naotaka Hashiguchi; Koichiro Motoki; Shunichi Miyazaki
    Journal of Cardiology Cases Elsevier Ltd 14 (5) 133 - 135 1878-5409 2016/11 [Refereed]
     
    Cardiac memory is an electrocardiographic manifestation of transient T wave abnormalities, which is observed after abrupt interruption of abnormal ventricular activation. We report a case with preexisting complete left bundle branch block in whom cardiac memory was induced. This cardiac memory was induced by normalization of QRS morphology after development of complete atrioventricular block due to acute inferior myocardial infarction. < Learning objective: Although T wave inversion can often be seen in acute coronary syndrome, cardiac memory might create unusual changes of T wave morphologies in the case with preexisting left bundle branch block. Premature beats arising from upstream of abnormal conduction site produced equalization of bi-ventricular activation in a case of preexisting complete left bundle branch block. This may cause normalization of the QRS complex and cardiac memory (T wave inversion).>
  • アジアにおける日本の心不全患者の検討 Asian Sudden Cardiac Death in Heart Failure(ASIAN HF)レジストリーからのメッセージ
    久保田 芳明; 浅井 邦也; 村井 綱児; 泉 佑樹; 中島 育太郎; 石橋 耕平; 和田 暢; 鈴木 敦; 久武 真二; 安岡 良文; 野田 崇; 栗田 隆志; 池田 隆徳; 萩原 誠久; 清水 渉
    日本心臓病学会学術集会抄録 (一社)日本心臓病学会 64回 O - 002 2016/09
  • Sousuke Sugimura; Takashi Kurita; Kazuaki Kaitani; Ryobun Yasuoka; Shunichi Miyazaki
    HEART AND VESSELS SPRINGER 31 (9) 1562 - 1569 0910-8327 2016/09 [Refereed]
     
    Episodes of atrial fibrillation (AF) are mainly initiated by triggers from pulmonary veins (PVs). The superior vena cava (SVC) has been identified as a second major substrate of non-PV foci, but the electrophysiologic features of the SVC have not been fully investigated. We hypothesized that SVC ectopies are suppressed by predominant features of PV ectopies and tend to appear after PV isolation (PVI). We evaluated the electrophysiological characteristics and clinical implications of SVC ectopies in patients with AF during catheter ablation using high-dose isoproterenol and the atrial overdrive pacing maneuver. The manifestation patterns and modes of onset (coupling interval and appearance interval) of ectopies from both the PVs and SVC were investigated. 205 patients were enrolled [153 males and 52 females; mean age 64 +/- A 10 years; paroxysmal in 143 patients (69.8 %), persistent in 40 (19.5 %), and long-standing persistent in 22 patients (10.7 %)]. Before PVI, PV ectopies were detected in 182/205 patients (89 %). SVC ectopies were rarely observed before PVI but were significantly more frequent after the completion of PVI (3/205 vs. 14/205 patients, p = 0.011). The coupling interval (CI) and % CI (CI/preceding the A-A interval x 100) of PV ectopies were significantly shorter than those of SVC ectopies (211 +/- A 78 vs. 282 +/- A 106 ms, p = 0.021, and 34 +/- A 9 vs. 51 +/- A 17 %, p < 0.001, respectively). The appearance intervals of the PV ectopies were shorter than those of the SVC ectopies (6.3 +/- A 4.0 vs. 10.7 +/- A 6.7 s, p = 0.030). During repeat procedures, PVs with reconnection to the left atrium were less frequently observed in patients with SVC firing than in patients without SVC firing (1.7 +/- A 1.5 vs. 2.9 +/- A 1.1 PVs, p = 0.029). We demonstrated that PVI tends to manifest SVC ectopies with less spontaneous activity and that an elimination of predominant ectopies from the PVs may affect appearance of SVC ectopy.
  • 非虚血性心筋症におけるICD留置後予後の差異
    河村 尚幸; 岩永 善高; 宮地 佑希; 安田 昌和; 中村 貴; 安岡 良文; 元木 康一郎; 栗田 隆志; 宮崎 俊一
    日本内科学会雑誌 (一社)日本内科学会 105 (臨増) 159 - 159 0021-5384 2016/02
  • Yasuhito Kotake; Takashi Kurita; Yuzuru Akaiwa; Ryobun Yasuoka; Koichiro Motoki; Kazuhiro Kobuke; Yoshitaka Lwanaga; Shunichi Miyazaki
    JOURNAL OF CARDIOLOGY ELSEVIER SCIENCE BV 66 (1-2) 161 - 167 0914-5087 2015/07 [Refereed]
     
    Background: The most critical adverse effects of class Ill drugs are marked QT prolongation and torsade de pointes. Even though intravenous amiodarone (iv-Amio) is a representative class Ill drug, it peculiarly inhibits both clinical ventricular tachycardia/fibrillation (VT/VF) and proarrhythmic effects. To test the hypothesis that iv-Amio homogeneously prolongs repolarization, we evaluated electrocardiographic changes before and during short-term amiodarone therapy, focusing closely on the ventricular dispersion of repolarization. Methods: Twenty-seven consecutive patients treated with iv-Amio for VT/VF as a first-line antiarrhythmic therapy were enrolled in this study. Twelve-lead electrocardiography was recorded before and during amiodarone therapy to evaluate the following electrocardiographic intervals: R-R, QRS, QT, QRS to T-peak (QTp), and T-peak to T-end (Tp-e; as an index of dispersion of repolarization). Repolarization indices were corrected to the heart rate by Bazett's method (QTc, c-QTp, c-Tp-e). Results: Amiodarone suppressed VT/VF in 19/27 (70%) patients without conferring any proarrhythmic effect. The QTc, c-QTp, and R-R interval were significantly prolonged during amiodarone (476 +/- 45 ms vs 511 +/- 45 ms, p < 0.05; 338 +/- 40 ms vs 364 35 ms, p < 0.05; 762 +/- 272 ms vs 870 189 ms, p < 0.05; respectively), whereas the c-Tp-e and QRS durations did not change significantly (139 33 ms vs 145 +/- 41 ms, p = 0.25; 96 +/- 20 ms vs 97 +/- 21 ms, p = 0.33; respectively). Conclusions: Iv-Amio homogeneously prolongs repolarization and properly inhibits original VT/VF recurrence without inducing torsade de pointes. (C) 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
  • Yoshiaki Kaneko; Minoru Horie; Shinichi Niwano; Kengo F. Kusano; Seiji Takatsuki; Takashi Kurita; Takeshi Mitsuhashi; Tadashi Nakajima; Tadanobu Irie; Kanae Hasegawa; Takashi Noda; Shiro Kamakura; Yoshiyasu Aizawa; Ryobun Yasuoka; Katsumi Torigoe; Hiroshi Suzuki; Toru Ohe; Akihiko Shimizu; Keiichi Fukuda; Masahiko Kurabayashi; Yoshifusa Aizawa
    CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY LIPPINCOTT WILLIAMS & WILKINS 7 (6) 1122 - 1128 1941-3149 2014/12 [Refereed]
     
    Background-Electrical storms (ESs) in patients with Brugada syndrome (BrS) are rare though potentially lethal. Methods and Results-We studied 22 men with BrS and ES, defined as >= 3 episodes/d of ventricular fibrillation (VF) and compared their characteristics with those of 110 age-matched, control men with BrS without ES. BrS was diagnosed by a spontaneous or drug-induced type 1 pattern on the ECG in the absence of structural heart disease. Early repolarization (ER) was diagnosed by J waves, ie, >0.1 mV notches or slurs of the terminal portion of the QRS complex. The BrS ECG pattern was provoked with pilsicainide. A spontaneous type I ECG pattern, J waves, and horizontal/descending ST elevation were found, respectively, in 77%, 36%, and 88% of patients with ES, versus 28% (P<0.0001), 9% (P=0.003), and 60% (P=0.06) of controls. The J-wave amplitude was significantly higher in patients with than without ES (P=0.03). VF occurred during undisturbed sinus rhythm in 14 of 19 patients (74%), and ES were controlled by isoproterenol administration. All patients with ES received an implantable cardioverter defibrillator and over a 6.0 +/- 5.4 years follow-up, the prognosis of patients with ES was significantly worse than that of patients without ES. Bepridil was effective in preventing VF in 6 patients. Conclusions-A high prevalence of ER was found in a subgroup of patients with BrS associated with ES. ES appeared to be suppressed by isoproterenol or quinidine, whereas bepridil and quinidine were effective in the long-term prevention of VF in the highest-risk patients.
  • Asamura S; Kurita T; Motoki K; Yasuoka R; Hashimoto T; Isogai N
    Eplasty 14 e40  1937-5719 2014 [Refereed]
     
    BACKGROUND: A common complication associated with implantable cardiac electrical device implantation compromises skin lesions caused by overstretching just above a buried device that is relatively large in size. Apart from affecting the cosmetic appearance in some patients, a compromised blood supply to the skin may also lead to ischemic necrosis, which is an important complication. We describe a novel procedure for the implantation of implantable cardiac electrical devices generators under the pectoralis major muscle to avoid such skin-related complications. METHODS: Twenty-one patients were referred to plastic surgeon for surgical support for the secondary replacement of implantable cardiac electrical devices. In all cases, the leads and devices had been implanted under the skin. We decided to perform device implantation under the pectoralis major muscle, which was highly recommended in all these patients. RESULTS: In Japan, leanness is determined on the basis of body mass index less than 18.5, and 11 patients out of 21 (52%) were considered to be lean. The surgeon's participation in the procedure for implantable cardiac electrical device implantation did not exceed 5 minutes in total. CONCLUSIONS: We consider that the novel method of sub-pectoralis major muscle device implantation described here minimizes the risk of the skin breakdown and improves the patient's quality of life.
  • 不整脈から心不全へ，よくなる新機能：心臓ペースメーカと心臓再同期療法
    安岡 良文; 栗田 隆志
    レジデントノート 羊土社 15 (1) 74 - 83 2013/04 
    医局論文番号526
  • 症例検討：陳旧性心筋梗塞患者に合併した重症心室頻拍ストームに対して緊急アブレーションが奏功した１例
    藤田 晃輔; 赤岩 譲; 栗田 隆志; 小竹 康仁; 磯野 員理; 安田 昌和; 野並 有紗; 安岡 良文; 小林 直也; 生田 新一郎; 元木 康一郎; 谷口 貢; 宮崎 俊一
    Osaka Heart Club Osaka Heart Club 大阪ハートクラブ 36 (9) 6 - 12 2013/03 
    医局論文番号524
  • 安岡 良文; 栗田 隆志; 小竹 康仁; 赤岩 譲; 野並 有紗; 元木 康一郎; 宮崎 俊一
    心臓 西村書店 44 ((*)3) 69 - 73 2012/12 
    医局登録番号 512

    第44巻（SUPPL.3）号69-73頁
  • Koichiro Motoki; Takashi Kurita; Ryobun Yasuoka; Shunichi Miyazaki
    JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY WILEY-BLACKWELL 23 (4) 436 - 439 1045-3873 2012/04 [Refereed]
     
    Double Chamber Tachycardias Originating from the Aortic Sinus of Valsalva. Monomorphic ventricular tachycardia is basically a benign phenomenon in patients without structural heart disease. The focal source of the tachycardia is usually located in the right ventricular outflow tract and more rarely in the left ventricular outflow tract. Aortic sinus of Valsalva (ASV) is a well-known source of atrial and ventricular tachycardias. We report a case with simultaneous existence of sustained atrial and ventricular tachycardias originating from ASV, which was successfully treated with radiofrequency catheter ablation. (J Cardiovasc Electrophysiol, Vol. 23, pp. 436-439, April 2012)
  • 不整脈の非薬物治療：その適応と限界を知る
    安岡 良文; 栗田 隆志
    Heart View Heart View メジカルビュー社 15 (12) 192 - 195 2011/11 
    医局登録番号 473
  • 不整脈の非薬物治療：その適応と限界を知る
    安岡 良文; 栗田 隆志
    Heart View Heart View メジカルビュー社 15 (12) 192 - 195 2011/11 
    医局登録番号 473
  • Takashi Kurita; Takashi Noda; Takeshi Aiba; Ikutaro Nakajima; Wataru Shimizu; Koichiro Motoki; Ryobun Yasuoka; Shunichi Miyazaki; Shiro Kamakura
    JOURNAL OF ELECTROCARDIOLOGY CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS 44 (6) 736 - 741 0022-0736 2011/11 [Refereed]
     
    Various clinical data demonstrate that cardiac resynchronization therapy (CRT) provides a favorable structural as well as electrical remodeling. The CArdiac Resynchronization-Heart Failure study, which tested the pure effect of CRT (using CRT devices without the capability of defibrillation) clearly showed a significant reduction in the total mortality by partly preventing sudden cardiac death. The antiarrhythmic effects of CRT are explained, at least in part, by ionic and genetic modulation of ventricular myocytes. It has been revealed in animal experiments to mimic disorganized ventricular contraction that CRT reverses down-regulation of certain K(+) channels and abnormal Ca(2+) homeostasis in the failing heart. However, CRT can be proarrhythmic in some particular cases especially in the early phase of this therapy. According to our study, proarrhythmic effects after CRT can be observed in approximately 10% of patients. The relatively high incidence of the proarrhythmic effects of CRT may promote a trend toward selecting CRT-D rather than CRT-P. (C) 2011 Elsevier Inc. All rights reserved.
  • Takashi Kurita; Koichiro Motoki; Ryobun Yasuoka; Takayoshi Hirota; Yuzuru Akaiwa; Yasuhito Kotake; Shunichi Miyazaki
    CIRCULATION JOURNAL JAPANESE CIRCULATION SOC 75 (4) 979 - 985 1346-9843 2011/04 [Refereed]
     
    The incidence of atrial fibrillation (AF) increases with advancing NHYA cardiac functional class, and it significantly affects the cardiac function of a failing heart. In such situations, clinicians should aim to maintain sinus rhythm in these patients with heart failure (HF) in order to improve their prognosis. However, according to various randomized clinical studies demonstrating the non-superiority of rhythm control over rate control, many clinicians seem to prefer to take the line of least resistance (ie, rate control). Curative catheter ablation mainly based on isolation procedure of the pulmonary veins in patients with AF and HF has demonstrated a significant improvement in left ventricular function, even in the presence of adequate ventricular rate control before the ablation. On the other hand, ablation and biventricular pacing therapy, which is an extreme rate control strategy, has not shown any beneficial effects for these patients. Therefore, a regular RR interval with an appropriate cycle length only is not sufficient to improve cardiac performance, and maintenance of sinus rhythm, which restores atrial contraction and the atrioventricular synchrony, is thought to be essential for an improvement in HF. Thoughtful clinicians should do their best to find a way to keep HF patients in sinus rhythm. (Circ J 2011; 75: 979-985)
  • Ryobun Yasuoka; Takashi Kurita; Yuzuru Akaiwa; Koichro Motoki; Hiromi Yamamoto; Yositaka Iwanaga; Yutaka Hirano; Shunichi Miyazaki
    Journal of Arrhythmia 27 1883-2148 2011 [Refereed]
     
    Trans-esophageal echocardiography < TEE> has been recognized as a standard procedure to exclude left atrial appendage thrombus < LAA-T> but it may cause discomfort in some patients. Multi-detector computed tomography < MDCT> may be performed to understand PV and LA anatomy as well as to detect LAA-T in patients with atrial fibrillation < AF> The purpose of this study is to determine whether TEE can be skipped before pulmonary vein isolation < PVI> by using MDCT.We enrolled 100 consecutive AF patients < paroxysmal AF in 73, persistent or long lasting AF in 27 > who underwent PVI. LAA-T was defined as well-contoured echogenic mass in LAA using TEE. To assess LAA by MDCT, the Hounsfield unit < HU> density was measured at LAA proximal < LAAp > and distal < LAAd> .The cutoff value of LAAp/LAAd to provide 100% probability of LAA-T absence was calculated using receiver operating characteristic curves R< OC-C> .LAA-T was detected in 7 patients < 7/27 patients with persistent or long lasting AF> . ROC-C indicates that LAAp/LAAd> 0.43 demonstrates 100% specificity. Using this cutoff value, 76% patients can be diagnosed as absence of LAA-T solely by MDCT In conclusion,LAA-T was observed only in persistent or long lasting AF patients.LAA-T can be excluded in 76% patients without using TEE. TEE could be unnecessary for PVI in PAF patients below the cutoff value of HU density. © 2011, Japanese Heart Rhythm Society. All rights reserved.
  • Koichiro Motoki; Takashi Kurita; Yasuhito Kotake; Yuzuru Akaiwa; Ryobun Yasuoka; Shunichi Miyazaki
    Journal of Arrhythmia 27 384  1883-2148 2011 [Refereed]
     
    Background: Little is known about clinical predictors for the recurrence after extensive pulmonary vein isolation (EPVI) in patients with atrial fibrillation (AF) Objectives The purpose of this study was to investigate clinical parameters which predict complete cure of AF after EPVI. Methods and Results: A total of 152 consecutive patients with paroxysmal AF (PAF) who underwent successful EPVI were examined. We divided them into two groups, 1: Complete cure group 103 patients who were free from PAF without any antiarrhythmic drugs and 2: recurrence group the remaining 49 patients with recurrence of PAF. Between the two groups, we compared several clinical parameters before EPVI as follows clinical backgrounds (presence of structural heart disease and CHADS2 score), parameters in transthoracic and transesophageal echocardiogram [left atrium (LA) dimension, systolic and diastolic LA appendage (LAA) flow velocity], LA volume assessed by multiditector CT, additional creation of cava-tricuspid isthmus block line, serum brain natriuretic peptide (BNP) level. Using multi-variate analysis, filling velocity of the LAA and BNP before EPVI were identified as the independent predictors of complete cure of PAF (p< 0.001, p< 0.05, respectively). Conclusion: Low BNP levels and better filling velocity of the LAA are the negative predictors for the recurrence after EPVI in patients with AF. These may relate to preserved LA function and to restricted AF substrates within PVs. © 2011, Japanese Heart Rhythm Society. All rights reserved.

Conference Activities & Talks

  • ３つの独立した心房細動気質を確認出来た発作性心房細動の１例  [Not invited]
    小竹 康仁; 栗田 隆志; 赤岩 譲; 安岡 良文; 元木 康一郎; 宮崎 俊一
    第116回 日本循環器学会近畿地方会  2013/11  大阪市  第116回 日本循環器学会近畿地方会
  • 交代性脚ブロックから完全房室ブロックへ進行した過程が詳細に記録された1症例  [Not invited]
    堀江 勝博; 栗田 隆志; 安岡 良文; 赤岩 譲; 小竹 康仁; 元木 康一郎; 宮崎 俊一
    第115回 日本循環器学会近畿地方会  2013/06  京都市  第115回 日本循環器学会近畿地方会
  • 植込み型心電計にて失神原因が診断できた2例  [Not invited]
    御勢 久也; 安岡 良文; 小竹 康仁; 赤岩 譲; 元木 康一郎; 栗田 隆志; 宮崎 俊一
    第115回 日本循環器学会近畿地方会  2013/06  京都市  第115回 日本循環器学会近畿地方会
  • 左房＿肺静脈のinteractionが心房細動成立に寄与していることが、ATP投与により証明された1例  [Not invited]
    元木 康一郎; 栗田 隆志; 小竹 康仁; 赤岩 譲; 安岡 良文; 宮崎 俊一
    第115回 日本循環器学会近畿地方会  2013/06  京都市  第115回 日本循環器学会近畿地方会
  • 経皮的心外膜カテーテルアブレーションが無効であった致死性不整脈に対する外科的直達手術の有効性  [Not invited]
    元木 康一郎; 栗田 隆志; 小竹 康仁; 赤岩 譲; 安岡 良文; 宮崎 俊一; 西野 貴子; 佐賀 俊彦; 里見和浩
    第25回 臨床不整脈研究会  2013/01  東京ステーションコンファレンス （東京都千代田区）  第25回 臨床不整脈研究会
  • 心筋炎の経過を辿った不整脈源性右室心筋症の一例  [Not invited]
    小竹 康仁; 生田 新一郎; 安田 昌和; 山治 憲司; 安岡 良文; 宮崎 俊一
    第114回 日本循環器学会近畿地方会  2012/12  大阪国際会議場  第114回 日本循環器学会近畿地方会
  • Very long term evaluation in patients with atrio-ventricular nodal reentrant tachycardia undergoing radiofrequency catheter Ablation  [Not invited]
    元木 康一郎; 栗田 隆志; 小竹 康仁; 赤岩 譲; 安岡 良文; 高井 博之; 宮崎 俊一
    International Symposium on Progress in Clinical Pacing 2012  2012/12  Rome, Italy  International Symposium on Progress in Clinical Pacing 2012
  • Simultaneous ipsilatetal superior and inferior pulmonary vein Isolation does not predict the clinical outcome in patients with paroxysmal atrial fibrillation  [Not invited]
    元木 康一郎; 栗田 隆志; 小竹 康仁; 赤岩 譲; 安岡 良文; 高井 博之; 宮崎 俊一
    International Symposium on Progress in Clinical Pacing 2012  2012/12  Rome, Italy  International Symposium on Progress in Clinical Pacing 2012
  • Does Simultaneous Ipsilatetal Superior and Inferior Pulmonary Vein Isolation Improve the Clinical Outcome in Patients with Paroxysmal Atrial Fibrillation?  [Not invited]
    元木 康一郎; 栗田 隆志; 小竹 康仁; 赤岩 譲; 安岡 良文; 宮崎 俊一
    第5回 アジアパシフィックハートリズム学会  2012/10  台湾 台北  第5回 アジアパシフィックハートリズム学会
  • 房室結節回帰性頻拍に対するカテーテルアブレーションの長期的有効性と安全性  [Not invited]
    元木 康一郎; 栗田 隆志; 小竹 康仁; 赤岩 譲; 野並 有紗; 安岡 良文; 宮崎 俊一; 高井 博之
    第27回 日本不整脈学会学術大会  2012/07  横浜市  第27回 日本不整脈学会学術大会
  • 陳旧性心筋梗塞患者に合併した重症心室頻拍ストームに対して緊急アブレーションが奏功した１例  [Not invited]
    藤田 晃輔; 栗田 隆志; 安田 昌和; 赤岩 譲; 野並 有紗; 安岡 良文; 元木 康一郎; 宮崎 俊一
    第113回 日本循環器学会近畿地方会  2012/06  大阪市  第113回 日本循環器学会近畿地方会
  • 完全左脚ブロック患者に生じた急性下壁心筋梗塞：補充調律時のQRS波とT波の興味ある心電図変化に関する考察  [Not invited]
    池田 智之; 谷口 貢; 安岡 良文; 安田 昌和; 中村 貴; 生田 新一郎; 岩永 善高; 栗田 隆志; 宮崎 俊一; 小林 直也
    第113回 日本循環器学会近畿地方会  2012/06  大阪市  第113回 日本循環器学会近畿地方会
  • 下大静脈フィルター留置後のため、鎖骨下静脈と内頸静脈からのアプローチにてアブレーションを施行した発作性上室性頻拍の一例  [Not invited]
    元木 康一郎; 栗田 隆志; 小竹 康仁; 赤岩 譲; 野並 有紗; 安岡 良文; 宮崎 俊一
    第113回 日本循環器学会近畿地方会  2012/06  大阪市  第113回 日本循環器学会近畿地方会
  • アブレーション終了直後にたこつぼ型心筋症を発症した通常型房室結節回帰性頻拍の一例  [Not invited]
    小竹 康仁; 元木 康一郎; 赤岩 譲; 安岡 良文; 栗田 隆志; 宮崎 俊一
    第111回 日本循環器学会近畿地方会  2011/11  京都市  第111回 日本循環器学会近畿地方会
  • Cardiac resynchronization therapy to prevent life-threatening arrhythmias in patients with congestive heart failure  [Not invited]
    栗田 隆志; 元木 康一郎; 安岡 良文; 宮崎 俊一; Takashi Noda; Takeshi Aiba; Ikutaro Nakajima; Wataru Shimizu; Shiro Kamakura
    2011/11 
    医局登録番号 478
  • 心室頻拍（VT)中のvery late systolic potentialを指標に通電し、根治に成功した不整脈原性右室心筋症（ARVC)の1例  [Not invited]
    安岡 良文; 栗田 隆志; 小竹 康仁; 赤岩 譲; 元木 康一郎; 宮崎 俊一; 堂上友紀; 永井
    第23回 カテーテル・アブレーション委員会公開研究会  2011/10  横浜市  第23回 カテーテル・アブレーション委員会公開研究会
  • Clinical Parameters Associated with Complete Cure of Atrial Fibrillation Undergoing Extensive Pulmonary Vein Isolation  [Not invited]
    元木 康一郎; 栗田 隆志; 小竹 康仁; 赤岩 譲; 安岡 良文; 宮崎 俊一
    4th Asia Pacific Heart Rhythm Society Scientific Session  2011/09  福岡市  4th Asia Pacific Heart Rhythm Society Scientific Session
  • Trans-esophageal Echocardiography Is Not Required in All Patients before Pulmonary Vein Isolation  [Not invited]
    安岡 良文; 栗田 隆志; 赤岩 譲; 元木 康一郎; 山本 裕美; 岩永 善高; 平野 豊; 宮崎 俊一
    4th Asia Pacific Heart Rhythm Society Scientific Session  2011/09  福岡市  4th Asia Pacific Heart Rhythm Society Scientific Session
  • Is Trans-esophageal Echocardiography Required in All Patients with Atrial Fibrillation who Undergo Catheter Ablation Using Pulmonary Vein Isolation?  [Not invited]
    安岡 良文; 栗田 隆志; 赤岩 譲; 元木 康一郎; 山本 裕美; 小夫家 和宏; 岩永 善高; 平野 豊; 宮崎 俊一; 中内 祥文; 弘田 隆省
    第75回 日本循環器学会総会・学術集会  2011/08  横浜市  第75回 日本循環器学会総会・学術集会
  • 一過性に両方向性伝導障害がみられた副伝導路症候群の一例  [Not invited]
    元木 康一郎; 栗田 隆志; 安岡 良文; 生駒興平; 谷口 貢; 木村 彰男; 宮崎 俊一
    第107回日本循環器学会近畿地方会  2009/06  大阪  第107回日本循環器学会近畿地方会

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