JCS/JHRS 2019 Guideline on Non-Pharmacotherapy of Cardiac Arrhythmias

Nogami, Akihiko; Kurita, Takashi; Abe, Haruhiko; Ando, Kenji; Ishikawa, Toshiyuki; Imai, Kyoichi; Usui, Akihiko; Okishige, Kaoru; Kusano, Kengo; Kumagai, Koji; Goya, Masahiko; Kobayashi, Yoshinori; Shimizu, Akihiko; Shimizu, Wataru; Shoda, Morio; Sumitomo, Naokata; Seo, Yoshihiro; Takahashi, Atsushi; Tada, Hiroshi; Naito, Shigeto; Nakazato, Yuji; Nishimura, Takashi; Nitta, Takashi; Niwano, Shinichi; Hagiwara, Nobuhisa; Murakawa, Yuji; Yamane, Teiichi; Aiba, Takeshi; Inoue, Koichi; Iwasaki, Yu‐ki; Inden, Yasuya; Uno, Kikuya; Ogano, Michio; Kimura, Masaomi; Sakamoto, Shun–ichiro; Sasaki, Satoshi; Sato, Kazuhiro; Shiga, Tsuyoshi; Suzuki, Tsugutoshi; Sekiguchi, Yukio; Soejima, Kyoko; Takagi, Masahiko; Chinushi, Masaomi; Nishi, Nobuhiro; Noda, Takashi; Hishida, Hitoshi; Mitsuno, Masataka; Mitsuhashi, Takeshi; Miyauchi, Yasushi; Miyazaki, Aya; Morimoto, Tomoshige; Yamasaki, Hiro; Aizawa, Yoshifusa; Ohe, Tohru; Kimura, Takeshi; Tanemoto, Kazuo; Tsutsui, Hiroyuki; Mitamura, Hideo

doi:10.1253/circj.cj-20-0637

Cited by 125 publications

(129 citation statements)

References 1,330 publications

(825 reference statements)

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“…In general, bradycardia with symptoms of transient ischemia or heart failure indicates pacemaker implantation. 4) In this case, bradyarrhythmia events were symptomatic. If bradycardia persists even after treatment for SAS, pacemaker implantation should be considered.…”

Section: Discussionmentioning

confidence: 74%

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Bradyarrhythmia Suspected to be Associated with Sleep Apnea Syndrome

et al. 2022

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Sleep apnea syndrome (SAS) is a condition in which apnea and hypoventilation at night cause hypoxemia and impaired wakefulness during the day, resulting in a general malaise and dozing. Sleep apnea has been implicated in the development of hypertension, ischemic heart disease, arrhythmia, heart failure, and cerebrovascular disease. 1) Approximately 50% of patients with sleep-disordered breathing have an arrhythmia. In severe cases with an apnea-hypopnea index (AHI) of 30 or more, the frequency of arrhythmias during sleep is two to four times that of individuals without SAS. Bradyarrhythmias such as sinus bradycardia, sinus arrest, and atrioventricular block occurs at night in about 5%-10% of patients with sleep-disordered breathing. 2) During nocturnal sleep, vagal excitation causes excessive muscle relaxation of the upper airway, leading to periodic airway diameter reduction, which increases snoring and obstructive apnea. As a result, hypoxemia is likely, further increasing vagal tone and leading to bradycardia. An increase in ventilation rate and volume quickly compensates for the decrease in arterial partial pressure of oxygen during apnea, which leads to new bradycardia due to a decrease in the partial pressure of oxygen in arterial blood, which suppresses vagal tone and respiration. 3) We experienced a case of a 44-year-old patient with bradyarrhythmia that might be associated with SAS. After continuous positive airway pressure treatment, AHI decreased, and very long cardiac arrests resolved.

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Section: Discussionmentioning

confidence: 74%

“…A pacemaker is recommended for patients with symptomatic bradycardia such as sick sinus syndrome or atrioventricular block. 4) However, bradyarrhythmias are not always due to irreversible illnesses, and they might be secondary to conditions such as electrolyte imbalances, vagal reflexes, or sleep apnea. 5) In such cases, pacemakers are not the best treatment.…”

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confidence: 99%

Bradyarrhythmia Suspected to be Associated with Sleep Apnea Syndrome

et al. 2022

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“…According to JCS/JHRS 2019 Guideline on Non-Pharmacotherapy of Cardiac Arrhythmia, the recommendation of implantable cardioverter defibrillator (ICD) for VF due to coronary vasospasm is regarded class IIa when the medical treatment is ineffective and it is regarded class IIb when the medical treatment is effective; however, it is regarded class III in the patients with severe hypoxicischemic encephalopathy [11] . Therefore, we decided not in implant ICD in the present case.…”

Section: Discussionmentioning

confidence: 99%

Out-of-hospital cardiac arrest due to acute myocardial infarction possibly caused by coronary vasospasm

Ozaki

Ueda

Kosugi

et al. 2022

Journal of Cardiology Cases

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“…Permanent AF episodes are episodes that persist until the patient and clinician make a shared decision together to cease further attempts to restore or maintain sinus rhythm. 13 Long‐standing persistent AF (continuous AF lasting >12 months in duration) was considered as permanent AF. The definition of new‐onset AF during the follow‐up period was that AF was documented for the first time under the recommended annual ECG follow‐up situation after the study registration in patients without documentation of AF before or at registration.…”

Section: Methodsmentioning

confidence: 99%

Clinical significance of new‐onset atrial fibrillation in patients with hypertrophic cardiomyopathy

et al. 2021

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Aims There is limited information about the clinical significance of atrial fibrillation (AF), particularly new‐onset AF, in patients with hypertrophic cardiomyopathy (HCM) in a community‐based patient cohort. This study was carried out to clarify the prevalence and prognostic impact of AF in Japanese HCM patients. Methods and results In 2004, we established a cardiomyopathy registration network in Kochi Prefecture as a prospective study, and finally, 293 patients with HCM were followed. In the patients' cohort, we recently reported the clinical outcomes including mortality and HCM‐related morbid events. HCM‐related adverse cardiovascular events were defined in the following: (i) sudden cardiac death (SCD)‐relevant events including SCD, spontaneous sustained ventricular tachycardia, and appropriate implantable cardioverter defibrillator discharge; (ii) heart failure (HF) events with the composite of HF death and hospitalization for HF; and (iii) embolic events included embolic stroke‐related death and admission for embolic events. In the present study, we focused on AF and conducted a detailed investigation. At registration, the mean age of the patients was 63 ± 14 years, and 86 patients (29%) had documented AF including paroxysmal AF. Patients with AF at registration were characterized by worse clinical profiles including more advanced age, more symptomatic, more advanced left ventricular, and left atrial remodelling at registration. During a mean follow‐up period of 6.1 ± 3.2 years, a total of 77 HCM‐related adverse events occurred, and the presence of AF at registration was associated with an increased risk of HCM‐related adverse events, particularly heart failure events. During the follow‐up period, an additional 31 patients (11%) had documentation of AF for the first time, defined as new‐onset AF, with an annual incidence of approximately 1.8%, and finally, a total of 117 patients (40%) showed AF. The presence of palpitation and enlarged left atrial diameter, particularly left atrial diameter ≥50 mm, at registration were significant predictors of new‐onset AF. Importantly, the incidence of overall HCM‐related adverse events was further higher in patients with new‐onset AF observed from AF onset than in patients with AF at registration. Conclusions In our HCM registry in an aged Japanese community, a significant proportion developed AF. The presence of AF, particularly new‐onset AF, was associated with increased incidence of HCM‐related events. AF may not be just a marker of disease stage but an important trigger of adverse events.

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JCS/JHRS 2019 Guideline on Non-Pharmacotherapy of Cardiac Arrhythmias

Cited by 125 publications

References 1,330 publications

Bradyarrhythmia Suspected to be Associated with Sleep Apnea Syndrome

Bradyarrhythmia Suspected to be Associated with Sleep Apnea Syndrome

Out-of-hospital cardiac arrest due to acute myocardial infarction possibly caused by coronary vasospasm

Clinical significance of new‐onset atrial fibrillation in patients with hypertrophic cardiomyopathy

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