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Articles by K Satomi
Total Records ( 3 ) for K Satomi
  S Kamakura , T Ohe , K Nakazawa , Y Aizawa , A Shimizu , M Horie , S Ogawa , K Okumura , K Tsuchihashi , K Sugi , N Makita , N Hagiwara , H Inoue , H Atarashi , N Aihara , W Shimizu , T Kurita , K Suyama , T Noda , K Satomi , H Okamura , H Tomoike and for the Brugada Syndrome Investigators in Japan

Background— The prognosis of patients with saddleback or noncoved type (non–type 1) ST-elevation in Brugada syndrome is unknown. The purpose of this study was to clarify the long-term prognosis of probands with non–type 1 ECG and those with coved (type 1) Brugada-pattern ECG.

Methods and Results— A total of 330 (123 symptomatic, 207 asymptomatic) probands with a coved or saddleback ST-elevation ≥1 mm in leads V1–V3 were divided into 2 ECG groups—type 1 (245 probands) and non–type 1 (85 probands)—and were prospectively followed for 48.7±15.0 months. The absence of type 1 ECG was confirmed by drug provocation test and multiple recordings. The ratio of individuals with a family history of sudden cardiac death (14%) was lower than previous studies. Clinical profiles and outcomes were not notably different between the 2 groups (annual arrhythmic event rate of probands with ventricular fibrillation; type 1: 10.2%, non–type 1: 10.6%, probands with syncope; type 1: 0.6%, non–type 1: 1.2%, and asymptomatic probands; type 1: 0.5%, non–type 1: 0%). Family history of sudden cardiac death at age <45 years and coexistence of inferolateral early repolarization with Brugada-pattern ECG were independent predictors of fatal arrhythmic events (hazard ratio, 3.28; 95% confidence interval, 1.42 to 7.60; P=0.005; hazard ratio, 2.66; 95% confidence interval, 1.06 to 6.71; P=0.03, respectively, by multivariate analysis), although spontaneous type 1 ECG and ventricular fibrillation inducibility by electrophysiological study were not reliable parameters.

Conclusions— The long-term prognosis of probands in non–type 1 group was similar to that of type 1 group. Family history of sudden cardiac death and the presence of early repolarization were predictors of poor outcome in this study, which included only probands with Brugada-pattern ST-elevation.

  K Satomi , K.R. J Chun , R Tilz , D Bansch , S Ernst , M Antz , B Schmidt , K. H Kuck and F. Ouyang

Background— Macroreentrant atrial tachycardia (AT) involving the right atrial free wall (RAFW) has been reported in patients without atriotomy. Catheter ablation of these ATs remains challenging due to the multiple morphologies of ATs with unstable reentrant circuits in some patients. The purpose of this study was to clarify the electrophysiological characteristics of these ATs and attempt the novel approach for catheter ablation.

Methods and Results— Electrophysiological study and catheter ablation were performed in 17 patients (14 men; 71 [quartile 1, 67; quartile 3, 76] years) with reentrant ATs originating from the RAFW using 3D mapping. All patients had no history of cardiac surgery. Clinical ATs with stable cycle length and atrial activation were identified in 11 patients (group A). All ATs were successfully ablated. In the remaining 6 patients, clinical tachycardia continuously changed, with a different cycle length and P-wave morphology and atrial activation sequence during mapping or entrainment study (group B). A complete isolation of the RAFW was attempted in group B. After complete isolation was achieved in 5 of 6 patients, ATs were not induced in these 6 patients. The number of previous failed catheter ablations and induced ATs were higher in group B than in group A. During 31 (19; 37) months of follow-up, AT recurrence developed in 27% patients from group A and 33% from group B.

Conclusions— Multiple and unstable macroreentrant ATs from the RAFW can occur in patients without a history of cardiac surgery. The RAFW isolation has the potential to abolish all ATs.

  T. a Matsuyama , T Kurita , K Suyama , H Okamura , T Noda , K Satomi , W Shimizu , N Aihara , Y Ikeda , S Inoue , S Kamakura and H. Ishibashi Ueda

A 68-year-old woman with idiopathic dilated cardiomyopathy suffered from drug-resistant monomorphic ventricular tachycardia (VT). Electrophysiological study revealed a re-entrant VT circuit located just beneath the inferior mitral valve annulus. The VT was considered to be related to the mitral valve isthmus and was abolished by radiofrequency ablation. The patient died 2 years after the ablation due to worsening of heart failure and an autopsy was performed. Pathological examination revealed ablation scar tissue on the localized myocardial bundle running parallel to the mitral valve annulus. Therefore, this bundle appeared to comprise the slow conduction area of the re-entrant VT in this case.

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