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  • Landiolol is an ultra short acting superselective titration

    2019-05-15

    Landiolol is an ultra-short-acting, β1-superselective, titration intravenous β-adrenergic blocker that is rapidly metabolized to inactive forms, and has relatively smaller negative inotropic effects on the cardiac output [11]. Landiolol is more effective for controlling rapid purchase GW788388 rate than digoxin in AF/AFL patients with LV dysfunction [12] and is also applicable for rhythm maintenance after catheter ablation [13]. A low-dose β1-blocker, landiolol, in combination with milrinone, improves intracellular Ca2+ handling in failing cardiomyocytes [14]. However, there are only a few clinical practice reports that examine how we can predict landiolol Responders and Non-Responders and patients who will experience adverse effects [15,16], especially in a study population including patients with much lower LVEF (<25%). The aim of this study was to clarify the potential applicability of landiolol for rapid AF and refractory ventricular tachyarrhythmias (VTs) in patients with HF.
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    Funding This work was supported by grants from the Ministry of Health, Labour, and Welfare of Japan (2010-145); a Grant-in-Aid for Scientific Research on Innovative Areas (22136011 A02, Aiba); a Grant-in-Aid for Scientific Research (C) (24591086 Aiba) from MEXT of Japan; a Research Grant for Cardiovascular Diseases (H24-033 Aiba) from the Ministry of Health, Labour, and Welfare of Japan; and the Intramural Research Fund for Cardiovascular Diseases of the National Cerebral and Cardiovascular Center (25-4-7 Kusano) (26-6-6 Wada).
    Conflict of interest
    Introduction There have been no clear established criteria for the selection of single- or dual-chamber implantable cardioverter defibrillators (ICDs) in patients without a pacing indication. In the United States, dual-chamber ICDs are predominantly used [1–3], but the reason for this trend is unclear. Potential benefits of dual-chamber ICD systems, such as superior supraventricular tachycardia (SVT) discrimination with atrial sensing [4,5] or physiological pacing for potential future bradycardia development [6], could encourage the physicians’ preference. Recent studies, however, demonstrated that not only did dual-chamber ICDs have no additional benefit over single-chamber ICDs but that they also resulted in a higher incidence of lead malfunctions or other adverse events [3]. These data shed light on the importance of careful consideration when selecting dual-chamber ICDs in patients without a pacing indication. The proportion of non-ischemic cardiomyopathy (NICM) in the Japanese ICD cohort is higher than that of ischemic cardiomyopathy (ICM) [7]. The different background of these patients might affect physicians’ decisions on ICD selection and lead to different clinical courses. As data on dual- or single-chamber ICD selection and respective outcomes in Japan are scarce, the aim of this study was to understand the Japanese trend in ICD selection and clinical outcomes.
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    Conflict of interest
    Acknowledgments
    Introduction Catheter ablation has become a first line approach for the treatment of patients with symptomatic atrial fibrillation (AF) resistant to antiarrhythmic medication and circumferential pulmonary vein (PV) isolation is currently considered to be the technique of choice. Catheter ablation using irrigated single-tip catheters and three-dimensional (3-D) mapping systems with point-by-point delivery of multiple applications has been reported to be an effective approach for the treatment of paroxysmal and persistent AF and is the most frequently used ablation procedure worldwide [1,2]. In the last decade, innovative technologies have been developed using so-called “single-shot” devices involving either balloon technology or circumferential multipolar ablation catheters. These new anatomically designed ablation tools allow for the delivery of different energy forms with the aim of creating linear lesions around PV ostia with only a few applications in order to achieve safer and simpler isolations [3–5].