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Issei Komuro - One of the best experts on this subject based on the ideXlab platform.
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quality of coronary arterial 320 slice computed tomography images in subjects with chronic atrial fibrillation compared with Normal Sinus Rhythm
International Journal of Cardiology, 2011Co-Authors: Masae Uehara, Nobusada Funabashi, Hiroyuki Takaoka, Marehiko Ueda, Taichi Murayama, Koichi Sawada, Tetsuharu Kasahara, Noriyuki Yanagawa, Issei KomuroAbstract:PURPOSE: To evaluate coronary arterial image quality on 320-slice CT in subjects with chronic atrial fibrillation (CAf) vs. Normal Sinus Rhythm (NSR). MATERIALS AND METHODS: In 92 consecutive subjects, 46 each with CAf (male:female ratio 2.54:1.00, age 69.7 ± 9.9 years) and NSR (male:female ratio 1.88:1.00, age 63.7 ± 13.7 years), 320-slice CT (Aquilion-one) was performed with enhanced images reconstructed at 80% of ECG R-to-R intervals. Visualized coronary vessels >1.5mm diameter in the right coronary artery, left anterior descending (LAD), and circumflex (LCx) distribution were evaluated for length, percentage of length free from motion artifacts, and image quality on a scale ranging from 1 (highest quality) to 5 (lowest quality). RESULTS: LCx length measurements were significantly greater in subjects with NSR (108.8 ± 27.0mm) than CAf (96.6 ± 31.4mm) (P = 0.049), whereas percentages of length free from motion artifacts did not differ between the three vascular beds. Image quality, was significantly but marginally better overall in NSR than in CAF, as well as for LAD and LCx vascular beds. Mean scores in subjects with CAf and NSR were 1.4 ± 0.7 and 1.3 ± 0.6 in all arteries, 1.4 ± 0.7 and 1.2 ± 0.5 in LAD, and 1.5 ± 0.7 and 1.2 ± 0.5 in LCx, respectively (all P<0.001). Despite this difference in image quality, mean scores for both CAf and NSR were weighted toward the high quality end of the scale. CONCLUSION: By 320-slice CT, the overall length of visualized coronary arteries, motion artifact-free length, and image quality using a 5-point scale showed values equal to or slightly lower in CAf than in NSR, but the absolute values were quite acceptable in both groups.
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quality of coronary arterial 320 slice computed tomography images in subjects with chronic atrial fibrillation compared with Normal Sinus Rhythm
International Journal of Cardiology, 2011Co-Authors: Masae Uehara, Nobusada Funabashi, Hiroyuki Takaoka, Marehiko Ueda, Taichi Murayama, Koichi Sawada, Tetsuharu Kasahara, Noriyuki Yanagawa, Issei KomuroAbstract:Abstract Purpose To evaluate coronary arterial image quality on 320-slice CT in subjects with chronic atrial fibrillation (CAf) vs. Normal Sinus Rhythm (NSR). Materials and methods In 92 consecutive subjects, 46 each with CAf (male:female ratio 2.54:1.00, age 69.7±9.9years) and NSR (male:female ratio 1.88:1.00, age 63.7±13.7years), 320-slice CT (Aquilion-one) was performed with enhanced images reconstructed at 80% of ECG R-to-R intervals. Visualized coronary vessels >1.5mm diameter in the right coronary artery, left anterior descending (LAD), and circumflex (LCx) distribution were evaluated for length, percentage of length free from motion artifacts, and image quality on a scale ranging from 1 (highest quality) to 5 (lowest quality). Results LCx length measurements were significantly greater in subjects with NSR (108.8±27.0mm) than CAf (96.6±31.4mm) ( P =0.049), whereas percentages of length free from motion artifacts did not differ between the three vascular beds. Image quality, was significantly but marginally better overall in NSR than in CAF, as well as for LAD and LCx vascular beds. Mean scores in subjects with CAf and NSR were 1.4±0.7 and 1.3±0.6 in all arteries, 1.4±0.7 and 1.2±0.5 in LAD, and 1.5±0.7 and 1.2±0.5 in LCx, respectively (all P Conclusion By 320-slice CT, the overall length of visualized coronary arteries, motion artifact-free length, and image quality using a 5-point scale showed values equal to or slightly lower in CAf than in NSR, but the absolute values were quite acceptable in both groups.
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cardiac sarcoidosis complicated with atrioventricular block and wall thinning edema and fibrosis in left ventricle confirmed recovery to Normal Sinus Rhythm and visualization of edema improvement by administration of predonisolone
International Journal of Cardiology, 2011Co-Authors: Shohko Miyazaki, Nobusada Funabashi, Masae Uehara, Hiroyuki Takaoka, Marehiko Ueda, Toshio Nagai, Akihisa Kataoka, Issei KomuroAbstract:Abstract A 65 year-old female had a node of some kind in her right leg five years ago and was diagnosed with sarcoidosis by gallium scintigraphy. Serum angiotension-converting enzyme levels had gradually increased, and three months ago she felt palpitations and dizziness when standing. On electrocardiogram, 2:1 atrioventricular (AV) block was observed. On transthoracic echocardiogram, the basal portion of the interventricular septum (IVS) revealed wall thinning with dyskinetic motion and lack of systolic thickening, and low attenuation. The basal portion of the left ventricular (LV) posterior inferior wall revealed mild wall thickening with low attenuation. Enhanced multislice-CT revealed a thickened LV posterior wall and thinned basal portion of IVS with interstitial change suggesting presence of fibrosis or edema. Late enhancement was also observed in the basal portion of the LV posterior inferior wall and basal IVS in T1 weighted magnetic resonance imaging (MRI); in addition, an area, the center of which indicated low attenuation surrounded by high attenuation, was observed in the basal portion of the LV posterior inferior wall in T2 weighted MRI. Positron emission tomography (PET) imaging using F-18 fluoro-deoxyglucose with the subject fasted for 6 h beforehand, revealed strong uptake in the basal portion of IVS and a thickened LV posterior wall, suggesting the presence of inflammation. Administration of predonisolone was started before pacemaker implantation and clinical symptoms immediately disappeared; in addition AV block recovered to Normal Sinus Rhythm. On a repeat MRI performed four months later, the late enhancement in T1 weighted MRI and the high attenuation surrounding low attenuation in the basal portion of the LV posterior inferior wall in T2 weighted MRI both disappeared, and we confirmed that temporary edema had also disappeared.
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abstract 2028 anatomical remodeling of the left atrium in paroxysmal atrial fibrillation by multislice computed tomography in comparison with chronic atrial fibrillation and Normal Sinus Rhythm
Circulation, 2007Co-Authors: Koki Nakamura, Nobusada Funabashi, Masae Uehara, Hiroyuki Takaoka, Marehiko Ueda, Taichi Murayama, Yuzuru Mita, Fumiaki Maeda, Issei KomuroAbstract:Purpose: Anatomical remodeling of the left atrium (LA) in subjects with paroxysmal atrial fibrillation (PAF), chronic atrial fibrillation (CAF) and Normal Sinus Rhythm (NSR) was examined by multisl...
Bramah N Singh - One of the best experts on this subject based on the ideXlab platform.
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long term efficacy of amiodarone for the maintenance of Normal Sinus Rhythm in patients with refractory atrial fibrillation or flutter
American Journal of Cardiology, 1995Co-Authors: Sung H Chun, Philip T Sager, William G Stevenson, Koonlawee Nademanee, Holly R Middlekauff, Bramah N SinghAbstract:The purpose of this study was to examine the efficacy and safety of amiodarone to maintain Sinus Rhythm in patients with refractory atrial fibrillation or flutter. One hundred ten patients with atrial fibrillation or flutter, refractory to ≥1 class I antiarRhythmk agents (mean ± SD 2.5 ± 1.5, median 2), were given low-dose amiodarone (mean maintenance dose 268 ± 100 mg/day) to determine Hs efficacy to maintain Normal Sinus Rhythm after chemical or electrical carcKoversion. Fifty-three patients had chronic and 57 patients had paroxysmal atrial fibrillation or flutter. Mean age of the study population was 60 ± 13 years, and me mean follow-up was 36 ± 38 months (range 31 days to 137 months). Actuarial rates for maintenance of Sinus Rhythm were 0.87, 0.70, and 0.55 at 1,3, and 5 years, respectively. Twenty-one patients (19%) with arRhythmia recurrence had an increase in amiodarone dose, and after a mean additional follow-up of 2.5 years, 86% remained in Normal Sinus Rhythm. The only observed predictor of atrial fibrillation or flutter recurrence was paroxysmal arRhythmia (40% recurrence vs 9% in patients with chronic atrial fibrillation or flutter; p
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long term efficacy of amiodarone for the maintenance of Normal Sinus Rhythm in patients with refractory atrial fibrillation or flutter
American Journal of Cardiology, 1995Co-Authors: Sung H Chun, Philip T Sager, William G Stevenson, Koonlawee Nademanee, Holly R Middlekauff, Bramah N SinghAbstract:The purpose of this study was to examine the efficacy and safety of amiodarone to maintain Sinus Rhythm in patients with refractory atrial fibrillation or flutter. One hundred ten patients with atrial fibrillation or flutter, refractory to > or = 1 class I antiarRhythmic agents (mean +/- SD 2.5 +/- 1.5, median 2), were given low-dose amiodarone (mean maintenance dose 268 +/- 100 mg/day) to determine its efficacy to maintain Normal Sinus Rhythm after chemical or electrical cardioversion. Fifty-three patients had chronic and 57 patients had paroxysmal atrial fibrillation or flutter. Mean age of the study population was 60 +/- 13 years, and the mean follow-up was 36 +/- 38 months (range 31 days to 137 months). Actuarial rates for maintenance of Sinus Rhythm were 0.87, 0.70, and 0.55 at 1, 3, and 5 years, respectively. Twenty-one patients (19%) with arRhythmia recurrence had an increase in amiodarone dose, and after a mean additional follow-up of 2.5 years, 86% remained in Normal Sinus Rhythm. The only observed predictor of atrial fibrillation or flutter recurrence was paroxysmal arRhythmia (40% recurrence vs 9% in patients with chronic atrial fibrillation or flutter; p < 0.001). Actuarial rates for withdrawal because of adverse effects were 0.08, 0.22, and 0.30 at 1, 3, and 5 years, respectively. The most frequent adverse effects necessitating withdrawal were skin discoloration (4.5%), pulmonary fibrosis (3.6%; none fatal), and thyroid toxicity (2.7%). No deaths occurred during the study period. In conclusion, amiodarone Sinus Rhythm in patients with atrial fibrillation or flutter, with a relatively low incidence of adverse effects necessitating withdrawal.
Panos E. Vardas - One of the best experts on this subject based on the ideXlab platform.
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long term maintenance of Normal Sinus Rhythm in patients with current symptomatic atrial fibrillation amiodarone vs propafenone both in low doses
Chest, 2004Co-Authors: George E. Kochiadakis, Nikos E. Igoumenidis, Michail E. Hamilos, Panagiotis G. Tzerakis, Nikos C. Klapsinos, E Zacharis, Panos E. VardasAbstract:Study objectives To compare the efficacy and safety of amiodarone and propafenone when used for the prevention of atrial fibrillation (AF) and maintenance of Normal Sinus Rhythm in patients with refractory AF. Design Prospective, randomized, single-blind trial. Setting Tertiary cardiac referral center. Patients One hundred forty-six consecutive patients (72 men; mean age, 63 ± 10 years [± SD]) with recurrent symptomatic AF. Interventions We studied 146 patients after restoration of Sinus Rhythm; patients were randomized to amiodarone, 200 mg/d, or propafenone, 450 mg/d. Follow-up clinical evaluations were conducted at the first, second, fourth, and sixth months, and at 3-month intervals thereafter. The proportion of patients relapsing to AF and/or experiencing side effects was calculated for each group using the Kaplan-Meier method. End point of the study was recurrence of AF or occurrence of side effects necessitating discontinuation of medication. Measurements and results Of 146 patients, 72 received amiodarone and 74 received propafenone. The two groups were clinically similar. Of the 72 patients receiving amiodarone, AF developed in 25 patients, after an average of 9.8 months, compared to 33 of the 74 patients receiving propafenone after an average of 3.8 months. Twelve patients receiving amiodarone and 2 patients receiving propafenone had side effects necessitating withdrawal of medication while still in Sinus Rhythm. Conclusions Amiodarone tends to be more effective than propafenone in maintaining Sinus Rhythm in patients with AF, but this advantage is offset by a higher incidence of side effects.
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Sotalol versus propafenone for long-term maintenance of Normal Sinus Rhythm in patients with recurrent symptomatic atrial fibrillation.
The American Journal of Cardiology, 2004Co-Authors: George E. Kochiadakis, Nikos E. Igoumenidis, Michail E. Hamilos, Panagiotis G. Tzerakis, Nikos C. Klapsinos, Gregory Chlouverakis, Panos E. VardasAbstract:This prospective, randomized, single-blinded, placebo-controlled study compared the efficacy and safety of sotalol and propafenone when used for long-term prevention of atrial fibrillation. For the long-term maintenance of Normal Sinus Rhythm, propafenone seems to be more effective than sotalol.
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amiodarone sotalol or propafenone in atrial fibrillation which is preferred to maintain Normal Sinus Rhythm
Pacing and Clinical Electrophysiology, 2000Co-Authors: George E. Kochiadakis, Nikos E. Igoumenidis, Maria E Marketou, Stavros I Chrysostomakis, Hercules E Mavrakis, Michail D Kaleboubas, Panos E. VardasAbstract:UNLABELLED This randomized study compared the efficacy and safety of amiodarone, propafenone and sotalol in the prevention of atrial fibrillation. METHODS The population consisted of 214 consecutive patients (mean age 64 +/- 8 years, 106 men) with recurrent symptomatic atrial fibrillation. After restoration of Sinus Rhythm, patients were randomized to amiodarone (200 mg/day), propafenone (450 mg/day) or sotalol (320 +/- 20 mg/day). Follow-up evaluations were conducted at 1, 2, 4 and 6 months, and at 3-month intervals thereafter. The proportion of patients developing recurrent atrial fibrillation and/or experiencing unacceptable adverse effects was measured in the three groups by the Kaplan-Meier method. RESULTS Recurrent atrial fibrillation occurred in 25 of the 75 patients treated with amiodarone compared to 51 of the 75 patients treated with sotalol and 24 of the 64 patients treated with propafenone. Fourteen patients treated with amiodarone, five with sotalol, and one with propafenone experienced adverse effects while in Sinus Rhythm, necessitating discontinuation of treatment (P < 0.001 for amiodarone and propafenone vs sotalol). The difference between amiodarone and propafenone was statistically nonsignificant when all events were included in the analysis. However, if the analysis was limited to recurrent atrial fibrillation events, amiodarone was more effective than propafenone (P < 0.05). CONCLUSIONS Amiodarone and propafenone were superior to sotalol in maintaining long-term Normal Sinus Rhythm in patients with atrial fibrillation. Amiodarone tended to be superior to propafenone, though its long-term efficacy was limited by adverse side effects.
Sung H Chun - One of the best experts on this subject based on the ideXlab platform.
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long term efficacy of amiodarone for the maintenance of Normal Sinus Rhythm in patients with refractory atrial fibrillation or flutter
American Journal of Cardiology, 1995Co-Authors: Sung H Chun, Philip T Sager, William G Stevenson, Koonlawee Nademanee, Holly R Middlekauff, Bramah N SinghAbstract:The purpose of this study was to examine the efficacy and safety of amiodarone to maintain Sinus Rhythm in patients with refractory atrial fibrillation or flutter. One hundred ten patients with atrial fibrillation or flutter, refractory to ≥1 class I antiarRhythmk agents (mean ± SD 2.5 ± 1.5, median 2), were given low-dose amiodarone (mean maintenance dose 268 ± 100 mg/day) to determine Hs efficacy to maintain Normal Sinus Rhythm after chemical or electrical carcKoversion. Fifty-three patients had chronic and 57 patients had paroxysmal atrial fibrillation or flutter. Mean age of the study population was 60 ± 13 years, and me mean follow-up was 36 ± 38 months (range 31 days to 137 months). Actuarial rates for maintenance of Sinus Rhythm were 0.87, 0.70, and 0.55 at 1,3, and 5 years, respectively. Twenty-one patients (19%) with arRhythmia recurrence had an increase in amiodarone dose, and after a mean additional follow-up of 2.5 years, 86% remained in Normal Sinus Rhythm. The only observed predictor of atrial fibrillation or flutter recurrence was paroxysmal arRhythmia (40% recurrence vs 9% in patients with chronic atrial fibrillation or flutter; p
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long term efficacy of amiodarone for the maintenance of Normal Sinus Rhythm in patients with refractory atrial fibrillation or flutter
American Journal of Cardiology, 1995Co-Authors: Sung H Chun, Philip T Sager, William G Stevenson, Koonlawee Nademanee, Holly R Middlekauff, Bramah N SinghAbstract:The purpose of this study was to examine the efficacy and safety of amiodarone to maintain Sinus Rhythm in patients with refractory atrial fibrillation or flutter. One hundred ten patients with atrial fibrillation or flutter, refractory to > or = 1 class I antiarRhythmic agents (mean +/- SD 2.5 +/- 1.5, median 2), were given low-dose amiodarone (mean maintenance dose 268 +/- 100 mg/day) to determine its efficacy to maintain Normal Sinus Rhythm after chemical or electrical cardioversion. Fifty-three patients had chronic and 57 patients had paroxysmal atrial fibrillation or flutter. Mean age of the study population was 60 +/- 13 years, and the mean follow-up was 36 +/- 38 months (range 31 days to 137 months). Actuarial rates for maintenance of Sinus Rhythm were 0.87, 0.70, and 0.55 at 1, 3, and 5 years, respectively. Twenty-one patients (19%) with arRhythmia recurrence had an increase in amiodarone dose, and after a mean additional follow-up of 2.5 years, 86% remained in Normal Sinus Rhythm. The only observed predictor of atrial fibrillation or flutter recurrence was paroxysmal arRhythmia (40% recurrence vs 9% in patients with chronic atrial fibrillation or flutter; p < 0.001). Actuarial rates for withdrawal because of adverse effects were 0.08, 0.22, and 0.30 at 1, 3, and 5 years, respectively. The most frequent adverse effects necessitating withdrawal were skin discoloration (4.5%), pulmonary fibrosis (3.6%; none fatal), and thyroid toxicity (2.7%). No deaths occurred during the study period. In conclusion, amiodarone Sinus Rhythm in patients with atrial fibrillation or flutter, with a relatively low incidence of adverse effects necessitating withdrawal.
George E. Kochiadakis - One of the best experts on this subject based on the ideXlab platform.
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long term maintenance of Normal Sinus Rhythm in patients with current symptomatic atrial fibrillation amiodarone vs propafenone both in low doses
Chest, 2004Co-Authors: George E. Kochiadakis, Nikos E. Igoumenidis, Michail E. Hamilos, Panagiotis G. Tzerakis, Nikos C. Klapsinos, E Zacharis, Panos E. VardasAbstract:Study objectives To compare the efficacy and safety of amiodarone and propafenone when used for the prevention of atrial fibrillation (AF) and maintenance of Normal Sinus Rhythm in patients with refractory AF. Design Prospective, randomized, single-blind trial. Setting Tertiary cardiac referral center. Patients One hundred forty-six consecutive patients (72 men; mean age, 63 ± 10 years [± SD]) with recurrent symptomatic AF. Interventions We studied 146 patients after restoration of Sinus Rhythm; patients were randomized to amiodarone, 200 mg/d, or propafenone, 450 mg/d. Follow-up clinical evaluations were conducted at the first, second, fourth, and sixth months, and at 3-month intervals thereafter. The proportion of patients relapsing to AF and/or experiencing side effects was calculated for each group using the Kaplan-Meier method. End point of the study was recurrence of AF or occurrence of side effects necessitating discontinuation of medication. Measurements and results Of 146 patients, 72 received amiodarone and 74 received propafenone. The two groups were clinically similar. Of the 72 patients receiving amiodarone, AF developed in 25 patients, after an average of 9.8 months, compared to 33 of the 74 patients receiving propafenone after an average of 3.8 months. Twelve patients receiving amiodarone and 2 patients receiving propafenone had side effects necessitating withdrawal of medication while still in Sinus Rhythm. Conclusions Amiodarone tends to be more effective than propafenone in maintaining Sinus Rhythm in patients with AF, but this advantage is offset by a higher incidence of side effects.
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Sotalol versus propafenone for long-term maintenance of Normal Sinus Rhythm in patients with recurrent symptomatic atrial fibrillation.
The American Journal of Cardiology, 2004Co-Authors: George E. Kochiadakis, Nikos E. Igoumenidis, Michail E. Hamilos, Panagiotis G. Tzerakis, Nikos C. Klapsinos, Gregory Chlouverakis, Panos E. VardasAbstract:This prospective, randomized, single-blinded, placebo-controlled study compared the efficacy and safety of sotalol and propafenone when used for long-term prevention of atrial fibrillation. For the long-term maintenance of Normal Sinus Rhythm, propafenone seems to be more effective than sotalol.
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amiodarone sotalol or propafenone in atrial fibrillation which is preferred to maintain Normal Sinus Rhythm
Pacing and Clinical Electrophysiology, 2000Co-Authors: George E. Kochiadakis, Nikos E. Igoumenidis, Maria E Marketou, Stavros I Chrysostomakis, Hercules E Mavrakis, Michail D Kaleboubas, Panos E. VardasAbstract:UNLABELLED This randomized study compared the efficacy and safety of amiodarone, propafenone and sotalol in the prevention of atrial fibrillation. METHODS The population consisted of 214 consecutive patients (mean age 64 +/- 8 years, 106 men) with recurrent symptomatic atrial fibrillation. After restoration of Sinus Rhythm, patients were randomized to amiodarone (200 mg/day), propafenone (450 mg/day) or sotalol (320 +/- 20 mg/day). Follow-up evaluations were conducted at 1, 2, 4 and 6 months, and at 3-month intervals thereafter. The proportion of patients developing recurrent atrial fibrillation and/or experiencing unacceptable adverse effects was measured in the three groups by the Kaplan-Meier method. RESULTS Recurrent atrial fibrillation occurred in 25 of the 75 patients treated with amiodarone compared to 51 of the 75 patients treated with sotalol and 24 of the 64 patients treated with propafenone. Fourteen patients treated with amiodarone, five with sotalol, and one with propafenone experienced adverse effects while in Sinus Rhythm, necessitating discontinuation of treatment (P < 0.001 for amiodarone and propafenone vs sotalol). The difference between amiodarone and propafenone was statistically nonsignificant when all events were included in the analysis. However, if the analysis was limited to recurrent atrial fibrillation events, amiodarone was more effective than propafenone (P < 0.05). CONCLUSIONS Amiodarone and propafenone were superior to sotalol in maintaining long-term Normal Sinus Rhythm in patients with atrial fibrillation. Amiodarone tended to be superior to propafenone, though its long-term efficacy was limited by adverse side effects.
