ddr1 On behalf of the Japanese
On behalf of the Japanese Heart Rhythm Society (JHRS), I am pleased to announce that we JHRS are merged with the Japanese Society of Electrocardiology (JCE) in 2015. Both societies have about 30-year history since their establishments, and have contributed to the development of sciences, education and spread in the field of the cardiac electrophysiology and arrhythmias. JHRS and JCE are registering a new general incorporated association in May, 2015, and the title is the Japanese Arrhythmia and Electrocardiology Society in Japanese and the Japanese Heart Rhythm Society in English. The new society is expected to have about 7000 physician and allied professional members. The recent advances of the medical science and treatment in cardiac electrophysiology have been remarkable, and the new society would be able to contribute to the developments more than ever. I would congratulate all of the JHRS and JCE members for their previous and current scientific and medical activities and would thank in advance for further cooperation in the launch of the new society.
Introduction The use of implantable cardioverter-defibrillators (ICDs) is the gold standard for primary and secondary prevention of sudden cardiac death [1,2]. However, shocks increase the risk of all-cause mortality, even if the shocks are inappropriate . Recent studies have reported the efficacy of prophylactic catheter ablation (PCA) before ICD ddr1 in patients with ventricular tachycardia (VT) and ischemic cardiomyopathy [4–6]. Some studies report the efficacy of catheter ablation with a combination endocardial and epicardial approach in patients with non-ischemic cardiomyopathy (NICM) [7,8]. However, the role of PCA before ICD implantation in NICM patients has not been well described. Results from the few published studies on the subject vary, but no prospective studies have compared clinical outcomes of patients with or without prophylactic endocardial catheter ablation before cardioverter-defibrillator implantation.
Material and methods
Conflict of interest
Introduction Implantable loop recorders (ILRs) were introduced in Japan in October 2009 as an effective diagnostic tool for unexplained recurrent syncope [1–3]. By August 2012, ILRs had been implanted in approximately 850 patients. Representative randomized trials explored and provided evidence for their efficacy in patients with neurally-mediated syncope (NMS), and these include RAST  (Randomized Assessment of Syncope Trial), ISSUE [5–7], and ISSUE2 . The PICTURE  trial revealed the usefulness of early implantation of ILRs, and the number of cases has increased remarkably ever since the introductory phase. Furthermore, as ILRs are smaller in size than other cardiac devices, such as pacemakers, implantable cardioverter defibrillators, and devices for cardiac resynchronization therapy, the implantation procedure is relatively safe. In order to accurately diagnose the causes of syncope, ILRs should be implanted in a region with higher R wave amplitude . However, R wave amplitude often varies depending on body position, and this can lead to temporary undersensing, resulting in false diagnoses of bradycardia, cardiac arrest, or chronic R wave amplitude decrement, all of which demand surgical intervention [11,12]. This study investigated the changes in R wave amplitude at different locations and angles of implanted electrodes, as well as different body positions of the patient, using a Reveal® cardiac monitor (Medtronic Inc., Minneapolis, MN, USA). The aim was to locate the optimal position for implantation in order to avoid false detection of arrhythmias. Basic information regarding this device is as follows. Distance between the electrodes is 40mm, the size of this device is 19×62×8mm. The manufacturer-recommended implant zones are either between the first intercostal space and the fourth rib (the V3 area) or between the fourth and the fifth rib. At these locations it is possible to obtain an R wave amplitude greater than 0.3mV.