Circulation journal : official journal of the Japanese Circulation Society
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Comparative Study Controlled Clinical Trial
Can nifekalant hydrochloride be used as a first-line drug for cardiopulmonary arrest (CPA)? : comparative study of out-of-hospital CPA with acidosis and in-hospital CPA without acidosis.
Early defibrillation of ventricular tachycardia and fibrillation (VT/VF) is an urgent and most important method of resuscitation for survival in cardiopulmonary arrest (CPA). We have previously reported that nifekalant (NIF), a specific I(Kr) blocker developed in Japan, is effective for lidocaine (LID) resistant VT/VF in out-of-hospital CPA (OHCPA). However, little is known about the differences in the effect of NIF on OHCPA with acidosis and in-hospital CPA (IHCPA) without acidosis. ⋯ NIF had a favorable defibrillating effect in both CPA groups, and it shows promise of becoming a first-line drug for CPR.
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Randomized Controlled Trial Comparative Study
Comparison of 2 mapping strategies for pulmonary vein isolation.
Pulmonary vein (PV) isolation using a circular catheter (CC) creates an entrance block from the left atrium (LA) to PV to eliminate paroxysmal atrial fibrillation (PAF). We describe a new approach for PV isolation during distal PV pacing using a basket catheter (BC). The purpose of the present study was to compare 2 mapping strategies for PV isolation. ⋯ This new approach for PV isolation during distal PV pacing using BC is useful for confirming a bidirectional PV-LA conduction block and is more effective than CC ablation.
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Early defibrillation and cardiopulmonary bypass have been postulated to be a promising intervention against out-of-hospital cardiac arrest (OHCA); however, little is known about the long-term prognosis. The effects of early recovery of circulation (ROC) on neurological recovery and the long-term outcome in patients with OHCA were examined. ⋯ Early ROC using on-site counter shock or cardiopulmonary bypass might result in better long-term outcome in patients with OHCA of cardiac origin.
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Although there is a close connection between emergency medical services (EMS) system and the outcome of out-of-hospital ventricular fibrillation (VF), few data are available regarding the situation in Japan. ⋯ In Japan, VF occurred in 63% of cases at the time of cardiac arrest and the performance of bystander CPR appeared to prolong VF.