National survey of catheter ablation for atrial fibrillation: The Japanese catheter ablation registry of atrial fibrillation (J-CARAF)

AbstractTo assess the current status of atrial fibrillation (AF) ablation in Japan, the Japanese Heart Rhythm Society (JHRS) instituted a national registry, the Japanese Catheter Ablation Registry of AF (J-CARAF).MethodsUsing an online questionnaire, the JHRS invited electrophysiology centers in Japan to voluntarily and retrospectively register data regarding the AF ablation procedures performed in September, 2011.ResultsA total of 128 centers submitted data regarding AF ablation procedures in 932 patients (age 62.1±10.4 years; male 76.8%; paroxysmal AF 65.7%, CHADS2 score 1.0±1.0). The majority received oral anticoagulant therapy during and following the procedure (68.9% and 97.5%, respectively). Pulmonary vein isolation (PVI) was performed in 97.5% of the patients; ipsilateral encircling PVI was the preferred technique (79.7%). Three-dimensional (3D) mapping systems and irrigated-tip catheters were used in 94.8% and 87.7% of the procedures, respectively. Ablation methods other than PVI were performed in 78.8% of all the patients and 73.5% of the patients with paroxysmal AF. Acute complications were reported in 6.2% of the patients, but no early deaths were recorded.ConclusionsIpsilateral encircling PVI, using 3D mapping and irrigated-tip catheters, is the standard AF ablation method in Japan. However, adjunctive ablations were performed frequently, even in patients with paroxysmal AF

CD153/CD30 signaling promotes age-dependent tertiary lymphoid tissue expansion and kidney injury

高齢者腎臓病を悪化させる原因細胞・分子の同定に成功. 京都大学プレスリリース. 2021-11-30.A new drug target for kidney disease. 京都大学プレスリリース. 2021-11-30.Tertiary lymphoid tissues (TLTs) facilitate local T- and B-cell interactions in chronically inflamed organs. However, the cells and molecular pathways that govern TLT formation are poorly defined. Here we identify TNF superfamily CD153-CD30 signaling between two unique age-dependent lymphocyte subpopulations, CD153⁺PD-1⁺CD4⁺ senescence-associated T (SAT) cells and CD30+T-bet+ age-associated B cells (ABCs), as a driver for TLT expansion. SAT cells, which produced ABC-inducing factors IL21 and IFNγ, and ABCs progressively accumulated within TLTs in aged kidneys after injury. Notably, in kidney injury models, CD153 or CD30 deficiency impaired functional SAT cell induction, which resulted in reduced ABC numbers and attenuated TLT formation with improved inflammation, fibrosis and renal function. Attenuated TLT formation after transplantation of CD153-deficient bone marrow further supported the importance of CD153 in immune cells. Clonal analysis revealed that SAT cells and ABCs in the kidneys arose from both local differentiation and recruitment from the spleen. In the synovium of aged rheumatoid arthritis patients, T peripheral helper/T follicular helper cells and ABCs also expressed CD153 and CD30, respectively. Together, our data reveal a previously unappreciated function of CD153-CD30 signaling in TLT formation and propose targeting CD153-CD30 signaling pathway as a therapeutic target for slowing kidney disease progression

Initial Evaluation of an Evolvable Microwave Circuit

Abstract. Microwave circuits are indispensable for mobile and multimedia communication. However, these circuits are very difficult to design, because of the nature of distributed-constant circuits in the microwave range (i.e., over 1 GHz). These circuits are also difficult to adjust for optimum performance, even for experienced engineers. These related problems make development costs of microwave circuits very high. In order to overcome these problems, we propose an EHW-based microwave circuit where performance adjustment is carried out automatically by a GA. This new approach of integrating a performance adjustment function within the circuit eliminates many of the design problems with associated these circuits. In this paper, we present an EHW-based image-rejection mixer circuit, which we have developed with this approach, and experimental data that demonstrates that the automatically adjusting circuit is capable of outperforming a circuit adjusted by an experienced engineer.

Hydralazine inhibits ventricular tachyarrhythmias in an acquired long QT rabbit model

Background: Some cardioactive vasodilating agents inhibit ventricular tachyarrhythmias (VT) associated with acquired long QT syndrome (LQT). We tested whether a vasodilator without direct cardiac effect can eliminate abnormal repolarization-related VT. Methods: The effect of hydralazine on the occurrence of VT was assessed in a methoxamine-sensitized rabbit model of acquired LQT. To verify that VTs in this animal model are triggered by early afterdepolarization (EAD), monophasic action potential (MAP) on the left ventricular surface was recorded in open-chest rabbits. Results: In control rabbits, combined administration of methoxamine and nifekalant frequently induced VTs (16/20, 80%). In contrast, VT occurred only in 2 out of 14 rabbits treated with hydralazine (14.3%, P<0.0001 vs. control). After the treatment, blood pressure was lower in the hydralazine group than in the control group (systolic pressure, 146±19 vs. 165±16 mmHg, P<0.0001; diastolic pressure, 54±10 vs. 101±11 mmHg, P<0.0001). EAD-like hump was less frequently detected in hydralazine-treated rabbits (2/10) than in saline-treated rabbits (9/10, P<0.005). Presence of a hump was significantly related to the appearance of VTs (P<0.05). Conclusion: Hydralazine inhibited VT in a rabbit LQT model. Vasodilation may have a therapeutic effect on abnormal repolarization-related VT