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Tsu-Juey Wu 發行單位:中華民國心律醫學會 (Taiwan Heart Rhythm Society) (Taiwan Heart Rhythm Society) 址: 址:10041 10041台北市中正區忠孝西路一段 台北市中正區忠孝西路一段50 5022 22樓之 樓之26 26 話: 886-2-23821530 真: 886-2-23821528 址:www.thrs.org.tw ISSN ISSN 2223-0130 2223-0130 林彥璋 林彥璋Yenn-Jiang Lin Yenn-Jiang Lin Kuo-Hung Lin Kuo-Hung Lin 本期主編: 本期主編: 張鴻猷 張鴻猷Hung-Yu Chang Hung-Yu Chang 輯: 輯: 李政鴻 李政鴻Cheng-Hung Li Cheng-Hung Li 蔡文欽 蔡文欽Wen-Chin Tsa Wen-Chin Tsa 鄭詩璁 鄭詩璁Shih-Tsung Cheng Shih-Tsung Cheng 趙子凡 趙子凡Tze-Fan Chao Tze-Fan Chao 邱舜南 邱舜南Shuenn-Nan Chiu Shuenn-Nan Chiu 黃世鐘 黃世鐘Shih-Chung Huang Shih-Chung Huang 陳建佑 陳建佑Jan-Yow Chen Jan-Yow Chen Po-Ching Chi Po-Ching Chi 黃炳賢 黃炳賢Bien-Hsien Huang Bien-Hsien Huang 陳偉華 陳偉華Wei-Hua Tang Wei-Hua Tang 黃姍惠 黃姍惠Shan-Huei Huang Shan-Huei Huang 沃宏達 沃宏達Hung-Ta Wo Hung-Ta Wo 886- 6 2- 2-23821530 886-2-23821530 886- 6-2-23821528 886-2-23821528 Mar. 2014 VOL. 013 013 Tsu- u-Ju Ju J ey ey W W Wu u u Tsu-Juey Wu Mar. 2 Mar. 2 Arrhythmia News Arrhythmia News 醫學不斷進步,心臟科近年來也有許多新技術的發展,且目前陸續引進台 灣,實為病人之福。有鑑於此,本期特地邀請幾位專家撰文介紹包括電極導線 移除術、MediGuide、左心耳閉合器等新技術。 適逢心律學會年會,本期亦有專文紀錄年會實況,祝各位會員閱讀愉快。 2014 中 華 民 國 心 律 醫 學 會 年 會 暨 學術研討會與會心得 振興醫院 馮文楷醫師 本年度之中華民國心律醫學會年會於39日圓滿落 幕,結束為期兩天的學術盛宴。 主辦單位在首日早上即安排本次會議的重頭戲 -- 示範手術(Live Demonstration) ,假台北榮總示範LAA occluder 置入術及epicardial ventricular tachycardia 電燒 術。LAA occlusion 是目前預防中風的重要策略之一, 適用於不宜長期使用抗凝血藥物的病患,目前市面上主 要有Watchman Amplazter Cardiac PlugACP)兩種選 擇。本次LAA occluder 之示範手術是由台北榮總羅力瑋 醫師擔任手術醫師,與來自香港的Prof. Yat-Yin Lam共同 合作,完成ACP的置入術,術中與與會來賓及醫師討論 手術技巧,選擇occluder的尺寸,以及分享置入時可能遭 遇的困難及可能產生的併發症等,討論相當熱烈。 示範手術的第二部分為 epicardial ventricular tachycardia電燒術。特別邀請來自日本的Kyoto Soejima師前來一同討論,分享經驗,主刀醫師為台北榮總林彥璋 醫師、與振興醫院馮安寧醫師、萬芳醫院林永國醫師共同 精彩的Live Demo吳茲睿 理事長開場。 LAA occlusion 由來自香港的Yat-Yin Lam及台北榮總羅力瑋醫師共同 完成。 P1 編輯的話 P1 2014中華民國心律醫學會年會暨學術研討會與會心得 P3 醫療新技術:Lead Extraction P4 嶄新的心導管導航系統—MediGuide簡介 P5 左心耳閉合器:非藥物方式降低心房顫動之中風風險 P6 醫學新知:心房顫動與自律神經系統 P7 EKG of the month P8 脈動新聞 P10 研究新知 P13 活動日誌 P14 2014年中國南京室性心律失常會議與會心得

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  • 1. Tsu-Juey Wu (Taiwan Heart Rhythm Society)(Taiwan Heart Rhythm Society) 1004110041505022222626 886-2-23821530 886-2-23821528 www.thrs.org.tw I S S NI S S N 2 2 2 3 - 0 1 3 02 2 2 3 - 0 1 3 0 Yenn-Jiang LinYenn-Jiang Lin Kuo-Hung LinKuo-Hung Lin Hung-Yu ChangHung-Yu Chang Cheng-Hung LiCheng-Hung Li Wen-Chin TsaWen-Chin Tsa Shih-Tsung ChengShih-Tsung Cheng Tze-Fan ChaoTze-Fan Chao Shuenn-Nan ChiuShuenn-Nan Chiu Shih-Chung HuangShih-Chung Huang Jan-Yow ChenJan-Yow Chen Po-Ching ChiPo-Ching Chi Bien-Hsien HuangBien-Hsien Huang Wei-Hua TangWei-Hua Tang Shan-Huei HuangShan-Huei Huang Hung-Ta WoHung-Ta Wo 886-6 2-2-23821530886-2-23821530 886-6-2-23821528886-2-23821528 Mar. 2014 VOL. 013013 Tsu-u-JuJuJ eyey WWWuuuTsu-Juey Wu Mar. 2Mar. 2Arrhythmia NewsArrhythmia News MediGuide 2014 39 -- (Live Demonstration)LAA occluder epicardial ventricular tachycardia LAA occlusion Watchman Amplazter Cardiac PlugACP LAA occluder Prof. Yat-Yin Lam ACP occluder epicardial ventricular tachycardiayoto Soejima Live Demo LAA occlusion Yat-Yin Lam P1 P1 2014 P3 Lead Extraction P4 MediGuide P5 P6 P7 EKG of the month P8 P10 P13 P14 2014

2. Taiwan Heart Rhythm Society1033THRS VOL.0132 ICD epicardial origin (epicardial puncture) Live demonstration Device remote monitoring in arrhythmia detectionlead extractionCRT optimization Professor Ken Okumura unknown EP tracing EP Professor Peng- Sheng Chen small conductance calcium activated K (SK) channel action potential durationrestitution curve SK channel blocker ( Apamin ) Association Between Renal Function, Diastolic Dysfunction, and Postoperative Atrial Fibrillation Following Cardiac Surgery Seasonal variation in the frequency of sudden cardiac death and ventricular tachyarrhythmia in patients with arrhythmogenic right ventricular dysplasia / cardiomyopathy: The effect of meteorological factors Statin therapy reduces the risk of ventricular arrhythmias, sudden cardiac death, and mortality in heart failure patients: A nationwide population-based cohort study Chaired poster 2014 () The Critical Role of MMP-9 Expression in the Pathogenesis of Ventricular Arrhythmias Kyoto Soejimaepicardial ventricular tachycardia ablation Live Demo Professor Peng-Sheng Chen Professor Young-Hoon Kim Professor Peng-Sheng Chen 3. Taiwan Heart Rhythm Society1033VOL.013 3THRS Lead Extraction ( pacemaker)(ICD ) (CRTP and CRTD) 1,2 (malfunction) ICD CRT (venous occlusion) 3,4 5%1% ( 0.5% generatorupgrade2-7% ) malfunctionICD lead1.65-20% upgrade9-12% venous occlusionredundant leads 1%lead capping HRS (Heart Rhythm Society) 2009indication lead capping 5,6 mini-surgery ( TEE) Locking stylettraction catchersnarebasket Locking styletsheath (mechanical or laser) 7,8 laser sheath (Subclavianinnominate superior vena cavasuperior vena cava-right atrium junctioninferior vena cava) valve damage protocol (>60 case/4year) < 10 2009 LExlCon studies 0.28% 1.4% 1.1% 9,10 References 1. Hammill SC, Kremers MS, Kadish AH, et al. Review of the ICD registrys third year, expansion to include lead data and pediatric ICD procedures, and role for measuring performance. Heart Rhythm 2009;6:1397-1401. 2. DeFrances CJ, Lucas CA, Buie VC, Golosinskiy A. National hospital discharge survey. Natl Health Stat Rep. 2006;2008:1-20. 3. Kleemann T, Becker T, Doenges K, et al. Annual rate of transvenous defibrillation lead defects in implantable cardioverter-defibrillators over a period of >10 years. Circulation. 2007;115:2474-2480. 4. Tarakji KG, Chan EJ, Cantillon DJ, et al. Cardiac implantable electronic device infections: presentation, management, and patient outcomes. Heart Rhythm 2010;7(8):1043-7. 5. Wilkoff BL, Love CJ, Byrd CL, et al. Transvenous lead extraction: Heart Rhythm Society expert consensus on facilities, training, indications, and patient management. Heart Rhythm. 2009;6:1085- 1104. 6. Hauser RG, Katsiyiannis WT, Gornick CC, Almquist AK, Kallimen LM. Deaths and cardiovascular injuries due to device-assisted implantable cardioverter-debrillator and pacemaker lead extraction. Europace. 2010;12:395-401. 7. Jones SO, Eckart RE, Albert CM, Epstein LM. Large, single- center, single-operator experience with transvenous lead extraction: outcomes and changing indications. Heart Rhythm. 2008;5:520-5. 8. Wilkoff BL, Byrd CL, Love CJ, et al. Pacemaker lead extraction with the laser sheath: results of the pacing lead extraction with the excimer sheath (PLEXES) trial. J Am Coll Cardiol. 1999;33:1671-6. 9. Wazni O, Epstein LM, Carrillo RG,, et al. Lead extraction in the contemporary setting: the LExICon study: an observational retrospective study of consecutive laser lead extractions. J Am Coll Cardiol 2010;55: 579-86. 10. Sohal M, Williams S, Akhtar M, et al. Laser lead extraction to facilitate cardiac implantable electronic device upgrade and revision in the presence of central venous obstruction. Europace. 2014;16:81-7. 2014 Baigalmaa Lkhagva Baigalmaa Lkhagva () A Novel Histone Deacetylase Inhibitor Reduces Pulmonary Vein Arrhythmogenesis through Calcium Regulation () Testosterone Replacement Increases Aged Pulmonary Vein and Left and Left Atrium Arrhythmogenesis with Enhanced Adrenergic Activity 4. Taiwan Heart Rhythm Society1033THRS VOL.0134 MediGuide 3D 3D 3DX X 3D-- MediGuide (St. Jude Medical) X XMediGuide(MediGuide Enabled, MediGuide X GPS X MediGuide MediGuide (CRT) (bi- plane) (EnSite Velocity System) MediGuide MediGuide 1. MediGuide 2. MediGuide 3. MediGuide MediGuide4. MediGuideMediGuide () MediGuide 1. (