Program

General Presentation

Young Investigator Award（YIA）Competition

Date：
Saturday, July 16, 16:00-17:00
Room：
Room 7（Small Hall, 2F）
Speakers：
Yosuke Kamikubo（Nagoya University Graduate School of Medicine, Nagoya, Japan）
Yukihiro Inamura（Saitama Red Cross Hospital, Saitama, Japan）
Shuntaro Tamura（Gunma University Hospital, Gunma, Japan）
Toyonobu Tsuda（Kanazawa University Graduate School of Medical Science, Kanazawa, Japan）
Tetsuya Handoh（Tohoku University Graduate School of Medicine, Sendai, Japan）
Chairpersons：
Minoru Horie（Shiga University of Medical Sciences, Otsu, Japan）
Kazuo Matsumoto（Higasimatsuyama Medical Association Hospital, Higashimatsuyama, Japan）
Selection
Committee Member：

Hiroshi Tada（Faculty of Medical Sciences, University of Fukui, Fukui, Japan）
Kyoko Soejima（Kyorin University Hospital, Tokyo, Japan）
Kengo Kusano（National Cerebral and Cardiovascular Center, Osaka, Japan）
Mitsuharu Kawamura（Showa University of Medicine, Tokyo, Japan）

Hideo Ueda Memorial Lecture

Date：
Friday, July 15, 14:00-15:00
Room：
Room 1（Conference Hall, 1F）
Speaker：
Michael R. Gold（Medical University of South Carolina, Charleston, USA）
Chairperson：
Ken Okumura（Saiseikai Kumamoto Hospital, Kumamoto, Japan）

Eiichi Kimura Memorial Lecture

Date：
Saturday, July 16, 10:30-11:30
Room：
Room 1（Conference Hall, 1F）
Speaker：
Michel Haïssaguerre（Liryc Institute - Bordeaux University Hospital - University of Bordeaux, Bordeaux, France）
Chairperson：
Yoshito Iesaka（Tsuchiura Kyodo Hospital, Tsuchiura, Japan）

Special Lectures

Special Lecture 1　

Date：
Friday, July 15, 10:30-11:30
Room：
Room 1（Conference Hall, 1F）
What did I explore in half a century of research?: What discovery, What invention, Where, When?
Speakers：
Leo Esaki（Nobel prize laureate/ President, Yokohama College of Pharmacy/ Former president, University of Tsukuba）
Chairperson：
Kazutaka Aonuma（University of Tsukuba, Tsukuba, Japan）

Special Lecture 2　

Date：
Sunday, July 17, 13:30-14:30
Room：
Room 1（Conference Hall, 1F）
Speaker：
Hiroyasu Shimizu（Nagano olympics Gold medalists in speed skating）
Chairperson：
Kazutaka Aonuma（University of Tsukuba, Tsukuba, Japan）

Congress Chairperson’s Lecture

Date：
Friday, July 15, 15:00-16:00
Room：
Room 1（Conference Hall, 1F）
Speaker：
Kazutaka Aonuma（President, Annual Meeting of JHRS 2016）
Chairperson：
Iwao Yamaguchi（University of Tsukuba, Tsukuba, Japan）

Symposia

Symposium 1

Leadless Pacemaker　
Date：
Friday, July 15, 9:00-10:30
Room：
Room 1（Conference Hall, 1F）
Keynote Lecture：
Massimo Santini（San Filippo Neri Hospital, Rome, Italy）
Speakers：
Kyoko Soejima（Kyorin University Hospital, Tokyo, Japan）
Kenji Kuroki（University of Tsukuba, Tsukuba, Japan）
Petr Neuzil（Na Homolce Hospital, Prague, Czech Republic）
Chairpersons：
Toshiyuki Ishikawa（Yokohama City University School of Medicine, Kanagawa, Japan）
Massimo Santini（San Filippo Neri Hospital, Rome, Italy）

Symposium 2

New Era of 3D Electroanatomical Mapping for Complex Arrhythmias　
Date：
Friday, July 15, 14:00-16:00
Room：
Room 2（Main Hall A, 1F）
Speakers：
Tatsuhiko Arafune（School of Science and Engineering, Tokyo Denki University, Saitama, Japan）
Michel Haïssaguerre（Liyrc Institute - Bordeaux University Hospital ? University of Bordeaux, Bordeaux, France）
Hiroshi Nakagawa（Heart Rhythm Institute, Univerity of Oklahoma, Oklahoma City, USA）
Morio Shoda（Tokyo Women' s Medical University, Tokyo, Japan）
Kyoko Soejima（Kyorin University Hospital, Tokyo, Japan）
Chairpersons：
Hiroshi Nakagawa（Heart Rhythm Institute, Univerity of Oklahoma, Oklahoma City, USA）
Morio Shoda（Tokyo Women' s Medical University, Tokyo, Japan）

Symposium 3

Management of Atrial Fibrillation: Rhythm Versus Rate Control Therapy　
Date：
Friday, July 15, 16:00-17:30
Room：
Room 2（Main Hall A, 1F）
Keynote Lecture：
Fiorenzo Gaita（University of Turin, Turin, Italy）
Speakers：
Koonlawee Nademanee（Pacific Rim Electrophysiology Research Institute, Los Angeles, USA）
Akinori Sairaku（Hiroshima University, Hiroshima, Japan）
Yoshiyuki Hama（Kimitsu Chuo Hospital, Kisarazu, Japan）
Yoshimori An（National Hospital Organization Kyoto Medical Center, Kyoto, Japan）
Chairpersons：
Takanori Ikeda（Toho University Faculty of Medicine, Tokyo, Japan）
Fiorenzo Gaita（University of Turin, Turin, Italy）

Symposium 4

Wearable Cardioverter Defibrillator: Role in Prevention of Sudden Cardiac Death　
Date：
Friday, July 15, 9:00-10:30
Room：
Room 3（Mid-sized Hall A, 1F）
Speakers：
Shingo Sasaki（Hirosaki University Graduate School of Medicine）
Yusuke Kondo（Chiba University Graduate School of Medicine）
Shinichi Niwano（Kitasato University）
Yuki Iwasaki（Nippon Medical School）
Chairpersons：
Akihiko Shimizu（Yamaguchi Graduate School of Medicine）
Takashi Nitta（Nippon Medical School）

Symposium 5

Identification of CRT Responder　
Date：
Friday, July 15, 14:00-15:30
Room：
Room 3（Mid-sized Hall A, 1F）
Keynote Lecture：
Cecilia M Linde（Karolinska University Hospital, Stockholm, Sweden）
Speakers：
Takashi Noda（National Cerebral and Cardiovascular Center, Suita, Japan）
Hirotoshi Ichibori（Kobe University Graduate School of Medicine, Kobe, Japan）
Itsuro Morishima（Ogaki Municipal Hospital, Ogaki, Japan）
Michael R Gold（Medical University of South Carolina, Charleston, USA）
Chairpersons：
Takashi Kurita（Kinki University, Osaka, Japan）
Cecilia M Linde（Karolinska University Hospital, Stockholm, Sweden）

Symposium 6

Mapping and Ablation of Idiopathic Left Ventricular Tachycardia　
Date：
Friday, July 15, 16:30-18:00
Room：
Room 3（Mid-sized Hall A, 1F）
Keynote Lecture：
Samuel Jayaprakash Asirvatham（Mayo Clinic, Rochester, USA）
Speakers：
Akihiko Nogami（University of Tsukuba, Tsukuba, Japan）
Mitsuharu Kawamura（Showa University of Medicine, Tokyo, Japan）
Ahmed Talib（University of Tsukuba, Tsukuba, Japan）
Yuki Komatsu（University of Tsukuba, Tsukuba, Japan）
Chairpersons：
Yoshinori Kobayashi（Tokai University Hachioji-hospital, Tokyo, Japan）
Hisashi Yokoshiki（Hokkaido University Hospital, Sapporo, Japan）

Symposium 7

Mechanisms Underlying Brugada Syndrome　
Date：
Friday, July 15, 9:00-11:00
Room：
Room 6（Meeting Room 107-108, 1F）
Speakers：
Koonlawee Nademanee（Pacific Rim Electrophysiology Research Institute, Los Angeles, USA）
Yasuya Inden（Nagoya University Graduate School of Medicine, Nagoya, Japan）
Hiroshi Morita（Okayama University Graduate School of Medicine, Okayama, Japan）
Seiko Ohno（Shiga University of Medical Science, Otsu, Japan）
Yukiko Nakano（Hiroshima University, Hiroshima, Japan）
Tsukasa Kamakura（National Cerebral and Cardiovascular Center, Suita, Japan）
Chairpersons：
Wataru Shimizu（Graduate School of Medicine, Nippon Medical School, Tokyo, Japan）
Koonlawee Nademanee（Pacific Rim Electrophysiology Research Institute, Los Angeles, USA）

Symposium 8

State of the Arts in Arrhythmia Research: Simulation and Development/Regeneration　
Date：
Friday, July 15, 16:00-18:00
Room：
Room 6（Meeting Room 107-108, 1F）
Speakers：
Natalia Alexandrova Trayanova（Johns Hopkins University, Baltimore, USA）
Takashi Ashihara（Shiga University of Medical Sciences, Otsu, Japan）
Vincent M. Christoffels（Academic Medical Center, Amsterdam, the Netherlands）
Ichiro Hisatome（Tottori University Faculty of Medicine, Yonago, Japan）
Tetsushi Furukawa（Tokyo Medical and Dental University, Tokyo, Japan）
Chairpersons：
Minoru Horie（Shiga University of Medical Sciences, Otsu, Japan）
Natalia Alexandrova Trayanova（Johns Hopkins University, Baltimore, USA）

Symposium 9

Non-pharmacological Prevention of Left Atrial Appendage Thrombus　
Date：
Friday, July 15, 14:00-15:30
Room：
Room 8（Meeting Room 204, 2F）
Speakers：
Shephal Kirit Doshi（Pacific Heart Institute, Santa Monica, USA）
Petr Neuzil（Na Homolce Hospital, Prague, Czech Republic）
Roland Richard Tilz（University Hospital Lübeck, Lübeck, Germany）
Toshiya Ohtsuka（Tokyo Metropolitan Tama Medical Center, Tokyo, Japan）
Andre Luiz Buchele d'Avila（Hospital Cardiologico, Florianopolis, Brazil）
Chairpersons：
Yuji Nakazato（Juntendo University Urayasu Hospital, Tokyo, Japan）
Shephal Kirit Doshi（Pacific Heart Institute, Santa Monica, USA）

Symposium 10（Debate）

ATP/adenosine-guided PVI improves the outcome.
Date：
Friday, July 15, 9:00-10:00
Room：
Room 7（Small Hall, 2F）
Speakers：
Atsushi Kobori（Kobe City Medical Center General Hospital, Kobe, Japan）
Laurent Macle（Montreal Heart Insitute, Department of Medicine, Université de Montréal, Montreal, Canada）
Chairpersons：
Seiji Takatsuki（Keio University, Tokyo, Japan）
Christopher Piorkowski（Heart Center Dresden University, Dresden, Germany）

Symposium 11

Reduction of Radiation Exposure　
Date：
Friday, July 15, 16:30-18:00
Room：
Room 7（Small Hall, 2F）
Keynote Lecture：
Kyoko Soejima（Kyorin University Hospital, Tokyo, Japan）
Speakers：
Wee Siong Teo（National Heart Centre Singapore, Singapore）
Isabelle Nault（Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Canada）
Akiko Ueda（Kyorin University Hospital, Tokyo, Japan）
Yoshihisa Naruse（Leiden University Medical Center, Leiden, the Netherlands）
Kohei Yamashiro（Heart Rhythm Center, Takatsuki General Hospital, Takatsuki, Japan）
Eitaro Fujii（Mie University Graduate School of Medicine, Tsu, Japan）
Chairpersons：
Kyoko Soejima（Kyorin University Hospital, Tokyo, Japan）
Wee Siong Teo（National Heart Centre Singapore, Singapore）

Symposium 12

The Usefulness and the Limitation of Subcutaneous ICD　
Date：
Friday, July 15, 15:00-16:30
Room：
Room 8（Meeting Room 204, 2F）
Keynote Lecture：
Michael R Gold（Medical University of South Carolina, USA）
Speakers：
Massimo Santini（S. Filippo Neri Hospital, Italy）
Hideo Okamura（Mayo Clinic, Rochester, Minnesota, USA）
Shingo Maeda（Tokyo Medical and Dental University）
Motomi Tachibana（Okayama University）
Yoshino Minoura（Showa University）
Chairpersons：
Youichi Kobayashi（Showa University）
Michael R Gold（Medical University of South Carolina, USA）

Symposium 13

New Mapping Technique for VT Ablation　
Date：
Saturday, July 16, 8:30-10:30
Room：
Room 1（Conference Hall, 1F）
Keynote Lecture：
Kalyanam Shivkumar（University of California Los Angeles, Los Angeles, USA）
Speakers：
Katja Zeppenfeld（Leiden University Medical Center, Leiden, the Netherlands）
Isabelle Nault（Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Canada）
Roderick Hschum Tung（The University of Chicago Medical Center, Chicago, USA）
Seigo Yamashita（The Jikei University School of Medicine, Tokyo, Japan）
Koji Miyamoto（National Cerebral and Cardiovascular Center, Suita, Japan）
Chairpersons：
Yukio Sekiguchi（University of Tsukuba, Tsukuba, Japan）
Kalyanam Shivkumar（University of California Los Angeles, Los Angeles, USA）

Symposium 14

Ablation of Ventricular Fibrillation（except Brugada Syndrome）　
Date：
Saturday, July 16, 13:30-15:30
Room：
Room 1（Conference Hall, 1F）
Speakers：
Michel Haïssaguerre（Liryc Institute - Bordeaux University Hospital - University of Bordeaux, Bordeaux, France）
Isabelle Nault（Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Canada）
Keita Masuda（University of Tsukuba, Tsukuba, Japan）
Hui-Nam Pak（Yonsei University Health System, Seoul, Korea）
Pasquale Santangeli（University of Pennsylvania, Philadelphia, USA）
Meiso Hayashi（Nippon Medical School, Tokyo, Japan）
Chairpersons：
Akihiko Nogami（University of Tsukuba, Tsukuba, Japan）
Michel Haïssaguerre（Liryc Institute - Bordeaux University Hospital - University of Bordeaux, Bordeaux, France）

Symposium 15

Controversy for Device Selection: CRT-P Versus CRT-D Versus ICD　
Date：
Saturday, July 16, 15:30-17:00
Room：
Room 1（Conference Hall, 1F）
Speakers：
Chu-Pak Lau（The University of Hong Kong, Hong Kong）
Atsushi Suzuki（Tokyo Women' s Medical University, Tokyo, Japan）
Kenzaburo Nakajima（National Cardiovascular Center, Suita, Osaka）
Yasushi Oginosawa（University of Occupational and Environmental Health, Kitakyushu, Japan）
Yuji Iwanami（Tokyo Women' s Medical University, Tokyo, Japan）
Chairpersons：
Haruhiko Abe（University of Occupational and Environmental Health, Kitakyushu, Japan）
Shu Zhang（National Center for Cardiovascular Diseases & Beijng Fuwai Hospital, Beijing, China）

Symposium 16

Arrhythmogenic Right Ventricular Cardiomyopathy　
Date：
Saturday, July 16, 8:30-10:00
Room：
Room 2（Main Hall A, 1F）
Keynote Lecture：
Shih-Ann Chen（National Yang-Ming University, Taiwan）
Speakers：
Pasquale Santangeli（University of Pennsylvania, Philadelphia, USA）
Yuko Wada（Shiga University of Medical Science, Otsu, Japan）
Yoshitaka Kimura（National Cerebral and Cardiovascular Center, Suita, Japan）
Noriko Kikuchi（Tokyo Women' s Medical University, Tokyo, Japan）
Chairpersons：
Masahiko Goya（Tokyo Medical and Dental University, Tokyo, Japan）
Shih-Ann Chen（National Yang-Ming University, Taiwan）

Symposium 17

Latest Modalities of Image Integration for VT Ablation　
Date：
Saturday, July 16, 10:00-11:30
Room：
Room 2（Main Hall A, 1F）
Keynote Lecture：
Saman Nazarian（Johns Hopkins University School of Medicine, Baltimore, USA）
Speakers：
Natalia Alexandrova Trayanova（Johns Hopkins University, Baltimore, USA）
Takeshi Sasaki（Tokyo Medical and Dental University, Tokyo, Japan）
Seigo Yamashita（Jikei University School of Medicine, Tokyo, Japan）
Roderick Hschum Tung（The University of Chicago Medical Center, Chicago, USA）
Chairpersons：
Kenzo Hirao（Tokyo Medical and Dental University, Tokyo, Japan）
Saman Nazarian（Johns Hopkins University School of Medicine, Baltimore, USA）

Symposium 18

Treatment of Arrhythmias with Modulation of Autonomic Nervous Function　
Date：
Saturday, July 16, 13:30-15:30
Room：
Room 3（Mid-sized Hall A, 1F）
Keynote Lecture：
Peng-Sheng Chen（The Krannert Institute of Cardiology, Indiana University, Indianapolis, USA）
Speakers：
Sabine Irmgard Sigrid Ernst（Royal Brompton Hospital, London, UK）
Marmar Vaseghi（UCLA Cardiac Arrhythmia Center, Los Angeles, USA）
Kunihiro Nishida（University of Toyama, Toyama, Japan）
Kyoko Soejima（Kyorin University Hospital, Tokyo, Japan）
Chairpersons：
Hiroshi Inoue（Saiseikai Toyama Hospital, Toyama, Japan）
Peng-Sheng Chen（The Krannert Institute of Cardiology, Indiana University, Indianapolis, USA）

Symposium 19

Approaches to Catheter Ablation for Atrial Fibrillation: Triggers or Substrate Modification　
Date：
Saturday, July 16, 15:30-17:00
Room：
Room 3（Mid-sized Hall A, 1F）
Speakers：
Koichi Inoue（Sakurabashi Watanabe Hospital, Osaka, Japan）
Toshiya Kurotobi（Shiroyama Hospital, Osaka, Japan）
Takanori Yamaguchi（Saga-ken Medical Centre Koseikan, Saga, Japan）
Hideko Toyama（Fukuoka Sanno Hospital, Fukuoka, Japan）
Koji Kumagai（Gunma Prefectural Cardiovascular Center, Maebashi, Japan）
Roland Richard Tilz（University Hospital Lübeck, Lübeck, Germany）
Takashi Ashihara（Shiga University of Medical Science, Otsu, Japan）
Chairpersons：
Koichiro Kumagai（Heart Rhythm Center, Fukuoka Sanno Hospital, Fukuoka, Japan）
Atsushi Takahashi（Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan）

Symposium 20

International Research Symposium of Inherited Arrhythmias　
Date：
Saturday, July 16, 9:30-11:30
Room：
Room 6（Meeting Room 107-108, 1F）
Speakers：
Hideki Itoh（Shiga University of Medical Science, Otsu, Japan）
Christian Dina（Université de Nantes, Nantes, France）
Chairpersons：
Minoru Horie（Shiga University of Medical Sciences, Otsu, Japan）
Wataru Shimizu（Nippon Medical School, Tokyo, Japan）
Speaker：
Toshihiro Tanaka（Tokyo Medical and Dental University, Tokyo, Japan）
Chairperson：
Hiroshi Watanabe（Niigata University, Niigata, Japan）
Speaker：
Vincent M. Christoffels（Academic Medical Center, Amsterdam, the Netherlands）
Chairpersons：
Naomasa Makita（Nagasaki University, Nagasaki, Japan）
Jean-Jacques Schott（Université de Nantes, Nantes, France）

Symposium 21

Treatment of Atrial Fibrillation and Genetic Background　
Date：
Saturday, July 16, 15:30-17:00
Room：
Room 6（Meeting Room 107-108, 1F）
Speakers：
Vincent Christoffels（Academic Medical Center, Amsterdam, the Netherlands）
James Martin（Baylor College of Medicine, Houston, USA）
Liu Lian（Tokyo Medical and Dental University, Tokyo, Japan）
Masahide Harada（Fujita Health University, Toyoake, Japan）
Kanae Hasegawa（University of Fukui, Fukui, Japan）
Yoshihide Takahashi（National Hospital Organization Disaster Medical Center, Tokyo, Japan）
Chairpersons：
Haruaki Nakaya（Chiba University, Chiba, Japan）
Yuji Murakawa（Teikyo University School of Medicine, Tokyo, Japan）

Symposium 22

Diagnosis and Treatment of Cardiac Sarcoidosis Up To Date　
Date：
Saturday, July 16, 9:30-11:30
Room：
Room 7（Small Hall, 2F）
Keynote Lecture：
William Henry Sauer（University of Colorado, Denver, USA）
Speakers：
Nobuhiro Tahara（Kurume University, Kurume, Japan）
Kensuke Hirasawa（Tokyo Medical and Dental University, Tokyo, Japan）
Toshiyuki Nagai（National Cerebral and Cardiovascular Center, Suita, Japan）
Kazuhiro Satomi（Tokyo Medical University, Tokyo, Japan）
Chairpersons：
Kengo Kusano（National Cerebral and Cardiovascular Center, Suita, Japan）
William Henry Sauer（University of Colorado, Denver, USA）

Symposium 23

Recent Progress and Future Prospects for Treating Cardiac Arrhythmias in Heart Failure　
Date：
Saturday, July 16, 14:30-16:00
Room：
Room 7（Small Hall, 2F）
Keynote Lecture：
Fiorenzo Gaita（University of Turin, Turin, Italy）
Speakers：
Tetsushi Furukawa（Tokyo Medical and Dental University, Tokyo, Japan）
Shih-Ann Chen（National Yang-Ming University, Taiwan）
Tsuyoshi Shiga（Tokyo Women' s Medical University, Tokyo, Japan）
John L. Sapp（Queen Elizabeth II Health Sciences Centre, Halifax, Canada）
Masahiro Maruyama（National Cerebral and Cardiovascular Center, Suita, Japan）
Chairpersons：
Nobuhisa Hagiwara（Tokyo Women' s Medical University）
Fiorenzo Gaita（University of Turin, Turin, Italy）

Symposium 24

The Treatment of Device Infection : The Current Status and Problems　
Date：
Saturday, July 16, 13:30-15:00
Room：
Room 8（Meeting Room 204, 2F）
Speakers：
Yusuke Kondo（Chiba University Graduate School of Medicine）
Ryuta Henmi（Tokyo Women’s Medical University）
Masato Fukunaga（Kokura Memorial Hospital）
Mitsuru Wada（National Cerebral and Cardiovascular）
Masahiko Goya（Tokyo Medical and Dental University）
Katsuhiko Imai（Hiroshima University）
Chairpersons：
Taijiro Sueda（Hiroshima University Graduate School of Medicine）
Masataka Mitsuno（Hyogo College of Medicine）

Symposium 25

State of the Art: Antiarrhythmic Management of Atrial Fibrillation　
Date：
Sunday, July 17, 8:30-10:00
Room：
Room 1（Conference Hall, 1F）
Keynote Lecture：
Alan John Camm（St. George' s University of London, London, UK）
Speakers：
Mitsunori Maruyama（Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan）
Takashi Tokano（Juntendo University Urayasu Hospital, Urayasu, Japan）
Akinori Sairaku（Hiroshima University, Hiroshima, Japan）
Tsuyoshi Shiga（Tokyo Women' s Medical University, Tokyo, Japan）
Chairpersons：
Hirotsugu Atarashi（Tsurumaki Onsen Hospital, Kanagawa, Japan）
Alan John Camm（St. George' s University of London, London, UK）

Symposium 26

Periprocedural Management of Atrial Fibrillation Patients Taking Oral Anti-coagulant　
Date：
Sunday, July 17, 10:00-11:30
Room：
Room 1（Conference Hall, 1F）
Keynote Lecture：
Koichi Inoue（Sakurabashi Watanabe Hospital）
Speakers：
Kenzo Hirao（Tokyo Medical and Dental University）
Koji Miyamoto（National Cerebral and Cardiovascular Center）
Kohki Nakamura（Gunma Prefectural Cardiovascular Center）
Michifumi Tokuda（Jikei University）
Taishi Kuwahara（Yokosuka Kyousai Hospital）
Chairpersons：
Koichi Inoue（Sakurabashi Watanabe Hospital）
Shigeto Naito（Gunma Prefectural Cardiovascular Center）

Symposium 27

Silent Atrial Fibrillation: Diagnosis, Therapy and Prognosis　
Date：
Sunday, July 17, 10:00-11:30
Room：
Room 2（Main Hall A, 1F）
Keynote Lecture：
Chu-Pak Lau（The University of Hong Kong, Hong Kong）
Speakers：
Toshiko Nakai（Nihon University School of Medicine, Tokyo, Japan）
Masahiro Esato（Ijinkai Takeda General Hospital, Kyoto, Japan）
Alan John Camm（St. George' s University of London, London, UK）
Yoshiyuki Hama（Kimitsu Chuo Hospital, Kisarazu, Japan）
Yasuyuki Iguchi（The Jikei University School of Medicine）
Chairpersons：
Teiichi Yamane（The Jikei University School of Medicine, Tokyo, Japan）
Chu-Pak Lau（The University of Hong Kong, Hong Kong）

Symposium 28

New Developments of Catheter Ablation for Outflow Tract Ventricular Tachycardia　
Date：
Sunday, July 17, 8:30-10:00
Room：
Room 3（Mid-sized Hall A, 1F）
Speakers：
Suguru Nishiuchi（Graduate School of Medicine and Faculty of Medicine Kyoto University, Kyoto, Japan）
Takumi Yamada（University of Alabama at Birmingham, Birmingham, USA）
Pasquale Santangeli（University of Pennsylvania, Philadelphia, USA）
Yasuhiro Shirai（Tokyo Medical and Dental University, Tokyo, Japan）
Chairpersons：
Mitsuhiro Nishizaki（Yokohama Minami Kyosai Hospital, Yokohama, Japan）
Takumi Yamada（University of Alabama at Birmingham, Birmingham, USA）

Symposium 29

Septal Ventricuar Tachycardias: Diagnosis and Recent Evolution of Mapping and Ablation　
Date：
Sunday, July 17, 10:00-11:30
Room：
Room 3（Mid-sized Hall A, 1F）
Speakers：
Katja Zeppenfeld（Leiden University Medical Center, the Netherlands）
Andre Luiz Buchele d'Avila（Hospital Cardiologico, Florianopolis, Brazil）
Miyako Igarashi（Tsuchiura Kyodo General Hospital, Tsuchiura, Japan）
John L. Sapp（Queen Elizabeth II Health Sciences Centre, Halifax, Canada）
Chairpersons：
Hiroshi Tada（University of Fukui, Fukui, Japan）
John L. Sapp（Queen Elizabeth II Health Sciences Centre, Halifax, Canada）

Symposium 30

Current Management of Tachyarrhythmia by Catheter Ablation in Congenital Heart Disease　
Date：
Sunday, July 17, 13:30-15:00
Room：
Room 3（Mid-sized Hall A, 1F）
Keynote Lecture：
George F. Van Hare（Washington University School of Medicine, Saint Louis, USA）
Speakers：
Yoshihito Hata（Showa University Northern Yokohama Hospital, Yokohama, Japan）
Keiko Toyohara（Tokyo Women' s Medical University, Tokyo, Japan） Katja Zeppenfeld（Leiden University Medical Center, Leiden, the Netherlands）
Chairpersons：
Naokata Sumitomo（Saitama Medical University International Medical Center, Saitama, Japan）
George F. Van Hare（Washington University School of Medicine, Saint Louis, USA）

Symposium 31

Atrial Fibrillation and Autonomic Nerve Function　
Date：
Sunday, July 17, 8:30-10:00
Room：
Room 6（Meeting Room 107-108, 1F）
Speakers：
Peng-Sheng Chen（The Krannert Institute of Cardiology, Indiana University, USA）
Kyoichi Ono（Akita University）
Masahide Harada（Fujita Health University）
Takashi Ashihara（Shiga University of Medical Sciences）
Kohei Yamashiro（Takatsuki General Hospital）
Chairpersons：
Katsushige Ono（Oita University）
Eiichi Watanabe（Fujita Health University）

Symposium 32

Catheter Ablation for Brugada Syndrome: Should We Target the Trigger or the Substrate of Ventricular Fibrillation?　
Date：
Sunday, July 17, 9:30-11:00
Room：
Room 7（Small Hall, 2F）
Keynote Lecture：
Yasuya Inden（Nagoya University Graduate School of Medicine, Nagoya, Japan）
Speakers：
Atsuyuki Watanabe（University of Okayama, Okayama, Japan）
Ahmed Talib（University of Tsukuba, Tsukuba, Japan）
Koonlawee Nademanee（Pacific Rim Electrophysiology Research Institute, Los Angeles, USA）
Hiroshi Nakagawa（University of Oklahoma Health Sciences Center, Oklahoma City, USA）
Chairpersons：
Yasuya Inden（Nagoya University Graduate School of Medicine, Nagoya, Japan）
Masahiko Takagi（Osaka City University Graduate School of Medicine, Osaka, Japan）

Medical Professional Symposia

Medical Professional Symposium 1

Remote Monitoring　
Date：
Friday, July 15, 9:00-10:30
Room：
Room 4（Mid-sized Hall B）
Speakers：
Tomohide Yonemura（Saiseikai Kumamoto Hospital）
Ayumi Yamauchi（Urasoe General Hospital）
Yuki Takenaka（Okayama University Hospital）
Masahisa Arimichi（The Sakakibara Heart Institute of Okayama）
Kenji Isomura（Osaka University Hospital）
Chairpersons：
Mari Hirai（Nagoya University）
Akiko Maeda（Kyorin University Hospital）

Medical Professional Symposium 2

Clinical Engineer’s Role in the Management of Cryoablation and Hot Balloon Ablation　
Date：
Friday, July 15, 14:00-15:30
Room：
Room 4（Mid-sized Hall B）
Speakers：
Aiko Fujimaki（Tokyo Medical and Dental University Hospital）
Ayaka Suzuki（Sapporo Cardio Vascular Center）
Akihiro Watanabe（Dokkyo University Koshigaya Hospital）
Kan Usui（Kurashiki Central Hospital）
Kyoichi Chijimi（Hospital of University of Tsukuba）
Chairpersons：
Koji Kumagai（Gunma Prefectural Cardiovascular Center）
Kyoichi Chijimi（Hospital of University of Tsukuba）

Medical Professional Symposium 3

Roles of Clinical Engineer in Mapping and Ablation Equipment　
Date：
Friday, July 15, 15:30-17:00
Room：
Room 4（Mid-sized Hall B）
Speakers：
Kyoichi Chijimi（Hospital of University of Tsukuba）
Takafumi Mutou（Ichinomiya Nishi Hospital）
Kenji Yasuda（Tenri Hospital）
Takuya Okada（Sapporo Cardio Vascular Center）
Daigo Tokudome（Yokohama Rosai Hospital）
Chairpersons：
Kikuya Uno(Sapporo Cardio Vascular Center）
Daigo Tokudome（Yokohama Rosai Hospital）

Medical Professional Symposium 4

Role of Clinical Engineer in Cardiac Programmed Stimulation　
Date：
Saturday, July 16, 8:30-10:00
Room：
Room 4（Mid-sized Hall B）
Speakers：
Masayoshi Shibata（Hokkaido Cardiovascular Hospital）
Motohiro Nakajima（Chiba University Graduate School of Medicine）
Yusuke Sakagen（Hospital of University of Tsukuba）
Chairpersons：
Yukihiko Yoshida（Nagoya Daini RedCross Hospital）
Fumiya Uchida（Mie Heart Center）

Medical Professional Symposium 5

The team management for patients with cardiac arrhythmia after hospital discharge　
Date：
Saturday, July 16, 13:30-15:00
Room：
Room 4（Mid-sized Hall B）
Speakers：
Ai Ozawa（Nagasawa Clinic）
Reiko Suga（Tottori Prefectural Central Hospital）
Mikiko Ajima（University of Tsukuba）
Masahisa Arimichi（The Sakakibara Heart Institute of Okayama）
Chisato Nagamachi（SakakibaraHeartInstituteClinic）
Chairpersons：
Yumie Matsui（Osaka Saiseikai Izuo Hospital）
Yoshirou Sakai（Saiseikai Kumamoto Hospital）

Medical Professional Symposium 6

Role of medical partners in device therapies for patients with various arrhythmias　
Date：
Sunday, July 17, 13:30-15:00
Room：
Room 4（Mid-sized Hall B）
Speakers：
Masaki Maekawa（Ohama Daiichi Hospital）
Mami Miyazono（Fukuoka Prefectural University）
Aiko Kohda（Natinal Cerebral and Cardiaovascular Center）
Hitoshi Ono（Chiba University Hospital）
Chairpersons：
Akiko Chishaki（Kyushu University）
Eri Miura（Tokyo Medical and Dental University Hospital）

Medical Professional Symposium 7

Role of Nurse in Interventional EP Lab　
Date：
Sunday, July 17, 15:00-16:30
Room：
Room 4（Mid-sized Hall B）
Speakers：
Watanabe Tomomi（New Tokyo Hospital）
Hiroko Nonaka（Miyazaki Medical Association Hospital）
Mayu Yoshida（Tenri hopital）
Hideyuki Morisawa（Tokai University Hachioji Hospital）
Chairpersons：
Junichi Nitta（Saitama Redcross Hospital）
Tsutom Umezu（University of Tsukuba Hospital）

Topics Designated by the JHRS Academic Committee　

Date：
Friday, July 15, 9:00-10:30
Room：
Room 2（Main Hall A, 1F）
Speakers：
Takanori Ikeda（Toho University Faculty of Medicine）
Shiro Kamakura（National Cerebral and Cardiovascular Center）
Yuji Nakazato（Juntendo University Urayasu Hospital）
Chairpersons：
Ken Okumura（Saiseikai Kumamoto Hospital）
Katsushige Ono（Oita University）

Electrocardiology Frontiers 2016　

Date：
Saturday, July 16, 13:30-15:30
Room：
Room 6（Meeting Room 107-108, 1F）
Speakers：
Toru Maruyama（Kyushu University）
Katsushige Ono（Oita University）
Nobuyuki Sato（Asahikawa Medical University）
Yoshino Minoura（Showa University）
Yoshiaki Kaneko（Gunma University）
Takeshi Kitamura（Tokyo Metropolitan Hiroo Hospital）
Chairpersons：
Katsushige Ono（Oita University）
Toru Maruyama（Kyushu University）

Joint Symposia

JHRS-APHRS Joint Symposium

Cure of Chronic Atrial Fibrillation: Challenges by New Ablation Strategies　
Date：
Friday, July 15, 16:00-18:00
Room：
Room 1（Conference Hall, 1F）
KeynoteLecture：
Young-Hoon Kim（Korea University Medical Center, Seoul, Korea）
State-of-the-Art Lecture：
Yoshito Iesaka（Tsuchiura Kyodo Hospital, Tsuchiura, Japan）
Speakers：
Minglong Chen（Nanjing Medical University Hospital, Nanjing, China）
Hiro Yamazaki（University of Tsukuba, Tsukuba, Japan）
Christopher Piorkowski（Heart Center Dresden University, Dresden, Germany）
Chairpersons：
Yoshito Iesaka（Tsuchiura Kyodo Hospital, Tsuchiura, Japan）
Young-Hoon Kim（Kore6a University Medical Center, Seoul, Korea）

JHRS-JHFS Joint Symposium　

Therapeutic Strategies for Arrhythmias Complicating Heart Failure　
Date：
Sunday, July 17, 13:30-15:30
Room：
Room 8（Meeting Room 204, 2F）
I. Atrial Fibrillation
Speakers：
Koichiro Kinugawa（University of Toyama）
Hiroshi Tada（University of Fukui）
II. Life-Threatening Ventricular Arrhythmias
Speakers：
Shinichi Momomura（Saitama Medical Center Jichi Medical University）
Takashi Kurita（Kinki University）
III. Mechanical Remodeling and Dyssynchrony
Speakers：
Akihiko Nogami（University of Tsukuba）
Hiroshi Ito（Okayama University）
Chairpersons：
Hideo Mitamura（Tachikawa Hospital）
Hiroyuki Tsutsui（Hokkaido University Graduate School of Medicine）

JHRS-CDR Joint Symposium　

Date：
Saturday, July 16, 9:00-10:30
Room：
Room 8（Meeting Room 204, 2F）
Chairpersons：
Toshiyuki Ishikawa（Yokohama City University Hospital）
Takashi Kurita（Kinki University）

JHRS-HRS Joint Symposium

Neural Control of the Heart-Implications for Clinical Electrophysiology　
Date：
Sunday, July 17, 14:30-16:30
Room：
Room 1（Conference Hall, 1F）
Speakers：
Kalyanam Shivkumar（University of California Los Angeles, Los Angeles, USA）
Peng-Sheng Chen（The Krannert Institute of Cardiology, Indiana University, USA）
Yuichiro Sakamoto（Toyohashi Heart Center, Toyohashi, Japan）
Akihiko Nogami（University of Tsukuba, Tsukuba, Japan）
Chairpersons：
Hiroshi Nakagawa（University of Oklahoma Health Sciences Center, Oklahoma City, USA）
Peng-Sheng Chen（The Krannert Institute of Cardiology, Indiana University, Indianapolis, USA）

JHRS-EHRA Joint Symposium

New Frontier of Balloon Based Technology for Ablation of Atrial Fibrillation　
Date：
Sunday, July 17, 8:30-10:00
Room：
Room 2（Main Hall A, 1F）
Speakers：
Andreas Metzner（Asklepios Klinik St Georg, Hamburg, Germany）
Saman Nazarian（Johns Hopkins University School of Medicine, Baltimore, USA）
Kazuo Matsumoto（Higasimatsuyama Medical Association Hospital Higasimatsuyama, Japan）
Hiroshi Sohara（Osaki Hospital Tokyo Heart Center, Tokyo, Japan）
Chairpersons：
Kaoru Okishige（Yokohama City Minato Red Cross Hospital, Yokohama, Japan）
Andreas Metzner（Asklepios Klinik St Georg, Hamburg, Germany）

JHRS-JSMBE Joint Symposium　

Current Status and Future Perspective of Biomedical Engineering in Electrocardiology and Arrhythmia Studies
Date：
Sunday, July 17, 13:30-15:00
Room：
Room 6（Meeting Room 107-108, 1F）
Speakers：
Eiichi Watanabe（Fujita Health University）
Shingo Tsukada（NTT Basic Research Laboratories）
Takashi Ashihara（Shiga University of Medical Sciences）
Naoki Tomii（Tokyo University）
Chairpersons：
Ichiro Sakuma（The University of Tokyo）
Masatoshi Yamazaki（Nagoya University）

Tawara-Aschoff Symposium

AV node Update
Date：
Sunday, July 17, 10:00-11:30
Room：
Room 6（Meeting Room 107-108, 1F）
Speakers：
Shin Inoue（Showa University of Medicine, Tokyo, Japan）
Roland Richard Tilz（University Hospital Lübeck, Lübeck, Germany）
Tetsuo Yagi（Sendai City Hospital, Sendai, Japan）
Yoshiaki Kaneko（Gunma University Graduate School of Medicine, Gunma, Japan）
Shephal Kirit Doshi（Pacific Heart Institue, Santa Monica, USA）
Chairpersons：
Kan Takayanaghi（Kasukabe Kosei Hospital, Kasukabe, Japan）
Youichi Kobayashi（Showa University of Medicine, Tokyo, Japan）

The 5th Antiarrhythmic Therapy Summit　

Date：
Saturday, July 16, 14:30-17:00
Room：
Room 2（Main Hall A, 1F）
Opening Remarks：
Kazutaka Aonuma（University of Tsukuba, Tsukuba, Japan）
Part 1　
Speakers：
Manabu Ikeda（Kumamoto University）
Ken Nagata（Yokohama General Hospital）
Ken Okumura（Saiseikai Kumamoto Hospital）
Chairpersons：
Hiroshi Inoue（Saiseikai Toyama Hospital）
Naohiko Takahashi（Oita University）
Part 2　
Speakers：
Toshihiro Tanaka（Tokyo Medical and Dental University）
Katsushige Ono（Oita Universitye）
Takanori Ikeda（Toho University Faculty of Medicine）
Chairpersons：
Hideo Mitamura（Tachikawa Hospital）
Wataru Shimizu（Nippon Medical School）
Closing Remarks：
Hirotsugu Atarashi（Nippon Medical School Tama Nagayama Hospital）

The 5th Ablation・Device Summit　

Date：
Sunday, July 17, 14:00-16:30
Room：
Room 2（Main Hall A, 1F）
Part 1 Ablation
Speakers：
Ritsushi Kato（Saitama Medical University）
Ken Tsuchiya（Team Tsuchiya）
Chairpersons：
Kazuo Matsumoto（Higasimatsuyama Medical Association Hospital）
Koichiro Kumagai（Fukuoka Sanno Hospital）
Part 2 Device
Speakers：
Yoshihiro Seo（University of Tsukuba）
Yoko Morishima（Ogaki Municipal Hospital）
Chairpersons：
Hiroshi Tada（University of Fukui）
Toshiko Nakai（Nihon University）

Unknown EP Tracing: Learn from the Experts

Date：
Saturday, July 16, 8:30-10:00
Room：
Room 3（Mid-sized Hall A, 1F）
Speakers：
Samuel J. Asirvatham（Mayo Clinic, Rochester, USA）
Hui-Nam Pak（Yonsei University Health System, Seoul, Korea）
Akihiko Nogami（University of Tsukuba, Tsukuba, Japan）
Chairpersons：
Samuel J. Asirvatham（Mayo Clinic, Rochester, USA）

Emerging Leaders

Date：
Sunday, July 17, 15:00-16:30
Room：
Room 3（Mid-sized Hall A, 1F）
Speakers：
Min-Tsun Liao（National Taiwan University Hospital, Taipei City, Taiwan）
Yue Yan Katherine FAN（Grantham Hospital, Hong Kong）
Yuko Inoue（National Cerebral and Cardiovascular Center Japan, Suita, Japan）
Nobuhiro Nishii（Okayama University, Okayama, Japan）
Chairpersons：
David O’Donnell（Austin Hospital, Melbourne, Australia）
Takashi Kurita（Kinki University, Osaka, Japan）

Sedation during catheter ablation and device-based therapy of cardiac arrhythmia　

Date：
Sunday, July 17, 13:30-15:00
Room：
Room 7（Small Hall, 2F）
Speakers：
Yoshimi Inagaki（Tottori University）
Takayuki Kunisawa（Asahikawa Medical University）
Takanori Yamaguchi（Saga-ken Medical Centre Koseikan）
Morio Shoda（Tokyo Women's Medical University）
Chairpersons：
Yasushi Miyauchi（Nippon Medical School Chiba Hokusoh Hospital）
Masaomi Chinushi（Niigata University）

Insurance Committee Session　

Date：
Sunday, July 17, 8:30-10:00
Room：
Room 8（Meeting Room 204, 2F）
Speakers：
Yuji Ishida（Hirosaki University）
Masahiko Takagi（Osaka City University Graduate School of Medicine）
Hisashi Yokoshiki（Hokkaido University Hospital）
Katsuhiko Imai（Hiroshima University Hospital）
Jun Yoshimoto（Shizuoka Childrens Hospital）
Chairpersons：
Teiichi Yamane（Jikei University）
Katsuhiko Imai（Hiroshima University Hospital）

Educational Lectures

Educational Lecture 1　
Date：
Friday, July 15, 10:30-11:30
Room：
Room 7（Small Hall, 2F）
Speakers：
Shigeyuki Watanabe（Mito Kyodo General Hosptal）
Eiichi Watanabe（Fujita Health University）
Chairperson：
Ritsuko Kono（University of Occupational and Environmental Health）
Educational Lecture 2　
Date：
Friday, July 15, 14:00-15:00
Room：
Room 7（Small Hall, 2F）
Speaker：
Hideo Okamura（Mayo Clinic, Rochester, Minnesota, USA）
Chairperson：
Masayuki Sakurai（Hokko Memorial Hospital）
Educational Lecture 3　
Date：
Saturday, July 16, 8:30-9:30
Room：
Room 7（Small Hall, 2F）
Speaker：
Takeshi Mitsuhashi（Saitama Medical Center Jichi Medical University）
Chairperson：
Harumizu Sakurada（Ohkubo Hospital）
Educational Lecture 4　
Date：
Saturday, July 16, 13:30-14:30
Room：
Room 7（Small Hall, 2F）
Speaker：
Fumio Suzuki（Fukujuji Hospital）
Chairperson：
Kaoru Sugi（Toho University Ohashi Medical Center）
Educational Lecture 5
Anatomic Considerations in VT Ablation：Efficacy and Safety
Date：
Sunday, July 17, 8:30-9:30
Room：
Room 7（Small Hall, 2F）
Speaker：
Samuel Jayaprakash Asirvatham（Mayo Clinic, Rochester, USA）
Chairperson：
Hitoshi Hachiya（Tsuchiura Kyodo General Hospital, Tsuchiura, Japan）

Educational Seminars

Educational Seminar 1　
Date：
Friday, July 15, 10:00-11:00
Room：
Room 5（Meeting Room 104-105）
Speaker：
Osamu Igawa（Nippon Medical School Tama Nagayama Hospital）
Educational Seminar 2　
Date：
Saturday, July 16, 10:00-11:00
Room：
Room 5（Meeting Room 104-105）
Speaker：
Osamu Igawa（Nippon Medical School Tama Nagayama Hospital）

Mirowski Fellowship Program Memorial Lecture　

Date：
Sunday, July 17, 10:30-11:30
Room：
Room 11（Meeting Room 201-202, 2F）
Speakers：
David S. Cannom（Good Samaritan Hospital, Cedars-Sinai Heart Institute, UCLA, Los Angeles, USA）
Yasushi Oginosaw（University of Occupational and Environmental Health）
Itsuro Morishima（Ogaki Municipal Hospital）
Mitsuharu Kawamura（Showa University of Medicine）
Chairpersons：
Ken Okumura（Saiseikai Kumamoto Hospital）
Minoru Horie（Shiga University of Medical Sciences）

The JHRS Paper Award Competition Sponsored by Suzuken Memorial Foundation　

Date：
Sunday, July 17, 14:30-15:00
Room：
Room 11（Meeting Room 201-202, 2F）
Chairperson：
Yuji Murakawa（Teikyo University）

Final Selection Committee for the Academic Excellence Award of the JHRS　

Date：
Friday, July 15, 14:00-15:00
Room：
Room 11（Meeting Room 201-202, 2F）
Chairperson：
Wataru Shimizu（Nippon Medical School）

JHRS Paper Award Competition　

Date：
Sunday, July 17, 15:00-15:30
Room：
Room 11（Meeting Room 201-202, 2F）
Chairperson：
Hiroshi Inoue（Saiseikai Toyama Hospital）

Journal of Arrhythmia（JOA） Best Article of the Year 2015　

Date：
Friday, July 15, 17:00-18:00
Room：
Room 11（Meeting Room 201-202, 2F）
Chairpersons：
Naohiko Takahashi（Oita University）
Tsuyoshi Shiga（Tokyo Women's Medical University）

Educational Courses

Educational Course 1　
Date：
Friday, July 15, 18:10-21:10
Room：
Room 2（Main Hall A, 1F）
Speakers：
Naohiko Takahashi（Oita University）
Yuji Maemura（Nagasaki University）
Haruhiko Abe（University of Occupational and Environmental Health）
Chairpersons：
Hiroshi Inoue（Saiseikai Toyama Hospital）
Takanori Ikeda（Toho University Faculty of Medicine）
Educational Course 2　
Date：
Saturday, July 16, 18:00-21:00
Room：
Room 2（Main Hall A, 1F）
Speakers：
Syun Kosaka（Keio University）
Koichiro Ejima（Tokyo Women's Medical University）
Chairpersons：
Kazuhiro Satomi（Tokyo Medical University）

Open Lecture（Phamacist）　

Date：
Friday, July 15, 18:30-21:00
Room：
Room 4（Mid-sized Hall B）
Opening Remarks：
Kazuyuki Ueno（Niigata University of Pharmacy and Applied Life Sciences）
Speakers：
Takashi Kurita（Kinki University）
Tsuyoshi Shiga（Tokyo Women's Medical University）
Masahiro Yasaka（Kyushu Medical Center）
Conclusion：
Hirotsugu Atarashi（Nippon Medical School Tama Nagayama Hospital）
Chairperson：
Kazuyuki Ueno（Niigata University of Pharmacy and Applied Life Sciences）

J-IVFS Session（Japan Idiopathic Ventricular Fibrillation Study）　

Date：
Saturday, July 16, 10:00-11:30
Room：
Room 3（Mid-sized Hall A, 1F）
Speakers：
Masahiko Takagi（Osaka City University Graduate School of Medicine）
Yasuhiro Yokoyama（St.Louis University）
Yukio Sekiguchi（University of Tsukuba）
Koonlawee Nademanee（Pacific Rim Electrophysiology Research Institute, USA）
Chairpersons：
Masayasu Hiraoka（Toride Kitasohma Medical Center Hospital）
Mitsuhiro Nishizaki（Yokohama Minami Kyosai Hospital）

Tokyo-Taipei-Seoul Conference

Date：
Saturday, July 16, 13:30-15:00
Room：
Room 9（Meeting Room 206, 2F）
Welcome speech：
Masayasu Hiraoka（Tokyo）
Opening address：
Shih-Ann Chen（Taipei）
Sesshion 1．Role of Imaging in Diagnosis and Risk Stratification of Life Threatening Ventricular Arrhythmias/Sudden Cardiac Death
Speakers：
Tetsuji Shinohara（Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan）
Jaemin Shim（Department of Cardiology, Korea University Anam Hospital, Seoul, Korea）
Fa-Po Chung（Department of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan）
Chairpersons：
Yoshinori Kobayashi（Tokai University Hachioji Hospital, Tokyo）
Dong Gu Shin（Yeongnam University Hospital, Daegu, Korea）
Tsu-Juey Wu（Taichung Veterans General Hospital, Taipei）
Sesshion 2．Management of cardiac Arrhythmias in Adult Congenital Heart Diseases
Speakers：
Yen-Jiang Lin（Department of Cardiology, Taipei Veterans General Hospital, Taipei）
Morio Shoda（Department of Cardiology, Tokyo Women's Medical University, Tokyo）
Jae-Sun Uhm（Department of Cardiology, Yonsei University, Seoul）
Chairpersons：
Chen-Chuan Cheng（Chi-Mei Medical Center, Taipei）
Kee-Joon Choi（Asan Medical Center, Seoul）
Morio Shoda（Tokyo Women's Medical University, Tokyo）
Closing Remarks：
Young-Hoon Kim（Korea University, Seoul）

New Era of 3D Electroanatomical Mapping for Complex Arrhythmias

Chairpersons： Hiroshi Nakagawa
  (University of Oklahoma Health Sciences Center, USA)
  Morio Shoda
  (Tokyo Women's Medical University)

Current 3D electroanatomical mapping systems accurately localize the site of earliest activation in focal tachycardias and are able to identify the reentrant circuit and localize arrhythmogenic channels in macroreentrant tachycardias. However, current systems have several limitations: 1) relatively low resolution; 2) difficulty in selecting the appropriate activation time in scarred areas with multiple low amplitude potentials; and 3) require relatively long mapping times. The requirement to manually annotate the activation time at sites with complex electrograms has limited the use of these systems in localizing arrhythmogenic channels in macroreentrant circuits in many laboratories. Non-contact mapping systems also have limitations within scarred regions, having difficulty reconstructing low amplitude potentials, and mapping accuracy is limited to sites close to the probe. This session will cover the recent progress of 3D mapping systems, including phase mapping, panoramic body surface mapping and automatic, high-resolution mapping in patients with complex atrial and ventricular arrhythmias.

Periprocedural Management of Atrial Fibrillation Patients Taking Oral Anti-coagulant

Chairpersons： Koichi Inoue
  (Sakurabashi Watanabe Hospi)

梗塞リスクを伴う非弁膜症性心房細動患者に対して、心原性脳梗塞・全身性塞栓症の予防のための抗凝固療法は必須である。経口抗凝固療薬がワルファリンしかなかった時代から、非ビタミンK依存型抗凝固薬（NOAC）が使える時代になり数年がたつ。ガイドラインでもワルファリンよりもNOACが望ましいと位置づけられ、リアルワールドにおけるNOACの使用経験も蓄積され、さらに、よりハイリスクでチャレンジングな状況でのNOAC使用に関する知見も徐々に深まってきている。本シンポジウムでは、「観血的処置の周術期」という「抗凝固療法のリスクとベネフィットのバランスをとるのが難しい状況における抗凝固療法はどうあるべきか」をテーマとした。ワルファリンとNOACのどちらが有用か、NOAC間で差異はあるのか、投与のプロトコルはどうするべきか、アブレーションの場合はどうか、ハイリスク患者やハイリスク手術ではどうするべきか、ヘパリンブリッジは有用か、などこのテーマで解決すべき課題は未だ多い。これらについて本邦の患者におけるデータをもとにして議論し，より有効かつ安全な抗凝固療法を見出す一助としたい。

Atrial Fibrillation and Autonomic Nerve Function

座長： 小野　克重 (大分大学医学部病態生理学講座)
  渡邉　英一 (藤田保健衛生大学医学部 循環器内科)

心臓は自律神経機能の活動によって興奮性が調節を受ける。心房筋及び心房筋近傍組織には交感神経と副交感神経（迷走神経）が密に分布しており、心房の容量負荷や伸展情報を延髄の心臓血管中枢に投影するだけでなく、圧受容体反射の遠心路などを介して様々な機能の調節を受ける。自律神経の活性化は心房細動をはじめとする頻脈性心房期外収縮の原因となり、自律神経活動の制御によって心房細動を停止させることも可能であるし、悪化させることもあり得る。心房細動の発症の背景には、炎症、加齢、遺伝子異常、内分泌異常等の様々な因子が複雑に関与しているが、本シンポジウムでは自律神経活動に的を絞り、関与のメカニズムを切り口を変えて解析する。ここでは心房筋の電気生理学的活動に対する自律神経の働きを、細胞レベルからアブレーションカテーテル治療法までの多角的なアプローチによって明らかにし、自律神経活動がどのようにして心房細動の発症と維持に関わり、更に抗不整脈手法としての自律神経活動の管理の重要性を実証することを目的とした。

State of Arts in Arrhythmia Research: Simulation and Development/Regeneration

Coordinator : Tetsushi Furukawa
  (Tokyo Medical and Dental University)
Chairperson： Minoru Horie
  (Shiga University of Medical Sciences)

The mechanism of arrhythmias has been advanced through multiple methodologies: intra-cellular potential recording, patch-clamp technique, intra-cardiac potential recording in animal models, and recently molecular biology. We certainly have learned a lot on the mechanism of arrhythmia by a means of these approaches; however, it is also evident that elucidation with these conventional techniques carry their intrinsic limitation, and in order to further advance our understanding, the introduction of new approaches is mandatory. Among various candidates of new approaches in arrhythmia study, this symposium will focus on two innovative methodologies: computer simulation and cardiomyocyte development/regeneration.

The computer simulation has conventionally been used to generate a single cell action potential model. The state-of-art technology has advanced the computer simulation to the level of generating a 3D electrical propagating model associated with 3D imaging. This approach will have a potential to improve the catheter ablation technique in the clinical setting. Prof. N. Trayanova and Dr. T. Ashihara will take care of this initial part of session.

Mammalian heart is originated from the primary heart field and the secondary heart field. Arrhythmias not associated with cardiovascular diseases occur from the peripheral region of the heart, and the heart region derived from the secondary heart field, and their interaction appears to play an important role. Thus, the study of cardiac development would give us new ideas regarding the arrhythmogeneity. In this part of session, Prof. V. Christoffels, Prof. I Hisatome and Prof. T. Furukawa will present their most updated research data.

We hope this symposium will bring you brainstorming, and provide new ways of thinking on arrhythmia researches. We also hope that this symposium will enhance the translation of the findings obtained in basic researches to clinical practice, and stimulate collaborated work between basic and clinical arrhythmia researchers.

Identification of CRT responders

Chairperson：Takashi Kurita

(Kinki University)


　Cardiac resynchronization therapy (CRT) has been established as the essential strategy to improve the mortality and QOL of patients with an impaired left ventricular function and wide QRS. The frontiers of CRT have been expected to expand the indication of this therapy for patients with mild heart failure (NHHA class I or II) or a narrow QRS. Recent large clinical trials (MADIT-RIT and RAFT) showed the positive results of an early indication of CRT for mild heart failure patients, and suggested that the electrocardiographic indices (QRS width >150 ms and left bundle branch block) are appropriate parameters to detect responders of CRT. On the contrary, EchoCRT study provided the negative impact of the echocardiographic evaluation of dyssynchrony for predicting responders of CRT in patients with a narrow QRS.

　Even using various evaluation methods, a certain amount of non-responders after CRT can be seen, and the proper identification of responders before the therapy is still a big concern for effectively using this expensive device. On the other hand, new developments in device capabilities, such as the “Quadripolar LV lead”, “Adoptive CRT” and “Multisite Pacing”, can be alternative approaches to reduce non-responders to CRT.

In this symposium, we will discuss the appropriate methods for speculating who will be responders to CRT, including the possibility echocardiograms provide, the role of advanced technologies in reducing non-responders, the next possible strategies when we encounter non-responders to CRT after the operation, and what is the highest percentage of responders we can expect to reach.

Current Management of Tachyarrhythmia by Catheter Ablation in Congenital Heart Disease

Chairperson： Naokata Sumitomo
（Saitama Medical University International Medical Center）

Recent advances in catheter ablation techniques have enable various types of atrial and ventricular arrhythmias to be cured for structural heart disease even in post operative congenital heart disease. The improvement of success rate of catheter ablation is largely depends upon the development of newer technologies of 3D mapping system, such as CARTO system. The 3D mapping system can visualize the isthmus of the arrhythmia circuit, with a detailed information of the anatomical structure and the prior surgical procedures of the underlining congenital heart disease. The arrhythmia circuit is mostly around anatomic obstacle, surgical incisions, and surgical patch or baffle of the previous surgery. To know the 3D information is one of the key points to success the catheter ablation of the tachyarrhythmia in congenital heart disease. However, catheter could not reach the optimal target point, because of the prior surgery, such as Fontan operation.
This symposium is aimed to introduce the current advanced management of tachyarrhythmia by catheter ablation in congenital heart disease.
KEYNOTE LECTURE     George F. Van Hare St Louis Children's Hospital, Washington University School of Medicine in St. Louis, St Louis Children's Hospital


演題名：Arrhythmias following repair of congenital heart disease

演者     Katja Zeppennfeld       Leiden University Medical Center 


演題名：Anatomical substrate and ablation of VT in Congenital heart disease

演者     Sabine Ernst    Royal Brompton Hospital       


演題名：Advanced ablation strategies for arrhythmia management in complex adult congenital heart disease

Septal VTs: Diagnosis and recent evolution of mapping and ablation.

Chairpersons： Hiroshi Tada (University of Fukui)

The ventricular septum is a major origin of ventricular tachycardia (VT): Among idiopathic VTs, most outflow tract VTs and some mitral and tricuspid annular VTs occur from the septum.  A rare and distinct type of verapamil-sensitive, left fascicular VT also could be ablated at the left upper septum (left upper septal VT).  In structural heart disease, especially in cardiac sarcoidosis and hypertrophic cardiomyopathy, the critical substrate of reentrant VTs is often found within the septum. 
In some VTs arising from the septum, because the VT origin and reentry substrate exist beyond the reach of ablation with the use of standard techniques, an open surgical approach is required for a cure.   However, recently emerged ablation techniques and instruments, such as bipolar radiofrequency ablation and intramyocardial infusion-needle catheter ablation may cure these kinds of septal VTs that have been refractory to the conventional catheter ablation therapy. 
In this symposium, eminent physicians in this field will present these issues and discuss how to diagnose and ablate septal VTs safely. 

Therapeutic Strategies for Arrhythmias Complicating Heart Failure

Chairpersons： Hideo　Mitamura (Tachikawa Hospital・Cardiology Division)
Hiroyuki Tsutsui (Hokkaido University Graduate School of Medicine)

Heart failure (HF) and arrhythmias often coexist and present a particular therapeutic challenge to clinicians.
Atrial fibrillation (AF) is a growing epidemic in the elderly, particularly with HF, associated with significant morbidity and mortality. Pharmacologic rhythm control has failed to improve outcomes compared with rate control. Catheter ablation of recent-onset AF offers an opportunity to achieve sinus rhythm without the downside of antiarrhythmic drugs. For chronic AF on the other hand, rate control is preferred whereas there is an ongoing debate on the safety of digoxin as well as β-blockers in HF+AF patients.
Life-threatening ventricular arrhythmias (VAs) in patients with HF are typically managed with implantable cardiac defibrillators (ICD). Although ICDs are highly effective in reducing sudden cardiac death, they do not prevent VA recurrences, loss of consciousness, or deterioration of ventricular function after recurrent shocks. Amiodarone or catheter ablation can be therapeutic options for patients with drug-refractory VAs to reduce or prevent ICD shocks.
There are additional unique electrical therapies in HF. Chronic arrhythmias such as frequent ectopic beats or sustained rapid ventricular response sometimes induce or worsen left ventricular dysfunction, which can be reversed by abolition of such arrhythmias by catheter ablation. Electrical dyssynchrony is another treatable mechanism of HF with regional conduction disturbances and can be treated with cardiac resynchronization therapy with biventricular pacing. However, a significant minority demonstrates nonresponse.
This symposium will discuss wide views of these important and exciting topics, which will be presented by distinguished experts from the 2 societies of HF and arrhythmia.

JHRS-EHRA Joint Symposium


New Frontier of Balloon Based Technology for Ablation of Atrial Fibrillation

Chairperson： Kaoru Okishige
  (Yokohama City Minato Red Cross Hospital)

　Radiofrequency catheter ablation by the “point-by-point” fashion around the orifices of pulmonary veins (PV) has been performed for the electrical isolation of PV in terms of the cure of atrial fibrillation (AF) these twenty years. However, it takes a relatively long time and the reconnection incidence associated with the recurrence of AF has been issues to be resolved for the sake of improvement of treatment of AF. Recently, the balloon-based ablation catheter systems such as cryoballoon, radiofrequency energy balloon, and laser balloon have been developed and released as the treatment options for refractory AF. Shorter ablation procedure time, lower reconnection rate between the PV and the left atrium, lower adverse events rate such as cardiac tamponade are expected according to the previous reports. Every therapeutic novel technologies of balloon-based systems connote their own problems which will have to be settled, even though they are expected to surpass focal ablation catheter system in terms of safety and efficacy issues. In this symposium, we would like to appreciate each these new technologies by discussing advantageous and disadvantageous aspects of each technologies with authorities of each fields for us to understand better and make the best use of them for patients suffering from AF.

Controversy for Device Selection: CRT-P Versus CRT-D Versus ICD

Chairperson： Haruhiko Abe
  (University of Occupational and Environmental Health)

In Japan, prevalence of sudden cardiac death patients, as well as heart failure patients, have been gradually increasing every year up to more than 70,000 persons/year, reported by Ministry of Health, Labour and Welfare (MHLW) in Japan. Several evidences have shown that mortality and morbidity in heart failure patients were improved with therapies of ICD and CRT devices. However, only less than 9,000 patients per year are received with these therapies, currently in Japan.
　The selection of devices for heart failure patients is the most important clinical issue for electrophysiologists, especially in proposed high risk patients for sudden cardiac death. Indeed, several guidelines have shown the indication for use of each device. However, several clinical issues for device selection are still remained in real world. For example, which devices should be selected in moderate heart failure patients (previously implanted RV paced patients with reduced ejection fraction 35-50%)? In patients with remained moderate lower ejection fraction after implanted CRT-P, how should we do, up-grade to CRT-D or not?
　In this symposium, Professor Chu-Pak Lau will be reviewed first concerning to current indications and topics for these devices with guidelines, and then discuss by all presenters and audience in this special and/or controversial topics in clinical studies and related issues for the device selection, CRT-P, ICD and CRT-D.

The Usefulness and the Limitation of Subcutaneous ICD

Chairperson： Youichi Kobayashi
  (Showa University School of Medicine)

Subcutaneous ICD (S-ICD) will be available in Japan soon. As there is no lead, epoch-making use can be considered, but on the other hand, there is also a limit.　As advantages, the case under the situation where a lead cannot be put in as infection of lead and the case it is expected to be that ICD becomes unnecessary in the future are considered to be good indications. Furthermore, S-ICD may be useful for a child case who will have a lead failure when growing up. However, of course the case who needs pacing S-ICD is unsuitable and the case who do not have the suitable QRS sensing will not be implantable. In this symposium we would like to discuss the usefulness and limitation in order to promote suitability in developing S-ICD.

Wearable Cardioverter Defibrillator: Role in Prevention of Sudden Cardiac Death

Chairperson： Akihiko Shimizu
  (Yamaguchi Graduate School of Medicine)

It has been more than 2 years since wearable cardioverter defibrillator (WCD) became available in Japan. The indication of WCD are as follows. 1) Patients who have a high risk of sudden cardiac death (SCD) due to VF or VT, but the indication for ICD implantation has not been determined yet, because of potential change of the risk of SCD over the time. 2) Patients who are indicated for ICD implantation, but are not appropriate to be implanted at that time, such as in infection. The WCD may reduce the risk of SCD until the indication for ICD implantation is determined or the conditions of the patient are met.

Although the experience of WCD in Japanese population is limited, as compared to the data in the US, fewer patients with primary prevention of SCD have been treated with WCD, suggesting that many patients with acute myocardial infarction with low ejection fraction have been followed without a WCD. The indication and other issues in WCD therapy will be discussed in this symposium.

Arrhythmogenic Right Ventricular Cardiomyopathy

Chairperson： Masahiko Goya
  (Tokyo Medical and Dental University)

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is progressive disease and an inherited desmosomal cardiomyopathy characterized by a high burden of ventricular arrhythmias and increased risk for sudden cardiac death (SCD). Fibro fatty replacement of the right ventricle (RV) within the so-called triangle of dysplasia which encompasses the RV inflow, outflow, and apex is thought to result in regions of slow conduction, which form the substrate for scar-related macroreentrant ventricular tachycardia (VT). The pathological lesions are believed to progress over time from the epicardium to the endocardium and with diffuse involvement of the RV and the left ventricle (LV) in half of the cases.

Restriction of the exercise and the titration of Beta-blockers up to the maximally tolerated dose are recommended as the first-line therapy. Patients with a history of aborted SCD, poorly tolerated VT and syncope have the highest risk of SCD and ICD therapy is required.

Catheter ablation should be considered in patients with frequent symptomatic PVC or VT unresponsive to medical therapy. In early 2000’s even though electroanatomic and voltage mapping systems provided significant improvement concerning the result of catheter ablation targeting ARVC-VT, it was not considered curative because of high recurrence rate. Recently several reports were published as for the importance of an endo-epicardial– based ablation strategy, catecholamine challenge and PVC mapping, and substrate of the left ventricle.

In this session, we will expect to have the most advanced concept, methodology, and technology for the better understanding the mechanisms and the innovative therapeutic techniques of this complex arrhythmias.

Diagnosis and Treatment of Cardiac Sarcoidosis Up To Date

Chairperson： Kengo Kusano
  (National Cerebral and Cardiovascular Center)

Sarcoidosis is a systemic granulomatous disease and cardiac involvement (Cardiac sarcoidosis, CS) is an important prognosis factor in this disease. However, CS is sometimes misdiagnosed as other cardiomyopathies, and therefore endomyocardial biopsy is important, but the problem is a low sensitivity of myocardial biopsy. Another diagnostic problem is the recognition of isolated types of CS. Recently MRI and 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) have been demonstrated to be useful tools for the noninvasive diagnosis of CS. Treatment of CS is usually done by corticosteroid to control inflammation, prevent fibrosis and protect deterioration of cardiac function but the long-term outcome is still in debate. Non-pharmacological approaches are also available but the result of catheter ablation for ventricular arrhythmias is not sufficient.

Accordingly, there are many issues to resolve about diagnosis and medical management.
In this session, we will focus on the recent advancement and understanding regarding CS diagnosis (FDG-PET and isolated CS) and management (corticosteroid and catheter ablation) to resolve the issues how to treat CS patients.

Treatment of Atrial Fibrillation and Genetic Background

Chairperson： Haruaki Nakatani
  (Chiba University)

Atrial fibrillation (AF) is a widely prevalent arrhythmia associated with increased morbidity, mortality and socioeconomic burden. For decades, treatment of AF has been discussed in the aspect of pharmacological or non-pharmacological modification of electrical property of the myocardium and propagation of excitation in the atria. It is almost 20 years since the concept structural remodeling of the atrial tissue by AF was experimentally confirmed. Recent reports have suggested that certain genetic backgrounds, such as variants in genes encoding gap junction proteins and ion channels, increase the risk of AF. Genome-wide association studies have disclosed that even common single-nucleotide polymorphisms　(SNPs) increase the vulnerability to the development of AF. Also, AF susceptibility SNPs seem to be related with recurrence of arrhythmia after catheter ablation for AF. AF occurs as a phenomenon of combination of genetic abnormalities or variations, acquired organic myocardial abnormalities, and/or autonomic modulation of myocardial electrical stability. Thus, most efficient management of this arrhythmia should be focused on a primary cause of AF in each patient. In this symposium, to obtain an insight into the future of AF management, the potential role of gene-oriented treatment of AF will be discussed.

International Research Symposium of Inherited Arrhythmias

Chairperson： Naomasa Makita
  (Nagasaki University)

Over the last two decades, there was a remarkable progress of research in the inherited arrhythmias, which promoted a breakthrough in both the research and clinical management. However, despite the rapid progress in understanding the genetic basis, the etiology still remains unknown in substantial fractions of affected individuals, additional paradigm shift therefore has been expected to reveal the missing heritable factors associated with these syndromes. In this symposium, we will invite four outstanding research scientists who are most familiar with the most advanced research technologies that uncover hidden etiologies of inherited arrhythmias of both congenital and acquired forms. These include conventional genetic screening techniques, and more advanced genome-wide association studies, as well as whole-exon or whole-genome sequencing using next generation sequencer, and in vivo and in vitro analysis using genetically engineered animal models.

Recent Progress and Future Prospects for Treating Cardiac Arrhythmias in Heart Failure

Chairperson： Nobuhisa Hagiwara
  （Department of Cardiology Tokyo Women's Medical University）

Cardiac arrhythmias can be a potential complication of heart failure (HF). Both atrial and ventricular arrhythmias are common in patients with HF and contribute significantly to mortality and morbidity. Atrial fibrillation occurs with increasing frequency as the severity of HF increases.
Anticoagulation and rate control are important. Attempted maintenance of sinus rhythm with class III antiarrhythmic drugs or the catheter ablation are reasonable considerations for selected patients with HF. Implantable cardioverter defibrillators (ICD) are first-line therapy for high-risk patients who have been resuscitated from sustained ventricular tachycardia (VT) or ventricular fibrillation (VF). Also, a number of randomized clinical trials have now demonstrated that primary prophylaxis of ICD can improve mortality in selected patients with HF. Therefore, the risk stratification and the prevention of VT/VF are the key common issues in the treatment of these patients. Furthermore, there has been much progress with the catheter ablation technique, ICD, and cardiac resynchronization therapy (CRT) devices, which are now useful in patients with arrhythmias and HF. In this symposium, we would like to discuss the pathogenesis of cardiac arrhythmias, recent progress and future prospects for treating cardiac arrhythmias in patients with HF.

JHRS-APHRS Joint Symposium


Cure of Chronic Atrial Fibrillation: Challenges by New Ablation Strategies

Chairperson： Yoshito Iesaka
  (Tsuchiura Kyodo Hospital)

The indication of catheter ablation has been widely extended to long-standing persistent atrial fibrillation (chronic AF, CAF). Bordeaux group published excellent results of catheter ablation for CAF in 2005. They performed stepwise ablation strategy for CAF with mean duration of 17 months, consisted of pulmonary vein isolation (PVI), defragmentation of complex fractionated atrial electrograms (dCFAE) in the both atria and linear ablation (Lab) at the mitral isthmus & LA roof. They hypothesized defragmentation at CFAE sites was performed to abolish multiple micro-reentrant sources (rotors) potentially maintaining CAF.

Stepwise ablation strategy has been widely accepted and routinely performed as standardized substrate modification strategy whole over the world, however, original high success could not be reproduced. The STAR AF II Study also demonstrated no contribution of dCFAE and Lab to eliminate AF recurrence. Recent meta-analysis also showed dCFAE could not reduce AF recurrence in CAF patients.

There are big controversies concerning driving mechanisms of persistent AF, multi-wavelets macro-reentry or rotor. Allessie, et al proposed multi-wavelets macro-reentry theory based on human epicardial mapping data during open chest surgery and endo-/epicardial mapping of chronic goat AF model. While, Jalife, et al proposed rotor theory only by optical mapping data in acetylcholine induced AF in isolated sheep heart. Recently, Allessie, et al proposed the role of epicardial breakthrough of endocardial AF wavelets on AF persistent mechanism and dual layered dissociated fibrillation wave as a main mechanism for long-lasting AF.

“Tackle AF/AT, whenever they are encountered”

Leadless pacemaker

Chairperson： Toshiyuki Ishikawa
  （Yokohama City University Hospital）

More than 50 years have passed since the first cardiac pacemaker was implanted in 1958 by Dr Senning and colleagues. How much closer are we now to developing a perfect pacemaker device? Multiple difficulties have been overcome, while many others are still to be addressed. Complications associated with conventional transvenous pacing systems are commonly related to the pacing lead and pocket. Pacing lead issue is one of the unsolved problems. Lead troubles including leak and fracture are still great problems. And pocket infection is another great problem. Prognosis of device infection is poor if complete extraction of the system is not performed. Pacing lead may be a week point of the pacing system. To solve these issues, leadless pacemaker may be promising. Early assessments of leadless pacemaker system showed the transcatheter pacemaker can safely and effectively be applied. Long-term safety and benefit of the pacemaker will be evaluated. In this symposium, we discuss about current status and future of the leadless pacemaker.

New Developments of Catheter Ablation for Outflow Tract Ventricular Tachycardia

Chairperson： Mitsuhiro Nishizaki
  （Yokohama Minami Kyosai Hospital）

Catheter ablation of ventricular tachycardias (VTs) has evolved rapidly and new technologies in mapping systems play an important role in improving outcomes. A percutaneous epicardial mapping is often required for ablation of VTs because of failure of endocardial ablation.
Catheter ablation is a crucial therapy of VTs originating from the outflow tract in patients without structural heart disease. Endocardial radiofrequency catheter ablation (RFCA) is highly successful for RV outflow tract VTs. However, VTs arising from LV outflow tract is sometimes eliminated by challenging epicardial ablation in addition to endocardial ablation. Analysis of twelve-lead ECG features is of limited effectiveness for accurately predicting successful ablation site in outflow tract VTs, especially epicardial site. Recently novel methods in RFCAs of ventricular arrhythmias (VAs) originating from LV summit and intramural foci in LV outflow tract have been reported.
On the other hand, there have been few clinical studies exploring mechanism of preferential pathway associated with QRS morphologic changes of the outflow tract VAs.
In this session, four speakers give a lecture about catheter ablation of VAs arising from the outflow tract from various points of view under the title of ‘New Developments of Catheter Ablation for Outflow Tract Ventricular Tachycardia’ .

Latest Modalities of Image Integration for VT Ablation

Chairperson： Kenzo Hirao
  （Tokyo Medical and Dental University）

Recent advances in the field of modalities of cardiac image integration enable electrophysiologists to perform ventricular tachycardia (VT) ablation more effectively and safely. Intraprocedural imaging is an important consideration in VT ablation, where it is needed for defining substrate, tagging ablation targets, tracking lesion location, and monitoring for complications.
The progress of 3-dimensional (3D) electroanatomic mapping has a significant impact on such advances in VT ablation. This mapping visualizes scar regions as low voltage area on substrate map, the site of origin of focal VTs and reentrant VT circuits on activation map as well as the geometry of the heart.
With mappable VTs, ascertainment of VT circuit components assessed by conventional activation and entrainment mapping occurs during tachycardia. In unmappable VTs, electroanatomical mapping system is effective in mapping the anatomical substrate and electrophysiological substrate identified by scar-related ventricular electrograms (e.g. late potentials , fractionated potentials) during non-VT rhythm.
Preprocedural assessment by various imaging modalities provides us helpful information for VT ablation regarding anatomy, cardiac function and VT substrate. Current gold standard for scar imaging is LGE (late gadolinium enhancement) on cardiac magnetic resonance imaging (MRI). This imaging modality can provide a detailed assessment of scar architecture and can be used for image integration with the 3D electroanatomic mapping system.
Patients who cannot undergo MRI scanning may have scar imaging performed with positron emission tomography (PET) and/or computed tomography (CT) to obtain a high-resolution metabolic scar map, which can also be used for image integration.
Besides fluoroscopy and electroanatomic mapping, intracardiac echocardiogramphy (ICE) has been used as an additional modality during VT ablation. It allows for real-time scar imaging, visualization of cardiac structures, catheter contact and lesion formation.
These challenges in VT ablation based on the different imaging modalities may eventually improve the outcome of VT ablation. In this symposium, 5 experts in this field will provide us lectures focusing on the latest modalities of image integration for VT ablation.

The Treatment of Device Infection : The Current Status and Problems

座長： 末田　泰二郎（広島大学大学院医歯薬保健学研究院 外科学）
  光野　正孝（兵庫医科大学 心臓血管外科）

　デバイス感染はデバイス植え込み後の最も重大な合併症のひとつであり、本学会等でも毎年のようにテーマに取り上げられている。昨今ではエキシマレーザーシースによるデバイス抜去等が徐々に普及し、エキスパートをもってすれば技術的には抜去がほぼ可能となってきた。
　一方で、デバイス植え込みは元来ハイリスク患者がその対象となっている場合が多く、感染デバイス抜去に成功しても、結局は感染や心不全等で救命できない症例も少なからず存在する。その治療成績に大きく影響を与えるものとして、例えば一時ペーシングの可否やペーシング部位（特に敗血症を呈しデバイス抜去を必要とするが心機能が悪く抜去直後からCRTを必要とするような症例）、デバイス抜去後の再植え込みの時期（同様に敗血症を呈する症例）、リスクは高くても外科の介入が必要な症例（心筋電極の使用も含む）等の問題があるが、未だ一定の見解は得られていない。
　本シンポジウムでは、「デバイス感染の治療の現状と問題点」として、技術的にリード抜去困難な症例に対する対策とともに、上記のような問題点についても検討し、最終的に患者を救命するにはどのように対策を構ずればよいかを考えたい。

Non-pharmacological prevention of left atrial appendage thrombus.

Chairperson： Yuji Nakazato
（Department of cardiology, Juntendo University Urayasu Hospital）

It is well known　that　an oral　anticoagulation　therapy　suggested　the　efficacy　for　preventing　thrombus formation in patients with atrial fibrillation. Currently, a novel anticoagulant is widely available and more feasible to control those patients. However, the risk of bleeding, particularly in elderly patients is always a concern with anticoagulant therapy.
　On the other hand, non-pharmacological prevention by the resection of the left atrial appendage has been mainly performed in valvular surgery as an additional procedure. Recently, less invasive surgical procedures including the thracoscopic approach or -percutaneous closure of the left atrial appendage with devices have been developed. Although each method has reported to be effective, perioperative safety is still controversial.
　In this session, we would like to discuss with the risk and benefit of various non-pharmacological measures of LAA thrombus prevention.

Treatment of arrhythmias with modulation of autonomic nervous function

Chairperson： Hiroshi Inoue (Saiseikai Toyama Hospital)

The autonomic nervous system modulates electrophysiological activities in cardiac tissues including sinus and atrioventricular node, conduction system, and atrial and ventricular myocardium. Generally, activation of the sympathetic nervous system enhances automaticity or triggered activity, accelerates conduction over the conduction system and facilitates reentry, thereby leading to induction of atrial as well as ventricular tachyarrhythmias. By contrast, activation of the parasympathetic nervous system exerts protective effects against tachyarrhythmias including ventricular fibrillation in subjects with myocardial infarction. However, activation of the parasympathetic nervous system is associated with induction of atrial fibrillation in apparently healthy subjects and also ventricular fibrillation in patients with Brugada syndrome. Modulation of the autonomic nervous system with invasive techniques is now becoming ａnovel, adjunctive treatment of several tachyarrhythmias. Ablation of the atrial epicardial ganglionated plexus is effective in eliminating paroxysms of atrial fibrillation in selected patients. For ventricular tachyarrhythmias, cervical vagal nerve stimulation with a sophisticated device, left stellate ganglionectomy, and renal sympathetic denervation with radiofrequency energy are now promising, adjunctive treatment techniques. Left stellate ganglionectomy has been employed to suppress refractory arrhythmias in patients with long QT syndrome, and recently this technique is shown to exert antiarrhythmic effects in patients with catecholaminergic polymorphic ventricular tachycardia. In this symposium, experts from abroad and Japan will discuss in detail the progress in basic as well as clinical cardiac electrophysiology.

Neural Control of the Heart-Implications for Clinical Electrophysiology

Chairperson： Hiroshi Nakagawa
  (Univerity of Oklahoma Health Sciences Center)

The autonomic nervous system (ANS) plays an important role in the pathogenesis of cardiac arrhythmias, including atrial fibrillation and ventricular tachycardia/fibrillation. Impaired parasympathetic response and enhanced sympathetic activity increase the risk of sudden cardiac death. The ANS comprises of the extrinsic (central) cardiac autonomic nervous system (vagosympatheic system from the brain and spinal cord to the heart) and the intrinsic cardiac autonomic nervous system (ganglionated plexi located within the epicardial fat pads) . The intrinsic system receives the input from the extrinsic system, but acts independently to modulate cardiac functions (automaticity, contractility, and conduction) . This session will cover the recent progress of basic and clinical researches on the relationship between the ANS and cardiac arrhythmias, including catheter and surgical intervention of the ANS for the treatment of atrial and ventricular fibrillation.

Ablation of Ventricular Fibrillation (except Brugada Syndrome)

Chairperson： Akihiko Nogami
(University of Tsukuba)

Sudden cardiac death is a major public health problem all over the world. Approximately 100,000 cardiac arrests in Japan occur annually in out-of-hospital settings. Recently, after improvements in the “chain of survival”, including the development of a public-access automated external defibrillator (AED) system and revisions to cardiopulmonary resuscitation guidelines, survival from out-of-hospital cardiac arrest has been improving. Although resuscitation rates are improving, the majority of individuals who experience sudden cardiac arrest will not survive. The gold standard treatment for the prevention of ventricular fibrillation (VF) is the insertion of an implantable cardiac-defibrillator (ICD). However, although an ICD can deliver life-saving therapy at the time of an event, it does not prevent the event from occurring. In most cases, structural heart diseases, i.e., ischemic or non-ischemic cardiomyopathy, are responsible; however, VF that occurs in the absence of any detectable structural heart disease is not rare. While previous studies have shown that VF is perpetuated by reentry or spiral waves, recent data suggest the role of specific sources triggering this arrhythmia. Haïssaguerre et al. reported that idiopathic VF could be suppressed by catheter ablation of those triggers originating from the Purkinje system or right ventricular outflow tract and the ablation therapy for VF has been increasingly reported during the last decade. In general, this ablation appears to have a high success rate and is relatively easy to perform, although precise mapping is required. However, little is known about the initiating mechanism of VF. Further, whether the mechanism of the ablation effect is due to the suppression of the trigger or substrate modification is also unclear. The objective of this symposium is to discuss the strategies we have incorporated into our catheter ablation procedures for VF, especially in difficult and complicated cases. (Catheter ablation for Brugada syndrome will be discussed in the other session.)

Mapping and Ablation of Idiopathic Left Ventricular Tachycardia

Chairpersons： Yoshinori Kobayashi
  (Tokai University Hachioji-hospital, Cardiology division)
  Hisashi Yokoshiki
  (Department of Cardiovascular Medicine, Hokkaido University Hospital)

The advance in the clinical electrophysiology has identified several types of idiopathic left ventricular tachycardia (ILVT). These include tachycardia originating from the outflow tract, the aortic sinus cusp, the superior portion of the epicardial LV (LV summit), the mitral annulus, the postero-septal region of LV (cardiac crux), the papillary muscles, and the Purkinje-fascicular network (such as verapamil-sensitive VT).
Our understanding of the mechanisms, anatomical location and characteristic intracardiac electrograms at the critical sites of those ILVTs is prerequisite for successful catheter ablation. In addition to endocardial mapping, some form of ILVTs requires the mapping in the coronary venous system and/or on the epicardial surface. Information regarding the morphology of QRS complex during tachycardia is also important for the mapping, and subtle differences in the QRS complex lead us to determine the distinct approach to the critical target for catheter ablation. The accumulating evidences using new electrophysiological and imaging technology have been helpful for further elucidating the mechanisms and origins of ILVTs.
This symposium aims to focus on the novel findings related to ILVTs and to share the important tips and pitfalls on the mapping and ablation of ILVTs.

Approaches to Catheter Ablation for Atrial Fibrillation: Triggers or Substrate Modification

Chairpersons： Koichiro Kumagai
  (Heart Rhythm Center, Fukuoka Sanno Hospital)

Trigger elimination by pulmonary vein isolation (PVI) represents the cornerstone of ablation strategies. However, some patients with paroxysmal atrial fibrillation (AF) may be undertreated with PVI alone. Further modification of atrial substrate maintaining AF seems necessary in some patients. Patient selection for additional atrial substrate modification is usually based on their clinical presentation although the correlation between AF type and the extent of atrial structural disease remains unclear. The two most common techniques for substrate modification are the creation of linear lesions in the left atrium (LA) and ablation at sites with complex fractionated atrial electrograms (CFAEs) during AF considered critical for AF perpetuation. However, a recent clinical study found no reduction in the rate of recurrent AF when either linear ablation or ablation of CFAEs was performed in addition to PVI. Perhaps neither CFAEs nor lines may be the additional targets for ablation. More selective targets may be needed to better characterize an individual patient’s specific arrhythmic substrate. Previous studies have shown the correlation of low-voltage areas with atrial fibrosis and scarring. A novel individualized approach for AF ablation based on low-voltage areas in the LA has been provided. However, the necessity of additional ablation of low-voltage areas to PVI for paroxysmal AF is less clear, and long-term data after ablation of low-voltage areas are limited. The additional ablation could increase risk. Consequently, extended AF ablation may lead to overtreatment in the sense of increased procedure and fluoroscopy time, complication rate, and proarrhythmia. We discuss the approaches to AF ablation targeting triggers or substrate modification.

Reduction of Radiation Exposure

Kyoko Soejima (Kyorin University Hospital)

WHO has launched the “Global Initiative on Radiation Safety in Health Care Settings” to mobilize the health sector in the safe use of radiation in medicine. In the interventional cardiology, the major concern regarding the brain cancer development has been raised. Previous data showed that the typical dose for atrial fibrillation catheter ablation is 15 mSv and 64-slice CT prior is 15mSv. Total of 30mSv is compatible with the average dose of evacuees from Chernobyl plant! In the EP field, non-fluoroscopic mapping systems contributed to the reduction of radiation exposure. Awareness of the radiation cannot be emphasized enough.

Management of Atrial Fibrillation: Rhythm versus Rate Control Therapy

Chairperson： Takanori Ikeda
  (Department of Cardiovascular Medicine, Toho University Faculty of Medicine)

There has been considerable debate for over a decade regarding the management of patients with atrial fibrillation (AF). It is about whether physicians should attempt to restore and maintain sinus rhythm using cardioversion, antiarrhythmic drugs, and/or catheter ablation, so-called “rhythm-control” therapy, or whether patients with AF should be treated with drugs such as beta-blockers, calcium-channel blockers, or digoxin, to control the rapid ventricular heart rate responsible for the majority of symptoms, the so-called “rate-control” therapy. Restoration and maintenance of sinus rhythm would intuitively seem to be the ideal approach for both stroke prevention and symptom alleviation. However, some studies demonstrated that long-term maintenance of sinus rhythm has proven difficult to achieve using antiarrhythmic drugs in AF patients. Moreover, adverse drug effects, ranging from proarrhythmic effects to organ toxicity, are a common concern when antiarrhythmic drugs were used. Conversely, rate control therapy is generally considered a safe and inexpensive therapeutic strategy mainly for persistent AF, although it may not be an effective treatment option in patients who are highly symptomatic. Recent several clinical trials revealed that rhythm control therapy offers no clinical benefit over rate control therapy. However, we should recognize that these studies primarily enrolled older patients with persistent AF, who were mildly symptomatic. Therefore, the results cannot be extrapolated to other patient populations, particularly patients with highly symptomatic younger than 65 years with paroxysmal and/or lone AF. In this symposium, we will widely discuss about which therapy is better regarding the management of AF in various clinical settings.

New mapping technique for VT ablation


Chairperson: Yukio Sekiguchi

(Cardiovascular Division, Faculty of Medicine, University of Tsukuba)


In these days, the therapies for ventricular tachycardia (VT) have been advanced by the progress of invasive strategies such as implantable cardioverter defibrillator (ICD) or radiofrequency catheter ablation (RFCA), in addition to conventional drug therapy.
Especially, RFCA has become a useful treatment of drug-refractory VTs in the patients with structural heart disease. Several studies clarified that radiofrequency lesions delivered on the basis of substrate mapping by electroanatomical mapping system have been effective in unmappable or multiple VTs. Besides, the technique of percutaneous pericardial puncture to perform epicardial mapping and ablation has gained wide acceptance for the treatment of epicardial VT. However, long-term success rates remain unsatisfactory and are limited by lack of defined ablation endpoint.
Recently, several new mapping or ablation techniques have been reported in order to eliminate such VTs and were able to achieve adequate outcome.
In this session, we would like to discuss the topics regarding the utility of new mapping strategy for VT ablation in the patients with structural heart disease.

Catheter Ablation for Brugada Syndrome: Should We Target the Trigger or the Substrate of Ventricular Fibrillation?


Chairperson： Yasuya Inden

(Department of Cardiology, Nagoya University Graduate School of Medicine)


Ventricular fibrillation (VF) in patients with Brugada syndrome is life-threating and repeated arrhythmia. Ablation for Brugada syndrome has been reported recently and the targets of ablation were the trigger ventricular premature beat (VPB) and/or the substrate of the right ventricular outflow. The goal of the Brugada ablation is the decrease of the attack frequency or the disappearance of VF attack. We can detect the origin of VPB easily in the patients with frequent VPBs, but it will be difficult to eliminate the triggers in the patients with few VPB. The substrate of Brugada syndrome has been reported to be located over the epicedial surface of the right ventricular outflow. The epicardial ablation targeting the abnormal electrograms is performed in this area. In contrast, the radiofrequency energy was delivered by the endocardial approach in some cases. But the endpoints of these procedures aren’t established well.
And the indication of Brugada ablation depends on the patient’s condition such as the attack frequency, but the ECG criteria for ablation isn’t clear. The short and long term effects of these ablation were not fully investigated. We discuss the Brugada ablation targeting the trigger or the substrate of VF.

Silent Atrial Fibrillation: Diagnosis, Prognosis and Therapy


Chairperson： Teiichi Yamane (Jikei University School of Medicine)


Silent or asymptomatic atrial fibrillation (AF) currently has gained wide interest not only in cardiovascular but also in neurologic field, which is reported to be responsible for the 25~40% of cryptogenic stroke. Furthermore, silent AF has been focused to be associated with the progression of dementia through the accumulation of micro-ischemic strokes.

In contrast to the manifest or symptomatic AF, there remained multiple unknown/debatable issues around the silent AF as follows; 1) Its epidemiology and populations, 2) How to diagnose and define the silent AF (standard Holter, external loop recorder, or implantable devices), 3) the proximity of silent AF episodes to thromboembolic events, 4) How to manage silent AF (including the necessity of anticoagulation therapy), 5) indication of curative ablation strategy for silent AF, etc.

Following the establishment of the management for the manifest AF, now we need to face the new disease entity of silent AF. In this symposium, we are planning to discuss the above non-resolved issues of silent AF among specialists of various medical fields (cardiology, neurology, etc).

State of the art: Antiarrhythmic Management of Atrial Fibrillation


Chairperson： Hirotsugu Atarashi (Nippon Medical School Tama Nagayama Hospital)


Goals of use antiarrhythmic medications for AF patients are including reduction in the frequency and duration of episodes of arrhythmia without increasing mortality and morbidity. Since the CAST study, noticed that suppression of arrhythmias using antiarrhythmic drugs may induce proarrhythmic events especially in patients with ischemic heart disease or heart failure. The majority of available antiarrhhthmic drugs exert predominant effects on cardiac sodium or potassium channels. How to select an appropriate drug for each patient, down regulation or up regulation of these ion channels depend on patient’s pathophysiology should be considered, therefore selection of drugs should be considered advancement of electrical remodeling. To maintain sinus rhythm, to date, non-pharmacological managements, pulmonary vein isolation is one of the effective approaches but adding antiarrhyhthmic drugs is not rare. In such cases what is the most effective pharmacological approach would be presented. Hopefully, what should we expect from next generation of antiarrhythmic drugs will be considered.

Mechanisms Underlying Brugada Syndrome


Chairperson：Wataru Shimizu

(Department of Cardiovascular Medicine, Graduate School of Medicine, Nippon Medical School)


Brugada syndrome (BrS) is characterized by a coved-type ST-segment elevation in the right precordial leads (V1 and V2) known as type-1 Brugada ECG and associated with a high risk of sudden cardiac death due to ventricular fibrillation (VF). The cellular mechanisms underlying BrS have long been a matter of debate. Two principal hypotheses have been advanced 1) The repolarization hypothesis asserts that an outward shift in the balance of currents in right ventricular epicardium can lead to repolarization abnormalities resulting in the development of phase 2 reentry, which generates closely-coupled premature beats capable of precipitating VT/VF; 2) The depolarization hypothesis suggests that slow conduction in the RVOT leading to discontinuities in conduction, plays a primary role in the development of the electrocardiographic and arrhythmic manifestations of the syndrome. The repolarization and depolarization hypotheses are not necessarily mutually exclusive and may indeed be synergistic. In this symposium, we will discuss on the potential mechanism underlying BrS from the viewpoint of electrocardiographic, electrophysiologic characteristics, genetics, and response to pharmacological agents or epicardial catheter ablation.

不整脈薬物治療サミット
超高齢化社会に向けた不整脈治療を考える

不整脈薬物治療最前線（薬物治療はカテーテル治療を超えられるか）

三田村秀雄、清水渉

座長の言葉

―Frontiers in the pharmacological management of arrhythmias―
Can pharmacological treatment become a better therapeutic approach than catheter ablation?

Current antiarrhythmic options include both pharmacological and non-pharmacological therapies using ablation techniques or device implantation. Both approaches have significantly improved clinical outcomes, yet their efficacy remains suboptimal, and their use is limited by a variety of potentially serious adverse effects.
Although substantial progress has been made in ablation techniques for atrial fibrillation （AF）, broad application of these non-pharmacological treatment modalities is limited particularly for chronic AF with long duration, enlarged left atrium, short AF cycle length, and impaired cardiac function. As about half of the AF patients in Japan are aged > 75 years, and have permanent AF which are often asymptomatic, antithrombotic treatment with or without antiarrhythmic drug treatment is still the cornerstone and the first-line therapy for the majority of such patients.
There is a clear need for improved therapeutic options. Several decades of research have substantially expanded our understanding of the basic mechanisms of arrhythmias. For example, the pathophysiology of AF has been shown to include ion channel dysfunction, Ca handling abnormalities, structural remodeling, and autonomic neural dysregulation. Moreover, recent functional genomic studies have made great strides towards translating genetic discoveries to an underlying mechanism.
In this symposium, we review recent insights into the basic mechanisms of arrhythmias and assess the potential value of contemporary discoveries for future therapeutic innovation.

第5回不整脈薬物治療サミット　札幌

「高齢者・超高齢者における心房細動トータルケア」　座長の言葉

井上　博　髙橋　尚彦

Total Care of Atrial Fibrillation in Elderly and Very Elderly Patients

Hiroshi Inoue, Naohiko Takahashi

Prevalence of atrial fibrillation （AF） is increasing along with aging of population. AF is associated with an increase in mortality and morbidity that includes ischemic stroke. Recently, evidence is emerging that AF is also associated with cognitive impairment or dementia. In Japan, elderly subjects aged 65 years or more account for 25% of the whole population, and very elderly subjects aged 85 years or more account for 4% of the whole population. It is therefore mandatory for physicians to manage their patients with AF, especially elderly or very elderly ones, from many clinical aspects. In this session, the association between AF and cognitive impairment or dementia will be discussed first. Then the strategy of anticoagulation treatment among elderly or very elderly patients with AF will be discussed, since silent as well as symptomatic cerebral infarction is closely associated with cognitive impairment among subjects with AF. It seems possible that anticoagulation would prevent cognitive decline among elderly subjects with AF. However, anticoagulation with warfarin is sometimes difficult to achieve an optimal intensity among elderly subjects, and therefore is associated with higher rates of thromboembolic as well as hemorrhagic events as compared with younger subjects. Anticoagulation with direct oral anticoagulants is now a promising choice for elderly or very elderly subjects with AF because of its effectiveness and safety profile.

PVIにATPは有用か？

ATP/adenosine-guided PVI improves the outcome.

座長： 高月　誠司
  （慶應義塾大学循環器内科）
Chairperson： Seiji Takatsuki
  （Keio University School of Medicine）

The pulmonary vein (PV) isolation by catheter ablation has been established as a curative therapy for paroxysmal atrial fibrillation. To maintain the complete conduction block between the PVs and the left atrium (LA), that is to improve the durability of PV isolation must be important to increase the sinus rhythm maintenance rate. The dormant conduction is a transient electrical conduction between PVs and the LA revealed by the rapid infusion of adenosine or adenosine triphosphate (ATP) after PV isolation, which suggests incomplete conduction block. And theoretically, to remove revealed dormant conduction seems to contribute PV durability. Recently, some papers reported the clinical efficacy to perform dormant conduction after PV isolation, which interestingly showed inconsistent results. Several factors could be concerned. Firstly, does eliminating dormant conduction guarantee the long term PV isolation? Secondly, the interval from PVI to administer adenosine/ATP could affect the results since the dormant conduction sometimes cannot be revealed just after PV isolation and longer waiting time also can reveal spontaneous conduction between PVs and LA without adenosine/ATP infusion. Thirdly, the manner and the energy source of the PV isolation could be involved, since if the rate of the induced dormant conduction is very low, to check the dormant conduction can be meaningless. Finally, the prevalence of atrial fibrillation triggered by the extra-PV foci can also be involved.
In this debate session, two experts will discuss the significance of the dormant conduction revealed by adenosine/ATP. And the audience could take an answer to the question whether physicians should check the dormant conduction after PV isolation through the discussion.

Congress
Office

Cardiovascular Division, Faculty of Medicine, University of Tsukuba
1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575

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