Ju-Yi Chen

• Professor at National Cheng Kung University

The urine albumin (Alb)-to-creatinine (Crn) ratio (UACR) is a sensitive and early indicator of chronic kidney disease (CKD) and cardiorenal syndrome. This study developed a portable and wireless electrochemical-sensing platform for the sensitive and accurate determination of UACR. The developed platform consists of a carbon nanotube (CNT)-2,2′-azin...

This work proposes a classification system for arrhythmias, aiming to enhance the efficiency of the diagnostic process for cardiologists. The proposed algorithm includes a naive preprocessing procedure for electrocardiography (ECG) data applicable to various ECG databases. Additionally, this work proposes an ultralightweight model for arrhythmia cl...

This study proposes a comprehensive and vision-based long-term healthcare system that includes time-of-flight (ToF) cameras at the front end, the Raspberry Pi at the edge point, and image database and classification at a cloud server. First, the ToF cameras capture human actions through depth maps. Next, the Raspberry Pi accomplishes image preproce...

An 89-year-old woman presented with presyncope and complete atrioventricular block (Panel A). She had adequate left ventricular (LV) systolic function (see Supplementary data online, Video S1). A dual-chamber pacemaker with left bundle branch area pacing (LBBaP) was implanted, and atrial sensing and ventricular pacing (Panel B) were confirmed. Afte...

A second-order voltage-controlled oscillator (VCO)-based continuous-time sigma-delta modulator (CTSDM) for current-sensing readout applications is proposed. Current signals from the sensor can directly be quantized by the proposed VCO-based CTSDM, which does not require any extra trans-impedance amplifiers. With the proportional-integral (PI) struc...

An electrocardiogram (ECG) test is usually performed through measurement with Ag/AgCl electrodes. However, this method has disadvantages, such as skin irritation, short shelf life, and conductance variation in gels over time, which limit the usability for long-term monitoring. One of the alternatives is adopting conductive fabric-based electrodes,...

Patients with device detected atrial high-rate episodes (AHRE) have an increased risk of MACE. The R2CHA2DS2-VASc, CHADS2, R2CHADS2 and CHA2DS2-VASc score have been investigated for predicting major adverse cardiovascular events (MACE) in different groups of patients. We aimed to evaluate the R2CHA2DS2-VASc score in combination with AHRE ≥ 6 min fo...

This paper proposes an intelligent stethoscope system that synchronously displays the electrocardiogram (ECG) and heart sound. The instrument, which accelerates auscultation, can be used for the diagnosis of valvular heart disease (VHD) for clinical physicians. The whole system with ECG patch and stethoscope includes four parts, namely, an analog f...

This case report describes a successful balloon venoplasty to overcome a total occlusion from the brachiocephalic vein to the superior vena cava in a patient undergoing cardiac resynchronization therapy. It is crucial for implanting physicians to be familiar with strategies to overcome venous occlusion in lead implantation, especially balloon venop...

Introduction: Emergency department (ED) visits for decompensated heart failure (HF) are frequent and associated with poor long-term outcomes. Plasma N-terminal pro b-type natriuretic peptide (NT-proBNP) and cyclic guanosine monophosphate (cGMP) are used in diagnosis and prognosis of HF patients, while clinical values of urine NT-proBNP/cGMP ratio...

This work presents a third-order high-pass sigma-delta modulator (HPSDM) for biomedical signal acquisition. The operational amplifier (op-amp) sharing and noise-coupling techniques are adopted to reduce the required quantity of op-amps and add a noise-shaping order, which can achieve low power consumption and high resolution. A novel switched-capac...

Cardiac implantable electronic devices (CIED) including pacemakers (PM), implantable cardioverter defibrillators (ICD), and cardiac resynchronized therapy (CRT) have become the mainstay of therapy for many cardiac conditions, consequently drawing attention to the risks and benefits of these procedures. Although CIED implantation is usually a safe p...

Left ventricular hypertrophy (LVH) is common among older adults. Amidst all causes, Fabry disease (FD) should be considered when LVH occurs with family history, specific clinical manifestations, or cardiac alert signs. Here, we report a case of a 76-year-old male who presented late onset concentric LVH with symptomatic high-grade atrioventricular (...

Aims Several predicting models have been evaluated for new‐onset atrial fibrillation (AF) in several clinical conditions, but never in patients with cardiac implantable electronic devices (CIED). We aimed to evaluate the five predicting models compared with atrial high rate episodes (AHRE) to predict new AF in patients with CIED. Methods and Resul...

Objectives: The HAT2CH2 score has been evaluated for predicting new-onset atrial fibrillation in several clinical conditions, but never for adverse neurologic events. We aimed to evaluate the effectiveness of HAT2CH2 score in predicting neurologic events in patients with cardiac implantable electronic device (CIED), comparing with atrial high-rate...

We present the case of a patient with anxiety who attempted suicide by self-removal of her permanent pacemaker (PPM). Self-harm involving a pacemaker is associated with significantly endangering patient well-being and often with greatly increased health care costs. It is an indication that the numbers of patients with a PPM who are clinically depre...

Background The HAT2CH2 score has been evaluated for predicting new-onset atrial fibrillation (AF) in several clinical conditions but never for adverse neurologic events. We aimed to evaluate the HAT2CH2 score for predicting neurologic events in patients with cardiac implantable electronic devices (CIED). Methods and results We retrospectively revi...

The detection of biosignals by using a comfortable material is important to improve human health. This paper presents a complete wearable system with smart clothing for the long-term monitoring of lead-I ECG and respiratory signals. The proposed system is divided into three parts, including biosignal-monitoring clothing, a biosignal acquisition dev...

Background: The HAT 2 CH 2 score has been evaluated for predicting new onset atrial fibrillation, but never for adverse systemic thromboembolic events (STE) in elderly. We aimed to evaluate the HAT 2 CH 2 score and comparing to atrial high rate episodes (AHRE) ≥24 h for predicting STE in older patients with cardiac implantable electronic devices (C...

Background Obesity-related cardiovascular risk, end points, and mortality are strongly related to arterial stiffening. Current therapeutic approaches for arterial stiffening are not focused on direct targeting within the vessel. Perivascular adipose tissue (PVAT) surrounding the artery has been shown to modulate vascular function and inflammation....

Background: Patients with sustained atrial high-rate episodes (AHRE) have a high risk of major adverse cardio/cerebrovascular events (MACCE). However, the prediction model and factors for the occurrence of AHRE are unknown. We aimed to identify independent factors and various risk models for predicting MACCE and AHRE. Methods: We retrospectively en...

The HAT 2 CH 2 score has been evaluated for predicting new-onset atrial fibrillation in several clinical conditions, but never for adverse neurologic events. We aimed to evaluate the effectiveness of HAT 2 CH 2 score in predicting neurologic events in patients with cardiac implantable electronic device (CIED), comparing with atrial high-rate episod...

Patients with atrial high-rate episodes (AHRE) have a high risk of neurologic events, although the causal role and optimal cutoff threshold of AHRE for major adverse cardio/cerebrovascular events (MACCE) are unknown. This study aimed to identify independent factors for AHRE and subsequent atrial fibrillation (AF) after documented AHRE. We enrolled...

Background Post cardiac injury syndrome (PCIS) is induced by myocardial infarction or cardiac surgery, as well as minor insults to the heart such as percutaneous coronary intervention (PCI), or insertion of a pacing lead. PCIS is characterized by pericarditis after injury to the heart. The relatively low incidence makes differential diagnosis of PC...

This work presents a portable wireless urine detection system which consists of an electrochemical readout application specific integrated circuit (ASIC) and a biosensor composed of 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) and carbon nanotube (ABTS-CNT) for the detection of urine albumin-to-creatinine ratio (UACR). The ASIC includes...

A high-pass sigmadelta modulator (HPSDM) is proposed for electrocardiography (ECG) signal acquisition system. The HPSDM is implemented using operational amplifier (op-amp) sharing and programmable feedforward coefficients. The op-amp sharing is adopted to reduce the quantity of amplifiers because they dominate the power consumption of the HPSDM. In...

Background Patients with atrial high‐rate episode (AHRE) are at higher risk of neurological events. This study aimed to identify the optimal cutoff threshold for AHRE duration in patients with dual chamber permanent pacemakers (PPM) without prior atrial fibrillation. Methods We included 355 consecutive patients receiving dual chamber pacemaker imp...

Patients with atrial high-rate episodes (AHRE) are at higher risk of major adverse cardiovascular events (MACE). The cutoff threshold for AHRE duration for MACE, with/without history of atrial fibrillation (AF) or myocardial infarction (MI), is unknown. A total of 481 consecutive patients with/without history of AF or MI receiving dual-chamber pace...

In patients with diabetes mellitus (DM), incident cardiovascular (CV) events are associated with poor long-term outcomes. Serum high-sensitivity troponin I (hs-TnI) is widely used to diagnose and predict outcomes in patients with acute coronary syndrome, however, few studies have investigated the accuracy of urine hs-TnI as a predictor for incident...

Objectives: Patients with permanent pacemaker (PPM) implantation may have altered coronary perfusion patterns that may influence the accuracy of myocardial perfusion examination modalities, which was observed in previous studies but with limited statistic power. Our aim was to examine the performance of thallium-201 (TL-201) myocardial perfusion e...

We presented a case of severe aortic regurgitation and moderate mitral regurgitation s/p aortic valve replacement and mitral valve repair. Deterioration of tachyarrhythmia attacks was noted. In EP study, left lateral accessory pathway with orthodromic atrioventricular reentrant tachycardia was identified. We successfully ablated the accessory pathw...

Chronic hepatitis C virus (HCV) infection is associated with risk of cardiovascular diseases. Although direct acting antivirals (DAA) result in rapid eradication of HCV, their long-term impact on arterial stiffness remains unclear. This study aimed to evaluate changes in parameters of central arterial stiffness from pretreatment, through sustained...

Background Patients with atrial high-rate episodes (AHRE) have a high risk of cardiovascular and cerebrovascular events (CCE); however, the optimal cut-off threshold for AHRE duration and the prediction power of AHRE with CHA2DS2-VASc score is unknown. Methods We enrolled 355 consecutive patients undergoing dual chamber pacemaker implantations. Th...

Aims Emergency department (ED) visits for decompensated heart failure (HF) are frequent and associated with poor long‐term outcomes in patients with HF. Serum N‐terminal pro b‐type natriuretic peptide (NT‐proBNP) is widely used to assist diagnosis and predict clinical outcomes in HF patients. Few studies have investigated the use of urine NT‐proBNP...

Background Inserting an electrophysiological (EP) catheter into the coronary sinus (CS) via the femoral vein can be difficult and time‐consuming in patients with variants of the CS orifice or lumen curve. Our experience with such patients inspired us to develop two new techniques: the Asclepius and Yellow Ribbon techniques. Methods Data from a 4‐y...

Background Subclavian vein obstruction may occur in patients with pacemaker leads, which may make the implantation of new pacemaker leads difficult. Case summary We report two cases in which upgrading to cardiac resynchronization therapy pacemaker was challenging due to total central vein occlusion. In the first case, a 78-year-old woman with perm...

Background: A new wearable pulse audiogram (PAG) of radial artery was developed with the main purpose to quickly screen atrial fibrillation (AF) and monitor pulse amplitude variation. Methods: Subjects with sinus rhythm (SR), AF, ectopic arrhythmia (EA), and a pacemaker rhythm (PM) were recruited to measure the PAG of radial artery. In total, 91 su...

Chronic hepatitis C (CHC) is strongly associated with risks of cardiovascular diseases. The impact of direct acting antiviral (DAA) therapy on central blood pressure remains unclear. This investigation evaluates changes in central blood pressure following DAA therapy. One hundred and two DAA-treated patients were prospectively enrolled. Lipid profi...

Electrocardiography (ECG) is a fundamental method not only commonly used in the hospital for clinical requirement but also widely adopted in home and personal healthcare systems to obtain the electrical activity of the heart. An arrhythmia monitoring system is proposed and used in a clinical trial. The proposed system has three parts. The first is...

Background: Currently, several geographies around the world remain underrepresented in medical device trials. The PANORAMA 2 study was designed to assess contemporary region-specific differences in clinical practice patterns of patients with cardiac implantable electronic devices (CIEDs). Methods: In this prospective, multicenter, observational,...

Bakground and aims: Obstructive sleep apnea (OSA) contributes to cardiovascular diseases, including arterial stiffness. The association between OSA and peripheral arterial stiffness indices remains controversial. Methods: This study recruited 275 patients who were referred for sleep apnea study. Arterial stiffness was assessed by peripheral comp...

Background:There are few data on ticagrelor in Asian patients. This study evaluated clinical outcomes with ticagrelor and clopidogrel in Taiwanese patients with acute myocardial infarction (AMI). Methods and Results:We used the Taiwan National Health Insurance Research Database to identify 27,339 AMI patients aged ≥18 years between January 2012 and...

Background: The extension catheter was originally developed to facilitate stent delivery to challenging lesions. We evaluated the efficacy and safety of using an extension catheter in patients undergoing percutaneous coronary interventions (PCI). Methods: Two interventional cardiologists reviewed the records of all consecutive patients who, betw...

Nonalcoholic fatty liver disease (NAFLD) is associated with increased arterial stiffness. Although chronic hepatitis C virus (HCV) infection was shown to be associated with metabolic disorder and chronic inflammation, the effects of chronic HCV infection on arterial stiffness remain unclear. This study recruited 221 patients including 32 normal con...

Out-of-hospital cardiac arrest (OHCA) remains a challenge for physicians since effective management and definitive salvage depend upon correct determination of the etiology and the extent of injury. Definitive diagnosis of organophosphate poisoning (OP) requires physicians’ clinical awareness of a typical toxidrome, that is, characteristic signs an...

Background: Despite limited evidence, postoperative prophylactic antibiotics are often used in the setting of permanent pacemaker implantation or replacement. The aim of this study is to investigate the efficacy of postoperative antibiotics. Hypothesis: Postoperative prophylactic antibiotics may be not clinically useful. Methods: We recruited...

It is unknown whether there has been any change in the causes of death for acute ST-segment elevation myocardial infarction (STEMI) in the era of aggressive reperfusion. We analyzed the direct causes of in-hospital death in patients with STEMI treated with primary percutaneous coronary intervention (PCI) in a tertiary referral center over the past...

This is the first study to investigate the vasculoangiogenic effects of cilostazol on endothelial progenitor cells (EPCs) and flow-mediated dilatation (FMD) in patients at high risk of cardiovascular disease (CVD). This double-blind, placebo-controlled study included 71 patients (37 received 200 mg/d cilostazol and 34 received placebo for 12 weeks)...

Loss of integrity and massive disruption of elastic fibers are key features of abdominal aortic aneurysm (AAA). Peroxisome proliferator-activated receptor γ (PPARγ) has been shown to attenuate AAA through inhibition of inflammation and proteolytic degradation. However, its involvement in elastogenesis during AAA remains unclear. PPARγ was highly ex...

Background: Regional strain by speckle-tracking echocardiography can be used to detect occult right ventricular (RV) myocardial dysfunction. However, in patients with coronary artery disease, the impact of RV strain is unknown. The aim of this study was to validate the prognostic value of RV strain in patients with non-acute coronary syndrome angi...

Background: Compliance index derived from digital volume pulse (CI-DVP), measuring the relationship between volume and pressure changes in fingertip, is a surrogate marker of peripheral arterial stiffness. This study investigated if CI-DVP can predict renal function deterioration, cardiovascular events and mortality in patients with chronic kidney...

Background: Although left ventricular (LV) global systolic longitudinal strain (GLS) reliably and accurately assesses LV systolic function and is also a powerful prognostic predictor, the importance and prognostic value of GLS in end-stage renal disease patients receiving maintenance peritoneal dialysis (PD) remain unclear. This study sought to det...

Supplementary material.

Background The American Heart Association Get With the Guidelines (GWTG) program has improved care quality of acute myocardial infarction (AMI) with important implications for other countries in the world. This study evaluated the incidence and care of AMI in Taiwan and assessed the compliance of GWTG in Taiwan. Methods and Results We used the Tai...

Thrombomodulin (TM) is an endothelial cell (EC) membrane-bound anticoagulant protein that has novel direct cellular effects. TM is shed from EC and becomes soluble form (sTM) in plasma. Higher sTM levels in healthy subjects are associated with lower cardiovascular risk, suggesting that sTM possesses a protective role. The purpose of the study was t...

Chronic ischemia related occult systolic dysfunction of the right ventricle is difficult to detect using traditional echocardiography. The aim of this study was to verify the diagnostic value of speckle-tracking echocardiography in proximal right coronary artery (pRCA) lesion-induced right ventricular (RV) occult dysfunction. One hundred forty-two...

Background: Regional strain by speckle tracking echocardiography is an emerging technique and can be used for assessment of right ventricle (RV). The aims of this study were to validate the prognostic value of RV strain as a new index of RV systolic function in patients with stable coronary artery disease. Methods and Results: We recruited 142 pati...

Much concern has arisen regarding critical adverse effects of thiazolidinediones (TZDs), including rosiglitazone and pioglitazone, on cardiac tissue. Although TZD-induced cardiac hypertrophy (CH) has been attributed to an increase in plasma volume or a change in cardiac nutrient preference, causative roles have not been established. To test the hyp...

Background: Evidence about the efficacy and safety of statin treatment in high-risk patients with hypercholesterolemia is available for some populations, but not for ethnic Chinese. To test the hypothesis that treatment with pitavastatin (2 mg/day) is not inferior to treatment with atorvastatin (10 mg/day) for reducing low-density lipoprotein chol...

The entrapment of a ruptured catheter balloon during percutaneous coronary intervention (PCI) is rare, but it can lead to life-threatening complications, such as myocardial infarction (MI) and lethal arrhythmias. Ruptured balloon entrapment usually occurs in either tortuous, calcified, or angulated coronary lesions without adequate balloon deflatio...

BACKGROUND Carotid arterial stiffness measured by techniques of speckle tracking echocardiography is helpful to assess vascular wall deformation. We conducted a study to investigate the relationship between vascular deformation of the carotid artery and ischemic stroke in the elderly.METHODS We recruited 89 consecutive individuals aged ≥60 years (m...