Research Topics

Shih Ann Chen


Country: Taiwan


  1. Chao T, Liu C, Lin Y, Chang S, Lo L, Hu Y, et al. Oral Anticoagulation in Very Elderly Patients With Atrial Fibrillation: A Nationwide Cohort Study. Circulation. 2018;138:37-47 pubmed publisher
    ..Compared with warfarin, NOACs were associated with a lower risk of ICH. Thus, OACs may still be considered as thromboprophylaxis for elderly patients, with NOACs being the more favorable choice. ..
  2. Yamada S, Lo L, Chou Y, Lin W, Chang S, Lin Y, et al. Beneficial Effect of Renal Denervation on Ventricular Premature Complex Induced Cardiomyopathy. J Am Heart Assoc. 2017;6: pubmed publisher
    ..Frequent VPCs are associated with the development of cardiac structural remodeling and high ventricular fibrillation inducibility. RDN prevents cardiac remodeling and the occurrence of ventricular arrhythmia through antifibrosis. ..
  3. Lo L, Chang H, Scherlag B, Lin Y, Chou Y, Lin W, et al. Temporary Suppression of Cardiac Ganglionated Plexi Leads to Long-Term Suppression of Atrial Fibrillation: Evidence of Early Autonomic Intervention to Break the Vicious Cycle of "AF Begets AF". J Am Heart Assoc. 2016;5: pubmed publisher
    ..Temporary suppression of major atrial GPs by BTX prevents autonomic remodeling and provides long-term suppression of AF, indicating the critical role of GPs in AF progression. ..
  4. Santangeli P, Tung R, Xue Y, Chung F, Lin Y, Di Biase L, et al. Outcomes of Catheter Ablation in Arrhythmogenic Right Ventricular Cardiomyopathy Without Background Implantable Cardioverter Defibrillator Therapy: A Multicenter International Ventricular Tachycardia Registry. JACC Clin Electrophysiol. 2019;5:55-65 pubmed publisher
    ..These data suggest that further prospective studies may refine selection of patients with structural heart disease at low risk for SCD, possibly obviating the benefit of ICD therapy. ..
  5. Yang T, Hu Y, Lin Y, Chang S, Lo L, Tuan T, et al. Atrial fibrillation influences survival in patients with hepatocellular carcinoma: experience from a single center in Taiwan. J Chin Med Assoc. 2014;77:117-21 pubmed publisher
    ..Tumor rupture was relatively common among patients with both HCC and AF. The anticoagulation treatment of AF in patients with HCC deviated from the current guidelines without an increase in thromboembolic events. ..
  6. Liao J, Chao T, Chen S. How do aging and comorbidities impact risk of ischemic stroke in patients with atrial fibrillation. Trends Cardiovasc Med. 2018;: pubmed publisher
  7. Yamada S, Chung F, Lin Y, Chang S, Lo L, Hu Y, et al. Electrocardiographic characteristics for predicting idiopathic right ventricular outflow tract premature ventricular complex-induced cardiomyopathy. J Interv Card Electrophysiol. 2018;53:175-185 pubmed publisher
    ..The ECG parameters, including a wider QRS duration and higher PDI, could predict the development of RVOT PVC-CMP, which could be effectively treated by RFCA. ..
  8. Lin Y, Lo M, Chang S, Lo L, Hu Y, Chao T, et al. Benefits of Atrial Substrate Modification Guided by Electrogram Similarity and Phase Mapping Techniques to Eliminate Rotors and Focal Sources Versus Conventional Defragmentation in Persistent Atrial Fibrillation. JACC Clin Electrophysiol. 2016;2:667-678 pubmed publisher
    ..74; p = 0.01). Our study showed that for persistent AF ablation, a specified substrate modification guided by nonlinear phase mapping could eliminate localized re-entry and non-pulmonary focal sources after pulmonary vein isolation. ..
  9. Singhal R, Chang S, Chong E, Hsiao Y, Liu S, Tsai Y, et al. Colchicine suppresses atrial fibrillation in failing heart. Int J Cardiol. 2014;176:651-60 pubmed publisher
    ..Colchicine regulates ion channel gene expression and activates the PI3K/AKT/eNOS signaling pathway in HF rabbits, which may reverse atrial remodeling and suppress AF. ..

More Information


  1. Chao T, Liu C, Chen S, Wang K, Lin Y, Chang S, et al. Does digoxin increase the risk of ischemic stroke and mortality in atrial fibrillation? A nationwide population-based cohort study. Can J Cardiol. 2014;30:1190-5 pubmed publisher
    ..34-0.68). Digoxin should be avoided for patients with AF without heart failure because it was associated with an increased risk of clinical events. β-Blockers may be a better choice for controlling ventricular rate in these patients. ..
  2. Chao T, Liu C, Wang K, Lin Y, Chang S, Lo L, et al. Using the CHA2DS2-VASc score for refining stroke risk stratification in 'low-risk' Asian patients with atrial fibrillation. J Am Coll Cardiol. 2014;64:1658-65 pubmed publisher
    ..95% at 1-year follow-up and 2.84% at 15-year follow-up. In contrast, patients with a CHA2DS2-VASc score of 0 had a truly low risk of ischemic stroke, with an annual stroke rate of approximately 1%. ..
  3. Liao J, Chao T, Liu C, Chen S, Hung C, Lin Y, et al. Seasonal variation in the risk of ischemic stroke in patients with atrial fibrillation: A nationwide cohort study. Heart Rhythm. 2018;15:1611-1616 pubmed publisher
    ..AF-related stroke may be influenced by environmental interactions. ..
  4. Chao T, Liu C, Chen S, Wang K, Lin Y, Chang S, et al. Statins and the risk of dementia in patients with atrial fibrillation: A nationwide population-based cohort study. Int J Cardiol. 2015;196:91-7 pubmed publisher
    ..In this large-scale nationwide cohort study, statin use was associated with a lower risk of non-vascular dementia in AF. Use of more potent statin and longer exposure time may be associated with greater benefits. ..
  5. Chan C, Lin Y, Chang S, Lo L, Hu Y, Chao T, et al. Early repolarization of surface ECG predicts fatal ventricular arrhythmias in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy and symptomatic ventricular arrhythmias. Int J Cardiol. 2015;197:300-5 pubmed publisher
    ..A high prevalence of electrocardiographic ER was found among symptomatic ARVD/C patients undergoing catheter ablation. ER in 12-lead ECG is associated with an increased risk of clinical fatal ventricular arrhythmias. ..
  6. Lin C, Chang S, Lin Y, Lo L, Chung F, Chen Y, et al. Long-term outcome of multiform premature ventricular complexes in structurally normal heart. Int J Cardiol. 2015;180:80-5 pubmed publisher
    ..The presence of multiform PVC was associated with a higher incidence of mortality, hospitalization, transient ischemic attack, new-onset AF, and new-onset HF independent of other clinical risk factors. ..
  7. Lin C, Lin Y, Lo L, Chen Y, Chong E, Chang S, et al. Factors predisposing to ventricular proarrhythmia during antiarrhythmic drug therapy for atrial fibrillation in patients with structurally normal heart. Heart Rhythm. 2015;12:1490-500 pubmed publisher
    ..Old age, presence of inferior lead J wave, and wider QRS on ECG were significant risk factors in our single-center study. ..
  8. Chao T, Lip G, Lin Y, Chang S, Lo L, Hu Y, et al. Major bleeding and intracranial hemorrhage risk prediction in patients with atrial fibrillation: Attention to modifiable bleeding risk factors or use of a bleeding risk stratification score? A nationwide cohort study. Int J Cardiol. 2018;254:157-161 pubmed publisher
    ..Simply depending on modifiable bleeding risk factors had suboptimal predictive value for the prediction of major bleeding in AF patients, when compared to the HAS-BLED score. ..
  9. Chong E, Chang S, Hsiao Y, Singhal R, Liu S, Leha T, et al. Resveratrol, a red wine antioxidant, reduces atrial fibrillation susceptibility in the failing heart by PI3K/AKT/eNOS signaling pathway activation. Heart Rhythm. 2015;12:1046-56 pubmed publisher
    ..Resveratrol decreases left atrial fibrosis and regulates variation in ion channels to reduce AF through the PI3K/AKT/eNOS signaling pathway. ..
  10. Lin C, Lo L, Lin Y, Chang S, Hu Y, Tuan T, et al. Ventricular arrhythmias originating from the cardiac crux and the basal inferior segment of the interventricular septum in the patients with structural heart diseases: characteristics, mapping, and electrophysiological properties. J Interv Card Electrophysiol. 2018;52:225-236 pubmed publisher
    ..The lower unipolar, bipolar voltage mapping, and longer EGM lateness are helpful to identify the abnormal substrate in the endocardium in these patients. ..
  11. Chao T, Liu C, Wang K, Lin Y, Chang S, Lo L, et al. Should atrial fibrillation patients with 1 additional risk factor of the CHA2DS2-VASc score (beyond sex) receive oral anticoagulation?. J Am Coll Cardiol. 2015;65:635-42 pubmed publisher
    ..Oral anticoagulation should be considered for AF patients with 1 additional stroke risk factor given their high risk of ischemic stroke. ..
  12. Liao J, Chao T, Liu C, Wang K, Chen S, Tuan T, et al. Risk and prediction of dementia in patients with atrial fibrillation--a nationwide population-based cohort study. Int J Cardiol. 2015;199:25-30 pubmed publisher
    ..589, 95% CI=0.586-0.592) (DeLong test p<0.001). In this nationwide cohort study, AF was independently associated with a higher risk of dementia. The CHA2DS2-VASc score can be used to estimate the risk of dementia in AF patients. ..
  13. Chao T, Liu C, Tuan T, Chen S, Wang K, Lin Y, et al. Comparisons of CHADS2 and CHA2DS2-VASc scores for stroke risk stratification in atrial fibrillation: Which scoring system should be used for Asians?. Heart Rhythm. 2016;13:46-53 pubmed publisher
    ..In contrast, patients with a CHA2DS2-VASc score of 0 had a truly low risk of ischemic stroke, with an annual stroke rate around 1.15%. As with Caucasians, the CHA2DS2-VASc score should be used for stroke risk stratification in Asians. ..
  14. Lin C, Chung F, Lin Y, Chong E, Chang S, Lo L, et al. Radiofrequency catheter ablation of ventricular arrhythmias originating from the continuum between the aortic sinus of Valsalva and the left ventricular summit: Electrocardiographic characteristics and correlative anatomy. Heart Rhythm. 2016;13:111-21 pubmed publisher
    ..9 months (interquartile range 9.2-24.2 months). The aVL/aVR Q-wave ratio is a useful parameter for predicting the successful ablation sites of VAs originating from the continuum between the ASV and the LV summit. ..
  15. Chao T, Wang K, Liu C, Lin Y, Chang S, Lo L, et al. Age Threshold for Increased Stroke Risk Among Patients With Atrial Fibrillation: A Nationwide Cohort Study From Taiwan. J Am Coll Cardiol. 2015;66:1339-47 pubmed publisher
    ..53%, which was truly low-risk, and OACs could be omitted. Whether resetting the age threshold to 50 years could refine current clinical risk stratification for Asian AF patients deserves further study. ..
  16. Chao T, Lip G, Liu C, Lin Y, Chang S, Lo L, et al. Relationship of Aging and Incident Comorbidities to Stroke Risk in Patients With Atrial Fibrillation. J Am Coll Cardiol. 2018;71:122-132 pubmed publisher
  17. Hung Y, Lo L, Lin Y, Chang S, Hu Y, Chung F, et al. Characteristics and long-term catheter ablation outcome in long-standing persistent atrial fibrillation patients with non-pulmonary vein triggers. Int J Cardiol. 2017;241:205-211 pubmed publisher
    ..Compared with PAF and PerAF, LSPAF had a higher incidence of NPV triggers and worse long-term outcome after catheter ablation. NPV triggers and LAD independently predicted AF recurrence after catheter ablation in LSPAF. ..
  18. Hung Y, Chao T, Liu C, Tuan T, Lin Y, Chang S, et al. Is an Oral Anticoagulant Necessary for Young Atrial Fibrillation Patients With a CHA2DS2-VASc Score of 1 (Men) or 2 (Women)?. J Am Heart Assoc. 2016;5: pubmed
    ..For atrial fibrillation patients aged 20 to 49 years with 1 risk factor in addition to sex, non-vitamin K antagonist OACs should be considered for stroke prevention to minimize the risk of a potentially fatal or disabling event. ..
  19. Chung F, Lin Y, Chong E, Chang S, Lo L, Hu Y, et al. The Application of Ambulatory Electrocardiographically-Based T-Wave Alternans in Patients with Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy. Can J Cardiol. 2016;32:1355.e15-1355.e22 pubmed publisher
    ..5% and 90.5%, respectively, in predicting SCD or ventricular tachyarrhythmias. The initial analysis of MMA TWA could provide prognostic implications in the prediction of SCD or ventricular tachyarrhythmias in patients with ARVD/C. ..
  20. Chao T, Liu C, Liao J, Wang K, Lin Y, Chang S, et al. Use of Oral Anticoagulants for Stroke Prevention in Patients With Atrial Fibrillation Who Have a History of Intracranial Hemorrhage. Circulation. 2016;133:1540-7 pubmed publisher
    ..Whether the use of non-vitamin K antagonist oral anticoagulants could lower the threshold for treatment deserves further study. ..
  21. Chong E, Chang H, Chen Y, Poh K, Chung F, Chang S, et al. When Atrial Fibrillation Co-Exists with Coronary Artery Disease in Patients with Prior Coronary Intervention - Does Ablation Benefit?. Heart Lung Circ. 2016;25:538-50 pubmed publisher
    ..001, HR 3.4, 95% confidence interval 1.9-5.9). In PAF patients with established CAD who underwent PCI, catheter ablation could lead to fewer major adverse cardiac events compared to medical therapy. ..
  22. Jhuo S, Lo L, Chang S, Lin Y, Chung F, Chiou C, et al. Periesophageal vagal plexus injury is a favorable outcome predictor after catheter ablation of atrial fibrillation. Heart Rhythm. 2016;13:1786-93 pubmed publisher
    ..PNI and associated symptoms are not uncommon after catheter ablation of AF. A better long-term outcome is thereby independently predicted, suggesting transmural ablation lesions during pulmonary vein isolation. ..
  23. Chung F, Raharjo S, Lin Y, Chang S, Lo L, Hu Y, et al. A novel method to enhance phenotype, epicardial functional substrates, and ventricular tachyarrhythmias in Brugada syndrome. Heart Rhythm. 2017;14:508-517 pubmed publisher
    ..Ablation by targeting the triggers and abnormal epicardial substrates provided an effective strategy for preventing ventricular tachyarrhythmia recurrences in BrS. ..
  24. Lo L, Lin Y, Chang S, Hu Y, Chung F, Chen S. Beyond Pulmonary Vein Isolation: the Role of Additional Sites in Catheter Ablation of Atrial Fibrillation. Curr Cardiol Rep. 2017;19:86 pubmed publisher
    ..Ablation beyond PV isolation is important, especially in non-paroxysmal AF patients, to modify the diseased atrial substrate and eliminate the non-PV triggers, which in turn improve the ablation outcome. ..
  25. Lin C, Chang S, Lin Y, Lo L, Hu Y, Chao T, et al. Predicting the Origin of Ventricular Arrhythmia Using Acoustic Cardiography. Sci Rep. 2017;7:15490 pubmed publisher
    ..4%, specificity 75.0%, cutoff value: -0.13). The change of S1 complexity and duration determined from acoustic cardiography could accurately predict the ventricular arrhythmia origin. ..
  26. Yamada S, Lo L, Chou Y, Lin W, Chang S, Lin Y, et al. Renal denervation regulates the atrial arrhythmogenic substrates through reverse structural remodeling in heart failure rabbit model. Int J Cardiol. 2017;235:105-113 pubmed publisher
    ..The degree of atrial fibrosis is severe in HF, but not in HF-RDN, suggesting that RDN may regulate the atrial arrhythmogenic substrates in HF mostly through reverse structural remodeling. ..
  27. Allamsetty S, Lo L, Lin Y, Chang S, Chung F, Hu Y, et al. Impact of aortic encroachment to left atrium on non-pulmonary vein triggers of atrial fibrillation. Int J Cardiol. 2017;227:650-655 pubmed publisher
    ..62% of total patients. Careful evaluation of the anatomical relationship between LA and aorta is important during AF ablation for a better long term outcome. ..