Host Mitsuaki Sawano welcomes Dr. Sachiyo Ono, MD (Department of Cardiology, Kurashiki Central Hospital; Minneapolis Heart Institute Foundation International Scholar) to discuss her JACC: Clinical Electrophysiology study from the OCEAN-LAAC registry. Focusing on patients undergoing Left Atrial Appendage Closure, this episode explores how Spontaneous Echo Contrast (SEC)—particularly when combined with persistent atrial fibrillation—relates to thromboembolic events and device-related thrombosis after LAAC. The conversation highlights practical implications for peri-procedural assessment, post-procedural risk stratification, and future considerations in antithrombotic management, while emphasizing how left atrial pathology may continue to matter even after appendage closure.

Hosts Mitsuaki Sawano, MD, Kentaro Ejiri, MD, Nobu Ikemura, MD, and Satoshi Shoji, MD welcome Dr. Shu Hirata, MD (Department of Cardiology, Nihon University Itabashi Hospital), with guest commentary from Dr. Hiroyuki Sato, MD (Tohoku University), to discuss the REHEALTH-AF Study published in JACC: Clinical Electrophysiology. Focusing on patients aged 80 years and older with atrial fibrillation—a group often underrepresented in research and less frequently considered for catheter ablation in routine practice—this prospective multicenter registry enrolled 703 clinically eligible patients (ablation n=249; non-ablation n=454) and compares ablation and non-ablation strategies with respect to symptom burden, quality of life, frailty trajectories, cognitive function, and cardiac biomarkers over one year.

Hosts Mitsuaki Sawano, MD, Shun Kohsaka, MD, and Satoshi Shoji, MD welcome Prof. Tomonori Okamura, MD, and Dr. Aya Hirata, MPH, PhD (Department of Preventive Medicine and Public Health, Keio University School of Medicine) to discuss their JACC Viewpoint, "Current Status of Cardiovascular Disease in Japan: Prevention Strategies, Future Challenges, and Fundamental Lessons." Building on the Global Burden of Disease (GBD) 2023 analysis featured in Epi 40, this episode explores why Japan has achieved one of the world's lowest cardiovascular DALY and mortality rates, highlighting decades of population-wide hypertension control, universal health insurance, and nationwide health checkups. The conversation then turns to emerging challenges—including super-aging, metabolic risk, and heart failure—and asks a key question: how can Japan move beyond single–risk-factor success toward personalized, sustainable prevention strategies for the next era of cardiovascular health? #jaccbaran