シヨウダ　モリオ   Shiyouda Morio   庄田　守男    所属   医学部 医学科（東京女子医科大学病院）    職種   寄附部門教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Impact of an Empiric Isolation of the Superior Vena Cava in Addition to Circumferential Pulmonary Vein Isolation on the Outcome of Paroxysmal Atrial Fibrillation Ablation.
掲載誌名	正式名：The American journal of cardiology 略　 称：Am J Cardiol ISSNコード：00029149/18791913
掲載区分	国外
出版社	Elsevier
巻・号・頁	116(11),pp.1711-1716
著者・共著者	EJIMA Koichiro†*, KATO Ken, IWANAMI Yuji, HENMI Ryuta, YAGISHITA Daigo, MANAKA Tetsuyuki, FUKUSHIMA Keiko, ARAI Kotaro, ASHIHARA Kyomi, SHODA Morio, HAGIWARA Nobuhisa
発行年月	2015/12
概要	The safety and efficacy of an empiric superior vena cava isolation (SVCI) in addition to circumferential pulmonary vein isolation (CPVI) in patients with paroxysmal atrial fibrillation (PAF) have not been clarified. A total of 186 consecutive patients who underwent catheter ablation of PAF were included. All patients underwent a CPVI. Patients in the first half underwent an additional SVCI only if SVC-triggered AF or rapid SVC activity was observed during the procedure (n = 93, as-needed SVCI, group I), and those in the second half underwent an empirical SVCI after the CPVI (n = 93, empiric SVCI, group II). The CPVI was successfully performed in all patients. An SVCI was performed in 8 of 93 patients (9%) in group I and 81 of the 93 patients (87%) in group II. In the remaining 12 patients in group II, an SVCI was not performed because of the lack of SVC potentials. During a mean follow-up of 27 ± 12 months, the atrial tachyarrhythmia recurrence rate after a single ablation procedure in the patients in group II was lower than that in group I (44% vs 23%, p = 0.035). A Cox regression multivariate analysis demonstrated that an empiric SVCI was an independent predictor of an atrial tachyarrhythmia recurrence after a single ablation procedure (odds ratio: 0.57, 95% confidence interval 0.31 to 0.999; p = 0.049). Neither sinus node injury nor any injury to the phrenic nerve was observed. In conclusion, an empiric SVCI in addition to the CPVI improved the outcome of AF ablation in patients with PAF without any additional adverse effects.
DOI	10.1016/j.amjcard.2015.09.005
PMID	26434513