エジマ　コウイチロウ   Ejima Kouichirou   江島　浩一郎    所属   医学部 医学科（東京女子医科大学病院）    職種   寄附部門准教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Long-term clinical course after catheter ablation of atrial fibrillation in patients with hypertrophic cardiomyopathy.
掲載誌名	正式名：Heart and vessels 略　 称：Heart Vessels ISSNコード：0910-8327/1615-2573
掲載区分	国内
出版社	Springer Japan KK
巻・号・頁	34(3),pp.527-537
著者・共著者	HIGUCHI Satoshi†, EJIMA Koichiro*, MINAMI Yuichiro, OOYABU Kenjiro, IWANAMI Yuji, YAGISHITA Daigo, SHODA Morio, HAGIWARA Nobuhisa
担当区分	責任著者
発行年月	2019/03
概要	Atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) patients is highly associated with deterioration of their clinical condition, such as worsening heart failure symptoms, and an increased thromboembolic stroke risk and cardiac mortality rate. This study aimed to investigate the long-term clinical course after catheter ablation (CA) in HCM patients with AF. Among 566 primary HCM patients at our institution, 94 who underwent rhythm control therapy to manage AF from 2002 to 2016 were retrospectively analyzed. The eligible patients were divided into two groups: those who managed AF with CA (n = 34) and those without CA (n = 60). The endpoints were the incidence of initial clinical events, including HCM-related death or an unplanned heart failure hospitalization, or new-onset thromboembolic strokes. During a mean follow-up of 5.8 years, 6% in the CA group and 28% in the non-CA group had a progression of the AF type into permanent AF (Log-rank: p = 0.012). In the Kaplan-Meyer curve analyses, the incidence of clinical events was significantly lower in the CA group than non-CA group (p = 0.025). The annual rates for the incidence of clinical events were 1.2% in the CA group and 6.7% in the non-CA group. In a Cox multivariate analysis, CA therapy (adjusted hazard ratio 0.22; 95% confidence interval: 0.05-0.97; p = 0.046) was the only independent predictor of the incidence of clinical events. In conclusion, CA may be associated with a favorable long-term clinical course in HCM patients with AF.
DOI	10.1007/s00380-018-1269-3
PMID	30255478