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	Electrophysiological features and radiofrequency catheter ablation of accessory pathways associated with atrioventricular discordance.
掲載誌名	正式名：Journal of cardiovascular electrophysiology 略　 称：J Cardiovasc Electrophysiol ISSNコード：10453873/1540816
掲載区分	国外
出版社	Wiley Periodicals, Inc.
巻・号・頁	31(1),pp.89-99
著者・共著者	TAKEUCHI Daiji†*, TOYOHARA Keiko, SHODA Morio, HAGIWARA Nobuhisa
発行年月	2020/01
概要	INTRODUCTION: Although a high prevalence of the presence of an accessory pathway (AP) associated with atrioventricular (AV) discordance has been reported, a case series of its characteristics and the results of catheter ablation (CA) have not been sufficiently documented. METHODS AND RESULTS: We retrospectively examined 11 consecutive patients with atrioventricular discordance who underwent CA for atrioventricular reciprocating tachycardia (AVRT) via an AP and planned cardiac surgery after CA. Orthodromic AVRTs were induced in 10 patients via AP, but no antidromic/duodromic AVRT was induced in any of the cases. A total of 13 APs were identified, and all of them were located around the anatomical tricuspid valve (TV) annulus, including two Ebsteinoid valves. The APs were predominantly located posteriorly, posterolaterally, and posteroseptally on the TV in nine patients (82%). Two patients (18%) had multiple APs or a single broad AP. Four (36%) and three (27%) patients showed twin AVNs and other supraventricular tachycardias (SVTs) except AVRT via the AP. Ten patients (91%) had acute successful CA in the first session, except for one patient with multiple APs who required the third session to eliminate all APs before the planned Fontan surgery. There were no major complications associated with CA. Seven of eight patients who underwent cardiac surgery after CA did not experience peri-/postoperative SVT. CONCLUSION: APs in patients with AV discordance are usually associated with the anatomical TV annulus. CA of an AP in AV discordance is highly effective and recommended to reduce the risk of SVT. The coexistence of twin AVNs and other SVTs should be considered during CA of an AP in AV discordance.
DOI	10.1111/jce.14273
PMID	31724792