ヒグチ　サトシ   HIGUCHI Satoshi   樋口　諭    所属   医学部 医学科（東京女子医科大学病院）    職種   寄附部門講師
論文種別	総説
言語種別	英語
査読の有無	査読あり
表題	Catheter ablation of short-coupled variant of torsade de pointes.
掲載誌名	正式名：Clinical research in cardiology : official journal of the German Cardiac Society 略　 称：Clin Res Cardiol ISSNコード：18610692/18610684
掲載区分	国外
巻・号・頁	111(5),pp.502-510
著者・共著者	Steinfurt Johannes, Nazer Babak, Aguilar Martin, Moss Joshua, Higuchi Satoshi, Zarse Markus, Trolese Luca, Gressler Alexander, Faber Thomas S, Odening Katja E, Zehender Manfred, Bode Christoph, Scheinman Melvin M, Tedrow Usha B, Bogossian Harilaos
発行年月	2022/05
概要	BACKGROUND:The short-coupled variant of torsade de pointes (sc-TdP) is a malignant arrhythmia that frequently presents with ventricular fibrillation (VF) electrical storm. Verapamil is considered the first-line therapy of sc-TdP while catheter ablation is not widely adopted. The aim of this study was to determine the origin of sc-TdP and to assess the outcome of catheter ablation using 3D-mapping.METHODS AND RESULTS:We retrospectively analyzed five patients with sc-TdP who underwent 3D-mapping and ablation of sc-TdP at five different institutions. Four patients initially presented with sudden cardiac arrest, one patient experienced recurrent syncope as the first manifestation. All patients demonstrated a monomorphic premature ventricular contraction (PVC) with late transition left bundle branch block pattern, superior axis, and a coupling interval of less than 300 ms. triggering recurrent TdP and VF. In four patients, the culprit PVC was mapped to the free wall insertion of the moderator band (MB) with a preceding Purkinje potential in two patients. Catheter ablation using 3D-mapping and intracardiac echocardiography eliminated sc-TdP in all patients, with no recurrence at mean 2.7 years (range 6 months to 8 years) of follow-up.CONCLUSION:3D-mapping and intracardiac echocardiography demonstrate that sc-TdP predominantly originates from the MB free wall insertion and its Purkinje network. Catheter ablation of the culprit PVC at the MB free wall junction leads to excellent short- and long-term results and should be considered as first-line therapy in recurrent sc-TdP or electrical storm.
DOI	10.1007/s00392-021-01840-z
PMID	33770204