キンジヨウ　タカヒコ   KINJIYOU Takahiko   金城　貴彦    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	Pulmonary Vein–Triggered Atrial Fibrillation in Unrepaired Double-Outlet Right Ventricle With Pulmonary Atresia
掲載誌名	正式名：JACC: Case Reports 略　 称：J Am Coll Cardiol Case Rep ISSNコード：2666-0849
掲載区分	国外
出版社	ELSEVIER
巻・号・頁	31(9),pp.x-xx
総ページ数	6
著者・共著者	Takahiko Kinjo†*, Masaomi Kimura, Yuichi Toyama, Kimitaka Nishizaki, Hirofumi Tomita
担当区分	責任著者
発行年月	2026/03/04
概要	Background Direct electrophysiological evidence that the pulmonary vein (PV) triggers atrial fibrillation (AF) in patients with complex adult congenital heart disease (ACHD) is lacking; nevertheless, PV isolation (PVI) has been empirically applied. Case Summary A 49-year-old man with an unrepaired double-outlet right ventricle with pulmonary atresia presented with AF and worsening heart failure. Radiofrequency catheter ablation was performed. Spontaneous ectopy originating from the left superior PV reproducibly triggered AF. Ipsilateral PVI achieved clinical success without complications, although right PV could not be isolated because of anatomical difficulties. The patient has remained free of arrhythmias or cardiovascular events for 4.5 years. Discussion Electrophysiological confirmation of AF triggers in a patient with complex ACHD is challenging because of limited procedural tolerance, making this single case a valuable piece of evidence. Take-Home Message PV-triggered AF was demonstrated in a patient with complex ACHD, which provides rare electrophysiological evidence supporting the empirical strategy of PVI.
DOI	https://doi.org/10.1016/j.jaccas.2025.106738