アライ コウタロウ   ARAI Kotaro
  新井 光太郎
   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 原著
言語種別 英語
査読の有無 査読あり
表題 Right atrial conduction time for predicting coexistent typical atrial flutter in patients with paroxysmal atrial fibrillation.
掲載誌名 正式名:Journal of cardiovascular electrophysiology
略  称:J Cardiovasc Electrophysiol
ISSNコード:10453873/15408167
掲載区分国外
出版社 John Wiley & Sons, Inc.
巻・号・頁 in press頁
著者・共著者 HIGUCHI Satoshi†, EJIMA Koichiro*, SHODA Morio, KANAI Miwa, KATAOKA Shohei, YAZAKI Kyoichiro, YAGISHITA Daigo, YOSHIDA Ayano, TANINO Sae, SAITO Chihiro, YAGISHITA Yoshimi, ARAI Kotaro, ASHIHARA Kyomi, HAGIWARA Nobuhisa
発行年月 2020/06
概要 INTRODUCTION:Screening of coexistent typical atrial flutter (AFL) in patients with atrial fibrillation (AF) is sometimes challenging. This study investigated whether a prolonged right atrial conduction time (RACT) estimated by tissue Doppler imaging (TDI) predicts patients with concomitant AFL and AF.METHODS AND RESULTS:We retrospectively analyzed 398 patients (mean age 61.6 years, 73.4% men) undergoing catheter ablation of paroxysmal AF. The patients were classified into 2 groups according to whether they had evidence of AFL (N=122, 30.7%) determined by a clinical observation (N=68), induction during procedures (N=33), or AFL recurrence after procedures (N=21) or not (N=276, 69.3%). The preoperative RACT, defined as a longer duration between the onset of the P-wave and peak A'-wave on the right atrial lateral wall or septal wall, and total atrial conduction time (TACT), defined as the same time duration on the left atrial lateral wall, were evaluated in all patients. Patients with evidence of AFL had a significantly longer RACT than those without AFL (p<0.001). A multiple logistic regression and receiver operator characteristics curve analysis revealed the ratio of the RACT and TACT (RACT/TACT) was the independent and most superior accurate cofounder for predicting evidence of AFL (area under the curve 0.867). When adding a discriminator of an RACT/TACT≧93% into the conventional screening, 98.4% of the patients with evidence of AFL were estimated to be treated during the initial procedures.CONCLUSION:The estimated RACT/TACT using the TDI may be useful for predicting patients with concomitant AFL in patients with AF. This article is protected by copyright. All rights reserved.
DOI 10.1111/jce.14623
PMID 32557919