エジマ コウイチロウ   EJIMA KOICHIRO
  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   特任准教授
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Impact of atrial remodeling on the outcome of radiofrequency catheter ablation of paroxysmal atrial fibrillation.
掲載誌名 正式名:Circulation journal : official journal of the Japanese Circulation Society
略  称:Circ J
ISSNコード:13469843/13474820
掲載区分国内
出版社 Japanese Circulation Society
巻・号・頁 78(4),872-877頁
著者・共著者 EJIMA Koichiro†*, KATO Ken, ARAI Kotaro, FUKUSHIMA Keiko, FUKUSHIMA Noritoshi, SUZUKI Tsuyoshi, YOSHIDA Kentaro, NUKI Toshiaki, UEMATSU Shoko, HOSHI Hiromi, MANAKA Tetsuyuki, ASHIHARA Kyomi, SHODA Morio, HAGIWARA Nobuhisa
発行年月 2014/04
概要 BACKGROUND:
 Both the left atrial volume index (LAVI) and estimated total atrial conduction time measured using tissue Doppler imaging of the atria (PA-TDI duration) are echocardiographic parameters reflecting atrial remodeling. We investigated their prognostic value for atrial tachyarrhythmia (AF/AT) recurrence after radiofrequency catheter ablation (RFCA) of paroxysmal atrial fibrillation (PAF).

METHODS AND RESULTS:
 We analyzed the data for 100 consecutive patients with drug-refractory PAF who underwent RFCA. The correlation between the LAVI and PA-TDI was extremely weak (r=0.26, P<0.01). We categorized the patients into 4 groups based on the median LAVI and PA-TDI duration: group 1 (LAVI <29ml/m(2)/PA-TDI duration <143ms), group 2 (LAVI ≥29ml/m(2)/PA-TDI duration <143ms), group 3 (LAVI <29ml/m(2)/PA-TDI duration ≥143ms), and group 4 (LAVI ≥29ml/m(2)/PA-TDI duration ≥143ms). With a mean follow-up of 20.2±8.9 months after a single RFCA procedure, 60 patients (60%) were in sinus rhythm without any antiarrhythmic drugs. Multivariate analysis using a Cox proportional hazards model demonstrated that the group was an independent predictor of AF/AT recurrence after RFCA (P=0.0017). The patients in groups 2, 3, and 4 had a 4.0-fold (P=0.048), 6.8-fold (P=0.0034) and 10.9-fold (P=0.0001) increase, respectively, in the probability of recurrent AF/AT as compared with group 1.

CONCLUSIONS:
 Preprocedural echocardiographic estimation of atrial remodeling was a useful predictor of AF/AT recurrence following a single RFCA of PAF.
DOI 10.1253/circj.CJ-13-1391