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シヨウダ モリオ
SHODA 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 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Influence of substrate modification in catheter ablation of atrial fibrillation on the incidence of acute complications : Analysis of 10 795 procedures in J-CARAF Study 2011-2016 |
| 掲載誌名 | 正式名：Journal of Arrhythmia 略 称：J Arrhythm ISSNコード：1880-4276/1883-2148 |
| 掲載区分 | 国内 |
| 出版社 | Japanese Heart Rhythm Society |
| 巻・号・頁 | 34(4),pp.435-440 |
| 著者・共著者 | Murakawa Yuji, Yamane Teiichi, Goya Masahiko, Inoue Koichi, Naito Shigeto, Kumagai Koichiro, Miyauchi Yasushi, Morita Norishige, Nogami Akihiko, Shoda Morio, Okumura Ken, Hirao Kenzo, |
| 発行年月 | 2018/07 |
| 概要 | BACKGROUND AND PURPOSE:
In expectation of better outcome of catheter ablation of atrial fibrillation (AF), several strategies of extra-PV (pulmonary vein) substrate modification have been utilized. We assessed whether substrate modification or ablation of extra-PV source is a predictor of complications. METHODS: Japanese Heart Rhythm Society requested electrophysiology centers to register the data of patients who underwent AF ablation. RESULTS: The data of 10 795 AF ablation cases (age; 63.8 ± 10.6 years) treated during 2011-2016 were registered. Pericardial effusion (n = 105), massive bleeding (n = 108), stroke (n = 6), atrial-esophageal fistula (n = 2), and other 114 complications occurred in 323 patients (3.0%). Univariate analysis revealed that age ≧ 65 years, female gender, heart failure, CHA2DS2-VASc≧3, hemodialysis, deep sedation, and complex fractionated atrial electrogram (CFAE)-guided ablation ([+] vs [-] = 4.3% vs 2.8%, P = .005) were related with the higher incidence of complications. Redo session, 3-D imaging system ([+] vs [-]: 4.4% vs 2.9%, P = .017), and periprocedural dabigatran were related with the lower incidence of complications. None of the linear ablation of the left atrium, ganglionated plexi ablation, and superior vena cava ablation affected the incidence of complications. Multiple logistic regression analysis showed that in addition to 3-D imaging system, age ≧ 65 years, redo session, and deep sedation, CFAE ablation was an independent predictor of the risk of complications (OR 1.78, P = .001). Specifically, implantation of a permanent pacemaker due to emerging sinus node dysfunction was frequent after CFAE ablation (CFAE [+] vs [-] = 4/1047 vs 2/9748, P < .001). CONCLUSIONS: Among extra-PV ablation strategies, CFAE-guided ablation is a predictor of ablation-related complications. |
| DOI | 10.1002/joa3.12081 |
| PMID | 30167015 |