トヨハラ　ケイコ   Toyohara Keiko   豊原　啓子    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
言語種別	日本語
発表タイトル	Prophylactic Catheter Ablation of the Arrhythmogenic Substrates for Total Cavo-pulmonary Connection Candidates
会議名	第81回日本循環器学会学術集会
主催者	日本循環器学会
学会区分	全国規模の学会
発表形式	ポスター掲示
講演区分	一般
発表者・共同発表者	◎豊原啓子, 庄田守男, 朴仁三
発表年月日	2017/03/19
開催地 （都市, 国名）	金沢市
学会抄録	第81回日本循環器学会学術集会　プログラム集 452
概要	Background: The substrates of supraventricular tachycardia (SVT) are often associated with candidates for total cavo- pulmonary connection (TCPC) procedure. Since SVT can be a serious complication and is mostly difficult to be cured by catheter ablation (CA) because of access limitation to the heart after TCPC. Therefore, pre‒operative electrophysiological study (EPS) seems important to prospect the risk of SVT. Patients: We performed EPS upon 27 consecutive patients (isomerism in 21, Ebstein anamoly in 3, ccTGA 2 and tricuspid atresia in 1) before TCPC. Median age was 3 years and median weight was 13 kg. Results: In 24 patients (88%) except 3 with Ebstein anmomaly, distinct His bundle electrograms were recorded at the unusual sites. Coronary sinus did not exist in 25 patients. The type of SVT was arioventricular (AV) reentrant tachycardia (AVRT) with accessory pathway in 2 patients, AVRT involving twin AV nodes in 13, uncommon AV nodal reentrant tachycardia (AVNRT) in 2, common atrial flutter (AFL) in 4 and incisional atrial reentrant tachycardia in 5 and ventricular tachycardia in 1. We achieved successful CA in 25 patients (92%). The mean follow‒up period was 3 years. In all patients after CA no recurrence of SVT was observed. All patients underwent TCPC procedure successfully and safely. Conclusion: Prophylactic CA of arrhythmogenic substrates in TCPC candidates may be an effective therapeutic option.