ヤギシタ　ダイゴ   Yagishita Daigo   柳下　大悟    所属   医学部 医学科（東京女子医科大学病院）    職種   寄附部門准教授
言語種別	日本語
発表タイトル	Predictive Value of Atrial Remodeling of Atrial Tachyarrhythmia Recurrence after Catheter Ablation of Atrial Fibrillation during the Long-term Follow
会議名	第79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	口頭
講演区分	一般
発表者・共同発表者	◎江島浩一郎, 加藤賢, 新井光太郎, 福島敬子, 鈴木豪, 逸見隆太, 諏訪邦明, 柳下大悟, 真中哲之, 芦原京美, 庄田守男, 萩原誠久
発表年月日	2015/04/24
開催地 （都市, 国名）	大阪市
学会抄録	第79回日本循環器学会学術集会　プログラム集 298
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 (ATA) recurrence after radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF).Methods and Results: We analyzed the data from 129 consecutive patients who underwent preprocedural transthoracic echocardiography in sinus rhythm and RFCA for AF. At a mean of 29±10 months after single sessions, 52 (40%) patients had ATA recurrences. The patients with ATA recurrences had a larger LAVI (p=0.014) and longer PA–TDI (p=0.007) than those without recurrences. Although the predictive accuracy of the LAVI cut-off value (≥35.1ml/m²) and PA–TDI (≥145.2ms) predicting a recurrence after RFCA estimated by an ROC curve were relatively low (AUC 0.63 and 0.64, respectively), the combined index (LAVI≥35.1ml/m² and PA–TDI≥145.2ms) was the only independent predictor of recurrence after a single RFCA (HR 2.9, 95%CI 1.55–5.33, p=0.0011) in the multivariate Cox regression analysis. Although 29 patients (30%) required repeat procedures, 95 (97%) of 98 patients not falling into a combined index were free from any ATAs without antiarrhythmic drugs at a mean of 26±11 months.Conclusion: Atrial remodeling was a useful predictor of recurrence following ablation procedure in patients with AF.