エジマ　コウイチロウ   Ejima Kouichirou   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   寄附部門准教授
言語種別	日本語
発表タイトル	Appropriate Waiting Time to Confirm Dormant Conduction after Pulmonary Vein Isolation in Patients with Atrial Fibrillation
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	ポスター掲示
講演区分	一般
発表者・共同発表者	◎加藤賢, 江島浩一郎, 庄田守男, 真中哲之, 柳下大悟, 逸見隆太, 諏訪邦明, 今井美智子, 萩原誠久
発表年月日	2015/04/26
開催地 （都市, 国名）	大阪市
学会抄録	PROGRAM JCS 2015 772
概要	Introduction: Little is known about the appropriate waiting time to confirm the elimination of dormant pulmonary vein (PV) conduction after administration of adenosine triphosphate (ATP). Aim: To clarify the relationship between the waiting time and clinical outcome after pulmonary vein isolation (PVI).Methods: We retrospectively included 191 consecutive patients (age 58.1±10.6, male 82%, paroxysmal atrial fibrillation [AF] 79%) who underwent circumferential PVI for AF. We investigated the waiting time from the final radiofrequency application to the final ATP administration without dormant conduction. Results: The patients were divided into two groups according to waiting times of ≥5, ≥10, ≥15 and ≥20 minutes, and only those with a waiting time of ≥20 minutes had a significantly lower AF recurrent rate (log-rank p=0.03). In patients without dormant conduction, those with waiting times of ≥20 minutes had a significantly lower recurrence of AF (p=0.01), but not in those with dormant conduction (p=0.67). In the multivariate analysis, structural heart disease (HR 2.10, 95%CI;1.17-3.65, p=0.02), the left atrial volume index (HR 1.02, 95%CI;1.00-1.04, p=0.03), and waiting times of <20 minutes (HR 1.86, 95%CI;1.10-3.31, p=0.02) were independent predictors of AF recurrence after the first ablation procedure. Conclusions: A waiting time of ≥ 20 minutes from the final radiofrequency application to the final ATP administration without dormant conduction may be adequate to achieve a good clinical outcome after PVI.