タケウチ　ダイジ   TAKEUCHI Daiji   竹内　大二    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
言語種別	英語
発表タイトル	Hybrid Therapy of Anti-Tachycardia Pacing and Catheter Ablation of Atrial Tachycardia for Patients with Complex Congenital Heart Disease
会議名	The 66th Annual Meeting of The Japanese Heart Rhythm Society
主催者	Japanese Heart Rhythm Society
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	◎TOYOHARA Keiko, KUDO Yoshimichi, TAKEUCHI Daiji, SHODA Morio
発表年月日	2019/07/26
開催地 （都市, 国名）	Yokohama, JAPAN
概要	*Oral Presentation 32 Congenital Heart Disease [Background] Device therapy of bradycardia may be required for patients with congenital heart disease (CHD) after surgery. Additionally, such patients may have complicated substrates of atrial tachycardia (AT) resistant to antiarrhythmic drugs and catheter ablation (CA). [Object] The aim of this study is to evaluate the clinical outcomes of hybrid therapy with anti-tachycardia pacing (ATP) and CA for AT in patients with complex CHD. [Methods] Twenty-four CHD patients after cardiac surgery (two-ventricular repair in 6, Fontan palliation in 12, atrial switch operation in 4, and palliative procedure in 2) with AT and pacemaker-indicated bradycardia were investigated retrospectively. A pacemaker was implanted in 23 patients for sick sinus syndrome in 18 and atrioventricular block in 5 and an implantable cardioverter defibrillator in 1 patient for ventricular tachycardia at the age of 9-59 years old. [Results] CA was performed in all patients and the acute success (no inducible AT) rate was 67% (16/24). Appropriate ATP and successful termination of AT was observed in 38% (9/24) during the average follow-up period of 4.0 years after implantation. However, ATP did not start in 25% (6/24) because of slow AT in 4 patients and of 1:1 atrioventricular conduction during AT in 2 patients. [Conclusions] Although CA was not always successful for complex CHD, an automatic atrial ATP option showed effective additional treatment for refractory AT. Further blushup of the ATP programming should be required.