所属 医学部 医学科（東京女子医科大学病院） 職種 助教
|発表タイトル||Impact of Rapid Ventricular Tachycardia Stability on the Effectiveness of Antitachycardia Pacing Therapy before Defibrillation|
|会議名||The 81st Annual Scientific Meeting of the Japanese Circulation Society (JCS2017)|
|主催者||Japanese Circulation Society|
|発表者・共同発表者||◎YAGISHITA Daigo, SHODA Morio, EJIMA Koichiro, IWANAMI Yuji, HENMI Ryuta, HAGIWARA Nobuhisa|
|学会抄録||PROGRAM JCS 2017 208|
|概要||Background: Antitachycardia pacing before defibrillation (ATP-BD) could potentially terminate fast ventricular tachycardia (FVT) detected in ventricular fibrillation zone (VFZ) in patients implanted with ICD or CRTD. Tachycardia cycle length (TCL) has been reported as a predictor of successful FVT termination by ATP-BD, however, the tachycardia stability has not been well investigated.
Methods: This study consisted of 212 patients implanted with Biotronik ICD/CRTD since May 2008 until July 2016 in our institution. A total of 212 appropriate VFZ episodes was recorded in 31 patients. Thirty-three ATP-BD episodes in 11 patients with structural heart disease were investigated. Tachycardia stability (TS) was automatically calculated as a maximum time difference between the TCL among the last four beats before ATP-BD as well as the average of TCL.
Results: Eighteen successful termination episodes (54.5%) were observed among 33 ATP-BD episodes. The TCL was significantly longer and the TS was significantly smaller in successful episodes than unsuccessful episodes (292.2±17.8ms vs. 259.9±32.9ms, p<0.01, 9.7±6.2ms vs. 14.5±7.0ms, p<0.05, respectively). The percentage of TS in the TCL (TS) was also significantly smaller in successful episodes (3.3±2.2% vs.5.7±2.7%, p<0.01). The predictive cut-off value in TCL was 270ms (sensitivity=83.3%, specificity=60.0%, p<0.01, AUC=0.83), and %TS was 3.6% (sensitivity=77.8%, specificity=60.0%, p<0.05, AUC=0.73).
Conclusion: TCL and TS could be the important factors for successful FVT termination by ATP-BD in patients
with an ICD/CRTD.