エジマ コウイチロウ   EJIMA KOICHIRO
  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   特任准教授
言語種別 日本語
発表タイトル Impact of Late Potentials on the Recurrence of Electrical Storm in Heart Failure Patients with Implantable Cardioverter Defibrillator
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◎野本美智留, 鈴木敦, 志賀剛, 逸見隆太, 柳下大悟, 江島浩一郎, 鈴木豪, 真中哲之, 庄田守男, 萩原誠久
発表年月日 2015/04/26
開催地
(都市, 国名)
大阪市
概要 Background: Implantable cardioverter defibrillator (ICD) improves survival among heart failure patients (HF) who are at high risk for sudden cardiac death (SCD). The aim of this study was to assess the predictors of electrical storm (ES) recurrence in HF patients.Methods: We studied 598 consecutive HF patients who underwent implantation of ICD between 1990 and 2013 (480 male, 58±15 years). We evaluated the impact of ventricular late potential on recurrence of electrical storm after ICD implantation. Results: During the mean follow-up of 3.8±3.6 years, 127 (21%) patients experienced ES. 38 (6%) patients experienced recurrence of electrical storm. Patients who implanted for secondary prevention for SCD experienced significantly higher rate of ES recurrence than others (12% vs. 2%, p < 0.05). There was significantly differences in RAM40 (10.7[5.2-19.1]μV vs. 18.3[7.8-38.2]μV, p < 0.05) and LAS40 (48.0[33.5-70.0]ms vs. 37.5[26.5-53.5]ms, p < 0.05) between patients with and without ES recurrence. Positive ventricular late potential demonstrated high sensitivity and negative predictive value for the prediction of ES recurrence. After correcting for age, sex and indication for ICD implantation in a multivariate logistic regression, positive ventricular late potential was still an independent predictor of ES recurrence (HR 2.3, 95% CI 1.02-5.11, p < 0.05).Conclusion: Ventricular late potential is associated with increased rate of ES recurrence in HF patients with ICD.