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
|発表タイトル||Comparison of Catheter Ablation of Atrial Fibrillation between Patients with and without Atrial Septal Defects: A Propensity Score Matched Analysis|
|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||◎IWANAMI Yuji, EJIMA Koichiro, HENMI Ryuta, YAGISHITA Daigo, SHODA Morio, HAGIWARA Nobuhisa|
|学会抄録||PROGRAM JCS 2017 275|
|概要||Background: Long-term follow-up after a staged approach with catheter ablation of atrial fibrillation (AF) preceding percutaneous closures in patients with AF and atrial septal defects (ASDs) is seldom reported.
Methods & Results: We compared the long-term efficacy of AF ablation in 14 patients with ASDs and 14 without that were matched using propensity score matching. All but 1 patient received a follow-up electrophysiological study 3 months after the first session, and ablation was performed if necessary. Twelve of 14 ASD patients underwent percutaneous closures 7.1±3.9 months after the last ablation session. There was no significant difference in the baseline characteristics between patients with and without ASDs. The mean number of ablation sessions was greater in the ASD patients than those without (2.0±0.4 vs. 1.4±0.5, p=0.003). During 28±17 months of follow-up after the final procedure, 1 (7%) ASD patient and 2 (14%) patients without ASDs experienced recurrences. A Kaplan-Meier analysis of the recurrence-free survival rate revealed no significant difference between the patients with and without ASDs (Log-rank, p=0.52). In univariate Cox proportional hazards analyses, the factor found to have a significant association with atrial tachyarrhythmia recurrences after the final ablation procedure was the age (hazard ratio 0.88, 95%CI 0.762-0.995, p=0.04).
Conclusion: Long-term outcomes of AF ablation in patients with ASDs were as favorable as that in those without ASDs.