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||Predictive value of the total atrial conduction time estimated with tissue Doppler imaging for predicting atrial tachyarrhythmia recurrences after catheter ablation|
|会議名||The Annual Congress of the European Heart Rhythm Association (EHRA 2018)|
|主催者||The European Heart Rhythm Association (EHRA)|
|発表者・共同発表者||◎EJIMA Koichiro, HIGUCHI Satoshi, IWANAMI Yuji, YAGISHITA Daigo, ARAI Kotaro, SAITO Chihiro, TANINO Sae, ASHIHARA Kyomi, SHODA Morio, HAGIWARA Nobuhisa|
|学会抄録||European Heart Journal Supplements 20(Supplement 1),i125 2018|
|概要||*Session Title: Atrial fibrillation ablation - New tools and strategies for lesion creation and evaluation
Background: The estimated total atrial conduction time measured using tissue Doppler imaging of the atria (PATDI duration) has been proposed as a marker of atrial remodeling.
Purpose: To investigate the prognostic value of the echocardiographic parameters, including the PATDI duration, obtained before paroxysmal atrial fibrillation (AF) ablation procedures, to predict atrial tachyarrhythmia recurrences after the procedure.
Methods and Results: We enrolled 294 consecutive patients (60±11 years; 213 men) with paroxysmal AF who underwent AF ablation and measured the preprocedural PATDI duration. All patients underwent a circumferential pulmonary vein isolation without either an empiric substrate modification or empiric left atrial linear ablation. During 38±21 months of followup after the final procedure (two procedures in 31%, three in 3%), 39 (13%) patients had atrial tachyarrhythmia recurrences. Eighteen patients who did not undergo repeat procedures despite AF recurrences after the first session were excluded from the analysis. A multivariate Cox regression analysis including the age, gender, structural heart disease, left atrial volume index, and PATDI duration as variables, demonstrated that the PATDI duration was an independent predictor of a recurrence (p<0.0001). The optimal cutoff value of the PATDI duration for predicting a recurrence was >151.0ms, with a sensitivity of 90%, specificity of 65%, and negative predictive value of 99%. Recurrences after repeat procedures were significantly higher in the patients with a PATDI duration >151.0ms compared to those with a PATDI duration <151.0ms (Logrank; p<0.0001). The patients with a PATDI duration >151ms had a 13 fold (p<0.0001) increase in the probability of recurrent AF as compared to the patients with a PATDI duration <151ms.
Conclusion: The PATDI duration was a useful predictor of recurrences after ablation procedures in patients with paroxysmal AF.