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||Catheter Ablation for Treatment of Atrial Fibrillation in Adults with Complex Congenital Heart Disease: A Multicenter Registry|
|会議名||The 66th Annual Meeting of The Japanese Heart Rhythm Society|
|主催者||Japanese Heart Rhythm Society|
|発表者・共同発表者||◎HIGUCHI Satoshi, SHODA Morio, TOYOHARA Keiko, TAKEUCHI Daiji, OKADA Ayako, KANAI Miwa, YAZAKI Kyoichiro, YAGISHITA Daigo, EJIMA Koichiro, UCHIDA Tatsuro, HAGIWARA Nobuhisa|
|概要||*Oral Presentation 9
Mechanisms of atrial fibrillation (AF) associated with complex congenital disease (CHD) have not been proved and the method of catheter ablation (CA) is still under investigation.
Eighteen complex CHD (Atrioventricular septal defects in 4, Tetralogy of Fallot/Double outlet right ventricle in 5, Anomalous pulmonary venous drainage in 2 and others in 7) who underwent CA for drug-refractory AF (paroxysmal AF 78% and mean age 51.7 years) at three hospitals were retrospectively evaluated. Patients following Fontan and atrial switch operation were excluded.
Previous CA for atrial tachycardia (AT) in the right atrium (RA) had been performed in 9 patients (50%). All patients underwent pulmonary vein isolation (PVI) without additional linear ablation and substrate modification during the first PVI procedure. After achieving complete PVI, automatic activities inside the PVs were found in 87% of the patients. During mean follow-up of 13.4 months after initial PVI, 10 patients (56%) became free from AF. Reconnections at PVs were seen in 6 out of 7 patients who received the second PVI procedure. Five patients required repeated CA for ATs, which were from RA in 4 patients and from left atrium in 1 patient. During mean follow-up of 16.7 months after the multiple CA procedures, the AF free rate was 89% and the AT/AF free rate was 78%. Acute hemothorax without a need of intervention was seen in 1.
PVI may be effective in selected patients with complex CHD although multiple CA procedures for AF and ATs were required in some patients.