ナカニシ トシオ   NAKANISHI Toshio
  中西 敏雄
   所属   医学部 医学科(東京女子医科大学病院)
   職種   特任教授
言語種別 日本語
発表タイトル Management of Tachyarrhythmias in Patients with Adult Congenital Heart Disease after Cardiac Surgery
会議名 第80回日本循環器学会学術集会
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◎豊原啓子, 庄田守男, 中西敏雄
発表年月日 2016/03/20
開催地
(都市, 国名)
仙台市
概要 Background: Tachyarrhythmia is a complication in patients with adult congenital heart disease (ACHD).Methods and results: 156 patients with the median age of 33 years old were investigated. 137 patients had supraventricular tachycardia (SVT) and 19 patients had ventricular tachycardia (VT). The previous surgery with SVT was APC-Fontan in 64 patients, TCPC-Fontan in 21, ASO (atrial switch operation) in 10 and biventricular repair (BVR) in 42. We performed catheter ablation (CA) in 116 patients with SVT. Acute success rate of CA was 67% (30/45) in APC, 68% (13/19) in TCPC, 90% (9/10) in ASO and 88% (37/42) in BVR. Recurrence rate after CA was 30% (9/30), 38% (5/13), 33% (3/9) and 8% (3/37), respectively. Antiarrhythmic drugs was also used in 81% (52/64), 66% (14/19), 60% (6/10) and 48% (20/42), respectively. A pacemaker was implanted to control SVT in 33% (21/64), 19% (4/21), 50% (5/10) and 24% (10/42), respectively. The previous surgery with VT was RVOT reconstruction in 10, Rastelli in 7, APC-Fontan in 1, ASO in 1. CA was performed in 36% (7/19), acute success rate was 42% (3/7). ICDswere implanted in 84% (16/19) and drugs were used in 94% (18/19).Conclusion: CA can be a curative approach especially for SVT of postoperative ACHD. However, hybrid therapy with antiarrhythmic drugs or cardiac implantable electric devices may be required in the selected population.