Diagnosis and ablation of superior type fast-slow atrioventricular nodal reentrant tachycardia

• Project/Area Number: 16K09418
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cardiovascular medicine
• Research Institution: Gunma University
• Principal Investigator: Kaneko Yoshiaki 群馬大学, 大学院医学系研究科, 准教授 (60302478)
• Co-Investigator(Kenkyū-buntansha): 中島 忠 群馬大学, 医学部附属病院, 講師 (40510574)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000); Fiscal Year 2018: ¥260,000 (Direct Cost: ¥200,000、Indirect Cost: ¥60,000); Fiscal Year 2017: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2016: ¥3,640,000 (Direct Cost: ¥2,800,000、Indirect Cost: ¥840,000)
• Keywords: 房室結節リエントリー性頻拍 / アブレーション / 臨床 / 内科 / 循環器・高血圧 / 不整脈 / 頻拍症

Outline of Final Research Achievements

We investigate varieties of atypical atrioventricular nodal reentrant tachycardia (AVNRT) using a superior slow pathway (sup-SP). Among 18 patients of superior type fast-slow AVNRT, we found 4 patients with the tachycardia using a sup-SP extending superoanterior right atrial free wall along the tricuspid annulus, namely superoanterior type. Also, among 43 patient of apparent slow-fast AVNRT who underwent different atrial entrainment pacing, we found 4 patients (9%) of the tachycardia presenting atypical response during the pacing, who might include slow-fast AVNRT using a sup-SP as an antegrade limb.

Academic Significance and Societal Importance of the Research Achievements

本研究では、稀ではあるが新たな房室結節リエントリー性頻拍の一亜型の機序、診断及びアブレーション治療法を明らかにした。さらに、稀な房室結節伝導路であるsuperior slow pathwayの成因が、三尖弁輪右房自由璧に存在する房室輪の遺残の可能性があることを示唆した。多くの上室性頻拍はカテーテル治療によって根治可能となっているが、本研究により未知の頻拍の存在が明らかになることによってさらなるアブレーション治療の適応拡大、治療成績の向上が期待される。

Research Products

• [Journal Article] A case of atypical fast-slow atrioventricular nodal reentrant tachycardia utilizing a slow pathway extending to the superoanterior right atrium. (2019)
  • Author(s): Kaneko Y, Nakajima T, Iizuka T, Tamura S, Kurabayashi M.
  • Journal Title: Int Heart J Volume: XX
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] 通常のSlow pathwayをbystander pathwayとするsuperior type fast-slow 房室結節リエントリー性頻拍の1例． (2018)
  • Author(s): 飯塚貴士、金古善明、中島忠、入江忠信、太田昌樹、飯島貴史、田村未央、田村峻太郎、齋藤章宏、倉林正彦
  • Journal Title: 臨床心臓電気生理 Volume: 41 Pages: 233-243
  • Peer Reviewed
• [Presentation] How to Ablate Atypical AVNRT Utilizing Variant of Slow Pathways? (2018)
  • Author(s): Kaneko Y, et al
  • Organizer: 11th Asia Pacific Heart Rhythm Society Scientific Session(APHRS 2018)
  • Int'l Joint Research / Invited
• [Presentation] Application of V-A-A-V Response Immediately after Ventricular Induction/Entrainment to Discriminate Atypical Atrioventricular Nodal Reentrant Tachycardia from Atrial Tachycardia. (2018)
  • Author(s): Kaneko Y, et al
  • Organizer: 11th Asia Pacific Heart Rhythm Society Scientific Session(APHRS 2018)
  • Int'l Joint Research
• [Presentation] Electophysiological characteristics and catheter ablation of atypical fast-slow atrioventricular nodal reentrant tachycardia. (2018)
  • Author(s): Yoshiaki Kaneko
  • Organizer: The 2018 International Congress on Electrocardiology (ICE 2018)
  • Int'l Joint Research / Invited
• [Presentation] Atypical fast-slow atrioventricular nodal reentrant tachycardia utilizing a slow pathway connected to the right atrial free wall along the tricuspid annulus. (2018)
  • Author(s): Yoshiaki Kaneko, Tadashi Nakajima, Akihiko Nogami, Yasuya Inden, Tetsuya Asakawa, Itsuro Morishima, Akira Mizukami, Tadanobu Irie, Takashi Iizuka, Shuntaro Tamura, Chihiro Ota, Yasunori Kanzaki, Kazuya Nakagawa, Makoto Suzuki, Masahiko Kurabayashi
  • Organizer: American College of Cardiology's 67th Annual Scientific Session
  • Int'l Joint Research
• [Presentation] Recognition of Lower Common Pathway in the Atrioventricular Node in ATP-sensitive Supraventricular Tachycardia Originating from His-bundle Region. (2017)
  • Author(s): Kaneko Y, Nakajima T, Irie T, Iizuka T, Tamura S, Tamura M, Ota M, Saito A, Kurabayashi M
  • Organizer: The 81th annual scientific meeting of the Japanese Circulation Society
  • Place of Presentation: 金沢
  • Year and Date: 2017-03-18
• [Presentation] Atypical Superior Slow Pathway That Extends Anterolaterally Along the Tricuspid Annulus in Superior Type of Fast-slow Atrioventricular Nodal Reentrant Tachycardia. (2017)
  • Author(s): Kaneko Y, Nakajima T, Irie T, Iizuka T, Tamura S, Tamura M, Ota M, Saito A, Kurabayashi M
  • Organizer: The 81th annual scientific meeting of the Japanese Circulation Society
  • Place of Presentation: 金沢
  • Year and Date: 2017-03-18
• [Presentation] Electroanatomically-estimated localization of superior slow pathway in superior type of fast-slow atrioventricular nodal reentrant tachycardia. (2016)
  • Author(s): Shuntaro Tamura, Yoshiaki Kaneko, Tadashi Nakajima, Tadanobu Irie, Takashi Iizuka, Masahiko Kurabayashi, Osamu Igawa
  • Organizer: ESC Congress 2016
  • Place of Presentation: Roma
  • Year and Date: 2016-08-27
• [Presentation] Atypical slow-fast atrioventricular nodal reentrant tachycardia incorporating “superior” slow pathway: a role of atrial differential entrainment pacing. (2016)
  • Author(s): Iizuka T, Kaneko Y, Nakajima T, Nakahara S, Irie T, Ota M, Iijima T, Tamura M, Tamura S, Saito A, Kurabayashi M
  • Organizer: Heart Rhythm 2016
  • Place of Presentation: San Farancisco
  • Year and Date: 2016-05-05
• [Book] Catheter ablation: acurrent apporach on cardiac arrhythmias (2018)
  • Author(s): Kaneko Y
  • Total Pages: 390
  • Publisher: Sprinder