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Postoperative atrial fibrillation in cardiac surgery: an approach to the mechanism and protection.

Research Project

Project/Area Number 16K10643
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Research Field Cardiovascular surgery
Research InstitutionNippon Medical School

Principal Investigator

IMURA HAJIME  日本医科大学, 医学部, 准教授 (40281422)

Project Period (FY) 2016-04-01 – 2020-03-31
Project Status Completed (Fiscal Year 2019)
Budget Amount *help
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2019: ¥130,000 (Direct Cost: ¥100,000、Indirect Cost: ¥30,000)
Fiscal Year 2018: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2017: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2016: ¥2,600,000 (Direct Cost: ¥2,000,000、Indirect Cost: ¥600,000)
Keywords心房細動 / 開心術 / 電気生理学検査 / 術後合併症 / ペーシング / 電気生理学 / マグネシウム / 心筋保護 / 心房電位 / 再灌流障害
Outline of Final Research Achievements

We investigated where and how postoperative atrial fibrillation (POAF) occurred in the atrium after cardiac surgeries. Electric potentials of the left and right atrium (RA and LA) were monitored through five pacing leads (upper and lower RA, Bachmann bundle on the atrial septum (BB), and lateral walls of LA near the lower pulmonary veins) in 41 patients who underwent valve surgeries. POAF was seen in 16 patients (39%), and POAF was recorded via the leads in 12 patients. Mean duration between surgery and POAF was 3.5 days. Six POAF started from the left LA (most frequent). In pacing study (100/min) at BB lead, the conductivities to other 4 leads (duration between pacing spike and atrial potential at the 4 leads) were significantly delayed (p<0.05) before cardiopulmonary bypass in POAF patients. Thus, this study demonstrated that simple pacing study might be useful to identify patients who were at high risk of POAF.

Academic Significance and Societal Importance of the Research Achievements

心臓手術後心房細動ではこれまで複数の素因(年齢や肥満、CT所見など)が報告されているが特異性に問題があった。我々の行った電気生理学検査によるアプローチは感度と特異性に優れる可能性があり、より有効にPOAF発生を予測する可能性がある。的確なPOAF発生の予想は、その予防に貢献し、医療費の軽減に寄与することが期待される。

Report

(5 results)
  • 2019 Annual Research Report   Final Research Report ( PDF )
  • 2018 Research-status Report
  • 2017 Research-status Report
  • 2016 Research-status Report

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Published: 2016-04-21   Modified: 2021-02-19  

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