Electrocardiographic score system for patients with adult congenital heart disease

• Project/Area Number: 17K09499
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cardiovascular medicine
• Research Institution: Okayama University
• Principal Investigator: WATANABE ATSUYUKI 岡山大学, 大学病院, 講師 (50766441)
• Co-Investigator(Kenkyū-buntansha): 森田 宏 岡山大学, 医歯薬学総合研究科, 教授 (50322227)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000); Fiscal Year 2019: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2018: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2017: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
• Keywords: 致死性不整脈 / スコアリング / 成人先天性心疾患 / 予後予測 / スコアリング化 / 不整脈 / MACE / 心電図指標 / 経皮的カテーテル心筋焼灼術 / 予後 / 先天性心疾患 / 心臓突然死 / 心不全 / 心血管イベント

Outline of Final Research Achievements

We investigated the electrocardiographic prognostic factors in cases with underlying heart disease. We tried to make a more accurate system construction by combining multiple factors and scoring. Especially, the fragmented QRS potential and symptoms were important in hypertrophic cardiomyopathy and Brugada syndrome, and could be applied to patients with ACHD. However, in ACHD cases, there was a large variety of diseases, and we found that it was difficult to predict using only conventional indicators. For scoring ACHD cases, it was found necessary to include quantification of invasive indicators.

Academic Significance and Societal Importance of the Research Achievements

心電図指標には様々なものがあるが、どの因子が予後を規定するかは不明である。今回の研究ではどの指標が重要で、何を注意して経過観察を行うべきかが明らかになった。特に基礎心疾患を有する症例について、心電図指標のみならず心室性期外収縮の形態によっても危険度を予測することが可能になった。これらの指標を注意深く観察することで若年者の突然死を予防することができれば社旗的意義は非常に高いといえる。

Research Products

• [Journal Article] Efficacy of catheter ablation for paroxysmal atrial fibrillation in patients with atrial septal defect: a comparison with transcatheter closure alone (2019)
  • Author(s): Nakagawa K, Akagi T, Nagase S, Takaya Y, Kijima Y, Toh N, Watanabe A, Nishii N, Nakamura K, Morita H, Kusano K, Ito H
  • Journal Title: Europace Volume: 21 Issue: 11 Pages: 1663-1669
  • DOI: 10.1093/europace/euz207
  • Peer Reviewed
• [Journal Article] Prognosis after lead extraction in patients with cardiac implantable electronic devices infection: Comparison of lead-related infective endocarditis with pocket infection in a Japanese single-center experience. (2019)
  • Author(s): Nishii N, Morimoto Y, Miyoshi A, Tsukuda S, Miyamoto M, Kawada S, Nakagawa K, Watanabe A, Nakamura K, Morita H, Morimatsu H, Kusano N, Kasahara S, Shoda M, Ito H
  • Journal Title: J Arrhythm. Volume: 35 Issue: 4 Pages: 654-663
  • DOI: 10.1002/joa3.12164
  • Peer Reviewed
• [Journal Article] A Low Critical Event Rate Despite a High Abnormal Event Rate in Patients with Cardiac Implantable Electric Devices Followed Up by Remote Monitoring. (2019)
  • Author(s): Morimoto Y, Nishii N, Tsukuda S, Kawada S, Miyamoto M, Miyoshi A, Nakagawa K, Watanabe A, Nakamura K, Morita H, Ito H.
  • Journal Title: Intern Med. Volume: 58 Pages: 2333-2340
  • NAID: 130007690136
  • Peer Reviewed
• [Journal Article] Radiofrequency catheter ablation prior to percutaneous coronary intervention in patients with atrial fibrillation coexisting with stable coronary artery disease: a single-center pilot study. (2019)
  • Author(s): Kawada S, Watanabe A, Morimoto Y, Nakagawa K, Nishii N, Nakamura K, Morita H, Ito H.
  • Journal Title: Heart Vessels. Volume: 34 Issue: 4 Pages: 632-640
  • DOI: 10.1007/s00380-018-1280-8
  • Peer Reviewed
• [Journal Article] Identification of electrocardiographic risk markers for the initial and recurrent episodes of ventricular fibrillation in patients with Brugada syndrome. (2018)
  • Author(s): Morita H, Watanabe A, Kawada S, Miyamoto M, Morimoto Y, Nakagawa K, Nishii N, Nakamura K, Ito H.
  • Journal Title: J Cardiovasc Electrophysiol Volume: 29 Issue: 1 Pages: 107-114
  • DOI: 10.1111/jce.13349
  • Peer Reviewed
• [Journal Article] Analysis of arrhythmic events is useful to detect lead failure earlier in patients followed by remote monitoring. (2018)
  • Author(s): Nishii N, Miyoshi A, Kubo M, Miyamoto M, Morimoto Y, Kawada S, Nakagawa K, Watanabe A, Nakamura K, Morita H, Ito H.
  • Journal Title: J Cardiovasc Electrophysiol. Volume: 29 Issue: 3 Pages: 463-470
  • DOI: 10.1111/jce.13399
  • Peer Reviewed
• [Journal Article] Recording of isolated very delayed potentials on the right ventricular epicardium in a patient with Brugada syndrome. (2017)
  • Author(s): Watanabe A, Morita H, Tsushima S, Nakagawa K, Nishii N, Ito H.
  • Journal Title: HeartRhythm Case Rep Volume: 3 Issue: 7 Pages: 344-347
  • DOI: 10.1016/j.hrcr.2017.05.001
  • Peer Reviewed
• [Journal Article] Distribution and Prognostic Significance of Fragmented QRS in Patients with Brugada Syndrome. (2017)
  • Author(s): Morita H, Watanabe A, Morimoto Y, Kawada S, Tachibana M, Nakagawa K, Nishii N, Ito H.
  • Journal Title: Circ Arrhythm Electrophysiol Volume: 印刷中 Issue: 3
  • DOI: 10.1161/circep.116.004765
  • Peer Reviewed / Int'l Joint Research
• [Presentation] Catheter Ablation of Left Ventricular Arrhythmias Using the Real-Time Three-Dimensional Anatomic Geometry from Ultrasound (2019)
  • Author(s): Atsuyuki Watanabe, Yuki Takenaka, Hironori Nishiyama, Saori Asada, Tomoo Kimura, Yoshimasa Morimoto, Masakazu Miyamoto, Koji Nakagawa, Nobuhiro Nishii, Kazufumi Nakamura, Morita Hiroshi, Ito Hiroshi
  • Organizer: 第66回日本不整脈心電学会学術大会
• [Presentation] The Clinical Characteristics in Patients with Hypertrophic Cardiomyopathy Related Ventricular Arrhythmia (2018)
  • Author(s): Atsuyuki Watanabe, Saori Tsukuda, Masakazu Miyamoto, Yoshimasa Morimoto, Koji Nakagawa, Nobuhiro Nishii, Kazufumi Nakamura, Hiroshi Morita, Hiroshi Ito
  • Organizer: APHRS 2018 Taipei: The 11th APHRS Scientific Session
  • Int'l Joint Research
• [Presentation] The relationship with scar location and QRS morphology of ventricular tachycardia in patients with hypertrophic cardiomyopathy (2018)
  • Author(s): Watanabe A, Morita H, Kawada S, Miyamoto M, Morimoto Y, Nakagawa K, Nishii N, Nakamura K, Ito H.
  • Organizer: 第82回日本循環器学会学術集会
• [Presentation] The Significance of Detailed Endocardial and Epicardial Mapping with Ventricular Tachyarrhythmias in Patients with Brugada syndrome (2017)
  • Author(s): Watanabe A, Morita H, Kawada S, Miyamoto M, Morimoto Y, Nakagawa K, Nishii N, Nakamura K, Ito H.
  • Organizer: Heart Rhythm Society (HRS) Scientific Sessions 2017
  • Int'l Joint Research
• [Presentation] Refractory Repetitive Ventricular Tachycardia In Patients With Hypertrophic Cardiomyopathy (2017)
  • Author(s): Watanabe A, Morita H, Kawada S, Miyamoto M, Morimoto Y, Nakagawa K, Nishii N, Nakamura K, Ito H.
  • Organizer: Asia Pacific Heart Rhythm Society (APHRS) Scientific Sessions 2017
  • Int'l Joint Research
• [Book] 循環器内科グリーンノート (2018)
  • Author(s): 渡邊 敦之
  • Total Pages: 542
  • Publisher: 中外医学社
  • ISBN: 9784498134270