Prognostic Significance of Immediate Arrhythmia Recurrences after Intracardiac Cardioversion in Patients Subsequently Undergoing Persistent Atrial Fibrillation Ablation

2020 Fiscal Year Final Research Report

• Project/Area Number: 18K15865
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Nippon Medical School
• Principal Investigator: FUJIMOTO YUHI 日本医科大学, 医学部, 助教 (80809393)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Keywords: 心房細動 / カテーテルアブレーション

Outline of Final Research Achievements

The purpose of the study was to examine a role of immediate recurrences of atrial fibrillation (IRAF)in predicting arrhythmia recurrences after the catheter ablation. Total 313 consecutive patients were enrolled. IRAF was observed in 62 patients(20%). The patients with IRAF were smaller left atrial volume index (LAVI) and right atrial area than those without. Multivariate analysis revealed LAVI was the predictor of the recurrence of arrhythmia (Hazard ratio {HR} 1.02) after the initial ablation session. The presence of IRAF and right atrial area were the predictors of the recurrence after the final ablation session(HR 0.35 and 1.09, respectively).

Free Research Field

循環器内科

Academic Significance and Societal Importance of the Research Achievements

持続性心房細動に対するアブレーション治療において、治療前に電気的除細動を行い、心房細動治療において有効とされる肺静脈隔離術への反応が良好である例とそうでない例を層別化できる可能性がある。
電気的除細動後にただちに心房細動が再発する例のアブレーション治療成績は、そうでない例と比較し最終再発が少ない結果だった。これは確立された治療法である肺静脈隔離術が有効な、肺静脈内からの期外収縮が心房細動に関与している例を簡便に見つけ出す有用な方法であることが示唆された。