Elucidation of the electrophysiological characteristics in high risk patients for sudden death after Fontan operation

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K17530
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Kyushu University
• Principal Investigator: Sakamoto Kazuo 九州大学, 大学病院, 助教 (80722363)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: 成人先天性心疾患 / Fontan手術 / 上室性不整脈 / 心室性不整脈

Outline of Final Research Achievements

The purpose of this study was to stratify the risk of sudden death in postoperative Fontan patients, one of the most severe disease groups of adult congenital heart disease (ACHD). I accumulated data on electrophysiological characteristics in patients at high risk for sudden death, which will lead to a better understanding of the pathogenesis of sudden death. According to the analysis of holter ECG, atriopulmonary connection (APC) and lateral tunnel (LT) had a significantly higher incidence of supraventricular arrhythmias compared to the epicardial conduit (EC), however, there was no difference in the incidence of ventricular arrhythmias. This study suggested that the different procedures of Fontan operation may have an impact on sudden death in ACHD patients. Furthermore, the accumulation of electrophysiological findings from cardiac catheterization studies may be useful to elucidate the high risk Fontan patients for sudden death.

Free Research Field

循環器内科学

Academic Significance and Societal Importance of the Research Achievements

Fontan患者において、これまでの限られた突然死リスクのみではなく、手術術式と不整脈の種類や出現様式に関する解析から突然死の高リスク因子を検討したことは、成人後の先天性心疾患患者のより良い治療方針決定に貢献できる。また、本研究結果から突然死の病態へ迫ることで長期的な予後を考慮した幼少期からの治療戦略の策定に寄与し得る。