Development of new targeted substrate for ablation based on dominant frequency and rotor analysis in persistent atrial fibrillation

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K08495
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Tohoku Medical and Pharmaceutical University
• Principal Investigator: KUMAGAI Koji 東北医科薬科大学, 医学部, 教授 (30400328)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 持続性心房細動 / 心房内低電位領域 / 高周波数部位 / 渦巻き型旋回興奮波 / 肺静脈隔離

Outline of Final Research Achievements

The proportion of low voltage areas (LVAs) in the left atrium (LA) after pulmonary vein isolation (PVI) in persistent atrial fibrillation (AF) was actually mild despite LA enlargement. There were no significant differences in maximum high dominant frequency values between the recurrent and non-recurrent groups. LVAs were mostly found in the septum, anterior and inferior wall in LA. The frequency of rotors, which were the driving force of AF, was still high even after PVI in persistent AF, but there was no significant difference between the recurrent and non-recurrent groups. Finally, there was a significant difference between both groups in the LVAs and the overlap area between LVAs and high dominant frequency. The high dominant frequency sites in the injured myocardium and fibrosis of the LA may reflect the potential drivers of AF.

Free Research Field

arrhythmia

Academic Significance and Societal Importance of the Research Achievements

発作性心房細動に対するカテーテルアブレーションの有効性は、すでに確立されているが、持続性心房細動に対しては未だ確立していない。肺静脈隔離後、心房細動基質に対する有効な追加すべき修飾法が明らかでないからである。本研究にて、肺静脈隔離後の低電位領域の割合は軽度であるが、低電位領域と、その高周波数部位とのoverlap部位が至適焼灼部位の候補であった。心房の傷害心筋・繊維化における高周波数部位が心房細動の駆動源を表すと考えられ、アブレーションの新しい標的となるかもしれない。