Preventing effect of catheter ablarion of atrial fibrillation for embolic stroke

• Project/Area Number: 17K09489
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cardiovascular medicine
• Research Institution: Tokyo Medical and Dental University
• Principal Investigator: Goya Masahiko 東京医科歯科大学, 大学院医歯学総合研究科, 准教授 (30521364)
• Co-Investigator(Kenkyū-buntansha): 平尾 見三 東京医科歯科大学, 大学院医歯学総合研究科, 教授 (30208805)
• Project Period (FY): 2017-04-01 – 2023-03-31
• Project Status: Completed (Fiscal Year 2022)
• Budget Amount: ¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000); Fiscal Year 2021: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2020: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2019: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2018: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2017: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
• Keywords: 脳梗塞 / 心房細動 / 経皮的カテーテル心筋焼灼術 / 予防効果 / 予防 / 脳卒中 / 循環器・高血圧 / 臨床 / 内科 / 老化

Outline of Final Research Achievements

Embolic stroke is one of the most catastrophic complications of atrial fibrillation (AF). While catheter ablation of AF is useful and effective. However, it is not well clarified that AF ablation can prevent embolic stroke or not. We planned prospective, observational, multi-center study to examine this issue. This study was conducted at 4 hospitals; Tokyo Medical and Dental University Hospital, Yokosuka Kyosai Hospital, Saitama Red Cross Hospital, and Musashino Red Cross Hospital. Patients that underwent a first-time AF ablation were enrolled. AF fibrillation was performed using each institution’s protocol. Between 2017 and April 30 in 2020, 2754 patients were enrolled in this study. Follow-up was performed according to each hospital’s protocol. During follow up period, only three stroke episodes (2 cerebral infarction and one cerebral hemorrhage) were observed. This study suggests that AF ablation is useful to manage AF and effective to prevent stroke including embolic stroke.

Academic Significance and Societal Importance of the Research Achievements

最も頻度が高い不整脈である心房細動が原因となる脳塞栓症がカテーテル心筋焼灼術により予防が可能であることが本多施設観察研究により示唆された。これは本邦で広く行われている心房細動に対する心筋焼灼術が発作を予防するというＱＯＬの改善のみではなく、脳塞栓症を予防することにより生命予後を改善しうる可能性が示唆された点が重要である

Research Products

• [Journal Article] Initial multicenter clinical experience with the first-generation endoscopic guided laser balloon in Japan (2023)
  • Author(s): Goya M, Hirao K, Aonuma K, Nogami A, Yamane T, Yamauchi Y, Okishige K, Yotsukura A, Kimura M, Naito S, Kato R, Nitta J, Inaba O, Satomi K, Morita N, Kobayashi Y, Inden Y, Yoshida Y, Kakita K, Kobori A, Kusano K, Inoue K, Masuda M, Hiroshima K, Koyama J, Kumagai K, Okumura K; HeartLight study investigators.
  • Journal Title: Journal of Interventional Cardiac Electrophysiology Volume: not yet Issue: 7 Pages: 1713-1721
  • DOI: 10.1007/s10840-023-01493-0
  • Peer Reviewed
• [Journal Article] Predictors of the "Crosstalk" Phenomenon During Cryoballoon Ablation in Patients with Atrial Fibrillation (2021)
  • Author(s): Hirao T, Yamauchi Y, Nakamura R, Shigeta T, Yoshida H, Tachibana S, Oda A, Ito A, Asano M, Suzuki H, Shimura T, Kurabayashi M, Goya M, Okishige K, Sasano T.
  • Journal Title: International Heart Journal Volume: 62 Issue: 2 Pages: 320-328
  • DOI: 10.1536/ihj.20-690
  • NAID: 130008007432
  • ISSN: 1349-2365, 1349-3299
  • Year and Date: 2021-03-30
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Catheter ablation for atrial fibrillation in patients with congestive heart failure (2021)
  • Author(s): Nitta G, Inaba O, Kato S, Kono T, Ikenouchi T, Murata K, Hada Y, Kanoh M, Takamiya T, Inamura Y, Negi K, Sato A, Yamato T, Matsumura Y, Eguchi K, Nitta J, Takahashi Y, Goya M, Sasano T.
  • Journal Title: International Journal of Cardiology Volume: 333 Pages: 98-104
  • DOI: 10.1016/j.ijcard.2021.02.060
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Impact of diagnosis-to-ablation time on non-pulmonary vein triggers and ablation outcomes in persistent atrial fibrillation (2021)
  • Author(s): Takamiya T, Nitta J, Inaba O, Sato A, Inamura Y, Murata K, Ikenouchi T, Kono T, Takahashi Y, Goya M, Sasano T.
  • Journal Title: Journal of Cardiovascular Electrophysiology Volume: 32 Issue: 5 Pages: 1251-1258
  • DOI: 10.1111/jce.15002
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Alcohol Consumption Reduction and Clinical Outcomes of Catheter Ablation for Atrial Fibrillation (2021)
  • Author(s): Takahashi Y, Nitta J, Kobori A, Sakamoto Y, Nagata Y, Tanimoto K, Matsuo S, Yamane T, Morita N, Satomi K, Inaba O, Murata K, Sasaki Y, Yoshimoto D, Kaneko M, Tanimoto Y, Isogai R, Yamashita S, Sato H, Hanazawa R, Hirakawa A, Goya M, Sasano T.
  • Journal Title: Circulation Arrhythmia Electrophysiology Volume: 6 Issue: 6
  • DOI: 10.1161/circep.121.009770
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Prone-position computed tomography in the late phase for detecting intracardiac thrombi in the left atrial appendage before catheter ablation for atrial fibrillation (2021)
  • Author(s): Nakamura R, Oda A, Tachibana S, Sudo K, Shigeta T, Sagawa Y, Kurabayashi M, Goya M, Okishige K, Sasano T, Yamauchi Y.
  • Journal Title: Journal of Cardiovascular Electrophysiology Volume: 32 Issue: 7 Pages: 1803-1811
  • DOI: 10.1111/jce.15062
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] The impact of left atrium size on selection of the pulmonary vein isolation method for atrial fibrillation: Cryoballoon or radiofrequency catheter ablation (2021)
  • Author(s): Ikenouchi T, Inaba O, Takamiya T, Inamura Y, Sato A, Matsumura Y, Sato H, Hirakawa A, Takahashi Y, Goya M, Sasano T, Nitta J
  • Journal Title: American Heart Journal Volume: 231 Pages: 82-92
  • DOI: 10.1016/j.ahj.2020.10.061
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] A Survey of Direct Oral Anticoagulant Cessation in General Surgery and Outcomes in Patients with Nonvalvular Atrial Fibrillation (2020)
  • Author(s): Kawabata M, Goya M, Maeda S, Yagishita A, Takahashi Y, Sasano T, Hirao K
  • Journal Title: International Heart Journal Volume: 61 Issue: 5 Pages: 905-912
  • DOI: 10.1536/ihj.19-625
  • NAID: 130007911343
  • ISSN: 1349-2365, 1349-3299
  • Year and Date: 2020-09-29
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Cryoballoon versus radiofrequency ablation for paroxysmal atrial fibrillation in hemodialysis patients (2020)
  • Author(s): Takamiya T, Nitta J, Inaba O, Sato A, Inamura Y, Kato N, Murata K, Ikenouchi T, Kono T, Nitta G, Matsumura Y, Takahashi Y, Goya M, Sasano T
  • Journal Title: Heart Vessels Volume: 35 Issue: 12 Pages: 1709-1716
  • DOI: 10.1007/s00380-020-01646-5
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Clinical outcome of pulmonary vein isolation alone ablation strategy using VISITAG SURPOINT in nonparoxysmal atrial fibrillation (2020)
  • Author(s): Yamaguchi J, Takahashi Y, Yamamoto T, Amemiya M, Sekigawa M, Shirai Y, Tao S, Hayashi T, Yagishita A, Takigawa M, Goya M, Sasano T.
  • Journal Title: Journal of Cardiovascular Electrophysiology Volume: 31(10) Issue: 10 Pages: 2592-2599
  • DOI: 10.1111/jce.14673
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Endocardial Contact Mapping of the Left Atrial Appendage in Persistent Atrial Fibrillation (2020)
  • Author(s): Takahashi Y, Akiyoshi K, Sekigawa M, Yagishita A, Yamamoto T, Maeda S, Kawabata M, Goya M, Hirao K, Sasano T.
  • Journal Title: Journal of Cardiovascular Electrophysiology Volume: 31 Issue: 1 Pages: 112-118
  • DOI: 10.1111/jce.14278
  • Peer Reviewed / Open Access
• [Journal Article] Characteristics of the Nonpulmonary Vein Foci Induced After Second-Generation Cryoballoon Ablation for Paroxysmal Atrial Fibrillation (2020)
  • Author(s): Kato N, Nitta J, Sato A, Inamura Y, Takamiya T, Inaba O, Negi K, Takahashi Y, Goya M, Sasano T
  • Journal Title: Journal of Cardiovascular Electrophysiology Volume: 31 Issue: 1 Pages: 174-184
  • DOI: 10.1111/jce.14314
  • Peer Reviewed / Open Access
• [Journal Article] Excessive prolongation of coagulation time during treatment with direct oral anticoagulants in patients with nonvalvular atrial fibrillation (2019)
  • Author(s): Kawabata M, Goya M, Takahashi Y, Maeda S, Yagishita A, Sekigawa M, Akiyoshi K, Yamamoto T, Koyama T, Hirao K
  • Journal Title: Canadian Journal of Cardiology Volume: 35 Issue: 6 Pages: 736-743
  • DOI: 10.1016/j.cjca.2019.02.012
  • Peer Reviewed / Open Access
• [Journal Article] Light and shadows of atrial fibrillation ablation using cryoballoon (2019)
  • Author(s): Goya M
  • Journal Title: Journal of Cardiology Volume: 73 Issue: 6 Pages: 468-469
  • DOI: 10.1016/j.jjcc.2019.01.004
  • Peer Reviewed / Open Access
• [Journal Article] Differences in the Electrophysiological Findings of Repeat Ablation Between Patients Who First Underwent Cryoballoon Ablation and Radiofrequency Catheter Ablation for Paroxysmal Atrial Fibrillation (2019)
  • Author(s): Inamura Y, Nitta J, Inaba O, Kono T, Ikenouchi T, Murata K, Takamiya T, Sato A, Matsumura Y, Takahashi Y, Goya M, Hirao K
  • Journal Title: Jornal of Cardiovascular Electrophysiology Volume: 30 Issue: 10 Pages: 1792-1800
  • DOI: 10.1111/jce.14065
  • Peer Reviewed / Open Access
• [Journal Article] Novel Ablation Strategy for Isolating the Superior Vena Cava Using Ultra High-Resolution Mapping (2018)
  • Author(s): 2.Tanaka Y, Takahashi A, Takagi T, Nakajima J, Takagi K, Hikita H, Goya M, Hirao K
  • Journal Title: Circulation Journal Volume: 82 Issue: 8 Pages: 2007-2015
  • DOI: 10.1253/circj.CJ-17-1352
  • NAID: 130007419949
  • ISSN: 1346-9843, 1347-4820
  • Year and Date: 2018-07-25
  • Peer Reviewed
• [Journal Article] Atrial fibrillation type matters: greater infarct volume and worse neurological defects seen in acute cardiogenic cerebral embolism due to persistent or permanent rather than paroxysmal atrial fibrillation.. (2018)
  • Author(s): 1.Inaba O, Yamauchi Y, Sekigawa M, Miwa N, Yamaguchi J, Nagata Y, Obayashi T, Miyamoto T, Kamata T, Isobe M, Goya M, Hirao K
  • Journal Title: Europace Volume: 20 Issue: 10 Pages: 1591-1597
  • DOI: 10.1093/europace/eux346
  • Peer Reviewed
• [Journal Article] Simultaneous Recording of the P Wave During Atrial Fibrillation. (2018)
  • Author(s): Yagishita A, Goya M, Hirao K
  • Journal Title: Circulation Volume: 138 Issue: 18 Pages: 2057-2060
  • DOI: 10.1161/circulationaha.118.037198
  • Peer Reviewed