Establishment of atrial fibrillation surgery indicated by 3D mapping system and frequency analysis of fibrillation waves.

2019 Fiscal Year Final Research Report

• Project/Area Number: 16K10623
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cardiovascular surgery
• Research Institution: University of Toyama
• Principal Investigator: FUKAHARA Kazuaki 富山大学, 学術研究部医学系, 准教授 (40343181)
• Co-Investigator(Kenkyū-buntansha): 芳村 直樹 富山大学, 学術研究部医学系, 教授 (20401804) ; 土居 寿男 富山大学, 学術研究部医学系, 講師 (80361963)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Keywords: 心房細動 / 周波数解析 / マッピング / 手術

Outline of Final Research Achievements

To investigate the individual mechanisms of chronic atrial fibrillation (AF) and reduce ablation lines for the surgical treatment of AF, we performed AF surgery guided by preoperative complex fractionated atrial electrogram (CFAE) mapping using a 3-dimensional (3D) mapping system and the frequency analysis of fibrillation waves.
As a result, we observed the similarity of the CFAE site and f-wave frequency analysis, and it would become clear that the site was involving as trigger or rotor of an atrial fibrillation. Mid-term results suggest that CFAE mapping and the frequency analysis of fibrillation waves guided atrial fibrillation surgery is feasible and effective. The fibrillation cycle length was closely related to CFAE site and CFAE site ablation might be effective to maintain sinus rhythm and favorable atrial function.

Free Research Field

心臓血管外科学

Academic Significance and Societal Importance of the Research Achievements

学術的意義として、術前のEPS(心臓電気生理学的検査)によるCFAEとf波周波数解析を組み合わせて心房細動の起源と基質を見出し、それを手術術式に反映させることにより心筋焼灼の範囲を限定することができ、洞調律化の成績のみならず、より有効な心房収縮による心機能の改善を図ることが可能となった。社会的意義としてはメイズ手術に代表される現在のような画一的な手術手技ではなく、患者さんの病態に応じた方法を用いるオーダーメード手術が可能となり、リスクの軽減と治療効果の向上、さらに医療コストの軽減につながると考えられた。