Prognostic Predictors of Sinus Rhythm Control by Amiodarone and Electrical Cardioversion in Patients Undergoing Percutaneous Transluminal Mitral Valvuloplasty for Rheumatic Atrial Fibrillation
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概要
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Background Conversion to sinus rhythm (SR) is rarely attempted in patients with rheumatic atrial fibrillation (AF) because the length of AF duration and the dilation of left atrium (LA) make maintenance of SR difficult. In this study, predictors of the successful maintenance of SR with amiodarone and electrical cardioversion in rheumatic AF patients receiving percutaneous transluminal mitral valvuloplasty (PTMV) were identified Methods and Results This study included 23 consecutive patients undergoing PTMV for rheumatic AF (6 men, 53±11 years; AF duration 25±24 months; LA diameter 44±6mm; mitral valve area (MV) 1.1±0.2cm^2). Electrical cardioversion was required for the successful conversion to SR in all patients regardless of whether they had received amiodarone (400mg/day) 2 months before PTMV (n=8) or 2 months after (n=15). After cardioversion, all patients received amiodarone 200mg/day. With a follow-up period of 35±8 months, 14 patients (61%) remained in SR. A greater reduction in LA size (-4±3 mm vs 1±1 mm; p=0.004) and an greater increase in MV area (0.8±0.4cm^2 vs 0.5±0.2cm^2; p=0.01) by PTMV, not AF duration, were found to be the independent predictors for patients with successful maintenance of SR as compared with patients with recurrence of AF. Conclusion In rheumatic AF patients receiving PTMV, the successful maintenance of SR with amiodarone and electrical cardioversion can be predicted by the degree to which LA size is reduced and MV area is increased.
- 社団法人日本循環器学会の論文
- 2007-06-20
著者
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CHANG Hsueh-Wen
Department of Biological Sciences, National Sun Yat-Sen University
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Cheng Cheng-i
Graduate Institute Of Clinical Medical Sciences Chang Gung University College Of Medicine
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Wu Chiung-jen
Division Of Cardiology Department Of Internal Medicine Chang Gung Memorial Hospital-kaohsiung Medica
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Wu Chiung-jen
Chang Gung Memorial Hospital-kaohsiung Medical Center Chang Gung University College Of Medicine
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Fang Chih-Yuan
Chang Gung University College of Medicine
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Chen Chien-Jen
Chang Gung University College of Medicine
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Fang Chih-yuan
Division Of Cardiology Department Of Internal Medicine Chang Gung Memorial Hospital-kaohsiung Medica
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Guo Gary
Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gang University College of Medicine
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Hang Chi-Ling
Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gang University College of Medicine
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Chang Hsueh-wen
Department Of Biological Sciences National Sun Yat-sen University
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Chang Hsueh-wen
Department Of Biological Science National Sun Yat-sen University
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Guo Gary
Chang Gung Memorial Hospital-kaohsiung Medical Center Chang Gang University College Of Medicine
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Guo Gary
Chang Gung Memorial Hospital-kaohsiung Medical Center Chang Gung University College Of Medicine
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Guo Gary
Division Of Cardiology Department Of Internal Medicine Kaohsiung Chang Gung Memorial Hospital
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Hang Chi-ling
Division Of Cardiology Department Of Internal Medicine
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