Combined Effect of Pulmonary Vein Isolation and Ablation of Cardiac Autonomic Nerves for Atrial Fibrillation

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概要

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• This study was designed to determine whether endocardial high-frequency stimulation at the pulmonary vein (PV) antrums can localize cardiac autonomic ganglionated plexi (GP) and whether ablation at these sites can evoke a vagal response and provide a long-term benefit after PV isolation (PVI) for atrial fibrillation (AF). Radiofrequency ablation of each PV antrum was performed in 21 patients with paroxysmal AF (n = 17) or persistent (n = 4) AF. In 8 patients with paroxysmal AF, a ring electrode catheter was placed at each PV antrum. High-frequency stimulation prolonged the R-R interval in 6 of 8 patients at the left superior (LS) PV, in 3 of 8 patients at the left inferior (LI) PV, in 3 of 8 patients at the right superior (RS) PV, and in 3 of 8 patients at the right inferior (RI) PV. A decrease in sinus rate > 20% was observed in 4 of 21 patients during LS PVI, in 2 of 21 patients during RS PVI, and in 1 of 2 patients during RI PVI. Atrioventricular block or a > 5 second pause was observed in 5 of 21 patients during LS PVI. AF recurred during the follow-up period in 5 of the 16 patients (31%) who had no atrioventricular block or > 5 second pause during PVI but did not recur in 5 patients in whom atrioventricular block or a > 5 second pause developed during PVI. GP can be identified by endocardial stimulation. The AF recurrence rate is decreased when a vagal response is achieved by radiofrequency ablation.

• インターナショナル・ハート・ジャーナル刊行会の論文

著者

• KASAMAKI Yuji

  Division of Cardiovascular Medicine, Department of Medicine, Nihon University School of Medicine

• HASHIMOTO Kenichi

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• WATANABE Ichiro

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• OKUMURA Yasuo

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• OHKUBO Kimie

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• ASHINO Sonoko

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• KOFUNE Masayoshi

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• NAKAI Toshiko

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• KUNIMOTO Satoshi

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• HIRAYAMA Atsushi

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• Kofune Tatsuya

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• Takagi Yasuhiro

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• Sugimura Hidezou

  Division of Cardiology, Department of Medicine, Nihon University School of Medicine

• Kofune Masayoshi

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Watanabe Ichiro

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Shindo Atsushi

  Division of Cardiovascular Disease, Department of Medicine, Nihon University School of Medicine

• Hashimoto Kenichi

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Kasamaki Yuji

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Hirayama Atsushi

  日本大学 医学部内科学系循環器内科

• Yamada Takeshi

  Division of cardiology, Department of Medicine, Nihon University School of Medicine

• Kunimoto Satoshi

  日本大学 医学部循環器内科学分野

• Kunimoto Satoshi

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Ashino Sonoko

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Sugimura Hidezou

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Kofune Tatsuya

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Shindo Atsushi

  Division Of Cardiology Nihon University School Of Medicine

• Okumura Yasuo

  Division Of Cardiology Department Of Cardiovascular Disease Nihon University School Of Medicine

• Nakai Toshiko

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Ohkubo Kimie

  Division Of Cardiology Department Of Medicine Nihon University School Of Medicine

• Hirayama Atsushi

  Division Of Cardiology Department Of Internal Medicine Nihon University School Of Medicine

• Yamada Takeshi

  Division Of Biology National Institute Of Radiological Sciences

• Takagi Yasuhiro

  Division Of Cardiology Bell Land General Hospital

• Nakai Toshiko

  Divisions of Cardiology, Department of Cardiovascular Disease, Nihon University School of Medicine

• Shindo Atsushi

  Divisions of Cardiology, Department of Cardiovascular Disease, Nihon University School of Medicine

• Ashino Sonoko

  Divisions of Cardiology, Department of Cardiovascular Disease, Nihon University School of Medicine

• Sugimura Hidezou

  Divisions of Cardiology, Department of Cardiovascular Disease, Nihon University School of Medicine

• Hashimoto Kenichi

  Divisions of Cardiology, Department of Cardiovascular Disease, Nihon University School of Medicine

• Ohkubo Kimie

  Divisions of Cardiology, Department of Cardiovascular Disease, Nihon University School of Medicine

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