Variable procedural strategies adapted to anatomical characteristics in catheter ablation of the cavotricuspid isthmus using a preoperative multidetector computed tomography analysis

• 資料種別: 博士論文
• タイトル: Variable procedural strategies adapted to anatomical characteristics in catheter ablation of the cavotricuspid isthmus using a preoperative multidetector computed tomography analysis
• 著者・編者: Kajihara, Kenta
• 出版年月日等: 2013-11-28
• 出版年（W3CDTF）: 2013-11-28
• 並列タイトル等: 術前撮影の多重検出器列CT画像の解析を用いた下大動脈三尖弁峡部に対するカテーテルアブレーションにおける解剖学的特徴に即した可変的治療戦略
• 授与機関名: 広島大学(Hiroshima University)
• 授与年月日: 2013-11-28
• 授与年月日（W3CDTF）: 2013-11-28
• 報告番号: 甲第6267号
• 学位: 博士(医学)
• 博論授与番号: 甲第6267号
• 本文の言語コード: eng
• 件名標目: atrial flutter; catheter ablation; cavotricuspid isthmus; eustachian ridge; multidetector row-computed tomography
• NDC: 490
• 一般注記: Objectives: This study aimed to investigate the anatomical characteristics complicating cavotricuspid isthmus (CTI) ablation and the effectiveness of various procedural strategies. Methods and Results: This study included 446 consecutive patients (362 males; mean age 60.5±10.4 years) in whom CTI ablation was performed. A total of 80 consecutive patients were evaluated in a preliminary study. The anatomy of the CTI was evaluated by multidetector row-computed tomography (MDCT) prior to the procedure. Amultivariate logistic regression analysis revealed that the angle and mean wall thickness of the CTI, a concave CTImorphology, and a prominent Eustachian ridge, were associated with a difficult CTI ablation (P < 0.01). In the main study, 366 consecutive patients were divided into 2 groups: a modulation group (catheter inversion technique for a concave aspect, prominent Eustachian ridge, and steep angle of the CTI or increased output for a thicker CTI) and nonmodulation group (conventional strategy). The duration and total amount of radiofrequency energy delivered were significantly shorter and smaller in the modulation group than those in the nonmodulation group (162.2 ± 153.5 vs 222.7 ± 191.9 seconds, P < 0.01, and 16,962.4 ± 11,545.6 vs 24,908.5 ± 22,804.2 J, P < 0.01, respectively). The recurrence rate of type 1 atrial flutter after the CTI ablation in the nonmodulation group was significantly higher than that in the modulation group (6.3 vs 1.7%, P = 0.02). Conclusion: Changing the procedural strategies by adaptating them to the anatomical characteristics improved the outcomes of the CTI ablation.; 元資料の権利情報 : Copyright(c) by Author
• 国立国会図書館永続的識別子: info:ndljp/pid/8952577; https://dl.ndl.go.jp/pid/8952577
• コレクション（共通）: 障害者向け資料
• コレクション（障害者向け資料：レベル1）: テキストデータ
• コレクション（個別）: 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• 収集根拠: 博士論文（自動収集）
• 公開開始日（W3CDTF）: 2015-03-03
• 受理日（W3CDTF）: 2015-02-03T05:25:05+09:00
• 作成日（W3CDTF）: 2014-11-21
• 記録形式（IMT）: application/pdf
• オンライン閲覧公開範囲: 国立国会図書館内限定公開
• デジタル化資料送信: 図書館・個人送信対象外
• 遠隔複写可否（NDL）: 可
• 掲載誌（URI）: http://ir.lib.hiroshima-u.ac.jp/00036277
• 連携機関・データベース: 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp

目次

2018-12-03 再収集

2018-12-03 再収集