Effects of Radiofrequency Catheter Ablation on Cardiac Reserve Using Preload Stress Echocardiography in Paroxysmal and Persistent Atrial Fibrillation

• Material Type: 博士論文
• Title: Effects of Radiofrequency Catheter Ablation on Cardiac Reserve Using Preload Stress Echocardiography in Paroxysmal and Persistent Atrial Fibrillation
• Author/Editor: Ishii, Nao; Kusunose, Kenya; Shono, Ayu; Matsumoto, Kensuke; Nishio, Susumu; Yamaguchi, Natsumi; Hirata, Yukina; Matsuura, Tomomi; Ise, Takayuki; Yamaguchi, Koji; Yagi, Shusuke; Fukuda, Daiju; Yamada, Hirotsugu; Soeki, Takeshi; Wakatsuki, Tetsuzo; Sata, Masataka
• Author Heading: Ishii, Nao; Kusunose, Kenya; Shono, Ayu; Matsumoto, Kensuke; Nishio, Susumu; Yamaguchi, Natsumi; Hirata, Yukina; Matsuura, Tomomi; Ise, Takayuki; Yamaguchi, Koji; Yagi, Shusuke; Fukuda, Daiju; Yamada, Hirotsugu; Soeki, Takeshi; Wakatsuki, Tetsuzo; Sata, Masataka
• Publication, Distribution, etc.: Elsevier
• Publication Date: 2022-01-19
• Publication Date (W3CDTF): 2022-01-19
• Alternative Title: 心収縮予備能に対する心房細動カテーテルアブレーションの効果 : 下肢陽圧負荷心エコー図法を用いた検討; Coronary Artery Disease/Effects of Ablation on Cardiac Reserve
• Periodical title: The American Journal of Cardiology
• No. or year of volume/issue: 168
• Volume: 168
• Pages: 71-77
• ISSN (Periodical Title): ISSN : 0002-9149
• Degree grantor/type: 徳島大学
• Date Granted: 2022-03-23
• Dissertation Number: 甲第3597号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Echocardiography; Preload Stress; atrial fibrillation; Cardiac Reserve; left atrial function
• Target Audience: 一般
• Note (General): The effects of catheter ablation on exercise tolerance and quality of life in patients with atrial fibrillation (AF) have been reported. We assessed cardiac function in more detail using the leg positive pressure (LPP) technique and found that contractile reserve is particularly important in relation to exercise tolerance and prognosis. In this study, we used the LPP technique to examine changes in contractile reserve immediately after ablation and 6 months later. We prospectively enrolled patients who underwent catheter ablation for AF at 2 institutes. We performed LPP stress echocardiography 2 to 3 days after (FU-1) and 6 months after (FU-2) ablation to examine changes in cardiac function indexes. The primary end point was improvement in contractile reserve. Ultimately, 109 patients (mean age 67.4 ± 9.6 years; 70% men) underwent 2 sessions of LPP stress echocardiography. The median CHA2DS2-VASC score was 2 (interquartile range 13). From FU-1 to FU-2, the change in the stroke volume index after the LPP maneuver increased in patients with paroxysmal and persistent AF with low CHA2DS2-VASC scores (both p <0.05). Regardless of AF subtype, contractile reserve at FU-2 improved in patients with low CHA2DS2-VASC scores compared with that at FU-1. In contrast, patients with high CHA2DS2-VASC scores had no change. In conclusion, patients with AF with a low CHA2DS2-VASC score had improved contractile reserve after ablation, whereas patients with high scores did not show any improvement. Aggressive interventions in patients with high scores may lead to better management after catheter ablation.
• Format (IMT): application/pdf
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1016/j.amjcard.2021.12.026
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 徳島大学 : 徳島大学機関リポジトリ

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