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

• Material Type: 博士論文
• Title: Variable procedural strategies adapted to anatomical characteristics in catheter ablation of the cavotricuspid isthmus using a preoperative multidetector computed tomography analysis
• Author/Editor: Kajihara, Kenta
• Publication Date: 2013-11-28
• Publication Date (W3CDTF): 2013-11-28
• Alternative Title: 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
• Degree grantor/type: 広島大学(Hiroshima University)
• Date Granted: 2013-11-28
• Date Granted (W3CDTF): 2013-11-28
• Dissertation Number: 甲第6267号
• Degree Type: 博士(医学)
• Conferring No. (Dissertation): 甲第6267号
• Text Language Code: eng
• Subject Heading: atrial flutter; catheter ablation; cavotricuspid isthmus; eustachian ridge; multidetector row-computed tomography
• NDC: 490
• Note (General): 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
• Persistent ID (NDL): info:ndljp/pid/8952577; https://dl.ndl.go.jp/pid/8952577
• Collection: 障害者向け資料
• Collection (Materials For Handicapped People:1): テキストデータ
• Collection (particular): 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
• Acquisition Basis: 博士論文（自動収集）
• Available (W3CDTF): 2015-03-03
• Date Accepted (W3CDTF): 2015-02-03T05:25:05+09:00
• Date Created (W3CDTF): 2014-11-21
• Format (IMT): application/pdf
• Access Restrictions: 国立国会図書館内限定公開
• Service for the Digitized Contents Transmission Service: 図書館・個人送信対象外
• Availability of remote photoduplication service: 可
• Periodical Title (URI): http://ir.lib.hiroshima-u.ac.jp/00036277
• Data Provider (Database): 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

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2018-12-03 再収集

2018-12-03 再収集