循環器ジャーナル69巻3号

2021年07月発行

特集 成人先天性心疾患 エキスパートコンセンサス Ⅲ．成人先天性心疾患の病態別の治療指針

難治性不整脈に対するアブレーション治療，デバイス治療

著者： 西井伸洋¹

所属機関： ¹岡山大学循環器内科

ページ範囲：P.462 - P.470

Point
・頻脈性不整脈は手術などの障害部位に関連したリエントリ性頻拍が多い．
・カテーテルのアプローチができれば，アブレーションで治療可能である．
・心臓植込み型電気デバイスの適応は，正常な解剖の患者と大きく変わらないが，リードのアプローチ方法に制限があり，さまざまな手技が試みられている．

参考文献

1) Yap SC, Harris L, Silversides CK, et al:Outcome of intra-atrial re-entrant tachycardia catheter ablation in adults with congenital heart disease:negative impact of age and complex atrial surgery. J Am Coll Cardiol 56:1589-1596, 2010

2) d'Udekem Y, Iyengar AJ, Galati JC, et al:Redefining expectations of long-term survival after the Fontan procedure:twenty-five years of follow-up from the entire population of Australia and New Zealand. Circulation 130:S32-38, 2014

3) Moore JP, Shannon KM, Fish FA, et al:Catheter ablation of supraventricular tachyarrhythmia after extracardiac Fontan surgery. Heart Rhythm 13:1891-1897, 2016

4) Chiu SN, Wang JK, Lu CW, et al:Electrophysiology Study for Complex Supraventricular Tachycardia in Congenital Heart Disease Patients With Single-Ventricle Physiology. J Am Heart Assoc 5:e004504, 2016

5) Takeuchi D, Shoda M, Takahashi K, et al:Absence of a resetting phenomenon suggests that a sling works as a part of the supraventricular tachycardia circuit involving twin atrioventricular nodes:A case of corrected transposition of the great arteries. HeartRhythm Case Rep 1:220-224, 2015

6) Mori H, Sumitomo N, Muraji S, et al:Successful demonstration of the detailed connection between the twin atrioventricular nodes and sling in a patient with asplenia syndrome. HeartRhythm Case Rep 4:480-483, 2018

7) Zeppenfeld K, Schalij MJ, Bartelings MM, et al:Catheter ablation of ventricular tachycardia after repair of congenital heart disease:electroanatomic identification of the critical right ventricular isthmus. Circulation 116:2241-2252, 2007

8) Miyamoto M, Nishii N, Morita H, et al:Ablation for idiopathic left ventricular tachycardia in a patient with double outlet right ventricle who underwent Fontan operation:a case report. Eur Heart J Case Rep 4:1-6, 2020

9) Yang J, Brunnquell M, Liang JJ, et al:Long term follow-up after ventricular tachycardia ablation in patients with congenital heart disease. J Cardiovasc Electrophysiol 30:1560-1568, 2019

10) Khairy P, Van Hare GF, Balaji S, et al:PACES/HRS Expert Consensus Statement on the Recognition and Management of Arrhythmias in Adult Congenital Heart Disease:developed in partnership between the Pediatric and Congenital Electrophysiology Society（PACES）and the Heart Rhythm Society（HRS）. Endorsed by the governing bodies of PACES, HRS, the American College of Cardiology（ACC）, the American Heart Association（AHA）, the European Heart Rhythm Association（EHRA）, the Canadian Heart Rhythm Society（CHRS）, and the International Society for Adult Congenital Heart Disease（ISACHD）. Heart Rhythm 11:e102-165, 2014

11) van Gelder BM, Scheffer MG, Meijer A, et al:Transseptal endocardial left ventricular pacing:an alternative technique for coronary sinus lead placement in cardiac resynchronization therapy. Heart Rhythm 4:454-460, 2007

12) Calvo N, Arguedas H, Canepa JP, et al:Endocardial left ventricular lead placement from the left subclavian vein approach. Europace 16:1857-1859, 2014

13) Rademakers LM, van Gelder BM, Scheffer MG, et al:Mid-term follow up of thromboembolic complications in left ventricular endocardial cardiac resynchronization therapy. Heart Rhythm 11:609-613, 2014

14) Kriebel T, Ruschewski W, Gonzalez y Gonzalez M, et al:ICD Implantation in infants and small children:the extracardiac technique. Pacing Clin Electrophysiol 29:1319-1325, 2006

15) Kowalski M, Nicolato P, Kalahasty G, et al:An alternative technique of implanting a nontransvenous implantable cardioverter-defibrillator system in adults with no or limited venous access to the heart. Heart Rhythm 7:1572-1577, 2010

16) Cannon BC, Friedman RA, Fenrich AL, et al:Innovative techniques for placement of implantable cardioverter-defibrillator leads in patients with limited venous access to the heart. Pacing Clin Electrophysiol 29:181-187, 2006

17) Burke MC, Gold MR, Knight BP, et al:Safety and Efficacy of the Totally Subcutaneous Implantable Defibrillator:2-Year Results From a Pooled Analysis of the IDE Study and EFFORTLESS Registry. J Am Coll Cardiol 65:1605-1615, 2015