Incidence and Characteristics of Coronary Artery Spasms Related to Atrial Fibrillation Ablation Procedures　― Large-Scale Multicenter Analysis ―

• Nakamura Toshihiro

  Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine

• Takami Mitsuru

  Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine

• Fukuzawa Koji

  Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine

• Kiuchi Kunihiko

  Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine

• Kono Hiroyuki

  Department of Cardiology, Kobe City Medical Center General Hospital

• Kobori Atsushi

  Department of Cardiology, Kobe City Medical Center General Hospital

• Sakamoto Yuichiro

  Department of Cardiovascular Medicine, Toyohashi Heart Center

• Watanabe Ryuta

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

• Okumura Yasuo

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

• Yamashita Soichiro

  Heart Rhythm Center, Takatsuki General Hospital

• Yamashiro Kohei

  Heart Rhythm Center, Takatsuki General Hospital

• Miyamoto Koji

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Kusano Kengo

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Kanda Takashi

  Kansai Rosai Hospital Cardiovascular Center

• Masuda Masaharu

  Kansai Rosai Hospital Cardiovascular Center

• Yoshitani Kazuyasu

  Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center

• Yoshida Akihiro

  Department of Cardiology, Kita-Harima Medical Center

• Hirayama Yasutaka

  Department of Cardiology, Akashi Medical Center

• Adachi Kazumasa

  Department of Cardiology, Akashi Medical Center

• Mine Takanao

  Department of Cardiovascular and Renal Medicine, Hyogo College of Medicine

• Shimane Akira

  Department of Cardiology, Himeji Cardiovascular Center

• Takeda Masafumi

  Department of Cardiology, Kobe Rosai Hospital

• Takei Asumi

  Department of Cardiology, Kobe Rosai Hospital

• Okajima Katsunori

  Department of Cardiology, Kakogawa Central City Hospital

• Fujiwara Ryudo

  Cardiovascular Division, Osaka Saiseikai Nakatsu Hospital

• Hirata Ken-ichi

  Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine

抄録

Background:Coronary artery spasms (CASs), which can cause angina attacks and sudden death, have been recently reported during catheter ablation. The aim of the present study was to report the incidence, characteristics, and prognosis of CASs related to atrial fibrillation (AF) ablation procedures. Methods and Results:The AF ablation records of 22,232 patients treated in 15 Japanese hospitals were reviewed. CASs associated with AF ablation occurred in 42 of 22,232 patients (0.19%). CASs occurred during ablation energy applications in 21 patients (50%). CASs also occurred before ablation in 9 patients (21%) and after ablation in 12 patients (29%). The initial change in the electrocardiogram was ST-segment elevation in the inferior leads in 33 patients (79%). Emergency coronary angiography revealed coronary artery stenosis and occlusions, which were relieved by nitrate administration. No air bubbles were observed. A comparison of the incidence of CASs during pulmonary vein isolation between the different ablation energy sources revealed a significantly higher incidence with cryoballoon ablation (11/3,288; 0.34%) than with radiofrequency catheter, hot balloon, or laser balloon ablation (8/18,596 [0.04%], 0/237 [0%], and 0/111 [0%], respectively; P<0.001). CASs most often occurred during ablation of the left superior pulmonary vein. All patients recovered without sequelae. Conclusions:CASs related to AF ablation are rare, but should be considered as a dangerous complication that can occur anytime during the periprocedural period.

収録刊行物

• Circulation Journal

  Circulation Journal 85 (3), 264-271, 2021-02-25

  一般社団法人 日本循環器学会

キーワード

• Atrial fibrillation
• Catheter ablation
• Coronary artery spasm
• Cryoballoon
• Radiofrequency

詳細情報

• CRID: 1390568772521561216
• NII論文ID: 130007991433
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-20-1096
• ISSN: 13474820
• ISSN: 13469843
• HANDLE: 20.500.14094/90009288
• NDL書誌ID: 031308969
• PubMed: 33431721
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I031308969
• Web Site: https://www.jstage.jst.go.jp/article/circj/85/3/85_CJ-20-1096/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2021325943
• 本文言語コード: en
• データソース種別:
  • JaLC
  • IRDB
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
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