記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

DOI： 10.5105/jse.40.263

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J00681&link_issn=&doc_id=20210112170007&doc_link_id=%2Fdn4eleca%2F2020%2F004004%2F008%2F0263-0271%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdn4eleca%2F2020%2F004004%2F008%2F0263-0271%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(公財)日本心臓財団  

DOI： 10.11281/shinzo.51.1270

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J00679&link_issn=&doc_id=20191213150007&doc_link_id=20191213150005&url=http%3A%2F%2Fsearch.jamas.or.jp%2Flink%2Fbc%2F20191213150005&type=jamaslink&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F99999_1.gif

記述言語：日本語   出版者・発行元：日本医科大学医学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

DOI： 10.5105/jse.39.69

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J00681&link_issn=&doc_id=20190327160009&doc_link_id=%2Fdn4eleca%2F2019%2F003901%2F011%2F0069-0084%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdn4eleca%2F2019%2F003901%2F011%2F0069-0084%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   出版者・発行元：(一社)日本循環器学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

近年、日米EU医薬品規制調和国際会議(ICH)-E14ガイドラインが厚生労働省から公表、規制化されたことにより、臨床試験において正確で信頼性の高いQT間隔計測システムが求められるようになった。われわれは独自に開発したコンピュータ補助接線法QT間隔計測システムの信頼性を、検査技師研修プログラム(4週間)の成績から検証した。健常者20例の12誘導心電図を用い、全誘導のそれぞれ2心拍、計480心拍の計測を2回行い、2名の熟達技師の計測平均値を基準に、基準値との差(計測者間差)と2回の計測値の差(計測者内差)における平均値、標準偏差、相関係数(R2)を求めた。熟達技師2名の計測者間差は0.01±7.02msec、相関係数(R2)は0.93であった。研修技師3名(A、B、C)の計測値と基準値との差は平均0.76±6.22msec、0.13±5.70msec、2.05±6.53msecであり、各研修技師の2回の計測値の相関係数(R2)は0.94〜0.97であった。本研究で用いた半自動計測システムは、接線を引くパターン認識作業に習熟することでT波終末部決定の精度と再現性を確保する方式であり、短期間の技師研修でも高い信頼性が確認できた。(著者抄録)

DOI： 10.5105/jse.32.137

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J00681&link_issn=&doc_id=20120803280001&doc_link_id=%2Fdn4eleca%2F2012%2F003202%2F002%2F0137-0144%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdn4eleca%2F2012%2F003202%2F002%2F0137-0144%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Most paroxysmal atrial fibrillation (PAF) ultimately becomes chronic atrial fibrillation (CAF), even in the presence of antiarrhythmic drugs. Upstream therapies such as calcium channel blockers (CCB), angiotensin-converting enzyme inhibitors (ACEI), or statins have attracted attention for treating AF patients. We have previously reported that ACEI inhibited the progression of PAF to CAF. CCB and statins were also reported to inhibit the development of AF, but the follow-up periods in several of the papers appeared to be too short to allow a clear verdict on the antiarrhythmic effects. We therefore conducted a retrospective analysis of the relationship between long-term treatment (over 5 years) with an ACEI, CCB, or statin and outcome in patients with PAF (n = 125).The follow-up period was 7.7 +/- 3.1 years. Class I antiarrhythmic drugs were prescribed for 76.6% of the patients, ACEI for 36.0%, CCB for 47.2%, and statins for 20.0%. We assessed the cardiac rhythm from the medical records or electrocardiograms and determined the time from the first visit to the development of CAF. Kaplan-Meier analysis showed that the use of an ACEI significantly decreased the cumulative probability of CAF, while class I antiarrhythmics, CCB, and statins did not inhibit progression to CAF. Multivariate analysis showed that only ACEI was related to a reduced progression to CAF (odds ratio, 0.112; 95% confidence interval, 0.034 to 0.374, P = 0.001). Class I antiarrhythmic drugs, CCBs, and statins showed no such association.ACEI thus appear to be superior to CCB or statins with respect to upstream therapy.

DOI： 10.1536/ihj.50.141

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記述言語：日本語   出版者・発行元：The Medical Association of Nippon Medical School  

DOI： 10.1272/manms.5.74

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その他リンク： http://search.jamas.or.jp/link/ui/2009199043

掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

DOI： 10.1016/s1880-4276(08)80008-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

To test the hypothesis that the reverse mode of the Na+/Ca2+ exchange augmented by a rapid heart rate has an antiarrhythmic effect by shortening the action potential duration, we examined the effects of KB-R7943 (2-[2-[4-(4-nitrobenzyloxy)phenyl]ethyl] isothiourea methanesulfonate), a selective inhibitor of the reverse mode of the Na+/Ca2+ exchange, to attenuate this effect. We recorded the electrocardiogram, monophasic action potential (MAP), and left ventricular pressure in canine beating hearts. In comparison to the control, KB-R7943 significantly increased the QTc value and MAP duration. MAP alternans and left ventricular pressure alternans were observed after changing the cycle length to 300 milliseconds in the control studies. KB-R7943 magnified both types of alternans and produced spatially discordant alternans between right and left ventricles. Early after-depolarizations and nonsustained ventricular tachycardia occurred in the presence of KB-R7943. Our data suggest that the reverse mode of the Na+/Ca2+ exchange may contribute to suppression of arrhythmias by abbreviating action potential duration under pathophysiological conditions. This conclusion is based on further confirmation by future studies of the specificity of KB-R7943 for block of the reverse mode of the Na+/Ca2+ exchange.

DOI： 10.1016/j.jelectrocard.2004.12.001

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Atrial fibrillation is a progressive disease, which in the paroxysmal form (PAF) becomes more frequent and finally becomes chronic (CAF). A retrospective analysis of patients with PAF was conducted to examine the hypothesis that angiotensin-converting enzyme inhibitors (ACEI) will prevent the progression to CAF. METHODS AND RESULTS: On the basis of their treatment, 95 patients with PAF were divided into 2 groups: 42 patients treated with ACEI for hypertension throughout the period of treatment and follow-up (ACEI group) and 53 patients not given ACEI (non-ACEI group). Cardiac rhythms were assessed either from the medical records or the electrocardiograms recorded every 2-4 weeks at follow-up visits. The mean follow-up time was 8.3+/-3.5 years. There was no significant difference in the use of antiarrhythmic drugs, left atrial diameter or left ventricular ejection fraction between the 2 groups. The Kaplan-Meier curve for the time to occurrence of CAF showed a lower incidence of CAF in the ACEI group and demonstrated that the 5-year probability for persistence of PAF without progression to CAF was 88.3%, but 47.5% in the non-ACEI group. CONCLUSIONS: These results indicate that ACEI will prevent progression from PAF to CAF.

DOI： 10.1253/circj.69.671

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The probabilistic nature of the ventricular defibrillation threshold (DFT) remains poorly understood. We hypothesized that shock outcome is a function of the amount of myocardium in its vulnerable period (VP). The endocardial surface of five isolated, perfused swine right ventricles was mapped with 477 bipolar electrodes during ventricular fibrillation (VF). Shock parameters and VF cycle length were not significantly different in the successful (S; n = 26) and failed (F; n = 26) trials. At the instant of the shock, the number of sites with 45- to 55-ms recovery was significantly smaller in the S trials than the F trials (P < 0.04). No significant difference in the number of sites with recovery intervals outside the 45- to 55-ms range was seen in S and F shocks. Endocardial action potential showed that a recovery time of 45-55 ms corresponded to the VP spanning -15 to -60 mV in 92% of the regenerative action potentials. We conclude that the probabilistic nature of the DFT is related to the amount of myocardium in its VP.

DOI： 10.1152/ajpheart.00742.2002

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掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: We sought to evaluate the effects of progressive shortening of the action potential duration (APD) on atrial wave front stability. BACKGROUND: The mechanisms of conversion from atrial flutter to atrial fibrillation (AF) are unclear. METHODS: Isolated canine right atria were perfused with 1 to 5 micromol/l of acetylcholine (ACh). We mapped the endocardium by using 477 bipolar electrodes and simultaneously recorded transmembrane potentials from the epicardium. The APD(90) was measured during regular pacing (S(1)) with cycle lengths of 300 ms. Atrial arrhythmia was induced by a premature stimulus (S(2)). RESULTS: At baseline, only short runs of repetitive beats (<10 cycles) were induced. After shortening the APD(90) from 124 +/- 15 ms to 72 +/- 9 ms (p < 0.01) with 1 to 2.5 micromol/l of ACh, S(2) pacing induced single, stable and stationary re-entrant wave fronts (307 +/- 277 cycles). They either anchored to pectinate muscles (5 tissues) or used pectinate muscles as part of the re-entry (4 tissues). When ACh was raised to 2.5 to 5 micromol/l, the APD(90) was further shortened to 40 +/- 12 ms (p < 0.01); S(2) pacing induced in vitro AF by two different mechanisms. In most episodes (n = 13), AF was characterized by rapid, nonstationary re-entry and multiple wave breaks. In three episodes with APD(90) <30 ms, AF was characterized by rapid, multiple, asynchronous, but stationary wave fronts. CONCLUSIONS: Progressive APD shortening modulates atrial wave front stability and converts atrial flutter to AF by two mechanisms: 1) detachment of stationary re-entry from the pectinate muscle and the generation of multiple wave breaks; and 2) formation of multiple, isolated, stationary wave fronts with different activation cycle lengths.

DOI： 10.1016/S0735-1097(01)01606-0

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: In dogs, chronic rapid pacing may result in sustained atrial fibrillation (AF). However, activation patterns in pacing-induced sustained AF are unclear. METHODS AND RESULTS: We induced sustained AF (>48 hours) in 6 dogs by rapid pacing for 139+/-84 days. We then performed computerized atrial epicardial mappings and recorded the activations in the ligament of Marshall (LOM) and the pulmonary veins (PVs). During AF, mean activation cycle length in the right atrial free wall (126+/-17 ms) was significantly longer than that in the left atrial free wall (96+/-5 ms, P:=0.006). In addition, mean activation cycle length in the left atrial free wall was significantly longer than that in the LOM (84+/-5 ms, P:<0.001), the left inferior PV (81+/-4 ms, P:=0.001), and the left superior PV (85+/-7 ms, P:=0.003). Similarly, the dominant frequency was highest in the LOM and the PVs (range 11.2 to 13.3 Hz), followed by the left and right atria (P:<0.001). In all dogs studied, rapid and complicated electrograms were consistently observed at the LOM and the PVs. During AF, both wandering wavelets and organized reentry were present. There were more wave fronts in the left atrium than in the right atrium (P:<0.001). CONCLUSIONS: In chronic pacing-induced sustained AF, the LOM and the PVs are the sources of rapid activations. The mechanism by which the left atrium activates faster and has more wave fronts than the right atrium may relate to the fact that the left atrium is closer to the sources of rapid activations.

DOI： 10.1161/01.CIR.103.8.1157

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: The study was done to test the hypothesis that an artificial anatomical obstacle prevents the maintenance of ventricular fibrillation (VF) by stabilizing reentrant wavefronts (RWF) and increases the critical mass (CM) of myocardium required to sustain VF. BACKGROUND: Artificial obstacles can anchor RWF in simulated models of VF. Whether an artificial obstacle affects multiple-wavelet VF in real tissue is unclear. METHODS: The endocardial surfaces of seven isolated, perfused swine right ventricles were mapped using a plaque of 477 bipolar electrodes with 1.6-mm resolution. An 8-mm hole was punched in the tissue. The CM was reached by tissue mass reductions, at which VF converted to periodic activity (ventricular tachycardia, VT). RESULTS: After the creation of the obstacle, the VF cycle length increased from 71.6+/-18.4 ms to 87.5+/-13.0 ms (p<0.05). The obstacle, together with the papillary muscle, facilitated the transition from VF to VT by serving as attachment sites for the RWF. When one RWF attaches to the obstacle and another attaches to the papillary muscle, it may result in stable VT with figure-eight patterns. The CM for VF in the presence of an 8-mm hole (28.7+/-3.8 g) was higher than in the control group (swine right ventricles without holes, 24.0+/-3.4 g, p<0.05). CONCLUSIONS: An artificial anatomical obstacle induces slowing and regularization of VF, impairs the persistence of VF as judged by an increase of the CM, and can convert VF to VT by serving as an attachment site to reentrant excitation.

DOI： 10.1016/S0735-1097(00)00941-4

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: To elucidate pharmacokinetics and pharmacodynamics of landiolol hydrochloride, newer developed ultra-short-acting beta-blocker, in patients with various cardiac tachyarrhythmias. BACKGROUND: The short duration of action and titratability of landiolol hydrochloride make it ideal for use in patients with a clinical need for beta-blockers. METHODS: In a total of 31 examinations we infused the drug in 19 patients (mean age, 55 +/- 14 years). After the persistence of the tachyarrhythmias was confirmed, continuous infusion was started at rates of 0.005, 0.01, 0.02, 0.04, and 0.08 mg/kg/min for 5 minutes (for paroxysmal atrial fibrillation, paroxysmal supraventricular tachycardia, and ventricular tachycardia) or 15 minutes (for ventricular premature complex). We analyzed the pharmacokinetics of 16 examinations. A one-compartment model provided a close fit for each blood concentration-time curve. RESULTS: The maximum blood concentrations obtained clearly showed the dose dependency and revealed very short half-lives (range, 2.3 to 4.0 minutes). Area under the blood concentration-time curves also increased, showing dose dependency. In paroxysmal atrial fibrillation, landiolol hydrochloride reduced the heart rate from 111 +/- 20 to 90 +/- 10/min. Sinus rhythm was restored, without any adverse effects, in three of five patients with paroxysmal supraventricular tachycardia and one patient with ventricular tachycardia. There was no significant change in peripheral blood pressure. CONCLUSIONS: Landiolol hydrochloride has a shorter elimination half-life than any other beta-blocker, and it can be administered safely to patients with various tachyarrhythmias.

DOI： 10.1067/mcp.2000.108733

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Although computerized mapping studies have demonstrated the presence of multiple wavelets during atrial fibrillation (AF) and that action potential amplitude and duration in AF vary significantly from beat to beat, no study has correlated the single cell action potential changes with the patterns of activation during AF. METHODS AND RESULTS: We studied wavefront dynamics and single cell transmembrane potential (TMP) characteristics in 12 isolated perfused canine right atria. The endocardial surface was mapped using 477 bipolar electrodes while TMP was recorded with a standard glass microelectrode from an epicardial cell. AF was induced in the presence of acetylcholine. Successful simultaneous TMP recordings and activation maps were made during six episodes of AF and for a total of 141 activations. Large variations of TMP amplitude and duration were observed frequently; 34% of them have a low amplitude (<50% of the amplitude recorded during pacing). Low-amplitude potentials were recorded when the impaled cell was (1) in an area of random reentry (67%, n = 36); (2) within 3.2 mm of the core of organized functional reentry (22%, n = 12); (3) in the middle of two merging wavefronts (9%, n = 5); and (4) at the point of spontaneous wavebreak (2%, n = 1). CONCLUSION: Large variations of TMP are observed frequently during in vitro AF. Low-amplitude TMPs are associated with specific patterns of AF activation wavefronts.

DOI： 10.1111/j.1540-8167.2000.tb00072.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The vulnerability of the infarcted hearts to ventricular fibrillation (VF) was tested in in situ canine hearts during nicotine infusion. The activation pattern was mapped with 477 bipolar electrodes in open-chest anesthetized dogs (n = 8) 5-6 wk after permanent occlusion of the left anterior descending coronary artery. Nicotine (129 +/- 76 ng/ml) lengthened (P < 0.01) the pacing cycle length at which VF was induced from 171 +/- 8.9 to 210 +/- 14. 7 ms. Nicotine selectively amplified the magnitude of conduction time and monophasic action potential (MAP) amplitude and duration (MAPA and MAPD, respectively) alternans in the epicardial border zone (EBZ) but not in the normal zone. With critical reduction of the MAPA and MAPD in the EBZ, conduction block occurred across the long axis of the EBZ cells. Block led immediately to reentry formation in the EBZ with a mean period of 105 +/- 10 ms, which, after one to two rotations, degenerated to VF. Nicotine widened the range of diastolic intervals over which the dynamic MAPD restitution curve had a slope >1. We conclude that nicotine facilitates conduction block, reentry, and VF in hearts with healed myocardial infarction by increasing the magnitude of depolarization and repolarization alternans consistent with the restitution hypothesis of vulnerability to VF.

DOI： 10.1152/ajpheart.2000.278.6.h2124

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

A detailed analysis of the ventricular activation along the posterior aspect of the mitral annulus was made using a multipolar catheter positioned in the coronary sinus in a patient with mitral isthmus ventricular tachycardia (VT) associated with a remote inferior myocardial infarction and prior cryosurgical ablation for the elimination of a different preexisting VT. A change in the timing and sequence of the ventricular activation along the isthmus could be observed during induction of the VT and entrainment pacing. A radiofrequency (RF) current application directed at the posterolateral region of the isthmus successfully eliminated this tachycardia. During the RF delivery, complete conduction block was confirmed by a sudden change in the activation sequence during sinus rhythm.

DOI： 10.1023/A:1009862702673

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The role of papillary muscle (PM) in the generation and maintenance of reentry is unclear. METHODS AND RESULTS: Computerized mapping (477 bipolar electrodes, 1.6-mm resolution) was performed in fibrillating right ventricles (RVs) of swine in vitro. During ventricular fibrillation (VF), reentrant wave fronts often transiently anchored to the PM. Tissue mass reduction was then performed in 10 RVs until VF converted to ventricular tachycardia (VT). In an additional 6 RVs, procainamide infusion converted VF to VT. Maps showed that 77% (34 of 44) of all VT episodes were associated with a single reentrant wave front anchored to the PM. Purkinje fiber potentials preceded the local myocardial activation, and these potentials were recorded mostly around the PM. When PM was trimmed to the level of endocardium (n = 4), sustained VT was no longer inducible. Transmembrane potential recordings (n = 5) at the PM revealed full action potential during pacing, without evidence of ischemia. Computer simulation studies confirmed the role of PM as a spiral wave anchoring site that stabilized wave conduction. CONCLUSIONS: We conclude that PM is important in the generation and maintenance of reentry during VT and VF.

DOI： 10.1161/01.CIR.100.13.1450

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The mechanism of the adrenergic atrial tachyarrhythmia is unclear. We hypothesize that the ligament of Marshall (LOM) is sensitive to adrenergic stimulation and may serve as a source of the adrenergic atrial tachyarrhythmia. METHODS AND RESULTS: We performed computerized mapping studies in isolated-perfused canine left atrial tissues from normal dogs (n=9) and from dogs with chronic atrial fibrillation (AF) induced by 10 to 41 weeks of rapid pacing (n=3). Before isoproterenol, spontaneous activity occurred in only one normal tissue (cycle length, CL >1300 ms). During isoproterenol infusion, automatic rhythm was induced in both normal tissues (CL=578+/-172 ms) and AF tissues (CL=255+/-29 ms, P<0.05). The origin of spontaneous activity was mapped to the LOM. In the AF tissues, but not the normal tissues, we observed the transition from rapid automatic activity to multiple wavelet AF. Ablation of the LOM terminated the spontaneous activity and prevented AF. Immunocytochemical studies of the LOM revealed muscle tracts surrounded by tyrosine hydroxylase-positive (sympathetic) nerves. CONCLUSIONS: We conclude that the LOM is richly innervated by sympathetic nerves and serves as a source of isoproterenol-sensitive focal automatic activity in normal canine atrium. The sensitivity to isoproterenol is upregulated after long-term rapid pacing and may contribute to the development of AF in this model.

DOI： 10.1161/01.CIR.100.8.876

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Ventricular fibrillation (VF) is maintained by 2 mechanisms: first by reentry formation and second by spontaneous wave break or wave splitting. We hypothesized that spontaneous wave break results from a critical shortening of the action potential duration (APD) during VF and that its prevention by procainamide eliminates spontaneous wave break. METHODS AND RESULTS: The endocardial surfaces of 7 isolated, perfused swine right ventricles were mapped with a 3.2x3.8 cm plaque with 477 bipolar electrodes. Activation pattern during VF was visualized dynamically while simultaneously recording epicardial action potentials with a glass microelectrode. APD restitution curves were constructed during VF (dynamic) and during S(1)S(2) protocols. At baseline, VF was maintained by 5.3+/-1 wavelets. Procainamide (PA) at 10 microgram/mL decreased the number of wavelets to 3.5+/-1 (P<0.05). At baseline VF was maintained by spontaneous wave break and by new reentrant wave front formation. PA eliminated spontaneous wave break during VF while having no effect on reentry formation. PA increased the cycle length of the VF (148.5+/-41.2 ms vs 81+/-10 ms, P<0.01) and the core area of the reentry from 5.8 to 14.5 mm(2) (P<0.05). Dynamic APD restitution curve during VF showed that PA eliminated the initiation of activation with APDs shorter than 30 ms. The effects of PA on cellular properties and wave front dynamics were reversed during 60 minutes of drug-free perfusion. CONCLUSIONS: Critically short APDs during VF promote spontaneous wave break. Their elimination with PA, however, maintains VF by generating new reentrant wave front.

DOI： 10.1161/01.CIR.100.6.666

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: The critical mass for human ventricular fibrillation (VF) and its electrical determinants are unclear. The goal of this study was to evaluate the relationship between repolarization characteristics and critical mass for VF in diseased human cardiac tissues. METHODS AND RESULTS: Eight native hearts from transplant recipients were studied. The right ventricle was immediately excised, then perfused (n = 6) or superfused (n = 2) with Tyrode's solution at 36 degrees C. The action potential duration (APD) restitution curve was determined by an S1-S2 method. Programmed stimulation and burst pacing were used to induce VF. In 3 of 8 tissues, 10 microM cromakalim, an ATP-sensitive potassium channel opener, was added to the perfusate and the stimulation protocol repeated. Results show that, at baseline, VF did not occur either spontaneously or during rewarming, and it could not be induced by aggressive electrical stimulation in any tissue. The mean APD at 90% depolarization (APD90) at a cycle length of 600 msec was 227+/-49 msec, and the mean slope of the APD restitution curve was 0.22+/-0.08. Among the six tissues perfused, five were not treated with any antiarrhythmic agent. The weight of these five heart samples averaged 111+/-23 g (range 85 to 138). However, after cromakalim infusion, sustained VF (> 30 min in duration) was consistently induced. As compared with baseline in the same tissues, cromakalim shortened the APD90 from 243+/-32 msec to 55+/-18 msec (P < 0.001) and increased the maximum slope of the APD restitution curve from 0.24+/-0.11 to 1.43+/-0.10 (P < 0.01). CONCLUSION: At baseline, the critical mass for VF in diseased human hearts in vitro is > 111 g. However, the critical mass for VF can vary, as it can be reduced by shortening APD and increasing the slope of the APD restitution curve.

DOI： 10.1111/j.1540-8167.1999.tb00280.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The influence of a pharmacologic agent on wavefront dynamics during ventricular fibrillation (VF) in a setting of remodeled and healed myocardial infarction (MI) remains poor explored. We hypothesized that nicotine, by virtue of its complex direct and indirect cardiovascular effects, increases wavefront complexity during VF. Specifically, we sought to determine whether nicotine increases the number and complexity (approximate entropy) of wavelets during stage II VF in hearts with healed MI. METHODS AND RESULTS: The left anterior descending coronary artery was permanently occluded in five mongrel dogs and wavefront dynamics during VF studied 5 to 6 weeks after occlusion in the open-chest anesthetized state. VF was induced by rapid pacing and the activation pattern mapped on the surviving epicardial border zone (EBZ) of the left ventricle with a plaque (3.2 x 3.8 cm) having 477 bipolar electrodes 1.6 mm apart. VF was mapped before and 20 minutes after 5 µg/kg/min nicotine infusion. Nicotine with a mean arterial plasma concentration of 127 +/- 76 ng/mL (range 57 to 240 ng/mL) significantly (P <.01) increased the number of wavelents from 3.8 +/- 0.4 to 5 +/- 0.41. The increased number of wavelets was caused by an increase (P <.01) in the spontaneous breakup of wavefronts from 4.1 +/- 0.9 times/s to 6.9 +/- 1.1 times/s. Wavebreak over the EBZ was functional in nature as no breakup occurred during normal sinus rhythm. Approximate entropy, a measure of complexity, significantly (P <.01) increased after nicotine administration from 0.23 +/- 0.02 to 0.28 +/- 0.01. CONCLUSIONS: Nicotine increases the number of wavelets and their complexity during VF by promoting spontaneous wavebreak over the EBZ of healed MI.

DOI： 10.1177/107424849900400207

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The effect of effective refractory period (ERP) shortening on the vulnerability and characteristics of induced functional reentry in the ventricle remain poorly defined. We hypothesized that ERP shortening increases ventricular vulnerability to reentry and accelerates its rate, as is the case in the atrium. METHODS AND RESULTS: The epicardial surfaces of 19 isolated and superfused canine right ventricular slices (4x4 cm and <2 mm thick) were mapped with 480 bipolar electrodes 1.6 mm apart. Vulnerability was tested during pacing at a cycle length (CL) of 600 ms and with a single premature stimulus of 5-ms duration at increasing current strength of 1 to 100 mA. Cromakalim (10 micromol/L), an ATP-sensitive potassium channel opener, caused a significant (P<0. 001) shortening of the ERP but had no effect on conduction velocity. Cromakalim increased (P<0.01) the vulnerability (product of current and the stimulus coupling interval) for reentry induction. Reentry had a significantly shorter CL and lasted for a longer duration (P<0. 001). The central core around which the wave front rotated became smaller, which caused shortening of the CL of reentry. A significant (P<0.001) linear correlation was found between core size and reentry CL. These effects of cromakalim were reversible. Two-dimensional simulation studies using the modified Luo-Rudy I model of cardiac action potential, in which the refractory period was variably shortened by a progressive increase of the time-independent potassium conductance, reproduced the experimental findings. CONCLUSIONS: ERP shortening by an ATP-sensitive potassium channel opener increases ventricular vulnerability to reentry and accelerates its rate by decreasing the core size around which the wave front rotates.

DOI： 10.1161/01.CIR.99.5.704

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Transmembrane action potentials (TAPs) were recorded during simultaneous mapping of a reentrant wavefront induced in canine isolated atria. The activation pattern was visualized dynamically using a high resolution electrode catheter mapping system. During functional reentry (spiral wave), cells in the core of the spiral wave remained quiescent near their resting membrane potential. Cells away from the core progressively gained TAP amplitude and duration, and at the periphery of the spiral wave the cells generated TAPs with full height and duration. During anatomical reentry, when the tip of the wavefront remained attached to the obstacle (a condition of high source-to-sink ratio), the TAP near the obstacle had normal amplitude and duration. However, when the tip of the wavefront detached from the obstacle (condition of lowered source-to-sink ratio) the TAP lost amplitude and duration. These results are consistent with the theory that the source-to-sink ratio determines the safety factor for wave propagation and wave block near the core. With decreasing source-to-sink ratio, TAP progressively decreases in amplitude and duration. In the center of the core, the cells, while excitable, remain quiescent near their resting potential. This decrease reflects a progressive decrease in the source-to-sink ratio. TAP vanishes in the core where cells remain quiescent near their resting potential. Functional and meandering reentrant wavefronts are compatible with the spiral mechanism of reentry where block at the rotating point is provided by the steep curvature of the wave tip.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

To determine the role of pectinate muscle (PM) bundles in the formation of intra-atrial reentry, 10 isolated canine right atrial tissues were perfused with Tyrode's solution containing 1 to 2.5 micromol/L acetylcholine (ACh). The endocardium was mapped using 477 bipolar electrodes with 1.6-mm resolution. Reentry was induced by a premature stimulus (S2). Computer simulation studies were used to investigate the importance of regional myocardial thickness in reentry formation. A total of 40 episodes of reentry were induced; 28 episodes were stationary, and the remaining 12 were nonstationary. The stationary reentry was induced either immediately after the S2 stimuli (n=9) or after an initial period of irregular activations that lasted 1460+/-1077 ms (n= 19). Of 28 episodes, 20 were initiated by conduction block along large PM ridges, leading to wave break and the initiation of reentry. The reentrant wave fronts remained stationary and rotated around these ridges as anchoring sites. During the transition from the initial irregular activations to stationary reentry, the electrogram morphology converted from "fibrillation-like" to "flutter-like" activity. In 8 episodes, initially stationary reentry converted to irregular activations because of interference with outside wave fronts (n=5) or spontaneous separation of waves from the ridges (n=3). Compared with stationary reentry, nonstationary reentry always occurred over an area without large PMs, and the mean life span was much shorter (102+/-151 versus 3.8+/-1.1 rotations, P<0.001). Computer simulation studies showed that a critical ridge thickness is needed for reentry to anchor, thereby converting fibrillation to flutter. We conclude that PM ridge forms an area where wave break occurs, allowing the initiation of reentry. It also provides a natural anchor to the reentrant wave front, lengthening the life span of reentry. The attachment and detachment of the reentrant wave front to and from the ridge determine "flutter-like" or "fibrillation-like" activity.

DOI： 10.1161/01.RES.83.4.448

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/S0022-0736(98)90280-1

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Closed-chest transcatheter electrical ablation (catheter ablation) has been applied to various supraventricular and ventricular tachyarrhythmias as a radical therapeutic technique since its introduction in 1982. Currently, it has become a first line therapy for supraventricular tachyarrhythmias except atrial fibrillation and uncommon types of atrial flutter. We first carried out the ablation procedure in 1991 for the treatment of ventricular tachycardia. Up to February 1997, a total of 187 patients underwent catheter ablation in our institution. The aims of this study are to demonstrate our results of catheter ablation in the early 5 years and to show the usefulness of this new curative method. Successful results were obtained in 168 of 187 patients (overall final success rate: 89.8%). The success rates of each category of tachyarrhythmias were 100/105 patients (95%) with WPW syndrome, 41/46 (89%) with atrioventricular nodal reentrant tachycardia, 7/10 (70%) with atrial flutter, 4/4 (100%) with atrial tachycardia, 2/2 (100%) with medically refractory atrial fibrillation, 13/15 (85%) with idiopathic ventricular tachycardia and 3/7 (43%) with sustained ventricular tachycardia associated with structural heart disease, respectively. Complications that required invasive treatments were observed in 3 patients (2 hemopericardium and 1 complete atrioventricular block). Our results indicate that catheter ablation is highly effective in most categories of tachyarrhythmias and can be applied safely without lethal complications.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Acetylcholine chloride (ACh) induces nonstationary meandering reentrant wave fronts in the atrium. We hypothesized that an anatomic obstacle of a suitable size prevents meandering by causing attachment of the reentrant wave front tip to the obstacle. Eight isolated canine right atrial tissues (area, 3.8 x 3.2 cm) were mounted in a tissue bath and superfused with Tyrode's solution containing 10 to 15 mumol/L ACh. Holes with 2- to 10-mm diameters were sequentially created in the center of the tissue with biopsy punches. Reentry was induced by a premature stimulus after eight regular stimuli at 400-ms cycle length. The endocardial activation maps and the motion of the induced reentry were visualized dynamically before and after each test lesion using 509 bipolar electrodes. In the absence of a lesion (n = 8), the induced single reentrant wave front, in the form of a spiral wave, meandered irregularly from one site to another before terminating at the tissue border. Holes with 2- to 4-mm diameters (n = 6) had no effect on meandering. However, when the hole diameters were increased to 6 mm (n = 8), 8 mm (n = 8), and 10 mm (n = 6), the tip of the spiral wave attached to the holes, and reentry became stationary. Transition from meandering to an attached state converted the irregular and polymorphic electrogram to a periodic and monomorphic activity with longer cycle lengths (101 +/- 11 versus 131 +/- 9 ms for no hole versus 10-mm hole, respectively; P < .001). Regression analysis showed a significant positive linear correlation between the cycle length of the reentry and the hole diameter (r = .89, P < .01) and between the cycle length of the reentry and the excitable gap (r = .89, P < .05). We conclude that a critically sized anatomic obstacle converts a nonstationary meandering reentrant wave front to a stationary one. This transition converts an irregular "fibrillation-like" activity into regular monomorphic activity.

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Paroxysmal atrial flutter is a drug-resistant supraventricular tachyarrhythmia that is often accompanied by hemodynamic instability due to an excessive ventricular response. We report here a case of atrial flutter with 1:1 atrioventricular conduction, in which we were able to rescue the patient from a state of cardiogenic shock by using intravenous dofetilide, a new class III antiarrhythmic agent. Dofetilide was suitable for the treatment because it immediately increased atrioventricular nodal refractoriness without any negative inotropic action.

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記述言語：日本語   出版者・発行元：The Japanese Society of Clinical Pharmacology and Therapeutics  

DOI： 10.3999/jscpt.25.17

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記述言語：日本語   出版者・発行元：The Japanese Society of Clinical Pharmacology and Therapeutics  

The electrophysiologic and hemodynamic effects and the pharmacokinetics of a single oral administration of pirmenol were evaluated in 20 patients with supraventricular tachycardia (SVT). Pirmenol, at 1hr after administration, significantly shortened sinus cycle length and sinoatrial conduction time. HV interval (46±10msec to 54±11msec, P<0.01), refractory period of the right atrium and the right ventricle were significantly prolonged. Furthermore, anterograde refractory period of accessory pathway and retrograde refractory period of AV node and accessory pathway were prolonged. Hemodynamic study revealed increased systemic and pulmonary vascular resistance and decreased stroke volume index. Induction of SVT was suppressed in 11 out of 16 patients. Among 5 patients who were not suppressed at 1hr, 2 patients resulted in noninducible at 2hr after administration. Plasma concentration of pirmenol at 1hr after administration was 1.0±0.4μg/ml in effective cases and was 0.4±0.5μg/ml in failed cases (P<0.05). Pharmacokinetics of single oral pirmenol were, t_max of 2.9hr, C_max of 1.4μg/ml, t_1/2 of 6.8hr and AUC of 18.7μg·hr/ml. In conclusion, a single oral administration of pirmenol was highly effective in suppression of induction of SVT with sufficient hemodynamic tolerance.

DOI： 10.3999/jscpt.22.745

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記述言語：日本語   出版者・発行元：The Japanese Society of Clinical Pharmacology and Therapeutics  

This study was designed to elucidate the basic changes in electrocardiogram during phase I study. Lead II electrocardiograms were recorded from 10 healthy male volunteers (Group P) with placebo administration and blood sampling, and 16 healthy male volunteers (Group N) with no placebo and no blood sampling by the time schedules of phase I study of some cardiovascular drugs. The RR intervals were significantly prolonged (P<0.01) before lunch and then shortened (P<0.05) by taking lunch, in both groups. Prolongation of RR interval was more pronounced in Group N. Maximum prolongation was observed at 3 hr (9.6%) in Group P, and at 2. 67 hr (12. 5%) in Group N. The PR intervals and QRS width revealed no significant change during observation period. The QT interval was significantly prolonged (P<0.05) before lunch in Group N, but not in group P, and significantly shortened (P<0.05) after lunch in Group P but not in Group N, whereas the QTc was significantly shortened (P<0.05) in both groups before lunch. These results indicated that the RR interval was lengthened with bed rest but this effect was attenuated by drawing blood sample, and suggested that rate-dependent QT prolongation and dis cordant shortening of QTc before lunch resulted in overcorrection by Bazett's formula The T wave amplitude was significantly increased (P<0.01) by 4 hr-check up point and then suddenly reduced by taking lunch. This suggests that T wave amplitude might be controlled by blood glucose level.<BR>It should be noted that the electrocardiographic effects of phase I study of cardiovascula: drugs might be affected by these changes.

DOI： 10.3999/jscpt.20.619

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その他リンク： http://search.jamas.or.jp/link/ui/1992218610

記述言語：日本語   出版者・発行元：The Japanese Society of Clinical Pharmacology and Therapeutics  

SUN 1165 is a newly synthesized antiarrhythmic drug with class Ic properties in vitro.We assessed acute electrophysiologic and hemodynamic effects of SUN 1165 in 18 patientswith supraventricular tachycardia (SVT) [6 patients with AV nodal reentrant tachycardia (AVNRT), and 12 patients with AV reentrant tachycardia (AVRT)]. All patients werefree from organic heart disease. Electrophysiologic and hemodynamic studies were performedbefore and 60 min after a single oral administration of SUN 1165 (150 or 200 mg).SUN 1165 significantly shortened sinus cycle length, lengthened sinoatrial conductiontime (98±21 to 112±21 msec, P< 0.01), AH interval (83±11 to 100±15, P<0.01), HVinterval (42±8 to 63±17, P<0.001), and RV effective refractory period (220±28 to 231±27, P<0.05).Antdrograde conduction via accessory pathway (AP) was abolished in 6out of 7 patients. Retrograde conduction via AP and AV node were abolished in 9 out of12 and 2 out of 6 patients respectively. Induction of SVT was completely suppressed in9 out of 13 patients. By hemodynamic studies (10 patients), decrease of stroke volumeindex and increase of mean pulmonary arterial pressure were demonstrated. No adverseeffects were observed. In conclusion, oral SUN 1165 has potent electrophysiologic effectson impulse propagation through AV node and AP with mild negative inotropic action. Andthe suppression of SVT induction was mediated through predominant effect on retrogradeconduction.

DOI： 10.3999/jscpt.20.677

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記述言語：日本語  

＜Point＞ほとんどは基礎心疾患を有さないが,稀に認める急性心筋梗塞や急性心膜炎・心筋炎のサインであることもある.基礎心疾患に伴う場合,非持続性心室頻拍によりめまい,失神を呈することもある.まず心エコーで基礎心疾患の有無と心機能の評価を行う.ホルター心電図検査で非持続性心室頻拍の有無を評価する.基礎心疾患のない,2連発までの心室期外収縮は通常経過観察のみで可.動悸症状が強い場合や不整脈の数が多い場合は,特発性心室期外収縮でも薬物療法やカテーテルアブレーションを考慮する.期外収縮の12誘導波形から原因・機序・薬剤選択を類推することができる.流出路型か中隔型かの鑑別を行う.カテーテルアブレーションは有力な治療手段.心室頻拍でなくとも期外収縮多発の場合には適応があり,一度検討を行う.(著者抄録)

DOI： 10.11477/mf.1438200044

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記述言語：日本語  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J03097&link_issn=&doc_id=20150722290015&doc_link_id=%2Fap4heard%2F2015%2F001908%2F016%2F0920-0926%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fap4heard%2F2015%2F001908%2F016%2F0920-0926%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：英語   出版者・発行元：(一社)日本循環器学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：一般社団法人 日本不整脈心電学会  

DOI： 10.5105/jse.37.3

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記述言語：日本語   出版者・発行元：(公財)日本心臓財団  

DOI： 10.11281/shinzo.48.511

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J00679&link_issn=&doc_id=20160531180006&doc_link_id=10.11281%2Fshinzo.48.511&url=https%3A%2F%2Fdoi.org%2F10.11281%2Fshinzo.48.511&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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J-GLOBAL

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記述言語：日本語   出版者・発行元：日本医科大学医学会  

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記述言語：日本語   出版者・発行元：(公財)日本心臓財団  

DOI： 10.11281/shinzo.46.891

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J00679&link_issn=&doc_id=20140724250013&doc_link_id=%2Fah2sinzd%2F2014%2F004607%2F015%2F0891-0892%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fah2sinzd%2F2014%2F004607%2F015%2F0891-0892%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(NPO)日本小児循環器学会  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

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J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：南江堂  

DOI： 10.15106/j00974.2008149298

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その他リンク： http://search.jamas.or.jp/link/ui/2008149298

記述言語：日本語   出版者・発行元：(一社)日本集中治療医学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：一般社団法人 日本不整脈心電学会  

DOI： 10.5105/jse.26.871

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記述言語：日本語   出版者・発行元：(株)ライフ・サイエンス  

拡張型心筋症22例をアミオダロン投与群(7例)と非投与群に分け,単球のケモカイン(MPC-1,IL-8)産生量を比較した.投与群でのみMPC-1,IL-8が有意に減少し,心機能が有意に改善された.さらに投与群では心不全の一指標とされるTNF-αの有意な減少が認められた

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記述言語：日本語  

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語  

DOI： 10.11281/shinzo1969.38.supplement1_10

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記述言語：日本語   出版者・発行元：(株)ライフ・サイエンス  

アミオダロンを投与した拡張型心筋症7例(男6例・女1例,平均63歳:A群)と非投与の15例(男12例・女3例,平均65歳:B群)を対象に,末梢血より単核球を抽出し,ELISA法により上清液中の炎症性サイトカイン濃度を測定した.その結果,A群では投与開始4週間後のBNP値が投与前に比較して有意に低下していた.単球が産生するTNF-α,IL-6についても,アミオダロン投与前後で有意な減少を認めた.B群ではこれらの有意な変化は認めなかった.また,左室駆出率はA群では有意な改善を認めたが,B群では認めなかった

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語  

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(NPO)日本不整脈学会  

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記述言語：日本語   出版者・発行元：(NPO)日本不整脈学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

CiNii Books

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語  

DOI： 10.11281/shinzo1969.32.supplement1_40

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(NPO)日本不整脈学会  

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：日本医科大学医学会  

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記述言語：日本語  

症例は70歳男性.10年来自覚する動悸発作に対する精査目的で入院.入院時12誘導心電図に異常なし.心臓電気生理学的検査を施行.心室刺激では,冠静脈洞(CS)左側側壁を最早期興奮部位(EAS)とし軽度の減衰伝導特性を有する室房伝導を認め,EASにおけるVA間隔は右室基部後壁ペーシングに比し右室流出路刺激で大であった.イソプロテレノール持続静注下の心室頻回刺激で同様の逆行伝導を介する房室回帰性頻拍が誘発された.洞調律中の僧帽弁下部のマッピングでは,EASでは単一の心房波(A波)を認めたが,冠静脈洞近位方向に移動すると,A波に引き続く副伝導路電位(KP)が記録され,近位ほど両者の間隔が増大した.また,CS先端ペーシングではいずれの部位でも単一のA波を認めるのみであった.EASの2.5cm近位において,心室刺激で局所心室波の直後に逆行性KP,その40msec後に逆行性A波が記録され,同部位での通電開始1.8秒後に副伝導路を介する逆行伝導が途絶した.<BR>斜走副伝導路の潜伏性順行伝導の電位が記録された潜在性WPW症候群を報告する.

DOI： 10.11281/shinzo1969.31.supplement5_61

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記述言語：日本語   出版者・発行元：臨床心臓電気生理研究会  

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：一般社団法人 日本不整脈心電学会  

DOI： 10.5105/jse.12.153

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

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記述言語：日本語   出版者・発行元：(株)日本臨床社  

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

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開催年月日： 2018年3月

記述言語：日本語  

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開催年月日： 2017年8月

記述言語：日本語  

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開催年月日： 2017年3月

記述言語：英語  

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開催年月日： 2017年3月

記述言語：日本語  

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開催年月日： 2017年3月

記述言語：日本語  

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