SURGICAL TREATMENT OF ATRIAL FIBRILLATION-Evaluation of card iac and hemodynamic effects for atrial isolation procedure

心房颤动的手术治疗-心房隔离手术中心脏和血流动力学效应的评估

• 批准号: 02807129
• 负责人: IKESHITA Masatoshi
• 金额: $ 1.02万
• 依托单位: Nippon Medical School
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1990
• 资助国家: 日本
• 起止时间: 1990 至 1991
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-02807129/
• 关键词: atrial fibrillation; atrial isolation; atrial septal defect; 心房細胞; 血栓塞栓症; 右房隔離術; 圧容積曲線

Atrial fibrillation is the most common arrhythmia noted in clinical practice. Three detrimental sequelae result from the development of atrial fibrillation: 1)an irregular heartbeat, 2)impaired cardiac hemodynamics, primarily because of loss of the synchronous atrial kick, and 3)an increased vulnerability to thromboembolism. Patients with chronic atrial fibrillation will experience an associated thromboembolic epithod. In 1988, Harada developped right atria isolation procedure, that has electrophysiologic effects of isolating the right atrium with the origin of atrial fibrillation while preserving normal function and continuity of the sinoatrial node with the remainder of the heart.Purpose of this study is to evaluate the cardiac function and hemodynamic effects, and apply this procedure to the patients with atrial fibrillation safely. Postopeartive cardiac and hemodynamic performance from some parameter of mean atria pressure, stroke volume index, left atrial pressure, right atrial pressure and Emax does not show significant changes for preoperative performance, and remained within normal limit. From these results, this procedure was applied two patients with atrial fibrillation and atrial septal defect. Postoperative normal sinus rhythm maintained for 10 months with disappearing atrial fibrillation. We conclude that the purpose of this study was achieved from these results.

房颤是临床上最常见的心律失常。房颤的发展导致三种有害的后遗症：1）不规则心跳，2）心脏血流动力学受损，主要是由于同步心房驱血的丧失，以及3）血栓栓塞的脆弱性增加。慢性房颤患者会出现相关的血栓栓塞性上皮病变。1988年，原田开发了右心房隔离术，其电生理作用是将右心房与房颤的起源隔离，同时保留窦房结与心脏其余部分的正常功能和连续性。本研究的目的是评估心脏功能和血流动力学影响，并安全地将该手术应用于房颤患者。平均心房压、每搏输出量指数、左心房压、右心房压和Emax等参数的术后心脏和血流动力学性能与术前性能相比未显示出显著变化，并保持在正常范围内。根据这些结果，该手术应用于两名患有心房颤动和房间隔缺损的患者。术后10个月维持正常窦性心律，房颤消失。我们的结论是，本研究的目的是从这些结果实现。

项目成果

庄司 佑、池下 正敏: "不整脈の外科治療" 胸部外科. 42. 655-664 (1989)

Yu Shoji、Masatoshi Ikeshita：“心律失常的手术治疗”胸外科。 42. 655-664 (1989)