Effectiveness of Catheter Ablation for Atrial Fibrillation Accompanying Hypertrophic Cardiomyopathy

要旨 背景:肥大型心筋症 (HCM) に心房細動 (AF) を 合併すると,呼吸困難,胸痛,心不全,肺水腫,失神, 脳卒中,植込み型除細動器の不適切作動,心血管死の発 生頻度が増加する. HCMに合併した AFに対する現在 の薬物治療は長期効果が乏しく,また副作用の観点から も,限界が有る.一方,AFに対するカテーテルアブレー ション (RFA) による肺静脈隔離 (PVI) は薬物療法よりも 洞調律維持率が良いと報告されている.今回,著者らは HCMに合併した AFに対する PVIを施行した成績に文 献的考察を加え報告する. 方法:発作性 AFを合併した HCM 5症例及び孤立性 持続性 AF10症例に対し,アブレーションを施行し,そ の後の経過を比較した. 結果:アブレーション後の最終的な再発率は HCMで は 80%,孤立性持続性 AFでは 90%であり,有意差は 認めなかった. 結語:HCMに合併した AFに対して,アブレーショ ンは有効な治療法に成り得る.

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