福岡 嘉弘, 田中 康博, 常盤 二起子, 寺田 浩和, 小牧 伸一郎, 山王 和寿, 寺師 利彦, 松下 毅彦, 春別府 稔仁, 薗田 正浩, 有馬 證牙享

Yoshihiro FUKUOKA, Yasuhiro TANAKA, Fukiko TOKIWA, Hirokazu TERADA, Shinichirou KOMAKI, Kazutoshi SANNOU, Toshihiko TERASHI, Takehiko MATUSHITA, Narihito HARUBYU, Masahiro SONODA, Terukatsu ARIMA

鹿児島大学医学部第二内科

Second Department of Internal Medicine, University of Kagoshima Faculty of Medicine

キーワード : atrial flutter, catheter ablation, transesophageal echocardiography, transthoracic echocardiography

Atrial stunning and the development of spontaneous echo contrast (SEC) are known consequences of cardioversion carried out to defibrillate atrial fibrillation or atrial flutter. Radio-frequency catheter ablation (RFCA) is regarded as a definitive treatment for chronic AFL, although little is known about left atrial stunning induced by this procedure. We treated a 49-year-old man who had atrial flutter while undergoing curative RFCA, and who had received transthoracic and transesophageal echocardiography for evaluation of transmitral flow velocity, left atrial appendage emptying velocity, and SEC before RFCA and 1 day, 1 month, 3 months, and 9 months after RFCA. Transesophageal echocardiograpfy showed that the ratio of atrial contraction flow and early diastolic flow had returned to normal 9 months after RFCA. Transesophageal echocardiography showed that left atrial appendage emptying velocity decreased significantly 1 day after RFCA but recovered 1 month after RFCA (55 cm/sec before RFCA, 30 cm/sec 1 day after RFCA, and 60 cm/sec 1 month after RFCA). The SEC observed before RFCA and 1 month after RFCA had disappeared completely 9 months after RFCA.