不整脈科
研究活動の概要

不整脈科では、種々の頻脈性・致死性不整脈の病態及び機序の解明、並びに新たな診断・治療法の開発に加え、近年増加している心房細動に関連した抗凝固療法や新しいアブレーション法を臨床研究のテーマとし難治性の不整脈疾患において種々の研究活動を行っている。特に致死性不整脈の病態解明として、心臓サルコイドーシスに関する全国実態調査が完了し740名を超える患者情報が得られ、さまざまな報告を国内外の学会で行った。新規抗凝固療法に関しては、周術期の出血性合併症を減らす工夫を検討している。隠れた心房細動を見つけ出す脈波計を用いた不整脈診断の研究を昨年から引き続いて行いAMEDからの援助のもと行い、遠隔医療への布石を行っている。遺伝性不整脈疾患に関しては臨床検査部、予防健診部の協力の下に、従来の遺伝子診断を継続している。遺伝性不整脈外来創設による効果で、昨年も500名近い遺伝子診断紹介を受け、次世代シーケンサーを使った診断を随時行っている。これらの結果を元に種々の国際学会・英文論文等でその成果を報告している。治療に関しては、心房細動に対するバルーン治療としてクライオバルーンだけでなくホットバルーンが登場し、良好な成績を収めている。 またデバイス（植込み型除細動器、心室再同期機能付き除細動器、ペースメーカ）に関しては、再同期治療に関する国際共同治験に日本代表として引き続いて参加し、皮下植込み型除細動器（S-ICD）が臨床に導入され負担の少ない治療が可能となってきている。また心房細動治療が可能な新しいアルゴリズムをもつデバイスの研究を行っている。デバイス遠隔モニタリングは600名を超える除細動器患者に行っているが、今後は2000例を超えるペースメーカ患者への広がりを検討している。それらの結果としてデバイス総手術件数は540例と依然として国内最大を誇っている。当科だけで年間1300名以上の入院患者を受け入れ診断・治療を行っている。今後もアブレーション件数をさらに増加させると共に、薬物・非薬物療法を駆使して、あらゆる方面から難治性心不全や不整脈の治療・管理・研究に取り組む予定である。

2016年の主な研究成果
  • 今年度はカテーテルアブレーション、デバイス植込み（リード抜去術を含む）が各500例前後、遺伝子検査数は400例を超え日本最大。
  • 国際多施設共同治験として、Adapt- Response試験に参加。
  • クライオバルーンを用いた多施設前向き介入試験（Ad-Balloon試験）を続行中。
  • AMEDからの援助で時計型脈波計を用いた心房細動診断の研究を施行中。
  • 心不全学会の協力を得て、心サルコイドーシスに関する全国実態調査を施行終了。
研究業績
  1. Honda Y, Nagai T, Iwakami N, Sugano Y, Honda S, Okada A, Asaumi Y, Aiba T, Noguchi T, Kusano K, Ogawa H, Yasuda S, Anzai T. Usefulness of Geriatric Nutritional Risk Index for Assessing Nutritional Status and Its Prognostic Impact in Patients Aged ≥65 Years With Acute Heart Failure. American Journal of Cardiology. 118, 550-555, 2016.
  2. Nagai T, Nagano N, Sugano Y, Asaumi Y, Aiba T, Kanzaki H, Kusano K, Noguchi T, Yasuda S, Ogawa H, Anzai T. Effect of Discontinuation of Prednisolone Therapy on Risk of Cardiac Mortality Associated With Worsening Left Ventricular Dysfunction in Cardiac Sarcoidosis. American Journal of Cardiology. 117, 966-971, 2016.
  3. Nakamura M, Iso H, Kitamura A, Imano H, Noda H, Kiyama M, Sato S, Yamagishi K, Nishimura K, Nakai M, Vesper HW, Teramoto T, Miyamoto Y. Comparison between the triglycerides standardization of routine methods used in Japan and the chromotropic acid reference measurement procedure used by the CDC Lipid Standardization Programme. Annals of Clinical Biochemistry. 53, 632-639, 2016.
  4. Wilde AAM, Moss AJ, Kaufman ES, Shimizu W, Peterson DR, Benhorin J, Lopes C, Towbin JA, Spazzolini C, Crotti L, Zareba W, Goldenberg I, Kanters JK, Robinson JL, Qi M, Hofman N, Tester DJ, Bezzina CR, Alders M, Aiba T, Kamakura S, Miyamoto Y, Andrews ML, McNitt S, Polonsky B, Schwartz PJ, Ackerman MJ. Clinical Aspects of Type 3 Long-QT Syndrome An International Multicenter Study. Circulation. 134, 872-882, 2016.
  5. Okada A, Nakajima I, Morita Y, Inoue YY, Kamakura T, Wada M, Ishibashi K, Miyamoto K, Okamura H, Nagase S, Noda T, Aiba T, Kamakura S, Anzai T, Noguchi T, Yasuda S, Kusano K. Diagnostic Value of Right Ventricular Dysfunction in Tachycardia-Induced Cardiomyopathy Using Cardiac Magnetic Resonance Imaging. Circulation Journal. 80, 2141-2148, 2016.
  6. Okamura H, Friedman PA, Inoue Y, Noda T, Aiba T, Yasuda S, Ogawa H, Kamakura S, Kusano K, Espinosa RE. Single-Coil Defibrillator Leads Yield Satisfactory Defibrillation Safety Margin in Hypertrophic Cardiomyopathy. Circulation Journal. 80, 2199-2203, 2016.
  7. Kawata H, Ohno S, Aiba T, Sakaguchi H, Miyazaki A, Sumitomo N, Kamakura T, Nakajima I, Inoue YY, Miyamoto K, Okamura H, Noda T, Kusano K, Kamakura S, Miyamoto Y, Shiraishi I, Horie M, Shimizu W. Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) Associated With Ryanodine Receptor (RyR2) Gene Mutations - Long-Term Prognosis After Initiation of Medical Treatment. Circulation Journal. 80, 1907-1915, 2016.
  8. Ueoka A, Morita H, Watanabe A, Nakagawa K, Nishii N, Nagase S, Ohe T, Ito H. Activation Pattern of the Polymorphic Ventricular Tachycardia and Ventricular Fibrillation on Body Surface Mapping in Patients With Brugada Syndrome. Circulation Journal. 80, 1734-1743, 2016.
  9. Yokokawa T, Sugano Y, Shimouchi A, Shibata A, Jinno N, Nagai T, Kanzaki H, Aiba T, Kusano K, Shirai M, Takeishi Y, Yasuda S, Ogawa H, Anzai T. Exhaled Acetone Concentration Is Related to Hemodynamic Severity in Patients With Non-Ischemic Chronic Heart Failure. Circulation Journal. 80, 1178-1186, 2016.
  10. Okada A, Sugano Y, Nagai T, Takashio S, Honda S, Asaumi Y, Aiba T, Noguchi T, Kusano KF, Ogawa H, Yasuda S, Anzai T. Prognostic Value of Prothrombin Time International Normalized Ratio in Acute Decompensated Heart Failure - A Combined Marker of Hepatic Insufficiency and Hemostatic Abnormality -. Circulation Journal. 80, 913-923, 2016.
  11. Funasako M, Aiba T, Ishibashi K, Nakajima I, Miyamoto K, Inoue Y, Okamura H, Noda T, Kamakura S, Anzai T, Noguchi T, Yasuda S, Miyamoto Y, Kusano KF, Ogawa H, Shimizu W. Pronounced Shortening of QT Interval With Mexiletine Infusion Test in Patients With Type 3 Congenital Long QT Syndrome. Circulation Journal. 80, 340-345, 2016.
  12. Ichikawa M, Aiba T, Ohno S, Shigemizu D, Ozawa J, Sonoda K, Fukuyama M, Itoh H, Miyamoto Y, Tsunoda T, Makiyama T, Tanaka T, Shimizu W, Horie M. Phenotypic Variability of ANK2 Mutations in Patients With Inherited Primary Arrhythmia Syndromes. Circulation Journal. 80, 2435-2442, 2016.
  13. Mahati E, Li P, Kurata Y, Maharani N, Ikeda N, Sakata S, Ogura K, Miake J, Aiba T, Shimizu W, Nakasone N, Ninomiya H, Higaki K, Yamamoto K, Nakai A, Shirayoshi Y, Hisatome I. M3 Muscarinic Receptor Signaling Stabilizes a Novel Mutant Human Ether-a-Go-Go-Related Gene Channel Protein via Phosphorylation of Heat Shock Factor 1 in Transfected Cells. Circulation Journal. 80, 2443-2452, 2016.
  14. Miyagi T, Asaumi Y, Nishimura K, Nakashima T, Sakamoto H, Nakao K, Kanaya T, Nagai T, Shimabukuro Y, Miyamoto Y, Fujita T, Kusano K, Anzai T, Kobayashi J, Noguchi T, Ogawa H, Yasuda S. Validation of the Coronary Artery Bypass Graft SYNTAX Score (Synergy Between Percutaneous Coronary Intervention With Taxus) as a Prognostic Marker for Patients With Previous Coronary Artery Bypass Graft Surgery After Percutaneous Coronary Intervention. Circulation-Cardiovasucular Interventions. 9, e003459, 2016.
  15. Kishimoto I, Makino H, Ohata Y, Tamanaha T, Tochiya M, Kusano K, Anzai T, Toyoda K, Yasuda S, Minematsu K, Ogawa H. Impact of B-type natriuretic peptide (BNP) on development of atrial fibrillation in people with Type 2 diabetes. Diabetic Medicine. 33, 1118-1124, 2016.
  16. Onuma Y, Sotomi Y, Shiomi H, Ozaki Y, Namiki A, Yasuda S, Ueno T, Ando K, Furuya J, Igarashi K, Kozuma K, Tanabe K, Kusano H, Rapoza R, Popma JJ, Stone GW, Simonton C, Serruys PW, Kimura T. Two-year clinical, angiographic, and serial optical coherence tomographic follow-up after implantation of an everolimus-eluting bioresorbable scaffold and an everolimus-eluting metallic stent: insights from the randomised ABSORB Japan trial. Eurointervention. 12, 1090-1101, 2016.
  17. Miyazaki A, Sakaguchi H, Kagisaki K, Tsujii N, Matsuoka M, Yamamoto T, Hoashi T, Noda T, Ohuchi H. Optimal pacing sites for cardiac resynchronization therapy for patients with a systemic right ventricle with or without a rudimentary left ventricle. Europace. 18, 100-112, 2016.
  18. Itoh H, Crotti L, Aiba T, Spazzolini C, Denjoy I, Fressart V, Hayashi K, Nakajima T, Ohno S, Makiyama T, Wu J, Hasegawa K, Mastantuono E, Dagradi F, Pedrazzini M, Yamagishi M, Berthet M, Murakami Y, Shimizu W, Guicheney P, Schwartz PJ, Horie M. The genetics underlying acquired long QT syndrome: impact for genetic screening. European Heart Journal. 37, 1456-1464, 2016.
  19. Koizumi A, Sasano T, Kimura W, Miyamoto Y, Aiba T, Ishikawa T, Nogami A, Fukamizu S, Sakurada H, Takahashi Y, Nakamura H, Ishikura T, Koseki H, Arimura T, Kimura A, Hirao K, Isobe M, Shimizu W, Miura N, Furukawa T. Genetic defects in a His-Purkinje system transcription factor, IRX3, cause lethal cardiac arrhythmias. European Heart Journal. 37, 1469-1475, 2016.
  20. Kaitani K, Inoue K, Kobori A, Nakazawa Y, Ozawa T, Kurotobi T, Morishima I, Miura F, Watanabe T, Masuda M, Naito M, Fujimoto H, Nishida T, Furukawa Y, Shirayama T, Tanaka M, Okajima K, Yao T, Egami Y, Satomi K, Noda T, Miyamoto K, Haruna T, Kawaji T, Yoshizawa T, Toyota T, Yahata M, Nakai K, Sugiyama H, Higashi Y, Ito M, Horie M, Kusano KF, Shimizu W, Kamakura S, Morimoto T, Kimura T, Shizuta S. Efficacy of Antiarrhythmic Drugs Short-Term Use After Catheter Ablation for Atrial Fibrillation (EAST-AF) trial. European Heart Journal. 37, 610-618, 2016.
  21. Kamakura T, Wada M, Nakajima I, Ishibashi K, Miyamoto K, Okamura H, Noda T, Aiba T, Takaki H, Yasuda S, Ogawa H, Shimizu W, Makiyama T, Kimura T, Kamakura S, Kusano K. Significance of electrocardiogram recording in high intercostal spaces in patients with early repolarization syndrome. European Heart Journal. 37, 630-637, 2016.
  22. Nagai T, Nishimura K, Honma T, Higashiyama A, Sugano Y, Nakai M, Honda S, Iwakami N, Okada A, Kawakami S, Kanaya T, Asaumi Y, Aiba T, Nishida Y, Kubota Y, Sugiyama D, Okamura T, Noguchi T, Kusano K, Ogawa H, Yasuda S, Anzai T. Prognostic significance of endogenous erythropoietin in long-term outcome of patients with acute decompensated heart failure. European Journal of Heart Failure. 18, 803-813, 2016.
  23. Miyamoto K, Aiba T, Arihiro S, Watanabe M, Kokubo Y, Ishibashi K, Hirose S, Wada M, Nakajima I, Okamura H, Noda T, Nagatsuka K, Noguchi T, Anzai T, Yasuda S, Ogawa H, Kamakura S, Shimizu W, Miyamoto Y, Toyoda K, Kusano K. Impact of renal function deterioration on adverse events during anticoagulation therapy using non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. Heart and Vessels. 31, 1327-1336, 2016.
  24. Miyamoto K, Noda T, Satomi K, Wada M, Nakajima I, Ishibashi K, Okamura H, Noguchi T, Anzai T, Yasuda S, Ogawa H, Shimizu W, Aiba T, Kamakura S, Kusano K. Larger low voltage zone in endocardial unipolar map compared with that in epicardial bipolar map indicates difficulty in eliminating ventricular tachycardia by catheter ablation. Heart and Vessels. 31, 1337-1346, 2016.
  25. Rodriguez-Manero M, Sacher F, de Asmundis C, Maury P, Lambiase PD, Sarkozy A, Probst V, Gandjbakhch E, Castro-Hevia J, Saenen J, Kusano KF, Rollin A, Arbelo E, Valderrabano M, Arias MA, Mosquera-Perez I, Schilling R, Chierchia GB, Garcia-Bolao I, Garcia-Seara J, Hernandez-Ojeda J, Kamakura T, Martinez-Sande L, Gonzalez-Juanatey JR, Haissaguerre M, Brugada J, Brugada P. Monomorphic ventricular tachycardia in patients with Brugada syndrome: A multicenter retrospective study. Heart Rhythm. 13, 669-682, 2016.
  26. Honda S, Nagai T, Sugano Y, Okada A, Asaumi Y, Aiba T, Noguchi T, Kusano K, Ogawa H, Yasuda S, Anzai T. Prevalence, determinants, and prognostic significance of delirium in patients with acute heart failure. International Journal of Cardiology. 222, 521-527, 2016.
  27. Fujino M, Takahama H, Hamasaki T, Sekiguchi K, Kusano K, Anzai T, Noguchi T, Goto Y, Kitakaze M, Yokoyama H, Ogawa H, Yasuda S. Risk stratification based on nutritional screening on admission: Three-year clinical outcomes in hospitalized patients with acute heart failure syndrome. Journal of Cardiology. 68, 392-398, 2016.
  28. Maeda T, Sakurai R, Nakagawa K, Morishima K, Maekawa M, Furumoto K, Kono T, Egawa A, Kubota Y, Kato S, Okamura H, Yoshitani K, Ohnishi Y. Cardiac Resynchronization Therapy-Induced Cardiac Index Increase Measured by Three-Dimensional Echocardiography Can Predict Decreases in Brain Natriuretic Peptide. Journal of Cardiothoracic and Vascular Anesthesia. 30, 599-605, 2016.
  29. Kawata H, Hirai T, Doukas D, Hirai R, Steinbrunner J, Wilson J, Noda T, Hsu J, Krummen D, Feld G, Wilber D, Santucci P, Birgersdotter-Green U. The Occurrence of Implantable Cardioverter Defibrillator Therapies After Generator Replacement in Patients Who No Longer Meet Primary Prevention Indications. Journal of Cardiovascular Electrophysiology. 27, 724-729, 2016.
  30. Teuho J, Johansson J, Linden J, Hansen AE, Holm S, Keller SH, Delso G, Veit-Haibach P, Magota K, Saunavaara V, Tolvanen T, Teras M, Iida H. Effect of Attenuation Correction on Regional Quantification Between PET/MR and PET/CT: A Multicenter Study Using a 3-Dimensional Brain Phantom. Journal of Nuclear Medicine. 57, 818-824, 2016.
  31. Tomari S, Homma K, Noguchi T, Aiba T, Matsuki T, Suzuki R, Koga M, Takigami M, Tagawa H, Hashimoto T, Toyoda K. Development of Interstitial Lung Disease after Initiation of Apixaban Anticoagulation Therapy. Journal of Stroke & Cerebrovascular Diseases. 25, 1767-1769, 2016.
  32. Yagihara N, Watanabe H, Barnett P, Duboscq-Bidot L, Thomas AC, Yang P, Ohno S, Hasegawa K, Kuwano R, Chatel S, Redon R, Schott JJ, Probst V, Koopmann TT, Bezzina CR, Wilde AAM, Nakano Y, Aiba T, Miyamoto Y, Kamakura S, Darbar D, Donahue BS, Shigemizu D, Tanaka T, Tsunoda T, Suda M, Sato A, Minamino T, Endo N, Shimizu W, Horie M, Roden DM, Makita N. Variants in the SCN5A Promoter Associated With Various Arrhythmia Phenotypes. Journal of the American Heart Association. 5, e003644, 2016.
  33. Honda Y, Nagai T, Ikeda Y, Sakakibara M, Asakawa N, Nagano N, Nakai M, Nishimura K, Sugano Y, Ohta-Ogo K, Asaumi Y, Aiba T, Kanzaki H, Kusano K, Noguchi T, Yasuda S, Tsutsui H, Ishibashi-Ueda H, Anzai T. Myocardial Immunocompetent Cells and Macrophage Phenotypes as Histopathological Surrogates for Diagnosis of Cardiac Sarcoidosis in Japanese. Journal of the American Heart Association. 5, e004019, 2016.
  34. Nagai T, Honda Y, Sugano Y, Nishimura K, Nakai M, Honda S, Iwakami N, Okada A, Asaumi Y, Aiba T, Noguchi T, Kusano K, Ogawa H, Yasuda S, Anzai T. Circulating Omega-6, But Not Omega-3 Polyunsaturated Fatty Acids, Are Associated with Clinical Outcomes in Patients with Acute Decompensated Heart Failure. PLoS One. 11, e0165841, 2016.
  35. Okata S, Yuasa S, Suzuki T, Ito S, Makita N, Yoshida T, Li M, Kurokawa J, Seki T, Egashira T, Aizawa Y, Kodaira M, Motoda C, Yozu G, Shimojima M, Hayashiji N, Hashimoto H, Kuroda Y, Tanaka A, Murata M, Aiba T, Shimizu W, Horie M, Kamiya K, Furukawa T, Fukuda K. Embryonic type Na+ channel beta-subunit, SCN3B masks the disease phenotype of Brugada syndrome. Scientific Reports. 6, 34198, 2016.
  36. Wada Y, Aiba T, Tsujita Y, Itoh H, Wada M, Nakajima I, Ishibashi K, Okamura H, Miyamoto K, Noda T, Sugano Y, Kanzaki H, Anzai T, Kusano K, Yasuda S, Horie M, Ogawa H. Practical applicability of landiolol, an ultra-short-acting β1-selective blocker, for rapid atrial and ventricular tachyarrhythmias with left ventricular dysfunction. Journal of Arrhythmia. 32, 82-88, 2016.
  37. Noguchi T, Yasuda S, Shibata T, Kawakami S, Tanaka T, Asaumi Y, Kanaya T, Nagai T, Nakao K, Fujino M, Nagatsuka K, Ishibashi-Ueda H, Nishimura K, Miyamoto Y, Kusano K, Anzai T, Goto Y, Ogawa H. Response to Letter Regarding Article, "Prevalence, Clinical Features, and Prognosis of Acute Myocardial Infarction Attributable to Coronary Artery Embolism". Circulation. 133, e379, 2016.
  38. Kijima Y, Akagi T, Takaya Y, Akagi S, Nakagawa K, Kusano K, Sano S, Ito H. Treat and Repair Strategy in Patients With Atrial Septal Defect and Significant Pulmonary Arterial Hypertension. Circulation Journal . 80, 227-234, 2016.
  39. Honda S, Nagai T, Sugano Y, Okada A, Asaumi Y, Aiba T, Noguchi T, Kusano K, Ogawa H, Yasuda S, Anzai T, NaDEF investigators. Prevalence, determinants, and prognostic significance of delirium in patients with acute heart failure. International Journal of Cardiology. 222, 521-527, 2016.
  40. Kawakami S, Takaki H, Hashimoto S, Kimura Y, Nakashima T, Aiba T, Kusano KF, Kamakura S, Yasuda S, Sugimachi M. Utility of High-Resolution Magnetocardiography to Predict Later Cardiac Events in Nonischemic Cardiomyopathy Patients With Normal QRS Duration. Circulation Journal . 81, 44-51, 2016.
  41. KamakuraT, SatoT, Wada M, Ishibashi K, Noda T, Kusano K. T-wave oversensing during drug challenge test after subcutaneous implantable cardioverter-defibrillator implantation in a patient with Brugada syndrome. Heart Rhythm Case Reports. 2, 391-394, 2016.
  42. Ishibashi K, Noda T, Nakajima I, Okamura H, Kanzaki H, Kusano K. Clinical impact of increasing left ventricular pacing output in cardiac resynchronization therapy - the new optimization strategy. Clinical Case Reports. 4, 629-632, 2016.
  43. Okamura H. Lead extraction using a laser system: Techniques, efficacy, and limitations. Journal of Arrhythmia. 32, 279-282, 2016.
  44. Okamura H, McLeod CJ, DeSimone CV, Webster TL, Bonnichsen CR, Grogan M, Phillips SD, Connolly HM, Ammash NM, Warnes CA, Friedman PA. Right Parasternal Lead Placement Increases Eligibility for Subcutaneous Implantable Cardioverter Defibrillator Therapy in Adults With Congenital Heart Disease. Circulation Journal . 80, 1328-1335, 2016.
  45. Ogawa Y, Aiba T, Kamei N, Tominaga K, Fujita H, Miyamoto Y, Tanaka T, Kido S. Coexistence of congenital long QT syndrome and autonomic dysregulation in children. Pediatrics International. 58, 672-674, 2016.
  46. Kondo T, Hisatome I, Yoshimura S, Mahati E, Notsu T, Li P, Iitsuka K, Kato M, Ogura K, Miake J, Aiba T, Shimizu W, Kurata Y, Sakata S, Nakasone N, Ninomiya H, Nakai A, Higaki K, Kawata Y, Shirayoshi Y, Yoshida A, Yamamoto K. Characterization of the novel mutant A78T-HERG from a long QT syndrome type 2 patient: Instability of the mutant protein and stabilization by heat shock factor 1. Journal of Arrhythmia. 32, 433-440, 2016.
  47. Kataoka N, Mizumaki K, Nakatani Y, Sakamoto T, Yamaguchi Y, Tsujino Y, Nishida K, Inoue H. Paced QRS fragmentation is associated with spontaneous ventricular fibrillation in patients with Brugada syndrome. Heart Rhythm. 13, 1497-1503, 2016.
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