プログラム一覧

*旧日本心電学会・旧日本不整脈学会の記念講演および招聘講演について
両学会には、上田英雄記念講演、木村榮一記念講演、廣澤弘七郎記念講演、山田和生招聘講演の4つの講演がありましたが、今後は2講演ずつ隔年で開催いたします。
来年(第64回大会)は、廣澤弘七郎記念講演、山田和生招聘講演を予定しています。

一般演題

Young Investigator Award(YIA)Competition

日時:
7/16(土)16:00-17:00
会場:
第7会場(2F 小ホール)
Chairpersons:
Minoru Horie(Shiga University of Medical Sciences, Otsu, Japan)
Kazuo Matsumoto(Higasimatsuyama Medical Association Hospital, Higashimatsuyama, Japan)
Selection
Committee Member:

Hiroshi Tada(Faculty of Medical Sciences, University of Fukui, Fukui, Japan)
Kyoko Soejima(Kyorin University Hospital, Tokyo, Japan)
Kengo Kusano(National Cerebral and Cardiovascular Center, Osaka, Japan)
Mitsuharu Kawamura(Showa University of Medicine, Tokyo, Japan)
Speakers:
Yosuke Kamikubo(Nagoya University Graduate School of Medicine, Nagoya, Japan)
Yukihiro Inamura(Saitama Red Cross Hospital, Saitama, Japan)
Shuntaro Tamura(Gunma University Hospital, Gunma, Japan)
Toyonobu Tsuda(Kanazawa University Graduate School of Medical Science, Kanazawa, Japan)
Tetsuya Handoh(Tohoku University Graduate School of Medicine, Sendai, Japan)

Hideo Ueda Memorial Lecture(上田英雄記念講演)

日時:
7/15(金)14:00-15:00
会場:
第1会場(1F 特別会議場)
Chairperson:
Ken Okumura(Saiseikai Kumamoto Hospital, Kumamoto, Japan)
Speaker:
Michael R. Gold(Medical University of South Carolina, Charleston, USA)

Eiichi Kimura Memorial Lecture(木村榮一記念講演)

日時:
7/16(土)10:30-11:30
会場:
第1会場(1F 特別会議室)
Chairperson:
Yoshito Iesaka(Tsuchiura Kyodo Hospital, Tsuchiura, Japan)
Speaker:
Michel Haïssaguerre(Liryc Institute - Bordeaux University Hospital - University of Bordeaux, Bordeaux, France)

特別講演

特別講演1

 
日時:
7/15(金)10:30-11:30
会場:
第1会場(1F 特別会議室)
半世紀に亘り、私は何を探求したか?半導体研究の世界で演じた創造のドラマ
What did I explore in half a century of research?: What discovery, What invention, Where, When?
座長:
青沼 和隆(筑波大学医学医療系 循環器内科)
演者:
江崎 玲於奈(横浜薬科大学 学長、元 筑波大学 学長、ノーベル物理学賞受賞)

特別講演2

 
日時:
7/17(日)13:30-14:30
会場:
第1会場(1F 特別会議室)
「逆境を跳ね除け限界に挑む:あるオリンピックゴールドメダリストの歩み」
座長:
青沼 和隆 (筑波大学医学医療系 循環器内科)
演者:
清水 宏保(長野オリンピック、スピードスケート ゴールドメダリスト)

会長講演―Congress Chairperson's Lecture―

The Wonderful Voyage through Catheter Ablation in Japan
日時:
7/15(金)15:00-16:00
会場:
第1会場(1F 特別会議室)
座長:
山口 巖(筑波大学/住吉クリニック病院)
演者:
青沼 和隆(第63回日本不整脈心電学会学術大会 会長)

シンポジウム

Symposium 1

Leadless Pacemaker 
リードレスペースメーカ
日時:
7/15(金)9:00-10:30
会場:
第1会場(1F 特別会議室)
Chairpersons:
Toshiyuki Ishikawa(Yokohama City University School of Medicine, Kanagawa, Japan)
Massimo Santini(San Filippo Neri Hospital, Rome, Italy)
KeynoteLecture:
Massimo Santini(San Filippo Neri Hospital, Rome, Italy)
Speakers:
Kyoko Soejima(Kyorin University Hospital, Tokyo, Japan)
Kenji Kuroki(University of Tsukuba, Tsukuba, Japan)
Petr Neuzil(Na Homolce Hospital, Prague, Czech Republic)

Symposium 2

New Era of 3D Electroanatomical Mapping for Complex Arrhythmias 
難治性不整脈に対する新世代の3次元マッピングシステム
日時:
7/15(金)14:00-16:00
会場:
第2会場(1F 大ホールA)
Chairpersons:
Hiroshi Nakagawa(Heart Rhythm Institute, Univerity of Oklahoma, Oklahoma City, USA)
Morio Shoda(Tokyo Women' s Medical University, Tokyo, Japan)
Speakers:
Tatsuhiko Arafune(School of Science and Engineering, Tokyo Denki University, Saitama, Japan)
Michel Haïssaguerre(Liyrc Institute - Bordeaux University Hospital ? University of Bordeaux, Bordeaux, France)
Hiroshi Nakagawa(Heart Rhythm Institute, Univerity of Oklahoma, Oklahoma City, USA)
Morio Shoda(Tokyo Women' s Medical University, Tokyo, Japan)
Kyoko Soejima(Kyorin University Hospital, Tokyo, Japan)

Symposium 3

Management of Atrial Fibrillation: Rhythm Versus Rate Control Therapy 
心房細動の管理:リズムコントロール vs. レートコントロール
日時:
7/15(金)16:00-17:30
会場:
第2会場(1F 大ホールA)
Chairpersons:
Takanori Ikeda(Toho University Faculty of Medicine, Tokyo, Japan)
Fiorenzo Gaita(University of Turin, Turin, Italy)
Keynote Lecture:
Fiorenzo Gaita(University of Turin, Turin, Italy)
Speakers:
Koonlawee Nademanee(Pacific Rim Electrophysiology Research Institute, Los Angeles, USA)
Akinori Sairaku(Hiroshima University, Hiroshima, Japan)
Yoshiyuki Hama(Kimitsu Chuo Hospital, Kisarazu, Japan)
Yoshimori An(National Hospital Organization Kyoto Medical Center, Kyoto, Japan)

シンポジウム4

着用型自動除細動器(WCD)の心臓突然死予防における役割 
Wearable Cardioverter Defibrillator: Role in Prevention of Sudden Cardiac Death
日時:
7/15(金)9:00-10:30
会場:
第3会場(1F 中ホールA)
座長:
清水 昭彦(山口大学大学院医学系研究科 保健学系学域)
新田 隆(日本医科大学 心臓血管外科)
演者:
佐々木 真吾(弘前大学大学院医学研究科 不整脈先進治療学講座)
近藤 祐介(千葉大学大学院医学研究院 中核研究部門 呼吸・循環治療学研究講座)
庭野 慎一(北里大学医学部 循環器内科)
岩崎 雄樹(日本医科大学付属病院 循環器内科)

Symposium 5

Identification of CRT Responder 
CRTレスポンダーの同定
日時:
7/15(金)14:00-15:30
会場:
第3会場(1F 中ホールA)
Chairpersons:
Takashi Kurita(Kinki University, Osaka, Japan)
Cecilia M Linde(Karolinska University Hospital, Stockholm, Sweden)
Keynote Lecture:
Cecilia M Linde(Karolinska University Hospital, Stockholm, Sweden)
Speakers:
Takashi Noda(National Cerebral and Cardiovascular Center, Suita, Japan)
Hirotoshi Ichibori(Kobe University Graduate School of Medicine, Kobe, Japan)
Itsuro Morishima(Ogaki Municipal Hospital, Ogaki, Japan)
Michael R Gold(Medical University of South Carolina, Charleston, USA)

Symposium 6

Mapping and Ablation of Idiopathic Left Ventricular Tachycardia 
左側特発性心室頻拍(ILVT)のマッピングとアブレーション
日時:
7/15(金)16:30-18:00
会場:
第3会場(1F 中ホールA)
Chairpersons:
Yoshinori Kobayashi(Tokai University Hachioji-hospital, Tokyo, Japan)
Hisashi Yokoshiki(Hokkaido University Hospital, Sapporo, Japan)
Keynote Lecture:
Samuel Jayaprakash Asirvatham(Mayo Clinic, Rochester, USA)
Speakers:
Akihiko Nogami(University of Tsukuba, Tsukuba, Japan)
Mitsuharu Kawamura(Showa University of Medicine, Tokyo, Japan)
Ahmed Talib(University of Tsukuba, Tsukuba, Japan)
Yuki Komatsu(University of Tsukuba, Tsukuba, Japan)

Symposium 7

Mechanisms Underlying Brugada Syndrome 
ブルガダ症候群のメカニズム
日時:
7/15(金)9:00-11:00
会場:
第6会場(1F 107・108室)
Chairpersons:
Wataru Shimizu(Graduate School of Medicine, Nippon Medical School, Tokyo, Japan)
Koonlawee Nademanee(Pacific Rim Electrophysiology Research Institute, Los Angeles, USA)
Speakers:
Koonlawee Nademanee(Pacific Rim Electrophysiology Research Institute, Los Angeles, USA)
Yasuya Inden(Nagoya University Graduate School of Medicine, Nagoya, Japan)
Hiroshi Morita(Okayama University Graduate School of Medicine, Okayama, Japan)
Seiko Ohno(Shiga University of Medical Science, Otsu, Japan)
Yukiko Nakano(Hiroshima University, Hiroshima, Japan)
Tsukasa Kamakura(National Cerebral and Cardiovascular Center, Suita, Japan)

Symposium 8

State of Arts in Arrhythmia Research: Simulation and Development/Regeneration 
不整脈研究のstate-of-art:シミュレーションと発生・再生
日時:
7/15(金)16:00-18:00
会場:
第6会場(1F 107・108)
Chairpersons:
Minoru Horie(Shiga University of Medical Sciences, Otsu, Japan)
Natalia Alexandrova Trayanova(Johns Hopkins University, Baltimore, USA)
Speakers:
Natalia Alexandrova Trayanova(Johns Hopkins University, Baltimore, USA)
Takashi Ashihara(Shiga University of Medical Sciences, Otsu, Japan)
Vincent M. Christoffels(Academic Medical Center, Amsterdam, the Netherlands)
Ichiro Hisatome(Tottori University Faculty of Medicine, Yonago, Japan)
Tetsushi Furukawa(Tokyo Medical and Dental University, Tokyo, Japan)

Symposium 9

Non-pharmacological Prevention of Left Atrial Appendage Thrombus 
非薬物的左心耳血栓予防法
日時:
7/15(金)14:00-15:30
会場:
第8会場(2F 204)
Chairpersons:
Yuji Nakazato(Juntendo University Urayasu Hospital, Tokyo, Japan)
Shephal Kirit Doshi(Pacific Heart Institute, Santa Monica, USA)
Speakers:
Shephal Kirit Doshi(Pacific Heart Institute, Santa Monica, USA)
Petr Neuzil(Na Homolce Hospital, Prague, Czech Republic)
Roland Richard Tilz(University Hospital Lübeck, Lübeck, Germany)
Toshiya Ohtsuka(Tokyo Metropolitan Tama Medical Center, Tokyo, Japan)
Andre Luiz Buchele d'Avila(Hospital Cardiologico, Florianopolis, Brazil)

Symposium 10(Debate)

ATP/adenosine-guided PVI improves the outcome. 
PVIにATPは有用か?
日時:
7/15(金)9:00-10:00
会場:
第7会場(2F 小ホール)
Chairpersons:
Seiji Takatsuki(Keio University, Tokyo, Japan)
Christopher Piorkowski(Heart Center Dresden University, Dresden, Germany)
Speakers:
Atsushi Kobori(Kobe City Medical Center General Hospital, Kobe, Japan)
Laurent Macle(Montreal Heart Insitute, Department of Medicine, Université de Montréal, Montreal, Canada)

Symposium 11

Reduction of Radiation Exposure 
透視軽減
日時:
7/15(金)16:30-18:00
会場:
第7会場(2F 小ホール)
Chairpersons:
Kyoko Soejima(Kyorin University Hospital, Tokyo, Japan)
Wee Siong Teo(National Heart Centre Singapore, Singapore)
Keynote Lecture:
Kyoko Soejima(Kyorin University Hospital, Tokyo, Japan)
Speakers:
Wee Siong Teo(National Heart Centre Singapore, Singapore)
Isabelle Nault(Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Canada)
Akiko Ueda(Kyorin University Hospital, Tokyo, Japan)
Yoshihisa Naruse(Leiden University Medical Center, Leiden, the Netherlands)
Kohei Yamashiro(Heart Rhythm Center, Takatsuki General Hospital, Takatsuki, Japan)
Eitaro Fujii(Mie University Graduate School of Medicine, Tsu, Japan)

Symposium 12

The Usefulness and the Limitation of Subcutaneous ICD 
皮下植込み型除細動器の有用性と限界
日時:
7/15(金)15:30-17:00
会場:
第8会場(2F 204)
Chairpersons:
Youichi Kobayashi(Showa University School of Medicine, Tokyo, Japan)
Michael R Gold(Medical University of South Carolina, Charleston, USA)
Keynote Lecture:
Michael R Gold(Medical University of South Carolina, Charleston, USA)
Speakers:
Massimo Santini(S. Filippo Neri Hospital, Rome, Italy)
Hideo Okamura(Mayo Clinic, Rochester, Minnesota, USA)
Shingo Maeda(Tokyo Medical and Dental University, Tokyo, Japan)
Motomi Tachibana(Okayama University, Okayama, Japan)
Yoshino Minoura(Showa University School of Medicine, Tokyo, Japan)

Symposium 13

New Mapping Technique for VT Ablation 
VTアブレーションにおける最新マッピング
日時:
7/16(土)8:30-10:30
会場:
第1会場(1F 特別会議場)
Chairpersons:
Yukio Sekiguchi(University of Tsukuba, Tsukuba, Japan)
Kalyanam Shivkumar(University of California Los Angeles, Los Angeles, USA)
Keynote Lecture:
Kalyanam Shivkumar(University of California Los Angeles, Los Angeles, USA)
Speakers:
Katja Zeppenfeld(Leiden University Medical Center, Leiden, the Netherlands)
Isabelle Nault(Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Canada)
Roderick Hschum Tung(The University of Chicago Medical Center, Chicago, USA)
Seigo Yamashita(The Jikei University School of Medicine, Tokyo, Japan)
Koji Miyamoto(National Cerebral and Cardiovascular Center, Suita, Japan)

Symposium 14

Ablation of Ventricular Fibrillation(except Brugada Syndrome) 
心室細動に対するアブレーション(ブルガダ症候群以外)
日時:
7/16(土)13:30-15:30
会場:
第1会場(1F 特別会議室)
Chairpersons:
Akihiko Nogami(University of Tsukuba, Tsukuba, Japan)
Michel Haïssaguerre(Liryc Institute - Bordeaux University Hospital - University of Bordeaux, Bordeaux, France)
Speakers:
Michel Haïssaguerre(Liryc Institute - Bordeaux University Hospital - University of Bordeaux, Bordeaux, France)
Isabelle Nault(Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec City, Canada)
Keita Masuda(University of Tsukuba, Tsukuba, Japan)
Hui-Nam Pak(Yonsei University Health System, Seoul, Korea)
Pasquale Santangeli(University of Pennsylvania, Philadelphia, USA)
Meiso Hayashi(Nippon Medical School, Tokyo, Japan)

Symposium 15

Controversy for Device Selection: CRT-P Versus CRT-D Versus ICD 
CRT-PかCRT-Dか、あるいはICDか
日時:
7/16(土)15:30-17:00
会場:
第1会場(1F 特別会議室)
Chairpersons:
Haruhiko Abe(University of Occupational and Environmental Health, Kitakyushu, Japan)
Shu Zhang(National Center for Cardiovascular Diseases & Beijng Fuwai Hospital, Beijing, China)
Speakers:
Chu-Pak Lau(The University of Hong Kong, Hong Kong)
Atsushi Suzuki(Tokyo Women' s Medical University, Tokyo, Japan)
Kenzaburo Nakajima(National Cardiovascular Center, Suita, Osaka)
Yasushi Oginosawa(University of Occupational and Environmental Health, Kitakyushu, Japan)
Yuji Iwanami(Tokyo Women' s Medical University, Tokyo, Japan)

Symposium 16

Arrhythmogenic Right Ventricular Cardiomyopathy 
不整脈原性右室心筋症
日時:
7/16(土)8:30-10:00
会場:
第2会場(1F 大ホールA)
Chairpersons:
Masahiko Goya(Tokyo Medical and Dental University, Tokyo, Japan)
Shih-Ann Chen(National Yang-Ming University, Taiwan)
Keynote Lecture:
Shih-Ann Chen(National Yang-Ming University, Taiwan)
Speakers:
Pasquale Santangeli(University of Pennsylvania, Philadelphia, USA)
Yuko Wada(Shiga University of Medical Science, Otsu, Japan)
Yoshitaka Kimura(National Cerebral and Cardiovascular Center, Suita, Japan)
Noriko Kikuchi(Tokyo Women' s Medical University, Tokyo, Japan)

Symposium 17

Latest Modalities of Image Integration for VT Ablation 
VTアブレーションのための最新画像診断法
日時:
7/16(土)10:00-11:30
会場:
第2会場(1F 大ホールA)
Chairpersons:
Kenzo Hirao(Tokyo Medical and Dental University, Tokyo, Japan)
Saman Nazarian(Johns Hopkins University School of Medicine, Baltimore, USA)
Keynote Lecture:
Saman Nazarian(Johns Hopkins University School of Medicine, Baltimore, USA)
Speakers:
Natalia Alexandrova Trayanova(Johns Hopkins University, Baltimore, USA)
Takeshi Sasaki(Tokyo Medical and Dental University, Tokyo, Japan)
Seigo Yamashita(Jikei University School of Medicine, Tokyo, Japan)
Roderick Hschum Tung(The University of Chicago Medical Center, Chicago, USA)

Symposium 18

Treatment of Arrhythmias with Modulation of Autonomic Nervous Function 
自律神経機能調節による不整脈治療
日時:
7/16(土)13:30-15:30
会場:
第3会場(1F 中ホールA)
Chairpersons:
Hiroshi Inoue(Saiseikai Toyama Hospital, Toyama, Japan)
Peng-Sheng Chen(The Krannert Institute of Cardiology, Indiana University, Indianapolis, USA)
Keynote lecture:
Peng-Sheng Chen(The Krannert Institute of Cardiology, Indiana University, Indianapolis, USA)
Speakers:
Sabine Irmgard Sigrid Ernst(Royal Brompton Hospital, London, UK)
Marmar Vaseghi(UCLA Cardiac Arrhythmia Center, Los Angeles, USA)
Kunihiro Nishida(University of Toyama, Toyama, Japan)
Kyoko Soejima(Kyorin University Hospital, Tokyo, Japan)

Symposium 19

Approaches to Catheter Ablation for Atrial Fibrillation: Triggers or Substrate Modification 
心房細動アブレーション:トリガーかサブストレートか
日時:
7/16(土)15:30-17:00
会場:
第3会場(1F 中ホールA)
Chairpersons:
Koichiro Kumagai(Heart Rhythm Center, Fukuoka Sanno Hospital, Fukuoka, Japan)
Atsushi Takahashi(Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan)
Speakers:
Koichi Inoue(Sakurabashi Watanabe Hospital, Osaka, Japan)
Toshiya Kurotobi(Shiroyama Hospital, Osaka, Japan)
Takanori Yamaguchi(Saga-ken Medical Centre Koseikan, Saga, Japan)
Hideko Toyama(Fukuoka Sanno Hospital, Fukuoka, Japan)
Koji Kumagai(Gunma Prefectural Cardiovascular Center, Maebashi, Japan)
Roland Richard Tilz(University Hospital Lübeck, Lübeck, Germany)
Takashi Ashihara(Shiga University of Medical Science, Otsu, Japan)

Symposium 20

International Research Symposium of Inherited Arrhythmias 
遺伝性不整脈国際研究シンポジウム
日時:
7/16(土)9:30-11:30
会場:
第6会場(1F 107・108)
Chairpersons:
Minoru Horie(Shiga University of Medical Sciences, Otsu, Japan)
Wataru Shimizu(Nippon Medical School, Tokyo, Japan)
Speakers:
Hideki Itoh(Shiga University of Medical Science, Otsu, Japan)
Christian Dina(Université de Nantes, Nantes, France)
Chairperson:
Hiroshi Watanabe(Niigata University, Niigata, Japan)
Speaker:
Toshihiro Tanaka(Tokyo Medical and Dental University, Tokyo, Japan)
Chairpersons:
Naomasa Makita(Nagasaki University, Nagasaki, Japan)
Jean-Jacques Schott(Université de Nantes, Nantes, France)
Speaker:
Vincent M. Christoffels(Academic Medical Center, Amsterdam, the Netherlands)

Symposium 21

Treatment of Atrial Fibrillation and Genetic Background 
遺伝子から考える心房細動治療
日時:
7/16(土)15:30-17:00
会場:
第6会場(1F 107・108室)
Chairpersons:
Haruaki Nakaya(Chiba University, Chiba, Japan)
Yuji Murakawa(Teikyo University School of Medicine, Tokyo, Japan)
Speakers:
Vincent Christoffels(Academic Medical Center, Amsterdam, the Netherlands)
James Martin(Baylor College of Medicine, Houston, USA)
Liu Lian(Tokyo Medical and Dental University, Tokyo, Japan)
Masahide Harada(Fujita Health University, Toyoake, Japan)
Kanae Hasegawa(University of Fukui, Fukui, Japan)
Yoshihide Takahashi(National Hospital Organization Disaster Medical Center, Tokyo, Japan)

Symposium 22

Diagnosis and Treatment of Cardiac Sarcoidosis Up To Date 
心臓サルコイドーシス:診断・治療に関する現状と課題
日時:
7/16(土)9:30-11:30
会場:
第7会場(2F 小ホール)
Chairpersons:
Kengo Kusano(National Cerebral and Cardiovascular Center, Suita, Japan)
William Henry Sauer(University of Colorado, Denver, USA)
Keynote lecture:
William Henry Sauer(University of Colorado, Denver, USA)
Speakers:
Nobuhiro Tahara(Kurume University, Kurume, Japan)
Kensuke Hirasawa(Tokyo Medical and Dental University, Tokyo, Japan)
Toshiyuki Nagai(National Cerebral and Cardiovascular Center, Suita, Japan)
Kazuhiro Satomi(Tokyo Medical University, Tokyo, Japan)

Symposium 23

Recent Progress and Future Prospects for Treating Cardiac Arrhythmias in Heart Failure. 
心不全患者における不整脈治療の進歩と展望
日時:
7/16(土)14:30-16:00
会場:
第7会場(2F 小ホール)
Chairpersons:
Nobuhisa Hagiwara(Tokyo Women' s Medical University)
Fiorenzo Gaita(University of Turin, Turin, Italy)
Keynote lecture:
Fiorenzo Gaita(University of Turin, Turin, Italy)
Speakers:
Tetsushi Furukawa(Tokyo Medical and Dental University, Tokyo, Japan)
Shih-Ann Chen(National Yang-Ming University, Taiwan)
Tsuyoshi Shiga(Tokyo Women' s Medical University, Tokyo, Japan)
John L. Sapp(Queen Elizabeth II Health Sciences Centre, Halifax, Canada)
Masahiro Maruyama(National Cerebral and Cardiovascular Center, Suita, Japan)

シンポジウム24

デバイス感染の治療の現状と問題点 
The Treatment of Device Infection : The Current Status and Problems
日時:
7/16(土)13:30-15:00
会場:
第8会場(2F 204室)
座長:
末田 泰二郎(広島大学大学院医歯薬学総合研究科 病態制御医科学講座外科学)
光野 正孝(兵庫医科大学 心臓血管外科)
演者:
近藤 祐介(千葉大学大学院医学研究院 中核研究部門 呼吸・循環治療学研究講座)
逸見 隆太(東京女子医科大学 循環器内科)
福永 真人(小倉記念病院 循環器内科)
和田 暢(国立循環器病研究センター 心臓血管内科)
合屋 雅彦(東京医科歯科大学 不整脈センター)
今井 克彦(広島大学病院 心臓血管外科)

Symposium 25

State of the art: Antiarrhythmic Management of Atrial Fibrillation 
抗不整脈薬の新展開
日時:
7/17(日)08:30-10:00
会場:
第1会場(1F 特別会議場)
Chairpersons:
Hirotsugu Atarashi(Tsurumaki Onsen Hospital, Kanagawa, Japan)
Alan John Camm(St. George' s University of London, London, UK)
Keynote Lecture:
Alan John Camm(St. George' s University of London, London, UK)
Speakers:
Mitsunori Maruyama(Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan)
Takashi Tokano(Juntendo University Urayasu Hospital, Urayasu, Japan)
Akinori Sairaku(Hiroshima University, Hiroshima, Japan)
Tsuyoshi Shiga(Tokyo Women' s Medical University, Tokyo, Japan)

シンポジウム26

心房細動患者における周術期の抗凝固療法 
Periprocedural Management of Atrial Fibrillation Patients Taking Oral Anti-coagulant
日時:
7/17(日)10:00-11:30
会場:
第1会場(1F 特別会議場)
座長:
井上 耕一(桜橋渡辺病院 心臓血管センター)
内藤 滋人(群馬県立心臓血管センター 循環器内科)
Keynote Lecture:
井上 耕一(桜橋渡辺病院 心臓血管センター)
演者:
平尾 見三(東京医科歯科大学 不整脈センター)
宮本 康二(国立循環器病研究センター 心臓血管内科)
中村 紘規(群馬県立心臓血管センター 循環器内科)
徳田 道史(東京慈恵会医科大学附属病院 循環器内科)
桑原 大志(横須賀共済病院 循環器内科)

Symposium 27

Silent Atrial Fibrillation: Diagnosis, Therapy and Prognosis 
無症候性心房細動の診断・治療と予後
日時:
7/17(日)10:00-11:30
会場:
第2会場(1F 大ホールA)
Chairpersons:
Teiichi Yamane(The Jikei University School of Medicine, Tokyo, Japan)
Chu-Pak Lau(The University of Hong Kong, Hong Kong)
Keynote Lecture:
Chu-Pak Lau(The University of Hong Kong, Hong Kong)
Speakers:
Toshiko Nakai(Nihon University School of Medicine, Tokyo, Japan)
Masahiro Esato(Ijinkai Takeda General Hospital, Kyoto, Japan)
Alan John Camm(St. George' s University of London, London, UK)
Yoshiyuki Hama(Kimitsu Chuo Hospital, Kisarazu, Japan)
Yasuyuki Iguchi(The Jikei University School of Medicine)

Symposium 28

New Developments of Catheter Ablation for Outflow Tract Ventricular Tachycardia 
流出路起源心室頻拍に対するカテーテルアブレーションの新たな展開
日時:
7/17(日)8:30-10:00
会場:
第3会場(1F 中ホールA)
Chairpersons:
Mitsuhiro Nishizaki(Yokohama Minami Kyosai Hospital, Yokohama, Japan)
Takumi Yamada(University of Alabama at Birmingham, Birmingham, USA)
Speakers:
Suguru Nishiuchi(Graduate School of Medicine and Faculty of Medicine Kyoto University, Kyoto, Japan)
Takumi Yamada(University of Alabama at Birmingham, Birmingham, USA)
Pasquale Santangeli(University of Pennsylvania, Philadelphia, USA)
Yasuhiro Shirai(Tokyo Medical and Dental University, Tokyo, Japan)

Symposium 29

Septal Ventricuar Tachycardias: Diagnosis and Recent Evolution of Mapping and Ablation 
心室中隔頻拍: マッピング、アブレーションの近年の進歩
日時:
7/17(日)10:00-11:30
会場:
第3会場(1F 中ホールA)
Chairpersons:
Hiroshi Tada(University of Fukui, Fukui, Japan)
John L. Sapp(Queen Elizabeth II Health Sciences Centre, Halifax, Canada)
Speakers:
Katja Zeppenfeld(Leiden University Medical Center, the Netherlands)
Andre Luiz Buchele d'Avila(Hospital Cardiologico, Florianopolis, Brazil)
Miyako Igarashi(Tsuchiura Kyodo General Hospital, Tsuchiura, Japan)
John L. Sapp(Queen Elizabeth II Health Sciences Centre, Halifax, Canada)

Symposium 30

Current Management of Tachyarrhythmia by Catheter Ablation in Congenital Heart Disease 
先天性心疾患に対する最新のカテーテルアブレーション治療
日時:
7/17(日)13:30-15:00
会場:
第3会場(1F 中ホールA)
Chairpersons:
Naokata Sumitomo(Saitama Medical University International Medical Center, Saitama, Japan)
George F. Van Hare(Washington University School of Medicine, Saint Louis, USA)
Keynote Lecture:
George F. Van Hare(Washington University School of Medicine, Saint Louis, USA)
Speakers:
Yoshihito Hata(Showa University Northern Yokohama Hospital, Yokohama, Japan)
Keiko Toyohara(Tokyo Women' s Medical University, Tokyo, Japan) Katja Zeppenfeld(Leiden University Medical Center, Leiden, the Netherlands)

シンポジウム31

心房細動と自律神経機能 
Atrial Fibrillation and Autonomic Nerve Function
日時:
7/17(日)8:30-10:00
会場:
第6会場(1F 107・108)
座長:
小野 克重(大分大学医学部 病態生理学講座)
渡邊 英一(藤田保健衛生大学医学部 循環器内科)
演者:
Peng-Sheng Chen(The Krannert Institute of Cardiology, Indiana University, USA)
尾野 恭一(秋田大学大学院医学系研究科 細胞生理学講座)
原田 将英(藤田保健衛生大学 循環器内科)
芦原 貴司(滋賀医科大学 循環器内科・不整脈センター)
山城 荒平(高槻病院不整脈センター)

Symposium 32

Catheter Ablation for Brugada Syndrome: Should We Target the Trigger or the Substrate of Ventricular Fibrillation? 
ブルガダ症候群に対するアブレーション:トリガーかサブストレートか
日時:
7/17(日)9:30-11:00
会場:
第7会場(2F 小ホール)
Chairpersons:
Yasuya Inden(Nagoya University Graduate School of Medicine, Nagoya, Japan)
Masahiko Takagi(Osaka City University Graduate School of Medicine, Osaka, Japan)
Keynote Lecture:
Yasuya Inden(Nagoya University Graduate School of Medicine, Nagoya, Japan)
Speakers:
Atsuyuki Watanabe(University of Okayama, Okayama, Japan)
Ahmed Talib(University of Tsukuba, Tsukuba, Japan)
Koonlawee Nademanee(Pacific Rim Electrophysiology Research Institute, Los Angeles, USA)
Hiroshi Nakagawa(University of Oklahoma Health Sciences Center, Oklahoma City, USA)

メディカルプロフェッショナルシンポジウム

メディカルプロフェッショナルシンポジウム1

遠隔モニタリング 
Remote Monitoring
日時:
7/15(金)9:00-10:30
会場:
第4会場(1F 中ホールB)
座長:
平井 真理(椙山女学園大学看護学部)
前田 明子(杏林大学医学部付属病院 循環器内科不整脈センター)
演者:
米村 友秀(済生会熊本病院 臨床工学部)
山内 亜由美(仁愛会浦添総合病院ME科)
竹中 祐樹(岡山大学病院 臨床工学部)
有道 真久(社会医療法人社団十全会心臓病センター榊原病院 診療支援部臨床工学科)
磯村 健二(大阪大学医学部附属病院MEサービス部)

メディカルプロフェッショナルシンポジウム2

クライオ・ホットバルーン治療におけるCEの役割 
Clinical Engineer’s Role in the Management of Cryoablation and Hot Balloon Ablation
日時:
7/15(金)14:00-15:30
会場:
第4会場(1F 中ホールB)
座長:
熊谷 浩司(群馬県立心臓血管センター 循環器内科)
縮 恭一(筑波大学附属病院 医療機器管理センター)
演者:
藤巻 愛子(東京医科歯科大学医学部附属病院MEセンター)
鈴木 彩佳(札幌心臓血管クリニック 臨床工学部)
渡邉 哲広(獨協医科大学越谷病院 臨床工学部)
臼井 幹(倉敷中央病院 臨床工学部)
縮 恭一(筑波大学附属病院 医療機器管理センター)

メディカルプロフェッショナルシンポジウム3

マッピングおよびアブレーション装置の使用におけるCEの役割 
Roles of Clinical Engineer in Mapping and Ablation Equipment
日時:
7/15(金)15:30-17:00
会場:
第4会場(1F 中ホールB)
座長:
鵜野 起久也(医療法人札幌ハートセンター)
徳留 大剛(横浜労災病院 臨床工学部)
演者:
縮 恭一(筑波大学附属病院 医療機器管理センター)
武藤 崇史(社会医療法人杏嶺会 一宮西病院 医療機器管理室)
安田 健治(天理よろづ相談所病院臨床検査部)
岡田 拓也(札幌ハートセンター札幌心臓血管クリニック臨床工学部)
徳留 大剛(横浜労災病院 臨床工学部)

メディカルプロフェッショナルシンポジウム4

心臓プログラム刺激におけるCEの役割 
Role of Clinical Engineer in Cardiac Programmed Stimulation
日時:
7/16(土)8:30-10:00
会場:
第4会場(1F 中ホールB)
座長:
吉田 幸彦(名古屋第二赤十字病院循環器センター 内科)
内田 文也(三重ハートセンター 診療支援部)
演者:
柴田 正慶(社会医療法人北海道循環器病院診療技術部臨床検査科)
中島 基裕(公立陶生病院 臨床工学部)
坂元 雄介(筑波大学附属病院 医療機器管理センター)

メディカルプロフェッショナルシンポジウム5

不整脈治療の退院後のチームマネージメント 
The team management for patients with cardiac arrhythmia after hospital discharge
日時:
7/16(土)13:30-15:00
会場:
第4会場(1F 中ホールB)
座長:
松井 由美恵(大阪府済生会 泉尾病院 循環器内科)
堺 美郎(済生会熊本病院 臨床工学部門)
演者:
小澤 あい(医療法人社団 永澤滋夫記念会 永沢クリニック)
菅 令子(鳥取県立中央病院 看護局)
安島 良輝子(筑波大学附属病院 看護部)
有道 真久(社会医療法人社団十全会心臓病センター榊原病院 診療支援部臨床工学科)
長町 千里(公益財団法人日本心臓血圧研究振興会 榊原記念クリニック)

メディカルプロフェッショナルシンポジウム6

不整脈のデバイス治療におけるメディカルパートナーの役割 
Role of medical partners in device therapies for patients with various arrhythmias
日時:
7/17(日)13:30-15:00
会場:
第4会場(1F 中ホールB)
座長:
樗木 晶子(九州大学医学部 保健学科)
三浦 英恵(東京医科歯科大学大学院保健衛生学研究科共同災害看護学専攻)
演者:
前川 正樹(おもと会大浜第一病院 診療技術部 臨床工学科)
宮園 真美(福岡県立大学 看護学部/看護学研究科)
幸田 愛子(国立循環器病研究センター 臨床検査部)
小野 仁(千葉大学医学部附属病院ME機器管理センター)

メディカルプロフェッショナルシンポジウム7

カテーテルアブレーション手技における看護師の役割 
Role of Nurse in Interventional EP Lab
日時:
7/17(日)15:00-16:30
会場:
第4会場(1F 中ホールB)
座長:
新田 順一(さいたま赤十字病院 循環器科)
梅津 努(筑波大学附属病院 看護部)
演者:
渡辺 朋美(新東京病院 看護部)
野中 寛子(宮崎市郡医師会病院 看護科)
吉田 真悠(天理よろづ相談所病院 看護部)
森澤 秀幸(東海大学医学部付属八王子病院 看護部)

学術委員会指定トピックス

不整脈治療温故知新
日時:
7/15(金)9:00-10:30
会場:
第2会場(1F 大ホールA)
座長:
奥村 謙(済生会熊本病院 心臓血管センター)
小野 克重(大分大学医学部 病態生理学講座)
演者:
池田 隆徳(東邦大学医学部内科学講座 循環器内科学分野)
鎌倉 史郎(真星病院 循環器内科)
中里 祐二(順天堂大学医学部附属浦安病院 循環器内科)

心電学フロンティア2016

日時:
7/16(土)13:30-15:30
会場:
第6会場(1F 107・108)
座長:
小野 克重(大分大学医学部 病態生理学講座)
丸山 徹(九州大学基幹教育院 健康支援センター)
演者:
丸山 徹(九州大学基幹教育院 健康支援センター)
小野 克重(大分大学医学部 病態生理学講座)
佐藤 伸之(旭川医科大学 内科学講座 循環呼吸神経病態内科学分野)
箕浦 慶乃(昭和大学医学部 内科学講座 循環器内科学部門)
金古 善明(群馬大学医学部附属病院 循環器内科)
北村 健(東京都立広尾病院 循環器科)

ジョイントシンポジウム

JHRS-APHRS Joint Symposium

Cure of Chronic Atrial Fibrillation: Challenges by New Ablation Strategies 
慢性心房細動を根治する:新たなアブレーション戦略による挑戦
日時:
7/15(金)16:00-18:00
会場:
第1会場(1F 特別会議場)
Chairpersons:
Yoshito Iesaka(Tsuchiura Kyodo Hospital, Tsuchiura, Japan)
Young-Hoon Kim(Kore6a University Medical Center, Seoul, Korea)
KeynoteLecture:
Young-Hoon Kim(Korea University Medical Center, Seoul, Korea)
State-of-the-Art Lecture:
Yoshito Iesaka(Tsuchiura Kyodo Hospital, Tsuchiura, Japan)
Speakers:
Minglong Chen(Nanjing Medical University Hospital, Nanjing, China)
Hiro Yamazaki(University of Tsukuba, Tsukuba, Japan)
Christopher Piorkowski(Heart Center Dresden University, Dresden, Germany)

日本不整脈心電学会・日本心不全学会ジョイントシンポジウム

心不全合併不整脈に対する治療戦略 
Therapeutic Strategies for Arrhythmias Complicating Heart Failure
日時:
7/17(日)13:30-15:30
会場:
第8会場(2F 204)
座長:
三田村 秀雄(国家公務員共済組合連合会立川病院 循環器センター)
筒井 裕之(北海道大学大学院医学研究科 循環病態内科)
I. Atrial Fibrillation
演者:
絹川 弘一郎(富山大学大学院医学薬学研究部内科学第二(第二内科))
夛田 浩(福井大学医学部病態制御医学講座 循環器内科学)
II. Life-Threatening Ventricular Arrhythmias
演者:
百村 伸一(自治医科大学附属さいたま医療センター 循環器科)
栗田 隆志(近畿大学医学部附属病院 心臓血管センター)
III. Mechanical Remodeling and Dyssynchrony
演者:
野上 昭彦(筑波大学医学医療系 循環器不整脈)
伊藤 浩(岡山大学 循環器内科)

JHRS-CDR ジョイントシンポジウム 

日時:
7/16(土)9:00-10:30
会場:
第8会場(2F 204)
座長:
石川 利之(横浜市立大学医学部 循環器腎臓内科)
栗田 隆志(近畿大学医学部附属病院 心臓血管センター)

JHRS-HRS Joint Symposium

Neural Control of the Heart-Implications for Clinical Electrophysiology 
自律神経活動と催不整脈作用
日時:
7/17(日)14:30-16:30
会場:
第1会場(1F 特別会議場)
Chairpersons:
Hiroshi Nakagawa(University of Oklahoma Health Sciences Center, Oklahoma City, USA)
Peng-Sheng Chen(The Krannert Institute of Cardiology, Indiana University, Indianapolis, USA)
Speakers:
Kalyanam Shivkumar(University of California Los Angeles, Los Angeles, USA)
Peng-Sheng Chen(The Krannert Institute of Cardiology, Indiana University, USA)
Yuichiro Sakamoto(Toyohashi Heart Center, Toyohashi, Japan)
Akihiko Nogami(University of Tsukuba, Tsukuba, Japan)

JHRS-EHRA Joint Symposium

New Frontier of Balloon Based Technology for Ablation of Atrial Fibrillation 
心房細動アブレーションにおけるバルーンベースアブレーション最新事情
日時:
7/17(日)8:30-10:00
会場:
第2会場(1F 大ホールA)
Chairpersons:
Kaoru Okishige(Yokohama City Minato Red Cross Hospital, Yokohama, Japan)
Andreas Metzner(Asklepios Klinik St Georg, Hamburg, Germany)
Speakers:
Andreas Metzner(Asklepios Klinik St Georg, Hamburg, Germany)
Saman Nazarian(Johns Hopkins University School of Medicine, Baltimore, USA)
Kazuo Matsumoto(Higasimatsuyama Medical Association Hospital Higasimatsuyama, Japan)
Hiroshi Sohara(Osaki Hospital Tokyo Heart Center, Tokyo, Japan)

日本不整脈心電学会・日本生体医工学会ジョイントシンポジウム

不整脈心電学研究における生体医工学研究の現状と展望 
Current Status and Future Perspective of Biomedical Engineering in Electrocardiology and Arrhythmia Studies
日時:
7/17(日)13:30-15:00
会場:
第6会場(1F 107・108)
座長:
佐久間 一郎(東京大学大学院工学系研究科附属医療福祉工学開発評価研究センター)
山崎 正俊(名古屋大学環境医学研究所 心・血管分野)
演者:
渡邊 英一(藤田保健衛生大学 循環器内科)
塚田 信吾(NTT物性科学基礎研究所 分子生体機能研究グループ)
芦原 貴司(滋賀医科大学 循環器内科・不整脈センター)
富井 直樹(東京大学大学院工学系研究科 バイオエンジニアリング専攻/日本学術振興会特別研究員)

Tawara-Aschoff Symposium

AV node Update

房室結節を巡る新知見
日時:
7/17(日)10:00-11:30
会場:
第6会場(1F 107・108)
Chairpersons:
Kan Takayanaghi(Kasukabe Kosei Hospital, Kasukabe, Japan)
Youichi Kobayashi(Showa University of Medicine, Tokyo, Japan)
Speakers:
Shin Inoue(Showa University of Medicine, Tokyo, Japan)
Roland Richard Tilz(University Hospital Lübeck, Lübeck, Germany)
Tetsuo Yagi(Sendai City Hospital, Sendai, Japan)
Yoshiaki Kaneko(Gunma University Graduate School of Medicine, Gunma, Japan)
Shephal Kirit Doshi(Pacific Heart Institue, Santa Monica, USA)

第5回不整脈薬物治療サミット

〜超高齢化社会に向けた不整脈治療を考える〜

日時:
7/16(土)14:30-17:00
会場:
第2会場(1F 大ホールA)
オープニングリマークス
青沼 和隆(筑波大学医学医療系 循環器内科)
第1部 高齢者・超高齢者における心房細動トータルケア 
座長:
井上 博(済生会富山病院)
髙橋 尚彦(大分大学医学部 循環器内科・臨床検査診断学講座)
演者:
池田 学(大阪大学大学院医学系研究科 精神医学教室)
長田 乾(横浜総合病院 臨床研究センター)
奥村 謙(済生会熊本病院 心臓血管センター)
第2部 不整脈薬物治療最前線-薬物治療はカテーテル治療を超えられるか- 
座長:
三田村 秀雄(国家公務員共済組合連合会立川病院 循環器センター)
清水 渉(日本医科大学大学院医学研究科 循環器内科学分野)
演者:
田中 敏博(東京医科歯科大学 疾患バイオリソースセンター)
小野 克重(大分大学医学部 病態生理学)
池田 隆徳(東邦大学医学部内科学講座 循環器内科学分野)
クロージングリマークス
新 博次(日本医科大学/鶴巻温泉病院)
共催:
第一三共株式会社

第5回アブレーション・デバイスサミット

日時:
7/17(日)14:00-16:30
会場:
第2会場(1F 大ホールA)
第1部 心房細動アブレーション
座長:
松本 万夫(埼玉医科大学国際医療センター/東松山医師会病院)
熊谷 浩一郎(福岡山王病院ハートリズムセンター)
演者:
加藤 律史(埼玉医科大学国際医療センター 不整脈科)
土谷 健(Team Tsuchiya)
第2部 デバイス
座長:
夛田 浩(福井大学医学部病態制御医学講座 循環器内科学)
中井 俊子(日本大学医学部内科学系 循環器内科学分野)
演者:
瀬尾 由広(筑波大学医学医療系 循環器内科)
森島 容子(大垣市民病院 形成外科)

Unknown EP Tracing : Learn from the Experts

日時:
7/16(土)8:30-10:00
会場:
第3会場(1F 中ホールA)
Chairperson:
Samuel J. Asirvatham(Mayo Clinic, Rochester, USA)
Speakers:
Samuel J. Asirvatham(Mayo Clinic, Rochester, USA)
Hui-Nam Pak(Yonsei University Health System, Seoul, Korea)
Akihiko Nogami(University of Tsukuba, Tsukuba, Japan)
共催:
日本メドトロニック株式会社

Emerging Leaders

日時:
7/17(日)15:00-16:30
会場:
第3会場(1F 中ホールA)
Chairpersons:
David O’Donnell(Austin Hospital, Melbourne, Australia)
Takashi Kurita(Kinki University, Osaka, Japan)
Speakers:
Min-Tsun Liao(National Taiwan University Hospital, Taipei City, Taiwan)
Yue Yan Katherine FAN(Grantham Hospital, Hong Kong)
Yuko Inoue(National Cerebral and Cardiovascular Center Japan, Suita, Japan)
Nobuhiro Nishii(Okayama University, Okayama, Japan)
共催:
日本メドトロニック株式会社

術中鎮静に関する講演会(不整脈専門医更新必須単位2単位)

不整脈手技中の鎮静
Sedation during catheter ablation and device-based therapy of cardiac arrhythmia
日時:
7/17(日)13:30-15:00
会場:
第7会場(2F 小ホール)
座長:
宮内 靖史(日本医科大学千葉北総病院 循環器内科)
池主 雅臣(新潟大学医学部保健学科)
演者:
稲垣 喜三(鳥取大学医学部器官制御外科学講座 麻酔・集中治療医学分野)
国沢 卓之(旭川医科大学 麻酔・蘇生学講座)
山口 尊則(佐賀県医療センター好生館 循環器内科)
庄田 守男(東京女子医大学 循環器内科)

保険委員会セッション

日時:
7/17(日)8:30-10:00
会場:
第8会場(2F 204)
座長:
山根 禎一 (東京慈恵会医科大学 循環器内科)
今井 克彦 (広島大学病院 心臓血管外科)
演者:
石田 祐司(弘前大学大学院医学研究科 循環器腎臓内科)
高木 雅彦(大阪市立大学大学院医学研究科 循環器内科学)
横式 尚司(北海道大学病院 循環器内科)
今井 克彦(広島大学病院 心臓血管外科)
芳本 潤(静岡県立こども病院 循環器科)

教育講演

教育講演1 ※ICD/CRT 研修修了証発行対象の教育講演

デバイス治療の道路交通法の概要とその運用の改訂に向けて
日時:
7/15(金)10:30-11:30
会場:
第7会場(2F 小ホール)
座長:
河野 律子(産業医科大学医学部 不整脈先端治療学)
演者:
渡邉 重行(筑波大学附属病院 水戸地域医療教育センター・水戸協同病院循環器科) 渡邊 英一(藤田保健衛生大学医学部 循環器内科)

教育講演2 ※ICD/CRT 研修修了証発行対象の教育講演

ショック遅延に向けたプログラミング
日時:
7/15(金)14:00-15:00
会場:
第7会場(2F 小ホール)
座長:
櫻井 正之(社会医療法人社団 カレスサッポロ 北光記念病院)
演者:
岡村 英夫(国立循環器病研究センター 心臓血管内科)

教育講演3 ※ICD/CRT 研修修了証発行対象の教育講演

デバイス治療におけるアブレーションの意義
日時:
7/16(土)8:30-9:30
会場:
第7会場(2F 小ホール)
座長:
櫻田 春水(東京都保健医療公社大久保病院 循環器内科)
演者:
三橋 武司(自治医科大学附属さいたま医療センター 循環器科)

教育講演4 ※ICD/CRT 研修修了証発行対象の教育講演

EPプログラム刺激の方法
日時:
7/16(土)13:30-14:30
会場:
第7会場(2F 小ホール)
座長:
杉 薫(小田原循環器病院)
演者:
鈴木 文男(結核予防会 複十字病院)

Educational Lecture 5 ※ICD/CRT 研修修了証発行対象の教育講演

Anatomic Considerations in VT Ablation:Efficacy and Safety
アブレーションにおける解剖
日時:
7/17(土)8:30-9:30
会場:
第7会場(2F 小ホール)
Chairperson:
Hitoshi Hachiya(Tsuchiura Kyodo General Hospital, Tsuchiura, Japan)
Speaker:
Samuel Jayaprakash Asirvatham(Mayo Clinic, Rochester, USA)

教育セミナー(心臓構造学)

教育セミナー1
日時:
7/15(金)10:00-11:00
会場:
第5会場(1F 104・105)
演者:
井川 修(日本医科大学多摩永山病院 内科・循環器内科)
教育セミナー2
日時:
7/16(土)10:00-11:00
会場:
第5会場(1F 104・105)
演者:
井川 修(日本医科大学多摩永山病院 内科・循環器内科)

Mirowski Fellowship報告会

日時:
7/17(日)10:30-11:30
会場:
第11会場(2F 201・202)
座長:
奥村 謙(済生会熊本病院 心臓血管センター)
堀江 稔(滋賀医科大学 呼吸循環器内科)
演者:
David S. Cannom(Good Samaritan Hospital, Cedars-Sinai Heart Institute, UCLA, Los Angeles, USA)
荻ノ沢 泰司(産業医科大学 第二内科学)
森島 逸郎(大垣市民病院 循環器内科)
河村 光晴(昭和大学医学部内科学講座循環器内科学部門)

医科学応用研究財団助成による日本不整脈心電学会論文賞

日時:
7/17(日)14:30-15:00
会場:
第11会場(2F 201・202)
座長:
村川 裕二(帝京大学医学部付属溝口病院 第四内科)
演者:
Ahmed Talib(旭川医科大学 第一内科)
林 研至(金沢大学大学院医学系研究科 循環器内科学)

日本不整脈心電学会 学術奨励賞

日時:
7/15(金)14:00-15:00
会場:
第11会場(2F 201・202)
座長:
清水 渉(日本医科大学大学院医学研究科 循環器内科学分野)
選考委員:
池主 雅臣(新潟大学医学部 保健学科)
因田 恭也(名古屋大学医学部 循環器内科)
髙橋 尚彦(大分大学医学部 循環器内科・臨床検査診断学講座)
横式 尚司(北海道大学病院 循環器内科)
関口 幸夫(筑波大学医学医療系 循環器内科)
演者:
斎藤 幸弘(岡山大学 循環器内科)
近藤 秀和(大分大学医学部 循環器内科・臨床検査診断学講座)
高橋 健太(日本医科大学付属病院循環器内科)
安達 亨(筑波大学医学医療系 循環器内科)

日本不整脈心電学会誌「心電図」最優秀論文賞

日時:
7/17(日)15:00-15:30
会場:
第11会場(2F 201・202)
座長:
井上 博(済生会富山病院)
演者:
丸山 徹(九州大学基幹教育院 健康支援センター)

Journal of Arrhythmia(JOA)Best Article of the Year 2015

日時:
7/15(金)17:00-18:00
会場:
第11会場(2F 201・202)
座長:
高橋 尚彦(大分大学医学部 循環器内科・臨床検査診断学講座)
志賀 剛(東京女子医科大学 循環器内科)
選考委員長:
夛田 浩(福井大学医学部病態制御医学講座 循環器内科学)
選考委員:
光野 正孝(兵庫医科大学 心臓血管外科)
庭野 慎一(北里大学医学部 循環器内科)
丹野 郁(昭和大学江東豊洲病院 循環器内科)
山根 禎一(東京慈恵会医科大学 循環器内科)
演者:
谷口 宏史(土浦協同病院 循環器内科)
前田 真吾(東京医科歯科大学 循環器内科)
奥村 恭男(日本大学医学部 循環器内科)

教育講座

教育講座1

コメディカルに伝えたい!心電図の基本的な読み方
日時:
7/15(金)18:10-21:10
会場:
第2会場(1F 大ホールA)
座長:
井上 博(済生会富山病院)
池田 隆徳(東邦大学医学部内科学講座循環器内科学分野)
演者:
髙橋 尚彦(大分大学医学部 循環器内科・臨床検査診断学講座)
前村 浩二(長崎大学大学院医歯薬学総合研究科循環器内科学)
安部 治彦(産業医科大学医学部不整脈先端治療学)
共催:
フクダ電子株式会社

教育講座2

漕ぎ出でよう!心電図という海原へ
日時:
7/16(土)18:00-21:00
会場:
第2会場(1F 大ホールA)
座長:
里見 和浩(東京医科大学 循環器内科)
演者:
香坂 俊(慶應義塾大学医学部 循環器内科)
江島 浩一郎(東京女子医科大学 循環器内科)
共催:
日本光電工業株式会社

公開講座

薬剤師として知っておきたい抗不整脈薬・抗凝固薬の基礎知識

日時:
7/15(金)18:30-21:00
会場:
第4会場(1F 中ホールB)
開会の言葉
上野 和行(新潟薬科大学薬学部 薬物動態学教室)
座長:
新 博次(日本医科大学/鶴巻温泉病院)
上野 和行(新潟薬科大学薬学部 薬物動態学教室)
演者:
栗田 隆志(近畿大学医学部附属病院 心臓血管センター)
志賀 剛(東京女子医科大学 循環器内科)
矢坂 正弘(九州医療センター 脳血管神経内科)
まとめ
新 博次(日本医科大学/鶴巻温泉病院)
共催:
第一三共株式会社

市民公開講座

日時:
7/17(日)13:00-15:30
会場:
ホテルさっぽろ芸文館3階「瑞雪の間」

果てしなき挑戦―今を真に生きる

座長:
山口 巖(筑波大学名誉教授 住吉クリニック病院病院長)
最高齢エベレスト登頂―心房細動を乗り越えて不可能に挑む―
演者:
三浦 雄一郎(プロスキーヤー、登山家)
地球上で最も多い不整脈、心房細動―その根治に挑む―
演者:
家坂 義人 (総合病院 土浦協同病院)

J-IVFSセッション(Japan Idiopathic Ventricular Fibrillation Study)

日本における特発性心室細動の課題とその解決に向けて
―New Indices and Treatment For The Future―
日時:
7/16(土)10:00-11:30
会場:
第3会場(1F 中ホールA)
座長:
平岡 昌和(取手北相馬保健医療センター医師会病院)
西崎 光弘(横浜南共済病院 循環器内科)
演者:
高木 雅彦(大阪市立大学大学院医学研究科 循環器内科学)
横山 泰廣(聖路加国際病院 心血管センター)
関口 幸夫(筑波大学医学医療系 循環器内科学)
Koonlawee Nademanee(Pacific Rim Electrophysiology Research Institute, Los Angeles, USA)

Tokyo-Taipei-Seoul Conference

日時:
7/16(土)13:30-15:00
会場:
第9会場(2F 206)
Welcome speech:
Masayasu Hiraoka(Tokyo)
Opening address:
Shih-Ann Chen(Taipei)
Sesshion 1.Role of Imaging in Diagnosis and Risk Stratification of Life Threatening Ventricular Arrhythmias/Sudden Cardiac Death
座長:
Yoshinori Kobayashi(Tokai University Hachioji Hospital, Tokyo)
Dong Gu Shin(Yeongnam University Hospital, Daegu, Korea)
Tsu-Juey Wu(Taichung Veterans General Hospital, Taipei)
演者:
Tetsuji Shinohara(Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan)
Jaemin Shim(Department of Cardiology, Korea University Anam Hospital, Seoul, Korea)
Fa-Po Chung(Department of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan)
Sesshion 2.Management of cardiac Arrhythmias in Adult Congenital Heart Diseases
座長:
Chen-Chuan Cheng(Chi-Mei Medical Center, Taipei)
Kee-Joon Choi(Asan Medical Center, Seoul)
Morio Shoda(Tokyo Women's Medical University, Tokyo)
演者:
Yen-Jiang Lin(Department of Cardiology, Taipei Veterans General Hospital, Taipei)
Morio Shoda(Department of Cardiology, Tokyo Women's Medical University, Tokyo)
Jae-Sun Uhm(Department of Cardiology, Yonsei University, Seoul)
Closing Remarks:
Young-Hoon Kim(Korea University, Seoul)

CRTレスポンダーの同定

Identification of CRT responders

座長: 栗田 隆志
(近畿大学医学部附属病院心臓血管センター)

Chairperson:Takashi Kurita

(Kinki University)


 Cardiac resynchronization therapy (CRT) has been established as the essential strategy to improve the mortality and QOL of patients with an impaired left ventricular function and wide QRS. The frontiers of CRT have been expected to expand the indication of this therapy for patients with mild heart failure (NHHA class I or II) or a narrow QRS. Recent large clinical trials (MADIT-RIT and RAFT) showed the positive results of an early indication of CRT for mild heart failure patients, and suggested that the electrocardiographic indices (QRS width >150 ms and left bundle branch block) are appropriate parameters to detect responders of CRT. On the contrary, EchoCRT study provided the negative impact of the echocardiographic evaluation of dyssynchrony for predicting responders of CRT in patients with a narrow QRS.

 Even using various evaluation methods, a certain amount of non-responders after CRT can be seen, and the proper identification of responders before the therapy is still a big concern for effectively using this expensive device. On the other hand, new developments in device capabilities, such as the “Quadripolar LV lead”, “Adoptive CRT” and “Multisite Pacing”, can be alternative approaches to reduce non-responders to CRT.

In this symposium, we will discuss the appropriate methods for speculating who will be responders to CRT, including the possibility echocardiograms provide, the role of advanced technologies in reducing non-responders, the next possible strategies when we encounter non-responders to CRT after the operation, and what is the highest percentage of responders we can expect to reach.

先天性心疾患に対する最新のカテーテルアブレーション治療

Current Management of Tachyarrhythmia by Catheter Ablation in Congenital Heart Disease

座長: 住友 直方
(埼玉医科大学国際医療センター小児心臓科)

Chairperson:Naokata Sumitomo

(Saitama Medical University International Medical Center)


Recent advances in catheter ablation techniques have enable various types of atrial and ventricular arrhythmias to be cured for structural heart disease even in post operative congenital heart disease. The improvement of success rate of catheter ablation is largely depends upon the development of newer technologies of 3D mapping system, such as CARTO system. The 3D mapping system can visualize the isthmus of the arrhythmia circuit, with a detailed information of the anatomical structure and the prior surgical procedures of the underlining congenital heart disease. The arrhythmia circuit is mostly around anatomic obstacle, surgical incisions, and surgical patch or baffle of the previous surgery. To know the 3D information is one of the key points to success the catheter ablation of the tachyarrhythmia in congenital heart disease. However, catheter could not reach the optimal target point, because of the prior surgery, such as Fontan operation.
This symposium is aimed to introduce the current advanced management of tachyarrhythmia by catheter ablation in congenital heart disease.
KEYNOTE LECTURE     George F. Van Hare St Louis Children's Hospital, Washington University School of Medicine in St. Louis, St Louis Children's Hospital


演題名:Arrhythmias following repair of congenital heart disease

演者     Katja Zeppennfeld       Leiden University Medical Center 


演題名:Anatomical substrate and ablation of VT in Congenital heart disease

演者     Sabine Ernst    Royal Brompton Hospital       


演題名:Advanced ablation strategies for arrhythmia management in complex adult congenital heart disease

心房細動患者における周術期の抗凝固療法

Periprocedural Management of Atrial Fibrillation Patients Taking Oral Anti-coagulant

座長: 井上 耕一
(桜橋渡辺病院 心臓血管センター)

Chairperson:Koichi Inoue

(Sakurabashi Watanabe Hospi)


梗塞リスクを伴う非弁膜症性心房細動患者に対して、心原性脳梗塞・全身性塞栓症の予防のための抗凝固療法は必須である。経口抗凝固療薬がワルファリンしかなかった時代から、非ビタミンK依存型抗凝固薬(NOAC)が使える時代になり数年がたつ。ガイドラインでもワルファリンよりもNOACが望ましいと位置づけられ、リアルワールドにおけるNOACの使用経験も蓄積され、さらに、よりハイリスクでチャレンジングな状況でのNOAC使用に関する知見も徐々に深まってきている。本シンポジウムでは、「観血的処置の周術期」という「抗凝固療法のリスクとベネフィットのバランスをとるのが難しい状況における抗凝固療法はどうあるべきか」をテーマとした。ワルファリンとNOACのどちらが有用か、NOAC間で差異はあるのか、投与のプロトコルはどうするべきか、アブレーションの場合はどうか、ハイリスク患者やハイリスク手術ではどうするべきか、ヘパリンブリッジは有用か、などこのテーマで解決すべき課題は未だ多い。これらについて本邦の患者におけるデータをもとにして議論し,より有効かつ安全な抗凝固療法を見出す一助としたい。

New Era of 3D Electroanatomical Mapping for Complex Arrhythmias

Chairpersons: Hiroshi Nakagawa
  (University of Oklahoma Health Sciences Center, USA)
  Morio Shoda
  (Tokyo Women's Medical University)

Current 3D electroanatomical mapping systems accurately localize the site of earliest activation in focal tachycardias and are able to identify the reentrant circuit and localize arrhythmogenic channels in macroreentrant tachycardias. However, current systems have several limitations: 1) relatively low resolution; 2) difficulty in selecting the appropriate activation time in scarred areas with multiple low amplitude potentials; and 3) require relatively long mapping times. The requirement to manually annotate the activation time at sites with complex electrograms has limited the use of these systems in localizing arrhythmogenic channels in macroreentrant circuits in many laboratories. Non-contact mapping systems also have limitations within scarred regions, having difficulty reconstructing low amplitude potentials, and mapping accuracy is limited to sites close to the probe. This session will cover the recent progress of 3D mapping systems, including phase mapping, panoramic body surface mapping and automatic, high-resolution mapping in patients with complex atrial and ventricular arrhythmias.

心房細動と自律神経機能

Atrial Fibrillation and Autonomic Nerve Function

座長: 小野 克重 (大分大学医学部病態生理学講座)
  渡邊 英一 (藤田保健衛生大学医学部 循環器内科)

心臓は自律神経機能の活動によって興奮性が調節を受ける。心房筋及び心房筋近傍組織には交感神経と副交感神経(迷走神経)が密に分布しており、心房の容量負荷や伸展情報を延髄の心臓血管中枢に投影するだけでなく、圧受容体反射の遠心路などを介して様々な機能の調節を受ける。自律神経の活性化は心房細動をはじめとする頻脈性心房期外収縮の原因となり、自律神経活動の制御によって心房細動を停止させることも可能であるし、悪化させることもあり得る。心房細動の発症の背景には、炎症、加齢、遺伝子異常、内分泌異常等の様々な因子が複雑に関与しているが、本シンポジウムでは自律神経活動に的を絞り、関与のメカニズムを切り口を変えて解析する。ここでは心房筋の電気生理学的活動に対する自律神経の働きを、細胞レベルからアブレーションカテーテル治療法までの多角的なアプローチによって明らかにし、自律神経活動がどのようにして心房細動の発症と維持に関わり、更に抗不整脈手法としての自律神経活動の管理の重要性を実証することを目的とした。

不整脈研究のstate-of-art:シミュレーションと発生・再生

State of Arts in Arrhythmia Research: Simulation and Development/Regeneration

企画 古川 哲史
  (東京医科歯科大学難治疾患研究所生体情報薬理学)
Coordinator : Tetsushi Furukawa
  (Tokyo Medical and Dental University)
座長 堀江 稔
  (滋賀医科大学呼吸循環器内科)
Chairperson: Minoru Horie
  (Shiga University of Medical Sciences)

The mechanism of arrhythmias has been advanced through multiple methodologies: intra-cellular potential recording, patch-clamp technique, intra-cardiac potential recording in animal models, and recently molecular biology. We certainly have learned a lot on the mechanism of arrhythmia by a means of these approaches; however, it is also evident that elucidation with these conventional techniques carry their intrinsic limitation, and in order to further advance our understanding, the introduction of new approaches is mandatory. Among various candidates of new approaches in arrhythmia study, this symposium will focus on two innovative methodologies: computer simulation and cardiomyocyte development/regeneration.

The computer simulation has conventionally been used to generate a single cell action potential model. The state-of-art technology has advanced the computer simulation to the level of generating a 3D electrical propagating model associated with 3D imaging. This approach will have a potential to improve the catheter ablation technique in the clinical setting. Prof. N. Trayanova and Dr. T. Ashihara will take care of this initial part of session.

Mammalian heart is originated from the primary heart field and the secondary heart field. Arrhythmias not associated with cardiovascular diseases occur from the peripheral region of the heart, and the heart region derived from the secondary heart field, and their interaction appears to play an important role. Thus, the study of cardiac development would give us new ideas regarding the arrhythmogeneity. In this part of session, Prof. V. Christoffels, Prof. I Hisatome and Prof. T. Furukawa will present their most updated research data.

We hope this symposium will bring you brainstorming, and provide new ways of thinking on arrhythmia researches. We also hope that this symposium will enhance the translation of the findings obtained in basic researches to clinical practice, and stimulate collaborated work between basic and clinical arrhythmia researchers.

不整脈のデバイス治療におけるメディカルパートナーの役割

Role of medical partners in device therapies for patients with various arrhythmias

座長: 樗木 晶子
  (九州大学大学院医科学研究院循環器内科学)

心臓ペースメーカー治療(PM)、植込み型除細動器 (ICD)や除細動機能の付いた心臓再同期療法(CRT-D)は徐脈性不整脈、致死的不整脈患者のQOLの向上や生命予後を改善する治療法である。しかし、植込み手術による出血、感染、植込み直後のリード離脱、デバイスの誤作動などがおこることがあり、植え込み前後のケアと慎重な対応が必要である。ICDやCRT-Dの場合には致死的不整脈や重症心不全患者でもありデバイス治療に対する不安も強く、誤作動に伴うメンタルケアも重要な課題である。不整脈・基礎心疾患の治療に加えて、植込み前からの患者管理システムの確立、QOLや精神的側面を含めたサポートの為には医師だけでなく看護師、臨床心理士、臨床工学士などからなるメディカルプロフェッショナルによるチーム医療が不可欠であり、集学的介入システムをめざして本邦におけるエビデンスを蓄積する必要がある。本セッションでは職種を越えて、このようなテーマで議論することができれば幸甚である。

不整脈治療の退院後のチームマネージメント

The team management for patients with cardiac arrhythmia after hospital discharge

座長: 松井 由美恵
  (社会福祉法人 恩賜財団 大阪府済生会泉尾病院)

近年、不整脈に対する治療は薬剤のみならずペースメーカー、植込み型除細動器、CRTなどの植込み型心臓デバイス、カテーテル・アブレーションと多様化しています。
入院治療が終了し退院となっても、継続的なフォローアップが必要であり、ワンポイントの外来診察ではすべてが把握できないのが現状です。また不整脈や基礎疾患の病態や重症度、社会的背景によっては、患者さんやご家族に多くの疑問や不安が生じ、その都度対応が必要となります。一方、ペースメーカー、植込み型除細動器、CRTなどの植込み型心臓デバイスの遠隔モニタリングはデバイス患者さんの管理を行う上で有用であり、外来受診回数や待ち時間の軽減、受診前のデーター収集、イベントの早期発見・早期対応などが可能となります。しかしながら医師のみの管理には限界があり、看護師・臨床工学技士をはじめとする多職種のスタッフが個々の症例におけるケアとマネージメントに関して共通の認識を持った上でチーム医療を行っていくことが重要であると考えられます。今回、各施設におけるそのような新しい試みを発表していただき、議論することにより、より良いチーム医療の形を考えたいと思います。

JHRS-APHRS ジョイントシンポジウム

JHRS-APHRS Joint Symposium


慢性心房細動を根治する:新たなアブレーション戦略による挑戦

Cure of Chronic Atrial Fibrillation: Challenges by New Ablation Strategies

座長: 家坂 義人
  (総合病院土浦協同病院)
Chairperson: Yoshito Iesaka
  (Tsuchiura Kyodo Hospital)

The indication of catheter ablation has been widely extended to long-standing persistent atrial fibrillation (chronic AF, CAF). Bordeaux group published excellent results of catheter ablation for CAF in 2005. They performed stepwise ablation strategy for CAF with mean duration of 17 months, consisted of pulmonary vein isolation (PVI), defragmentation of complex fractionated atrial electrograms (dCFAE) in the both atria and linear ablation (Lab) at the mitral isthmus & LA roof. They hypothesized defragmentation at CFAE sites was performed to abolish multiple micro-reentrant sources (rotors) potentially maintaining CAF.

Stepwise ablation strategy has been widely accepted and routinely performed as standardized substrate modification strategy whole over the world, however, original high success could not be reproduced. The STAR AF II Study also demonstrated no contribution of dCFAE and Lab to eliminate AF recurrence. Recent meta-analysis also showed dCFAE could not reduce AF recurrence in CAF patients.

There are big controversies concerning driving mechanisms of persistent AF, multi-wavelets macro-reentry or rotor. Allessie, et al proposed multi-wavelets macro-reentry theory based on human epicardial mapping data during open chest surgery and endo-/epicardial mapping of chronic goat AF model. While, Jalife, et al proposed rotor theory only by optical mapping data in acetylcholine induced AF in isolated sheep heart. Recently, Allessie, et al proposed the role of epicardial breakthrough of endocardial AF wavelets on AF persistent mechanism and dual layered dissociated fibrillation wave as a main mechanism for long-lasting AF.

“Tackle AF/AT, whenever they are encountered”

JHRS-EHRA ジョイントシンポジウム

JHRS-EHRA Joint Symposium


心房細動アブレーションにおけるバルーンベースアブレーション最新事情

New Frontier of Balloon Based Technology for Ablation of Atrial Fibrillation

座長: 沖重 薫
  (横浜市立みなと赤十字病院循環器内科)
Chairperson: Kaoru Okishige
  (Yokohama City Minato Red Cross Hospital)

 Radiofrequency catheter ablation by the “point-by-point” fashion around the orifices of pulmonary veins (PV) has been performed for the electrical isolation of PV in terms of the cure of atrial fibrillation (AF) these twenty years. However, it takes a relatively long time and the reconnection incidence associated with the recurrence of AF has been issues to be resolved for the sake of improvement of treatment of AF. Recently, the balloon-based ablation catheter systems such as cryoballoon, radiofrequency energy balloon, and laser balloon have been developed and released as the treatment options for refractory AF. Shorter ablation procedure time, lower reconnection rate between the PV and the left atrium, lower adverse events rate such as cardiac tamponade are expected according to the previous reports. Every therapeutic novel technologies of balloon-based systems connote their own problems which will have to be settled, even though they are expected to surpass focal ablation catheter system in terms of safety and efficacy issues. In this symposium, we would like to appreciate each these new technologies by discussing advantageous and disadvantageous aspects of each technologies with authorities of each fields for us to understand better and make the best use of them for patients suffering from AF.

CRT-PかCRT-Dか、あるいはICDか

Controversy for Device Selection: CRT-P Versus CRT-D Versus ICD

座長: 安部 治彦
  (順天堂大学浦安病院循環器内科)
Chairperson: Haruhiko Abe
  (University of Occupational and Environmental Health)

In Japan, prevalence of sudden cardiac death patients, as well as heart failure patients, have been gradually increasing every year up to more than 70,000 persons/year, reported by Ministry of Health, Labour and Welfare (MHLW) in Japan. Several evidences have shown that mortality and morbidity in heart failure patients were improved with therapies of ICD and CRT devices. However, only less than 9,000 patients per year are received with these therapies, currently in Japan.
 The selection of devices for heart failure patients is the most important clinical issue for electrophysiologists, especially in proposed high risk patients for sudden cardiac death. Indeed, several guidelines have shown the indication for use of each device. However, several clinical issues for device selection are still remained in real world. For example, which devices should be selected in moderate heart failure patients (previously implanted RV paced patients with reduced ejection fraction 35-50%)? In patients with remained moderate lower ejection fraction after implanted CRT-P, how should we do, up-grade to CRT-D or not?
 In this symposium, Professor Chu-Pak Lau will be reviewed first concerning to current indications and topics for these devices with guidelines, and then discuss by all presenters and audience in this special and/or controversial topics in clinical studies and related issues for the device selection, CRT-P, ICD and CRT-D.

皮下植込み型除細動器の有用性と限界

The Usefulness and the Limitation of Subcutaneous ICD

座長: 小林 洋一
  (昭和大学医学部循環器内科学部門)
Chairperson: Youichi Kobayashi
  (Showa University School of Medicine)

Subcutaneous ICD (S-ICD) will be available in Japan soon. As there is no lead, epoch-making use can be considered, but on the other hand, there is also a limit. As advantages, the case under the situation where a lead cannot be put in as infection of lead and the case it is expected to be that ICD becomes unnecessary in the future are considered to be good indications. Furthermore, S-ICD may be useful for a child case who will have a lead failure when growing up. However, of course the case who needs pacing S-ICD is unsuitable and the case who do not have the suitable QRS sensing will not be implantable. In this symposium we would like to discuss the usefulness and limitation in order to promote suitability in developing S-ICD.

着用型自動除細動器(WCD)の心臓突然死予防における役割

Wearable Cardioverter Defibrillator: Role in Prevention of Sudden Cardiac Death

座長: 清水 昭彦
  (山口大学大学院医学系研究科保健学専攻)
Chairperson: Akihiko Shimizu
  (Yamaguchi Graduate School of Medicine)

It has been more than 2 years since wearable cardioverter defibrillator (WCD) became available in Japan. The indication of WCD are as follows. 1) Patients who have a high risk of sudden cardiac death (SCD) due to VF or VT, but the indication for ICD implantation has not been determined yet, because of potential change of the risk of SCD over the time. 2) Patients who are indicated for ICD implantation, but are not appropriate to be implanted at that time, such as in infection. The WCD may reduce the risk of SCD until the indication for ICD implantation is determined or the conditions of the patient are met.

Although the experience of WCD in Japanese population is limited, as compared to the data in the US, fewer patients with primary prevention of SCD have been treated with WCD, suggesting that many patients with acute myocardial infarction with low ejection fraction have been followed without a WCD. The indication and other issues in WCD therapy will be discussed in this symposium.

不整脈原性右室心筋症

Arrhythmogenic Right Ventricular Cardiomyopathy

座長: 合屋 雅彦
  (東京医科歯科大学医学部附属病院循環器内科)
Chairperson: Masahiko Goya
  (Tokyo Medical and Dental University)

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is progressive disease and an inherited desmosomal cardiomyopathy characterized by a high burden of ventricular arrhythmias and increased risk for sudden cardiac death (SCD). Fibro fatty replacement of the right ventricle (RV) within the so-called triangle of dysplasia which encompasses the RV inflow, outflow, and apex is thought to result in regions of slow conduction, which form the substrate for scar-related macroreentrant ventricular tachycardia (VT). The pathological lesions are believed to progress over time from the epicardium to the endocardium and with diffuse involvement of the RV and the left ventricle (LV) in half of the cases.

Restriction of the exercise and the titration of Beta-blockers up to the maximally tolerated dose are recommended as the first-line therapy. Patients with a history of aborted SCD, poorly tolerated VT and syncope have the highest risk of SCD and ICD therapy is required.

Catheter ablation should be considered in patients with frequent symptomatic PVC or VT unresponsive to medical therapy. In early 2000’s even though electroanatomic and voltage mapping systems provided significant improvement concerning the result of catheter ablation targeting ARVC-VT, it was not considered curative because of high recurrence rate. Recently several reports were published as for the importance of an endo-epicardial– based ablation strategy, catecholamine challenge and PVC mapping, and substrate of the left ventricle.

In this session, we will expect to have the most advanced concept, methodology, and technology for the better understanding the mechanisms and the innovative therapeutic techniques of this complex arrhythmias.

心臓サルコイドーシス:診断・治療に関する現状と課題

Diagnosis and Treatment of Cardiac Sarcoidosis Up To Date

座長: 草野 研吾
  (国立循環器病研究センター心臓血管内科)
Chairperson: Kengo Kusano
  (National Cerebral and Cardiovascular Center)

Sarcoidosis is a systemic granulomatous disease and cardiac involvement (Cardiac sarcoidosis, CS) is an important prognosis factor in this disease. However, CS is sometimes misdiagnosed as other cardiomyopathies, and therefore endomyocardial biopsy is important, but the problem is a low sensitivity of myocardial biopsy. Another diagnostic problem is the recognition of isolated types of CS. Recently MRI and 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) have been demonstrated to be useful tools for the noninvasive diagnosis of CS. Treatment of CS is usually done by corticosteroid to control inflammation, prevent fibrosis and protect deterioration of cardiac function but the long-term outcome is still in debate. Non-pharmacological approaches are also available but the result of catheter ablation for ventricular arrhythmias is not sufficient.

Accordingly, there are many issues to resolve about diagnosis and medical management.
In this session, we will focus on the recent advancement and understanding regarding CS diagnosis (FDG-PET and isolated CS) and management (corticosteroid and catheter ablation) to resolve the issues how to treat CS patients.

遺伝子から考える心房細動治療

Treatment of Atrial Fibrillation and Genetic Background

座長: 中谷 晴昭
  (千葉大学 理事)
Chairperson: Haruaki Nakatani
  (Chiba University)

Atrial fibrillation (AF) is a widely prevalent arrhythmia associated with increased morbidity, mortality and socioeconomic burden. For decades, treatment of AF has been discussed in the aspect of pharmacological or non-pharmacological modification of electrical property of the myocardium and propagation of excitation in the atria. It is almost 20 years since the concept structural remodeling of the atrial tissue by AF was experimentally confirmed. Recent reports have suggested that certain genetic backgrounds, such as variants in genes encoding gap junction proteins and ion channels, increase the risk of AF. Genome-wide association studies have disclosed that even common single-nucleotide polymorphisms (SNPs) increase the vulnerability to the development of AF. Also, AF susceptibility SNPs seem to be related with recurrence of arrhythmia after catheter ablation for AF. AF occurs as a phenomenon of combination of genetic abnormalities or variations, acquired organic myocardial abnormalities, and/or autonomic modulation of myocardial electrical stability. Thus, most efficient management of this arrhythmia should be focused on a primary cause of AF in each patient. In this symposium, to obtain an insight into the future of AF management, the potential role of gene-oriented treatment of AF will be discussed.

遺伝性不整脈国際研究シンポジウム

International Research Symposium of Inherited Arrhythmias

座長: 蒔田 直昌
  (長崎大学大学院医歯薬総合研究科分子生理学)
Chairperson: Naomasa Makita
  (Nagasaki University)

Over the last two decades, there was a remarkable progress of research in the inherited arrhythmias, which promoted a breakthrough in both the research and clinical management. However, despite the rapid progress in understanding the genetic basis, the etiology still remains unknown in substantial fractions of affected individuals, additional paradigm shift therefore has been expected to reveal the missing heritable factors associated with these syndromes. In this symposium, we will invite four outstanding research scientists who are most familiar with the most advanced research technologies that uncover hidden etiologies of inherited arrhythmias of both congenital and acquired forms. These include conventional genetic screening techniques, and more advanced genome-wide association studies, as well as whole-exon or whole-genome sequencing using next generation sequencer, and in vivo and in vitro analysis using genetically engineered animal models.

クライオ・ホットバルーン治療におけるCEの役割

Clinical Engineer’s role in the management of cryoablation and hot balloon ablation

座長: 熊谷 浩司
  (群馬県立心臓血管センター 循環器内科)

現在心房細動の高周波カテーテルアブレーション治療は,急速な進歩を遂げ、発作性に関しては既に第一選択治療として確立された感がある。2015年にはクライオ・温熱などの方法によるバルーンカテーテル肺静脈電気的隔離術が使用できるようになったが、高周波エネルギーを用いた従来の方法は複雑な症例に対する有効性は高いものの,手技が術者の技術力や経験に左右されること、施術時間が問題であった。クライオバルーンでは,バルーン形状のカテーテルに冷気ガスを送気し,標的部位を円周状に一括で冷却することで心房細動を治療する。バルーン形状での一括隔離により手技時間の短縮が見込めるとともに,冷凍アブレーションにより合併症発生などのリスク低減や再発率の低下が期待される。持続性心房細動や複雑な心房不整脈に対しては,従来の高周波カテーテル焼灼術の利点を利用した治療が必要であるが、初期の病態である発作性心房細動に対しては,短時間で確実な治療が可能である経皮的カテーテル心筋冷凍焼灼術が有用である。発作性心房細動患者さんの早期発見・早期治療が,心房細動の持続性を防ぎ,重大な合併症である脳梗塞の抑制にもつながることと期待される。このセッションでは、 クライオ・ホットバルーン治療の現状と課題についてCEの視点から議論できればと思う。

カテーテルアブレーション手技における看護師の役割

Cardiac Catheter Laboratory Nursing during Catheter Ablation Procedures

座長: 新田 順一
  (さいたま赤十字病院循環器科)

カテーテルアブレーションは技術・知識の進歩により、発作性上室性頻拍から心房細動や心室頻拍まで適応が拡大している。また、虚血性心疾患と異なり、対象となる年齢層も小児から高齢者まで幅広く扱っている。したがって、現場では、アブレーション手技を行う医師に加え多職種の医療スタッフ(看護師、臨床工学技士、放射線技師など)の必要性がますます増大している。特に看護師は直接患者と接し、観察・看護および処置を行なっており、様々な状況に対応しなくてはならない。特に心房細動や心室頻拍のアブレーションの際にはバイタルサインのチェックや合併症の早期発見における看護師の役割は大きい。 本シンポジウムでは、カテーテルアブレーション手技における看護師の役割をさまざまな視点から発表していただき、今後スムーズで安全なカテーテルアブレーションを施行するための一助となることを期待する。

心不全患者における不整脈治療の進歩と展望

Recent Progress and Future Prospects for Treating Cardiac Arrhythmias in Heart Failure

座長: 萩原 誠久
  (東京女子医科大学循環器内科)
Chairperson: Nobuhisa Hagiwara
  (Department of Cardiology Tokyo Women's Medical University)

Cardiac arrhythmias can be a potential complication of heart failure (HF). Both atrial and ventricular arrhythmias are common in patients with HF and contribute significantly to mortality and morbidity. Atrial fibrillation occurs with increasing frequency as the severity of HF increases.
Anticoagulation and rate control are important. Attempted maintenance of sinus rhythm with class III antiarrhythmic drugs or the catheter ablation are reasonable considerations for selected patients with HF. Implantable cardioverter defibrillators (ICD) are first-line therapy for high-risk patients who have been resuscitated from sustained ventricular tachycardia (VT) or ventricular fibrillation (VF). Also, a number of randomized clinical trials have now demonstrated that primary prophylaxis of ICD can improve mortality in selected patients with HF. Therefore, the risk stratification and the prevention of VT/VF are the key common issues in the treatment of these patients. Furthermore, there has been much progress with the catheter ablation technique, ICD, and cardiac resynchronization therapy (CRT) devices, which are now useful in patients with arrhythmias and HF. In this symposium, we would like to discuss the pathogenesis of cardiac arrhythmias, recent progress and future prospects for treating cardiac arrhythmias in patients with HF.

リードレスペースメーカ

Leadless pacemaker

座長: 石川 利之
  (横浜市立大学医学部 循環器腎臓内科学)
Chairperson: Toshiyuki Ishikawa
  (Yokohama City University Hospital)

More than 50 years have passed since the first cardiac pacemaker was implanted in 1958 by Dr Senning and colleagues. How much closer are we now to developing a perfect pacemaker device? Multiple difficulties have been overcome, while many others are still to be addressed. Complications associated with conventional transvenous pacing systems are commonly related to the pacing lead and pocket. Pacing lead issue is one of the unsolved problems. Lead troubles including leak and fracture are still great problems. And pocket infection is another great problem. Prognosis of device infection is poor if complete extraction of the system is not performed. Pacing lead may be a week point of the pacing system. To solve these issues, leadless pacemaker may be promising. Early assessments of leadless pacemaker system showed the transcatheter pacemaker can safely and effectively be applied. Long-term safety and benefit of the pacemaker will be evaluated. In this symposium, we discuss about current status and future of the leadless pacemaker.

流出路起源心室頻拍に対するカテーテルアブレーションの新たな展開

New Developments of Catheter Ablation for Outflow Tract Ventricular Tachycardia

座長: 西崎 光弘
  (横浜南共済病院 循環器センター 循環器内科)
Chairperson: Mitsuhiro Nishizaki
  (Yokohama Minami Kyosai Hospital)

Catheter ablation of ventricular tachycardias (VTs) has evolved rapidly and new technologies in mapping systems play an important role in improving outcomes. A percutaneous epicardial mapping is often required for ablation of VTs because of failure of endocardial ablation.
Catheter ablation is a crucial therapy of VTs originating from the outflow tract in patients without structural heart disease. Endocardial radiofrequency catheter ablation (RFCA) is highly successful for RV outflow tract VTs. However, VTs arising from LV outflow tract is sometimes eliminated by challenging epicardial ablation in addition to endocardial ablation. Analysis of twelve-lead ECG features is of limited effectiveness for accurately predicting successful ablation site in outflow tract VTs, especially epicardial site. Recently novel methods in RFCAs of ventricular arrhythmias (VAs) originating from LV summit and intramural foci in LV outflow tract have been reported.
On the other hand, there have been few clinical studies exploring mechanism of preferential pathway associated with QRS morphologic changes of the outflow tract VAs.
In this session, four speakers give a lecture about catheter ablation of VAs arising from the outflow tract from various points of view under the title of ‘New Developments of Catheter Ablation for Outflow Tract Ventricular Tachycardia’ .

VTアブレーションのための最新画像診断法

Latest Modalities of Image Integration for VT Ablation

座長: 平尾 見三
  (東京医科歯科大学 不整脈センター)
Chairperson: Kenzo Hirao
  (Tokyo Medical and Dental University)

Recent advances in the field of modalities of cardiac image integration enable electrophysiologists to perform ventricular tachycardia (VT) ablation more effectively and safely. Intraprocedural imaging is an important consideration in VT ablation, where it is needed for defining substrate, tagging ablation targets, tracking lesion location, and monitoring for complications.
The progress of 3-dimensional (3D) electroanatomic mapping has a significant impact on such advances in VT ablation. This mapping visualizes scar regions as low voltage area on substrate map, the site of origin of focal VTs and reentrant VT circuits on activation map as well as the geometry of the heart.
With mappable VTs, ascertainment of VT circuit components assessed by conventional activation and entrainment mapping occurs during tachycardia. In unmappable VTs, electroanatomical mapping system is effective in mapping the anatomical substrate and electrophysiological substrate identified by scar-related ventricular electrograms (e.g. late potentials , fractionated potentials) during non-VT rhythm.
Preprocedural assessment by various imaging modalities provides us helpful information for VT ablation regarding anatomy, cardiac function and VT substrate. Current gold standard for scar imaging is LGE (late gadolinium enhancement) on cardiac magnetic resonance imaging (MRI). This imaging modality can provide a detailed assessment of scar architecture and can be used for image integration with the 3D electroanatomic mapping system.
Patients who cannot undergo MRI scanning may have scar imaging performed with positron emission tomography (PET) and/or computed tomography (CT) to obtain a high-resolution metabolic scar map, which can also be used for image integration.
Besides fluoroscopy and electroanatomic mapping, intracardiac echocardiogramphy (ICE) has been used as an additional modality during VT ablation. It allows for real-time scar imaging, visualization of cardiac structures, catheter contact and lesion formation.
These challenges in VT ablation based on the different imaging modalities may eventually improve the outcome of VT ablation. In this symposium, 5 experts in this field will provide us lectures focusing on the latest modalities of image integration for VT ablation.

デバイス感染の治療の現状と問題点

The Treatment of Device Infection : The Current Status and Problems

座長: 末田 泰二郎(広島大学大学院医歯薬保健学研究院 外科学)
  光野 正孝(兵庫医科大学 心臓血管外科)

 デバイス感染はデバイス植え込み後の最も重大な合併症のひとつであり、本学会等でも毎年のようにテーマに取り上げられている。昨今ではエキシマレーザーシースによるデバイス抜去等が徐々に普及し、エキスパートをもってすれば技術的には抜去がほぼ可能となってきた。
 一方で、デバイス植え込みは元来ハイリスク患者がその対象となっている場合が多く、感染デバイス抜去に成功しても、結局は感染や心不全等で救命できない症例も少なからず存在する。その治療成績に大きく影響を与えるものとして、例えば一時ペーシングの可否やペーシング部位(特に敗血症を呈しデバイス抜去を必要とするが心機能が悪く抜去直後からCRTを必要とするような症例)、デバイス抜去後の再植え込みの時期(同様に敗血症を呈する症例)、リスクは高くても外科の介入が必要な症例(心筋電極の使用も含む)等の問題があるが、未だ一定の見解は得られていない。
 本シンポジウムでは、「デバイス感染の治療の現状と問題点」として、技術的にリード抜去困難な症例に対する対策とともに、上記のような問題点についても検討し、最終的に患者を救命するにはどのように対策を構ずればよいかを考えたい。

マッピングおよびアブレーション装置の使用におけるCEの役割

Roles of Clinical Engineer in Mapping and Ablation Equipment


座長:鵜野 起久也 (医療法人札幌ハートセンター )


カテーテルアブレーションはイリゲーションの進歩とコンタクトフォース認識型カテーテルの登場、さらにバルーン型カテーテルが今後も相次いで登場することからも最近の進歩は目を見張るものがある。アブレーションの進歩と表裏一体でその進歩を支える上で、正確で詳細、かつ時間的にも侵襲度の低いマッピング技術と複雑なアブレーション周辺機器を安全に的確に取り扱えることはクオリティの高いカテーテルアブレーションを底支えする、必要不可欠な要件である。本シンポジウムでは、よりクオリティの高いアブレーションを施行する上で、その最も根幹に関わる重要要件をCEが如何にクリアし完遂していくか、CEの視点と最高のパーフォーマンスを発揮するために専門医の視点から明らかにして行きたい。

PVIにATPは有用か?

ATP/adenosine-guided PVI improves the outcome.

座長: 高月 誠司
  (慶應義塾大学循環器内科)
Chairperson: Seiji Takatsuki
  (Keio University School of Medicine)

The pulmonary vein (PV) isolation by catheter ablation has been established as a curative therapy for paroxysmal atrial fibrillation. To maintain the complete conduction block between the PVs and the left atrium (LA), that is to improve the durability of PV isolation must be important to increase the sinus rhythm maintenance rate. The dormant conduction is a transient electrical conduction between PVs and the LA revealed by the rapid infusion of adenosine or adenosine triphosphate (ATP) after PV isolation, which suggests incomplete conduction block. And theoretically, to remove revealed dormant conduction seems to contribute PV durability. Recently, some papers reported the clinical efficacy to perform dormant conduction after PV isolation, which interestingly showed inconsistent results. Several factors could be concerned. Firstly, does eliminating dormant conduction guarantee the long term PV isolation? Secondly, the interval from PVI to administer adenosine/ATP could affect the results since the dormant conduction sometimes cannot be revealed just after PV isolation and longer waiting time also can reveal spontaneous conduction between PVs and LA without adenosine/ATP infusion. Thirdly, the manner and the energy source of the PV isolation could be involved, since if the rate of the induced dormant conduction is very low, to check the dormant conduction can be meaningless. Finally, the prevalence of atrial fibrillation triggered by the extra-PV foci can also be involved.
In this debate session, two experts will discuss the significance of the dormant conduction revealed by adenosine/ATP. And the audience could take an answer to the question whether physicians should check the dormant conduction after PV isolation through the discussion.

非薬物的左心耳血栓予防法

Non-pharmacological prevention of left atrial appendage thrombus.

座長: 中里 祐二
(順天堂大学浦安病院循環器内科)

Chairperson:Yuji Nakazato

(Department of cardiology, Juntendo University Urayasu Hospital)


It is well known that an oral anticoagulation therapy suggested the efficacy for preventing thrombus formation in patients with atrial fibrillation. Currently, a novel anticoagulant is widely available and more feasible to control those patients. However, the risk of bleeding, particularly in elderly patients is always a concern with anticoagulant therapy.
 On the other hand, non-pharmacological prevention by the resection of the left atrial appendage has been mainly performed in valvular surgery as an additional procedure. Recently, less invasive surgical procedures including the thracoscopic approach or -percutaneous closure of the left atrial appendage with devices have been developed. Although each method has reported to be effective, perioperative safety is still controversial.
 In this session, we would like to discuss with the risk and benefit of various non-pharmacological measures of LAA thrombus prevention.

左側特発性心室頻拍(ILVT)のマッピングとアブレーション

Mapping and Ablation of Idiopathic Left Ventricular Tachycardia

小林 義典 東海大学医学部付属八王子病院循環器内科
横式 尚司 北海道大学病院循環器内科

The advance in the clinical electrophysiology has identified several types of idiopathic left ventricular tachycardia (ILVT). These include tachycardia originating from the outflow tract, the aortic sinus cusp, the superior portion of the epicardial LV (LV summit), the mitral annulus, the postero-septal region of LV (cardiac crux), the papillary muscles, and the Purkinje-fascicular network (such as verapamil-sensitive VT).
Our understanding of the mechanisms, anatomical location and characteristic intracardiac electrograms at the critical sites of those ILVTs is prerequisite for successful catheter ablation. In addition to endocardial mapping, some form of ILVTs requires the mapping in the coronary venous system and/or on the epicardial surface. Information regarding the morphology of QRS complex during tachycardia is also important for the mapping, and subtle differences in the QRS complex lead us to determine the distinct approach to the critical target for catheter ablation. The accumulating evidences using new electrophysiological and imaging technology have been helpful for further elucidating the mechanisms and origins of ILVTs.
This symposium aims to focus on the novel findings related to ILVTs and to share the important tips and pitfalls on the mapping and ablation of ILVTs.

心房細動アブレーション:トリガーかサブストレートか

Approaches to Catheter Ablation for Atrial Fibrillation:Triggers or Substrate Modification

熊谷 浩一郎 福岡山王病院ハートリズムセンター

Trigger elimination by pulmonary vein isolation (PVI) represents the cornerstone of ablation strategies. However, some patients with paroxysmal atrial fibrillation (AF) may be undertreated with PVI alone. Further modification of atrial substrate maintaining AF seems necessary in some patients. Patient selection for additional atrial substrate modification is usually based on their clinical presentation although the correlation between AF type and the extent of atrial structural disease remains unclear. The two most common techniques for substrate modification are the creation of linear lesions in the left atrium (LA) and ablation at sites with complex fractionated atrial electrograms (CFAEs) during AF considered critical for AF perpetuation. However, a recent clinical study found no reduction in the rate of recurrent AF when either linear ablation or ablation of CFAEs was performed in addition to PVI. Perhaps neither CFAEs nor lines may be the additional targets for ablation. More selective targets may be needed to better characterize an individual patient’s specific arrhythmic substrate. Previous studies have shown the correlation of low-voltage areas with atrial fibrosis and scarring. A novel individualized approach for AF ablation based on low-voltage areas in the LA has been provided. However, the necessity of additional ablation of low-voltage areas to PVI for paroxysmal AF is less clear, and long-term data after ablation of low-voltage areas are limited. The additional ablation could increase risk. Consequently, extended AF ablation may lead to overtreatment in the sense of increased procedure and fluoroscopy time, complication rate, and proarrhythmia. We discuss the approaches to AF ablation targeting triggers or substrate modification.

心室中隔頻拍: マッピング,アブレーションの近年の進歩

Septal VTs: Diagnosis and recent evolution of mapping and ablation.

夛田 浩 福井大学医学部 病態制御医学講座 循環器内科学

The ventricular septum is a major origin of ventricular tachycardia (VT): Among idiopathic VTs, most outflow tract VTs and some mitral and tricuspid annular VTs occur from the septum.  A rare and distinct type of verapamil-sensitive, left fascicular VT also could be ablated at the left upper septum (left upper septal VT).  In structural heart disease, especially in cardiac sarcoidosis and hypertrophic cardiomyopathy, the critical substrate of reentrant VTs is often found within the septum. 
In some VTs arising from the septum, because the VT origin and reentry substrate exist beyond the reach of ablation with the use of standard techniques, an open surgical approach is required for a cure.   However, recently emerged ablation techniques and instruments, such as bipolar radiofrequency ablation and intramyocardial infusion-needle catheter ablation may cure these kinds of septal VTs that have been refractory to the conventional catheter ablation therapy. 
In this symposium, eminent physicians in this field will present these issues and discuss how to diagnose and ablate septal VTs safely. 

透視軽減

Reduction of Radiation Exposure

副島 京子 杏林大学医学部 循環器内科

WHO has launched the “Global Initiative on Radiation Safety in Health Care Settings” to mobilize the health sector in the safe use of radiation in medicine. In the interventional cardiology, the major concern regarding the brain cancer development has been raised. Previous data showed that the typical dose for atrial fibrillation catheter ablation is 15 mSv and 64-slice CT prior is 15mSv. Total of 30mSv is compatible with the average dose of evacuees from Chernobyl plant! In the EP field, non-fluoroscopic mapping systems contributed to the reduction of radiation exposure. Awareness of the radiation cannot be emphasized enough.

心房細動の管理:リズムコントロール vs. レートコントロール

Management of Atrial Fibrillation: Rhythm versus Rate Control Therapy

池田 隆徳 東邦大学医学部内科学講座 循環器内科学分野

There has been considerable debate for over a decade regarding the management of patients with atrial fibrillation (AF). It is about whether physicians should attempt to restore and maintain sinus rhythm using cardioversion, antiarrhythmic drugs, and/or catheter ablation, so-called “rhythm-control” therapy, or whether patients with AF should be treated with drugs such as beta-blockers, calcium-channel blockers, or digoxin, to control the rapid ventricular heart rate responsible for the majority of symptoms, the so-called “rate-control” therapy. Restoration and maintenance of sinus rhythm would intuitively seem to be the ideal approach for both stroke prevention and symptom alleviation. However, some studies demonstrated that long-term maintenance of sinus rhythm has proven difficult to achieve using antiarrhythmic drugs in AF patients. Moreover, adverse drug effects, ranging from proarrhythmic effects to organ toxicity, are a common concern when antiarrhythmic drugs were used. Conversely, rate control therapy is generally considered a safe and inexpensive therapeutic strategy mainly for persistent AF, although it may not be an effective treatment option in patients who are highly symptomatic. Recent several clinical trials revealed that rhythm control therapy offers no clinical benefit over rate control therapy. However, we should recognize that these studies primarily enrolled older patients with persistent AF, who were mildly symptomatic. Therefore, the results cannot be extrapolated to other patient populations, particularly patients with highly symptomatic younger than 65 years with paroxysmal and/or lone AF. In this symposium, we will widely discuss about which therapy is better regarding the management of AF in various clinical settings.

VTアブレーションにおける最新マッピング

New mapping technique for VT ablation

座長: 関口 幸夫 (筑波大学医学医療系 循環器内科学)

Chairperson: Yukio Sekiguchi

(Cardiovascular Division, Faculty of Medicine, University of Tsukuba)


In these days, the therapies for ventricular tachycardia (VT) have been advanced by the progress of invasive strategies such as implantable cardioverter defibrillator (ICD) or radiofrequency catheter ablation (RFCA), in addition to conventional drug therapy.
Especially, RFCA has become a useful treatment of drug-refractory VTs in the patients with structural heart disease. Several studies clarified that radiofrequency lesions delivered on the basis of substrate mapping by electroanatomical mapping system have been effective in unmappable or multiple VTs. Besides, the technique of percutaneous pericardial puncture to perform epicardial mapping and ablation has gained wide acceptance for the treatment of epicardial VT. However, long-term success rates remain unsatisfactory and are limited by lack of defined ablation endpoint.
Recently, several new mapping or ablation techniques have been reported in order to eliminate such VTs and were able to achieve adequate outcome.
In this session, we would like to discuss the topics regarding the utility of new mapping strategy for VT ablation in the patients with structural heart disease.

ブルガダ症候群に対するアブレーション:トリガーかサブストレートか

Catheter Ablation for Brugada Syndrome: Should We Target the Trigger or the Substrate of Ventricular Fibrillation?


因田 恭也(名古屋大学医学部 循環器内科)

Chairperson:Yasuya Inden

(Department of Cardiology, Nagoya University Graduate School of Medicine)


Ventricular fibrillation (VF) in patients with Brugada syndrome is life-threating and repeated arrhythmia. Ablation for Brugada syndrome has been reported recently and the targets of ablation were the trigger ventricular premature beat (VPB) and/or the substrate of the right ventricular outflow. The goal of the Brugada ablation is the decrease of the attack frequency or the disappearance of VF attack. We can detect the origin of VPB easily in the patients with frequent VPBs, but it will be difficult to eliminate the triggers in the patients with few VPB. The substrate of Brugada syndrome has been reported to be located over the epicedial surface of the right ventricular outflow. The epicardial ablation targeting the abnormal electrograms is performed in this area. In contrast, the radiofrequency energy was delivered by the endocardial approach in some cases. But the endpoints of these procedures aren’t established well.
And the indication of Brugada ablation depends on the patient’s condition such as the attack frequency, but the ECG criteria for ablation isn’t clear. The short and long term effects of these ablation were not fully investigated. We discuss the Brugada ablation targeting the trigger or the substrate of VF.

自律神経機能調節による不整脈治療

Treatment of arrhythmias with modulation of autonomic nervous function

座長: 井上 博(済生会富山病院)

Chairperson:Hiroshi Inoue (Saiseikai Toyama Hospital)


The autonomic nervous system modulates electrophysiological activities in cardiac tissues including sinus and atrioventricular node, conduction system, and atrial and ventricular myocardium. Generally, activation of the sympathetic nervous system enhances automaticity or triggered activity, accelerates conduction over the conduction system and facilitates reentry, thereby leading to induction of atrial as well as ventricular tachyarrhythmias. By contrast, activation of the parasympathetic nervous system exerts protective effects against tachyarrhythmias including ventricular fibrillation in subjects with myocardial infarction. However, activation of the parasympathetic nervous system is associated with induction of atrial fibrillation in apparently healthy subjects and also ventricular fibrillation in patients with Brugada syndrome. Modulation of the autonomic nervous system with invasive techniques is now becoming anovel, adjunctive treatment of several tachyarrhythmias. Ablation of the atrial epicardial ganglionated plexus is effective in eliminating paroxysms of atrial fibrillation in selected patients. For ventricular tachyarrhythmias, cervical vagal nerve stimulation with a sophisticated device, left stellate ganglionectomy, and renal sympathetic denervation with radiofrequency energy are now promising, adjunctive treatment techniques. Left stellate ganglionectomy has been employed to suppress refractory arrhythmias in patients with long QT syndrome, and recently this technique is shown to exert antiarrhythmic effects in patients with catecholaminergic polymorphic ventricular tachycardia. In this symposium, experts from abroad and Japan will discuss in detail the progress in basic as well as clinical cardiac electrophysiology.

無症候性心房細動の診断・治療と予後

Silent Atrial Fibrillation: Diagnosis, Prognosis and Therapy


山根 禎一 東京慈恵会医科大学 循環器内科

Chairperson:Teiichi Yamane (Jikei University School of Medicine)


Silent or asymptomatic atrial fibrillation (AF) currently has gained wide interest not only in cardiovascular but also in neurologic field, which is reported to be responsible for the 25~40% of cryptogenic stroke. Furthermore, silent AF has been focused to be associated with the progression of dementia through the accumulation of micro-ischemic strokes.

In contrast to the manifest or symptomatic AF, there remained multiple unknown/debatable issues around the silent AF as follows; 1) Its epidemiology and populations, 2) How to diagnose and define the silent AF (standard Holter, external loop recorder, or implantable devices), 3) the proximity of silent AF episodes to thromboembolic events, 4) How to manage silent AF (including the necessity of anticoagulation therapy), 5) indication of curative ablation strategy for silent AF, etc.

Following the establishment of the management for the manifest AF, now we need to face the new disease entity of silent AF. In this symposium, we are planning to discuss the above non-resolved issues of silent AF among specialists of various medical fields (cardiology, neurology, etc).

Current Status and Future Perspective of Biomedical Engineering in Electrocardiology and Arrhythmia Studies

不整脈心電学研究における生体医工学研究の現状と展望


Chairperson:Ichiro Sakuma

(Graduate School of Engineering, The University of Tokyo)

座長: 佐久間 一郎(東京大学大学院工学系研究科医工学RSセンター)

 カテーテルナビゲーションにおけるカテーテルのトラッキング、リエントリダイナミクスの心電信号処理による解析、多電極マッピング結果のコンピュータによる可視化、ICT技術を活用した心電図の遠隔モニタリング、ウェアラブル心電モニタリングシステム、不整脈・心電現象のコンピュータシミュレーション等近年の不整脈・心電図の計測・解析には先端技術が活用されている。我が国における不整脈心電学に関する医学的研究を基礎に、我が国の優れた情報処理技術・微細加工技術、計測技術等の技術的シーズを活用して、臨床的に有用な革新的な医療デバイス、医療システムを開発するためには医工連携の推進が重要となる。不整脈学・心電学領域のおける医工連携について議論することを目的に、本企画は日本生体医工学会と日本不整脈心電学会の共催企画で実施する。医学側よりは工学的な解決法を必要とする臨床医学的・基礎医学的研究に関する演題と、工学側からは当該分野の進歩に寄与する工学的研究に関する演題から構成する。

抗不整脈薬の新展開

State of the art: Antiarrhythmic Management of Atrial Fibrillation

座長: 新 博次 (鶴巻温泉病院)

Chairperson:Hirotsugu Atarashi (Nippon Medical School Tama Nagayama Hospital)


Goals of use antiarrhythmic medications for AF patients are including reduction in the frequency and duration of episodes of arrhythmia without increasing mortality and morbidity. Since the CAST study, noticed that suppression of arrhythmias using antiarrhythmic drugs may induce proarrhythmic events especially in patients with ischemic heart disease or heart failure. The majority of available antiarrhhthmic drugs exert predominant effects on cardiac sodium or potassium channels. How to select an appropriate drug for each patient, down regulation or up regulation of these ion channels depend on patient’s pathophysiology should be considered, therefore selection of drugs should be considered advancement of electrical remodeling. To maintain sinus rhythm, to date, non-pharmacological managements, pulmonary vein isolation is one of the effective approaches but adding antiarrhyhthmic drugs is not rare. In such cases what is the most effective pharmacological approach would be presented. Hopefully, what should we expect from next generation of antiarrhythmic drugs will be considered.

心不全合併不整脈に対する治療戦略

Therapeutic Strategies for Arrhythmias Complicating Heart Failure

座長: 三田村 秀雄(国家公務員共済組合連合会 立川病院循環器センター)
筒井 裕之(北海道大学大学院医学研究科 循環病態内科学)

Chairpersons:

Hideo Mitamura (Tachikawa Hospital・Cardiology Division)

Hiroyuki Tsutsui (Hokkaido University Graduate School of Medicine)


Heart failure (HF) and arrhythmias often coexist and present a particular therapeutic challenge to clinicians.
Atrial fibrillation (AF) is a growing epidemic in the elderly, particularly with HF, associated with significant morbidity and mortality. Pharmacologic rhythm control has failed to improve outcomes compared with rate control. Catheter ablation of recent-onset AF offers an opportunity to achieve sinus rhythm without the downside of antiarrhythmic drugs. For chronic AF on the other hand, rate control is preferred whereas there is an ongoing debate on the safety of digoxin as well as β-blockers in HF+AF patients.
Life-threatening ventricular arrhythmias (VAs) in patients with HF are typically managed with implantable cardiac defibrillators (ICD). Although ICDs are highly effective in reducing sudden cardiac death, they do not prevent VA recurrences, loss of consciousness, or deterioration of ventricular function after recurrent shocks. Amiodarone or catheter ablation can be therapeutic options for patients with drug-refractory VAs to reduce or prevent ICD shocks.
There are additional unique electrical therapies in HF. Chronic arrhythmias such as frequent ectopic beats or sustained rapid ventricular response sometimes induce or worsen left ventricular dysfunction, which can be reversed by abolition of such arrhythmias by catheter ablation. Electrical dyssynchrony is another treatable mechanism of HF with regional conduction disturbances and can be treated with cardiac resynchronization therapy with biventricular pacing. However, a significant minority demonstrates nonresponse.
This symposium will discuss wide views of these important and exciting topics, which will be presented by distinguished experts from the 2 societies of HF and arrhythmia.

ブルガダ症候群のメカニズム

Mechanisms Underlying Brugada Syndrome

座長: 清水 渉 日本医科大学 内科学(循環器内科学)

Chairperson:Wataru Shimizu

(Department of Cardiovascular Medicine, Graduate School of Medicine, Nippon Medical School)


Brugada syndrome (BrS) is characterized by a coved-type ST-segment elevation in the right precordial leads (V1 and V2) known as type-1 Brugada ECG and associated with a high risk of sudden cardiac death due to ventricular fibrillation (VF). The cellular mechanisms underlying BrS have long been a matter of debate. Two principal hypotheses have been advanced 1) The repolarization hypothesis asserts that an outward shift in the balance of currents in right ventricular epicardium can lead to repolarization abnormalities resulting in the development of phase 2 reentry, which generates closely-coupled premature beats capable of precipitating VT/VF; 2) The depolarization hypothesis suggests that slow conduction in the RVOT leading to discontinuities in conduction, plays a primary role in the development of the electrocardiographic and arrhythmic manifestations of the syndrome. The repolarization and depolarization hypotheses are not necessarily mutually exclusive and may indeed be synergistic. In this symposium, we will discuss on the potential mechanism underlying BrS from the viewpoint of electrocardiographic, electrophysiologic characteristics, genetics, and response to pharmacological agents or epicardial catheter ablation.

Remote Monitoring

遠隔モニタリング


平井 真理(名古屋大学医学部保健学科)


不整脈領域における遠隔モニタリングは、ICDやCRT-Dをはじめとした植込み型デバイ スにおいて発展し、J-HOME-ICD研究等において無症候性イベントの早期診断に有用で あることが判明しています。この遠隔モニタリングのセッションにおいては、ICTの 進歩に伴い発展している広い意味での不整脈と心電図の遠隔モニタリングにおけるシ ステムの運用経験やその利活用における医学的メリットおよび問題点を明らかにし今 後のさらなる発展に寄与することを目的に一つとしています。また、現行の遠隔モニ タリングシステムにおいて経験された症例等を検討することで現行の遠隔モニタリン グシステムの有用な点と問題点を明確にしコメディカルの皆様の果たす役割を明確に することも課題の一つとしたいと思います。多くのコメディカルの皆様の参加を期待 いたします。

心臓プログラム刺激におけるCEの役割

Role of Clinical Engineer in Cardiac Programmed Stimulation

座長:吉田 幸彦(名古屋第二赤十字病院循環器センター内科)

Chairperson: Yukihiko Yoshida
(Cardiovascular Center, Nagoya Dai-ni Red Cross Hospital)

近年アブレーション症例数の増加は目覚ましいものがありますが、高度な医療を提供するためには医師とコメディカル、特にClinical Engineer(CE)とのチーム医療が不可欠です。現在アブレーション症例の多くが心房細動症例となっているために、心臓電気生理学的検査における、心臓プログラム刺激の意義・重要性への認識が薄らいでいる感があります。しかしながら心臓プログラム刺激に対する作業心筋や刺激伝導系の反応、頻拍誘発のためのプロトコール、頻拍機序の鑑別に必要な刺激法、至適通電部位同定および治療効果判定に用いる刺激法などを充分理解していなければ正確な診断や治療はできません。本セッションでは、指定演者による教育講演によって心臓プログラム刺激に関する知識を今一度整理して頂き、公募演題を通してその有用性を再認識して頂ければと思います。公募演題としては心臓プログラム刺激の有用性を示す研究発表、症例報告を募集いたします。医師の指示を待って刺激をするだけでなく、術者の意図を先回りして準備ができ、心内心電図を適切に判読できるようなレベルにまで到達する一助となれば幸いです。多くの皆様のご参加、演題応募をお待ちしております。

自律神経活動と催不整脈作用

Neural Control of the Heart-Implications for Clinical Electrophysiology

座長:中川 博(オクラホマ大学医学部)

Chairperson: Hiroshi Nakagawa
(Univerity of Oklahoma Health Sciences Center)

The autonomic nervous system (ANS) plays an important role in the pathogenesis of cardiac arrhythmias, including atrial fibrillation and ventricular tachycardia/fibrillation. Impaired parasympathetic response and enhanced sympathetic activity increase the risk of sudden cardiac death. The ANS comprises of the extrinsic (central) cardiac autonomic nervous system (vagosympatheic system from the brain and spinal cord to the heart) and the intrinsic cardiac autonomic nervous system (ganglionated plexi located within the epicardial fat pads) . The intrinsic system receives the input from the extrinsic system, but acts independently to modulate cardiac functions (automaticity, contractility, and conduction) . This session will cover the recent progress of basic and clinical researches on the relationship between the ANS and cardiac arrhythmias, including catheter and surgical intervention of the ANS for the treatment of atrial and ventricular fibrillation.

心室細動に対するアブレーション(ブルガダ症候群以外)

Ablation of Ventricular Fibrillation (except Brugada Syndrome)

座長:野上 昭彦 (筑波大学医学医療系 循環器不整脈)

Chairperson: Akihiko Nogami
(University of Tsukuba)

Sudden cardiac death is a major public health problem all over the world. Approximately 100,000 cardiac arrests in Japan occur annually in out-of-hospital settings. Recently, after improvements in the “chain of survival”, including the development of a public-access automated external defibrillator (AED) system and revisions to cardiopulmonary resuscitation guidelines, survival from out-of-hospital cardiac arrest has been improving. Although resuscitation rates are improving, the majority of individuals who experience sudden cardiac arrest will not survive. The gold standard treatment for the prevention of ventricular fibrillation (VF) is the insertion of an implantable cardiac-defibrillator (ICD). However, although an ICD can deliver life-saving therapy at the time of an event, it does not prevent the event from occurring. In most cases, structural heart diseases, i.e., ischemic or non-ischemic cardiomyopathy, are responsible; however, VF that occurs in the absence of any detectable structural heart disease is not rare. While previous studies have shown that VF is perpetuated by reentry or spiral waves, recent data suggest the role of specific sources triggering this arrhythmia. Haïssaguerre et al. reported that idiopathic VF could be suppressed by catheter ablation of those triggers originating from the Purkinje system or right ventricular outflow tract and the ablation therapy for VF has been increasingly reported during the last decade. In general, this ablation appears to have a high success rate and is relatively easy to perform, although precise mapping is required. However, little is known about the initiating mechanism of VF. Further, whether the mechanism of the ablation effect is due to the suppression of the trigger or substrate modification is also unclear. The objective of this symposium is to discuss the strategies we have incorporated into our catheter ablation procedures for VF, especially in difficult and complicated cases. (Catheter ablation for Brugada syndrome will be discussed in the other session.)

保健委員会セッション

不整脈臨床医が肌で感じる本邦の保険制度

座長:山根禎一

今井克彦

日本は現在国民皆保険制度を取り、世界に類のない国民にとって優しい医療環境にあると言われています。保険診療のシステムは、項目毎に決められた点数に従って行われるレセプト請求に対して、我々被保険者が納付する保険料により運営される保健者から病院に「医療の対価」として支払われるものですが、「決められた点数」については、原則2年ごとに中医協で審議・決定される改定が有り、世の現状に則することになっています。
本セッションでは、当学会に所属する医療者が、不整脈に関連する診療行為の点数についてどう考えているのかを、保険制度や都度都度の改定の流れなどを理解した上で、現場のリアルな声として語って頂き、参加頂く聴衆の方々を含めて、問題の認識、公正な理解、今後学会として取るべき、または取り得る方向性、などについて協議出来ればと思い、委員会として企画致しました。多数の皆様のご参集をお願い申し上げる次第です。

不整脈薬物治療サミット
超高齢化社会に向けた不整脈治療を考える

不整脈薬物治療最前線(薬物治療はカテーテル治療を超えられるか)

三田村秀雄、清水渉

座長の言葉

―Frontiers in the pharmacological management of arrhythmias―
Can pharmacological treatment become a better therapeutic approach than catheter ablation?

Current antiarrhythmic options include both pharmacological and non-pharmacological therapies using ablation techniques or device implantation. Both approaches have significantly improved clinical outcomes, yet their efficacy remains suboptimal, and their use is limited by a variety of potentially serious adverse effects.
Although substantial progress has been made in ablation techniques for atrial fibrillation (AF), broad application of these non-pharmacological treatment modalities is limited particularly for chronic AF with long duration, enlarged left atrium, short AF cycle length, and impaired cardiac function. As about half of the AF patients in Japan are aged > 75 years, and have permanent AF which are often asymptomatic, antithrombotic treatment with or without antiarrhythmic drug treatment is still the cornerstone and the first-line therapy for the majority of such patients.
There is a clear need for improved therapeutic options. Several decades of research have substantially expanded our understanding of the basic mechanisms of arrhythmias. For example, the pathophysiology of AF has been shown to include ion channel dysfunction, Ca handling abnormalities, structural remodeling, and autonomic neural dysregulation. Moreover, recent functional genomic studies have made great strides towards translating genetic discoveries to an underlying mechanism.
In this symposium, we review recent insights into the basic mechanisms of arrhythmias and assess the potential value of contemporary discoveries for future therapeutic innovation.

第5回不整脈薬物治療サミット 札幌

「高齢者・超高齢者における心房細動トータルケア」 座長の言葉

井上 博 髙橋 尚彦

Total Care of Atrial Fibrillation in Elderly and Very Elderly Patients

Hiroshi Inoue, Naohiko Takahashi

Prevalence of atrial fibrillation (AF) is increasing along with aging of population. AF is associated with an increase in mortality and morbidity that includes ischemic stroke. Recently, evidence is emerging that AF is also associated with cognitive impairment or dementia. In Japan, elderly subjects aged 65 years or more account for 25% of the whole population, and very elderly subjects aged 85 years or more account for 4% of the whole population. It is therefore mandatory for physicians to manage their patients with AF, especially elderly or very elderly ones, from many clinical aspects. In this session, the association between AF and cognitive impairment or dementia will be discussed first. Then the strategy of anticoagulation treatment among elderly or very elderly patients with AF will be discussed, since silent as well as symptomatic cerebral infarction is closely associated with cognitive impairment among subjects with AF. It seems possible that anticoagulation would prevent cognitive decline among elderly subjects with AF. However, anticoagulation with warfarin is sometimes difficult to achieve an optimal intensity among elderly subjects, and therefore is associated with higher rates of thromboembolic as well as hemorrhagic events as compared with younger subjects. Anticoagulation with direct oral anticoagulants is now a promising choice for elderly or very elderly subjects with AF because of its effectiveness and safety profile.

第31回日本不整脈心電学会公開講座(薬剤師・MR対象)
「薬剤師として知っておきたい抗不整脈・抗凝固薬の基礎知識」

上野和行

 高齢化に伴い、循環器疾患の中でも、不整脈の治療が問題になっています。不整脈の薬物療法では抗不整脈薬だけでなく抗凝固薬による治療が重要ですが、これらの薬物においては重篤な副作用や特徴的な薬物動態を有することから適正使用が難しいことでも知られています。そのため症例ごとの適正な薬物療法などによる管理が求められており、コメディカルスタッフの管理への参画も期待されています。
 本学会では、これまでコメディカルスタッフに対する色々な教育の企画が実施きていますが、今回は薬剤師・MRを対象として本テーマを取り上げました。最近抗不整脈薬のTDMのガイドラインも発表され、薬剤師の関心が高い分野でもあります。また新規抗凝固薬の登場により、心房細動の合併症である血栓塞栓症の予防に関する諸問題も話題になっております。
 今回は、それぞれの領域において第一線で活躍されている専門医を迎え、抗不整脈・抗凝固薬の基礎知識から最近の薬物療法における管理などについて解説していただく企画と致しました。是非、多くの皆様の参加をお待ちしています。

学術大会
事務局

筑波大学 医学医療系 臨床医学域 循環器内科
〒305-8575 茨城県つくば市天王台 1-1-1

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