@article{oai:dmu.repo.nii.ac.jp:00001000,
 author = {虎溪, 則孝 and 中原, 志朗 and 虎溪, 瑞穂 and 酒井, 良彦 and 高柳, 寛 and Toratani, Noritaka and Nakahara, Shiro and Toratani, Mizuho and Sakai, Yoshihiko and Talayanagi, Kan},
 issue = {1},
 journal = {Dokkyo journal of medical sciences},
 month = {Mar},
 note = {【目的】右室心尖部ペーシングによる左心機能への悪影響が指摘され,右室流出路中隔(right ventricularoutflow septum:RVOS)領域のペーシングが注目を集めている.この領域におけるペーシングの長期の心室自動閾値計測管理(ventricular capture management:VCM)に関するデータは不詳である.今回我々はRVOS ペーシングでのVCM の長期有用性を評価した.【方法】対象は21 例のRVOS ペーシング症例.植込み後,毎日のVCM 計測および各フォローアップ時のマニュアル,及びVCM による閾値計測を比較検討した.【結果】各フォローアップでのマニュアルとVCM 計測の差(gap)はいずれも0.25mV 以内で有意差はなく,長期フォローアップ(521±180 日)でのVCM 成功率は99%(3707/3739)と良好であった.VCM 不成功の要因として心房性不整脈の持続(AF burden)時間と(r=0.62, p<0.01),心房センシング低値(0.25-1.0 mV;93% vs. 1.1-5.6mV;99%,p<0.01)が関与していた.【結論】 VCM はRVOS 領域のペーシングに関し長期的に有用で精度の高いアルゴリズムであるが,心房性不整脈の合併症例に関してはその設定に注意が必要である., Background:Detrimental effects of right ventricular apical pacing on the left ventricular function have driven interest in selective site pacing, predominantly for the right ventricular outflow tract septum (RVOS). There is currently no information on the long-term performance of ventricular capture management from this site.Objective:This study aimed to evaluate a novel algorithm for the automatic measurement of the stimulation threshold of RVOS leads.Methods:Twenty-three patients with a ventricular lead placement on the RVOS undergoing pacemaker implantations for bradycardia indications were analyzed prospectively.Automatic threshold measurements were collected and compared with manual threshold tests at each followup visit. Long-term( 521±180days) follow-up was obtained in 17 patients( 81%).Results:The proportion of RVOS Capture Management(RVOS-CM) in-office threshold tests within one programming step of the manual threshold test was 99 %(3707/3739) with a two-sided 95% confidence interval( 96% , 100 %). There was a significant negative correlation between the RVOS-CM success rate and burden of atrial fibrillation(AF)(R=0.62;P<0.01).Conclusion:This study demonstrated that the RVOSCMalgorithm is safe, accurate, and highly reliable;thismay increase the battery longevity. However, proper attention in patients with paroxysmal AF is required., 原著, Original},
 pages = {57--65},
 title = {右室流出路中隔ペーシングにおける自動閾値計測管理の長期フォロー結果},
 volume = {39},
 year = {2012},
 yomi = {トラタニ, ノリタカ and ナカハラ, シロウ and トラタニ, ミズホ and サカイ, ヨシヒコ and タカヤナギ, カン}
}