担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Bipolar (BIP) radiofrequency (RF) ablation creates deep myocardial lesions but ideal energy application modes to treat ventricular arrhythmias originating from deep inside the thick myocardium have not been well established. An experimental study was performed to clarify whether high power and long application time BIP ablation were performable by impedance-decline-guide power control (PC) and whether it could create transmural lesions in the thick ventricle with a minimum risk of steam-pop. METHODS AND RESULTS: Perfused porcine ventricle (18.4 ± 2.3 mm) was placed in an experimental bath and BIP ablation (50 W) for 120 s was attempted with catheter contact of 30-g using two protocols; fixed power (FP) and impedance-decline-guide PC. In the latter protocol, BIP ablation was started from 50 W, while the energy was decreased to 40-20 W according to the impedance decline during RF ablation. FP ablation was attempted in 30 applications and the transmural lesion was created in all 30, although steam-pop occurred in 16/30 applications (53%). Low minimum impedance, large total impedance decline (TID), and %-TID were associated with the steam-pop occurrence. PC ablation was attempted in another 21 applications, and the transmural lesion was created in all 21 without steam-pop. PC ablation was superior to FP ablation (21/21 vs. 14/30, p < .001) in the creation of a transmural lesion without resulting in steam-pop. CONCLUSIONS: High power and long application time BIP ablation seems to be feasible according to the impedance-decline-guide approach, which could create transmural lesions in thick porcine ventricles with minimal risk of steam-pop.

DOI： 10.1111/jce.15684

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1161/CIRCEP.121.010392

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

BACKGROUND: Anti-tachycardia pacing (ATP) delivered from an implantable device is a useful tool to terminate ventricular tachycardia (VT). But its real-world efficacy for those patients having multiple VTs with varying VT rates has not been fully studied. METHODS: Using the Nippon-storm study database, efficacy of patient-by-patient basis ATP programing for Japanese patients having both non-fast (120-187 bpm) and fast VT (≥188 bpm) was assessed. According to the useful criteria of ≥50% success termination by ATP, patients were divided into three subgroups; success ≥50% for both non-fast and fast VT (both useful), ≥50% only for non-fast VT (non-fast VT useful), or ≥50% for neither non-fast nor fast VT (neither useful). RESULTS: During a median follow-up of 28 months, ATP terminated 184 of the 203 non-fast VT episodes (91%) and 86 of the 113 fast VT episodes (76%) in all 41 patients. In the patient-by-patient analysis, efficacy of ATP was not different between non-fast and fast VT in most of the patients (36/41 = 88%); 32 patients were in the both useful and four other patients in the neither useful. Neither ischemic nor non-ischemic structural heart disease was associated with the ATP efficacy, whereas LVEF more than 37.0% and non-prescribed amiodarone were characteristics of the patients classified into the both useful. CONCLUSIONS: ATP well terminated both non-fast and fast VT occurring in individual Japanese patients with various structural heart diseases in the real-world device treatment and this finding further supports ATP programing for all device tachycardia detection zones in most patients with multiple VTs.

DOI： 10.1002/joa3.12572

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

INTRODUCTION: This experimental study was conducted to explore impedance monitoring for safely performing bipolar (BIP) radiofrequency (RF) ablation targeted to arrhythmia focus. METHODS AND RESULTS: Using a newly designed dual-bath experimental model, contact-force-controlled (20-g) BIP ablation (50 W, 60 s) was attempted for porcine left ventricle (17.0 ± 2.7 mm thickness). BIP ablation was successfully accomplished for 60 s in 75 of the 89 RF applications (84.3%), whereas audible steam-pop occurred in the other 14 RF applications (15.7%). Receiver operating characteristic analysis demonstrated the optimal predictive values regarding the occurrence of steam-pop as follows; thinner myocardial wall (≤14.8 mm), low minimum impedance (≤89 ohm), greater total impedance decrement (TID) (≤ -25 ohm) and %TID (≤ -22.5%). Greater impedance decrement was not observed immediately preceding the occurrence of steam-pop but appeared around 15 s before. Four steam-pops happened before reaching the optimal predictive values of minimum impedance, whereas all 14 steam-pops developed 11.5 ± 9.2 and 8.1 ± 8.1 s after reaching the optimal predictive values of TID and %TID, respectively. Total lesion depth (endocardial plus epicardial) was 10.7 ± 1.2 mm on average, and was well correlated with TID and %TID. Transmural lesion through the myocardial wall was created in 22 RF applications. CONCLUSION: Relatively thinner areas of the myocardium are likely to be at greater risk for steam-pop during BIP RF ablation. Lowering the RF application energy to reduce the impedance decrement may help to lessen this risk.

DOI： 10.1111/jce.14764

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Anti-tachycardia pacing (ATP) delivered from an implantable device is an important tool to terminate ventricular tachycardia (VT). But its real-world efficacy for fast VT has not been fully studied. METHODS: Using the database of Nippon-storm study, effect of patient-by-patient basis ATP programming for fast VT (≥188 bpm) was assessed for the patients with structural heart diseases. Fast VTs were divided into three groups depending on heart rate (HR); Group A was 188-209 bpm, and Group-B and Group-C were 210-239 bpm and ≥240 bpm, respectively. RESULTS: During a median follow-up of 28 months, 202 fast VT episodes (209 ± 19 bpm) were demonstrated in the 85 patients. ATP terminated 151 of the 202 episodes (74.8%) in total. The success rate of the ATP was not different among the three groups: 73.3% in Group A, 80.6% in Group B, and 66.7% in Group C. ATP success rate of >50% and >70% was 77.6% and 64.7% of the patients, respectively. Left ventricular ejection fraction (LVEF) was significantly higher in the patients with rather than without successful ATP therapy, and receiver operating characteristic (ROC) analysis revealed that LVEF of 23% was the optimal cut-off value. ATP was less effective in patients taking amiodarone, but etiology of the structural heart diseases, indication of the device implantation, and all Electrocardiogram (ECG) parameters were not useful predictors for successful ATP therapy. CONCLUSIONS: ATP highly terminated fast VT with wide HR ranges in patients with structural heart diseases, and should be considered as the first-line therapy for fast VT except for patients with very low LVEF.

DOI： 10.1111/pace.13980

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Sympathetic nerve activity has arrhythmogenic potential for ventricular arrhythmias associated with structural heart diseases. However, a sufficient amount of beta-blockers occasionally cannot be prescribed in some patients.An experimental study was performed to clarify the therapeutic effects of bepridil, a multiple ionic current inhibitor that does not affect beta-adrenergic receptors, for premature beats occurring during enhanced sympathetic nerve activity. Cardio-sympathetic nerve activity was augmented via stellate-ganglion (SG) stimulation in a canine model (n = 8), and the arrhythmogenic potential and anti-arrhythmic effects of bepridil (2 and 4 mg/kg intravenously) were assessed. For safe use, vagal-stimulation-induced slow HR and programmed electrical stimulation were applied to evaluate possible pro-arrhythmic effects of the drug. Heart rate variability (HRV) indexes were used to estimate cardio-autonomic nerve activity.Either side of the SG-stimulation increased BP and HR. Premature beats were induced in 10/16 SG-stimulations and it was more frequent in left (8/8) rather than right stimulation (2/8). Following 2 mg/kg drug administration, premature beats were still inducible in 8/16 stimulations (7/8 in left and 1/8 in right), but burden of the premature beats decreased from 87.1 ± 46.8 to 62.1 ± 42.6 beats. After 4 mg/kg administration, premature beats were inducible in one SG-stimulation. Proarrhythmic effects were not observed in all experiments. Steady-state HRV indexes and percent increases in SG-stimulation-induced BP-elevation and HR-acceleration were similar among the 3 periods (before, 2 and 4 mg/kg of the drug).Bepridil may be an option for ventricular arrhythmias developed during enhanced cardio-sympathetic nerve activity with minimal effect on autonomic nerve responses.

DOI： 10.1536/ihj.19-494

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier {BV}  

BACKGROUND: Renal artery catheter ablation has been reported as a possible therapeutic option for drug-refractory ventricular arrhythmias (VAs) associated with structural heart diseases. OBJECTIVE: To further clarify its therapeutic background, we examined the relationship between electrical nerve stimulation (ENS)-induced blood pressure (BP) elevation and occurrence of VAs by using an acute canine model of renal artery ablation. METHODS: Using a decapolar electrode catheter, ENS was successively applied from the distal, mid, and proximal segments of the renal artery in 8 beagles. The same ENS was repeated after accomplishment of radiofrequency ablation at the ostial site of the renal artery by using an irrigation catheter. RESULTS: Before ablation, ENS increased BP from 140 ± 11/77 ± 11 to 167 ± 20/98 ± 16 mm Hg and heart rate from 100 ± 21 to 131±33 beats/min as well as induced VAs in 20 of the 45 ENS applications. Occurrence of VAs was associated with a greater magnitude of sympathetic nerve augmentation, and VAs were more frequently observed by ENS at the distal (67%) rather than mid/proximal segments of the renal artery (33%). Renal artery ablation was accomplished without any angiographic stenosis, and ENS-induced BP elevation, heart rate acceleration, and VAs occurrence were attenuated not only at the close segment (proximal) but also at the remote segments (mid/distal) of the renal artery. CONCLUSION: The renal autonomic nerves are considered as one of the therapeutic targets for suppression of frequent VAs because its activation has arrhythmogenic potential and induces premature ventricular beats.

DOI： 10.1016/j.hrthm.2019.07.029

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

Therapy-resistant ventricular arrhythmias can occur during accidental advanced hypothermic conditions. On the other hand, hypothermic therapy using mild cooling has been successfully accomplished with infrequent ventricular arrhythmia events.To further clarify the therapeutic-resistant arrhythmogenic substrate which develops in hypothermic conditions, an experimental study was performed using a perfusion wedge preparation model of porcine ventricle, and electrophysiological characteristics, inducibility of ventricular arrhythmias, and effects of therapeutic interventions were assessed at 3 target temperatures (37, 32 and 28°C).As the myocardial temperature decreased, myocardial contractions and the number of spontaneous beats deceased. Depolarization (QRS width, stimulus-QRS interval) and repolarization (QT interval, ERP) parameters progressively increased, and dispersion of the ventricular repolarization increased. At 28°C, VF tended to be inducible more frequently (1/11 at 37°C, 1/11 at 32°C, and 5/11 hearts at 28°C), and some VFs at 28°C required greater defibrillation energy to resume basic rhythm.An advanced but not a mild hypothermic condition had an enhanced arrhythmogenic potential in our model. In the advanced hypothermic condition, VF with relatively prolonged F-F intervals and a greater defibrillation energy were occasionally inducible based on the arrhythmogenic substrate characterized as slowed conduction and prolonged repolarization of the ventricle.

DOI： 10.1536/ihj.18-711

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier Ltd  

In an 86-year-old woman who had been treated for sick sinus syndrome, the small high-frequency current delivered by pacemaker in order to measure the minutes ventilation for utilizing the rate-response mode was transiently over-sensed on the Holter electrocardiogram. Although her pacing system was working appropriately, the numbers of the paced beats on the automatic Holter analysis were undercounted (from >60% to <5%) during the over-sensing periods because these currents were recognized as multiple pacing spikes. Physicians need to pay attention to such multiple pacing spike markers, because these can be a cause of unreliable results of the Holter analysis. <Learning objective: Paying attention to multiple pacing spike markers on Holter electrocardiogram is clinically important in patients treated by a rate-response pacemaker. This is because (1) this does not imply the malfunction of the pacemaker system, and (2) results from automatic Holter analysis would not be reliable during the period when these multiple pacing markers were recorded.>.

DOI： 10.1016/j.jccase.2017.08.007

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：新潟医学会  

【目的】深部心筋から生じる不整脈の新しい治療法として期待されるバイポーラー高周波アブレーションの有効性と安全性を実験的に検証する. 【方法】食肉用のブタ心筋切片を用いて実験水槽内で高周波通電を行い (30-40W, 総計122回) , 形成される焼灼傷の大きさ, 貫壁性焼灼の達成度, スチームポップ現象の発生頻度を検討した. 高周波通電モードは, (1) 2本のイリゲーションカテーテルによるバイポーラー通電 (BIP-4) , (2) 2本のイリゲーションカテーテルによるシーケンシャル・ユニポーラー通電 (SEQ) , (3) イリゲーションカテーテルと8mm大型電極ノン・イリゲーションカテーテルによるバイポーラー通電 (BIP-8) を用いた. 【結果】SEQの心筋焼灼深達度は浅く, BIP-4と同等の深部焼灼効果を得ることはできなかった (SEQ vs. BIP-4, 30W : 5.53±1.84 vs. 9.36±2.09mm, P=0.0216, 40W : 6.98±2.01 vs. 10.30±1.78mm, P=0.0362) が, 表面焼灼面積は同等であった. BIP-8での心筋焼灼深達度もBIP-4に至らなかった (30W : 5.98±2.09mm, 40W : 7.54±2.25mm) . 心筋貫壁性焼灼傷の達成はBIP-4で高かったが (30W : 32.4%, 40W : 35.3%) , 同時にスチームポップ現象も高率に観察された (30W : 5.9%, 40W : 14.7%) . SEQでは心筋貫壁性焼灼傷もスチームポップ現象も観察されなかった. 【結論】深部心筋の不整脈起源を焼灼する効果はBIP-4が最も優れており, 2本のイリゲーションカテーテルの必要性が示された. 同時にスチームポップ現象の併発率も高率であったため, 有効・安全にバイポーラー高周波アブレーションを施行するための新たな通電指標の構築が課題にあげられた.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY  

BACKGROUND: During bipolar (BIP) radiofrequency (RF) ablation using two catheters in humans, each catheter is placed in separate cardiac chambers or spaces. We developed a contact force-controlled experimental preparation, and compared measurements made with two catheters placed in a single bath (SB), versus each catheter placed in separate baths, in order to assess the preparation-dependent differences in the results of BIP-RF ablation. METHODS: In the SB experiments, a porcine heart was placed in the center of the bath, while in the dual-bath (DB) experiments, it was placed between two half baths communicating through windows. RESULTS: The initial impedance was greatest (110.5 ± 7.2 Ω) with the BIP-DB, followed by the BIP-SB (92.0 ± 5.6 Ω) and the unipolar (UNIP) DB (84.9 ± 4.7 Ω) configurations. During 50-W ablation for 60 seconds at a 20-g contact force, the root mean square voltage was 75.7 ± 2.5 V in the BIP-DB, 68.0 ± 2.1 V in the BIP-SB, and 66.8 ± 2.0 V in the UNIP-DB. The mean surface lesion diameters were similar among the three configurations. However, the endocardial lesion depth was 5.60 ± 0.56 mm with the BIP-DB, 4.71 ± 0.64 mm with the BIP-SB, and 4.24 ± 0.58 mm with the UNIP-DB configuration. On average, the endocardial lesions were significantly deeper than the epicardial ones. CONCLUSIONS: BIP ablation created much deeper lesions as compared to UNIP ablation. Lesion depth could be different depending on experimental preparation, and contact force-controlled DB preparation may be a much more appropriate model for studying the effects of BIP ablation.

DOI： 10.1111/pace.12993

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

BACKGROUND Catheter ablation of the renal artery can be performed without apparent angiographic stenosis. This suggests that renal nerve function can be attenuated with minor structural damage to the renal artery.
OBJECTIVE To clarify this hypothesis, we examined the relationship between electrical nerve stimulation (ENS)-induced blood pressure (BP) response and severity of histological injury of the renal artery using an acute canine model of renal artery ablation.
METHODS An irrigation catheter was inserted into the renal arteries of 8 dogs, and radiofrequency current was delivered at 15, 20, or 25 W. ENS was applied to each artery before and after ablation.
RESULTS Before ablation, ENS increased the BP and heart rate from 145 15/86 13 to 189 21/111 19 mm Hg and from 116 9 to 130 6 beats/min, respectively. Heart rate variability indices and serum catecholamine levels were elevated concomitantly. After ablation, the ENS -induced increase in BP and heart rate were markedly attenuated after 15 W ablation and those were nearly completely inhibited after 20 or 25 W ablation. An increase in heart rate variability indices and serum catecholamine levels became insignificant regardless of the applied energy. Renal artery angiograms revealed stenotic lesions only after 25 W ablation procedures. Histological studies showed mild to moderate injury of the arterial wall and autonomic nerves caused by 20 and 25 W ablation procedures, whereas only minor changes caused by 15 W ablation.
CONCLUSION Functional renal autonomic nerve ablation is potentially performable with the guidance of ENS.

DOI： 10.1016/j.hrthm.2016.04.021

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記述言語：日本語   出版者・発行元：公益財団法人 日本心臓財団  

腎動脈アブレーションでは両側腎動脈に高周波通電が行われているが, その根拠は明らかにされていない. 高周波通電が両側腎動脈に行われる理由を検証するため動物実験を行った. ビーグル犬を用いて血圧調整における左右腎交感神経興奮の効果を, 腎動脈高周波アブレーション前後の神経電気刺激の昇圧反応から検討した. 腎動脈にイリゲーションカテーテルを挿入して高周波通電を片側腎動脈に行い, 先端電極からの神経電気刺激をアブレーション前後で施行した. アブレーション前の神経電気刺激で昇圧速脈反応が左右腎動脈で同程度に誘発され, 心拍変動解析の交感神経指標と血中カテコラミン値も上昇した. アブレーションを施行した腎動脈では神経電気刺激による昇圧速脈反応は観察されなくなったが, アブレーションをしなかった腎動脈の神経電気刺激では, アブレーション前と同等の昇圧速脈反応が再度誘発された. 腎交感神経刺激による全身交感神経緊張は左右腎動脈で同等に生じ, 一側腎動脈アブレーションは, 対側腎動脈刺激の昇圧速脈誘発に影響を与えなかった. 腎動脈アブレーションで成果を得るには, 両側腎動脈通電が望まれることを支持する所見と思われる.&lt;/p&gt;

DOI： 10.11281/shinzo.48.608

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：一般社団法人 日本不整脈心電学会  

交感神経興奮は器質的心疾患症例の心室不整脈に対する催不整脈効果を有し，迷走神経興奮は抗不整脈作用を示すと考えられる．自律神経興奮はその強度のみならず，交感神経興奮と迷走神経興奮のバランス，変動のダイナミクスも不整脈発症に影響を及ぼす．日常診療では，器質的心疾患を有する心室不整脈に，心機能と不整脈の両面からβ遮断薬が用いられるとともに，β遮断薬作用を併せもつIII群抗不整脈薬が処方されている．繰り返し生じる心室頻拍によりelectrical stormに陥った場合，自律神経は重要な治療介入ポイントとなる．初期治療では鎮痛・鎮静・麻酔とともにβ遮断薬が用いられるが，重症例では短期作用型β遮断薬静注，さらには心臓交感神経のブロック・切除，腎動脈カテーテルアブレーション，硬膜外ブロックなどの非薬物治療が用いられる場合があり，交感神経興奮抑制を介した一定の治療効果が期待できる．

DOI： 10.5105/jse.36.31

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JAPAN SOC INTERNAL MEDICINE  

Objective The dominant frequency (DF) in frequency analyses is considered to represent the objective cycle length and complexity of activation under conditions of ventricular fibrillation (VF). However, knowledge regarding the mechanisms determining the DF in human VF is limited. We studied the characteristics of the DF of human VF and relationship between DF and the defibrillation threshold.
Methods Seventy-two implantable cardioverter-defibrillator patients and 211 VF were studied. Using defibrillation tests, we performed a frequency analysis with fast Fourier transformation. The correlations between DF and clinical characteristics, including the defibrillation threshold, were assessed.
Results The mean DF of all induced VFs was 5.2 +/- 0.8 Hz. The patients were divided into two groups according to DF: the low-DF (DF &lt;5.2 Hz, n=32) and high-DF (DF &gt;= 5.2 Hz, n=40) groups. The frequency of structural heart disease was significantly higher in the low-DF group. In addition, the QRS duration, QT interval and effective refractory period of the right ventricle (RV-ERP) were significantly longer in the low-DF group. A multivariate analysis showed RV-ERP to be the only independent predictor of DF. Excluding patients receiving group III anti-arrhythmic drugs, which are known to have potent defibrillation threshold effects, the defibrillation threshold was significantly lower in the low-DF group (p=0.026).
Conclusion We found that the DF of human VF is associated with underlying heart disease, the cardiac function, cardiac conduction, ventricular refractoriness and defibrillation threshold. Our findings may be useful for identifying and managing patients with a high defibrillation threshold.

DOI： 10.2169/internalmedicine.54.3113

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記述言語：日本語   出版者・発行元：(一社)新潟県臨床検査技師会  

トレッドミル運動負荷試験中のQT間隔の変動がBazett補正式で適正に補正されるか検討した。対象は健常者226名とし、運動によるQT/QTc間隔のダイナミクスを回帰曲線式で分析した。結果、安静臥位から立位への体位変化または運動中の心拍数増加に伴ってBazett補正によるQTc間隔が適正範囲を逸脱した者が23%存在した。

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記述言語：日本語   出版者・発行元：(一社)新潟県臨床検査技師会  

心電図でJ波を認めた正常洞調律の27例(男19例、女8例、平均36歳)を対象に、時系列コンピュータ解析によりJ波高の定量的評価を行った。24時間心電図で期外収縮等を除外した正常心拍を毎分加算平均し、QRS波の開始直前の基線を基準点としてR波頂点の8ms後から72ms後までの区間の電位高を8ms間隔ごとに計測した。この結果とマニュアル計測したJ波高とは、幅広いレンジでほぼ一致した。J波高には日内変動がみられ、夜間上昇型が22例(A群)、非夜間上昇型が5例(B群)で、患者背景やJ波高の変動幅は両群間で有意差がなかった。心拍変動解析では、高周波成分(HF)パワーは両群とも夜間に上昇し、低周波成分/HFは夜間に低下する傾向で、日中のHFパワーに有意差はなかったが、夜間はA群で有意に高値であった。A群の最大J波高はHFパワー値と正の相関を示し、夜間のJ波増高に迷走神経興奮の関与が示唆された。

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記述言語：日本語   出版者・発行元：科学評論社  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Radiofrequency (RF) catheter ablation of the renal artery is therapeutic in patients with drug-refractory essential hypertension. This study was designed to examine the role of the renal autonomic nerves and of RF application from inside the renal artery in the regulation of blood pressure (BP). An open irrigation catheter was inserted into either the left or right renal artery in 8 dogs. RF current (17±2 watts) was delivered to one renal artery. Electrical autonomic nerve stimulation was applied to each renal artery before and after RF ablation. BP, heart rate, indices of heart rate variability, and serum catecholamines were analyzed. Before RF ablation, electrical autonomic nerve stimulation of either renal artery increased BP from 150±16/ 92±15 to 173±21/105±16 mm Hg. After RF ablation, BP increased similarly when the nonablated renal artery was electrically stimulated, although the rise in BP was attenuated when the ablated renal artery was stimulated. Serum catecholamines and sympathetic nerve indices of heart rate variability increased when electrical autonomic nerve stimulation was applied before RF ablation and to the nonablated renal artery after RF ablation, although it changed minimally when the ablated renal artery was stimulated, suggesting interconnectivity between afferent renal nerve stimulation and systemic sympathetic activity. Renal artery angiogram showed no apparent injury after RF ablation. In conclusion, electrical stimulation of the renal arterial autonomic nerves increases BP via an increase in central sympathetic nervous activity. This response might be used to determine the target ablation site and end point of renal artery RF ablation. © 2012 American Heart Association, Inc.

DOI： 10.1161/HYPERTENSIONAHA.111.00095

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担当区分：筆頭著者   記述言語：日本語   出版者・発行元：医歯薬出版(株)  

T波は心室の再分極過程を反映する。T波高は各誘導ともQRS波振幅の10%以上で、肢誘導では0.5mV以下、胸部誘導では1.0mV以下である。T波異常は増高T波、平坦化(平低化)T波、陰性T波に大別される。T波の極性および形状から心臓で生じている電気現象をイメージし、心電図を読み解くことが重要である。(著者抄録)

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記述言語：日本語   出版者・発行元：(株)日本臨床社  

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記述言語：日本語   出版者・発行元：(株)日本臨床社  

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：メディカルレビュー社  

CiNii Article

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その他リンク： http://search.jamas.or.jp/link/ui/2015060704

記述言語：日本語   出版者・発行元：医学出版  

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その他リンク： http://search.jamas.or.jp/link/ui/2014124469

記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：羊土社  

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その他リンク： http://search.jamas.or.jp/link/ui/2013181427

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