2022/03/31 更新

写真a

スガ カズマサ
須賀 一将
SUGA Kazumasa
所属
医学部附属病院 循環器内科 病院助教
職名
病院助教
外部リンク

学位 1

  1. 学士(医学) ( 2009年3月   藤田保健衛生大学 ) 

研究分野 1

  1. ライフサイエンス / 循環器内科学  / カテーテルアブレーション

 

論文 7

  1. Efficacy of His Bundle Pacing on LV Relaxation and Clinical Improvement in HF and LBBB 国際誌

    Kato Hiroyuki, Yanagisawa Satoshi, Sakurai Taku, Mizuno Chiaki, Ota Ryusuke, Watanabe Ryo, Suga Kazumasa, Okada Takuya, Murakami Hisashi, Kada Kenji, Inden Yasuya, Tsuboi Naoya, Murohara Toyoaki

    JACC-CLINICAL ELECTROPHYSIOLOGY   8 巻 ( 1 ) 頁: 59 - 69   2022年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JACC: Clinical Electrophysiology  

    Objectives: This study aimed to compare acute hemodynamic improvements and responses to His bundle pacing (HBP) and conventional biventricular pacing (BVP). Background: HBP can correct left bundle branch block (LBBB) and may be an alternative cardiac resynchronization therapy (CRT) to BVP. Methods: Fourteen consecutive patients with heart failure (HF) and typical LBBB who required CRT were enrolled. The acute hemodynamic responses during HBP and BVP were compared using a micromanometer-tipped catheter inserted into the left ventricle (LV) before CRT. Each configuration was compared with AAI mode. A permanent HBP device was implanted when LBBB correction threshold was ≤1.5 V at 1.0 ms, and remaining patients were treated with BVP. Clinical and echocardiographic improvements were assessed during a 12-month follow-up period. Results: The LV contractile index (positive maximal rate of LV pressure rise [dP/dtmax]) increased similarly during HBP and BVP (18.8% ± 6.4% vs 18.0% ± 10.2%; P = 0.810). LV relaxation indices (negative dP/dtmax and tau) were significantly improved during HBP compared with BVP (negative dP/dtmax: 14.3% ± 5.5% vs 3.1% ± 8.1%; P < 0.001; tau: 7.2% ± 4.3% vs −0.8% ± 8.1%; P = 0.001). Nine (64%) patients received permanent HBP devices, while 5 patients were treated with BVP. The New York Heart Association functional class, LV ejection fraction, LV end-systolic volume, and B-type natriuretic peptide level improved in patients treated with HBP and BVP (all P < 0.05 vs baseline). Patients treated with HBP exhibited earlier and greater improvements of the LV ejection fraction and LV end-systolic volume than did those with BVP. Conclusions: HBP improves systolic function and LV relaxation in patients with HF and LBBB. CRT via HBP produced earlier and greater clinical responses than BVP.

    DOI: 10.1016/j.jacep.2021.06.011

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  2. Permanent His-bundle pacing using distal His-bundle electrogram-guided approach in patients with atrioventricular block 査読有り 国際誌

    Suga Kazumasa, Kato Hiroyuki, Inden Yasuya, Yanagisawa Satoshi, Murakami Hisashi, Kada Kenji, Tsuboi Naoya, Murohara Toyoaki

    PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY   44 巻 ( 11 ) 頁: 1907 - 1917   2021年11月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:PACE - Pacing and Clinical Electrophysiology  

    Background: Permanent His-bundle pacing (HBP) is effective and safe; however, the success rate of HBP is low, especially in patients with infranodal block. This study aimed to assess the efficacy and feasibility of HBP implantation using an electrophysiological guided approach targeting a distal His-bundle electrogram (HBE) in patients with atrioventricular block (AVB). Methods: Thirty-four consecutive patients with AVB (infranodal block in 28 patients) who underwent HBP were enrolled. During implantation, we attempted to target the distal part of the HBE (distal HBE) beyond the block site based on unipolar mapping. The His-capture threshold was evaluated for 1 year after implantation. Results: HBP was achieved in 26 patients and in 21 patients (75%) with infranodal block. Detection of distal HBE was significantly higher in the successful HBP group than in the HBP failure group (65.4% vs. 0%, p =.001). Among 15 patients with intra-Hisian block, 14 patients (93%) successfully achieved HBP with distal HBE detection. During the 1-year follow-up period, an increase in His-capture threshold by ≥1.0 V at 1.0 ms occurred in five (19.2%) of 26 patients. The increased His-capture threshold group exhibited significantly less detection of distal HBE (20% vs. 76.2%; odds ratio 0.078, 95% confidence interval 0.07–0.87, p =.038) and a higher His-capture threshold at implantation (2.0 ± 1.1 V vs. 1.1 ± 0.9 V; odds ratio 1.702, 95% confidence interval 1.025–2.825, p = 0.04) than the non-increased His-capture threshold group. Conclusion: HBP implantation guided by distal HBE approach may be feasible with subsequent stable pacing in patients with intra-Hisian and atrioventricular nodal block.

    DOI: 10.1111/pace.14363

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  3. Identification of high priority focal activations in persistent atrial fibrillation using a novel mapping strategy

    Shimojo Masafumi, Inden Yasuya, Yanagisawa Satoshi, Riku Shuro, Suga Kazumasa, Furui Koichi, Nakagomi Toshifumi, Okajima Takashi, Shibata Rei, Murohara Toyoaki

    HEART AND VESSELS     2021年10月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Heart and Vessels  

    Focal activation is believed to be an atrial fibrillation (AF) driver; however, little is known about whether all focal activations are necessary for AF persistence. The purpose of this study was to assess the electrical nature of focal activation and identify high-priority focal activations using a novel mapping system (CARTOFINDER). Thirty-five patients with persistent AF who underwent catheter ablation were assessed. Cycle length (CL) and CL standard deviation (CLSD) on unipolar recordings and voltage amplitude and electrogram morphologies on bipolar recordings were evaluated at all points of interest. The most frequent CL at each mapping site was defined as the dominant CL. We identified dominant focal activations (DFAs) that had a shorter dominant CL on the integrated CARTOFINDER map. The effect of elimination of DFAs on AF maintenance was assessed by the composite endpoint (termination to sinus rhythm, organization of the rhythm to atrial tachycardia, and AF CL slowing). In all, 450 focal activations were identified among 10,868 points, and 50.4% of focal activations were DFAs. Focal activations showed relatively long CL and regularity with short CLSD. Most focal activations showed an isoelectric baseline and were located outside of the fractionated electrogram area. Both DFAs and non-DFAs were typically observed in the normal voltage range. Elimination of DFAs was achieved in 19 (54.3%) patients, with a remarkable impact on AF maintenance (68.4% vs. 25.0%, p = 0.018). In conclusion, DFAs may play an important role in AF maintenance and could be an attractive therapeutic target for AF.

    DOI: 10.1007/s00380-021-01977-x

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  4. Incidence of Left Atrial Thrombus Development and Imaging Approach in Patients Scheduled for Repeat Catheter Ablation for Atrial Fibrillation 国際誌

    Yanagisawa Satoshi, Inden Yasuya, Riku Shuro, Suga Kazumasa, Furui Koichi, Nakagomi Toshifumi, Shimojo Masafumi, Okajima Takashi, Shibata Rei, Murohara Toyoaki

    AMERICAN JOURNAL OF CARDIOLOGY   155 巻   頁: 52 - 63   2021年9月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:American Journal of Cardiology  

    The risk for developing left atrial (LA) thrombi after initial catheter ablation for atrial fibrillation (AF) and requirements for imaging evaluation for thrombi screening at repeat ablation is unclear. This study aimed to assess the occurrence of thrombus development and frequency of any imaging study evaluating thrombus formation during repeat ablation for AF. Of 2,066 patients undergoing initial catheter ablation for AF with uninterrupted oral anticoagulation, 615 patients underwent repeat ablation after 258.0 (105.0–882.0) days. We investigated the factors associated with safety outcomes and requirements for thrombus screening. All patients underwent at least one imaging examination to screen for thrombi in the initial session; however, the examination rate decreased to 476 patients (77%) before the repeat session. The frequency of imaging evaluations was 5.0%, 11%, 21%, 84%, and 91% for transesophageal echocardiography and 18%, 33%, 49%, 98%, and 99% for any imaging modality at repeat ablation performed ≤60 days, ≤90 days, ≤180 days, >180 days, and >1 year after the initial session, respectively. Three patients (0.5%) developed LA thrombi at repeat ablation due to identifiable causes, and no patients experienced thromboembolic events when no imaging evaluation was performed. Multivariate analysis revealed that repeat ablation performed after >180 days, non-paroxysmal atrial arrhythmias, and lower left ventricular ejection fraction were predictors of thrombus development and severe spontaneous echocardiography contrast. In conclusion, the risk for thrombus development at repeat ablation for AF was low. There needs to be a risk stratification of the imaging screening for thrombi at repeat ablation.

    DOI: 10.1016/j.amjcard.2021.06.019

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  5. The mechanism and prognosis of acute and late improvement in mitral regurgitation after cardiac resynchronization therapy

    Okamoto Hiroya, Inden Yasuya, Yanagisawa Satoshi, Fujii Aya, Tomomatsu Toshiro, Mamiya Keita, Riku Shuro, Suga Kazumasa, Furui Koichi, Nakagomi Toshifumi, Shibata Rei, Murohara Toyoaki

    HEART AND VESSELS   36 巻 ( 7 ) 頁: 986 - 998   2021年7月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Heart and Vessels  

    Cardiac resynchronization therapy (CRT) improves functional mitral regurgitation (MR); however, the mechanism and differences in acute and late improvement in MR are unclear. We aimed to evaluate the factors associated with the acute and late MR improvements and the prognosis of MR improvement after CRT. This retrospective study included 121 patients who underwent CRT implantation with full echocardiography assessment at baseline, 1 week, and 6 months after implantation. MR severity was classified into five grades (0: none to 4: severe). Two-dimensional speckle-tracking echocardiography with radial strain was used to assess dyssynchrony, and the time difference between the lateral and inferior segments at papillary muscle levels (TDlate-inf) was calculated. The MR improved 1 week and 6 months after CRT in 40 (33%) and 45 (37%) patients, respectively. On multivariate analyses, TDlate-inf (baseline–1 week) and SPWMD were independently associated with acute MR improvement. The %reduction in left ventricular end-systolic volume (LVESV) (baseline–6 months) and TDlate-inf (baseline–1 week) were independently correlated with late MR improvement. The patients with pre-MR grades 2–4 and improved MR after CRT showed significantly better prognosis in heart failure hospitalization. Cutoff values of ≥ 19.5 ms of the reduction of TDlate-inf and ≥ 30.8% of the %reduction of LVESV were significantly associated with the decrease in heart failure hospitalization. The improved interpapillary muscle activation time delay and volume reduction after CRT were associated with acute and late MR improvements. There may be different time course of recovery and distinct causes for late MR improvement.

    DOI: 10.1007/s00380-021-01771-9

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  6. Dynamic Changes in Electrocardiogram Parameters After Epicardial Substrate Catheter Ablation of Brugada Syndrome

    Mamiya Keita, Inden Yasuya, Yanagisawa Satoshi, Fujii Aya, Tomomatsu Toshiro, Okamoto Hiroya, Riku Shuro, Suga Kazumasa, Furui Koichi, Nakagomi Toshifumi, Shibata Rei, Murohara Toyoaki

    日本循環器學誌   advpub 巻 ( 0 ) 頁: 1283 - +   2021年3月

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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 日本循環器学会  

    Background: Catheter ablation (CA) is effective for recurrent episodes of ventricular fibrillation (VF) in Brugada syndrome (BrS). VF development in BrS is associated with several electrocardiogram (ECG) abnormalities. This study investigated changes in ECG parameters in high-risk BrS patients who underwent epicardial CA. Methods and Results: In all, 27 BrS patients were implanted with an implantable cardioverter-defibrillator (ICD). Patients were divided into 2 groups: (1) an ablation group (n=11) that underwent epicardial CA because of VF recurrence; and (2) a primary prevention (PP) group (n=16) with ICD implantation only. ECG parameters were evaluated before and 12 months after CA and compared with ECG parameters in the PP group. The T wave peak-to-end interval was significantly longer and the number of abnormal spikes in leads V1-V3 at the second, third, and fourth intercostal spaces was greater in the ablation than PP group. After ablation, ST levels and the sum of abnormal spikes in leads V1-V3 were significantly decreased. The mean (±SD) number of ICD shocks decreased markedly during a mean follow-up period of 42.0 months (from 3.8±3.7 to 0.2±0.4/year). Four patients had an ICD shock following the ablation procedure. Greater reductions in ST-segment elevation and abnormal spikes were observed in the group without than with VF recurrence. Conclusions: Improvements in surface ECG parameters appear to be associated with successful ablation in high-risk BrS patients.

    DOI: 10.1253/circj.cj-20-1060

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  7. A case of heart failure complicated with double ventricular response triggered by beta blocker 国際誌

    Kazama S., Kondo T., Suga K., Yanagisawa S., Morimoto R., Okumura T., Inden Y., Murohara T.

    HeartRhythm Case Reports   7 巻 ( 3 ) 頁: 174 - 177   2021年3月

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    記述言語:英語   出版者・発行元:HeartRhythm Case Reports  

    DOI: 10.1016/j.hrcr.2020.12.004

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▼全件表示

講演・口頭発表等 4

  1. Relationship between Duration of Pseudo-Delta Wave and Left Ventricular Mechanical Dyssynchrony In Non-selective His Bundle Pacing

    Kazumasa Suga

    2021年3月 

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    国名:日本国  

  2. Permanent His Bundle Pacing In Patients With Atrioventricular Block; The Usefullness Of Distal His Bundle Electrogram 国際会議

    Kazumasa Suga

    Heart Rhythm Society 2020 Science  2020年5月  Heart Rhythm Society

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    記述言語:英語  

    開催地:San Diego  

  3. The Correlation Between Duration Of Pseudo-delta Wave And Left Ventricular Mechanical Dyssynchrony In Non-selective His Bundle Pacing 国際共著 国際会議

    Kazumasa Suga

    Heart Rhythm Society 2020 Science  2020年5月  Heart Rhythm Society

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    記述言語:英語  

    開催地:San Diego   国名:アメリカ合衆国  

  4. Relationship between the Area of Right Ventricular Epicardial Abnormal Potentials and Electrocardiographic Changes in Brugada Syndrome

    The 86th Annual Scientific Meeting of the Japanese Circulation Society  2022年3月  Japanese Circulation Society

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    記述言語:英語   会議種別:口頭発表(一般)  

    開催地:Web