Global multielectrode contact-mapping plus ablation with a single catheter in patients with atrial fibrillation: Global AF study.

Introduction: The critical question for technological advancement of catheter ablation of atrial fibrillation (AF) is whether a creative new concept can combine and even improve the options of single-tip catheters with the simplicity of the use of balloon catheters. Herein are described the results from the first clinical study of a new multielectrode contact-mapping plus ablation array (Globe) offering such a complete solution.

Methods And Results: The multielectrode Globe array consists of 16 flat ribs with 122 gold-plated electrodes.

Therapeutic Approaches to Atrial Fibrillation Ablation Targeting Atrial Fibrosis.

Atrial fibrosis is the fundamental histopathologic finding in atrial fibrillation (AF) patients and an important predictor of ablation failure beyond pulmonary vein isolation. There is wide variation in the extent and localization of left atrial fibrosis in patients with paroxysmal and nonparoxysmal AF. Box isolation of fibrotic areas is an effective rhythm control concept in patients with paroxysmal AF despite durable pulmonary vein isolation, and this strategy has recently been implemented successfully in initial AF ablation procedures in addition to pulmonary vein isolation for patients with nonparoxysmal AF.

A novel ablation approach in atrial fibrillation patients undergoing fibrotic-based substrate modification: Targeting the Bachmann's bundle?

Introduction: Box isolation of fibrotic areas (BIFA) is a promising ablation approach for atrial fibrillation (AF) patients. However, complete isolation of fibrotic anteroseptal left atrial area, where Bachmann's bundle is blending into the left atrial myocardium, is very specific and complex.

Methods And Results: In 34 AF patients with anteroseptal fibrosis, circumferential BIFA was performed in addition to pulmonary vein isolation.

Box Isolation of fibrotic areas: A substrate modification approach in atrial fibrillation patients.

In the last years, atrial fibrosis was shown to be an independent predictor of procedural failure in patients with paroxysmal and persistent atrial fibrillation. Ablation strategies have been developed to improve the outcome of catheter ablation by targeting detected areas of fibrosis, based either on endocardial voltage mapping or cardiac magnetic resonance. Box isolation of fibrotic areas (BIFA) is a new and promising patient-tailored ablation strategy for atrial fibrillation patients targeting substantial fibrotic areas by circumferential isolation of left atrial fibrosis.

Global multielectrode contact mapping plus ablation with a single catheter: Preclinical and preliminary experience in humans with atrial fibrillation.

Introduction: One question for the technological advancement of catheter ablation of atrial fibrillation (AF) is whether a creative new concept can combine and even improve the diagnostic mapping options of single-tip and basket catheters with the simplicity of the use of balloon catheters for ablation. Herein, we describe the first in-human experience with a single catheter offering such a complete solution.

Methods And Results: A new catheter (Globe ) with a distal multielectrode array consisting of 16 ribs with 122 gold-plated electrodes was used.

Catheter ablation of atrial fibrillation with box isolation of fibrotic areas: Lessons on fibrosis distribution and extent, clinical characteristics, and their impact on long-term outcome.

Introduction: The BIFA concept (box isolation of fibrotic areas) supplementing pulmonary vein isolation (PVI) was implemented in atrial fibrillation (AF) patients with fibrotic atrial cardiomyopathy (FACM) to improve catheter ablation outcomes.

Methods And Results: Ninety-two patients with FACM underwent PVI + BIFA. We investigated patient characteristics (58 persistent/34 paroxysmal, 68 ± 8 years, LA 44 ± 7 mm, CHA DS -VASc 2.

Box Isolation of Fibrotic Areas (BIFA): A Patient-Tailored Substrate Modification Approach for Ablation of Atrial Fibrillation.

Background: Catheter ablation strategies beyond pulmonary vein isolation (PVI) for treatment of atrial fibrillation (AF) are less well defined. Increasing clinical data indicate that atrial fibrosis is a critical common left atrial (LA) substrate in AF patients (pts).

Objective: We applied a new substrate modification concept according to the individual fibrotic substrate as estimated from electroanatomic voltage mapping (EAVM) in 41 pts undergoing catheter ablation of AF.

A review of computer-based simulators for ultrasound training.

Computer-based simulators for ultrasound training are a topic of recent interest. During the last 15 years, many different systems and methods have been proposed. This article provides an overview and classification of systems in this domain and a discussion of their advantages.

Efficiency of 7.2% hypertonic saline hydroxyethyl starch 200/0.5 versus mannitol 15% in the treatment of increased intracranial pressure in neurosurgical patients - a randomized clinical trial [ISRCTN62699180].

Introduction: This prospective randomized clinical study investigated the efficacy and safety of 7.2% hypertonic saline hydroxyethyl starch 200/0.5 (7.

Influence of moderate and profound hyperventilation on cerebral blood flow, oxygenation and metabolism.

Objective: The aim of the present study was to examine the impact of moderate and profound hyperventilation on regional cerebral blood flow (rCBF), oxygenation and metabolism.

Materials And Methods: Twelve anesthetized pigs were subjected to moderate (mHV) and profound (pHV) hyperventilation (target arterial pO(2): 30 and 20 mmHg, respectively) for 30 min each, after baseline normoventilation (BL) for 1 h. Local cerebral extracellular fluid (ECF) concentrations of glucose, lactate, pyruvate and glutamate as well as brain tissue oxygenation (p(ti)O(2)) were monitored using microdialysis and a Licox oxygen sensor, respectively.

Experiences with continuous intra-arterial blood gas monitoring: precision and drift of a pure optode-system.

Objective: The utility of continuous intra-arterial blood gas analysis (CBGA) with combined electrochemical and optode sensors has been demonstrated. More recently, a pure optode sensor with a changed sensing element architecture has become available. The aim was to determine the measurement accuracy and long-term stability of the new sensor.

Vertebral autograft used as bone transplant for anterior cervical corpectomy: technical note.

Objective: In this prospective patient study, we used a surgical technique for autograft bone fusion during anterior cervical corpectomy (ACC) in patients experiencing cervical spondylotic myelopathy. We packed the resected bone material of the corpectomy into a titanium mesh cage. To evaluate the efficacy of our autograft technique, we analyzed the results according to neurological outcome, radiological outcome, and complications.