Electroanatomic mapping of the left ventricle in a porcine model of chronic myocardial infarction with magnetic resonance-based catheter tracking.

Background: X-ray fluoroscopy constitutes the fundamental imaging modality for catheter visualization during interventional electrophysiology procedures. The minimal tissue discriminative capability of fluoroscopy is mitigated in part by the use of electroanatomic mapping systems and enhanced by the integration of preacquired 3-dimensional imaging of the heart with computed tomographic or magnetic resonance (MR) imaging. A more ideal paradigm might be to use intraprocedural MR imaging to directly image and guide catheter mapping procedures.

Esophageal injury and temperature monitoring during atrial fibrillation ablation.

Background: It is common practice to empirically limit the radiofrequency (RF) power when ablating the posterior left atrium during atrial fibrillation ablation to avoid thermal injury to the esophagus. The objective of this study was to determine whether RF energy delivery limited by luminal esophageal temperature (LET) monitoring is associated with a reduction in esophageal injury compared with a strategy of RF power limitation alone.

Methods And Results: Eighty-one consecutive patients who underwent atrial fibrillation ablation followed by esophageal endoscopy were included in this observational study.

High prevalence of nasopharyngeal colonization by Staphylococcus aureus among children with HIV-1 infection in extreme southern Brazil.

Objectives: To compare nasopharyngeal colonization between children with HIV-1 infection and those without HIV-1 infection, with special emphasis on nasopharyngeal carriage of Staphylococcus aureus.

Methods: This hospital-based cross-sectional study was carried out in the Paediatric Day Hospital of a teaching hospital. Nasopharyngeal swabs were collected in 93 children aged up to 18 years old born to HIV-positive mothers (31 children with HIV-1 infection and 62 age-matched non-infected children).

Effect of presenting rhythm on image integration to direct catheter ablation of atrial fibrillation.

Introduction: Magnetic resonance (MR) imaging of the left atrium (LA) can be integrated with electroanatomic mapping systems to guide catheter ablation of atrial fibrillation (AF). The usefulness of this technique is dependent on the accuracy of image integration.

Objective: The aim of this study is to determine the effect of heart rhythm at the time of pre-procedure MR imaging and heart rhythm at the time of ablation on integration error.

Temporary occlusion of the great cardiac vein and coronary sinus to facilitate radiofrequency catheter ablation of the mitral isthmus.

Introduction: Ablation of the mitral isthmus to achieve bidirectional conduction block is technically challenging, and incomplete block slows isthmus conduction and is often proarrhythmic. The presence of the blood pool in the coronary venous system may act as a heat-sink, thereby attenuating transmural RF lesion formation. This porcine study tested the hypothesis that elimination of this heat-sink effect by complete air occlusion of the coronary sinus (CS) would facilitate transmural endocardial ablation at the mitral isthmus.

Immediate ureterovaginal fistula secondary to oocyte retrieval--a case report.

Objective: To report a case of ureterovaginal fistula secondary to transvaginal oocyte retrieval (TVOR).

Design: Case report.

Setting: IVF Center IN a private hospital.

[Psycho-pathological risk factor of arterial disease (prevalence, superposition or vinculation with other factors)].

Alexitimia and depression may or not coexist with others risk factors (comportment o physical). Frecuently they have relation with socio-echonomic status and with ethnia. Sometimes are determinants of the atherosclerotic process by increasing the vascular reactivity by the alteration of the evolution.

Atrial tachycardia after ablation of persistent atrial fibrillation: identification of the critical isthmus with a combination of multielectrode activation mapping and targeted entrainment mapping.

Background: Atrial tachycardia (AT) that develops after ablation of atrial fibrillation often poses a more difficult clinical situation than the index arrhythmia. This study details the use of an impedance-based electroanatomic mapping system (Ensite NavX) in concert with a specialized multielectrode mapping catheter for rapid, high-density atrial mapping. In this study, this activation mapping was combined with entrainment mapping to eliminate ATs developing late after atrial fibrillation ablation.

The proarrhythmic effect of incomplete pulmotricuspid isthmus ablation in a patient with sarcoid-related ventricular tachycardia?

Proarrhythmia is relatively common after extensive atrial ablation for atrial fibrillation, but has not been frequently documented after catheter ablation of ventricular tachycardia (VT). In theory, this phenomenon could occur if an incomplete ablation line is created between two nonconducting structures, such as dense scar or valvular annuli. This report illustrates the possible proarrhythmic effect of ablation in a patient with sarcoid-related VT and extensive right ventricular (RV) myopathy who presented with slow incessant VT one month after an ablation procedure including ablation at the pulmotricuspid isthmus (PTI).

Balloon catheter ablation to treat paroxysmal atrial fibrillation: what is the level of pulmonary venous isolation?

Background: Unlike the initial balloon ablation catheters that were designed to deliver ablation lesions within the pulmonary veins (PVs), the current balloon prototypes are fashioned to deliver lesions at the PV ostia.

Objective: Using electroanatomical mapping, this study evaluates the actual location of ablation lesions generated by cryo-based, laser-based, or ultrasound-based balloon catheters.

Methods: In a total of 14 patients with paroxysmal atrial fibrillation, PV isolation was performed using either a cryoballoon catheter (8 patients), laser catheter (4 patients) or ultrasound balloon catheter (2 patients).

Transient deformation analysis by a carrier method of pulsed electronic speckle-shearing pattern interferometry.

The introduction of a pulsed laser into an electronic speckle-shearing pattern interferometer allows high-speed transient deformations to be measured. We report on a computerized system that permits automatic data reduction by introducing carrier fringes through the translation of a diverging lens. The quantitative determination of the phase map that is due to deformation is carried out by the spatial synchronous detection method.

Extreme shearing interferometry: theoretical limits with practical consequences.

In this work we analyze the frequency response, the spatial distribution and continuity of the recovered phase in Lateral Shearing Interferometry (LSI). This frequency content and topology of the recovered phase is analyzed for the forward LSI operator as well as its inverse LSI operator using one, two, or n two-dimensional sheared interferograms. The spatial frequency response of the shearing interferometer is well known and for the reader's convenience, it is briefly revisited in a new perspective.

Catheter ablation of peri-AV nodal atrial tachycardia from the noncoronary cusp of the aortic valve.

Introduction: Atrial tachycardias (AT) originating from the anteroseptal region of the aortic root, near the atrioventricular node can be challenging to eliminate safely by catheter ablation. In this study, we examine the characteristics of anteroseptal ATs in a cohort of patients at our centers, and demonstrate the long-term efficacy and safety of targeting the arrhythmias from within the base of the noncoronary aortic valve cusp (NCC).

Methods & Results: From among a cohort of 54 patients with symptomatic focal AT undergoing invasive electrophysiological evaluation, the point of earliest right atrial (RA) activation was at the peri-AV nodal region in 10 patients, just postero-superior to the His-bundle.

Intraprocedural volume imaging of the left atrium and pulmonary veins with rotational X-ray angiography: implications for catheter ablation of atrial fibrillation.

Introduction: The use of preprocedural CT or MR imaging to generate patient-specific cardiac anatomy greatly facilitates catheter ablation of the left atrium and pulmonary veins (LA-PVs) to treat atrial fibrillation (AF). This report details the accuracy and utility of an intraprocedural means to generate 3-D volumetric renderings of the LA-PV anatomy: contrast-enhanced rotational X-ray angiography (3DRA).

Methods And Results: Preprocedural CT or MR imaging and intraprocedural rotational angiography was performed in 42 patients undergoing AF ablation procedures.

Improving model construction of profile HMMs for remote homology detection through structural alignment.

Background: Remote homology detection is a challenging problem in Bioinformatics. Arguably, profile Hidden Markov Models (pHMMs) are one of the most successful approaches in addressing this important problem. pHMM packages present a relatively small computational cost, and perform particularly well at recognizing remote homologies.

ProtozoaDB: dynamic visualization and exploration of protozoan genomes.

ProtozoaDB (http://www.biowebdb.org/protozoadb) is being developed to initially host both genomics and post-genomics data from Plasmodium falciparum, Entamoeba histolytica, Trypanosoma brucei, T.

Pain and anatomical locations of radiofrequency ablation as predictors of esophageal temperature rise during pulmonary vein isolation.

Introduction: Esophageal temperature rise (ETR) during ablation inside left atrium has been reported as a marker for esophageal thermal injury. We sought to investigate the possible relationships between chest pain and ETR during radiofrequency (RF) ablation, and ETR and locations of RF application, in patients undergoing pulmonary vein (PV) isolation under moderate sedation.

Methods And Results: We analyzed anatomical locations of each RF application and its association with esophageal temperature and presence/absence of pain.

Isolating the posterior left atrium and pulmonary veins with a "box" lesion set: use of epicardial ablation to complete electrical isolation.

Similar to the surgical mini-maze procedure, the posterior "box" lesion set employs linear ablation lesions along the anterior aspects of both sets of PVs connected by a roof line and an inferior line to electrically isolate the PVs and complete posterior LA wall en masse. However, creating fully transmural linear atrial lesions can be difficult to achieve, even with an irrigated ablation catheter. This report details a case wherein a combined endocardial and epicardial approach was required to create an electrically continuous posterior box lesion in a patient with persistent AF.

Experimental efficacy of pericardial instillation of anti-inflammatory agents during percutaneous epicardial catheter ablation to prevent postprocedure pericarditis.

Introduction: Pericarditis is a potential complication of catheter-based percutaneous epicardial mapping and ablation. This study evaluates the efficacy and safety of intrapericardial instillation of anti-inflammatory agents after pericardial mapping and ablation in a porcine model of postprocedural pericarditis.

Methods And Results: Twenty-five healthy swine underwent epicardial mapping and ablation after transthoracic subxyphoid puncture.

The influence of early conditions on health status among elderly Puerto Ricans.

The demographic origins of aging in Puerto Rican and other Latin American and Caribbean (LAC) countries may have important implications for the profile of health status and mortality of elderly people. For this article we tested a general conjecture about the relation between early childhood conditions and adult health status among Puerto Rican elderly using a rich data set recently collected through an island-wide survey (N = 4,293). We examined the association between markers of early nutritional status, self-reports of health and on socioeconomic conditions during early childhood, and the prevalence of 3 conditions during adult ages: obesity, diabetes, and cardiovascular diseases.

Compression of the left atrium by the thoracic aorta in patients undergoing pulmonary vein isolation procedure for atrial fibrillation.

Introduction: With the increasing use of pre-procedural imaging techniques such as magnetic resonance imaging (MRI) and their integration with electroanatomic mapping systems in catheter ablation for atrial fibrillation (AF), atypical anatomy of the pulmonary veins (PV), left atrium (LA) and their relationship to the thoracic aorta is increasingly recognized.

Objective: To characterize atypical LA-PV anatomies revealed by pre-procedural MRI and their impact on the safety and efficacy of AF ablation procedures.

Materials And Methods: We reported four patients who underwent AF ablation in our electrophysiology laboratory within the last year who had atypical LA-PV anatomy due to aorta compression recognized by pre-procedural three-dimensional (3D) MRI and anatomic segmentation.

Combined ventricular endocardial and epicardial substrate mapping using a sonomicrometry-based electroanatomical mapping system.

Background: Substrate mapping using a magnetic electroanatomical mapping system (MEAM) has been shown to accurately delineate the location/extent of scarred myocardium. This study examined the ability of a sonomicrometry-based electroanatomic mapping system (SEAM) to render endocardial and epicardial substrate maps of infarcted ventricular myocardium.

Methods And Results: In 7 swine with healed myocardial infarctions, combined epicardial and endocardial left ventricular (LV) substrate maps were created with both SEAM and MEAM mapping systems using 246+/-68 and 244+/-44 points respectively.