Introduction: The aim of this study was to compare the outcome of anatomical pulmonary vein (PV) radiofrequency (RF) ablation with that of an integrated approach (anatomical with electrophysiological confirmation of PV disconnection).
Methods: Sixty consecutive patients affected by drug-refractory paroxysmal (39), persistent (13), and permanent (8) atrial fibrillation (AF) were assigned to an anatomical (group A: 30 patients; 25 male, 5 female, mean age: 55 +/- 7 years) or integrated approach (group B: 30 patients; 26 male, 4 female, mean age: 52 +/- 9 years). In all cases, RF ablation was performed by means of the Carto system in order to anatomically create circumferential lines around PVs. In group B, the persistence of PV potentials was then assessed with a multipolar circular catheter. If PV potentials persisted, RF pulses targeting the electrophysiological breakthroughs were delivered to disconnect PVs.
Results: Total procedure duration, fluoroscopy time, and RF delivery time were similar in both groups: 227 +/- 43, 50 +/- 23, and 43 +/- 16 minutes (group A); 232 +/- 32, 55 +/- 15, and 42 +/- 10 minutes (group B), respectively (ns). One asymptomatic PV stenosis and one pericardial effusion occurred in group A and B, respectively. After 15.4 +/- 7.4 months, 17 (57%) group A patients and 25 (83%) group B patients were in stable sinus rhythm (P = 0.02) (RR 1.78; 95% CI: 1.7-2.9).
Conclusions: PV ablation by means of an integrated anatomical and electrophysiological approach seems more effective than a purely anatomical RF ablation approach. Electrophysiological confirmation of PV disconnection could be a useful marker of successful RF treatment of AF.
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http://dx.doi.org/10.1111/j.1540-8167.2005.00217.x | DOI Listing |
Z Evid Fortbild Qual Gesundhwes
January 2025
Institut für Medizinmanagement und Gesundheitswissenschaften (IMG) der Universität Bayreuth, Bayreuth, Deutschland.
Introduction: Unmet health care needs are seen as a key indicator of equity in access to health care. With younger people, they can lead to poorer health outcomes in adulthood, and in older people they can be associated with an increased risk of mortality. The presence of a disability is considered a risk factor for unmet needs.
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January 2025
Venture Rehabilitation Sciences Group, Saskatoon, SK, Canada; School of Rehabilitation Science, University of Saskatchewan, Saskatoon, SK, Canada. Electronic address:
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Acad Radiol
January 2025
Department of Radiology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China (Q.X.). Electronic address:
Rationale And Objectives: Alzheimer's disease (AD) is the most common pathogenesis of dementia, and mild cognitive impairment (MCI) is considered as the intermediate stage from normal elderly to AD. Early detection of MCI is an essential step for the timely intervention of AD to slow the progression of this disease. Different form previous studies in the whole-brain spontaneous activities, this research aimed to explore the low-frequency amplitude spectrum activities of patients with MCI within the default mode network (DMN), which has been involved in the process of maintaining normal cognitive function.
View Article and Find Full Text PDFTransplant Proc
January 2025
Department of Nephrology, La Paz University Hospital, Madrid, Spain.
The management of anticoagulation and antiplatelet therapy in stage V chronic kidney disease (CKD) patients undergoing renal transplantation remains controversial. Some centers advocate for the use of reversal agents or procoagulants preoperatively, while others suggest that transplantation can proceed safely without halting these treatments. This study aims to evaluate the incidence of hemorrhagic and thrombotic complications in the first 72 hours post-transplant in patients receiving anticoagulant or antiplatelet therapy compared to a control group without such treatments.
View Article and Find Full Text PDFHPB (Oxford)
December 2024
Institute for Surgical Pathology, Medical Center - University of Freiburg, Germany; Core Facility for Histopathology and Digital Pathology, University of Freiburg, Germany; Faculty of Medicine, University of Freiburg, Germany. Electronic address:
Background: In pancreatic surgery Postoperative pancreatic fistula (POPF) represents the most dreaded complication, for which pancreatic texture is acknowledged as one of the strongest predictors. No consensual objective reference has been defined to evaluate the pancreas composition. The presented study aimed to mine histology data of the pancreatic tissue composition with AI assist and correlate it with clinic-pathological parameters derived from the RECOPANC study.
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