Since its introduction at the beginning of the 1980s, radiofrequency ablation of accessory atrioventricular pathways has become method because of its excellent results and the indications have increased to cases in which only symptomatic improvement is the objective. These advances have been made possible by technical innovations to the generators of the radiofrequency current and, above all, to the ablation catheters which enable mapping nearly all the perimeter of the atrioventricular rings and reach all the accessory pathways irrespective of their site. The approach depends on the localisation of the accessory pathway but the criteria of mapping are the same: detection of a specific accessory pathway potential, precession or concordance (depending on the topography) of the initial peak of the endocavitary ventriculogramme and the onset of the delta wave on the surface ECG, QS morphology of the ventriculogramme on monopolar recording, shortest VA' interval in orthodromic reciprocating tachycardia for latent kent bundles. In specialised centres, the global success rate is 90 to 98% but certain sites, especially the right lateral pathways, are more difficult to attain. The complication rate is about 4% but it tends to decrease with the experience of the operating teams and close monitoring of the patients. However, there persists an uncertainty concerning potentially arrhythmogenic effects of the lesions induced which justifies restricting the indications in young children.
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J Interv Card Electrophysiol
January 2025
Department of Cardiovascular Medicine, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsugagun, Tochigi, 321-0293, Japan.
Background: The conventional mapping approach for the atrioventricular accessory pathway (AP) involves point-by-point mapping to identify the connection sites of the AP to the atria or ventricle and accurate interpretation of local electrograms. Omnipolar mapping technology (OMT) explains how vector and wave speed are produced by using both unipolar and bipolar signals to obtain omnipolar signals, directions, and conduction velocity. The aim of this study is to verify the effectiveness of OMT for catheter ablation of AP.
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RNA Virus Replication Laboratory, The Francis Crick Institute, London, United Kingdom.
Coronaviruses express their structural and accessory genes via a set of subgenomic RNAs, whose synthesis is directed by transcription regulatory sequences (TRSs) in the 5' genomic leader and upstream of each body open reading frame. In SARS-CoV-2, the TRS has the consensus AAACGAAC; upon searching for emergence of this motif in the global SARS-CoV-2 sequences, we find that it evolves frequently, especially in the 3' end of the genome. We show well-supported examples upstream of the Spike gene-within the nsp16 coding region of ORF1b-which is expressed during human infection, and upstream of the canonical Envelope gene TRS, both of which have evolved convergently in multiple lineages.
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Int J Surg Case Rep
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Department of Orthopaedics and Traumatology, Faculty of medicine Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia.
Introduction And Importance: Cleft hand is a rare congenital deformity which may impair the aesthetic appearance and psychosocial of a child. The operative technique of cleft hand is rarely reported. We aimed to describe the surgical management of cleft hand.
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Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, Tennessee.
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