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  • 1
    Electronic Resource
    Electronic Resource
    Usefulness of Atrial Fibrillation Burden as a Predictor for Success of Pulmonary Vein Isolation (2005)
    350 Main Street , Malden , MA 02148-5018 , USA and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Pacing and clinical electrophysiology 28 (2005), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The definition of symptomatic improvement after pulmonary vein isolation (PVI) is controversial. We assessed primarily the usefulness and predictive accuracy (PA) of AF (atrial fibrillation) burden (AFB) within the first 3 months after the procedure as an early predictor for curative success as well as reduction of symptoms. Methods: We studied 100 pts (62 men, mean age: 54 ± 9 years, LVEF: 57 ± 9%, paroxysmal AF, 85, persistent AF, 15) who underwent PVI. RF ablation was used in 63 patients. The combination of cryoablation and RF (Hybrid therapy) was used in the remaining 37 patients, in 19 patients of whom additionally linear lesions were performed. All patients were followed up 3 months after PVI (the blanking period) and every 3 months thereafter. The significance of early recurrence of AF (ERAF) was separately analyzed for RF and for hybrid therapy arm. Quality of life (QoL) was assessed using the physical composite summary score (PCS) and mental composite summary score (MCS). AFB was dichotomized at: 0, 0.5, 1, 6, 12, and 24 hours. Results: ANOVA revealed significant differences between PCS at baseline and after PVI in patients without recurrence and with those with postablation AFB 〈12 hours. There was no difference between PCS in patients with AFB ≥12 hours within a 3 months interval and PCS at baseline. ERAF occurred in 35% of patients (16 patients, AFB ≥12 hours). Symptomatic ERAF occurred in 29 patients (17 patients AFB ≥12 hours). After the blanking period, documented AF recurrence was found in 50 patients (17 patients, AFB ≥12 hour). Symptomatic late recurrence was found in 47 patients (31 patients with AFB ≥12 hours). Absence of ERAF was revealed to be predictive for long-term success and symptomatic ERAF was found to be predictive for symptomatic AF recurrence (P 〈0.0001). Conclusion: AF recurrence with AFB ≥12 hours within 3 months is associated with a missed improvement of QoL. Symptomatic ERAF predicts recurrence independently of therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.2005.00270.x
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  • 2
    Electronic Resource
    Electronic Resource
    Microwave, Irrigated, Pulsed, or Conventional Radiofrequency Energy Source: Which Energy Source for Which Catheter Ablation? (2003)
    350 Main Street , Malden , MA 02148-5018 , USA . : Blackwell Futura Publishing, Inc.
    Pacing and clinical electrophysiology 26 (2003), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: ERDOGAN, A., et al.: Microwave, Irrigated, Pulsed, or Conventional Radiofrequency Energy Source: Which Energy Source for Which Catheter Ablation? The aim of the study was to compare the diameter of endomyocardial lesions induced with the delivery of microwave, cooled, or pulsed energy versus conventional RF energy. In vitro tests were performed in fresh endomyocardial preparations of pig hearts in a 10-L bath of NaCl 0.9% solution at 37°C and constant 1.5 L/min flow. Ablation 7 Fr catheters with 4-mm tip electrodes were used, except for the delivery of microwave energy. Energy delivery time was set to 60 s/50 W in all experiments. Cooled energy delivery was performed with a closed irrigation catheter. Pulsed energy delivery was performed using a special controller with a duty-cycle of 5 ms. Microwave energy was delivered with a 2.5-GHz generator and 10-mm antenna. Electrode temperature and impedance were measured simultaneously. After ablation, lesion length, width, and depth were measured with microcalipers, and volume calculated by a formula for ellipsoid bodies. Each energy delivery mode was tested in ten experiments. The deepest lesions were created with cooled energy delivery, and the largest volume by microwave energy delivery. Pulsed RF produced significantly deeper lesions than conventional RF energy delivery. Cooled or pulsed RF energy delivery created deeper transmural lesions than conventional RF. To create linear lesions at anatomically complex sites (isthmus), microwave energy seemed superior by rapidly creating deep and long lesions. (PACE 2003; 26:[Pt. II]:504–506)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2003.00082.x
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  • 3
    Electronic Resource
    Electronic Resource
    A Decrease in Pulmonary Vein Diameter After Radiofrequency Ablation Predicts the Development of Severe Stenosis (2005)
    350 Main Street , Malden , MA 02148-5018 , USA and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Pacing and clinical electrophysiology 28 (2005), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A decrease in ostial pulmonary vein (PV) diameter was observed in patients on the day after radiofrequency ablation of atrial fibrillation (AF). This study examined whether a relative reduction in PV diameter on day 1 (RRPVD1) after the procedure predicts the late development of severe PV stenosis (PVS). The study included 104 consecutive patients (mean age = 55 years, range 46–61, 34 women) with drug refractory AF. Pulmonary vein diameter was measured using MR angiography (MRA) on the day before and on day 1 after the ablation procedure. The MRA was repeated every 3 months after the procedure. Severe PVS was defined as a 〉70% diameter reduction from the initial ostial diameter. The cut-off of RRPVD1 was prespecified as 25% decrease in initial diameter. The data are presented as medians and interquartile range. A total of 357 PV were treated. The RRPVD1 was 0.0% (0.0–11.1%). Severe PVS was found in 18 PV during a follow-up of 12 months (range 6–13). The log-rank analysis confirmed a strong association between a RRPVD1 ≥25% and the development of PVS (hazard ratio: 7.1; 95% confidence interval 3.8–13.5, P 〈 0.0001). By multivariate Cox regression model, after adjustment of procedure variables, RRPVD1 was the strongest predictor of development of severe PVS. RRPVD1 ≥25% was a strong independent predictor of development of severe PVS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.2005.00018.x
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  • 4
    Electronic Resource
    Electronic Resource
    Invasive Optimization of Cardiac Resynchronization Therapy: Role of Sequential Biventricular and Left Ventricular Pacing (2005)
    350 Main Street , Malden , MA 02148-5018 , USA and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Pacing and clinical electrophysiology 28 (2005), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Aim of this invasive study was to characterize and quantify changes in left ventricular (LV) systolic function due to sequential biventricular pacing (BV) as compared to right atrial triggered simultaneous BV (BV0), LV, and right ventricular (RV) pacing in patients with congestive heart failure (CHF). Methods: In 22 CHF patients, all in sinus rhythm, temporary multisite pacing was performed prior to implantation of a permanent system. LV systolic function was evaluated invasively by the maximum rate of LV pressure increase (dP/dtmax). Sequential BV pacing was performed with preactivation of either ventricle at 20–80 ms. Results: In comparison to RV pacing, LV and BV0 pacing increased dP/dtmax by 33.9 ± 19.3% and 34.0 ± 22.6%, respectively (P 〈 0.001). In 9 patients, optimized sequential BV pacing further improved dP/dtmax by 8.5 ± 4.8% compared to BV0 (range 3.3–17.1, P 〈 0.05). In 10 patients exhibiting a PR interval ≤200 ms, LV pacing was either superior (n = 6) or equal to BV0 pacing (n = 4). In these 10 patients, LV pacing yielded a 7.4 ± 8.0% higher dP/dtmax than BV0 pacing (P 〈 0.05). Conclusions: Using sequential BV pacing, generally with LV preactivation, moderate improvements in LV systolic function can be achieved in selected patients. Baseline PR interval may aid in the selection of the optimum cardiac resynchronization therapy (CRT) mode, favoring LV pacing in patients with a PR interval ≤200 ms.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.2005.00181.x
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  • 5
    Electronic Resource
    Electronic Resource
    Quality-of-Life in Patients with Paroxysmal Atrial Fibrillation After Catheter Ablation: (2003)
    350 Main Street , Malden , MA 02148-5018 , U.S.A . : Blackwell Publishing Inc
    Pacing and clinical electrophysiology 26 (2003), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: ERDOGAN, A., et al.: Quality-of-Life in Patients with Paroxysmal Atrial Fibrillation After Catheter Ablation: Results of Long-Term Follow-Up. Paroxysmal atrial fibrillation (PAF) significantly impairs patients' quality-of-life (QOL). The effect on QOL of recently developed ablation techniques with curative intention has not been studied. Thirty patients (21 men, age 54.1 ± 9.5 years) with PAF (duration 5.6 ± 5.2 years) who failed antiarrhythmic (3.8 ± 1.2 trials) drug therapy underwent catheter ablation. The follow-up time was 33.9 ± 11 months. QOL was assessed preablation, 3, 6, 9, 12, 24, and 36 months after catheter ablation. The Medical Outcomes Survey Short-Form (SF-36), scored on a 0–100 scale for each of eight domains: bodily pain, general health, mental health, physical functioning, role-emotional, role-physical, social functioning, and vitality, was used. Simultaneously, patients filled out a symptom-specific checklist (SSC) with seven clinical items scored 1–4 (1 best): dyspnea, nausea, palpitations, anxiety, syncope, presyncope, and NYHA classification. Patients with successful catheter ablation had a significant benefit in seven of eight subscales while patients with recurrence had an impact on QOL in two of eight subscales. Using SSC, a successful ablation influenced scores in all seven items while patients with recurrence had a significant change of clinical symptoms in only one item, anxiety. The subscales of the study group compared to a healthy population show higher scores after 24 months of follow-up. Patients with PAF experience a significant improvement in QOL after a successful catheter ablation. In contrast, in patients with recurrence of PAF the QOL showed improvement to a lesser extent and patients experienced ongoing symptoms. (PACE 2003; 26:678–684)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2003.00117.x
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  • 6
    Electronic Resource
    Electronic Resource
    Segmentation of the southern Mariana back-arc spreading center (1998)
    Oxford UK : Blackwell Science Pty
    The @island arc 7 (1998), S. 0 
    Details
    ISSN: 1440-1738
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Geosciences
    Notes: SeaBeam multibeam bathymetry obtained during cruise SO-69 of research vessel (R/V) Sonne defines the segmentation and structure of ∼ 300 km of the Mariana back-arc spreading center south of the Pagan fracture zone at 17°33′N. Eight ridge segments, ranging from 14 to 64 km in length, are displaced as much as 2.7–14.5 km by both right- (predominantly) and left-lateral offsets and transform faults. An axial ridge commonly occupies the middle portion of the rift valley and rises from 200 to 700 m above the adjacent sea floor, in places shoaling to a water depth of 3200 m. An exception is the 60-km-long segment between 16°58′ and 17°33′N where single peaks only a few tens of meters high punctuate the rift axis. Photographic evidence and rock samples reveal the presence of mostly pillow lavas outcropping on the axial ridges or peaks whereas the deeper parts of the rift valley floor (max. depth 4900 m) are heavily to totally sedimented. Abundant talus ramps along fault scarps testify to ongoing disruption of the crust. Lozenge-shaped collapse structures are covered by layers of sediment up to tens of centimeters thick on the rift valley floor. The presence of discrete volcanic ridges in the southern Mariana back-arc spreading region suggests that emplacement of oceanic crust at this slow spreading center occurs by `multi-site' injection of magma. Along-axis variations in length, crestal depth, and size of the axial ridges can be best explained by different stages in the cyclicity of magma supply along-axis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1440-1738.1998.00207.x
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  • 7
    Electronic Resource
    Electronic Resource
    Deuterium isotope effects on the solvolysis of 1-(1-adamantyl)ethyl sulfonate esters (1982)
    s.l. : American Chemical Society
    Journal of the American Chemical Society 104 (1982), S. 354-355 
    Details
    ISSN: 1520-5126
    Source: ACS Legacy Archives
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1021/ja00365a092
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  • 8
    Electronic Resource
    Electronic Resource
    Percutaneous Pulmonary Vein Stenting for the Treatment of Severe Stenosis After Pulmonary Vein Isolation (2005)
    350 Main Street , Malden , MA 02148-5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 16 (2005), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Introduction: Pulmonary vein stenosis (PVS) is a potential complication of pulmonary vein isolation (PVI) using radiofrequency energy. The aim of our study was the evaluation of the severity and long-term outcome of primary angioplasty and angioplasty with pulmonary vein stenting for PVS. Methods and Results: Twelve patients with 15 PVS (greater than 70% stenosis) were prospectively evaluated. Primary dilation of the stenosis was performed because of clinical symptoms (10 patients) and/or the lung perfusion scans showed a significant perfusion defect (11 patients). Magnetic resonance imaging and lung perfusion scans performed before, directly after, during 3-month, and 6-month follow-up. In the stenting group additional multislice CT-scans directly after, during 6-month, and 12-month follow-up were performed.Within 2 months after primary balloon angioplasty, the PV size parameters were significantly reduced (P 〈 0.001) with recurrence of PVS in 11 of 15 PVs (73%). Pulmonary vein stenting in 8 patients and 11 PVs resulted in no vein stenosis during 12-month follow-up. Normalization of lung perfusion was noted in 8 of 12 patients. We observed 2 patients with hemoptysis during PV dilation, as severe complications with potential life-threatening character. Conclusion: PVS stenting seems to be superior to balloon angioplasty and effective at least over a period of 12 months in treating acquired PVS after pulmonary vein isolation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8167.2005.50073.x
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  • 9
    Electronic Resource
    Electronic Resource
    Risk Stratification Using Heart Rate Turbulence and Ventricular Arrhythmia in MADIT II: Usefulness and Limitations of a 10-Minute Holter Recording (2004)
    350 Main Street , Malden , MA 02148 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Annals of noninvasive electrocardiology 9 (2004), S. 0 
    Details
    ISSN: 1542-474X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: We evaluated the usefulness of heart rate turbulence (HRT) parameters and frequency of ventricular premature beats (VPBs) for risk-stratifying postinfarction patients with depressed left ventricular function enrolled in Multicenter Automatic Defibrillator Trial II (MADIT II). Methods: In 884 MADIT II patients, 10-minute Holter monitoring at enrollment was used to evaluate HRT parameters and frequency of VPBs. The primary endpoints were defined as all-cause mortality in patients randomized to conventional treatment and as appropriate therapy for ventricular tachycardia or fibrillation in patients randomized to implantable cardioverter defibrillator (ICD) therapy. Results: The median turbulence slope was lower in patients who died in comparison to survivors in the conventional arm (2.3 vs 4.5 ms/RR; P 〈 0.05); but it was not a significant predictor of mortality after adjustment for clinical covariates (age, ejection fraction, beta-blocker use, and BUN levels). There was no association between HRT parameters and arrhythmic events in ICD patients. Conventionally treated patients who died and ICD patients who had appropriate ICD therapy had significantly more frequent VPBs than those without such adverse events. After adjustment for clinical covariates, frequent VPBs〉3/10 min were associated with death in the conventional arm (HR = 1.63; P = 0.070) and were predictive for appropriate ICD therapy in the ICD arm (HR = 1.75; P = 0.003). Conclusion: In postinfarction patients with severe left ventricular dysfunction, frequent VPBs are associated with increased risk of mortality and with appropriate ICD therapy. HRT obtained from 10-min Holter ECG showed a trend toward the association with mortality in univariate analysis but HRT parameters were not predictive of the outcome in multivariate analyses.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1542-474X.2004.93600.x
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  • 10
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    The Physiological Consequences of Child-Rearing among the Creek, Chicasaw, and Choctaw (1976)
    Ottawa : Periodicals Archive Online (PAO)
    Anthropologica. n.s.:18:1 (1976) 3 
    Details
    ISSN: 0003-5459
    Topics: Ethnic Sciences
    URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pao:&rft_dat=xri:pao:article:5100-1976-018-01-000001
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