961-78 Importance of Left Ventricular Ejection Fraction and Signal Averaged Electrocardiogram but not of Coronary Artery Patency nor Holter Monitoring to Predict Severe Arrhythmic Events After a First Myocardial Infarction in the Thrombolytic Era

We followed-up 244 consecutive patients (210 men, mean age56±9 yrs) who survived the acute phase (alive after day 7) of a first anterior (N=102) or inferior (N=142) myocardial infarction (MI) with a mean follow-up (FU) delay of 57±18 months. In the acute phase, 97/244 patients (40%) received a thrombolytic therapy. Within the second and third week after admission, all patients underwent a Holter ECG monitoring graded by the Lown classification, a signal averaged electrocardiogram (SAECG) and a coronary angiography. Three parameters were measured by SAECG (predictor system, 40Hz high-pass filter): total QRS duration (QRSd), root mean square voltage of the last 40ms (RMS) and duration of the terminal low (<40 uV) amplitude signal (LAS). The number of diseased vessels as well as the infarct related artery (IRA) patency was evaluated by TIMI grading (TIMI 2 or 3=patent) and left ventricular ejection fraction (LVEF) was measured angiographically. Cox proportional hazards model was used for the statistical analysis.ResultsWe observed 18 arrhythmic events (AE): 10 sudden cardiac death and 8 ventricular tachycardia during the FU period. Statistical analysis identified 3 independent factors predictive of the occurence of an AE: 1) LVEF, with a risk multiplied by 1.9 for each 0.10 decrease in the LVEF value, 2) LAS, with a risk multiplied by 1.3 for each 5ms increase in LAS value and 3) absence of thrombolysis, with a risk multiplied by 3.9.ConclusionsAfter MI in the thrombolytic era the Holter ECG monitoring and the results of the coronary angiography do not predict the risk of an AE. LVEF, SAECG and absence of thrombolysis are the 3 independent predictors of such a risk

Thromboembolic prophylaxis protocol with warfarin after radiofrequency catheter ablation of infarct‐related ventricular tachycardia

IntroductionAblation in the left ventricle (LV) is associated with a risk of thromboembolism. There are limited data on the use of specific thromboembolic prophylaxis strategies postablation. We aimed to evaluate a thromboembolic prophylaxis protocol after ventricular tachycardia (VT) ablation.Methods and resultsThe index procedures of 217 patients undergoing ablation for infarct‐related VT with open irrigated‐tip catheters were included. Patients with large LV endocardial ablation area (>3 cm between ablation lesions) were started on low‐dose, slowly escalating unfractionated heparin (UFH) infusion 8 hours after access hemostasis, followed by 3 months of anticoagulation. Patients with less extensive ablation were treated only with antiplatelet agents postablation. Postablation bridging anticoagulation was used in 181 (83%) patients. Of them, 11 (6%) patients experienced bleeding events (1 required endovascular intervention) and 1 (0.6%) experienced lower extremity arterial embolism requiring vascular surgery. Systemic anticoagulation was prescribed in 190 (89%) of 214 patients discharged from the hospital (warfarin in 98%), while the rest received single‐ or dual‐antiplatelet therapy alone. Patients treated with an anticoagulant had significantly longer radiofrequency time compared to patients treated with antiplatelet agents only. One (0.5%) of the patients treated with oral anticoagulation experienced major bleeding 2 weeks postablation. No thromboembolic events were documented in either the anticoagulation or the “antiplatelet only” group postdischarge.ConclusionA slowly escalating bridging regimen of UFH, followed by 3 months of oral anticoagulation, is associated with low thromboembolic and bleeding risks after infarct‐related VT ablation. In the absence of extensive ablation, antiplatelet therapy alone is reasonable.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/143666/1/jce13418.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143666/2/jce13418_am.pd

A CONDENAÇÃO DO BRASIL PELA CORTE INTERAMERICANA DE DIREITOS HUMANOS NO CASO FAZENDA BRASIL VERDE VS. BRASIL

O presente artigo tem por finalidade analisar a condenação do Brasil pela Corte Interamericana de Direitos Humanos no caso Fazenda Brasil Verde vs. Brasil, a qual foi a primeira sentença da Corte a respeito do trabalho escravo contemporâneo. Neste sentido, pretende-se, sobretudo, compreender os motivos pelos quais o país foi condenado. Para tanto, visa-se inicialmente analisar o conceito de trabalho escravo contemporâneo ou trabalho em condições análogas à escravidão e depois, verificar o desenvolvimento histórico de proteção contra o trabalho escravo a partir da legislação nacional e dos tratados e convenções internacionais. Por fim, objetiva-se analisar a sentença da Corte no caso em questão, de forma a compreender os fatos que levaram o caso ao Tribunal, identificar as vítimas, verificar as violações de direitos humanos cometidas pelo Brasil e o conteúdo da sentença condenatória. O método de pesquisa utilizado foi o qualitativo, a partir da análise do caso concreto, e exame de fontes bibliográficas e documentos legais

Research of the Additional Losses Occurring in Optical Fiber at its Multiple Bends in the Range Waves 1310nm, 1550nm and 1625nm Long

Article is devoted to research of the additional losses occurring in the optical fiber at its multiple bends in the range waves of 1310 nanometers, 1550 nanometers and 1625 nanometers long. Article is directed on creation of the external factors methods which allow to estimate and eliminate negative influence. The automated way of calculation of losses at a bend is developed. Results of scientific researches are used by engineers of "Kazaktelekom" AS for practical definition of losses service conditions. For modeling the Wolfram|Alpha environment - the knowledge base and a set of computing algorithms was chosen. The greatest losses are noted on wavelength 1310nm and 1625nm. All dependences are nonlinear. Losses with each following excess are multiplicative