Left Atrial Pressure as a Predictor of Success in Catheter Ablation of Atrial Fibrillation in a Real-Life Cohort

Aims: The clinical role of the left atrial (LA) hypertension in patients with atrial fibrillation (AF) and its role as predictor in those undergoing pulmonary vein (PV) isolation is still unknown. The aim of the present study was to analyze the role of LA pressure in patients with nonvalvular AF who underwent PV isolation and its implication for AF catheter ablation. Methods: Consecutive patients with drug resistant AF who underwent PV isolation at San Maurizio Regional Hospital of Bolzano (Italy) as index procedure were included in this analysis. Results: A total of 132 consecutive patients (97 males, 73%; mean age 58.0 ± 13.2 years) were included in the analysis. Eleven patients (8%) underwent radiofrequency ablation and 121 (92%) cryoballoon ablation. Higher LA pressures were found in 54 patients (40.9%). At a mean follow up of 14.3 ± 8.2 months (median 12 months), the success rate without antiarrhythmic therapy was 65.9% (87/132; considering the blanking period). Female gender and continuous mean LA pressure were significantly associated with AF recurrence and remained significant on multivariable Cox analysis (respectively, HR 1.845, 1.00–3.40, p = 0.05 and HR 1.066, 1.002–1.134, p = 0.04). We identified a LA mean pressure of >15 mmHg as ideal cutoff and constructed a model to predict AF recurrence which fitted with a concordance index (C-index) of 0.65 (95% CI 0.56–0.75), logrank score p = 0.003

A particular case of transient ST elevation during cryoballoon ablation of atrial fibrillation

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Superluminal, subluminal, and negative velocities in free-space electromagnetic propagation

In this Chapter the time-domain analysis of the velocity of the electromagnetic field pulses generated by a spatially compact source in free space is presented. Recent simulations and measurements of anomalous superluminal, subluminal, and negative velocities are discussed. It is shown that such velocities are local and instantaneous in nature and do not violate either causality or special relativity. Although these effects are mainly confined to the near- and intermediate-field zones, some of them seem paradoxical and still lack adequate physical interpretation.Comment: This is an extended account (21 pages, 9 figures) of my previous work: PRL 102, 02040

Abnormally high risk of stroke in Brugada syndrome

BACKGROUND The present study sought to evaluate the incidence of cerebrovascular events in a large cohort of patients with Brugada syndrome (BrS) analysing possible predictors, clinical characteristics and prognosis of cardioembolic events secondary to atrial fibrillation. METHODS A total of 671 consecutive patients (age 42.1 ± 17.0 years; men 63%) with a diagnosis of BrS were retrospectively analysed over a mean follow-up period of 10.8 ± 5.5 years. The diagnosis of ischemic stroke was made according to the AHA/ASA guidelines using computed tomography (CT) and angio-CT in the emergency department. RESULTS Among 671 patients with BrS, 79 (11.8%) had atrial fibrillation. The incidence of cardioembolic stroke in patients with BrS and atrial fibrillation was 13.9% (11 events). These patients had a low CHA2DS2Vasc score (82%, 0 and 1). Patients with transient ischemic attack/stroke were more frequently asymptomatic (91 vs. 25%; P < 0.0001) and older (59.4 ± 11.2 vs. 43.9 ± 16.7; P = 0.004) as compared with those without cerebrovascular events. CONCLUSION The incidence of cardioembolic stroke in patients with BrS and atrial fibrillation was unexpectedly high. The cerebrovascular accidents were often the presenting clinical manifestation and were significantly associated with asymptomatic atrial fibrillation and older age. CHADS2 and CHA2DS2Vasc scores did not predict the unexpectedly high risk of thromboembolic events in this group of patients. The use of more invasive diagnostic tools might be useful in order to increase the rate of atrial fibrillation detection

Second generation cryoballoon ablation for atrial fibrillation in young adults: midterm outcome in patients under 40 years of age

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Notulae to the Italian alien vascular flora 6

In this contribution, new data concerning the distribution of vascular flora alien to Italy are presented. It includes new records, confirmations, exclusions, and status changes for Italy or for Italian administrative regions of taxa in the genera Acalypha, Acer, Canna, Cardamine, Cedrus, Chlorophytum, Citrus, Cyperus, Epilobium, Eucalyptus, Euphorbia, Gamochaeta, Hesperocyparis, Heteranthera, Lemna, Ligustrum, Lycium, Nassella, Nothoscordum, Oenothera, Osteospermum, Paspalum, Pontederia, Romulea, Rudbeckia, Salvia, Sesbania, Setaria, Sicyos, Styphnolobium, Symphyotrichum, and Tradescantia. Nomenclature and distribution updates, published elsewhere, and corrigenda are provided as supplementary material

Bryophyte, lichen, and vascular plant communities of badland grasslands show weak cross-taxon congruence but high local uniqueness in biancana pediments

Cross-taxon congruence, i.e., using certain taxonomic groups as surrogates for others, is receiving growing interest since it may allow decreasing efforts in biodiversity studies. In this work, we investigated the patterns of cross-taxon congruence in species richness and composition between communities of bryophytes, lichens, and vascular plants in different biancana grasslands of a Special Area of Conservation (SAC) of central Italy. We recorded species presence and abundance in 16 plots of 1 × 1 m size and analyzed the data using Procrustes correlation, co-correspondence analysis, and indicator species analysis. We did not highlight any correlation in species richness and composition between the three taxonomic groups. Conversely, the species composition of bryophyte communities was predictive of the species composition of lichen communities. Moreover, lichen richness was negatively correlated with the total cover of vascular plants. Indicator species analysis evidenced the presence of species from the three biotic communities being particularly related, at least at the local scale, to biancana pediments, like the bryophytes Didymodon acutus and Trichostomum crispulum, the lichens Enchylium tenax, Cladonia foliacea, and Psora decipiens, and the vascular plants Brachypodium distachyon, Parapholis strigosa, and Artemisia caerulescens subsp. cretacea. In the biancana pediments, acrocarp mosses, squamulose lichens, therophyte plants and chamaephyte plants coexisted. In spite of the weak cross-taxon congruence between the three taxonomic groups, this study could highlight a locally unique diversity of bryophytes, lichens, and vascular plants related to the extreme environment of biancana pediments, selected by high soil salinity and deposition from the upper eroded slope. Soil erosion and deposition in biancana badlands supports the increase of local multi-taxonomic plant diversity by creating unique ecosystems. Such biodiversity should be considered locally at risk of disappearance, due to the ongoing vanishing of biancana badlands in central Italy