Catheter ablation of atrial fibrillation : radiofrequency catheter ablation for redo procedures after cryoablation

Aim: To evaluate the effectiveness of two different strategies using radiofrequency catheter ablation for redo procedures after cryoablation of atrial fibrillation. Methods: Thirty patients (paroxysmal atrial fibrillation: 22 patients, persistent atrial fibrillation: 8 patients) had to undergo a redo procedure after initially successful circumferential pulmonary vein (PV) isolation with the cryoballoon technique (Arctic Front Balloon, CryoCath Technologies/Medtronic). The redo ablation procedures were performed using a segmental approach or a circumferential ablation strategy (CARTO; Biosense Webster) depending on the intra-procedural findings. After discharge, patients were scheduled for repeated visits at the arrhythmia clinic. A 7-day Holter monitoring was performed at 3, 12 and 24 mo after the ablation procedure. Results: During the redo procedure, a mean number of 2.9 re-conducting pulmonary veins (SD ± 1.0 PVs) were detected (using a circular mapping catheter). In 20 patients, a segmental approach was sufficient to eliminate the residual pulmonary vein conduction because there were only a few recovered pulmonary vein fibres. In the remaining 10 patients, a circumferential ablation strategy was used because of a complete recovery of the PV-LA conduction. All recovered pulmonary veins could be isolated successfully again. At 2-year follow-up, 73.3% of all patients were free from an arrhythmia recurrence (22/30). There were no major complications. Conclusion: In patients with an initial circumferential pulmonary vein isolation using the cryoballoon technique, a repeat ablation procedure can be performed safely and effectively using radiofrequency catheter ablation

How can monetary policy be improved?

Monetary policy - United States ; Monetary policy ; Banks and banking, Central

Time deposits in monetary analysis

Certificates of deposit ; Savings accounts

Training and Practice of Readers' Advisory by Public Library Staff in North Carolina

Research was conducted examining a link between education and training on readers' advisory and confidence levels when conducting the service. A survey was sent to all public libraries in North Carolina. The respondents were asked about their education, training received on the job and their level of confidence when conducting readers' advisory. The results from the survey showed that most library staff did not receive initial or ongoing training. Despite the lack of training, the respondents reported high levels of confidence, comfort and success when performing readers' advisory.Master of Science in Library Scienc

The praxeological square as a method for the intercultural study of religious movements

Schäfer H. The praxeological square as a method for the intercultural study of religious movements. In: Gramley S, Schneider R, eds. Cultures in Process: Encounter and Experience. The Bielefeld English and American Studies. Vol 2. Bielefeld: Aisthesis; 2009: 6-20

Обзор и назначение экономических информационных систем

ObjectivesThis study was designed to develop a technique to selectively increase the sympathetic tone to the heart by cardiac sympathetic nerve stimulation (SNS).BackgroundAccess to the cardiac sympathetic neurons may allow modulating the adrenergic tone of the heart while avoiding systemic side effects.MethodsCardiac sympathetic nerves course within neural sleeves along the subclavian artery. Because of this proximity, transvascular SNS was attempted with electrode catheters inside the subclavian artery in 16 pigs.ResultsRight/left (R-/L-) SNS (20 Hz) during ventricular pacing at 200/min evoked a >100% increase of left ventricular systolic pressure (baseline: 51 ± 1 mm Hg; L-SNS: 118 ± 26 mm Hg; R-SNS: 116 ± 33 mm Hg; p < 0.001) while systemic vascular resistance remained unchanged. There was a sigmoid dose-response curve with rapid on- and offset of the effect during SNS initiation/cessation. Positive inotropic effects persisted for 12 h of continued SNS (n = 4). Besides positive dromotropic effects, L-SNS/R-SNS yielded a 41% and 77% sinus rate increase, respectively.ConclusionsThe neural adrenergic tone to the heart can be selectively increased by catheter stimulation of cardiac efferent sympathetic nerves

Monitoring changes in the position and boundaries of climate clusters at different time intervals

This article describes the development of a web application for the study of the correlation-regression analysis of meteorological data and search, the shift of the geographic center of clusters of different time intervals