Analysis of Heart Rate Variability before and after Catheter Ablation for Atrial Flutter with Complicating Atrial Fibrillation

Efficacy of radiofrequency (RF) catheter ablation in suppressing atrial fibrillation (AF) was studied by analysis of heart rate variability (HRV) in 13 patients with atrial flutter complicated with AF. We treated these patients by RF ablation of the isthmus between the tricuspid valve annulus and the inferior vena cava to create a bidirectional conduction block. To analyze the HRV, 24-h ambulatory electrocardiographic monitoring was performed 1 day before, 1 day after and 1 month after the ablation. After the RF ablation of the isthmus, 7 patients continued to experience AF attacks, while the remaining 6 patients did not. We divided them into 2 groups, attacked by AF (AF group) and not attacked by AF (non-AF group), and analyzed HRV parameters. The results obtained were compared between the groups. One month after the ablation, the non-AF group showed a significantly higher average heart rate than the AF group. The HRV parameters indicating cardiac vagal nervous activities, such as the root-mean-square of differences, percentage of adjacent normal RR intervals and high frequency power, were significantly lower in the non-AF group 1 month after. Furthermore, the ratio of low frequency power to high frequency power, which is a measure for cardiac sympathetic nervous activity, was significantly higher in the non-AF group 1 month after. From these results, we postulate that the suppression of postoperative AF may involve vagal nerve suppression and sympathetic nerve activation

Vacuum-Assisted Closure (VAC) for Bilateral Severe Ischemic Foot after Revascularization: A Patient Report

The Vacuum-Assisted Closure (VAC) Therapy (KCI, San Antonio, TX) is a unique system that helps promote wound healing. We report a case of severe ischemic foot in which VAC therapy markedly improved wound healing. A 73-year-old man underwent left axillopopliteal bypass and left 3rd, 4th and 5th digital amputations for gangrene. Although his amputation stumps were complicated with methicillin-resistant Staphylococcus aureus (MRSA) infection, the stumps were successfully healed by VAC. He also had gangrene in his right 1st toe, which could not healed by VAC alone, and we performed right femoropopliteal bypass and right 1st digital amputation. The stump with MRSA infection was also successfully healed by VAC. Histopathologic examination revealed a lot of microvessels in the increased granulation tissue

Dietary Mercury Exposure Resulted in Behavioral Differences in Mice Contaminated with Fish-Associated Methylmercury Compared to Methylmercury Chloride Added to Diet

Methylmercury (MeHg) is a potent neurotoxin, and humans are mainly exposed to this pollutant through fish consumption. However, in classical toxicological studies, pure methylmercury chloride (MeHgCl) is injected, given to drink or incorporated within feed assuming that its effects are identical to those of MeHg naturally associated to fish. In the present study, we wanted to address the question whether a diet containing MeHg associated to fish could result in observable adverse effects in mice as compared to a diet containing the same concentration of MeHg added pure to the diet and whether beneficial nutriments from fish were able to counterbalance the deleterious effects of fish-associated mercury, if any. After two months of feeding, the fish-containing diet resulted in significant observable effects as compared to the control and MeHg-containing diets, encompassing altered behavioral performances as monitored in a Y-shaped maze and an open field, and an increased dopamine metabolic turnover in hippocampus, despite the fact that the fish-containing diet was enriched in polyunsaturated fatty acids and selenium compared to the fish-devoid diets