Abstract:
BACKGROUND:Ablation procedures in patients with paroxysmal atrial fibrillation (PAF) includes isolation of all pulmonary veins (PVs). We hypothesized that an approach using an algorithm to detect arrhythmogenic PVs (aPVs) might lead to shorter procedure duration (PD) and fewer proarrhythmic effects (PE). HYPOTHESIS:Isolation of the aPVs only leads to a reduced PD, reduced PEs, and fewer adverse events, with a success rate comparable to the standard all-PV approach. METHODS:In this prospective trial, 207 patients with PAF were randomized to undergo isolation of the aPV (AG group, n = 105) or isolation of all PVs (VG group, n = 102). The aPV was identified by atrial fibrillation (AF) induction, focal discharge, or short local PV decremental conduction during PV pacing. Patients were followed with repetitive 7-day Holter electrocardiograms (ECGs) after 3, 6, and 12 months in our arrhythmia clinic. RESULTS:In 97% of patients, at least 1 aPV was identified (mean, 2.1). PD did not differ significantly (152.3 ± 57.1 minutes vs 162 ± 68 minutes, P = 0.27) between the groups, but the number of radiofrequency (RF) applications and fluoroscopy time (FT) and dose were significantly lower in the AG group than in the VG group. The occurrence of PE (new-onset atrial tachycardia) and adverse events (AE) did not differ between the 2 groups (P = 0.1). Sinus rhythm off antiarrhythmic medication (documented on 7-day Holter ECGs) 12 months after a single procedure was achieved in 53% in the AG group and 59% in the VG group (P = 0.51). CONCLUSIONS:Isolation of the aPVs detected by a straightforward algorithm leads to similar success rates compared to a standard all-PV approach with regard to PD, AE, or PE and is associated with less RF and a shorter FT.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Fichtner S,Hessling G,Ammar S,Reents T,Estner HL,Jilek C,Kathan S,Büchner M,Dillier R,Deisenhofer Idoi
10.1002/clc.22132subject
Has Abstractpub_date
2013-07-01 00:00:00pages
422-6issue
7eissn
0160-9289issn
1932-8737journal_volume
36pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Troponin I (TnI) is increasingly employed as a highly specific marker of acute myocardial ischemia. The value of this marker after cardiac surgery is unclear. HYPOTHESIS:The purpose of this study was to measure serum TnI levels prospectively at 1, 6, and 72 h after elective cardiac operations. In addition, ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960231009
更新日期:2000-10-01 00:00:00
abstract::Nonpharmacologic therapies for patients with sustained ventricular tachycardia have been necessitated by the low frequency of drug-responsive patients. These nonpharmacologic therapies include antitachycardia pacemakers, low-energy cardioverters, defibrillators, surgery and, for the present, catheter ablation. Antitac...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:
更新日期:1988-03-01 00:00:00
abstract::Intracoronary (i.c.) thrombus is a frequent finding in patients with unstable angina (UA). Accordingly, thrombolytic treatment could be beneficial, as resolution of thrombus might result in increased delivery of blood flow to the ischemic regions. To test this hypothesis, we studied 13 patients with active UA and ST-s...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960150206
更新日期:1992-02-01 00:00:00
abstract:BACKGROUND:Little is known about the relationship of body fluid status with the levels and fluctuations of B-type natriuretic peptide (BNP) over the long-term. HYPOTHESIS:If BNP is to become useful for monitoring of patients with chronic heart failure (HF), the levels should reliably reflect both decompensation and im...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960291008
更新日期:2006-10-01 00:00:00
abstract::Arrhythmogenic right ventricular dysplasia (ARVD) is a rare cardiomyopathy characterized by the progressive replacement of cardiomyocytes by fatty and fibrous tissue in the right ventricle (RV). These infiltrations lead to cardiac electrical instability and ventricular arrhythmia. Current treatment for ARVD is empiric...
journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1002/clc.22884
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Low levels of high-density lipoprotein cholesterol (HDL-C; <40 mg/dL) are associated with increased risk of cardiovascular events, but it is unclear whether lower thresholds (<30 mg/dL) are associated with increased hazard. HYPOTHESIS:Very low levels of HDL-C may provide prognostic information in acute coro...
journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1002/clc.22533
更新日期:2016-06-01 00:00:00
abstract::Coronary artery stents have been developed to overcome arterial abrupt closure and restenosis following balloon angioplasty. Complications of stent insertion include loss of the device from its delivery system into the peripheral circulation. Certain types of stents are almost radiolucent, making localization of the l...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960180313
更新日期:1995-03-01 00:00:00
abstract::The renin-angiotensin system regulates blood pressure and sodium homeostasis through a series of coordinated substrate-enzyme interactions. These interactions result in the production of angiotensin II (AII), which exerts a number of diverse biologic effects mediated through AII cell-surface receptors. Dysregulation o...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960200103
更新日期:1997-01-01 00:00:00
abstract::A method for noninvasive generation of central aortic systolic pressure curves is presented. The method is based on plotting the occlusive pressure values applied at the brachial artery level against the time intervals needed for the aortic pressure wave to equalize and break through the occlusive pressure at the brac...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960100402
更新日期:1987-04-01 00:00:00
abstract:BACKGROUND:Disruption of the atherosclerotic plaque is a common feature of both acute coronary syndromes and balloon dilatation of coronary artery stenoses. HYPOTHESIS:The study was undertaken to evaluate whether the known association of cholesterol levels and acute coronary syndromes also exists for the occurrence of...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4950260708
更新日期:2003-07-01 00:00:00
abstract::Hyperkalemia was associated with complete heart block in one patient that resolved by first showing right anterior hemiblock). Then the right bundle branch block resolved, leaving the marked left axis deviation that was present before the hyperkalemic episode. Another patient with hyperkalemia had right bundle branch ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960040110
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:Although women typically develop coronary artery disease several years after men, once they have symptomatic disease their thromboembolic complications are worse than in men. The mechanism mediating this gender difference in outcome after thromboembolic events is unknown. We previously studied platelet funct...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/clc.4960191106
更新日期:1996-11-01 00:00:00
abstract::Recommendations in the 2007 update of the American College of Cardiology/American Heart Association guidelines for patients with non-ST-elevation myocardial infarction (NSTEMI) provide considerable latitude regarding treatment choices and care pathways. Nevertheless, as accumulating evidence leads to increased recomme...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.20671
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) reduce perioperative cardiac events in high-risk patients undergoing cardiovascular surgery. However, there is paucity of data on the role of statins in patients undergoing intermediate-risk noncardiac, nonvascular surgery (NCNVS). HYPOTHESIS:S...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22135
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Following successful cavotricuspid isthmus (CTI) ablation during typical atrial flutter (AFL), anticoagulation therapy is usually withdrawn. However, potential subsequent atrial fibrillation (AF) in these patients may increase embolic risk in the long term. Embolic rates in this setting have not been clearly...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22538
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Congenital coronary-pulmonary fistulas (CPFs) are commonly unilateral, but bilateral and multilateral fistulas may occur. In multilateral CPFs, the value of a multidetector computed tomography (MDCT) imaging technique as an adjuvant to coronary angiography (CAG) is eminent. The purpose of this study was to d...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.22297
更新日期:2014-09-01 00:00:00
abstract::Various anatomical and functional features of hypertrophic cardiomyopathy are analyzed in view of the data provided by two-dimensional echocardiography. Measurement of septal thickness is crucial, and is best done by a combination of M-Mode and 2-D echo. Two types of systolic anterior movement of the mitral valve (SAM...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960071203
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND:Recent data suggests that low molecular weight heparins (LMWHs) may be superior to unfractionated heparin (UFH) as an adjunct to fibrinolytic therapy in patients with acute ST-segment elevation myocardial infarction (STEMI). HYPOTHESIS:We evaluated cardiac outcomes and the risk of major bleeding with LMWHs ...
journal_title:Clinical cardiology
pub_type: 杂志文章,meta分析,评审
doi:10.1002/clc.20432
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Emerging biomarkers for acute myocardial infarction (AMI) may enhance conventional risk-prediction algorithms if they are informative and associated with risk independently of established predictors. In this study, we constructed a cohort for testing emerging biomarkers for AMI in managed-care populations us...
journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究
doi:10.1002/clc.22146
更新日期:2013-08-01 00:00:00
abstract::The cardiokymograph, a relatively new noninvasive device capable of recording anterior left ventricular segmental wall motion, was used to evaluate the frequency and type of wall motion abnormalities in 25 normal patients and in 109 patients with ischemic heart disease. Of the 25 patients with normal coronary arteries...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960030605
更新日期:1980-12-01 00:00:00
abstract:BACKGROUND:Vasovagal syncope (VVS) is a common cause of recurrent syncope. Nevertheless, the exact hemodynamic mechanism has not been elucidated. Pulse wave analysis (PWA) is widely used to evaluate vascular properties, as it reflects the condition of the entire arterial system. HYPOTHESIS:Cardiovascular autonomic mod...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23380
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Limited information is available regarding outcome of very elderly patients referred for percutaneous coronary intervention (PCI). PURPOSE:This study aimed to assess acute and intermediate term clinical outcomes among nonagenarians. METHODS:The study included 32 consecutive nonagenarian patients undergoing...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20596
更新日期:2009-12-01 00:00:00
abstract::Adenosine triphosphate (ATP) and adenosine exert strong and transient depressant effects on the sinoatrial and atrioventricular (AV) nodes of the human heart. The AV nodal effects of these drugs explain their high efficacy in either terminating AV re-entrant supraventricular tachycardia or in slowing ventricular rate ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960080903
更新日期:1985-09-01 00:00:00
abstract:BACKGROUND:Percutaneous interventions for aorto-ostial narrowing of native coronary arteries are challenging because of early elastic recoil after the procedure and the high restenosis rate. Cutting balloon angioplasty may reduce this complication. HYPOTHESIS:The purpose of the study was to evaluate the clinical outco...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20351
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Atherosclerotic cardiovascular disease is prevalent among renal transplant patients. Increase in serum total cholesterol, low-density lipoprotein, and very low-density lipoprotein is common in those patients. Alterations in chylomicron metabolism, however, are also related to atherogenesis and were not studi...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960210608
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:The relationship between eicosapentaenoic acid (EPA) therapy and coronary plaque stability assessed by optical frequency domain imaging (OFDI) has not been thoroughly described. HYPOTHESIS:EPA therapy is associated with decreased plaque instability in patients undergoing percutaneous coronary intervention (...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23185
更新日期:2019-06-01 00:00:00
abstract::Thirty-eight patients treated by atrial pacing were divided into three groups (Group I, patients with neither coronary stenosis nor anginal pain during pacing; Group II, patients with no coronary stenosis but having anginal pain during pacing; Group III, patients with coronary stenosis). The concentrations of adenosin...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960120203
更新日期:1989-02-01 00:00:00
abstract::Cellular interactions between leukocytes and the endothelium are critical events in vascular biology, such as atherosclerosis and acute coronary syndrome. When monocytes and endothelial cells are activated via direct cell-cell interaction, both types of cells express several biologically active molecules such as adhes...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960210103
更新日期:1998-01-01 00:00:00
abstract::An unusual case of metastatic disease of the right ventricle is described in a 74-year-old woman who had presented with a malignant fibrous histiocytoma of the right thigh previously treated with surgery and radiotherapy. Two years later she presented with signs and symptoms of tricuspid regurgitation and right ventri...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960140216
更新日期:1991-02-01 00:00:00
abstract::This manuscript was written in an effort to emphasize the points made by Porter et al. (Clin Cardiol 1997; 20:971-973). Right ventricular infarction may be erroneously interpreted as an anteroseptal infarction because of elevation of the S-T segments in leads V1-V4. The two can be separated when, using the Grant metho...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960210411
更新日期:1998-04-01 00:00:00