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1.
J Environ Manage ; 364: 121466, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38870784

RESUMO

One of the important non-engineering measures for flood forecasting and disaster reduction in watersheds is the application of machine learning flood prediction models, with Long Short-Term Memory (LSTM) being one of the most representative time series prediction models. However, the LSTM model has issues of underestimating peak flows and poor robustness in flood forecasting applications. Therefore, based on a thorough analysis of complex underlying surface attributes, this study proposes a framework for distinguishing runoff models and integrates a Grid-based Runoff Generation Model (GRGM). Simultaneously considering the time series characteristics of runoff processes, including rising, peak, and recession, a runoff process vectorization (RPV) method is proposed. In this study, a hybrid deep learning flood forecasting framework, GRGM-RPV-LSTM, is constructed by coupling the GRGM, RPV, and LSTM neural network models. Taking the Jialu River in the Zhongmu station control basin as an example, the model is validated using 18 instances of measured floods and compared with the LSTM and GRGM-LSTM models. The study shows that the GRGM model has a relative error and average coefficient of determination for simulating runoff of 8.41% and 0.976, respectively, indicating that considering the spatial distribution of runoff patterns leads to more accurate runoff calculations. Under the same lead time conditions, the GRGM-RPV-LSTM hybrid forecasting model has a Nash efficiency coefficient greater than 0.9, demonstrating better simulation performance compared to the GRGM-LSTM and LSTM models. As the lead time increases, the GRGM-RPV-LSTM model provides more accurate peak flow predictions and exhibits better robustness. The research findings can provide scientific basis for coordinated management of flood control and disaster reduction in watersheds.


Assuntos
Inundações , Previsões , Aprendizado de Máquina , Modelos Teóricos , Redes Neurais de Computação , Rios , Movimentos da Água
2.
J Environ Manage ; 362: 121260, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38833924

RESUMO

Accurate multi-step ahead flood forecasting is crucial for flood prevention and mitigation efforts as well as optimizing water resource management. In this study, we propose a Runoff Process Vectorization (RPV) method and integrate it with three Deep Learning (DL) models, namely Long Short-Term Memory (LSTM), Temporal Convolutional Network (TCN), and Transformer, to develop a series of RPV-DL flood forecasting models, namely RPV-LSTM, RPV-TCN, and RPV-Transformer models. The models are evaluated using observed flood runoff data from nine typical basins in the middle Yellow River region. The key findings are as follows: Under the same lead time conditions, the RPV-DL models outperform the DL models in terms of Nash-Sutcliffe efficiency coefficient, root mean square error, and relative error for peak flows in the nine typical basins of the middle Yellow River region. Based on the comprehensive evaluation results of the train and test periods, the RPV-DL model outperforms the DL model by an average of 2.82%-22.21% in terms of NSE across nine basins, with RMSE and RE reductions of 10.86-28.81% and 36.14%-51.35%, respectively. The vectorization method significantly improves the accuracy of DL flood forecasting, and the RPV-DL models exhibit better predictive performance, particularly when the lead time is 4h-6h. When the lead time is 4-6h, the percentage improvement in NSE is 9.77%, 15.07%, and 17.94%. The RPV-TCN model shows superior performance in overcoming forecast errors among the nine basins. The research findings provide scientific evidence for flood prevention and mitigation efforts in river basins.


Assuntos
Aprendizado Profundo , Inundações , Previsões , Rios , Algoritmos , Modelos Teóricos
3.
Respiration ; 102(6): 458-462, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37232039

RESUMO

Lung cancer is the leading cause of deaths from malignant neoplasms worldwide, and a satisfactory biopsy that allows for histological and other analyses is critical for its diagnosis. Guidelines have recommended endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) as the reference standard for the staging of lung cancer. However, the relatively limited sample volume retrieved by needle aspiration might restrict the diagnostic capacity of EBUS-TBNA in other uncommon thoracic tumors. Transbronchial mediastinal cryobiopsy is a recently developed sampling strategy for mediastinal lesions, which demonstrates added diagnostic value to conventional needle aspiration. Here, we present a case of thoracic SMARCA4-deficient undifferentiated tumor successfully diagnosed by mediastinal cryobiopsy additional to EBUS-TBNA.


Assuntos
Broncoscopia , Neoplasias Pulmonares , Humanos , Estadiamento de Neoplasias , Mediastino/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Linfonodos/patologia , DNA Helicases , Proteínas Nucleares , Fatores de Transcrição
4.
J Card Fail ; 27(5): 568-576, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33387632

RESUMO

BACKGROUND: Autonomic dysregulation in heart failure with reduced ejection fraction plays a major role in endothelial dysfunction. Low-level tragus stimulation (LLTS) is a novel, noninvasive method of autonomic modulation. METHODS AND RESULTS: We enrolled 50 patients with heart failure with reduced ejection fraction (left ventricular ejection fraction of ≤40%) in a randomized, double-blinded, crossover study. On day 1, patients underwent 60 minutes of LLTS with a transcutaneous stimulator (20 Hz, 200 µs pulse width) or sham (ear lobule) stimulation. Macrovascular function was assessed using flow-mediated dilatation in the brachial artery and cutaneous microcirculation with laser speckle contrast imaging in the hand and nail bed. On day 2, patients were crossed over to the other study arm and underwent sham or LLTS; vascular tests were repeated before and after stimulation. Compared with the sham, LLTS improved flow-mediated dilatation by increasing the percent change in the brachial artery diameter (from 5.0 to 7.5, LLTS on day 1, P = .02; and from 4.9 to 7.1, LLTS on day 2, P = .003), compared with no significant change in the sham group (from 4.6 to 4.7, P = .84 on day 1; and from 5.6 to 5.9 on day 2, P = .65). Cutaneous microcirculation in the hand showed no improvement and perfusion of the nail bed showed a trend toward improvement. CONCLUSIONS: Our study demonstrated the beneficial effects of acute neuromodulation on macrovascular function. Larger studies to validate these findings and understand mechanistic links are warranted.


Assuntos
Insuficiência Cardíaca , Disfunção Ventricular Esquerda , Estudos Cross-Over , Insuficiência Cardíaca/terapia , Humanos , Volume Sistólico , Função Ventricular Esquerda
5.
Exp Physiol ; 106(11): 2210-2222, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34533881

RESUMO

NEW FINDINGS: What is the central question of this study? Does vagus nerve stimulation have protective effects against both direct liver damage and distant lung injury in a rat model of hepatic ischaemia-reperfusion? What is the main finding and its importance? Vagus nerve stimulation provides protection through anti-inflammatory and anti-oxidative stress effects, possibly achieved by the vagovagal reflex. ABSTRACT: Hepatic ischaemia-reperfusion (I/R) is not an isolated event; instead, it can result in remote organ dysfunction. The aim of this study was to investigate whether vagus nerve stimulation (VNS) can alleviate hepatic I/R-induced lung injury and to explore the underlying mechanism. Thirty male Sprague-Dawley rats were randomly allocated into five groups (n = 6 each): the sham group (without I/R or VNS), the I/R group (hepatic I/R) and three different VNS treatment groups (hepatic I/R plus VNS). The hepatic I/R group was subjected to occlusion of the portal vein and hepatic artery for 1 h, followed by 6 h of reperfusion. The intact afferent and efferent cervical vagus nerves were stimulated throughout the I/R process. During VNS, cervical neural activity was recorded. At the end of the experiment, liver function, the wet-to-dry lung weight ratio, histology of the liver and lung and inflammatory/oxidative indices were evaluated. We found that VNS significantly mitigated lung injury, as demonstrated by alleviation of pulmonary oedema and pathological alterations, by limiting inflammatory cytokine infiltration and increasing antioxidant capability. This proof-of-concept study suggested that VNS might protect patients from lung injury induced by hepatic I/R related to various circumstances.


Assuntos
Lesão Pulmonar , Traumatismo por Reperfusão , Estimulação do Nervo Vago , Animais , Anti-Inflamatórios , Antioxidantes , Apoptose , Humanos , Isquemia , Fígado/patologia , Pulmão , Lesão Pulmonar/patologia , Lesão Pulmonar/prevenção & controle , Masculino , Ratos , Ratos Sprague-Dawley , Reflexo , Reperfusão , Traumatismo por Reperfusão/patologia
6.
J Asthma ; 54(5): 447-455, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27589490

RESUMO

INTRODUCTION: The currently available treatments for severe asthma are insufficient. Infiltration of neutrophils rather than eosinophils into the airways is an important inflammatory characteristic of severe asthma. However, the mechanism of the phenotypic change from eosinophilic to neutrophilic inflammation has not yet been fully elucidated. METHODS: In the current study, we examined the effect of lipopolysaccharides (LPS) on eosinophilic asthmatic mice sensitized with ovalbumin (OVA), as well as the roles of interleukin (IL)-17A/T helper (Th) 17 cells on the change in the airway inflammatory phenotype from eosinophilic to neutrophilic inflammation in asthmatic lungs of IL-17A-deficient mice. RESULTS: Following exposure of OVA-induced asthmatic mice to LPS, neutrophil-predominant airway inflammation rather than eosinophil-predominant inflammation was observed, with increases in airway hyperresponsiveness (AHR), the IL-17A level in bronchoalveolar lavage fluid (BALF) and Th17 cells in the spleen and in the pulmonary hilar lymph nodes. Moreover, the neutrophilic asthmatic mice showed decreased mucus production and Th2 cytokine levels (IL-4 and IL-5). In contrast, IL-17A knockout (KO) mice exhibited eosinophil-predominant lung inflammation, decreased AHR, mucus overproduction and increased Th2 cytokine levels and Th2 cells. CONCLUSION: These findings suggest that the eosinophilic inflammatory phenotype of asthmatic lungs switches to the neutrophilic phenotype following exposure to LPS. The change in the inflammatory phenotype is strongly correlated with the increases in IL-17A and Th17 cells.


Assuntos
Asma/imunologia , Eosinófilos/imunologia , Lipopolissacarídeos/farmacologia , Neutrófilos/imunologia , Células Th17/metabolismo , Células Th2/metabolismo , Animais , Asma/induzido quimicamente , Líquido da Lavagem Broncoalveolar/citologia , Modelos Animais de Doenças , Feminino , Inflamação/imunologia , Mediadores da Inflamação/imunologia , Interleucina-17/metabolismo , Interleucina-4/metabolismo , Interleucina-5/metabolismo , Pulmão/patologia , Camundongos , Camundongos Endogâmicos BALB C , Ovalbumina/farmacologia
7.
Mediators Inflamm ; 2016: 6470364, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26941484

RESUMO

Th17/IL-17 plays an important role in host defense and hyperimmune responses against pathogenic bacteria accompanied by the recruitment of neutrophils. Th17-associated immune response is also involved in the pathogenesis of asthma, which is known as a noninfectious allergic airway disease and has been shown to be heterogeneous. Th17-associated inflammation usually contributes to the neutrophilic phenotype, which is often characterized by greater severity, airflow obstruction, and steroid resistance. Concurrently, advanced culture-independent molecular techniques have increased our understanding of the lung microbiome and demonstrated that disorders of the lung microbiome, including changes of the total burden, diversity, and community composition, may contribute to severe, treatment-resistant neutrophilic asthma, although the precise mechanism is still unclear. Because Th17/IL-17 plays a role in bacteria-mediated immune responses and is involved in neutrophilic asthma, there may be a link between them. We review the effects of Th17/IL-17 on bacteria and asthma, showing the possibility that Th17/IL-17 may be a key player in neutrophilic asthma which may be characterized as severe or treatment-resistant by responding to the disordered lung microbiome.


Assuntos
Asma/metabolismo , Asma/microbiologia , Interleucina-17/metabolismo , Pulmão/metabolismo , Pulmão/microbiologia , Microbiota/fisiologia , Neutrófilos/metabolismo , Animais , Asma/imunologia , Humanos , Pulmão/imunologia , Microbiota/imunologia , Neutrófilos/imunologia
8.
J Asthma ; 52(10): 989-95, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26333305

RESUMO

INTRODUCTION: T helper 17 cell (Th17) cells play an important role in neutrophilic asthma, and 1,25(OH)2D3 has been reported to modulate the proliferation and differentiation of T cells. In this study, we examined the effects of 1,25(OH)2D3 on the dendritic cell (DC)-mediated regulation of Th17differentiation from OVA-sensitized mice. METHODS: DCs were isolated from ovalbumin-sensitized mouse spleens. Lipopolysaccharide (LPS) was administered to stimulate the DCs for 24 h, and dexamethasone or 1,25(OH)2D3 was applied simultaneously. The expression of Notch ligand delta-like ligand 4 (Dll4) in the DCs was detected in each group. All the groups of treated DCs were co-cultured with T cells, and Dll4 was inhibited in these groups. After 24 h, Th17 and Treg cell differentiation and the IL-17A levels were measured. RESULTS: Dll4 expression was increased in LPS-treated DCs compared with the control group (p = 0.05), resulting in increased Th17 cell differentiation (p = 0.002). Treatment with 1,25(OH)2D3 inhibited the Dll4 expression(p = 0.04) and decreased Th17 cell differentiation (p = 0.001) in DCs that was induced by LPS. Directly inhibiting Dll4 reduced Th17 cell differentiation, and Th17 cell differentiation was not further inhibited by 1,25(OH)2D3 once Dll4 was blocked. CONCLUSIONS: These result suggest that Dll4 in the DCs isolated from OVA-sensitized mice is involved in Th17 differentiation inhibition by 1,25(OH)2D3.


Assuntos
Calcitriol/farmacologia , Interleucina-17/metabolismo , Peptídeos e Proteínas de Sinalização Intracelular/antagonistas & inibidores , Proteínas de Membrana/antagonistas & inibidores , Ovalbumina/farmacologia , Células Th17/metabolismo , Animais , Asma , Técnicas de Cultura de Células , Diferenciação Celular , Células Dendríticas/metabolismo , Dexametasona/farmacologia , Ensaio de Imunoadsorção Enzimática , Feminino , Citometria de Fluxo , Lipopolissacarídeos/farmacologia , Camundongos , Camundongos Endogâmicos C57BL , Linfócitos T Reguladores/metabolismo
9.
Cells ; 12(5)2023 02 21.
Artigo em Inglês | MEDLINE | ID: mdl-36899814

RESUMO

Electrophysiological and structural disruptions in cardiac arrhythmias are closely related to mitochondrial dysfunction. Mitochondria are an organelle generating ATP, thereby satisfying the energy demand of the incessant electrical activity in the heart. In arrhythmias, the homeostatic supply-demand relationship is impaired, which is often accompanied by progressive mitochondrial dysfunction leading to reduced ATP production and elevated reactive oxidative species generation. Furthermore, ion homeostasis, membrane excitability, and cardiac structure can be disrupted through pathological changes in gap junctions and inflammatory signaling, which results in impaired cardiac electrical homeostasis. Herein, we review the electrical and molecular mechanisms of cardiac arrhythmias, with a particular focus on mitochondrial dysfunction in ionic regulation and gap junction action. We provide an update on inherited and acquired mitochondrial dysfunction to explore the pathophysiology of different types of arrhythmias. In addition, we highlight the role of mitochondria in bradyarrhythmia, including sinus node dysfunction and atrioventricular node dysfunction. Finally, we discuss how confounding factors, such as aging, gut microbiome, cardiac reperfusion injury, and electrical stimulation, modulate mitochondrial function and cause tachyarrhythmia.


Assuntos
Arritmias Cardíacas , Coração , Humanos , Espécies Reativas de Oxigênio , Arritmias Cardíacas/patologia , Mitocôndrias/patologia , Trifosfato de Adenosina
10.
Geroscience ; 44(6): 2655-2670, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35773441

RESUMO

Aging of the cardiovascular regulatory function manifests as an imbalance between the sympathetic and parasympathetic (vagal) components of the autonomic nervous system (ANS). The most characteristic change is sympathetic overdrive, which is manifested by an increase in the muscle sympathetic nerve activity (MSNA) burst frequency with age. Age-related changes that occur in vagal nerve activity is less clear. The resting tonic parasympathetic activity can be estimated noninvasively by measuring the increase in heart rate occurring in response to muscarinic cholinergic receptor blockade; animal study models have shown this to diminish with age. Humoral, cellular, and neural mechanisms work together to prevent non-resolving inflammation. This review focuses on the mechanisms underlying age-related alternations in the ANS and how an imbalance in the ANS, evaluated by MSNA and heart rate variability (HRV), potentially facilitates inflammation when the homeostatic mechanisms between reflex neural circuits and the immune system are compromised, particularly the dysfunction of the cholinergic anti-inflammatory reflex. Physiologically, the efferent arm of this reflex acts via the [Formula: see text] 7 nicotinic acetylcholine receptors expressed in macrophages, monocytes, dendritic cells, T cells, and endothelial cells to curb the release of inflammatory cytokines, in which inhibition of NF­κB nuclear translocation and activation of a JAK/STAT-mediated signaling cascade in macrophages and other immune cells are implicated. This reflex is likely to become less adequate with advanced age. Consequently, a pro-inflammatory state induced by reduced vagus output with age is associated with endothelial dysfunction and may significantly contribute to the development and propagation of atherosclerosis, heart failure, and hypertension. The aim of this review is to summarize the relationship between ANS dysfunction, inflammation, and endothelial dysfunction in the context of aging. Meanwhile, this review also attempts to describe the role of HRV measures as a predictor of the level of inflammation and endothelial dysfunction in the aged population and explore the possible therapeutical effects of vagus nerve stimulation.


Assuntos
Células Endoteliais , Doenças Vasculares , Animais , Inflamação , Sistema Nervoso Autônomo , Sistema Nervoso Simpático , Sistema Imunitário
11.
Heart Rhythm ; 18(2): 172-180, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32911051

RESUMO

BACKGROUND: It is known that electrical signals can be affected by notch filtering. OBJECTIVE: We sought to investigate the effect of 60-Hz notch filtering on local abnormal ventricular activities (LAVA) in patients undergoing ventricular tachycardia ablation. METHODS: To ensure catheter stability, only patients undergoing ablation using Stereotaxis mapping catheters were enrolled. Catheter stability was judged by the display on the electroanatomic map and the morphology of the bipolar and unipolar electrograms of the ablation catheter. At sites recording stable LAVA, 60-Hz notch filtering was applied. The duration, amplitude, and morphology of LAVA were compared before and after filtering. The area under LAVA was used to analyze the amplitude of continuous LAVA. RESULTS: A total of 110 LAVA potentials recorded from 13 patients were analyzed. Notch filtering significantly affected the LAVA morphology and reduced their amplitude (the sum of the absolute value of the largest positive and negative voltages before filtering: 0.267 mV [0.191-0.395 mV]; after filtering: 0.172 mV [0.112-0.266 mV]; P < .001). At least 2 high-frequency components were introduced into the LAVA by filtering at 33 sites. The area under continuous LAVA was reduced by 28% from 24.64 cm2 (16.20-33.45 cm2) to 17.53 cm2 (10.52-23.82 cm2) (P < .001). The duration of continuous LAVA was reduced by 12% from 79.2 ms (55.0-93.0 ms) to 69.5 ms (53.0-88.5 ms) (P < .001). CONCLUSION: Notch filtering can distort LAVA by reducing their amplitude, changing their morphology, and shortening their duration, leading to potential false positives and negatives. Mitigating the 60-Hz noise should focus on eliminating the source of noise, not applying notch filtering.


Assuntos
Mapeamento Potencial de Superfície Corporal/métodos , Ablação por Cateter/métodos , Catéteres , Sistema de Condução Cardíaco/fisiopatologia , Técnicas Estereotáxicas/instrumentação , Cirurgia Assistida por Computador/métodos , Taquicardia Ventricular/cirurgia , Idoso , Idoso de 80 Anos ou mais , Desenho de Equipamento , Feminino , Seguimentos , Ventrículos do Coração/fisiopatologia , Humanos , Imageamento Tridimensional/métodos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taquicardia Ventricular/fisiopatologia
12.
Arrhythm Electrophysiol Rev ; 9(1): 40-46, 2020 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-32637119

RESUMO

Low-level tragus stimulation (LLTS) is a non-invasive approach of transcutaneous vagus nerve stimulation. LLTS has applications in diseases of multiple systems, including epilepsy, depression, headache and potentially several cardiovascular diseases. LLTS has shown promising results in suppressing AF, alleviating post-MI ventricular arrhythmias and ischaemia-reperfusion injury along with improving diastolic parameters in heart failure with preserved left ventricular ejection fraction (HFpEF). Preliminary pilot clinical studies in patients with paroxysmal AF, HFpEF, heart failure with reduced ejection fraction and acute MI have demonstrated promising results. The beneficial effects are likely secondary to favourable alteration of the sympathovagal imbalance. On-going exploratory work focused on underlying mechanisms of LLTS in cardiovascular disease states and larger scale clinical trials will shed more light on the non-invasive modulation of the neuro-immune axis.

13.
Chemosphere ; 214: 846-854, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30316177

RESUMO

Nickel-containing wastewater is a serious hazard to water environment, so that it is a burning issue to find an efficient and environment-friendly adsorbent. The conventional biochar could not effectively adsorb nickel (Ni(II)), so our study focuses on exploring the adsorption of chemically modified biochar to Ni(II). In this study, the biochar derived from waste peanut shell was modified by KMnO4 and KOH (MBC). And a series of experiment were carried out to evaluate the sorption ability and explore adsorption mechanism of modified biochar to Ni(II). The results showed the adsorption ability of MBC to Ni(II) reached 87.15 mg g-1. And the reaction process was spontaneous and endothermic chemisorption. Meanwhile, the analysis of FTIR and XPS visually revealed that the amine groups in the modified biochar could form NH2Ni with Ni(II) by complexation, while the hydroxyl could form nickel hydroxide and complexed nickel oxide by co-precipitation and complexation. This research showed this novel MBC is a promising adsorbent and has a fantastic prospect in the application of nickel-containing wastewater.


Assuntos
Arachis/química , Carvão Vegetal/química , Níquel/química
14.
PLoS One ; 13(1): e0190170, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29298352

RESUMO

INTRODUCTION: Hybrid ablation, an emerging therapy that combines surgical intervention and catheter ablation, has become a viable option for the treatment of persistent atrial fibrillation. In this analysis, we aimed to evaluate the safety and efficacy of hybrid ablation, as well as compare the outcomes of one-step and staged approaches. METHODS: We conducted a search in major online databases and selected the studies that met the inclusion criteria. The primary endpoint was defined as no episode of atrial fibrillation or atrial tachycardia lasting longer than 30 seconds without administration of antiarrhythmic drugs. RESULTS: Sixteen studies including 785 patients (paroxysmal atrial fibrillation, n = 83; persistent atrial fibrillation, n = 214; long-standing persistent atrial fibrillation, n = 488) were selected. Average history of atrial fibrillation was (5.0±1.6) years. The pooled proportion of patients who were arrhythmia-free at the primary endpoint was 73% (95% CI, 64%-81%, Cochran's Q, P<0.001; I2 = 81%). The pooled rate of severe short-term complications was 4% (95% CI, 2%-7%, Cochran's Q, P = 0.01; I2 = 51%). The success rate after one-step procedures (69%) was lower than that after staged procedures (78%). The staged approach could ultimately prove to be safer, although complication rates were relatively low for both approaches (2% and 5%, respectively). CONCLUSIONS: Hybrid ablation is an effective and generally safe procedure. The current data suggest that staged hybrid ablation could be the optimal approach, as it is associated with a higher success rate and a seemingly lower complication rate. Additional randomized controlled trials are necessary to confirm these results.


Assuntos
Fibrilação Atrial/cirurgia , Ablação por Cateter/métodos , Fibrilação Atrial/terapia , Ablação por Cateter/efeitos adversos , Humanos
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