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1.
Small ; 20(24): e2308863, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38287727

RESUMO

Ternary organic solar cells (T-OSCs) have attracted significant attention as high-performance devices. In recent years, T-OSCs have achieved remarkable progress with power conversion efficiency (PCE) exceeding 19%. However, the introduction of the third component complicates the intermolecular interaction compared to the binary blend, resulting in poor controllability of active layer and limiting performance improvement. To address these issues, dual-functional third components have been developed that not only broaden the spectral range but also optimize morphology. In this review, the effect of the third component on expanding the absorption range of T-OSCs is first discussed. Second, the extra functions of the third component are introduced, including adjusting the crystallinity and molecular stack in active layer, regulating phase separation and purity, altering molecular orientation of the donor or acceptor. Finally, a summary of the current research progress is provided, followed by a discussion of future research directions.

2.
Artigo em Inglês | MEDLINE | ID: mdl-38841867

RESUMO

OBJECTIVES: The clinical efficacy and safety of a novel left atrial appendage (LAA) occluder of the SeaLA closure system in patients with nonvalvular atrial fibrillation (NVAF) were reported. BACKGROUND: Patients with NVAF are at a higher risk of stroke compared to healthy individuals. Left atrial appendage closure (LAAC) has emerged as a prominent strategy for reducing the risk of thrombosis in individuals with NVAF. METHODS: A prospective, multicenter study was conducted in NVAF patients with a high risk of stroke. RESULTS: The LAAC was successfully performed in 163 patients. The mean age was 66.93 ± 7.92 years, with a mean preoperative CHA2DS2-VASc score of 4.17 ± 1.48. One patient with residual flow >3 mm was observed at the 6-month follow-up, confirmed by TEE. During the follow-up, 2 severe pericardiac effusions were noted, and 2 ischemic strokes were observed. Four device-related thromboses were resolved after anticoagulation treatment. There was no device embolism. CONCLUSIONS: The LAAC with the SeaLA device demonstrates encouraging feasibility, safety, and efficacy outcomes.

3.
Europace ; 26(7)2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38912887

RESUMO

AIMS: Pulsed field ablation (PFA) is an emerging non-thermal ablative modality demonstrating considerable promise for catheter ablation of atrial fibrillation (AF). However, these PFA trials have almost universally included only Caucasian populations, with little data on its effect on other races/ethnicities. The PLEASE-AF trial sought to study the 12-month efficacy and the safety of a multi-electrode hexaspline PFA catheter in treating a predominantly Asian/Chinese population of patients with drug-refractory paroxysmal AF. METHODS AND RESULTS: Patients underwent pulmonary vein (PV) isolation (PVI) by delivering different pulse intensities at the PV ostium (1800 V) and atrium (2000 V). Acute success was defined as no PV potentials and entrance/exit conduction block of all PVs after a 20-min waiting period. Follow-up at 3, 6, and 12 months included 12-lead electrocardiogram and 24-h Holter examinations. The primary efficacy endpoint was 12-month freedom from any atrial arrhythmias lasting at least 30 s. The cohort included 143 patients from 12 hospitals treated by 28 operators: age 60.2 ± 10.0 years, 65.7% male, Asian/Chinese 100%, and left atrial diameter 36.6 ± 4.9 mm. All PVs (565/565, 100%) were successfully isolated. The total procedure, catheter dwell, total PFA application, and total fluoroscopy times were 123.5 ± 38.8 min, 63.0 ± 30.7 min, 169.7 ± 34.6 s, and 27.3 ± 10.1 min, respectively. The primary endpoint was observed in 124 of 143 patients (86.7%). One patient (0.7%) developed a small pericardial effusion 1-month post-procedure, not requiring intervention. CONCLUSION: The novel hexaspline PFA catheter demonstrated universal acute PVI with an excellent safety profile and promising 12-month freedom from recurrent atrial arrhythmias in an Asian/Chinese population with paroxysmal AF. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05114954.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Veias Pulmonares , Humanos , Fibrilação Atrial/cirurgia , Fibrilação Atrial/fisiopatologia , Fibrilação Atrial/diagnóstico , Masculino , Feminino , Pessoa de Meia-Idade , Ablação por Cateter/métodos , Ablação por Cateter/efeitos adversos , Veias Pulmonares/cirurgia , Veias Pulmonares/fisiopatologia , Idoso , Resultado do Tratamento , Povo Asiático , China , Cateteres Cardíacos , Recidiva , Eletrocardiografia Ambulatorial , Fatores de Tempo , Desenho de Equipamento , Frequência Cardíaca , Potenciais de Ação
4.
Opt Express ; 31(25): 42111-42124, 2023 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-38087592

RESUMO

Thin-film silicon solar cells (TSSC) has received great attention due to its advantages of low cost and eco-friendly. However, traditional single-layer patterned solar cells (SPSC) still fall short in light-trapping efficiency. This article presents an all layers patterned (ALP) conical nanostructured TSSC to enhance the low absorption caused by the thin absorption layers. The Finite-Difference Time-Domain result shows that a photocurrent density up to 41.27 mA/cm2 can be obtained for the structure, which is 31.39% higher than that of the SPSC. An electrical optimization simulation of doping concentration was carried out on the parameters of the optically optimal structure of the model. The power conversion efficiency is 17.15%, which is 1.72 times higher than that of the planar structure. These results demonstrate a success for the potential and prospect of the fully patterned nanostructures in thin-film photovoltaic devices.

5.
Opt Lett ; 48(18): 4781-4784, 2023 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-37707901

RESUMO

Slow light devices have significant applications in memory, switching, and quantum optics. However, the design and fabrication of slow light devices with large tunable group delay are still challenging. Here, a graphene-based slow light device that can electrically modulate the group delay of terahertz (THz) waves is proposed and experimentally demonstrated. The unit cell of the device consists of a U-shaped metal resonator and an Ω-shaped metal resonator, with three graphene ribbons embedded between the two resonators. Under electrical stimuli, a relatively high amplitude modulation depth of 74% is achieved and the maximum transmission amplitude is as high as 0.7 at the transmission peak of 0.6 THz. Most importantly, the maximum group delay variation reaches 5 ps at 0.76 THz and the maximum group delay amplitude is as high as 8.8 ps. The experiment shows good agreement with simulation. This study paves a new way for developing novel switchable nanophotonic devices and slow light devices.

6.
J Nucl Cardiol ; 30(6): 2712-2720, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37626209

RESUMO

BACKGROUND: To evaluate the feasibility of using radiolabeled fibroblast activation protein inhibitor (FAPI) PET/CT imaging to assess activated fibroblasts in the atria of individuals with AF and to identify factors contributing to enhanced atrial activity. METHODS: We constructed left atrial appendage (LAA) pacing beagle dog AF models (n = 5) and conducted 18F-FAPI PET/CT imaging at baseline and eight weeks after pacing. Right atrial (RA) specimens were collected from these models. Additionally, 28 AF patients and ten age- and sex-matched healthy volunteers underwent 18F-FAPI PET/CT imaging. RESULTS: RA of AF beagles showed increased 18F-FAPI uptake. Among AF patients, 18 out of 28 (64.3%) exhibited enhanced atrial FAPI activity. No atrial 18F-FAPI uptake was observed in the sham beagle and healthy volunteers. In animal RA specimens, 18F-FAPI activity correlated positively with FAP mRNA (r = .98, P = .002) and protein (r = .82, P = .03) levels, as well as collagen I mRNA expression (r = .85, P = .02). B-type natriuretic peptide levels were associated with atrial 18F-FAPI activity (OR = 3.01, P = .046). CONCLUSION: This proof-of-concept study suggests that 18F-FAPI PET/CT imaging may be a feasible method for evaluating activated fibroblasts in the atria of AF patients.


Assuntos
Fibrilação Atrial , Animais , Humanos , Cães , Fibrilação Atrial/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Átrios do Coração/diagnóstico por imagem , Fibroblastos , RNA Mensageiro , Fluordesoxiglucose F18
7.
8.
Molecules ; 28(3)2023 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-36771028

RESUMO

Microwave-assisted chemical reactions have been widely used, but the overheating effect limits further applications. The aim of this paper is to investigate the coupling degree of the electromagnetic field and thermal field in microwave-heating chemical reactions whose polarization changes as the reactions proceed. First, the entropy-balance equation of microwave-heating polar-molecule reactions is obtained. Then, the coupling degree of the electromagnetic field and the thermal field in microwave-heating polar-molecule reactions is derived, according to the entropy-balance equation. Finally, the effects of reaction processes on the degree of coupling are discussed. When the time scale of the component-concentration variation is much greater than the wave period during the chemical processes, the degree of coupling is sufficiently small, and the electric and thermal fields are considered as weakly coupled. On the other hand, the degree of coupling may change during the reactions. If the absolute value of the coupling degree becomes larger, due to the change in component concentration, this will lead to a transition from weak coupling to strong coupling.

9.
Yi Chuan ; 45(1): 52-66, 2023 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-36927638

RESUMO

As an effective supplement to the current forensic DNA typing and one of the research hotpots in forensic science, the in-depth mining and characterization of biological evidence can provide rich and reliable clues for case investigation. In this study, the time-dependent variations of transcriptome were confirmed in in vitro blood samples within 0-168 days and a random forest model was established to realize the classification of blood samples with different TSD (time since deposition). Meanwhile, significant differences were observed in the transcripts of blood samples with different smoking habits and genders within a certain time period. HLA-DRB1, HLA-DQB1 and HLA-DQA2 were identified as markers for smoking habit identification, while the transcripts for RPS4Y1 and EIF1AY from the non-recombining region of the Y chromosome (NRY) were identified as markers for male sex identification. Thus, this study provides a theoretical foundation and experimental strategy for establishing a transcriptome-based method for characterizing blood sample retention time and donor characteristics in the field of forensic investigation.


Assuntos
Transcriptoma , Humanos , Masculino , Feminino , Cadeias HLA-DRB1/genética , Reação em Cadeia da Polimerase , Alelos
10.
Opt Express ; 30(13): 23198-23207, 2022 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-36225005

RESUMO

Two-dimensional (2D) materials, which have attracted attention due to intriguing optical properties, form a promising building block in optical and photonic devices. This paper numerically investigates a tunable and anisotropic perfect absorber in a graphene-black phosphorus (BP) nanoblock array structure. The suggested structure exhibits polarization-dependent anisotropic absorption in the mid-infrared, with maximum absorption of 99.73% for x-polarization and 53.47% for y-polarization, as determined by finite-difference time-domain FDTD analysis. Moreover, geometrical parameters and graphene and BP doping amounts are possibly employed to tailor the absorption spectra of the structures. Hence, our results have the potential in the design of polarization-selective and tunable high-performance devices in the mid-infrared, such as polarizers, modulators, and photodetectors.

11.
Opt Express ; 30(19): 34862-34874, 2022 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-36242489

RESUMO

Based on graphene's phase modulation property and vanadium dioxide's amplitude modulation property, we developed an array reflector for terahertz frequencies that is individually adjustable. Starting with a theoretical analysis, we look into the effects of voltage on the Fermi level of graphene and temperature on the conductivity of vanadium dioxide, analyze the beam focusing characteristics, and finally link the controllable quantities with the reflected beam characteristics to independently regulate each cell in the array. The simulation findings demonstrate that the suggested array structure can precisely manage the focus point's position, intensity, and scattering degree and that, with phase compensation, it can control the wide-angle incident light. The array structure offers a novel concept for adjustable devices and focusing lenses, which has excellent potential for study and application.

12.
Pacing Clin Electrophysiol ; 45(10): 1186-1193, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35939332

RESUMO

BACKGROUND: Ablation index (AI) is a novel technology of ablation lesion quality to help improve homogeneity of lesion size and continuity. In this study, we aim to evaluate whether AI-guided PVI improves clinical outcomes compared to CF-guided PVI in patients with paroxysmal AF (PAF). METHODS: Patients undergoing first-time radiofrequency ablation for PAF were randomized in a 2:1 ratio to two groups: AI-guided PVI and CF-guided PVI. In the AI group, AI ≥500 was recommended at the anterior/superior/inferior walls, 350-400 at the posterior wall, and inter-lesion distance ≤4 mm. The primary endpoint is the freedom from atrial arrhythmia recurrence during 12 months follow-up, without antiarrhythmic drug therapy (ADT). The key secondary endpoints include intra-procedural efficiency and peri-procedural complications. RESULTS: Two hundred twenty five patients were randomized (AI group [n = 149] and CF group [n = 76]). First-pass isolation rate in AI group was significantly higher than that in CF group (58.3% vs. 43.4%, p = .035). After a median follow-up of 12.2 months, 154/225 (68.4%) of patients were free from atrial arrhythmia recurrence without ADT, which was higher in AI group compared with CF group, but without significant difference (71.1% vs. 63.2%, p = .253). The incidence of peri-procedural complications is low and without difference between two groups. CONCLUSIONS: AI-guided ablation provided higher acute efficacy than CF-guided ablation in PV isolation for patients with paroxysmal AF. The long-term success rate in AI group was higher than CF group, but did not reach statistical significance.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Veias Pulmonares , Ablação por Radiofrequência , Humanos , Veias Pulmonares/cirurgia , Fibrilação Atrial/cirurgia , Antiarrítmicos , Resultado do Tratamento , Recidiva
13.
J Cardiovasc Electrophysiol ; 32(7): 1842-1848, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34028119

RESUMO

INTRODUCTION: Ablation index (AI)-guided radiofrequency ablation has been increasingly used for the treatment of drug-resistant paroxysmal atrial fibrillation (AF),but the optimal AI targets remain to be determined. We aimed to examine the efficacy and safety of catheter ablation guided by moderate AI values but more strict procedural endpoints in patients with paroxysmal AF. METHODS: We conducted a retrospective review of a consecutive series of patients who received their first AI-guided ablation for paroxysmal AF from 2017 to 2018. The standard procedural protocol recommends AI targets as follows: anterior: 400-450; posterior: 280-330; and roof/inferior wall: 380-430. After circumferential pulmonary vein isolation (PVI), we performed bipolar pacing along the ablation line, adenosine triphosphate (ATP)-provocation, and waited for 30 min to verify PVI. The primary clinical outcome was the rate of freedom from AF recurrence at 12 months. RESULTS: A total of 140 consecutive patients were included. The mean procedure and ablation times were 132.2 ± 30.2 min and 24.2 ± 7.9 min, respectively. The first-pass isolation and final isolation rates were documented in 49.3% and in 100% of the patients, respectively. At 12 months, single-procedure freedom from atrial tachyarrhythmias was observed in 92.1% of patients. No major procedure-related complications were encountered. CONCLUSIONS: Moderate AI-guided catheter ablation is highly effective for the treatment of drug-refractory paroxysmal AF in real-world settings. Over 90% of patients achieved single-procedure arrhythmia-free survival at 1 year. The outcome was obtained without major complications and the procedure involved relatively short procedure and ablation times.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Veias Pulmonares , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/cirurgia , Ablação por Cateter/efeitos adversos , Humanos , Veias Pulmonares/cirurgia , Recidiva , Estudos Retrospectivos , Resultado do Tratamento
14.
Heart Vessels ; 36(6): 874-881, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33782749

RESUMO

BACKGROUND: Thoracoscopic ablation has emerged as an effective therapy for patients with long-standing persistent Atrial fibrillation (LsPAF). We aimed to investigate the immediate electrophysiological characteristics following modified ablation with 3 circular and 3 linear lesions in the thoracoscopic procedure via a unilateral approach. METHODS: Between May 2015 and October 2018, 40 patients underwent the one-stage hybrid procedure for LsPAF. Isolation of the pulmonary veins (PV) and left atrium posterior wall (LAPW), excision of the left atrial appendage (LAA), and high-density endocardial mapping and individualized percutaneous catheter ablation for AF termination were performed. RESULTS: The modified thoracoscopic procedure may enable successful PV and LAPW isolation and LAA removal. Endocardial electrophysiological examination showed 6 out of 40 (15%) patients with a right PV gap, 3 (7.5%) patients with incomplete roof lesions, and 8 (20%) patients with incomplete Dallas lesions. A total of 44 driving areas were mapped and ablated. Thirty-five patients achieved procedural AF termination. After a mean follow-up period of 26 months, the success rate of a single procedure was 85%. Cox regression analysis demonstrated that the failure of procedural AF termination may be a risk factor in atrial tachyarrhythmia recurrence. DISCUSSION: Endocardial electrophysiological examination is a necessary partner to thoracoscopic ablation. Our modified thoracoscopic ablation and driving areas-based ablation contribute to high rates of procedural AF termination, which may lead to reduced recurrence rate. The hybrid procedure may be an effective strategy for the management of LsPAF.


Assuntos
Fibrilação Atrial/fisiopatologia , Ablação por Cateter/métodos , Técnicas Eletrofisiológicas Cardíacas/métodos , Toracoscopia/métodos , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Resultado do Tratamento
15.
Sensors (Basel) ; 21(9)2021 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-34066493

RESUMO

Proximal sensing offers a novel means for determination of the heavy metal concentration in soil, facilitating low cost and rapid analysis over large areas. In this respect, spectral data and model variables play an important role. Thus far, no attempts have been made to estimate soil heavy metal content using continuum-removal (CR), different preprocessing and statistical methods, and different modeling variables. Considering the adsorption and retention of heavy metals in spectrally active constituents in soil, this study proposes a method for determining low heavy metal concentrations in soil using spectral bands associated with soil organic matter (SOM) and visible-near-infrared (Vis-NIR). To rapidly determine the concentration of heavy metals using hyperspectral data, partial least squares regression (PLSR), principal component regression (PCR), and support vector machine regression (SVMR) statistical methods and 16 preprocessing combinations were developed and explored to determine an optimal combination. The results showed that the multiplicative scatter correction and standard normal variate preprocessing methods evaluated with the second derivative spectral transformation method could accurately determine soil Cr and Ni concentrations. The root-mean-square error (RMSE) values of Vis-NIR model combinations with PLSR, PCR, and SVMR were 0.34, 3.42, and 2.15 for Cr, and 0.07, 1.78, and 1.14 for Ni, respectively. Soil Cr and Ni showed strong spectral responses to the Vis-NIR spectral band. The R2 value of the Vis-NIR-based PLSR model was higher than 0.99, and the RMSE value was 0.07-0.34, suggesting higher stability and accuracy. The results were more accurate for Ni than Cr, and PLSR showed the best performance, followed by SVMR and PCR. This perspective has critical implications for guiding quantitative biogeochemical analysis using proximal sensing data.

16.
Sensors (Basel) ; 21(4)2021 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-33562255

RESUMO

Herein, we propose a tunable plasmonic sensor with Fano resonators in an inverted U-shaped resonator. By manipulating the sharp asymmetric Fano resonance peaks, a high-sensitivity refractive index sensor can be realized. Using the multimode interference coupled-mode theory and the finite element method, we numerically simulate the influences of geometrical parameters on the plasmonic sensor. Optimizing the structure parameters, we can achieve a high plasmonic sensor with the maximum sensitivity for 840 nm/RIUand figure of merit for 3.9 × 105. The research results provide a reliable theoretical basis for designing high sensitivity to the next generation plasmonic nanosensor.

17.
Zhongguo Zhong Yao Za Zhi ; 46(22): 5792-5796, 2021 Nov.
Artigo em Zh | MEDLINE | ID: mdl-34951166

RESUMO

Fusarium is the major pathogen of root rot of Pseudostellaria heterophylla. This study aims to explain the possible distribution of Fusarium species and the contamination of its toxin-chemotypes in tuberous root of P. heterophylla. A total of 89 strains of fungi were isolated from the tuberous root of P. heterophylla. Among them, 29 strains were identified as Fusarium by ITS2 sequence, accounting for 32.5%. They were identified as five species of F. avenaceum, F. tricinctum, F. fujikuroi, F. oxysporum, and F. graminearum based on ß-Tubulin and EF-1α genes. LC-MS/MS detected 18, 1, and 5 strains able to produce ZEN, DON, and T2, which accounted for 62.1%, 3.4%, and 17.2%, respectively. Strain JK3-3 can produce ZEN, DON, and T2, while strains BH1-4-1, BH6-5, and BH16-2 can produce ZEN and T2. PCR detected six key synthase genes of Tri1, Tri7, Tri8, Tri13, PKS14, and PKS13 in strain JK3-3, which synthesized three toxins of ZEN, DON, and T2. Four key synthase genes of Tri8, Tri13, PKS14, and PKS13 were detected in strains BH1-4-1, BH6-5, and BH16-2, which were responsible for the synthesis of ZEN and T2. The results showed that the key genes of toxin biosynthesis were highly correlated with the toxins produced by Fusarium, and the biosynthesis of toxin was strictly controlled by the genetic information of the strain. This study provides a data basis for the targeted prevention and control of exo-genous mycotoxins in P. heterophylla and a possibility for the development of PCR for rapid detection of toxin contamination.


Assuntos
Caryophyllaceae , Fusarium , Micotoxinas , Cromatografia Líquida , Fusarium/genética , Espectrometria de Massas em Tandem
18.
J Nucl Cardiol ; 27(5): 1501-1512, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-30088193

RESUMO

BACKGROUND: This retrospective study was designed to explore the factors relevant to increased atrial 18F-fluorodeoxyglucose (FDG) uptake in patients with atrial fibrillation (AF) who had undergone routine whole-body positron emission tomography/computed tomography (PET/CT) imaging. METHODS AND RESULTS: Forty-eight consecutive AF patients (32 persistent, 16 paroxysmal) were identified from our routine FDG PET/CT database. Twenty-two control subjects were selected to establish the normal range of FDG uptake (maximum standardized uptake value, SUVmax) in target tissues. A target-to-background ratio (TBR) was calculated to determine abnormal uptake in the atrium and atrial appendage (AA). Univariate comparisons and multivariate regression analyses were conducted to explore the factors associated with the increased FDG accumulation in the atrium and AA. Seventeen AF patients, all with persistent AF, had increased atrial FDG uptake. Most of them (14, or 82.4%) had increased uptake in the right atrium. Eleven AF patients, 9 with persistent AF, had increased uptake in the AA, and bilateral AAs were equally involved. Multivariate logistic regression analyses identified that female gender, persistent AF, and activity in epicardial adipose tissue (EAT) were independent factors predicting the increased activity of the atrium; also, SUVmax of the left ventricle was found for the AA. In addition, multivariate linear regression analyses showed that EAT activity was the only independent variable linearly correlated with the activity of the atrium and AA. CONCLUSIONS: Atrial uptake was present in persistent AF and localized mainly in the right atrium, whereas bilateral AAs could be equally involved. Multiple factors contributed to the increased activity in atrium; in particular, the EAT activity was independently correlated with the activity of the atrium and AA.


Assuntos
Fibrilação Atrial/diagnóstico por imagem , Fibrilação Atrial/metabolismo , Fluordesoxiglucose F18/farmacocinética , Átrios do Coração/metabolismo , Compostos Radiofarmacêuticos/farmacocinética , Idoso , Feminino , Átrios do Coração/diagnóstico por imagem , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Estudos Retrospectivos , Imagem Corporal Total
19.
Europace ; 22(8): 1197-1205, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32514560

RESUMO

AIMS: Circumferential pulmonary vein isolation can be effective as sole treatment for persistent atrial fibrillation. However, identifying those patients who will respond to this therapy remains a challenge. We investigated the clinical value of the sequential low-dose ibutilide test for identifying patients with persistent atrial fibrillation in whom pulmonary vein isolation is effective as sole therapy. METHODS AND RESULTS: In a prospective cohort of 180 consecutive patients with persistent atrial fibrillation, intravenous low-dose (0.004 mg/kg) ibutilide was administered 3 days before ablation and after the completion of circumferential pulmonary vein isolation. In patients in whom ibutilide did not terminate atrial fibrillation pre-procedurally, but successfully terminated it intraprocedurally, no further atrial substrate modification was performed. Pre-procedural low-dose ibutilide failed to terminate the arrhythmia in all patients with persistent atrial fibrillation, while pulmonary vein isolation ± low-dose ibutilide terminated persistent atrial fibrillation in 55 (30.6%) of them (PsAF group 1). The remaining 125 (69.4%) patients underwent electrogram-based ablation (PsAF Group 2). The control group comprised 379 consecutive patients with paroxysmal atrial fibrillation who underwent pulmonary vein isolation over the same period. At 24 months follow-up, 39 (70.9%) patients in PsAF Group 1 and 276 (72.8%) patients in the control group were free from atrial tachyarrhythmias (P = NS); the arrhythmia-free rates in both groups were higher than that in PsAF group 2 (58.4%, P = 0.005). CONCLUSION: The sequential low-dose ibutilide test is a simple method for identifying patients with persistent atrial fibrillation in whom pulmonary vein isolation alone is an appropriate treatment strategy.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Veias Pulmonares , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/cirurgia , Humanos , Estudos Prospectivos , Veias Pulmonares/cirurgia , Recidiva , Sulfonamidas , Resultado do Tratamento
20.
Pacing Clin Electrophysiol ; 43(11): 1358-1365, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33000472

RESUMO

INTRODUCTION: Combined catheter ablation (CA) and left atrial appendage closure (LAAC) have proven to be a feasible and safe strategy in treating patients with nonvalvular atrial fibrillation (AF). However, the interactions between CA and LAAC have not been systematically explored. We analyzed the impact of CA on long-term outcomes of LAAC in patients with AF treated with the hybrid procedure. METHODS: A total of 107 consecutive patients with AF who underwent LAAC were divided into two groups: group A (n = 61) included patients who underwent CA followed by LAAC during the same procedure and group B (n = 46) included patients who underwent LAAC only. All patients underwent systematic transesophageal echocardiography (TEE) follow-up. RESULTS: In group A, CA resulted in severe edema of the left atrial ridge (LAR), which manifested as an increase in LAR thickness from 4.6 ± 0.4 mm before CA to 6.8 ± 0.6 mm (P < .01) after CA. TEE at 45 days showed that the incidence of peri-device leakage was significantly higher in group A than in group B (45.9% vs 4.3%, P < .001). At the 12-month follow-up, the peri-device leakage rate remained higher in group A than in group B (14.8% vs 2.2%, P < .01). Three (4.9%) patients in group A experienced transient ischemia attacks; no events were reported in group B during the 1-year follow-up. CONCLUSION: Edema of LAR with the single-stage procedure that consists of CA followed by LAAC could result in increased peri-device leakage and decreased compression rate over time, which may be also associated with elevated risk profiles when compared with an LAAC-only procedure.


Assuntos
Apêndice Atrial/cirurgia , Fibrilação Atrial/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Ablação por Cateter/métodos , Complicações Pós-Operatórias/epidemiologia , Idoso , Terapia Combinada , Feminino , Humanos , Masculino , Fatores de Risco
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