RESUMEN
Pulmonary vein potentials (PVPs), though obvious during ectopic activity, are frequently invisible during sinus rhythm when they need to be distinguished from left atrial (LA) potentials to perform successful ablation procedures. Thirty-six patients with paroxysmal atrial fibrillation underwent circumferential PV mapping with a circular ten-electrode catheter during sinus rhythm, and during pacing from the right atrium, proximal and distal coronary sinus (CS), and LA. Ablation was performed at the ostium of the PV, the procedural endpoint consisting of electrical disconnection of the PV from the LA. A total of 93 PVs (excluding the right inferior PV) were mapped. During sinus rhythm, distinct right PVPs were present in all instances, while they were concealed within the electrograms recorded from the left inferior and superior PV in 23 (64%) patients. Distal CS or LA appendage pacing unmasked and separated left PV from LA potentials by a mean of 19 +/- 14 ms; the LA-to-left-PV potential interval measured 36 +/- 14 ms. The number of deflections also increased from 2.1 +/- 0.7 during sinus rhythm to 3 +/- 1.4 during LA stimulation. However, in the right superior PV, pacing caused overlapping of atrial potentials with right superior PVPs. RF ablation of the left PVPs was performed during distal or LA pacing in 23 patients, while in the right superior PV it was performed during sinus rhythm eliminating all, including unmasked, left PVPs, providing proof of their PV origin. Distal CS or LA pacing is required to recognize left PVPs in approximately 2/3 of patients and facilitates RF ablation.
Asunto(s)
Fibrilación Atrial/fisiopatología , Atrios Cardíacos/fisiopatología , Venas Pulmonares/fisiopatología , Enfermedades Vasculares/complicaciones , Fibrilación Atrial/cirugía , Ablación por Catéter , Cateterismo Venoso Central/instrumentación , Estimulación Eléctrica , Técnicas Electrofisiológicas Cardíacas/instrumentación , Femenino , Humanos , Masculino , Potenciales de la Membrana , Persona de Mediana Edad , Estudios Prospectivos , Venas Pulmonares/cirugía , Resultado del Tratamiento , Enfermedades Vasculares/cirugíaRESUMEN
The medicinal plants used in Indian system of medicine and its distribution in Jammu and Kashmir has been categorized systematically here. The paper deals with 246 medicinal plants and has to off-set an index which is not there so far.Out of 246 medicinal plants 12 plants are considered to be controversial. Substitutes, Adulterants of these plants which are being used in various parts of India were also recorded separately in this study.
RESUMEN
Kesar has been an important ingredient of the recipes of our ancient physicians in the field of Indian systems of medicine and its cultivation is a monopoly of Jammu and Kashmir. This paper presents in detail the historical review, botanical description, vernacular names, distribution in India and world, cultivation, collection, preservation and storage, adulterants, purity tests, chemical composition, action and uses, folk - lore claims and markets with special reference to its medicinal utility.