[Long term outcome of atrial fibrillation patients with KCNA5 and NPPA mutations post circumferential pulmonary vein ablation].

OBJECTIVE: The outcome of atrial fibrillation patients with genetic mutations post ablation was not well evaluated. METHODS AND RESULTS: Three atrial fibrillation patients with evidence of mutations in KCNA5 and NPPA post successful circumferential pulmonary vein ablation were included. Mutation in KCNA5 was found in one male patient with paroxysmal atrial fibrillation. He was free of atrial fibrillation post ablation after 46 months follow-up. Mutations in NPPA were found in two male patients with persistent atrial fibrillation and they were free from atrial fibrillation after 64 months and 38 months follow-up post circumferential pulmonary vein ablation, roof line and mitral isthmus line ablation. CONCLUSION: Satisfactory long term results are observed in atrial fibrillation patients with KCNA5 and NPPA mutations post circumferential pulmonary vein ablation.

Wavelet and principal component analysis of electromyographic activity and slow component of oxygen uptake during heavy and severe cycling exercise.

The aim of the study was to investigate whether the slow component of oxygen uptake was concurrent with the recruitment of large α-motoneuron muscle fibres by using wavelet and principal component analysis (PCA) of electromyography (EMG) during heavy and severe cycling exercise. Eleven male subjects participated in the study. After establishing each subject's maximum value of oxygen uptake through an incremental test on the cycle ergometer, the subjects performed 6-min cycling tests at heavy and severe intensity. EMG signals were collected from rectus femoris, biceps femoris long head, tibialis anterior, and medial gastrocnemius and processed by combined use of wavelet and PCA analysis. The time delays to the onset of slow component occurred significantly earlier during severe (105.22 ± 5.45 s) compared with during heavy (138.78 ± 15.09 s) exercise. ANOVA with repeated measures showed that for all muscles tested, the angle θ formed by the first and second principal components decreased significantly between time windows during heavy and severe exercise. However, significant increases of EMG mean power frequency (MPF) were found only during heavy exercise. Our results show the concurrence of the oxygen uptake slow component with the additional recruitment of muscle fibres, presumably less efficient large α-motoneuron fibres. Novelty The expected rise in MPF may be offset by muscle fatigue occurring in the later time windows of the slow component during severe exercise. The gradual shift to higher EMG frequencies throughout the slow-component phase was reflected in the progressive and significant decrease of angle θ.

[Chronic outcome of patients with paroxysmal atrial fibrillation post catheter ablation].

OBJECTIVE: High short-term successful rate was reported for catheter ablation in patients with paroxysmal atrial fibrillation (AF), we analyzed the long-term outcome (success rate, anticoagulation therapy and embolism event, anti-arrhythmic therapy and death post procedure) of catheter ablation for paroxysmal AF in this study. METHODS: From January 2000 to December 2004, 106 consecutive patients with drug-refractory paroxysmal AF underwent catheter ablation and were followed-up for (60.7 + or - 11.8) months. Segmental pulmonary vein isolation (SPVI) was routinely performed by radiofrequency energy under the guidance of circular mapping catheter. The patients were followed up with 24 h-holter, ECG, telephone or letter. Data on recurrence of AF, the anticoagulation medication and the incidence of embolism, anti-arrhythmic therapy were obtained. RESULTS: There were 9 patients lost to follow up. In the remaining 97 patients [65 males, (54.8 + or - 11.2) years old], 3 cases died from cancer, sinus rhythm was maintained in 68 patients (Group S, 72.3%) and AF recurrence evidenced in 26 patients (Group R, 27.7%). In Group S, 56 patients (82.4%) discontinued anticoagulation medication, and 12 patients continued to take aspirin. There was no embolism event in Group S during follow-up. In Group R, 1 patient continued to take warfarin; 11 patients continued to take aspirin and 2 patients suffered from cerebral embolism. Anticoagulation medication was discontinued in 14 patients (53.8%) and 1 patient suffered form cerebral embolism. The incidence of embolism event in Group R is significantly higher than in Group S (P < 0.01). More patients discontinued anti-arrhythmic medication in Group S than in Group R (80.9% vs. 56.0%, P < 0.05). CONCLUSION: Catheter ablation is associated with satisfactory long-term success rate, reduced anti-arrhythmia medication, improved quality of life in patients with paroxysmal AF.