Growth performance and mammary gland development of Holstein calves fed milk with 15% solids and treated with growth promoters.

The objective of this study was to evaluate growth performance, and mammary gland parenchyma (PAR) development in Holstein female calves fed whole milk combined with milk replacer for 15% total solids (15TS) or only milk (11% TS; 11TS). The effects of zilpaterol hydrochloride (ZH) and an estrogenic implant (EI) on growth performance, serum metabolites, and PAR development in post-weaning calves (63-90 days of age) fed 15TS or 11TS were also investigated. In the first phase, 78 calves were randomly divided into two groups (n = 39/group), 15TS, or 11TS (5 to 8 L/day; starter ad libitum). After weaning, calves were randomly assigned to four treatments, no EI, EI, ZH, and ZH-EI. In phase 1, 15TS calves had greater (P < 0.01) average body weight at weaning than 11TS calves (82.0 ± 5.8 vs. 74.1 ± 5.7 kg). Pre-weaning average daily gain (718 ± 67 vs. 576 ± 64 g/day) was higher (P < 0.01) for 15TS calves than 11TS calves. Feed/gain (1.5 ± 0.3 vs. 1.8 ± 0.3 kg of DMI/kg of gain) was lower (P < 0.01) for 15TS calves than 11TS calves. PAR area (8.8 ± 3.3 vs. 5.0 ± 1.6 cm2) was greater (P < 0.01) for 15TS calves than 11TS calves. No differences (P > 0.10) in average daily gain (986 ± 79 g/day across treatments) were observed in calves receiving ZH, EI, or ZH-EI fed 15TS or 11TS diets previously. However, the PAR area of 15TS calves administered ZH-EI was 2.2 times greater (P < 0.01) than 11TS calves with no ZH and CI. This study demonstrated the benefits of supplying milk with 15% TS for enhancing overall animal growth and PAR development. Further use of ZH and EI during the post-weaning period did improve mammary PAR growth.

Predictors of pacemaker dependency in patients implanted with a pacemaker after Transaortic valve replacement.

INTRODUCTION AND OBJECTIVES: The development of complete AV block and the need for pacemaker implantation (PM) is the most frequent complication after Transaortic valve replacement (TAVR). In other PM clinical contexts, a higher percentage of ventricular stimulation has been associated with worse prognosis. The objective was to study the existence of predictors of PM dependence. METHODS: We identified 96 consecutive patients who had received a PM post-TAVR (all Core-Valve). We retrospectively analyzed this cohort with the aim of identifying predictors of a high and very high percentage of ventricular pacing (VP), PM dependency and survival. RESULTS: The mean age was 82.3 years, with a mean logistic EuroSCORE of 17.1, 53% were women and 12% of patients had LVEF < 50%. The indication was complete AV block in 40.5%, and LBBB in 59.5%. Mean survival was 62.7 months, IQR [54.4-71]. The only independent predictor of mortality was the pre-TAVR logistic Euro-SCORE (RR = 1,026, p = 0.033), but not LVEF < 50%, VP > 50%, VP > 85% or PM dependence. In 73 patients PM rhythm was documented at the end of follow-up. Of these, 14 (19.2%) were considered dependent, and 37 (50.7%) presented VP > 50%. The post-TAVR complete AV block recovery rate was 67.8%. In multivariate analysis, female sex (HR = 5.6, p = 0.005), and indication of complete AV block vs. LBBB (HR = 15.7, p = 0.017) were independently associated with PM dependency. CONCLUSIONS: Female sex and indication due to complete AV block were independent predictors of PM dependency during follow up. In our series of patients with mostly normal LVEF, a high percentage of stimulation does not influence prognosis.

Ablación pediátrica con catéter: características y resultados del procedimiento en un centro terciario de referencia / Pediatric catheter ablation: characteristics and results of a series in a tertiary referral hospital

Introducción y objetivos: La ablación con catéter es un método para tratar arritmias en población pediátrica indicada en un creciente número de casos. Hay poca evidencia sobre la experiencia en estos procedimientos en España. El objetivo es describir las características y los resultados de una serie contemporánea de un hospital terciario de referencia nacional. Métodos: Se revisaron los procedimientos de ablación realizados entre 2004 y 2016 en menores de 17 años en el momento de la indicación. Se analizaron características clínicas, metodología de la ablación y resultados agudos y a largo plazo. Resultados: Se realizaron 291 procedimientos en 224 pacientes (mediana de edad, 12,2 años; el 60% varones). El 46% de los pacientes venían derivados desde otras comunidades autónomas. Los sustratos más frecuentemente abordados fueron las vías accesorias (VAC) (el 70,2%; más del 50% septales) y la taquicardia intranodular (TIN) (15,8%). El 16,8% presentaba cardiopatía congénita, familiar o adquirida. El 35,5% de los casos se realizaron con crioablación. El éxito agudo general de los procedimientos primarios fue del 93,5% (el 93,8% en las VAC y el 100% en las TIN). Se repitieron procedimientos por recurrencia en el 18,9% de los casos, con un éxito acumulado del 98,4% (el 99,3% en las VAC y el 100% en las TIN). Se registró un bloqueo auriculoventricular completo (0,37%), sin otras complicaciones mayores. Conclusiones: El elevado porcentaje de éxito con mínimas complicaciones en una serie con alto nivel de complejidad reproduce los resultados publicados en otros países y refrenda el uso de la ablación con catéter en población pediátrica en centros especializados de referencia

Introduction and objectives: Catheter ablation has become the treatment of choice in an increasing number of arrhythmias in children and adolescents. There is still limited evidence of its use at a national level in Spain. The aim was to describe the characteristics and results of a modern monocentric series form a referral tertiary care centre. Methods: Retrospective register of invasive procedures between 2004 and 2016 performed in patients under 17 years and recorded clinical characteristic, ablation methodology and acute and chronic results of the procedure. Results: A total of 291 procedures in 224 patients were included. Median age was 12.2 years, 60% male. Overall, 46% patients were referred from other autonomous communities. The most frequent substrates were accessory pathways (AP) (70.2%, > 50% septal AP localization) and atrioventricular nodal reentrant tachycardia (AVNRT) (15.8%). Congenital and acquired heart disease was frequent (16.8%). Cryoablation was used in 35.5% of the cases. Overall acute success of the primary procedure was 93.5% (AP 93.8%; AVNRT 100%). Redo procedures after recurrence were performed in 18.9% of all substrates, with a long-term cumulative efficacy of 98.4% (AP 99.3%; AVNRT 100%). One (0.37%) serious complication occurred, a case of complete atrioventricular block. Conclusions: Our study replicated previous international reports of high success rates with scarce complications in a high complexity series, confirming the safety and efficacy of pediatric catheter ablation in our environment performed at highly experienced referral centers

Pediatric Catheter Ablation: Characteristics and Results of a Series in a Tertiary Referral Hospital.

INTRODUCTION AND OBJECTIVES: Catheter ablation has become the treatment of choice in an increasing number of arrhythmias in children and adolescents. There is still limited evidence of its use at a national level in Spain. The aim was to describe the characteristics and results of a modern monocentric series form a referral tertiary care centre. METHODS: Retrospective register of invasive procedures between 2004 and 2016 performed in patients under 17 years and recorded clinical characteristic, ablation methodology and acute and chronic results of the procedure. RESULTS: A total of 291 procedures in 224 patients were included. Median age was 12.2 years, 60% male. Overall, 46% patients were referred from other autonomous communities. The most frequent substrates were accessory pathways (AP) (70.2%,>50% septal AP localization) and atrioventricular nodal reentrant tachycardia (AVNRT) (15.8%). Congenital and acquired heart disease was frequent (16.8%). Cryoablation was used in 35.5% of the cases. Overall acute success of the primary procedure was 93.5% (AP 93.8%; AVNRT 100%). Redo procedures after recurrence were performed in 18.9% of all substrates, with a long-term cumulative efficacy of 98.4% (AP 99.3%; AVNRT 100%). One (0.37%) serious complication occurred, a case of complete atrioventricular block. CONCLUSIONS: Our study replicated previous international reports of high success rates with scarce complications in a high complexity series, confirming the safety and efficacy of pediatric catheter ablation in our environment performed at highly experienced referral centers.

Safety and efficacy of cryoablation vs. radiofrequency ablation of septal accessory pathways: systematic review of the literature and meta-analyses.

Aims: Radiofrequency ablation (RFA) of septal accessory pathways (APs) is associated with a significant rate of first procedure failures and complications. Cryoablation is an alternative energy source but there are no studies comparing both ablation techniques. We aimed to systematically review the literature and compare the efficacy and safety of cryoablation vs. RFA of septal APs. Methods and results: We conducted two separate meta-analysis of cryoablation and RFA of septal APs and calculated the global estimates of the efficacy and safety. Sixty-four articles were included: 38 articles reporting RFA and 27 articles reporting cryoablation procedures. Additionally, we included the previously non-published cryoablation registry of septal APs performed at our institution. Overall, 4244 septal APs constitute our study population, 3495 in the RFA cohort and 749 in the cryoablation cohort. Acute procedural success rate of cryoablation was 86.0% (95% CI 81.6-89.4%) and RFA 89.0% (95% CI 86.8-91.0%). Recurrence rate of cryoablation was 18.1% (95% CI 14.8-21.8%) and RFA 9.9% (95% CI 8.2-12.0%). Long-term success rate after multiple ablation procedures of cryoablation was 75.9% (95% CI 68.2-82.3%) and RFA 88.4% (95% CI 84.7-91.3%). There were no reported cases of persistent atrioventricular block (AVB) with cryoablation and 2.7% (95% CI 2.2-3.4%) with RFA. Conclusion: Studies of RFA for treatment of septal APs report higher efficacy rates than do studies using cryoablation, but a significantly higher rate of AVB.