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31.
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33.
Remote-controlled catheter ablation of accessory pathways: results from the magnetic laboratory. 总被引:7,自引:0,他引:7
Julian Kyoung-Ryul Chun Sabine Ernst Shibu Matthews Boris Schmidt Dietmar Bansch Sigrid Boczor Amaar Ujeyl Matthias Antz Feifan Ouyang Karl-Heinz Kuck 《European heart journal》2007,28(2):190-195
AIMS: This study evaluates feasibility, safety, and efficacy of magnetic remote-controlled accessory pathway (AP) ablation. METHODS AND RESULTS: The novel magnetic navigation system (MNS) (Niobe, Stereotaxis) creates a steerable magnetic field (0.08 T) controlling the distal magnetic tip of an ablation catheter. In conjunction with a catheter advancer system (Cardiodrive, Stereotaxis) remote catheter ablation is enabled. Conventional electrophysiology study identified AP conduction in 59 patients (37 males, 36+/-14 years, 60 APs). First generation 1-magnet tip (1-M) (group I, n=18), second generation bipolar 3-magnet tip (3-M) (group II, n=27), and third generation quadripolar 3-magnet tip catheters (3-M quad.) (group III, n=14) were used for magnetic remote-controlled ablation. Successful AP ablation was achieved in 67% (group I), 85% (group II), and 92% (group III). A significant decrease of median [IQR: Q1-Q3] fluoroscopy time and dosage was observed: 21.2 [12.1-33.8] min, 1110 [395-3234] microGym2 (group I); 6.5 [4.4-15.4] min, 290 [129-489] microGym2 (group II), and 4.9 [3.4-8.0] min, 129 [74-270] microGym2 (group III). Mean procedure time (217+/-67 min; 182+/-68 min, and 172+/-90 min) significantly decreased in group III. Median number [Q1-Q3] of radiofrequency current applications in groups I, II, and III was 4 [2-9], 4 [2-6], and 2 [2-4], respectively. No complications occurred. CONCLUSION: Remote AP ablation is safe and feasible using the novel MNS. Introduction of the 3-magnet quadripolar ablation catheter significantly improved the efficacy of the procedure. 相似文献
34.
Christoph R?cken Jutta Ernst Ernst Hund Hartmut Michels Jolanta Perz Wolfgang Saeger Orhan Sezer Simone Spuler Friedrich Willig und Hartmut H.-J. Schmidt 《Medizinische Klinik》2006,101(10):825-829
Ohne Zusammenfassung 相似文献
35.
Ignatius Gerardo E Zarraga Ernst R Schwarz 《Journal of the American College of Cardiology》2007,49(1):1-14
Since their approval in 1998, the popularity of selective cyclooxygenase-2 (COX2) inhibitors has swung from a domination of drug sales to serious disputes about their cardiovascular safety. Despite the numerous studies on COX2 inhibitors that have emerged, drawing conclusions about their cardiovascular safety has been complicated by conflicting results, underpowered clinical trials, and the lack of a placebo group and use of post hoc analyses in many trials. Nonetheless, certain conclusions can be made with reasonable accuracy. This review addresses the controversy in 3 segments. It begins with a discussion of the several mechanisms proposed to explain how selective COX2 inhibition impacts the cardiovascular system. This is followed by a recount of the several clinical studies that delved into the cardiovascular outcomes associated with COX2 inhibitors. Finally, answers to key questions are provided to assist the clinician in devising a systematic approach to the risk-benefit analysis of COX2 inhibitors in actual practice. 相似文献
36.
G. Aernout Somsen Ernst E. van der Wall Bob van Vlies Judocus J. J. Borm Eric A. van Royen 《The International Journal of Cardiac Imaging》1996,12(4):305-310
In patients with chronic heart failure, increased sympathetic activity and cardiac sympathetic neuronal dysfunction are present and have been related to unfavourable clinical outcome. Modification of these alterations with the objective to improve prognosis has become an important aim of pharmacological therapy for these patients. A noninvasive technique to assess sympathetic neuronal function at the cardiac level may be valuable in evaluating newly developed therapeutic strategies. 123-iodine metaiodobenzylguanidine can be used visualize cardiac sympathetic nerve function and activity. Single photon emission computerized tomographic is preferred to planar scintigraphy since it does not depend on superposition of other anatomical structures and may allow assessment of regional cardiac 123-iodine metaiodobenzylguanidine uptake. Although the quantitation of cardiac uptake in these tomographic images has several limitations, the use of the left ventricular cavity as a reference, calibrated by the 123-iodine activity in a blood sample drawn at the time of acquisition, may have clinical applications, with respect to the evaluation of therapeutical intervention in patients with heart failure.Abbreviations BS
blood sample
- CD
count density
- dP/dt
change in pressure over time
- [123I]
123-iodine
- Km
affinity constant
- MIBG
metaiodobenzylguanidine
- MBq
mega Bequerel
- SPECT
single photon emission computerized tomography
- Vm
capacity constant 相似文献
37.
Amir Kurtaran Josef Pfreitfellner Peter Schaffarich Peter Smith-Jones Bruno Niederle Markus Raderer Irene Virgolini Helmar Bergmann Ernst Havlik 《European journal of nuclear medicine and molecular imaging》1997,24(10):1298-1300
The purpose of this study was to estimate the radiation doses to nursing staff, other patients, accompanying persons and family
members deriving from patients undergoing 111In-DTPA-d-Phe-1-octreotide (111In-OCT) scintigraphy. Dose rates were measured from 16 patients who had received an intravenous injection of 140±40 MBq 111In-OCT. The measurements were performed at three different distances (0.5, 1 and 2 m) at 10–20 min, 5–7 h and 24 h (and in
some cases, up to 48 h) after administration of 111In-OCT. The effective half-lives of the biexponential decrease of the dose rates were estimated to be 2.94±0.27 h (T
1) and 65.17±0.58 h (T
2). The calculated maximum dose to other persons in the waiting area was 27.2 μSv, to family members 61.5 μSv, to nursing staff
in a ward 24.1 μSv and to neighbouring patients in the ward 69.5 μSv. Our results clearly demonstrate that the calculated
maximum radiation exposure to accompanying persons, personnel, family members and other patients is well below the maximum
annual dose limit for non-professionally exposed persons.
Received 20 May and in revised form 9 July 1997 相似文献
38.
E Ernst 《British journal of hospital medicine》1992,48(6):303-4, 307
The prophylactic value of physical activity for arteriosclerotic diseases is generally accepted. Regular exercise is also the most effective therapy for intermittent claudication although drug treatment is more popular in general practice. Recent findings show that exercise and drug treatments complement each other. 相似文献
39.
Coronary vasomotion in patients with syndrome X: evaluation with positron emission tomography and parametric myocardial perfusion imaging 总被引:1,自引:1,他引:0
Joan G. Meeder Paul K. Blanksma Ernst E. van der Wall Antoon T. M. Willemsen Jan Pruim Rutger L. Anthonio Richard M. de Jong Willem Vaalburg Kong I. Lie 《European journal of nuclear medicine and molecular imaging》1997,24(5):530-537
The aim of this study was to elucidate further the causative mechanism of abnormal coronary vasomotion in patients with syndrome X. In patients with syndrome X, defined as angina pectoris and documented myocardial ischaemia during stress testing with normal findings at coronary angiography, abnormal coronary vasomotion of either the micro- or the macrocirculation has been suggested as the causative mechanism. Accordingly, we evaluated endothelial function, vasodilator reserve, and perfusion heterogeneity in these patients. Twenty-five patients with syndrome X (definitely normal coronary arteriogram, group A), 15 patients with minimal coronary artery disease (group B) and 21 healthy volunteers underwent [13N]ammonia positron emission tomography at rest, during cold pressor stimulation (endothelial function) and during dipyridamole stress testing (vasodilator reserve). Heterogeneity of myocardial perfusion was analysed by parametric polar mapping using a 480-segment model. In both patient groups, resting perfusion was increased compared to the normal subjects: group A, 127±31 ml·min–1·100 g–1; group B, 124±30 ml·min–1·100 g–1 normal subjects, 105±21 ml·min–1·100 g–1 (groups A and B vs normals,P<0.05). These differences were abolished after correction for rate-pressure product. During cold pressor stimulation, the perfusion responses (ratio of cold pressor perfusion to resting perfusion) were similar among the patients and the control subjects (group A, 1.20±0.23; group B, 1.24±0.22; normal subjects, 1.23±0.14). Likewise, during dipyridamole stress testing, perfusion responses were similar among the three groups (group A, 2.71±0.67; group B, 2.77±1.29; normal subjects, 2.91±1.04). In group A the heterogeneity of resting perfusion, expressed as coefficient of variation, was significantly different from the volunteers (20.1±4.5 vs 17.0±3.0,P<0.05). In group B (coefficient of variation 19.4±3.9) the difference from normal volunteers was not significant. In this study, patients with syndrome X and patients with minimal coronary artery disease showed normal perfusion responses during cold pressor stimulation and dipyridamole stress testing. Our findings therefore suggest that endothelial dysfunction and impaired vasodilator reserve are of no major pathophysiological relevance in patients with syndrome X. Rather, other mechanisms such as increased sympathetic tone and focal release of vasoactive substances may play a role in the pathogenesis of syndrome X. 相似文献
40.
Rainer O. Seidl Ingo Todt Arne Ernst 《European archives of oto-rhino-laryngology》2007,264(3):291-293
We report on a case of esophageal atresia following cervical spine surgery. A swallowing examination was performed using fibre-optic
endoscopy and videofluoroscopy. There was scar tissue fixation of the larynx and esophagus to the cervical spine. Operative
mobilization of the larynx and esophagus and formation of a sliding layer using a platysma-fascia flap was done. The PEG and
tracheal cannula were removed; oral nutrition was initiated after 3 months. Swallowing disorders following operations on the
upper cervical spine should be investigated. Careful preparation that preserves the layers should be carried out. Fixation
of tissues as a result of scarring should be treated with a sliding layer. 相似文献