Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Sep 2004
Left atrial tachycardia after circumferential pulmonary vein ablation for atrial fibrillation: electroanatomic characterization and treatment.
The purpose of this study was to evaluate the electroanatomic characteristics of left atrial tachycardia (AT) in a series of patients who underwent circumferential pulmonary vein ablation (CPVA) and to describe the ablation strategy and clinical outcome. ⋯ Left AT after CPVA can be due to a macro-re-entrant or focal mechanism. Re-entry occurs most commonly across the mitral isthmus, the posterior wall, or gaps on previous ablation lines. Such gaps and foci occur most commonly at the anterior aspect of the left superior pulmonary vein and at the septal aspect of the right pulmonary veins. These arrhythmias can be successfully mapped and ablated with an electroanatomic mapping system.
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J. Am. Coll. Cardiol. · Sep 2004
Multiple, brief coronary occlusions during early reperfusion protect rabbit hearts by targeting cell signaling pathways.
An in situ model was used to test whether and how multiple occlusions at reperfusion can protect rabbit myocardium. ⋯ Multiple, short, regional coronary occlusions immediately after prolonged myocardial ischemia are an effective cardioprotective intervention in the rabbit, and the mechanism of protection involves activation of ERK, production of nitric oxide, and opening of mitochondrial K(ATP) channels. These observations suggest that a similar approach could be applied in the cardiac catheterization laboratory to protect reperfused myocardium after primary angioplasty in patients with acute myocardial infarction.
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J. Am. Coll. Cardiol. · Aug 2004
Randomized Controlled Trial Clinical TrialN-Acetylcysteine versus fenoldopam mesylate to prevent contrast agent-associated nephrotoxicity.
We performed a study to assess the efficacy of fenoldopam mesylate (a specific agonist of the dopamine-1 receptor) as compared with N-acetylcysteine (NAC) in preventing contrast agent-associated nephrotoxicity (CAN). ⋯ N-acetylcysteine seems to be more effective than fenoldopam in preventing CAN.
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J. Am. Coll. Cardiol. · Aug 2004
Comparative StudyComparison of medical treatment with percutaneous closure of patent foramen ovale in patients with cryptogenic stroke.
The purpose of this study was to compare the efficacy of medical treatment with percutaneous closure of patent foramen ovale (PFO). ⋯ Percutaneous PFO closure appears at least as effective as medical treatment for prevention of recurrent cerebrovascular events in cryptogenic stroke patients with PFO. It might be more effective than medical treatment in patients with complete closure and more than one cerebrovascular event.
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J. Am. Coll. Cardiol. · Aug 2004
Clinical TrialIbutilide added to propafenone for the conversion of atrial fibrillation and atrial flutter.
We evaluated the safety and efficacy of ibutilide when added to propafenone in treating both paroxysmal and chronic atrial fibrillation (AF) and atrial flutter (AFL). ⋯ Our graded approach using propafenone and ibutilide appears to be a relatively safe and effective alternative for the treatment of paroxysmal and chronic AF/AFL to both rapidly restore sinus rhythm in nonresponders to monotherapy with propafenone and prevent immediate recurrences of the arrhythmia.