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Lixuewen Lixuewen - One of the best experts on this subject based on the ideXlab platform.
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CLINICAL EFFECT ANALYSIS OF ATRIAL FIBRILLATION AFTER CATHETER ABLATION
Heart, 2012Co-Authors: Lixuewen LixuewenAbstract:Objectives Atrial fibrillation (AF) is one of the most common cardiac arrhythmias, which is harmful to human health and quality of life. AADs are limited in clinical because of their side effects, so in recent years, RFCA has become one of the effective treatments for AF, whose clinical application is showing a clear upward trend. In order to explore the efficacy and safety of catheter ablation for AF, we have followed up the patients with AF undergoing catheter ablation in this study. Methods A cohort of 39 patients with AF after RFCA from 2008 to 2011 was studied, 25 male and 14 female; the average age was 61.08±10.17 (36–74) years old. Among them, there were 32 cases with paroxysmal AF, and seven cases with persistent AF. 19 cases were complicated with hypertension, six cases with coronary heart disease, seven cases with diabetes and two cases with cerebral infarction. All the patients suffered from obvious clinical discomfortable symptoms. Although treated by one to two kinds of AADs already, the effects were poor. CPVI was performed in the all of them (five cases recurred, 13.51%). The endpoint of the ablation was complete electronic isolation of all the pulmonary veins (PVs). The patients who were converted to sinus rhythm in the cause of ablation were validated by Lasso electrodes, and could not be evoked atrial arrhythmia again. However, those who were failed to be converted to sinus rhythm would be validated after electroversion. For those who weren9t isolated PVs completely, the conducted gap was initially posited by the mapping catheter, and the earliest fragmented potential was targeted for ablation till the complete electronic isolation of all the PVs. Results (1) The results of catheter ablation: 37 cases were successfully achieved immediately the endpoint after the ablation. Surgery average time of operation was (174.89±35.05) min, average X-ray exposure time (33.62±16.44) min, average discharge time (40.78±11.61) min; No severe complications such as pulmonary vein stenosis, pericardial tamponade, cardio-Esophagus Fistula, stroke occurred during and after the procedure. One case with paroxysmal AF was converted to auricular flutter after ablation, who were failed to be converted to sinus rhythm by synchronised cardioversion, but converted after Marshall Ligament ablation; three cases with persistent AF undergoing ablation were turned to be sinus rhythm by cardioversion; one case with persistent AF undergoing ablation was converted to sinus rhythm by intravenous irapbullitt. Five cases developed atrial tachyarrhythmias in 5–7 days after ablation: four cases appeared paroxysmal AF with fast ventricular rate; one case appeared paroxysmal atrial tachycardia; another one was sinus bradycardia, junctional escape. All the patients didn9t suffer dysponea, cough, haemoptysis and so on before discharge, moreover distention of jugular vein, pulsus paradoxus and pericardial rub were not found through physical examination. No severe complication happened during and after the procedure, and all of them maintained sinus rhythm before discharge. (2) Follow-up: 37 cases were followed-up after 6–12 months, average 6±2 months, only one case lost communication and one case died of congestive heart failure. Five cases recurred: one case with paroxysmal AF who recurred after simple CPVI refused re-ablation, decreased episode frequency and took amiodarone to maintain sinus rhythm. One patient who performed CPVI and atria sinistrum isthmus ablation, three cases with paroxysmal AF appeared atrial arrhythmia after RFCA, but they refused re-ablation temporarily because of decreasing episode frequency. 36 cases took warfarin according to monitoring INR periodically, while one case took warfarin only 2 months after ablation because of hemorrhinia. Dysponea, cough related to pulmonary vein stenosis, and thromboembolism complications didn9t occur for all of the cases. The LAD of 29 cases recovered normal size (LAD≤35 mm) on cardiac ultrasound 3 months after ablation. The lower the preoperative LVEF is, the more obvious the improvement is after RFCA. Conclusions Catheter ablation is safe and effective for treating AF.
Khaled A. Dajani - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of the Pulmonary Veins and Left Atrial Volume using Multidetector Computed Tomography in Patients Undergoing Catheter Ablation for Atrial Fibrillation.
Current cardiology reviews, 2009Co-Authors: Hiroki Ito, Khaled A. DajaniAbstract:Catheter ablation is an evolving treatment option in patients with atrial fibrillation. Contrast enhanced electrocardiogram-gated multi-detector computed tomography (MDCT) has rapidly evolved over the past few years into an important tool in the diagnosis of coronary atherosclerosis. There is increasing recognition that MDCT is a useful tool to evaluate non-coronary structures, such as cardiac chambers, valves, the coronary sinus and adjacent structures including pulmonary veins. In particular, MDCT is playing an increasingly important role in the evaluation of the left atrium and the pulmonary veins in patients undergoing catheter ablation for atrial fibrillation. It provides accurate and reliable identification of the pulmonary veins and anatomical relationship between the left atrium and Esophagus although the mobile Esophagus may limit the value of MDCT to reduce the risk of atrio-Esophagus Fistula. In this article, we will review the evaluation of the left atrium and pulmonary veins using MDCT in patients undergoing catheter ablation of atrial fibrillation.
Hiroki Ito - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of the Pulmonary Veins and Left Atrial Volume using Multidetector Computed Tomography in Patients Undergoing Catheter Ablation for Atrial Fibrillation.
Current cardiology reviews, 2009Co-Authors: Hiroki Ito, Khaled A. DajaniAbstract:Catheter ablation is an evolving treatment option in patients with atrial fibrillation. Contrast enhanced electrocardiogram-gated multi-detector computed tomography (MDCT) has rapidly evolved over the past few years into an important tool in the diagnosis of coronary atherosclerosis. There is increasing recognition that MDCT is a useful tool to evaluate non-coronary structures, such as cardiac chambers, valves, the coronary sinus and adjacent structures including pulmonary veins. In particular, MDCT is playing an increasingly important role in the evaluation of the left atrium and the pulmonary veins in patients undergoing catheter ablation for atrial fibrillation. It provides accurate and reliable identification of the pulmonary veins and anatomical relationship between the left atrium and Esophagus although the mobile Esophagus may limit the value of MDCT to reduce the risk of atrio-Esophagus Fistula. In this article, we will review the evaluation of the left atrium and pulmonary veins using MDCT in patients undergoing catheter ablation of atrial fibrillation.
Wang Limin - One of the best experts on this subject based on the ideXlab platform.
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Prevention and management of complications associated with anterior cervical spinal surgery
Central Plains Medical Journal, 2006Co-Authors: Wang LiminAbstract:Objective To study the prevention and management of complications associated with anterior cervical spinal surgery.Methods Included in the study were 252 cases of anterior cervical spinal surgery performed from July 1998 to June 2005.Twenty-seven complications associated with the surgery occurred,with an incidence of 10.7%.Discectomy,trephination and corpectomy were used for decompression.Bone grafting consisted of autogenous iliac bone,cage and titanium mesh cage.Internal fixation with plate was also performed in some patients.Results Six of the 7 complications of recurrent laryngeal nerve or superior laryngeal nerve injuries recovered fully in 1~4 weeks postoperatively.CSF leakage of 2 cases were cured after two-week conservative management.Implant failure occurred in 5 cases,including malposition,loosening or pullout of screws.Partial dislodgement of iliac autograft bone was noted in 3 cases without internal fixation.The bonegraft did not slip further after strict immobilization with solid fusion obtained.Both 1 spinal cord injury and 1 nerve root injury were treated with methylprednisolone and medicine for dehydration.Four cases of wound infection healed after debridement and antibiotics administration.Four complications related to the iliac bone donor site presented as wound infections and lateral femoral cutaneous nerve injury.Delayed Esophagus Fistula was found in 1 outpatient.Conclusion Many kinds of complications could occur in anterior cervical spinal surgery.Adequate preoperative preparation,deep understanding of anatomy related to the anterior approach,skilled surgical technique and close postoperative follow-up are the keys to prevent or aviod the occurrence of these complications.
Zhou Yu-ling - One of the best experts on this subject based on the ideXlab platform.
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Nursing and observation of complications in 228 patients with anterior cervical spine surgery
Nursing Practice and Research, 2011Co-Authors: Zhou Yu-lingAbstract:To study the observation and nursing of early complications in 228 anterior cervical spine surgery.We concluded several important nursing points: to make the rounds of sickroom in time,observe the change of vital sign and blood oxygen saturation closely,evaluate the sensation,activity,myodynamia of patient's limbs accurately;to enchance the postoperative blindness,laryngeal nerve and superior laryngeal nerve damage,cervical sympathetic nerve damage,respiratory failure,pulmonary embolism,tardive Esophagus Fistula,cervical jargon haematoma and infection,et al.The key of the complication prevention and treatment is to discovery the problem of patient promptly and to interfere early.