35 results on '"Sora N"'
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2. Safety and efficacy of transvenous lead extraction of left ventricular leads
- Author
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Mazzone, P., Ciconte, G., Marzi, A., Paglino, G., Vergara, P., Sora, N., Gulletta, S., and Della Bella, P.
- Published
- 2011
3. Transvenous lead extraction with the evolution mechanical dilator sheath
- Author
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Ciconte, G., Mazzone, P., Paglino, G., Marzi, A., Vergara, P., Sora, N., Gulletta, S., and Della Bella, P.
- Published
- 2011
4. Liraglutide and Renal Outcomes in Type 2 Diabetes
- Author
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Mann JFE, Ørsted DD, Brown-Frandsen K, Marso SP, Poulter NR, Rasmussen S, Tornøe K, Zinman B, Buse JB, LEADER Steering Committee and Investigators. 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E, Maia F, Maia J, Maia KP, Mañas N, Marchisotti F, Marinho C, Martins C, Figueiredo de Medeiros F, Melo A, Melo F, Mendonca E, Mendonça P, Filho RM, Miguel M, Miléo K, Miyahara M, Montenegro AP, Moraes A, Moreira A, Ítalo Mota J, Mothe FS, Murro A, Nakatani V, Napoli TF, Neto BG, Neto OQ, Niclewicz E, Ohe LN, Oliveira F, Oliveira M, Panarotto D, Parente E, Parolin S, Pechmann L, Costa da Penha P, Perlamagna L, Perotta B, Pimentel L, Pinto M, Poço C, Ponte C, Prazeres P, Quintao E, Raduan R, Rassi DT, Rassi N, Reck L, Montenegro R Jr, Ribeiro R, Rodovalho S, Silveira Rodrigues G, Rollin G, Rossi S, Sabino C, Sales AP, Salles J, Sampaio CR, Santana L, Sato V, da Silva Santos M, Santos NL, Santos R, Saraiva J, Sartori C, Sena R, Sevilha M, Sgarbi J, Silva D, D'albuquerque Silva L, Silva ME, Siqueira K, Soares S, Sobreira W, Sousa B, Souza AC, Souza B, Tambascia M, Tarantino R, Tenor F, Tomarchio M, Triches C, Tristão LJ, Valenti A, Vasques E, Vencio S, Vianna A, Munhoz Vidotto T, Vieira 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S, Doshi P, Dostou J, Douglas D, Douglass S, Dowell M, Drazich E, Driver E, Du H, DuBose R III, Duclos M, Dunn K, Dunnam T, Durham N, Dye L, Eagerton D, Ebenibo S, Edeoga C, Edwards G, Ekwensi J, El Asmar I, El Sayad N, Eliopoulos C, Elkosseifi M, Elmer R, Elmore M, Elson D, ElZein L, Emmert L, Erbe L, Estes S, Estrada L, Estrada A, Eveleigh T, Everhart B, Faas F, Faircloth C, Farmer M, Fehr K, Ferguson T, Fernandes J, Ferree K, Ferrington B, Fitzhugh M, Fitzsimmons R, Flanders D, Flores M, Flores E, Flores J, Florida C, Flynn J, Folmar P, Forbes R, Ford W, Fowler M, Fraker A, Francis S, Franco-Cotto E, Fratila C, Fuentes M, Galagan R, Galloway A, Garcia M, Garcia R, Garriott M, Garza J, Gass N, Gates S, Geary M, Geiger K, Geishauser J, Giglio A, Gilbert M, Godwin S, Goetter B, Goley A, Golici L, Gomori E, Gonzales J, Gore A, Gorman T, Gosmanova A, Goswami K, Gotham A, Govoni J, Graddick S, Grant T, Greca A, Green C, Greenbaum K, Greenwald J, Grover D, Grunberger G, Guice M, Guirao D, Gunna V, Guseva N, Ha T, Hagan A, Hager S, Haggag A, Haggar M, Hamilton M, Hamlet P, Hammond J, Hansen A, Harrell W, Harris E, Harris K, Harris M, Harrison L, Hartman I, Hatch A, Hayes D, Hayes M, Heath J, Heineman R, Heinzman A, Hendrick M, Herbst R, Hermayer K, Hibbard J, Hill WD, Hilliard B, Hix M, Hoch B, Hollander P, Holmes Z, Horobetz C, Horowitz R, Hsieh P, Hsieh S, Htun W, Huang J, Huber C, Hudson T, Huizar S, Hull B, Hull J, Hummer K, Hundal R, Hunt G, Hunt V, Hutchinson P, Hwang J, Iannamorelli A, Iannuzzi L, Ingram M, Iram N, Ismail-Beigi F, Jabbour S, Jackson T, Jaen L, Jain V, Jannesari R, Januski V, Japa U, Jarvis K, Jayson L, Jensen R, Jester D, Jocko C, Johnson C, Johnson M, Johnston K, Jones D, Jones J, Jordan T, Juarez M, Kaapuraala A, Kain A, Kaiser V, Kamradt K, Karatoprakli P, Karegar M, Karounos C, Karounos D, Karunaratne H, Katalenich B, Katic K, Katz M, Kaur G, Kawa A, Keib C, Keider G, Kem D, Kennedy R, Kenney B, Kereiakes D, Ketana M, Kettinger L, Khaira A, Khan A, Khan K, Khan M, Khoo T, Khrlobyan N, Kilgore J, Kim G, Kimble S, Kinsley M, Kitchen T, Klick M, Kniffen W, Knight R, Kodzwa D, Koenig T, Komarovskiy K, Kong Y, Koontz D, Krishnasamy S, Krueger E, Kuechenmeister L, Kuehl A, Kuettel K, Kugler D, Kulow T, Kupriyanchik I, Kuruvanka T, Kushner D, Kwon E, Kwon S, Kyle M, LaBryer L, Labuda J, Lafave J, Laguerre J, Laliberte A, Lane J, Langel C, Lann D, Largay J, Latif K, Latus T, Lawrence J, Ledger G, Lee FG, Lee E, Leffert J, Leinung M, Lenhard MJ, Lentino J, Leon J, Leonard M, Letassy N, Leuck K, Levin P, Levinson D, Lewis M, Light T, Lim J, Lindamood R, Lingvay I, Lipps J, Lisa A, Livingston Y, Llamas L, Loesch R, Long T, Looby R, Lopez C, Lorenz T, Lovre D, Lu P, Lucas K, Luevano G, Luidens M, Luna B, Luttrell L, Lyons T, MacAdams M, Mack D, Mack M, Madden M, Madder R, Madireddy S, Mae L, Mahakala A, Maheshwari H, Malbari H, Maldonado N, Mallitz M, Mandviwala M, Mann K, Mardahay M, Marino J, Marney A, Marshall L, Martin A, Martin E, Martinez G, Martinez-Miss S, Marx P, Massara L, Mastoor M, Matfin G, Maturu A, Maurides P, May M, Mayfield R, Maynard B, Mazza A, McCann K, McCoy J, McCoy T, McCullen MK, McDaniel C, McDaniel AM, McDermott M, McDonald A, McMasters B, McMurray C, Medlin T, Meinel M, Mendez I, Menefee J, Meredith M, Merriweather M, Mersey J, Messino C, Meyer S, Meyers L, Michael D, Midyett C, Miklius A, Milford E, Miller B, Miller H, Milligan M, Minor A, Miranda-Palma B, Mirarchi N, Mittadodla S, Mittle J, Moffat A, Mohaupt S, Mohiuddin K, Mokshagundam S, Monaco S, Monsaert R, Montano-Pereira C, Montgomery A, Moody K, Moon M, Moore D, Moore L, Morawski E, Moreau C, Morin D, Moscoa C, Motzkin C, Mueller R, Munoz C, Munoz M, Myneni A, Naderi B, Nagireddy P, Naidu J, Naidu R, Naik S, Naimark R, Nardicchi M, Ndukwu I, Neller C, Netten-Foster L, Neumiller J, New T, Newman S, Newton T, Nguyen B, Nicol B, Nicol P, Ninivaggi L, Niswender K, Norman L, Noworatzky G, Nyenwe E, O'Brien H, O'Connell T, Oden W, Odugbesan A, Oliver M, Oliver T, Olmeda C, O'Neil C, Oremus R, Ortega T, Ortiz-Santos S, Osborn T, Padmanabhan S, Papacostea O, Park I, Parker A, Parker K, Parker R, Patel C, Patel M, Patel R, Patino M, Patterson S, Paulson K, Paz A, Pemba R, Pepe C, Perez J, Perez T, Perry D, Phillips B, Phillips J, Pickett A, Pinson M, Pitzer R, Poduri M, Poehls J, Poteat T, Powell L, Prasad S, Prevost J, Price E, Priest D, Prieto L, Purewal T, Purighalla R, Purighalla U, Quadrel M, Qureshi A, Radhamma R, Rafla E, Rajab H, Ramalingam R, Ramirez A, Ramirez J, Ramirez K, Ramirez M, Randall M, Rangaraj U, Rao V, Rasmussen P, Rasouli N, Ray A, Reed J, Rems L, Renaud K, Reno M, Resnick M, Reusch J, Reynolds L, Rhoton K, Rhudy J, Ricci C, Rice L, Richardson A, Richardson L, Rickard H, Rickels M, Riff D, Rightenour N, Risser J, Rizvi A, Robertson J, Robinson A, Robinson R, Rockwell M, Rodriguez JP, Rodriguez M, Rojas M, Rojas W, Rooker-Morris L, Root C, Rose M, Rosenberg R, Rosenstock J, Roth M, Ruby R, Sachson R, Sack P, Sadler RK, Sahai S, Salazar J, Salgam M, Samal A, Samson A, Sanagorski R, Sanchez A, Sandberg J, Sanderson M, Sandoval J, Santiago E, Sapp T, Saunders J, Schill J, Schott C, Schreiman R, Schu D, Schuh K, Schutta M, Schwartz J, Schweppe L, Scofield H, Scribner A, Seal J, Sealock J, Seaton B, Sedlak-Hanslik T, Seekins K, Segal M, Seggelke S, Semenza S, Sentman P, Serra M, Seshadri P, Sevilla E, Shah S, Shaheen K, Shanik M, Shaw J, Sheets M, Shellabarger C, Sher J, Shippey J, Shivaswamy V, Shomali M, Shore D, Shroff P, Siddiqui T, Siegwald A, Silver R, Simmons D, Simons R, Sinan A, Singh M, Sirinvaravong S, Skero J, Slover-Zipf J, Small S, Smith B, Smith K, Smith M, Sohl J, Solarz SH, Soler D, Sood A, Sora N, Souchet A, Soule J, Sparks J, Spector L, Speicher R, Spillers L, Spivey T, Springer N, Sprouse H, St John J, Stacey A, Stacey H, Stafford M, Stagner E, Staples K, Steadman E, Steed R, Steeves G, Steinberg H, Stell C, Stirman E, Straub K, Strock E, Sue M, Suris O, 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C, Wise J, Witte M, Wittenmyer J, Wood C, Wood R, Woodruff C, Worthington B, Wynn D, Wysham C, Xavier P, Yela S, Yenoby L, Young L, Younus N, Yourell V, Zaid M, Zubair I., Mann, Jfe, Ørsted, Dd, Brown-Frandsen, K, Marso, Sp, Poulter, Nr, Rasmussen, S, Tornøe, K, Zinman, B, Buse, Jb, Bergenstal R, LEADER Steering Committee and Investigators., Daniels, G, Moses, Ac, Nauck, M, Nissen, S, Pocock, S, Steinberg, W, Stockner, M, Kristensen, P, Ravn, L, Zychma, M, Flyvbjerg, A, Ford, I, Kloos, Rt, Schactman, Mj, Sleight, P, Swedberg, K, Tenner, Sm, Akalın, S, Arechavaleta, R, Bain, S, Babkowski, Mc, Benroubi, M, Berard, L, Comlekci, A, Czupryniak, L, Eliasson, B, Eriksson, M, Fonseca, V, Franek, E, Gross, J, Hafidh, K, Haluzik, M, Hayes, F, Huang, Yy, Jacob, S, Kaddaha, G, Khalil, A, Kilhovd, B, Laakso, M, Leiter, L, Lalic, N, Ji, L, Luedemann, J, Mannucci, E, Marre, M, Masmiquel, L, Mota, M, Omar, M, O’Shea, D, Pan, C, Petrie, J, Pieber, T, Pratley, R, Raz, I, Rea, R, Rutten, G, Satman, I, Shestakova, M, Simpson, R, Smith, D, Tack, C, Tarnow, L, Thomas, N, Van Gaal, L, Travert, F, Vidal, J, Warren, M, Yoon, Kh, Tuttle, Rm, Sheerman, Si, Hegedüs, L, Baerwald, H, Bergenstal, M, Celik, S, Dias, C, Eder, M, Fitzgibbons, S, Irvhage, L, Kloluckova, J, Kriulianski, R, Mcduffie, R, Moen, S, Paster, A, Saalfeld, Rm, Sankar, K, Shehaj, E, Swierzewska, P, Tiktin, M, Tovey, S, Gibson, Cm, Chakrabarti, Ak, Dashe, Jf, Hinchey, J, Leary, Mc, Pride, Y, Wiviott, S, Allen, S, Mehr, Ap, Mutter, Wp, Parikh, S, Ray, S, Cheifetz, A, Leffler, D, Sheth, S, Alexander, E, Gaglia, Jl, Goessling, W, Mitzner, Ld, Rosenberg, C, Snow, Kj, Wagner, A, Piazza, G, Abell, S, Davis, T, D'Emden, M, Ding, Sa, Gilfillan, C, Greenaway, T, Gunawan, F, Ho, J, Jackson, R, Kalra, B, Lau, Sl, Lin, J, Macisaac, R, Makepeace, A, Malabu, U, Marjason, J, Mccallum, R, Mclean, M, Moin, N, Petersons, C, Price, S, Roberts, A, Roberts, D, Sangla, K, Stranks, S, Tan, Y, Thynne, T, Walters, J, Ward, G, Wen, W, Zhang, J, Brix, J, Feder, A, Höbaus, C, Höllerl, F, Höller, V, Kotter, T, Kratz, E, Krzizek, Ec, Leb-Stoeger, U, Mader, J, Mras, N, Novak, E, Obendorf, F, Peric, S, Pesau, G, Prager, R, Ribitsch, A, Schnack, C, Schernthaner, G, Wascher, T, Batens, Ah, Benhalima, K, De Block, C, Ernest, P, Fouckova, A, Jandrain, B, Lapauw, B, Letiexhe, M, Mathieu, C, Neven, S, Peiffer, F, Ruige, J, Scheen, A, Taes, Y, Van Boxelaer, I, Vandistel, G, Van Durme, Y, Verhaegen, A, Alencar, E, Alencar, R, Almeida, Ac, B, Alve, Alves, E, Alves, G, Alves, J, Araujo, L, Arruda, V, Augusto, Ga, Baggentoss, R, Balestrassi, L, Barbosa, M, Barcelos, I, Belem, L, de Bem, A, Betti, Rt, Bona, R, Bosco, A, Branda, J, Bronstein, M, Bueno, T, Bulcão, T, Caiado, F, Camazzola, F, Cambréa, Mf, Campos, S, Canani, L, Carra, Mk, Caruso, S, Carvalho, N, Casillo, A, Castro, D, Cavalcanti, T, Cavichioli, V, Cercato, C, Chacra, A, Challela, W, Charchar, H, C, Chave, Chrisman, C, Correia-Deur, J, da Costa, A Jr, Costa, M, Costi, B, Coutinho, P, 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S, Pechmann, L, Costa da Penha, P, Perlamagna, L, Perotta, B, Pimentel, L, Pinto, M, Poço, C, Ponte, C, Prazeres, P, Quintao, E, Raduan, R, Rassi, Dt, Rassi, N, Reck, L, Montenegro, R Jr, Ribeiro, R, Rodovalho, S, Silveira Rodrigues, G, Rollin, G, Rossi, S, Sabino, C, Sales, Ap, Salles, J, Sampaio, Cr, Santana, L, Sato, V, da Silva Santos, M, Santos, Nl, Santos, R, Saraiva, J, Sartori, C, Sena, R, Sevilha, M, Sgarbi, J, Silva, D, D'albuquerque Silva, L, Silva, Me, Siqueira, K, Soares, S, Sobreira, W, Sousa, B, Souza, Ac, Souza, B, Tambascia, M, Tarantino, R, Tenor, F, Tomarchio, M, Triches, C, Tristão, Lj, Valenti, A, Vasques, E, Vencio, S, Vianna, A, Munhoz Vidotto, T, Vieira, S, Villar, H, Visconti, G, Volaco, A, Wajchenberg, B, Zanatta, L, Zimmerman, L, Abbott, Ec, Abu-Bakare, A, Advani, A, Allison, R, Bishara, P, Bowering, Ck, Cheng, A, Chouinard, S, Clayton, D, Conway, J, D'Amours, M, de Tugwell, B, Deyoung, P, D'Ignazio, G, Dube, F, Ekoe, Jm, Fagan, S, Garceau, C, Gottesman, I, 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O, Stidsen, J, Cederberg, H, Haapamäki, H, Hukkanen, J, Jauhiainen, R, Kujari, Ml, Lahtela, J, Laine, M, Mäkelä, J, Miilunpohja, M, Savolainen, M, Taurio, J, Vänttinen, M, Creton, C, Cosma, Nv, Dillinger, J, Jacques, Jl, Guedj, Am, Moulla, M, Petit, C, Ratsianoharana, V, Richter, D, Rodier, M, Roussel, R, Hinz, A, Politz, E, Esser, M, Deuse, U, Mittag, D, Hagenow, A, Jacob, F, Jordan, R, Gantke, D, Venschott-Jordan, U, Löhr, C, Klausmann, G, Eschenbrücher, K, Karakas, M, Jahrsdörfer, B, Kunze, Mr, Wöhrle, J, König, W, Spielhagen, H, Kilimnik, A, Lüdemann, Hp, Lüdemann, J, Mölle, A, Mölle, M, Müller, J, Appelt, S, Sauter, A, Sauter, J, Hartmann, U, Löw, A, Krötz, F, Sohn, Hy, von Schacky, C, Klauss, V, Braun, D, Segner, A, Degtyareva, E, Kreutzmann, K, Paschmionka, R, Hauck, N, Sihal, O, Busch, Ak, Maus, O, Stübler, P, Füllgraf-Horst, S, Vietzke, A, Müller, C, Tosch-Sisting, R, Lengsfeld, B, Thaler, J, Schaum, T, Steindorf, J, Steindorf, S, König, A, Reitschuster, S, Schlott, D, Clever, 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Kennedy, R, Kenney, B, Kereiakes, D, Ketana, M, Kettinger, L, Khaira, A, Khan, A, Khan, K, Khan, M, Khoo, T, Khrlobyan, N, Kilgore, J, Kim, G, Kimble, S, Kinsley, M, Kitchen, T, Klick, M, Kniffen, W, Knight, R, Kodzwa, D, Koenig, T, Komarovskiy, K, Kong, Y, Koontz, D, Krishnasamy, S, Krueger, E, Kuechenmeister, L, Kuehl, A, Kuettel, K, Kugler, D, Kulow, T, Kupriyanchik, I, Kuruvanka, T, Kushner, D, Kwon, E, Kwon, S, Kyle, M, Labryer, L, Labuda, J, Lafave, J, Laguerre, J, Laliberte, A, Lane, J, Langel, C, Lann, D, Largay, J, Latif, K, Latus, T, Lawrence, J, Ledger, G, Lee, Fg, Lee, E, Leffert, J, Leinung, M, Lenhard, Mj, Lentino, J, Leon, J, Leonard, M, Letassy, N, Leuck, K, Levin, P, Levinson, D, Lewis, M, Light, T, Lim, J, Lindamood, R, Lingvay, I, Lipps, J, Lisa, A, Livingston, Y, Llamas, L, Loesch, R, Long, T, Looby, R, Lopez, C, Lorenz, T, Lovre, D, Lu, P, Lucas, K, Luevano, G, Luidens, M, Luna, B, Luttrell, L, Lyons, T, Macadams, M, Mack, D, Mack, M, Madden, M, Madder, R, Madireddy, S, Mae, L, Mahakala, A, Maheshwari, H, Malbari, H, Maldonado, N, Mallitz, M, Mandviwala, M, Mann, K, Mardahay, M, Marino, J, Marney, A, Marshall, L, Martin, A, Martin, E, Martinez, G, Martinez-Miss, S, Marx, P, Massara, L, Mastoor, M, Matfin, G, Maturu, A, Maurides, P, May, M, Mayfield, R, Maynard, B, Mazza, A, Mccann, K, Mccoy, J, Mccoy, T, Mccullen, Mk, Mcdaniel, C, Mcdaniel, Am, Mcdermott, M, Mcdonald, A, Mcmasters, B, Mcmurray, C, Medlin, T, Meinel, M, Mendez, I, Menefee, J, Meredith, M, Merriweather, M, Mersey, J, Messino, C, Meyer, S, Meyers, L, Michael, D, Midyett, C, Miklius, A, Milford, E, Miller, B, Miller, H, Milligan, M, Minor, A, Miranda-Palma, B, Mirarchi, N, Mittadodla, S, Mittle, J, Moffat, A, Mohaupt, S, Mohiuddin, K, Mokshagundam, S, Monaco, S, Monsaert, R, Montano-Pereira, C, Montgomery, A, Moody, K, Moon, M, Moore, D, Moore, L, Morawski, E, Moreau, C, Morin, D, Moscoa, C, Motzkin, C, Mueller, R, Munoz, C, Munoz, M, Myneni, A, Naderi, B, Nagireddy, P, Naidu, J, Naidu, R, Naik, S, Naimark, R, Nardicchi, M, Ndukwu, I, Neller, C, Netten-Foster, L, Neumiller, J, New, T, Newman, S, Newton, T, Nguyen, B, Nicol, B, Nicol, P, Ninivaggi, L, Niswender, K, Norman, L, Noworatzky, G, Nyenwe, E, O'Brien, H, O'Connell, T, Oden, W, Odugbesan, A, Oliver, M, Oliver, T, Olmeda, C, O'Neil, C, Oremus, R, Ortega, T, Ortiz-Santos, S, Osborn, T, Padmanabhan, S, Papacostea, O, Park, I, Parker, A, Parker, K, Parker, R, Patel, C, Patel, M, Patel, R, Patino, M, Patterson, S, Paulson, K, Paz, A, Pemba, R, Pepe, C, Perez, J, Perez, T, Perry, D, Phillips, B, Phillips, J, Pickett, A, Pinson, M, Pitzer, R, Poduri, M, Poehls, J, Poteat, T, Powell, L, Prasad, S, Prevost, J, Price, E, Priest, D, Prieto, L, Purewal, T, Purighalla, R, Purighalla, U, Quadrel, M, Qureshi, A, Radhamma, R, Rafla, E, Rajab, H, Ramalingam, R, Ramirez, A, J, Ramirez, Ramirez, K, Ramirez, M, Randall, M, Rangaraj, U, Rao, V, Rasmussen, P, Rasouli, N, Ray, A, Reed, J, Rems, L, Renaud, K, Reno, M, Resnick, M, Reusch, J, Reynolds, L, Rhoton, K, Rhudy, J, Ricci, C, Rice, L, Richardson, A, Richardson, L, Rickard, H, Rickels, M, Riff, D, Rightenour, N, Risser, J, Rizvi, A, Robertson, J, Robinson, A, Robinson, R, Rockwell, M, Rodriguez, Jp, Rodriguez, M, Rojas, M, Rojas, W, Rooker-Morris, L, Root, C, Rose, M, Rosenberg, R, Rosenstock, J, Roth, M, Ruby, R, Sachson, R, Sack, P, Sadler, Rk, Sahai, S, J, Salazar, Salgam, M, Samal, A, Samson, A, Sanagorski, R, Sanchez, A, Sandberg, J, Sanderson, M, Sandoval, J, Santiago, E, Sapp, T, Saunders, J, Schill, J, Schott, C, Schreiman, R, Schu, D, Schuh, K, Schutta, M, Schwartz, J, Schweppe, L, Scofield, H, Scribner, A, Seal, J, Sealock, J, Seaton, B, Sedlak-Hanslik, T, Seekins, K, Segal, M, Seggelke, S, Semenza, S, Sentman, P, Serra, M, Seshadri, P, Sevilla, E, Shah, S, Shaheen, K, Shanik, M, Shaw, J, Sheets, M, Shellabarger, C, Sher, J, Shippey, J, Shivaswamy, V, Shomali, M, Shore, D, Shroff, P, Siddiqui, T, Siegwald, A, Silver, R, Simmons, D, Simons, R, Sinan, A, Singh, M, Sirinvaravong, S, Skero, J, Slover-Zipf, J, Small, S, Smith, B, Smith, K, Smith, M, Sohl, J, Solarz, Sh, Soler, D, Sood, A, Sora, N, Souchet, A, Soule, J, Sparks, J, Spector, L, Speicher, R, Spillers, L, Spivey, T, Springer, N, Sprouse, H, St John, J, Stacey, A, Stacey, H, Stafford, M, Stagner, E, Staples, K, Steadman, E, Steed, R, Steeves, G, Steinberg, H, Stell, C, Stirman, E, Straub, K, Strock, E, Sue, M, Suris, O, Sutton, T, Tabbah, I, Talsania, M, Tang, R, Tapia, J, Taylor, K, Taylor-Hancher, R, Teator, R, Tekateka, M, Temple, B, Temple, K, Teodori, M, Tharp, P, Thethi, T, Theuma, P, Thomas, S, Thottan, A, Thrasher, J, Thrasher, L, Tiemeyer, M, Tinney, I, Tobin, T, Toma, S, Tovar, M, Townsend, J, Trantow, C, Traylor, H, Trevino, M, Troy, M, Trumper, D, Tryggestad, J, Tucker, C, Turner, J, Turney, R, Tuten, C, Tyzack, J, Ullo, L, Underkofler, C, Unger, J, Urdanetta, R, Valdivia, V, Valenti, S, Vanderheiden, A, Vanderlinde-Wood, M, Varma, C, Vasquez, E, Vazquez, M, Vickery, D, Villafuerte, B, Villegas, C, Vivar, J, Vivekananthan, K, Vo, G, Vukojicic, K, Wachter, A, Wahl, D, Waitmann, J, Walker, D, Walsh, J, Walsh, K, Walton, A, Wang, A, Wardell, K, Watkins, S, Watkinson, J, Watts, M, Watwe, V, Weaver, N, Weber, R, Wedick, C, Weeks, D, Weeks, L, Weindorff, K, Weinstein, R, Weiss, S, Wenger, K, Wentworth, M, Werner, A, West, M, Whelan, S, White, B, White, J, Whitmire, M, Whittington, R, Wical, J, Wigley, C, Wilkins, F, Will, K, Williams, A, Wilson, Le, Wince, M, Wine, S, Winkle, P, Winner, C, Wise, J, Witte, M, Wittenmyer, J, Wood, C, Wood, R, Woodruff, C, Worthington, B, Wynn, D, Wysham, C, Xavier, P, Yela, S, Yenoby, L, Young, L, Younus, N, Yourell, V, Zaid, M, Zubair, I., Mann J.F.E., Orsted D.D., Brown-Frandsen K., Marso S.P., Poulter N.R., Rasmussen S., Tornoe K., Zinman B., Buse J.B., and Buscemi S.
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Male ,Settore MED/09 - Medicina Interna ,Acute Kidney Injury ,Aged ,Albuminuria ,Creatinine ,Diabetes Mellitus, Type 2 ,Diabetic Nephropathies ,Double-Blind Method ,Female ,Follow-Up Studies ,Glomerular Filtration Rate ,Glucagon-Like Peptide 1 ,Humans ,Hypoglycemic Agents ,Intention to Treat Analysis ,Kidney Failure, Chronic ,Liraglutide ,Middle Aged ,Type 2 diabetes ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,GLOMERULAR-FILTRATION-RATE ,KIDNEY-FUNCTION ,DISEASE ,law.invention ,Kidney Failure ,chemistry.chemical_compound ,0302 clinical medicine ,Randomized controlled trial ,law ,Medicine ,Settore MED/49 - Scienze Tecniche Dietetiche Applicate ,Chronic ,RISK ,Kidney ,Acute kidney injury ,11 Medical And Health Sciences ,General Medicine ,medicine.anatomical_structure ,TRIAL ,liraglutide, randomized controlled trial, type 2 diabetes, renal outcomes ,Life Sciences & Biomedicine ,Type 2 ,medicine.drug ,medicine.medical_specialty ,Renal function ,030209 endocrinology & metabolism ,CARDIOVASCULAR OUTCOMES ,Follow-Up Studie ,03 medical and health sciences ,Medicine, General & Internal ,General & Internal Medicine ,Diabetes mellitus ,Internal medicine ,Diabetes Mellitus ,Intensive care medicine ,Science & Technology ,business.industry ,MORTALITY ,medicine.disease ,INTENSIVE GLUCOSE CONTROL ,INDIVIDUALS ,chemistry ,Diabetic Nephropathie ,LEADER Steering Committee and Investigators ,business - Abstract
BACKGROUND: In a randomized, controlled trial that compared liraglutide, a glucagon-like peptide 1 analogue, with placebo in patients with type 2 diabetes and high cardiovascular risk who were receiving usual care, we found that liraglutide resulted in lower risks of the primary end point (nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes) and death. However, the long-term effects of liraglutide on renal outcomes in patients with type 2 diabetes are unknown. METHODS: We report the prespecified secondary renal outcomes of that randomized, controlled trial in which patients were assigned to receive liraglutide or placebo. The secondary renal outcome was a composite of new-onset persistent macroalbuminuria, persistent doubling of the serum creatinine level, end-stage renal disease, or death due to renal disease. The risk of renal outcomes was determined with the use of time-to-event analyses with an intention-to-treat approach. Changes in the estimated glomerular filtration rate and albuminuria were also analyzed. RESULTS: A total of 9340 patients underwent randomization, and the median follow-up of the patients was 3.84 years. The renal outcome occurred in fewer participants in the liraglutide group than in the placebo group (268 of 4668 patients vs. 337 of 4672; hazard ratio, 0.78; 95% confidence interval [CI], 0.67 to 0.92; P=0.003). This result was driven primarily by the new onset of persistent macroalbuminuria, which occurred in fewer participants in the liraglutide group than in the placebo group (161 vs. 215 patients; hazard ratio, 0.74; 95% CI, 0.60 to 0.91; P=0.004). The rates of renal adverse events were similar in the liraglutide group and the placebo group (15.1 events and 16.5 events per 1000 patient-years), including the rate of acute kidney injury (7.1 and 6.2 events per 1000 patient-years, respectively). CONCLUSIONS: This prespecified secondary analysis shows that, when added to usual care, liraglutide resulted in lower rates of the development and progression of diabetic kidney disease than placebo. (Funded by Novo Nordisk and the National Institutes of Health; LEADER ClinicalTrials.gov number, NCT01179048 .).
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- 2017
5. 3D MODEL VISUALIZATION FUNCTION FOR RESPONSIVE WEB DESIGN
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Sora Nazhan KAMAL and Abdullahi Abdu IBRAHIM
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CAD ,CAD 3D ,Web ,GIS ,Electronic computers. Computer science ,QA75.5-76.95 - Abstract
Except for critical basic implementations seen in historical records, the sheer quantity of similar frameworks, platforms, and apps available may be deceptive. Striking a balance between 3D certified displays and incorporated complicated features continues to be difficult. Geometrically precise point clouds and meshes are the result of cutting-edge methodology (computer vision, reverse engineering, and digital photogrammetry), cutting-edge technology (LiDAR, laser scanners, and unmanned aerial vehicles), and random research approaches. They are a by-product of the procedure. As the precision, size, and complexity of these things rise, the capabilities of present technology to manage them deteriorate. In this paper we propose a method for Development of a low-cost 3d visualization platform, capable of interactively perform tasks. Moreover, we seek to verify the methodological aspect of implementing steps and simplified algorithms in a virtual reality.
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- 2023
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6. Updated National Diagnostic Reference Levels and Achievable Doses for CT Protocols: A National Survey of Korean Hospitals
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Sora Nam, Hyemin Park, Soonmu Kwon, Pyong-kon Cho, Yongsu Yoon, Sang-wook Yoon, and Jungsu Kim
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diagnostic reference levels ,national survey ,archivable dose ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Background: In 2021, the Korean government proposed a new CT diagnostic reference level. This study performed a nationwide survey and developed new DRLs and AD for 13 common CT examinations. We compared other countries’ DRLs for CT examinations. Methods: This study investigated the CTDIvol and DLP of the 12 types of CT protocols for adults and brain CT protocol for pediatrics. A total of 7829 CT examinations were performed using 225 scanners. We defined the DRLs values in the distribution of radiation exposure levels to determine the nationwide patient dose and distribution status of the dose. Results: This study showed that the new Korean national CT DRLs are slightly higher or similar to those of previous surveys and are similar or lower than those of other countries. In some protocols, although the DLP value increased, the CTDIvol decreased; therefore, it can be concluded that the patient’s dose in CT examinations was well managed. Conclusions: The new CT DRLs were slightly higher than or similar to that of the previous survey and were evaluated to be similar or lower than CT DRLs of other countries. These DRLs will be used for radiation optimization and effective dose calculation for an individual.
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- 2022
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7. Neurophysiological investigation of executive function in Alzheimers disease
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LEOCANI , ANNUNZIATA MARIA LETIZIA, Magnani G, Sora N, Silva AM, Schiatti E, Comi G., Leocani, ANNUNZIATA MARIA LETIZIA, Magnani, G, Sora, N, Silva, Am, Schiatti, E, and Comi, G.
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- 2004
8. FEM simulation of positioning systems using segment type surface PMSM.
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Kesamaru, K. and Sora, N.
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- 2009
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9. Prevention of iatrogenic atrial tachycardia after ablation of atrial fibrillation: a prospective randomized study comparing circumferential pulmonary vein ablation with a modified approach.
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Pappone C, Manguso F, Vicedomini G, Gugliotta F, Santinelli O, Ferro A, Gulletta S, Sala S, Sora N, Paglino G, Augello G, Agricola E, Zangrillo A, Alfieri O, and Santinelli V
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- 2004
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10. Power Spectrum Analysis Of Heart Rate Variability Signal In Neurological Central And Autonomic Pathologies.
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Bianchi, A., Cerutti, S., Comi, G., Grazia, M., and Sora, N.
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- 1990
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11. Genomic and Pathogenic Characterization of Akanthomyces muscarius Isolated from Living Mite Infesting Hazelnut Big Buds.
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Turco S, Drais MI, Rossini L, Di Sora N, Brugneti F, Speranza S, Contarini M, and Mazzaglia A
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- Animals, Mites microbiology, Mites genetics, Ascomycota genetics, Ascomycota pathogenicity, Genomics methods, Plant Tumors microbiology, Plant Tumors parasitology, Plant Diseases microbiology, Plant Diseases parasitology, Corylus microbiology, Corylus parasitology, Genome, Fungal
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The capability of entomopathogenic fungi to live as plant endophytes is well established. However, their presence in undiscovered environmental niches represents the beginning of a new challenging research journey. Recently, Akanthomyces muscarius (Ascomycota, Cordycipitaceae) (Petch) Spatafora, Kepler & B. Shrestha was isolated from hazelnut buds infested by the big bud mite pest Phytoptus avellanae Nalepa, which makes the buds swollen, reddish, and unable to further develop. Gall formation is known to be regulated by a consortium of microbes and mites, and to better understand the possible role of A. muscarius within the infested gall, its whole genome sequence was obtained using a hybrid approach of Illumina and Nanopore reads. The functional and comparative genomics analysis provided within this study may help answer questions related to the ecology and the entomopathogenicity of this fungus.
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- 2024
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12. Are the ladybugs Cryptolaemus montrouzieri and Exochomus quadripustulatus (Coleoptera: Coccinellidae) candidate predators of Toumeyella parvicornis (Hemiptera: Coccidae)?
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Di Sora N, Rossini L, Contarini M, Virla EG, and Speranza S
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- Animals, Pinus, Female, Nymph physiology, Nymph growth & development, Italy, Food Chain, Coleoptera physiology, Predatory Behavior, Hemiptera physiology, Pest Control, Biological
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Background: Toumeyella parvicornis is an alien pest of recent introduction in Italy that infests stone pines (Pinus pinea L.), its main host plant in Europe. Infestations are currently controlled through endotherapic treatments, but the high costs and the long-term inefficacy highlight the need for alternative control strategies applicable in natural systems as well. An analysis of the effectiveness of autochthonous and naturalized predators is the first step to achieve this goal. This work focused on two candidate predators, Exochomus quadripustulatus and Cryptolaemus montrouzieri (Coleoptera: Coccinellidae), that may potentially control T. parvicornis. The analysis was carried out under laboratory-controlled and semi-field conditions., Results: Laboratory tests were carried out to assess: (i) the predation rate of the ladybugs over different densities of pest preimaginal stages, and (ii) the effect of the presence of heterospecific and conspecific predators on the attractiveness of prey colonies. Semi-field experimentations were carried out by wrapping infested stone pine twigs with net sleeves and applying one of three treatments: (i) Exochomus quadripustulatus, (ii) Cryptolaemus montrouzieri, and (iii) control containing only the pest population. Both the ladybugs were attracted by T. parvicornis, offered as prey. Exochomus quadripustulatus was more attracted to conspecific and heterospecific ladybugs than Cryptolaemus montrouzieri and responded to prey more quickly., Conclusions: The results obtained could be useful for planning further experimentations to explore the potential use of these predators in biological control programs that may be applied in infested areas. Besides the use in an urban context, where pesticide use is strongly limited, the release of natural enemies may help safeguard stone pine forests. © 2024 Society of Chemical Industry., (© 2024 Society of Chemical Industry.)
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- 2024
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13. Toumeyella parvicornis versus endotherapic abamectin: three techniques, 1 year after.
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Di Sora N, Rossini L, Contarini M, Mastrandrea G, and Speranza S
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- Animals, Ivermectin, Pest Control, Insecticides, Hemiptera, Pinus chemistry
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Background: Toumeyella parvicornis is an invasive soft scale insect native to North America that is rapidly spreading in Italy and France, provoking severe infestations on Pinus pinea L. To date, the control of this pest is entrusted to three endotherapic techniques whose short-term efficacy is partially known. No information on long-term efficacy is currently available, although fundamental. This work aims to report on the long-term effect that abamectin-based insecticides, injected with the three different techniques, have on adult female populations., Results: The study was carried out in an infested P. pinea forest in the area of Rome, Italy. Results showed that the tested methods had a similar long-term effect, and only in one case there were differences with the untreated control. Multiresidue analysis reported a zero level of abamectin in plant tissues 14 months apart from injection, except for one treatment where pesticide concentration was just above the limit of quantification., Conclusions: This study represents the first long-term evaluation about endotherapic control strategy against T. parvicornis. In fact, the pest may quickly bring the death and fall of the stone pines, representing a concerning risk for citizens, however, control actions to manage it are still partially known and deserve more in-depth investigations. © 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry., (© 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.)
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- 2023
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14. Using Species Distribution Models (SDMs) to Estimate the Suitability of European Mediterranean Non-Native Area for the Establishment of Toumeyella Parvicornis (Hemiptera: Coccidae).
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Di Sora N, Mannu R, Rossini L, Contarini M, Gallego D, and Speranza S
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The pine tortoise scale, Toumeyella parvicornis , is an insect native to the Nearctic region that is able to infest several Pinus species. It can cause weakening, defoliation and, at high infestation levels, tree death. After its first report in Italy in 2015, the pest spread rapidly over the surrounding areas and was reported in France in 2021. Due to the threat that this pest poses to pine trees, the suitability of European Mediterranean basin areas for T. parvicornis at different spatial scales was estimated by constructing species distribution models (SDMs) using bioclimatic variables. Our results showed that several coastal areas of the Mediterranean basin area could be suitable for T. parvicornis . Based on performance assessment, all the SDMs tested provided a good representation of the suitability of European Mediterranean non-native area for T. parvicornis at different spatial scales. In particular, most of the areas with a medium or high level of suitability corresponded to the geographical range of distribution of different Pinus spp. in Europe. Predicting the suitability of European Mediterranean areas for T. parvicornis provides a fundamental tool for early detection and management of the spread of this pest in Europe.
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- 2023
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15. Endotherapic treatment to control Toumeyella parvicornis Cockerell infestations on Pinus pinea L.
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Di Sora N, Rossini L, Contarini M, Chiarot E, and Speranza S
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- Animals, Europe, Female, Italy, Trees, Hemiptera, Pinus
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Background: The pine tortoise scale, Toumeyella parvicornis (Cockerell, 1897), is a damaging insect pest native to North America. Its accidental introduction into Europe, where it was first reported in central-southern Italy, is leading to severe infestations among stone pine trees, Pinus pinea L. causing severe infestations and generating a major risk to the health and safety of the citizens as well. This preliminary study aimed at finding an effective low-impact control strategy against Toumeyella parvicornis. We evaluated the effect of endotherapic abamectin injected into infested stone pines in the Parco Archeologico di Ostia Antica (Rome)., Results: Results showed that endotherapic abamectin significantly reduced the pine tortoise adult female populations and had a persistence into plants of approximately 60 days. The first trace of abamectin on the plant's crown was detected 1 month after the treatment. Moreover, the survey highlighted a higher presence of the pest on the twigs of the plants than on needles., Conclusions: These findings offer an important tool in fighting the damaging activity of this phytophagous, especially in an urban context where interventions with treatments are strictly regulated by national laws. Endotherapy, in fact, would reduce the dispersion of active ingredients by drift, an aspect that could represent a valid alternative to manage plants in public areas. Given the actual lack of scientific information about other control solutions, abamectin endotherapic treatments would be the more effective strategy currently applicable. © 2022 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry., (© 2022 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.)
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- 2022
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16. A case of a Rhizopus infection in a patient with diabetes and fear.
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Engle K, Shayto R, and Sora N
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- 2021
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17. Phrenic nerve palsy during right-sided pulmonary veins cryoapplications: new insights from pulmonary vein anatomy addressed by computed tomography.
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Maj R, Borio G, Ströker E, Sieira J, Rizzo A, Galli A, Varnavas V, Al Housari M, Sofianos D, Kazawa S, Terasawa M, Bala G, Cecchini F, Iacopino S, Osório TG, Sora N, Brugada P, De Asmundis C, and Chierchia GB
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- Humans, Paralysis etiology, Retrospective Studies, Treatment Outcome, Atrial Fibrillation diagnostic imaging, Atrial Fibrillation surgery, Catheter Ablation, Cryosurgery adverse effects, Phrenic Nerve injuries, Pulmonary Veins diagnostic imaging, Pulmonary Veins surgery
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Purpose: There is still sparse information regarding phrenic nerve palsy (PNP) during the cryoablation of both right-sided pulmonary vein (PV) and its anatomical predictors., Methods: Consecutive patients who had undergone pulmonary vein isolation (PVI) using CB-A and suffered PNP during both right-sided PVs were retrospectively included in our study. Two other groups were then selected among patients who experienced PNP during RIPV application only (group 2) and RSPV application only (group 3)., Results: The incidence of PNI during both right-sided PVs cryoapplications was 2.1%, (32 of 1542 patients). There were no significant clinical differences between the 3 groups. Time from basal temperature to -40 °C significantly differed among the groups for both RIPV (p = 0.0026) and RSPV applications (p = 0.0382). Patients with PNP occurring during RSPV applications had significantly larger RSPV cross-sectional area compared to patients without PNP (p = 0.0116), while in patients with PNP during RIPV application, the angle of RIPV ostium on the transverse plane was significantly smaller compared to patients without PNP (p = 0.0035). The carina width was significantly smaller in patients with PNP occurring during both right-sided PVs cryoapplications compared to patients in which PNP occurred only during one right-sided PV application (p < 0.0001); a cutoff value of 8.5 mm had a sensitivity of 87.3% and a specificity of 75.0%., Conclusion: PNP in both right-sided PVs applications is a complication that occurred in 2.1% of cases during CB-A. Pre-procedural evaluation of right PVs anatomy might be useful in evaluating the risk of PNP.
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- 2021
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18. Percutaneous left atrial appendage occlusion with the Amulet device: The impact of device disc position upon periprocedural and long-term outcomes.
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Oraii Yazdani K, Mitomo S, Ruparelia N, Candilio L, Giannini F, Jabbour RJ, Regazzoli D, Mazzone P, Stella S, Sora N, Montorfano M, Colombo A, and Latib A
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- Aged, Aged, 80 and over, Atrial Appendage diagnostic imaging, Atrial Fibrillation diagnostic imaging, Atrial Fibrillation physiopathology, Cardiac Catheterization adverse effects, Equipment Design, Female, Humans, Male, Middle Aged, Retrospective Studies, Time Factors, Treatment Outcome, Atrial Appendage physiopathology, Atrial Fibrillation therapy, Cardiac Catheterization instrumentation, Heart Rate
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Objective: To investigate the effect of left atrial appendage (LAA) occlusion device positioning upon periprocedural and long-term outcomes., Background: The Amulet device is designed to cover the ostium of the LAA. Prolapse of the device into the neck of the LAA is not uncommon resulting in incomplete coverage of the ostium. The clinical consequences of this remain uncertain., Methods: Outcomes of 87 patients with successful LAA closure were analyzed according to Amulet disc position: group A (n = 45) had complete LAA ostium coverage; group B (n = 42) had incomplete ostium coverage because of disc prolapse. Periprocedural major adverse events (MAE) (composite of all cause death, tamponade, device/air embolization, cerebrovascular events, myocardial infarction, and major bleeding not related to vascular access complications) and total device-related periprocedural adverse events (defined as MAE and pericardial effusion) were evaluated. All patients were followed up longitudinally with long-term events defined as a composite of: cardiovascular death, cerebrovascular events, systemic embolization, and major bleeding requiring transfusion or intervention., Results: Median follow-up was 234 days (IQR 150-436 days). There was a trend toward more periprocedural MAE in group B (P = 0.07) with deep implantation of the Amulet device associated with significantly more periprocedural adverse events (P = 0.03). There were no differences in reposition attempts (P = 0.9) or long-term events (P = 0.57)., Conclusions: Our data suggest that suboptimal device positioning may be associated with worse periprocedural outcomes but no difference in long-term clinical outcomes. The results of this relatively small cohort does not seem to be affected by repositioning attempts during the index procedure., (© 2018 Wiley Periodicals, Inc.)
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- 2019
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19. Safety and efficacy of the new bidirectional rotational Evolution® mechanical lead extraction sheath: results from a multicentre Italian registry.
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Mazzone P, Migliore F, Bertaglia E, Facchin D, Daleffe E, Calzolari V, Crosato M, Melillo F, Peruzza F, Marzi A, Sora N, and Della Bella P
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- Aged, Female, Humans, Italy, Male, Middle Aged, Prospective Studies, Registries statistics & numerical data, Treatment Outcome, Defibrillators, Implantable adverse effects, Device Removal adverse effects, Device Removal instrumentation, Device Removal methods, Pacemaker, Artificial adverse effects, Prosthesis-Related Infections surgery
- Abstract
Aims: The aim of this prospective multicentre study is to evaluate safety and efficacy of the new bidirectional rotational mechanical lead extraction (LE) sheath (Evolution RL, Cook Medical, USA) in chronically implanted leads (>1-year-old leads)., Methods and Results: Between September 2013 and June 2016, a total of 238 leads in 124 consecutive patients were removed by using the new Evolution RL rotational mechanical sheath. Indications for LE were cardiac device infection in 63 (50.8%) cases, lead malfunction in 41 (33.1%), upgrade in 1 (0.8%) case and for other reasons in the remaining 19 cases (15.3%). Ninety-one leads (38.2%) were implantable cardioverter defibrillator leads (81 dual coil vs. 10 single coil), 38 (16%) right ventricular leads, 86 (36.1%) right atrial leads, and 23 (9.7%) coronary sinus leads. The mean implant duration was 92.2 ± 52.9 months (range 12-336). 91.6% of the leads (218/238) were extracted completely with the Evolution RL alone, with the complete success rate rising to 98.7% (235/238 leads) with combined use of a snare. Overall clinical success rate was 100%. No Evolution sheath-related complications were noted. There were no deaths or major complications. Five minor complications (4%) were encountered. In cases of companion leads no wrapping or lead damage were observed., Conclusion: On the basis of our prospective multicentre study, the new hand-powered bidirectional rotational mechanical LE sheath is an effective and safe tool for the extraction of chronically implanted leads without major complications and lead wrapping or lead damage.
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- 2018
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20. Left atrial appendage closure: A single center experience and comparison of two contemporary devices.
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Figini F, Mazzone P, Regazzoli D, Porata G, Ruparelia N, Giannini F, Stella S, Ancona F, Agricola E, Sora N, Marzi A, Aurelio A, Trevisi N, Della Bella P, Colombo A, and Montorfano M
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- Aged, Atrial Appendage diagnostic imaging, Atrial Fibrillation complications, Atrial Fibrillation diagnosis, Echocardiography, Doppler, Color, Echocardiography, Three-Dimensional, Echocardiography, Transesophageal, Female, Follow-Up Studies, Humans, Incidence, Italy epidemiology, Male, Prosthesis Design, Retrospective Studies, Stroke epidemiology, Stroke etiology, Time Factors, Treatment Outcome, Atrial Appendage surgery, Atrial Fibrillation surgery, Cardiac Catheterization methods, Cardiac Surgical Procedures methods, Septal Occluder Device, Stroke prevention & control, Surgery, Computer-Assisted methods
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Objectives: To compare indications and clinical outcomes of two contemporary left atrial appendage (LAA) percutaneous closure systems in a "real-world" population., Background: Percutaneous LAA occlusion is an emerging therapeutic option for stroke prevention in atrial fibrillation. Some questions however remain unanswered, such as the applicability of results of randomized trials to current clinical practice. Moreover, currently available devices have never been directly compared., Methods: We retrospectively analyzed consecutive patients who underwent LAA closure at San Raffaele Hospital, Milan, Italy between 2009 and 2015. Clinical indications and device selection were left to operators' decision; routine clinical and transesophageal echocardiography (TEE) follow-up was performed., Results: One-hundred and sixty-five patients were included in the study, of which 99 were treated with the Amplatzer Cardiac Plug (ACP) and 66 with the Watchman system. During the follow-up period (median 15 months, interquartile range 6-26 months) five patients died. The incidence of ischemic events was low, with one patient suffering a transient ischemic attack and no episodes recorded of definitive strokes. Twenty-six leaks ≥1 mm were detected (23%); leaks were less common with the ACP and with periprocedural three-dimensional TEE evaluation, but were not found to correlate with clinical events. Clinical outcomes were comparable between the two devices., Conclusions: Our data show excellent safety and efficacy of LAA closure, irrespectively of the device utilized, in a population at high ischemic and hemorrhagic risk. The use of ACP and 3D-TEE minimized the incidence of residual leaks; however, the clinical relevance of small peri-device flow warrants further investigation. © 2016 Wiley Periodicals, Inc., (© 2016 Wiley Periodicals, Inc.)
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- 2017
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21. Electroanatomical voltage and morphology characteristics in postinfarction patients undergoing ventricular tachycardia ablation: pragmatic approach favoring late potentials abolition.
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Tsiachris D, Silberbauer J, Maccabelli G, Oloriz T, Baratto F, Mizuno H, Bisceglia C, Vergara P, Marzi A, Sora N, Guarracini F, Radinovic A, Cireddu M, Sala S, Gulletta S, Paglino G, Mazzone P, Trevisi N, and Della Bella P
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- Aged, Coronary Angiography, Female, Follow-Up Studies, Humans, Male, Middle Aged, Recurrence, Retrospective Studies, Tachycardia, Ventricular diagnosis, Tachycardia, Ventricular surgery, Body Surface Potential Mapping methods, Catheter Ablation, Tachycardia, Ventricular physiopathology
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Background: Catheter ablation is an important therapeutic option in postmyocardial infarction patients with ventricular tachycardia (VT). We analyzed the endo-epicardial electroanatomical mapping (EAM) voltage and morphology characteristics, their association with clinical data and their prognostic value in a large cohort of postmyocardial infarction patients., Methods and Results: We performed total and segmental analysis of voltage (bipolar dense scar [DS] and low voltage areas, unipolar low voltage and penumbra areas) and morphology characteristics (presence of abnormal late potentials [LPs] and early potentials [EPs]) in 100 postmyocardial infarction patients undergoing electroanatomical mapping-based VT ablation (26 endo-epicardial procedures) from 2010-2012. All patients had unipolar low voltage areas, whereas 18% had no identifiable endocardial bipolar DS areas. Endocardial bipolar DS area >22.5 cm(2) best predicted scar transmurality. Endo-epicardial LPs were recorded in 2/3 patients, more frequently in nonseptal myocardial segments and were abolished in 51%. Endocardial bipolar DS area >7 cm(2) and endocardial bipolar scar density >0.35 predicted epicardial LPs. Isolated LPs are located mainly epicardially and EPs endocardially. As a primary strategy, LPs and VT-mapping ablation occurred in 48%, only VT-mapping ablation in 27%, only LPs ablation in 17%, and EPs ablation in 6%. Endocardial LP abolition was associated with reduced VT recurrence and increased unipolar penumbra area predicted cardiac death., Conclusions: Endocardial scar extension and density predict scar transmurality and endo-epicardial presence of LPs, although DS is not always identified in postmyocardial infarction patients. LPs, most frequently located in nonseptal myocardial segments, were abolished in 51% resulting in improved outcome., (© 2015 American Heart Association, Inc.)
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- 2015
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22. Impact of a chronic total occlusion in an infarct-related artery on the long-term outcome of ventricular tachycardia ablation.
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Di Marco A, Paglino G, Oloriz T, Maccabelli G, Baratto F, Vergara P, Bisceglia C, Anguera I, Sala S, Sora N, Dallaglio P, Marzi A, Trevisi N, Mazzone P, and Della Bella P
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- Aged, Chronic Disease, Comorbidity, Coronary Angiography, Coronary Occlusion diagnosis, Coronary Occlusion mortality, Electrophysiologic Techniques, Cardiac, Female, Hospital Mortality, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Myocardial Infarction diagnosis, Myocardial Infarction mortality, Proportional Hazards Models, Prospective Studies, Recurrence, Retrospective Studies, Risk Factors, Spain, Tachycardia, Ventricular complications, Tachycardia, Ventricular diagnosis, Tachycardia, Ventricular mortality, Time Factors, Treatment Outcome, Catheter Ablation adverse effects, Catheter Ablation mortality, Coronary Occlusion complications, Myocardial Infarction etiology, Tachycardia, Ventricular surgery
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Introduction: In patients with a prior myocardial infarction (MI), angiographic predictors of ventricular tachycardia (VT) recurrence after ablation are lacking. Recently, a proarrhythmic effect of a chronic total occlusion (CTO) in a coronary artery has been suggested., Methods and Results: A total of 191 patients with prior MI were referred to our Hospital between 2010 and June 2013 for a first ablation of VT. Of these, 84 patients (44%) with stable coronary artery disease that underwent a coronary angiography during the index hospitalization were included in this study. A CTO in an infarct-related artery (IRA-CTO) was present in 47 patients (56%). Patients with and without IRA-CTO did not differ in terms of comorbidities, severity of heart failure, presentation of VT or acute outcome of ablation, that was completely successful in 93% of cases. At electroanatomic mapping, IRA-CTO was associated with greater scar and especially with greater area of border zone (34 cm(2) vs. 19 cm(2) , P = 0.001). Median follow-up was 19 months (IQR 18). At follow-up, patients with IRA-CTO had a significantly higher rate of VT recurrence (47% vs. 16%, P = 0.003). At multivariate analysis, IRA-CTO resulted to be an independent predictor of VT recurrence after ablation (HR 4.05, P = 0.004)., Conclusions: IRA-CTO is an independent predictor of VT recurrence after ablation and identifies a subgroup of patients with high recurrence rate despite a successful procedure. IRA-CTO is associated with greater scars and border zone area; however, this association does not completely justify its proarrhythmic effect., (© 2015 Wiley Periodicals, Inc.)
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- 2015
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23. Electrical storm induced by cardiac resynchronization therapy is determined by pacing on epicardial scar and can be successfully managed by catheter ablation.
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Roque C, Trevisi N, Silberbauer J, Oloriz T, Mizuno H, Baratto F, Bisceglia C, Sora N, Marzi A, Radinovic A, Guarracini F, Vergara P, Sala S, Paglino G, Gulletta S, Mazzone P, Cireddu M, Maccabelli G, and Della Bella P
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- Action Potentials, Aged, Aged, 80 and over, Cicatrix pathology, Cicatrix physiopathology, Electrophysiologic Techniques, Cardiac, Female, Humans, Italy, Male, Middle Aged, Pericardium pathology, Pericardium physiopathology, Risk Factors, Tachycardia, Ventricular diagnosis, Tachycardia, Ventricular etiology, Tachycardia, Ventricular physiopathology, Treatment Outcome, Ventricular Function, Left, Ventricular Function, Right, Cardiac Resynchronization Therapy adverse effects, Cardiac Resynchronization Therapy Devices, Catheter Ablation, Cicatrix surgery, Pericardium surgery, Tachycardia, Ventricular surgery
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Background: The mechanism of cardiac resynchronization therapy (CRT)-induced proarrhythmia remains unknown. We postulated that pacing from a left ventricular (LV) lead positioned on epicardial scar can facilitate re-entrant ventricular tachycardia. The aim of this study was to investigate the relationship between CRT-induced proarrhythmia and LV lead location within scar., Methods and Results: Twenty-eight epicardial and 63 endocardial maps, obtained from 64 CRT patients undergoing ventricular tachycardia ablation, were analyzed. A positive LV lead/scar relationship, defined as a lead tip positioned on scar/border zone, was determined by overlaying fluoroscopic projections with LV electroanatomical maps. CRT-induced proarrhythmia occurred in 8 patients (12.5%). They all presented early with electrical storm (100% versus 39% of patients with no proarrhythmia; P<0.01), requiring temporary biventricular pacing discontinuation in half of cases. They more frequently presented with heart failure/cardiogenic shock (50% versus 7%; P<0.01), requiring intensive care management. Ventricular tachycardia was re-entrant in all. The LV lead location within epicardial scar was significantly more frequent in the proarrhythmia group (60% versus 9% P=0.03 on epicardial bipolar scar, 80% versus 17% P=0.02 on epicardial unipolar scar, and 80% versus 17% P=0.02 on any-epicardial scar). Ablation was performed within epicardial scar, close to the LV lead, and allowed CRT reactivation in all patients., Conclusions: CRT-induced proarrhythmia presented early with electrical storm and was associated with an LV lead positioning within epicardial scar. Catheter ablation allowed for resumption of biventricular stimulation in all patients., (© 2014 American Heart Association, Inc.)
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- 2014
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24. Catheter ablation of ventricular arrhythmia in nonischemic cardiomyopathy: anteroseptal versus inferolateral scar sub-types.
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Oloriz T, Silberbauer J, Maccabelli G, Mizuno H, Baratto F, Kirubakaran S, Vergara P, Bisceglia C, Santagostino G, Marzi A, Sora N, Roque C, Guarracini F, Tsiachris D, Radinovic A, Cireddu M, Sala S, Gulletta S, Paglino G, Mazzone P, Trevisi N, and Della Bella P
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- Adult, Aged, Analysis of Variance, Cardiomyopathies mortality, Cardiomyopathies surgery, Catheter Ablation methods, Cicatrix pathology, Cohort Studies, Epicardial Mapping methods, Female, Follow-Up Studies, Heart Septum pathology, Humans, Incidence, Kaplan-Meier Estimate, Male, Middle Aged, Proportional Hazards Models, Retrospective Studies, Risk Assessment, Severity of Illness Index, Survival Rate, Tachycardia, Ventricular diagnosis, Tachycardia, Ventricular mortality, Treatment Outcome, Cardiomyopathies pathology, Catheter Ablation adverse effects, Cicatrix etiology, Electrocardiography methods, Tachycardia, Ventricular surgery
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Background: The aim was to relate distinct scar distributions found in nonischemic cardiomyopathy with ventricular tachycardia (VT) morphology, late potential distribution, ablation strategy, and outcome., Methods and Results: Eighty-seven patients underwent catheter ablation for drug-refractory VT. Based on endocardial unipolar voltage, 44 were classified as predominantly anteroseptal and 43 as inferolateral. Anteroseptal patients more frequently fulfilled diagnostic criteria for dilated cardiomyopathy (64% versus 36%), associated with more extensive endocardial unipolar scar (41 [22-83] versus 9 [1-29] cm(2); P<0.001). Left inferior VT axis was predictive of anteroseptal scar (positive predictive value, 100%) and right superior axis for inferolateral (positive predictive value, 89%). Late potentials were infrequent in the anteroseptal group (11% versus 74%; P<0.001). Epicardial late potentials were common in the inferolateral group (81% versus 4%; P<0.001) and correlated with VT termination sites (κ=0.667; P=0.014), whereas no anteroseptal patient had an epicardial VT termination (P<0.001). VT recurred in 44 patients (51%) during a median follow-up of 1.5 years. Anteroseptal scar was associated with higher VT recurrence (74% versus 25%; log-rank P<0.001) and redo procedure rates (59% versus 7%; log-rank P<0.001). After multivariable analysis, clinical predictors of VT recurrence were electrical storm (hazard ratio, 3.211; P=0.001) and New York Heart Association class (hazard ratio, 1.608; P=0.018); the only procedural predictor of VT recurrence was anteroseptal scar pattern (hazard ratio, 5.547; P<0.001)., Conclusions: Unipolar low-voltage distribution in nonischemic cardiomyopathy allows categorization of scar pattern as inferolateral, often requiring epicardial ablation mainly based on late potentials, and anteroseptal, which frequently involves an intramural septal substrate, leading to a higher VT recurrence., (© 2014 American Heart Association, Inc.)
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- 2014
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25. Noninducibility and late potential abolition: a novel combined prognostic procedural end point for catheter ablation of postinfarction ventricular tachycardia.
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Silberbauer J, Oloriz T, Maccabelli G, Tsiachris D, Baratto F, Vergara P, Mizuno H, Bisceglia C, Marzi A, Sora N, Guarracini F, Radinovic A, Cireddu M, Sala S, Gulletta S, Paglino G, Mazzone P, Trevisi N, and Della Bella P
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- Aged, Analysis of Variance, Catheter Ablation mortality, Cohort Studies, Combined Modality Therapy, Electrocardiography methods, Female, Humans, Male, Middle Aged, Myocardial Infarction complications, Myocardial Infarction diagnosis, Myocardial Infarction mortality, Prognosis, Proportional Hazards Models, Recurrence, Retrospective Studies, Risk Assessment, Severity of Illness Index, Survival Analysis, Tachycardia, Ventricular etiology, Tachycardia, Ventricular mortality, Treatment Outcome, Catheter Ablation methods, Cause of Death, Defibrillators, Implantable, Myocardial Infarction therapy, Tachycardia, Ventricular surgery
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Background: Successful late potential (LP) abolition and postprocedural ventricular tachycardia (VT) noninducibility constitute significant end points after catheter ablation for VT. We investigated the prognostic impact of a combined procedural end point of VT noninducibility and LP abolition in a large series of post-myocardial infarction patients with VT., Methods and Results: A total of 160 (154 men, 94% with implantable cardioverter defibrillators) consecutive post-myocardial infarction patients undergoing first-time ablation procedures from 2010 to 2012 were included. Of the 159 patients surviving the procedure, 137 (86%) were either inducible or in VT at baseline and 103 (65%) had baseline LP presence, of which 79 (77%) underwent successful LP abolition. The combined end point was assessable in 155 (97%) patients. There were 50 (32%) patients with VT recurrences and 17 (11%) cardiac deaths during follow-up. Patients who fulfilled the combined end point of VT noninducibility and LP abolition compared with inducible patients exhibited a significantly lower incidence of VT recurrence (16.4% versus 47.4%; log-rank P<0.001) and cardiac death (4.1% versus 42.1%; log-rank P<0.001). Among noninducible patients, those with additional LP abolition also had a lower incidence of VT recurrence (16.4% versus 46.0%; log-rank P<0.001). After multivariate analysis, the combined end point of VT noninducibility and LP abolition (hazard ratio, 0.205, P<0.001) was independently associated with VT recurrence and cardiac death (hazard ratio, 0.106; P=0.001)., Conclusions: Achieving a combined catheter ablation procedural end point of VT noninducibility and LP abolition reduces VT recurrence rates to low levels (16%). The overall strategy was associated with a significant impact on cardiac survival., (© 2014 American Heart Association, Inc.)
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- 2014
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26. Advanced techniques for chronic lead extraction: heading from the laser towards the evolution system.
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Mazzone P, Tsiachris D, Marzi A, Ciconte G, Paglino G, Sora N, Gulletta S, Vergara P, and Della Bella P
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- Aged, Cardiac Catheters, Device Removal adverse effects, Device Removal instrumentation, Equipment Design, Female, Humans, Lasers, Excimer, Male, Middle Aged, Radiography, Interventional, Retrospective Studies, Time Factors, Treatment Outcome, Defibrillators, Implantable, Device Removal methods, Dilatation adverse effects, Dilatation instrumentation, Laser Therapy adverse effects, Laser Therapy instrumentation, Pacemaker, Artificial
- Abstract
Aim: The evolution mechanical dilator sheath has been reported to be an effective tool for chronic lead extraction (LE). We examined safety and efficacy of evolution system as compared with laser system., Methods and Results: From 2005 to 2009, all extractions requiring the use of a powered sheath were performed using the excimer laser system (n = 73). Since 2009, laser system was no longer available and the evolution system was introduced as the first-line method for powered extraction (n = 48). All procedures were performed by a single first operator. Success and complications were defined according to the current guidelines. Patients of the evolution group compared with those of the laser group had a greater number of extracted leads per patient (2.77 vs. 2.4, P = 0.049) and a longer implant duration (101.1 vs. 62.4 months, P = 0.001). Additional use of snare was required in 27.1% of the evolution group and 8.2% of the laser group (P = 0.005). Complete procedural success was achieved in 91.7% of the evolution group and 97.3% of the laser group (P = 0.16). There was also no difference between evolution and laser groups in clinical success (97.9 vs. 98.6%, P = 0.76), as well as regarding major (4.2 vs. 2.7%, P = 0.66) or minor complications (4.2 vs. 5.5%, P = 0.76)., Conclusion: Use of the recently introduced evolution system for LE exhibit acceptably high levels of safety, as well as of procedural and clinical success, although additional use of snare was required more frequently in the evolution compared with the laser group.
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- 2013
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27. Predictors of advanced lead extraction based on a systematic stepwise approach: results from a high volume center.
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Mazzone P, Tsiachris D, Marzi A, Ciconte G, Paglino G, Sora N, Sala S, Vergara P, Gulletta S, and Della Bella P
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- Adult, Age Distribution, Aged, Aged, 80 and over, Device Removal instrumentation, Female, Humans, Italy epidemiology, Male, Middle Aged, Prevalence, Prognosis, Retrospective Studies, Risk Factors, Sex Distribution, Treatment Outcome, Young Adult, Algorithms, Device Removal statistics & numerical data, Electrodes, Implanted statistics & numerical data, Equipment Failure statistics & numerical data, Heart Diseases epidemiology, Heart Diseases prevention & control, Postoperative Complications epidemiology
- Abstract
Background: Lead extraction (LE) techniques have evolved from simple traction to extraction with dilators and powered sheaths with very high success rates. On the basis of the systematic implementation of a stepwise approach, we aimed to identify those characteristics that can predict the need for advanced LE techniques., Methods: Between April 2005 and March 2012, 208 consecutive LE procedures were performed and 456 leads were extracted using an initial superior approach. Advanced techniques for LE (step 4 according to our stepwise approach) were used in 122 patients (58.7%)., Results: Younger patient age (odds ratio [OR] = 0.963, P = 0.002), longer duration of the initial implantation (OR = 1.013, P = 0.002), the number of extracted leads (OR = 2.184, P < 0.001), and the presence of right ventricular defibrillator leads (OR = 2.144, P = 0.049) independently predicted the necessity of using step 4 in multivariate analysis. A prediction tool was created taking into account four categorical variables derived even from Receiver Operating Curve analysis of quantitative characteristics (age < 70.7 years, implant duration > 37 months, extraction of at least two leads, one of them being a defibrillator lead). The absence of all the four characteristics was accompanied by 0% positive predictive value for the requirement of step 4 for LE, whereas the coexistence of all four risk factors is characterized by 87% requirement of advanced LE., Conclusion: In most of the patients with indication for LE, use of a powered sheath extraction is necessary in order to obtain clinical success. We have identified four patient and lead characteristics that may help the operator plan the means of extraction., (©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.)
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- 2013
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28. Echocardiographic 'brainstorm' to detect anomalous origin of the left coronary artery from the pulmonary artery.
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Grimaldi A, Ammirati E, La Canna G, Sora N, Faletra F, De Bonis M, Maisano F, Castiglioni A, Colombo A, and Alfieri O
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- Adult, Coronary Angiography methods, Female, Humans, Predictive Value of Tests, Pulmonary Artery abnormalities, Tomography, X-Ray Computed, Coronary Vessel Anomalies diagnostic imaging, Echocardiography, Pulmonary Artery diagnostic imaging
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- 2012
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29. Pseudoaneurysm of mitral-aortic intervalvular fibrosa.
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Grimaldi A, Ho SY, Pozzoli A, Sora N, Taramasso M, Benussi S, La Canna G, and Alfieri O
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- Aged, Aneurysm, False diagnostic imaging, Aneurysm, False surgery, Aortic Valve Insufficiency diagnostic imaging, Aortic Valve Insufficiency surgery, Echocardiography, Female, Follow-Up Studies, Heart Aneurysm diagnostic imaging, Heart Aneurysm surgery, Heart Rupture diagnostic imaging, Heart Rupture surgery, Humans, Male, Middle Aged, Mitral Valve Insufficiency diagnostic imaging, Mitral Valve Insufficiency surgery, Prognosis, Retrospective Studies, Aneurysm, False complications, Aortic Valve Insufficiency complications, Cardiac Surgical Procedures methods, Heart Aneurysm complications, Heart Rupture etiology, Mitral Valve Insufficiency complications
- Abstract
The mitral-aortic intervalvular fibrosa (MAIF) is involved in the functional integrity of the two valves. We discuss the clinical decision-making in a population with MAIF pseudoaneurysms following valve replacement surgery. From 2003 to 2010, 16 patients (age 65 ± 17 years) were referred to our institute with worsening valvular disease. All the patients had undergone previous aortic or mitral valve replacement surgery. Transthoracic and transesophageal echocardiography was performed in these patients. According to the echocardiographic findings, we described two groups of patients with MAIF pseudoaneurysms: group 1 (seven patients) without previously known infective disease, and group 2 (nine patients) with a medical history of endocarditis. For asymptomatic patients without an infective background or valve regurgitation (group 1), clinical and echocardiographic follow-up was selected. Reintervention was planned for postinfection pseudoaneurysms (group 2), on account of the residual paravalvular leak and the high-risk of MAIF rupture. The case series emphasizes the need for more awareness about MAIF pseudoaneurysms, rare complications of aortic and mitral valve surgery, which occur far more frequently than expected. Although clinical decision-making is debatable, it may be helpful to differentiate patients into those with or without previous endocarditis, and according to heart failure symptoms.
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- 2011
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30. Myometrial wound healing post-Cesarean delivery in the MRL/MpJ mouse model of uterine scarring.
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Buhimschi CS, Zhao G, Sora N, Madri JA, and Buhimschi IA
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- Animals, Ear pathology, Female, Humans, Mice, Mice, Inbred C57BL, Mice, Inbred Strains, Myometrium anatomy & histology, Pregnancy, Regeneration physiology, Tensile Strength, Uterus anatomy & histology, Uterus physiology, Cesarean Section adverse effects, Cicatrix pathology, Myometrium pathology, Myometrium physiology, Uterus pathology, Wound Healing physiology
- Abstract
There is little known about healing of the uterus after Cesarean delivery (CD). Uterine wound repair was studied by using two strains of mice with different wound healing characteristics: MRL/MpJ(+/+) (MRL: "high-healer" phenotype) and C57Bl/6 ("low-healer" phenotype). First, we examined the morphology and histology of the uterine wall repair. We identified wound granulation tissue 3 days post-CD in both strains, albeit less in the MRL strain. Macroscopically, no scar could be identified either in MRL or C57Bl/6 mice on day 60 post-CD. However, histologically, we found significant differences in wound integration, inflammation, and collagen birefringence between the two strains of mice. Using a histological index, we provided evidence for significant differences in mitotic activity in the initial phases of uterine healing among strains. Functional behavior of the uterine scar also was analyzed by using biomechanical parameters such as slope (measure of stiffness), yield point (measure of elasticity), and break point (measure of strength). There were significant differences in stiffness of the scarred myometrium between the two phenotypes. MRL mice displayed a significantly lower yield point compared with C57Bl/6. The break point was reached faster on days 15 and 60 in both C57Bl/6 and MRL strains compared with day 3 post-CD. Our findings indicate that differences in regenerative ability translate in histological, mitotic, and functional differences in biomechanical properties of the scarred myometrium after CD.
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- 2010
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31. Genetic background affects the biomechanical behavior of the postpartum mouse cervix.
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Buhimschi CS, Sora N, Zhao G, and Buhimschi IA
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- Animals, Female, Mice, Mice, Inbred C57BL, Time Factors, Biomechanical Phenomena genetics, Cervix Uteri physiology, Postpartum Period genetics
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Objective: We hypothesized that the genetic makeup has an impact on the functional behavior of the uterine cervix. Therefore, we compared the biomechanical properties of uterine cervix in postpartum in 2 strains of mice that differ in their underlying regenerative collagen remodeling characteristics: MRL/MpJ+/+ (MRL: high regenerative repair) and C57BL/6 (C57: low regenerative high fibrotic repair)., Study Design: Cervical tensile proprieties were assessed on day 3, 15, and 60 postpartum in MRL (n = 14) and C57 (n = 13) mice (4-5 animals at each time point). Stress-strain curves were generated using Shimadzu EZ-test instrumentation. Cervical tissue was stretched by 0.42 mm/min until rupture. Parameters of viscoelasticity including slope (a measure of stiffness), yield point (YP; moment when tissue changes its proprieties from elastic to plastic), and break point (BP; measure of tissue strength) were recorded and analyzed blindly between strains. Data were normalized to the weight of the tissue and analyzed by 2-way analysis of variance. Histological and collagen birefringence evaluation of the uterine cervix (MRL: n = 4; C57: n = 4) was performed 5 days after delivery., Results: At 3 and 15 days postpartum, cervices of MRL mice were significantly more compliant than those of C57 (P < .001). MRL mice displayed a significant increase in stiffness from day 3 to day 60 (slope, median +/- SEM: day 3: 3.1 +/- 0.5 vs day 15: 20.3 +/- 4.9 vs day 60: 33.1 +/- 3.5 N/mm per gram; P < .001). In contrast, the stiffness of C57 cervices reached maximum on day 15 (slope day 3: 14.1 +/- 4.3 vs day 15: 40.0 +/- 6.5 N/mm per gram; P = .02) and rested at a similar level on day 60 (day 60: 26.1 +/- 7.0 N/mm per gram; day 60 vs day 15: P = .937). More force was required to reach YP in C57 on day 3 (C57: 72.5 +/- 14.7 vs MRL: 19.9 +/- 1.6 N/g; P < .001) but not on either day 15 (C57: 156.1 +/- 27.5 vs MRL: 109.2 +/- 26.0 N/g; P = .120) or on day 60 (C57: 143.4 +/- 26.5 vs MRL: 164.5 +/- 18.7 N/g; P = .412). There was a significant decrease in BP in both strains on both day 15 and day 60 compared with day 3 postpartum (P = .856 for strain, P = .008 for day). MRL mice displayed significantly less cervical collagen birefringence compared with C57 control (P < .001) but increased proteoglycan staining and increased water content., Conclusion: We provide evidence that genetic makeup may have an impact on cervical tissue remodeling and function. There are significant differences in postpartum cervical stiffness and compliance that vary with the regenerative collagen remodeling phenotype.
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- 2009
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32. A randomized trial of circumferential pulmonary vein ablation versus antiarrhythmic drug therapy in paroxysmal atrial fibrillation: the APAF Study.
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Pappone C, Augello G, Sala S, Gugliotta F, Vicedomini G, Gulletta S, Paglino G, Mazzone P, Sora N, Greiss I, Santagostino A, LiVolsi L, Pappone N, Radinovic A, Manguso F, and Santinelli V
- Subjects
- Age Factors, Aged, Amiodarone therapeutic use, Anti-Arrhythmia Agents administration & dosage, Anti-Arrhythmia Agents adverse effects, Atrial Fibrillation complications, Atrial Fibrillation physiopathology, Cardiovascular Diseases etiology, Cardiovascular Diseases therapy, Catheter Ablation adverse effects, Dose-Response Relationship, Drug, Female, Flecainide therapeutic use, Follow-Up Studies, Hospitalization statistics & numerical data, Humans, Hypertension complications, Kaplan-Meier Estimate, Male, Medical Records, Middle Aged, Prognosis, Retreatment, Sotalol therapeutic use, Stroke Volume, Treatment Failure, Anti-Arrhythmia Agents therapeutic use, Atrial Fibrillation drug therapy, Atrial Fibrillation surgery, Pulmonary Veins surgery
- Abstract
Objectives: We compared ablation strategy with antiarrhythmic drug therapy (ADT) in patients with paroxysmal atrial fibrillation (PAF)., Background: Atrial fibrillation (AF) ablation strategy is superior to ADT in patients with an initial history of PAF, but its role in patients with a long history of AF as compared with ADT remains a challenge., Methods: One hundred ninety-eight patients (age, 56 +/- 10 years) with PAF of 6 +/- 5 years' duration (mean AF episodes 3.4/month) who had failed ADT were randomized to AF ablation by circumferential pulmonary vein ablation (CPVA) or to the maximum tolerable doses of another ADT, which included flecainide, sotalol, and amiodarone. Crossover to CPVA was allowed after 3 months of ADT., Results: By Kaplan-Meier analysis, 86% of patients in the CPVA group and 22% of those in the ADT group who did not require a second ADT were free from recurrent atrial tachyarrhythmias (AT) (p < 0.001); a repeat ablation was performed in 9% of patients in the CPVA group for recurrent AF (6%) or atrial tachycardia (3%). At 1 year, 93% and 35% of the CPVA and ADT groups, respectively, were AT-free. Ejection fraction, hypertension, and age independently predicted AF recurrences in the ADT group. Circumferential pulmonary vein ablation was associated with fewer cardiovascular hospitalizations (p < 0.01). One transient ischemic attack and 1 pericardial effusion occurred in the CPVA group; side effects of ADT were observed in 23 patients., Conclusions: Circumferential pulmonary vein ablation is more successful than ADT for prevention of PAF with few complications. Atrial fibrillation ablation warrants consideration in selected patients in whom ADT had already failed and maintenance of sinus rhythm is desired. (A Controlled Randomized Trial of CPVA Versus Antiarrhythmic Drug Therapy in for Paroxysmal AF: APAF/01; http://clinicaltrials.gov/ct/show; NCT00340314).
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- 2006
- Full Text
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33. Electroanatomic remodeling of the left atrium in patients undergoing repeat pulmonary vein ablation: mechanistic insights and implications for ablation.
- Author
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Mesas CE, Augello G, Lang CC, Gugliotta F, Vicedomini G, Sora N, De Paola AA, and Pappone C
- Subjects
- Atrial Fibrillation diagnosis, Catheter Ablation, Female, Heart Atria surgery, Heart Conduction System surgery, Humans, Male, Middle Aged, Pulmonary Veins physiopathology, Reoperation, Treatment Outcome, Atrial Fibrillation physiopathology, Atrial Fibrillation surgery, Body Surface Potential Mapping, Heart Atria physiopathology, Heart Conduction System physiopathology, Pulmonary Veins surgery
- Abstract
Introduction: There is limited information describing late changes in the electroanatomic characteristics of the left atrium (LA) associated with recurrence after an anatomical circumferential pulmonary vein ablation (CPVA) for atrial fibrillation (AF)., Methods and Results: Forty-seven patients (57 +/- 8 years) undergoing a repeat ablation after CPVA were included. Using an electroanatomic mapping system, we measured the bipolar voltage by averaging points in the pulmonary vein (PV)-LA junction and four other LA sites. Conduction velocity and AF cycle length (AFCL) were also measured and the results are compared with the first procedure. After an initial decrease observed at the end of the first procedure, voltage and conduction velocity returned to intermediate values in all LA sites, with lower voltage at the LIPV antrum (P = 0.004), and lower conduction velocity across the LIPV and RSPV (P < 0.001). Conduction gaps were more prevalent at the septal aspect of the right PV encircling lines (85%), between the left atrial appendage (LAA) and the LSPV (70%) and lines at the posterior wall (71%). There was a nonsignificant increase in AFCL, with a more widespread distribution of organized electrograms (32.4% vs 46.6%)., Conclusion: Recurrence after CPVA is associated with a reverse process of voltage and conduction velocity increase across ablated areas, especially the PV-LA junction, and is related to the presence of conduction gaps, which are distributed mostly at the septal aspect of the lines encircling the right PVs and at the LAA-LSPV area. Organization of atrial electrograms seen during AF ablation is maintained at a repeat procedure.
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- 2006
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34. Robotic magnetic navigation for atrial fibrillation ablation.
- Author
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Pappone C, Vicedomini G, Manguso F, Gugliotta F, Mazzone P, Gulletta S, Sora N, Sala S, Marzi A, Augello G, Livolsi L, Santagostino A, and Santinelli V
- Subjects
- Adult, Aged, Atrial Fibrillation diagnostic imaging, Catheter Ablation instrumentation, Catheterization, Equipment Design, Feasibility Studies, Female, Fluoroscopy, Humans, Male, Middle Aged, Pliability, Treatment Outcome, Atrial Fibrillation therapy, Catheter Ablation methods, Magnetics, Robotics
- Abstract
Objectives: We assessed feasibility of magnetic catheter guidance in patients with atrial fibrillation (AF) undergoing circumferential pulmonary vein ablation (CPVA)., Background: No data are available on feasibility of remote navigation for AF ablation., Methods: Forty patients underwent CPVA for symptomatic AF using the NIOBE II remote magnetic system (Stereotaxis Inc., St. Louis, Missouri). Ablation was performed with a 4-mm tip, magnetic catheter (65 degrees C, maximum 50 W, 15 s). The catheter tip was guided by a uniform magnetic field (0.08-T), and a motor drive (Cardiodrive unit, Stereotaxis Inc.). Left atrium maps were created using an integrated CARTO RMT system (Stereotaxis Inc.). End point of ablation was voltage abatement >90% of bipolar electrogram amplitude., Results: Remote ablation was successful in 38 of 40 patients without complications. The median mapping and ablation time was 152.5 min (range, 90 to 380 min) but was much longer in the first 12 patients (192.5 min vs. 148 min; p = 0.012). Median ablation time was 49.5 min (range, 17 to 154 min), but it was much shorter in the last 28 patients than in the first 12 patients (49 min vs. 70 min; p = 0.021). Patients receiving remote ablation had longer procedure times than control patients (p < 0.001) with similar mapping time but shorter ablation time on right-sided pulmonary veins. Many more mapping points regardless of their location were collected remotely (p < 0.001)., Conclusions: Remote magnetic navigation for AF ablation is safe and feasible with a short learning curve. Although all procedures were performed by a highly experienced operator, remote AF ablation can be performed even by less experienced operators.
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- 2006
- Full Text
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35. Transcatheter radiofrequency ablation of atrial fibrillation in patients with mitral valve prostheses and enlarged atria: safety, feasibility, and efficacy.
- Author
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Lang CC, Santinelli V, Augello G, Ferro A, Gugliotta F, Gulletta S, Vicedomini G, Mesas C, Paglino G, Sala S, Sora N, Mazzone P, Manguso F, and Pappone C
- Subjects
- Aged, Anti-Arrhythmia Agents therapeutic use, Atrial Fibrillation drug therapy, Atrial Fibrillation mortality, Disease-Free Survival, Female, Follow-Up Studies, Heart Atria diagnostic imaging, Heart Atria pathology, Heart Atria surgery, Heart Valve Prosthesis Implantation, Humans, Male, Middle Aged, Mitral Valve Prolapse drug therapy, Mitral Valve Prolapse mortality, Postoperative Complications etiology, Postoperative Complications mortality, Recurrence, Tachycardia, Ectopic Atrial etiology, Tachycardia, Ectopic Atrial mortality, Tomography, X-Ray Computed, Treatment Outcome, Atrial Fibrillation surgery, Catheter Ablation, Heart Valve Prosthesis, Mitral Valve Prolapse surgery
- Abstract
Objectives: Few data have been published on transcatheter ablation of atrial fibrillation (AF) in patients with mitral valve prostheses. Thus, we sought to report our experience., Background: Ablation is an effective treatment for AF. Patients with prosthetic mitral valves represent a special group because of an increased risk from the ablation procedure due to the possibility of damage to the prosthetic valve., Methods: Between July 2001 and July 2003, 26 patients with mitral valve prostheses (MVP) underwent circumferential pulmonary vein ablation for AF. A matched group of 52 ablated patients without MVP acted as control subjects. After a blanking period of three months, a follow-up of 12 months was considered for MVP patients and controls. Holter recordings were performed in all subjects at 3, 6, and 12 months., Results: Radiation exposure was higher in the MVP group, with fluoroscopy times of 35.3 +/- 21 min versus 20.9 +/- 15 min in controls. At the end of follow-up, 73% of MVP patients were in sinus rhythm, compared with 75% of controls. Atrial tachycardia occurred in six (23%) MVP patients, requiring repeat ablation in three, and one (2%) control subject, which settled without treatment. One transient ischemic attack and one femoral pseudoaneurysm occurred in the MVP group. No complications occurred in the control group., Conclusions: Ablation of AF in patients with MVP is feasible, with outcomes similar to those of standard patients. Complications were higher among MVP patients with a greater radiation exposure and a higher incidence of post-ablation atrial tachycardia.
- Published
- 2005
- Full Text
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