ABSTRACT
Objective@#To compare the outcome of radiofrequency catheter ablation under local anesthesia/sedation (S) or general anesthesia(GA) in atrial fibrillation patients.@*Methods@#Data of 498 patients with atrial fibrillation undergoing radiofrequency catheter ablation in our departmentfrom January 2014 to December 2015 were retrospectively analyzed. Two hundred and twenty patients assigned to the GA group, the other 278 patients to the S group. Patients were followed clinically every 3 months within one year after procedure. Immediate electrocardiogram was performed in patients with palpitation or choking sensation in chest. The end point of the study was recurrence of any atrial tachyarrhythmia lasting >30 seconds in device interrogation, 24-hour Holter monitoring or 12-lead electrocardiogram after a single procedure. After the ablation procedure, a blanking period of 3 months was allowed according to the guidelines. Procedure time, radiofrequency time, fluoroscopy time, the detection of paroxysmal supraventricular tachycardia, the success rate and the complications were compared between the two groups.@*Results@#There was no difference in the baseline characteristics between the two groups, such as age, gender, BMI, complications, LVEF, LAD (all P>0.05). The duration of procedure ((117.8±51.7)minutes vs.(115.4±36.9)minutes, P=0.79), duration of fluoroscopy((12.5±11.2)minutes vs. (10.4±10.2)minutes, P=0.35), duration of radiofrequency((40.1±12.9)minutes vs. (48.6±44.3)minutes, P=0.48) were similar between the two groups (P>0.05). Compared with S group, discovery of the frequency of atrioventricular node reentrant tachycardia (AVNRT) was significantly lower in GA group (0 vs. 3.6%(10/278), P<0.01), but the difference disappeared with repeat electrophysiological examination when patients become conscious from GA(3.2%(7/220) vs. 3.6%(10/278), P=0.311). The difference of atrioventricular reentrant tachycardia (AVRT) was similar between the two groups(0.9%(2/220) vs. 0.7%(2/278), P=0.841). Compared with S group, reflection of vagus nerve was less in GA group (1.4%(3/220) vs. 8.6%(24/278), P=0.026). After following up of (356±92) days, freedom from atrial fibrillation/atrial flutter/atrial tachyarrhythmia was similar between the two groups(77.9%(162/208) vs. 79.9%(215/269), P=0.818).@*Conclusion@#General anesthesia is a promising method to atrial fibrillation ablation, in view of stable patient status and safety for the procedure. There is no difference in complications, recurrence of arrhythmia between the two groups, but detection rate of AVNRT is lower in GA group.
ABSTRACT
Objective:To investigate the morphology and growth kinetics of the cells derived from the adult normal and herniated nucleus pulposus tissues.Methods: The cells derived from the adult normal and herniated nucleus pulposus were cultured in vitro.Passage 1,3,5 cells were chosen for light microscope and electron microscope observation.The cell growth rate,MTT value,maximal growth density,cellular mitotic index,cloning efficiency,and other parameters were observed in normal and herniated nucleus pulposus and the results were compared.Results: Compared with adult normal nucleus pulposus cells,the cells isolated from herniated nucleus pulposus were irregularly arranged and lost polarization,with rough endoplasmic reticulum slightly dilated.Under the same cellular density and culture conditions,the growth rate of passage 1 cells from adult normal and herinated nucleus pulposus had no significant difference,but the differences of passage 3 cells(P(0.05);) those of passage 3 cells were respectively 6.96?0.19 and 5.48?0.22,0.154?0.018 and 0.110?0.009,(22.52?(2.16)‰) and((16.68?)(2.35)‰,) and(48.7?3.3)% and(40.7?2.5)%;and of passage 5 cells were respectively 2.42?0.13 and 0.98?(0.14,) 0.085?0.006 and 0.050?0.007,(15.61?1.96)‰ and(9.34?2.12)‰,and(40.2?2.3)% and(28.34?(2.9)%.) There were significant differences between the parameters of passage 3 and 5 cells(P