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1.
Ned Tijdschr Geneeskd ; 1682024 May 16.
Article in Dutch | MEDLINE | ID: mdl-38747585

ABSTRACT

A dropping foot is the consequence of a variety of debilitating conditions and is oftentimes treated conservatively by general practitioners and other specialists. Typically, it is caused by peroneal nerve palsy secondary to compression or a hernia nucleosipulpei at the level L4-L5. Identifying the underlying pathology requires a neurological work-up oftentimes including ultrasound and electromyographic investigation. When a peroneal nerve compression is found, decompression can be achieved operatively. Should the underlying cause of the dropping foot have been treated adequately without an effect on the foot itself, then a posterior tibial tendon transfer may be considered. Generally, a posterior tibial tendon transfer has good outcomes for the treatment of dropping foot although it is partly dependent on the physiotherapy that accompanies it.


Subject(s)
Gait Disorders, Neurologic , Peroneal Neuropathies , Humans , Peroneal Neuropathies/etiology , Gait Disorders, Neurologic/etiology , Tendon Transfer/methods , Decompression, Surgical/methods , Treatment Outcome
2.
Clin Cardiol ; 42(4): 438-443, 2019 Apr.
Article in English | MEDLINE | ID: mdl-30756396

ABSTRACT

BACKGROUND: Cryoballoon isolation is considered a safe and effective treatment for atrial fibrillation (AF). However, recurrence of AF after first cryoballoon ablation occurs in ~30% of patients. Pre-procedurally identifying patients at risk of AF recurrence could be beneficial. HYPOTHESIS: Our aim was to determine how pulmonary vein (PV) anatomy influences the recurrence of AF using the second-generation cryoballoon in patients with paroxysmal AF. METHODS: We included 88 consecutive patients with paroxysmal AF undergoing PVI procedure with a second-generation 28-mm cryoballoon. All patients were evaluated at 3, 6 and 12 months using a 12-lead ECG and 24-hour Holter monitoring. PV anatomy was assessed by creating three-dimensional models using computed tomography (CT) segmentations of the left atrium. RESULTS: Fifty-one patients (61%) had left PVs with a shared carina, 35 patients (42%) had a shared right carina. Nine patients (11%) were classified having a right middle PV. In total 17 (20.2%) of patients had a left common PV. At 12 months, 14 patients (17%) had experienced AF recurrence. Neither PV ovality, variant anatomy, the presence of shared carina nor a common left PV was a predictor for AF recurrence. CONCLUSIONS: No specific characteristics of PV dimensions nor morphology were associated with AF recurrence after cryoballoon ablation in patients with paroxysmal AF.


Subject(s)
Atrial Fibrillation/surgery , Cryosurgery/methods , Heart Conduction System/physiopathology , Imaging, Three-Dimensional , Multidetector Computed Tomography/methods , Pulmonary Veins/diagnostic imaging , Atrial Fibrillation/diagnosis , Atrial Fibrillation/physiopathology , Electrocardiography, Ambulatory , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pulmonary Veins/surgery , Reproducibility of Results , Retrospective Studies
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