Impact of a Novel Catheter Tracking System on Radiation Exposure during the Procedural Phases of Atrial Fibrillation and Flutter Ablation.

BACKGROUND: Fluoroscopic guidance is used to position catheters during cardiac ablation. We evaluated the impact of a novel nonfluoroscopic sensor-guided electromagnetic navigation system (MG) on radiation exposure during catheter ablation of atrial fibrillation (AF) or atrial flutter (AFL). METHODS: A total of 134 consecutive patients referred for ablation of AF (n = 44) or AFL (n = 90) ablation were prospectively enrolled. In one group the MG system was used for nonfluoroscopic catheter positioning, whereas in the conventional group standard fluoroscopy was utilized. Fluoroscopy times were assessed for each stage of procedure and total radiation exposure was quantified. RESULTS: Patient characteristics were similar between the groups. The procedural end point was achieved in all. Median (interquartile range [IQR]) fluoroscopy times were 12.5 minutes (7.6, 17.4) MG group versus 21.5 minutes (15.3, 23.0) conventional group (P < 0.0001) for AF ablation, and 0.8 minutes (0.4, 2.5) MG group versus 9.9 minutes (5.1, 22.5) conventional group (P < 0.0001) for AFL ablation. Median (IQR) total radiation exposure (µGy·m(2)) was 1,107 (906, 2,033) MG group versus 2,835 (1,688, 3,855) conventional group (P = 0.0001) for AF ablation, and 161 (65, 537) MG group versus 1,651 (796, 4,569) conventional group (P < 0.0001) for AFL ablation. No difference in total procedural time was seen. CONCLUSIONS: The use of a novel nonfluoroscopic catheter tracking system is associated with a significant reduction in radiation exposure during AF and AFL ablation (61% and 90% reduction, respectively). In the era of heightened awareness of the importance of radiation reduction, this system represents a safe and efficient tool to decrease radiation exposure during electrophysiological ablation procedures.

Treatment of severe diphtheritic myocarditis by temporary insertion of a cardiac pacemaker.

Vietnamese children and adolescents with diphtheritic myocarditis and severe conduction abnormalities were treated prospectively with temporary insertion of a cardiac pacemaker. Five of 32 patients died before the procedure could be performed; the remaining 27 patients underwent successful pacemaker insertion. In children and adolescents with diphtheritic myocarditis and severe conduction defects, temporary insertion of a cardiac pacemaker may improve the outcome.

Some artery parameters of ultrasound duplex of carotid and extra cranial arteries in healthy people

200 persons, average age is 59,27 (from 15-93) without vascular risk factors were studied by colour Duplex scanning. Results showed that average systolic velocity in common carotid arteries is 81,14 +/- 14,67 cm/s, average diastolic velocity is 23,27 +/- 5,15 cm/s, average diastolic velocity is 25,53 +/- 5,21 cm/s. Average systolic velocity in vertebral arteries is 42,58 +/- 7,73cm/s, average diastolic velocity is 14,68 +/- 3,63 cm/s. No statistic significantly difference of these parameters between men and women. No statistic difference of these parameters between right and left side. Systolic and diastolic velocities in common and internal carotid arteries decrease significantly with age. Other parameters do not change clearly with age

Initial ultrasonographic investigation of carotid intima-media thickness in healthy older people

The study aimed to determine the normal range of the intima-media thickness that was measured in common carotid artery and carotid groove and evaluate the changes in measurement with age in 200 healthy adults (113 males, 87 females, from 15 to 93 years old) between August 1998 and December 1999. Results: On average, the intima-media thickness is 0.7+/-0.16 mm in common carotid artery and is 0.87+/-0.25 mm in carotid groove. There is not difference in the intima-media thickness of common carotid and carotid groove between left and right. The intima-media thickness of both common carotid artery and carotid groove is increased over age. There is a linear correlation between the intima-media thickness with age. The intima-media thickness of common carotid artery, but not of carotid groove, is higher in men than in women