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catheter ablation of atrial fibrillation in elderly population

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Journal of Geriatric Cardiology 2017年第9期14卷 563-568页

作者： Josef Kautzner Petr Peichl Marek Sramko Robert Cihak Bashar Aldhoon Dan Wichterle Department of Cardiology Institute for Clinical and Experimental Medicine (IKEM) Videnska 1958/9 14021 Prague Czech Republic

Background Although elderly patients have been included in published series of catheter ablation for atrial fibrillation （AF）, clinicalbenefit and safety remain still less defined in this population. A retrospective analysis of the results of catheter ablation for AF in a large volumecenter focused on comparison of elderly patients with the rest of the patient cohort was conducted in this study. Methods Consecutive patientswho underwent catheter ablation for AF between January 2001 and December 2016 were analysed. A total population of 3197 patients wasdichotomized by the age of 70 years （394 elderly vs. 2803 younger subjects）. Patients were followed in terms of arrhythmia status and sur-vival for a median period of 18 vs. 21 and 35 vs. 57 months, respectively. Results Elderly patients were more frequently females （49% vs.29%, P 〈 0.0001）, had a history of hypertension （79% vs. 57%, P 〈 0.0001）, diabetes （16% vs. 11%, P 〈 0.01）, stroke （9% vs. 6%, P 〈 0.01）,coronary/peripheral artery disease （14% vs. 8%, P 〈 0.0001）, and CHAzDS2-VASc score （3.1 ± 1.3 vs. 1.5 ± 1.2 s, P 〈 0.0001）. Major com-plications were more frequent in elderly （5.3% vs. 3.2%, P = 0.03）; however, this difference was driven by vascular complications （3.6% vs.1.9%, P = 0.04）. There were comparable rates of cerebrovascular （0.3 vs. 0.3%） or nonvascular complications （1.8 vs. 1.2%）. Good arrhyth-mia control was inferior in elderly patients as compared with the rest of the cohort, both without and with antiarrhythmic drugs： 44.2% vs.58.2% （P 〈 0.0001） and 78.2 vs. 83.2% （P 〈 0.01）, respectively. Poor arrhythmia control was associated with relative risk of all-cause mor-tality of 2.7 （95% CI： 1.1-6.4） in elderly patients and 1.4 （95% CI： 0.9-2.0） in younger subjects. Conclusions catheter ablation for AF inelderly patients is safe although somewhat less effective. Good arrhythmia control is associated with better survival, especially in elderly patients.

关键词： Atrial fibrillation catheter ablation Complications The elderly

Structural and Interfacial Effects on Drug Release Kinetics of Liquid‑Based Fibrous catheter

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Advanced Fiber Materials 2022年第6期4卷 1645-1655页

作者： Chunyan Wang Yaqi Hou Xingyi Wang Weijun Li Yunmao Zhang Shuli Wang Jing Zheng Xu Hou College of Chemistry and Chemical Engineering State Key Laboratory of Physical Chemistry of Solid SurfacesXiamen UniversityXiamen 361005China Collaborative Innovation Center of Chemistry for Energy Materials Xiamen UniversityXiamen 361005China Department of Electronic Science Fujian Engineering Research Center for Solid‑State LightingSchool of Electronic Science and EngineeringXiamen UniversityXiamen 361005China College of Physical Science and Technology Xiamen UniversityXiamen 361005China

catheterization is indispensable in the field of modern ***,catheter-related thrombosis and infections almost inevitably occur during the process,and as drugs can only be administered at the end of catheter,auxiliary strategies are required for successful *** these intractable limitations,a type of self-adaptive,anti-coagulate liquidbased fibrous catheter has been *** importantly,it has positional drug release property that traditional catheters desperately need but couldn’t *** enlightening,the feasibility and performance of the positional drug release have only been demonstrated by fluorescents,the specific drug release kinetics remains unknown for adaptation to application ***,we systematically investigate the structural and interfacial effects of drug molecules and fibrous matrixes on drug release kinetics in a liquid-based fibrous *** calculations and experiments demonstrate that oleophilic and hydrophilic molecules release slowly due to a dissolution-diffusion *** molecules,however,will significantly affect the gating performance by affecting the interfacial stability,hence they release quickly with emulsifying the gating *** the significant impact of molecular properties and interfacial effects,matrix pore size also has a slight influence that molecules release faster in bigger *** this study,the liquid-based fibrous catheter may step further toward practical applications including chemotherapy,haemodialysis,angiography,*** overcome the existing catheter-related limitations.

关键词： Liquid-based materials Electrospinning fibrous materials catheter Drug release

Mathematical modelling of couple stresses on fluid flow in constricted tapered artery in presence of slip velocity-effects of catheter

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Applied Mathematics and Mechanics(English Edition) 2014年第8期35卷 947-958页

作者： J.V.R.REDDY D.SRIKANTH S.K.MURTHY Department of Applied Mathematics Defence Institute of Advanced Technology Deemed UniversityPune 411025MaharastraIndia

This paper explores the mathematical model for couple stress fluid flow through an annular region. The above model is used for studying the blood flow be-tween the clogged （stenotic） artery and the catheter. The asymmetric nature of the stenosis is considered. The closed form expressions for the physiological parameters such as impedance and shear stress at the wall are obtained. The effects of various geomet-ric parameters and the parameters arising out of the fluid considered are discussed by considering the slip velocity and tapering angle. The study of the above model is very significant as it has direct applications in the treatment of cardiovascular diseases.

关键词： blood flow couple stress fluid stenosed artery tapered artery catheter

Value of cystatin C in predicting atrial fibrillation recurrence after radiofrequency catheter ablation

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Journal of Geriatric Cardiology 2018年第12期15卷 725-731页

作者： Li-Li JIN Ling YOU Rui-Qin XIE Department of Cardiology the Second Hospital of Hebei Medical UniversityShijiazhuangChina

Backgroud Recent studies have demonstrated that cystatin C is a valuable risk marker for cardiovascular disease morbidity and ***,we hypothesized that the pre-ablation cystatin C level was associated with post-ablation atrial fibrillation(AF)*** 207 patients were enrolled and completed in this prospective observational *** with AF scheduled for receive radiofrequency catheter ablation(RFCA)therapy were screened for the *** ablation therapy,electrocardiogram,24 h holter monitor,transesophageal echocardiography,serum cystatin C,high-sensitivity C-reactive protein,creatinine levels,and routine blood examinations were *** ablation,patients were followed up every week for the first month,and then at 2,3,6,9,and 12 ***,patients came back to out-patient clinic every six months *** or 24 h holter monitor were repeated if the patient experienced palpitations or every six *** recurrence was defined as atrial flbrillation/atrial flutter or atrial tachycardia lasting≥30 seconds within three months after *** Compared to patients with no AF recurrence,patients with recurrence had longer AF history(P=0.007),more early recurrence(P=0.000),a larger left atrium(P=0.004),and higher pre-ablation cystatin C levels(P=0.000).Multivariate regression analysis revealed that cystatin C and left atria(LA)diameter were risk factors for AF *** adjusting for LA diameter,the risk of AF recurrence increased 30%with every milligram cystatin C elevation(95%CI:1.117-1.523).Conclusions Pre-ablation cystatin C levels were associated with AF recurrence after RFCA therapy,an optimal cut-off value of 1.190 mg/L(sensitivity=0.576;specificity=0.851).

关键词： Atrial fibrillation catheter ablation Cystatin C Recurrence

Clinical outcomes of radiofrequency catheter ablation of atrial fibrillation in octogenarians lO-year experience of a one high-volume center

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Journal of Geriatric Cardiology 2017年第9期14卷 575-581页

作者： Alan Bulava Jiri Hanis Ladislav Dusek Department of Cardiology Ceske Budejovice Hospital Ceske Budejovice Czech Republic Faculty of Medicine and Dentistry Palacky University Olomouc Czech Republic Faculty of Health and Social Sciences University of South Bohemia in Ceske Budejovice Czech Republic Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno Czech Republic

Background Prevalence of atrial fibrillation （AF） increases with age. Radiofrequency catheter ablation （RFCA） is an establishedtreatment option superior to antiarrhythmics （AAs）. In this study, we investigated safety and efficacy of RFCA of AF in *** From our database, we extracted procedural and follow-up data for patients 〉 80 years with symptomatic AF undergoing RFCAand compared this population to RFCA patients 〈 50 years. All patients underwent pulmonary vein isolation （PVI） supplemented by linearlesions in PVI-nonresponders. Arrhythmia-free survival was assessed using seven day Holter every three months post procedure. All patientscompleted their 12 months follow-up. Results Fifty patients aged ≥80 years （80.5 ± 1.6 years） were compared to 259 patients aged 〈 50years （43.5±5.5 years）. The RFCA complication rate did not vary between groups. No differences in procedural characteristics were seenafter being analyzed by type of AF. Among patients with paroxysmal AF, 71.4% octogenarian vs. 84.7% young patients was free of anyarrhythmia, without AAs, after single procedure. For non-paroxysmal AF, arrhythmia-free survival without AAs, was considerably lower（58.6% octogenarians vs. 81.2% younger patients, P = 0.023）. If AAs were used, arrhythmia-free survival for paroxysmal AF increased to90.5% and 92.1% in octogenarians and younger patients, respectively; and in non-paroxysmal AF it increased to 79.3% vs. 88.4%. ConclusionsRFCA is a safe and effective strategy to achieve normal sinus rhythm in a highly selected group of octogenarians. Paroxysmal AF ablation inoctogenarians has similar clinical effectiveness as that seen in much younger patients. Non-paroxysmal AF ablation has lower, but still rea-sonable clinical effectiveness.

关键词： Atrial fibrillation catheter ablation Effectiveness Octogenarians Safety The elderly

Dual-sized hollow particle incorporated fibroin thermal insulating coatings on catheter for cerebral therapeutic hypothermia

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Bioactive Materials 2023年第8期26卷 116-127页

作者： Ming Li Yuan Gao Miaowen Jiang Hongkang Zhang Yang Zhang Yan Wu Wenhao Zhou Di Wu Chuanjie Wu Longfei Wu Luzi Bao Xiaoxiao Ge Zhengfei Qi Ming Wei Ang Li Yuchuan Ding Jicheng Zhang Guangzhen Pan Yu Wu Yan Cheng Yufeng Zheng Xunming Ji China-America Institute of Neuroscience and Beijing Institute of Geriatrics Xuanwu HospitalCapital Medical UniversityBeijing100053China School of Instrumentation and Optoelectronic Engineering Beihang UniversityBeijing100191China Beijing Institute for Brain Disorders Capital Medical UniversityBeijing100069China School of Materials Science and Engineering Peking UniversityBeijing100871China Shaanxi Key Laboratory of Biomedical Metallic Materials Northwest Institute for Nonferrous Metal ResearchXi’an710016China Department of Biomedical Engineering Columbia UniversityNew York CityNY10027USA Department of Neurosurgery Wayne State University School of MedicineDetroitMI48201USA Gong Yi Van-research Innovation Composite Material Co.Ltd Zheng Zhou451299China Department of Neurosurgery Xuanwu HospitalCapital Medical UniversityBeijing100053China

Selective endovascular hypothermia has been used to provide cooling-induced cerebral neuroprotection,but current catheters do not support thermally-insulated transfer of cold infusate,which results in an increased exit temperature,causes hemodilution,and limits its cooling ***,air-sprayed fibroin/silica-based coatings combined with chemical vapor deposited parylene-C capping film was prepared on *** coating features in dual-sized-hollow-microparticle incorporated structures with low thermal *** infusate exit temperature is tunable by adjusting the coating thickness and infusion *** peeling or cracking was observed on the coatings under bending and rotational scenarios in the vascular *** efficiency was verified in a swine model,and the outlet temperature of coated catheter(75μm thickness)was 1.8-2.0◦C lower than that of the uncoated *** pioneering work on catheter thermal insulation coatings may facilitate the clinical translation of selective endovascular hypothermia for neuroprotection in patients with acute ischemic stroke.

关键词： Silk fibroin Thermal insulation coating catheter Stroke Hypothermia

Double pigtail catheter reduction for seriously displaced intravenous infusion port catheter:A case report

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World Journal of Clinical Cases 2023年第4期11卷 883-887页

作者： Yu Liu Duan-Ming Du Department of Interventional Therapy Shenzhen Second People’s HospitalThe First Affiliated Hospital of Shenzhen UniversityShenzhen 518035Guangdong ProvinceChina

BACKGROUND Implanted intravenous infusion port(TIAP)is mainly used for patients who need central venous infusion and poor peripheral vascular *** the advantages of easy to carry,long maintenance cycle,few complications and excellent quality of life,it has been widely used in the fields of malignant tumor chemotherapy,parenteral nutrition support and repeated blood *** intravenous infusion port(IVAP)dislocation can have significant complications if not recognised and reinstated *** SUMMARY A 24-year-old man was treated with adjuvant chemotherapy for *** displacement of IVAP catheter was found by chest X-ray *** IVAP cannot be used ***,we conducted an emergency procedure to reset the catheter through double pigtail catheters,the operation was successful and the infusion port was *** When IVAP catheter displacement cannot be reset by conventional techniques,two pigtail catheters can be successfully used instead.

关键词： catheter Displaced catheter Implantable Implanted intravenous infusion port Pigtail catheter Case report

Workflow for treating inadvertent arterial placement of the central venous catheter

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Journal of Geriatric Cardiology 2024年第11期21卷 1096-1098页

作者： Joho Tokumine Keisuke Fujimaki Kiyoshi Moriyama Tomoko Yorozu Department of Anesthesiology Kyorin University School of Medicine6-20-2 ShinkawaMitakaTokyoJapan Department of Cardiovascular Surgery Sakakibara Heart Institute3-16-1 Asahi-choFuchu-shiTokyoJapan

We read the article“How to manage the malposition of deep vein catheterization into the artery”[1]with keen ***,we have several concerns with the proposed ***,the site of catheter misplacement is assumed to be the subclavian artery,the most frequent site of misplacement during internal jugular vein catheterization.[2]However,catheter misplacement can occur in the common carotid and vertebral arteries during internal jugular vein catheterization.[2,3]If a catheter is misplaced in one of these arteries,preventing cerebral ischemia is a priority.[2,4,5]For example,if a thrombus forms around the catheter,a method is chosen to resolve it while preventing dispersion and closing the perforation.[2,6]Therefore,open surgical closure must be ***,the algorithm may not handle instances of realistic catheter misplacement in the *** assume a case where an internal jugular venous catheter(5Fr double-lumen catheter)is inserted but accidentally penetrates the subclavian artery and is placed in the thoracic *** that the injured site is about 5 mm from the confluence of the right common carotid or vertebral arteries.

关键词： catheter closure instance

Radiofrequency catheter ablation of atrial tachycardias related to myocardial scar or incision

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Journal of Geriatric Cardiology 2006年第4期3卷 250-253页

作者： Jianqiang HU Jiang CAO Shengqiang WANG Yongwen QIN Bingyan ZHOU Department of Cardiology Changhai Hospital Second Military Medical University Shanghai 200433 China Department of Cardiology Changhai Hospital Second Military Medical University Shanghai 200433 China Department of Cardiology PLA 148th Hospital Zibo Shandong 255300 China Department of Cardiology Changhai Hospital Second Military Medical University Shanghai 200433 China Department of Cardiology Changhai Hospital Second Military Medical University Shanghai 200433 China

Objectives Intra-atrial re-entrant tachycardias(IARTs)are common late after heart *** mapping and ablation is relatively difficult because of the complicated anatomy and multiple potential re-entry *** this study we aimed to evaluate the electrophysiological characteristics and radiofrequency catheter ablation of atrial tachycardia(AT)induced by myocardial scar or *** In 6 patients(three male and three female,aged 33.3±11.8 years)who had AT related to myocardial scar or incision, electrophysiological study and radiofrequency catheter ablation(RFCA)were *** activation combined with entrain- ment mapping was adopted to determine a critical *** Re-entry related to the lateral atriotomy scar was inducible in 5 of 6 *** entrainment mapping,the PPI(post-pacing interval)-TCL(tachycardia cycle length)difference was＜30 ms when pacing at the inferior margins of the right lateral atriotomy *** them,3 patients had successful linear ablation between scar area to inferior vena cava,and 2 patients between scar area to tricuspid ***-entry involving an ASD patch was demonstrated in 1 of 6 ***-TCL differences＜30 ms were observed when entraining tachycardia at sites near the septal *** linear ablation failed in terminating *** was no complication during *** recurrence of AT related to incision was observed during follow-up except for the failed *** Under conventional electrophysiological mapping,adopting linear ablation from scar area to anatomic barrier,successful ablation can be obtained in patients with IRATs related to myocardial scar or incision.

关键词： atrial tachycardia radiofrequency catheter ablation heart surgery