50,682 research outputs found
Long-term Outcomes of Stand-Alone Maze IV for Persistent or Long-standing Persistent Atrial Fibrillation
No full textBackground: The study sought to assess the long-term outcomes of the stand-alone Cox-Maze IV procedure in symptomatic patients with refractory, persistent, or long-standing persistent atrial fibrillation (AF). Methods: Fifty-nine consecutive patients (mean age 52 ± 10.5 years, previous catheter ablation 80%, left ventricular ejection fraction 55% ± 3.4%, median left atrial volume index 41 [interquartile range, 34-47] mL/m2) with symptomatic, refractory, persistent (56%), or longstanding persistent (44%) AF, underwent stand-alone Cox-Maze IV procedure. Biatrial ablations were performed with bipolar radiofrequency and cryoenergy. Left atrial appendage was excluded in 56 of 59 (95%) patients. Results: No hospital deaths occurred and 1 (1.7%) patient required postoperative pacemaker implantation. Follow-up was 97% complete (median 5.8 [interquartile range, 3.92-7.11] years). The overall survival at 7 years was 97% ± 2.3%. The 7-year cumulative incidence function of AF recurrence and of AF recurrence off class I or III antiarrhythmic drugs (AADs), with death as competing risk, was 14.2% ± 5.6% (95% confidence interval [CI], 5.5%-26.8%) and 26.5% ± 6.9% (95% CI, 14.2%-40.4%), respectively. Multivariate analysis identified the duration of AF as the only predictor of AF recurrence (hazard ratio, 1.01; 95% CI, 1.01-1.02; P < .001). At 7 years, the proportion of patients in sinus rhythm was 84%, of whom 74% were off class I or III AADs. At the last follow-up, 75% of patients were in European Heart Rhythm Association functional class I, no stroke and thromboembolic events were documented, and 70% of patients were off anticoagulation therapy. Left ventricular ejection fraction improved from 53% ± 3.4% at baseline to 59% ± 3.4% at follow-up (P = .003). Conclusions: This study confirmed the safety and efficacy in the long term (7 years) of the stand-alone Cox-Maze IV surgical procedure for persistent or long-standing persistent AF. Indeed, more than 70% of the patients were in sinus rhythm off class I or III AADs and off oral anticoagulation
Long-term results of thoracoscopic ablation of paroxysmal atrial fibrillation: is the glass half full or half empty?
No full textOBJECTIVES: Previous series showed the outcomes of thoracoscopic ablation of stand-alone symptomatic paroxysmal atrial fibrillation (AF) for up to 7 years of follow-up. The goal of this study was to assess the long-term durability of surgical pulmonary vein isolation (PVI) beyond 7 years. METHODS: Fifty consecutive patients {mean age 55 [standard deviation (SD): 11.2] years, previous catheter ablation in 56%, left ventricular ejection fraction 60% (SD: 4.6), left atrium volume 65 ml (SD: 17)} with stand-alone symptomatic paroxysmal AF underwent PVI through bilateral thoracoscopy ablation between 2005 and 2014. The CHA(2)DS(2)-VASc score was >= 2 in 12 patients (24%). RESULTS: No hospital deaths occurred. At hospital discharge all patients but 1 (2%) were in sinus rhythm (SR). Follow-up was 100% complete [mean 8.4 years (SD: 2.3), max 15]. The 8-year cumulative incidence function of AF recurrence, with death as a competing risk, on or off class I/III antiarrhythmic drugs (AADs)/electrocardioversion/re-transcatheter ablation (TCA) was 20% (SD: 5; 95% confidence interval: 10, 32); and off class I/III AADs/electrocardioversion/re-TCA was 52% (SD: 7; 95% confidence interval: 0.83, 8.02). At 8 years, the predicted prevalence of patients in SR was 87% and 53% were off class I/III AADs/electrocardioversion/re-TCA. The recurrent arrhythmia was AF in all patients except 2, who had atypical atrial flutter (4%). No predictors of AF recurrence were identified. At the last follow-up, 76% of the patients showed European Heart Rhythm Association class I. No strokes or thromboembolic events were documented and 76% of the subjects were off anticoagulation therapy. CONCLUSIONS: Despite a considerable AF recurrence rate, our single-centre, long-term outcome of surgical PVI showed encouraging data, with the majority of patients remaining in SR, although many of them were on antiarrhythmic therapy
Speculu[m] exemploru[m] ex diuersis libris in vnu[m] laboriose collectu[m].
No full textEerste blad (blanco) ontbreektThe author is probably Johannes Busch (CIBN)Titel uit incipit. Drukker en datum uit colofonBMC: Catalogue of books printed in the XVth century now in the British Museum I 226bGesamtkatalog der Wiegendrucke ; M42951Machiels, J. Catalogus van de boeken gedrukt vóór 1600 ; S 488Polain, M.-L. Catalogue des livres imprimé au 15e siècle ... ; 3574Europeana-GoogleBook
Continuità e reinvenzione dell’habitat nel Marocco post-coloniale. Il caso di Derb Jdid a Casablanca
No full textIl contributo si inquadra nell'ambito degli studi sullo sviluppo dei nuovi habitat moderni nei contesti delle ex-colonie Europee,con un ripensamento sostanziale dei paradigmi del progetto in seguito al CIAM 9 del 1953 basato su un nuovo equilibrio di rapporti tra l'architettura dell'abitare e l'uomo, sugli aspetti relazionali e soprattutto su una nuova comprensione della realtà che individuava nel quotidiano il principale campo d'azione progettuale e nelle pratiche ordinarie dell'abitare il soggetto stesso dell'architettura.
Il contributo affronta il caso studio del quartiere di Derb Jdid nella periferia di Casablanca, progettato negli anni tra il 1958 e il 1963 dall'architetto marocchino Elie Azagury, uno degli interventi di riqualificazione urbana più significativi della Casablanca post-coloniale che, sulla scia delle sperimentazioni sull’“habitat évolutif”, aveva come obiettivo il re-insediamento delle bidonvilles che in quegli anni rappresentavano una delle problematiche urbane e sociali più stringenti.
All'interno di questo quadro di riferimento Derb Jdid si inserisce come esempio significativo di progetto-habitat "a-temporale", da un lato capace di interpretare, incorporandoli nel progetto originario, i temi
delle culture abitative tradizionali, dall'altro aperto alle modellazioni spaziali e a nuovi usi da parte degli abitanti secondo un modello di habitat-processo che trova la sua valenza più compiuta proprio nella contemporaneità. A partire da questo caso studio si vuole quindi offrire una riflessione sui temi dell'habitat inteso come sistema aperto i cui riferimenti temporali di costruzione dello spazio si intersecano con le dinamiche storico-culturali e con le questioni legate alle pratiche ordinarie umane e sociali
The long-wavelength view of GG Tau A: rocks in the ring world
No full textWe present the first detection of GG Tau A at centimetre wavelengths, made with the Arcminute Microkelvin Imager Large Array at a frequency of 16 GHz (λ = 1.8 cm). The source is detected at >6 σrms with an integrated flux density of S16GHz = 249 ± 45 µJy. We use these new centimetre-wave data, in conjunction with additional measurements compiled from the literature, to investigate the long-wavelength tail of the dust emission from this unusual protoplanetary system. We use an MCMC-based method to determine maximum likelihood parameters for a simple parametric spectral model and consider the opacity and mass of the dust contributing to the microwave emission. We derive a dust mass of Md ~ 0.1 Msun, constrain the dimensions of the emitting region and find that the opacity index at λ > 7 mm is less than unity, implying a contribution to the dust population from grains exceeding ~4 cm in size. We suggest that this indicates coagulation within the GG Tau A system has proceeded to the point where dust grains have grown to the size of small rocks with dimensions of a few centimetres. Considering the relatively young age of the GG Tau association in combination with the low derived disc mass, we suggest that this system may provide a useful test case for rapid core accretion planet formation models
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