162 research outputs found
Pulsed-field ablation of atrial fibrillation: kinetics of release of multiple cardiac biomarkers
No full textSafety and Efficacy of Stereotactic Arrhythmia Radioablation for the Treatment of Ventricular Tachycardia: A Systematic Review
No full textCatheter ablation (CA) is a fundamental therapeutic option for the treatment of recurrent ventricular arrhythmias. Notwithstanding the tremendous improvements in the available technology and the increasing amount of evidence in support of CA, in some patients the procedure fails, or is absolutely contraindicated due to technical or clinical issues. In these cases, the clinical management of patients is highly challenging, and mainly involves antiarrhythmic drugs escalation. Over the last 5 years, stereotactic arrhythmia radioablation (STAR) has been introduced into clinical practice, with several small studies reporting favorable arrhythmia-free outcomes, without severe side effects at a short to mid-term follow-up. In the present systematic review, we provide an overview of the available studies on stereotactic arrhythmia radioablation, by describing the potential indications and technical aspects of this promising therapy
Lettere diplomatiche e lettere familiari: alle origini dell’epistolario di Baldassarre Castiglione
No full textBaldassarre Castiglione (1478-1529), uno dei letterati cinquecenteschi più noti della penisola come autore del Libro del Cortegiano, ricoprì numerosi incarichi diplomatici: oratore dei marchesi di Mantova e poi dei duchi d’Urbino, infine nunzio in Spagna presso l’imperatore Carlo V tra il 1524 e il 1529, anno della sua morte. Nell’arco della sua vita e in virtù del suo ruolo di ambasciatore, Castiglione produsse un’ingente quantità di lettere che abbracciava un arco cronologico di oltre trent’anni (1497-1529). Si tratta di una fonte straordinaria, che costituisce una miniera di informazioni, di natura sia pubblica sia privata, e segue pressoché l’intera parabola biografica e professionale di un personaggio che attraversò, con ruoli da protagonista in ambito politico, culturale, artistico, alcuni decenni cruciali della storia dell’Italia e dell’Europa moderna.Questo articolo si propone di ricostruire la vicenda travagliata del progetto di pubblicazione dell’epistolario di Castiglione negli anni ’70-’80 del XVI secolo e di indagare le diverse ragioni del suo esito fallimentare tra interessi privati, esigenze morali e censure di Stato.Baldassarre Castiglione (1478-1529), one of the 16th-century best known man of letters and author of the Book of the Courtier, held many diplomatic posts: orator of the marquises of Mantua and later of the dukes of Urbino, and finally, nuntius in Spain to Emperor Charles V between 1524 and 1529, the year of his death. During his life and by virtue of his role as ambassador, Castiglione produced an enormous quantity of letters that spanned more than thirty years (1497-1529). This is an extraordinary source, a mine for both public and private information covering nearly the entire personal and professional trajectory of a figure who played a leading role in the fields of politics, culture and art during several decades in the history of Italy and modern Europe.The article aims to reconstruct the complicated story of the project to publish Castiglione’s correspondence during the 1570s and 1580s and the reasons why it failed, which included private interests, moral expectations and State censorship
Francesco Sansovino
No full textAs part of a larger project on the history of relations between Christians and Muslims in the modern age, this essay aims to shed light on the figure and work of Francesco Sansovino (Rome 1521- Venice 1583), writer, translator and curator of texts as well as founder of print shop which over a period of roughly twenty years published more than fifty works. Sansovino was author of two texts (Historia universale, 1560-61 and Annali turcheschi 1571) which deal with the history, customs, culture and religion of the Ottoman civilization and which enjoyed a wide circulation. The essay aims to show how within the panorama contemporary publications these works of Sansovino’s were intended, above all, to disseminate knowledge about the Ottoman Turks: an approach that was quite unlike that of ideological confrontation against the infidels following the footsteps of Paolo Giovio’s Commentario de le cose de’ Turchi , a work dedicated to emperor Charles V and published in 1531 and which served as Sansovino’s main source and model
Technological advances in ventricular tachycardia catheter ablation: the relentless quest for novel solutions to old problems
No full textBackgroundSeveral novel technologies allowing catheter ablation (CA) with a favorable safety/efficacy profile have been recently developed, but not yet extensively clinically tested in the setting of ventricular tachycardia CA.MethodsIn this technical report, we overview technical aspects and preclinical/clinical information concerning the application of three novel CA technologies in the ventricular milieu: a pulsed field ablation (PFA) generator (CENTAURI (TM), Galaxy Medical) to be used with linear, contact force-sensing radiofrequency ablation catheters; a contact force-sensing radiofrequency ablation catheter equipped with six thermocouples and three microelectrodes (QDOT Micro (TM), Biosense-Webster), allowing high-resolution mapping and temperature-controlled CA; and a flexible and mesh-shaped irrigation tip, contact force-sensing radiofrequency ablation catheter (Tactiflex, Abbott). We also report three challenging VT cases in which CA was performed using these technologies.ResultsThe CENTAURI system was used with the Tacticath (TM) (Abbott) ablation catheter to perform ventricular PFA in a patient with advanced heart failure, electrical storm, and a deep intramural septal substrate. Microelectrode mapping using QDOT Micro (TM) helped to refine substrate assessment in a VT patient with congenitally corrected transposition of the great arteries, and allowed the identification of the critical components of the VT circuit, which were successfully ablated. Tactiflex (TM) was used in two challenging CA cases (one endocardial and one epicardial), allowing acute and mid-term control of VT episodes without adverse events.ConclusionThe ideation and development of novel technologies initially intended to treat atrial arrhythmias and successfully implemented in the ventricular milieu is contributing to the progressive improvement in the clinical benefits derived from VT CA, making this procedure key for successful management of increasingly complex patients
Arrhythmic Mitral Valve Prolapse and Sports Activity: Pathophysiology, Risk Stratification, and Sports Eligibility Assessment
No full textAlthough mitral valve prolapse (MVP) is the most prevalent valvular abnormality in Western countries and generally carries a good prognosis, a small subset of patients is exposed to a significant risk of malignant ventricular arrhythmias (VAs) and sudden cardiac death (SCD), the so-called arrhythmic MVP (AMVP) syndrome. Recent work has emphasized phenotypical risk features of severe AMVP and clarified its pathophysiology. However, the appropriate assessment and risk stratification of patients with suspected AMVP remains a clinical conundrum, with the possibility of both overestimating and underestimating the risk of malignant VAs, with the inappropriate use of advanced imaging and invasive electrophysiology study on one hand, and the catastrophic occurrence of SCD on the other. Furthermore, the sports eligibility assessment of athletes with AMVP remains ill defined, especially in the grey zone of intermediate arrhythmic risk. The definition, epidemiology, pathophysiology, risk stratification, and treatment of AMVP are covered in the present review. Considering recent guidelines and expert consensus statements, we propose a comprehensive pathway to facilitate appropriate counseling concerning the practice of competitive/leisure-time sports, envisioning shared decision making and the multidisciplinary “sports heart team” evaluation of borderline cases. Our final aim is to encourage an active lifestyle without compromising patients’ safety
Beyond Measure: Implicating Law Reviews and Author Rankings in Low Impact Factors in Legal Scholarship
No full textThis article argues that the current academic author ranking system is flawed. This flaw arises due to obscuring the scope and value of legal scholarship. This obfuscation ultimately hinders innovation and meaningful impact across the legal landscape
Beyond Measure: Implicating Law Reviews and Author Rankings in Low Impact Factors in Legal Scholarship
No full textThis article argues that the current academic author ranking system is flawed. This flaw arises due to obscuring the scope and value of legal scholarship. This obfuscation ultimately hinders innovation and meaningful impact across the legal landscape
Cardiac Magnetic Resonance and Cardiac Implantable Electronic Devices: Are They Truly Still “Enemies”?
No full textThe application of cardiac magnetic resonance (CMR) imaging in clinical practice has grown due to technological advancements and expanded clinical indications, highlighting its superior capabilities when compared to echocardiography for the assessment of myocardial tissue. Similarly, the utilization of implantable cardiac electronic devices (CIEDs) has significantly increased in cardiac arrhythmia management, and the requirements of CMR examinations in patients with CIEDs has become more common. However, this type of exam often presents challenges due to safety concerns and image artifacts. Until a few years ago, the presence of CIED was considered an absolute contraindication to CMR. To address these challenges, various technical improvements in CIED technology, like the reduction of the ferromagnetic components, and in CMR examinations, such as the introduction of new sequences, have been developed. Moreover, a rigorous protocol involving multidisciplinary collaboration is recommended for safe CMR examinations in patients with CIEDs, emphasizing risk assessment, careful monitoring during CMR, and post-scan device evaluation. Alternative methods to CMR, such as computed tomography coronary angiography with tissue characterization techniques like dual-energy and photon-counting, offer alternative potential solutions, although their diagnostic accuracy and availability do limit their use. Despite technological advancements, close collaboration and specialized staff training remain crucial for obtaining safe diagnostic CMR images in patients with CIEDs, thus justifying the presence of specialized centers that are equipped to handle these type of exams
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