Notes

Protocol for Quickly arranged and also Chaperonin-assisted in vitro Refolding of an Slow-folding Mutant of GFP, sGFP.
The correlation between number of reconnected PVs and time of AF recurrence was -0.32 for PVAC and -0.52 for CB.

CB PVI was associated with greater durability and lesser PV reconnections/patient. There were negative correlations for both devices between extent of PV reconnections and time of AF recurrence. CB patients with early AF recurrences- although less frequently observed compared with PVAC patients had more reconnected PVs than PVAC patients, suggesting additional effects for AF prevention after CB PVI.
CB PVI was associated with greater durability and lesser PV reconnections/patient. There were negative correlations for both devices between extent of PV reconnections and time of AF recurrence. CB patients with early AF recurrences- although less frequently observed compared with PVAC patients had more reconnected PVs than PVAC patients, suggesting additional effects for AF prevention after CB PVI.
High-power (HP) ablation protocols are increasingly used for ablation procedures to shorten procedural times and improve short- and long-term success. The ablation index (AI) combines contact force, power settings, and ablation time. It can be used in combination with HP protocols to guide operators toward standardized lesions. selleck kinase inhibitor The purpose of this study was to evaluate both a HP and AI-guided strategy for ablation of the cavotricuspid isthmus (CTI) in patients with typical atrial flutter (AFL).

In this single-center study, consecutive patients with typical AFL (n=52, mean age 68.7±8.3years, 21/52 [40.4%] female) underwent AI-guided HP radiofrequency (RF) ablation of the CTI. Ablation was performed with 50W and AI target values of 550 with a maximum ablation duration of 25secondsper lesion. Target interlesion distance was ≤6mm. Ablation was performed with a 3.5mm porous tip Smarttouch SF catheter.

Acute CTI block was achieved in 52 of 52 patients (100%), and first-pass conduction block was achieved in 41 of 52 patients (80.4%). Spontaneous reconduction after 30minutes waiting time occurred in 1 of 52 (1.9%) patient. Average ablation time until CTI block was 351±140; 233±101minutes of bonus ablation pulses were applied after CTI block. An audible steam pop was noted in one patient (1.9%). No major complications occurred. After a mean follow-up of 193.7±152.2days, no patient showed recurrence of typical AFL.

In this pilot study, AI-guided HP ablation of the CTI was fast, safe, and effective.
In this pilot study, AI-guided HP ablation of the CTI was fast, safe, and effective.
New protocols of pulmonary veins isolation (PVI) result in easier and more efficient procedure performance. Ablation index (AI) is the novel tool which helps to achieve transmural lesions during catheter ablation. However, benefit of this protocol in the reduction of myocardial injury is still not known.

The aim of the study was to compare myocardial injury during catheter ablation using standard and AI protocol.

To the analysis we included 24 patients with paroxysmal atrial fibrillation, who underwent radiofrequency catheter PVI using CARTO system (Biosense Webster, Inc). In all patients cardiac troponin I (cTnI) levels were assessed before and 24hours after the procedure. In 12 patients PVI was performed using continuous applications (dragging technique) and in 12 patients during PVI ablation AI protocol was implemented. To unify analyzed groups, we excluded patients with additional ablation lines (including line separating ipsilateral pulmonary veins).

In analyzed group mean age was 59.3±7.7years and 18 (75%) patients were male. There were no differences in the clinical characteristic between both subgroups. Trend in shorter total x-ray time was observed in AI group compared with dragging group (8.6±5.4 vs. 5.3±3.2min.;
=.093) with no differences in total procedure time (146.3±28.9 vs. 153.2±37.1min.;
=.616). Twenty-four hours after the PVI procedure cTnI levels were significantly lower in AI group than in dragging group (1.984±0.644 vs. 3.369±1.818ng/mL;
=.026), with no difference in mean baseline cTnI levels (0.004±0.006 vs. 0.015±0.032ng/mL;
=.304).

Presented study revealed that compared with standard, continuous applications, AI protocol implementation results in reduction of myocardial injury during catheter PVI in patients with paroxysmal atrial fibrillation.
Presented study revealed that compared with standard, continuous applications, AI protocol implementation results in reduction of myocardial injury during catheter PVI in patients with paroxysmal atrial fibrillation.
Information on apixaban anticoagulant activity is required to prevent major bleeding or thrombosis during its use.

We enrolled 194 patients with nonvalvular atrial fibrillation (NVAF) in whom warfarin was replaced with apixaban 105 (54.1%) received the standard dose of apixaban (5mg twice daily [BID]; 5mg group) and 89 (45.9%) received a reduced dose (2.5mg BID; 2.5mg group). Multiple regression analysis was performed to predict the prothrombin time of apixaban (PTa) based on factors including age, body weight (BW), serum creatinine, and CHA
DS
-VASc score.

PTa and PT of warfarin (PTw) were significantly correlated in both groups (correlation coefficient R=0.239 [
=.014] in the 5mg group; R=0.248 [
=.019] in the 2.5mg group). PTa in the 5mg group was predicted as follows 16.952-0.036×BW +0.299×CHA
DS
-VASc score (
<.0004; R=0.378). However, in the 2.5mg group, PTa could not be predicted. The mean of the predicted and measured PTa values in the 5mg group was 15.6s, which was similar to the mean measured PTa of 15.5s in the 2.5mg group.

PT can be predicted by a formula including simple clinical parameters in patients receiving the standard dose of apixaban. This simple predictive formula may help to stratify bleeding and thrombosis risks in patients treated with apixaban.
PT can be predicted by a formula including simple clinical parameters in patients receiving the standard dose of apixaban. This simple predictive formula may help to stratify bleeding and thrombosis risks in patients treated with apixaban.
The coarse F waves on the 12-lead surface electrocardiogram (ECG) in patients with atrial fibrillation (AF) are known as atrial viability and contractility indicator. Our aim in this study was to investigate the effect of coarse F wave on thromboembolism in patients with permanent AF.

In our study, 328 patients with permanent AF were included. Routine laboratory, echocardiographic and electrocardiographic parameters were examined. Cerebrovascular event (CVE) or acute artery occlusion was considered a thromboembolic event.

In our study, 46 (14.0%) of the patients were found to have thromboembolic events and 282 (86%) of them were found without thromboembolic events. In the group with thromboembolic event, the number of patients with hypertension (HT) (
<.001) and history of coronary artery disease (
=.003) and elderly patients (
<.001) was significantly higher and warfarin use was significantly lower (
=.025). In the group of patients without thromboembolic events, the number of patients with a coarse F wave in surface ECG was significantly lower (
=.001). Age (OR 1.105, 95% CI 1.066-1.145,
<.001), HT (OR 2.831, 95% CI 1.266-6.331,
=.011), and coarse F wave (OR 0.290, 95% CI 0.126- 0.670,
=.004) were determined as independent variables for thromboembolic events.

Coarse F wave in 12-lead surface ECG in patients with permanent AF may be associated with good prognosis.
Coarse F wave in 12-lead surface ECG in patients with permanent AF may be associated with good prognosis.
This study aims to research the clinical features of atrial thrombi in patients with nonvalvular atrial fibrillation (AF).

This study included 191 patients of AF who had atrial thrombi. One hundred and twenty-eight of them were assigned into nonventricular cardiomyopathy group (non-VCM), and the remaining 63 into ventricular cardiomyopathy group (VCM). After atrial thrombi diagnosed, all patients had taken oral anticoagulant therapy. The resolution rates of thrombi within 12months were compared between the two groups, as well as the locations of thrombi.

Of all 191 patients, 161 had thrombi only detected in left atrial appendage (LAA), 20 in both left atrium (LA) and LAA, six in LA only, and four in right atrium only. More patients had thrombi out of LAA in the VCM group than in the non-VCM group (30.2% vs 8.6%,
<.001). After propensity score matching, the atrial thrombi were resolved faster in the non-VCM group than in the VCM group (mean time length 22±2weeks vs 30±3weeks,
=.038), and the resolution rate within 12months was higher in the non-VCM group than in the VCM group (88.7% vs 61.4%, Log-rank,
=.038). In Cox proportional hazards model, absence of ventricular cardiomyopathy was an independent predictor for the resolution of atrial thrombus (hazard ratio 1.76;
=.035).

The patients of atrial fibrillation with ventricular cardiomyopathies have higher incidence of thrombosis in the body of left atrium or right atrium. And the resolution rate was lower in these patients.
The patients of atrial fibrillation with ventricular cardiomyopathies have higher incidence of thrombosis in the body of left atrium or right atrium. And the resolution rate was lower in these patients.
Inflammation has been implicated in the initiation and perpetuation of non-valvular atrial fibrillation (AF). However, there is a lack of similar data on AF in rheumatic heart disease (RHD). The objective of this study was to analyze the association of inflammation as measured by serum inflammatory biomarkers with AF in rheumatic mitral stenosis (Rh-MS).

A comparative cross-sectional analytical study was conducted on 181 Rh-MS patients in normal sinus rhythm (NSR; n=69), subclinical transient AF (SCAF; detected by 24-hours Holter monitoring; n=30) and chronic AF (n=82). Serum hs-CRP, IL-6, and sCD-40L were assessed using ELISA immunoassay and compared in all groups of Rh-MS with or without AF.

We found significantly higher serum hs-CRP and sCD-40L levels in the overall AF (Chronic AF+SCAF) group (
4.5±3.4 vs 2.3±2.9mg/L,
<.01;
6.4±4.8 vs 3.1±3.4ng/mL,
<.01) and chronic AF subgroup (
4.9±3.4 vs 2.3±2.9mg/L,
<.01;
6.9±5.1 vs 3.1±3.4ng/mL,
<.01) compared to patients with sinus rhythm. There was a statistically significant graded increase of serum IL-6 level from the NSR to the SCAF (
6.8±3.9 vs 4.0±2.2pg/mL,
=.03), and chronic AF subgroups (
9.3±6.5 vs 4.0±2.2pg/mL,
<.01; vs
9.3±6.5 vs 6.8±3.9,
=.05) of atrial fibrillation.

Elevated levels of serum hs-CRP, IL-6, and sCD-40L were strongly associated with overall AF and also with SCAF and chronic AF in Rh-MS patients indicating a potential role of inflammation in the pathophysiology of rheumatic AF.
Elevated levels of serum hs-CRP, IL-6, and sCD-40L were strongly associated with overall AF and also with SCAF and chronic AF in Rh-MS patients indicating a potential role of inflammation in the pathophysiology of rheumatic AF.
A scoring system to determine indications for catheter ablation (CA) in atrial fibrillation (AF) is desired.

Among 2898 consecutive patients with AF, CA was performed in 938 (32.4%). A new HEAL-AF score has been developed by six variables, all of which were independently associated with CA by multivariate analysis and for each 1 point was assigned heart failure ≥ NYHA II, elderly patients (age ≥75years), asymptomatic AF, long-standing persistent AF, atrial dilation (left atrial diameter≥50mm), and female sex. Low HEAL-AF score was associated with high incidence of CA performance (52.0% for 0, 36.5% for 1, 15.1% for 2, and 5.6% for≥3) and the predictive capability of this score by AUC of ROC curve was 0.720 (95% CI 0.701-0.739,
<.001). The rates of freedom from AF/AT recurrence were 73.2% in HEAL-AF score 0, 71.0% in 1, 60.0% in 2, and 50.0% in≥3 (log-rank test,
=.004). HEAL-AF score 2 and≥3 were significantly associated with recurrence of atrial tachyarrhythmia as compared with HEAL-AF 0 (HR 1.755,
=.
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