Drought is one of the severe meteorological disasters and causes of serious losses for agricultural productions, and early assessment of drought hazard degree is critical in management of maize farming. This study pro...Drought is one of the severe meteorological disasters and causes of serious losses for agricultural productions, and early assessment of drought hazard degree is critical in management of maize farming. This study proposes a novel method for assessment of maize drought hazard in different growth stages. First, the study divided the maize growth period into four critical growth stages, including seeding, elongation, tasseling, and filling. Second, maize drought causal factors were selected and the fuzzy membership function was established. Finally, the study built a fuzzy gamma model to assess maize drought hazards, and the gamma 0.93 was finally established using Monte Carlo Analysis. Performing fuzzy gamma operation with 0.93 for gamma and classifying the area yielded a map of maize drought hazards with four zones of light, moderate, severe, and extreme droughts. Using actual field collected data, seven selected samples for drought hazard degree were examined, the model output proved to be a valid tool in the assessment maize drought hazard. This model will be very useful in analyzing the spatial change of maize drought hazard and influence on yield, which is significant for drought management in major agricultural areas.展开更多
Background It is unclear whether a history of paroxysmal atrial fibrillation (PAF) would impact the effect of catheter ablation on persistent atrial fibrillation (AF). This study aimed to compare the effect of cat...Background It is unclear whether a history of paroxysmal atrial fibrillation (PAF) would impact the effect of catheter ablation on persistent atrial fibrillation (AF). This study aimed to compare the effect of catheter ablation on persistent AF with and without a history of PAF. Methods One hundred and eighty-three patients underwent catheter ablation of persistent AF lasting for 〉1 month and were reviewed. Patients were divided into two groups according to whether they had a history of PAF or not. Group I consisted of persistent AF patients with a history of PAF, and group II consisted of persistent AF patients without such a history. All patients received catheter ablation focused on pulmonary vein isolation and were observed for arrhythmia recurrences, which were defined as documented episodes of AF or atrial tachycardia after a blanking period of 3 months. Results One hundred and three patients (60.9%) in group I and sixty-six patients (39.1%) in group II were successfully followed and included in analysis. There were no significant differences in clinical and echocardiographic characteristics between both groups except for a younger age and more male patients in group II. After (15.5±10.7) months of follow-up, 59 (57.3%) patients in group I and 49 (74.2%) patients in group II maintained sinus rhythm free of anti-arrhythmia drugs (P=0.025). Multivariate analyses found left atrial anteroposterior diameter (P=0.006) and persistent AF with a history of PAF (OR 1.792, 95% CI 1.019-3.152; P=0.043) as the only independent statistical predictors of arrhythmia recurrences. Conclusion The arrhythmia recurrence rate of catheter ablation based on pulmonary vein isolation in persistent AF with a history of PAF was hiQher than those without a history of PAF展开更多
Catheter ablation of atrial fibrillation (AF) has been ,increased dramatically recently. However, it is an unpleasant procedure with intolerable pain without sedation. Propofol and fentanyl/midazolam have been widel...Catheter ablation of atrial fibrillation (AF) has been ,increased dramatically recently. However, it is an unpleasant procedure with intolerable pain without sedation. Propofol and fentanyl/midazolam have been widely used in painful clinical examination and cardiovascular procedures with established safety and efficacy. Propofol, alfentanyl and midazolam were administrated for catheter ablation in some electrophysiological labs for a less painful procedure. However, there is few published work on the sedation regimen for catheter ablation of AF.展开更多
Background Previous studies have investigated the technique of linear ablation at the mitral isthmus (MI) in patients with idopathic atrial fibrillation (AF), but MI ablation in patients with prosthetic natural mi...Background Previous studies have investigated the technique of linear ablation at the mitral isthmus (MI) in patients with idopathic atrial fibrillation (AF), but MI ablation in patients with prosthetic natural mitral valves (MVs) was not described in detail. Present study sought to summarize our initial experience of ablating MI in patients with prosthetic MVs Methods Patients with drug refractory AF and prosthetic MVs were eligible for this study, and the patients with natural MVs but received MI ablation served as control group. Left atrium (LA) mapping and ablation was carried out guided by CARTO system. The anatomy of MI was assessed via computer topography scan. Results During the study period, a consecutive of 19 patients (male/female=12/7, mean age of (48±6) years) with prosthetic MVs (16 with metal valves, 3 with biologic valves) entered for AF ablation, other 35 patients served as control group. In study group, mapping along MI documented lower voltages ((2.0±1.0) vs. (3.1±1.3) mV, P=-0.002), more fragmented potentials (19/19 vs. 20/15, P 〈0.001 ), and higher impedance ((132±34) vs. (110±20) Ω, P=0.004). After initial ablation, more residual gaps along the MI lesions were found in study group (2.4±0.4 vs. 1.7±0.3, P 〈0.001). The mean length of MI ((6.2±3.3) vs. (7.1±2.3) cm, P=-0.25) was comparable between 2 groups, but the MI in study group was much thicker ((3.1±1.8) vs. (2.1±1.07) cm, P=0.01) and all were found as pouch type (19/19 vs. 2/35, P 〈0.001). The follow-up results were comparable (65.1% vs. 72.3%, P=-0.30). Conclusion For patients with prosthetic MVs, linear ablation at MI could be successfully carried out despite anatomical and pathological changes.展开更多
Background When performing superior vena cava isolation, the major concerns are inadvertent ablation on sinus node and right phrenic nerve. However, little is known about the spatial relationship of electrical connect...Background When performing superior vena cava isolation, the major concerns are inadvertent ablation on sinus node and right phrenic nerve. However, little is known about the spatial relationship of electrical connections between superior vena cava and right atrium with the sinus node and phrenic nerve locations among individual patients.Methods We studied 87 patients (male/female 60/27, mean age of (51±9) years) with atrial fibrillation. Before superior vena cava isolation, the sinus node site was defined by right atrium activation mapping during sinus rhythm and the right phrenic nerve site was localized via pacing manoeuvre. Superior vena cava was isolated by ablation at the electrical connection under the guidance of circular mapping catheter. The sites of sinus node, phrenic nerve and electrical connections were noted. Continuous variables were compared using Student's t test. A P value 〈0.05 was considered statistically significant.Results Right atrium activation mapping revealed that the sinus node located at the anterior lateral segment of superior vena cava-right atrium junction in all patients. In 82 patients with detectable diaphragmatic stimulations, the phrenic nerve sites were predominantly at the lateral segment (70/82) with anterior lateral and anterior segments for a few patients. A total of 165 electrical connections were located among all 87 patients, and this averaged 1.8±0.6 (1-3) per patient. The anterior septum (72 patients (43.6%)), the anterior wall (40 (24.2%)), and the posterior septum (35 (35.4%)) of superior vena cava-right atrium junction were the electrical connection regular sites. Superior vena cava was isolated in all patients. Two patients developed sinus bradycardia, with 3 mild superior vena cava stenosis and 2 phrenic nerve palsy.Conclusions The sinus node, phrenic nerve and electrical connection sites were distributed along the superior vena cava-right atrium junctions at expected locations for most patients. The electrical connections were separated from the sinus node and phrenic nerve sites. With the activation mapping of right atrium and pacing along superior vena cava-right atrium junctions, the sinus node and phrenic nerve were localized and superior vena cava isolated in most patients.展开更多
The present report demonstrates two cases of transient inferior ST-segment elevation accompanied by profound hypotension and bradycardia immediately after transseptal puncture for catheter ablation of atrial fibrillat...The present report demonstrates two cases of transient inferior ST-segment elevation accompanied by profound hypotension and bradycardia immediately after transseptal puncture for catheter ablation of atrial fibrillation. This rare complication of transseptal puncture was resolved quickly within several minutes. The most likely mechanism of this phenomenon is coronary vasospasm, although coronary embolism can not be ruled out completely. This complication is characterized as follows: (1) The right coronary artery might be the most likely involved vessel and therefore myocardial ischemia usually occurs in the inferior wall of left ventricular; (2) Reflex hypotension and bradycardia by the Bezold-Jarisch reflex secondary to inferior ischemia often occur at the same time. Though it appears to be a transient and completely reversible phenomenon, there are still potential life-threatening risks because of myocardial ischemia and profound haemodynamic instability. Clinical cardioloaists should be aware of this rare comolication and orooerlv deal with it.展开更多
基金supported by the National High-Tech R&D Program of China (2011BAD32B00-04)the National Basic Research Program of China (2010CB951102)+1 种基金the National Natural Science Foundation of China (41071326)the National Scientific Research Special Project of Public Sectors (Agriculture) of China (200903041)
文摘Drought is one of the severe meteorological disasters and causes of serious losses for agricultural productions, and early assessment of drought hazard degree is critical in management of maize farming. This study proposes a novel method for assessment of maize drought hazard in different growth stages. First, the study divided the maize growth period into four critical growth stages, including seeding, elongation, tasseling, and filling. Second, maize drought causal factors were selected and the fuzzy membership function was established. Finally, the study built a fuzzy gamma model to assess maize drought hazards, and the gamma 0.93 was finally established using Monte Carlo Analysis. Performing fuzzy gamma operation with 0.93 for gamma and classifying the area yielded a map of maize drought hazards with four zones of light, moderate, severe, and extreme droughts. Using actual field collected data, seven selected samples for drought hazard degree were examined, the model output proved to be a valid tool in the assessment maize drought hazard. This model will be very useful in analyzing the spatial change of maize drought hazard and influence on yield, which is significant for drought management in major agricultural areas.
文摘Background It is unclear whether a history of paroxysmal atrial fibrillation (PAF) would impact the effect of catheter ablation on persistent atrial fibrillation (AF). This study aimed to compare the effect of catheter ablation on persistent AF with and without a history of PAF. Methods One hundred and eighty-three patients underwent catheter ablation of persistent AF lasting for 〉1 month and were reviewed. Patients were divided into two groups according to whether they had a history of PAF or not. Group I consisted of persistent AF patients with a history of PAF, and group II consisted of persistent AF patients without such a history. All patients received catheter ablation focused on pulmonary vein isolation and were observed for arrhythmia recurrences, which were defined as documented episodes of AF or atrial tachycardia after a blanking period of 3 months. Results One hundred and three patients (60.9%) in group I and sixty-six patients (39.1%) in group II were successfully followed and included in analysis. There were no significant differences in clinical and echocardiographic characteristics between both groups except for a younger age and more male patients in group II. After (15.5±10.7) months of follow-up, 59 (57.3%) patients in group I and 49 (74.2%) patients in group II maintained sinus rhythm free of anti-arrhythmia drugs (P=0.025). Multivariate analyses found left atrial anteroposterior diameter (P=0.006) and persistent AF with a history of PAF (OR 1.792, 95% CI 1.019-3.152; P=0.043) as the only independent statistical predictors of arrhythmia recurrences. Conclusion The arrhythmia recurrence rate of catheter ablation based on pulmonary vein isolation in persistent AF with a history of PAF was hiQher than those without a history of PAF
基金This work was funded by the National Natural Science Foundation of China(No.30500202 and No.30570724)
文摘Catheter ablation of atrial fibrillation (AF) has been ,increased dramatically recently. However, it is an unpleasant procedure with intolerable pain without sedation. Propofol and fentanyl/midazolam have been widely used in painful clinical examination and cardiovascular procedures with established safety and efficacy. Propofol, alfentanyl and midazolam were administrated for catheter ablation in some electrophysiological labs for a less painful procedure. However, there is few published work on the sedation regimen for catheter ablation of AF.
文摘Background Previous studies have investigated the technique of linear ablation at the mitral isthmus (MI) in patients with idopathic atrial fibrillation (AF), but MI ablation in patients with prosthetic natural mitral valves (MVs) was not described in detail. Present study sought to summarize our initial experience of ablating MI in patients with prosthetic MVs Methods Patients with drug refractory AF and prosthetic MVs were eligible for this study, and the patients with natural MVs but received MI ablation served as control group. Left atrium (LA) mapping and ablation was carried out guided by CARTO system. The anatomy of MI was assessed via computer topography scan. Results During the study period, a consecutive of 19 patients (male/female=12/7, mean age of (48±6) years) with prosthetic MVs (16 with metal valves, 3 with biologic valves) entered for AF ablation, other 35 patients served as control group. In study group, mapping along MI documented lower voltages ((2.0±1.0) vs. (3.1±1.3) mV, P=-0.002), more fragmented potentials (19/19 vs. 20/15, P 〈0.001 ), and higher impedance ((132±34) vs. (110±20) Ω, P=0.004). After initial ablation, more residual gaps along the MI lesions were found in study group (2.4±0.4 vs. 1.7±0.3, P 〈0.001). The mean length of MI ((6.2±3.3) vs. (7.1±2.3) cm, P=-0.25) was comparable between 2 groups, but the MI in study group was much thicker ((3.1±1.8) vs. (2.1±1.07) cm, P=0.01) and all were found as pouch type (19/19 vs. 2/35, P 〈0.001). The follow-up results were comparable (65.1% vs. 72.3%, P=-0.30). Conclusion For patients with prosthetic MVs, linear ablation at MI could be successfully carried out despite anatomical and pathological changes.
文摘Background When performing superior vena cava isolation, the major concerns are inadvertent ablation on sinus node and right phrenic nerve. However, little is known about the spatial relationship of electrical connections between superior vena cava and right atrium with the sinus node and phrenic nerve locations among individual patients.Methods We studied 87 patients (male/female 60/27, mean age of (51±9) years) with atrial fibrillation. Before superior vena cava isolation, the sinus node site was defined by right atrium activation mapping during sinus rhythm and the right phrenic nerve site was localized via pacing manoeuvre. Superior vena cava was isolated by ablation at the electrical connection under the guidance of circular mapping catheter. The sites of sinus node, phrenic nerve and electrical connections were noted. Continuous variables were compared using Student's t test. A P value 〈0.05 was considered statistically significant.Results Right atrium activation mapping revealed that the sinus node located at the anterior lateral segment of superior vena cava-right atrium junction in all patients. In 82 patients with detectable diaphragmatic stimulations, the phrenic nerve sites were predominantly at the lateral segment (70/82) with anterior lateral and anterior segments for a few patients. A total of 165 electrical connections were located among all 87 patients, and this averaged 1.8±0.6 (1-3) per patient. The anterior septum (72 patients (43.6%)), the anterior wall (40 (24.2%)), and the posterior septum (35 (35.4%)) of superior vena cava-right atrium junction were the electrical connection regular sites. Superior vena cava was isolated in all patients. Two patients developed sinus bradycardia, with 3 mild superior vena cava stenosis and 2 phrenic nerve palsy.Conclusions The sinus node, phrenic nerve and electrical connection sites were distributed along the superior vena cava-right atrium junctions at expected locations for most patients. The electrical connections were separated from the sinus node and phrenic nerve sites. With the activation mapping of right atrium and pacing along superior vena cava-right atrium junctions, the sinus node and phrenic nerve were localized and superior vena cava isolated in most patients.
基金This work was supported by a grant from the National Natural Science Foundation of China (No. 81070147).
文摘The present report demonstrates two cases of transient inferior ST-segment elevation accompanied by profound hypotension and bradycardia immediately after transseptal puncture for catheter ablation of atrial fibrillation. This rare complication of transseptal puncture was resolved quickly within several minutes. The most likely mechanism of this phenomenon is coronary vasospasm, although coronary embolism can not be ruled out completely. This complication is characterized as follows: (1) The right coronary artery might be the most likely involved vessel and therefore myocardial ischemia usually occurs in the inferior wall of left ventricular; (2) Reflex hypotension and bradycardia by the Bezold-Jarisch reflex secondary to inferior ischemia often occur at the same time. Though it appears to be a transient and completely reversible phenomenon, there are still potential life-threatening risks because of myocardial ischemia and profound haemodynamic instability. Clinical cardioloaists should be aware of this rare comolication and orooerlv deal with it.