Articles de revues : « Pharmacological ablation »

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Gourraud, Jean-Baptiste, Jason G. Andrade, Laurent Macle et Blandine Mondésert. « Pharmacological Tests in Atrial Fibrillation Ablation ». Arrhythmia & ; Electrophysiology Review 5, n^o 3 (2016) : 170. http://dx.doi.org/10.15420/aer.2016:27:2.

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The invasive management of atrial fibrillation (AF) has been considerably changed by the identification of major sites of AF initiation and/or maintenance within the pulmonary vein antra. Percutaneous catheter ablation of these targets has become the standard of care for sustained maintenance of sinus rhythm. Long-term failure of ablation is related to an inability to create a durable transmural lesion or to identify all of the non-pulmonary vein arrhythmia triggers. Pharmacological challenges during catheter ablation have been suggested to improve outcomes in both paroxysmal and persistent AF. Herein we review the mechanism and evidence for the use of pharmacological adjuncts during the catheter ablation of AF.

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Rordorf, Roberto, Simone Savastano, Edoardo Gandolfi, Alessandro Vicentini, Barbara Petracci et Maurizio Landolina. « Pharmacological therapy following catheter ablation of atrial fibrillation ». Journal of Cardiovascular Medicine 13, n^o 1 (janvier 2012) : 9–15. http://dx.doi.org/10.2459/jcm.0b013e32834d5880.

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Baher, Alex, et Nassir F. Marrouche. « Treatment of Atrial Fibrillation in Patients with Co-existing Heart Failure and Reduced Ejection Fraction : Time to Revisit the Management Guidelines ? » Arrhythmia & ; Electrophysiology Review 7, n^o 2 (2018) : 91. http://dx.doi.org/10.15420/aer.2018.17.2.

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AF in patients with heart failure and reduced ejection fraction (HFrEF) is common and is associated with an increased risk of stroke, heart failure hospitalisation and all-cause mortality. Rhythm control of AF in this population has been traditionally limited to the use of antiarrhythmic drugs. Clinical trials assessing superiority of pharmacological rhythm control over rate control have been largely disappointing. Catheter ablation has emerged as a viable alternative to pharmacological rhythm control in symptomatic AF and has enjoyed significant technological advancements over the past decade. Recent clinical trials have suggested that catheter ablation is superior to pharmacological interventions in patients with co-existing AF and HFrEF. In this article, we will review the therapeutic options for AF in patients with HFrEF in the context of the latest clinical trials beyond the current established guidelines.

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Hung, Yuan, Shih-Ann Chen, Shih-Lin Chang, Wei-Shiang Lin et Wen-Yu Lin. « Atrial Tachycardias After Atrial Fibrillation Ablation : How to Manage ? » Arrhythmia & ; Electrophysiology Review 9, n^o 2 (13 août 2020) : 54–60. http://dx.doi.org/10.15420/aer.2020.07.

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With catheter ablation becoming effective for non-pharmacological management of AF, many cases of atrial tachycardia (AT) after AF ablation have been reported in the past decade. These arrhythmias are often symptomatic and respond poorly to medical therapy. Post-AF-ablation ATs can be classified into the following three categories: focal, macroreentrant and microreentrant ATs. Mapping these ATs is challenging because of atrial remodelling and its complex mechanisms, such as double ATs and multiple-loop ATs. High-density mapping can achieve precise identification of the circuits and critical isthmuses of ATs and improve the efficacy of catheter ablation. The purpose of this article is to review the mechanisms, mapping and ablation strategy, and outcome of ATs after AF ablation.

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Piotrowski, Roman, et Piotr Kułakowski. « Ablation in persistent atrial fibrillation ». In a good rythm 3, n^o 48 (26 octobre 2018) : 17–23. http://dx.doi.org/10.5604/01.3001.0012.7127.

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Atrial fibrillation is an arrhythmia which causes deterioration of the quality of life and increases frequency of hospitalizations. It also causes a significant increase in the risk of stroke, heart failure and other thrombo-embolic complications. Ablation is more effective than pharmacological treatment in patients with paroxysmal atrial fibrillation, however data and recommendations in patients with persistent atrial fibrillation are less clear. This article summarizes the issues that should be considered in planning ablation of persistent atrial fibrillation in order to optimize efficacy of this treatment.

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He, Bo, Benjamin J. Scherlag, Hiroshi Nakagawa, Ralph Lazzara et Sunny S. Po. « The Intrinsic Autonomic Nervous System in Atrial Fibrillation : A Review ». ISRN Cardiology 2012 (19 juin 2012) : 1–8. http://dx.doi.org/10.5402/2012/490674.

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The procedure of catheter ablation for the treatment of drug resistant atrial fibrillation (AF) has evolved but still relies on lesion sets intended to isolate areas of focal firing, mainly the myocardial sleeves of the pulmonary veins (PVs), from the rest of the atria. However the success rates for this procedure have varied inversely with the type of AF. At best success rates have been 20 to 30% below that of other catheter ablation procedures for Wolff-Parkinson-White syndrome, atrioventricular junctional re-entrant tachycardia and atrial flutter. Basic and clinical evidence has emerged suggesting a critical role of the ganglionated plexi (GP) at the PV-atrial junctions in the initiation and maintenance of the focal form of AF. At present the highest success rates have been obtained with the combination of PV isolation and GP ablation both as catheter ablation or minimally invasive surgical procedures. Various lines of evidence from earlier and more recent reports provide that both neurally based and myocardially based forms of AF can separately dominate or coexist within the context of atrial remodeling. Future studies are focusing on non-pharmacological, non-ablative approaches for the prevention and treatment of AF in order to avoid the substantive complications of both these regimens.

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Eysenck, William, et Magdi Saba. « Rhythm Control in Heart Failure Patients with Atrial Fibrillation ». Arrhythmia & ; Electrophysiology Review 9, n^o 3 (5 novembre 2020) : 161–66. http://dx.doi.org/10.15420/aer.2020.23.

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AF and heart failure (HF) commonly coexist. Left atrial ablation is an effective treatment to maintain sinus rhythm (SR) in patients with AF. Recent evidence suggests that the use of ablation for AF in patients with HF is associated with an improved left ventricular ejection fraction and lower death and HF hospitalisation rates. We performed a systematic search of world literature to analyse the association in more detail and to assess the utility of AF ablation as a non-pharmacological tool in the treatment of patients with concomitant HF.

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Mukherjee, Rahul K., Steven E. Williams et Mark D. O’Neill. « Atrial Fibrillation Ablation in Patients with Heart Failure : One Size Does Not Fit All ». Arrhythmia & ; Electrophysiology Review 7, n^o 2 (2018) : 84. http://dx.doi.org/10.15420/aer.2018.11.3.

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Atrial fibrillation (AF) is common in patients with heart failure and is associated with poorer clinical outcomes compared with patients with heart failure alone. Recent evidence has challenged previous treatment paradigms in which rate control was considered equivalent to rhythm control in this population. Catheter ablation has emerged as a safe and effective treatment strategy in selected patients and overcomes the issues of limited efficacy and drug toxicities associated with pharmacological rhythm control. Numerous studies have explored the benefits of catheter ablation in patients with heart failure, but these have included heterogeneous patient cohorts and variable ablation strategies. This state-of-the-art review explores the evidence from these trials and examines the need for tailored, patient-specific strategies for AF ablation in patients with heart failure.

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Joll, J. Ethan, Cynthia R. Clark, Christine S. Peters, Michael A. Raddatz, Matthew R. Bersi et W. David Merryman. « Genetic ablation of serotonin receptor 2B improves aortic valve hemodynamics of Notch1 heterozygous mice in a high-cholesterol diet model ». PLOS ONE 15, n^o 11 (25 novembre 2020) : e0238407. http://dx.doi.org/10.1371/journal.pone.0238407.

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Calcific aortic valve disease (CAVD) is a deadly disease that is rising in prevalence due to population aging. While the disease is complex and poorly understood, one well-documented driver of valvulopathy is serotonin agonism. Both serotonin overexpression, as seen with carcinoid tumors and drug-related agonism, such as with Fenfluramine use, are linked with various diseases of the valves. Thus, the objective of this study was to determine if genetic ablation or pharmacological antagonism of the 5-HT2B serotonin receptor (gene: Htr2b) could improve the hemodynamic and histological progression of calcific aortic valve disease. Htr2b mutant mice were crossed with Notch1+/- mice, an established small animal model of CAVD, to determine if genetic ablation affects CAVD progression. To assess the effect of pharmacological inhibition on CAVD progression, Notch1+/- mice were treated with the 5-HT2B receptor antagonist SB204741. Mice were analyzed using echocardiography, histology, immunofluorescence, and real-time quantitative polymerase chain reaction. Htr2b mutant mice showed lower aortic valve peak velocity and mean pressure gradient–classical hemodynamic indicators of aortic valve stenosis–without concurrent left ventricle change. 5-HT2B receptor antagonism, however, did not affect hemodynamic progression. Leaflet thickness, collagen density, and CAVD-associated transcriptional markers were not significantly different in any group. This study reveals that genetic ablation of Htr2b attenuates hemodynamic development of CAVD in the Notch1+/- mice, but pharmacological antagonism may require high doses or long-term treatment to slow progression.

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Dan, Gheorghe-Andrei. « Rhythm Control in AF : Have We Reached the Last Frontier ? » European Cardiology Review 14, n^o 2 (11 juillet 2019) : 77–81. http://dx.doi.org/10.15420/ecr.2019.8.1.

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AF is a worldwide epidemic, affecting approximately 33 million people, and its rising prevalence is expected to account for increasing clinical and public health costs. AF is associated with an increased risk of MI, heart failure, stroke, dementia, chronic kidney disease and mortality. Preserving sinus rhythm is essential for a better outcome. However, because of the inherent limits of both pharmacological and interventional methods, rhythm strategy management is reserved for symptom and quality-of-life improvement. While ‘classical’ antiarrhythmic drug therapy remains the first-line therapy for rhythm control, its efficacy and safety are limited by empirical use, proarrhythmic risk and organ toxicity. Ablative techniques have had an impressive development, but AF ablation still failed to demonstrate a significant impact on hard endpoints. Understanding of the complex mechanisms of AF will help to develop new vulnerable targets to therapy. Promising molecules are under development, intended to fill the gap between the current pharmacological treatment aimed at maintaining sinus rhythm and the expectations from rhythm strategy.

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Papageorgiou, Nikolaos, Rui Providência, Debbie Falconer, Tanakal Wongwarawipat, Dimitris Tousoulis, Wei Yao Lim, Anthony W. Chow, Richard J. Schilling et Pier D. Lambiase. « Predictive Role of BNP/NT-proBNP in Non-Heart Failure Patients Undergoing Catheter Ablation for Atrial Fibrillation : An Updated Systematic Review ». Current Medicinal Chemistry 27, n^o 27 (5 août 2020) : 4469–78. http://dx.doi.org/10.2174/0929867326666191213095554.

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: Atrial Fibrillation (AF) is a growing public health issue, associated with significant morbidity and mortality. In addition to pharmacological therapy, catheter ablation is an effective strategy in restoring and maintaining sinus rhythm. However, ablation is not without risk, and AF recurs in a significant proportion of patients. Non-invasive, easily accessible markers or indices that could stratify patients depending on the likelihood of a successful outcome following ablation would allow us to select the most appropriate patients for the procedure, reducing the AF recurrence rate and exposure to potentially life-threatening risks. : There has been much attention paid to Brain Natriuretic Peptide (BNP) and N-Terminal prohormone of Brain Natriuretic Peptide (NT-proBNP) as possible predictive markers of successful ablation. Several studies have demonstrated an association between higher pre-ablation levels of these peptides, and a greater likelihood of AF recurrence. Therefore, there may be a role for measuring brain natriuretic peptides levels when selecting patients for catheter ablation.

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Femenía, Francisco, Georgia Sarquella-Brugada et Josep Brugada. « Single-catheter radiofrequency ablation of a permanent junctional reciprocating tachycardia in a premature neonate ». Cardiology in the Young 22, n^o 5 (8 mars 2012) : 606–9. http://dx.doi.org/10.1017/s1047951112000182.

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AbstractA 34-week premature neonate presented with drug-refractory permanent junctional incessant tachycardia and haemodynamic compromise. The patient underwent successful radiofrequency catheter ablation using a single-catheter approach. The child remains in sinus rhythm, without pharmacological treatment, 2 years after the procedure.

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Brignole, M., L. Gianfranchi, C. Menozzi, P. Alboni, G. Musso, M. G. Bongiorni, M. Gasparini et al. « Prospective, randomized study of atrioventricular ablation and mode-switching, dual chamber pacemaker implantation versus medical therapy in drug-resistant paroxysmal atrial fibrillation ». EP Europace 1, n^o 1 (1 janvier 1999) : 15–19. http://dx.doi.org/10.1053/eupc.1998.0007.

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Abstract We performed a prospective randomized 6-month evaluation of the clinical effects of atrioventricular junctional ablation together with placement of a DDDR mode-switching pacemaker vs pharmacological treatment in 43 patients with intolerable paroxysmal atrial fibrillation not controlled with antiarrhythmic drugs. Ablation and pacemaker treatment were highly effective and superior to drug therapy in controlling symptoms and improving quality of life. However, discontinuation of drug therapy exposed patients to further recurrences of paroxysmal atrial fibrillation and the risk of developing permanent atrial fibrillation.

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Iliodromitis, Konstantinos E., Marc Bonsels, Rolf Borchard et Anja Dorszewski. « Radiofrequency Ablation of Atrial Fibrillation in Patients with Ebstein's Anomaly : A Two-Case Report ». Cardiology 139, n^o 1 (29 novembre 2017) : 33–36. http://dx.doi.org/10.1159/000484039.

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Ebstein's anomaly (EA) is a rare congenital heart disease characterized by “atrialization” of the right ventricle, due to apical displacement of the tricuspid leaflets into the right ventricle. Patients with EA may develop all kinds of supraventricular arrhythmias requiring radiofrequency ablation. Atrial fibrillation (Afib) is a common arrhythmia in EA patients, and results in debilitating symptoms that often require surgical treatment. This is a follow-up report of 2 patients with EA undergoing radiofrequency ablation for Afib. The first patient underwent pulmonary vein isolation (PVI) and the ablation of a concomitant atrioventricular nodal reentrant tachycardia. The second patient was also treated with a PVI and a redo PVI 8 months later. Both patients remain in sinus rhythm 8 months on. Radiofrequency ablation is the therapy of choice for patients with pharmacological refractory Afib, but it is not common in patients with EA.

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Sweeney, Patrick, Michelle N. Bedenbaugh, Jose Maldonado, Pauline Pan, Katelyn Fowler, Savannah Y. Williams, Luis E. Gimenez et al. « The melanocortin-3 receptor is a pharmacological target for the regulation of anorexia ». Science Translational Medicine 13, n^o 590 (21 avril 2021) : eabd6434. http://dx.doi.org/10.1126/scitranslmed.abd6434.

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Ablation of hypothalamic AgRP (Agouti-related protein) neurons is known to lead to fatal anorexia, whereas their activation stimulates voracious feeding and suppresses other motivational states including fear and anxiety. Despite the critical role of AgRP neurons in bidirectionally controlling feeding, there are currently no therapeutics available specifically targeting this circuitry. The melanocortin-3 receptor (MC3R) is expressed in multiple brain regions and exhibits sexual dimorphism of expression in some of those regions in both mice and humans. MC3R deletion produced multiple forms of sexually dimorphic anorexia that resembled aspects of human anorexia nervosa. However, there was no sexual dimorphism in the expression of MC3R in AgRP neurons, 97% of which expressed MC3R. Chemogenetic manipulation of arcuate MC3R neurons and pharmacologic manipulation of MC3R each exerted potent bidirectional regulation over feeding behavior in male and female mice, whereas global ablation of MC3R-expressing cells produced fatal anorexia. Pharmacological effects of MC3R compounds on feeding were dependent on intact AgRP circuitry in the mice. Thus, the dominant effect of MC3R appears to be the regulation of the AgRP circuitry in both male and female mice, with sexually dimorphic sites playing specialized and subordinate roles in feeding behavior. Therefore, MC3R is a potential therapeutic target for disorders characterized by anorexia, as well as a potential target for weight loss therapeutics.

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Zou, Runmei, Shuo Wang et Cheng Wang. « The Diagnosis and Management of Vasovagal Syncope in Pediatric Patients ». Journal of Neurology and Epidemiology 7 (7 juillet 2022) : 1–8. http://dx.doi.org/10.12974/2309-6179.2022.07.01.

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Vasovagal syncope is the most common cause of syncope in pediatric patients. The present study is aim to provide a comprehensive literature review of the latest advances in the diagnosis and treatment of vasovagal syncope in children. Diagnosis of vasovagal syncope is based on clinical history. For patients with suspected VVS but lack of confident diagnosis after initial assessment, head-up tilt test is helpful. There are four options for treatment of vasovagal syncope: conservative therapy, pharmacologic therapy, pacemaker therapy, and catheter ablation of ganglionated plexi. Conservative therapy (health education, avoidance of triggers, salts and water intake, physical countermeasures and orthostatic training) is recommended for patients with occasional syncope. Pharmacological therapy should be considered for patients with recurrent syncope or for whom conservative therapy has failed. Patients with the predominantly cardioinhibitory response, associated with repeated injury, limited prodromes, and documented asystole may benefit from cardiac pacing. Catheter ablation of ganglionated plexi is a new strategy, its efficacy and safety in pediatric patients should be verified by randomized controlled trials.

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Irimie, Diana Andrada, Adela Viviana Sitar-Tăut, Bogdan Caloian, Florina Frîngu, Gabriel Cismaru, Radu Roşu, Mihai Puiu et al. « Particularities of Catheter Ablation in Women with Atrial Fibrillation and Associated Ischemic Heart Disease ». Journal of Clinical Medicine 11, n^o 19 (22 septembre 2022) : 5568. http://dx.doi.org/10.3390/jcm11195568.

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Background: Atrial fibrillation is more common in men, but in the presence of ischemic heart disease, this arrhythmia is more frequent in women. However, like in coronary heart disease, women with atrial fibrillation are suboptimally treated. Methods: To identify particularities of ablation, in women with atrial fibrillation and ischemic heart disease. Results: 29 women and 26 men, with documented ischemic heart disease and atrial fibrillation, who underwent catheter ablation, were admitted in the study. No significant differences were registered regarding the heart rate control treatment. Electrical cardioversion was significantly higher in men, while pharmacological cardioversion was predominantly recommended in women. The ablation was performed later in women, after 2.55 ± 1.84 years versus 1.80 ± 1.05 in men (p = 0.05). The time elapsed until the ablation was performed was statistically correlated with atypical symptomatology and with the number of antiarrhythmics used prior to the ablation. There were no significant differences for the relapse of atrial fibrillation at 3 months. Quality of life at 3 months after ablation was increased in both groups. Conclusion: Catheter ablation is performed much later in women, and the causes responsible for this delay would be more atypical symptoms and a greater number of antiarrhythmics tried before the ablation.

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Mesirca, Pietro, Isabelle Bidaud, François Briec, Stéphane Evain, Angelo G. Torrente, Khai Le Quang, Anne-Laure Leoni et al. « G protein-gated IKACh channels as therapeutic targets for treatment of sick sinus syndrome and heart block ». Proceedings of the National Academy of Sciences 113, n^o 7 (1 février 2016) : E932—E941. http://dx.doi.org/10.1073/pnas.1517181113.

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Dysfunction of pacemaker activity in the sinoatrial node (SAN) underlies “sick sinus” syndrome (SSS), a common clinical condition characterized by abnormally low heart rate (bradycardia). If untreated, SSS carries potentially life-threatening symptoms, such as syncope and end-stage organ hypoperfusion. The only currently available therapy for SSS consists of electronic pacemaker implantation. Mice lacking L-type Cav1.3 Ca2+ channels (Cav1.3−/−) recapitulate several symptoms of SSS in humans, including bradycardia and atrioventricular (AV) dysfunction (heart block). Here, we tested whether genetic ablation or pharmacological inhibition of the muscarinic-gated K+ channel (IKACh) could rescue SSS and heart block in Cav1.3−/− mice. We found that genetic inactivation of IKACh abolished SSS symptoms in Cav1.3−/− mice without reducing the relative degree of heart rate regulation. Rescuing of SAN and AV dysfunction could be obtained also by pharmacological inhibition of IKACh either in Cav1.3−/− mice or following selective inhibition of Cav1.3-mediated L-type Ca2+ (ICa,L) current in vivo. Ablation of IKACh prevented dysfunction of SAN pacemaker activity by allowing net inward current to flow during the diastolic depolarization phase under cholinergic activation. Our data suggest that patients affected by SSS and heart block may benefit from IKACh suppression achieved by gene therapy or selective pharmacological inhibition.

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Jasim, Awatif Saber, Saif Khalel Jasim et Ammar Ayesh Habeeb. « the Synthesis of Cinnamon Nanoparticles by Using Laser Ablation Technique ». Iraqi Journal of Physics (IJP) 19, n^o 49 (18 mai 2021) : 7–14. http://dx.doi.org/10.30723/ijp.v19i49.625.

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The natural polyphenolic compound that cinnamon contains is well known for its various biological activities, a broad variety of pharmacological and therapeutic properties. Diversified biomedical and pharmacological applications benefit from organic nanoparticles with controlled properties. Bioactive and non-toxic, cinnamon nanoparticles (CNPs) can be effective antibacterial agents. Driven by this idea, we prepared spherical CNPs using liquid (PLAL) pulse laser ablation technique and defined those NPs. Using Q-switched Nd : YAG With a wavelength of 1064 nm pulse laser of constant energy 500 mj , And different laser pulses ( 250 , 500 , 750 , 1000 ) pulse /sec a pure cinnamon target submerged in liquid ethanol (5 mL) was ablated. The results on the composition, morphology and optical properties of as-grown CNPs of differing laser fluence were determined. Samples were described through Fe-SEM , UV-Vis , FTIR , The synergy between ethanol as liquid growth media and fundamental laser wavelength has been due to certain distinctive characteristics of CNPs. It has been developed that the spherical CNPs achieved in the suspension of ethanol could be beneficial for antioxidant purposes.

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Kusa, Shigeki, Hiroshi Taniguchi, Kiyoshi Otomo, Kei Takayama, Yuki Komatsu, Takashi Uchiyama, Keiichi Hishikari et Yoshito Iesaka. « Impact of Preceded Pharmacological Cardioversion on Ablation Strategy of Persistent Atrial Fibrillation ». Journal of Arrhythmia 27, Supplement (2011) : OP42_3. http://dx.doi.org/10.4020/jhrs.27.op42_3.

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Lévy, Samuel. « Do we need pharmacological therapy for atrial fibrillation in the ablation era ? » Journal of Interventional Cardiac Electrophysiology 17, n^o 3 (6 mars 2007) : 189–94. http://dx.doi.org/10.1007/s10840-006-9075-8.

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Balla, Cristina, et Riccardo Cappato. « Atrial fibrillation ablation in heart failure ». European Heart Journal Supplements 22, Supplement_E (29 mars 2020) : E50—E53. http://dx.doi.org/10.1093/eurheartj/suaa059.

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Abstract Atrial fibrillation (AF) and heart failure (HF) commonly coexist in the same patient and either condition predisposes to the other. Several mechanisms promote the pathophysiological relationship between AF and HF, reducing quality of life, increasing the risk of stroke, and worsening HF progression. Although restoration and maintenance of sinus rhythm would be ideal for those patients, several trials comparing rhythm and rate control failed to show a benefit of rhythm control strategy, achieved with pharmacological therapy, in terms of hospitalization for HF or death. Catheter ablation is a well-established option for symptomatic AF patients, resistant to drug therapy, with normal cardiac function. Several recent studies have shown an improvement in clinical outcomes after AF ablation in HF patients highlighting the emerging role of the invasive approach in this subset of patients. However, several concerns regarding patients’ selection and standardization of the procedure still remain to be addressed.

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Miyazaki, S., T. Kuwahara, A. Kobori, Y. Takahashi, A. Takei, A. Sato, M. Isobe et A. Takahashi. « Pharmacological cardioversion preceding left atrial ablation : bepridil predicts the clinical outcome following ablation in patients with persistent atrial fibrillation ». Europace 11, n^o 12 (11 novembre 2009) : 1620–23. http://dx.doi.org/10.1093/europace/eup363.

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Rajbhandari, Sujeeb, Man Bahadur KC, D. Sharma, MP Shrestha et Ajaya Niak. « Electrophysiologic Study and Ablation in Nepal - Our Initial Experience ». Nepalese Heart Journal 3, n^o 3 (30 décembre 2004) : 44. http://dx.doi.org/10.3126/njh.v3i3.26118.

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Cardiac electrophysiology study (EPS) is one of the most advanced, challenging and a complex branch of invasive cardiology. It involves placement of large sized multipolar catheters in various chambers of the heart. They are used to map and also to ablate the culprit focus of arrhythmia generation. Supraventricular arrhythmias are a nuisance as the pharmacological treatment is only suppressive. When done by experts, the procedure can be curative. During the month of October 03, twelve cases were selected for EPS.

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Estrela, Karolyne A. R., Lisa Senninger, Josephine Arndt, Melanie Kabas, Ferdinand Schmid, Larissa Dillmann, Sophia Auer, Thomas Stepfer, Peter J. Flor et Nicole Uschold-Schmidt. « Blocking Metabotropic Glutamate Receptor Subtype 7 via the Venus Flytrap Domain Promotes a Chronic Stress-Resilient Phenotype in Mice ». Cells 11, n^o 11 (2 juin 2022) : 1817. http://dx.doi.org/10.3390/cells11111817.

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Chronic psychosocial stress participates prominently in the etiology of various psychiatric conditions and comorbid somatic pathologies; however, suitable pharmacotherapy of these disorders is still of high medical need. During the last few decades, research on mGlu receptors advanced remarkably and much attention was given to the mGlu7 subtype. Here, genetic mGlu7 ablation, short-term pharmacological mGlu7 blockade, as well as siRNA-mediated knockdown of mGlu7 were shown to result in an acute anti-stress, antidepressant- and anxiolytic-like phenotype in mice. Moreover, we recently revealed a prominent stress-protective effect of genetic mGlu7 ablation also with respect to chronic psychosocial stress. In addition, we are able to demonstrate in the present study that the chronic pharmacological blockade of mGlu7 interferes with various chronic stress-induced alterations. For this, we used the chronic subordinate colony housing (CSC), a mouse model of chronic male subordination, in combination with chronic treatment with the mGlu7-selective orthosteric-like antagonist XAP044 (7-hydroxy-3-(4-iodophenoxy)-4H-chromen-4-one). Interestingly, XAP044 dose-dependently ameliorates hypothalamic–pituitary–adrenal axis dysfunctions, thymus atrophy, as well as the CSC-induced increase in innate anxiety. Taken together, our findings provide further evidence for the role of mGlu7 in chronic psychosocial stress-induced alterations and suggests the pharmacological blockade of mGlu7 as a promising therapeutic approach for the treatment of chronic stress-related pathologies in men.

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Huang, Weiting, Felix YJ Keng et Chi Keong Ching. « Rate or Rhythm Control of Atrial Fibrillation – Pearls for the Internist ». Annals of the Academy of Medicine, Singapore 46, n^o 11 (15 novembre 2017) : 433–38. http://dx.doi.org/10.47102/annals-acadmedsg.v46n11p433.

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Atrial fibrillation is an epidemic in Asia that is increasingly prevalent. Apart from stroke risk stratification and management of anticoagulation, physicians managing this group of patients also need to determine an optimal strategy in terms of rate or rhythm control. With new techniques of catheter ablation to maintain patients in sinus rhythm, patients with atrial fibrillation now have more options for treatment, on top of pharmacological methods. This paper aims to review the current evidence for rate and rhythm control in both general patients and subgroups of interest commonly encountered in clinical practices such as obesity, heart failure and thyroid disease. Key words: Ablation, Anti-arrhythmic drugs, Stroke

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Alrumayh, Abdullah, et Muath Alobaida. « Catheter ablation superiority over the pharmacological treatments in atrial fibrillation : a dedicated review ». Annals of Medicine 53, n^o 1 (1 janvier 2021) : 551–57. http://dx.doi.org/10.1080/07853890.2021.1905873.

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Palamà, Zefferino, Martina Nesti, Antonio Gianluca Robles, Antonio Scarà, Silvio Romano, Elena Cavarretta, Maria Penco et al. « Tailoring the Ablative Strategy for Atrial Fibrillation : A State-of-the-Art Review ». Cardiology Research and Practice 2022 (28 février 2022) : 1–10. http://dx.doi.org/10.1155/2022/9295326.

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In spite of technological progress and the improving skills of operators, atrial fibrillation (AF) ablation results appear to date to be at a plateau. In any case, the superiority of ablation over pharmacological therapy in terms of effectiveness, reduction of hospitalizations, and improvement has been well demonstrated in recent randomized trials. Triggers, substrate, and modulating factors (elements of Coumel’s triangle) play different roles in paroxysmal and persistent AF, so induction and perpetuation mechanisms of arrhythmia may be different in each patient. Although effective ablative strategies are available for the treatment of paroxysmal AF triggers and persistent AF substrates, an adequate clinical evaluation of the patient is crucial in order to increase the chances of success. Recognizing triggers allows not only performing an effective ablation but also to avoid unnecessary lesions and at the same time reducing the risk of complications. AF beginning and triggers could be recorded by 12-lead ECG, continuous Holter monitoring, or implantable devices. In case of an unsuccessful noninvasive evaluation, nonpulmonary vein triggers should be investigated with an electrophysiological study. Persistent AF needs more effort to perform an accurate substrate characterization. Among the many methods proposed, recently the use of high-density mapping and multipolar catheters seems of particular benefit in order to clarify the arrhythmia mechanisms. Surgical and hybrid techniques allow to treat regions such as the posterior wall or Bachmann’s bundle, which is fundamental for an ablative strategy that goes beyond just pulmonary vein isolation. Too often, patients are referred to electrophysiology laboratories without adequate preprocedural screening and planning in order to submit them to a standard “ready-made” procedure. The accurate search for triggers in paroxysmal AF and the correct recognition of the link between a possible underlying heart disease and the substrate in persistent AF could allow us to tailor the interventional approach in order to overcome the current plateau, increasing ablative procedure success and minimizing complications.

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Marcuzzi, Annalisa, Erika Rimondi, Elisabetta Melloni, Floriana Zennaro, Aurelio Sonzogni, Sara Leo et Natalia Maximova. « Acute Neurological Involvement after Donor Lymphocyte Infusion for Post-Transplant Viral Infection : The Same Pattern of Novel Cancer Immunotherapy-Related CNS Toxicity ? » International Journal of Molecular Sciences 23, n^o 7 (24 mars 2022) : 3553. http://dx.doi.org/10.3390/ijms23073553.

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Early post-transplant is the critical phase for the success of hematopoietic stem cell transplantation (HSCT). New viral infections and the reactivations associated with complete ablation of the recipient’s T-cell immunity and inefficient reconstitution of the donor-derived system represent the main risks of HSCT. To date, the pharmacological treatments for post-HSCT viral infection-related complications have many limitations. Adoptive cell therapy (ACT) represents a new pharmacological strategy, allowing us to reconstitute the immune response to infectious agents in the post-HSC period. To demonstrate the potential advantage of this novel immunotherapy strategy, we report three cases of pediatric patients and the respective central nervous system complications after donor lymphocyte infusion.

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Zoubeidi, Amina, et Paramita M. Ghosh. « Celebrating the 80th anniversary of hormone ablation for prostate cancer ». Endocrine-Related Cancer 28, n^o 8 (1 août 2021) : T1—T10. http://dx.doi.org/10.1530/erc-21-0192.

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In this issue of Endocrine-Related Cancer, we are celebrating the 80th anniversary of hormone ablation as treatment for metastatic prostate cancer. Our understanding has evolved from the observation that androgen withdrawal, either surgical or pharmacological, resulted in prostatic atrophy in animal models, to its application in patients, to investigation of the mysterious way in which prostate cancer escapes androgen dependence. We are now in an era of novel AR pathway inhibitors, the combination of androgen ablation with chemotherapy, PARP inhibitors, immunotherapies, guided radiotherapy, and novel drug application based upon genetic testing of individual tumors. In this special issue, we bring together a collection of eight reviews that cover not only the history of 80 years of progress after the initial identification of androgen ablation as an effective treatment of prostate cancer, but subsequent improvements in the understanding of the biology of the disease, development of novel treatment paradigms, resistance to those treatments and disease progression following that resistance.

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Chandía-Cristi, América, Nicolás Stuardo, Cristian Trejos, Nancy Leal, Daniela Urrutia, Francisca C. Bronfman et Alejandra Álvarez Rojas. « c-Abl Tyrosine Kinase Is Required for BDNF-Induced Dendritic Branching and Growth ». International Journal of Molecular Sciences 24, n^o 3 (18 janvier 2023) : 1944. http://dx.doi.org/10.3390/ijms24031944.

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Brain-derived neurotrophic factor (BDNF) induces activation of the TrkB receptor and several downstream pathways (MAPK, PI3K, PLC-γ), leading to neuronal survival, growth, and plasticity. It has been well established that TrkB signaling regulation is required for neurite formation and dendritic arborization, but the specific mechanism is not fully understood. The non-receptor tyrosine kinase c-Abl is a possible candidate regulator of this process, as it has been implicated in tyrosine kinase receptors’ signaling and trafficking, as well as regulation of neuronal morphogenesis. To assess the role of c-Abl in BDNF-induced dendritic arborization, wild-type and c-Abl-KO neurons were stimulated with BDNF, and diverse strategies were employed to probe the function of c-Abl, including the use of pharmacological inhibitors, an allosteric c-Abl activator, and shRNA to downregulates c-Abl expression. Surprisingly, BDNF promoted c-Abl activation and interaction with TrkB receptors. Furthermore, pharmacological c-Abl inhibition and genetic ablation abolished BDNF-induced dendritic arborization and increased the availability of TrkB in the cell membrane. Interestingly, inhibition or genetic ablation of c-Abl had no effect on the classic TrkB downstream pathways. Together, our results suggest that BDNF/TrkB-dependent c-Abl activation is a novel and essential mechanism in TrkB signaling.

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Haegeli, Laurent M., et Firat Duru. « Atrial fibrillation in the aging heart : pharmacological therapy and catheter ablation in the elderly ». Future Cardiology 7, n^o 3 (mai 2011) : 415–23. http://dx.doi.org/10.2217/fca.11.22.

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Rosker, Christian, Nicolò Salvarani, Stephan Schmutz, Teddy Grand et Stephan Rohr. « Abolishing Myofibroblast Arrhythmogeneicity by Pharmacological Ablation of α-Smooth Muscle Actin Containing Stress Fibers ». Circulation Research 109, n^o 10 (28 octobre 2011) : 1120–31. http://dx.doi.org/10.1161/circresaha.111.244798.

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Takahashi, Atsushi. « Non-pharmacological therapy for atrial fibrillation : catheter ablation based on extensive pulmonary vein isolation. » Folia Pharmacologica Japonica 135, n^o 2 (2010) : 66–69. http://dx.doi.org/10.1254/fpj.135.66.

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Lee, Man K. S., Michael J. Kraakman, Dragana Dragoljevic, Nordin M. J. Hanssen, Michelle C. Flynn, Annas Al-Sharea, Gopalkrishna Sreejit et al. « Apoptotic Ablation of Platelets Reduces Atherosclerosis in Mice With Diabetes ». Arteriosclerosis, Thrombosis, and Vascular Biology 41, n^o 3 (mars 2021) : 1167–78. http://dx.doi.org/10.1161/atvbaha.120.315369.

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Objective: People with diabetes are at a significantly higher risk of cardiovascular disease, in part, due to accelerated atherosclerosis. Diabetic subjects have increased number of platelets that are activated, more reactive, and respond suboptimally to antiplatelet therapies. We hypothesized that reducing platelet numbers by inducing their premature apoptotic death would decrease atherosclerosis. Approach and Results: This was achieved by targeting the antiapoptotic protein Bcl-x L (B-cell lymphoma-extra large; which is essential for platelet viability) via distinct genetic and pharmacological approaches. In the former, we transplanted bone marrow from mice carrying the Tyr15 to Cys loss of function allele of Bcl-x (known as Bcl-x Plt20 ) or wild-type littermate controls into atherosclerotic-prone Ldlr +/− mice made diabetic with streptozotocin and fed a Western diet. Reduced Bcl-x L function in hematopoietic cells significantly decreased platelet numbers, exclusive of other hematologic changes. This led to a significant reduction in atherosclerotic lesion formation in Bcl-x Plt20 bone marrow transplanted Ldlr +/− mice. To assess the potential therapeutic relevance of reducing platelets in atherosclerosis, we next targeted Bcl-x L with a pharmacological strategy. This was achieved by low-dose administration of the BH3 (B-cell lymphoma-2 homology domain 3) mimetic, ABT-737 triweekly, in diabetic Apoe −/− mice for the final 6 weeks of a 12-week study. ABT-737 normalized platelet numbers along with platelet and leukocyte activation to that of nondiabetic controls, significantly reducing atherosclerosis while promoting a more stable plaque phenotype. Conclusions: These studies suggest that selectively reducing circulating platelets, by targeting Bcl-x L to promote platelet apoptosis, can reduce atherosclerosis and lower cardiovascular disease risk in diabetes. Graphic Abstract: A graphic abstract is available for this article.

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Gao, Zhanguo, Aiping Lu, Alexes C. Daquinag, Yongmei Yu, Matthieu Huard, Chieh Tseng, Xueqin Gao, Johnny Huard et Mikhail G. Kolonin. « Partial Ablation of Non-Myogenic Progenitor Cells as a Therapeutic Approach to Duchenne Muscular Dystrophy ». Biomolecules 11, n^o 10 (15 octobre 2021) : 1519. http://dx.doi.org/10.3390/biom11101519.

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Duchenne muscular dystrophy (DMD), caused by the loss of dystrophin, remains incurable. Reduction in muscle regeneration with DMD is associated with the accumulation of fibroadipogenic progenitors (FAPs) differentiating into myofibroblasts and leading to a buildup of the collagenous tissue aggravating DMD pathogenesis. Mesenchymal stromal cells (MSCs) expressing platelet-derived growth factor receptors (PDGFRs) are activated in muscle during DMD progression and give rise to FAPs promoting DMD progression. Here, we hypothesized that muscle dysfunction in DMD could be delayed via genetic or pharmacologic depletion of MSC-derived FAPs. In this paper, we test this hypothesis in dystrophin-deficient mdx mice. To reduce fibro/adipose infiltration and potentiate muscle progenitor cells (MPCs), we used a model for inducible genetic ablation of proliferating MSCs via a suicide transgene, viral thymidine kinase (TK), expressed under the Pdgfrb promoter. We also tested if MSCs from fat tissue, the adipose stromal cells (ASCs), contribute to FAPs and could be targeted in DMD. Pharmacological ablation was performed with a hunter-killer peptide D-CAN targeting ASCs. MSC depletion with these approaches resulted in increased endurance, measured based on treadmill running, as well as grip strength, without significantly affecting fibrosis. Although more research is needed, our results suggest that depletion of pathogenic MSCs mitigates muscle damage and delays the loss of muscle function in mouse models of DMD.

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Ma, Shuo, Chencheng Zhang, Ti-fei Yuan, Douglas Steele, Valerie Voon et Bomin Sun. « Neurosurgical treatment for addiction : lessons from an untold story in China and a path forward ». National Science Review 7, n^o 3 (17 décembre 2019) : 702–12. http://dx.doi.org/10.1093/nsr/nwz207.

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Abstract Addiction is a major public-health crisis associated with significant disability and mortality. Although various pharmacological and behavioral treatments are currently available, the clinical efficacy of these treatments is limited. Given this situation, there is a growing interest in finding an effective neurosurgical treatment for addiction. First, we discuss the use of ablative surgery in treating addiction. We focus on the rise and fall of nucleus accumbens ablation for addiction in China. Subsequently, we review recent studies that have explored the efficacy and safety of deep-brain-stimulation treatment for addiction. We conclude that neurosurgical procedures, particularly deep-brain stimulation, have a potentially valuable role in the management of otherwise intractable addictive disorders. Larger well-controlled clinical trials, however, are needed to assess clinical efficacy and safety. We end by discussing several key issues involved in this clinical field and identifying some areas of progress.

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Brynza, Mariia, et Natalia Lisova. « Two-year outcomes of pulmonary vein isolation and cava-tricuspid isthmus radiofrequency ablation vs pharmacological only antiarrhythmic therapy : a single center experience ». EUREKA : Health Sciences, n^o 1 (31 janvier 2022) : 10–16. http://dx.doi.org/10.21303/2504-5679.2022.002278.

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The benefit of radiofrequency ablation (RFA) in rhythm control in atrial fibrillation (AF) and flutter patients is uncertain, but risk of death, arrhythmia recurrence and other post ablation complications remains high. Existing data on the impact of pulmonary vein isolation and cava-tricuspid isthmus RFA on long-term prognosis of patients with AF and flutter and its advantage over pharmacological antiarrhythmic therapy (AAT) are insufficient and contradictory. The aim: we sought to evaluate two-year outcomes of pulmonary vein isolation and cava-tricuspid isthmus RFA vs pharmacological only AAT according to a single center experience. Material and methods: we enrolled 174 patients after pulmonary vein isolation RFA, cava-tricuspid isthmus RFA and their combination and 122 patient who did not undergo RFA and got pharmacological AAT only. Results: there was no significant difference in mortality between the RFA and AAT only groups (5.8 % and 9.0 % respectively) with the same structure of causes of death. The Caplan-Meyer curve analysis demonstrated better survivance (p=0.031) after RFA just during first year of observation. RFA effectiveness in arrhythmia relapse prevention was the highest for cava-tricuspid isthmus RFA procedure and worst – in group of combined pulmonary vein isolation and cava-tricuspid isthmus procedures. RFA showed an advantage over AAT in smaller quantities of non-fatal cardiovascular events (p<0.001) and cardiovascular hospitalizations (p=0.0026). Conclusions: RFA of pulmonary vein isolation and cava-tricuspid isthmus RFA decrease arrhythmia episodes frequency, risk of non-fatal cardiovascular events and cardiovascular hospitalizations. Timely combined PVI and CTI procedure is associated with worsening of all outcomes.

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Cascella, Marco, Maria Rosaria Muzio, Daniela Viscardi et Arturo Cuomo. « Features and Role of Minimally Invasive Palliative Procedures for Pain Management in Malignant Pelvic Diseases : A Review ». American Journal of Hospice and Palliative Medicine® 34, n^o 6 (2 mars 2016) : 524–31. http://dx.doi.org/10.1177/1049909116636374.

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Pain is a common and debilitating symptom in pelvic cancer diseases. Failure in controlling this pain through pharmacological approaches calls for employing multimodal management and invasive techniques. Various strategies are commonly used for this purpose, including palliative radiotherapy, epidural medications and intrathecal administration of analgesic and local anesthetic drugs with pumps, and neural or plexus blockade. This review focuses on the features of minimally invasive palliative procedures (MIPPs), such as radiofrequency ablation, laser-induced thermotherapy, cryoablation, irreversible electroporation, electrochemotherapy, microwave ablation, and cementoplasty as well as their role in palliation of cancer pelvic pain. Despite the evidence of effectiveness and safety of these interventions, there are still many barriers to accessing MIPPs, including the availability of trained staff, the lack of precise criteria of indication, and the high costs.

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D’Souza, Lucas J., Stephen H. Wright et Deepta Bhattacharya. « Genetic evidence that uptake of the fluorescent analog 2NBDG occurs independently of known glucose transporters ». PLOS ONE 17, n^o 8 (24 août 2022) : e0261801. http://dx.doi.org/10.1371/journal.pone.0261801.

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The fluorescent derivative of glucose, 2-Deoxy-2-[(7-nitro-2,1,3-benzoxadiazol-4-yl)-amino]-D-glucose (2NBDG), is a widely used surrogate reagent to visualize glucose uptake in live cells at single cell resolution. Using CRISPR-Cas9 gene editing in 5TGM1 myeloma cells, we demonstrate that ablation of the glucose transporter gene Slc2a1 abrogates radioactive glucose uptake but has no effect on the magnitude or kinetics of 2NBDG import. Extracellular 2NBDG, but not NBD-fructose was transported by primary plasma cells into the cytoplasm suggesting a specific mechanism that is unlinked from glucose import and that of chemically similar compounds. Neither excess glucose nor pharmacological inhibition of GLUT1 impacted 2NBDG uptake in myeloma cells or primary splenocytes. Genetic ablation of other expressed hexose transporters individually or in combination with one another also had no impact on 2NBDG uptake. Ablation of the genes in the Slc29 and Slc35 families of nucleoside and nucleoside sugar transporters also failed to impact 2NBDG import. Thus, cellular uptake of 2NBDG is not necessarily a faithful indicator of glucose transport and is promoted by an unknown mechanism.

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Voigt, Niels, et Dobromir Dobrev. « Ion Channel Remodelling in Atrial Fibrillation ». European Cardiology Review 7, n^o 2 (2011) : 97. http://dx.doi.org/10.15420/ecr.2011.7.2.97.

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Atrial fibrillation (AF) is the most common arrhythmia and is associated with substantial cardiovascular morbidity and mortality, with stroke being the most critical complication. Present drugs used for the therapy of AF (antiarrhythmics and anticoagulants) have major limitations, including incomplete efficacy, risks of life-threatening proarrhythmic events and bleeding complications. Non-pharmacological ablation procedures are efficient and apparently safe, but the very large size of the patient population allows ablation treatment of only a small number of patients. These limitations largely result from limited knowledge about the underlying mechanisms of AF and there is a hope that a better understanding of the molecular basis of AF may lead to the discovery of safer and more effective therapeutic targets. This article reviews the current knowledge about AF-related ion-channel remodelling and discusses how these alterations might affect the efficacy of antiarrhythmic drugs.

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Sekine, Mai, Satoshi Masutani, Tomohiko Imamura, Yoichi Iwamoto, Shota Muraji, Shigeki Yoshiba, Hirotaka Ishido et Naokata Sumitomo. « Improvement in Dyssynchrony with Pharmacological Ablation of Right-Sided Accessory Pathway-Induced Cardiomyopathy in Infants ». International Heart Journal 60, n^o 5 (27 septembre 2019) : 1201–5. http://dx.doi.org/10.1536/ihj.18-723.

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Sugiyama, Atsushi, Yoshioki Satoh, Yuko Ishida, Masahiko Yoneyama, Hiroshi Yoshida et Keitaro Hashimoto. « Pharmacological and Electrophysiological Characterization of Junctional Rhythm During Radiofrequency Catheter Ablation of the Atrioventricular Node ». Circulation Journal 66, n^o 7 (2002) : 696. http://dx.doi.org/10.1253/circj.66.696.

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Si, Man, Krystle Trosclair, Kathryn A. Hamilton et Edward Glasscock. « Genetic ablation or pharmacological inhibition of Kv1.1 potassium channel subunits impairs atrial repolarization in mice ». American Journal of Physiology-Cell Physiology 316, n^o 2 (1 février 2019) : C154—C161. http://dx.doi.org/10.1152/ajpcell.00335.2018.

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Voltage-gated Kv1.1 potassium channel α-subunits, encoded by the Kcna1 gene, have traditionally been regarded as neural-specific with no expression or function in the heart. However, recent data revealed that Kv1.1 subunits are expressed in atria where they may have an overlooked role in controlling repolarization and arrhythmia susceptibility independent of the nervous system. To explore this concept in more detail and to identify functional and molecular effects of Kv1.1 channel impairment in the heart, atrial cardiomyocyte patch-clamp electrophysiology and gene expression analyses were performed using Kcna1 knockout ( Kcna1−/−) mice. Specifically, we hypothesized that Kv1.1 subunits contribute to outward repolarizing K+ currents in mouse atria and that their absence prolongs cardiac action potentials. In voltage-clamp experiments, dendrotoxin-K (DTX-K), a Kv1.1-specific inhibitor, significantly reduced peak outward K+ currents in wild-type (WT) atrial cells but not Kcna1−/− cells, demonstrating an important contribution by Kv1.1-containing channels to mouse atrial repolarizing currents. In current-clamp recordings, Kcna1−/− atrial myocytes exhibited significant action potential prolongation which was exacerbated in right atria, effects that were partially recapitulated in WT cells by application of DTX-K. Quantitative RT-PCR measurements showed mRNA expression remodeling in Kcna1−/− atria for several ion channel genes that contribute to the atrial action potential including the Kcna5, Kcnh2, and Kcnj2 potassium channel genes and the Scn5a sodium channel gene. This study demonstrates a previously undescribed heart-intrinsic role for Kv1.1 subunits in mediating atrial repolarization, thereby adding a new member to the already diverse collection of known K+ channels in the heart.

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Maor, Elad, David Kain, Yaniv Zager et Jonathan Leor. « MYOCARDIAL ABLATION AND DECELLULARIZATION BY IRREVERSIBLE ELECTROPORATION : A NOVEL NON–THERMAL NON–PHARMACOLOGICAL BIOPHYSICAL APPROACH ». Journal of the American College of Cardiology 61, n^o 10 (mars 2013) : E1832. http://dx.doi.org/10.1016/s0735-1097(13)61832-x.

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Córdova Serrano, Carlos Joaquín, María Belén Saavedra Ortega, Diego Patricio Serrano Piedra et Aldo Mateo Torracchi Carrasco. « Resultado del tratamiento en pacientes sometidos a ablación percutánea por arritmias supraventriculares en la ciudad de Cuenca, periodo abril 2013 - julio 2018 ». Revista Médica del Hospital José Carrasco Arteaga 12, n^o 2 (31 juillet 2020) : 98–105. http://dx.doi.org/10.14410/2020.12.2.ao.14.

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BACKGROUND: Supraventricular tachycardia is commonly diagnosed in clinical practice, despite having a good prognosis, it can significantly affect the patient’s life quality. Pharmacological treatment does not result in the total absence of the arrhythmia, which is why ablation therapy has become the treatment of choice, due to its high success rate, and for offering a definitive solution. The aim of this study was to determine the frequency of each supraventricular tachycardia type, according to age and sex, the rate of success of percutaneous ablation and its related factors, and the frequency of complications due to the procedure. METHODS: A cross-sectional, descriptive, correlational study was conducted, including 156 patients diagnosed with supraventricular tachycardia and ablated, from five hospitals where the procedure was performed, based on their clinical records. RESULTS: From the 156 patients in this study, 51.9% were women and 48.1% men, the age ranged between 10 and 80 years. The most commonly reported arrhythmias were nodal reentrant tachycardia, atrioventricular reentrant tachycardia and atrial flutter, being the atrioventricular reentrant tachycardia the most frequent of all. The global success rate was 93.5%, no complications were reported, and none of the studied factors had significant statistical association with the success rate. CONCLUSION: Ablation treatment had a high success rate, with cero complications in this study, demonstrating the efficacy and safety of the procedure.

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Roy, Kaushambi, Sandeep Kumar et Stewart A. Bloomfield. « Gap junctional coupling between retinal amacrine and ganglion cells underlies coherent activity integral to global object perception ». Proceedings of the National Academy of Sciences 114, n^o 48 (13 novembre 2017) : E10484—E10493. http://dx.doi.org/10.1073/pnas.1708261114.

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Coherent spike activity occurs between widely separated retinal ganglion cells (RGCs) in response to a large, contiguous object, but not to disjointed objects. Since the large spatial separation between the RGCs precludes common excitatory inputs from bipolar cells, the mechanism underlying this long-range coherence remains unclear. Here, we show that electrical coupling between RGCs and polyaxonal amacrine cells in mouse retina forms the synaptic mechanism responsible for long-range coherent activity in the retina. Pharmacological blockade of gap junctions or genetic ablation of connexin 36 (Cx36) subunits eliminates the long-range correlated spiking between RGCs. Moreover, we find that blockade of gap junctions or ablation of Cx36 significantly reduces the ability of mice to discriminate large, global objects from small, disjointed stimuli. Our results indicate that synchronous activity of RGCs, derived from electrical coupling with amacrine cells, encodes information critical to global object perception.

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Wagenaar-Miller, Rebecca A., Lars H. Engelholm, Julie Gavard, Susan S. Yamada, J. Silvio Gutkind, Niels Behrendt, Thomas H. Bugge et Kenn Holmbeck. « Complementary Roles of Intracellular and Pericellular Collagen Degradation Pathways In Vivo ». Molecular and Cellular Biology 27, n^o 18 (9 juillet 2007) : 6309–22. http://dx.doi.org/10.1128/mcb.00291-07.

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ABSTRACT Collagen degradation is essential for cell migration, proliferation, and differentiation. Two key turnover pathways have been described for collagen: intracellular cathepsin-mediated degradation and pericellular collagenase-mediated degradation. However, the functional relationship between these two pathways is unclear and even controversial. Here we show that intracellular and pericellular collagen turnover pathways have complementary roles in vivo. Individual deficits in intracellular collagen degradation (urokinase plasminogen activator receptor-associated protein/Endo180 ablation) or pericellular collagen degradation (membrane type 1-matrix metalloproteinase ablation) were compatible with development and survival. Their combined deficits, however, synergized to cause postnatal death by severely impairing bone formation. Interestingly, this was mechanistically linked to the proliferative failure and poor survival of cartilage- and bone-forming cells within their collagen-rich microenvironment. These findings have important implications for the use of pharmacological inhibitors of collagenase activity to prevent connective tissue destruction in a variety of diseases.

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Newman, Jan B. « Heart Disease : From Psychosocial to Pathophysiological to Treatment with Biofeedback—An Overview ». Biofeedback 41, n^o 1 (1 mars 2013) : 39–42. http://dx.doi.org/10.5298/1081-5937-41.1.03.

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Emotions have been connected to the heart throughout the ages, yet they have been largely discounted as playing an important role in heart disease. There is mounting evidence that anxiety, anger, depression, and stress play significant contributing roles in cardiac diseases. These emotional states, coronary artery disease, and heart failure have physiology consistent with the ongoing stress response characterized by parasympathetic withdrawal and sympathetic activation. Pharmacological therapies, vagal stimulation, and sympathetic ablation have shown efficacy in these diseases. Similar results can be obtained by biofeedback therapies.

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Li, Guang, Jianke Gong, Jie Liu, Jinzhi Liu, Huahua Li, Ao-Lin Hsu, Jianfeng Liu et X. Z. Shawn Xu. « Genetic and pharmacological interventions in the aging motor nervous system slow motor aging and extend life span inC. elegans ». Science Advances 5, n^o 1 (janvier 2019) : eaau5041. http://dx.doi.org/10.1126/sciadv.aau5041.

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As animals and humans age, the motor system undergoes a progressive functional decline, leading to frailty. Age-dependent functional deteriorations at neuromuscular junctions (NMJs) contribute to this motor aging. However, it is unclear whether one can intervene in this process to slow motor aging. TheCaenorhabditis elegansBK channel SLO-1 dampens synaptic transmission at NMJs by repressing synaptic release from motor neurons. Here, we show that genetic ablation of SLO-1 not only reduces the rate of age-dependent motor activity decline to slow motor aging but also surprisingly extends life span. SLO-1 acts in motor neurons to mediate both functions. Genetic knockdown or pharmacological inhibition of SLO-1 in aged, but not young, worms can slow motor aging and prolong longevity. Our results demonstrate that genetic and pharmacological interventions in the aging motor nervous system can promote both health span and life span.

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