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Characterization of return cycle responses predictive of successful pacing-mediated termination of ventricular tachycardia buy 100mg nizagara with amex erectile dysfunction pill brands. Resetting of ventricular tachycardia with electrocardiographic fusion: incidence and significance purchase nizagara 100 mg without a prescription erectile dysfunction 50. Resetting and entrainment of reentrant ventricular tachycardia associated with myocardial infarction purchase nizagara 25mg online erectile dysfunction doctors in tulsa. The “leading circle” concept: a new model of circus movement in cardiac tissue without the involvement of an anatomical obstacle order 25 mg nizagara amex erectile dysfunction clinics. Demonstration of the presence of slow conduction during sustained ventricular tachycardia in man: use of transient entrainment of the tachycardia. Region of slow conduction in sustained ventricular tachycardia: direct endocardial recordings and functional characterization in humans. Entrainment of idiopathic ventricular tachycardia of left ventricular origin with evidence for reentry with an area of slow conduction and effect of verapamil. Characteristics of slow conduction zone demonstrated during entrainment of idiopathic ventricular tachycardia of left ventricular origin. Changes in the topology of gap junctions as an adaptive structural response of the myocardium. Disturbed connexin43 gap junction distribution correlates with the location of reentrant circuits in the epicardial border zone of healing canine infarcts that cause ventricular tachycardia. Optimizing implantable cardioverter-defibrillator treatment of rapid ventricular tachycardia: antitachycardia pacing therapy during charging. Differences in effects of electrical therapy type for ventricular arrhythmias on mortality in implantable cardioverter-defibrillator patients. Evidence of multiuse reentry with spontaneous and induced block in portions of reentrant path complex. Termination of sustained ventricular tachycardia by ultrarapid subthreshold stimulation in humans. Termination of ventricular tachycardia with ventricular stimulation: salutary effect of increased current strength. Effect of procainamide, propranolol and verapamil on mechanism of tachycardia in patients with chronic recurrent ventricular tachycardia. Comparison of individual and combined effects of procainamide and amiodarone in patients with sustained ventricular tachyarrhythmias. Electrode-catheter arrhythmia induction in the selection and assessment of antiarrhythmic drug therapy for recurrent ventricular tachycardia. Electrophysiologic approach to therapy of recurrent sustained ventricular tachycardia. Intracardiac electrophysiologic studies as a method for the optimization of drug therapy in chronic ventricular arrhythmia. Serial electrophysiologic- pharmacologic testing for control of recurrent tachyarrhythmias. Procainamide-induced slowing of ventricular tachycardia with insights from analysis of resetting response patterns. Electropharmacology of nonsustained ventricular tachycardia: effects of class I antiarrhythmic agents, verapamil and propranolol. Role of catheter mapping in the preoperative evaluation of ventricular tachycardia. Activation mapping in patients with coronary artery disease with multiple ventricular tachycardia configurations: occurrence and therapeutic implications of widely separate apparent sites of origin. Epicardial and endocardial activation during sustained ventricular tachycardia in man. Comparison of endocardial catheter mapping with intraoperative mapping of ventricular tachycardia. Endocardial mapping by simultaneous recording of endocardial electrograms during cardiac surgery for ventricular aneurysm. Activation sequence of ventricular tachycardia: endocardial and epicardial mapping studies in the human ventricle. Endocardial mapping of ventricular tachycardia in the intact human ventricle: evidence for reentrant mechanisms. Resetting of ventricular tachycardia: implications for localizing the area of slow conduction. Identification and catheter ablation of a zone of slow conduction in the reentrant circuit of ventricular tachycardia in humans. Electrogram patterns predicting successful catheter ablation of ventricular tachycardia. Identification of reentry circuit sites during catheter mapping and radiofrequency ablation of ventricular tachycardia late after myocardial infarction. Exploring postinfarction reentrant ventricular tachycardia with entrainment mapping. Nonsurgical transthoracic epicardial catheter ablation to treat recurrent ventricular tachycardia occurring late after myocardial infarction. Epicardial approach to the ablation of ventricular tachycardia in coronary artery disease: an alternative or ancillary approach. Reconstruction of endocardial potentials and activation sequences from intracavitary probe measurements. Simultaneous endocardial mapping in the human left ventricle using a noncontact catheter: comparison of contact and reconstructed electrograms during sinus rhythm. Characteristics of wavefront propagation in reentrant circuits causing human ventricular tachycardia. Fractionated endocardial electrograms are associated with slow conduction in humans: evidence from pace-mapping. The origin of premature ventricular complexes–role and limitations of the 12-lead electrocardiogram. Electrocardiographic localization of the site of origin of ventricular tachycardia in patients with prior myocardial infarction. Elimination of local abnormal ventricular activities: a new end point for substrate modification in patients with scar-related ventricular tachycardia. The substrate and ablation of ventricular tachycardia in patients with nonischemic cardiomyopathy. Catheter ablation of ventricular epicardial tissue: a comparison of standard and cooled-tip radiofrequency energy. Reversal of reentry and acceleration due to double-wave reentry: two mechanisms for failure to terminate tachycardias by rapid pacing. Clinical value of the postpacing interval for mapping of ventricular tachycardia in patients with prior myocardial infarction. Endo-epicardial homogenization of the scar versus limited substrate ablation for the treatment of electrical storms in patients with ischemic cardiomyopathy. Localizing the critical isthmus of postinfarct ventricular tachycardia: the value of pace-mapping during sinus rhythm. Electrophysiologic testing in the evaluation of patients with syncope of undetermined origin.

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The subjective outcome (“perfectly happy/pleased nizagara 100mg on-line impotence stress,” question 33 in the Bristol Female Urinary Tract Symptoms questionnaire) showed 55% cured in both the laparoscopic and the open group cheap nizagara 50 mg visa erectile dysfunction medication for diabetes. These results demonstrated that proven 50mg nizagara erectile dysfunction only with partner, in the hands of experienced laparoscopic surgeons generic nizagara 50 mg with amex impotence trials france, laparoscopic surgery does not produce an inferior cure rate to open colposuspension. The long-term efficacy of both laparoscopic and open colposuspension has been reported. As well as objective and subjective cure rates, authors have evaluated differences in operative time, length of hospital stay, and return to normal activities, between the two operative routes. The latter group did, however, report a significantly quicker return to normal activities in the laparoscopic arm of patients. It is noteworthy, however, that length of stay in 1478 hospital and time of return to work are also strongly influenced by local and cultural issues as well as surgical morbidity. They concluded that the former is associated with a similar subjective and objective cure (continence) rate compared to the open operation. It is also associated with a lower operative blood loss, earlier postoperative recovery, and an earlier return to work. There have been Cochrane reviews evaluating the colposuspension procedure [76,90]. In the most recent review published in 2012, 12 trials were included [49,78,79,81,82,86–88,91–94]. In the analysis comparing open with laparoscopic colposuspension, a total of 1260 women were studied. As is often the case, pooling data from the studies poses problems as most of the trials employ different criteria to define objective and subjective levels of success. Data were analyzed from all of the studies apart from one [78] (Burton) that included visual analogue scores as outcome data. The authors concluded that patient-reported incontinence rates at short-, medium-, and long-term follow-up showed no significant differences between open and laparoscopic retropubic colposuspension [76]. There were no significant differences in the risk for developing adverse events, in terms of perioperative complications, de novo urge symptoms or urge incontinence, detrusor overactivity, voiding difficulties, or new or recurrent prolapse. The authors did highlight four trials [86,88,93,94] that provided limited evidence of a greater tendency for laparoscopic colposuspension to have a higher rate of bladder perforation (0. Ultimately, the authors concluded that laparoscopic colposuspension should allow speedier recovery, and available evidence shows comparable effectiveness with open surgery. Cost Differences in costs are difficult to assess as there is a great variation in each country as to how long patients tend to stay in hospital following surgery and there are differing costs of operating time. The laparoscopic approach is generally reported to require longer operating time than the open colposuspension or midurethral sling procedures. The other cited factor against the laparoscopic approach is the increased cost of disposables associated with minimal access procedures. With greater adoption of laparoscopic surgery, there has been a continued drive for industry to produce better and more cost-effective equipment, and there is a growing competitive market for this, which ultimately may further drive down costs with no compromise on quality. It is also important to mention that the cost of sterilization of reusable instruments is rarely if ever allowed for during cost comparisons of techniques. This is a measure reflecting both patient’s health-related quality of life and mortality into a single index. Interestingly, in this study, both groups had a suprapubic catheter inserted at the time of surgery, and both groups were subjected to a particular postoperative trial of void regimen. This is likely to have influenced the length of inpatient stay and may have inadvertently minimized the actual differences between the two study arms in terms of length of hospital stay. The total theater costs for the laparoscopic group were, as expected, markedly higher than the open surgery group (£944 versus £464), mainly due to the longer theater time used and the extra equipment required for the laparoscopic surgery. After 24-month analysis, the authors concluded “the laparoscopic approach might be a cost-effective alternative in the medium term, provided that there are no major cost implications from treatment failure compared with the open group. They found that the laparoscopic approach was more expensive than the open approach ($4960 versus $4079). This reflected the high hourly operative room charges in North America as the laparoscopic group took on average 44 minutes longer operating time. Other studies have similarly confirmed the greater expense of the laparoscopic route compared to midurethral surgery [99]. Laparoscopic Colposuspension versus Tension-Free Vaginal Tape Procedures With the advent of midurethral tape procedures, it is pertinent to evaluate the performance of laparoscopic colposuspension compared with these even more minimally invasive procedures. Of the seven studies [97,101–106], three were published as abstracts and one used Prolene mesh and tacks. One patient in the laparoscopic group required a laparotomy to remove the tacks inadvertently placed in the bladder, as they were too difficult to remove laparoscopically. The authors also concluded “if cases that were lost to follow-up were regarded as failures, the intention-to-treat analysis found no difference between the groups. The use of sutures, irrespective of surgical approach, is seen to be better than the use of mesh [49]. When urodynamics was used to objectively assess clinical outcome, again no difference was seen between the two operations. Reported differences in de novo urgency were conflicting in the studies, and the numbers of women with voiding dysfunction following different surgery were too small to satisfactorily analyze. There was a shorter hospital stay by a mean of 1 day and a quicker return to normal activities. Over a median follow-up time of 65 months, no differences were seen in patient- reported urinary incontinence or bothersome stress urinary incontinence symptoms. The favorable outcomes seen with midurethral slings are an encouraging development for the treatment of urinary stress incontinence. Notwithstanding this, the merits of a colposuspension remain, and judicious use in appropriate patients ensures that a range of treatment choices is available. The use of mesh, tacks, or staples and only one suture appears to reduce the success rate. The laparoscopic approach is associated with a quicker return to normal activity than the open procedure. Perhaps the recent controversies associated with the placement of vaginal mesh will stimulate the rebirth of the colposuspension in its modern-day form, and a growing number of pelvic floor surgeons will be able to include it in their repertoire of anti-incontinence procedures. Each of the many available techniques offers its own set of advantages and disadvantages, and one single procedure is unlikely to offer a universal panacea. Any successful anti-incontinence procedure should take into account patient symptoms, medical comorbidities, and the presence of other pelvic floor problems. The ability to choose from a range of surgical techniques will inevitably optimize treatment for the individual woman. The laparoscopic approach requires the surgeon to be competent in minimal access surgery skills as well as urogynecology. We believe that efforts should now be directed toward improvements in training and theater environment, both of which can act as either facilitators or barriers to surgical uptake.

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Successful clinical laser ablation of ventricular tachycardia: a promising new therapeutic method nizagara 25mg with amex erectile dysfunction age 35. Termination of ventricular tachycardia with epicardial laser photocoagulation: a clinical comparison with patients undergoing successful endocardial photocoagulation alone purchase 100mg nizagara overnight delivery erectile dysfunction pills philippines. Modification of atrioventricular node transmission properties by intraoperative neodymium-yag laser photocoagulation in dogs generic nizagara 100 mg with visa erectile dysfunction doctors in fresno ca. Microtransection of the his bundle with laser radiation through a pervenous catheter: correlation of histologic and electrophysiologic data nizagara 50mg on line erectile dysfunction caused by hemorrhoids. Transcatheter ablation: comparison between laser photoablation and electrode shock ablation in the dog. Feasibility of circumferential pulmonary vein isolation using a novel endoscopic ablation system. Pulmonary vein isolation using a visually guided laser balloon catheter: the first 200- patient multicenter clinical experience. First human experience with pulmonary vein isolation using a through-the-balloon circumferential ultrasound ablation system for recurrent atrial fibrillation. Fatal end of a safety algorithm for pulmonary vein isolation with use of high-intensity focused ultrasound. Surgical therapy for supraventricular tachycardia, a potentially curable disorder. Left atrial isolation: new technique for the treatment of supraventricular arrhythmias. Sinus node-atrioventricular node isolation: long-term results with the “corridor” operation for atrial fibrillation. Electrosurgical treatment of atrial fibrillation with a new intraoperative radiofrequency ablation catheter. Endocardial and epicardial radiofrequency ablation in the treatment of atrial fibrillation with a new intra-operative device. Elective prolongation of atrioventricular conduction by multiple discrete cryolesions: a new technique for the treatment of paroxysmal supraventricular tachycardia. Alteration of antegrade atrioventricular conduction by cryoablation of peri- atrioventricular nodal tissue. Implications for the surgical treatment of atrioventricular nodal reentry tachycardia. Cryosurgical modification of atrioventricular conduction for treatment of atrioventricular node reentrant tachycardia. Catheter-induced ablation of the atrioventricular junction to control refractory supraventricular arrhythmias. Catheter technique for closed-chest ablation of the atrioventricular conduction system. Direct endocardial recording from an accessory atrioventricular pathway: localization of the site of block, effect of antiarrhythmic drugs, and attempt at nonsurgical ablation. Transvenous catheter ablation of the accessory atrioventricular pathway in the permanent form of junctional reciprocating tachycardia. Long-term results of catheter ablation of a posteroseptal accessory atrioventricular connection in 48 patients. Transcatheter ablative techniques for treatment of the permanent form of junctional reciprocating tachycardia in young patients. Electrogram patterns predictive of successful catheter ablation of accessory pathways. Catheter ablation of accessory atrioventricular pathways (Wolff-Parkinson-White syndrome) by radiofrequency current. Closed-chest ablation of retrograde conduction in patients with atrioventricular nodal reentrant tachycardia. Diagnosis and cure of the Wolff-Parkinson-White syndrome or paroxysmal supraventricular tachycardias during a single electrophysiologic test. Fulguration for av nodal tachycardia: results in 42 patients with a mean follow- up of 23 months. Catheter modification of the atrioventricular junction with radiofrequency energy for control of atrioventricular nodal reentry tachycardia. Right coronary epicardial mapping improves accessory pathway catheter ablation success [abstract]. High resolution mapping of ventriculo-atrial conduction over the accessory pathway in patients with the Wolff-Parkinson-White syndrome. New catheter technique for recording left free-wall accessory atrioventricular pathway activation. Assessment of pacing maneuvers used to validate anterograde accessory pathway potentials. Localization of left free-wall and posteroseptal accessory atrioventricular pathways by direct recording of accessory pathway activation. Effects of the discrete pattern of electrical coupling on propagation through an electrical syncytium. The functional role of structural complexities in the propagation of depolarization in the atrium of the dog. Cardiac conduction disturbances due to discontinuities of effective axial resistivity. Evidence for recurrent discontinuities of intracellular resistance that affect the membrane currents. Catheter ablation of accessory pathways, atrioventricular nodal reentrant tachycardia, and the atrioventricular junction: final results of a prospective, multicenter clinical trial. Role of radiofrequency ablation in the management of supraventricular arrhythmias: experience in 760 consecutive patients. Cost-effectiveness of radiofrequency ablation compared with other strategies in Wolff-Parkinson-White syndrome. Risk of malignant arrhythmias in initially symptomatic patients with Wolff- Parkinson-White syndrome: results of a prospective long-term electrophysiological follow-up study. Wolff-Parkinson-White syndrome in the era of catheter ablation: insights from a registry study of 2169 patients. Radiofrequency ablation of left-sided accessory pathways: transaortic versus transseptal approach. Radiofrequency endocardial catheter ablation of accessory atrioventricular pathway atrial insertion sites. Atrial unipolar waveform analysis during retrograde conduction over left-sided accessory atrioventricular pathways. Reversing the direction of paced ventricular and atrial wavefronts reveals an oblique course in accessory av pathways and improves localization for catheter ablation.

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