Phonetic transcriptions of babbling samples from 11 normally hearing subjects, age 4-18 months, were compared with samples from 11 hearing-impaired subjects, age 4-28 months. Longitudinal data were available for all hearing babies and for 8 of the 11 hearing-impaired subjects. The analysis focused on two measures: (a) size of consonantal repertoire over time and (b) proportional occurrence of multisyllabic consonant-vowel utterances. On average, the normally hearing subjects evidenced an increase in size of their consonantal repertoires with age; in contrast, the hearing-impaired subjects in the same age range had smaller repertoires that decreased over time. Comparison of multisyllabic utterances revealed a general tendency for the hearing-impaired subjects to produce fewer multisyllabic utterances containing true consonants and for some of the hearing-impaired children to produce a high proportion of vocalizations with glides or glottal stops. These findings suggest both qualitative and quantitative differences in the babbling of the two groups.

No abstract

Background-High-intensity focused ultrasound (HIFU) can achieve pulmonary vein isolation (PVI), but there are safety concerns after severe complications. Therefore, we evaluated an esophageal temperature (ET)-guided safety algorithm to apply HIFU safely. Methods and Results-After standard left atrial access, HIFU was repeatedly applied until PVI was complete. A safety algorithm was used: Յ3 complete ablations per pulmonary vein (PV), early abortion when no effect after 50% of programmed time or when ET was Ն40.0°C, use of power modulation (PM) at ET 39.0°C: to reduce ablation temperature in surrounding tissue, acoustic power is switched on/off at 1 Hz; in all first ablations, use of PM after 50% of programmed time. Touch-up radiofrequency ablation was used when PVI failed. Periprocedural ET monitoring and endoscopy 2 days after ablation were performed. Twenty-eight patients (18 males; mean age at enrollment, 63 years), with paroxysmal atrial fibrillation (AF; nϭ19) and persistent AF (nϭ9) were included. In 84 of 109 PV (9 of 25 patients), PVI was achieved using HIFU only. In 9 of 109 PV, HIFU was aborted because of high ET. Mean ET at the end of the ablations with and without use of PM were 38.1Ϯ2.0°C and 37.4Ϯ1.0°C (Pϭ0.0002). During endoscopy in 2 of 26 patients, a small thermal lesion was found. Other complications included 2 persistent phrenic nerve palsies, 1 ischemic stroke, 1 pericardial effusion 48 days after ablation, 1 unexplained death 49 days after ablation, and 1 lethal atrial-to-esophageal fistula 31 days after ablation. Conclusions-The safety algorithm failed to prevent lethal complications. Currently HIFU does not meet the safety standards required for treatment of atrial fibrillation. (Circ Arrhythm Electrophysiol. 2010;3:260-265.)

CARTO is useful for characterizing the anatomical and electrophysiological substrates, and for identifying the optimal ablation sites for VT associated with ARVD.