Articlecomplications. In addition, the rate of prolonged hospitalization was lower in the USguided puncture group (5.04% vs. 1.01%, p=0.032). ConclusionThe use of US for femoral vein puncture in patients undergoing PVI decreased the rate of both major and minor vascular complications. This quasi-randomized comparison strongly supports adapting routine use of US for AF ablation procedures.

Introduction: Both isoproterenol (Iso) and adenosine (Ado) are used to induce atrial fibrillation (AF) in the electrophysiology lab. However, the utility of Ado has not been systematically established.Objective: The purpose of this study was to compare Ado to Iso for the induction of paroxysmal AF.Methods: Forty patients (16 women; mean age, 60 ± 12 years) with paroxysmal AF, presenting for ablation were prospectively included of whom 36 (90%) received Ado (18-36 mg) and/or Iso (3-20 µg/min incremental dose) in a randomized order (26 [72%] received both drugs).Results: AF was induced with Iso in 15 of 32 (47%) and with Ado in 12 of 30 (40%) patients (P = 0.9). Iso-triggered AF started from the left pulmonary veins (PVs) in 11 of 15 (73%), from the right PVs in 3 of 15 (20%), and from the coronary sinus (CS) in 1 of 15 (7%) cases. Ado-induced AF episodes originated from the left PVs in 6 of 12 (50%), from the right atrium (RA) in 4 of 12 (33%), and from the CS in 2 of 12 (17%) cases. Altogether, Iso-induced AF was more likely initiated from the PVs (93%) compared with Ado (50%) (P = 0.02). Ado-induced non-PV triggers were not predictive of arrhythmia recurrence after PV isolation.Conclusion: Ado much more frequently induces non-PV triggers, especially from the RA. The clinical significance of these foci, however, is questionable. K E Y W O R D S adenosine, atrial fibrillation, isoproterenol, pulmonary vein, triggers 1 | INTRODUCTION Elimination of initiating triggers has become the cornerstone of atrial fibrillation (AF) treatment. Most of these triggers reside in the pulmonary veins (PVs) 1 ; however, non-PV triggers are an important source of recurrence after PV isolation (PVI). Triggers can be identified during the electrophysiology study if spontaneously occurring or can be induced by a drug challenge. Owing to the spurious nature of spontaneous triggers and the laboriousness of AF provocation, empirical isolation of all PVs has become the standard in AF ablation, despite the fact that selective isolation of only the triggering PV can achieve similar success in selected patients. 2 Even if total PV isolation is pursued as a first step, identification of non-PV triggers gains importance when AF occurs despite isolated PVs. 3,4The role of high dose isoproterenol (Iso) infusion to elicit AF triggers is well established. 5,6 Besides Iso, adenosine (Ado) or adenosine triphosphate (ATP) is increasingly used for the induction of AF, despite the lack of systematic studies on the sensitivity and

The authors have verified that retina dysfunction in patients suffering from chronic pancreatitis could be demonstrated by the help of electroretinography and eliminated or significantly corrected by administration of pancreas enzyme preparations. The retinograph may be applied successfully in the diagnosis of chronic pancreatitis and also in evaluation of the efficacy of the substitution treatment. The insufficiency of zinc absorption may play a definite role in the development of these functional disturbances. It has also been established that lower zinc values parallel with the decrease of the stool fat contents in patients suffering from chronic pancreatitis and can be significantly improved by enzyme preparations.

No abstract

No abstract