The purpose of this scientific work was to evaluate safety and efficacy of treatment of atrial fibrillation using monopolar radiofrequency ablation electrodes in patients who undergo mitral valve surgical correction using incisions of atrial septum (trans-septal and superior septal approaches). More than 80% of the patients are free of atrial fibrillation one year after the operation and 76% of these patients do not use anti-arrhythmic drugs. During the final visit of follow-up it was recorded that 71.5% of the patients remained free of atrial fibrillation and flutter. The maze procedure increases duration of cardiopulmonary by-pas for 16 ± 3 min, only. The baseline and surgical correction data in groups of patients of trans-septal and superior septal approaches did not differ. The method of mitral valve correction (implantation of mitral valve prosthesis or plasty of the valve) had no statistically significant influence on the results of atrial fibrillation treatment. The factors influencing the efficacy of the treatment include higher class of heart failure and larger longitudinal measurement of the left atrium found on echoscopy using M-mode. Combined therapy of secondary atrial tachycardia and atypical atrial flutter (by means of anti-arrhythmic drugs, trans-oesophageal stimulation and per-catheter ablation) enables to improve the results of maze procedure. The superior septal approach should be used in complicated operations as using this incision it is more convenient... [to full text] / Šio mokslinio darbo tikslas buvo įvertinti efektyvumą bei saugumą gydant prieširdžių virpėjimą, naudojant elektrofiziologinius RD abliacijos unipolinius elektrodinius kateterius pacientams, kuriems mitralinio vožtuvo ydą koreguojančios operacijos atliekamos per prieširdžių pertvaros(tarprieširdinės ir viršutinio pertvaros) pjūvius. Atlikus šią operaciją – po 1 metų >80% pacientų neturi prieširdžių virpėjimo/plazdėjimo, iš jų 76% nevartoja antiaritminių vaistų. Galutinio sekimo metu fiksuota, kad išliko 71,5% pacientų be prieširdžių virpėjimo ir plazdėjimo. Labirinto procedūra prailgina tik 16 ± 3 min dirbtinės kraujotakos laiką. Išeities ir operacinių parametrų atžvilgiu tarprieširdinės ir viršutinio pertvaros pjūvių grupės nesiskyrė. Mitralinio vožtuvo ydos korekcijos pobūdis – protezavimas ar plastika - statistiškai patikimai neturėjo PV gydymo rezultams. Gydymo efektyvumui įtakos turi: didesnė širdies nepakankamumo funkcinė klasė ir kairiojo prieširdžio išilginis dydis nustatytas echoskopiškai M - režimu. Pooperacinių antrinių prieširdinių tachikardijų ir atipinių prieširdžių plazdėjimo kombinuota (taikant antiaritminius vaistus, perstemplinę stimuliaciją ir perkateterinę radiodažnuminę abliacija) terapija leidžia pagerinti labirinto procedūros rezultatus. Viršutinis pertvaros pjūvis naudotinas sudėtingose operacijose, taip galima lengviau apžiūrėti mitralinį vožtuvą ir koreguoti mitralinę ydą.

Šio mokslinio darbo tikslas buvo įvertinti efektyvumą bei saugumą gydant prieširdžių virpėjimą, naudojant elektrofiziologinius RD abliacijos unipolinius elektrodinius kateterius pacientams, kuriems mitralinio vožtuvo ydą koreguojančios operacijos atliekamos per prieširdžių pertvaros(tarprieširdinės ir viršutinio pertvaros) pjūvius. Atlikus šią operaciją – po 1 metų >80% pacientų neturi prieširdžių virpėjimo/plazdėjimo, iš jų 76% nevartoja antiaritminių vaistų. galutinio sekimo metu fiksuota, kad išliko 71,5% pacientų be prieširdžių virpėjimo ir plazdėjimo. Labirinto procedūra prailgina tik 16 ± 3 min dirbtinės kraujotakos laiką. Išeities ir operacinių parametrų atžvilgiu tarprieširdinės ir viršutinio pertvaros pjūvių grupės nesiskyrė. Mitralinio vožtuvo ydos korekcijos pobūdis – protezavimas ar plastika - statistiškai patikimai neturėjo PV gydymo rezultams. Gydymo efektyvumui įtakos turi: didesnė širdies nepakankamumo funkcinė klasė ir kairiojo prieširdžio išilginis dydis nustatytas echoskopiškai M - režimu. Pooperacinių antrinių prieširdinių tachikardijų ir atipinių prieširdžių plazdėjimo kombinuota (taikant antiaritminius vaistus, perstemplinę stimuliaciją ir perkateterinę radiodažnuminę abliacija) terapija leidžia pagerinti labirinto procedūros rezultatus. Viršutinis pertvaros pjūvis naudotinas sudėtingose operacijose, taip galima lengviau apžiūrėti mitralinį vožtuvą ir koreguoti mitralinę ydą. / The purpose of this scientific work was to evaluate safety and efficacy of treatment of atrial fibrillation using monopolar radiofrequency ablation electrodes in patients who undergo mitral valve surgical correction using incisions of atrial septum (trans-septal and superior septal approaches). More than 80% of the patients are free of atrial fibrillation one year after the operation and 76% of these patients do not use anti-arrhythmic drugs. During the final visit of follow-up it was recorded that 71.5% of the patients remained free of atrial fibrillation and flutter. The maze procedure increases duration of cardiopulmonary by-pas for 16 ± 3 min, only. The baseline and surgical correction data in groups of patients of trans-septal and superior septal approaches did not differ. The method of mitral valve correction (implantation of mitral valve prosthesis or plasty of the valve) had no statistically significant influence on the results of atrial fibrillation treatment. The factors influencing the efficacy of the treatment include higher class of heart failure and larger longitudinal measurement of the left atrium found on echoscopy using M-mode. Combined therapy of secondary atrial tachycardia and atypical atrial flutter (by means of anti-arrhythmic drugs, trans-oesophageal stimulation and per-catheter ablation) enables to improve the results of maze procedure. The superior septal approach should be used in complicated operations as using this incision it is more... [to full text]

Prevention science has suggested that universal screening can enhance educational and mental health outcomes in the schools (Greenberg et al., 2003). A three-tier model of prevention has been proposed by Albers, Glover, and Kratochwill (2007) and Brown-Chidsey and Steege (2005) employing universal screening assessments of basic academic skills at Tier-1. Curriculum-based measurement maze (CBM-maze) probes are universal screeners that were developed as measures of reading comprehension. They are characterized as easy to administer, time-efficient, valid, and reliable (Parker, Hasbrouck, & Tindal, 1992). CBM-maze probes are short stories consisting of 400 words where every seventh word is omitted and replaced with three answer choices. Students are given 3-minutes to read the passage silently and select a word from the answer choices that restores the meaning of the story. Maze probes have been utilized as reading comprehension assessments for universal screening (Tier 1) and progress monitoring (Tier 2 and Tier 3; Espin, Deno, Maruyama, & Cohen, 1989; D. Fuchs & Fuchs, 1992). The current research study was conducted to further extend the research on the reliability and validity of CBM-maze probes. More specifically, it investigated if there were any differences between 1-minute, 2-minute, and 3-minute time frames, alternate form reliability, concurrent validity, and social validity of the maze probes. Results indicated differences in correct word selections (CWS) between 1-minute, 2-minute, and 3-minute time frames with significant interaction effects noted for the 2-minute maze probe. Alternate form reliability correlation were statistically significant and moderately strong (r = .47 to .71). Concurrent validity correlations between the STAR Reading norm referenced test (computer adaptive reading comprehension test) and CBM-maze probes yielded statistically significant and moderate correlations (r = .30 to .50). Tabulations of the assessment rating scale indicated that students perceived maze probes as acceptable measures for reading comprehension. Implications for practice, cautions in interpreting the results, and future directions are discussed. / School Psychology

<p>Atrial fibrillation is a common disease. With pharmacological therapy most patients with atrial fibrillation have moderate or little symptoms, but a number of patients have severely symptomatic disease. This study evaluates two new non-pharmacological therapies for atrial fibrillation, the Maze procedure and atrial overdrive pacing.</p><p>In the patients planned for Maze surgery the quality of life, assessed with the SF-36 questionnaire, was very low before the operation. The quality of life was markedly improved 6 and 12 months after the Maze operation, and was comparable to values of the general Swedish population.</p><p>In the patients with sinus rhythm before surgery, the atrial size and transport function was assessed with echocardiography, and the autonomic balance was assessed with heart rate variability (HRV). The sizes of both atria were reduced and the transmitral early filling / atrial filling (E/A) ratio was increased at 6 months after the operation compared to before. A progressive increase of the E/A ratio was seen during the 24 months follow-up period, indicating a progressive decline of the left atrial transport function.</p><p>All components of HRV, including the parameters expressing sympathetic and parasympathetic modulation, were markedly decreased early after the Maze procedure compared to before. Late after the operation all components of HRV were still markedly depressed. This is interpreted as a partial autonomic denervation of the heart</p><p>Single-site right atrial overdrive pacing with two different levels of overdriving was compared with no pacing in patients with paroxysmal atrial fibrillation in a cross-over study. Overdrive pacing reduced the median number of episodes of atrial fibrillation with 50% compared to no pacing. There was no difference between medium rate overdrive pacing and high rate overdrive pacing.</p>

Atrial fibrillation is a common disease. With pharmacological therapy most patients with atrial fibrillation have moderate or little symptoms, but a number of patients have severely symptomatic disease. This study evaluates two new non-pharmacological therapies for atrial fibrillation, the Maze procedure and atrial overdrive pacing. In the patients planned for Maze surgery the quality of life, assessed with the SF-36 questionnaire, was very low before the operation. The quality of life was markedly improved 6 and 12 months after the Maze operation, and was comparable to values of the general Swedish population. In the patients with sinus rhythm before surgery, the atrial size and transport function was assessed with echocardiography, and the autonomic balance was assessed with heart rate variability (HRV). The sizes of both atria were reduced and the transmitral early filling / atrial filling (E/A) ratio was increased at 6 months after the operation compared to before. A progressive increase of the E/A ratio was seen during the 24 months follow-up period, indicating a progressive decline of the left atrial transport function. All components of HRV, including the parameters expressing sympathetic and parasympathetic modulation, were markedly decreased early after the Maze procedure compared to before. Late after the operation all components of HRV were still markedly depressed. This is interpreted as a partial autonomic denervation of the heart Single-site right atrial overdrive pacing with two different levels of overdriving was compared with no pacing in patients with paroxysmal atrial fibrillation in a cross-over study. Overdrive pacing reduced the median number of episodes of atrial fibrillation with 50% compared to no pacing. There was no difference between medium rate overdrive pacing and high rate overdrive pacing.