The primary purpose of lesion-forming technologies in atrial fibrillation is to create safe and effective myocardial lesions in a reasonable time frame while avoiding collateral damage. The complex ...anatomy of the left atrium creates unique difficulties for any lesion-forming technology employed in the ablation of atrial fibrillation. Unfortunately, the ideal energy source for the treatment of atrial fibrillation has yet to be developed, and thus multiple different technologies are still used. Lesion-forming technologies currently employed in the treatment of atrial fibrillation include radio-frequency energy, cryothermal energy, and high-intensity focused ultrasound. This review touches on the basic principles behind each of these technologies and highlights the advantages and limitations of their use in the treatment of atrial fibrillation. Finally, we briefly review some evolving strategies for the treatment of atrial fibrillation, including the use of lasers, microwaves, and Beta-irradiation as well as the injection of autologous fibroblasts.
The electrocardiograms of 146 patients with metastatic carcinoma of the breast were reviewed before, during, and after the patients received Adriamycin (Doxorubicin) chemotherapy (AD). The most ...significant electrocardiographic change occurred in the amplitude of the QRS voltage. Seven patients developed cardiomyopathy after AD and showed a significant decrease in QRS voltage. This decrease, however, was more severe at the onset of congestive heart failure than at conclusion of Adriamycin. In 35 patients with pleural effusion, there was an inverse relation between the extent of the effusion and the amplitude of QRS voltage in the absence of congestive heart failure. These results indicate that 1) the sudden and relatively severe decrease in QRS voltage with the onset of CHF limits the value of this ECG criterion for predicting early Adriamycin toxicity, and 2) caution should be exercised in the interpretation of QRS voltage changes in patients with significant pleural effusion. Cancer 43:465–471, 1979.
Between 1983 and 1985, 170 consecutive patients received doxorubicin-containing adjuvant chemotherapy through central venous catheters, and four via a long indwelling catheter in the antecubital ...fossa. The objective of this retrospective study is to determine the acute and chronic complications associated with indwelling catheters. Ninety-four (56%) patients did not experience any complications. The incidence of acute complications was 2%, which included three pneumothorax. Twenty-nine (17%) patients experienced chronic complications. Of those, 20 (12%) developed infectious complications, and 9 (19%) developed thrombus. In addition, 12 (7%) developed multiple complications, and 32 (19%) patients had other local complications at the catheter site, which included allergic reactions and catheter breakage. Each of these complications was resolved with appropriate treatment. None of the patients died from complications of the indwelling catheter.
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