Wolff-Parkinson-White ablation after a prior failure: A 7-year multicentre experience
ABSTRACT Catheter ablation for Wolff-Parkinson-White syndrome (WPW) can be challenging and is associated with failure in approximately 1-5% of cases. We analysed the reasons for failure.
All patients (89 patients, 28 +/- 16 years old) referred for WPW ablation after a prior failure were studied. Reasons for the prior failure as well as for the acute success were analysed. The repeat procedure was successful in 81 (91%) patients. Multiple (2.7 +/- 0.9) or large accessory pathways (APs) were seen in 13 patients. For left lateral APs, inaccurate mapping and lack of transseptal access during the index procedure accounted for failure (n = 15). An irrigated-tip catheter was required for epicardial APs (n = 7). In addition, seven posteroseptal APs required bi-atrial and coronary sinus (CS) applications in order to succeed. For parahisian and midseptal APs, radiofrequency was cautiously titrated from 5 to 30 W, eliminating the AP in three patients. Cryoablation was used in seven patients (acute success in six but delayed recurrences in three of these). For patients with CS AP, irrigated ablation in the CS was crucial to deliver adequate power. For anteroseptal and right lateral APs, a successful outcome was achieved with long sheaths (n = 5) or a left subclavian approach (anteroseptal, n = 4).
Failure in WPW ablation may be due to a variety of reasons but catheter manipulation and inaccurate mapping remain the two major causes. Knowledge of the reasons for failure depending on the location of the WPW may facilitate a successful outcome.
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ABSTRACT: There is a demanding need for manufacturers to reduce the escape rate of inspection of golf logos. The quality of the logo is primarily depending on the small and local deviation of the logo contours. In this study, the concept of mathematical piecewise continuous approximation and the accumulation of turn angles (ATA) are employed to deal with the problem of different degrees of contour stretching and shrinking. Each of the test contours, as well as the sample one, is partitioned into a number of sub-contours. The ATA values for each sub-contour form an ATA sub-chain, and all the sub-chains in sequence form an ATA chain for the overall contour. The sizes of the sample and test ATA chains are to be compared and "rescaled" by interpolation. Through the study, the correspondence problem can be explored in detail. Lots of experimental and simulation examples have been conducted to support the adequacy of the proposed measure. The results of this study can be useful for fine inspection of the object quality based on detecting small and local deviation of the object image contour.Control Applications, 2004. Proceedings of the 2004 IEEE International Conference on; 10/2004
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