Novedades en alteraciones del ritmo cardiaco: electrofisiología cardiaca, arritmias y estimulación cardiaca

Multimodal Locomotion and Active Targeted Thermal Control of Magnetic Agents for Biomedical Applications

Magnetic microrobots can be miniaturized to a nanometric scale owing to their wireless actuation, thereby rendering them ideal for numerous biomedical applications. As a result, nowadays, there exist several mechano-electromagnetic systems for their actuation. However, magnetic actuation is not sufficient for implementation in biomedical applications, and further functionalities such as imaging and heating are required. This study proposes a multimodal electromagnetic system comprised of three pairs of Helmholtz coils, a pair of Maxwell coils, and a high-frequency solenoid to realize multimodal locomotion and heating control of magnetic microrobots. The system produces different configurations of magnetic fields that can generate magnetic forces and torques for the multimodal locomotion of magnetic microrobots, as well as generate magnetic traps that can control the locomotion of magnetic swarms. Furthermore, these magnetic fields are employed to control the magnetization of magnetic nanoparticles, affecting their magnetic relaxation mechanisms and diminishing their thermal properties. Thus, the system enables the control of the temperature increase of soft-magnetic materials and selective heating of magnetic microrobots at different positions, while suppressing the heating properties of magnetic nanoparticles located at undesired areas.

Predictors of Luminal Loss in Pulmonary Veins After Radiofrequency Ablation

INTRODUCTION AND OBJECTIVES

The reported incidences of stenosis after radiofrequency ablation of pulmonary veins are highly variable. Moreover, most studies have focused on severe stenosis and have overlooked mild stenosis. Our aims were to study postablation morphological changes in the pulmonary veins and to evaluate preablation magnetic resonance imaging predictors for stenosis.

METHODS

Eighty consecutive patients with atrial fibrillation underwent cardiac magnetic resonance imaging before undergoing radiofrequency ablation. Magnetic resonance imaging was repeated a median of 95 days after ablation. Ostium area/ellipticity and atrial volume were blindly assessed. We evaluated the presence of stenosis and classified it as mild (< 50% area reduction), moderate (50%-70%), and severe (> 70%).

RESULTS

Postablation stenosis was identified in 78 of 322 veins (24.2%). The stenosis was mild in 66 (84.6%), moderate in 11 (14.1%), and severe in 1 (1.3%). All of them were asymptomatic. The left inferior pulmonary vein showed the highest frequency of stenosis, which was detected in 26% of them (P < .001). A multiple regression analysis revealed that left inferior pulmonary vein (odds ratio = 3.089; P = .02) and a greater preablation ostium area (odds ratio = 1.009; P < .001) were independent predictors for postablation stenosis. Age (odds ratio = 1.033) showed a strong trend to statistical significance (P = .06).

CONCLUSIONS

After ablation, vein ostia size is reduced and stenosis is detected in less than one third of patients. Most cases are mild, and severe stenosis is rare. Postablation stenosis is more likely to develop in older patients, those with larger vein ostia, and in the left inferior pulmonary veins.