The purpose of this study was to assess tolerance and safety of unconscious sedation with intravenous propofol and midazolam during catheter ablation of AF.
Methods: A total of 316 consecutive patients (age 59 +/- 10 years, 68% men) presenting to our center for catheter ablation of symptomatic AF were enrolled prospectively.
A total number of 424 procedures were performed under unconscious sedation with propofol and midazolam. SaO(2), electrocardiogram, arterial blood pressure, and arterial blood gases were monitored throughout the procedure.
Results: Mean procedure duration was 235 +/- 48 minutes. Patients received 1.125 +/- 684 mg propofol, 9.5 Torin 2 +/- 3 midazolam, and 1.963 +/- RG-7388 order 813 mL NaCl infusion. Complications during the procedure were identified in eight patients (2.5%, one x coronary air embolization, one x myocardial infarction, four x pericardial effusion, two x pericardial tamponade). All eight patients were symptomatic (distress, report of pain); none of the complications was attributable to unconscious sedation itself.
Conclusion: Unconscious sedation with propofol and midazolam in AF ablation procedures lasting 3-5 hours did
not result in severe changes of vital parameters or serum electrolytes. Anesthesia-associated problems were not observed. Propofol and midazolam can be safely used during catheter ablation of AF. (PACE 2012; 35:38-43)”
“Climate change alters phenological relations between interacting species. We might expect the historical baseline, or starting-point, for such effects to be precise synchrony between the season at which a consumer most requires food and the time when its resources are most available. We synthesize evidence that synchrony
was not the historical condition in two insect-plant www.selleckchem.com/products/pd-1-pd-l1-inhibitor-3.html interactions involving Edith’s checkerspot butterfly (Euphydryas editha), the winter moth (Operophtera brumata) and their host plants. Initial observations of phenological mismatch in both systems were made prior to the onset of anthropogenically driven climate change. Neither species can detect the phenology of its host plants with precision. In both species, evolution of life history has involved compromise between maximizing fecundity and minimizing mortality, with the outcome being superficially maladaptive strategies in which many, or even most, individuals die of starvation through poor synchrony with their host plants. Where phenological asynchrony or mismatch with resources forms the starting point for effects of anthropogenic global warming, consumers are particularly vulnerable to impacts that exacerbate the mismatch.