The value of electrophysiologic study in decision-making regarding the need for pacemaker implantation after TAVI
Purpose The purpose of this study was to evaluate electrophysiologic study (EPS) in risk stratification of relative indications for pacemaker implantation (PMI) after transcatheter aortic valve implantation (TAVI). Methods We reviewed files of all patients who had a left bundle branch block (LBBB) a...
Gespeichert in:
| Veröffentlicht in: | Journal of interventional cardiac electrophysiology 2017-03, Vol.48 (2), p.121-130 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 130 |
|---|---|
| container_issue | 2 |
| container_start_page | 121 |
| container_title | Journal of interventional cardiac electrophysiology |
| container_volume | 48 |
| creator | Tovia-Brodie, Oholi Ben-Haim, Yael Joffe, Erel Finkelstein, Ariel Glick, Aharon Rosso, Raphael Belhassen, Bernard Michowitz, Yoav |
| description | Purpose
The purpose of this study was to evaluate electrophysiologic study (EPS) in risk stratification of relative indications for pacemaker implantation (PMI) after transcatheter aortic valve implantation (TAVI).
Methods
We reviewed files of all patients who had a left bundle branch block (LBBB) and underwent EPS after TAVI between 3/2009 and 5/2015. The indications for EPS were new-onset LBBB and the presence of an old or a new-onset LBBB associated with either PR prolongation after TAVI (∆PR >20 ms) or with “slow” atrial fibrillation (20 ms (
n
= 9, 34.6%), baseline LBBB + ∆PR >20 ms (
n
= 7, 26.9%) and new LBBB + slow AF 20 ms are at a higher risk of mortality and late PMI at 1-year follow-up. EPS can be used to safely identify patients in whom a PMI is needed. |
| doi_str_mv | 10.1007/s10840-016-0218-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1877841062</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4317054051</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-56dbe751fd51e66efe171f2588c7a64e6f8479196b0761e567c8fc43c85537c23</originalsourceid><addsrcrecordid>eNqNkU1r3DAQhkVJadK0P6CXIMilF6Ua2frwMYR-BAK9bEtvQiuPNk5ty5Hswv77yGxaSiCQk4bRM69GPIR8AH4BnOtPGbipOeOgGBdgmHhFTkBqwYxs5FGpK1Mxo-WvY_I25zvOecOFekOOhW6M5lqckPvNLdI_rl-QxkCxRz-nON3ucxf7uOs8zfPS7mk30hZ9V7ojG9zvbtzRhDuX2rWaS8SI2NIQE52cx0Jgot0w9W6c3VyGqAtzaW0uf16_I6-D6zO-fzxPyY8vnzdX39jN96_XV5c3zNdczkyqdotaQmgloFIYEDQEIY3x2qkaVTC1bqBRW64VoFTam-DryhspK-1FdUo-HnKnFO8XzLMduuyxLzthXLIFo7WpgauXoFKohptGFfT8CXoXlzSWj6yBoFUlYKXgQPkUc04Y7JS6waW9BW5XdfagzhZ1dlVn1yXOHpOX7YDtv4m_rgogDkAuV-MO039PP5v6AN3so4Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1871763216</pqid></control><display><type>article</type><title>The value of electrophysiologic study in decision-making regarding the need for pacemaker implantation after TAVI</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Tovia-Brodie, Oholi ; Ben-Haim, Yael ; Joffe, Erel ; Finkelstein, Ariel ; Glick, Aharon ; Rosso, Raphael ; Belhassen, Bernard ; Michowitz, Yoav</creator><creatorcontrib>Tovia-Brodie, Oholi ; Ben-Haim, Yael ; Joffe, Erel ; Finkelstein, Ariel ; Glick, Aharon ; Rosso, Raphael ; Belhassen, Bernard ; Michowitz, Yoav</creatorcontrib><description>Purpose
The purpose of this study was to evaluate electrophysiologic study (EPS) in risk stratification of relative indications for pacemaker implantation (PMI) after transcatheter aortic valve implantation (TAVI).
Methods
We reviewed files of all patients who had a left bundle branch block (LBBB) and underwent EPS after TAVI between 3/2009 and 5/2015. The indications for EPS were new-onset LBBB and the presence of an old or a new-onset LBBB associated with either PR prolongation after TAVI (∆PR >20 ms) or with “slow” atrial fibrillation (<100/min). Pacemakers were implanted when significant infranodal disease was demonstrated. The control group comprised of 55 consecutive patients who underwent TAVI and had an indication for an EPS per our definitions. These patients were discharged without further intervention. All patients were followed during 1 year for the composite endpoint of mortality or PMI after hospital discharge.
Results
Indications for EPS were new LBBB (
n
= 8, 30.8%), new LBBB + ∆PR >20 ms (
n
= 9, 34.6%), baseline LBBB + ∆PR >20 ms (
n
= 7, 26.9%) and new LBBB + slow AF <100 bpm (
n
= 2, 7.7%). Multilevel conduction disturbances involving the AV node (
n
= 19, 73.1%), the His (
n
= 3, 11.5%), and the infra-His system (
n
= 4, 15.4%) were found. Post discharge, there were 5 (9%) deaths and 3 (5.5%) PMI in the control group compared to none in the EPS group corresponding to event-free survival of 85 and 100%, respectively (
p
= 0.04).
Conclusions
Patients with LBBB with or without ∆PR >20 ms are at a higher risk of mortality and late PMI at 1-year follow-up. EPS can be used to safely identify patients in whom a PMI is needed.</description><identifier>ISSN: 1383-875X</identifier><identifier>EISSN: 1572-8595</identifier><identifier>DOI: 10.1007/s10840-016-0218-2</identifier><identifier>PMID: 27987072</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Aged ; Aged, 80 and over ; Aortic Valve Stenosis - diagnosis ; Aortic Valve Stenosis - epidemiology ; Aortic Valve Stenosis - surgery ; Bundle-Branch Block - diagnosis ; Bundle-Branch Block - epidemiology ; Bundle-Branch Block - prevention & control ; Cardiology ; Causality ; Clinical Decision-Making ; Comorbidity ; Electrophysiologic Techniques, Cardiac - utilization ; Female ; Humans ; Israel - epidemiology ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Needs Assessment ; Pacemaker, Artificial - utilization ; Patient Selection ; Postoperative Complications - diagnosis ; Postoperative Complications - epidemiology ; Postoperative Complications - prevention & control ; Prevalence ; Risk Factors ; Survival Rate ; Transcatheter Aortic Valve Replacement - mortality ; Transcatheter Aortic Valve Replacement - rehabilitation ; Treatment Outcome</subject><ispartof>Journal of interventional cardiac electrophysiology, 2017-03, Vol.48 (2), p.121-130</ispartof><rights>Springer Science+Business Media New York 2016</rights><rights>Journal of Interventional Cardiac Electrophysiology is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-56dbe751fd51e66efe171f2588c7a64e6f8479196b0761e567c8fc43c85537c23</citedby><cites>FETCH-LOGICAL-c405t-56dbe751fd51e66efe171f2588c7a64e6f8479196b0761e567c8fc43c85537c23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10840-016-0218-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10840-016-0218-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27987072$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tovia-Brodie, Oholi</creatorcontrib><creatorcontrib>Ben-Haim, Yael</creatorcontrib><creatorcontrib>Joffe, Erel</creatorcontrib><creatorcontrib>Finkelstein, Ariel</creatorcontrib><creatorcontrib>Glick, Aharon</creatorcontrib><creatorcontrib>Rosso, Raphael</creatorcontrib><creatorcontrib>Belhassen, Bernard</creatorcontrib><creatorcontrib>Michowitz, Yoav</creatorcontrib><title>The value of electrophysiologic study in decision-making regarding the need for pacemaker implantation after TAVI</title><title>Journal of interventional cardiac electrophysiology</title><addtitle>J Interv Card Electrophysiol</addtitle><addtitle>J Interv Card Electrophysiol</addtitle><description>Purpose
The purpose of this study was to evaluate electrophysiologic study (EPS) in risk stratification of relative indications for pacemaker implantation (PMI) after transcatheter aortic valve implantation (TAVI).
Methods
We reviewed files of all patients who had a left bundle branch block (LBBB) and underwent EPS after TAVI between 3/2009 and 5/2015. The indications for EPS were new-onset LBBB and the presence of an old or a new-onset LBBB associated with either PR prolongation after TAVI (∆PR >20 ms) or with “slow” atrial fibrillation (<100/min). Pacemakers were implanted when significant infranodal disease was demonstrated. The control group comprised of 55 consecutive patients who underwent TAVI and had an indication for an EPS per our definitions. These patients were discharged without further intervention. All patients were followed during 1 year for the composite endpoint of mortality or PMI after hospital discharge.
Results
Indications for EPS were new LBBB (
n
= 8, 30.8%), new LBBB + ∆PR >20 ms (
n
= 9, 34.6%), baseline LBBB + ∆PR >20 ms (
n
= 7, 26.9%) and new LBBB + slow AF <100 bpm (
n
= 2, 7.7%). Multilevel conduction disturbances involving the AV node (
n
= 19, 73.1%), the His (
n
= 3, 11.5%), and the infra-His system (
n
= 4, 15.4%) were found. Post discharge, there were 5 (9%) deaths and 3 (5.5%) PMI in the control group compared to none in the EPS group corresponding to event-free survival of 85 and 100%, respectively (
p
= 0.04).
Conclusions
Patients with LBBB with or without ∆PR >20 ms are at a higher risk of mortality and late PMI at 1-year follow-up. EPS can be used to safely identify patients in whom a PMI is needed.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aortic Valve Stenosis - diagnosis</subject><subject>Aortic Valve Stenosis - epidemiology</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Bundle-Branch Block - diagnosis</subject><subject>Bundle-Branch Block - epidemiology</subject><subject>Bundle-Branch Block - prevention & control</subject><subject>Cardiology</subject><subject>Causality</subject><subject>Clinical Decision-Making</subject><subject>Comorbidity</subject><subject>Electrophysiologic Techniques, Cardiac - utilization</subject><subject>Female</subject><subject>Humans</subject><subject>Israel - epidemiology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Needs Assessment</subject><subject>Pacemaker, Artificial - utilization</subject><subject>Patient Selection</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - prevention & control</subject><subject>Prevalence</subject><subject>Risk Factors</subject><subject>Survival Rate</subject><subject>Transcatheter Aortic Valve Replacement - mortality</subject><subject>Transcatheter Aortic Valve Replacement - rehabilitation</subject><subject>Treatment Outcome</subject><issn>1383-875X</issn><issn>1572-8595</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkU1r3DAQhkVJadK0P6CXIMilF6Ua2frwMYR-BAK9bEtvQiuPNk5ty5Hswv77yGxaSiCQk4bRM69GPIR8AH4BnOtPGbipOeOgGBdgmHhFTkBqwYxs5FGpK1Mxo-WvY_I25zvOecOFekOOhW6M5lqckPvNLdI_rl-QxkCxRz-nON3ucxf7uOs8zfPS7mk30hZ9V7ojG9zvbtzRhDuX2rWaS8SI2NIQE52cx0Jgot0w9W6c3VyGqAtzaW0uf16_I6-D6zO-fzxPyY8vnzdX39jN96_XV5c3zNdczkyqdotaQmgloFIYEDQEIY3x2qkaVTC1bqBRW64VoFTam-DryhspK-1FdUo-HnKnFO8XzLMduuyxLzthXLIFo7WpgauXoFKohptGFfT8CXoXlzSWj6yBoFUlYKXgQPkUc04Y7JS6waW9BW5XdfagzhZ1dlVn1yXOHpOX7YDtv4m_rgogDkAuV-MO039PP5v6AN3so4Q</recordid><startdate>20170301</startdate><enddate>20170301</enddate><creator>Tovia-Brodie, Oholi</creator><creator>Ben-Haim, Yael</creator><creator>Joffe, Erel</creator><creator>Finkelstein, Ariel</creator><creator>Glick, Aharon</creator><creator>Rosso, Raphael</creator><creator>Belhassen, Bernard</creator><creator>Michowitz, Yoav</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20170301</creationdate><title>The value of electrophysiologic study in decision-making regarding the need for pacemaker implantation after TAVI</title><author>Tovia-Brodie, Oholi ; Ben-Haim, Yael ; Joffe, Erel ; Finkelstein, Ariel ; Glick, Aharon ; Rosso, Raphael ; Belhassen, Bernard ; Michowitz, Yoav</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-56dbe751fd51e66efe171f2588c7a64e6f8479196b0761e567c8fc43c85537c23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aortic Valve Stenosis - diagnosis</topic><topic>Aortic Valve Stenosis - epidemiology</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Bundle-Branch Block - diagnosis</topic><topic>Bundle-Branch Block - epidemiology</topic><topic>Bundle-Branch Block - prevention & control</topic><topic>Cardiology</topic><topic>Causality</topic><topic>Clinical Decision-Making</topic><topic>Comorbidity</topic><topic>Electrophysiologic Techniques, Cardiac - utilization</topic><topic>Female</topic><topic>Humans</topic><topic>Israel - epidemiology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Needs Assessment</topic><topic>Pacemaker, Artificial - utilization</topic><topic>Patient Selection</topic><topic>Postoperative Complications - diagnosis</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - prevention & control</topic><topic>Prevalence</topic><topic>Risk Factors</topic><topic>Survival Rate</topic><topic>Transcatheter Aortic Valve Replacement - mortality</topic><topic>Transcatheter Aortic Valve Replacement - rehabilitation</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tovia-Brodie, Oholi</creatorcontrib><creatorcontrib>Ben-Haim, Yael</creatorcontrib><creatorcontrib>Joffe, Erel</creatorcontrib><creatorcontrib>Finkelstein, Ariel</creatorcontrib><creatorcontrib>Glick, Aharon</creatorcontrib><creatorcontrib>Rosso, Raphael</creatorcontrib><creatorcontrib>Belhassen, Bernard</creatorcontrib><creatorcontrib>Michowitz, Yoav</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of interventional cardiac electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tovia-Brodie, Oholi</au><au>Ben-Haim, Yael</au><au>Joffe, Erel</au><au>Finkelstein, Ariel</au><au>Glick, Aharon</au><au>Rosso, Raphael</au><au>Belhassen, Bernard</au><au>Michowitz, Yoav</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The value of electrophysiologic study in decision-making regarding the need for pacemaker implantation after TAVI</atitle><jtitle>Journal of interventional cardiac electrophysiology</jtitle><stitle>J Interv Card Electrophysiol</stitle><addtitle>J Interv Card Electrophysiol</addtitle><date>2017-03-01</date><risdate>2017</risdate><volume>48</volume><issue>2</issue><spage>121</spage><epage>130</epage><pages>121-130</pages><issn>1383-875X</issn><eissn>1572-8595</eissn><abstract>Purpose
The purpose of this study was to evaluate electrophysiologic study (EPS) in risk stratification of relative indications for pacemaker implantation (PMI) after transcatheter aortic valve implantation (TAVI).
Methods
We reviewed files of all patients who had a left bundle branch block (LBBB) and underwent EPS after TAVI between 3/2009 and 5/2015. The indications for EPS were new-onset LBBB and the presence of an old or a new-onset LBBB associated with either PR prolongation after TAVI (∆PR >20 ms) or with “slow” atrial fibrillation (<100/min). Pacemakers were implanted when significant infranodal disease was demonstrated. The control group comprised of 55 consecutive patients who underwent TAVI and had an indication for an EPS per our definitions. These patients were discharged without further intervention. All patients were followed during 1 year for the composite endpoint of mortality or PMI after hospital discharge.
Results
Indications for EPS were new LBBB (
n
= 8, 30.8%), new LBBB + ∆PR >20 ms (
n
= 9, 34.6%), baseline LBBB + ∆PR >20 ms (
n
= 7, 26.9%) and new LBBB + slow AF <100 bpm (
n
= 2, 7.7%). Multilevel conduction disturbances involving the AV node (
n
= 19, 73.1%), the His (
n
= 3, 11.5%), and the infra-His system (
n
= 4, 15.4%) were found. Post discharge, there were 5 (9%) deaths and 3 (5.5%) PMI in the control group compared to none in the EPS group corresponding to event-free survival of 85 and 100%, respectively (
p
= 0.04).
Conclusions
Patients with LBBB with or without ∆PR >20 ms are at a higher risk of mortality and late PMI at 1-year follow-up. EPS can be used to safely identify patients in whom a PMI is needed.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>27987072</pmid><doi>10.1007/s10840-016-0218-2</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1383-875X |
| ispartof | Journal of interventional cardiac electrophysiology, 2017-03, Vol.48 (2), p.121-130 |
| issn | 1383-875X 1572-8595 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1877841062 |
| source | MEDLINE; SpringerNature Journals |
| subjects | Aged Aged, 80 and over Aortic Valve Stenosis - diagnosis Aortic Valve Stenosis - epidemiology Aortic Valve Stenosis - surgery Bundle-Branch Block - diagnosis Bundle-Branch Block - epidemiology Bundle-Branch Block - prevention & control Cardiology Causality Clinical Decision-Making Comorbidity Electrophysiologic Techniques, Cardiac - utilization Female Humans Israel - epidemiology Male Medicine Medicine & Public Health Middle Aged Needs Assessment Pacemaker, Artificial - utilization Patient Selection Postoperative Complications - diagnosis Postoperative Complications - epidemiology Postoperative Complications - prevention & control Prevalence Risk Factors Survival Rate Transcatheter Aortic Valve Replacement - mortality Transcatheter Aortic Valve Replacement - rehabilitation Treatment Outcome |
| title | The value of electrophysiologic study in decision-making regarding the need for pacemaker implantation after TAVI |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T23%3A05%3A13IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20value%20of%20electrophysiologic%20study%20in%20decision-making%20regarding%20the%20need%20for%20pacemaker%20implantation%20after%20TAVI&rft.jtitle=Journal%20of%20interventional%20cardiac%20electrophysiology&rft.au=Tovia-Brodie,%20Oholi&rft.date=2017-03-01&rft.volume=48&rft.issue=2&rft.spage=121&rft.epage=130&rft.pages=121-130&rft.issn=1383-875X&rft.eissn=1572-8595&rft_id=info:doi/10.1007/s10840-016-0218-2&rft_dat=%3Cproquest_cross%3E4317054051%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1871763216&rft_id=info:pmid/27987072&rfr_iscdi=true |