Preprocedural Clinical Parameters Determining Perimitral Conduction Time During Mitral Isthmus Line Ablation
BACKGROUND—Achievement of complete conduction block across left mitral isthmus (MI) is challenging. Anticipation of perimitral conduction time (PMCT) associated with MI block may expedite this procedure. We evaluated the relationship between the preprocedural variables and the quantum of PMCT in pat...
Gespeichert in:
| Veröffentlicht in: | Circulation. Arrhythmia and electrophysiology 2011-06, Vol.4 (3), p.287-294 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 294 |
|---|---|
| container_issue | 3 |
| container_start_page | 287 |
| container_title | Circulation. Arrhythmia and electrophysiology |
| container_volume | 4 |
| creator | Miyazaki, Shinsuke Shah, Ashok J Liu, Xingpeng Jadidi, Amir S Nault, Isabelle Wright, Matthew Forclaz, Andrei Linton, Nick Xhaët, Olivier Rivard, Lena Derval, Nicolas Knecht, Sébastien Sacher, Frédéric Hocini, Mélèze Jaïs, Pierre Haïssaguerre, Michel |
| description | BACKGROUND—Achievement of complete conduction block across left mitral isthmus (MI) is challenging. Anticipation of perimitral conduction time (PMCT) associated with MI block may expedite this procedure. We evaluated the relationship between the preprocedural variables and the quantum of PMCT in patients with bidirectionally blocked MI.
METHODS AND RESULTS—We reviewed clinical and echocardiographic parameters in 290 consecutive patients with confirmed bidirectional MI block during atrial fibrillation (AF) ablation. PMCT was defined as the temporal delay to the latest of the double potentials on the line of block while pacing posteroseptal to it in the left atrium (LA). LA size and type of AF significantly influenced PMCT in multivariate analysis. A cumulative score based on LA size (0≦45 mm; 1>45 mm) and type of AF (0paroxysmal; 1=nonparoxysmal) ranged from 0 to 2. PMCT was directly correlated to the cumulative score (0169 ms; n=78; 95% confidential interval, 156 to 181); 1187 ms; n=103; 95% confidential interval, 178 to 196; 2209 ms; n=109; 95% confidential interval, 200 to 217). In 61 patients who underwent AF ablation twice, the difference between 2 PMCT values was |
| doi_str_mv | 10.1161/CIRCEP.110.958983 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_872130241</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>872130241</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4847-111313268780ec4d3f5e024791a9cc9110c176c3b77f23ce8405559ac3db8c573</originalsourceid><addsrcrecordid>eNpFkMFu1DAQhi1UREvhAbigXCpOKR7bie1jlRa60iJWqJwtrzPpujhJsRNVvD1Os4WDNb_sb8aaj5APQC8BavjcbH40N7uc6aWulFb8FTkDLaDkVImTlwxCn5K3KT1QWoOC-g05ZcAlY7U-I2EX8TGODts52lA0wQ_e5bCz0fY4YUzF9VL6fD_cFzuMvvfTMzoO7ewmPw7Fne-xuJ7jQnxbXzdpOvRzKrZ-wOJqH-wCviOvOxsSvj_Wc_Lzy81dc1tuv3_dNFfb0gklZAkAHDirlVQUnWh5VyFlQmqw2jmd13Uga8f3UnaMO1SCVlWlrePtXrlK8nPyaZ2bN_s9Y5pM75PDEOyA45yMkllAngiZhJV0cUwpYmce84I2_jFAzeLYrI5zpmZ1nHs-HqfP-x7bfx0vUjNwcQRsyi67aAfn039OMMV4xTInVu5pDIvpX2F-wmgOaMN0MBQ4l0LzktH8eU0pLfOhkv8F0ISUNQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>872130241</pqid></control><display><type>article</type><title>Preprocedural Clinical Parameters Determining Perimitral Conduction Time During Mitral Isthmus Line Ablation</title><source>MEDLINE</source><source>American Heart Association Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Miyazaki, Shinsuke ; Shah, Ashok J ; Liu, Xingpeng ; Jadidi, Amir S ; Nault, Isabelle ; Wright, Matthew ; Forclaz, Andrei ; Linton, Nick ; Xhaët, Olivier ; Rivard, Lena ; Derval, Nicolas ; Knecht, Sébastien ; Sacher, Frédéric ; Hocini, Mélèze ; Jaïs, Pierre ; Haïssaguerre, Michel</creator><creatorcontrib>Miyazaki, Shinsuke ; Shah, Ashok J ; Liu, Xingpeng ; Jadidi, Amir S ; Nault, Isabelle ; Wright, Matthew ; Forclaz, Andrei ; Linton, Nick ; Xhaët, Olivier ; Rivard, Lena ; Derval, Nicolas ; Knecht, Sébastien ; Sacher, Frédéric ; Hocini, Mélèze ; Jaïs, Pierre ; Haïssaguerre, Michel</creatorcontrib><description>BACKGROUND—Achievement of complete conduction block across left mitral isthmus (MI) is challenging. Anticipation of perimitral conduction time (PMCT) associated with MI block may expedite this procedure. We evaluated the relationship between the preprocedural variables and the quantum of PMCT in patients with bidirectionally blocked MI.
METHODS AND RESULTS—We reviewed clinical and echocardiographic parameters in 290 consecutive patients with confirmed bidirectional MI block during atrial fibrillation (AF) ablation. PMCT was defined as the temporal delay to the latest of the double potentials on the line of block while pacing posteroseptal to it in the left atrium (LA). LA size and type of AF significantly influenced PMCT in multivariate analysis. A cumulative score based on LA size (0≦45 mm; 1>45 mm) and type of AF (0paroxysmal; 1=nonparoxysmal) ranged from 0 to 2. PMCT was directly correlated to the cumulative score (0169 ms; n=78; 95% confidential interval, 156 to 181); 1187 ms; n=103; 95% confidential interval, 178 to 196; 2209 ms; n=109; 95% confidential interval, 200 to 217). In 61 patients who underwent AF ablation twice, the difference between 2 PMCT values was <30 ms in 75% patients. Another consecutive 143 patients with and without MI block after at least 15 minutes of radiofrequency application were analyzed. Perimitral conduction delay <130 ms ruled out bidirectional MI block. Perimitral conduction delay >173 ms predicted bidirectional block with an accuracy of 86%.
CONCLUSIONS—LA size and AF type significantly influence PMCT in patients undergoing successful MI ablation. These parameters can be used to predict the time value associated with MI block, preprocedurally.</description><identifier>ISSN: 1941-3149</identifier><identifier>EISSN: 1941-3084</identifier><identifier>DOI: 10.1161/CIRCEP.110.958983</identifier><identifier>PMID: 21372269</identifier><language>eng</language><publisher>Hagerstown, MD: American Heart Association, Inc</publisher><subject>Atrial Appendage - physiopathology ; Atrial Appendage - surgery ; Biological and medical sciences ; Body Surface Potential Mapping - methods ; Cardiac dysrhythmias ; Cardiology. Vascular system ; Cardiovascular system ; Catheter Ablation - methods ; Coronary Sinus - physiopathology ; Female ; Follow-Up Studies ; Heart ; Heart Conduction System - physiopathology ; Heart Conduction System - surgery ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Preoperative Care - methods ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Retrospective Studies ; Treatment Outcome ; Ultrasonic investigative techniques</subject><ispartof>Circulation. Arrhythmia and electrophysiology, 2011-06, Vol.4 (3), p.287-294</ispartof><rights>2011 American Heart Association, Inc.</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4847-111313268780ec4d3f5e024791a9cc9110c176c3b77f23ce8405559ac3db8c573</citedby><cites>FETCH-LOGICAL-c4847-111313268780ec4d3f5e024791a9cc9110c176c3b77f23ce8405559ac3db8c573</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3673,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24282352$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21372269$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Miyazaki, Shinsuke</creatorcontrib><creatorcontrib>Shah, Ashok J</creatorcontrib><creatorcontrib>Liu, Xingpeng</creatorcontrib><creatorcontrib>Jadidi, Amir S</creatorcontrib><creatorcontrib>Nault, Isabelle</creatorcontrib><creatorcontrib>Wright, Matthew</creatorcontrib><creatorcontrib>Forclaz, Andrei</creatorcontrib><creatorcontrib>Linton, Nick</creatorcontrib><creatorcontrib>Xhaët, Olivier</creatorcontrib><creatorcontrib>Rivard, Lena</creatorcontrib><creatorcontrib>Derval, Nicolas</creatorcontrib><creatorcontrib>Knecht, Sébastien</creatorcontrib><creatorcontrib>Sacher, Frédéric</creatorcontrib><creatorcontrib>Hocini, Mélèze</creatorcontrib><creatorcontrib>Jaïs, Pierre</creatorcontrib><creatorcontrib>Haïssaguerre, Michel</creatorcontrib><title>Preprocedural Clinical Parameters Determining Perimitral Conduction Time During Mitral Isthmus Line Ablation</title><title>Circulation. Arrhythmia and electrophysiology</title><addtitle>Circ Arrhythm Electrophysiol</addtitle><description>BACKGROUND—Achievement of complete conduction block across left mitral isthmus (MI) is challenging. Anticipation of perimitral conduction time (PMCT) associated with MI block may expedite this procedure. We evaluated the relationship between the preprocedural variables and the quantum of PMCT in patients with bidirectionally blocked MI.
METHODS AND RESULTS—We reviewed clinical and echocardiographic parameters in 290 consecutive patients with confirmed bidirectional MI block during atrial fibrillation (AF) ablation. PMCT was defined as the temporal delay to the latest of the double potentials on the line of block while pacing posteroseptal to it in the left atrium (LA). LA size and type of AF significantly influenced PMCT in multivariate analysis. A cumulative score based on LA size (0≦45 mm; 1>45 mm) and type of AF (0paroxysmal; 1=nonparoxysmal) ranged from 0 to 2. PMCT was directly correlated to the cumulative score (0169 ms; n=78; 95% confidential interval, 156 to 181); 1187 ms; n=103; 95% confidential interval, 178 to 196; 2209 ms; n=109; 95% confidential interval, 200 to 217). In 61 patients who underwent AF ablation twice, the difference between 2 PMCT values was <30 ms in 75% patients. Another consecutive 143 patients with and without MI block after at least 15 minutes of radiofrequency application were analyzed. Perimitral conduction delay <130 ms ruled out bidirectional MI block. Perimitral conduction delay >173 ms predicted bidirectional block with an accuracy of 86%.
CONCLUSIONS—LA size and AF type significantly influence PMCT in patients undergoing successful MI ablation. These parameters can be used to predict the time value associated with MI block, preprocedurally.</description><subject>Atrial Appendage - physiopathology</subject><subject>Atrial Appendage - surgery</subject><subject>Biological and medical sciences</subject><subject>Body Surface Potential Mapping - methods</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular system</subject><subject>Catheter Ablation - methods</subject><subject>Coronary Sinus - physiopathology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Heart Conduction System - physiopathology</subject><subject>Heart Conduction System - surgery</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Preoperative Care - methods</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Ultrasonic investigative techniques</subject><issn>1941-3149</issn><issn>1941-3084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkMFu1DAQhi1UREvhAbigXCpOKR7bie1jlRa60iJWqJwtrzPpujhJsRNVvD1Os4WDNb_sb8aaj5APQC8BavjcbH40N7uc6aWulFb8FTkDLaDkVImTlwxCn5K3KT1QWoOC-g05ZcAlY7U-I2EX8TGODts52lA0wQ_e5bCz0fY4YUzF9VL6fD_cFzuMvvfTMzoO7ewmPw7Fne-xuJ7jQnxbXzdpOvRzKrZ-wOJqH-wCviOvOxsSvj_Wc_Lzy81dc1tuv3_dNFfb0gklZAkAHDirlVQUnWh5VyFlQmqw2jmd13Uga8f3UnaMO1SCVlWlrePtXrlK8nPyaZ2bN_s9Y5pM75PDEOyA45yMkllAngiZhJV0cUwpYmce84I2_jFAzeLYrI5zpmZ1nHs-HqfP-x7bfx0vUjNwcQRsyi67aAfn039OMMV4xTInVu5pDIvpX2F-wmgOaMN0MBQ4l0LzktH8eU0pLfOhkv8F0ISUNQ</recordid><startdate>201106</startdate><enddate>201106</enddate><creator>Miyazaki, Shinsuke</creator><creator>Shah, Ashok J</creator><creator>Liu, Xingpeng</creator><creator>Jadidi, Amir S</creator><creator>Nault, Isabelle</creator><creator>Wright, Matthew</creator><creator>Forclaz, Andrei</creator><creator>Linton, Nick</creator><creator>Xhaët, Olivier</creator><creator>Rivard, Lena</creator><creator>Derval, Nicolas</creator><creator>Knecht, Sébastien</creator><creator>Sacher, Frédéric</creator><creator>Hocini, Mélèze</creator><creator>Jaïs, Pierre</creator><creator>Haïssaguerre, Michel</creator><general>American Heart Association, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><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>7X8</scope></search><sort><creationdate>201106</creationdate><title>Preprocedural Clinical Parameters Determining Perimitral Conduction Time During Mitral Isthmus Line Ablation</title><author>Miyazaki, Shinsuke ; Shah, Ashok J ; Liu, Xingpeng ; Jadidi, Amir S ; Nault, Isabelle ; Wright, Matthew ; Forclaz, Andrei ; Linton, Nick ; Xhaët, Olivier ; Rivard, Lena ; Derval, Nicolas ; Knecht, Sébastien ; Sacher, Frédéric ; Hocini, Mélèze ; Jaïs, Pierre ; Haïssaguerre, Michel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4847-111313268780ec4d3f5e024791a9cc9110c176c3b77f23ce8405559ac3db8c573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Atrial Appendage - physiopathology</topic><topic>Atrial Appendage - surgery</topic><topic>Biological and medical sciences</topic><topic>Body Surface Potential Mapping - methods</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular system</topic><topic>Catheter Ablation - methods</topic><topic>Coronary Sinus - physiopathology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart</topic><topic>Heart Conduction System - physiopathology</topic><topic>Heart Conduction System - surgery</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Preoperative Care - methods</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Ultrasonic investigative techniques</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Miyazaki, Shinsuke</creatorcontrib><creatorcontrib>Shah, Ashok J</creatorcontrib><creatorcontrib>Liu, Xingpeng</creatorcontrib><creatorcontrib>Jadidi, Amir S</creatorcontrib><creatorcontrib>Nault, Isabelle</creatorcontrib><creatorcontrib>Wright, Matthew</creatorcontrib><creatorcontrib>Forclaz, Andrei</creatorcontrib><creatorcontrib>Linton, Nick</creatorcontrib><creatorcontrib>Xhaët, Olivier</creatorcontrib><creatorcontrib>Rivard, Lena</creatorcontrib><creatorcontrib>Derval, Nicolas</creatorcontrib><creatorcontrib>Knecht, Sébastien</creatorcontrib><creatorcontrib>Sacher, Frédéric</creatorcontrib><creatorcontrib>Hocini, Mélèze</creatorcontrib><creatorcontrib>Jaïs, Pierre</creatorcontrib><creatorcontrib>Haïssaguerre, Michel</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation. Arrhythmia and electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Miyazaki, Shinsuke</au><au>Shah, Ashok J</au><au>Liu, Xingpeng</au><au>Jadidi, Amir S</au><au>Nault, Isabelle</au><au>Wright, Matthew</au><au>Forclaz, Andrei</au><au>Linton, Nick</au><au>Xhaët, Olivier</au><au>Rivard, Lena</au><au>Derval, Nicolas</au><au>Knecht, Sébastien</au><au>Sacher, Frédéric</au><au>Hocini, Mélèze</au><au>Jaïs, Pierre</au><au>Haïssaguerre, Michel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preprocedural Clinical Parameters Determining Perimitral Conduction Time During Mitral Isthmus Line Ablation</atitle><jtitle>Circulation. Arrhythmia and electrophysiology</jtitle><addtitle>Circ Arrhythm Electrophysiol</addtitle><date>2011-06</date><risdate>2011</risdate><volume>4</volume><issue>3</issue><spage>287</spage><epage>294</epage><pages>287-294</pages><issn>1941-3149</issn><eissn>1941-3084</eissn><abstract>BACKGROUND—Achievement of complete conduction block across left mitral isthmus (MI) is challenging. Anticipation of perimitral conduction time (PMCT) associated with MI block may expedite this procedure. We evaluated the relationship between the preprocedural variables and the quantum of PMCT in patients with bidirectionally blocked MI.
METHODS AND RESULTS—We reviewed clinical and echocardiographic parameters in 290 consecutive patients with confirmed bidirectional MI block during atrial fibrillation (AF) ablation. PMCT was defined as the temporal delay to the latest of the double potentials on the line of block while pacing posteroseptal to it in the left atrium (LA). LA size and type of AF significantly influenced PMCT in multivariate analysis. A cumulative score based on LA size (0≦45 mm; 1>45 mm) and type of AF (0paroxysmal; 1=nonparoxysmal) ranged from 0 to 2. PMCT was directly correlated to the cumulative score (0169 ms; n=78; 95% confidential interval, 156 to 181); 1187 ms; n=103; 95% confidential interval, 178 to 196; 2209 ms; n=109; 95% confidential interval, 200 to 217). In 61 patients who underwent AF ablation twice, the difference between 2 PMCT values was <30 ms in 75% patients. Another consecutive 143 patients with and without MI block after at least 15 minutes of radiofrequency application were analyzed. Perimitral conduction delay <130 ms ruled out bidirectional MI block. Perimitral conduction delay >173 ms predicted bidirectional block with an accuracy of 86%.
CONCLUSIONS—LA size and AF type significantly influence PMCT in patients undergoing successful MI ablation. These parameters can be used to predict the time value associated with MI block, preprocedurally.</abstract><cop>Hagerstown, MD</cop><pub>American Heart Association, Inc</pub><pmid>21372269</pmid><doi>10.1161/CIRCEP.110.958983</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1941-3149 |
| ispartof | Circulation. Arrhythmia and electrophysiology, 2011-06, Vol.4 (3), p.287-294 |
| issn | 1941-3149 1941-3084 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_872130241 |
| source | MEDLINE; American Heart Association Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | Atrial Appendage - physiopathology Atrial Appendage - surgery Biological and medical sciences Body Surface Potential Mapping - methods Cardiac dysrhythmias Cardiology. Vascular system Cardiovascular system Catheter Ablation - methods Coronary Sinus - physiopathology Female Follow-Up Studies Heart Heart Conduction System - physiopathology Heart Conduction System - surgery Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Preoperative Care - methods Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Retrospective Studies Treatment Outcome Ultrasonic investigative techniques |
| title | Preprocedural Clinical Parameters Determining Perimitral Conduction Time During Mitral Isthmus Line Ablation |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-22T01%3A01%3A27IST&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=Preprocedural%20Clinical%20Parameters%20Determining%20Perimitral%20Conduction%20Time%20During%20Mitral%20Isthmus%20Line%20Ablation&rft.jtitle=Circulation.%20Arrhythmia%20and%20electrophysiology&rft.au=Miyazaki,%20Shinsuke&rft.date=2011-06&rft.volume=4&rft.issue=3&rft.spage=287&rft.epage=294&rft.pages=287-294&rft.issn=1941-3149&rft.eissn=1941-3084&rft_id=info:doi/10.1161/CIRCEP.110.958983&rft_dat=%3Cproquest_cross%3E872130241%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=872130241&rft_id=info:pmid/21372269&rfr_iscdi=true |