Recognition of inferiorly dislocated fast pathways guided by three-dimensional electro-anatomical mapping
Purpose Slow pathway (SP) ablation of atrioventricular (AV) nodal reentrant tachycardia (AVNRT) can be complicated by unexpected AV block even at sites >10 mm inferior to the bundle of His (HB), and one cause is thought to be the inferior dislocation of an antegrade fast pathway (A-FP). We assess...
Gespeichert in:
Veröffentlicht in: | Journal of interventional cardiac electrophysiology 2011-11, Vol.32 (2), p.95-103 |
---|---|
Hauptverfasser: | , , , , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 103 |
---|---|
container_issue | 2 |
container_start_page | 95 |
container_title | Journal of interventional cardiac electrophysiology |
container_volume | 32 |
creator | Tanaka, Satoko Yoshida, Akihiro Fukuzawa, Koji Takei, Asumi Kanda, Gaku Takami, Kaoru Kumagai, Hiroyuki Takami, Mitsuru Itoh, Mitsuaki Imamura, Kimitake Fujiwara, Ryudo Hirata, Ken-ichi |
description | Purpose
Slow pathway (SP) ablation of atrioventricular (AV) nodal reentrant tachycardia (AVNRT) can be complicated by unexpected AV block even at sites >10 mm inferior to the bundle of His (HB), and one cause is thought to be the inferior dislocation of an antegrade fast pathway (A-FP). We assessed locations of FPs guided by CARTO.
Methods
Sites of FPs were mapped guided by CARTO before SP ablation in 18 patients with slow–fast AVNRT. The A-FP was defined as the site with the minimum interval between the stimulus and HB potential when pace mapping in the right atrial septum.
Results
The A-FP was 7.9 ± 7.5 mm inferior and 2.9 ± 5.0 mm posterior to the HB. In 6 of 18 patients (33%), the A-FP was inferiorly dislocated >10 mm to the HB. SP ablation was successfully performed in all patients at sites >10 mm from both the HB and the A-FP without AV block. In the inferiorly dislocated A-FP group, A-FPs seemed to be positioned much more on atrial sites and sufficiently posterior to SP ablation sites.
Conclusions
The A-FP inferiorly dislocated >10 mm to the HB in one third of patients with AVNRT and seemed to be positioned deep on atrial sites. It is again emphasized that SP ablation within the triangle of Koch should be performed at a very ventricular annulus site, particularly in the inferiorly dislocated A-FP group. |
doi_str_mv | 10.1007/s10840-011-9595-8 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_901304705</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2497631611</sourcerecordid><originalsourceid>FETCH-LOGICAL-c436t-68ef188205214a840c0f672abd080e61686008ea7bbfb84c2dbd913e2bb51d5b3</originalsourceid><addsrcrecordid>eNp1kUuLFTEQhYMozssf4EYaN66iVelXejkM6gwMCKIwu5BH9Z0M3Z02SSP335vLnVEYcJXk5KtTVB3G3iJ8RID-U0KQDXBA5EM7tFy-YKfY9oLL8npZ7rWsuezbuxN2ltIDAAwgutfsRGAPKBtxyvx3smG3-OzDUoWx8stI0Yc47Svn0xSszuSqUadcrTrf_9b7VO0274po9lW-j0Tc-ZmWVAz0VNFENsfA9aJzmL0t0qzX1S-7C_Zq1FOiN4_nOfv55fOPq2t---3rzdXlLbdN3WXeSRpRSgGtwEaX8SyMXS-0cSCBOuxkByBJ98aMRjZWOOMGrEkY06JrTX3OPhx91xh-bZSymn2yNE16obAlNQDW0PTQFvL9M_IhbLFMcYBgQMS6LhAeIRtDSpFGtUY_67hXCOqQgjqmoEoK6pCCkqXm3aPxZmZyfyue1l4AcQRS-Vp2FP91_r_rH99Zk7E</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>900911133</pqid></control><display><type>article</type><title>Recognition of inferiorly dislocated fast pathways guided by three-dimensional electro-anatomical mapping</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Tanaka, Satoko ; Yoshida, Akihiro ; Fukuzawa, Koji ; Takei, Asumi ; Kanda, Gaku ; Takami, Kaoru ; Kumagai, Hiroyuki ; Takami, Mitsuru ; Itoh, Mitsuaki ; Imamura, Kimitake ; Fujiwara, Ryudo ; Hirata, Ken-ichi</creator><creatorcontrib>Tanaka, Satoko ; Yoshida, Akihiro ; Fukuzawa, Koji ; Takei, Asumi ; Kanda, Gaku ; Takami, Kaoru ; Kumagai, Hiroyuki ; Takami, Mitsuru ; Itoh, Mitsuaki ; Imamura, Kimitake ; Fujiwara, Ryudo ; Hirata, Ken-ichi</creatorcontrib><description>Purpose
Slow pathway (SP) ablation of atrioventricular (AV) nodal reentrant tachycardia (AVNRT) can be complicated by unexpected AV block even at sites >10 mm inferior to the bundle of His (HB), and one cause is thought to be the inferior dislocation of an antegrade fast pathway (A-FP). We assessed locations of FPs guided by CARTO.
Methods
Sites of FPs were mapped guided by CARTO before SP ablation in 18 patients with slow–fast AVNRT. The A-FP was defined as the site with the minimum interval between the stimulus and HB potential when pace mapping in the right atrial septum.
Results
The A-FP was 7.9 ± 7.5 mm inferior and 2.9 ± 5.0 mm posterior to the HB. In 6 of 18 patients (33%), the A-FP was inferiorly dislocated >10 mm to the HB. SP ablation was successfully performed in all patients at sites >10 mm from both the HB and the A-FP without AV block. In the inferiorly dislocated A-FP group, A-FPs seemed to be positioned much more on atrial sites and sufficiently posterior to SP ablation sites.
Conclusions
The A-FP inferiorly dislocated >10 mm to the HB in one third of patients with AVNRT and seemed to be positioned deep on atrial sites. It is again emphasized that SP ablation within the triangle of Koch should be performed at a very ventricular annulus site, particularly in the inferiorly dislocated A-FP group.</description><identifier>ISSN: 1383-875X</identifier><identifier>EISSN: 1572-8595</identifier><identifier>DOI: 10.1007/s10840-011-9595-8</identifier><identifier>PMID: 21701842</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Adult ; Aged ; Body Surface Potential Mapping - methods ; Bundle of His - physiopathology ; Cardiac Electrophysiology - methods ; Cardiology ; Catheter Ablation - adverse effects ; Catheter Ablation - methods ; Cohort Studies ; Female ; Follow-Up Studies ; Heart Rate - physiology ; Humans ; Imaging, Three-Dimensional - methods ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Monitoring, Intraoperative - instrumentation ; Preoperative Care - methods ; Recovery of Function ; Risk Assessment ; Severity of Illness Index ; Tachycardia, Atrioventricular Nodal Reentry - diagnosis ; Tachycardia, Atrioventricular Nodal Reentry - surgery ; Treatment Outcome</subject><ispartof>Journal of interventional cardiac electrophysiology, 2011-11, Vol.32 (2), p.95-103</ispartof><rights>Springer Science+Business Media, LLC 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c436t-68ef188205214a840c0f672abd080e61686008ea7bbfb84c2dbd913e2bb51d5b3</citedby><cites>FETCH-LOGICAL-c436t-68ef188205214a840c0f672abd080e61686008ea7bbfb84c2dbd913e2bb51d5b3</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/s10840-011-9595-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10840-011-9595-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21701842$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tanaka, Satoko</creatorcontrib><creatorcontrib>Yoshida, Akihiro</creatorcontrib><creatorcontrib>Fukuzawa, Koji</creatorcontrib><creatorcontrib>Takei, Asumi</creatorcontrib><creatorcontrib>Kanda, Gaku</creatorcontrib><creatorcontrib>Takami, Kaoru</creatorcontrib><creatorcontrib>Kumagai, Hiroyuki</creatorcontrib><creatorcontrib>Takami, Mitsuru</creatorcontrib><creatorcontrib>Itoh, Mitsuaki</creatorcontrib><creatorcontrib>Imamura, Kimitake</creatorcontrib><creatorcontrib>Fujiwara, Ryudo</creatorcontrib><creatorcontrib>Hirata, Ken-ichi</creatorcontrib><title>Recognition of inferiorly dislocated fast pathways guided by three-dimensional electro-anatomical mapping</title><title>Journal of interventional cardiac electrophysiology</title><addtitle>J Interv Card Electrophysiol</addtitle><addtitle>J Interv Card Electrophysiol</addtitle><description>Purpose
Slow pathway (SP) ablation of atrioventricular (AV) nodal reentrant tachycardia (AVNRT) can be complicated by unexpected AV block even at sites >10 mm inferior to the bundle of His (HB), and one cause is thought to be the inferior dislocation of an antegrade fast pathway (A-FP). We assessed locations of FPs guided by CARTO.
Methods
Sites of FPs were mapped guided by CARTO before SP ablation in 18 patients with slow–fast AVNRT. The A-FP was defined as the site with the minimum interval between the stimulus and HB potential when pace mapping in the right atrial septum.
Results
The A-FP was 7.9 ± 7.5 mm inferior and 2.9 ± 5.0 mm posterior to the HB. In 6 of 18 patients (33%), the A-FP was inferiorly dislocated >10 mm to the HB. SP ablation was successfully performed in all patients at sites >10 mm from both the HB and the A-FP without AV block. In the inferiorly dislocated A-FP group, A-FPs seemed to be positioned much more on atrial sites and sufficiently posterior to SP ablation sites.
Conclusions
The A-FP inferiorly dislocated >10 mm to the HB in one third of patients with AVNRT and seemed to be positioned deep on atrial sites. It is again emphasized that SP ablation within the triangle of Koch should be performed at a very ventricular annulus site, particularly in the inferiorly dislocated A-FP group.</description><subject>Adult</subject><subject>Aged</subject><subject>Body Surface Potential Mapping - methods</subject><subject>Bundle of His - physiopathology</subject><subject>Cardiac Electrophysiology - methods</subject><subject>Cardiology</subject><subject>Catheter Ablation - adverse effects</subject><subject>Catheter Ablation - methods</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Rate - physiology</subject><subject>Humans</subject><subject>Imaging, Three-Dimensional - methods</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Monitoring, Intraoperative - instrumentation</subject><subject>Preoperative Care - methods</subject><subject>Recovery of Function</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><subject>Tachycardia, Atrioventricular Nodal Reentry - diagnosis</subject><subject>Tachycardia, Atrioventricular Nodal Reentry - surgery</subject><subject>Treatment Outcome</subject><issn>1383-875X</issn><issn>1572-8595</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kUuLFTEQhYMozssf4EYaN66iVelXejkM6gwMCKIwu5BH9Z0M3Z02SSP335vLnVEYcJXk5KtTVB3G3iJ8RID-U0KQDXBA5EM7tFy-YKfY9oLL8npZ7rWsuezbuxN2ltIDAAwgutfsRGAPKBtxyvx3smG3-OzDUoWx8stI0Yc47Svn0xSszuSqUadcrTrf_9b7VO0274po9lW-j0Tc-ZmWVAz0VNFENsfA9aJzmL0t0qzX1S-7C_Zq1FOiN4_nOfv55fOPq2t---3rzdXlLbdN3WXeSRpRSgGtwEaX8SyMXS-0cSCBOuxkByBJ98aMRjZWOOMGrEkY06JrTX3OPhx91xh-bZSymn2yNE16obAlNQDW0PTQFvL9M_IhbLFMcYBgQMS6LhAeIRtDSpFGtUY_67hXCOqQgjqmoEoK6pCCkqXm3aPxZmZyfyue1l4AcQRS-Vp2FP91_r_rH99Zk7E</recordid><startdate>20111101</startdate><enddate>20111101</enddate><creator>Tanaka, Satoko</creator><creator>Yoshida, Akihiro</creator><creator>Fukuzawa, Koji</creator><creator>Takei, Asumi</creator><creator>Kanda, Gaku</creator><creator>Takami, Kaoru</creator><creator>Kumagai, Hiroyuki</creator><creator>Takami, Mitsuru</creator><creator>Itoh, Mitsuaki</creator><creator>Imamura, Kimitake</creator><creator>Fujiwara, Ryudo</creator><creator>Hirata, Ken-ichi</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>20111101</creationdate><title>Recognition of inferiorly dislocated fast pathways guided by three-dimensional electro-anatomical mapping</title><author>Tanaka, Satoko ; Yoshida, Akihiro ; Fukuzawa, Koji ; Takei, Asumi ; Kanda, Gaku ; Takami, Kaoru ; Kumagai, Hiroyuki ; Takami, Mitsuru ; Itoh, Mitsuaki ; Imamura, Kimitake ; Fujiwara, Ryudo ; Hirata, Ken-ichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c436t-68ef188205214a840c0f672abd080e61686008ea7bbfb84c2dbd913e2bb51d5b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Body Surface Potential Mapping - methods</topic><topic>Bundle of His - physiopathology</topic><topic>Cardiac Electrophysiology - methods</topic><topic>Cardiology</topic><topic>Catheter Ablation - adverse effects</topic><topic>Catheter Ablation - methods</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Rate - physiology</topic><topic>Humans</topic><topic>Imaging, Three-Dimensional - methods</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Monitoring, Intraoperative - instrumentation</topic><topic>Preoperative Care - methods</topic><topic>Recovery of Function</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><topic>Tachycardia, Atrioventricular Nodal Reentry - diagnosis</topic><topic>Tachycardia, Atrioventricular Nodal Reentry - surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tanaka, Satoko</creatorcontrib><creatorcontrib>Yoshida, Akihiro</creatorcontrib><creatorcontrib>Fukuzawa, Koji</creatorcontrib><creatorcontrib>Takei, Asumi</creatorcontrib><creatorcontrib>Kanda, Gaku</creatorcontrib><creatorcontrib>Takami, Kaoru</creatorcontrib><creatorcontrib>Kumagai, Hiroyuki</creatorcontrib><creatorcontrib>Takami, Mitsuru</creatorcontrib><creatorcontrib>Itoh, Mitsuaki</creatorcontrib><creatorcontrib>Imamura, Kimitake</creatorcontrib><creatorcontrib>Fujiwara, Ryudo</creatorcontrib><creatorcontrib>Hirata, Ken-ichi</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>Tanaka, Satoko</au><au>Yoshida, Akihiro</au><au>Fukuzawa, Koji</au><au>Takei, Asumi</au><au>Kanda, Gaku</au><au>Takami, Kaoru</au><au>Kumagai, Hiroyuki</au><au>Takami, Mitsuru</au><au>Itoh, Mitsuaki</au><au>Imamura, Kimitake</au><au>Fujiwara, Ryudo</au><au>Hirata, Ken-ichi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Recognition of inferiorly dislocated fast pathways guided by three-dimensional electro-anatomical mapping</atitle><jtitle>Journal of interventional cardiac electrophysiology</jtitle><stitle>J Interv Card Electrophysiol</stitle><addtitle>J Interv Card Electrophysiol</addtitle><date>2011-11-01</date><risdate>2011</risdate><volume>32</volume><issue>2</issue><spage>95</spage><epage>103</epage><pages>95-103</pages><issn>1383-875X</issn><eissn>1572-8595</eissn><abstract>Purpose
Slow pathway (SP) ablation of atrioventricular (AV) nodal reentrant tachycardia (AVNRT) can be complicated by unexpected AV block even at sites >10 mm inferior to the bundle of His (HB), and one cause is thought to be the inferior dislocation of an antegrade fast pathway (A-FP). We assessed locations of FPs guided by CARTO.
Methods
Sites of FPs were mapped guided by CARTO before SP ablation in 18 patients with slow–fast AVNRT. The A-FP was defined as the site with the minimum interval between the stimulus and HB potential when pace mapping in the right atrial septum.
Results
The A-FP was 7.9 ± 7.5 mm inferior and 2.9 ± 5.0 mm posterior to the HB. In 6 of 18 patients (33%), the A-FP was inferiorly dislocated >10 mm to the HB. SP ablation was successfully performed in all patients at sites >10 mm from both the HB and the A-FP without AV block. In the inferiorly dislocated A-FP group, A-FPs seemed to be positioned much more on atrial sites and sufficiently posterior to SP ablation sites.
Conclusions
The A-FP inferiorly dislocated >10 mm to the HB in one third of patients with AVNRT and seemed to be positioned deep on atrial sites. It is again emphasized that SP ablation within the triangle of Koch should be performed at a very ventricular annulus site, particularly in the inferiorly dislocated A-FP group.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>21701842</pmid><doi>10.1007/s10840-011-9595-8</doi><tpages>9</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1383-875X |
ispartof | Journal of interventional cardiac electrophysiology, 2011-11, Vol.32 (2), p.95-103 |
issn | 1383-875X 1572-8595 |
language | eng |
recordid | cdi_proquest_miscellaneous_901304705 |
source | MEDLINE; SpringerLink Journals - AutoHoldings |
subjects | Adult Aged Body Surface Potential Mapping - methods Bundle of His - physiopathology Cardiac Electrophysiology - methods Cardiology Catheter Ablation - adverse effects Catheter Ablation - methods Cohort Studies Female Follow-Up Studies Heart Rate - physiology Humans Imaging, Three-Dimensional - methods Male Medicine Medicine & Public Health Middle Aged Monitoring, Intraoperative - instrumentation Preoperative Care - methods Recovery of Function Risk Assessment Severity of Illness Index Tachycardia, Atrioventricular Nodal Reentry - diagnosis Tachycardia, Atrioventricular Nodal Reentry - surgery Treatment Outcome |
title | Recognition of inferiorly dislocated fast pathways guided by three-dimensional electro-anatomical mapping |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-10T03%3A15%3A37IST&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=Recognition%20of%20inferiorly%20dislocated%20fast%20pathways%20guided%20by%20three-dimensional%20electro-anatomical%20mapping&rft.jtitle=Journal%20of%20interventional%20cardiac%20electrophysiology&rft.au=Tanaka,%20Satoko&rft.date=2011-11-01&rft.volume=32&rft.issue=2&rft.spage=95&rft.epage=103&rft.pages=95-103&rft.issn=1383-875X&rft.eissn=1572-8595&rft_id=info:doi/10.1007/s10840-011-9595-8&rft_dat=%3Cproquest_cross%3E2497631611%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=900911133&rft_id=info:pmid/21701842&rfr_iscdi=true |