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- Ekanem, Emmanuel, et al.
(författare)
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Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study
- 2024
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Ingår i: Nature Medicine. - : NATURE PORTFOLIO. - 1078-8956 .- 1546-170X.
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Tidskriftsartikel (refereegranskat)abstract
- Pulsed field ablation (PFA) is an emerging technology for the treatment of atrial fibrillation (AF), for which pre-clinical and early-stage clinical data are suggestive of some degree of preferentiality to myocardial tissue ablation without damage to adjacent structures. Here in the MANIFEST-17K study we assessed the safety of PFA by studying the post-approval use of this treatment modality. Of the 116 centers performing post-approval PFA with a pentaspline catheter, data were received from 106 centers (91.4% participation) regarding 17,642 patients undergoing PFA (mean age 64, 34.7% female, 57.8% paroxysmal AF and 35.2% persistent AF). No esophageal complications, pulmonary vein stenosis or persistent phrenic palsy was reported (transient palsy was reported in 0.06% of patients; 11 of 17,642). Major complications, reported for similar to 1% of patients (173 of 17,642), were pericardial tamponade (0.36%; 63 of 17,642) and vascular events (0.30%; 53 of 17,642). Stroke was rare (0.12%; 22 of 17,642) and death was even rarer (0.03%; 5 of 17,642). Unexpected complications of PFA were coronary arterial spasm in 0.14% of patients (25 of 17,642) and hemolysis-related acute renal failure necessitating hemodialysis in 0.03% of patients (5 of 17,642). Taken together, these data indicate that PFA demonstrates a favorable safety profile by avoiding much of the collateral damage seen with conventional thermal ablation. PFA has the potential to be transformative for the management of patients with AF.
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| 2. |
- Vivek, S.S., et al.
(författare)
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Impact and Durability Properties of Alccofine-Based Hybrid Fibre-Reinforced Self-Compacting Concrete
- 2023
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Ingår i: Case Studies in Construction Materials. - : Elsevier. - 2214-5095. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Many research works have already been made and are still in progress on metallic fibres, as their incorporation reduces the brittleness of the concrete and improves its resistance to the impact and crack propagation. But the use of such non-metallic fibres may induce corrosion which is a major problem to be addressed from the durability aspect. To overcome this problem, in the present research work, a non-metallic hybrid fibre combination was investigated with synthetic fibres like polypropylene and abaca fibres. Also, rather than using conventional cementitious materials such as silica fume, fly ash, and ground granulated blast furnace slag, a new generation of ultra-fine material namely alccofine was used as a partial replacement for the cement by 15%. Abaca fibre was utilised in a constant addition of 0.5% and blended with polypropylene fibre in a range varying from 0% to 2% with an increment of 0.5%. The fresh properties of self-compacting concrete (SCC) in mono and hybrid fibres combinations were assessed through slump flow, J-ring, and V-funnel tests. Water absorption and sorptivity tests were conducted to ensure the durability of the prepared mix. Further, impact tests were carried out on the prepared cylinder specimens to check the capability of the mix with the non-metallic hybrid combination. The main objective here was to check whether a high-strength durable SCC could be achieved using non-metallic fibres and natural fibres. From the obtained experimental results, it was observed that 15% alccofine as a partial substitute to the cement with the addition of 0.5% of abaca fibre and 2% of polypropylene fibre to SCC performed better than the control SCC.
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