Significance of abnormal and late ventricular signals in ventricular tachycardia ablation of ischemic and nonischemic cardiomyopathies

BACKGROUND

Abnormal ventricular signals (AVS) are the cornerstone of substrate-based ventricular tachycardia (VT) ablation in sinus rhythm. Signal characterization of AVS in ischemic and nonischemic cardiomyopathies has never been performed.

OBJECTIVE

The purpose of this study was to describe ventricular signal abnormalities in 3 different pathologies and examine their association with the diastolic component of VT circuits.

METHODS

A total of 45 patients (15 ischemic cardiomyopathy [ICM], 15 arrhythmogenic cardiomyopathy [ACM], 15 dilated cardiomyopathy [DCM]) who had undergone VT ablation with >50% of the diastolic pathway of the VT circuit recorded were studied. AVS were classified into late potentials (LPs) and continuous fractionated ventricular signals (CFVS), and their characteristics and correlation with the diastolic pathway of VT circuits were analyzed.

RESULTS

Seventy-five VT circuits were analyzed. Bipolar scars were greatest in ICM endocardially (53 cm² ICM vs 36 cm² ACM vs 25 cm² DCM; P = .010) and in ACM epicardially (98 cm² ACM vs 25 cm² ICM vs 24 cm² DCM; P = .005). Location of the VT diastolic interval coincided with AVS location in 54% of VTs in ICM, 89% in ACM, and 72% in DCM (P = .036). There was a trend toward a greater association of diastolic intervals coinciding with LPs than with CFVS (78% vs 57%; P = .052) (69% diastolic intervals in ICM coincided with LPs, 33% with CFVS; P = .063). All patients (100%) with CFVS in ACM had VT diastolic components arising from CFVS (33% ICM, 64% DCM; P = .049). Positive predictive value for LPs vs CFVS was 77.8% vs 56.7%, and sensitivity was 67.3% vs 32.7%, respectively.

CONCLUSION

The nature of abnormal signals in different cardiomyopathies reflects underlying pathology. LPs rather than CFVS seem to be more linked to diastolic components of VT circuits, especially in ICM. LPs have greater sensitivity and specificity for VT; however, CFVS may be of more relevance in ACM.

Effects of dietary supplementation with extruded linseed and oregano in autochthonous goat breeds on the fatty acid profile of milk and quality of Padraccio cheese

The study aimed to evaluate the effects of linseed and oregano supplementation to the diet of goats on fatty acid profile and sensory properties of Padraccio, a typical cheese produced during spring through summer in the Basilicata region (southern Italy). Extruded linseed and dried oregano inflorescences were integrated in the pelleted concentrate supplementation (500 g/head per day) in 21 grazing goats that were randomly assigned, 7 per group, to the following experimental treatments: concentrate, concentrate with addition of linseed, and concentrate with addition of linseed and oregano. Pooled milk from each group was used in cheesemaking. From a nutritional perspective, integration of extruded linseed in the goat diet improved the fatty acid profile of Padraccio cheese. Moreover, the cheese from this group evidenced the highest scoring on color, flavor, texture, and overall liking.

Bone health in menopausal women: a role for General Practitioners

General Practitioners (GPs) are in a prime location to assess patient health needs, knowing clinical history, living habits and risk factors. GPs can identify in healthy people those in which prevention could be useful, in order to avoid or delay some diseases. For this purpose GPs need to change their care model from a waiting model to a proactive model, in order to identify health needs before the development of diseases.

Effects of different heat treatments on lysozyme quantity and antimicrobial activity of jenny milk

Thermal treatments are used to improve milk microbial safety, shelf life, and biological activity of some of its components. However, thermal treatments can reduce the nutritional quality of milk, affecting the molecular structure of milk proteins, such as lysozyme, which is a very important milk component due to its antimicrobial effect against gram-positive bacteria. Jenny milk is characterized by high lysozyme content. For this reason, in the last few years, it has been used as an antimicrobial additive in dairy products as an alternative to hen egg white lysozyme, which can cause allergic reactions. This study aimed to investigate the effect of pasteurization and condensation on the concentration and antimicrobial activity of lysozyme in jenny milk. Furthermore, lysozyme quantity and activity were tested in raw and pasteurized milk after condensation at 40 and 20% of the initial volume. Reversed-phase HPLC was performed under fluorescence detection to monitor lysozyme in milk samples. We evaluated the antimicrobial activity of the tested milk against Bacillus megaterium, Bacillus mojavensis, Clavibacter michiganensis, Clostridium tyrobutyricum, Xanthomonas campestris, and Escherichia coli. Condensation and pasteurization did not affect the concentration or antimicrobial activity of lysozyme in jenny milk, except for B. mojaventis, which showed resistance to lysozyme in milk samples subjected to heat treatments. Moreover, lysozyme in jenny milk showed antimicrobial activity similar to synthetic antibiotics versus some gram-positive strains and also versus the gram-negative strain X. campestris.