Coronavirus Disease 2019: Hysteresis Effect of Chest CT and the Correlation with its Severity

2021 ◽  
Vol 17 ◽  
Author(s):  
Kui Li ◽  
Wei Wang ◽  
Lei Wu ◽  
Changwu Zhao ◽  
Zicheng Jiang ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Lung Volume ◽  
Lymphocyte Count ◽  
Statistical Significance ◽  
Symptom Relief ◽  
Univariate Analysis ◽  
Chest Ct ◽  
Hysteresis Effect ◽  
Transcutaneous Oxygen ◽  
Total Lung Volume

Purpose: The purpose of this study was to investigate the influencing factors for chest CT hysteresis and severity of coronavirus disease 2019 (COVID-19). Methods: The chest CT data of patients with confirmed COVID-19 in 4 hospitals were retrospectively analyzed. An independent assessment was performed by one clinician using the DEXIN FACT Workstation Analysis System, and the assessment results were reviewed by another clinician. Furthermore, the mean hysteresis time was calculated according to the median time from progression to the most serious situation to improve chest CT in patients after fever relief. The optimal scaling regression analysis was performed by including variables with statistical significance in univariate analysis. In addition, a multivariate regression model was established to investigate the relationship of the percentage of lesion/total lung volume with lymphocyte and other variables. Results: In the included 166 patients with COVID-19, the average value of the most serious percentage of lesion/total lung volume was 6.62, of which 90 patients with fever had an average hysteresis time of 4.5 days after symptom relief, with a similar trend observed in those without fever. Multivariate analysis revealed that lymphocyte count in peripheral blood and transcutaneous oxygen saturation decreased with the increase of the percentage of lesion/total lung volume. Conclusion: There is a hysteresis effect in the improvement of chest CT image relative to fever relief in patients with COVID-19. The pulmonary lesions may be related to the severity as well as decreased lymphocyte count or percutaneous oxygen saturation.

scholarly journals Corona virus disease 2019: hysteresis effect of chest CT and the correlation of its severity with lymphocyte count in peripheral blood

2020 ◽  
Author(s):  
Kui Li ◽  
Wei Wang ◽  
Chang-Wu Zhao ◽  
Lei Wu ◽  
Ya-Nan Zhu ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Lung Volume ◽  
Peripheral Blood ◽  
Lymphocyte Count ◽  
Virus Disease ◽  
Chest Ct ◽  
Hysteresis Effect ◽  
Transcutaneous Oxygen ◽  
Total Lung Volume ◽  
Transcutaneous Oxygen Saturation

Abstract Background Chest computed tomography (CT) has been accepted to provide reference for the diagnose and assessment the severity of Corona Virus Disease 2019 (COVID-19). Decrease in the counts of lymphocyte and leukocyte is used as the diagnostic indicator of suspected COVID-19 cases. However, there is few study on exploring the hysteresis of chest CT changes and the predictive role of lymphocyte count in peripheral blood before treatment in the severity of the disease. Methods A retrospective analysis was carried out focusing on the data of patients tested to be positive for RNA nucleic acid test of SARS-CoV-2 with nasopharyngeal swabs in 4 hospitals. An independent assessment was performed by one clinician using the DEXIN FACT Workstation Analysis System, and the assessment results were reviewed by another clinician. Furthermore, the mean hysteresis time was calculated according to the median time from progression to the most serious situation to improvement of chest CT in patients after fever relief. The optimal scaling regression analysis was performed by including variables with statistical significance in univariate analysis. In addition, a multivariate regression model was established to investigate the relationship of the percentage of lesion/total lung volume with lymphocyte and other variables. Results In the included 166 patients with COVID-19, the average value of the most serious percentage of lesion/total lung volume was 6.62, of which 90 patients with fever had an average hysteresis time of 4.5 days after symptom relief, with a similar trend observed in those without fever. Multivariate analysis revealed that lymphocyte count in peripheral blood and transcutaneous oxygen saturation decreased with the increase of the percentage of lesion/total lung volume. Meanwhile, age, fever and C-reactive protein exhibited no such effect in the established model. Conclusions There is a hysteresis effect in the improvement of chest CT image in relative to fever relief in patients with COVID-19. Besides, the percentage of lesion/total lung volume of chest CT correlates negatively with lymphocyte count in peripheral blood and transcutaneous oxygen saturation. Findings in our study may contribute to understanding the disease status of patients with COVID-19 and grasping the opportunity of treatment by clinicians.

scholarly journals Evolution of CT Findings and Lung Residue in Patients with COVID-19 Pneumonia: Quantitative Analysis of the Disease with a Computer Automatic Tool

2021 ◽  
Vol 11 (7) ◽  
pp. 641
Author(s):  
Roberto Grassi ◽  
Salvatore Cappabianca ◽  
Fabrizio Urraro ◽  
Vincenza Granata ◽  
Giuliana Giacobbe ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Lung Disease ◽  
Lung Volume ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Ct Scans ◽  
P Value ◽  
Total Lung Volume ◽  
Computer Aided ◽  
Discharged Patients

Purpose: the purpose of this study was to assess the evolution of computed tomography (CT) findings and lung residue in patients with COVID-19 pneumonia, via quantified evaluation of the disease, using a computer aided tool. Materials and methods: we retrospectively evaluated 341 CT examinations of 140 patients (68 years of median age) infected with COVID-19 (confirmed by real-time reverse transcriptase polymerase chain reaction (RT-PCR)), who were hospitalized, and who received clinical and CT examinations. All CTs were evaluated by two expert radiologists, in consensus, at the same reading session, using a computer-aided tool for quantification of the pulmonary disease. The parameters obtained using the computer tool included the healthy residual parenchyma, ground glass opacity, consolidation, and total lung volume. Results: statistically significant differences (p value ≤ 0.05) were found among quantified volumes of healthy residual parenchyma, ground glass opacity (GGO), consolidation, and total lung volume, considering different clinical conditions (stable, improved, and worsened). Statistically significant differences were found among quantified volumes for healthy residual parenchyma, GGO, and consolidation (p value ≤ 0.05) between dead patients and discharged patients. CT was not performed on cadavers; the death was an outcome, which was retrospectively included to differentiate findings of patients who survived vs. patients who died during hospitalization. Among discharged patients, complete disease resolutions on CT scans were observed in 62/129 patients with lung disease involvement ≤5%; lung disease involvement from 5% to 15% was found in 40/129 patients, while 27/129 patients had lung disease involvement between 16 and 30%. Moreover, 8–21 days (after hospital admission) was an “advanced period” with the most severe lung disease involvement. After the extent of involvement started to decrease—particularly after 21 days—the absorption was more obvious. Conclusions: a complete disease resolution on chest CT scans was observed in 48.1% of discharged patients using a computer-aided tool to quantify the GGO and consolidation volumes; after 16 days of hospital admission, the abnormalities identified by chest CT began to improve; in particular, the absorption was more obvious after 21 days.

The integrated interventional radiology match: a bibliometric analysis of matched first-year residents

2019 ◽  
Vol 3 ◽  
pp. 13 ◽  
Author(s):  
Vishnu Chandra ◽  
Neil Jain ◽  
Pratik Shukla ◽  
Ethan Wajswol ◽  
Sohail Contractor ◽  
...  
Keyword(s):  
Interventional Radiology ◽  
Bibliometric Analysis ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Impact Factors ◽  
Index Number ◽  
Research Information ◽  
H Index ◽  
Scopus Database ◽  
Journal Impact

Objectives: The integrated interventional radiology (IR) residency has only been established relatively recently as compared to other specialties. Although some preliminary information is available based on survey data five, no comprehensive bibliometric analysis documenting the importance of the quantity and quality of research in applying to an integrated-IR program currently exists. As the first bibliometric analysis of matched IR residents, the data obtained from this study fills a gap in the literature. Materials and Methods: A list of matched residents from the 2018 integrated-IR match were identified by contacting program directors. The Scopus database was used to search for resident research information, including total publications, first-author publications, radiology-related publications, and h-indices. Each matriculating program was categorized into one of five tiers based on the average faculty Hirsch index (h-index). Results: Sixty-three programs and 117 matched residents were identified and reviewed on the Scopus database. For the 2018 cycle, 274 total publications were produced by matched applicants, with a mean of 2.34 ± 0.41 publication per matched applicant. The average h-index for matched applicants was 0.96 ± 0.13. On univariate analysis, the number of radiology-related publications, highest journal impact factor, and h-index were all associated with an increased likelihood of matching into a higher tier program (P < 0.05). Other research variables displayed no statistical significance. All applicants with PhDs matched into tier one programs. Conclusions: Research serves as an important element in successfully matching into an integrated-IR residency. h-index, number of radiology-related manuscripts, and highest journal impact factors are all positively associated with matching into a higher tier program.

Predictors of Faster Decline of Residual Renal Function in Taiwanese Peritoneal Dialysis Patients

2008 ◽  
Vol 28 (3_suppl) ◽  
pp. 191-195 ◽  
Author(s):  
Chia-Te Liao ◽  
Chih-Chung Shiao ◽  
Jenq-Wen Huang ◽  
Kuan-Yu Hung ◽  
Hsueh-Fang Chuang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Renal Function ◽  
Peritoneal Dialysis ◽  
Clinical Laboratory ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Residual Renal Function ◽  
Measure Data ◽  
Chi Square ◽  
Artery Disease

⋄ Objective Loss of residual renal function (RRF) in peritoneal dialysis (PD) patients is a powerful predictor of mortality. The present study was conducted to determine the predictors of faster decline of RRF in PD patients in Taiwan. ⋄ Methods The study enrolled 270 patients starting PD between January 1996 and December 2005 in a single hospital in Taiwan. We calculated RRF as the mean of the sum of 24-hour urea and creatinine clearance. The slope of the decline of residual glomerular filtration rate (GFR) was the main outcome measure. Data on demographic, clinical, laboratory, and treatment parameters; episodes of peritonitis; and hypotensive events were analyzed by Student t-test, Mann–Whitney U-test, and chi-square, as appropriate. All variables with statistical significance were included in a multivariate linear regression model to select the best predictors ( p < 0.05) for faster decline of residual GFR. ⋄ Results All patients commencing PD during the study period were followed for 39.4 ± 24.0 months (median: 35.5 months). The average annual rate of decline of residual GFR was 1.377 ± 1.47 mL/min/m2. On multivariate analysis, presence of diabetes mellitus ( p < 0.001), higher baseline residual GFR ( p < 0.001), hypotensive events ( p = 0.001), use of diuretics ( p = 0.002), and episodes of peritonitis ( p = 0.043) independently predicted faster decline of residual GFR. Male sex, old age, larger body mass index, and presence of coronary artery disease or congestive heart failure were also risk factors on univariate analysis. ⋄ Conclusions Our results suggested that diabetes mellitus, higher baseline residual GFR, hypotensive events, and use of diuretics are independently associated with faster decline of residual GFR in PD patients in Taiwan.

The effect of mask use on maternal oxygen saturation in term pregnancies during the COVID-19 process

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Erzat Toprak ◽  
Ayça Nazlı Bulut
Keyword(s):  
Oxygen Saturation ◽  
Pregnant Women ◽  
Stress Test ◽  
Statistical Significance ◽  
Categorical Variables ◽  
Fisher Exact Test ◽  
Coin Toss ◽  
Arterial Blood ◽  
Surgical Masks ◽  
Before And After

AbstractObjectivesOur aim was to evaluate the effect of standard surgical and N-95 respiratory mask use on maternal oxygen saturation, vital signs and result on non-stress tests in term pregnancies.MethodsIt is a prospective observational study. The study included healthy, not in labor, singleton pregnant women of 370/7–410/7 weeks who were applied to our hospital for routine obstetric control examination between March 1, 2020, and August 31, 2020. Patients were randomised by coin toss method. Oxygen saturation, systolic, and diastolic arterial blood pressure, pulse, respiratory rate, and temperature of pregnant women using surgical masks and respiratory masks were measured before and after the non-stress test. The tolerance of the masks was also evaluated. Student’s t-test was used for variables showing parametric distribution and the Mann Whitney U-test was used for non-parametric tests. The categorical variables between the groups was analyzed by using the Chi square test or Fisher Exact test. The statistical significance level was taken as p<0.05 in all tests.ResultsA total of 297 pregnant women using masks were included in the study. The effect of mask type on oxygen saturation before and after the non-stress test was found to be significant (97.1±1.8 corresponds to 95.3±2.6 for the surgical mask, p=0.0001; 97.8±1.7 corresponds to 93.7±2.0 for the respiratory mask, p=0.0001). Mask tolerance of patients using respiratory masks was significantly higher than those using surgical masks (mean 8, 1–10, p=0.0001).ConclusionsSurgical mask and respiratory mask usage decreased significantly in oxygen saturation in term pregnancies.

scholarly journals EPIDEMIOLOGY OF PEDIATRIC CARTILAGE RESTORATION PROCEDURES IN THE UNITED STATES: INSURANCE AND GEOGRAPHY PLAY A ROLE

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0024
Author(s):  
Tyler B. Hall ◽  
Max J. Hyman ◽  
Neeraj M. Patel
Keyword(s):  
United States ◽  
Children And Adolescents ◽  
Statistical Significance ◽  
Private Insurance ◽  
Univariate Analysis ◽  
The United States ◽  
National Database ◽  
The West ◽  
Cartilage Restoration ◽  
Common Diagnosis

Background: A number of surgical options are available for sizeable articular cartilage lesions of the knee. These include osteochondral autograft (OAU) or allograft (OAL) transfer, or autologous chondrocyte implantation (ACI). In the pediatric population, there is little data on the patients undergoing these procedures or evidence to support one technique over another, which may lead to variation in preferred practice. Hypothesis/Purpose: The purpose of this study is to analyze the epidemiology of children and adolescents undergoing OAU, OAL, and ACI in the United States, with attention to variation along the lines of demographic and geographic factors. Methods: The Pediatric Health Information System, a national database consisting of 49 children’s hospitals, was queried for all patients undergoing OAU, OAL, and ACI between 2012 and 2018. Demographic information was collected for each subject. United States Census guidelines were used to categorize hospitals geographically into regions. Univariate analysis was followed by purposeful entry multivariate regression to adjust for confounding factors. Results: A total of 809 subjects with a mean age of 15.4±2.4 years were included in the analysis. Of these, 393 (48.6%) underwent OAL, 339 (41.9%) underwent OAU, and 77 (9.5%) underwent ACI. The most common diagnosis at the time of surgery was osteochondritis dissecans in 360 patients (44.5%) followed by an associated cruciate ligament injury in 126 (15.6%) and patellar instability in 98 (12.1%). After adjusting for confounders in a multivariate model, ACI was more 3.4 times more likely to be performed in patients with private insurance than those that were publicly insured (95% CI 1.5-7.5, p=0.002). Furthermore, a patient in this Northeast was 29.3 times more likely to undergo ACI than in the West (95% CI 4.0-217.4, p=0.001). OAU was performed most frequently in the West and Midwest (52.4% and 51.8% of the time, respectively; p<0.001). Univariate analysis also revealed differences along the lines of race, but these findings did not maintain statistical significance in multivariate analysis. Conclusion: In the United States, there is substantial variation in the procedures performed for cartilage restoration in children and adolescents. Though ACI is the least commonly selected operation overall, it is significantly more likely to be performed on patients with private insurance and those in the Northeast. OAU is the most commonly performed procedure in the West and Midwest.

scholarly journals THE LUNG VOLUME IN HEART DISEASE

1923 ◽  
Vol 38 (4) ◽  
pp. 445-476 ◽  
Author(s):  
Carl A. L. Binger
Keyword(s):  
Heart Disease ◽  
Lung Volume ◽  
Vital Capacity ◽  
Lung Volumes ◽  
Total Lung Volume ◽  
Surface Areas ◽  
Normal Individuals ◽  
The Absolute ◽  
Total Capacity ◽  
Residual Air

The lung volumes in a group of individuals suffering from chronic cardiac disease have been studied by a method which is applicable to patients suffering from dyspnea. In a number of instances the same patients were investigated during various stages of decompensation and compensation. The values found have been compared with those determined in a group of normal subjects. Lung volumes have been considered from three points of view: (1) relative lung volumes or subdivisions of total lung volume expressed as percentage of total lung volume; (2) the absolute lung volumes of patients with heart disease have been compared with lung volumes calculated for normal individuals having similar surface areas or chest measurements; and (3) in individual cases absolute lung volumes have been measured in various stages of compensation and decompensation. (1) In patients with heart disease it has been observed that the vital capacity forms a portion of the total lung volume relatively smaller than in normal individuals, and that the mid-capacity and residual air form relatively larger portions. When the patient progresses from the compensated to the decompensated state these changes become more pronounced. (2) When the absolute lung volumes determined for patients are compared with volumes of the same sort, as calculated for normal individuals of the same surface areas and chest measurements, the following differences are found. The vital capacities are always smaller in the patients and the volumes of residual air are always larger. There is a tendency for middle capacity and total capacity to be smaller, though, when the patients are in a compensated state, these volumes may approximate normal. (3) When decompensation occurs the absolute lung volumes undergo changes as follows: (a) vital capacity, mid-capacity, and total capacity decrease in volume; and (b) the residual air may either increase or decrease according to the severity of the state of decompensation. The significance of these changes has been discussed and an explanation offered for the occurrence of a residual air of normal volume in patients with heart disease. It results from a combination of two tendencies working in opposite directions: one to increase the residual air—stiffness of the lungs (Lungenstarre); the other to decrease it—distended capillaries (Lungenschwellung), edema, round cell infiltration.

scholarly journals Clinical and radiological imaging as prognostic predictors in COVID-19 patients

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Maha Ibrahim Metwally ◽  
Mohammad Abd Alkhalik Basha ◽  
Mohamed M. A. Zaitoun ◽  
Housseini Mohamed Abdalla ◽  
Hanaa Abu Elazayem Nofal ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Old Age ◽  
Fatal Outcome ◽  
Age Groups ◽  
Lower Lobe ◽  
Chest Ct ◽  
Imaging Features ◽  
Age Group ◽  
Significant Relation ◽  
Ct Features

Abstract Background Since the announcement of COVID-19 as a pandemic infection, several studies have been performed to discuss the clinical picture, laboratory finding, and imaging features of this disease. The aim of this study is to demarcate the imaging features of novel coronavirus infected pneumonia (NCIP) in different age groups and outline the relation between radiological aspect, including CT severity, and clinical aspect, including age, oxygen saturation, and fatal outcome. We implemented a prospective observational study enrolled 299 laboratory-confirmed COVID-19 patients (169 males and 130 females; age range = 2–91 years; mean age = 38.4 ± 17.2). All patients were submitted to chest CT with multi-planar reconstruction. The imaging features of NCIP in different age groups were described. The relations between CT severity and age, oxygen saturation, and fatal outcome were evaluated. Results The most predominant CT features were bilateral (75.4%), posterior (66.3%), pleural-based (93.5%), lower lobe involvement (89.8%), and ground-glass opacity (94.7%). ROC curve analysis revealed that the optimal cutoff age that was highly exposed to moderate and severe stages of NCIP was 38 years old (AUC = 0.77, p < 0.001). NCIP was noted in 42.6% below 40-year-old age group compared to 84% above 40-year-old age group. The CT severity was significantly related to age and fatal outcome (p < 0.001). Anterior, centrilobular, hilar, apical, and middle lobe involvements had a significant relation to below 90% oxygen saturation. A significant negative correlation was found between CT severity and oxygen saturation (r = − 0.49, p < 0.001). Crazy-paving pattern, anterior aspect, hilar, centrilobular involvement, and moderate and severe stages had a statistically significant relation to higher mortality. Conclusion The current study confirmed the value of CT as a prognostic predictor in NCIP through demonstration of the strong relation between CT severity and age, oxygen saturation, and the fatal outcome. In the era of COVID-19 pandemic, this study is considered to be an extension to other studies discussing chest CT features of COVID-19 in different age groups with demarcation of the relation of chest CT severity to different pattern and distribution of NCIP, age, oxygen saturation, and mortality rate.

MO775CONTROL OF BONE DISEASE ASSOCIATED WITH CHRONIC KIDNEY DISEASE AS A PREDICTOR OF PRIMARY PERMEABILITY AFTER THE CREATION OF THE VASCULAR ACCESS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Luis Guillermo Piccone Saponara ◽  
Maria Paz Castro Fernández ◽  
Nancy Giovanna Uribe Heredia ◽  
Agustin Carreno ◽  
Sara Anaya Fernandez ◽  
...  
Keyword(s):  
Antiplatelet Therapy ◽  
Vascular Access ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Primary Patency ◽  
Categorical Variables ◽  
Cross Sectional ◽  
High Phosphorus ◽  
The Creation ◽  
Phosphorus Levels

Abstract Background and Aims Clinical practice guidelines recommend an arteriovenous fistula (AVF) as the preferred vascular access for hemodialysis. Patency of the arteriovenous access is important for effective hemodialysis. However, maintaining the patency of the AVF remains a challenge. We determined those independent prognostic factors for the patency of the AVF at the time of its creation. Method Cross-sectional study; We include all AVFs performed at the HGUCR in the last 2 decades. Demographic variables (age, sex), etiology of CKD and associated comorbidity were collected. We determine the factors involved in the primary patency of AVFs. Statistical analysis with SPSS 25.0. Categorical variables are expressed as percentages and are compared using the Chi2 test. Quantitative variables are expressed as mean ± standard deviation and the Mann Whitney Student-T/U was used to compare them. Statistical significance for a value of p &lt;0.05. Results 622 AVFs performed in 482 patients were reviewed. 86.8% were autologous. The mean age was 65.4±14 years; 66.6% were male. The most frequent etiologies of CKD were diabetic nephropathy (30.2%), unknown (18%), and glomerulonephritis (16.6%). 91.2% had arterial hypertension (HBP) and diabetes mellitus (DM) 47.9%. 48.7% received antiplatelet therapy and 15.6% anticoagulation prior to the creation of the AVF. 27% presented primary failure. The univariate analysis showed statistical significance for the qualitative variables HTA (p=0.002), treatment with statins (p&lt;0.01) and antiplatelet (p&lt;0.01), and for the quantitative variables fibrinogen (p=0.048), serum phosphorus (p=0.001), CRP (p=0.004), triglycerides (p=0.05), ferritin (p=0.006) and age (p=0.05). When performing a multivariate analysis using logistic regression, HTA (OR: 0.46 95% CI 0.22-0.95 p = 0.036), high phosphorus levels (OR: 1.22 95% CI 1.08-1, 49 p = 0.004) and statin treatment (OR: 0.58 95% CI 0.36-0.96 p = 0.004) are predictors of primary VA failure. Conclusion In our study, HTA and antiplatelet therapy prior to the creation of the VA behave as protective factors for primary failure, with high phosphorus levels being an independent factor for primary failure of AVFs.

Abstract 16884: Evaluating the Effectiveness of Atrial Fibrillation Ablation Guided by Spatiotemporal Electrogram Dispersion

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Brian Liu ◽  
Arismendy Nunez-Garcia ◽  
Cao Tran ◽  
Michael Wu
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Tachycardia ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
External Validation ◽  
Posterior Wall ◽  
High Rate ◽  
Single Center Experience ◽  
The Mean

Introduction: Catheter ablation of atrial fibrillation (AF) guided by spatiotemporal dispersion (SD) of electrograms has been proposed as an ablation strategy to treat patients with persistent AF. However, external validation of this technique is lacking. Here we report a single center experience using ablation by SD. Hypothesis: Targeting regions with SD is associated with a high rate of termination and favorable freedom from AF among patients with persistent AF. Methods: Patients with persistent AF who underwent SD from November 2018 to January 2020 were included in this study. All patients underwent pulmonary vein isolation (PVI) in addition to targeting areas of SD. Lesions on areas of electrogram dispersion were anchored to the PVI or to mitral or posterior wall lines where appropriate. EKG, Holter, event monitors or device interrogations were obtained at 3 and 6 months to assess for arrhythmia recurrence. Results: 44 patients met the inclusion criteria and were included in the study. The patients had a mean age of 69±8 years and were 68 % male. The prevalence of comorbidities was as follows: hypertension (89%), diabetes (21%), OSA (37%) and CAD (26%). Average CHADSVASC score was 2.9±1.4, LVEF was 53±11% and left atrium (LA) diameter was 5.2±1 cm. The recurrence rate of AF at 6 months was 14% whereas the recurrence of atrial tachycardia was 20%. Acute AF termination was observed in 73% of the patients. Termination to sinus occurred in 38% of the patients and the remaining terminated to atrial tachycardia which was subsequently ablated to sinus. The mean procedure duration was 240±90 minutes. Univariate analysis showed recurrence was associated with LA diameter (r=.52; p<.001). No recurrences were observed among patients with a LA diameter < 5 cm. Termination rates were higher among patients with LA diameter < 5 cm when compared to LA diameter ≥ 5 cm. However, it did not reach statistical significance (80% vs. 60%; p=.21). Conclusions: The target of electrograms with SD during AF ablation added to PVI was associated with a high termination rate and a good freedom from AF recurrence at 6 months. The ideal candidate for this procedure may be those with LA diameter < 5 cm among persistent AF. The long-term efficacy of this technique merits further studies in larger populations.

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