Background-There is a paucity of data regarding the mechanism of maintaining atrial fibrillation (AF) after pulmonary vein isolation (PVI) in patients with AF. The aim of this study was to examine the impact of circumferential PVI on the left atrial (LA) substrate characteristics. Methods and Results-Seventy-two AF patients (age, 53Ϯ11 years) underwent mapping and catheter ablation using an NavX system. The biatrial characteristics such as the complex fractionated atrial electrograms (CFEs; based on fractionated intervals) and frequency analysis (based on dominant frequencies) were mapped before and after PVI. PVI with electric isolation was performed in all patients.

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Self-management intervention is a good method to improve self-care ability, as such, to promote quality of life. However, the research focused on self-management intervention in heart failure patients in Taiwan is very limited. Therefore, the purposes of this study were to test the effectiveness of self-management intervention in patients with heart failure in Taiwan and examine the relationship between self-care ability and quality of life. A quasi-experimental design was used in this study with convenience sampling. Of the 82 subjects participating in this study, 40 of them chose to join the experimental (self-management intervention plus usual care) and 42 of them chose to join control (usual care) group. Three questionnaires were used to collect the data, which were the demographic questionnaire, the self-care questionnaire (Self-Care of HF Index V 6), and the quality of life questionnaire (Minnesota Living with Heart Failure Questionnaire). To examine the effectiveness of the intervention, self-care ability and quality of life were measured, using a pretest, 1- and 2-month follow-up assessment. Generalized estimation equations (GEE) were used to compare changes over time among groups for outcomes to ensure the effectiveness of the intervention. This study confirmed the effectiveness of the self-management intervention. The clinical provider should increase the awareness of the importance of self-management skills and self-care ability especially for heart failure patients. The designated disease-specific self-management patient book and individualize intervention should be dispensing and implementing.

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This study indicated the importance of complete linear lesions and additional carina ablation when the wide area circumferential PV isolation was applied.

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Dabigatran, a selective direct thrombin inhibitor, reversibly binds to thrombin and reduces thrombus formation and can also reduce stroke in AF patients. 24 However, the electrophysiological effect of dabigatran has not been elucidated. It is not clear whether dabigatran regulates the cardiac effects of thrombin. The purposes of this study were to investigate the electrophysiological effects of thrombin and blood clots in PVs and the LA and to evaluate the potential modulatory roles of NO, PAR1, and a direct thrombin inhibitor. Key Words: atrial fibrillation ◼ direct thrombin inhibitor ◼ protease-activated receptor ◼ pulmonary vein ◼ thrombin