Publications
112 results found
Sau A, Sikkel MB, Luther V, et al., 2017, The sawtooth EKG pattern of typical atrial flutter is not related to slow conduction velocity at the cavotricuspid isthmus., Journal of Cardiovascular Electrophysiology, Vol: 28, Pages: 1445-1453, ISSN: 1045-3873
INTRODUCTION: We hypothesized that very high density mapping of typical atrial flutter (AFL) would facilitate a more complete understanding of its circuit. Such very high density mapping was performed with the Rhythmia mapping system using its 64 electrode basket catheter. METHODS AND RESULTS: Data were acquired from 13 patients in AFL. Functional anatomy of the right atrium (RA) was readily identified during mapping including the Crista Terminalis and Eustachian ridge. The leading edge of the activation wavefront was identified without interruption and its conduction velocity (CV) calculated. CV was not different at the cavotricuspid isthmus (CTI) compared to the remainder of the RA (1.02 vs. 1.03 m/s, p = 0.93). The sawtooth pattern of the surface EKG flutter waves were compared to the position of the dominant wavefront. The downslope of the surface EKG flutter waves represented on average, 73% ± 9% of the total flutter cycle length. During the downslope the activation wavefront travelled significantly further than during the upslope (182 ± 21 ms vs. 68 ± 29 ms, p < 0.0001) with no change in conduction velocity between the two phases (0.88 vs. 0.91 m/s, p = 0.79). CONCLUSION: CV at the CTI is not slower than other RA regions during typical AFL. The gradual downslope of the sawtooth EKG is not due to slow conduction at the CTI suggesting that success of ablation at this site relates to anatomical properties rather than presence of a "slow isthmus". This article is protected by copyright. All rights reserved.
Leong KMW, Guerrero F, Lim PB, 2017, Cavotricuspid-Isthmus Dependent Flutter or Left-Sided Atrial Tachycardia?, Journal of Invasive Cardiology, Vol: 29, Pages: E92-E93, ISSN: 1042-3931
A 52-year-old man with previous mitral valve replacement, cavotricuspid isthmus, and left-sided roof-line ablation for previous typical atrial flutter and tachycardia presented with recurrence of symptoms with an atrial tachycardia measuring 260 ms cycle length on electrocardiogram. Rhythmia electroanatomical mapping (Boston Scientific) was performed to understand the mechanism of arrhythmia and to guide ablative treatment.
Masoud S, Lim PB, Kitas GD, et al., 2017, Sudden cardiac death in patients with rheumatoid arthritis, WORLD JOURNAL OF CARDIOLOGY, Vol: 9, Pages: 562-573, ISSN: 1949-8462
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Roney CH, Cantwell CD, Bayer JD, et al., 2017, Spatial resolution requirements for accurate identification of drivers of atrial fibrillation, Circulation-Arrhythmia and Electrophysiology, Vol: 10, Pages: 1-13, ISSN: 1941-3084
Background—Recent studies have demonstrated conflicting mechanisms underlying atrial fibrillation (AF), with the spatial resolution of data often cited as a potential reason for the disagreement. The purpose of this study was to investigate whether the variation in spatial resolution of mapping may lead to misinterpretation of the underlying mechanism in persistent AF.Methods and Results—Simulations of rotors and focal sources were performed to estimate the minimum number of recording points required to correctly identify the underlying AF mechanism. The effects of different data types (action potentials and unipolar or bipolar electrograms) and rotor stability on resolution requirements were investigated. We also determined the ability of clinically used endocardial catheters to identify AF mechanisms using clinically recorded and simulated data. The spatial resolution required for correct identification of rotors and focal sources is a linear function of spatial wavelength (the distance between wavefronts) of the arrhythmia. Rotor localization errors are larger for electrogram data than for action potential data. Stationary rotors are more reliably identified compared with meandering trajectories, for any given spatial resolution. All clinical high-resolution multipolar catheters are of sufficient resolution to accurately detect and track rotors when placed over the rotor core although the low-resolution basket catheter is prone to false detections and may incorrectly identify rotors that are not present.Conclusions—The spatial resolution of AF data can significantly affect the interpretation of the underlying AF mechanism. Therefore, the interpretation of human AF data must be taken in the context of the spatial resolution of the recordings.
Jawad ZAR, Fajardo-Puerta AB, Lefroy D, et al., 2017, Complete laparoscopic excision of a giant retroperitoneal paraganglioma, ANNALS OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND, Vol: 99, Pages: E148-E150, ISSN: 0035-8843
Li Kam Wa ME, Taraborrelli P, Hayat S, et al., 2017, Respiration driven excessive sinus tachycardia treated with clonidine., BMJ Case Rep, Vol: 2017
A 26-year-old man presented to our syncope service with debilitating daily palpitations, shortness of breath, presyncope and syncope following a severe viral respiratory illness 4 years previously. Mobitz type II block had previously been identified, leading to a permanent pacemaker and no further episodes of frank syncope. Transthoracic echocardiography, electophysiological study and repeated urine metanepherines were normal. His palpitations and presyncope were reproducible on deep inspiration, coughing, isometric hand exercise and passive leg raises. We demonstrated rapid increases in heart rate with no change in morphology on his 12 lead ECG. His symptoms were resistant to fludrocortisone, flecainide, β blockers and ivabradine. Initiation of clonidine in combination with ivabradine led to rapid resolution of his symptoms. We suggest that an excessive respiratory sinus arrhythmia was responsible for his symptoms and achieved an excellent response with the centrally acting sympatholytic clonidine, where previous peripherally acting treatments had failed.
Luther V, Sikkel M, Bennett N, et al., 2017, Visualizing Localized Reentry With Ultra-High Density Mapping in Iatrogenic Atrial Tachycardia Beware Pseudo-Reentry, CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY, Vol: 10, ISSN: 1941-3149
Background—The activation pattern of localized reentry (LR) in atrial tachycardia remains incompletely understood. We used the ultra–high density Rhythmia mapping system to study activation patterns in LR.Methods and Results—LR was suggested by small rotatory activations (carousels) containing the full spectrum of the color-coded map. Twenty-three left-sided atrial tachycardias were mapped in 15 patients (age: 64±11 years). 16 253±9192 points were displayed per map, collected over 26±14 minutes. A total of 50 carousels were identified (median 2; quartiles 1–3 per map), although this represented LR in only n=7 out of 50 (14%): here, rotation occurred around a small area of scar (<0.03 mV; 12±6 mm diameter). In LR, electrograms along the carousel encompassed the full tachycardia cycle length, and surrounding activation moved away from the carousel in all directions. Ablating fractionated electrograms (117±18 ms; 44±13% of tachycardia cycle length) within the carousel interrupted the tachycardia in every LR case. All remaining carousels were pseudo-reentrant (n=43/50 [86%]) occurring in areas of wavefront collision (n=21; median 0.5; quartiles 0–2 per map) or as artifact because of annotation of noise or interpolation in areas of incomplete mapping (n=22; median 1, quartiles 0–2 per map). Pseudo-reentrant carousels were incorrectly ablated in 5 cases having been misinterpreted as LR.Conclusions—The activation pattern of LR is of small stable rotational activations (carousels), and this drove 30% (7/23) of our postablation atrial tachycardias. However, this appearance is most often pseudo-reentrant and must be differentiated by interpretation of electrograms in the candidate circuit and activation in the wider surrounding region.
Ng FS, Guerrero F, Luther V, et al., 2017, Microreentrant left atrial tachycardia circuit mapped with an ultra-high-density mapping system, HeartRhythm Case Reports, Vol: 3, Pages: 224-228, ISSN: 2214-0271
Micro-reentrant tachycardias are well described and are thought to be responsible for a small proportion of atrial tachycardias post-atrial fibrillation ablation. However, due to the small size of these re-entrant circuits and the poor spatial resolution of conventional mapping tools, they have not previously been mapped accurately in vivo in humans, and have therefore been difficult to distinguish from non-reentrant focal tachycardias. The newly-developed Rhythmia electroanatomical mapping system allows for the rapid creation of activation maps of ultra-high resolution. In this case report, we provide the first images of a micro-reentrant atrial tachycardia circuit in a post-atrial fibrillation setting, mapped with the high resolution Rhythmia mapping system.
Sikkel MB, Luther V, Sau A, et al., 2017, High-Density Electroanatomical Mapping to Identify Point of Epicardial to Endocardial Breakthrough in Perimitral Flutter, JACC: Clinical Electrophysiology, Vol: 3, Pages: 637-639, ISSN: 2405-500X
Rajkumar CA, Qureshi N, Ng F, et al., 2017, Adenosine induced ventricular fibrillation in a structurally normal heart: a case report, Journal of Medical Case Reports, Vol: 11, ISSN: 1752-1947
BackgroundAdenosine is the first-line pharmacotherapy for termination of supraventricular tachycardia through its action on the atrioventricular node. However, pro-arrhythmic effects of adenosine are also recognised, most notably in the presence of pre-excited atrial fibrillation. In this case report, we describe the induction of ventricular fibrillation in a patient with no demonstrable accessory pathway, nor any other structural heart disease. This rare, idiosyncratic reaction has never previously been reported and is of relevance given the widespread and routine use of adenosine in clinical practice.Case presentationA 26-year-old woman of Cypriot origin presented to our emergency department with a sudden onset of palpitations and chest discomfort. She was healthy, with no previous medical history and no regular medications. An electrocardiogram demonstrated a narrow complex tachycardia with a rate of 194 beats per minute. Following failure of vagal maneuvers to terminate the tachycardia, the assessing physician administered a single intravenous dose of 6 mg adenosine. Our patient instantaneously developed coarse ventricular fibrillation and circulatory collapse. Cardiopulmonary resuscitation was initiated and our patient was rapidly defibrillated to sinus rhythm with a single 150 J direct current shock. A 900-mg loading dose of intravenous amiodarone was commenced and our patient was managed in the cardiac high dependency unit. No further arrhythmias were identified on continuous cardiac monitoring.On review, her presenting electrocardiogram had demonstrated rapidly conducted atrial fibrillation with no evidence of ventricular pre-excitation. Concordantly, her resting electrocardiogram was not suggestive of any accessory pathway. This was conclusively excluded on invasive electrophysiology study, with negative programmed ventricular stimulation up to three extrastimuli. Extensive laboratory investigations were unremarkable and failed to identify an underlying cau
Salciccioli J, Marshall D, Sykes M, et al., 2017, Basic Life Support Education in Secondary Schools: a cross-sectional survey in London, United Kingdom, BMJ Open, Vol: 7, ISSN: 2044-6055
Objectives: Basic life support (BLS) training inschools is associated with improved outcomes fromcardiac arrest. International consensus statements haverecommended universal BLS training for school-agedchildren. The current practice of BLS training inLondon schools is unknown. The aim of this studywas to assess current practices of BLS training inLondon secondary schools.Setting, population and outcomes: A prospectiveaudit of BLS training in London secondary schools wasconducted. Schools were contacted by email, and asubsequent telephone interview was conducted withstaff familiar with local training practices. Responsedata were anonymised and captured electronically.Universal training was defined as any programme whichdelivers BLS training to all students in the school.Descriptive statistics were used to summarise theresults.Results: A total of 65 schools completed the surveycovering an estimated student population of 65 396across 19 of 32 London boroughs. There were 5 (8%)schools that provide universal training programmes forstudents and an additional 31 (48%) offering training aspart of an extracurricular programme or chosenmodule. An automated external defibrillator (AED) wasavailable in 18 (28%) schools, unavailable in 40 (61%)and 7 (11%) reported their AED provision as unknown.The most common reasons for not having a universalBLS training programme are the requirement foradditional class time (28%) and that funding isunavailable for such a programme (28%). There were 5students who died from sudden cardiac arrest over theperiod of the past 10 years.Conclusions: BLS training rates in London secondaryschools are low, and the majority of schools do nothave an AED available in case of emergency. These datahighlight an opportunity to improve BLS training andAEDs provision. Future studies should assessprogrammes which are cost-effective and do not requiresignificant amounts of additional class time.
Morimoto R, Goto T, Pritchard J, et al., 2016, Magnetic domains driving a Q-switched laser, Scientific Reports, Vol: 6, ISSN: 2045-2322
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- Citations: 11
Roney CH, Cantwell CD, Qureshi NA, et al., 2016, Rotor tracking using phase of electrograms recorded during atrial fibrillation, Annals of Biomedical Engineering, Vol: 45, Pages: 910-923, ISSN: 1573-9686
Extracellular electrograms recorded during atrial fibrillation (AF) are challenging to interpret due to the inherent beat-to-beat variability in amplitude and duration. Phase mapping represents these voltage signals in terms of relative position within the cycle, and has been widely applied to action potential and unipolar electrogram data of myocardial fibrillation. To date, however, it has not been applied to bipolar recordings, which are commonly acquired clinically. The purpose of this study is to present a novel algorithm for calculating phase from both unipolar and bipolar electrograms recorded during AF. A sequence of signal filters and processing steps are used to calculate phase from simulated, experimental, and clinical, unipolar and bipolar electrograms. The algorithm is validated against action potential phase using simulated data (trajectory centre error <0.8 mm); between experimental multi-electrode array unipolar and bipolar phase; and for wavefront identification in clinical atrial tachycardia. For clinical AF, similar rotational content (R (2) = 0.79) and propagation maps (median correlation 0.73) were measured using either unipolar or bipolar recordings. The algorithm is robust, uses standard signal processing techniques, and accurately quantifies AF wavefronts and sources. Identifying critical sources, such as rotors, in AF, may allow for more accurate targeting of ablation therapy and improved patient outcomes.
McAloon CJ, Boylan LM, Hamborg T, et al., 2016, The changing face of cardiovascular disease 2000-2012: An analysis of the world health organisation global health estimates data, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 224, Pages: 256-264, ISSN: 0167-5273
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- Citations: 166
Ng FS, Rashid M, Lim E, et al., 2016, Mapping signatures of ventricular ectopy of endocavitary origin, JACC: Clinical Electrophysiology, Vol: 3, Pages: 186-188, ISSN: 2405-5018
A 53-year-old man with very frequent ventricular ectopic activity (39.4% burden) and a structurally normal heart was admitted for percutaneous ablation. Electrocardiography showed a bigeminal unifocal ventricular ectopic pattern, with a right bundle branch block configuration and superior axis, indicating likely origin at the inferior left ventricle.During mapping at the inferior left ventricle, multiple sites with good morphological match to the ectopic beats during pace mapping, and with early local electrograms relative to the QRS complex, were identified. Despite this, the proximal electrograms at these sites consistently preceded the distal bipolar electrograms (Figure 1A) with the mapping catheter oriented perpendicularly to the inferior left ventricular wall (Figures 1B and 1C). Figure 1D shows the good pace matches obtained from these sites. The locations of these sites were roughly in a circle (Figure 1B), presumed to represent sites encircling the posteromedial papillary muscle, with the origin of the ectopic activity at the mid–papillary muscle, which would account for the consistent finding of proximal electrograms preceding distal electrograms at the surrounding sites.
Malcolme-Lawes L, Sandler BC, Sikkel MB, et al., 2016, Ablation therapy for left atrial autonomic modification., Autonomic Neuroscience, Vol: 199, Pages: 80-87, ISSN: 1566-0702
The autonomic nervous system is implicated in the multifactorial pathogenesis of atrial fibrillation (AF) but few studies have attempted neural targeting for therapeutic intervention. We have demonstrated that short bursts of stimulation, at specific sites of left atrial ganglionated plexi (GPs), trigger fibrillation-inducing atrial ectopy and importantly continuous stimulation of these sites may not induce AV block, the 'conventional' marker used to locate GPs. We have shown that these ectopy-triggering GP (ET-GP) sites are anatomically stable and can be rendered inactive by either ablation at the site or by ablation between the site and the adjacent pulmonary vein (PV). This may have important implications for planning patient specific strategies for ablation of paroxysmal AF in the future.
Mereu R, Taraborrelli P, Sau A, et al., 2016, Diagnostic role of head-up tilt test in patients with cough syncope, EUROPACE, Vol: 18, Pages: 1273-1279, ISSN: 1099-5129
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- Citations: 8
Luther V, Linton NW, Jamil-Copley S, et al., 2016, A prospective study of ripple mapping the post-infarct ventricular scar to guide substrate ablation for ventricular tachycardia, Circulation: Arrhythmia and Electrophysiology, Vol: 9, Pages: 1-12, ISSN: 1941-3084
BACKGROUND: Post-infarct ventricular tachycardia is associated with channels of surviving myocardium within scar characterized by fractionated and low-amplitude signals usually occurring late during sinus rhythm. Conventional automated algorithms for 3-dimensional electro-anatomic mapping cannot differentiate the delayed local signal of conduction within the scar from the initial far-field signal generated by surrounding healthy tissue. Ripple mapping displays every deflection of an electrogram, thereby providing fully informative activation sequences. We prospectively used CARTO-based ripple maps to identify conducting channels as a target for ablation. METHODS AND RESULTS: High-density bipolar left ventricular endocardial electrograms were collected using CARTO3v4 in sinus rhythm or ventricular pacing and reviewed for ripple mapping conducting channel identification. Fifteen consecutive patients (median age 68 years, left ventricular ejection fraction 30%) were studied (6 month preprocedural implantable cardioverter defibrillator therapies: median 19 ATP events [Q1-Q3=4-93] and 1 shock [Q1-Q3=0-3]). Scar (<1.5 mV) occupied a median 29% of the total surface area (median 540 points collected within scar). A median of 2 ripple mapping conducting channels were seen within each scar (length 60 mm; initial component 0.44 mV; delayed component 0.20 mV; conduction 55 cm/s). Ablation was performed along all identified ripple mapping conducting channels (median 18 lesions) and any presumed interconnected late-activating sites (median 6 lesions; Q1-Q3=2-12). The diastolic isthmus in ventricular tachycardia was mapped in 3 patients and colocated within the ripple mapping conducting channels identified. Ventricular tachycardia was noninducible in 85% of patients post ablation, and 71% remain free of ventricular tachycardia recurrence at 6-month median follow-up. CONCLUSIONS: Ripple mapping can be used to identify conduction channels within scar to guide functional substrate
Leong KMW, Chow J-J, Ng FS, et al., 2016, Risk Stratification in Hypertrophic Cardiomyopathy: Evaluation of the European Society of Cardiology Sudden Cardiac Death Risk Scoring System, Annual Conference of the British Cardiovascular Society (BCS) on Prediction and Prevention, Publisher: BMJ Publishing Group, Pages: A104-A105, ISSN: 1355-6037
Leong KMW, Ng FS, Yao C, et al., 2016, Contribution of Conduction and Repolarisation Abnormalities to the Type I Brugada Pattern: A Study Using Non-Invasive Electrocardiographic Imaging, Annual Conference of the British Cardiovascular Society (BCS) on Prediction and Prevention, Publisher: BMJ Publishing Group, Pages: A105-A106, ISSN: 1468-201X
Hartley A, Lim PB, Hayat SA, 2016, Rumpel-Leede phenomenon in a hypertensive patient due to mechanical trauma: a case report., Journal of Medical Case Reports, Vol: 10, ISSN: 1752-1947
BACKGROUND: In this report, we present an interesting case of a patient with Rumpel-Leede phenomenon, a rare occurrence that can result in significant delays in medical treatment. This phenomenon is characterized by the presence of a petechial rash that results from acute dermal capillary rupture. In our patient, it occurred secondary to raised pressure in the dermal vessels caused by repeated inflation of a sphygmomanometer cuff. Contributory factors in Rumpel-Leede phenomenon include prevalent conditions such as diabetes mellitus, hypertension, thrombocytopenia, chronic steroid use, antiplatelets, and anticoagulants. CASE PRESENTATION: A 58-year-old Russian woman with diabetes and hypertension presented to our hospital with a non-ST elevation myocardial infarction, and she subsequently developed a petechial rash on her distal upper limbs. A vasculitic screen was performed, with normal results. CONCLUSIONS: Given the timing and distribution of the rash, it was felt that this was an example of Rumpel-Leede phenomenon in a susceptible individual. This is an important diagnosis to be aware of in patients with vascular risk factors presenting for acute medical care who subsequently develop a petechial rash.
Luther V, Linton NW, Jamil-Copley S, et al., 2016, RIPPLE MAPPING THE VENTRICULAR SCAR: A NOVEL APPROACH TO SUBSTRATE ABLATION OF POST-INFARCT VENTRICULAR TACHYCARDIA TO PREVENT IMPLANTABLE DEFIBRILLATOR THERAPY, Annual Conference of the British-Cardiovascular-Society (BCS) on Prediction and Prevention, Publisher: BMJ PUBLISHING GROUP, Pages: A49-A50, ISSN: 1355-6037
Ng FS, Ariff B, Punjabi PP, et al., 2016, Pyopneumopericardium Secondary to Pericardioesophageal Fistula After Radiofrequency Ablation of Atrial Fibrillation, JACC: Clinical Electrophysiology, Vol: 2, Pages: 397-399, ISSN: 2405-500X
Williams ST, Sykes MC, Lim PB, et al., 2016, The 2015 advanced life support guidelines: a summary and evidence for the updates, EMERGENCY MEDICINE JOURNAL, Vol: 33, Pages: 357-360, ISSN: 1472-0205
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Williams ST, Sykes MC, Lim PB, et al., 2016, The 2015 advanced life support guidelines: a summary and evidence for the updates, Emergency Medicine Journal, Vol: 33, Pages: 357-360, ISSN: 1472-0205
The International Liaison Committee on Resuscitation (ILCOR) recently released updated 2015 recommendations for resuscitation. The guidelines form the basis for all levels of resuscitation training, now from first aid to advanced life support (ALS), and for trainees of varying medical skills, from schoolchildren to medical students and consultants. We highlight major updates relating to intra-arrest and post-arrest care, and the evidence for their recommendation. We also summarise areas of uncertainty in the evidence for ALS, and highlight current discussions that will likely inform the next round of recommendations.
Sau A, Mereu R, Taraborrelli P, et al., 2016, A long-term follow-up of patients with prolonged asystole of greater than 15 s on head-up tilt testing, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 203, Pages: 482-485, ISSN: 0167-5273
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- Citations: 3
Luther V, Linton NW, Koa-Wing M, et al., 2016, A prospective study of ripple mapping in atrial tachycardias: a novel approach to interpreting activation in low-voltage areas, Circulation: Arrhythmia and Electrophysiology, Vol: 9, Pages: 1-13, ISSN: 1941-3084
BACKGROUND: Post ablation atrial tachycardias are characterized by low-voltage signals that challenge current mapping methods. Ripple mapping (RM) displays every electrogram deflection as a bar moving from the cardiac surface, resulting in the impression of propagating wavefronts when a series of bars move consecutively. RM displays fractionated signals in their entirety thereby helping to identify propagating activation in low-voltage areas from nonconducting tissue. We prospectively used RM to study tachycardia activation in the previously ablated left atrium.METHODS AND RESULTS: Patients referred for atrial tachycardia ablation underwent dense electroanatomic point collection using CARTO3v4. RM was played over a bipolar voltage map and used to determine the voltage "activation threshold" that differentiated functional low voltage from nonconducting areas for each map. Ablation was guided by RM, but operators could perform entrainment or review the isochronal activation map for diagnostic uncertainty. Twenty patients were studied. Median RM determined activation threshold was 0.3 mV (0.19-0.33), with nonconducting tissue covering 33±9% of the mapped surface. All tachycardias crossed an isthmus (median, 0.52 mV, 13 mm) bordered by nonconducting tissue (70%) or had a breakout source (median, 0.35 mV) moving away from nonconducting tissue (30%). In reentrant circuits (14/20) the path length was measured (87-202 mm), with 9 of 14 also supporting a bystander circuit (path lengths, 147-234 mm). In breakout tachycardias, splitting of wavefronts resulted in 2 to 4 incomplete circuits. RM-guided ablation interrupted the tachycardia in 19 of 20 cases with the first ablation set. CONCLUSIONS: RM helps to define activation through low-voltage regions and aids ablation of atrial tachycardias.
McAloon CJ, Osman F, Glennon P, et al., 2016, Global Epidemiology and Incidence of Cardiovascular Disease, CARDIOVASCULAR DISEASES: GENETIC SUSCEPTIBILITY, ENVIRONMENTAL FACTORS AND THEIR INTERACTION, Editors: Papageorgiou, Publisher: ACADEMIC PRESS LTD-ELSEVIER SCIENCE LTD, Pages: 57-96, ISBN: 978-0-12-803312-8
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Ng J, Ng JK, Parikh P, et al., 2015, Computer Simulation to Study the Effect of Structural Remodeling on Atrial Fibrillation Using Clinically-obtained Cardiac MR's, Scientific Sessions and Resuscitation Science Symposium of the American-Heart-Association (AHA), Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0009-7322
Kim M-Y, Ng FS, Ariff B, et al., 2015, Extensive Intramural Esophageal Hematoma After Transesophageal Echocardiography During Atrial Fibrillation Ablation, CIRCULATION, Vol: 132, Pages: 1847-1849, ISSN: 0009-7322
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