Skip to main page content home • subscriptions • archives • feedback • authors • help • circulation journals home • aha journals home search: go advanced search user name password sign in â« previous article | table of contents | next article â» circulation. much prescription viagra without insurance 2011;124:a12612 abstracts and presentations are embargoed for release at date and time of presentation or time of aha/asa news event. buy viagra without prescription Information may not be released before then. Failure to honor embargo policies will result in the abstract being withdrawn and barred from presentation. much prescription viagra without insurance Core 4. viagra online without prescription Heart rhythm disorders and resuscitation science session title: radiofrequency lesion biophysics/new ablation techniques abstract 12612: employing techniques to maximize lesion contiguity and transmurality during pv isolation: impact on the durability of electrical pv isolation marc a miller; srinivas dukkipati; jacob koruth; andre d'avila; vivek y reddy cardiology, mount sinai sch of medicine, new york, ny background: durable pv isolation, the cornerstone of af ablation, has been an elusive goal. Objective: in an attempt to minimize gap-related pv reconnections, we instituted a series of modifications in rf ablation technique to maximize the possibility of lesion contiguity and transmurality. viagra results men While a routine 2nd procedure would most accurately determine the durability of pvi, for practical reasons, we instead studied a cohort of pts with recurrent symptoms (though this cohort is likely to provide an underestimate of true pvi success). buy cheap viagra During the second procedures, we assessed the effect of this standardized series of modifications on the durability of pv isolation. viagra women hindi Methods: the pv isolation strategy consisted of: 1) circumferential pv isolation (cpvi) as ipsilateral pv pairs, 2) use irrigated rf catheter, 3) careful placement of contiguous lesions using deflectable sheath to maximize tissue contact, 4) attention to impedance drop during ablation, 5) full cpvi despite electrical isolation prior to full encirclement, 6) after pvi, additional ablation at areas of pace-capture on the ablation line, and 7) use of isoproterenol and adenosine to identify dormant conduction. Persistent af patients received additional la/ra ablation as needed. much prescription viagra without insurance Results: of 81 consecutive patients (paroxysmal, n=42) who underwent rf ablation for af, 14 (17%) underwent repeat mapping (for either recurrence or laa closure). In the 14 pts (7 paf / 7 peraf), a 2nd procedure at 91â±59 days revealed durable pv isolation in 26/28 pv pairs (93%) - translating to 12/14 (86%) pts with all pvs isolated. cheap generic viagra The two pv pair reconnections occurred in the rpvs: a breakthrough postero-inferior near the ripv, and two breakthrough points in the rpvs in the second case. viagra without prescription Of the 13 pts with clinical recurrences, 38% (n=5/13) were due to an atypical flutter; the remainder were due to non-pv related focal triggers. Conclusions: despite evaluating a patient cohort in whom the durability of pvi was. viagra coupon