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Articles by W. C Tsai
Total Records ( 2 ) for W. C Tsai
  Y. J Lin , C. T Tai , T Kao , S. L Chang , L. W Lo , T. C Tuan , A. R Udyavar , W Wongcharoen , Y. F Hu , H. W Tso , W. C Tsai , C. J Chang , K. C Ueng , S Higa and S. A. Chen

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, 53±11 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. In the 45 patients who did not respond to PVI, the continuous CFEs (>8 seconds, 18±18% and 12±17% of the LA sites, before and after PVI, respectively, P=0.02), degree of LA fractionation (mean fractionated interval: 75.6±14.3 msec versus 87.3±16.7 msec, P=0.001), and mean LA dominant frequencies (6.92±0.88 Hz versus 6.58±0.91 Hz, P=0.001) decreased after PVI. Complete PVI altered the distribution of the CFEs toward the LA anteroseptum, mitral annulus, and LA appendage regions. A persistent presence of continuous CFEs in the vicinity of the dominant frequencies sites (observed in 53% patients) correlated with a higher procedural AF termination rate for the CFE ablation (63% versus 23%, P<0.05).

Conclusions— Complete PVI eliminated some CFEs in the LA and altered the distribution of the CFEs. The persistent presence of CFEs before and after PVI in the vicinity of the high frequency sites is important for AF maintenance after PVI.

  C. C Hsu , W. C Tsai , C. P. C Chen , Y. M Lu and J. S. Wang

Negative-pressure wound therapy has recently gained popularity in chronic wound care. This study attempted to explore effects of different negative pressures on epithelial migration in the wound-healing process. The electric cell-substrate impedance sensing (ECIS) technique was used to create a 5 x 10–4 cm2 wound in the Madin-Darby canine kidney (MDCK) and human keratinocyte (HaCaT) cells. The wounded cells were cultured in a negative pressure incubator at ambient pressure (AP) and negative pressures of 75 mmHg (NP75), 125 mmHg (NP125), and 175 mmHg (NP175). The effective time (ET), complete wound healing time (Tmax), healing rate (Rheal), cell diameter, and wound area over time at different pressures were evaluated. Traditional wound-healing assays were prepared for fluorescent staining of cells viability, cell junction proteins, including ZO-1 and E-cadherin, and actins. Amount of cell junction proteins at AP and NP125 was also quantified. In MDCK cells, the ET (1.25 ± 0.27 h), Tmax (1.76 ± 0.32 h), and Rheal (2.94 ± 0.62 x 10–4 cm2/h) at NP125 were significantly (P < 0.01) different from those at three other pressure conditions. In HaCaT cells, the Tmax (7.34 ± 0.29 h) and Rheal (6.82 ± 0.26 x 10–5 cm2/h) at NP125 were significantly (P < 0.01) different from those at NP75. Prominent cell migration features were identified in cells at the specific negative pressure. Cell migration activities at different pressures can be documented with the real-time wound-healing measurement system. Negative pressure of 125 mmHg can help disassemble the cell junction to enhance epithelial migration and subsequently result in quick wound closure.

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