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AIMS: Pulmonary vein isolation (PVI) can be accomplished using radiofrequency (RF) or second generation cryoballoon (CB2). We aimed to compare the freedom from very late recurrence (VLR) defined as recurrence beyond one year in patients who were AF-free during the first post-procedural year after PVI using CB2 or RF. METHODS: Consecutive patients who underwent PVI by RF or CB2 ablation between August 2014 and December 2015 were included. The primary endpoint was the occurrence of VLR in follow-up after 12 months. Patients who experienced recurrence between the first 3 to 12 months after PVI and those who did not complete 15-month follow-up time were excluded. RESULTS: 139 patients were included: 68 underwent PVI by CB2 and 71 using RF. The global VLR rate was of 22.15%. The freedom from VLR beyond 12-month follow-up was of 84.5% (57 patients) for the CB2 group vs. 71% (50 patients) in the RF group (p=0.037). 15 patients underwent re-ablation (11 of the RF group and 4 of the CB2 group): all of the patients who had undergone PVI by RF in the index procedure were found to have vein reconnection, whereas none of the CB2 group had reconnected veins (3 cavotricuspid isthmus and 1 mitral isthmus). CONCLUSION: In patients free of recurrence during the first post-procedural year after pulmonary vein isolation for the treatment of paroxysmal atrial fibrillation: second generation cryoballoon ablation showed a significantly lower very late recurrence rate compared to radiofrequency ablation. CONDENSED ABSTRACT: The present study evaluates the freedom from very late recurrence (VLR), defined as recurrence in patients who were arrhythmia-free during the first post-procedural year after pulmonary vein isolation using second generation cryoballoon (CB2) or radiofrequency (RF). CB2 ablation had a lower VLR rate compared to RF.
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La toma de decisiones es una actividad básica en el día a día de todos los seres humanos. Según se va madurando, como proceso natural y en la mayoría de los casos, más se van agudizando y complicando la toma de decisiones. A nivel personal se toman decisiones básicamente de manera automática, desde dónde y que se va a comer, hasta que ruta se tomará hacia el trabajo. Pero, cuando se trata de tomar decisiones de más envergadura, entonces se complica el panorama e influyen otros factores en esa toma de decisiones, factores como el estrés. El presente escrito contiene una revisión de literatura sobre el estrés y su efecto en la toma decisiones de dirigentes empresariales, sus causas y posibles implicaciones, discutiendo la influencia del estrés en cuanto a efectos positivos o negativos se refiere. Alterno a la discusión inicial se presentan estrategias para la mejora en la toma de decisiones a nivel organizacional y empresarial.
Decision making is a basic activity in the day to day of all human beings us. As it matures, as a natural process and in most cases, more they become more acute and complicate decision making. On a personal level, they take basically automatically, from where and what you are going to eat, to what route will be taken to work. But, when it comes to making decisions over scale, then the picture gets complicated and other factors influence that take of decisions, factors such as stress. This document contains a review of lite about stress and its effect on the decision making of business leaders, their causes and possible implications, discussing the influence of stress in terms of effects positive or negative refers. Alternate to the initial discussion strategies are presented for the improvement in decision making at the organizational and business level.