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Arrhythmias in children with ventricular assist devices
- W. Buck Kyle, Jamie Decker, Scott L. Macicek, Santiago O. Valdes, David Morales, Borah Hong, Jack F. Price, William J. Dreyer, Susan W. Denfield, Jeffrey J. Kim
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- Journal:
- Cardiology in the Young / Volume 25 / Issue 2 / February 2015
- Published online by Cambridge University Press:
- 26 November 2013, pp. 255-260
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- Article
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Background: Children with decompensated heart failure are at high risk for arrhythmias, and ventricular assist device placement is becoming a more common treatment strategy. The impact of ventricular assist devices on arrhythmias and how arrhythmias affect the clinical course of this population are not well described. Methods and results: A single-centre retrospective analysis of children receiving a ventricular assist device between 1998 and 2011 was performed. In all, 45 patients received 56 ventricular assist devices. The median age at initial placement was 13 years (interquartile range 6–15). The median duration of support was 10 days (range 2–260). The aetiology of heart failure included cardiomyopathy, transplant rejection, myocarditis, and congenital heart disease. In all, 32 patients (71%) had an arrhythmia; 19 patients (42%) had an arrhythmia before ventricular assist device and eight patients (18%) developed new arrhythmias on ventricular assist device. Ventricular tachycardia was most common (25/32, 78%). There was no correlation between arrhythmia and risk of death or transplantation (p=0.14). Of the 15 patients who weaned from ventricular assist device, post-ventricular assist device arrhythmias occurred in nine (60%), with five (33%) having their first arrhythmia after weaning. Patients with ventricular dysfunction after ventricular assist device were more likely to have arrhythmias (p<0.02). Conclusions: Arrhythmias, especially ventricular, are common in children requiring ventricular assist device. They frequently persist for those able to wean from ventricular assist device.
Chapter XXIII - Latin America 1610–60
- from THE FRONTIERS OF EUROPE
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- By W. Borah, University of California, Berkeley
- Edited by J. P. Cooper
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- Book:
- The New Cambridge Modern History
- Published online:
- 28 March 2008
- Print publication:
- 02 November 1970, pp 707-726
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- Chapter
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Summary
In 1610 Philip III, Rex Hispaniarum et Indiarum, claimed sovereignty over two great empires in America, one governed from Madrid as part of his crown of Castile, the other governed from Lisbon as part of his crown of Portugal. Together the claimed dominions of the two empires covered all of America, stretching from the yet unknown lands that lay between the Gulf of Mexico and the mysterious Arctic, southward to the equally unknown lands of Tierra del Fuego on the far side of the Straits of Magellan. The territories of the crown of Castile were divided into two viceroyalties: that of New Spain, with its capital at Mexico City, comprised all of the Iberian possessions to the north of Panama, including the islands of the Caribbean and the territory of present-day Venezuela; that of Peru, with its capital at Lima, governed the Castilian possessions from Panama to Chile and Buenos Aires. The American Empire of the crown of Portugal was Brazil, then defined as all land east of the north–south line of demarcation set by the Treaty of Tordesillas, running from the eastern stretches of the Amazon delta to the Island of Santa Catarina on the coast of the present-day Brazilian state of Santa Catarina. This territory was governed by a captain-general at Bahia.
Effective occupation in the form of domination of the native population or direct settlement by Iberian subjects fell far short of Iberian claims, as other European governments did not fail to point out. Nevertheless, the area under effective occupation constituted immense territories. In North America, Spanish dominion touched the present areas of the United States and Canada at two points. In Florida, a small settlement at St Augustine, refounded permanently in 1597, attempted to keep foreign intruders away from the Bahama Channel and the return route of the Spanish fleets, and served as a base for missionary work among the Indians of Florida and Georgia.