Results: 78 patients had 90 leads implanted: 25 via TV route and 65 via Epi route. Median follow-up was 1.6 years (TV) and 3.6 years (Epi). TV leads were implanted BBI608 in older patients (23.1 vs 9.3 years, P < 0.001) and at longer intervals after Fontan (15.2 vs 4.9 years, P < 0.001). Pacing indication for most TV leads was SND, while Epi leads were also indicated for atrioventricular block. Acute complication rates were similar (8% TV vs 19% Epi, P = 0.23), but median hospital stay was shorter for TV (2 vs 5 days, P = 0.03). Thrombus was observed in five patients (two in TV; three in Epi), but no thromboembolic events were observed. Mean lead
survival was similar (TV 9.9 vs Epi 7.8 years, P = NS). Energy threshold was lower at implant for TV leads (0.9 vs 2.2 mu J, P = 0.049), but similar at follow-up (1.2 vs 2.6 mu J, P = 0.35). Atrial sensing was unchanged over time for TV (2.2 to 2.1 mV, P = NS), but decreased for Epi (3.3 to 2.5 mV, P = 0.02).
Conclusions: Compared to epicardial leads, transvenous atrial pacing leads may be placed in Fontan patients with lower procedural morbidity and equivalent expectation of lead performance and
(PACE 2009; 32:779-785).”
“Background: The objective of this study was to systematically review the literature on anterior cruciate ligament (ACL) injury prevention programs and to perform a meta-analysis to address three questions: NSC 683864 First, what is the effectiveness of ACL injury prevention programs? Second, is there evidence for a “”best”"
program? Third, what is the quality of the current literature on ACL injury prevention?
Methods: We conducted a systematic review with use of the online PubMed, MEDLINE, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health), and Cochrane Central Register of Controlled Trials databases. Search terms were anterior cruciate ligament, knee, injury, prevention, and control. Data on study design and clinical outcomes were extracted independently in triplicate. After assessment of between-study heterogeneity, DerSimonian-Laird random-effect models were used to calculate pooled risk ratios and risk differences. The risk difference was used to estimate the number needed to treat (the number of individuals find more who would need to be treated to avoid one ACL tear).
Results: The pooled risk ratio was 0.38 (95% confidence interval [CI], 0.20 to 0.72), reflecting a significant reduction in the risk of ACL rupture in the prevention group (p = 0.003). The number needed to treat ranged from five to 187 in the individual studies. Stratified by sex, the pooled risk ratio was 0.48 (95% CI, 0.26 to 0.89) for female athletes and 0.15 (95% CI, 0.08 to 0.28) for male athletes.
Conclusions: Our study indicated strong evidence in support of a significant effect of ACL injury prevention programs.