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Numerous studies in airways, ileum, and urinary bladder have demonstrated that relaxation by β-adrenoceptor agonists has lower potency and/or efficacy when contraction was elicited by muscarinic receptor agonists as compared to other G-protein-coupled receptors, KCl, or basal tone, but the molecular mechanisms behind this relative resistance remain unclear. A paper by Huang et al. in this issue demonstrates that NAV2729, an inhibitor of ADP ribosylation factor 6, inhibits contraction of isolated blood vessels elicited by muscarinic receptor agonists, but not by α1-adrenoceptor agonists or KCl. Against this background, we discuss the role of ADP ribosylation factor 6 in cellular responses to G-protein-coupled receptor stimulation. While ADP ribosylation factor 6 apparently is the only promising molecular explanation for the relative resistance of smooth muscle contraction elicited by muscarinic agonists, the existing data are insufficient for a robust conclusion.

The recent rapid increase in the satellite population in low Earth orbit (LEO) causes the number of conjunctions between operational spacecraft to increase sharply as well. In order to be able to cope with the associated workload in the future, it is necessary to define precise and acceptable rules that determine which spacecraft has to evade and how the avoidance manoeuvres shall be performed. To enable the assessment of different conceivable rule sets, a holistic simulation framework has been developed within the “Rules4CREAM” (R4C) activity at the Technical University of Darmstadt. Based on current and expected trends in growth and distribution of satellites in LEO, long-term propagation in the order of years can be performed for arbitrary satellite populations with the R4C framework which enables the generation of realistic conjunction data. This paper presents the core modules of this simulation framework. The satellites are described by osculating Keplerian orbits and analytical models are implemented to represent the most dominant perturbations in LEO. Different modes of station keeping are depicted within the satellite operations module of the simulation. For constellations, a generic model has been developed that is able to model the simultaneous deployment of multiple constellation planes as well as other operational key aspects specific to constellations. The models are validated with other simulations and real-life data. Finally two methods for the all-on-all conjunction detection are examined and the number of detected conjunctions is compared.

DÉNOMINATION, TAXINOMIE, PHYLOGÉNIE Dans la classe des mammifères et l’ordre supérieur des ongulés, le bouquetin relève de la catégorie des artiodactyles. Il appartient à la famille des bovidés, sous-famille des caprinés, tribu des Caprini, dans le genre Capra et se répartit sur différentes formes géographiques, qui vont de la Sibérie au Portugal et aux Sierras du sud de la péninsule Ibérique, entre 43o 30’ et 47o 30’ de latitude et 6o-15o 30’ de longitude. La systématique des ongulés, qui a ...

LES BOUQUETINS MOBILIERS DU PARPALLO´ EN ESPAGNE GÉNÉRALITÉS Simultanément à leur étude descriptive, nous confrontons entre elles les figures du Parpalló, en vue d’une analyse stylistique comparative avec les bouquetins pariétaux méditerranéens. La raison majeure de ce choix est le nombre élevé de bouquetins qu’offre le site valencien, soit cent vingt-six, selon notre lecture, accru de l’immense intérêt que lui procure la mise au jour d’une collection de plaquettes en stratigraphie, couvrant ...

L’ART DANS LES GROTTES ET ABRIS GROTTE DU LOUOI¨ (COMMUNE DE VALLON-PONT-D’ARC) La caverne (plan 1), classée Monument historique (MH), est creusée à moins de 200 m en amont de la grotte du Déroc, à la même altitude que celle-ci, au-dessus de la rive gauche de l’Ibie, c’est-à-dire à 100 m au-dessus du lit actuel de cet affluent de l’Ardèche, peu avant la confluence des deux cours d’eau. Grottecouloir de plus de 200 m de longueur, sa largeur se réduit au bout de 35 m, en restant constamment de ...

Les données techniques et le support conditionnant directement le style, nous décelons sur les bouquetins du Parpallóne facture globale forcément différente de celle des bouquetins pariétaux. Mais nous dégageons un certain nombre de conventions graphiques qui s’avèrent communes à l’art mobilier et à l’art pariétal. La comparaison technostylistique paraît d’ailleurs plus adéquate avec les cavernes françaises qu’avec les grottes espagnoles, en raison précisément de l’aspect technique qui accord...

LES BOUQUETINS PARIÉTAUX EN FRANCE INDICE DE PRÉSENCE La présence du bouquetin (graph. XIV), assez constante dans les cavernes ornées du Midi de la France, évolue logiquement avec l’importance du site, mais son indice aurait plutôt tendance à varier en sens inverse. Il oscille, évidemment, de 1 au Déroc et à Baume de Bouchon, où il est la seule espèce, réduite à une seule unité, ou de 0,94 à l’abri du Colombier, dans lequel un seul intrus s’immisce parmi les seize bouquetins, à 0,05 dans la g...

En parcourant l’espace séparant l’Atlantique de la Méditerranée, nous avons, d’ouest en est, sélectionné un panel de sites offrant un intérêt par la présence plus ou moins marquante du bouquetin et procurant des exemples des différentes cultures paléolithiques. LE DOMAINE LUSITANO-CANTABRIQUE LE PORTUGAL On rencontre en premier lieu, dans la vallée du Douro, le grand ensemble de plein air de Foz Cõa, véritable galerie d’art à ciel ouvert. La composition de son bestiaire, typiquement méridiona...

LES GROTTES ÉTUDIÉES GROTTE D’EL NIÑO (COMMUNE D’AYNA) La « Cueva del Niño » se situe au sud-est de la province d’Albacete, aux confins de la ville d’Ayna, à 60 km d’Albacete. À 700 m d’altitude, elle se niche dans une sierra, prolongement le plus septentrional des cordillères bétiques, constituant une avancée vers la Meseta. Une grande falaise verticale de 30 m de hauteur surplombe l’entrée de la caverne. Au-dessous, un grand talus s’abaisse jusqu’au lit de la rivière. Orientée au sud-est, l...

De la recherche menée sur les représentations du bouquetin dans l’art paléolithique en Europe méditerranéenne, nous retiendrons de nombreuses notions sur leur participation à un authentique « dispositif orné » et sur leurs caractéristiques technostylistiques, en relation avec une appartenance chronoculturelle, grâce à l’appui de la riche séquence du Parpalló, dont on ne trouve qu’un équivalent mineur dans les gravures pourtant abondantes de la grotte de La Marche (Pales, Tassin de Saint-Péreu...

L’art nous fait rêver de la première nuit glacée ou` une sorte de gorille se sentit mystérieusement le frère du ciel étoilé. André Malraux, Les voix du silence. Pénétrer dans une grotte ornée, c’est aller à la découverte des balbutiements originaux de notre nature humaine. Pour la première fois, l’homme, surmontant les nécessités triviales de la vie, relate son appréhension du monde sur des parois et des objets. Que reflètent ses dessins ? Que signifient les signes innombrables qui...

Background Bariatric surgery virtually ceased with the advent of the Covid-19 pandemic and has been amongst the last sector of operative practice to restart. There have been understandable concerns about restarting bariatric surgery including the risks to patients of contracting Covid infection in the peri-operative period, potential de-skilling of surgeons and theatre teams and the appropriateness of directing scarce and limited resources to bariatric surgery when every surgical specialty is experiencing rapidly rising waiting times and ever lengthening waiting lists. This study describes the restart programme at our NHS bariatric unit and offers a template for safe commencement of complex benign surgeries in the current era. Methods In the months after the pandemic started, our Bariatric MDT reviewed every case on the waiting list and contacted each patient to explain the current waiting times and the importance of not gaining weight to be eligible for surgery when surgical practice resumed. Group education and Support Group sessions were moved from face-to-face appointments to online classrooms and regular input was sought from specialist dieticians, nurses and psychologists. The expected waiting times for patients was pro-actively submitted to the Executive Board of the Trust with details about >104-week waiting patients being clearly articulated. Once approval was given to restart bariatric surgery, every patient was assessed and prioritised in terms of waiting time and clinical need. A bariatric theatre team was brought together and engaged in pre-operative training and a local refresher course on equipment and the planned surgeries. There was engagement with industry to provide on-the-ground support for the first lists to ensure proper and safe use of energy and stapling devices. Each list had two consultant surgeons assigned to it and just two cases per day were planned and patients were managed on an entirely green pathway within the NHS hospital . Results The bariatric restart programme commenced in May 2021; between May 2021 and August 2021, there have been 27 operations carried out (25 Roux-en-Y gastric bypass, 2 sleeve gastrectomy) and two cancellations on the day (both due to patient choice). Each operating list finished between two and three hours before the planned finish time. Formal debrief sessions after each list identified no problems with the operations of the equipment and none of the patients had any post-operative complications. Length of stay was between 1 to 2 days for the entire cohort. Since the restart programme commenced, the requirement for dual consultant operating has ceased and the last 5 cases have been entirely training cases for the operating registrar, again without complication. Each list is now planned to increase to pre-pandemic levels of activity with four cases per list. Conclusions Restarting complex benign surgical practice is complicated and requires engagement with management, theatre and nursing colleagues to ensure that cases are not ‘left behind'. It is important to reduce the risk of complications and of peri-operative covid-19 infection in bariatric patients and development of a pathway that all members of the theatre team have input in to meant that there were few problems or issues with either the planning of the lists or the running of the lists. Such an approach could be considered for restarting any high volume, complex benign surgical practice.

Background The Covid-19 pandemic has led to markedly reduced capacity in almost all areas of normal face-to-face activity in our hospitals. Prior to the pandemic, the standard pre-operative pathway for all patients included an initial appointment in the outpatients clinic and formal examination before recommending surgery. With the reality of limited clinic capacity, our unit developed a non face-to-face assessment pathway alongside a parallel green operating area in our local Independent Sector (IS) hospitals for laparoscopic cholecystectomy. This study describes and methodology and outcomes of this approach Methods A non face-to-face (telephone) proforma for all new referrals for consideration of laparoscopic cholecystectomy was prepared in April 2020 with the first operations carried out in June 2020. All consultations were carried out by consultant surgeons and included thorough history, careful documentation of previous surgery and duration of symptoms and, where appropriate, patients were told to send images of their abdominal wall if they were unable to describe their scars. The first stage of the consent process was completed at initial appointment and all patients were sent written information about surgery. Patients who had BMI A telephone pre-assessment was completed by the hospital and patients were sent blood tests forms in the post, as well as a Covid test to be completed at home followed by a period of self isolation before surgery. All patients were examined on the day of surgery by the operating surgeon and formal consent taken on the day. Primary outcomes that were recorded were cancellation on the day, transfer to the NHS hospital after surgery and complications. Results From June 2020 to December 2020, when the contract with the IS changed, 218 patients attended the IS hospitals for planned elective laparoscopic cholecystectomy. Four patients (2%) did not have surgery (one cancelled as inappropriate for the Independent Sector, two patients whose Covid swab result was not complete and one patient who no longer wished to have surgery). Three patients required transfer to the NHS hospital for post-operative care (drains inserted after unanticipated difficult surgery). All patients were given details of the surgical SDEC unit at the NHS hospital to allow ease of admission in the event of any problems or complications. 28 patients (13%) attended SDEC within 30 days after surgery; most had blood tests and clinical assessment alone. One patient ( The waiting time from initial assessment to surgery for patients on this pathway was less than 18 weeks for 168 patients though patients who were not suitable for the Independent Sector have had waiting times that are considerably longer. Conclusions These results demonstrate that it is possible to plan surgery for laparoscopic cholecystectomy without a face-to-face appointment at all which has considerable implications for resource allocation in the future; indeed, this approach has been continued within our unit even as clinic capacity has increased and been rolled out to patients with inguinal or para-umbilical hernia. Use of a green site away from the acute NHS hospital allowed elective surgery for non-urgent pathology to continue with acceptable waiting times even during the worst of the Covid-19 pandemic though patients who were not suitable have had markedly worse experiences and waiting times.

Background The World Health Organisation declared a global pandemic on the 11th March 2020 regarding the COVID-19 infection. This has had a dramatic impact on both acute and elective hospital services that will take a considerable time to recover from. Initial emergency intercollegiate surgical guidance released in March 2020 raised concern regarding laparoscopic surgery and advised to pursue alternative non-surgical or radiological treatment options for the safety of patients and theatre teams. The aim of this study was to assess the safety of emergency laparoscopic cholecystectomy (ELC) for patients presenting to our centre with acute gallstone pathology during the pandemic. Methods Retrospective analysis of all cholecystectomies undertaken in the department during the first year of the pandemic from 11th March 2020 to 11th March 2021. This period encapsulated two recognised peaks of the pandemic in the United Kingdom. Demographic data, elective/emergency, operative time, postop ITU admissions due to COVID and COVID related mortality was collected. Operative numbers and times were compared with historical data (HD) from the previous five years over the same time frame. Results 399 laparoscopic cholecystectomies were performed during the first year of the pandemic which was less than the previous five-year average of 570 cholecystectomies per annum (30% reduction). 247 (61.9%) were performed as an emergency on patients presenting with acute gallstone pathology compared to 35% (HD) performed acutely on average historically. Average age was 56 yrs (16-88 range). Average operative time for ELC during the pandemic was 69 minutes compared to 78 minutes HD (NS). No patients were admitted to ITU with post-operative Covid infections and there were no 30 day post-operative deaths. Conclusions We performed more ELC’s in the first year of the pandemic compared to the previous five-year average as we were conscious of the inevitable long waiting lists, we would certainly be faced with in the coming months. The Covid-19 pandemic was a global healthcare crisis and one the NHS had never encountered before. At the time there was no high-quality evidence on the safety of laparoscopy on patients presenting acutely. This study adds to the growing body of evidence that with consistent preoperative testing, PPE and appropriate patient flow pathways that emergency laparoscopic cholecystectomies are safe to perform in the current climate.

Background The road to recovery from the Covid-19 pandemic has started but no-one knows when it will end. 18 months on from the World Health Organisation declaring a global pandemic on the 11th March 2020 this has had a dramatic impact on both acute and elective hospital services. Whilst, quite rightly, the focus has been on prioritising cancer resections during the pandemic, many patients awaiting benign operations are facing lengthy waiting times. The aim of this study was to quantify the impact of the COVID-19 pandemic on benign upper GI surgery at a single centre compared to previous operating activity levels. Methods Retrospective analysis of computerised theatre records for the first 12 months of the pandemic (11th March 2020-11th March 2021) were compared to average historical data (HD) over the last five years (2015-2019) over the same time frame. Benign upper Gi operations included were cholecystectomy, anti-reflux/hiatus hernia repairs, cardiomyotomies and bariatric procedures. Results Conclusions The Covid-19 pandemic has dramatically affected benign upper GI surgery at our unit. Overall total operation numbers were down by 31% when compared to HD (440 vs 641). The largest deficit was in bariatrics where no bariatric surgery was performed during the first 12 months of the pandemic, which has restarted as of July 2021. There was also a 30% reduction in the number of cholecystectomies performed likely due to initial guidance recommending non-operative management at the start of the pandemic. Hiatal work numbers remained consistent. This quantitative study can direct future service delivery and help guide the post-pandemic recovery.

Aims To assess the 30-day mortality rate in patients undergoing vascular procedures in a single vascular centre during the first wave of the Covid-19 pandemic. Methods Retrospective analysis of all vascular operations undertaken at our unit from 11th March 2020 to 16th November 2020. Thirty-day mortality rate, ASA grade, 30-day Covid-19 PCR test positivity and cause of death were assessed. Mortality rate was compared to previous five-year average with a Chi- Square test. Results Within the observed period, 237 vascular operations were performed (49% operative reduction). 57 patients (24%) were operated electively through the “Green pathway” (day case) and there were no perioperative positive Covid-19 tests. 180 patients were operated through the “Amber” (elective Inpatient) or “Red” (emergency) pathway. Eight inpatients (4.4%) died within 30 days from surgery, similar to the average 30-day mortality observed in the previous years (5.9% p > 0.05). Three patients (1.42%) tested positive preoperatively but were all asymptomatic from Covid-19. One patient who died tested positive for Covid-19 but was asymptomatic from a respiratory aspect and died of cardiovascular disease. Conclusion We found no difference in 30-day post-operative mortality rate during the initial wave of Covid-19. Only 3 patients undergoing emergency operations tested positive. This study does reinforce the “Green pathway” strategy for elective patients to ensure minimising exposure to Covid-19 but we also did not witness any difference in mortality rate in the “Amber” or “Red” pathway. The impact of the second or third “wave” on current numbers will need to be studied further.

The influence of water deficits and drought on tree physiological processes, growth, and survival has been the focus of substantial research efforts and debate over the past decades, but there is still a need to quantitatively link finer scale mechanistic explanations of the influence of water status with the physiological responses of trees, particularly for those past the sapling stage. Hence, the objective of this study was to link accumulated water stress during the growing season to leaf physiological response mechanisms of Juglans nigra L. trees. Results showed that trees subjected to higher cumulative water stress had lower maximum light-saturated photosynthesis (Amax), initiated net photosynthesis at higher light levels (Ic), and displayed reduced effectiveness of CO2 fixation per photons absorbed (Qe) at the bottom and upper positions along the vertical canopy gradient. Results suggest that water stress integral (Sψ), a variable that takes into account accumulated water deficits, would be useful to help future research efforts aimed at investigating responses to drought in trees past the sapling stage.

Saint-Domingue est une terre de feu (...), je n’y ai laissé que désolation, misère et carnage. Pauline Bonaparte, novembre 1802 La terreur est l’un des principes ultimes du pouvoir et des relations politiques, mais inerte en période normale, un peu comme l’or au regard de la monnaie. Dans les contextes de crise, en revanche, notamment révolutionnaires, il resurgit au point d’imprégner entièrement ces relations. D’autant plus cataclysmique que les parties qui s’affrontent sont de cultures dive...

Over the last two decades, awareness of the negative repercussions of flaws in the planning, conduct and reporting of preclinical research involving experimental animals has been growing. Several initiatives have set out to increase transparency and internal validity of preclinical studies, mostly publishing expert consensus and experience. While many of the points raised in these various guidelines are identical or similar, they differ in detail and rigour. Most of them focus on reporting, only few of them cover the planning and conduct of studies. The aim of this systematic review is to identify existing experimental design, conduct, analysis and reporting guidelines relating to preclinical animal research. A systematic search in PubMed, Embase and Web of Science retrieved 13 863 unique results. After screening these on title and abstract, 613 papers entered the full-text assessment stage, from which 60 papers were retained. From these, we extracted unique 58 recommendations on the planning, conduct and reporting of preclinical animal studies. Sample size calculations, adequate statistical methods, concealed and randomised allocation of animals to treatment, blinded outcome assessment and recording of animal flow through the experiment were recommended in more than half of the publications. While we consider these recommendations to be valuable, there is a striking lack of experimental evidence on their importance and relative effect on experiments and effect sizes.

The enzyme laccase is a copper-containing oxidoreductase with the ability to oxidize a wide range of substrates, such as ferulic acid. Thus, the ferulic acid-containing sugar beet pectin (SBP) can be cross-linked through laccase-mediated oxidation. As cross-linking increases viscosity, it could be applied to stabilize SBP-containing foams. In this study, laccase-mediated cross-linking of SBP was investigated under conditions of a high-pressure foaming process. Shear, presence of CO2, and pressure were simulated in a rheometer equipped with a high-pressure cell. At rest, addition of laccase to SBP solution led to the formation of a stiff gel. Application of shear upon mixing of laccase and SBP solution decreased the storage modulus with increasing shear duration and shear rate. This can be attributed to the formation of a fluid gel. However, when shear was stopped before all available ferulic acid groups were cross-linked, a stronger and more coherent network was formed. Pressure exerted by CO2 did not affect cross-linking. Additionally, this approach was tested in a stirred high-pressure vessel where SBP was foamed through CO2 dissolution under pressure and shear followed by controlled pressure release. While pure SBP foam was highly unstable, addition of laccase decelerated collapse. Highest stability was reached when laccase and SBP were mixed prior to depressurization. At the point of foam formation, the continuous phase was thereby viscous enough to increase foam stability. At the same time, continuation of cross-linking at rest caused gel templating of the foam structure., Food & Function, 11 (3), ISSN:2042-6496, ISSN:2042-650X

We used 11 silvicultural trials in forests dominated by sugar maple (Acer saccharum Marsh.) to compare the development of structural attributes between unmanaged stands and stands subjected to two selection cuttings. Results showed that managed stands had significantly lower amounts of large live and dead trees, lower downed coarse woody debris (CWD) volume and lower density of large trees with wildlife cavities compared to unmanaged stands. Despite these differences, both managed and unmanaged stands had sufficient amounts of large trees and large trees with wildlife cavities to maintain excavator bird habitat based on minimum target guidelines from the literature. In both managed and unmanaged stands, minimum target guidelines to emulate old-growth conditions were not met: at least 30 live trees ha⁻¹ >49.0 cm in diameter at breast height, and at least 11 m³ ha⁻¹ of downed CWD volume with large-end diameter >44.0 cm. We discuss management options to promote the development of structural attributes in managed, uneven-aged sugar maple stands.

We studied late-entry commercial thinning effects on growth, yield, and regeneration in a 48-year-old jack pine (Pinus banksiana Lamb.) stand. Applied thinning intensities were 27, 32, and 47% of merchantable basal area (BA) excluding skidding trails. After 15 years, mean diameter at breast height of surviving trees in the 47% BA removal increased by 4.9 cm (25%) compared to the unthinned control. The 47% BA removal also increased gross merchantable volume (GMV) tree−1 by 46% compared to the control. The 27% BA removal had twice as much GMV ha−1 compared to the 47% BA removal after 15 years. Moreover, cumulative GMV ha−1 was much higher in the 27% BA removal than in the unthinned control. The highest thinning intensity produced larger trees on average, while the lowest thinning intensity maximized volume production per hectare. Maintenance of acceptable growing stock throughout the 15-year period in the 27% BA removal could provide other ecosystem functions such as biodiversity enhancement or wildlife habitat by delaying senescence. Regeneration data showed that a shift in species composition occurred in the understory. After 15 years, the understory was dominated by black spruce (Picea mariana (Mill.) B.S.P.), white birch (Betula papyrifera Marsh.), and trembling aspen (Populus tremuloides Michx.). If regenerating jack pine is an objective after final overstory removal, additional efforts will be needed to re-establish this species.

Loopedia is a new database at loopedia.org for information on Feynman integrals, intended to provide both bibliographic information as well as results made available by the community. Its bibliometry is complementary to that of SPIRES or arXiv in the sense that it admits searching for integrals by graph-theoretical objects, e.g. its topology., 16 pages, lots of screenshots

Uvod: Chirurgicka terapie fibrilace sini (FS) je běžnou a osvědcenou metodou lecby teto arytmie, a to buď jako samostatný výkon, nebo výkon spojený s kardiochirurgickou operaci z jine indikace (konkomitantni výkon). I přes vysokou ucinnost chirurgicke lecby dochazi k recidivam arytmii. Tyto arytmie jsou casto rezistentni k farmakoterapii (diky velkemu jizevnatemu substratu) a elektroanatomicke mapovani s katetrizacni ablaci je výrazně ucinnějsi. Arytmogenni jizevnatý substrat je nasledkem jednak primarniho srdecniho onemocněni (stojiciho za dilataci sini) a jednak přimo chirurgicke intervence (incize, mista vstupu kanyl, linie výkonu maze s obnoveným vedenim na těchto blocich).Metoda a soubor pacientů: Od ledna roku 2010 do listopadu roku 2015 jsme na nasem pracovisti provedli elektroanatomicke mapovani a ablaci u 92 pacientů s recidivou arytmie po konkomitantni chirurgicke lecbě fibrilace sini. Po radiofrekvencni ablaci byl u pacientů monitorovan rytmus v půlrocnich intervalech (24hodinove holterovske EKG monitorovani, sedmidenni smyckový rekorder, u casti pacientů i implantovanými kardiostimulatory nebo implantabilnim smyckovým zaznamnikem). Průměrna velikost leve sině (PLAX) byla 50 mm, 59 % pacientů mělo operaci mitralni chlopně, 54 % trikuspidalni chlopně, operaci vrozene vývojove vady podstoupilo 16 % pacientů, 17 % kardiochirurgickou reoperaci. Z uvedeneho vyplýva, že se jedna o pacienty s velkým jizevnatým substratem.Výsledky: Výkon maze vedl k organizaci rozsahleho jizevnateho siňoveho arytmogenniho substratu (recidivujici arytmie po maze jsou castěji pravidelne siňove tachykardie [AT], zatimco mezi arytmiemi, pro ktere byla maze u pacienta indikovana, převlada FS). Vsichni pacienti dosahli 12. měsicni kontroly, 80 % pacientů mělo 24. měsicni kontrolu. Casnou recidivu po ablaci (od výkonu do třetiho měsice) mělo 21 % pacientů. Casna recidiva po ablaci byla statisticky významně spojena s recidivou arytmie do 12 měsiců (p = 0,003) i s recidivou do 24. měsice (p = 0,003). Třiasedmdesat procent pacientů ve 12. měsici a 53 % ve 24. měsici nemělo rekurenci FS nebo siňove tachykardie. Celkem jsme ablovali 146 arytmii, tj. jedna třetina pacientů měla vice než jednu arytmii. Ve 24 % se jednalo o perzistentni FS, ve 13 % o paroxysmalni FS a v 53 % o pravidelnou siňovou tachykardii. Vice než polovina pravidelných siňových tachykardii pochazela z leve sině (LS) (větsinou perimitralni flutter sini). Zbytek arytmii pochazi z prave sině (v polovině připadů typický flutter sini). Sedmapadesat procent pacientů mělo obnovene vedeni na mitralnim isthmu (u jedne třetiny byla nutna ablace v koronarnim sinu). Žadna z plicnich žil nedominovala v poctu rekonexi. Nalez výrazne redukce amplitudy signalu v cele LS byl asociovan s vyssim rizikem akutniho selhani ablace (p = 0,001). Akutni selhani ablace bylo spojeno s trendem k vyssimu riziku recidivy ve 12. měsici (p = 0,07). Zjistili jsme trend vyssi cetnosti výskytu AT z prave sině u pacientů po operaci pro vrozenou srdecni vadu (VSV) (p = 0,06). Diagnoza arterialni hypertenze byla spojena s trendem k vyssimu riziku recidiv arytmii (p = 0,13). Nenasli jsme žadný vztah mezi typem arytmie na EKG před ablaci (EKG, dle ktereho byla u pacienta stanovena indikace k ablaci) a rizikem recidivy po ablaci.Zavěr: I přes rozsahlý arytmogenni substrat u pacientů po kardiochirurgickem výkonu je katetrizacni terapie recidiv arytmii ucinnou metodou nasledne lecby. Nemale množstvi AT pochazi z prave sině, a to hlavně u pacientů po operaci vrozených srdecnich vad. Nejsložitějsimi pacienty jsou ti s výrazně redukovaným signalem ve větsině sině pro obrovský arytmogenni substrat.