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Morgan Hayes
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[Works] ~ [Performances] ~ [Recordings]
Born in 1973, Morgan Hayes reflects the cultural pluralism of his generation in his open and relaxed attitude to many kinds of musical expression. At the same time, he has pursued a single-minded artistic vision that has won him admirers from among the ranks of enthusiasts for modernism as well as those of the broader musical community, and an impressive list of performances to date, in Argentina, Austria, Bulgaria, Denmark, Estonia, France, Germany, Holland, Italy, Japan, Poland, Russia, Switzerland and the USA, as well as in the United Kingdom.
A composer since the age of ten, he had already confidently laid the foundations of his own musical style by the time he won the Guildhall School of Music & Drama's coveted Lutoslawski Prize in 1995, following studies with Michael Finnissy, Simon Bainbridge and Robert Saxton. From each of these teachers he had acquired distinctive skills. Yet it is arguable that the essential decorum of his music - its innate sense of rhythmic poise and melodic profile - is already present in youthful essays such as Only Jesting for piano (1991) or Snapshots (1994). Intensified through refinement of detail and of structure, it blossomed in his first widely acknowledged scores for ensemble, Mirage (1995) and Viscid (1996), the former evoking through an idiosyncratic blending of microtonality and exuberant rhythmical prose the harshly bright landscape of Israel, the latter a condition of matter graphically portrayed in musical terms likewise uniquely the composer's own.
Since then, in a series of ambitious pieces composed for many of Britain's leading new-music ensembles, Hayes has shaped and extended his musical vision to encompass a diversity of forms and expressive modes within a highly original musical language. For the glutinous aspect of Viscid, Shellac (1997) for piano and orchestra, substituted brightness and verve, echoes of which may be heard in the raw vibrations of Slippage, one of four remarkable pieces composed and premiered in 1999. Though separately conceived, together they amount to a summative statement of Hayes's still-developing language: languidly floating in Alluvial, with dominant timbres of piccolo and E flat clarinet; unstable and explosive in Divided Nettings; and light and luminous with a streak of obsessive insistency in Buoy. Add to these the blend of unusual colours in Trio (2000) for piano, violin and bass clarinet, and the intriguing 'mixed double' of contrabassoon and mandolin with strings in Balustrades (2001), plus the exuberant textual exchanges of two works for flexible orchestration premiered in 2000, Boaz and Dislocated Chorales, and the picture emerges of a composer whose breadth of imagination is a continuing source of fascination and musical discovery.
An accomplished pianist, Hayes has also composed an impressive oeuvre of solo music that brilliantly exploits the instrument's potential as catalyst and confessional in both intimate and virtuoso manner. Outstanding contemporary soloists including Andrew Ball, Stephen Gutman, Rolf Hind, Sarah Nicolls, Ian Pace and Jonathan Powell have each identified with facets of its wit, humour, nostalgia and playful energy, qualities also richly present in the piano parts of two vocal works, No Glints in It (2000) written for soprano Loré Lixenberg, and My Compass (2001), for soprano Sarah Leonard. An admirer of the quixotic artistry of Glenn Gould, not least his recording of the Goldberg Variations, Hayes in several keyboard works has turned to the music of Bach and that of other baroque masters including Rameau (in Le Lardon) and Purcell (in Weaving) as source-material for creative fission. This impulse for exchange and interchange with a strongly contrasting musical presence relates, in turn, to Hayes's fascination with the art of keyboard improvisation, and its extension to the applied musics of stage, dance and film.
As 2001-2002 Leverhulme Composer-in-Residence at the Purcell School, Hayes's major achievement was the 'Tatewalks' project, based on Musorgsky's Pictures at an Exhibition, and involving young composers in collaboration with the distinguished photographer Malcolm Crowthers and with the London Sinfonietta, who featured the work in the 2002 'State of the Nation' festival. In a continuing engagement with the visual arts, Hayes also provided music for the exhibition Jacqueline Morreau: Reflections on Water Music at the Morley Gallery in summer 2003 and further extended his range of reference with an iridescent transcription of Squarepusher's Port Rhombus for the South Bank Centre's 'Ether Festival' in March of that year.
Meanwhile, the successful premieres and recordings of the clarinet concerto Dark Room by Mark van de Wiel and the London Sinfonietta at the 2003 Bath Festival, and the violin-and-piano duo Opera, inspired by Italian director Dario Argento's giallo classic of that name and written for Darragh Morgan (http://www.darraghmorgan.com/main.html) and Mary Dullea, signalled a new phase in the composer's creative development. Lute Stop for solo piano was premiered by Sarah Nicolls in December 2003 as part of the BMIC's 'Cutting Edge' season, and in August 2005, at the BBC Promenade Concerts, the composer's debut orchestral work Strip, played by the BBC Symphony Orchestra, conductor Joseph Swensen, was heard for the first time. Two other major works were heard the following year: the Violin Concerto, a Birmingham Contemporary Music Group 'Sound Investment' commission, premiered by the young Japanese soloist Keisuke Okazaki, and Senedd Sound, specially written for outdoor performance at Richard Rogers' new Welsh Assembly building in Cardiff, as the focus of the 2006 'Urban Legacies' conference.
The creative use of space as an element of musical form - in this case the unique interior of Christ Church, Spitalfields - was also the inspiration for Original Version, premiered in June 2007. The same month also saw Hayes's first contribution to the distinctively English medium of the string orchestra, with Futurist Manifesto, commissioned by the Munich Chamber Orchestra. A period as composer-in-association with Music Theatre Wales concluded in 2008 with Shirley and Jane, an operatic scena based on the career of Dame Shirley Porter.
February 2009 saw the first performance of a Smith Quartet commission, Dances on a Ground, at the Artrix, Bromsgrove. In April, Dictionary of London, part of the NMC Songbook, was premiered at Kings Place, London, also the venue in June for the premiere of Shatner's Bassoon, commissioned by Endymion as part of their 30th anniversary celebrations. E Vesuvio Monte, an account of the destruction of Pompeii in AD 79, was premiered in June 2010 at the Aldeburgh Festival by the vocal group Exaudi.
© 2010 Stainer & Bell Ltd
These titles can be ordered in our online shop, or, in the case of rental works, through our Hire Library.
The items with [PDF] after them are links to free sample pages in the Adobe Actobat format.
Solo Piano
Birthday Capriccio 2001 [1'30'']
(Ref. AC191) [PDF]
Conway Hall 1998 [1'30''] (Ref. AC165) [PDF]
Five Distressed Surfaces 1998 [15'30''] (Ref. H407)
Chipped Marble [4'], Flaking Yellow Stucco [2'], Corrugated [2'], Weaving [5'], Only Jesting [2'30'']
Le Lardon (Variations on a theme by Rameau) 1999 [2'] (Ref. AC173) [PDF]
Lute Stop 2003 [6'] (Ref. Y215) [PDF] [INFOMATION]
Puppet Theatre 1999 [6'] (Ref. AC174) [PDF] [INFOMATION]
Strides Book 1. Three pieces for solo piano. 2006 [5'] (Ref. Y229) [PDF] [REVIEWS]
Strides Book 2. Five pieces for solo piano. 2007 [5'] (Ref. Y236) [PDF] [INFORMATION]
Wigmore Hall 2001 [1'30''] (Ref. Y190) [PDF]
Dictionary of London, A 2009 (Y246) [PDF]
[MP3 Clip]
soprano and piano
Handbag 2000, rev. 2001 [3'] (Ref. Y186) [PDF]
soprano, clarinet, bass clarinet, viola, cello and double bass
My Compass 2001 [3'30''] (Ref. Y188) [PDF]
soprano and piano
No Glints in It 2000 [9'] (Ref. AC185) [PDF]
Song Cycle for voice and piano
Choral Works
Citizen Vain 2000 [3'] (Ref. AC178) [PDF] [INFORMATION]
male voices and piano duet
E Vesuvio Monte 2010 (Ref.
Japanese Sweet 2006 (Traditional Japanese)
[2'] (Ref. Y235) [PDF] [INFORMATION]
unison voices, hand-held percussion and piano
Solo Instrument
Lucky's Dream 2008 [3'] (Ref. Y274) [PDF]
solo violin
Lucky's Speech 2006 [3'] (Ref. Y237) [PDF]
solo violin
Totem 1991 [1'30''] (Ref. Y214) [PDF]
solo clarinet
Chamber Works
Alluvial 1999 [6'] (Rental Ref. HL341)
alto flute (doubling piccolo), E flat clarinet (doubling bass clarinet), percussion, piano, violin, 'cello & bass
Balustrades 2001 [7'] (Rental Ref. HL351)
contrabassoon, mandolin and string quintet
Boaz 2000 (Ref. Y187) [PDF]
for flexible instrumental ensemble
Buoy 1999 [6'] (Rental Ref. HL334) [MP3 Clip] [INFORMATION]
flute (doubling piccolo & alto flute), clarinet (doubling bass clarinet), piano, viola & 'cello
Dances on a Ground 2009 [6'] (Ref. Y248) [PDF] [INFORMATION]
string quartet
Dances on a Ground 2009 [6'] (Ref. Y261) [PDF] [INFORMATION]
clarinet in A, violin, cello, double bass (optional) and piano
Dark Room 2003 [13'] (Rental Ref. HL356) [MP3 Clip] [INFORMATION]
solo clarinet and large ensemble
Dislocated Chorales 2000 [11'] (Ref. Y180) [PDF]
for 8 groups of instruments
Divided Nettings 1999 [6'] (Rental Ref. HL336) [REVIEWS]
flute, oboe, B flat clarinet (doubling bass clarinet), bassoon, horn, harp, 2 violins, viola & 'cello
Mirage 1995 [10'] (Rental Ref. HL316)
oboe (doubling cor anglais), soprano B flat saxophone, 2 tenor trombones, percussion (2), piano, violin, viola, 'cello & bass
Opera 2003 [7'] (Ref. H448) [PDF] [MP3 Clip] [INFORMATION]
violin and piano
Recorded by Darragh Morgan and Mary Dullea on NMC (see discography)
Original Version 2007 [12'] (Rental Ref. HL381) [PDF Vn Duo] [PDF Score] [INFORMATION]
Two ensembles and violin duo
Ensemble 1: oboe, bass clarinet, trumpet in C, viola
Ensemble 2: flute, alto flute, bass trombone, percussion, piano, cello
Port Rhombus 2003 [4'] (Rental Ref. HL371) [INFORMATION
piccolo, cor anglais, bass clarinet, conta bassoon, horn, trumpet, trombone, percussion (1), piano/celeste, 2 violins, viola, 'cello & bass
Senedd Sound 2006 [12'] (Rental Ref. HL384) [PDF] [INFORMATION]
piccolo, clarinet in E flat, bass clarinet, horn, trumpet in C, trombone, percussion (2)
Shatner's Bassoon 2009 (Ref. Y253) [PDF] [INFORMATION]
clarinet in A, trumpet in C, trombone, piano, viola and double bass
Shellac 1997 [13'] (Rental Ref. HL319) [PDF] [INFORMATION]
solo piano, flute (doubling piccolo), oboe (doubling cor anglais), B flat clarinet (doubling A, E flat & bass clarinets), bassoon (doubling contra bassoon), 2 horns, trumpet, trombone, percussion (2), harp, celeste, 2 violins, viola, 'cello & bass
Slippage 1999 [8'] (Rental Ref. HL333) [PDF] [INFORMATION]
flute, oboe, clarinet, piano, & Str(s) violin, viola, 'cello & bass
Snapshots 1994 [5'] (Ref. Y141) [PDF]
flute, clarinet, violin, cello & piano
Three Buoys 2002 [7'] (Ref. Y198) [PDF]
violin, viola & piano
Trio 2000 [8'] (Ref. AC177) [REVIEWS]
piano, violin & bass clarinet
Viscid 1996, rev. 1997 [10'] (Rental Ref. HL318) [PDF] [INFORMATION]
flute (doubling piccolo & alto flute), oboe (doubling cor anglais), A clarinet (doubling E flat & bass clarinets), bassoon (doubling contra bassoon), horn, trumpet, trombone, percussion (2), piano (doubling celesta), 2 violins, viola, 'cello & bass
Völklinger Hütte 2011 [6'] (Ref. Y285) [INFORMATION]
piano trio
String Orchestra
Futurist Manifesto 2007 [10'] (Rental Ref.
string orchestra (minimum 220.127.116.11.1. players)
Orchestral Works
Strip 2005 [c.12'] (Rental Ref. HL374) [PDF] [INFORMATION]
2 flutes (both doubling piccolo), 2 oboes, 2 clarinets in A (both doubling clarinet in E flat), 2 bassoons, contrabassoon, 4 horns in F, 2 trumpets in C, 3 trombones, tuba, percussion (3), Harp, Piano, Cimbalom, Harmonium, Str(s) 184.108.40.206.6. minimum
Violin Concerto 2006 [16'] (Rental Ref.
flute (doubling piccolo), cor anglais, clarinet (doubling E flat clarinet and bass clarinet), bassoon (doubling double bassoon), horn in F, trumpet in C, trombone, percussion (1), harp, piano & strings
Dark Room
Dictionary of London
Shatner's Bassoon
Recent and
Forthcoming Performances
Dictionary of London
Nardus Williams (soprano), Peter Foggitt (piano)
21 April 2016, 7.30pm St John's Smith Square, London
For further information about Morgan
Hayes and his works,
please e-mail Richard Bullen firstname.lastname@example.com


text:
Most Cited Heart Rhythm Articles
The most cited articles published since 2011, extracted from Scopus.
2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial DesignHugh Calkins | Karl Heinz Kuck | Riccardo Cappato | Josep Brugada | A. John Camm | Shih Ann Chen | Harry J G Crijns | Ralph J. Damiano | D. Wyn Davies | John Dimarco | James Edgerton | Kenneth Ellenbogen | Michael D. Ezekowitz | David E. Haines | Michel Haissaguerre | Gerhard Hindricks | Yoshito Iesaka | Warren Jackman | José Jalife | Pierre Jais | Jonathan Kalman | David Keane | Young Hoon Kim | Paulus Kirchhof | George Klein | Hans Kottkamp | Koichiro Kumagai | Bruce D. Lindsay | Moussa Mansour | Francis E. Marchlinski | Patrick M. McCarthy | J. Lluis Mont | Fred Morady | Koonlawee Nademanee | Hiroshi Nakagawa | Andrea Natale | Stanley Nattel | Douglas L. Packer | Carlo Pappone | Eric Prystowsky | Antonio Raviele | Vivek Reddy | Jeremy N. Ruskin | Richard J. Shemin | Hsuan Ming Tsao | David Wilber
Volume 9, Issue 4, January 2012, Pages 632-696.e21
Efficacy and safety of cryoballoon ablation for atrial fibrillation: A systematic review of published studiesJason G. Andrade | Paul Khairy | Peter G. Guerra | Marc W. Deyell | Lena Rivard | Laurent Macle | Bernard Thibault | Mario Talajic | Denis Roy | Marc Dubuc
Volume 8, Issue 9, September 2011, Pages 1444-1451
The relationship between contact force and clinical outcome during radiofrequency catheter ablation of atrial fibrillation in the TOCCATA studyVivek Y. Reddy | Dipen Shah | Josef Kautzner | Boris Schmidt | Nadir Saoudi | Claudia Herrera | Pierre Jaïs | Gerhard Hindricks | Petr Peichl | Aude Yulzari | Hendrik Lambert | Petr Neuzil | Andrea Natale | Karl Heinz Kuck
Volume 9, Issue 11, November 2012, Pages 1789-1795
Background: The clinical efficacy of catheter ablation of paroxysmal atrial fibrillation (AF) remains limited by difficulty in achieving durable pulmonary vein isolation (PVI). Suboptimal catheter tip-to-tissue contact force (CF) during lesion delivery is believed to reduce clinical efficacy. Objective: To determine the relationship between catheter CF during irrigated catheter ablation for AF and clinical recurrences during follow-up. Methods: Thirty-two patients with paroxysmal AF underwent PVI by using a radiofrequency ablation catheter with a CF sensor integrated at its tip, and they were followed for 12 months. The relationship between the CF and clinical outcomes was determined. Results: Acute PVI was achieved in 100% of the veins. Thirty-five percent (351 of 1017) of the applications were placed with an average CF of <10 g (low CF). All patients treated with an average CF of <10 g (5 of 5 patients) experienced recurrences, whereas 80% of the patients treated with an average CF of >20 g (8 of 10 patients) were free from AF recurrence at 12 months. The analysis of the average force-time integral showed that 75% of the patients treated with <500 gs were recurrent whereas only 31% of the patients treated with >1000 gs had recurrences at 12 months. Conclusions: The CF during catheter ablation for AF correlates with clinical outcome. Arrhythmia control is best achieved when ablation lesions are placed with an average CF of >20 g, and clinical failure is universally noted with an average CF of <10 g.
Magnetic resonance imaging in patients with a pacemaker system designed for the magnetic resonance environmentBruce L. Wilkoff | David Bello | Milos Taborsky | Josef Vymazal | Emanuel Kanal | Hubertus Heuer | Katrin Hecking | W. Ben Johnson | William Young | Brian Ramza | Naveed Akhtar | Bernhard Kuepper | Peter Hunold | Roger Luechinger | Helmut Puererfellner | Firat Duru | M. J W Gotte | Richard Sutton | Torsten Sommer
Volume 8, Issue 1, January 2011, Pages 65-73
Background Magnetic resonance imaging (MRI) of pacemaker patients is contraindicated due to documented potential risks to the patient from hazardous interactions between the MRI and pacemaker system. Objective The purpose of this prospective, randomized, controlled, worldwide clinical trial was to evaluate the safety and effectiveness of a pacemaker system designed for safe use in MRI for any bradycardia indicated patient. Methods Patients (n = 464) were randomized to undergo an MRI scan between 9 and 12 weeks postimplant (MRI group, n = 258) or not to undergo MRI (control group, n = 206) after successful implantation of the specially designed dual-chamber pacemaker and leads. Patients were monitored for arrhythmias, symptoms, and pacemaker system function during 14 nonclinically indicated relevant brain and lumbar MRI sequences. Sequences were performed at 1.5 T and included scans with high radiofrequency power deposition and/or high gradient dB/dt exposure. Clinical evaluation of the pacemaker system function occurred immediately before and after MRI, 1 week and 1 month post-MRI, and at corresponding times for the control group. Primary endpoints for safety analyzed the MRI procedure complication-free rate and for effectiveness compared capture and sensing performance between MRI and control groups. Results No MRI-related complications occurred during or after MRI, including sustained ventricular arrhythmias, pacemaker inhibition or output failures, electrical resets, or other pacemaker malfunctions. Pacing capture threshold and sensed electrogram amplitude changes were minimal and similar between study groups. Conclusion This trial documented the ability of this pacemaker system to be exposed in a controlled fashion to MRI in a 1.5 T scanner without adverse impact on patient outcomes or pacemaker system function. © 2011 Heart Rhythm Society.
A novel radiofrequency ablation catheter using contact force sensing: Toccata studyKarl Heinz Kuck | Vivek Y. Reddy | Boris Schmidt | Andrea Natale | Petr Neuzil | Nadir Saoudi | Josef Kautzner | Claudia Herrera | Gerhard Hindricks | Pierre Jas | Hiroshi Nakagawa | Hendrik Lambert | Dipen C. Shah
Volume 9, Issue 1, January 2012, Pages 18-23
The aim of this multicenter study was to evaluate the device- and procedure-related safety of a novel force-sensing radiofrequency (RF) ablation catheter capable of measuring the real-time contact force (CF) and to present CF data and its possible implications on patient safety. The clinical outcome of RF ablation for the treatment of cardiac arrhythmias may be affected by the CF between the catheter tip and the tissue. Insufficient CF may result in an ineffective lesion, whereas excessive CF may result in complications. Seventy-seven patients (43 with right-sided supraventricular tachycardia [SVT] and 34 with atrial fibrillation [AF]) received percutaneous ablation with the novel studied catheter. The CF applied and safety events related to the procedure were reported. CF values at mapping ranged from 8 ± 8 to 60 ± 35 g and from 12 ± 10 to 39 ± 29 g in the SVT group and the LA group, respectively, showing a significant interinvestigator variability (P <.0001). High transient CFs (>100 g) were noted in 27 patients (79%) of the LA group. One device-related complication (tamponade, 3%) occurred in the AF group. Catheter ablation using real-time CF technology is safe for the treatment of SVT and AF. High CFs may occur during catheter manipulation and not just during ablation, suggesting that measuring CF may provide additional useful information to the operator for safe catheter manipulation. In the future, CF-sensing catheters may also increase the effectiveness of RF ablations by allowing better control of the RF lesion size.
Electrophysiologic basis for the antiarrhythmic actions of ranolazineCharles Antzelevitch | Alexander Burashnikov | Serge Sicouri | Luiz Belardinelli
Volume 8, Issue 8, August 2011, Pages 1281-1290
Ranolazine is a Food and Drug Administrationapproved antianginal agent. Experimental and clinical studies have shown that ranolazine has antiarrhythmic effects in both ventricles and atria. In the ventricles, ranolazine can suppress arrhythmias associated with acute coronary syndrome, long QT syndrome, heart failure, ischemia, and reperfusion. In atria, ranolazine effectively suppresses atrial tachyarrhythmias and atrial fibrillation (AF). Recent studies have shown that the drug may be effective and safe in suppressing AF when used as a pill-in-the pocket approach, even in patients with structurally compromised hearts, warranting further study. The principal mechanism underlying ranolazine's antiarrhythmic actions is thought to be primarily via inhibition of late I Na in the ventricles and via use-dependent inhibition of peak I Na and I Kr in the atria. Short- and long-term safety of ranolazine has been demonstrated in the clinic, even in patients with structural heart disease. This review summarizes the available data regarding the electrophysiologic actions and antiarrhythmic properties of ranolazine in preclinical and clinical studies. © 2011 Heart Rhythm Society.
Distinguishing "benign" from "malignant early repolarization": The value of the ST-segment morphologyRaphael Rosso | Eran Glikson | Bernard Belhassen | Amos Katz | Amir Halkin | Arie Steinvil | Sami Viskin
Volume 9, Issue 2, February 2012, Pages 225-229
Background: Means for distinguishing the very common "benign early repolarization" from the very rare but malignant form are needed. Recently, the presence of early repolarization with "horizontal ST segment" was found to predict arrhythmic death during long-term follow-up in a large population study. We therefore speculated that the combination of "J waves with horizontal ST segment" would correlate with a history of idiopathic ventricular fibrillation (VF) better than the mere presence of J waves. Objectives: To determine whether the morphology of the ST segment adds diagnostic value to the mere presence of J waves in a casecontrol series of idiopathic VF. Methods: We reanalyzed our casecontrol study showing that the presence of J waves strongly correlates with a history of idiopathic VF among 45 patients with this disorder, 124 controls matched for age and gender ("matched-control" group), and 121 young athletes. This time we focused only on those patients with J waves and graded their ST-segment morphology as either "horizontal" or "ascending" according to predefined criteria. Results: The presence of J waves was associated with a history of idiopathic VF with an odds ratio of 4.0 (95% confidence intervals = 2.07.9), but having both J waves and horizontal ST segment yielded an odds ratio of 13.8 (95% confidence intervals = 5.137.2) for having idiopathic VF. Conclusions: We report, for the first time, that the combination of J waves with horizontal/descending ST segment improved our ability to distinguish patients with idiopathic VF from controls matched by gender and age. © 2012 Heart Rhythm Society.
PACES/HRS Expert Consensus Statement on the Management of the Asymptomatic Young Patient with a Wolff-Parkinson-White (WPW, Ventricular Preexcitation) Electrocardiographic Pattern: Developed in partnership between the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS).Mitchell I. Cohen | John K. Triedman | Bryan C. Cannon | Andrew M. Davis | Fabrizio Drago | Jan Janousek | George J. Klein | Ian H. Law | Fred J. Morady | Thomas Paul | James C. Perry | Shubhayan Sanatani | Ronn E. Tanel
Volume 9, Issue 6, June 2012, Pages 1006-1024
Cardiac resynchronization therapy and the relationship of percent biventricular pacing to symptoms and survivalDavid L. Hayes | John P. Boehmer | John D. Day | F. R. Gilliam | Paul A. Heidenreich | Milan Seth | Paul W. Jones | Leslie A. Saxon
Volume 8, Issue 9, September 2011, Pages 1469-1475
BACKGROUND With the advent of cardiac resynchronization therapy, it was unclear what percentage of biventricular pacing would be required to obtain maximal symptomatic and mortality benefit from the therapy. The optimal percentage of biventricular pacing and the association between the amount of continuous pacing and survival is unknown. OBJECTIVE The purpose of this study was to assess the optimal percentage of biventricular pacing and any association with survival in a large cohort of networked patients. METHODS A large cohort of 36,935 patients followed up in a remote-monitoring network, the LATITUDE Patient Management system (Boston Scientific Corp., Natick, Massachusetts), was assessed to determine the association between the percentage of biventricular pacing and mortality. RESULTS The greatest magnitude of reduction in mortality was observed with a biventricular pacing achieved in excess of 98% of all ventricular beats. Atrial fibrillation and native atrial ventricular condition can limit a high degree of biventricular pacing. Incremental increases in mortality benefit are observed with an increasing percentage of biventricular pacing. CONCLUSION Every effort should be made to reduce native atrioventricular conduction with cardiac resynchronization therapy systems in an attempt to achieve biventricular pacing as close to 100% as possible. © 2011 Heart Rhythm Society.
Outcomes of cardiac resynchronization therapy in patients with versus those without atrial fibrillation: A systematic review and meta-analysisStephen B. Wilton | Alexander A. Leung | William A. Ghali | Peter Faris | Derek V. Exner
Volume 8, Issue 7, July 2011, Pages 1088-1094
Background: Whether the benefits observed with cardiac resynchronization therapy (CRT) are similar in patients with versus those without atrial fibrillation (AF) is unclear. Furthermore, whether patients with AF receiving CRT should undergo atrioventricular nodal (AVN) ablation remains uncertain. Objective: The purpose of this study was to compare outcomes in patients with and those without AF receiving CRT and to evaluate the influence of AVN ablation on outcomes in patients with AF. Methods: A systematic review and meta-analysis was performed. Outcomes included death, CRT nonresponse, and changes in left ventricular (LV) remodeling, quality of life (QoL), and 6-minute hall walk distance (6MWD). Results: Twenty-three observational studies were included and followed a total of 7,495 CRT recipients, 25.5% with AF, for a mean of 33 months. AF was associated with an increased risk of nonresponse to CRT (34.5% vs 26.7%; pooled relative risk [RR] 1.32; 95% confidence interval [CI] 1.12, 1.55; P = .001)) and all-cause mortality (10.8% vs 7.1% per year, pooled RR 1.50, 95% CI 1.08, 2.09; P = .015). The presence of AF was also associated with less improvement in QoL, 6-minute hall walk distance, and LV end-systolic volume but not LV ejection fraction. Among patients with AF, AVN ablation appeared favorable with a lower risk of clinical nonresponse (RR 0.40; 95% CI 0.28, 0.58; P <.001) and a reduced risk of death. Conclusion: The benefits of CRT appear to be attenuated in patients with AF. The presence of AF is associated with an increased risk of clinical nonresponse and death than in patients without AF. AVN ablation may improve CRT outcomes in patients with AF. © 2011 Heart Rhythm Society. All rights reserved.
Transient outward current (I to) gain-of-function mutations in the KCND3-encoded Kv4.3 potassium channel and Brugada syndromeJohn R. Giudicessi | Dan Ye | David J. Tester | Lia Crotti | Alessandra Mugione | Vladislav V. Nesterenko | Richard M. Albertson | Charles Antzelevitch | Peter J. Schwartz | Michael J. Ackerman
Volume 8, Issue 7, July 2011, Pages 1024-1032
Background: Brugada syndrome (BrS) is a sudden death-predisposing genetic condition characterized electrocardiographically by ST segment elevation in the leads V 1-V 3. Given the prominent role of the transient outward current (I to) in BrS pathogenesis, we hypothesized that rare gain-of-function mutations in KCND3 may serve as a pathogenic substrate for BrS. Methods: Comprehensive mutational analysis of KCND3-encoded Kv4.3 (I to) was conducted using polymerase chain reaction, denaturing high performance liquid chromatography, and direct sequencing of DNA derived from 86 unrelated BrS1-8 genotype-negative BrS patients. DNA from 780 healthy individuals was examined to assess allelic frequency for nonsynonymous variants. Putative BrS-associated Kv4.3 mutations were engineered and coexpressed with wild-type KChIP2 in HEK293 cells. Wild-type and mutant I to ion currents were recorded using whole-cell patch clamp. Results: Two BrS1-8 genotype-negative cases possessed novel Kv4.3 missense mutations. Both Kv4.3-L450F and Kv4.3-G600R were absent in 1,560 reference alleles and involved residues highly conserved across species. Both Kv4.3-L450F and Kv4.3-G600R demonstrated a gain-of-function phenotype, increasing peak I to current density by 146.2% (n = 15, P <.05) and 50.4% (n = 15, P <.05), respectively. Simulations using a Luo-Rudy II action potential (AP) model demonstrated the stable loss of the AP dome as a result of the increased I to maximal conductance associated with the heterozygous expression of either L450F or G600R. Conclusions: These findings provide the first molecular and functional evidence implicating novel KCND3 gain-of-function mutations in the pathogenesis and phenotypic expression of BrS, with the potential for a lethal arrhythmia being precipitated by a genetically enhanced I to current gradient within the right ventricle where KCND3 expression is the highest.
Complications arising from catheter ablation of atrial fibrillation: Temporal trends and predictorsHana Hoyt | Aditya Bhonsale | Karuna Chilukuri | Fawaz Alhumaid | Matthew Needleman | David Edwards | Ashul Govil | Saman Nazarian | Alan Cheng | Charles A. Henrikson | Sunil Sinha | Joseph E. Marine | Ronald Berger | Hugh Calkins | David D. Spragg
Volume 8, Issue 12, December 2011, Pages 1869-1874
Background: The reported complication rate of catheter ablation of atrial fibrillation (AF) varies. Objective: Our goal was to assess temporal trends and the effect of both institutional and individual operators' experience on the incidence of complications. Methods: All patients undergoing AF ablation at Johns Hopkins Hospital between February 2001 and December 2010 were prospectively enrolled in a database. Major complications were defined as those that were life-threatening, resulted in permanent harm, required intervention, or significantly prolonged hospitalization. Results: Fifty-six major complications occurred in 1190 procedures (4.7%). The majority of complications were vascular (18; 1.5%), followed by pericardial tamponade (13; 1.1%) and cerebrovascular accident (12; 1.1%). No cases of death or atrioesophageal fistula occurred. The overall complication rate decreased from 11.1% in 2002 to 1.6% in 2010 (P <.05). On univariate analysis, demographic and clinical factors associated with the increased risk of complications were CHADS 2 score of <2 (hazard ratio [HR] = 2.5; 95% confidence interval [CI] = 1.44.4; P =.002), female gender (HR = 2.0; 95% CI = 1.23.5; P =.014), and age (HR = 1.03; 95% CI = 1.01.1; P =.042). Gender and CHADS 2 score of <2 remained independent predictors of complication on multivariable analysis. Conclusion: The complication rate of catheter ablation of AF decreased with increased institutional experience. Female gender and CHADS 2 score of <2 are significant independent risk factors for complications and should be considered when referring patients for AF ablation. © 2011 Heart Rhythm Society. All rights reserved.
Rapid pulmonary vein isolation combined with autonomic ganglia modification: A randomized studyDemosthenes G. Katritsis | Eleftherios Giazitzoglou | Theodoros Zografos | Evgeny Pokushalov | Sunny S. Po | A. John Camm
Volume 8, Issue 5, May 2011, Pages 672-678
Background: Evidence indicates that the combination of left atrial ganglionated plexi (GP) ablation and pulmonary vein (PV) isolation is beneficial for treatment of paroxysmal atrial fibrillation (AF). Objective: The purpose of this study was to compare GP and PV ablation with PV isolation alone for treatment of paroxysmal AF. Methods: Sixty-seven patients with paroxysmal AF were randomized to either PV isolation using a circular catheter suitable for both mapping and ablation (PV group) or anatomic GP modification followed by PV isolation (GP+PV group). Patients were seen at monthly visits, and 48-hour ambulatory ECG recordings were obtained every 3 months for a predefined follow-up period of 12 months. Primary endpoint was freedom from AF or other sustained atrial arrhythmia recurrence 3 to 12 months postablation after one or two procedures, without antiarrhythmic medications. Results: Recurrence of arrhythmia was documented in 18 (54.5%) patients in the PV group 4.7 ± 1.0 months after ablation, and repeat PV isolation was performed in 7 (21.2%) of these patients 5.1 ± 1.1 months after the first procedure. Recurrence of arrhythmia was documented in 9 (26.5%) patients in the GP+PV group 5.0 ± 1.3 months after ablation, and repeat ablation was performed in 6 (17.6%) of these patients 4.3 ± 0.5 months after the first procedure. At the end of follow-up, 20 (60.6%) patients in the PV group and 29 (85.3%) patients in the GP+PV group remained arrhythmia-free (log rank test, P = .019). Conclusion: Addition of anatomic GP modification to PV isolation confers significantly better outcomes than PV isolation alone during a follow-up period of 12 months. © 2011 Heart Rhythm Society.
Dabigatran vs warfarin for radiofrequency catheter ablation of atrial fibrillationJin Seok Kim | Fei She | Krit Jongnarangsin | Aman Chugh | Rakesh Latchamsetty | Hamid Ghanbari | Thomas Crawford | Arisara Suwanagool | Mohammed Sinno | Thomas Carrigan | Robert Kennedy | Wouter Saint-Phard | Miki Yokokawa | Eric Good | Frank Bogun | Frank Pelosi | Fred Morady | Hakan Oral
Volume 10, Issue 4, April 2013, Pages 483-489
Background: It is not clear whether dabigatran is as safe and effective as uninterrupted anticoagulation with warfarin during radiofrequency catheter ablation (RFA) of atrial fibrillation (AF). Objective: To compare the safety and efficacy of dabigatran by using a novel administration protocol and uninterrupted anticoagulation with warfarin for periprocedural anticoagulation in patients undergoing RFA of AF. Methods: In this case-control analysis, 763 consecutive patients (mean age 61±10 years) underwent RFA of AF using dabigatran (N = 191) or uninterrupted warfarin (N = 572) for periprocedural anticoagulation. In all patients, anticoagulation was started≥4 weeks before RFA. Dabigatran was held after the morning dose on the day before the procedure and resumed 4 hours after vascular hemostasis was achieved. Results: A transesophageal echocardiogram performed in all patients receiving dabigatran did not demonstrate an intracardiac thrombus. There were no thromboembolic complications in either group. The prevalence of major (4 of 191, 2.1%) and minor (5 of 191, 2.6%) bleeding complications in the dabigatran group were similar to those in the warfarin group (12 of 572, 2.1%; P = 1.0 and 19 of 572, 3.3%; P =.8, respectively). Pericardial tamponade occurred in 2 of 191 (1%) patients in the dabigatran group and in 7 of 572 (1.2%) patients in the warfarin group (P = 1.0). All patients who had a pericardial tamponade, including 2 in the dabigatran group, had uneventful recovery after perdicardiocentesis. On multivariate analysis, international normalized ratio (odds ratio [OR] 4.0; 95% confidence interval [CI] 1.1-15.0; P =.04), clopidogrel use (OR 4.2; 95% CI 1.5-12.3; P =.01), and CHA2DS2-VASc score (OR 1.4; 95% CI 1.1-1.8; P =.01) were the independent risk factors of bleeding complications only in the warfarin group. Conclusions: When held for approximately 24 hours before the procedure and resumed 4 hours after vascular hemostasis, dabigatran appears to be as safe and effective as uninterrupted warfarin for periprocedural anticoagulation in patients undergoing RFA of AF. © 2013 Heart Rhythm Society.
Temporal relationship of atrial tachyarrhythmias, cerebrovascular events, and systemic emboli based on stored device data: A subgroup analysis of TRENDSEmile G. Daoud | Taya V. Glotzer | D. George Wyse | Michael D. Ezekowitz | Christopher Hilker | Jodi Koehler | Paul D. Ziegler
Volume 8, Issue 9, September 2011, Pages 1416-1423
BACKGROUND The temporal relationship between atrial tachyarrhythmias (atrial tachycardia [AT] and atrial fibrillation [AF]) and cerebrovascular events/systemic emboli (CVE/SE) is unknown. OBJECTIVE The purpose of this study was to evaluate this relationship using stored AT/AF diagnostic data from implanted devices in patients with and those without AF. METHODS The TRENDS study enrolled 2,486 patients with an indication for an implantable device, at least one stroke risk factor, and available device data. The current study includes the subgroup of 40 (1.6%) patients enrolled in TRENDS who experienced CVE/SE. RESULTS AT/AF was detected prior to CVE/SE in 20 (50%) of 40 patients. Other than average and maximum daily AT/AF burden and duration of device monitoring prior to CVE/SE, no statistically significant differences were found between patients with and those without AT/AF prior to CVE/SE. For the 20 patients with AT/AF detected prior to CVE/SE, 9 (45%) did not have any AT/AF in the 30 days prior to CVE/SE. Therefore, 29 (73%) of 40 patients with CVE/SE had zero AT/AF burden within 30 days prior to CVE/SE. Fourteen (70%) of the 20 patients with AT/AF detected prior to CVE/SE were not in AT/AF at diagnosis of CVE/SE. The last episode of AT/AF in these 14 patients was 168 ± 199 days (range 3-642 days) before CVE/SE. CONCLUSION The majority of CVE/SE in this population did not occur proximal to recent AT/AF episodes. These data imply that the mechanisms of CVE/SE in patients with implantable devices may importantly involve mechanisms other than cardioembolism due to atrial tachyarrhythmias. © 2011 Heart Rhythm Society.
Pulmonary vein isolation with complex fractionated atrial electrogram ablation for paroxysmal and nonparoxysmal atrial fibrillation: A meta-analysisRobert M. Hayward | Gaurav A. Upadhyay | Theofanie Mela | Patrick T. Ellinor | Conor D. Barrett | E. Kevin Heist | Atul Verma | Niteesh K. Choudhry | Jagmeet P. Singh
Volume 8, Issue 7, July 2011, Pages 994-1000
Background: Pulmonary vein isolation (PVI) is recognized as a potentially curative treatment for atrial fibrillation (AF). Ablation of complex fractionated atrial electrograms (CFAEs) in addition to PVI has been advocated as a means to improve procedural outcomes, but the benefit remains unclear. Objective: This study sought t synthesize the available data testing the incremental benefit of adding CFAE ablation to PVI. Methods: We performed a meta-analysis of controlled studies comparing the effect of PVI with CFAE ablation vs. PVI alone in patients with paroxysmal and nonparoxysmal AF. Results: Of the 481 reports identified, 8 studies met our inclusion criteria. There was a statistically significant increase in freedom from atrial tachyarrhythmia (AT) with the addition of CFAE ablation (relative risk [RR] 1.15, P = .03). In the 5 reports of nonparoxysmal AF (3 randomized controlled trials, 1 controlled clinical trial, and 1 trial using matched historical controls), addition of CFAE ablation resulted in a statistically significant increase in freedom from AT (n = 112 of 181 [62%] for PVI+CFAE vs. n = 84 of 179 [47%] for PVI alone; RR 1.32, P = .02). In trials of paroxysmal AF (3 randomized controlled trials and 1 trial using matched historical controls), addition of CFAE ablation did not result in a statistically significant increase in freedom from AT (n = 131 of 166 [79%] for PVI+CFAE vs. n = 122 of 164 [74%] for PVI alone; RR 1.04, P = .52). Conclusion: In these studies of patients with nonparoxysmal AF, addition of CFAE ablation to PVI results in greater improvement in freedom from AF. No additional benefit of this combined approach was observed in patients with paroxysmal AF. © 2011 Heart Rhythm Society. All rights reserved.
HRS expert consensus statement on the diagnosis and management of arrhythmias associated with cardiac sarcoidosisDavid H. Birnie | William H. Sauer | Frank Bogun | Joshua M. Cooper | Daniel A. Culver | Claire S. Duvernoy | Marc A. Judson | Jordana Kron | Davendra Mehta | Jens Cosedis Nielsen | Amit R. Patel | Tohru Ohe | Pekka Raatikainen | Kyoko Soejima
Volume 11, Issue 7, January 2014, Pages 1305-1324
Long-term single- and multiple-procedure outcome and predictors of success after catheter ablation for persistent atrial fibrillationThomas Rostock | Tushar V. Salukhe | Daniel Steven | Imke Drewitz | Boris A. Hoffmann | Karsten Bock | Helge Servatius | Kai Müllerleile | Arian Sultan | Nils Gosau | Thomas Meinertz | Karl Wegscheider | Stephan Willems
Volume 8, Issue 9, September 2011, Pages 1391-1397
BACKGROUND Stepwise ablation is an effective treatment for persistent atrial fibrillation (AF), although it often requires multiple procedures to eliminate recurrent arrhythmias. OBJECTIVE This study evaluated single- and multiple-procedure long-term success rates and potential predictors of a favorable single-procedure outcome of stepwise ablation for persistent AF. METHODS This study comprised 395 patients with persistent AF (duration 16 months) undergoing de novo catheter ablation using the stepwise approach. Procedural success was defined as the absence of any arrhythmia recurrence. Patient characteristics and electrophysiological parameters were analyzed with respect to single- and multiple-procedure outcomes. RESULTS After a follow-up of 27 ± 7 months, 108 (27%) patients were free of arrhythmia recurrences with a single procedure. After 2.3 ± 0.6 procedures, 312 (79%) patients were free of arrhythmia with concomitant antiarrhythmic treatment in 38% (23% on β-blocker). Female gender, duration of persistent AF, and congestive heart failure were predictive for the outcome after first ablation. However, the strongest predictors for single-procedure success were longer baseline AF cycle length (CL) and procedural AF termination. Moreover, procedural AF termination during the index procedure also predicted a favorable outcome after the last procedure, while the existence of congestive heart failure was associated with an increased risk for eventual arrhythmia recurrences. CONCLUSIONS Single-procedure long-term success is anticipated in approximately a quarter of patients undergoing de novo ablation of persistent AF. Baseline AFCL emerged as the strongest predictor of single-procedure success, while AF termination during index ablation predicts the overall outcome. However, an overall success rate of 79% is achievable with multiple procedures. © 2011 Heart Rhythm Society.
Atrial remodeling in obstructive sleep apnea: Implications for atrial fibrillationHany Dimitri | Michelle Ng | Anthony G. Brooks | Pawel Kuklik | Martin K. Stiles | Dennis H. Lau | Nicholas Antic | Andrew Thornton | David A. Saint | Doug McEvoy | Ral Antic | Jonathan M. Kalman | Prashanthan Sanders
Volume 9, Issue 3, March 2012, Pages 321-327
Background: There is a known association between obstructive sleep apnea (OSA) and atrial fibrillation (AF); however, how OSA affects the atrial myocardium is not well described. Objective: To determine whether patients with OSA have an abnormal atrial substrate. Methods: Forty patients undergoing ablation of paroxysmal AF and in sinus rhythm (20 with OSA [apneahypopnea index < 15] and 20 reference patients with no OSA [apneahypopnea index < 15] by polysomnography) were studied. Multipolar catheters were positioned at the lateral right atrium (RA), coronary sinus, crista terminalis, and RA septum to determine the effective refractory period at 5 sites, conduction time along linear catheters at the RA and the coronary sinus, conduction at the crista terminalis, and sinus node function (corrected sinus node recovery time). Biatrial electroanatomic maps were created to determine the voltage, conduction, and distribution of complex electrograms (duration < 50 ms). Results: The groups had no differences in the prevalence of established risk factors for AF. Patients with OSA had the following compared with those without OSA: no difference in effective refractory period (P =.9), prolonged conduction times along the coronary sinus and RA (P =.02), greater number (P =.003) and duration (P =.03) of complex electrograms along the crista terminalis, longer P-wave duration (P =.01), longer corrected sinus node recovery time (P =.02), lower atrial voltage (RA, P <.001; left atrium, P <.001), slower atrial conduction velocity (RA, P =.001; left atrium, P =.02), and more widespread complex electrograms in both atria (RA, P =.02; left atrium, P =.01). Conclusion: OSA is associated with significant atrial remodeling characterized by atrial enlargement, reduction in voltage, site-specific and widespread conduction abnormalities, and longer sinus node recovery. These features may in part explain the association between OSA and AF. © 2012 Published by Elsevier Inc. on behalf of Heart Rhythm Society. All rights reserved.
Classifying fractionated electrograms in human atrial fibrillation using monophasic action potentials and activation mapping: Evidence for localized drivers, rate acceleration, and nonlocal signal etiologiesSanjiv M. Narayan | Matthew Wright | Nicolas Derval | Amir Jadidi | Andrei Forclaz | Isabelle Nault | Shinsuke Miyazaki | Frédéric Sacher | Pierre Bordachar | Jacques Clémenty | Pierre Jaïs | Michel Hasïsaguerre | Mélèqze Hocini
Volume 8, Issue 2, February 2011, Pages 244-253
Background Complex fractionated electrograms (CFAEs) detected during substrate mapping for atrial fibrillation (AF) reflect etiologies that are difficult to separate. Without knowledge of local refractoriness and activation sequence, CFAEs may represent rapid localized activity, disorganized wave collisions, or far-field electrograms. Objective The purpose of this study was to separate CFAE types in human AF, using monophasic action potentials (MAPs) to map local refractoriness in AF and multipolar catheters to map activation sequence. Methods MAP and adjacent activation sequences at 124 biatrial sites were studied in 18 patients prior to AF ablation (age 57 ± 13 years, left atrial diameter 45 ± 8 mm). AF cycle length, bipolar voltage, and spectral dominant frequency were measured to characterize types of CFAE. Results CFAE were observed at 91 sites, most of which showed discrete MAPs and (1) pansystolic local activity (8%); (2) CFAE after AF acceleration, often with MAP alternans (8%); or (3) nonlocal (far-field) signals (67%). A fourth CFAE pattern lacked discrete MAPs (17%), consistent with spatial disorganization. CFAE with discrete MAPs and pansystolic activation (consistent with rapid localized AF sites) had shorter cycle length (P <.05) and lower voltage (P <.05) and trended to have higher dominant frequency than other CFAE sites. Many CFAEs, particularly at the septa and coronary sinus, represented far-field signals. Conclusion CFAEs in human AF represent distinct functional types that may be separated using MAPs and activation sequence. In a minority of cases, CFAEs indicate localized rapid AF sites. The majority of CFAEs reflect far-field signals, AF acceleration, or disorganization. These results may help to interpret CFAE during AF substrate mapping. © 2011 Heart Rhythm Society. All rights reserved.
Feasibility of closed-chest ligation of the left atrial appendage in humansKrzysztof Bartus | Jacek Bednarek | Jacek Myc | Boguslaw Kapelak | Jerzy Sadowski | Jacek Lelakowski | Steven J. Yakubov | Randall J. Lee
Volume 8, Issue 2, February 2011, Pages 188-193
Background: Atrial fibrillation is associated with an increased risk of embolic events. The left atrial appendage (LAA) is believed to be an incubator for thrombus formation. LAA exclusion has been advocated to potentially reduce embolic events arising from the LAA. Objective: The aim of the study was to determine the feasibility of a closed-chest surgical suture ligation of the LAA in man. Methods: Thirteen patients undergoing either mitral valve surgery (n = 2) or electrophysiological study and radiofrequency catheter ablation for atrial fibrillation (n = 11) underwent ligation of the LAA with the LARIAT snare device. In patients having an ablation procedure, pericardial access was obtained prior to the patients undergoing radiofrequency catheter ablation. After transseptal catheterization, endocardial and epicaridal magnet-tipped guide wires were positioned under fluoroscopic guidance to stabilize the LAA. Transesophageal echocardiography (TEE) was used as guidance for positioning a marker balloon at the ostium of the LAA. An over-the-wire approach was used to guide the LARIAT snare device over the LAA to allow closure and suture ligation of the LAA. TEE and contrast fluoroscopy were used to confirm acute closure of the LAA. Results: Both mitral valve replacement (MVR) patients had complete closure of the LAA determined by visual inspection. Ten of 11 patients having ablation underwent a successful closed-chest LAA ligation procedure with TEE and contrast fluoroscopy verification of closure of the LAA. Only one of 11 procedures was terminated owing to the lack of echocardiography guidance of the snare over the marker balloon. One patient with pectus excavatum did have ligation of his LAA; however, a thorascopic procedure was required to remove the snare from the LAA owing to compression of the LARIAT by the concave sternum. There were no other significant complications. Conclusions: Catheter-based surgical suture ligation of the LAA is feasible in humans. This novel catheter approach may be appropriate for patients with atrial fibrillation who are ineligible for anticoagulation therapy. Further investigation is needed to demonstrate the long-term safety and efficacy of LAA closure. © 2011 Heart Rhythm Society. All rights reserved.
Arrhythmia characterization and long-term outcomes in catecholaminergic polymorphic ventricular tachycardiaRaymond W. Sy | Michael H. Gollob | George J. Klein | Raymond Yee | Allan C. Skanes | Lorne J. Gula | Peter Leong-Sit | Robert M. Gow | Martin S. Green | David H. Birnie | Andrew D. Krahn
Volume 8, Issue 6, June 2011, Pages 864-871
Background: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is characterized by adrenergically induced ventricular tachycardia (VT) associated with syncope and sudden death. Objective: This study sought to characterize arrhythmias associated with CPVT with respect to provocation by exercise and drugs, electrocardiographic characteristics, and association with long-term outcomes; and to explore the relation between age and clinical presentation. Methods: Seventy patients from 16 families were evaluated with exercise and selective adrenaline challenge, and screened for RyR2 mutations. CPVT was diagnosed in probands with symptoms and stress- or adrenaline-provoked VT, or in asymptomatic relatives with provoked VT or RyR2 mutations. Patients were followed up for recurrent syncope, VT, and sudden death. Results: Twenty-seven patients including 16 probands were identified (median age 35 years, 67% female). Presentation was cardiac arrest in 33% and syncope in 56%, and 11% were asymptomatic. Polymorphic or bidirectional VT was provoked with exercise in 63% and adrenaline in 82%. The initiating beat of VT was late-coupled and wide (coupling interval 418 ± 42 ms; QRSd 131 ± 17 ms), and QRS morphology suggested an outflow tract origin in 59%. During follow-up of 6.2 ± 5.7 years, 2 patients died despite an implantable cardioverter- defibrillator (ICD), 4 patients received ICD therapy for VT, and 5 patients had inappropriate therapy for supraventricular tachycardia. Patients presenting with late-onset CPVT (age > 21; n = 10) were often female (80%) and less likely to have RyR2 (Ryanodine receptor type 2) mutations (33%), and fatal events were not observed during follow-up (4.1 ± 3.6 years). Conclusion: Ventricular arrhythmia in CPVT is often initiated from the outflow tract region. Despite β-blocker therapy and selective ICD implantation, breakthrough arrhythmias occur and may be associated with adverse outcomes.
Riata implantable cardioverter-defibrillator lead failure: Analysis of explanted leads with a unique insulation defectRobert G. Hauser | Deepa McGriff | Linda Kallinen Retel
Volume 9, Issue 5, May 2012, Pages 742-749
BACKGROUND: The Riata family of implantable cardioverter-defibrillator leads (St Jude Medical, Sylmar, CA) appears prone to a unique failure mechanism whereby the conductor cables wear through the silicone insulation from inside-out and are seen outside the lead body (externalized conductors). OBJECTIVE: To assess the extent of Riata lead damage associated with inside-out insulation defects and their clinical consequences. METHODS: In September 2011, we searched the U.S. Food and Drug Administration's Manufacturers and User Defined Experience medical device database for reports describing Riata lead failures that had been analyzed by the manufacturer. RESULTS: The Manufacturers and User Defined Experience search identified 105 leads that had inside-out insulation defects. Eight-French single-coil Riata leads accounted for a higher-than-expected proportion (25.7%) of the leads with this defect. A total of 226 insulation defects were found in the 105 leads (2.2 defects per lead), including 143 inside-out defects (1.4 defects per lead). The most common location of insulation defects was distal to the proximal coil (n = 108). Twenty-eight leads (26.7%) had inside-out insulation defects underneath the shocking coils. Of 43 leads whose cables were assessed for the integrity of the ethylene-tetrafluoroethylene cable coating, 22 (51.2%) were found to be abraded, exposing the conductor surfaces. On X-ray radiography or fluoroscopy, 7 leads were found to have externalized cables; 2 of these leads had no electrical abnormalities, while 4 exhibited noise or increased impedance. Inappropriate shocks were experienced by 31 of the 105 patients (29.5%). CONCLUSION: Riata leads that have inside-out insulation defects often have multiple defects, including additional inside-out abrasions along the body of the lead and beneath the shocking coils. Eight-French single-coil Riata models may be more prone to externalized cables than are dual-coil and 7-F designs. Externalized cables are but one manifestation of interior insulation damage. Our findings question the durability of the ethylene-tetrafluoroethylene cable coating on exposed cables. © 2012 Heart Rhythm Society.

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I used an impression matt to imprint the sides on this one. Chocolate roses on top. I'm really liking the effect. Was for a dorm warming party for my niece. Her first year at college.
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As the winter ice thaws around the country, baseball teams are flocking to warm weather this week for the beginning of spring training, marking the official start of the 2016 MLB season. From the Kansas City Royals' defense of their championship, to the surprising big-spending Arizona Diamondbacks, there is no shortage …Read More »
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MLB Adds Two More Teams To Postseason
Major League Baseball expanded its postseason to ten teams on Friday, adding one more wild-card team to each league. Under the new playoff format, the two teams with the best records who do not win their divisions will meet in a one-game, wild-card round to begin the postseason. Baseball Commissioner Bud …Read More »


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Travel Trac Comp Fluid TrainerThe faster you pedal, the harder it gets. The Travel Trac Comp Fluid Trainer uses progressive fluid resistance to give you a great workout. Progressive resistance increases as you increase speed, simulating a true road-like feel. Internal disc spins in fluid for smooth, quiet and affordable performance.
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Moise and Flavorful Apple Cranberry and Herb Stuffing Recipe! I am so excited to be cooking Thanksgiving at the #1905Cottage for the first time this year! I want it to be a fun and memorable meal so I have been working on some fun recipes for the big day! My son is vegetarian and we have a family friend who is allergic to nuts. So I want to serve a stuffing that everyone will love. After a few … [Read more...]
Moist and Flavorful Apple, Cranberry and Herb Stuffing!
Give Thanks Wall Hanging! [And Free Printables!]
I'm so excited to have the very talented Brenda from Pebbles in My Pocket and Pebbles Inc. here sharing this beautiful Give Thanks wall hanging. Perfect for Thanksgiving decorating!! I love working with her and the whole Pebbles in my Pocket team on my Home+Made and Cottage Living paper decor lines! Here's how easy this is to make - complete with free printables and patterns! … [Read more...]
Getting Ready for Fall Entertaining and FREE "Be Thankful" Printable!
October might be my favorite month! I love the feeling of Autumn in the air and the anticipation of all of the fun holidays coming up - Halloween, Thanksgiving, Christmas and New Years. One of the things I love most about the holidays is family and friends. And this is year is the first that I will be hosting Thanksgiving Dinner at the #1905Cottage. I am so excited!! So this year as … [Read more...]
DIY Be Thankful Board and New Gratitude Tradition!
Hey guys, it's Jen and Jodie from Eighteen25, and we are excited to be back sharing another project here with you. This is also a fun tradition you may like to start with your family for the month of November. Hopefully it will have everyone thinking about all the wonderful blessings in their lives. We used: HOME + MADE kraft/glitter bags HOME + MADE gold metal clips HOME + MADE … [Read more...]
15 Thanksgiving Turkey Recipes to Try
Have you ever cooked the Thanksgiving turkey? It can be intimidating when it's your first time! Or maybe you've done it a hundred times and are just looking for something different? If so, I have some ideas for you! There are lots of ways to cook a Thanksgiving turkey. Whether you're cooking for two or a whole crowd, this list of 15 Thanksgiving Turkey Recipes will help you with some new … [Read more...]
Teacher Appreciation "Creative Juice" Gift Idea and Printable!!
I think it's always fun to give teachers a gift that they can use during the summer on their time off. And coffee gift card gifts are great -- but what if your teacher doesn't drink coffee?? We love smoothies and I thought it would be great to use a play on words with juice and a gift certificate to a juice bar. Here's what I came up with (also with a little help from my husband and his … [Read more...]
Thanksgiving Turkey with Oil and Herb Marinade {recipe tutorial}
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Kate Hans was never convinced she was a good actress until Doug de Lisle suggested she start performing outside Rensselaer County. "He asked me why I only worked on the east side of the Hudson River," said Hans, part of a talented ensemble cast set to put on "Big Maggie" beginning Friday at Albany Civic Theater. "God bless Doug. He told me, 'You gotta get out more. Get over on the other side of the ...
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2016 Subaru WRX STI Limited
Make: SubaruStock #: 165487AExterior Color: Dk. GrayTransmission: 6-Speed ManualDrivetrain: Mileage: 18440Year: 2016Trim: STI LimitedModel: WRXVIN: JF1VA2Y66G9808159Interior Color:
Year: 2016, Make: Subaru
2014 fully loaded Subaru Crosstrek XV $22000
We are selling our 2014 subaru crosstrek. Aprox 47k miles. Super clean. New tires. Runs like it\'s brand new still. These all wheel drive vehicles are perfect for colorado winter. Handling in the snow is second to none. Call or text Tommy at
Year: 2014, Make: Subaru
2016 Subaru WRX STI Limited
Drivetrain: VIN: JF1VA2Y66G9808159Interior Color: Carbon BlackTransmission: 6-Speed ManualEngine: 2.5 Liter 4 CylinderModel: WRXMileage: 18440Year: 2016Make: SubaruStock #: 165487AT
Year: 2016, Make: Subaru
97 Subaru Legacy Outback
2005 Subaru sti (bugeye)
I\'ve got a special kind of 2005 sti up for trade. It\'s all original 2005 sti except the front end is white from the bugeye swap. It runs great. No check engine light. All stock except cat back exhaust. With only that it\'s super reliable and not abused. Comes with brand new BC racing coilovers, 17x9...
Year: 2005, Make: Subaru
2014 Subaru Forester 2.5i AWD
TRINITY MOTORS INC. 2226 EAST PLATTE AVE. COLORADO SPRINGS, COLORADO 719-630-7220FOLLOW OUR ENTIRE INVENTORY ON FACEBOOK....Trinity Motors of Colorado SpringsCLEAN CARFAX!COLORADO VEHICLE!LOW MILES!FACTORY WARRANTY!Stock #4062A -- 29400 Miles -- VIN #JF2
2000 Subaru 2.5 RS with STI swap and RWD swap
Couple small things on the body other than that body is good, only thing it needs is a new radiator, battery, and new tires soon.Has an 05 WRX transmission with brand new clutch and full STI suspension, comes with subs and amp you just need new wiring
Year: 2000, Make: Subaru
1998 Subaru legacy wagon $1500
Runs and drives great Ac is cold heater is hot. Comes with snow tiresGreat daily never left strandedSmall rust on front pass fender and hatch.5 speed manual transmission (needs shifter bushing but goes into all gears fine.) TypicL issue of this car and is 50 dollar part Drive her h
2009 Subaru Legacy 2.5i Special Edition
2013 Subaru Impreza
2014 Subaru Impreza WRX WRX
Year: 2014, Make: Subaru, Model: Impreza WRX
2011 Subaru Legacy 3.6R Limited
Used 2014 Subaru Impreza WRX STI
We believe in a no nonsense approach that we think you not only appreciate but find refreshing. We have been traveling the country for years hand selecting vehicles from many of the west's largest dealers and have decided to offer our vehicles to the general public. Our promise: You will be treated wi...
Year: 2014, Make: Subaru, Model: Impreza WRX STI
Manufacturer Certified 2015 Subaru XV Crosstrek For Sale
All Wheel Drive! Don\'t let the miles fool you! This vehicle includes our exclusive Buyer\'s Assurance Package. Complimentary 3year/125,000 mile limited powertrain warranty, 30 DAY EXCHANGE and 14 Day Price Match Guarantee.Want to save some money? Get the NEW look for the used price on this one owner ...
Year: 2015, Make: Subaru, Model: XV Crosstrek
2011 Subaru Impreza WRX STi WRX STi
Year: 2011, Make: Subaru, Model: Impreza WRX STi
2013 Subaru Legacy 2.5i Limited
Used 2010 Subaru Forester 2.5X
Bob Penkhus Mitsubishi is offering this 2010 Subaru Forester 2.5X, 4WD/AWD, LEATHER, DEALER SERVICED, and FRESH DETAIL. 5 speed! Stick shift!

Don't miss your opportunity at buying this outstanding 2010 Subaru Forester. Designated by Consumer Guide as a Recommended Compact SUV in 20...
Year: 2010, Make: Subaru, Model: Forester 2.5X


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Joint Notice of Privacy PracticesThis notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
"Dear Staff of Mulberry Gardens,For people so nice and compassionate, there are no words to express our gratitude, when it came to the care you generously provided for our uncle, "JOHN".It was such a comfort to know that "UNCLE TOMMY" was so well taken care of and happy at the home your staff lovingly shared with him and the other residents. Please give our special regards to Dawn, Shirley and all the nurses who helped our uncle."
—Annetta Laye


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James Earl Jones, Neil Patrick Harris To Appear At TonysTony Award host James Corden will be getting some starry help when he hands out the trophies next weekend — fellow Tony-winners Angela Lansbury, James Earl Jones and Neil Patrick Harris have also signed up.
Cooper, Mirren, Sting Share Their Favorite Tonys MomentWhen it comes to favorite Tony Award moments, some of this year's nominees are divided into two main camps: The moments with Neil Patrick Harris and the ones with Hugh Jackman.
Disney•Pixar Reveals New Trailer For Upcoming Dinosaur FilmVIDEO: This marks the 2nd film to release in 2015 for the Emeryville-based animation studio...
Presenters Announced For 2015 Tony AwardsSome of the biggest stars from stage, television, film and music will present at The 69th Annual Tony Awards.
#Trending In Entertainment: Kesha's Lawsuit & NPH Is Hosting The OscarsThis week, a pop star files a lawsuit, the Oscars are already on the road to success, and television is breaking new ground (sort of).
email@example.com's Movie Review: 'Gone Girl'VIDEO: Hooman & Marcus review the intricate drama w/ Ben Affleck & Rosamund Pike...
Neil Patrick Harris Gets Married In Italy"Yup, we put the 'n' and 'd' in 'husband,'" Harris tweeted
New 'Gone Girl' Preview Starring Ben Affleck Hits InternetAll evidence points to Ben Affleck's Nick Dunne in the latest trailer for David Fincher's adaptation of the bestselling crime novel...
Tony's Big Night For Murderous Musical, Audra McDonald, Bryan Cranston, NPHThe lethal romp "A Gentleman's Guide to Love and Murder" got a lot of love at Sunday night's Tony Awards, nabbing the best new musical trophy on a night that also saw Audra McDonald make Broadway history, Bryan Cranston win as a rookie and four-time host Neil Patrick Harris get his own award.
Tony Award Nominees Preview The Big NightThis year's list of Tony nominees include big name TV stars taking on very different roles and stage veterans taking on new challenges. CBS New York's Dana Tyler sat down with some of this year's Tony nominees ahead of the big night.
More Stars Added To Tony Awards Presenters And Performers ListOrlando Bloom, Barrett Foa, Jonathan Groff, T.I., LL COOL J, Samuel L. Jackson, Judith Light, Rosie O'Donnell and Patrick Wilson have been added to the star-studded lineup on "The 68th Annual Tony Awards."
Neil Patrick Harris Hopes For Tony Glory For 'Hedwig And The Angry Inch'For nine years, Neil Patrick Harris played unabashed ladies' man Barney Stinson on the smash CBS comedy "How I Met Your Mother." His Broadway comeback role as Hedwig could not be more different.


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©1995 Wayne W. Dyer; (P)1995 Hay House, Inc.
"love the meditation....."
short and sweet . I can meditate while driving, plug in to my headphones while waiting anywhere.....
"Stop it! Please!"
I thought these meditations were simply awful, and mostly I think it was because of Dr. Dyers voice. He seems to have a grating Ahhh and Ommm. I could have gone down to the local library and had a more conducive environment for meditating than listening to these meditations.
"Powerful prayer"
Dr. Dyer reinforces the inner power we fail to use, connecting with our Source, committing to daily meditation. When will we realize the importance of taking care of self. This is what is needed for all of us. Commit to this daily, everyone, and peace and harmony will manifest on this good earth.
The morning and evening meditations help me to acquire an absolute trust and peace in the manifestation of all my desires. I experience such serenity and awe after I complete the meditations because I am more aware of the awesome power of the Universe/God.
"Truly Awesome!!"
Did not read
The coolest thing about the meditation is that it solved a problem I was having with imagining things. I have too much noise in my mind and my imagination had a mind of it's own. The meditations eliminated the problem. Awesome audio and I would recommend it to anyone.
This Audio is Great, I've used it a few years back, day and night and now I've come in contact with it again. just like Waynes timeless wisdom,;there it sits waiting to be used morning and evening. this meditation guides us with the sounds of creation to project what we desire to create in our lives. I have experienced great joy and Abundance with continued use of this Audio. The Best Audio for conscious creation I know of.
"Great for my first introduction to meditation."
I've been doing it for months now and it's so positive. Still learning to concentrate more, but I know it just takes time. I've recommended it to several friends already.
"reaches my soul carreses my heart.
reached and touched my soul. comforting
exilhirating.Closeness kindness pure love.
relax free your tbougjts and just love yourself. love God.
"loved it"
he not only tells you how to do it but he also shows you. Loved it
"It doesn't get any better than this."
If you do commit to 20 minutes in the morning and 20 minutes in the evening to these mediations your life will profoundly the change
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About Jeff Masters
Cat 6 lead authors: WU cofounder Dr. Jeff Masters (right), who flew w/NOAA Hurricane Hunters 1986-1990, & WU meteorologist Bob Henson, @bhensonweather
By: Dr. Jeff Masters , 2:42 PM GMT on September 29, 2006
The tropical wave over the northernmost Lesser Antilles Islands (designated 97L by the NHC yesterday) has weakened. The wave is north of Puerto Rico this morning, and could bring some heavy rains to that island today. The system is very small and disorganized, and the 10-15 knots of wind shear over it will probably not allow such a small system to develop. You can follow the progress of 97L today on long range Puerto Rico radar.
Figure 1. Preliminary models tracks for Invest 97L.
Typhoon Xangsane
The Philippine Islands continue to count the dead and assess the damage left by Typhoon Xangsane, which roared over the main Philippine Island of Luzon Wednesday, passing directly over the capital city of Manila. At least 60 are dead and another 60 missing, with many hard-hit areas still to be heard from, due to failed communications and washed out roads. The majority of the victims died in mudslides, flash floods, and building collapses. Xangsane cut power to all 43 million people on the island of Luzon, making it one of the most extensive blackouts due to natural disaster in world history. Power had been restored to about 40% of the island this morning. Xangsane (from the Laotian word for Elephant) hit as a Category 4 typhoon with 145 mph winds before weakening during its passage over land. It has reintensified today into a Category 4 typhoon over the South China Sea, and is expected to deliver a heavy blow to Vietnam on Sunday.
Figure 2. Rainfall from Typhoon Xangsane over the Philippines as measured by NASA's TRMM satellite. The pink color represents about ten inches of rain. Image credit: NASA TRMM Project.
Tropical Storm Isaac continues to look unimpressive, thanks to dry air on the south side being drawn in, wind shear from an upper level low, and passage over some cool ocean waters stirred up by hurricanes Gordon and Helene. All of these influences should diminish a bit over the next day, which may allow Isaac the opportunity to do some modest intensification. The storm is not a threat to any land areas, and should recurve out to sea this weekend.
Elsewhere in the tropics
A strong cold front has pushed off the North American coast, and is serving as the focus of some thunderstorm development from the Bahamas southwestward through the waters south of Florida. We'll have to watch this region over the coming days for some possible development. However, the computer models are no longer forecasting development along this old front.
Next week, a non-tropical low pressure system is expected to form in the mid-Atlantic south of the Azores Islands, and this system may make the transition to a tropical storm like Delta, Epsilon, and Zeta did last year.
I'll have an update Saturday morning, and I'll post my outlook for October on Monday. We might be done with landfalling hurricanes for the year!
Jeff Masters
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Cat 6 lead authors: WU cofounder Dr. Jeff Masters (right), who flew w/NOAA Hurricane Hunters 1986-1990, & WU meteorologist Bob Henson, @bhensonweather
Mostly Cloudy


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Lists, Lists
Another week, another list of states – this time the list of "most stressed out states in the country," from a real estate blog. In this list, factors such as length of commute, number of hours worked, population density, unemployment, percentage of income spent on housing and percentage of population without health insurance were crunched in order to give a numerical ranking that does not quite match up with the results of some other recent "studies."
West Virginia, according to this list, is the 33rd most stressed out state. It was shown in a nice, relaxed green on the map. Remember, of course, that it has not been long at all since another report showed West Virginia was the most miserable state in the country. According to the folks who throw these things together, we here in the Mountain State are wretchedly miserable, but not terribly worried about it.
Ohio, though, fell in the middle of the stressed list – it was yellow, on the map. The Buckeye State ranked 25th, tied with Pennsylvania.
Meanwhile, shown in a menacing red, the top ten most stressed states included Florida, California, New York, New Jersey, Illinois and Nevada. To give some idea of how confusing (and meaningless) all this studying can be, most of those states fell in either the second or third quintile for happiness, in the same report that showed West Virginia is the most miserable state. So, folks in places like Miami, Los Angeles, New York City, Newark, Chicago and Las Vegas are pretty happy, they are just too stressed out to notice?
While it may be amusing to briefly take a look at the results of these studies, the two sets of results demonstrate fairly clearly how dangerous it can be to base anything – be it casual conversation or public policy – on the numbers presented.
Speaking of stress, here is hoping today is stress-free for the Mid-Ohio Valley dads and granddads being celebrated on this Father's Day.


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In addition to the accommodations provided by the Office of Disability Services, students are encouraged to use the following on-campus resources.
Assistive Technology Lab
The Assistive Technology Lab combines the resources of the Office of Disability Services (ODS), the Smith College libraries and the college's Educational Technology Services (ETS). The goal of the lab is to provide the latest assistive technology for individuals with physical, visual, psychological or learning disabilities.
Available resources include reading software tools (voice to text), screen and document magnification, nonvisual web readers and voice-recognition software (text to voice).
The Assistive Technology Lab is located in the basement of Neilson Library. Those interested in using the lab may contact ODS for a consultation concerning the use and application of various software. To arrange a demonstration of the available technology, please contact Joanne Cameron in ETS at extension 3472.
The Jacobson Center for Writing, Teaching and Learning
The Jacobson Center, located in Seelye 307, offers a variety of services to help students develop skills in writing and effective learning. Jacobson Center staff make every effort to address the needs of students with learning disabilities.
Professional Writing Counselors
A staff of professional writing counselors is available to review student drafts, point out strengths and weaknesses, listen to new ideas, and make suggestions for improvement. In the evenings and on weekends, the same services are provided by student writing assistants stationed in the center and at other campus locations.
Tutorial Program
In the tutorial program, students seeking help with a particular subject taught at Smith are matched with student tutors who have done well in that subject and have been recommended by faculty members. All of these services are free and are used by substantial numbers of Smith undergraduates, ranging from first-year students taking their first college courses to seniors writing honors essays.
Time Management & Study Skills
The Jacobson Center also offers workshops and one-to-one sessions on time management, organization and academic study skills.
The Career Development Office
The Lazarus Center for Career Development (CDO) provides assistance to students, alumnae, Smith staff and faculty, and their families in preparing for changing career environments and climates. The CDO's professional staff offers counseling, both individually and in groups, and their services are available throughout the calendar year. They hold seminars, workshops and panel discussions that cover internships, career choice and decision-making, resumé writing, interviewing and job search techniques, alumnae networking, career presentations, applying to graduate and professional schools and for summer jobs.
Events and Meeting Access Guidelines
Events and Meeting Access Guidelines (PDF)
There are four essential requirements that should be addressed proactively, as well as some additional accessibility guidelines that will make events more accessible, and that should be considered in the planning process and incorporated to the greatest extent possible. All individually requested accommodations must be arranged for and provided, unless there is a specific reason this is not possible. Contact the Office of Disability Services (email@example.com) with questions.


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Squid Vicious is a self-taught photographer from Portland, Oregon. His images have appeared in the Willamette Week newspaper, Portland Mercury newspaper, The Progressive magazine, an Elmer's commercial, in addition to numerous business offices and homes. He specializes in landscape, concert and event photography, along with weddings and portraiture.
Please contact Squid directly at email@example.com to discuss your photography needs. We hope you enjoy Squid's eye to the world.


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realmagick.com The shrine of knowledge.
- Dibrugarh voters to take pledge for free, fair polls
- Dibrugarh district administration has introduced a voter pledge-taking slip whereby the electorate promise to ensure free, fair and peaceful election upholding the country's democratic process during the upcoming Assam Assembly election on April 4.
- Rly consumer depot for Dibrugarh
- Dibrugarh: A new railway consumer depot was inaugurated at Dibrugarh railway station in Banipur on Friday. The Indian Oil Corporation (IOC) depot, with a capacity of 6.
- Dibrugarh University recalls Hazarika
- Speaking at the Dr Bhupen Hazarika Memorial Lecture in Dibrugarh University (DU)'s Rang Ghar auditorium on Tuesday, Choudhuri said the musical genius touched millions of hearts through his timeless songs. Referring to him as the Bard of Brahmaputra, ...
- 17 migratory geese 'poisoned' in Dibrugarh
- Dibrugarh: At least 17 migratory grey-legged geese (Raj Deo Hah in Assamese) died of poisoning in Dikhoumukh, 22 km from Sivasagar town, in the past 24 hours. Members of NGOs Dolphin and Nature's Beckon found the carcasses in Krishna Sagar Pathar ...
Dibrugarh is described in multiple online sources, as addition to our editors' articles, see section below for printable documents, Dibrugarh books and related discussion.
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