Magnetic Navigation in Left‐Sided AV Reentrant Tachycardias: Preliminary Results of a Retrograde Approach
Identifieur interne : 002435 ( Main/Corpus ); précédent : 002434; suivant : 002436Magnetic Navigation in Left‐Sided AV Reentrant Tachycardias: Preliminary Results of a Retrograde Approach
Auteurs : Andrew S. Thornton ; Maximo Rivero-Ayerza ; Paul Knops ; Luc J. JordaensSource :
- Journal of Cardiovascular Electrophysiology [ 1045-3873 ] ; 2007-05.
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Abstract
Introduction: A novel magnetic navigation system allows remote guidance of floppy radiofrequency (RF) ablation catheters. We evaluated the feasibility of mapping and ablation of left‐sided accessory pathways (APs) using the retrograde transaortic approach with this system. This might open the gate to retrograde ablation of left atrial arrhythmias. Methods and Results: Twenty consecutive patients were included. A Helios II was used in five and in 15 a Celsius RMT RF catheter with higher magnetic mass and different flexibility was used. Mapping and ablation were attempted. The learning curve was analyzed. Ablation was acutely successful in 60% of the patients using the Helios II and in 80% using the Celsius RMT. Median procedure time was 158 minutes, with median patient and physician fluoroscopy times of 26 and 4 minutes. In the last 10 patients, procedure times became significantly shorter (median 122 minutes, only Celsius RMT catheters) and standard catheters had to be used only twice. No complications occurred. Conclusions: Remote retrograde transaortic RF ablation of left‐sided APs is feasible, safe, and reduces the physician's fluoroscopy exposure. There is a very steep initial learning curve, with the success rate increasing from 50% in the first 10 cases to 80% in the last 10 cases. Different catheter configurations may influence the outcome.
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DOI: 10.1111/j.1540-8167.2007.00783.x
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ISTEX:86B423369828BE5261A775D866C64BF5EC6D3E22Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Magnetic Navigation in Left‐Sided AV Reentrant Tachycardias: Preliminary Results of a Retrograde Approach</title><author><name sortKey="Thornton, Andrew S" sort="Thornton, Andrew S" uniqKey="Thornton A" first="Andrew S." last="Thornton">Andrew S. Thornton</name><affiliation><mods:affiliation>Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Rivero Yerza, Maximo" sort="Rivero Yerza, Maximo" uniqKey="Rivero Yerza M" first="Maximo" last="Rivero-Ayerza">Maximo Rivero-Ayerza</name><affiliation><mods:affiliation>Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Knops, Paul" sort="Knops, Paul" uniqKey="Knops P" first="Paul" last="Knops">Paul Knops</name><affiliation><mods:affiliation>Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Jordaens, Luc J" sort="Jordaens, Luc J" uniqKey="Jordaens L" first="Luc J." last="Jordaens">Luc J. Jordaens</name><affiliation><mods:affiliation>Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:86B423369828BE5261A775D866C64BF5EC6D3E22</idno><date when="2007" year="2007">2007</date><idno type="doi">10.1111/j.1540-8167.2007.00783.x</idno><idno type="url">https://api.istex.fr/document/86B423369828BE5261A775D866C64BF5EC6D3E22/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">002435</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Magnetic Navigation in Left‐Sided AV Reentrant Tachycardias: Preliminary Results of a Retrograde Approach</title><author><name sortKey="Thornton, Andrew S" sort="Thornton, Andrew S" uniqKey="Thornton A" first="Andrew S." last="Thornton">Andrew S. Thornton</name><affiliation><mods:affiliation>Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Rivero Yerza, Maximo" sort="Rivero Yerza, Maximo" uniqKey="Rivero Yerza M" first="Maximo" last="Rivero-Ayerza">Maximo Rivero-Ayerza</name><affiliation><mods:affiliation>Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Knops, Paul" sort="Knops, Paul" uniqKey="Knops P" first="Paul" last="Knops">Paul Knops</name><affiliation><mods:affiliation>Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Jordaens, Luc J" sort="Jordaens, Luc J" uniqKey="Jordaens L" first="Luc J." last="Jordaens">Luc J. Jordaens</name><affiliation><mods:affiliation>Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Cardiovascular Electrophysiology</title><idno type="ISSN">1045-3873</idno><idno type="eISSN">1540-8167</idno><imprint><publisher>Blackwell Publishing Inc</publisher><pubPlace>Malden, USA</pubPlace><date type="published" when="2007-05">2007-05</date><biblScope unit="volume">18</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="467">467</biblScope><biblScope unit="page" to="472">472</biblScope></imprint><idno type="ISSN">1045-3873</idno></series><idno type="istex">86B423369828BE5261A775D866C64BF5EC6D3E22</idno><idno type="DOI">10.1111/j.1540-8167.2007.00783.x</idno><idno type="ArticleID">JCE783</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1045-3873</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AV reentrant tachycardia</term><term>Wolff‐Parkinson‐White syndrome</term><term>arrhythmias</term><term>catheter ablation</term><term>magnetic navigation</term><term>stereotactic therapy</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Introduction: A novel magnetic navigation system allows remote guidance of floppy radiofrequency (RF) ablation catheters. We evaluated the feasibility of mapping and ablation of left‐sided accessory pathways (APs) using the retrograde transaortic approach with this system. This might open the gate to retrograde ablation of left atrial arrhythmias. Methods and Results: Twenty consecutive patients were included. A Helios II was used in five and in 15 a Celsius RMT RF catheter with higher magnetic mass and different flexibility was used. Mapping and ablation were attempted. The learning curve was analyzed. Ablation was acutely successful in 60% of the patients using the Helios II and in 80% using the Celsius RMT. Median procedure time was 158 minutes, with median patient and physician fluoroscopy times of 26 and 4 minutes. In the last 10 patients, procedure times became significantly shorter (median 122 minutes, only Celsius RMT catheters) and standard catheters had to be used only twice. No complications occurred. Conclusions: Remote retrograde transaortic RF ablation of left‐sided APs is feasible, safe, and reduces the physician's fluoroscopy exposure. There is a very steep initial learning curve, with the success rate increasing from 50% in the first 10 cases to 80% in the last 10 cases. Different catheter configurations may influence the outcome.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>ANDREW S. THORNTON M.B.B.Ch.</name><affiliations><json:string>Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands</json:string></affiliations></json:item><json:item><name>MAXIMO RIVERO‐AYERZA M.D.</name><affiliations><json:string>Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands</json:string></affiliations></json:item><json:item><name>PAUL KNOPS B.Sc.</name><affiliations><json:string>Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands</json:string></affiliations></json:item><json:item><name>LUC J. JORDAENS M.D., PH.D.</name><affiliations><json:string>Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>arrhythmias</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>AV reentrant tachycardia</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>catheter ablation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>magnetic navigation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>stereotactic therapy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Wolff‐Parkinson‐White syndrome</value></json:item></subject><articleId><json:string>JCE783</json:string></articleId><language><json:string>eng</json:string></language><abstract>Introduction: A novel magnetic navigation system allows remote guidance of floppy radiofrequency (RF) ablation catheters. We evaluated the feasibility of mapping and ablation of left‐sided accessory pathways (APs) using the retrograde transaortic approach with this system. This might open the gate to retrograde ablation of left atrial arrhythmias. Methods and Results: Twenty consecutive patients were included. A Helios II was used in five and in 15 a Celsius RMT RF catheter with higher magnetic mass and different flexibility was used. Mapping and ablation were attempted. The learning curve was analyzed. Ablation was acutely successful in 60% of the patients using the Helios II and in 80% using the Celsius RMT. Median procedure time was 158 minutes, with median patient and physician fluoroscopy times of 26 and 4 minutes. In the last 10 patients, procedure times became significantly shorter (median 122 minutes, only Celsius RMT catheters) and standard catheters had to be used only twice. No complications occurred. Conclusions: Remote retrograde transaortic RF ablation of left‐sided APs is feasible, safe, and reduces the physician's fluoroscopy exposure. There is a very steep initial learning curve, with the success rate increasing from 50% in the first 10 cases to 80% in the last 10 cases. 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We evaluated the feasibility of mapping and ablation of left‐sided accessory pathways (APs) using the retrograde transaortic approach with this system. This might open the gate to retrograde ablation of left atrial arrhythmias. Methods and Results: Twenty consecutive patients were included. A Helios II was used in five and in 15 a Celsius RMT RF catheter with higher magnetic mass and different flexibility was used. Mapping and ablation were attempted. The learning curve was analyzed. Ablation was acutely successful in 60% of the patients using the Helios II and in 80% using the Celsius RMT. Median procedure time was 158 minutes, with median patient and physician fluoroscopy times of 26 and 4 minutes. In the last 10 patients, procedure times became significantly shorter (median 122 minutes, only Celsius RMT catheters) and standard catheters had to be used only twice. No complications occurred. Conclusions: Remote retrograde transaortic RF ablation of left‐sided APs is feasible, safe, and reduces the physician's fluoroscopy exposure. There is a very steep initial learning curve, with the success rate increasing from 50% in the first 10 cases to 80% in the last 10 cases. Different catheter configurations may influence the outcome.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>arrhythmias</term></item><item><term>AV reentrant tachycardia</term></item><item><term>catheter ablation</term></item><item><term>magnetic navigation</term></item><item><term>stereotactic therapy</term></item><item><term>Wolff‐Parkinson‐White syndrome</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2007-05">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/86B423369828BE5261A775D866C64BF5EC6D3E22/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Inc</publisherName><publisherLoc>Malden, USA</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1540-8167</doi><issn type="print">1045-3873</issn><issn type="electronic">1540-8167</issn><idGroup><id type="product" value="JCE"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY">Journal of Cardiovascular Electrophysiology</title></titleGroup></publicationMeta><publicationMeta level="part" position="05005"><doi origin="wiley">10.1111/jce.2007.18.issue-5</doi><numberingGroup><numbering type="journalVolume" number="18">18</numbering><numbering type="journalIssue" number="5">5</numbering></numberingGroup><coverDate startDate="2007-05">May 2007</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="3" status="forIssue"><doi origin="wiley">10.1111/j.1540-8167.2007.00783.x</doi><idGroup><id type="unit" value="JCE783"></id></idGroup><countGroup><count type="pageTotal" number="6"></count></countGroup><titleGroup><title type="tocHeading1">ORIGINAL ARTICLES</title><title type="tocHeading2"><i>Clinical</i></title></titleGroup><eventGroup><event type="firstOnline" date="2007-03-06"></event><event type="publishedOnlineFinalForm" date="2007-03-06"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.2 mode:FullText source:FullText result:FullText" date="2010-03-10"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-29"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-24"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="467">467</numbering><numbering type="pageLast" number="472">472</numbering></numberingGroup><correspondenceTo>Address for correspondence: A.S. Thornton, M.B.B.Ch., Clinical Electrophysiology Unit, Department of Cardiology, Thoraxcentre, Erasmus MC, Dr Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands. +31‐10‐4634420; E‐mail: <email>a.thornton@erasmusmc.nl</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:JCE.JCE783.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="2"></count><count type="tableTotal" number="3"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="20"></count><count type="linksCrossRef" number="21"></count></countGroup><titleGroup><title type="main">Magnetic Navigation in Left‐Sided AV Reentrant Tachycardias: Preliminary Results of a Retrograde Approach</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>ANDREW S.</givenNames><familyName>THORNTON</familyName><degrees>M.B.B.Ch.</degrees></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1"><personName><givenNames>MAXIMO</givenNames><familyName>RIVERO‐AYERZA</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1"><personName><givenNames>PAUL</givenNames><familyName>KNOPS</familyName><degrees>B.Sc.</degrees></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a1"><personName><givenNames>LUC J.</givenNames><familyName>JORDAENS</familyName><degrees>M.D., PH.D.</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="NL"><unparsedAffiliation>Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1"><i>arrhythmias</i></keyword><keyword xml:id="k2"><i>AV reentrant tachycardia</i></keyword><keyword xml:id="k3"><i>catheter ablation</i></keyword><keyword xml:id="k4"><i>magnetic navigation</i></keyword><keyword xml:id="k5"><i>stereotactic therapy</i></keyword><keyword xml:id="k6"><i>Wolff‐Parkinson‐White syndrome</i></keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><!-- Retrograde Magnetic Ablation of Accessory Pathways. 
<p> <i>Introduction:</i> A novel magnetic navigation system allows remote guidance of floppy radiofrequency (RF) ablation catheters. We evaluated the feasibility of mapping and ablation of left‐sided accessory pathways (APs) using the retrograde transaortic approach with this system. This might open the gate to retrograde ablation of left atrial arrhythmias.</p><p> <i>Methods and Results:</i> Twenty consecutive patients were included. A Helios II was used in five and in 15 a Celsius RMT RF catheter with higher magnetic mass and different flexibility was used. Mapping and ablation were attempted. The learning curve was analyzed. Ablation was acutely successful in 60% of the patients using the Helios II and in 80% using the Celsius RMT. Median procedure time was 158 minutes, with median patient and physician fluoroscopy times of 26 and 4 minutes. In the last 10 patients, procedure times became significantly shorter (median 122 minutes, only Celsius RMT catheters) and standard catheters had to be used only twice. No complications occurred.</p><p> <i>Conclusions:</i> Remote retrograde transaortic RF ablation of left‐sided APs is feasible, safe, and reduces the physician's fluoroscopy exposure. There is a very steep initial learning curve, with the success rate increasing from 50% in the first 10 cases to 80% in the last 10 cases. Different catheter configurations may influence the outcome.</p><!-- (J Cardiovasc Electrophysiol, Vol. 18, pp. 467-472, May 2007)
</abstractGroup></contentMeta><noteGroup><note xml:id="n-fnt-1" numbered="no"><p>A. Thornton received speaker's fees from Stereotaxis. L. Jordaens and Erasmus MC received a research grant from Stereotaxis.</p></note><note xml:id="n-fnt-2" numbered="no"><p>Manuscript received 30 October 2006; Revised manuscript received 25 December 2006; Accepted for publication 10 January 2007.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Magnetic Navigation in Left‐Sided AV Reentrant Tachycardias: Preliminary Results of a Retrograde Approach</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Magnetic Navigation in Left‐Sided AV Reentrant Tachycardias: Preliminary Results of a Retrograde Approach</title></titleInfo><name type="personal"><namePart type="given">ANDREW S.</namePart><namePart type="family">THORNTON</namePart><namePart type="termsOfAddress">M.B.B.Ch.</namePart><affiliation>Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">MAXIMO</namePart><namePart type="family">RIVERO‐AYERZA</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">PAUL</namePart><namePart type="family">KNOPS</namePart><namePart type="termsOfAddress">B.Sc.</namePart><affiliation>Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">LUC J.</namePart><namePart type="family">JORDAENS</namePart><namePart type="termsOfAddress">M.D., PH.D.</namePart><affiliation>Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Inc</publisher><place><placeTerm type="text">Malden, USA</placeTerm></place><dateIssued encoding="w3cdtf">2007-05</dateIssued><copyrightDate encoding="w3cdtf">2007</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">2</extent><extent unit="tables">3</extent><extent unit="references">20</extent></physicalDescription><abstract lang="en">Introduction: A novel magnetic navigation system allows remote guidance of floppy radiofrequency (RF) ablation catheters. We evaluated the feasibility of mapping and ablation of left‐sided accessory pathways (APs) using the retrograde transaortic approach with this system. This might open the gate to retrograde ablation of left atrial arrhythmias. Methods and Results: Twenty consecutive patients were included. A Helios II was used in five and in 15 a Celsius RMT RF catheter with higher magnetic mass and different flexibility was used. Mapping and ablation were attempted. The learning curve was analyzed. Ablation was acutely successful in 60% of the patients using the Helios II and in 80% using the Celsius RMT. Median procedure time was 158 minutes, with median patient and physician fluoroscopy times of 26 and 4 minutes. In the last 10 patients, procedure times became significantly shorter (median 122 minutes, only Celsius RMT catheters) and standard catheters had to be used only twice. No complications occurred. Conclusions: Remote retrograde transaortic RF ablation of left‐sided APs is feasible, safe, and reduces the physician's fluoroscopy exposure. There is a very steep initial learning curve, with the success rate increasing from 50% in the first 10 cases to 80% in the last 10 cases. Different catheter configurations may influence the outcome.</abstract><subject lang="en"><genre>Keywords</genre><topic>arrhythmias</topic><topic>AV reentrant tachycardia</topic><topic>catheter ablation</topic><topic>magnetic navigation</topic><topic>stereotactic therapy</topic><topic>Wolff‐Parkinson‐White syndrome</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Cardiovascular Electrophysiology</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">1045-3873</identifier><identifier type="eISSN">1540-8167</identifier><identifier type="DOI">10.1111/(ISSN)1540-8167</identifier><identifier type="PublisherID">JCE</identifier><part><date>2007</date><detail type="volume"><caption>vol.</caption><number>18</number></detail><detail type="issue"><caption>no.</caption><number>5</number></detail><extent unit="pages"><start>467</start><end>472</end><total>6</total></extent></part></relatedItem><identifier type="istex">86B423369828BE5261A775D866C64BF5EC6D3E22</identifier><identifier type="DOI">10.1111/j.1540-8167.2007.00783.x</identifier><identifier type="ArticleID">JCE783</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Inc</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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