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Sample records for atrial flutter

  1. Late atypical atrial flutter after ablation of atrial fibrillation.

    Science.gov (United States)

    Ferreira, Raquel; Primo, João; Adão, Luís; Gonzaga, Anabela; Gonçalves, Helena; Santos, Rui; Fonseca, Paulo; Santos, José; Gama, Vasco

    2016-10-01

    Cardiac surgery for structural heart disease (often involving the left atrium) and radiofrequency catheter ablation of atrial fibrillation have led to an increased incidence of regular atrial tachycardias, often presenting as atypical flutters. This type of flutter is particularly common after pulmonary vein isolation, especially after extensive atrial ablation including linear lesions and/or defragmentation. The authors describe the case of a 51-year-old man, with no relevant medical history, referred for a cardiology consultation in 2009 for paroxysmal atrial fibrillation. After failure of antiarrhythmic therapy, he underwent catheter ablation, with criteria of acute success. Three years later he again suffered palpitations and atypical atrial flutter was documented. The electrophysiology study confirmed the diagnosis of atypical left flutter and reappearance of electrical activity in the right inferior pulmonary vein. This vein was again ablated successfully and there has been no arrhythmia recurrence to date. In an era of frequent catheter ablation it is essential to understand the mechanism of this arrhythmia and to recognize such atypical flutters.

  2. Prevention of atrial flutter with cryoablation may be proarrhythmogenic

    DEFF Research Database (Denmark)

    Lukac, Peter; Hjortdal, Vibeke E; Pedersen, Anders K;

    2007-01-01

    BACKGROUND: Atrial flutter is a serious problem after surgery for congenital heart disease. METHODS: We performed an intraoperative linear one-minute cryolesion between a right atriotomy and the tricuspid annulus to prevent atrial flutter in 17 consecutive adult patients undergoing surgery...... for congenital heart disease. Coronary angiography and electrophysiology study using an electroanatomic mapping system to assess the conduction across the line and to try to induce atrial flutter were performed three months after the operation in 15 patients. RESULTS: Eleven patients had bidirectional block...

  3. Outcomes after ablation for typical atrial flutter (from the Loire Valley Atrial Fibrillation Project).

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    Clementy, Nicolas; Desprets, Laurent; Pierre, Bertrand; Lallemand, Bénédicte; Simeon, Edouard; Brunet-Bernard, Anne; Babuty, Dominique; Fauchier, Laurent

    2014-11-01

    Similar predisposing factors are found in most types of atrial arrhythmias. The incidence of atrial fibrillation (AF) among patients with atrial flutter is high, suggesting similar outcomes in patients with those arrhythmias. We sought to investigate the long-term outcomes and prognostic factors of patients with AF and/or atrial flutter with contemporary management using radiofrequency ablation. In an academic institution, we retrospectively examined the clinical course of 8,962 consecutive patients admitted to our department with a diagnosis of AF and/or atrial flutter. After a median follow-up of 934 ± 1,134 days, 1,155 deaths and 715 stroke and/thromboembolic (TE) events were recorded. Patients with atrial flutter undergoing cavotricuspid isthmus ablation (n = 875, 37% with a history of AF) had a better survival rate than other patients (hazard ratio [HR] 0.35, 95% confidence interval [CI] 0.25 to 0.49, p <0.0001). Using Cox proportional hazards model and propensity score model, after adjustment for main other confounders, ablation for atrial flutter was significantly associated with a lower risk of all-cause mortality (HR 0.55, 95% CI 0.36 to 0.84, p = 0.006) and stroke and/or TE events (HR 0.53, 95% CI 0.30 to 0.92, p = 0.02). After ablation, there was no significant difference in the risk of TE between patients with a history of AF and those with atrial flutter alone (HR 0.83, 95% CI 0.41 to 1.67, p = 0.59). In conclusion, in patients with atrial tachyarrhythmias, those with atrial flutter with contemporary management who undergo cavotricuspid isthmus radiofrequency ablation independently have a lower risk of stroke and/or TE events and death of any cause, whether a history of AF is present or not.

  4. Impact of dronedarone in atrial fibrillation and flutter on stroke reduction

    DEFF Research Database (Denmark)

    Christiansen, Christine Benn; Torp-Pedersen, Christian; Køber, Lars

    2010-01-01

    Dronedarone has been developed for treatment of atrial fibrillation (AF) or atrial flutter (AFL). It is an amiodarone analogue but noniodinized and without the same adverse effects as amiodarone.......Dronedarone has been developed for treatment of atrial fibrillation (AF) or atrial flutter (AFL). It is an amiodarone analogue but noniodinized and without the same adverse effects as amiodarone....

  5. Efficacy and safety of intravenous dofetilide for rapid termination of atrial fibrillation and atrial flutter

    NARCIS (Netherlands)

    Kingma, JH; Crijns, HJGM; Dunselman, PHJM

    2000-01-01

    Dofetilide may be advantageous in terminating atrial fibrillation/atrial flutter (AFl) when there are contraindications for class I drugs (left ventricular dysfunction and/or manifest myocardial ischemia) and beta blockers. In particular, its successful outcome in usually drug-resistant AFl is promi

  6. Atrial flutter in myotonic dystrophy type 1: Patient characteristics and clinical outcome.

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    Wahbi, Karim; Sebag, Frederic A; Lellouche, Nicolas; Lazarus, Arnaud; Bécane, Henri-Marc; Bassez, Guillaume; Stojkovic, Tanya; Fayssoil, Abdallah; Laforêt, Pascal; Béhin, Anthony; Meune, Christophe; Eymard, Bruno; Duboc, Denis

    2016-03-01

    The prevalence and the incidence of atrial flutter in patients with myotonic dystrophy type 1 (DM1) and the most appropriate strategies for its management are unknown. We retrospectively included in the DM1 Heart Registry 929 adult patients with DM1 admitted to our Institutions between January 2000 and September 2013. We selected patients presenting with atrial flutter and analysed data relative to the occurrence of arterial thromboembolism, severe bradyarrhythmias and atrial flutter recurrences. Atrial flutter was present in 79 of the 929 patients included in our Registry, representing a 8.5% prevalence. Patients with atrial flutter were older, had a higher muscular disability rating scale score and had higher prevalence of other cardiac manifestations of DM1. Sixty patients presented with a first episode of atrial flutter, representing a 4.6% incidence. Severe bradyarrhythmias requiring permanent pacing were present in 4 patients (6.7%). Over a 53 ± 28 months mean follow-up duration, 2 patients (3.3%) had ischaemic stroke and 12 (20%) had atrial flutter recurrences. Patients who underwent radiofrequency ablation were more frequently free of atrial flutter recurrence than other patients (95 vs. 61%; HR = 0.17; P = 0.04). Atrial flutter is a common manifestation of DM1, potentially complicated by arterial thromboembolism or severe bradyarrhythmias. Radiofrequency catheter ablation is associated with a lower risk for recurrences.

  7. Long-term outcome of electrical cardioversion in patients with chronic atrial flutter

    NARCIS (Netherlands)

    Crijns, HJGM; VanGelder, IC; Tieleman, RG; Brugemann, J; DeKam, PJ; Gosselink, ATM; BinkBoelkens, MTE; Lie, KI

    1997-01-01

    Objective-To determine she long-term outcome of serial electrical cardioversion therapy in patients with chronic atrial flutter. Design-Prospective study, case series. Setting-University hospital. Patients-50 consecutive patients with chronic (> 24 hours) atrial flutter without a previous relapse on

  8. Typical flutter ablation as an adjunct to catheter ablation of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Dipen Shah

    2008-12-01

    Full Text Available Typical atrial flutter and atrial fibrillation are frequently observed to coexist(1 .  In the current context of interventional electrophysiology, curative or at least definitive ablation is available for both arrhythmias. Despite their coexistence, it is not clear whether typical flutter ablation is necessary in all patients undergoing catheter ablation of atrial fibrillation. The following review explores the pathophysiology of both arrhythmias, their interrelationships and the available data pertaining to this theme.

  9. Clinical Differences between Subtypes of Atrial Fibrillation and Flutter: Cross-Sectional Registry of 407 Patients

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    Eduardo Dytz Almeida

    2015-01-01

    Full Text Available Introduction: Atrial fibrillation and atrial flutter account for one third of hospitalizations due to arrhythmias, determining great social and economic impacts. In Brazil, data on hospital care of these patients is scarce. Objective: To investigate the arrhythmia subtype of atrial fibrillation and flutter patients in the emergency setting and compare the clinical profile, thromboembolic risk and anticoagulants use. Methods: Cross-sectional retrospective study, with data collection from medical records of every patient treated for atrial fibrillation and flutter in the emergency department of Instituto de Cardiologia do Rio Grande do Sul during the first trimester of 2012. Results: We included 407 patients (356 had atrial fibrillation and 51 had flutter. Patients with paroxysmal atrial fibrillation were in average 5 years younger than those with persistent atrial fibrillation. Compared to paroxysmal atrial fibrillation patients, those with persistent atrial fibrillation and flutter had larger atrial diameter (48.6 ± 7.2 vs. 47.2 ± 6.2 vs. 42.3 ± 6.4; p < 0.01 and lower left ventricular ejection fraction (66.8 ± 11 vs. 53.9 ± 17 vs. 57.4 ± 16; p < 0.01. The prevalence of stroke and heart failure was higher in persistent atrial fibrillation and flutter patients. Those with paroxysmal atrial fibrillation and flutter had higher prevalence of CHADS2 score of zero when compared to those with persistent atrial fibrillation (27.8% vs. 18% vs. 4.9%; p < 0.01. The prevalence of anticoagulation in patients with CHA2DS2-Vasc ≤ 2 was 40%. Conclusions: The population in our registry was similar in its comorbidities and demographic profile to those of North American and European registries. Despite the high thromboembolic risk, the use of anticoagulants was low, revealing difficulties for incorporating guideline recommendations. Public health strategies should be adopted in order to improve these rates.

  10. Results of Atrial Fibrillation Ablation in Patients With or Without a History of Atrial Flutter

    Institute of Scientific and Technical Information of China (English)

    Lu chunshan; Liu Xingpeng; Dong Jianzeng; Ma Changsheng

    2006-01-01

    Objectives There are two kind of atrial flutter during circumferential ablation for atrial fibrillation (AF): new onset left atrial flutter (LAFL), with a history of atrial flutter (AFL). What is the relationship of AFL and AF? Whether there are some differences in clinical course and mechanism between the new onset LAFL and the with a history of AFL remained unclear. The aim of this study was to assess the impacts of circumferential ablation on the occurrence of arrhythmias in follow-up in 2 groups:( 1 ) patients with a history of AFL and AF, and (2)patients with new onset LAFL. Methods Data from 465 patients who had circumferential pulmonary vein ablation (CPVA) or segmental pulmonary vein ablation (SPVA) were analyzed. Patients with a history of AFL ablation and patients who had concomitant AFL ablation were included from analysis. Forty-one patients constituted the history of AFL group (group 1, aged 57±13 years, 7 females) and twenty-eight patients constituted the new onset LAFL group (group 2, aged 55±12 years, 6 females). bipolar recordings were obtained from the tricuspid annulus, coronary sinus,interatrial septum and left atrium. Target sites were identified by early, fragmented or double potentials and by concealed entrainment. Linear lesions were created between target sites and nearby anatomical barriers (1) typical atrial flutter (cycle length, 242±39 ms). cavotricuspid isthmus ablation was performed.(2) new onset LAFL (cycle length, 282±153 ms). 20 episodes of AAFs were documented in 20/28 (71.4%)patients. Target sites were identified around pulmonary veins (n=10), gap in linear lesion (n=7), left atrial roof lines (1 case). For those cases the ablation line between PV and mitral annulus was performed.Patients in Group 2 had larger left atria, higher incidence of AFL pre-CPVA, and lower ejection fraction. Results There was no significant difference in post-CPVA AF recurrence between Groups 1 and 2, but AFL incidence after CPVA was higher in Group

  11. Endurance sport practice as a risk factor for atrial fibrillation and atrial flutter.

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    Mont, Lluís; Elosua, Roberto; Brugada, Josep

    2009-01-01

    Although the benefits of regular exercise in controlling cardiovascular risk factors have been extensively proven, little is known about the long-term cardiovascular effects of regular and extreme endurance sport practice, such as jogging, cycling, rowing, swimming, etc. Recent data from a small series suggest a relationship between regular, long-term endurance sport practice and atrial fibrillation (AF) and flutter. Reported case control studies included less than 300 athletes, with mean age between 40 and 50. Most series recruited only male patients, or more than 70% males, who had been involved in intense training for many years. Endurance sport practice increases between 2 and 10 times the probability of suffering AF, after adjusting for other risk factors. The possible mechanisms explaining the association remain speculative. Atrial ectopic beats, inflammatory changes, and atrial size have been suggested. Some of the published studies found that atrial size was larger in athletes than in controls, and this was a predictor for AF. It has also been shown that the left atrium may be enlarged in as many as 20% of competitive athletes. Other proposed mechanisms are increased vagal tone and bradycardia, affecting the atrial refractory period; however, this may facilitate rather than cause the arrhythmia. In summary, recent data suggest an association between endurance sport practice and atrial fibrillation and flutter. The underlying mechanism explaining this association is unclear, although structural atrial changes (dilatation and fibrosis) are probably present. Larger longitudinal studies and mechanistic studies are needed to further characterize the association to clarify whether a threshold limit for the intensity and duration of physical activity may prevent AF, without limiting the cardiovascular benefits of exercise.

  12. Electrophysiological characteristics and radiofrequency ablation of right atrial flutter

    Directory of Open Access Journals (Sweden)

    Yoga Yuniadi

    2007-09-01

    Full Text Available This study aimed to elaborate the electrophysiology characteristics and radiofrequency ablation (RFA results of atrial flutter (AFL which has not been established in Indonesia. Three multipolar catheters were inserted percutaneously and positioned into coronary sinus (CS, His bundle area and around tricuspid annulus. Eight mm ablation catheter was used to make linear ablation at CTI of typical and reverse typical AFL. Bidirectional block was confirmed by conduction time prolongation of more than 90 msec from low lateral to CS ostium and vice versa, and/or by means of differential pacing. Thirty AFL from 27 patients comprised of 19 typical AFL, 5 reverse typical AFL and 6 atypical AFL enrolled the study. Mean tachycardia cycle length (TCL were 261.8 ± 42.84, 226.5 ± 41.23, and 195.4 ± 9.19 msec, respectively (p = 0.016. CTI conduction time occupied up to 60% of TCL with mean conduction time of 153.0 ± 67.37 msec. CS activation distributed to three categories which comprised of proximal to distal, distal to proximal and fusion activation. Only nine of 27 patients had no structural heart disease. RFA of symptomatic typical and reverse typical AFL demonstrated 96% success and 4.5 % recurrence rate during 13 ± 8 months follow up. Typical AFL is the predominant type of AFL in our population. The majority of AFL cases suffered from structural heart disease. RFA was highly effective to cure typical and reverse typical AFL. (Med J Indones 2007; 16:151-8 Keywords: atrial flutter, electrophysiology, ablation

  13. Intra-atrial reentry as a mechanism for atrial flutter induced by acetylcholine and rapid pacing in the dog.

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    Allessie, M A; Lammers, W J; Bonke, I M; Hollen, J

    1984-07-01

    In the isolated blood-perfused canine heart we produced episodes of rapid atrial flutter by continuous infusion of acetylcholine and rapid pacing. The spread of excitation during atrial flutter was mapped with the aid of two endocavitary mapping electrodes containing 960 leads and recording from 192 different sites simultaneously. The flutter maps clearly showed that intra-atrial reentry was the mechanism responsible for the arrhythmia. However, the localization and size of the intra-atrial circuits differed from case to case even in the same heart. The orifices of the venae cavae or the atrioventricular ring did not serve as a central anatomic obstacle for circus movement. We also failed to identify a special role of the internodal pathways in the formation of the loop. Instead, the intra-atrial circuits could be found everywhere, provided sufficient atrial mass was available to accommodate the circuit. The diameter of the circuits varied between 1.5 and 3 cm at a cycle length between 65 and 155 msec. The average conduction velocity of the circulating impulse varied between 60 and 80 cm/sec. Spontaneous termination of atrial flutter frequently occurred and was based on local conduction block in a narrow part of the circuit. Another interesting aspect of these studies is the finding that during continuous circus movement of the impulse, the amount of myocardium that is activated may vary considerably. This marked periodicity in excited tissue mass during atrial flutter could adequately explain the continuously undulating baseline or typical sawtoothlike F waves as seen in the surface electrocardiogram during atrial flutter.

  14. Intermittent changing axis deviation with intermittent left anterior hemiblock during atrial flutter with subclinical hyperthyroidism.

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    Patanè, Salvatore; Marte, Filippo

    2009-06-26

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with CHD or mortality from cardiovascular causes but it is usually associated with a higher heart rate and a higher risk of supraventricular arrhythmias including atrial fibrillation and atrial flutter. Intermittent changing axis deviation during atrial fibrillation has also rarely been reported. We present a case of intermittent changing axis deviation with intermittent left anterior hemiblock in a 59-year-old Italian man with atrial flutter and subclinical hyperthyroidism. To our knowledge, this is the first report of intermittent changing axis deviation with intermittent left anterior hemiblock in a patient with atrial flutter.

  15. Changing axis deviation and paroxysmal atrial flutter associated with subclinical hyperthyroidism.

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    Patanè, Salvatore; Marte, Filippo

    2010-10-08

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. Rarely, it has also been reported intermittent changing axis deviation during atrial fibrillation and during atrial flutter. We present a case of paroxysmal atrial flutter and changing axis deviation associated with subclinical hyperthyroidism, in a 76-year-old Italian man. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  16. Pharmacologic versus direct-current electrical cardioversion of atrial flutter and fibrillation

    NARCIS (Netherlands)

    Van Gelder, IC; Tuinenburg, AE; Schoonderwoerd, BS; Tieleman, RG; Crijns, HJGM

    1999-01-01

    Conversion of atrial flutter and atrial fibrillation (AF) can be achieved by either pharmacologic or direct-current (DC) electrical cardioversion. DC electrical cardioversion is more effective and restores sinus rhythm instantaneously; however, general anesthesia is necessary, which can cause severe

  17. INCIDENCE AND CLINICAL-SIGNIFICANCE OF ST SEGMENT ELEVATION AFTER ELECTRICAL CARDIOVERSION OF ATRIAL-FIBRILLATION AND ATRIAL-FLUTTER

    NARCIS (Netherlands)

    VANGELDER, IC; CRIJNS, HJ; VANDERLAARSE, A; VANGILST, WH; LIE, KI

    1991-01-01

    To study the incidence and clinical significance of postshock ST segment elevations, we recorded 12-lead ECGs immediately after transthoracic direct-current electrical cardioversion in 146 patients with atrial fibrillation or flutter. Among 23 patients (19%), acute ST segment elevations amounted to

  18. The occurrence and prognostic significance of atrial fibrillation/-flutter following acute myocardial infarction. TRACE Study group. TRAndolapril Cardiac Evalution

    DEFF Research Database (Denmark)

    Pedersen, O D; Bagger, H; Køber, L;

    1999-01-01

    AIMS: To investigate the occurrence and prognostic significance of atrial fibrillation/-flutter following acute myocardial infarction. METHODS AND RESULTS: The occurrence and prognostic significance of atrial fibrillation/-flutter were studied in 6676 consecutive patients with acute myocardial...... extensive, thrombolytic therapy was received less frequently, and anterior Q wave myocardial infarction was experienced more frequently than patients without atrial fibrillation/-flutter. History of acute myocardial infarction and/or angina pectoris was similar in patients with and without atrial......, relative risk=1.4 (95% Cl: 1.2-1.7). CONCLUSION: Atrial fibrillation/-flutter often occurs after acute myocardial infarction and our analysis demonstrated that it was an independent predictor of an increased short and long-term mortality....

  19. Transesophageal cardioversion of atrial flutter and atrial fibrillation using an electric balloon electrode system

    Institute of Scientific and Technical Information of China (English)

    郑方胜; 祁学文; 刘海峰; 康宁宁

    2003-01-01

    Objective To determine the feasibility and efficiency of terminating atrial flutter (AFL) and atrial fibrillation (AF) using synchronous low-energy shocks delivered through a novel transesophageal electric balloon electrode system.Methods By using a novel electric balloon electrode system, we attempted 91 transesophageal cardioversions in 52 patients, to treat 53 episodes of AFL and 38 episodes of AF.Results Of the 40 patients of AFL that failed to respond to drug therapy, 37 (92.5%) were successfully countershocked to sinus rhythm by transesophageal cardioversion, with a mean energy of (22.70±4.50) J (20-30 J). Of the 19 patients in AF, transesophageal cardioversion was successful in 16 (84.2%) cases, requiring a mean delivered energy of (17.38±8.58) J (3-30 J). There were no complications such as heart block or ventricular fibrillation, and no evidence of esophageal injury. Conclusions Transesophageal cardioversion using an electric balloon electrode system is an effective and feasible method for the treatment of AFL and AF. It requires low energy and no anesthesia, leads to less trauma, and shows a high cardioversion success rate that may prove valuable in the management of tachyarrhythmias.

  20. Voltage-guided ablation technique for cavotricuspid isthmus-dependent atrial flutter

    DEFF Research Database (Denmark)

    Jacobsen, Peter K; Klein, George J; Gula, Lorne J;

    2012-01-01

    Ablation of the cavotricuspid isthmus has become first-line therapy for "isthmus-dependent" atrial flutter. The goal of ablation is to produce bidirectional cavotricuspid isthmus block. Traditionally, this has been obtained by creation of a complete ablation line across the isthmus from the ventr...

  1. Acute success and short-term follow-up of catheter ablation of isthmus-dependent atrial flutter; a comparison of 8 mm tip radiofrequency and cryothermy catheters

    NARCIS (Netherlands)

    A.S. Thornton (Andrew); P. Janse (Petter); M. Alings (Marco); M.F. Scholten (Marcoen); J.M. Mekel (Joris); M. Miltenburg (Max); E. Jessurun; L.J.L.M. Jordaens (Luc)

    2008-01-01

    textabstractObjectives: To compare the acute success and short-term follow-up of ablation of atrial flutter using 8 mm tip radiofrequency (RF) and cryocatheters. Methods: Sixty-two patients with atrial flutter were randomized to RF or cryocatheter (cryo) ablation. Right atrial angiography was perfor

  2. Effects of a novel class III antiarrhythmic agent, NIP-142, on canine atrial fibrillation and flutter.

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    Nagasawa, Hidehiko; Fujiki, Akira; Fujikura, Naoki; Matsuda, Tomoyuki; Yamashita, Toru; Inoue, Hiroshi

    2002-02-01

    The effects of a new benzopyran derivative, NIP-142, on atrial fibrillation (AF) and flutter (AFL) and on electrophysiological variables were studied in the dog. NIP-142 (3mg/kg) was administered intravenously to pentobarbital-anesthetized beagles during vagally-induced AF and during AFL induced after placement of an intercaval crush. Isolated canine atrial tissues were studied using standard microelectrode technique. NIP-142 terminated AF in 5 of 6 dogs after an increase in fibrillation cycle length (CL) and prevented reinitiation of AF in all 6 dogs. NIP-142 terminated AFL in all 6 dogs without any appreciable change in flutter CL, and prevented reinitiation of AFL in all 6 dogs. NIP-142 prolonged atrial effective refractory periods (11+/-5%, 3+/-3%, 12+/-3%, and 10+/-5% from the baseline value at basic CLs of 150, 200, 300, and 350ms, respectively) without changes in intraatrial conduction time. The prolongation of the atrial effective refractory period was greater in the presence of vagal stimulation. NIP-142 decreased action potential phase-1 notch and increased phase-2 plateau height without making any changes in the action potential duration, although it did reverse carbachol-induced shortening of the action potential duration. In conclusion, NIP-142 is effective in treating AFL and vagally-induced AF by prolonging atrial refractoriness.

  3. RECURRENCE OF PAROXYSMAL ATRIAL-FIBRILLATION OR FLUTTER AFTER SUCCESSFUL CARDIOVERSION IN PATIENTS WITH NORMAL LEFT-VENTRICULAR FUNCTION

    NARCIS (Netherlands)

    SUTTORP, MJ; KINGMA, JH; KOOMEN, EM; VANTHOF, A; TIJSSEN, JGP; LIE, KI

    1993-01-01

    One hundred twenty-four consecutive patients (85%) with paroxysmal atrial fibrillation (AF) and 21 (15%) with atrial flutter (AFI) were studied immediately after pharmacologic or electrical cardioversion to sinus rhythm. Mean age was 59 +/- 13 years (range 23 to 79). Patients with reduced left ventr

  4. Impact of congestive heart failure and left ventricular systolic function on the prognostic significance of atrial fibrillation and atrial flutter following acute myocardial infarction

    DEFF Research Database (Denmark)

    Pedersen, Ole Dyg; Bagger, Henning; Køber, Lars

    2005-01-01

    BACKGROUND: Reports on the prognostic importance of atrial fibrillation following myocardial infarction have provided considerable variation in results. Thus, this study examined the impact of left ventricular systolic function and congestive heart failure on the prognostic importance of atrial...... and congestive heart failure were prospectively collected. Mortality was followed for 5 years. RESULTS: In patients with left ventricular ejection fraction... mortality. In patients with 0.250.35. In patients with congestive heart failure, atrial fibrillation/atrial flutter was associated with an increased in-hospital mortality (OR=1.5 (1.2-1.9); p

  5. Voltage-guided ablation technique for cavotricuspid isthmus-dependent atrial flutter: refining the continuous line.

    Science.gov (United States)

    Jacobsen, Peter K; Klein, George J; Gula, Lorne J; Krahn, Andrew D; Yee, Raymond; Leong-Sit, Peter; Mechulan, Alexis; Skanes, Allan C

    2012-06-01

    Ablation of the cavotricuspid isthmus has become first-line therapy for "isthmus-dependent" atrial flutter. The goal of ablation is to produce bidirectional cavotricuspid isthmus block. Traditionally, this has been obtained by creation of a complete ablation line across the isthmus from the ventricular end to the inferior vena cava. This article describes an alternative method used in our laboratory. There is substantial evidence that conduction across the isthmus occurs preferentially over discrete separate bundles of tissue. Consequently, voltage-guided ablation targeting only these bundles with large amplitude atrial electrograms results in a highly efficient alternate method for the interruption of conduction across the cavotricuspid isthmus. Understanding the bundle structure of conduction over the isthmus facilitates more flexible approaches to its ablation and targeting maximum voltages in our hands has resulted in reduction of ablation time and fewer recurrences.

  6. Acute myocardial infarction after radiofrequency catheter ablation of typical atrial flutter.

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    Yune, Sehyo; Lee, Woo Joo; Hwang, Ji-won; Kim, Eun; Ha, Jung Min; Kim, June Soo

    2014-02-01

    A 53-yr-old man underwent radiofrequency ablation to treat persistent atrial flutter. After the procedure, the chest pain was getting worse, and the electrocardiogram showed ST-segment elevation in inferior leads with reciprocal changes. Immediate coronary angiography showed total occlusion with thrombi at the distal portion of the right coronary artery, which was very close to the ablation site. Intervention with thrombus aspiration and balloon dilatation was successful, and the patient recovered without any kind of sequelae. Although the exact mechanism is obscure, the most likely explanation is a thermal injury to the vascular wall that ruptured into the lumen and formed thrombus. Vasospasm and thromboembolism can also be other possibilities. This case raise the alarm to cardiologists who perform radiofrequency ablation to treat various kinds of cardiac arrhythmias, in that myocardial infarction has been rarely considered one of the complications.

  7. Flutter Atrial Fetal en Madre Portadora de Síndrome de Brugada: Caso Clínico

    Directory of Open Access Journals (Sweden)

    Gustavo Kiekebusch Hurel

    2011-01-01

    Full Text Available Se presenta el caso de mujer portadora de Síndrome de Brugada que cursa embarazo de 35 semanas, en cuyo control ecográfico prenatal se observa flutter atrial fetal. Se realizó interrupción del embarazo vía cesárea de urgencia, obteniéndose recién nacido de pretérmino sexo masculino, vivo, con taquiarritmia persistente, la cual requirió manejo con Adenosina. Este caso representa un gran desafío en cuanto a la asociación entre la patología materna y la fetal, además de su utilidad como orientación en el manejo de otros casos similares. Palabras Clave: Síndrome de Brugada, flutter atrial fetal, recién nacido de pretérmino, embarazo.

  8. Sick sinus syndrome, progressive cardiac conduction disease, atrial flutter and ventricular tachycardia caused by a novel SCN5A mutation

    DEFF Research Database (Denmark)

    Holst, Anders G; Liang, Bo; Jespersen, Thomas

    2010-01-01

    Mutations in the cardiac sodium channel encoded by the gene SCN5A can result in a wide array of phenotypes. We report a case of a young male with a novel SCN5A mutation (R121W) afflicted by sick sinus syndrome, progressive cardiac conduction disorder, atrial flutter and ventricular tachycardia. His...... the spectrum of SCN5A loss-of-function associated disease entities should be viewed as one syndrome....

  9. PREDICTION OF UNEVENTFUL CARDIOVERSION AND MAINTENANCE OF SINUS RHYTHM FROM DIRECT-CURRENT ELECTRICAL CARDIOVERSION OF CHRONIC ATRIAL-FIBRILLATION AND FLUTTER

    NARCIS (Netherlands)

    VANGELDER, IC; CRIJNS, HJ; VANGILST, WH; LIE, KI

    1991-01-01

    The present study was undertaken to reassess prospectively the immediate and long-term results of direct-current electrical cardioversion in chronic atrial fibrillation or atrial flutter, and to determine factors predicting clinical outcome of the arrhthmia after direct-current cardioversion. Two-hu

  10. Varying types of circus movement re-entry with both normal and dissociated contralateral conduction causing different right and left atrial rhythms in canine atrial flutter.

    Science.gov (United States)

    Yamauchi, S; Boineau, J P; Schuessler, R B; Cox, J L

    1998-03-01

    The purpose of this study was to develop an animal model of atrial flutter (AFL) or fibrillation (AFB) and to determine precisely the pathway of atrial activation during arrhythmias induced by programmed stimulation. In 10 dogs, a shunt from the left subclavian artery to the left upper pulmonary vein was created to produce left atrial enlargement. Five months later, using programmed electrical stimulation, it was possible to induce 17 sustained atrial tachycardias in 9 of the 10 dogs, including 9 episodes of AFL caused by circus movement re-entry, 6 episodes of focal tachycardia, and 2 episodes of AFB. Short cycle length left atrial tachycardias caused by either circus movement or a focus did not propagate in a uniform 1:1 pattern to the right atrium (RA), resulting in RA dissociation. In these arrhythmias, complex wavefronts from both current and preceding left atrial cycles coexisted in the RA. Circus movement was associated with a spectrum of different re-entrant pathways with different path lengths. These differences in the path length were determined by various ways in which obstacles such as the superior vena cava and orifice of the right atrial appendage or pulmonary vein orifices were combined by contiguous areas of functional block.

  11. Case report: successful repeat tricuspid valve replacement combined with atrial flutter ablation during correction of Ebstein's anomaly

    Directory of Open Access Journals (Sweden)

    Bockeria L.A.

    2013-09-01

    Full Text Available Patients with Ebstein's anomaly often suffer from a variety of arrhythmias, such as paroxysmal supraventricular tachycardia, atrial fibrillation and atrial flutter, which in turn adversely affects the prognosis of these patients. This is why early diagnosis and treatment can reduce the risk of sudden cardiac death. Patient V. 34 years old admitted to the department of surgical treatment of interactive pathology Bakoulev's Сenter for Сardiovascular Surgery RAMS. In 1987 the patient underwent tricuspid valve replacement with bioprosthesis made of aortic valve of a pig. After the operation he felt well. Worsening of the disease was noticed in July 2012. Due to worsening of the symptoms the patient admitted to a hospital. Dysfunction of bioprosthesis with calcification and insufficiency were revealed. Atrial flutter was diagnosed as well. 19.10.2012 redo tricuspid valve replacement with bioprosthesis Bioglis (28 in diameter, cryoablation of right isthmus and the dase of right atrial appendage with Atri Cure system. The patient was discharged on postoperative day 12. He felt well and was sent to supervision of cardiologist for follow-up.

  12. Alta dose de amiodarona em curto período reduz incidência de fibrilação atrial e flutter atrial no pós-operatório de cirurgia de revascularização miocárdica High dose of amiodarone in a short-term period reduces the incidence of postoperative atrial fibrillation and atrial flutter

    Directory of Open Access Journals (Sweden)

    Rafael Vieira Alcalde

    2006-09-01

    Full Text Available OBJETIVOS: Avaliar se a administração de amiodarona, em doses altas e curso rápido, reduz a incidência de fibrilação ou flutter atrial, após cirurgia de revascularização miocárdica e se reduz, também, o tempo de internação hospitalar. MÉTODOS: A amostra se constituiu de 93 pacientes randomizados, em estudo duplo-cego, para receberem amiodarona (46 pacientes ou placebo (47 pacientes. A terapia consistia na aplicação de 600mg de amiodarona, três vezes ao dia, iniciada no mínimo 30 horas e no máximo 56 horas antes da cirurgia. RESULTADOS: Fibrilação ou flutter atrial no pós-operatório ocorreu em 8 dos 46 pacientes no grupo amiodarona (17,4% e em 19 dos 47 pacientes no grupo placebo (40,4% (p=0,027. A dose média de amiodarona foi de 2,8g. Os pacientes do grupo amiodarona ficaram hospitalizados por 8,9±3,1 dias, enquanto a internação dos pacientes do grupo placebo foi de 11,4± 8,7 dias (p=0,07. O tempo de internação foi significativamente prolongado nos pacientes que desenvolveram fibrilação ou flutter atrial após a cirurgia, independente do grupo randomizado. CONCLUSÃO: Esta nova alternativa de administração de amiodarona em alta dose e por um curto período, antes da cirurgia de revascularização miocárdica, reduz a incidência de fibrilação ou flutter atrial no pós-operatório desta cirurgia.OBJECTIVE: To investigate wheter oral amiodarone administered before surgery for a short period in high dose would reduce the incidence of postoperative atrial fibrillation or atrial flutter and reduces the lenght of hospital stay. METHODS: In the double-blind, randomized study, 93 patients were given either oral amiodarone (46 patients or placebo (47 patients. Therapy consisted of 600mg of amiodarone three times a day, started at mininum 30 hours and at maximum 56 hours before surgery. RESULTS: Postoperative atrial fibrillation or atrial flutter occurred in 8 of 46 patients in the amiodarone group (17.4% and 19 of the

  13. Efficacy comparison between cryoablation and radiofrequency ablation for patients with cavotricuspid valve isthmus dependent atrial flutter: a meta-analysis

    Science.gov (United States)

    Chen, Yi-He; Lin, Hui; Xie, Cheng-Long; Zhang, Xiao-Ting; Li, Yi-Gang

    2015-06-01

    We perform this meta-analysis to compare the efficacy and safety of cryoablation versus radiofrequency ablation for patients with cavotricuspid valve isthmus dependent atrial flutter. By searching EMBASE, MEDLINE, PubMed and Cochrane electronic databases from March 1986 to September 2014, 7 randomized clinical trials were included. Acute (risk ratio[RR]: 0.93; P = 0.14) and long-term (RR: 0.94; P = 0.08) success rate were slightly lower in cryoablation group than in radiofrequency ablation group, but the difference was not statistically significant. Additionally, the fluoroscopy time was nonsignificantly reduced (weighted mean difference[WMD]: -2.83 P = 0.29), whereas procedure time was significantly longer (WMD: 25.95; P = 0.01) in cryoablation group compared with radiofrequency ablation group. Furthermore, Pain perception during the catheter ablation was substantially less in cryoabaltion group than in radiofrequency ablation group (standardized mean difference[SMD]: -2.36 P < 0.00001). Thus, our meta-analysis demonstrated that cryoablation and radiofrequency ablation produce comparable acute and long-term success rate for patients with cavotricuspid valve isthmus dependent atrial flutter. Meanwhile, cryoablation ablation tends to reduce the fluoroscopy time and significantly reduce pain perception in cost of significantly prolonged procedure time.

  14. ATRIAL-FLUTTER CAN BE TERMINATED BY A CLASS-III ANTIARRHYTHMIC DRUG BUT NOT BY A CLASS-IC DRUG

    NARCIS (Netherlands)

    CRIJNS, HJGM; VANGELDER, IC; KINGMA, JH; DUNSELMAN, PHJM; GOSSELINK, ATM; LIE, KI

    1994-01-01

    In atrial flutter, chemical conversion with class I drugs is often unsuccessful, whereas class III drugs seem more promising. The different electrophysiological effects of these drugs may explain this discrepancy. To date, only experimental data show the differential effects of these drugs on conver

  15. THE VALUE OF CLASS-IC ANTIARRHYTHMIC DRUGS FOR ACUTE CONVERSION OF PAROXYSMAL ATRIAL-FIBRILLATION OR FLUTTER TO SINUS RHYTHM

    NARCIS (Netherlands)

    SUTTORP, MJ; KINGMA, JH; JESSURUN, ER; LIEAHUEN, L; VANHEMEL, NM; LIE, KI

    1990-01-01

    In a single-blind randomized study, the efficacy and safety of intravenous propafenone (2 mg/kg body weight per 10 min) versus flecainide (2 mg/kg per 10 min) were assessed in 50 patients with atrial fibrillation or flutter. Treatment was considered successful if sinus rhythm occurred within 1 h. Co

  16. Efficacy of dofetilide in the treatment of atrial fibrillation-flutter in patients with reduced left ventricular function: a Danish investigations of arrhythmia and mortality on dofetilide (diamond) substudy

    DEFF Research Database (Denmark)

    Pedersen, O D; Bagger, H; Keller, N;

    2001-01-01

    BACKGROUND: In patients with left ventricular dysfunction, atrial fibrillation and flutter (AF and AFl, respectively) are common arrhythmias associated with increased morbidity and mortality. The present study investigated the potential of dofetilide in AF-AFl patients with left ventricular...

  17. Safety of short-term use of dabigatran or rivaroxaban for direct-current cardioversion in patients with atrial fibrillation and atrial flutter.

    Science.gov (United States)

    Yadlapati, Ajay; Groh, Christopher; Passman, Rod

    2014-04-15

    Direct-current cardioversion (DCCV) for persistent atrial fibrillation or atrial flutter (AF) carries a risk of thromboembolic events (TEs). Therapeutic anticoagulation with warfarin is recommended for 3 to 4 weeks before and 4 weeks after DCCV to reduce TE; however, the safety of short-term anticoagulation with the novel oral anticoagulants (dabigatran and rivaroxaban) before DCCV has not been assessed. A retrospective cohort study was performed on all patients undergoing elective DCCV for AF at Northwestern Memorial Hospital from June 1, 2012 to September 30, 2013. Inclusion criteria included patients taking any of the novel oral anticoagulants for 21 to 60 days before DCCV and successful DCCV to sinus rhythm. Patients were monitored for a minimum of 60 days after DCCV to evaluate for TEs including stroke, transient ischemic attack, systemic emboli, and death. In total, 53 patients (47 men, 89%; age 65±10 years, median 66) were evaluated. Agents used were dabigatran (30 patients, 57%) and rivaroxaban (23 patients, 43%) for an average of 38±9 days. The mean CHADS2 score was 1.2±1.1 (score=0, 26%; 1, 43%; 2, 17%; and >3, 13%). Eleven patients (21%) underwent a transesophageal echocardiography before their DCCV; all showed no thrombus. No patients were found to have episodes of TE within 60 days of DCCV. No patients were found to have major bleeding events. In conclusion, the use of short-term dabigatran or rivaroxaban therapy for DCCV of AF appears safe.

  18. Radiofrequency ablation of an atypical left atrial flutter after pulmonary vein isolation

    Directory of Open Access Journals (Sweden)

    Bockeria L.A.

    2014-12-01

    Full Text Available In paroxysmal atrial fibrillation usually pulmonary veins isolation is enough, while in persistent and long-standing persistent forms ablation lines in the left atrium are needed. After that post ablational macroreentry tachycardia and focal atrial tachycardia, resistant to antiarrhythmic therapy, occur. Left atrial macroreentry tachycardia are localized perimitrally, around pulmonary veins and septally. There are also roof and posterior wall-associated macroreentry tachycardia. Considering relevance of postablation arrhythmias, we present our case report. A patient had paroxysmal atrial fibrillation. Pulmonary vein isolation was performed. After patient’s radiofrequency pulmonary vein isolation, three-dimensional map of left atrium was made using CARTO XP navigation system. Macroreentry tachycardia around left inferior pulmonary vein was revealed.There were fragmented potentials between left superior and left inferior pulmonary veins. An ablation lineconnecting inferior and superior pulmonary veins was made. After the completion of ablation line sinus rhythmwas restored.

  19. Increased risk of sudden and non-sudden cardiovascular death in patients with atrial fibrillation/flutter following acute myocardial infarction

    DEFF Research Database (Denmark)

    Pedersen, Ole Dyg; Abildstrøm, Steen Z; Ottesen, Michael M;

    2005-01-01

    between AF/atrial flutter (AFL) and modes of death in 5983 consecutive patients discharged alive after an acute myocardial infarction screened in the TRAndolapril Cardiac Evaluation registry. This cohort of patients with an enzyme-verified acute myocardial infarction was admitted to 27 centres in 1990......AIMS: Atrial fibrillation (AF) is a common complication in patients with acute myocardial infarction and is associated with an increase in the risk of death. The excess mortality associated with AF complicating acute myocardial infarction has not been studied in detail. Observations indicate...... or paroxysmal AF/AFL was observed in 1149 patients (19%) during hospitalization. During follow-up, 1659 patients (34%) died: 482 (50%) patients with AF/AFL and 1177 (30%) patients without AF/AFL, P

  20. Case report of surgical treatment of abnormal atrial flutter (incisional atrial tachycardia in the patient after mitral valve replacement and radiofrequency modification of Maze procedure

    Directory of Open Access Journals (Sweden)

    Revishvili А. Sh.

    2012-12-01

    Conclusion. This type of tachycardia following after an atrial fibrillation surgery may be considered as a failing transmural myocardial damage during the procedure. The catheter method can be used succesfully unless there are no effects of antiarrhythmic therapy. The catheter method enables not only to verify the disconnection between the left atrial pulmonary veins and left atrium myocardium but also to perform the ablation in zones of the atrial myocardium that are anatomic substrates of post surgery tachyarrhythmias.

  1. Atrial fibrillation or flutter

    Science.gov (United States)

    ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of ...

  2. [Comparison of the efficacy and safety of electrical cardioversion and pharmacological cardioversion with nibentan in patients with persisting atrial fibrillation and flutter].

    Science.gov (United States)

    Giliarov, M Iu; Novikova, N A; Sulimov, V A; Suchkova, S A; Syrkin, A L

    2007-01-01

    The aim of the study was to compare the efficacy and safety of pharmacological cardioversion (PC) by nibentan, a class III antiarrhythmic agent, and electrical cardioversion (EC) in patients with persisting atrial fibrillation (AFib) and atrial flutter (AFI) receiving basic antiarrhythmic therapy. Ninety-seven patients with persisting AFib and AFI were included in the trial (45 patients constituted PC group, and 52 constituted EC group). Both groups were comparable according to basic demographic and clinical parameters as well as antiarrhythmic therapy being applied. The results of the study showed that the efficacy of PC did not differ from that of EC (86.7% and 92.3% respectively, p = 0.282). the frequency of arrhythmogenic effect did not differ between the groups either (p = 0.46). One case of non-stable ventricular tachycardia was registered in the PC group. The most significant adverse effect was bradicardia, which was registered more often in the PC group than in EC group (26.7% and 3.8%, respectively, p = 0.001). In conclusion, the efficacy and safety of PC with nibentan in patients with persisting AFib/AFI is comparable with those of EC.

  3. Radiofrequency ablation for typical atrial flutter under the guidance of non-contact mapping system%非接触标测系统指导下射频消融治疗典型心房扑动

    Institute of Scientific and Technical Information of China (English)

    苏浩; 严激; 徐健; 孙贤林; 范西真

    2012-01-01

    Objective To explore the radiofrequency ablation for typical atrial flutter under the guidance of non - contact mapping system. Methods Twenty - five cases of typical atrial flutter patients had been definitely diagnosed based on the body surface 12 - lead ECG and Holter, including 17 cases of paroxysmal atrial flutter and 8 of persistent atrial flutter. All patients had oral administration of 2 or more anti - arrhythmic therapeutics with poor effect. 10 - poles coronary sinus and right ventricular electrode were routinely placed, and ARRAY balloon was placed in the lower right atrium. The right atrial model was constructed, followed by ablating the tricuspid isthmus under the guidance of non - contact mapping system. Results All patients received successful ablation. Atrial flutter was terminated during the ablation in 18 cases, and 7 patients were in sinus rhythm under ablation. The delayed two -way conduction time was noted during pacing proximal coronary sinus and low right atrium respectively after surgery, no excitement was detected through the isthmus ablation line, and isthmus block was confirmed. Only one patient encountered recurrence of atrial flutter in the period of 6 to 18 months follow - up, and the recurrence rate was found to be 4.0% . Conclusion Non - contact mapping system guided radiofrequency ablation of typical atrial flutter therapy is safe and reliable, and can reduce X - ray exposure time and discharge cycles.%目的 总结非接触标测系统指导下射频消融治疗典型心房扑动的经验.方法 根据体表12导心电图及动态心电图诊断为典型心房扑动25例,其中阵发性心房扑动17例,持续性心房扑动8例.全部患者口服过2种及以上抗心律失常药物,治疗效果较差.常规放置10极冠状窦、右室电极,ARRAY球囊置于右房中下部,构建右房模型,在非接触标测系统指引下进行三尖瓣峡部消融.结果 手术全部成功,其中18例放电过程中房扑终止,7例在窦

  4. 硫酸镁对伊布利特转复心房颤动/心房扑动疗效的影响%Influence of magnesium sulfate on conversion effect of ibutilide on atrial fibrillation or flutter

    Institute of Scientific and Technical Information of China (English)

    吕薇; 牛铁生; 曹乾

    2013-01-01

    AIM To investigate the influence of pre-injected magnesium sulfate on the conversion effect of ibutilide on atrial fibrillation or flutter. METHODS Sixty -four patients who has atrial fibrillation or flutter were randomized to give placebo plus ibutilide group (control group) or magnesium sulfate plus ibutilide group (trial group) , receive either an infusion of 100 mL of 0.9% sodium chloride or the same amount of sodium chloride with 20 mL of 25% magnesium sulfate in one hour. After 10 min, ibutilide was infused. The conversion rate of atrial fibrillation or flutter and adverse events were observed. RESULTS Conversion rate of ibutilide for atrial fibrillation or flutter in the control group and the trial group is 50% and 84% respectively (P < 0.05). Adverse events are not significantly different between the two groups. CONCLUSION Pre - injection of mag -nesium sulfate enhances the ability of ibutilide for the conversion of atrial fibrillation or flutter.%目的 观察预先静脉给予硫酸镁对伊布利特转复心房颤动/心房扑动的影响.方法 选择符合条件的心房颤动/心房扑动患者64例,随机单盲法分为安慰剂+伊布利特组(对照组)和硫酸镁+伊布利特组(试验组),分别在1h内静脉滴注氯化钠注射液100 mL或氯化钠注射液100 mL加25%硫酸镁20 mL,10 min后给予伊布利特静脉注射,观察两组患者的心房颤动/心房扑动转复率及不良事件发生情况.结果 对照组与试验组对于心房颤动/心房扑动的转复率分别为50%及84%,两组比较差异显著(P<0.05);两组间不良反应发生率无显著差异(P>0.05).结论 预先静脉给予硫酸镁可显著提高伊布利特转复心房颤动/心房扑动的成功率.

  5. Impact of typical atrial flutter on the recurrence of atrial fibrillation after catheter ablation of paroxysmal atrial fibrillation%典型心房扑动对心房颤动导管消融复发的影响

    Institute of Scientific and Technical Information of China (English)

    汤日波; 陶海龙; 蒋晨曦; 桑才华; 宁曼; 马长生; 董建增; 刘兴鹏; 龙德勇; 喻荣辉; 刘小慧; 康俊萍; 高凌云

    2008-01-01

    目的 评价典型心房扑动(房扑)对心房颤动(房颤)导管消融复发的影响.方法 120例药物治疗无效的阵发性房颤患者在三维电解剖标测系统和肺静脉环状标测电极导管联合指导下行环肺静脉电隔离.其中17例(14.2%)合并典型房扑(房扑组,其余作为对照组),行三尖瓣环峡部消融,三尖瓣环峡部消融终点为三尖瓣环峡部双向阻滞.房颤复发定义为导管消融3个月后发生房性快速心律失常.结果 房扑组房颤病程(9.8±10.7)年,长于对照组(5.9±6.3)年,差异有统计学意义(P=0.036).房扑组与对照组相比,年龄、性别、合并器质性心脏病、左心房直径、左心室射血分数差异无统计学意义.随访91~401(237±79)d,房扑组房颤复发率为47.1%,对照组房颤复发率为12.6%,两组间差异有统计学意义(P=0.001).经校正年龄、房颤病程、合并器质性心脏病、左心房直径等因素,Cox多因素分析发现消融术前合并房扑是房颤复发的独立危险因素(危险比3.52,95%可信区间1.32~9.34,P=0.012).结论 典型房扑可能增加房颤导管消融术后房颤的复发,房颤导管消融前应对患者是否合并典型房扑进行认真评价.%Objective This study sought to investigate the impact of typical atrial flutter(AFL)on the recurrence of atrial fibrillation(AF)after catheter ablation of paroxysmal AF.Methods One hundred and twenty consecutive patients with paroxysmal AF undergoing circumferential pulmonary vein isolation guided by 3D mapping system and Lasso catheter were enrolled in the retrospective study.Cavotricuspid isthmus were targeted and bilateral block were achieved in 17(14.2%)patients who were combined with typical AFL AF recurrence was defined as atrial tachyarrhythmias beyond three months washout period.Results The mean AF duration Was significantly longer in patients with typical AFL(AFL group)than those without AFL[non-AFL group,(9.8±10.7)yrs vs(5.9±6.3)yrs,P=0.036].The

  6. Ablação por cateter do flutter atrial. Caracterização eletrofisiológica da interrupção da condução pelos istmos posterior e septal Catheter ablation of atrial flutter. Electrophysiological characterization of posterior and septal isthmus block

    Directory of Open Access Journals (Sweden)

    José Marcos Moreira

    1998-07-01

    Full Text Available OBJETIVO: Avaliar os tipos de bloqueio obtidos nos istmos posterior (entre o anel tricuspídeo e veia cava inferior e septal (entre o anel tricuspídeo e óstio do seio coronário, após ablação do flutter atrial (FLA. MÉTODOS: Foram submetidos à ablação por radiofreqüência (RF 14 pacientes com FLA tipo I (9 homens em 16 procedimentos. A ativação atrial ao redor do anel tricuspídeo foi avaliada em ritmo sinusal utilizando-se cateter "Halo" com 10 pares de eletrodos (H1-2 a H19-20, durante estimulação do seio coronário proximal (SCP e região póstero-lateral do átrio direito (H1-2, antes e após ablações lineares. De acordo com a frente de programação do impulso definiu-se: ausência de bloqueio (condução bidirecional, bloqueio incompleto (condução bidirecional com retardo num dos sentidos e bloqueio completo (ausência de condução pelo istmo. O intervalo desta ativação (deltaSCP/H1-2 foi analisado. RESULTADOS: Bloqueio completo foi obtido em 7 procedimentos (44% e incompleto em 4 (25%. O deltaSCP/H1-2 foi de 74 ± 26ms no primeiro grupo e de 30,5 ± 7,5ms no segundo (pPURPOSE: Evaluate the different types of conduction blocks obtained between inferior vena cava-tricuspid annulus (posterior isthmus and between tricuspid annulus-coronary sinus ostium (septal isthmus after radiofrequency (RF catheter ablation of atrial flutter (AFL METHODS: In 16 procedures, 14 patients (pts, 9 male, with type I AFL underwent RF ablation. Atrial activation around tricuspid annulus was performed with a 10-bipole "Halo" catheter (H1-2; H19-20. In sinus rhythm, isthmus conduction was evaluated during proximal coronary sinus (PCS and low lateral right atrium (H1-2 pacing, before and after linear ablation. According to the wave front of impulse propagation we assessed absence of block (bidirectional conduction; incomplete block (bidirectional conduction with delay in one front of impulse propagation and complete block (absence of conduction

  7. Hiatal hernia squeezing the heart to flutter.

    Science.gov (United States)

    Patel, Arpan; Shah, Rushikesh; Nadavaram, Sravanthi; Aggarwal, Aakash

    2014-04-01

    An 80-year-old woman presented to the emergency department with failure to thrive and weakness for 14 days. Medical history was significant for polio. On admission her electrocardiogram showed atrial flutter, and cardiac enzymes were elevated. Echocardiogram revealed a high pulmonary artery pressure, but no other wall motion abnormalities or valvulopathies. Chest x-ray showed a large lucency likely representing a diaphragmatic hernia. Computed tomographic scan confirmed the hernia. Our patient remained in atrial flutter despite rate control, and thereafter surgery was consulted to evaluate the patient. She underwent hernia repair. After surgery, the patient was taken off rate control and monitored for 72 hours; she did not have any episode of atrial flutter and was discharged with follow up in a week showing no arrhythmia. Her flutter was caused directly by the mechanical effect of the large hiatal hernia pressing against her heart, as the flutter resolved after the operation.

  8. Aneurysm of the Right Atrial Appendage

    Directory of Open Access Journals (Sweden)

    Silvio Henrique Barberato

    2002-02-01

    Full Text Available Atrial aneurysms involving the free wall or atrial appendage are rare entities in cardiology practice and may be associated with atrial arrhythmias or embolic phenomena. We review the literature and report a case of aneurysm of the right atrial appendage in a young adult, whose diagnosis was established with echocardiography after an episode of paroxysmal atrial flutter.

  9. [Nosology and mechanism of monomorphous atrial tachycardia].

    Science.gov (United States)

    Puech, P

    1990-12-01

    Monomorphous atrial tachycardias have been classified taking into account the ectopic rhythm rate, atrial wave morphology, the mode of activation of the atrial studied by endocavitary cartography, stimulation tests and their natural history. Atrial flutter is a right intra-atrial macroreentry of anticlockwise (common flutter) or clockwise (atypical flutter) rotation, maintained by anisotropic conduction around two pivotal zones located at the posterior and inferior part of the atrium. Tachycardia is made possible by the existence of an excitable zone on the circuit. Paroxysmal atrial tachycardias are far more often linked to localised reentry (sino-atrial or intra-atrial microreentry) than to provoked activity, stimulation tests enabling the distinction to be made. "Digitalis tachycardias" must be seen in the context of activity induced by late post-potential. Focal atrial tachycardias linked to ectopic automatism are a separate entity. They follow a chronic course in the young individual and may lead to a cardiomyopathy purely due to the rhythm abnormality.

  10. The gap junction modifier, GAP-134 [(2S,4R)-1-(2-aminoacetyl)-4-benzamido-pyrrolidine-2-carboxylic acid], improves conduction and reduces atrial fibrillation/flutter in the canine sterile pericarditis model.

    Science.gov (United States)

    Rossman, Eric I; Liu, Kun; Morgan, Gwen A; Swillo, Robert E; Krueger, Julie A; Gardell, Stephen J; Butera, John; Gruver, Matthew; Kantrowitz, Joel; Feldman, Hal S; Petersen, Jørgen S; Haugan, Ketil; Hennan, James K

    2009-06-01

    Gap junction uncoupling can alter conduction pathways and promote cardiac re-entry mechanisms that potentiate many supraventricular arrhythmias, such as atrial fibrillation (AF) and atrial flutter (AFL). Our objective was to determine whether GAP-134 [(2S,4R)-1-(2-aminoacetyl)-4-benzamido-pyrrolidine-2-carboxylic acid], a small dipeptide gap junction modifier, can improve conduction and ultimately prevent AF/AFL. In rat atrial strips subjected to metabolic stress, GAP-134 prevented significantly conduction velocity slowing at 10 nM compared with vehicle (p < 0.01). In the canine sterile pericarditis model, conduction time (CT; n = 5), atrial effective refractory period (AERP; n = 3), and AF/AFL duration/inducibility (n = 16) were measured 2 to 3 days postoperatively in conscious dogs. CT was significantly faster after GAP-134 infusion (average plasma concentration, 250 nM) at cycle lengths of 300 ms (66.2 +/- 1.0 versus 62.0 +/- 1.0 ms; p < 0.001) and 200 ms (64.4 +/- 0.9 versus 61.0 +/- 1.3 ms; p < 0.001). No significant changes in AERP were noted after GAP-134 infusion. The mean number of AF/AFL inductions per animal was significantly decreased after GAP-134 infusion (2.7 +/- 0.6 versus 1.6 +/- 0.8; p < 0.01), with total AF/AFL burden being decreased from 12,280 to 6063 s. Western blot experiments showed no change in connexin 43 expression. At concentrations exceeding those described in the AF/AFL experiments, GAP-134 had no effect on heart rate, blood pressure, or any electrocardiogram parameters. In conclusion, GAP-134 shows consistent efficacy on measures of conduction and AF/AFL inducibility in the canine sterile pericarditis model. These findings, along with its oral bioavailability, underscore its potential antiarrhythmic efficacy.

  11. Vernakalant hydrochloride for the rapid conversion of atrial fibrillation after cardiac surgery

    DEFF Research Database (Denmark)

    Kowey, Peter R; Dorian, Paul; Mitchell, L Brent;

    2009-01-01

    Postoperative atrial arrhythmias are common and are associated with considerable morbidity. This study was designed to evaluate the efficacy and safety of vernakalant for the conversion of atrial fibrillation (AF) or atrial flutter (AFL) after cardiac surgery....

  12. The study of inhibiting heart rate and rapidly terminating atrial flutter of ibutilide on canine%伊布利特对犬心率抑制与终止心房扑动机制的初步探讨

    Institute of Scientific and Technical Information of China (English)

    孙健玲; 李小鹰; 郭继鸿; 刘鹏; 张萍; 易忠

    2009-01-01

    Objective To observe the electrophysiological effects of ibufilide on canine and to explore the potential mechanisms of ibutilide on terminating atrial flutter. Methods Eighteen mongrel dogs were anesthetized and intubated. The heart was exposed through thoracotomy for electrodes implantation. The electrophysiologic variables (heart rate, the conduction of intraatrium and interatrium, the conduction ratio of isthmus, the effective refractory period) were measured in the absence or presence of ibutilide ( 10 minute infusion with 0. 10 mg/kg ibutilide, 30 minutes later with a maintaining dose of 0.01 mg/min). Results Ibutilide significant suppressed sinus atrial node function, the peak effect was observed at 20 -30 min post drug infusion and heart rate returned to normal at 2 hours post infusion. Post ibutilide infusion, 1 canine developed sinus pause for 5 seconds and 2:1 atrioventricular conduction block was evidenced in another canine. The atrial, ventricular and pulmonary vein effective refractory periods were all significant prolonged (all P0.05). Conclusions Ibutilide could suppress sinus atrial node and the atrioventricular node function. The mechanism of ibutilide on rapidly terminating atrial flutter might be related to the prolongation of the refractory periods which might then result in the reduction of the whole excitable gap of the reentrant circuit and induce proceed inability of reentrant wavefront.%目的 观察伊布利特对犬心房与心室电生理特性的作用特点,初步探讨其终止心房扑动(房扑)的机制.方法 18只成年健康雄性杂种犬,麻醉后气管插管,开胸并缝合电极,伊布利特按0.10 mg/kg静脉推注给药,观察给药前后心率、房内与房间传导时间、峡部缓慢传导区传导速度、各部位不应期的变化.结果 伊布利特对心率有明显的抑制作用,作用的高峰时间在给药后20~30min,2 h后心率基本恢复到用药前的水平.实验中,1只犬在给药后出现长达5

  13. 伊布利特和胺碘酮转复心房扑动及心房颤动的临床观察%Efficacy of ibutilide and amiodarone for termination of atrial fibrillation and flutter

    Institute of Scientific and Technical Information of China (English)

    王磊

    2011-01-01

    目的 观察新一代Ⅲ类抗心律失常药物伊布利特和经典Ⅲ类抗心律失常药物胺碘酮转复心房颤动(房颤)和心房扑动(房扑)的成功率及安全性.方法 选择40 ~ 75岁,持续时间≤90 d的房颤和房扑患者38例,按入院顺序随机分为伊布利特组19例和胺碘酮组19例,伊布利特组体质量≥60 kg者首剂1 mg、体质量<60 kg者首剂0.01 mg/kg,如无效10 min后再给予1 mg或0.01 mg/kg;胺碘酮组首剂150 mg,如无效10 min后再给予150 mg,观察转复率和转复时间,记录不良反应.结果 伊布利特和胺碘酮组4h内转复窦律分别为78.9%和31.5%,24 h内转复窦律分别为84.2%和52.6%,平均转复时间分别为(19±12)min和(48 ±17)min (P<0.01).两组均未发生致命性不良反应.结论 伊布利特与胺碘酮均能终止房颤和房扑,伊布利特转复房颤、房扑的疗效高于胺碘酮,转复时间短于胺碘酮,但须在严格监控下进行.%Objective To investigate the efficacy,safety and tolerance of intravenous ibutilide and amiodarone for conversion of atrial fibrillation( AF) and flutter( AFL) to normal sinus rhythm.Methods Thirty - eight consecutive patients aged 40 - 75 years with AF/AFL were included.The duration of arrhythmia were less than 90 days (ranged from 3 hours to 90 days),and ventricular rate(VR) were more than 60 beats/min.Two groups were assigned randomly.Patients in the ibutilide group( 19 cases) received ibutilide 1 mg if body weight ≥60 kg or 0.01 mg/kg if body weight < 60 kg; Treatment was repeated if atrial fibrillation or flutter was not converted after 10 min of the first dosage.Patients in the amiodarone group( 19 cases) received amiodarone 150 mg,followed by amiodarone 150 mg if atrial fibrillation or flutter persisted after 10 min of the first dosage.Results In 4 hours AF/AFL were converted in 15 of 19 patients(78.9% )in ibutilide group and in 6 of 19 patients(31.5% )in amiodarone group (P < 0.05),and in 24

  14. Atrial rate and rhythm abnormalities in a patient with hyperkalemia.

    Science.gov (United States)

    Rosman, Jonathan; Thiagarajah, Prashan; Schweitzer, Paul; Rachko, Maurice; Hanon, Sam

    2009-05-15

    A 67 year old man presented with a serum potassium of 7.7 mEq/L and slow atrial flutter with variable A-V block and peaked T waves. Initial treatment for hyperkalemia was followed by an increase in the atrial flutter rate to 300 beats per minute. After hemodialysis the rhythm converted to sinus.

  15. Achieving Bidirectional Long Delays In Pulmonary Vein Antral Lines Prior To Bidirectional Block In Patients With Paroxysmal Atrial Fibrillation (The Bi-Bi Technique For Atrial Fibrillation Ablation)

    OpenAIRE

    Mina MD FACC, FHRS, Adel F; L Warnecke, PA-C, Nicholas

    2016-01-01

    Background: Pulmonary Vein Antral isolation (PVAI) is currently the standard of care for both paroxysmal and persistent atrial fibrillation ablation. Reconnection to the pulmonary vein is the most common cause of recurrence of atrial fibrillation. Achieving the endpoint of bidirectional block (BDB) for cavotricuspid isthmus dependant flutter has improved our outcomes for atrial flutter ablation. With this we tried to achieve long delays in the pulmonary veins antral lines prior to complete is...

  16. Stochastic Flutter Analysis

    NARCIS (Netherlands)

    Verhoosel, C.V.; Gutiérrez, M.A.; Hulshoff, S.J.

    2006-01-01

    The field of fluid-structure interaction is combined with the field of stochastics to perform a stochastic flutter analysis. Various methods to directly incorporate the effects of uncertainties in the flutter analysis are investigated. The panel problem with a supersonic fluid flowing over it is con

  17. Supersonic unstalled flutter

    Science.gov (United States)

    Adamczyk, J. J.; Goldstein, M. E.; Hartmann, M. J.

    1978-01-01

    Recently two flutter analyses have been developed at NASA Lewis Research Center to predict the onset of supersonic unstalled flutter of a cascade of two-dimensional airfoils. The first of these analyzes the onset of supersonic flutter at low levels of aerodynamic loading (i.e., backpressure), while the second examines the occurrence of supersonic flutter at moderate levels of aerodynamic loading. Both of these analyses are based on the linearized unsteady inviscid equations of gas dynamics to model the flow field surrounding the cascade. The details of the development of the solution to each of these models have been published. The objective of the present paper is to utilize these analyses in a parametric study to show the effects of cascade geometry, inlet Mach number, and backpressure on the onset of single and multi degree of freedom unstalled supersonic flutter. Several of the results from this study are correlated against experimental qualitative observation to validate the models.

  18. Antiarrhythmic Effect Of Antioxidants In Patients With Atrial Fibrillation

    OpenAIRE

    Khabchabov PhD, Rustam; RG PhD, Khabchabov; ER PhD, Makhmudova

    2016-01-01

    Resume In accordance with modern concepts, one of the leading roles in the development of paroxysmal atrial fibrillation and flutter, belongs - the restructuring of the myocardium, in second place - sick sinus syndrome and in third place - the presence of accessory pathways and hormonal disorders. The development of atrial fibrillation and flutter in the structural pathology, primarily begins with of drugs if it does not work, we have to carry out ablation. Providing proper, effective and imp...

  19. The Development of Atrial Flutter and Fibrillation

    Directory of Open Access Journals (Sweden)

    Rustam G. Habchabov

    2013-01-01

    Full Text Available Reasons of development of life-threatening arrhythmias that lead to sudden and total death in cases of cardiovascular diseases are still unclear, though cardiac research of this problem is conducted throughout the world. Damage of connective tissues insulation cover of the heart’s conductive pathways with oxidation of ectopic nodes can lead to life-threatening arrhythmias. This damage has never been considered before as a cause of electrical instability of the heart. Accordingly, treatment of such patients should change, and consequently should reduce the total number of sudden deaths due to cardiovascular diseases.The speed of electricity conduction from the heart to the nervous system and its distribution throughout the body remains underestimated. Slowdown of electric magnetic induction (acceleration between the heart and the central nervous system as well as slowdown of its distribution results in insufficient speed of electric flow and reduction of bioelectric processes of the body. This leads to activation of the sympathetic nervous system with the subsequent cascade of pressor mechanisms and development of essential hypertension.

  20. Atrial Ectopics Precipitating Atrial Fibrillation

    OpenAIRE

    Johnson Francis

    2015-01-01

    Holter monitor tracing showing blocked atrial ectopics and atrial ectopic precipitating atrial fibrillation is being demonstrated. Initially it was coarse atrial fibrillation, which rapidly degenerated into fine atrial fibrillation.

  1. Sotalol for atrial tachycardias after surgery for congenital heart disease

    NARCIS (Netherlands)

    BeaufortKrol, GCM; BinkBoelkens, MTE

    1997-01-01

    Atrial tachycardias, in particular atrial flutter after surgery for congenital heart disease, is associated with a high mortality. Treatment with various antiarrhythmic drugs and/or antitachycardia pacemakers is not very successful. Sotalol, a Class III drug, has shown to be a promising drug in adul

  2. Geared-elevator flutter study. [transonic flutter characteristics of empennage

    Science.gov (United States)

    Ruhlin, C. L.; Doggett, R. V., Jr.; Gregory, R. A.

    1976-01-01

    The paper describes an experimental and analytical study of the transonic flutter characteristics of an empennage flutter model having an all-movable horizontal tail with a geared elevator. Two configurations were flutter tested: one with a geared elevator and one with a locked elevator with the model cantilever-mounted on a sting in the wind tunnel. The geared-elevator configuration fluttered experimentally at about 20% higher dynamic pressures than the locked-elevator configuration. The experimental flutter boundary was nearly flat at transonic speeds for both configurations. It was found that an analysis which treated the elevator as a discrete surface predicted flutter dynamic pressure levels better than analyses which treated the stabilizer and elevator as a warped surface. Warped-surface methods, however, predicted more closely the experimental flutter frequencies and Mach number trends.

  3. STUDIES ON FLUTTER PREDICTION

    Directory of Open Access Journals (Sweden)

    Irina-Carmen ANDREI

    2012-03-01

    Full Text Available The purpose of this paper is to study the instability of the dynamic flutter. The justification is expressed by the fact that the occurrence of flutter within the aircraft’s flight envelope results in irreversible structural deformation which consequently leads to serious damage. Therefore the mathematical modeling of this phenomenon and its validation are very important. The instability of the dynamic flutter is characterized by critical speed and critical pulsation of oscillatory movements. In this paper, the quasi-stationary model and the Theodorsen model have been analyzed for calculating the aerodynamic forces and torques, and a comparison of them has been carried out. The fluid-structure coupling is done by rewriting the equations, considering that the forces are given by closed formulas. For the mathematical modeling of the flutter there have been used the p-k and V-g methods based on the Theodorsen model and the quasi-stationary model. In order to modeling the free vortices aerodynamic forces and moments, the equations which describe both the motion of the structure and the fluid flow had to be integrated simultaneously in time. The fluid-structure coupling is considered as a combination of two systems that describe the aeroelastic behavior of the structure.

  4. The Flutter Shutter Camera Simulator

    Directory of Open Access Journals (Sweden)

    Yohann Tendero

    2012-10-01

    Full Text Available The proposed method simulates an embedded flutter shutter camera implemented either analogically or numerically, and computes its performance. The goal of the flutter shutter is to make motion blur invertible, by a "fluttering" shutter that opens and closes on a well chosen sequence of time intervals. In the simulations the motion is assumed uniform, and the user can choose its velocity. Several types of flutter shutter codes are tested and evaluated: the original ones considered by the inventors, the classic motion blur, and finally several analog or numerical optimal codes proposed recently. In all cases the exact SNR of the deconvolved result is also computed.

  5. The Flutter Shutter Code Calculator

    Directory of Open Access Journals (Sweden)

    Yohann Tendero

    2015-08-01

    Full Text Available The goal of the flutter shutter is to make uniform motion blur invertible, by a"fluttering" shutter that opens and closes on a sequence of well chosen sub-intervals of the exposure time interval. In other words, the photon flux is modulated according to a well chosen sequence calledflutter shutter code. This article provides a numerical method that computes optimal flutter shutter codes in terms of mean square error (MSE. We assume that the observed objects follow a known (or learned random velocity distribution. In this paper, Gaussian and uniform velocity distributions are considered. Snapshots are also optimized taking the velocity distribution into account. For each velocity distribution, the gain of the optimal flutter shutter code with respectto the optimal snapshot in terms of MSE is computed. This symmetric optimization of theflutter shutter and of the snapshot allows to compare on an equal footing both solutions, i.e. camera designs. Optimal flutter shutter codes are demonstrated to improve substantially the MSE compared to classic (patented or not codes. A numerical method that permits to perform a reverse engineering of any existing (patented or not flutter shutter codes is also describedand an implementation is given. In this case we give the underlying velocity distribution fromwhich a given optimal flutter shutter code comes from. The combination of these two numerical methods furnishes a comprehensive study of the optimization of a flutter shutter that includes a forward and a backward numerical solution.

  6. Antiarrhythmic Effect Of Antioxidants In Patients With Atrial Fibrillation.

    Science.gov (United States)

    Khabchabov PhD, Rustam; Rg PhD, Khabchabov; Er PhD, Makhmudova

    2016-01-01

    Resume In accordance with modern concepts, one of the leading roles in the development of paroxysmal atrial fibrillation and flutter, belongs - the restructuring of the myocardium, in second place - sick sinus syndrome and in third place - the presence of accessory pathways and hormonal disorders. The development of atrial fibrillation and flutter in the structural pathology, primarily begins with of drugs if it does not work, we have to carry out ablation. Providing proper, effective and important combination therapy - is the main challenge in cardiology.

  7. Aircraft vibration and flutter

    Directory of Open Access Journals (Sweden)

    R. R. Aggarwal

    1958-04-01

    Full Text Available "The paper outlines the theoretical and experimental procedure one has to adopt for flutter prevention during the various stages (project, design and prototype of the development of modern aircraft. With the advent of high speed, the aerodynamic coefficients have to be calculated with due regards to the effects of compressibility, finite aspect ratio of the lifting surfaces, sweep back and other peculiar shapes of the wings. The use of thin, small aspect ratio with external masses, necessitates the computation of higher frequency modes of vibration. Single degree of freedom flutter and the effect of control surface non-linearities has also become very important. Thus, it is shown how the availability of high speed computing machines, improved experimental technique for model and full scale testing has not kept pace with the uncertainties associated with the transonic speeds, low aspect ratio and the high frequency modes. Cross-checking of theoretical and experimental results at every stage seem to be the only answer."

  8. 14 CFR 27.629 - Flutter.

    Science.gov (United States)

    2010-01-01

    ... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction General § 27.629 Flutter. Each aerodynamic surface of the rotorcraft must be free from flutter under each appropriate speed and power...

  9. Reduction of atrial tachyarrhythmia episodes during the overdrive pacing period using the post-mode switch overdrive pacing (PMOP) algorithm

    NARCIS (Netherlands)

    Puerefellner, Helmut; Ruiter, Jaap H.; Widdershoven, Joseph W. M. G.; Van Gelder, Isabelle C.; Urban, Lubos; Kirchhof, Charles J. H. J.; Havlicek, Ales; Kornet, Lilian

    2006-01-01

    BACKGROUND Early recurrences within 10 minutes after termination of an atria[ tachyarrhythmia, such as atria[ tachycardia (AT), atrial flutter, or atrial fibrillation (AF) episodes, account for a large part of paroxysmal AT/AF episodes. It is unclear whether these arrhythmias can be suppressed by ov

  10. FLUTTER SUPPRESSION USING DISTRIBUTEDPIEZOELECTRIC ACTUATORS

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    A piezoelectric actuator has the benefits of flexibility of its position, without time lag and wide bandpass characteristics. The early results of the wind tunnel flutter suppression test using the piezoeletric actuator were presented in Ref.[1]. A rigid rectangular wing model is constrained by a plunge spring and a pitch spring, and a pair of piezoelectric actuators is bonded on both sides of the plunge spring so as to carry out the active control. Refs.[2,3] reported two flutter suppression wind tunnel tests where the distributed piezoelectric actuators were used. In Ref.[2] low speed wind tunnel tests were conducted with aluminum and composite plate-like rectangular models fully covered by piezoelectric actuators. Flutter speed is increased by 11%. In Ref.[3] a composite plate-like swept back model with piezoceramic actuators bonded on the inboard surface was tested in a transonic wind tunnel and a 12% increment of flutter dynamic pressure was achieved.  In the present investigation, an aluminum plate-like rectangular model with inboard bonded piezoceramic actuators is adopted. Active flutter suppression control law has been designed. A series of analyses and ground tests and, finally, low-speed wind tunnel tests with the active control system opened and closed are conducted. Reasonable results have been obtained.

  11. Fluttering in Stratified Flows

    Science.gov (United States)

    Lam, Try; Vincent, Lionel; Kanso, Eva

    2016-11-01

    The descent motion of heavy objects under the influence of gravitational and aerodynamic forces is relevant to many branches of engineering and science. Examples range from estimating the behavior of re-entry space vehicles to studying the settlement of marine larvae and its influence on underwater ecology. The behavior of regularly shaped objects freely falling in homogeneous fluids is relatively well understood. For example, the complex interaction of a rigid coin with the surrounding fluid will cause it to either fall steadily, flutter, tumble, or be chaotic. Less is known about the effect of density stratification on the descent behavior. Here, we experimentally investigate the descent of discs in both pure water and in a linearly salt-stratified fluids where the density is varied from 1.0 to 1.14 of that of water where the Brunt-Vaisala frequency is 1.7 rad/sec and the Froude number Fr < 1. We found that stratification enhances the radial dispersion of the disc at landing, and simultaneously, decrease the descent speed and the inclination (or nutation) angle while falling. We conclude by commenting on the relevance of these results to the use of unpowered vehicles and robots for space exploration and underwater missions.

  12. Disturbances in atrial rhythm and conduction following the surgical creation of an atrial septal defect by the Blalock-Hanlon technique.

    Science.gov (United States)

    Hamilton, S D; Bartley, T D; Miller, R H; Schiebler, G L; Marriott, H J

    1968-07-01

    Disturbances in atrial conduction or rhythm, or both, were found in 16 of 27 patients undergoing the surgical creation of an atrial septal defect by the Blalock-Hanlon technique. These included P-wave aberrations of intra-atrial block and ectopic atrial rhythm, A-V rhythm, A-V dissociation, sinus bradycardia, atrial flutter, escape-capture bigeminy, and atrial premature beats. Some of these were transient and occurred within 2 weeks after surgery. It seems likely that tissue trauma engendered by the clamp and resection of the atrial septum with possible injury to the internodal conducting pathways may be the genesis of these early postoperative disturbances. Of the eight cases with transient disturbances, six occurred in this period. Later changes, such as intra-atrial block, sinus bradycardia, and atrial flutter, may be attributed to changes in atrial size secondary to the postoperative pathophysiology. Digitalis intoxication and congestive heart failure cannot be excluded as contributory factors in either the early or the late disturbances. It was not possible to correlate the incidence and nature of these disturbances with morbidity and mortality. In such severely ill, cyanotic infants, irregularities, however slight, may have altered cardiac function significantly and contributed to their deaths.

  13. Real-time flutter analysis

    Science.gov (United States)

    Walker, R.; Gupta, N.

    1984-01-01

    The important algorithm issues necessary to achieve a real time flutter monitoring system; namely, the guidelines for choosing appropriate model forms, reduction of the parameter convergence transient, handling multiple modes, the effect of over parameterization, and estimate accuracy predictions, both online and for experiment design are addressed. An approach for efficiently computing continuous-time flutter parameter Cramer-Rao estimate error bounds were developed. This enables a convincing comparison of theoretical and simulation results, as well as offline studies in preparation for a flight test. Theoretical predictions, simulation and flight test results from the NASA Drones for Aerodynamic and Structural Test (DAST) Program are compared.

  14. Analysis of stroke in ATHENA: a placebo-controlled, double-blind, parallel-arm trial to assess the efficacy of dronedarone 400 mg BID for the prevention of cardiovascular hospitalization or death from any cause in patients with atrial fibrillation/atrial flutter

    DEFF Research Database (Denmark)

    Connolly, Stuart J; Crijns, Harry J G M; Torp-Pedersen, Christian

    2009-01-01

    of either oral anticoagulant therapy or antiplatelet agent alone was 60%. Dronedarone reduced the risk of stroke from 1.8% per year to 1.2% per year (hazard ratio 0.66, 95% confidence interval 0.46 to 0.96, P=0.027). The effect of dronedarone was similar whether or not patients were receiving oral...... anticoagulant therapy, and there was a significantly greater effect of dronedarone in patients with higher CHADS(2) scores. CONCLUSIONS: In this post hoc analysis, a reduction in stroke was observed in patients with atrial fibrillation who were receiving usual care, which included antithrombotic therapy...... and heart rate control, who were randomized to dronedarone. Further studies to investigate the effect of dronedarone and other antiarrhythmic agents on stroke are indicated....

  15. Atrial fibrillation associated with subclinical hyperthyroidism.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2009-05-29

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. We present a case of atrial fibrillation associated with subclinical hyperthyroidism, in a 78-year-old Italian woman. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  16. Association between CHADS2 score and long-term atrial fibrillation recurrence rate after catheter ablation

    Institute of Scientific and Technical Information of China (English)

    胡晓锋

    2014-01-01

    Objective To investigate the association between CHADS2score and long-term(≥3 years)outcomes post catheter ablation in patients with atrial fibrillation(AF).Methods AF patients who received single catheter ablation in our hospital from January 2004 to March 2009 in our department were included and patients received regular follow-up.AF recurrence was defined as the occurrence of atrial arrhythmias(AF,atrial flutter and atrial tachycardia)recorded by electrocardiogram monitor(≥30 seconds)after ablation during follow-up period(after

  17. Achieving Bidirectional Long Delays In Pulmonary Vein Antral Lines Prior To Bidirectional Block In Patients With Paroxysmal Atrial Fibrillation (The Bi-Bi Technique For Atrial Fibrillation Ablation).

    Science.gov (United States)

    Mina Md Facc Fhrs, Adel F; L Warnecke Pa-C, Nicholas

    2016-01-01

    Background: Pulmonary Vein Antral isolation (PVAI) is currently the standard of care for both paroxysmal and persistent atrial fibrillation ablation. Reconnection to the pulmonary vein is the most common cause of recurrence of atrial fibrillation. Achieving the endpoint of bidirectional block (BDB) for cavotricuspid isthmus dependant flutter has improved our outcomes for atrial flutter ablation. With this we tried to achieve long delays in the pulmonary veins antral lines prior to complete isolation comparable to those delays found in patient with bidirectional block of atrial flutter lines. Study Objective:The objective of this paper was to evaluate feasibility and efficacy of achieving Bidirectional long delays in pulmonary vein antral lines prior to Bidirectional Block in patient with paroxysmal atrial fibrillation. Method: A retrospective analysis was performed on patients who had paroxysmal atrial fibrillation procedures at Unity Point Methodist from January 2015 to January 2016. 20 consecutive patients with paroxysmal atrial fibrillation who had AF ablation using the Bi-Bi technique were evaluated. Result: Mean age was 63, number of antiarrhythmic used prior to ablation was 1.4, mean left atrial size was 38 mm. Mean chads score was 1.3. Mean EF was 53%. Long delays in the left antral circumferential lines were achieved with mean delay of 142 milliseconds +/-100. Also long delays in the right antral circumferential lines were achieved with mean delay of 150 milliseconds +/-80. 95 % (19/20) of patients were free of any atrial arrhythmias and were off antiarrhythmic medications for AF post procedure. There was only one transient complication in one patient who developed a moderate pericardial effusion that was successfully drained with no hemodynamic changes. The only patient who had recurrence was found to have asymptomatic AF with burden on his device paroxysmal atrial fibrillation is feasible and highly effective technique in this small cohort of patients

  18. Efficacy and safety of vernakalant in patients with atrial flutter

    DEFF Research Database (Denmark)

    Camm, A John; Toft, Egon; Torp-Pedersen, Christian;

    2012-01-01

    , 3%) converted to sinus rhythm. A reduced mean absolute ventricular response rate occurred within 50 min in patients receiving vernakalant (mean change from baseline -8.2 b.p.m.) vs. patients receiving placebo (-0.2 b.p.m.) (P = 0.037). A post-hoc analysis revealed that vernakalant increased AFL...

  19. Sinus node dysfunction in non-medicational treatment of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Bockeria L. А.

    2012-12-01

    Full Text Available Sinus node dysfunction or sick sinus syndrome (SSS includes clinical conditions such as symptomatic sinus bradycardia, sinus pauses or arrest, sinus node exit block, atrial tachycardias and chronotropic incompetence. Even though SSS incidence increases in an exponential-like manner with age, it can occur at all ages, including in the newborn. The mean age of patients with the syndrome is 68 years, with both genders being affected in approximately equal proportion. This condition occurs in 1 of every 600 cardiac patients over 65. Degenerative fibrosis of the tissues of the node has been suggested to be a common cause of SSS. Although it is still disputed. SSS is frequently associated with atrial fibrillation and flutter, tachy-bradycardia syndrome. Tachy-bradycardia syndrome is defined as sinus bradycardia coupled with atrial flutter/fibrillation or reciprocal atrial tachycardia. This syndrome is common in young patients following a surgical treatment of a congenital heart disease. Patients with chronic or persistent atrial flutter/fibrillation show high rates of cardiovascular disorders and mortality while sinus bradycardia is thought as an independent risk factor of atrial flutter/fibrillation. There are certain restrictions to medical treatment: long-term administration of the same medication (sotalol, amiodarone for atrial flutter/fibrillation can cause symptomatic bradycardia while administration of other medication (a class 1 drug increases the likelihood of ventricular arrythmias or evident bradycardia that enhances the risk of sudden cardiac death. Following atrial fibrillation ablation patients saw a significant improvement in the sinus node function, or saw a better sinus node function disrupted due to remodelling that takes place during atrial fibrillation. The surgical methods applications proved most efficient in non-medicational treatment of atrial fibrillation. In the late 1980s American surgeon J. L. Cox developed a so-called Maze

  20. [Assessment of adaptive response of the cardiovascular system in a patient with paroxysmal atrial fibrillation].

    Science.gov (United States)

    Chibisov, S M; Zotova, T Iu; Zotov, A K; Skrylev, D S

    2010-01-01

    This study showed that monitoring arterial pressure and heart rate during a few consecutive days allows for early diagnosis of cardiovascular disorders long before manifestation of its clinical symptoms. It is maintained that atrial fibrillation and fluttering are preceded by systemic disturbances of systolic pressure regulation.

  1. Interval Finite Element Analysis of Wing Flutter

    Institute of Scientific and Technical Information of China (English)

    Wang Xiaojun; Qiu Zhiping

    2008-01-01

    The influences of uncertainties in structural parameters on the flutter speed of wing are studied. On the basis of the deterministic flutter analysis model of wing, the uncertainties in structural parameters are considered and described by interval numbers. By virtue of first-order Taylor series expansion, the lower and upper bound curves of the transient decay rate coefficient versus wind velocity are given. So the interval estimation of the flutter critical wind speed of wing can be obtained, which is more reasonable than the point esti- mation obtained by the deterministic flutter analysis and provides the basis for the further non-probabilistic interval reliability analysis of wing flutter. The flow chart for interval finite element model of flutter analysis of wing is given. The proposed interval finite element model and the stochastic finite element model for wing flutter analysis are compared by the examples of a three degrees of freedorn airfoil and fuselage and a 15° swepthack wing, and the results have shown the effectiveness and feasibility of the presented model. The prominent advantage of the proposed interval finite element model is that only the bounds of uncertain parameters axe required, and the probabilistic distribution densities or other statistical characteristics are not needed.

  2. Right atrial aneurysm with downward displacement of the anterior leaflet that resembled Ebstein's anomaly.

    Science.gov (United States)

    Yamauchi, Sanae; Suzuki, Yasuyuki; Daitoku, Kazuyuki; Kimura, Masaomi; Okumura, Ken; Fukuda, Ikuo

    2016-06-08

    A 13-year-old boy presented with right atrial aneurysm and downward displacement of the anterior leaflet in the tricuspid valve into the right ventricle, without tricuspid valve regurgitation. Paroxysmal atrial flutter was caused by an abnormal electrical re-entry circuit, which could not be treated using catheter radiofrequency ablation. Therefore, the patient underwent surgical ablation and resection of the enlarged right atrial wall. The anterior leaflet of the tricuspid valve was plastered and displaced downward into the right ventricle, which resembled Ebstein's anomaly. Pathological evaluation revealed a thin wall that contained fibrous tissue with lipomatous degeneration and few muscular elements. No postoperative arrhythmia was observed.

  3. Electrophysiologic study of dysrhythmias after atrial operations in dogs.

    Science.gov (United States)

    Tamiya, T; Yamashiro, T; Hata, A; Kuge, K; Asano, S; Sato, T

    1992-10-01

    Experiments were conducted with 159 dogs to investigate the mechanism of persistent dysrhythmias clinically encountered after atrial-level operations. Those found after incisions to the internodal pathways (INPs) of the right atrium were analyzed using cardiac mapping in an anesthetized or extracorporeally perfused state. Longitudinal incisions of the posterior INP often allowed inducible sustained atrial flutter, with circus movement of excitation around the right atrium near the tricuspid orfice. Sustained atrial flutter thus produced was modified in cycle length by coexisting division of the middle INP but inhibited by that of the anterior INP. Its incidence increased at chronic stage, with marked cicatricial changes. The disrupted anterior INP markedly prolonged conduction time to the atrioventricular node and A-H interval compared with the other disruptions. Persistent atrioventricular junctional rhythm developed in about 50% of the animals after disruption of all three INPs or anterior and posterior INPs; division of the anterior INP was the common potent factor, although no single blocked INP produced persistent junctional rhythm. Our results support the "summation theory." The incidence of junctional rhythm and hypoxia of the sinoatrial node (flow rate of less than 10 mL.100 g-1.min-1) were markedly enhanced by coexisting blockade of atrial feeding arteries in addition to division of the anterior INP. In conclusion, massive posterior INP disruption is a potent anatomic substrate in producing sustained atrial flutter, middle INP division a modifier, and anterior INP division an inhibitor. Division of the anterior INP is a potent anatomic substrate in producing junctional rhythm, and hypoxia involving the sinoatrial node reacts as its synergic factor.

  4. Supersonic Flutter of Laminated Curved Panels

    Directory of Open Access Journals (Sweden)

    M. Ganapathi

    1995-04-01

    Full Text Available Supersonic flutter analysis of laminated composite curved panels is investigated using doubly-curved, quadrilateral, shear flexible, shell element based on field-consistency approach. The formulation includes transverse shear deformation, in-plane and rotary inertias. The aerodynamic force is evaluated using two-dimensional static aerodynamic approximation for high supersonic flow. Initially, the model developed here is verified for the flutter analysis of flat plates. Numerical results are presented for isotropic, orthotropic and laminated anisotropic curved panels. A detailed parametric study is carried out to observe the effects of aspect and thickness ratios, number of layers, lamination scheme, and boundary conditions on flutter boundary.

  5. Propfan test assessment testbed aircraft flutter model test report

    Science.gov (United States)

    Jenness, C. M. J.

    1987-01-01

    The PropFan Test Assessment (PTA) program includes flight tests of a propfan power plant mounted on the left wind of a modified Gulfstream II testbed aircraft. A static balance boom is mounted on the right wing tip for lateral balance. Flutter analyses indicate that these installations reduce the wing flutter stabilizing speed and that torsional stiffening and the installation of a flutter stabilizing tip boom are required on the left wing for adequate flutter safety margins. Wind tunnel tests of a 1/9th scale high speed flutter model of the testbed aircraft were conducted. The test program included the design, fabrication, and testing of the flutter model and the correlation of the flutter test data with analysis results. Excellent correlations with the test data were achieved in posttest flutter analysis using actual model properties. It was concluded that the flutter analysis method used was capable of accurate flutter predictions for both the (symmetric) twin propfan configuration and the (unsymmetric) single propfan configuration. The flutter analysis also revealed that the differences between the tested model configurations and the current aircraft design caused the (scaled) model flutter speed to be significantly higher than that of the aircraft, at least for the single propfan configuration without a flutter boom. Verification of the aircraft final design should, therefore, be based on flutter predictions made with the test validated analysis methods.

  6. Atrial fibrillation

    DEFF Research Database (Denmark)

    Lip, Gregory Y H; Fauchier, Laurent; Freedman, Saul B;

    2016-01-01

    Atrial fibrillation (AF) is the most common sustained cardiac rhythm disorder, and increases in prevalence with increasing age and the number of cardiovascular comorbidities. AF is characterized by a rapid and irregular heartbeat that can be asymptomatic or lead to symptoms such as palpitations...

  7. Atrial fibrillation

    DEFF Research Database (Denmark)

    Olesen, Morten S; Nielsen, Morten W; Haunsø, Stig;

    2014-01-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting 1-2% of the general population. A number of studies have demonstrated that AF, and in particular lone AF, has a substantial genetic component. Monogenic mutations in lone and familial AF, although rare, have been recognized...

  8. Fan Stall Flutter Flow Mechanism Studied

    Science.gov (United States)

    Lepicovsky, Jan

    2002-01-01

    Modern turbofan engines employ a highly loaded fan stage with transonic or low-supersonic velocities in the blade-tip region. The fan blades are often prone to flutter at off-design conditions. Flutter is a highly undesirable and dangerous self-excited mode of blade oscillations that can result in high-cycle fatigue blade failure. The origins of blade flutter are not fully understood yet. Experimental data that can be used to clarify the origins of blade flutter in modern transonic fan designs are very limited. The Transonic Flutter Cascade Facility at the NASA Glenn Research Center was developed to experimentally study the details of flow mechanisms associated with fan flutter. The cascade airfoils are instrumented to measure high-frequency unsteady flow variations in addition to the steady flow data normally recorded in cascade tests. The test program measures the variation in surface pressure in response to the oscillation of one or more of the cascade airfoils. However, during the initial phases of the program when all airfoils were in fixed positions, conditions were found where significant time variations in the pressures near the airfoil leading edges could be observed.

  9. Risk of atrial fibrillation associated with use of bisphosphonates and other drugs against osteoporosis: a cohort study

    DEFF Research Database (Denmark)

    Vestergaard, Peter; Schwartz, Kristoffer; Pinholt, Else Marie;

    2010-01-01

    We studied the association between bisphosphonate use and risk of atrial fibrillation or flutter and the effect of confounders such as heart and lung disease in a nationwide retrospective cohort from Denmark. All users of bisphosphonates and other drugs against osteoporosis between 1996 and 2006 ...

  10. Paroxysmal atrial fibrillation and atrial flutter : current concepts and new strategies

    NARCIS (Netherlands)

    Suttorp, Maarten Jan

    1992-01-01

    Ondanks het feit dat al meer dan een eeuw geneesmiddelen worden voorgeschreven ter behandeling en preventie van boezemfibrilleren en boezemflutter, zoals het aloude digitalis en kinidine, beschikken wij pas sinds kort over een groeiende reeks van nieuwe en veelbelovende antiaritmica. Met het onderzo

  11. Atrial Fibrillation.

    Science.gov (United States)

    Zimetbaum, Peter

    2017-03-07

    This issue provides a clinical overview of atrial fibrillation, focusing on diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  12. 14 CFR 29.629 - Flutter and divergence.

    Science.gov (United States)

    2010-01-01

    ... AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction General § 29.629 Flutter and divergence. Each aerodynamic surface of the rotorcraft must be free from flutter and divergence under...

  13. Numerical modeling of flutter in a transonic fan

    OpenAIRE

    Milandre, Olivier

    2014-01-01

    Flutter is a self-feeding and potentially destructive vibration that can lead to devastating effects such as broken blades. Using accurate numerical models to predict flutter in the conception of an engine is essential to avoid huge waste of money. The software 2, using the elsA CFD package developed by the French Aerospace Lab, ONERA, is used to perform unsteady calculations and predict flutter margin. The current methodology does not systematically manage to reproduce the expected flutter p...

  14. Atrial Arrhythmias in Astronauts - Summary of a NASA Summit

    Science.gov (United States)

    Barr, Yael R.; Watkins, Sharmila D.; Polk, J. D.

    2010-01-01

    Background and Problem Definition: To evaluate NASA s current standards and practices related to atrial arrhythmias in astronauts, Space Medicine s Advanced Projects Section at the Johnson Space Center was tasked with organizing a summit to discuss the approach to atrial arrhythmias in the astronaut cohort. Since 1959, 11 cases of atrial fibrillation, atrial flutter, or supraventricular tachycardia have been recorded among active corps crewmembers. Most of the cases were paroxysmal, although a few were sustained. While most of the affected crewmembers were asymptomatic, those slated for long-duration space flight underwent radiofrequency ablation treatment to prevent further episodes of the arrhythmia. The summit was convened to solicit expert opinion on screening, diagnosis, and treatment options, to identify gaps in knowledge, and to propose relevant research initiatives. Summit Meeting Objectives: The Atrial Arrhythmia Summit brought together a panel of six cardiologists, including nationally and internationally renowned leaders in cardiac electrophysiology, exercise physiology, and space flight cardiovascular physiology. The primary objectives of the summit discussions were to evaluate cases of atrial arrhythmia in the astronaut population, to understand the factors that may predispose an individual to this condition, to understand NASA s current capabilities for screening, diagnosis, and treatment, to discuss the risks associated with treatment of crewmembers assigned to long-duration missions or extravehicular activities, and to discuss recommendations for prevention or management of future cases. Summary of Recommendations: The summit panel s recommendations were grouped into seven categories: Epidemiology, Screening, Standards and Selection, Treatment of Atrial Fibrillation Manifesting Preflight, Atrial Fibrillation during Flight, Prevention of Atrial Fibrillation, and Future Research

  15. Atrial Substrate Modification in Atrial Fibrillation: Targeting GP or CFAE? Evidence from Meta-Analysis of Clinical Trials

    Science.gov (United States)

    Qin, Mu; Liu, Xu; Wu, Shao-Hui; Zhang, Xiao-Dong

    2016-01-01

    Several clinically relevant outcomes post atrial substrate modification in patients with atrial fibrillation (AF) have not been systematically analyzed among published studies on adjunctive cardiac ganglionated plexi (GP) or complex fractionated atrial electograms (CFAE) ablation vs. pulmonary vein isolation (PVI) alone. Out of 176 reports identified, the present meta-analysis included 14 randomized and non-randomized controlled trials (1613 patients) meeting inclusion criteria. Addition of GP ablation to PVI significantly increased freedom from atrial tachyarrhythmia in short- (OR: 1.72; P = 0.003) and long-term (OR: 2.0, P = 0.0006) follow-up, while adjunctive CFAE ablation did not after one or repeat procedure (P<0.05). The percentage of atrial tachycardia or atrial flutter (AT/AFL) after one procedure was higher for CFAE than GP ablation. In sub-analysis of non-paroxysmal AF, relative to PVI alone, adjunctive GP but not CFAE ablation significantly increased sinus rhythm maintenance (OR: 1.88, P = 0.01; and OR:1.24, P = 0.18, respectively). Meta regression analysis of the 14 studies indicated that sample size was significant source of heterogeneity either in outcomes after one or repeat procedure. In conclusion, in patients with AF, adjunctive GP but not CFAE ablation appeared to significantly add to the beneficial effects on sinus rhythm maintenance of PVI ablation alone; and CFAE ablation was associated with higher incidence of subsequent AT/AFL. PMID:27764185

  16. FLUTTER SUPPRESSION USING DISTRIBUTED PIEZOELECTRIC ACTUATORS

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The Flutter suppression using distributed piezoelectric actuators has been analyzed and tested. In constructing the finite element equation, effects of piezoelectric matrices are investigated. LQG method is used in designing the control law. In reducing the order of the control law, both balance realization and LK methods are used. For the rational approximation of the unsteady aerodynamic forces LS method is improved. In determining the piezoelectric constants d31 a new dynamic response method is developed. Laser vibrameter is used to pick up the model response and in ground resonance test the model is excited by piezoelectric actuators. Reasonable agreement of the wind tunnel flutter suppression test with calculated results is obtained.

  17. Decoupler pylon: wing/store flutter suppressor

    Science.gov (United States)

    Reed, W. H., III (Inventor)

    1982-01-01

    A device for suspending a store from a support such as an aircraft wing and more specifically for increasing the flutter speed of an aircraft flying with attached store and reducing the sensitivity of flutter to changes in the pitch inertia and center of gravity location of the store is described. It comprises softspring where the store pitch mode is decoupled from support modes and a low frequency active control mechanism which maintains store alignment. A pneumatic suspension system both isolates the store in pitch and, under conditions of changing mean load, aligns the store with the wing to which it is attached.

  18. Implementation of the non-flutter design principle

    DEFF Research Database (Denmark)

    Andersen, Michael Styrk; Sahin, Emrah; Laustsen, Benjamin

    2014-01-01

    The non-flutter design principle is introduced. Aerodynamically stable section model tests performed by three different research groups indicate, that flutter might be avoided if the torsional-to-vertical frequency ratio is kept below 1. A case study of a suspension bridge spanning 3:7 km...... with a torsional-to-vertical frequency ratio = 0.89 is presented. Using a multimodal flutter approach and bridge deck flutter derivatives equal to those of a thin airfoil, classical flutter was shown not to occur....

  19. Atrial fibrillation associated with exogenous subclinical hyperthyroidism.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2010-11-19

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. Moreover acute myocardial infarction has been reported during L-thyroxine substitution therapy. Far more common and relatively less studied is exogenous subclinical hyperthyroidism caused by L-thyroxine administration to thyroidectomized or hypothyroid patients or patients with simple or nodular goiter. We present a case of atrial fibrillation associated with exogenous subclinical hyperthyroidism, in a 72-year-old Italian woman. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  20. Atrial fibrillation associated with exogenous subclinical hyperthyroidism, changing axis deviation, troponin-I positive and without acute coronary syndrome.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2011-08-04

    Changing axis deviation has been rarely reported also during atrial fibrillation or atrial flutter. Changing axis deviation has been also rarely reported during acute myocardial infarction associated with atrial fibrillation or at the end of atrial fibrillation during acute myocardial infarction. Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. Serum troponin-I is a sensitive indicator of myocardial damage but abnormal troponin-I levels have been also reported without acute coronary syndrome and without cardiac damage. Abnormal troponin-I levels after supraventricular tachycardia have been also reported. We present a case of changing axis deviation in a 49-year-old Italian man with atrial fibrillation, exogenous subclinical hyperthyroidism and troponin-I positive without acute coronary syndrome. Also this case focuses attention on changing axis deviation, on subclinical hyperthyroidism and on the importance of a correct evaluation of abnormal troponin-I levels.

  1. Managing atrial fibrillation in the elderly: critical appraisal of dronedarone

    Directory of Open Access Journals (Sweden)

    Trigo P

    2011-12-01

    Full Text Available Paula Trigo, Gregory W FischerDepartment of Anesthesiology, Mount Sinai School of Medicine, New York, NY, USAAbstract: Atrial fibrillation is the most commonly seen arrhythmia in the geriatric population and is associated with increased cardiovascular morbidity and mortality. Treatment of the elderly with atrial fibrillation remains challenging for physicians, because this unique subpopulation is characterized by multiple comorbidities requiring chronic use of numerous medications, which can potentially lead to severe drug interactions. Furthermore, age-related changes in the cardiovascular system as well as other physiological changes result in altered drug pharmacokinetics. Dronedarone is a new drug recently approved for the treatment of arrhythmias, such as atrial fibrillation and/or atrial flutter. Dronedarone is a benzofuran amiodarone analog which lacks the iodine moiety and contains a methane sulfonyl group that decreases its lipophilicity. These differences in chemical structure are responsible for making dronedarone less toxic than amiodarone which, in turn, results in fewer side effects. Adverse events for dronedarone include gastrointestinal side effects and rash. No dosage adjustments are required for patients with renal impairment. However, the use of dronedarone is contraindicated in the presence of severe hepatic dysfunction.Keywords: atrial fibrillation, elderly, antiarrhythmic agents, amiodarone, dronedarone

  2. Effects of electrical and structural remodeling on atrial fibrillation maintenance: a simulation study.

    Science.gov (United States)

    Krogh-Madsen, Trine; Abbott, Geoffrey W; Christini, David J

    2012-01-01

    Atrial fibrillation, a common cardiac arrhythmia, often progresses unfavourably: in patients with long-term atrial fibrillation, fibrillatory episodes are typically of increased duration and frequency of occurrence relative to healthy controls. This is due to electrical, structural, and contractile remodeling processes. We investigated mechanisms of how electrical and structural remodeling contribute to perpetuation of simulated atrial fibrillation, using a mathematical model of the human atrial action potential incorporated into an anatomically realistic three-dimensional structural model of the human atria. Electrical and structural remodeling both shortened the atrial wavelength--electrical remodeling primarily through a decrease in action potential duration, while structural remodeling primarily slowed conduction. The decrease in wavelength correlates with an increase in the average duration of atrial fibrillation/flutter episodes. The dependence of reentry duration on wavelength was the same for electrical vs. structural remodeling. However, the dynamics during atrial reentry varied between electrical, structural, and combined electrical and structural remodeling in several ways, including: (i) with structural remodeling there were more occurrences of fragmented wavefronts and hence more filaments than during electrical remodeling; (ii) dominant waves anchored around different anatomical obstacles in electrical vs. structural remodeling; (iii) dominant waves were often not anchored in combined electrical and structural remodeling. We conclude that, in simulated atrial fibrillation, the wavelength dependence of reentry duration is similar for electrical and structural remodeling, despite major differences in overall dynamics, including maximal number of filaments, wave fragmentation, restitution properties, and whether dominant waves are anchored to anatomical obstacles or spiralling freely.

  3. Atrial Substrate Modification in Atrial Fibrillation: Targeting GP or CFAE? Evidence from Meta-Analysis of Clinical Trials.

    Science.gov (United States)

    Qin, Mu; Liu, Xu; Wu, Shao-Hui; Zhang, Xiao-Dong

    2016-01-01

    Several clinically relevant outcomes post atrial substrate modification in patients with atrial fibrillation (AF) have not been systematically analyzed among published studies on adjunctive cardiac ganglionated plexi (GP) or complex fractionated atrial electograms (CFAE) ablation vs. pulmonary vein isolation (PVI) alone. Out of 176 reports identified, the present meta-analysis included 14 randomized and non-randomized controlled trials (1613 patients) meeting inclusion criteria. Addition of GP ablation to PVI significantly increased freedom from atrial tachyarrhythmia in short- (OR: 1.72; P = 0.003) and long-term (OR: 2.0, P = 0.0006) follow-up, while adjunctive CFAE ablation did not after one or repeat procedure (Patrial tachycardia or atrial flutter (AT/AFL) after one procedure was higher for CFAE than GP ablation. In sub-analysis of non-paroxysmal AF, relative to PVI alone, adjunctive GP but not CFAE ablation significantly increased sinus rhythm maintenance (OR: 1.88, P = 0.01; and OR:1.24, P = 0.18, respectively). Meta regression analysis of the 14 studies indicated that sample size was significant source of heterogeneity either in outcomes after one or repeat procedure. In conclusion, in patients with AF, adjunctive GP but not CFAE ablation appeared to significantly add to the beneficial effects on sinus rhythm maintenance of PVI ablation alone; and CFAE ablation was associated with higher incidence of subsequent AT/AFL.

  4. Long-term Prognosis of Paroxysmal Atrial Fibrillation and Predictors for Progression to Persistnt or Chronic Atrial Fibrillation in the Korean Population.

    Science.gov (United States)

    Im, Sung Ii; Chun, Kwang Jin; Park, Seung-Jung; Park, Kyoung-Min; Kim, June Soo; On, Young Keun

    2015-07-01

    Little is known about the long-term prognosis of or predictors for the different clinical types of atrial fibrillation (AF) in Korean populations. The aim of this study was to validate a risk stratification to assess the probability of AF progression from paroxysmal AF (PAF) to persistent AF (PeAF) or permanent AF. A total of 434 patients with PAF were consecutively enrolled (mean age; 71.7 ± 10.7 yr, 60.6% male). PeAF was defined as episodes that are sustained > 7 days and not self-terminating, while permanent AF was defined as an ongoing long-term episode. Atrial arrhythmia during follow-up was defined as atrial premature complex, atrial tachycardia, and atrial flutter. During a mean follow-up of 72.7 ± 58.3 months, 168 patients (38.7%) with PAF progressed to PeAF or permanent AF. The mean annual AF progression was 10.7% per year. In univariate analysis, age at diagnosis, body mass index, atrial arrhythmia during follow-up, left ventricular ejection fraction, concentric left ventricular hypertrophy, left atrial diameter (LAD), and severe mitral regurgitation (MR) were significantly associated with AF progression. In multivariate analysis, age at diagnosis (P = 0.009), atrial arrhythmia during follow-up (P = 0.015), LAD (P = 0.002) and MR grade (P = 0.026) were independent risk factors for AF progression. Patients with younger age at diagnosis, atrial arrhythmia during follow-up, larger left atrial chamber size, and severe MR grade are more likely to progress to PeAF or permanent AF, suggesting more intensive medical therapy with close clinical follow-up would be required in those patients.

  5. Ground vibration test and flutter analysis of air sampling probe

    Science.gov (United States)

    Ellison, J. F.

    1986-01-01

    The Dryden Flight Research Facility of NASA Ames Research Center conducted a ground vibration test and a flutter analysis of an air sampling probe that was to be mounted on a Convair 990 airplane. The probe was a steel, wing-shaped structure used to gather atmospheric data. The ground vibration test was conducted to update the finite-element model used in the flutter analysis. The analysis predicted flutter speeds well outside the operating flight envelope of the Convair 990 airplane.

  6. Real-time flutter analysis of an active flutter-suppression system on a remotely piloted research aircraft

    Science.gov (United States)

    Gilyard, G. B.; Edwards, J. W.

    1983-01-01

    Flight-test results of the first three flights of an aeroelastic research wing are described. The flight flutter-test technique used to obtain real-time damping estimates from fast-frequency sweep data was obtained and the open-loop flutter boundary determined. Nyquist analyses of sweep maneuvers appear to provide additional valuable information about flutter suppression system operation, both in terms of phase-margin estimates and as a means of evaluating maneuver quality. An error in implementing the flutter-suppression system required in a one-half nominal gain configuration, which caused the wing to be unstable at lower Mach numbers than anticipated, and the vehicle experienced closed-loop flutter on its third flight. Real-time flutter-testing procedures were improved.

  7. Nonlinear Characteristics of Randomly Excited Transonic Flutter

    DEFF Research Database (Denmark)

    Christiansen, Lasse Engbo; Lehn-Schiøler, Tue; Mosekilde, Erik

    2002-01-01

    shown that the self-sustained oscillations arise in a subcritical Hopf bifurcation. However, analysis of the experimental data also reveals that this bifurcation is modified in various ways. We present an outline of the construction of a 6 DOF model of the aeroelastic behavior of the wing structure...... reproduce several of the experimentally observed modifications of the flutter transition. In particular, the models display the characteristic phenomena of coherence resonance....

  8. Supersonic Chordwise Bending Flutter in Cascades

    Science.gov (United States)

    1975-05-31

    such a flutter boundary can be made by utilizing the trend lines predicted from a supersonic analysis based on supersonic cascade theory (Appendix I...bonding agent was injected via hypodermic needles after the blade tabs were properly inserted, The integrity and repeatability of the mounting of the indi...in conjunction with NASTRAN predictions and supersonic cascade aerodynamic computa- tions. Comparisons between theory and experiment are discussed. DD

  9. Piezo-actuated Vibration and Flutter Control

    OpenAIRE

    S.B. Kandagal; Kartik Venkatraman

    2006-01-01

    The potential application of smart materials is being investigated by various researchers inthe perspective of building intelligent systems. A smart structure consists of distributed actuatorsand sensors with associated processors to analyse and control the structure. Piezoceramics,magnetostrictive materials, electro-rheological fluids, magneto-rheological fluids, shape memoryalloys, fibre optics are quite often used in realising a smart/intelligent system. In this paper,vibration and flutter...

  10. YF-16 flight flutter test procedures

    Science.gov (United States)

    Brignac, W. J.; Ness, H. B.; Johnson, M. K.; Smith, L. M.

    1976-01-01

    The Random Decrement technique (Randomdec) was incorporated in procedures for flight testing of the YF-16 lightweight fighter prototype. Damping values obtained substantiate the adequacy of the flutter margin of safety. To confirm the structural modes which were being excited, a spectral analysis of each channel was performed using the AFFTC time/data 1923/50 time series analyzer. Inflight test procedure included the careful monitoring of strip charts, three axis pulses, rolls, and pullups.

  11. Stall Flutter Control of a Smart Blade Section Undergoing Asymmetric Limit Oscillations

    Directory of Open Access Journals (Sweden)

    Nailu Li

    2016-01-01

    Full Text Available Stall flutter is an aeroelastic phenomenon resulting in unwanted oscillatory loads on the blade, such as wind turbine blade, helicopter rotor blade, and other flexible wing blades. Although the stall flutter and related aeroelastic control have been studied theoretically and experimentally, microtab control of asymmetric limit cycle oscillations (LCOs in stall flutter cases has not been generally investigated. This paper presents an aeroservoelastic model to study the microtab control of the blade section undergoing moderate stall flutter and deep stall flutter separately. The effects of different dynamic stall conditions and the consequent asymmetric LCOs for both stall cases are simulated and analyzed. Then, for the design of the stall flutter controller, the potential sensor signal for the stall flutter, the microtab control capability of the stall flutter, and the control algorithm for the stall flutter are studied. The improvement and the superiority of the proposed adaptive stall flutter controller are shown by comparison with a simple stall flutter controller.

  12. Atrial fibrillation.

    Science.gov (United States)

    Bang, Casper N

    2013-10-01

    Atrial fibrillation (AF) is a common complication after myocardial infarction (MI) and new-onset AF has been demonstrated to be associated with adverse outcome and a large excess risk of death in both MI and aortic stenosis (AS) patients. Prevention of new-onset AF is therefore a potential therapeutic target in AS and MI patients. Lipid-lowering drugs, particularly statins, have anti-inflammatory and antioxidant properties that may prevent AF. Accordingly, statins are recommended as a class IIa recommendation for prevention of new-onset AF after coronary artery bypass grafting (CABG). However, this preventive effect has not been investigated on new-onset AF in asymptomatic patients with AS or a large scale first-time MI patient sample and data in patients not undergoing invasive cardiac interventions are limited. This PhD thesis was conducted at the Heart Centre, Rigshospitalet, Denmark, with the aim to investigate the three aforementioned questions and to add to the existing evidence of AF prevention with statins. This was done using three different settings: 1) a randomized patients sample of 1,873 from the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study, 2) a register patient sample of 97,499 with first-time MI, and 3) all published studies until beginning of June 2011 examining statin treatment on new-onset and recurrent AF in patients not undergoing cardiac surgery. This thesis revealed that statins did not lower the incidence or the time to new-onset AF in patients with asymptomatic AS. However, statin treatment showed an independently preventive effect on new-onset AF, including type-dependent effect and a trend to dosage-dependent effect. In addition, this thesis showed that good compliance to statin treatment was important to prevent new-onset AF. Finally, the meta-analysis in this PhD thesis showed a preventive effect in the observational studies although this effect was absent in the randomized controlled trials. Based on this PhD thesis

  13. Feasibility and safety of remote-controlled magnetic navigation for ablation of atrial fibrillation.

    Science.gov (United States)

    Katsiyiannis, William T; Melby, Daniel P; Matelski, Jayme L; Ervin, Vanessa L; Laverence, Kerri L; Gornick, Charles C

    2008-12-15

    Radiofrequency ablation for atrial fibrillation (AF) involves complex catheter manipulation resulting in prolonged procedure time and fluoroscopy exposure. Remote magnetic navigation (RMN) represents a novel approach toward improving the ability to perform complex ablation. Forty patients underwent ablation for AF, 20 using RMN (NIOBE II, Stereotaxis, Inc) with a 4-mm-tip magnetic catheter (Celsius, Biosense Webster) and 20 using a conventional 8-mm-tip bidirectional ablation catheter (Blazer, Boston Scientific). All patients underwent a combined wide area circumferential ablation and segmental pulmonary vein (PV) isolation using a circular mapping catheter and cavotricuspid isthmus ablation for right atrial flutter. The procedural end point was PV entrance block. There was no difference in atrial size, left ventricular systolic function, or type of AF between groups. PV entrance block was achieved in all patients. Mean procedure time was 279 +/- 60 minutes in the conventional group versus 209 +/- 56 minutes in the RMN group (p RMN group (p RMN group free from clinical AF and off antiarrhythmic drugs (p = NS). There were 2 additional ablations performed for atypical atrial flutter in the conventional group and 3 in the RMN group (p = ns). Ablation catheter char formation was not observed. There were no procedural complications. In conclusion, radiofrequency ablation of AF performed with RMN is safe and feasible. Compared with conventional hand-navigated ablation, RMN ablation results in similar clinical outcomes with decreased fluoroscopy and procedure times.

  14. Analysis of tiltrotor whirl flutter in time and frequency domain

    DEFF Research Database (Denmark)

    Kim, Taeseong; Shin, SanJoon; Kim, Taehyoun

    2009-01-01

    The whirl flutter phenomenon in a rotor is induced by in-plane hub forces, and imposes a serious limit on the forward speed. In this paper, based on Greenberg’s model, quasi-steady and unsteady aerodynamic forces are formulated to examine the whirl flutter stability for a three-bladed rotor witho...

  15. Non-Flutter Design Principle for long Span Bridges

    DEFF Research Database (Denmark)

    Johansson, Jens; Andersen, Michael Styrk; Starch Øvre, Michele

    velocity for a thin airfoil shows an asymptotical behavior. In traditional bridge design the torsional-to-vertical frequency ratio is increased to obtain higher flutter wind velocities. In the present study, we investigate, what we will label the non-flutter design principle, in which the torsional...

  16. Detection of Rapid Atrial Arrhythmias in SQUID Magnetocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ki Woong; Kwon, Hyuk Chan; Kim, Ki Dam; Lee, Yong Ho; Kim, Jin Mok; Kim, In Seon; Lim, Hyun Kyoon; Park, Yong Ki [Biomagnetism Research, Korea Research Institute of Standards and Science, Daejeon (Korea, Republic of); Kim, Doo Sang [Seoul Veterans Hospital, Seoul (Korea, Republic of); Lim, Seung Pyung [Chungnam National University Hospital, Daejeon (Korea, Republic of)

    2005-10-15

    We propose a method to measure atrial arrhythmias (AA) such as atrial fibrillation (Afb) and atrial flutter (Afl) with a SQUID magnetocardiograph (MCG) system. To detect AA is one of challenging topics in MCG. As the AA generally have irregular rhythm and atrio-ventricular conduction, the MCG signal cannot be improved by QRS averaging; therefore a SQUID MCG system having a high SNR is required to measure informative atrial excitation with a single scan. In the case of Afb, diminished f waves are much smaller than normal P waves because the sources are usually located on the posterior wall of the heart. In this study, we utilize an MCG system measuring tangential field components, which is known to be more sensitive to a deeper current source. The average noise spectral density of the whole system in a magnetic shielded room was 10 fT/Hz(a) 1 Hz and 5 fT/Hz(a) 100 Hz. We measured the MCG signals of patients with chronic Afb and Afl. Before the AA measurement, the comparison between the measurements in supine and prone positions for P waves has been conducted and the experiment gave a result that the supine position is more suitable to measure the atrial excitation. Therefore, the AA was measured in subject's supine position. Clinical potential of AA measurement in MCG is to find an aspect of a reentry circuit and to localize the abnormal stimulation noninvasively. To give useful information about the abnormal excitation, we have developed a method, separative synthetic aperture magnetometry (sSAM). The basic idea of sSAM is to visualize current source distribution corresponding to the atrial excitation, which are separated from the ventricular excitation and the Gaussian sensor noises. By using sSAM, we localized the source of an Afl successfully.

  17. Comparisons of bridges flutter derivatives and generalized ones

    Institute of Scientific and Technical Information of China (English)

    Fuyou XU; Airong CHEN; Zhe ZHANG; Cailiang HUANG

    2009-01-01

    The causes of the nonlinearity of self-excited aerodynamic force of bridge are interpreted from such two aspects as amplitude and wind velocity. The concept of "generalized flutter derivative" is proposed, and its physical meaning is illustrated. The graphs of the general-ized flutter derivatives of plate and Sutong Bridge section model are plotted. The characteristics of all generalized flutter derivatives are compared and analyzed, and their superiorities are verified. The results indicate that the physical meaning of generalized flutter derivatives are more explicit compared to the traditional ones. It is more convenient to understand the nonlinearity properties of self-excited aerodynamic force of bridge according to the generalized flutter derivatives graphs with the wind velocity as the horizontal coordinate.

  18. Preliminary study of effects of winglets on wing flutter

    Science.gov (United States)

    Doggett, R. V., Jr.; Farmer, M. G.

    1976-01-01

    Some experimental flutter results are presented over a Mach number range from about 0.70 to 0.95 for a simple, swept, tapered, flat-plate wing model having a planform representative of subsonic transport airplanes and for the same wing model equipped with two different upper surface winglets. Both winglets had the same planform and area (about 2 percent of the basic-wing area); however, one weighed about 0.3 percent of the basic-wing weight, and the other weighed about 1.8 percent of the wing weight. The addition of the lighter winglet reduced the wing-flutter dynamic pressure by about 3 percent; the heavier winglet reduced the wing-flutter dynamic pressure by about 12 percent. The experimental flutter results are compared at a Mach number of 0.80 with analytical flutter results obtained by using doublet-lattice and lifting-surface (kernel-function) unsteady aerodynamic theories.

  19. A danger of induction of Brugada syndrome during pill-in-the-pocket therapy for paroxysmal atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Yoshiyasu Aizawa

    2010-08-01

    Full Text Available Yoshiyasu Aizawa, Tomohiro Matsuhashi, Toshiaki Sato, Seiji Takatsuki, Keiichi FukudaDivision of Cardiology, Keio University School of Medicine, Tokyo, JapanAbstract: Rhythm control therapy by sodium channel blockers is widely performed for the ­treatment of paroxysmal atrial fibrillation. Here, we present a case of acquired Brugada ­syndrome by pill-in-the-pocket treatment using pilsicainide. It is important that this therapy should be applied only after confirming the drug safety to the patients.Keywords: syncope, sudden death, drug, rhythm control, pilsicainide, atrial flutter

  20. A CFD analysis of controlled flutter phenomenon

    Directory of Open Access Journals (Sweden)

    Thirusangu Velmurugan

    2016-01-01

    Full Text Available In the present study, the concept of aero elastic wind energy generator is utilized wind turbines and it applied to produce electricity at low wind speeds. Flutter is the mechanism of dynamic instability in which the energy can be extracted from the wind. This energy might possibly transform into electric power. A straight rectangular wing with single degree of freedom at stalling angle is employed to do suitable work for producing power. A computational model of aero elastic wind energy generator is developed by using ICEM CFD and the flow analysis is carried out at different speeds for the prediction of co-efficient of power for the proposed device. Further a small model is experimentally fabricated and tested in a wind tunnel with different velocities using non-linear theory to predict the power co-efficient of a model. The test results from experiment are compared with the computational results. Thus it is evident that the correlated results are accurate within the acceptable range. The input from the flow analysis is used for structural analysis in ANSYS. The frequency, amplitude of oscillation and phase response of the proposed system can be obtained and it compared with the numerical values from MATLAB simulation of the same system to ensure for obtaining sustained oscillation which is capable of producing power. The flutter mechanism is having the advantage of producing power at very low velocity, eventhough low efficiency.

  1. Interactive flutter analysis and parametric study for conceptual wing design

    Science.gov (United States)

    Mukhopadhyay, Vivek

    1995-01-01

    An interactive computer program was developed for wing flutter analysis in the conceptual design stage. The objective was to estimate the flutter instability boundary of a flexible cantilever wing, when well defined structural and aerodynamic data are not available, and then study the effect of change in Mach number, dynamic pressure, torsional frequency, sweep, mass ratio, aspect ratio, taper ratio, center of gravity, and pitch inertia, to guide the development of the concept. The software was developed on MathCad (trademark) platform for Macintosh, with integrated documentation, graphics, database and symbolic mathematics. The analysis method was based on nondimensional parametric plots of two primary flutter parameters, namely Regier number and Flutter number, with normalization factors based on torsional stiffness, sweep, mass ratio, aspect ratio, center of gravity location and pitch inertia radius of gyration. The plots were compiled in a Vaught Corporation report from a vast database of past experiments and wind tunnel tests. The computer program was utilized for flutter analysis of the outer wing of a Blended Wing Body concept, proposed by McDonnell Douglas Corporation. Using a set of assumed data, preliminary flutter boundary and flutter dynamic pressure variation with altitude, Mach number and torsional stiffness were determined.

  2. Left atrial strain: a new predictor of thrombotic risk and successful electrical cardioversion

    Directory of Open Access Journals (Sweden)

    Cátia Costa

    2016-06-01

    Full Text Available Background: Left atrial deformation (LAD parameters are new markers of atrial structural remodelling that seem to be affected in atrial fibrillation (AF and atrial flutter (AFL. This study aimed to determine whether LAD can identify patients with a higher risk of thrombosis and unsuccessful electrical cardioversion (ECV. Methods: Retrospective study including 56 patients with AF or AFL undergoing ECV, with previous transthoracic (TTE and transoesophageal echocardiography (TEE studies. Echocardiographic parameters analysed were as follows: left ventricle function, left atrium (LA dimensions, LAD parameters (positive and negative strain peaks, left atrial appendage (LAA filling and emptying velocities and the presence of thrombi. Strain values were analysed according to thrombotic risk and success of ECV. Results: Lower mean values of peak-positive strain (PPS in patients with prothrombotic velocities (<25 cm/s and a higher incidence of thrombi in LAA were observed compared with those with normal velocities. Multivariate analysis revealed PPS normalised by LA maximum volume indexed by body surface area (BSA to be associated with prothrombotic risk (odds ratio 0.000 (95% CI: 0.000–0.243, P 0.017, regardless of CHADs2VASC score. Peak-negative strain normalised by LA volumes indexed by BSA were associated with unsuccessful ECV. Conclusions: Atrial deformation parameters identify AF and AFL patients with a high risk of thrombosis and unsuccessful ECV. Therefore, these new parameters should be included in anticoagulation management and rhythm vs rate control strategies.

  3. A multiple ion channel blocker, NIP-142, for the treatment of atrial fibrillation.

    Science.gov (United States)

    Tanaka, Hikaru; Hashimoto, Norio

    2007-01-01

    Atrial fibrillation (AF) is one of the most frequent cardiac arrhythmia and is associated with increased cardiovascular morbidity and mortality, and the risk of stroke. Although currently available antiarrhythmic drugs are moderately effective in restoring normal sinus rhythm in patients with AF, excessive delay of ventricular repolarization by these agents may be associated with increased risk of proarrhythmia. Therefore, selective blockers of cardiac ion channel(s) that are exclusively present in the atria are highly desirable. NIP-142 is a novel benzopyrane derivative, which blocks potassium, calcium, and sodium channels and shows atrial specific action potential duration prolongation. NIP-142 preferentially blocks the ultrarapid delayed rectifier potassium current (I Kur) and the acetylcholine-activated potassium current (I KACh). Since I Kur and I KACh have been shown to be expressed more abundantly in the atrial than in the ventricular myocardium, the atrial-specific repolarization prolonging effect of NIP-142 is considered to be due to the blockade of these potassium currents. In canine models, NIP-142 was shown to terminate the microreentry type AF induced by vagal nerve stimulation and the macroreentry type atrial flutter induced by an intercaval crush. These effects of NIP-142 have been attributed to the prolongation of atrial effective refractory period (ERP), because this compound prolonged atrial ERP without affecting intraatrial and interatrial conduction times in these models. The ERP prolongation by NIP-142 was greater in the atrium than in the ventricle. NIP-142 also terminated the focal activity type AF induced by aconitine. In addition, NIP-142 reversed the atrial ERP shortening and the loss of rate adaptation induced by short-term rapid atrial pacing in anesthetized dogs. Thus, although clinical trials are required to provide evidence for its efficacy and safety, the novel multiple ion channel blocker, NIP-142, appears to be a useful agent for

  4. Left atrial volume index

    DEFF Research Database (Denmark)

    Poulsen, Mikael K; Dahl, Jordi S; Henriksen, Jan Erik;

    2013-01-01

    To determine the prognostic importance of left atrial (LA) dilatation in patients with type 2 diabetes (T2DM) and no history of cardiovascular disease.......To determine the prognostic importance of left atrial (LA) dilatation in patients with type 2 diabetes (T2DM) and no history of cardiovascular disease....

  5. Supersonic stall flutter of high-speed fans

    Science.gov (United States)

    Adamczyk, J. J.; Stevans, W.; Jutras, R.

    1981-01-01

    An analytical model is proposed for predicting the onset of supersonic stall bending flutter in high-speed rotors. The analysis is based on a modified two-dimensional, compressible, unsteady actuator disk theory. The stability boundary predicted by the analysis is shown to be in good agreement with the measured boundary of a high speed fan. The prediction that the flutter mode would be a forward traveling wave sensitive to wheel speed and aerodynamic loading is confirmed by experimental measurements. In addition, the analysis shows that reduced frequency and dynamic head also play a significant role in establishing the supersonic stall bending flutter boundary of an unshrouded fan.

  6. GVT-Based Ground Flutter Test without Wind Tunnel Project

    Data.gov (United States)

    National Aeronautics and Space Administration — ZONA Technology, Inc (ZONA) and Arizona State University (ASU) propose a R&D effort to further develop the ground flutter testing system in place of a wind...

  7. Wing/store flutter with nonlinear pylon stiffness

    Science.gov (United States)

    Desmarais, R. N.; Reed, W. H., III

    1980-01-01

    Recent wind tunnel tests and analytical studies show that a store mounted on a pylon with soft pitch stiffness provides substantial increase in flutter speed of fighter aircraft and reduces dependency of flutter on mass and inertia of the store. This concept, termed the decoupler pylon, utilizes a low frequency control system to maintain pitch alignment of the store during maneuvers and changing flight conditions. Under rapidly changing transient loads, however, the alignment control system may allow the store to momentarily bottom against a relatively stiff backup structure in which case the pylon stiffness acts as a hardening nonlinear spring. Such structural nonlinearities are known to affect not only the flutter speed but also the basic behavior of the instability. The influence of pylon stiffness nonlinearities or the flutter characteristics of wing mounted external stores is examined.

  8. GVT-Based Ground Flutter Test without Wind Tunnel Project

    Data.gov (United States)

    National Aeronautics and Space Administration — ZONA Technology, Inc (ZONA) and Arizona State University (ASU) propose a R&D effort to develop a ground flutter testing system without wind tunnel, called the...

  9. Effects of beta-blockade on atrial and atrioventricular nodal refractoriness, and atrial fibrillatory rate during atrial fibrillation in pigs

    NARCIS (Netherlands)

    van den Berg, MP; van de Ven, LLM; Witting, W; Crijns, JGM; Haaksma, J; Bel, KJ; de Langen, CDJ; Lie, KI

    1997-01-01

    Despite their widespread use in atrial fibrillation, the effects of beta-adrenoceptor blockers on atrial and atrioventricular (AV) nodal refractoriness, and atrial fibrillatory rate during atrial fibrillation have been incompletely characterised. In particular, it is unknown whether additional sodiu

  10. Bayesian analysis of the flutter margin method in aeroelasticity

    Science.gov (United States)

    Khalil, Mohammad; Poirel, Dominique; Sarkar, Abhijit

    2016-12-01

    A Bayesian statistical framework is presented for Zimmerman and Weissenburger flutter margin method which considers the uncertainties in aeroelastic modal parameters. The proposed methodology overcomes the limitations of the previously developed least-square based estimation technique which relies on the Gaussian approximation of the flutter margin probability density function (pdf). Using the measured free-decay responses at subcritical (preflutter) airspeeds, the joint non-Gaussain posterior pdf of the modal parameters is sampled using the Metropolis-Hastings (MH) Markov chain Monte Carlo (MCMC) algorithm. The posterior MCMC samples of the modal parameters are then used to obtain the flutter margin pdfs and finally the flutter speed pdf. The usefulness of the Bayesian flutter margin method is demonstrated using synthetic data generated from a two-degree-of-freedom pitch-plunge aeroelastic model. The robustness of the statistical framework is demonstrated using different sets of measurement data. It will be shown that the probabilistic (Bayesian) approach reduces the number of test points required in providing a flutter speed estimate for a given accuracy and precision.

  11. Wing flutter boundary prediction using unsteady Euler aerodynamic method

    Science.gov (United States)

    Lee-Rausch, Elizabeth M.; Batina, John T.

    1993-01-01

    Modifications to an existing 3D implicit upwind Euler/Navier-Stokes code for the aeroelastic analysis of wings are described. These modifications include the incorporation of a deforming mesh algorithm and the addition of the structural equations of motion for their simultaneous time-integration with the governing flow equations. The paper gives a brief description of these modifications and presents unsteady calculations which check the modifications to the code. Euler flutter results for an isolated 45 deg swept-back wing are compared with experimental data for seven freestream Mach numbers which define the flutter boundary over a range of Mach number from 0.499 to 1.14. These comparisons show good agreement in flutter characteristics for freestream Mach numbers below unity. For freestream Mach numbers above unity, the computed aeroelastic results predict a premature rise in the flutter boundary as compared with the experimental boundary. Steady and unsteady contours of surface Mach number and pressure are included to illustrate the basic flow characteristics of the time-marching flutter calculations and to aid in identifying possible causes for the premature rise in the computational flutter boundary.

  12. Flutter suppression of plates using passive constrained viscoelastic layers

    Science.gov (United States)

    Cunha-Filho, A. G.; de Lima, A. M. G.; Donadon, M. V.; Leão, L. S.

    2016-10-01

    Flutter in aeronautical panels is a self-excited aeroelastic phenomenon which occurs during supersonic flights due to dynamic instability of inertia, elastic and aerodynamic forces of the system. In the flutter condition, when the critical aerodynamic pressure is reached, the vibration amplitudes of the panel become dynamically unstable and increase exponentially with time, significantly affecting the fatigue life of the existing aeronautical components. Thus, in this paper, the interest is to investigate the possibility reducing the effects of the supersonic aeroelastic instability of rectangular plates by applying passive constrained viscoelastic layers. The rationale for such study is the fact that as the addition of viscoelastic materials provides decreased vibration amplitudes it becomes important to quantify the suppression of plate flutter coalescence modes that can be obtained. Moreover, despite the fact that much research on the suppression of panel flutter has been carried out by using passive, semi-active and active control techniques, few works have been proposed to deal with the problem of predicting the flutter boundary of aeroviscoelastic systems, since they must conveniently account for the frequency- and temperature-dependent behavior of the viscoelastic material. After the presentation of the theoretical foundations of the methodology, the description of a numerical study on the flutter analysis of a three-layer sandwich plate is addressed.

  13. Surgery for atrial fibrillation.

    Science.gov (United States)

    Lawrance, Christopher P; Henn, Matthew C; Damiano, Ralph J

    2014-11-01

    Atrial fibrillation is the most common cardiac arrhythmia, and its treatment options include drug therapy or catheter-based or surgical interventions. The surgical treatment of atrial fibrillation has undergone multiple evolutions over the last several decades. The Cox-Maze procedure went on to become the gold standard for the surgical treatment of atrial fibrillation and is currently in its fourth iteration (Cox-Maze IV). This article reviews the indications and preoperative planning for performing a Cox-Maze IV procedure. This article also reviews the literature describing the surgical results for both approaches including comparisons of the Cox-Maze IV to the previous cut-and-sew method.

  14. Parametric studies on relationships between flutter derivatives of slender bridge (I)

    Institute of Scientific and Technical Information of China (English)

    Xu Xu

    2009-01-01

    Relationships between flutter derivatives of slender bridge are investigated based on our previously proposed semi-analytical flutter derivatives of flexible structure.The intrinsic relations are validated with test data of flutter derivatives of two bridges.Changes in flutter derivatives with the aerodynamic center, rotation speed, and angle variation are also studied by using a parametric method. The results show correctness of the proposed expressions of flutter derivatives given by authors in Ref.[1], and indicate that certain relations exist between these derivatives. It is also shown that semi-analytical flutter derivatives are applicable to bridges with a streamlined cross-section.

  15. On-Line Flutter Prediction Tool for Wind Tunnel Flutter Testing using Parameter Varying Estimation Methodology Project

    Data.gov (United States)

    National Aeronautics and Space Administration — ZONA Technology, Inc. (ZONA) proposes to develop an on-line flutter prediction tool for wind tunnel model using the parameter varying estimation (PVE) technique to...

  16. On-Line Flutter Prediction Tool for Wind Tunnel Flutter Testing using Parameter Varying Estimation Methodology Project

    Data.gov (United States)

    National Aeronautics and Space Administration — ZONA Technology, Inc. (ZONA) proposes to develop an on-line flutter prediction tool using the parameter varying estimation (PVE) methodology, called the PVE Toolbox,...

  17. Dronedarone: an emerging therapy for atrial fibrillation.

    Science.gov (United States)

    Rosei, Enrico Agabiti; Salvetti, Massimo

    2010-06-01

    Atrial fibrillation (AF) is a common arrhythmia, with a prevalence ranging from 0.1% to 9.0% at different ages, and is associated with increased cardiovascular events and mortality. A significant increase in the prevalence of the disease is expected to occur in the coming years as a consequence of the aging of the population and advances in the management of coronary artery disease and heart failure. Effective rhythm control may be difficult to obtain in a significant proportion of patients with AF. The limited efficacy and the possible adverse effects of antiarrhythmic drugs has led researchers to focus their attention on new molecules, in a search of compounds with antiarrhythmic efficacy and a more favourable safety profile. Among several new drugs developed for the management of AF, dronedarone, a benzofuran derivative that shares many of the antiarrhythmic properties of amiodarone, but with a more favourable safety profile, seems particularly promising. The drug is noniodinated, has less lipophilicity, reaches therapeutic concentrations over a shorter period of time and has lower tissue accumulation. Dronedarone, similarly to amiodarone, exhibits electrophysiologic characteristics of all 4 Vaughan Williams classes. Clinical studies have shown that dronedarone effectively reduces ventricular rate, may prevent or delay the recurrence of AF, and may reduce cardiovascular morbidity and mortality in patients with AF or atrial flutter. The drug has an overall good safety profile, in particular with low pulmonary and thyroid toxicity. An important exception is represented by patients with unstable haemodynamic conditions, in which the use of dronedarone has been found to be associated with an increase in mortality. Dronedarone has been recently approved for clinical use by the Food and Drug Administration and by the European Medicines Agency. Further results from trials and clinical use will better define the efficacy and safety profile of dronedarone in AF compared

  18. What Is Atrial Fibrillation?

    Science.gov (United States)

    ... regular beat. Certain cells in your heart make electric signals that cause the heart to contract and pump ... read your ECG to find out if the electric signals are normal. In atrial fibrillation (AFib), the heart’s ...

  19. Lost life years attributable to stroke among patients with nonvalvular atrial fibrillation: a nationwide population-based follow-up study

    DEFF Research Database (Denmark)

    Frost, Lars; Andersen, Ljubica; Johnsen, Søren Paaske;

    2007-01-01

    Registry of Patients from calendar year 1980 to 2002, and no previous or concomitant diagnosis of stroke or heart valve disease. All patients were followed in the Danish National Registry of Patients for occurrence of an incident diagnosis of stroke of any type (ischemic and/or hemorrhagic......AIM: We assessed the number of lost life years attributable to stroke among patients with a hospital diagnosis of nonvalvular atrial fibrillation. METHODS: We identified all patients, aged 40-89 years, with an incident hospital diagnosis of atrial fibrillation or flutter in the Danish National...... lost life years by sex, age, and time to incident stroke after diagnosis of atrial fibrillation, adjusted for conditions of comorbidity and calendar year of diagnosis of atrial fibrillation. RESULTS: The mean loss of life years attributable to incident stroke within 20 years after a first diagnosis...

  20. [Afobasol efficacy in a model of vagotonic atrial fibrillation].

    Science.gov (United States)

    Stoliaruk, V N; Vititnova, M B; Tsorin, I B; Kryzhanovskiĭ, S A

    2010-01-01

    The new anxiolytic agent afobasol (Russia) was introduced into clinical practice by V. V. Zakusov Research Institute of Pharmacology. When administered to cats with vagotonic atrial fibrillation afobasol (7.5 mg/kg v/v) exhibited anti-arrhythmic activity at least as high as that of class 1 and III anti-arrhythmic agents (etacisin and cardiocyclide respectively) (Vaughan Williams classification). However, duration of its action was much smaller. These experimental findings were confirmed in clinical studies involving patients with severe psychosomatic pathology associated with paroxysmal flutter. It is supposed that afobasol activates cytosolic sigma-1 receptors in cardiomyocytes and may be used to manage psychoasthenic conditions accompanied by cardioneuroses and/or cardiophobias with disturbed rhythmic activity of the heart.

  1. Effect of chronic kidney diseases on mortality among digoxin users treated for non-valvular atrial fibrillation

    DEFF Research Database (Denmark)

    Sessa, Maurizio; Mascolo, Annamaria; Andersen, Mikkel Porsborg;

    2016-01-01

    , 1997 to December 31, 2012 were identified in Danish nationwide administrative registries. Cox proportional hazard model was used to compare the adjusted risk of all-causes and cardiovascular mortality among patients with and without chronic kidney disease and among patients with different chronic......PURPOSE: This study investigated the impact of chronic kidney disease on all-causes and cardiovascular mortality in patients with atrial fibrillation treated with digoxin. METHODS: All patients with non-valvular atrial fibrillation and/or atrial flutter as hospitalization diagnosis from January 1...... kidney disease stages within 180 days and 2 years from the first digoxin prescription. RESULTS: We identified 37,981 patients receiving digoxin; 1884 patients had the diagnosis of chronic kidney disease. Cox regression analysis showed no statistically significant differences in all-causes (Hazard Ratio...

  2. Supersonic Stall Flutter of High Speed Fans. [in turbofan engines

    Science.gov (United States)

    Adamczyk, J. J.; Stevens, W.; Jutras, R.

    1981-01-01

    An analytical model is developed for predicting the onset of supersonic stall bending flutter in axial flow compressors. The analysis is based on a modified two dimensional, compressible, unsteady actuator disk theory. It is applied to a rotor blade row by considering a cascade of airfoils whose geometry and dynamic response coincide with those of a rotor blade element at 85 percent of the span height (measured from the hub). The rotor blades are assumed to be unshrouded (i.e., free standing) and to vibrate in their first flexural mode. The effects of shock waves and flow separation are included in the model through quasi-steady, empirical, rotor total-pressure-loss and deviation-angle correlations. The actuator disk model predicts the unsteady aerodynamic force acting on the cascade blading as a function of the steady flow field entering the cascade and the geometry and dynamic response of the cascade. Calculations show that the present model predicts the existence of a bending flutter mode at supersonic inlet Mach numbers. This flutter mode is suppressed by increasing the reduced frequency of the system or by reducing the steady state aerodynamic loading on the cascade. The validity of the model for predicting flutter is demonstrated by correlating the measured flutter boundary of a high speed fan stage with its predicted boundary. This correlation uses a level of damping for the blade row (i.e., the log decrement of the rotor system) that is estimated from the experimental flutter data. The predicted flutter boundary is shown to be in good agreement with the measured boundary.

  3. Complex Mode Frequency Iteration Method for Flutter Analysis of 2-DOF Systems

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    For a vibration system with 2-DOF of bend and torsion, itscritical flutter wind speed can be calculated by using complex mode frequency iteration (CMFI) method based on MatLab 5.2, the results of which are in agree with those acquired by wind tunnel test. Not only critical flutter wind speed, but also vibration characteristic of a system under different wind speeds can be determined. CMFI method is suitable for both of separated-flow torsional flutter and classic coupling flutter analysis, which is presented by flutter analysis of an ideal thin plate and a bluff bridge deck. Furthermore, it is proved through the investigation of the relationship between flutter derivatives and its critical flutter wind speed that coupling aerodynamic derivatives are necessary for classic coupling flutter to occur.

  4. Flutter clearance of the horizontal tail of the Bellanca Skyrocket II airplane

    Science.gov (United States)

    Ricketts, R. H.; Cazier, F. W., Jr.; Farmer, M. G.

    1982-01-01

    The Skyrocket II is an all composite constructed experimental prototype airplane. A flutter clearance program was conducted on the horizontal tail so that the airplane could be safely flown to acquire natural laminar flow aerodynamic data. Ground vibration test data were used in a lifting surface flutter analysis to predict symmetric and antisymmetric flutter boundaries. Subcritical response data which were acquired during flight tests are compared with the analytical results. The final flutter clearance placard speed was based on flight test data.

  5. Analytical and experimental investigation of flutter suppression by piezoelectric actuation

    Science.gov (United States)

    Heeg, Jennifer

    1993-01-01

    The objective of this research was to analytically and experimentally study the capabilities of piezoelectric plate actuators for suppressing flutter. Piezoelectric materials are characterized by their ability to produce voltage when subjected to a mechanical strain. The converse piezoelectric effect can be utilized to actuate a structure by applying a voltage. For this investigation, a two-degree-of-freedom wind tunnel model was designed, analyzed, and tested. The model consisted of a rigid wing and a flexible mount system that permitted a translational and a rotational degree of freedom. The model was designed such that flutter was encountered within the testing envelope of the wind tunnel. Actuators made of piezoelectric material were affixed to leaf springs of the mount system. Command signals, applied to the piezoelectric actuators, exerted control over the damping and stiffness properties. A mathematical aeroservoelastic model was constructed by using finite element methods, laminated plate theory, and aeroelastic analysis tools. Plant characteristics were determined from this model and verified by open loop experimental tests. A flutter suppression control law was designed and implemented on a digital control computer. Closed loop flutter testing was conducted. The experimental results represent the first time that adaptive materials have been used to actively suppress flutter. They demonstrate that small, carefully placed actuating plates can be used effectively to control aeroelastic response.

  6. Epistemic uncertainty quantification in flutter analysis using evidence theory

    Institute of Scientific and Technical Information of China (English)

    Tang Jian; Wu Zhigang; Yang Chao

    2015-01-01

    Aimed at evaluating the structural stability and flutter risk of the system, this paper man-ages to quantify epistemic uncertainty in flutter analysis using evidence theory, including both para-metric uncertainty and method selection uncertainty, on the basis of information from limited experimental data of uncertain parameters. Two uncertain variables of the actuator coupling system with unknown probability distributions, that is bending and torsional stiffness, which are both described with multiple intervals and the basic belief assignment (BBA) extricated from the modal test of actuator coupling systems, are taken into account. Considering the difference in dealing with experimental data by different persons and the reliability of various information sources, a new combination rule of evidence––the generalized lower triangular matrices method is formed to acquire the combined BBA. Finally the parametric uncertainty and the epistemic uncertainty of flut-ter analysis method selection are considered in the same system to realize quantification. A typical rudder of missile is selected to examine the present method, and the dangerous range of velocity as well as relevant belief and plausibility functions is obtained. The results suggest that the present method is effective in obtaining the lower and upper bounds of flutter probability and assessing flut-ter risk of structures with limited experimental data of uncertain parameters and the belief of dif-ferent methods.

  7. Predicting Flutter and Forced Response in Turbomachinery

    Science.gov (United States)

    VanZante, Dale E.; Adamczyk, John J.; Srivastava, Rakesh; Bakhle, Milind A.; Shabbir, Aamir; Chen, Jen-Ping; Janus, J. Mark; To, Wai-Ming; Barter, John

    2005-01-01

    TURBO-AE is a computer code that enables detailed, high-fidelity modeling of aeroelastic and unsteady aerodynamic characteristics for prediction of flutter, forced response, and blade-row interaction effects in turbomachinery. Flow regimes that can be modeled include subsonic, transonic, and supersonic, with attached and/or separated flow fields. The three-dimensional Reynolds-averaged Navier-Stokes equations are solved numerically to obtain extremely accurate descriptions of unsteady flow fields in multistage turbomachinery configurations. Blade vibration is simulated by use of a dynamic-grid-deformation technique to calculate the energy exchange for determining the aerodynamic damping of vibrations of blades. The aerodynamic damping can be used to assess the stability of a blade row. TURBO-AE also calculates the unsteady blade loading attributable to such external sources of excitation as incoming gusts and blade-row interactions. These blade loadings, along with aerodynamic damping, are used to calculate the forced responses of blades to predict their fatigue lives. Phase-lagged boundary conditions based on the direct-store method are used to calculate nonzero interblade phase-angle oscillations; this practice eliminates the need to model multiple blade passages, and, hence, enables large savings in computational resources.

  8. Left atrial appendage occlusion

    Directory of Open Access Journals (Sweden)

    Ahmad Mirdamadi

    2013-01-01

    Full Text Available Left atrial appendage (LAA occlusion is a treatment strategy to prevent blood clot formation in atrial appendage. Although, LAA occlusion usually was done by catheter-based techniques, especially percutaneous trans-luminal mitral commissurotomy (PTMC, it can be done during closed and open mitral valve commissurotomy (CMVC, OMVC and mitral valve replacement (MVR too. Nowadays, PTMC is performed as an optimal management of severe mitral stenosis (MS and many patients currently are treated by PTMC instead of previous surgical methods. One of the most important contraindications of PTMC is presence of clot in LAA. So, each patient who suffers of severe MS is evaluated by Trans-Esophageal Echocardiogram to rule out thrombus in LAA before PTMC. At open heart surgery, replacement of the mitral valve was performed for 49-year-old woman. Also, left atrial appendage occlusion was done during surgery. Immediately after surgery, echocardiography demonstrates an echo imitated the presence of a thrombus in left atrial appendage area, although there was not any evidence of thrombus in pre-pump TEE. We can conclude from this case report that when we suspect of thrombus of left atrial, we should obtain exact history of previous surgery of mitral valve to avoid misdiagnosis clotted LAA, instead of obliterated LAA. Consequently, it can prevent additional evaluations and treatments such as oral anticoagulation and exclusion or postponing surgeries including PTMC.

  9. Impact of dronedarone on hospitalization burden in patients with atrial fibrillation

    DEFF Research Database (Denmark)

    Torp-Pedersen, Christian; Crijns, Harry J G M; Gaudin, Christophe;

    2011-01-01

    Cardiovascular (CV) hospitalization is a predictor of CV mortality and has a negative impact on patients' quality of life. The primary endpoint of A placebo-controlled, double-blind, parallel-arm Trial to assess the efficacy of dronedarone 400 mg bid for the prevention of cardiovascular Hospitali......Cardiovascular (CV) hospitalization is a predictor of CV mortality and has a negative impact on patients' quality of life. The primary endpoint of A placebo-controlled, double-blind, parallel-arm Trial to assess the efficacy of dronedarone 400 mg bid for the prevention of cardiovascular...... Hospitalization or death from any cause in patiENTs with Atrial fibrillation/atrial flutter (ATHENA), a composite of first CV hospitalization or death from any cause, was significantly reduced by dronedarone. This post hoc analysis evaluated the secondary endpoint of CV hospitalization and the clinical benefit...

  10. Surface Acoustic Wave Vibration Sensors for Measuring Aircraft Flutter

    Science.gov (United States)

    Wilson, William C.; Moore, Jason P.; Juarez, Peter D.

    2016-01-01

    Under NASA's Advanced Air Vehicles Program the Advanced Air Transport Technology (AATT) Project is investigating flutter effects on aeroelastic wings. To support that work a new method for measuring vibrations due to flutter has been developed. The method employs low power Surface Acoustic Wave (SAW) sensors. To demonstrate the ability of the SAW sensor to detect flutter vibrations the sensors were attached to a Carbon fiber-reinforced polymer (CFRP) composite panel which was vibrated at six frequencies from 1Hz to 50Hz. The SAW data was compared to accelerometer data and was found to resemble sine waves and match each other closely. The SAW module design and results from the tests are presented here.

  11. Integrin β1 Participates in Atrial Remodeling in Rapid Atrial Pacing Induced Canine Atrial Fibrillation Model

    Institute of Scientific and Technical Information of China (English)

    Zhang wei; Yang guirong; Zheng zhaotong; Wang sujia; Zhang yun

    2004-01-01

    @@ Objective Integrin β1 regulates cell to cell and cell to extracellualr matrix interaction in heart. however, its pathop hysiological role in atrial fibrillation is unclear. The purpose of t his study was to determine whether atrial structural remodeling during atrial fibrillation is associated with altered integrinβ1.

  12. Stroke prevention in atrial fibrillation

    DEFF Research Database (Denmark)

    Freedman, Ben; Potpara, Tatjana S; Lip, Gregory Y H

    2016-01-01

    Atrial fibrillation is found in a third of all ischaemic strokes, even more after post-stroke atrial fibrillation monitoring. Data from stroke registries show that both unknown and untreated or under treated atrial fibrillation is responsible for most of these strokes, which are often fatal...... or debilitating. Most could be prevented if efforts were directed towards detection of atrial fibrillation before stroke occurs, through screening or case finding, and treatment of all patients with atrial fibrillation at increased risk of stroke with well-controlled vitamin K antagonists or non-vitamin K...

  13. Perturbation and harmonic balance methods for nonlinear panel flutter.

    Science.gov (United States)

    Kuo, C.-C.; Morino, L.; Dugundji, J.

    1972-01-01

    A systematic way of applying both perturbation methods and harmonic balance methods to nonlinear panel flutter problems is developed here. Results obtained by both these methods for two-dimensional simply supported and three-dimensional clamped-clamped plates with six modes agree well with those obtained by the straightforward direct integration method, yet require less computer time and provide better insight into the solutions. Effects of viscoelastic structural damping on the flutter stability boundary are generally found to be destabilizing and the postflutter behavior becomes more explosive. The methods developed here may be of interest in related vibration problems.

  14. Determination of Flutter Derivatives for the Great Belt Bridge

    DEFF Research Database (Denmark)

    Poulsen, Niels Kjølstad; Damsgaard, Aage; Reinhold, Thim A.

    1992-01-01

    A new method which combines control theory and system identification techniques has been used to extract flutter derivatives from section model tests for the Great Belt East Bridge. Tests were conducted by exciting the section model simultaneously in vertical and torsional modes of vibration. Tests...... coupled motion derivatives from a simple set of tests.This paper describes the control theory and system identification approach used and discusses the limitations encountered. Results are compared with flutter derivatives obtained by other researchers. The method offers a reasonably robust technique...

  15. Vector plotting as an indication of the approach to flutter

    Science.gov (United States)

    Broadbent, E. G.

    1975-01-01

    A binary flexure-torsion analysis was made to check theoretically a method for predicting flutter which depends on plotting vectorially the amplitudes of response relative to the exciting force and extracting the relevant damping rate. The results of this calculation are given in graphs both of the vector plots themselves and of the estimated damping rate against forward speed. The estimated damping rates are compared with calculated values. The method has the advantage that in a flight flutter test damping can be estimated from continuous excitation records: the method is an extension of the Kennedy and Pancu technique used in ground resonance testing.

  16. Winglet effects on the flutter of twin-engine-transport type wing

    Science.gov (United States)

    Bhatia, K. G.; Nagaraja, K. S.; Ruhlin, C. L.

    1984-01-01

    Flutter characteristics of a cantilevered high aspect ratio wing with winglet were investigated. The configuration represented a current technology, twin-engine airplane. A low-speed and a high-speed model were used to evaluate compressibility effects through transonic Mach numbers and a wide range of mass-density ratios. Four flutter mechanisms were obtained in test, as well as analysis from various combinations of configuration parameters. The coupling between wing tip vertical and chordwise motions was shown to have significant effect under some conditions. It is concluded that, for the flutter model configurations studied, the winglet related flutter was amenable to the conventional flutter analysis techniques.

  17. Atrial natriuretic peptide in patients with heart failure and chronic atrial fibrillation : Role of duration of at atrial fibrillation

    NARCIS (Netherlands)

    Van Den Berg, MP; Crijns, HJGM; Van Veldhuisen, DJ; Van Gelder, IC; De Kam, PJ; Lie, KI

    1998-01-01

    The purpose of this study was to analyze the determinants of atrial natriuretic peptide level in patients with congestive heart failure and atrial fibrillation. In particular, the duration of atrial fibrillation was analyzed because atrial fibrillation per se might have a specific effect on atrial n

  18. Right atrial mural thrombi: An autopsy study of an under-diagnosed complication at an unusual site

    Directory of Open Access Journals (Sweden)

    P Vaideeswar

    2017-01-01

    Full Text Available Background: Right atrial mural thrombi (RAMT are often seen in association with cardiac diseases or foreign bodies. Unusual locations at the flutter isthmus and the atrial appendage prompted us to evaluate our 2-year autopsy data on such thrombi. Materials and Methods: In the 2-year retrospective autopsy, the clinical and autopsy records of patients with RAMT were reviewed, with particular reference to the presence of central venous catheter (CVC, its site of insertion, its type, material and size, its duration of placement, and the drugs infused through the catheter. Results: Of the 940 autopsies performed in 2 years, RAMT was seen in 24 hearts and was related to an insertion of a CVC in 23 patients (95.8%. The risk and/or associated factors for this complication were tunneled and polyethylene catheters, Intensive Care Unit admission, infused drugs, underlying cardiac diseases, and pregnancy. A noteworthy feature was the location of the thrombi in the flutter isthmus in 16 hearts (66.7% and atrial appendage in another six hearts. Localized endocarditis/myocarditis and pulmonary thromboembolism were observed in six and four patients, respectively.Conclusions: This autopsy study, which has a high incidence of catheter-related RAMT, does not reflect the true incidence but reiterates the importance of guided insertion of central venous and prompt recognition of thrombus formation.

  19. Lesson Five Atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    鲁端; 吴文烈

    2003-01-01

    @@ Atrial fibrillation(AF) may occur in paroxysmaland persistent forms. It may be seen in normal subjects,particularly during emotional stress or follow-ing surgery,exercise, or acute alcoholic intoxication.It also may occur in patients with heart or lungdisease who develop acute hypoxia, hypercapnia,ormetabolic or hemodynamic derangements.

  20. Modulation of atrial fibrillation

    NARCIS (Netherlands)

    Geuzebroek, G.S.C.

    2013-01-01

    In this thesis we investigate the results of various surgical procedures for atrial fibrillation which have been performed in the last 2 decades in the Sint Antonius Hospital, Nieuwegein, The Netherlands. In the 1990s the classical Maze III procedure was the main surgical technique for drug-refracto

  1. Rivaroxaban in atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Giorgi MA

    2012-08-01

    Full Text Available Mariano A Giorgi,1,2 Lucas San Miguel31Cardiology Service, Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno”, 2Department of Pharmacology, School of Medicine, Universidad Austral, 3Department of Cardiology and Cardiovascular Surgery, FLENI, Buenos Aires, ArgentinaAbstract: Warfarin is the traditional therapeutic option available to manage thromboembolic risk in atrial fibrillation. The hemorrhagic risk with warfarin depends mainly on the international normalized ratio (INR. Data from randomized controlled trials show that patients have a therapeutic INR (2.00–3.00 only 61%–68% of the time while taking warfarin, and this target is sometimes hard to establish. Many compounds have been developed in order to optimize the profile of oral anticoagulants. We focus on one of them, rivaroxaban, comparing it with novel alternatives, ie, dabigatran and apixaban. The indication for rivaroxaban in nonvalvular atrial fibrillation was evaluated in ROCKET-AF (Rivaroxaban-once daily, Oral, direct factor Xa inhibition Compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation. In this trial, rivaroxaban was associated with a 12% reduction in the incidence of the primary endpoint compared with warfarin (hazard ratio 0.88; 95% confidence interval [CI] 0.74–1.03; P < 0.001 for noninferiority and P = 0.12 for superiority. However, patients remained in the therapeutic range for INR only 55% of the time, which is less than that in RE-LY (the Randomized Evaluation of Long-Term Anticoagulation Therapy, 64% and in the ARISTOTLE trial (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation, 66%. This shorter time spent in the therapeutic range has been one of the main criticisms of the ROCKET-AF trial, but could actually reflect what happens in real life. In addition, rivaroxaban exhibits good pharmacokinetic and pharmacoeconomic properties. Novel anticoagulants

  2. Flutter-driven triboelectrification for harvesting wind energy.

    Science.gov (United States)

    Bae, Jihyun; Lee, Jeongsu; Kim, SeongMin; Ha, Jaewook; Lee, Byoung-Sun; Park, YoungJun; Choong, Chweelin; Kim, Jin-Baek; Wang, Zhong Lin; Kim, Ho-Young; Park, Jong-Jin; Chung, U-In

    2014-09-23

    Technologies to harvest electrical energy from wind have vast potentials because wind is one of the cleanest and most sustainable energy sources that nature provides. Here we propose a flutter-driven triboelectric generator that uses contact electrification caused by the self-sustained oscillation of flags. We study the coupled interaction between a fluttering flexible flag and a rigid plate. In doing so, we find three distinct contact modes: single, double and chaotic. The flutter-driven triboelectric generator having small dimensions of 7.5 × 5 cm at wind speed of 15 ms(-1) exhibits high-electrical performances: an instantaneous output voltage of 200 V and a current of 60 μA with a high frequency of 158 Hz, giving an average power density of approximately 0.86 mW. The flutter-driven triboelectric generation is a promising technology to drive electric devices in the outdoor environments in a sustainable manner.

  3. Aeroservoelastic Modeling of Body Freedom Flutter for Control System Design

    Science.gov (United States)

    Ouellette, Jeffrey

    2017-01-01

    One of the most severe forms of coupling between aeroelasticity and flight dynamics is an instability called freedom flutter. The existing tools often assume relatively weak coupling, and are therefore unable to accurately model body freedom flutter. Because the existing tools were developed from traditional flutter analysis models, inconsistencies in the final models are not compatible with control system design tools. To resolve these issues, a number of small, but significant changes have been made to the existing approaches. A frequency domain transformation is used with the unsteady aerodynamics to ensure a more physically consistent stability axis rational function approximation of the unsteady aerodynamic model. The aerodynamic model is augmented with additional terms to account for limitations of the baseline unsteady aerodynamic model and to account for the gravity forces. An assumed modes method is used for the structural model to ensure a consistent definition of the aircraft states across the flight envelope. The X-56A stiff wing flight-test data were used to validate the current modeling approach. The flight-test data does not show body-freedom flutter, but does show coupling between the flight dynamics and the aeroelastic dynamics and the effects of the fuel weight.

  4. Effects of Intrinsic and Extrinsic Cardiac Nerves on Atrial Arrhythmia in Experimental Pulmonary Artery Hypertension.

    Science.gov (United States)

    Zhao, Qingyan; Deng, Hongping; Jiang, Xuejun; Dai, Zixuan; Wang, Xiaozhan; Wang, Xule; Guo, Zongwen; Hu, Wei; Yu, Shengbo; Yang, Bo; Tang, Yanhong; Huang, Congxin

    2015-11-01

    Atrial arrhythmia, which includes atrial fibrillation (AF) and atrial flutter (AFL), is common in patients with pulmonary arterial hypertension (PAH), who often have increased sympathetic nerve activity. Here, we tested the hypothesis that autonomic nerves play important roles in vulnerability to AF/AFL in PAH. The atrial effective refractory period and AF/AFL inducibility at baseline and after anterior right ganglionated plexi ablation were determined during left stellate ganglion stimulation or left renal sympathetic nerve stimulation in beagle dogs with or without PAH. Then, sympathetic nerve, β-adrenergic receptor densities and connexin 43 expression in atrial tissues were assessed. The sum of the window of vulnerability to AF/AFL was increased in the right atrium compared with the left atrium at baseline in the PAH dogs but not in the controls. The atrial effective refractory period dispersion was increased in the control dogs, but not in the PAH dogs, during left stellate ganglion stimulation. The voltage thresholds for inducing AF/AFL during anterior right ganglionated plexi stimulation were lower in the PAH dogs than in the controls. The AF/AFL inducibility was suppressed after ablation of the anterior right ganglionated plexi in the PAH dogs. The PAH dogs had higher sympathetic nerve and β1-adrenergic receptor densities, increased levels of nonphosphorylated connexin 43, and heterogeneous connexin 43 expression in the right atrium when compared with the control dogs. The anterior right ganglionated plexi play important roles in the induction of AF/AFL. AF/AFL induction was associated with right atrium substrate remodeling in dogs with PAH.

  5. Study of flutter related computational procedures for minimum weight structural sizing of advanced aircraft

    Science.gov (United States)

    Oconnell, R. F.; Hassig, H. J.; Radovcich, N. A.

    1976-01-01

    Results of a study of the development of flutter modules applicable to automated structural design of advanced aircraft configurations, such as a supersonic transport, are presented. Automated structural design is restricted to automated sizing of the elements of a given structural model. It includes a flutter optimization procedure; i.e., a procedure for arriving at a structure with minimum mass for satisfying flutter constraints. Methods of solving the flutter equation and computing the generalized aerodynamic force coefficients in the repetitive analysis environment of a flutter optimization procedure are studied, and recommended approaches are presented. Five approaches to flutter optimization are explained in detail and compared. An approach to flutter optimization incorporating some of the methods discussed is presented. Problems related to flutter optimization in a realistic design environment are discussed and an integrated approach to the entire flutter task is presented. Recommendations for further investigations are made. Results of numerical evaluations, applying the five methods of flutter optimization to the same design task, are presented.

  6. Radiofrequency ablation for treating paroxysmal supraventricular tachycardia complicated by atrial fibrillation: A single-center retrospective analysis

    Institute of Scientific and Technical Information of China (English)

    WEI Zhan-yang; CHEN Li-hua; MO Jing-lan

    2016-01-01

    Background The effect of selective radiofrequency ablation for treating paroxysmal supraventricular tachycardia (PSVT) and its associated paroxysmal atrial fibrillation (PAF) was assessed.Methods Data were collected retrospectively from patients diagnosed of PSVT and subsequently treated with radiofrequency ablation.Regular monthly follow-up by dynamic electrocardiography (ECG) was performed.Incident rates of atrial fibrillation before and after ablation were compared.Results 382 PSVT patients with 58 having atrial fibrillation were enrolled.The order of complicated PAF from high to low in these patients was displayed as:atrial tachycardia (AT),atrioventricular reentrant tachycardia (AVRT) and atrioventricular nodal reentrant tachycardia (AVNRT).Among AVRT patients,PAF was more frequent in patients having accessory pathways.AVNRT patients had significantly lower PAF rate comparing to other patients.PAF incident rate was significantly reduced by radiofrequency ablation therapy.Conclusion We advise regular dynamic ECG for PSVT patients,especially those with atrial flutter,AT or pre-excitation syndrome.Selective radiofrequency ablation is a feasible approach for treating AF complicated PSVT patients.

  7. The Relationship between physical activity and risk of atrial fibrillation-A systematic review and meta-Analysis

    DEFF Research Database (Denmark)

    Nielsen, Jens Erik Rokkedal; Wachtell, K; Abdulla, J

    2013-01-01

    The aim of this systematic literature review and meta-Analyses was to explore the relationship between physical activity and risk of new-onset atrial fibrillation (AF) or flutter (AFlu).Results: The search revealed 10 published studies that were eligible for three different meta-Analyses. A meta......-Analysis of six case-control studies showed that risk of AF increased more than 5-fold in athletes compared to non-Athletic controls, OR=5.3 [(3.6, 7.9; 95% confidence interval (CI)], p...

  8. Atrial fibrillation in the elderly

    Institute of Scientific and Technical Information of China (English)

    Roberto A.Franken; Ronaldo F.Rosa; Silvio CM Santos

    2012-01-01

    This review discusses atrial fibrillation according to the guidelines of Brazilian Society of Cardiac Arrhythmias and the Brazilian Cardiogeriatrics Guidelines. We stress the thromboembolic burden of atrial fibrillation and discuss how to prevent it as well as the best way to conduct cases of atrial fibrillatios in the elderly, reverting the arrhythmia to sinus rhythm, or the option of heart rate control. The new methods to treat atrial fibrillation, such as radiofrequency ablation, new oral direct thrombin inhibitors and Xa factor inhibitors, as well as new antiarrhythmic drugs, are depicted.

  9. Hypertension and Atrial Fibrillation

    DEFF Research Database (Denmark)

    Dzeshka, Mikhail S.; Shahid, Farhan; Shantsila, Alena

    2017-01-01

    Atrial fibrillation (AF) is the most prevalent sustained arrhythmia found in clinical practice. AF rarely exists as a single entity but rather as part of a diverse clinical spectrum of cardiovascular diseases, related to structural and electrical remodeling within the left atrium, leading to AF o...... of complications as the first clinical manifestation of the disease. Antithrombotic prevention in AF combined with strict blood pressure control is of primary importance, since stroke risk and bleeding risk are both greater with underlying hypertension....... onset, perpetuation, and progression. Due to the high overall prevalence within the AF population arterial hypertension plays a significant role in the pathogenesis of AF and its complications. Fibroblast proliferation, apoptosis of cardiomyocytes, gap junction remodeling, accumulation of collagen both...... in atrial and ventricular myocardium all accompany ageing-related structural remodeling with impact on electrical activity. The presence of hypertension also stimulates oxidative stress, systemic inflammation, rennin-angiotensin-aldosterone and sympathetic activation, which further drives the remodeling...

  10. Parametric studies on relationships between flutter derivatives of slender bridge (Ⅱ)

    Institute of Scientific and Technical Information of China (English)

    Xu xu

    2009-01-01

    Based on curve fitting of coefficients of three component forces of the Messina Straits Bridge, and the previously proposed semi-analytical expressions of flutter deriva-tives of flexible structure, the change of flutter derivatives of slender bridge cross-section with respect to its aerodynamic center, rotational speed and angle variation is studied using a parametric method. The calculated results are compared with the measured ones, and expressions of flutter derivatives of the Messina Straits Bridge are derived. The in-trinsic relationships existing in flutter derivatives are validated again. It is shown that the influence of the rotational speed on flutter derivatives is not negligible. Therefore, it provides an additional semi-analytical approach for analyzing flutter derivatives of the bridge with streamlined cross-section to get its aerodynamic information.

  11. Coupled-Mode Flutter of Bending-Bending Type in Highly-Flexible Uniform Airfoils

    Science.gov (United States)

    Pourazarm, Pariya; Modarres-Sadeghi, Yahya

    2016-11-01

    We study the behavior of a highly flexible uniform airfoil placed in wind both numerically and experimentally. It is shown that for a non-rotating highly-flexible cantilevered airfoil, placed at very small angles of attack (less than 1 degree), the airfoil loses its stability by buckling. For slightly higher angles of attack (more than 1 degree) a coupled-mode flutter in which the first and the second flapwise modes coalesce toward a flutter mode is observed, and thus the observed flutter has a bending-bending nature. The flutter onset and frequency found experimentally matched the numerical predictions. If the same airfoil is forced to rotate about its fixed end, the static deflection decreases and the observed couple-mode flutter becomes of flapwise-torsional type, same as what has already been observed for flutter of rotating wind turbine blades. The support provided by the National Science Foundation, CBET-1437988, is greatly acknowledged.

  12. Left atrial appendage occlusion for stroke prevention in atrial fibrillation

    DEFF Research Database (Denmark)

    Tzikas, Apostolos; Shakir, Samera; Gafoor, Sameer;

    2015-01-01

    Aims: To investigate the safety, feasibility, and efficacy of left atrial appendage occlusion (LAAO) with the AMPLATZER Cardiac Plug (ACP) for stroke prevention in patients with atrial fibrillation (AF). Methods and results: Data from consecutive patients treated in 22 centres were collected...

  13. The role of atrial electrical remodeling in the progression of focal atrial ectopy to persistent atrial fibrillation

    NARCIS (Netherlands)

    Hobbs, WJC; Van Gelder, IC; Fitzpatrick, AP; Crijns, HJGM; Garratt, CJ

    1999-01-01

    Focal Atrial Fibrillation and Electrical Remodeling. Although atrial fibrillation- (AF) induced changes in atrial refractoriness (atrial electrical remodeling) have been demonstrated in a number of different animal models, the clinical significance of this process is unknown. We describe a patient i

  14. The influence of trailed vorticity on flutter speed estimations

    DEFF Research Database (Denmark)

    Pirrung, Georg; Aagaard Madsen, Helge; Kim, Taeseong

    2014-01-01

    . The influence of the near wake model on the aeroelastic stability of the blades of the NREL 5 MW turbine in overspeed conditions is investigated in the second part of the paper. The analysis is based on a runaway case in which the turbine is free to speed up without generator torque and vibrations start...... building up at a critical rotor speed. Blades with modified torsional and flapwise stiffness are also investigated. A flutter analysis is often part of the stability investigations for new blades but is normally carried out with engineering models that do not include the influence of unsteady trailed...... vorticity. Including this influence results in a slightly increased safety margin against classical flutter in all simulated cases....

  15. Investigating the Transonic Flutter Boundary of the Benchmark Supercritical Wing

    Science.gov (United States)

    Heeg, Jennifer; Chwalowski, Pawel

    2017-01-01

    This paper builds on the computational aeroelastic results published previously and generated in support of the second Aeroelastic Prediction Workshop for the NASA Benchmark Supercritical Wing configuration. The computational results are obtained using FUN3D, an unstructured grid Reynolds-Averaged Navier-Stokes solver developed at the NASA Langley Research Center. The analysis results focus on understanding the dip in the transonic flutter boundary at a single Mach number (0.74), exploring an angle of attack range of ??1 to 8 and dynamic pressures from wind off to beyond flutter onset. The rigid analysis results are examined for insights into the behavior of the aeroelastic system. Both static and dynamic aeroelastic simulation results are also examined.

  16. Analysis of supersonic stall bending flutter in axial-flow compressor by actuator disk theory

    Science.gov (United States)

    Adamczyk, J. J.

    1978-01-01

    An analytical model was developed for predicting the onset of supersonic stall bending flutter in axial-flow compressors. The analysis is based on two-dimensional, compressible, unsteady actuator disk theory. It is applied to a rotor blade row by considering a cascade of airfoils. The effects of shock waves and flow separation are included in the model. Calculations show that the model predicts the onset, in an unshrouded rotor, of a bending flutter mode that exhibits many of the characteristics of supersonic stall bending flutter. The validity of the analysis for predicting this flutter mode is demonstrated.

  17. Application of a flight test and data analysis technique to flutter of a drone aircraft

    Science.gov (United States)

    Bennett, R. M.

    1981-01-01

    Modal identification results presented were obtained from recent flight flutter tests of a drone vehicle with a research wing (DAST ARW-1 for Drones for Aerodynamic and Structural Testing, Aeroelastic Research Wing-1). This vehicle is equipped with an active flutter suppression system (FSS). Frequency and damping of several modes are determined by a time domain modal analysis of the impulse response function obtained by Fourier transformations of data from fast swept sine wave excitation by the FSS control surface on the wing. Flutter points are determined for two different altitudes with the FSS off. Data are given for near the flutter boundary with the FSS on.

  18. Effects of trimetazidine on atrial structural remodeling and platelet activation in dogs with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    HAN Wei; LI Wei-min; ZHOU Hong-yan; HUO Hong; WEI Na; DONG Guo; CAO Yong; ZHOU Guo; YANG Shu-sen

    2009-01-01

    @@ Atrial fibrillation (AF) is one of the most common arrhythmias in clinical practice. AF results in electrophysiological alterations which involve increased atrial effective refractory period and atrial effective refractory period dispersion, reduced rate adaptation of atrial effective refractory period, and slowed atrial conduction.

  19. Anatomic approach for ganglionic plexi ablation in patients with paroxysmal atrial fibrillation.

    Science.gov (United States)

    Katritsis, Demosthenes; Giazitzoglou, Eleftherios; Sougiannis, Demetrios; Goumas, Nicolaos; Paxinos, George; Camm, A John

    2008-08-01

    There is evidence that parasympathetic denervation may prevent atrial fibrillation (AF) recurrences. This study aimed at applying an anatomic approach for ablation of atrial ganglionic plexi (GPs) in patients with paroxysmal AF. Nineteen patients with symptomatic, paroxysmal AF underwent anatomically guided radiofrequency ablation at the location of the 4 main left atrial GPs and were prospectively assessed for recurrence of AF or other atrial arrhythmia. This group was compared with 19 age- and gender-matched patients who previously underwent conventional circumferential pulmonary vein ablation. All ablation procedures were uneventful. Circumferential and GP ablations were accomplished with a radiofrequency delivery time of 28 +/- 5 versus 18 +/- 3 min (p <0.001) and a fluoroscopy time of 31 +/- 5 versus 18 +/- 5 min (p <0.001), respectively. Parasympathetic reflexes during radiofrequency ablation were elicited in 4 patients (21%). Arrhythmia recurred in 7 patients (37%) with circumferential ablation and 14 patients (74%) with GP ablation, during 1-year follow-up (p for log-rank test = 0.017). In 2 patients with GP ablation, left atrial flutters were documented in addition to AF during follow-up. Patients who underwent GP ablation had an almost 2.5 times higher risk of AF recurrence compared with those who underwent circumferential ablation (hazard ratio 2.6, 95% confidence interval 1.0 to 6.6, p = 0.038). In conclusion, anatomically guided GP ablation is feasible and safe in the electrophysiology laboratory, but this approach yields inferior clinical results compared with circumferential ablation.

  20. Effects of flutter and PEP mask physiotherapy on symptoms and lung function in children with cystic fibrosis

    NARCIS (Netherlands)

    C.M. van Winden; A. Visser (Adriaan); P.J. Sterk (Peter); S. Beckers; J.C. de Jongste (Johan); W.C.J. Hop (Wim)

    1998-01-01

    textabstractRecently, the flutter was introduced as a new device to improve sputum expectoration. Preliminary data suggested a significant improvement in expectoration and lung function during flutter treatment in patients with cystic fibrosis (CF). The aim of the prese

  1. Labyrinth Seal Flutter Analysis and Test Validation in Support of Robust Rocket Engine Design

    Science.gov (United States)

    El-Aini, Yehia; Park, John; Frady, Greg; Nesman, Tom

    2010-01-01

    High energy-density turbomachines, like the SSME turbopumps, utilize labyrinth seals, also referred to as knife-edge seals, to control leakage flow. The pressure drop for such seals is order of magnitude higher than comparable jet engine seals. This is aggravated by the requirement of tight clearances resulting in possible unfavorable fluid-structure interaction of the seal system (seal flutter). To demonstrate these characteristics, a benchmark case of a High Pressure Oxygen Turbopump (HPOTP) outlet Labyrinth seal was studied in detail. First, an analytical assessment of the seal stability was conducted using a Pratt & Whitney legacy seal flutter code. Sensitivity parameters including pressure drop, rotor-to-stator running clearances and cavity volumes were examined and modeling strategies established. Second, a concurrent experimental investigation was undertaken to validate the stability of the seal at the equivalent operating conditions of the pump. Actual pump hardware was used to construct the test rig, also referred to as the (Flutter Rig). The flutter rig did not include rotational effects or temperature. However, the use of Hydrogen gas at high inlet pressure provided good representation of the critical parameters affecting flutter especially the speed of sound. The flutter code predictions showed consistent trends in good agreement with the experimental data. The rig test program produced a stability threshold empirical parameter that separated operation with and without flutter. This empirical parameter was used to establish the seal build clearances to avoid flutter while providing the required cooling flow metering. The calibrated flutter code along with the empirical flutter parameter was used to redesign the baseline seal resulting in a flutter-free robust configuration. Provisions for incorporation of mechanical damping devices were introduced in the redesigned seal to ensure added robustness

  2. Atrial fibrillation and acute myocardial infarction without significant coronary stenoses associated with subclinical hyperthyroidism and erythrocytosis.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2010-11-05

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that sub-clinical hyperthyroidism is not associated with CHD or mortality from cardiovascular causes but is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. Moreover increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. It has been also reported an acute myocardial infarction with normal coronary arteries associated with iatrogenic hyperthyroidism and with a myocardial bridge too. It has been also reported an acute myocardial infarction without significant coronary stenoses associated with subclinical hyperthyroidism. Furthermore it has been reported that at highly increased hematocrit levels patients may experience hyperviscosity symptoms. We present a case of atrial fibrillation and acute myocardial infarction without significant coronary stenoses associated with subclinical hyperthyroidism and erythrocytosis. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  3. The cost of illness of atrial fibrillation: a systematic review of the recent literature.

    Science.gov (United States)

    Wolowacz, S E; Samuel, M; Brennan, V K; Jasso-Mosqueda, J-G; Van Gelder, I C

    2011-10-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia, its prevalence increasing markedly with age. Atrial fibrillation is strongly associated with increased risk of morbidity, including stroke and thromboembolism. There is growing awareness of the economic burden of AF due to ageing populations and constrained public finances. A systematic review was performed (1990-2009). Cost studies for AF or atrial flutter were included; acute-onset and post-operative AF were excluded. Total, direct, and indirect costs were extracted. Of 875 records retrieved, 37 studies were included. The cost of managing individual AF patients is high. Direct-cost estimates ranged from $2000 to 14,200 per patient-year in the USA and from €450 to 3000 in Europe. This is comparable with other chronic conditions such as diabetes. The direct cost of AF represented 0.9-2.4% of the UK health-care budget in 2000 and had almost doubled over the previous 5 years. Inpatient care accounted for 50-70% of annual direct costs. In the USA, AF hospitalizations alone cost ∼$6.65 billion in 2005. In this first systematic review of the economic burden of AF, hospitalizations consistently represented the major cost driver. Costs and hospitalizations attributable to AF have increased markedly over recent decades and are expected to increase in future due to ageing populations.

  4. Ablação por radiofreqüência da fibrilação atrial paroxística: fatores determinantes da eficácia clínica a longo-prazo Radiofrequency ablation of paroxysmal atrial fibrillation: factors determining long-term clinical efficacy

    Directory of Open Access Journals (Sweden)

    Raul José Pádua Sartini

    2008-02-01

    Full Text Available FUNDAMENTO: A maioria dos trabalhos tem descrito preditores de recorrência de fibrilação atrial após ablação por cateter, com tempos de seguimento relativamente curtos. OBJETIVO: Avaliar retrospectivamente, em longo prazo, os preditores de recorrência de fibrilação atrial paroxística (FA em pacientes submetidos ao isolamento das veias pulmonares, após um único procedimento. MÉTODOS: Foram estudados 139 pacientes (102 homens com idade média de 55 ± 12 anos submetidos à ablação por radiofreqüência, por meio das técnicas ostial ou extra-ostial de abordagem do átrio esquerdo, associadas ou não à ablação do istmo cavo-tricuspídeo (ICT. Variáveis pré, intra e pós-ablação foram avaliadas por análise uni e multivariada, para determinar os preditores de recorrência da FA após um procedimento. RESULTADOS: Após um seguimento de 33 ± 12 meses, observou-se que maior tempo de história de FA, uso de mais antiarrítmicos e recorrência de FA num período de sessenta dias pós-procedimento aumentaram o risco de recorrência de FA em longo prazo. Por sua vez, a associação de flutter atrial e a ablação concomitante do ICT reduziram o risco de recorrência. CONCLUSÃO: Variáveis clínicas como tempo de história de FA e maior quantidade de antiarrítmicos já utilizadas influenciam os resultados da ablação por cateter. Em pacientes com flutter atrial associado, a realização concomitante de linha de bloqueio no ICT reduziu significativamente a recorrência de fibrilação atrial em longo prazo.BACKGROUND: Most of the studies on this subject have reported predictors of recurrence of atrial fibrillation after catheter ablation with relatively short follow-up periods. OBJECTIVE: To retrospectively evaluate predictors of long-term recurrence of paroxysmal atrial fibrillation (AF in patients undergoing pulmonary vein isolation following one single procedure. METHODS: The authors studied a total of 139 patients (102 men; mean

  5. Mid-to-long-term follow-up results of transcatheter closure of atrial septal defect in patients older than 40 years.

    Science.gov (United States)

    Wang, Jou-Kou; Chiu, Shuenn-Nan; Lin, Ming-Tai; Chen, Chun-An; Lu, Chun-Wei; Wu, Mei-Hwan

    2016-08-16

    We investigated the mid-to-long-term results of transcatheter closure of atrial septal defect (ASD) in patients ≥40 years since there are issues with patients presenting with pulmonary hypertension and arrhythmia at the time of closure. In an 8.8 year period, transcatheter closure of ASD was successful in 179 patients aged ≥40 years, but failed in 2. Of the 179 patients (44 males, median 53 years), NYHA functional class, presence of arrhythmia and severity of pulmonary hypertension were compared before and after closure. Patients with pulmonary hypertension (n = 43, 24 %) were significantly older (60 ± 11 vs. 52 ± 9 years, p atrial fibrillation (AF), 4 atrial flutter and 5 supraventricular tachycardia. Patients with AF or atrial flutter (n = 26) were significantly older (63 ± 10 vs. 53 ± 10 years, p = 0.048) and had a higher pulmonary artery mean pressure (29.2 ± 12.6 vs. 20.2 ± 7.6 mmHg, p = 0.041) than those without. The mean follow-up period was 3.8 ± 2.1 years. Early new-onset arrhythmia was documented in 23 patients of whom 1 had persistent AF, 1 developed sick sinus syndrome and others were in sinus rhythm at latest visit. There was significant improvement in NYHA functional class after closure (p paroxysmal AF, and 11 had persistent AF. Pulmonary hypertension persisted in 13 patients. Transcatheter closure of atrial septal defect in patients above 40 years is beneficial in terms of NYHA functional class, pulmonary artery pressure and cardiac rhythm.

  6. Parametric Flutter Analysis of the TCA Configuration and Recommendation for FFM Design and Scaling

    Science.gov (United States)

    Baker, Myles; Lenkey, Peter

    1997-01-01

    The current HSR Aeroelasticity plan to design, build, and test a full span, free flying transonic flutter model in the TDT has many technical obstacles that must be overcome for a successful program. One technical obstacle is the determination of a suitable configuration and point in the sky to use in setting the scaling point for the ASE models program. Determining this configuration and point in the sky requires balancing several conflicting requirements, including model buildability, tunnel test safety, and the ability of the model to represent the flutter mechanisms of interest. As will be discussed in detail in subsequent sections, the current TCA design exhibits several flutter mechanisms of interest. It has been decided that the ASE models program will focus on the low frequency symmetric flutter mechanism, and will make no attempt to investigate high frequency flutter mechanisms. There are several reasons for this choice. First, it is believed that the high frequency flutter mechanisms are similar in nature to classical wing bending/torsion flutter, and therefore there is more confidence that this mechanism can be predicted using current techniques. The low frequency mode, on the other hand, is a highly coupled mechanism involving wing, body, tail, and engine motion which may be very difficult to predict. Second, the high frequency flutter modes result in very small weight penalties (several hundred pounds), while suppression of the low frequency mechanism inside the flight envelope causes thousands of pounds to be added to the structure. In order to successfully test the low frequency flutter mode of interest, a suitable starting configuration and point in the sky must be identified. The configuration and point in the sky must result in a wind tunnel model that (1) represents the low-frequency wing/body/engine/empennage flutter mechanisms that are unique to HSCT configurations, (2) flutters at an acceptably low frequency in the tunnel, (3) flutters at an

  7. Developing Uncertainty Models for Robust Flutter Analysis Using Ground Vibration Test Data

    Science.gov (United States)

    Potter, Starr; Lind, Rick; Kehoe, Michael W. (Technical Monitor)

    2001-01-01

    A ground vibration test can be used to obtain information about structural dynamics that is important for flutter analysis. Traditionally, this information#such as natural frequencies of modes#is used to update analytical models used to predict flutter speeds. The ground vibration test can also be used to obtain uncertainty models, such as natural frequencies and their associated variations, that can update analytical models for the purpose of predicting robust flutter speeds. Analyzing test data using the -norm, rather than the traditional 2-norm, is shown to lead to a minimum-size uncertainty description and, consequently, a least-conservative robust flutter speed. This approach is demonstrated using ground vibration test data for the Aerostructures Test Wing. Different norms are used to formulate uncertainty models and their associated robust flutter speeds to evaluate which norm is least conservative.

  8. Supersonic unstalled flutter. [aerodynamic loading of thin airfoils induced by cascade motion

    Science.gov (United States)

    Adamczyk, J. J.; Goldstein, M. E.; Hartmann, M. J.

    1978-01-01

    Flutter analyses were developed to predict the onset of supersonic unstalled flutter of a cascade of two-dimensional airfoils. The first of these analyzes the onset of supersonic flutter at low levels of aerodynamic loading (i.e., backpressure), while the second examines the occurrence of supersonic flutter at moderate levels of aerodynamic loading. Both of these analyses are based on the linearized unsteady inviscid equations of gas dynamics to model the flow field surrounding the cascade. These analyses are utilized in a parametric study to show the effects of cascade geometry, inlet Mach number, and backpressure on the onset of single and multi degree of freedom unstalled supersonic flutter. Several of the results are correlated against experimental qualitative observation to validate the models.

  9. Further studies of stall flutter and nonlinear divergence of two-dimensional wings

    Science.gov (United States)

    Dugundji, J.; Chopra, I.

    1975-01-01

    An experimental investigation is made of the purely torsional stall flutter of a two-dimensional wing pivoted about the midchord, and also of the bending-torsion stall flutter of a two-dimensional wing pivoted about the quarterchord. For the purely torsional flutter case, large amplitude limit cycles ranging from + or - 11 to + or - 160 degrees were observed. Nondimensional harmonic coefficients were extracted from the free transient vibration tests for amplitudes up to 80 degrees. Reasonable nondimensional correlation was obtained for several wing configurations. For the bending-torsion flutter case, large amplitude coupled limit cycles were observed with torsional amplitudes as large as + or - 40 degrees. The torsion amplitudes first increased, then decreased with increasing velocity. Additionally, a small amplitude, predominantly torsional flutter was observed when the static equilibrium angle was near the stall angle.

  10. A preliminary study of the effects of vortex diffusers (winglets) on wing flutter

    Science.gov (United States)

    Doggett, R. V., Jr.; Farmer, M. G.

    1975-01-01

    Some experimental flutter results are presented for a simple, flat-plate wing model and for the same wing model equipped with two different upper surface vortex diffusers over the Mach number range from about 0.70 to 0.95. Both vortex diffusers had the same planform, but one weighed about 0.3 percent of the basic wing weight, whereas the other weighed about 1.8 percent of the wing weight. The addition of the lighter vortex diffuser reduced the flutter dynamic pressure by about 3 percent; the heavier vortex diffuser reduced the flutter dynamic pressure by about 12 percent. The experimental flutter results are compared at a Mach number of 0.80 with analytical flutter results obtained by using doublet lattice and lifting surface (Kernel function) unsteady aerodynamic theories.

  11. Some considerations on the effects of the P-derivatives on bridge deck flutter

    Science.gov (United States)

    Zhang, Xin; Brownjohn, James Mark William

    2005-05-01

    Using two degrees of freedom (dof) experimental flutter derivatives to perform three-dimensional flutter analysis for a cable-supported bridge is a widely practiced method. It is important to consider the P-derivatives effect to have more accurate analysis for a long-span bridge. Through a case example, this paper studied some of the issues relating to the P-derivatives effects on flutter. The operational condition in two-dof experiments was discussed. It was suggested that due to the strong aeroelastic coupling effect of the sectional model studied in this research, there was an inherent weakness of two-dof experiments. The effect of the P-derivatives was studied for an example bridge by comparing the flutter analysis results using two-dof and three-dof experimental flutter derivatives.

  12. Atrial fibrillation and heart failure: is atrial fibrillation a disease?

    Science.gov (United States)

    Tilman, V

    2014-09-01

    Atrial fibrillation in heart failure often occur together. The relationship between atrial fibrillation and heart failure has remained a subject of research. The main manifestation of the violation of hydrodynamics in heart failure is the increased end-diastolic pressure, which is transmitted through the intercommunicated system (left ventricle-left atrium-pulmonary veins-alveolar capillaries) causing increased pulmonary wedge pressure with the danger for pulmonary edema. End-diastolic pressure is the sum of left ventricle diastolic pressure and left atrial systolic pressure. Stopping the mechanical systole of the left atrium can reduce the pressure in the system in heart failure. Atrial fibrillation stops the mechanical systole of the left atrium and decreases the intercommunicating pressure and pulmonary wedge pressure. It is possible that atrial fibrillation is a mechanism for protection from increasing end-diastolic pressure and pulmonary wedge pressure, and prevents the danger of pulmonary edema. This hypothesis may explain the relationship between heart failure and atrial fibrillation and their frequent association.

  13. Idiopathic giant right atrial aneurysm

    Directory of Open Access Journals (Sweden)

    Santosh C Uppu

    2013-01-01

    Full Text Available A 2-year-old boy with an incidental finding of massive cardiomegaly on a chest X-ray was diagnosed with a giant right atrial aneurysm upon further investigation with echocardiography. The patient underwent successful surgical reduction of the right atrium and closure of the patent foramen ovale to prevent thromboembolic complications and to lower the risk of atrial arrhythmias. The resected atrium had paper-thin walls and pathological features of interstitial fibrosis with endocardial thickening.

  14. Aeroelastic Tailoring of Transport Wings Including Transonic Flutter Constraints

    Science.gov (United States)

    Stanford, Bret K.; Wieseman, Carol D.; Jutte, Christine V.

    2015-01-01

    Several minimum-mass optimization problems are solved to evaluate the effectiveness of a variety of novel tailoring schemes for subsonic transport wings. Aeroelastic stress and panel buckling constraints are imposed across several trimmed static maneuver loads, in addition to a transonic flutter margin constraint, captured with aerodynamic influence coefficient-based tools. Tailoring with metallic thickness variations, functionally graded materials, balanced or unbalanced composite laminates, curvilinear tow steering, and distributed trailing edge control effectors are all found to provide reductions in structural wing mass with varying degrees of success. The question as to whether this wing mass reduction will offset the increased manufacturing cost is left unresolved for each case.

  15. Suspension Bridge Flutter for Girder with Separate Control Flaps

    DEFF Research Database (Denmark)

    Huynh, T.; Thoft-Christensen, Palle

    Active vibration control of long span suspension bridge flutter using separated control flaps (SFSC) has shown to increase effectively the critical wind speed of bridges. In this paper, an SFSC calculation based on modal equations of the vertical and torsional motions of the bridge girder including...... the flaps is presented. The length of the flaps attached to the girder, the flap configuration and the flap rotational angles are parameters used to increase the critical wind speed of the bridge. To illustrate the theory a numerical example is shown for a suspension bridge of 1000m+2500m+1000m span based...

  16. Structural testing for static failure, flutter and other scary things

    Science.gov (United States)

    Ricketts, R. H.

    1983-01-01

    Ground test and flight test methods are described that may be used to highlight potential structural problems that occur on aircraft. Primary interest is focused on light-weight general aviation airplanes. The structural problems described include static strength failure, aileron reversal, static divergence, and flutter. An example of each of the problems is discussed to illustrate how the data acquired during the tests may be used to predict the occurrence of the structural problem. While some rules of thumb for the prediction of structural problems are given the report is not intended to be used explicitly as a structural analysis handbook.

  17. Probucol attenuates atrial autonomic remodeling in a canine model of atrial fibrillation produced by prolonged atrial pacing

    Institute of Scientific and Technical Information of China (English)

    GONG Yong-tai; LI Wei-min; LI Yue; YANG Shu-sen; SHENG Li; YANG Ning; SHAN Hong-bo; XUE Hong-jie; LIU Wei; YANG Bao-feng; DONG De-li; LI Bao-xin

    2009-01-01

    Background We hypothesize that increased atrial oxidative stress and inflammation may play an important role in atrial nerve sprouting and heterogeneous sympathetic hyperinnervation during atrial fibrillation (AF). To test the hypothesis, we examined whether the antioxidant and anti-inflammatory treatment with probucol attenuates atrial autonomic remodeling in a canine model of AF produced by prolonged rapid right atrial pacing. Methods Twenty-one dogs were divided into a sham-operated group, a control group and a probucol group. Dogs in the control group and probucol group underwent right atrial pacing at 400 beats per minute for 6 weeks, and those in the probucol group received probucol 1 week before rapid atrial pacing until pacing stopped. After 6-week rapid atrial pacing, general properties including left atrial structure and function, atrial hemodynamics and the inducibility and duration of AF were measured in all the groups. Atrial oxidative stress markers and serum C-reactive protein (CRP) concentration were estimated. The degree of nerve sprouting and sympathetic innervation at the right atrial anterior wall (RAAW) and the left atrial anterior wall (LAAW) were quantified by immunohistochemistry, atdal norepinephrine contents were also detected. Atrial beta-nerve growth factor (beta-NGF) mRNA and protein expression at the RAAW and LAAW were assessed by real-time quantitative RT-PCR and Western blotting respectively. Results Atrial tachypacing induced significant nerve sprouting and heterogeneous sympathetic hyperinnervation, and the magnitude of nerve sprouting and hyperinnervation was higher in the RAAW than in the LAAW. Atrial beta-NGF mRNA and protein levels were significantly increased at the RAAW and LAAW, and the upregulation of beta-NGF expression was greater at the RAAW than at the LAAW in the control group. The beta-NGF protein level was positively correlated with the density of sympathetic nerves in all groups. Probucol decreased the increase of

  18. Left atrial electrophysiologic feature specific for the genesis of complex fractionated atrial electrogram during atrial fibrillation.

    Science.gov (United States)

    Hoshiyama, Tadashi; Yamabe, Hiroshige; Koyama, Junjiroh; Kanazawa, Hisanori; Ogawa, Hisao

    2016-05-01

    Complex fractionated atrial electrogram (CFAE) has been suggested to contribute to the maintenance of atrial fibrillation (AF). However, electrophysiologic characteristics of the left atrial myocardium responsible for genesis of CFAE have not been clarified. Non-contact mapping of the left atrium was performed at 37 AF onset episodes in 24 AF patients. Electrogram amplitude, width, and conduction velocity were measured during sinus rhythm, premature atrial contraction (PAC) with long- (L-PAC), short- (S-PAC) and very short-coupling intervals (VS-PAC). These parameters were compared between CFAE and non-CFAE regions. Unipolar electrogram amplitude was higher in CFAE than non-CFAE during sinus rhythm, L-, S- and VS-PAC (1.82 ± 0.73 vs. 1.13 ± 0.38, p genesis of CFAE.

  19. Fluttering energy harvesters in the wind: A review

    Science.gov (United States)

    McCarthy, J. M.; Watkins, S.; Deivasigamani, A.; John, S. J.

    2016-01-01

    The growing area of harvesting energy by aerodynamically induced flutter in a fluid stream is reviewed. Numerous approaches were found to understand, demonstrate and [sometimes] optimise harvester performance based on Movement-Induced or Extraneously Induced Excitation. Almost all research was conducted in smooth, unidirectional flow domains; either experimental or computational. The power outputs were found to be very low when compared to conventional wind turbines, but potential advantages could be lower noise levels. A consideration of the likely outdoor environment for fluttering harvesters revealed that the flow would be highly turbulent and having a mean flow angle in the horizontal plane that could approach a harvester from any direction. Whilst some multiple harvester systems in smooth, well-aligned flow found enhanced efficiency (due to beneficial wake interaction) this would require an invariant flow approach angle. It was concluded that further work needs to be performed to find a universally accepted metric for efficiency and to understand the effects of the realities of the outdoors, including the highly variable and turbulent flow conditions likely to be experienced.

  20. Chirality-dependent flutter of Typha blades in wind

    Science.gov (United States)

    Zhao, Zi-Long; Liu, Zong-Yuan; Feng, Xi-Qiao

    2016-07-01

    Cattail or Typha, an emergent aquatic macrophyte widely distributed in lakes and other shallow water areas, has slender blades with a chiral morphology. The wind-resilient Typha blades can produce distinct hydraulic resistance for ecosystem functions. However, their stem may rupture and dislodge in excessive wind drag. In this paper, we combine fluid dynamics simulations and experimental measurements to investigate the aeroelastic behavior of Typha blades in wind. It is found that the chirality-dependent flutter, including wind-induced rotation and torsion, is a crucial strategy for Typha blades to accommodate wind forces. Flow visualization demonstrates that the twisting morphology of blades provides advantages over the flat one in the context of two integrated functions: improving wind resistance and mitigating vortex-induced vibration. The unusual dynamic responses and superior mechanical properties of Typha blades are closely related to their biological/ecosystem functions and macro/micro structures. This work decodes the physical mechanisms of chirality-dependent flutter in Typha blades and holds potential applications in vortex-induced vibration suppression and the design of, e.g., bioinspired flight vehicles.

  1. Rapid Aeroelastic Analysis of Blade Flutter in Turbomachines

    Science.gov (United States)

    Trudell, J. J.; Mehmed, O.; Stefko, G. L.; Bakhle, M. A.; Reddy, T. S. R.; Montgomery, M.; Verdon, J.

    2006-01-01

    The LINFLUX-AE computer code predicts flutter and forced responses of blades and vanes in turbomachines under subsonic, transonic, and supersonic flow conditions. The code solves the Euler equations of unsteady flow in a blade passage under the assumption that the blades vibrate harmonically at small amplitudes. The steady-state nonlinear Euler equations are solved by a separate program, then equations for unsteady flow components are obtained through linearization around the steady-state solution. A structural-dynamics analysis (see figure) is performed to determine the frequencies and mode shapes of blade vibrations, a preprocessor interpolates mode shapes from the structural-dynamics mesh onto the LINFLUX computational-fluid-dynamics mesh, and an interface code is used to convert the steady-state flow solution to a form required by LINFLUX. Then LINFLUX solves the linearized equations in the frequency domain to calculate the unsteady aerodynamic pressure distribution for a given vibration mode, frequency, and interblade phase angle. A post-processor uses the unsteady pressures to calculate generalized aerodynamic forces, response amplitudes, and eigenvalues (which determine the flutter frequency and damping). In comparison with the TURBO-AE aeroelastic-analysis code, which solves the equations in the time domain, LINFLUX-AE is 6 to 7 times faster.

  2. Experimental Methods Applied in a Study of Stall Flutter in an Axial Flow Fan

    Directory of Open Access Journals (Sweden)

    John D. Gill

    2004-01-01

    Full Text Available Flutter testing is an integral part of aircraft gas turbine engine development. In typical flutter testing blade mounted sensors in the form of strain gages and casing mounted sensors in the form of light probes (NSMS are used. Casing mounted sensors have the advantage of being non-intrusive and can detect the vibratory response of each rotating blade. Other types of casing mounted sensors can also be used to detect flutter of rotating blades. In this investigation casing mounted high frequency response pressure transducers are used to characterize the part-speed stall flutter response of a single stage unshrouded axial-flow fan. These dynamic pressure transducers are evenly spaced around the circumference at a constant axial location upstream of the fan blade leading edge plane. The pre-recorded experimental data at 70% corrected speed is analyzed for the case where the fan is back-pressured into the stall flutter zone. The experimental data is analyzed using two probe and multi-probe techniques. The analysis techniques for each method are presented. Results from these two analysis methods indicate that flutter occurred at a frequency of 411 Hz with a dominant nodal diameter of 2. The multi-probe analysis technique is a valuable method that can be used to investigate the initiation of flutter in turbomachines.

  3. Time-domain and frequency-domain approaches to identification of bridge flutter derivatives

    Institute of Scientific and Technical Information of China (English)

    Zhengqing CHEN

    2009-01-01

    Flutter derivatives are essential for flutter analysis of long-span bridges, and they are generally identified from the vibration testing data of a sectional model suspended in a wind tunnel. Making use of the forced vibration testing data of three sectional models,namely, a thin-plate model, a nearly streamlined model,and a bluff-body model, a comparative study was made to identify the flutter derivatives of each model by using a time-domain method and a frequency-domain method. It was shown that all the flutter derivatives of the thin-plate model identified with the frequency-domain method and time-domain method, respectively, agree very well. Moreover, some of the flutter derivatives of each of the other two models identified with the two methods deviate to some extent. More precisely, the frequency-domain method usually results in smooth curves of the flutter derivatives.The formulation of time-domain method makes the identification results of flutter derivatives relatively sensitive to the signal phase lag between vibration state vector and aerodynamic forces and also prone to be disturbed by noise and nonlinearity.

  4. Robust fault-tolerant control for wing flutter under actuator failure

    Institute of Scientific and Technical Information of China (English)

    Gao Mingzhou; Cai Guoping

    2016-01-01

    Many control laws, such as optimal controller and classical controller, have seen their applications to suppressing the aeroelastic vibrations of the aeroelastic system. However, those con-trol laws may not work effectively if the aeroelastic system involves actuator faults. In the current study for wing flutter of reentry vehicle, the effect of actuator faults on wing flutter system is rarely considered and few of the fault-tolerant control problems are taken into account. In this paper, we use the radial basis function neural network and the finite-time H∞adaptive fault-tolerant control technique to deal with the flutter problem of wings, which is affected by actuator faults, actuator saturation, parameter uncertainties and external disturbances. The theory of this article includes the modeling of wing flutter and fault-tolerant controller design. The stability of the finite-time adaptive fault-tolerant controller is theoretically proved. Simulation results indicate that the designed fault-tolerant flutter controller can effectively deal with the faults in the flutter system and can promptly suppress the wing flutter as well.

  5. An Interactive Software for Conceptual Wing Flutter Analysis and Parametric Study

    Science.gov (United States)

    Mukhopadhyay, Vivek

    1996-01-01

    An interactive computer program was developed for wing flutter analysis in the conceptual design stage. The objective was to estimate the flutter instability boundary of a flexible cantilever wing, when well-defined structural and aerodynamic data are not available, and then study the effect of change in Mach number, dynamic pressure, torsional frequency, sweep, mass ratio, aspect ratio, taper ratio, center of gravity, and pitch inertia, to guide the development of the concept. The software was developed for Macintosh or IBM compatible personal computers, on MathCad application software with integrated documentation, graphics, data base and symbolic mathematics. The analysis method was based on non-dimensional parametric plots of two primary flutter parameters, namely Regier number and Flutter number, with normalization factors based on torsional stiffness, sweep, mass ratio, taper ratio, aspect ratio, center of gravity location and pitch inertia radius of gyration. The parametric plots were compiled in a Vought Corporation report from a vast data base of past experiments and wind-tunnel tests. The computer program was utilized for flutter analysis of the outer wing of a Blended-Wing-Body concept, proposed by McDonnell Douglas Corp. Using a set of assumed data, preliminary flutter boundary and flutter dynamic pressure variation with altitude, Mach number and torsional stiffness were determined.

  6. Robust fault-tolerant control for wing flutter under actuator failure

    Directory of Open Access Journals (Sweden)

    Gao Mingzhou

    2016-08-01

    Full Text Available Many control laws, such as optimal controller and classical controller, have seen their applications to suppressing the aeroelastic vibrations of the aeroelastic system. However, those control laws may not work effectively if the aeroelastic system involves actuator faults. In the current study for wing flutter of reentry vehicle, the effect of actuator faults on wing flutter system is rarely considered and few of the fault-tolerant control problems are taken into account. In this paper, we use the radial basis function neural network and the finite-time H∞ adaptive fault-tolerant control technique to deal with the flutter problem of wings, which is affected by actuator faults, actuator saturation, parameter uncertainties and external disturbances. The theory of this article includes the modeling of wing flutter and fault-tolerant controller design. The stability of the finite-time adaptive fault-tolerant controller is theoretically proved. Simulation results indicate that the designed fault-tolerant flutter controller can effectively deal with the faults in the flutter system and can promptly suppress the wing flutter as well.

  7. Flutter of flexible plate in an inhomogeneous temperature field

    Directory of Open Access Journals (Sweden)

    Baghdasaryan G.Y.

    2012-12-01

    Full Text Available There are several works devoted to the investigation of the stability of plates and shells in a supersonic gas flow. Remarks on these works in monographs [1,2] and in the paper [3] can be found. The issues of the influence of constant temperature field on the stability of deformable thin bodies in a supersonis gas flow are investigated also [4-7]. In the paper [8], in linear formulation we consider the problem of stability of long rectangular plate under the influence of both variable along the thickness temperature field and supersonic gas flow (with the unperturbed speed, which directed along the short edges of the plate. Due to the inhomogeneity of along the thickness temperature field the buckling of the plate is takes place and this state is taken as unperturbed. Conditions of stability of unperturbed state of examined termogasoelastic system are obtained and on its base the stability area is constructed in the space of variables characterizing the value of the flown speed, the temperature at the middle plane of the plate and the temperature gradient along the normal direction of this plane. It is shown that via the combined action of the temperature field and the flowing stream one can regulate the process of stability and with the help of temperature field one can significantly change the value of the flutter critical speed. In this paper, the problem, posed in [8], considered in nonlinear formulation. The effect of temperature field on the dependence of "amplitude-speed" is studied. It is shown that: a in the case of relatively thick plates if gradually increase the speed flowing stream , the flutter type vibrations persist up to ( – is the upper critical speed, the value of which depends on the temperature of the mid-plane of the plate, where the oscillations "pluck" and restored the undisturbed state of the plate. By reducing the speed the unperturbed state becomes stable up to ( – is the lower critical speed. For the amplitude of

  8. Isolated Atrial Amyloidosis in Patients with Various Types of Atrial Fibrillation.

    Science.gov (United States)

    Sukhacheva, T V; Eremeeva, M V; Ibragimova, A G; Vaskovskii, V A; Serov, R A; Revishvili, A Sh

    2016-04-01

    The myocardium of the right and left atrial appendages (auricles) in patients with paroxysmal, persistent, and permanent forms of atrial fibrillation was examined by histological methods and electron microscopy. Isolated atrial amyloidosis was detected in the left (50.0-56.3% patients) and in the right (45.0-55.6% patients) atrial appendages. In all cases, immunohistochemistry revealed atrial natriuretic peptide in fibrillary amyloid deposits. Ultrastructurally, amyloid masses formed clusters of myofibrils 8-10 nm in diameter. They were chaotically located in the extracellular space along the sarcolemma as well as in membrane invaginations, dilated tubules of cardiomyocyte T-tubular system, and vascular walls. Amyloidosis was predominantly observed in women; its degree positively correlated with age of patients and duration of atrial fibrillation but negatively correlated with atrial fibrosis. The study revealed positive (in permanent atrial fibrillation) and negative (in paroxysmal atrial fibrillation) correlation of amyloidosis with myofibril content in atrial cardiomyocytes.

  9. Intravenous heparin dosing strategy in hospitalized patients with atrial dysrhythmias.

    Science.gov (United States)

    Roswell, Robert O; Greet, Brian; Shah, Sunny; Bernard, Samuel; Milin, Alexandra; Lobach, Iryna; Guo, Yu; Radford, Martha J; Berger, Jeffrey S

    2016-08-01

    Patients with non-valvular atrial fibrillation (AF) have an elevated stroke risk that is 2-7 times greater than in those without AF. Intravenous unfractionated heparin (UFH) is commonly used for hospitalized patients with atrial fibrillation and atrial flutter (AFL) to prevent stroke. Dosing strategies exist for intravenous anticoagulation in patients with acute coronary syndromes and venous thromboembolic diseases, but there are no data to guide providers on a dosing strategy for intravenous anticoagulation in patients with AF/AFL. 996 hospitalized patients with AF/AFL on UFH were evaluated. Bolus dosing and initial infusion rates of UFH were recorded along with rates of stroke, thromboemobolic events, and bleeding events as defined by the International Society on Thrombosis and Haemostasis criteria. Among 226 patients included in the analysis, 76 bleeding events occurred. Using linear regression analysis, initial rates of heparin infusion ranging from 9.7 to 11.8 units/kilogram/hour (U/kg/h) resulted in activated partial thromboplastin times that were within therapeutic range. The median initial infusion rate in patients with bleeding was 13.3 U/kg/h, while in those without bleeding it was 11.4 U/kg/h; p = 0.012. An initial infusion rate >11.0 U/kg/h yielded an OR 1.95 (1.06-3.59); p = 0.03 for any bleeding event. Using IV heparin boluses neither increased the probability of attaining a therapeutic aPTT (56.1 vs 56.3 %; p = 0.99) nor did it significantly increase bleeding events in the study (35.7 vs 31.3 %; p = 0.48). The results suggest that higher initial rates of heparin are associated with increased bleeding risk. From this dataset, initial heparin infusion rates of 9.7-11.0 U/kg/h without a bolus can result in therapeutic levels of anticoagulation in hospitalized patients with AF/AFL without increasing the risk of bleeding.

  10. Left Atrial Linear Ablation of Paroxysmal Atrial Fibrillation Guided by Three-dimensional Electroanatomical System

    DEFF Research Database (Denmark)

    Zhang, Dai-Fu; Li, Ying; Qi, Wei-Gang

    2005-01-01

    Objective To investigate the safety and efficacy of Left atrial linear ablation of paroxysmal atrial fibrillation guided by three-dimensional electroanatomical system. Methods 29 patients with paroxysmal atrial fibrillation in this study. A nonfluoroscopic mapping system was used to generate a 3D...... attacks unchanged. No pulmonary vein narrowing was observed. Conclusion Left atrial linear ablation of paroxysmal atrial fibrillation guided by three-dimensional electroanatomical system was safe and effective....

  11. Nonlinear dynamics approach of modeling the bifurcation for aircraft wing flutter in transonic speed

    DEFF Research Database (Denmark)

    Matsushita, Hiroshi; Miyata, T.; Christiansen, Lasse Engbo

    2002-01-01

    The procedure of obtaining the two-degrees-of-freedom, finite dimensional. nonlinear mathematical model. which models the nonlinear features of aircraft flutter in transonic speed is reported. The model enables to explain every feature of the transonic flutter data of the wind tunnel tests...... conducted at National Aerospace Laboratory in Japan for a high aspect ratio wing. It explains the nonlinear features of the transonic flutter such as the subcritical Hopf bifurcation of a limit cycle oscillation (LCO), a saddle-node bifurcation, and an unstable limit cycle as well as a normal (linear...

  12. LCO flutter of cantilevered woven glass/epoxy laminate in subsonic flow

    Institute of Scientific and Technical Information of China (English)

    Dayang Laila Abang Haji Abdul Majid; ShahNor Basri

    2008-01-01

    The paper presents aeroelastic characteristics of a cantilevered composite wing,idealized as a composite flat plate laminate.The composite laminate was made from woven glass fibers with epoxy matrix.The elastic and dynamic properties of the laminate were determined experimentally for aeroelastic calculations.Aeroelastic wind tunnel testing of the laminate was performed and the result showed that flutter,a dynamic instability occurred.The cantilevered laminate also displayed limit cycle amplitude,post-flutter oscillation.The experimental flutter velocity and frequency were verified by our computational analysis.

  13. Some experimental and theoretical flutter characteristics of an arrow-wing configuration

    Science.gov (United States)

    Doggett, R. V., Jr.; Ricketts, R. H.

    1977-01-01

    Experimental and theoretical flutter results are presented for a simplified 1/50-size wind-tunnel model of an arrow-wing configuration. Transonic flutter characteristics are presented for three configurations - wing without engine nacelles, wing with flow-through nacelles, and wing with pencil nacelles (thin, streamline bodies). Experimental results are correlated with analytical results obtained from kernel-function and doublet-lattice unsteady aerodynamic theories. Theoretical results are presented that show the effects on flutter of systematic changes in structural stiffness and mass.

  14. Decoupler pylon - A simple, effective wing/store flutter suppressor. [in fighter/attack aircraft

    Science.gov (United States)

    Reed, W. H.; Foughner, J. T., Jr.; Runyan, H. L., Jr.

    1979-01-01

    As an alternative to alleviating wing/store flutter by conventional passive methods or by more advanced active control methods, a quasi-passive concept, referred to as the decoupler pylon, is investigated which combines desirable features of both methods. Passive soft-spring/damper elements are used to decouple wing modes from store pitch modes, and a low-power control system maintains store alignment under changing mean loads. It is shown by analysis and wind tunnel tests that the decoupler pylon provides substantial increase in flutter speed and makes flutter virtually insensitive to inertia and center-of-gravity location of the store.

  15. Application of two synthesis methods for active flutter suppression on an aeroelastic wind tunnel model

    Science.gov (United States)

    Abel, I.; Newsom, J. R.; Dunn, H. J.

    1979-01-01

    Two flutter suppression control laws have been synthesized, implemented, and demonstrated on an aeroelastic wind-tunnel model of a transport-type wing. One control law was synthesized using an aerodynamic energy method and the other from using results of optimal control theory. At M = 0.95, the model was tested to a dynamic pressure 44 percent above the system-off flutter dynamic pressure. Both synthesis methods yielded control laws effective in suppressing flutter. The experimental results also indicate that wind-tunnel turbulence is an important factor in the experimental demonstration of system performance.

  16. RELATION BETWEEN LEFT ATRIAL SIZE AND ATRIAL FIBRILLATION IN DIFFERENT DISEASES

    Directory of Open Access Journals (Sweden)

    Rajith

    2014-11-01

    Full Text Available BACKGROUND: Atrial fibrillation is the most common cardiac dysrhythmia and left atrial size is an important factor in the development of atrial fibrillation. In the presence of atrial fibrillation an increase in left atrial size is associated with increased risk of stroke as well as increased morbidity and mortality. In this context, this study entitled “relation between left atrial size and atrial fibrillation in different diseases” was undertaken to study the left atrial size in different diseases causing atrial fibrillation and its relation to the atrial fibrillation. METHODS: A cross-sectional study was done from March 2004 to February 2006 in all medical units of Basaveshwar teaching and general hospital and Government general hospital Gulbarga. 70 cases of atrial fibrillation were studied in the present study. RESULTS: In the present study Atrial Fibrillation was common in >40 years age group (70%, left atrial enlargement was also more common in this age group (69.38%. Left atrial enlargement was seen in 70% of patients with Atrial Fibrillation. Rheumatic heart disease was the most common cause of Atrial Fibrillation (54.28% and left atrial enlargement was seen in 92% of these patients with mean left atrial size of 58.92 mm. Next most common cause was coronary artery disease (20% and left atrial enlargement was seen in 57.14% patients with a mean left atrial size of 39.5 mm. Left atrial size was normal in patients with thyrotoxicosis, congenital heart disease, lone Atrial Fibrillation and primary pulmonary hypertension. Left atrial enlargement was significantly associated with worsening of functional status (p<0.01, pulmonary arterial hypertension (p<0.005 and congestive cardial failure (p<0.02. 17.14% of patients with Atrial Fibrillation had embolic complications like stroke, of them left atrial enlargement was seen in 83.33% patients. 4.27% of patients with Atrial Fibrillation died during the hospital course, of them left atrial

  17. Tachy-Brady Arrhythmias: The Critical Role of Adenosine-induced Sino-Atrial Conduction Block in Post-Tachycardia Pauses

    Science.gov (United States)

    Lou, Qing; Glukhov, Alexey V.; Hansen, Brian; Hage, Lori; Vargas-Pinto, Pedro; Billman, George E.; Carnes, Cynthia A.; Fedorov, Vadim V.

    2012-01-01

    Background In patients with sinoatrial nodal (SAN) dysfunction, atrial pauses lasting several seconds may follow rapid atrial pacing or paroxysmal tachycardia (tachy-brady arrhythmias). Clinical studies suggest that adenosine may play an important role in SAN dysfunction, but the mechanism remains unclear. Objective To define the mechanism of SAN dysfunction induced by the combination of adenosine and tachycardia. Methods We studied the mechanism of SAN dysfunction produced by a combination of adenosine and rapid atrial pacing in isolated coronary-perfused canine atrial preparations using high-resolution optical mapping (n=9). Sinus cycle length (SCL) and sinoatrial conduction time (SACT) were measured during adenosine (1–100μM) and 1μM DPCPX (A1 receptor antagonist, n=7) perfusion. Sinoatrial node recovery time was measured after one minute of “slow” pacing (3.3Hz) or tachypacing (7–9Hz). Results Adenosine significantly increased SCL (477±62 vs. 778±114 ms, p<0.01), and SACT during sinus rhythm (41±11 vs. 86±16 ms, p<0.01) dose-dependently. Adenosine dramatically affected SACT of the first SAN beat after tachypacing (41±5 vs. 221±98ms, p<0.01). Moreover, at high concentrations of adenosine (10–100μM), termination of tachypacing or atrial flutter/fibrillation produced atrial pauses of 4.2±3.4 seconds (n=5) due to conduction block between the SAN and atria, despite a stable SAN intrinsic rate. Conduction block was preferentially related to depressed excitability in SAN conduction pathways. Adenosine-induced changes were reversible upon washout or DPCPX treatment. Conclusions These data directly demonstrate that adenosine contributes to post-tachycardia atrial pauses through SAN exit block rather than slowed pacemaker automaticity. Thus, these data suggest an important modulatory role of adenosine in tachy-brady syndrome. PMID:22985657

  18. Low atrial septum pacing in pacemaker patients

    NARCIS (Netherlands)

    Voogt, Willem Gijsbert de

    2006-01-01

    In patients with an indication for anti bradycardia pacing, atrial fibrillation (AF) is a common arrhythmia (30-50%) even in the absence of atrial tachy arrhythmias before pacemaker implantation. Pace prevention and pace intervention for atrial tachy arrhythmias could be an interesting adjuvant trea

  19. The internodal atrial myocardium.

    Science.gov (United States)

    Anderson, R H; Ho, S Y; Smith, A; Becker, A E

    1981-09-01

    The anatomical substrates of internodal conduction have long been a contentious topic. Debated first by the German Pathological Society in 1910, the consensus of established opinion for over half a century was that conduction between sinus and atrioventricular nodes occurred through plain myocardium. This was a conclusion supported by Truex in 1961. Despite his restatement of this fact in 1976, it has become fashionable to describe internodal conduction as being mediated by specialized internodal pathways. To reinvestigate this problem we studied 22 human fetal and 32 human infant hearts. In each case it was possible to cut the atrial tissues as a single block of tissue and to examine serial sections through the internodal myocardium. The sinus node, atrioventricular node, and segments of atrioventricular ring specialized tissue were recognized as specialized tissue using the light microscope in each heart. In contrast, there was nothing "special" about the myocardium between the nodes, nor was it possible to recognize tracts on the basis of either histological appearance or cellular architecture. It is concluded that, from the standpoint of light microscopy, there is no evidence whatsoever to support the purported concept of specialized anatomical substrates for internodal conduction.

  20. Antony van Leeuwenhoek and the description of diaphragmatic flutter (respiratory myoclonus).

    Science.gov (United States)

    Larner, Andrew J

    2005-08-01

    This article reviews the first account of diaphragmatic flutter, published by Antony van Leeuwenhoek, the renowned microscopist, in 1723. The completeness of the clinical description merits the eponymous description of Leeuwenhoek's disease.

  1. Experimental Model Based Feedback Control for Flutter Suppression and Gust Load Alleviation Project

    Data.gov (United States)

    National Aeronautics and Space Administration — ZONA Technology, Inc. (ZONA) proposes an R&D effort to develop an Experimental Model Based Feedback Control (EMBFC) Framework for the flutter suppression and...

  2. A Conceptual Wing Flutter Analysis Tool for Systems Analysis and Parametric Design Study

    Science.gov (United States)

    Mukhopadhyay, Vivek

    2003-01-01

    An interactive computer program was developed for wing flutter analysis in the conceptual design stage. The objective was to estimate flutt er instability boundaries of a typical wing, when detailed structural and aerodynamic data are not available. Effects of change in key flu tter parameters can also be estimated in order to guide the conceptual design. This userfriendly software was developed using MathCad and M atlab codes. The analysis method was based on non-dimensional paramet ric plots of two primary flutter parameters, namely Regier number and Flutter number, with normalization factors based on wing torsion stiffness, sweep, mass ratio, taper ratio, aspect ratio, center of gravit y location and pitch-inertia radius of gyration. These parametric plo ts were compiled in a Chance-Vought Corporation report from database of past experiments and wind tunnel test results. An example was prese nted for conceptual flutter analysis of outer-wing of a Blended-Wing- Body aircraft.

  3. Impact of the origin of sinus node artery on recurrence after pulmonary vein isolation in patients with paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhi-jun; CHEN Ke; TANG Ri-bo; gANG Cai-hua; Edmundo Patricio Lopes Lao; YAN Qian; HE Xiao-nan

    2013-01-01

    Background Major atrial coronary arteries,including the sinus node artery (SNA),were commonly found in the areas involved in atrial fibrillation (AF) ablation and could cause difficulties in achieving linear block at the left atrial (LA) roof.The SNA is a major atrial coronary artery of the atrial coronary circulation.This study aimed to determine impact of the origin of SNA on recurrence of AF after pulmonary vein isolation (PVI) in patients with paroxysmal AF.Methods Seventy-eight patients underwent coronary angiography for suspected coronary heart disease,followed by catheter ablation for paroxysmal AF.According to the origin of SNA from angiographic findings,they were divided into right SNA group (SNA originating from the right coronary artery) and left SNA group (SNA originating from the left circumflex artery).Guided by an electroanatomic mapping system,circumferential pulmonary vein ablation (CPVA) was performed in both groups and PVI was the procedural endpoint.All patients were followed up at 1,3,6,9 and 12 months post-ablation.Recurrence was defined as any episode of atrial tachyarrhythmias (ATAs),including AF,atrial flutter or atrial tachycardia,that lasted longer than 30 seconds after a blanking period of 3 months.Results The SNA originated from the right coronary artery in 34 patients (43.6%) and the left circumflex artery in 44 patients (56.4%).Freedom from AF and antiarrhythmic drugs (AADs) at 1 year was 67.9 % (53/78) for all patients.After 1 year follow-up,79.4% (27/34) in right SNA group and 59.1% (26/44) in left SNA group (P=0.042) were in sinus rhythm.On multivariate analysis,left atrium size (HR=1.451,95%CI:1.240-1.697,P <0.001) and a left SNA (HR=6.22,95%CI:2.01-19.25,P=0.002)were the independent predictors of AF recurrence.Conclusions The left SNA is more frequent in the patients with paroxysmal AF.After one year follow-up,the presence of a left SNA was identified as an independent predictor of AF recurrence after CPVA in

  4. Supersonic flutter analysis of thin cracked functionally graded material plates

    CERN Document Server

    Natarajan, S; Bordas, S

    2012-01-01

    In this paper, the flutter behaviour of simply supported square functionally graded material plates immersed in a supersonic flow is studied. An enriched 4-noded quadrilateral element based on field consistency approach is used for this study and the crack is modelled independent of the underlying mesh. The material properties are assumed to be temperature dependent and graded only in the thickness direction. The effective material properties are estimated using the rule of mixtures. The formulation is based on the first order shear deformation theory and the shear correction factors are evaluated employing the energy equivalence principle. The influence of the crack length, the crack orientation, the flow angle and the gradient index on the aerodynamic pressure and the frequency are numerically studied. The results obtained here reveal that the critical frequency and the critical pressure decreases with increase in crack length and it is minimum when the crack is aligned to the flow angle.

  5. Kinetic mesh-free method for flutter prediction in turbomachines

    Indian Academy of Sciences (India)

    V Ramesh; S M Deshpande

    2014-02-01

    The present paper deals with the development and application of a kinetic theory-based mesh-free method for unsteady flows. The method has the capability to compute on any arbitrary distribution of moving nodes. In general, computation of unsteady flow past multiple moving boundaries using conventional finite volume solvers are quite involved. They invariably require repeated grid generation or an efficient grid movement strategy. This approach becomes more difficult when there are many moving boundaries. In the present work, we propose a simple and an effective node movement strategy for the mesh-free solver. This can tackle the unsteady problems with moving boundaries in a much easier way. Using the present method we have computed unsteady flow in oscillating turbomachinery blades. A simple energy method has been used to predict flutter using the unsteady computations. The results compare well with the available experiments and other computations.

  6. Atrial fibrillation and delayed gastric emptying.

    Directory of Open Access Journals (Sweden)

    Isadora C Botwinick

    Full Text Available BACKGROUND: Atrial fibrillation and delayed gastric emptying (DGE are common after pancreaticoduodenectomy. Our aim was to investigate a potential relationship between atrial fibrillation and DGE, which we defined as failure to tolerate a regular diet by the 7(th postoperative day. METHODS: We performed a retrospective chart review of 249 patients who underwent pancreaticoduodenectomy at our institution between 2000 and 2009. Data was analyzed with Fisher exact test for categorical variables and Mann-Whitney U or unpaired T-test for continuous variables. RESULTS: Approximately 5% of the 249 patients included in the analysis experienced at least one episode of postoperative atrial fibrillation. Median age of patients with atrial fibrillation was 74 years, compared with 66 years in patients without atrial fibrillation (p = 0.0005. Patients with atrial fibrillation were more likely to have a history of atrial fibrillation (p = 0.03. 92% of the patients with atrial fibrillation suffered from DGE, compared to 46% of patients without atrial fibrillation (p = 0.0007. This association held true when controlling for age. CONCLUSION: Patients with postoperative atrial fibrillation are more likely to experience delayed gastric emptying. Interventions to manage delayed gastric function might be prudent in patients at high risk for postoperative atrial fibrillation.

  7. Aeroelastic flutter of feathers, flight and the evolution of non-vocal communication in birds.

    Science.gov (United States)

    Clark, Christopher J; Prum, Richard O

    2015-11-01

    Tonal, non-vocal sounds are widespread in both ordinary bird flight and communication displays. We hypothesized these sounds are attributable to an aerodynamic mechanism intrinsic to flight feathers: aeroelastic flutter. Individual wing and tail feathers from 35 taxa (from 13 families) that produce tonal flight sounds were tested in a wind tunnel. In the wind tunnel, all of these feathers could flutter and generate tonal sound, suggesting that the capacity to flutter is intrinsic to flight feathers. This result implies that the aerodynamic mechanism of aeroelastic flutter is potentially widespread in flight of birds. However, the sounds these feathers produced in the wind tunnel replicated the actual flight sounds of only 15 of the 35 taxa. Of the 20 negative results, we hypothesize that 10 are false negatives, as the acoustic form of the flight sound suggests flutter is a likely acoustic mechanism. For the 10 other taxa, we propose our negative wind tunnel results are correct, and these species do not make sounds via flutter. These sounds appear to constitute one or more mechanism(s) we call 'wing whirring', the physical acoustics of which remain unknown. Our results document that the production of non-vocal communication sounds by aeroelastic flutter of flight feathers is widespread in birds. Across all birds, most evolutionary origins of wing- and tail-generated communication sounds are attributable to three mechanisms: flutter, percussion and wing whirring. Other mechanisms of sound production, such as turbulence-induced whooshes, have evolved into communication sounds only rarely, despite their intrinsic ubiquity in ordinary flight.

  8. Pressure measurements on a rectangular wing with a NACA0012 airfoil during conventional flutter

    Science.gov (United States)

    Rivera, Jose A., Jr.; Dansberry, Bryan E.; Durham, Michael H.; Bennett, Robert M.; Silva, Walter A.

    1992-01-01

    The Structural Dynamics Division at NASA LaRC has started a wind tunnel activity referred to as the Benchmark Models Program. The primary objective of the program is to acquire measured dynamic instability and corresponding pressure data that will be useful for developing and evaluating aeroelastic type CFD codes currently in use or under development. The program is a multi-year activity that will involve testing of several different models to investigate various aeroelastic phenomena. The first model consisted of a rigid semispan wing having a rectangular planform and a NACA 0012 airfoil shape which was mounted on a flexible two degree-of-freedom mount system. Two wind-tunnel tests were conducted with the first model. Several dynamic instability boundaries were investigated such as a conventional flutter boundary, a transonic plunge instability region near Mach = 0.90, and stall flutter. In addition, wing surface unsteady pressure data were acquired along two model chords located at the 60 to 95-percent span stations during these instabilities. At this time, only the pressure data for the conventional flutter boundary is presented. The conventional flutter boundary and the wing surface unsteady pressure measurements obtained at the conventional flutter boundary test conditions in pressure coefficient form are presented. Wing surface steady pressure measurements obtained with the model mount system rigidized are also presented. These steady pressure data were acquired at essentially the same dynamic pressure at which conventional flutter had been encountered with the mount system flexible.

  9. Fluid Structural Modal Coupled Numerical Investigation of Transonic Fluttering Of Axial Flow Compressor Blades

    Directory of Open Access Journals (Sweden)

    Rio Melvin Aro.T

    2015-05-01

    Full Text Available Flutter is an unstable oscillation which can lead to destruction. Flutter can occur on fixed surfaces, such as blades, wing or the stabilizer. By self-excited aeroelastic instability, flutter can lead to mechanical or structural failure of aircraft engine blades. The modern engines have been designed with increased pressure ratio and reduced weight in order to improve aerodynamic efficiency, resulting in severe aeroelastic problems. Particularly flutter in axial compressors with transonic flow can be characterized by a number of aerodynamic nonlinear effects such as shock boundary layer interaction, rotating stall, and tip vortex instability. Rotating blades operating under high centrifugal forces may also encounter structural nonlinearities due to friction damping and large deformations. In the future work a standard axial flow compressor blade will be taken for analysis, both Subsonic and Transonic range are taken for analysis. Fluid and Structure are two different domains which will be coupled by full system coupling technique to predict the fluttering effect on the compressor blade. ANSYS is a commercial simulation tool, which will be deployed in this work to perform FSI (Fluid Structure Interaction and FSI coupled Modal to predict the flutter in the compressor blades

  10. Sensitivity Analysis of Flutter Response of a Wing Incorporating Finite-Span Corrections

    Science.gov (United States)

    Issac, Jason Cherian; Kapania, Rakesh K.; Barthelemy, Jean-Francois M.

    1994-01-01

    Flutter analysis of a wing is performed in compressible flow using state-space representation of the unsteady aerodynamic behavior. Three different expressions are used to incorporate corrections due to the finite-span effects of the wing in estimating the lift-curve slope. The structural formulation is based on a Rayleigh-Pitz technique with Chebyshev polynomials used for the wing deflections. The aeroelastic equations are solved as an eigen-value problem to determine the flutter speed of the wing. The flutter speeds are found to be higher in these cases, when compared to that obtained without accounting for the finite-span effects. The derivatives of the flutter speed with respect to the shape parameters, namely: aspect ratio, area, taper ratio and sweep angle, are calculated analytically. The shape sensitivity derivatives give a linear approximation to the flutter speed curves over a range of values of the shape parameter which is perturbed. Flutter and sensitivity calculations are performed on a wing using a lifting-surface unsteady aerodynamic theory using modules from a system of programs called FAST.

  11. Recurrent acute pulmonary embolism and paroxysmal atrial fibrillation associated with subclinical hyperthyroidism.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo; Currò, Alessio; Cimino, Claudia

    2010-07-09

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. Elevated D-dimer levels have been reported in acute pulmonary embolism and it has also been reported that right ventricular overload and hypoxia in acute pulmonary embolism may lead to right ventricular myocardium injury reflected by elevated cardiac troponin levels too. We present a case of recurrent pulmonary embolism associated with subclinical hyperthyroidism, in an 81-year-old Italian woman. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  12. Genetic basis of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Oscar Campuzano

    2016-12-01

    Full Text Available Atrial fibrillation is the most common sustained arrhythmia and remains as one of main challenges in current clinical practice. The disease may be induced secondary to other diseases such as hypertension, valvular heart disease, and heart failure, conferring an increased risk of stroke and sudden death. Epidemiological studies have provided evidence that genetic factors play an important role and up to 30% of clinically diagnosed patients may have a family history of atrial fibrillation. To date, several rare variants have been identified in a wide range of genes associated with ionic channels, calcium handling protein, fibrosis, conduction and inflammation. Important advances in clinical, genetic and molecular basis have been performed over the last decade, improving diagnosis and treatment. However, the genetics of atrial fibrillation is complex and pathophysiological data remains still unraveling. A better understanding of the genetic basis will induce accurate risk stratification and personalized clinical treatment. In this review, we have focused on current genetics basis of atrial fibrillation.

  13. Radiofrequency ablation of atrial fibrillation

    NARCIS (Netherlands)

    Wiesfeld, ACP; Tan, ES; Van Veldhuisen, DJ; Crijns, HJGM; Van Gelder, IC

    2004-01-01

    Twenty-five patients (16 males, mean age 46 years.) underwent radiofrequency ablation because of either paroxysmal (13 patients) or persistent atrial fibrillation (12 patients). Ablation aimed at earliest activation of spontaneous and catheter-induced repetitive ectopy in left and right atria and ap

  14. [New antithrombotics for atrial fibrillation].

    NARCIS (Netherlands)

    Verheugt, F.W.A.

    2011-01-01

    Cerebral infarction is the most serious complication of atrial fibrillation. Coumarin derivatives (vitamin K antagonists) counteract systemic thromboembolism and reduce the risk of stroke by more than 60%, but carry a risk of serious bleeding. Antiplatelet therapy and subcutaneous low-molecular-weig

  15. Facts about Atrial Septal Defect

    Science.gov (United States)

    ... Living With Heart Defects Data & Statistics Tracking & Research Articles & Key Findings Free Materials Multimedia and Tools Links to Other Websites Information For... Media Policy Makers Facts about Atrial Septal Defect Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir ...

  16. [Atrial fibrillation and cognitive function].

    Science.gov (United States)

    Duron, Emmanuelle; Hanon, Olivier

    2010-09-01

    Atrial fibrillation (AF), which prevalence increases with age, is a growing public health problem and a well known risk factor for stroke. On the other hand, dementia is one of the most important neurological disorders in the elderly, and with aging of the population in developed countries, the number of demented patients will increase in absence of prevention. In the past decade, several vascular risk factors (hypertension, obesity and metabolic syndrome, hypercholesterolemia) have been found, with various degree of evidence, to be associated with vascular dementia but also, surprisingly, with Alzheimer's disease. This review is devoted to the links between atrial fibrillation, cognitive decline and dementia. Globally, transversal studies showed a significant association between atrial fibrillation, cognitive decline and dementia. However, these studies are particularly sensitive to various biases. In this context, recent longitudinal studies of higher level of evidence have been conducted to assess the link between AF and dementia. One study disclosed a high incidence of dementia among patients suffering from atrial fibrillation during a 4.6 years follow-up. Similarly another study showed that atrial fibrillation was significantly associated with conversion from mild cognitive impairment to dementia during a 3 years follow-up. Nevertheless two other longitudinal studies did not find any significant association between AF and dementia, but this discrepancy should be interpreted taking into account that the comparability of all these studies is moderate because they were using different methodologies (population, cognitive testing, and mean follow-up). Possible explanatory mechanisms for the association between AF and the risk of dementia are proposed, such as thrombo-embolic ischemic damage and cerebral hypo perfusion due to fluctuations in the cardiac output. Thus, there is some evidence that FA could be associated with cognitive decline and dementia but this

  17. Physics-Based Identification, Modeling and Risk Management for Aeroelastic Flutter and Limit-Cycle Oscillations (LCO) Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The proposed research program will develop a physics-based identification, modeling and risk management infrastructure for aeroelastic transonic flutter and...

  18. Parametric study on supersonic flutter of angle-ply laminated plates using shear deformable finite element method

    Institute of Scientific and Technical Information of China (English)

    Wei Xia; Qiao Ni

    2011-01-01

    The influence of fiber orientation,flow yaw angle and length-to-thickness ratio on flutter characteristics of angle-ply laminated plates in supersonic flow is studied by finite element approach.The structural model is established using the Reissner-Mindlin theory in which the transverse shear deformation is considered.The aerodynamic pressure is evaluated by the quasi-steady first-order piston theory.The equations of motion are formulated based on the principle of virtual work.With the harmonic motion assumption,the flutter boundary is determined by solving a series of complex eigenvalue problems.Numerical study shows that (1)The flutter dynamic pressure and the coalescence of flutter modes depend on fiber orientation,flow yaw angle and length-to-thickness ratio; (2) The laminated plate with all fibers aligned with the flow direction gives the highest flutter dynamic pressure,but a slight yawing of the flow from the fiber orientation results in a sharp decrease of the flutter dynamic pressure; (3) The angle-ply laminated plate with fiber orientation angle equal to flow yaw angle gives high flutter dynamic pressure,but not the maximum flutter dynamic pressure; (4) With the decrease of length-to-thickness ratio,an adverse effect due to mode transition on the flutter dynamic pressure is found.

  19. Atrioverter : An implantable device for the treatment of atrial fibrillation

    NARCIS (Netherlands)

    Wellens, HJJ; Lau, CP; Luderitz, B; Akhtar, M; Waldo, AL; Camm, AJ; Timmermans, C; Tse, HF; Jung, W; Jordaens, L; Ayers, G

    1998-01-01

    Background-During atrial fibrillation, electrophysiological changes occur in atrial tissue that favor the maintenance of the arrhythmia and facilitate recurrence after conversion to sinus rhythm. An implantable defibrillator connected to right atrial and coronary sinus defibrillation leads allows pr

  20. Uso da radiofrequência bipolar para o tratamento da fibrilação atrial durante cirurgia cardíaca Uso de la radiofrecuencia bipolar para el tratamiento de la fibrilación atrial durante cirugía cardíaca Use of bipolar radiofrequency for the treatment of atrial fibrillation during cardiac surgery

    Directory of Open Access Journals (Sweden)

    Leonardo Secchin Canale

    2011-06-01

    Full Text Available FUNDAMENTO: O tratamento da fibrilação atrial com dispositivo de ablação de tecidos por radiofrequência bipolar em concomitância à cirurgia cardíaca tem se mostrado método eficaz no tratamento desta arritmia. OBJETIVO: Descrever a experiência inicial do Instituto Nacional de Cardiologia no tratamento cirúrgico da fibrilação atrial com uso de dispositivo de radiofrequência bipolar em pacientes submetidos à cirurgia cardíaca, relatando o resultado de acompanhamento pós-operatório de um ano. MÉTODOS: Entre janeiro de 2008 e março de 2009, 47 pacientes (36 mulheres consecutivos, com idade média de 53,7 ± 10,6 anos, apresentando fibrilação atrial por um período médio de 34,6 meses (3 a 192 meses foram submetidos à ablação cirúrgica desta arritmia, por radiofrequência bipolar, durante o procedimento que motivou a indicação da cirurgia. Oito apresentavam fibrilação atrial intermitente e 39, contínua. Oitenta e um por cento foram submetidos à cirurgia valvar como procedimento principal. Esta é uma análise retrospectiva, observacional, com avaliação de um ano de pós-operatório das variáveis clínicas e de Holter 24 h. RESULTADOS: Dos 47 pacientes, 40 sobreviveram um ano. Desses, 33 foram submetidos a Holter 24 h, em um intervalo médio de 401 dias após a cirurgia. Encontrou-se a seguinte distribuição de ritmos: 24 (73% sinusal, 5 (15% fibrilação atrial, três (9% Flutter atrial e um (3% ritmo juncional. Foram observados dois acidentes vasculares encefálicos, sendo um associado à arritmia supraventricular. CONCLUSÃO: A ablação cirúrgica de fibrilação atrial com dispositivo de radiofrequência bipolar concomitante à cirurgia cardíaca é método eficaz para o tratamento desta arritmia.FUNDAMENTO: El tratamiento de la fibrilación atrial con dispositivo de ablación de tejidos por radiofrecuencia bipolar en concomitancia con la cirugía cardíaca se muestra un método eficaz en el tratamiento de esta

  1. Response of SI cortex to ipsilateral, contralateral and bilateral flutter stimulation in the cat

    Directory of Open Access Journals (Sweden)

    Favorov Oleg

    2005-04-01

    Full Text Available Abstract Background While SII cortex is considered to be the first cortical stage of the pathway that integrates tactile information arising from both sides of the body, SI cortex is generally not considered as a region in which neuronal response is modulated by simultaneous stimulation of bilateral (and mirror-image skin sites. Results Optical intrinsic signal imaging was used to evaluate the response of SI and SII in the same hemisphere to 25 Hz sinusoidal vertical skin displacement stimulation ("skin flutter" applied contralaterally, ipsilaterally, and bilaterally (simultaneously to the central pads of the forepaws. A localized increase in absorbance in both SI and SII occurred in response to both contralateral and bilateral flutter stimulation. Ipsilateral flutter stimulation evoked a localized increase in absorbance in SII, but little or no change in SI absorbance. In the forepaw representational region of SI, however, bilateral stimulation of the central pads evoked a response substantially smaller (approximately 30–35% smaller than the response to flutter stimulation of the contralateral central pad. Conclusion The finding that the response of SI cortex to bilateral central pad flutter stimulation is substantially smaller than the response evoked by a contralateral flutter stimulus, together with the recently published observation that a region located posteriorly in SII responds with a substantially larger response to a bilateral flutter stimulus than the response evoked from the contralateral central pad, lead us to propose that the SI activity evoked by contralateral skin stimulation is suppressed/inhibited (via corticocortical connections between SII and SI in the same hemisphere by the activity a simultaneous ipsilateral skin stimulus evokes in posterior SII.

  2. Long-term results of a minimally invasive surgical pulmonary vein isolation and ganglionic plexi ablation for atrial fibrillation.

    Directory of Open Access Journals (Sweden)

    Shuai Zheng

    Full Text Available BACKGROUND: Ganglionated plexi (GP ablation has been become an adjunct to pulmonary vein isolation (PVI. This study describes the long-term results of minimally invasive surgical PVI, ablation of GPs, and exclusion of the left atrial appendage for atrial fibrillation (AF. METHODS: Long-term follow-up of 55 months was performed in 139 consecutive patients (age 58.3±20.8 years with symptomatic, drug-refractory lone AF who underwent minimally invasive surgical PVI, GPs ablation, and exclusion of the left atrial appendage. Success was defined as freedom from AF, atrial flutter, or atrial tachycardia off antiarrhythmic drugs. RESULTS: AF was paroxysmal in 77.7%, persistent in 12.2% and long-standing persistent in 10.1%. Single-procedure success rate was 71.7%, 59.4% and 46.6% at 12, 24 and 60 months respectively. Single-procedure success rate was 72.9%, 62.6% and 51.8% for paroxysmal AF, 64.7%, 35.3%, and 28.2% for persistent AF, 71.4%, 64.3% and 28.6% for long-standing persistent AF at 12, 24 and 60 months respectively. Duration of AF>24 months (hazard ratio [HR]: 3.09, 95% confidence interval [CI]: 1.51 to 6.32; p = 0.002, left atrial diameter≥40 mm (HR: 4.03, 95% CI: 1.88 to 8.65; p<0.001, early recurrence of AF (HR: 4.66, 95% CI: 2.25 to 9.63; p<0.001 independently predicted long-term recurrence of AF. There was no procedure-related death. One patient converted to median sternotomy because of uncontrolled bleeding. Two patients underwent perioperative cerebrovascular events. CONCLUSIONS: At nearly 5-year of clinical follow-up, single-procedure success rate of minimally invasive surgical PVI with GP ablation was 51.8% for paroxysmal AF, 28.2% for persistent AF, 28.6% for long-standing persistent AF after initial procedure. Patients with AF duration≤24 months, left atrial diameter<40 mm and no early recurrence of AF, had favorable outcomes.

  3. Atrial septal stenting - How I do it?

    Directory of Open Access Journals (Sweden)

    Kothandam Sivakumar

    2015-01-01

    Full Text Available A wide atrial communication is important to maintain hemodynamics in certain forms of congenital and acquired heart defects. In comparison to balloon septostomy or blade septostomy, atrial septal stenting provides a controlled, predictable, and long-lasting atrial communication. It often needs a prior Brockenbrough needle septal puncture to obtain a stable stent position. A stent deployed across a previously dilated and stretched oval foramen or tunnel form of oval foramen carries higher risk of embolization. This review provides technical tips to achieve a safe atrial septal stenting. Even though this is a "How to do it article," an initial discussion about the indications for atrial septal stenting is vital as the resultant size of the atrial septal communication should be tailored for each indication.

  4. Risk of atrial fibrillation in diabetes mellitus

    DEFF Research Database (Denmark)

    Pallisgaard, Jannik L.; Schjerning, Anne-Marie; Lindhardt, Tommi B.

    2016-01-01

    AIM: Diabetes has been associated with atrial fibrillation but the current evidence is conflicting. In particular knowledge regarding young diabetes patients and the risk of developing atrial fibrillation is sparse. The aim of our study was to investigate the risk of atrial fibrillation in patients...... with diabetes compared to the background population in Denmark. METHODS AND RESULTS: Through Danish nationwide registries we included persons above 18 years of age and without prior atrial fibrillation and/or diabetes from 1996 to 2012. The study cohort was divided into a background population without diabetes...... and a diabetes group. The absolute risk of developing atrial fibrillation was calculated and Poisson regression models adjusted for sex, age and comorbidities were used to calculate incidence rate ratios of atrial fibrillation. The total study cohort included 5,081,087 persons, 4,827,713 (95%) in the background...

  5. Atrial – Ventricular Septal Defect

    Directory of Open Access Journals (Sweden)

    T Panagiotopoulos

    2009-05-01

    Full Text Available Atrial and ventricular septal defect constitute the most common congenital heart disease.Aim: Τhe aim of the present retrospective study was to record data and factors that affect atrial and ventricular septal defect.Method and material: The sample study included patients of both sexes who were hospitalized with diagnosis atrial and ventricular septal defect in a Cardiac Surgery hospital of Athens. A specially constructed printed form was used for data collection, where were recorded the demographic and personal variables, the pathological, surgical, cardiology and obstetric history, the habits of adults, as well as the personal characteristics of mothers. Analysis of data was performed by descriptive statistical analysis.Results: The sample study consisted of 101 individuals with diagnosis atrial or ventricular Septal Defect, of which 40% were boys and 60% girls. The 70% of the sample study suffered from atrial Septal Defect and the 30% suffered from ventricular Septal Defect. Regarding age, 12% of the sample study was 0-1 years old, 35% was >1 years old, 8% was >12-18 years old and 45% over than 18 years old. Regarding educational status of the adult participants, 9% was of 0-6 years education, 22%>6 -12 years, 13%>12 years. 14% of the adult paticipants smoked, 4% consumed alcohol and 5% smoked in conjunction with alcohol. In terms of the obstetric history of the sample studied, 32% of the cases had normal birth, 4% had a twin birth and 1% had a triplet one. According to the variables related to mothers, the mean age of the mother was 30 years and 3 months, 10% were smokers at pregnancy and 3% used chemical substance and mainly hair color. Also, the results of the present study showed that individuals of 12-18 and >18 years old did not suffer from ventricular Septal Defect, whereas the infants 0-1 years old did not suffer from Atrial Septal Defect. The mean value of age at the admission in intensive care unit was 7 months (12% for the infants

  6. Correlation of Left Atrial Diameter by Echocardiography and Left Atrial Volume by Computed Tomography

    NARCIS (Netherlands)

    Hof, Irene; Arbab-Zadeh, Armin; Scherr, Daniel; Chilukuri, Karuna; Dalal, Darshan; Abraham, Theodore; Lima, Joao; Calkins, Hugh

    2009-01-01

    Computed Tomography. Introduction: For patients undergoing catheter ablation of atrial fibrillation (AF), left atrial size is a predictor of recurrence of AF during follow-up. For this reason, major clinical trials have used a left atrial diameter (LAD) of more than 5.0 or 5.5 cm, assessed by echoca

  7. ANALYSIS OF RANDOMNESS OF ATRIAL AND VENTRICULAR RHYTHM IN ATRIAL-FIBRILLATION

    NARCIS (Netherlands)

    VANDENBERG, MP; DELANGEN, CDJ; HAAKSMA, J; BEL, KJ; CRIJNS, HJGM; DIJK, WA; LIE, KI

    1995-01-01

    The aim of the present study was top examine the relationship between randomness of atrial and ventricular rhythm during atrial fibrillation. Atrial fibrillation was induced in 10 open-chest pigs by application of metacholine on the surface of the right atrium followed by incremental pacing. Local a

  8. Atrial Fibrillation and Colonic Neoplasia in African Americans.

    Directory of Open Access Journals (Sweden)

    Mehdi Nouraie

    Full Text Available Colorectal cancer (CRC and atrial fibrillation/flutter (AF share several risk factors including increasing age and obesity. However, the association between CRC and AF has not been thoroughly examined, especially in African Americans. In this study we aimed to assess the prevalence of AF and its risk factors in colorectal neoplasia in an African American.We reviewed records of 527 African American patients diagnosed with CRC and 1008 patients diagnosed with benign colonic lesions at Howard University Hospital from January 2000 to December 2012. A control group of 731 hospitalized patients without any cancer or colonic lesion were randomly selected from the same time and age range, excluding patients who had diagnosis of both CRC and/or adenoma. The presence or absence of AF was based upon ICD-9 code documentation. The prevalence of AF in these three groups was compared by multivariate logistic regression.The prevalence of AF was highest among CRC patients (10% followed by adenoma patients (7.2% then the control group (5.4%, P for trend = 0.002. In the three groups of participants, older age (P<0.008 and heart failure (P<0.001 were significantly associated with higher risk of AF. After adjusting for these risk factors, CRC (OR: 1.4(95%CI:0.9-2.2, P = 0.2 and adenoma (OR: 1.1(95%CI:0.7-1.6, P = 0.7 were not significantly associated AF compared to control group.AF is highly prevalent among CRC patients; 1 in 10 patients had AF in our study. The predictors of AF in CRC was similar to that in adenoma and other patients after adjustment for potential confounders suggesting that the increased AF risk in CRC is explained by higher prevalence of AF risk factors.

  9. Personalized management of atrial fibrillation

    DEFF Research Database (Denmark)

    Kirchhof, Paulus; Breithardt, Günter; Aliot, Etienne

    2013-01-01

    to detect AF. Most clinical management decisions in AF patients can be based on validated parameters that encompass type of presentation, clinical factors, electrocardiogram analysis, and cardiac imaging. Despite these advances, patients with AF are still at increased risk for death, stroke, heart failure......, and hospitalizations. During the fourth Atrial Fibrillation competence NETwork/European Heart Rhythm Association (AFNET/EHRA) consensus conference, we identified the following opportunities to personalize management of AF in a better manner with a view to improve outcomes by integrating atrial morphology and damage......, brain imaging, information on genetic predisposition, systemic or local inflammation, and markers for cardiac strain. Each of these promising avenues requires validation in the context of existing risk factors in patients. More importantly, a new taxonomy of AF may be needed based...

  10. T-tail flutter: Potential-flow modelling, experimental validation and flight tests

    Science.gov (United States)

    Murua, Joseba; Martínez, Pablo; Climent, Héctor; van Zyl, Louw; Palacios, Rafael

    2014-11-01

    Flutter of T-tail configurations is caused by the aeroelastic coupling between the vertical fin and the horizontal stabiliser. The latter is mounted on the fin instead of the fuselage, and hence the arrangement presents distinct characteristics compared to other typical empennage setups; specifically, T-tail aeroelasticity is governed by inplane dynamics and steady aerodynamic loading, which are typically not included in flutter clearance methodologies based on the doublet lattice method. As the number of new aircraft featuring this tail configuration increases, there is a need for precise understanding of the phenomenon, appropriate tools for its prediction, and reliable benchmarking data. This paper addresses this triple challenge by providing a detailed explanation of T-tail flutter physics, describing potential-flow modelling alternatives, and presenting detailed numerical and experimental results to compensate for the shortage of reproducible data in the literature. A historical account of the main milestones in T-tail aircraft development is included, followed by a T-tail flutter research review that emphasises the latest contributions from industry as well as academia. The physical problem is dissected next, highlighting the individual and combined effects that drive the phenomenon. Three different methodologies, all based on potential-flow aerodynamics, are considered for T-tail subsonic flutter prediction: (i) direct incorporation of supplementary T-tail effects as additional terms in the flutter equations; (ii) a generalisation of the boundary conditions and air loads calculation on the double lattice; and (iii) a linearisation of the unsteady vortex lattice method with arbitrary kinematics. Comparison with wind-tunnel experimental results evidences that all three approaches are consistent and capture the key characteristics in the T-tail dynamics. The validated numerical models are then exercised in easy-to-duplicate canonical test cases. These

  11. Atrial fibrillation in the elderly

    Institute of Scientific and Technical Information of China (English)

    Roger Kerzner; Michael W. Rich

    2005-01-01

    Atrial fibrillation (AF) is an extremely common condition in the elderly, with increasing prevalence around the world as the population ages. AF may be associated with serious health consequences, including stroke, heart failure, and decreased quality of life, so that careful management of AF by geriatric health care providers is required. With careful attention to anticoagulation therapy, and prudent use of medications and invasive procedures to minimize symptoms, many of the adverse health consequences of AF can be prevented.

  12. CORRELATION OF LEFT ATRIAL SIZE AND ATRIAL FIBRILLATION IN RHD WITH MITRAL VALVE DISEASE

    Directory of Open Access Journals (Sweden)

    Raghavendra

    2016-03-01

    Full Text Available BACKGROUND Atrial fibrillation (AF, the most common sustained cardiac rhythm disturbance, commonly occurs with rheumatic heart disease, particularly mitral stenosis. Hemodynamic impairment and thromboembolic events result in significant morbidity& mortality. Left atrial (LA enlargement is one of the elements that evolve in the natural history of mitral stenosis. The objective of this study is to study the relation between echo cardio graphically determined left atrial size and atrial fibrillation in mitral valve disease (MVD. METHODOLOGY 50 Patients with rheumatic heart disease with mitral valve disease were studied using ECG and ECHO, excluding patients with congenital heart diseases, non-rheumatic mitral valve disease, essential hypertension, patients undergone PTMC or valvuloplasty or valve replacement, coronary artery diseases, patients on antiarrhythmic drugs, pregnant women. Left atrial dimensions measured by ECHO in patients of MVD and AF on ECG were compared with the left atrial dimension of patients in sinus rhythm. RESULTS In this study 42 patients had left atrial size >40 mm, 29(93.55% of them were in atrial fibrillation and only 13(68.42% were in sinus rhythm. Among 8 patients with left atrial size <40 mm, 2(6.45% were in atrial fibrillation and 06(31.58% were in sinus rhythm with p<0.02 which is significant. CONCLUSION Atrial fibrillation incidence was common when left atrial dimension was above 40 mm. There is a quantitative relation between left atrial size measured echocardiographically and the presence or absence of atrial fibrillation. These results may have therapeutic implication in that it may be possible with echocardiography, to identify patients in sinus rhythm, who are at high risk of developing atrial fibrillation. Prophylactic anticoagulation, antiarrhythmic therapy or both might be considered in management to prevent embolism.

  13. Reliability and Sensitivity Analysis of Transonic Flutter Using Improved Line Sampling Technique

    Institute of Scientific and Technical Information of China (English)

    Song Shufang; Lu Zhenzhou; Zhang Weiwei; Ye Zhengyin

    2009-01-01

    The improved line sampling (LS) technique, an effective numerical simulation method, is employed to analyze the probabilistic characteristics and reliability sensitivity of flutter with random structural parameter in transonic flow. The improved LS technique is a novel methodology for reliability and sensitivity analysis of high dimensionality and low probability problem with implicit limit state function, and it does not require any approximating surrogate of the implicit limit state equation. The improved LS is used to estimate the flutter reliability and the sensitivity of a two-dimensional wing, in which some structural properties, such as frequency, parameters of gravity center and mass ratio, are considered as random variables. Computational fluid dynamics (CFD) based unsteady aerodynamic reduced order model (ROM) method is used to construct the aerodynamic state equations. Coupling structural state equations with aerodynamic state equations, the safety margin of flutter is founded by using the critical velocity of flutter. The results show that the improved LS technique can effectively decrease the computational cost in the random uncertainty analysis of flutter. The reliability sensitivity, defined by the partial derivative of the failure probability with respect to the distribution parameter of random variable, can help to identify the important parameters and guide the structural optimization design.

  14. Structural Nonlinear Flutter Characteristics Analysis for an Actuator-fin System with Dynamic Stiffness

    Institute of Scientific and Technical Information of China (English)

    YANG Ning; WU Zhigang; YANG Chao

    2011-01-01

    The flutter characteristics of an actuator-fin system are investigated with structural nonlinearity and dynamic stiffness of the electric motor.The component mode substitution method is used to establish the nonlinear governing equations in time domain and frequency domain based on the fundamental dynamic equations of the electric motor and decelerator.The existing describing function method and a proposed iterative method are used to obtain the flutter characteristics containing preload freeplay nonlinearity when the control command is zero.A comparison between the results of frequency domain and those of time domain is studied.Simulations are carried out when the control command is not zero and further analysis is conducted when the freeplay angle is changed.The results show that structural nonlinearity and dynamic stiffness have a significant influence on the flutter characteristics.Limit cycle oscillations(LCOs)are observed within linear flutter boundary.The response of the actuator-fin system is related to the initial disturbance.In the nonlinear condition,the amplitude of the control command has an influence on the flutter characteristics.

  15. Flutter performance of bend-twist coupled large-scale wind turbine blades

    Science.gov (United States)

    Hayat, Khazar; de Lecea, Alvaro Gorostidi Martinez; Moriones, Carlos Donazar; Ha, Sung Kyu

    2016-05-01

    The bend-twist coupling (BTC) is proven to be effective in mitigating the fatigue loads for large-scale wind turbine blades, but at the same time it may cause the risk of flutter instability. The BTC is defined as a feature of twisting of the blade induced by the primary bending deformation. In the classical flutter, the BTC arises from the aerodynamic loads changing with the angle of attack. In this study, the effects of the structural BTC on the flutter are investigated by considering the layup unbalances (ply angle, material and thickness of the composite laminates) in the NREL 5-MW wind turbine rotor blade of glass fiber/epoxy [02/+45/-45]S laminates. It is numerically shown that the flutter speed may decrease by about 5 percent with unbalanced ply-angle only (one side angle, from 45° to 25°). It was then demonstrated that the flutter performance of the wind turbine blade can be increased by using lighter and stiffer carbon fibers which ensures the higher structural BTC at the same time.

  16. Flight test of a decoupler pylon for wing/store flutter suppression

    Science.gov (United States)

    Cazier, F. W., Jr.; Kehoe, M. W.

    1986-01-01

    The decoupler pylon is a NASA concept of passive wing-store flutter suppression achieved by providing a low store-pylon pitch frequency. Flight tests were performed on an F-16 aircraft carrying on each wing an AIM-9J wingtip missile, a GBU-8 bomb near midspan, and an external fuel tank. Baseline flights with the GBU-8 mounted on a standard pylon established that this configuration is characterized by an antisymmetric limited amplitude flutter oscillation within the operational envelope. The airplane was then flown with the GBU-8 mounted on the decoupler pylon. The decoupler pylon successfully suppressed wing-store flutter throughout the flight envelope. A 37-percent increase in flutter velocity over the standard pylon was demonstrated. Maneuvers with load factors to 4g were performed. Although the static store displacements during maneuvers were not sufficiently large to be of concern, a store pitch alignment system was tested and performed successfully. One GBU-8 was ejected demonstrating that weapon separation from the decoupler pylon is normal. Experience with the present decoupler pylon design indicated that friction in the pivoting mechanism could affect its proper functioning as a flutter suppressor.

  17. Flight Flutter Modal Parameters Identification with Atmospheric Turbulence Excitation Based on Wavelet Transformation

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    In view of the feature of flight flutter test data with atmospheric turbulence excitation, a method which combines wavelet transformation with random decrement technique for identifying flight flutter modal parameters is presented. This approach firstly uses random decrement technique to gain free decays corresponding to the acceleration response of the structure to some non-zero initial conditions. Then the continuous Morlet wavelet transformation of the free decays is performed; and the Parseval formula and residue theorem are used to simplify the transformation. The maximal wavelet transformation coefficients in different scales are searched out by means of band-filtering characteristic of Morlet wavelet, and then the modal parameters are identified according to the relationships with maximal modulus and angle of the wavelet transform. In addition, the condition of modal uncoupling is discussed according to variation trend of flight flutter modal parameters in the flight flutter state. The analysis results of simulation and flight flutter test data show that this approach is not only simple, effective and feasible, but also having good noise immunity.

  18. Evaluation of four subcritical response methods for on-line prediction of flutter onset in wind-tunnel tests

    Science.gov (United States)

    Ruhlin, C. L.; Watson, J. J.; Ricketts, R. H.; Doggett, R. V., Jr.

    1982-01-01

    Four subcritical response methods were evaluated for on-line use in transonic wind-tunnel tests where the flutter model is excited solely by airstream turbulence. The methods were: randomdec, power-spectral-density, peak-hold, and cross-spectrum. Subcritical response data were obtained during tests in the Langley Transonic Dynamics Tunnel of a cantilevered flutter model wing. The test procedure was to maintain a constant Mach number and increase the dynamic pressure (q) in incremental steps. The four methods provided damping trends by which the flutter mode could be tracked and extrapolated to a flutter-onset q. A hard flutter point was obtained at M = 0.82. The peak-mold and cross-spectrum methods gave reliable results and could be most readily used for on-line testing.

  19. Comparison of analysis and flight test data for a drone aircraft with active flutter suppression

    Science.gov (United States)

    Newsom, J. R.; Pototzky, A. S.

    1981-01-01

    A drone aircraft equipped with an active flutter suppression system is considered with emphasis on the comparison of modal dampings and frequencies as a function of Mach number. Results are presented for both symmetric and antisymmetric motion with flutter suppression off. Only symmetric results are given for flutter suppression on. Frequency response functions of the vehicle are presented from both flight test data and analysis. The analysis correlation is improved by using an empirical aerodynamic correction factor which is proportional to the ratio of experimental to analytical steady-state lift curve slope. The mathematical models are included and existing analytical techniques are described as well as an alternative analytical technique for obtaining closed-loop results.

  20. Atrial Arrhythmia Summit: Post Summit Report

    Science.gov (United States)

    Barr, Yael

    2010-01-01

    The Atrial Arrhythmia Summit brought together nationally and internationally recognized experts in cardiology, electrophysiology, exercise physiology, and space medicine in an effort to elucidate the mechanisms, risk factors, and management of atrial arrhythmias in the unique occupational cohort of the U.S. astronaut corps.

  1. Corticosteroids and the risk of atrial fibrillation

    NARCIS (Netherlands)

    van der Hooft, CS; Heeringa, J; Brusselle, GG; Hofman, A; Witteman, JCM; Kingma, JH; Sturkenboom, MCJM; Stricker, BHC

    2006-01-01

    Background: High-dose ( pulse) corticosteroid therapy has been associated with the development of atrial fibrillation. This association, however, is mainly based on case reports. Methods: To test the hypothesis that high-dose corticosteroid exposure increases the risk of new-onset atrial fibrillatio

  2. A novel and simple atrial retractor.

    Science.gov (United States)

    Kofidis, Theo; Lee, Chuen Neng

    2011-05-01

    Minimally invasive cardiac operations require specialized equipment. Atrial retractors are a frequently used tool to expose heart valves for minimally invasive and open procedures. The models currently available in the market are efficient; however, they may be complex, bulky, or expensive. We introduce a novel, very simple atrial retractor we designed using ubiquitously available materials.

  3. PAROXYSMAL ATRIAL FIBRILLATION: CHOICE OF CARDIOVERSION THERAPY

    Directory of Open Access Journals (Sweden)

    B. A. Tatarskii

    2007-01-01

    Full Text Available Characteristics and classification of different patterns of paroxysmal atrial fibrillation are presented. Main indications to restoration of sinus rhythm are discussed. The features of main medications used to terminate of atrial fibrillation are given. The choice of antiarrhythmic drug is considerate. Necessity of individual approach to therapy tactics is proved.

  4. Atrial Remodeling And Atrial Fibrillation: Mechanistic Interactions And Clinical Implications

    OpenAIRE

    2009-01-01

    Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. The prevalence of AF increases dramatically with age and is seen in as high as 9% of individuals by the age of 80 years. In high-risk patients, the thromboembolic stroke risk can be as high as 9% per year and is associated with a 2-fold increase in mortality. Although the pathophysiological mechanism underlying the genesis of AF has been the focus of many studies, it remains only partially understood. Conventional th...

  5. Stall flutter and nonlinear divergence of a two-dimensional flat plate wing

    Science.gov (United States)

    Dugundji, J.; Aravamudan, K.

    1976-01-01

    Tests were conducted in a small wind tunnel to study the torsional stall flutter behavior of a two-dimensional flat-plate wing pivoted about the midchord. The nonlinear static divergence equilibrium properties of the wing were well predicted from the measured static moment characteristics. Large amplitude limit cycles ranging from plus or minus 11 degrees to plus or minus 100 degrees were observed. Stall flutter occurred above a critical value of a reduced frequency of about 2. Self-excitation occurred for initial angles of attack between 0 and 8 degrees. Nondimensional harmonic coefficients were extracted from the free transient vibration tests for amplitudes up to 80 degrees.

  6. Uncertainty Quantification of the FUN3D-Predicted NASA CRM Flutter Boundary

    Science.gov (United States)

    Stanford, Bret K.; Massey, Steven J.

    2017-01-01

    A nonintrusive point collocation method is used to propagate parametric uncertainties of the flexible Common Research Model, a generic transport configuration, through the unsteady aeroelastic CFD solver FUN3D. A range of random input variables are considered, including atmospheric flow variables, structural variables, and inertial (lumped mass) variables. UQ results are explored for a range of output metrics (with a focus on dynamic flutter stability), for both subsonic and transonic Mach numbers, for two different CFD mesh refinements. A particular focus is placed on computing failure probabilities: the probability that the wing will flutter within the flight envelope.

  7. Identification of Flutter Derivatives of Bridge Decks in Wind Tunnel Test by Stochastic Subspace Identification

    Directory of Open Access Journals (Sweden)

    T. Janesupasaeree

    2009-01-01

    Full Text Available Problem statement: Flutter derivatives are the essential parameters in the estimations of the flutter critical wind velocity and the responses of long-span cable supported bridges. These derivatives can be experimentally estimated from wind tunnel test results. Generally, wind tunnel test methods can be divided into free decay test and buffeting test. Compared with the free decay method, the buffeting test is simpler but its outputs appear random-like. This makes the flutter derivatives extraction from its outputs more difficult and then a more advanced system identification is required. Most of previous studies have used deterministic system identification techniques, in which buffeting forces and responses are considered as noises. These previous techniques were applicable only to the free decay method. They also confronted some difficulties in extracting flutter derivatives at high wind speeds and under turbulence flow cases where the buffeting responses dominate. Approach: In this study, the covariance-driven stochastic subspace identification technique (SSI-COV was presented to extract the flutter derivatives of bridge decks from the buffeting test results. An advantage of this method is that it considers the buffeting forces and responses as inputs rather than as noises. Numerical simulations and wind tunnel tests of a streamlined thin plate model conducted under smooth flow by the free decay and the buffeting tests were used to validate the applicability of the SSI-COV method. Then, wind tunnel tests of a two-edge girder blunt type of Industrial-Ring-Road Bridge deck (IRR were conducted under smooth and turbulence flow. Results: The identified flutter derivatives of the thin plate model by the SSI-COV technique agree well with those obtained theoretically. The results from the thin plate and the IRR Bridge deck validated the reliability and applicability of the SSI-COV technique to various experimental methods and conditions of wind flow

  8. Flutter parametric studies of cantilevered twin-engine-transport type wing with and without winglet. Volume 1: Low-speed investigations

    Science.gov (United States)

    Bhatia, K. G.; Nagaraja, K. S.

    1984-01-01

    Flutter characteristics of a cantilevered high aspect ratio wing with winglet were investigated. The configuration represented a current technology, twin-engine airplane. A low-speed and high-speed model were used to evaluate compressibility effects through transonic Mach numbers and a wide range of mass-density ratios. Four flutter mechanisms were obtained in test, as well as analysis from various combinations of configuration parameters. The coupling between wing tip vertical and chordwise motions was shown to have significant effect under some conditions. It is concluded that for the flutter model configurations studied, the winglet related flutter was amenable to the conventional flutter analysis techniques.

  9. Atrial fibrillation in patients with ischemic stroke

    DEFF Research Database (Denmark)

    Thygesen, Sandra Kruchov; Frost, Lars; Eagle, Kim A;

    2009-01-01

    BACKGROUND: Atrial fibrillation is a major risk factor for ischemic stroke. However, the prognostic impact of atrial fibrillation among patients with stroke is not fully clarified. We compared patient characteristics, including severity of stroke and comorbidity, quality of in-hospital care...... and outcomes in a cohort of first-time ischemic stroke patients with and without atrial fibrillation. METHODS: Based on linkage of public medical databases, we did a population-based follow-up study among 3,849 stroke patients from the County of Aarhus, Denmark admitted in the period of 2003......-2007 and prospectively registered in the Danish National Indicator Project. RESULTS: Atrial fibrillation was associated with an adverse prognostic profile but not with an overall poorer quality of in-hospital care. Patients with atrial fibrillation had a longer total length of stay (median: 15 vs 9 days), and were...

  10. Galectin-3 in patients undergoing ablation of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Nicolas Clementy

    2014-11-01

    Conclusions: Persistent type of atrial fibrillation is an independent predictor of higher Galectin-3 concentration. This biomarker of fibrosis may be implied in the mechanisms of atrial remodeling and maintenance of atrial fibrillation, and thus be helpful for the design of therapeutic strategy in patients with atrial fibrillation.

  11. Artificial atrial fibrillation in the dog. An artifact?

    NARCIS (Netherlands)

    Strackee, J.; Hoelen, A.J.; Zimmerman, A.N.E.; Meijler, F.L.

    1971-01-01

    R-R interval sequences during artificial atrial fibrillation in dogs were studied in the same way as in patients in a previous study and compared with results obtained in dogs with spontaneous atrial fibrillation. Artificial atrial fibrillation was effected by right atrial stimulation in three close

  12. Impact of different ablation strategies on the delayed cure after trans-catheter ablation for treating patients with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    DONG Jian-zeng; MA Chang-sheng; LIU Xing-peng; LONG De-yong; LIU Xiao-qing; WANG Jing; Fang Dong-ping; HAO Peng; LI Yong-sheng; LIU Chuang

    2005-01-01

    Background Delayed cure had been observed in recurrent cases after index ablation of atrial fibrillation (AF), however, its mechanism and incidence have not been elucidated in detail. This study aims to investigate the impact of different ablation strategies on the incidence of delayed cure and its possible mechanisms after trans-catheter ablation of AF. Methods One hundred and fifty-one consecutive cases with highly symptomatic, drug refractory AF were included in this study [M/F=109/42, mean age (56.0±11.2) (18-79) years]. Segmental pulmonary vein ablation (SPVA) was performed in 83 patients with the guidance of circular mapping catheter (SPVA Group), circumferential PV linear ablation (CPVA) was carried out in the rest 68 cases under the guidance of 3 dimensional mapping system in conjunction with circular mapping catheter (CPVA Group). Delayed cure was defined as that early recurrence of atrial tachyarrhythmias (AF, atrial tachycardia, or atrial flutter) after ablation procedure was no longer observed during subsequent follow-up, and stable sinus rhythm was maintained ≥2 months. Results Early recurrence of atrial tachyarrhythmias was detected in 41 cases from SPVA group and 23 cases from CPVA group, and delayed cure occurred in 21.9% (9/41) of the cases from SPVA group and 47.8% (11/23) of the cases from CPVA group, more delayed cure in later group was observed (P<0.05). Meanwhile, patients in SPVA group took a longer time to achieve a delayed cure [(27.0±18.0) days vs (14.0±8.1) days, P<0.05], and presented more recurrent episodes [(3.50±1.08) times a week vs (2.42±1.11) times a week, P<0.05]. However, recurrent episodes after index ablation were markedly decreased in cases with delayed cure from both groups (P<0.05). Conclusions Despite of an early recurrence of atrial tachyarrhythimas after index ablation of AF, delayed cure occurs in a significant number of patients undergoing either SPVA or CPVA. However, different ablation strategies place

  13. Geared-elevator flutter study. [wind tunnel tests of transonic flutter effects on control surfaces of supersonic transport tail assemblies, conducted in a NASA-Langley transonic wind tunnel

    Science.gov (United States)

    Ruhlin, C. L.; Doggett, R. V., Jr.; Gregory, R. A.

    1976-01-01

    An experimental and analytical study was made of the transonic flutter characteristics of a supersonic transport tail assembly model having an all-movable, horizontal tail with a geared elevator. Two model configurations, namely, one with a gear-elevator (2.8 to 1.0 gear ratio) and one with locked-elevator (1.0 to 1.0 gear ratio), were flutter tested in the Langley transonic dynamics tunnel with an empennage cantilever-mounted on a sting. The geared-elevator configuration fluttered experimentally at about 20% higher dynamic pressures than the locked-elevator configuration. The experimental flutter dynamic pressure boundaries for both configurations were nearly flat over a Mach number range from 0.9 to 1.1. Flutter calculations (mathematical models) were made for the geared-elevator configuration using three subsonic lifting-surface methods. In one method, the elevator was treated as a discrete surface, and in the other two methods, the stabilizer and elevator were treated as a single warped-surface with the primary difference between these two methods being in the mathematical implementation used. A comparison of the experimental and analytical results shows that the discrete-elevator method predicted best the experimental flutter dynamic pressure level. However, the single warped-surface methods predicts more closely the experimental flutter frequencies and Mach number trends.

  14. Flutter parametric studies of cantilevered twin-engine transport type wing with and without winglet. Volume 2: Transonic and density effect investigations

    Science.gov (United States)

    Bhatia, K. G.; Nagaraja, K. S.

    1984-01-01

    Flutter characteristics of a cantilevered high aspect ratio wing with winglet were investigated. The configuration represented a current technology, twin engine airplane. Compressibility effects through transonic Mach numbers and a wide range of mass-density ratios were evaluated on a low speed and high speed model. Four flutter mechanisms were obtained from test, and analysis from various combinations of configuration parameters. It is shown that the coupling between wing tip vertical and chordwise motions have significant effect under some conditions. It is concluded that for the flutter model configurations studied, the winglet related flutter is amenable to the conventional flutter analysis techniques. The low speed model flutter and the high-speed model flutter results are described.

  15. Surgical Treatment of Concomitant Atrial Fibrillation: Focus onto Atrial Contractility

    Directory of Open Access Journals (Sweden)

    Claudia Loardi

    2015-01-01

    Full Text Available Background. Maze procedure aims at restoring sinus rhythm (SR and atrial contractility (AC. This study evaluated multiple aspects of AC recovery and their relationship with SR regain after ablation. Methods. 122 mitral and fibrillating patients underwent radiofrequency Maze. Rhythm check and echocardiographic control of biatrial contractility were performed at 3, 6, 12, and 24 months postoperatively. A multivariate Cox analysis of risk factors for absence of AC recuperation was applied. Results. At 2-years follow-up, SR was achieved in 79% of patients. SR-AC coexistence increased from 76% until 98%, while biatrial contraction detection augmented from 84 to 98% at late stage. Shorter preoperative arrhythmia duration was the only common predictor of SR-AC restoring, while pulmonary artery pressure (PAP negatively influenced AC recuperation. Early AC restoration favored future freedom from arrhythmia recurrence. Minor LA dimensions correlated with improved future A/E value and vice versa. Right atrial (RA contractility restoring favored better left ventricular (LV performance and volumes. Conclusions. SR and left AC are two interrelated Maze objectives. Factors associated with arrhythmia “chronic state” (PAP and arrhythmia duration are negative predictors of procedural success. Our results suggest an association between postoperative LA dimensions and “kick” restoring and an influence of RA contraction onto LV function.

  16. Left atrial ball valve thrombus

    Directory of Open Access Journals (Sweden)

    R. Balaji

    2013-10-01

    Full Text Available "Ball valve thrombus" which is a spherical free floating clot in left atrium is an often quoted, but uncommonly encountered complication in patients with severe mitral stenosis of rheumatic origin, who are in atrial fibrillation. We describe the case of a 31-year-old lady with rheumatic heart disease, severe mitral stenosis and moderately severe aortic stenosis who had undergone closed mitral valvotomy 13 years ago. The patient presented with an episode of non-exertional syncope and breathlessness on exertion of 6 months duration and was in normal sinus rhythm. Echocardiography facilitated ante-mortem diagnosis and prompt institution of surgery was life saving.

  17. Differential gene expression during atrial structural remodeling in human left and right atrial appendages in atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    Hui Zhu; Wei Zhang; Ming Zhong; Gong Zhang; Yun Zhang

    2011-01-01

    Extracellular matrix (ECM) remodeling increases the vulnerability to atrial fibrillation (AF). Some gene expressions are crucial for the metabolism of ECM. The left atrium plays an important role in maintaining AF.However, most studies investigated only the right atrial tissue. We therefore chose human tissue samples from both the left and right atrial to detect the different gene expressions during structural remodeling in AF. The atrial appendages tissue samples from 24 patients with chronic AF and 12 patients with sinus rhythm were obtained when they were undergoing mitral/aortic valve replacement operation. The mRNA levels of matrix metalloproteinases-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), disintegrin, metalloproteases-15, and integrins β1 were determined by reverse transcriptionpolymerase chain reaction (RT-PCR). in AF group, the level of MMP-9 in left atrial appendage (LAA) was increased (P<0.001), while integrin β1 level was decreased (P< 0.05) compared with those expressed in right atrial appendage (RAA) tissue. The levels of disintegrin, metalloproteinases-15, and TIMP-1 genes in the LAA and RAA had no significant differences. The results demonstrated that the gene expressions in the LAA and RAA are different during AF, which implied that the mechanism of atrial structural remodeling in AF is due to multiple sources and is complicated.

  18. Treatment of atrial fibrillation. Part II. Current realities and future prospects.

    Directory of Open Access Journals (Sweden)

    Bockeria L.A.

    Full Text Available Atrial fibrillation (AF is one of the most common arrhythmias in the world. It causes serious disturbances in cardiac hemodynamics and is dangerous because of its life-threatening consequences. The problem of treatment of AF is one the main and discussed problems in contemporary arrhythmology and cardiac surgery. Nowadays there are a lot of methods of treatment of atrial fibrillation, but their effectiveness and indications to them need a detailed analysis. Strategies of conservative therapy of AF help us to achieve sinus rhythm only in 50% cases. That's why the question of searching more effective surgical methods was obvious. First attempts in surgical treatment were made in 1980s. Such operations as left atrial isolation, His-bundle’s ablation and the “corridor” procedure were performed. But these operations were trying to isolate AF or to localize it in the certain part of atrium to minimize its negative effects on the ventricles, but the fibrillation was preserved. Fist operation eliminating AF was named Maze operation and was made in 1987 year. The conception of this operation is to create surgical incisions with cut and sew technique that helps us to divide atrial myocardium into the small segments that doesn’t allow macro-reentrant circuits to sustain. That's why the ability to fibrillate or to flutter is excluded. Later this operation had undergone several modifications what helped to correct its main disadvantages. Eventually Maze III operation became gold standard in AF treatment. But this operation was technically difficult and was not possible to be made by average surgeons. That’s why the necessity to search alternative energy sources to make ablation lines instead of surgical incisions and simplify the operation appeared. The main types of ablation used in this operation are cryoablation, radiofrequency, ultrasound and microwave ablation. In many investigations alternative energy sources are compared to each other to

  19. Mapping strategy for multiple atrial tachyarrhythmias in a transplant heart

    DEFF Research Database (Denmark)

    Jin, Qi; Pehrson, Steen; Jacobsen, Peter Karl;

    2015-01-01

    BACKGROUND: Different atrial arrhythmias can coexist in the recipient and donor atria after heart transplantation. CASE PRESENTATION: We report an unusual case of a patient with three different types of atrial arrhythmia after heart transplantation: an atrial fibrillation in the recipient atria....... CONCLUSIONS: It is critical to understand the surgical anatomy of a bi-atrial anastomosis and its relevant electrical activation pattern before ablation. Appropriate electroanatomical mapping strategy with RMN can facilitate the successful ablation of post-transplant atrial arrhythmias....

  20. Transonic flutter study of a wind-tunnel model of a supercritical wing with/without winglet

    Science.gov (United States)

    Ruhlin, C. L.; Rauch, F. J., Jr.; Waters, C.

    1982-01-01

    The scaled flutter model was a 1/6.5-size, semispan version of a supercritical wing (SCW) proposed for an executive-jet-transport airplane. The model was tested cantilever-mounted with a normal wingtip, a wingtip with winglet, and a normal wingtip ballasted to simulate the winglet mass properties. Flutter and aerodynamic data were acquired at Mach numbers from 0.6 to 0.95. The measured transonic flutter speed boundary for each wingtip configuration had roughly the same shape with a minimum flutter speed near M = 0.82. The winglet addition and wingtip mass ballast decreased the wing flutter speed by about 7 and 5%, respectively; thus, the winglet effect on flutter was more a mass effect than an aerodynamic effect. Flutter characteristics calculated using a doublet-lattice analysis (which included interference effects) were in good agreement with the experimental results up to M = 0.82. Comparisons of measured static aerodynamic data with predicted data indicated that the model was aerodynamically representative of the airplane SCW.

  1. Atrial fibrillation and survival in colorectal cancer

    Directory of Open Access Journals (Sweden)

    Justin Timothy A

    2004-11-01

    Full Text Available Abstract Background Survival in colorectal cancer may correlate with the degree of systemic inflammatory response to the tumour. Atrial fibrillation may be regarded as an inflammatory complication. We aimed to determine if atrial fibrillation is a prognostic factor in colorectal cancer. Patients and methods A prospective colorectal cancer patient database was cross-referenced with the hospital clinical-coding database to identify patients who had underwent colorectal cancer surgery and were in atrial fibrillation pre- or postoperatively. Results A total of 175 patients underwent surgery for colorectal cancer over a two-year period. Of these, 13 patients had atrial fibrillation pre- or postoperatively. Atrial fibrillation correlated with worse two-year survival (p = 0.04; log-rank test. However, in a Cox regression analysis, atrial fibrillation was not significantly associated with survival. Conclusion The presence or development of atrial fibrillation in patients undergoing surgery for colorectal cancer is associated with worse overall survival, however it was not found to be an independent factor in multivariate analysis.

  2. Anticoagulation therapy for atrial fibrillation.

    Science.gov (United States)

    Hylek, Elaine M

    2013-03-01

    Atrial fibrillation (AF) is the most common significant cardiac rhythm disorder, and its prevalence is increasing worldwide. Atrial fibrillation confers a fivefold increased risk of stroke, and these strokes are associated with significant mortality and disability. The vitamin K antagonist, warfarin, has been the mainstay of anticoagulant therapy for patients with AF, reducing the risk of stroke by 65%. Despite its efficacy, warfarin remains underused in clinical practice because of its variable dose response, diet and medication interactions, and need for frequent monitoring. Stroke prevention in AF has entered an exciting therapeutic era with new classes of targeted anticoagulants that avoid the many pitfalls of the vitamin K antagonists. Dabigatran, an oral thrombin inhibitor, and the factor Xa inhibitors, rivaroxaban and apixaban, have demonstrated efficacy for stroke prevention and a reduced risk of intracranial hemorrhage relative to warfarin. Translating the efficacy of clinical trials into effective use of these novel agents in clinical practice will require an understanding of their pharmacokinetic profiles, dose selection, and management in select clinical situations.

  3. Computed and Experimental Flutter/LCO Onset for the Boeing Truss-Braced Wing Wind-Tunnel Model

    Science.gov (United States)

    Bartels, Robert E.; Scott, Robert C.; Funk, Christie J.; Allen, Timothy J.; Sexton, Bradley W.

    2014-01-01

    This paper presents high fidelity Navier-Stokes simulations of the Boeing Subsonic Ultra Green Aircraft Research truss-braced wing wind-tunnel model and compares the results to linear MSC. Nastran flutter analysis and preliminary data from a recent wind-tunnel test of that model at the NASA Langley Research Center Transonic Dynamics Tunnel. The simulated conditions under consideration are zero angle of attack, so that structural nonlinearity can be neglected. It is found that, for Mach number greater than 0.78, the linear flutter analysis predicts flutter onset dynamic pressure below the wind-tunnel test and that predicted by the Navier-Stokes analysis. Furthermore, the wind-tunnel test revealed that the majority of the high structural dynamics cases were wing limit cycle oscillation (LCO) rather than flutter. Most Navier-Stokes simulated cases were also LCO rather than hard flutter. There is dip in the wind-tunnel test flutter/LCO onset in the Mach 0.76-0.80 range. Conditions tested above that Mach number exhibited no aeroelastic instability at the dynamic pressures reached in the tunnel. The linear flutter analyses do not show a flutter/LCO dip. The Navier-Stokes simulations also do not reveal a dip; however, the flutter/LCO onset is at a significantly higher dynamic pressure at Mach 0.90 than at lower Mach numbers. The Navier-Stokes simulations indicate a mild LCO onset at Mach 0.82, then a more rapidly growing instability at Mach 0.86 and 0.90. Finally, the modeling issues and their solution related to the use of a beam and pod finite element model to generate the Navier-Stokes structure mode shapes are discussed.

  4. Study and Analysis on the Influence of Flutter Frequency on Airplane Stability

    Directory of Open Access Journals (Sweden)

    B. Janarthanan

    2013-10-01

    Full Text Available In the nationwide requirement of the growth in commercial aviation safety and profit, the field of Aeroelastic science plays a vital role. Flutter is one of the dynamic aeroelastic problems, it mainly occurs at lifting surfaces when the airplane cruises at high speeds. At relatively low speeds, the torsional stiffness of the wing is enough to counteract the twisting. However, the variation in flutter frequency causes the instability motion on aircraft. Therefore, the wing displacement against the flow field plays a vital role in dynamic stability analysis. As per the commercial aviation concern, an aircraft which is able to overcome the significant aeroelastic problems can yield maximum running profit. In order to maintain the airplane stability in high-speed, wings can be designed to minimize the distance between aerodynamic centre and shear centre (on the elastic axis. The main focus of this project is to calculate the frequency of an aircraft wing while it is subjected to aeroelastic (flutter instability. The analytical process identified for this work is the Eigen value method. By using MATLAB solver, the optimization has been carried out along the span of real-time model. In future, the efficient structural model is then simulated and analysis is carried out to evaluate the longitudinal stability due to flutter phenomena.

  5. Nonlinear flutter wind tunnel test and numerical analysis of folding fins with freeplay nonlinearities

    Institute of Scientific and Technical Information of China (English)

    Yang Ning; Wang Nan; Zhang Xin; Liu Wei

    2016-01-01

    The flutter characteristics of folding control fins with freeplay are investigated by numer-ical simulation and flutter wind tunnel tests. Based on the characteristics of the structures, fins with different freeplay angles are designed. For a 0? angle of attack, wind tunnel tests of these fins are conducted, and vibration is observed by accelerometers and a high-speed camera. By the expansion of the connected relationships, the governing equations of fit for the nonlinear aeroelastic analysis are established by the free-interface component mode synthesis method. Based on the results of the wind tunnel tests, the flutter characteristics of fins with different freeplay angles are analyzed. The results show that the vibration divergent speed is increased, and the divergent speed is higher than the flutter speed of the nominal linear system. The vibration divergent speed is increased along with an increase in the freeplay angle. The developed free-interface component mode synthesis method could be used to establish governing equations and to analyze the characteristics of nonlinear aeroe-lastic systems. The results of the numerical simulations and the wind tunnel tests indicate the same trends and critical velocities.

  6. Experimental unsteady pressures at flutter on the Supercritical Wing Benchmark Model

    Science.gov (United States)

    Dansberry, Bryan E.; Durham, Michael H.; Bennett, Robert M.; Rivera, Jose A.; Silva, Walter A.; Wieseman, Carol D.; Turnock, David L.

    1993-01-01

    This paper describes selected results from the flutter testing of the Supercritical Wing (SW) model. This model is a rigid semispan wing having a rectangular planform and a supercritical airfoil shape. The model was flutter tested in the Langley Transonic Dynamics Tunnel (TDT) as part of the Benchmark Models Program, a multi-year wind tunnel activity currently being conducted by the Structural Dynamics Division of NASA Langley Research Center. The primary objective of this program is to assist in the development and evaluation of aeroelastic computational fluid dynamics codes. The SW is the second of a series of three similar models which are designed to be flutter tested in the TDT on a flexible mount known as the Pitch and Plunge Apparatus. Data sets acquired with these models, including simultaneous unsteady surface pressures and model response data, are meant to be used for correlation with analytical codes. Presented in this report are experimental flutter boundaries and corresponding steady and unsteady pressure distribution data acquired over two model chords located at the 60 and 95 percent span stations.

  7. Flutter Analysis of the Thermal Protection Layer on the NASA HIAD

    Science.gov (United States)

    Goldman, Benjamin D.; Dowell, Earl H.; Scott, Robert C.

    2013-01-01

    A combination of classical plate theory and a supersonic aerodynamic model is used to study the aeroelastic flutter behavior of a proposed thermal protection system (TPS) for the NASA HIAD. The analysis pertains to the rectangular configurations currently being tested in a NASA wind-tunnel facility, and may explain why oscillations of the articles could be observed. An analysis using a linear flat plate model indicated that flutter was possible well within the supersonic flow regime of the wind tunnel tests. A more complex nonlinear analysis of the TPS, taking into account any material curvature present due to the restraint system or substructure, indicated that significantly greater aerodynamic forcing is required for the onset of flutter. Chaotic and periodic limit cycle oscillations (LCOs) of the TPS are possible depending on how the curvature is imposed. When the pressure from the base substructure on the bottom of the TPS is used as the source of curvature, the flutter boundary increases rapidly and chaotic behavior is eliminated.

  8. On the interrelation of divergence, flutter and auto-parametric resonance.

    Science.gov (United States)

    Herrmann, G.; Hauger, W.

    1973-01-01

    The dependence between static instability and kinetic instability (flutter) on autoparameteric resonance is studied by taking compressibility into account in a model of a cantilever beam under the action of a follower force. It is shown that both instabilities are formally special cases of instabilities known as subharmonic and combination resonances.

  9. Effect of blade flutter and electrical loading on small wind turbine noise

    Science.gov (United States)

    The effect of blade flutter and electrical loading on the noise level of two different size wind turbines was investigated at the Conservation and Production Research Laboratory (CPRL) near Bushland, TX. Noise and performance data were collected on two blade designs tested on a wind turbine rated a...

  10. Comparison of driven and simulated "free" stall flutter in a wind tunnel

    Science.gov (United States)

    Culler, Ethan; Farnsworth, John; Fagley, Casey; Seidel, Jurgen

    2016-11-01

    Stall flutter and dynamic stall have received a significant amount of attention over the years. To experimentally study this problem, the body undergoing stall flutter is typically driven at a characteristic, single frequency sinusoid with a prescribed pitching amplitude and mean angle of attack offset. This approach allows for testing with repeatable kinematics, however it effectively decouples the structural motion from the aerodynamic forcing. Recent results suggest that this driven approach could misrepresent the forcing observed in a "free" stall flutter scenario. Specifically, a dynamically pitched rigid NACA 0018 wing section was tested in the wind tunnel under two modes of operation: (1) Cyber-Physical where "free" stall flutter was physically simulated through a custom motor-control system modeling a torsional spring and (2) Direct Motor-Driven Dynamic Pitch at a single frequency sinusoid representative of the cyber-physical motion. The time-resolved pitch angle and moment were directly measured and compared for each case. It was found that small deviations in the pitch angle trajectory between these two operational cases generate significantly different aerodynamic pitching moments on the wing section, with the pitching moments nearly 180o out of phase in some cases. This work is supported by the Air Force Office of Scientific Research through the Flow Interactions and Control Program and by the National Defense Science and Engineering Graduate Fellowship Program.

  11. Flutter and thermal buckling control for composite laminated panels in supersonic flow

    Science.gov (United States)

    Li, Feng-Ming; Song, Zhi-Guang

    2013-10-01

    Aerothermoelastic analysis for composite laminated panels in supersonic flow is carried out. The flutter and thermal buckling control for the panels are also investigated. In the modeling for the equation of motion, the influences of in-plane thermal load on the transverse bending deflection are taken into account, and the unsteady aerodynamic pressure in supersonic flow is evaluated by the linear piston theory. The governing equation of the structural system is developed applying the Hamilton's principle. In order to study the influences of aerodynamic pressure on the vibration mode shape of the panel, both the assumed mode method (AMM) and the finite element method (FEM) are used to derive the equation of motion. The proportional feedback control method and the linear quadratic regulator (LQR) are used to design the controller. The aeroelastic stability of the structural system is analyzed using the frequency-domain method. The effects of ply angle of the laminated panel on the critical flutter aerodynamic pressure and the critical buckling temperature change are researched. The flutter and thermal buckling control effects using the proportional feedback control and the LQR are compared. An effective method which can suppress the flutter and thermal buckling simultaneously is proposed.

  12. Aircraft Flutter Modal Parameter Identification Using a Numerically Robust Least-squares Estimator in Frequency Domain

    Institute of Scientific and Technical Information of China (English)

    Tang Wei; Shi Zhongke; Chen Jie

    2008-01-01

    Recently, frequency-based least-squares (LS) estimators have found wide application in identifying aircraft flutter parameters. However, the frequency methods are often known to suffer from numerical difficulties when identifying a continuous-time model, espe-cially, of broader frequency or higher order. In this article, a numerically robust LS estimator based on vector orthogonal polynomial is proposed to solve the numerical problem of multivariable systems and applied to the flutter testing. The key idea of this method is to represent the frequency response function (FRF) matrix by a right matrix fraction description (RMFD) model, and expand the numerator and denominator polynomial matrices on a vector onhogonal basis. As a result, a perfect numerical condition (numerical condition equals 1) can be obtained for linear LS estimator. Finally, this method is verified by flutter test of a wing model in a wind tunnel and real flight flutter test of an aircraft. The results are compared to those with notably LMS PolyMAX, which is not troubled by the numerical problem as it is established in z domain (e.g. derived from a discrete-time model). The verification has evidenced that this method, apart from overcoming the numerical problem, yields the results comparable to those acquired with LMS PolyMAX, or even considerably better at some frequency bands.

  13. Aeroservoelastic Pitch Control of Stall-Induced Flap/Lag Flutter of Wind Turbine Blade Section

    Directory of Open Access Journals (Sweden)

    Tingrui Liu

    2015-01-01

    Full Text Available The aim of this paper is to analyze aeroelastic stability, especially flutter suppression for aeroelastic instability. Effects of aeroservoelastic pitch control for flutter suppression on wind turbine blade section subjected to combined flap and lag motions are rarely studied. The work is dedicated to solving destructive flapwise and edgewise instability of stall-induced flutter of wind turbine blade by aeroservoelastic pitch control. The aeroelastic governing equations combine a flap/lag structural model and an unsteady nonlinear aerodynamic model. The nonlinear resulting equations are linearized by small perturbation about the equilibrium point. The instability characteristics of stall-induced flap/lag flutter are investigated. Pitch actuator is described by a second-order model. The aeroservoelastic control is analyzed by three types of optimal PID controllers, two types of fuzzy PID controllers, and neural network PID controllers. The fuzzy controllers are developed based on Sugeno model and intuition method with good results achieved. A single neuron PID control strategy with improved Hebb learning algorithm and a radial basic function neural network PID algorithm are applied and performed well in the range of extreme wind speeds.

  14. Nonlinear flutter wind tunnel test and numerical analysis of folding fins with freeplay nonlinearities

    Directory of Open Access Journals (Sweden)

    Yang Ning

    2016-02-01

    Full Text Available The flutter characteristics of folding control fins with freeplay are investigated by numerical simulation and flutter wind tunnel tests. Based on the characteristics of the structures, fins with different freeplay angles are designed. For a 0° angle of attack, wind tunnel tests of these fins are conducted, and vibration is observed by accelerometers and a high-speed camera. By the expansion of the connected relationships, the governing equations of fit for the nonlinear aeroelastic analysis are established by the free-interface component mode synthesis method. Based on the results of the wind tunnel tests, the flutter characteristics of fins with different freeplay angles are analyzed. The results show that the vibration divergent speed is increased, and the divergent speed is higher than the flutter speed of the nominal linear system. The vibration divergent speed is increased along with an increase in the freeplay angle. The developed free-interface component mode synthesis method could be used to establish governing equations and to analyze the characteristics of nonlinear aeroelastic systems. The results of the numerical simulations and the wind tunnel tests indicate the same trends and critical velocities.

  15. Vibration and Flutter Analysis of the B-29 - F-84 Tip-to-Tip Configuration

    Science.gov (United States)

    1949-01-01

    OKT t.;. MDCEL JJL E-5JLF-MX1Q16- , B-29 - F-a’ and are taken outalde the Integral sign , however, the varying chord renaina under the... Integral sign * - c) Flutter Determinant igiai The lagran i n equations of notion may be written for a fixed value of ^ *i.(t

  16. Application of output feedback sliding mode control to active flutter suppression of two-dimensional airfoil

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    The effectiveness of the sliding mode control(SMC) method for active flutter suppression(AFS) and the issues concerning control system discretization and control input constraints were studied using a typical two-dimensional airfoil.The airfoil has a trailing-edge flap for flutter control.The aeroelastic system involves a two-degrees-of-freedom motion(pitch and plunge),and the equations were constructed by utilizing quasi-steady aerodynamic forces.The control system,designed by the output feedback SMC method,was incorporated to suppress the pitch-plunge flutter.Meanwhile,the system discretization and the flap deflection constraints were implemented.Then,a classical Runge-Kutta(RK) algorithm was utilized for numerical calculations.The results indicated that the close-loop system with the SMC system could be stable at a speed above the flutter boundary.However,when the flap deflection limits are reached,the close-loop system with the simple discretized control system loses control.Furthermore,control compensation developed by theoretical analysis was proposed to make the system stable again.The parameter perturbations and the time delay effects were also discussed in this paper.

  17. Some observations on the Houbolt-Rainey and peak-hold methods of flutter onset prediction

    Science.gov (United States)

    Doggett, Robert V., Jr.

    1990-01-01

    A subcritical response method for flutter onset prediction developed by Houbolt and Rainey in 1958 is compared with the Peak-Hold Method which was apparently first applied to flutter onset prediction by Sandford, Abel, and Gray in the early 1970's. The rational argument presented shows that the two methods are not different, but are actually the same. So, because there is an analytical foundation for the Houbolt-Rainey Method, then there is the same analytical foundation for the Peak-Hold Method. Further, it is suggested that, in applying Peak-Hold Method in cases where turbulence is used as the excitation force, the variation of the reciprocal of the response amplitude with the reciprocal of the dynamic pressure to be used to extrapolate to flutter onset rather than the variation with dynamic pressure which is the current practice because the linear trend which is predicted to occur for the former is easier to extrapolate to the flutter condition than the nonlinear trend predicted to occur for the latter.

  18. Impact of pulmonary vein isolation on atrial vagal activity and atrial electrical remodeling

    Institute of Scientific and Technical Information of China (English)

    Yingxue Dong; Shulong Zhang; Lianjun Gao; Hongwei Zhao; Donghui Yang; Yunlong Xia; Yanzong Yang

    2008-01-01

    Objective Mechanisms of pulmonary vein isolation (PVI) for atrial fibrillation remain controversy.This study aimed to investigate the impact of PVI on vagal modulation to atria.Methods Eighteen adult mongrel dogs under general anesthesia were randomly divided into two groups.Bilateral cervical sympathovagal trunks were decentralized and sympathetic effects was blocked by metoprolol administration.Atrial electrical remodeling (AER) was established by rapid right atrial pacing at the rate of 600 bpm for 30 minutes.PVI was performed in group A.Atrial effective refractory period (ERP),vulnerability window (VW) of atrial fibrillation,and sinus rhythm cycle length (SCL) were measured at baseline and during vagal stimulation before and after atrial rapid pacing with and without PVI at fight atrial appendage (RAA),left atrial appendage (LAA),distal coronary sinus (CSd) and proximal coronary sinus (CSp).Results (1) Effects of PVI on vagal modulation:Shortening of SCL during vagal stimulation decreased significantly after PVI compared with that before PVI in group A (P<0.001).Shortening of ERP during vagal stimulation decreaseed significantly after PVI compared with that before PVI (P<0.05).VW of atrial fibrillation during vagal stimulation decreased significantly after PVI compared with that before PVI (P<0.05).(2) Effects of PVI on AER:shortening of ERP before and after atrial rapid pacing increased significantly at baseline and vagal stimulation in group B compared with that in group A (P<0.05).VW during vagal stimulation increased significantly after atrial rapid pacing in group B (P<0.05).Conclusion PVI attenuates the vagal modulation to the atria,thereby decreases the susceptibility to atrial fibrillation mediated by vagal activity.PVI releases AER,which maybe contributes to the vagal denervation.Our study indicates that PVI not only can eradicate triggered foci but also modify substrates for AF.(J Geriatr Cardiol 2008;5:28-32)

  19. The circadian variation of premature atrial contractions

    DEFF Research Database (Denmark)

    Strøier Larsen, Bjørn; Kumarathurai, Preman; Wendelboe Nielsen, Olav;

    2016-01-01

    AIMS: The aim of the study was to assess a possible circadian variation of premature atrial contractions (PACs) in a community-based population and to determine if the daily variation could be used to assess a more vulnerable period of PACs in predicting later incidence of atrial fibrillation (AF...... variation in heart rate. After adjusting for relevant risk factors, the risk of AF was equal in all time intervals throughout the day. CONCLUSION: Premature atrial contractions showed a circadian variation in subjects with frequent PACs. No specific time interval of the day was more predictive of AF than...

  20. Ablation of the atrioventricular node executed after paranodal ablation of the atrioventricular node for the treatment of paroxysmal atrial-ventricular node of reentry tachycardia in conditions of artificial blood circulation

    Directory of Open Access Journals (Sweden)

    Melikulov A.Kh.

    2014-03-01

    Full Text Available In this clinical observation is shown the data of the patient who was previously undergone paranodal ablation of atrial-ventricular junction for the treatment of atrioventricular (AV nodal reentrant tachycardia. Radiofrequency ablation of right lower isthmus for treatment of the paroxysmal form of atrial flutter was made for the patient. Sick sinus node syndrome and paroxysmal form of atrial fibrillation were diagnosed. Then dual-chamber pacemaker was implanted. Antiarrhythmic therapy about the persistent form of atrial fibrillation had no effect. The decision for the implementation of radio frequency modification of atrioventricular connection using right ventriclar access failed because of the lack of verification of the His bundle's spike. Using retrograde access through the aorta we managed to create AV blockade of III degree. Taking into account the fact that in 1990-ies patients with atrioventricular nodal reentrant tachycardia were operated using paranodal ablation of the AV node using extracorporeal circulation, this case has a practical significance when endovascular catheter modification of AV nodal conduction in this category of patients is made.

  1. Incidence, type of atrial fibrillation and risk factors for stroke: a population-based cohort study

    Science.gov (United States)

    Johansson, Cecilia; Dahlqvist, Erik; Andersson, Jonas; Jansson, Jan-Håkan; Johansson, Lars

    2017-01-01

    Purpose The aims of this study were to estimate the incidence of atrial fibrillation and atrial flutter (AF), to assess the presence of provoking factors and risk factors for stroke and systemic embolism, and to determine the type of AF in patients with first-diagnosed AF. Patients and methods This cohort study was performed in northern Sweden between January 1, 2011 and December 31, 2012. Diagnosis registries were searched for the International Classification of Diseases-10 code for AF (I48) to identify cases of incident AF. All AF diagnoses were electrocardiogram-verified. Data pertaining to provoking factors, type of AF and presence of risk factors for stroke and systemic embolism according to the CHA2DS2-VASc score were obtained from medical records. Results The incidence of AF in the entire population was 4.0 per 1,000 person-years. The incidence was 27.5 per 1,000 person-years in patients aged ≥80 years. A total of 21% of all patients had a provoking factor in association with the first-diagnosed episode of AF. The CHA2DS2-VASc score was 2 or higher in 81% of the patients. Permanent AF was the most common type of AF (29%). Conclusion There was a considerable increase in the incidence of AF with age, and a provoking factor was found in one-fifth. The most common type of AF was permanent AF. Four in five patients had a CHA2DS2-VASc score of 2 or more. PMID:28182159

  2. Towards Low Energy Atrial Defibrillation

    Directory of Open Access Journals (Sweden)

    Philip Walsh

    2015-09-01

    Full Text Available A wireless powered implantable atrial defibrillator consisting of a battery driven hand-held radio frequency (RF power transmitter (ex vivo and a passive (battery free implantable power receiver (in vivo that enables measurement of the intracardiac impedance (ICI during internal atrial defibrillation is reported. The architecture is designed to operate in two modes: Cardiac sense mode (power-up, measure the impedance of the cardiac substrate and communicate data to the ex vivo power transmitter and cardiac shock mode (delivery of a synchronised very low tilt rectilinear electrical shock waveform. An initial prototype was implemented and tested. In low-power (sense mode, >5 W was delivered across a 2.5 cm air-skin gap to facilitate measurement of the impedance of the cardiac substrate. In high-power (shock mode, >180 W (delivered as a 12 ms monophasic very-low-tilt-rectilinear (M-VLTR or as a 12 ms biphasic very-low-tilt-rectilinear (B-VLTR chronosymmetric (6ms/6ms amplitude asymmetric (negative phase at 50% magnitude shock was reliably and repeatedly delivered across the same interface; with >47% DC-to-DC (direct current to direct current power transfer efficiency at a switching frequency of 185 kHz achieved. In an initial trial of the RF architecture developed, 30 patients with AF were randomised to therapy with an RF generated M-VLTR or B-VLTR shock using a step-up voltage protocol (50–300 V. Mean energy for successful cardioversion was 8.51 J ± 3.16 J. Subsequent analysis revealed that all patients who cardioverted exhibited a significant decrease in ICI between the first and third shocks (5.00 Ω (SD(σ = 1.62 Ω, p < 0.01 while spectral analysis across frequency also revealed a significant variation in the impedance-amplitude-spectrum-area (IAMSA within the same patient group (|∆(IAMSAS1-IAMSAS3[1 Hz − 20 kHz] = 20.82 Ω-Hz (SD(σ = 10.77 Ω-Hz, p < 0.01; both trends being absent in all patients that failed to cardiovert

  3. Atrial Fibrillation and Stroke in Elderly Patients

    Directory of Open Access Journals (Sweden)

    Geetanjali Dang

    2016-11-01

    Full Text Available The increasing prevalence of stroke, with an estimated annual cost of $71.5 billion, has made it a major health problem that increases disability and death, particularly in patients with atrial fibrillation. Although advanced age and atrial fibrillation are recognized as strong risk factors for stroke, the basis for this susceptibility are not well defined. Aging or associated diseases are accompanied by changes in rheostatic, humoral, metabolic and hemodynamic factors that may contribute more to stroke predisposition than rhythm abnormality alone. Several thromboembolism-predisposing clinical characteristics and serum biomarkers with prognostic significance have been identified in patients with atrial fibrillation. Although anticoagulation decreases the risk of thromboembolism, management in the elderly remains complex due to major concerns about bleeding. New anticoagulants and nonpharmacologic strategies are helpful to reduce the risk of bleeding, particularly in older-elderly patients. Herein, we review the pathogenesis and management of select issues of thromboembolism in the elderly with atrial fibrillation.

  4. POSTOPERATIVE ATRIAL FIBRILLATION – AN UPDATE

    Directory of Open Access Journals (Sweden)

    Johnson Francis

    2015-12-01

    Full Text Available Atrial fibrillation is the most common perioperative cardiac arrhythmia. Sympathetic overactivity, inflammatory state and oxidative stress are important contributors to the genesis of postoperative atrial fibrillation. Advancing age and mitral valve disease along with left atrial size are important parameters in noted in multivariate prediction model. Genetic predisposition has also been noted. Preventive strategies tried include beta blockers, statins, posterior pericardiotomy, carperitide infusion and thoracic epidural analgesia. Treatment options include rate and rhythm control along with anticoagulation if it persists more than 48 hours with high CHADS2 score. Some of the therapeutic modalities which have been found to be NOT useful in preventing post operative atrial fibrillation are dexamethasone, magnesium infusion and concomitant pulmonary vein isolation.

  5. Atrial Fibrillation During an Exploration Class Mission

    Science.gov (United States)

    Lipsett, Mark; Hamilton, Douglas; Lemery, Jay; Polk, James

    2011-01-01

    This slide presentation reviews a possible scenario of an astronaut having Atrial Fibrillation during a Mars Mission. In the case review the presentation asks several questions about the alternatives for treatment, medications and the ramifications of the decisions.

  6. Alcohol consumption and risk of atrial fibrillation

    DEFF Research Database (Denmark)

    Tolstrup, Janne Schurmann; Wium-Andersen, Marie Kim; Ørsted, David Dynnes

    2016-01-01

    BACKGROUND: The aim of this study was to test the hypothesis that alcohol consumption, both observational (self-reported) and estimated by genetic instruments, is associated with a risk of atrial fibrillation and to determine whether people with high cardiovascular risk are more sensitive towards...... register. As a measure of alcohol exposure, both self-reported consumption and genetic variations in alcohol metabolizing genes (ADH1B/ADH1C) were used as instrumental variables. The endpoint was admission to hospital for atrial fibrillation as recorded in a validated hospital register. RESULTS: A total...... of 3493 cases of atrial fibrillation occurred during follow-up. High alcohol consumption was associated with a risk of atrial fibrillation among men, but not among women. Among the men who drank 28-35 and 35+ drinks/week, the hazards ratios were 1.40 (95% confidence interval 1.09-1.80) and 1.62 (95...

  7. [Cardiac rehabilitation in patients with atrial fibrillation].

    Science.gov (United States)

    Schlitt, Axel; Kamke, Wolfram; Guha, Manju; Haberecht, Olaf; Völler, Heinz

    2015-06-01

    The course of cardiac rehabilitation is often altered due to episodes of paroxysmal, predominantly postoperative atrial fibrillation. In symptomatic patients, a TEE-guided cardioversion - preferential DC shock - is indicated. In patients with persistent / permanent atrial fibrillation, a heart rate up to 110 / min and 170 / min at rest and during physical activity should, respectively, be tolerated. Therefore, training should not be quitted by heart rate but rather by load. The antithrombotic management is in addition a great task in treating patients with atrial fibrillation. With the exception of patients with a CHA2DS2-VASc-Score < 1, oral anticoagulation is indicated. Atrial fibrillation has little impact on social aspects, whereas the underlying heart disease and drug treatment (oral anticoagulation) has an important impact.

  8. Atrial conduction delay predicts atrial fibrillation in paroxysmal supraventricular tachycardia patients after radiofrequency catheter ablation.

    Science.gov (United States)

    Xu, Zhen-Xing; Zhong, Jing-Quan; Zhang, Wei; Yue, Xin; Rong, Bing; Zhu, Qing; Zheng, Zhaotong; Zhang, Yun

    2014-06-01

    This study aimed to assess whether intra- and inter-atrial conduction delay could predict atrial fibrillation (AF) for paroxysmal supraventricular tachycardia (PSVT) patients after successful treatment by radiofrequency catheter ablation (RFCA). Echocardiography examination was performed on 524 consecutive PSVT patients (15 patients were excluded). Left atrial dimension, right atrial diameter and intra- and inter-atrial conduction delay were measured before ablation. Patients were divided into group A (n = 32): occurrence of AF after the ablation and group B (n = 477): remained in sinus rhythm during follow-up. Receiver operating characteristic (ROC) curve analysis was performed to estimate the predictive value of intra- and inter-atrial conduction delay. Both intra- and inter-atrial conduction delay were higher in group A than in group B (4.79 ± 0.30 msec vs. 4.56 ± 0.32 msec; 21.98 ± 1.32 msec vs. 20.01 ± 1.33; p < 0.05). Binary logistic regression analysis showed that intra- and inter-atrial conduction were significant influential factors for the occurrence of AF (odds ratio [OR] = 13.577, 95% confidence interval [CI], 3.469-48.914; OR = 2.569, 95% CI, 1.909-3.459, p < 0.05). The ROC cure analysis revealed that intra-atrial conduction delay ≥ 4.45 msec and inter-atrial conduction delay ≥ 20.65 were the most optimal cut-off value for predicting AF in PSVT patients after RFCA. In conclusion, this is the first study to show that the intra- and inter-atrial conduction delay could effectively predict AF in post-ablation PSVT patients.

  9. Calpain I Inhibition prevents atrial structural remodeling in a canine model with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    XUE Hong-jie; SHAN Hong-bo; LIU Jie; LI Wei-min; LI Yue; GONG Yong-tai; YANG Bao-feng; JIN Cheng-luo; SHENG Li; CHU Shan; ZHANG Li

    2008-01-01

    Background Atrial fibrillation (AF) is accompanied by atrial structural remodeling. Calpain activity is induced during AR To lest a causal relationship between calpain activation and atrial structural changes, N-acetyl-Leu-Leu-Met (ALLM), a calpain inhibitor, was utilized in a canine AF model.Methods Fifteen dogs were randomly divided into 3 groups: sham-operated group, control group and calpain inhibitor group; each with 5 dogs. Sustained AF was induced by rapid right atrium pacing at 600 beats per minute for 3 weeks. ALLM was administered at a dosage of 1.0 mg-kg-1·d-1 in the calpain inhibitor group. Three weeks later, the proteolysis, protein expression of TnT and myosin, calpain l localization and expression and structural changes were examined in left atrial free walls, right atrial free walls and the interatrial septum respectively. Atrial size and contractile function were also measured by echocardiography.Results Long-term rapid atrial pacing induced marked structural changes such as enlarged atrial volume, myolysis, degradation of TnT and myosin, accumulation of glycogen and changes in mitochondrial shape and size, which were paralleled by an increase in calpain activity. The positive correlation between calpain activity and the degree of myolysis (rs=0.90 961, P<0.0001) was demonstrated. In addition to structural abnormalities, pacing-induced atrial contractile dysfunction was observed in this study. The pacing-induced atrial structural alterations and loss of contractility were partially prevented by the calpain inhibitor ALLM.Conclusions Activation of calpain represents key features in the progression towards overt structural remodeling. Calpain inhibitor, ALLM, suppressed the increased calpain activity and reversed structural remodeling caused by sustained atrial fibrillation in the present model. Calpain Inhibition may therefore provide a possibility for therapeutic Intervention in AF.

  10. Presence of accessory left atrial appendage/diverticula in a population with atrial fibrillation compared with those in sinus rhythm: a retrospective review.

    Science.gov (United States)

    Troupis, John; Crossett, Marcus; Scneider-Kolsky, Michal; Nandurkar, Dee

    2012-02-01

    Accessory left atrial appendages and atrial diverticula have an incidence of 10-27%. Their association with atrial fibrillation needs to be confirmed. This study determined the prevalence, number, size, location and morphology of accessory left atrial appendages/atrial diverticula in patients with atrial fibrillation compared with those in sinus rhythm. A retrospective analysis of 47 consecutive patients with atrial fibrillation who underwent 320 multidetector Coronary CT angiography (CCTA) was performed. A random group of 47 CCTA patients with sinus rhythm formed the control group. The presence, number, size, location and morphology of accessory left atrial appendages and atrial diverticula in each group were analysed. Twenty one patients had a total of 25 accessory left atrial appendages and atrial diverticula in the atrial fibrillation group and 22 patients had a total of 24 accessory left atrial appendages and atrial diverticula in the sinus rhythm group. Twenty-one atrial diverticula were identified in 19 patients in the atrial fibrillation group and 19 atrial diverticula in 17 patients in the sinus rhythm group. The mean length and width of accessory left atrial appendage was 6.9 and 4.7 mm, respectively in the atrial fibrillation group and 12 and 4.6 mm, respectively, in the sinus rhythm group, P = ns (not significant). The mean length and width of atrial diverticulum was 4.7 and 3.6 mm, respectively in the atrial fibrillation group and 6.2 and 5 mm, respectively in the sinus rhythm group (P = ns). Eighty-four % and 96% of the accessory left atrial appendages/atrial diverticula in the atrial fibrillation and sinus rhythm groups were located along the right anterosuperior left atrial wall. Accessory left atrial appendages and atrial diverticula are common structures with similar prevalence in patients with atrial fibrillation and sinus rhythm.

  11. Avaliação da atividade elétrica atrial em pacientes submetidos ao tratamento cirúrgico da valvopatia mitral Evaluation of atrial electrical activity in patients operated on mitral valve disease

    Directory of Open Access Journals (Sweden)

    Cesar Augusto Ferreira

    2002-01-01

    Full Text Available INTRODUÇÃO: O acesso cirúrgico por esternotomia mediana e atriotomia subseptal clássica pode, em certos casos, resultar em má exposição da valva mitral. Incisões atriais alternativas otimizam a exposição da valva mitral mas podem interferir na atividade elétrica atrial pós-operatória. OBJETIVO: Padronizar método para investigar a atividade elétrica atrial para emprego em estudos comparativos de diferentes atriotomias em cardiopatas sumetidos à cirurgia cardíaca. MÉTODOS: Análise com eletrocardiograma convencional e de 24 h (sistema Holter, pré e pós-operatória, e cardioestimulação epicárdica pós-operatória pelo método de Narula, em 10 pacientes submetidos à correção de valvopatias mitrais. RESULTADOS: No pré-op., os pacientes em ritmo sinusal apresentaram ectopias supraventriculares, com episódios de taquicardia supraventricular em 57% dos casos, "flutter" atrial em 10% e ritmo juncional em 10%. Todos apresentaram ectopias ventriculares, de baixa incidência em 70% dos casos, e taquicardia ventricular não sustentada foi detectada em 30% dos pacientes. No pós-operatório, houve 40% de novas arritmias supraventriculares (fibrilação atrial, ritmo juncional, ritmo atrial baixo e taquicardia supraventricular paroxística, mas não ocorreram arritmias ventriculares. No pós-op. a função do nó sinusal não se alterou, ocorreu redução significativa das ectopias supraventriculares, com reversão de FA para ritmo sinusal em 1 paciente, mas não houve redução significativa das ectopias ventriculares. O tempo de condução inter-atrial correlacionou-se com o tamanho do átrio esquerdo. CONCLUSÃO: A metodologia mostrou-se adequada e segura, e poderá ser empregada na comparação de diferentes incisões atriais para exposição valvar mitral.INTRODUCTION: The selection of the surgical approach to the mitral valve is a critical factor in obtaining good exposure and minimizing lesions of the surrounding structures

  12. [Anticoagulation in atrial fibrillation - an update].

    Science.gov (United States)

    Antz, Matthias; Hullmann, Bettina; Neufert, Christian; Vocke, Wolfgang

    2008-12-01

    The correct anticoagulation regimen for prevention of thromboembolic events is essential in patients with atrial fibrillation. However, only a minority of patients receives anticoagulation according to the guidelines. The current guidelines are intended to make the indication for anticoagulation more simple and are summarized in the present article. This includes recommendations for chronic anticoagulation, prevention of thromboembolic events after cardioversion and in ablation of atrial fibrillation.

  13. Uso da radiofrequência bipolar para o tratamento da fibrilação atrial durante cirurgia cardíaca

    Directory of Open Access Journals (Sweden)

    Leonardo Secchin Canale

    2011-06-01

    Full Text Available FUNDAMENTO: O tratamento da fibrilação atrial com dispositivo de ablação de tecidos por radiofrequência bipolar em concomitância à cirurgia cardíaca tem se mostrado método eficaz no tratamento desta arritmia. OBJETIVO: Descrever a experiência inicial do Instituto Nacional de Cardiologia no tratamento cirúrgico da fibrilação atrial com uso de dispositivo de radiofrequência bipolar em pacientes submetidos à cirurgia cardíaca, relatando o resultado de acompanhamento pós-operatório de um ano. MÉTODOS: Entre janeiro de 2008 e março de 2009, 47 pacientes (36 mulheres consecutivos, com idade média de 53,7 ± 10,6 anos, apresentando fibrilação atrial por um período médio de 34,6 meses (3 a 192 meses foram submetidos à ablação cirúrgica desta arritmia, por radiofrequência bipolar, durante o procedimento que motivou a indicação da cirurgia. Oito apresentavam fibrilação atrial intermitente e 39, contínua. Oitenta e um por cento foram submetidos à cirurgia valvar como procedimento principal. Esta é uma análise retrospectiva, observacional, com avaliação de um ano de pós-operatório das variáveis clínicas e de Holter 24 h. RESULTADOS: Dos 47 pacientes, 40 sobreviveram um ano. Desses, 33 foram submetidos a Holter 24 h, em um intervalo médio de 401 dias após a cirurgia. Encontrou-se a seguinte distribuição de ritmos: 24 (73% sinusal, 5 (15% fibrilação atrial, três (9% Flutter atrial e um (3% ritmo juncional. Foram observados dois acidentes vasculares encefálicos, sendo um associado à arritmia supraventricular. CONCLUSÃO: A ablação cirúrgica de fibrilação atrial com dispositivo de radiofrequência bipolar concomitante à cirurgia cardíaca é método eficaz para o tratamento desta arritmia.

  14. RR-Interval variance of electrocardiogram for atrial fibrillation detection

    Science.gov (United States)

    Nuryani, N.; Solikhah, M.; Nugoho, A. S.; Afdala, A.; Anzihory, E.

    2016-11-01

    Atrial fibrillation is a serious heart problem originated from the upper chamber of the heart. The common indication of atrial fibrillation is irregularity of R peak-to-R-peak time interval, which is shortly called RR interval. The irregularity could be represented using variance or spread of RR interval. This article presents a system to detect atrial fibrillation using variances. Using clinical data of patients with atrial fibrillation attack, it is shown that the variance of electrocardiographic RR interval are higher during atrial fibrillation, compared to the normal one. Utilizing a simple detection technique and variances of RR intervals, we find a good performance of atrial fibrillation detection.

  15. Unfolding the conical zones of the dissipation-induced subcritical flutter for the rotationally symmetrical gyroscopic systems

    OpenAIRE

    Kirillov, Oleg N.

    2008-01-01

    Flutter of an elastic body of revolution spinning about its axis of symmetry is prohibited in the subcritical spinning speed range by the Krein theorem for the Hamiltonian perturbations. Indefinite damping creates conical domains of the subcritical flutter (subcritical parametric resonance) bifurcating into the pockets of two Whitney's umbrellas when non-conservative positional forces are additionally taken into account. This explains why in contrast to the common intuition, but in agreement ...

  16. Prednisone prevents atrial fibrillation promotion by atrial tachycardia remodeling in dogs

    NARCIS (Netherlands)

    Shiroshita-Takeshita, A; Brundel, BJJM; Lavoie, J; Nattel, S

    2006-01-01

    Background: There is evidence suggesting involvement of oxidative stress, inflammation, and calcineurin/nuclear factor of activated T cell pathways in atrial fibrillation. This study evaluated the efficacy of anti-inflammatory and calcineurin-inhibitory drugs on promotion of atrial fibrillation by a

  17. Predictors of left atrial appendage stunning after electrical cardioversion of non-valvular atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    杨沙宁; 黄从新; 胡晓军; 金立军; 李凤翥; 彭水先

    2003-01-01

    Objective To identify predictors of left atrial appendage stunning after the use of electrical cardioversion to restore sinus rhythm in patients with non-valvular atrial fibrillation.Methods A total of 68 consecutive patients (45 men, 23 women, 60.5±8.7 years of age) with non-valvular atrial fibrillation undergoing electrical cardioversion were enlisted in this study. Clinical and echocardiographic variables were analyzed by univariate regression and multivariate logistic regression to investigate the relationship between occurrences of left atrial appendage stunning and these factors. Results Univariate analysis revealed that, in comparing patients without and with left atrial appendage stunning, there were significant differences in the duration of atrial fibrillation > 8 weeks (32.3% vs 75.5%, P 50 mm (29.0% vs 54.1%, P 8 weeks (OR=7.249, 95%CI=1.998-26.304, P 50 mm (OR=3.896, 95%CI=1.105-13.734, P8 weeks, left atrial diameter >50 mm, left ventricular ejection fraction <50%, and cumulative energy of electrical cardioversion are independent predictors of left atrial appendage stunning. Anticoagulation treatment should be individualized for patients undergoing electrical cardioversion to reduce the risk of both cardioversion-related thromboembolic events and hemorrhagic complications caused by warfarin treatment.

  18. Effect of age on stroke prevention therapy in patients with atrial fibrillation: the atrial fibrillation investigators

    DEFF Research Database (Denmark)

    van Walraven, Carl; Hart, Robert G; Connolly, Stuart

    2009-01-01

    on the relative efficacy of oral anticoagulants (OAC) and antiplatelet (AP) therapy (including acetylsalicylic acid and triflusal) on ischemic stroke, serious bleeding, and vascular events in patients with atrial fibrillation. METHODS: This is an analysis of the Atrial Fibrillation Investigators database, which...

  19. Physical Insights, Steady Aerodynamic Effects, and a Design Tool for Low-Pressure Turbine Flutter

    Science.gov (United States)

    Waite, Joshua Joseph

    The successful, efficient, and safe turbine design requires a thorough understanding of the underlying physical phenomena. This research investigates the physical understanding and parameters highly correlated to flutter, an aeroelastic instability prevalent among low pressure turbine (LPT) blades in both aircraft engines and power turbines. The modern way of determining whether a certain cascade of LPT blades is susceptible to flutter is through time-expensive computational fluid dynamics (CFD) codes. These codes converge to solution satisfying the Eulerian conservation equations subject to the boundary conditions of a nodal domain consisting fluid and solid wall particles. Most detailed CFD codes are accompanied by cryptic turbulence models, meticulous grid constructions, and elegant boundary condition enforcements all with one goal in mind: determine the sign (and therefore stability) of the aerodynamic damping. The main question being asked by the aeroelastician, "is it positive or negative?'' This type of thought-process eventually gives rise to a black-box effect, leaving physical understanding behind. Therefore, the first part of this research aims to understand and reveal the physics behind LPT flutter in addition to several related topics including acoustic resonance effects. A percentage of this initial numerical investigation is completed using an influence coefficient approach to study the variation the work-per-cycle contributions of neighboring cascade blades to a reference airfoil. The second part of this research introduces new discoveries regarding the relationship between steady aerodynamic loading and negative aerodynamic damping. Using validated CFD codes as computational wind tunnels, a multitude of low-pressure turbine flutter parameters, such as reduced frequency, mode shape, and interblade phase angle, will be scrutinized across various airfoil geometries and steady operating conditions to reach new design guidelines regarding the influence

  20. Investigation of the Flow Physics Driving Stall-Side Flutter in Advanced Forward Swept Fan Designs

    Science.gov (United States)

    Sanders, Albert J.; Liu, Jong S.; Panovsky, Josef; Bakhle, Milind A.; Stefko, George; Srivastava, Rakesh

    2003-01-01

    Flutter-free operation of advanced transonic fan designs continues to be a challenging task for the designers of aircraft engines. In order to meet the demands of increased performance and lighter weight, these modern fan designs usually feature low-aspect ratio shroudless rotor blade designs that make the task of achieving adequate flutter margin even more challenging for the aeroelastician. This is especially true for advanced forward swept designs that encompass an entirely new design space compared to previous experience. Fortunately, advances in unsteady computational fluid dynamic (CFD) techniques over the past decade now provide an analysis capability that can be used to quantitatively assess the aeroelastic characteristics of these next generation fans during the design cycle. For aeroelastic applications, Mississippi State University and NASA Glenn Research Center have developed the CFD code TURBO-AE. This code is a time-accurate three-dimensional Euler/Navier-Stokes unsteady flow solver developed for axial-flow turbomachinery that can model multiple blade rows undergoing harmonic oscillations with arbitrary interblade phase angles, i.e., nodal diameter patterns. Details of the code can be found in Chen et al. (1993, 1994), Bakhle et al. (1997, 1998), and Srivastava et al. (1999). To assess aeroelastic stability, the work-per-cycle from TURBO-AE is converted to the critical damping ratio since this value is more physically meaningful, with both the unsteady normal pressure and viscous shear forces included in the work-per-cycle calculation. If the total damping (aerodynamic plus mechanical) is negative, then the blade is unstable since it extracts energy from the flow field over the vibration cycle. TURBO-AE is an integral part of an aeroelastic design system being developed at Honeywell Engines, Systems & Services for flutter and forced response predictions, with test cases from development rig and engine tests being used to validate its predictive

  1. Determinants of Left Atrial Volume in Patients with Atrial Fibrillation

    Science.gov (United States)

    Hochgruber, Thomas; Krisai, Philipp; Zimmermann, Andreas J.; Aeschbacher, Stefanie; Pumpol, Katrin; Kessel-Schaefer, Arnheid; Stephan, Frank-Peter; Handschin, Nadja; Sticherling, Christian; Osswald, Stefan; Kaufmann, Beat A.; Paré, Guillaume; Kühne, Michael; Conen, David

    2016-01-01

    Introduction Left atrial (LA) enlargement is an important risk factor for incident stroke and a key determinant for the success of rhythm control strategies in patients with atrial fibrillation (AF). However, factors associated with LA volume in AF patients remain poorly understood. Methods Patients with paroxysmal or persistent AF were enrolled in this study. Real time 3-D echocardiography was performed in all participants and analyzed offline in a standardized manner. We performed stepwise backward linear regression analyses using a broad set of clinical parameters to determine independent correlates for 3-D LA volume. Results We included 210 patients (70.9% male, mean age 61±11years). Paroxysmal and persistent AF were present in 95 (45%) and 115 (55%) patients, respectively. Overall, 115 (55%) had hypertension, 11 (5%) had diabetes, and 18 (9%) had ischemic heart disease. Mean indexed LA volume was 36±12ml/m2. In multivariable models, significant associations were found for female sex (β coefficient -10.51 (95% confidence interval (CI) -17.85;-3.16), p = 0.0053), undergoing cardioversion (β 11.95 (CI 5.15; 18.74), p = 0.0006), diabetes (β 14.23 (CI 2.36; 26.10), p = 0.019), body surface area (BSA) (β 34.21 (CI 19.30; 49.12), pglomerular filtration rate (β -0.21 (CI -0.36; -0.06), p = 0.0064) and plasma levels of NT-pro brain natriuretic peptide (NT-proBNP) (β 6.79 (CI 4.05; 9.52), p<0.0001), but not age (p = 0.59) or hypertension (p = 0.42). Our final model explained 52% of the LA volume variability. Conclusions In patients with AF, the most important correlates with LA volume are sex, BSA, diabetes, renal function and NT-proBNP, but not age or hypertension. These results may help to refine rhythm control strategies in AF patients. PMID:27701468

  2. Risk of atrial fibrillation and stroke in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Lindhardsen, Jesper; Ahlehoff, Ole; Gislason, Gunnar Hilmar;

    2012-01-01

    To determine if patients with rheumatoid arthritis have increased risk of atrial fibrillation and stroke.......To determine if patients with rheumatoid arthritis have increased risk of atrial fibrillation and stroke....

  3. Management and prognosis of atrial fibrillation in the diabetic patient

    DEFF Research Database (Denmark)

    Pallisgaard, Jannik Langtved; Lindhardt, Tommi Bo; Olesen, Jonas Bjerring

    2015-01-01

    The global burden of atrial fibrillation and diabetes mellitus (diabetes) is considerable, and prevalence rates are increasing. Diabetes is associated with an increased risk of developing atrial fibrillation; however, diabetes also influences the management and prognosis of atrial fibrillation. I...... and outcomes of heart failure and the success rates of both ablation and cardioversion in atrial fibrillation patients with diabetes. Finally, this article describes the association of HbA1c levels with the management and prognosis of atrial fibrillation patients.......The global burden of atrial fibrillation and diabetes mellitus (diabetes) is considerable, and prevalence rates are increasing. Diabetes is associated with an increased risk of developing atrial fibrillation; however, diabetes also influences the management and prognosis of atrial fibrillation...

  4. Flutter Characteristic Study of Composite Sandwich Panel with Functionally Graded Foam Core

    Directory of Open Access Journals (Sweden)

    Peng Jin

    2016-01-01

    Full Text Available This paper attempts to investigate the flutter characteristic of sandwich panel composed of laminated facesheets and a functionally graded foam core. The macroscopic properties of the foam core change continuously along this direction parallel to the facesheet lamina. The model used in the study is a simple sandwich panel-wing clamped at the root, with three simple types of grading strategies for FGM core: (1 linear grading strategy in the chord-wise direction, (2 linear grading strategy in the span-wise direction, and (3 bilinear grading of properties of foam core across the panel. The results show that use of FGM core has the potential to increase the flutter speed of the sandwich panel. Finally, a minimum weight design of composite sandwich panel with lamination parameters of facesheet and density distribution of foam core as design variables is conducted using particle swarm optimization (PSO.

  5. Flutter and Forced Response Analyses of Cascades using a Two-Dimensional Linearized Euler Solver

    Science.gov (United States)

    Reddy, T. S. R.; Srivastava, R.; Mehmed, O.

    1999-01-01

    Flutter and forced response analyses for a cascade of blades in subsonic and transonic flow is presented. The structural model for each blade is a typical section with bending and torsion degrees of freedom. The unsteady aerodynamic forces due to bending and torsion motions. and due to a vortical gust disturbance are obtained by solving unsteady linearized Euler equations. The unsteady linearized equations are obtained by linearizing the unsteady nonlinear equations about the steady flow. The predicted unsteady aerodynamic forces include the effect of steady aerodynamic loading due to airfoil shape, thickness and angle of attack. The aeroelastic equations are solved in the frequency domain by coupling the un- steady aerodynamic forces to the aeroelastic solver MISER. The present unsteady aerodynamic solver showed good correlation with published results for both flutter and forced response predictions. Further improvements are required to use the unsteady aerodynamic solver in a design cycle.

  6. Giant right atrial myxoma: characterization with cardiac magnetic resonance imaging.

    LENUS (Irish Health Repository)

    Ridge, Carole A

    2012-02-01

    A 53-year-old woman presented to the emergency department with a 2-week history of dyspnoea and chest pain. Computed tomography pulmonary angiography was performed to exclude acute pulmonary embolism (PE). This demonstrated a large right atrial mass and no evidence of PE. Transthoracic echocardiography followed by cardiac magnetic resonance imaging confirmed a mobile right atrial mass. Surgical resection was then performed confirming a giant right atrial myxoma. We describe the typical clinical, radiologic, and pathologic features of right atrial myxoma.

  7. Gene expression of the natriuretic peptide system in atrial tissue of patients with paroxysmal and persistent atrial fibrillation

    NARCIS (Netherlands)

    Tuinenburg, AE; Brundel, BJJM; Van Gelder, IC; Henning, RH; Van den Berg, MP; Driessen, C; Grandjean, JG; Van Gilst, WH; Crijns, HJGM

    1999-01-01

    Natriuretic Peptide System in AF. Introduction: Circulating cardiac natriuretic peptides play an important role in maintaining volume homeostasis, especially during conditions affecting hemodynamics. During atrial fibrillation (AF), levels of plasma atrial natriuretic peptide (ANP) becomes elevated.

  8. Airfoil Aeroelastic Flutter Analysis Based on Modified Leishman-Beddoes Model at Low Mach Number

    Institute of Scientific and Technical Information of China (English)

    SHAO Song; ZHU Qinghua; ZHANG Chenglin; NI Xianping

    2011-01-01

    Based on modified Leishman-Beddoes(L-B)state space model at low Mach number(lower than 0.3),the airfoil aeroelastic system is presented in this paper.The main modifications for L-B model include a new dynamic stall criterion and revisions of normal force and pitching moment coefficient.The bifurcation diagrams,the limit cycle oscillation (LCO)phase plane plots and the time domain response figures are applied to investigating the stall flutter bifurcation behavior of airfoil aeroelastic systems with symmetry or asymmetry.It is shown that the symmetric periodical oscillation happens after subcritical bifurcation caused by dynamic stall,and the asymmetric periodical oscillation,which is caused by the interaction of dynamic stall and static divergence,only happens in the airfoil aeroelastic system with asymmetry.Validations of the modified L-B model and the airfoil aeroelastic system are presented with the experimental airload data of NACA0012 and OA207 and experimental stall flutter data of NACA0012 respectively.Results demonstrate that the airfoil aeroelastic system presented in this paper is effective and accurate,which can be applied to the investigation of airfoil stall flutter at low Mach number.

  9. Flutter Analysis of a Morphing Wing Technology Demonstrator: Numerical Simulation and Wind Tunnel Testing

    Directory of Open Access Journals (Sweden)

    Andreea KOREANSCHI

    2016-03-01

    Full Text Available As part of a morphing wing technology project, the flutter analysis of two finite element models and the experimental results of a morphing wing demonstrator equipped with aileron are presented. The finite element models are representing a wing section situated at the tip of the wing; the first model corresponds to a traditional aluminium upper surface skin of constant thickness and the second model corresponds to a composite optimized upper surface skin for morphing capabilities. The two models were analyzed for flutter occurrence and effects on the aeroelastic behaviour of the wing were studied by replacing the aluminium upper surface skin of the wing with a specially developed composite version. The morphing wing model with composite upper surface was manufactured and fitted with three accelerometers to record the amplitudes and frequencies during tests at the subsonic wind tunnel facility at the National Research Council. The results presented showed that no aeroelastic phenomenon occurred at the speeds, angles of attack and aileron deflections studied in the wind tunnel and confirmed the prediction of the flutter analysis on the frequencies and modal displacements.

  10. Flutter Derivatives Identification and Aerodynamic Performance of an Optimized Multibox Bridge Deck

    Directory of Open Access Journals (Sweden)

    Zhida Wang

    2016-01-01

    Full Text Available The bridge deck sections used for long-span suspension bridges have evolved through the years, from the compact box deck girders geometrical configurations to twin-box and three-box bridge decks sections. The latest generation of split and multiple-box bridge decks proved to have better aerodynamic behavior; thus further optimization methods are sought for such geometrical configurations. A new type of multibox bridge deck, consisting of four aerodynamically shaped deck boxes, two side decks for the traffic lanes and two middle decks for the railway traffic, connected between them by stabilizing beams, was tested in the wind tunnel for identifying the flutter derivatives and to verify the aerodynamic performance of the proposed multibox deck. Aerodynamic static force coefficients were measured for the multibox bridge deck model, scaled 1 : 80, for Reynolds numbers up to 5.1 × 105, under angles of attack between −8° and 8°. Iterative Least Squares (ILS method was employed for identifying the flutter derivatives of the multibox bridge deck model, based on the results obtained from the free vibration tests and based on the frequency analysis the critical flutter wind speed for the corresponding prototype of the multibox bridge was estimated at 188 m/s.

  11. Autonomic and surgical substrate modulation of atrial fibrillation

    NARCIS (Netherlands)

    Krul, S.P.J.

    2016-01-01

    This thesis focuses on the effects of fibrosis and the autonomic nervous system on conduction in patients with atrial fibrillation and the surgical ablation of the atria and autonomic nervous system as treatment of atrial fibrillation. Atrial fibrillation is the most common arrhythmia and results fr

  12. Echocardiographic evaluation of patent foramen ovale and atrial septal defect.

    Science.gov (United States)

    Hari, Pawan; Pai, Ramdas G; Varadarajan, Padmini

    2015-01-01

    Patent foramen ovale (PFO) is a common variant present in up to 25% of the population. Atrial septal defect (ASD) is a direct communication between the 2 atrial chambers, of which the ostium secundum variety is the most common. This manuscript is an in depth review of the complex atrial septation, the diagnosis of PFO and ASD and its clinical and therapeutic implications.

  13. Surgical Treatment of Atrial Fibrillation: A Review

    Directory of Open Access Journals (Sweden)

    Nadine Hiari

    2011-01-01

    Full Text Available Atrial fibrillation is the most commonly sustained arrhythmia in man. While it affects millions of patients worldwide, its incidence will markedly increase with an aging population. Primary goals of AF therapy are to (1 reduce embolic complications, particularly stroke, (2 alleviate symptoms, and (3 prevent long-term heart remodelling. These have been proven to be a challenge as there are major limitations in our knowledge of the pathological and electrophysiological mechanisms underlying AF. Although advances continue to be made in the medical management of this condition, pharmacotherapy is often unsuccessful. Because of the high recurrence rate of AF despite antiarrhythmic drug therapy for maintenance of sinus rhythm and the adverse effects of these drugs, there has been growing interest in nonpharmacological strategies. Surgery for treatment of AF has been around for some time. The Cox-Maze procedure is the gold standard for the surgical treatment of atrial fibrillation and has more than 90% success in eliminating atrial fibrillation. Although the cut and sew maze is very effective, it has been superseded by newer operations that rely on alternate energy sources to create lines of conduction block. In addition, the evolution of improved ablation technology and instrumentation has facilitated the development of minimally invasive approaches. In this paper, the rationale for surgical ablation for atrial fibrillation and the different surgical techniques that were developed will be explored. In addition, it will detail the new approaches to surgical ablation of atrial fibrillation that employ alternate energy sources.

  14. The effect of atrial preference pacing on atrial fibrillation electrophysiological substrate in Myotonic Dystrophy type 1 population

    OpenAIRE

    Russo, Vincenzo; NIGRO, GERARDO; DI MEO, FEDERICA; PAPA, ANDREA ANTONIO; CIOPPA, NADIA DELLA; PROIETTI, RICCARDO; Russo, Maria Giovanna; Calabrò, Raffaele; Politano, Luisa

    2014-01-01

    P-wave dispersion is a non invasive indicator of intra-atrial conduction heterogeneity producing substrate for reentry, which is a pathophysiological mechanism of atrial fibrillation. The relationship between P-wave dispersion (PD) and atrial fibrillation (AF) in Myotonic dystrophy type 1 (DM1) patients is still unclear. Atrial Preference Pacing (APP) is an efficient algorithm to prevent paroxysmal AF in patients implanted with dual-chamber pacemaker. Aim of our study was to evaluate the poss...

  15. Atrial tachycardia originating from the atrial septum in a patient with dextrocardia and complex structural heart disease.

    Science.gov (United States)

    Niu, Ya-Lei; Chang, Shih-Lin; Lin, Yenn-Jiang; Lo, Li-Wei; Hu, Yu-Feng; Lee, Pi-Chang; Chen, Shih-Ann

    2012-10-01

    We report a case with dextrocardia, corrected transposition of the great arteries. He also had an atrial septum defect (ASD) with patch repair. Activation map showed a centrifugal activation from a focal origin on the systemic lower left atrial ASD patch. Ablation of the origin can terminate the atrial tachycardia.

  16. Study on Effect of Compound Salvia Pellet in Preventing Atrial Fibrillation with Left Atrial Thrombosis

    Institute of Scientific and Technical Information of China (English)

    连耀植; 李玉光; 张汉灵; 张元春; 闫纯英; 林建才; 许端敏; 张钰; 郑宝群; 麦芒

    2004-01-01

    @@ Atrial fibrillation (AF) is a kind of common arrhythmia, which, besides affecting cardiac function, has another serious outcome, that is, it is easy to form atrial thrombosis and induce thrombus/embolus, especially cerebral embolus.The incidence of left atrial thrombosis (LAT)could reach 25%-30%(1), the incidence of embolic complication per year could reach 2. 98%-6.30%, even 20% or more(2,3). To prevent thrombosis so as to lower the incidence of cerebral stroke and other embolic complications has been so far the focal point of AF treatment.

  17. Effects of irbesartan on atrial cell electrophysiology

    Institute of Scientific and Technical Information of China (English)

    HUANG Cong-xin; CAO Feng; JIANG Hong; WANG Teng; LI Xia

    2005-01-01

    @@ Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in clinical practice.1 Its incidence increases with age and the presence of structural heart disease. It is a major cause of stroke, especially in the elderly. It has been shown that angiotensin converting enzyme inhibitor (ACEI) can reduce the incidence of AF after acute myocardial infarction.2 Several studies have shown that activation of the rennin-angiotensin system is associated with the mechanisms of AF. Irbesartan is a long-acting angiotensin Ⅱ type 1 receptor antagonist used widely in the treatment of hypertension.3 In recent years, it has been demonstrated that patients treated with amiodarone plus irbesartan had a lower rate of recurrence of atrial fibrillation than did patients treated with amiodarone alone.4 These findings suggest that the inhibition of angiotensin Ⅱ may prevent AF, but its underlying electrophysiological mechanisms are obscure. The purpose of this study is to investigate the effects of irbesartan on atrial cell electrophysiology.

  18. The Effect of Aggressive Blood Pressure Control on the Recurrence of Atrial Fibrillation After Catheter Ablation: A Randomized, Open Label, Clinical Trial (Substrate Modification with Aggressive Blood Pressure Control: SMAC- AF).

    Science.gov (United States)

    Parkash, Ratika; Wells, George A; Sapp, John L; Healey, Jeffrey S; Tardif, Jean-Claude; Greiss, Isabelle; Rivard, Léna; Roux, Jean-Francois; Gula, Lorne; Nault, Isabelle; Novak, Paul G; Birnie, David H; Ha, Andrew C; Wilton, Stephen B; Mangat, Iqwal; Gray, Christopher J; Gardner, Martin J; Tang, Anthony S L

    2017-02-22

    Background -Radiofrequency catheter ablation for atrial fibrillation has become an important therapy for AF, however recurrence rates remain high. We proposed to determine whether aggressive blood pressure (BP) lowering prevents recurrent atrial fibrillation (AF) after catheter ablation in patients with AF and a high symptom burden. Methods -We randomly assigned 184 patients with AF and a BP greater than 130/80 mmHg to aggressive BP (target <120/80 mm Hg) or standard BP treatment (target <140/90 mmHg) prior to their scheduled AF catheter ablation. The primary outcome was symptomatic recurrence of AF/atrial tachycardia/atrial flutter lasting greater than 30 seconds, determined 3 months beyond catheter ablation by a blinded endpoint evaluation. Results -The median follow-up was 14 months. At six months, the mean systolic BP in the aggressive BP treatment group was 123.2±13.2 versus 135.4±15.7mm Hg (p<0.001) in the standard treatment group. The primary outcome occurred in 106 patients, 54 (61.4%) in the aggressive BP treatment group, compared to 52 (61.2%) in the standard treatment group, (Hazard Ratio 0.94, 95% Confidence Interval 0.65-1.38, p=0.763). In the prespecified subgroup analysis of the influence of age, patients aged ≥ 61 years had a lower primary outcome event rate with aggressive BP (Hazard Ratio 0.58, 95% Confidence Interval (0.34, 0.97), p=0.013). There was a higher rate of hypotension requiring medication adjustment in the aggressive BP group (26% versus 0%). Conclusions -In this study, this duration of aggressive BP treatment did not reduce atrial arrhythmia recurrence after catheter ablation for AF, but resulted in more hypotension. Clinical Trial Registration -Clinicaltrials.gov Identifier: NCT00438113.

  19. Atrial tachyarrhythmia in Rgs5-null mice.

    Directory of Open Access Journals (Sweden)

    Mu Qin

    Full Text Available AIMS: The aim of this study was to elucidate the effects of regulator of G-protein signaling 5 (Rgs5, a negative regulator of G protein-mediated signaling, on atrial repolarization and tachyarrhythmia (ATA in mice. METHODS AND RESULTS: In present study, the incidence of ATA were increased in Rgs5(-/- Langendorff-perfused mouse hearts during program electrical stimulation (PES (46.7%, 7 of 15 and burst pacing (26.7%, 4 of 15 compared with wild-type (WT mice (PES: 7.1%,1 of 14; burst:7.1%,1 of 14 (P30 s but none of them observed in WT mice. Atrial prolonged repolarization was observed in Rgs5(-/- hearts including widened P wave in surface ECG recording, increased action potential duration (APD and atrial effective refractory periods (AERP, all of them showed significant difference with WT mice (P<0.05. At the cellular level, whole-cell patch clamp recorded markedly decreased densities of repolarizing K(+ currents including I(Kur (at +60 mV: 14.0±2.2 pF/pA and I(to (at +60 mV: 16.7±1.3 pA/pF in Rgs5(-/- atrial cardiomyocytes, compared to those of WT mice (at +60 mV I(to: 20.4±2.0 pA/pF; I(kur: 17.9±2.0 pF/pA (P<0.05. CONCLUSION: These results suggest that Rgs5 is an important regulator of arrhythmogenesis in the mouse atrium and that the enhanced susceptibility to atrial tachyarrhythmias in Rgs5(-/- mice may contribute to abnormalities of atrial repolarization.

  20. Exercise-based cardiac rehabilitation for adults with atrial fibrillation

    DEFF Research Database (Denmark)

    Risom, Signe S; Zwisler, Ann-Dorthe; Johansen, Pernille P

    2017-01-01

    BACKGROUND: Exercise-based cardiac rehabilitation may benefit adults with atrial fibrillation or those who had been treated for atrial fibrillation. Atrial fibrillation is caused by multiple micro re-entry circuits within the atrial tissue, which result in chaotic rapid activity in the atria....... OBJECTIVES: To assess the benefits and harms of exercise-based rehabilitation programmes, alone or with another intervention, compared with no-exercise training controls in adults who currently have AF, or have been treated for AF. SEARCH METHODS: We searched the following electronic databases; CENTRAL...... the benefits and harms of exercise-based cardiac rehabilitation for adults with atrial fibrillation on patient-relevant outcomes....

  1. Antihypertensive treatment and risk of atrial fibrillation

    DEFF Research Database (Denmark)

    Marott, Sarah C W; Nielsen, Sune F; Benn, Marianne

    2014-01-01

    AIMS: To examine the associations between antihypertensive treatment with angiotensin-converting enzyme inhibitors (ACEis) or angiotensin receptor blockers (ARBs), β-blockers, diuretics, or calcium-antagonists, and risk of atrial fibrillation. We examined these associations using the entire Danish......, and hyperthyroidism at baseline and none received any other antihypertensive medication. We studied risk of atrial fibrillation, and used risk of stroke, influenced by lowering blood pressure rather than renin-angiotensin system blockade per se, as an indicator of the importance of blood pressure lowering per se...

  2. Cryoballoon Catheter Ablation in Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Cevher Ozcan

    2011-01-01

    Full Text Available Pulmonary vein isolation with catheter ablation is an effective treatment in patients with symptomatic atrial fibrillation refractory or intolerant to antiarrhythmic medications. The cryoballoon catheter was recently approved for this procedure. In this paper, the basics of cryothermal energy ablation are reviewed including its ability of creating homogenous lesion formation, minimal destruction to surrounding vasculature, preserved tissue integrity, and lower risk of thrombus formation. Also summarized here are the publications describing the clinical experience with the cryoballoon catheter ablation in both paroxysmal and persistent atrial fibrillation, its safety and efficacy, and discussions on the technical aspect of the cryoballoon ablation procedure.

  3. [Obesity as a risk factor for atrial fibrillation].

    Science.gov (United States)

    Duraj, Iwona; Broncel, Marlena

    2016-01-01

    Atrial fibrillation (AF) and obesity is a growing problem of public health both in Poland and in the whole world. AF risk factors may be summarized as elderliness, male sex, smoking, hypertension, diabetes, obesity, coronary heart disease, heart failure, valvular heart disease, cardiac surgery. Once obesity is an independent, potentially modifiable risk factor for AF. The connection between obesity and atrial fibrillation is very up-to-date because of incremental prevalence, almost epidemic of obesity in the whole world. The probability of AF among obese patients increases with concomitant obstructive sleep apnea. Regardless many researches it hasn't been assessed yet how obesity itself predisposes to AF. It could be an effect of change in the atrial anatomy, the rise of atrial pressure, mechanical stretch, interstitial atrial fibrosis and disruption of atrial electric integrity. A great role is ascribed to inflammation, especially proinflammatory cytokines increased by adipocites of left atrial epicardial adiposity.

  4. A rare large right atrial myxoma with rapid growth rate.

    Science.gov (United States)

    Kelly, Shawn C; Steffen, Kelly; Stys, Adam T

    2014-10-01

    Atrial myxomas are the most common benign intracavitary cardiac neoplasms. They most frequently occur in the left atrium. Right atrial tumors are rare, comprising 20 percent of myxomas achieving an incidence of 0.02 percent. Due to their rarity, right atrial tumor development and associated clinical symptoms has not been well described. The classical clinical triad for the presentation of left atrial myxomas--heart failure, embolic events, and constitutional symptoms--may not be applicable to right sided tumors. Also, natural development of myxoma is not well described, as surgical resection is the common practice. Previously ascribed growth rates of myxomas refer mostly to left atrial ones, as right atrial tumors are rare. We present a case of right atrial myxoma with growth rates exceeding those previously described.

  5. New risk factors for atrial fibrillation : causes of 'not-so-lone atrial fibrillation'

    NARCIS (Netherlands)

    Schoonderwoerd, Bas A.; Smit, Marcelle D.; Pen, Lucas; Van Gelder, Isabelle C.

    2008-01-01

    Atrial fibrillation (AF) is a prevalent arrhythmia in patients with cardiovascular disease. The classical risk factors for developing AF include hypertension, valvular disease, (ischaemic) cardiomyopathy, diabetes mellitus, and thyroid disease. In some patients with AF, no underlying (cardiovascular

  6. An analytical and experimental study to investigate flutter suppression via piezoelectric actuation. M.S. Thesis - George Washington Univ., 1991

    Science.gov (United States)

    Heeg, Jennifer

    1991-01-01

    The objective was to analytically and experimentally study the capabilities of adaptive material plate actuators for suppressing flutter. The validity of analytical modeling techniques for piezoelectric materials was also investigated. Piezoelectrics are materials which are characterized by their ability to produce voltage when subjected to a mechanical strain. The converse piezoelectric effect can be utilized to actuate a structure by applying a voltage. For this investigation, a two degree of freedom wind tunnel model was designed, analyzed, and tested. The model consisted of a rigid airfoil and a flexible mount system which permitted a translational and a rotational degree of freedom. It was designed such that flutter was encounted within the testing envelope of the wind tunnel. Actuators, made of piezoelectric material were affixed to leaf springs of the mount system. Each degree of freedom was controlled by a separate leaf spring. Command signals, applied to the piezoelectric actuators, exerted control over the damping and stiffness properties. A mathematical aeroservoelastic model was constructed using finite element methods, laminated plate theory, and aeroelastic analysis tools. Plant characteristics were determined from this model and verified by open loop experimental tests. A flutter suppression control law was designed and implemented on a digital control computer. Closed loop flutter testing was conducted. The experimental results represent the first time that adaptive materials have been used to actively suppress flutter. It demonstrates that small, carefully placed actuating plates can be used effectively to control aeroelastic response.

  7. Left atrial appendage occlusion for stroke prevention in atrial fibrillation in Europe

    DEFF Research Database (Denmark)

    Lip, Gregory Y.H.; Dagres, Nikolaos; Proclemer, Alessandro;

    2013-01-01

    The purpose of this EP wire survey was to assess clinical practice in relation to the use of left atrial appendage occlusion (LAAO) devices for stroke prevention in atrial fibrillation (AF) among members of the European Heart Rhythm Association research network. The average number of performed LA...... are most often performed by interventional cardiologists. Experience varied widely, and this was reflected in the wide range of thromboembolic and procedural (tamponade, bleeding) complications reported by the respondents to this EP wire survey....

  8. Computational models of atrial cellular electrophysiology and calcium handling, and their role in atrial fibrillation.

    Science.gov (United States)

    Heijman, Jordi; Erfanian Abdoust, Pegah; Voigt, Niels; Nattel, Stanley; Dobrev, Dobromir

    2016-02-01

    The complexity of the heart makes an intuitive understanding of the relative contribution of ion channels, transporters and signalling pathways to cardiac electrophysiology challenging. Computational modelling of cardiac cellular electrophysiology has proven useful to integrate experimental findings, extrapolate results obtained in expression systems or animal models to other systems, test quantitatively ideas based on experimental data and provide novel hypotheses that are experimentally testable. While the bulk of computational modelling has traditionally been directed towards ventricular bioelectricity, increasing recognition of the clinical importance of atrial arrhythmias, particularly atrial fibrillation, has led to widespread efforts to apply computational approaches to understanding atrial electrical function. The increasing availability of detailed, atrial-specific experimental data has stimulated the development of novel computational models of atrial-cellular electrophysiology and Ca(2+) handling. To date, more than 300 studies have employed mathematical simulations to enhance our understanding of atrial electrophysiology, arrhythmogenesis and therapeutic responses. Future modelling studies are likely to move beyond current whole-cell models by incorporating new data on subcellular architecture, macromolecular protein complexes, and localized ion-channel regulation by signalling pathways. At the same time, more integrative multicellular models that take into account regional electrophysiological and Ca(2+) handling properties, mechano-electrical feedback and/or autonomic regulation will be needed to investigate the mechanisms governing atrial arrhythmias. A combined experimental and computational approach is expected to provide the more comprehensive understanding of atrial arrhythmogenesis that is required to develop improved diagnostic and therapeutic options. Here, we review this rapidly expanding area, with a particular focus on Ca(2+) handling, and

  9. Flutter Phenomenon in Flow Driven Energy Harvester-A Unified Theoretical Model for “Stiff” and “Flexible” Materials

    Science.gov (United States)

    Chen, Yu; Mu, Xiaojing; Wang, Tao; Ren, Weiwei; Yang, Ya; Wang, Zhong Lin; Sun, Chengliang; Gu, Alex Yuandong

    2016-10-01

    Here, we report a stable and predictable aero-elastic motion in the flow-driven energy harvester, which is different from flapping and vortex-induced-vibration (VIV). A unified theoretical frame work that describes the flutter phenomenon observed in both “stiff” and “flexible” materials for flow driven energy harvester was presented in this work. We prove flutter in both types of materials is the results of the coupled effects of torsional and bending modes. Compared to “stiff” materials, which has a flow velocity-independent flutter frequency, flexible material presents a flutter frequency that almost linearly scales with the flow velocity. Specific to “flexible” materials, pre-stress modulates the frequency range in which flutter occurs. It is experimentally observed that a double-clamped “flexible” piezoelectric P(VDF-TrFE) thin belt, when driven into the flutter state, yields a 1,000 times increase in the output voltage compared to that of the non-fluttered state. At a fixed flow velocity, increase in pre-stress level of the P(VDF-TrFE) thin belt up-shifts the flutter frequency. In addition, this work allows the rational design of flexible piezoelectric devices, including flow-driven energy harvester, triboelectric energy harvester, and self-powered wireless flow speed sensor.

  10. Percutaneous closure of atrial septal defects leads to normalisation of atrial and ventricular volumes

    Directory of Open Access Journals (Sweden)

    Worthley Matthew I

    2008-12-01

    Full Text Available Abstract Background Percutaneous closure of atrial septal defects (ASDs should potentially reduce right heart volumes by removing left-to-right shunting. Due to ventricular interdependence, this may be associated with impaired left ventricular filling and potentially function. Furthermore, atrial changes post-ASD closure have been poorly understood and may be important for understanding risk of atrial arrhythmia post-ASD closure. Cardiovascular magnetic resonance (CMR is an accurate and reproducible imaging modality for the assessment of cardiac function and volumes. We assessed cardiac volumes pre- and post-percutaneous ASD closure using CMR. Methods Consecutive patients (n = 23 underwent CMR pre- and 6 months post-ASD closure. Steady state free precession cine CMR was performed using contiguous slices in both short and long axis views through the ASD. Data was collected for assessment of left and right atrial, ventricular end diastolic volumes (EDV and end systolic volumes (ESV. Data is presented as mean ± SD, volumes as mL, and paired t-testing performed between groups. Statistical significance was taken as p Results There was a significant reduction in right ventricular volumes at 6 months post-ASD closure (RVEDV: 208.7 ± 76.7 vs. 140.6 ± 60.4 mL, p Conclusion ASD closure leads to normalisation of ventricular volumes and also a reduction in right atrial volume. Further follow-up is required to assess how this predicts outcomes such as risk of atrial arrhythmias after such procedures.

  11. The effect of asanguinous cardioplegic arrest on atrial preservation using atrial ATP as a marker.

    Science.gov (United States)

    Hines, G L; Scheaffer, P; Williams, L; Mantell, P; Cheifitz, P

    1990-01-01

    Changes in atrial adenosine triphosphate (ATP) and the presence of postoperative arrhythmias were studied in 14 patients during routine coronary artery bypass grafting to 1) attempt to evaluate atrial preservation, and 2) determine if a relationship exists between changes in ATP and the development of postoperative arrhythmias. Atrial biopsies were obtained at the time of cannulation (preischemic sample) and after the removal of the aortic crossclamp (postischemic sample). Methods of myocardial protection included systemic hypothermia (28 degrees C), periodic reinfusion of crystalloid cardioplegia into the aortic root and completed vein grafts, and iced slush in the pericardial well. Atrial temperature was monitored. Preischemic ATP was 0.412 +/- 0.32 mu mol/gm, and the postischemic value was 0.220 +/- 0.13 mu mol/gm (p less than .02). Atrial temperature routinely decreased to 13-18 degrees C after cardioplegic infusion but rose to 24 degrees C between infusions. There was no correlation between postoperative supraventricular arrhythmias (4 patients) and changes in ATP. In conclusion, routine coronary artery bypass grafting with standard methods of cardiac preservation does not appear to satisfactorily preserve atrial tissue. The clinical correlation and significance of this remains to be elucidated.

  12. Atrial Tachycardias Arising from Ablation of Atrial Fibrillation: A Proarrhythmic Bump or an Antiarrhythmic Turn?

    Directory of Open Access Journals (Sweden)

    Ashok J. Shah

    2010-01-01

    Full Text Available The occurrence of atrial tachycardias (AT is a direct function of the volume of atrial tissue ablated in the patients with atrial fibrillation (AF. Thus, the incidence of AT is highest in persistent AF patients undergoing stepwise ablation using the strategic combination of pulmonary vein isolation, electrogram based ablation and left atrial linear ablation. Using deductive mapping strategy, AT can be divided into three clinical categories viz. the macroreentry, the focal and the newly described localized reentry all of which are amenable to catheter ablation with success rate of 95%. Perimitral, roof dependent and cavotricuspid isthmus dependent AT involve large reentrant circuits which can be successfully ablated at the left mitral isthmus, left atrial roof and tricuspid isthmus respectively. Complete bidirectional block across the sites of linear ablation is a necessary endpoint. Focal and localized reentrant AT commonly originate from but are not limited to the septum, posteroinferior left atrium, venous ostia, base of the left atrial appendage and left mitral isthmus and they respond quickly to focal ablation. AT not only represents ablation-induced proarrhythmia but also forms a bridge between AF and sinus rhythm in longstanding AF patients treated successfully with catheter ablation.

  13. Structural and functional atrial remodeling in patients after catheter and surgical ablation of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Bockeria L.A.

    2016-03-01

    Full Text Available Atrial fibrillation (AF is the most common supraventricular arrhythmia which occurs in 1.5–2.0% of population. Morbidity of AF increased by 13% over the past two decades. Modern treatment of AF includes drug therapy, catheter radiofrequency ablation and various modifications of Cox Maze operations. The purpose of this review was to assess the atrial remodeling according to world literature. This involved a search of published articles in Medline, Web of Science, PubMed, Cochrane Central Register of Controlled Trials medical databases. During the primary stage of analysis 25 articles of 456 were identified. The researches carried out demonstrate that after catheter ablation and Cox Maze operation in patients with atrial fibrillation left atrium volume decrease, atrial contractile function improvment and sinus rhythm restoration are observed. In the absence of AF recurrence and postoperative atrial arrhythmias in early and late postoperative periods in some patients atrial remodeling is expressed. All data were confirmed by echocardiography, computer tomography and magnetic resonance imaging studies both before and after surgery.

  14. Left atrial appendage closure devices for cardiovascular risk reduction in atrial fibrillation patients

    Directory of Open Access Journals (Sweden)

    Cruz-Gonzalez I

    2015-05-01

    Full Text Available Ignacio Cruz-Gonzalez,* Juan Carlos Rama-Merchan,* Javier Rodriguez-Collado, Javier Martin-Moreiras, Alejandro Diego-Nieto, Antonio Arribas-Jimenez, Pedro Luís SanchezDepartment of Cardiology, University Hospital of Cardiology and IBSAL, Salamanca, Spain *Ignacio Cruz-Gonzalez and Juan Carlos Rama-Merchan have contributed equally to this work and should be considered co-first authors Abstract: Atrial fibrillation (AF is the most common sustained arrhythmia in clinical practice. AF is associated with a 4–5-fold increased risk of stroke and systemic embolism. Oral anticoagulant is the first-line therapy for this purpose, but it has various limitations and is often contraindicated or underutilized. Autopsy and surgical data have suggested that 90% of atrial thrombi in nonvalvular AF patients originate from the left atrial appendage, leading to the development of percutaneous closure for thromboembolic prevention. This paper examines the current evidence on left atrial appendage closure devices for cardiovascular risk reduction in AF patients. Keywords: atrial fibrillation, left atrial appendage, stroke, oral anticoagulant, percutaneous closure, thromboembolic prevention

  15. The antiarrhythmic peptide analog ZP123 prevents atrial conduction slowing during metabolic stress

    DEFF Research Database (Denmark)

    Haugan, Ketil; Olsen, Kristine Boisen; Hartvig, Line;

    2005-01-01

    OBJECTIVE: As atrial conduction slowing is important in the pathogenesis of atrial reentry arrhythmias, a drug that increases atrial conduction or prevents atrial conduction slowing could serve to prevent atrial reentry arrhythmias. In this study, we investigated whether the novel stable antiarrh...

  16. ANTIARRHYTMIC EFFICACY OF SOTALOL IN PATIENTS WITH TACHY-BRADY SYNDROME HAVING ATRIAL PACEMAKER WITH DIFFERENT ATRIAL ELECTRODE POSITION

    Directory of Open Access Journals (Sweden)

    T. N. Novikova

    2009-01-01

    Full Text Available Aim. To evaluate efficacy of the combined therapy (sotalol and constant electric cardiostimulation in AAI regimen at two atrial electrode position: in low back part of interatrial septum (IAS and in right atrial auricle (RAA.Material and methods. 20 patients with tachy-brady syndrome were examined. They were randomized in 2 groups depending on atrial electrode position. Sotalol (160 mg daily was prescribed to all patients in a month after implantation of constant atrial pacemaker (CAP. A number of atrial fibrillation paroxysms (AFP was evaluated initially, in a month after CAP implantation and in a month after start of sotalol therapy.Results. Significant AFP reduction was observed in IAS stimulation, unlike RAA stimulation. Sotalol addition had essential significance in the termination or reduction of AFP. Sotalol effect did not depend on atrial electrode position.Conclusion. Sotalol usage together with constant electric cardiostimulation significantly reduces AFP irrespectively of atrial electrode position. 

  17. Primary care aspects of atrial fibrillation

    NARCIS (Netherlands)

    Meijler, F.L.; Tweel, I. van der

    1985-01-01

    A better understanding of the pathophysiologic mechanisms that determine the random pattem of ventricular rhythm may assist the primary care physician in treating and guiding atrial fibrillation patients. These mechanisms also form the basis for our understanding of drug action and effect on ventric

  18. Right juxtaposition of the atrial appendages.

    Science.gov (United States)

    Mathew, R; Replogle, R; Thilenius, O G; Arcilla, R A

    1975-04-01

    We present an infant with right-sided juxtaposition of atrial appendages who had open heart surgery for ventricular septal defect and patent ductus arteriosus. Of 12 cases thus far reported, ventricular d-loop was observed in nine, and normal position of great vessels in four. Contrary to previous views, this condition may not be accompanied by severe conotruncal anomalies.

  19. Hypercoagulability promotes atrial fibrosis and fibrillation

    NARCIS (Netherlands)

    Spronk, Henri M.H.; De Jong, Anne-Margreet; De Boer, Hetty C.; Maas, Alexander; Verheule, Sander; Rienstra, Michiel; Kamphuisen, Pieter W.; Ten Cate, Hugo; Crijns, Harry J.; Van Gelder, Isabelle; Van Zonneveld, Anton Jan; Schotten, Ullrich

    2014-01-01

    Background: It is well known that atrial fibrillation (AF) induces a hypercoagulable state, which significantly increases stroke risk in patients with AF contributing to morbidity and mortality in these patients. Active coagulation factors can also provoke diverse cellular responses through stimulat

  20. Nonpenetrating right atrial and pericardial trauma.

    Science.gov (United States)

    Grande, Antonino M; Rinaldi, Mauro; Pasquino, Stefano; Dore, Roberto; Viganò, Mario

    2003-09-01

    Nonpenetrating chest trauma can cause cardiac rupture. Ventricles are affected more frequently than atria. Survival is rare and depends upon prompt diagnosis and immediate surgical intervention. We report the case of a 42-year-old man involved in a car accident with consequent right atrial rupture and pericardial tearing.

  1. Genetic Risk Prediction of Atrial Fibrillation

    NARCIS (Netherlands)

    Lubitz, Steven A; Yin, Xiaoyan; Lin, Henry; Kolek, Matthew; Smith, J Gustav; Trompet, Stella; Rienstra, Michiel; Rost, Natalia S; Teixeira, Pedro; Almgren, Peter; Anderson, Christopher D; Chen, Lin Y; Engström, Gunnar; Ford, Ian; Furie, Karen L; Guo, Xiuqing; Larson, Martin G; Lunetta, Kathryn; Macfarlane, Peter W; Psaty, Bruce M; Soliman, Elsayed Z; Sotoodehnia, Nona; Stott, David J; Taylor, Kent D; Weng, Lu-Chen; Yao, Jie; Geelhoed, Bastiaan; Verweij, Niek; Siland, Joylene E; Kathiresan, Sekar; Roselli, Carolina; Roden, Dan M; van der Harst, Pim; Darbar, Dawood; Jukema, J Wouter; Melander, Olle; Rosand, Jonathan; Rotter, Jerome I; Heckbert, Susan R; Ellinor, Patrick T; Alonso, Alvaro; Benjamin, Emelia J

    2016-01-01

    BACKGROUND: -Atrial fibrillation (AF) has a substantial genetic basis. Identification of individuals at greatest AF risk could minimize the incidence of cardioembolic stroke. METHODS: -To determine whether genetic data can stratify risk for development of AF, we examined associations between AF gene

  2. The Atrial Fibrillation Ablation Pilot Study

    DEFF Research Database (Denmark)

    Arbelo, Elena; Brugada, Josep; Hindricks, Gerhard;

    2014-01-01

    was achieved in 40.7% of patients (43.7% in paroxysmal AF; 30.2% in persistent AF; 36.7% in long-lasting persistent AF). A second ablation was required in 18% of the cases and 43.4% were under antiarrhythmic treatment. Thirty-three patients (2.5%) suffered an adverse event, 272 (21%) experienced a left atrial...

  3. Spontaneous conversion of first onset atrial fibrillation

    DEFF Research Database (Denmark)

    Lindberg, Søren Østergaard; Hansen, Sidsel; Nielsen, Tonny

    2011-01-01

    Background  We studied all patients admitted to hospital with first onset atrial fibrillation (AF) to determine the probability of spontaneous conversion to sinus rhythm and to identify factors predictive of such a conversion. Methods and Results  We retrospectively reviewed charts of 438...

  4. Attitudes Towards Catheter Ablation for Atrial Fibrillation

    DEFF Research Database (Denmark)

    Vadmann, Henrik; Pedersen, Susanne S; Nielsen, Jens Cosedis;

    2015-01-01

    BACKGROUND: Catheter ablation for atrial fibrillation (AF) is an important but expensive procedure that is the subject of some debate. Physicians´ attitudes towards catheter ablation may influence promotion and patient acceptance. This is the first study to examine the attitudes of Danish...

  5. Genetic aspects of lone atrial fibrillation

    DEFF Research Database (Denmark)

    Andreasen, Laura; Nielsen, Jonas B; Olesen, Morten S

    2015-01-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia. A subgroup of patients presents with AF without traditional risk factors and is diagnosed before the age of 60 years. Such patients are commonly referred as having "lone AF" and comprise 10-20% of all cases. A number of studies have...

  6. Transonic flutter study of a wind-tunnel model of a supercritical wing with/without winglet. [conducted in Langley Transonic Dynamics Tunnel

    Science.gov (United States)

    Ruhlin, C. L.; Rauch, F. J., Jr.; Waters, C.

    1982-01-01

    The model was a 1/6.5-size, semipan version of a wing proposed for an executive-jet-transport airplane. The model was tested with a normal wingtip, a wingtip with winglet, and a normal wingtip ballasted to simulate the winglet mass properties. Flutter and aerodynamic data were acquired at Mach numbers (M) from 0.6 to 0.95. The measured transonic flutter speed boundary for each wingtip configuration had roughly the same shape with a minimum flutter speed near M=0.82. The winglet addition and wingtip mass ballast decreased the wing flutter speed by about 7 and 5 percent, respectively; thus, the winglet effect on flutter was more a mass effect than an aerodynamic effect.

  7. Stability analysis of the fluttering and autorotation of flow-induced rotation of a hinged flat plate

    Institute of Scientific and Technical Information of China (English)

    MIRZAEISEFAT Sina; FERNANDES Antonio Carlos

    2013-01-01

    This work describes investigations performed on the interaction of uniform current and freely rotating plate about a fixed vertical axis. Fluttering and autorotation are two different motions that may occur during the flow induced rotation. The dimensional analysis proves that the motion in flow induced rotation motion is governed essentially by the dimensionless moment of inertia and Reynolds number. Certain combinations define the stability boundaries between fluttering and autorotation. Fluttering is oscillation of body about a vertical axis and the autorotation is a name given to the case when the body turns continuously about the vertical axis. First, the loads and moment coefficients are calculated by experiments and streamline theory for different angles of attack for a fixed flat plate. Then for dynamic case, a bifurcation diagram is presented based on experiments to classify different motion states of flow induced rotation. Finally, a dynamical model is proposed for stability analysis of flow induced rotation of a flat plate.

  8. Dual chamber pacemaker in the treatment of paroxysmal atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Rađen Goran

    2005-01-01

    Full Text Available Background. Atrial fibrillation is the most frequent cardiac dysrhythmia. The aim of this study was to show the role and the efficacy of a dual chamber pacemaker with the algorithm of atrial dynamic overdrive, in the suppression of paroxysmal atrial fibrillation. Case report. A woman with a classical bradycardia-tachycardia syndrome, and frequent attacks of atrial fibrillation, underwent the implantation of a single chamber permanent pacemaker (VVI. Pacemaker successfully treated the episodes of symptomatic bradycardia, but the patient had frequent attacks of atrial fibrillation, despite the use of different antiarrhythmic drugs, which she did not tolerate well. The decision was made to reimplant a permanent dual chamber pacemaker with the algorithm of atrial dynamic overdrive. The pacemaker was programmed to the basic rate of 75/min, while rate at rest was 55/min. In addition, sotalol was administered. After three months, the patient became asymptomatic with only 4 short − term episodes of atrial fibrillation, and a high level of atrial pacing (99%. Conclusion. In selected patients with bradycardia−tachycardia syndrome, atrial-based pacing seemed to be very effective in reducing the incidence of paroxysmal atrial fibrillation.

  9. Aerothermoelastic analysis of panel flutter based on the absolute nodal coordinate formulation

    Energy Technology Data Exchange (ETDEWEB)

    Abbas, Laith K., E-mail: laithabbass@yahoo.com; Rui, Xiaoting, E-mail: ruixt@163.com [Nanjing University of Science and Technology, Institute of Launch Dynamics (China); Marzocca, Piergiovanni, E-mail: pmarzocc@clarkson.edu [Clarkson University, Mechanical and Aeronautical Engineering Department (United States)

    2015-02-15

    Panels of reentry vehicles are subjected to a wide range of flow conditions during ascent and reentry phases. The flow can vary from subsonic continuum flow to hypersonic rarefied flow with wide ranging dynamic pressure and associated aerodynamic heating. One of the main design considerations is the assurance of safety against panel flutter under the flow conditions characterized by sever thermal environment. This paper deals with supersonic/hypersonic flutter analysis of panels exposed to a temperature field. A 3-D rectangular plate element of variable thickness based on absolute nodal coordinate formulation (ANCF) has been developed for the structural model and subjected to an assumed thermal profile that can result from any residual heat seeping into the metallic panels through the thermal protection systems. A continuum mechanics approach for the definition of the elastic forces within the finite element is considered. Both shear strain and transverse normal strain are taken into account. The aerodynamic force is evaluated by considering the first-order piston theory to linearize the potential flow and is coupled with the structural model to account for pressure loading. A provision is made to take into account the effect of arbitrary flow directions with respect to the panel edges. Aerothermoelastic equations using ANCF are derived and solved numerically. Values of critical dynamic pressure are obtained by a modal approach, in which the mode shapes are obtained by ANCF. A detailed parametric study is carried out to observe the effects of different temperature loadings, flow angle directions, and aspect ratios on the flutter boundary.

  10. Response of SII cortex to ipsilateral, contralateral and bilateral flutter stimulation in the cat

    Directory of Open Access Journals (Sweden)

    Favorov Oleg

    2005-02-01

    Full Text Available Abstract Background A distinctive property of SII is that it is the first cortical stage of the somatosensory projection pathway that integrates information arising from both sides of the body. However, there is very little known about how inputs across the body mid-line are processed within SII. Results Optical intrinsic signal imaging was used to evaluate the response of primary somatosensory cortex (SI and SII in the same hemisphere to 25 Hz sinusoidal vertical skin displacement stimulation ("skin flutter" applied contralaterally, ipsilaterally, and bilaterally to the central pads of the forepaws. A localized increase in absorbance in both SI and SII was evoked by both contralateral and bilateral flutter stimulation. Ipsilateral flutter stimulation evoked a localized increase in absorbance in SII, but not in SI. The SII region that responded with an increase in absorbance to ipsilateral stimulation was posterior to the region in which absorbance increased maximally in response to stimulation of the contralateral central pad. Additionally, in the posterior SII region that responded maximally to ipsilateral stimulation of the central pad, bilateral central pad stimulation approximated a linear summation of the SII responses to independent stimulation of the contralateral and ipsilateral central pads. Conversely, in anterior SII (the region that responded maximally to contralateral stimulation, bilateral stimulation was consistently less than the response evoked from the contralateral central pad. Conclusions The results indicate that two regions located at neighboring, but distinctly different A-P levels of the anterior ectosylvian gyrus process input from opposite sides of the body midline in very different ways. The results suggest that the SII cortex, in the cat, can be subdivided into at least two functionally distinct regions and that these functionally distinct regions demonstrate a laterality preference within SII.

  11. A parametric sensitivity and optimization study for the active flexible wing wind-tunnel model flutter characteristics

    Science.gov (United States)

    Rais-Rohani, Masoud

    1991-01-01

    In this paper an effort is made to improve the analytical open-loop flutter predictions for the Active Flexible Wing wind-tunnel model using a sensitivity based optimization approach. The sensitivity derivatives of the flutter frequency and dynamic pressure of the model with respect to the lag terms appearing in the Roger's unsteady aerodynamics approximations are evaluated both analytical and by finite differences. Then, the Levenberg-Marquardt method is used to find the optimum values for these lag-terms. The results obtained here agree much better with the experimental (wind tunnel) results than those found in the previous studies.

  12. Unfolding the conical zones of the dissipation-induced subcritical flutter for the rotationally symmetrical gyroscopic systems

    CERN Document Server

    Kirillov, Oleg N

    2008-01-01

    Flutter of an elastic body of revolution spinning about its axis of symmetry is prohibited in the subcritical spinning speed range by the Krein theorem for the Hamiltonian perturbations. Indefinite damping creates conical domains of the subcritical flutter (subcritical parametric resonance) bifurcating into the pockets of two Whitney's umbrellas when non-conservative positional forces are additionally taken into account. This explains why in contrast to the common intuition, but in agreement with experience, symmetry-breaking stiffness variation can promote subcritical friction-induced oscillations of the rotor rather than inhibit them.

  13. Assessment of the dynamics of atrial signals and local atrial period series during atrial fibrillation: effects of isoproterenol administration

    Directory of Open Access Journals (Sweden)

    Mantica Massimo

    2004-10-01

    Full Text Available Abstract Background The autonomic nervous system (ANS plays an important role in the genesis and maintenance of atrial fibrillation (AF, but quantification of its electrophysiologic effects is extremely complex and difficult. Aim of the study was to evaluate the capability of linear and non-linear indexes to capture the fine changing dynamics of atrial signals and local atrial period (LAP series during adrenergic activation induced by isoproterenol (a sympathomimetic drug infusion. Methods Nine patients with paroxysmal or persistent AF (aged 60 ± 6 underwent electrophysiological study in which isoproterenol was administered to patients. Atrial electrograms were acquired during i sinus rhythm (SR; ii sinus rhythm during isoproterenol (SRISO administration; iii atrial fibrillation (AF and iv atrial fibrillation during isoproterenol (AFISO administration. The level of organization between two electrograms was assessed by the synchronization index (S, whereas the degree of recurrence of a pattern in a signal was defined by the regularity index (R. In addition, the level of predictability (LP and regularity of LAP series were computed. Results LAP series analysis shows a reduction of both LP and R index during isoproterenol infusion in SR and AF (RSR = 0.75 ± 0.07 RSRISO = 0.69 ± 0.10, p AF = 0.31 ± 0.08 RAFISO = 0.26 ± 0.09, p SR = 99.99 ± 0.001 LPSRISO = 99.97 ± 0.03, p AF = 69.46 ± 21.55 LPAFISO = 55 ± 24.75; p SR = 0.49 ± 0.08 RSRISO = 0.46 ± 0.09 p AF = 0.29 ± 0.09 RAFISO = 0.28 ± 0.08 n.s.. Conclusions The proposed parameters succeeded in discriminating the subtle changes due to isoproterenol infusion during both the rhythms especially when considering LAP series analysis. The reduced value of analyzed parameters after isoproterenol administration could reflect an important pro-arrhythmic influence of adrenergic activation on favoring maintenance of AF.

  14. Supercritical as well as subcritical Hopf bifurcation in nonlinear flutter systems

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    The Hopf bifurcations of an airfoil flutter system with a cubic nonlinearity are investigated,with the flow speed as the bifurcation parameter.The center manifold theory and complex normal form method are used to obtain the bifurcation equation.Interestingly,for a certain linear pitching stiffness the Hopf bifurcation is both supercritical and subcritical.It is found,mathematically,this is caused by the fact that one coefficient in the bifurcation equation does not contain the first power of the bifurcation parameter.The solutions of the bifurcation equation are validated by the equivalent linearization method and incremental harmonic balance method.

  15. Aero-servo-viscoelasticity theory: Lifting surfaces, plates, velocity transients, flutter, and instability

    Science.gov (United States)

    Merrett, Craig G.

    -partial differential equations. The spatial component of the governing equations is eliminated using a series expansion of basis functions and by applying Galerkin's method. The number of terms in the series expansion affects the convergence of the spatial component, and convergence is best determined by the von Koch rules that previously appeared for column buckling problems. After elimination of the spatial component, an ordinary integral-differential equation in time remains. The dynamic stability of elastic and viscoelastic problems is assessed using the determinant of the governing system of equations and the time component of the solution in the form exp (lambda t). The determinant is in terms of lambda where the values of lambda are the latent roots of the aero-servo-viscoelastic system. The real component of lambda dictates the stability of the system. If all the real components are negative, the system is stable. If at least one real component is zero and all others are negative, the system is neutrally stable. If one or more real components are positive, the system is unstable. In aero-servo-viscoelasticity, the neutrally stable condition is termed flutter. For an aero-servo-viscoelastic lifting surface, the unstable condition is historically termed torsional divergence. The more general aero-servo-viscoelastic theory has produced a number of important results, enumerated in the following list: 1. Subsonic panel flutter can occur before panel instability. This result overturned a long held assumption in aeroelasticity, and was produced by the novel application of the von Koch rules for convergence. Further, experimental results from the 1950s by the Air Force were retrieved to provide additional proof. 2. An expanded definition for flutter of a lifting surface. The legacy definition is that flutter is the first occurrence of simple harmonic motion of a structure, and the flight velocity at which this motion occurs is taken as the flutter speed. The expanded definition

  16. Transonic test of a forward swept wing configuration exhibiting Body Freedom Flutter

    Science.gov (United States)

    Chipman, R.; Rauch, F.; Rimer, M.; Muniz, B.; Ricketts, R. H.

    1985-01-01

    The aeroelastic dynamic instability designated Body Freedom Flutter (BFF) involves aircraft pitch and wing bending motions characteristic of forward swept wing (FSW) aircraft. Attention is presently given to the results of tests conducted on a 1/2-scale cable-mounted FSW wind tunnel model, with and without relaxed static stability (RSS) control conditions. BFF instability boundaries were found to occur at significantly lower air speeds than those associated with aeroelastic wing divergence on the same model. Servoaeroelastic stability analyses have been conducted which proved capable of predicting the measured onset of BFF, in both the statically stable and RSS configurations tested.

  17. Three-dimensional nonlinear flutter analysis of long-span suspension bridges during erection.

    Science.gov (United States)

    Zhang, Xin-jun; Sun, Bing-nan; Xiang, Hai-fan

    2003-01-01

    In this work, the aerodynamic stability of the Yichang Suspension Bridge over Yangtze River during erection was determined by three-dimensional nonlinear flutter analysis, in which the nonlinearities of structural dynamic characteristics and aeroelastic forces caused by large deformation are fully considered. An interesting result obtained was that the bridge was more stable when the stiffening girders were erected in a non-symmetrical manner as opposed to the traditional symmetrical erection schedule. It was also found that the severe decrease in the aerodynamic stability was due to the nonlinear effects. Therefore, the nonlinear factors should be considered accurately in aerodynamic stability analysis of long-span suspension bridges during erection.

  18. Three-dimensional nonlinear flutter analysis of long-span suspension bridges during erection

    Institute of Scientific and Technical Information of China (English)

    张新军; 孙炳楠; 项海帆

    2003-01-01

    In this work, the aerodynamic stability of the Yichang Suspension Bridge over Yangtze River during erection was determined by three-dimensional nonlinear flutter analysis, in which the nonlinearities of structural dynamic characteristics and aeroelastic forces caused by large deformation are fully considered. An interesting result obtained was that the bridge was more stable when the stiffening girders were erected in a non-symmetrical manner as opposed to the traditional symmetrical erection schedule. It was also found that the severe decrease in the aerodynamic stability was due to the nonlinear effects. Therefore, the nonlinear factors should be considered accurately in aerodynamic stability analysis of long-span suspension bridges during erection.

  19. Three-dimensional nonlinear flutter analysis of long-span suspension bridges during erection

    Institute of Scientific and Technical Information of China (English)

    张新军; 孙炳楠; 项海帆

    2003-01-01

    In this work, the aerodynamic stability of the Yichang Suspension Bridge over Yangtze River during erection was determined by three-dimensional nonlinear flutter analysis, in which the nonlinearities of structural dynamic characteristics and aeroelastic forces caused by large deformation are fully considered. An interesting resuh obtained was that the bridge was more stable when the stiffening girders were erected in a non-symmetrical manner as opposed to the traditional symmetrical erection schedule. It was also found that the severe decrease in the aerodynamic stability was due to the nonlinear effects. Therefore, the nonlinear factors should be considered accurately in aerodynamic stability analysis of long-span suspension bridges during erection.

  20. Finite element modal formulation for panel flutter at hypersonic speeds and elevated temperatures

    Science.gov (United States)

    Cheng, Guanfeng

    A finite element time domain modal formulation for analyzing flutter behavior of aircraft surface panels in hypersonic airflow has been developed and presented for the first time. Von Karman large deflection plate theory is used for description of the structural nonlinearity and third order piston theory is employed to account for the aerodynamic nonlinearity. The thermal loadings of uniformly distributed temperature and temperature gradients across the panel thickness are incorporated into the finite element formulation. By applying the modal reduction technique, the number of governing equations of motion is reduced dramatically so that the computational time of direct numerical integration is dropped significantly. All possible types of panel behavior, including flat, buckled but dynamically stable, limit cycle oscillation (LCO), periodic motion, and chaotic motion can be observed and analyzed. As examples of the applications of the proposed methodology, flutter responses of isotropic, specially orthotropic and laminated composite panels are investigated. Special emphasis is put on the boundary between LCO and chaos, as well as the routes to chaos. A systematic mode filtering procedure that helps mode selection without specific knowledge of the complex mode shapes is presented and illustrated. Influences of aerodynamic parameters, including aerodynamic damping and Mach number, on the panel flutter responses are studied. The importance of nonlinear aerodynamic terms is examined in detail. The supporting conditions and panel aspect ratio on the onset condition of chaos are also investigated as an illustration of optimization among different design options. Several mathematical tools, including the time history, phase plane plot, Poincare map, and bifurcation diagram are employed in the chaos study. The largest Lyapunov exponent is also evaluated to assist in detection of chaos. It is found that at low or moderately high nondimensional dynamic pressures, the

  1. 78 FR 11207 - Clinical Study Designs for Surgical Ablation Devices for Treatment of Atrial Fibrillation...

    Science.gov (United States)

    2013-02-15

    ... Treatment of Atrial Fibrillation; Guidance for Industry and Food and Drug Administration Staff; Availability... Ablation Devices for Treatment of Atrial Fibrillation.'' This guidance provides FDA's recommendations on clinical trial designs for surgical ablation devices intended for the treatment of atrial...

  2. Protein analysis of atrial fibrosis via label-free proteomics in chronic atrial fibrillation patients with mitral valve disease.

    Directory of Open Access Journals (Sweden)

    Peide Zhang

    Full Text Available BACKGROUND: Atrial fibrosis, as a hallmark of atrial structure remodeling, plays an important role in maintenance of chronic atrial fibrillation, but interrelationship of atrial fibrosis and atrial fibrillation is uncertain. Label-free proteomics can implement high throughput screening for finding and analyzing pivotal proteins related to the disease.. Therefore, we used label-free proteomics to explore and analyze differentially proteins in chronic atrial fibrillation patients with mitral valve disease. METHODS: Left and right atrial appendages obtained from patients with mitral valve disease were both in chronic atrial fibrillation (CAF, AF≥6 months, n = 6 and in sinus rhythm (SR, n = 6. One part of the sample was used for histological analysis and fibrosis quantification; other part were analyzed by label-free proteomic combining liquid chromatography with mass spectrometry (LC-MS, we utilized bioinformatics analysis to identify differential proteins. RESULTS: Degree of atrial fibrosis was higher in CAF patients than that of SR patients. 223 differential proteins were detected between two groups. These proteins mainly had vital functions such as cell proliferation, stress response, focal adhesion apoptosis. We evaluated that serine/threonine protein kinase N2 (PKN2, dermatopontin (DP, S100 calcium binding protein B (S100B, protein tyrosine kinase 2 (PTK2 and discoidin domain receptor tyrosine kinase 2 (DDR2 played important roles in fibrotic process related to atrial fibrillation. CONCLUSION: The study presented differential proteins responsible for atrial fibrosis in chronic atrial fibrillation patients through label-free proteomic analysis. We assessed some vital proteins including their characters and roles. These findings may open up new realm for mechanism research of atrial fibrillation.

  3. [Atrial fibrillation as consequence and cause of structural changes of atria].

    Science.gov (United States)

    Aparina, O P; Chikhireva, L N; Stukalova, O V; Mironova, N A; Kashtanova, S Iu; Ternovoĭ, S K; Golitsyn, S P

    2014-01-01

    Changes of atrial structure and function are the contributors of atrial fibrillation clinical course, complications and treatment effectiveness. Effects of inflammation and mechanical stretch on atrial structural remodeling leading to atrial fibrillation are reviewed in the article. Contemporary invasive and non-invasive methods of evaluation (including late gadolinium enhancement magnetic resonance imaging) of patients with atrial structural remodeling in atrial fibrillation are also described.

  4. Atrial infarction is a unique and often unrecognized clinical entity

    Directory of Open Access Journals (Sweden)

    Rosana G. G. Mendes

    1999-03-01

    Full Text Available A patient with heart failure and acute atrial fibrillation received the final diagnosis of atrial infarction associated with ventricular infarction based on clinical findings of ischemia in association with atrial fibrillation and heart failure (mechanisms probably involved: contractile dysfunction and loss of atrial contribution. Although a transesophageal echocardiography, which could refine the diagnosis of anatomic abnormalities, was not performed, all evidence led to the diagnosis of atrial involvement. Electrocardiographic findings were consistent with Liu's major criterion 3. Therapy with digitalis, quinidine and angiotensin-converting enzyme inhibitors was chosen, as the patient had acute pulmonary edema. The use of beta-blockers and verapamil was restricted. No other complications, such as thrombo-embolism or atrial rupture, were noted.

  5. Atrial Myxoma in a Patient with Hypertrophic Cardiomyopathy

    Science.gov (United States)

    Abdou, Mahmoud; Hayek, Salim; Williams, Byron R.

    2013-01-01

    Atrial myxoma is the most common primary cardiac tumor. Patients with atrial myxoma typically present with obstructive, embolic, or systemic symptoms; asymptomatic presentation is very rare. To our knowledge, isolated association of atrial myxoma with hypertrophic cardiomyopathy has been reported only once in the English-language medical literature. We report the case of an asymptomatic 71-year-old woman with known hypertrophic cardiomyopathy in whom a left atrial mass was incidentally identified on cardiac magnetic resonance images. After surgical excision of the mass and partial excision of the left atrial septum, histopathologic analysis confirmed the diagnosis of atrial myxoma. The patient was placed on preventive implantable cardioverter-defibrillator therapy and remained asymptomatic. The management of asymptomatic cardiac myxoma is a topic of debate, because no reports definitively favor either conservative or surgical measures. PMID:24082380

  6. Inter-subject variability in human atrial action potential in sinus rhythm versus chronic atrial fibrillation.

    Directory of Open Access Journals (Sweden)

    Carlos Sánchez

    Full Text Available Human atrial electrophysiology exhibits high inter-subject variability in both sinus rhythm (SR and chronic atrial fibrillation (cAF patients. Variability is however rarely investigated in experimental and theoretical electrophysiological studies, thus hampering the understanding of its underlying causes but also its implications in explaining differences in the response to disease and treatment. In our study, we aim at investigating the ability of populations of human atrial cell models to capture the inter-subject variability in action potential (AP recorded in 363 patients both under SR and cAF conditions.Human AP recordings in atrial trabeculae (n = 469 from SR and cAF patients were used to calibrate populations of computational SR and cAF atrial AP models. Three populations of over 2000 sampled models were generated, based on three different human atrial AP models. Experimental calibration selected populations of AP models yielding AP with morphology and duration in range with experimental recordings. Populations using the three original models can mimic variability in experimental AP in both SR and cAF, with median conductance values in SR for most ionic currents deviating less than 30% from their original peak values. All cAF populations show similar variations in G(K1, G(Kur and G(to, consistent with AF-related remodeling as reported in experiments. In all SR and cAF model populations, inter-subject variability in I(K1 and I(NaK underlies variability in APD90, variability in I(Kur, I(CaL and I(NaK modulates variability in APD50 and combined variability in Ito and I(Kur determines variability in APD20. The large variability in human atrial AP triangulation is mostly determined by I(K1 and either I(NaK or I(NaCa depending on the model.Experimentally-calibrated human atrial AP models populations mimic AP variability in SR and cAF patient recordings, and identify potential ionic determinants of inter-subject variability in human atrial AP

  7. Association of Atrial Fibrillation with Morphological and Electrophysiological Changes of the Atrial Myocardium.

    Science.gov (United States)

    Matějková, Adéla; Šteiner, Ivo

    Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. For long time it was considered as pure functional disorder, but in recent years, there were identified atrial locations, which are involved in the initiation and maintenance of this arrhythmia. These structural changes, so called remodelation, start at electric level and later they affect contractility and morphology. In this study we attempted to find a possible relation between morphological (scarring, amyloidosis, left atrial (LA) enlargement) and electrophysiological (ECG features) changes in patients with AF. We examined grossly and histologically 100 hearts of necropsy patients - 54 with a history of AF and 46 without AF. Premortem ECGs were evaluated. The patients with AF had significantly heavier heart, larger LA, more severely scarred myocardium of the LA and atrial septum, and more severe amyloidosis in both atria. Severity of amyloidosis was higher in LAs vs. right atria (RAs). Distribution of both fibrosis and amyloidosis was irregular. The most affected area was in the LA anterior wall. Patients with a history of AF and with most severe amyloidosis have more often abnormally long P waves. Finding of long P wave may contribute to diagnosis of a hitherto undisclosed atrial fibrillation.

  8. Predictors of Occult Paroxysmal Atrial Fibrillation in Cryptogenic Strokes Detected by Long-Term Noninvasive Cardiac Monitoring

    Directory of Open Access Journals (Sweden)

    Archit Bhatt

    2011-01-01

    Full Text Available Background and Purpose. Paroxysmal Atrial fibrillation/Flutter (PAF detection rates in cryptogenic strokes have been variable. We sought to determine the percentage of patients with cryptogenic stroke who had PAF on prolonged non-invasive cardiac monitoring. Methods and Results. Sixty-two consecutive patients with stroke and TIA in a single center with a mean age of 61 (+/− 14 years were analyzed. PAF was detected in 15 (24% patients. Only one patient reported symptoms of shortness of breath during the episode of PAF while on monitoring, and 71 (97% of these 73 episodes were asymptomatic. A regression analysis revealed that the presence of PVCs (ventricular premature beats lasting more than 2 minutes (OR 6.3, 95% CI, 1.11–18.92; P=.042 and strokes (high signal on Diffusion Weighted Imaging (OR 4.3, 95% CI, 5–36.3; P=.041 predicted PAF. Patients with multiple DWI signals were more likely than solitary signals to have PAF (OR 11.1, 95% CI, 2.5–48.5, P<.01. Conclusion. Occult PAF is common in cryptogenic strokes, and is often asymptomatic. Our data suggests that up to one in five patients with suspected cryptogenic strokes and TIAs have PAF, especially if they have PVCs and multiple high DWI signals on MRI.

  9. Echocardiographic assessment and percutaneous closure of multiple atrial septal defects

    Directory of Open Access Journals (Sweden)

    Timperley Jonathan

    2004-07-01

    Full Text Available Abstract Atrial septal defect closure is now routinely performed using a percutaneous approach under echocardiographic guidance. Centrally located, secundum defects are ideal for device closure but there is considerable morphological variation in size and location of the defects. A small proportion of atrial septal defects may have multiple fenestrations and these are often considered unsuitable for device closure. We report three cases of multiple atrial septal defects successfully closed with two Amplatzer septal occluders.

  10. STRATEGIES OF PROPHYLAXIS AND MANAGEMENT OF POSTOPERATIVE ATRIAL FIBRILLATION

    Directory of Open Access Journals (Sweden)

    Dembele, A.

    2016-07-01

    Full Text Available This article analyses different strategies of prophylaxis and management of postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting (CABG at different periods after acute myocardial infarction (AMI. It examines the efficacy of early administration of beta-adrenergic blocking agents (metoprolol and amiodarone (in prophylactic doses in the diminution of the risk of postoperative atrial fibrillation in different groups of patients. The article also discerns the effectiveness of digoxin in the management of episodes of postoperative atrial fibrillation.

  11. Juxtaposed atrial appendages: A curiosity with some clinical relevance

    Directory of Open Access Journals (Sweden)

    Anil Kumar Singhi

    2016-01-01

    Full Text Available If the atrial appendages lie adjacent to each other on same side of the great arteries, instead of encircling their roots, they are referred as juxtaposed. Right juxtaposition of atrial appendages is less common than left juxtaposition. The images demonstrate the classical radiological, echocardiographic, and surgical images of juxtaposed atrial appendages. Their clinical incidence, associations, and relevance during interventional and surgical procedures are discussed.

  12. Cardiac ion channels and mechanisms for protection against atrial fibrillation

    DEFF Research Database (Denmark)

    Grunnet, Morten; Bentzen, Bo Hjorth; Sørensen, Ulrik S;

    2011-01-01

    Atrial fibrillation (AF) is recognised as the most common sustained cardiac arrhythmia in clinical practice. Ongoing drug development is aiming at obtaining atrial specific effects in order to prevent pro-arrhythmic, devastating ventricular effects. In principle, this is possible due to a different...... to the recent discovery that Ca(2+)-activated small conductance K(+) channels (SK channels) are important for the repolarisation of atrial action potentials. Finally, an overview of current pharmacological treatment of AF is included....

  13. Dynamic stiffness testing-based flutter analysis of a fin with an actuator

    Institute of Scientific and Technical Information of China (English)

    Zhang Renjia; Wu Zhigang; Yang Chao

    2015-01-01

    Engineering-oriented modeling and synthesized modeling of the fin-actuator system of a missile fin are introduced, including mathematical modeling of the fin, motor and multi-stage gear reducer. The fin-actuator model is verified using dynamic stiffness testing. Good agreement is achieved between the test and theoretical results. The parameter-variable analysis indicates that the inertia of the motor rotor, reduction ratio of the reducer, connection stiffness and damping between the actuator and fin shaft have significant impacts on the dynamic stiffness characteristics. In flutter analysis, test data are directly used in the frequency domain method and indirectly used in the time domain method through the updated fin-actuator model. The two methods play different roles in engineering applications but are of equal importance. The results indicate that dynamic stiffness and constant stiffness treatments may lead to completely different flutter characteristics. Attention should be paid to the design of the fin-actuator system of a missile.

  14. Steady dynein forces induce flutter instability and propagating waves in mathematical models of flagella.

    Science.gov (United States)

    Bayly, P V; Dutcher, S K

    2016-10-01

    Cilia and flagella are highly conserved organelles that beat rhythmically with propulsive, oscillatory waveforms. The mechanism that produces these autonomous oscillations remains a mystery. It is widely believed that dynein activity must be dynamically regulated (switched on and off, or modulated) on opposite sides of the axoneme to produce oscillations. A variety of regulation mechanisms have been proposed based on feedback from mechanical deformation to dynein force. In this paper, we show that a much simpler interaction between dynein and the passive components of the axoneme can produce coordinated, propulsive oscillations. Steady, distributed axial forces, acting in opposite directions on coupled beams in viscous fluid, lead to dynamic structural instability and oscillatory, wave-like motion. This 'flutter' instability is a dynamic analogue to the well-known static instability, buckling. Flutter also occurs in slender beams subjected to tangential axial loads, in aircraft wings exposed to steady air flow and in flexible pipes conveying fluid. By analysis of the flagellar equations of motion and simulation of structural models of flagella, we demonstrate that dynein does not need to switch direction or inactivate to produce autonomous, propulsive oscillations, but must simply pull steadily above a critical threshold force.

  15. Malfunction of a Heimlich flutter valve causing tension pneumothorax: case report of a rare complication

    Directory of Open Access Journals (Sweden)

    Braunstein Volker A

    2010-06-01

    Full Text Available Abstract Background Thoracic injuries play an important role in major trauma patients due to their high incidence and critical relevance. A serious consequence of thoracic trauma is pneumothorax, a condition that quickly can become life-threatening and requires immediate treatment. Decompression is the state of the art for treating tension pneumothorax. There are many different methods of decompression using different techniques, devices, valves and drainage systems. Referring to our case report we would like to discuss the utilization of these devices. Case presentation We report of a patient suffering from tension pneumothorax despite insertion of a chest drain at the accident scene. The decompression was by tube thoracostomy which was connected to a Heimlich flutter valve. During air transportation the patient suffered from cardiorespiratory arrest with asystole and was admitted to the trauma room undergoing manual chest compressions. The initial chest film showed a persisting tension pneumothorax, despite the chest tube that had been correctly placed and connected properly to the Heimlich valve. We assume that the Heimlich valve leaves did not open up and thus tension pneumothorax was not released. Conclusion We would like to raise awareness to the fact that if a Heimlich flutter valve is applied in the pre-hospital setting it should be used with caution. Failure in this type of valve may lead to recurrent tension pneumothorax.

  16. Reduced-Order Modeling for Flutter/LCO Using Recurrent Artificial Neural Network

    Science.gov (United States)

    Yao, Weigang; Liou, Meng-Sing

    2012-01-01

    The present study demonstrates the efficacy of a recurrent artificial neural network to provide a high fidelity time-dependent nonlinear reduced-order model (ROM) for flutter/limit-cycle oscillation (LCO) modeling. An artificial neural network is a relatively straightforward nonlinear method for modeling an input-output relationship from a set of known data, for which we use the radial basis function (RBF) with its parameters determined through a training process. The resulting RBF neural network, however, is only static and is not yet adequate for an application to problems of dynamic nature. The recurrent neural network method [1] is applied to construct a reduced order model resulting from a series of high-fidelity time-dependent data of aero-elastic simulations. Once the RBF neural network ROM is constructed properly, an accurate approximate solution can be obtained at a fraction of the cost of a full-order computation. The method derived during the study has been validated for predicting nonlinear aerodynamic forces in transonic flow and is capable of accurate flutter/LCO simulations. The obtained results indicate that the present recurrent RBF neural network is accurate and efficient for nonlinear aero-elastic system analysis

  17. Transient aeroelastic responses and flutter analysis of a variable-span wing during the morphing process

    Institute of Scientific and Technical Information of China (English)

    Huang Ren; Qiu Zhiping

    2013-01-01

    To investigate the transient aeroelastic responses and flutter characteristics of a variable-span wing during the morphing process, a novel first-order state-space aeroelastic model is pro-posed. The time-varying structural model of the morphing wing is established based on the Euler-Bernoulli beam theory with time-dependent boundary conditions. A nondimensionalization method is used to translate the time-dependent boundary conditions to be time-independent. The time-domain aerodynamic forces are calculated by the reduced-order unsteady vortex lattice method. The morphing parameters, i.e., wing span length and morphing speed, are of particular interest for understanding the fundamental aeroelastic behavior of variable-span wings. A test case is proposed and numerical results indicate that the flutter characteristics are sensitive to both of the two morphing parameters. It could be noticed that the aeroelastic characteristics during the wing extracting process are more serious than those during the extending process at the same morphing speed by transient aeroelastic response analysis. In addition, a faster morphing process can get bet-ter aeroelastic performance while the mechanism comlexity will arise.

  18. Adaptive Flutter Suppression for a Fighter Wing via Recurrent Neural Networks over a Wide Transonic Range

    Directory of Open Access Journals (Sweden)

    Haojie Liu

    2016-01-01

    Full Text Available The paper presents a digital adaptive controller of recurrent neural networks for the active flutter suppression of a wing structure over a wide transonic range. The basic idea behind the controller is as follows. At first, the parameters of recurrent neural networks, such as the number of neurons and the learning rate, are initially determined so as to suppress the flutter under a specific flight condition in the transonic regime. Then, the controller automatically adjusts itself for a new flight condition by updating the synaptic weights of networks online via the real-time recurrent learning algorithm. Hence, the controller is able to suppress the aeroelastic instability of the wing structure over a range of flight conditions in the transonic regime. To demonstrate the effectiveness and robustness of the controller, the aeroservoelastic model of a typical fighter wing with a tip missile was established and a single-input/single-output controller was synthesized. Numerical simulations of the open/closed-loop aeroservoelastic simulations were made to demonstrate the efficacy of the adaptive controller with respect to the change of flight parameters in the transonic regime.

  19. Control on a 2-D Wing Flutter Using an AdaptiveNonlinear Neural Controller

    Directory of Open Access Journals (Sweden)

    Hayder S. Abd Al-Amir

    2011-01-01

    Full Text Available An adaptive nonlinear neural controller to reduce the nonlinear flutter in 2-D wing is proposed in the paper. The nonlinearities in the system come from the quasi steady aerodynamic model and torsional spring in pitch direction. Time domain simulations are used to examine the dynamic aero elastic instabilities of the system (e.g. the onset of flutter and limit cycle oscillation, LCO. The structure of the controller consists of two models :the modified Elman neural network (MENN and the feed forward multi-layer Perceptron (MLP. The MENN model is trained with off-line and on-line stages to guarantee that the outputs of the model accurately represent the plunge and pitch motion of the wing and this neural model acts as the identifier. The feed forward neural controller is trained off-line and adaptive weights are implemented on-line to find the flap angles, which controls the plunge and pitch motion of the wing. The general back propagation algorithm is used to learn the feed forward neural controller and the neural identifier. The simulation results show the effectiveness of the proposed control algorithm; this is demonstrated by the minimized tracking error to zero approximation with very acceptable settling time even with the existence of bounded external disturbances.

  20. Vascular disease and stroke risk in atrial fibrillation

    DEFF Research Database (Denmark)

    Olesen, Jonas Bjerring; Lip, Gregory Y.H.; Lane, Deirdre A;

    2012-01-01

    Vascular disease (including myocardial infarction and peripheral artery disease) has been proposed as a less well-validated risk factor for stroke in patients with atrial fibrillation. We investigated whether vascular disease is an independent risk factor of stroke/thromboembolism in atrial fibri...... fibrillation and whether adding vascular disease improves Congestive heart failure, Hypertension, Age 75 years, Diabetes, previous Stroke (CHADS(2)) risk stratification.......Vascular disease (including myocardial infarction and peripheral artery disease) has been proposed as a less well-validated risk factor for stroke in patients with atrial fibrillation. We investigated whether vascular disease is an independent risk factor of stroke/thromboembolism in atrial...

  1. Fibrosis in Atrial Fibrillation - Role of Reactive Species and MPO.

    Science.gov (United States)

    Friedrichs, Kai; Baldus, Stephan; Klinke, Anna

    2012-01-01

    Atrial fibrosis with enhanced turnover and deposition of matrix proteins leads to inhomogeneous atrial electrical conduction and gives rise to electrical reentry circuits resulting in atrial fibrillation. The multifactorial pathogenesis of atrial fibrosis involves resident cardiac cells as well as infiltrating leukocytes, both generating and sequestering matrix metalloproteinases (MMPs), a key enzyme family involved in fibrosis. A growing body of evidence points toward an important role of reactive oxygen species (ROS) in the release and activation of pro-MMPs and the stimulation of pro-fibrotic cascades. Myeloperoxidase (MPO), a bactericidal enzyme released from activated polymorphonuclear neutrophils (PMN) is not only associated with a variety of cardiovascular diseases, but has also been shown to be mechanistically linked to atrial fibrosis and fibrillation. MPO catalyzes the generation of reactive species like hypochlorous acid, which affect intracellular signaling cascades in various cells and advance activation of pro-MMPs and deposition of atrial collagen resulting in atrial arrhythmias. Thus, inflammatory mechanisms effectively promote atrial structural remodeling and importantly contribute to the initiation and perpetuation of atrial fibrillation.

  2. [Atrial fibrillation ablation: application of nurse methodology].

    Science.gov (United States)

    Ramos-González-Serna, Amelia; Mateos-García, M Dolores

    2011-01-01

    Ablation of pulmonary veins for treatment of atrial fibrillation involves applying radiofrequency energy wave by a catheter that causes a circumferential lesion to achieve electrical isolation and voltage drop in the interior. It is mainly applied when there is resistance to treatment and recurrence of symptoms affecting the quality of life of patients. The nurse is an important part of the multidisciplinary team who care for patients who undergo this procedure. The provision of comprehensive nursing care should include nursing procedures prior to, during, and after treatment to ensure the careful and systematic quality required. The aims of this article are: to provide specialised knowledge on the procedure of atrial fibrillation ablation, to describe the preparation of the electrophysiology laboratory, analyse nursing care and develop a standardized care plan for patients on whom this procedure is performed using the NANDA (North American Nursing Association) taxonomy and NIC (Nursing Intervention Classification).

  3. Pathogenic Mechanisms of Atrial Fibrillation in Obesity

    Directory of Open Access Journals (Sweden)

    O. M. Drapkina

    2016-01-01

    Full Text Available Atrial fibrillation (AF is one of the most common arrhythmias. It reduces quality of life and its duration due to thromboembolic complications. Obesity contributes to the structural and electrical remodeling of atrial myocardium. This leads to occurrence of ectopic foci in the mouths of the pulmonary veins and the disruption of normal electrical conduction in the atria. Systemic inflammation, myocardial fibrosis, cardiomyocyte overload by Na+ and Ca2+ ions, accumulation in the cells of unoxidized metabolic products, imbalance of the autonomic regulation are considered as the main mechanisms of arrhythmogenic substrate formation. Hypertension, insulin resistance, and obstructive sleep apnea, associated with obesity, increase the risk of development and progression of the arrhythmia. Study of pathogenetic mechanisms of AF in obesity is necessary to develop new strategies for its prevention and the creation of more effective methods of treatment of these patients.

  4. [Atrial fibrillation concomitant with valvular heart disease].

    Science.gov (United States)

    Ishii, Yosuke

    2013-01-01

    Patients with valvular heart disease frequently have atrial fibrillation(AF) due to elevated pressure and dilatation of the left and right atria and pulmonary veins. Guidelines for valvular heart disease and AF recommend that surgical treatment for the valvular heart disease should be performed concomitantly with AF surgery. The Full-Maze procedure has evolved into the gold standard of treatment for medically refractory AF. In addition to the pulmonary vein isolation, the right and left atrial incisions of the Full-Maze procedure are designed to block potential macroreentrant pathways. According to the mechanisms of AF with valvular heart disease, the Full-Maze procedure is more effective for the patients than the pulmonary vein isolation alone.

  5. Propofol effects on atrial fibrillation wavefront delays.

    Science.gov (United States)

    Cervigón, Raquel; Moreno, Javier; Millet, José; Pérez-Villacastín, Julián; Castells, Francisco

    2010-08-01

    Since the cardiac activity during atrial fibrillation (AF) may be influenced by autonomic modulations, in this study, a novel method to quantify the effects of the most common anesthetic agent (propofol) in AF ablation procedures is introduced. This study has two main objectives: first, to assess whether the sedation earlier to radio frequency ablation affects the arrhythmia itself, and second, to provide new information that contributes to a better understanding of the influence of the autonomic nervous system on AF. The methodology presented is based on the measurement of synchronization and delay indexes between two atrial activations at adjacent intracavitary electrodes. These parameters aim to estimate whether two activations at different sites may be caused by the same propagating wavefront, or otherwise, are the consequence of independent wavefronts. The results showed that the mentioned indexes have a different behavior at both atria: the right atrium becomes more synchronized with propofol administration, whereas the synchronization index decreases at the left atrium.

  6. Acute atrial fibrillation during dengue hemorrhagic fever

    Directory of Open Access Journals (Sweden)

    Veloso Henrique Horta

    2003-01-01

    Full Text Available Dengue fever is a viral infection transmitted by the mosquito, Aedes aegypti. Cardiac rhythm disorders, such as atrioventricular blocks and ventricular ectopic beats, appear during infection and are attributed to viral myocarditis. However, supraventricular arrhythmias have not been reported. We present a case of acute atrial fibrillation, with a rapid ventricular rate, successfully treated with intravenous amiodarone, in a 62-year-old man with dengue hemorrhagic fever, who had no structural heart disease.

  7. Atrial fibrillation in obstructive sleep apnea

    OpenAIRE

    Goyal, Sandeep K; Sharma, Abhishek

    2013-01-01

    Atrial fibrillation (AF) is a common arrhythmia with rising incidence. Obstructive sleep apnea (OSA) is prevalent among patients with AF. This observation has prompted significant research in understanding the relationship between OSA and AF. Multiple studies support a role of OSA in the initiation and progression of AF. This association has been independent of obesity, body mass index and hypertension. Instability of autonomic tone and wide swings in intrathoracic pressure are seen in OSA. T...

  8. Atrial Fibrillation During an Exploration Class Mission

    Science.gov (United States)

    Lipset, Mark A.; Lemery, Jay; Polk, J. D.; Hamilton, Douglas R.

    2010-01-01

    Background: A long-duration exploration class mission is fraught with numerous medical contingency plans. Herein, we explore the challenges of symptomatic atrial fibrillation (AF) occurring during an exploration class mission. The actions and resources required to ameliorate the situation, including the availability of appropriate pharmaceuticals, monitoring devices, treatment modalities, and communication protocols will be investigated. Challenges of Atrial Fibrillation during an Exploration Mission: Numerous etiologies are responsible for the initiation of AF. On Earth, we have the time and medical resources to evaluate and determine the causative situation for most cases of AF and initiate therapy accordingly. During a long-duration exploration class mission resources will be severely restricted. How is one to determine if new onset AF is due to recent myocardial infarction, pulmonary embolism, fluid overload, thyrotoxicosis, cardiac structural abnormalities, or CO poisoning? Which pharmaceutical therapy should be initiated and what potential side effects can be expected? Should anti-coagulation therapy be initiated? How would one monitor the therapeutic treatment of AF in microgravity? What training would medical officers require, and which communication strategies should be developed to enable the best, safest therapeutic options for treatment of AF during a long-duration exploration class mission? Summary: These questions will be investigated with expert opinion on disease elucidation, efficient pharmacology, therapeutic monitoring, telecommunication strategies, and mission cost parameters with emphasis on atrial fibrillation being just one illustration of the tremendous challenges that face a long-duration exploration mission. The limited crew training time, medical hardware, and drugs manifested to deal with such an event predicate that aggressive primary and secondary prevention strategies be developed to protect a multibillion-dollar asset like the

  9. Some key issues of aircraft T-Tail flutter calculation%飞机T型尾翼颤振计算的若干关键问题

    Institute of Scientific and Technical Information of China (English)

    杨飞; 杨智春

    2011-01-01

    由于飞机T型尾翼的结构与气动布局特点,T型尾翼颤振计算不能套用常规尾翼的分析方法,而需要考虑平尾面内运动以及静升力等因素的影响.从T型尾翼的工程颤振分析出发,讨论了T型尾翼颤振计算中的若干关键问题,阐述了T型尾翼颤振特性的特点和影响T型尾翼颤振特性的关键参数,分别介绍了现有的几种T型尾翼颤振计算中的气动力修正方法,提出了T型尾翼颤振工程计算中必须注意的问题.%The flutter calculation method for convensional aircraft tail wing can not be used directly to T-tail flutter analysis due to T-Tail features in structural and aerodynamic configurations, and the effects of in-plane motion and steady aerodynamic force of horizontal plane must be considered in T-tail flutter calculation.From the view point of engineering analysis for T-tail flutter, some key issues of T-tail flutter calculation were discussed here, the characteristics of T-tail flutter problem and the key parameters affecting T-tail flutter properties were described.Especially, four methods to correct aerodynamic force of T-tail in its flutter calculation were intrduced and finally some specific problems to be noticed in T-tail flutter analysis were presented.

  10. Atrial Substrate Modification in Atrial Fibrillation: Targeting GP or CFAE? Evidence from Meta-Analysis of Clinical Trials

    OpenAIRE

    Qin, Mu; Liu, Xu; Wu, Shao-Hui; Zhang, Xiao-dong

    2016-01-01

    Several clinically relevant outcomes post atrial substrate modification in patients with atrial fibrillation (AF) have not been systematically analyzed among published studies on adjunctive cardiac ganglionated plexi (GP) or complex fractionated atrial electograms (CFAE) ablation vs. pulmonary vein isolation (PVI) alone. Out of 176 reports identified, the present meta-analysis included 14 randomized and non-randomized controlled trials (1613 patients) meeting inclusion criteria. Addition of G...

  11. A parametric study on supersonic/hypersonic flutter behavior of aero-thermo-elastic geometrically imperfect curved skin panel

    NARCIS (Netherlands)

    Abbas, L.K.; Rui, X.; Marzocca, P.; Abdalla, M.; De Breuker, R.

    2011-01-01

    In this paper, the effect of the system parameters on the flutter of a curved skin panel forced by a supersonic/hypersonic unsteady flow is numerically investigated. The aeroelastic model investigated includes the third-order piston theory aerodynamics for modeling the flow-induced forces and the V

  12. The mechanisms of atrial fibrillation in hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Bielecka-Dabrowa Agata

    2009-04-01

    Full Text Available Abstract Atrial fibrillation (AF is a complex condition with several possible contributing factors. The rapid and irregular heartbeat produced by AF increases the risk of blood clot formation inside the heart. These clots may eventually become dislodged, causing embolism, stroke and other disorders. AF occurs in up to 15% of patients with hyperthyroidism compared to 4% of people in the general population and is more common in men and in patients with triiodothyronine (T3 toxicosis. The incidence of AF increases with advancing age. Also, subclinical hyperthyroidism is a risk factor associated with a 3-fold increase in development of AF. Thyrotoxicosis exerts marked influences on electrical impulse generation (chronotropic effect and conduction (dromotropic effect. Several potential mechanisms could be invoked for the effect of thyroid hormones on AF risk, including elevation of left atrial pressure secondary to increased left ventricular mass and impaired ventricular relaxation, ischemia resulting from increased resting heart rate, and increased atrial eopic activity. Reentry has been postulated as one of the main mechanisms leading to AF. AF is more likely if effective refractory periods are short and conduction is slow. Hyperthyroidism is associated with shortening of action potential duration which may also contribute to AF.

  13. Atrial fibrillation: effects beyond the atrium?

    Science.gov (United States)

    Wijesurendra, Rohan S; Casadei, Barbara

    2015-03-01

    Atrial fibrillation (AF) is the most common sustained clinical arrhythmia and is associated with significant morbidity, mostly secondary to heart failure and stroke, and an estimated two-fold increase in premature death. Efforts to increase our understanding of AF and its complications have focused on unravelling the mechanisms of electrical and structural remodelling of the atrial myocardium. Yet, it is increasingly recognized that AF is more than an atrial disease, being associated with systemic inflammation, endothelial dysfunction, and adverse effects on the structure and function of the left ventricular myocardium that may be prognostically important. Here, we review the molecular and in vivo evidence that underpins current knowledge regarding the effects of human or experimental AF on the ventricular myocardium. Potential mechanisms are explored including diffuse ventricular fibrosis, focal myocardial scarring, and impaired myocardial perfusion and perfusion reserve. The complex relationship between AF, systemic inflammation, as well as endothelial/microvascular dysfunction and the effects of AF on ventricular calcium handling and oxidative stress are also addressed. Finally, consideration is given to the clinical implications of these observations and concepts, with particular reference to rate vs. rhythm control.

  14. Fibrilación atrial: nuevos conceptos

    Directory of Open Access Journals (Sweden)

    Luis Gutiérrez-Jaikel

    2004-06-01

    Full Text Available La fibrilación atrial es la arritmia más frecuente en la práctica clínica, se presenta tanto en pacientes con cardiopatía estructural de base principalmente hipertensiva, isquémica y valvular, como en pacientes sin trastorno cardiaco de fondo al avanzar la edad. Debido a la morbilidad asociada a esta, es vital su reconocimiento temprano y el manejo adecuado, con la finalidad de reducir la incidencia de complicaciones asociadas y mejorar la calidad de vida de quienes la padecen.Atrial fibrillation is the most frequent arrhythmia seen in clinical practice.It occurs most commonly on patients with hypertensive, isquemic and valvular heart disease as well as in patients without cardiac disease principally in elderly patients. Due to the morbidity rate associated with it (atrial fibrillation, early diagnosis and adequate treatment is necessary in order to reduce any associated complication and to improve the health related quality of life of patients who suffer from it.

  15. Atrial and ventricular volume and function in persistent and permanent atrial fibrillation, a magnetic resonance imaging study

    DEFF Research Database (Denmark)

    Therkelsen, Susette Krohn; Groenning, Bjoern Aaris; Svendsen, Jesper Hastrup

    2005-01-01

    Left atrial size is independently related to cardiovascular morbidity and mortality, and atrial fibrillation (AF) is strongly associated with atrial size. Our aims were to report atrial and ventricular dimensions in patients with AF evaluated with magnetic resonance imaging (MRI), and to assess...... the inter-study reproducibility of the measurements. Nineteen healthy volunteers, 19 patients with permanent AF, and 58 patients with persistent AF had cardiac dimensions evaluated by 6-mm cinematographic breath-hold MRI scans using a 1.5 Tesla Siemens Vision Magnetom scanner with a phased array chest coil...

  16. Efficacy of atrial substrate modification based on dominant frequency of paroxysmal atrial fibrillation

    OpenAIRE

    KUMAGAI, Koji; Minami, Kentaro; Kutsuzawa, Daisuke; Oshima, Shigeru

    2016-01-01

    Background The endpoint of ablation procedures is suggested to be non-inducibility of paroxysmal atrial fibrillation (PAF). However, the prognosis of induced AF/atrial tachycardia (AT) after pulmonary vein isolation (PVI) in PAF patients remains unclear. Methods A total of 122 PAF patients were divided into the following 3 groups: Group 1, 79 without AF/AT induced after PVI; Group 2, 21 with AF/AT induced or sustained after PVI, and followed by a high-dominant frequency (DF) and continuous co...

  17. Study on Effect of Compound Salvia Pellet in Preventing Atrial Fibrillation with Left Atrial Thrombosis

    Institute of Scientific and Technical Information of China (English)

    连耀植; 李玉光; 张汉灵; 张元春; 闫纯英; 林建才; 许瑞敏; 张钰; 郑宝群; 麦芒

    2004-01-01

    Atrialarrhythmia,fibrillation (AF) is a kind of common arrhythmia which, besides affecting cardiac function, has another serious outcome, that is, it is easy to form atrial thrombosis and induce thrombus/embolus, especially cerebral embolus. The incidence of left atrial thrombosis (LAT) could reach 25%—30%, the incidence of embolic complication per year could reach 2. 98%-6.30%, even 20% or more. To prevent thrombosis so as to lower the incidence of cerebral stroke and other embolic complications has been so far the focal point of AF treatment.

  18. Rotigaptide (ZP123) improves atrial conduction slowing in chronic volume overload-induced dilated atria.

    Science.gov (United States)

    Haugan, Ketil; Miyamoto, Takuya; Takeishi, Yasuchika; Kubota, Isao; Nakayama, Jun; Shimojo, Hisashi; Hirose, Masamichi

    2006-07-01

    Chronic atrial dilation is associated with atrial conduction velocity slowing and an increased risk of developing atrial tachyarrhythmias. Rotigaptide (ZP123) is a selective gap junction modifier that increases cardiac gap junctional intercellular communication. We hypothesised that rotigaptide treatment would increase atrial conduction velocity and reduce the inducibility to atrial tachyarrhythmias in a model of chronic volume overload induced chronic atrial dilatation characterized by atrial conduction velocity slowing. Chronic volume overload was created in Japanese white rabbits by arterio-venous shunt formation. Atrial conduction velocity and atrial tachyarrhythmias inducibility were examined in Langendorff-perfused chronic volume overload hearts (n=12) using high-resolution optical mapping before and after treatment with rotigaptide. Moreover, expression levels of atrial gap junction proteins (connexin40 and connexin43) were examined in chronic volume overload hearts (n=6) and compared to sham-operated controls (n=6). Rotigaptide treatment significantly increased atrial conduction velocity in chronic volume overload hearts, however, rotigaptide did not decrease susceptibility to the induction of atrial tachyarrhythmias. Protein expressions of Cx40 and Cx43 were decreased by 32% and 72% (P<0.01), respectively, in chromic volume overload atria compared to control. To conclude, rotigaptide increased atrial conduction velocity in a rabbit model of chromic volume overload induced atrial conduction velocity slowing. The demonstrated effect of rotigaptide on atrial conduction velocity did not prevent atrial tachyarrhythmias inducibility. Whether rotigaptide may possess antiarrhythmic efficacy in other models of atrial fibrillation remains to be determined.

  19. The Connexin40A96S mutation from a patient with atrial fibrillation causes decreased atrial conduction velocities and sustained episodes of induced atrial fibrillation in mice.

    Science.gov (United States)

    Lübkemeier, Indra; Andrié, René; Lickfett, Lars; Bosen, Felicitas; Stöckigt, Florian; Dobrowolski, Radoslaw; Draffehn, Astrid M; Fregeac, Julien; Schultze, Joachim L; Bukauskas, Feliksas F; Schrickel, Jan Wilko; Willecke, Klaus

    2013-12-01

    Atrial fibrillation (AF) is the most common type of cardiac arrhythmia and a major cause of stroke. In the mammalian heart the gap junction proteins connexin40 (Cx40) and connexin43 (Cx43) are strongly expressed in the atrial myocardium mediating effective propagation of electrical impulses. Different heterozygous mutations in the coding region for Cx40 were identified in patients with AF. We have generated transgenic Cx40A96S mice harboring one of these mutations, the loss-of-function Cx40A96S mutation, as a model for atrial fibrillation. Cx40A96S mice were characterized by immunochemical and electrophysiological analyses. Significantly reduced atrial conduction velocities and strongly prolonged episodes of atrial fibrillation were found after induction in Cx40A96S mice. Analyses of the gating properties of Cx40A96S channels in cultured HeLa cells also revealed significantly lower junctional conductance and enhanced sensitivity voltage gating of Cx40A96S in comparison to Cx40 wild-type gap junctions. This is caused by reduced open probabilities of Cx40A96S gap junction channels, while single channel conductance remained the same. Similar to the corresponding patient, heterozygous Cx40A96S mice revealed normal expression levels and localization of the Cx40 protein. We conclude that heterozygous Cx40A96S mice exhibit prolonged episodes of induced atrial fibrillation and severely reduced atrial conduction velocities similar to the corresponding human patient.

  20. SUSTAINED ATRIAL-FLUTTER AROUND THE TRICUSPID-VALVE IN PIGS - DIFFERENTIATION OF PROCAINAMIDE (CLASS-IA) FROM FLECAINIDE (CLASS-IC) AND THEIR RATE-DEPENDENT EFFECTS

    NARCIS (Netherlands)

    CRIJNS, HJGM; DELANGEN, CDJ; GRANDJEAN, JG; BEL, KJ; EBELS, T; LIE, KI; WESSELING, H

    1993-01-01

    The wavelength theory considers two determinants of reentry, i.e., refractoriness and conduction velocity. It does not take excitability into account primarily. We evaluated frequency-dependence of excitability and refractoriness before and after flecainide or procainamide administration in relation

  1. Prolonged and fractionated right atrial electrograms during sinus rhythm in patients with paroxysmal atrial fibrillation and sick sinus node syndrome.

    Science.gov (United States)

    Tanigawa, M; Fukatani, M; Konoe, A; Isomoto, S; Kadena, M; Hashiba, K

    1991-02-01

    Intraatrial catheter mapping of the right atrium was performed during sinus rhythm in 92 patients: Group I = 43 control patients without paroxysmal atrial fibrillation or sick sinus node syndrome; Group II = 31 patients with paroxysmal atrial fibrillation but without sick sinus node syndrome; and Group III = 18 patients with both paroxysmal atrial fibrillation and sick sinus node syndrome. Atrial electrograms were recorded at 12 sites in the right atrium. The duration and number of fragmented deflections of the atrial electrograms were quantitatively measured. The mean duration and number of fragmented deflections of the 516 atrial electrograms in Group I were 74 +/- 11 ms and 3.9 +/- 1.3, respectively. The criteria for an abnormal atrial electrogram were defined as a duration of greater than or equal to 100 ms or eight or more fragmented deflections, or both. Abnormal atrial electrograms were observed in 10 patients (23.3%) in Group I, 21 patients (67.7%) in Group II and 15 patients (83.3%) in Group III (Group II versus Group I, p less than 0.001; Group III versus Group I, p less than 0.001). The mean number of abnormal electrograms per patient with an abnormal electrogram was 1.3 +/- 0.7 in Group I, 2.5 +/- 1.9 in Group II and 3.5 +/- 2.5 in Group III (Group I versus Group II, p less than 0.01; Group II versus Group III, p less than 0.05). A prolonged and fractionated atrial electrogram characteristic of paroxysmal atrial fibrillation can be closely related to the vulnerability of the atrial muscle.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Hypertension and Atrial Fibrillation: Any Change with the New Anticoagulants.

    Science.gov (United States)

    Ghiadoni, Lorenzo; Taddei, Stefano; Virdis, Agostino

    2014-01-01

    Hypertension and atrial fibrillation are the most common cardiovascular risk factors and clinically significant arrhythmia, respectively. These conditions frequently coexist and their prevalence increases rapidly with aging. Despite several different risk factors and clinical conditions predisposing to hypertension for its high prevalence in the population is still the main risk factor for the development of atrial fibrillation. Several pathophysiologic mechanisms (such as structural changes at the level of left ventricle and or atrium, neurohormonal activation, arterial stiffness, etc.) can contribute to the onset of atrial fibrillation. Some antihypertensive treatments have been shown to contribute to reduce the risk of new-onset atrial fibrillation. Atrial fibrillation is a major risk factor for stroke, which is further increased in the presence of hypertension. For this reason, hypertension is included as a major risk factor in the available models for the risk stratification and the prevention of thromboembolism in patients with atrial fibrillation. In this article we will review the relationship between atrial fibrillation and hypertension, looking at the possible specific indications of the antithrombotic treatment with new classes of anticoagulants in the prevention of thromboembolic events in hypertensive patients with atrial fibrillation.

  3. Atrial Arrhythmias and Their Implications for Space Flight - Introduction

    Science.gov (United States)

    Polk, J. D.; Barr, Y. R.; Bauer, P.; Hamilton, D. R.; Kerstman, E.; Tarver, B.

    2010-01-01

    This panel will discuss the implications of atrial arrhythmias in astronauts from a variety of perspectives; including historical data, current practices, and future challenges for exploration class missions. The panelists will present case histories, outline the evolution of current NASA medical standards for atrial arrhythmias, discuss the use of predictive tools, and consider potential challenges for current and future missions.

  4. Atrial fibrillation in patients with sick sinus syndrome

    DEFF Research Database (Denmark)

    Nielsen, Jens Cosedis; Thomsen, Poul Erik B; Højberg, Søren;

    2012-01-01

    AimsIn the recently published DANPACE trial, incidence of atrial fibrillation (AF) was significantly higher with single-lead atrial (AAIR) pacing than with dual-chamber (DDDR) pacing. The present analysis aimed to evaluate the importance of baseline PQ-interval and percentage of ventricular pacin...

  5. Atrial fibrillation: a new look at an old arrhythmia

    NARCIS (Netherlands)

    Meijler, F.L.

    1983-01-01

    The ventricular rhythm during atrial fibrillation in human beings is random because the excitatory process of atrial fibrillation itself is almost certainly a random phenomenon. It remains random because A V junctional memory is too short to inftuence the sequence of conducted impulses . In human be

  6. Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation

    DEFF Research Database (Denmark)

    Cosedis Nielsen, Jens; Johannessen, Arne; Raatikainen, Pekka;

    2012-01-01

    There are limited data comparing radiofrequency catheter ablation with antiarrhythmic drug therapy as first-line treatment in patients with paroxysmal atrial fibrillation.......There are limited data comparing radiofrequency catheter ablation with antiarrhythmic drug therapy as first-line treatment in patients with paroxysmal atrial fibrillation....

  7. Pulmonary edema following transcatheter closure of atrial septal defect

    Directory of Open Access Journals (Sweden)

    Singhi Anil

    2010-01-01

    Full Text Available Pulmonary edema after device closure of atrial septal defect (ASD is a rare complication. We present illustrative images of a case of pulmonary edema after device closure of ASD in a 53 year old adult. Older patients undergoing ASD closure can benefit from their left atrial and left ventricular end diastolic pressures measurement before and after temporary balloon occlusion of ASD.

  8. Ethnic Differences in Atrial Fibrillation Identified Using Implanted Cardiac Devices

    NARCIS (Netherlands)

    Lau, Chu-Pak; Gbadebo, T. David; Connolly, Stuart J.; Van Gelder, Isabelle C.; Capucci, Alessandro; Gold, Michael R.; Israel, Carsten W.; Morillo, Carlos A.; Siu, Chung-Wah; Abe, Haruhiko; Carlson, Mark; Tse, Hung-Fat; Hohnloser, Stefan H.; Healey, Jeff S.

    2013-01-01

    Ethnic Difference in Atrial Fibrillation Incidence.Introduction: Atrial fibrillation (AF) is suggested to be less common among black and Asian individuals, which could reflect bias in symptom reporting and access to care. In the Asymptomatic AF and Stroke Evaluation in Pacemaker Patients and the AF

  9. Dronedarone in high-risk permanent atrial fibrillation

    DEFF Research Database (Denmark)

    Connolly, Stuart J; Camm, A John; Halperin, Jonathan L;

    2011-01-01

    Dronedarone restores sinus rhythm and reduces hospitalization or death in intermittent atrial fibrillation. It also lowers heart rate and blood pressure and has antiadrenergic and potential ventricular antiarrhythmic effects. We hypothesized that dronedarone would reduce major vascular events...... in high-risk permanent atrial fibrillation....

  10. Dynamics of Focal Fibrillation Waves during Persistent Atrial Fibrillation.

    Science.gov (United States)

    Lanters, Eva A H; Allessie, Maurits A; DE Groot, Natasja M S

    2016-04-01

    The incidence and appearance of focal fibrillation waves on the right and left atrial epicardial surface were visualized during 10 seconds of persistent atrial fibrillation in a 71-year-old woman with valvular heart disease. The frequent, nonrepetitive, widespread, and capricious distribution of focal waves suggests that transmural conduction of fibrillation waves is most likely the mechanism underlying focal fibrillation waves.

  11. Rising rates of hospital admissions for atrial fibrillation

    DEFF Research Database (Denmark)

    Friberg, Jens; Buch, Nina Pernille Gardshodn; Scharling, Henrik;

    2003-01-01

    Atrial fibrillation is a common arrhythmia associated with excess morbidity and mortality. We studied temporal changes in hospital admission rates for atrial fibrillation using data from a prospective population-based cohort study spanning 2 decades (the Copenhagen City Heart Study)....

  12. Atrial fibrillation: Is ablation the way of the future?

    Institute of Scientific and Technical Information of China (English)

    Brian Olshansky

    2004-01-01

    @@ This issue of the Journal of Geriatric Cardiology features a manuscript entitled "A three-pulmonary vein isolation approach to treat paroxysmal atrial fibrillation".Dr. Lexin Wang addresses an important issue, and is to be congratulated for taking a new look at an approach to ablate atrial fibrillation.

  13. KCNE3 R53H substitution in familial atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    ZHANG Dai-fu; LIANG Bo; LIN Jie; LIU Ban; ZHOU Qin-shu; YANG Yi-qing

    2005-01-01

    @@ Atrial fibrillation (AF) is the most common cardiac arrhythmia with debilitating compli-cations of stroke. Multiple-wavelet re-entry and focal activation from pulmonary vein foci are two dominant electrophysiological theories of AF. Atrial electrical remodeling plays a role in the maintenance of AF. However, molecular mechanisms of the arrhythmia are still poorly understood.

  14. The immediate future for the medical treatment of atrial fibrillation

    DEFF Research Database (Denmark)

    Pedersen, Ole Dyg; Brendorp, Bente; Køber, Lars;

    2002-01-01

    Atrial fibrillation is the most commonly sustained cardiac arrhythmia and a common reason for mortality and morbidity. Atrial fibrillation causes disease for three reasons: i) the ventricular rate is often high, which leads to symptoms ranging from discomfort to life threatening heart failure; ii...

  15. Molecular mechanisms of early atrial remodeling by rapid atrial pacing in rabbits

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To establish a rabbit atrial fibrillation model with rapid atrial pacing (RAP) and investigate its ultrastructural changes and expressions of L-type calcium channel subunits and potassium channel Ky4.3. Methods: Thirty-six rabbits were performed electrical stimulation through bipolar endocardial led by surgical technique, 600 beat per min from 0 to 48 h. Atrial ultrastructure was observed by transmission electron microscope (TEM) after different pacing times. mRNA were measured by reverse transcription-polymerase chain reaction (RT-PCR). Results: Atrial ultrastructure had alteration after 3 hours' pacing, such as mitochondria vacuolization, myofilament lysis and glucogen aggregation. The mRNA of the Ca2+ channel β1 and α1 subunits began to decrease after pacing of 6 h, which were paralleled with the change of Kv4.3 mRNA. But the auxiliary subunit α2 were not affected. Conclusion: Ultrastructural changes and mRNA levels of L-type calcium channel subunits and potassium channel Kv4.3 are decreased after RAP, with a mechanism of transcriptional down-regulation of underlying ion channels due to calcium overloading after RAP.

  16. Recurrent patterns of atrial depolarization during atrial fibrillation assessed by recurrence plot quantification.

    Science.gov (United States)

    Censi, F; Barbaro, V; Bartolini, P; Calcagnini, G; Michelucci, A; Gensini, G F; Cerutti, S

    2000-01-01

    The aim of this study was to determine the presence of organization of atrial activation processes during atrial fibrillation (AF) by assessing whether the activation sequences are wholly random or are governed by deterministic mechanisms. We performed both linear and nonlinear analyses based on the cross correlation function (CCF) and recurrence plot quantification (RPQ), respectively. Recurrence plots were quantified by three variables: percent recurrence (PR), percent determinism (PD), and entropy of recurrences (ER). We recorded bipolar intra-atrial electrograms in two atrial sites during chronic AF in 19 informed subjects, following two protocols. In one, both recording sites were in the right atrium; in the other protocol, one site was in the right atrium, the other one in the left atrium. We extracted 19 episodes of type I AF (Wells' classification). RPQ detected transient recurrent patterns in all the episodes, while CCF was significant only in ten episodes. Surrogate data analysis, based on a cross-phase randomization procedure, decreased PR, PD, and ER values. The detection of spatiotemporal recurrent patterns together with the surrogate data results indicate that during AF a certain degree of local organization exists, likely caused by deterministic mechanisms of activation.

  17. Association between familial atrial fibrillation and risk of new-onset atrial fibrillation

    NARCIS (Netherlands)

    Lubitz, Steven A.; Yin, Xiaoyan; Fontes, Joao D.; Magnani, Jared W.; Rienstra, Michel; Pai, Manju; Villalon, Mark L.; Vasan, Ramachandran S.; Pencina, Michael J.; Levy, Daniel; Larson, Martin G.; Ellinor, Patrick T.; Benjamin, Emelia J.

    2010-01-01

    CONTEXT: Although the heritability of atrial fibrillation (AF) is established, the contribution of familial AF to predicting new-onset AF remains unknown. OBJECTIVE: To determine whether familial occurrence of AF is associated with new-onset AF beyond established risk factors. DESIGN, SETTING, AND P

  18. Atrial metabolism and tissue perfusion as determinants of electrical and structural remodelling in atrial fibrillation.

    Science.gov (United States)

    Opacic, Dragan; van Bragt, Kelly A; Nasrallah, Hussein M; Schotten, Ulrich; Verheule, Sander

    2016-04-01

    Atrial fibrillation (AF) is the most common tachyarrhythmia in clinical practice. Over decades of research, a vast amount of knowledge has been gathered about the causes and consequences of AF related to cellular electrophysiology and features of the tissue structure that influence the propagation of fibrillation waves. Far less is known about the role of myocyte metabolism and tissue perfusion in the pathogenesis of AF. However, the rapid rates of electrical activity and contraction during AF must present an enormous challenge to the energy balance of atrial myocytes. This challenge can be met by scaling back energy demand and by increasing energy supply, and there are several indications that both phenomena occur as a result of AF. Still, there is ample evidence that these adaptations fall short of redressing this imbalance, which may represent a driving force for atrial electrical as well as structural remodelling. In addition, several 'metabolic diseases' such as diabetes, obesity, and abnormal thyroid function precipitate some well-known 'culprits' of the AF substrate such as myocyte hypertrophy and fibrosis, while some other AF risk factors, such as heart failure, affect atrial metabolism. This review provides an overview of metabolic and vascular alterations in AF and their involvement in its pathogenesis.

  19. Atrial Arrhythmias in Astronauts. Summary of a NASA Summit

    Science.gov (United States)

    Barr, Yael; Watkins, Sharmila; Polk, J. D.

    2011-01-01

    This slide presentation reviews the findings of a panel of heart experts brought together to study if atrial arrhythmias more prevalent in astronauts, and potential risk factors that may predispose astronauts to atrial arrhythmias. The objective of the panel was to solicit expert opinion on screening, diagnosis, and treatment options, identify gaps in knowledge, and propose relevant research initiatives. While Atrial Arrhythmias occur in approximately the same percents in astronauts as in the general population, they seem to occur at younger ages in astronauts. Several reasons for this predisposition were given: gender, hypertension, endurance training, and triggering events. Potential Space Flight-Related Risk factors that may play a role in precipitating lone atrial fibrillation were reviewed. There appears to be no evidence that any variable of the space flight environment increases the likelihood of developing atrial arrhythmias during space flight.

  20. Genetics of Atrial Fibrillation and Possible Implications for Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Robin Lemmens

    2011-01-01

    Full Text Available Atrial fibrillation is the most common cardiac arrhythmia mainly caused by valvular, ischemic, hypertensive, and myopathic heart disease. Atrial fibrillation can occur in families suggesting a genetic background especially in younger subjects. Additionally recent studies have identified common genetic variants to be associated with atrial fibrillation in the general population. This cardiac arrhythmia has important public health implications because of its main complications: congestive heart failure and ischemic stroke. Since atrial fibrillation can result in ischemic stroke, one might assume that genetic determinants of this cardiac arrhythmia are also implicated in cerebrovascular disease. Ischemic stroke is a multifactorial, complex disease where multiple environmental and genetic factors interact. Whether genetic variants associated with a risk factor for ischemic stroke also increase the risk of a particular vascular endpoint still needs to be confirmed in many cases. Here we review the current knowledge on the genetic background of atrial fibrillation and the consequences for cerebrovascular disease.

  1. Left atrial dimension and atrial fibrillation in surgical heart disease patients

    Institute of Scientific and Technical Information of China (English)

    Kaihu Shi; Peisheng Liu; David Shek; Hongwei Shi; Ying Yu; Fei Ye; Xinwei Mu; Youxiang Zhang; Leiyang Zhang; Junjie Shao; Rui Wang

    2008-01-01

    Objective The effect of left atrial (LA) dimension on the occurrence of atrial fibrillation (AF) has been examined in some small studies.Less is known about the relationship of LA dimension,hemodynamic with AF during echocardiographic evaluation,especially,the flow dynamics in LA poorly described.The objective of this study was to investigate the relationship between LA dimension and the occurrence of AE Methods Two hundred and forty-five consecutive patients with heart disease scheduled to undergo open heart surgery were prospectively enrolled in the study.Patients were divided into 2 groups according to atrial fibrillation:AF group (n=148,99 men and 49 women,with a mean age 59.3+8.4 years),and no-AF group (n= 97,60 men and 37 womem).Echocardiography was performed before surgery.All measurements were performed following the American Society of Echocardiography recommendations.Results There were more patients with congestive heart failure in AF group than in no-AF group (45.9% vs 39.1%,P <0.05).The mean LA volume was 49.2±12.2 ml/m2 in AF group and 33.1±10.8 ml/m2 in no-AF group.There were also significant differences between two groups in left atrial end systolic dimension (LAESD) (50±13mm vs 27±14mm),left atrial end diastolic dimension (LAEDD) (79±17mm vs 53±13mm),PA pressure ( 41.3+11.6 mmHg vs 37.5±10.4 mmHg),and ratio of mitral E velocity and septal mitral annulus motion velocity (E/E') .The percentage of abnormal diastolic function grades (DGF) was also higher in AF than in no-AF group (89.9% versus 59.8% );.Conclusion Atrial fibrillation is associated more frequently with an increased LA dimension and more severe atrial hemodynamics disorder.(J Geriatr Cardiol 2008;5:11-4)

  2. Atrial Strain and Strain Rate: A Novel Method for the Evaluation of Atrial Stunning

    Science.gov (United States)

    Ozkan, Hakan; Binici, Suleyman; Tenekecioglu, Erhan; Ari, Hasan; Bozat, Tahsin

    2016-01-01

    Background Atrial fibrillation (AF) is the most common arrhythmia seen in adults. Atrial stunning is defined as the temporary mechanical dysfunction of the atrial appendage developing after AF has returned to sinus rhythm (SR). Objectives We aimed to evaluate atrial contractile functions by strain and strain rate in patients with AF, following pharmacological and electrical cardioversion and to compare it with conventional methods. Methods This study included 41 patients with persistent AF and 35 age-matched control cases with SR. All the AF patients included in the study had transthoracic and transesophageal echocardiography performed before and after. Septum (SEPsSR), left atrium (LAsSR) and right atrium peak systolic strain rate (RAsSR) were defined as the maximum negative value during atrial contraction and septum (SEPε), left atrium (LAε) and right atrium peak systolic strain (RAε) was defined as the percentage of change. Parameters of two groups were compared. Results In the AF group, 1st hour and 24th hour LAε, RAε, SEPε, LAsSR, RAsSR, SEPsSR found to be significantly lower than in the control group (LAε: 2.61%±0.13, 3.06%±0.19 vs 6.45%±0.27, p<0.0001; RAε: 4.03%±0.38, 4.50%±0.47 vs 10.12%±0.64, p<0.0001; SEPε: 3.0%±0.22, 3.19%±0.15 vs 6.23%±0.49, p<0.0001; LAsSR: 0.61±0.04s-1, 0.75±0.04s-1 vs 1.35±0.04s-1, p<0.0001; RAsSR: 1.13±0.06s-1, 1.23±0.07s-1 vs 2.10±0.08s- 1, p<0.0001; SEPsSR: 0.76±0.04s- 1, 0.78±0.04s- 1 vs 1.42±0.06 s- 1, p<0.0001). Conclusion Atrial strain and strain rate parameters are superior to conventional echocardiographic parameters for the evaluation of atrial stunning in AF cases where SR has been achieved. PMID:27627221

  3. Episodic syncope caused by ventricular flutter in a tiger (Panthera tigris).

    Science.gov (United States)

    DeLillo, Daniel M; Jesty, Sophy A; Souza, Marcy J

    2013-06-01

    A captive, 9-yr-old castrated male tiger (Panthera tigris) from an exotic cat sanctuary and rescue facility was observed to have three collapsing episodes within a 2-wk interval prior to being examined by veterinarians. No improvement in clinical signs was noted after empiric treatment with phenobarbital. During a more complete workup for epilepsy, ventricular flutter was observed on electrocardiogram (ECG). The arrhythmia resolved with a single intravenous bolus of lidocaine. Cardiac structure and function were unremarkable on echocardiogram and cardiac troponin I levels were within normal limits for domestic felids. No significant abnormalities were noted on abdominal ultrasound. Complete blood count and biochemistry panel were unremarkable, and heartworm antigen and Blastomyces urine antigen enzyme-linked immunosorbent assays were negative. Antiarrhythmic treatment with sotalol was initiated. On follow-up ECG performed 1 mo later, no significant arrhythmias were noted, and clinical signs have completely resolved.

  4. NACA 0012 benchmark model experimental flutter results with unsteady pressure distributions

    Science.gov (United States)

    Rivera, Jose A., Jr.; Dansberry, Bryan E.; Bennett, Robert M.; Durham, Michael H.; Silva, Walter A.

    1992-01-01

    The Structural Dynamics Division at NASA Langley Research Center has started a wind tunnel activity referred to as the Benchmark Models Program. The primary objective of the program is to acquire measured dynamic instability and corresponding pressure data that will be useful for developing and evaluating aeroelastic type CFD codes currently in use or under development. The program is a multi-year activity that will involve testing of several different models to investigate various aeroelastic phenomena. This paper describes results obtained from a second wind tunnel test of the first model in the Benchmark Models Program. This first model consisted of a rigid semispan wing having a rectangular planform and a NACA 0012 airfoil shape which was mounted on a flexible two degree-of-freedom mount system. Experimental flutter boundaries and corresponding unsteady pressure distribution data acquired over two model chords located at the 60 and 95 percent span stations are presented.

  5. Neural codes for perceptual discrimination of acoustic flutter in the primate auditory cortex

    Science.gov (United States)

    Lemus, Luis; Hernández, Adrián; Romo, Ranulfo

    2009-01-01

    We recorded from single neurons of the primary auditory cortex (A1), while trained monkeys reported a decision based on the comparison of 2 acoustic flutter stimuli. Crucially, to form the decision, monkeys had to compare the second stimulus rate to the memory trace of the first stimulus rate. We found that the responses of A1 neurons encode stimulus rates both through their periodicity and through their firing rates during the stimulation periods, but not during the working memory and decision components of this task. Neurometric thresholds based on firing rate were very similar to the monkey's discrimination thresholds, whereas neurometric thresholds based on periodicity were lower than the experimental thresholds. Thus, an observer could solve this task with a precision similar to that of the monkey based only on the firing rates evoked by the stimuli. These results suggest that the A1 is exclusively associated with the sensory and not with the cognitive components of this task. PMID:19458263

  6. Parallel numerical simulation of oscillating airfoil NACA0015 in the channel due to flutter instability

    Directory of Open Access Journals (Sweden)

    Řidký Václav

    2014-03-01

    Full Text Available The work is devoted to 3D and 2D parallel numerical computation of pressure and velocity fields around an elastically supported airfoil self-oscillating due to interaction with the airflow. Numerical solution is computed in the OpenFOAM package, an open-source software package based on finite volume method. Movement of airfoil is described by translation and rotation, identified from experimental data. A new boundary condition for the 2DOF motion of the airfoil was implemented. The results of numerical simulations (velocity are compared with data measured in a wind tunnel, where a physical model of NACA0015 airfoil was mounted and tuned to exhibit the flutter instability. The experimental results were obtained previously in the Institute of Thermomechanics by interferographic measurements in a subsonic wind tunnel in Nový Knín.

  7. Silent Atrial Fibrillation: Definition, Clarification, and Unanswered Issues.

    Science.gov (United States)

    Kennedy, Harold L

    2015-11-01

    Silent or subclinical asymptomatic atrial fibrillation has currently gained wide interest in the epidemiologic, neurologic and cardiovascular communities. The association of brief episodes of paroxysmal atrial fibrillation or surrogate atrial arrhythmias which predict future clinical adverse events have been established. Nevertheless there exists a confounding array of definitions to indicate its presence without discrete indication of which populations should be examined. Moreover the term "atrial fibrillation burden" (AFB) has emerged from such studies with a plethora of descriptions to prognosticate both arrhythmic and clinical adverse events. This presentation suggests clarification of diagnostic definitions associated with silent atrial fibrillation, and a more precise description of AFB. It examines the populations across the current disease and cardiovascular invasive therapeutic spectrum that lead to both silent atrial fibrillation and AFB. It describes the diagnostic methods of arrhythmia detection utilizing the surface ECG, subcutaneous ECG or intra-cardiac devices and their relationship in seeking meaningful arrhythmic markers of silent atrial fibrillation. Whereas a wide range of clinical risk factors of silent atrial fibrillation have been validated in the literature, there is an ongoing search for those arrhythmic risk factors that precisely identify and prognosticate outcome events in diverse populations at risk of atrial fibrillation and its complications. This presentation identifies this chaos, and focuses attention on the issues to be addressed to facilitate descriptive and comparative scientific studies in the future. It is a call to action specifically to the medical arrhythmic community and its specialty societies (i.e., ISHNE, HRS, EHRA) to begin a quest to unravel the arrhythmic quagmire associated with "silent atrial fibrillation."

  8. Progression of atrial fibrillation in the REgistry on Cardiac rhythm disORDers assessing the control of Atrial Fibrillation cohort

    DEFF Research Database (Denmark)

    De Vos, Cees B; Breithardt, Günter; Camm, A John;

    2012-01-01

    Paroxysmal atrial fibrillation (AF) may progress to persistent AF. We studied the clinical correlates and the effect of rhythm-control strategy on AF progression.......Paroxysmal atrial fibrillation (AF) may progress to persistent AF. We studied the clinical correlates and the effect of rhythm-control strategy on AF progression....

  9. Ion channel remodeling is related to intraoperative atrial effective refractory periods in patients with paroxysmal and persistent atrial fibrillation

    NARCIS (Netherlands)

    Brundel, BJJM; Van Gelder, IC; Henning, RH; Tieleman, RG; Tuinenburg, AE; Wietses, M; Grandjean, JG; Van Gilst, WH; Crijns, HJGM

    2001-01-01

    Background-Sustained shortening of the atrial effective refractory period (AERP), probably due to reduction in the L-type calcium current, is a major factor in the initiation and maintenance of atrial fibrillation (AF), We investigated underlying molecular changes by studying the relation between ge

  10. Rapid slowing of the atrial fibrillatory rate after administration of AZD7009 predicts conversion of atrial fibrillation

    DEFF Research Database (Denmark)

    Aunes, Maria; Egstrup, Kenneth; Frison, Lars

    2014-01-01

    BACKGROUND: Effects on the atrial fibrillatory rate (AFR) were studied during infusion with the combined potassium and sodium channel blocker AZD7009. METHODS AND RESULTS: Patients with persistent atrial fibrillation (AF) were randomized to AZD7009 or placebo. Thirty-five patients converted...

  11. Electrophysiological properties and the results of catheter ablation of symptomatic atrial tachyarrhythmia after surgical ablation of atrial fibrillation

    OpenAIRE

    Bockeria L.A.; Bockeria O.L.; Sergeev A.V.; Melikulov A.Kh.; Klimchuk I.Ya.; Temirbulatov I.A.; Fatulaev Z.F.

    2016-01-01

    Objective. To characterize electrophysiological properties of postablational arrhythmia and to assess shortand long-term efficacy of catheter radiofrequency ablation of these arrhythmias. Material and methods. We analyzed retrospectively 20 consecutive patients with highly symptomatic postsurgical atrial arrhythmia operated on valvular heart disease in conjunction with paroxysmal, persistent, longstanding persistent and permanent forms of atrial fibrillation during 2010–2013. Medi...

  12. Atrial-based pacing has no benefit over ventricular pacing in preventing atrial arrhythmias in adults with congenital heart disease

    NARCIS (Netherlands)

    Opic, P.; Yap, S.C.; Kranenburg, M. van; Dijk, A.P.J. van; Budts, W.; Vliegen, H.W.; Erven, L. van; Can, A.; Sahin, G.; Groot, N.M. de; Witsenburg, M.; Roos-Hesselink, J.W.

    2013-01-01

    AIMS: To determine whether atrial-based pacing prevents atrial arrhythmias in adults with congenital heart disease (CHD) compared with ventricular pacing. METHODS AND RESULTS: All adult CHD patients from four participating centres with a permanent pacemaker were identified. Patients with permanent a

  13. Effect of mmPs/TIMPs on Atrial Structural Remodeling in A Chronic Canine Atrial Fibrillation Model

    Institute of Scientific and Technical Information of China (English)

    Yang guirong; Zhang wei; Li li; Wang sujia; Zhu hui; Zhang yun

    2004-01-01

    @@ Objective Atrial fibrillation (AF) is commonly associatedwith atrial dilation and fibrosis, but the mechanism underlying these abnormalities remains unclear. The purpose of this study is to investigate the effect of matrix metalloproteinase-9 (mmP-9)and tissue in hibitor metalloproteinase -1 (TIMP-1) on extracellular matrix of atrium.

  14. EFFECT OF METOPROLOL ON ATRIAL FIBRILLATORY RATE, ATRIOVENTRICULAR NODAL CONCEALED CONDUCTION, AND VENTRICULAR RESPONSE DURING ATRIAL-FIBRILLATION IN PIGS

    NARCIS (Netherlands)

    VANDENBERG, MP; DELANGEN, CDJ; CRIJNS, HJGM; HAAKSMA, J; BEL, KJ; WESSELING, H; LIE, KI

    1994-01-01

    We wished to elucidate the effect of beta-blockade on fibrillatory rate and atrioventricular (AV) nodal concealed conduction during atrial fibrillation (AF). Subsequent to determination of the effect on atrial functional refractoriness with the extrastimulus technique (basic cycle length 400 ms), th

  15. Ionic Remodeling and Direct Effects of Valsartan on Ionic Currentsin Human Atrial Myocytes with Atrial Fibrillation

    Institute of Scientific and Technical Information of China (English)

    Xue Yumei; Wu Shulin; Deng Chunyu; Qian Weimin; Chen Chunbo

    2004-01-01

    Objectives Previous studies demonstrated that angiotensin receptor antagonists had effects on some potassium channels in guinea pig myocytes and cloned channels that expressed in human cardiac myocytes. This study determined the direct effects of Valsartan on I caL, INa, IKur, IK1 and Ito1 in isolated human atrial myocytes. Methods and Results Specimens of right atrial appendage tissue were obtained from 39 patients with coronary artery and valvular heart diseases during cardiopulmonary bypass procedure. Pre- operation cardiac rhythm was sinus (SR)in 19 patients and was atrial fibrillation (AF) in the others. Single atrial myocyte was isolated by enzymatic dissociation with the chunk method. The ionic currents were recorded using the whole cell coffiguration of the voltage clamp technique. ICaL and Ito1 densities in AF patients were significantly lower than those in SR patients by 74% and 60%, respectively, while IK1density was significantly higher by 34% at command potential of - 120 mV. With 10 μmol/L Valsartan, INa density was significantly decreased by 59% in SR patients and by 66% in AF patients. IKur and IKl density were significantly decreased in only AF patients by 31% and23%, respectively. Conclusions Conclusions Decreased IcaL and Itol and increased IKl at hyperpolarizing potentials in AF patients' atrial myocytes may result from the electrophysiological remodeling by AF. Valsartan significantly decreases INa, IK1 and IKur current densities in AF patients' myocyte, but decreases only INa in SR patients' myocyte, suggesting that Valsartan may be beneficial to the recovering of remolded atria.

  16. Sustained spatial attention to vibrotactile stimulation in the flutter range: relevant brain regions and their interaction.

    Directory of Open Access Journals (Sweden)

    Dominique Goltz

    Full Text Available The present functional magnetic resonance imaging (fMRI study was designed to get a better understanding of the brain regions involved in sustained spatial attention to tactile events and to ascertain to what extent their activation was correlated. We presented continuous 20 Hz vibrotactile stimuli (range of flutter concurrently to the left and right index fingers of healthy human volunteers. An arrow cue instructed subjects in a trial-by-trial fashion to attend to the left or right index finger and to detect rare target events that were embedded in the vibrotactile stimulation streams. We found blood oxygen level-dependent (BOLD attentional modulation in primary somatosensory cortex (SI, mainly covering Brodmann area 1, 2, and 3b, as well as in secondary somatosensory cortex (SII, contralateral to the to-be-attended hand. Furthermore, attention to the right (dominant hand resulted in additional BOLD modulation in left posterior insula. All of the effects were caused by an increased activation when attention was paid to the contralateral hand, except for the effects in left SI and insula. In left SI, the effect was related to a mixture of both a slight increase in activation when attention was paid to the contralateral hand as well as a slight decrease in activation when attention was paid to the ipsilateral hand (i.e., the tactile distraction condition. In contrast, the effect in left posterior insula was exclusively driven by a relative decrease in activation in the tactile distraction condition, which points to an active inhibition when tactile information is irrelevant. Finally, correlation analyses indicate a linear relationship between attention effects in intrahemispheric somatosensory cortices, since attentional modulation in SI and SII were interrelated within one hemisphere but not across hemispheres. All in all, our results provide a basis for future research on sustained attention to continuous vibrotactile stimulation in the range

  17. Sustained spatial attention to vibrotactile stimulation in the flutter range: relevant brain regions and their interaction.

    Science.gov (United States)

    Goltz, Dominique; Pleger, Burkhard; Thiel, Sabrina D; Thiel, Sabrina; Villringer, Arno; Müller, Matthias M

    2013-01-01

    The present functional magnetic resonance imaging (fMRI) study was designed to get a better understanding of the brain regions involved in sustained spatial attention to tactile events and to ascertain to what extent their activation was correlated. We presented continuous 20 Hz vibrotactile stimuli (range of flutter) concurrently to the left and right index fingers of healthy human volunteers. An arrow cue instructed subjects in a trial-by-trial fashion to attend to the left or right index finger and to detect rare target events that were embedded in the vibrotactile stimulation streams. We found blood oxygen level-dependent (BOLD) attentional modulation in primary somatosensory cortex (SI), mainly covering Brodmann area 1, 2, and 3b, as well as in secondary somatosensory cortex (SII), contralateral to the to-be-attended hand. Furthermore, attention to the right (dominant) hand resulted in additional BOLD modulation in left posterior insula. All of the effects were caused by an increased activation when attention was paid to the contralateral hand, except for the effects in left SI and insula. In left SI, the effect was related to a mixture of both a slight increase in activation when attention was paid to the contralateral hand as well as a slight decrease in activation when attention was paid to the ipsilateral hand (i.e., the tactile distraction condition). In contrast, the effect in left posterior insula was exclusively driven by a relative decrease in activation in the tactile distraction condition, which points to an active inhibition when tactile information is irrelevant. Finally, correlation analyses indicate a linear relationship between attention effects in intrahemispheric somatosensory cortices, since attentional modulation in SI and SII were interrelated within one hemisphere but not across hemispheres. All in all, our results provide a basis for future research on sustained attention to continuous vibrotactile stimulation in the range of flutter.

  18. Minimally invasive surgery for atrial fibrillation.

    Science.gov (United States)

    Zembala, Michael O; Suwalski, Piotr

    2013-11-01

    Atrial fibrillation (AF) remains the most common cardiac arrhythmia, affecting nearly 2% of the general population worldwide. Minimally invasive surgical ablation remains one of the most dynamically evolving fields of modern cardiac surgery. While there are more than a dozen issues driving this development, two seem to play the most important role: first, there is lack of evidence supporting percutaneous catheter based approach to treat patients with persistent and long-standing persistent AF. Paucity of this data offers surgical community unparalleled opportunity to challenge guidelines and change indications for surgical intervention. Large, multicenter prospective clinical studies are therefore of utmost importance, as well as honest, clear data reporting. Second, a collaborative methodology started a long-awaited debate on a Heart Team approach to AF, similar to the debate on coronary artery disease and transcatheter valves. Appropriate patient selection and tailored treatment options will most certainly result in better outcomes and patient satisfaction, coupled with appropriate use of always-limited institutional resources. The aim of this review, unlike other reviews of minimally invasive surgical ablation, is to present medical professionals with two distinctly different, approaches. The first one is purely surgical, Standalone surgical isolation of the pulmonary veins using bipolar energy source with concomitant amputation of the left atrial appendage-a method of choice in one of the most important clinical trials on AF-The Atrial Fibrillation Catheter Ablation Versus Surgical Ablation Treatment (FAST) Trial. The second one represents the most complex approach to this problem: a multidisciplinary, combined effort of a cardiac surgeon and electrophysiologist. The Convergent Procedure, which includes both endocardial and epicardial unipolar ablation bonds together minimally invasive endoscopic surgery with electroanatomical mapping, to deliver best of the

  19. A mutation in the atrial-specific myosin light chain gene (MYL4) causes familial atrial fibrillation.

    Science.gov (United States)

    Orr, Nathan; Arnaout, Rima; Gula, Lorne J; Spears, Danna A; Leong-Sit, Peter; Li, Qiuju; Tarhuni, Wadea; Reischauer, Sven; Chauhan, Vijay S; Borkovich, Matthew; Uppal, Shaheen; Adler, Arnon; Coughlin, Shaun R; Stainier, Didier Y R; Gollob, Michael H

    2016-04-12

    Atrial fibrillation (AF), the most common arrhythmia, is a growing epidemic with substantial morbidity and economic burden. Mechanisms underlying vulnerability to AF remain poorly understood, which contributes to the current lack of highly effective therapies. Recognizing mechanistic subtypes of AF may guide an individualized approach to patient management. Here, we describe a family with a previously unreported syndrome characterized by early-onset AF (age <35 years), conduction disease and signs of a primary atrial myopathy. Phenotypic penetrance was complete in all mutation carriers, although complete disease expressivity appears to be age-dependent. We show that this syndrome is caused by a novel, heterozygous p.Glu11Lys mutation in the atrial-specific myosin light chain gene MYL4. In zebrafish, mutant MYL4 leads to disruption of sarcomeric structure, atrial enlargement and electrical abnormalities associated with human AF. These findings describe the cause of a rare subtype of AF due to a primary, atrial-specific sarcomeric defect.

  20. Combined percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation for rheumatic mitral stenosis and atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Murdoch, Dale, E-mail: dale_murdoch@health.qld.gov.au [The Prince Charles Hospital, Brisbane (Australia); The University of Queensland, Brisbane (Australia); McAulay, Laura [The Prince Charles Hospital, Brisbane (Australia); Walters, Darren L. [The Prince Charles Hospital, Brisbane (Australia); The University of Queensland, Brisbane (Australia)

    2014-11-15

    Rheumatic heart disease is a common cause of cardiovascular morbidity and mortality worldwide, mostly in developing countries. Mitral stenosis and atrial fibrillation often coexist, related to both structural and inflammatory changes of the mitral valve and left atrium. Both predispose to left atrial thrombus formation, commonly involving the left atrial appendage. Thromboembolism can occur, with devastating consequences. We report the case of a 62 year old woman with rheumatic heart disease resulting in mitral stenosis and atrial fibrillation. Previous treatment with warfarin resulted in life-threatening gastrointestinal bleeding and she refused further anticoagulant therapy. A combined procedure was performed, including percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation with the Atritech® Watchman® device. No thromboembolic or bleeding complications were encountered at one year follow-up. Long-term follow-up in a cohort of patients will be required to evaluate the safety and efficacy of this strategy.

  1. The polyuria of paroxysmal atrial tachycardia

    Science.gov (United States)

    Kinney, M. J.; Stein, R. M.; Discala, V. A.

    1974-01-01

    Two patients with paroxysmal atrial fibrillation and an associated polyuria were studied to delineate the mechanism of the increase in urine flow. A striking saluresis was noted in both patients. The increased sodium excretion was probably due to decreased sodium reabsorption, perhaps at proximal tubular nephron sites. This inhibition of sodium reabsorption could explain both the saluresis and some part or all of the polyuria. Re-evaluation of earlier case reports reveals patterns of concomitant salt and water excretion consistent with this mechanism. The saluresis cannot be explained by the previously favored hypothesis of antidiuretic hormone inhibition.

  2. Fibrilación atrial: nuevos conceptos

    Directory of Open Access Journals (Sweden)

    Luis Gutiérrez-Jaikel

    2004-06-01

    Full Text Available La fibrilación atrial es la arritmia más frecuente en la práctica clínica, se presenta tanto en pacientes con cardiopatía estructural de base principalmente hipertensiva, isquémica y valvular, como en pacientes sin trastorno cardiaco de fondo al avanzar la edad. Debido a la morbilidad asociada a esta, es vital su reconocimiento temprano y el manejo adecuado, con la finalidad de reducir la incidencia de complicaciones asociadas y mejorar la calidad de vida de quienes la padecen.

  3. NASA's First Atrial Fibrillation Case - Deke Slayton

    Science.gov (United States)

    Tarver, William J.

    2010-01-01

    Concerns about heart dysrhythmia have been present since the earliest days of the US manned space program. While information about an astronaut's health is general kept private, one of the original seven American astronaut's health status was played out in a very public forum. Donald "Deke" Slayton was removed from the second manned space flight when it was discovered he had idiopathic atrial fibrillation. Referencing the original medical documents, details of how this was discovered and managed from the medical perspective will be reviewed. This is NASA's first heart dysrhythmia case in an astronaut and it proves quite interesting when placed in historic perspective.

  4. Atrial fibrillation in China: a brief review

    Institute of Scientific and Technical Information of China (English)

    MA Chang-sheng; DU Xin; JIANG Chen-xi

    2009-01-01

    @@ Atrial fibrillation (AF) is the most common heart rhythm disturbance encountered in clinical practice.It affects at least ten million Chinese, constituting a major public health epidemic. For the shortness of resource in the initial stage of new China and the chaos during the culture revolution, there was a scarcity of AF data on the Chinese population. However, Chinese physicians had never stopped exploring in this field, which has provided a solid foundation for today's flourishing development in the research of AF. This paper aims to review the major achievements in dealing with AF in the past 60 years in China, especially in the latest 15 years.

  5. Current approaches in atrial fibrillation treatment

    Directory of Open Access Journals (Sweden)

    Cenk Sarı

    2014-09-01

    Full Text Available Atrial fibrillation (AF is the most common sustained arrhythmia encountered in clinical practice. Its incidence increases with age. AF is classified into subtypes according to the duration and/or able to provide sinus rhytym. İnitially, patients should be evaluated for rhythm or rate control for appropriate treatment. Second stage of strategy aimed to investigate the feasibility of anticoagulation therapy. Recently, due to the progress made in treatment with rhythm control and anticoagulation therapy, either American or European guidelines have been renovated. These developments have taken place in the newly published guide. In this article, the current change in the management of AF is discussed.

  6. Echocardiographic study of left atrial myxoma

    Directory of Open Access Journals (Sweden)

    Dalal J

    1979-01-01

    Full Text Available Four cases of left atrial myxoma were diagnosed pre-operatively by echocardiography. All cases showed characteristic echocardio-graphic features of variegated shadows behind the mitral valve in diastole and within the left atrium in systole. In two cases the my-xomas were surgically removed and confirmed on histology. In one case the post-operative echocardiogram showed complete dis-appearance of the abnormal shadows. Echocardiography is the most reliable method today for the diagnosis of a myxoma.

  7. Verification of the Mechanism of the Head-Positioning Error Caused by Disk Flutter and Slider Supporting Structure for Reducing Head-Positioning Error

    Science.gov (United States)

    Imai, Satomitsu

    In magnetic disk drives, the disk flutter due to high-rotational speed causes the increase of the head-positioning error. It is important to clear the mechanism of the head-positioning error caused by the disk flutter. This paper conducts the experiments to verify the mechanism proposed in the former report. The experiment was conducted by comparing the head-positioning error predicted by the proposed mechanism with the measured head-positioning error signal. It is confirmed that the proposed mechanism can predict the head-positioning error within the 10% error. The former reports also said that the flutter transfer ratio defined in the report could decrease the head-positioning error without reducing the amplitude of the disk flutter. This paper also verifies it experimentally. In the experiment, the thickness of the slider was changed to make the flutter transfer ratio small. This paper also proposes the method of making the beam angle of the gimbal slant to make the flutter transfer ratio small. The effectiveness was confirmed by the simulation.

  8. Atrial conduction times and left atrial mechanical functions and their relation with diastolic function in prediabetic patients

    Science.gov (United States)

    Gudul, Naile Eris; Karabag, Turgut; Sayin, Muhammet Rasit; Bayraktaroglu, Taner; Aydin, Mustafa

    2017-01-01

    Background/Aims The aim of this study was to investigate atrial conduction times and left atrial mechanical functions, the noninvasive predictors of atrial fibrillation, in prediabetic patients with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). Methods Study included 59 patients (23 males, 36 females; mean age 52.5 ± 10.6 years) diagnosed with IFG or IGT by the American Diabetes Association criteria, and 43 healthy adults (22 males, 21 females; mean age 48.5 ± 12.1 years). Conventional and tissue Doppler echocardiography were performed. The electromechanical delay parameters were measured from the onset of the P wave on the surface electrocardiogram to the onset of the atrial systolic wave on tissue Doppler imaging from septum, lateral, and right ventricular annuli. The left atrial volumes were calculated by the disk method. Left atrial mechanical functions were calculated. Results The mitral E/A and E’/A’ ratios measured from the lateral and septal annuli were significantly lower in the prediabetics compared to the controls. The interatrial and left atrial electromechanical delay were significantly longer in prediabetic group compared to the controls. Left atrial active emptying volume (LAAEV) and fraction (LAAEF) were significantly higher in the prediabetics than the controls. LAAEV and LAAEF were significantly correlated with E/A, lateral and septal E’/A’. Conclusions In the prediabetic patients, the atrial conduction times and P wave dispersion on surface electrocardiographic were longer before the development of overt diabetes. In addition, the left atrial mechanical functions were impaired secondary to a deterioration in the diastolic functions in the prediabetic patients. PMID:27919159

  9. Detecting and Diagnosing Atrial Fibrillation (D2AF): study protocol for a cluster randomised controlled trial

    OpenAIRE

    Uittenbogaart, Steven B.; Verbiest-van Gurp, Nicole; Erkens, Petra M. G.; Lucassen, Wim A M; Knottnerus, J. André; Winkens, Bjorn; van Weert, Henk C P M; Stoffers, Henri E. J. H.

    2015-01-01

    Background Atrial fibrillation is a common cause of stroke and other morbidity. Adequate treatment with anticoagulants reduces the risk of stroke by 60 %. Early detection and treatment of atrial fibrillation could prevent strokes. Atrial fibrillation is often asymptomatic and/or paroxysmal. Case-finding with pulse palpation is an effective screening method, but new methods for detecting atrial fibrillation have been developed. To detect paroxysmal atrial fibrillation ambulatory rhythm recordi...

  10. Imaging atrial arrhythmic intracellular calcium in intact heart.

    Science.gov (United States)

    Xie, Wenjun; Santulli, Gaetano; Guo, Xiaoxiao; Gao, Melanie; Chen, Bi-Xing; Marks, Andrew R

    2013-11-01

    Abnormalities in intracellular Ca(2+) signaling have been proposed to play an essential role in the pathophysiology of atrial arrhythmias. However, a direct observation of intracellular Ca(2+) in atrial myocytes during atrial arrhythmias is lacking. Here, we have developed an ex vivo model of simultaneous Ca(2+) imaging and electrocardiographic recording in cardiac atria. Using this system we were able to record atrial arrhythmic intracellular Ca(2+) activities. Our results indicate that atrial arrhythmias can be tightly linked to intracellular Ca(2+) waves and Ca(2+) alternans. Moreover, we applied this strategy to analyze Ca(2+) signals in the hearts of WT and knock-in mice harboring a 'leaky' type 2 ryanodine receptor (RyR2-R2474S). We showed that sarcoplasmic reticulum (SR) Ca(2+) leak increases the susceptibility to Ca(2+) alternans and Ca(2+) waves increasing the incidence of atrial arrhythmias. Reduction of SR Ca(2+) leak via RyR2 by acute treatment with S107 reduced both Ca(2+) alternans and Ca(2+) waves, and prevented atrial arrhythmias.

  11. Clinical characteristics, management, and control of permanent vs. nonpermanent atrial fibrillation: insights from the RealiseAF survey.

    LENUS (Irish Health Repository)

    Murin, Jan

    2014-01-01

    Atrial fibrillation can be categorized into nonpermanent and permanent atrial fibrillation. There is less information on permanent than on nonpermanent atrial fibrillation patients. This analysis aimed to describe the characteristics and current management, including the proportion of patients with successful atrial fibrillation control, of these atrial fibrillation subsets in a large, geographically diverse contemporary sample.

  12. Right Atrial Metastatic Melanoma with Unknown Primaries

    Directory of Open Access Journals (Sweden)

    Robin Kuriakose

    2015-01-01

    Full Text Available A 54-year-old male with history of anemia and rheumatoid arthritis presented with a three-month history of dyspnea on exertion and lower extremity edema. Patient was referred for a transthoracic echocardiogram that revealed a large right atrial mass with reduced ejection fraction of 40% and an incidental large liver mass. Subsequent cardiac MRI revealed a lobulated right atrial mass measuring 5.4 cm × 5.3 cm with inferior vena cava compression and adjacent multiple large liver lesions confirmed to be malignant melanoma through biopsy. Interestingly, no primaries were found in the patient. PET/CT imaging displayed hypermetabolic masses within the right atrium and liver that likely represent metastases, as well as bilateral pleural effusions, most likely due to heart failure. Preoperative coronary angiogram demonstrated perfusion to the mass by a dense network of neovasculature arising from the mid right coronary artery. The cardiac melanoma was surgically removed, and the right atrium was reconstructed with a pericardial patch. After surgery, all cardiac chambers appeared normal in size and function with associated moderate tricuspid regurgitation. The patient is currently being administered ipilimumab for systemic therapy of metastatic melanoma.

  13. [Metabolic syndrome and chronic persistent atrial fibrillation].

    Science.gov (United States)

    Onuchina, E L; Solov'ev, O V; Mochalova, O V; Kononov, S K; Onuchin, S G

    2011-01-01

    The aim of the study was to elucidate specific features of chronic recurrent atrial fibrillation (AF) in patients with metabolic syndrome (MS) and disturbed carbohydrate metabolism compared with AF patients without MS. It enrolled 145 patients aged 44-83 years: 117 with abdominal obesity (BMI >30 kg/m2, waist circumference >80 and 94 cm in women and men respectively) including 30 without metabolic disturbances; 35 with impaired glucose tolerance (IGT), 52 with type 2 DM, and 28 controls without MS. Parameters measured included frequency and severity of AF, carbohydrate and lipid metabolism, albuminurea, C-reactive peptide level, quality of AH control, results of echocardiography and 24 hour ECG monitoring (sinus rhythm), and insulin resistance index (HOMA IRindex). Groups of AF and MS patients were dominated by women. The frequency and severity of AF relapses in MS patients were higher than in controls (especially in the presence of IGT and DM). IGT and DM2 associated with structural changes in myocardium (left atrial dilatation, prevalence of LV concentric hypertrophy, diastolic dysfunction) coupled to higher systolic AH and marked metabolic disorders (hyperglycemia, IR, elevated microalbuminurea and C-reactive protein level, dyslipidemia). These conditions contribute to the frequency and severity of AF relapses. Development of AF in MS is a multifactor problem necessitating strict control of AH, dyslipidemia, DM2 and IGT, reduction of body weight and abdominal obesity.

  14. Atrial Fibrillation Predictors: Importance of the Electrocardiogram.

    Science.gov (United States)

    German, David M; Kabir, Muammar M; Dewland, Thomas A; Henrikson, Charles A; Tereshchenko, Larisa G

    2016-01-01

    Atrial fibrillation (AF) is the most common arrhythmia in adults and is associated with significant morbidity and mortality. Substantial interest has developed in the primary prevention of AF, and thus the identification of individuals at risk for developing AF. The electrocardiogram (ECG) provides a wealth of information, which is of value in predicting incident AF. The PR interval and P wave indices (including P wave duration, P wave terminal force, P wave axis, and other measures of P wave morphology) are discussed with regard to their ability to predict and characterize AF risk in the general population. The predictive value of the QT interval, ECG criteria for left ventricular hypertrophy, and findings of atrial and ventricular ectopy are also discussed. Efforts are underway to develop models that predict AF incidence in the general population; however, at present, little information from the ECG is included in these models. The ECG provides a great deal of information on AF risk and has the potential to contribute substantially to AF risk estimation, but more research is needed.

  15. An experimental study of tip shape effects on the flutter of aft-swept, flat-plate wings

    Science.gov (United States)

    Dansberry, Bryan E.; Rivera, Jose A., Jr.; Farmer, Moses G.

    1990-01-01

    The effects of tip chord orientation on wing flutter are investigated experimentally using six cantilever-mounted, flat-plate wing models. Experimentally determined flutter characteristics of the six models are presented covering both the subsonic and transonic Mach number ranges. While all models have a 60 degree leading edge sweep, a 40.97 degree trailing edge sweep, and a root chord of 34.75 inches, they are subdivided into two series characterized by a higher aspect ratio and a lower aspect ratio. Each series is made up of three models with tip chord orientations which are parallel to the free-stream flow, perpendicular to the model mid-chord line, and perpendicular to the free-stream flow. Although planform characteristics within each series of models are held constant, structural characteristics such as mode shapes and natural frequencies are allowed to vary.

  16. Flutter and Thermal Buckling Analysis for Composite Laminated Panel Embedded with Shape Memory Alloy Wires in Supersonic Flow

    Directory of Open Access Journals (Sweden)

    Chonghui Shao

    2016-01-01

    Full Text Available The flutter and thermal buckling behavior of laminated composite panels embedded with shape memory alloy (SMA wires are studied in this research. The classical plate theory and nonlinear von-Karman strain-displacement relation are employed to investigate the aeroelastic behavior of the smart laminated panel. The thermodynamic behaviors of SMA wires are simulated based on one-dimensional Brinson SMA model. The aerodynamic pressure on the panel is described by the nonlinear piston theory. Nonlinear governing partial differential equations of motion are derived for the panel via the Hamilton principle. The effects of ply angle of the composite panel, SMA layer location and orientation, SMA wires temperature, volume fraction and prestrain on the buckling, flutter boundary, and amplitude of limit cycle oscillation of the panel are analyzed in detail.

  17. YKL-40 levels and atrial fibrillation in the general population

    DEFF Research Database (Denmark)

    Marott, Sarah C W; Benn, Marianne; Johansen, Julia S

    2013-01-01

    BACKGROUND: Atrial fibrillation is associated with inflammation. In contrast to inflammatory markers like C-reactive protein (CRP) and fibrinogen produced in the liver, YKL-40 is produced at the site of inflammation including in the myocardium. We hypothesized that elevated plasma YKL-40 levels...... associate with increased risk of atrial fibrillation. METHOD AND RESULTS: We measured plasma YKL-40 in 8731 participants from the prospective Copenhagen City Heart Study including 896 individuals who developed atrial fibrillation during up to 18years of follow-up. Additionally, we measured YKL-40 in 6621...

  18. Atrial natriuretic peptide and feeding activity patterns in rats

    Directory of Open Access Journals (Sweden)

    Oliveira M.H.A.

    1997-01-01

    Full Text Available This review presents historical data about atrial natriuretic peptide (ANP from its discovery as an atrial natriuretic factor (ANF to its role as an atrial natriuretic hormone (ANH. As a hormone, ANP can interact with the hypothalamic-pituitary-adrenal axis (HPA-A and is related to feeding activity patterns in the rat. Food restriction proved to be an interesting model to investigate this relationship. The role of ANP must be understood within a context of peripheral and central interactions involving different peptides and pathways

  19. Pulmonary edema following transcatheter closure of atrial septal defect

    Directory of Open Access Journals (Sweden)

    Keerthi Chigurupati

    2015-01-01

    Full Text Available We describe an incident of development of acute pulmonary edema after the device closure of a secundum atrial septal defect in a 52-year-old lady, which was treated with inotropes, diuretics and artificial ventilation. Possibility of acute left ventricular dysfunction should be considered after the defect closure in the middle-aged patients as the left ventricular compliance may be reduced due to increased elastic stiffness and diastolic dysfunction. Baseline left atrial pressure may be > 10 mmHg in these patients. Associated risk factors for the left ventricular dysfunction are a large Qp:Qs ratio, systemic hypertension, severe pulmonary hypertension and paroxysmal atrial fibrillation.

  20. Acute Pulmonary Edema Caused by a Giant Atrial Myxoma

    Directory of Open Access Journals (Sweden)

    Andrea Fisicaro

    2013-01-01

    Full Text Available Atrial myxoma is the most common primary cardiac tumor. Its clinical presentation spreads from asymptomatic incidental mass to serious life-threatening cardiovascular complications. We report the case of a 44-year-old man with evening fever and worsening dyspnea in the last weeks, admitted to our hospital for acute pulmonary edema. The cardiac auscultation was very suspicious for mitral valve stenosis, but the echocardiography revealed a huge atrial mass with a diastolic prolapse into mitral valve orifice causing an extremely high transmitral gradient pressure. Awareness of this uncommon acute presentation of atrial myxoma is necessary for timely diagnosis and prompt surgical intervention.

  1. Pulmonary edema following transcatheter closure of atrial septal defect

    Science.gov (United States)

    Chigurupati, Keerthi; Reshmi, Liza Jose; Gadhinglajkar, Shrinivas; Venkateshwaran, S.; Sreedhar, Rupa

    2015-01-01

    We describe an incident of development of acute pulmonary edema after the device closure of a secundum atrial septal defect in a 52-year-old lady, which was treated with inotropes, diuretics and artificial ventilation. Possibility of acute left ventricular dysfunction should be considered after the defect closure in the middle-aged patients as the left ventricular compliance may be reduced due to increased elastic stiffness and diastolic dysfunction. Baseline left atrial pressure may be > 10 mmHg in these patients. Associated risk factors for the left ventricular dysfunction are a large Qp:Qs ratio, systemic hypertension, severe pulmonary hypertension and paroxysmal atrial fibrillation. PMID:26139760

  2. Platypnea-orthodeoxia induced by fenestrated atrial septal aneurysm.

    Science.gov (United States)

    Giombolini, Claudio; Notaristefano, Salvatore; Santucci, Stefano; Savino, Ketty; Pasquino, Stefano; Ragni, Temistocle; Ambrosio, Giuseppe

    2005-02-01

    Platypnea-orthodeoxia is a peculiar syndrome characterized by a right-to-left shunt, which occurs in the upright position. The diagnosis is made by contrast transesophageal echocardiography, paying attention to include contrast visualization in the orthostatic decubitus. The association of this syndrome with a fenestrated atrial septal aneurysm is rare and probably underlies a peculiar and also rare mechanism of shunting in presence of normal pulmonary pressure. We report of a case of a 58-year-old man with a fenestrated atrial septal aneurysm and platypnea-orthodeoxia syndrome treated by surgical closure of the atrial defect.

  3. Atrial secretion of B-type natriuretic peptide

    DEFF Research Database (Denmark)

    Goetze, Jens Peter; Friis-Hansen, Lennart; Rehfeld, Jens F;

    2006-01-01

    In the normal heart, the endocrine capacity resides in the atria. Atrial myocytes express and secrete natriuretic hormones that regulate fluid homeostasis and blood pressure. But in ventricular disease, atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) gene expression is also...... activated in ventricular myocytes. Plasma concentrations of natriuretic peptides and their biosynthetic precursors are accordingly increased in patients with marked ventricular dysfunction. In contrast, atrial peptide secretion in ventricular disease has received less attention, and our present...... are also active in heart failure. Plasma measurement of cardiac natriuretic peptides and their molecular precursors can perhaps help us to discriminate when, where and how....

  4. 'Real-world' atrial fibrillation management in Europe

    DEFF Research Database (Denmark)

    Proietti, Marco; Laroche, Cécile; Opolski, Grzegorz;

    2016-01-01

    AIMS: Atrial fibrillation (AF) is commonly associated with a high risk of stroke, thromboembolism, and mortality. The 1-year follow-up of the EURObservational Research Programme-Atrial Fibrillation (EORP-AF) Pilot Registry demonstrated a high mortality but good outcomes with European Society...... (61.8%). Atrial fibrillation readmissions were frequent, particularly related to arrhythmias and heart failure. On multivariate analyses, any cardiovascular reason for admission rather than AF was significantly associated with increased mortality during the 2-year follow-up. CONCLUSION: In this 2-year...

  5. Optimal locations of piezoelectric patches for supersonic flutter control of honeycomb sandwich panels, using the NSGA-II method

    Science.gov (United States)

    Nezami, M.; Gholami, B.

    2016-03-01

    The active flutter control of supersonic sandwich panels with regular honeycomb interlayers under impact load excitation is studied using piezoelectric patches. A non-dominated sorting-based multi-objective evolutionary algorithm, called non-dominated sorting genetic algorithm II (NSGA-II) is suggested to find the optimal locations for different numbers of piezoelectric actuator/sensor pairs. Quasi-steady first order supersonic piston theory is employed to define aerodynamic loading and the p-method is applied to find the flutter bounds. Hamilton’s principle in conjunction with the generalized Fourier expansions and Galerkin method are used to develop the dynamical model of the structural systems in the state-space domain. The classical Runge-Kutta time integration algorithm is then used to calculate the open-loop aeroelastic response of the system. The maximum flutter velocity and minimum voltage applied to actuators are calculated according to the optimal locations of piezoelectric patches obtained using the NSGA-II and then the proportional feedback is used to actively suppress the closed loop system response. Finally the control effects, using the two different controllers, are compared.

  6. Nonlocal and surface effects on the flutter instability of cantilevered nanotubes conveying fluid subjected to follower forces

    Science.gov (United States)

    Bahaadini, Reza; Hosseini, Mohammad; Jamalpoor, Ali

    2017-03-01

    On the basis of nonlocal elasticity theory, this paper studies the dynamic structural instability behavior of cantilever nanotubes conveying fluid incorporating end concentrated follower force and distributed tangential load, resting on the visco-Pasternak substrate. In order to improve the accuracy of the results, surface effects, i.e. surface elasticity and residual stresses are considered. Extended Hamilton's principle is implemented to obtain the nonlocal governing partial differential equation and related boundary conditions. Then, the extended Galerkin technique is used to convert partial differential equations into a general set of ordinary differential equations. Numerical results are expressed to reveal the variations of the critical flow velocity for flutter phenomenon of cantilever nanotubes with the various values of nonlocal parameter, mass ratios, nanotubes thickness, surface effects, various parameters of the visco-Pasternak medium, constant follower force and distributed compressive tangential load. Some numerical results of this research illustrated that the values of critical flutter flow velocity and stable region increase by considering surface effects. Also, critical flutter flow velocity decreases towards zero by increasing the value of the distributed compressive tangential load and constant follower force.

  7. Atrial ectopy predicts late recurrence of atrial fibrillation after pulmonary vein isolation

    DEFF Research Database (Denmark)

    Gang, Uffe J O; Nalliah, Chrishan J; Lim, Toon Wei

    2015-01-01

    BACKGROUND: Late recurrence of atrial fibrillation (AF) after radiofrequency ablation remains significant. Asymptomatic recurrence poses a difficult clinical problem as it is associated with an equally increased risk of stroke and death compared with symptomatic AF events. Meta-analyses reveal th...... with a significantly increased risk of late AF recurrence. These results could have important clinical implications for the design of post-PVI follow-up. CLINICAL TRIAL REGISTRATION: URL: http://www.anzctr.org.au. Unique identifier: ACRTN12606000467538....

  8. Electrical and structural remodeling: role in the genesis and maintenance of atrial fibrillation.

    Science.gov (United States)

    Schoonderwoerd, Bas A; Van Gelder, Isabelle C; Van Veldhuisen, Dirk J; Van den Berg, Maarten P; Crijns, Harry J G M

    2005-01-01

    Atrial fibrillation (AF) and congestive heart failure (CHF) are 2 frequently encountered conditions in clinical practice. Both lead to changes in atrial function and structure, an array of processes known as atrial remodeling. This review provides an overview of ionic, electrical, contractile, neurohumoral, and structural atrial changes responsible for initiation and maintenance of AF. In the last decade, many studies have evaluated atrial remodeling due to AF or CHF. Both conditions often coexist, which makes it difficult to distinguish the contribution of each. Because of atrial stretch in the setting of hypertension or CHF, atrial remodeling frequently occurs long before AF arises. Alternatively, AF may lead to electrical remodeling, that is, shortening of refractoriness due to the high atrial rate itself. In many experimental AF or rapid atrial pacing studies, the ventricular rate was uncontrolled. In those studies, atrial stretch due to CHF may have interfered with the high atrial rate to produce a mixed type of electrical and structural remodeling. Other studies have dissected the individual role of AF or atrial tachycardia from the role CHF plays in atrial remodeling. Atrial fibrillation itself does not lead to structural remodeling, whereas this is frequently produced by hypertension or CHF, even in the absence of AF. Primary and secondary prevention programs should tailor treatment to the various types of remodeling.

  9. Women Sex Importance in Stroke Patients with Atrial Fibrillation

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    Cemile Handan Mısırlı

    2014-08-01

    Full Text Available OBJECTIVE: It was shown the differences in age, risk factors and treatment between women and men in stroke patients with atrial fibrillation METHODS: The stroke patients with atrial fibrillation who were hospitalized in our department at the last 2 years were seperated into 2 groups of aged above 75 and below 75, investigated with CHADS2 and CHA2DS2VASc scores and looked at the sex differences of women and men. RESULTS: Stroke ratio according to sex was statistically meaningful especially in women above the age of 75. Risc factors also were founded in elderly women and CHA2DS2VASc scores were higher in women than men so more anticoagulan treatment were begun. No differences were shown between sexes at lone atrial fibrillation and no treatment were begun. CONCLUSION: Women with atrial fibrillation had more risk factors, higher stroke rate and higher anticoagulation treatment.

  10. Emerging options to prevent stroke in atrial fibrillation patients

    Directory of Open Access Journals (Sweden)

    Silver B

    2012-01-01

    Full Text Available Brian SilverStroke Center, Rhode Island Hospital, Providence, RI, USAAbstract: Atrial fibrillation is a common condition in the population and increases in prevalence with age. A new method for evaluating stroke risk with atrial fibrillation, called CHA2DS2Vasc, has been developed, as has a novel method for estimating the risk of bleeding, called HAS-BLED. Further, the last decade has seen a dramatic increase in the number of treatment options tested for this condition. These include novel oral anticoagulants such as apixaban, dabigatran, and rivaroxaban, and devices that occlude the left atrial appendage, such as WATCHMAN. This review will compare these new agents with the historical gold standard of warfarin.Keywords: stroke, atrial fibrillation, treatment

  11. Dronedarone in high-risk permanent atrial fibrillation

    DEFF Research Database (Denmark)

    Connolly, Stuart J; Camm, A John; Halperin, Jonathan L;

    2011-01-01

    Dronedarone restores sinus rhythm and reduces hospitalization or death in intermittent atrial fibrillation. It also lowers heart rate and blood pressure and has antiadrenergic and potential ventricular antiarrhythmic effects. We hypothesized that dronedarone would reduce major vascular events in ...

  12. [New oral anticoagulants for atrial fibrillation: a neurologist's view

    NARCIS (Netherlands)

    Dijk, E.J. van; Koudstaal, P.J.; Roos, Y.B.; Brouwers, P.J.; Kappelle, L.J.

    2012-01-01

    - Recent randomized controlled trials have shown that new oral anticoagulants (dabigatran, rivaroxaban en apixaban) in patients with atrial fibrillation are equally or more effective in preventing cerebral infarction than vitamin K antagonists (VKA).- New oral anticoagulants cause significant less i

  13. Atrial fibrillation in fracture patients treated with oral bisphosphonates

    DEFF Research Database (Denmark)

    Abrahamsen, B; Eiken, P; Brixen, K

    2009-01-01

    OBJECTIVES: To determine if patients receiving oral bisphosphonates are at excess risk of atrial fibrillation (AF), stroke and myocardial infarction. DESIGN: Register-based restricted cohort study. SETTING: National Hospital Discharge Register and National Prescriptions Database (1995...

  14. Cardiac adipose tissue and atrial fibrillation: the perils of adiposity.

    Science.gov (United States)

    Hatem, Stéphane N; Redheuil, Alban; Gandjbakhch, Estelle

    2016-04-01

    The amount of adipose tissue that accumulates around the atria is associated with the risk, persistence, and severity of atrial fibrillation (AF). A strong body of clinical and experimental evidence indicates that this relationship is not an epiphenomenon but is the result of complex crosstalk between the adipose tissue and the neighbouring atrial myocardium. For instance, epicardial adipose tissue is a major source of adipokines, inflammatory cytokines, or reactive oxidative species, which can contribute to the fibrotic remodelling of the atrial myocardium. Fibro-fatty infiltrations of the subepicardium could also contribute to the functional disorganization of the atrial myocardium. The observation that obesity is associated with distinct structural and functional remodelling of the atria has opened new perspectives of treating AF substrate with aggressive risk factor management. Advances in cardiac imaging should lead to an improved ability to visualize myocardial fat depositions and to localize AF substrates.

  15. Dabigatran use in Danish atrial fibrillation patients in 2011

    DEFF Research Database (Denmark)

    Sørensen, Rikke; Gislason, Gunnar; Torp-Pedersen, Christian;

    2013-01-01

    Objective: Dabigatran was recently approved for anticoagulation in patients with atrial fibrillation (AF); data regarding real-world use, comparative effectiveness and safety are sparse. Design: Pharmacoepidemiological cohort study. Methods/settings: From nationwide registers, we identified...

  16. Pharmacological Management of Atrial Fibrillation: One, None, One Hundred Thousand

    Directory of Open Access Journals (Sweden)

    Fabiana Lucà

    2011-01-01

    This paper summarizes the available evidence regarding the efficacy of medications used for acute management of AF, rhythm and ventricular rate control, and stroke prevention in patients with atrial fibrillation and focuses on the current pharmacological agents.

  17. Echocardiographic quantification of systolic function during atrial fibrillation

    DEFF Research Database (Denmark)

    Olsen, Flemming Javier; Jørgensen, Peter Godsk; Dons, Maria;

    2016-01-01

    It is often difficult to provide an exact echocardiographic measure of left ventricular systolic function in patients with atrial fibrillation, partly because of the varying cycle length affecting pre and afterload and partly because of the increased heart rate often accompanying this arrhythmia....... We sought to elucidate two points: whether it would be possible to correct for the cyclic variance in systolic output, and if global longitudinal strain is preferable to the left ventricular ejection fraction at evaluating systolic function during atrial fibrillation....

  18. ANTITHROMBOTIC THERAPY IN ATRIAL FIBRILLATION: NEW DATA AND NEW HORIZONS

    Directory of Open Access Journals (Sweden)

    M. Yu. Gilyarov

    2011-01-01

    Full Text Available New data and perspectives of antithrombotic therapy are highlighted in patients with atrial fibrillation. Factors of warfarin therapy efficacy, as well as the possibility of new antithrombotic drugs are considered. Special attention are paid to the direct thrombin inhibitors — dabigatran. Possibilities and usage prospects of dabigatran in patients with atrial fibrillation are discussed in detail in the light of new results of RE-LY trial.

  19. Cryoballoon or Radiofrequency Ablation for Paroxysmal Atrial Fibrillation.

    OpenAIRE

    Chun, KR; Bestehorn, K; Pocock, SJ; FIRE AND ICE Investigators; , COLLABORATORS; Kuck, KH; Metzner, A; Ouyang, F; Chun, J; Fürnkranz, A; Elvan, A.; Arentz, T.; Kühne, M.; Sticherling, C; Gellér, L

    2016-01-01

    BACKGROUND: Current guidelines recommend pulmonary-vein isolation by means of catheter ablation as treatment for drug-refractory paroxysmal atrial fibrillation. Radiofrequency ablation is the most common method, and cryoballoon ablation is the second most frequently used technology. METHODS: We conducted a multicenter, randomized trial to determine whether cryoballoon ablation was noninferior to radiofrequency ablation in symptomatic patients with drug-refractory paroxysmal atrial fibrillatio...

  20. Stroke and bleeding in atrial fibrillation with chronic kidney disease

    DEFF Research Database (Denmark)

    Olesen, Jonas Bjerring; Lip, Gregory Y.H.; Kamper, Anne-Lise;

    2012-01-01

    Both atrial fibrillation and chronic kidney disease increase the risk of stroke and systemic thromboembolism. However, these risks, and the effects of antithrombotic treatment, have not been thoroughly investigated in patients with both conditions.......Both atrial fibrillation and chronic kidney disease increase the risk of stroke and systemic thromboembolism. However, these risks, and the effects of antithrombotic treatment, have not been thoroughly investigated in patients with both conditions....