Orczykowski, Michał; Jaworska-Wilczyńska, Maria; Urbanek, Piotr; Bodalski, Robert; Derejko, Paweł; Gajek, Jacek; Hryniewiecki, Tomasz; Szumowski, Lukasz; Walczak, Franciszek
2010-08-01
We present a case of a 61 year-old woman with tachycardia originating close to the His bundle where radiofrequency (RF) ablation may bear potential risk of atrioventricular (AV) block. In this case report we discuss the possibility of a AV nodal reciprocating tachycardia with tendon of Todaro breakthrough. Patient was safely and effectively treated with RF catheter ablation.
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Ken-Pen Weng
2005-10-01
Full Text Available A healthy 15-year-old male patient presented with a 6-month history of recurrent attacks of palpitations. On multiple emergency room visits, a sustained wide QRS complex tachycardia with a right bundle branch block and northwest axis deviation was documented. The tachycardia was not terminated by intravenous adenosine, but was suppressed with intravenous verapamil. There was no evidence of structural heart disease, myocarditis, long QT syndrome, or electrolyte imbalance after a series of standard examinations. Idiopathic left ventricular tachycardia (ILVT was suspected. Electrophysiologic studies revealed 2 inducible tachycardias, which were shown to represent atrioventricular nodal reentrant tachycardia (AVNRT and ILVT. Transformation from AVNRT to ILVT occurred spontaneously following atrial pacing. Successful ablation of ILVT and the slow atrioventricular nodal pathway resulted in cure of the double tachycardia.
Fallavollita, Luca; Santillo, Elpidio; Marini, Luciano; Balestrini, Fabrizio
2012-12-01
We descrive a patient who presents palpitations during cardiac rehabilitation after mitral valvuloplasty. ECG showed regular narrow QRS tachycardia compatible with Atrioventricular Node Reentrant Tachycardia. After slow pathway radiofrequency catheter ablation, the patient completed the rehabilitation program remained tachycardia and palpitations-free.
Mechanism of polyuria and natriuresis in atrioventricular nodal tachycardia.
Canepa-Anson, R; Williams, M; Marshall, J; Mitsuoka, T; Lightman, S; Sutton, R
1984-01-01
A woman with tachycardia associated with polyuria was investigated. Electrophysiological analysis showed that the tachycardia was an atrioventricular nodal re-entrant tachycardia. Programmed stimulation was then used to provoke and sustain the tachycardia for 40 minutes. Polyuria, with an appreciable increase in free water clearance, was observed. This was associated with reduction in plasma and urinary arginine vasopressin concentrations. Appreciable natriuresis also developed. These results support the hypothesis that the polyuria with increased free water clearance and the natriuresis occurring during sustained tachycardia in man are due to inhibition of secretion of vasopressin and the release of natriuretic factor. PMID:6434116
Kim, Dongmin; Lee, Myung-Yong
2016-07-01
Among patients with Wolff-Parkinson-White syndrome, atrioventricular reciprocating tachycardia (AVRT) and atrioventricular nodal reentrant tachycardia (AVNRT) can coexist in a single patient. Direct transition of both tachycardias is rare; however, it can occur after premature atrial or ventricular activity if the cycle lengths of the two tachycardias are similar. Furthermore, persistent atrial activation by an accessory pathway (AP) located outside of the AV node during ongoing AVNRT is also rare. This article describes a case of uncommon atrial activation by an AP during AVNRT and gradual transition of the two supraventricular tachycardias without any preceding atrial or ventricular activity in a patient with preexcitation syndrome.
Katritsis, Demosthenes G.; Ellenbogen, Kenneth A.; Becker, Anton E.
2006-01-01
Detailed right and left septal mapping of retrograde atrial activation during typical atrioventricular nodal reentrant tachycardia (AVNRT) has not been undertaken and may provide insight into the complex physiology of AVNRT, especially the anatomic localization of the fast and slow pathways. The
Hahurij, Nathan D.; Gittenberger-de Groot, Adriana C.; Kolditz, Denise P.; Bökenkamp, Regina; Schalij, Martin J.; Poelmann, Robert E.; Blom, Nico A.
2008-01-01
BACKGROUND: Fetal and neonatal atrioventricular (AV) reentrant tachycardias can be life-threatening but resolve in most cases during the first year of life. The transient presence of accessory AV myocardial connections during annulus fibrosus development may explain this phenomenon. METHODS AND
Familial atrioventricular nodal re-entrant tachycardia: A case seriers and a systematic review
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Muthiah Subramanian
2017-11-01
Full Text Available Multiple reports of familial clustering suggest that genetic factors may contribute in the pathogenesis of atrioventricular nodal re-entrant tachycardia (AVNRT. We report three cases of AVNRT in a father and his two sons along with a review of literature of other similar cases. Electrophysiological studies induced typical AVNRT, which was successfully eliminated by radiofrequency ablation in all of them. Of the 22 reported cases, 96% had typical (slow-fast variant of AVNRT. The predominant pattern of inheritance appears to be autosomal dominant, though other patterns may exist. Further research is needed to understand the genetic influence of AVNRT and its pathophysiology. Keywords: Familial, AVNRT, Tachycardia
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Aksu T
2015-02-01
Full Text Available Tolga Aksu, Tumer Erdem Guler, Ebru Golcuk, Ismail Erden, Kazim Serhan Ozcan Department of Cardiology, Kocaeli Derince Education and Research Hospital, Derince, Kocaeli, Turkey Abstract: Radiofrequency catheter ablation of the slow pathway is considered to be the treatment of choice for patients with atrioventricular nodal reentrant tachycardia. We report a 34-year-old female with mirror image dextrocardia due to unilateral pulmonary agenesis who underwent successful slow pathway ablation for typical atrioventricular nodal reentrant tachycardia. Using contrast injection, cardiac anatomy was identified in a short time and successfully ablated. Keywords: dextrocardia, AVNRT, ablation, pulmonary agenesis
An approach to the patient with a suspected tachycardia in the ...
African Journals Online (AJOL)
ectopic tachycardia (JET). AVJRT can be due to atrioventricular nodal re-entrant tachycardia. (AVNRT), where the antegrade limb is the slow pathway of the atrioventricular (AV) node and the retrograde limb the fast pathway, or atrioventricular re-entrant tachycardia (AVRT), where the antegrade limb is the AV node and.
Mechanical circulatory treatment of advanced heart failure
DEFF Research Database (Denmark)
Rujic, Dragana; Sundbøll, Jens; Tofig, Bawer Jalal
2016-01-01
The paroxysmal supraventricular tachycardias (SVT) are commonly encountered arrhythmias and include atrioventricular nodal re-entrant tachycardia, atrioventricular reciprocating tachycardia, and focal atrial tachycardia. These tachycardias share several clinical features as well as similar manage...
Tanaka, Kazushi; Shiotani, Shinji; Fukuda, Keisuke; Fujihara, Masahiko; Higashimori, Akihiro; Morioka, Nobuyuki; Yokoi, Yoshiaki; Fujimura, Osamu
2014-01-01
Herein, we report the case of a 49-year-old woman with typical atrioventricular nodal (AVN) reentrant tachycardia, confined to the compact atrioventricular node, showing numerous rare electrophysiological findings such as unique AVN reentrant echoes, double ventricular responses, latent retrograde dual AVN pathways, antegrade triple AVN pathways, and longitudinal dissociation within the lower final common pathway.
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Kazushi Tanaka, M.D., Ph.D.
2014-12-01
Full Text Available Herein, we report the case of a 49-year-old woman with typical atrioventricular nodal (AVN reentrant tachycardia, confined to the compact atrioventricular node, showing numerous rare electrophysiological findings such as unique AVN reentrant echoes, double ventricular responses, latent retrograde dual AVN pathways, antegrade triple AVN pathways, and longitudinal dissociation within the lower final common pathway.
Paroxysmal supraventricular tachycardia: physiopathology and management
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Paola Neroni
2014-06-01
Full Text Available Paroxysmal supraventricular tachycardia (PSVT is the most frequent arrhythmia in newborns and infants. Most supraventricular tachycardias affect structurally healthy hearts. Apart from occasional detection by parents, most tachycardias in this age group are revealed by heart failure signs, such as poor feeding, sweating and shortness of breath. The main symptom reported by school-age children is palpitations. The chronic tachycardia causes a secondary form of dilative cardiomyopathy. Treatment of acute episode usually has an excellent outcome. Vagal manoeuvres are effective in patients with atrioventricular reentrant tachycardia. Adenosine is the drug of choice at all ages for tachycardias involving the atrioventricular node. Its key advantage is its short half life and minimum or no negative inotropic effects. Verapamil is not indicated in newborns and children as it poses a high risk of electromechanical dissociation. Antiarrhythmic prophylaxis of PSVT recurrence is usually recommended in the first year of life, because the diagnosis of tachycardia may be delayed up to the appearance of symptoms. Digoxin can be administered in all forms of PSVT involving the atrioventricular node, except for patients with Wolff-Parkinson-White syndrome below one year of age. Patients with atrioventricular reentrant PSVT can be treated effectively by class Ic drugs, such as propaphenone and flecainide. Amiodarone has the greatest antiarrhythmic effect, but should be used with caution owing to the high incidence of side effects. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou
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Claes Williamsson
2014-01-01
Full Text Available The mechanism behind the female preponderance for atrio-ventricular node reentrant tachycardia (AVNRT is not clear. We compared baseline electrophysiological measurements and clinical data in 141 consecutive patients (96 women who underwent successful AVNRT ablation at their fi rst therapeutic procedure. Women had on average 9% higher resting heart rate than men (p<0.05, but were similar in all measures of AV node function. Isoproterenol infusion was required for AVNRT induction in 69 cases (49%, and the need for isoproterenol was associated with lower resting heart rate and longer anterograde and retrograde AV node refractory periods (p<0.05 for comparisons, but not with sex. We conclude that the spectrum of baseline AV node physiology in AVNRT patients is wide, and is similar in men and women. The female preponderance for AVNRT cannot be explained from comparisons of baseline AV node electrophysiological properties.
Luani, Blerim; Zrenner, Bernhard; Basho, Maksim; Genz, Conrad; Rauwolf, Thomas; Tanev, Ivan; Schmeisser, Alexander; Braun-Dullaeus, Rüdiger C
2018-01-01
Stochastic damage of the ionizing radiation to both patients and medical staff is a drawback of fluoroscopic guidance during catheter ablation of cardiac arrhythmias. Therefore, emerging zero-fluoroscopy catheter-guidance techniques are of great interest. We investigated, in a prospective pilot study, the feasibility and safety of the cryothermal (CA) slow-pathway ablation in patients with symptomatic atrioventricular-nodal-re-entry-tachycardia (AVNRT) using solely intracardiac echocardiography (ICE) for endovascular and endocardial catheter visualization. Twenty-five consecutive patients (mean age 55.6 ± 12.0 years, 17 female) with ECG-documentation or symptoms suggesting AVNRT underwent an electrophysiology study (EPS) in our laboratory utilizing ICE for catheter navigation. Supraventricular tachycardia was inducible in 23 (92%) patients; AVNRT was confirmed by appropriate stimulation maneuvers in 20 (80%) patients. All EPS in the AVNRT subgroup could be accomplished without need for fluoroscopy, relying solely on ICE-guidance. CA guided by anatomical location and slow-pathway potentials was successful in all patients, median cryo-mappings = 6 (IQR:3-10), median cryo-ablations = 2 (IQR:1-3). Fluoroscopy was used to facilitate the trans-septal puncture and localization of the ablation substrate in the remaining 3 patients (one focal atrial tachycardia and two atrioventricular-re-entry-tachycardias). Mean EPS duration in the AVNRT subgroup was 99.8 ± 39.6 minutes, ICE guided catheter placement 11.9 ± 5.8 minutes, time needed for diagnostic evaluation 27.1 ± 10.8 minutes, and cryo-application duration 26.3 ± 30.8 minutes. ICE-guided zero-fluoroscopy CA in AVNRT patients is feasible and safe. Real-time visualization of the true endovascular borders and cardiac structures allow for safe catheter navigation during the ICE-guided EPS and might be an alternative to visualization technologies using geometry reconstructions. © 2017 Wiley Periodicals, Inc.
Santilli, R A; Perego, M; Crosara, S; Gardini, F; Bellino, C; Moretti, P; Spadacini, G
2008-01-01
The 12-lead surface ECG is validated for differentiating supraventricular tachycardias (SVT) in humans. Despite the description of SVT in veterinary medicine, no studies have analyzed the electrocardiographic features of this type of arrhythmias in dogs. To describe the specific electrocardiographic criteria used to differentiate the most common SVT in dogs. Twenty-three dogs examined at Clinica Veterinaria Malpensa for SVT with the mechanism documented by electrophysiologic studies (EPS). Twelve-lead electrocardiographic variables obtained from 14 dogs with orthodromic atrioventricular reciprocating tachycardia (OAVRT) and 9 dogs with focal atrial tachycardia (FAT) were compared. Dogs with FAT had faster heart rates (278 +/- 62 versus 229 +/- 42 bpm; P= .049) and less QRS alternans (33 versus 86%; P= .022). P waves appeared during tachycardia in 22 dogs, with a superior axis in 100% of OAVRT and 22% of FAT (P < .001). OAVRT was characterized by a shorter RP interval (85.0 +/- 16.8 versus 157.1 +/- 37.3 ms; P < .001) and smaller RP/PR ratio (0.60 +/- 0.18 versus 1.45 +/- 0.52; P < .001). Repolarization anomalies were present in 64% of OAVRT and no FAT (P < .001). Multivariate analysis identified QRS alternans and a positive P wave in aVR during tachycardia as independent predictors of arrhythmia type. Electrocardiographic criteria used in people for differentiating SVT can also be applied in dogs.
Fragakis, Nikolaos; Krexi, Lydia; Kyriakou, Panagiota; Sotiriadou, Melani; Lazaridis, Charalambos; Karamanolis, Athanasios; Dalampyras, Panagiotis; Tsakiroglou, Stelios; Skeberis, Vassilios; Tsalikakis, Dimitrios; Vassilikos, Vassilios
2018-01-01
Radiofrequency (RF) ablation of the slow pathway (SP) in atrioventricular nodal reentry tachycardia (AVNRT) is occasionally complicated with atrioventricular block (AVB) often predicted by junctional beats (JB) with loss of ventriculo-atrial (VA) conduction. We analyzed retrospectively 153 patients undergoing ablation of SP for typical AVNRT. Patients were divided into two age groups: 127 ≤ 70 years and 26 > 70 years. We analyzed the interval between the atrial electrogram in the His-bundle position and the distal ablation catheter [A(H)-A(RFd)] and between the distal ablation catheter and the proximal coronary sinus catheter [A(RFd)-A(CS)] before RF applications with and without JB. We evaluated if these intervals can be used as predictors of JB incidence and also of JB with loss of VA conduction. We also assessed if age influences the risk of loss of VA conduction. The A(H)-A(RFd) and A(RFd)-A(CS) intervals were significantly shorter in RF applications causing JB than those without JB (33 ± 11 ms vs 39 ± 9 ms, P JB with VA block than those with VA conduction (29 ± 11 ms vs 35 ± 11 ms, P 70 years had shorter intervals (36 ± 11 ms vs 29 ± 8 ms, P = 0.012, 17 ± 8 ms vs 13 ± 7 ms, P = 0.027, respectively), while VA block was more common in this age group. The A(H)-A(RFd) and A(RFd)-A(CS) intervals can be used as markers for predicting JB occurrence as well as impending AVB. JB with loss of VA conduction occur more often in older patients possibly due to a higher position of SP. © 2017 Wiley Periodicals, Inc.
Wang, Huan; Che, Xiaoru
2018-03-01
Differentiation of wide QRS complex tachycardia required repeated electrophysiological stimuli and mapping. However, instability of tachycardia would increase the difficulty in differential diagnosis. In this paper, we reported a wide QRS tachycardia following ablation of an atrioventricular reentrant tachycardia participated by a poster-septal accessory pathway. Limited differentiation strategy was performed because the wide QRS tachycardia was self-limited and with unstable hemodynamics. We analyzed the mechanism of the wide QRS tachycardia by only 4 beats ventricular overpacing. On the basis of the last ventricular pacing, an atypical atrioventricular nodal reentrant tachycardia was confirmed. After slow-pathway modification, the wide QRS tachycardia was eliminated. It was an atypical atrial-ventricular node reentrant tachycardia with right bundle branch block. Reasonable analysis based on electrophysiological electrophysiologic knowledge was the basis of successful diagnosis and treatment.
Paroxysmal supraventricular tachycardia in an octogenarian.
Lutwak, Nancy; Dill, Curt
2012-09-01
Paroxysmal supraventricular tachycardia is a common dysrhythmia that occurs at all ages. Its management is determined by presenting symptoms and previous history of the patient. Patients present with a continuum of symptoms ranging from palpitations to syncope. The incidence of supraventricular tachycardia increases with age. To discuss the etiology, precipitating factors, and acute management of supraventricular tachycardia; and to discuss nodal reentry circuits and representative electrocardiographic findings. We present the case of an 84-year-old man with gallstone pancreatitis, choledolcholithiasis, and cholecystitis complicated by paroxysmal supraventricular tachycardia. We review this dysrhythmia, emphasizing its significance in elderly patients. Supraventricular tachycardia is a common dysrhythmia that can result in syncope or myocardial infarction. We present a case of an elderly man with new-onset atrioventricular (AV) nodal reentry tachycardia, possibly precipitated by overdrive of his autonomic nervous system due to pain and infection. As the percentage of the elderly in our population is growing rapidly and the incidence of AV nodal reentry tachycardia increases with age, emergency physicians should be familiar with this dysrhythmia-its etiology, precipitating factors, presentations, and treatment. It will present more frequently in the future. Published by Elsevier Inc.
Sato, Yoshiharu; Nagata, Hirofumi; Inoda, Ayako; Miura, Hiroko; Watanabe, Yoko; Suzuki, Kenji
2014-10-01
We report a case of paroxysmal supraventricular tachycardia (PSVT) that occurred during video-assisted thoracoscopic (VATS) lobectomy in a patient with concealed Wolff-Parkinson-White (WPW) syndrome. A 59-year-old man with lung cancer was scheduled for VATS lobectomy under general anesthesia. After inserting a thoracic epidural catheter, general anesthesia was induced with intravenous administration of propofol. Anesthesia was maintained with inhalation of desfurane in an air/oxygen mixture and intravenous infusion of remifentanil. Recurrent PSVT occurred three times, and the last episode of PSVT continued for 50 minutes regardless of administration of antiarrhythmic drugs. Synchronized electric shock via adhesive electrode pads on the patient's chest successfully converted PSVT back to normal sinus rhythm. The remaining course and postoperative period were uneventful. An electrophysiological study performed after hospital discharge detected concealed WPW syndrome, which had contributed to the development of atrioventricular reciprocating tachycardia. Concealed WPW syndrome is a rare, but critical complication that could possibly cause lethal atrial tachyarrhythmias during the perioperative period. In the present case, cardioversion using adhesive electrode pads briefly terminated PSVT in a patient with concealed WPW syndrome.
DEFF Research Database (Denmark)
Andreasen, Laura; Ahlberg, Gustav; Tang, Chuyi
2018-01-01
Atrioventricular nodal reentry tachycardia (AVNRT) is the most common form of regular paroxysmal supraventricular tachycardia. This arrhythmia affects women twice as frequently as men, and is often diagnosed in patients <40 years of age. Familial clustering, early onset of symptoms and lack of st...
Reentry Tachycardia in Children: Adenosine Can Make It Worse.
Hien, Maximilian D; Benito Castro, Fernando; Fournier, Philippe; Filleron, Anne; Tran, Tu-Anh
2016-10-08
We report on a rare but severe complication of adenosine use in a child with reentry tachycardia. Treatment with adenosine, which is the standard medical therapy of atrioventricular reentry tachycardia, led to the development of an irregular wide complex tachycardia, caused by rapid ventricular response to atrial fibrillation. The girl was finally stabilized with electrical cardioversion. We analyze the pathomechanism and discuss possible treatment options. Atrial fibrillation, as well as its conduction to the ventricles, can be caused by adenosine. Rapid ventricular response in children with Wolff-Parkinson-White syndrome is more frequent than previously believed. A patient history of atrial fibrillation is a contraindication for cardioversion with adenosine and needs to be assessed in children with reentry tachycardia. High-risk patients may potentially profit from prophylactic comedication with antiarrhythmic agents, such as flecainide, ibutilide, or vernakalant, before adenosine administration.
Surgical treatment for ectopic atrial tachycardia.
Graffigna, A; Vigano, M; Pagani, F; Salerno, G
1992-08-01
Atrial tachycardia is an infrequent but potentially dangerous arrhythmia which often determines cardiac enlargement. Surgical ablation of the arrhythmia is effective and safe, provided a careful atrial mapping is performed and the surgical technique is tailored to the individual focus location. Eight patients underwent surgical ablation of ectopic atrial tachycardia between 1977 and 1990. Different techniques were adopted for each patient according to the anatomical location of the focus and possibly associated arrhythmias. Whenever possible, a closed heart procedure was chosen. In 1 patient a double focal origin was found and treated by separate procedures. In 1 patient with ostium secundum atrial septal defect and atrial flutter, surgical isolation of the right appendage and the ectopic focus was performed. In all patients ectopic atrial tachycardia was ablated with maintenance of the sinoatrial and atrioventricular nodal function as well as internodal conduction. In follow-up up to December 1991, no recurrency was recorded.
WOLFF–PARKINSON–WHITE SYNDROME IN CHILDREN: CLINICAL COURSE, DIAGNOSTICS, TREATMENT
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T.K. Kruchina
2011-01-01
Full Text Available Wolff–Parkinson–White (WPW syndrome — is the most common cause of tachycardia in children. The clinical significance of WPW udden cardiac death. Data are presented on the principles of diagnosis of various types of WPW syndrome and characteristics of various types of tachycardia occurring in this disease. At present there is a radical method of treatment of the WPW syndrome — radiofrequency ablation of atrioventricular additional connections. Antiarhythmic therapy remains relevant in arresting attacks of tachycardia, as well as in the treatment of young children who have the age limits for radiofrequency ablation. The principles of choice of treatment and relief of the attack algorithm tachycardia syndrome WPW are described. Key words: Wolff–Parkinson–White syndrome, paroxysmal atrioventricular reciprocal tachycardia, children. (Pediatric Pharmacology. — 2011; 8 (5: 49–53.
Flyer, Jonathan N; Zuckerman, Warren A; Richmond, Marc E; Anderson, Brett R; Mendelsberg, Tamar G; McAllister, Jennie M; Liberman, Leonardo; Addonizio, Linda J; Silver, Eric S
2017-06-20
Supraventricular tachycardia is common after heart transplantation. Adenosine, the standard therapy for treating supraventricular tachycardia in children and adults without transplantation, is relatively contraindicated after transplantation because of a presumed risk of prolonged atrioventricular block in denervated hearts. This study tested whether adenosine caused prolonged asystole after transplantation and if it was effective in blocking atrioventricular nodal conduction in these patients. This was a single-center prospective clinical study including healthy heart transplant recipients 6 months to 25 years of age presenting for routine cardiac catheterization during 2015 to 2016. After catheterization, a transvenous pacing catheter was placed and adenosine was given following a dose-escalation protocol until atrioventricular block was achieved. The incidence of clinically significant asystole (≥12 seconds after adenosine) was quantified. The effects of patient characteristics on adenosine dose required to produce atrioventricular block and duration of effect were also measured. Eighty patients completed adenosine testing. No patient (0%; 95% confidence interval, 0-3) required rescue ventricular pacing. Atrioventricular block was observed in 77 patients (96%; 95% confidence interval, 89-99). The median longest atrioventricular block was 1.9 seconds (interquartile range, 1.4-3.2 seconds), with a mean duration of adenosine effect of 4.3±2.0 seconds. No patient characteristic significantly predicted the adenosine dose to produce atrioventricular block or duration of effect. Results were similar across patient weight categories. Adenosine induces atrioventricular block in healthy pediatric and young adult heart transplant recipients with minimal risk when low initial doses are used (25 μg/kg; 1.5 mg if ≥60 kg) and therapy is gradually escalated. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02462941. © 2017 American Heart Association, Inc.
[AV-reentrant tachycardia and Wolff-Parkinson-White syndrome : Diagnosis and treatment].
Voss, Frederik; Eckardt, Lars; Busch, Sonia; Estner, Heidi L; Steven, Daniel; Sommer, Philipp; von Bary, Christian; Neuberger, Hans-Ruprecht
2016-12-01
The AV-reentrant tachycardia (AVRT) is a supraventricular tachycardia with an incidence of 1-3/1000. The pathophysiological basis is an accessory atrioventricular pathway (AP). Patients with AVRT typically present with palpitations, an on-off characteristic, anxiety, dyspnea, and polyuria. This type of tachycardia may often be terminated by vagal maneuvers. Although the clinical presentation of AVRT is quite similar to AV-nodal reentrant tachycardias, the correct diagnosis is often facilitated by analyzing a standard 12-lead ECG at normal heart rate showing ventricular preexcitation. Curative catheter ablation of the AP represents the therapy of choice in symptomatic patients. This article is the fourth part of a series written to improve the professional education of young electrophysiologists. It explains pathophysiology, symptoms, and electrophysiological findings of an invasive EP study. It focusses on mapping and ablation of accessory pathways.
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Sou Takenaka
2016-01-01
Full Text Available A 74-year-old male suffering from congestive heart failure with atrial tachycardia (AT with 2 : 1 atrioventricular conduction was admitted to our hospital. After the therapy with diuretics and β-blocker, his rapid AT was still sustained. He took the catheter ablation for his AT. Postpacing interval mapping from entrainment and noncontact mapping system revealed the mechanism of his AT, originated from sinus venosa. His AT was successfully terminated and eliminated by radiofrequency catheter ablation. After the successful ablation, he has been free from any AT, and his cardiac function was also improved.
The value of electrocardiography for differential diagnosis in wide QRS complex tachycardia.
Sousa, Pedro A; Pereira, Salomé; Candeias, Rui; de Jesus, Ilídio
2014-03-01
Correct diagnosis in wide QRS complex tachycardia remains a challenge. Differential diagnosis between ventricular and supraventricular tachycardia has important therapeutic and prognostic implications, and although data from clinical history and physical examination may suggest a particular origin, it is the 12-lead surface electrocardiogram that usually enables this differentiation. Since 1978, various electrocardiographic criteria have been proposed for the differential diagnosis of wide complex tachycardias, particularly the presence of atrioventricular dissociation, and the axis, duration and morphology of QRS complexes. Despite the wide variety of criteria, diagnosis is still often difficult, and errors can have serious consequences. To reduce such errors, several differential diagnosis algorithms have been proposed since 1991. However, in a small percentage of wide QRS tachycardias the diagnosis remains uncertain and in these the wisest decision is to treat them as ventricular tachycardias. The authors' objective was to review the main electrocardiographic criteria and differential diagnosis algorithms of wide QRS tachycardia. Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.
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Kazushi Tanaka, MD PhD
2011-01-01
Full Text Available We report on a case of a 23-year-old male with Wolff-Parkinson-White syndrome. At baseline, constant right atrial pacing induced antidromic atrioventricular reentrant tachycardia (AVRT, whereas constant right ventricular (RV pacing only revealed a normal His-Purkinje system. Mapping below the mitral annulus during sinus rhythm revealed fusion of atrial and ventricular potentials at multiple lateral sites. After unsuccessful ablation at these sites, constant RV pacing induced a long RP interval, orthodromic AVRT with the earliest atrial site being located at an anterior aspect, where successful ablation was later achieved. These phenomena may indicate an unexpected arrhythmogenic effect of initial ablations.
Supraventricular tachycardia induced by chocolate: is chocolate too sweet for the heart?
Parasramka, Saurabh; Dufresne, Alix
2012-09-01
Conflicting studies have been published concerning the association between chocolate and cardiovascular diseases. Fewer articles have described the potential arrhythmogenic risk related to chocolate intake. We present a case of paroxysmal supraventricular tachycardia in a woman after consumption of large quantity of chocolate. A 53-year-old woman with no significant medical history presented to us with complaints of palpitations and shortness of breath after consuming large amounts of chocolate. Electrocardiogram showed supraventricular tachycardia at 165 beats per minute, which was restored to sinus rhythm after adenosine bolus injection. Electrophysiology studies showed atrioventricular nodal reentry tachycardia, which was treated with radiofrequency ablation. Chocolate contains caffeine and theobromine, which are methylxanthines and are competitive antagonists of adenosine and can have arrhythmogenic potential. Our case very well describes an episode of tachycardia precipitated by large amount of chocolate consumption in a patient with underlying substrate. There are occasional case reports describing association between chocolate, caffeine, and arrhythmias. A large Danish study, however, did not find any association between amount of daily caffeine consumption and risk of arrhythmia.
Dechering, Dirk G; Schleberger, Ruben; Greiser, Eva; Dickow, Jannis; Koebe, Julia; Frommeyer, Gerrit; Willems, Stephan; Eckardt, Lars; Hoffmann, Boris A; Wasmer, Kristina
2018-03-19
Slow pathway modulation is the treatment of choice in patients with atrioventricular nodal reentrant tachycardia (AVNRT). No comparative data on ablation strategies exist. Therefore, we sought to compare two common ablation approaches. We analyzed prospective ablation databases of two high-volume tertiary centers (> 1000 ablations/year) using either 30 or 50 W for slow pathway modulation from 2012 to 2013. We analyzed procedural characteristics as well as short- and long-term outcomes. Mean follow-up was 36 ± 9 months. Six hundred thirty-four patients (50 W center: n = 342, 30 W center: n = 292) were ablated. Slow pathway modulation was successful in 99% in both groups (p = ns). Periprocedural AV block occurred in nine patients (2.6%) in the 50 W and five patients (1.7%) in the 30 W group (p = 0.59), respectively. We documented no permanent higher-degree AV block. The number of RF lesions and seconds of RF delivery was significantly less in the 50 W group (p = 0.04 for number of lesions; p modulation are highly effective and safe. Significantly, fewer RF duration was necessary to modulate the slow pathway with higher power output (50 W). Our subgroup analysis suggests that males and females might benefit most from different modulation approaches.
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Akira Shimane, MD
2014-12-01
Full Text Available We report a case of Ebstein׳s anomaly in which radiofrequency catheter ablation of an accessory pathway was successfully performed under intra-cardiac echocardiography. A 50-year-old woman was referred to our hospital for radiofrequency catheter ablation of a paroxysmal supraventricular tachycardia. A 12-lead surface electrocardiogram revealed ventricular pre-excitation associated with type B Wolff–Parkinson–White syndrome. In the baseline electrophysiological study, an orthodromic atrioventricular reciprocating tachycardia with a right posterior accessory pathway was induced. A phased-array intra-cardiac echo probe was positioned in the right atrium to visualize the atrioventricular junction. The key structures for catheter ablation, such as the atrialized right ventricle, atrioventricular junction, and tricuspid valve, were clearly visualized on intra-cardiac echocardiography. Radiofrequency current was successfully delivered at the atrioventricular junction, where a Kent potential was recorded. During a 6-month follow-up period, the patient was free from arrhythmias. The findings in this case suggest that phased-array intra-cardiac echocardiography is useful for ablation of right-sided accessory pathways in patients with Ebstein׳s anomaly.
Repair of Tetralogy of Fallot in Infancy via the Atrioventricular Approach
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Hamid Bigdelian
2016-02-01
Full Text Available Background: Tetralogy of Fallot (TOF is a well-recognized congenital heart disease. Despite improvements in the outcomes of surgical repair, the optimal timing of surgery and type of surgical management of patients with TOF remains controversial. The purpose of this study was to assess outcomes following the repair of TOF in infants depending on the surgical procedure used. Methods: This study involved the retrospective review of 120 patients who underwent TOF repair between 2010 and 2013. Patients were divided into three groups depending on the surgical procedure that they underwent. Corrective surgery was done via the transventricular approach (n=40, the transatrial approach (n=40, or a combined atrioventricular approach (n=40. Demographic data and the outcomes of the surgical procedures were compared among the groups. Results: In the atrioventricular group, the incidence of the following complications was found to be significantly lower than in the other groups: complete heart block (p=0.034, right ventricular failure (p=0.027 and mediastinal bleeding (p=0.007. Patients in the atrioventricular group had a better postoperative right ventricular ejection fraction (p=0.001. No statistically significant differences were observed among the three surgical groups in the occurrence of tachycardia, renal failure, and tricuspid incompetence. The one-year survival rates in the three groups were 95%, 90%, and 97.5%, respectively (p=0.395. Conclusion: Combined atrioventricular repair of TOF in infancy can be safely performed, with acceptable surgical risk, a low incidence of reoperation, good ventricular function outcomes, and an excellent survival rate.
INTERMITTENT ANTIARYTHMIC THERAPY OF ARIOVENTICULAR NODAL REENTRY TACHYCARDIA IN CHILDREN
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Boris Djindjic
2008-04-01
Full Text Available Until recent advances in pharmacology and clinical cardiology regarding farmacodynamics of antiarrhythmic drugs and their efficiency in patients with refractory paroxysmal supraventricular tachycardia, chronic prophylactic therapy was the only treatment option for patients refusing catheter ablation. Another treatment option, also known by eponym “pill in pocket” have been shown to be equally useful and efficacious.The aim of our study was prospective examination of children with refractory atrioventricular nodal reentry tachycardia (AVNRT who were withdrawn from chronic antiarrhythmic prophylactic therapy and started with intermittent oral beta blocker treatment (propranolol at dosage 1 mg/kg - max 80 mg.Twelve children (8 boys and 4 girls with AVNRT were included in the study. Four children did not have arrhythmia during first six months after withdrawal and 7 were successfully treated without complication.Intermittent antiarrhythmic therapy in children with AVNRT could be very efficacious and useful treatment option which significantly improves their quality of life.
Tachycardia-Induced Cardiomyopathy in a 12-Year-Old Child With Long QT Syndrome
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Ghandi
2016-05-01
Full Text Available Introduction Tachycardia-induced cardiomyopathy (TIC is a ventricular dysfunction secondary to chronic and persistent tachycardia that can regress partially or completely following heart rate normalization. Paroxysmal atrial tachycardia and permanent junctional reciprocating tachycardia are two types of frequent arrhythmias that can cause cardiomyopathy in children. Case Presentation A 12-year-old child with obesity (body mass index > 26.8 was admitted with fatigue, pallor and tachypnea to the clinic. He had palpitation for the past 24 hours. On the cardiac auscultation, holosystolic 2/6 murmur was heard in the apex as well as gallop rhythm. Electrocardiogram revealed heart rate of 150 - 160 bpm and negative P waves in II, III and AVF leads. The echocardiography revealed dilated cardiomyopathy with an ejection fraction of 30%. Conclusions Diagnosis of tachycardia-induced cardiomyopathy in children is important, since appropriate treatment improves the prognosis. Every child with recurrent and persistent palpitation with the first episode of congestive heart failure should be evaluated for tachycardia- induced cardiomyopathy.
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Kotaro Oe, MD
2009-01-01
Full Text Available An 83-year-old woman was admitted to our hospital because of palpitation. She had hypertension and paroxysmal atrial fibrillation, treated with digoxin and cibenzoline, and took dipyridamole for microalbuminuria. Before admission, she had taken pilsicainide pills in addition. On admission, electrocardiogram showed regular tachycardia with mildly prolonged QRS width. For the purpose of terminating tachycardia, 10 mg of adenosine triphosphate (ATP was rapidly injected. About 20 sec later, atrioventricular block and ventricular standstill occurred. She presented loss of consciousness and convulsion, and chest compression was performed. About 30 sec later, the QRS complex reappeared, and she became alert. Serum concentration of digoxin, cibenzoline and pilsicainide was within therapeutic level, respectively. We should be cautious in using ATP for a patient taking dipyridamole and antiarrhythmic agents.
Complete atrioventricular canal.
Calabrò, Raffaele; Limongelli, Giuseppe
2006-04-05
Complete atrioventricular canal (CAVC), also referred to as complete atrioventricular septal defect, is characterised by an ostium primum atrial septal defect, a common atrioventricular valve and a variable deficiency of the ventricular septum inflow. CAVC is an uncommon congenital heart disease, accounting for about 3% of cardiac malformations. Atrioventricular canal occurs in two out of every 10,000 live births. Both sexes are equally affected and a striking association with Down syndrome was found. Depending on the morphology of the superior leaflet of the common atrioventricular valve, 3 types of CAVC have been delineated (type A, B and C, according to Rastelli's classification). CAVC results in a significant interatrial and interventricular systemic-to-pulmonary shunt, thus inducing right ventricular pressure and volume overload and pulmonary hypertension. It becomes symptomatic in infancy due to congestive heart failure and failure to thrive. Diagnosis of CAVC might be suspected from electrocardiographic and chest X-ray findings. Echocardiography confirms it and gives anatomical details. Over time, pulmonary hypertension becomes irreversible, thus precluding the surgical therapy. This is the reason why cardiac catheterisation is not mandatory in infants (less than 6 months) but is indicated in older patients if irreversible pulmonary hypertension is suspected. Medical treatment (digitalis, diuretics, vasodilators) plays a role only as a bridge toward surgery, usually performed between the 3rd and 6th month of life.
Complete atrioventricular canal
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Limongelli Giuseppe
2006-04-01
Full Text Available Abstract Complete atrioventricular canal (CAVC, also referred to as complete atrioventricular septal defect, is characterised by an ostium primum atrial septal defect, a common atrioventricular valve and a variable deficiency of the ventricular septum inflow. CAVC is an uncommon congenital heart disease, accounting for about 3% of cardiac malformations. Atrioventricular canal occurs in two out of every 10,000 live births. Both sexes are equally affected and a striking association with Down syndrome was found. Depending on the morphology of the superior leaflet of the common atrioventricular valve, 3 types of CAVC have been delineated (type A, B and C, according to Rastelli's classification. CAVC results in a significant interatrial and interventricular systemic-to-pulmonary shunt, thus inducing right ventricular pressure and volume overload and pulmonary hypertension. It becomes symptomatic in infancy due to congestive heart failure and failure to thrive. Diagnosis of CAVC might be suspected from electrocardiographic and chest X-ray findings. Echocardiography confirms it and gives anatomical details. Over time, pulmonary hypertension becomes irreversible, thus precluding the surgical therapy. This is the reason why cardiac catheterisation is not mandatory in infants (less than 6 months but is indicated in older patients if irreversible pulmonary hypertension is suspected. Medical treatment (digitalis, diuretics, vasodilators plays a role only as a bridge toward surgery, usually performed between the 3rd and 6th month of life.
International Nuclear Information System (INIS)
Kovoor, P.; Ricciardello, M.; Collins, L.; Uther, J.B.; Ross, D.L.
1995-01-01
Radiofrequency (RF) ablation has become the primary method of treatment for supraventricular tachycardia and often requires prolonged fluoroscopy times. The aim of this study was to quantitate radiation exposure to patient and operator during RF ablation for supra- ventricular tachycardia. Thermoluminescent dosemeters were used to monitor radiation at seven sites. Positions were: patient's thyroid, left scapula, T9 vertebra, right scapula and L4-L5 vertebra and the operator's thyroid and left hand. Monitoring was performed during 22 procedures. Of the patients studied 10 (45%) had atrioventricular junctional re-entry tachycardia (AVJRT) and 12 (55%) had accessory pathway tachycardia. The median fluoroscopy times (minutes) and inter-quartile ranges were 46 (39-65) for AVJRT, 55 (52-60) for left free wall accessory pathway (LFW), 107 (89-140) for septal and 166 (128-176) for RFW pathways. The mean radiation doses (mGy) to the chest wall were 50 for AVJRT, 47 for LFW, 87 for septal and 151 for RFW pathways. The mean radiation to the chest wall of the patient per case was found to be 3.9 times that reported for diagnostic cardiac catheterisation and 1.5 times that reported for angioplasty. It is concluded that radiofrequency ablation is associated with significant irradiation of the patient and operator. All precautions should be taken to decrease this exposure. If eye irradiation is assumed to be equal to that to the thyroid, more than 45 procedures per month by a single operator (using ceiling-suspended lead glass shielding) may result in exceeding the recommended dose limit to the eye. 32 refs., 3 tabs
Financial audit of antitachycardia pacing for the control of recurrent supraventricular tachycardia.
Griffith, M J; Bexton, R S; McComb, J M
1993-03-01
To assess the financial implications of antitachycardia pacing in patients with frequent supraventricular tachycardia. Intertach pacemakers were implanted in 25 patients (mean age 47 years, five men): 22 had atrioventricular nodal reentry tachycardia. The patients had failed a mean of 4.9 (range zero to eight) drugs and had been admitted to hospital 3.7 (zero to 31) times over a symptomatic period of 13.9 years (two months to 54 years). The mean admission time for implantation was 2.8 (two to seven) days. One patient with Wolff-Parkinson-White syndrome subsequently underwent surgery. Infection occurred in two patients, and pain over the pacemaker required its resiting in two. Two patients have had one admission each for tachycardia. Six patients remain on anti-arrhythmic drugs. Costs were calculated including value added tax, capital charges, and allocated overheads. The cost a year before pacing was 1174 pounds including drug costs, clinic visits, and hospital admissions. The mean cost of pacemaker implantation was 3364.22 pounds, including the pacemaker and lead, admission and procedure, readmissions and first pacing check. Subsequent annual follow up cost was 73.72 pounds including annual clinic visits and drug costs. The cost of pacing is 4241 pounds whereas medical management costs 7044 pounds assuming pacemaker life of six years: with a 10 year life the cost is 4537 pounds compared with 11,740 pounds: with a 12 year life the cost is 4685 pounds compared with 14,088 pounds. The excess cost of implantation of an antitachycardia pacemaker is minimal in patients with frequent supraventricular tachycardia despite drug treatment and is justified by excellent control of symptoms and reduction of drug use and hospital admissions.
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Marcelo Felipe Kozak
2015-04-01
Full Text Available AbstractIntroduction:Left atrioventricular valve regurgitation is the most concerning residual lesion after surgical correction of atrioventricular septal defect.Objective:To determine factors associated with moderate or greater left atrioventricular valve regurgitation within 30 days of surgical repair of incomplete atrioventricular septal defect.Methods:We assessed the results of 51 consecutive patients 14 years-old and younger presenting with incomplete atrioventricular septal defect that were operated on at our practice between 2002 and 2010. The following variables were considered: age, weight, absence of Down syndrome, grade of preoperative left atrioventricular valve regurgitation, abnormalities on the left atrioventricular valve and the use of annuloplasty. The median age was 4.1 years; the median weight was 13.4 Kg; 37.2% had Down syndrome. At the time of preoperative evaluation, there were 23 cases with moderate or greater left atrioventricular valve regurgitation (45.1%. Abnormalities on the left atrioventricular valve were found in 17.6%; annuloplasty was performed in 21.6%.Results:At the time of postoperative evaluation, there were 12 cases with moderate or greater left atrioventricular valve regurgitation (23.5%. The variation between pre- and postoperative grades of left atrioventricular valve regurgitation of patients with atrioventricular valve malformation did not reach significance (P=0.26, unlike patients without such abnormalities (P=0.016. During univariate analysis, only absence of Down syndrome was statistically significant (P=0.02. However, after a multivariate analysis, none of the factors reached significance.Conclusion:None of the factors studied was determinant of a moderate or greater left atrioventricular valve regurgitation within the first 30 days of repair of incomplete atrioventricular septal defect in the sample. Patients without abnormalities on the left atrioventricular valve benefit more of the operation.
... rate to rise during exercise or as a physiological response to stress, trauma or illness (sinus tachycardia). ... increase the risk of tachycardia include: Older age. Aging-related wear on the heart makes you more ...
Li, Chunli; Jia, Libo; Wang, Zhenzhou; Niu, Ling; An, Xinjiang
2018-05-01
The present study investigated the therapeutic effect of radiofrequency ablation on children with supraventricular tachycardia (SVT), and explored the risk factors for postoperative recurrence. A total of 312 patients with pediatric SVT were selected in the Affiliated Children's Hospital of Xuzhou Medical University from April, 2011 to March, 2017. All the patients were subjected to radiofrequency ablation, and clinical data were retrospectively analyzed. Tilt table test was performed before and after treatment, and heart rate, systolic and diastolic blood pressure before and after treatment were compared. Plasma levels of D-dimer (D-D), platelet α-granule membrane protein (GMP-140) and thrombin-antithrombin III complex (TAT) were detected by enzyme-linked immunosorbent assay before treatment, immediately after radiofrequency oblation, and at 1, 3 and 7 days after treatment. Treatment outcomes were compared between the atrioventricular reentrant tachycardia (AVRT) and atrioventricular nodal reentrant tachycardia (AVNRT) groups. Risk factors for postoperative recurrence were analyzed. Supine position heart rate after treatment was not significantly different from that before treatment (P>0.05), while the upright position heart rate was significantly increased after treatment (P0.05). No significant difference in radiofrequency ablation rate, recurrence rate and incidence of complications were found between the AVRT and AVNRT groups (P>0.05). After radiofrequency, the levels of D-D, GMP-140 and TAT ablation showed an upward trend, but decreased at day 7 to reach preoperative levels. Logistic regression analysis revealed that residual slow pathway (OR=6.718, P=0.005) and inaccurate targeting (OR=2.815, P=0.007) were independent risk factors for postoperative recurrence (Pradiofrequency ablation can damage the cardiac vagal nerve, resulting in an increase in the heart rate after ablation during the course of the tilt table test and changed hemagglutination state
Atrioventricular block, ECG tracing (image)
... an abnormal rhythm (arrhythmia) called an atrioventricular (AV) block. P waves show that the top of the ... wave (and heart contraction), there is an atrioventricular block, and a very slow pulse (bradycardia).
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Bhalaghuru Chokkalingam Mani, MD
2014-01-01
Full Text Available More than half a century has passed since the concept of dual atrioventricular (AV nodal pathways physiology was conceived. Dual AV nodal pathways have been shown to be responsible for many clinical arrhythmia syndromes, most notably AV nodal reentrant tachycardia. Although there has been a considerable amount of research on this topic, the subject of dual AV nodal pathways physiology remains heavily debated and discussed. Despite advances in understanding arrhythmia mechanisms and the widespread use of invasive electrophysiologic studies, there is still disagreement on the anatomy and physiology of the AV node that is the basis of discontinuous antegrade AV conduction. The purpose of this paper is to review the concept of dual AV nodal pathways physiology and its varied electrocardiographic manifestations.
Reversible chronic acquired complete atrioventricular block.
Rakovec, P; Milcinski, G; Voga, G; Korsic, L
1982-01-01
The return of atrioventricular conduction is reported in a case after nearly four years of complete acquired heart block. After recovery from atrioventricular block, right bundle branch block persisted, but P-R interval and H-V interval were normal. Three months later a relapse of second degree infranodal atrioventricular block was noted. A short review of similar cases from the literature is given.
Atrioventricular Pacemaker Lead Reversal
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Mehmet K Aktas, MD
2007-01-01
Full Text Available During cardiac surgery temporary epicardial atrial and ventricular leads are placed in case cardiac pacing is required postoperatively. We present the first reported series of patients with reversal of atrioventricular electrodes in the temporary pacemaker without any consequent deleterious hemodynamic effect. We review the electrocardiographic findings and discuss the findings that lead to the discovery of atrioventricular lead reversal.
Frid, Christina; Björkhem, Gudrun; Jonzon, Anders; Sunnegårdh, Jan; Annerén, Göran; Lundell, Bo
2004-02-01
The survival for patients with atrioventricular septal defect has improved markedly over the last decades and, during the same period, the survival of children with Down's syndrome has also increased. The aim of our study was to investigate long-term survival in patients having atrioventricular septal defect with common valvar orifice, but without associated significant congenital heart defects, in the setting of Down's syndrome, comparing the findings to those in chromosomally normal children with the same malformation. In a population-based retrospective study, we scrutinised the medical records from 801 liveborn children with atrioventricular septal defect born in Sweden during the period 1973 through 1997. Data on gender, presence or absence of Down's syndrome, associated congenital heart defects, date of birth, operation and death were recorded and followed up until 2001. An isolated atrioventricular septal defect with common atrioventricular valvar orifice was present in 502 children, of whom 86% had Down's syndrome. We found a significant reduc tion over time in age at operation, and in postoperative mortality at 30 days, from 28 to 1%. Using a multiple logistic regression model, we found no significant differences in mortality between genders, nor between those with or without Down's syndrome. Early corrective surgery could not be identified as a significant independent factor for survival. The 5-year postoperative survival in patients with Down's syndrome increased from 65% over the period from 1973 through 1977, to about 90% in the period 1993 through 1997, and the same trend was observed in chromosomally normal patients. Survival in uncomplicated atrioventricular septal defect with common atrioventricular valvar orifice has greatly increased, and surgical correction is now equally successful in patients with Down's syndrome and chromosomally normal patients, and for both genders. Death in connection with surgery is no longer the major threat, and focus
Frequency of Syncope in Patients with Accessory Atrioventricular Connection
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A Aslani
2010-03-01
Full Text Available Background: Syncope in patients with Wolff-Parkinson-White (WPW syndrome is related to rapid reciprocating tachycardia or rapid ventricular response over the accessory pathway during atrial fibrillation (AF. The aim of this retrospective study is to evaluate the frequency of syncope in patients with WPW syndrome. Methods: We reviewed the records of 150 consecutive patients with WPW syndrome.Results: There were 20 patients (13.3% who reported at least one episode of syncope and 130 patients (86.7% without such a history.Conclusion: Syncope is relatively frequent in patients with WPW. Patient with WPW syndrome who has experienced this symptom should be thoroughly evaluated.
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Scott D. N. Else
2012-01-01
Full Text Available Catecholaminergic polymorphic ventricular tachycardia (CPVT is a severe arrhythmia associated with sudden death in the young. It is caused by defective calcium handling in ventricular myocytes. The association of supraventricular tachycardia (SVT with CPVT is described in the literature, occurring in the lead-up to ventricular tachycardia during exercise testing. We describe three cases of SVT that were initiated in the recovery period of exercise testing in children with CPVT.
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Agustin Bortone
2010-02-01
Full Text Available We report on an atrial tachycardia (AT, emanating from the non-coronary (NC aortic cusp, ablated with the aid of an electro-anatomical navigation system. In this setting, the electrocardiographic, electrophysiologic (EP, anatomical, and ablative considerations are discussed.Although NC aortic cusp focal ATs are an uncommon EP finding, their ablation is effective and safe, especially from an atrio-ventricular (AV conductive point of view. This origin of AT must be invoked and systematically disclosed when a peri-AV nodal AT origin is suspected, in order to avoid a potentially harmful energy application at the vicinity of the AV conductive tissue.
Unbalanced atrioventricular septal defect: definition and decision making.
Overman, David M; Baffa, Jeanne M; Cohen, Meryl S; Mertens, Luc; Gremmels, David B; Jegatheeswaram, Anusha; McCrindle, Brian W; Blackstone, Eugene H; Morell, Victor O; Caldarone, Christopher; Williams, William G; Pizarro, Christian
2010-04-01
Unbalanced atrioventricular septal defect is an uncommon lesion with widely varying anatomic manifestations. When unbalance is severe, diagnosis and treatment is straightforward, directed toward single-ventricle palliation. Milder forms, however, pose a challenge to current diagnostic and therapeutic approaches. The transition from anatomies that are capable of sustaining biventricular physiology to those that cannot is obscure, resulting in uneven application of surgical strategy and excess mortality. Imprecise assessments of ventricular competence have dominated clinical decision making in this regard. Malalignment of the atrioventricular junction and its attendant derangement of inflow physiology is a critical factor in determining the feasibility of biventricular repair in the setting of unbalanced atrioventricular septal defect. The atrioventricular valve index accurately identifies unbalanced atrioventricular septal defect and also brings into focus a zone of transition from anatomies that can support a biventricular end state and those that cannot.
Anatomy of the human atrioventricular junctions revisited
Anderson, R. H.; Ho, S. Y.; Becker, A. E.
2000-01-01
There have been suggestions made recently that our understanding of the atrioventricular junctions of the heart is less than adequate, with claims for several new findings concerning the arrangement of the ordinary working myocardium and the specialised pathways for atrioventricular conduction. In
[Reversible first-degree atrioventricular block due to hyperthyroidism].
Çelebi, Aksüyek Savaş; Amasyalı, Basri
2017-04-01
Hyperthyroidism often causes tachyarrhythmia. Reversible atrioventricular block caused by hyperthyroidism is rare occurrence. Presently described is a case of atrioventricular block due to hyperthyroidism and recovery after antithyroid treatment.
[Surgical treatment of supraventricular tachycardia].
Vigano, A N; Minzioni, G; Graffigna, A; Paganini, F; Salerno, J A
1991-10-01
The article deals with the modern approaches to the treatment of supraventricular tachycardia . The authors analyse the results of operations in ectopic atrial tachycardias, the Wolff-Parkinson-White syndrome, modal re-entry tachycardias, and atrial fibrillation . The last-named is of most interest because the authors possess experience in a new operation for isolation of the internodal tracts. In all conditions the authors obtained convincing evidence on the efficacy of modern surgical treatment in supraventricular tachycardias.
Field, Michael E; Donateo, Paolo; Bottoni, Nicola; Iori, Matteo; Brignole, Michele; Kipp, Ryan T; Kopp, Douglas E; Leal, Miguel A; Eckhardt, Lee L; Wright, Jennifer M; Walsh, Kathleen E; Page, Richard L; Hamdan, Mohamed H
2018-04-19
The mechanism of inappropriate sinus tachycardia (IST) remains incompletely understood. We prospectively compared 3 patient groups: 11 patients with IST (IST Group), 9 control patients administered isoproterenol (Isuprel Group), and 15 patients with cristae terminalis atrial tachycardia (AT Group). P-wave amplitude in lead II and PR interval were measured at a lower and higher heart rate (HR1 and HR2, respectively). P-wave amplitude increased significantly with the increase in HR in the IST Group (0.16±0.07 mV at HR1=97±12 beats per minute versus 0.21±0.08 mV at HR2=135±21 beats per minute, P =0.001). The average increase in P-wave amplitude in the IST Group was similar to the Isuprel Group ( P =0.26). PR interval significantly shortened with the increases in HR in the IST Group (146±15 ms at HR1 versus 128±16 ms at HR2, P PR interval was noted in the Isuprel Group ( P =0.6). In contrast, patients in the atrial tachycardia Group experienced PR lengthening during atrial tachycardia when compared with baseline normal sinus rhythm (153±25 ms at HR1=78±17 beats per minute versus 179±29 ms at HR2=140±28 beats per minute, P PR shortening similar to what is seen in healthy controls following isoproterenol infusion. The increase in P-wave amplitude and absence of PR lengthening in IST support an extrinsic mechanism consistent with a state of sympatho-excitation with cephalic shift in sinus node activation and enhanced atrioventricular nodal conduction. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
Wolff-Parkinson-White syndrome: lessons learnt and lessons remaining.
Benson, D Woodrow; Cohen, Mitchell I
2017-01-01
The Wolff-Parkinson-White pattern refers to the electrocardiographic appearance in sinus rhythm, wherein an accessory atrioventricular pathway abbreviates the P-R interval and causes a slurring of the QRS upslope - the "delta wave". It may be asymptomatic or it may be associated with orthodromic reciprocating tachycardia; however, rarely, even in children, it is associated with sudden death due to ventricular fibrillation resulting from a rapid response by the accessory pathway to atrial fibrillation, which itself seems to result from orthodromic reciprocating tachycardia. Historically, patients at risk for sudden death were characterised by the presence of symptoms and a shortest pre- excited R-R interval during induced atrial fibrillation Wolff-Parkinson-White pattern and availability of catheter ablation, there has been a need to identify risk among asymptomatic patients. Recent guidelines recommend invasive evaluation for such patients where pre-excitation clearly does not disappear during exercise testing. This strategy has a high negative predictive value only. The accuracy of this approach is under continued investigation, especially in light of other considerations: Patients having intermittent pre-excitation, once thought to be at minimal risk may not be, and the role of isoproterenol in risk assessment.
Congenital Complete Atrioventricular Block : Clinical and Experimental Studies
Blank, A.C.
2014-01-01
Complete atrioventricular block (CAVB) is a cardiac conduction defect wherein the trans¬mission of the normal electrical impulse from the atria to the ventricle is interrupted due to structural or functional impairment of the atrioventricular (AV) conduction system. If CAVB is diagnosed in utero or
Blocked Atrial Bi/Trigeminy In Utero Evolving in Supraventricular Tachycardia after Birth
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V. Martucci
2012-01-01
Full Text Available Transient episodes of fetal bradycardia (heart rate less than 110 bpm are usually benign and typically result from increased vagal stimulation in the fetus. Causes of sustained fetal bradycardia include sinus bradycardia, blocked atrial bigeminy/trigeminy, high-degree atrioventricular block, and long QT syndrome. We present the case of a 34-year-old Caucasian patient referred to our department for “blocked atrial bigeminy with pseudobradycardia” detected elsewhere at 33 weeks of gestation. A fetal echocardiography showed during all the examination a blocked atrial trigeminy with a mean fetal heart rate of 100 bpm. After birth three subsequent ECGs until day 3 showed no evidence of atrial extrasystoles, confirming the well-known frequent regression of this kind of fetal benign arrhythmia, but on day 11 recurrence of supraventricular trigeminy and development of episodes of paroxystic supraventricular tachycardia were observed. On the basis of this observation, we recommend that fetuses with complex atrial ectopic beats should be closely monitored before and after birth for evidence of new arrhythmias.
Fetal tachycardia : diagnosis and treatment
Oudijk, Martijn Alexander
2003-01-01
Part I: Fetal tachyarrhythmias Diagnosis Fetal tachycardia is a serious condition warranting specialized evaluation. In chapter 2, methods of diagnosis of fetal tachycardia are described, including doppler and M-mode echocardiography and fetal magnetocardiography. The study presented in chapter 3
Oxygen therapy reduces postoperative tachycardia
DEFF Research Database (Denmark)
Stausholm, K; Kehlet, H; Rosenberg, J
1995-01-01
Concomitant hypoxaemia and tachycardia in the postoperative period is unfavourable for the myocardium. Since hypoxaemia per se may be involved in the pathogenesis of postoperative tachycardia, we have studied the effect of oxygen therapy on tachycardia in 12 patients randomly allocated to blinded...... air or oxygen by facemask on the second or third day after major surgery. Inclusion criteria were arterial hypoxaemia (oxygen saturation 90 beat.min-1). Each patient responded similarly to oxygen therapy: an increase in arterial oxygen saturation and a decrease...... in heart rate (p oxygen has a positive effect on the cardiac oxygen delivery and demand balance....
DEFF Research Database (Denmark)
Axelsson, Anna; Weibring, Kristina; Havndrup, Ole
2014-01-01
.1-9.4) after ASA. Patients with high-grade atrioventricular block at follow-up had longer PR intervals at baseline [205 ms (200-230)] than the rest of the cohort [180 ms (140-200), P = 0.004] and a higher incidence of acute complete heart block (63 vs. 15%; P = 0.007) during ASA. A PR interval of at least 200...... ms at baseline was associated with higher prevalence of high-grade atrioventricular block at follow-up (30 vs. 2%; P = 0.0013). The incidence of late-onset complete heart block was 1.5% per year after ASA. CONCLUSION: We found normalized atrioventricular conduction at long-term follow-up, suggesting...... recovery in 6 of 14 patients with a pacemaker implanted in relation to ASA. Permanent atrioventricular conduction abnormalities were associated with baseline PR intervals of at least 200 ms and acute persistent complete heart block during ASA....
Swallow syncope caused by third-degree atrioventricular block
DEFF Research Database (Denmark)
Roust Aaberg, Anne Marie; Eriksson, Anna Elin; Madsen, Per Lav
2015-01-01
We report a case of a patient with more than 30 years of repeated syncopes, always following food intake. The patient was diagnosed with a swallow-related third-degree atrioventricular block and successfully treated with an artificial pacemaker.......We report a case of a patient with more than 30 years of repeated syncopes, always following food intake. The patient was diagnosed with a swallow-related third-degree atrioventricular block and successfully treated with an artificial pacemaker....
[Wide QRS tachycardia preceded by pacemaker spikes].
Romero, M; Aranda, A; Gómez, F J; Jurado, A
2014-04-01
The differential diagnosis and therapeutic management of wide QRS tachycardia preceded by pacemaker spike is presented. The pacemaker-mediated tachycardia, tachycardia fibrillo-flutter in patients with pacemakers, and runaway pacemakers, have a similar surface electrocardiogram, but respond to different therapeutic measures. The tachycardia response to the application of a magnet over the pacemaker could help in the differential diagnosis, and in some cases will be therapeutic, as in the case of a tachycardia-mediated pacemaker. Although these conditions are diagnosed and treated in hospitals with catheterization laboratories using the application programmer over the pacemaker, patients presenting in primary care clinic and emergency forced us to make a diagnosis and treat the haemodynamically unstable patient prior to referral. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.
Supraventricular tachycardia associated with phentermine use
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Pakpoom Tantrachoti
2016-07-01
Full Text Available Phentermine, a very popular diet pill, is reportedly associated with tachycardia but rarely with other cardiac arrhythmias. We report a 36-year-old woman with no significant past medical history who developed supraventricular tachycardia after taking phentermine for four months. The supraventricular tachycardia has not recurred after the patient stopped taking the medication. With growing prevalence of obesity, clinicians should be aware of the potential serious side effects of phentermine and people with high cardiovascular risk should avoid using this medication.
Fatal Lyme carditis and endodermal heterotopia of the atrioventricular node.
Cary, N. R.; Fox, B.; Wright, D. J.; Cutler, S. J.; Shapiro, L. M.; Grace, A. A.
1990-01-01
A fatal case of Lyme carditis occurring in a Suffolk farmworker is reported. Post-mortem examination of the heart showed pericarditis, focal myocarditis and prominent endocardial and interstitial fibrosis. The additional finding of endodermal heterotopia ('mesothelioma') of the atrioventricular node raises the possibility that this could also be related to Lyme infection and account for the relatively frequent occurrence of atrioventricular block in this condition. Lyme disease should always be considered in a case of atrioventricular block, particularly in a young patient from a rural area. The heart block tends to improve and therefore only temporary pacing may be required. Images Figure 1 Figure 2 Figure 3 PMID:2349186
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Ohkusu, Yasuo; Takahashi, Nobukazu; Ishikawa, Toshiyuki [Yokohama City Univ. (Japan). School of Medicine] [and others
2002-11-01
We investigated whether anti-tachycardia therapy might improve the altered cardiac adrenergic and systolic function in tachycardia-induced cardiomyopathy (TC) in contrast to dilated cardiomyopathy (DCM). The subjects were 23 patients with heart failure, consisting of 8 patients with TC (43.6{+-}10.0 yrs) and 15 with DCM (45.3{+-}8.2 yrs). TC was determined as impairment of left ventricular function secondary to chronic or very frequent arrhythmia during more than 10% of the day. All patients were receiving anti-tachycardia treatment. Cardiac {sup 123}I-MIBG uptake was assessed as the heart/mediastinum activity ratio (H/M) before and after treatment. Left ventricular ejection fraction (LVEF) was also assessed. In the baseline study, H/M and LVEF showed no difference between TC and DCM (2.21{+-}0.44 vs. 2.10{+-}0.42, 35.3{+-}13.1 vs. 36.0{+-}10.9%, respectively). After treatment, the degree of change in H/M and LVEF differed significantly (0.41{+-}0.34 vs. 0.08{+-}0.20, 20.5{+-}14.4 vs. -2.1{+-}9.6%, p<0.01). In TC, heart failure improved after a shorter duration of treatment (p<0.05). In conclusion, anti-tachycardia therapy can improve altered cardiac adrenergic function and systolic function in patients with TC over a shorter period than in those with DCM. (author)
Ahmad, Zaheer; Lim, Zek; Roman, Kevin; Haw, Marcus; Anderson, Robert H; Vettukattil, Joseph
2016-02-01
Multiplanar re-formatting of full-volume three-dimensional echocardiography data sets offers new insights into the morphology of atrioventricular septal defects. We hypothesised that distortion of the alignment between the atrial and ventricular septums results in imbalanced venous return to the ventricles, with consequent proportional ventricular hypoplasia. A single observer evaluated 31 patients, with a mean age of 52.09 months, standard deviation of 55, and with a range from 2 to 264 months, with atrioventricular septal defects, of whom 17 were boys. Ventricular imbalance, observed in nine patients, was determined by two-dimensional assessment, and confirmed at surgical inspection in selected cases when a univentricular strategy was undertaken. Offline analysis using multiplanar re-formatting was performed. A line was drawn though the length of the ventricular septum and a second line along the plane of the atrial septum, taking the angle between these two lines as the atrioventricular septal angle. We compared the angle between 22 patients with adequately sized ventricles, and those with ventricular imbalance undergoing univentricular repair. In the 22 patients undergoing biventricular repair, the septal angle was 0 in 14 patients; the other eight patients having angles ranging from 1 to 36, with a mean angle of 7.4°, and standard deviation of 11.1°.The mean angle in the nine patients with ventricle imbalance was 28.6°, with a standard deviation of 3.04°, and with a range from 26 to 35°. Of those undergoing univentricular repair, two patients died, with angles of 26 and 30°, respectively. The atrioventricular septal angle derived via multiplanar formatting gives important information regarding the degree of ventricular hypoplasia and imbalance. When this angle is above 25°, patients are likely to have ventricular imbalance requiring univentricular repair.
Does the atrioventricular node conduct?
Meijler, F.L.; Fisch, C.
1989-01-01
It is difficult to be certain wh en the term "conduction" was first applied to the transfer of atrial activation to the ventricles .' In 1894, Engelmann used the word "Leitung", which can be translated as "connection" or as "conduction" .2 In 1906, Tawara described the atrioventricular node,
Aguiar Rosa, Silvia; Timóteo, Ana Teresa; Ferreira, Lurdes; Carvalho, Ramiro; Oliveira, Mario; Cunha, Pedro; Viveiros Monteiro, André; Portugal, Guilherme; Almeida Morais, Luis; Daniel, Pedro; Cruz Ferreira, Rui
2018-04-01
The aim was to characterise acute coronary syndrome patients with complete atrioventricular block and to assess the effect on outcome. Patients admitted with acute coronary syndrome were divided according to the presence of complete atrioventricular block: group 1, with complete atrioventricular block; group 2, without complete atrioventricular block. Clinical, electrocardiographic and echocardiographic characteristics and prognosis during one year follow-up were compared between the groups. Among 4799 acute coronary syndrome patients admitted during the study period, 91 (1.9%) presented with complete atrioventricular block. At presentation, group 1 patients presented with lower systolic blood pressure, higher Killip class and incidence of syncope. In group 1, 86.8% presented with ST-segment elevation myocardial infarction (STEMI), and inferior STEMI was verified in 79.1% of patients in group 1 compared with 21.9% in group 2 ( Pblock was observed in 7.3% in contrast to 2.5% in patients submitted to primary percutaneous coronary intervention ( Pblock was an independent predictor of hospital mortality (odds ratio 3.671; P=0.045). There was no significant difference in mortality at one-year follow-up between the study groups. Complete atrioventricular block conferred a worse outcome during hospitalisation, including a higher incidence of cardiogenic shock, ventricular arrhythmias and death.
Michael, Kevin A; Enriquez, Andres; Baranchuk, Adrian; Haley, Charlotte; Caldwell, Jane; Simpson, Christopher S; Abdollah, Hoshiar; Redfearn, Damian P
2015-01-01
Atrial fibrillation/tachycardia (AF/AT) may result in inappropriate therapies in implantable cardioverter-defibrillators (ICDs). The post-pacing interval (PPI) and tachycardia cycle length difference (PPI - TCL) has been previously demonstrated to indicate the proximity of the pacing site to a tachycardia origin. We postulated that the PPI and PPI - TCL would be greater in AT/AF vs. ventricular tachycardia (VT) after episodes of failed anti-tachycardia pacing (ATP). This was a single-centre, retrospective study evaluating consecutive patients implanted with dual (DR)/biventricular (BIV) ICDs. Stored electrograms were used to determine whether the ATP captured the arrhythmia and the arrhythmia did not present with primary or secondary termination. Measurements were done using manual calipers. A total of 155 patients were included. There were 79 BIV and 76 DR devices. In total, 39 episodes were identified in 20 patients over a 23-month follow-up period. A total of 76 sequences of ATP (burst/ramp) were delivered, 28 (37%) of them inappropriate. Fifty-one events (18 AT/AF and 33 VT) were compared. The mean PPI was 693 ± 96 vs. 512 ± 88 ms (P failed ATP differs significantly between AF/AT and VT and are therefore useful indices to discriminate between supraventricular tachycardia and VT in ICDs. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.
International Nuclear Information System (INIS)
Paech, Christian; Dähnert, Ingo; Kostelka, Martin; Mende, Meinhardt; Gebauer, Roman
2015-01-01
Junctional ectopic tachycardia (JET) is a postoperative complication with a mortality rate of up to 14% after surgery for congenital heart disease. This study evaluated the risk factors of JET and explored the association of postoperative temporary third degree atrioventricular (AV) block and the occurrence of JET. Data were collected retrospectively from 1158 patients who underwent surgery for congenital heart disease. The overall incidence of JET was 2.8%. Temporary third degree AV block occurred in 1.6% of cases. Permanent third degree AV block requiring pacemaker implantation occurred in 1% of cases. In all, 56% of patients with JET had temporary AV block (P < 0.001), whereas no case of postoperative JET was reported in patients with permanent AV block (P = 0.56). temporary third degree AV block did not suffer from JET. A correlation between temporary third degree AV block and postoperative JET could be observed. The risk factors identified for JET include younger age groups at the time of surgery, longer aortic cross clamping time and surgical procedures in proximity to the AV node
A rare form of atrioventricular septal defect with severe subaortic stenosis.
Venugopalan, P; Agarwal, A K; Reyes, Z
2001-06-01
An unusual form of atrioventricular septal defect associated with severe subaortic obstruction is reported in a neonate who presented with intractable cardiac failure. The baby had a large defect in the atrioventricular septum allowing communication from the left ventricle to the right atrium, without interatrial or interventricular communication, and a cleft anterior mitral leaflet. The baby expired despite palliative surgery performed to bypass the subaortic stenosis.
Atrial Fibrillation, Atrioventricular Blocks and Bundle Branch Blocks in Hemodialysis Patients
Mandic, Ante; Tomic, Monika; Petrov, Bozo; Romic, Zeljko
2012-01-01
Atrial fibrillation is one of the most frequent arrhythmias diagnosed in clinical practice and it is also relatively common in dialysis patients. Atrioventricular and intraventricular conduction disturbances are less investigated in hemodialysis patients and data about their prevalence are insufficient. The objective of this study was to determine the prevalence of atrial fibrillation, atrioventricular blocks and bundle branch blocks in hemodialysis patients and to analyze different clinical ...
Complete atrioventricular block following radiation therapy for malignant thymoma
International Nuclear Information System (INIS)
Nakao, Takeshi; Kanaya, Honin; Namura, Masanobu; Ohsato, Kazuo; Araki, Tsutomu; Ohka, Takio; Sugihara, Norihiko; Takeda, Ryoyu.
1990-01-01
Complete atrioventricular block following radiation is very rare. We present a case which developed after radiation therapy for malignant thymoma. The etiology of conduction disturbances due to radiation is unknown. In our case, serial electrocardiograms showed stepwise progression of the conduction disturbance, and his bundle electrocardiograms revealed new prolongation of the H-V interval. Endomyocardial biopsy specimens demonstrated occlusion in small arteries and diffuse degenerative changes in the myocardium. We therefore attributed the complete atrioventricular block in our patient to secondary damage to the conduction system, caused by radiation-induced occlusive changes in the small arteries supplying the conduction system. (author)
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Le Guludec, D.; Bourguignon, M.; Sebag, C.; Valette, H.; Sirinelli, A.; Davy, J.M.; Syrota, A.; Motte, G.
1987-01-01
Accuracy of Fourier phase mapping of radionuclide gated biventriculograms in detecting the origin of abnormal ventricular activation was studied during ventricular tachycardia or preexcitation. Group I included six patients suffering from clinical recurrent VT; 3 gated blood pool studies were acquired for each patient: during sinus rhythm, right ventricular pacing, and induced sustained VT-Group II included seven patients with Wolff-Parkinson-White syndrome and recurrent paroxysmal tachycardia; 3 gated blood pool studies were acquired for each patient: during sinus rhythm, right atrial pacing and orthodromic reciprocating tachycardia. Each acquisition lasted 5 min, in 30 degrees-40 degrees left anterior oblique projection. In Group I, the Fourier phase mapping was consistent with QRS morphology and axis during VT (5/6), except in one patient with LV aneurysm and LBBB electrical pattern during VT. Origin of VT on phase mapping was located in the right ventricle (n = 2) or in left ventricle (n = 4), at the border of wall motion abnormalities each time they existed (5/6). In Group II, the phase advance correlated with the location of the accessory pathway determined by ECG and endocardial mapping (n = 6) and per-operative epicardial mapping (n = 1). Discrimination between anterior and posterior localization of paraseptal pathways and location of intermittent preexcitation was not possible. We conclude that Fourier phase mapping is an accurate method for locating the origin of VT and determining its etiology. It can help locate the site of ventricular preexcitation in patients with only one accessory pathway; its accuracy in locating multiple accessory pathways remains unknown.
International Nuclear Information System (INIS)
Le Guludec, D.; Bourguignon, M.; Sebag, C.; Valette, H.; Sirinelli, A.; Davy, J.M.; Syrota, A.; Motte, G.
1987-01-01
Accuracy of Fourier phase mapping of radionuclide gated biventriculograms in detecting the origin of abnormal ventricular activation was studied during ventricular tachycardia or preexcitation. Group I included six patients suffering from clinical recurrent VT; 3 gated blood pool studies were acquired for each patient: during sinus rhythm, right ventricular pacing, and induced sustained VT-Group II included seven patients with Wolff-Parkinson-White syndrome and recurrent paroxysmal tachycardia; 3 gated blood pool studies were acquired for each patient: during sinus rhythm, right atrial pacing and orthodromic reciprocating tachycardia. Each acquisition lasted 5 min, in 30 degrees-40 degrees left anterior oblique projection. In Group I, the Fourier phase mapping was consistent with QRS morphology and axis during VT (5/6), except in one patient with LV aneurysm and LBBB electrical pattern during VT. Origin of VT on phase mapping was located in the right ventricle (n = 2) or in left ventricle (n = 4), at the border of wall motion abnormalities each time they existed (5/6). In Group II, the phase advance correlated with the location of the accessory pathway determined by ECG and endocardial mapping (n = 6) and per-operative epicardial mapping (n = 1). Discrimination between anterior and posterior localization of paraseptal pathways and location of intermittent preexcitation was not possible. We conclude that Fourier phase mapping is an accurate method for locating the origin of VT and determining its etiology. It can help locate the site of ventricular preexcitation in patients with only one accessory pathway; its accuracy in locating multiple accessory pathways remains unknown
Organized Atrial Tachycardias after Atrial Fibrillation Ablation
Castrejón-Castrejón, Sergio; Ortega, Marta; Pérez-Silva, Armando; Doiny, David; Estrada, Alejandro; Filgueiras, David; López-Sendón, José L.; Merino, José L.
2011-01-01
The efficacy of catheter-based ablation techniques to treat atrial fibrillation is limited not only by recurrences of this arrhythmia but also, and not less importantly, by new-onset organized atrial tachycardias. The incidence of such tachycardias depends on the type and duration of the baseline atrial fibrillation and specially on the ablation technique which was used during the index procedure. It has been repeatedly reported that the more extensive the left atrial surface ablated, the higher the incidence of organized atrial tachycardias. The exact origin of the pathologic substrate of these trachycardias is not fully understood and may result from the interaction between preexistent regions with abnormal electrical properties and the new ones resultant from radiofrequency delivery. From a clinical point of view these atrial tachycardias tend to remit after a variable time but in some cases are responsible for significant symptoms. A precise knowledge of the most frequent types of these arrhythmias, of their mechanisms and components is necessary for a thorough electrophysiologic characterization if a new ablation procedure is required. PMID:21941669
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Gokhan Aksan
2016-05-01
Full Text Available Upper septal fascicular ventricular tachycardia is a very rare form of idiopathic fascicular ventricular tachycardia. Upper septal fascicular tachycardia uses the posterior fascicle as the anterograde limb and the septal fascicle as the retrograde limb. When evaluating the electrocardiography for this form of tachycardia, the presence of narrow QRS morphology and normal axis may be misinterpreted as supraventricular tachycardia. Here, we report a very rare subtype of fascicular tachycardia that originates more proximally in the His-Purkinje system at the base of the heart.
Eyuboglu, Mehmet
2016-10-01
Ventricular tachycardia (VT) is life-threatening subgroup of wide QRS complex tachycardia (WCT). VT is usually associated with structural heart diseases, but it can occur in the absence of any cardiovascular diseases. Adverse cardiac effect of sodium bicarbonate in healthy subjects is not well described. A 30-year-old healthy man with excessive intake of sodium bicarbonate-related VT is presented. He was using sodium bicarbonate during last 2 months to lose weight. He has no risk factors and any cardiovascular or systemic diseases. After intravenous administration of amiodarone, tachycardia ended and his rhythm converted to sinus rhythm with normal electrocardiogram. Patient is asymptomatic, and no VT was observed without any medications at 1 year of follow-up.
DEFF Research Database (Denmark)
Valeur, Nana; Fritz-Hansen, Thomas; Risum, Niels
2010-01-01
In studies showing benefits of cardiac resynchronization therapy (CRT), individual atrioventricular (AV) delays have been optimized using echocardiography. However, the method for AV delay optimization remains controversial.......In studies showing benefits of cardiac resynchronization therapy (CRT), individual atrioventricular (AV) delays have been optimized using echocardiography. However, the method for AV delay optimization remains controversial....
Atrioventricular conduction abnormality and hyperchloremic metabolic acidosis in toluene sniffing
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Jian-Hsiung Tsao
2011-10-01
Full Text Available Toluene is an aromatic hydrocarbon with widespread industrial use as an organic solvent. As a result of the euphoric effect and availability of these substances, inhalation of toluene-based products is popular among young adults and children. Chronic or acute exposure is known to cause acid–base and electrolyte disorders, and to be toxic to the nervous and hematopoietic systems. We report a 38-year-old man who suffered from general muscular weakness of all extremities after toluene sniffing, which was complicated with hypokalemic paralysis, atrioventricular conduction abnormality, and normal anion gap hyperchloremic metabolic acidosis. Renal function, serum potassium and acid–base status normalized within 3 days after aggressive potassium chloride and intravenous fluid replacement. Electrocardiography showed regression of first-degree atrioventricular block. Exposure to toluene can lead to cardiac arrhythmias and sudden sniffing death syndrome. Tachyarrhythmia is the classical manifestation of toluene cardiotoxicity. Atrioventricular conduction abnormalities have been rarely mentioned in the literature. Knowledge of the toxicology and medical complications associated with toluene sniffing is essential for clinical management of these patients.
Bidirectional ventricular tachycardia of unknown etiology
International Nuclear Information System (INIS)
Ali, M.; Khan, J.A.; Masood, T.; Shamsi, F.; Dero, M.H.; Khan, S.
2013-01-01
A 45 years old male presented to the emergency department with palpitations, headache and apprehension. His electrocardiogram revealed bidirectional ventricular tachycardia. He remained vitally stable and responded to intravenous beta-blocker. Initially digitalis toxicity was suspected but history was negative for digitalis intake. The cause remained unidentified in patient despite detailed investigations. During a short follow-up (of 6 months) he remained asymptomatic and no cause was further identified during this period. Some other unseen causes of bidirectional ventricular tachycardia need to be explored. (author)
Atrioventricular Dissociation after Electroconvulsive Therapy
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Siegfried William Yu
2011-01-01
Full Text Available Electroconvulsive therapy (ECT is increasingly used as a treatment for psychiatric disorders. Cardiac effects are the principal cause of medical complications in these patients. We report a case of atrioventricular (AV dissociation that occurred after ECT that was treated with pacemaker implantation. The mechanisms contributing to the onset of AV dissociation in this patient, and the management and rationale for device therapy, in light of the most recent guidelines, are reviewed.
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Akbarzadeh Mohammad Ali
2017-06-01
Full Text Available A 95-year old woman was admitted to our emergency unit because of acute abdominal pain. After urgent surgery according to the acute abdomen, she was referred to intensive care unit (ICU of the emergency unit as she was intubated. It was developed a run of new arrhythmia which was diagnosed by cardiology resident as bidirectional ventricular tachycardia due to beat to beat changing the axis of the QRS. However, a second and more precise evaluation of the abnormal ECG suggested a narrow supraventricular tachycardia, most probably AV nodal reentrant tachycardia with a 2:1 right bundle branch block.
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Antonio R. Vilches
2004-02-01
Full Text Available El cuadro clínico de la tirotoxicosis incluye síntomas cardiovasculares variados. La taquicardia sinusal es el trastorno electrocardiográfico más frecuente y los trastornos de conducción son extremadamente raros como modo de presentación. Comunicamos un caso de bloqueo aurículo-ventricular de primer grado en una paciente con hipertiroidismo recién diagnosticado y que comenzó días antes de la consulta con un cuadro general inespecífico. Su evaluación ulterior demostró que se trataba de una tirotoxicosis aguda autoinmune, y su tratamiento con metimazol corrigió el trastorno totalmente. Se discuten los mecanismos fisiopatológicos involucrados y las implicancias clínicas desde el punto de vista del internista.Thyrotoxicosis may present with a variety of cardiovascular symptoms. Sinus tachycardia is the most frequently encountered electrocardiographic abnormality and conduction disturbances are extremely uncommon. We present a case of first degree atrio-ventricular block in a patient with newly diagnosed hyperthyroidism and discuss the underlying pathophysiological mechanisms and the clinical implications from the internist’s standpoint.
Effect of atrioventricular conduction on heart rate variability
Ahmad, Talha Jamal; Ali, Hussnain; Majeed, S. M Imran; Khan, Shoab A.
2011-01-01
This paper discusses the effect of atrioventricular conduction time (AVCT) on the short-term Heart Rate Variability (HRV) by computing HRV parameters using intervals between the onsets of successive P waves (PP time series) for three groups: normal
Ventricular tachycardia induced by weight loss pills
DEFF Research Database (Denmark)
Pareek, Manan; Hansson, Nils Henrik; Grove, Erik Lerkevang
2013-01-01
A previously healthy 29-year-old man was admitted with palpitations, dizziness, and near-syncope after he had recently started taking weight loss pills purchased on the internet. The pills contained caffeine and ephedrine. An electrocardiogram and telemetry revealed multiple episodes of non......-sustained monomorphic ventricular tachycardia, which was successfully treated with amiodarone. In conclusion, unauthorized weight loss pills can be harmful. In particular, ephedrine-containing drugs carry a risk of ventricular tachycardia and should be discouraged....
Long-term effectiveness of surgical treatment of ectopic atrial tachycardia.
Prager, N A; Cox, J L; Lindsay, B D; Ferguson, T B; Osborn, J L; Cain, M E
1993-07-01
The purpose of this study was to determine the long-term clinical outcome of patients with ectopic atrial tachycardias treated surgically. Ectopic atrial tachycardia is an uncommon arrhythmia that can be symptomatic and is associated with the development of a cardiomyopathy. Management strategies are not well defined because of the paucity of data on the long-term effectiveness of pharmacologic and nonpharmacologic therapies. The long-term clinical impact of medical and surgical therapy was determined in 15 consecutive patients with ectopic atrial tachycardia. All 15 patients were initially treated with antiarrhythmic drugs (mean 5.7 +/- 2.2 drugs/patient). An effective drug regimen was identified in only 5 (33%) of the 15 patients; the remaining 10 patients were treated surgically. In each, individualized surgical procedures were guided by computer-assisted intraoperative mapping, with atrial plaques comprising up to 156 electrodes. Focal ablation was performed in four patients and atrial isolation procedures in six. The 10 patients treated surgically were followed up a mean of 4 +/- 3.2 years. Ectopic atrial tachycardia recurred in one patient. A permanent pacemaker was implanted in two patients, one of whom also required reoperation for constrictive pericarditis. There were no operative deaths. Ectopic atrial tachycardia recurred in three (60%) of the five patients discharged on antiarrhythmic drug therapy during a mean follow-up interval of 6.4 +/- 4.3 years. There was one nonarrhythmic death. Map-guided surgery demonstrated long-term efficacy in abolishing symptoms in 9 of the 10 patients with ectopic atrial tachycardia. Results demonstrate that surgery is effective for patients with ectopic atrial tachycardias who are not easily treated with antiarrhythmic drugs.
Repair of tetralogy of Fallot associated with atrioventricular septal defect.
Tláskal, T; Hucín, B; Kostelka, M; Chaloupecký, V; Marek, J; Tax, P; Janouàek, J; Kuèera, V; Hruda, J; Reich, O; Skovránek, J
1998-01-01
Tetralogy of Fallot, when associated with atrioventricular septal defect permitting shunting at ventricular level, represents a complex cyanotic congenital malformation. Experience with surgical repair is limited, and results vary considerably. Between 1984 and 1996, we repaired 14 consecutive patients with this combination seen in our center. Their ages ranged from 8 months to 21 years (median 7.4 years). Six (42.9%) had Down's syndrome. In eight patients the correct diagnosis was made using echocardiography alone. In the remaining six patients, who had previously-constructed arterial shunts and/or suspected pulmonary arterial stenosis, catheterization and angiocardiography were also performed. The repair consisted of double patch closure of the septal defect, reconstruction of two atrioventricular orifices, and relief of pulmonary stenosis at all levels. In five patients with a hypoplastic pulmonary trunk, a monocusp transannular patch (four patients) or an allograft (one patient) was used for restoration of continuity from the right ventricle to the pulmonary arteries. Patch enlargement of one or both pulmonary arteries was necessary in five patients. One patient (7.1%) died early, and another late. The twelve surviving (85.8%) patients have been followed for 1.2-12.5 years after surgery (median 4.9 years, mean 5.9+/-3.9 years). During the follow-up, reoperation was necessary for repair of residual ventricular septal defect and pulmonary regurgitation in two patients, and closure of an atrial septal defect and alteration to left atrioventricular valvar regurgitation in one patient. Seven patients are in class I of the New York Heart Association, four in class II, and one in class III. Tetralogy of Fallot associated with atrioventricular septal defect can be corrected with low mortality and good long-term results. Residual lesions, however, have a tendency to progress, especially when seen in combination. After surgery, all patients need long-term close follow-up.
The Postural Tachycardia Syndrome (POTS: Pathophysiology, Diagnosis & Management
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Satish R Raj
2006-04-01
Full Text Available Postural tachycardia syndrome (POTS, characterized by orthostatic tachycardia in the absence of orthostatic hypotension, has been the focus of increasing clinical interest over the last 15 years 1. Patients with POTS complain of symptoms of tachycardia, exercise intolerance, lightheadedness, extreme fatigue, headache and mental clouding. Patients with POTS demonstrate a heart rate increase of ≥30 bpm with prolonged standing (5-30 minutes, often have high levels of upright plasma norepinephrine (reflecting sympathetic nervous system activation, and many patients have a low blood volume. POTS can be associated with a high degree of functional disability. Therapies aimed at correcting the hypovolemia and the autonomic imbalance may help relieve the severity of the symptoms. This review outlines the present understanding of the pathophysiology, diagnosis, and management of POTS.
EXERCISE-INDUCED VENTRICULAR-TACHYCARDIA - A RARE MANIFESTATION OF DIGITALIS TOXICITY
GOSSELINK, ATM; CRIJNS, HJGM; WIESFELD, ACP; LIE, KI
Digitalis intoxication is one of the most common adverse drug reactions. Although some arrhythmias are seen more frequently than others, virtually any rhythm disturbance, including ventricular tachycardia, may occur. However, to our knowledge, exercise-induced ventricular tachycardia as a
Ishizaki, Masatoshi; Fujimoto, Akiko; Ueyama, Hidetsugu; Nishida, Yasuto; Imamura, Shigehiro; Uchino, Makoto; Ando, Yukio
2015-01-01
We herein present a report of three patients with Becker muscular dystrophy in the same family who developed complete atrioventricular block or ventricular tachycardia with severe cardiomyopathy. Our cases became unable to walk in their teens, and were introduced to mechanical ventilation due to respiratory muscle weakness in their twenties and thirties. In all three cases, a medical device such as a permanent cardiac pacemaker or an implantable cardiac defibrillator was considered to be necessary. The duplication of exons 3-4 in the dystrophin gene was detected in two of the patients. In patients with Becker muscular dystrophy, complete atrioventricular block or ventricular tachycardia within a family has rarely been reported. Thus attention should be paid to the possibility of severe arrhythmias in the severe phenotype of Becker muscular dystrophy.
Tachycardia may prognosticate life- or organ-threatening diseases in children with abdominal pain.
Hayakawa, Itaru; Sakakibara, Hiroshi; Atsumi, Yukari; Hataya, Hiroshi; Terakawa, Toshiro
2017-06-01
Abdominal pain is common in children, but expeditious diagnosis of life- or organ-threatening diseases can be challenging. An evidence-based definition of tachycardia in children was established recently, but its diagnostic utility has not yet been studied. To test the hypothesis that abdominal pain with tachycardia may pose a higher likelihood of life- or organ-threatening diseases in children. A nested case-control study was conducted in a pediatric emergency department in 2013. Tachycardia was defined as a resting heart rate of more than 3 standard deviations above the average for that age. Life- or organ-threatening diseases were defined as "disorders that might result in permanent morbidity or mortality without appropriate intervention." A triage team recorded vital signs before emergency physicians attended patients. Patients with tachycardia (cases) and without tachycardia (controls) were systematically matched for age, sex, and month of visit. The groups were compared for the presence of life- or organ-threatening diseases. There were 1683 visits for abdominal pain, 1512 of which had vital signs measured at rest. Eighty-three patients experienced tachycardia, while 1429 did not. Fifty-eight cases and 58 controls were matched. Life- or organ-threatening diseases were more common in the case group (19%) than the control group (5%, p=0.043). The relative risk of tachycardia to the presence of the diseases was 3.7 (95% confidence interval 1.2-12.0). Tachycardia significantly increased the likelihood of life- or organ-threatening diseases. Tachycardia in children with abdominal pain should alert emergency physicians to the possibility of serious illness. Copyright © 2017 Elsevier Inc. All rights reserved.
Mahaim Fibre Tachycardia: Recognition and Management
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Eduardo Back Sternick
2003-04-01
Full Text Available Dr. Gallagher et al1 wrote 22 years ago that "the role of Mahaim fibers in the genesis of cardiac arrhythmias in man has been controversial since they were first described " in the late 30's by Dr. Ivan Mahaim2. The very early reports were strictly anatomical studies2,3,4,5,6. This histopathologic quest did not end yet. Mahaim fibers were supposed to be accessory connections taking off from the His bundle and fascicles (FV-fasciculoventricular to the right ventricle or from the atrioventricular node (NV-nodoventricular fibers to the right ventricle. Anderson et al7 proposed 2 varieties of NV fibers, one that arises from the transitional zone and the other which inserted from the deep, compact nodal portion of the AV junction. In his pioneering work HJJ Wellens paved the road for clinical electrophysiological investigation. He was the first to study a patient with accessory pathway with decremental properties and long conduction times assuming its relationship with the fibers described long ago by "Mahaim", as reported in his doctoral thesis8 in 1971. The term nodofascicular (NF was applied when the retrograde His bundle potential preceded the ventricular deflection, while nodoventricular pathway would be appropriate when the retrograde His bundle deflection followed the ventricular potential. It took some years to electrophysiologists realize the conceptual mismatch among the "Mahaim" physiology and structure described by Mahaim et al. An important observation was done in 1978 by Becker et al5 who found an accessory node associated with a bundle of specialized fibers measuring 1 cm and coursing through the right ventricle, mimicking a second AV conduction system located on the lateral tricuspid annulus. However, that did not change the mainstream concept of NV fibers. During the early 80's many centers started to refer patients with drug refractory tachycardias to surgical treatment. According to the current concepts at that time targeting the A
Syndrome and Phenomenon of Wolff — Parkinson — White in Children (Literature Review
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N.V. Nagornaya
2013-03-01
Full Text Available The article deals with the data on the history of the discovery and study of the phenomenon and syndrome Wolff — Parkinson — White (WPW. The features of the anatomy and electrophysiology of additional ways, mechanisms of attacks of atrioventricular reentrant tachycardia in WPW syndrome are considered. The role of the standard ECG, methods for topical analysis of additional atrioventricular connections and non-invasive electrophysiological studies in the diagnosis of this disease is shown.
Ciardulli, Andrea; D'Antonio, Francesco; Magro-Malosso, Elena R; Manzoli, Lamberto; Anisman, Paul; Saccone, Gabriele; Berghella, Vincenzo
2018-03-07
To explore the effect of maternal fluorinated steroid therapy on fetuses affected by second-degree immune-mediated congenital atrioventricular block. Studies reporting the outcome of fetuses with second-degree immune-mediated congenital atrioventricular block diagnosed on prenatal ultrasound and treated with fluorinated steroids compared with those not treated were included. The primary outcome was the overall progression of congenital atrioventricular block to either continuous or intermittent third-degree congenital atrioventricular block at birth. Meta-analyses of proportions using random effect model and meta-analyses using individual data random-effect logistic regression were used. Five studies (71 fetuses) were included. The progression rate to congenital atrioventricular block at birth in fetuses treated with steroids was 52% (95% confidence interval 23-79) and in fetuses not receiving steroid therapy 73% (95% confidence interval 39-94). The overall rate of regression to either first-degree, intermittent first-/second-degree or sinus rhythm in fetuses treated with steroids was 25% (95% confidence interval 12-41) compared with 23% (95% confidence interval 8-44) in those not treated. Stable (constant) second-degree congenital atrioventricular block at birth was present in 11% (95% confidence interval 2-27) of cases in the treated group and in none of the newborns in the untreated group, whereas complete regression to sinus rhythm occurred in 21% (95% confidence interval 6-42) of fetuses receiving steroids vs. 9% (95% confidence interval 0-41) of those untreated. There is still limited evidence as to the benefit of administered fluorinated steroids in terms of affecting outcome of fetuses with second-degree immune-mediated congenital atrioventricular block. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.
Cyclic Fatigue Resistance of Reciproc Blue, Reciproc, and WaveOne Gold Reciprocating Instruments.
Keskin, Cangül; Inan, Uğur; Demiral, Murat; Keleş, Ali
2017-08-01
The aim of the present study was to compare the cyclic fatigue resistance of Reciproc Blue R25 (VDW, Munich, Germany) with Reciproc R25 (VDW) and WaveOne Gold Primary (Denstply Maillefer, Ballaigues, Switzerland). Fifteen Reciproc Blue R25, 15 Reciproc R25, and 15 WaveOne Gold Primary instruments were collected and tested in a dynamic cyclic fatigue test device, which has an artificial canal with a 60° angle of curvature and a 5-mm radius of curvature. All instruments were operated until fracture occurred, and time to fracture (TF) and the lengths of the fractured fragments were recorded. The mean and standard deviations of TF and fragment length were calculated for each reciprocating system. TF data were subjected to Kruskal-Wallis 1-way analysis of variance and the Dunn test, whereas fractured fragment length data were subjected to 1-way analysis of variance (P .05). Reciproc Blue R25 instruments had significantly higher cyclic fatigue resistance than WaveOne Gold and Reciproc R25 instruments. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Direct reciprocity in spatial populations enhances R-reciprocity as well as ST-reciprocity.
Miyaji, Kohei; Tanimoto, Jun; Wang, Zhen; Hagishima, Aya; Ikegaya, Naoki
2013-01-01
As is well-known, spatial reciprocity plays an important role in facilitating the emergence of cooperative traits, and the effect of direct reciprocity is also obvious for explaining the cooperation dynamics. However, how the combination of these two scenarios influences cooperation is still unclear. In the present work, we study the evolution of cooperation in 2 × 2 games via considering both spatial structured populations and direct reciprocity driven by the strategy with 1-memory length. Our results show that cooperation can be significantly facilitated on the whole parameter plane. For prisoner's dilemma game, cooperation dominates the system even at strong dilemma, where maximal social payoff is still realized. In this sense, R-reciprocity forms and it is robust to the extremely strong dilemma. Interestingly, when turning to chicken game, we find that ST-reciprocity is also guaranteed, through which social average payoff and cooperation is greatly enhanced. This reciprocity mechanism is supported by mean-field analysis and different interaction topologies. Thus, our study indicates that direct reciprocity in structured populations can be regarded as a more powerful factor for the sustainability of cooperation.
Management of paroxysmal ectopic atrial tachycardia with long sinus pauses in a teenager
Seshadri Balaji
2015-01-01
Sinus pauses in the setting of supraventricular tachycardia is rare in children. We describe an asymptomatic teen with irregular heart rate detected during an incidental exam who was found to have short runs of a slow ectopic atrial tachycardia on electrocardiogram and prolonged sinus pauses on routine ambulatory ECG. Successful catheter ablation of the ectopic atrial tachycardia led to resolution of the sinus pauses.
Magnetic electroanatomical mapping for ablation of focal atrial tachycardias.
Marchlinski, F; Callans, D; Gottlieb, C; Rodriguez, E; Coyne, R; Kleinman, D
1998-08-01
Uniform success for ablation of focal atrial tachycardias has been difficult to achieve using standard catheter mapping and ablation techniques. In addition, our understanding of the complex relationship between atrial anatomy, electrophysiology, and surface ECG P wave morphology remains primitive. The magnetic electroanatomical mapping and display system (CARTO) offers an on-line display of electrical activation and/or signal amplitude related to the anatomical location of the recorded sites in the mapped chamber. A window of electrical interest is established based on signals timed from an electrical reference that usually represents a fixed electrogram recording from the coronary sinus or the atrial appendage. This window of electrical interest is established to include atrial activation prior to the onset of the P wave activity associated with the site of origin of a focal atrial tachycardia. Anatomical and electrical landmarks are defined with limited fluoroscopic imaging support and more detailed global chamber and more focal atrial mapping can be performed with minimal fluoroscopic guidance. A three-dimensional color map representing atrial activation or voltage amplitude at the magnetically defined anatomical sites is displayed with on-line data acquisition. This display can be manipulated to facilitate viewing from any angle. Altering the zoom control, triangle fill threshold, clipping plane, or color range can all enhance the display of a more focal area of interest. We documented the feasibility of using this single mapping catheter technique for localizing and ablating focal atrial tachycardias. In a consecutive series of 8 patients with 9 focal atrial tachycardias, the use of the single catheter CARTO mapping system was associated with ablation success in all but one patient who had a left atrial tachycardia localized to the medial aspect of the orifice of the left atrial appendage. Only low power energy delivery was used in this patient because of the
Cutting efficiency of Reciproc and waveOne reciprocating instruments.
Plotino, Gianluca; Giansiracusa Rubini, Alessio; Grande, Nicola M; Testarelli, Luca; Gambarini, Gianluca
2014-08-01
The aim of the present study was to evaluate the cutting efficiency of 2 new reciprocating instruments, Reciproc and WaveOne. Twenty-four new Reciproc R25 and 24 new WaveOne Primary files were activated by using a torque-controlled motor (Silver Reciproc) and divided into 4 groups (n = 12): group 1, Reciproc activated by Reciproc ALL program; group 2, Reciproc activated by WaveOne ALL program; group 3, WaveOne activated by Reciproc ALL program; and group 4, WaveOne activated by WaveOne ALL program. The device used for the cutting test consisted of a main frame to which a mobile plastic support for the handpiece is connected and a stainless steel block containing a Plexiglas block (inPlexiglass, Rome, Italy) against which the cutting efficiency of the instruments was tested. The length of the block cut in 1 minute was measured in a computerized program with a precision of 0.1 mm. Means and standard deviations of each group were calculated, and data were statistically analyzed with 1-way analysis of variance and Bonferroni test (P cutting efficiency than WaveOne Primary for both the movements used (P cutting efficiency than WaveOne instruments used with their proper reciprocating motion (P .05). Reciproc instruments demonstrated statistically higher cutting efficiency than WaveOne instruments. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
de Paola, A A; Mendonça, A; Balbão, C E; Tavora, M Z; da Silva, R M; Hara, V M; Guiguer Júnior, N; Vattimo, A C; Souza, I A; Portugal, O P
1993-10-01
A 8-year-old female patient with refractory incessant atrial tachycardia, very symptomatic and with left ventricular ejection fraction of 0.25. Electrophysiological study and endocardial mapping localized the site of the origin of atrial tachycardia in the superior right atrium. In this site 2 applications of radiofrequency current (25V, 20 and 50 seconds) resulted in termination of the atrial tachycardia. She was discharged off antiarrhythmic drugs and after 2 months ejection fraction was 0.52. She was completely asymptomatic 6 months after ablation procedure.
Palmisano, Pietro; Ziacchi, Matteo; Biffi, Mauro; Ricci, Renato P; Landolina, Maurizio; Zoni-Berisso, Massimo; Occhetta, Eraldo; Maglia, Giampiero; Botto, Gianluca; Padeletti, Luigi; Boriani, Giuseppe
2018-04-01
: The purpose of this two-part consensus document is to provide specific suggestions (based on an extensive literature review) on appropriate pacemaker setting in relation to patients' clinical features. In part 2, criteria for pacemaker choice and programming in atrioventricular blocks and neurally mediate syncope are proposed. The atrioventricular blocks can be paroxysmal or persistent, isolated or associated with sinus node disease. Neurally mediated syncope can be related to carotid sinus syndrome or cardioinhibitory vasovagal syncope. In sinus rhythm, with persistent atrioventricular block, we considered appropriate the activation of mode-switch algorithms, and algorithms for auto-adaptive management of the ventricular pacing output. If the atrioventricular block is paroxysmal, in addition to algorithms mentioned above, algorithms to maximize intrinsic atrioventricular conduction should be activated. When sinus node disease is associated with atrioventricular block, the activation of rate-responsive function in patients with chronotropic incompetence is appropriate. In permanent atrial fibrillation with atrioventricular block, algorithms for auto-adaptive management of the ventricular pacing output should be activated. If the atrioventricular block is persistent, the activation of rate-responsive function is appropriate. In carotid sinus syndrome, adequate rate hysteresis should be programmed. In vasovagal syncope, specialized sensing and pacing algorithms designed for reflex syncope prevention should be activated.
Lakhno, Igor; Behar, Joachim A; Oster, Julien; Shulgin, Vyacheslav; Ostras, Oleksii; Andreotti, Fernando
2017-01-01
Complete atrioventricular block in fetuses is known to be mostly associated with autoimmune disease and can be irreversible if no steroids treatment is provided. Conventional methods used in clinical practice for diagnosing fetal arrhythmia are limited since they do not reflect the primary electrophysiological conduction processes that take place in the myocardium. The non-invasive fetal electrocardiogram has the potential to better support fetal arrhythmias diagnosis through the continuous analysis of the beat to beat variation of the fetal heart rate and morphological analysis of the PQRST complex. We present two retrospective case reports on which atrioventricular block diagnosis could have been supported by the non-invasive fetal electrocardiogram. The two cases comprised a 22-year-old pregnant woman with the gestational age of 31 weeks and a 25-year-old pregnant woman with the gestational age of 41 weeks. Both women were admitted to the Department of Maternal and Fetal Medicine at the Kyiv and Kharkiv municipal perinatal clinics. Patients were observed using standard fetal monitoring methods as well as the non-invasive fetal electrocardiogram. The non-invasive fetal electrocardiographic recordings were analyzed retrospectively, where it is possible to identify the presence of the atrioventricular block. This study demonstrates, for the first time, the feasibility of the non-invasive fetal electrocardiogram as a supplementary method to diagnose of the fetal atrioventricular block. Combined with current fetal monitoring techniques, non-invasive fetal electrocardiography could support clinical decisions.
Viganò, M; Graffigna, A; Pagani, F; Salerno, J A
1991-12-01
Surgery can provide treatment for supraventricular tachyarrhythmias without operative risk and with a definite improvement of patients' quality of life. Ectopic atrial tachycardia is a rare but invalidating arrhythmia that may lead to cardiomyopathy: intraoperative mapping is necessary for the location of the location of the ectopic focus; in our experience, surgical, cryothermal or isolation ablation of the area were effective in 9 patients out of 9, with regression of the cardiomyopathy. Atrioventricular node reentry tachycardia is a reentry tachycardia which is often associated with Wolff-Parkinson-White syndrome and is amenable to surgical treatment. Discrete cryolesions around the Koch triangle are effective in interrupting the atrial inputs to the atrioventricular node and therefore the reentry mechanism: in our experience, 7 patients were successfully treated without operative mortality: 3 patients underwent surgical ablation of Kent bundles as well. Atrial fibrillation is not based on a well-defined mechanism, and therefore does not permit an electrically-guided surgical treatment. However, in case of atrial septal defect it is possible to isolate the enlarged right atrium in order to allow sinus rhythm to activate the left atrium and ventricles.(ABSTRACT TRUNCATED AT 250 WORDS)
Animal model of neuropathic tachycardia syndrome
Carson, R. P.; Appalsamy, M.; Diedrich, A.; Davis, T. L.; Robertson, D.
2001-01-01
Clinically relevant autonomic dysfunction can result from either complete or partial loss of sympathetic outflow to effector organs. Reported animal models of autonomic neuropathy have aimed to achieve complete lesions of sympathetic nerves, but incomplete lesions might be more relevant to certain clinical entities. We hypothesized that loss of sympathetic innervation would result in a predicted decrease in arterial pressure and a compensatory increase in heart rate. Increased heart rate due to loss of sympathetic innervation is seemingly paradoxical, but it provides a mechanistic explanation for clinical autonomic syndromes such as neuropathic postural tachycardia syndrome. Partially dysautonomic animals were generated by selectively lesioning postganglionic sympathetic neurons with 150 mg/kg 6-hydroxydopamine hydrobromide in male Sprague-Dawley rats. Blood pressure and heart rate were monitored using radiotelemetry. Systolic blood pressure decreased within hours postlesion (Delta>20 mm Hg). Within 4 days postlesion, heart rate rose and remained elevated above control levels. The severity of the lesion was determined functionally and pharmacologically by spectral analysis and responsiveness to tyramine. Low-frequency spectral power of systolic blood pressure was reduced postlesion and correlated with the diminished tyramine responsiveness (r=0.9572, P=0.0053). The tachycardia was abolished by treatment with the beta-antagonist propranolol, demonstrating that it was mediated by catecholamines acting on cardiac beta-receptors. Partial lesions of the autonomic nervous system have been hypothesized to underlie many disorders, including neuropathic postural tachycardia syndrome. This animal model may help us better understand the pathophysiology of autonomic dysfunction and lead to development of therapeutic interventions.
Gillers, Benjamin S.; Chiplunkar, Aditi; Aly, Haytham; Valenta, Tomas; Basler, Konrad; Christoffels, Vincent M.; Efimov, Igor R.; Boukens, Bastiaan J.; Rentschler, Stacey
2015-01-01
Proper patterning of the atrioventricular canal (AVC) is essential for delay of electrical impulses between atria and ventricles, and defects in AVC maturation can result in congenital heart disease. To determine the role of canonical Wnt signaling in the myocardium during AVC development. We used a
Complete paroxysmal atrioventricular block in a 2-year-old girl
DEFF Research Database (Denmark)
Holst, Line Marie; Dixen, Ulrik; Jeppesen, Dorthe L
2015-01-01
We present a case of atypical syncope in a 2-year-old, otherwise healthy girl. The patient presented with three episodes of syncope without any precipitating factors and no family history of sudden unexpected death. Holter monitoring revealed 24 events of complete atrioventricular block lasting up...
Atrioventricular Dissociation following Blunt Chest Trauma
Directory of Open Access Journals (Sweden)
Salim Surani
2014-01-01
Full Text Available Blunt chest trauma (BCT is a common clinical presentation seen in emergency departments. Few cases of cardiac conduction abnormalities due to BCT have been reported in the medical literature. This dysrhythmias may present as permanent conduction defects requiring permanent pacemaker or may have temporary conduction abnormalities requiring temporary pacemaker or supportive care. We present the case of a young woman who suffered from BCT after being kicked by a horse with the development of a significant substernal hematoma. She developed temporary atrioventricular block, which was completely resolved with the decrease in the size of the substernal hematoma suffered.
Kroesen, M.; Maseland, M.; Smal, J.; Reimer, A.; van Setten, P.
2012-01-01
We present the case of a 2-year-old asthmatic boy with atrioventricular (AV)-reentry tachycardia following albuterol inhalation, who was later diagnosed with Wolff-Parkinson-White (WPW) syndrome. The Naranjo adverse drug reaction probability scale score for this adverse event was 7, indicating that
de Paola, A A; Balbão, C E; Castiglioni, M L; Barbieri, A; Mendonça, A; Netto, O S; Guiguer Júnior, N; Vattimo, A C; Souza, I A; Portugal, O P
1993-06-01
To localize the site of the origin of sustained ventricular tachycardia in chronic chagasic cardiomyopathy patients refractory to antiarrhythmic therapy by radionuclide angiography techniques. Five patients underwent radionuclide angiography by intravenous administration of 25mCi 99mTc. The images were obtained in sinus rhythm and during sustained ventricular tachycardia induced in the electrophysiologic laboratory for endocardial mapping. Amplitude and phase images were obtained resulting in a contraction wave synchronic to ventricular dispolarization. All patients had haemodynamic stability during the arrhythmia. One patient had incessant ventricular tachycardia. Mean ejection fraction was 0.38. In 4 patients the site of the origin of ventricular tachycardia was posterior and in one it was localized in the interventricular septum. There was identity in the site of the origin of ventricular tachycardia obtained by endocardial mapping or radionuclide angiography in all patients. The therapy was chemical ablation in 3 patients, surgical aneurysmectomy in one and pharmacologic therapy in the last patient. The site of the origin of ventricular tachycardia can be estimated by analyzing the contraction wave obtained by radionuclide angiography techniques in patients with hemodynamic stable sustained ventricular tachycardia.
International Nuclear Information System (INIS)
Horta, J. de; Reyes, W.; Calleriza, F.; Pouso, J.; Besada, E.
1998-01-01
The auricular tachycardia are the supraventricular tachycardias whose origin mechanism and maintenance is located at level exclusively auricular. It show diagnostic and therapeutics difficulties.The inadequate handling can cause commitment of the ventricular function and to commit the predict vital.The pharmacological treatment, is more used is few effective.The ablation for catheter with radiofrequency is a new weapon transcendent therapy for the resolution of a significant group of these patients. A review of the concept of auricular tachycardias, it upgrades its classification and the mechanisms pathophysiologic.It describes the techniques of ablation for catheter in these arrhythmias and their results are revised in the literature. In the end it presents the casuistry of the Service in the treatment of the auricular tachycardias focal s,incision ales and atrial flutter by means of ablation for catheter with radiofrequency [es
Directory of Open Access Journals (Sweden)
Eyup Aslan
2014-12-01
Full Text Available Hyoscine N-Butylbromide, is a peripherally acting antimuscarinic, anticholinergic agent. It is used for spasms of gastrointestinal and genitourinary trackt. Because of anticholinergic effects, it exerts positive chronotropic agent like atropine, may lead to sinus tachycardia. However, there has been no reported an association of supraventricular tachycardia and hyoscine n-butylbromide. In this report, we report a case that developed supraventricular tachycardia during hyoscine n-butylbromide therapy for his abdominal pain.
Directory of Open Access Journals (Sweden)
José Geraldo Pereira da Cruz
2006-03-01
Full Text Available A estimulação elétrica do nervo vago diminui a freqüência cardíaca e aumenta o intervalo PQ no eletrocardiograma, podendo ativar a via anterógrada do nodo atrioventricular. Neste experimento é investigada a interação da morfina sobre o controle nervoso parassimpático cardíaco em relação à dupla condução do nodo atrioventricular. A estimulação do nervo vago induz uma significativa bradicardia e um bloqueio atrioventricular de terceiro grau, com a onda P aparecendo negativa na derivação II. Devido aos efeitos moduladores da anestesia sobre o coração, administração de injeções de morfina induz o aparecimento de onda P positiva através de uma ação inibitória sobre a reentrância do nodo atrioventricular. Tudo sugere a presença de duas vias atrioventriculares, anatômica e funcionalmente distintasThat electrical stimulation of the vagus decreased heart rate and increased the PQ interval in electrocardiogram, consistent with anterograde dual atriventricular conduction. The present experiments were investigating the interaction of the morphine with cardiac parasympathetic nervous control in dual atrioventricular node. Electrical stimulation of the vagus nerve induced significant bradycardia and of third degree atrioventricular block and the P wave appearance was negative in leads II. Because background anesthesia modulates the heart, administered morphine injection the P waves appearance was positive through one inhibitory action on atrioventricular nodal reentry. All suggest the presence of two functionally and anatomically distinct atrioventricular pathways
DEFF Research Database (Denmark)
Valeur, Nana; Fritz-Hansen, Thomas; Risum, Niels
2010-01-01
In studies showing benefits of cardiac resynchronization therapy (CRT), individual atrioventricular (AV) delays have been optimized using echocardiography. However, the method for AV delay optimization remains controversial....
The treatment of malignant ventricular tachycardia by aorto-coronary saphenous vein bypass graft
Ikram, H.; Jeffery, R. M.; Parkins, R. A.; Makey, A. R.; Emery, E. R. J.; Stone, D. L.
1974-01-01
A 61-year-old man with a previous cardiac infarction had at least fifteen attacks of ventricular tachycardia which finally did not respond to either drug or electrical therapy. Angiography showed a blocked right coronary artery and a non-contractile portion of postero-inferior left ventricular wall. An aorto to right coronary saphenous vein bypass graft was inserted, and although attacks of tachycardia occurred following the operation these were of short duration and reverted spontaneously. He has been free of tachycardia for 5 weeks, with a greatly improved effort tolerance. ImagesFig. 2Fig. 3
International Nuclear Information System (INIS)
Potton, R J
2004-01-01
The application of reciprocity principles in optics has a long history that goes back to Stokes, Lorentz, Helmholtz and others. Moreover, optical applications need to be seen in the context of applications of reciprocity in particle scattering, acoustics, seismology and the solution of inverse problems, generally. In some of these other fields vector wave propagation is, as it is in optics, of the essence. For this reason the simplified approach to light wave polarization developed by, and named for, Jones is explored initially to see how and to what extent it encompasses reciprocity. The characteristic matrix of a uniform dielectric layer, used in the analysis of interference filters and mirrors, is reciprocal except when the layer is magneto-optical. The way in which the reciprocal nature of a characteristic matrix can be recognized is discussed next. After this, work on the influence of more realistic attributes of a dielectric stack on reciprocity is reviewed. Some of the numerous technological applications of magneto-optic non-reciprocal media are identified and the potential of a new class of non-reciprocal components is briefly introduced. Finally, the extension of the classical reciprocity concept to systems containing components that have nonlinear optical response is briefly mentioned
[Ventricular tachycardia in a patient with rate-responsive cardiac pacemaker].
Himbert, C; Lascault, G; Tonet, J; Coutte, R; Busquet, P; Frank, R; Grosgogeat, Y
1992-11-01
The authors report a case of syncopal ventricular tachycardia in a patient with a respiratory-dependent rate responsive pacemaker, followed-up for valvular heart disease with severe left ventricular dysfunction and sustained atrial and ventricular arrhythmias. The introduction of low dose betablocker therapy with reinforcement of the treatment of cardiac failure controlled the ventricular arrhythmia, after suppression of the data responsive function had been shown to be ineffective. The authors discuss the role of the rate responsive function in the triggering of the ventricular tachycardias.
Morfologia da junção atrioventricular em Iguana iguana (Reptilia-Iguanidae
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Sonia Regina Jurado
2006-06-01
Full Text Available The atrioventricular junctional area (AVJA, including atrioventricular (AV node and bundle was investigated in seven hearts of common or green iguana (Iguana iguana using the light microscopy. Adult animals, both sexes, were captured in the Pantanal, Brazil. All hearts were fixed in buffered formaldehyde 10% (pH 7.2 for 24 hours, embedded in paraplast according to routine methods, and serially cut at 5 µm thickness. In the Iguana iguana, the AVJA consists of a mass of the fibers intermingled with variable amount of connective tissue and blood vessels surrounded by adjacent myocardium and the attachment of the right atrioventricular valve in the fibrous skeleton. By light microscopy, conducting cells of the AV node and bundle can be distinguished from working cells by their much smaller size, paler staining reaction and the presence of a sheath of connective tissue. The AV node and bundle and its branches were found to constitute a continuous tract. Histochemically, we found elastic fibers between cells of the conduction, mainly in the AV node. The PAS method reveals absence of glycogen in specialized cells. The fibrous skeleton, mainly the right trigone, showed a well-developed chondroid tissue, made by hyaline like cartilage (binucleated condrocytes included in the big lacunas and extracellular matrix with fibrillar collagen. In conclusion, the nodal and Purkinje cells in heart iguana presented poorly morphological differentiation comparing mammals and birds, however the skeleton fibrous has a different cartilage kind.
Directory of Open Access Journals (Sweden)
Távora Maria Zildany P.
1999-01-01
Full Text Available OBJECTIVE: To study electrophysiological characteristics that enable the identification and ablation of sites of chagasic tachycardia. METHODS: Thirty-one patients with chronic Chagas' heart disease and sustained ventricular tachycardia (SVT underwent electrophysiological study to map and ablate that arrhythmia. Fifteen patients had hemodinamically stable SVT reproducible by programmed ventricular stimulation, 9 men and 6 women with ages ranging from 37 to 67 years and ejection fraction varying from 0.17 to 0.64. Endocardial mapping was performed during SVT in all patients. Radiofrequency (RF current was applied to sites of presystolic activity of at least 30 ms. Entrainment was used to identify reentrant circuits. In both successful and unsuccessful sites of RF current application, electrogram and entrainment were analyzed. RESULTS: Entrainment was obtained during all mapped SVT. In 70.5% of the sites we observed concealed entrainment and ventricular tachycardia termination in the first 15 seconds of RF current application. In the unsuccessful sites, significantly earlier electrical activity was seen than in the successful ones. Concealed entrainment was significantly associated with ventricular tachycardia termination. Bystander areas were not observed. CONCLUSION: The reentrant mechanism was responsible for the genesis of all tachycardias. In 70.5% of the studied sites, the endocardial participation of the slow conducting zone of reentrant circuits was shown. Concealed entrainment was the main electrophysiological parameter associated with successful RF current application. There was no electrophysiological evidence of bystander regions in the mapped circuits of SVT.
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Masahiko Goya, MD
2008-01-01
Full Text Available A 70-year-old woman was referred because of drug resistant and daily incessant palpitation attack. She had undergone two previous unsuccessful radiofrequency catheter ablations at another hospital. The physical examination, chest X-ray, and echocardiogram were all normal. The 12-lead ECG during tachycardia showed narrow QRS, short PR tachycardia and negative polarity of the P wave in leads I and aVL (Fig. 1A. The ECG monitor showed incessant tachycardia with warming-up phenomenon. Three dimensional electroanatomical map integrated with CT imaging (CARTOMERGE®, Biosense Webster Inc. clearly revealed the radial activation pattern originating from the basalo-postero-inferior aspect of the left atrial appendage. Radiofrequency energy application at this site eliminated tachycardia permanently.
Turitto, Gioia; Akhrass, Philippe; Leonardi, Marino; Saponieri, Cesare; Sette, Antonella; El-Sherif, Nabil
2009-01-01
To compare patients with atrial flutter (AFl) and 1:1 atrioventricular conduction (AVC) with patients with AFl and higher AVC. The characteristics of 19 patients with AFl and 1:1 AVC (group A) were compared with those of 116 consecutive patients with AFl and 2:1 AVC or higher degree AV block (group B). Age, gender, and left ventricular function were similar in the two groups. In group A versus group B, more patients had no structural heart disease (42% vs 17%, P AVC or vice versa was associated with small but definite changes in AFl CL, which showed larger variations in response to sympathetic stimulation. In group A patients who were studied off drugs, the atrial-His interval was not different from group B, but maximal atrial pacing rate with 1:1 AVC was faster. In group A, five patients were misdiagnosed as ventricular tachyarrhythmias, and three with a defibrillator received inappropriate shocks. Four patients had ablation of AVC and six had ablation of AFl circuit. The main difference between groups A and B may be an inherent capacity of the AV node for faster conduction, especially in response to increased sympathetic tone. The latter affects not only AVC but also the AFl CL. One should be aware of the different presentations of AFl with 1:1 AVC to avoid misdiagnosis/mismanagement and to consider the diagnosis in patients with narrow or wide QRS tachycardia and rates above 220/min.
Bidirectional ventricular tachycardia of unusual etiology
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Praloy Chakraborty
2015-11-01
Full Text Available Bidirectional ventricular tachycardia (BDVT is a rare form of ventricular arrhythmia, characterized by changing QRS axis of 180 degrees. Digitalis toxicity is considered as commonest cause of BDVT; other causes include aconite toxicity, myocarditis, myocardial infarction, metastatic cardiac tumour and cardiac channelopathies. We describe a case of BDVT in a patient with Anderson-Tawil syndrome.
Electrocardiografía clínica: Taquiarritmias supraventriculares de origen atrial
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Abraham Katime Zúñiga
2013-10-01
Full Text Available Resumen Las arritmias se pueden definir como “cualquier anormalidad en la frecuencia, regularidad o sitio de origen del impulso cardiaco o trastorno de la conducción que produce una alteración de la activación auricular o ventricular”; mientras que taquicardia se define como “frecuencia cardiaca en adultos, mayor de 100 latidos por minuto (lat/ min.”. Por tanto, las taquiarritmias supraventriculares son “aquellas taquicardias que requieren tejido atrial o de conducción atrioventricular para su iniciación y mantenimiento”. En este artículo se expondrán las características electrocardiográficas de aquellas provenientes del tejido auricular. (DUAZARY 2010, 117 - 124AbstractThe arrhythmias are defined as “any abnormality in the frequency, regularity, or site of origin of the cardiac impulse or conduction disorder that produces an alteration in the atrial or ventricular activation”; whereas tachycardia is defined as a “heart rate in adults greater than 100 beats per minute”. Therefore, supraventricular tachyarrhythmias are “those tachycardias who require atrial tissue or atrioventricular conduction for its initiation and maintenance”. This article explains the electrocardiographic characteristics of those arrhythmias from atrial tissue.Keywords: Tachyarrhythmia; Tachycardia; Atrial; Auricular; Fibrilation; Flutter; Sinusal; Electrocardiography.
Czech Academy of Sciences Publication Activity Database
Gourdie, R. G.; Sedmera, David
2008-01-01
Roč. 118, - (2008), e106-e106 ISSN 0009-7322 Institutional research plan: CEZ:AV0Z50450515 Keywords : conduction system * heart development * atrioventricular canal Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 14.595, year: 2008
Yanni, Joseph; Maczewski, Michal; Mackiewicz, Urszula; Siew, Samuel; Fedorenko, Olga; Atkinson, Andrew; Price, Marcus; Beresewicz, Andrzej; Anderson, Robert H; Boyett, Mark R; Dobrzynski, Halina
2014-07-01
Heart failure (HF) causes dysfunction of the atrioventricular node (AVN) - first or second-degree heart block is a risk factor for sudden cardiac death in HF patients. The aim of the study was to determine if HF causes remodelling of the AVN and right atrioventricular ring (RAVR). HF was induced in rats (n=4) by ligation of the proximal left coronary artery, which resulted in a large infarct of the left ventricle. Sham-operated rats (n=4) were used as controls. Eight weeks after surgery, functional experiments were performed and the hearts were frozen. The body weight of HF rats was similar to control rats, but the mean heart weight of HF rats was significantly enlarged. In HF rats compared to controls, the left ventricle was dilated, left ventricular end-diastolic pressure elevated (21.0 ± 0.6 and 5.4 ± 0.2 mm Hg), left ventricular ejection fraction reduced (0.2 ± 0.02 and 0.5 ± 0.02) and left ventricular end-systolic pressure reduced (102 ± 4.2 and 127 ± 3.1 mm Hg). In HF rats, the in vivo and in vitro PR intervals were increased (41% and 20%), as was the Wenckebach cycle length, indicative of AVN dysfunction. The collagen content was significantly increased in the AVN and RAVR indicating fibrosis. Immunolabelling of caveolin3 (cell membrane marker) showed that there was hypertrophy in HF (cell diameter was increased by 63%, 39% in AVN, RAVR). The TUNEL assay showed that the myocytes of the AVN and RAVR in HF undergo apoptotic cell death. Immunolabelling showed that expression of HCN4 was significantly decreased in the AVN and RAVR (43% and 47%) in HF. We conclude that in HF there is remodelling of the AVN and RAVR and this remodelling may explain the AVN dysfunction.
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Kordic Kresimir
2018-03-01
Full Text Available Fascicular left ventricular tachycardia (VT is the second most frequent idiopathic left VT in the setting of a structurally normal heart. Catheter ablation is curative in most patients with low complication rates. We report a case of ostial left anterior descending coronary artery (LAD occlusion during fascicular ventricular tachycardia ablation.
Chorro, F J; Sanchis, J; Such, L; Artal, L; Llavador, J J; Llavador, E; Monmeneu, J V; López-Merino, V
1997-05-01
An analysis was made in 14 isolated and perfused rabbit hearts of the electrophysiological effects of selective radiofrequency (RF) delivery in the anterior (group I, n = 7) or posterior zone (group II, n = 7) of the Koch triangle, with the aim of modifying atrioventricular nodal (AVN) conduction without suppressing 1:1 transmission. After opening the right atrium, RF was delivered (0.5 W) with a 1-mm diameter unipolar electrode positioned in the selected zone until a prolongation of no less than 15% was obtained in the Wenckebach cycle length (WCL). Before and after (30 min) RF, anterograde and retrograde AVN refractoriness and conduction were evaluated, stimulating from the crista terminalis (CT), the interatrial septum (IAS), and from the RV epicardium. After RF, the following percentage increments were observed in group I: AH(CT) = 36% +/- 9%, AH(IAS) = 38% +/- 11%, WCL(CT) = 28% +/- 8%, WCL(IAS) = 22% +/- 6%, functional refractory period (FRP) of the AVN(CT) = 13% +/- 11%, FRP-AVN(IAS) = 13% +/- 8%, retrograde WCL = 20% +/- 19%, and retrograde FRPVA = 13% +/- 16%. The increments observed in group II and the significances of the differences with respect to group I were: AH(CT) = 11% +/- 14% (P IAS) = 19% +/- 32% (NS), WCL(CT) = 42% +/- 14% (P IAS) = 42% +/- 16% (P < 0.01), FRP-AVN(CT) = 28% +/- 28% (NS), FRP-AVN(LAS) = 21% +/- 19% (NS), retrograde WCL = 35% +/- 24% (NS), and retrograde FRP = 16% +/- 13% (NS). In both groups, the AH interval variations were not correlated with those of the rest of the parameters analyzed. Truncated nodal function curves suggestive of a dual AV nodal pathway were obtained in three experiments, though in only one of them was this observed under basal conditions. In the other two experiments, with dual AV nodal physiology only after RF (one from each group), AV nodal reentrant tachycardias were triggered with atrial extrastimulus at coupling intervals equal to or shorter than at those that cause a sudden lengthening of the AH
Congenital intermittent atrio-ventricular dissociation in tetralogy of Fallot (a case report.
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Karande S
1991-01-01
Full Text Available A case of tetralogy of fallot with congenital intermittent atrioventricular dissociation is reported. A review of standard postgraduate books of cardiology fails to describe this condition, thus showing its extreme rarity. The therapeutic dilemma in treating such a case is also discussed.
Perioperative care of an adolescent with postural orthostatic tachycardia syndrome
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Kernan Scott
2010-01-01
Full Text Available Postural orthostatic tachycardia syndrome (POTS is a disorder characterized by postural tachycardia in combination with orthostatic symptoms without associated hypotension. Symptoms include light-headedness, palpitations, fatigue, confusion, and anxiety, which are brought on by assuming the upright position and usually relieved by sitting or lying down. Given the associated autonomic dysfunction that occurs with POTS, various perioperative concerns must be considered when providing anesthetic care for such patients. We present an adolescent with POTS who required anesthetic care during posterior spinal fusion for the treatment of scoliosis. The potential perioperative implications of this syndrome are discussed.
Jones, Charles W.
1981-04-07
A machine for pressing loose powder into pellets using a series of reciprocating motions has an interchangeable punch and die as its only accurately machines parts. The machine reciprocates horizontally between powder receiving and pressing positions. It reciprocates vertically to press, strip and release a pellet.
Surgical ablation of ventricular tachycardia secondary to congenital ventricular septal aneurysm.
Graffigna, A; Minzioni, G; Ressia, L; Vigano, M
1994-04-01
Three patients underwent surgical ablation for ventricular tachycardia resulting from an aneurysm of the membranous portion of the ventricular septum. Two patients had a definite history of cardiac murmur during infancy, and one of them was found at the time of operation to have a left-to-right shunt through the apex of the aneurysm. The earliest ventricular activation sites were located around the neck of the aneurysm and were ablated in 1 patient by encircling the endocardial ventriculotomy and by cryoablation in the remaining 2. After focus resection had been completed, aneurysm resection and ventricular septal reconstruction were performed. All patients were alive and free of ventricular tachycardia and did not need medication as of 61, 66, and 88 months postoperatively. Spontaneous closure of a ventricular septal defect may lead to the formation of an aneurysm in the ventricular septum that may sustain ventricular tachycardias. Such arrhythmias can be effectively treated using electrically guided surgical techniques.
Lin, J L; Schie, J T; Tseng, C D; Chen, W J; Cheng, T F; Tsou, S S; Chen, J J; Tseng, Y Z; Lien, W P
1995-01-01
Despite similar guidance by local electrogram criteria, catheter ablation of right-sided accessory atrioventricular (AV) pathways by radiofrequency current has been less effective than that of left-sided ones. In order to elucidate the possible diversities in local electrosignal criteria, we systematically analyzed the morphological and timing characteristics of 215 bipolar local electrograms from catheter ablation sites of 65 left-sided accessory AV pathways and of 356 from those of 37 right-sided ones in 92 consecutive patients with Wolff-Parkinson-White syndrome or AV reentrant tachycardia incorporating concealed accessory AV pathways. After stepwise multivariate analysis, we selected the presence of a possible accessory pathway potential, local ventricular activation preceding QRS complex for 20 ms or more during ventricular insertion mapping, and the local retrograde ventriculoatrial (VA) continuity, local retrograde VA interval right-sided targets only) during atrial insertion mapping, as independent local electrogram predictors for successful ablation of left- and right-sided accessory AV pathways. Combination of all local electrogram predictors could have moderate chance of success (80 and 51%) for the ventricular and atrial insertion ablation of left-sided accessory AV pathways, but only low probability of success (40% in ventricular insertion ablation) or very low sensitivity (12.5% in atrial insertion ablation) for right-sided ones. In conclusion, with the present approach, successful catheter ablation of right-sided accessory AV pathways, compared to left-sided ones, still necessitate a breakthrough in the precision mapping and the efficiency of energy delivery.
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Brock, Malcolm, E-mail: mabrock@jhmni.edu [Johns Hopkins University, Department of Thoracic Surgery, Center for Sweat Disorders (United States); Chung, Tae Hwan, E-mail: Tchang7@jhmi.edu [Johns Hopkins University, Physical Medicine and Rehabilitation (United States); Gaddam, Sathvika Reddy, E-mail: drsathvikareddy@yahoo.com; Kathait, Anjaneya Singh, E-mail: askathait@gmail.com [Johns Hopkins University, Vascular & Interventional Radiology (United States); Ober, Cecily, E-mail: ceober21@gmail.com [Johns Hopkins University, Department of Thoracic Surgery (United States); Georgiades, Christos, E-mail: cgeorgi@jhmi.edu [Johns Hopkins University, Vascular & Interventional Radiology (United States)
2016-12-15
Postural orthostatic tachycardia syndrome is characterized by orthostatic intolerance. Orthostasis (or other mild physical stress) triggers a cascade of inappropriate tachycardia, lightheadedness, palpitations, and often fainting. The underlying defect is sympathetic dysregulation of the heart, which receives its sympathetic tone from the cervical and upper thoracic sympathetic ganglia. Primary hyperhidrosis is also thought to be the result of sympathetic dysregulation. We present the case of a patient treated with CT-guided, percutaneous T2 EtOH sympatholysis for craniofacial hyperhidrosis. The patient also suffered from postural orthostatic tachycardia syndrome for many years and was unresponsive to treatment. Immediately after sympatholysis, the patient experienced resolution of both craniofacial hyperhidrosis and postural orthostatic tachycardia syndrome.
Reciprocity of weighted networks.
Squartini, Tiziano; Picciolo, Francesco; Ruzzenenti, Franco; Garlaschelli, Diego
2013-01-01
In directed networks, reciprocal links have dramatic effects on dynamical processes, network growth, and higher-order structures such as motifs and communities. While the reciprocity of binary networks has been extensively studied, that of weighted networks is still poorly understood, implying an ever-increasing gap between the availability of weighted network data and our understanding of their dyadic properties. Here we introduce a general approach to the reciprocity of weighted networks, and define quantities and null models that consistently capture empirical reciprocity patterns at different structural levels. We show that, counter-intuitively, previous reciprocity measures based on the similarity of mutual weights are uninformative. By contrast, our measures allow to consistently classify different weighted networks according to their reciprocity, track the evolution of a network's reciprocity over time, identify patterns at the level of dyads and vertices, and distinguish the effects of flux (im)balances or other (a)symmetries from a true tendency towards (anti-)reciprocation.
Evolution and scaling of atrioventricular conduction time in mammals. [Pt. 1
Meijler, F.L.; Strackee, J.
2006-01-01
Scaling can be defined as the adjustment of a structure, a function, or an organ to the size of the mammalian body. An example is the size of the heart in relation to the size of the body. The duration of the PR interval on the electrocardiogram (atrioventricular delay) in relation to the size of
Directory of Open Access Journals (Sweden)
Carla Tanamati
2006-09-01
Full Text Available Os defeitos do septo atrioventricular total (DSAVT representam 4% das mal formações cardíacas e acima de 50% dos defeitos observados na síndrome de Down (SD¹. A apresentação clínica é de insuficiência cardíaca precoce na infância e hipertensão pulmonar por hiperfluxo. Raramente a cianose é observada e sugere hipertensão pulmonar ou associação à tetralogia de Fallot³, dupla via de saída de ventrículo direito², anomalia de Ebstein4, drenagem anômala de cava esquerda persistente em átrio esquerdo (Barbero Marcial, comunicação pessoal. Crianças com SD são particularmente difíceis de avaliação por apresentarem obstrução de vias aéreas superiores, que podem contribuir com o aumento da resistência pulmonar observada no cateterismo cardíaco. A presença de cianose pré-operatória constitui-se um desafio ao tratamento cirúrgico devido ao risco de hipertensão pulmonar irreversível com falência ventricular direita com, a correção dos defeitos intracardíacos.Atrioventricular septal defects account for 4% of congenital cardiac malformations and over 50% of cardiac defects seen in Down syndrome¹. Clinical presentation is marked by congestive heart failure early in infancy. Cyanosis is rarely found in infants and suggests irreversible pulmonary hypertension or associated cardiac defects as tetralogy of Fallot, double outlet right ventricle², Ebstein anomaly³, persistent left superior vena cava draining in the left atrium (Barbero Marcial, personal communication. Children with Down's syndrome is particularly difficult to assess because they often suffer from upper airways obstruction4, which may contribute to the increased pulmonary vascular resistance determined at cardiac catheterization. This association of factors becomes a challenge for operability and, we will report one such case.
Wnt signaling regulates atrioventricular canal formation upstream of BMP and Tbx2
Verhoeven, Manon C.; Haase, Christa; Christoffels, Vincent M.; Weidinger, Gilbert; Bakkers, Jeroen
2011-01-01
In the developing heart, the atrioventricular canal (AVC) is essential for separation and alignment of the cardiac chambers, for valve formation, and serves to delay the electrical impulse from the atria to the ventricles. Defects in various aspects of its formation are the most common form of
Congenital and childhood atrioventricular blocks: pathophysiology and contemporary management.
Baruteau, Alban-Elouen; Pass, Robert H; Thambo, Jean-Benoit; Behaghel, Albin; Le Pennec, Solène; Perdreau, Elodie; Combes, Nicolas; Liberman, Leonardo; McLeod, Christopher J
2016-09-01
Atrioventricular block is classified as congenital if diagnosed in utero, at birth, or within the first month of life. The pathophysiological process is believed to be due to immune-mediated injury of the conduction system, which occurs as a result of transplacental passage of maternal anti-SSA/Ro-SSB/La antibodies. Childhood atrioventricular block is therefore diagnosed between the first month and the 18th year of life. Genetic variants in multiple genes have been described to date in the pathogenesis of inherited progressive cardiac conduction disorders. Indications and techniques of cardiac pacing have also evolved to allow safe permanent cardiac pacing in almost all patients, including those with structural heart abnormalities. Early diagnosis and appropriate management are critical in many cases in order to prevent sudden death, and this review critically assesses our current understanding of the pathogenetic mechanisms, clinical course, and optimal management of congenital and childhood AV block. • Prevalence of congenital heart block of 1 per 15,000 to 20,000 live births. AV block is defined as congenital if diagnosed in utero, at birth, or within the first month of life, whereas childhood AV block is diagnosed between the first month and the 18th year of life. As a result of several different etiologies, congenital and childhood atrioventricular block may occur in an entirely structurally normal heart or in association with concomitant congenital heart disease. Cardiac pacing is indicated in symptomatic patients and has several prophylactic indications in asymptomatic patients to prevent sudden death. • Autoimmune, congenital AV block is associated with a high neonatal mortality rate and development of dilated cardiomyopathy in 5 to 30 % cases. What is New: • Several genes including SCN5A have been implicated in autosomal dominant forms of familial progressive cardiac conduction disorders. • Leadless pacemaker technology and gene therapy for
Mirror Image Gerbode or Partial Atrioventricular Canal Defect?
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Cem Ariturk
2015-12-01
Full Text Available Gebode defect, that can accurately be treated surgical repair, is defined as a true communication between left ventricle and right atrium. A 74-year-old woman with a worsening history of ortophnea and peripheral edema was hospitalised. A communication between right atrium and left ventricle was diagnosed using transeusophageal echocardiography. The defect was repaired and mitral valve was replaced with a biologic valve. It would be beter to tailor surgical strategy for each case with atrioventricular canal defect after preoperative transeusophageal echocardiography and peroperative direct sight.
The personal norm of reciprocity
Perugini, M.; Gallucci, M.; Presaghi, F.; Ercolani, A.P.
2002-01-01
Reciprocity is here considered as an internalized social norm, and a questionnaire to measure individual differences in the internalized norm of reciprocity is presented. The questionnaire, Personal Norm of Reciprocity (PNR), measures three aspects of reciprocity: positive reciprocity, negative
[Complete atrioventricular block in Duchenne muscular dystrophy].
Kuru, Satoshi; Tanahashi, Tamotsu; Matsumoto, Shinjirou; Kitamura, Tetsuya; Konagaya, Masaaki
2012-01-01
We report a case of complete atrioventricular (AV) block in a 40-year-old patient with Duchenne muscular dystrophy (DMD). While he was bed-ridden and required mechanical ventilation, his cardiac involvement was mild. He had the deletion of exon 45-52 in the dystrophin gene. He underwent transient complete AV block and came to require pacemaker implantation due to recurrence of complete AV block ten days after the first attack. Electrophysiological study revealed mild prolonged AH and HV interval. Although DMD patients with AV block have been rarely reported so far, attention should be paid to AV block for patients who prolonged their lives.
His-Purkinje system-related incessant ventricular tachycardia arising from the left coronary cusp
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Eiji Sato, MD
2014-08-01
Full Text Available We describe the case of a 23-year-old woman who had His-Purkinje system-related incessant ventricular tachycardia with a narrow QRS configuration. The ventricular tachycardia was ablated successfully in the left coronary cusp where the earliest endocardial activation had been recorded. We hypothesize that a remnant of the subaortic conducting tissue was the source of the ventricular arrhythmias.
Ischemic stroke associated with radio frequency ablation for nodal reentry
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Diaz M, Juan C; Duran R, Carlos E; Perafan B, Pablo; Pava M, Luis F
2010-01-01
Atrioventricular nodal reentry tachycardia is the most common type of paroxysmal supraventricular tachycardia. In those patients in whom drug therapy is not effective or not desired, radio frequency ablation is an excellent therapeutic method. Although overall these procedures are fast and safe, several complications among which ischemic stroke stands out, have been reported. We present the case of a 41 year old female patient with repetitive episodes of tachycardia due to nodal reentry who was treated with radiofrequency ablation. Immediately after the procedure she presented focal neurologic deficit consistent with ischemic stroke in the right medial cerebral artery territory. Angiography with angioplastia and abxicimab was performed and then tissue plasminogen activator (rtPA) was locally infused, with appropriate clinical and angiographic outcome.
Full Atrioventricular Block Secondary to Acute Poisoning Mercury: A Case Report
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Amelia Geraldine Peregrina-Chávez
2018-04-01
Full Text Available Background: The biological behaviour and clinical significance of mercury toxicity vary according to its chemical structure. Mercury differs in its degree of toxicity and in its effects on the nervous, digestive and immune systems as well as on organs such as the lungs, kidneys, skin, eyes and heart. Human exposure occurs mainly through inhalation of elemental mercury vapours during industrial and artisanal processes such as artisanal and small-scale gold mining. Case presentation: A 52-years-old female, housewife, with a body mass index of 25.3 kg/cm2, without smoking or alcohol habits or any important clinical or chronic cardiovascular history, was admitted to the emergency room due to probable accidental poisoning by butane gas. Clinical manifestations with a headache, dizziness, cough, and dyspnoea of medium to small efforts. An initial physical exploration with Glasgow scored at 15, with arrhythmic heart sounds, pulmonary fields with bilateral subcrepitant rales and right basal predominance. Electrocardiographic findings were as follows: a cardiac frequency of 50 beats per minute and atrioventricular dissociation. Laboratory parameters were: white blood cells at 15.8 × 109/L; aspartate aminotransferase at 38 U/L; lactate dehydrogenase at 1288 U/L; creatine-kinase at 115 U/L; CK-MB fraction at 28 U/L; and other biochemical parameters were within the reference values. A radiographic evaluation showed flow cephalization, diffuse bilateral infiltrates with right basal predominance. In addition, the patient presented data of low secondary expenditure to third-degree atrioventricular (AV block for which the placement of a transvenous pacemaker was decided, substantially improving the haemodynamic parameters. Subsequently, after a family interrogation, the diagnosis of mercury inhalation poisoning was established. An initial detection of mercury concentration (Hg(0 was carried out, reporting 243.5 µg/L. In view of this new evidence, mercury
Prognostic significance of nonsustained ventricular tachycardia after revascularization.
Mittal, Suneet; Lomnitz, David J; Mirchandani, Sunil; Stein, Kenneth M; Markowitz, Steven M; Slotwiner, David J; Iwai, Sei; Das, Mithilesh K; Lerman, Bruce B
2002-04-01
Two randomized trials (Multicenter Automatic Defibrillator Implantation Trial [MADIT] and Multicenter Unsustained Tachycardia Trial [MUSTT]) suggest that implantable cardioverter defibrillator (ICD) placement is associated with improved survival in patients with coronary artery disease, depressed left ventricular function, and nonsustained ventricular tachycardia (VT) who also have inducible sustained VT. However, neither study directly addresses the management of such patients who develop nonsustained VT early after revascularization. We evaluated 109 consecutive patients who underwent electrophysiologic testing to evaluate nonsustained VT, which occurred 5 +/- 4 days following revascularization. Sustained monomorphic VT was inducible in 46 (42%) patients; these patients received an ICD. The remaining 63 (58%) noninducible patients received neither antiarrhythmic drug therapy nor an ICD. During 27 +/- 12 months of follow-up, 15 (33%) of 45 patients with an implanted ICD received at least one appropriate therapy from the device and 26 (24%) of the 109 study patients died. The 1- and 2-year freedom from ventricular tachycardia/fibrillation or sudden death in noninducible patients (97% and 93%) was significantly greater than that of inducible patients (84% and 71%; P = 0.001). However, no difference was observed in total mortality. Patients with nonsustained VT during the early postrevascularization period who have inducible VT have a high incidence of arrhythmic events. Although this study was not designed to assess the impact of ICD placement on the total mortality of inducible patients, the finding that one third of these patients received appropriate ICD therapy suggests that the device may have a protective effect in these patients.
Learning electrocardiogram on YouTube: how useful is it?
Akgun, Taylan; Karabay, Can Yucel; Kocabay, Gonenc; Kalayci, Arzu; Oduncu, Vecih; Guler, Ahmet; Pala, Selcuk; Kirma, Cevat
2014-01-01
YouTube has become a useful resource for knowledge and is widely used by medical students as an e-learning source. The purpose of this study was to assess the videos relating electrocardiogram (ECG) on YouTube. YouTube was searched on May 28, 2013 for the search terms "AF ecg" for atrial fibrillation, "AVNRT" for atrioventricular nodal reentrant tachycardia, "AVRT" for atrioventricular reentrant tachycardia, "AV block or heart block" for atrioventricular block, "LBBB, RBBB" for bundle branch block, "left anterior fascicular block or left posterior fascicular block" for fascicular blocks, "VT ecg" for ventricular tachycardia, "long QT" and "Brugada ecg". Non-English language, unrelated and non-educational videos were excluded. Remaining videos were assessed for usefulness, source and characteristics. Usefulness was assessed with using a checklist developed by the authors. One hundred nineteen videos were included in the analysis. Sources of the videos were as follows: individuals n=70, 58.8%, universities/hospitals n=10, 8.4% and medical organizations n=3, 2.5%, health ads n=10 8.4%, health websites n=26, 21.8%. Fifty-six (47.1%) videos were classified as very useful and 16 (13.4%) videos were misleading. 90% of the videos uploaded by universities/hospitals were grouped as very useful videos, the same ratio was 45% for the individual uploads. There were statistically significant differences in ECG diagnosis among the groups (for very useful, useful and misleading, pYouTube has a substantial amount of videos on ECG with a wide diversity from useful to misleading content. The lack of quality content relating to ECG on YouTube necessitates that videos should be selected with utmost care. © 2013 Elsevier Inc. All rights reserved.
Supraventricular Tachycardia Atackt Due to Losewieght Drug
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Murat Yalcin
2016-01-01
Full Text Available Obesity is an important health problem. Treatment of obesity includes diet, exercise and drugs. Some of these drugs are out of prescription. Advers effects of these drugs have not been known. In this report; we present a case with supraventricular tachycardia attack due to loseweight drug containing mangostana (mango, hibiscus, citrus mate, L-karnitin, guarana.
Treatment of out-of-hospital supraventricular tachycardia: adenosine vs verapamil.
Brady, W J; DeBehnke, D J; Wickman, L L; Lindbeck, G
1996-06-01
To compare the use of adenosine and the use of verapamil as out-of-hospital therapy for supraventricular tachycardia (SVT). A period of prospective adenosine use (March 1993 to February 1994) was compared with a historical control period of verapamil use (March 1990 to February 1991) for SVT. Data were obtained for SVT patients treated in a metropolitan, fire-department-based paramedic system serving a population of approximately 1 million persons. Standard drug protocols were used and patient outcomes (i.e., conversion rates, complications, and recurrences) were monitored. During the adenosine treatment period, 105 patients had SVT; 87 (83%) received adenosine, of whom 60 (69%) converted to a sinus rhythm (SR). Vagal maneuvers (VM) resulted in restoration of SR in 8 patients (7.6%). Some patients received adenosine for non-SVT rhythms: 7 sinus tachycardia, 18 atrial fibrilation, 7 wide-complex tachycardia (WCT), and 2 ventricular tachycardia; no non-SVT rhythm converted to SR and none of these patients experienced an adverse effect. Twenty-five patients were hemodynamically unstable (systolic blood pressure fibrillation). Recurrence of SVT was noted in 2 adenosine patients and 2 verapamil patients in the out-of-hospital setting and in 23 adenosine patients and 15 verapamil patients after ED arrival, necessitating additional therapy (p = 0.48 and 0.88, for recurrence rates and types of additional therapies, respectively). Hospital diagnoses, outcomes, and ED dispositions were similar for the 2 groups. Adenosine and verapamil were equally successful in converting out-of-hospital SVT in patients with similar etiologies responsible for the SVT. Recurrence of SVT occurred at similar rates for the 2 medications. Rhythm misidentification remains a common issue in out-of-hospital cardiac care in this emergency medical services system.
Electrocardiogram artifact caused by rigors mimicking narrow complex tachycardia: a case report.
Matthias, Anne Thushara; Indrakumar, Jegarajah
2014-02-04
The electrocardiogram (ECG) is useful in the diagnosis of cardiac and non-cardiac conditions. Rigors due to shivering can cause electrocardiogram artifacts mimicking various cardiac rhythm abnormalities. We describe an 80-year-old Sri Lankan man with an abnormal electrocardiogram mimicking narrow complex tachycardia during the immediate post-operative period. Electrocardiogram changes caused by muscle tremor during rigors could mimic a narrow complex tachycardia. Identification of muscle tremor as a cause of electrocardiogram artifact can avoid unnecessary pharmacological and non-pharmacological intervention to prevent arrhythmias.
Junctional ectopic tachycardia following repair of congenital heart ...
African Journals Online (AJOL)
Background: Postoperative junctional ectopic tachycardia (JET) is a rare and transient phenomenon occurring after repair of congenital heart defects. Report on this arrhythmia in the subregion is rare. We set out to determine the incidence of this arrhythmia and review the treatment and outcomes of treatment in our centre.
Beroukhim, Rebecca S; Reed, John H; Schaffer, Michael S; Yetman, Anji T
2006-01-01
We describe the case of a 3-year-old child with neonatal Marfan syndrome complicated by mitral valve prolapse with regurgitation, marked aortic root dilatation, and ventricular tachycardia. The patient had resolution of ventricular tachycardia following surgical intervention consisting of a valve-sparing aortic root replacement and mitral valve annuloplasty.
Arai, Masaru; Nagashima, Koichi; Kato, Mahoto; Akutsu, Naotaka; Hayase, Misa; Ogura, Kanako; Iwasawa, Yukino; Aizawa, Yoshihiro; Saito, Yuki; Okumura, Yasuo; Nishimaki, Haruna; Masuda, Shinobu; Hirayama, Atsushi
2016-01-01
Patient: Male, 74 Final Diagnosis: Infective endocarditis Symptoms: Apetite loss ? fever Medication: ? Clinical Procedure: Transesophageal echocardiography Specialty: Cardiology Objective: Rare co-existance of disease or pathology Background: Infective endocarditis (IE) involving the mitral valve can but rarely lead to complete atrioventricular block (CAVB). Case Report: A 74-year-old man with a history of infective endocarditis caused by Streptococcus gordonii (S. gordonii) presented to our ...
Left cardiac sympathetic denervation for catecholaminergic polymorphic ventricular tachycardia
Wilde, Arthur A. M.; Bhuiyan, Zahurul A.; Crotti, Lia; Facchini, Mario; de Ferrari, Gaetano M.; Paul, Thomas; Ferrandi, Chiara; Koolbergen, Dave R.; Odero, Attilio; Schwartz, Peter J.
2008-01-01
Catecholaminergic polymorphic ventricular tachycardia is a potentially lethal disease characterized by adrenergically mediated ventricular arrhythmias manifested especially in children and teenagers. Beta-blockers are the cornerstone of therapy, but some patients do not have a complete response to
Energy Technology Data Exchange (ETDEWEB)
Aldridge, David F.
2014-11-01
A reciprocity theorem is an explicit mathematical relationship between two different wavefields that can exist within the same space - time configuration. Reciprocity theorems provi de the theoretical underpinning for mod ern full waveform inversion solutions, and also suggest practical strategies for speed ing up large - scale numerical modeling of geophysical datasets . In the present work, several previously - developed electromagnetic r eciprocity theorems are generalized to accommodate a broader range of medi um, source , and receiver types. Reciprocity relations enabling the interchange of various types of point sources and point receivers within a three - dimensional electromagnetic model are derived. Two numerical modeling algorithms in current use are successfully tested for adherence to reciprocity. Finally, the reciprocity theorem forms the point of departure for a lengthy derivation of electromagnetic Frechet derivatives. These mathe matical objects quantify the sensitivity of geophysical electromagnetic data to variatio ns in medium parameters, and thus constitute indispensable tools for solution of the full waveform inverse problem. ACKNOWLEDGEMENTS Sandia National Labor atories is a multi - program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the US Department of Energy's National Nuclear Security Administration under contract DE - AC04 - 94AL85000. Signif icant portions of the work reported herein were conducted under a Cooperative Research and Development Agreement (CRADA) between Sandia National Laboratories (SNL) and CARBO Ceramics Incorporated. The author acknowledges Mr. Chad Cannan and Mr. Terry Pa lisch of CARBO Ceramics, and Ms. Amy Halloran, manager of SNL's Geophysics and Atmospheric Sciences Department, for their interest in and encouragement of this work. Special thanks are due to Dr . Lewis C. Bartel ( recently retired from Sandia National Labo ratories
K-groups of reciprocity functors
Ivorra, Florian; Rülling, Kay
2012-01-01
In this work we introduce reciprocity functors, construct the associated K-group of a family of reciprocity functors, which itself is a reciprocity functor, and compute it in several different cases. It may be seen as a first attempt to get close to the notion of reciprocity sheaves imagined by B. Kahn. Commutative algebraic groups, homotopy invariant Nisnevich sheaves with transfers, cycle modules or K\\"ahler differentials are examples of reciprocity functors. As commutative algebraic groups...
Mutations in calmodulin cause ventricular tachycardia and sudden cardiac death
DEFF Research Database (Denmark)
Nyegaard, Mette; Overgaard, Michael Toft; Sondergaard, M.T.
2012-01-01
a substantial part of sudden cardiac deaths in young individuals. Mutations in RYR2, encoding the cardiac sarcoplasmic calcium channel, have been identified as causative in approximately half of all dominantly inherited CPVT cases. Applying a genome-wide linkage analysis in a large Swedish family with a severe......Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a devastating inherited disorder characterized by episodic syncope and/or sudden cardiac arrest during exercise or acute emotion in individuals without structural cardiac abnormalities. Although rare, CPVT is suspected to cause...... calmodulin-binding-domain peptide at low calcium concentrations. We conclude that calmodulin mutations can cause severe cardiac arrhythmia and that the calmodulin genes are candidates for genetic screening of individual cases and families with idiopathic ventricular tachycardia and unexplained sudden cardiac...
Tbx20 interacts with smads to confine tbx2 expression to the atrioventricular canal
Singh, Reena; Horsthuis, Thomas; Farin, Henner F.; Grieskamp, Thomas; Norden, Julia; Petry, Marianne; Wakker, Vincent; Moorman, Antoon F. M.; Christoffels, Vincent M.; Kispert, Andreas
2009-01-01
RATIONALE: T-box transcription factors play critical roles in the coordinated formation of the working chambers and the atrioventricular canal (AVC). Tbx2 patterns embryonic myocardial cells to form the AVC and suppresses their differentiation into chamber myocardium. Tbx20-deficient embryos, which
Reciprocity is not give and take: asymmetric reciprocity to positive and negative acts.
Keysar, Boaz; Converse, Benjamin A; Wang, Jiunwen; Epley, Nicholas
2008-12-01
Unlike economic exchange, social exchange has no well-defined "value." It is based on the norm of reciprocity, in which giving and taking are to be repaid in equivalent measure. Although giving and taking are colloquially assumed to be equivalent actions, we demonstrate that they produce different patterns of reciprocity. In five experiments utilizing a dictator game, people reciprocated in like measure to apparently prosocial acts of giving, but reciprocated more selfishly to apparently antisocial acts of taking, even when the objective outcomes of the acts of giving and taking were identical. Additional results demonstrate that acts of giving in social exchanges are perceived as more generous than objectively identical acts of taking, that taking tends to escalate, and that the asymmetry in reciprocity is not due to gaining versus losing resources. Reciprocity appears to operate on an exchange rate that assigns value to the meaning of events, in a fashion that encourages prosocial exchanges.
DEFF Research Database (Denmark)
Sebald, Alexander Christopher
2010-01-01
, in turn, influence behavior. Dufwenberg and Kirchsteiger [Dufwenberg, M., Kirchsteiger, G., 2004. A theory of sequential reciprocity. Games Econ. Behav. 47 (2), 268-298] formalize this empirical finding in their ‘theory of sequential reciprocity'. This paper extends their analysis by moves of chance. More...... precisely, an extended framework is presented which allows for the analysis of strategic interactions of reciprocal agents in situations in which material outcomes also depend on chance. Moves of chance influence the attribution of responsibilities, people's perceptions about the (un)kindness of others and......, hence, their reciprocal behavior. Furthermore, with the help of two applications it is demonstrated how this framework can be used to explain experimental findings showing that people react very differently in outcomewise-identical situations depending on the moves of chance involved....
Atrioventricular depolarization differences identify coronary artery anomalies in Kawasaki disease.
Cortez, Daniel; Sharma, Nandita; Jone, Pei-Ni
2017-03-01
Kawasaki disease (KD) is the leading cause of acquired heart disease in children. Signal average electrocardiogram changes in patients during the acute phase of KD with coronary artery anomalies (CAA) include depolarization changes. We set out to determine if 12-lead-derived atrioventricular depolarization differences can identify CAA in patients with KD. A blinded, retrospective case-control study of patients with KD was performed. Deep Q waves, corrected QT-intervals (QTc), spatial QRS-T angles, T-wave vector magnitudes (RMS-T), and a novel parameter for assessment of atrioventricular depolarization difference (the spatial PR angle) and a two dimensional PR angle were assessed. Comparisons between groups were performed to test for significant differences. One hundred one patients with KD were evaluated, with 68 having CAA (67.3%, mean age 3.6 ± 3.0 years, 82.6% male), and 32 without CAA (31.7%, mean age 2.7 ± 3.2 years, 70.4% male). The spatial PR angle significantly discriminated KD patients with CAA from those without, 59.7° ± 31.1° versus 41.6° ± 11.5° (p differences, measured by the spatial or two dimensional PR angle differentiate KD patients with CAA versus those without. © 2016 Wiley Periodicals, Inc.
The neural correlates of reciprocity are sensitive to prior experience of reciprocity.
Cáceda, Ricardo; Prendes-Alvarez, Stefania; Hsu, Jung-Jiin; Tripathi, Shanti P; Kilts, Clint D; James, G Andrew
2017-08-14
Reciprocity is central to human relationships and is strongly influenced by multiple factors including the nature of social exchanges and their attendant emotional reactions. Despite recent advances in the field, the neural processes involved in this modulation of reciprocal behavior by ongoing social interaction are poorly understood. We hypothesized that activity within a discrete set of neural networks including a putative moral cognitive neural network is associated with reciprocity behavior. Nineteen healthy adults underwent functional magnetic resonance imaging scanning while playing the trustee role in the Trust Game. Personality traits and moral development were assessed. Independent component analysis was used to identify task-related functional brain networks and assess their relationship to behavior. The saliency network (insula and anterior cingulate) was positively correlated with reciprocity behavior. A consistent array of brain regions supports the engagement of emotional, self-referential and planning processes during social reciprocity behavior. Published by Elsevier B.V.
Rayleigh reciprocity relations: Applications
International Nuclear Information System (INIS)
Lin Ju; Li Xiao-Lei; Wang Ning
2016-01-01
Classical reciprocity relations have wide applications in acoustics, from field representation to generalized optical theorem. In this paper we introduce our recent results on the applications and generalization of classical Rayleigh reciprocity relation: higher derivative reciprocity relations as a generalization of the classical one and a theoretical proof on the Green’s function retrieval from volume noises. (special topic)
Jegatheeswaran, Anusha; Pizarro, Christian; Caldarone, Christopher A; Cohen, Meryl S; Baffa, Jeanne M; Gremmels, David B; Mertens, Luc; Morell, Victor O; Williams, William G; Blackstone, Eugene H; McCrindle, Brian W; Overman, David M
2010-09-14
Although identification of unbalanced atrioventricular septal defect (AVSD) is obvious when extreme, exact criteria to define the limits of unbalanced are not available. We sought to validate an atrioventricular valve index (AVVI) (left atrioventricular valve area/total atrioventricular valve area, centimeters squared) as a discriminator of balanced and unbalanced forms of complete AVSD and to characterize the association of AVVI with surgical strategies and outcomes. Diagnostic echocardiograms and hospital records of 356 infants with complete AVSD at 4 Congenital Heart Surgeons' Society (CHSS) institutions (2000-2006) were reviewed and AVVI measured (n=315). Patients were classified as unbalanced if AVVI≤0.4 (right dominant) or ≥0.6 (left dominant). Surgical strategy and outcomes were examined across the range of AVVI. Competing risks analysis until the time of commitment to a surgical strategy examined 4 end states: biventricular repair (BVR), univentricular repair (UVR), pulmonary artery banding (PAB), and death before surgery. A prediction nomogram for surgical strategy based on AVVI was developed. The majority of patients had balanced AVSD (0.4
Reciprocity, World Prices and Welfare
DEFF Research Database (Denmark)
Raimondos-Møller, Pascalis; Woodland, Alan D.
We examine in detail the circumstances under which reciprocity, as defined in Bagwell and Staiger (1999), leads to fixed world prices. We show that a change of tariffs satisfying reciprocity does not necessarily imply constant world prices in a world of many goods and countries. While it is possi...... of all countries, independently of whether world prices change and independently of the relative numbers of goods and countries.......We examine in detail the circumstances under which reciprocity, as defined in Bagwell and Staiger (1999), leads to fixed world prices. We show that a change of tariffs satisfying reciprocity does not necessarily imply constant world prices in a world of many goods and countries. While...... it is possible to find tariff reforms that are consistent with both reciprocity and constant world prices, these reforms do not follow from the reciprocity condition, but rather from the requirement of unchanged world prices. We propose an alternative reciprocity rule that is guaranteed to raise the welfare...
Role of ventricular tachycardia ablation in arrhythmogenic right ventricular cardiomyopathy
Directory of Open Access Journals (Sweden)
Alberto Cipriani
2017-11-01
Full Text Available Arrhythmogenic right ventricular cardiomyopathy (ARVC is characterized by progressive fibro-fatty replacement of the myocardium that represents the substrate for recurrent sustained ventricular tachycardia (VT. These arrhythmias characterize the clinical course of a sizeable proportion of patients and have significant implications for their quality of life and long-term prognosis. Antiarrhythmic drugs are often poorly tolerated and usually provide incomplete control of arrhythmia relapses. Catheter ablation is a potentially effective strategy to treat frequent VT episodes and ICD shocks in ARVC patients. The aims of this review are to discuss the electrophysiological and electroanatomic substrates of ventricular tachycardia in patients with ARVC and to analyze the role of catheter ablation in their management with particular reference to selection of patients, technical issues, potential complications and outcomes.
Electrocardiographic characteristics of atrioventricular block induced by tilt testing.
Zyśko, Dorota; Gajek, Jacek; Koźluk, Edward; Mazurek, Walentyna
2009-02-01
The electrocardiographic (ECG) characteristics of atrioventricular (AV) block during reflex syncope may be unique due to the presence of hypervagotonia. The aim of the present study was to define the ECG characteristics of the AV block induced by neurocardiogenic reflex provoked by tilt testing (TT). A series of 31 patients with presumed vasovagal syncope and AV block provoked by TT was studied. The duration of PP and PR interval, AV block grade and type, concomitant arrhythmias, and timing of the AV block occurrence were assessed. The AV block occurred at TT termination in 26 patients, in the recovery in 4 patients, and in both periods in 1 patient. Atrioventricular block was preceded by sinus slowing, and sinus rhythm during AV block was slow and instable. Mobitz I, 2:1 second-degree AV block, and advanced second-degree AV block were recognized in 35.5, 48.4, and 67.8% of patients, respectively. Third-degree AV block was diagnosed in 41.9% of patients. Twenty-one patients had at least two AV block forms. The most prevalent concomitant arrhythmia was junctional escape rhythm (61.3%). (i) The occurrence of the AV block during neurocardiogenic reaction induced by TT is always preceded by sinus rhythm slowing and usually by PR interval prolongation. (ii) The AV block provoked by TT usually occurs at TT termination, but may occur even in the recovery period in a supine position. Sometimes the AV block may be present both at TT termination and during the recovery period.
Directory of Open Access Journals (Sweden)
T Guo
2014-05-01
Full Text Available Objective: This study is to evaluate the feasibility and safety of intracardiac radiofrequency catheter ablation (RFCA of the atrioventricular node (AVN and pacemaker implantation using transthoracic echocardiography. Methods: Eleven patients – six males and five females (mean age 66 years – with persistent or permanent atrial fibrillation/atrial flutter received RFCA of AVN and VVI pacemaker implantation (paces and senses the ventricle and is inhibited if it senses ventricular activity. Under transthoracic echocardiography, the electrode catheters were positioned intracardiac, and target ablation was performed, with the permanent pacemaking catheter in the left subclavian vein and the ablation catheter in the right femoral vein. The multi-view imaging and dynamic observation applied during the stable AV dissociation were successful. Results: Atrioventricular node ablation and permanent pacemaker implantation in 11 patients were completed successfully without X-ray exposure. The operation success rate was 100%. All patients recovered well within the follow-up period. Conclusions: Radiofrequency catheter ablation of AVN and VVI pacemaker implantation under transthoracic echocardiography guidance is a safe, easy and feasible approach. This procedure could be an important supplemental measure to catheter ablation of arrhythmia under routine X-ray fluoroscopy.
Marmoset monkeys evaluate third-party reciprocity.
Kawai, Nobuyuki; Yasue, Miyuki; Banno, Taku; Ichinohe, Noritaka
2014-05-01
Many non-human primates have been observed to reciprocate and to understand reciprocity in one-to-one social exchanges. A recent study demonstrated that capuchin monkeys are sensitive to both third-party reciprocity and violation of reciprocity; however, whether this sensitivity is a function of general intelligence, evidenced by their larger brain size relative to other primates, remains unclear. We hypothesized that highly pro-social primates, even with a relatively smaller brain, would be sensitive to others' reciprocity. Here, we show that common marmosets discriminated between human actors who reciprocated in social exchanges with others and those who did not. Monkeys accepted rewards less frequently from non-reciprocators than they did from reciprocators when the non-reciprocators had retained all food items, but they accepted rewards from both actors equally when they had observed reciprocal exchange between the actors. These results suggest that mechanisms to detect unfair reciprocity in third-party social exchanges do not require domain-general higher cognitive ability based on proportionally larger brains, but rather emerge from the cooperative and pro-social tendencies of species, and thereby suggest this ability evolved in multiple primate lineages. © 2014 The Author(s) Published by the Royal Society. All rights reserved.
Arai, Marina; Fukamizu, Seiji; Kawamura, Iwanari; Miyazawa, Satoshi; Hojo, Rintaro; Sakurada, Harumizu; Hiraoka, Masayasu
2018-04-01
The acquisition of good contact force for radiofrequency catheter ablation of ventricular premature complexes (VPCs) originating from the basal septum of the left ventricle (LV) is often difficult. We describe a case of VPCs originating from the basal septum of the LV, which were successfully eliminated by applying radiofrequency at the right atrium (RA) side of the atrioventricular septum (AVS) without causing any significant impairment of atrioventricular conduction because the ablation catheter could obtain better contact force through the RA approach. Moreover, intracardiac echocardiography (ICE) and RA angiography effectively demonstrated the AVS.
Occult etiologies of complete atrioventricular block: Report of two cases
Directory of Open Access Journals (Sweden)
Neeta Bachani
2016-09-01
Full Text Available In patients presenting with complete atrioventricular (AV block, the common causes are degeneration of the conduction system, acute myocardial infarction, congenital and metabolic disorders (such as azotemia. However, at times, no cause can be ascribed and the label congenital or degenerative is applied depending on the patient's age and the QRS complex width. We present two cases of patients with complete AV block, who were subsequently found to have rare etiologies – sarcoidosis (with isolated feature of AV block and non-Hodgkin's lymphoma.
Belief in reciprocity in a Chinese sample.
Zhang, Zhen; Zhang, Jianxin
2012-08-01
Belief in reciprocity refers to a personally internalized faith in the reciprocity norm: that people will return positive and negative interactions or favors in kind. The current study aims to examine the relationship between belief in reciprocity and altruism among a Chinese sample. The Personal Norm of Reciprocity Scale, Trait Forgiveness Scale, Prosocial Tendency Measure, and Altruism Scale were used to assess extent of belief in reciprocity, forgiveness, and prosocial motivation, respectively, among 204 Chinese undergraduates. The results indicated that belief in reciprocity was a partially negative, but not neutral, reciprocity norm for Chinese people. Specifically, belief in reciprocity was positively related to negative reciprocity, but not significantly related to positive reciprocity. Moreover, belief in reciprocity was negatively related to both prosocial tendency and altruistic motivation. The results also indicated that forgiveness largely mediated the effect of belief in reciprocity on altruism. Finally, the implications and limitations of the current study were discussed.
Directory of Open Access Journals (Sweden)
Randhir S Rajput
2014-01-01
Full Text Available Background: Junctional ectopic tachycardia occurs frequently after congenital cardiac surgery and can be a cause of increased morbidity and mortality. Dexmedetomidine (DEX is an a2 adrenoreceptor agonist, has properties of controlling tachyarrhythmia by regulating the sympatho-adrenal system. Objective: To evaluate the efficacy of DEX for control of junctional ectopic tachycardia after repair of Tetralogy of Fallot (TOF. Materials and Methods: Two hundred and twenty pediatric cardiac patients with TOFs were enrolled in a prospective randomized control study. Patients underwent correction surgery. They were divided into two groups, i.e., Group 1 (DEX and Group 2 (control. Heart rate, rhythm, mean arterial pressure (MAP were recorded after the anesthetic induction (T1, after termination of bypass (T2, after 04 hours (T3, and 08 hours after transferring the patient to intensive care unit (ICU; T4. Results: Heart rate was comparable between two groups before starting the drug but statistically significant after bypass until 08 hours after transferring the patient to ICU. Junctional ectopic tachycardia occurred more in Group-2 (20% as compared to Group-1 (9.09%; P = 0.022. Junctional ectopic tachycardia occurs early in Group-2 (0.14 ± 0.527 hours as compared to Group 1 (0.31 ± 1.29 hours; P = 0.042. The duration of junctional ectopic tachycardia was more prolonged in Group-2 (1.63 ± 3.64 hours as compared to Group-1 (0.382 ± 1.60 hours; P = 0.012. The time to withdraw from mechanical ventilation and ICU stay of Group 1 patient was less than of Group 2 patients (P = <0.001. Conclusion: DEX had a therapeutic role in the prevention of junctional ectopic tachycardia in patients undergoing repair for TOF.
Johnsrude, Christopher
2015-01-01
Recognition of the potential for phrenic nerve injury (PNI) often prompts less aggressive attempts at catheter ablation of multiple forms of tachycardia or abandoning ablation altogether. Some novel techniques to avoid PNI during catheter ablation have been described. Five patients (age: 13-57 years, three females) with ectopic atrial tachycardia originating from the right atrial free wall (RAFW) near the phrenic nerve underwent electrophysiology study with three-dimensional mapping and endocardial cryoablation. Upstream phrenic pacing was performed after cryoadherence was achieved, and cryoablation of ectopic foci was performed during close observation for occurrence of PNI and tachycardia elimination. Cryoablation acutely eliminated five of six atrial tachycardias originating close to the phrenic nerve. Transient PNI during cryothermy occurred in two patients, and resolved within 3 minutes. Patients were observed overnight on telemetry, with no early recurrences of targeted atrial tachycardias and no evidence of PNI. At last follow-up of 1-39 months, four patients were arrhythmia free on no medications. Catheter cryoablation during simultaneous upstream phrenic nerve pacing can lead to safe and effective elimination of focal atrial tachycardias originating from the RAFW close to the phrenic nerve. ©2014 Wiley Periodicals, Inc.
Atriofascicular Mahaim with Ebstein anomaly: A case report
Directory of Open Access Journals (Sweden)
Kazushi Ueshima, MD
2017-10-01
Full Text Available We report a case of a 7-year-old girl with atriofascicular Mahaim (AFM pathway concomitant with Ebstein's anomaly. The QRS wave showed left bundle branch block pattern on electrocardiogram. Holter electrocardiogram showed prolongation of the PR interval and QRS morphological change during sinus tachycardia. An electrophysiological study demonstrated that the distal His potential appeared earlier than the proximal His potential, which suggested retrograde His conduction toward the atrioventricular node. Conduction from the Mahaim fiber to the His bundle was faster than that from the atrioventricular node towards the His bundle. The findings of this important case allowed a differential diagnosis between AFM and Wolff-Parkinson-White (WPW syndrome.
van Borren, Marcel M. G. J.; Vos, Marc A.; Houtman, Marien J. C.; Antoons, Gudrun; Ravesloot, Jan H.
2013-01-01
Dogs with compensated biventricular hypertrophy due to chronic atrioventricular block (cAVB), are more susceptible to develop drug-induced Torsade-de-Pointes arrhythmias and sudden cardiac death. It has been suggested that the increased Na+ influx in hypertrophied cAVB ventricular myocytes
Cardiac development : the posterior heart field and atrioventricular reentry tachycardia
Hahurij, Nathan Dominggus
2011-01-01
This thesis is separated in two parts (Part I and Part II) in which normal and abnormal heart development are studied and related to congenital heart disease, in particular to the etiology of supraventricular arrhythmias in fetuses and neonates. Part I describes the development of the posterior
Honjo, Osami; Atlin, Cori R; Mertens, Luc; Al-Radi, Osman O; Redington, Andrew N; Caldarone, Christopher A; Van Arsdell, Glen S
2011-08-01
This study was to determine whether atrioventricular valve repair modifies natural history of single-ventricle patients with atrioventricular valve insufficiency and to identify factors predicting survival and reintervention. Fifty-seven (13.5%) of 422 single-ventricle patients underwent atrioventricular valve repair. Valve morphology, regurgitation mechanism, and ventricular morphology and function were analyzed for effect on survival, transplant, and reintervention with multivariate logistic and Cox regression models. Comparative analysis used case-matched controls. Atrioventricular valve was tricuspid in 67% and common in 28%. Ventricular morphology was right in 83%. Regurgitation mechanisms were prolapse (n = 24, 46%), dysplasia (n = 18, 35%), annular dilatation (n = 8, 15%), and restriction or cleft (n = 2, 4%). Postrepair insufficiency was none or trivial in 14 (26%), mild in 33 (61%), and moderate in 7 (13%). Survival in repair group was lower than in matched controls (78.9% vs 92.7% at 1 year, 68.7% vs 90.6% at 3 years, P = .015). Patients with successful repair and normal ventricular function had equivalent survival to matched controls (P = .36). Independent predictors for death or transplant included increased indexed annular size (P = .05), increased cardiopulmonary bypass time (P = .04), and decreased postrepair ventricular function (P = .01). Ventricular dilation was a time-related factor for all events, including failed repair. Survival was lower in single-ventricle patients operated on for atrioventricular valve insufficiency than in case-matched controls. Patients with little postoperative residual regurgitation and preserved ventricular function had equivalent survival to controls. Lower grade ventricular function and ventricular dilation correlated with death and repair failure, suggesting that timing of intervention may affect outcome. Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All
Low Latency Digit-Recurrence Reciprocal and Square-Root Reciprocal Algorithm and Architecture
DEFF Research Database (Denmark)
Antelo, Elisardo; Lang, Tomas; Montuschi, Paolo
2005-01-01
The reciprocal and square-root reciprocal operations are important in several applications. For these operations, we present algorithms that combine a digit-by-digit module and one iteration of a quadratic-convergence approximation. The latter is implemented by a digit-recurrence, which uses......-up of about 2 and, because of the approximation part, the area factor is also about 2. We also show a combined implementation for both operations that has essentially the same complexity as that for square-root reciprocal alone....
Okishige, Kaoru; Sakurada, Harumizu; Mizusawa, Yuka; Yamauchi, Yasuteru; Fukamizu, Seiji; Aoyagi, Hideshi; Okano, Yoshifumi; Azegami, Koji; Sasano, Tetsuo; Hirao, Kenzo
2014-01-01
Macro-reentrant ventricular tachycardias (VT) utilizing the bundle branches and Purkinje fibers have been reported as verapamil sensitive VT (idiopathic left VT), bundle branch reentrant VT (BBRT) and inter-fascicular reentrant tachycardia (inter-fascicular VT). However, diagnostic confusion exists
Non-reciprocity in nonlinear elastodynamics
Blanchard, Antoine; Sapsis, Themistoklis P.; Vakakis, Alexander F.
2018-01-01
Reciprocity is a fundamental property of linear time-invariant (LTI) acoustic waveguides governed by self-adjoint operators with symmetric Green's functions. The break of reciprocity in LTI elastodynamics is only possible through the break of time reversal symmetry on the micro-level, and this can be achieved by imposing external biases, adding nonlinearities or allowing for time-varying system properties. We present a Volterra-series based asymptotic analysis for studying spatial non-reciprocity in a class of one-dimensional (1D), time-invariant elastic systems with weak stiffness nonlinearities. We show that nonlinearity is neither necessary nor sufficient for breaking reciprocity in this class of systems; rather, it depends on the boundary conditions, the symmetries of the governing linear and nonlinear operators, and the choice of the spatial points where the non-reciprocity criterion is tested. Extension of the analysis to higher dimensions and time-varying systems is straightforward from a mathematical point of view (but not in terms of new non-reciprocal physical phenomena), whereas the connection of non-reciprocity and time irreversibility can be studied as well. Finally, we show that suitably defined non-reciprocity measures enable optimization, and can provide physical understanding of the nonlinear effects in the dynamics, enabling one to establish regimes of "maximum nonlinearity." We highlight the theoretical developments by means of a numerical example.
Blom, Nico A.; Ottenkamp, Jaap; Wenink, Arnold G. C.; Gittenberger-de Groot, Adriana C.
2003-01-01
Data on the morphogenesis of atrioventricular septal defect (AVSD) in Down syndrome are lacking to support molecular studies on Down syndrome heart critical region. Therefore, we studied the development of complete AVSD in human embryos and fetuses with trisomy 21 using 3-dimensional graphic
Panduranga, Prashanth; Al-Farqani, Abdullah; Al-Rawahi, Najib
2012-11-01
A 10-year-old girl presented to the emergency department of a regional hospital with 1 episode of generalized tonic-clonic seizures. Postictal monitoring followed by a 12-lead electrocardiogram showed fast atrial fibrillation with intermittent wide QRS regular tachycardia. Immediately following this, her rhythm changed to wide QRS irregular tachycardia without hemodynamic compromise. She was suspected to have ventricular tachycardia and was treated with intravenous amiodarone with cardioversion to sinus rhythm. Subsequent electrocardiogram in sinus rhythm showed typical features of manifest Wolff-Parkinson-White (WPW) accessory pathway. This case illustrates the diagnostic and therapeutic dilemmas in patients with atrial fibrillation, wide QRS tachycardia, and undiagnosed WPW syndrome with antidromic conduction of atrial arrhythmias through the accessory pathway. Furthermore, this case demonstrates that undiagnosed wide QRS tachycardias need to be treated with drugs acting on the accessory pathway, thus keeping in mind underlying WPW syndrome as a possibility to avoid potentially catastrophic events.
Modelling the heart with the atrioventricular plane as a piston unit.
Maksuti, Elira; Bjällmark, Anna; Broomé, Michael
2015-01-01
Medical imaging and clinical studies have proven that the heart pumps by means of minor outer volume changes and back-and-forth longitudinal movements in the atrioventricular (AV) region. The magnitude of AV-plane displacement has also shown to be a reliable index for diagnosis of heart failure. Despite this, AV-plane displacement is usually omitted from cardiovascular modelling. We present a lumped-parameter cardiac model in which the heart is described as a displacement pump with the AV plane functioning as a piston unit (AV piston). This unit is constructed of different upper and lower areas analogous with the difference in the atrial and ventricular cross-sections. The model output reproduces normal physiology, with a left ventricular pressure in the range of 8-130 mmHg, an atrial pressure of approximatly 9 mmHg, and an arterial pressure change between 75 mmHg and 130 mmHg. In addition, the model reproduces the direction of the main systolic and diastolic movements of the AV piston with realistic velocity magnitude (∼10 cm/s). Moreover, changes in the simulated systolic ventricular-contraction force influence diastolic filling, emphasizing the coupling between cardiac systolic and diastolic functions. The agreement between the simulation and normal physiology highlights the importance of myocardial longitudinal movements and of atrioventricular interactions in cardiac pumping. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
DEFF Research Database (Denmark)
Anzouan-Kacou, J B; Ncho-Mottoh, M P; Konin, C
2012-01-01
Cardiac dyssynchrony causes disorganised cardiac contraction, delayed wall contraction and reduced pumping efficiency. We aimed to assess the prevalence of different types of dyssynchrony in patients with dilated cardiomyopathy (DCM), and to establish the correlation between atrio-ventricular block...
[Catecholaminergic polymorphic ventricular tachycardia is a rare inherited heart disease.
DEFF Research Database (Denmark)
Holst, Anders Gaarsdal; Tfelt-Hansen, 1jacob; Olesen, Morten S
2010-01-01
Catecholaminergic polymorphic ventricular tachycardia is a rare inherited heart disease, which can lead to life-threatening ventricular arrhythmias in patients with a structurally normal heart. The age of onset is usually between two and 12 years and the initial symptom is frequently syncope...
Sartipy, Ulrik; Albåge, Anders; Insulander, Per; Lindblom, Dan
2007-09-01
This article presents a review on the efficacy of surgical ventricular restoration and direct surgery for ventricular tachycardia in patients with left ventricular aneurysm or dilated ischemic cardiomyopathy. The procedure includes a non-electrophysiologically guided subtotal endocardiectomy and cryoablation in addition to endoventricular patch plasty of the left ventricle. Coronary artery bypass surgery and mitral valve repair are performed concomitantly as needed. In our experience, this procedure yielded a 90% success rate in terms of freedom from spontaneous ventricular tachycardia, with an early mortality rate of 3.8%. A practical guide to the pre- and postoperative management of these patients is provided.
Directory of Open Access Journals (Sweden)
Dursun Aras, MD
2015-08-01
Full Text Available Transseptal catheterization has become part of the interventional electrophysiologist׳s technical armamentarium since the development of left atrial catheter ablation and percutaneous technologies for treating mitral and aortic valve disease. Although frequently performed, the procedure׳s most feared complication is aortic root penetration. Focal atrial tachycardia has been described as the most common late sequela of surgical valve replacements. We present a complicated case involving the inadvertent delivery of an 8 French sheath across the noncoronary cusp during radiofrequency catheter ablation for left atrial tachycardia originating from the mitral annulus in a patient with prior mitral valve replacement.
[Catheter ablation in patients with refractory cardiac arrhythmias with radiofrequency techniques].
de Paola, A A; Balbão, C E; Silva Netto, O; Mendonça, A; Villacorta, H; Vattimo, A C; Souza, I A; Guiguer Júnior, N; Portugal, O P; Martinez Filho, E E
1993-02-01
evaluate the efficacy of radiofrequency catheter ablation in patients with refractory cardiac arrhythmias. twenty patients with refractory cardiac arrhythmias were undertaken to electrophysiologic studies for diagnosis and radiofrequency catheter ablation of their reentrant arrhythmias. Ten patients were men and 10 women with ages varying from 13 to 76 years (mean = 42.4 years). Nineteen patients had supraventricular tachyarrhythmias: One patient had atrial tachycardia and 1 atrial fibrillation with rapid ventricular rate, 5 patients had reentrant nodal tachycardia, 12 patients had reentrant atrioventricular tachycardia and 1 patient had right ventricular outflow tract tachycardia. the mean time of the procedure was 4.1 hours. The radiofrequency current energy applied was 40-50 V for 30-40 seconds. Ablation was successful in 18/20 (90%) patients; in 15/18 (83%) of successfully treated patients the same study was done for diagnosis and radiofrequency ablation. One patient had femoral arterial occlusion and was treated with no significant sequelae. During a mean follow-up of 4 months no preexcitation or reentrant tachycardia occurred. the results of our experience with radiofrequency catheter ablation of cardiac arrhythmias suggest that this technique can benefit an important number of patients with cardiac arrhythmias.
Detecting reciprocity at a global scale
Frank, Morgan R.; Obradovich, Nick; Sun, Lijun; Woon, Wei Lee; LeVeck, Brad L.; Rahwan, Iyad
2018-01-01
Reciprocity stabilizes cooperation from the level of microbes all the way up to humans interacting in small groups, but does reciprocity also underlie stable cooperation between larger human agglomerations, such as nation states? Famously, evolutionary models show that reciprocity could emerge as a widespread strategy for achieving international cooperation. However, existing studies have only detected reciprocity-driven cooperation in a small number of country pairs. We apply a new method for detecting mutual influence in dynamical systems to a new large-scale data set that records state interactions with high temporal resolution. Doing so, we detect reciprocity between many country pairs in the international system and find that these reciprocating country pairs exhibit qualitatively different cooperative dynamics when compared to nonreciprocating pairs. Consistent with evolutionary theories of cooperation, reciprocating country pairs exhibit higher levels of stable cooperation and are more likely to punish instances of noncooperation. However, countries in reciprocity-based relationships are also quicker to forgive single acts of noncooperation by eventually returning to previous levels of mutual cooperation. By contrast, nonreciprocating pairs are more likely to exploit each other’s cooperation via higher rates of defection. Together, these findings provide the strongest evidence to date that reciprocity is a widespread mechanism for achieving international cooperation. PMID:29326983
Detecting reciprocity at a global scale.
Frank, Morgan R; Obradovich, Nick; Sun, Lijun; Woon, Wei Lee; LeVeck, Brad L; Rahwan, Iyad
2018-01-01
Reciprocity stabilizes cooperation from the level of microbes all the way up to humans interacting in small groups, but does reciprocity also underlie stable cooperation between larger human agglomerations, such as nation states? Famously, evolutionary models show that reciprocity could emerge as a widespread strategy for achieving international cooperation. However, existing studies have only detected reciprocity-driven cooperation in a small number of country pairs. We apply a new method for detecting mutual influence in dynamical systems to a new large-scale data set that records state interactions with high temporal resolution. Doing so, we detect reciprocity between many country pairs in the international system and find that these reciprocating country pairs exhibit qualitatively different cooperative dynamics when compared to nonreciprocating pairs. Consistent with evolutionary theories of cooperation, reciprocating country pairs exhibit higher levels of stable cooperation and are more likely to punish instances of noncooperation. However, countries in reciprocity-based relationships are also quicker to forgive single acts of noncooperation by eventually returning to previous levels of mutual cooperation. By contrast, nonreciprocating pairs are more likely to exploit each other's cooperation via higher rates of defection. Together, these findings provide the strongest evidence to date that reciprocity is a widespread mechanism for achieving international cooperation.
Effect of atrioventricular conduction on heart rate variability
Ahmad, Talha Jamal
2011-08-01
This paper discusses the effect of atrioventricular conduction time (AVCT) on the short-term Heart Rate Variability (HRV) by computing HRV parameters using intervals between the onsets of successive P waves (PP time series) for three groups: normal, arrhythmia and sudden cardiac death (SCD) patients. A very precise wavelet transform based ECG delineator was developed to detect PP, PR and RR time series. Mean PR variation in arrhythmia and SCD group was found to be significantly high as compared to the normal group. It was observed that when PR variations in arrhythmia and SCD cases crossed a certain threshold, RR variability no longer provided a very accurate estimate of HRV. In such cases, PP variability was able to provide a better assessment of HRV. © 2011 IEEE.
2010-07-01
... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Reciprocity. 955.16 Section 955.16 Mineral... AND ON INDIAN LANDS § 955.16 Reciprocity. (a) Grant of certificate. OSM shall grant an OSM blaster certificate through reciprocity to any qualified applicant who demonstrates that he or she, and whom OSM finds...
2010-10-01
... 46 Shipping 1 2010-10-01 2010-10-01 false Reciprocity. 8.120 Section 8.120 Shipping COAST GUARD... § 8.120 Reciprocity. (a) The Commandant may delegate authority to a classification society that has... determine reciprocity on a “case-by-case” basis. (b) In order to demonstrate that the conditions described...
Using reciprocity in Boundary Element Calculations
DEFF Research Database (Denmark)
Juhl, Peter Møller; Cutanda Henriquez, Vicente
2010-01-01
The concept of reciprocity is widely used in both theoretical and experimental work. In Boundary Element calculations reciprocity is sometimes employed in the solution of computationally expensive scattering problems, which sometimes can be more efficiently dealt with when formulated...... as the reciprocal radiation problem. The present paper concerns the situation of having a point source (which is reciprocal to a point receiver) at or near a discretized boundary element surface. The accuracy of the original and the reciprocal problem is compared in a test case for which an analytical solution...
Hollander, J E; Delagi, R; Sciammarella, J; Viccellio, P; Ortiz, J; Henry, M C
1995-04-01
To evaluate the need for on-line telemetry control in an all-volunteer, predominantly advanced emergency medical technician (A-EMT) ambulance system. Emergency medical service (EMS) advanced life support (ALS) providers were asked to transmit the ECG rhythms of monitored patients over a six-month period in 1993. The ECG rhythm interpretations of volunteer EMS personnel were compared with those of the on-line medical control physician. All discordant readings were reviewed by a panel of physicians to decide whether the misdiagnosis would have resulted in treatment aberrations had transmission been unavailable. Patients were monitored and rhythms were transmitted in 1,825 cases. 1,642 of 1,825 rhythms were correctly interpreted by the EMS providers (90%; 95% CI 89-91%). The accuracy of the EMS providers was dependent on the patient's rhythm (chi-square, p < 0.00001), the chief complaint (chi-square, p = 0.0001), and the provider's level of training (chi-square, p = 0.02). Correct ECG rhythm interpretations were more common when the out-of-hospital interpretation was sinus rhythm (95%), ventricular fibrillation (87%), paced rhythm (94%), or agonal rhythm (96%). The EMS providers were frequently incorrect when the out-of-hospital rhythm interpretation was atrial fibrillation/flutter (71%), supraventricular tachycardia (46%), ventricular tachycardia (59%), or atrioventricular block (50%). Of the 183 discordant cases, 124 (68%) involved missing a diagnosis of, or incorrectly diagnosing, atrial fibrillation/flutter. Review of the discordant readings identified 11 cases that could have resulted in treatment errors had the rhythms not been transmitted, one of which might have resulted in an adverse outcome. In this all-volunteer, predominantly A-EMT ALS system, patients with a field interpretation of a sinus rhythm do not require ECG rhythm transmission. Field interpretations of atrial fibrillation/flutter, supraventricular tachycardia, ventricular tachycardia, and
Pseudo ventricular tachycardia: a case report.
LENUS (Irish Health Repository)
Riaz, A
2012-02-01
BACKGROUND: Dramatic artifacts of pseudo flutter have been reported in the past secondary to various factors including tremor (Handwerker and Raptopoulos in N Engl J Med 356:503, 2007) and dialysis machines (Kostis et al. in J Electrocardiol 40(4):316-318, 2007). METHODS: We present this unusual case where the artifact, produced by tremor, was so pronounced to be misdiagnosed and treated as ventricular tachycardia. CONCLUSION: This case highlights the importance of correlating ECG findings with history and clinical examination and of using 12 lead ECGs for rhythm interpretation especially to confirm consistence of arrhythmias in all leads.
Catecholaminergic polymorphic ventricular tachycardia in 2012
Directory of Open Access Journals (Sweden)
Christian van der Werf
2011-12-01
Full Text Available Catecholaminergic polymorphic ventricular tachycardia (CPVT is a rare, potentially lethal inherited arrhythmia syndrome characterized by stress or emotion-induced ventricular arrhythmias. CPVT was first described in 1960, while the genetic basis underlying this syndrome was discovered in 2001. The past decade has seen substantial advances in understanding the pathophysiology of CPVT. In addition, significant advances have been made in elucidating clinical characteristics of CPVT patients and new treatment options have become available. Here, we review current literature on CPVT to present state-of-the-art knowledge on the subject of the genetic basis, pathophysiology, clinical presentation, diagnosis, treatment and prognosis.
Ventricular tachycardia in ischemic heart disease substrates
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Olujimi A. Ajijola
2014-01-01
This review will discuss the central role of the ischemic heart disease substrate in the development MMVT. Electrophysiologic characterization of the post-infarct myocardium using bipolar electrogram amplitudes to delineate scar border zones will be reviewed. Functional electrogram determinants of reentrant circuits such as isolated late potentials will be discussed. Strategies for catheter ablation of reentrant ventricular tachycardia, including structural and functional targets will also be examined, as will the role of the epicardial mapping and ablation in the management of recurrent MMVT.
Effect of novel mucoadhesive buccal patches of carvedilol on isoprenaline-induced tachycardia
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Navneet Verma
2014-01-01
Full Text Available The main aim of the study was designed to develop bioadhesive buccal patches of carvedilol (CR and evaluate for isoprenaline-induced tachycardia. Buccal patches of carvedilol were prepared by using chitosan (CH, sodium salt of carboxy methyl cellulose (NaCMC, and polyvinyl alcohol (PVA as mucoadhesive polymers. The solvent evaporation method was used for the preparation of buccal patches. The patches were evaluated for their physical characteristics like patch thickness, weight variation, content uniformity, folding endurance, surface pH, residence time, in vitro drug release, and in vivo pharmacodynamic study. The swelling index of the patches was found to be proportional to the polymer concentration, whereas surface pH of all the formulated bioadhesive patches was found to lie between neutral ranges. In-vitro release study shows that 94.75% drug was release in 8 hours from the patch, which containing 2% w/v chitosan. The folding endurance result shows good elasticity in all the patches.Application of buccal patches on buccal mucosa of rabbit shows a significant result in % inhibition of isoprenaline-induced tachycardia. Prepared buccal patches of chitosan, NaCMC, and PVA containing Carvedilol meet the ideal requirement for the delivery of cardiovascular drugs and inhibit the isoprenaline tachycardia.
Takezawa, Masanori; Price, Michael E
2010-05-21
For many years in evolutionary science, the consensus view has been that while reciprocal altruism can evolve in dyadic interactions, it is unlikely to evolve in sizable groups. This view had been based on studies which have assumed cooperation to be discrete rather than continuous (i.e., individuals can either fully cooperate or else fully defect, but they cannot continuously vary their level of cooperation). In real world cooperation, however, cooperation is often continuous. In this paper, we re-examine the evolution of reciprocity in sizable groups by presenting a model of the n-person prisoner's dilemma that assumes continuous rather than discrete cooperation. This model shows that continuous reciprocity has a dramatically wider basin of attraction than discrete reciprocity, and that this basin's size increases with efficiency of cooperation (marginal per capita return). Further, we find that assortative interaction interacts synergistically with continuous reciprocity to a much greater extent than it does with discrete reciprocity. These results suggest that previous models may have underestimated reciprocity's adaptiveness in groups. However, we also find that the invasion of continuous reciprocators into a population of unconditional defectors becomes realistic only within a narrow parameter space in which the efficiency of cooperation is close to its maximum bound. Therefore our model suggests that continuous reciprocity can evolve in large groups more easily than discrete reciprocity only under unusual circumstances. Copyright (c) 2010 Elsevier Ltd. All rights reserved.
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Amitesh Aggarwal
2009-11-01
Full Text Available Endomyocardial fibrosis is a progressive disease of unknown origin affecting children and young adults. It involves inflow portion of right and/or left ventricle and apex. It may be associated with thrombus. Literature regarding right ventricular endomyocardial fibrosis with thrombus is scarce. Here we report a rare case of right ventricular endomyocardial fibrosis presenting as ventricular tachycardia and echocardiographic evidence of apical thrombus. Interestingly there was no pulmonary involvement or evidence of deep venous thrombosis. This case also underscores the importance of urgent echocardiography in diagnosis of obscure cases of ventricular tachycardia.
Yang, Jian-du; Sun, Qi; Guo, Xiao-Gang; Zhou, Gong-Bu; Liu, Xu; Luo, Bin; Wei, Hui-Qiang; Santangeli, Pasquale; Liang, Jackson J; Ma, Jian
2018-04-03
Right atrial dual-loop reentry tachycardia has been described in patients with open-heart surgery. However, the prevalence, electrophysiologic substrate and ablation outcomes have been poorly characterized. We aimed to investigate the prevalence, electrophysiologic substrate and ablation outcomes for RA dual-loop reentry tachycardia following cardiac surgery. We identified all patients with atrial tachycardia after cardiac surgery. We compared electrophysiologic findings and outcomes of those with RA dual-loop reentry tachycardia versus a control group of patients with RA macro-reentrant arrhythmias in the setting of linear RA free wall (FW) scar. Out of 127 patients with 152 post-surgical atrial tachycardias (ATs), 28 (18.4%) had diagnosis of RA dual-loop reentry and 24/28 (85.7%) had tricuspid annular (TA) reentry combined with FW incisional reentry. An incision length > 51.5mm along the FW predicted the substrate for a second loop. In 22/23 patients (95.7%) with initial ablation in the cavo-tricuspid isthmus, a change in the interval between Halo d to CS p could be recorded, while 15/23 patients (65.2%) had CS activation pattern change. Complete success was achieved in 25/28 (89.3%) and 64/69 (92.8%) in the dual-loop reentry and control groups, respectively. After mean follow-up of 33.9±24.2 months, 24/28 (85.7%) and 60/69 (86.95%) were free of arrhythmias after initial procedure in two groups. The prevalence of RA dual-loop reentry is 18.4% among ATs with prior atriotomy scar. A long incision should alert physician the possibility of the second loop at the FW. Halo and CS activation pattern are important clues for circuit transformation. Copyright © 2018. Published by Elsevier Inc.
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Krishna Kumar Mohanan Nair
2017-03-01
Full Text Available A 30year old patient presented to us with recurrent episodes of palpitation and documented tachycardia. In all his presentations a wide QRS tachycardia was recorded. The baseline ECG showed pre excitation. The 12 lead ECG of the tachycardia and the baseline ECG is shown in Fig. 1A. During EP study the patient had baseline pre excitation and the HV interval was 16 ms. A duo-decapolar halo (HL catheter was used to map right atrium and a decapolar coronary sinus (CS catheter was used to map coronary sinus. In addition a His bundle and right ventricular (RV quadripolar catheters were used. The delta wave morphology was suggestive of a posteroseptal pathway. Ventricular pacing from RV apex showing central decremental conduction with ventriculo-atrial Wenkebach at 290 ms. Ventricular extrastimulation also showed decremental conduction and VA block at S1 S2 of 400,240. The intra cardiac recording of tachycardia and its initiation is shown in Fig. 1B. Pacing from lateral RA (HL 5, 6 electrodes showed progressive pre excitation with extrastimulation and induction of tachycardia. The QRS morphology was same as the patient's clinical tachycardia and the tachycardia cycle length (TCL was 304 ms. An atrial entrainment protocol showed entrainment with the same QRS morphology while pacing from right atrium. The VA interval of the first return cycle was the same as the subsequent VA intervals. A ventricular entrainment protocol showed V-A-V response and post pacing interval of 414 ms. An atrial extra systole was given from the mid CS electrodes (CS 5, 6 – the effect is shown in Fig. 3. In sinus rhythm a parahisian pacing manoeuvre was done as shown in Fig. 4A. What is the mechanism of the tachycardia and what are the pathways involved?
Coronary sinus and atrioventricular groove avulsion after motor vehicle crash
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Bradley M Dennis
2014-01-01
Full Text Available Simultaneous cardiac and pericardial rupture from blunt chest trauma is a highly lethal combination with rarely reported survival. We report of a case of young patient with a right atrioventricular groove injury, pericardial rupture and a unique description of a coronary sinus avulsion following blunt chest trauma. Rapid recognition of this injury is crucial to patient survival, but traditional diagnostic adjuncts such as ultrasound, echocardiography and computed tomography are often unhelpful. Successful repair of these injuries requires high suspicion of injury, early cardiac surgery involvement of and possible even placement of the patient on cardiopulmonary bypass.
Pauriah, Maheshwar; Cismaru, Gabriel; Sellal, Jean-Marc; De Chillou, Christian; Brembilla-Perrot, Béatrice
2013-01-01
We have studied the results of electrophysiological study (EPS) in patients with Wolff-Parkinson-White syndrome (WPW) and spontaneous adverse clinical presentation and determined whether isoproterenol added incremental value. EPS was performed in 63 patients with WPW and adverse clinical presentation at baseline. EPS was repeated after infusion of isoproterenol in 37 patients, including 25 without criteria for a malignant form at baseline. Atrioventricular orthodromic tachycardia was induced 44%, antidromic tachycardia in 11%, atrial fibrillation (AF) in 68% at baseline. At baseline EPS, criteria for a malignant form (AF induction and shortest CL <250 ms) were noted in 60%; tachycardia was not inducible in 16%. All the patients met the criteria for a malignant form after isoproterenol. EPS at baseline missed 16% of patients at risk of life-threatening arrhythmias who had no inducible tachyarrhythmia and 40% without classical criteria for malignant form. Copyright © 2013 Elsevier Inc. All rights reserved.
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Diletta Sabatini
2014-01-01
Full Text Available Acute digoxin intoxication is a life-threating condition associated with severe cardiotoxicity. Female gender, age, low lean body mass, hypertension, and renal insufficiency may worsen the prognosis. Arrhythmias caused by digitalis glycosides are characterized by an increased automaticity coupled with concomitant conduction delay. Bidirectional tachycardia is pathognomonic of digoxin intoxication, but it is rarely observed. An 83-year-old woman was admitted to the Emergency Department after self-administration of 5 mg of digoxin i.v. for suicidal purpose. Her digoxin serum concentration was 17.4 ng/mL. The patient developed a bidirectional tachycardia and the Poison Control Center of the hospital provided digoxin immune fab. Bidirectional tachycardia quickly reversed and the patient remained stable throughout the hospital stay. This case shows that a multiple disciplinary approach, involving cardiologists and toxicologists, is essential for the management of digoxin intoxication. The optimal treatment of this rare event depends on the clinical conditions and on the serum drug concentration of the patient. Digoxin immune fab represents a safe, effective, and specific method for rapidly reversing digitalis cardiotoxicity and should be started as soon as the diagnosis is defined.
Reents, Tilko; Jilek, Clemens; Schuster, Peter; Nölker, Georg; Koch-Büttner, Katharina; Ammar-Busch, Sonia; Semmler, Verena; Bourier, Felix; Kottmaier, Marc; Kornmayer, Marie; Brooks, Stephanie; Fichtner, Stephanie; Kolb, Christof; Deisenhofer, Isabel; Hessling, Gabriele
2017-12-01
Remote magnetic navigation (RMN) is attributed to diminish radiation exposure for both patient and operator performing catheter ablation for different arrhythmia substrates. The purpose of this prospective, randomized study was to compare RMN with manually guided catheter ablation for AV nodal reentrant tachycardia (AVNRT) regarding fluoroscopy time/dosage, acute and long-term efficacy as well as safety. A total of 218 patients with AVNRT undergoing catheter ablation at three centers (male 34%, mean age 50 ± 17 years) were randomized to a manual approach (n = 113) or RMN (n = 105) using the Niobe ® magnetic navigation system. The primary study endpoint was total fluoroscopy time/dosage for patient and operator at the end of the procedure. Secondary endpoints included acute success, procedure duration, complications and success rate after 6 months. Fluoroscopy time and dosage for the patient were significantly reduced in the RMN group compared to the manual group (6 ± 6 vs. 11 ± 10 min; p < 0.001 and 425 ± 558 vs. 751 ± 900 cGycm 2 , p = 0.002). A reduction in fluoroscopy time/dose also applied to the operator (3 ± 5 vs. 7 ± 9 min 209 ± 444 vs. 482 ± 689 cGycm 2 , p < 0.001). Procedure duration was significantly longer in the RMN group (88 ± 29 vs. 79 ± 29 min; p = 0.03) and crossover from the RMN group to manual ablation occurred in 7.6% of patients (7.6 vs. 0.1%; p = 0.02). Acute success was achieved in 100% of patients in both groups. Midterm success after 6 months was 97 vs. 98% (p = 0.67). No complications occurred in both groups. The use of RMN for catheter ablation of AVNRT compared to a manual approach results in a reduction of fluoroscopy time and dosage of about 50% for both patients and physicians. Acute and midterm success and safety are comparable. RMN is a good alternative to a manual approach for AVNRT ablation.
Cai, Xiaoqiang; Nomura-Kitabayashi, Aya; Cai, Weibin; Yan, Jianyun; Christoffels, Vincent M.; Cai, Chen-Leng
2011-01-01
During early embryogenesis, the formation of the cardiac atrioventricular canal (AVC) facilitates the transition of the heart from a linear tube into a chambered organ. However, the genetic pathways underlying this developmental process are poorly understood. The T-box transcription factor Tbx20 is
Tacit Collusion under Fairness and Reciprocity
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Doruk İriş
2013-02-01
Full Text Available This paper departs from the standard profit-maximizing model of firm behavior by assuming that firms are motivated in part by personal animosity–or respect–towards their competitors. A reciprocal firm responds to unkind behavior of rivals with unkind actions (negative reciprocity, while at the same time, it responds to kind behavior of rivals with kind actions (positive reciprocity. We find that collusion is easier to sustain when firms have a concern for reciprocity towards competing firms provided that they consider collusive prices to be kind and punishment prices to be unkind. Thus, reciprocity concerns among firms can have adverse welfare consequences for consumers.
The double switch for atrioventricular discordance.
Brawn, William J
2005-01-01
Conventional surgery for atrioventricular discordance usually associated with ventricular arterial discordance leaves the morphologic right ventricle in the systemic circulation. Long-term follow-up results with this approach reveal a high incidence of right ventricular failure. The double switch procedure was introduced to restore the morphologic left ventricle to the systemic circulation. This operation is performed in two main ways: the atrial-arterial switch and the atrial switch plus Rastelli procedure. This double switch approach has been successful at least in the medium term in abolishing morphologic right ventricular failure and its associated tricuspid valve regurgitation. In the atrial-arterial switch group, there is an incidence of morphologic left ventricular dysfunction, sometimes associated with neoaortic valve regurgitation, and the minority of cases need aortic valve replacement. The long-term function of the morphologic left ventricle and the aortic valve need careful surveillance in the future. The atrial-Rastelli group of patients has not in the medium term shown evidence of ventricular dysfunction but will require change on a regular basis of their ventricular to pulmonary artery valved conduits.
Inoue, S.; Becker, A. E.
1998-01-01
Catheter ablation procedures have revived interest in the detailed anatomy of the specialized atrioventricular (AV) septal junctional area. The compact AV node usually is considered to have a blunt posterior end. The objective of this study was to reconstruct the human compact AV node in relation to
Directory of Open Access Journals (Sweden)
Yasser Alsayegh
2012-01-01
Full Text Available We present an unusual diagnosis of a permanent third-degree atrioventricular block under general anesthesia in an otherwise healthy and asymptomatic child. This diagnosis of unclear causality represented a serious rare finding, requiring judicious management and resulting in the placement of a permanent pacemaker.
Public privacy: Reciprocity and Silence
Directory of Open Access Journals (Sweden)
Jenny Kennedy
2014-10-01
Full Text Available In his 1958 poem 'Dedication to my Wife' TS Eliot proclaims "these are private words addressed to you in public". Simultaneously written for his wife, Valerie Fletcher, and to the implied you of a discourse network, Eliot's poem helps to illustrate the narrative voices and silences that are constitutive of an intimate public sphere. This paper situates reciprocity as a condition of possibility for public privacy. It shows how reciprocity is enabled by systems of code operating through material and symbolic registers. Code promises to control communication, to produce neutral, systemic forms of meaning. Yet such automation is challenged by uneven and fragmented patterns of reciprocity. Moreover, examining the media of public privacy reveals historical trajectories important for understanding contemporary sociotechnical platforms of reciprocity. To explore the implicit requirement of reciprocity in publicly private practices, three sites of communication are investigated framed by a media archaeology perspective: postal networks, the mailart project PostSecret and the anonymous zine 'You'.
Hidden patterns of reciprocity.
Syi
2014-03-21
Reciprocity can help the evolution of cooperation. To model both types of reciprocity, we need the concept of strategy. In the case of direct reciprocity there are four second-order action rules (Simple Tit-for-tat, Contrite Tit-for-tat, Pavlov, and Grim Trigger), which are able to promote cooperation. In the case of indirect reciprocity the key component of cooperation is the assessment rule. There are, again, four elementary second-order assessment rules (Image Scoring, Simple Standing, Stern Judging, and Shunning). The eight concepts can be formalized in an ontologically thin way we need only an action predicate and a value function, two agent concepts, and the constant of goodness. The formalism helps us to discover that the action and assessment rules can be paired, and that they show the same patterns. The logic of these patterns can be interpreted with the concept of punishment that has an inherent paradoxical nature. Copyright © 2013 Elsevier Ltd. All rights reserved.
Nguyen, Yen Ngoc; Ismail, Munirah; Kabinejadian, Foad; Tay, Edgar Lik Wui; Leo, Hwa Liang
2018-04-01
Intra-ventricular flow dynamics has recently emerged as an important evaluation and diagnosis tool in different cardiovascular conditions. The formation of vortex pattern during the cardiac cycle has been suggested to play important epigenetic and energy-modulation roles in cardiac remodelling, adaptations and mal-adaptations. In this new perspective, flow alterations due to different cardiovascular procedures can affect the long-term outcome of those procedures. Especially, repairs and replacements performed on atrioventricular valves are likely to exert direct impact on intra-ventricular flow pattern. In this review, current consensus around the roles of vortex dynamics in cardiac function is discussed. An overview of physiological vortex patterns found in healthy left and right ventricles as well as post-operative ventricular flow phenomenon owing to different atrioventricular valvular procedures are reviewed, followed by the summary of different vortex identification schemes used to characterise intraventricular flow. This paper also emphasises on future research directions towards a comprehensive understanding of intra-cardiac flow and its clinical relevance. The knowledge could encourage more effective pre-operative planning and better outcomes for current clinical practices. Copyright © 2018. Published by Elsevier Ltd.
Capuchin Monkeys Judge Third-Party Reciprocity
Anderson, James R.; Takimoto, Ayaka; Kuroshima, Hika; Fujita, Kazuo
2013-01-01
Increasing interest is being shown in how children develop an understanding of reciprocity in social exchanges and fairness in resource distribution, including social exchanges between third parties. Although there are descriptions of reciprocity on a one-to-one basis in other species, whether nonhumans detect reciprocity and violations of…
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Dr Zia Zuberi, BSc PhD MRCP
2014-01-01
Full Text Available We describe a patient presenting with incessant ectopic atrial tachycardia during a high risk twin pregnancy. Tachycardia was resistant to escalating doses of beta-blockade with digoxin. Because of increasing left ventricular dysfunction early in the third trimester, catheter ablation was performed successfully at 30 weeks gestation. Electro-anatomic mapping permitted the entire procedure to be conducted without the use of ionizing radiation. The pregnancy proceeded to successful delivery near term and after three years the patient remains recurrence free with normal left ventricular function, off all medication.
Imperfect information facilitates the evolution of reciprocity.
Kurokawa, Shun
2016-06-01
The existence of cooperation demands explanation since cooperation is costly to the actor. Reciprocity has long been regarded as a potential explanatory mechanism for the existence of cooperation. Reciprocity is a mechanism wherein a cooperator responds to an opponent's behavior by switching his/her own behavior. Hence, a possible problematic case relevant to the theory of reciprocity evolution arises when the mechanism is such that the information regarding an opponent's behavior is imperfect. Although it has been confirmed also by previous theoretical studies that imperfect information interferes with the evolution of reciprocity, this argument is based on the assumption that there are no mistakes in behavior. And, a previous study presumed that it might be expected that when such mistakes occur, reciprocity can more readily evolve in the case of imperfect information than in the case of perfect information. The reason why the previous study considers so is that in the former case, reciprocators can miss defections incurred by other reciprocators' mistakes due to imperfect information, allowing cooperation to persist when such reciprocators meet. However, contrary to this expectation, the previous study has shown that even when mistakes occur, imperfect information interferes with the evolution of reciprocity. Nevertheless, the previous study assumed that payoffs are linear (i.e., that the effect of behavior is additive and there are no synergetic effects). In this study, we revisited the same problem but removed the assumption that payoffs are linear. We used evolutionarily stable strategy analysis to compare the condition for reciprocity to evolve when mistakes occur and information is imperfect with the condition for reciprocity to evolve when mistakes occur and information is perfect. Our study revealed that when payoffs are not linear, imperfect information can facilitate the evolution of reciprocity when mistakes occur; while when payoffs are linear
Fallot's tetralogy in combination with an open common atrioventricular canal
International Nuclear Information System (INIS)
Alekyan, B.G.; Dvinyaninova, N.B.; Chiaureli, M.R.; Arzhanukhina, S.Yu.
1987-01-01
The methods and clinics of diagnostics of Fallot tetrad (FT) combined with the opened general atrioventricular canal (AVC) of the heart are described on the basis of observation of a 6.5-year old patient and analysis of literary data. On the basis of studying clinical data, electro-, phono-, echocardiography and roentgenography, as well as heart catheterization and angiocardiography the conclusion is made that nowadays the most informative method of diagnostics of FT and AVC combination before angiocardiography is a dimer echocardiography which permits to diagnoze AVC. Angiocardiographic study proves this diagnosis and gives a precise anotomical picture of various components of this combination of heart failure
Epidemiology of Arrhythmias in Children
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R Prem Sekar
2008-05-01
Full Text Available Unlike the adult population, arrhythmias occur less commonly in childhood. Only 5% of the emergency hospital admissions in the paediatric population is attributed to symptomatic arrhythmias. Majority of these tend to be accessory pathway mediated supraventricular tachyarrhythmias such as Wolff-Parkinson-White (WPW syndrome, permanent junctional reciprocating tachycardia (PJRT and Mahaim tachycardia. The non accessory pathway mediated supraventricular tachyarrhythmias commonly seen in children are junctional ectopic tachycardia (JET and automatic ectopic atrial tachycardia (AET and occur mostly in the post operative period after intracardiac repair for a structural heart defect. Ventricular tachycardia (VT although uncommon, occurs in the paediatric age group in association with hypertrophic cardiomyopathy (HCM, long QT syndrome (LQTS and Brugada syndrome. Occasionally, VT can also present symptomatically as incessant idiopathic infant ventricular tachycardia, right ventricular outflow tract tachycardia, benign VT, catecholaminic VT, idiopathic left ventricular tachycardia and in post cardiac surgical patients.
Reciprocating Linear Electric Motor
Goldowsky, M. P.
1984-01-01
Features include structural simplicity and good force/displacement characteristics. Reciprocating motor has simple, rugged construction, relatively low reciprocating weight, improved power delivery, and improved force control. Wear reduced by use of magnetic bearings. Intended to provide drivers for long-lived Stirling-cycle cryogenic refrigerators, concept has less exotic applications, such as fuel pumps.
Smith, K.; Lagendijk, A.K.; Courtney, A.D.; Chen, H.; Paterson, S.; Hogan, B.M.; Wicking, C.; Bakkers, J.
2011-01-01
The atrioventricular canal (AVC) physically separates the atrial and ventricular chambers of the heart and plays a crucial role in the development of the valves and septa. Defects in AVC development result in aberrant heart morphogenesis and are a significant cause of congenital heart malformations.
Reciprocity of agonistic support in ravens.
Fraser, Orlaith N; Bugnyar, Thomas
2012-01-01
Cooperative behaviour through reciprocation or interchange of valuable services in primates has received considerable attention, especially regarding the timeframe of reciprocation and its ensuing cognitive implications. Much less, however, is known about reciprocity in other animals, particularly birds. We investigated patterns of agonistic support (defined as a third party intervening in an ongoing conflict to attack one of the conflict participants, thus supporting the other) in a group of 13 captive ravens, Corvus corax. We found support for long-term, but not short-term, reciprocation of agonistic support. Ravens were more likely to support individuals who preened them, kin and dominant group members. These results suggest that ravens do not reciprocate on a calculated tit-for-tat basis, but aid individuals from whom reciprocated support would be most useful and those with whom they share a good relationship. Additionally, dyadic levels of agonistic support and consolation (postconflict affiliation from a bystander to the victim) correlated strongly with each other, but we found no evidence to suggest that receiving agonistic support influences the victim's likelihood of receiving support (consolation) after the conflict ends. Our findings are consistent with an emotionally mediated form of reciprocity in ravens and provide additional support for convergent cognitive evolution in birds and mammals.
Reciprocity Outperforms Conformity to Promote Cooperation.
Romano, Angelo; Balliet, Daniel
2017-10-01
Evolutionary psychologists have proposed two processes that could give rise to the pervasiveness of human cooperation observed among individuals who are not genetically related: reciprocity and conformity. We tested whether reciprocity outperformed conformity in promoting cooperation, especially when these psychological processes would promote a different cooperative or noncooperative response. To do so, across three studies, we observed participants' cooperation with a partner after learning (a) that their partner had behaved cooperatively (or not) on several previous trials and (b) that their group members had behaved cooperatively (or not) on several previous trials with that same partner. Although we found that people both reciprocate and conform, reciprocity has a stronger influence on cooperation. Moreover, we found that conformity can be partly explained by a concern about one's reputation-a finding that supports a reciprocity framework.
Molm, Linda D.
2010-01-01
Reciprocity is one of the defining features of social exchange and social life, yet exchange theorists have tended to take it for granted. Drawing on work from a decade-long theoretical research program, I argue that reciprocity is structured and variable across different forms of exchange, that these variations in the structure of reciprocity…
Static non-reciprocity in mechanical metamaterials.
Coulais, Corentin; Sounas, Dimitrios; Alù, Andrea
2017-02-23
Reciprocity is a general, fundamental principle governing various physical systems, which ensures that the transfer function-the transmission of a physical quantity, say light intensity-between any two points in space is identical, regardless of geometrical or material asymmetries. Breaking this transmission symmetry offers enhanced control over signal transport, isolation and source protection. So far, devices that break reciprocity (and therefore show non-reciprocity) have been mostly considered in dynamic systems involving electromagnetic, acoustic and mechanical wave propagation associated with fields varying in space and time. Here we show that it is possible to break reciprocity in static systems, realizing mechanical metamaterials that exhibit vastly different output displacements under excitation from different sides, as well as one-way displacement amplification. This is achieved by combining large nonlinearities with suitable geometrical asymmetries and/or topological features. In addition to extending non-reciprocity and isolation to statics, our work sheds light on energy propagation in nonlinear materials with asymmetric crystalline structures and topological properties. We anticipate that breaking reciprocity will open avenues for energy absorption, conversion and harvesting, soft robotics, prosthetics and optomechanics.
Steckiewicz, Roman; Rosiak, Marek; Stolarz, Przemysław; Świętoń, Elżbieta B; Grabowski, Marcin; Kosior, Dariusz A
Reversible complete atrioventricular block in patient with Wegener's granulomatosis - a report on a positive outcome with long term follow-up. Atrioventricular (AV) block is a rare complication of Wegener's granulomatosis (WG), thus there are no standards of management in such cases. We present a case of a patient with a dual-chamber pacemaker (DDD) implanted due to complete AV block in the course of Wegener's granulomatosis (WG). An immunosuppressive therapy resulted in the resolution of non-cardiac and AV conduction disorders. The diagnostic functions of the pacemaker enabled us to evaluate AV conduction over a five-year follow-up period. The resolution of AV conduction disorders, which accompanied WG remission, suggests that careful monitoring with temporary cardiac pacing may be considered in some patients before permanent pacemaker implantation.
Troponin elevation in patients with various tachycardias and normal epicardial coronaries
Directory of Open Access Journals (Sweden)
Yousuf Kanjwal
2008-08-01
Full Text Available Troponin elevation is usually synonymous with acute coronary syndrome (ACS. Although sensitive for ACS, the elevation of serum troponin, in the absence of clinical evidence of ischemia, should prompt a search for other etiologies of myocardial necrosis. In fact, elevated values of troponin are correlated with myocardial necrosis even though it does not discriminate the mechanism involved. We report a series of seven patients (age range 18-67 years, who presented with complaints of chest discomfort and were found to have regular supraventricular tachycardia (5 patients and one patient each with atrial fibrillation and ventricular tachycardia. All these patients had elevated troponin I and underwent coronary angiography that revealed normal epicardial coronary arteries. This is first case series in which all patients underwent coronary angiography and none of the patients was hemodynamically unstable at the time of presentation. Patients with elevated troponin due to conditions other than ACS can receive inappropriate and delayed definitive diagnosis and treatment.
Bonanno, C; Ometto, R; Finocchi, G; Rulfo, F; La Vecchia, L; Vincenzi, M
1999-12-01
Incessant ventricular tachycardia is an arrhythmia refractory to conventional antiarrhythmic treatment. We describe the case of 55-year-old man who presented incessant ventricular tachycardia in the early post-acute phase of myocardial infarction. Optimal coronary revascularization was not effective, but radiofrequency catheter ablation was able to eliminate the anatomic substrate and clinical arrhythmic recurrence.
Drenthen, W; Pieper, PG; van der Tuuk, K; Roos-Hesselink, JW; Voors, AA; Mostert, B; Mulder, BJM; Moons, P; Ebels, T; van Veldhuisen, DJ
2005-01-01
Aims In most pregnancy reports, atrioventricular septal defects (AVSD) are not differentiated from more simple septal defects, thus underestimating the risks of pregnancy. To investigate the magnitude and determinants of risk during pregnancy in female patients with balanced AVSD. Methods and
Directory of Open Access Journals (Sweden)
Emanuele Cecchi
2012-01-01
Full Text Available Here we report the case of a 31-year-old man admitted to our hospital with echocardiografic and Cardiac Magnetic Resonance signs of myocarditis complicated by ventricular tachycardia, initially resolved with direct current shock. After the recurrence of ventricular tachycardia the patient was submitted to electrophysiological study revealing a re-entrant circuit at the level of the medium segment of interventricular septum, successfully treated with transcatheter ablation. This case highlights how the presence of recurrent ventricular arrhythmias at the onset of acute myocarditis, suspected or proven, could be associated with a pre-existing arrhythmogenic substrate, therefore these patients should be submitted to electrophysiological study in order to rule out the presence of arrhythmogenic focuses that can be treated with transcatheter ablation.
Vinyoles, Ernest; de la Sierra, Alejandro; Roso, Albert; de la Cruz, Juan J; Gorostidi, Manuel; Segura, Julián; Banegas, José R; Martell-Claros, Nieves; Ruilope, Luís M
2014-05-01
Epidemiological studies have shown that an elevated resting heart rate (HR) is a risk factor for both total and cardiovascular mortality. Our aim was to estimate the night-time HR cut-off point that best predicts cardiovascular risk office tachycardia in hypertensive patients. Untreated hypertensive patients without concomitant cardiovascular diseases were included. Office and ambulatory HRs were measured. Cardiovascular risk office tachycardia was defined by office HR at least 85 beats per minute (bpm). Different night-time HR cut-offs were estimated by receiver operating characteristic curve analyses to predict cardiovascular risk office tachycardia. The best cut-off was selected on the basis of its combined sensitivity and specificity. A total of 32 569 hypertensive patients were included: 46.5% women, mean age (SD) 52 (14) years, office blood pressure 146 (16)/89 (11) mmHg, diabetes 10.3%, smoking 19.2%, BMI 29 (6.8) kg/m, office HR 77 (11.2) bpm, and night-time HR 64.9 (9.3) bpm. A total of 7070 (21.7%) patients were found to have cardiovascular risk office tachycardia. The night-time HR value that better predicted cardiovascular risk office tachycardia was more than 66 bpm. In comparison with patients with night HR below this value, those with night-time tachycardia were predominantly women, younger, with higher ambulatory blood pressure, greater BMI, and higher prevalence of diabetes and smoking. All comparisons were statistically significant (P less than 0.001). A mean night-time HR more than 66 bpm is a good predictor of cardiovascular risk office tachycardia in untreated hypertensive patients and could be considered a variable associated with an increased cardiovascular risk.
Molesti, Sandra; Majolo, Bonaventura
2017-09-01
Reciprocity is one of the mechanisms that have been proposed to explain the exchange of social behaviors, such as grooming, in animals. Reciprocity assumes that individuals act as the donor and recipient of grooming and switch roles over time to balance the benefits and costs of this behavior. Three main patterns of reciprocity may follow a grooming given: (i) direct reciprocity, where the former recipient returns the grooming to the former donor; (ii) indirect reciprocity, where another individual returns the grooming to the former donor; and (iii) generalized reciprocity, where the former recipient returns the grooming to another individual. While there is evidence that direct reciprocity plays an important role in various species of animals, the role of indirect and generalized reciprocity is less clear and has been rarely analyzed. We tested the role of direct, indirect, and generalized reciprocity in explaining grooming exchanges of wild Barbary macaques, by analyzing the temporal contingency between giving and receiving grooming. We collected the occurrence and latency of the three types of grooming reciprocation during 1 hr long focal sessions run simultaneously on two partners who just stopped grooming (post-grooming session) or who were in proximity (i.e., within 1.5 m) without grooming each other (control session). We ran the analyses on 284 post-grooming and 63 control sessions. The results revealed a temporal contingency of grooming interactions exchanged according to direct reciprocity but not according to indirect or generalized reciprocity. Our results indicate that grooming distribution in Barbary macaques is partner-specific. We discuss the possible role of cognition and emotions in explaining direct reciprocity in animals. © 2017 Wiley Periodicals, Inc.
Two distinct neural mechanisms underlying indirect reciprocity.
Watanabe, Takamitsu; Takezawa, Masanori; Nakawake, Yo; Kunimatsu, Akira; Yamasue, Hidenori; Nakamura, Mitsuhiro; Miyashita, Yasushi; Masuda, Naoki
2014-03-18
Cooperation is a hallmark of human society. Humans often cooperate with strangers even if they will not meet each other again. This so-called indirect reciprocity enables large-scale cooperation among nonkin and can occur based on a reputation mechanism or as a succession of pay-it-forward behavior. Here, we provide the functional and anatomical neural evidence for two distinct mechanisms governing the two types of indirect reciprocity. Cooperation occurring as reputation-based reciprocity specifically recruited the precuneus, a region associated with self-centered cognition. During such cooperative behavior, the precuneus was functionally connected with the caudate, a region linking rewards to behavior. Furthermore, the precuneus of a cooperative subject had a strong resting-state functional connectivity (rsFC) with the caudate and a large gray matter volume. In contrast, pay-it-forward reciprocity recruited the anterior insula (AI), a brain region associated with affective empathy. The AI was functionally connected with the caudate during cooperation occurring as pay-it-forward reciprocity, and its gray matter volume and rsFC with the caudate predicted the tendency of such cooperation. The revealed difference is consistent with the existing results of evolutionary game theory: although reputation-based indirect reciprocity robustly evolves as a self-interested behavior in theory, pay-it-forward indirect reciprocity does not on its own. The present study provides neural mechanisms underlying indirect reciprocity and suggests that pay-it-forward reciprocity may not occur as myopic profit maximization but elicit emotional rewards.
Reciprocity in therapeutic relationships: A conceptual review.
Sandhu, Sima; Arcidiacono, Eleonora; Aguglia, Eugenio; Priebe, Stefan
2015-12-01
Reciprocity has generally been understood as a process of giving and taking, within an exchange of emotions or services, and has long been recognized as a central part of human life. However, an understanding of reciprocity in professional helping relationships has seldom received attention, despite movements in mental health care towards more collaborative approaches between service users and professionals. In this review, a systematic search of the published papers was conducted in order to explore how reciprocity is conceptualized and understood as part of the dyadic therapeutic relationship between professionals and service users. Eleven papers met our inclusion criteria and a narrative synthesis was used to synthesize the key concepts of reciprocity. The concepts of: 'dynamic equilibrium', 'shared affect', 'asymmetric alliance', and 'recognition as a fellow human being' were recurrent in understandings of reciprocity in professional contexts. These conceptualizations of reciprocity were also linked to specific behavioural and psychological processes. The findings suggest that reciprocity may be conceptualized and incorporated as a component of mental health care, with recurrent and observable processes which may be harnessed to promote positive outcomes for service users. To this end, we make recommendations for further research to progress and develop reciprocal processes in mental health care. © 2015 Australian College of Mental Health Nurses Inc.
Reciprocity in quantum, electromagnetic and other wave scattering
International Nuclear Information System (INIS)
Deák, L.; Fülöp, T.
2012-01-01
The reciprocity principle is that, when an emitted wave gets scattered on an object, the scattering transition amplitude does not change if we interchange the source and the detector—in other words, if incoming waves are interchanged with appropriate outgoing ones. Reciprocity is sometimes confused with time reversal invariance, or with invariance under the rotation that interchanges the location of the source and the location of the detector. Actually, reciprocity covers the former as a special case, and is fundamentally different from–but can be usefully combined with–the latter. Reciprocity can be proved as a theorem in many situations and is found violated in other cases. The paper presents a general treatment of reciprocity, discusses important examples, shows applications in the field of photon (Mössbauer) scattering, and establishes a fruitful connection with a recently developing area of mathematics. - Highlights: ► A frame independent generalized reciprocity theorem of scattering theory is given. ► Reciprocity for two spin/polarization degrees of freedom is detailed. ► Relationship of reciprocity to time reversal and to 180 degree rotation is discussed. ► Reciprocal and nonreciprocal settings in Mossbauer spectroscopy are studied. ► The symmetry of diffuse omega-scans is explained with the aid of reciprocity.
Reciprocity principle in duct acoustics
Cho, Y.-C.
1979-01-01
Various reciprocity relations in duct acoustics have been derived on the basis of the spatial reciprocity principle implied in Green's functions for linear waves. The derivation includes the reciprocity relations between mode conversion coefficients for reflection and transmission in nonuniform ducts, and the relation between the radiation of a mode from an arbitrarily terminated duct and the absorption of an externally incident plane wave by the duct. Such relations are well defined as long as the systems remain linear, regardless of acoustic properties of duct nonuniformities which cause the mode conversions.
Zeng, Shao-ying; Shi, Ji-jun; Li, Hong; Zhang, Zhi-wei; Li, Yu-fen
2010-08-01
To simplify the methods of transcatheter mapping and ablation in the pediatric patients with left posterior fascicular tachycardia. While in sinus rhythm, the fascicular potential can be mapped at the posterior septal region (1 - 2 cm below inferior margin of orifice of coronary sinus vein), which display a biphasic wave before ventricular wave, and exist equipotential lines between them. When the fascicular potential occurs 20 ms later than the bundle of His' potential, radiofrequency was applied. Before applying radiofrequency, catheter position must be observed using double angle viewing (LAO 45°RAO 30°), and it should be made sure that the catheter is not at His' bundle. If the electrocardiogram displays left posterior fascicular block, the correct region is identified and ablation can continue for 60 s. Electrocardiogram monitoring should continue for 24 - 48 hours after operation, and notice abnormal repolarization after termination of ventricular tachycardia. Aspirin [2 - 3 mg/(kg·d)] was used for 3 months, and antiarrhythmic drug was discontinued. Surface electrocardiogram, chest X-ray and ultrasound cardiography were rechecked 1 d after operation. Follow-up was made at 1 month and 3 months post-discharge. Recheck was made half-yearly or follow-up was done by phone from then on. Fifteen pediatric patients were ablated successfully, and their electrocardiograms all displayed left posterior fascicular block after ablation. None of the patients had recurrences during the 3 to 12 months follow-up period. In one case, the electrocardiogram did not change after applying radiofrequency ablation and the ventricular tachycardia remained; however, on second attempt after remapping, the electrocardiogram did change. The radiofrequency lasted for 90 seconds and ablation was successful. This case had no recurrences at 6 months follow-up. Transcatheter ablation of the fascicular potential in pediatric patients with left posterior fascicular tachycardia can simplify
Structural Behaviour of Reciprocal Structures
DEFF Research Database (Denmark)
Parigi, Dario; Kirkegaard, Poul Henning
2013-01-01
The present paper focuses on the comparison of several two-dimensional and three-dimensional reciprocal configurations. The goal of such comparison is to analyse the structural behaviour when changing the geometric parameters used to describe the geometry of reciprocal structures....
Free-Form Kinetic Reciprocal System
DEFF Research Database (Denmark)
Parigi, Dario; Sassone, Mario
2011-01-01
Kinetic Reciprocal System (KRS) are innovative moveable structures based on the principle of reciprocity [1] with internal pin-slot constraints [2]. The analysis of KRS kinematic and static determinacy is developed through the construction of kinematic matrices, accordingly with [3] and a discuss...
Directory of Open Access Journals (Sweden)
Woo-Sik Yu
2015-06-01
Full Text Available A patient presented with loss of consciousness and conversion. During an exercise test, catecholaminergic polymorphic ventricular tachycardia (CPVT resulted in cardiac arrest. He started taking medication (a beta-blocker and flecainide and an implantable cardioverter defibrillator (ICD was inserted, but the ventricular tachycardia did not resolve. Left cardiac sympathetic denervation (LCSD was then performed under general anesthesia, and the patient was discharged on the second postoperative day without complications. One month after the operation, no shock had been administered by the ICD, and an exercise stress test did not induce ventricular tachycardia. Although beta- blockers are the gold standard of therapy in patients with CPVT, thoracoscopic LCSD is safe and can be an effective alternative treatment option for patients with intractable CPVT.
Towards a unified theory of reciprocity.
Rosas, Alejandro
2012-02-01
In a unified theory of human reciprocity, the strong and weak forms are similar because neither is biologically altruistic and both require normative motivation to support cooperation. However, strong reciprocity is necessary to support cooperation in public goods games. It involves inflicting costs on defectors; and though the costs for punishers are recouped, recouping costs requires complex institutions that would not have emerged if weak reciprocity had been enough.
Arai, Masaru; Nagashima, Koichi; Kato, Mahoto; Akutsu, Naotaka; Hayase, Misa; Ogura, Kanako; Iwasawa, Yukino; Aizawa, Yoshihiro; Saito, Yuki; Okumura, Yasuo; Nishimaki, Haruna; Masuda, Shinobu; Hirayama, Astushi
2016-09-08
BACKGROUND Infective endocarditis (IE) involving the mitral valve can but rarely lead to complete atrioventricular block (CAVB). CASE REPORT A 74-year-old man with a history of infective endocarditis caused by Streptococcus gordonii (S. gordonii) presented to our emergency room with fever and loss of appetite, which had lasted for 5 days. On admission, results of serologic tests pointed to severe infection. Electrocardiography showed normal sinus rhythm with first-degree atrioventricular block and incomplete right bundle branch block, and transthoracic echocardiography and transesophageal echocardiography revealed severe mitral regurgitation caused by posterior leaflet perforation and 2 vegetations (5 mm and 6 mm) on the tricuspid valve. The patient was initially treated with ceftriaxone and gentamycin because blood and cutaneous ulcer cultures yielded S. agalactiae. On hospital day 2, however, sudden CAVB requiring transvenous pacing occurred, and the patient's heart failure and infection worsened. Although an emergent surgery is strongly recommended, even in patients with uncontrolled heart failure or infection, surgery was not performed because of the Child-Pugh class B liver cirrhosis. Despite intensive therapy, the patient's condition further deteriorated, and he died on hospital day 16. On postmortem examination, a 2×1-cm vegetation was seen on the perforated posterior mitral leaflet, and the infection had extended to the interventricular septum. Histologic examination revealed extensive necrosis of the AV node. CONCLUSIONS This rare case of CAVB resulting from S. agalactiae IE points to the fact that in monitoring patients with IE involving the mitral valve, clinicians should be aware of the potential for perivalvular extension of the infection, which can lead to fatal heart block.
2010-04-01
... 23 Highways 1 2010-04-01 2010-04-01 false Reciprocity. 1235.8 Section 1235.8 Highways NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION AND FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION GUIDELINES UNIFORM SYSTEM FOR PARKING FOR PERSONS WITH DISABILITIES § 1235.8 Reciprocity. The State system...
Indirect Reciprocity; A Field Experiment.
van Apeldoorn, Jacobien; Schram, Arthur
2016-01-01
Indirect reciprocity involves cooperative acts towards strangers, either in response to their kindness to third parties (downstream) or after receiving kindness from others oneself (upstream). It is considered to be important for the evolution of cooperative behavior amongst humans. Though it has been widely studied theoretically, the empirical evidence of indirect reciprocity has thus far been limited and based solely on behavior in laboratory experiments. We provide evidence from an online environment where members can repeatedly ask and offer services to each other, free of charge. For the purpose of this study we created several new member profiles, which differ only in terms of their serving history. We then sent out a large number of service requests to different members from all over the world. We observe that a service request is more likely to be rewarded for those with a profile history of offering the service (to third parties) in the past. This provides clear evidence of (downstream) indirect reciprocity. We find no support for upstream indirect reciprocity (in this case, rewarding the service request after having previously received the service from third parties), however. Our evidence of downstream indirect reciprocity cannot be attributed to reputational effects concerning one's trustworthiness as a service user.
Acute supraventricular tachycardia in children.
Paul, Siba Prosad; Blaikley, Sarah; Peevers, Camilla; Fitz-John, Lin
2012-10-01
This article describes the management in emergency departments of supraventricular tachycardia (SVT) in children. Of all forms of symptomatic arrhythmia in infants, children and adolescents, SVT is the most common. Its clinical presentation varies with the child's age, and it can be difficult to diagnose in infants and young children. It is important that the nurses in the emergency department consider a diagnosis of SVT in young children with histories of poor feeding, lethargy, irritability, excessive sweating or pallor (Zeigler 1994) and in older children with histories of palpitations, dizziness, chest pain, syncope or shortness of breath (Uzun 2010). If SVT is suspected, a 12-lead electrocardiogram should be recorded. Vagal manoeuvre may be successful but in some cases intravenous adenosine is necessary. Children with Wolff-Parkinson-White syndrome are at risk of sudden cardiac death associated with SVT, and should not be treated with calcium channel blockers or digoxin.
Neural correlate of human reciprocity in social interactions.
Sakaiya, Shiro; Shiraito, Yuki; Kato, Junko; Ide, Hiroko; Okada, Kensuke; Takano, Kouji; Kansaku, Kenji
2013-01-01
Reciprocity plays a key role maintaining cooperation in society. However, little is known about the neural process that underpins human reciprocity during social interactions. Our neuroimaging study manipulated partner identity (computer, human) and strategy (random, tit-for-tat) in repeated prisoner's dilemma games and investigated the neural correlate of reciprocal interaction with humans. Reciprocal cooperation with humans but exploitation of computers by defection was associated with activation in the left amygdala. Amygdala activation was also positively and negatively correlated with a preference change for human partners following tit-for-tat and random strategies, respectively. The correlated activation represented the intensity of positive feeling toward reciprocal and negative feeling toward non-reciprocal partners, and so reflected reciprocity in social interaction. Reciprocity in social interaction, however, might plausibly be misinterpreted and so we also examined the neural coding of insight into the reciprocity of partners. Those with and without insight revealed differential brain activation across the reward-related circuitry (i.e., the right middle dorsolateral prefrontal cortex and dorsal caudate) and theory of mind (ToM) regions [i.e., ventromedial prefrontal cortex (VMPFC) and precuneus]. Among differential activations, activation in the precuneus, which accompanied deactivation of the VMPFC, was specific to those without insight into human partners who were engaged in a tit-for-tat strategy. This asymmetric (de)activation might involve specific contributions of ToM regions to the human search for reciprocity. Consequently, the intensity of emotion attached to human reciprocity was represented in the amygdala, whereas insight into the reciprocity of others was reflected in activation across the reward-related and ToM regions. This suggests the critical role of mentalizing, which was not equated with reward expectation during social interactions.
Neural correlate of human reciprocity in social interactions
Directory of Open Access Journals (Sweden)
Shiro eSakaiya
2013-12-01
Full Text Available Reciprocity plays a key role maintaining cooperation in society. However, little is known about the neural process that underpins human reciprocity during social interactions. Our neuroimaging study manipulated partner identity (computer, human and strategy (random, tit-for-tat in repeated prisoner’s dilemma games and investigated the neural correlate of reciprocal interaction with humans. Reciprocal cooperation with humans but exploitation of computers by defection was associated with activation in the left amygdala. Amygdala activation was also positively and negatively correlated with a preference change for human partners following tit-for-tat and random strategies, respectively. The correlated activation represented the intensity of positive feeling toward reciprocal and negative feeling toward non-reciprocal partners, and so reflected reciprocity in social interaction. Reciprocity in social interaction, however, might plausibly be misinterpreted and so we also examined the neural coding of insight into the reciprocity of partners. Those with and without insight revealed differential brain activation across the reward-related circuitry (i.e., the right middle dorsolateral prefrontal cortex and dorsal caudate and theory of mind (ToM regions (i.e., ventromedial prefrontal cortex [VMPFC] and precuneus. Among differential activations, activation in the precuneus, which accompanied deactivation of the VMPFC, was specific to those without insight into human partners who were engaged in a tit-for-tat strategy. This asymmetric (deactivation might involve specific contributions of ToM regions to the human search for reciprocity. Consequently, the intensity of emotion attached to human reciprocity was represented in the amygdala, whereas insight into the reciprocity of others was reflected in activation across the reward-related and ToM regions. This suggests the critical role of mentalizing, which was not equated with reward expectation during
2010-07-01
... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Reciprocity. 173.17 Section 173.17 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) BOATING SAFETY VESSEL NUMBERING AND CASUALTY AND ACCIDENT REPORTING Numbering § 173.17 Reciprocity. (a) Section...
2010-10-01
... 49 Transportation 5 2010-10-01 2010-10-01 false Reciprocity. 384.214 Section 384.214 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER SAFETY... Reciprocity. The State shall allow any person to operate a CMV in the State who is not disqualified from...
Overview of the management of postural tachycardia syndrome in pregnant patients.
Ruzieh, Mohammed; Grubb, Blair P
2018-02-16
Postural tachycardia syndrome (POTS) is a chronic condition characterized by symptoms of orthostatic intolerance. Pregnancy can cause different physiological changes in cardiovascular parameters, that could have greater impact on POTS patients. In this review, we discuss the management of POTS in the pregnant and obstetric settings. Copyright © 2018 Elsevier B.V. All rights reserved.
International Nuclear Information System (INIS)
Golonzko, R.R.; Chernova, M.P.; Berishvili, I.I.; Bulchinskij, S.A.
1982-01-01
Data on routine radiologic examination of 51 patients aged 3 days to 3 years with the right atrio-ventricular ostium atresia were presented. The evidence obtained was compared with angiographic and, in part of cases, with morphometric findings. All patients were divided in two groups, depending on pulmonary circulation functions. Characteristic radiologic features of the valvular defect were revealed: ''quadrangle'' heart configuration; increase of right auricle; ''sheared off'' profile of the right ventricle, absence of increase of leftauricle in children up to 1 year
Vaish, Amrisha; Hepach, Robert; Tomasello, Michael
2018-03-01
Young children engage in direct reciprocity, but the mechanisms underlying such reciprocity remain unclear. In particular, prior work leaves unclear whether children's reciprocity is simply a response to receiving benefits (regardless of whether the benefits were intended) or driven by a mechanism of rewarding or preferring all benefactors (regardless of whom they benefited). Alternatively, perhaps children engage in genuine reciprocity such that they are particularly prosocial toward benefactors who intentionally provided them with benefits. Our findings support this third, richer possibility; the 3-year-olds who received benefits through the good intentions of a benefactor were subsequently more generous toward the benefactor than children who either (a) received the same benefits from the benefactor unintentionally or (b) observed the benefactor bestow the same benefits on another individual. Thus, young children are especially motivated to benefit those who have demonstrated goodwill toward them, suggesting, as one possible mechanism, an early sense of gratitude. Copyright © 2017 Elsevier Inc. All rights reserved.
Schofield, J R; Blitshteyn, S; Shoenfeld, Y; Hughes, G R V
2014-06-01
Antiphospholipid syndrome (APS) is an autoimmune hypercoagulable disorder that has been shown to cause a large number of cardiac and neurological manifestations. Two recent studies have demonstrated abnormalities in cardiovascular autonomic function testing in APS patients without other cardiovascular or autoimmune disease. However, an association between autonomic disorders such as postural tachycardia syndrome and APS has not previously been described. Data were obtained by retrospective chart review. We identified 15 patients who have been diagnosed with APS and an autonomic disorder. The median age of the patients at the time of data analysis was 39 years. The autonomic disorders seen in these patients included postural tachycardia syndrome, neurocardiogenic syncope and orthostatic hypotension. The majority of patients (14/15) were female and the majority (14/15) had non-thrombotic neurological manifestations of APS, most commonly migraine, memory loss and balance disorder. Many also had livedo reticularis (11/15) and Raynaud's phenomenon (nine of 15). In some patients, the autonomic manifestations improved with anticoagulation and/or anti-platelet therapy; in others they did not. Two patients with postural tachycardia syndrome who failed to improve with the usual treatment of APS have been treated with intravenous immunoglobulin with significant improvement in their autonomic symptoms. We believe that autonomic disorders in APS may represent an important clinical association with significant implications for treatment. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
An Inquiry into Relationship Suicides and Reciprocity
Davis, Mark S.; Callanan, Valerie J.; Lester, David; Haines, Janet
2009-01-01
Few theories on suicide have been grounded in the norm of reciprocity. There is literature on suicide, however, describing motivations such as retaliation and retreat which can be interpreted as modes of adaptation to the norm of reciprocity. We propose a reciprocity-based theory to explain suicides associated with relationship problems. Employing…
Li, Chunli; Jia, Libo; Wang, Zhenzhou; Niu, Ling; An, Xinjiang
2017-10-01
The aim of this study was to investigate the efficacy of radiofrequency ablation in the treatment of pediatric arrhythmia and to assess the changes in serum interleukin-6 (IL-6) and hs-CRP levels after treatment. Hundred and six children with tachyarrhythmia who were admitted to Xuzhou Children's Hospital from November, 2014 to December, 2015 were recruited for study. The efficacies of radiofrequency in the treatment of different types of arrhythmia were analyzed. Successful ablation was found in 104 cases (98.11%) and recurrence was found in 7 cases (6.73%). Among 62 cases of atrioventricular reentrant tachycardia (AVRT), successful ablation was found in 60 cases (96.77%) and recurrence was found in 3 cases (4.84%). Among 33 cases of atrioventricular nodal reentrant tachycardia (AVNRT), successful ablation was found in 33 cases (100%) and recurrence was found in 2 cases (6.06%). Among 5 cases of ventricular tachycardia (VT), successful ablation was found in 5 cases (100%) and no recurrence was found. Among 4 cases of atrial tachycardia (AT), successful ablation was found in 4 cases (100%) and recurrence was found in 1 case (25%). Among 2 cases of atrial flutter (AFL), successful ablation was found in both (100%) and recurrence was found in 1 case (50%). After operation, the levels of IL-6 and hs-CRP were increased and were continually increased within 6 h after operation. The levels of IL-6 and hs-CRP at 24 h after operation were reduced but still higher than preoperative levels. The duration of radiofrequency and ablation energy were positively correlated with the levels of IL-6 and hs-CRP, while the number of discharges was not significantly correlated with either. In conclusion, radiofrequency ablation is a safe and effective treatment for pediatric arrhythmia. Postoperative monitoring of IL-6 and hs-CRP levels is conducive to understanding postoperative myocardial injury and inflammatory response.
Electromagnetic reciprocity in antenna theory
Stumpf, Martin
2018-01-01
The reciprocity theorem is among the most intriguing concepts in wave field theory and has become an integral part of almost all standard textbooks on electromagnetic (EM) theory. This book makes use of the theorem to quantitatively describe EM interactions concerning general multiport antenna systems. It covers a general reciprocity-based description of antenna systems, their EM scattering properties, and further related aspects. Beginning with an introduction to the subject, Electromagnetic Reciprocity in Antenna Theory provides readers first with the basic prerequisites before offering coverage of the equivalent multiport circuit antenna representations, EM coupling between multiport antenna systems and their EM interactions with scatterers, accompanied with the corresponding EM compensation theorems.
Hajdú, J; Szabó, I; Német, J
1996-10-06
The supraventricular tachycardia is a life threatening state in the intrauterine life. It can cause non-immune hydrops fetalis, intrauterine death or complications during the delivery. The unexplained tachycardia can cause fetal distress and premature delivery. Usually the digoxin is the first drug of choice for transplacental cardioversion. If digitalisation does not achieve cardioversion, the second line antiarrhythmic drugs should be instituted. Amiodarone has been suggested as a therapeutic alternative after failure of digoxin-verapamil combination. We give a drug in standard therapeutic doses for four-five days and after it we determine whether it is effective or not. We should determine the newer therapy or termination of pregnancy. The transplacental administration of amiodarone may be dangerous because of fetal cretinism. Our case is the first in Hungary-in our best knowledge- and we suggest the amiodarone for transplacental therapy.
Abbasoğlu, Aslıhan; Ecevit, Ayşe; Tuğcu, Ali Ulaş; Erdoğan, Lkay; Kınık, Sibel Tulgar; Tarcan, Aylin
2015-03-01
Neonatal thyrotoxicosis is a rare condition caused by the transplacental passage of thyroid stimulating immunoglobulins from mothers with Graves' disease. We report a case of neonatal thyrotoxicosis with concurrent supraventricular tachycardia (SVT). The female infant, who was born by section due to breech delivery and meconium in the amniotic fluid at 36 weeks of gestation, presented with tachycardia on day 7. Her heart rate was between 260 and 300 beats/min, and an electrocardiogram revealed ongoing SVT. Sotalol was effective after two cardioversions in maintaining sinus rhythm. Thyroid function studies revealed hyperthyroidism in the infant, and her mother was found to have Graves' disease. Since symptoms and signs can vary, especially in preterm infants with neonatal hyperthyroidism, we want to emphasize the importance of prenatal care and follow-ups of Graves' disease associated pregnancies and management of newborns after birth.
Directory of Open Access Journals (Sweden)
Aleksander DOBRIANSKYJ
1997-10-01
Full Text Available Entre maio de 1987 e dezembro de 1996, o reparo do defeito do septo atrioventricular, forma total (DSAVT, com duplo retalho de pericárdio bovino e tricuspidização da valva atrioventricular (VAV esquerda, foi realizado em 34 pacientes consecutivos com mortalidade global de 5 (14,7% pacientes (pac.. Grupo I: abaixo de 6 meses (m com 12 pac. (1 óbito; 8,3%; Grupo II: entre 7m e 12m, com 15 pac. (4 óbitos; 26,6% e Grupo III: entre 1 e 5 anos (a com 7 pac. sem óbitos. Ocorreram 2 óbitos tardios (1 por Insuficiência mitral residual + insuficiência cardíaca congestiva e outro por pneumonia + insuficiência respiratória. Duas crianças receberam implante de marcapasso definitivo (após 45 dias e 4 anos. Nenhum paciente foi reoperado, apesar de mais 2 apresentarem insuficiência da VAV esquerda e 1 VAV direita, controlada clinicamente, e as restantes encontram-se nos graus I e II da New York Heart Association (NYHA. Apesar de 29 pacientes apresentarem peso abaixo de 10 kg, utilizou-se circulação extracorpórea (CEC e hipotermia a 25°C sem parada circulatória total. Iniciou-se o reparo pela zona de "aposição" da VAV única com um ou dois pontos em "x", mantendo tricúspide. Sutura-se o primeiro retalho de pericárdio bovino (PB em forma de "gota", insinuando-o entre as cordas do lado direito do septo; a seguir, sutura-se o segundo retalho, fazendo uma aposição concomitante com a VAV única, septando-se, desta forma, as quatro cavidades. As vantagens desta técnica são: preservação da integridade valvar, maior durabilidade funcional da VAV esquerda, menor possibilidade de reoperação mesmo em pacientes mais jovens e que devem ser preferencialmente operados em torno de 6º mês de vida.Between May 1987 and December 1996, repair of the "Ostium Atrioventricularis Communis" (OAVC, with total shaping by means of a double bovine pericardial patch and tricuspidation of the left atrioventricular valve (AVV was performed on 34 consecutive
On Reciprocal Causation in the Evolutionary Process.
Svensson, Erik I
2018-01-01
Recent calls for a revision of standard evolutionary theory (SET) are based partly on arguments about the reciprocal causation. Reciprocal causation means that cause-effect relationships are bi-directional, as a cause could later become an effect and vice versa. Such dynamic cause-effect relationships raise questions about the distinction between proximate and ultimate causes, as originally formulated by Ernst Mayr. They have also motivated some biologists and philosophers to argue for an Extended Evolutionary Synthesis (EES). The EES will supposedly expand the scope of the Modern Synthesis (MS) and SET, which has been characterized as gene-centred, relying primarily on natural selection and largely neglecting reciprocal causation. Here, I critically examine these claims, with a special focus on the last conjecture. I conclude that reciprocal causation has long been recognized as important by naturalists, ecologists and evolutionary biologists working in the in the MS tradition, although it it could be explored even further. Numerous empirical examples of reciprocal causation in the form of positive and negative feedback are now well known from both natural and laboratory systems. Reciprocal causation have also been explicitly incorporated in mathematical models of coevolutionary arms races, frequency-dependent selection, eco-evolutionary dynamics and sexual selection. Such dynamic feedback were already recognized by Richard Levins and Richard Lewontin in their bok The Dialectical Biologist . Reciprocal causation and dynamic feedback might also be one of the few contributions of dialectical thinking and Marxist philosophy in evolutionary theory. I discuss some promising empirical and analytical tools to study reciprocal causation and the implications for the EES. Finally, I briefly discuss how quantitative genetics can be adapated to studies of reciprocal causation, constructive inheritance and phenotypic plasticity and suggest that the flexibility of this approach
Koźluk, Edward; Timler, Dariusz; Zyśko, Dorota; Piątkowska, Agnieszka; Grzebieniak, Tomasz; Gajek, Jacek; Gałązkowski, Robert; Fedorowski, Artur
2015-01-01
Atrial fibrillation (AF) in patients with Wolff-Parkinson-White (WPW) syndrome is potentially life-threatening as it may deteriorate into ventricular fibrillation. The aim of this study was to assess whether the emergency medical team members are able to diagnose AF with a rapid ventricular response due to the presence of atrioventricular bypass tract in WPW syndrome. The study group consisted of 316 participants attending a national congress of emergency medicine. A total of 196 questionnaires regarding recognition and management of cardiac arrhythmias were distributed. The assessed part presented a clinical scenario with a young hemodynamically stable man who had a 12-lead electrocardiogram performed in the past with signs of pre-excitation, and who presented to the emergency team with an irregular broad QRS-complex tachycardia. A total of 71 questionnaires were filled in. Only one responder recognized AF due to WPW syndrome, while 5 other responders recognized WPW syndrome and paroxysmal supraventricular tachycardia or broad QRS-complex tachycardia. About 20% of participants did not select any diagnosis, pointing out a method of treatment only. The most common diagnosis found in the survey was ventricular tachycardia/broad QRS-complex tachycardia marked by approximately a half of the participants. Nearly 18% of participants recognized WPW syndrome, whereas AF was recognized by less than 10% of participants. Members of emergency medical teams have limited skills for recognizing WPW syndrome with rapid AF, and ventricular tachycardia is the most frequent incorrect diagnosis.
Direct reciprocity in structured populations.
van Veelen, Matthijs; García, Julián; Rand, David G; Nowak, Martin A
2012-06-19
Reciprocity and repeated games have been at the center of attention when studying the evolution of human cooperation. Direct reciprocity is considered to be a powerful mechanism for the evolution of cooperation, and it is generally assumed that it can lead to high levels of cooperation. Here we explore an open-ended, infinite strategy space, where every strategy that can be encoded by a finite state automaton is a possible mutant. Surprisingly, we find that direct reciprocity alone does not lead to high levels of cooperation. Instead we observe perpetual oscillations between cooperation and defection, with defection being substantially more frequent than cooperation. The reason for this is that "indirect invasions" remove equilibrium strategies: every strategy has neutral mutants, which in turn can be invaded by other strategies. However, reciprocity is not the only way to promote cooperation. Another mechanism for the evolution of cooperation, which has received as much attention, is assortment because of population structure. Here we develop a theory that allows us to study the synergistic interaction between direct reciprocity and assortment. This framework is particularly well suited for understanding human interactions, which are typically repeated and occur in relatively fluid but not unstructured populations. We show that if repeated games are combined with only a small amount of assortment, then natural selection favors the behavior typically observed among humans: high levels of cooperation implemented using conditional strategies.
Case report of complete atrioventricular block following therapeutic irradiation for breast cancer
Energy Technology Data Exchange (ETDEWEB)
Nishizawa, Tadashi; Suzuki, Ichiro; Kobayashi, Jun; Terashima, Masafumi
1987-12-01
A 49-year-old woman developed complete atrioventricular (A-V) block 16 years after radiotherapy for breast cancer. The patient had received 60 Gy of cobalt 60 irradiation for left breast cancer arising 3 years after contracting right breast cancer. It took one year before complete A-V block was fixed, during which two-degree A-V block, atrial fibrillation, and sinus rhythm were predominant. She had myocardial insertion of pacemaker electrode. Fibrosis and hyaloid degeneration of the pericardium and thickened sclerosis of the epicardium seemed to be radiation-induced. There was no evidence of recurrence of breast cancer. (Namekawa, K.).
Idiopathic ventricular tachycardia and fibrillation.
Belhassen, B; Viskin, S
1993-06-01
Important data have recently been added to our understanding of sustained ventricular tachyarrhythmias occurring in the absence of demonstrable heart disease. Idiopathic ventricular tachycardia (VT) is usually of monomorphic configuration and can be classified according to its site of origin as either right monomorphic (70% of all idiopathic VTs) or left monomorphic VT. Several physiopathological types of monomorphic VT can be presently individualized, according to their mode of presentation, their relationship to adrenergic stress, or their response to various drugs. The long-term prognosis is usually good. Idiopathic polymorphic VT is a much rarer type of arrhythmia with a less favorable prognosis. Idiopathic ventricular fibrillation may represent an underestimated cause of sudden cardiac death in ostensibly healty patients. A high incidence of inducibility of sustained polymorphic VT with programmed ventricular stimulation has been found by our group, but not by others. Long-term prognosis on Class IA antiarrhythmic medications that are highly effective at electrophysiologic study appears excellent.
Kroesen, Michiel; Maseland, Machiel; Smal, Jaime; Reimer, Annet; van Setten, Petra
2012-01-01
We present the case of a 2-year-old asthmatic boy with atrioventricular (AV)-reentry tachycardia following albuterol inhalation, who was later diagnosed with Wolff-Parkinson-White (WPW) syndrome. The Naranjo adverse drug reaction probability scale score for this adverse event was 7, indicating that the association between his AV-reentry tachycardia and inhalation of albuterol is probable. To our knowledge, this is the first case report that shows the potential arrhythmogenic effects of albuterol in a child with WPW syndrome. We urge clinicians to be aware of this potentially life-threatening adverse effect and to closely monitor these patients when they need beta-adrenergic drugs in case of emergency. Furthermore, this report highlights the dilemma regarding the safe treatment of pediatric patients with both asthma and WPW syndrome. PMID:23118663
Mechanism-specific effects of adenosine on ventricular tachycardia.
Lerman, Bruce B; Ip, James E; Shah, Bindi K; Thomas, George; Liu, Christopher F; Ciaccio, Edward J; Wit, Andrew L; Cheung, Jim W; Markowitz, Steven M
2014-12-01
There is no universally accepted method by which to diagnose clinical ventricular tachycardia (VT) due to cAMP-mediated triggered activity. Based on cellular and clinical data, adenosine termination of VT is thought to be consistent with a diagnosis of triggered activity. However, a major gap in evidence mitigates the validity of this proposal, namely, defining the specificity of adenosine response in well-delineated reentrant VT circuits. To this end, we systematically studied the effects of adenosine in a model of canine reentrant VT and in human reentrant VT, confirmed by 3-dimensional, pace- and substrate mapping. Adenosine (12 mg [IQR 12-24]) failed to terminate VT in 31 of 31 patients with reentrant VT due to structural heart disease, and had no effect on VT cycle length (age, 67 years [IQR 53-74]); ejection fraction, 35% [IQR 20-55]). In contrast, adenosine terminated VT in 45 of 50 (90%) patients with sustained focal right or left outflow tract tachycardia. The sensitivity of adenosine for identifying VT due to triggered activity was 90% (95% CI, 0.78-0.97) and its specificity was 100% (95% CI, 0.89-1.0). Additionally, reentrant circuits were mapped in the epicardial border zone of 4-day-old infarcts in mongrel dogs. Adenosine (300-400 μg/kg) did not terminate sustained VT or have any effect on VT cycle length. These data support the concept that adenosine's effects on ventricular myocardium are mechanism specific, such that termination of VT in response to adenosine is diagnostic of cAMP-mediated triggered activity. © 2014 Wiley Periodicals, Inc.
2010-07-01
... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Reciprocity. 251.63 Section 251.63 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE LAND USES Special Uses § 251.63 Reciprocity. If it is determined that a right-of-way shall be needed by the United States...
Do infants detect indirect reciprocity?
Meristo, Marek; Surian, Luca
2013-10-01
In social interactions involving indirect reciprocity, agent A acts prosocially towards B and this prompts C to act prosocially towards A. This happens because A's actions enhanced its reputation in the eyes of third parties. Indirect reciprocity may have been of central importance in the evolution of morality as one of the major mechanisms leading to the selection of helping and fair attitudes. Here we show that 10-month-old infants expect third parties to act positively towards fair donors who have distributed attractive resources equally between two recipients, rather than toward unfair donors who made unequal distributions. Infants' responses were dependent on the reciprocator's perceptual exposure to previous relevant events: they expected the reciprocator to reward the fair donor only when it had seen the distributive actions performed by the donors. We propose that infants were able to generate evaluations of agents that were based on the fairness of their distributive actions and to generate expectations about the social preferences of informed third parties. Copyright © 2013 Elsevier B.V. All rights reserved.
Teacher License Reciprocity. 50-State Review
Aragon, Stephanie
2017-01-01
This policy report defines and provides a 50-state review of teacher license reciprocity, explores how state-specific licensing requirements impact the teacher labor market, and includes examples of national and state efforts to facilitate reciprocity.
Reciprocity Effects in the Trust Game
Directory of Open Access Journals (Sweden)
Alexander Smith
2013-07-01
Full Text Available I use data from a previous experiment for classifying subjects based on their behavior in the trust game. Prior literature defines a “reciprocity effect” as the tendency for Second Movers to return proportions increasing in the amounts that they receive. In the data that I use, 31% of Second Movers show reciprocity effects, 31% are neutral, and 25% consistently free-ride, indicating that the aggregate reciprocity effect for the sample as a whole is attributable to a minority of the subjects.
Koa-Wing, Michael; Nakagawa, Hiroshi; Luther, Vishal; Jamil-Copley, Shahnaz; Linton, Nick; Sandler, Belinda; Qureshi, Norman; Peters, Nicholas S; Davies, D Wyn; Francis, Darrel P; Jackman, Warren; Kanagaratnam, Prapa
2015-11-15
Ripple Mapping (RM) is designed to overcome the limitations of existing isochronal 3D mapping systems by representing the intracardiac electrogram as a dynamic bar on a surface bipolar voltage map that changes in height according to the electrogram voltage-time relationship, relative to a fiduciary point. We tested the hypothesis that standard approaches to atrial tachycardia CARTO™ activation maps were inadequate for RM creation and interpretation. From the results, we aimed to develop an algorithm to optimize RMs for future prospective testing on a clinical RM platform. CARTO-XP™ activation maps from atrial tachycardia ablations were reviewed by two blinded assessors on an off-line RM workstation. Ripple Maps were graded according to a diagnostic confidence scale (Grade I - high confidence with clear pattern of activation through to Grade IV - non-diagnostic). The RM-based diagnoses were corroborated against the clinical diagnoses. 43 RMs from 14 patients were classified as Grade I (5 [11.5%]); Grade II (17 [39.5%]); Grade III (9 [21%]) and Grade IV (12 [28%]). Causes of low gradings/errors included the following: insufficient chamber point density; window-of-interestRipple Maps in atrial tachycardias. This algorithm requires prospective testing on a real-time clinical platform. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Profit Sharing and Reciprocity: Theory and Survey Evidence
Cornelissen, Thomas; Heywood, John S.; Jirjahn, Uwe
2010-01-01
The 1/n problem potentially limits the effectiveness of profit sharing in motivating workers. While the economic literature suggests that reciprocity can mitigate this problem, it remains silent on the optimal degree of reciprocity. We present a representative model demonstrating that reciprocity may increase productive effort but may also increase unproductive effort such as socializing on the job. The model implies that reciprocity increases profit up to a point but decreases profit beyond ...
Pappone, Carlo; Vicedomini, Gabriele; Manguso, Francesco; Baldi, Mario; Pappone, Alessia; Petretta, Andrea; Vitale, Raffaele; Saviano, Massimo; Ciaccio, Cristiano; Giannelli, Luigi; Calovic, Zarko; Tavazzi, Luigi; Santinelli, Vincenzo
2012-02-07
The available amount of detailed long-term data in patients with Wolff-Parkinson-White syndrome is limited, and no prospective electrophysiological studies looking at predictors of malignant arrhythmia are available. Among 8575 symptomatic Wolff-Parkinson-White patients with atrioventricular reentrant tachycardia referred for electrophysiological test, 369 (mean age, 23±12.5 years) declined catheter ablation and were followed up. The primary end point of the study was to evaluate over a 5-year follow-up the predictors and characteristics of patients who develop malignant arrhythmias. After a mean follow-up of 42.1±10 months, malignant arrhythmias developed in 29 patients (mean age, 13.9±5.6 years; 26 male), resulting in presyncope/syncope (25 patients), hemodynamic collapse (3 patients), or cardiac arrest caused by ventricular fibrillation (1 patient). Of the remaining 340 patients, 168 (mean age, 34.2±9.0 years) remained asymptomatic up to 5 years, and 172 (mean age, 13.6±5.1 years) had benign recurrence, including sustained atrioventricular reentrant tachycardia (132 patients) or atrial fibrillation (40 patients). Compared with the group with no malignant arrhythmias, the group with malignant arrhythmias showed shorter accessory-pathway effective refractory period (PWolff-Parkinson-White syndrome generally have a good outcome, and predictors of malignant arrhythmias are similar to those reported for asymptomatic patients with ventricular pre-excitation.
Development of the reciprocity of self-disclosure.
Rotenberg, K J; Chase, N
1992-03-01
This study was designed to assess whether children demonstrate covariant and equivalent forms of the reciprocity of self-disclosure, and if so, at what age. Twenty-one kindergarten, 23 second-grade, 24 fourth-grade, and 24 sixth-grade children were shown videotapes of three children (partners) who provided pre-established low-, medium-, and high-intimate disclosures. The subjects were required to send a message to the partners on topics varying in personal content. Fourth-grade children showed evidence of covariant reciprocity of self-disclosure by disclosing higher intimacy to high-intimate partners than to low-intimate partners. Sixth-grade children showed equivalent reciprocity of self-disclosure by providing a greater number of high- and medium-intimate disclosures to high- and medium-intimate partners, respectively, than to low-intimate partners. By contrast, neither form of reciprocity of self-disclosure was shown by kindergarten and second-grade children. Consistent with our expectations, girls provided a greater number of high-intimate disclosures than did boys in three of the four grades. The findings are discussed in terms of interplay between the development of the reciprocity of self-disclosure and the norm of the reciprocity of self-disclosure.
Reciprocal Relationships: Something for Everyone.
Tumosa, Nina
2017-01-01
Reciprocal relationships based on mutual goals, respect and trust are key to maintaining working relationships and getting reliable research results. Yet relationship building is not a concept taught in academia. These skills are often learned the hard way, with singular solutions found for case-by-case scenarios. Several journeys to identify the components, barriers and rewards of reciprocal relationships are discussed.
Trust and Reciprocity: Are Effort and Money Equivalent?
Vilares, Iris; Dam, Gregory; Kording, Konrad
2011-01-01
Trust and reciprocity facilitate cooperation and are relevant to virtually all human interactions. They are typically studied using trust games: one subject gives (entrusts) money to another subject, which may return some of the proceeds (reciprocate). Currently, however, it is unclear whether trust and reciprocity in monetary transactions are similar in other settings, such as physical effort. Trust and reciprocity of physical effort are important as many everyday decisions imply an exchange of physical effort, and such exchange is central to labor relations. Here we studied a trust game based on physical effort and compared the results with those of a computationally equivalent monetary trust game. We found no significant difference between effort and money conditions in both the amount trusted and the quantity reciprocated. Moreover, there is a high positive correlation in subjects' behavior across conditions. This suggests that trust and reciprocity may be character traits: subjects that are trustful/trustworthy in monetary settings behave similarly during exchanges of physical effort. Our results validate the use of trust games to study exchanges in physical effort and to characterize inter-subject differences in trust and reciprocity, and also suggest a new behavioral paradigm to study these differences. PMID:21364931
Transient nature of cooperation by pay-it-forward reciprocity.
Horita, Yutaka; Takezawa, Masanori; Kinjo, Takuji; Nakawake, Yo; Masuda, Naoki
2016-01-20
Humans often forward kindness received from others to strangers, a phenomenon called the upstream or pay-it-forward indirect reciprocity. Some field observations and laboratory experiments found evidence of pay-it-forward reciprocity in which chains of cooperative acts persist in social dilemma situations. Theoretically, however, cooperation based on pay-it-forward reciprocity is not sustainable. We carried out laboratory experiments of a pay-it-forward indirect reciprocity game (i.e., chained gift-giving game) on a large scale in terms of group size and time. We found that cooperation consistent with pay-it-forward reciprocity occurred only in a first few decisions per participant and that cooperation originated from inherent pro-sociality of individuals. In contrast, the same groups of participants showed persisting chains of cooperation in a different indirect reciprocity game in which participants earned reputation by cooperating. Our experimental results suggest that pay-it-forward reciprocity is transient and disappears when a person makes decisions repeatedly, whereas the reputation-based reciprocity is stable in the same situation.
Directory of Open Access Journals (Sweden)
Eduardo Keller Saadi
1993-06-01
Full Text Available Pacientes com defeito septal atrioventricular de forma total (DSAVT freqüentemente apresentam insuficiência cardíaca intratável e hipertensão arterial pulmonar nos primeiros meses de vida, e apenas uma minoria sobrevive sem tratamento cirúrgico precoce. Por essa razão, indica-se a correção definitiva para alterar favoravelmente a história natural da doença. Entretanto, vários fatores são responsáveis pela alta mortalidade cirúrgica. O presente trabalho estuda a experiência na correção cirúrgica do DSAVT com o objetivo de identificar alguns fatores de risco estatisticamente significativos para a ocorrência de morte operatória. Analisaram-se, retrospectivamente, 52 pacientes submetidos, entre janeiro de 1974 e dezembro de 1990, a cirurgia definitiva para correção de DSAVT no Royal Brompton and National Heart and Lung Institute, sendo estudadas as seguintes variáveis: idade, peso, sexo, ano da operação, presença de síndrome de Down, grau de regurgitação da valva AV, bandagem prévia do tronco pulmonar, presença de anomalias associadas, pressão sistólica pulmonar, duplo orifício mitral, classificação do defeito segundo Rastelli, emprego de parada circulatória e técnica de correção (1 x 2 retalhos. Todos os fatores foram avaliados isoladamente, mediante a análise univariada. Para determinar quais os fatores que, independentemente da ação de outros, contribuíram significativamente para maior mortalidade cirúrgica, foi utilizada a análise multivariada com regressão logística. A análise multivariada demonstrou que o baixo peso na época da operação e a técnica de correção com um retalho aumentam significativamente a mortalidade cirúrgica.Patients with complete atrioventricular septal defects (CAVSD frequently present with severe heart failure which cannot be controllable medically and pulmonary hypertension in infancy. Just a small number survives without early surgical treatment. For this reason
Ventricular tachycardia during arthroscopic shoulder surgery: a report of two cases.
Cho, Seung Hyun; Yi, Jin Woong; Kwack, Yoon Ho; Park, Sung Wook; Kim, Mi Kyeong; Rhee, Yong Girl
2010-03-01
We routinely have performed arthroscopic shoulder surgery under general anesthesia in the beach chair position using epinephrine (0.33 mg/L) saline irrigation. At a 2-week interval, two patients, a 19-year-old man scheduled to undergo an arthroscopic Bankart repair for left traumatic anterior instability and a 49-year-old woman scheduled for an arthroscopic rotator cuff repair for a left rotator cuff tear, were resuscitated by chest compression and defibrillation due to a sudden developed cardiogenic shock following ventricular tachycardia at the time of arthroscopic shoulder surgery. They were transferred to the intensive care unit because their emergent echocardiogram showed significantly decreased cardiac functions. They were fully recovered and then discharged. Epinephrine was considered to be the cause of ventricular tachycardia because the two patients showed no anaphylactic reaction to drugs or symptoms of air embolism related to the beach chair position. In addition, according to our observation of epinephrine flow patterns, it was more likely that highly concentrated epinephrine was rapidly infused into the body. This complication is very rare. However, thorough understanding of the side effects and their development of epinephrine during arthroscopic shoulder surgery should neither be overemphasized nor disregarded.
Reciprocity in electron diffraction
International Nuclear Information System (INIS)
Gunning, J.; Goodman, P.
1992-01-01
The symmetry of reciprocity is reviewed in the context of relativistic quantum mechanics with the specific aim of relating to C, P and T invariances. From this investigation global time reversal is found to be a sufficient condition for reciprocity to hold in scattering from a vector potential. The present proof is free from assumptions of small-angle scattering and from restrictions on z-dependent terms in the scattering equation, and by avoiding S-matrix theory is thought to be accessible to undergraduate teaching. (orig.)
Alternative energy efficient membrane bioreactor using reciprocating submerged membrane.
Ho, J; Smith, S; Roh, H K
2014-01-01
A novel membrane bioreactor (MBR) pilot system, using membrane reciprocation instead of air scouring, was operated at constant high flux and daily fluctuating flux to demonstrate its application under peak and diurnal flow conditions. Low and stable transmembrane pressure was achieved at 40 l/m(2)/h (LMH) by use of repetitive membrane reciprocation. The results reveal that the inertial forces acting on the membrane fibers effectively propel foulants from the membrane surface. Reciprocation of the hollow fiber membrane is beneficial for the constant removal of solids that may build up on the membrane surface and inside the membrane bundle. The membrane reciprocation in the reciprocating MBR pilot consumed less energy than coarse air scouring used in conventional MBR systems. Specific energy consumption for the membrane reciprocation was 0.072 kWh/m(3) permeate produced at 40 LMH flux, which is 75% less than for a conventional air scouring system as reported in literature without consideration of energy consumption for biological aeration (0.29 kWh/m(3)). The daily fluctuating flux test confirmed that the membrane reciprocation is effective to handle fluctuating flux up to 50 LMH. The pilot-scale reciprocating MBR system successfully demonstrated that fouling can be controlled via 0.43 Hz membrane reciprocation with 44 mm or higher amplitude.
Directory of Open Access Journals (Sweden)
P Syamasundar Rao
2018-04-01
Full Text Available This review discusses the management of ventricular septal defects (VSDs and atrioventricular septal defects (AVSDs. There are several types of VSDs: perimembranous, supracristal, atrioventricular septal, and muscular. The indications for closure are moderate to large VSDs with enlarged left atrium and left ventricle or elevated pulmonary artery pressure (or both and a pulmonary-to-systemic flow ratio greater than 2:1. Surgical closure is recommended for large perimembranous VSDs, supracristal VSDs, and VSDs with aortic valve prolapse. Large muscular VSDs may be closed by percutaneous techniques. A large number of devices have been used in the past for VSD occlusion, but currently Amplatzer Muscular VSD Occluder is the only device approved by the US Food and Drug Administration for clinical use. A hybrid approach may be used for large muscular VSDs in small babies. Timely intervention to prevent pulmonary vascular obstructive disease (PVOD is germane in the management of these babies. There are several types of AVSDs: partial, transitional, intermediate, and complete. Complete AVSDs are also classified as balanced and unbalanced. All intermediate and complete balanced AVSDs require surgical correction, and early repair is needed to prevent the onset of PVOD. Surgical correction with closure of atrial septal defect and VSD, along with repair and reconstruction of atrioventricular valves, is recommended. Palliative pulmonary artery banding may be considered in babies weighing less than 5 kg and those with significant co-morbidities. The management of unbalanced AVSDs is more complex, and staged single-ventricle palliation is the common management strategy. However, recent data suggest that achieving two-ventricle repair may be a better option in patients with suitable anatomy, particularly in patients in whom outcomes of single-ventricle palliation are less than optimal. The majority of treatment modes in the management of VSDs and AVSDs are safe
Directory of Open Access Journals (Sweden)
Andres Di Leoni Ferrari
2011-09-01
Full Text Available INTRODUÇÃO: Distúrbios do sistema de condução cardíaco são complicações potenciais e conhecidas dos procedimentos de cirurgia cardíaca valvar. OBJETIVOS: Investigar a associação entre fatores peri-operatórios com bloqueio atrioventricular (BAV e a necessidade de estimulação cardíaca artificial temporária (ECAT e, se necessário, implante de marcapasso definitivo no pós-operatório de cirurgia cardíaca (POCC valvar. MÉTODOS: Coorte histórica de pacientes submetidos a cirurgia cardíaca valvar, sendo realizada análise de banco de dados por regressão logística. RESULTADOS: No período de janeiro de 1996 a dezembro de 2008, foram realizadas 1102 cirurgias cardíacas valvares: 718 (65,2% na valva aórtica e 407 (36,9% na valva mitral; destas, 190 (17,2% cirurgias de revascularização miocárdica associadas à cirurgia valvar e 23 (2,1% cirurgias valvares combinadas (aórtica+mitral. Cento e oitenta e sete (17% pacientes apresentaram quadro clínico e eletrocardiográfico de BAV durante o POCC valvar, necessitando de ECAT. Quatorze (7,5% pacientes evoluíram para implante de marcapasso definitivo (1,27% do total da amostra. A análise multivariada evidenciou associação significativa de BAV com cirurgia de valva mitral (OR=1,76; IC 95% 1,08-2,37; P=0,002, implante de prótese biológica (OR=1,59; IC 95% 1,02-3,91; P= 0,039, idade maior que 60 anos (OR = 1,99; IC 95% 1,35-2,85; PINTRODUCTION: Disturbances of the cardiac conduction system are potential complications after cardiac valve surgery. OBJECTIVES: This study was designed to investigate the association between perioperative factors and atrio-ventricular block, the need for temporary cardiac artificial pacing and, if necessary, permanent pacemaker implantation after cardiac valve surgery. METHODS: Retrospective analysis of the Cardiac Surgery Database - Hospital São Lucas/PUCRS. The data are collected prospectively and analyzed retrospectively. RESULTS: Between January
32 CFR 634.16 - Reciprocal state-military action.
2010-07-01
... 32 National Defense 4 2010-07-01 2010-07-01 true Reciprocal state-military action. 634.16 Section... Reciprocal state-military action. (a) Commanders will recognize the interests of the states in matters of POV... formal military reciprocity, the procedures below will be adopted: (1) Commanders will recognize official...
On reciprocal Baecklund transformations of inverse scattering schemes
International Nuclear Information System (INIS)
Rogers, C.; Wong, P.
1984-01-01
The notion of reciprocally related inverse scattering schemes is introduced and is shown to be a key component in the link between the AKNS and WKI schemes. Reciprocal auto-Baecklund transformations are represented both for a generalised Harry-Dym equation and an equation descriptive of nonlinear oscillation of elastic beams. Further, the N-loop soliton solution of the KIW equation is generated in a convenient parametric form via reciprocal Baecklund transformations. Finally, an important reduction to canonical spectral form is shown to be a reciprocal transformation. (Auth.)
Özyürek, Taha; Uslu, Gülşah; Yılmaz, Koray; Gündoğar, Mustafa
2018-06-01
The purpose of this article was to compare the cyclic fatigue resistance of Reciproc and Reciproc Blue files (VDW GmbH, Munich, Germany) that were used to prepare root canals of mandibular molar teeth with or without a glide path. Sixty Reciproc R25 and 60 Reciproc Blue R25 files were used. The Reciproc and Reciproc Blue groups were divided into 3 subgroups (ie, as received condition, used without a glide path, and used with a glide path). All the instruments were rotated in a stainless steel artificial canal with an inner diameter of 1.5 mm, a 60° angle of curvature, and a radius of curvature of 5 mm until fracture occurred. The number of cycle to fracture was calculated, and the length of the fractured segments was measured. The Kruskal-Wallis test was performed to statistically analyze the data using SPSS 21.0 software (IBM Corp, Armonk, NY) at a 5% significance level. The cyclic fatigue resistance of as received condition Reciproc Blue files was found to be higher than as received condition Reciproc files (P .05). There was no statistically significant difference in the mean length of the fractured fragments of the instruments (P > .05). Within the limitations of this in vitro study, it was concluded that creating a glide path using ProGlider files had no effect on the cyclic fatigue resistance of RPC and RPC Blue files. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
van der Werf, Christian; Kannankeril, Prince J.; Sacher, Frederic; Krahn, Andrew D.; Viskin, Sami; Leenhardt, Antoine; Shimizu, Wataru; Sumitomo, Naokata; Fish, Frank A.; Bhuiyan, Zahurul A.; Willems, Albert R.; van der Veen, Maurits J.; Watanabe, Hiroshi; Laborderie, Julien; Haïssaguerre, Michel; Knollmann, Björn C.; Wilde, Arthur A. M.
2011-01-01
Objectives This study evaluated the efficacy and safety of flecainide in addition to conventional drug therapy in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT). Background CPVT is an inherited arrhythmia syndrome caused by gene mutations that destabilize cardiac
A. Enayati; V. Khori*; M. Azadbakhat; M. Zahedi
2017-01-01
Background and objectives: The ideal drug for treatment of a wide range of supraventricular arrhythmia hasn't yet been developed. Previous studies have shown antihypertensive and negative inotropic effects of the Urtica dioica L. (nettle). Therefore, the aim of present study is to determine the rate dependent inhibitory effects of ethanol extract of nettle root and investigate the role of adrenoceptors in the anti-arrhythmic mechanism of nettle on the isolated rabbit atrio-ventricular node. M...
NABIPOUR, Abolghasem
2014-01-01
This study examined the atrioventricular conducting system in 4 adult male hedgehogs (Hemiechinus auritus). The histological structure of these components was studied using routine histological methods. The AVN was located at the lower and anterior part of the interatrial septum, near the root of the aorta. It was almost oval and consisted of twisted cells. Internodal pathways in the hedgehog heart were not observed, but there were numerous purkinje-like fibers within the myocardium of the at...
Katritsis, Demosthenes G.; Becker, Anton E.; Ellenbogen, Kenneth A.; Karabinos, Ilias; Giazitzoglou, Eleftherios; Korovesis, Socrates; Camm, A. John
2004-01-01
The purpose of this study was to investigate the electrophysiologic characteristics of the inferior extensions of the human atrioventricular (AV) node and their possible relationship to slow pathway conduction. The human heart contains right and left inferior extensions of the AV node that relate to
Kurosawa, H.; Becker, A. E.
1985-01-01
A stillborn baby girl was found to have an anomalous muscle bundle of the right ventricle, associated with a doubly committed subarterial ventricular septal defect. The latter was separated from the area of the atrioventricular conduction bundle by muscle. Serial histologic sectioning of the
Reciprocity and Ethical Tuberculosis Treatment and Control.
Silva, Diego S; Dawson, Angus; Upshur, Ross E G
2016-03-01
This paper explores the notion of reciprocity in the context of active pulmonary and laryngeal tuberculosis (TB) treatment and related control policies and practices. We seek to do three things: First, we sketch the background to contemporary global TB care and suggest that poverty is a key feature when considering the treatment of TB patients. We use two examples from TB care to explore the role of reciprocity: isolation and the use of novel TB drugs. Second, we explore alternative means of justifying the use of reciprocity through appeal to different moral and political theoretical traditions (i.e., virtue ethics, deontology, and consequentialism). We suggest that each theory can be used to provide reasons to take reciprocity seriously as an independent moral concept, despite any other differences. Third, we explore general meanings and uses of the concept of reciprocity, with the primary intention of demonstrating that it cannot be simply reduced to other more frequently invoked moral concepts such as beneficence or justice. We argue that reciprocity can function as a mid-level principle in public health, and generally, captures a core social obligation arising once an individual or group is burdened as a result of acting for the benefit of others (even if they derive a benefit themselves). We conclude that while more needs to be explored in relation to the theoretical justification and application of reciprocity, sufficient arguments can be made for it to be taken more seriously as a key principle within public health ethics and bioethics more generally.
Reciprocation of perceived organizational support.
Eisenberger, R; Armeli, S; Rexwinkel, B; Lynch, P D; Rhoades, L
2001-02-01
Four hundred thirteen postal employees were surveyed to investigate reciprocation's role in the relationships of perceived organizational support (POS) with employees' affective organizational commitment and job performance. The authors found that (a) POS was positively related to employees' felt obligation to care about the organization's welfare and to help the organization reach its objectives; (b) felt obligation mediated the associations of POS with affective commitment, organizational spontaneity, and in-role performance; and (c) the relationship between POS and felt obligation increased with employees' acceptance of the reciprocity norm as applied to work organizations. Positive mood also mediated the relationships of POS with affective commitment and organizational spontaneity. The pattern of findings is consistent with organizational support theory's assumption that POS strengthens affective commitment and performance by a reciprocation process.
Symmetry-based reciprocity: evolutionary constraints on a proximate mechanism.
Campennì, Marco; Schino, Gabriele
2016-01-01
Background. While the evolution of reciprocal cooperation has attracted an enormous attention, the proximate mechanisms underlying the ability of animals to cooperate reciprocally are comparatively neglected. Symmetry-based reciprocity is a hypothetical proximate mechanism that has been suggested to be widespread among cognitively unsophisticated animals. Methods. We developed two agent-based models of symmetry-based reciprocity (one relying on an arbitrary tag and the other on interindividual proximity) and tested their ability both to reproduce significant emergent features of cooperation in group living animals and to promote the evolution of cooperation. Results. Populations formed by agents adopting symmetry-based reciprocity showed differentiated "social relationships" and a positive correlation between cooperation given and received: two common aspects of animal cooperation. However, when reproduction and selection across multiple generations were added to the models, agents adopting symmetry-based reciprocity were outcompeted by selfish agents that never cooperated. Discussion. In order to evolve, hypothetical proximate mechanisms must be able to stand competition from alternative strategies. While the results of our simulations require confirmation using analytical methods, we provisionally suggest symmetry-based reciprocity is to be abandoned as a possible proximate mechanism underlying the ability of animals to reciprocate cooperative interactions.
Familial Reciprocity and Subjective Well-Being in Ghana
Tsai, Ming-Chang; Dzorgbo, Dan-Bright S.
2012-01-01
The authors investigated variations in reciprocity and the impact of reciprocity on well-being in a West African society. They hypothesized that household size and income diversity encourage reciprocity, which in turn enhances subjective well-being. In empirical testing of these hypotheses the authors used the data of the Core Welfare Indicators…
Short-Term Reciprocity in Late Parent-Child Relationships
Leopold, Thomas; Raab, Marcel
2011-01-01
Long-term concepts of parent-child reciprocity assume that the amount of support given and received is only balanced in a generalized fashion over the life course. We argue that reciprocity in parent-child relationships also operates in the short term. Our analysis of short-term reciprocity focuses on concurrent exchange in its main upward and…
Reciprocity theory of homogeneous reactions
Agbormbai, Adolf A.
1990-03-01
The reciprocity formalism is applied to the homogeneous gaseous reactions in which the structure of the participating molecules changes upon collision with one another, resulting in a change in the composition of the gas. The approach is applied to various classes of dissociation, recombination, rearrangement, ionizing, and photochemical reactions. It is shown that for the principle of reciprocity to be satisfied it is necessary that all chemical reactions exist in complementary pairs which consist of the forward and backward reactions. The backward reaction may be described by either the reverse or inverse process. The forward and backward processes must satisfy the same reciprocity equation. Because the number of dynamical variables is usually unbalanced on both sides of a chemical equation, it is necessary that this balance be established by including as many of the dynamical variables as needed before the reciprocity equation can be formulated. Statistical transformation models of the reactions are formulated. The models are classified under the titles free exchange, restricted exchange and simplified restricted exchange. The special equations for the forward and backward processes are obtained. The models are consistent with the H theorem and Le Chatelier's principle. The models are also formulated in the context of the direct simulation Monte Carlo method.
Indirect reciprocity with optional interactions.
Ghang, Whan; Nowak, Martin A
2015-01-21
Indirect reciprocity is a mechanism for the evolution of cooperation that is relevant for prosocial behavior among humans. Indirect reciprocity means that my behavior towards you also depends on what you have done to others. Indirect reciprocity is associated with the evolution of social intelligence and human language. Most approaches to indirect reciprocity assume obligatory interactions, but here we explore optional interactions. In any one round a game between two players is offered. A cooperator accepts a game unless the reputation of the other player indicates a defector. For a game to take place, both players must accept. In a game between a cooperator and a defector, the reputation of the defector is revealed to all players with probability Q. After a sufficiently large number of rounds the identity of all defectors is known and cooperators are no longer exploited. The crucial condition for evolution of cooperation can be written as hQB>1, where h is the average number of rounds per person and B=(b/c)-1 specifies the benefit-to-cost ratio. We analyze both stochastic and deterministic evolutionary game dynamics. We study two extensions that deal with uncertainty: hesitation and malicious gossip. Copyright © 2014 Elsevier Ltd. All rights reserved.
Calkoen, Emmeline E.; de Koning, Patrick J. H.; Blom, Nico A.; Kroft, Lucia J. M.; de Roos, Albert; Wolterbeek, Ron; Roest, Arno A. W.; Westenberg, Jos J. M.
2015-01-01
Objectives Four-dimensional (3 spatial directions and time) velocity-encoded flow magnetic resonance imaging with quantitative particle tracing analysis allows assessment of left ventricular (LV) blood flow organization. Corrected atrioventricular septal defect (AVSD) patients have an abnormal left
Ventricular Tachycardia in the Absence of Structural Heart Disease
Directory of Open Access Journals (Sweden)
Luis R. P. Scott
2005-04-01
Full Text Available In up to 10% of patients who present with ventricular tachycardia (VT, obvious structural heart disease is not identified. In such patients, causes of ventricular arrhythmia include right ventricular outflow tract (RVOT VT, extrasystoles, idiopathic left ventricular tachycardia (ILVT, idiopathic propranolol-sensitive VT (IPVT, catecholaminergic polymorphic VT (CPVT, Brugada syndrome, and long QT syndrome (LQTS. RVOT VT, ILVT, and IPVT are referred to as idiopathic VT and generally do not have a familial basis. RVOT VT and ILVT are monomorphic, whereas IPVT may be monomorphic or polymorphic. The idiopathic VTs are classified by the ventricle of origin, the response to pharmacologic agents, catecholamine dependence, and the specific morphologic features of the arrhythmia. CPVT, Brugada syndrome, and LQTS are inherited ion channelopathies. CPVT may present as bidirectional VT, polymorphic VT, or catecholaminergic ventricular fibrillation. Syncope and sudden death in Brugada syndrome are usually due to polymorphic VT. The characteristic arrhythmia of LQTS is torsades de pointes. Overall, patients with idiopathic VT have a better prognosis than do patients with ventricular arrhythmias and structural heart disease. Initial treatment approach is pharmacologic and radiofrequency ablation is curative in most patients. However, radiofrequency ablation is not useful in the management of inherited ion channelopathies. Prognosis for patients with VT secondary to ion channelopathies is variable. High-risk patients (recurrent syncope and sudden cardiac death survivors with inherited ion channelopathies benefit from implantable cardioverter-defibrillator placement. This paper reviews the mechanism, clinical presentation, and management of VT in the absence of structural heart disease.
Pre-excitation pattern associated with accessory pathway related tachycardia: Case report
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Burazor Mirko
2010-01-01
Full Text Available Introduction. Pre-excitation is based on an accessory conduction pathway between the atrium and ventricle. The term Wolff- Parkinson-White (WPW syndrome is used for patients with the pre-excitation/WPW pattern associated with AP-related tachycardia. Case Outline. We present a 52-year-old man with severe palpitation, fatigue, lightheadedness and difficulty breathing. The initial ECG showed tachyarrhythmia with heart rate between 240 and 300/min. He was treated with antiarrhythmics (Digitalis, Verapamil, Lidocaine with no response. Then, the patient was treated with electrical cardioversion and was referred to our Clinic for further evaluation with the diagnosis: “Ventricular tachycardia”. During in-hospital stay, the previously undiagnosed WPW pattern had been seen. Additional diagnostic tests confirmed permanent pre-excitacion pattern (ECG Holter recording, exercises test. The patient was referred to an electrophysiologist for further evaluation. Mapping techniques provided an accurate assessment of the position of the accessory pathway which was left lateral. The elimination of the accessory pathway by radiofrequent catheter ablation is highly effective in termination and elimination of tacchyarrhythmias. Conclusion. Symptomatic, life-threatening arrhythmia, first considered as ventricular tachycardia, reflected atrial fibrillation with ventricular pre-excitation over an accessory pathway in a patient with previously undiagnosed WPW syndrome.
van Dessel, Pascal F.; van Hemel, Norbert M.; Groenewegen, Arne Sippens; de Bakker, Jacques M.; Linnebank, André C.; Defauw, Jo J.
2002-01-01
This article investigates the influence of body surface mapping on outcome of ventricular antiarrhythmic surgery. Preoperative mapping is advocated to optimize map-guided antiarrhythmic surgery of postinfarction ventricular tachycardia. We sequentially analyzed the results of catheter activation
Static and kinematic formulation of planar reciprocal assemblies
DEFF Research Database (Denmark)
Parigi, Dario; Sassone, Mario; Kirkegaard, Poul Henning
2014-01-01
Planar reciprocal frames are two dimensional structures formed by elements joined together according to the principle of structural reciprocity. In this paper a rigorous formulation of the static and kinematic problem is proposed and developed extending the theory of pin-jointed assemblies....... This formulation is used to evaluate the static and kinematic determinacy of reciprocal assemblies from the properties of their equilibrium and kinematic matrices...
Participation costs can suppress the evolution of upstream reciprocity.
Peña, Jorge; Pestelacci, Enea; Berchtold, André; Tomassini, Marco
2011-03-21
Indirect reciprocity, one of the many mechanisms proposed to explain the evolution of cooperation, is the idea that altruistic actions can be rewarded by third parties. Upstream or generalized reciprocity is one type of indirect reciprocity in which individuals help someone if they have been helped by somebody else in the past. Although empirically found to be at work in humans, the evolution of upstream reciprocity is difficult to explain from a theoretical point of view. A recent model of upstream reciprocity, first proposed by Nowak and Roch (2007) and further analyzed by Iwagami and Masuda (2010), shows that while upstream reciprocity alone does not lead to the evolution of cooperation, it can act in tandem with mechanisms such as network reciprocity and increase the total level of cooperativity in the population. We argue, however, that Nowak and Roch's model systematically leads to non-uniform interaction rates, where more cooperative individuals take part in more games than less cooperative ones. As a result, the critical benefit-to-cost ratios derived under this model in previous studies are not invariant with respect to the addition of participation costs. We show that accounting for these costs can hinder and even suppress the evolution of upstream reciprocity, both for populations with non-random encounters and graph-structured populations. Copyright © 2011 Elsevier Ltd. All rights reserved.
Detailed balance and reciprocity in solar cells
Energy Technology Data Exchange (ETDEWEB)
Kirchartz, Thomas; Rau, Uwe [IEF5-Photovoltaik, Forschungszentrum Juelich, 52425 Juelich (Germany)
2008-12-15
The limiting efficiency of photovoltaic devices follows from the detailed balance of absorption and emission of a diode according to the Shockley-Queisser theory. However, the principle of detailed balance has more implications for the understanding of photovoltaic devices than only defining the efficiency limit. We show how reciprocity relations between carrier collection and dark carrier injection, between electroluminescence emission and photovoltaic quantum efficiency and between open circuit voltage and light emitting diode quantum efficiency all follow from the principle of detailed balance. We also discuss the validity range of the Shockley-Queisser limit and the reciprocity relations. Discussing the validity of the reciprocity relations helps to deepen the understanding of photovoltaic devices and allows us to identify interrelationships between the superposition principle, the diode ideality and the reciprocity relations. (copyright 2008 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)
Carvalho, Maira de Souza; Junior, Emílio Carlos Sponchiado; Bitencourt Garrido, Angela Delfina; Roberti Garcia, Lucas da Fonseca; Franco Marques, André Augusto
2015-01-01
The aim of this study was to evaluate the cleaning effectiveness achieved with two reciprocating single-file systems in severely curved root canals: Reciproc and WaveOne. Twenty-five mesial roots of mandibular molars were randomly separated into two groups, according to the instrumentation system used. The negative control group consisted of five specimens that were not instrumented. The mesial canals (buccal and lingual) in Reciproc Group were instrumented with file R25 and the WaveOne group with the Primary file. The samples were submitted to histological processing and analyzed under a digital microscope. The WaveOne group presented a larger amount of debris than the Reciproc Group, however, without statistically significant difference (P > 0.05). A larger amount of debris in the control group was observed, with statistically significant difference to Reciproc and WaveOne groups (P file instrumentation systems presented similar effectiveness for root canal cleaning.
Reciprocity on the hardwood: passing patterns among professional basketball players.
Directory of Open Access Journals (Sweden)
Robb Willer
Full Text Available Past theory and research view reciprocal resource sharing as a fundamental building block of human societies. Most studies of reciprocity dynamics have focused on trading among individuals in laboratory settings. But if motivations to engage in these patterns of resource sharing are powerful, then we should observe forms of reciprocity even in highly structured group environments in which reciprocity does not clearly serve individual or group interests. To this end, we investigated whether patterns of reciprocity might emerge among teammates in professional basketball games. Using data from logs of National Basketball Association (NBA games of the 2008-9 season, we estimated a series of conditional logistic regression models to test the impact of different factors on the probability that a given player would assist another player in scoring a basket. Our analysis found evidence for a direct reciprocity effect in which players who had "received" assists in the past tended to subsequently reciprocate their benefactors. Further, this tendency was time-dependent, with the probability of repayment highest soon after receiving an assist and declining as game time passed. We found no evidence for generalized reciprocity - a tendency to "pay forward" assists - and only very limited evidence for indirect reciprocity - a tendency to reward players who had sent others many assists. These findings highlight the power of reciprocity to shape human behavior, even in a setting characterized by extensive planning, division of labor, quick decision-making, and a focus on inter-group competition.
Reciprocity on the hardwood: passing patterns among professional basketball players.
Willer, Robb; Sharkey, Amanda; Frey, Seth
2012-01-01
Past theory and research view reciprocal resource sharing as a fundamental building block of human societies. Most studies of reciprocity dynamics have focused on trading among individuals in laboratory settings. But if motivations to engage in these patterns of resource sharing are powerful, then we should observe forms of reciprocity even in highly structured group environments in which reciprocity does not clearly serve individual or group interests. To this end, we investigated whether patterns of reciprocity might emerge among teammates in professional basketball games. Using data from logs of National Basketball Association (NBA) games of the 2008-9 season, we estimated a series of conditional logistic regression models to test the impact of different factors on the probability that a given player would assist another player in scoring a basket. Our analysis found evidence for a direct reciprocity effect in which players who had "received" assists in the past tended to subsequently reciprocate their benefactors. Further, this tendency was time-dependent, with the probability of repayment highest soon after receiving an assist and declining as game time passed. We found no evidence for generalized reciprocity - a tendency to "pay forward" assists - and only very limited evidence for indirect reciprocity - a tendency to reward players who had sent others many assists. These findings highlight the power of reciprocity to shape human behavior, even in a setting characterized by extensive planning, division of labor, quick decision-making, and a focus on inter-group competition.
Information seeking and reciprocity: A transformational analysis
Gallucci, M.; Perugini, M.
2003-01-01
The motivation to reciprocate is analyzed within the framework of interdependence theory, with focus on the process of transformation of situations. A model of transformation is presented for the motivation to reciprocate and hypotheses regarding allocation behavior and information seeking are
Bah humbug: Unexpected Christmas cards and the reciprocity norm.
Meier, Brian P
2016-01-01
The reciprocity norm refers to the expectation that people will help those who helped them. A well-known study revealed that the norm is strong with Christmas cards, with 20% of people reciprocating a Christmas card received from a stranger. I attempted to conceptually replicate and extend this effect. In Study 1, 755 participants received a Christmas card supposedly from a more- versus less-similar stranger. The reciprocation rate was unexpectedly low (2%), which did not allow for a test of a similarity effect. Two potential reasons for this low rate were examined in Study 2 in which 494 participants reported their likelihood of reciprocating a Christmas card from a stranger as well as their felt suspicions/threat about the card and their frequency of e-mail use. Reciprocation likelihood was negatively correlated with perceived threat/suspicion and e-mail use. It appears that reciprocating a gift from a stranger in offline settings may be less likely than expected.
Nonreciprocal and Reciprocal Dating Violence and Injury Occurrence among Urban Youth
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Swahn, Monica H
2010-08-01
Full Text Available Objective: Dating violence is a significant health problem among youth that leads to adverse health outcomes, including injuries. Reciprocal violence (perpetrated by both partners is associated with increased injury in adults, but very little is known about the prevalence and context for reciprocal violence, as well as injury rates, among youth. We sought to determine the prevalence and scope of reciprocal dating violence and injury occurrence among urban youth in a high-risk community. Methods: Analyses were based on data from the Youth Violence Survey, conducted in 2004, and administered to over 80% of public school students in grades 7, 9, 11, and 12 (N=4,131 in a high-risk, urban school district. The current analyses were restricted to those who reported dating in the past year and who also reported any dating violence (n=1,158. Dating violence was categorized as reciprocal (the participant reported both violence perpetration and victimization and non-reciprocal (the participant report either violence perpetration or victimization, but not both. Results: Dating violence reciprocity varied by sex. Girls who reported any dating violence were more likely to report reciprocal dating violence (50.4% than were boys (38.9%. However, reciprocity did not vary by race/ethnicity or grade level. Reciprocal dating violence was more common among participants who reported more frequent violence experiences. Reciprocal violence was also associated with greater injury occurrences relative to non-reciprocal relationships (10.1% versus 1.2%. Conclusion: Reciprocal dating violence is common among adolescents and leads more often to injury outcomes. In particular, relationships in which boys report reciprocal violence against their partner appear to lead to more frequent injury occurrences. These findings underscore the importance of addressing dating violence and factors that increase risk for reciprocal violence and therefore exacerbate injury occurrence
A 1.5 GFLOPS Reciprocal Unit for Computer Graphics
DEFF Research Database (Denmark)
Nannarelli, Alberto; Rasmussen, Morten Sleth; Stuart, Matthias Bo
2006-01-01
The reciprocal operation 1/d is a frequent operation performed in graphics processors (GPUs). In this work, we present the design of a radix-16 reciprocal unit based on the algorithm combining the traditional digit-by-digit algorithm and the approximation of the reciprocal by one Newton-Raphson i...
Reciprocity in electron diffraction
International Nuclear Information System (INIS)
Gunning, J.; Goodman, P.
1991-01-01
The symmetry of reciprocity is reviewed in the context of relativistic quantum mechanics with the specific aim of relating to P-C-T invariances. From this investigation global time reversal is found to be sufficient condition for reciprocity to hold in scattering from a vector potential. Elastic scattering is assumed. The paper also deals exclusively with the scattering of a charged particle by an electromagnetic field. The present proof is free from assumptions of small angle scattering and from restrictions on z-dependent terms in the scattering equation, and by avoiding S-matrix theory is thought to be accessible to undergraduate teaching. 9 refs., 1 tab., 1 fig
Some properties of generalized self-reciprocal polynomials over finite fields
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Ryul Kim
2014-07-01
Full Text Available Numerous results on self-reciprocal polynomials over finite fields have been studied. In this paper we generalize some of these to a-self reciprocal polynomials defined in [4]. We consider some properties of the divisibility of a-reciprocal polynomials and characterize the parity of the number of irreducible factors for a-self reciprocal polynomials over finite fields of odd characteristic.
Luther, Vishal; Linton, Nick W F; Jamil-Copley, Shahnaz; Koa-Wing, Michael; Lim, Phang Boon; Qureshi, Norman; Ng, Fu Siong; Hayat, Sajad; Whinnett, Zachary; Davies, D Wyn; Peters, Nicholas S; Kanagaratnam, Prapa
2016-06-01
Post-infarct ventricular tachycardia is associated with channels of surviving myocardium within scar characterized by fractionated and low-amplitude signals usually occurring late during sinus rhythm. Conventional automated algorithms for 3-dimensional electro-anatomic mapping cannot differentiate the delayed local signal of conduction within the scar from the initial far-field signal generated by surrounding healthy tissue. Ripple mapping displays every deflection of an electrogram, thereby providing fully informative activation sequences. We prospectively used CARTO-based ripple maps to identify conducting channels as a target for ablation. High-density bipolar left ventricular endocardial electrograms were collected using CARTO3v4 in sinus rhythm or ventricular pacing and reviewed for ripple mapping conducting channel identification. Fifteen consecutive patients (median age 68 years, left ventricular ejection fraction 30%) were studied (6 month preprocedural implantable cardioverter defibrillator therapies: median 19 ATP events [Q1-Q3=4-93] and 1 shock [Q1-Q3=0-3]). Scar (ripple mapping conducting channels were seen within each scar (length 60 mm; initial component 0.44 mV; delayed component 0.20 mV; conduction 55 cm/s). Ablation was performed along all identified ripple mapping conducting channels (median 18 lesions) and any presumed interconnected late-activating sites (median 6 lesions; Q1-Q3=2-12). The diastolic isthmus in ventricular tachycardia was mapped in 3 patients and colocated within the ripple mapping conducting channels identified. Ventricular tachycardia was noninducible in 85% of patients post ablation, and 71% remain free of ventricular tachycardia recurrence at 6-month median follow-up. Ripple mapping can be used to identify conduction channels within scar to guide functional substrate ablation. © 2016 American Heart Association, Inc.
A Case Report and Review of Postural Orthostatic Tachycardia Syndrome in Pregnancy
Lide, Brianna; Haeri, Sina
2015-01-01
Purpose - Postural orthostatic tachycardia syndrome (POTS) is a form of orthostatic intolerance characterized by an increased heart rate upon transition from supine to standing, and head-up tilt without orthostatic hypotension. Its etiology is multifactorial, and no clear cause has been identified. Common symptoms include light-headedness, blurred vision, weakness, cognitive difficulties, and fatigue and are often accompanied by palpitations, shortness of breath, syncope, or gastrointestinal ...
Reciprocal relations for transmission coefficients - Theory and application
Qu, Jianmin; Achenbach, Jan D.; Roberts, Ronald A.
1989-01-01
The authors present a rigorous proof of certain intuitively plausible reciprocal relations for time harmonic plane-wave transmission and reflection at the interface between a fluid and an anisotropic elastic solid. Precise forms of the reciprocity relations for the transmission coefficients and for the transmitted energy fluxes are derived, based on the reciprocity theorem of elastodynamics. It is shown that the reciprocity relations can be used in conjunction with measured values of peak amplitudes for transmission through a slab of the solid (water-solid-water) to obtain the water-solid coefficients. Experiments were performed for a slab of a unidirectional fiber-reinforced composite. Good agreement of the experimentally measured transmission coefficients with theoretical values was obtained.
Indirect reciprocity in three types of social dilemmas.
Nakamura, Mitsuhiro; Ohtsuki, Hisashi
2014-08-21
Indirect reciprocity is a key mechanism for the evolution of human cooperation. Previous studies explored indirect reciprocity in the so-called donation game, a special class of Prisoner's Dilemma (PD) with unilateral decision making. A more general class of social dilemmas includes Snowdrift (SG), Stag Hunt (SH), and PD games, where two players perform actions simultaneously. In these simultaneous-move games, moral assessments need to be more complex; for example, how should we evaluate defection against an ill-reputed, but now cooperative, player? We examined indirect reciprocity in the three social dilemmas and identified twelve successful social norms for moral assessments. These successful norms have different principles in different dilemmas for suppressing cheaters. To suppress defectors, any defection against good players is prohibited in SG and PD, whereas defection against good players may be allowed in SH. To suppress unconditional cooperators, who help anyone and thereby indirectly contribute to jeopardizing indirect reciprocity, we found two mechanisms: indiscrimination between actions toward bad players (feasible in SG and PD) or punishment for cooperation with bad players (effective in any social dilemma). Moreover, we discovered that social norms that unfairly favor reciprocators enhance robustness of cooperation in SH, whereby reciprocators never lose their good reputation. Copyright © 2014 Elsevier Ltd. All rights reserved.
Complete atrio-ventricular septal defect and Wolf-Parkinson-White syndrome
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Gudrun Björkhem
2006-09-01
Full Text Available A full term female infant was born after 41 weeks of gestation, with a birth weight of 3815g and normal Apgar scores (9-10-10. Immediately after birth tachycardia was noted. An electrocardiogram (ECG showed a heart rate of 300 beats per minute (bpm and narrow QRS complexes. The newborn was clinically stable. She was admitted to the neonatal intensive care unite and an intravenous line was inserted for treatment with Adenosine. While preparing for Adenosine infusion her heart rate spontaneously decreased. Her ECG at presentation with normal heart rate is shown in figure1a. On auscultation, a soft systolic murmur was heard.
Alzand, B. S. N.; Timmermans, C. C. M. M.; Wellens, H. J. J.; Dennert, R.; Philippens, S. A. M.; Portegijs, P. J. M.; Rodriguez, LM.
2011-01-01
Purpose The frequent occurrence of ventricular tachycardia can create a serious problem in patients with an implantable cardioverter defibrillator. We assessed the long-term efficacy of catheter-based substrate modification using the voltage mapping technique of infarct-related ventricular tachycardia and recurrent device therapy. Methods The study population consisted of 27 consecutive patients (age 68 ± 8 years, 25 men, mean left ventricular ejection fraction 31 ± 9%) with an old myocardial...
Evaluation of highly accelerated real-time cardiac cine MRI in tachycardia.
Bassett, Elwin C; Kholmovski, Eugene G; Wilson, Brent D; DiBella, Edward V R; Dosdall, Derek J; Ranjan, Ravi; McGann, Christopher J; Kim, Daniel
2014-02-01
Electrocardiogram (ECG)-gated breath-hold cine MRI is considered to be the gold standard test for the assessment of cardiac function. However, it may fail in patients with arrhythmia, impaired breath-hold capacity and poor ECG gating. Although ungated real-time cine MRI may mitigate these problems, commercially available real-time cine MRI pulse sequences using parallel imaging typically yield relatively poor spatiotemporal resolution because of their low image acquisition efficiency. As an extension of our previous work, the purpose of this study was to evaluate the diagnostic quality and accuracy of eight-fold-accelerated real-time cine MRI with compressed sensing (CS) for the quantification of cardiac function in tachycardia, where it is challenging for real-time cine MRI to provide sufficient spatiotemporal resolution. We evaluated the performances of eight-fold-accelerated cine MRI with CS, three-fold-accelerated real-time cine MRI with temporal generalized autocalibrating partially parallel acquisitions (TGRAPPA) and ECG-gated breath-hold cine MRI in 21 large animals with tachycardia (mean heart rate, 104 beats per minute) at 3T. For each cine MRI method, two expert readers evaluated the diagnostic quality in four categories (image quality, temporal fidelity of wall motion, artifacts and apparent noise) using a Likert scale (1-5, worst to best). One reader evaluated the left ventricular functional parameters. The diagnostic quality scores were significantly different between the three cine pulse sequences, except for the artifact level between CS and TGRAPPA real-time cine MRI. Both ECG-gated breath-hold cine MRI and eight-fold accelerated real-time cine MRI yielded all four scores of ≥ 3.0 (acceptable), whereas three-fold-accelerated real-time cine MRI yielded all scores below 3.0, except for artifact (3.0). The left ventricular ejection fraction (LVEF) measurements agreed better between ECG-gated cine MRI and eight-fold-accelerated real-time cine MRI
Acoustic reciprocity: An extension to spherical harmonics domain.
Samarasinghe, Prasanga; Abhayapala, Thushara D; Kellermann, Walter
2017-10-01
Acoustic reciprocity is a fundamental property of acoustic wavefields that is commonly used to simplify the measurement process of many practical applications. Traditionally, the reciprocity theorem is defined between a monopole point source and a point receiver. Intuitively, it must apply to more complex transducers than monopoles. In this paper, the authors formulate the acoustic reciprocity theory in the spherical harmonics domain for directional sources and directional receivers with higher order directivity patterns.
Structural optimization of free-form reciprocal structures
DEFF Research Database (Denmark)
Parigi, Dario
2014-01-01
This paper presents an optimization algorithm for the design of structurally efficient free-form reciprocal structures. Because of the geometric complexity of reciprocal structures, only a few structural studies have been carried out so far, and we have a limited knowledge of the relation between...
Loneliness, exchange orientation, and reciprocity in friendships
Buunk, Abraham (Bram); Prins, K.S.
Guided by equity theory this study among 185 Dutch students explored the effects of exchange orientation and reciprocity in the relationship with the best friend upon loneliness. Reciprocity was in general more common in this relationship than feeling advantaged or deprived. The association between
24 CFR 3282.11 - Preemption and reciprocity.
2010-04-01
... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Preemption and reciprocity. 3282.11 Section 3282.11 Housing and Urban Development Regulations Relating to Housing and Urban Development... and reciprocity. (a) No State manufactured home standard regarding manufactured home construction and...
Clustering in large networks does not promote upstream reciprocity.
Directory of Open Access Journals (Sweden)
Naoki Masuda
Full Text Available Upstream reciprocity (also called generalized reciprocity is a putative mechanism for cooperation in social dilemma situations with which players help others when they are helped by somebody else. It is a type of indirect reciprocity. Although upstream reciprocity is often observed in experiments, most theories suggest that it is operative only when players form short cycles such as triangles, implying a small population size, or when it is combined with other mechanisms that promote cooperation on their own. An expectation is that real social networks, which are known to be full of triangles and other short cycles, may accommodate upstream reciprocity. In this study, I extend the upstream reciprocity game proposed for a directed cycle by Boyd and Richerson to the case of general networks. The model is not evolutionary and concerns the conditions under which the unanimity of cooperative players is a Nash equilibrium. I show that an abundance of triangles or other short cycles in a network does little to promote upstream reciprocity. Cooperation is less likely for a larger population size even if triangles are abundant in the network. In addition, in contrast to the results for evolutionary social dilemma games on networks, scale-free networks lead to less cooperation than networks with a homogeneous degree distribution.
Clustering in large networks does not promote upstream reciprocity.
Masuda, Naoki
2011-01-01
Upstream reciprocity (also called generalized reciprocity) is a putative mechanism for cooperation in social dilemma situations with which players help others when they are helped by somebody else. It is a type of indirect reciprocity. Although upstream reciprocity is often observed in experiments, most theories suggest that it is operative only when players form short cycles such as triangles, implying a small population size, or when it is combined with other mechanisms that promote cooperation on their own. An expectation is that real social networks, which are known to be full of triangles and other short cycles, may accommodate upstream reciprocity. In this study, I extend the upstream reciprocity game proposed for a directed cycle by Boyd and Richerson to the case of general networks. The model is not evolutionary and concerns the conditions under which the unanimity of cooperative players is a Nash equilibrium. I show that an abundance of triangles or other short cycles in a network does little to promote upstream reciprocity. Cooperation is less likely for a larger population size even if triangles are abundant in the network. In addition, in contrast to the results for evolutionary social dilemma games on networks, scale-free networks lead to less cooperation than networks with a homogeneous degree distribution.
Born's reciprocity principle in stochastic phase space
International Nuclear Information System (INIS)
Prugovecki, E.
1981-01-01
It is shown that the application of Born's reciprocity principle to relativistic quantum mechanics in stochastic phase space (by the requirement that the proper wave functions of extended particles satisfy the Born-Lande as well as the Klein-Gordon equation) leads to the unique determination of these functions for any given value of their rms radius. The resulting particle propagators display not only Lorentz but also reciprocal invariance. This feature remains true even in the case of mass-zero particles, such as photons, when their localization is achieved by means of extended test particles whose proper wave functions obey the reciprocity principle. (author)
A review of postural orthostatic tachycardia syndrome.
LENUS (Irish Health Repository)
Carew, Sheila
2012-01-31
A 21-year-old female reports an 18-month history of light-headedness on standing. This is often associated with palpitations and a feeling of intense anxiety. She has had two black-outs in the past 12 months. She is not taking any regular medications. Her supine blood pressure was 126\\/84 mmHg with a heart rate of 76 bpm, and her upright blood pressure was 122\\/80 mmHg with a heart rate of 114 bpm. A full system examination was otherwise normal. She had a 12-lead electrocardiogram performed which was unremarkable. She was referred for head-up tilt testing. She was symptomatic during the test and lost consciousness at 16 min. Figure 1 summarizes her blood pressure and heart rate response to tilting. A diagnosis of postural orthostatic tachycardia syndrome with overlapping vasovagal syncope was made.
Reciprocal Tutoring: Design with Cognitive Load Sharing
Chou, Chih-Yueh; Chan, Tak-Wai
2016-01-01
"Reciprocal tutoring," as reported in "Exploring the design of computer supports for reciprocal tutoring" (Chan and Chou 1997), has extended the meaning and scope of "intelligent tutoring" originally implemented in stand alone computers. This research is a follow-up to our studies on a "learning companion…
Atrioventricular junction (AVJ) motion tracking: a software tool with ITK/VTK/Qt.
Pengdong Xiao; Shuang Leng; Xiaodan Zhao; Hua Zou; Ru San Tan; Wong, Philip; Liang Zhong
2016-08-01
The quantitative measurement of the Atrioventricular Junction (AVJ) motion is an important index for ventricular functions of one cardiac cycle including systole and diastole. In this paper, a software tool that can conduct AVJ motion tracking from cardiovascular magnetic resonance (CMR) images is presented by using Insight Segmentation and Registration Toolkit (ITK), The Visualization Toolkit (VTK) and Qt. The software tool is written in C++ by using Visual Studio Community 2013 integrated development environment (IDE) containing both an editor and a Microsoft complier. The software package has been successfully implemented. From the software engineering practice, it is concluded that ITK, VTK, and Qt are very handy software systems to implement automatic image analysis functions for CMR images such as quantitative measure of motion by visual tracking.
Kolditz, Denise P.; Wijffels, Maurits C. E. F.; Blom, Nico A.; van der Laarse, Arnoud; Markwald, Roger R.; Schalij, Martin J.; Gittenberger-de Groot, Adriana C.
2007-01-01
BACKGROUND: During heart development, the ventricular activation sequence changes from a base-to-apex to an apex-to-base pattern. We investigated the possibility of impulse propagation through remnants of atrioventricular (AV) connections in quail hearts. METHODS AND RESULTS: In 86 hearts (group A,
Bayraktarova, Iskra H; Stoyanov, Milko K; Kunev, Boyan T; Shalganov, Tchavdar N
To study the correlation between the sudden prolongations of the atrio-Hisian (AH) interval with ≥50 ms during burst and programmed atrial stimulation, and to define whether the AH jump during burst atrial pacing is a reliable diagnostic criterion for dual AV nodal physiology. Retrospective data on 304 patients with preliminary ECG diagnosis of AV nodal reentrant tachycardia (AVNRT), confirmed during electrophysiological study, was analyzed for the presence of AH jump during burst and programmed atrial stimulation, and for correlation between the pacing modes for inducing the jump. Wilcoxon signed-ranks test and Spearman's bivariate correlation coefficient were applied, significant was P-value jump occurred during burst atrial pacing in 81% of the patients, and during programmed stimulation - in 78%, P = 0.366. In 63.2% AH jump was induced by both pacing modes; in 17.8% - only by burst pacing; in 14.8% - only by programmed pacing; in 4.2% there was no inducible jump. There was negative correlation between both pacing modes, ρ = -0.204, Р<0.001. Burst and programmed atrial stimulation separately prove the presence of dual AV nodal physiology in 81 and 78% of the patients with AVNRT, respectively. There is negative correlation between the two pacing modes, allowing the combination of the two methods to prove diagnostic in 95.8% of the patients. Copyright © 2017 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. All rights reserved.
Drift stabilizer for reciprocating free-piston devices
Ward, William C.; Corey, John A.; Swift, Gregory W.
2003-05-20
A free-piston device has a stabilized piston drift. A piston having a frequency of reciprocation over a stroke length and with first and second sides facing first and second variable volumes, respectively, for containing a working fluid defining an acoustic wavelength at the frequency of reciprocation. A bypass tube waveguide connects the first and second variable volumes at all times during reciprocation of the piston. The waveguide has a relatively low impedance for steady flow and a relatively high impedance for oscillating flow at the frequency of reciprocation of the piston, so that steady flow returns fluid leakage from about the piston between the first and second volumes while oscillating flow is not diverted through the waveguide. Thus, net leakage about the piston is returned during each stroke of the piston while oscillating leakage is not allowed and pressure buildup on either the first or second side of the piston is avoided to provide a stable piston location.
DEFF Research Database (Denmark)
Jensen, Nini Skovgaard; Møller, Kate; Gesser, Hans
2009-01-01
The intrinsic heart rate of most vertebrates studied, including humans, is elevated during digestion, suggesting that a non-adrenergic-non-cholinergic factor contributes to the postprandial tachycardia. The regulating factor, however, remains elusive and difficult to identify. Pythons can ingest...... very large meals and digestion is associated with a marked rise in metabolism that is sustained for several days. The metabolic rise causes more than a doubling of heart rate and a four-fold rise in cardiac output. This makes the python an interesting model to investigate the postprandial tachycardia....... We measured blood pressure and heart rate in fasting Python regius, and at 24 and 48h after ingestion of a meal amounting to 25% of body weight. Digestion caused heart rate to increase from 25 to 56 min-1 while blood pressure was unchanged. The postprandial rise in heart rate was partially due...
Indirect Reciprocity under Incomplete Observation
Nakamura, Mitsuhiro; Masuda, Naoki
2011-01-01
Indirect reciprocity, in which individuals help others with a good reputation but not those with a bad reputation, is a mechanism for cooperation in social dilemma situations when individuals do not repeatedly interact with the same partners. In a relatively large society where indirect reciprocity is relevant, individuals may not know each other's reputation even indirectly. Previous studies investigated the situations where individuals playing the game have to determine the action possibly without knowing others' reputations. Nevertheless, the possibility that observers of the game, who generate the reputation of the interacting players, assign reputations without complete information about them has been neglected. Because an individual acts as an interacting player and as an observer on different occasions if indirect reciprocity is endogenously sustained in a society, the incompleteness of information may affect either role. We examine the game of indirect reciprocity when the reputations of players are not necessarily known to observers and to interacting players. We find that the trustful discriminator, which cooperates with good and unknown players and defects against bad players, realizes cooperative societies under seven social norms. Among the seven social norms, three of the four suspicious norms under which cooperation (defection) to unknown players leads to a good (bad) reputation enable cooperation down to a relatively small observation probability. In contrast, the three trustful norms under which both cooperation and defection to unknown players lead to a good reputation are relatively efficient. PMID:21829335
Deviseti, Pravalika; Pujari, Vinayak S
2016-02-01
Wolff-Parkinson-White (WPW) syndrome is an uncommon cardiac condition where there is an abnormal band of atrial tissue connecting atria and ventricles which can electrically bypass atrioventricular node. The anaesthetic management in these patients is challenging as life threatening complications can occur perioperatively like paroxysmal supraventricular tachycardia and atrial fibrillation. Also, regional anaesthetic technique like subarachnoid block is a safe and cost effective alternative to general anaesthesia as it avoids polypharmacy. We report the successful anaesthetic management of Wolff Parkinson White syndrome in a primi with hydatiform mole posted for suction and evacuation.
Intrinsic rippling enhances static non-reciprocity in a graphene metamaterial.
Ho, Duc Tam; Park, Harold S; Kim, Sung Youb
2018-01-18
In mechanical systems, Maxwell-Betti reciprocity means that the displacement at point B in response to a force at point A is the same as the displacement at point A in response to the same force applied at point B. Because the notion of reciprocity is general, fundamental, and is operant for other physical systems like electromagnetics, acoustics, and optics, there is significant interest in understanding systems that are not reciprocal, or exhibit non-reciprocity. However, most studies on non-reciprocity have occurred in bulk-scale structures for dynamic problems involving time reversal symmetry. As a result, little is known about the mechanisms governing static non-reciprocal responses, particularly in atomically-thin two-dimensional materials like graphene. Here, we use classical atomistic simulations to demonstrate that out-of-plane ripples, which are intrinsic to graphene, enable significant, multiple orders of magnitude enhancements in the statically non-reciprocal response of graphene metamaterials. Specifically, we find that a striking interplay between the ripples and the stress fields that are induced in the metamaterials due to their geometry impacts the displacements that are transmitted by the metamaterial, thus leading to a significantly enhanced static non-reciprocal response. This study thus demonstrates the potential of two-dimensional mechanical metamaterials for symmetry-breaking applications.
Heart rate variability analysis in postural orthostatic tachycardia syndrome: a case report
Directory of Open Access Journals (Sweden)
Raffaele Calabrò
2006-09-01
Full Text Available The authors present a case of 36 year old male patient with idiopathic postural orthostatic tachycardia syndrome (POTS diagnosed during head-up tilt testing. Power spectral analysis of heart rate variability (HRV during the tilt test revealed that the ratio of low and high frequency powers (LF/HF increased with the onset of orthostatic intolerance. This analysis confirmed in our patient a strong activation in sympathetic tone.
Y-Hassan, Shams; Sylv?n, Christer
2013-01-01
Electrocardiographic (ECG) artefacts may closely simulate both supraventricular and ventricular tachycardias. We describe a case initially diagnosed as rapid atrial fibrillation, based on 12-lead surface ECG (especially the limb leads) and monitor tracing. The arrhythmia was resistant to beta blockers. Because of the at times apparently regular rhythm, an esophageal ECG recording was performed, and adenosine was administered. When the presumed atrial fibrillation terminated after sodium pento...
Mortality salience increases personal relevance of the norm of reciprocity.
Schindler, Simon; Reinhard, Marc-André; Stahlberg, Dagmar
2012-10-01
Research on terror management theory found evidence that people under mortality salience strive to live up to salient cultural norms and values, like egalitarianism, pacifism, or helpfulness. A basic, strongly internalized norm in most human societies is the norm of reciprocity: people should support those who supported them (i.e., positive reciprocity), and people should injure those who injured them (i.e., negative reciprocity), respectively. In an experiment (N = 98; 47 women, 51 men), mortality salience overall significantly increased personal relevance of the norm of reciprocity (M = 4.45, SD = 0.65) compared to a control condition (M = 4.19, SD = 0.59). Specifically, under mortality salience there was higher motivation to punish those who treated them unfavourably (negative norm of reciprocity). Unexpectedly, relevance of the norm of positive reciprocity remained unaffected by mortality salience. Implications and limitations are discussed.
Design and Fabrication of a Free-Form Reciprocal Roof
DEFF Research Database (Denmark)
Parigi, Dario
2015-01-01
The paper presents the framework and the design and construction process of a freeform reciprocal pavilion realized during a one-week long workshop with the students of the 1st semester of the Master of Science in Architecture and Design, fall 2014, at Aalborg University. The workshop didactic...... of relations between design parameters and a wide array of measurable performances. Due to the reciprocal structures geometric complexity, the shape generation process is handled using the Reciprocalizer, a software tool developed by the author that embeds in a computational environment the constructional...... logic of reciprocal structures. It enables to engage in real time in iterative processes that allows unfolding the geometric complexity and turn it into a source of inspiration for expanding the design space and triggering the development of unique, adapted and integrated design solutions. Reciprocal...
Directory of Open Access Journals (Sweden)
Eitaro Fujii, MD
2010-01-01
Full Text Available A 34-year-old man with a surgically repaired Tetralogy of Fallot complained of palpitation, fatigue, and presyncope. A 12-lead ECG showed atrial tachycardia with a cycle length of 250 ms and a P wave morphology positive in leads II, III and aVF, and negative in lead V1. Although the EnSite system (version 6.OJ made use of noncontact mapping to delineate the counterclockwise reentry around the crista tenninalis, it was difficult to rule out the incisional atrial reentry because the location of the surgical incision was far from the multi-electrode array. Since the bipolar contact mapping of the EnSite system revealed the location of the atriotomy incision, entrainment mapping during the tachycardia demonstrated the critical reentry circuit around the crista terminalis. Radiofrequency ablation targeting the critical isthmus from the lower position of the crista terminalis to the posterior dense scar which was continuous with the inferior vena cava, and to the atriotomy scar, eliminated the tachycardia.
DEFF Research Database (Denmark)
Gang, Uffe Jakob Ortved; Hvelplund, Anders; Pedersen, Sune
2012-01-01
Primary percutaneous coronary intervention (pPCI) has replaced thrombolysis as treatment-of-choice for ST-segment elevation myocardial infarction (STEMI). However, the incidence and prognostic significance of high-degree atrioventricular block (HAVB) in STEMI patients in the pPCI era has been only...... sparsely investigated. The objective of this study was to assess the incidence, predictors and prognostic significance of HAVB in STEMI patients treated with pPCI....
Postma, Alex V.; Bhuiyan, Zahurul A.; Bikker, Hennie
2006-01-01
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an arrhythmogenic disease characterized by adrenergic-induced arrhythmias in the form of bidirectional and PVT. CPVT is a distinct clinical entity associated with a high mortality rate of up to 50% by the age of 30 yr. Recently, the
[Surgical therapy of life-threatening tachycardic cardiac arrhythmias in children].
Frank, G; Schmid, C; Baumgart, D; Lowes, D; Klein, H; Kallfelz, H C
1989-05-01
Surgical techniques for tachyarrhythmias refractory to medical treatment are used with increasing frequency. Among 211 patients undergoing antiarrhythmic surgery 10 children (2 to 14 years old) were operated by electrophysiologically directed procedures. 7 patients suffered from WPW syndrome, 2 from focal atrial tachycardias and 1 from recurrent ventricular tachycardia following the repair of Fallot's tetralogy. In all cases preoperative electrophysiologic study and intraoperative mapping preceded operative ablation. Surgical treatment consisted of interruption of the bundle of Kent (3 right-sided, 2 left-sided, 3 septal), ablation of the atrial focus (1 right-sided, 1 left-sided) and right ventricular outflow tract incision. In 7 operations cryo-techniques were added. 2 children with WPW syndrome had two interventions because of tachycardia recurrences due to multiple accessory pathways. In 1 case a VVI-pacemaker was implanted postoperatively due to complete atrioventricular block. Another 2 children with prolonged postoperative bradycardia received a pacemaker prophylactically. Only the child with previous tetralogy of Fallot is still under antiarrhythmic medication while all other children are free of tachycardiac episodes. Our data confirm the efficacy of surgical treatment of tachyarrhythmias in children thereby abolishing the need for life-long antiarrhythmic medication.
Chen, Kang; Mao, Ye; Liu, Shao-hua; Wu, Qiong; Luo, Qing-zhi; Pan, Wen-qi; Jin, Qi; Zhang, Ning; Ling, Tian-you; Chen, Ying; Gu, Gang; Shen, Wei-feng; Wu, Li-qun
2014-06-01
We are aimed to investigate whether right ventricular mid-septal pacing (RVMSP) is superior to conventional right ventricular apical pacing (RVAP) in improving clinical functional capacity and left ventricular ejection fraction (LVEF) for patients with high-degree atrio-ventricular block and moderately depressed left ventricle (LV) function. Ninety-two patients with high-degree atrio-ventricular block and moderately reduced LVEF (ranging from 35% to 50%) were randomly allocated to RVMSP (n=45) and RVAP (n=47). New York Heart Association (NYHA) functional class, echocardiographic LVEF, and distance during a 6-min walk test (6MWT) were determined at 18 months after pacemaker implantation. Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured using an enzyme-linked immunosorbent assay (ELISA) kit. Compared with baseline, NYHA functional class remained unchanged at 18 months, distance during 6MWT (485 m vs. 517 m) and LVEF (36.7% vs. 41.8%) were increased, but BNP levels were reduced (2352 pg/ml vs. 710 pg/ml) in the RVMSP group compared with those in the RVAP group, especially in patients with LVEF 35%-40% (for all comparisons, Pfunction capacity and LV function measurements were not significantly changed in patients with RVAP, despite the pacing measurements being similar in both groups, such as R-wave amplitude and capture threshold. RVMSP provides a better clinical utility, compared with RVAP, in patients with high-degree atrioventricular block and moderately depressed LV function whose LVEF levels ranged from 35% to 40%.
Anno, T.; Kodama, I.; Shibata, S.; Toyama, J.; Yamada, K.
1986-01-01
Effects of hypoxia on atrioventricular conduction were investigated in the Langendorff-perfused isolated heart of the rabbit with various extracellular calcium concentrations ([Ca2+]) as well as in the presence of verapamil, nifedipine, N-(6-aminohexyl)-5-chloro-1-naphthalenesulphonamide (W-7) and chlorpromazine. The prolongation of the atrio-His (AH) interval by hypoxia for 7 min was greater with increasing [Ca2+]o ranging from 1.2 to 5.2 mM. At [Ca2+]o of over 3.2 mM under hypoxic condition...
Education, Gift and Reciprocity: A Preliminary Discussion
Sabourin, Eric
2013-01-01
This paper analyzes the importance and role of the reciprocity relationship in education. It presents a review on the mobilization of the principle of reciprocity--in the anthropological but also sociological and economic senses--in educational processes, especially in adult education. The study is divided into three parts. The first part analyzes…
Working dogs cooperate among one another by generalised reciprocity.
Gfrerer, Nastassja; Taborsky, Michael
2017-03-06
Cooperation by generalised reciprocity implies that individuals apply the decision rule "help anyone if helped by someone". This mechanism has been shown to generate evolutionarily stable levels of cooperation, but as yet it is unclear how widely this cooperation mechanism is applied among animals. Dogs (Canis familiaris) are highly social animals with considerable cognitive potential and the ability to differentiate between individual social partners. But although dogs can solve complex problems, they may use simple rules for behavioural decisions. Here we show that dogs trained in an instrumental cooperative task to provide food to a social partner help conspecifics more often after receiving help from a dog before. Remarkably, in so doing they show no distinction between partners that had helped them before and completely unfamiliar conspecifics. Apparently, dogs use the simple decision rule characterizing generalised reciprocity, although they are probably capable of using the more complex decision rule of direct reciprocity: "help someone who has helped you". However, generalized reciprocity involves lower information processing costs and is therefore a cheaper cooperation strategy. Our results imply that generalised reciprocity might be applied more commonly than direct reciprocity also in other mutually cooperating animals.
Baardman, G.; IJzerman, Maarten Joost; Hermens, Hermanus J.; Veltink, Petrus H.; Boom, H.B.K.; Zilvold, G.; Zilvold, G.
1997-01-01
The effect of reciprocally linking the hip hinges of a hip-knee-ankle-foot orthosis on standing performance was studied in a comparative trial of the Advanced Reciprocating Gait Orthosis (ARGO) and an ARGO in which the Bowden cable was removed (A_GO). Six male subjects with spinal cord injury (SCI)
Reciprocity, social ties, and competition in markets for experience goods
DEFF Research Database (Denmark)
Huck, Steffen; Tyran, Jean-Robert
2007-01-01
a positive externality for non-reciprocal customers who would, in the absence of reciprocal types, face market breakdown. This efficiency-enhancing effect of reciprocity is boosted when there are social ties between consumers and competition between firms. The existence of social ties or competition alone...
Postural tachycardia in hypermobile Ehlers-Danlos syndrome: A distinct subtype?
Miglis, Mitchell G; Schultz, Brittany; Muppidi, Srikanth
2017-12-01
It is not clear if patients with postural tachycardia syndrome (POTS) and Ehlers-Danlos syndrome (hEDS) differ from patients with POTS due to other etiologies. We compared the results of autonomic testing and healthcare utilization in POTS patients with and without hEDS. Patients with POTS+hEDS (n=20) and POTS controls without hypermobility (n=20) were included in the study. All patients underwent autonomic testing, and the electronic medical records were reviewed to determine the number and types of medications patients were taking, as well as the number of outpatient, emergency department, and inpatient visits over the prior year. Patients with hEDS had twice as many outpatient visits (21 v. 10, p=0.012), were taking more prescription medications (8 vs. 5.5, p=0.030), and were more likely to see a pain physician (70% vs 25%, p=0.005). Autonomic testing demonstrated a slight reduction in heart rate variability and slightly lower blood pressures on tilt table testing in hEDS patients, however for most patients these variables remained within the range of normal. Orthostatic tachycardia on tilt table testing was greater in POTS controls (46bpm vs 39bpm, p=0.018). Abnormal QSweat responses were common in both groups (38% of POTS+hEDS and 36% of POTS controls). While autonomic testing results were not significantly different between groups, patients with POTS+hEDS took more medications and had greater markers of healthcare utilization, with chronic pain likely playing a prominent role. Copyright © 2017 Elsevier B.V. All rights reserved.
Armelin, Vinicius Araújo; da Silva Braga, Victor Hugo; Abe, Augusto Shinya; Rantin, Francisco Tadeu; Florindo, Luiz Henrique
2014-10-01
Orthostasis dramatically influences the hemodynamics of terrestrial vertebrates, especially large and elongated animals such as snakes. When these animals assume a vertical orientation, gravity tends to reduce venous return, cardiac filling, cardiac output and blood pressure to the anterior regions of the body. The hypotension triggers physiological responses, which generally include vasomotor adjustments and tachycardia to normalize blood pressure. While some studies have focused on understanding the regulation of these vasomotor adjustments in ectothermic vertebrates, little is known about regulation and the importance of heart rate in these animals during orthostasis. We acquired heart rate and carotid pulse pressure (P PC) in pythons in their horizontal position, and during 30 and 60° inclinations while the animals were either untreated (control) or upon muscarinic cholinoceptor blockade and a double autonomic blockade. Double autonomic blockade completely eradicated the orthostatic-tachycardia, and without this adjustment, the P PC reduction caused by the tilts became higher than that which was observed in untreated animals. On the other hand, post-inclinatory vasomotor adjustments appeared to be of negligible importance in counterbalancing the hemodynamic effects of gravity. Finally, calculations of cardiac autonomic tones at each position revealed that the orthostatic-tachycardia is almost completely elicited by a withdrawal of vagal drive.
The Role of Friendship Reciprocity in University Freshmen's Alcohol Consumption.
Giese, Helge; Stok, F Marijn; Renner, Britta
2017-07-01
The similarity of friends in the frequency and quantity of alcohol consumption is explored. During their first semester, 57 psychology freshmen indicated weekly drinking frequency and quantity and nominated the three peers of this group they liked most. These nominations were then used to derive the weekly alcohol consumption of friends that either did or did not reciprocate a nomination. Multilevel modeling of weekly variations showed that individuals' drinking frequency was similar to peers who reciprocated a friendship (b = 0.15, p = .001), but not to non-reciprocating peers (b = -0.01, p = .720). In contrast, weekly variation in quantity of individual students' drinking was similar to both reciprocating (b = 0.11, p = .018) and non-reciprocating peers' drinking (b = 0.10, p = .014). Yet across all weeks, quantity tended only to be similar to non-reciprocating peers (b = 0.49, p = .020). Freshmen might spend drinking time with peers who reciprocate a friendship, but are similar regarding the quantity of drinks consumed to all people they find interesting. Thus, alcohol consumption is used strategically for social purposes. This social purpose should also be acknowledged in alcohol-reduction interventions. © 2017 The International Association of Applied Psychology.
Negative reciprocity and retrenched pension rights
Montizaan, R.M.; Cörvers, F.; de Grip, A.; Dohmen, T.J.
2012-01-01
We document the importance of negatively reciprocal inclinations in labor relationships by showing that a retrenchment of pension rights, which is perceived as unfair, causes a larger reduction in job motivation the stronger workers' negatively reciprocal inclinations are. We exploit unique matched survey and administrative data on male employees in the public sector in the Netherlands and compare the job motivation of employees born in 1950, who faced a substantial retrenchment of their pens...
Mitral valve m-mode echo in complete heart block with atrial tachycardia
Directory of Open Access Journals (Sweden)
Kalathingathodika Sajeer
2013-01-01
Full Text Available We report a 48-year-old man who presented with history of syncope. Electrocardiogram on admission showed infrahisian complete heart block with a ventricular rate of 36 beats per min with wide QRS junctional escape and atrial rate was 188 beats per min. Transthoracic echocardiogram showed fine vibratory movement of both mitral leaflet tips. M-mode evaluation of mitral leaflets showed multiple ′a′ waves corresponding to atrial tachycardia rate.
The extended reciprocity: Strong belief outperforms persistence.
Kurokawa, Shun
2017-05-21
The existence of cooperation is a mysterious phenomenon and demands explanation, and direct reciprocity is one key potential explanation for the evolution of cooperation. Direct reciprocity allows cooperation to evolve for cooperators who switch their behavior on the basis of information about the opponent's behavior. Here, relevant to direct reciprocity is information deficiency. When the opponent's last move is unknown, how should players behave? One possibility is to choose cooperation with some default probability without using any further information. In fact, our previous paper (Kurokawa, 2016a) examined this strategy. However, there might be beneficial information other than the opponent's last move. A subsequent study of ours (Kurokawa, 2017) examined the strategy which uses the own last move when the opponent's last move is unknown, and revealed that referring to the own move and trying to imitate it when information is absent is beneficial. Is there any other beneficial information else? How about strong belief (i.e., have infinite memory and believe that the opponent's behavior is unchanged)? Here, we examine the evolution of strategies with strong belief. Analyzing the repeated prisoner's dilemma game and using evolutionarily stable strategy (ESS) analysis against an invasion by unconditional defectors, we find the strategy with strong belief is more likely to evolve than the strategy which does not use information other than the opponent player's last move and more likely to evolve than the strategy which uses not only the opponent player's last move but also the own last move. Strong belief produces the extended reciprocity and facilitates the evolution of cooperation. Additionally, we consider the two strategies game between strategies with strong belief and any strategy, and we consider the four strategies game in which unconditional cooperators, unconditional defectors, pessimistic reciprocators with strong belief, and optimistic reciprocators with
Reciprocity relations in aerodynamics
Heaslet, Max A; Spreiter, John R
1953-01-01
Reverse flow theorems in aerodynamics are shown to be based on the same general concepts involved in many reciprocity theorems in the physical sciences. Reciprocal theorems for both steady and unsteady motion are found as a logical consequence of this approach. No restrictions on wing plan form or flight Mach number are made beyond those required in linearized compressible-flow analysis. A number of examples are listed, including general integral theorems for lifting, rolling, and pitching wings and for wings in nonuniform downwash fields. Correspondence is also established between the buildup of circulation with time of a wing starting impulsively from rest and the buildup of lift of the same wing moving in the reverse direction into a sharp-edged gust.
Preschool children's behavioral tendency toward social indirect reciprocity.
Directory of Open Access Journals (Sweden)
Mayuko Kato-Shimizu
Full Text Available Social indirect reciprocity seems to be crucial in enabling large-scale cooperative networks among genetically unrelated individuals in humans. However, there are relatively few studies on social indirect reciprocity in children compared to adults. Investigating whether young children have a behavioral tendency toward social indirect reciprocity will help us understand how and when the fundamental ability to form cooperative relationships among adults is acquired. Using naturalistic observation at a nursery school, this study examined whether 5- to 6-year-olds show a behavioral tendency to engage in social indirect reciprocity in response to their peers' prosocial behavior toward a third party. The results revealed that bystander children tended to display prosocial behavior toward their peers more frequently after observing these peers' prosocial behavior toward third-party peers, compared with control situations; this suggests that 5- to 6-year-olds may have an essential behavioral tendency to establish social indirect reciprocity when interacting with peers in their daily lives. In addition, bystanders tended to display affiliative behavior after observing focal children's prosocial behavior. In other words, observing peers' prosocial behavior toward third-party peers evoked bystanders' positive emotions toward the helpers. Considering both the present results and previous findings, we speculate that in preschoolers, such positive emotions might mediate the increase in the bystander's prosocial behavior toward the helper. In addition, an intuitional emotional process plays an important role in the preschooler's behavioral tendency toward social indirect reciprocity in natural interactions with peers.
Preschool children's behavioral tendency toward social indirect reciprocity.
Kato-Shimizu, Mayuko; Onishi, Kenji; Kanazawa, Tadahiro; Hinobayashi, Toshihiko
2013-01-01
Social indirect reciprocity seems to be crucial in enabling large-scale cooperative networks among genetically unrelated individuals in humans. However, there are relatively few studies on social indirect reciprocity in children compared to adults. Investigating whether young children have a behavioral tendency toward social indirect reciprocity will help us understand how and when the fundamental ability to form cooperative relationships among adults is acquired. Using naturalistic observation at a nursery school, this study examined whether 5- to 6-year-olds show a behavioral tendency to engage in social indirect reciprocity in response to their peers' prosocial behavior toward a third party. The results revealed that bystander children tended to display prosocial behavior toward their peers more frequently after observing these peers' prosocial behavior toward third-party peers, compared with control situations; this suggests that 5- to 6-year-olds may have an essential behavioral tendency to establish social indirect reciprocity when interacting with peers in their daily lives. In addition, bystanders tended to display affiliative behavior after observing focal children's prosocial behavior. In other words, observing peers' prosocial behavior toward third-party peers evoked bystanders' positive emotions toward the helpers. Considering both the present results and previous findings, we speculate that in preschoolers, such positive emotions might mediate the increase in the bystander's prosocial behavior toward the helper. In addition, an intuitional emotional process plays an important role in the preschooler's behavioral tendency toward social indirect reciprocity in natural interactions with peers.
Realizing total reciprocity violation in the phase for photon scattering.
Deák, László; Bottyán, László; Fülöp, Tamás; Merkel, Dániel Géza; Nagy, Dénes Lajos; Sajti, Szilárd; Schulze, Kai Sven; Spiering, Hartmut; Uschmann, Ingo; Wille, Hans-Christian
2017-02-22
Reciprocity is when wave or quantum scattering satisfies a symmetry property, connecting a scattering process with the reversed one. While reciprocity involves the interchange of source and detector, it is fundamentally different from rotational invariance, and is a generalization of time reversal invariance, occurring in absorptive media as well. Due to its presence at diverse areas of physics, it admits a wide variety of applications. For polarization dependent scatterings, reciprocity is often violated, but violation in the phase of the scattering amplitude is much harder to experimentally observe than violation in magnitude. Enabled by the advantageous properties of nuclear resonance scattering of synchrotron radiation, we have measured maximal, i.e., 180-degree, reciprocity violation in the phase. For accessing phase information, we introduced a new version of stroboscopic detection. The scattering setting was devised based on a generalized reciprocity theorem that opens the way to construct new types of reciprocity related devices.
Busquet, J; Fontan, F; Choussat, A; Caianiello, G; Fernandez, G
1988-01-01
Double outlet right ventricle associated with atrioventricular concordance, pulmonary stenosis and situs solitus of the atria is a subset of double outlet right ventricle related through the surgical treatment. From 1974 to 1985, 14 patients, 5 males, 9 females (mean age 8.9 years, range 13 months-22 years) were operated upon. All patients had infundibular stenosis and normal or large pulmonary arteries. The apex of the heart was to the right in 2 patients, the right and left ventricles were superior and inferior in 2 patients and 1 patient had both anomalies. The ventricular septal defect was subaortic in 11 patients (aorto-mitral discontinuity in 5) and non-committed in 3 patients. Three patients had 2 ventricular septal defects. The aorta was anterior in 3 patients and to the right of the pulmonary artery in 11 patients. All patients, through a transventricular and transatrial approach, had a reconstructive surgery. In 3 patients, an aortic homograft valved conduit was used. One patient had the ventricular septal defect enlarged. There was one early death (7.1%) from high residual right ventricle pressure and no late death. One patient had a transient atrioventricular block. One patient was reoperated upon for a residual ventricular septal defect. All survivors had a good clinical result. Re-evaluation in 8 patients confirmed excellent haemodynamics: the right ventricle to pulmonary artery pressure gradient decreased from 80 mm Hg (range 60-95) preoperatively to 24 mm Hg (range 3-32) postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
Crystallization features of ternary reversible reciprocal systems
International Nuclear Information System (INIS)
Tomashik, V.N.; Shcherbak, L.P.; Fejchuk, P.I.; Grytsiv, V.I.
2006-01-01
Some features of the primary crystallization of phases in ternary reversible reciprocal system are considered and discussed. The diagonal join CdTe-GeSe of the CdTe + GeSe = CdSe + GeTe ternary reciprocal system is studied to show that the features in primary and secondary heating and cooling curves in such systems under fully equilibrium conditions are not reproduced upon consecutive heating and cooling sessions, because of the existence of different amounts of the reagents and the reaction products in the mixture; the temperatures of each transformation lie in a range. Those who experimentally investigate other ternary and more complex reversible reciprocal systems should take this fact into account [ru
Reciprocity and its utilization in ultrasonic flow meters
Energy Technology Data Exchange (ETDEWEB)
Lunde, Per; Vestrheim, Magne; Boe, Reidar; Smoergrav, Skule; Abrahamsen, Atle K.
2005-07-01
In ultrasonic transit time flow meters for gas and liquid (USMs), the flow direction, the flow velocity and the sound velocity are estimated from the measured up- and downstream transit times. At no-flow conditions, the up- and downstream transit times of such meters should ideally be the same, or the difference should be negligible. This may not be the case unless special precautions are made. In order to reduce the possibility of the meter to detect a false flow at no-flow conditions, USMs are typically ''dry calibrated'' before being installed in the field. ''Dry calibration'' (which may be made in different ways), in general involves measurement of (a) the time delays due to electronics, cables and transducers, (b) the so called ''{delta}t-correction'' (for each acoustic path, also denoted ''zero flow offset factor''), and (c) geometrical parameters. Various {delta}t-correction approaches may be used by different manufacturers, but these are basically similar and have the same purpose: to reduce the false flow detection and improve the accuracy at low and no-flow conditions (''zero flow adjustment''), without significantly affecting the accuracy at the high velocity measurements. The AGA-9 report and the API MPMS Ch. 5.8 standard both prescribe need for ''zero flow verification test (zero test)'' or ''zeroing the meter'', for gas and liquid USMs, respectively. Advances in USM technology based on the electro acoustic reciprocity principle have provided methods for reduction or even neglect ion of the need for ''{delta} t-correction'' of USMs. That means, if the USM measurement system is reciprocal, and operated in a ''sufficiently reciprocal'' way, the ''{delta}t-correction'' may be negligibly small over the operational range of pressure and temperature, and
Attitudes toward reciprocity systems for organ donation and allocation for transplantation.
Burkell, Jacquelyn A; Chandler, Jennifer A; Shemie, Sam D
2013-10-01
Many of those who support organ donation do not register to become organ donors. The use of reciprocity systems, under which some degree of priority is offered to registered donors who require an organ transplant, is one suggestion for increasing registration rates. This article uses a combination of survey and focus group methodologies to explore the reaction of Canadians to a reciprocity proposal. Our results suggest that the response is mixed. Participants are more convinced of the efficacy than they are of the fairness of a reciprocity system. Those more positive about donation (decided donors and those leaning toward donation) rate the system more positively. Although there is general endorsement of the notion that those who wish to receive should be prepared to give (the Golden Rule), this does not translate into universal support for a reciprocity system. In discussions of efficacy, decided donors focus on the positive impact of reciprocity, whereas undecided donors also reflect on the limits of reciprocity for promoting registration. The results demonstrate divided support for reciprocity systems in the Canadian context, with perceptions of efficacy at the cost of fairness. Further studies are warranted prior to considering a reciprocity system in Canada.
Reciprocal link for a coupled Camassa–Holm type equation
International Nuclear Information System (INIS)
Li, Nianhua; Zhang, Jinshun; Wu, Lihua
2016-01-01
Highlights: • We construct a reciprocal transformation for a coupled Camassa–Holm type equation proposed by Geng and Xue. • The transformed coupled Camassa–Holm type system is a reduction of the first negative flow in a modified Drinfeld–Sokolov III hierarchy. • The Lax pair and bi-Hamiltonian structure behaviors of the coupled Camassa–Holm type equation under the reciprocal transformation are analyzed. - Abstract: A coupled Camassa–Holm type equation is linked to the first negative flow in a modified Drinfeld–Sokolov III hierarchy by a transformation of reciprocal type. Meanwhile the Lax pair and bi-Hamiltonian structure behaviors of this coupled Camassa–Holm type equation under the reciprocal transformation are analyzed.
Relatedness decreases and reciprocity increases cooperation in Norway rats.
Schweinfurth, Manon K; Taborsky, Michael
2018-03-14
Kin selection and reciprocity are two mechanisms underlying the evolution of cooperation, but the relative importance of kinship and reciprocity for decisions to cooperate are yet unclear for most cases of cooperation. Here, we experimentally tested the relative importance of relatedness and received cooperation for decisions to help a conspecific in wild-type Norway rats ( Rattus norvegicus ). Test rats provided more food to non-kin than to siblings, and they generally donated more food to previously helpful social partners than to those that had refused help. The rats thus applied reciprocal cooperation rules irrespective of relatedness, highlighting the importance of reciprocal help for cooperative interactions among both related and unrelated conspecifics. © 2018 The Author(s).
Alzand, B S N; Timmermans, C C M M; Wellens, H J J; Dennert, R; Philippens, S A M; Portegijs, P J M; Rodriguez, L M
2011-08-01
The frequent occurrence of ventricular tachycardia can create a serious problem in patients with an implantable cardioverter defibrillator. We assessed the long-term efficacy of catheter-based substrate modification using the voltage mapping technique of infarct-related ventricular tachycardia and recurrent device therapy. The study population consisted of 27 consecutive patients (age 68 ± 8 years, 25 men, mean left ventricular ejection fraction 31 ± 9%) with an old myocardial infarction and multiple and/or hemodynamically not tolerated ventricular tachycardia necessitating repeated device therapy. A total of 31 substrate modification procedures were performed using the three-dimensional electroanatomical mapping system. Patients were followed up for a median of 23.5 (interquartile range 6.5-53.2) months before and 37.8 (interquartile range 11.7-71.8) months after ablation. Antiarrhythmic drugs were not changed after the procedure, and were stopped 6 to 9 months after the procedure in patients who did not show ventricular tachycardia recurrence. Median ventricular tachycardias were 1.6 (interquartile range 0.7-6.7) per month before and 0.2 (interquartile range 0.00-1.3) per month after ablation (P = 0.006). Nine ventricular fibrillation episodes were registered in seven patients before and two after ablation (P = 0.025). Median antitachycardia pacing decreased from 1.6 (interquartile range 0.01-5.5) per month before to 0.18 (interquartile range 0.00-1.6) per month after ablation (P = 0.069). Median number of shocks decreased from 0.19 (interquartile range 0.04-0.81) per month before to 0.00 (interquartile range 0.00-0.09) per month after ablation (P = 0.001). One patient had a transient ischemic attack during the procedure, and another developed pericarditis. Nine patients died during follow-up, eight patients due to heart failure and one patient during valve surgery. Catheter-based substrate modification using voltage mapping results in a long-lasting reduction
Benign joint hypermobility syndrome with postural orthostatic tachycardia syndrome and acrocyanosis
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Navjyot Kaur
2017-01-01
Full Text Available Benign joint hypermobility syndrome (BJHS and postural orthostatic tachycardia syndrome (POTS are two common conditions which are frequently overlooked. While patients with BJHS are known to attend rheumatology, orthopedic, and medical outpatient departments for years with polyarthralgia; POTS is commonly misdiagnosed as anxiety neurosis or panic attack. Described first in 1940, POTS is one of the common causes of orthostatic symptoms in females. POTS is defined as orthostatic intolerance associated with tachycardia exceeding 120 beats/min (bpm or an increase in the heart rate (HR of 30 bpm from baseline within 10 min of changing the posture from a lying to standing position, in the absence of long-term chronic diseases and medications that affect the autonomic or vascular tone. Classified as primary and secondary, the underlying pathophysiological mechanism is assumed to be a failure of peripheral vascular resistance to increase sufficiently in response to orthostatic stress, and consequently, venous pooling occurs in the legs resulting in decreased venous return to the heart. This is compensated by an increase in HR and inotropy. We present a case of BJHS, who reported to us with recurrent episodes of syncope and presyncope and was diagnosed to have POTS secondary to his hypermobility syndrome. Although the tilt-table test is the gold standard for diagnosis of POTS, this case highlights the importance of bedside tests in evaluation of orthostatic symptoms and in diagnosis of relatively common but frequently overlooked syndrome.
Indirect reciprocity and the evolution of "moral signals"
Smead, Rory
2010-01-01
Signals regarding the behavior of others are an essential element of human moral systems and there are important evolutionary connections between language and large-scale cooperation. In particular, social communication may be required for the reputation tracking needed to stabilize indirect reciprocity. Additionally, scholars have suggested that the benefits of indirect reciprocity may have been important for the evolution of language and that social signals may have coevolved with large-scale cooperation. This paper investigates the possibility of such a coevolution. Using the tools of evolutionary game theory, we present a model that incorporates primitive "moral signaling" into a simple setting of indirect reciprocity. This model reveals some potential difficulties for the evolution of "moral signals." We find that it is possible for "moral signals" to evolve alongside indirect reciprocity, but without some external pressure aiding the evolution of a signaling system, such a coevolution is unlikely.
Static And Kinematic Formulation Of Planar Reciprocal Assemblies
DEFF Research Database (Denmark)
Parigi, Dario; Kirkegaard, Poul Henning
2013-01-01
Planar reciprocal frames are two dimensional structures formed by elements joined together according to the principle of structural reciprocity. In this paper a rigorous formulation of the static and kinematic problem is proposed and developed by extending the work on pin-jointed assemblies by Pe...
Reciprocity on Demand : Sharing and Exchanging Food in Northwestern Namibia.
Schnegg, Michael
2015-09-01
Two competing models concerning food transfers prominent in the anthropological literature conceptualize such transfers either as sharing or as exchange. Sharing is understood as situational transactions formed through demands and unconditional giving, whereas reciprocal exchange is understood in terms of networking and keeping score. I propose that the picture is more complicated than these classifications suggests. Drawing on data collected in Northwestern Namibia, I show that sharing and reciprocal exchange are dynamically interrelated in actual food transfers. As a local norm, people can demand food from anyone, and they are typically given food in response to a demand. However, in practice, food transfer networks emerge (N = 62) that are highly reciprocal and fit the exchange model much better. Although the sharing norm makes no restrictions on whom to ask, in practice people often turn to their neighbors. Interpersonal dynamics account for why some of those ties become strongly reciprocal and others do not. Under these circumstances, unconditional sharing, a norm that has been viewed as an alternative to exchange, can lead to reciprocity via reciprocity on demand.
Generalized Gribov-Lipatov Reciprocity and AdS/CFT
International Nuclear Information System (INIS)
Beccaria, M.; Macorini, G.; Forini, V.
2010-01-01
Planar □=4 SYM theory and QCD share the gluon sector, suggesting the investigation of Gribov-Lipatov reciprocity in the supersymmetric theory. Since the AdS/CFT correspondence links □=4 SYM and superstring dynamics on AdS 5 x S5, reciprocity is also expected to show up in the quantum corrected energies of certain classical string configurations dual to gauge theory twist-operators. We review recent results confirming this picture and revisiting the old idea of Gribov-Lipatov reciprocity as a modern theoretical tool useful for the study of open problems in AdS/CFT.
Research on networked manufacturing system for reciprocating pump industry
Wu, Yangdong; Qi, Guoning; Xie, Qingsheng; Lu, Yujun
2005-12-01
Networked manufacturing is a trend of reciprocating pump industry. According to the enterprises' requirement, the architecture of networked manufacturing system for reciprocating pump industry was proposed, which composed of infrastructure layer, system management layer, application service layer and user layer. Its main functions included product data management, ASP service, business management, and customer relationship management, its physics framework was a multi-tier internet-based model; the concept of ASP service integration was put forward and its process model was also established. As a result, a networked manufacturing system aimed at the characteristics of reciprocating pump industry was built. By implementing this system, reciprocating pump industry can obtain a new way to fully utilize their own resources and enhance the capabilities to respond to the global market quickly.
Is there reciprocity in preferential trade agreements on services?
Marchetti, Juan; Roy, Martin; Zoratto, Laura
2012-01-01
Are market access commitments on services in Preferential Trade Agreements (PTAs) reciprocal or simply unilateral? If reciprocal, do concessions granted in services depend on concessions received from the trading partner in other services or in non-services areas as well? In this paper we investigate the presence of reciprocity in bilateral services agreements, by sub-sector, mode of supply and type of agreement (North-North, South-North, South-South). To do so, we use a database of concessio...
Cheng, Jem L; Au, Jason S; Guzman, Juan C; Morillo, Carlos A; MacDonald, Maureen J
2017-04-01
The cardiovascular profile of postural orthostatic tachycardia syndrome + Ehlers-Danlos syndrome hypermobility type (POTS + EDSIII) has not been described, despite suggestions that it plays a role in orthostatic intolerance. We studied nine individuals diagnosed with POTS + EDSIII and found that the arterial stiffness and cardiac profiles of patients with POTS + EDSIII were comparable to those of age- and sex-matched controls, suggesting an alternate explanation for orthostatic intolerance.
The Explanatory Power of Reciprocal Behavior for the Inter-Organizational Exchange Context
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Martina Pieperhoff
2018-06-01
Full Text Available In order to create sustainable competitive advantages, organizations are embedded in dyadic exchange relationships, which depend on the coordination of the behavior of the actors involved. Often, coordinated behavior is explained by trust. Since trust develops in a process of reciprocal responses to presumed trustworthy behavior, it is a reciprocity-based concept. While inter-organizational exchange relationships can appear in different stages (forming, establishing, broken, different reciprocity types (direct, indirect, negative can be distinguished. The study links reciprocal behavior to different stages of inter-organizational exchange relationships in order to investigate reciprocity as a possible coordination mechanism of behavior and thus explore the basis of coordination of trust-based behavior. Qualitative Comparative Analysis as a set-theoretic approach is applied to analyze the empirical data consisting of 78 qualitative semi-structured interviews with managers of small-, medium- and large-sized companies. The results show that different reciprocity types become effective in different stages of an inter-organizational exchange relationship: For forming inter-organizational exchange relationships indirect reciprocal behavior, besides direct reciprocity, becomes effective while in establishing inter-organizational exchange relationships, direct reciprocal behavior is evident. Negative reciprocal behavior leads to a break up of relationships. Using these results, on the one hand, the concept of trust can be sharpened by deepening the understanding of the trust-building mechanisms and on the other hand, reciprocity can be seen as coordination mechanism in exchange relationships of different stages. In doing so, with this knowledge, relationships can be coordinated towards a long-term orientation in order to create sustainable advantages.
Sex differences in the reciprocal behaviour of children with autism.
Backer van Ommeren, Tineke; Koot, Hans M; Scheeren, Anke M; Begeer, Sander
2017-08-01
Differences in the social limitations of girls compared to boys on the autism spectrum are still poorly understood. Impaired social-emotional reciprocity is a core diagnostic criterion for an autism spectrum disorder. This study compares sex differences in reciprocal behaviour in children with autism spectrum disorder (32 girls, 114 boys) and in typically developing children (24 girls, 55 boys). While children with autism spectrum disorder showed clear limitations in reciprocal behaviour compared to typically developing children, sex differences were found only in the autism spectrum disorder group: girls with autism spectrum disorder had higher reciprocity scores than boys with autism spectrum disorder. However, compared to typically developing girls, girls with autism spectrum disorder showed subtle differences in reciprocal behaviour. The sex-specific response patterns in autism spectrum disorder can inform and improve the diagnostic assessment of autism in females.
Bossu, Alexandre; Varkevisser, Rosanne; Beekman, Henriette D.M.; Houtman, Marien J C; Van Der Heyden, Marcel A.G.; Vos, Marc A.
2017-01-01
Short-term variability (STV), to quantify beat-to-beat variability of repolarization, is a surrogate parameter that reliably identifies proarrhythmic risk in preclinical models. Examples include not only the use in the chronic atrioventricular block (CAVB) dog model whereby it was developed but also
Briggs, Laura E.; Phelps, Aimee L.; Brown, Elizabeth; Kakarla, Jayant; Anderson, Robert H.; van den Hoff, Maurice J. B.; Wessels, Andy
2013-01-01
The dorsal mesenchymal protrusion (DMP) is a prong of mesenchyme derived from the second heart field (SHF) located at the venous pole of the developing heart. Recent studies have shown that perturbation of its development is associated with the pathogenesis of atrioventricular (AV) septal defect.
Takahashi, Kazuhiro; Fuchigami, Tai; Nabeshima, Taisuke; Sashinami, Arata; Nakayashiro, Mami
2016-03-01
The success of catheter ablation of focal atrial tachycardia is limited by possible collateral damage to the phrenic nerve. Protection of the phrenic nerve is required. Here we present a case of a 9-year-old girl having a history of an unsuccessful catheter ablation of a focal atrial tachycardia near the crista terminalis (because of proximity of the phrenic nerve) who underwent a successful ablation by means of a novel technique for phrenic nerve protection: packing of gauze into the pericardial space. This method is a viable approach for patients with a failed endocardial ablation due to the proximity of the phrenic nerve.
Reciprocally-Rotating Velocity Obstacles
Giese, Andrew; Latypov, Daniel; Amato, Nancy M.
2014-01-01
obstacles. One state-of-the-art local collision avoidance technique is Optimal Reciprocal Collision Avoidance (ORCA). Despite being fast and efficient for circular-shaped agents, ORCA may deadlock when polygonal shapes are used. To address this shortcoming
BitTorrent's dilemma: Enhancing reciprocity or reducing inequity
Jia, A.L.; D'Acunto, L.; Meulpolder, M.; Pouwelse, J.A.; Epema, D.H.J.
2011-01-01
Enhancing reciprocity has been one of the primary motivations for the design of incentive policies in BitTorrent-like P2P systems. Reciprocity implies that peers need to contribute their bandwidth to other peers if they want to receive bandwidth in return. However, the over-provisioning that
Guilt driven reciprocity in a psychological signaling game
Fong, Y.; Huang, C.-Y.; Offerman, T.
2007-01-01
We propose a theory of reciprocity according to which reciprocal behavior is driven by a donor's guilt. Through an experiment we show that subjects respond to factors which induce guilt but do not reflect allocative equity or intention. When the guilt inducing factor is privately observed by the
Guilt driven reciprocity in a psychological signaling game
Fong, Y.; Huang, C.-Y.; Offerman, T.
2009-01-01
We propose a theory of reciprocity according to which reciprocal behavior is driven by a donor’s guilt. Through an experiment we show that subjects respond to factors which induce guilt but do not reflect allocative equity or intention. When the guilt inducing factor is privately observed by the
Malignant ventricular tachycardia in acromegaly: a case report
Directory of Open Access Journals (Sweden)
Zhe An
Full Text Available CONTEXT: In patients with acromegaly, cardiovascular complications are the main cause of death; sudden death has been associated with ventricular tachyarrhythmias. In other patients with life-threatening malignant ventricular tachyarrhythmias, surgical placement of an implantable cardioverter-defibrillator (ICD has proved highly effective in reducing sudden death rates. CASE REPORT: The present article reports the case of a 50-year-old male acromegalic patient who presented symptoms of syncope induced by ventricular tachycardia. An ICD was surgically implanted and a pituitary adenoma, which was responsible for the acromegaly, was completely removed in the same procedure. The surgery was successful and the ventricular arrhythmias were effectively terminated. During six months of follow-up, no documented arrhythmic episodes occurred. CONCLUSION: In patients with acromegaly, malignant ventricular tachyarrhythmia might be effectively controlled by implantation of an ICD and surgical removal of the pituitary adenoma.
Allen, Emily; Coote, John H; Grubb, Blair D; Batten, Trevor Fc; Pauza, Dainius H; Ng, G André; Brack, Kieran E
2018-05-22
The intrinsic cardiac nervous system (ICNS) is a rich network of cardiac nerves that converge to form distinct ganglia and extend across the heart and is capable of influencing cardiac function. To provide a picture of the neurotransmitter/neuromodulator profile of the rabbit ICNS and determine the action of spatially divergent ganglia on cardiac electrophysiology. Nicotinic or electrical stimulation was applied at discrete sites of the intrinsic cardiac nerve plexus in the Langendorff perfused rabbit heart. Functional effects on sinus rate and atrioventricular conduction were measured. Immunohistochemistry for choline acetyltransferase (ChAT), tyrosine hydroxylase (TH) and/or neuronal nitric oxide synthase (nNOS) was performed on whole-mount preparations. Stimulation within all ganglia produced either bradycardia, tachycardia or a biphasic brady-tachycardia. Electrical stimulation of the right atrial (RA) and right neuronal cluster (RNC) regions produced the greatest chronotropic responses. Significant prolongation of atrioventricular conduction (AVC) was predominant at the pulmonary vein-caudal vein region (PVCV). Neurons immunoreactive (IR) only for ChAT, or TH or nNOS were consistently located within the limits of the hilum and at the roots of the right cranial and right pulmonary veins. ChAT-IR neurons were most abundant (1946±668 neurons). Neurons IR solely for nNOS were distributed within ganglia. Stimulation of intrinsic ganglia, shown to be of phenotypic complexity but predominantly of cholinergic nature, indicates that clusters of neurons are capable of independent selective effects on cardiac electrophysiology, therefore providing a potential therapeutic target for the prevention and treatment of cardiac disease. Copyright © 2018. Published by Elsevier Inc.
A Comparison of Several Statistical Tests of Reciprocity of Self-Disclosure.
Dindia, Kathryn
1988-01-01
Reports the results of a study that used several statistical tests of reciprocity of self-disclosure. Finds little evidence for reciprocity of self-disclosure, and concludes that either reciprocity is an illusion, or that different or more sophisticated methods are needed to detect it. (MS)
Postural tachycardia syndrome and other forms of orthostatic intolerance in Ehlers-Danlos syndrome.
Roma, Maria; Marden, Colleen L; De Wandele, Inge; Francomano, Clair A; Rowe, Peter C
2018-03-05
To review the association between orthostatic intolerance syndromes and both joint hypermobility and Ehlers-Danlos syndrome, and to propose reasons for identifying hereditary connective tissue disorders in those with orthostatic intolerance in the context of both clinical care and research. We searched the published peer-reviewed medical literature for papers reporting an association between joint hypermobility or Ehlers-Danlos syndrome and orthostatic intolerance. We identified 10 relevant papers. Although methodological variability between studies introduces some limitations, the published literature consistently identifies a significantly higher prevalence of orthostatic intolerance symptoms in patients with joint hypermobility or Ehlers-Danlos syndrome than in healthy controls, and a significantly higher prevalence of cardiovascular and autonomic abnormalities both at rest and during orthostatic challenge. Postural tachycardia syndrome is the most commonly recognized circulatory disorder. The severity of orthostatic symptoms in those with EDS correlates with impairments in quality of life. There is a strong association between several forms of cardiovascular dysfunction, most notably postural tachycardia syndrome, and joint hypermobility or Ehlers-Danlos syndrome. We propose that recognition of joint hypermobility and Ehlers-Danlos syndrome among those with orthostatic intolerance syndromes has the potential to improve clinical care and the validity of research findings. Copyright © 2018 Elsevier B.V. All rights reserved.
Directory of Open Access Journals (Sweden)
Shafqat MN
2017-07-01
Full Text Available Muhammad Nabeel Shafqat,1 Muhammad Aadil,2 Maria Shoaib31Department of Medicine, University of Medical Sciences “Serafin Ruiz de Zarate” Villa Clara (UCMVC, Villa Clara, Cuba; 2Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA; 3Department of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, PakistanWe read with great interest the currently published article written by Pederson and Brook1 entitled “Sleep disturbance linked to suicidal ideation in postural orthostatic tachycardia syndrome”. Awareness of postural orthostatic tachycardia syndrome (POTS has increased in recent years. However, sleep disturbance has not been thoroughly investigated as a cause of increased suicidal risk in patients with POTS. We would like to applaud the authors on conducting this novel cross-sectional study to understand and highlight the potential relationship between sleep disturbances and increased risk of suicide in patients suffering from POTS.1View the original paper by Pederson and Brook.
The stability of quadratic-reciprocal functional equation
Song, Aimin; Song, Minwei
2018-04-01
A new quadratic-reciprocal functional equation f ((k +1 )x +k y )+f ((k +1 )x -k y )=2/f (x )f (y )[(k+1 ) 2f (y )+k2f (x )] [(k+1)2f (y )-k2f (x )] 2 is introduced. The Hyers-Ulam stability for the quadratic-reciprocal functional equations is proved in Banach spaces using the direct method and the fixed point method, respectively.
Reciprocity principle in stochastic quantum mechanics
International Nuclear Information System (INIS)
Brooke, J.A.; Guz, W.; Prugovecki, E.
1982-01-01
Born's reciprocity theory can be combined with a recently proposed framework for quantum spacetime by requiring that the free test particle propagators obey the Born-Lande equation in addition to the Klein-Gordon equation. If, furthermore, the coordinate transition amplitudes in between various standards are required to be eigenfunctions of Born's metric operator, then a mass formula results which predicts linear dependence on spin of the squared rest mass of elementary particles. This procedure also leads to a guage and reciprocally invariant formulation of the relativistic canonical commutation relations
Jiao, Zhenyu; Tian, Ying; Yang, Xinchun; Liu, Xingpeng
2017-10-01
A 59-year-old male patient was admitted with the main complaints of stuffiness and shortness of breath. An ECG from precordial leads on admission showed masquerading bundle branch block. Syncope frequently occurred after admission. During syncope episodes, ECG telemetry showed that the syncope was caused by intermittent complete atrioventricular block, with the longest RR interval lasting for 4.36 s. At the gap of syncope, ECG showed complete right bundle branch block accompanied by alternation of left anterior fascicular block and left posterior fascicular block. The patient was implanted with a dual-chamber permanent pacemaker. Follow-up of 9 months showed no reoccurrence of syncope.
Payoff non-linearity sways the effect of mistakes on the evolution of reciprocity.
Kurokawa, Shun
2016-09-01
The existence of cooperation is considered to require explanation, and reciprocity is a potential explanatory mechanism. Animals sometimes fail to cooperate even when they attempt to do so, and a reciprocator has an Achilles' heel: it is vulnerable to error (the interaction between two reciprocators can lead to an endless vendetta.). However, the strategy favored by natural selection is determined also by its interaction with other strategies. The relationship between two reciprocators leading to a collapse of cooperation through error does not straightforwardly imply that mistakes make the conditions under which reciprocity evolves stringent. Hence, mistakes may facilitate the evolution of reciprocity. However, it has been shown through the analysis of the interaction between reciprocators and unconditional defectors that the existence of mistakes makes the conditions for reciprocators stable against invasion by an unconditional defector more stringent, which indicates that mistakes discourage the evolution of reciprocity. However, this result is based on the assumption that the effects of cooperation are additive (payoff is linear), while the game played by real animals does not always display this feature. In such cases, the result may be swayed. In this paper, we remove this assumption, reexamining whether mistakes disturb the evolution of reciprocity. Using the analysis of an evolutionarily stable strategy (ESS), we show that when extra fitness costs are present in cases where mutual cooperation is established, mistakes can facilitate the evolution of reciprocity; whereas, when the effect of cooperation is additive, mistakes always disturb the evolution of reciprocity, as has been shown previously. Copyright © 2016. Published by Elsevier Inc.
Simons, G R; Newby, K H; Kearney, M M; Brandon, M J; Natale, A
1998-02-01
The objective of this study was to assess the safety and efficacy of transvenous low energy cardioversion of atrial fibrillation in patients with ventricular tachycardia and atrial fibrillation and to study the mechanisms of proarrhythmia. Previous studies have demonstrated that cardioversion of atrial fibrillation using low energy, R wave synchronized, direct current shocks applied between catheters in the coronary sinus and right atrium is feasible. However, few data are available regarding the risk of ventricular proarrhythmia posed by internal atrial defibrillation shocks among patients with ventricular arrhythmias or structural heart disease. Atrial defibrillation was performed on 32 patients with monomorphic ventricular tachycardia and left ventricular dysfunction. Shocks were administered during atrial fibrillation (baseline shocks), isoproterenol infusion, ventricular pacing, ventricular tachycardia, and atrial pacing. Baseline shocks were also administered to 29 patients with a history of atrial fibrillation but no ventricular arrhythmias. A total of 932 baseline shocks were administered. No ventricular proarrhythmia was observed after well-synchronized baseline shocks, although rare inductions of ventricular fibrillation occurred after inappropriate T wave sensing. Shocks administered during wide-complex rhythms (ventricular pacing or ventricular tachycardia) frequently induced ventricular arrhythmias, but shocks administered during atrial pacing at identical ventricular rates did not cause proarrhythmia. The risk of ventricular proarrhythmia after well-synchronized atrial defibrillation shocks administered during narrow-complex rhythms is low, even in patients with a history of ventricular tachycardia. The mechanism of proarrhythmia during wide-complex rhythms appears not to be related to ventricular rate per se, but rather to the temporal relationship between shock delivery and the repolarization time of the previous QRS complex.
Directory of Open Access Journals (Sweden)
D. R. Sabirova
2014-01-01
Full Text Available The diagnosis and treatment of life-threatening arrhythmias after surgical correction of congenital heart diseases is one the urgent problems in pediatrlc cardiology. The paper describes the clinical picture, diagnosis, and therapy in a patent with transient complete atrioventricular block after open heart surgery. A protracted Morgagni—Adams—Stokes attack is one of the causes of sudden cardiac death. The occurrence of even single syncopes in patients after surgery for congenital heart disease requires that the arrhythmogenic nature of the attack should be ruled out for the timely and adequate therapy including the implantation of antiarrhythmic devices.
Reciprocity and depressive symptoms in Belgian workers: a cross-sectional multilevel analysis.
De Clercq, Bart; Clays, Els; Janssens, Heidi; De Bacquer, Dirk; Casini, Annalisa; Kittel, France; Braeckman, Lutgart
2013-07-01
This study examines the multidimensional association between reciprocity at work and depressive symptoms. Data from the Belgian BELSTRESS survey (32 companies; N = 24,402) were analyzed. Multilevel statistical procedures were used to account for company-level associations while controlling for individual-level associations. Different dimensions of individual reciprocity were negatively associated with depressive symptoms. On the company level, only vertical emotional reciprocity was negatively associated (β = -4.660; SE = 1.117) independently from individual reciprocity (β = -0.557; SE = 0.042). Complex interactions were found such that workplace reciprocity (1) may not uniformly benefit individuals and (2) related differently to depressive symptoms, depending on occupational group. This study extends the existing literature with evidence on the multidimensional, contextual, and cross-level interaction associations of reciprocity as a key aspect of social capital on depressive symptoms.
Atrioventricular node functional remodeling induced by atrial fibrillation.
Zhang, Youhua; Mazgalev, Todor N
2012-09-01
The atrioventricular node (AVN) plays a vital role in determining the ventricular rate during atrial fibrillation (AF). AF results in profound electrophysiological and structural remodeling in the atria as well as the sinus node. However, it is unknown whether AVN undergoes remodeling during AF. To determine whether AVN undergoes functional remodeling during AF. AVN conduction properties were studied in vitro in 9 rabbits with AF and 10 normal controls. A previously validated index of AVN dual-pathway electrophysiology, His-electrogram alternans, was used to monitor fast-pathway or slow-pathway (SP) AVN conduction in these experiments. AVN conduction properties were further studied in vivo in 7 dogs with chronic AF and 8 controls. Compared with the control rabbits, the rabbits with AF had a longer AVN conduction time (83 ± 16 ms vs 68 ± 7 ms; P AVN effective refractory period (141 ± 27 ms vs 100 ± 9 ms; P AVN effective refractory period and a slower ventricular rate during AF compared with the controls. Pronounced AVN functional electrophysiological remodeling occurs after long-term AF, which could lead to a spontaneous slowing of the ventricular rate. Furthermore, the SP dominance during AF underscores the effectiveness of its modification by ablation for ventricular rate control during AF. Copyright © 2012 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
Monkeys fail to reciprocate in an exchange task.
Pelé, Marie; Thierry, Bernard; Call, Josep; Dufour, Valérie
2010-09-01
Exchanges form the basis of human economies. Animals too can engage in reciprocal interactions but they do not barter goods like humans, which raises the question of the abilities necessary for trading to occur. Previous studies have shown that non-human primates can exchange food with human partners. Here, we tested the ability of brown capuchin monkeys and Tonkean macaques to reciprocate in a task requiring two conspecifics to exchange tokens in order to obtain rewards from an experimenter. We recorded 56 transfers between subjects in capuchin monkeys and 10 in Tonkean macaques. All transfers were passive in both species. Capuchins preferentially picked up tokens valuable for them in the partner's compartment. They tended to manipulate the partner-valued tokens more often than the no-value ones, leading to more opportunities for these tokens to end up within reach of the partner. Despite optimal conditions where values of goods were defined and known by partners, however, none of the pairs tested engaged in short-term reciprocal interactions. These results indicate that calculated reciprocity was difficult if not impossible in the animals tested.
Grooming reciprocity in female tibetan macaques macaca thibetana.
Xia, Dongpo; Li, Jinhua; Garber, Paul A; Sun, Lixing; Zhu, Yong; Sun, Binghua
2012-06-01
Grooming among nonhuman primates is widespread and may represent an important service commodity that is exchanged within a biological marketplace. In this study, using focal animal sampling methods, we recorded grooming relationships among 12 adult females in a free-ranging group of Tibetan macaques (Macaca thibetana) at Huangshan, China, to determine the influence of rank and kinship on grooming relationships, and whether females act as reciprocal traders (exchange grooming received for grooming given) or interchange traders (interchange grooming for social tolerance or other commodities). The results showed that: (1) grooming given was positively correlated with grooming received; (2) kinship did not exert a significant influence on grooming reciprocity; and (3) grooming reciprocity occurred principally between individuals of adjacent rank; however, when females of different rank groomed, females tended to groom up the hierarchy (lower ranking individuals groomed higher ranking individuals more than vice versa). Our results support the contention that both grooming reciprocity and the interchange of grooming for tolerance represent important social tactics used by female Tibetan macaques. © 2012 Wiley Periodicals, Inc.
Disjunctured reciprocity: Paradoxes of community-school relationship in Nepal
DEFF Research Database (Denmark)
Pradhan, Uma; Shrestha, Shivana; Valentin, Karen
2018-01-01
and community. This article questions the simplistic assumption through an ethnographic study of community-school relationship in Nepal. While these relationships may conflict with the kind of reciprocity assumed in school governance policies, we argue that this disjunctured reciprocity, firstly, reflects...
DEFF Research Database (Denmark)
Jabbari, Javad; Jabbari, Reza; Nielsen, Morten Wagner
2013-01-01
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a lethal, rare hereditary disease with an estimated prevalence of 1:10 000. The genetic variants that cause CPVT are usually highly penetrant. To date, about 189 variants in 5 genes (RYR2, CASQ2, CALM1, TRND, and KCNJ2) have been...
WIESFELD, ACP; CRIJNS, HJGM; HILLEGE, HL; TUININGA, YS; LIE, KI
The role of ischaemia in post-infarct patients with ventricular tachyarrhythmias is not firmly established Using coronary angiography, 82 post-infarct patients with sustained ventricular tachycardia or fibrillation were subclassified into three groups. Fourteen patients (17%) had significant
International Nuclear Information System (INIS)
Rajeev, V.R.; Dwivedi, D.K.; Jain, S.C.
2010-01-01
In the present paper, the effect of normal load and reciprocating velocity on transition from mild to severe wear of A319/15%SiC p , A336/15%SiC p , and A390/15%SiC p composites have been reported. Composites were produced through liquid metal metallurgy route. Adhesive wear behavior of composites was studied under dry reciprocating conditions using indigenously developed reciprocating friction wear test rig conforming to ASTM Standard G133-05. It was found that increase in normal load increases wear rate and depending upon the reciprocating velocity and type of composites, mode of wear changes from mild oxidative to severe metallic wear was noticed. The load corresponding to the transition from mild to severe wear usually termed as transition load was found to decrease with increase in reciprocating velocity and reduction in silicon content in the alloys used for the development of Al-Si-SiC p composites. At 1 m/s reciprocating velocity, the transition load for A319/15%SiC p , A336/15%SiC p and A390/15%SiC p composites were found to be in the range of 60-90 N, 60-105 N and 60-120 N respectively. Scanning electron microscope (SEM) study of wear surface and wear debris were conducted to analyze the mode of wear and operating wear mechanism. Severe wear was characterized by massive plastic deformation and gross material removal while the mild wear was found to be associated with delamination and scoring as main wear mechanisms responsible for material loss. Wear mechanism maps for different Al-(6-18)%Si-15%SiC p composites were proposed in reciprocating contacts.
Bagai, Kanika; Peltier, Amanda C.; Malow, Beth A.; Diedrich, André; Shibao, Cyndya A.; Black, Bonnie K.; Paranjape, Sachin Y.; Orozco, Carlos; Biaggioni, Italo; Robertson, David; Raj, Satish R.
2016-01-01
Study Objectives: Patients with postural tachycardia syndrome (POTS) commonly complain of fatigue, unrefreshing sleep, daytime sleepiness, and diminished quality of life. The study objective was to assess objective sleep quality in POTS patients using overnight polysomnography. Methods: We studied 16 patients with POTS and 15 healthy control subjects performing daytime autonomic functions tests and overnight polysomnography at the Vanderbilt Clinical Research Center. Results: There were no significant differences in the objective sleep parameters including sleep efficiency, sleep onset latency, wake time after sleep onset, REM latency, percentage of time spent in N1, N2, N3, and REM sleep, arousal index, apnea-hypopnea index, or periodic leg movement index in POTS patients as compared with healthy control subjects. There were significant negative correlations between sleep efficiency and the change in HR from supine to stand (rs = −0.527; p = 0.036) Conclusions: POTS patients do not have significant differences in objective sleep parameters as compared to control subjects based on overnight polysomnograms. Activation of the sympathetic nervous system may contribute significantly to the hyper arousal state and worsening of subjective estimates of sleep quality as previously reported in POTS patients. Citation: Bagai K, Peltier AC, Malow BA, Diedrich A, Shibao CA, Black BK, Paranjape SY, Orozco C, Biaggioni I, Robertson D, Raj SR. Objective sleep assessments in patients with postural tachycardia syndrome using overnight polysomnograms. J Clin Sleep Med 2016;12(5):727–733. PMID:26951415
Brembilla-Perrot, B; Chometon, F; Groben, L; Ammar, S; Bertrand, J; Marcha, C; Cloez, J L; Tisserand, A; Huttin, O; Tatar, C; Duhoux, F; Yangni N'da, O; Beurrier, D; Terrier de Chaise, A; Zhang, N; Abbas, M; Cedano, J; Marçon, F
2007-09-01
To determine the feasibility and the results of exercise testing (ET) and electrophysiological study (EPS) in outpatient asymptomatic children with a Wolff-Parkinson-White (WPW) syndrome. Exercise testing and transesophageal EPS were performed in 55 outpatient asymptomatic children aged 6 to 19 years old (14 +/- 3) with WPW. Wolff-Parkinson-White persisted during maximal exercise. Isoproterenol was not required in five children younger than 10 years old, because they developed a catecholaminergic sinus tachycardia. Maximal rate conducted through accessory pathway (AP) was higher in children younger than 16 years old than in teenagers (P < 0.05). Atrioventricular re-entrant tachycardia (AVRT) was induced in six children; atrial fibrillation (AF) in 12 children. The induction of tachycardias and the dangerous forms (18%) were not influenced by age. After 5 +/- 1 years, one child, 12 year old with inducible rapid AF, had a sudden cardiac arrest; two children became symptomatic after ablation. Transesophageal EPS was required to determine the prognosis of asymptomatic WPW in children. The maximal rate conducted in AP was higher in children younger than 16 years old than in teenagers; other data did not differ. AVRT was rare; 71% of children had no inducible arrhythmia and were authorized to resume physical activities.
Advances in Design and Fabrication of Free-Form Reciprocal Structures
DEFF Research Database (Denmark)
Parigi, Dario
2016-01-01
The paper presents the advances in design and fabrication of free-form Reciprocal Structures, and their application a during a one-week long workshop with the students of the 1st semester of the Master of Science in Architecture and Design, fall 2015, at Aalborg University. Two new factors were...... introduced and tested: a new version of the software Reciprocalizer, and an evolution of the Reciprocalizer Robot. The workshop didactic framework Performance Aided/Assisted Design (PAD) is presented....
LENUS (Irish Health Repository)
Corrado, Domenico
2010-09-21
The role of implantable cardioverter-defibrillator (ICD) in patients with arrhythmogenic right ventricular cardiomyopathy\\/dysplasia and no prior ventricular fibrillation (VF) or sustained ventricular tachycardia is an unsolved issue.
Cooperation under indirect reciprocity and imitative trust.
Saavedra, Serguei; Smith, David; Reed-Tsochas, Felix
2010-10-27
Indirect reciprocity, a key concept in behavioral experiments and evolutionary game theory, provides a mechanism that allows reciprocal altruism to emerge in a population of self-regarding individuals even when repeated interactions between pairs of actors are unlikely. Recent empirical evidence show that humans typically follow complex assessment strategies involving both reciprocity and social imitation when making cooperative decisions. However, currently, we have no systematic understanding of how imitation, a mechanism that may also generate negative effects via a process of cumulative advantage, affects cooperation when repeated interactions are unlikely or information about a recipient's reputation is unavailable. Here we extend existing evolutionary models, which use an image score for reputation to track how individuals cooperate by contributing resources, by introducing a new imitative-trust score, which tracks whether actors have been the recipients of cooperation in the past. We show that imitative trust can co-exist with indirect reciprocity mechanisms up to a threshold and then cooperation reverses -revealing the elusive nature of cooperation. Moreover, we find that when information about a recipient's reputation is limited, trusting the action of third parties towards her (i.e. imitating) does favor a higher collective cooperation compared to random-trusting and share-alike mechanisms. We believe these results shed new light on the factors favoring social imitation as an adaptive mechanism in populations of cooperating social actors.
Cooperation under indirect reciprocity and imitative trust.
Directory of Open Access Journals (Sweden)
Serguei Saavedra
Full Text Available Indirect reciprocity, a key concept in behavioral experiments and evolutionary game theory, provides a mechanism that allows reciprocal altruism to emerge in a population of self-regarding individuals even when repeated interactions between pairs of actors are unlikely. Recent empirical evidence show that humans typically follow complex assessment strategies involving both reciprocity and social imitation when making cooperative decisions. However, currently, we have no systematic understanding of how imitation, a mechanism that may also generate negative effects via a process of cumulative advantage, affects cooperation when repeated interactions are unlikely or information about a recipient's reputation is unavailable. Here we extend existing evolutionary models, which use an image score for reputation to track how individuals cooperate by contributing resources, by introducing a new imitative-trust score, which tracks whether actors have been the recipients of cooperation in the past. We show that imitative trust can co-exist with indirect reciprocity mechanisms up to a threshold and then cooperation reverses -revealing the elusive nature of cooperation. Moreover, we find that when information about a recipient's reputation is limited, trusting the action of third parties towards her (i.e. imitating does favor a higher collective cooperation compared to random-trusting and share-alike mechanisms. We believe these results shed new light on the factors favoring social imitation as an adaptive mechanism in populations of cooperating social actors.
Reciprocally-Rotating Velocity Obstacles
Giese, Andrew
2014-05-01
© 2014 IEEE. Modern multi-agent systems frequently use highlevel planners to extract basic paths for agents, and then rely on local collision avoidance to ensure that the agents reach their destinations without colliding with one another or dynamic obstacles. One state-of-the-art local collision avoidance technique is Optimal Reciprocal Collision Avoidance (ORCA). Despite being fast and efficient for circular-shaped agents, ORCA may deadlock when polygonal shapes are used. To address this shortcoming, we introduce Reciprocally-Rotating Velocity Obstacles (RRVO). RRVO generalizes ORCA by introducing a notion of rotation for polygonally-shaped agents. This generalization permits more realistic motion than ORCA and does not suffer from as much deadlock. In this paper, we present the theory of RRVO and show empirically that it does not suffer from the deadlock issue ORCA has, permits agents to reach goals faster, and has a comparable collision rate at the cost of performance overhead quadratic in the (typically small) user-defined parameter δ.
Drigalla, Dorian; Essler, Shannon E; Stone, C Keith
2017-11-01
Lightning strike is a rare medical emergency. The primary cause of death in lightning strike victims is immediate cardiac arrest. The mortality rate from lightning exposure can be as high as 30%, with up to 70% of patients left with significant morbidity. An 86-year-old male was struck by lightning while driving his vehicle and crashed. On initial emergency medical services evaluation, he was asymptomatic with normal vital signs. During his transport, he lost consciousness several times and was found to be in atrial fibrillation with intermittent runs of ventricular tachycardia during the unconscious periods. In the emergency department, atrial fibrillation persisted and he experienced additional episodes of ventricular tachycardia. He was treated with i.v. amiodarone and admitted to cardiovascular intensive care unit, where he converted to a normal sinus rhythm on the amiodarone drip. He was discharged home without rhythm-control medications and did not have further episodes of dysrhythmias on follow-up visits. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Lightning strikes are one of the most common injuries suffered from natural phenomenon, and short-term mortality ordinarily depends on the cardiac effects. This case demonstrates that the cardiac effects can be multiple, delayed, and recurrent, which compels the emergency physician to be vigilant in the initial evaluation and ongoing observation of patients with lightning injuries. Copyright © 2017 Elsevier Inc. All rights reserved.
Social Dilemmas and Indirect Reciprocity: A systematic review
Directory of Open Access Journals (Sweden)
Cristian Acosta
2014-08-01
Full Text Available Indirect reciprocity is an evolutionary theory of altruism and cooperation in social dilemmas. Its explanation of cooperation incorporates information on the reputation people hold of other people regarding whether they are cooperative or not. This study systematically reviewed the current empirical literature on indirect reciprocity in social dilemma situations. The following databases were consulted: ScienceDirect, EBSCO, and OVID, using has key words "indirect reciprocity" AND "dilemma" OR "cooperation" OR "charity". Twenty-three articles were selected which met the inclusion criteria (papers written in English and studies whose methodology was based on experimental games and the theories, objectives, the main types of samples used, and main results were analyzed. The results show that the games used were the indirect reciprocity and public goods games, which may vary according to the objectives. It was found that reputation is a key variable that helps to promote cooperation. In turn, information on previous cooperation helps to build reputation, which is subsequently involved in the decision to cooperate with others. Finally, we highlight the need for more experimental studies that incorporate other explanatory variables and evaluate them in new contexts.
Evidence of Reciprocity in Reports on International Partnerships
Directory of Open Access Journals (Sweden)
Rachel A. Umoren
2012-01-01
Full Text Available The increase in global health opportunities in medical education has been accompanied by calls for ethical and reciprocal institutional partnerships. The Working Group on Ethics Guidelines in Global Health Training (WEIGHT guidelines were developed in 2010 and are widely accepted by the global health community. We reviewed 43 articles on international partnerships from 1970 to 2010 for eight principles of reciprocity derived from the WEIGHT guidelines. The results showed that, while few articles reflected all principles, there was a trend to increasing consideration of the international partner’s local needs, pre-departure cultural training, and collaborative authorship. However, learner supervision and consideration of local cost/benefit ratios decreased over the same time period. Partnerships with only one international partner or with institutional partners in Africa had lower reciprocity scores than those with two or more partners and institutional partners in Asia and South America. We recommend that a new focus on ethics in global health partnerships leads to the inclusion of the principles of reciprocity in model program descriptions in order to enable and encourage ethical, sustainable, and mutually beneficial institutional partnerships.
Gauge invariance and reciprocity in quantum mechanics
International Nuclear Information System (INIS)
Leung, P. T.; Young, K.
2010-01-01
Reciprocity in wave propagation usually refers to the symmetry of the Green's function under the interchange of the source and the observer coordinates, but this condition is not gauge invariant in quantum mechanics, a problem that is particularly significant in the presence of a vector potential. Several possible alternative criteria are given and analyzed with reference to different examples with nonzero magnetic fields and/or vector potentials, including the case of a multiply connected spatial domain. It is shown that the appropriate reciprocity criterion allows for specific phase factors separable into functions of the source and observer coordinates and that this condition is robust with respect to the addition of any scalar potential. In the Aharonov-Bohm effect, reciprocity beyond monoenergetic experiments holds only because of subsidiary conditions satisfied in actual experiments: the test charge is in units of e and the flux is produced by a condensate of particles with charge 2e.
Transcranial electrical neuromodulation based on the reciprocity principle
Directory of Open Access Journals (Sweden)
Mariano eFernandez Corazza
2016-05-01
Full Text Available A key challenge in multi-electrode transcranial electrical stimulation (TES or transcranial direct current stimulation (tDCS is to find a current injection pattern that delivers the necessary current density at a target and minimizes it in the rest of the head, which is mathematically modelled as an optimization problem. Such an optimization with the Least Squares (LS or Linearly Constrained Minimum Variance (LCMV algorithms is generally computationally expensive and requires multiple independent current sources. Based on the reciprocity principle in electroencephalography (EEG and TES, it could be possible to find the optimal TES patterns quickly whenever the solution of the forward EEG problem is available for a brain region of interest. Here, we investigate the reciprocity principle as a guideline for finding optimal current injection patterns in TES that comply with safety constraints. We define four different trial cortical targets in a detailed seven-tissue finite element head model, and analyze the performance of the reciprocity family of TES methods in terms of electrode density, targeting error, focality, intensity, and directionality using the LS and LCMV solutions as the reference standards. It is found that the reciprocity algorithms show good performance comparable to the LCMV and LS solutions. Comparing the 128 and 256 electrode cases, we found that use of greater electrode density improves focality, directionality, and intensity parameters. The results show that reciprocity principle can be used to quickly determine optimal current injection patterns in TES and help to simplify TES protocols that are consistent with hardware and software availability and with safety constraints.
Transcranial Electrical Neuromodulation Based on the Reciprocity Principle.
Fernández-Corazza, Mariano; Turovets, Sergei; Luu, Phan; Anderson, Erik; Tucker, Don
2016-01-01
A key challenge in multi-electrode transcranial electrical stimulation (TES) or transcranial direct current stimulation (tDCS) is to find a current injection pattern that delivers the necessary current density at a target and minimizes it in the rest of the head, which is mathematically modeled as an optimization problem. Such an optimization with the Least Squares (LS) or Linearly Constrained Minimum Variance (LCMV) algorithms is generally computationally expensive and requires multiple independent current sources. Based on the reciprocity principle in electroencephalography (EEG) and TES, it could be possible to find the optimal TES patterns quickly whenever the solution of the forward EEG problem is available for a brain region of interest. Here, we investigate the reciprocity principle as a guideline for finding optimal current injection patterns in TES that comply with safety constraints. We define four different trial cortical targets in a detailed seven-tissue finite element head model, and analyze the performance of the reciprocity family of TES methods in terms of electrode density, targeting error, focality, intensity, and directionality using the LS and LCMV solutions as the reference standards. It is found that the reciprocity algorithms show good performance comparable to the LCMV and LS solutions. Comparing the 128 and 256 electrode cases, we found that use of greater electrode density improves focality, directionality, and intensity parameters. The results show that reciprocity principle can be used to quickly determine optimal current injection patterns in TES and help to simplify TES protocols that are consistent with hardware and software availability and with safety constraints.
Efficient Design And Fabrication Of Free-Form Reciprocal Structures
DEFF Research Database (Denmark)
Parigi, Dario; Kirkegaard, Poul Henning
2013-01-01
Structures based on the principle of reciprocity have been autonomously studied and used since the antiquity on the basis of different needs and purposes. The application of the principle of reciprocity requires the presence of at least two elements, at the same time both supporting and being sup...
Apical extrusion of debris using reciprocating files and rotary ...
African Journals Online (AJOL)
Procedure: Sixty extracted human mandibular premolars were used. The root canals were instrumented using reciprocating (WaveOne, Reciproc, SafeSider) or rotary ... and cross‑sections, and kinematics, and this situation may influence the amount of apically extruded debris through the apical foramen.[15]. The aim of this ...
Lack of Acceptance of Reciprocity Norms in Preschool Children.
Berndt, Thomas J.
1979-01-01
Two studies investigated preschool children's acceptance of the reciprocity norms that allow retaliation and that require returning favors. Children viewed cartoons that portrayed animal puppets involved in reciprocal or nonreciprocal aggressive and prosocial behavior. They were then asked to evaluate the actor in each cartoon as "good"…
Coordinated vigilance provides evidence for direct reciprocity in coral reef fishes.
Brandl, Simon J; Bellwood, David R
2015-09-25
Reciprocity is frequently assumed to require complex cognitive abilities. Therefore, it has been argued that reciprocity may be restricted to animals that can meet these demands. Here, we provide evidence for the potential presence of direct reciprocity in teleost fishes. We demonstrate that in pairs of coral reef rabbitfishes (f. Siganidae), one fish frequently assumes an upright vigilance position in the water column, while the partner forages in small crevices in the reef substratum. Both behaviours are strongly coordinated and partners regularly alternate their positions, resulting in a balanced distribution of foraging activity. Compared to solitary individuals, fishes in pairs exhibit longer vigilance bouts, suggesting that the help provided to the partner is costly. In turn, fishes in pairs take more consecutive bites and penetrate deeper into crevices than solitary individuals, suggesting that the safety provided by a vigilant partner may outweigh initial costs by increasing foraging efficiency. Thus, the described system appears to meet all of the requirements for direct reciprocity. We argue that the nature of rabbitfish pairs provides favourable conditions for the establishment of direct reciprocity, as continuous interaction with the same partner, simultaneous needs, interdependence, and communication relax the cognitive demands of reciprocal cooperation.
The Normative Foundation of Legal Orders: A Balance between Reciprocity and Mutuality
Pessers, D.
2014-01-01
Reciprocity seems to figure as a self-evident normative foundation of legal orders. Yet a clear understanding of the often opaque role that reciprocity plays in this regard demands drawing a conceptual distinction. This article views reciprocity as a social morality of duties, in opposition to
Priya, N Tulasi; Chandrasekhar, Veeramachaneni; Anita, S; Tummala, Muralidhar; Raj, T B Phanindhar; Badami, Vijetha; Kumar, Pradeep; Soujanya, E
2014-12-01
The purpose of this study was to compare the incidence of dentinal micro cracks after instrumentation with various types of NiTi files in rotary and reciprocating motion. One hundred human extracted mandibular central incisors were taken and divided into 10 groups (n=10 teeth per group). Group 1- No preparation, Group 2 - Hand instrumentation, Groups 3,4 - ProTaper files in rotary and reciprocating motion, Groups 5,6 - ProTaper Next files in rotary and reciprocating motion, Groups 7,8 - Oneshape files in rotary and reciprocating motion, Groups 9,10 - Reciproc files in rotary and reciprocating motion. Specimens were sectioned horizontally at 3,6 and 9 mm from the apex and dentinal micro cracks were observed under a stereomicroscope. There was a statistically significant difference between the groups (pProtaper Next - Rot, Protaper Next - Rec, Reciproc - Rec); (ProTaper - Rot, ProTaper - Rec, Oneshape - Rot), (Oneshape - Rot, Reciproc - Rot), (One shape Reciproc, Reciproc - Rec); (p >.05). Least cracks were seen in canals instrumented with Pro Taper Next files both in rotary and reciprocating motion. Full sequence rotary systems showed less cracks than single file systems and full sequence rotary systems showed less cracks in reciprocating motion than in rotary motion.
The general chain transform and self-reciprocal functions
Directory of Open Access Journals (Sweden)
Cyril Nasim
1985-01-01
Full Text Available A theory of a generalized form of the chain transforms of order n is developed, and various properties of these are established including the Parseval relation. Most known cases of the standard theory are derived as special cases. Also a theory of self-reciprocal functions is given, based on these general chain transforms; and relations among various classes of self-reciprocal functions are established.
Perceptions of intimacy and friendship reciprocity moderate peer influence on aggression.
Meter, Diana J; Casper, Deborah M; Card, Noel A
2015-01-01
Previous research has shown that close friends' influence can exacerbate adolescents' aggressive behavior, but results of studies which examine whether friendships of greater or lesser qualities moderate peer influence effects are inconsistent. The present study tested whether the perception of the positive friendship quality of intimate exchange and friendship reciprocity moderated best friend influence on participant aggression over time. The 243 participants were approximately 12 years old and ethnically diverse. Neither intimate exchange nor reciprocity significantly moderated friend influence on aggression in a simple way, but the interaction of intimate exchange and friendship reciprocity predicted peer influence on participants' aggression over time. Specifically, highly intimate, nonreciprocal best friendships and less intimate, reciprocal best friendships showed greatest influence when friends' proportion of peer nominations for aggression was high. Reciprocity and intimacy should be considered when predicting peer influence on aggression. © 2014 Wiley Periodicals, Inc.
Indirect reciprocity can overcome free-rider problems on costly moral assessment.
Sasaki, Tatsuya; Okada, Isamu; Nakai, Yutaka
2016-07-01
Indirect reciprocity is one of the major mechanisms of the evolution of cooperation. Because constant monitoring and accurate evaluation in moral assessments tend to be costly, indirect reciprocity can be exploited by cost evaders. A recent study crucially showed that a cooperative state achieved by indirect reciprocators is easily destabilized by cost evaders in the case with no supportive mechanism. Here, we present a simple and widely applicable solution that considers pre-assessment of cost evaders. In the pre-assessment, those who fail to pay for costly assessment systems are assigned a nasty image that leads to them being rejected by discriminators. We demonstrate that considering the pre-assessment can crucially stabilize reciprocal cooperation for a broad range of indirect reciprocity models. In particular for the most leading social norms, we analyse the conditions under which a prosocial state becomes locally stable. © 2016 The Authors.
Supersymmetric reciprocal transformation and its applications
International Nuclear Information System (INIS)
Liu, Q. P.; Popowicz, Ziemowit; Tian Kai
2010-01-01
The supersymmetric analog of the reciprocal transformation is introduced. This is used to establish a transformation between one of the supersymmetric Harry Dym equations and the supersymmetric modified Korteweg-de Vries equation. The reciprocal transformation, as a Baecklund-type transformation between these two equations, is adopted to construct a recursion operator for the supersymmetric Harry Dym equation. By proper factorization of the recursion operator, a bi-Hamiltonian structure is found for the supersymmetric Harry Dym equation. Furthermore, a supersymmetric Kawamoto equation is proposed and is associated with the supersymmetric Sawada-Kotera equation. The recursion operator and odd bi-Hamiltonian structure of the supersymmetric Kawamoto equation are also constructed.
Kapetanakis, Stamatis; Bhan, Amit; Monaghan, Mark J
2008-10-01
Cardiac resynchronization therapy (CRT) has revolutionized not only the treatment of chronic heart failure but also how we assess left ventricular (LV) dysfunction on echo. Increasingly, it has become clear that identifying and quantifying delays in events during the cardiac cycle is an important assessment in LV dysfunction as it has prognostic implications for patients undergoing CRT. The delays in atrioventricular, right-to-left ventricular, and LV segmental contraction have been shown to be important components in cardiac performance, and this review provides an overview of the commonest methods used for these assessments and their implications for selecting patients for biventricular pacing.
Enhanced additive manufacturing with a reciprocating platen
Lind, Randall F.; Blue, Craig A.; Love, Lonnie J.; Post, Brian K.; Lloyd, Peter D.
2018-02-06
An additive manufacturing extrusion head that includes a heated nozzle for accepting a feedstock and extruding the feedstock onto a substrate at a deposition plane, the nozzle having a longitudinal extrusion axis. A reciprocating platen surrounds the nozzle, the platen operable to reciprocate along the extrusion axis at or above the deposition plane as the nozzle extrudes feedstock onto the substrate; and wherein the platen flattens the extruded feedstock such that it does not protrude above the deposition plane as the extrusion head traverses over the substrate.
Structural Implications of Reciprocal Exchange: A Power-Dependence Approach
Bonacich, Phillip; Bienenstock, Elisa Jayne
2009-01-01
This paper presents and tests a general model to predict emergent exchange patterns and power differences in reciprocal exchange networks when individual actors follow the norm of reciprocity. With an interesting qualification, the experimental results reported here support the power-dependence approach (Emerson 1972a, b): those who acquire the…
Energy Technology Data Exchange (ETDEWEB)
Yagi, Yukihiro [Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143–8540 (Japan); Pharmaceutical Research Center, Meiji Seika Pharma Co., Ltd., 760 Morooka-cho, Kohoku-ku, Yokohama, Kanagawa 222–8567 (Japan); Nakamura, Yuji [Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143–8540 (Japan); Kitahara, Ken [Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143–8540 (Japan); Division of Cardiovascular Medicine, Department of Internal Medicine, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143–8541 (Japan); Harada, Takuma [Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143–8540 (Japan); Kato, Kazuhiko; Ninomiya, Tomohisa [Pharmaceutical Research Center, Meiji Seika Pharma Co., Ltd., 760 Morooka-cho, Kohoku-ku, Yokohama, Kanagawa 222–8567 (Japan); Cao, Xin [Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143–8540 (Japan); Ohara, Hiroshi [Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143–8540 (Japan); Division of Cardiovascular Medicine, Department of Internal Medicine, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143–8541 (Japan); Izumi-Nakaseko, Hiroko [Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143–8540 (Japan); Suzuki, Kokichi [Pharmaceutical Research Center, Meiji Seika Pharma Co., Ltd., 760 Morooka-cho, Kohoku-ku, Yokohama, Kanagawa 222–8567 (Japan); Ando, Kentaro [Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143–8540 (Japan); and others
2014-11-15
Fingolimod, a sphingosine 1-phosphate (S1P) receptor subtype 1, 3, 4 and 5 modulator, has been used for the treatment of patients with relapsing forms of multiple sclerosis, but atrioventricular conduction block and/or QT-interval prolongation have been reported in some patients after the first dose. In this study, we directly compared the electropharmacological profiles of fingolimod with those of siponimod, a modulator of sphingosine 1-phosphate receptor subtype 1 and 5, using in vivo guinea-pig model and in vitro human ether-a-go-go-related gene (hERG) assay to better understand the onset mechanisms of the clinically observed adverse events. Fingolimod (0.01 and 0.1 mg/kg) or siponimod (0.001 and 0.01 mg/kg) was intravenously infused over 10 min to the halothane-anaesthetized guinea pigs (n = 4), whereas the effects of fingolimod (1 μmol/L) and siponimod (1 μmol/L) on hERG current were examined (n = 3). The high doses of fingolimod and siponimod induced atrioventricular conduction block, whereas the low dose of siponimod prolonged PR interval, which was not observed by that of fingolimod. The high dose of fingolimod prolonged QT interval, which was not observed by either dose of siponimod. Meanwhile, fingolimod significantly inhibited hERG current, which was not observed by siponimod. These results suggest that S1P receptor subtype 1 in the heart could be one of the candidates for fingolimod- and siponimod-induced atrioventricular conduction block since S1P receptor subtype 5 is localized at the brain, and that direct I{sub Kr} inhibition may play a key role in fingolimod-induced QT-interval prolongation. - Highlights: • Fingolimod and siponimod are S1P{sub 1,3,4,5} and S1P{sub 1,5} receptor modulators, respectively. • Fingolimod and siponimod induced AV block in the halothane-anesthetized guinea pigs. • S1P{sub 1} in the hearts may be the target of fingolimod- and siponimod-induced AV block. • Fingolimod directly inhibited hERG current, which was not
International Nuclear Information System (INIS)
Yagi, Yukihiro; Nakamura, Yuji; Kitahara, Ken; Harada, Takuma; Kato, Kazuhiko; Ninomiya, Tomohisa; Cao, Xin; Ohara, Hiroshi; Izumi-Nakaseko, Hiroko; Suzuki, Kokichi; Ando, Kentaro
2014-01-01
Fingolimod, a sphingosine 1-phosphate (S1P) receptor subtype 1, 3, 4 and 5 modulator, has been used for the treatment of patients with relapsing forms of multiple sclerosis, but atrioventricular conduction block and/or QT-interval prolongation have been reported in some patients after the first dose. In this study, we directly compared the electropharmacological profiles of fingolimod with those of siponimod, a modulator of sphingosine 1-phosphate receptor subtype 1 and 5, using in vivo guinea-pig model and in vitro human ether-a-go-go-related gene (hERG) assay to better understand the onset mechanisms of the clinically observed adverse events. Fingolimod (0.01 and 0.1 mg/kg) or siponimod (0.001 and 0.01 mg/kg) was intravenously infused over 10 min to the halothane-anaesthetized guinea pigs (n = 4), whereas the effects of fingolimod (1 μmol/L) and siponimod (1 μmol/L) on hERG current were examined (n = 3). The high doses of fingolimod and siponimod induced atrioventricular conduction block, whereas the low dose of siponimod prolonged PR interval, which was not observed by that of fingolimod. The high dose of fingolimod prolonged QT interval, which was not observed by either dose of siponimod. Meanwhile, fingolimod significantly inhibited hERG current, which was not observed by siponimod. These results suggest that S1P receptor subtype 1 in the heart could be one of the candidates for fingolimod- and siponimod-induced atrioventricular conduction block since S1P receptor subtype 5 is localized at the brain, and that direct I Kr inhibition may play a key role in fingolimod-induced QT-interval prolongation. - Highlights: • Fingolimod and siponimod are S1P 1,3,4,5 and S1P 1,5 receptor modulators, respectively. • Fingolimod and siponimod induced AV block in the halothane-anesthetized guinea pigs. • S1P 1 in the hearts may be the target of fingolimod- and siponimod-induced AV block. • Fingolimod directly inhibited hERG current, which was not observed by
Catheter ablation as a treatment of atrioventricular block.
Tuohy, Stephen; Saliba, Walid; Pai, Manjunath; Tchou, Patrick
2018-01-01
Symptomatic second-degree atrioventricular (AV) block is typically treated by implantation of a pacemaker. An otherwise healthy AV conduction system can nevertheless develop AV block due to interference from junctional extrasystoles. When present with a high burden, these can produce debilitating symptoms from AV block despite an underlying normal AV node and His-Purkinje system properties. The purpose of this study was to describe a catheter ablation approach for alleviating symptomatic AV block due to a ventricular nodal pathway interfering with AV conduction. Common clinical monitoring techniques such as Holter and event recorders were used. Standard electrophysiological study techniques using multipolar recording and ablation catheters were utilized during procedures. A 55-year-old woman presented with highly symptomatic, high-burden second-degree AV block due to concealed and manifest junctional premature beats. Electrophysiological characteristics indicated interference of AV conduction due to a concealed ventricular nodal pathway as the cause of the AV block. The patient's AV nodal and His-Purkinje system conduction characteristics were otherwise normal. Radiofrequency catheter ablation of the pathway was successful in restoring normal AV conduction and eliminating her clinical symptoms. Pathways inserting into the AV junction can interfere with AV conduction. When present at a high burden, this type of AV block can be highly symptomatic. Catheter ablation techniques can be used to alleviate this type of AV block and restore normal AV conduction. Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
Bürklein, Sebastian; Tsotsis, Polymnia; Schäfer, Edgar
2013-04-01
The purpose of this study was to evaluate the incidence of dentinal defects after root canal preparation with reciprocating instruments (Reciproc and WaveOne) and rotary instruments. One hundred human central mandibular incisors were randomly assigned to 5 groups (n = 20 teeth per group). The root canals were instrumented by using the reciprocating single-file systems Reciproc and WaveOne and the full-sequence rotary Mtwo and ProTaper instruments. One group was left unprepared as control. Roots were sectioned horizontally at 3, 6, and 9 mm from the apex and evaluated under a microscope by using 25-fold magnification. The presence of dentinal defects (complete/incomplete cracks and craze lines) was noted and analyzed by using the chi-square test. No defects were observed in the controls. All canal preparation created dentinal defects. Overall, instrumentation with Reciproc was associated with more complete cracks than the full-sequence files (P = .021). Although both reciprocating files produced more incomplete cracks apically (3 mm) compared with the rotary files (P = .001), no statistically significant differences were obtained concerning the summarized values of all cross sections (P > .05). Under the conditions of this study, root canal preparation with both rotary and reciprocating instruments resulted in dentinal defects. At the apical level of the canals, reciprocating files produced significantly more incomplete dentinal cracks than full-sequence rotary systems (P < .05). Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Reciprocity in the electronic stopping of slow ions in matter
International Nuclear Information System (INIS)
Sigmund, P.
2008-01-01
The principle of reciprocity, i.e., the invariance of the inelastic excitation in ion-atom collisions against interchange of projectile and target, has been applied to the electronic stopping cross section of low-velocity ions and tested empirically on ion-target combinations supported by a more or less adequate amount of experimental data. Reciprocity is well obeyed (within ∼10%) for many systems studied, and deviations exceeding ∼20% are exceptional. Systematic deviations such as gas-solid or metal-insulator differences have been looked for but not identified on the present basis. A direct consequence of reciprocity is the equivalence of Z 1 with Z 2 structure for random slowing down. This feature is reasonably well supported empirically for ion-target combinations involving carbon, nitrogen, aluminium and argon. Reciprocity may be utilized as a criterion to reject questionable experimental data. In cases where a certain stopping cross section has not been or cannot be measured, the stopping cross section for the inverted system may be available and serve as a first estimate. It is suggested to build in reciprocity as a fundamental requirement into empirical interpolation schemes directed at the stopping of low-velocity ions. Examination of the SRIM and MSTAR codes reveals cases where reciprocity is obeyed accurately, but deviations of up to a factor of two are common. In case of heavy ions such as gold, electronic stopping cross sections predicted by SRIM are asserted to be almost an order of magnitude too high. (authors)
Reciprocity in the electronic stopping of slow ions in matter
Sigmund, P.
2008-04-01
The principle of reciprocity, i.e., the invariance of the inelastic excitation in ion-atom collisions against interchange of projectile and target, has been applied to the electronic stopping cross section of low-velocity ions and tested empirically on ion-target combinations supported by a more or less adequate amount of experimental data. Reciprocity is well obeyed (within ~10%) for many systems studied, and deviations exceeding ~20% are exceptional. Systematic deviations such as gas-solid or metal-insulator differences have been looked for but not identified on the present basis. A direct consequence of reciprocity is the equivalence of Z1 with Z2 structure for random slowing down. This feature is reasonably well supported empirically for ion-target combinations involving carbon, nitrogen, aluminium and argon. Reciprocity may be utilized as a criterion to reject questionable experimental data. In cases where a certain stopping cross section has not been or cannot be measured, the stopping cross section for the inverted system may be available and serve as a first estimate. It is suggested to build in reciprocity as a fundamental requirement into empirical interpolation schemes directed at the stopping of low-velocity ions. Examination of the SRIM and MSTAR codes reveals cases where reciprocity is obeyed accurately, but deviations of up to a factor of two are common. In case of heavy ions such as gold, electronic stopping cross sections predicted by SRIM are asserted to be almost an order of magnitude too high.
Using Excel's Matrix Operations to Facilitate Reciprocal Cost Allocations
Leese, Wallace R.; Kizirian, Tim
2009-01-01
The reciprocal method of service department cost allocation requires linear equations to be solved simultaneously. These computations are often so complex as to cause the abandonment of the reciprocal method in favor of the less sophisticated direct or step-down methods. Here is a short example demonstrating how Excel's sometimes unknown matrix…
Scanlan, Adam B; Nguyen, Alex V; Ilina, Anna; Lasso, Andras; Cripe, Linnea; Jegatheeswaran, Anusha; Silvestro, Elizabeth; McGowan, Francis X; Mascio, Christopher E; Fuller, Stephanie; Spray, Thomas L; Cohen, Meryl S; Fichtinger, Gabor; Jolley, Matthew A
2018-03-01
Mastering the technical skills required to perform pediatric cardiac valve surgery is challenging in part due to limited opportunity for practice. Transformation of 3D echocardiographic (echo) images of congenitally abnormal heart valves to realistic physical models could allow patient-specific simulation of surgical valve repair. We compared materials, processes, and costs for 3D printing and molding of patient-specific models for visualization and surgical simulation of congenitally abnormal heart valves. Pediatric atrioventricular valves (mitral, tricuspid, and common atrioventricular valve) were modeled from transthoracic 3D echo images using semi-automated methods implemented as custom modules in 3D Slicer. Valve models were then both 3D printed in soft materials and molded in silicone using 3D printed "negative" molds. Using pre-defined assessment criteria, valve models were evaluated by congenital cardiac surgeons to determine suitability for simulation. Surgeon assessment indicated that the molded valves had superior material properties for the purposes of simulation compared to directly printed valves (p 3D echo-derived molded valves are a step toward realistic simulation of complex valve repairs but require more time and labor to create than directly printed models. Patient-specific simulation of valve repair in children using such models may be useful for surgical training and simulation of complex congenital cases.
Neural precursors of future liking and affective reciprocity.
Zerubavel, Noam; Hoffman, Mark Anthony; Reich, Adam; Ochsner, Kevin N; Bearman, Peter
2018-04-24
Why do certain group members end up liking each other more than others? How does affective reciprocity arise in human groups? The prediction of interpersonal sentiment has been a long-standing pursuit in the social sciences. We combined fMRI and longitudinal social network data to test whether newly acquainted group members' reward-related neural responses to images of one another's faces predict their future interpersonal sentiment, even many months later. Specifically, we analyze associations between relationship-specific valuation activity and relationship-specific future liking. We found that one's own future (T2) liking of a particular group member is predicted jointly by actor's initial (T1) neural valuation of partner and by that partner's initial (T1) neural valuation of actor. These actor and partner effects exhibited equivalent predictive strength and were robust when statistically controlling for each other, both individuals' initial liking, and other potential drivers of liking. Behavioral findings indicated that liking was initially unreciprocated at T1 yet became strongly reciprocated by T2. The emergence of affective reciprocity was partly explained by the reciprocal pathways linking dyad members' T1 neural data both to their own and to each other's T2 liking outcomes. These findings elucidate interpersonal brain mechanisms that define how we ultimately end up liking particular interaction partners, how group members' initially idiosyncratic sentiments become reciprocated, and more broadly, how dyads evolve. This study advances a flexible framework for researching the neural foundations of interpersonal sentiments and social relations that-conceptually, methodologically, and statistically-emphasizes group members' neural interdependence. Copyright © 2018 the Author(s). Published by PNAS.
Reciprocal Relationships between Math Self-Concept and Math Anxiety
Ahmed, Wondimu; Minnaert, Alexander; Kuyper, Hans; van der Werf, Greetje
2012-01-01
The present study examined the reciprocal relationships between self-concept and anxiety in mathematics. A sample of 495 grade 7 students (51% girls) completed self-report measures assessing self-concept and anxiety three times in a school year. Structural equation modeling was used to test a cross-lagged panel model of reciprocal effects between…
Direct reciprocity in animals: The roles of bonding and affective processes.
Freidin, Esteban; Carballo, Fabricio; Bentosela, Mariana
2017-04-01
The presence of direct reciprocity in animals is a debated topic, because, despite its evolutionary plausibility, it is believed to be uncommon. Some authors claim that stable reciprocal exchanges require sophisticated cognition which has acted as a constraint on its evolution across species. In contrast, a more recent trend of research has focused on the possibility that direct reciprocity occurs within long-term bonds and relies on simple as well as more complex affective mechanisms such as emotional book-keeping, rudimentary and higher forms of empathy, and inequity aversion, among others. First, we present evidence supporting the occurrence of long-term reciprocity in the context of existing bonds in social birds and mammals. Second, we discuss the evidence for affective responses which, modulated by bonding, may underlie altruistic behaviours in different species. We conclude that the mechanisms that may underlie reciprocal exchanges are diverse, and that some act in interaction with bonding processes. From simple associative learning in social contexts, through emotional contagion and behavioural mimicry, to empathy and a sense of fairness, widespread and diverse social affective mechanisms may explain why direct reciprocity may not be a rare phenomenon among social vertebrates. © 2015 International Union of Psychological Science.
Synchronized conductivity modulation to realize broadband lossless magnetic-free non-reciprocity.
Dinc, Tolga; Tymchenko, Mykhailo; Nagulu, Aravind; Sounas, Dimitrios; Alu, Andrea; Krishnaswamy, Harish
2017-10-06
Recent research has explored the spatiotemporal modulation of permittivity to break Lorentz reciprocity in a manner compatible with integrated-circuit fabrication. However, permittivity modulation is inherently weak and accompanied by loss due to carrier injection, particularly at higher frequencies, resulting in large insertion loss, size, and/or narrow operation bandwidths. Here, we show that the presence of absorption in an integrated electronic circuit may be counter-intuitively used to our advantage to realize a new generation of magnet-free non-reciprocal components. We exploit the fact that conductivity in semiconductors provides a modulation index several orders of magnitude larger than permittivity. While directly associated with loss in static systems, we show that properly synchronized conductivity modulation enables loss-free, compact and extremely broadband non-reciprocity. We apply these concepts to obtain a wide range of responses, from isolation to gyration and circulation, and verify our findings by realizing a millimeter-wave (25 GHz) circulator fully integrated in complementary metal-oxide-semiconductor technology.Optical non-reciprocity achieved through refractive index modulation can have its challenges and limitations. Here, Dinc et al. introduce the concept of non-reciprocity based on synchronized spatio-temporal modulation of conductivity to achieve different types of non-reciprocal functionality.
Reciprocal locomotion of dense swimmers in Stokes flow
International Nuclear Information System (INIS)
Gonzalez-Rodriguez, David; Lauga, Eric
2009-01-01
Due to the kinematic reversibility of Stokes flow, a body executing a reciprocal motion (a motion in which the sequence of body configurations remains identical under time reversal) cannot propel itself in a viscous fluid in the limit of negligible inertia; this result is known as Purcell's scallop theorem. In this limit, the Reynolds numbers based on the fluid inertia and on the body inertia are all zero. Previous studies characterized the breakdown of the scallop theorem with fluid inertia. In this paper we show that, even in the absence of fluid inertia, certain dense bodies undergoing reciprocal motion are able to swim. Using Lorentz's reciprocal theorem, we first derive the general differential equations that govern the locomotion kinematics of a dense swimmer. We demonstrate that no reciprocal swimming is possible if the body motion consists only of tangential surface deformation (squirming). We then apply our general formulation to compute the locomotion of four simple swimmers, each with a different spatial asymmetry, that perform normal surface deformations. We show that the resulting swimming speeds (or rotation rates) scale as the first power of a properly defined 'swimmer Reynolds number', demonstrating thereby a continuous breakdown of the scallop theorem with body inertia.
Chimpanzees trust conspecifics to engage in low-cost reciprocity.
Engelmann, Jan M; Herrmann, Esther; Tomasello, Michael
2015-02-22
Many of humans' most important social interactions rely on trust, including most notably among strangers. But little is known about the evolutionary roots of human trust. We presented chimpanzees (Pan troglodytes) with a modified version of the human trust game--trust in reciprocity--in which subjects could opt either to obtain a small but safe reward on their own or else to send a larger reward to a partner and trust her to reciprocate a part of the reward that she could not access herself. In a series of three studies, we found strong evidence that in interacting with a conspecific, chimpanzees show spontaneous trust in a novel context; flexibly adjust their level of trust to the trustworthiness of their partner and develop patterns of trusting reciprocity over time. At least in some contexts then, trust in reciprocity is not unique to humans, but rather has its evolutionary roots in the social interactions of humans' closest primate relatives. © 2015 The Author(s) Published by the Royal Society. All rights reserved.
Modern Social Science Concepts, Proportionate Reciprocity, Modesty, and Democracy
Directory of Open Access Journals (Sweden)
Gerasimos T. SOLDATOS
2014-06-01
Full Text Available Proportionate Reciprocity, Modesty, and Democracy, are the key concepts in Aristotle’s economics of exchange. The following correspondence of these concepts with modern social science may be contemplated: (a Ideally, reciprocal justice in bilateral bargaining to minimize expenditure given utility levels results in Pareto-efficient, envy-free, equitable outcomes. (b Practically, bargaining under the threat or actual recontracting may act as a surrogate of reciprocal justice, leading to an N-person contract topology. (c But, recontracting is subject to practical limitations too, in which case near-reciprocal justice/general equilibrium outcomes may be fostered if, as a surrogate of recontracting, modesty in interaction is exhibited in an evolutionarily-stable-strategy fashion. (d That is, incomplete recontracting amounts to asymmetric agent-type information, which in turn lays the ground for injustices; the same lack of information prevents rectificatory justice from being efficient and hence, modesty can be efficient only if it operates as a social norm and hence, only in a modest polity, which can be no other than democracy.
Local activation time sampling density for atrial tachycardia contact mapping: how much is enough?
Williams, Steven E; Harrison, James L; Chubb, Henry; Whitaker, John; Kiedrowicz, Radek; Rinaldi, Christopher A; Cooklin, Michael; Wright, Matthew; Niederer, Steven; O'Neill, Mark D
2018-02-01
Local activation time (LAT) mapping forms the cornerstone of atrial tachycardia diagnosis. Although anatomic and positional accuracy of electroanatomic mapping (EAM) systems have been validated, the effect of electrode sampling density on LAT map reconstruction is not known. Here, we study the effect of chamber geometry and activation complexity on optimal LAT sampling density using a combined in silico and in vivo approach. In vivo 21 atrial tachycardia maps were studied in three groups: (1) focal activation, (2) macro-re-entry, and (3) localized re-entry. In silico activation was simulated on a 4×4cm atrial monolayer, sampled randomly at 0.25-10 points/cm2 and used to re-interpolate LAT maps. Activation patterns were studied in the geometrically simple porcine right atrium (RA) and complex human left atrium (LA). Activation complexity was introduced into the porcine RA by incomplete inter-caval linear ablation. In all cases, optimal sampling density was defined as the highest density resulting in minimal further error reduction in the re-interpolated maps. Optimal sampling densities for LA tachycardias were 0.67 ± 0.17 points/cm2 (focal activation), 1.05 ± 0.32 points/cm2 (macro-re-entry) and 1.23 ± 0.26 points/cm2 (localized re-entry), P = 0.0031. Increasing activation complexity was associated with increased optimal sampling density both in silico (focal activation 1.09 ± 0.14 points/cm2; re-entry 1.44 ± 0.49 points/cm2; spiral-wave 1.50 ± 0.34 points/cm2, P density (0.61 ± 0.22 points/cm2 vs. 1.0 ± 0.34 points/cm2, P = 0.0015). Optimal sampling densities can be identified to maximize diagnostic yield of LAT maps. Greater sampling density is required to correctly reveal complex activation and represent activation across complex geometries. Overall, the optimal sampling density for LAT map interpolation defined in this study was ∼1.0-1.5 points/cm2. Published on behalf of the European Society of
Radiation induced reciprocal translocations and inversions in anopheles albimanus
International Nuclear Information System (INIS)
Kaiser, P.E.; Seawright, J.A.; Benedict, M.Q.; Narang, S.
1982-01-01
Reciprocal translocations and inversions were induced in Anopheles albimanus Wiedemann by irradiation of males with X rays. A total of 1669 sperm were assayed, and 175 new aberrations were identified as follows: 102 reciprocal translocations (67 autosomal and 35 sex-linked), 45 pericentric inversions, and 28 paracentric inversions. Eleven of the translocations were nearly whole-arm interchanges, and these were selected for the construction of 'capture systems' for compound chromosomes. Two double-heterozygous translocation strains and four homozygous translocation strains were established. Anopheles albimanus females were irradiated, and a pseudolinkage scheme involving mutant markers was employed to identify reciprocal translocations. The irradiation of females was very inefficient; only one translocation was recovered from 1080 ova tested
A Journey into Reciprocal Space; A crystallographer's perspective
Glazer, A. M.
2017-10-01
This book introduces undergraduate and graduate students to a crystallographer's view of real and reciprocal space, a concept that has been of particular use by crystallographers to understand the patterns of spots when x-rays are diffracted by crystals. It then proceeds to develop the concept in a form suitable for physics applications; such as how solid-state physicists use reciprocal space to explain various solid-state properties such as thermal and electrical phenomena.
Sex differences in the reciprocal behaviour of children with autism
Backer van Ommeren, Tineke; Koot, Hans M; Scheeren, Anke M; Begeer, Sander
2017-01-01
Differences in the social limitations of girls compared to boys on the autism spectrum are still poorly understood. Impaired social-emotional reciprocity is a core diagnostic criterion for an autism spectrum disorder. This study compares sex differences in reciprocal behaviour in children with
Who takes the most revenge? Individual differences in negative reciprocity norm endorsement.
Eisenberger, Robert; Lynch, Patrick; Aselage, Justin; Rohdieck, Stephanie
2004-06-01
The authors report that beliefs favoring the reciprocation of unfavorable treatment form a unitary factor that is distinct from beliefs favoring the reciprocation of favorable treatment. Individual differences in endorsement of this negative reciprocity norm were related to (a) beliefs that people are generally malevolent; (b) inclination toward anger in everyday life; (c) anger, disagreement, and ridicule directed toward a new acquaintance who treated participants unfavorably; and (d) reduced anxiety, positive emotional engagement, and encouragement of a new acquaintance who treated participants favorably. These findings suggest that individual differences in endorsement of the negative norm of reciprocity influence the extent of vengeance.
A Theory of Sequential Reciprocity
Dufwenberg, M.; Kirchsteiger, G.
1998-01-01
Many experimental studies indicate that people are motivated by reciprocity. Rabin (1993) develops techniques for incorporating such concerns into game theory and economics. His model, however, does not fare well when applied to situations with an interesting dynamic structure (like many
Group differences in reciprocity, multiplexity and exchange : measures and application
Agneessens, Filip; Skvoretz, John
Local forces structure social networks. One major and widely researched local force is reciprocity, often assumed to work homogeneously across actors-i.e., all actors are equally subject to the same level of force towards reciprocity. Other local forces, like multiplexity and exchange, are also
International Nuclear Information System (INIS)
El-Mas, Mahmoud M.; Fouda, Mohamed A.; El-gowilly, Sahar M.; Saad, Evan I.
2012-01-01
We have previously shown that acute exposure of male rats to nicotine preferentially attenuates baroreceptor-mediated control of reflex tachycardia in contrast to no effect on reflex bradycardia. Here, we investigated whether female rats are as sensitive as their male counterparts to the baroreflex depressant effect of nicotine and whether this interaction is modulated by estrogen. Baroreflex curves relating reflex chronotropic responses evoked by i.v. doses (1–16 μg/kg) of phenylephrine (PE) or sodium nitroprusside (SNP), were constructed in conscious freely moving proestrus, ovariectomized (OVX), and estrogen (50 μg/kg/day s.c., 5 days)-replaced OVX (OVXE 2 ) rats. Slopes of the curves were taken as a measure of baroreflex sensitivity (BRS PE and BRS SNP ). Nicotine (100 μg/kg i.v.) reduced BRS SNP in OVX rats but not in proestrus or OVXE 2 rats. The attenuation of reflex tachycardia by nicotine was also evident in diestrus rats, which exhibited plasma estrogen levels similar to those of OVX rats. BRS PE was not affected by nicotine in all rat preparations. Experiments were then extended to determine whether central estrogenic receptors modulate the nicotine–BRS SNP interaction. Intracisteral (i.c.) treatment of OVX rats with estrogen sulfate (0.2 μg/rat) abolished the BRS SNP attenuating effect of i.v. nicotine. This protective effect of estrogen disappeared when OVX rats were pretreated with i.c. ICI 182,780 (50 μg/rat, selective estrogen receptor antagonist). Together, these findings suggest that central neural pools of estrogen receptors underlie the protection offered by E 2 against nicotine-induced baroreceptor dysfunction in female rats. -- Highlights: ► Estrogen protects against the depressant effect of nicotine on reflex tachycardia. ► The baroreflex response and estrogen status affect the nicotine–BRS interaction. ► The protection offered by estrogen is mediated via central estrogen receptors.
Bürklein, Sebastian; Schäfer, Edgar
2012-06-01
The purpose of this in vitro study was to assess the amount of apically extruded debris using rotary and reciprocating nickel-titanium instrumentation systems. Eighty human mandibular central incisors were randomly assigned to 4 groups (n = 20 teeth per group). The root canals were instrumented according to the manufacturers' instructions using the 2 reciprocating single-file systems Reciproc (VDW, Munich, Germany) and WaveOne (Dentsply Maillefer, Ballaigues, Switzerland) and the 2 full-sequence rotary Mtwo (VDW, Munich, Germany) and ProTaper (Dentsply Maillefer, Ballaigues, Switzerland) instruments. Bidistilled water was used as irrigant. The apically extruded debris was collected in preweighted glass vials using the Myers and Montgomery method. After drying, the mean weight of debris was assessed with a microbalance and statistically analyzed using analysis of variance and the post hoc Student-Newman-Keuls test. The time required to prepare the canals with the different instruments was also recorded. The reciprocating files produced significantly more debris compared with both rotary systems (P rotary instruments (P > .05), the reciprocating single-file system Reciproc produced significantly more debris compared with all other instruments (P Instrumentation was significantly faster using Reciproc than with all other instrument (P rotary instrumentation was associated with less debris extrusion compared with the use of reciprocating single-file systems. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
The TORE SUPRA fast reciprocating RF probe
International Nuclear Information System (INIS)
Thomas, C.E. Jr.; Harris, J.H.; Haste, G.R.
1994-01-01
A fast reciprocating ICRF (Ion Cyclotron Range of Frequencies) probe was installed and operated on TORE SUPRA during 1992/1993. The body of the probe was originally used on the ATF experiment at ORNL. The probe was adapted for use on TORE SUPRA, and mounted on one of the two fast reciprocating probe mounts. The probe consists of two orthogonal single-turn wire loops, mounted so that one loop senses toroidal RF magnetic fields and the other senses poloidal RF magnetic fields. The probe began operation in June, 1993. The probe active area is approximately 5 cm long by 2 cm, and the reciprocating mount has a slow stroke (5 cm/sec) of 30 cm by 2 cm, and the reciprocating mount has a slow stroke (5 cm/sec) of 30 cm and a fast stroke (1.5 m/sec) of about 10 cm. The probe was operated at distances from the plasma edge ranging from 30 cm to -5 cm (i.e., inside the last closed flux surface). The probe design, electronics, calibration, data acquisition and data processing are discussed. First data from the probe are presented as a function of ICRF power, distance from the plasma, loop orientation, and other plasma parameters. Initial data shows parametric instabilities do not play an important role for ICRF in the TORE SUPRA edge and scrape-off-layer (SOL) plasmas. Additionally it is observed that the probe signal has little or no dependence on position in the SOL/plasma edge
Coexistence of Wolff-Parkinson-white and Brugada syndrome: mere curiosity?
Kaiser, Elisabeth; Sacilotto, Luciana; Darrieux, Francisco; Sosa, Eduardo
2014-09-01
The association between Brugada syndrome (BS) and ventricular preexcitation is a rare condition, with sporadic cases already reported. We report the case of a 29-year-old man, with palpitation unrelated to physical or emotional stress. The electrocardiogram of the first visit revealed a ventricular preexcitation pattern and an end-conduction delay, with negative T wave in V1 and intraventricular conduction disturbance in V2 (atypical for BS). The typical aspect of BS occurred after introduction of propafenone for the prevention of atrioventricular tachycardia. We discuss the recognition of this rare association, the proarrhythmic effects of some drugs, treatment options, and prognosis. © 2014 Wiley Periodicals, Inc.
Directory of Open Access Journals (Sweden)
Lakshmi Ramanathan
2009-05-01
Full Text Available FUNDAMENTO: Estudar o suprimento arterial do sistema condutor e sua correlação com a dominância das artérias coronárias em população do sul da Índia. OBJETIVO: Determinar angiograficamente as origens da artéria do nó sinoatrial (AnSA e artéria do nó atrioventricular (AnAV em indianos. MÉTODOS: O ESTudo incluiu 300 pacientes consecutivos (114 do sexo feminino e 186 do sexo masculino; idade média, 55 anos, habitantes da região costeira ao sul da Índia, submetidos a cineangiocoronariografia devido a sintomas como dor no peito, angina pectoris ou teste ergométrico positivo. As angiografias incluíram ambas as artérias coronárias (direita e esquerda em posição oblíqua anterior direita e esquerda. A origem da AnSA e AnAV a partir das artérias coronárias foi observada e correlacionada à dominância arterial. RESULTADOS: O nó SA (sinoatrial recebeu suprimento pela artéria coronária direita (ACD em 53% dos casos, pelo ramo circunflexo (Cx da artéria coronária esquerda (ACE em 42,66% dos casos, e em 4,33% dos casos esse nó foi irrigado por ambas as artérias coronárias. O nó AV (atrioventricular também recebeu suprimento sanguíneo com mais frequência da ACD (72,33% dos casos do que do ramo Cx da ACE (27,66%. Surpreendentemente, em nenhum caso este nó recebeu suprimento de ambas as artérias coronárias. CONCLUSÃO: Os Resultados do presente estudo podem auxiliar os cirurgiões cardíacos, sobretudo em cirurgias relacionadas a valvopatias, devido à franca proximidade entre os ramos nodais e o complexo valvar.FUNDAMENTO: Estudiar el suministro arterial del sistema conductor y su correlación con la dominancia de las arterias coronarias en población del Sur de la India. OBJETIVO: Determinar angiográficamente los orígenes de la arteria del nódulo sinusal (AnSA y la arteria del nódulo atrioventricular (AnAV en indios. MÉTODOS: El estudio incluyó 300 pacientes consecutivos (114 del sexo femenino y 186 del sexo
Matejkowski, Jason; McCarthy, Kevin S; Draine, Jeffrey
2011-01-01
A measure of an individual's level of internalization of the norm of reciprocity may signal exchange preferences and indicate whether "active" or "passive" mental health services are preferable to consumers. We evaluated the psychometric properties of one such measure, the Personal Norm of Reciprocity (PNR) scale. We recruited 70 persons receiving mental health services and 65 comparison participants to complete questionnaires assessing reciprocity tendencies and correlates of mental illness. Two of three subscales of a shortened PNR showed evidence of reliability and validity. Consumers endorsed higher levels of the reciprocity norm than persons not seeking services. Persons in "active" service settings displayed greater rigidity in application of the reciprocity norm than individuals in "passive" service settings or comparison participants. The shortened PNR can be a useful measure of individual reciprocity preferences. Measurement of the internalization of the norm of reciprocity may assist practitioners in identifying what types of services are more likely to retain and benefit mental health service consumers.
Sofaer, Neema
2014-11-01
A common reason for giving research participants post-trial access (PTA) to the trial intervention appeals to reciprocity, the principle, stated most generally, that if one person benefits a second, the second should reciprocate: benefit the first in return. Many authors consider it obvious that reciprocity supports PTA. Yet their reciprocity principles differ, with many authors apparently unaware of alternative versions. This article is the first to gather the range of reciprocity principles. It finds that: (1) most are false. (2) The most plausible principle, which is also problematic, applies only when participants experience significant net risks or burdens. (3) Seldom does reciprocity support PTA for participants or give researchers stronger reason to benefit participants than equally needy non-participants. (4) Reciprocity fails to explain the common view that it is bad when participants in a successful trial have benefited from the trial intervention but lack PTA to it. © 2013 John Wiley & Sons Ltd.
Spatially correlated heterogeneous aspirations to enhance network reciprocity
Tanimoto, Jun; Nakata, Makoto; Hagishima, Aya; Ikegaya, Naoki
2012-02-01
Perc & Wang demonstrated that aspiring to be the fittest under conditions of pairwise strategy updating enhances network reciprocity in structured populations playing 2×2 Prisoner's Dilemma games (Z. Wang, M. Perc, Aspiring to the fittest and promoted of cooperation in the Prisoner's Dilemma game, Physical Review E 82 (2010) 021115; M. Perc, Z. Wang, Heterogeneous aspiration promotes cooperation in the Prisoner's Dilemma game, PLOS one 5 (12) (2010) e15117). Through numerical simulations, this paper shows that network reciprocity is even greater if heterogeneous aspirations are imposed. We also suggest why heterogeneous aspiration fosters network reciprocity. It distributes strategy updating speed among agents in a manner that fortifies the initially allocated cooperators' clusters against invasion. This finding prompted us to further enhance the usual heterogeneous aspiration cases for heterogeneous network topologies. We find that a negative correlation between degree and aspiration level does extend cooperation among heterogeneously structured agents.
Powering up with indirect reciprocity in a large-scale field experiment.
Yoeli, Erez; Hoffman, Moshe; Rand, David G; Nowak, Martin A
2013-06-18
A defining aspect of human cooperation is the use of sophisticated indirect reciprocity. We observe others, talk about others, and act accordingly. We help those who help others, and we cooperate expecting that others will cooperate in return. Indirect reciprocity is based on reputation, which spreads by communication. A crucial aspect of indirect reciprocity is observability: reputation effects can support cooperation as long as peoples' actions can be observed by others. In evolutionary models of indirect reciprocity, natural selection favors cooperation when observability is sufficiently high. Complimenting this theoretical work are experiments where observability promotes cooperation among small groups playing games in the laboratory. Until now, however, there has been little evidence of observability's power to promote large-scale cooperation in real world settings. Here we provide such evidence using a field study involving 2413 subjects. We collaborated with a utility company to study participation in a program designed to prevent blackouts. We show that observability triples participation in this public goods game. The effect is over four times larger than offering a $25 monetary incentive, the company's previous policy. Furthermore, as predicted by indirect reciprocity, we provide evidence that reputational concerns are driving our observability effect. In sum, we show how indirect reciprocity can be harnessed to increase cooperation in a relevant, real-world public goods game.
The Principle of Structural Reciprocity
DEFF Research Database (Denmark)
Pugnale, Alberto; Parigi, Dario; Kirkegaard, Poul Henning
2011-01-01
This paper deals with the principle of structural reciprocity, considering its origins in both Occidental and Orient culture and aiming to highlight the definition, main peculiarities and interesting aspects of such concept referring to its application to the world of construction. Issues spannin...
Indirect Reciprocity : A Field Experiment
van Apeldoorn, J.; Schram, A.
2016-01-01
Indirect reciprocity involves cooperative acts towards strangers, either in response to their kindness to third parties (downstream) or after receiving kindness from others oneself (upstream). It is considered to be important for the evolution of cooperative behavior amongst humans. Though it has
The quadratic reciprocity law a collection of classical proofs
Baumgart, Oswald
2015-01-01
This book is the English translation of Baumgart’s thesis on the early proofs of the quadratic reciprocity law (“Über das quadratische Reciprocitätsgesetz. Eine vergleichende Darstellung der Beweise”), first published in 1885. It is divided into two parts. The first part presents a very brief history of the development of number theory up to Legendre, as well as detailed descriptions of several early proofs of the quadratic reciprocity law. The second part highlights Baumgart’s comparisons of the principles behind these proofs. A current list of all known proofs of the quadratic reciprocity law, with complete references, is provided in the appendix. This book will appeal to all readers interested in elementary number theory and the history of number theory.
High-Resolution Reciprocal Space Mapping for Characterizing Deformation Structures
DEFF Research Database (Denmark)
Pantleon, Wolfgang; Wejdemann, Christian; Jakobsen, Bo
2014-01-01
With high-angular resolution three-dimensional X-ray diffraction (3DXRD), quantitative information is gained about dislocation structures in individual grains in the bulk of a macroscopic specimen by acquiring reciprocal space maps. In high-resolution 3D reciprocal space maps of tensile......-deformed copper, individual, almost dislocation-free subgrains are identified from high-intensity peaks and distinguished by their unique combination of orientation and elastic strain; dislocation walls manifest themselves as a smooth cloud of lower intensity. The elastic strain shows only minor variations within...... dynamics is followed in situ during varying loading conditions by reciprocal space mapping: during uninterrupted tensile deformation, formation of subgrains is observed concurrently with broadening of Bragg reflections shortly after the onset of plastic deformation. When the traction is terminated, stress...
Feasibility analysis of reciprocating magnetic heat pumps
Larson, A. V.; Hartley, J. G.; Shelton, Sam V.; Smith, M. M.
1989-01-01
A reciprocating gadolinium core in a regeneration fluid column in the warm bore of a superconducting solenoidal magnet is considered for magnetic refrigeration in 3.517 MW (1000 ton) applications. A procedure is presented to minimize the amount of superconducting cable needed in the magnet design. Estimated system capital costs for an ideal magnetic refrigerator of this type become comparable to conventional chillers as the frequency of reciprocation approaches 10 Hertz. A 1-D finite difference analysis of a regenerator cycling at 0.027 Hertz is presented which exhibits some of the features seen in the experiments of G. V. Brown.
Gain-loss framing effects in dilemmas of trust and reciprocity
Evans, A.M.; van Beest, I.
2017-01-01
How do trust and reciprocity decisions change when outcomes are framed in terms of potential losses (vs gains)? In two studies, with 7464 trust decisions from 359 participants and 2723 reciprocity decisions from 221 participants, we find that loss framing increases mean-level trust, but has no
Reciprocity and Dependency Considerations in Adult Donating and Verbal Judgments.
Peterson, Lizette; McCommis, Bruce
The norms of social responsibility and reciprocity govern altruistic behavior. Children and adults show a consistent developmental trend in comparisons of their responses to positive reciprocal situations and their subsequent altruism. Research indicates, however, that children, given the choice to behaviorally aid a needy individual, choose more…
Neural signatures of trust in reciprocity: A coordinate-based meta-analysis.
Bellucci, Gabriele; Chernyak, Sergey V; Goodyear, Kimberly; Eickhoff, Simon B; Krueger, Frank
2017-03-01
Trust in reciprocity (TR) is defined as the risky decision to invest valued resources in another party with the hope of mutual benefit. Several fMRI studies have investigated the neural correlates of TR in one-shot and multiround versions of the investment game (IG). However, an overall characterization of the underlying neural networks remains elusive. Here, a coordinate-based meta-analysis was employed (activation likelihood estimation method, 30 articles) to investigate consistent brain activations in each of the IG stages (i.e., the trust, reciprocity and feedback stage). Results showed consistent activations in the anterior insula (AI) during trust decisions in the one-shot IG and decisions to reciprocate in the multiround IG, likely related to representations of aversive feelings. Moreover, decisions to reciprocate also consistently engaged the intraparietal sulcus, probably involved in evaluations of the reciprocity options. On the contrary, trust decisions in the multiround IG consistently activated the ventral striatum, likely associated with reward prediction error signals. Finally, the dorsal striatum was found consistently recruited during the feedback stage of the multiround IG, likely related to reinforcement learning. In conclusion, our results indicate different neural networks underlying trust, reciprocity, and feedback learning. These findings suggest that although decisions to trust and reciprocate may elicit aversive feelings likely evoked by the uncertainty about the decision outcomes and the pressing requirements of social standards, multiple interactions allow people to build interpersonal trust for cooperation via a learning mechanism by which they arguably learn to distinguish trustworthy from untrustworthy partners. Hum Brain Mapp 38:1233-1248, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Towards an understanding of the relative strengths of positive and negative reciprocity
Directory of Open Access Journals (Sweden)
Omar Al-Ubaydli
2010-12-01
Full Text Available Scholars in economics and psychology have created a large literature studying reward, punishment and reciprocity. Labor markets constitute a popular application of this body of work, with particular emphasis on how reciprocity helps regulate workplace relationships where managers are unable to perfectly monitor workers. We study how idiosyncratic features of the labor market (compared to most scenarios in which reciprocity applies affect the nature of worker reciprocity. In particular, we show how having an excess supply of workers (simulating unemployment and managers who can observe the reciprocal behavior of workers and hire/fire them on that basis (simulating the reputational concerns inherent in labor market transactions profoundly alters worker reciprocity. In the absence of reputational concerns, workers tend to reward kind behavior and punish unkind behavior by managers in approximately equal measure. In the presence of reputational concerns, workers exhibit a marked increase (decrease in the propensity to reward kind (punish unkind behavior by managers. We demonstrate how this is a consequence of workers and managers responding to changes in the strategic incentives to reward and punish. %JEL codes: D03, D63, J3, J53
A reciprocity-based formula for the capacitance with quadrupolar electrodes
Energy Technology Data Exchange (ETDEWEB)
Cho, Sungbo [Gachon University of Medicine and Science, Incheon (Korea, Republic of)
2011-11-15
A new capacitance formula for the practical design and characterization of quadrupolar electrode arrays with capacitive structures was derived based on the reciprocal theorem. The reciprocity-based capacitance formula agreed with the empirical equations established to estimate the capacitance of a single strip line or disk electrode compensating for the fringing field effect that occurs at the electrode edge. The reciprocity-based formula was applied to compute the capacitance measurable by using a quadrupolar square electrode array with a symmetric dipole-dipole configuration and was compared with the analytical equation established based on the image method assuming that the electrodes were points. The results showed that the capacitance of the quadrupolar electrodes was determined by the size of the quadrupolar electrodes relative to the separation distance between the electrodes and that the reciprocity-based capacitance formula was in agreement with the established analytical equation if the separated distance between the electrodes relative to the electrode size was large enough.
A reciprocity-based formula for the capacitance with quadrupolar electrodes
International Nuclear Information System (INIS)
Cho, Sungbo
2011-01-01
A new capacitance formula for the practical design and characterization of quadrupolar electrode arrays with capacitive structures was derived based on the reciprocal theorem. The reciprocity-based capacitance formula agreed with the empirical equations established to estimate the capacitance of a single strip line or disk electrode compensating for the fringing field effect that occurs at the electrode edge. The reciprocity-based formula was applied to compute the capacitance measurable by using a quadrupolar square electrode array with a symmetric dipole-dipole configuration and was compared with the analytical equation established based on the image method assuming that the electrodes were points. The results showed that the capacitance of the quadrupolar electrodes was determined by the size of the quadrupolar electrodes relative to the separation distance between the electrodes and that the reciprocity-based capacitance formula was in agreement with the established analytical equation if the separated distance between the electrodes relative to the electrode size was large enough.
Osaka, Kengo; Toriumi, Fujio; Sugawara, Toshihauru
2017-01-01
Social networking services (SNSs) are widely used as communicative tools for a variety of purposes. SNSs rely on the users' individual activities associated with some cost and effort, and thus it is not known why users voluntarily continue to participate in SNSs. Because the structures of SNSs are similar to that of the public goods (PG) game, some studies have focused on why voluntary activities emerge as an optimal strategy by modifying the PG game. However, their models do not include direct reciprocity between users, even though reciprocity is a key mechanism that evolves and sustains cooperation in human society. We developed an abstract SNS model called the reciprocity rewards and meta-rewards games that include direct reciprocity by extending the existing models. Then, we investigated how direct reciprocity in an SNS facilitates cooperation that corresponds to participation in SNS by posting articles and comments and how the structure of the networks of users exerts an influence on the strategies of users using the reciprocity rewards game. We run reciprocity rewards games on various complex networks and an instance network of Facebook and found that two types of stable cooperation emerged. First, reciprocity slightly improves the rate of cooperation in complete graphs but the improvement is insignificant because of the instability of cooperation. However, this instability can be avoided by making two assumptions: high degree of fun, i.e. articles are read with high probability, and different attitudes to reciprocal and non-reciprocal agents. We then propose the concept of half free riders to explain what strategy sustains cooperation-dominant situations. Second, we indicate that a certain WS network structure affects users' optimal strategy and facilitates stable cooperation without any extra assumptions. We give a detailed analysis of the different characteristics of the two types of cooperation-dominant situations and the effect of the memory of
Sorting genomes by reciprocal translocations, insertions, and deletions.
Qi, Xingqin; Li, Guojun; Li, Shuguang; Xu, Ying
2010-01-01
The problem of sorting by reciprocal translocations (abbreviated as SBT) arises from the field of comparative genomics, which is to find a shortest sequence of reciprocal translocations that transforms one genome Pi into another genome Gamma, with the restriction that Pi and Gamma contain the same genes. SBT has been proved to be polynomial-time solvable, and several polynomial algorithms have been developed. In this paper, we show how to extend Bergeron's SBT algorithm to include insertions and deletions, allowing to compare genomes containing different genes. In particular, if the gene set of Pi is a subset (or superset, respectively) of the gene set of Gamma, we present an approximation algorithm for transforming Pi into Gamma by reciprocal translocations and deletions (insertions, respectively), providing a sorting sequence with length at most OPT + 2, where OPT is the minimum number of translocations and deletions (insertions, respectively) needed to transform Pi into Gamma; if Pi and Gamma have different genes but not containing each other, we give a heuristic to transform Pi into Gamma by a shortest sequence of reciprocal translocations, insertions, and deletions, with bounds for the length of the sorting sequence it outputs. At a conceptual level, there is some similarity between our algorithm and the algorithm developed by El Mabrouk which is used to sort two chromosomes with different gene contents by reversals, insertions, and deletions.
[The reciprocity rule in the construction of relationships as the key in relational processes].
Fenelli, Antonio; Volpi, Cecilia; Guarracino, Emanuele; Galli, Virginia; Esposito, Massimo
2011-01-01
Reciprocity as an expression of the therapist-patient relationship is pointed-out by Mario Reda who refers to Comparetti's studies on the mother-foetus reciprocity, mediated by the so-called "jumps". Reciprocal behaviours are clearly observable during bird and other animal courtship behaviour, whereas in the Sapiens sapiens species, we may observe the establishing of a very complex reciprocity system, which starts with gestures and bodily attitudes, subsequently activating sensory-motor emotional schemata and internal working models, thus enabling the construction of personal meanings. A relationship may result from an encounter provided that "compatible" meanings are constructed in the context of "possible reciprocity" of significant systems. The observation of reciprocity provides a concrete possibility to reduce the risk of absolute subjectivity related to the I or the you, superceding it through the us.
Talking about Service-Learning: Product or Process? Reciprocity or Solidarity?
Clifford, Joan
2017-01-01
Through an exploration of values of the neoliberal university and critical service-learning, this article explores how associating service-learning with products and relationships based on reciprocity negatively impacts its connection to social justice. By emphasizing the constructs of process and solidarity, instead of products and reciprocity,…
State Authorization Reciprocity Agreement: Participation and Access to Higher Education
Onwuameze, Nkechi
2017-01-01
The State Authorization Reciprocity Agreement initiative was launched in 2014 to provide a uniform standard for the regulation of distance education across states in the United States. The system established by the National Council for State Authorization Reciprocity Agreement (NC-SARA) allows willing post-secondary institutions to participate…
Medical image of the week: Wolff-Parkinson-White syndrome
Directory of Open Access Journals (Sweden)
Van Hook C
2017-04-01
Full Text Available No abstract available. Article truncated at 150 words. A 38-year-old man developed sustained rapid heart rate while rock climbing. The patient reported that he had experienced rare bouts of self-limited palpitations in the past. Blood pressure on arrival to the emergency department was 112/ 65 mm Hg. The patient’s initial EKG demonstrated a regular, narrow complex supraventricular tachycardia, with a rate of 232 (Figure 1. Intravenous adenosine was administered with no change in his rate or rhythm. The patient then received amiodarone by intravenous bolus, with subsequent conversion to sinus rhythm (Figure 2. Wolff-Parkinson-White (WPW syndrome is a congenital cardiac condition present in approximately 0.15% of the general population. WPW is characterized by the abnormal presence of conduction tissue that creates an accessory atrioventricular pathway and thus potentiates reentrant tachycardia (1. The classic resting EKG findings in WPW are: a shortened PR interval (less than 0.12 seconds, an indistinct initial upslope of the QRS complex (known as the …
DEFF Research Database (Denmark)
Pedersen, Henriette Sloth; Elming, Hanne; Seibaek, Marie
2007-01-01
The purpose of this study was to identify risk factors of Torsade de pointes (TdP) ventricular tachycardia in patients medicated with a class III antiarrhythmic drug (dofetilide) and left ventricular systolic dysfunction with heart failure (HF) or recent myocardial infarction (MI). The 2 Danish...
Reciprocal cooperation in avian mobbing: playing nice pays.
Wheatcroft, David J; Price, Trevor D
2008-08-01
Unrelated passerine birds often join together while mobbing, a widespread antipredator behavior during which birds harass a predator. Although previous analyses concluded that mobbing could not have evolved via reciprocity, Krams and colleagues' field experiments show that birds preferentially join mobs with neighbors that have aided them previously, suggesting that these birds utilize reciprocity-based strategies involving individual recognition and recollection of previous interactions with others. This implies a level of sophistication in bird communities greater than had previously been realized.
Smith, Gavin
2017-01-01
This thesis provides a comprehensive reporting of the work undertaken to identify evidence supporting pre-hospital management of supraventricular tachycardia (SVT), delivering an evidence base for paramedic treatment of these patients. The literature search identified absences in evidence supporting therapies used within existing clinical guidelines. The vagal manoeuvres, the simplest and least invasive therapy to employ in the stable patient, were insufficiently evidenced regarding technique...
Apically extruded dentin debris by reciprocating single-file and multi-file rotary system.
De-Deus, Gustavo; Neves, Aline; Silva, Emmanuel João; Mendonça, Thais Accorsi; Lourenço, Caroline; Calixto, Camila; Lima, Edson Jorge Moreira
2015-03-01
This study aims to evaluate the apical extrusion of debris by the two reciprocating single-file systems: WaveOne and Reciproc. Conventional multi-file rotary system was used as a reference for comparison. The hypotheses tested were (i) the reciprocating single-file systems extrude more than conventional multi-file rotary system and (ii) the reciprocating single-file systems extrude similar amounts of dentin debris. After solid selection criteria, 80 mesial roots of lower molars were included in the present study. The use of four different instrumentation techniques resulted in four groups (n = 20): G1 (hand-file technique), G2 (ProTaper), G3 (WaveOne), and G4 (Reciproc). The apparatus used to evaluate the collection of apically extruded debris was typical double-chamber collector. Statistical analysis was performed for multiple comparisons. No significant difference was found in the amount of the debris extruded between the two reciprocating systems. In contrast, conventional multi-file rotary system group extruded significantly more debris than both reciprocating groups. Hand instrumentation group extruded significantly more debris than all other groups. The present results yielded favorable input for both reciprocation single-file systems, inasmuch as they showed an improved control of apically extruded debris. Apical extrusion of debris has been studied extensively because of its clinical relevance, particularly since it may cause flare-ups, originated by the introduction of bacteria, pulpal tissue, and irrigating solutions into the periapical tissues.
International Nuclear Information System (INIS)
Peters, K.A.; Atkinson, P.F.; Hammond, E.C. Jr.
1986-01-01
Reciprocity failure was examined for IIaO spectroscopic film. Three separate experiments were performed in order to study film batch variations, thermal and aging effects in relationship to reciprocity failure, and shifting of reciprocity failure points as a function of thermal and aging effects. The failure was examined over ranges of time between 5 and 60 seconds. The variation to illuminance was obtained by using thirty neutral density filters. A standard sensitometer device imprinted the wedge pattern on the film as exposure time was subjected to variation. The results indicate that film batch differences, temperature, and aging play an important role in reciprocity failure of IIaO spectroscopic film. A shifting of the failure points was also observed in various batches of film
Zebrafish heart as a model to study the integrative autonomic control of pacemaker function
Stoyek, Matthew R.; Quinn, T. Alexander; Croll, Roger P.
2016-01-01
The cardiac pacemaker sets the heart's primary rate, with pacemaker discharge controlled by the autonomic nervous system through intracardiac ganglia. A fundamental issue in understanding the relationship between neural activity and cardiac chronotropy is the identification of neuronal populations that control pacemaker cells. To date, most studies of neurocardiac control have been done in mammalian species, where neurons are embedded in and distributed throughout the heart, so they are largely inaccessible for whole-organ, integrative studies. Here, we establish the isolated, innervated zebrafish heart as a novel alternative model for studies of autonomic control of heart rate. Stimulation of individual cardiac vagosympathetic nerve trunks evoked bradycardia (parasympathetic activation) and tachycardia (sympathetic activation). Simultaneous stimulation of both vagosympathetic nerve trunks evoked a summative effect. Effects of nerve stimulation were mimicked by direct application of cholinergic and adrenergic agents. Optical mapping of electrical activity confirmed the sinoatrial region as the site of origin of normal pacemaker activity and identified a secondary pacemaker in the atrioventricular region. Strong vagosympathetic nerve stimulation resulted in a shift in the origin of initial excitation from the sinoatrial pacemaker to the atrioventricular pacemaker. Putative pacemaker cells in the sinoatrial and atrioventricular regions expressed adrenergic β2 and cholinergic muscarinic type 2 receptors. Collectively, we have demonstrated that the zebrafish heart contains the accepted hallmarks of vertebrate cardiac control, establishing this preparation as a viable model for studies of integrative physiological control of cardiac function by intracardiac neurons. PMID:27342878
2011-03-09
... National Emission Standards for Hazardous Air Pollutants for Reciprocating Internal Combustion Engines... pollutants for existing stationary spark ignition reciprocating internal combustion engines. The final rule... reciprocating internal combustion generation, engine. transmission, or distribution. 622110 Medical and surgical...
2010-08-20
... Air Pollutants for Reciprocating Internal Combustion Engines; Final Rule #0;#0;Federal Register / Vol... for Hazardous Air Pollutants for Reciprocating Internal Combustion Engines AGENCY: Environmental... hazardous air pollutants for existing stationary spark ignition reciprocating internal combustion engines...
Groupwise information sharing promotes ingroup favoritism in indirect reciprocity.
Nakamura, Mitsuhiro; Masuda, Naoki
2012-11-05
Indirect reciprocity is a mechanism for cooperation in social dilemma situations. In indirect reciprocity, an individual is motivated to help another to acquire a good reputation and receive help from others afterwards. Another aspect of human cooperation is ingroup favoritism, whereby individuals help members in their own group more often than those in other groups. Ingroup favoritism is a puzzle for the theory of cooperation because it is not easily evolutionarily stable. In the context of indirect reciprocity, ingroup favoritism has been shown to be a consequence of employing a double standard when assigning reputations to ingroup and outgroup members. An example of such a double standard is the situation in which helping an ingroup member is regarded as good, whereas the same action toward an outgroup member is regarded as bad. We analyze a computational model of indirect reciprocity in which information sharing is conducted groupwise. In our model, individuals play social dilemma games within and across groups, and the information about their reputations is shared within each group. We show that evolutionarily stable ingroup favoritism emerges even if all the players use the same reputation assignment rule regardless of group (i.e., a single standard). Two reputation assignment rules called simple standing and stern judging yield ingroup favoritism; under these rules, cooperation with (defection against) good individuals is regarded as good (bad) and defection against bad individuals is regarded as good. Stern judging induces much stronger ingroup favoritism than does simple standing. Simple standing and stern judging are evolutionarily stable against each other when groups employing different assignment rules compete and the number of groups is sufficiently large. In addition, we analytically show as a limiting case that homogeneous populations of reciprocators that use reputations are unstable when individuals independently infer reputations of individuals
Groupwise information sharing promotes ingroup favoritism in indirect reciprocity
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Nakamura Mitsuhiro
2012-11-01
Full Text Available Abstract Background Indirect reciprocity is a mechanism for cooperation in social dilemma situations. In indirect reciprocity, an individual is motivated to help another to acquire a good reputation and receive help from others afterwards. Another aspect of human cooperation is ingroup favoritism, whereby individuals help members in their own group more often than those in other groups. Ingroup favoritism is a puzzle for the theory of cooperation because it is not easily evolutionarily stable. In the context of indirect reciprocity, ingroup favoritism has been shown to be a consequence of employing a double standard when assigning reputations to ingroup and outgroup members. An example of such a double standard is the situation in which helping an ingroup member is regarded as good, whereas the same action toward an outgroup member is regarded as bad. Results We analyze a computational model of indirect reciprocity in which information sharing is conducted groupwise. In our model, individuals play social dilemma games within and across groups, and the information about their reputations is shared within each group. We show that evolutionarily stable ingroup favoritism emerges even if all the players use the same reputation assignment rule regardless of group (i.e., a single standard. Two reputation assignment rules called simple standing and stern judging yield ingroup favoritism; under these rules, cooperation with (defection against good individuals is regarded as good (bad and defection against bad individuals is regarded as good. Stern judging induces much stronger ingroup favoritism than does simple standing. Simple standing and stern judging are evolutionarily stable against each other when groups employing different assignment rules compete and the number of groups is sufficiently large. In addition, we analytically show as a limiting case that homogeneous populations of reciprocators that use reputations are unstable when individuals
Magneto-optical non-reciprocal devices in silicon photonics
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Yuya Shoji
2014-01-01
Full Text Available Silicon waveguide optical non-reciprocal devices based on the magneto-optical effect are reviewed. The non-reciprocal phase shift caused by the first-order magneto-optical effect is effective in realizing optical non-reciprocal devices in silicon waveguide platforms. In a silicon-on-insulator waveguide, the low refractive index of the buried oxide layer enhances the magneto-optical phase shift, which reduces the device footprints. A surface activated direct bonding technique was developed to integrate a magneto-optical garnet crystal on the silicon waveguides. A silicon waveguide optical isolator based on the magneto-optical phase shift was demonstrated with an optical isolation of 30 dB and insertion loss of 13 dB at a wavelength of 1548 nm. Furthermore, a four port optical circulator was demonstrated with maximum isolations of 15.3 and 9.3 dB in cross and bar ports, respectively, at a wavelength of 1531 nm.
Propagation of Economic Inequality Through Reciprocity and Reputation.
Hackel, Leor M; Zaki, Jamil
2018-04-01
Reciprocity and reputation are powerful tools for encouraging cooperation on a broad scale. Here, we highlight a potential side effect of these social phenomena: exacerbating economic inequality. In two novel economic games, we manipulated the amount of money with which participants were endowed and then gave them the opportunity to share resources with others. We found that people reciprocated more toward higher-wealth givers, compared with lower-wealth givers, even when those givers were equally generous. Wealthier givers also achieved better reputations than less wealthy ones and therefore received more investments in a social marketplace. These discrepancies were well described by a formal model of reinforcement learning: Individuals who weighted monetary outcomes, rather than generosity, when learning about interlocutors also most strongly helped wealthier individuals. This work demonstrates that reciprocity and reputation-although globally increasing prosociality-can widen wealth gaps and provides a precise account of how inequality grows through social processes.
Feldman, Ruth; Bamberger, Esther; Kanat-Maymon, Yaniv
2013-01-01
Reciprocity - the capacity to engage in social exchange that integrates inputs from multiple partners into a unified social event - is a cornerstone of adaptive social life that is learned within dyad-specific attachments during an early period of neuroplasticity. Yet, very little research traced the expression of children's reciprocity with their mother and father in relation to long-term outcomes. Guided by evolutionary models, we followed mothers, fathers, and their firstborn child longitudinally and observed mother-child and father-child reciprocity in infancy, preschool, and adolescence. In preschool, children's social competence, aggression, and prosocial behavior were observed at kindergarten. In adolescence, children's dialogical skills were assessed during positive and conflict interactions with same-sex best friends. Father-child and mother-child reciprocity were individually stable, inter-related at each stage, and consisted of distinct behavioral components. Structural equation modeling indicated that early maternal and paternal reciprocity were each uniquely predictive of social competence and lower aggression in preschool, which, in turn, shaped dialogical skills in adolescence. Father-adolescent reciprocity contributed to the dialogical negotiation of conflict, whereas mother-adolescent reciprocity predicted adolescents' dialogical skills during positive exchanges. Results highlight the role of parent-child reciprocity in shaping children's social collaboration and intimate relationships with non-kin members of their social world.
Thermodynamic Analysis of an Irreversible Maisotsenko Reciprocating Brayton Cycle
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Fuli Zhu
2018-03-01
Full Text Available An irreversible Maisotsenko reciprocating Brayton cycle (MRBC model is established using the finite time thermodynamic (FTT theory and taking the heat transfer loss (HTL, piston friction loss (PFL, and internal irreversible losses (IILs into consideration in this paper. A calculation flowchart of the power output (P and efficiency (η of the cycle is provided, and the effects of the mass flow rate (MFR of the injection of water to the cycle and some other design parameters on the performance of cycle are analyzed by detailed numerical examples. Furthermore, the superiority of irreversible MRBC is verified as the cycle and is compared with the traditional irreversible reciprocating Brayton cycle (RBC. The results can provide certain theoretical guiding significance for the optimal design of practical Maisotsenko reciprocating gas turbine plants.
Five-Year-Old Preschoolers' Sharing is Influenced by Anticipated Reciprocation.
Xiong, Mingrui; Shi, Jiannong; Wu, Zhen; Zhang, Zhen
2016-01-01
Whether children share in anticipation of future benefits returned by a partner is an interesting question. In this study, 5-year-old children and an adult partner played a sharing game, in which children donated first and the partner donated afterward. In Experiment 1, the partner's resources were more attractive than the child's. In the reciprocal condition, the child was told that s/he would be a recipient when the partner played as a donor. In the non-reciprocal condition, however, the child was told that an anonymous child would be the recipient when the partner donated. Results showed that children shared more with the partner when they knew that they would be a recipient later. In Experiment 2, the child was always the recipient when the partner donated, but the partner's resources were more desirable than the child's in the high-value condition, and less desirable in the low-value condition. We found that children were more generous when the partner's resources were valued higher. These findings demonstrate that 5-year-old preschoolers' sharing choices take into account the anticipated reciprocity of the recipient, suggesting either self-interested tactical sharing or direct reciprocity in advance of receiving. Specifically, they adjust their sharing behavior depending on whether a partner has the potential to reciprocate, and whether it is worth sharing relative to the value of the payback.
Social evolution: reciprocity there is.
Taborsky, Michael
2013-06-03
The theory of cooperation predicts that altruism can be established by reciprocity, yet empirical evidence from nature is contentious. Increasingly though, experimental results from social vertebrates challenge the nearly exclusive explanatory power of relatedness for the evolution of cooperation. Copyright © 2013 Elsevier Ltd. All rights reserved.
Reciprocal Learning: One Teacher's Narrative
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Adrienne RIGLER
2017-01-01
This paper is a personal narrative from the perspective of one teacher in Toronto who participated in the Canada-China Reciprocal Learning in Teacher Education and School Education Partnership Grant Project.I took part in a Sister School partnership between 2013 and 2017.Over the four years,I came to understand relationships in an international professional learning community.Participating in the project gave me the benefit of seeing my practice through an international lens.For my students,it offered a global citizenship experience.Although there are numerous professional development opportunities in Toronto,this partnership extends beyond a lunch and learn,or a full day professional learning.The commitment to my partners has fueled my desire to incorporate new teaching ideas and has required ongoing reflection on my own teaching practice.In this article,I will explain some of the challenges,stages of development,reciprocal learning,and implications for future international professional learning communities.