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Sample records for cardiac pacing artificial

  1. Cardiomyopathy induced by artificial cardiac pacing: myth or reality sustained by evidence?

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    Andrés Di Leoni Ferrari

    2014-09-01

    Full Text Available Implantable cardiac pacing systems are a safe and effective treatment for symptomatic irreversible bradycardia. Under the proper indications, cardiac pacing might bring significant clinical benefit. Evidences from literature state that the action of the artificial pacing system, mainly when the ventricular lead is located at the apex of the right ventricle, produces negative effects to cardiac structure (remodeling, dilatation and function (dissinchrony. Patients with previously compromised left ventricular function would benefit the least with conventional right ventricle apical pacing, and are exposed to the risk of developing higher incidence of morbidity and mortality for heart failure. However, after almost 6 decades of cardiac pacing, just a reduced portion of patients in general would develop these alterations. In this context, there are not completely clear some issues related to cardiac pacing and the development of this cardiomyopathy. Causality relationships among QRS widening with a left bundle branch block morphology, contractility alterations within the left ventricle, and certain substrates or clinical (previous systolic dysfunction, structural heart disease, time from implant or electrical conditions (QRS duration, percentage of ventricular stimulation are still subjecte of debate. This review analyses contemporary data regarding this new entity, and discusses alternatives of how to use cardiac pacing in this context, emphasizing cardiac resynchronization therapy.

  2. [Advances in cardiac pacing].

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    de Carranza, María-José Sancho-Tello; Fidalgo-Andrés, María Luisa; Ferrer, José Martínez; Mateas, Francisco Ruiz

    2012-01-01

    This article contains a review of the current status of remote monitoring and follow-up involving cardiac pacing devices and of the latest developments in cardiac resynchronization therapy. In addition, the most important articles published in the last year are discussed.

  3. Recent developments in cardiac pacing.

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    Rodak, D J

    1995-10-01

    Indications for cardiac pacing continue to expand. Pacing to improve functional capacity, which is now common, relies on careful patient selection and technical improvements, such as complex software algorithms and diagnostic capabilities.

  4. Pneumothorax in cardiac pacing

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard;

    2012-01-01

    AIM: To identify risk factors for pneumothorax treated with a chest tube after cardiac pacing device implantation in a population-based cohort.METHODS AND RESULTS: A nationwide cohort study was performed based on data on 28 860 patients from the Danish Pacemaker Register, which included all Danish...... patients who received their first pacemaker (PM) or cardiac resynchronization device from 1997 to 2008. Multiple logistic regression was used to estimate adjusted odds ratios (aOR) with 95% confidence intervals for the association between risk factors and pneumothorax treated with a chest tube. The median...... age was 77 years (25th and 75th percentile: 69-84) and 55% were male (n = 15 785). A total of 190 patients (0.66%) were treated for pneumothorax, which was more often in women [aOR 1.9 (1.4-2.6)], and in patients with age >80 years [aOR 1.4 (1.0-1.9)], a prior history of chronic obstructive pulmonary...

  5. Update in cardiac arrhythmias and pacing.

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    García-Bolao, Ignacio; Ruiz-Mateas, Francisco; Bazan, Victor; Berruezo, Antonio; Alcalde, Oscar; Leal del Ojo, Juan; Acosta, Juan; Martínez Sellés, Manuel; Mosquera, Ignacio

    2015-03-01

    This article discusses the main advances in cardiac arrhythmias and pacing published between 2013 and 2014. Special attention is given to the interventional treatment of atrial fibrillation and ventricular arrhythmias, and on advances in cardiac pacing and implantable cardioverter defibrillators, with particular reference to the elderly patient.

  6. Permanent cardiac pacing in pediatric patients.

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    Lotfy, Wael; Hegazy, Ranya; AbdElAziz, Osama; Sobhy, Rodina; Hasanein, Hossam; Shaltout, Fawzan

    2013-02-01

    Pediatric pacemaker (PM) implants comprise less than 1 % of all PM implants. This study aimed to investigate permanent cardiac pacing among the pediatric population, identifying different indications and complications of pediatric cardiac pacing, especially focusing on the effect of the pacing sites, the PM lead type, and the indications for pacing. The current work is a cross-sectional study of 103 procedures for permanent PM insertion in pediatric patients between January 2001 and December 2010. The patients were followed up 1, 3, and 6 months after implantation, then every 6 months or as needed. Evaluation included routine clinical examination, electrocardiography, chest X-ray, echocardiography, and a full analysis of the pacing system measurements. The ages of the patients ranged from 0.09 to 12 years (median, 2.3 years). The most common indication for pacing was postoperative complete heart bock, noted in 54 patients (52.4 %). Transvenous endocardial PM insertion was performed in 92 procedures (89.3 %), whereas transthoracic epicardial insertion was performed in 11 procedures (10.7 %). The most common site of pacing was the right ventricular apex (n = 64, 62 %), followed by the right ventricular outflow tract (n = 25, 24.3 %). Transthoracic epicardial PM insertion was associated with a significantly higher percentage and greater severity of complications. In this study, 65 % of the patients with left ventricle (LV) dilation before pacing showed a significant improvement in LV dimensions and function after pacing. This was noted only in those with endocardially inserted PM leads in both the congenital and the postoperative groups regardless of the pacing site. Endocardial PM insertion in children is a safe procedure with fewer complications and a lower ventricular threshold than the epicardial route. Permanent single-chamber right ventricle pacing is safe and can lead to significant improvement in LV function and dimensions. However, long-term follow

  7. Almanac 2013: cardiac arrhythmias and pacing.

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    Liew, Reginald

    2013-10-01

    Important advances have been made in the past few years in the fields of clinical cardiac electrophysiology and pacing. Researchers and clinicians have a greater understanding of the pathophysiological mechanisms underlying atrial fibrillation (AF), which has transpired into improved methods of detection, risk stratification, and treatments. The introduction of novel oral anticoagulants has provided clinicians with alternative options in managing patients with AF at moderate to high thromboembolic risk and further data has been emerging on the use of catheter ablation for the treatment of symptomatic AF. Another area of intense research in the field of cardiac arrhythmias and pacing is in the use of cardiac resynchronisation therapy (CRT) for the treatment of patients with heart failure. Following the publication of major landmark randomised controlled trials reporting that CRT confers a survival advantage in patients with severe heart failure and improves symptoms, many subsequent studies have been performed to further refine the selection of patients for CRT and determine the clinical characteristics associated with a favourable response. The field of sudden cardiac death and implantable cardioverter defibrillators also continues to be actively researched, with important new epidemiological and clinical data emerging on improved methods for patient selection, risk stratification, and management. This review covers the major recent advances in these areas related to cardiac arrhythmias and pacing.

  8. Cardiac pacing in pediatrics: Is still the right ventricle the optimal pacing site?

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    Michel Cabrera Ortega

    2015-10-01

    Full Text Available Permanent cardiac pacing is frequently indicated in pediatric patients due to atrioventricular block. Traditionally, the right ventricle has been the pacing site because it is readily accessible, and provides lead stability and optimal chronic pacing thresholds. However, it is associated with a dyssynchrony pattern of ventricular activation, that may cause remodeling and impairment of left ventricular function. In pediatric patients, paced from an early age and with a long life expectancy, the preservation of cardiac function is a premise. Therefore, the prevention of dyssynchrony, using possible alternative sites, is not just a priority, is a challenge. The aim of the article is to show the effects of chronic right ventricular pacing as well as the evidence of benefits provided by alternatives pacing sites in pediatric population and their clinical and practical implications.

  9. Optogenetics for in vivo cardiac pacing and resynchronization therapies.

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    Nussinovitch, Udi; Gepstein, Lior

    2015-07-01

    Abnormalities in the specialized cardiac conduction system may result in slow heart rate or mechanical dyssynchrony. Here we apply optogenetics, widely used to modulate neuronal excitability, for cardiac pacing and resynchronization. We used adeno-associated virus (AAV) 9 to express the Channelrhodopsin-2 (ChR2) transgene at one or more ventricular sites in rats. This allowed optogenetic pacing of the hearts at different beating frequencies with blue-light illumination both in vivo and in isolated perfused hearts. Optical mapping confirmed that the source of the new pacemaker activity was the site of ChR2 transgene delivery. Notably, diffuse illumination of hearts where the ChR2 transgene was delivered to several ventricular sites resulted in electrical synchronization and significant shortening of ventricular activation times. These findings highlight the unique potential of optogenetics for cardiac pacing and resynchronization therapies.

  10. Impact of pacing modality and biventricular pacing on cardiac output and coronary conduit flow in the post-cardiotomy patient.

    LENUS (Irish Health Repository)

    Healy, David G

    2012-02-03

    We have previously demonstrated the role of univentricular pacing modalities in influencing coronary conduit flow in the immediate post-operative period in the cardiac surgery patient. We wanted to determine the mechanism of this improved coronary conduit and, in addition, to explore the possible benefits with biventricular pacing. Sixteen patients undergoing first time elective coronary artery bypass grafting who required pacing following surgery were recruited. Comparison of cardiac output and coronary conduit flow was performed between VVI and DDD pacing with a single right ventricular lead and biventricular pacing lead placement. Cardiac output was measured using arterial pulse waveform analysis while conduit flow was measured using ultrasonic transit time methodology. Cardiac output was greatest with DDD pacing using right ventricular lead placement only [DDD-univentricular 5.42 l (0.7), DDD-biventricular 5.33 l (0.8), VVI-univentricular 4.71 l (0.8), VVI-biventricular 4.68 l (0.6)]. DDD-univentricular pacing was significantly better than VVI-univentricular (P=0.023) and VVI-biventricular pacing (P=0.001) but there was no significant advantage to DDD-biventricular pacing (P=0.45). In relation to coronary conduit flow, DDD pacing again had the highest flow [DDD-univentricular 55 ml\\/min (24), DDD-biventricular 52 ml\\/min (25), VVI-univentricular 47 ml\\/min (23), VVI-biventricular 50 ml\\/min (26)]. DDD-univentricular pacing was significantly better than VVI-univentricular (P=0.006) pacing but not significantly different to VVI-biventricular pacing (P=0.109) or DDD-biventricular pacing (P=0.171). Pacing with a DDD modality offers the optimal coronary conduit flow by maximising cardiac output. Biventricular lead placement offered no significant benefit to coronary conduit flow or cardiac output.

  11. Altering embryonic cardiac dynamics with optical pacing.

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    Peterson, L M; McPheeters, M; Barwick, L; Gu, S; Rollins, A M; Jenkins, M W

    2012-01-01

    Several studies have shown that altering blood flow early in development leads to congenital heart defects. In these studies the perturbations to hemodynamics were very gross manipulations (vessel ligation, conotruncal banding, etc.) that would be inappropriate for probing the delicate mechanisms responsible for mechanically-transduced signaling. Also, these perturbations lacked feedback from a monitoring system to determine the exact degree of alteration and the location of its effect. Here, we employed optical pacing (OP) to alter the heart rate in quail embryos and optical coherence tomography (OCT) to measure the resultant shear forces on the endocardium. OP is a new technique utilizing pulsed 1.851 µm infrared laser light to noninvasively capture the heart rate to the pulse frequency of the laser without the use of exogenous agents. To measure shear stress on the endocardium, we extended our previous OCT algorithms to enable the production of 4-D shear maps. 4-D shear maps allowed observation of the spatial and temporal distribution of shear stress. Employing both OCT and OP, we were able to develop perturbation protocols that increase regurgitant flow and greatly modify the oscillatory shear index (OSI) in a region of the heart tube where future valves will develop. Regurgitant flow has been linked with valve development and precise perturbations may allow one to determine the role of hemodynamics in valvulogenesis.

  12. Cardiac pacing in left bundle branch/ bifascicular block patients

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    Maddali Madan

    2010-01-01

    Full Text Available The primary concern in patients with bifascicular block is the increased risk of progression to complete heart block. Further, an additional first-degree A-V block in patients with bifascicular block or LBBB might increase the risk of block progression. Anesthesia, monitoring and surgical techniques can induce conduction defects and bradyarrhythmias in patients with pre-existing bundle branch block. In the setting of an acute MI, several different types of conduction disturbance may become manifest and complete heart block occurs usually in patients with acute myocardial infarction more commonly if there is pre-existing or new bundle branch block. The question that arises is whether it is necessary to insert a temporary pacing catheter in patients with bifascicular block undergoing anesthesia. It is important that an anesthesiologist should be aware of the indications for temporary cardiac pacing as well as the current recommendations for permanent pacing in patients with chronic bifascicular and trifascicular block. This article also highlights the recent guidelines for temporary transvenous pacing in the setting of acute MI and the different pacing modalities that are available for an anesthesiologist.

  13. [Effects of temporary dual-chamber cardiac pacing in refractory cardiac failure].

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    Scanu, P; Lecluse, E; Michel, L; Bureau, G; Saloux, E; Cleron, S; Valette, B; Grollier, G; Potier, J C; Foucault, J P

    1996-12-01

    The authors studied 18 patients (15 men, 3 women) with an average age of 67 +/- 8 years with refractory cardiac failure. In order to determine the potential of pacing to raise cardiac output in severe cardiac failure. The average ejection fraction was 26 +/- 6.5%. All patients were in sinus rhythm:resting cardiac output was 3.35 l/min. Two temporary pacing catheters were positioned in the right atrium and at the apex of the right ventricle for dual-chamber mode pacing triggered by the spontaneous P waves. Changes in cardiac output were measured by Doppler echocardiography at different values of atrioventricular delay. Patients were considered to be responders if their cardiac outputs rose by 15%. In 7 patients meeting this criterion, the average increase in cardiac output was 27% (2.99 +/- 0.7 to 3.81 +/- 0.86 l/mn; p < 0.01); all had dilated cardiomyopathies with left bundle branch block and the optimal AV delay was 103 +/- 21 ms (80-140 ms); the duration of diastolic filling increased from 212 +/- 98 to 292 +/- 116 ms (p = 0.02). In the non-responding group (11 patients with an increase of cardiac output of only 3.6 +/- 0.09 to 3.9 +/- 0.92 l/mn; p < 0.01), the underlying disease process was mainly ischaemic. Two predictive factors of efficacy of dual-chamber pacing were identified: a short ventricular filling period (29 +/- 8% of the RR interval in the responders vs 44 +/- 9% in the non-responders; p < 0.01) and the presence of 1st degree atrioventricular block. Dual-chamber pacing could be a valuable method of increasing resting cardiac outputs in a selected group of patients with severe, refractory, cardiac failure.

  14. Estimulação cardíaca artificial em pacientes portadores de cardiomiopatia hipertrófica: uma coorte com 24 anos de seguimento Cardiac pacing in hypertrophic cardiomyopathy: a cohort with 24 years of follow-up

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    Lenine Angelo Alves Silva

    2008-10-01

    on those benefits is scarce. OBJECTIVE: To describe the indication, clinical response, complications and survival time related to pacemaker implant in HCM patients. METHODS: Thirty-nine hypertrophic cardiomyopathy patients were studied (41% males and submitted to pacemaker implant from May, 1980 through November, 2003. RESULTS: Twenty-seven patients presented obstructive hypertrophic cardiomyopathy, and 12, non-obstructive. Mean age was 46.4 years of age (range 14 - 77, with follow-up of 6.4 ± 4.1 years. Major indications for implant were: spontaneous or induced atrioventricular block (54%, refractoriness to therapeutic conduct associated to high gradient (33%, support for drug therapy to treat bradychardia (8%, and atrial fibrillation prevention (5%. Functional class was shown to improve from 2.41±0.87 to 1.97±0.92 (p = 0.008, and symptoms referred were reduced. No change was made in drug therapy administration. No procedure-related deaths were reported. Although shown to be safe, the procedure was not free from complications (6 patients - 15.4%. Three deaths occurred in the follow-up period - the three of them were atrial fibrillation female patients, with evidence of functional deterioration. A close association was observed between clinical condition worsening and the onset of atrial fibrillation or flutter. CONCLUSION: Cardiac pacing in HCM patients was successful, with evidence of symptoms relief in obstructive HCM patients. No functional improvement was observed in non-obstructive patients.

  15. Electrical Pacing of Cardiac Tissue Including Potassium Inward Rectification.

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    Galappaththige, Suran; Roth, Bradley J

    2015-01-01

    In this study cardiac tissue is stimulated electrically through a small unipolar electrode. Numerical simulations predict that around an electrode are adjacent regions of depolarization and hyperpolarization. Experiments have shown that during pacing of resting cardiac tissue the hyperpolarization is often inhibited. Our goal is to determine if the inward rectifying potassium current (IK1) causes the inhibition of hyperpolarization. Numerical simulations were carried out using the bidomain model with potassium dynamics specified to be inward rectifying. In the simulations, adjacent regions of depolarization and hyperpolarization were observed surrounding the electrode. For cathodal currents the virtual anode produces a hyperpolarization that decreases over time. For long duration pulses the current-voltage curve is non-linear, with very small hyperpolarization compared to depolarization. For short pulses, the hyperpolarization is more prominent. Without the inward potassium rectification, the current voltage curve is linear and the hyperpolarization is evident for both long and short pulses. In conclusion, the inward rectification of the potassium current explains the inhibition of hyperpolarization for long duration stimulus pulses, but not for short duration pulses.

  16. Electrical Pacing of Cardiac Tissue Including Potassium Inward Rectification.

    Directory of Open Access Journals (Sweden)

    Suran Galappaththige

    Full Text Available In this study cardiac tissue is stimulated electrically through a small unipolar electrode. Numerical simulations predict that around an electrode are adjacent regions of depolarization and hyperpolarization. Experiments have shown that during pacing of resting cardiac tissue the hyperpolarization is often inhibited. Our goal is to determine if the inward rectifying potassium current (IK1 causes the inhibition of hyperpolarization. Numerical simulations were carried out using the bidomain model with potassium dynamics specified to be inward rectifying. In the simulations, adjacent regions of depolarization and hyperpolarization were observed surrounding the electrode. For cathodal currents the virtual anode produces a hyperpolarization that decreases over time. For long duration pulses the current-voltage curve is non-linear, with very small hyperpolarization compared to depolarization. For short pulses, the hyperpolarization is more prominent. Without the inward potassium rectification, the current voltage curve is linear and the hyperpolarization is evident for both long and short pulses. In conclusion, the inward rectification of the potassium current explains the inhibition of hyperpolarization for long duration stimulus pulses, but not for short duration pulses.

  17. Temporary pacing

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    L.J. Workman

    1983-09-01

    Full Text Available Artificial cardiac pacing, the use of electrical stimuli to cause contraction of heart muscle, is a sophisticated therapeutic and diagnostic tool. Its rapid technologic improvement since first developed in the late 1930’s by Hyman, has made it possible not only to avoid certain cases of death due to heart block, but also to extend and improve the quality of life. Pacemaker therapy is generally used to treat heart rate or rhythm disturbances, being either tachy- or bradyarrhythmias that produce a detrimental drop in cardiac output. Of the many different types of pacemakers and electrodes currently available, ventricular demand pacing is the most commonly used.

  18. TEE-guided left ventricular epicardial pacing lead placement for cardiac resynchronization therapy

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    Rajesh Chand Arya

    2012-01-01

    Full Text Available Biventricular pacing has demonstrated improvement in cardiac functions in treating congestive cardiac failure patients. Recent trials have proven the clinical and functional benefits of cardiac resynchronization therapy in severe heart failure and intraventricular cardiac delays, mainly left bundle branch block. Biventricular pacing improves the exercise tolerance, quality of life, systolic heart function, reduces hospitalization and slows progression of the disease. A 54-year-old lady, a known case of dilated cardiomyopathy, was on biventricular pacing since 2 years. She presented in emergency with sudden deterioration of dyspnea to NYHA class III/IV. When investigated, the coronary sinus lead was found displaced; thus, left ventricle (LV was not getting paced. After multiple failures to reposition the coronary sinus lead, it was decided to surgically place the epicardial lead for LV pacing under general anesthesia. Lateral thoracotomy was done and LV pacing lead was placed at different sites with simultaneous monitoring of cardiac output (CO and stroke volume (SV by transesophageal echocardiography (TEE. Baseline CO and SV were 1.9 l/min and 19.48 ml respectively and increased at different sites of pacing at LV, the best CO and SV were 4.2 l/min and 42.39 ml respectively on lateral surface. Intraoperative TEE can calculate beat to beat stroke volume and thus CO and helps to choose optimal site for placement of epicardial pacing lead.

  19. New method for cardiac resynchronization therapy: Transapical endocardial lead implantation for left ventricular free wall pacing

    NARCIS (Netherlands)

    I. Kassai (Imre); C. Foldesi (Csaba); A. Szekely (Andrea); T. Szili-Torok (Tamas)

    2008-01-01

    textabstractCoronary sinus lead placement for transvenous left ventricular (LV) pacing in cardiac resynchronization therapy (CRT) has a significant failure rate at implant and a significant dislocation rate during follow-up. For these patients, epicardial pacing lead implantation is the most frequen

  20. Effects of right atrial and ventricular DDD pacing on cardiac function and ventricular contraction synchrony

    Institute of Scientific and Technical Information of China (English)

    支力大; 华伟; 张澍; 史蓉芳; 王方正; 陈新

    2004-01-01

    Background Right ventricular apical pacing has been reported to reduce cardiac performance. But there are few reports on the effects of dual chamber (DDD) pacing on cardiac function compared to sinus rhythm. In this study, we evaluated the effects of right atrial and ventricular DDD pacing on cardiac function and ventricular contraction synchrony using equilibrium radionuclide angiography.Methods Ten patients implanted with a right atrial and ventricular DDD pacemaker underwent equilibrium radionuclide angiography. The scintigraphic data were obtained during sinus rhythm and pacing rhythm. Cardiac function parameters were obtained semimanually. Phase analysis was used to study the ventricular activation sequence and ventricular synchrony.Results The left ventricular 1/3 ejection fraction decreased significantly during pacing compared with that during sinus rhythm[(23.4 ±6.1)% vs(27.7 ±4.5)%, P =0.01]. Regional ejection fraction also decreased during pacing, although the difference was not statistically significant. Phase analysis showed that the right ventricle was activated earlier than the left ventricle during pacing, and that the phase shift was significantly greater during pacing than that during sinus rhythm[64.13°±16.80° vs 52.88°± 9.26°, P =0.007]. The activation of both ventricles occurred simultaneously during sinus rhythm, with the activation sequence from proximal septum or base of left ventricle to apex. The earliest activation during pacing occurred at the right ventricular apex, and subsequently spread to the base and left ventricle.Conclusion Right atrial and ventricular DDD pacing impairs left ventricular systolic function and ventricular synchrony.

  1. Acute impact of pacing at different cardiac sites on left ventricular rotation and twist in dogs.

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    Zhi-Wen Zhou

    Full Text Available We evaluated the acute impact of different cardiac pacing sites on two-dimensional speckle-tracking echocardiography (STE derived left ventricular (LV rotation and twist in healthy dogs.Twelve dogs were used in this study. The steerable pacing electrodes were positioned into right heart through the superior or inferior vena cava, into LV through aorta across the aortic valve. The steerable pacing electrodes were positioned individually in the right atrium (RA, right ventricular apex (RVA, RV outflow tract (RVOT, His bundle (HB, LV apex (LVA and LV high septum (LVS, individual pacing mode was applied at 10 minutes interval for at least 5 minutes from each position under fluoroscopy and ultrasound guidance and at stabilized hemodynamic conditions. LV short-axis images at the apical and basal levels were obtained during sinus rhythm and pacing. Offline STE analysis was performed. Rotation, twist, time to peak rotation (TPR, time to peak twist (TPT, and apical-basal rotation delay (rotational synchronization index, RSI values were compared at various conditions. LV pressure was monitored simultaneously.Anesthetic death occurred in 1 dog, and another dog was excluded because of bad imaging quality. Data from 10 dogs were analyzed. RVA, RVOT, HB, LVA, LVS, RARV (RA+RVA pacing resulted in significantly reduced apical and basal rotation and twist, significantly prolonged apical TPR, TPT and RSI compared to pre-pacing and RA pacing (all P<0.05. The apical and basal rotation and twist values were significantly higher during HB pacing than during pacing at ventricular sites (all P<0.05, except basal rotation at RVA pacing. The apical TPR during HB pacing was significantly shorter than during RVOT and RVA pacing (both P<0.05. The LV end systolic pressure (LVESP was significantly lower during ventricular pacing than during pre-pacing and RA pacing.Our results show that RA and HB pacing results in less acute reduction on LV twist, rotation and LVESP compared

  2. Coronary grafts flow and cardiac pacing modalities: how to improve perioperative myocardial perfusion.

    LENUS (Irish Health Repository)

    D'Ancona, Giuseppe

    2012-02-03

    OBJECTIVE: Aim of this study was to investigate modifications of coronary grafts flow during different pacing modalities after CABG. MATERIALS AND METHODS: Two separate prospective studies were conducted in patients undergoing CABG and requiring intraoperative epicardial pacing. In a first study (22 patients) coronary grafts flows were measured during dual chamber pacing (DDD) and during ventricular pacing (VVI). In a second study (10 patients) flows were measured during DDD pacing at different atrio-ventricular (A-V) delay periods. A-V delay was adjusted in 25 ms increments from 25 to 250 ms and flow measurements were performed for each A-V delay increment. A transit time flowmeter was used for the measurements. RESULTS: An average of 3.4 grafts\\/patient were performed. In the first study, average coronary graft flow was 47.4+\\/-20.8 ml\\/min during DDD pacing and 41.8+\\/-18.2 ml\\/min during VVI pacing (P = 0.0004). Furthermore average systolic pressure was 94.3+\\/-10.1 mmHg during DDD pacing and 89.6+\\/-12.2 mmHg during VVV pacing (P = 0.0007). No significant differences in diastolic pressure were recorded during the two different pacing modalities. In the second study, maximal flows were achieved during DDD pacing with an A-V delay of 175 ms (54+\\/-9.6 ml\\/min) and minimal flows were detected at 25 ms A-V delay (38.1+\\/-4.7 ml\\/min) (P=ns). No significant differences in systolic or diastolic blood pressure were noticed during the different A-V delays. CONCLUSION: Grafts flowmetry provides an extra tool to direct supportive measures such as cardiac pacing after CABG. DDD mode with A-V delay around 175 ms. should be preferred to allow for maximal myocardial perfusion via the grafts.

  3. Risk factors for lead complications in cardiac pacing

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nøhr, Ellen Aagaard;

    2011-01-01

    Lead complications are the main reason for reoperation after implantation of pacemakers (PM) or cardiac resynchronization therapy (CRT-P) devices.......Lead complications are the main reason for reoperation after implantation of pacemakers (PM) or cardiac resynchronization therapy (CRT-P) devices....

  4. Effects of Long-term Right Ventricular Apical Pacing on Left Ventricular Remodeling and Cardiac Function

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Objective: To investigate the impacts of long-term right ventricular apical pacing on the ventricular remodeling and cardiac functions of patients with high-grade and third-degree atrioventricular blockage with normal heart structures and cardiac functions. In addition, we provide many evidences for choosing an optimal electrode implantation site.Methods: Study participants included patients who were admitted for pacemaker replacements and revisited for examinations of implanted pacemakers at outpatient. Pa...

  5. Optimal Cardiac Resynchronization Therapy Pacing Rate in Non-Ischemic Heart Failure Patients

    DEFF Research Database (Denmark)

    Ghotbi, Adam Ali; Sander, Mikael; Køber, Lars;

    2015-01-01

    BACKGROUND: The optimal pacing rate during cardiac resynchronization therapy (CRT) is unknown. Therefore, we investigated the impact of changing basal pacing frequencies on autonomic nerve function, cardiopulmonary exercise capacity and self-perceived quality of life (QoL). METHODS: Twelve CRT...... patients with non-ischemic heart failure (NYHA class II-III) were enrolled in a randomized, double-blind, crossover trial, in which the basal pacing rate was set at DDD-60 and DDD-80 for 3 months (DDD-R for 2 patients). At baseline, 3 months and 6 months, we assessed sympathetic nerve activity...... by microneurography (MSNA), peak oxygen consumption (pVO2), N-terminal pro-brain natriuretic peptide (p-NT-proBNP), echocardiography and QoL. RESULTS: DDD-80 pacing for 3 months increased the mean heart rate from 77.3 to 86.1 (p = 0.001) and reduced sympathetic activity compared to DDD-60 (51±14 bursts/100 cardiac...

  6. Evidence for a Border-Collision Bifurcation in Paced Cardiac Tissue

    Science.gov (United States)

    Berger, Carolyn

    2005-11-01

    Bifurcations in the electrical response of cardiac tissue can destabilize spatial-temporal waves of electrical activity in the heart, leading to tachycardia or even fibrillation. Therefore, it is important to characterize the types of bifurcations occurring in cardiac tissue. Our goal is to classify the bifurcation that occurs in cardiac cells when a change in pacing rate induces a transition from 1:1 to 2:2 phase-locked behavior. Current mathematical models predict that the bifurcation mediating the transition is a supercritical pitchfork type. For such a bifurcation, small random noise is predicted to be amplified by greater amounts as the bifurcation is approached (Weisenfeld). However, our experimental observations of paced bullfrog myocardium driven by small beat-to-beat alternations in the pacing rate (rather than driven by noise) displays de-amplification as the bifurcation is approached. To explain this surprising result, we hypothesize that the transition to 2:2 behavior is mediated by border-collision bifurcation, which is predicted to show little noise amplification. Wiesenfeld, K. Phys. Rev. A 32, 1744 (1985).

  7. Non-invasive cardiac pacing with image-guided focused ultrasound

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    Marquet, Fabrice; Bour, Pierre; Vaillant, Fanny; Amraoui, Sana; Dubois, Rémi; Ritter, Philippe; Haïssaguerre, Michel; Hocini, Mélèze; Bernus, Olivier; Quesson, Bruno

    2016-11-01

    Currently, no non-invasive cardiac pacing device acceptable for prolonged use in conscious patients exists. High Intensity Focused Ultrasound (HIFU) can be used to perform remote pacing using reversibility of electromechanical coupling of cardiomyocytes. Here we described an extracorporeal cardiac stimulation device and study its efficacy and safety. We conducted experiments ex vivo and in vivo in a large animal model (pig) to evaluate clinical potential of such a technique. The stimulation threshold was determined in 10 different ex vivo hearts and different clinically relevant electrical effects such as consecutive stimulations of different heart chambers with a single ultrasonic probe, continuous pacing or the inducibility of ventricular tachycardia were shown. Using ultrasonic contrast agent, consistent cardiac stimulation was achievable in vivo for up to 1 hour sessions in 4 different animals. No damage was observed in inversion-recovery MR sequences performed in vivo in the 4 animals. Histological analysis revealed no differences between stimulated and control regions, for all ex vivo and in vivo cases.

  8. Interventricular cardiac resynchronization with right ventricular apical pacing in a patient with Ebstein's defect.

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    Maffe, Stefano; Perucca, Antonello; Paffoni, Paola; Signorotti, Fabiana; Pardo, Nicolò Franchetti; Dellavesa, Pierfranco; Parravicini, Umberto; Zenone, Franco; Paino, Anna Maria; Bielli, Massimo; Carola, Federico; Zanetta, Marco

    2008-06-01

    We present the case of a patient with Ebstein's defect surgically corrected, and a complete right bundle branch block (RBBB) documented on echocardiogram. After an episode of near syncope due to a high-grade atrioventricular (AV) block, the patient was assisted with a bicameral DDDR pacemaker implanted with traditional right ventricular apical pacing. After the DDDR, and after stimulation with an AV delay of 180 ms, a narrow QRS complex was observed. Meanwhile, the typical left bundle branch block morphology of the right ventricular pacing and the native RBBB morphology were missing. The QRS complex narrowing persisted, even with physical activity and also with the heart rate progression. An echocardiographic study confirmed an improvement of the cardiac resynchronization parameters with this programmed stimulation.

  9. Usefulness of Hemodynamic Sensors for Physiologic Cardiac Pacing in Heart Failure Patients

    Directory of Open Access Journals (Sweden)

    Eraldo Occhetta

    2011-01-01

    Full Text Available The rate adaptive sensors applied to cardiac pacing should respond as promptly as the normal sinus node with an highly specific and sensitive detection of the need of increasing heart rate. Sensors operating alone may not provide optimal heart responsiveness: central venous pH sensing, variations in the oxygen content of mixed venous blood, QT interval, breathing rate and pulmonary minute ventilation monitored by thoracic impedance variations, activity sensors. Using sensors that have different attributes but that work in a complementary manners offers distinct advantages. However, complicated sensors interactions may occur. Hemodynamic sensors detect changes in the hemodynamic performances of the heart, which partially depends on the autonomic nervous system-induced inotropic regulation of myocardial fibers. Specific hemodynamic sensors have been designed to measure different expression of the cardiac contraction strength: Peak Endocardial Acceleration (PEA, Closed Loop Stimulation (CLS and TransValvular Impedance (TVI, guided by intraventricular impedance variations. Rate-responsive pacing is just one of the potential applications of hemodynamic sensors in implantable pacemakers. Other issues discussed in the paper include: hemodynamic monitoring for the optimal programmation and follow up of patients with cardiac resynchronization therapy; hemodynamic deterioration impact of tachyarrhythmias; hemodynamic upper rate limit control; monitoring and prevention of vasovagal malignant syncopes.

  10. Left ventricular performance during triggered left ventricular pacing in patients with cardiac resynchronization therapy and left bundle branch block

    DEFF Research Database (Denmark)

    Witt, Christoffer Tobias; Kronborg, Mads Brix; Nohr, Ellen Aagaard;

    2016-01-01

    PURPOSE: To assess the acute effect of triggered left ventricular pacing (tLVp) on left ventricular performance and contraction pattern in patients with heart failure, left bundle branch block (LBBB), and cardiac resynchronization therapy (CRT). METHODS: Twenty-three patients with pre-implant QRS...... conduction, tLVp, and BiV pacing and compared as paired data. Echocardiographic analysis was done blinded with respect to pacing mode. RESULTS: LVEF was significantly higher during BiV pacing (47 ± 11 %) compared with intrinsic conduction (43 ± 13 %, P = 0.001) and tLVp (44 ± 13 %, P = 0.001), while......V pacing. CONCLUSIONS: The acute effect of tLVp on LV systolic function and contraction pattern is significantly lower than the effect of BiV pacing and not different from intrinsic conduction in patients with LBBB and CRT....

  11. In vivo mechanical study of helical cardiac pacing electrode interacting with canine myocardium

    Institute of Scientific and Technical Information of China (English)

    Xiangming Zhang; Nianke Ma; Hualin Fan; Guodong Niu; Wei Yang

    2007-01-01

    Cardiac pacing is a medical device to help human to overcome arrhythmia and to recover the regular beats of heart. A helical configuration of electrode tip is a new type of cardiac pacing lead distal tip. The helical electrode attaches itself to the desired site of heart by screwing its helical tip into the myocardium. In vivo experiments on anesthetized dogs were carried out to measure the acute interactions between helical electrode and myocardium during screw-in and pull-out processes. These data would be helpful for electrode tip design and electrode/myocardium adherence safety evaluation. They also provide reliability data for clinical site choice of human heart to implant and to fix the pacing lead.A special design of the helical tip using strain gauges is instrumented for the measurement of the screw-in and pull-out forces. We obtained the data of screw-in torques and pull-out forces for five different types of helical electrodes at nine designed sites on ten canine hearts. The results indicate that the screw-in torques increased steplike while the torque-time curves presente saw-tooth fashion. The maximum torque has a range of 0.3-1.9N mm. Obvious differences are observed for different types of helical tips and for different test sites.Large pull-out forces are frequently obtained at epicardium of left ventricle and right ventricle lateral wall, and the forces obtained at right ventricle apex and outflow tract of right ventricle are normally small. The differences in pull-out forces are dictated by the geometrical configuration of helix and regional structures of heart muscle.

  12. Uncovering the dynamics of cardiac systems using stochastic pacing and frequency domain analyses.

    Science.gov (United States)

    Lemay, Mathieu; de Lange, Enno; Kucera, Jan P

    2012-01-01

    Alternans of cardiac action potential duration (APD) is a well-known arrhythmogenic mechanism which results from dynamical instabilities. The propensity to alternans is classically investigated by examining APD restitution and by deriving APD restitution slopes as predictive markers. However, experiments have shown that such markers are not always accurate for the prediction of alternans. Using a mathematical ventricular cell model known to exhibit unstable dynamics of both membrane potential and Ca²⁺ cycling, we demonstrate that an accurate marker can be obtained by pacing at cycle lengths (CLs) varying randomly around a basic CL (BCL) and by evaluating the transfer function between the time series of CLs and APDs using an autoregressive-moving-average (ARMA) model. The first pole of this transfer function corresponds to the eigenvalue (λ(alt)) of the dominant eigenmode of the cardiac system, which predicts that alternans occurs when λ(alt) ≤ -1. For different BCLs, control values of λ(alt) were obtained using eigenmode analysis and compared to the first pole of the transfer function estimated using ARMA model fitting in simulations of random pacing protocols. In all versions of the cell model, this pole provided an accurate estimation of λ(alt). Furthermore, during slow ramp decreases of BCL or simulated drug application, this approach predicted the onset of alternans by extrapolating the time course of the estimated λ(alt). In conclusion, stochastic pacing and ARMA model identification represents a novel approach to predict alternans without making any assumptions about its ionic mechanisms. It should therefore be applicable experimentally for any type of myocardial cell.

  13. Uncovering the dynamics of cardiac systems using stochastic pacing and frequency domain analyses.

    Directory of Open Access Journals (Sweden)

    Mathieu Lemay

    Full Text Available Alternans of cardiac action potential duration (APD is a well-known arrhythmogenic mechanism which results from dynamical instabilities. The propensity to alternans is classically investigated by examining APD restitution and by deriving APD restitution slopes as predictive markers. However, experiments have shown that such markers are not always accurate for the prediction of alternans. Using a mathematical ventricular cell model known to exhibit unstable dynamics of both membrane potential and Ca²⁺ cycling, we demonstrate that an accurate marker can be obtained by pacing at cycle lengths (CLs varying randomly around a basic CL (BCL and by evaluating the transfer function between the time series of CLs and APDs using an autoregressive-moving-average (ARMA model. The first pole of this transfer function corresponds to the eigenvalue (λ(alt of the dominant eigenmode of the cardiac system, which predicts that alternans occurs when λ(alt ≤ -1. For different BCLs, control values of λ(alt were obtained using eigenmode analysis and compared to the first pole of the transfer function estimated using ARMA model fitting in simulations of random pacing protocols. In all versions of the cell model, this pole provided an accurate estimation of λ(alt. Furthermore, during slow ramp decreases of BCL or simulated drug application, this approach predicted the onset of alternans by extrapolating the time course of the estimated λ(alt. In conclusion, stochastic pacing and ARMA model identification represents a novel approach to predict alternans without making any assumptions about its ionic mechanisms. It should therefore be applicable experimentally for any type of myocardial cell.

  14. Exogenous midkine administration prevents cardiac remodeling in pacing-induced congestive heart failure of rabbits.

    Science.gov (United States)

    Harada, Masahide; Hojo, Mayumi; Kamiya, Kaichiro; Kadomatsu, Kenji; Murohara, Toyoaki; Kodama, Itsuo; Horiba, Mitsuru

    2016-01-01

    Midkine (MK), a heparin-binding growth factor, has been shown to prevent cardiac remodeling after ischemic injury through its anti-apoptotic effect. Cell apoptosis is central to the pathophysiology of cardiac remodeling in congestive heart failure (CHF) of ischemic as well as non-ischemic origin. We hypothesized that MK exerts the anti-apoptotic cardioprotective effect in CHF of non-ischemic etiology. MK protein or vehicle (normal saline) was subcutaneously administered in tachycardia-induced CHF rabbits (right ventricular pacing, 350 beats/min, 4 weeks). The vehicle-treated rabbits (n = 19, control) demonstrated severe CHF and high mortality rate, whereas MK (n = 16) demonstrated a well-compensated state and a lower mortality rate. In echocardiography, left ventricular (LV) end-diastolic dimension decreased in MK versus control, whereas LV systolic function increased. In histological analysis (picrosirius red staining), MK decreased collagen deposition area compared with control. TUNEL staining showed that MK prevented cell apoptosis and minimized myocyte loss in the CHF rabbit ventricle, associated with activation of PI3-K/Akt signaling, producing a parallel decrease of Bax/Bcl-2 ratio. MK prevented progression of cardiac remodeling in the CHF rabbit, likely by activation of anti-apoptotic signaling. Exogenous MK application might be a novel therapeutic strategy for CHF due to non-ischemic origin.

  15. BK channels regulate sinoatrial node firing rate and cardiac pacing in vivo.

    Science.gov (United States)

    Lai, Michael H; Wu, Yuejin; Gao, Zhan; Anderson, Mark E; Dalziel, Julie E; Meredith, Andrea L

    2014-11-01

    Large-conductance Ca(2+)- and voltage-activated K(+) (BK) channels play prominent roles in shaping muscle and neuronal excitability. In the cardiovascular system, BK channels promote vascular relaxation and protect against ischemic injury. Recently, inhibition of BK channels has been shown to lower heart rate in intact rodents and isolated hearts, suggesting a novel role in heart function. However, the underlying mechanism is unclear. In the present study, we recorded ECGs from mice injected with paxilline (PAX), a membrane-permeable BK channel antagonist, and examined changes in cardiac conduction. ECGs revealed a 19 ± 4% PAX-induced reduction in heart rate in wild-type but not BK channel knockout (Kcnma1(-/-)) mice. The heart rate decrease was associated with slowed cardiac pacing due to elongation of the sinus interval. Action potential firing recorded from isolated sinoatrial node cells (SANCs) was reduced by 55 ± 15% and 28 ± 9% by application of PAX (3 μM) and iberiotoxin (230 nM), respectively. Furthermore, baseline firing rates from Kcnma1(-/-) SANCs were 33% lower than wild-type SANCs. The slowed firing upon BK current inhibition or genetic deletion was due to lengthening of the diastolic depolarization phase of the SANC action potential. Finally, BK channel immunoreactivity and PAX-sensitive currents were identified in SANCs with HCN4 expression and pacemaker current, respectively, and BK channels cloned from SANCs recapitulated similar activation as the PAX-sensitive current. Together, these data localize BK channels to SANCs and demonstrate that loss of BK current decreases SANC automaticity, consistent with slowed sinus pacing after PAX injection in vivo. Furthermore, these findings suggest BK channels are potential therapeutic targets for disorders of heart rate.

  16. Automated Electrophysiology Makes the Pace for Cardiac Ion Channel Safety Screening

    Directory of Open Access Journals (Sweden)

    Clemens eMoeller

    2011-11-01

    Full Text Available The field of automated patch-clamp electrophysiology has emerged from the tension between the pharmaceutical industry’s need for high-throughput compound screening versus its need to be conservative due to regulatory requirements. On the one hand, hERG channel screening was increasingly requested for new chemical entities, as the correlation between blockade of the ion channel coded by hERG and Torsades de Pointes cardiac arrhythmia gained increasing attention. On the other hand, manual patch-clamping, typically quoted as the gold-standard for understanding ion channel function and modulation, was far too slow (and, consequently, too expensive for keeping pace with the numbers of compounds submitted for hERG channel investigations from pharmaceutical R&D departments. In consequence it became more common for some pharmaceutical companies to outsource safety pharmacological investigations, with a focus on hERG channel interactions. This outsourcing has allowed those pharmaceutical companies to build up operational flexibility and greater independence from internal resources, and allowed them to obtain access to the latest technological developments that emerged in automated patch-clamp electrophysiology – much of which arose in specialized biotech companies. Assays for nearly all major cardiac ion channels are now available by automated patch-clamping using heterologous expression systems, and recently, automated action potential recordings from stem-cell derived cardiomyocytes have been demonstrated. Today, most of the large pharmaceutical companies have acquired automated electrophysiology robots and have established various automated cardiac ion channel safety screening assays on these, in addition to outsourcing parts of their needs for safety screening.

  17. INDICACIONES DE ESTIMULACIÓN ELÉCTRICA TRANSITORIA, COMPLICACIONES Y NECESIDAD DE ESTIMULACIÓN CARDÍACA PERMANENTE / Use of temporary cardiac pacing, its complications and need for permanent cardiac pacing

    Directory of Open Access Journals (Sweden)

    Humberto Ramos González

    2013-07-01

    Full Text Available Resumen: Introducción: La estimulación cardíaca temporal está indicada en diversas situaciones de extrema urgencia, en pacientes con bradiarritmias graves y bloqueos aurículo-ventriculares de II o III grados.Su indicación siempre se considera ante la presencia de síntomas como: compromiso hemodinámico importante, que no responde a los medicamentos, y poca tolerancia el ritmo lento. Objetivo: Describir las principales indicaciones de estimulación eléctrica transitoria que pueden llevar a la estimulación eléctrica permanente, así como las complicaciones que se presentan al utilizarla. Método: Se realizó un estudio descriptivo donde se estudiaron 266 pacientes de 281 ingresados en el Hospital "Arnaldo Milián Castro", a los cuales se les implantó un marcapasos transitorio. Se describen las indicaciones y complicaciones del procedimiento. Resultados: Se observó un mayor número de indicaciones de estimulación eléctrica transitoria cuando aumenta la edad de la población en estudio, 45,86 % para los mayores de 80 años. El sexo femenino predominó (156 pacientes, con una relación mujer-hombre de 1,56:1. La causa degenerativa (42,1 % fue la mayor indicación de estimulación eléctrica permanente. La punción de vasos no deseados fue la complicación más frecuente (7,1 %. Conclusiones: La indicación de estimulación eléctrica transitoria es más frecuente en los mayores de 80 años, principalmente por causa degenerativa, que finalmente lleva a la estimulación eléctrica permanente. El porcentaje de complicaciones no se muestra elevado cuando se tiene en cuenta que este procedimiento no se realizó bajo visión fluoroscópica. / Abstract: Introduction: Temporary cardiac pacing is used in various extreme emergency situations, in patients with severe bradyarrhythmias and second and third degree atrioventricular block. Its use is always considered when there are symptoms such as a significant hemodynamic compromise, not responding

  18. [Antibiotics and artificial nutrition in the cardiac intensive care unit].

    Science.gov (United States)

    De Gaudio, Raffaele; Selmi, Valentina; Chelazzi, Cosimo

    2010-04-01

    Patients admitted to cardiac intensive care units are at high risk for infections, particularly nosocomial pneumonia, pacemaker's pocket and sternotomic wound infections. These complications delay recovery, prolong hospitalization, time on mechanical ventilation, and increase mortality. Both behavioral and pharmacological measures are needed to prevent and control infections in these patients, as well as specific antibiotic treatment and nutritional support. In infected critically ill patients, pathophysiological alterations modify distribution and clearance of antibiotics, and hypercatabolic state leads to malnutrition and immune paralysis, which both contribute to increased infectious risk and worsened outcome. A deep understanding of antibacterial agents pharmacology in the critically ill is essential in order to treat severe infections; moreover, it is necessary to know routes of administration and composition of artificial nutrition solutions. The aim of this review is to define main and specific aspects of antibiotic therapy and nutritional support in cardiac critical care patients in light of recent literature data.

  19. Cardiac Pacing in Cienfuegos from 2005 to 2009 Comportamiento de la estimulación cardiaca en Cienfuegos durante el quinquenio 2005 – 2009

    Directory of Open Access Journals (Sweden)

    Yanier Coll Muñoz

    2011-03-01

    Full Text Available Introduction: permanent artificial pacemaker implantation improves cardiac function and life quality of patients requiring cardiac pacing. Objective: to describe the characteristics of patients undergoing permanent artificial pacemaker implantation and their results, in the period from January 2005 to December 2009 in the General University Hospital “Dr. Gustavo Aldereguía Lima". Methods: a descriptive study was conducted. The sample consisted of 300 patients who were implanted with permanent artificial pacemakers in the Cardiology Service of the General University Hospital “Dr. Gustavo Aldereguía Lima" in Cienfuegos, from 2005 to 2009. General data were collected from patients such as diagnosis, pacing mode used, surgical approach and complications. Results: the predominant age group was that of elderlies over 75 years old, and mostly males were predominant. The main action taken was that of a first implant using the cephalic vein dissection. The most common causes of implant were blocks the atrioventricular conduction and sinus node disease. The type of stimulation used was the VV-VVIR. Major complications included displacement of the electrode, hematomas and the pacemaker syndrome. Conclusion: the number of patients requiring cardiac electrical stimulation continues to increase in Cienfuegos. Elderly patients and the type of single-chamber pacing are predominant. Good results have been obtained with few complications.Introducción: la implantación de un marcapaso permanente mejora la función cardiaca y la calidad de vida de los pacientes con necesidad de estimulación eléctrica cardiaca. Objetivo: describir las características de los pacientes sometidos a implante de marcapasos permanentes y sus resultados, en el quinquenio de enero de 2005 a diciembre de 2009 en el Hospital General Universitario ¨Dr. Gustavo

  20. PERMANENT CARDIAC PACING IN CHILDREN - MORBIDITY AND EFFICACY OF FOLLOW-UP

    NARCIS (Netherlands)

    KERSTJENSFREDERIKSE, MWS; BINKBOELKENS, MTE; DEJONGSTE, MJL; VANDERHEIDE, JNH

    1991-01-01

    The data from 50 permanently paced children [mean standard deviation follow-up 5.3 +/- 3.7 years] were reviewed, with special attention being paid to the cause of complications and the efficacy of follow-up. The 5-year survival (SD) of the patients was 78 +/- 6%; mortality was mainly due to the unde

  1. Association between frequency of atrial and ventricular ectopic beats and biventricular pacing percentage and outcomes in patients with cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Ruwald, Martin H; Mittal, Suneet; Ruwald, Anne-Christine

    2014-01-01

    -defibrillator device with data available on biventricular pacing percentage and pre-implantation 24-h Holter recordings were included. Using logistic regression, we estimated the influence of ectopic beats on the percentage of biventricular pacing. Reverse remodeling was measured as reductions in atrial and left.......001) in patients with >1.5% ectopic beats compared with those with reverse remodeling (percent reduction in LVESV 31 ± 15%) than patients with ... biventricular pacing (reverse remodeling and higher risk of HF/death and VTA. This supports pre-implantation Holter monitoring of patients selected for CRT for optimal outcome. (MADIT-CRT: Multicenter Automatic Defibrillator Implantation With Cardiac Resynchronization...

  2. Open-loop (feed-forward) and feedback control of coronary blood flow during exercise, cardiac pacing, and pressure changes.

    Science.gov (United States)

    Pradhan, Ranjan K; Feigl, Eric O; Gorman, Mark W; Brengelmann, George L; Beard, Daniel A

    2016-06-01

    A control system model was developed to analyze data on in vivo coronary blood flow regulation and to probe how different mechanisms work together to control coronary flow from rest to exercise, and under a variety of experimental conditions, including cardiac pacing and with changes in coronary arterial pressure (autoregulation). In the model coronary flow is determined by the combined action of a feedback pathway signal that is determined by the level of plasma ATP in coronary venous blood, an adrenergic open-loop (feed-forward) signal that increases with exercise, and a contribution of pressure-mediated myogenic control. The model was identified based on data from exercise experiments where myocardial oxygen extraction, coronary flow, cardiac interstitial norepinephrine concentration, and arterial and coronary venous plasma ATP concentrations were measured during control and during adrenergic and purinergic receptor blockade conditions. The identified model was used to quantify the relative contributions of open-loop and feedback pathways and to illustrate the degree of redundancy in the control of coronary flow. The results indicate that the adrenergic open-loop control component is responsible for most of the increase in coronary blood flow that occurs during high levels of exercise. However, the adenine nucleotide-mediated metabolic feedback control component is essential. The model was evaluated by predicting coronary flow in cardiac pacing and autoregulation experiments with reasonable fits to the data. The analysis shows that a model in which coronary venous plasma adenine nucleotides are a signal in local metabolic feedback control of coronary flow is consistent with the available data.

  3. IN VIVO CHARACTERIZATION OF ATTACHMENT SAFETY BETWEEN CARDIAC PACING LEAD AND CANINE HEART MUSCLE

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    In vivo experiments of screwing the electrode of canine hearts and assigning external excitation on the lead-myocardium interface was carried out to evaluate the lead/myocardium adherence safety. The electrode is specially designed to host a measurement unit of strain gauges.We obtained the lead/heart interactions data from 12 dogs under natural heart beating and beating with external excitations. The data recorded from the acute phase and the chronic phase of pulling out pacing leads were compared with each other. The electrode/heart interaction is caused by the heart beat and influenced by the lung breath. This process induced tolerable damage to the lead or myocardium. The interaction decreases as the frequency of external excitations increases. The lead is more likely to be detached from myocardium under higher excitation frequency. At the same implanting sites, safer pacing lead/myocardium attachment can be realized in the chronic tests than in the acute tests.

  4. Presence of notched QRS on paced electrocardiographs as a predictor of poor response to cardiac resynchronization therapy

    Institute of Scientific and Technical Information of China (English)

    Wang Jiayu; Zhang Ping; Li Xuebin; Zhu Tiangang; Li Hua; Wang Long; Li Ding

    2014-01-01

    Background Cardiac resynchronization therapy (CRT) on patients with advanced and refractory heart failure has made remarkable progress.Clinically,notched QRS (nQRS) is commonly seen on electrocardiographs (ECGs) with bundle branch block morphology and on paced ECGs after implantation of a CRT device,which may reflect the heterogeneity of ventricular myocardial depolarization and electrical activity.The aim of this study was to determine whether patients with more nQRS myocardial segments on paced ECGs had a worse response to CRT than patients with fewer nQRS myocardial segments.Methods We prospectively enrolled 56 patients of CRT with chronic heart failure from People's Hospital affiliated to Peking University from January 2007 to October 2013.Based on nQRS segments on ECGs before CRT,we allocated them to two groups:fewer nQRS (<2) myocardial segments (lateral,inferior,anterior segments) group (F-nQRS,G1,n=23) and more nQRS (≥2) myocardial segments group (M-nQRS,G2,n=33).Then according to nQRS segments on ECGs after CRT,we divided them into two groups similarly:fewer nQRS (<2) myocardial segments group (G3,n=24) and more nQRS (≥2) myocardial segments group (G4,n=32).This study was approved by the ethics committee of People's Hospital.Results At 6 months in the baseline-ECG group,there was a greater absolute increase in left ventricular ejection fraction (LVEF) in G2 than in G1 ((11.5±8.9)% vs.(5.5±10.4)%,P=0.023),with the incidence of nonresponse lower in G2than in G1 (9.1% vs.39.1%,P=0.018).In the paced-ECG group,the absolute increase in LVEF was less in G4 than in G3 ((6.4±8.8)% vs.(12.5±10.4)%,P=0.024) and the incidence of nonresponse was higher in G4 than in G3 (31.3% vs.8.3%,P=0.039).Multivariate analysis showed that fewer nQRS (<2) myocardial segments on paced ECGs (odds ratio 13.920) was a predictor of positive response to CRT.Conclusion nQRS ≥2 myocardial segments (lateral,inferior,anterior) on paced ECGs may predict a poor

  5. Pacing to treat low cardiac output syndrome following elective aortic valve replacement

    Directory of Open Access Journals (Sweden)

    Muhammad Ishaq

    2012-01-01

    Full Text Available We report a case of low cardiac output syndrome caused by dynamic left ventricular (LV outflow obstruction after aortic valve replacement (AVR. This recognized phenomenon probably occurs more frequently than appreciated, and the author suggests that this should be considered when managing patients with severe hemodynamic instability after AVR. In addition, we also focus on the fact that invasive pacemaker systems have significant effects on cardiac output augmentation postoperatively and in long-term management of patients with LV outflow tract (LVOT obstruction following AVR. The possible mechanisms and subsequent treatments are discussed.

  6. Keeping Pace with New Technology: An Introduction to Robotics, FORTH, and Artificial Intelligence.

    Science.gov (United States)

    Reck, Gene

    A course was developed to introduce students at a community college to four major areas of emphasis in emerging technologies: FORTH programming language, elementary electronic theory, robotics, and artificial intelligence. After a needs assessment indicated the importance of such a course, a pretest focusing on the four areas was given to students…

  7. Almanac 2013: cardiac arrhythmias and pacing--an editorial overview of selected research that has driven recent advances in clinical cardiology.

    Science.gov (United States)

    Liew, Reginald

    2014-04-01

    Important advances have been made in the past few years in the fields of clinical cardiac electrophysiology and pacing. Researchers and clinicians have a greater understanding of the pathophysiological mechanisms underlying atrial fibrillation (AF), which has transpired into improved methods of detection, risk stratification, and treatments. The introduction of novel oral anticoagulants has provided clinicians with alternative options in managing patients with AF at moderate to high thromboembolic risk and further data has been emerging on the use of catheter ablation for the treatment of symptomatic AF. Another area of intense research in the field of cardiac arrhythmias and pacing is in the use of cardiac resynchronisation therapy (CRT) for the treatment of patients with heart failure. Following the publication of major landmark randomised controlled trials reporting that CRT confers a survival advantage in patients with severe heart failure and improves symptoms, many subsequent studies have been performed to further refine the selection of patients for CRT and determine the clinical characteristics associated with a favourable response. The field of sudden cardiac death and implantable cardioverter defibrillators also continues to be actively researched, with important new epidemiological and clinical data emerging on improved methods for patient selection, risk stratification, and management.This review covers the major recent advances in these areas related to cardiac arrhythmias and pacing.

  8. OPTOGENETICS: A NOVEL APPROACH IN PACING HAERT TISSUE AND ENGENDER PROPAGATING CARDIAC IMPULSES

    Directory of Open Access Journals (Sweden)

    Pasam Naga Abhinay

    2012-04-01

    Full Text Available The cardiac pacemaker controls the rhythmicity of heart contractions and these can be substituted by battery-operated devices as last resource. Optogenetics involves insertion of light-sensitive proteins into human embryonic stem cell to encode DNA making mammalian tissues light-sensitive. The first discovered protein of this type is Channelrhodopsin2 (ChR2, which is widely used in neuroscience. The limitation of electrical stimulation of heart, a standard technique can be overcome by using ChR2.The various methods involved in optogenetics and energy needs were discussed in this section. Initially, optogenetics is confined only to neuronal system, later on extended to heart and other organs. This method involves precise localized stimulation and constant prolonged depolarization of cardiomyocytes and cardiac tissue resulting in alterations of pacemaking, Ca2+ homeostasis, electrical coupling and arrhythmogenic spontaneous extra beats.

  9. Diagnostic accuracy of pace spikes in the electrocardiogram to diagnose paced rhythm

    DEFF Research Database (Denmark)

    Andersson, Hedvig; Hansen, Marco Bo; Thorsberger, Mads;

    2015-01-01

    OBJECTIVE: To determine how often cardiac resynchronization therapy (CRT) pacing systems generate visible pace spikes in the electrocardiogram (ECG). METHODS: In 46 patients treated with CRT pacing systems, we recorded ECGs during intrinsic rhythm, atrial pacing and ventricular pacing. ECGs were...

  10. The Use of a Quadripolar Left Ventricular Lead Increases Successful Implantation Rates in Patients with Phrenic Nerve Stimulation and/or High Pacing Thresholds Undergoing Cardiac Resynchronisation Therapy with Conventional Bipolar Leads

    OpenAIRE

    Ohlow, Marc-Alexander; Lauer, Bernward; Brunelli, Michele; Daralammouri, Yunis; Geller, Christoph

    2013-01-01

    Background Phrenic nerve stimulation (PNS) and high pacing thresholds (HPT) hinder biventricular stimulation in patients (pts) undergoing cardiac resynchronization therapy (CRT). A new quadripolar left ventricular (LV) lead (Quartet 1458Q, St. Jude Medical) with increased number of pacing configuration, might overcome this problem. Methods All consecutive pts in whom a standard bipolar lead intraoperatively resulted in PNS and/or HPT (≥4.00V/1mV), received, during the same implant, a quadripo...

  11. Relationship Between Changes in Pulse Pressure and Frequency Domain Components of Heart Rate Variability During Short-Term Left Ventricular Pacing in Patients with Cardiac Resynchronization Therapy

    Science.gov (United States)

    Urbanek, Bożena; Ruta, Jan; Kudryński, Krzysztof; Ptaszyński, Paweł; Klimczak, Artur; Wranicz, Jerzy Krzysztof

    2016-01-01

    Background The aim of the study was to explore the relationship between changes in pulse pressure (PP) and frequency domain heart rate variability (HRV) components caused by left ventricular pacing in patients with implanted cardiac resynchronization therapy (CRT). Material/Methods Forty patients (mean age 63±8.5 years) with chronic heart failure (CHF) and implanted CRT were enrolled in the study. The simultaneous 5-minute recording of beat-to-beat arterial systolic and diastolic blood pressure (SBP and DBP) by Finometer and standard electrocardiogram with CRT switched off (CRT/0) and left ventricular pacing (CRT/LV) was performed. PP (PP=SBP-DBP) and low- and high-frequency (LF and HF) HRV components were calculated, and the relationship between these parameters was analyzed. Results Short-term CRT/LV in comparison to CRT/0 caused a statistically significant increase in the values of PP (P<0.05), LF (P<0.05), and HF (P<0.05). A statistically significant correlation between ΔPP and ΔHF (R=0.7384, P<0.05) was observed. The ΔHF of 6 ms2 during short-term CRT/LV predicted a PP increase of ≥10% with 84.21% sensitivity and 85.71% specificity. Conclusions During short-term left ventricular pacing in patients with CRT, a significant correlation between ΔPP and ΔHF was observed. ΔHF ≥6 ms2 may serve as a tool in the selection of a suitable site for placement of a left ventricular lead. PMID:27305349

  12. Effects of pacing site and stimulation history on alternans dynamics and the development of complex spatiotemporal patterns in cardiac tissue

    Directory of Open Access Journals (Sweden)

    Alessio eGizzi

    2013-04-01

    Full Text Available Alternans of action potential duration has been associated with T-wave alternans and the development of arrhythmias because it produces large gradients of repolarization. However, little is known about alternans dynamics in large mammalian hearts. Using optical mapping to record electrical activations simultaneously from the epicardium and endocardium of 9 canine right ventricles, we demonstrate novel arrhythmogenic complex spatiotemporal dynamics. (i Alternans predominantly develops first on the endocardium. (ii The postulated simple progression from normal rhythm to concordant to discordant alternans is not always observed; concordant alternans can develop from discordant alternans as the pacing period is decreased. (iii In contrast to smaller tissue preparations, multiple stationary nodal lines may exist and need not be perpendicular to the pacing site or to each other. (iv Alternans has fully three-dimensional dynamics and the epicardium and endocardium can show significantly different dynamics: multiple nodal surfaces can be transmural or intramural and can form concave/convex surfaces resulting in islands of discordant alternans. (v The complex spatiotemporal patterns observed during alternans are very sensitive to both the site of stimulation and the stimulation history. Alternans in canine ventricles not only exhibit larger amplitudes and persist for longer cycle length regimes compared those found in smaller mammalian hearts, but also show novel dynamics not previously described that enhance dispersion and show high sensitivity to initial conditions. This indicate some underlying predisposition to chaos and can help the design of new drugs and devices controlling and preventing arrhythmic events.

  13. 以右室起搏对心功能影响为例探讨META分析方法%Taking an Example of the Effects of Right Ventricular Pacing on Cardiac Function to Discuss META Analysi

    Institute of Scientific and Technical Information of China (English)

    王蔚宗; 尹香翠; 张玉娇

    2014-01-01

    目的:该篇META分析比较右室非心尖部起搏(RVNAP)和心尖部起搏(RVAP)对心功能的影响。方法检索 MEDLINE、EMBASE和 Cochrane Control ed Trials Register数据库,收集随访时间≥2个月的随机对照试验。结果20个试验包括1114例患者入选。与 RVAP相比,RVNAP不仅在起搏阈值及 R波感知方面表现优异,左室射血分数在随访末也明显升高。结论 RVNAP在电极参数方面表现出令人满意的长期结果,并在6个月随访后,提高左室射血分数方面作用有利。%Objective A meta-analysis of randomized control ed trials (RCTs) was conducted to compare the ef ects of right ventricular nonapical (RVNA) and right ventricular apical (RVA) pacing on cardiac function. Methods A systematic literature search was performed using MEDLINE, EMBASE, and the Cochrane Library to identify RCTs comparing RVNA pacing with RVA pacing with fol ow-up≥2 months. Results Twenty RCTs involving 1,114 patients were included. Compared with RVA pacing, RVNA pacing exhibited not only excellent pacing threshold and R-wave amplitude but also higher impedance. RVNA pacing showed a significant increase in left ventricular ejection fraction (LVEF) at the end of fol ow-up. Conclusion This meta-analysis found that RVNA pacing exhibited satisfactory long-term lead performance compared with RVA pacing and demonstrated beneficial ef ects in improving LVEF after the 6-month fol ow-up.

  14. 三度房室传导阻滞患者心脏起搏的临床分析%Clinical analysis on cardiac pacing in patients with third degree atrioventricular block

    Institute of Scientific and Technical Information of China (English)

    夏思良; 张小兵; 周建松

    2015-01-01

    目的:探讨三度房室传导阻滞患者心脏起搏的临床应用。方法回顾分析我科住院的心电图示三度房室传导阻滞患者心脏起搏的应用情况。结果36例三度房室传导阻滞患者中,31例在入院后即刻置入临时起搏导管,1例于入院4 d 后置入,4例择期行永久起搏器安装术。1例高钾血症临时起搏3 d 后拔除,3例重症心肌炎临时起搏5~7 d 后拔除,2例急性下壁心肌梗死在临时起搏3 d 后死于心衰。26例在临时起搏1~16 d 后,采取穿刺左锁骨下静脉或切开头静脉的方法植入单腔或双腔永久起搏器,术后立即拔除临时起搏电极。全部患者术中均无并发症发生,其中 1例永久起搏器安装术后第二天死于急性脑梗死。结论三度房室传导阻滞患者一般需要急诊临时心脏起搏,后根据病因及心率恢复情况行永久起搏器安装术。%Objective To investigate the safety and effectiveness of cardiac pacing in treating patients with third degree atrioventricular block(Ⅲ°AVB).Methods Retrospective analysis was carried out on the application of cardiac pacing in inpatients in our department showed Ⅲ°AVB by ECG.Results Among the enrolled 36 patients with Ⅲ°AVB,31 cases were implanted with tempo-rary pacing catheters the moment on admission,one case was implanted four days after admission, and another four underwent elective permanent pacemaker implantation.The temporary pacing cath-eter was pulled out three days after implantation in one case with hyperpotassemia,and 5 -7 days after implantation in three cases for severe myocarditis while two cases with inferior wall acute myo-cardial infarction died of heart failure three days after temporary cardiac pacing.Twenty-six patients were implanted with single-chamber or dual-chamber permanent pacemakers by means of puncturing left subclavian vein or cutting cephalic vein open,1 -16 days after temporary cardiac pacing,and the

  15. Keeping Pace

    Science.gov (United States)

    Henderson, Nancy

    2008-01-01

    This article describes the struggles of two tough moms who team up to start their own company. Fed up with a lack of stylish, properly-fitting shoes for their children with cerebral palsy, they established "Keeping Pace" which currently offers a selection of stylish girls' and boys' athletic sneakers and casual dress shoes for boys, all sold…

  16. CLASSIFICATION OF CARDIAC ARRHYTHMIAS WITH ARTIFICIAL NEURAL NETWORKS ACCORDING TO GENDER DIFFERENCES

    Directory of Open Access Journals (Sweden)

    KASIM SERBEST

    2015-09-01

    Full Text Available Cardiac arrhythmias are common heart diseases. Electrocardiography (ECG is an important measure for diagnosing arrhythmias. Researchers use the ECG signals in order to train artificial neural networks (ANN. In previous studies the ECG signals of males and females were analysed together. We know that there are some differences between male and female ECG signals. This paper suggests that classifying the arrhythmias according to gender differences gives more accurate results. In this study we classify the subjects as normal and right bundle branch block (RBBB using cascade forward back algorithm in MATLAB. The accuracy of network simulations are as follow: 81.25% only male, 80% only female, 40% male and female together.

  17. Clinical summarization of 40 cases with temporary cardiac pacing by bedside emergently%紧急床边临时心脏起搏40例临床总结

    Institute of Scientific and Technical Information of China (English)

    陈小卫; 吴铿; 黄志文

    2009-01-01

    Objective To summarize the effect and safety of temporary cardiac pacing by bedside emergently. Methods 40 cases with serious bradyarrhythmias were involved. The left subclavian vein was punctured with Seldinger's technique and the commom temporary pacing lead was inserted into the right ventricle to capture the ventricle under the monitoring of electocardiogram and pacing impulse. Results All of the cases were paced successfully. The procedure lasted 3~18 min and the temporary pacing lasted 2~14 d without serious complications happened. Conclusions Temporary transvenous endocardial pacing by bedside emergently is convenient, safe, rapid and effective and is worthy of clinical application.%目的 总结紧急床边临时心脏起搏的治疗效果和安全性.方法 对40例严重缓慢性心律失常患者应用Seldinger技术穿刺左锁骨下静脉,在心电监护和起搏脉冲引导下置入普通临时起搏电极至右心室内膜夺获心室.结果 全部病例均起搏成功,操作时间3~18 min, 起搏持续时间2~14 d,未发生严重起搏操作相关并发症.结论 经静脉紧急床边临时心脏起搏方便、安全、快捷,成功率高,值得在临床推广应用.

  18. Effect of Low-level Vagus Nerve Stimulation on Cardiac Remodeling in a Rapid Atrial Pacing-induced Canine Model of Atrial Fibrillation.

    Science.gov (United States)

    Lu, Yanmei; Sun, Juan; Zhou, Xianhui; Zhang, Ling; Ma, Mei; Tang, Baopeng

    2016-03-01

    The aim of this study was to establish a rapid atrial pacing-induced canine model of atrial fibrillation in studying the effects of low-level vagus nerve stimulation (LLVNS) on atrial fibrillation and the underlying mechanisms for those effects. Adult beagle dogs were randomly assigned to 3 groups: a sham operation group (sham group), a fast left atrial appendage 12-hour pacing group (pacing group), and a 12-hour pacing + LLVNS group (LLVNS group). All dogs underwent tests for their left and right atrial effective refractory period at various time points, after which they were killed, and samples of atrial and anterior right ganglionated plexi tissue were removed and microscopically examined. As pacing times increased, the mean effective refractory period in the pacing group became significantly shortened. The pacing group and the LLVNS group did show significant differences (P nerve growth factor and neurturin (NRTN) in the sham group and the LLVNS group were lower than those in the pacing group (nerve growth factor in 3 groups were (36.35 ± 6.18) × 1000, (86.35 ± 5.63) × 1000, and (40.50 ± 7.24) × 1000 μm²/mm², P nerves.

  19. Vector flow mapping for assessing Beagle dogs′ left ventricular vortex in selective bi-polar single site cardiac pacing%超声血流向量成像评价健康比格犬心脏不同位点起搏左心室血流涡旋

    Institute of Scientific and Technical Information of China (English)

    丁戈琦; 尹立雪; 王志刚; 陆景; 李文华; 张红梅

    2015-01-01

    Objective To investigate the changes of left ventricular(LV) vortex strength(VS) and distribution during selective cardiac pacing in a phases of cardiac cycle using vector flow mapping techniques ,and associate with LV mechanical performance ,so as to provide basic experimental database for optimizing the sites of the artificial cardiac pacing in clinic conditions .Methods Eight heathy open‐chest Beagle dog models were employed for selective right ventricular apical (RVAP ) ,left ventricular apical (LVAP) and lateral wall pacing (LVLP) .The standard two‐dimensional apical three views with color Doppler flow and dynamic two‐dimensional images were acquired consecutively in three cardiac cycles for further off‐line analysis ,conventional parameters were measured at same time .Results Compared with baseline ,LVSV ,LVEF ,LVCO and dp/dtmax were both reduced ,and the parameters obtained leftside cardiac pacing were lower than that of right ventricular pacing ( P < 0 0.5) ,there′s no significant difference in E/Vp .The vortex pattern ,distribution and vorticity at six typical phases induced by selective cardiac pacing were totally different from those at baseline with sinus rhythm ,and leftside pacing were worsen than RVAP ,the LVAP were most obvious .On multivariable regression analysis ,the VS during ES (VSES ) at baseline was independently related to late‐diastolic VS and longitudinal strain (R2 = 0 6.3 ,P < 0 0.01 and P=0 0.03 ,respectively) .Conclusions The selective cardiac pacing could induce intracardiac vortex changes and differ from that at baseline ,and the persistence of vortex from late diastole into ES is a haemodynamic measure of coupling between diastole and systole .%目的:应用超声血流向量成像(VFM)技术评价健康比格犬心脏不同位点起搏心动周期内左室流场涡旋分布、强度变化及心肌力学参数,探讨起搏状态下心腔内涡旋变化特征,为临床优化人工心脏起搏位点提供流体

  20. Temporary Cardiac Pacing Experiment in Self-Developed Intervention Treatment Shelter in Maneuver Environment%模拟野战条件,自主研制介入方舱内临时起搏实验

    Institute of Scientific and Technical Information of China (English)

    霍煜; 梁延春; 姚天明; 孙景阳; 梁卓; 韩雅玲

    2011-01-01

    Objective: To assess the feasibility and timeliness of emergency temporary cardiac pacing in self-developed intervention treatment shelter in maneuver environment.Methods:Five dogs were temporarily paced in the shelter,and we observe the time,success rates of the rescue procedure and copperation of the faculties.Results:Five dogs were all successfully paced by the common temporary overdriving endocardium pacing electrode.They all complete in eight minutes.there was no any complication like hcmatoma at siteofparacentesis,infection,thromboembolism,cardiac perforation in all dogs.Conclusions:The process of emergency temporary cardiac pacing in high-speed minimally invasive intervention treatment shelter in wild environment is safe,practical and fast.It may play an important role during emergency aid either in wartime or peacetime.%目的:研究模拟野战条件下在自主创新研制介入方舱内行临时起搏实验的可行性和时效性.方法:对5例正常狗在微创介入方舱内使用普通电极导管进行急诊心脏临时起搏模拟操作,观察该过程的时间,和操作效果,以及舱内人员的配合.结果:应用普通电极导管急诊心脏超速起搏5例全部成功,股静脉穿刺,无穿刺部位血肿、感染,血栓栓塞,心脏穿孔等并发症发生.时间在10分钟以内.结论:依托微创介入方舱,在野外恶劣条件下进行临时起搏的急救过程安全,实用,快捷.可用于战时以及非战争卫勤急救任务中,发挥重要作用.

  1. [The influence of cardiosurgical intervention type and conditions of artificial blood circulation of perioperative dynamics of cardiac biomarkers].

    Science.gov (United States)

    Dement'eva, I I; Morozov, Iu A; Charnaia, M A

    2013-01-01

    125 patients after cardiac surgery operated on with the use of artificial blood circulation (ABC) were followed-up. Blood levels of cardiac protein, binding aliphatic acids and troponin 1 and 3 days after the operation were registered. The study showed that aorta clamping more then 90 minutes and hypothermic perfusion regimen influence cardiomyocites negatively. The state of "surgical trauma" and reperfusional myocardium damage was approximately the same during aortic surgery, myocardium revascularization with the use of aortic clamping and cardioplegia, and correction of the acquired heart disease, according to the dynamics of the studied proteins in blood. The minimal blood level of cardiac protein, binding aliphatic acids after coronary by-pass surgery on the working heart witnesses about negative influence of crystalloid hypothermic cardioplegia on coronary microcirculation.

  2. Optogenetic pacing in Drosophila melanogaster (Conference Presentation)

    Science.gov (United States)

    Alex, Aneesh; Li, Airong; Men, Jing; Jerwick, Jason; Tanzi, Rudolph E.; Zhou, Chao

    2016-03-01

    A non-invasive, contact-less cardiac pacing technology can be a powerful tool in basic cardiac research and in clinics. Currently, electrical pacing is the gold standard for cardiac pacing. Although highly effective in controlling the cardiac function, the invasive nature, non-specificity to cardiac tissues and possible tissue damage limits its capabilities. Optical pacing of heart is a promising alternative, which is non-invasive and more specific, has high spatial and temporal precision, and avoids shortcomings in electrical stimulation. Optical coherence tomography has been proved to be an effective technique in non-invasive imaging in vivo with ultrahigh resolution and imaging speed. In the last several years, non-invasive specific optical pacing in animal hearts has been reported in quail, zebrafish, and rabbit models. However, Drosophila Melanogaster, which is a significant model with orthologs of 75% of human disease genes, has rarely been studied concerning their optical pacing in heart. Here, we combined optogenetic control of Drosophila heartbeat with optical coherence microscopy (OCM) technique for the first time. The light-gated cation channel, channelrhodopsin-2 (ChR2) was specifically expressed by transgene as a pacemaker in drosophila heart. By stimulating the pacemaker with 472 nm pulsed laser light at different frequencies, we achieved non-invasive and more specific optical control of the Drosophila heart rhythm, which demonstrates the wide potential of optical pacing for studying cardiac dynamics and development. Imaging capability of our customized OCM system was also involved to observe the pacing effect visually. No tissue damage was found after long exposure to laser pulses, which proved the safety of optogenetic control of Drosophila heart.

  3. The association between biventricular pacing and cardiac resynchronization therapy-defibrillator efficacy when compared with implantable cardioverter defibrillator on outcomes and reverse remodelling

    DEFF Research Database (Denmark)

    Ruwald, Anne-Christine; Kutyifa, Valentina; Ruwald, Martin H;

    2015-01-01

    : Using Kaplan-Meier plots, we estimated the threshold of BIV pacing percentage needed for CRT-D to be superior to ICD on the end-point of heart failure (HF) or death in 1219 left bundle branch block (LBBB) patients in the MADIT-CRT trial. Patients were censored at the time of crossover. In multivariable...

  4. Cardiac and Vascular Function in Bedrested Volunteers: Effects of Artificial Gravity Training

    Science.gov (United States)

    Meng, M.; Platts, S.; Stenger, M.; Diedrich, A.; Schlegel, T.; Natapoff, A.; Knapp, C.; Evans, J.

    2007-01-01

    Cardiovascular effects of an artificial gravity (AG) countermeasure on deconditioned male volunteers were studied. In two groups of men we measured cardiovascular parameters at rest and in response to 30 minutes of 80 deg. head up tilt (HUT) before, at the end of, and four days following 21 days of 6 deg. head down bed rest (HDBR). One group (N=7) underwent no countermeasure while the other (N=8) received a daily, one hour, dose (2.5 gz at the foot, decreasing to 1.0 gz at the heart) of AG training on the Johnson Space Center short radius centrifuge. Cardiovascular parameters measured included heart rate, blood pressure, stroke volume, cardiac output, peripheral vascular resistance, plasma volume shifts, and vasoactive hormones. Untrained subjects exhibited shorter tilt survival (on average 8 minutes shorter) compared to trained subjects. By the end of bed rest, mean heart rate (MHR) was elevated in both groups (both supine and during tilt). In addition, treated subjects demonstrated lower, tilt-induced, increases in MHR four days following HDBR, indicating a more rapid return to pre bed rest conditions. Results from an index of autonomic balance (percentage of MHR spectral power in the respiratory frequency range) in control of heart rate are consistent with the interpretation that parasympathetic nervous system withdrawal was responsible for both tilt- and bed rest-induced increases in MHR. Our data support our pre-study hypothesis that AG treatment would lessen cardiovascular effects of deconditioning in bed rested men and suggest that AG should be further pursued as a space flight countermeasure.

  5. Non-Cardiac Symptoms of Moderate to Severe Hypokalemia in a Patient with a Syncardia™ Total Artificial Heart.

    Science.gov (United States)

    Prasad, Amit; Ghodsizad, Ali; Pae, Walter; Singbartl, Kai; Boone, Jacqueline; Zeriouh, M; Ruhparwar, Arjang; Loebe, M; Khorrami, G Sadat Hoesseini; Koerner, Michael M; Brehm, Christoph

    2016-02-17

    The Syncardia™ total artificial heart (TAH) is an option for patients as a bridge to transplant in those who are not candidates for left ventricular assist devices (LVAD) due to right ventricular failure. Postoperative course is highly dependent on volume status and aggressive diuresis is often necessary. One complication from aggressive diuresis is hypokalemia; however, in these patients we tolerate a lower potassium level because cardiac arrhythmias are not a concern.  However, in two separate instances non-cardiac symptoms related to severe hypokalemia occurred. These symptoms included nystagmus in one patient and agitation, tremors, and having an "out-of-body" experience in the other patient. Both these patients had resolution of symptoms with potassium replacement.

  6. Study on Apoptosis and Expression of P53, Bcl-2, Bax in Cardiac Myocytys of Congestive Heart Failure Induced by Ventricular Pacing

    Institute of Scientific and Technical Information of China (English)

    QI; Benling; CAO; Linsheng; WANG; Lin; ZHOU; Jingqun

    2001-01-01

    The apoptosis and the expression of p53, bcl-2 and Bax in myocytes of chronic rapid ventricular pacing-induced congestive heart failure (CHF) in rabbits were investigated. The CHF rabbit model (P, n= 7) was established by chronic rapid ventricular pacing for 3 weeks. By using TUNEL technique the apoptosis in the myocytes in the rabbit model was studied and the expression of p53,bcl-2 and Bax in myocytes was detected by using immunohistochemical method. Sham-operated (C,n = 9) group served as control group. The results showed that there were about 4033± 884.56 apoptotic cells/106 myocytes in P group, but no apoptotic cells were found in C group. Myocytes positive for p53 immunoreactivity (18. 86±8. 48 vs 5. 06±0. 87, P<0.01) and positive for Bax immunoreactivity (7. 15±1.91 vs 0. 43±0. 09, P<0.01) were increased in P group as compared with those in C group, while the myocytes positive for bcl-2 immunoreactivity (7. 08±1.05 vs 14. 97±4.47,P<0. 01) and the ratio of bcl-2/Bax were decreased in P group as compared with those in C group.Apoptosis was involved in the development of CHF induced by continuously rapid ventricular pacing in rabbit. The expression of p53 and Bax was increased, while the expression of bcl-2 was inhibited.These might play an important role in the acceleration of the apoptosis.

  7. Effect of right ventricular outflow tract pacing and right ventricular apex pacing on cardiac function by tissue Doppler imaging%组织多普勒成像评价右心室心尖部与右心室流出道间隔部起搏对心功能的影响

    Institute of Scientific and Technical Information of China (English)

    卜婕; 俞杉; 吴强; 安亚平

    2011-01-01

    Objective To explore the effects of right ventricular apex(RVA) pacing and right ventricular outflow tract (RVOT) pacing on cardiac function using tissue Doppler imaging technique.Methods 65 lentitude arrhythmia patients were randomly divided into RVA pacing group ( n =30), RVOT pacing group ( n =35).Before the pacemaker implantation, after 1 month, 3 months, 6 months and 12 months respectively, early diastolic mitral annulus velocity(E a), systolic velocity (Sa), Tel index were measured by tissue velocity-time curve; left ventricular ejection fraction(LVEF) was measured by SIMPSON method; mitral early diastolic peak velocity(E) was measured by pulsed Doppler,E,E and Ea ratio (E/Ea) were calculated.Results RVA and RVOT both groups before and after 1,3 months,all the indicators were not statistically significant.After 1, 3 months in the above two groups, LVEF was respectively(61.8913.37) % vs(61.51±3.11)% ,(60.22±4.85)% vs(60.32±4.25) % ,Sa (11.38± 1.14) cm/s vs (11.44±2.14) cm/s,(10.88±1.91) cm/s vs (11.02± 1.31) cm/s, E/A 0.96±0.19 vs 0.97± 0.23,0.95±0.15 vs 0.96±0.13,E/Ea 8.8±3.6 vs 8.4±4.3,9.1±4.3 vs 8.8±3.2,Tei index 0.48±0.05 vs 0.47±0.08,0.50±0.20 vs 0.47±0.11(all P >0.05).After 6 months,RVA pacing and RVOT pacing compared with tissue Doppler indexes,Tel index and E/Ea increased 0.76±0.26 vs 0.67 ± 0.32, 10.9 ± 3.96 vs 9.0 ± 2.8, all P < 0.05), after 12 months, Sa decreased, (8.22 ± 1.72) cm/s vs (9.52± 2.56) cm/s( P <0.05).Conclusion RVA pacing induced heart contractions are not synchronized to the detriment of left ventricular systolic and diastolic function.RVOT septai pacing obtains more optimal parameters of heart function than RVA pacing,and RVOT septal pacing is a good right ventricular pacing site.%目的 运用组织多普勒成像技术(TDI)比较右心室流出道(RVOT)间隔部起搏和右心室心尖部(RVA)起搏对心功能的影响.方法 将缓慢心律失常患者65例随机分为RVA起搏组(n=30)

  8. Sensing and stimulation of the vagus nerve for artificial cardiac control

    NARCIS (Netherlands)

    Ordelman, Simone Cornelia Maria Anna

    2012-01-01

    This thesis focuses on sensing cardiovascular signals from the vagus nerve and electrically stimulating the vagus nerve for cardiovascular effects. Sensing cardiovascular signals was attempted on both spontaneous and evoked neural activity. A cardiac-modulated vagus nerve activity pattern was found

  9. Effects of VAT and DDD pacing on left cardiac function in the patients of high right ventricular septal pacing with third degree atrioventricular block%Ⅲ度房室传导阻滞患者高位右室间隔部起搏VAT与DDD模式对左心功能的影响

    Institute of Scientific and Technical Information of China (English)

    王燕; 章蓉; 王旭; 邵一兵

    2012-01-01

    目的 通过研究Ⅲ度房室传导阻滞患者高位右室间隔部起搏( HRVS)时,VAT与DDD模式对心功能的影响,探讨心房的生理收缩和舒张对左心功能的作用.方法 32例Ⅲ度房室传导阻滞患者,在HRVS时,分别给予DDD模式或VAT模式工作,于调控即刻通过超声心动图测定二尖瓣口快速充盈期峰值血流速度(Ep),二尖瓣口左房收缩期峰值血流速度(Ap),二尖瓣环后壁处收缩期脉冲组织多普勒峰值速度平均值(Vs),二尖瓣环后壁处舒张早期脉冲组织多普勒峰值速度平均值(Ve),二尖瓣环后壁处舒张晚期脉冲组织多普勒峰值速度平均值(Va),二尖瓣血流频谱等容舒张时间(IVRT),通过Ep/Ap,Ve/Va,Ep/Ve和IVRT评价左室舒张功能,通过Vs,LVEF和LVFS评价收缩功能.结果 HRVS时DDD较VAT模式Ep/Ap、Ve/Va、Ep/Ve,IVRT差异有显著性(0.97 ±0.11 vs 1.01±0.11,0.89 ±0.09 vs 0.97 ±0.07,6.00 ±0.45 vs 6.24 ±0.36,100.4±14.32 vs 89.99 ±7.94;P均<0.01),Vs、左室射血分数和左室短轴缩短率无显著性差异.结论 Ⅲ度房室传导阻滞时,HRVS起搏时,DDD模式较VAT模式使左室舒张功能下降,收缩功能无影响,表明了心房生理性起搏的重要性.%Objective To analyze the effects of physiologic systole and diastole of atrium, through the influence of VAT and DDD pacing mode on left cardiac function in patients of high right ventricular septal( HRVS) pacing with third degree atrioventricular block. Methods Thirty-two patients of HRVS pacing with third degree atrioventricular block with pacemaker mode of VAT or DDD underwent complete standard echocardiography (2D,M-mode, pulsed Doppler) and PW-DTI. Transmitral inflow velocity Ep and Ap, peak systolic velocity ( Vs ) , peak early diastolic velocity ( Ve) , peak late diastolic velocity (Va) of posterior mitral annulus and the isovolumic relaxation time(IVRT) were obtained . Then left ventricular diastolic function were evaluated through Ep/Ap, Ve/Va and Ep

  10. Indeterminacy of Spatiotemporal Cardiac Alternans

    CERN Document Server

    Zhao, Xiaopeng

    2007-01-01

    Cardiac alternans, a beat-to-beat alternation in action potential duration (at the cellular level) or in ECG morphology (at the whole heart level), is a marker of ventricular fibrillation, a fatal heart rhythm that kills hundreds of thousands of people in the US each year. Investigating cardiac alternans may lead to a better understanding of the mechanisms of cardiac arrhythmias and eventually better algorithms for the prediction and prevention of such dreadful diseases. In paced cardiac tissue, alternans develops under increasingly shorter pacing period. Existing experimental and theoretical studies adopt the assumption that alternans in homogeneous cardiac tissue is exclusively determined by the pacing period. In contrast, we find that, when calcium-driven alternans develops in cardiac fibers, it may take different spatiotemporal patterns depending on the pacing history. Because there coexist multiple alternans solutions for a given pacing period, the alternans pattern on a fiber becomes unpredictable. Usin...

  11. Artificial intelligence in medicine and cardiac imaging: harnessing big data and advanced computing to provide personalized medical diagnosis and treatment.

    Science.gov (United States)

    Dilsizian, Steven E; Siegel, Eliot L

    2014-01-01

    Although advances in information technology in the past decade have come in quantum leaps in nearly every aspect of our lives, they seem to be coming at a slower pace in the field of medicine. However, the implementation of electronic health records (EHR) in hospitals is increasing rapidly, accelerated by the meaningful use initiatives associated with the Center for Medicare & Medicaid Services EHR Incentive Programs. The transition to electronic medical records and availability of patient data has been associated with increases in the volume and complexity of patient information, as well as an increase in medical alerts, with resulting "alert fatigue" and increased expectations for rapid and accurate diagnosis and treatment. Unfortunately, these increased demands on health care providers create greater risk for diagnostic and therapeutic errors. In the near future, artificial intelligence (AI)/machine learning will likely assist physicians with differential diagnosis of disease, treatment options suggestions, and recommendations, and, in the case of medical imaging, with cues in image interpretation. Mining and advanced analysis of "big data" in health care provide the potential not only to perform "in silico" research but also to provide "real time" diagnostic and (potentially) therapeutic recommendations based on empirical data. "On demand" access to high-performance computing and large health care databases will support and sustain our ability to achieve personalized medicine. The IBM Jeopardy! Challenge, which pitted the best all-time human players against the Watson computer, captured the imagination of millions of people across the world and demonstrated the potential to apply AI approaches to a wide variety of subject matter, including medicine. The combination of AI, big data, and massively parallel computing offers the potential to create a revolutionary way of practicing evidence-based, personalized medicine.

  12. Self-Paced Fortran.

    Science.gov (United States)

    Burnett, James

    1979-01-01

    This paper describes the instructional format of the lecture and the self-paced methods of teaching FORTRAN at Michigan State University and compares end-of-term grades of students taking a second computer science course based on whether they took the first course in the self-paced or the traditional lecture format. (Author/BB)

  13. 心脏起搏患者术前社会心理状况及其影响因素%Investigation of sociopsychological status and its influence factors in cardiac-pacing patients

    Institute of Scientific and Technical Information of China (English)

    杨海涛; 刘茜倩; 李思特; 祁述善; 沈向前; 金淑莲

    2004-01-01

    Objective: To investigate the sociopsychological status and its related influence factors.Method: SCL-90 (Symptom Checklist 90) was used for evaluating the psychological status of the patients. The total factors score >160 or the single factor score >2 suggested the patient has psychological problem. SAS (Self-Rating Anxiety Scale), SDS (Self-Rating Depression Scale) and SSRS (Social Support Scale) were used for rating the situation in anxiety, depression and social-supporting respectively. The scores in anxiety, depression and social- supporting of cadiac-pacing patients were compared respectively with those of the control.Result: The SCL-90 showed the 125 cardiac-pacing patients had serious psychological problems in five factors: anxiety (60 patients), somatization (57 patients), phobic anxiety (38 patients), depression (55 patients), interpersonal sensitivity (34 patients). All of the factors scores were respectively significant higher than those of the corresponding normal (P <0.01). The scores of SAS and SDS of the patients were also significantly higher than those of the control (P <0.01). However the score of SSRS was significantly lower than that of the control (P<0.01). Multistep regressive analysis showed the income, the severity of the disease, the interpersonal relation and the living of the family were markedly related to the total score of the SCL-90. Conclusion: Cardiac-pacing patients have obvious psychological problems in anxiety, somatization, phobic anxiety, depression,interpersonal sensitivity and social supporting. The income, the severity of the disease, the interpersonal relation and the living of the family were markedly related to the psychological status.%目的了解心脏起搏患者术前社会心理状况及其影响因素.方法采用症状自评量表(SCL-90)、焦虑自评量表(SAS)、抑郁自评量表(SDS)、社会支持评定量表(SSRS)评价125例心脏起搏患者心脏起搏术前社会、心理状况及其影响

  14. Pacing for Dramaturgy

    OpenAIRE

    Pensjö, Jonas

    2014-01-01

    This thesis is a study on how game mechanics affect dramaturgy through pacing within the multiplayer MOBA genre of video games and serves as an addition to ease dramaturgic design for future games. The thesis contains an introduction of drama and some of related terms in addition to the MOBA game genre, its format and a short history of the genre. To compare the observations and analysis made in this study, previous work on both dramaturgy and pacing have been recollected.

  15. Pacing stress echocardiography

    Directory of Open Access Journals (Sweden)

    Agrusta Marco

    2005-12-01

    Full Text Available Abstract Background High-rate pacing is a valid stress test to be used in conjunction with echocardiography; it is independent of physical exercise and does not require drug administration. There are two main applications of pacing stress in the echo lab: the noninvasive detection of coronary artery disease through induction of a regional transient dysfunction; and the assessment of contractile reserve through peak systolic pressure/ end-systolic volume relationship at increasing heart rates to assess global left ventricular contractility. Methods The pathophysiologic rationale of pacing stress for noninvasive detection of coronary artery disease is obvious, with the stress determined by a controlled increase in heart rate, which is a major determinant of myocardial oxygen demand, and thereby tachycardia may exceed a fixed coronary flow reserve in the presence of hemodynamically significant coronary artery disease. The use of pacing stress echo to assess left ventricular contractile reserve is less established, but promising. Positive inotropic interventions are mirrored by smaller end-systolic volumes and higher end-systolic pressures. An increased heart rate progressively increases the force of ventricular contraction (Bowditch treppe or staircase phenomenon. To build the force-frequency relationship, the force is determined at different heart rate steps as the ratio of the systolic pressure (cuff sphygmomanometer/end-systolic volume index (biplane Simpson rule. The heart rate is determined from ECG. Conclusion Two-dimensional echocardiography during pacing is a useful tool in the detection of coronary artery disease. Because of its safety and ease of repeatability noninvasive pacing stress echo can be the first-line stress test in patients with permanent pacemaker. The force-frequency can be defined as up- sloping (normal when the peak stress pacing systolic pressure/end-systolic volume index is higher than baseline and intermediate stress

  16. PACE Status Update

    Energy Technology Data Exchange (ETDEWEB)

    M., Zimring,; Hoffman, I.; Fuller, M.

    2010-08-11

    The Federal Housing Finance Agency (FHFA) regulates Fannie Mae, Freddie Mac, and the 12 Federal Home Loan Banks (the government-sponsored enterprises - GSEs). On July 6, 2010, FHFA and the Office of the Comptroller of the Currency (OCC) concluded that Property Assessed Clean Energy (PACE) programs 'present significant safety and soundness concerns' to the housing finance industry. This statement came after a year of discussions with state and federal agencies in which PACE, a novel mechanism for financing energy efficiency and renewable energy improvements, has gone from receiving support from the White House, canonization as one of Scientific American's 'World Changing Ideas' and legislative adoption in 24 states to questionable relevance, at least in the residential sector. Whether PACE resumes its expansion as an innovative tool for financing energy efficiency and clean generation depends on outcomes in each of the three branches of government - discussions on a PACE pilot phase among federal agencies, litigation in federal court, and legislation in Congress - all highly uncertain. This policy brief addresses the practical impacts of these possible outcomes on existing and emerging PACE programs across the United States and potential paths forward.

  17. Effect of atrial pacing therapy with selective pacing algorithms on paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    潘晓宏; 张雪华; 徐耕; 傅国胜; 单江

    2004-01-01

    @@ Atrial fibrillation (AF) is the most common cardiac arrhythmia among the elderly. Its incidence increases dramatically with increasing age and decreasing left ventricular function, peaking in subjects with overt congestive heart failure.1 Because of the unsatisfactory efficacy and possible serious side effects of clinically available anti-AF drugs for AF patients with sick sinus syndrome, pacing techniques have recently been applied in the treatment of AF. The cardiac pacemaker Vitatron Selection 900E has special AF diagnostic and prophylactic therapy algorithms. The objective of this study was to use the diagnostic information concerning the onset mechanisms of AF to program the preventive pacing algorithms for each patient individually and to find out whether a reduction in AF burden could be achieved.

  18. Graybar – pace project

    OpenAIRE

    Morillo Peres, Xavier

    2014-01-01

    Proyecto Final de Carrera en el se presenta una memoria del trabajo realizado en la empresa Graybar de implantación de un sistema de Gestión de la Cadena de Suministro Mètodes basat en investigació operativa per agilitzar la logística interna d´industries Graybar.Projecte PACE

  19. Classification of Atrial Septal Defect and Ventricular Septal Defect with Documented Hemodynamic Parameters via Cardiac Catheterization by Genetic Algorithms and Multi-Layered Artificial Neural Network

    Directory of Open Access Journals (Sweden)

    Mustafa Yıldız

    2012-08-01

    Full Text Available Introduction: We aimed to develop a classification method to discriminate ventricular septal defect and atrial septal defect by using severalhemodynamic parameters.Patients and Methods: Forty three patients (30 atrial septal defect, 13 ventricular septal defect; 26 female, 17 male with documentedhemodynamic parameters via cardiac catheterization are included to study. Such parameters as blood pressure values of different areas,gender, age and Qp/Qs ratios are used for classification. Parameters, we used in classification are determined by divergence analysismethod. Those parameters are; i pulmonary artery diastolic pressure, ii Qp/Qs ratio, iii right atrium pressure, iv age, v pulmonary arterysystolic pressure, vi left ventricular sistolic pressure, vii aorta mean pressure, viii left ventricular diastolic pressure, ix aorta diastolicpressure, x aorta systolic pressure. Those parameters detected from our study population, are uploaded to multi-layered artificial neuralnetwork and the network was trained by genetic algorithm.Results: Trained cluster consists of 14 factors (7 atrial septal defect and 7 ventricular septal defect. Overall success ratio is 79.2%, andwith a proper instruction of artificial neural network this ratio increases up to 89%.Conclusion: Parameters, belonging to artificial neural network, which are needed to be detected by the investigator in classical methods,can easily be detected with the help of genetic algorithms. During the instruction of artificial neural network by genetic algorithms, boththe topology of network and factors of network can be determined. During the test stage, elements, not included in instruction cluster, areassumed as in test cluster, and as a result of this study, we observed that multi-layered artificial neural network can be instructed properly,and neural network is a successful method for aimed classification.

  20. TCP Pacing Developed

    Science.gov (United States)

    Ivancic, William D.

    2002-01-01

    Transmission control protocol (TCP) was conceived and designed to run over a variety of communication links, including wireless and high-bandwidth links. However, with recent technological advances in satellite and fiber-optic networks, researchers are reevaluating the flexibility of TCP. The TCP pacing and packet pair probing implementation may help overcome two of the major obstacles identified for efficient bandwidth utilization over communication links with large delay-bandwidth products.

  1. Evaluation of the effects of transvenous pacing site on left ventricular function and synchrony in healthy anesthetized dogs.

    Science.gov (United States)

    Maisenbacher, Herbert W; Estrada, Amara H; Prosek, Robert; Shih, Andre C; Vangilder, James M

    2009-04-01

    OBJECTIVE-To compare the acute effects of cardiac pacing from various transvenous pacing sites on left ventricular (LV) function and synchrony in clinically normal dogs. ANIMALS-10 healthy adult mixed-breed dogs. PROCEDURES-Dogs were anesthetized, and dual-chamber transvenous biventricular pacing systems were implanted. Dogs were paced in single-chamber mode from the right atrial appendage (RAA) alone and in dual-chamber mode from the right ventricular apex (RVA), from the left ventricular free wall (LVFW), and simultaneously from the RVA and LVFW (BiV). Standard ECG and echocardiographic measurements, cardiac output measured with the lithium dilution method (LiDCO), and tissue Doppler-derived measurements of LV synchrony were obtained during each of the pacing configurations. RESULTS-Placement of the biventricular pacing systems was possible in 8 of the 10 dogs. The QRS duration was significantly different among all pacing sites, and the order of increasing duration was RAA, BiV, LVFW, and RVA. Pacing sites did not differ with respect to fractional shortening; however, pacing from the RVA resulted in a significantly lower ejection fraction than pacing from all other sites. During RVA and LVFW pacing, LiDCO was significantly lower than that at other sites; there was no significant difference between RAA and BiV pacing with respect to LiDCO. Although the degree of dyssynchrony was significantly lower during pacing from the RAA versus other ventricular pacing sites, it was not significantly different among sites. CONCLUSIONS AND CLINICAL RELEVANCE-Ventricular activation by RAA pacing provided the best LV function and synchrony. Pacing from the RVA worsened LV function, and although pacing from the LVFW improved it, BiV pacing may provide additional improvement.

  2. Hemodynamic improvement by right ventricular septal pacing in elderly patients with chronic atrial fibrillation and slow ventricular response

    Institute of Scientific and Technical Information of China (English)

    Wei HUA; Shidong GUO; Shu ZHANG; Fangzheng WANG; Lida ZHI; Hongxia NIU; Xin CHEN

    2005-01-01

    Background and objectives Right ventricular apical (RVA) pacing has been reported impairing left ventricular (LV)performance. Alternative pacing sites in right ventricle (RV) has been explored to obtain better cardiac function. Our study was designed to compare the hemodynamic effects of right ventricular septal (RVS) pacing with RVA pacing. Methods Ten elderly patients with chronic atrial fibrillation (AF) and long RR interval or slow ventricular response (VR) received VVI pacing. The hemodynamic difference between RVS and RVA pacing were examined by transthoracic echocardiography (TTE). Results Pacing leads were implanted successfully at the RVA and then RVS in all patients without complication. The left ventricular (LV) parameters,measured during RVA pacing including left ventricular ejection fraction (LVEF), FS, stroke volume (SV) and peak E wave velocity (EV) were decreased significantly compared to baseline data, while during RVS pacing, they were significantly better than those during RVA pacing. However, after 3-6 weeks there was no statistical significant difference between pre- and post- RVS pacing.Conclusions The LV hemodynamic parameters during RVA pacing were significantly worse than baseline data. The short term LV hemodynamic parameters of RVS pacing were significantly better than those of RVA pacing; RVS pacing could improve the hemodynamic effect through maintaining normal ventricular activation sequence and biventricular contraction synchrony in patients with chronic AF and slow ventricular response.

  3. Using noise to determine cardiac restitution with memory

    Science.gov (United States)

    Dai, Shu; Keener, James P.

    2012-06-01

    Variation in cardiac pacing cycles, as seen, for example, in heart rate variability, has been observed for decades. Contemporarily, various mathematical models have been constructed to investigate the electrical activity of paced cardiac cells. Yet there has not been a study of these cardiac models when there is variation in the pacing cycles such as noise. We present a method that uses the stochasticity of pacing cycles to determine approximate models of the dynamics of cardiac cells, and use these models to detect bifurcations to alternans.

  4. 右心室心尖部与间隔部起搏对患者心功能的远期影响%Comparison of long-term effects on cardiac function of right ventricular septal pacing versus right ventricular apical pacing

    Institute of Scientific and Technical Information of China (English)

    彭珍云; 向力群; 曾向辉; 张良; 钟常青; 刘振芳; 张翼

    2013-01-01

    目的 探讨右心室心尖部与间隔部起搏对长期起搏依赖患者心功能的远期影响.方法 入选在湖南师范大学第一附属医院就诊并行双腔起搏器植入术的Ⅲ度房室传导阻滞108例,据心室电极固定部位分为间隔部起搏组(RVS组,57例)及心尖部起搏组(RVA组,51例);比较两组患者术前与术后3年血清氨基末端脑钠肽前体(NT-proBNP)浓度及左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)变化、左心房大小(LA)及心电图Ⅱ导联QRS波时程变化.对NT-proBNP水平与LA及QRS波时程进行直线相关分析.结果 术前NT-proBNP浓度、QRS波时程及LA大小两组间差异无统计学意义(P>0.05).术后两组患者NT-proBNP浓度、QRS波时程及LA大小均较术前明显增大,差异有统计学意义(P<0.05),但心尖部起搏组各观察指标值上升幅度较大.RVA组与RVS组比较显示,NT-proBNP浓度升高更明显[(367.4±38.5) pg/ml比(210.4±36.7)pg/ml,P<0.05];QRS波时程延长[(0.192 ±0.042)s比(0.151 ±0.091)s,P<0.05];LA明显扩大[(32.9±4.1) mm比(28.9±4.2)mm,P<0.05].组内及组间比较,LVEF及LVEDD差异均无统计学意义.双变量直线相关分析显示,NT-proBNP与QRS波时程呈直线正相关(r=0.701);与LA大小呈直线正相关(r=0.671).结论 心尖部起搏易引起心室收缩失同步及左心房不良重构,间隔部起搏更接近生理性起搏,是相对理想的起搏部位.%Objective To investigate and compare the efficiency of right ventricular apical pacing (RVA) with right ventricular septal pacing (RVS).Methods A total of one hundred and eight consecutive patients with Ⅲ ° atrio-ventricular block (Ⅲ° AVB) and normal ejection fraction undergoing dual-chamber pacemaker implantation were randomly divided into right ventricular apical pacing group (RVA,n =51) and right ventricular septal pacing group (RVS,n =57) according to the pacing electrode's position in the right ventricular apex.At baseline

  5. Improvement of pacing induced regional myocardial ischemia by Solcoseryl in conscious dogs with coronary stenosis.

    Science.gov (United States)

    Shimada, T; Sasayama, S; Takahashi, M; Osakada, G; Kawai, C

    1984-02-01

    The effects of Solcoseryl on regional myocardial function were studied in 5 conscious dogs with partial coronary constriction, in which temporary ischemia was induced by rapid cardiac pacing. During the coronary artery constriction, the percent shortening of the ischemic segment decreased by 9%. When the heart rate was increased by pacing, the percent shortening of the ischemic segments was further reduced by 57%. On cessation of cardiac pacing, the early potentiation of dP/dt and of control segment shortening became evident and was followed by exponential decay in the subsequent several beats. In the ischemic segment, the percent shortening was significantly improved in the first post-pacing beat but was more severely depressed at five seconds. Thirty minutes after administration of Solcoseryl, the cardiac pacing was repeated in the same manner but the pacing-induced hypokinesia of the ischemic segment were less marked, the percent shortening being at an average of 9.1% during control pacing and 12.7% during the second pacing after Solcoseryl (p less than 0.05). Postpacing deterioration of the ischemic segment shortening was also significantly improved from 9.8 to 11.8% at 5 seconds (p less than 0.05). These findings indicate that Solcoseryl exerts protective effects on the ischemic myocardium by promoting a rapid recovery from ischemia, probably due to the improvement of oxygen utility through activated cellular respiration.

  6. Chronic activation of peroxisome proliferator-activated receptor-alpha with fenofibrate prevents alterations in cardiac metabolic phenotype without changing the onset of decompensation in pacing-induced heart failure

    Science.gov (United States)

    Severe heart failure (HF) is characterized by profound alterations in cardiac metabolic phenotype, with down-regulation of the free fatty acid (FFA) oxidative pathway and marked increase in glucose oxidation. We tested whether fenofibrate, a pharmacological agonist of peroxisome proliferator-activat...

  7. Marathon pacing and elevation change

    CERN Document Server

    Elliott, J B

    2012-01-01

    An analysis of marathon pacing and elevation change is presented. It is based on an empirical observation of how the pace of elite and non-elite marathon runners change over the course of the marathon and a simple approximation of the energy cost of ascent and decent. It was observed that the pace of the runners slowed in a regular manner that could be broken up into four regions. That observation can be used to project target paces for a desired marathon finish time. However, that estimate fails to take in to account the energetic costs of elevation changes (hills) along the marathon course. Several approximations are made to give a coarse estimate of target paces for marathon run on courses with significant elevation changes, i.e. a hilly course. The 2012 Oakland Marathon course is used as and example of a hilly course and the times of 23 finishers are examined.

  8. Factors influencing pacing in triathlon.

    Science.gov (United States)

    Wu, Sam Sx; Peiffer, Jeremiah J; Brisswalter, Jeanick; Nosaka, Kazunori; Abbiss, Chris R

    2014-01-01

    Triathlon is a multisport event consisting of sequential swim, cycle, and run disciplines performed over a variety of distances. This complex and unique sport requires athletes to appropriately distribute their speed or energy expenditure (ie, pacing) within each discipline as well as over the entire event. As with most physical activity, the regulation of pacing in triathlon may be influenced by a multitude of intrinsic and extrinsic factors. The majority of current research focuses mainly on the Olympic distance, whilst much less literature is available on other triathlon distances such as the sprint, half-Ironman, and Ironman distances. Furthermore, little is understood regarding the specific physiological, environmental, and interdisciplinary effects on pacing. Therefore, this article discusses the pacing strategies observed in triathlon across different distances, and elucidates the possible factors influencing pacing within the three specific disciplines of a triathlon.

  9. Multimodality imaging to guide cardiac interventional procedures

    NARCIS (Netherlands)

    Tops, Laurens Franciscus

    2010-01-01

    In recent years, a number of new cardiac interventional procedures have been introduced. Catheter ablation procedures for atrial fibrillation (AF) have been refined and are now considered a good treatment option in patients with drug-refractory AF. In cardiac pacing, cardiac resynchronization therap

  10. ECG Database Applicable for Development and Testing of Pace Detection Algorithms

    Directory of Open Access Journals (Sweden)

    Irena Jekova

    2014-12-01

    Full Text Available This paper presents an ECG database, named 'PacedECGdb' (available at http://biomed.bas.bg/bioautomation/2014/vol_18.4/files/PacedECGdb.zip, which contains different arrhythmias generated by HKP (Heidelberger Praxisklinik simulator, combined with artificially superimposed pacing pulses that cover the wide ranges of rising edge (from <10 µs to 100 µs and total pulse durations (from 100 µs to 2 ms and correspond to various pacemaker modes. It involves a total number of 1404 recordings - 780 representing 'pure' ECG with pacing pulses and 624 that comprise paced ECGs corrupted by tremor. The signals are recorded with 9.81 µV/LSB amplitude resolution at 128 kHz sampling rate in order to preserve the steep raising and trailing edges of the pace pulses. To the best of our knowledge, 'PacedECGdb' is the first publicly available paced ECG database. It could be used for development and testing of methods for pace detection in the ECG. The existence of ECGs corrupted by tremor (the only physiological noise that could compromise the methods for pacing pulses detection is an advantage, since such signals could be applied to define the signal-to-noise level for correct operation of the algorithm, or for improvement of the noise immunity of a method that is under development. The open access of the database makes it suitable for comparative studies including different algorithms.

  11. Nursing of the dilated cardiomyopathy complicated with malignant arrhythmia patients treated with cardiac resynchronization pacing defibrillator%经心脏再同步化起搏除颤器治疗扩张型心肌病伴恶性心律失常患者的护理研究

    Institute of Scientific and Technical Information of China (English)

    吴晓英

    2015-01-01

    Objective:To investigate the nursing method and effects in the dilated cardiomyopathy complicated with malignant arrhythmia patients treated with cardiac resynchronization pacing defibrillator. Methods:Ninety patients with the dilated cardiomyopathy complicated with malignant arrhythmia treated with cardiac resynchronization pacing defibrillator were randomly divided into the control group(treatment with routine care) and observation group(treatment with nursing intervention)(45 cases each group). The quality of life in two groups was evaluated by WHO quality of life scale(WHOQOL-BREF) before and after treatment. The changes of clinical indicators,treatment effect, heart function classification, postoperative adverse events and satisfaction were compared between two groups. Results:The LVEF,6 min walking distance,WHOQOL-BREF score(including physical field,psychological field,social field and environment field) in two groups after treatment were significantly higher than those in before treatment(P0. 05). Conclusions:When the patients with dilated cardiomyopathy complicated with malignant arrhythmia are treated with cardiac resynchronization pacing defibrillator,the effective nursing intervention can significantly improve heart function and quality of life.%目的::探讨心脏再同步化起搏除颤器治疗扩张型心肌病伴恶性心律失常的护理方法及其效果。方法:将行心脏再同步化起搏除颤器治疗的扩张型心肌病伴恶性心律失常患者90例,随机分为对照组(常规护理)和观察组(护理干预)各45例。采用世界卫生组织生存质量测定量表( WHOQOL-BREF)评价2组患者治疗前后的生存质量,比较2组患者临床指标改变情况、疗效、心功能分级、术后不良事件发生情况和护理满意度。结果:2组患者治疗后左心室射血分数、6 min 步行距离、WHOQOL-BREF评分(生理领域、心理领域、社会领域、环境领域)均显著增加(P0.05)。结论:扩

  12. Predicting the physiological response of Tivela stultorum hearts with digoxin from cardiac parameters using artificial neural networks.

    Science.gov (United States)

    Flores, Dora-Luz; Gómez, Claudia; Cervantes, David; Abaroa, Alberto; Castro, Carlos; Castañeda-Martínez, Rubén A

    2017-01-01

    Multi-layer perceptron artificial neural networks (MLP-ANNs) were used to predict the concentration of digoxin needed to obtain a cardio-activity of specific biophysical parameters in Tivela stultorum hearts. The inputs of the neural networks were the minimum and maximum values of heart contraction force, the time of ventricular filling, the volume used for dilution, heart rate and weight, volume, length and width of the heart, while the output was the digoxin concentration in dilution necessary to obtain a desired physiological response. ANNs were trained, validated and tested with the dataset of the in vivo experiment results. To select the optimal network, predictions for all the dataset for each configuration of ANNs were made, a maximum 5% relative error for the digoxin concentration was set and the diagnostic accuracy of the predictions made was evaluated. The double-layer perceptron had a barely higher performance than the single-layer perceptron; therefore, both had a good predictive ability. The double-layer perceptron was able to obtain the most accurate predictions of digoxin concentration required in the hearts of T. stultorum using MLP-ANNs.

  13. Factors influencing pacing in triathlon

    Directory of Open Access Journals (Sweden)

    Wu SSX

    2014-09-01

    Full Text Available Sam SX Wu,1 Jeremiah J Peiffer,2 Jeanick Brisswalter,3 Kazunori Nosaka,1 Chris R Abbiss1 1Centre for Exercise and Sports Science Research, School of Exercise and Health Sciences, Edith Cowan University, Perth, WA, Australia; 2School of Psychology and Exercise Science, Murdoch University, Perth, WA, Australia; 3Laboratory of Human Motricity, Education Sport and Health, University of Nice Sophia Antipolis, Nice, France Abstract: Triathlon is a multisport event consisting of sequential swim, cycle, and run disciplines performed over a variety of distances. This complex and unique sport requires athletes to appropriately distribute their speed or energy expenditure (ie, pacing within each discipline as well as over the entire event. As with most physical activity, the regulation of pacing in triathlon may be influenced by a multitude of intrinsic and extrinsic factors. The majority of current research focuses mainly on the Olympic distance, whilst much less literature is available on other triathlon distances such as the sprint, half-Ironman, and Ironman distances. Furthermore, little is understood regarding the specific physiological, environmental, and interdisciplinary effects on pacing. Therefore, this article discusses the pacing strategies observed in triathlon across different distances, and elucidates the possible factors influencing pacing within the three specific disciplines of a triathlon. Keywords: cycle, endurance, multisport, pacing strategy, run, swim

  14. Experiência brasileira com uso de marcapasso cardíaco artificial: resultados atuais obtidos pelo Registro Brasileiro de Marcapassos - RBM Brazilian permanent cardiac pacemaker implantation experience: results obtained from the Brazilian Pacemaker Register's data

    Directory of Open Access Journals (Sweden)

    Roberto Costa

    1995-06-01

    Estimulação Cardíaca Artificial (DECA, com o apoio das empresas fornecedoras de marcapasso, e o respaldo do Ministério da Saúde permitiram que a implantação do RBM ocorresse da forma mais tranqüila possível. Hoje se dispõe de uma estatística nacional, volumosa e confiável, sobre a cirurgia de marcapasso no Brasil. As dificuldades enfrentadas estão relacionadas, principalmente, à estrutura individual de coleta de dados e a graus variados de familiaridade com o formulário, dificuldades estas que, com o tempo, tenderão a desaparecer.BACKGROUND: Brazilian Pacemaker Registry (RBM is a nationwide database to collect informations about all permanent pacemaker procedures performed in Brazil. It is a task force composed by Medical Society, Health Ministeryand Pacemaker Companies. OBJECTIVE: To report the data obtained from June to December, 1994. METHODS: From June 1 st to December 31,1994,4696 surgical procedures for permanent cardiac pacing were informed. These procedures were 3403 (72,5% initial implantations, 1053 (22.4% re-operations and in 240 cases this information was non-available. RESULTS: From 3403 initial implantations informed, 52.8% were males and 73.7% Caucasians. Preoperative dizziness or syncopes were refered in 76.4% and congestive heart failure in 85.0% of the patients. EKG evaluation showed 3rd degree atrioventricular (AV block in 57.7%, sick sinus syndrome in 13.9%, 2nd degree AV block in 13.8%, and high degree AV block and flutter or atrial fibrillation in 6.6% of patients. Chaga's disease was the prédominât ethiology (30.4%. Ventricular pacemakers were implanted in 83.6% of cases, atrioventricular in 16.1 % and atrial pacing in 0.3%. In the 1053 cases of re-operation, the interval between the initial implantation and the present procedure ranged from 1 month to 24 years (M=7.1 years. Pulse generator replacements were refered in 917 patients (87.0% of re-operation procedures, 65.7% of them at the end of life. Atrial lead replacement were

  15. Left ventricular pacing improves haemodynamic variables in patients with heart failure with a normal QRS duration

    Science.gov (United States)

    Turner, M S; Bleasdale, R A; Mumford, C E; Frenneaux, M P; Morris-Thurgood, J A

    2004-01-01

    Objectives: To assess whether patients with congestive heart failure (CHF) and a normal QRS duration can benefit from left ventricular (VDD-LV) pacing. Design: Cardiac resynchronisation is reserved for patients with a broad QRS duration on the premise that systolic resynchronisation is the mechanism of benefit, yet improvement from pacing correlates poorly with QRS duration. In CHF patients with a broad QRS duration, those with a high resting pulmonary capillary wedge pressure (PCWP) > 15 mm Hg benefit. In this acute haemodynamic VDD-LV pacing study, patients with CHF with a normal QRS duration were divided into two groups—patients with a resting PCWP > 15 mm Hg and patients with a resting PCWP 15 mm Hg (n  =  10), cardiac output increased from 3.9 (1.5) to 4.5 (1.65) l/min (p 15 mm Hg derive acute haemodynamic benefit from VDD-LV pacing. PMID:15084543

  16. 先天性完全性房室传导阻滞临床特征及心脏起搏器的安置选择%Clinical features of congenital complete atrioventricular block and its indications for permanent cardiac pacing

    Institute of Scientific and Technical Information of China (English)

    李奋; 周爱卿; 高伟; 李筠; 黄美蓉

    2001-01-01

    Objective The data of 66 patients with congenital complete atrioventricular block (CCAVB) were analyzed retrospectively to investigate the clinical features of CCAVB and its indications for permanent cardiac pacing. Methods Between March 1974 to June 2000, 66 patients (inpatients and outpatients) were confirmed with CCAVB in our hospital, 2 of those with ventricular septal defects and 25 with onsets of Adams-Stokes syndrome. The patients without onsets of Adams-Stokes syndrome were followed up in outpatient department. The patients with onsets of Adams-Stokes syndrome were treated with medicines. If they were unresponsive, the patients underwent temporarily right ventricular pacing. The patients with frequent onsets of Adams-Stokes syndrome were candidates for permanent cardiac pacing. All patients were followed up regularly, including electrocardiography, execise-test, efficiency of cardiac pacing and function of pacemaker (those received pacemakers), etc. Results In this series, 25 patients experienced onsets of Adams-Stokes syndrome. The mean age at initial onsets was 4.5±2.6 years and the mean heart rate 41±3.5 beats per minute. During the period of onsets, electrocardiograms showed bradycardia in 10 patients, ventricular tachycardia (mainly torsades de pointes) in 13 patients and unknown in 2 patients. The factors relative to onsets of Adams-Stokes syndrome were age, heart rate, QT interval, exercise and the level of blood potassium. At the follow-up, those without onsets of Adams-Stokes syndrome lived normal lives. Majority with onsets of Adams-Stokes syndrome were controlled by infusion of isoproterenol, maintenance of potassium balance, infusion of lidocaine, etc. Minority unresponsive to medicines underwent temporarily right ventricular pacing with good results. 9 patients with frequent onsets of Adams-Stokes syndrome and 2 patients with infrequent onsets of Adams-Stokes syndrome received permanent cardiac pacemaker implantations with good results

  17. Primary prevention of sudden cardiac death of the young athlete: the controversy about the screening electrocardiogram and its innovative artificial intelligence solution.

    Science.gov (United States)

    Chang, Anthony C

    2012-03-01

    The preparticipation screening for athlete participation in sports typically entails a comprehensive medical and family history and a complete physical examination. A 12-lead electrocardiogram (ECG) can increase the likelihood of detecting cardiac diagnoses such as hypertrophic cardiomyopathy, but this diagnostic test as part of the screening process has engendered considerable controversy. The pro position is supported by argument that international screening protocols support its use, positive diagnosis has multiple benefits, history and physical examination are inadequate, primary prevention is essential, and the cost effectiveness is justified. Although the aforementioned myriad of justifications for routine ECG screening of young athletes can be persuasive, several valid contentions oppose supporting such a policy, namely, that the sudden death incidence is very (too) low, the ECG screening will be too costly, the false-positive rate is too high, resources will be allocated away from other diseases, and manpower is insufficient for its execution. Clinicians, including pediatric cardiologists, have an understandable proclivity for avoiding this prodigious national endeavor. The controversy, however, should not be focused on whether an inexpensive, noninvasive test such as an ECG should be mandated but should instead be directed at just how these tests for young athletes can be performed in the clinical imbroglio of these disease states (with variable genetic penetrance and phenotypic expression) with concomitant fiscal accountability and logistical expediency in this era of economic restraint. This monumental endeavor in any city or region requires two crucial elements well known to business scholars: implementation and execution. The eventual solution for the screening ECG dilemma requires a truly innovative and systematic approach that will liberate us from inadequate conventional solutions. Artificial intelligence, specifically the process termed "machine

  18. Presentation Time Concerning System-Paced Multimedia Instructions and the Superiority of Learner Pacing

    Science.gov (United States)

    Stiller, Klaus D.; Petzold, Kirstin; Zinnbauer, Peter

    2011-01-01

    The superiority of learner-paced over system-paced instructions was demonstrated in multiple experiments. In these experiments, the system-paced presentations were highly speeded, causing cognitive overload, while the learner-paced instructions allowed adjustments of the presentational flow to the learner's needs by pacing facilities, mostly…

  19. Successful treatment with biventricular pacing in a patient with hypertrophic obstructive cardiomyopathy

    Institute of Scientific and Technical Information of China (English)

    HE Ji-qiang; JIANG Teng-yong; WANG Yun-long; WANG Yan; L(U) Shu-zheng

    2011-01-01

    We report the effects of biventricular pacing in a patient with hypertrophic obstructive cardiomyopathy (HOCM) refractory to medical therapy. A 58-year-old man with HOCM had suffered from dyspnea,chest pain and palpitation for 5 years. Cardiac catheterization showed a left ventricular outflow tract (LVOT) gradient of 80 mmHg. He refused septal myomectomy and the septal ablation was not available. Based on intraoperative pressure measurements,he was implanted with biventricular pacing and LVOT gradient decreased to 10 mmHg. During the follow-up period of 6 months, the patient's symptoms were markedly improved. Biventricular pacing may be an alternative therapy for patients with HOCM.

  20. Artificial vision.

    Science.gov (United States)

    Zarbin, M; Montemagno, C; Leary, J; Ritch, R

    2011-09-01

    A number treatment options are emerging for patients with retinal degenerative disease, including gene therapy, trophic factor therapy, visual cycle inhibitors (e.g., for patients with Stargardt disease and allied conditions), and cell transplantation. A radically different approach, which will augment but not replace these options, is termed neural prosthetics ("artificial vision"). Although rewiring of inner retinal circuits and inner retinal neuronal degeneration occur in association with photoreceptor degeneration in retinitis pigmentosa (RP), it is possible to create visually useful percepts by stimulating retinal ganglion cells electrically. This fact has lead to the development of techniques to induce photosensitivity in cells that are not light sensitive normally as well as to the development of the bionic retina. Advances in artificial vision continue at a robust pace. These advances are based on the use of molecular engineering and nanotechnology to render cells light-sensitive, to target ion channels to the appropriate cell type (e.g., bipolar cell) and/or cell region (e.g., dendritic tree vs. soma), and on sophisticated image processing algorithms that take advantage of our knowledge of signal processing in the retina. Combined with advances in gene therapy, pathway-based therapy, and cell-based therapy, "artificial vision" technologies create a powerful armamentarium with which ophthalmologists will be able to treat blindness in patients who have a variety of degenerative retinal diseases.

  1. The pace and shape of ageing

    DEFF Research Database (Denmark)

    Baudisch, Annette

    2011-01-01

    dimensions of age-specific change - the pace and the shape of ageing. 2.Based on the two axes of pace and shape, I introduce a new conceptual framework to classify how species age. 3.With this method, I rank species according to how strongly they age (shape) and how fast they age (pace). Depending on whether...... they are ranked by pace or by shape, species are ordered differently. 4.Alternative pace measures turn out to be highly correlated. Alternative shape measures are also highly correlated. The correlation between pace and shape ranking is negative but weak. Among the examples here, no species is long lived yet...

  2. Pacing-induced congenital heart defects assessed by OCT (Conference Presentation)

    Science.gov (United States)

    Ford, Stephanie M.; McPheeters, Matt T.; Wang, Yves T.; Gu, Shi; Doughman, Yong Qiu; Strainic, James P.; Rollins, Andrew M.; Watanabe, Michiko; Jenkins, Michael W.

    2016-03-01

    The role of hemodynamics in early heart development is poorly understood. In order to successfully assess the impact of hemodynamics on development, we need to monitor and perturb blood flow, and quantify the resultant effects on morphology. Here, we have utilized cardiac optical pacing to create regurgitant flow in embryonic hearts and OCT to quantify regurgitation percentage and resultant morphology. Embryonic quail in a shell-less culture were optically paced at 3 Hz (well above the intrinsic rate or 1.33-1.67 Hz) on day 2 of development (3-4 weeks human) for 5 minutes. The pacing fatigued the heart and led to a prolonged period (> 1 hour) of increased regurgitant flow. Embryos were kept alive until day 3 (cardiac looping - 4-5 weeks human) or day 8 (4 chambered heart - 8 weeks human) to quantify resultant morphologic changes with OCT. All paced embryos imaged at day 3 displayed cardiac defects. The extent of regurgitant flow immediately after pacing was correlated with cardiac cushion size 24-hours post pacing (p-value congenital heart defects (CHDs) including 11/18 with valve defects, 5/18 with ventricular septal defects and 5/18 with hypoplastic right ventricles. Our data suggests that regurgitant flow leads to smaller cushions, which develop into abnormal valves and septa. Our model produces similar phenotypes as found in our fetal alcohol syndrome and velo-cardio-facial/DiGeorge syndrome models suggesting that hemodynamics plays a role in these syndromes as well. Utilizing OCT and optical pacing to understand hemodynamics in development is an important step towards determining CHD mechanisms and ultimately developing earlier treatments.

  3. 右室间隔部不同部位起搏对心功能和心室收缩同步性的影响%Effects of pacing sites in the right ventricular septum on cardiac function and ventricular systolic synchrony

    Institute of Scientific and Technical Information of China (English)

    陈文苏; 张超群; 程明月; 李承宗

    2015-01-01

    followed-up visits one year after surgery, when data were collected including cumulative ventricular pacing proportion ( Cum VP%) , electrocardiogram and Color Doppler sonographic in assessment of the heart.Their QRS com-plex, Crochetage (notch) on R wave, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter ( LVEDD) , left ventricular fractional shortening ( FS) , septal-to-posterior wall motion delay ( SPWMD) and interven-tricular mechanical delay ( IVMD) were compared to determine the optimal pacing site in the right ventricular septum. Results There were no statistic differences among the three groups as to baseline information like age, gender, primary disease, EF, LVEDD and FS before operation.After surgery, the pacing modes were all DDD, while no significant differences were seen in the Cum%VP among the three groups.For the follow-up visit one year later, compared with the low-septal implantation group, the mid-septal group produced narrower QRS complex, shorter SPWMD and IVMD, as well as less frequency in notch on R wave and higher values of FS.There was no statistic difference in EF and LVEDD between the two groups.Compared with the high-septal implantation group, the mid-septal group produced narrower QRS complex, shorter SPWMD and IVMD, as well as less frequency in notch on R wave and higher values of EF.There was no statistic difference in FS and LVEDD between the two groups.Compared with the high -septal implantation group, the low-septal group produced narrower QRS complex and higher values of LVEF.There was no statistic differ-ence in LVEDD, FS, SPWMD and IVMD between the two groups.Conclusion Pacing from the middle site of the right ventricle results in narrower QRS complex with the least effects on cardiac function and ventricular systolic synchrony and better hemodynamic results, in comparison with other pacing sites.

  4. Recovery in ERG gene expression with biventricular pacing in a rabbit model of myocardial infarction

    Directory of Open Access Journals (Sweden)

    Saba S

    2013-05-01

    Full Text Available Samir Saba,* Haider Mehdi,* William Barrington, Fardeen Mehdi, Zahid Islam, Barry LondonCardiovascular Institute of the University of Pittsburgh Medical Center, Pittsburgh, PA, USA*These authors contributed equally to this workBackground: Improved clinical and echocardiographic parameters have been documented with biventricular (BIV pacing in patients after myocardial infarction (MI. We investigated the changes in gene expression in cardiac tissue with BIV pacing, using a rabbit model of MI.Method: New Zealand White rabbits were divided into four groups: sham-operated controls, MI with no pacing, MI with right ventricle (RV pacing (MI + RV, and MI with BIV pacing (MI + BIV. Pacing was initiated 1–2 weeks after the coronary ligation. At 5 weeks, the hearts were excised. The tissue extracted from the left ventricle (LV and RV underwent analysis for protein and messenger ribonucleic acid (mRNA levels.Results: The ether-a-go-go-related gene (ERG protein levels recovered from the base of the LV away from the MI area were two- to threefold lower in the MI and the MI + RV compared with the MI + BIV groups (P = 0.07. The ERG protein levels were similar between the MI + BIV and the control groups. However, the RNA levels were comparable between the four study groups, suggesting that a posttranscriptional mechanism accounted for the difference in protein levels.Conclusion: In this rabbit model of MI, we demonstrated a recovery in ERG protein levels with BIV pacing, after MI. This recovery may underlie some of the benefits seen with BIV pacing in ischemic cardiomyopathy.Keywords: heart failure, biventricular pacing, cardiac reverse remodeling, ether-a-go-go-related gene

  5. Low atrial septum pacing in pacemaker patients

    NARCIS (Netherlands)

    Voogt, Willem Gijsbert de

    2006-01-01

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

  6. 右心室起搏部位的国内外研究进展%Domestic and foreign research progress on pacing sites of right ventricular

    Institute of Scientific and Technical Information of China (English)

    孙倩; 张文娟

    2015-01-01

    自1958年第一例埋藏式起搏器问世以来,人工心脏起搏经历了50余年的发展,起搏器植入技术已成为治疗缓慢性心律失常最有效的手段。心脏起搏治疗已不仅局限在维持患者的基本心率及患者生存率,更重要的是提高患者生活质量,而这与起搏器激动心肌的顺序、心肌细胞重构程度、心脏电-机械活动的同步性以及血流动力学的稳定性密切相关。在心脏起搏方式、起搏参数一定时,起搏部位的选择是决定临床疗效的重要因素之一。人工心脏起搏器技术经过半个多世纪的发展已取得了长足发展,电生理专家们在积极探索更为接近生理状态的起搏部位。如何提高良好的安全性及可操作性,降低并发症的发生率,提高患者的生活质量,越来越成为当今起搏器发展过程中最需要关注的问题。%Artificial cardiac pacing has developed more than 50 years, since the first implantable pacemaker invented in 1958. Pacemaker has become the most effective treatments of bradycardia. Cardiac pacing therapy is not only limited in maintaining the patients' basic heart rates and the survival rate, the more important is to improve the quality of life, which relies on the order of myocardium exciting, the degree of myocardium remodeling, the Synchronization of cardiac electro-mechanical activity and the stability of hemodynamics. In a certain way, pacing site selection is one of the important factors to determine the clinical efficacy when the means and parameters of pacing are definitive. Artificial cardiac pacemaker technology has made considerable development after more than half a century. Electrophysiological experts have actively explored pacing sites which is closer to physiological status. How to improve the good safety and operability, reduce the incidence of complications and improve patient quality of life need more attention in the development of pacemaker.

  7. Optical recording-guided pacing to create functional line of block during ventricular fibrillation

    Science.gov (United States)

    Ravi, Krishna; Nihei, Motoki; Willmer, Anjuli; Hayashi, Hideki; Lin, Shien-Fong

    2006-03-01

    Low-energy defibrillation is very desirable in cardiac rhythm management. We previously reported that ventricular fibrillation (VF) can be synchronized with a novel synchronized pacing technique (SyncP) using low-energy pacing pulses. This study sought to create a line of block during VF using SyncP. SyncP was performed in six isolated rabbit hearts during VF using optical recording to control the delivery of pacing pulses in real time. Four pacing electrodes with interelectrode distances of 5 mm were configured in a line along and across the myocardial fiber direction. The electrodes were controlled independently (independent mode) or fired together (simultaneous mode). Significant wavefront synchronization was observed along the electrode line as indicated by a decrease in variance. With the independent SyncP protocol, the decrease in the variance was 19.3 and 13.7% (Pventricular defibrillation.

  8. [Competitive pacing in a patient with DDD pacemaker and bigeminal ventricular extrasystoles].

    Science.gov (United States)

    Carbone, Vincenzo; Candelmo, Fiore; Todaro, Chiara; Oreto, Giuseppe

    2008-11-01

    The ECG recorded from a patient with DDD pacemaker showed variable responses of the pacing system to bigeminal ventricular extrasystoles, dependent on the coupling interval of premature beats. For relatively short coupling intervals, the premature spontaneous event was detected by the pacemaker, inhibiting both atrial and ventricular output, and resulting in a relatively long pacing pause. In slightly less premature end-diastolic extrasystoles, in contrast, the pacing system delivered an atrial spike that was superimposed upon the spontaneous premature QRS complex (pseudo-pseudofusion); under these circumstances, the atrial spike was followed, at the end of the programmed atrioventricular interval, by a ventricular spike falling on the extrasystolic T wave apex (competitive ventricular pacing). This phenomenon, however, did not express a sensing malfunction, but was due to post-atrial ventricular blanking (PAVB), a short period initiated by the atrial spike during which ventricular sensing is temporarily disabled, so that no signal can be detected. Finally, whenever premature end-diastolic impulses occurred after PAVB, during the brief interval defined ventricular safety pacing, the spontaneous event was sensed, being followed by an earlier-than-expected ventricular spike, whose prematurity was aimed at avoiding the occurrence of an artificial impulse upon the T wave of extrasystole. In conclusion, despite several not sensed ventricular extrasystoles and competitive pacing, no sensing malfunction was present. This case demonstrates how complex can be the electrocardiographic analysis of a DDD pacemaker, owing to the many complicating phenomena related to this pacing mechanism.

  9. Equivalence randomized controlled study of Shen Xian liter artificial cardiac pacemaker pulse and impact on quality of life in patients with arrhythmia%参仙升脉口服液联合人工心脏起搏器对缓慢性心律失常患者生活质量影响等效性随机平行对照研究

    Institute of Scientific and Technical Information of China (English)

    刘桂勇; 潘迪光; 蒋靖波; 李斌; 路华; 李薇; 张伟; 伍于斌

    2016-01-01

    目的:应用等效性随机平行对照法分析参仙升脉口服液联合人工心脏起搏器对缓慢性心律失常患者生活质量影响。方法选取从2015年1月到2015年8月入院治疗的50例缓慢性心律失常患者作为研究对象。按照入院顺序随机分为治疗组25例与对照组25例。两组患者均植入永久心脏起搏器,治疗组患者应用参仙升脉口服液治疗,对照组患者应用对照安慰剂治疗。对比两组患者治疗前后及两组患者间心室起搏频率、基础心率、电池容量、起搏电压、阻抗、阈值、脉宽和感知电流等指标变化情况,评估不同措施对于患者预后生活质量的影响。结果治疗组患者治疗后起搏器参数及心功能水平均优于对照组,差异具有统计学意义( P <0.05)。治疗组患者治疗后生活质量各指标均优于对照组,差异具有统计学意义( P <0.05)。结论临床应用参仙升脉口服液联合植入永久性人工心脏起搏器治疗缓慢性心律失常患者,可大大改善起搏器功能与降低心脏起搏率,具有延长起搏器寿命与改善患者预后的效果,临床值得广泛推广应用。%Objective Randomized parallel group equivalence analysis shenxian liter artificial cardiac pacemaker pulse and impact on quality of life in patients with arrhythmia. Methods From January 2015 to August 2015,50 patients with arrhythmia were selected as research objects,who were randomly divided into treatment group and control group,25 cases in each group. Patients were implanted a permanent pace-maker. Treatment group were treated with oral application parameters cents liter vein treatment,the control group with placebo. Ventricular pacing rate,basic heart rate,battery capacity,pacing voltage,impedance,threshold,pulse and other indicators of the current perception changes be-tween the two groups were compared and evaluate influence of different measures on the prognosis of patients

  10. Exploration of clinical application of exercise cardiac contractility monitor in artificial abortion with general anesthesia%运动心力监测仪在全麻人流手术中的临床应用探讨

    Institute of Scientific and Technical Information of China (English)

    李玮; 刘德顺; 袁蔚; 漆洪波

    2012-01-01

    Objective To monitor the cardiac reserve in artificial abortion with general anesthesia with exercise cardiac contractility monitor. Methods One hundred and seventy-nine pregnant women aged 20-40 years with 8. 0 ± 1. 9 gestational weeks were recruited, and they all accepted artificial abortion with general anesthesia. The heart rate ( HR ), the ratio of the amplitude of the first heart sound to the second heart sound ( S1/S2 ) and the ratio of diastolic phase duration to systolic phase duration ( D/S ) were measured before general anesthesia, after anesthesia and in operation. Results HR in operation was lower than that before anesthesia( 82.36 ± 12. 29/min vs 85. 12 ± 15.54/min,t=2. 19, P<0. 05 ). Compared with that after anesthesia, the HR in operation decreased ( 82.36 ±12.29 /min vs 90.52 ± 10. 86/min, t =6.66, P <0.05 ). S1/S2 decreased and D/S increased, and the differences were significant ( t value was 2. 62 and 5. 37, respectively, both P < 0. 05 ). Conclusion Cardiac function is up-regulated after general anesthesia and down-regulated in operation in women of artificial abortion. The exercise cardiac contractility monitor may measure cardiac reserve during artificial abortion with general anesthesia and provide safe data for predicting safety of women.%目的 运用运动心力监测仪监测全麻人流手术中心脏储备变化.方法 选择179名20~40岁孕8.0±1.9周的早孕妇女为研究对象,均进行全麻无痛人流手术,测量及计算无痛人流麻醉前,麻醉后及手术中心率、第一心音幅值与第二心音幅值的比值(S1/S2),舒张期与收缩期时限比值(D/S).结果 术中心率较麻醉前降低(82.36±12.29次/min vs 85.12±15.54次/min,t=2.19,P<0.05);术中与麻醉后比较心率降低(82.36±12.29次/min vs 90.52±10.86次/min,t=6.66,P<0.05),S1/S2降低、D/S升高,差异有统计学意义(t分别为2.62、5.37,均P<0.05).结论 无痛人流手术麻醉后应激使心脏功能上调,术中心脏功能下

  11. Speckle-tracking echocardiography elucidates the effect of pacing site on left ventricular synchronization in the normal and infarcted rat myocardium.

    Directory of Open Access Journals (Sweden)

    Michal Mor

    Full Text Available BACKGROUND: Right ventricular (RV pacing generates regional disparities in electrical activation and mechanical function (ventricular dyssynchrony. In contrast, left ventricular (LV or biventricular (BIV pacing can improve cardiac efficiency in the setting of ventricular dyssynchrony, constituting the rationale for cardiac resynchronization therapy (CRT. Animal models of ventricular dyssynchrony and CRT currently relay on large mammals which are expensive and not readily available to most researchers. We developed a methodology for double-site epicardial pacing in conscious rats. Here, following post-operative recovery, we compared the effects of various pacing modes on LV dyssynchrony in normal rats and in rats with ischemic cardiomyopathy. METHODS: Two bipolar electrodes were implanted in rats as follows: Group A (n = 6 right atrial (RA and RV sites; Group B (n = 7 RV and LV sites; Group C (n = 8 as in group B in combination with left coronary artery ligation. Electrodes were exteriorized through the back. Following post-operative recovery, two-dimensional transthoracic echocardiography was performed during pacing through the different electrodes. Segmental systolic circumferential strain (Ecc was used to evaluate LV dyssynchrony. RESULTS: In normal rats, RV pacing induced marked LV dyssynchrony compared to RA pacing or sinus rhythm, as measured by the standard deviation (SD of segmental time to peak Ecc, SD of peak Ecc, and the average delay between opposing ventricular segments. LV pacing and, to a greater extend BIV pacing diminished the LV dyssynchrony compared to RV pacing. In rats with extensive MI, the effects of LV and BIV pacing were markedly attenuated, and the response of individual animals was variable. CONCLUSIONS: Rodent cardiac pacing mimics important features seen in humans. This model may be developed as a simple new tool to study the pathophysiology of ventricular dyssynchrony and CRT.

  12. The Value of Bedside Temporary Cardiac Pacing in Severe Slow Arrhythmia Patients in Emergency%床旁临时心脏起搏术在严重缓慢性心律失常患者抢救中的价值

    Institute of Scientific and Technical Information of China (English)

    黄影兰; 陈文智; 蓝志新

    2015-01-01

    目的:探讨床旁临时心脏起搏术在抢救急诊科严重缓慢性心律失常患者中的临床应用价值。方法选取2013年8月~2014年8月我院急诊科的严重缓慢型心律失常患者22例作为观察组,同期选取住院的23例在DSA引导下安装临时心脏起搏器的患者作为对照组。观察组给予床旁安装心脏起搏器。观察比较两组心脏起搏器的安装时间、一次起搏成功率、一次点击未到率,术后观察比较两组的并发症情况及临床疗效。结果观察组床边临时心脏起搏器的安装时间明显要短于对照组,差异高度有统计学意义(P0.05). Observa-tion of complications postoperative hematoma, arrhythmia, dislocation of electrode and catheter re-lated infection, the incidence of pacemaker syndrome compared with the control group, the differ-ence was not statistically significant(P>0.05). The observation group the sinus rhythm recovery rate and postoperative 1 weeks after their sinus rhythm recovery rate and the mortality rate compared with the control group, the difference was not statistically significant (P>0.05). Conclusions The bedside temporary cardiac pacing in the emergency department treatment of severe slow arrhythmia patients is a simple and applicable method, good safety, convenient operation, less complications, the curative effect, it is worthy of popularization and application.

  13. Cardiac applications of optogenetics.

    Science.gov (United States)

    Ambrosi, Christina M; Klimas, Aleksandra; Yu, Jinzhu; Entcheva, Emilia

    2014-08-01

    In complex multicellular systems, such as the brain or the heart, the ability to selectively perturb and observe the response of individual components at the cellular level and with millisecond resolution in time, is essential for mechanistic understanding of function. Optogenetics uses genetic encoding of light sensitivity (by the expression of microbial opsins) to provide such capabilities for manipulation, recording, and control by light with cell specificity and high spatiotemporal resolution. As an optical approach, it is inherently scalable for remote and parallel interrogation of biological function at the tissue level; with implantable miniaturized devices, the technique is uniquely suitable for in vivo tracking of function, as illustrated by numerous applications in the brain. Its expansion into the cardiac area has been slow. Here, using examples from published research and original data, we focus on optogenetics applications to cardiac electrophysiology, specifically dealing with the ability to manipulate membrane voltage by light with implications for cardiac pacing, cardioversion, cell communication, and arrhythmia research, in general. We discuss gene and cell delivery methods of inscribing light sensitivity in cardiac tissue, functionality of the light-sensitive ion channels within different types of cardiac cells, utility in probing electrical coupling between different cell types, approaches and design solutions to all-optical electrophysiology by the combination of optogenetic sensors and actuators, and specific challenges in moving towards in vivo cardiac optogenetics.

  14. Permanent cardiac pacemaker in infants and children.

    Science.gov (United States)

    Dasmahapatra, H K; Jamieson, M P; Brewster, G M; Doig, B; Pollock, J C

    1986-08-01

    Between October 1970 and November 1984, 26 infants and children aged 11 days to 18 years (mean 5.7 years) received 42 permanent cardiac pacemakers (26 primary implants, 16 re-implants) for congenital or surgically acquired heart block, bradycardia and sinus node dysfunction. Twenty-two patients had unipolar pacing and 4 bipolar pacing. Of 26 primary implantations, 2 had fixed rate epicardial pacing, 16 ventricular demand pacing (13 epicardial, 3 endocardial), 3 epicardial VAT (P-synchronous) pacing and 5 DDD (universal) pacing (4 epicardial, one endocardial). Fourteen patients required a further 19 operations for change of generators (16), ventricular lead (1), generator site (1) and generator encasing (1). Thirty-day hospital mortality was 11.5% (3/26), of which one death was possibly related to pacing failure. Four patients died during the follow-up period (3 months to 10 years; mean 3.4 years). Sixteen of the 19 survivors achieved complete symptomatic relief, without any medical therapy. Our results indicate that modern cardiac pacemaker systems are safe and reliable, and are associated with major relief of symptoms in this age group.

  15. Optimized cardiac resynchronization therapy in patients with congestive heart failure

    Institute of Scientific and Technical Information of China (English)

    NIU Hong-xia; HUA Wei; ZHANG Shu; SUN Xin; CHEN Ke-ping; WANG Fang-zheng; CHEN Xin

    2007-01-01

    @@ Heart failure was a major and increasing public health problem, with an almost "epidemic increase in the number of patients.1 Despite recent advances in pharmacotherapy, the prognosis remains poor. Cardiac resynchronization therapy (CRT), by pacing right and left ventricles, has been proved to improve symptoms and reduce mortality for heart failure patients with cardiac dyssynchrony.

  16. Percutaneously injectable fetal pacemaker: electronics, pacing thresholds, and power budget.

    Science.gov (United States)

    Nicholson, Adriana; Chmait, Ramen; Bar-Cohen, Yaniv; Zheng, Kaihui; Loeb, Gerald E

    2012-01-01

    We are developing a cardiac pacemaker that is designed to be implanted percutaneously into a fetus to treat complete heart block and consequent hydrops fetalis, which is otherwise fatal. One of the most significant considerations for this device is the technical challenges presented by the battery and charging system. The size of the device is limited to about 3 mm in diameter; batteries on this scale have very small charge capacities. The smaller capacity means that the device needs to be designed so that it uses as little current as possible and so that its battery can be recharged wirelessly. We determined the pacing thresholds for a simple relaxation oscillator that can be assembled from discrete, surface mount components and analyzed the power consumption of the device given different electrode configurations and stimulus parameters. An inductive recharging system will be required for some patients; it is feasible within the package constraints and under development.

  17. Observation of functional remodeling of Ca2+-activated Cl- channel in pacing-induced canine failing heart

    Institute of Scientific and Technical Information of China (English)

    浦介麟

    2006-01-01

    Objective To study whether Ca2+-activated Cl-current (Ito2) contributes to the functional remodeling of the failing heart. Methods The cardiac myocytes were isolated enzymatically from rapidly pacing-induced failing canine hearts (HF) at room temperature. Patch-Clamp whole cell recording technique was employed to record the Ito2.The Cl- transport blocker 4,4’-diisothiocyanos-

  18. Transferring PACE Assessments Upon Home Sale

    Energy Technology Data Exchange (ETDEWEB)

    National Renewable Energy Laboratory (NREL); Coughlin, Jason; Fuller, Merrian; Zimring, Mark

    2010-04-12

    A significant barrier to investing in renewable energy and comprehensive energy efficiency improvements to homes across the country is the initial capital cost. Property Assessed Clean Energy (PACE) financing is one of several new financial models broadening access to clean energy by addressing this upfront cost issue. Recently, the White House cited PACE programs as an important element of its 'Recovery through Retrofit' plan. The residential PACE model involves the creation of a special clean energy financing district that homeowners elect to opt into. Once opted in, the local government (usually at the city or county level) finances the upfront investment of the renewable energy installation and/or energy efficiency improvements. A special lien is attached to the property and the assessment is paid back as a line item on the property tax bill. As of April 2010, 17 states have passed legislation to allow their local governments to create PACE programs, two already have the authority to set up PACE programs, and over 10 additional states are actively developing enabling legislation. This policy brief analyzes one of the advantages of PACE, which is the transferability of the special assessment from one homeowner to the next when the home is sold. This analysis focuses on the potential for the outstanding lien to impact the sales negotiation process, rather than the legal nature of the lien transfer itself. The goal of this paper is to consider what implications a PACE lien may have on the home sales negotiation process so that it can be addressed upfront rather than risk a future backlash to PACE programs. If PACE programs do expand at a rapid rate, the chances are high that there will be other cases where prospective buyers uses PACE liens to negotiate lower home prices or require repayment of the lien as a condition of sale. As a result, PACE programs should highlight this issue as a potential risk factor for the sake of full disclosure. A good example

  19. Pollution Abatement and Control Expenditures Survey (PACE)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Pollution Abatement Costs and Expenditures (PACE) survey is the most comprehensive national source of pollution abatement costs and expenditures related to...

  20. Synchronization of ventricular fibrillation with electrical pacing guided by optical signals: comparison of pacing locations

    Science.gov (United States)

    Hernandez, Heidy; Hwang, Gyo-Seung; Lin, Shien-Fong

    2006-02-01

    Wavefront synchronization is an important aspect preceding the termination of ventricular fibrillation (VF). We designed a novel approach using multi-electrode pacing that could reduce the energy consumption of successful defibrillation by more than 100-fold. We compared the efficacy of a synchronized pacing algorithm using optical recording-guided pacing at the right ventricle and the posterior left ventricle in isolated rabbit hearts. Two modes of pacing were used in the study. The electrodes were individually controlled (independent mode, ISyncP) or fired together (simultaneous mode, SSyncP) when triggered by tissue polarization at a reference site separate from the pacing sites. The hearts were stained with voltage-sensitive dye and illuminated with laser for epifluorescence imaging during pacing. The number of phase singularities of VF propagation was used to estimate the complexity of VF. A decrease in the number of PS signified a higher degree of VF organization. We found that the pacing algorithm was more effective if the pacing was applied to the posterior left ventricle than to the right ventricle. Pacing in the posterior left ventricle resulted in a 25.3% decrease in the number of PS for ISyncP and a 31% decrease for SSyncP. Pacing in the right ventricle resulted in a 29.0% decrease for ISyncP and a 2.3% increase for SSyncP. The 5mA current reflected a 27.8% decrease for ISyncP and a 32.2% decrease for SSyncP, whereas the 10mA current reflected a 27.2% decrease for ISyncP and a 5.2% increase for SSyncP. We conclude that synchronized pacing can induce VF organization, and the efficacy is higher when pacing in the left ventricle with 5 mA.

  1. The Manipulation of Pace within Endurance Sport

    Science.gov (United States)

    Skorski, Sabrina; Abbiss, Chris R.

    2017-01-01

    In any athletic event, the ability to appropriately distribute energy is essential to prevent premature fatigue prior to the completion of the event. In sport science literature this is termed “pacing.” Within the past decade, research aiming to better understand the underlying mechanisms influencing the selection of an athlete's pacing during exercise has dramatically increased. It is suggested that pacing is a combination of anticipation, knowledge of the end-point, prior experience and sensory feedback. In order to better understand the role each of these factors have in the regulation of pace, studies have often manipulated various conditions known to influence performance such as the feedback provided to participants, the starting strategy or environmental conditions. As with all research there are several factors that should be considered in the interpretation of results from these studies. Thus, this review aims at discussing the pacing literature examining the manipulation of: (i) energy expenditure and pacing strategies, (ii) kinematics or biomechanics, (iii) exercise environment, and (iv) fatigue development. PMID:28289392

  2. Inhomogeneity of action potential waveshape assists frequency entrainment of cardiac pacemaker cells.

    Science.gov (United States)

    Cloherty, S L; Lovell, N H; Celler, B G; Dokos, S

    2001-10-01

    In this paper, we have employed ionic models of sinoatrial node cells to investigate the synchronization of a pair of coupled cardiac pacemaker cells from central and peripheral regions of the sinoatrial node. The free-running cycle length of the cell models was perturbed using two independent techniques and the minimum coupling conductance required to achieve frequency entrainment was used to assess the relative ease with which various cell pairs achieve entrainment. The factors effecting entrainment were further investigated using single-cell models paced with an artificial biphasic coupling current. Our simulation results suggest that dissimilar cell types, those with largely different upstroke velocities entrain more easily, that is, they require less coupling conductance to achieve 1:1 frequency entrainment. We, therefore, propose that regional variation in action-potential waveshape within the sinoatrial node assists frequency synchronization in vivo.

  3. Ischemic Stroke Due to Cardiac Involvement: Emery Dreifuss Patient

    Directory of Open Access Journals (Sweden)

    Ersin Kasım Ulusoy

    2015-08-01

    Full Text Available Emery-Dreifuss muscular dystrophy (EDMD is a hereditary disease. It is characterized by early-onset contractures, slowly progressive weakness, fatigue related to skapulo-humero-peroneal muscle weakness, cardiomyopathy which develops in adulthood and cardiac conduction system block. Cardiac involvement has a prognostic significance in patients with EDMD and even sudden cardiac death may be the first clinical presentation. In this article, an EDMD patient with ischemic stroke clinic who didn’t have regular cardiac follow-up was reported and the importance of the treatment of cardiac diseases which could play a role in ischemic stroke etiology and the implantation of pace-maker was mentioned.

  4. 42 CFR 460.60 - PACE organizational structure.

    Science.gov (United States)

    2010-10-01

    ... planning a change in organizational structure must notify CMS and the State administering agency, in... 42 Public Health 4 2010-10-01 2010-10-01 false PACE organizational structure. 460.60 Section 460... ELDERLY (PACE) PACE Administrative Requirements § 460.60 PACE organizational structure. (a) A...

  5. Improved Cardiac Contractility of Human Recombinant Growth Hormone on the Congestive Heart Failure of Pig

    Institute of Scientific and Technical Information of China (English)

    Yang Ping; He Yu-quan; Zeng Hong; Ni Jin-song; Yun Qing-jun; Huang Xiao-ping; Li Shu-mei

    2005-01-01

    The enhanced cardiac contractility effect of human recombinant growth hormone (hr-GH) on the congestive heart failure (CHF) was studied on the pig. To build a pig model of congestive heart failure, a temporary artificial cardiac pacemaker was implanted in the pig's body and paced at 220 beats to 240 beats per minute for 1 week. After the model of congestive heart failure was successfully set up, the frequency of the pacemaker was changed to 150 beats to 180 beats per minute to maintain the CHF model stable. Pigs were divided into three groups: The hr-GH group in which 0.5 mg/kg per day of hr-GH was administrated intramuscularly for 15 days, the injection control group in which an equal amount of physiological saline was injected intramuscularly, and a normal control group. The left ventricular diastolic end pressure was (10.60±2.41 ) mmHg in the hr-GH group, but (19.00±3.81) mmHg in the saline control group (P<0.01); Cardiac output was (1.86±0.13) L/min in the hr-GH group, but (1.56 ±0.18) L/min in the saline control group (P<0.05); Peripheral min) -1 in the saline control group (P<0.05); ± dp/dtmax was (2900 ±316.23) and (2280 ±286.36) in the hr-HG group and the saline control group respectively (P<0.05). The results show that hr-GH enhances myocardial contractility of CHF, and the CHF model built by a temporary artificial cardiac pacemaker at a high rate of stimulation is reasonable and applicable.

  6. Optimal pacing for symptomatic AV block: a comparison of VDD and DDD pacing.

    Science.gov (United States)

    Huang, Max; Krahn, Andrew D; Yee, Raymond; Klein, George J; Skanes, Allan C

    2004-01-01

    VDD pacing provides the physiological benefits of atrioventricular synchronous pacing with the convenience of a single lead system, but is hampered by uncertainty regarding long term atrial sensing and potential development of sinus node disease. To examine the long-term reliability and complication rates of VDD pacing, we compared the outcome of 112 consecutive patients (age 70 +/- 13 years, 59% men) with symptomatic AV block who received a single pass bipolar VDD system, to 80 patients (age 63 +/- 16 years, 70% men) who received DDD pacing for the same indication. All patients were judged to have intact sinus node function based on submitted ECGs and monitoring results at the time of implant. Implant time was reduced in VDD patients compared to DDD patients (63 +/- 20 vs 97 +/- 36 minutes, P DDD patients compared to 3 (3%) VDD patients (P = 0.15). The implant P wave was lower with VDD pacing compared to DDD patients (2.91 +/- 1.48 vs 4.0 +/- 1.7 mv, P DDD patients. Physiological atrioventricular activation was maintained in 94%-99% of beats throughout the follow-up period in the VDD group. VDD pacing is an excellent strategy for treatment of patients with symptomatic AV block. The lower cost, high reliability, and abbreviated implantation time suggest that VDD pacing is a viable alternative to DDD pacing in patients with high degree AV block and normal sinus node function.

  7. A Simulation Study of Paced TCP

    Science.gov (United States)

    Kulik, Joanna; Coulter, Robert; Rockwell, Dennis; Partridge, Craig

    2000-01-01

    In this paper, we study the performance of paced TCP, a modified version of TCP designed especially for high delay- bandwidth networks. In typical networks, TCP optimizes its send-rate by transmitting increasingly large bursts, or windows, of packets, one burst per round-trip time, until it reaches a maximum window-size, which corresponds to the full capacity of the network. In a network with a high delay-bandwidth product, however, Transmission Control Protocol's (TCPs) maximum window-size may be larger than the queue size of the intermediate routers, and routers will begin to drop packets as soon as the windows become too large for the router queues. The TCP sender then concludes that the bottleneck capacity of the network has been reached, and it limits its send-rate accordingly. Partridge proposed paced TCP as a means of solving the problem of queueing bottlenecks. A sender using paced TCP would release packets in multiple, small bursts during a round-trip time in which ordinary TCP would release a single, large burst of packets. This approach allows the sender to increase its send-rate to the maximum window size without encountering queueing bottlenecks. This paper describes the performance of paced TCP in a simulated network and discusses implementation details that can affect the performance of paced TCP.

  8. Cardiac fluid dynamics anticipates heart adaptation.

    Science.gov (United States)

    Pedrizzetti, Gianni; Martiniello, Alfonso R; Bianchi, Valter; D'Onofrio, Antonio; Caso, Pio; Tonti, Giovanni

    2015-01-21

    Hemodynamic forces represent an epigenetic factor during heart development and are supposed to influence the pathology of the grown heart. Cardiac blood motion is characterized by a vortical dynamics, and it is common belief that the cardiac vortex has a role in disease progressions or regression. Here we provide a preliminary demonstration about the relevance of maladaptive intra-cardiac vortex dynamics in the geometrical adaptation of the dysfunctional heart. We employed an in vivo model of patients who present a stable normal heart function in virtue of the cardiac resynchronization therapy (CRT, bi-ventricular pace-maker) and who are expected to develop left ventricle remodeling if pace-maker was switched off. Intra-ventricular fluid dynamics is analyzed by echocardiography (Echo-PIV). Under normal conditions, the flow presents a longitudinal alignment of the intraventricular hemodynamic forces. When pacing is temporarily switched off, flow forces develop a misalignment hammering onto lateral walls, despite no other electro-mechanical change is noticed. Hemodynamic forces result to be the first event that evokes a physiological activity anticipating cardiac changes and could help in the prediction of longer term heart adaptations.

  9. An integrated optical coherence microscopy imaging and optical stimulation system for optogenetic pacing in Drosophila melanogaster (Conference Presentation)

    Science.gov (United States)

    Alex, Aneesh; Li, Airong; Men, Jing; Jerwick, Jason; Tanzi, Rudolph E.; Zhou, Chao

    2016-03-01

    Electrical stimulation is the clinical standard for cardiac pacing. Although highly effective in controlling cardiac rhythm, the invasive nature, non-specificity to cardiac tissues and possible tissue damage limits its applications. Optogenetic pacing of the heart is a promising alternative, which is non-invasive and more specific, has high spatial and temporal precision, and avoids the shortcomings in electrical stimulation. Drosophila melanogaster, which is a powerful model organism with orthologs of nearly 75% of human disease genes, has not been studied for optogenetic pacing in the heart. Here, we developed a non-invasive integrated optical pacing and optical coherence microscopy (OCM) imaging system to control the heart rhythm of Drosophila at different developmental stages using light. The OCM system is capable of providing high imaging speed (130 frames/s) and ultrahigh imaging resolutions (1.5 μm and 3.9 μm for axial and transverse resolutions, respectively). A light-sensitive pacemaker was developed in Drosophila by specifically expressing the light-gated cation channel, channelrhodopsin-2 (ChR2) in transgenic Drosophila heart. We achieved non-invasive and specific optical control of the Drosophila heart rhythm throughout the fly's life cycle (larva, pupa, and adult) by stimulating the heart with 475 nm pulsed laser light. Heart response to stimulation pulses was monitored non-invasively with OCM. This integrated non-invasive optogenetic control and in vivo imaging technique provides a novel platform for performing research studies in developmental cardiology.

  10. Artificial intelligence

    CERN Document Server

    Hunt, Earl B

    1975-01-01

    Artificial Intelligence provides information pertinent to the fundamental aspects of artificial intelligence. This book presents the basic mathematical and computational approaches to problems in the artificial intelligence field.Organized into four parts encompassing 16 chapters, this book begins with an overview of the various fields of artificial intelligence. This text then attempts to connect artificial intelligence problems to some of the notions of computability and abstract computing devices. Other chapters consider the general notion of computability, with focus on the interaction bet

  11. Self-Paced Instruction: Hello, Education

    Science.gov (United States)

    Leuba, Richard J.; Flammer, Gordon H.

    1975-01-01

    Answers criticisms of self-paced instruction (SPI) by citing advantages of SPI over lecture methods. Concludes that criticisms of SPI are useful since they indicate in which areas further research should be conducted to improve this method of instruction. (MLH)

  12. Cardiac arrest

    Science.gov (United States)

    ... Article.jsp. Accessed June 16, 2014. Myerburg RJ, Castellanos A. Approach to cardiac arrest and life-threatening ... PA: Elsevier Saunders; 2011:chap 63. Myerburg RJ, Castellanos A. Cardiac arrest and audden aardiac death. In: ...

  13. Impact of right-ventricular apical pacing on the optimal left-ventricular lead positions measured by phase analysis of SPECT myocardial perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Hung, Guang-Uei [Chang Bing Show Chwan Memorial Hospital, Changhua (China); China Medical University, Department of Biomedical Imaging and Radiological Science, Taichung (China); Huang, Jin-Long [Taichung Veterans General Hospital, Cardiovascular Center, Taichung (China); School of Medicine, National Yang-Ming University, Institute of Clinical Medicine, and Cardiovascular Research Institute, Department of Medicine, Taipei (China); Chung-Shan Medical University, Department of Medicine, School of Medicine, Taichung (China); Lin, Wan-Yu; Tsai, Shih-Chung [Taichung Veterans General Hospital, Department of Nuclear Medicine, Taichung (China); Wang, Kuo-Yang [Taichung Veterans General Hospital, Cardiovascular Center, Taichung (China); Chung-Shan Medical University, Department of Medicine, School of Medicine, Taichung (China); Chen, Shih-Ann [School of Medicine, National Yang-Ming University, Institute of Clinical Medicine, and Cardiovascular Research Institute, Department of Medicine, Taipei (China); Taipei Veterans General Hospital, Division of Cardiology, Department of Medicine, Taipei (China); Lloyd, Michael S.; Chen, Ji [Emory University, Department of Radiology and Imaging Sciences, Atlanta, GA (United States)

    2014-06-15

    The use of SPECT phase analysis to optimize left-ventricular (LV) lead positions for cardiac resynchronization therapy (CRT) was performed at baseline, but CRT works as simultaneous right ventricular (RV) and LV pacing. The aim of this study was to assess the impact of RV apical (RVA) pacing on optimal LV lead positions measured by SPECT phase analysis. This study prospectively enrolled 46 patients. Two SPECT myocardial perfusion scans were acquired under sinus rhythm with complete left bundle branch block and RVA pacing, respectively, following a single injection of {sup 99m}Tc-sestamibi. LV dyssynchrony parameters and optimal LV lead positions were measured by the phase analysis technique and then compared between the two scans. The LV dyssynchrony parameters were significantly larger with RVA pacing than with sinus rhythm (p ∝0.01). In 39 of the 46 patients, the optimal LV lead positions were the same between RVA pacing and sinus rhythm (kappa = 0.861). In 6 of the remaining 7 patients, the optimal LV lead positions were along the same radial direction, but RVA pacing shifted the optimal LV lead positions toward the base. The optimal LV lead positions measured by SPECT phase analysis were consistent, no matter whether the SPECT images were acquired under sinus rhythm or RVA pacing. In some patients, RVA pacing shifted the optimal LV lead positions toward the base. This study supports the use of baseline SPECT myocardial perfusion imaging to optimize LV lead positions to increase CRT efficacy. (orig.)

  14. Artificial Intelligence.

    Science.gov (United States)

    Waltz, David L.

    1982-01-01

    Describes kinds of results achieved by computer programs in artificial intelligence. Topics discussed include heuristic searches, artificial intelligence/psychology, planning program, backward chaining, learning (focusing on Winograd's blocks to explore learning strategies), concept learning, constraint propagation, language understanding…

  15. Leave-one-out prediction error of systolic arterial pressure time series under paced breathing

    CERN Document Server

    Ancona, N; Marinazzo, D; Nitti, L; Pellicoro, M; Pinna, G D; Stramaglia, S

    2004-01-01

    In this paper we show that different physiological states and pathological conditions may be characterized in terms of predictability of time series signals from the underlying biological system. In particular we consider systolic arterial pressure time series from healthy subjects and Chronic Heart Failure patients, undergoing paced respiration. We model time series by the regularized least squares approach and quantify predictability by the leave-one-out error. We find that the entrainment mechanism connected to paced breath, that renders the arterial blood pressure signal more regular, thus more predictable, is less effective in patients, and this effect correlates with the seriousness of the heart failure. The leave-one-out error separates controls from patients and, when all orders of nonlinearity are taken into account, alive patients from patients for which cardiac death occurred.

  16. Physics of Cardiac Arrhythmogenesis

    Science.gov (United States)

    Karma, Alain

    2013-04-01

    A normal heartbeat is orchestrated by the stable propagation of an excitation wave that produces an orderly contraction. In contrast, wave turbulence in the ventricles, clinically known as ventricular fibrillation (VF), stops the heart from pumping and is lethal without prompt defibrillation. I review experimental, computational, and theoretical studies that have shed light on complex dynamical phenomena linked to the initiation, maintenance, and control of wave turbulence. I first discuss advances made to understand the precursor state to a reentrant arrhythmia where the refractory period of cardiac tissue becomes spatiotemporally disordered; this is known as an arrhythmogenic tissue substrate. I describe observed patterns of transmembrane voltage and intracellular calcium signaling that can contribute to this substrate, and symmetry breaking instabilities to explain their formation. I then survey mechanisms of wave turbulence and discuss novel methods that exploit electrical pacing stimuli to control precursor patterns and low-energy pulsed electric fields to control turbulence.

  17. 42 CFR 460.122 - PACE organization's appeals process.

    Science.gov (United States)

    2010-10-01

    ...) PACE organization's written appeals process. The PACE organization must have a formal written appeals... process must include written procedures for the following: (1) Timely preparation and processing of a... writing. (e) Services furnished during appeals process. During the appeals process, the PACE...

  18. Visual aided pacing in respiratory maneuvers

    Energy Technology Data Exchange (ETDEWEB)

    Rambaudi, L R [Laboratorio de Biofisica y Fisiologia ' Antonio Sadi Frumento' (Argentina); Rossi, E [Catedra de Bioingenieria II (Argentina); Mantaras, M C [Catedra de Bioingenieria II (Argentina); Perrone, M S [Laboratorio de Biofisica y Fisiologia ' Antonio Sadi Frumento' (Argentina); Siri, L Nicola [Catedra de Bioingenieria II (Argentina)

    2007-11-15

    A visual aid to pace self-controlled respiratory cycles in humans is presented. Respiratory manoeuvres need to be accomplished in several clinic and research procedures, among others, the studies on Heart Rate Variability. Free running respiration turns to be difficult to correlate with other physiologic variables. Because of this fact, voluntary self-control is asked from the individuals under study. Currently, an acoustic metronome is used to pace respiratory frequency, its main limitation being the impossibility to induce predetermined timing in the stages within the respiratory cycle. In the present work, visual driven self-control was provided, with separate timing for the four stages of a normal respiratory cycle. This visual metronome (ViMet) was based on a microcontroller which power-ON and -OFF an eight-LED bar, in a four-stage respiratory cycle time series handset by the operator. The precise timing is also exhibited on an alphanumeric display.

  19. Multi-Leu PACE4 Inhibitor Retention within Cells Is PACE4 Dependent and a Prerequisite for Antiproliferative Activity

    Directory of Open Access Journals (Sweden)

    Frédéric Couture

    2015-01-01

    Full Text Available The overexpression as well as the critical implication of the proprotein convertase PACE4 in prostate cancer progression has been previously reported and supported the development of peptide inhibitors. The multi-Leu peptide, a PACE4-specific inhibitor, was further generated and its capability to be uptaken by tumor xenograft was demonstrated with regard to its PACE4 expression status. To investigate whether the uptake of this inhibitor was directly dependent of PACE4 levels, uptake and efflux from cancer cells were evaluated and correlations were established with PACE4 contents on both wild type and PACE4-knockdown cell lines. PACE4-knockdown associated growth deficiencies were established on the knockdown HepG2, Huh7, and HT1080 cells as well as the antiproliferative effects of the multi-Leu peptide supporting the growth capabilities of PACE4 in cancer cells.

  20. Temporary emergency pacing-an orphan in district hospitals

    DEFF Research Database (Denmark)

    Gjesdal, Knut; Johansen, Jens Brock; Gadler, Fredrik

    2012-01-01

    This editorial discusses a report on the 1 year experience with temporary pacing, especially in the emergency setting, in several Norwegian district hospitals. The vast majority of the patients received transvenous temporary pacing, and the majority of leads were placed by noncardiologists....... The procedure times were long and complications were frequent. The organization of emergency pacing is discussed, and we suggest that unless qualified physicians can establish transvenous pacing, the patients who need that should be transferred with transcutaneous pacing as back-up during transport...

  1. Pre-operative MRI in heart failure patients scheduled for cardiac resynchronization therapy

    NARCIS (Netherlands)

    Manzke, R.; Lutz, A.; Bornstedt , A.; Binner, L.; Merkle, N.; Gradinger, R..; Hombach, V.; Rasche, V.

    2009-01-01

    Cardiac resynchronization therapy (CRT) aims at improving the pumping function of the heart using bi-ventricular pacing. For the lead implantation procedure, knowledge of the heart function, the relevant anatomy (i.e. coro-nary sinus (CS), great cardiac vein (GCV) and its tributaries) and left ventr

  2. Cardiac Sarcoidosis.

    Science.gov (United States)

    Birnie, David; Ha, Andrew C T; Gula, Lorne J; Chakrabarti, Santabhanu; Beanlands, Rob S B; Nery, Pablo

    2015-12-01

    Studies suggest clinically manifest cardiac involvement occurs in 5% of patients with pulmonary/systemic sarcoidosis. The principal manifestations of cardiac sarcoidosis (CS) are conduction abnormalities, ventricular arrhythmias, and heart failure. Data indicate that an 20% to 25% of patients with pulmonary/systemic sarcoidosis have asymptomatic (clinically silent) cardiac involvement. An international guideline for the diagnosis and management of CS recommends that patients be screened for cardiac involvement. Most studies suggest a benign prognosis for patients with clinically silent CS. Immunosuppression therapy is advocated for clinically manifest CS. Device therapy, with implantable cardioverter defibrillators, is recommended for some patients.

  3. Systems biology and cardiac arrhythmias.

    Science.gov (United States)

    Grace, Andrew A; Roden, Dan M

    2012-10-27

    During the past few years, the development of effective, empirical technologies for treatment of cardiac arrhythmias has exceeded the pace at which detailed knowledge of the underlying biology has accumulated. As a result, although some clinical arrhythmias can be cured with techniques such as catheter ablation, drug treatment and prediction of the risk of sudden death remain fairly primitive. The identification of key candidate genes for monogenic arrhythmia syndromes shows that to bring basic biology to the clinic is a powerful approach. Increasingly sophisticated experimental models and methods of measurement, including stem cell-based models of human cardiac arrhythmias, are being deployed to study how perturbations in several biologic pathways can result in an arrhythmia-prone heart. The biology of arrhythmia is largely quantifiable, which allows for systematic analysis that could transform treatment strategies that are often still empirical into management based on molecular evidence.

  4. Cardiac Malpositions

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Shi Joon; Im, Chung Gie; Yeon, Kyung Mo; Hasn, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1979-06-15

    Cardiac Malposition refers to any position of the heart other than a left-sided heart in a situs solitus individual. Associated cardiac malformations are so complex that even angiocardiographic and autopsy studies may not afford an accurate information. Although the terms and classifications used to describe the internal cardiac anatomy and their arterial connections in cardiac malpositions differ and tend to be confusing, common agreement exists on the need for a segmental approach to diagnosis. Authors present 18 cases of cardiac malpositions in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul National University Hospital between 1971 and 1979. Authors analyzed the clinical, radiographic, operative and autopsy findings with the emphasis on the angiocardiographic findings. The results are as follows: 1. Among 18 cases with cardiac malpositions, 6 cases had dextrocardia with situs inversus, 9 cases had dextrocardia with situs solitus and 3 cases had levocardia with situs inversus. 2. There was no genuine exception to visceroatrial concordance rule. 3. Associated cardiac malpositions were variable and complex with a tendency of high association of transposition and double outlet varieties with dextrocardia in situs solitus and levocardia in situs inversus. Only one in 6 cases of dextrocardia with situs inversus had pure transposition. 4. In two cases associated pulmonary atresia was found at surgery which was not predicted by angiocardiography. 5. Because many of the associated complex lesions can be corrected surgically provided the diagnosis is accurate, the selective biplane angiocardiography with or without cineradiography is essential.

  5. Optimized pacing mode for hypertrophic cardiomyopathy: Impact of ECG fusion during pacing

    NARCIS (Netherlands)

    Berruezo, A.; Penela, D.; Burgos, F.; Evertz, R.; Fernandez-Armenta, J.; Roca, J.; Doltra, A.; Acosta, J.; Francino, A.; Sitges, M.; Alsina, X.; Ordonez, A.; Villuendas, R.; Brugada, R.; Mont, L.; Brugada, J.

    2015-01-01

    BACKGROUND: Electrocardiographic (ECG) fusion with intrinsic QRS could reduce the benefit of atrial synchronous biventricular pacing (AS-BiVP) in patients with hypertrophic obstructive cardiomyopathy (HOCM). OBJECTIVES: The purpose of this study was to assess the benefit of AS-BiVP and the influence

  6. Artificial blood

    Directory of Open Access Journals (Sweden)

    Sarkar Suman

    2008-01-01

    Full Text Available Artificial blood is a product made to act as a substitute for red blood cells. While true blood serves many different functions, artificial blood is designed for the sole purpose of transporting oxygen and carbon dioxide throughout the body. Depending on the type of artificial blood, it can be produced in different ways using synthetic production, chemical isolation, or recombinant biochemical technology. Development of the first blood substitutes dates back to the early 1600s, and the search for the ideal blood substitute continues. Various manufacturers have products in clinical trials; however, no truly safe and effective artificial blood product is currently marketed. It is anticipated that when an artificial blood product is available, it will have annual sales of over $7.6 billion in the United States alone.

  7. Artificial blood.

    Science.gov (United States)

    Sarkar, Suman

    2008-07-01

    Artificial blood is a product made to act as a substitute for red blood cells. While true blood serves many different functions, artificial blood is designed for the sole purpose of transporting oxygen and carbon dioxide throughout the body. Depending on the type of artificial blood, it can be produced in different ways using synthetic production, chemical isolation, or recombinant biochemical technology. Development of the first blood substitutes dates back to the early 1600s, and the search for the ideal blood substitute continues. Various manufacturers have products in clinical trials; however, no truly safe and effective artificial blood product is currently marketed. It is anticipated that when an artificial blood product is available, it will have annual sales of over $7.6 billion in the United States alone.

  8. Echocardiographic estimation of acute haemodynamic response during optimization of multisite pace-maker using different pacing modalities and atrioventricular delays

    Directory of Open Access Journals (Sweden)

    Šalinger-Martinović Sonja

    2009-01-01

    Full Text Available Background/Aim. Cardiac resynchronization therapy (CRT improves ventricular dyssynchrony and is associated with an improvement in symptoms, quality of life and prognosis in patients with severe heart failure and intraventricular conduction delay. Different pacing modalities produce variable activation patterns and may be a cause of different haemodynamic changes. The aim of our study was to investigate acute haemodynamic changes with different CRT configurations during optimization procedure. Methods. This study included 30 patients with severe left ventricular systolic dysfunction and left bundle branch block with wide QRS (EF 24.33 ± 3.7%, QRS 159 ± 17.3 ms, New York Heart Association III/IV 25/5 with implanted CRT device. The whole group of patients had severe mitral regurgitation in order to measure dP/dt. After implantation and before discharge all the patients underwent optimization procedure guided by Doppler echocardiography. Left and right ventricular pre-ejection intervals (LVPEI and RVPEI, interventricular mechanical delay (IVD and the maximal rate of ventricular pressure rise during early systole (max dP/dt were measured during left and biventricular pacing with three different atrioventricular (AV delays. Results. After CRT device optimization, optimal AV delay and CRT mode were defined. Left ventricular pre-ejection intervals changed from 170.5 ± 24.6 to 145.9 ± 9.5 (p < 0.001, RVPEI from 102.4 ± 15.9 to 119.8 ± 10.9 (p < 0.001, IVD from 68.1 ± 18.3 to 26.5 ± 8.2 (p < 0.001 and dP/dt from 524.2 ± 67 to 678.2 ± 88.5 (p < 0.01. Conclusion. In patients receiving CRT echocardiographic assessment of the acute haemodynamic response to CRT is a useful tool in optimization procedure. The variability of Doppler parameters with different CRT modalities emphasizes the necessity of individualized approach in optimization procedure.

  9. Enact legislation supporting residential property assessed clean energy financing (PACE)

    Energy Technology Data Exchange (ETDEWEB)

    Saha, Devashree

    2012-11-15

    Congress should enact legislation that supports residential property assessed clean energy (PACE) programs in the nation’s states and metropolitan areas. Such legislation should require the Federal Housing Finance Agency (FHFA) to allow Fannie Mae and Freddie Mac to purchase residential mortgages with PACE assessments while at the same time providing responsible underwriting standards and a set of benchmarks for residential PACE assessments in order to minimize financial risks to mortgage holders. Congressional support of residential PACE financing will improve energy efficiency, encourage job creation, and foster economic growth in the nation’s state and metropolitan areas.

  10. Artificial intelligence

    CERN Document Server

    Ennals, J R

    1987-01-01

    Artificial Intelligence: State of the Art Report is a two-part report consisting of the invited papers and the analysis. The editor first gives an introduction to the invited papers before presenting each paper and the analysis, and then concludes with the list of references related to the study. The invited papers explore the various aspects of artificial intelligence. The analysis part assesses the major advances in artificial intelligence and provides a balanced analysis of the state of the art in this field. The Bibliography compiles the most important published material on the subject of

  11. Artificial urushi.

    Science.gov (United States)

    Kobayashi, S; Uyama, H; Ikeda, R

    2001-11-19

    A new concept for the design and laccase-catalyzed preparation of "artificial urushi" from new urushiol analogues is described. The curing proceeded under mild reaction conditions to produce the very hard cross-linked film (artificial urushi) with a high gloss surface. A new cross-linkable polyphenol was synthesized by oxidative polymerization of cardanol, a phenol derivative from cashew-nut-shell liquid, by enzyme-related catalysts. The polyphenol was readily cured to produce the film (also artificial urushi) showing excellent dynamic viscoelasticity.

  12. A comparative study of right ventricular outflow tract pacing and right ventricular apical pacing in children%儿童右室流出道起搏与右室心尖起搏的对比研究

    Institute of Scientific and Technical Information of China (English)

    陈晶; 曾国洪; 曾少颖; 王树水

    2014-01-01

    目的:回顾性对比研究儿童行VVI起搏治疗的右室流出道起搏与右室心尖部起搏对近期心功能、QRS波时限及起搏参数的影响。方法:回顾2006年7月至2013年11月,在我科行VVI起搏治疗的38例患儿病例资料,根据术中记录螺旋电极植入的部位分为右室流出道组(n=22)和右室心尖部组(n=16)。记录术前和术后的心脏彩超心功能指标及QRS波时限,术中与术后起搏参数指标进行比较。结果:右室流出道组与右室心尖组在术前及术后心功能指标、术中及术后的起搏阈值差值、导线阻抗差值、R波幅度差值差异无统计学意义。右室流出道起搏组与右室心尖起搏组术后QRS波时限增宽,差异有统计学意义。术前与术后的QRS波时限差值[(134.95±12.86)ms vs(147.44±22.35)ms,t=1.35,P=0.01],差异有统计学意义。结论:儿童右室流出道起搏安全可行,两者起搏术后QRS波时限增宽,但右室心尖起搏组QRS波时限增宽更明显。%Objective To compare the impacts of right ventricular outflow tract pacing and right ventricular apical pacing on short-term cardiac function, QRS duration and pacing parameters in children undergoing VVI pacemaker therapy. Methods The clinical data of 38 children undergoing VVI pacemaker treatment in our department from July 2006 to November 2013 were retrospectively reviewed and analyzed to make grouping: 22 with right ventricular outflow tract pacing based on the operational records were assigned in one group and 16 with right ventricular apical pacing as the other group. The two groups were compared in terms of cardiac function indexes , QRS complex width and intra- and post- operative parameters of the implanted pacemakers. Results There were no significant differences between the two groups in pre-and post-operative cardiac function indexes , intra- and post-operative difference in pacing thresholds

  13. Cardiac cameras.

    Science.gov (United States)

    Travin, Mark I

    2011-05-01

    Cardiac imaging with radiotracers plays an important role in patient evaluation, and the development of suitable imaging instruments has been crucial. While initially performed with the rectilinear scanner that slowly transmitted, in a row-by-row fashion, cardiac count distributions onto various printing media, the Anger scintillation camera allowed electronic determination of tracer energies and of the distribution of radioactive counts in 2D space. Increased sophistication of cardiac cameras and development of powerful computers to analyze, display, and quantify data has been essential to making radionuclide cardiac imaging a key component of the cardiac work-up. Newer processing algorithms and solid state cameras, fundamentally different from the Anger camera, show promise to provide higher counting efficiency and resolution, leading to better image quality, more patient comfort and potentially lower radiation exposure. While the focus has been on myocardial perfusion imaging with single-photon emission computed tomography, increased use of positron emission tomography is broadening the field to include molecular imaging of the myocardium and of the coronary vasculature. Further advances may require integrating cardiac nuclear cameras with other imaging devices, ie, hybrid imaging cameras. The goal is to image the heart and its physiological processes as accurately as possible, to prevent and cure disease processes.

  14. Artificial Reefs

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — An artificial reef is a human-made underwater structure, typically built to promote marine life in areas with a generally featureless bottom, control erosion, block...

  15. Artificial Limbs

    Science.gov (United States)

    ... diabetes. They may cause you to need an amputation. Traumatic injuries, including from traffic accidents and military combat Cancer Birth defects If you are missing an arm or leg, an artificial limb can sometimes replace it. The device, which is ...

  16. Natural - synthetic - artificial!

    DEFF Research Database (Denmark)

    Nielsen, Peter E

    2010-01-01

    The terms "natural," "synthetic" and "artificial" are discussed in relation to synthetic and artificial chromosomes and genomes, synthetic and artificial cells and artificial life.......The terms "natural," "synthetic" and "artificial" are discussed in relation to synthetic and artificial chromosomes and genomes, synthetic and artificial cells and artificial life....

  17. Increases in myocardial workload induced by rapid atrial pacing trigger alterations in global metabolism.

    Directory of Open Access Journals (Sweden)

    Aslan T Turer

    Full Text Available To determine whether increases in cardiac work lead to alterations in the plasma metabolome and whether such changes arise from the heart or peripheral organs.There is growing evidence that the heart influences systemic metabolism through endocrine effects and affecting pathways involved in energy homeostasis.Nineteen patients referred for cardiac catheterization were enrolled. Peripheral and selective coronary sinus (CS blood sampling was performed at serial timepoints following the initiation of pacing, and metabolite profiling was performed by liquid chromatography-mass spectrometry (LC-MS.Pacing-stress resulted in a 225% increase in the median rate·pressure product from baseline. Increased myocardial work induced significant changes in the peripheral concentration of 43 of 125 metabolites assayed, including large changes in purine [adenosine (+99%, p = 0.006, ADP (+42%, p = 0.01, AMP (+79%, p = 0.004, GDP (+69%, p = 0.003, GMP (+58%, p = 0.01, IMP (+50%, p = 0.03, xanthine (+61%, p = 0.0006], and several bile acid metabolites. The CS changes in metabolites qualitatively mirrored those in the peripheral blood in both timing and magnitude, suggesting the heart was not the major source of the metabolite release.Isolated increases in myocardial work can induce changes in the plasma metabolome, but these changes do not appear to be directly cardiac in origin. A number of these dynamic metabolites have known signaling functions. Our study provides additional evidence to a growing body of literature on metabolic 'cross-talk' between the heart and other organs.

  18. How do we perceive activity pacing in rheumatology care?

    DEFF Research Database (Denmark)

    Cuperus, N.; Vliet Vlieland, T.; Brodin, N.;

    2015-01-01

    Background: Activity pacing is a recommended non-pharmacological intervention for the management of rheumatic and musculoskeletal diseases in international clinical guidelines. In clinical practice, activity pacing aims at adapting daily activities, and is often an important component of self-management...

  19. PACE3 - front-end chip for the CMS Preshower

    CERN Multimedia

    Aspel, Paul

    2003-01-01

    This is PACE3 which is the front-end chip for the CMS Preshower. In fact PACE3 is the combination of two ASICs called Delta3 and PACEAM3. Delta3 is on the left and PACEAM3 is on the right. The two ASICs are bonded together and then packaged within a single 196 pin fpBGA package.

  20. Is Self-Paced Instruction Really Worth It?

    Science.gov (United States)

    Roberson, J. A.; Crowe, C. T.

    1975-01-01

    Describes a self-paced, learning-for-mastery course in undergraduate fluid mechanics. Includes the method of course assessment, method of student evaluation, and a description of the instructor's role and work load. Summarizes aspects of self-paced instruction considered favorable and unfavorable. (GS)

  1. Rechargeable silver-modified mercuric oxide-zinc cell for cardiac pacemakers.

    Science.gov (United States)

    Tyers, G F; Hughes, H C; Brownlee, R R; Manley, N J; Gorman, I N

    1976-11-04

    Tests were conducted on rechargeable mercury-zinc pacemaker batteries under simulated and actual biologic conditions, using a variety of discharge rates and charging schedules. In tests on 96 cells at a 6.4 milliampere (ma) discharge, recharging once every 15 months of simulated pacing at a 25 microampere (mua) drain, the earliest cell failure occurred after an equivalent of 50 years of pacing. The mean pacing equivalent for all 96 cells was more than 140 years. In 6.4 ma discharge tests on 24 cells, recharging once every 8 days of simulated pacing, only 1 cell in 24 failed after an equivalent of more than 500 years of pacing (actual time 2 years). In tests on 13 cells pacing at a 200 mua drain without recharging, the simulated mean duration of pacing before total discharge was 4.8 years. Seven other cells at a 200 mua drain with periodic recharging continue to function normally after more than 7 years of actual time, simulating 56 years of pacing at a 25 mua drain. Cardiac pacemakers using the rechargeable mercury-zinc cell have been implanted in animals for more than 2 1/2 years and in patients for more than 1 year with all units continuing to function satisfactorily. It has been demonstrated unequivocally that a rechargeable mercury-zinc pacemaker will function continuously for more than 4 years without recharging and that periodic recharging will extend pacing life far beyond that predicted for lithium and nuclear primary power sources.

  2. Atrial-based pacing has no benefit over ventricular pacing in preventing atrial arrhythmias in adults with congenital heart disease

    NARCIS (Netherlands)

    Opic, P.; Yap, S.C.; Kranenburg, M. van; Dijk, A.P.J. van; Budts, W.; Vliegen, H.W.; Erven, L. van; Can, A.; Sahin, G.; Groot, N.M. de; Witsenburg, M.; Roos-Hesselink, J.W.

    2013-01-01

    AIMS: To determine whether atrial-based pacing prevents atrial arrhythmias in adults with congenital heart disease (CHD) compared with ventricular pacing. METHODS AND RESULTS: All adult CHD patients from four participating centres with a permanent pacemaker were identified. Patients with permanent a

  3. A comparison of single-lead atrial pacing with dual-chamber pacing in sick sinus syndrome

    DEFF Research Database (Denmark)

    Nielsen, Jens Cosedis; Thomsen, Poul Erik B; Højberg, Søren

    2011-01-01

    In patients with sick sinus syndrome, bradycardia can be treated with a single-lead pacemaker or a dual-chamber pacemaker. Previous trials have revealed that pacing modes preserving atrio-ventricular synchrony are superior to single-lead ventricular pacing, but it remains unclear if there is any ...

  4. Cardiac echinococcosis

    Directory of Open Access Journals (Sweden)

    Ivanović-Krstić Branislava A.

    2002-01-01

    Full Text Available Cardiac hydatid disease is rare. We report on an uncommon hydatid cyst localized in the right ventricular wall, right atrial wall tricuspid valve left atrium and pericard. A 33-year-old woman was treated for cough, fever and chest pain. Cardiac echocardiograpic examination revealed a round tumor (5.8 x 4 cm in the right ventricular free wall and two smaller cysts behind that tumor. There were cysts in right atrial wall and tricuspidal valve as well. Serologic tests for hydatidosis were positive. Computed tomography finding was consistent with diagnosis of hydatid cyst in lungs and right hylar part. Surgical treatment was rejected due to great risk of cardiac perforation. Medical treatment with albendazole was unsuccessful and the patient died due to systemic hydatid involvement of the lungs, liver and central nervous system.

  5. Biventricular Pacing Therapy for Heart Failure

    Institute of Scientific and Technical Information of China (English)

    Henry; Cheuk - Man Yu

    2001-01-01

    @@eart failure is a disease with high morbidity and mortality. It is also the commonest cause of medical ward admission. The incidence of heart failure has been increasing world-wide in the past decade.Studies observed that about 25 - 50 % of patients with heart failure had evidence of electromechanical delay,commonly in the form of left bundle branch block or intraventricular conduction delay on surface electrocardiogram. This condition results in dyssynchronous contraction, mitral regurgitation and was associated with a worse prognosis. These patients may therefore benefit from cardiac resynchronization therapy.

  6. Artificial Intelligence

    CERN Document Server

    Warwick, Kevin

    2011-01-01

    if AI is outside your field, or you know something of the subject and would like to know more then Artificial Intelligence: The Basics is a brilliant primer.' - Nick Smith, Engineering and Technology Magazine November 2011 Artificial Intelligence: The Basics is a concise and cutting-edge introduction to the fast moving world of AI. The author Kevin Warwick, a pioneer in the field, examines issues of what it means to be man or machine and looks at advances in robotics which have blurred the boundaries. Topics covered include: how intelligence can be defined whether machines can 'think' sensory

  7. Artificial sweeteners

    DEFF Research Database (Denmark)

    Raben, Anne Birgitte; Richelsen, Bjørn

    2012-01-01

    Artificial sweeteners can be a helpful tool to reduce energy intake and body weight and thereby risk for diabetes and cardiovascular diseases (CVD). Considering the prevailing diabesity (obesity and diabetes) epidemic, this can, therefore, be an important alternative to natural, calorie-containin......Artificial sweeteners can be a helpful tool to reduce energy intake and body weight and thereby risk for diabetes and cardiovascular diseases (CVD). Considering the prevailing diabesity (obesity and diabetes) epidemic, this can, therefore, be an important alternative to natural, calorie...

  8. Pushing the pace of tree species migration.

    Directory of Open Access Journals (Sweden)

    Eli D Lazarus

    Full Text Available Plants and animals have responded to past climate changes by migrating with habitable environments, sometimes shifting the boundaries of their geographic ranges by tens of kilometers per year or more. Species migrating in response to present climate conditions, however, must contend with landscapes fragmented by anthropogenic disturbance. We consider this problem in the context of wind-dispersed tree species. Mechanisms of long-distance seed dispersal make these species capable of rapid migration rates. Models of species-front migration suggest that even tree species with the capacity for long-distance dispersal will be unable to keep pace with future spatial changes in temperature gradients, exclusive of habitat fragmentation effects. Here we present a numerical model that captures the salient dynamics of migration by long-distance dispersal for a generic tree species. We then use the model to explore the possible effects of assisted colonization within a fragmented landscape under a simulated tree-planting scheme. Our results suggest that an assisted-colonization program could accelerate species-front migration rates enough to match the speed of climate change, but such a program would involve an environmental-sustainability intervention at a massive scale.

  9. The evolution of pace in popular movies.

    Science.gov (United States)

    Cutting, James E

    2016-01-01

    Movies have changed dramatically over the last 100 years. Several of these changes in popular English-language filmmaking practice are reflected in patterns of film style as distributed over the length of movies. In particular, arrangements of shot durations, motion, and luminance have altered and come to reflect aspects of the narrative form. Narrative form, on the other hand, appears to have been relatively unchanged over that time and is often characterized as having four more or less equal duration parts, sometimes called acts - setup, complication, development, and climax. The altered patterns in film style found here affect a movie's pace: increasing shot durations and decreasing motion in the setup, darkening across the complication and development followed by brightening across the climax, decreasing shot durations and increasing motion during the first part of the climax followed by increasing shot durations and decreasing motion at the end of the climax. Decreasing shot durations mean more cuts; more cuts mean potentially more saccades that drive attention; more motion also captures attention; and brighter and darker images are associated with positive and negative emotions. Coupled with narrative form, all of these may serve to increase the engagement of the movie viewer.

  10. The road to right ventricular septal pacing: techniques and tools.

    Science.gov (United States)

    Mond, Harry G

    2010-07-01

    Prolonged right ventricular (RV) apical pacing is associated with progressive left ventricular dysfunction due to dysynchronous ventricular activation and contraction. RV septal pacing allows a narrower QRS compared to RV apical pacing, which might reflect a more physiological and synchronous ventricular activation. Previous clinical studies, which did not consistently achieve RV septal pacing, were not confirmatory and need to be repeated. This review summarizes the anatomy of the RV septum, the radiographic appearances of pacing leads in the RV, the electrocardiograph correlates of RV septal lead positioning, and the techniques and tools required for implantation of an active-fixation lead onto the RV septum. Using the described techniques and tools, conventional active-fixation leads can now be reliably secured to either the RV outflow tract septum or mid-RV septum with very low complication rates and good long-term performance. Even though physiologic and hemodynamic studies on true RV septal pacing have not been completed, the detrimental effects of long-term RV apical pacing are significant enough to suggest that it is now time to leave the RV apex and secure all RV leads onto the septum.

  11. Cardiac Rehabilitation

    Science.gov (United States)

    ... your risk of future heart problems, and to improve your health and quality of life. Cardiac rehabilitation programs increase ... exercise routine at home or at a local gym. You may also continue to ... health concerns. Education about nutrition, lifestyle and weight loss ...

  12. 基因重组心肌肌钙蛋白I融合蛋白的抗肿瘤效应%Inhibitory effect of tumor growth of recombinant protein fused with cardiac troponin I and artificial peptide

    Institute of Scientific and Technical Information of China (English)

    雷光强; 刘朝阳; 姜懿纳; 李金萍; 曹勤燕; 李涛; 刘凤鸣

    2015-01-01

    目的:研究基因重组心肌肌钙蛋白I 与人工短肽的融合蛋白( CIS)对肿瘤生长的作用。方法用MTT法观察CIS体外对人脐静脉内皮细胞( HUVEC)生长的作用。利用鸡胚绒毛尿囊膜模型观察CIS对新生血管生长的影响。用6种小鼠肿瘤异位可移植模型观察CIS在体内对肿瘤生长的作用。结果 CIS对HUVEC细胞增殖具有明显抑制作用,并呈剂量依赖关系;鸡胚绒毛尿囊膜实验显示,CIS 浓度为5、10 mg·L-1时,新生血管生成的数量明显减少;荷瘤鼠体内异位移植模型实验显示:CIS(10 mg·kg-1)处理组肿瘤生长缓慢,瘤体明显小于模型对照组,对 S180肿瘤瘤重抑制率85.3%,对Lewis肺癌肿瘤瘤重抑制率87.0%,对H22肝癌肿瘤瘤重抑制率84.2%,对人小细胞肺癌H446肿瘤瘤重抑制率60.42%,对人可移植性肝癌SMMC7721肿瘤瘤重抑制率61.62%,对人胃低分化腺癌BGC823肿瘤瘤重抑制率为41.84%。结论 CIS在体外抑制HUVEC细胞的生长,在鸡胚绒毛尿囊膜实验中,CIS对新生血管生成有明显的抑制作用。在体内,CIS融合蛋白可有效抑制小鼠可移植肿瘤细胞的生长。 CIS抗肿瘤效应很可能是通过抑制肿瘤组织中血管内皮细胞的增殖,进而减少肿瘤组织中新生血管生成的数量而达到的。%Aim To examine the inhibitory effect of re-combinant cardiac troponin fusion protein composed of subunit I and artificial peptide which was called CIS on tumor growth. Methods The CIS ’ s effect on the growth of human umbilical vein endothelial cells ( HU-VEC) was examined using MTT assay in vitro. Chick chorioallantoic membrane model was applied to study the alteration of angiogenesis treated with purified re-combinant CIS protein. The effect of tumor growth trea-ted with CIS was observed using several in vivo mice xenograft models. Results There was a statistically significant reduction in HUVEC cell proliferative rate when the cells were treated

  13. Pacing: A Concept Analysis of a Chronic Pain Intervention

    Directory of Open Access Journals (Sweden)

    Kathryn Jamieson-Lega

    2013-01-01

    Full Text Available BACKGROUND: The intervention of pacing is regularly recommended for chronic pain patients. However, pacing is poorly defined and appears to be interpreted in varying, potentially contradictory manners within the field of chronic pain. This conceptual lack of clarity has implications for effective service delivery and for researchers’ ability to conduct rigorous study. An examination of the background literature demonstrates that while pacing is often one part of a multidisciplinary pain management program, outcome research is hindered by a lack of a clear and shared definition of this currently ill-defined construct.

  14. Artificial life: The coming evolution

    Energy Technology Data Exchange (ETDEWEB)

    Farmer, J.D. (Los Alamos National Lab., NM (USA) Santa Fe Inst., NM (USA)); Belin, A.d' A. (Shute, Mihaly, and Weinberger, Santa Fe, NM (USA))

    1990-01-01

    Within fifty to a hundred years a new class of organisms is likely to emerge. These organisms will be artificial in the sense that they will originally be designed by humans. However, they will reproduce, and will evolve into something other than their initial form; they will be alive'' under any reasonable definition of the word. These organisms will evolve in a fundamentally different manner than contemporary biological organisms, since their reproduction will be under at least partial conscious control, giving it a Lamarckian component. The pace of evolutionary change consequently will be extremely rapid. The advent of artificial life will be the most significant historical event since the emergence of human beings. The impact on humanity and the biosphere could be enormous, larger than the industrial revolution, nuclear weapons, or environmental pollution. We must take steps now to shape the emergence of artificial organisms; they have potential to be either the ugliest terrestrial disaster, or the most beautiful creation of humanity. 22 refs., 3 figs.

  15. Fast Paced, Low Cost Projects at MSFC

    Science.gov (United States)

    Watson-Morgan, Lisa; Clinton, Raymond

    2012-01-01

    What does an orbiting microsatellite, a robotic lander and a ruggedized camera and telescope have in common? They are all fast paced, low cost projects managed by Marshall Space Flight Center (MSFC) teamed with successful industry partners. MSFC has long been synonymous with human space flight large propulsion programs, engineering acumen and risk intolerance. However, there is a growing portfolio/product line within MSFC that focuses on these smaller, fast paced projects. While launching anything into space is expensive, using a managed risk posture, holding to schedule and keeping costs low by stopping at egood enough f were key elements to their success. Risk is defined as the possibility of loss or failure per Merriam Webster. The National Aeronautics and Space Administration (NASA) defines risk using procedural requirement 8705.4 and establishes eclasses f to discern the acceptable risk per a project. It states a Class D risk has a medium to significant risk of not achieving mission success. MSFC, along with industry partners, has created a niche in Class D efforts. How did the big, cautious MSFC succeed on these projects that embodied the antithesis of its heritage in human space flight? A key factor toward these successful projects was innovative industry partners such as Dynetics Corporation, University of Alabama in Huntsville (UAHuntsville), Johns Hopkins Applied Physics Laboratory (JHU APL), Teledyne Brown Engineering (TBE), Von Braun Center for Science and Innovation (VCSI), SAIC, and Jacobs. Fast Affordable Satellite Technology (FastSat HSV01) is a low earth orbit microsatellite that houses six instruments with the primary scientific objective of earth observation and technology demonstration. The team was comprised of Dynetics, UAHuntsvile, SAIC, Goddard Space Flight Center (GSFC) and VCSI with the United States Air Force Space Test Program as the customer. The team completed design, development, manufacturing, environmental test and integration in

  16. Characterizing Spatial Dynamics of Bifurcation to Alternans in Isolated Whole Rabbit Hearts Based on Alternate Pacing

    Directory of Open Access Journals (Sweden)

    Kanchan Kulkarni

    2015-01-01

    Full Text Available Sudden cardiac death instigated by ventricular fibrillation (VF is the largest cause of natural death in the USA. Alternans, a beat-to-beat alternation in the action potential duration, has been implicated as being proarrhythmic. The onset of alternans is mediated via a bifurcation, which may occur through either a smooth or a border-collision mechanism. The objective of this study was to characterize the mechanism of bifurcation to alternans based on experiments in isolated whole rabbit hearts. High resolution optical mapping was performed and the electrical activity was recorded from the left ventricle (LV epicardial surface of the heart. Each heart was paced using an “alternate pacing protocol,” where the basic cycle length (BCL was alternatively perturbed by ±δ. Local onset of alternans in the heart, BCLstart, was measured in the absence of perturbations (δ=0 and was defined as the BCL at which 10% of LV exhibited alternans. The influences of perturbation size were investigated at two BCLs: one prior to BCLstart (BCLprior=BCLstart+20 ms and one preceding BCLprior (BCLfar=BCLstart+40 ms. Our results demonstrate significant spatial correlation of the region exhibiting alternans with smooth bifurcation characteristics, indicating that transition to alternans in isolated rabbit hearts occurs predominantly through smooth bifurcation.

  17. Artificial ribonucleases.

    Science.gov (United States)

    Morrow, J R

    1994-01-01

    Many inorganic and organic compounds promote the reactions catalyzed by RNase A. Both the transesterification step, where a 2',3'-cyclic phosphate is formed with concomitant cleavage of RNA, and the hydrolysis step, where the 2',3'-cyclic phosphate is converted to a phosphate monoester, may be mimicked with compounds that are readily synthesized in the laboratory. Electrophilic activation of the phosphate ester and charge neutralization are generally important means by which artificial RNases promote phosphate diester displacement reactions. Several artificial RNases operate by a bifunctional general acid/general base mechanism, as does RNase A. Provision of an intramolecular nucleophile appears to be an important pathway for metal complex promoted phosphate diester hydrolysis. In contrast to the successful design of compounds that promote the reactions catalyzed by RNase A, there are no artificial nucleases to date that will cleave the 3' P-O bond of RNA or hydrolyze an oligonucleotide of DNA. Artificial RNases based on both metal complexes and organic compounds have been described. Metal complexes may be particularly effective catalysts for both transesterification and hydrolysis reactions of phosphate diesters. Under physiological conditions (37 degrees C and neutral pH), several metal complexes catalyze the transesterification of RNA. Future work should involve the development of metal complexes which are inert to metal ion release but which maintain open coordination sites for catalytic activity. The design of compounds containing multiple amine or imidazole groups that may demonstrate bifunctional catalysis is a promising route to new artificial RNases. Further design of these compounds and careful placement of catalytic groups may yield new RNase mimics that operate under physiological conditions. The attachment of artificial RNases to recognition agents such as oligodeoxynucleotides to create new sequence-specific endoribonucleases is an exciting field of

  18. Direct His-bundle pacing: present and future.

    Science.gov (United States)

    Deshmukh, Pramod M; Romanyshyn, Mary

    2004-06-01

    Direct His-bundle pacing (DHBP) produces rapid sequential multisite synchronous ventricular activation and, therefore, would be an ideal alternative to right ventricular apical (RVA) pacing. In 54 patients with cardiomyopathy, ejection fraction (EF) 0.23 +/- 0.11, persistent atrial fibrillation, and normal QRS Treppe effect) was investigated. Twelve patients who also received a RVA lead underwent cardiopulmonary testing. After a mean follow-up of 42 months, 29 patients are still alive with EF improving from 0.23 +/- 0.11 to 0.33 +/- 0.15. Functional class improved from 3.5 to 2.2. DP/dt increased at each pacing site (P Treppe effect and increased cardiopulmonary reserve when compared to RVA pacing.

  19. Functional remodeling of Ca2+-activated Cl- channel in pacing induced canine failing heart

    Institute of Scientific and Technical Information of China (English)

    Ning Li; Kejuan Ma; Siyong Teng; Jonathan C.Makielski; Jielin Pu

    2008-01-01

    Objective To determine whether Ca2+ activated Cl- current(Icl(Ca)) contributes to the functional remodeling of the failing heart.Methods Whole cell patch-clamp recording technique was employed to record the Icl(Ca) in cardiac myocytes enzymatically isolatedfrom rapidly pacing induced canine failing hearts at room temperature and compared that of the normal hearts (Nor).Results Thecurrent density of DIDS(200M)sensitive Icl(Ca) induced by intracellular Ca2+ release trigged by L-type Ca2+ current(Ica,L)wassignificantly decreased in heart failare(HE)cells compared to Nor cells.At membrane voltage of 20mV,the Icl(Ca) density was 3.02±0.54 pA/pF in Nor(n=6)vs.1.31±0.25 pA/pF in HF(n=8)cells,(P<0.01),while the averaged Ica,L density did not show differencebetween two groups.The time constant of current decay of Icl(Ca) was similar in both types of cells.On the other hand,in intra cellularCa2+ clamped mode,where the[Ca2+];was maintained at 100nmol/L,Icl(Ca) density be increased significantly in HF cells when themembrane voltage at+30mV or higher.Conclusions Our results suggest that Icl(Ca) density was decreased in pacing induced failingheart but the channel function be enhanced.Impaired Ca2+ handing in HF cells rather than reduced,Icl(Ca) channel function itself may havecaused this abnormality.The Icl(Ca) density reduction might contribute to the prolongation of action potential in failing heart.The Icl(Ca)channel function up-rugulation is likely to cause cardiac arrhythmia by inducing a delayed after depolarization,when Ca2+ overloadoccurred in diastolic failing heart cells.

  20. Cardiac resynchronization therapy pacemaker: critical appraisal of the adaptive CRT-P device

    Directory of Open Access Journals (Sweden)

    Daoud GE

    2016-01-01

    Full Text Available Georges E Daoud,1 Mahmoud Houmsse2 1Department of the Biomedical Research, 2Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA Abstract: Cardiac resynchronization therapy (CRT is an effective and well-established therapy for patients suffering with heart failure, left ventricular (LV systolic dysfunction (ejection fraction ≤35%, and electrical dyssynchrony, demonstrated by a surface QRS duration of ≥120 ms. Patients undergoing treatment with CRT have shown significant improvement in functional class, quality of life, LV ejection fraction, exercise capacity, hemodynamics, and reverse remodeling of LV, and ultimately, morbidity and mortality. However, 30%–40% of patients who receive a CRT device may not show improvement, and they are termed as nonresponders. The nonresponders have a poor prognosis; several methods have been developed to try to enhance response to CRT. Echocardiography-guided optimization of CRT has not resulted in significant clinical benefit, since it is done at rest with the patient in supine position. An ideal optimization strategy would provide continuous monitoring and adjustment of device pacing to provide maximal cardiac resynchronization, under a multitude of physiologic states. Intrinsic activation of the right ventricle (RV with paced activation of the RV, even in the setting of biventricular (BiV pacing, may result in an adverse effect on cardiac performance. With this physiology, the use of LV-only pacing may be preferred and may enhance CRT. Adaptive CRT is a novel device-based algorithm that was designed to achieve patient-specific adjustment in CRT so as to provide appropriate BiV pacing or LV-only pacing. This article will review the goals of CRT optimization, and implementation and outcomes associated with adaptive CRT. Keywords: heart failure, cardiac resynchronization, therapy, adaptive, left and biventricular pacing

  1. Artificial Intelligence.

    Science.gov (United States)

    Lawrence, David R; Palacios-González, César; Harris, John

    2016-04-01

    It seems natural to think that the same prudential and ethical reasons for mutual respect and tolerance that one has vis-à-vis other human persons would hold toward newly encountered paradigmatic but nonhuman biological persons. One also tends to think that they would have similar reasons for treating we humans as creatures that count morally in our own right. This line of thought transcends biological boundaries-namely, with regard to artificially (super)intelligent persons-but is this a safe assumption? The issue concerns ultimate moral significance: the significance possessed by human persons, persons from other planets, and hypothetical nonorganic persons in the form of artificial intelligence (AI). This article investigates why our possible relations to AI persons could be more complicated than they first might appear, given that they might possess a radically different nature to us, to the point that civilized or peaceful coexistence in a determinate geographical space could be impossible to achieve.

  2. Artificial blood.

    OpenAIRE

    1983-01-01

    #Blood substitutes have been developed for almost a century. The various type of artificial blood was continuously available on the market. The theme of this report is to identify the best substitute in emergency situation for some patients and science students. The definition of best is given; thus, as the vital part of the report, the comparison between them is described and discussed. Modified hemoglobin, bovine-based hemoglobin and PFCs are three basic types. In terms of the perfor...

  3. Cardiac Calcification

    Directory of Open Access Journals (Sweden)

    Morteza Joorabian

    2011-05-01

    Full Text Available There is a spectrum of different types of cardiac"ncalcifications with the importance and significance"nof each type of cardiac calcification, especially"ncoronary artery calcification. Radiologic detection of"ncalcifications within the heart is quite common. The"namount of coronary artery calcification correlates"nwith the severity of coronary artery disease (CAD."nCalcification of the aortic or mitral valve may indicate"nhemodynamically significant valvular stenosis."nMyocardial calcification is a sign of prior infarction,"nwhile pericardial calcification is strongly associated"nwith constrictive pericarditis. A spectrum of different"ntypes of cardiac calcifications (linear, annular,"ncurvilinear,... could be seen in chest radiography and"nother imaging modalities. So a carful inspection for"ndetection and reorganization of these calcifications"nshould be necessary. Numerous modalities exist for"nidentifying coronary calcification, including plain"nradiography, fluoroscopy, intravascular ultrasound,"nMRI, echocardiography, and conventional, helical and"nelectron-beam CT (EBCT. Coronary calcifications"ndetected on EBCT or helical CT can be quantifie,"nand a total calcification score (Cardiac Calcification"nScoring may be calculated. In an asymptomatic"npopulation and/or patients with concomitant risk"nfactors like diabetes mellitus, determination of the"npresence of coronary calcifications identifies the"npatients at risk for future myocardial infarction and"ncoronary artery disease. In patients without coronary"ncalcifications, future cardiovascular events could"nbe excluded. Therefore, detecting and recognizing"ncalcification related to the heart on chest radiography"nand other imaging modalities such as fluoroscopy, CT"nand echocardiography may have important clinical"nimplications.

  4. The Pace of Perceivable Extreme Climate Change

    Science.gov (United States)

    Tan, X.; Gan, T. Y.

    2015-12-01

    When will the signal of obvious changes in extreme climate emerge over climate variability (Time of Emergence, ToE) is a key question for planning and implementing measures to mitigate the potential impact of climate change to natural and human systems that are generally adapted to potential changes from current variability. We estimated ToEs for the magnitude, duration and frequency of global extreme climate represented by 24 extreme climate indices (16 for temperature and 8 for precipitation) with different thresholds of the signal-to-noise (S/N) ratio based on projections of CMIP5 global climate models under RCP8.5 and RCP4.5 for the 21st century. The uncertainty of ToE is assessed by using 3 different methods to calculate S/N for each extreme index. Results show that ToEs of the projected extreme climate indices based on the RCP4.5 climate scenarios are generally projected to happen about 20 years later than that for the RCP8.5 climate scenarios. Under RCP8.5, the projected magnitude, duration and frequency of extreme temperature on Earth will all exceed 2 standard deviations by 2100, and the empirical 50th percentile of the global ToE for the frequency and magnitude of hot (cold) extreme are about 2040 and 2054 (2064 and 2054) for S/N > 2, respectively. The 50th percentile of global ToE for the intensity of extreme precipitation is about 2030 and 2058 for S/N >0.5 and S/N >1, respectively. We further evaluated the exposure of ecosystems and human societies to the pace of extreme climate change by determining the year of ToE for various extreme climate indices projected to occur over terrestrial biomes, marine realms and major urban areas with large populations. This was done by overlaying terrestrial, ecoregions and population maps with maps of ToE derived, to extract ToEs for these regions. Possible relationships between GDP per person and ToE are also investigated by relating the mean ToE for each country and its average value of GDP per person.

  5. Continuous renal replacement therapy. Keeping pace with changes in technology and technique.

    Science.gov (United States)

    Baldwin, Ian

    2002-01-01

    The rapidly changing nature of new technologies and techniques in acute health care means it can be difficult keeping pace. Most facilities, large or small, are usually in continuous evaluation of a new technology. Published reviews and professional group guidelines can assist the process of change for continuous renal replacement therapy (CRRT) technologies and techniques. The current techniques and technologies are a mixed application of old and new technologies providing a combination of convective and diffusive solute clearance methods. There are a variety of anticoagulation approaches. New, purpose-built CRRT machines offer many advantages over old technology but their costs can be prohibitive and users do not always meet them with rapid behavioral change. Reading journal publications and texts, scientific meetings, education and training, Internet web site review/participation, quality improvement activities and an accurate local data base are the keys to keeping pace with changes and identifying whether a benefit can be anticipated and demonstrated. Possible changes for the future of techniques and technologies may be in the areas of modified approaches to continuous therapy with tailored approaches for specific patient care settings. Improved membrane characteristics for wider indications and the bio-artificial kidney are emerging along with blood pump and circuit design improvements, with new machine/operator interfaces.

  6. Effects of gastric pacing on gastric emptying and plasma motilin

    Institute of Scientific and Technical Information of China (English)

    Min Yang; Dian-Chun Fang; Qian-Wei Li; Nian-Xu Sun; Qing-Lin Long; Jian-Feng Sui; Lu Gan

    2004-01-01

    AIM: To invertigate the effects of gastric pacing on gastric emptying and plasma motilin level in a canine model of gastric motility disorders and the correlation between gastric emptying and plasma motilin level.METHODS: Ten healthy Mongrel dogs were divided into:experimental group of six dogs and control group of four dogs. A model of gastric motility disorders was established in the experimental group undergone truncal vagotomy combined with injection of glucagon. Gastric half-emptying time (GEt1/2) was monitored with single photon emission computerized tomography (SPECT), and the half-solid test meal was labeled with an isotope-99m Tc sulfur colloid. Plasma motilin concentration was measured with radioimmunoassay (RIA) kit. Surface gastric pacing at 1.1-1.2 times the intrinsic slow-wave frequency and a superimposed series of high frequency pulses (10-30 Hz) was performed for 45 min daily for a month in conscious dogs.RESULTS: After surgery, GEt1/2 in dogs undergone truncal vagotomy was increased significantly from 56.35±2.99 min to 79.42±l.91 min (P<0.001), but surface gastric pacing markedly accelerated gastric emptying and significantly decreased GEt1/2 to 64,94±l.75 min (P<0.001) in animals undergone vagotomy. There was a significant increase of plasma level of motilin at the phase of IMCⅢ (interdigertive myoelectrical complex, IMCⅢ) in the dogs undergone bilateral truncal vagotomy (baseline vs vagotomy, 184.29±9.81 pg/ml vs 242.09±17,22 pg/ml; P<0.01). But plasma motilin concentration (212.55±11.20 pg/ml; P<0.02) was decreased significantly after a long-term treatment with gastric pacing.Before gastric pacing, GEt1/2 and plasma motilin concentration of the dogs undergone vagotomy showed a positive correlation (r=0.867, P<0.01), but after a long-term gastric pacing, GEt1/2 and motilin level showed a negative correlation (r=-0.733, P<0,04).CONCLUSION: Surface gastric pacing with optimal pacing parameters can improve gastric emptying

  7. Cardiac conductive system excitation maps using intracardiac tissue Doppler imaging

    Institute of Scientific and Technical Information of China (English)

    尹立雪; 郑昌琼; 蔡力; 郑翊; 李春梅; 邓燕; 罗芸; 李德玉; 赵树魁

    2003-01-01

    Objective To precisely visualize cardiac anatomic structures and simultaneously depict ele ctro-mechanical events for the purpose of precise underblood intervention. Methods Intracardiac high-resolution tissue Doppler imaging was used to map realt imemyocardial contractions in response to electrical activation within the anat omic structure of the cardiac conductive system using a canine open-chest model . Results The detailed inner anatomic structure of the cardiac conductive system at differ entsites (i.e., sino-atrial, atrial wall, atrial-ventricular node and ventr icular wall) with the inside onset and propagation of myocardial velocity and ac celeration induced by electrical activation was clearly visualized and quan titatively evaluated.Conclusion The simultaneous single modality visualization of the anatomy, function and electrical events of the cardiac conductive system will foster target pacing and pre cision ablation.

  8. Right ventricular pacing: the best site is yet to be defined

    Institute of Scientific and Technical Information of China (English)

    Li ZHOU; Brian Olshansky

    2005-01-01

    @@ The right ventricular (RV) apex is the traditional site to provide stable and reliable chronic ventricular pacing. Interest in alternate site pacing has grown since RV apical pacing has been associated with increased mortality and morbidity compared to normal atrio-ventricular conduction. 1-4 Alternate pacing sites include the RV septum and outflow tract.

  9. 生理性起搏的研究进展%Advances in Study of Physiological Pacing

    Institute of Scientific and Technical Information of China (English)

    李林; 李兴德

    2014-01-01

    Cur ently ,Cardiac pacemaker is the preferred treatment of sinus node dysfunction , high degree atrioventricular block and other slow ar hythmia disease , and the clinical indications has been extended to refractory congestive heart failure , ventricular fibril ation , carotid sinus hypersensitivity induced syncope and other non-pacing and conduction system diseases . However, mimicking the physiological pacing maximum has been the main direction of electric physiologists to research , we do the fol owing review on the research progress of physiological pacing.%心脏起搏器是目前治疗窦房结功能障碍、高度房室传导阻滞等缓慢型心律失常的首选治疗方案,且临床适应症已经扩展到顽固性充血性心力衰竭、心室颤动、颈动脉窦过敏所致晕厥等非起搏及传导系统疾病的治疗。然而最大程度的模仿生理性起搏,一直是起搏电生理学家们所研究的主要方向,现就生理性起搏的研究进展做如下综述。

  10. T wave alternans during exercise and atrial pacing in humans

    Science.gov (United States)

    Hohnloser, S. H.; Klingenheben, T.; Zabel, M.; Li, Y. G.; Albrecht, P.; Cohen, R. J.

    1997-01-01

    INTRODUCTION: Evidence is accumulating that microvolt T wave alternans (TWA) is a marker of increased risk for ventricular tachyarrhythmias. Initially, atrial pacing was used to elevate heart rate and elicit TWA. More recently, a noninvasive approach has been developed that elevates heart rate using exercise. METHODS AND RESULTS: In 30 consecutive patients with a history of ventricular tachyarrhythmias, the spectral method was used to detect TWA during both atrial pacing and submaximal exercise testing. The concordance rate for the presence or absence of TWA using the two measurement methods was 84%. There was a patient-specific heart rate threshold for the detection of TWA that averaged 100 +/- 14 beats/min during exercise compared with 97 +/- 9 beats/min during right atrial pacing (P = NS). Beyond this threshold, there was a significant and comparable increase in level of TWA with decreasing pacing cycle length and increasing exercise heart rates. CONCLUSIONS: The present study is the first to demonstrate that microvolt TWA can be assessed reliably and noninvasively during exercise stress. There is a patient-specific heart rate threshold beyond which TWA continues to increase with increasing heart rates. Heart rate thresholds for the onset of TWA measured during atrial pacing and exercise stress were comparable, indicating that heart rate alone appears to be the main factor of determining the onset of TWA during submaximal exercise stress.

  11. Right coronary artery perforation by an active-fixation atrial pacing lead resulting in life-threatening tamponade.

    Science.gov (United States)

    Nakagawa, Eiichiro; Abe, Yukio; Komatsu, Ryushi; Naruko, Takahiko; Itoh, Akira

    2015-10-01

    Cardiac tamponade resulting from perforation of a cardiac chamber is a relatively rare complication of pacemaker implantation. We report the first case of perforation of the right coronary artery related to the implantation of a screw-in atrial pacing lead, presenting as life-threatening cardiac tamponade. We report the case of a 72-year-old woman with complete atrioventricular block and dyspnea on exertion. A permanent pacemaker was implanted with bipolar Medtronic active-fixation leads positioned in the right atrial appendage and at the right ventricular basal septum without any difficulty. Approximately 3.5 h after the procedure, the patient complained of nausea, and the systolic blood pressure decreased to less than 60 mmHg. Echocardiography revealed a large pericardial effusion. Because the effects of pericardiocentesis lasted for less than an hour, the patient underwent a thoracotomy. After evacuation of a massive hemopericardium, bright red blood was seen gushing out from the right coronary artery, which was located on the opposite site of the right atrial appendage where a small portion of the screw tip was observed to be penetrating the atrial wall. The right coronary artery perforation was repaired using autologous pericardium-reinforced 7-0 prolene mattress sutures. Perforation of the right coronary artery is a potential complication and should be part of the differential diagnosis of cardiac tamponade after pacemaker implantation.

  12. Three-dimensional binding sites volume assessment during cardiac pacing lead extraction

    Directory of Open Access Journals (Sweden)

    Bich Lien Nguyen

    2015-07-01

    Conclusions: Real-time 3D binding sites assessment is feasible and improves transvenous lead extraction outcomes. Its role as a complementary information requires extensive validation, and might be beneficial for a tailored strategy.

  13. Association between RR interval and high-frequency heart rate variability acquired during short-term, resting recordings with free and paced breathing.

    Science.gov (United States)

    Sandercock, Gavin; Gladwell, Valerie; Dawson, Samantha; Nunan, David; Brodie, David; Beneke, Ralph

    2008-07-01

    High-frequency (HF) oscillations in RR interval from 0.15-0.40 Hz are widely accepted as a measure of cardiac vagal outflow but the HF/RR relationship appears complex, particularly with longer RR intervals. The aim of this study was to evaluate the HF/RR interval relationship during free and paced breathing. HF power and mean RR interval length were recorded in 150 men and 120 women (mean age 34.5 +/- 11.4) during 5 min of supine rest with either free or paced (12 cycles min(-1)) breathing. Linear and quadratic models were used to assess the relationship between RR interval and the natural logarithm of HF power (lnHF). The RR interval length at which there was no further increase in lnHF was determined as the deflection point. ANCOVA was used to determine differences in the linear regression slopes for lnHF/RR with paced or free breathing. With free breathing (n = 131), the adjusted R(2) was similar between linear (15.3%) and quadratic (17.5%) fits and saturation of lnHF occurred within the recorded RR interval range (1326 ms). With paced breathing (n = 139), adjusted R(2) values were again similar between linear (22.4%) and quadratic (23.2%) fits. The deflection point was outside the range of recorded RR intervals at 1458 ms. ANCOVA showed a significant difference in the slope of the lnHF/RR regression lines between free and paced breathing. The lnHF/RR relationship is weaker when derived from between-subject recordings than from repeated within-subject samples. lnHF/RR showed evidence of saturation at approximately 45 bpm with free breathing. With paced breathing, a deflection in lnHF was found outside the recorded RR interval range ( approximately 41 bpm). Paced breathing creates a stronger lnHF/RR relationship. The slope of the lnHF/RR regression line with paced breathing is significantly different from that observed with free breathing. It appears that lnHF is a valid index of vagal outflow, except in subjects with very low heart rates. Paced breathing data

  14. Pacing during an ultramarathon running event in hilly terrain

    Directory of Open Access Journals (Sweden)

    Hugo A. Kerhervé

    2016-10-01

    Full Text Available Purpose The dynamics of speed selection as a function of distance, or pacing, are used in recreational, competitive, and scientific research situations as an indirect measure of the psycho-physiological status of an individual. The purpose of this study was to determine pacing on level, uphill and downhill sections of participants in a long (>80 km ultramarathon performed on trails in hilly terrain. Methods Fifteen ultramarathon runners competed in a  173 km event (five finished at  103 km carrying a Global-Positioning System (GPS device. Using the GPS data, we determined the speed, relative to average total speed, in level (LEV, uphill (UH and downhill (DH gradient categories as a function of total distance, as well as the correlation between overall performance and speed variability, speed loss, and total time stopped. Results There were no significant differences in normality, variances or means in the relative speed in 173-km and 103-km participants. Relative speed decreased in LEV, UH and DH. The main component of speed loss occurred between 5% and 50% of the event distance in LEV, and between 5% and 95% in UH and DH. There were no significant correlations between overall performance and speed loss, the variability of speed, or total time stopped. Conclusions Positive pacing was observed at all gradients, with the main component of speed loss occurring earlier (mixed pacing in LEV compared to UH and DH. A speed reserve (increased speed in the last section was observed in LEV and UH. The decrease in speed and variability of speed were more important in LEV and DH than in UH. The absence of a significant correlation between overall performance and descriptors of pacing is novel and indicates that pacing in ultramarathons in trails and hilly terrain differs to other types of running events.

  15. Ictal Asystole in Focal Epilepsy: To Pace or Not to Pace?

    Science.gov (United States)

    Newey, Christopher R; Sarwal, Aarti

    2015-10-01

    Ictal bradyarrhythmias are rare episodes occurring in patients with or without a past cardiac history. These episodes go unnoticed unless the patient is monitored on simultaneous video-electroencephalogram and 1-lead electrocardiogram. Recognizing ictal bradyarrhythmias is important, since episodes may predispose patients to sudden, unexplained death in epilepsy. We present 2 cases of ictal asystole in patients with right temporal lobe epilepsy. The first patient had seizures refractory to medical therapy and received a pacemaker. The seizures in the second patient responded well to antiepileptic medication, and a pacemaker was deferred. These cases highlight the differing cardiovascular treatment options for ictal asystole.

  16. Cardiac MRI in Athletes

    NARCIS (Netherlands)

    Luijkx, T.

    2012-01-01

    Cardiac magnetic resonance imaging (CMR) is often used in athletes to image cardiac anatomy and function and is increasingly requested in the context of screening for pathology that can cause sudden cardiac death (SCD). In this thesis, patterns of cardiac adaptation to sports are investigated with C

  17. "Set the Pace": Nutrition Education DVD for Head Start Parents

    Science.gov (United States)

    Adedze, Pascasie; Orr, Robin A.; Chapman-Novakofski, Karen; Donovan, Sharon M.

    2013-01-01

    Childhood overweight remains a major public health problem and innovative nutrition education programs are still needed. Thus, the "Set the Pace" is a nutrition education DVD for Head Start parents which provides visual nutrition education and physical activities to incorporate in their daily routines. (Contains 1 table.)

  18. Entrainment of Activation during Ventricular Fibrillation (VF) by Distributed Pacing.

    Science.gov (United States)

    Gu, Yiping; Moghe, Sachin; Patwardhan, Abhijit

    2002-03-01

    Optical mapping and pacing studies show excitable gaps during VF. This observation supports entrainment of activation by spatially distributed pacing. Such pacing approach would be enhanced by availability of an index of spatio-temporal heterogeneity in activation. We use simulations to demonstrate feasibility of entraining activations and of using spatially averaged coherence as an index of uniformity in activation. We used a Luo-Rudy model to simulate VF in a matrix of 400x400 cells. Stimuli were delivered from 8 rows of electrodes. Trans-membrane voltages from nine locations spanning the entrained area were used to compute 6 time-coherencies. Average of 6 coherencies was used as an index of uniformity of activations. Results showed that when stimuli were delivered at cycle lengths slightly shorter than intrinsic activation intervals, activations during VF could be entrained into a planar pattern. As expected, average coherence was low during native VF and increased during entrainment. Thus, distributed pacing and time-coherence may be used to entrain and modify activation during VF.

  19. Self-Paced Instruction Methods in a Required Sophomore Course.

    Science.gov (United States)

    King, Franklin G.; Hossain, Muhammad A.

    1984-01-01

    Compares a personalized system of instruction (PSI) to the lecture method and linear self-paced instruction (LSPI) of teaching stoichiometry to undergraduate students. Discusses the methods used to assess student achievement which includes: the use of common midterms and final examinations; and modules, mini-courses and mini-course final exams.…

  20. Hardware packet pacing using a DMA in a parallel computer

    Science.gov (United States)

    Chen, Dong; Heidelberger, Phillip; Vranas, Pavlos

    2013-08-13

    Method and system for hardware packet pacing using a direct memory access controller in a parallel computer which, in one aspect, keeps track of a total number of bytes put on the network as a result of a remote get operation, using a hardware token counter.

  1. The pace of shifting climate in marine and terrestrial ecosystems

    DEFF Research Database (Denmark)

    Burrows, Michael T.; Schoeman, David S.; Buckley, Lauren B.

    2011-01-01

    Climate change challenges organisms to adapt or move to track changes in environments in space and time. We used two measures of thermal shifts from analyses of global temperatures over the past 50 years to describe the pace of climate change that species should track: the velocity of climate cha...

  2. 'Human paced' walking: Followers adopt stride time dynamics of leaders

    NARCIS (Netherlands)

    Marmelat, V.C.M.; Delignières, D.; Torre, K.; Beek, P.J.; Daffertshofer, A.

    2014-01-01

    Isochronous cueing is widely used in gait rehabilitation even though it alters the stride-time dynamics toward anti-persistent rather than the persistent, fractal fluctuations characteristic of human walking. In the present experiment we tested an alternative cueing method: pacing by a human. To thi

  3. Design Recommendations for Self-Paced Online Faculty Development Courses

    Science.gov (United States)

    Rizzuto, Melissa

    2017-01-01

    An increased need for self-paced, online professional development opportunities in higher education has emerged from a variety of factors including dispersed geographic locations of faculty, full teaching loads, and institutional evaluation requirements. This article is a report of the examination of the design and evaluation of a self-paced…

  4. 42 CFR 460.180 - Medicare payment to PACE organizations.

    Science.gov (United States)

    2010-10-01

    ... risk adjustment model. (5) CMS may adjust the monthly capitation amount to take into account other... or Federal workers' compensation, any no-fault insurance, or any liability insurance policy or plan, including a self-insured plan, the PACE organization may charge any of the following: (i) The...

  5. Gait coordination after stroke: Benefits of acoustically paced treadmill walking

    NARCIS (Netherlands)

    Roerdink, Melvyn; Lamoth, Claudine J.C.; Kwakkel, Gert; Van Wieringen, Piet C.W.; Beek, Peter J.

    2007-01-01

    Background and Purpose: Gait coordination often is compromised after stroke. The purpose of this study was to evaluate the efficacy of acoustically paced treadmill walking as a method for improving gait coordination in people after stroke. Participants: Ten people after stroke volunteered for the st

  6. Gait coordination after stroke: benefits of acoustically paced treadmill walking.

    NARCIS (Netherlands)

    Roerdink, M.; Lamoth, C.J.; Kwakkel, G.; Wieringen, P.C. van; Beek, P.J.

    2007-01-01

    BACKGROUND AND PURPOSE: Gait coordination often is compromised after stroke. The purpose of this study was to evaluate the efficacy of acoustically paced treadmill walking as a method for improving gait coordination in people after stroke. PARTICIPANTS: Ten people after stroke volunteered for the st

  7. Artificial Economy

    Directory of Open Access Journals (Sweden)

    Alexandru JIVAN

    2011-08-01

    Full Text Available This paper proposes to eliminate, a routine in the economic thinking, claimed to be responsible for the negative essence of economic developments, from the point of view, of the ecological implications (employment in the planetary ecosystem. The methodological foundations start from the natural origins of the functionality of the human economic society according to the originary physiocrat liberalism, and from specific natural characteristics of the humankind. This paper begins with a comment-analysis of the difference between natural and artificial within the economy, and then explains some of the most serious diversions from the natural essence of economic liberalism. It shall be explained the original (heterodox interpretation of the Classical political economy (economics, by making calls to the Romanian economic thinking from aggravating past century. Highlighting the destructive impact of the economy - which, under the invoked doctrines, we call unnatural - allows an intuitive presentation of a logical extension of Marshall's market price, based on previous research. Besides the doctrinal arguments presented, the economic realities inventoried along the way (major deficiencies and effects, determined demonstrate the validity of the hypothesis of the unnatural character and therefore necessarily to be corrected, of the concept and of the mechanisms of the current economy.The results of this paper consist of original heterodox methodspresented, intuitive or developed that can be found conclusively within the key proposals for education and regulation.

  8. Generation of cardiac pacemaker cells by programming and differentiation.

    Science.gov (United States)

    Husse, Britta; Franz, Wolfgang-Michael

    2016-07-01

    A number of diseases are caused by faulty function of the cardiac pacemaker and described as "sick sinus syndrome". The medical treatment of sick sinus syndrome with electrical pacemaker implants in the diseased heart includes risks. These problems may be overcome via "biological pacemaker" derived from different adult cardiac cells or pluripotent stem cells. The generation of cardiac pacemaker cells requires the understanding of the pacing automaticity. Two characteristic phenomena the "membrane-clock" and the "Ca(2+)-clock" are responsible for the modulation of the pacemaker activity. Processes in the "membrane-clock" generating the spontaneous pacemaker firing are based on the voltage-sensitive membrane ion channel activity starting with slow diastolic depolarization and discharging in the action potential. The influence of the intracellular Ca(2+) modulating the pacemaker activity is characterized by the "Ca(2+)-clock". The generation of pacemaker cells started with the reprogramming of adult cardiac cells by targeted induction of one pacemaker function like HCN1-4 overexpression and enclosed in an activation of single pacemaker specific transcription factors. Reprogramming of adult cardiac cells with the transcription factor Tbx18 created cardiac cells with characteristic features of cardiac pacemaker cells. Another key transcription factor is Tbx3 specifically expressed in the cardiac conduction system including the sinoatrial node and sufficient for the induction of the cardiac pacemaker gene program. For a successful cell therapeutic practice, the generated cells should have all regulating mechanisms of cardiac pacemaker cells. Otherwise, the generated pacemaker cells serve only as investigating model for the fundamental research or as drug testing model for new antiarrhythmics. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel.

  9. SolarPaces: genealogy of an international research program; SolarPaces: genealogie d`un programme international de recherche

    Energy Technology Data Exchange (ETDEWEB)

    Pharabod, F.; Lede, J. [Centre National de la Recherche Scientifique (CNRS), 75 - Paris (France); Lefevre, P.; D`Humieres, B.; Forget, F.

    1998-07-01

    What are the stakes of SolarPaces, the solar research program of the International Energy Agency (IEA)? The explanations are given by Francais Pharabod and Jacques Lede which analyze the France joining conditions in this program and evoke the industrial repercussions. (O.M.)

  10. Micro and Nano-mediated 3D Cardiac Tissue Engineering

    Science.gov (United States)

    2011-10-01

    in cardiology since early 50s is the development of an artificial heart that can replace a failing heart. Until today, artificial heart is used only...Engineering Dr. M. Gibb, Head of Cardiology , Carle Hospital Dr. Sherrie Clark, UIUC swine species veterinarian 7 Year 3 Project Goals Interface DFB...sarcomere lengths in the normal dog heart, Circulation Research 21 (1967) 671-678. [5] E.J. DeSouza, W. Ahmed, V. Chan, R. Bahir, T.M. Saif, Cardiac

  11. Cardiac resynchronization therapy guided by late gadolinium-enhancement cardiovascular magnetic resonance

    Directory of Open Access Journals (Sweden)

    Smith Russell EA

    2011-06-01

    Full Text Available Abstract Background Myocardial scarring at the LV pacing site leads to incomplete resynchronization and a suboptimal symptomatic response to CRT. We sought to determine whether the use of late gadolinium cardiovascular magnetic resonance (LGE-CMR to guide left ventricular (LV lead deployment influences the long-term outcome of cardiac resynchronization therapy (CRT. Methods 559 patients with heart failure (age 70.4 ± 10.7 yrs [mean ± SD] due to ischemic or non-ischemic cardiomyopathy underwent CRT. Implantations were either guided (+CMR or not guided (-CMR by LGE-CMR prior to implantation. Fluoroscopy and LGE-CMR were used to localize the LV lead tip and and myocardial scarring retrospectively. Clinical events were assessed in three groups: +CMR and pacing scar (+CMR+S; CMR and not pacing scar (+CMR-S, and; LV pacing not guided by CMR (-CMR. Results Over a maximum follow-up of 9.1 yrs, +CMR+S had the highest risk of cardiovascular death (HR: 6.34, cardiovascular death or hospitalizations for heart failure (HR: 5.57 and death from any cause or hospitalizations for major adverse cardiovascular events (HR: 4.74 (all P Conclusions Compared with a conventional implantation approach, the use of LGE-CMR to guide LV lead deployment away from scarred myocardium results in a better clinical outcome after CRT. Pacing scarred myocardium was associated with the worst outcome, in terms of both pump failure and sudden cardiac death.

  12. Improved quality of life after treatment of prolonged asystole during breath holding spells with a cardiac pacemaker

    Directory of Open Access Journals (Sweden)

    Bruno Kolterer

    2015-01-01

    Conclusion: Cardiac pacing using appropriate pacemaker settings seems effective in the prevention of LOC and reduction of the frequency of BHS. Our results imply a reduction of subjective stress levels of patients and parents as well as an increased quality of everyday life. After all, randomized controlled trials of the influence of cardiac pacemaker implantation on subjective stress levels in patients with BHS are needed.

  13. Estudo clínico e epidemiológico de pacientes submetidos a implante de marcapasso cardíaco artificial permanente: comparação dos portadores da doença de Chagas com os de doenças degenerativas do sistema de condução Clinical and epidemiological characteristics of patients with Chagas' disease submitted to permanent cardiac pacemaker implantation

    Directory of Open Access Journals (Sweden)

    Roberto Costa

    2004-06-01

    Full Text Available OBJETIVO: Estudar os pacientes portadores de marcapasso cardíaco artificial permanente, comparando as características clínicas e epidemiológicas dos portadores da doença de Chagas com a dos portadores de doenças degenerativas do sistema de condução. MÉTODO: Foram analisados 57.632 procedimentos cadastrados no Registro Brasileiro de Marcapassos, realizados no período de 1995 a 2003, sendo: 25.648 pacientes portadores da doença de Chagas e 31.984, de doenças degenerativas. A comparação das características dessas populações foi feita pelos testes do Qui-quadrado e t-Student com nível de significância de 5%. RESULTADOS: Houve predomínio da doença de Chagas na região Centro-Oeste, nos implantes iniciais. Nas reoperações, a população chagásica representou maioria também no Sudeste. A idade dos pacientes chagásicos foi 58,6 ± 15,3 e 59,3 ± 14,8 anos, respectivamente para implantes iniciais e reoperações, e, nos não chagásicos, 73,5 ± 12,6 e 73,7 ± 13,5. Não foi notada diferença na distribuição entre os dois sexos. Houve maior ocorrência de síncopes, pré-síncopes e bloqueio atrioventricular com QRS largo nos pacientes chagásicos e de tonturas, insuficiência cardíaca e QRS estreito nos não chagásicos. O modo de estimulação ventricular foi utilizado em 60% e 63% nos implantes iniciais e em 77% e 76% das reoperações, respectivamente para os pacientes chagásicos e não chagásicos. A depleção da bateria por desgaste normal foi o principal motivo para reoperação dos pacientes, tendo ocorrido em 76,1% e 79,6% das reoperações, respectivamente para chagásicos e não chagásicos. CONCLUSÕES: Os dados analisados demonstraram diferenças significativas nas características clínicas e demográficas das populações estudadas.OBJECTIVE: To study patients with permanent cardiac pacemakers, comparing the clinical and epidemiological characteristics of patients with Chagas' disease versus the ones with

  14. "U-Pace" Instruction: Improving Student Success by Integrating Content Mastery and Amplified Assistance

    Science.gov (United States)

    Reddy, Diane M.; Pfeiffer, Heidi M.; Fleming, Raymond; Ports, Katie A.; Pedrick, Laura E.; Barnack-Tavlaris, Jessica L.; Jirovec, Danielle L.; Helion, Alicia M.; Swain, Rodney A.

    2013-01-01

    "U-Pace," an instructional intervention, has potential for widespread implementation because student behavior recorded in any learning management system is used by "U-Pace" instructors to tailor coaching of student learning based on students' strengths and motivations. "U-Pace" utilizes an online learning environment…

  15. Effects of Modality and Pace on Achievement, Mental Effort, and Positive Affect in Multimedia Learning Environments

    Science.gov (United States)

    Izmirli, Serkan; Kurt, Adile Askim

    2016-01-01

    The purpose of the study was to examine the effects of instruction given with different multimedia modalities (written text + animation or narration + animation) on the academic achievement, cognitive load, and positive affect in different paces (learner-paced or system-paced); 97 freshmen university students divided into four groups taught in…

  16. 3D engineered cardiac tissue models of human heart disease: learning more from our mice.

    Science.gov (United States)

    Ralphe, J Carter; de Lange, Willem J

    2013-02-01

    Mouse engineered cardiac tissue constructs (mECTs) are a new tool available to study human forms of genetic heart disease within the laboratory. The cultured strips of cardiac cells generate physiologic calcium transients and twitch force, and respond to electrical pacing and adrenergic stimulation. The mECT can be made using cells from existing mouse models of cardiac disease, providing a robust readout of contractile performance and allowing a rapid assessment of genotype-phenotype correlations and responses to therapies. mECT represents an efficient and economical extension to the existing tools for studying cardiac physiology. Human ECTs generated from iPSCMs represent the next logical step for this technology and offer significant promise of an integrated, fully human, cardiac tissue model.

  17. Potential proarrhythmic effect of cardiac resynchronization therapy during perioperative period: data from a single cardiac center

    Institute of Scientific and Technical Information of China (English)

    LUO Nian-sang; YUAN Wo-liang; LIN Yong-qing; CHEN Yang-xin; MAO Xiao-qun; XIE Shuang-lun; KONG Min-yi; ZHOU Shu-xian; WANG Jing-feng

    2010-01-01

    Background Cardiac resynchronization therapy (CRT) could improve heart function, symptom status, quality of life and reduce hospitalization and mortality in patients with severe heart failure (HF) with optimal medical management. However,the possible adverse effects of CRT are often ignored by clinicians.Method A retrospective analysis of CRT over a 6-year period was made in a single cardiac center.Results Fifty-four patients were treated with CRT(D) device, aged (57±11) years, with left ventricular ejection fraction of (32.1±9.8)%, of which 4 (7%) developed ventricular tachycardia/ventricular fibrillation (VT/VF) or junctional tachycardia after operation. Except for one with frequent ventricular premature beat before operation, the others had no previous history of ventricular arrhythmia. Of the 4 patients, 3 had dilated cardiomyopathy and 1 had ischemic cardiomyopathy,and tachycardia occurred within 3 days after operation. Sustained, refractory VT and subsequent VF occurred in one patient, frequent nonsustained VT in two patients and nonparoxysmal atrioventricular junctional tachycardia in one patient. VT was managed by amiodarone in two patients, amiodarone together with beta-blocker in one patient, and junctional tachycardia was terminated by overdrive pacing. During over 12-month follow-up, except for one patient's death due to refractory heart and respiratory failure in hospital, the others remain alive and arrhythmia-free.Conclusions New-onset VT/VF or junctional tachycardia may occur in a minority of patients with or without prior history of tachycardia after biventricular pacing. Arrhythmia can be managed by conventional therapy, but may require temporary discontinuation of pacing. More observational studies should be performed to determine the potential proarrhythmic effect of CRT.

  18. 640 X 480 Pace HgCdTe FPA

    Science.gov (United States)

    Kozlowski, Lester J.; Bailey, Robert B.; Cabelli, Scott A.; Cooper, Donald E.; McComas, Gail D.; Vural, Kadri; Tennant, William E.

    1992-12-01

    A hybrid HgCdTe 640 X 480 infrared (IR) focal plane array (FPA) that meets the sensitivity, resolution, and field-of-view requirements of high-performance medium wavelength infrared (MWIR) imaging systems has been developed. The key technology making this large, high sensitivity device producible is the epitaxial growth of HgCdTe on a CdTe-buffered, sapphire substrate (referred to as PACE, for Producible Alternative to CdTe for Epitaxy; PACE-I refers to sapphire). The device offers TV resolution with excellent sensitivity at temperatures below 120 K. Mean NE(Delta) T as low as 13 mK has been achieved at operating temperatures nonuniformity compensation.

  19. The pace of vocabulary growth helps predict later vocabulary skill.

    Science.gov (United States)

    Rowe, Meredith L; Raudenbush, Stephen W; Goldin-Meadow, Susan

    2012-01-01

    Children vary widely in the rate at which they acquire words--some start slow and speed up, others start fast and continue at a steady pace. Do early developmental variations of this sort help predict vocabulary skill just prior to kindergarten entry? This longitudinal study starts by examining important predictors (socioeconomic status [SES], parent input, child gesture) of vocabulary growth between 14 and 46 months (n = 62) and then uses growth estimates to predict children's vocabulary at 54 months. Velocity and acceleration in vocabulary development at 30 months predicted later vocabulary, particularly for children from low-SES backgrounds. Understanding the pace of early vocabulary growth thus improves our ability to predict school readiness and may help identify children at risk for starting behind.

  20. De pace fidei: de la libertad a la tolerancia

    Directory of Open Access Journals (Sweden)

    Enzo Solari

    2012-01-01

    Full Text Available Este articulo resume las articulaciones fundamentales de De pace fidei, luego de lo cual muestra algunas de sus mejores interpretaciones recientes y plantea ciertas cuestiones que adn merece la pena explorar en aquella obra, particularmente la de su conexión con la filosofia de la libertad del Cusano y la del reflejo ya renacentista que tal filosofia halla en la oratio de Pico della Mirandola.This article summarizes the fundamental reasonings in De pace fidei and goes on to show some of their most relevant recent readings, to finally lay down some questions which are still worth exploring in the cited work, in particular its connection with the philosophy of freedom of the Cusanus and the reflection, with renaissance spirit, which such philosophy finds in the oratio of Pico della Mirandola.

  1. Mapping cardiac surface mechanics with structured light imaging.

    Science.gov (United States)

    Laughner, Jacob I; Zhang, Song; Li, Hao; Shao, Connie C; Efimov, Igor R

    2012-09-15

    Cardiovascular disease often manifests as a combination of pathological electrical and structural heart remodeling. The relationship between mechanics and electrophysiology is crucial to our understanding of mechanisms of cardiac arrhythmias and the treatment of cardiac disease. While several technologies exist for describing whole heart electrophysiology, studies of cardiac mechanics are often limited to rhythmic patterns or small sections of tissue. Here, we present a comprehensive system based on ultrafast three-dimensional (3-D) structured light imaging to map surface dynamics of whole heart cardiac motion. Additionally, we introduce a novel nonrigid motion-tracking algorithm based on an isometry-maximizing optimization framework that forms correspondences between consecutive 3-D frames without the use of any fiducial markers. By combining our 3-D imaging system with nonrigid surface registration, we are able to measure cardiac surface mechanics at unprecedented spatial and temporal resolution. In conclusion, we demonstrate accurate cardiac deformation at over 200,000 surface points of a rabbit heart recorded at 200 frames/s and validate our results on highly contrasting heart motions during normal sinus rhythm, ventricular pacing, and ventricular fibrillation.

  2. Case study thoracic radiotherapy in an elderly patient with pacemaker: The issue of pacing leads

    Energy Technology Data Exchange (ETDEWEB)

    Kirova, Youlia M., E-mail: youlia.kirova@curie.net [Department of Radiation Oncology, Institut Curie, Paris (France); Menard, Jean; Chargari, Cyrus; Mazal, Alejandro [Department of Radiation Oncology, Institut Curie, Paris (France); Kirov, Krassen [Department of Anesthesiology and Reanimation, Institut Curie, Paris (France)

    2012-07-01

    To assess clinical outcome of patients with pacemaker treated with thoracic radiation therapy for T8-T9 paravertebral chloroma. A 92-year-old male patient with chloroma presenting as paravertebral painful and compressive (T8-T9) mass was referred for radiotherapy in the Department of Radiation Oncology, Institut Curie. The patient presented with cardiac dysfunction and a permanent pacemaker that had been implanted prior. The decision of Multidisciplinary Meeting was to deliver 30 Gy in 10 fractions for reducing the symptoms and controlling the tumor growth. The patient received a total dose of 30 Gy in 10 fractions using 4-field conformal radiotherapy with 20-MV photons. The dose to pacemaker was 0.1 Gy but a part of the pacing leads was in the irradiation fields. The patient was treated the first time in the presence of his radiation oncologist and an intensive care unit doctor. Moreover, the function of his pacemaker was monitored during the entire radiotherapy course. No change in pacemaker function was observed during any of the radiotherapy fractions. The radiotherapy was very well tolerated without any side effects. The function of the pacemaker was checked before and after the radiotherapy treatment by the cardiologist and no pacemaker dysfunction was observed. Although updated guidelines are needed with acceptable dose criteria for implantable cardiac devices, it is possible to treat patients with these devices and parts encroaching on the radiation field. This case report shows we were able to safely treat our patient through a multidisciplinary approach, monitoring the patient during each step of the treatment.

  3. Alternate Pacing of Border-Collision Period-Doubling Bifurcations.

    Science.gov (United States)

    Zhao, Xiaopeng; Schaeffer, David G

    2007-11-01

    Unlike classical bifurcations, border-collision bifurcations occur when, for example, a fixed point of a continuous, piecewise C1 map crosses a boundary in state space. Although classical bifurcations have been much studied, border-collision bifurcations are not well understood. This paper considers a particular class of border-collision bifurcations, i.e., border-collision period-doubling bifurcations. We apply a subharmonic perturbation to the bifurcation parameter, which is also known as alternate pacing, and we investigate the response under such pacing near the original bifurcation point. The resulting behavior is characterized quantitatively by a gain, which is the ratio of the response amplitude to the applied perturbation amplitude. The gain in a border-collision period-doubling bifurcation has a qualitatively different dependence on parameters from that of a classical period-doubling bifurcation. Perhaps surprisingly, the differences are more readily apparent if the gain is plotted vs. the perturbation amplitude (with the bifurcation parameter fixed) than if plotted vs. the bifurcation parameter (with the perturbation amplitude fixed). When this observation is exploited, the gain under alternate pacing provides a useful experimental tool to identify a border-collision period-doubling bifurcation.

  4. Factors affecting the regulation of pacing: current perspectives

    Directory of Open Access Journals (Sweden)

    Mauger AR

    2014-09-01

    Full Text Available Alexis R Mauger Endurance Research Group, School of Sport and Exercise Sciences, Faculty of Science, University of Kent, Chatham, UK Abstract: During prolonged dynamic and rhythmic exercise, muscular pain and discomfort arises as a result of an increased concentration of deleterious metabolites. Sensed by peripheral nociceptors and transmitted via afferent feedback to the brain, this provides important information regarding the physiological state of the muscle. These sensations ultimately contribute to what is termed "exercise-induced pain". Despite being well recognized by athletes and coaches, and suggested to be integral to exercise performance, this construct has largely escaped attention in experimental work. This perspective article highlights the current understanding of pacing in endurance performance, and the causes of exercise-induced pain. A new perspective is described, which proposes how exercise-induced pain may be a contributing factor in helping individuals to regulate their work rate during exercise and thus provides an important construct in pacing. Keywords: pain, exercise-induced pain, discomfort, exercise performance, self-paced

  5. Unilateral Laryngeal Pacing System and Its Functional Evaluation

    Directory of Open Access Journals (Sweden)

    Taiping Zeng

    2017-01-01

    Full Text Available Goal. To establish a reliable instrumental system for synchronized reactivation of a unilaterally paralyzed vocal fold and evaluate its functional feasibility. Methods. Unilateral vocal fold paralysis model was induced by destruction of the left recurrent laryngeal nerve (RLN in anesthetized dogs. With a micro controller-based electronic system, electromyography (EMG signals from cricothyroid (CT muscle on the ipsilateral side were recorded and used to trigger pacing of paralyzed vocalis muscles. The dynamic movement of vocal folds was continuously monitored using an endoscope, and the opening and closing of the glottis were quantified with customized imaging processing software. Results. The recorded video images showed that left side vocal fold was obviously paralyzed after destructing the RLN. Using the pacing system with feedback triggering EMG signals from the ipsilateral CT muscle, the paralyzed vocal fold was successfully reactivated, and its movement was shown to be synchronized with the healthy side. Significance. The developed unilateral laryngeal pacing system triggered by EMG from the ipsilateral side CT muscle could be successfully used in unilateral vocal fold paralysis with the advantage of avoiding disturbance to the healthy side muscles.

  6. Combined obliquity and precession pacing of late Pleistocene deglaciations.

    Science.gov (United States)

    Huybers, Peter

    2011-12-08

    Milankovitch proposed that Earth resides in an interglacial state when its spin axis both tilts to a high obliquity and precesses to align the Northern Hemisphere summer with Earth's nearest approach to the Sun. This general concept has been elaborated into hypotheses that precession, obliquity or combinations of both could pace deglaciations during the late Pleistocene. Earlier tests have shown that obliquity paces the late Pleistocene glacial cycles but have been inconclusive with regard to precession, whose shorter period of about 20,000 years makes phasing more sensitive to timing errors. No quantitative test has provided firm evidence for a dual effect. Here I show that both obliquity and precession pace late Pleistocene glacial cycles. Deficiencies in time control that have long stymied efforts to establish orbital effects on deglaciation are overcome using a new statistical test that focuses on maxima in orbital forcing. The results are fully consistent with Milankovitch's proposal but also admit the possibility that long Southern Hemisphere summers contribute to deglaciation.

  7. Tropical birds have a slow pace of life.

    Science.gov (United States)

    Wiersma, Popko; Muñoz-Garcia, Agustí; Walker, Amy; Williams, Joseph B

    2007-05-29

    Tropical birds are relatively long-lived and produce few offspring, which develop slowly and mature relatively late in life, the slow end of the life-history axis, whereas temperate birds lie at the opposite end of this continuum. We tested the hypothesis that tropical birds have evolved a reduced basal metabolic rate (BMR). We measured BMR of 69 species of tropical birds, the largest data set amassed on metabolic rates of tropical birds, and compared these measurements with 59 estimates of BMR for temperate birds. Our analyses included conventional least squares regression, regressions based on phylogenetic independent contrasts, and a comparison of BMR of 13 phylogenetically matched pairs, one species from the tropics and one from northerly temperate areas. Our triptych showed that tropical birds had a reduced BMR, compelling evidence for a connection between the life history of tropical birds and a slow pace of life. Further, tropical migrants breeding in temperate habitats had a lower BMR than did temperate residents, suggesting that these migrants have physiological traits consistent with a slow pace of life. In addition, we determined that tropical birds had a lower cold-induced peak metabolic rate and thermogenic metabolic scope than temperate species, a finding that is consistent with the hypothesis that their environment has not selected for high levels of thermogenesis, or alternatively, that a slow pace of life may be incompatible with high thermogenic capacity. We conclude that physiological function correlates with the suite of life-history traits.

  8. Cardiac tamponade (image)

    Science.gov (United States)

    Cardiac tamponade is a condition involving compression of the heart caused by blood or fluid accumulation in the space ... they cannot adequately fill or pump blood. Cardiac tamponade is an emergency condition that requires hospitalization.

  9. What Is Cardiac Rehabilitation?

    Science.gov (United States)

    ANSWERS by heart Treatments + Tests What Is Cardiac Rehabilitation? A cardiac rehabilitation (rehab) program takes place in a hospital or ... special help in making lifestyle changes. During your rehabilitation program you’ll… • Have a medical evaluation to ...

  10. Cardiac sodium channelopathies

    NARCIS (Netherlands)

    Amin, A.S.; Asghari-Roodsari, A.; Tan, H.L.

    2010-01-01

    Cardiac sodium channel are protein complexes that are expressed in the sarcolemma of cardiomyocytes to carry a large inward depolarizing current (I-Na) during phase 0 of the cardiac action potential. The importance of I-Na for normal cardiac electrical activity is reflected by the high incidence of

  11. Cardiac resynchronization therapy in congenital heart disease.

    Science.gov (United States)

    Janoušek, Jan; Kubuš, Peter

    2016-06-01

    Cardiac resynchronization therapy (CRT) is an established treatment option for adult patients suffering heart failure due to idiopathic or ischemic cardiomyopathy associated with electromechanical dyssynchrony. There is limited evidence suggesting similar efficacy of CRT in patients with congenital heart disease (CHD). Due to the heterogeneity of structural and functional substrates, CRT implantation techniques are different with a thoracotomy or hybrid approach prevailing. Efficacy of CRT in CHD seems to depend on the anatomy of the systemic ventricle with best results achieved in systemic left ventricular patients upgraded to CRT from conventional pacing. Indications for CRT in patients with CHD were recently summarized in the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS) Expert Consensus Statement on the Recognition and Management of Arrhythmias in Adult Congenital Heart Disease and are presented in the text.

  12. Recent progress of pediatric cardiac surgery in China

    Institute of Scientific and Technical Information of China (English)

    WU Kai-hong; L(U) Xiao-dong; LIU Ying-long

    2006-01-01

    @@ Pediatric cardiac surgery in China has made great progress since the first successful open heart operation for correction of ventricular septal defect (VSD) with an artificial heart-lung machine in 1958.1 In recent years, the state has paid much attention to both the basic research and the primary,secondary and tertiary prevention of congenital heart disease.

  13. Cardiac Optogenetics: Enhancement by All-trans-Retinal.

    Science.gov (United States)

    Yu, Jinzhu; Chen, Kay; Lucero, Rachel V; Ambrosi, Christina M; Entcheva, Emilia

    2015-11-16

    All-trans-Retinal (ATR) is a photosensitizer, serving as the chromophore for depolarizing and hyperpolarizing light-sensitive ion channels and pumps (opsins), recently employed as fast optical actuators. In mammalian optogenetic applications (in brain and heart), endogenous ATR availability is not considered a limiting factor, yet it is unclear how ATR modulation may affect the response to optical stimulation. We hypothesized that exogenous ATR may improve light responsiveness of cardiac cells modified by Channelrhodopsin2 (ChR2), hence lowering the optical pacing energy. In virally-transduced (Ad-ChR2(H134R)-eYFP) light-sensitive cardiac syncytium in vitro, ATR supplements ≤2 μM improved cardiomyocyte viability and augmented ChR2 membrane expression several-fold, while >4 μM was toxic. Employing integrated optical actuation (470 nm) and optical mapping, we found that 1-2 μM ATR dramatically reduced optical pacing energy (over 30 times) to several μW/mm(2), lowest values reported to date, but also caused action potential prolongation, minor changes in calcium transients and no change in conduction. Theoretical analysis helped explain ATR-caused reduction of optical excitation threshold in cardiomyocytes. We conclude that cardiomyocytes operate at non-saturating retinal levels, and carefully-dosed exogenous ATR can enhance the performance of ChR2 in cardiac cells and yield energy benefits over orders of magnitude for optogenetic stimulation.

  14. Trends in Artificial Intelligence.

    Science.gov (United States)

    Hayes, Patrick

    1978-01-01

    Discusses the foundations of artificial intelligence as a science and the types of answers that may be given to the question, "What is intelligence?" The paradigms of artificial intelligence and general systems theory are compared. (Author/VT)

  15. Mechanisms of cardiac pain.

    Science.gov (United States)

    Foreman, Robert D; Garrett, Kennon M; Blair, Robert W

    2015-04-01

    Angina pectoris is cardiac pain that typically is manifested as referred pain to the chest and upper left arm. Atypical pain to describe localization of the perception, generally experienced more by women, is referred to the back, neck, and/or jaw. This article summarizes the neurophysiological and pharmacological mechanisms for referred cardiac pain. Spinal cardiac afferent fibers mediate typical anginal pain via pathways from the spinal cord to the thalamus and ultimately cerebral cortex. Spinal neurotransmission involves substance P, glutamate, and transient receptor potential vanilloid-1 (TRPV1) receptors; release of neurokinins such as nuclear factor kappa b (NF-kb) in the spinal cord can modulate neurotransmission. Vagal cardiac afferent fibers likely mediate atypical anginal pain and contribute to cardiac ischemia without accompanying pain via relays through the nucleus of the solitary tract and the C1-C2 spinal segments. The psychological state of an individual can modulate cardiac nociception via pathways involving the amygdala. Descending pathways originating from nucleus raphe magnus and the pons also can modulate cardiac nociception. Sensory input from other visceral organs can mimic cardiac pain due to convergence of this input with cardiac input onto spinothalamic tract neurons. Reduction of converging nociceptive input from the gallbladder and gastrointestinal tract can diminish cardiac pain. Much work remains to be performed to discern the interactions among complex neural pathways that ultimately produce or do not produce the sensations associated with cardiac pain.

  16. Artificiality in Social Sciences

    OpenAIRE

    Rennard, Jean-Philippe

    2007-01-01

    This text provides with an introduction to the modern approach of artificiality and simulation in social sciences. It presents the relationship between complexity and artificiality, before introducing the field of artificial societies which greatly benefited from the computer power fast increase, gifting social sciences with formalization and experimentation tools previously owned by "hard" sciences alone. It shows that as "a new way of doing social sciences", artificial societies should undo...

  17. Artificial life and Piaget.

    Science.gov (United States)

    Mueller, Ulrich; Grobman, K H.

    2003-04-01

    Artificial life provides important theoretical and methodological tools for the investigation of Piaget's developmental theory. This new method uses artificial neural networks to simulate living phenomena in a computer. A recent study by Parisi and Schlesinger suggests that artificial life might reinvigorate the Piagetian framework. We contrast artificial life with traditional cognitivist approaches, discuss the role of innateness in development, and examine the relation between physiological and psychological explanations of intelligent behaviour.

  18. Activation of cardiac ryanodine receptors by cardiac glycosides.

    Science.gov (United States)

    Sagawa, Toshio; Sagawa, Kazuko; Kelly, James E; Tsushima, Robert G; Wasserstrom, J Andrew

    2002-03-01

    This study investigated the effects of cardiac glycosides on single-channel activity of the cardiac sarcoplasmic reticulum (SR) Ca2+ release channels or ryanodine receptor (RyR2) channels and how this action might contribute to their inotropic and/or toxic actions. Heavy SR vesicles isolated from canine left ventricle were fused with artificial planar lipid bilayers to measure single RyR2 channel activity. Digoxin and actodigin increased single-channel activity at low concentrations normally associated with therapeutic plasma levels, yielding a 50% of maximal effect of approximately 0.2 nM for each agent. Channel activation by glycosides did not require MgATP and occurred only when digoxin was applied to the cytoplasmic side of the channel. Similar results were obtained in human RyR2 channels; however, neither the crude skeletal nor the purified cardiac channel was activated by glycosides. Channel activation was dependent on [Ca2+] on the luminal side of the bilayer with maximal stimulation occurring between 0.3 and 10 mM. Rat RyR2 channels were activated by digoxin only at 1 microM, consistent with the lower sensitivity to glycosides in rat heart. These results suggest a model in which RyR2 channel activation by digoxin occurs only when luminal [Ca2+] was increased above 300 microM (in the physiological range). Consequently, increasing SR load (by Na+ pump inhibition) serves to amplify SR release by promoting direct RyR2 channel activation via a luminal Ca2+-sensitive mechanism. This high-affinity effect of glycosides could contribute to increased SR Ca2+ release and might play a role in the inotropic and/or toxic actions of glycosides in vivo.

  19. Pajarito Aerosol Couplings to Ecosystems (PACE) Field Campaign Report

    Energy Technology Data Exchange (ETDEWEB)

    Dubey, M [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-03-01

    Laboratory (LANL) worked on the Pajarito Aerosol Couplings to Ecosystems (PACE) intensive operational period (IOP). PACE’s primary goal was to demonstrate routine Mobile Aerosol Observing System (MAOS) field operations and improve instrumental and operational performance. LANL operated the instruments efficiently and effectively with remote guidance by the instrument mentors. This was the first time a complex suite of instruments had been operated under the ARM model and it proved to be a very successful and cost-effective model to build upon.

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

    Science.gov (United States)

    Russo, Vincenzo; Nigro, Gerardo; DI Meo, Federica; Papa, Andrea Antonio; Cioppa, Nadia Della; Proietti, Riccardo; Russo, Maria Giovanna; Calabrò, Raffaele; Politano, Luisa

    2014-12-01

    P-wave dispersion is a non invasive indicator of intra-atrial conduction heterogeneity producing substrate for reentry, which is a pathophysiological mechanism of atrial fibrillation. The relationship between P-wave dispersion (PD) and atrial fibrillation (AF) in Myotonic dystrophy type 1 (DM1) patients is still unclear. Atrial Preference Pacing (APP) is an efficient algorithm to prevent paroxysmal AF in patients implanted with dual-chamber pacemaker. Aim of our study was to evaluate the possible correlation between atrial preference pacing algorithm, P-wave dispersion and AF burden in DM1 patients with normal cardiac function underwent permanent dual-chamber pacemaker implantation. We enrolled 50 patients with DM1 (age 50.3 ± 7.3; 11 F) underwent dual-chamber pacemaker implantation for various degree of atrioventricula block. The study population was randomized following 1 months stabilization period to APP algorithm features programmed OFF or ON. Patients were assessed every 3 months for the first year, and every 6 months thereafter up to 3 years. At each follow-up visit, we counted: the number of premature atrial beats, the number and the mean duration of AF episodes, AF burden and the percentage of atrial and ventricular pacing. APP ON Group showed lower number of AF episodes (117 ± 25 vs. 143 ± 37; p = 0.03) and AF burden (3059 ± 275 vs. 9010 ± 630 min; p < 0.04) than APP OFF Group. Atrial premature beats count (44903 ± 30689 vs. 13720 ± 7717 beats; p = 0.005) and Pwave dispersion values (42,1 ± 11 ms vs. 29,1 ± 4,2 ms, p = 0,003) were decreased in APP ON Group. We found a significant positive correlation between PD and AF burden (R = 0,8, p = 0.007). Atrial preference pacing algorithm, decreasing the number of atrial premature beats and the P-wave dispersion, reduces the onset and perpetuator factors of AF episodes and decreases the AF burden in DM1 patients underwent dual chamber pacemaker implantation for various degree of atrioventricular blocks

  1. [Effects and the mechanisms of cardiac short-term memory on cellular electrical excitability].

    Science.gov (United States)

    Wang, Juan; Zhang, Hong; Yang, Lin; Wu, Ruijuan; Zhang, Zhenxi

    2012-08-01

    Electrical instability easily induces a unidirectional conduction block, resulting in ventricular tachycardia (VT) or even fibrillation (VF). Cardiac memory affects dynamic electrical characteristics through previous pacing so that it makes the memory important in arrhythmia study. This paper investigates the impact of the rapid pacing duration on cellular excitability and its mechanism. Based on the canine endocardial single cell, a one-dimensional tissue model was developed. Simulations were realized with OpenMP parallel programming method. The results showed that with repetitive pacing, the cellular excitability became low while the conduction velocity decreased. Accumulation of intracellular [Ca2+]i and [Na+]i and depletion of [K+]i led to the shift of membrane current-voltage curves, changing the membrane resistance. Excitability determined by the resistance at the large width of stimulus pulse, therefore, it suggested that [Ca2+]i and [K+]i-induced memory formed the ionic substrates for the alteration of excitability.

  2. Aspectos técnicos do implante de eletrodo para estimulação ventricular esquerda através do seio coronariano, com a utilização de anatomia radiológica e eletrograma intracavitário, na terapia de ressincronização cardíaca Technical aspects of lead implantation for left ventricle pacing through the coronary sinus, using anatomic radiology and intracavitary electrography in the cardiac resynchronization therapy

    Directory of Open Access Journals (Sweden)

    Fernando Sérgio Oliva de Souza

    2005-09-01

    Full Text Available OBJETIVO: Apresentar a experiência de 157 implantes utilizando uma técnica simplificada para cateterização do seio coronariano, baseada no eletrograma intracavitário e anatomia radiológica, demonstrando o porcentual de sucesso e tempo total de utilização de radioscopia. MÉTODO: De outubro de 2001 a fevereiro de 2005, foram realizados 157 implantes de marcapasso biventricular em pacientes previamente selecionados, utilizando-se anatomia radiológica e observação de eletrograma intracavitário, demonstrando a taxa de sucesso, complicações e tempo total de utilização de radioscopia. RESULTADOS: O implante do sistema, utilizando-se a estimulação do ventrículo esquerdo via seio coronariano, não foi possível em onze procedimentos. Em 20 pacientes foram observadas dificuldades na canulação do óstio coronário e em 39 pacientes observou-se dificuldade de progressão do eletrodo através do seio coronário. O tempo médio de utilização de radioscopia foi 18,27 ± 15,46 min. CONCLUSÃO: A técnica de implante, proposta pelo autor, utilizando o eletrograma intracavitário e anatomia radiológica, demonstrou ser segura e eficaz para canulação do óstio do seio coronário, necessitando de reduzidos tempos de radioscopia.OBJECTIVE: To present the experience of 157 implantations using a simplified technique for coronary sinus catheterization, based on the atrial component of the intracavitary electrogram and radiological anatomy, showing the success rate and total time of radioscopy use. METHOD: From October 2001 to February 2005, 157 biventricular pacemaker implantations were performed in previously selected patients, using radiological anatomy and observation of the intracavitary electrogram, focusing on the atrial component. Here we show the success rate, complications and total time of radioscopy use. RESULTS: The implantation of the system employing left ventricular pacing via the coronary sinus was not possible in 11 patients

  3. Stimulating endogenous cardiac regeneration

    Directory of Open Access Journals (Sweden)

    Amanda eFinan

    2015-09-01

    Full Text Available The healthy adult heart has a low turnover of cardiac myocytes. The renewal capacity, however, is augmented after cardiac injury. Participants in cardiac regeneration include cardiac myocytes themselves, cardiac progenitor cells, and peripheral stem cells, particularly from the bone marrow compartment. Cardiac progenitor cells and bone marrow stem cells are augmented after cardiac injury, migrate to the myocardium, and support regeneration. Depletion studies of these populations have demonstrated their necessary role in cardiac repair. However, the potential of these cells to completely regenerate the heart is limited. Efforts are now being focused on ways to augment these natural pathways to improve cardiac healing, primarily after ischemic injury but in other cardiac pathologies as well. Cell and gene therapy or pharmacological interventions are proposed mechanisms. Cell therapy has demonstrated modest results and has passed into clinical trials. However, the beneficial effects of cell therapy have primarily been their ability to produce paracrine effects on the cardiac tissue and recruit endogenous stem cell populations as opposed to direct cardiac regeneration. Gene therapy efforts have focused on prolonging or reactivating natural signaling pathways. Positive results have been demonstrated to activate the endogenous stem cell populations and are currently being tested in clinical trials. A potential new avenue may be to refine pharmacological treatments that are currently in place in the clinic. Evidence is mounting that drugs such as statins or beta blockers may alter endogenous stem cell activity. Understanding the effects of these drugs on stem cell repair while keeping in mind their primary function may strike a balance in myocardial healing. To maximize endogenous cardiac regeneration,a combination of these approaches couldameliorate the overall repair process to incorporate the participation ofmultiple cell players.

  4. Current topics in glycemic control by wearable artificial pancreas or bedside artificial pancreas with closed-loop system.

    Science.gov (United States)

    Hanazaki, Kazuhiro; Munekage, Masaya; Kitagawa, Hiroyuki; Yatabe, Tomoaki; Munekage, Eri; Shiga, Mai; Maeda, Hiromichi; Namikawa, Tsutomu

    2016-09-01

    The incidence of diabetes is increasing at an unprecedented pace and has become a serious health concern worldwide during the last two decades. Despite this, adequate glycemic control using an artificial pancreas has not been established, although the 21st century has seen rapid developments in this area. Herein, we review current topics in glycemic control for both the wearable artificial pancreas for type 1 and type 2 diabetic patients and the bedside artificial pancreas for surgical diabetic patients. In type 1 diabetic patients, nocturnal hypoglycemia associated with insulin therapy remains a serious problem that could be addressed by the recent development of a wearable artificial pancreas. This smart phone-like device, comprising a real-time, continuous glucose monitoring system and insulin pump system, could potentially significantly reduce nocturnal hypoglycemia compared with conventional glycemic control. Of particular interest in this space are the recent inventions of a low-glucose suspend feature in the portable systems that automatically stops insulin delivery 2 h following a glucose sensor value artificial pancreas with the closed-loop system has also proved safe and effective for not only avoiding hypoglycemia, but also for reducing blood glucose level variability resulting in good surgical outcomes. We hope that a more sophisticated artificial pancreas with closed-loop system will now be taken up for routine use worldwide, providing enormous relief for patients suffering from uncontrolled hyperglycemia, hypoglycemia, and/or variability in blood glucose concentrations.

  5. Paced QRS duration and myocardial scar amount: predictors of long-term outcome of right ventricular apical pacing.

    Science.gov (United States)

    Lee, Seung-Ah; Cha, Myung-Jin; Cho, Youngjin; Oh, Il-Young; Choi, Eue-Keun; Oh, Seil

    2016-07-01

    Long-term right ventricular apical pacing (RVAP) is reportedly associated with heart failure (HF) development. However, the predictors of pacing-induced HF (PHF) remained unclear. We retrospectively enrolled 234 patients without structural heart disease who underwent a permanent pacemaker implantation with RVAP between 1982 and 2004. RVAP-induced HF was defined as left ventricular ejection fraction decrease >5 % with HF symptom without other HF development etiology. The QRS duration of a paced beat (pQRSd) and myocardial scar score were analyzed from each patient's 12-lead ECG. During a mean 15.6 years (range 3.3-30.0 years), 48 patients (20.5 %) patients developed RVAP-induced HF. The PHF group patients had a longer pQRSd (192.4 ± 13.5 vs. 175.7 ± 14.7 ms in non-PHF patients, p scar score (5.2 ± 1.9 vs. 2.7 ± 1.9, respectively p scar score (HR 1.23, 95 % CI 1.03-1.49, p = 0.037), and a higher percentage of ventricular pacing (HR 1.31, 95 % CI 1.01-1.49, p = 0.010) were independent predictors of PHF. Based on the results of the receiver-operating characteristic (ROC) curve, the pQRSd cutoff was 185 ms (AUC 0.79, sensitivity 66.7 %, specificity 76.3 %) and myocardial scar score cutoff value was 4 (AUC 0.81, sensitivity 81.3 %, specificity 66.1 %). The pQRSd was positively correlated with scar score (r = 0.70, p scar score ≥4 might be independent long-term prognostic markers of PHF.

  6. Pilot trial of an age-paced parenting newsletter.

    Science.gov (United States)

    Keane, Brigid; Waterston, Tony; McConachie, Helen; Towner, Elizabeth; Cook, Margaret; Birks, Eileen

    2005-10-01

    Supporting parents in the first three years of a child's life has the potential to produce successful outcomes. Present government initiatives such as Sure Start focus on this age group. An American educational intervention, in the style of a monthly newsletter, was adapted for use in the UK for parents of young children. Topics were presented in an easy-to-read format and focused on infant emotional development, parent interaction and play. Newsletters, called Baby Express were posted at monthly intervals to the family home providing age-paced information which could meet the specific needs of parents at that stage of their child's life. The aim of the study was to determine the applicability of the newsletter to UK parents and evaluate their satisfaction. Sixty home-based interviews were conducted and 95 per cent of mothers reported reading all or part of the newsletter. Changes in parenting style were spontaneously reported by 28 per cent of mothers. This study found that an aged-paced parenting newsletter was an acceptable and useful method of supporting parents in the early months of a child's life and promotes positive changes in parenting behaviour.

  7. Self-paced model learning for robust visual tracking

    Science.gov (United States)

    Huang, Wenhui; Gu, Jason; Ma, Xin; Li, Yibin

    2017-01-01

    In visual tracking, learning a robust and efficient appearance model is a challenging task. Model learning determines both the strategy and the frequency of model updating, which contains many details that could affect the tracking results. Self-paced learning (SPL) has recently been attracting considerable interest in the fields of machine learning and computer vision. SPL is inspired by the learning principle underlying the cognitive process of humans, whose learning process is generally from easier samples to more complex aspects of a task. We propose a tracking method that integrates the learning paradigm of SPL into visual tracking, so reliable samples can be automatically selected for model learning. In contrast to many existing model learning strategies in visual tracking, we discover the missing link between sample selection and model learning, which are combined into a single objective function in our approach. Sample weights and model parameters can be learned by minimizing this single objective function. Additionally, to solve the real-valued learning weight of samples, an error-tolerant self-paced function that considers the characteristics of visual tracking is proposed. We demonstrate the robustness and efficiency of our tracker on a recent tracking benchmark data set with 50 video sequences.

  8. Social Interaction in Self-paced Distance Education

    Directory of Open Access Journals (Sweden)

    Terry Anderson

    2015-02-01

    Full Text Available In this paper we present a case study of a self-paced university course that was originally designed to support independent, self-paced study at distance. We developed a social media intervention, in design-based research terms, that allows these independent students to contribute archived content to enhance the course, to engage in discussions with other students and to share as little or as much personal information with each other as they wished. We describe the learning design for the intervention and present survey data of student and tutor perception of value and content analysis of the archived contributions. The results indicate that the intervention was positively received by tutors and by the majority (but not all students and that the archive created by the students’ contributions was adding value to the course. We conclude that the intervention was a modest, yet manageable example of a learning enhancement to a traditional cognitive-behavioral, course that has positive impact and potential with little negative impact on workload.

  9. Data reproducibility of pace strategy in a laboratory test run

    Science.gov (United States)

    de França, Elias; Xavier, Ana Paula; Hirota, Vinicius Barroso; Côrrea, Sônia Cavalcanti; Caperuto, Érico Chagas

    2016-01-01

    This data paper contains data related to a reproducibility test for running pacing strategy in an intermittent running test until exhaustion. Ten participants underwent a crossover study (test and retest) with an intermittent running test. The test was composed of three-minute sets (at 1 km/h above Onset Blood Lactate Accumulation) until volitional exhaustion. To assess pace strategy change, in the first test participants chose the rest time interval (RTI) between sets (ranging from 30 to 60 s) and in the second test the maximum RTI values were either the RTI chosen in the first test (maximum RTI value), or less if desired. To verify the reproducibility of the test, rating perceived exertion (RPE), heart rate (HR) and blood plasma lactate concentration ([La]p) were collected at rest, immediately after each set and at the end of the tests. As results, RTI, RPE, HR, [La]p and time to exhaustion were not statistically different (p>0.05) between test and retest, as well as they demonstrated good intraclass correlation. PMID:27081672

  10. Unidirectional Pinning and Hysteresis of Spatially Discordant Alternans in Cardiac Tissue

    CERN Document Server

    Skardal, Per Sebastian; Restrepo, Juan G

    2011-01-01

    Spatially discordant alternans is a widely observed pattern of voltage and calcium signals in cardiac tissue that can precipitate lethal cardiac arrhythmia. Using spatially coupled iterative maps of the beat-to-beat dynamics, we explore this pattern's dynamics in the regime of a calcium-dominated period-doubling instability at the single cell level. We find a novel nonlinear bifurcation associated with the formation of a discontinuous jump in the amplitude of calcium alternans at nodal lines separating discordant regions. We show that this jump unidirectionally pins nodal lines by preventing their motion away from the pacing site following a pacing rate decrease, but permitting motion towards this site following a rate increase. This unidirectional pinning leads to strongly history-dependent nodal line motion that is strongly arrhythmogenic.

  11. Animal personality and pace-of-life syndromes: do fast-exploring fairy-wrens die young?

    Directory of Open Access Journals (Sweden)

    Michelle L Hall

    2015-03-01

    Full Text Available The pace-of-life syndrome (POLS hypothesis for animal personality proposes that variation among individuals in life-history strategies is associated with consistent differences in behavior. We tested predictions of this hypothesis in the superb fairy-wren, Malurus cyaneus, by investigating long-term individual differences in risk-related behaviors (latency to enter a novel artificial environment, exploration, activity and response to mirror image stimulation and survival. We found consistent differences between individuals in these behaviors (adjusted repeatability of exploration of artificial novel environment = 0.37. Individual differences were consistent over several years and bi-variate analyses showed a significant among-individual correlation (‘behavioral syndrome’ between exploration behavior at two life stages (young adult and old adult. Docility at the nestling stage predicted exploration behavior of juveniles. Behavioral traits measured in a risky context were correlated with one another, forming a behavioral syndrome of coping strategies ranging from ‘proactive’ to ‘reactive’. Nestlings that were more active and exploratory in isolation were less docile during handling, while adults that entered the artificial environment fast were more exploratory, active, and aggressive in the artificial environment. Exploration behavior increased within individuals as they aged and when they were in poorer condition, consistent with expectations of more risk-prone behavior with lower residual reproductive value (reduced ‘asset protection’. Risk-related behavior predicted the probability of apparent survival: more exploratory individuals were less likely to be present in the population twelve months later. Our findings suggest that, consistent with the predictions of the POLS hypothesis, individual variation in survival is associated with consistent individual differences in risk-related behavior that are maintained long-term and

  12. Pacing a data transfer operation between compute nodes on a parallel computer

    Science.gov (United States)

    Blocksome, Michael A.

    2011-09-13

    Methods, systems, and products are disclosed for pacing a data transfer between compute nodes on a parallel computer that include: transferring, by an origin compute node, a chunk of an application message to a target compute node; sending, by the origin compute node, a pacing request to a target direct memory access (`DMA`) engine on the target compute node using a remote get DMA operation; determining, by the origin compute node, whether a pacing response to the pacing request has been received from the target DMA engine; and transferring, by the origin compute node, a next chunk of the application message if the pacing response to the pacing request has been received from the target DMA engine.

  13. Marketing cardiac CT programs.

    Science.gov (United States)

    Scott, Jason

    2010-01-01

    There are two components of cardiac CT discussed in this article: coronary artery calcium scoring (CACS) and coronary computed tomography angiography (CCTA).The distinctive advantages of each CT examination are outlined. In order to ensure a successful cardiac CT program, it is imperative that imaging facilities market their cardiac CT practices effectively in order to gain a competitive advantage in this valuable market share. If patients receive quality care by competent individuals, they are more likely to recommend the facility's cardiac CT program. Satisfied patients will also be more willing to come back for any further testing.

  14. Sick sinus syndrome in a patient with extensive cardiac lipomatosis (sinus node dysfunction in lipomatosis).

    Science.gov (United States)

    Kadmon, Ehud; Paz, Rami; Kusniec, Jairo; Strasberg, Boris

    2010-04-01

    We present a case of a 45-year-old man with an incidental and longstanding diagnosis of extensive mediastinal and cardiac lipomatosis. Along the years, he had experienced various arrhythmias, mainly bradyarrhythmias, mostly asymptomatic. Recently after documenting a sinus pause of 6 seconds and runs of nonsustained ventricular tachycardias, he underwent an implantation of a cardioverter-defibrillator. There are many reports of cardiac lipomatosis in the literature, including reports of related ventricular arrhythmias, some of which are fatal. (PACE 2010; 513-515).

  15. Hemodynamic Sensor in Cardiac Implantable Electric Devices: The Endocardial Accelaration Technology

    Directory of Open Access Journals (Sweden)

    Stefania Sacchi

    2013-01-01

    Full Text Available There have been substantial progresses in the technology of cardiac implantable electric devices (CIEDs during the past decades. One of the progresses is represented by the development of a hemodynamic sensor embedded at the tip of a pacing lead that measures myocardial contractility by the analysis of myocardial mechanical vibrations occurring during the cardiac cycle. This sensor, providing continuous hemodynamic monitoring, could play an important role in clinical practice because of several clinical applications in CIEDs recipients. The objectives of this work are to report how this sensor operates and to review the main findings about its clinical applications.

  16. Controlling Spiral Dynamics in Excitable Media by a Weakly Localized Pacing

    Institute of Scientific and Technical Information of China (English)

    LI Bing-Wei; SUN Li-Li; CHEN Bin; YING He-Ping

    2007-01-01

    @@ Spiral dynamics controlled by a weakly localized pacing around the spiral tip is investigated. Numerical simulations show two distinct characteristics when the pacing is applied with the weak amplitude for suitable frequencies:for a rigidly rotating spiral, a transition from rigid rotation to meandering motion is observed, and for unstable spiral waves, spiral breakup can be prevented. Successfully preventing spiral breakup is relevant to the modulation of the tip trajectory induced by a localized pacing.

  17. Exploring the Role of Calcium in Cardiac Cell Dynamics

    Science.gov (United States)

    Berger, Carolyn; Idriss, Salim; Rouze, Ned; Hall, David; Gauthier, Daniel

    2007-03-01

    Bifurcations in the electrical response of cardiac tissue can destabilize spatio-temporal waves of electrochemical activity in the heart, leading to tachycardia or even fibrillation. Therefore, it is important to understand the mechanisms that cause instabilities in cardiac tissue.Traditionally, researchers have focused on understanding how the transmembrane voltage is altered in response to an increase in pacing rate, i.e. a shorter time interval between propagating electrochemical waves. However, the dynamics of the transmembrane voltage are coupled to the activity of several ions that traverse the membrane. Therefore, to fully understand the mechanisms that drive these bifurcations, we must include an investigation of the ionic behavior. We will present our recent investigation of the role of intracellular calcium in an experimental testbed of frog ventricle. Calcium and voltage are measured simultaneously, allowing for the previous research regarding voltage to guide our understanding of the calcium dynamics.

  18. Cardiac contraction induces discordant alternans and localized block

    Science.gov (United States)

    Radszuweit, M.; Alvarez-Lacalle, E.; Bär, M.; Echebarria, B.

    2015-02-01

    In this paper we use a simplified model of cardiac excitation-contraction coupling to study the effect of tissue deformation on the dynamics of alternans, i.e., alternations in the duration of the cardiac action potential, that occur at fast pacing rates and are known to be proarrhythmic. We show that small stretch-activated currents can produce large effects and cause a transition from in-phase to off-phase alternations (i.e., from concordant to discordant alternans) and to conduction blocks. We demonstrate numerically and analytically that this effect is the result of a generic change in the slope of the conduction velocity restitution curve due to electromechanical coupling. Thus, excitation-contraction coupling can potentially play a relevant role in the transition to reentry and fibrillation.

  19. Feasibility of dual-chamber (DDD) pacing via a single-pass (VDD) pacing lead employing a floating atrial ring (dipole): case series, future considerations, and refinements.

    Science.gov (United States)

    Kassotis, John; Voigt, Louis; Mongwa, Mbu; Reddy, C V R

    2005-01-01

    The objective of this study was to assess the feasibility of DDD pacing from a standard single-pass VDD pacemaker system. Over the past 2 decades significant advances have been made in the development of single-pass VDD pacing systems. These have been shown in long-term prospective studies to effectively preserve atrioventricular (AV)synchrony in patients with AV block and normal sinus node function. What remains problematic is the development of a single-pass pacing system capable of DDD pacing. Such a lead configuration would be useful in those patients with peripheral venous anomalies and in younger patients with congenital anomalies, which may require lead revisions in the future. In addition, with the increased use of resynchronization (biventricular pacing) therapy, the availability of a reliable single-pass lead will minimize operative time, enhance patient safety, and minimize the amount of hardware within the heart. The feasibility of DDD pacing via a Medtronic Capsure VDD-2 (Model #5038) pacing lead was evaluated. Twenty patients who presented with AV block and normal sinus node function were recruited for this study. Atrial pacing thresholds and sensitivities were assessed intraoperatively in the supine position with various respiratory maneuvers. Five patients who agreed to participate in long-term follow-up received a dual-chamber generator and were evaluated periodically over a 12-month period. Mean atrial sensitivity was 2.35 +/- 0.83 mV at the time of implantation. Effective atrial stimulation was possible in all patients at the time of implantation (mean stimulation threshold 3.08 +/- 1.04 V at 0.5 ms [bipolar], 3.34 +/- 0.95 V at 0.5 ms [unipolar]). Five of the 20 patients received a Kappa KDR701 generator, and atrial electrical properties were followed up over a 1-year period. There was no significant change in atrial pacing threshold or incidence of phrenic nerve stimulation over the 1-year follow-up. A standard single-pass VDD pacing lead

  20. Perfil clínico de pacientes chagásicos e não-chagásicos portadores de marca-passo cardíaco artificial Clinical profile of Chagas and non-Chagas' disease patients with cardiac pacemaker

    Directory of Open Access Journals (Sweden)

    Leonor Garcia Rincon

    2006-06-01

    Full Text Available O objetivo do estudo foi comparar pacientes chagásicos e não-chagásicos com marca-passo cardíaco artificial uni ou bicameral quanto à fração de ejeção do ventrículo esquerdo, o limiar de estimulação ventricular e a incidência de arritmias cardíacas. Entre janeiro/2001 e novembro/2002 foram avaliados 45 pacientes chagásicos e 35 não-chagásicos portadores de marca-passo quanto à história clínica, radiografia do tórax, ecocardiograma, Holter 24h e análise telemétrica do marca-passo. Embora os chagásicos fossem mais jovens, os dois grupos foram semelhantes quanto a variáveis radiológicas e o limiar de estimulação ventricular direito. Os chagásicos apresentaram menor fração de ejeção do ventrículo esquerdo ao ecocardiograma e maior incidência de arritmia ventricular ao Holter 24h. Observou-se correlação positiva entre a baixa fração de ejeção do ventrículo esquerdo e a intensidade da arritmia ventricular ao Holter 24h. Em pacientes com marca-passo, a doença de Chagas está associada a marcadores cardíacos de prognóstico adverso.The aim of this study was to compare Chagas and non-Chagas' disease patients using single or dual-chamber pacemaker in relation to the ejection fraction of the left ventricle, the ventricular stimulation threshold and the occurrence of ventricular arrhythmia. From January, 2001 to November, 2002, 45 Chagas' disease patients and 35 non-Chagas' disease patients, all pacemaker users, were evaluated considering clinical history, echocardiographic study, Holter monitoring and analysis of the pacemaker telemetry data. Chagas' disease patients were significantly younger, but both groups were similar when chest X-Ray variables and right ventricular stimulation threshold were analyzed. Chagas' disease patients had a lower left ventricular ejection fraction and more frequent ventricular arrhythmia during Holter monitoring. A positive correlation between the low ejection fraction of the left

  1. Effects of Amiodarone plus Losartan on Electrical Remodeling in Rapid Atrial Pacing in Rabbits

    Institute of Scientific and Technical Information of China (English)

    Liye Wei; Yue Xia; Guoqing Qi; Qingwen Zhang

    2008-01-01

    Objectives To investigate the electrical remodeling and the effects of amiodarone and losartan on electrical remode-ling in rapid atrial pacing on rabbit model. Methods 40 normal rabbits were randomly divided into 4 groups: the sa-line group (control group), amiodarone group, losartan group, ami + los group. All rabbits were raised drugs in a week. The atrial effective refractory period (AERP) was measured. Then, take a rapid atrial pacing (600 bpm) and the AERP was measured after 0. 5, 1, 2, 4, 6 and 8 hours pacing and 30 minutes after the termination of rapid pacing. Results ① In control group, after 8 hours rapid pacing, AERP 200 and AERP 150 were significantly shortened 16. 11%± 3. 1% (P <0. 01) and 9. 99%±4. 2% (P <0. 01). And the degree of AERP shortening induced by rapid pacing was greater at basic cycle lengths of 200 ms (BCL200) than that at BCL150. The AERP of amiodarone, losartan group and anti + los group were not shortened during rapid pacing.② In the control group, after the termination of rapid pacing, the AERP gradually increased. The AERP at all of the BCLS examined recovered to almost the 95.78% and 96. 76% of baseline values within the first 10 minutes and recovered to almost the 99. 07% and 99. 39% of baseline values within the first 30 minutes. Condusions Short-term atrial rapid pacing can induce the atrial electrical remodeling. Amiodarone and losartan can prevent the electrical remodeling.

  2. Mechanical communication in cardiac cell synchronized beating

    Science.gov (United States)

    Nitsan, Ido; Drori, Stavit; Lewis, Yair E.; Cohen, Shlomi; Tzlil, Shelly

    2016-05-01

    Cell-cell communication, which enables cells to coordinate their activity and is essential for growth, development and function, is usually ascribed a chemical or electrical origin. However, cells can exert forces and respond to environment elasticity and to mechanical deformations created by their neighbours. The extent to which this mechanosensing ability facilitates intercellular communication remains unclear. Here we demonstrate mechanical communication between cells directly for the first time, providing evidence for a long-range interaction that induces long-lasting alterations in interacting cells. We show that an isolated cardiac cell can be trained to beat at a given frequency by mechanically stimulating the underlying substrate. Deformations are induced using an oscillatory mechanical probe that mimics the deformations generated by a beating neighbouring cardiac cell. Unlike electrical field stimulation, the probe-induced beating rate is maintained by the cell for an hour after the stimulation stops, implying that long-term modifications occur within the cell. These long-term alterations provide a mechanism for cells that communicate mechanically to be less variable in their electromechanical delay. Mechanical coupling between cells therefore ensures that the final outcome of action potential pacing is synchronized beating. We further show that the contractile machinery is essential for mechanical communication.

  3. Artificial neural interfaces for bionic cardiovascular treatments.

    Science.gov (United States)

    Kawada, Toru; Sugimachi, Masaru

    2009-01-01

    An artificial nerve, in the broad sense, may be conceptualized as a physical and logical interface system that reestablishes the information traffic between the central nervous system and peripheral organs. Studies on artificial nerves targeting the autonomic nervous system are in progress to explore new treatment strategies for several cardiovascular diseases. In this article, we will review our research targeting the autonomic nervous system to treat cardiovascular diseases. First, we identified the rule for decoding native sympathetic nerve activity into a heart rate using transfer function analysis, and established a framework for a neurally regulated cardiac pacemaker. Second, we designed a bionic baroreflex system to restore the baroreflex buffering function using electrical stimulation of the celiac ganglion in a rat model of orthostatic hypotension. Third, based on the hypothesis that autonomic imbalance aggravates chronic heart failure, we implanted a neural interface into the right vagal nerve and demonstrated that intermittent vagal stimulation significantly improved the survival rate in rats with chronic heart failure following myocardial infarction. Although several practical problems need to be resolved, such as those relating to the development of electrodes feasible for long-term nerve activity recording, studies of artificial neural interfaces with the autonomic nervous system have great possibilities in the field of cardiovascular treatment. We expect further development of artificial neural interfaces as novel strategies to cope with cardiovascular diseases resistant to conventional therapeutics.

  4. Sex differences in pacing during ‘Ultraman Hawaii’

    Directory of Open Access Journals (Sweden)

    Beat Knechtle

    2016-09-01

    Full Text Available Background To date, little is known for pacing in ultra-endurance athletes competing in a non-stop event and in a multi-stage event, and especially, about pacing in a multi-stage event with different disciplines during the stages. Therefore, the aim of the present study was to examine the effect of age, sex and calendar year on triathlon performance and variation of performance by events (i.e., swimming, cycling 1, cycling 2 and running in ‘Ultraman Hawaii’ held between 1983 and 2015. Methods Within each sex, participants were grouped in quartiles (i.e., Q1, Q2, Q3 and Q4 with Q1 being the fastest (i.e., lowest overall time and Q4 the slowest (i.e., highest overall time. To compare performance among events (i.e., swimming, cycling 1, cycling 2 and running, race time in each event was converted in z score and this value was used for further analysis. Results A between-within subjects ANOVA showed a large sex × event (p = 0.015, η2 = 0.014 and a medium performance group × event interaction (p = 0.001, η2 = 0.012. No main effect of event on performance was observed (p = 0.174, η2 = 0.007. With regard to the sex × event interaction, three female performance groups (i.e., Q2, Q3 and Q4 increased race time from swimming to cycling 1, whereas only one male performance group (Q4 revealed a similar trend. From cycling 1 to cycling 2, the two slower female groups (Q3 and Q4 and the slowest male group (Q4 increased raced time. In women, the fastest group decreased (i.e., improved race time from swimming to cycling 1 and thereafter, maintained performance, whereas in men, the fastest group decreased race time till cycling 2 and increased it in the running. Conclusion In summary, women pace differently than men during ‘Ultraman Hawaii’ where the fastest women decreased performance on day 1 and could then maintain on day 2 and 3, whereas the fastest men worsened performance on day 1 and 2 but improved on day 3.

  5. Mechanical Blood Pumps for Cardiac Assistance

    Directory of Open Access Journals (Sweden)

    M. Akdis

    2005-01-01

    Full Text Available Cardiac assist devices are classified into the traditional engineering categories of displacement and rotary pumps. Clinical use and indications of the various pump categories are outlined and a detailed description of currently available systems is given. The first part deals with extracorporeal as well as implantable ventricular assist devices (VAD of the displacement type and is followed by a section on current developments in the field of total artificial hearts (TAH. The second part covers the rotary pump category from cardiopulmonary bypass applications to implantable systems, including specific design aspects of radial, diagonal, and axial pumps.

  6. Artificial cognition architectures

    CERN Document Server

    Crowder, James A; Friess, Shelli A

    2013-01-01

    The goal of this book is to establish the foundation, principles, theory, and concepts that are the backbone of real, autonomous Artificial Intelligence. Presented here are some basic human intelligence concepts framed for Artificial Intelligence systems. These include concepts like Metacognition and Metamemory, along with architectural constructs for Artificial Intelligence versions of human brain functions like the prefrontal cortex. Also presented are possible hardware and software architectures that lend themselves to learning, reasoning, and self-evolution

  7. The Thoratec system implanted as a modified total artificial heart: the Bad Oeynhausen technique.

    Science.gov (United States)

    Arusoglu, Latif; Reiss, Nils; Morshuis, Michiel; Schoenbrodt, Michael; Hakim-Meibodi, Kavous; Gummert, Jan

    2010-12-01

    The CardioWest™ total artificial heart (SynCardia Systems, Tuscon, AZ, USA) is the only FDA-approved total artificial heart determined as a bridge to human heart transplantation for patients dying of biventricular heart failure. Implantation provides immediate hemodynamic restoration and clinical stabilization, leading to end-organ recovery and thus eventually allowing cardiac transplantation. Occasionally, implantation of a total artificial heart is not feasible for anatomical reasons. For this patient group, we have developed an alternative technique using the paracorporeal Thoratec biventricular support system (Thoratec, Pleasanton, CA, USA) as a modified total artificial heart. A detailed description of the implantation technique is presented.

  8. Cardiac Procedures and Surgeries

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Cardiac Procedures and Surgeries Updated:Sep 16,2016 If you've had ... degree of coronary artery disease (CAD) you have. Cardiac Procedures and Surgeries Angioplasty Also known as Percutaneous Coronary Interventions [PCI], ...

  9. Total Artificial Heart Implantation after Excision of Right Ventricular Angiosarcoma.

    Science.gov (United States)

    Bruckner, Brian A; Abu Saleh, Walid K; Al Jabbari, Odeaa; Copeland, Jack G; Estep, Jerry D; Loebe, Matthias; Reardon, Michael J

    2016-06-01

    Primary cardiac sarcomas, although rare, are aggressive and lethal, requiring thorough surgical resection and adjuvant chemotherapy for the best possible outcome. We report the case of a 32-year-old woman who underwent total artificial heart implantation for right-sided heart failure caused by right ventricular angiosarcoma. For the first several weeks in intensive care, the patient recovered uneventfully. However, a postoperative liver biopsy indicated hepatocellular injury consistent with preoperative chemotherapy. She developed continuing liver failure, from which she died despite good cardiac function.

  10. Specific Intensity for Peaking: Is Race Pace the Best Option?

    Directory of Open Access Journals (Sweden)

    Munoz

    2015-09-01

    Full Text Available Background The peaking period for endurance competition is characterized for a relative increase of the intensity of training, after a longer period of training relatively dominated by lower intensity and higher volume Objectives The present study was designed to compare physiological and 10 km performance effects of high intensity training (HIT versus race pace interval training (RP during peaking for competition in well-trained runners. Patients and Methods 13 athletes took part in the study, they were divided into two groups: HIT and RP. HIT performed short intervals at ~105% of the maximal aerobic velocity (MAV, while RP trained longer intervals at a speed of ~90% of the MAV (a speed approximating 10 km race pace. After 12 weeks of baseline training, the athletes trained for 6 weeks under one of the two peaking regimes. Subjects performed 10 km prior to and after the intervention period. The total load of training was matched between groups during the treatment phase. Subjects completed a graded treadmill running test until volitional exhaustion prior to each 10 km race. MAV was determined as the minimal velocity eliciting maximal oxygen consumption (VO2max. Results Both groups significantly improved their 10 km time (35 minutes 29 seconds ± 1 minutes 41 seconds vs 34 minutes 53 seconds ± 1 minutes 55 seconds, P 0.05. In contrast, running economy decreased significantly after HIT (210 ± 6 ml.Kg-1.km-1 vs 218 ± 9, P < 0.05. Conclusions A 6 week period of training at either 105% of MAV or 90% of MAV yielded similar performance gains in a 10km race performed at ~90% MAV. Therefore, the physiological impact of HIT training seems to be positive for VO2max but negative for running economy.

  11. Biomaterials for cardiac regeneration

    CERN Document Server

    Ruel, Marc

    2015-01-01

    This book offers readers a comprehensive biomaterials-based approach to achieving clinically successful, functionally integrated vasculogenesis and myogenesis in the heart. Coverage is multidisciplinary, including the role of extracellular matrices in cardiac development, whole-heart tissue engineering, imaging the mechanisms and effects of biomaterial-based cardiac regeneration, and autologous bioengineered heart valves. Bringing current knowledge together into a single volume, this book provides a compendium to students and new researchers in the field and constitutes a platform to allow for future developments and collaborative approaches in biomaterials-based regenerative medicine, even beyond cardiac applications. This book also: Provides a valuable overview of the engineering of biomaterials for cardiac regeneration, including coverage of combined biomaterials and stem cells, as well as extracellular matrices Presents readers with multidisciplinary coverage of biomaterials for cardiac repair, including ...

  12. Mathematical cardiac electrophysiology

    CERN Document Server

    Colli Franzone, Piero; Scacchi, Simone

    2014-01-01

    This book covers the main mathematical and numerical models in computational electrocardiology, ranging from microscopic membrane models of cardiac ionic channels to macroscopic bidomain, monodomain, eikonal models and cardiac source representations. These advanced multiscale and nonlinear models describe the cardiac bioelectrical activity from the cell level to the body surface and are employed in both the direct and inverse problems of electrocardiology. The book also covers advanced numerical techniques needed to efficiently carry out large-scale cardiac simulations, including time and space discretizations, decoupling and operator splitting techniques, parallel finite element solvers. These techniques are employed in 3D cardiac simulations illustrating the excitation mechanisms, the anisotropic effects on excitation and repolarization wavefronts, the morphology of electrograms in normal and pathological tissue and some reentry phenomena. The overall aim of the book is to present rigorously the mathematica...

  13. Right ventricular septal pacing: Safety and efficacy in a long term follow up

    Institute of Scientific and Technical Information of China (English)

    Eraldo; Occhetta; Gianluca; Quirino; Lara; Baduena; Rosaria; Nappo; Chiara; Cavallino; Emanuela; Facchini; Paolo; Pistelli; Andrea; Magnani; Miriam; Bortnik; Gabriella; Francalacci; Gabriele; Dell’Era; Laura; Plebani; Paolo; Marino

    2015-01-01

    AIM: To evaluate the safety and efficacy of the permanent high interventricular septal pacing in a long term follow up, as alternative to right ventricular apical pacing. METHODS: We retrospectively evaluated:(1) 244 patients(74 ± 8 years; 169 men, 75 women) implanted with a single(132 pts) or dual chamber(112 pts) pacemaker(PM) with ventricular screw-in lead placed at the right ventricular high septal parahisian site(SEPTAL pacing);(2) 22 patients with permanent pacemaker and low percentage of pacing(< 20%)(NO pacing);(3) 33 patients with high percentage(> 80%) right ventricular apical pacing(RVA). All patients had a narrow spontaneous QRS(101 ± 14 ms). We evaluated New York Heart Association(NYHA) class, quality of life(Qo L), 6 min walking test(6MWT) and left ventricular function(end-diastolic volume, LV-EDV; end-systolic volume, LVESV; ejection fraction, LV-EF) with 2D-echocardiography. RESULTS: Pacing parameters were stable duringfollow up(21 mo/patient). In SEPTAL pacing group we observed an improvement in NYHA class, Qo L score and 6MWT. While LV-EDV didn’t significantly increase(104 ± 40 m L vs 100 ± 37 m L; P = 0.35), LV-ESV slightly increased(55 ± 31 m L vs 49 ± 27 m L; P = 0.05) and LV-EF slightly decreased(49% ± 11% vs 53% ± 11%; P = 0.001) but never falling < 45%. In the RVA pacing control group we observed a worsening of NYHA class and an important reduction of LV-EF(from 56% ± 6% to 43% ± 9%, P < 0.0001).CONCLUSION: Right ventricular permanent high septal pacing is safe and effective in a long term follow up evaluation; it could be a good alternative to the conventional RVA pacing in order to avoid its deleterious effects.

  14. Artificial life and life artificialization in Tron

    Directory of Open Access Journals (Sweden)

    Carolina Dantas Figueiredo

    2012-12-01

    Full Text Available Cinema constantly shows the struggle between the men and artificial intelligences. Fiction, and more specifically fiction films, lends itself to explore possibilities asking “what if?”. “What if”, in this case, is related to the eventual rebellion of artificial intelligences, theme explored in the movies Tron (1982 and Tron Legacy (2010 trat portray the conflict between programs and users. The present paper examines these films, observing particularly the possibility programs empowering. Finally, is briefly mentioned the concept of cyborg as a possibility of response to human concerns.

  15. Electrical modalities beyond pacing for the treatment of heart failure.

    Science.gov (United States)

    Cornelussen, Richard N; Splett, Vincent; Klepfer, Ruth Nicholson; Stegemann, Berthold; Kornet, Lilian; Prinzen, Frits W

    2011-05-01

    In this review, we report on electrical modalities, which do not fit the definition of pacemaker, but increase cardiac performance either by direct application to the heart (e.g., post-extrasystolic potentiation or non-excitatory stimulation) or indirectly through activation of the nervous system (e.g., vagal or sympathetic activation). The physiological background of the possible mechanisms of these electrical modalities and their potential application to treat heart failure are discussed.

  16. Comparison of the rhythm control treatment strategy versus the rate control strategy in patients with permanent or long-standing persistent atrial fibrillation and heart failure treated with cardiac resynchronization therapy - a pilot study of Cardiac Resynchronization in Atrial Fibrillation Trial (Pilot-CRAfT): study protocol for a randomized controlled trial

    OpenAIRE

    Ciszewski, Jan; Maciag, Aleksander; Kowalik, Ilona; Syska, Pawel; Lewandowski, Michal; Farkowski, Michal M; Borowiec, Anna; Chwyczko, Tomasz; Pytkowski, Mariusz; Szwed, Hanna; Sterlinski, Maciej

    2014-01-01

    Background The only subgroups of patients with heart failure and atrial fibrillation in which the efficacy of cardiac resynchronization therapy has been scientifically proven are patients with indications for right ventricular pacing and patients after atrioventricular junction ablation. However it is unlikely that atrioventricular junction ablation would be a standard procedure in the majority of the heart failure patients with cardiac resynchronization therapy and concomitant atrial fibrill...

  17. Design and Implementation of programmable Cardiac Pacemaker Using VHDL

    Directory of Open Access Journals (Sweden)

    Omkar Dwivedi

    2015-05-01

    Full Text Available Pacemaker design has evolved very rapidly over the last several years. There has been a great deal of work in enhancing the programmability of pacemakers, to enable them to be programmed to work with different selected operating parameters, and indeed to work in different modes. In Taiwan, about 70%of cardiac pacemakerpatients are paced only from the ventricle with some pacing parameter programmability. This paper goal is to design a cardiac pacemaker with various NBG modes. A state machine approach has been followed to achieve the desired purpose. The pacemaker system is divide into three main sections i.e. controlling unit, sensing unit and pulse generator. In this paper we mainly concentrate on controlling unit and pulse generator. It has been developed using VHDL coding and implemented in hardware using FPGA. In a simple pacemaker process i.e. single chamber or dual chamber pacemaker, first an input signal or an event is detected in heart through leads. When the input signal is detected a timer generates a delay for approximately 0.8 sec. It is the time between two consecutive heartbeats, thus giving us 72 heartbeats per minute. Once the generated delay expires, sensing unit again start detecting a new event. If any event is detected we repeat the process of detection and waiting. If no event is detected we need to provide an electrical pulse to the heart and then repeat the whole process of detection and waiting. The code has been optimized and modified for different pacemaker modes.

  18. Atrioventricular Left Ventricular Apical Pacing Improves Haemodynamic, Rotational, and Deformation Variables in Comparison to Pacing at the Lateral Wall in Intact Myocardium: Experimental Study

    Directory of Open Access Journals (Sweden)

    Savvas Toumanidis

    2014-01-01

    Full Text Available Aim. To assess the effect on left ventricular (LV function of atrioventricular (AV and ventricular pacing at the LV apical or lateral wall and to compare the normal torsional and deformation pattern of the intact LV myocardium with those created by the aforementioned LV pacing modes and sites. Methods. Experiments were conducted in pigs (n=21 with normal LV function to investigate the acute hemodynamic effects of epicardial AV and ventricular LV pacing at the LV apical or lateral wall. Torsional and deformation indices of LV function were assessed using speckle tracking echocardiography. Results. AV pacing at the apex revealed a significant reduction in the radial strain of the base (P<0.03, without affecting significantly the ejection fraction and the LV torsion or twist. In contrast, AV pacing at the lateral wall produced, in addition to the reduction of the radial strain of the base (P<0.01, significant reduction of the circumferential and the radial strain of the apex (both P<0.01 as well as of the ejection fraction (P<0.002 and twist (P<0.05. Conclusions. In pig hearts with intact myocardium, LV function is maintained at sinus rhythm level when AV pacing is performed at the LV apex.

  19. Prevalence of sleep-disordered breathing in elderly patients with cardiac pacemaker: a case-control study

    Institute of Scientific and Technical Information of China (English)

    Haiyun WU; Shiwen WANG; Jianping JIA; Wenli ZHANG; Qiang XU

    2005-01-01

    Objective To investigate the prevalence of sleep-disordered breathing in elderly patients with permanent cardiac pacemaker implantation due to bradyarrhythmias, and the relationship between pacing mode and patients' sleep apnea-hypopnea index.Methods Forty-four elderly patients (>60 years) with cardiac pacemaker and their 44 controls matched for gender, age, body mass index and cardiovascular morbidity were studied using polysomnography or portable sleep monitoring device. Results Prevalence of sleep-disordered breathing (apnea-hypopnea index ≥5/h) was 44.7% and the mean apnea-hypopnea index was 8.2 ±4.1/h in the cardiac pacemaker group, which were significantly higher than those in control subjects (25% and 4.6±2.4/h, respectively, P<0.01 and P<0.05). The mean apnea-hypopnea index of patients with DDD or AAI pacemaker was significantly lower than that of patients with VVI pacemaker. Conclusions Sleep-disordered breathing was more common in patients who had their cardiac pacemaker implanted due to bradyarrhythmias than in their matched controls. Compared with VVI pacing, DDD or AAI pacing may be more beneficial to patients with bradyarrhythmias and sleep-disordered breathing.

  20. Perioperative Care of the Patient With the Total Artificial Heart.

    Science.gov (United States)

    Yaung, Jill; Arabia, Francisco A; Nurok, Michael

    2017-01-19

    Advanced heart failure continues to be a leading cause of morbidity and mortality despite improvements in pharmacologic therapy. High demand for cardiac transplantation and shortage of donor organs have led to an increase in the utilization of mechanical circulatory support devices. The total artificial heart is an effective biventricular assist device that may be used as a bridge to transplant and that is being studied for destination therapy. This review discusses the history, indications, and perioperative management of the total artificial heart with emphasis on the postoperative concerns.

  1. Meta-analysis of randomized controlled trials comparing isolated left ventricular and biventricular pacing in patients with chronic heart failure.

    Science.gov (United States)

    Liang, Yixiu; Pan, Wenzhi; Su, Yangang; Ge, Junbo

    2011-10-15

    Cardiac resynchronization therapy (CRT) has been mostly achieved by biventricular pacing (BVP) in patients with chronic heart failure (CHF), although it can also be provided by left ventricular pacing (LVP). The superiority of BVP over LVP remains uncertain. The present meta-analysis of randomized controlled trials was performed to compare the effects of LVP to BVP in patients with CHF. Outcomes analyzed included clinical status (6-minute walk distance, peak oxygen consumption, quality of life, New York Heart Association class), LV function (LV ejection fraction), and LV remodeling (LV end-systolic volume). Five trials fulfilled criteria for inclusion in analysis, which included 574 patients with CHF indicated for CRT. After a midterm follow-up, pooled analysis demonstrated that LVP resulted in similar improvements in 6-minute walk distance (weighted mean difference [WMD] 11.25, 95% confidence interval [CI] -12.39 to 34.90, p = 0.35), quality of life (WMD 0.34, 95% CI -3.72 to 4.39, p = 0.87), peak oxygen consumption (WMD 1.00, 95% CI -0.84 to 2.85, p = 0.29), and New York Heart Association class (WMD -0.19, 95% CI -0.79 to 0.42, p = 0.54). There was a trend toward a superiority of BVP over LVP for LV ejection fraction (WMD 1.28, 95% CI -0.11 to 2.68, p = 0.07) and LV end-systolic volume (WMD -5.73, 95% CI -11.86 to 0.39, p = 0.07). In conclusion, LVP achieves similar improvement in clinical status as BVP in patients with CHF, whereas there was a trend toward superiority of BVP over LVP for LV reverse modeling and systolic function.

  2. Onion artificial muscles

    Science.gov (United States)

    Chen, Chien-Chun; Shih, Wen-Pin; Chang, Pei-Zen; Lai, Hsi-Mei; Chang, Shing-Yun; Huang, Pin-Chun; Jeng, Huai-An

    2015-05-01

    Artificial muscles are soft actuators with the capability of either bending or contraction/elongation subjected to external stimulation. However, there are currently no artificial muscles that can accomplish these actions simultaneously. We found that the single layered, latticed microstructure of onion epidermal cells after acid treatment became elastic and could simultaneously stretch and bend when an electric field was applied. By modulating the magnitude of the voltage, the artificial muscle made of onion epidermal cells would deflect in opposing directions while either contracting or elongating. At voltages of 0-50 V, the artificial muscle elongated and had a maximum deflection of -30 μm; at voltages of 50-1000 V, the artificial muscle contracted and deflected 1.0 mm. The maximum force response is 20 μN at 1000 V.

  3. Effect of right ventricular pacing on ventricular rhythm during atrial fibrillation

    NARCIS (Netherlands)

    Wittkampf, F.H.M.; Jongste, M.J.L. de; Lie, H.I.; Meijler, F.L.

    1988-01-01

    In 13 patients with atrial fibrillation, the effect of right ventricular pacing at various rates on spontaneous RR intervals was studied. Five hundred consecutive RR intervals were recorded and measured before and during varying right ventricular pacing rates. As anticipated, all RR intervals longer

  4. The effect of work pace on workload, motor variability and fatigue during simulated light assembly work.

    Science.gov (United States)

    Bosch, T; Mathiassen, S E; Visser, B; de Looze, M P; van Dieën, J H

    2011-02-01

    This study investigated the effect of work pace on workload, motor variability and fatigue during light assembly work. Upper extremity kinematics and electromyography (EMG) were obtained on a cycle-to-cycle basis for eight participants during two conditions, corresponding to "normal" and "high" work pace according to a predetermined time system for engineering. Indicators of fatigue, pain sensitivity and performance were recorded before, during and after the task. The level and variability of muscle activity did not differ according to work pace, and manifestations of muscle fatigue or changed pain sensitivity were not observed. In the high work pace, however, participants moved more efficiently, they showed more variability in wrist speed and acceleration, but they also made more errors. These results suggest that an increased work pace, within the range addressed here, will not have any substantial adverse effects on acute motor performance and fatigue in light, cyclic assembly work. STATEMENT OF RELEVANCE: In the manufacturing industry, work pace is a key issue in production system design and hence of interest to ergonomists as well as engineers. In this laboratory study, increasing the work pace did not show adverse effects in terms of biomechanical exposures and muscle fatigue, but it did lead to more errors. For the industrial engineer, this observation suggests that an increase in work pace might diminish production quality, even without any noticeable fatigue being experienced by the operators.

  5. Beyond a Unitary Conception of Pedagogic Pace: Quantitative Measurement and Ethnographic Experience

    Science.gov (United States)

    Lefstein, Adam; Snell, Julia

    2013-01-01

    English education policy-makers have targeted classroom time as a key area for regulation and intervention, with "brisk pace" widely accepted as a feature of good teaching practice. We problematise this conventional wisdom through an exploration of objective and subjective dimensions of lesson pace in a corpus of 30 Key Stage 2 literacy…

  6. Right ventricular outflow and apical pacing comparably worsen the echocardioghraphic normal left ventricle

    NARCIS (Netherlands)

    T.J.F. ten Cate (Tim); M.G. Scheffer (Michael); G.R. Sutherland (George); J.F. Verzijlbergen (Fred); N.M. van Hemel (Norbert)

    2008-01-01

    textabstractAims: A depressed left ventricular function (LVF) is sometimes observed during right ventricular apical (RVA) pacing, but any prediction of this adverse effect cannot be done. Right ventricular outflow tract (RVOT) pacing is thought to deteriorate LVF less frequently because of a more no

  7. Effects of permanent dual chamber pacing on myocardial perfusion in symptomatic hypertrophic cardiomyopathy

    NARCIS (Netherlands)

    Posma, JL; Blanksma, PK; VanderWall, EE; Vaalburg, W; Crijns, HJGM; Lie, KI

    1996-01-01

    Objective-Angina and the presence of myocardial ischaemia are common in hypertrophic cardiomyopathy. Dual chamber pacing results in clinical improvement in these patients. This study evaluates the effects of permanent dual chamber pacing on absolute regional myocardial perfusion and perfusion reserv

  8. Self-Paced Economics Instruction: A Large-Scale Disaggregated Evaluation

    Science.gov (United States)

    Soper, John C.; Thorton, Richard M.

    1976-01-01

    This paper reports on an evaluation of the Sterling Institute self-paced macroeconomics course at Northern Illinois University. Results show that a completely self-paced teaching format for macroeconomics is inferior to a well-directed, concept-oriented, graduate-student instructed, lecture-discussion taught course. (Author/RM)

  9. Cardiac tumors: echo assessment.

    Science.gov (United States)

    Mankad, Rekha; Herrmann, Joerg

    2016-12-01

    Cardiac tumors are exceedingly rare (0.001-0.03% in most autopsy series). They can be present anywhere within the heart and can be attached to any surface or be embedded in the myocardium or pericardial space. Signs and symptoms are nonspecific and highly variable related to the localization, size and composition of the cardiac mass. Echocardiography, typically performed for another indication, may be the first imaging modality alerting the clinician to the presence of a cardiac mass. Although echocardiography cannot give the histopathology, certain imaging features and adjunctive tools such as contrast imaging may aid in the differential diagnosis as do the adjunctive clinical data and the following principles: (1) thrombus or vegetations are the most likely etiology, (2) cardiac tumors are mostly secondary and (3) primary cardiac tumors are mostly benign. Although the finding of a cardiac mass on echocardiography may generate confusion, a stepwise approach may serve well practically. Herein, we will review such an approach and the role of echocardiography in the assessment of cardiac masses.

  10. Research on Electrical Remodeling After Short Term Pacing in Canine Model

    Institute of Scientific and Technical Information of China (English)

    Kebbati A Hafid; Huang Congxin; Wang Xi; Zhao Qingyan

    2007-01-01

    Objectives To evaluate the changes in atrial effective refractory period (AERP) proprieties and in ionic currents in PVs myocytes from dogs subjected to rapid atrial pacing in PVs and right atrial appendage (RAA) and to relate these changes to the ability to induce AF. Methods Twelve mongrel dogs in normal sinus rhythm were paced from the superior left PVs or RAA at 500 bpm for 4 hours. Electrophysiologic studies conducted to determine changes in AERP, dispersion and rhythm. Ionic currents were studies with the patch clamp technique in single PVs myocytes in sham operated dogs and compared with those from PVs pacing and RAA pacing groups. Results The presence of rapid atrial pacing was associated with a marked shortening in AERP in both PVs and RAA pacing group with a marked increase of AERP dispersion in PVs pacing. Both L-type calcium current (ICa, L) and the transient outward current (Ito)were reduced in both groups with an increased significance in PVs pacing group. The density of ICa-L WaS decreased significantly from ( - 6.03 ± 0.63 ) pA/pF in the control group to ( -3.21±0.34) pA/pF in PVs pacing group and ( - 4,75 ± 0.41 ) pA/pF in RAA pacing group (n = 6, P<0.05) while the density of Ito was decreased significantly from (8.45±0.71 ) pA/pF in the control group to (5.21 ±0.763 ) pA/pF in PVs pacing group and (6,84 ± 0.69) pA/pF in RAA pacing group (n = 6, P<0.05). Conclusions Our findings provide likely ionic mechanisms of shortened repolarization in induced atrial tachycardia with a decrease in Ica,L and Ito current densities which is the likely mechanism for a decrease in Action potential duration (APD) rate adaptation in the canine rapid pacing model more pronounced in PVs pacing group underlying the crucial role of PVs in initiating AF.

  11. Nuclear cardiac imaging for the diagnosis and management of heart failure: what can be learned from recent guidelines?

    Science.gov (United States)

    Vervloet, Delphine M; DE Sutter, Johan

    2016-01-20

    The aim of this review is to provide the clinical cardiologist and nuclear medicine specialist a brief overview of the currently accepted clinical use of cardiac nuclear imaging for the diagnosis and management of patients with heart failure based on recent (2012-2015) European Society of Cardiology (ESC) guidelines. We used the most recent ESC guidelines on heart failure, management of stable coronary artery disease, cardiac pacing, myocardial revascularisation, non-cardiac surgery and ventricular arrhythmias and sudden death. Nowadays cardiac nuclear imaging is useful in almost every step in heart failure from diagnostics to treatment. In first diagnosis of heart failure radionuclide imaging can provide information on ventricular function and volumes and nuclear imaging techniques provide accurate and reproducible left ventricular function assessment. In work out of the aetiology of the heart failure CMR, SPECT and PET imaging can demonstrate presence of inducible ischemia and myocardial viability. For prognostic information MIBG might be promising in the future. In treatment planning cardiac nuclear imaging is important to evaluate new angina and to assess accurate left ventricular ejection fraction before cardiac resynchronization therapy. Imaging stress testing is useful in the preoperative evaluation for non-cardiac surgery of heart failure patients. There is until now no recommended place for cardiac nuclear imaging in the follow-up of heart failure patients or prior to the initiation of cardiac rehabilitation.

  12. Artificial intelligence in medicine.

    Science.gov (United States)

    Ramesh, A. N.; Kambhampati, C.; Monson, J. R. T.; Drew, P. J.

    2004-01-01

    INTRODUCTION: Artificial intelligence is a branch of computer science capable of analysing complex medical data. Their potential to exploit meaningful relationship with in a data set can be used in the diagnosis, treatment and predicting outcome in many clinical scenarios. METHODS: Medline and internet searches were carried out using the keywords 'artificial intelligence' and 'neural networks (computer)'. Further references were obtained by cross-referencing from key articles. An overview of different artificial intelligent techniques is presented in this paper along with the review of important clinical applications. RESULTS: The proficiency of artificial intelligent techniques has been explored in almost every field of medicine. Artificial neural network was the most commonly used analytical tool whilst other artificial intelligent techniques such as fuzzy expert systems, evolutionary computation and hybrid intelligent systems have all been used in different clinical settings. DISCUSSION: Artificial intelligence techniques have the potential to be applied in almost every field of medicine. There is need for further clinical trials which are appropriately designed before these emergent techniques find application in the real clinical setting. PMID:15333167

  13. Molecular Basis of Cardiac Myxomas

    Directory of Open Access Journals (Sweden)

    Pooja Singhal

    2014-01-01

    Full Text Available Cardiac tumors are rare, and of these, primary cardiac tumors are even rarer. Metastatic cardiac tumors are about 100 times more common than the primary tumors. About 90% of primary cardiac tumors are benign, and of these the most common are cardiac myxomas. Approximately 12% of primary cardiac tumors are completely asymptomatic while others present with one or more signs and symptoms of the classical triad of hemodynamic changes due to intracardiac obstruction, embolism and nonspecific constitutional symptoms. Echocardiography is highly sensitive and specific in detecting cardiac tumors. Other helpful investigations are chest X-rays, magnetic resonance imaging and computerized tomography scan. Surgical excision is the treatment of choice for primary cardiac tumors and is usually associated with a good prognosis. This review article will focus on the general features of benign cardiac tumors with an emphasis on cardiac myxomas and their molecular basis.

  14. Cardiac Tumors; Tumeurs cardiaques

    Energy Technology Data Exchange (ETDEWEB)

    Laissy, J.P.; Fernandez, P. [Centre Hospitalier Universitaire Bichat Claude Bernard, Service d' Imagerie, 76 - Rouen (France); Mousseaux, E. [Hopital Europeen Georges Pompidou (HEGP), Service de Radiologie Cardio Vasculaire et Interventionnelle, 75 - Paris (France); Dacher, J.N. [Centre Hospitalier Universitaire Charles Nicolle, 75 - Rouen (France); Crochet, D. [Centre Hospitalier Universitaire, Hopital Laennec, Centre Hemodynamique, Radiologie Thoracique et Vasculaire, 44 - Nantes (France)

    2004-04-01

    Metastases are the most frequent tumors of the heart even though they seldom are recognized. Most primary cardiac tumors are benign. The main role of imaging is to differentiate a cardiac tumor from thrombus and rare pseudo-tumors: tuberculoma, hydatid cyst. Echocardiography is the fist line imaging technique to detect cardiac tumors, but CT and MRl arc useful for further characterization and differential diagnosis. Myxoma of the left atrium is the most frequent benign cardiac tumor. It usually is pedunculated and sometimes calcified. Sarcoma is the most frequent primary malignant tumor and usually presents as a sessile infiltrative tumor. Lymphoma and metastases are usually recognized by the presence of known tumor elsewhere of by characteristic direct contiguous involvement. Diagnosing primary and secondary pericardial tumors often is difficult. Imaging is valuable for diagnosis, characterization, pre-surgical evaluation and follow-up. (author)

  15. Socially differentiated cardiac rehabilitation

    DEFF Research Database (Denmark)

    Meillier, Lucette Kirsten; Nielsen, Kirsten Melgaard; Larsen, Finn Breinholt;

    2012-01-01

    to a standard rehabilitation programme (SRP). If patients were identified as socially vulnerable, they were offered an extended version of the rehabilitation programme (ERP). Excluded patients were offered home visits by a cardiac nurse. Concordance principles were used in the individualised programme elements......%. Patients were equally distributed to the SRP and the ERP. No inequality was found in attendance and adherence among referred patients. Conclusions: It seems possible to overcome unequal referral, attendance, and adherence in cardiac rehabilitation by organisation of systematic screening and social......Aim: The comprehensive cardiac rehabilitation (CR) programme after myocardial infarction (MI) improves quality of life and results in reduced cardiac mortality and recurrence of MI. Hospitals worldwide face problems with low participation rates in rehabilitation programmes. Inequality...

  16. Cardiac arrest - cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    Basri Lenjani; Besnik Elshani; Nehat Baftiu; Kelmend Pallaska; Kadir Hyseni; Njazi Gashi; Nexhbedin Karemani; Ilaz Bunjaku; Taxhidin Zaimi; Arianit Jakupi

    2014-01-01

    Objective:To investigate application of cardiopulmonary resuscitation(CPR) measures within the golden minutes inEurope.Methods:The material was taken from theUniversityClinical Center ofKosovo -EmergencyCentre inPristina, during the two(2) year period(2010-2011).The collected date belong to the patients with cardiac arrest have been recorded in the patients' log book protocol at the emergency clinic.Results:During the2010 to2011 in the emergency center of theCUCK inPristina have been treated a total of269 patients with cardiac arrest, of whom159 or59.1% have been treated in2010, and110 patients or40.9% in2011.Of the269 patients treated in the emergency centre,93 or34.6% have exited lethally in the emergency centre, and176 or 65.4% have been transferred to other clinics.In the total number of patients with cardiac arrest, males have dominated with186 cases, or69.1%.The average age of patients included in the survey was56.7 year oldSD±16.0 years.Of the269 patients with cardiac arrest, defibrillation has been applied for93 or34.6% of patients.In the outpatient settings defibrillation has been applied for3 or3.2% of patients.Patients were defibrillated with application of one to four shocks. Of27 cases with who have survived cardiac arrest, none of them have suffered cardiac arrest at home,3 or11.1% of them have suffered cardiac arrest on the street, and24 or88.9% of them have suffered cardiac arrest in the hospital.5 out of27 patients survived have ended with neurological impairment.Cardiac arrest cases were present during all days of the week, but frequently most reported cases have been onMonday with32.0% of cases, and onFriday with24.5% of cases. Conclusions:All survivors from cardiac arrest have received appropriate medical assistance within10 min from attack, which implies that if cardiac arrest occurs near an institution health care(with an opportunity to provide the emergent health care) the rate of survival is higher.

  17. Cardiac imaging in adults

    Energy Technology Data Exchange (ETDEWEB)

    Jaffe, C.C.

    1987-01-01

    This book approaches adult cardiac disease from the correlative imaging perspective. It includes chest X-rays and angiographs, 2-dimensional echocardiograms with explanatory diagrams for clarity, plus details on digital radiology, nuclear medicine techniques, CT and MRI. It also covers the normal heart, valvular heart disease, myocardial disease, pericardial disease, bacterial endocarditis, aortic aneurysm, cardiac tumors, and congenital heart disease of the adult. It points out those aspects where one imaging technique has significant superiority.

  18. Port Access Cardiac Surgery.

    Science.gov (United States)

    Viganó, Mario; Minzioni, Gaetano; Spreafico, Patrizio; Rinaldi, Mauro; Pasquino, Stefano; Ceriana, Piero; Locatelli, Alessandro

    2000-10-01

    The port-access technique for cardiac surgery was recently developed at Stanford University in California as a less invasive method to perform some cardiac operations. The port-access system has been described in detail elsewhere. It is based on femoral arterial and venous access for cardiopulmonary bypass (CPB) and on the adoption of a specially designed triple-lumen catheter described originally by Peters, and subsequently modified and developed in the definitive configuration called the endoaortic clamp.

  19. Awareness in cardiac anesthesia.

    LENUS (Irish Health Repository)

    Serfontein, Leon

    2010-02-01

    Cardiac surgery represents a sub-group of patients at significantly increased risk of intraoperative awareness. Relatively few recent publications have targeted the topic of awareness in this group. The aim of this review is to identify areas of awareness research that may equally be extrapolated to cardiac anesthesia in the attempt to increase understanding of the nature and significance of this scenario and how to reduce it.

  20. Post cardiac injury syndrome

    DEFF Research Database (Denmark)

    Nielsen, S L; Nielsen, F E

    1991-01-01

    The post-pericardiotomy syndrome is a symptom complex which is similar in many respects to the post-myocardial infarction syndrome and these are summarized under the diagnosis of the Post Cardiac Injury Syndrome (PCIS). This condition, which is observed most frequently after open heart surgery, i...... on the coronary vessels, with cardiac tamponade and chronic pericardial exudate. In the lighter cases, PCIS may be treated with NSAID and, in the more severe cases, with systemic glucocorticoid which has a prompt effect....

  1. Autonomic cardiac innervation

    OpenAIRE

    Hasan, Wohaib

    2013-01-01

    Autonomic cardiac neurons have a common origin in the neural crest but undergo distinct developmental differentiation as they mature toward their adult phenotype. Progenitor cells respond to repulsive cues during migration, followed by differentiation cues from paracrine sources that promote neurochemistry and differentiation. When autonomic axons start to innervate cardiac tissue, neurotrophic factors from vascular tissue are essential for maintenance of neurons before they reach their targe...

  2. Infected cardiac hydatid cyst

    OpenAIRE

    Ceviz, M; Becit, N; Kocak, H.

    2001-01-01

    A 24 year old woman presented with chest pain and palpitation. The presence of a semisolid mass—an echinococcal cyst or tumour—in the left ventricular apex was diagnosed by echocardiography, computed tomography, and magnetic resonance imaging. The infected cyst was seen at surgery. The cyst was removed successfully by using cardiopulmonary bypass with cross clamp.


Keywords: cardiac hydatid cyst; infected cardiac hydatid cyst

  3. Permanent His-bundle pacing clinical application%永久希氏束起搏临床应用

    Institute of Scientific and Technical Information of China (English)

    吴高俊; 苏蓝; 方丹红; 黄伟剑

    2012-01-01

    Objective To explore the safety and feasibility of permanent His-bundle pacing (HBP).Methods Seventeen patients[ ( 11 male,mean age(67.8±9.6)years)with a standard pacemaker(PM) indication or systolic heart failure who have frequent dependence on right ventricular pacing were enrolled between February,2011 and November,2011.A system consisting of a steerable catheter and a4.1 F screw-in lead were used for permanent HBP.Results After initial failure of HBP in the first 7 cases,HBP was successful in 9 patients.The total success rate was 52.9% (9/17),but the success rate increased to 90% in the later practice.In permanent HBP pacing,the acute pacing threshold was( 1.2±0.7 )V at pulse duration of O.4msec,and the sensed potentials were (3.5± 1.4) mV.The pacing threshold was ( 1.7 ± 1.3 ) V,and sensed potentials were (3.4±3.3) mV during 5 ~ 14 months follow-up,which were not significantly different compared with the measurements at implantation( P>0.05 ).The QRS width was( 104.4±23.5 ) ms at implantation and( 108.9±23.7 ) ms at the follow-up,which were similar to the native QRS width( 107.8±27.7)ms.Among them,QRS width was reduced from 150 ms and 200 ms to 120、160 ms in two patients with systolic heart failure( one patient had depended on right ventricular pacing for half a year).In the two patients,cardiac function was improved (from NYHA Class Ⅲ to Class Ⅰ and Ⅱ ) after HBP.No major complications were observed.Conclusion Permanent HBP is feasible and safe,may be a better choice for the patients with systolic heart failure who require permanent PM with anticipated frequent ventricular pacing or who have frequent dependence on right ventricular pacing.%目的 探讨永久希氏束起搏(HBP)的安全性和可行性.方法 对17例有常规心脏起搏适应证或长期依赖右心室起搏伴收缩性心力衰竭的患者,采用4.1F螺旋导线进行永久HBP,门诊随访3~l2个月.结果 成功HBP 9例(52.9%),急性期和慢性期

  4. Artificial Neural Networks

    OpenAIRE

    Chung-Ming Kuan

    2006-01-01

    Artificial neural networks (ANNs) constitute a class of flexible nonlinear models designed to mimic biological neural systems. In this entry, we introduce ANN using familiar econometric terminology and provide an overview of ANN modeling approach and its implementation methods.

  5. Introduction to artificial intelligence

    Science.gov (United States)

    Cheeseman, P.; Gevarter, W.

    1986-01-01

    This paper presents an introductory view of Artificial Intelligence (AI). In addition to defining AI, it discusses the foundations on which it rests, research in the field, and current and potential applications.

  6. High-resolution entrainment mapping of gastric pacing: a new analytical tool.

    Science.gov (United States)

    O'Grady, Gregory; Du, Peng; Lammers, Wim J E P; Egbuji, John U; Mithraratne, Pulasthi; Chen, Jiande D Z; Cheng, Leo K; Windsor, John A; Pullan, Andrew J

    2010-02-01

    Gastric pacing has been investigated as a potential treatment for gastroparesis. New pacing protocols are required to improve symptom and motility outcomes; however, research progress has been constrained by a limited understanding of the effects of electrical stimulation on slow-wave activity. This study introduces high-resolution (HR) "entrainment mapping" for the analysis of gastric pacing and presents four demonstrations. Gastric pacing was initiated in a porcine model (typical amplitude 4 mA, pulse width 400 ms, period 17 s). Entrainment mapping was performed using flexible multielectrode arrays (entrainment onset was quantified over successive waves in spatiotemporal detail. In the second demonstration, slow-wave velocity was accurately determined with HR field analysis, and paced propagation was found to be anisotropic (longitudinal 2.6 +/- 1.7 vs. circumferential 4.5 +/- 0.6 mm/s; P Entrainment mapping enables an accurate quantification of the effects of gastric pacing on slow-wave activity, offering an improved method to assess whether pacing protocols are likely to achieve physiologically and clinically useful outcomes.

  7. Differences in atrial septal activation with an intrasinoatrial nodal pacemaker and epicardial sinoatrial nodal pacing.

    Science.gov (United States)

    Goldberg, J M

    1979-01-01

    Changes in Intra-SA nodal pacemaker localization were produced through stimulation of the decentralized cervical vagi and stellate ganglia in the anesthetized dog. Shifts in pacemaker to the rostral, middle, or caudal regions of the SA node produced a change in the timing as well as a change in the sequence of activation of recording sites overlying the AV node. Epicardial pacing with a plaque electrode from either the rostral, middle, or caudal regions of the SA node produced the same activation sequence of the AV nodal electrodes irrespective of the epicardial SA nodal pacing site. The inability of epicardial SA nodal pacing to precisely reproduce the activation pattern of the atrial septum overlying the AV node observed with a natural SA nodal pacemaker can be explained by the geographic relationship of the pacemaker cells within the node to the preferential internodal pathways and the area of atrial tissue stimulated by pacing. Pacing activates a large mass of tissue, whereas an intrinsic pacemaker probably acts as a more localized focus. The inability of pacing to reproduce the activation pattern seen with spontaneous rhythm may be a determinant in the varied P wave morphology seen with coronary sinus or AV nodal junctional rhythms, as compared with more consistent morphology seen with pacing.

  8. Pulmonary artery rupture in a patient receiving an orthotopic heart transplant after total artificial heart explant.

    Science.gov (United States)

    Nomoto, Koichi; Weiner, Menachem M; Evans, Adam

    2014-02-01

    Our case illustrates a patient who suffered a pulmonary artery rupture despite previous total artificial heart implantation and replacement with orthotopic heart transplant. Pulmonary artery rupture during or following cardiac surgery has been reported to occur due to both pulmonary artery catheter use and surgical technique. Our case is the first to demonstrate the occurrence of this complication in the total artificial heart patient population.

  9. Global artificial photosynthesis project: a scientific and legal introduction.

    Science.gov (United States)

    Faunce, Thomas

    2011-12-01

    With the global human population set to exceed 10 billion by 2050, its collective energy consumption to rise from 400 to over 500 EJ/yr and with the natural environment under increasing pressure from these sources as well as from anthropogenic climate change, political solutions such as the creation of an efficient carbon price and trading scheme may arrive too late. In this context, the scientific community is exploring technological remedies. Central to these options is artificial photosynthesis--the creation, particularly through nanotechnology, of devices capable to doing what plants have done for millions of years - transforming sunlight, water and carbon dioxide into food and fuel. This article argues that a Global Artificial Photosynthesis (GAP) project can raise the public profile and encourage the pace, complexity and funding of scientific collaborations in artificial photosynthesis research. The legal structure of a GAP project will be critical to prevent issues such as state sovereignty over energy and food resources and corporate intellectual monopoly privileges unduly inhibiting the important contribution of artificial photosynthesis to global public health and environmental sustainability. The article presents an introduction to the scientific and legal concepts behind a GAP project.

  10. Principles of artificial intelligence

    CERN Document Server

    Nilsson, Nils J

    1980-01-01

    A classic introduction to artificial intelligence intended to bridge the gap between theory and practice, Principles of Artificial Intelligence describes fundamental AI ideas that underlie applications such as natural language processing, automatic programming, robotics, machine vision, automatic theorem proving, and intelligent data retrieval. Rather than focusing on the subject matter of the applications, the book is organized around general computational concepts involving the kinds of data structures used, the types of operations performed on the data structures, and the properties of th

  11. Physics of Artificial Gravity

    Science.gov (United States)

    Bukley, Angie; Paloski, William; Clement, Gilles

    2006-01-01

    This chapter discusses potential technologies for achieving artificial gravity in a space vehicle. We begin with a series of definitions and a general description of the rotational dynamics behind the forces ultimately exerted on the human body during centrifugation, such as gravity level, gravity gradient, and Coriolis force. Human factors considerations and comfort limits associated with a rotating environment are then discussed. Finally, engineering options for designing space vehicles with artificial gravity are presented.

  12. Facility Composer (Trademark) and PACES (Trademark) Integration: Development of an XML Interface Based on Industry Foundation Classes

    Science.gov (United States)

    2007-11-01

    Density Parameters. ...............................111 Figure C5. PACES Facilities Values editing screen, Shell Quantity Parameters...112 Figure C6. PACES Facilities Values editing screen, Shell Descriptive Parameters...........................113 Figure C7. PACES import... COCOA B1 12008 FL COCOA B2 12009 FL COCOA OC 12010 FL FT PIERCE 12011 FL JONATHAN 12012 FL MALABAR 12013 FL MELBOURN 12014 FL STUART 12015 FL

  13. Heidegger and artificial intelligence

    Energy Technology Data Exchange (ETDEWEB)

    Diaz, G.

    1987-01-01

    The discipline of Artificial Intelligence, in its quest for machine intelligence, showed great promise as long as its areas of application were limited to problems of a scientific and situation neutral nature. The attempts to move beyond these problems to a full simulation of man's intelligence has faltered and slowed it progress, largely because of the inability of Artificial Intelligence to deal with human characteristic, such as feelings, goals, and desires. This dissertation takes the position that an impasse has resulted because Artificial Intelligence has never been properly defined as a science: its objects and methods have never been identified. The following study undertakes to provide such a definition, i.e., the required ground for Artificial Intelligence. The procedure and methods employed in this study are based on Heidegger's philosophy and techniques of analysis as developed in Being and Time. Results of this study show that both the discipline of Artificial Intelligence and the concerns of Heidegger in Being and Time have the same object; fundamental ontology. The application of Heidegger's conclusions concerning fundamental ontology unites the various aspects of Artificial Intelligence and provides the articulation which shows the parts of this discipline and how they are related.

  14. [Psychosomatic aspects of cardiac arrhythmias].

    Science.gov (United States)

    Siepmann, Martin; Kirch, Wilhelm

    2010-07-01

    Emotional stress facilitates the occurrence of cardiac arrhythmias including sudden cardiac death. The prevalence of anxiety and depression is increased in cardiac patients as compared to the normal population. The risk of cardiovascular mortality is enhanced in patients suffering from depression. Comorbid anxiety disorders worsen the course of cardiac arrhythmias. Disturbance of neurocardiac regulation with predominance of the sympathetic tone is hypothesized to be causative for this. The emotional reaction to cardiac arrhythmias is differing to a large extent between individuals. Emotional stress may result from coping with treatment of cardiac arrhythmias. Emotional stress and cardiac arrhythmias may influence each other in the sense of a vicious circle. Somatoform cardiac arrhythmias are predominantly of psychogenic origin. Instrumental measures and frequent contacts between physicians and patients may facilitate disease chronification. The present review is dealing with the multifaceted relationships between cardiac arrhythmias and emotional stress. The underlying mechanisms and corresponding treatment modalities are discussed.

  15. Anesthesia for robotic cardiac surgery: An amalgam of technology and skill

    Directory of Open Access Journals (Sweden)

    Chauhan Sandeep

    2010-01-01

    Full Text Available The surgical procedures performed with robtic assitance and the scope for its future assistance is endless. To keep pace with the developing technologies in this field it is imperative for the cardiac anesthesiologists to have aworking knowledge of these systems, recognize potential complications and formulate an anesthetic plan to provide safe patient care. Challenges posed by the use of robotic systems include, long surgical times, problems with one lung anesthesia in presence of coronary artery disease, minimally invasive percutaneous cardiopulmonary bypass management and expertise in Trans-Esophageal Echocardiography. A long list of cardiac surgeries are performed with the use of robotic assistance, and the list is continuously growing as surgical innovation crosses new boundaries. Current research in robotic cardiac surgery like beating heart off pump intracardic repair, prototype epicardial crawling device, robotic fetal techniques etc. are in the stage of animal experimentation, but holds a lot of promise in future

  16. Obliquity-paced Pliocene West Antarctic ice sheet oscillations

    Science.gov (United States)

    Naish, T.; Powell, R.; Levy, R.; Wilson, G.; Scherer, R.; Talarico, F.; Krissek, L.; Niessen, F.; Pompilio, M.; Wilson, T.; Carter, L.; DeConto, R.; Huybers, P.; McKay, R.; Pollard, D.; Ross, J.; Winter, D.; Barrett, P.; Browne, G.; Cody, R.; Cowan, E.; Crampton, J.; Dunbar, G.; Dunbar, N.; Florindo, F.; Gebhardt, C.; Graham, I.; Hannah, M.; Hansaraj, D.; Harwood, D.; Helling, D.; Henrys, S.; Hinnov, L.; Kuhn, G.; Kyle, P.; Laufer, A.; Maffioli, P.; Magens, D.; Mandernack, K.; McIntosh, W.; Millan, C.; Morin, R.; Ohneiser, C.; Paulsen, T.; Persico, D.; Raine, I.; Reed, J.; Riesselman, C.; Sagnotti, L.; Schmitt, D.; Sjunneskog, C.; Strong, P.; Taviani, M.; Vogel, S.; Wilch, T.; Williams, T.

    2009-01-01

    Thirty years after oxygen isotope records from microfossils deposited in ocean sediments confirmed the hypothesis that variations in the Earth's orbital geometry control the ice ages, fundamental questions remain over the response of the Antarctic ice sheets to orbital cycles. Furthermore, an understanding of the behaviour of the marine-based West Antarctic ice sheet (WAIS) during the 'warmer-than-present' early-Pliocene epoch (???5-3 Myr ago) is needed to better constrain the possible range of ice-sheet behaviour in the context of future global warming. Here we present a marine glacial record from the upper 600 m of the AND-1B sediment core recovered from beneath the northwest part of the Ross ice shelf by the ANDRILL programme and demonstrate well-dated, ???40-kyr cyclic variations in ice-sheet extent linked to cycles in insolation influenced by changes in the Earth's axial tilt (obliquity) during the Pliocene. Our data provide direct evidence for orbitally induced oscillations in the WAIS, which periodically collapsed, resulting in a switch from grounded ice, or ice shelves, to open waters in the Ross embayment when planetary temperatures were up to ???3??C warmer than today and atmospheric CO 2 concentration was as high as ???400 p.p.m.v. (refs 5, 6). The evidence is consistent with a new ice-sheet/ice-shelf model that simulates fluctuations in Antarctic ice volume of up to +7 m in equivalent sea level associated with the loss of the WAIS and up to +3 m in equivalent sea level from the East Antarctic ice sheet, in response to ocean-induced melting paced by obliquity. During interglacial times, diatomaceous sediments indicate high surface-water productivity, minimal summer sea ice and air temperatures above freezing, suggesting an additional influence of surface melt under conditions of elevated CO2. ??2009 Macmillan Publishers Limited. All rights reserved.

  17. Pace: an advanced structure for handling multi-technique NDT; Pace: une structure avancee pour la gestion de donnees CND multitechniques

    Energy Technology Data Exchange (ETDEWEB)

    Mayos, M.; Guisnel, F.

    1995-08-01

    The growing extent and complexity of NDT data analysis has reached a stage where dedicated systems are required. In the context of a European research program, EDF participated from 1992 to 1994 in one of the first international projects in this field, TRAPPIST and, in 1993, began developing An application for the electricity generating industry, giving rise to the PACE project. The prime objective specially targets the French electricity generating industry, where PACE was to be the reference system for analysis of NDE data concerning EdF power plants. The second objective is to promote the adoption of PACE by other industrial sectors and other countries. The analysis of needs shows that the required system must be designed to analyze data from widely different sources. The PACE entry point consequently has to be a standard format compatible with geometrical data as well as those provided by NDT. The TRAPPIST format constitutes the first version of this standard and is the first step towards European standardization in this respect. Consideration of the different user modes defined for PACE led to the design of a 2-part user structure comprising a database management system (Ingres/Windows 4GL) and a display/processing tool (AVS), also usable to construct analysis scenarios. The structure of PACE is defined nd seems well suited to industrial requirements, but before it is possible to proceed further towards its adoption for actual power plant inspections, it has to be validated on a more realistic application, the eddy current and ultrasonic testing of a full-scale T-joint. This is already under way, whilst work on format standardization and industrialization preparatory procedures are proceeding in parallel. (authors). 4 refs., 6 figs.

  18. Utility of a Novel Biofeedback Device for Within-Breath Modulation of Heart Rate in Rats: A Quantitative Comparison of Vagus Nerve vs. Right Atrial Pacing.

    Science.gov (United States)

    O'Callaghan, Erin L; Chauhan, Ashok S; Zhao, Le; Lataro, Renata M; Salgado, Helio C; Nogaret, Alain; Paton, Julian F R

    2016-01-01

    In an emerging bioelectronics era, there is a clinical need for physiological devices incorporating biofeedback that permits natural and demand-dependent control in real time. Here, we describe a novel device termed a central pattern generator (CPG) that uses cutting edge analog circuitry producing temporally controlled, electrical stimulus outputs based on the real time integration of physiological feedback. Motivated by the fact that respiratory sinus arrhythmia (RSA), which is the cyclical changes in heart rate every breath, is an essential component of heart rate variability (HRV) (an indicator of cardiac health), we have explored the versatility and efficiency of the CPG for producing respiratory modulation of heart rate in anesthetized, spontaneously breathing rats. Diaphragmatic electromyographic activity was used as the input to the device and its output connected to either the right cervical vagus nerve or the right atrium for pacing heart rate. We found that the CPG could induce respiratory related heart rate modulation that closely mimicked RSA. Whether connected to the vagus nerve or right atrium, the versatility of the device was demonstrated by permitting: (i) heart rate modulation in any phase of the respiratory cycle, (ii) control of the magnitude of heart rate modulation, and (iii) instant adaptation to changes in respiratory frequency. Vagal nerve pacing was only possible following transection of the nerve limiting its effective use chronically. Pacing via the right atrium permitted better flexibility and control of heart rate above its intrinsic level. This investigation now lays the foundation for future studies using this biofeedback technology permitting closer analysis of both the function and dysfunction of RSA.

  19. Utility of a novel biofeedback device for within-breath modulation of heart rate in rats: a quantitative comparison of vagus nerve versus right atrial pacing.

    Directory of Open Access Journals (Sweden)

    Erin Louise O'Callaghan

    2016-02-01

    Full Text Available In an emerging bioelectronics era, there is a clinical need for physiological devices incorporating biofeedback that permits natural and demand-dependent control in real time. Here, we describe a novel device termed a central pattern generator (CPG that uses cutting edge analogue circuitry producing temporally controlled, electrical stimulus outputs based on the real time integration of physiological feedback. Motivated by the fact that respiratory sinus arrhythmia (RSA, which is the cyclical changes in heart rate every breath, is an essential component of heart rate variability (an indicator of cardiac health, we have explored the versatility and efficiency of the CPG for producing respiratory modulation of heart rate in anaesthetised, spontaneously breathing rats. Diaphragmatic electromyographic activity was used as the input to the device and its output connected to either the right cervical vagus nerve or the right atrium for pacing heart rate. We found that the CPG could induce respiratory related heart rate modulation that closely mimicked RSA. Whether connected to the vagus nerve or right atrium, the versatility of the device was demonstrated by permitting: (i heart rate modulation in any phase of the respiratory cycle, (ii control of the magnitude of heart rate modulation and (iii instant adaptation to changes in respiratory frequency. Vagal nerve pacing was only possible following transection of the nerve limiting its effective use chronically. Pacing via the right atrium permitted better flexibility and control of heart rate above its intrinsic level. This investigation now lays the foundation for future studies using this biofeedback technology permitting closer analysis of both the function and dysfunction of RSA.

  20. Cardiac radiology: centenary review.

    Science.gov (United States)

    de Roos, Albert; Higgins, Charles B

    2014-11-01

    During the past century, cardiac imaging technologies have revolutionized the diagnosis and treatment of acquired and congenital heart disease. Many important contributions to the field of cardiac imaging were initially reported in Radiology. The field developed from the early stages of cardiac imaging, including the use of coronary x-ray angiography and roentgen kymography, to nowadays the widely used echocardiographic, nuclear medicine, cardiac computed tomographic (CT), and magnetic resonance (MR) applications. It is surprising how many of these techniques were not recognized for their potential during their early inception. Some techniques were described in the literature but required many years to enter the clinical arena and presently continue to expand in terms of clinical application. The application of various CT and MR contrast agents for the diagnosis of myocardial ischemia is a case in point, as the utility of contrast agents continues to expand the noninvasive characterization of myocardium. The history of cardiac imaging has included a continuous process of advances in our understanding of the anatomy and physiology of the cardiovascular system, along with advances in imaging technology that continue to the present day.

  1. Transvenous right ventricular pacing in a patient with tricuspid mechanical prosthesis

    Directory of Open Access Journals (Sweden)

    Rubio José

    2008-07-01

    Full Text Available Abstract We report a patient in whom permanent endocardial pacing was accomplished by passage of the electrode through a mechanical tricuspid valve. Echocardiography study showed a minimal tricuspid regurgitation.

  2. Classifying running-related injuries based upon etiology, with emphasis on volume and pace

    DEFF Research Database (Denmark)

    Nielsen, Rasmus Oestergaard; Nohr, Ellen Aagaard; Rasmussen, Sten;

    2013-01-01

    of patellofemoral pain syndrome, iliotibial band syndrome, and patellar tendinopathy, while change in running pace may be associated with the development of achilles tendinopathy, gastrocnemius injuries, and plantar fasciitis. DISCUSSIONRELATION TO CLINICAL PRACTICE: If this assertion is correct, bias may...

  3. Photovoltaics (PV) as an Eligible Measure in Residential PACE Programs: Benefits and Challenges (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    Coughlin, J.

    2010-06-01

    Property Assessed Clean Energy (PACE) financing is one of several new financial models broadening access to clean energy by addressing the barrier of initial capital cost. The majority of the PACE programs in the market today include PV as an eligible measure. PV appeals to homeowners as a way to reduce utility bills, self-generate sustainable power, increase energy independence and demonstrate a commitment to the environment. If substantial state incentives for PV exist, PV projects can be economic under PACE, especially when partnered with good net metering policies. At the same time, PV is expensive relative to other eligible measures with a return on investment horizon that might exceed program targets. This fact sheet reviews the benefits and potential challenges of including PV in PACE programs.

  4. Self-Paced Mathematics Instruction: How Effective Has it Been in Secondary and Postsecondary Schools?

    Science.gov (United States)

    Schoen, Harold L.

    1976-01-01

    Seventeen studies of self-paced instruction in algebra, geometry, trigonometry, and college mathematics courses are reviewed. In general these studies did not find the individualized programs to be superior to theregular instruction with which they were compared. (SD)

  5. Conditioning of the diaphragm by phrenic nerve pacing in primary alveolar hypoventilation.

    OpenAIRE

    Wilcox, P G; Paré, P D; Fleetham, J A

    1988-01-01

    A patient with respiratory muscle weakness due to alveolar hypoventilation was treated with nocturnal bilateral phrenic nerve pacing for one year. Treatment was associated with a progressive increase in diaphragmatic strength and endurance.

  6. Effects of thallium on membrane currents at diastolic potentials in canine cardiac Purkinje strands.

    Science.gov (United States)

    Cohen, I S; Mulrine, N K

    1986-01-01

    A two-micro-electrode voltage-clamp technique was used to record membrane currents from canine cardiac Purkinje strands during hyperpolarizing steps to potentials between -70 and -150 mV in Tyrode solutions containing K+ and/or Tl+. Complete replacement of external K+ by equimolar Tl+ increases the instantaneous inwardly rectifying current. The inwardly rectifying region of the instantaneous I-V relation is shifted to more positive potentials and its slope is increased. The diastolic time-dependent current is reduced or reversed. Partial substitution of equimolar Tl+ for K+ reduces the diastolic time-dependent current. The instantaneous I-V relation is shifted inward for molar fractions of Tl+ (YTl) greater than 0.5, and is slightly more inward or unchanged for YTl less than or equal to 0.5. Addition of small amounts of Tl+ shifts the instantaneous I-V relation inward and reduces the diastolic time-dependent current. Addition of Tl+ in solutions containing Ba2+ to block the background inward rectifier has no effect on the instantaneous I-V relation; the diastolic time-dependent (pace-maker) current is reduced. Block of the pace-maker current by Tl+ is largely independent of potential in Ba2+ Tyrode solution. Since Tl+ has opposite effects on the pace-maker current and the inward rectifier, these findings support other evidence that the pace-maker current is not part of the background inward rectifier.

  7. EFFECT OF ADAPTIVE PACED CARDIOLOCOMOTOR SYNCHRONIZATION DURING RUNNING: A PRELIMINARY STUDY

    Directory of Open Access Journals (Sweden)

    Bill Phillips

    2013-09-01

    Full Text Available Cardiolocomotor synchronization (CLS has been well established for individuals engaged in rhythmic activity, such as walking, running, or cycling. When frequency of the activity is at or near the heart rate, entrainment occurs. CLS has been shown in many cases to improve the efficiency of locomotor activity, improving stroke volume, reducing blood pressure variability, and lowering the oxygen uptake (VO2. Instead of a 1:1 frequency ratio of activity to heart rate, an investigation was performed to determine if different harmonic coupling at other simple integer ratios (e.g. 1:2, 2:3, 3:2 could achieve any performance benefits. CLS was ensured by pacing the stride rate according to the measured heartbeat (i.e., adaptive paced CLS, or forced CLS. An algorithm was designed that determined the simplest ratio (lowest denominator that, when multiplied by the heart rate will fall within an individualized, predetermined comfortable pacing range for the user. The algorithm was implemented on an iPhone 4, which generated a 'tick-tock' sound through the iPhone's headphones. A sham-controlled crossover study was performed with 15 volunteers of various fitness levels. Subjects ran a 3 mile (4.83 km simulated training run at their normal pace on two consecutive days (randomized one adaptive pacing, one sham. Adaptive pacing resulted in faster runs run times, with subjects running an average of 26:03 ± 3:23 for adaptive pacing and 26:38 ± 3:31 for sham (F = 5.46, p < 0.05. The increase in heart rate from the start of the race as estimated by an exponential time constant was significantly longer during adaptive pacing, τ = 0.99 ± 0.30, compared to sham, τ = 1.53 ± 0.34 (t = -6.62, p < 0.01. Eighty-seven percent of runners found it easy to adjust their stride length to match the pacing signal with seventy-nine percent reporting that pacing helped their performance. These results suggest that adaptive paced CLS may have a beneficial effect on running

  8. Pediatric cardiac postoperative care

    Directory of Open Access Journals (Sweden)

    Auler Jr. José Otávio Costa

    2002-01-01

    Full Text Available The Heart Institute of the University of São Paulo, Medical School is a referral center for the treatment of congenital heart diseases of neonates and infants. In the recent years, the excellent surgical results obtained in our institution may be in part due to modern anesthetic care and to postoperative care based on well-structured protocols. The purpose of this article is to review unique aspects of neonate cardiovascular physiology, the impact of extracorporeal circulation on postoperative evolution, and the prescription for pharmacological support of acute cardiac dysfunction based on our cardiac unit protocols. The main causes of low cardiac output after surgical correction of heart congenital disease are reviewed, and methods of treatment and support are proposed as derived from the relevant literature and our protocols.

  9. Comprehensive cardiac rehabilitation

    DEFF Research Database (Denmark)

    Kruse, Marie; Hochstrasser, Stefan; Zwisler, Ann-Dorthe O;

    2006-01-01

    OBJECTIVES: The costs of comprehensive cardiac rehabilitation are established and compared to the corresponding costs of usual care. The effect on health-related quality of life is analyzed. METHODS: An unprecedented and very detailed cost assessment was carried out, as no guidelines existed...... for the situation at hand. Due to challenging circumstances, the cost assessment turned out to be ex-post and top-down. RESULTS: Cost per treatment sequence is estimated to be approximately euro 976, whereas the incremental cost (compared with usual care) is approximately euro 682. The cost estimate is uncertain...... and may be as high as euro 1.877. CONCLUSIONS: Comprehensive cardiac rehabilitation is more costly than usual care, and the higher costs are not outweighed by a quality of life gain. Comprehensive cardiac rehabilitation is, therefore, not cost-effective....

  10. Toothache of cardiac origin.

    Science.gov (United States)

    Kreiner, M; Okeson, J P

    1999-01-01

    Pain referred to the orofacial structures can sometimes be a diagnostic challenge for the clinician. In some instances, a patient may complain of tooth pain that is completely unrelated to any dental source. This poses a diagnostic and therapeutic problem for the dentist. Cardiac pain most commonly radiates to the left arm, shoulder, neck, and face. In rare instances, angina pectoris may present as dental pain. When this occurs, an improper diagnosis frequently leads to unnecessary dental treatment or, more significantly, a delay of proper treatment. This delay may result in the patient experiencing an acute myocardial infarction. It is the dentist's responsibility to establish a proper diagnosis so that the treatment will be directed toward the source of pain and not to the site of pain. This article reviews the literature concerning referred pain of cardiac origin and presents a case report of toothache of cardiac origin.

  11. The cardiac anxiety questionnaire: cross-validation among cardiac inpatients

    NARCIS (Netherlands)

    Beek, M.H. van; Oude Voshaar, R.C.; Deelen, F.M. van; Balkom, A.J. van; Pop, G.A.; Speckens, A.E.

    2012-01-01

    OBJECTIVE: General anxiety symptoms are common in patients with cardiac disease and considered to have an adverse effect on cardiac prognosis. The role of specific cardiac anxiety, however, is still unknown. The aim of this study is to examine the factor structure, reliability, and validity of the D

  12. THE CARDIAC ANXIETY QUESTIONNAIRE : CROSS-VALIDATION AMONG CARDIAC INPATIENTS

    NARCIS (Netherlands)

    van Beek, M. H. C. T.; Voshaar, R. C. Oude; van Deelen, F. M.; van Balkom, A. J. L. M.; Pop, G.; Speckens, A. E. M.

    2012-01-01

    Objective: General anxiety symptoms are common in patients with cardiac disease and considered to have an adverse effect on cardiac prognosis. The role of specific cardiac anxiety, however, is still unknown. The aim of this study is to examine the factor structure, reliability, and validity of the D

  13. Cardiac arrhythmias and sudden unexpected death in epilepsy (SUDEP).

    Science.gov (United States)

    Velagapudi, Poonam; Turagam, Mohit; Laurence, Thomas; Kocheril, Abraham

    2012-03-01

    Sudden unexpected death in epilepsy (SUDEP) is a major clinical problem in epilepsy patients in the United States, especially those with chronic, uncontrolled epilepsy. Several pathophysiological events contributing to SUDEP include cardiac arrhythmias, respiratory dysfunction, and dysregulation of systemic or cerebral circulation. There is a significant body of literature suggesting the prominent role of cardiac arrhythmias in the pathogenesis of SUDEP. There is evidence to say that long-standing epilepsy can cause physiological and anatomical autonomic instability resulting in life-threatening arrhythmias. Tachyarrhythmias, bradyarrhythmias, and asystole are commonly seen during ictal, interictal, and postictal phase in epilepsy patients. It is unclear if these rhythm disturbances need attention as some of them may be just benign findings. Evidence regarding prolonged cardiovascular monitoring or the benefit of pacemaker/defibrillator implantation for primary or secondary prevention in epilepsy patients is limited. Awareness regarding pathophysiology, cardiac effects, and management options of SUDEP will become useful in guiding more individualized treatment in the near future. (PACE 2011; 1-8).

  14. The effect of visitor number and spice provisioning in pacing expression by jaguars evaluated through a case study

    Directory of Open Access Journals (Sweden)

    L. S. Vidal

    Full Text Available Abstract Captive animals exhibit stereotypic pacing in response to multiple causes, including the inability to escape from human contact. Environmental enrichment techniques can minimize pacing expression. By using an individual-based approach, we addressed whether the amount of time two males and a female jaguar (Panthera onca devote to pacing varied with the number of visitors and tested the effectiveness of cinnamon and black pepper in reducing pacing. The amount of time that all jaguars engaged in pacing increased significantly with the number of visitors. Despite the difference between the males regarding age and housing conditions, both devoted significantly less time to pacing following the addition of both spices, which indicates their suitability as enrichment techniques. Mean time devoted to pacing among the treatments did not differ for the female. Our findings pointed out to the validity of individual-based approaches, as they can reveal how suitable olfactory stimuli are to minimizing stereotypies irrespective of particular traits.

  15. The effect of visitor number and spice provisioning in pacing expression by jaguars evaluated through a case study.

    Science.gov (United States)

    Vidal, L S; Guilherme, F R; Silva, V F; Faccio, M C S R; Martins, M M; Briani, D C

    2016-06-01

    Captive animals exhibit stereotypic pacing in response to multiple causes, including the inability to escape from human contact. Environmental enrichment techniques can minimize pacing expression. By using an individual-based approach, we addressed whether the amount of time two males and a female jaguar (Panthera onca) devote to pacing varied with the number of visitors and tested the effectiveness of cinnamon and black pepper in reducing pacing. The amount of time that all jaguars engaged in pacing increased significantly with the number of visitors. Despite the difference between the males regarding age and housing conditions, both devoted significantly less time to pacing following the addition of both spices, which indicates their suitability as enrichment techniques. Mean time devoted to pacing among the treatments did not differ for the female. Our findings pointed out to the validity of individual-based approaches, as they can reveal how suitable olfactory stimuli are to minimizing stereotypies irrespective of particular traits.

  16. Moderate hypothermia technique for chronic implantation of a total artificial heart in calves.

    Science.gov (United States)

    Karimov, Jamshid H; Grady, Patrick; Sinkewich, Martin; Sunagawa, Gengo; Dessoffy, Raymond; Byram, Nicole; Moazami, Nader; Fukamachi, Kiyotaka

    2017-02-25

    The benefit of whole-body hypothermia in preventing ischemic injury during cardiac surgical operations is well documented. However, application of hypothermia during in vivo total artificial heart implantation has not become widespread because of limited understanding of the proper techniques and restrictions implied by constitutional and physiological characteristics specific to each animal model. Similarly, the literature on hypothermic set-up in total artificial heart implantation has also been limited. Herein we present our experience using hypothermia in bovine models implanted with the Cleveland Clinic continuous-flow total artificial heart.

  17. Paralympic athletes with cerebral palsy display altered pacing strategies in distance-deceived shuttle running trials.

    Science.gov (United States)

    Runciman, P; Tucker, R; Ferreira, S; Albertus-Kajee, Y; Derman, W

    2016-10-01

    This study investigated performance and physiology to understand pacing strategies in elite Paralympic athletes with cerebral palsy (CP). Six Paralympic athletes with CP and 13 able-bodied (AB) athletes performed two trials of eight sets of 10 shuttles (total 1600m). One trial was distance-deceived (DEC, 1000 m + 600 m) one trial was nondeceived (N-DEC, 1600 m). Time (s), heart rate (HR, bpm), ratings of perceived exertion (RPE, units), and electromyography of five bilateral muscles (EMG) were recorded for each set of both trials. The CP group ran slower than the AB group, and pacing differences were seen in the CP DEC trial, presenting as a flat pacing profile over the trial (P < 0.05). HR was higher and RPE was lower in the CP group in both trials (P < 0.05). EMG showed small differences between groups, sides, and trials. The present study provides evidence for a possible pacing strategy underlying exercise performance and fatigue in CP. The results of this study show (1) underperformance of the CP group, and (2) altered pacing strategy utilization in the CP group. We proposed that even at high levels of performance, the residual effects of CP may negatively affect performance through selection of conservative pacing strategies during exercise.

  18. Active avoidance but not activity pacing is associated with disability in fibromyalgia.

    Science.gov (United States)

    Karsdorp, Petra A; Vlaeyen, Johan W S

    2009-12-15

    Activity pacing has been suggested as a behavioural strategy that may protect patients with fibromyalgia (FM) against activity dysregulation and disability. The aim of the present study was to empirically test whether the construct of activity pacing is distinct from other behavioural strategies assessed with the Chronic Pain Coping Inventory (CPCI), such as guarding, resting, asking for assistance, relaxation, task persistence, exercise/stretch, seeking social support, and coping self-statements. The second objective was to test whether pacing was associated with physical disability when controlling for pain catastrophizing, pain severity and the other behavioural strategies as measured with CPCI. A random sample of patients with FM (N=409) completed the CPCI, the Pain Catastrophizing Scale (PCS), the Physical Index of the Fibromyalgia Impact Questionnaire (FIQ-PH) and the Pain Disability Index (PDI). The results demonstrated that the Dutch version of the CPCI including the pacing subscale has adequate internal consistency and construct validity. Moreover, guarding and asking for assistance, but not pacing, were associated with disability. These findings are in line with fear-avoidance models and suggest that specifically active avoidance behaviours are detrimental in FM. The authors recommend developing cognitive-behavioural and exposure-based interventions and challenge the idea that pacing as an intervention is essential in pain self-management programs.

  19. Artificial vision workbench.

    Science.gov (United States)

    Frenger, P

    1997-01-01

    Machine vision is an important component of medical systems engineering. Inexpensive miniature solid state cameras are now available. This paper describes how these devices can be used as artificial retinas, to take snapshots and moving pictures in monochrome or color. Used in pairs, they produce a stereoscopic field of vision and enable depth perception. Macular and peripheral vision can be simulated electronically. This paper also presents the author's design of an artificial orbit for this synthetic eye. The orbit supports the eye, protects it, and provides attachment points for the ocular motion control system. Convergence and image fusion can be produced, and saccades simulated, along with the other ocular motions. The use of lenses, filters, irises and focusing mechanisms are also discussed. Typical camera-computer interfaces are described, including the use of "frame grabbers" and analog-to-digital image conversion. Software programs for eye positioning, image manipulation, feature extraction and object recognition are discussed, including the application of artificial neural networks.

  20. Artificial intelligence in nanotechnology.

    Science.gov (United States)

    Sacha, G M; Varona, P

    2013-11-15

    During the last decade there has been increasing use of artificial intelligence tools in nanotechnology research. In this paper we review some of these efforts in the context of interpreting scanning probe microscopy, the study of biological nanosystems, the classification of material properties at the nanoscale, theoretical approaches and simulations in nanoscience, and generally in the design of nanodevices. Current trends and future perspectives in the development of nanocomputing hardware that can boost artificial-intelligence-based applications are also discussed. Convergence between artificial intelligence and nanotechnology can shape the path for many technological developments in the field of information sciences that will rely on new computer architectures and data representations, hybrid technologies that use biological entities and nanotechnological devices, bioengineering, neuroscience and a large variety of related disciplines.

  1. Artificial muscles on heat

    Science.gov (United States)

    McKay, Thomas G.; Shin, Dong Ki; Percy, Steven; Knight, Chris; McGarry, Scott; Anderson, Iain A.

    2014-03-01

    Many devices and processes produce low grade waste heat. Some of these include combustion engines, electrical circuits, biological processes and industrial processes. To harvest this heat energy thermoelectric devices, using the Seebeck effect, are commonly used. However, these devices have limitations in efficiency, and usable voltage. This paper investigates the viability of a Stirling engine coupled to an artificial muscle energy harvester to efficiently convert heat energy into electrical energy. The results present the testing of the prototype generator which produced 200 μW when operating at 75°C. Pathways for improved performance are discussed which include optimising the electronic control of the artificial muscle, adjusting the mechanical properties of the artificial muscle to work optimally with the remainder of the system, good sealing, and tuning the resonance of the displacer to minimise the power required to drive it.

  2. Artificial intelligence in nanotechnology

    Science.gov (United States)

    Sacha, G. M.; Varona, P.

    2013-11-01

    During the last decade there has been increasing use of artificial intelligence tools in nanotechnology research. In this paper we review some of these efforts in the context of interpreting scanning probe microscopy, the study of biological nanosystems, the classification of material properties at the nanoscale, theoretical approaches and simulations in nanoscience, and generally in the design of nanodevices. Current trends and future perspectives in the development of nanocomputing hardware that can boost artificial-intelligence-based applications are also discussed. Convergence between artificial intelligence and nanotechnology can shape the path for many technological developments in the field of information sciences that will rely on new computer architectures and data representations, hybrid technologies that use biological entities and nanotechnological devices, bioengineering, neuroscience and a large variety of related disciplines.

  3. Artificial organ engineering

    CERN Document Server

    Annesini, Maria Cristina; Piemonte, Vincenzo; Turchetti, Luca

    2017-01-01

    Artificial organs may be considered as small-scale process plants, in which heat, mass and momentum transfer operations and, possibly, chemical transformations are carried out. This book proposes a novel analysis of artificial organs based on the typical bottom-up approach used in process engineering. Starting from a description of the fundamental physico-chemical phenomena involved in the process, the whole system is rebuilt as an interconnected ensemble of elemental unit operations. Each artificial organ is presented with a short introduction provided by expert clinicians. Devices commonly used in clinical practice are reviewed and their performance is assessed and compared by using a mathematical model based approach. Whilst mathematical modelling is a fundamental tool for quantitative descriptions of clinical devices, models are kept simple to remain focused on the essential features of each process. Postgraduate students and researchers in the field of chemical and biomedical engineering will find that t...

  4. Climatic controls on the pace of glacier erosion

    Science.gov (United States)

    Koppes, Michele; Hallet, Bernard; Rignot, Eric; Mouginot, Jeremie; Wellner, Julia; Love, Katherine

    2016-04-01

    precipitation rates at the end of glaciations favor the production of water from rainfall, surface melting and internal melting, which promotes sliding, erosion and sediment production and evacuation from under the ice. Hence, climatic variation, more than the extent of ice cover or ice volume, controls the pace at which glaciers shape mountains.

  5. Perioperative management of cardiac disease.

    Science.gov (United States)

    Aresti, N A; Malik, A A; Ihsan, K M; Aftab, S M E; Khan, W S

    2014-01-01

    Pre-existing cardiac disease contributes significantly to morbidity and mortality amongst patients undergoing non cardiac surgery. Patients with pre-existing cardiac disease or with risk factors for it, have as much as a 3.9% risk of suffering a major perioperative cardiac event (Lee et al 1999, Devereaux 2005). Furthermore, the incidence of perioperative myocardial infarction (MI) is increased 10 to 50 fold in patients with previous coronary events (Jassal 2008).

  6. Bayesian artificial intelligence

    CERN Document Server

    Korb, Kevin B

    2003-01-01

    As the power of Bayesian techniques has become more fully realized, the field of artificial intelligence has embraced Bayesian methodology and integrated it to the point where an introduction to Bayesian techniques is now a core course in many computer science programs. Unlike other books on the subject, Bayesian Artificial Intelligence keeps mathematical detail to a minimum and covers a broad range of topics. The authors integrate all of Bayesian net technology and learning Bayesian net technology and apply them both to knowledge engineering. They emphasize understanding and intuition but also provide the algorithms and technical background needed for applications. Software, exercises, and solutions are available on the authors' website.

  7. Artificial human vision.

    Science.gov (United States)

    Dowling, Jason

    2005-01-01

    Can vision be restored to the blind? As early as 1929 it was discovered that stimulating the visual cortex of an individual led to the perception of spots of light, known as phosphenes [1] . The aim of artificial human vision systems is to attempt to utilize the perception of phosphenes to provide a useful substitute for normal vision. Currently, four locations for electrical stimulation are being investigated; behind the retina (subretinal), in front of the retina (epiretinal), the optic nerve and the visual cortex (using intra- and surface electrodes). This review discusses artificial human vision technology and requirements, and reviews the current development projects.

  8. Spatially Resolved Artificial Chemistry

    DEFF Research Database (Denmark)

    Fellermann, Harold

    2009-01-01

    Although spatial structures can play a crucial role in chemical systems and can drastically alter the outcome of reactions, the traditional framework of artificial chemistry is a well-stirred tank reactor with no spatial representation in mind. Advanced method development in physical chemistry has...... made a class of models accessible to the realms of artificial chemistry that represent reacting molecules in a coarse-grained fashion in continuous space. This chapter introduces the mathematical models of Brownian dynamics (BD) and dissipative particle dynamics (DPD) for molecular motion and reaction...

  9. General artificial neuron

    Science.gov (United States)

    Degeratu, Vasile; Schiopu, Paul; Degeratu, Stefania

    2007-05-01

    In this paper the authors present a model of artificial neuron named the general artificial neuron. Depending on application this neuron can change self number of inputs, the type of inputs (from excitatory in inhibitory or vice versa), the synaptic weights, the threshold, the type of intensifying functions. It is achieved into optoelectronic technology. Also, into optoelectronic technology a model of general McCulloch-Pitts neuron is showed. The advantages of these neurons are very high because we have to solve different applications with the same neural network, achieved from these neurons, named general neural network.

  10. Data analysis in cardiac arrhythmias.

    Science.gov (United States)

    Rodrigo, Miguel; Pedrón-Torecilla, Jorge; Hernández, Ismael; Liberos, Alejandro; Climent, Andreu M; Guillem, María S

    2015-01-01

    Cardiac arrhythmias are an increasingly present in developed countries and represent a major health and economic burden. The occurrence of cardiac arrhythmias is closely linked to the electrical function of the heart. Consequently, the analysis of the electrical signal generated by the heart tissue, either recorded invasively or noninvasively, provides valuable information for the study of cardiac arrhythmias. In this chapter, novel cardiac signal analysis techniques that allow the study and diagnosis of cardiac arrhythmias are described, with emphasis on cardiac mapping which allows for spatiotemporal analysis of cardiac signals.Cardiac mapping can serve as a diagnostic tool by recording cardiac signals either in close contact to the heart tissue or noninvasively from the body surface, and allows the identification of cardiac sites responsible of the development or maintenance of arrhythmias. Cardiac mapping can also be used for research in cardiac arrhythmias in order to understand their mechanisms. For this purpose, both synthetic signals generated by computer simulations and animal experimental models allow for more controlled physiological conditions and complete access to the organ.

  11. Biosynthesis of cardiac natriuretic peptides

    DEFF Research Database (Denmark)

    Goetze, Jens Peter

    2010-01-01

    Cardiac-derived peptide hormones were identified more than 25 years ago. An astonishing amount of clinical studies have established cardiac natriuretic peptides and their molecular precursors as useful markers of heart disease. In contrast to the clinical applications, the biogenesis of cardiac...

  12. Cardiac troponins and high-sensitivity cardiac troponin assays.

    Science.gov (United States)

    Conrad, Michael J; Jarolim, Petr

    2014-03-01

    Measurement of circulating cardiac troponins I and T has become integral to the diagnosis of myocardial infarction. This article discusses the structure and function of the troponin complex and the release of cardiac troponin molecules from the injured cardiomyocyte into the circulation. An overview of current cardiac troponin assays and their classification according to sensitivity is presented. The diagnostic criteria, role, and usefulness of cardiac troponin for myocardial infarction are discussed. In addition, several examples are given of the usefulness of high-sensitivity cardiac troponin assays for short-term and long-term prediction of adverse events.

  13. Amplify scientific discovery with artificial intelligence

    Energy Technology Data Exchange (ETDEWEB)

    Gil, Yolanda; Greaves, Mark T.; Hendler, James; Hirsch, Hyam

    2014-10-10

    Computing innovations have fundamentally changed many aspects of scientific inquiry. For example, advances in robotics, high-end computing, networking, and databases now underlie much of what we do in science such as gene sequencing, general number crunching, sharing information between scientists, and analyzing large amounts of data. As computing has evolved at a rapid pace, so too has its impact in science, with the most recent computing innovations repeatedly being brought to bear to facilitate new forms of inquiry. Recently, advances in Artificial Intelligence (AI) have deeply penetrated many consumer sectors, including for example Apple’s Siri™ speech recognition system, real-time automated language translation services, and a new generation of self-driving cars and self-navigating drones. However, AI has yet to achieve comparable levels of penetration in scientific inquiry, despite its tremendous potential in aiding computers to help scientists tackle tasks that require scientific reasoning. We contend that advances in AI will transform the practice of science as we are increasingly able to effectively and jointly harness human and machine intelligence in the pursuit of major scientific challenges.

  14. Cardiac potassium channel subtypes

    DEFF Research Database (Denmark)

    Schmitt, Nicole; Grunnet, Morten; Olesen, Søren-Peter

    2014-01-01

    About 10 distinct potassium channels in the heart are involved in shaping the action potential. Some of the K(+) channels are primarily responsible for early repolarization, whereas others drive late repolarization and still others are open throughout the cardiac cycle. Three main K(+) channels...

  15. Cardiac Risk Assessment

    Science.gov (United States)

    ... Risk Assessment Related tests: Lipid Profile , VLDL Cholesterol , hs-CRP , Lp(a) Overview | Common Questions | Related Pages What ... cardiac risk include: High-sensitivity C-reactive protein (hs-CRP) : Studies have shown that measuring CRP with a ...

  16. The cardiac malpositions.

    Science.gov (United States)

    Perloff, Joseph K

    2011-11-01

    Dextrocardia was known in the 17th century and was 1 of the first congenital malformations of the heart to be recognized. Fifty years elapsed before Matthew Baillie published his account of complete transposition in a human of the thoracic and abdominal viscera to the opposite side from what is natural. In 1858, Thomas Peacock stated that "the heart may be congenitally misplaced in various ways, occupying either an unusual position within the thorax, or being situated external to that cavity." In 1915, Maude Abbott described ectopia cordis, and Richard Paltauf's remarkable illustrations distinguished the various types of dextrocardia. In 1928, the first useful classification of the cardiac malpositions was proposed, and in 1966, Elliott et al's radiologic classification set the stage for clinical recognition. The first section of this review deals with the 3 basic cardiac malpositions in the presence of bilateral asymmetry. The second section deals with cardiac malpositions in the presence of bilateral left-sidedness or right-sidedness. Previous publications on cardiac malpositions are replete with an arcane vocabulary that confounds rather than clarifies. Even if the terms themselves are understood, inherent complexity weighs against clarity. This review was designed as a guided tour of an unfamiliar subject.

  17. Hepato-cardiac disorders

    Institute of Scientific and Technical Information of China (English)

    Yasser; Mahrous; Fouad; Reem; Yehia

    2014-01-01

    Understanding the mutual relationship between the liver and the heart is important for both hepatologists and cardiologists. Hepato-cardiac diseases can be classified into heart diseases affecting the liver, liver diseases affecting the heart, and conditions affecting the heart and the liver at the same time. Differential diagnoses of liver injury are extremely important in a cardiologist’s clinical practice calling for collaboration between cardiologists and hepatologists due to the many other diseases that can affect the liver and mimic haemodynamic injury. Acute and chronic heart failure may lead to acute ischemic hepatitis or chronic congestive hepatopathy. Treatment in these cases should be directed to the primary heart disease. In patients with advanced liver disease, cirrhotic cardiomyopathy may develop including hemodynamic changes, diastolic and systolic dysfunctions, reduced cardiac performance and electrophysiological abnormalities. Cardiac evaluation is important for patients with liver diseases especially before and after liver transplantation. Liver transplantation may lead to the improvement of all cardiac changes and the reversal of cirrhotic cardiomyopathy. There are systemic diseases that may affect both the liver and the heart concomitantly including congenital, metabolic and inflammatory diseases as well as alcoholism. This review highlights these hepatocardiac diseases

  18. Micromachined Artificial Haircell

    Science.gov (United States)

    Liu, Chang (Inventor); Engel, Jonathan (Inventor); Chen, Nannan (Inventor); Chen, Jack (Inventor)

    2010-01-01

    A micromachined artificial sensor comprises a support coupled to and movable with respect to a substrate. A polymer, high-aspect ratio cilia-like structure is disposed on and extends out-of-plane from the support. A strain detector is disposed with respect to the support to detect movement of the support.

  19. Artificial Gravity Research Plan

    Science.gov (United States)

    Gilbert, Charlene

    2014-01-01

    This document describes the forward working plan to identify what countermeasure resources are needed for a vehicle with an artificial gravity module (intermittent centrifugation) and what Countermeasure Resources are needed for a rotating transit vehicle (continuous centrifugation) to minimize the effects of microgravity to Mars Exploration crewmembers.

  20. Artificial Left Ventricle

    CERN Document Server

    Ranjbar, Saeed; Meybodi, Mahmood Emami

    2014-01-01

    This Artificial left ventricle is based on a simple conic assumption shape for left ventricle where its motion is made by attached compressed elastic tubes to its walls which are regarded to electrical points at each nodal .This compressed tubes are playing the role of myofibers in the myocardium of the left ventricle. These elastic tubes have helical shapes and are transacting on these helical bands dynamically. At this invention we give an algorithm of this artificial left ventricle construction that of course the effect of the blood flow in LV is observed with making beneficiary used of sensors to obtain this effecting, something like to lifegates problem. The main problem is to evaluate powers that are interacted between elastic body (left ventricle) and fluid (blood). The main goal of this invention is to show that artificial heart is not just a pump, but mechanical modeling of LV wall and its interaction with blood in it (blood movement modeling) can introduce an artificial heart closed to natural heart...

  1. Artificial intelligence and psychiatry.

    Science.gov (United States)

    Servan-Schreiber, D

    1986-04-01

    This paper provides a brief historical introduction to the new field of artificial intelligence and describes some applications to psychiatry. It focuses on two successful programs: a model of paranoid processes and an expert system for the pharmacological management of depressive disorders. Finally, it reviews evidence in favor of computerized psychotherapy and offers speculations on the future development of research in this area.

  2. Observations of artificial satellites

    Directory of Open Access Journals (Sweden)

    A. MAMMANO

    1964-06-01

    Full Text Available The following publication gives the results of photographic
    observations of artificial satellites made at Asiago during the second
    and third year of this programme. The fixed camera technique and that
    with moving film (the latter still in its experimental stage have been used.

  3. Artificial intelligence within AFSC

    Science.gov (United States)

    Gersh, Mark A.

    1990-01-01

    Information on artificial intelligence research in the Air Force Systems Command is given in viewgraph form. Specific research that is being conducted at the Rome Air Development Center, the Space Technology Center, the Human Resources Laboratory, the Armstrong Aerospace Medical Research Laboratory, the Armamant Laboratory, and the Wright Research and Development Center is noted.

  4. Cardiac magnetic resonance imaging: patient safety considerations.

    Science.gov (United States)

    Giroletti, Elio; Corbucci, Giorgio

    Magnetic Resonance Imaging (MRI) is widely used in medicine. In cardiology, it is used to assess congenital or acquired diseases of the heat: and large vessels. Unless proper precautions are taken, it is generally advisable to avoid using this technique in patients with implanted electronic stimulators, such as pacemakers and defibrillators, on account of the potential risk of inducing electrical currents on the endocardial catheters, since these currents might stimulate the heart at a high frequency, thereby triggering dangerous arrhythmias. In addition to providing some basic information on pacemakers, defibrillators and MRI, and on the possible physical phenomena that may produce harmful effects, the present review examines the indications given in the literature, with particular reference to coronary stents, artificial heart valves and implantable cardiac stimulators.

  5. Experimental and computational studies on complex spiral waves in 2-D cardiac substrates

    Science.gov (United States)

    Bursac, Nenad

    2005-03-01

    A variety of chemical and biological nonlinear excitable media including heart tissue can support stable, self-organized waves of activity in a form of rotating single-arm spirals. In the heart tissue, stable single-arm spirals can underlie highly periodic activity such as monomorphic ventricular tachycardia (VT), while unstable spirals that continuously form and break up are shown to underlie aperiodic and lethal heart activity, namely fibrillation. Although fast pacing from a point in the heart is commonly used to terminate VT, it can occasionally yield a transient or stable acceleration of tachicardia rate and/or fibrillation. In this study we tested the effect of rapid point pacing on sustained spiral waves in the uniformly anisotropic cultures of cardiac myocytes. In 15/79 cultures, rapid pacing induced a stable formation of multiple bound spiral waves (a complex spiral) and acceleration of overall excitation rate in the tissue, as assessed by pseudo ECG (pECG). The level of rate acceleration correlated with the number of rotating waves. Further rapid point pacing decelerated, terminated, or further accelerated the complex spiral activity via a change in the number of coexisting rotating waves. The dynamic restitution analysis revealed no alternans in action potential duration in any of the cultures. Stable formation of complex spirals was accomplished only in the cultures that showed relatively broad and steep impulse wavelength and conduction velocity restitutions. A necessary condition for rate acceleration in a medium with monotonic restitution is that the rate of rotation of a single spiral wave is significantly lower than maximum sustainable rate of excitation in the medium. Preliminary data in a homogeneous medium using 3-variable Fenton-Karma (FK) based model of cardiac tissue suggest that decrease of fast inward current (excitability) can shift the spiral rate away from the break point on the restitution curve, enabling a necessary condition for rate

  6. A fast-start pacing strategy speeds pulmonary oxygen uptake kinetics and improves supramaximal running performance.

    Directory of Open Access Journals (Sweden)

    Tiago Turnes

    Full Text Available The focus of the present study was to investigate the effects of a fast-start pacing strategy on running performance and pulmonary oxygen uptake (VO2 kinetics at the upper boundary of the severe-intensity domain. Eleven active male participants (28±10 years, 70±5 kg, 176±6 cm, 57±4 mL/kg/min visited the laboratory for a series of tests that were performed until exhaustion: 1 an incremental test; 2 three laboratory test sessions performed at 95, 100 and 110% of the maximal aerobic speed; 3 two to four constant speed tests for the determination of the highest constant speed (HS that still allowed achieving maximal oxygen uptake; and 4 an exercise based on the HS using a higher initial speed followed by a subsequent decrease. To predict equalized performance values for the constant pace, the relationship between time and distance/speed through log-log modelling was used. When a fast-start was utilized, subjects were able to cover a greater distance in a performance of similar duration in comparison with a constant-pace performance (constant pace: 670 m±22%; fast-start: 683 m±22%; P = 0.029; subjects also demonstrated a higher exercise tolerance at a similar average speed when compared with constant-pace performance (constant pace: 114 s±30%; fast-start: 125 s±26%; P = 0.037. Moreover, the mean VO2 response time was reduced after a fast start (constant pace: 22.2 s±28%; fast-start: 19.3 s±29%; P = 0.025. In conclusion, middle-distance running performances with a duration of 2-3 min are improved and VO2 response time is faster when a fast-start is adopted.

  7. An integrated platform for image-guided cardiac resynchronization therapy

    Science.gov (United States)

    Ma, Ying Liang; Shetty, Anoop K.; Duckett, Simon; Etyngier, Patrick; Gijsbers, Geert; Bullens, Roland; Schaeffter, Tobias; Razavi, Reza; Rinaldi, Christopher A.; Rhode, Kawal S.

    2012-05-01

    Cardiac resynchronization therapy (CRT) is an effective procedure for patients with heart failure but 30% of patients do not respond. This may be due to sub-optimal placement of the left ventricular (LV) lead. It is hypothesized that the use of cardiac anatomy, myocardial scar distribution and dyssynchrony information, derived from cardiac magnetic resonance imaging (MRI), may improve outcome by guiding the physician for optimal LV lead positioning. Whole heart MR data can be processed to yield detailed anatomical models including the coronary veins. Cine MR data can be used to measure the motion of the LV to determine which regions are late-activating. Finally, delayed Gadolinium enhancement imaging can be used to detect regions of scarring. This paper presents a complete platform for the guidance of CRT using pre-procedural MR data combined with live x-ray fluoroscopy. The platform was used for 21 patients undergoing CRT in a standard catheterization laboratory. The patients underwent cardiac MRI prior to their procedure. For each patient, a MRI-derived cardiac model, showing the LV lead targets, was registered to x-ray fluoroscopy using multiple views of a catheter looped in the right atrium. Registration was maintained throughout the procedure by a combination of C-arm/x-ray table tracking and respiratory motion compensation. Validation of the registration between the three-dimensional (3D) roadmap and the 2D x-ray images was performed using balloon occlusion coronary venograms. A 2D registration error of 1.2 ± 0.7 mm was achieved. In addition, a novel navigation technique was developed, called Cardiac Unfold, where an entire cardiac chamber is unfolded from 3D to 2D along with all relevant anatomical and functional information and coupled to real-time device detection. This allowed more intuitive navigation as the entire 3D scene was displayed simultaneously on a 2D plot. The accuracy of the unfold navigation was assessed off-line using 13 patient data sets

  8. Diritto internazionale umanitario, guerra e pace, diritti delle persone

    Directory of Open Access Journals (Sweden)

    Giovanni Barberini

    2011-11-01

    Full Text Available SOMMARIO: 1. Il diritto umanitario nei conflitti armati - 2. La codificazione del diritto umanitario - 3. Diritto della guerra e diritto della pace - 4. L’articolo 11 della costituzione italiana - 5. La protezione internazionale dei diritti e delle libertà della persona - 6. Conclusioni. Abstract: The military operators must also assure the peace with the weapons and, above all, the persons responsible of the operations must give test of great sensibility because busy to conjugate laws and rules war with the objectives of pacification. The authorities responsible for the operations at any time they need to know what they can or must do and what orders impart; they must know what it cannot do or what should be avoided. The international humanitarian law, important part of the international law, is constituted by conventional and consuetudinary norms that are applied in the relationships among States with a specific objective: to protect in time of armed conflict the people who do not take part or do not take more part in hostilities and impose bans or limits to the use of means offensive, of sophisticated weapons and methods of warfare in situations of armed conflict in act or to avoid sleepwalking. The codification of the international humanitarian law is initiated in the century XIX, above all when it was tried to introduce with the Declaration of Petersbourg in 1868 a principle that individualized in the contrariety to the laws of the humanity the impassable limit to respect in the armed conflicts. The codification has received then force and importance after the second world conflict that the consciences of the people had struck with the systematic practice of the most merciless violence making to record million of deads. The fundamental importance of the 1949 Geneva four Conventions is unanimously recognized. They are based on ratio of the existence and the responsibilities of the Organization of United Nations; they have properly

  9. Introduction to Artificial Neural Networks

    DEFF Research Database (Denmark)

    Larsen, Jan

    1999-01-01

    The note addresses introduction to signal analysis and classification based on artificial feed-forward neural networks.......The note addresses introduction to signal analysis and classification based on artificial feed-forward neural networks....

  10. The cardiac implantable electronic device power source: evolution and revolution.

    Science.gov (United States)

    Mond, Harry G; Freitag, Gary

    2014-12-01

    Although the first power source for an implantable pacemaker was a rechargeable nickel-cadmium battery, it was rapidly replaced by an unreliable short-life zinc-mercury cell. This sustained the small pacemaker industry until the early 1970s, when the lithium-iodine cell became the dominant power source for low voltage, microampere current, single- and dual-chamber pacemakers. By the early 2000s, a number of significant advances were occurring with pacemaker technology which necessitated that the power source should now provide milliampere current for data logging, telemetric communication, and programming, as well as powering more complicated pacing devices such as biventricular pacemakers, treatment or prevention of atrial tachyarrhythmias, and the integration of innovative physiologic sensors. Because the current delivery of the lithium-iodine battery was inadequate for these functions, other lithium anode chemistries that can provide medium power were introduced. These include lithium-carbon monofluoride, lithium-manganese dioxide, and lithium-silver vanadium oxide/carbon mono-fluoride hybrids. In the early 1980s, the first implantable defibrillators for high voltage therapy used a lithium-vanadium pentoxide battery. With the introduction of the implantable cardioverter defibrillator, the reliable lithium-silver vanadium oxide became the power source. More recently, because of the demands of biventricular pacing, data logging, and telemetry, lithium-manganese dioxide and the hybrid lithium-silver vanadium oxide/carbon mono-fluoride laminate have also been used. Today all cardiac implantable electronic devices are powered by lithium anode batteries.

  11. Beating heart on a chip: a novel microfluidic platform to generate functional 3D cardiac microtissues.

    Science.gov (United States)

    Marsano, Anna; Conficconi, Chiara; Lemme, Marta; Occhetta, Paola; Gaudiello, Emanuele; Votta, Emiliano; Cerino, Giulia; Redaelli, Alberto; Rasponi, Marco

    2016-02-07

    In the past few years, microfluidic-based technology has developed microscale models recapitulating key physical and biological cues typical of the native myocardium. However, the application of controlled physiological uniaxial cyclic strains on a defined three-dimension cellular environment is not yet possible. Two-dimension mechanical stimulation was particularly investigated, neglecting the complex three-dimensional cell-cell and cell-matrix interactions. For this purpose, we developed a heart-on-a-chip platform, which recapitulates the physiologic mechanical environment experienced by cells in the native myocardium. The device includes an array of hanging posts to confine cell-laden gels, and a pneumatic actuation system to induce homogeneous uniaxial cyclic strains to the 3D cell constructs during culture. The device was used to generate mature and highly functional micro-engineered cardiac tissues (μECTs), from both neonatal rat and human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM), strongly suggesting the robustness of our engineered cardiac micro-niche. Our results demonstrated that the cyclic strain was effectively highly uniaxial and uniformly transferred to cells in culture. As compared to control, stimulated μECTs showed superior cardiac differentiation, as well as electrical and mechanical coupling, owing to a remarkable increase in junction complexes. Mechanical stimulation also promoted early spontaneous synchronous beating and better contractile capability in response to electric pacing. Pacing analyses of hiPSC-CM constructs upon controlled administration of isoprenaline showed further promising applications of our platform in drug discovery, delivery and toxicology fields. The proposed heart-on-a-chip device represents a relevant step forward in the field, providing a standard functional three-dimensional cardiac model to possibly predict signs of hypertrophic changes in cardiac phenotype by mechanical and biochemical co-stimulation.

  12. Cardiac fusion and complex congenital cardiac defects in thoracopagus twins: diagnostic value of cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of); Park, Jeong-Jun [University of Ulsan College of Medicine, Asan Medical Center, Department of Pediatric Cardiac Surgery, Seoul (Korea, Republic of); Kim, Ellen Ai-Rhan [University of Ulsan College of Medicine, Asan Medical Center, Division of Neonatology, Department of Pediatrics, Seoul (Korea, Republic of); Won, Hye-Sung [University of Ulsan College of Medicine, Asan Medical Center, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of)

    2014-09-15

    Most thoracopagus twins present with cardiac fusion and associated congenital cardiac defects, and assessment of this anatomy is of critical importance in determining patient care and outcome. Cardiac CT with electrocardiographic triggering provides an accurate and quick morphological assessment of both intracardiac and extracardiac structures in newborns, making it the best imaging modality to assess thoracopagus twins during the neonatal period. In this case report, we highlight the diagnostic value of cardiac CT in thoracopagus twins with an interatrial channel and complex congenital cardiac defects. (orig.)

  13. In Heart Failure Patients with Left Bundle Branch Block Single Lead MultiSpot Left Ventricular Pacing Does Not Improve Acute Hemodynamic Response To Conventional Biventricular Pacing. A Multicenter Prospective, Interventional, Non-Randomized Study

    OpenAIRE

    Maciej Sterliński; Adam Sokal; Radosław Lenarczyk; Frederic Van Heuverswyn; Aldo Rinaldi, C.; Marc Vanderheyden; Vladimir Khalameizer; Darrel Francis; Joeri Heynens; Berthold Stegemann; Richard Cornelussen

    2016-01-01

    Introduction Recent efforts to increase CRT response by multiSPOT pacing (MSP) from multiple bipols on the same left ventricular lead are still inconclusive. Aim The Left Ventricular (LV) MultiSPOTpacing for CRT (iSPOT) study compared the acute hemodynamic response of MSP pacing by using 3 electrodes on a quadripolar lead compared with conventional biventricular pacing (BiV). Methods Patients with left bundle branch block (LBBB) underwent an acute hemodynamic study to determine the %change in...

  14. A biophysically-based finite state machine model for analysing gastric experimental entrainment and pacing recordings

    Science.gov (United States)

    Sathar, Shameer; Trew, Mark L.; Du, Peng; O’ Grady, Greg; Cheng, Leo K.

    2014-01-01

    Gastrointestinal motility is coordinated by slow waves (SWs) generated by the interstitial cells of Cajal (ICC). Experimental studies have shown that SWs spontaneously activate at different intrinsic frequencies in isolated tissue, whereas in intact tissues they are entrained to a single frequency. Gastric pacing has been used in an attempt to improve motility in disorders such as gastroparesis by modulating entrainment, but the optimal methods of pacing are currently unknown. Computational models can aid in the interpretation of complex in-vivo recordings and help to determine optical pacing strategies. However, previous computational models of SW entrainment are limited to the intrinsic pacing frequency as the primary determinant of the conduction velocity, and are not able to accurately represent the effects of external stimuli and electrical anisotropies. In this paper, we present a novel computationally efficient method for modelling SW propagation through the ICC network while accounting for conductivity parameters and fiber orientations. The method successfully reproduced experimental recordings of entrainment following gastric transection and the effects of gastric pacing on SW activity. It provides a reliable new tool for investigating gastric electrophysiology in normal and diseased states, and to guide and focus future experimental studies. PMID:24276722

  15. Physiological and psychological effects of deception on pacing strategy and performance: a review.

    Science.gov (United States)

    Jones, Hollie S; Williams, Emily L; Bridge, Craig A; Marchant, Dave; Midgley, Adrian W; Micklewright, Dominic; Mc Naughton, Lars R

    2013-12-01

    The aim of an optimal pacing strategy during exercise is to enhance performance whilst ensuring physiological limits are not surpassed, which has been shown to result in a metabolic reserve at the end of the exercise. There has been debate surrounding the theoretical models that have been proposed to explain how pace is regulated, with more recent research investigating a central control of exercise regulation. Deception has recently emerged as a common, practical approach to manipulate key variables during exercise. There are a number of ways in which deception interventions have been designed, each intending to gain particular insights into pacing behaviour and performance. Deception methodologies can be conceptualised according to a number of dimensions such as deception timing (prior to or during exercise), presentation frequency (blind, discontinuous or continuous) and type of deception (performance, biofeedback or environmental feedback). However, research evidence on the effects of deception has been perplexing and the use of complex designs and varied methodologies makes it difficult to draw any definitive conclusions about how pacing strategy and performance are affected by deception. This review examines existing research in the area of deception and pacing strategies, and provides a critical appraisal of the different methodological approaches used to date. It is hoped that this analysis will inform the direction and methodology of future investigations in this area by addressing the mechanisms through which deception impacts upon performance and by elucidating the potential application of deception techniques in training and competitive settings.

  16. Application of PACE Principles for Population Health Management of Frail Older Adults.

    Science.gov (United States)

    Stefanacci, Richard G; Reich, Shelley; Casiano, Alex

    2015-10-01

    To determine which practices would have the most impact on reducing hospital and emergency department admissions and nursing home placement among older adults with multiple comorbid conditions, a literature search and survey were conducted to identify and prioritize comprehensive care principles as practiced in the Program of All-inclusive Care for the Elderly (PACE). PACE medical directors and members of the PACE interdisciplinary team (IDT) were surveyed to gain their insights on the most impactful practices, which were identified as: End-of-Life Management, Caregiver Support, Management of Red Flags, Medication Management, Participant and Caregiver Health Care System Literacy, and Care Coordination. In addition, this research evaluated measures that could be used to assess an organization's level of success with regard to each of the 6 PACE practices identified. The results reported in this article, found through a survey with PACE medical directors and IDT members concerning effective interventions, can be viewed as strategies to improve care for older adults, enabling them to maintain their independence in the community, avoid the expense of facility-based care, and enhance their quality of life.

  17. Potential Effect of Physical Activity Calorie Equivalent (PACE Labeling on Adult Fast Food Ordering and Exercise.

    Directory of Open Access Journals (Sweden)

    Ray Antonelli

    Full Text Available Numeric calorie content labels show limited efficacy in reducing the number of calories ordered from fast food meals. Physical activity calorie equivalent (PACE labels are an alternative that may reduce the number of calories ordered in fast food meals while encouraging patrons to exercise.A total of 1000 adults from 47 US states were randomly assigned via internet survey to one of four generic fast food menus: no label, calories only, calories + minutes, or calories + miles necessary to walk to burn off the calories. After completing hypothetical orders participants were asked to rate the likelihood of calorie-only and PACE labels to influence (1 food choice and (2 physical activity.Respondents (n = 823 ordered a median of 1580 calories from the no-label menu, 1200 from the calories-only menu, 1140 from the calories + minutes menu, and 1210 from the calories + miles menu (p = 0.0001. 40% of respondents reported that PACE labels were "very likely" to influence food item choice vs. 28% for calorie-only labels (p<0.0001. 64% of participants reported that PACE labels were "somewhat likely" or "very likely" to influence their level of physical activity vs. 49% for calorie-only labels (p<0.0001.PACE labels may be helpful in reducing the number of calories ordered in fast food meals and may have the added benefit of encouraging exercise.

  18. Ventricular evoked response in patients with hypertrophic obstructive cardiomyopathy treated with DDD pacing

    Directory of Open Access Journals (Sweden)

    João Ricardo M. Sant'Anna

    1999-08-01

    Full Text Available OBJECTIVE: To assess the changes in ventricular evoked responses (VER produced by the decrease in left ventricular outflow tract gradient (LVOTG in patients with hypertrophic obstructive cardiomyopathy (HOCM treated with dual-chamber (DDD pacing. METHODS: A pulse generator Physios CTM (Biotronik, Germany was implanted in 9 patients with severe drug-refractory HOCM. After implantation, the following conditions were assessed: 1 Baseline evaluation: different AV delay (ranging from 150ms to 50 ms were sequentially programmed during 5 to 10 minutes, and the LVOTG (as determined by Doppler echocardiography and VER recorded; 2 standard evaluation, when the best AV delay (resulting in the lowest LVOTG programmed at the initial evaluation was maintained so that its effect on VER and LVOTG could be assessed during each chronic pacing evaluation. RESULTS: LVOTG decreased after DDD pacing, with a mean value of 59 ± 24 mmHg after dual chamber pacemaker, which was significantly less than the gradient before pacing (98 + 22mmHg. An AV delay >100ms produced a significantly lower decrease in VER depolarization duration (VER DD when compared to an AV delay <=100ms. Linear regression analyses showed a significant correlation between the LVOTG values and the magnitude of VER (r=0.69; p<0.05 in the 9 studied patients. CONCLUSION: The telemetry obtained intramyocardial electrogram is a sensitive means to assess left ventricular dynamics in patients with HOCM treated with DDD pacing.

  19. Provenance Context Entity (PaCE): Scalable Provenance Tracking for Scientific RDF Data.

    Science.gov (United States)

    Sahoo, Satya S; Bodenreider, Olivier; Hitzler, Pascal; Sheth, Amit; Thirunarayan, Krishnaprasad

    The Resource Description Framework (RDF) format is being used by a large number of scientific applications to store and disseminate their datasets. The provenance information, describing the source or lineage of the datasets, is playing an increasingly significant role in ensuring data quality, computing trust value of the datasets, and ranking query results. Current provenance tracking approaches using the RDF reification vocabulary suffer from a number of known issues, including lack of formal semantics, use of blank nodes, and application-dependent interpretation of reified RDF triples. In this paper, we introduce a new approach called Provenance Context Entity (PaCE) that uses the notion of provenance context to create provenance-aware RDF triples. We also define the formal semantics of PaCE through a simple extension of the existing RDF(S) semantics that ensures compatibility of PaCE with existing Semantic Web tools and implementations. We have implemented the PaCE approach in the Biomedical Knowledge Repository (BKR) project at the US National Library of Medicine. The evaluations demonstrate a minimum of 49% reduction in total number of provenance-specific RDF triples generated using the PaCE approach as compared to RDF reification. In addition, performance for complex queries improves by three orders of magnitude and remains comparable to the RDF reification approach for simpler provenance queries.

  20. of right ventricular pacing threshold on heart function in patients with sick sinus syndrome%右心室起搏阈值对病态窦房结综合征患者心功能的影响

    Institute of Scientific and Technical Information of China (English)

    陆卫红; 鲍小京; 薄小萍; 杨传高; 张涛

    2016-01-01

    Objective To evaluate the influence of right ventricular pacing threshold on cardiac function in pa-tients with sick sinus syndrome. Methods Ninety-one patients with sick sinus syndrome scheduled for dual chamber pacemaker implantation were selected in our hospital from January 2013 to December 2015. Pacing threshold was mea-sured preoperatively at the bottom, the free wall and outflow of the right ventricle separately using temporary pacemaker electrode, and the average value was calculated. According to the average, the patients were divided into normal pacing threshold group (n=55, pacing threshold≤1V) and high pacing threshold group (n=36, pacing threshold>1V). The cen-tral venous pressure (CVP) was measured intraoperatively, and B-type brain natriuretic peptide (BNP) and cardiac func-tion [left ventricular end-diastolic diameter (LVEDD) and ejection fraction (EF)] were detected at preoperative postopera-tive one week. Results The preoperative CVP and BNP, LVEDD, EF showed statistically significant difference between normal pacing threshold group [(10.13 ± 1.12) mmHg, (103.42 ± 10.12) pg/mL, (42.56 ± 5.67) mm, (51.21 ± 6.43)%, respec-tively] and high pacing threshold group [(13.36±1.45) mmHg, (121.42±12.24) pg/mL, (45.68±5.89) mm, (48.02±5.89)%, respectively], P1V),术中测得中心静脉压力(CVP),两组患者术前和术后一周均行B型脑钠肽(BNP)和心超检查测定心功能[左室舒张末内径(LVEDD)和射血分数(EF值)]。结果正常起搏阈值组术前CVP、BNP、LVEDD和EF分别为(10.13±1.12) mmHg、(103.42±10.12) pg/mL、(42.56±5.67) mm和(51.21±6.43)%,高起搏阈值组分别为(13.36±1.45) mmHg、(121.42±12.24) pg/mL、(45.68±5.89) mm和(48.02±5.89)%,术前两组患者的上述各项指标比较差异均有统计学意义(P<0.05);正常起搏阈值组术后BNP、LVEDD和EF分别为(81.36±8.07) pg/mL、(40.12±5.18) mm和(53.87±7.09)%,高起搏阈值组分别为(98.79±9.81) pg/mL、(44.51±5.32) mm

  1. Cardiac nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Gerson, M.C.

    1987-01-01

    The book begins with a review of the radionuclide methods available for evaluating cardiac perfusion and function. The authors discuss planar and tomographic thallium myocardial imaging, first-pass and equilibrium radionuclide angiography, and imaging with infarct-avid tracers. Several common but more specialized procedures are then reviewed: nonogemetric measurement of left ventricular volume, phase (Fourier) analysis, stroke volume ratio, right ventricular function, and diastolic function. A separate chapter is devoted to drug interventions and in particular the use of radionuclide ventriculography to monitor doxorubicin toxicity and therapy of congestive heart failure. The subsequent chapters provide a comprehensive guide to test selection, accuracy, and results in acute myocardial infarction, in postmyocardial infarction, in chronic coronary artery disease, before and after medical or surgical revascularization, in valvular heart disease, in cardiomyopathies, and in cardiac trauma.

  2. Sudden Cardiac Death

    Directory of Open Access Journals (Sweden)

    Yipsy María Gutiérrez Báez

    2015-09-01

    Full Text Available Since the second half of the twentieth century, dying suddenly due to heart-related problems has become the main health issue in all countries where infectious diseases are not prevalent. Sudden death from cardiac causes is an important global health problem. Major databases were searched for the leading causes of sudden cardiac death. It has been demonstrated that there is a group of hereditary diseases with structural alterations or without apparent organic cause that explains many cases of sudden death in young people, whether related or not to physical exertion. Certain population groups are at higher risk for this disease. They are relatively easy to identify and can be the target of primary prevention measures.

  3. Cardiac arrhythmias in pregnancy.

    Science.gov (United States)

    Knotts, Robert J; Garan, Hasan

    2014-08-01

    As more women with repaired congenital heart disease survive to their reproductive years and many other women are delaying pregnancy until later in life, a rising concern is the risk of cardiac arrhythmias during pregnancy. Naturally occurring cardiovascular changes during pregnancy increase the likelihood that a recurrence of a previously experienced cardiac arrhythmia or a de novo arrhythmia will occur. Arrhythmias should be thoroughly investigated to determine if there is a reversible etiology, and risks/benefits of treatment options should be fully explored. We discuss the approach to working up and treating various arrhythmias during pregnancy with attention to fetal and maternal risks as well as treatment of fetal arrhythmias. Acute management in stable patients includes close monitoring and intravenous pharmacologic therapy, while DC cardioversion should be used to terminate arrhythmias in hemodynamically unstable patients. Long-term management may require continued oral antiarrhythmic therapy, with particular attention to fetal safety, to prevent complications associated with arrhythmias.

  4. Artificial Enzymes, "Chemzymes"

    DEFF Research Database (Denmark)

    Bjerre, Jeannette; Rousseau, Cyril Andre Raphaël; Pedersen, Lavinia Georgeta M;

    2008-01-01

    Enzymes have fascinated scientists since their discovery and, over some decades, one aim in organic chemistry has been the creation of molecules that mimic the active sites of enzymes and promote catalysis. Nevertheless, even today, there are relatively few examples of enzyme models...... that successfully perform Michaelis-Menten catalysis under enzymatic conditions (i.e., aqueous medium, neutral pH, ambient temperature) and for those that do, very high rate accelerations are seldomly seen. This review will provide a brief summary of the recent developments in artificial enzymes, so called...... "Chemzymes", based on cyclodextrins and other molecules. Only the chemzymes that have shown enzyme-like activity that has been quantified by different methods will be mentioned. This review will summarize the work done in the field of artificial glycosidases, oxidases, epoxidases, and esterases, as well...

  5. Cardiac surgery 2015 reviewed.

    Science.gov (United States)

    Doenst, Torsten; Strüning, Constanze; Moschovas, Alexandros; Gonzalez-Lopez, David; Essa, Yasin; Kirov, Hristo; Diab, Mahmoud; Faerber, Gloria

    2016-10-01

    For the year 2015, almost 19,000 published references can be found in PubMed when entering the search term "cardiac surgery". The last year has been again characterized by lively discussions in the fields where classic cardiac surgery and modern interventional techniques overlap. Lacking evidence in the field of coronary revascularization with either percutaneous coronary intervention or bypass surgery has been added. As in the years before, CABG remains the gold standard for the revascularization of complex stable triple-vessel disease. Plenty of new information has been presented comparing the conventional to transcatheter aortic valve implantation (TAVI) demonstrating similar short- and mid-term outcomes at high and low risk, but even a survival advantage with transfemoral TAVI at intermediate risk. In addition, there were many relevant and interesting other contributions from the purely operative arena. This review article will summarize the most pertinent publications in the fields of coronary revascularization, surgical treatment of valve disease, heart failure (i.e., transplantation and ventricular assist devices), and aortic surgery. While the article does not have the expectation of being complete and cannot be free of individual interpretation, it provides a condensed summary that is intended to give the reader "solid ground" for up-to-date decision-making in cardiac surgery.

  6. Cardiac hybrid imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gaemperli, Oliver [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); University Hospital Zurich, Nuclear Cardiology, Cardiovascular Center, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland)

    2014-05-15

    Hybrid cardiac single photon emission computed tomography (SPECT)/CT imaging allows combined assessment of anatomical and functional aspects of cardiac disease. In coronary artery disease (CAD), hybrid SPECT/CT imaging allows detection of coronary artery stenosis and myocardial perfusion abnormalities. The clinical value of hybrid imaging has been documented in several subsets of patients. In selected groups of patients, hybrid imaging improves the diagnostic accuracy to detect CAD compared to the single imaging techniques. Additionally, this approach facilitates functional interrogation of coronary stenoses and guidance with regard to revascularization procedures. Moreover, the anatomical information obtained from CT coronary angiography or coronary artery calcium scores (CACS) adds prognostic information over perfusion data from SPECT. The use of cardiac hybrid imaging has been favoured by the dissemination of dedicated hybrid systems and the release of dedicated image fusion software, which allow simple patient throughput for hybrid SPECT/CT studies. Further technological improvements such as more efficient detector technology to allow for low-radiation protocols, ultra-fast image acquisition and improved low-noise image reconstruction algorithms will be instrumental to further promote hybrid SPECT/CT in research and clinical practice. (orig.)

  7. Cardiac tissue engineering

    Directory of Open Access Journals (Sweden)

    MILICA RADISIC

    2005-03-01

    Full Text Available We hypothesized that clinically sized (1-5 mm thick,compact cardiac constructs containing physiologically high density of viable cells (~108 cells/cm3 can be engineered in vitro by using biomimetic culture systems capable of providing oxygen transport and electrical stimulation, designed to mimic those in native heart. This hypothesis was tested by culturing rat heart cells on polymer scaffolds, either with perfusion of culture medium (physiologic interstitial velocity, supplementation of perfluorocarbons, or with electrical stimulation (continuous application of biphasic pulses, 2 ms, 5 V, 1 Hz. Tissue constructs cultured without perfusion or electrical stimulation served as controls. Medium perfusion and addition of perfluorocarbons resulted in compact, thick constructs containing physiologic density of viable, electromechanically coupled cells, in contrast to control constructs which had only a ~100 mm thick peripheral region with functionally connected cells. Electrical stimulation of cultured constructs resulted in markedly improved contractile properties, increased amounts of cardiac proteins, and remarkably well developed ultrastructure (similar to that of native heart as compared to non-stimulated controls. We discuss here the state of the art of cardiac tissue engineering, in light of the biomimetic approach that reproduces in vitro some of the conditions present during normal tissue development.

  8. Artificial neural network modelling

    CERN Document Server

    Samarasinghe, Sandhya

    2016-01-01

    This book covers theoretical aspects as well as recent innovative applications of Artificial Neural networks (ANNs) in natural, environmental, biological, social, industrial and automated systems. It presents recent results of ANNs in modelling small, large and complex systems under three categories, namely, 1) Networks, Structure Optimisation, Robustness and Stochasticity 2) Advances in Modelling Biological and Environmental Systems and 3) Advances in Modelling Social and Economic Systems. The book aims at serving undergraduates, postgraduates and researchers in ANN computational modelling. .

  9. Artificial Neural Network

    Directory of Open Access Journals (Sweden)

    Kapil Nahar

    2012-12-01

    Full Text Available An artificial neural network is an information-processing paradigm that is inspired by the way biological nervous systems, such as the brain, process information.The key element of this paradigm is the novel structure of the information processing system. It is composed of a large number of highly interconnected processing elements (neurons working in unison to solve specific problems.Ann’s, like people, learn by example.

  10. Essentials of artificial intelligence

    CERN Document Server

    Ginsberg, Matt

    1993-01-01

    Since its publication, Essentials of Artificial Intelligence has beenadopted at numerous universities and colleges offering introductory AIcourses at the graduate and undergraduate levels. Based on the author'scourse at Stanford University, the book is an integrated, cohesiveintroduction to the field. The author has a fresh, entertaining writingstyle that combines clear presentations with humor and AI anecdotes. At thesame time, as an active AI researcher, he presents the materialauthoritatively and with insight that reflects a contemporary, first hand

  11. Artificial Neural Network

    Directory of Open Access Journals (Sweden)

    Kapil Nahar

    2012-12-01

    Full Text Available An artificial neural network is an information-processing paradigm that is inspired by the way biological nervous systems, such as the brain, process information. The key element of this paradigm is the novel structure of the information processing system. It is composed of a large number of highly interconnected processing elements (neurons working in unison to solve specific problems. Ann’s, like people, learn by example.

  12. Artificial sweetener; Jinko kanmiryo

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-08-01

    The patents related to the artificial sweetener that it is introduced to the public in 3 years from 1996 until 1998 are 115 cases. The sugar quality which makes an oligosaccharide and sugar alcohol the subject is greatly over 28 cases of the non-sugar quality in the one by the kind as a general tendency of these patents at 73 cases in such cases as the Aspartame. The method of manufacture patent, which included new material around other peptides, the oligosaccharide and sugar alcohol isn`t inferior to 56 cases of the formation thing patent at 43 cases, and pays attention to the thing, which is many by the method of manufacture, formation. There is most improvement of the quality of sweetness with 31 cases in badness of the aftertaste which is characteristic of the artificial sweetener and so on, and much stability including the improvement in the flavor of food by the artificial sweetener, a long time and dissolution, fluid nature and productivity and improvement of the economy such as a cost are seen with effect on a purpose. (NEDO)

  13. ARTIFICIAL INSEMINATION IN BOVINE

    Directory of Open Access Journals (Sweden)

    A. L. M Marinho

    2016-02-01

    Full Text Available This literature review aims to show the main scientific advances achieved in the area of Artificial Insemination (AI within animal reproduction and how these can improve reproductive efficiency and productive of the Brazilian cattle herd. With knowledge of the mechanisms involved in the control of reproductive physiology, in levels endocrine, cellular and molecular, it was possible the development of reproductive biotechnologies, standing out the IA, It has been used on a large scale, by allow the multiplication of animals superior genetically , increase the birthrate and be particularly effective in adjusting the breeding season in cattle. Artificial insemination has an important role in animal genetic improvement; it is the main and more viable middle of spread of genes worldwide when compared to other methods how technologies of embryos and the natural breeding. There are several advantages in using artificial insemination in herd both of cutting as milkman, as herd genetic improvement in lesser time and at a low cost through the use of semen of demonstrably superior sires for production, well as in the control and decrease of diseases which entail reproductive losses and consequently productive, by allowing the creator The crossing of zebuine females with bulls of European breeds and vice-versa, through the use of semen, increasing the number of progeny of a reproducer superior

  14. NSTX ELM Pacing and L-H Threshold Experiments for ITER

    Science.gov (United States)

    Canik, J. M.; Maingi, R.; Sontag, A. C.; Gerhardt, S. P.; Kaye, S.; Bell, R. E.; Gates, D.; Goldston, R.; Leblanc, B. P.; Menard, J.; Park, J.-K.; Evans, T.; Osborne, T.; Sabbagh, S.; Unterberg, E. A.

    2009-11-01

    We present a summary of recent edge-localized mode (ELM) pacing and L-H power threshold (PLH) experiments performed in NSTX in support of ITER. ELM triggering using 3D magnetic perturbations was used to perform pacing during ELM-free H-modes induced by lithium conditioning, mitigating the impurity accumulation typically observed in these conditions. The waveform of the applied field has been tailored to provide high reliability triggering at frequencies of >60 Hz to reduce the average ELM size. ELM pacing was also performed using vertical position oscillations, with the ELM frequency increased to ˜30 Hz from a natural frequency of ˜15 Hz. PLH is reduced by ˜50% at low triangularity, and also decreased by ˜50% during discharge with thick lithium wall coatings. PLH was observed to increase strongly with plasma current during sustained H-modes. The influence of heating method, non-axisymmetric fields, and magnetic balance on PLH will be presented.

  15. Preparative activities in posterior parietal cortex for self-paced movement in monkeys.

    Science.gov (United States)

    Gemba, Hisae; Matsuura-Nakao, Kazuko; Matsuzaki, Ryuichi

    2004-02-26

    Cortical field potentials were recorded by electrodes implanted chronically on the surface and at a 2.0-3.0 mm depth in various cortices in monkeys performing self-paced finger, toe, mouth, hand or trunk movements. Surface-negative, depth-positive potentials (readiness potential) appeared in the posterior parietal cortex about 1.0 s before onset of every self-paced movement, as well as in the premotor, motor and somatosensory cortices. Somatotopical distribution was seen in the readiness potential in the posterior parietal cortex, although it was not so distinct as that in the motor or somatosensory cortex. This suggests that the posterior parietal cortex is involved in preparation for self-paced movement of any body part. This study contributes to the investigation of central nervous mechanisms of voluntary movements initiated by internal stimulus.

  16. The Influence of Mid-Event Deception on Psychophysiological Status and Pacing Can Persist across Consecutive Disciplines and Enhance Self-paced Multi-modal Endurance Performance

    Science.gov (United States)

    Taylor, Daniel; Smith, Mark F.

    2017-01-01

    Purpose: To examine the effects of deceptively aggressive bike pacing on performance, pacing, and associated physiological and perceptual responses during simulated sprint-distance triathlon. Methods: Ten non-elite, competitive male triathletes completed three simulated sprint-distance triathlons (0.75 km swim, 500 kJ bike, 5 km run), the first of which established personal best “baseline” performance (BL). During the remaining two trials athletes maintained a cycling power output 5% greater than BL, before completing the run as quickly as possible. However, participants were informed of this aggressive cycling strategy before and during only one of the two trials (HON). Prior to the alternate trial (DEC), participants were misinformed that cycling power output would equal that of BL, with on-screen feedback manipulated to reinforce this deception. Results: Compared to BL, a significantly faster run performance was observed following DEC cycling (p triathlon performance to be quicker during DEC (4339 ± 395 s) compared to HON (4356 ± 384 s), the only significant and almost certainly meaningful differences were between each of these trials and BL (4465 ± 420 s; p triathlon run. Conclusions: The present study is the first to show that mid-event pace deception can have a practically meaningful effect on multi-modal endurance performance, though the relative importance of different psychophysiological and emotional responses remains unclear. Whilst our findings support the view that some form of anticipatory “template” may be used by athletes to interpret levels of psychophysiological and emotional strain, and regulate exercise intensity accordingly, they would also suggest that individual constructs such as RPE and affect may be more loosely tied with pacing than previously suggested. PMID:28174540

  17. Physiological demand and pacing strategy during the new combined event in elite pentathletes.

    Science.gov (United States)

    Le Meur, Yann; Dorel, Sylvain; Baup, Yann; Guyomarch, Jean Pierre; Roudaut, Christian; Hausswirth, Christophe

    2012-07-01

    To evaluate the physiological demands and effects of different pacing strategies on performance during the new combined event (CE) of the modern pentathlon (consisting of three pistol shooting sessions interspersed by three 1-km running legs). Nine elite pentathletes realised five tests: a free-paced CE during an international competition; an incremental running test to determine [Formula: see text] and its related velocity ([Formula: see text]) and three experimental time-trial CE, where the pacing strategy was manipulated (CE(ref), CE(100%), CE(105%)). CE(ref) reproduced the international competition strategy with a 170-m fast running start within the first 2 km. CE(100%) and CE(105%) imposed a constant strategy over km-1 and km-2 with a velocity of 100 and 105% of the mean speed adopted over the same sections during the international competition, respectively. Km-3 was always self-paced. The subjects ran CE(ref) at 99 ± 4% of [Formula: see text] and reached 100 ± 5, 100 ± 7, 99 ± 8% of [Formula: see text] at the end of kilometres 1, 2 and 3, respectively ([Formula: see text]: 72 ± 6 mL O(2) min(-1) kg(-1)), with a peak blood lactate concentration of 13.6 ± 1.5 mmol L(-1). No significant differences in overall performance were found between the pacing conditions (753 ± 30, 770 ± 39, 768 ± 27 s for CE(ref), CE(100%) and CE(105%), respectively, p = 0.63), but all of the shooting performance parameters were only stable in CE(ref). Completion of CE by elite pentathletes elicits a maximal aerobic contribution coupled with a high glycolytic supply. Manipulating the mean running speed over km-1 and km-2 had strong influence on the overall pacing strategy and induced minor differences in shooting performance, but it did not affect overall performance.

  18. Developmental Differences in Effects of Task Pacing on Implicit Sequence Learning

    Directory of Open Access Journals (Sweden)

    Amanda Sue Hodel

    2014-02-01

    Full Text Available Although there is now substantial evidence that developmental change occurs in implicit learning abilities over the lifespan, disparate results exist regarding the specific developmental trajectory of implicit learning skills. One possible reason for discrepancies across implicit learning studies may be that younger children show an increased sensitivity to variations in implicit learning task procedures and demands relative to adults. Studies using serial-reaction time (SRT tasks have suggested that in adults, measurements of implicit learning are robust across variations in task procedures. Most classic SRT tasks have used response-contingent pacing in which the participant’s own reaction time determines the duration of each trial. However, recent paradigms with adults and children have used fixed trial pacing, which leads to alterations in both response and attention demands, accuracy feedback, perceived agency, and task motivation for participants. In the current study, we compared learning on fixed-paced and self-paced versions of a spatial sequence learning paradigm in 4-year-old children and adults. Results indicated that preschool-aged children showed reduced evidence of implicit sequence learning in comparison to adults, regardless of the SRT paradigm used. In addition, we found the preschoolers showed significantly greater learning when stimulus presentation was self-paced. These data provide evidence for developmental differences in implicit sequence learning that are dependent on specific task demands such as stimulus pacing, which may be related to developmental changes in the impact of broader constructs such as attention and task motivation on implicit learning.

  19. First Observation Of ELM Pacing With Vertical Jogs In A Spherical Torus

    Energy Technology Data Exchange (ETDEWEB)

    Gerhardt, S P; Canik, J M; Maingi, R; Bell, R; Gates, d; Goldston, R; Hawryluk, R; Le Blanc, B P; Menard, J; Sontag, A C; Sabbagh, S

    2010-07-15

    Experiments in a number of conventional aspect ratio tokamaks have been successful in pacing edge localized modes (ELMs) by rapid vertical jogging of the plasma. This paper demonstrates the first pacing of ELMs in a spherical torus plasma. Applied 30 Hz vertical jogs synchronized the ELMs with the upward motion of the plasma. 45 Hz jogs also lead to an increase in the ELM frequency, though the synchronization of the ELMs and jogs was unclear. A reduction in the ELM energy was observed at the higher driven ELM frequencies. __________________________________________________

  20. First observation of ELM pacing with vertical jogs in a spherical torus

    Energy Technology Data Exchange (ETDEWEB)

    Gerhardt, S.P. [Princeton Plasma Physics Laboratory (PPPL); Ahn, Joon-Wook [Oak Ridge National Laboratory (ORNL); Canik, John [ORNL; Maingi, R. [Oak Ridge National Laboratory (ORNL); Bell, R. [Princeton Plasma Physics Laboratory (PPPL); Gates, D. [Princeton Plasma Physics Laboratory (PPPL); Goldston, R. [Princeton Plasma Physics Laboratory (PPPL); Hawryluk, R. [Princeton Plasma Physics Laboratory (PPPL); Le Blanc, B. P. [Princeton Plasma Physics Laboratory (PPPL); Menard, J. [Princeton Plasma Physics Laboratory (PPPL); Sontag, Aaron C [ORNL; Sabbagh, S. A. [Columbia University; Tritz, K. [Johns Hopkins University

    2010-01-01

    Experiments in a number of conventional aspect ratio tokamaks have been successful in pacing edge localized modes (ELMs) by rapid vertical jogging of the plasma. This paper demonstrates the first pacing of ELMs in a spherical torus plasma. Applied 30 Hz vertical jogs synchronized the ELMs with the upward motion of the plasma. 45 Hz jogs also lead to an increase in the ELM frequency, though the synchronization of the ELMs and jogs was unclear. A reduction in the ELM energy was observed at the higher driven ELM frequencies.

  1. First observation of ELM pacing with vertical jogs in a spherical torus

    Science.gov (United States)

    Gerhardt, S. P.; Ahn, J.-W.; Canik, J. M.; Maingi, R.; Bell, R.; Gates, D.; Goldston, R.; Hawryluk, R.; Le Blanc, B. P.; Menard, J.; Sontag, A. C.; Sabbagh, S.; Tritz, K.

    2010-06-01

    Experiments in a number of conventional aspect ratio tokamaks have been successful in pacing edge localized modes (ELMs) by rapid vertical jogging of the plasma. This paper demonstrates the first pacing of ELMs in a spherical torus plasma. Applied 30 Hz vertical jogs synchronized the ELMs with the upward motion of the plasma. 45 Hz jogs also lead to an increase in the ELM frequency, though the synchronization of the ELMs and jogs was unclear. A reduction in the ELM energy was observed at the higher driven ELM frequencies.

  2. Pacing Lead-Induced Granuloma in the Atrium: A Foreign Body Reaction to Polyurethane

    Directory of Open Access Journals (Sweden)

    Shinagawa Yoko

    2013-01-01

    Full Text Available We described a case of an 82-year-old male who presented with a granuloma entrapping the polyurethane-coated pacing lead at the site of contact on the atrium. He had been paced for 8 years without symptoms or signs suggestive of an allergic reaction to the pacemaker system and died from thrombosis of the superior mesenteric artery and heart failure. A histological examination of the nodule showed an incidental granuloma with multinucleated giant cells. No granuloma was found in the heart or the lung.

  3. MCTS self-paced training kit (exam 70-680) configuring Windows 7

    CERN Document Server

    McLean, Ian

    2010-01-01

    NOTE: The most recent printings of this title incorporate corrections to errors found in the earlier printings. This Self-Paced Training Kit is designed to help maximize your performance on 70-680, the required exam for the Microsoft® Certified Technology Specialist (MCTS): Windows 7, Configuration certification.This 2-in-1 kit includes the official Microsoft study guide, plus practice tests on CD to help you assess your skills. It comes packed with the tools and features exam candidates want most-including in-depth, self-paced training based on final exam content; rigorous, objective-by-obj

  4. Pacing the Cell: Walking and Productivity in the Work of Bruce Nauman

    Directory of Open Access Journals (Sweden)

    Ruth Burgon

    2016-12-01

    Full Text Available After graduating from art school in the late 1960s Bruce Nauman found himself pacing his studio, unsure how to produce work as a professional artist. Out of this practice arose several films and videos recording these performances of studio pacing. This paper draws upon Michel Foucault’s Discipline and Punish (1975, translated into English 1977 to shed light upon the aesthetic of confinement and incarceration found in Nauman’s use of the walking body in this early work.

  5. Unification of Frequency direction Pilot-symbol Aided Channel Estimation (PACE) for OFDM

    DEFF Research Database (Denmark)

    Rom, Christian; Manchón, Carles Navarro; Deneire, Luc

    2007-01-01

    Frequency direction Pilot-symbol Aided Channel Estimation (PACE) for Orthogonal Frequency Division Multiplexing (OFDM) is crucial in high-rate wireless systems. The choice of an estimator for upcoming standards, such as the Long Term Evolution (LTE) of UTRA, has to take into account their specifi......Frequency direction Pilot-symbol Aided Channel Estimation (PACE) for Orthogonal Frequency Division Multiplexing (OFDM) is crucial in high-rate wireless systems. The choice of an estimator for upcoming standards, such as the Long Term Evolution (LTE) of UTRA, has to take into account...

  6. Crawling to the finish line: why do endurance runners collapse? Implications for understanding of mechanisms underlying pacing and fatigue.

    Science.gov (United States)

    St Clair Gibson, Alan; De Koning, Jos J; Thompson, Kevin G; Roberts, William O; Micklewright, Dominic; Raglin, John; Foster, Carl

    2013-06-01

    Effective regulation of pace enables the majority of runners to complete competitive endurance events without mishap. However, some runners do experience exercise-induced collapse associated with postural hypotension, which in rare cases results from life-threatening conditions such as cardiac disorders, cerebral events, heat stroke and hyponatraemia. Despite the experience of either catastrophic system failure or extreme peripheral muscle fatigue, some runners persist in attempting to reach the finish line, and this often results in a sequence of dynamic changes in posture and gait that we have termed the 'Foster collapse positions'. The initial stage involves an unstable gait and the runner assumes the 'Early Foster' collapse position with hips slightly flexed and their head lowered. This unstable gait further degrades into a shuffle referred to as the 'Half Foster' collapse position characterized by hip flexion of approximately 90° with the trunk and head parallel to the ground. At this point, the muscles of postural support and the co-ordination of propulsion begin to be compromised. If the condition worsens, the runner will fall to the ground and assume the 'Full Foster' collapse position, which involves crawling forwards on knees and elbows towards the finish line, with their trunk angled such that the head is at a lower angle than the hips. Upon reaching the finish line, or sometimes before that, the runner may collapse and remain prone until recovering either with or without assistance or medical treatment. The Foster collapse positions are indicative of a final, likely primordial, protective mechanism designed to attenuate postural hypotension, cardiac 'pump' insufficiency or cerebral blood flow deficiency. Continuing to attempt to reach the finish line in this impaired state is also perhaps indicative of a high psychological drive or a variety of neurological and psychological pathologies such as diminished sensitivity to interoceptive feedback

  7. β-Adrenergic stimulation and rapid pacing mutually promote heterogeneous electrical failure and ventricular fibrillation in the globally ischemic heart.

    Science.gov (United States)

    Garg, Vivek; Taylor, Tyson; Warren, Mark; Venable, Paul; Sciuto, Katie; Shibayama, Junko; Zaitsev, Alexey

    2015-05-01

    Global ischemia, catecholamine surge, and rapid heart rhythm (RHR) due to ventricular tachycardia or ventricular fibrillation (VF) are the three major factors of sudden cardiac arrest (SCA). Loss of excitability culminating in global electrical failure (asystole) is the major adverse outcome of SCA with increasing prevalence worldwide. The roles of catecholamines and RHR in the electrical failure during SCA remain unclear. We hypothesized that both β-adrenergic stimulation (βAS) and RHR accelerate electrical failure in the globally ischemic heart. We performed optical mapping of the action potential (OAP) in the right ventricular (RV) and left (LV) ventricular epicardium of isolated rabbit hearts subjected to 30-min global ischemia. Hearts were paced at a cycle length of either 300 or 200 ms, and either in the presence or in the absence of β-agonist isoproterenol (30 nM). 2,3-Butanedione monoxime (20 mM) was used to reduce motion artifact. We found that RHR and βAS synergistically accelerated the decline of the OAP upstroke velocity and the progressive expansion of inexcitable regions. Under all conditions, inexcitability developed faster in the LV than in the RV. At the same time, both RHR and βAS shortened the time to VF (TVF) during ischemia. Moreover, the time at which 10% of the mapped LV area became inexcitable strongly correlated with TVF (R(2) = 0 .72, P < 0.0001). We conclude that both βAS and RHR are major factors of electrical depression and failure in the globally ischemic heart and may contribute to adverse outcomes of SCA such as asystole and recurrent/persistent VF.

  8. Case Report: Penetrating Cardiac Injury

    Directory of Open Access Journals (Sweden)

    Adem Grbolar

    2013-10-01

    Full Text Available Summary: Penetrating cardiac injurys caused by gunshots and penetrating tools have high mortality rates. The way of injury, how the cardiac area is effected and the presence of cardiac tamponadecauses mortality in different rates. However the better treatment quality of hospitals, increasingoperative techniques, and internel care unit quality has not been change during the years. Searching the literature, we want to present a 42 years old male patient whowas injured by knife and had a 1 cm skin wound on chest with cardiac tamponade. After sternotomy a 7 cm laseration was observed in heart. Cardioraphy was performed.

  9. Cardiac surgery for Kartagener syndrome.

    Science.gov (United States)

    Tkebuchava, T; von Segesser, L K; Niederhäuser, U; Bauersfeld, U; Turina, M

    1997-01-01

    Two patients (one girl, one boy) with Kartagener syndrome (situs inversus, bronchiectasis, sinusitis), despite pulmonary problems and associated congenital cardiac anomalies, were operated on at the ages of 4 years and 7 years, respectively. They had had previous palliative treatment at the age of 3 months and 1.3 years, respectively. Both postoperative periods after total correction were without significant complications. Long-term follow-up was available for 9 and 19 years, respectively, with no manifestations of heart insufficiency. Both patients are physically active, and neither requires cardiac medication. Patients with Kartagener syndrome and associated congenital cardiac anomalies can successfully undergo multiple cardiac operations with good long-term outcome.

  10. Artificial intelligence in hematology.

    Science.gov (United States)

    Zini, Gina

    2005-10-01

    Artificial intelligence (AI) is a computer based science which aims to simulate human brain faculties using a computational system. A brief history of this new science goes from the creation of the first artificial neuron in 1943 to the first artificial neural network application to genetic algorithms. The potential for a similar technology in medicine has immediately been identified by scientists and researchers. The possibility to store and process all medical knowledge has made this technology very attractive to assist or even surpass clinicians in reaching a diagnosis. Applications of AI in medicine include devices applied to clinical diagnosis in neurology and cardiopulmonary diseases, as well as the use of expert or knowledge-based systems in routine clinical use for diagnosis, therapeutic management and for prognostic evaluation. Biological applications include genome sequencing or DNA gene expression microarrays, modeling gene networks, analysis and clustering of gene expression data, pattern recognition in DNA and proteins, protein structure prediction. In the field of hematology the first devices based on AI have been applied to the routine laboratory data management. New tools concern the differential diagnosis in specific diseases such as anemias, thalassemias and leukemias, based on neural networks trained with data from peripheral blood analysis. A revolution in cancer diagnosis, including the diagnosis of hematological malignancies, has been the introduction of the first microarray based and bioinformatic approach for molecular diagnosis: a systematic approach based on the monitoring of simultaneous expression of thousands of genes using DNA microarray, independently of previous biological knowledge, analysed using AI devices. Using gene profiling, the traditional diagnostic pathways move from clinical to molecular based diagnostic systems.

  11. Management of radiation therapy patients with cardiac defibrillator or pacemaker.

    Science.gov (United States)

    Salerno, Francesca; Gomellini, Sara; Caruso, Cristina; Barbara, Raffaele; Musio, Daniela; Coppi, Tamara; Cardinale, Mario; Tombolini, Vincenzo; de Paula, Ugo

    2016-06-01

    The increasing growth of population with cardiac implantable electronic devices (CIEDs) such as Pacemaker (PM) and Implantable Cardiac Defibrillators (ICD), requires particular attention in management of patients needing radiation treatment. This paper updates and summarizes some recommendations from different international guidelines. Ionizing radiation and/or electromagnetic interferences could cause device failure. Current approaches to treatment in patients who have these devices vary among radiation oncology centres. We refer to the German Society of Radiation Oncology and Cardiology guidelines (ed. 2015); to the Society of Cardiology Australia and New Zealand Statement (ed. 2015); to the guidelines in force in the Netherlands (ed. 2012) and to the Italian Association of Radiation Oncology recommendations (ed. 2013) as reported in the guidelines for the treatment of breast cancer in patients with CIED. Although there is not a clear cut-off point, risk of device failure increases with increasing doses. Cumulative dose and pacing dependency have been combined to categorize patients into low-, medium- and high-risk groups. Measures to secure patient safety are described for each category. The use of energy ≤6MV is preferable and it's strongly recommended not to exceed a total dose of 2 Gy to the PM and 1 Gy for ICD. Given the dangers of device malfunction, radiation oncology departments should adopt all the measures designed to minimize the risk to patients. For this reason, a close collaboration between cardiologist, radiotherapist and physicist is necessary.

  12. Clinical applications of magnets on cardiac rhythm management devices.

    Science.gov (United States)

    Jacob, Sony; Panaich, Sidakpal S; Maheshwari, Rahul; Haddad, John W; Padanilam, Benzy J; John, Sinoj K

    2011-09-01

    The growing indications for permanent pacemaker and implantable cardioverter defibrillator (ICD) implantation have increased the number of patients with these cardiac rhythm management devices (CRMDs). Cardiac rhythm management devices occasionally perform inappropriately in response to electromagnetic interference (e.g. surgical electrocautery) or lead noise over-sensing (e.g. lead fracture). Temporary reprogramming of the CRMDs using device programmers can prevent these untoward device responses. However, these programmers are device manufacturer specific and require technically qualified personnel to operate. This could cause delayed patient care and increased use of resources in certain clinical situations. Alternatively, clinical magnets, when appropriately positioned over the device site, can change the pacing to an asynchronous mode in pacemakers and suspend tachycardia therapies in ICDs. Although readily available, clinical magnets have not been widely used for this purpose, perhaps due to the unfamiliarity with the variable responses of CRMDs to magnet application. This article provides a comprehensive overview of the current literature on the mechanism of action and the specific responses of various CRMDs to clinical magnets.

  13. Practical aspects of cardiac tissue engineering with electrical stimulation.

    Science.gov (United States)

    Cannizzaro, Christopher; Tandon, Nina; Figallo, Elisa; Park, Hyoungshin; Gerecht, Sharon; Radisic, Milica; Elvassore, Nicola; Vunjak-Novakovic, Gordana

    2007-01-01

    Heart disease is a leading cause of death in western society. Despite the success of heart transplantation, a chronic shortage of donor organs, along with the associated immunological complications of this approach, demands that alternative treatments be found. One such option is to repair, rather than replace, the heart with engineered cardiac tissue. Multiple studies have shown that to attain functional tissue, assembly signaling cues must be recapitulated in vitro. In their native environment, cardiomyocytes are directed to beat in synchrony by propagation of pacing current through the tissue. Recently, we have shown that electrical stimulation directs neonatal cardiomyocytes to assemble into native-like tissue in vitro. This chapter provides detailed methods we have employed in taking this "biomimetic" approach. After an initial discussion on how electric field stimulation can influence cell behavior, we examine the practical aspects of cardiac tissue engineering with electrical stimulation, such as electrode selection and cell seeding protocols, and conclude with what we feel are the remaining challenges to be overcome.

  14. Polymer artificial muscles

    Directory of Open Access Journals (Sweden)

    Tissaphern Mirfakhrai

    2007-04-01

    Full Text Available The various types of natural muscle are incredible material systems that enable the production of large deformations by repetitive molecular motions. Polymer artificial muscle technologies are being developed that produce similar strains and higher stresses using electrostatic forces, electrostriction, ion insertion, and molecular conformational changes. Materials used include elastomers, conducting polymers, ionically conducting polymers, and carbon nanotubes. The mechanisms, performance, and remaining challenges associated with these technologies are described. Initial applications are being developed, but further work by the materials community should help make these technologies applicable in a wide range of devices where muscle-like motion is desirable.

  15. Mechanism of artificial heart

    CERN Document Server

    Yamane, Takashi

    2016-01-01

    This book first describes medical devices in relation to regenerative medicine before turning to a more specific topic: artificial heart technologies. Not only the pump mechanisms but also the bearing, motor mechanisms, and materials are described, including expert information. Design methods are described to enhance hemocompatibility: main concerns are reduction of blood cell damage and protein break, as well as prevention of blood clotting. Regulatory science from R&D to clinical trials is also discussed to verify the safety and efficacy of the devices.

  16. Uncertainty in artificial intelligence

    CERN Document Server

    Kanal, LN

    1986-01-01

    How to deal with uncertainty is a subject of much controversy in Artificial Intelligence. This volume brings together a wide range of perspectives on uncertainty, many of the contributors being the principal proponents in the controversy.Some of the notable issues which emerge from these papers revolve around an interval-based calculus of uncertainty, the Dempster-Shafer Theory, and probability as the best numeric model for uncertainty. There remain strong dissenting opinions not only about probability but even about the utility of any numeric method in this context.

  17. Bayesian artificial intelligence

    CERN Document Server

    Korb, Kevin B

    2010-01-01

    Updated and expanded, Bayesian Artificial Intelligence, Second Edition provides a practical and accessible introduction to the main concepts, foundation, and applications of Bayesian networks. It focuses on both the causal discovery of networks and Bayesian inference procedures. Adopting a causal interpretation of Bayesian networks, the authors discuss the use of Bayesian networks for causal modeling. They also draw on their own applied research to illustrate various applications of the technology.New to the Second EditionNew chapter on Bayesian network classifiersNew section on object-oriente

  18. Diagnostic accuracy of metronome-paced tachypnea to detect dynamic hyperinflation

    NARCIS (Netherlands)

    Lahaije, A.J.M.C.; Willems, L.M.; Hees, H.W. van; Dekhuijzen, P.N.R.; Helvoort, H.A.C. van; Heijdra, Y.F.

    2013-01-01

    INTRODUCTION: This prospective study was carried out to investigate if metronome-paced tachypnea (MPT) can serve as an accurate diagnostic tool to identify patients with chronic obstructive pulmonary disease (COPD) who are susceptible to develop dynamic hyperinflation during exercise. Commonly, this

  19. Dynamic hyperinflation after metronome-paced hyperventilation in COPD--a 2 year follow-up.

    NARCIS (Netherlands)

    Hannink, J.D.C.; Lahaije, A.; Bischoff, E.W.M.A.; Helvoort, H.A.C. van; Dekhuijzen, R.; Schermer, T.R.J.; Heijdra, Y.F.

    2010-01-01

    In contrast to the decline in FEV(1), the behavior of dynamic hyperinflation (DH) over time is unknown in patients with COPD. Metronome-paced hyperventilation (MPH) is a simple applicable surrogate for exercise to detect DH. OBJECTIVE: To evaluate changes in MPH-induced DH during two years follow-up

  20. Pacing Behavior and Tactical Positioning in 500-and 1000-m Short-Track Speed Skating

    NARCIS (Netherlands)

    Noorbergen, Olaf S.; Konings, Marco J.; Micklewright, Dominic; Elferink-Gemser, Marge T.; Hettinga, Florentina J.

    2016-01-01

    Purpose: To explore pacing behavior and tactical positioning during the shorter 500- and 1000-m short-track competitions. Methods: Lap times and intermediate rankings of elite 500- and 1000-m short-track-skating competitors were collected over the 2012-13 season. First, lap times were analyzed using

  1. China's Manufacturing Expands at Slowest Pace in 28 Months

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    The manufacturing sector expanded at its slowest pace in 28 months in June, with the Purchasing Managers Index (PMI) falling 1.1 percentage points monthon-month to 50.9 percent, according to the China Federation of Logistics and Purchasing (CFLP).

  2. On the Cutting Edge (of Torpor): Innovation and the Pace of Change in American Higher Education

    Science.gov (United States)

    Murray, Gordon

    2008-01-01

    This article considers the pace of innovation and technology adoption in higher education and suggests that the rate of change on 21st century campuses is remarkably similar to earlier centuries when it may have taken over 30 years to introduce "modern" inventions like the telescope, microscope, and barometer to students. The literature shows that…

  3. Characterizing the concept of activity pacing as a non-pharmacological intervention in rheumatology care

    DEFF Research Database (Denmark)

    Cuperus, N; Vliet Vlieland, Tpm; Brodin, N;

    2016-01-01

    OBJECTIVE: To develop a consensual list of the most important aspects of activity pacing (AP) as an intervention within the context of non-pharmacological rheumatology care. METHOD: An international, multidisciplinary expert panel comprising 60 clinicians and/or healthcare providers experienced i...

  4. Self-Pacing a Gross Motor Skills Course: Crawler Tractor Operator, MOS 62E20.

    Science.gov (United States)

    Brennan, Mark F.; Taylor, John E.

    As part of the Army's emphasis on performance-oriented instruction in training centers, a study was conducted to determine the feasibility of using self-paced instruction in a gross motor skills course. The Crawler Tractor Operator Course, a seven-week heavy equipment course conducted at Fort Leonard Wood, Missouri was selected for the study…

  5. Molecular mechanisms of early atrial remodeling by rapid atrial pacing in rabbits

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To establish a rabbit atrial fibrillation model with rapid atrial pacing (RAP) and investigate its ultrastructural changes and expressions of L-type calcium channel subunits and potassium channel Ky4.3. Methods: Thirty-six rabbits were performed electrical stimulation through bipolar endocardial led by surgical technique, 600 beat per min from 0 to 48 h. Atrial ultrastructure was observed by transmission electron microscope (TEM) after different pacing times. mRNA were measured by reverse transcription-polymerase chain reaction (RT-PCR). Results: Atrial ultrastructure had alteration after 3 hours' pacing, such as mitochondria vacuolization, myofilament lysis and glucogen aggregation. The mRNA of the Ca2+ channel β1 and α1 subunits began to decrease after pacing of 6 h, which were paralleled with the change of Kv4.3 mRNA. But the auxiliary subunit α2 were not affected. Conclusion: Ultrastructural changes and mRNA levels of L-type calcium channel subunits and potassium channel Kv4.3 are decreased after RAP, with a mechanism of transcriptional down-regulation of underlying ion channels due to calcium overloading after RAP.

  6. Developmental Pacing as an Alternative to Ability Grouping in a Primary Setting.

    Science.gov (United States)

    Piel, John A.

    An alternative to ability grouping for instructional purposes exists. Cognitive developmental grouping (CDG), sometimes labeled "tracking" or "pacing," organizes students in terms of similar learning styles and takes into consideration the child's intellectual maturation rather than performance within a particular curriculum…

  7. Constitutive innate immunity is a component of the pace-of-life syndrome in tropical birds

    NARCIS (Netherlands)

    Tieleman, BI; Williams, JB; Ricklefs, RE; Klasing, KC; Williams, Joseph B.; Ricklefs, Robert E.; Klasing, Kirk C.

    2005-01-01

    We studied the relationship between one component of immune function and basal metabolic rate (BMR), an indicator of the 'pace-of-life syndrome', among 12 tropical bird species and among individuals of the tropical house wren (Troglodytes aedon), to gain insights into functional connections between

  8. Effects of wind application on thermal perception and self-paced performance

    NARCIS (Netherlands)

    Teunissen, L.P.J.; Haan, A. de; Koning, J.J. de; Daanen, H.A.M.

    2013-01-01

    Physiological and perceptual effects of wind cooling are often intertwined and have scarcely been studied in self-paced exercise. Therefore, we aimed to investigate (1) the independent perceptual effect of wind cooling and its impact on performance and (2) the responses to temporary wind cooling dur

  9. VDDR pacing after His-bundle ablation for paroxysmal atrial fibrillation : A pilot study

    NARCIS (Netherlands)

    Buys, EM; van Hemel, NM; Jessurun, ER; Bakema, L; Kingma, JH

    1998-01-01

    His-bundle ablation followed by pacemaker implantation is today a widely accepted therapeutic choice when drug refractoriness of symptomatic AF is evident. The selection of pacing mode in patients suffering from paroxysmal AF is still controversial. Preservation of AV synchrony is an attractive opti

  10. Exercise capacity in children with isolated congenital complete atrioventricular block: does pacing make a difference?

    NARCIS (Netherlands)

    Blank, A.C.; Hakim, S.; Strengers, J.L.; Tanke, R.B.; Veen, T.A. van; Vos, M.E. de; Takken, T.

    2012-01-01

    The management of patients with isolated congenital complete atrioventricular block (CCAVB) has changed during the last decades. The current policy is to pace the majority of patients based on a variety of criteria, among which is limited exercise capacity. Data regarding exercise capacity in this p

  11. Exercise Capacity in Children With Isolated Congenital Complete Atrioventricular Block : Does Pacing Make a Difference?

    NARCIS (Netherlands)

    Blank, A. Christian; Hakim, Sara; Strengers, Jan L.; Tanke, Ronald B.; van Veen, Toon A.; Vos, Marc A.; Takken, Tim

    2012-01-01

    The management of patients with isolated congenital complete atrioventricular block (CCAVB) has changed during the last decades. The current policy is to pace the majority of patients based on a variety of criteria, among which is limited exercise capacity. Data regarding exercise capacity in this p

  12. Investigating the Effects of Concurrent Performance of Physical and Cognitive Demanding Task in Paced Assembly Lines

    Directory of Open Access Journals (Sweden)

    Shakil Ahmed Shaikh

    2013-07-01

    Full Text Available The study was undertaken to investigate the effects of pacing on aspects of performance at an assembly task and on the operators' responses related to work behaviour, perceived workload and perceived stress. A particular objective of the study was to investigate whether physical and cognitive demands may interact in their influences on these effects. An assembly task was simulated in the laboratory and the level of pacing imposed, work height and memory load within the task were all varied. The results showed that the type of pacing commonly imposed (as is common with a lean manufacturing Takt time system in industry can significantly affect both performance and perceived workload and stress. Physical demands (through work height affecting posture and mental demand (through memory load were also found to have significant effects, as would be expected from the many studies of these in the literature. More importantly, some interactions were found between pacing and work height in their effects on quality of assembly and the operator's own rating of performance, and between work height and memory load in their effects on errors. These findings will need to be taken into account by companies when implementing Takt time systems.

  13. Pacing, the missing piece of the puzzle to high-intensity interval training.

    Science.gov (United States)

    Zadow, E K; Gordon, N; Abbiss, C R; Peiffer, J J

    2015-03-01

    This study examined physiological and perceptual responses to matched work high-intensity interval training using all-out and 2 even-paced methodologies. 15 trained male cyclists performed 3 interval sessions of three 3-min efforts with 3 min of active recovery between efforts. The initial interval session was completed using all-out pacing, with the following 2 sessions being completed with computer- and athlete-controlled pacing in a randomised and semi-counterbalanced manner. Computer- and athlete-controlled intervals were completed at the mean power from the corresponding interval during the all-out trial. Oxygen consumption and ratings of perceived exertion were recorded during each effort. 20 min following each session, participants completed a 4-km time trial and provided sessional rating of perceived exertion. Oxygen consumption was greater during all-out (54.1±6.6 ml.kg(-1).min(-1); pintervals. Distribution of pace throughout high-intensity interval training can influence perceptual and metabolic stress along with subsequent performance and should be considered during the prescription of such training.

  14. Pacing Strategy, Muscle Fatigue and Technique in 1500m Speed Skating and Cycling Time-Trials

    NARCIS (Netherlands)

    Stoter, Inge K; MacIntosh, Brian R; Fletcher, Jared R; Pootz, Spencer; Zijdewind, Inge; Hettinga, Florentina J

    2016-01-01

    PURPOSE: To evaluate pacing behavior and peripheral and central contributions to muscle fatigue in 1500m speed skating and cycling time-trials, when a faster or slower start is instructed. METHODS: Nine speed skaters and nine cyclists, all competing at regional or national level, performed two 1500m

  15. Unusual QRS morphology on ECG: a rare condition and an interesting response to pacing.

    Science.gov (United States)

    Gula, Lorne J; Eckart, Robert E; Klein, George J; Peralta, Adelqui

    2005-08-01

    We present the interesting case of a young man with borderline wide QRS complexes noted on electrocardiogram (ECG). The diagnosis of an unusual form of preexcitation was reached using observations from intracardiac tracings at electrophysiology study. Atrial pacing consistently resulted in further widening of the first conducted QRS complex, and the physiology underlying this unusual finding is explored.

  16. Mobitz type I atrio-ventricular block in dengue myocarditis, requiring temporary pacing

    Directory of Open Access Journals (Sweden)

    S. de Mel

    2015-01-01

    Full Text Available We present a case of dengue myocarditis related Mobitz type I atrio-ventricular (A-V block. To our knowledge, this is the first report of such a patient requiring pacing. An early response to methylprednisolone suggests the possibility of a therapeutic role for steroids in these patients.

  17. Early Sensitivity to Discourse-Level Anomalies: Evidence from Self-Paced Reading

    Science.gov (United States)

    Stewart, Andrew J.; Kidd, Evan; Haigh, Matthew

    2009-01-01

    Two word-by-word, self-paced reading experiments investigated the speed with which readers were sensitive to discourse-level anomalies. An account arguing for delayed sensitivity (Guzman & Klin, 2000) was contrasted with one allowing for rapid sensitivity (Myers & O'Brien, 1998). Anomalies related to spatial information (Experiment 1) and…

  18. Evaluation of Parent and Child Enhancement (PACE) Program: Randomized Controlled Trial

    Science.gov (United States)

    Leung, Cynthia; Tsang, Sandra; Lo, Cyrus

    2017-01-01

    Objective: This study examined the efficacy of the Parent and Child Enhancement (PACE) program on child learning, child behavior problems, and parental stress, using randomized controlled trial design, in social services centers. Methods: Eligibility criteria were (1) children aged 2 years at program commencement, (2) low-income, new immigrant, or…

  19. Children's Use of Self-Paced Slideshows: An Extension of the Video Deficit Effect?

    Science.gov (United States)

    Sage, Kara D.; Baldwin, Dare

    2015-01-01

    Past research has established that children typically learn better from live demonstrations than from two-dimensional (2D) media. In the present set of experiments, we investigated the efficacy of a new 2D learning medium-the self-paced slideshow. A primary goal was to determine whether the "video deficit effect" extended to self-paced…

  20. Using "U-Pace" Instruction to Improve the Academic Performance of Economically Disadvantaged Undergraduates

    Science.gov (United States)

    Fleming, R.; Stoiber, L. C.; Pfeiffer, H. M.; Kienzler, S. E.; Fleming, R. R.; Pedrick, L. E.; Barth, D. J.; Reddy, D. .

    2016-01-01

    This study was undertaken to evaluate whether the student success associated with the "U-Pace" instructional approach, which integrates mastery-based learning with proactive instructor support in an online learning environment, would replicate for both economically disadvantaged students and students who are not economically…

  1. Effect of heat and heat acclimatization on cycling time trial performance and pacing

    DEFF Research Database (Denmark)

    Racinais, Sebastien; Périard, Julien D; Karlsen, Anders;

    2015-01-01

    PURPOSE: To determine the effects of heat-acclimatization on performance and pacing during outdoor cycling time-trials (TT, 43.4km) in the heat. METHODS: Nine cyclists performed 3 TTs in hot ambient conditions (TTH, ∼37ºC) on the first (TTH-1), sixth (TTH-2) and fourteenth (TTH-3) days of trainin...

  2. Artificial Intelligence in Space Platforms.

    Science.gov (United States)

    1984-12-01

    computer algorithms, there still appears to be a need for Artificial Inteligence techniques in the navigation area. The reason is that navigaion, in...RD-RI32 679 ARTIFICIAL INTELLIGENCE IN SPACE PLRTFORNSMU AIR FORCE 1/𔃼 INST OF TECH WRIGHT-PRTTERSON AFB OH SCHOOL OF ENGINEERING M A WRIGHT DEC 94...i4 Preface The purpose of this study was to analyze the feasibility of implementing Artificial Intelligence techniques to increase autonomy for

  3. Trimaran Resistance Artificial Neural Network

    Science.gov (United States)

    2011-01-01

    11th International Conference on Fast Sea Transportation FAST 2011, Honolulu, Hawaii, USA, September 2011 Trimaran Resistance Artificial Neural Network Richard...Trimaran Resistance Artificial Neural Network 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e... Artificial Neural Network and is restricted to the center and side-hull configurations tested. The value in the parametric model is that it is able to

  4. Parallel artificial liquid membrane extraction

    DEFF Research Database (Denmark)

    Gjelstad, Astrid; Rasmussen, Knut Einar; Parmer, Marthe Petrine

    2013-01-01

    This paper reports development of a new approach towards analytical liquid-liquid-liquid membrane extraction termed parallel artificial liquid membrane extraction. A donor plate and acceptor plate create a sandwich, in which each sample (human plasma) and acceptor solution is separated by an arti...... by an artificial liquid membrane. Parallel artificial liquid membrane extraction is a modification of hollow-fiber liquid-phase microextraction, where the hollow fibers are replaced by flat membranes in a 96-well plate format....

  5. How to teach artificial organs.

    Science.gov (United States)

    Zapanta, Conrad M; Borovetz, Harvey S; Lysaght, Michael J; Manning, Keefe B

    2011-01-01

    Artificial organs education is often an overlooked field for many bioengineering and biomedical engineering students. The purpose of this article is to describe three different approaches to teaching artificial organs. This article can serve as a reference for those who wish to offer a similar course at their own institutions or incorporate these ideas into existing courses. Artificial organ classes typically fulfill several ABET (Accreditation Board for Engineering and Technology) criteria, including those specific to bioengineering and biomedical engineering programs.

  6. [Artificial neural networks in Neurosciences].

    Science.gov (United States)

    Porras Chavarino, Carmen; Salinas Martínez de Lecea, José María

    2011-11-01

    This article shows that artificial neural networks are used for confirming the relationships between physiological and cognitive changes. Specifically, we explore the influence of a decrease of neurotransmitters on the behaviour of old people in recognition tasks. This artificial neural network recognizes learned patterns. When we change the threshold of activation in some units, the artificial neural network simulates the experimental results of old people in recognition tasks. However, the main contributions of this paper are the design of an artificial neural network and its operation inspired by the nervous system and the way the inputs are coded and the process of orthogonalization of patterns.

  7. Development of artificial empathy.

    Science.gov (United States)

    Asada, Minoru

    2015-01-01

    We have been advocating cognitive developmental robotics to obtain new insight into the development of human cognitive functions by utilizing synthetic and constructive approaches. Among the different emotional functions, empathy is difficult to model, but essential for robots to be social agents in our society. In my previous review on artificial empathy (Asada, 2014b), I proposed a conceptual model for empathy development beginning with emotional contagion to envy/schadenfreude along with self/other differentiation. In this article, the focus is on two aspects of this developmental process, emotional contagion in relation to motor mimicry, and cognitive/affective aspects of the empathy. It begins with a summary of the previous review (Asada, 2014b) and an introduction to affective developmental robotics as a part of cognitive developmental robotics focusing on the affective aspects. This is followed by a review and discussion on several approaches for two focused aspects of affective developmental robotics. Finally, future issues involved in the development of a more authentic form of artificial empathy are discussed.

  8. Creating an Artificial Muscle

    Science.gov (United States)

    Bohon, Katherine; Krause, Sonja

    1997-03-01

    Striated skeletal muscle responds to a nerve impulse in less than 100 ms. In the past, polymeric gels and conducting polymers have been investigated for use as artificial muscle. However, the main problem with these materials is their relatively slow response (>3 seconds). On the other hand, electrorheological (ER) fluids are materials that change from a liquid to a solid upon application of an electric field. These fluids have a response on the order of a millisecond. A novel approach to artificial muscle utilizing the fast time response of ER fluids and the elasticity of polymeric gels has been investigated. A commercial sample of a two-part poly(dimethyl siloxane) (PDMS) dielectric gel was used. The PDMS was cured around two flexible electrodes 5 mm apart while a mixture of PDMS with solvent was cured between the electrodes. The solvents were either silicone oil or an ER fluid composed of crosslinked poly(ethylene oxide) (PEO) particles in silicone oil. The mixtures investigated were 90/10, 60/40, 50/50, 40/60, 10/90 PDMS/solvent. Upon application of a 6.2 kV/cm DC electric field the gel was reversibly compressed. The time response of the gel was actuator has been created using the 60/40 PDMS/ER fluid mixture.

  9. The total artificial heart.

    Science.gov (United States)

    Cook, Jason A; Shah, Keyur B; Quader, Mohammed A; Cooke, Richard H; Kasirajan, Vigneshwar; Rao, Kris K; Smallfield, Melissa C; Tchoukina, Inna; Tang, Daniel G

    2015-12-01

    The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient's native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review.

  10. Hypokalemia and sudden cardiac death

    DEFF Research Database (Denmark)

    Kjeldsen, Keld

    2010-01-01

    Worldwide, approximately three million people suffer sudden cardiac death annually. These deaths often emerge from a complex interplay of substrates and triggers. Disturbed potassium homeostasis among heart cells is an example of such a trigger. Thus, hypokalemia and, also, more transient...... of fatal arrhythmia and sudden cardiac death a patient is, the more attention should be given to the potassium homeostasis....

  11. The Danish Cardiac Rehabilitation Database

    DEFF Research Database (Denmark)

    Zwisler, Ann-Dorthe; Rossau, Henriette Knold; Nakano, Anne

    2016-01-01

    AIM OF DATABASE: The Danish Cardiac Rehabilitation Database (DHRD) aims to improve the quality of cardiac rehabilitation (CR) to the benefit of patients with coronary heart disease (CHD). STUDY POPULATION: Hospitalized patients with CHD with stenosis on coronary angiography treated with percutane...

  12. Biosynthesis of cardiac natriuretic peptides

    DEFF Research Database (Denmark)

    Goetze, Jens Peter

    2010-01-01

    . An inefficient post-translational prohormone maturation will also affect the biology of the cardiac natriuretic peptide system. This review aims at summarizing the myocardial synthesis of natriuretic peptides focusing on B-type natriuretic peptide, where new data has disclosed cardiac myocytes as highly...

  13. [Cardiac myxoma with cerebral metastases].

    Science.gov (United States)

    Bazin, A; Peruzzi, P; Baudrillard, J C; Pluot, M; Rousseaux, P

    1987-01-01

    A 56 year old woman developed multiple metastases in the cerebrum and cerebellum, four years after cardiac intervention on a left atrial myxoma. The absence of stroke is noteworthy. Multiple high density lesions with contrast enhancement were seen by CT scan, suggesting metastatic neoplasms. Histological examination confirmed the diagnosis of metastases of cardiac myxoma. Only four cases were recorded in the literature.

  14. Health Instruction Packages: Cardiac Anatomy.

    Science.gov (United States)

    Phillips, Gwen; And Others

    Text, illustrations, and exercises are utilized in these five learning modules to instruct nurses, students, and other health care professionals in cardiac anatomy and functions and in fundamental electrocardiographic techniques. The first module, "Cardiac Anatomy and Physiology: A Review" by Gwen Phillips, teaches the learner to draw…

  15. Leadership in cardiac surgery.

    Science.gov (United States)

    Rao, Christopher; Patel, Vanash; Ibrahim, Michael; Ahmed, Kamran; Wong, Kathie A; Darzi, Ara; von Segesser, Ludwig K; Athanasiou, Thanos

    2011-06-01

    Despite the efficacy of cardiac surgery, less invasive interventions with more uncertain long-term outcomes are increasingly challenging surgery as first-line treatment for several congenital, degenerative and ischemic cardiac diseases. The specialty must evolve if it is to ensure its future relevance. More importantly, it must evolve to ensure that future patients have access to treatments with proven long-term effectiveness. This cannot be achieved without dynamic leadership; however, our contention is that this is not enough. The demands of a modern surgical career and the importance of the task at hand are such that the serendipitous emergence of traditional charismatic leadership cannot be relied upon to deliver necessary change. We advocate systematic analysis and strategic leadership at a local, national and international level in four key areas: Clinical Care, Research, Education and Training, and Stakeholder Engagement. While we anticipate that exceptional individuals will continue to shape the future of our specialty, the creation of robust structures to deliver collective leadership in these key areas is of paramount importance.

  16. The effect of three recovery protocols on blood lactate clearance after race-paced swimming.

    Science.gov (United States)

    Lomax, Mitch

    2012-10-01

    The purpose of the present study was to assess the impact of 3 recovery protocols on blood lactate clearance after maximal intensity swimming. Thirty-three regional standard swimmers were tested throughout the course a year and were required to complete a race-paced 200-m swim in their main stroke or individual medley. After the race-paced swim, swimmers were assigned a self-paced continuous steady rate swim of 20 minutes (self-prescribed); a 20-minute coach-administered modified warm-up consisting of various swimming modes, intensities, and rest intervals (coach prescribed); or a 20-minute land-based recovery consisting of light-intensity walking, skipping, and stretching (land based). Blood lactate concentration was measured from the fingertip before and after the race-paced swim and after the recovery activity. The concentration of blood lactate was higher (p swimming (range of 10.5-11.0 mmol·L(-1)) compared with baseline (range 1.3-1.4 mmol·L(-1)). However, there were no differences (p > 0.05) between the groups (recovery protocols) at these time points. Conversely, differences were observed between groups after the recovery activities (p swimming protocols. The results of the present study suggest that it does not matter whether a self-paced continuous steady rate swimming velocity or a swimming recovery consisting of various strokes, intensities, and rest intervals is adopted as a recovery activity. As both swimming recoveries removed more blood lactate than the land-based recovery, swimmers should therefore be advised to undertake a swimming-based recovery rather than a land-based recovery.

  17. Artificial Heart Fluid Dynamics.

    Science.gov (United States)

    Mussivand, Tofigh Varcaneh

    Flow characteristics within pneumatic, pulsatile, and pusher plate prosthetic hearts were studied. The blood pumps evaluated were duplicates of pumps used for in vivo calf and for clinical implantation at the Cleveland Clinic Foundation. Human dura mater bioprosthetic, caged disk, and Bjork-Shiley tilting disk valves were employed in the pumps. Dual camera video tape and synchronized still photography were used to study flow patterns. Diffused light and a planar laser source provided illumination. The laser light was fanned into a plane with a thickness of 0.2 mm to 10 mm. Magnesium oxide and Amberlite particles were used as tracers. Aqueous-glycerol, aqueous-sucrose solutions and mineral oil were used as blood analog fluids. Inflow, outflow, drive, and afterload pressures, diaphragm motion, cardiac output, and heart rate were measured and recorded. An electrical circuit was developed to synchronize pump diaphragm motion with captured images of flow trajectories. After digitizing the trajectories, velocities, global and local turbulence, and shear stresses were obtained. Disturbed and recirculating zones were identified. Qualitative and quantitative analyses were performed using data obtained from the digitization of flow trajectories. Simultaneous turbulence and stasis were observed during most phases of the cardiac cycles in all the pumps tested. A maximum Reynold's shear stress of 2889 dynes/cm ^2 occurred at 120 beats per minute (bpm). The peak velocity was 146 cm/sec during systole. The identified regions of recirculation, low velocity and disturbed flow were shown to correlate with thrombosed areas of explanted blood pumps. The maximum calculated turbulence intensity was 106 cm/sec which occurred at 120 bpm during systole.

  18. Generative Artificial Intelligence : Philosophy and Theory of Artificial Intelligence

    NARCIS (Netherlands)

    van der Zant, Tijn; Kouw, Matthijs; Schomaker, Lambertus; Mueller, Vincent C.

    2013-01-01

    The closed systems of contemporary Artificial Intelligence do not seem to lead to intelligent machines in the near future. What is needed are open-ended systems with non-linear properties in order to create interesting properties for the scaffolding of an artificial mind. Using post-structuralistic

  19. Echocardiography in evaluating right ventricular function of patients with sick sinus syndrome and atrioventricular delay with perianal abscesson under AAI and DDD pacing modes%病态窦房结综合征伴房室传导延迟AAI与DDD起搏模式右心功能的超声评价

    Institute of Scientific and Technical Information of China (English)

    陈晓栋; 许迪; 丁文波; 沈建平; 娄彬; 于圣永

    2012-01-01

    Objective To explore the right ventricular function of patients with sick sinus syndrome and atrioventricular delay under AAI and DDD pacing modes. Methods Thirty - five sick sinus syndrome combined with I degree atrioventricular block implantation of DDD patients with dual chamber pacemaker were included in the study. The program- controlled instrument was used to change the pacemaker to DDD mode first,and then to AAI mode. Echocardiography was employed to detect parameter changes of patients with two kinds of pacing mode. Results RVPEP RVPEP/RVET and Sm,Tei index of DDD pacing mode were significantly higher than those of AAI pacing mode (P<0. 05). The E/Em of DDD pacing mode was less than that of AAI pacing mode (P<0.05). Conclusion The right cardiac systolic and diastolic function of the patients with AV is better under the AAI mode pacing mode than under the DDD mode pacing mode.%目的 探讨AAI与DDD起搏模式下病态窦房结综合征伴房室传导阻滞患者的右心功能.方法 35例病态窦房结综合征伴Ⅰ度房室传导阻滞植入DDD双腔起搏器患者,先用程控仪将起搏器程控为DDD模式,最后程控为AAI模式.超声心动图检测患者2种起搏模式下的各参数变化情况.结果 DDD起搏模式下的RVPEP、RVPEP/RVET、Sm、Tei指数明显高于AAI起搏模式(P<0 05),E/Em低于AAI起搏模式(P<0.05).结论 AAI起搏模式右心的收缩和舒张功能均优于AV间期优化的DDD起搏模式.

  20. Artificial Diets for Mosquitoes

    Directory of Open Access Journals (Sweden)

    Kristina K. Gonzales

    2016-12-01

    Full Text Available Mosquito-borne diseases are responsible for more than a million human deaths every year. Modern mosquito control strategies such as sterile insect technique (SIT, release of insects carrying a dominant lethal (RIDL, population replacement strategies (PR, and Wolbachia-based strategies require the rearing of large numbers of mosquitoes in culture for continuous release over an extended period of time. Anautogenous mosquitoes require essential nutrients for egg production, which they obtain through the acquisition and digestion of a protein-rich blood meal. Therefore, mosquito mass production in laboratories and other facilities relies on vertebrate blood from live animal hosts. However, vertebrate blood is expensive to acquire and hard to store for longer times especially under field conditions. This review discusses older and recent studies that were aimed at the development of artificial diets for mosquitoes in order to replace vertebrate blood.

  1. Artificial Immune Systems (2010)

    CERN Document Server

    Greensmith, Julie; Aickelin, Uwe

    2010-01-01

    The human immune system has numerous properties that make it ripe for exploitation in the computational domain, such as robustness and fault tolerance, and many different algorithms, collectively termed Artificial Immune Systems (AIS), have been inspired by it. Two generations of AIS are currently in use, with the first generation relying on simplified immune models and the second generation utilising interdisciplinary collaboration to develop a deeper understanding of the immune system and hence produce more complex models. Both generations of algorithms have been successfully applied to a variety of problems, including anomaly detection, pattern recognition, optimisation and robotics. In this chapter an overview of AIS is presented, its evolution is discussed, and it is shown that the diversification of the field is linked to the diversity of the immune system itself, leading to a number of algorithms as opposed to one archetypal system. Two case studies are also presented to help provide insight into the m...

  2. Sucrose compared with artificial sweeteners

    DEFF Research Database (Denmark)

    Sørensen, Lone Brinkmann; Vasilaras, Tatjana H; Astrup, Arne;

    2014-01-01

    There is a lack of appetite studies in free-living subjects supplying the habitual diet with either sucrose or artificially sweetened beverages and foods. Furthermore, the focus of artificial sweeteners has only been on the energy intake (EI) side of the energy-balance equation. The data are from...

  3. Instructional Applications of Artificial Intelligence.

    Science.gov (United States)

    Halff, Henry M.

    1986-01-01

    Surveys artificial intelligence and the development of computer-based tutors and speculates on the future of artificial intelligence in education. Includes discussion of the definitions of knowledge, expert systems (computer systems that solve tough technical problems), intelligent tutoring systems (ITS), and specific ITSs such as GUIDON, MYCIN,…

  4. A Primer on Artificial Intelligence.

    Science.gov (United States)

    Leal, Ralph A.

    A survey of literature on recent advances in the field of artificial intelligence provides a comprehensive introduction to this field for the non-technical reader. Important areas covered are: (1) definitions, (2) the brain and thinking, (3) heuristic search, and (4) programing languages used in the research of artificial intelligence. Some…

  5. Generalized Adaptive Artificial Neural Networks

    Science.gov (United States)

    Tawel, Raoul

    1993-01-01

    Mathematical model of supervised learning by artificial neural network provides for simultaneous adjustments of both temperatures of neurons and synaptic weights, and includes feedback as well as feedforward synaptic connections. Extension of mathematical model described in "Adaptive Neurons For Artificial Neural Networks" (NPO-17803). Dynamics of neural network represented in new model by less-restrictive continuous formalism.

  6. Artificial Ligaments: Promise or Panacea?

    Science.gov (United States)

    Lubell, Adele

    1987-01-01

    The Food and Drug Administration has approved a prosthetic ligament for limited use in persons with damaged anterior cruciate ligaments (ACL). This article addresses ligament repair, ACL tears, current treatment, development of the Gore-Tex artificial ligament, other artificial ligaments in process, and arguments for and against their use.…

  7. Caquexia cardíaca Cardiac cachexia

    Directory of Open Access Journals (Sweden)

    Alberto Miján

    2006-05-01

    .Chronic heart failure (CHF, especially affecting the right heart, frequently leads to malnutrition. If the latter is severe and is combined to other factors, it may lead to cardiac cachexia. This one is associated to increased mortality and lower survival of patients suffering from it. The causes of cardiac cachexia are diverse, generally associated to maintenance of a negative energy balance, with increasing evidence of its multifactorial origin. Neurohumoral, inflammatory, immunological, and metabolic factors, among others, are superimposed in the patient with CHF, leading to involvement and deterioration of several organs and systems, since this condition affects both lean (or active cellular mass and adipose and bone tissue - osteoporosis. Among all, the most pronounced deterioration may be seen at skeletal muscle tissue, at both structural and functional levels, the heart not being spared. As for treatment, it should be based on available scientific evidence. Assessment of nutritional status of any patient with CHF is a must, with the requirement of nutritional intervention in case of malnutrition. In this situation, especially if accompanied by cardiac cachexia, it is required to modify energy intake and oral diet quality, and to consider the indication of specific complementary or alternative artificial nutrition. Besides, the causal relationship of the beneficial role of moderate physical exertion is increasing, as well as modulation of metabolic and inflammatory impairments observed in cardiac cachexia with several drugs, leading to a favorable functional and structural response in CHF patients.

  8. Evaluation of cardiac vulnerability and antifibrillatory properties of anti-arrhythmic drugs.

    Science.gov (United States)

    Smailys, A; Gasiunas, V; Gasiuniene, G

    1989-10-01

    A method of evaluating the antifibrillatory properties of drugs by their effect on the acceleration of the cardiac rhythm by electric pulses was developed. It permitted measurement of fibrillation thresholds and the maximal driving frequency of stimulation. The heart was accelerated in closed chest dogs, and this increased the fibrillation thresholds after the application of lidocaine (1 mg/kg), quinidine (5 mg/kg), and novocainamide (15 mg/kg body wt.). The development of an original programmed stimulator increased the accuracy of the method by means of establishing the initial and terminal stimulation rates and observing the constant steps of change of pulse intervals. Four methods of causing fibrillation were compared: (1) a single pulse during the vulnerable phase of the cardiac cycle; (2) a train of pulses overlapping the vulnerable phase; (3) sequential R on T pacing; (4) simple acceleration of the cardiac rhythm. In addition to the other methods, the method of accelerating the heart rate differs in that only a small amplitude of stimulating pulses is needed. The present method may be used in the case of an unstable initial cardiac rhythm.

  9. Cardiorespiratory Mechanical Simulator for In Vitro Testing of Impedance Minute Ventilation Sensors in Cardiac Pacemakers.

    Science.gov (United States)

    Marcelli, Emanuela; Cercenelli, Laura

    2016-01-01

    We developed a cardiorespiratory mechanical simulator (CRMS), a system able to reproduce both the cardiac and respiratory movements, intended to be used for in vitro testing of impedance minute ventilation (iMV) sensors in cardiac pacemakers. The simulator consists of two actuators anchored to a human thorax model and a software interface to control the actuators and to acquire/process impedance signals. The actuators can be driven separately or simultaneously to reproduce the cardiac longitudinal shortening at a programmable heart rate and the diaphragm displacement at a programmable respiratory rate (RR). A standard bipolar pacing lead moving with the actuators and a pacemaker case fixed to the thorax model have been used to measure impedance (Z) variations during the simulated cardiorespiratory movements. The software is able to discriminate the low-frequency component because of respiration (Z(R)) from the high-frequency ripple because of cardiac effect (Z(C)). Impedance minute ventilation is continuously calculated from Z(R) and RR. From preliminary tests, the CRMS proved to be a reliable simulator for in vitro evaluation of iMV sensors. Respiration impedance recordings collected during cardiorespiratory movements reproduced by the CRMS were comparable in morphology and amplitude with in vivo assessments of transthoracic impedance variations.

  10. Successful heart transplant after 1374 days living with a total artificial heart.

    Science.gov (United States)

    Gerosa, Gino; Gallo, Michele; Bottio, Tomaso; Tarzia, Vincenzo

    2016-04-01

    The CardioWest Total Artificial Heart (CW-TAH) has been approved as a temporary device for bridge to cardiac transplantation and is under investigation for destination therapy by US Food and Drug Administration (FDA). We herein report the longest worldwide survival out of hospital (1374 days) of a patient supported with Cardio West Total Artificial Heart (CW-TAH). This experience is intended as a proof of concept of using CW-TAH as the destination therapy in patients with biventricular failure.

  11. Soft computing in artificial intelligence

    CERN Document Server

    Matson, Eric

    2014-01-01

    This book explores the concept of artificial intelligence based on knowledge-based algorithms. Given the current hardware and software technologies and artificial intelligence theories, we can think of how efficient to provide a solution, how best to implement a model and how successful to achieve it. This edition provides readers with the most recent progress and novel solutions in artificial intelligence. This book aims at presenting the research results and solutions of applications in relevance with artificial intelligence technologies. We propose to researchers and practitioners some methods to advance the intelligent systems and apply artificial intelligence to specific or general purpose. This book consists of 13 contributions that feature fuzzy (r, s)-minimal pre- and β-open sets, handling big coocurrence matrices, Xie-Beni-type fuzzy cluster validation, fuzzy c-regression models, combination of genetic algorithm and ant colony optimization, building expert system, fuzzy logic and neural network, ind...

  12. Beyond AI: Artificial Dreams Conference

    CERN Document Server

    Zackova, Eva; Kelemen, Jozef; Beyond Artificial Intelligence : The Disappearing Human-Machine Divide

    2015-01-01

    This book is an edited collection of chapters based on the papers presented at the conference “Beyond AI: Artificial Dreams” held in Pilsen in November 2012. The aim of the conference was to question deep-rooted ideas of artificial intelligence and cast critical reflection on methods standing at its foundations.  Artificial Dreams epitomize our controversial quest for non-biological intelligence, and therefore the contributors of this book tried to fully exploit such a controversy in their respective chapters, which resulted in an interdisciplinary dialogue between experts from engineering, natural sciences and humanities.   While pursuing the Artificial Dreams, it has become clear that it is still more and more difficult to draw a clear divide between human and machine. And therefore this book tries to portrait such an image of what lies beyond artificial intelligence: we can see the disappearing human-machine divide, a very important phenomenon of nowadays technological society, the phenomenon which i...

  13. Platelets and cardiac arrhythmia

    Directory of Open Access Journals (Sweden)

    Jonas S De Jong

    2010-12-01

    Full Text Available Sudden cardiac death remains one of the most prevalent modes of death in industrialized countries, and myocardial ischemia due to thrombotic coronary occlusion is its primary cause. The role of platelets in the occurrence of SCD extends beyond coronary flow impairment by clot formation. Here we review the substances released by platelets during clot formation and their arrhythmic properties. Platelet products are released from three types of platelet granules: dense core granules, alpha-granules, and platelet lysosomes. The physiologic properties of dense granule products are of special interest as a potential source of arrhythmic substances. They are released readily upon activation and contain high concentrations of serotonin, histamine, purines, pyrimidines, and ions such as calcium and magnesium. Potential arrhythmic mechanisms of these substances, e.g. serotonin and high energy phosphates, include induction of coronary constriction, calcium overloading, and induction of delayed after-depolarizations. Alpha-granules produce thromboxanes and other arachidonic acid products with many potential arrhythmic effects mediated by interference with cardiac sodium, calcium and potassium channels. Alpha-granules also contain hundreds of proteins that could potentially serve as ligands to receptors on cardiomyocytes. Lysosomal products probably do not have an important arrhythmic effect. Platelet products and ischemia can induce coronary permeability, thereby enhancing interaction with surrounding cardiomyocytes. Antiplatelet therapy is known to improve survival after myocardial infarction. Although an important part of this effect results from prevention of coronary clot formation, there is evidence to suggest that antiplatelet therapy also induces anti-arrhythmic effects during ischemia by preventing the release of platelet activation products.

  14. Mediastinitis after cardiac transplantation

    Directory of Open Access Journals (Sweden)

    Noedir A. G. Stolf

    2000-05-01

    Full Text Available OBJECTIVE: Assessment of incidence and behavior of mediastinitis after cardiac transplantation. METHODS: From 1985 to 1999, 214 cardiac transplantations were performed, 12 (5.6% of the transplanted patients developed confirmed mediastinitis. Patient's ages ranged from 42 to 66 years (mean of 52.3±10.0 years and 10 (83.3% patients were males. Seven (58.3% patients showed sternal stability on palpation, 4 (33.3% patients had pleural empyema, and 2 (16.7% patients did not show purulent secretion draining through the wound. RESULTS: Staphylococcus aureus was the infectious agent identified in the wound secretion or in the mediastinum, or both, in 8 (66.7% patients. Staphylococcus epidermidis was identified in 2 (16.7% patients, Enterococcus faecalis in 1 (8.3% patient, and the cause of mediastinitis could not be determined in 1 (8.3% patient. Surgical treatment was performed on an emergency basis, and the extension of the débridement varied with local conditions. In 2 (16.7% patients, we chose to leave the surgical wound open and performed daily dressings with granulated sugar. Total sternal resection was performed in only 1 (8.3% patient. Out of this series, 5 (41.7% patients died, and the causes of death were related to the infection. Autopsy revealed persistence of mediastinitis in 1 (8.3% patient. CONCLUSION: Promptness in diagnosing mediastinitis and precocious surgical drainage have changed the natural evolution of this disease. Nevertheless, observance of the basic precepts of prophylaxis of infection is still the best way to treat mediastinitis.

  15. The influence of restoration of spontaneous circulation in temporary different pacing sites%不同的起搏部位对复苏后自主循环恢复的影响

    Institute of Scientific and Technical Information of China (English)

    王合金; 潘莹; 谢江霞

    2014-01-01

    different pacing sites in hemodynamic and cardiovascular events after restoration of spontaneous circulation.Methods A total of 76 patients with-in hospital cardiac arrest occurred from November 2010 to January 2014 were confirmed by electrionic device monitoring or electrocardiogram and they received cardiopulmonary resuscitation,and their ages were over 18 years.Patients with end-stage of various disease,malignancy and cardiac arrest due to incurable diseases or debility of physical conditions were excluded.The 76 patients were divided into two groups according to pacing site checked by X-ray fluoroscopy in emergency rescue unit:right ventriclular outflow trace pacing group [n =36,male 26 cases,female 10 cases,age (57.31 ± 16.65) years] and right ventricular apex pacing group [n =40,22 male cases and 18 female cases,age (60.43 ± 15.48) years].All patients' QRS duration were measured by ECG after pacemaker implantition and left ventricular ejection fraction (LVEF),left ventricular short axis reduced rate (FS),heart rate (HR),cardiac index (CI) were tested by bedside echocardiography and non-invasive hemodynamic monitoring was used during the early to middle stage.All the hemodynamic variables and the cardiac events were observed after spontaneous circulation recovery.All the data were analyzed by SPSS version 13.0 statistical software.Results There were no significant differences in age,gender,the primary disease,the time from cardiac arrest to spontaneous circulation restoration and dosage of epinephrine (P > 0.05).In comparison with right ventricular apex pacing group,LVEF,FS,HR,CI were higher in right ventriclular outflow trace pacing group [(0.46 ± 0.04)% vs.(0.44 ±0.05)%,(0.34±0.05) vs.(0.32±0.04),(0.04±0.46) L/minvs.(3.47±0.46) L/min,(0.46±0.29) L/ (min · m2) vs.(2.46 ±0.26) L/ (min · m2),P < 0.05] and right ventriclular outflow trace pacing group had shorter QRS duration than right ventriclular apex pacing group [(128.25 ± 6.06) ms vs.(151.93

  16. Metoclopramide-induced cardiac arrest

    Directory of Open Access Journals (Sweden)

    Martha M. Rumore

    2011-11-01

    Full Text Available The authors report a case of cardiac arrest in a patient receiving intravenous (IV metoclopramide and review the pertinent literature. A 62-year-old morbidly obese female admitted for a gastric sleeve procedure, developed cardiac arrest within one minute of receiving metoclopramide 10 mg via slow intravenous (IV injection. Bradycardia at 4 beats/min immediately appeared, progressing rapidly to asystole. Chest compressions restored vital function. Electrocardiogram (ECG revealed ST depression indicative of myocardial injury. Following intubation, the patient was transferred to the intensive care unit. Various cardiac dysrrhythmias including supraventricular tachycardia (SVT associated with hypertension and atrial fibrillation occurred. Following IV esmolol and metoprolol, the patient reverted to normal sinus rhythm. Repeat ECGs revealed ST depression resolution without pre-admission changes. Metoclopramide is a non-specific dopamine receptor antagonist. Seven cases of cardiac arrest and one of sinus arrest with metoclopramide were found in the literature. The metoclopramide prescribing information does not list precautions or adverse drug reactions (ADRs related to cardiac arrest. The reaction is not dose related but may relate to the IV administration route. Coronary artery disease was the sole risk factor identified. According to Naranjo, the association was possible. Other reports of cardiac arrest, severe bradycardia, and SVT were reviewed. In one case, five separate IV doses of 10 mg metoclopramide were immediately followed by asystole repeatedly. The mechanism(s underlying metoclopramide’s cardiac arrest-inducing effects is unknown. Structural similarities to procainamide may play a role. In view of eight previous cases of cardiac arrest from metoclopramide having been reported, further elucidation of this ADR and patient monitoring is needed. Our report should alert clinicians to monitor patients and remain diligent in surveillance and

  17. Fetal cardiac rhabdomyoma: case report

    Directory of Open Access Journals (Sweden)

    Seyed Mostafa Ghavami

    2016-07-01

    Full Text Available Background: The primary manifestation of cardiac tumors in embryonic period is a very rare condition. Cardiac rhabdomyomas most frequently arise in the ventricular myocardium, they may also occur in the atria and the epicardial surface. In spite of its benign nature, the critical location of the tumor inside the heart can lead to lethal arrhythmias and chamber obstruction. Multiple rhabdomyomas are strongly associated with tuberous sclerosis which is associated with mental retardation and epilepsy of variable severity. Ultrasonography as a part of routine prenatal screening, is the best method for the diagnosis of cardiac rhabdomyomas. In the review of articles published in Iran, fetal cardiac rhabdomyoma was not reported. Case presentation: We report a case of cardiac rhabdomyoma on a 24-year-old gravid 1, referred to Day Medical Imaging Center for routine evaluation of fetal abnormalities at 31 weeks of her gestational age. Ultrasonographic examination displayed a homogenous echogenic mass (13×9mm, originating from the left ventricle of the fetal heart. It was a normal pregnancy without any specific complications. Other organs of the fetus were found normal and no cardiac abnormalities were appeared. No Pericardial fluid effusion was found. The parents did not have consanguineous marriage. They did not also have any specific disease such as tuberous sclerosis. Conclusion: The clinical features of cardiac rhabdomyomas vary widely, depending on the location, size, and number of tumors in the heart. Although cardiac rhabdomyoma is a benign tumor in many affected fetuses, an early prenatal diagnosis of the tumor is of great significance in making efficient planning and providing adequate follow up visits of the patients and the complications such as, heart failure and outlet obstruction of cardiac chambers.

  18. What Is a Total Artificial Heart?

    Science.gov (United States)

    ... the NHLBI on Twitter. What Is a Total Artificial Heart? A total artificial heart (TAH) is a device ... outside power source. Normal Heart and CardioWest Total Artificial Heart Figure A shows the normal structure and location ...

  19. Epigenetic regulation in cardiac fibrosis

    Institute of Scientific and Technical Information of China (English)

    Li-Ming; Yu; Yong; Xu

    2015-01-01

    Cardiac fibrosis represents an adoptive response in the heart exposed to various stress cues. While resolution of the fibrogenic response heralds normalization of heart function, persistent fibrogenesis is usually associated with progressive loss of heart function and eventually heart failure. Cardiac fibrosis is regulated by a myriad of factors that converge on the transcription of genes encoding extracellular matrix proteins, a process the epigenetic machinery plays a pivotal role. In this minireview, we summarize recent advances regarding the epigenetic regulation of cardiac fibrosis focusing on the role of histone and DNA modifications and non-coding RNAs.

  20. Cardiac Involvement in Ankylosing Spondylitis

    Science.gov (United States)

    Ozkan, Yasemin

    2016-01-01

    Ankylosing spondylitis is one of the subgroup of diseases called “seronegative spondyloarthropathy”. Frequently, it affects the vertebral colon and sacroiliac joint primarily and affects the peripheral joints less often. This chronic, inflammatory and rheumatic disease can also affect the extraarticular regions of the body. The extraarticular affections can be ophthalmologic, cardiac, pulmonary or neurologic. The cardiac affection can be 2-10% in all patients. Cardiac complications such as left ventricular dysfunction, aortitis, aortic regurgitation, pericarditis and cardiomegaly are reviewed. PMID:27222669

  1. Acupuncture therapy related cardiac injury.

    Science.gov (United States)

    Li, Xue-feng; Wang, Xian

    2013-12-01

    Cardiac injury is the most serious adverse event in acupuncture therapy. The causes include needling chest points near the heart, the cardiac enlargement and pericardial effusion that will enlarge the projected area on the body surface and make the proper depth of needling shorter, and the incorrect needling method of the points. Therefore, acupuncture practitioners must be familiar with the points of the heart projected area on the chest and the correct needling methods in order to reduce the risk of acupuncture therapy related cardiac injury.

  2. 犬体内带钛镍记忆合金支架的人工血管移植可行性及心功能的评估分析%The feasibility of artificial blood vessel transplantation in dogs with titanium nickel memory alloy stent and evaluation of cardiac func-tion

    Institute of Scientific and Technical Information of China (English)

    郭建中; 杨传瑞; 缪卫东

    2015-01-01

    Objective To investigate the feasibility of artificial blood vessel with titanium nickel memory alloy stent graft in the dogˊs as-cending aorta,aortic arch and descending aorta,assessment on the anticipating value of the plasma N - terminal pro brain natriuretic peptide(NT proBNP)precursors,serum aspartate aminotransferase(AST)and creatine kinase(CK)on heart failure. Methods From March 2015 to May 2014,Selecting 23 15kg or more adult hybrid dogs. Under the condition of deep hypothermia circulatory arrest and retrograde perfusion of the su-perior vena cava,all thoracic aortic vascular grafts were performed. The physiological parameters,operation time,survival time and death cause were recorded. To investigate the relationship between plasma NT - proBNP,AST,CK concentration and heart failure at different time after opera-tion. Results The overall survival rate was 65. 2%(15 / 23)of 23 adult hybrid dogs in the whole group. Operation time was about(174. 6 ± 27. 0)min. The survival period of the dog in the 30 d,which the time of the artificial blood vessel anastomosis was significantly longer than that of over 30 d. 24 ~ 48 h after artificial blood vessel transplantation,NT - proBNP,AST and CK concentrations reached the highest level. With the extension of survival time,the concentration of above three index gradually decreased,but the concentration of the index of the dog reached the highest value 1 ~ 3 d before death. Conclusion Method of artificial blood vessel with titanium nickel memory alloy stent for the whole thoracic aortic transplantation is feasible. The shorter time of artificial blood vessel anastomosis,the smaller the impact on the physiological parameters,the function of heart,liver and kidney. The concentration of NT - proBNP,AST and CK can be estimated to the extent of heart failure after artificial blood vessel transplantation.%目的:探讨带钛镍记忆合金支架的人工血管将犬升主动脉、主动脉弓及降主动脉合为一体进行

  3. Sequential biventricular pacing improves regional contractility, longitudinal function and dyssynchrony in patients with heart failure and prolonged QRS

    Directory of Open Access Journals (Sweden)

    Ring Margareta

    2010-04-01

    Full Text Available Abstract Aims Biventricular pacing (BiP is an effective treatment in systolic heart failure (HF patients with prolonged QRS. However, approximately 35% of the patients receiving BiP are classified as non-responders. The aim of this study is to evaluate the acute effects of VV-optimization on systolic heart function. Methods Twenty-one HF patients aged 72 (46-88 years, QRS 154 (120-190 ms, were studied with echocardiography, Tissue Doppler Imaging (TDI and 3D-echo the first day after receiving a BiP device. TDI was performed; during simultaneous pacing (LV-lead pacing 4 ms before the RV-lead and during sequential pacing (LV 20 and 40 ms before RV and RV 20 and 40 ms before LV-lead pacing. Systolic heart function was studied by tissue tracking (TT for longitudinal function and systolic maximal velocity (SMV for regional contractility and signs of dyssynchrony assessed by time-delays standard deviation of aortic valve opening to SMV, AVO-SMV/SD and tissue synchronization imaging (TSI. Results The TT mean value preoperatively was 4,2 ± 1,5 and increased at simultaneous pacing to 5,0 ± 1,2 mm (p Conclusions VV-optimization in the acute phase improves systolic heart function more than simultaneous BiP pacing. Long-term effects should be evaluated in prospective randomized trials.

  4. Acute left ventricular dysfunction secondary to right ventricular septal pacing in a woman with initial preserved contractility: a case report

    Directory of Open Access Journals (Sweden)

    Gribaa Rim

    2011-10-01

    Full Text Available Abstract Introduction Right ventricular apical pacing-related heart failure is reported in some patients after long-term pacing. The exact mechanism is not yet clear but may be related to left ventricular dyssynchrony induced by right ventricular apical pacing. Right ventricular septal pacing is thought to deteriorate left ventricular function less frequently because of a more normal left ventricular activation pattern. Case presentation We report the case of a 55-year-old Tunisian woman with preserved ventricular function, implanted with a dual-chamber pacemaker for complete atrioventricular block. Right ventricular septal pacing induced a major ventricular dyssynchrony, severe left ventricular ejection fraction deterioration and symptoms of congestive heart failure. Upgrading to a biventricular device was associated with a decrease in the symptoms and the ventricular dyssynchrony, and an increase of left ventricular ejection fraction. Conclusion Right ventricular septal pacing can induce reversible left ventricular dysfunction and heart failure secondary to left ventricular dyssynchrony. This complication remains an unpredictable complication of right ventricular septal pacing.

  5. Normal cardiac function in mice with supraphysiological cardiac creatine levels.

    Science.gov (United States)

    Santacruz, Lucia; Hernandez, Alejandro; Nienaber, Jeffrey; Mishra, Rajashree; Pinilla, Miguel; Burchette, James; Mao, Lan; Rockman, Howard A; Jacobs, Danny O

    2014-02-01

    Creatine and phosphocreatine levels are decreased in heart failure, and reductions in myocellular phosphocreatine levels predict the severity of the disease and portend adverse outcomes. Previous studies of transgenic mouse models with increased creatine content higher than two times baseline showed the development of heart failure and shortened lifespan. Given phosphocreatine's role in buffering ATP content, we tested the hypothesis whether elevated cardiac creatine content would alter cardiac function under normal physiological conditions. Here, we report the creation of transgenic mice that overexpress the human creatine transporter (CrT) in cardiac muscle under the control of the α-myosin heavy chain promoter. Cardiac transgene expression was quantified by qRT-PCR, and human CrT protein expression was documented on Western blots and immunohistochemistry using a specific anti-CrT antibody. High-energy phosphate metabolites and cardiac function were measured in transgenic animals and compared with age-matched, wild-type controls. Adult transgenic animals showed increases of 5.7- and 4.7-fold in the content of creatine and free ADP, respectively. Phosphocreatine and ATP levels were two times as high in young transgenic animals but declined to control levels by the time the animals reached 8 wk of age. Transgenic mice appeared to be healthy and had normal life spans. Cardiac morphometry, conscious echocardiography, and pressure-volume loop studies demonstrated mild hypertrophy but normal function. Based on our characterization of the human CrT protein expression, creatine and phosphocreatine content, and cardiac morphometry and function, these transgenic mice provide an in vivo model for examining the therapeutic value of elevated creatine content for cardiac pathologies.

  6. Do immunological, endocrine and metabolic traits fall on a single Pace-of-Life axis? Covariation and constraints among physiological systems

    NARCIS (Netherlands)

    Versteegh, M. A.; Schwabl, I.; Jaquier, S.; Tieleman, B. I.

    2012-01-01

    Variation in demographic and physiological attributes of life history is thought to fall on one single axis, a phenomenon termed the Pace-of-Life. A slow Pace-of-Life is characterized by low annual reproduction, long life span and low metabolic rate, a fast Pace-of-Life by the opposite characteristi

  7. Use of cardiac biomarkers in neonatology.

    Science.gov (United States)

    Vijlbrief, Daniel C; Benders, Manon J N L; Kemperman, Hans; van Bel, Frank; de Vries, Willem B

    2012-10-01

    Cardiac biomarkers are used to identify cardiac disease in term and preterm infants. This review discusses the roles of natriuretic peptides and cardiac troponins. Natriuretic peptide levels are elevated during atrial strain (atrial natriuretic peptide (ANP)) or ventricular strain (B-type natriuretic peptide (BNP)). These markers correspond well with cardiac function and can be used to identify cardiac disease. Cardiac troponins are used to assess cardiomyocyte compromise. Affected cardiomyocytes release troponin into the bloodstream, resulting in elevated levels of cardiac troponin. Cardiac biomarkers are being increasingly incorporated into clinical trials as indicators of myocardial strain. Furthermore, cardiac biomarkers can possibly be used to guide therapy and improve outcome. Natriuretic peptides and cardiac troponins are potential tools in the diagnosis and treatment of neonatal disease that is complicated by circulatory compromise. However, clear reference ranges need to be set and validation needs to be carried out in a population of interest.

  8. The artificial leaf.

    Science.gov (United States)

    Nocera, Daniel G

    2012-05-15

    To convert the energy of sunlight into chemical energy, the leaf splits water via the photosynthetic process to produce molecular oxygen and hydrogen, which is in a form of separated protons and electrons. The primary steps of natural photosynthesis involve the absorption of sunlight and its conversion into spatially separated electron-hole pairs. The holes of this wireless current are captured by the oxygen evolving complex (OEC) of photosystem II (PSII) to oxidize water to oxygen. The electrons and protons produced as a byproduct of the OEC reaction are captured by ferrodoxin of photosystem I. With the aid of ferrodoxin-NADP(+) reductase, they are used to produce hydrogen in the form of NADPH. For a synthetic material to realize the solar energy conversion function of the leaf, the light-absorbing material must capture a solar photon to generate a wireless current that is harnessed by catalysts, which drive the four electron/hole fuel-forming water-splitting reaction under benign conditions and under 1 sun (100 mW/cm(2)) illumination. This Account describes the construction of an artificial leaf comprising earth-abundant elements by interfacing a triple junction, amorphous silicon photovoltaic with hydrogen- and oxygen-evolving catalysts made from a ternary alloy (NiMoZn) and a cobalt-phosphate cluster (Co-OEC), respectively. The latter captures the structural and functional attributes of the PSII-OEC. Similar to the PSII-OEC, the Co-OEC self-assembles upon oxidation of an earth-abundant metal ion from 2+ to 3+, may operate in natural water at room temperature, and is self-healing. The Co-OEC also activates H(2)O by a proton-coupled electron transfer mechanism in which the Co-OEC is increased by four hole equivalents akin to the S-state pumping of the Kok cycle of PSII. X-ray absorption spectroscopy studies have established that the Co-OEC is a structural relative of Mn(3)CaO(4)-Mn cubane of the PSII-OEC, where Co replaces Mn and the cubane is extended in a

  9. Towards Development of a 3-State Self-Paced Brain-Computer Interface

    Directory of Open Access Journals (Sweden)

    Ali Bashashati

    2007-01-01

    the presence of a right- or a left-hand movement and the second classifies the detected movement as a right or a left one. In an offline analysis of the EEG data collected from four able-bodied individuals, the 3-state brain-computer interface shows a comparable performance with a 2-state system and significant performance improvement if used as a 2-state BCI, that is, in detecting the presence of a right- or a left-hand movement (regardless of the type of movement. It has an average true positive rate of 37.5% and 42.8% (at false positives rate of 1% in detecting right- and left-hand extensions, respectively, in the context of a 3-state self-paced BCI and average detection rate of 58.1% (at false positive rate of 1% in the context of a 2-state self-paced BCI.

  10. Trame di Pace. Simboli, carte, azioni di un’utopia possibile. 1945-2003

    Directory of Open Access Journals (Sweden)

    Nadia Baiesi

    2014-06-01

    Full Text Available La mostra racconta la storia degli uomini e delle donne che hanno ragionato di pace non più come di una nobile speranza, ma come dell’unica chance di salvezza per l’umanità. La scansione cronologica, per decenni, parte dal 1945 e arriva al 2003 con la diffusione della bandiera arcobaleno in occasione della campagna «Pace da tutti i balconi», nata per scongiurare il secondo conflitto in Iraq. Al centro della mostra un percorso sui simboli che sono stati inventati, ripresi, risignificati in diversi contesti, movimenti radicali del pacifismo antimilitarista e nonviolento e movimenti contro singole guerre. Accompagnano i materiali iconografici (bandiere e manifesti originali, opere d’arte del maestro Anastasi, due percorsi documentari con immagini d’epoca, locandine, testi di decreti, opuscoli, volantini, articoli di quotidiani e riviste.

  11. Self-Paced E-Training in E-Learning for University Teaching Staff

    Directory of Open Access Journals (Sweden)

    Norah Ahmed Al-Malki

    2015-03-01

    Full Text Available The shift towards adopting e-training methods and practices in the workplace to equip staff with soft and hard skills have become an essential component of training in many Higher Education institutions. The aim of this paper is to advocate such a shift in Saudi universities through presenting the preliminary outcomes of a short-scale pilot study conducted by the Deanship of E-learning and Distance Education (DELDE during August 2014. Basically, the paper introduces the results of a first run of a self-paced e-training program focusing on introducing topics related to e-learning development and instruction. The paper 1 explores the pedagogical motivation for adopting the self-paced learning model, 2 outlines the elements of the developed course, and 3 discusses the results of the first run of the e-training program.

  12. Permanent pacing system malfunction due to hidden adjacent fractures of atrial and ventricular leads.

    Science.gov (United States)

    Wang, L; Davis, M J

    1997-03-01

    Periods of failure of ventricular pacing and atrial sensing were discovered on Holter recording in a 10-year-old boy 4 years after the implantation of a dual-chamber pacemaker with endocardial bipolar leads brought out through the right atrial wall. The old generator was explanted and the old leads tested. There was considerable atrial oversensing of an electrical artefact. The pacing threshold of ventricular lead was 1.8 V compared with 0.3 V 6 days post implantation. Post-operative lateral chest X-ray disclosed fractures of both atrial and ventricular leads at the approximate site of exit from the right atriotomy. Review of the preoperative lateral film showed that the fractures had been hidden by an ECG electrode.

  13. Interaction Equivalency in Self-Paced Online Learning Environments: An Exploration of Learner Preferences

    Directory of Open Access Journals (Sweden)

    Jason F. Rhode

    2009-02-01

    Full Text Available This mixed methods study explored the dynamics of interaction within a self-paced online learning environment. It used rich media and a mix of traditional and emerging asynchronous computer-mediated communication tools to determine what forms of interaction learners in a self-paced online course value most and what impact they perceive interaction to have on their overall learning experience. This study demonstrated that depending on the specific circumstance, not all forms of interaction may be either equally valued by learners or effective. Participants differentiated among the various learning interactions available and indicated that informal interactions were as important as formal interactions in determining the quality of the online learning experience. Participants also reported the activity of blogging as being equally valued and in some ways superior to instructor-directed asynchronous discussion via the discussion board in a learning management system.

  14. Pellet Fueling, ELM pacing, and Disruption Mitigation Technology Development for ITER

    Energy Technology Data Exchange (ETDEWEB)

    Baylor, Larry R [ORNL; Combs, Stephen Kirk [ORNL; Foust, Charles R [ORNL; Jernigan, Thomas C [ORNL; Meitner, S. J. [Oak Ridge National Laboratory (ORNL); Parks, P. B. [General Atomics; Caughman, John B [ORNL; Maruyama, S. [ITER International Team, Garching, Germany; Qualls, A L [ORNL; Rasmussen, David A [ORNL; ThomasJr., C. E. [Third Dimension Technologies, LLC, Knoxville, TN

    2009-01-01

    Plasma fueling with pellet injection, pacing of edge localized modes (ELMs) by small frequent pellets, and disruption mitigation with gas jets or injected pellets are some of the most important technological capabilities needed for successful operation of ITER. Tools are being developed at Oak Ridge National Laboratory that can be employed on ITER to provide the necessary core pellet fueling and the mitigation of ELMs and disruptions. Here we present progress on the development of the technology to provide reliable high throughput inner wall pellet fueling, pellet ELM pacing with high frequency small pellets, and disruption mitigation with gas jets and pellets. Examples of how these tools can be employed on ITER are discussed.

  15. Pacing, packing and sex-based differences in Olympic and IAAF World Championship marathons.

    Science.gov (United States)

    Hanley, Brian

    2016-09-01

    The aim of this study was to describe pacing profiles and packing behaviours of athletes in Olympic and World Championship marathons. Finishing and split times were collated for 673 men and 549 women across nine competitions. The mean speeds for each intermediate 5 km and end 2.2 km segments were calculated. Medallists of both sexes maintained even-paced running from 10 km onwards whereas slower finishers dropped off the lead pack at approximately half-distance. Athletes who ran with the same opponents throughout slowed the least in the second half (P medal positions. Marathon runners are advised to identify rivals with similar abilities and ambitions to run alongside provided they start conservatively. Coaches should note important sex-based differences in tactics adopted and design training programmes accordingly.

  16. [Research and development of artificial retina material].

    Science.gov (United States)

    Hu, Ning; Yang, Jun; Peng, Chenglin; Wang, Xing; Zhang, Sijie; Zhang, Ying; Zheng, Erxin

    2008-04-01

    The application of artificial retina was introduced. The principal characteristics of artificial retina material were reviewed in particular. Moreover, the recent research development and application prospect were discussed.

  17. natural or artificial diets

    Directory of Open Access Journals (Sweden)

    A. O. Meyer-Willerer

    2005-01-01

    Full Text Available Se probaron alimentos artificiales y naturales con larva de camarón (Litopenaeus vannamei cultivados en diferentes recipientes. Estos fueron ocho frascos cónicos con 15L, ocho acuarios con 50L y como grupo control, seis tanques de fibra de vidrio con 1500L; todos con agua marina fresca y filtrada. La densidad inicial en todos los recipientes fue de 70 nauplios/L. Aquellos en frascos y acuarios recibieron ya sea dieta natural o artificial. El grupo control fue cultivado con dieta natural en los tanques grandes que utilizan los laboratorios para la producción masiva de postlarvas. El principal producto de excreción de larva de camarón es el ión amonio, que es tóxico cuando está presente en concentraciones elevadas. Se determinó diariamente con el método colorimétrico del indofenol. Los resultados muestran diferencias en la concentración del ión amonio y en la sobrevivencia de larvas entre las diferentes dietas y también entre los diferentes recipientes. En aquellos con volúmenes pequeños comparados con los grandes, se presentó mayor concentración de amonio (500 a 750µg/L, en aquellos con dietas naturales, debido a que este ión sirve de fertilizante a las algas adicionadas, necesitando efectuar recambios diarios de agua posteriores al noveno día de cultivo para mantener este ión a una concentración subletal. Se obtuvo una baja cosecha de postlarvas (menor a 15% con el alimento artificial larvario, debido a la presencia de protozoarios, alimentándose con el producto comercial precipitado en el fondo de los frascos o acuarios. Los acuarios con larvas alimentadas con dieta natural también mostraron concentraciones subletales de amonio al noveno día; sin embargo, la sobrevivencia fue cuatro veces mayor que con dietas artificiales. Los tanques control con dietas naturales presentaron tasas de sobrevivencia (70 ± 5% similares a la reportada por otros laboratorios.

  18. Effect of Environmental and Feedback Interventions on Pacing Profiles in Cycling: A Meta-Analysis

    Science.gov (United States)

    Davies, Michael J.; Clark, Bradley; Welvaert, Marijke; Skorski, Sabrina; Garvican-Lewis, Laura A.; Saunders, Philo; Thompson, Kevin G.

    2016-01-01

    In search of their optimal performance athletes will alter their pacing strategy according to intrinsic and extrinsic physiological, psychological and environmental factors. However, the effect of some of these variables on pacing and exercise performance remains somewhat unclear. Therefore, the aim of this meta-analysis was to provide an overview as to how manipulation of different extrinsic factors affects pacing strategy and exercise performance. Only self-paced exercise studies that provided control and intervention group(s), reported trial variance for power output, disclosed the type of feedback received or withheld, and where time-trial power output data could be segmented into start, middle and end sections; were included in the meta-analysis. Studies with similar themes were grouped together to determine the mean difference (MD) with 95% confidence intervals (CIs) between control and intervention trials for: hypoxia, hyperoxia, heat-stress, pre-cooling, and various forms of feedback. A total of 26 studies with cycling as the exercise modality were included in the meta-analysis. Of these, four studies manipulated oxygen availability, eleven manipulated heat-stress, four implemented pre-cooling interventions and seven studies manipulated various forms of feedback. Mean power output (MPO) was significantly reduced in the middle and end sections (p 0.05). Negative feedback improved overall trial MPO and MPO in the middle section of trials (p 0.05). The available data suggests exercise regulation in hypoxia and heat-stress is delayed in the start section of trials, before significant reductions in MPO occur in the middle and end of the trial. Additionally, negative feedback involving performance deception may afford an upward shift in MPO in the middle section of the trial improving overall performance. Finally, performance improvements can be retained when participants are informed of the deception. PMID:27994554

  19. Basal metabolism in tropical birds: Latitude, altitude, and the 'pace of life'

    OpenAIRE

    Londoño, GA; Chappell, MA; Castañeda, MDR; Jankowski, JE; Robinson, SK

    2015-01-01

    © 2014 The Authors. Life history varies across latitudes, with the 'pace of life' being 'slower' in tropical regions. Because life history is coupled to energy metabolism via allocation tradeoffs and links between performance capacity and energy use, low metabolic intensity is expected in tropical animals. Low metabolism has been reported for lowland tropical birds, but it is unclear if this is due to 'slow' life history or to a warm, stable environment. We measured basal metabolic rates (BMR...

  20. The impact of the perception of rhythmic music on oscillatory self-paced movements

    Directory of Open Access Journals (Sweden)

    Mathieu ePeckel

    2014-09-01

    Full Text Available Inspired by theories of perception-action coupling and embodied music cognition, we investigated how rhythmic music perception impacts self-paced oscillatory movements. In a pilot study, we examined the kinematic parameters of self-paced oscillatory movements, walking and finger tapping using optical motion capture. In accordance with biomechanical constraints accounts of motion, we found that movements followed a hierarchical organization depending on the proximal/distal characteristic of the limb used. Based on these findings, we were interested in knowing how and when the perception of rhythmic music could resonate with the motor system in the context of these constrained oscillatory movements. In order to test this, we conducted an experiment where participants performed four different effector-specific movements (lower leg, whole arm and forearm oscillation and finger tapping while rhythmic music was playing in the background. Musical stimuli consisted of computer-generated MIDI musical pieces with a 4/4 metrical structure. The musical tempo of each song increased from 60 BPM to 120 BPM by 6 BPM increments. A specific tempo was maintained for 20s before a 2s transition to the higher tempo. The task of the participant was to maintain a comfortable pace for the four movements (self-paced while not paying attention to the music. No instruction on whether to synchronize with the music was given. Results showed that participants were distinctively influenced by the background music depending on the movement used with the tapping task being consistently the most influenced. Furthermore, eight strategies put in place by participants to cope with task were unveiled. Despite not instructed to do so, participants also occasionally synchronized with music. Results are discussed in terms of the link between perception and action (i.e. motor/perceptual resonance. In general, our results give support to the notion that rhythmic music is processed in a