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Sample records for degree atrioventricular block

  1. [Reversible first-degree atrioventricular block due to hyperthyroidism].

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    Çelebi, Aksüyek Savaş; Amasyalı, Basri

    2017-04-01

    Hyperthyroidism often causes tachyarrhythmia. Reversible atrioventricular block caused by hyperthyroidism is rare occurrence. Presently described is a case of atrioventricular block due to hyperthyroidism and recovery after antithyroid treatment.

  2. Pseudopacemaker syndrome and marked first-degree atrioventricular block: Case report

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    Panić Miloš

    2010-01-01

    Full Text Available Introduction. Pacemaker syndrome consists of the symptoms and signs present in the single chamber (VVI pacemaker patient with electrode placed in the right ventricular apex. It is caused by inadequate timing of atrial and ventricular contractions. Pacemaker syndrome without a pacemaker (or pseudopacemaker syndrome refers to occurrence of symptoms in the presence of marked first-degree atrioventricular (AV block, when P wave is too close to the preceding QRS complex producing the same haemodynamic disturbance as artificial pacemaker cardiac stimulation with retrograde VA conduction. Case Outline. We present the patient with acute inferior myocardial infarction due to late bare metal stent thrombosis, treated with primary pectutaneous coronary intervention. Hospital course was complicated by complete heart block which was treated with temporary pacing. During the stand-by mode of temporary pacing, sinus rhythm with marked first-degree AV block (PQ interval 480 ms was observed while the patients re-experienced the symptoms that were present prior to pacemaker implantation. Temporary pacing was continued for the next 24 hours when spontaneous shorteninig of PQ interval (250-270 ms was noticed; since the patient was asymptomatic during the stand-by mode, the pacemaker electrodes were removed and the patient discharged 11 days after admission. Conclusion. Conduction disturbances, such as the varying degrees of AV blocks, are relatively common in acute inferior myocardial infarction. The first degree AV blok is usually asymptomatic and does not require treatment, unless when it is associated with pseudopacemaker syndrome. In that case, temporary pacing provides haemodynamic stability until conduction system recovers.

  3. High-degree atrioventricular block complicating ST-segment elevation myocardial infarction in the era of primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Gang, Uffe Jakob Ortved; Hvelplund, Anders; Pedersen, Sune

    2012-01-01

    Primary percutaneous coronary intervention (pPCI) has replaced thrombolysis as treatment-of-choice for ST-segment elevation myocardial infarction (STEMI). However, the incidence and prognostic significance of high-degree atrioventricular block (HAVB) in STEMI patients in the pPCI era has been only...... sparsely investigated. The objective of this study was to assess the incidence, predictors and prognostic significance of HAVB in STEMI patients treated with pPCI....

  4. Prognostic importance of complete atrioventricular block complicating acute myocardial infarction

    DEFF Research Database (Denmark)

    Aplin, Mark; Engstrøm, Thomas; Vejlstrup, Niels G

    2003-01-01

    Third-degree atrioventricular block after acute myocardial infarction is considered to have prognostic importance. However, its importance in conjunction with thrombolytic therapy and its relation to left ventricular function remains uncertain. This report also outlines an important distinction...... between atrioventricular block in the setting of anterior and inferior wall acute myocardial infarction, with profound clinical and prognostic implications....

  5. Prognostic importance of complete atrioventricular block complicating acute myocardial infarction

    DEFF Research Database (Denmark)

    Aplin, Mark; Engstrøm, Thomas; Vejlstrup, Niels G

    2003-01-01

    Third-degree atrioventricular block after acute myocardial infarction is considered to have prognostic importance. However, its importance in conjunction with thrombolytic therapy and its relation to left ventricular function remains uncertain. This report also outlines an important distinction...... between atrioventricular block in the setting of anterior and inferior wall acute myocardial infarction, with profound clinical and prognostic implications....

  6. Risk markers of late high-degree atrioventricular block in patients with left ventricular dysfunction after an acute myocardial infarction: a CARISMA substudy

    DEFF Research Database (Denmark)

    Gang, Uffe Jakob Ortved; Jøns, Christian; Jørgensen, Rikke Mørch;

    2011-01-01

    was documented in 28 (10%) patients during a median follow-up of 2.0 (0.4-2.0) years. Heart rate variability (HRV) measures and non-sustained ventricular tachycardia occurring at the week 6 Holter monitoring were highly predictive of HAVB. Power law slope .... An ILR was implanted for continuous arrhythmia surveillance. Risk stratification testing was performed at inclusion and 6 weeks after AMI. The tests included echocardiography, electrocardiogram (ECG), 24 h Holter monitoring, and an invasive electrophysiological study. High-degree atrioventricular block...

  7. Intermittent Atrioventricular Block following Fingolimod Initiation

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    E. Gialafos

    2014-01-01

    Full Text Available A 47-year-old female patient with multiple sclerosis (MS developed symptomatic intermittent 2nd degree atrioventricular block (AVB of five-hour duration, five hours after the first two doses of fingolimod, that resolved completely. Frequency domain analysis of heart rate variability (HRV revealed increased parasympathetic activity and decreased sympathetic tone, while modified Ewing tests were suggestive of impaired cardiac sympathetic function. We hypothesize that expression of this particular arrhythmia might be related to autonomic nervous system (ANS dysfunction due to demyelinating lesions in the upper thoracic spinal cord, possibly augmented by the parasympathetic effect of the drug.

  8. [Acute atrioventricular block in chronic Lyme disease].

    Science.gov (United States)

    Wagner, Vince; Zima, Endre; Gellér, László; Merkely, Béla

    2010-09-26

    The tick bite transmitted Lyme disease is one of the most common antropozoonosis, about 10 000 new infections are reported in Hungary each year. The progress and clinical presentation can vary, and carditis can occur in later stages. A serologically verified Lyme disease caused third degree atrioventricular block in young male presenting with presyncope. Based on the tick-bites mentioned a few weeks prior to hospital admission, Lyme carditis was considered with the administration of antibiotics and monitor observation. Typical skin lesions were not recognized and laboratory findings showed no pathology. An electrophysiological study recorded a predominant supra-His atrioventricular block. Total regression of conduction could be detected later and the serological tests established an underlying Lyme disease. Currently no definite treatment recommendation is available for the potentially reversible Lyme carditis. The tick bite seemed to be the key on our way to diagnosis; however, serological tests proved the disease to be older than one year. A detailed medical history and serological tests are essential in identifying the cause and pacemaker implantation can be avoided.

  9. Amplatzer Septal Occluder-induced Transient Complete Atrioventricular Block

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    Shan-Miao Lin

    2007-12-01

    Full Text Available Percutaneous transcatheter atrial septal defect (ASD closure is a widely used technique that has replaced open-heart surgical closure in many centers. The most common implant is the Amplatzer septal occluder which seems to be a highly effective and safe device. However, there are reports of complications associated with its implantation. We report a 9-year-old boy who presented with complete atrioventricular block after undergoing percutaneous closure of a large secundum ASD with an Amplatzer septal occluder. We treated the patient with oral prednisolone. The patient's atrioventricular conduction improved to second-degree Mobitz type 1 block on post-procedure day 24 and first-degree block on day 35. We conclude that patients with Amplatzer septal occluder-induced complete atrioventricular block generally have a good outcome, although it may take several weeks for improvement.

  10. Bloqueo aurículo-ventricular de primer grado en tirotoxicosis aguda First degree atrio-ventricular block in acute thyrotoxicosis

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    Antonio R. Vilches

    2004-02-01

    Full Text Available El cuadro clínico de la tirotoxicosis incluye síntomas cardiovasculares variados. La taquicardia sinusal es el trastorno electrocardiográfico más frecuente y los trastornos de conducción son extremadamente raros como modo de presentación. Comunicamos un caso de bloqueo aurículo-ventricular de primer grado en una paciente con hipertiroidismo recién diagnosticado y que comenzó días antes de la consulta con un cuadro general inespecífico. Su evaluación ulterior demostró que se trataba de una tirotoxicosis aguda autoinmune, y su tratamiento con metimazol corrigió el trastorno totalmente. Se discuten los mecanismos fisiopatológicos involucrados y las implicancias clínicas desde el punto de vista del internista.Thyrotoxicosis may present with a variety of cardiovascular symptoms. Sinus tachycardia is the most frequently encountered electrocardiographic abnormality and conduction disturbances are extremely uncommon. We present a case of first degree atrio-ventricular block in a patient with newly diagnosed hyperthyroidism and discuss the underlying pathophysiological mechanisms and the clinical implications from the internist’s standpoint.

  11. Clinical significance of late high-degree atrioventricular block in patients with left ventricular dysfunction after an acute myocardial infarction--a Cardiac Arrhythmias and Risk Stratification After Acute Myocardial Infarction (CARISMA) substudy

    DEFF Research Database (Denmark)

    Gang, Uffe Jakob Ortved; Jøns, Christian; Jørgensen, Rikke Mørch;

    2011-01-01

    High-degree atrioventricular block (HAVB) is a frequent complication in the acute stages of a myocardial infarction associated with an increased rate of mortality. However, the incidence and clinical significance of HAVB in late convalescent phases of an AMI is largely unknown. The aim of this st......High-degree atrioventricular block (HAVB) is a frequent complication in the acute stages of a myocardial infarction associated with an increased rate of mortality. However, the incidence and clinical significance of HAVB in late convalescent phases of an AMI is largely unknown. The aim...... of this study was to assess the incidence and prognostic value of late HAVB documented by continuous electrocardiogram (ECG) monitoring in post-AMI patients with reduced left ventricular function....

  12. Clinical significance of late high-degree atrioventricular block in patients with left ventricular dysfunction after an acute myocardial infarction--a Cardiac Arrhythmias and Risk Stratification After Acute Myocardial Infarction (CARISMA) substudy

    DEFF Research Database (Denmark)

    Gang, Uffe Jakob Ortved; Jøns, Christian; Jørgensen, Rikke Mørch;

    2011-01-01

    High-degree atrioventricular block (HAVB) is a frequent complication in the acute stages of a myocardial infarction associated with an increased rate of mortality. However, the incidence and clinical significance of HAVB in late convalescent phases of an AMI is largely unknown. The aim of this st...... of this study was to assess the incidence and prognostic value of late HAVB documented by continuous electrocardiogram (ECG) monitoring in post-AMI patients with reduced left ventricular function....

  13. Controversies in the Management of Isolated Congenital Atrioventricular Block.

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    DeNoble, Anna E; Kuller, Jeffrey A; Rhee, Eleanor J

    2015-08-01

    Congenital atrioventricular block (CAVB) affects approximately 2% of fetuses of mothers with anti-Ro or anti-La antibodies, regardless of maternal rheumatologic symptoms. Anti-Ro and anti-La antibodies are antinuclear antibodies commonly found in autoimmune diseases. Congenital atrioventricular block is associated with a relatively high fetal morbidity and mortality, particularly more advanced degrees of block. There is significant controversy surrounding surveillance of anti-Ro/La-positive pregnancies and treatment of fetuses diagnosed with CAVB. Studies of dexamethasone in the treatment of CAVB have yielded conflicting results, with most suggesting only a limited potential benefit in first- and seconddegree CAVB and in cases complicated by fetal hydrops. Larger prospective studies are needed to further evaluate the efficacy of intravenous immunoglobulin in the treatment of CAVB and of intravenous immunoglobulin and hydroxychloroquine in the prevention of CAVB in fetuses of at-risk mothers. Surveillance and treatment regimens should be determined on a case-by-case basis, taking into consideration the degree of CAVB, costs, and potential adverse effects of treatment.

  14. Brucella Infection Associated with Complete Atrioventricular Block

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    Bilici, Meki; Demir, Fikri; Yılmazer, Murat Muhtar; Bozkurt, Fatma; Tuzcu, Volkan

    2016-01-01

    Background: The clinical spectrum of Brucella infection is quite diverse and characterized by multi-system involvement. Patients present with myocarditis, endocarditis, or pericarditis. Infective endocarditis is the most common cardiovascular complication in patients with brucellosis. Although conduction abnormalities are seen in cases with endocarditis, they are reported very rarely in the setting of cardiac Brucella infection. Case Report: An eight and a half-year-old male patient was referred to our clinic due to inadequate response to cotrimaxazole plus streptomycin treatment at the 15th day of admission. Although local hospital records on the patient showed a heart rate of 80 bpm, we determined a heart rate of 46 bpm. The electrocardiogram showed complete atrioventricular (AV) block. The average heart rate was determined as 48 bpm with 24-hour Holter electrocardiogram (ECG) monitoring. The echocardiographic examination showed normal-sized heart chambers and the absence of valvular involvement. An agglutination test for brucellosis was found to be positive with a titer of 1/320. High fever, arthralgia, and splenomegaly regressed following doxycycline plus rifampicin therapy, but there was no improvement in the AV block. A permanent pacemaker was implanted because of the detection of an average heart rate of 48 bpm. Conclusion: Because cardiac failure and rhythm abnormalities are reported in the course of Brucella infection and may be associated with significant outcomes, cases with brucellosis should be evaluated carefully in terms of cardiac involvement. This report aims to draw attention to complete AV block as an extremely rare complication of Brucella infection. PMID:27761286

  15. Atrioventricular block and wiry hair in Teebi hypertelorism syndrome.

    Science.gov (United States)

    Han, Xiao-Dong; Cox, Vicki; Slavotinek, Anne

    2006-09-15

    We report on a 4 1/2-year-old girl with clinical features of Teebi hypertelorism syndrome (THS), including a prominent forehead with a widow's peak, heavy and broad eyebrows, hypertelorism, long palpebral fissures, ptosis, a thin upper lip, a grooved chin, and a left preauricular cyst. She required a pacemaker for third degree atrioventricular (AV) block, a finding that has not been previously reported in 36 other patients with THS and for which we were unable to identify other causes. We have reviewed the previous reports of THS and note a characteristic facial appearance with hypertelorism, heavy, broad, and arched eyebrows, a thin upper lip with a long and deep philtrum, and a prominent forehead. Structural cardiac defects were present in five patients, implying that cardiac investigations are warranted in patients with a cardiac murmur and a clinical diagnosis of THS.

  16. Electrical Injury-Induced Complete Atrioventricular Block: Is Permanent Pacemaker Required?

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    Osman Beton

    2015-01-01

    Full Text Available A considerable percentage of electrical injuries occur as a result of work activities. Electrical injury can lead to various cardiovascular disorders: acute myocardial necrosis, myocardial ischemia, heart failure, arrhythmias, hemorrhagic pericarditis, acute hypertension with peripheral vasospasm, and anomalous, nonspecific ECG alterations. Ventricular fibrillation is the most common arrhythmia resulting from electrical injury and is the leading cause of death in electrical (especially low voltage alternating current injury cases. Asystole, premature ventricular contractions, ventricular tachycardia, conduction disorders (various degrees of heart blocks, bundle-brunch blocks, supraventricular tachycardia, and atrial fibrillation are the other arrhythmic complications of electrical injury. Complete atrioventricular block has rarely been reported and permanent pacemaker was required for the treatment in some of these cases. Herein, we present a case of reversible complete atrioventricular block due to low voltage electrical injury in a young electrical technician.

  17. A Rare Heart Rhythm Problem in Acute Rheumatic Fever: Complete Atrioventricular Block

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    Ayse Kibar

    2014-03-01

    Full Text Available Rheumatic heart disease remains the most important cause of acquired heart disease in children and young adults. Different kinds of rhythm and conduction disturbances may be seen during the course of acute rheumatic fever (ARF. Long PR intervals are found commonly in rheumatic fever, but complete atrioventricular (AV block is an exceptionally rare manifestation. This case report is about a 14 year-old-female patient diagnosed as ARF based on migratory arthralgia and mild carditis who also developed complete heart block on admission. Electrocardiogram on the 3rd day of hospitalization depicts 2nd degree atrioventricular block (Mobitz I combined with PR prolongation. The ECG revealed a normal sinus rhythm with PR prolongation on the 4th day of hospitalization. Rarely, complete AV heart block can occur as a complication of ARF and may develop during the acute phase

  18. [Congenital atrioventricular block and maternal autoimmune diseases].

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    Herreman, G; Sauvaget, F; Généreau, T; Galezowski, N

    1990-01-01

    Congenital heart block is rare; it is acquired in utero, definitive and, more often than not, complete. It can be diagnosed by the appearance of fetal bradycardia around the 23rd week of gestation, during ultrasonographic monitoring of pregnancy. Heart block is usually associated with the presence of anti-Ro and/or anti-La antibodies in the mother's serum. These maternal immunological abnormalities can be isolated or associated with an autoimmune disease, usually systemic lupus erythematosus, but also Sjögren's syndrome, or more rarely still, an as yet unclassified connective tissue disease. Anti-Ro and anti-La antibodies cross the placental barrier and react with a fetal heart, leading to acute fetal myocarditis by the 17th week of gestation. When severe, it is lethal, otherwise it can result in degeneration and endocardial fibroelastosis, disrupting conduction and leading to congenital heart block. The ideal treatment would be prevention with corticosteroids. When the mother is Ro or La antibody-positive before pregnancy, elimination of these circulating antibodies can be attempted by treatment with 0.5 mg/kg body wt/d of prednisolone for 3 months. If the treatment is successful, corticotherapy can be prescribed early in the pregnancy to try to protect the fetus. However, there is not always a relationship between maternal anti-Ro antibodies and fetal heart block. If the Ro/La antibody-positive woman is already pregnant, but before her 17th week, it is possible to prescribe dexamethasone, which crosses the placenta and remains active, sometimes in association with plasmapheresis.

  19. Rapidly Progressive Atrioventricular Block in a Patient with Sarcoidosis

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    Nagham Saeed Jafar

    2014-01-01

    Full Text Available Cardiac sarcoidosis is a major cause of death in patients with systemic sarcoidosis. Cardiac manifestations are seen in 2.3% of the patients. Atrioventricular (AV block is one of the common manifestations of cardiac sarcoidosis. Other presentations of cardiac involvement include congestive heart failure, ventricular arrhythmias, and sudden cardiac death. The presence of AV block in young patients should raise the suspicion of sarcoidosis. AV block may be the only manifestation and patients may not have clinical evidence of pulmonary involvement. Here we describe a young male presented with exercise induced AV block rapidly progressing to complete heart block with recurrent syncope needing urgent pacemaker implantation. Factors that suggested an infiltrative process included his young age, rapidly progressive conduction abnormalities in the ECG in the absence of coronary disease, and previous history of cutaneous sarcoidosis.

  20. 急性心肌梗死伴一过性Ⅰ°房室传导阻滞的相关因素分析%Analysis of factors related to temporary first degree atrioventricular block in patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    马云霞; 王幸

    2014-01-01

    Objective To investigate the relationship between acute myocardial infarction with temporary first degree atrioventricular block and related factors. Methods 80 cases of hospitalized patients with acute myocardial infarction were retrospectively analyzed. Infarct location, the results of coronary angiography with temporary first degree atrioventricular block were observed and compared; the incidence of the risk factors of coronary heart disease, the incidence of shock and heart failure, and the incidence of second degree or third degree atrioventricular block with temporary first degree atrioventricular block (observation group) and those without first degree atrioventricular block (control group) were observed and compared. Results The incidence of the temporary Ⅰ ° AVB in patients with inferior wal AMI, inferior wal and other parts of the AMI had no significant difference (P>0.01); The incidence of the temporary Ⅰ ° AVB in patients with inferior wal , inferior wal and other parts of the AMI was significantly higher than that in patients with anterior wal AMI (P20.01);下壁及下壁合并其他部位AMI一过性Ⅰ° AVB发生率明显高于前壁AMI患者(P2<0.002,P3<0.01);右冠状动脉病变一过性Ⅰ° AVB明显高于前降支和回旋支(P<0.001);观察组与对照组在冠心病危险因素、发生休克和心衰、出现Ⅱ°或Ⅲ°房室传导阻滞(AVB)方面比较,其发生率无统计学差异。结论急性心肌梗死患者心电图出现一过性Ⅰ°房室传导阻滞与心梗部位及罪犯血管有关且预后较好。

  1. High-septal pacing reduces ventricular electrical remodeling and proarrhythmia in chronic atrioventricular block dogs

    DEFF Research Database (Denmark)

    Winckels, Stephan K G; Thomsen, Morten Bækgaard; Oosterhoff, Peter

    2007-01-01

    This study was designed to analyze the relevance of ventricular activation patterns for ventricular electrical remodeling after atrioventricular (AV) block in dogs.......This study was designed to analyze the relevance of ventricular activation patterns for ventricular electrical remodeling after atrioventricular (AV) block in dogs....

  2. [Complete atrioventricular block as the first clinical manifestation of a tick bite (Lyme disease)].

    Science.gov (United States)

    Bacino, Luca; Gazzarata, Massimo; Siri, Giambattista; Cordone, Stefano; Bellotti, Paolo

    2011-03-01

    A 52-year-old male patient presented to the emergency department because of malaise and frequent dizziness. The ECG revealed high-grade atrioventricular block that required placement of a temporary pacemaker. There were no other abnormalities in physical and echocardiographic examination, and coronary angiography excluded the presence of coronary artery disease. IgM and IgG antibodies against Borrelia were positive, and antibiotic therapy with ceftriaxone at the dose of 2 g/die for 15 days resulted in rapid regression of atrioventricular block. Seven-day ECG recording immediately after discharge and 24h ECG monitoring at 40 days confirmed the total disappearance of atrioventricular block. This represents a case of atrioventricular block as the first manifestation of Borrelia infection (Lyme disease). A prompt diagnosis and antibiotic therapy usually result in complete resolution of atrioventricular block without the need for a permanent pacemaker.

  3. [Supra-His complete atrioventricular block in a patient with subclinical hyperthyroidism].

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    Amasyalı, Basri; Barçın, Cem; Kılıç, Ayhan

    2011-12-01

    Subclinical hyperthyroidism is a difficult entity to diagnose because of silent clinical features and it may be easily underdiagnosed unless it is suspected and thyroid hormone levels are examined. Although atrioventricular (AV) conduction abnormalities such as complete heart block may occasionally be seen in hyperthyroidism, its association with subclinical hyperthyroidism has not been reported previously. We report on a 50-year-old female patient who did not have any systemic or cardiovascular disease or history of drug use that could affect AV conduction and presented with presyncope and complete heart block with narrow QRS complexes. Thyroid function tests showed subclinical hyperthyroidism and an electrophysiological study showed the supra-His level as the site of complete AV block. After initiation of antithyroid treatment (propylthiouracil), the patient's rhythm improved to second-degree AV block on the third day and returned to normal sinus rhythm on the fourth day.

  4. 室间隔缺损介入术后并发三度房室阻滞%Third-degree atrioventricular block after transcatheter closure of ventricular septal defect

    Institute of Scientific and Technical Information of China (English)

    白元; 宗刚军; 秦永文

    2009-01-01

    目的 分析国内室间隔缺损患者介入封堵术后三度房室阻滞的发生特点和原因.方法通过中国生物医学文献数据库和清华同方医学期刊数据库文献检索系统,以"室间隔缺损"和"传导"为任意字段进行检索,在纳入的文献中,重点对患者年龄、性别、术后三度房室阻滞的发生时间、恢复时间、处理措施等进行总结分析.结果 总计纳入23篇文献,共报道了73例术后出现三度房室阻滞的患者,女性和儿童多见.88%的三度房室阻滞发生于术后3~7 d.80%的病例均在症状出现后的7~15 d恢复窦性心律.有3例患者植入了永久起搏器.结论 室间隔缺损介入术后的三度房室阻滞有其发生发展的规律,多数为一过性,需植入永久性起搏器的患者极少.%Objective To observe clinical characteristics of third-degree atrioventricular block (AVB Ⅲ) after transcatheter closure of ventricular septal defect in China. Methods All the data were collected from the Chinese Bio-Medical Data-base and the Chinese Journal Full-text Data-base. The search term (all fields) used was "ventricular septal defect and conduction". The major items included age, sex, size of ven-tricular septal defect and the features of postoperative AVB Ⅲ. Results Twenty-three articles were reviewed in which the emphasis of analysis was conduction disorders after transcatheter closure of ventricular septal de-fect. There were 73 cases of postoperative AVB Ⅲ of the total 73 patients, most of them were women and chil-dren. In 88% of patients the AVB Ⅲ occurred in the first 3~7 day after surgery. AVB Ⅲ reversed during the 7~15 day after the onset of it in 80% of patients. Three patients required permanent pacemaker implantation due to irreversible AVB Ⅲ. Conclusion Postoperative AVB Ⅲ was transient in most of cases. The require-ment of permanent pacemaker implantation after closure is a rare but serious complication.

  5. 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

  6. Atrioventricular and interventricular groove and septal extension of right sinus of valsalva aneurysm: a rare cause of complete heart block.

    Science.gov (United States)

    Khan, Javaid Arif; Hussain, Mushtaq; Rizvi, Nadeem H; Fehmi, Nadeem; Hussain, Akhtar; Sial, Jawaid A

    2013-10-01

    A 26 years old male presented with vertigo and history of fall. The electrocardiogram revealed 2:1 second-degree heart block and later progression to complete heart block. Transthoracic echocardiography revealed aneurysm at the site of ascending aorta and computed tomographic scan showed an aneurysm of right sinsus of Valsalva extending into right atrioventricular and interventricular groove and causing complete heart block by compression on the conduction system. He also suffered from lymph node tuberculosis. This case report is unique because of rare presentation as complete heart block.

  7. Pathology of complete atrioventricular block in chronic chagas' myocarditis

    Directory of Open Access Journals (Sweden)

    Zilton A. Andrade

    1988-03-01

    Full Text Available Sclero-atrophy, fibrosis, vascular ectasia, phlebosclerosis and mild non-specific chronic inflammatory changes were observed in variable location and proportion involving the atrioventricular conducting tissue of the heart in five human cases of chronic Chagas' myocarditis associated with complete atrioventricular block. One case presented complete destruction of the A-V conduction system. In three cases the lesions were disseminated all along the conducting tissue but did not cause anywhere a complete disruption in the continuity of the system. The distal portion of the bundle branches were the most damaged sector of the system, exceptfor the fasciculi of the posterior division of the left bundle branch which were relatively preserved. One case exhibited bilateral sclero-atrophy of the bundle branches as the main change; and another showed early and mild fibrocalcific damage of the penetrating portion of the His bundle. The A-V node appeared as the least involved part of the conducting system in the cases studied. Demonstration of the lesions in this series of cases seems important because: a it reveals that complete atrioventriculr block in chronic Chagas' disease results from disseminated lesions and not from focal disruptive change as has been commonly observed in cases of other etiologies; b it shows that chronic inflammation can produce at the end variable and widespread vascular, degenerative andfibrotic alterations within the conducting tissue of the heart, which may lead to its total destruction.O estudo do sistema de condução atrioventricular através cortes seriados completos em cinco casos humanos de miocardite crônica chagásica e bloqueio A-V total revelou a presença de lesões de esclero-atrofia, fibrose, ectasia vascular, fleboesclerose e inflamação crônica inespeclfica envolvendo o sistema de maneira disseminada, mas com distribuição e intensidade variáveis de caso para caso. Em um caso, todo o sistema, do nódulo A

  8. Potential additional indicators for pacemaker requirement in isolated congenital atrioventricular block.

    NARCIS (Netherlands)

    Breur, J.M.; Udink ten Cate, F.E.; Kapusta, L.; Boramanand, N.; Cohen, M.I.; Crosson, J.E.; Lubbers, L.J.; Friedman, A.H.; Brenner, J.I.; Vetter, V.L.; Meijboom, E.J.

    2006-01-01

    Low heart rate is the predominantly used indication for pacemaker intervention in patients with isolated congenital atrioventricular block (CAVB). The aim of this study was to compare the difference in heart rates recorded with ECG and Holter monitoring between paced (PM) and nonpaced (NPM) patients

  9. Potential additional indicators for pacemaker requirement in isolated congenital atrioventricular block

    NARCIS (Netherlands)

    J.M.P.J. Breur; F.E.A.U. ten Cate; L. Kapusta; N. Boramanand; M.I. Cohen; J.E. Crosson; L.J. Lubbers; A.H. Friedman; J.I. Brenner; V.L. Vetter; E.J. Meijboom

    2006-01-01

    Low heart rate is the predominantly used indication for pacemaker intervention in patients with isolated congenital atrioventricular block (CAVB). The aim of this study was to compare the difference in heart rates recorded with ECG and Holter monitoring between paced (PM) and nonpaced (NPM) patients

  10. [Exercise-induced atrioventricular block. Significance of the ischemic component. Report of 4 new cases].

    Science.gov (United States)

    Rumoroso, J R; Montes Orbe, P M; Cembellín, J C; Pérez-García, P; González-Liébana, J; Gómez-Varela, S; Bodegas, A; Barrenetxea, J I

    1997-04-01

    We report four new cases of exercise-induced atrio-ventricular block (appearing during treadmill exercise testing). The mechanism was ischemia in two patients and the conduction disturbance disappeared after coronary artery bypass grafting. The literature on this matter is reviewed. Also the etiology, the natural history and management are discussed in these cases.

  11. Longitudinal echocardiographic follow-up in children with congenital complete atrioventricular block

    NARCIS (Netherlands)

    Beaufort-Krol, Gertie C. M.; Leeuwen, Miek J. M. Schasfoort-Van; Stienstra, Ymkje; Bink-Boelkens, Margreet Th. E.

    2007-01-01

    Background: Due to a low heart rate (HR) in children with congenital complete atrioventricular block (CCAVB), a larger stroke volume of the left ventricle (LV) may be expected. If so, end-diastolic (LVEDD) and end-systolic (LVESD) diameters may be enlarged and even dilated cardiomyopathy (DCM) may o

  12. Potential additional indicators for pacemaker requirement in isolated congenital atrioventricular block.

    NARCIS (Netherlands)

    Breur, J.M.; Udink ten Cate, F.E.A.; Kapusta, L.; Boramanand, N.; Cohen, M.I.; Crosson, J.E.; Lubbers, L.J.; Friedman, A.H.; Brenner, J.I.; Vetter, V.L.; Meijboom, E.J.

    2006-01-01

    Low heart rate is the predominantly used indication for pacemaker intervention in patients with isolated congenital atrioventricular block (CAVB). The aim of this study was to compare the difference in heart rates recorded with ECG and Holter monitoring between paced (PM) and nonpaced (NPM) patients

  13. 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

  14. 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

  15. Fetal atrioventricular and outflow tract flow velocity waveforms during conducted and blocked supraventricular extrasystoles

    NARCIS (Netherlands)

    K. van der Mooren (K.); J.W. Wladimiroff (Juriy); Th. Stijnen (Theo)

    1992-01-01

    textabstractMaximum flow velocity waveforms at atrioventricular and outflow tract level were studied cross‐sectionally in 19 human fetuses with conducted and/or blocked supraventricular extrasystoles ranging from 25 to 38 weeks of gestation. At outflow tract level, peak systolic velocity and acceler

  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. Third-degree AV block sensitive to prednisolone 72 hours post AVNRT ablation.

    Science.gov (United States)

    Parwani, Abdul S; Schröder, Anna I; Blaschke, Daniela; Blaschke, Florian; Huemer, Martin; Attanasio, Philipp; Pieske, Burkert; Boldt, Leif-Hendrik; Haverkamp, Wilhelm

    2017-05-01

    A patient developed a transient first-degree AV block during a radiofrequency ablation of an atrioventricular nodal reentrant tachycardia. Three days later the patient presented with a third-degree AV block. It resolved within 24 h under antiphlogistic therapy. Patient was asymptomatic without necessity for pacemaker implantation at 12 months follow-up.

  18. Complete atrioventricular block in adult Sjögren's syndrome with anti-Ro autoantibody.

    Science.gov (United States)

    Sung, Myung Jun; Park, Sung-Hoon; Kim, Seong-Kyu; Lee, Young-Soo; Park, Chul-Yeon; Choe, Jung-Yoon

    2011-06-01

    Anti-Ro autoantibody is associated with Sjögren's syndrome (SS), systemic lupus erythematosus (SLE), and neonatal lupus syndrome (i.e., congenital complete heart block in newborns). Generally, the adult atrioventricular (AV) node is believed to be relatively resistant to the scarring effects of anti-Ro/anti-La autoantibodies. However, there have been some reports of adult complete AV block in SS and SLE patients. Here, we report a case of complete heart block in primary SS with anti-Ro autoantibodies, with no other risk factor for the development of heart block, and review their etiological association.

  19. A Case of Adult-Onset Acute Rheumatic Fever With Long-Lasting Atrioventricular Block Requiring Permanent Pacemaker Implantation.

    Science.gov (United States)

    Oba, Yusuke; Watanabe, Hiroaki; Nishimura, Yoshioki; Ueno, Shuichi; Nagashima, Takao; Imai, Yasushi; Shimpo, Masahisa; Kario, Kazuomi

    2015-01-01

    A 45-year-old hypertensive Japanese woman presented with epigastric pain on inspiration, fever, complete atrioventricular block and polyarthritis. Her antistreptolysin O levels were markedly elevated. A diagnosis of rheumatic fever was made according to the modified Jones criteria. She was prescribed loxoprofen sodium, which was partially effective for her extracardiac clinical symptoms. However, she had syncope due to complete atrioventricular block with asystole longer than 10 seconds. Consequently, we implanted a permanent pacemaker. Although we prescribed prednisolone, the efficacy of which was limited for the patient's conduction disturbance, the complete atrioventricular block persisted. In our systematic review of 12 similar cases, the duration of complete heart block was always transient and there was no case requiring a permanent pacemaker. We thus encountered a very rare case of adult-onset acute rheumatic fever with persistent complete atrioventricular block necessitating permanent pacemaker implantation.

  20. Atrioventricular block induced by mad-honey intoxication: confirmation of diagnosis by pollen analysis.

    Science.gov (United States)

    Cagli, Kumral Ergun; Tufekcioglu, Omac; Sen, Nihat; Aras, Dursun; Topaloglu, Serkan; Basar, Nur; Pehlivan, Sevil

    2009-01-01

    An unusual type of food poisoning, mad-honey intoxication, can be observed in the Black Sea region of Turkey and various other parts of the world. It can occur after ingestion of grayanotoxin-contaminated honey produced from the nectar of Rhododendron ponticum and other plant species, chiefly of the Ericaceae and Sapindaceae families. Mad-honey intoxication can result in severe cardiac complications, such as complete atrioventricular block. The diagnosis is generally reached on the basis of the patient's history of honey intake. In this report, we describe the case of a patient who had mad-honey-related complete atrioventricular block; in this instance, the diagnosis was confirmed by a pollen analysis of the suspect honey.

  1. Atrioventricular block in coronary artery bypass surgery: perioperative predictors and impact on mortality

    Directory of Open Access Journals (Sweden)

    Ricardo Medeiros Piantá

    2015-04-01

    Full Text Available AbstractIntroduction:Disturbances of the cardiac conduction system are frequent in the postoperative period of coronary artery bypass surgery. They are mostly reversible and associated with some injury of the conduction tissue, caused by the ischemic heart disease itself or by perioperative factors.Objective:Primary: investigate the association between perioperative factors and the emergence of atrioventricular block in the postoperative period of coronary artery bypass surgery. Secondary: determine the need for temporary pacing and of a permanent pacemaker in the postoperative period of coronary artery bypass surgery and the impact on hospital stay and hospital mortality.Methods:Analysis of a retrospective cohort of patients submitted to coronary artery bypass surgery from the database of the Postoperative Heart Surgery Unit of the Sao Lucas Hospital of the Pontifical Catholic University of Rio Grande do Sul, using the logistic regression method.Results:In the period from January 1996 to December 2012, 3532 coronary artery bypass surgery were carried out. Two hundred and eighty-eight (8.15% of the total sample patients had atrioventricular block during the postoperative period of coronary artery bypass surgery, requiring temporary pacing. Eight of those who had atrioventricular block progressed to implantation of a permanent pacemaker (0.23% of the total sample. Multivariate analysis revealed a significant association of atrioventricular block with age above 60 years (OR=2.34; CI 95% 1.75-3.12; P<0.0001, female gender (OR=1.37; CI 95% 1.06-1.77; P=0.015, chronic kidney disease (OR=2.05; CI 95% 1.49-2.81; P<0.0001, atrial fibrillation (OR=2.06; CI 95% 1.16-3.66; P=0.014, functional class III and IV of the New York Heart Association (OR=1.43; CI 95% 1.03-1.98; P=0.031, perioperative acute myocardial infarction (OR=1.70; CI 95% 1.26-2.29; P<0.0001 and with the use of the intra-aortic balloon in the postoperative period of coronary artery bypass

  2. Complete paroxysmal atrioventricular block in a 2-year-old girl

    DEFF Research Database (Denmark)

    Holst, Line M; Dixen, Ulrik; Jeppesen, Dorthe L

    2014-01-01

    We present a case of atypical syncope in a 2-year-old, otherwise healthy girl. The patient presented with three episodes of syncope without any precipitating factors and no family history of sudden unexpected death. Holter monitoring revealed 24 events of complete atrioventricular block lasting u...... to 6 seconds. A normal 12-lead electrocardiogram does not necessarily exclude cardiac disease, and Holter monitoring is warranted in children with atypical syncope....

  3. Takotsubo Cardiomyopathy With Significant Coronary Stenosis and Atrioventricular Conduction Block: A Rare Case Report With 3 Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Saadatifar

    2015-12-01

    Full Text Available Introduction Takotsubo cardiomyopathy (TCMP is a rare acute cardiomyopathy characterized by acute chest pain syndrome, similar to myocardial infarction, except that no significant stenosis is observed on coronary angiography in patients with this condition; these findings aid the diagnosis of TCMP. Case Presentation We discuss an unusual case of TCMP in a 45-year-old woman with complete heart block and significant coronary artery stenosis. Maximal exercise test and perfusion scan after 1 month from the acute event did not show any ischemia; therefore, revascularization was not recommended. Her follow-up with normal echocardiographic data 3 years after the first event showed no recurrence Conclusions The present case and a few previous cases have showed that severe coronary artery disease may be occur in patients with TCMP and that TCMP may be associated with a high-degree atrioventricular block. The association between atrioventricular conduction block and TCMP as well as significant coronary stenosis is rarely reported; therefore, coronary angiography should be performed in all patients with clinical TCMP and the previous definition should be reconsidered. The occurrence of arrhythmia and later recovery is expected in these patients (due to a catecholamine surge.

  4. Atrium-atrioventricular node block: an unusual complication during catheter ablation of persistent atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    MIAO Cheng-long; SANG Cai-hua; DONG Jian-zeng; MA Chang-sheng

    2011-01-01

    Ablation of persistent atrial fibrillation is still a challenge for the ablationist. Extensive ablation is required under some conditions and could lead to some unintended complications. Here we report a case of atrium-atrioventricular node block complicating multiple catheter ablation procedures for persistent atrial fibrillation. After extensive ablation, including circumferential pulmonary vein ablation, linear ablation at the left atrial roof, mitral isthmus, atrial septum, cavotricuspid isthmus, and complex fractionated atrial electrogram ablation, conduction obstacle was found, and sinus impulse could not travel from the right atrium, atrial septum and left atrium to atrioventricular node. The case indicated that intensive ablation at some key sites, especially the interatrial septum, should be careful during ablation of atrial fibrillation.

  5. Transient complete atrioventricular block in a preterm neonate with congenital myotonic dystrophy: case report.

    Science.gov (United States)

    Kim, Hee Na; Cho, Young Kuk; Cho, Joo Hyun; Yang, Eun Mi; Song, Eun Song; Choi, Young Youn

    2014-06-01

    Congenital myotonic dystrophy (CMD) is an inherited neuromuscular disorder with cardiac rhythm abnormalities that may occur as a child grows. No report has described complete atrioventricular (AV) block detected in a neonate with CMD. We report a floppy infant of 31(+4) weeks gestation with complete AV block at birth, who was diagnosed with CMD by Southern analysis. She recovered from complete AV block 32 hr after temporary transcutaneous pacing was applied. To the best our knowledge, this is the first recorded case of a complete AV block accompanied by CMD during the neonatal period. When a newborn has a complete AV block, the physician should consider the possibility of the CMD and conduct a careful physical examination.

  6. 频率适应型双腔起搏器对男性Ⅲ度房室传导阻滞患者运动耐量和性生活质量的影响%Effect of rate adaptive dual-chamber pacemaker on exercise capacity and quality of sexual activity in male patients with third-degree atrioventricular block

    Institute of Scientific and Technical Information of China (English)

    闫哲; 豆颖; 王明太; 孙福成

    2013-01-01

    Objective To investigate the effect of rate adaptive dual-chamber pacemaker on exercise capacity and quality of sexual activity in male patients with third-degree atrioventricular block.Methods We randomly assigned 170 male patients with third-degree atrioventricular block to DDDR group (n =106) and control group (n =64).At the baseline and post treatment,we assessed the international index of erectile function (IIEF-5) and frequency of sexual activity.At the same time,6 min walking test (6MWT) was recorded.The distance and heart rate of 6MWT were measured; left ventricular ejection fraction (LVEF) and cardiac output were also calculated.Results Compared with the control group,The IIEF-5 score,sexual satisfaction and frequency of sexual activity [(20 ± 6) scores vs (16 ± 5) scores,(4.6 ± 1.3) scores vs (2.6 ± 1.6) scores,(6.1 ± 2.9) times/month vs (3.4 ± 1.7) times/month] had a significant increase in DDDR group after treatment (P < 0.05).Compared with the control group,the distance and heart rate of 6MWT and cardiac output in DDDR group significant increased [(528±106)m vs (379 ±75)m,(127 ± 9) times/min vs (51 ± 8)times/min,(4.8 ±0.7)times/min vs (3.9 ±0.5)times/min] ; there was a significant difference between the DDDR group and control group (P < 0.05).Conclusions Among male patients with third-degree atrioventricular block,those treated with DDDR have improvements in exercise capacity and quality of sexual activity than control group.These improvements are positively associated with increases in exercise capacity during sexual intercourse.%目的 观察频率适应型双腔起搏器(DDDR型起搏器)对男性Ⅲ度房室传导阻滞患者运动耐量和性生活质量的影响.方法 选择2008年8月至2012年8月在商丘市第一人民医院住院治疗的Ⅲ度房室传导阻滞患者共计170例.根据有无植入DDDR型起搏器分组为对照组(64例)和DDDR组(106例).采用国际男性性功能判断指数(IIEF-5)量表观察治疗前

  7. A case of Kearns-Sayre sindrome with autoimmune thyroiditis and complete atrio-ventricular block.

    Science.gov (United States)

    Berio, A; Piazzi, A

    2006-06-01

    The Kearns-Sayre syndrome, (characterized by its onset before the age of 20 years, chronic ophthalmoplegia, pigmentary retinal degeneration and at least one of the following symptoms: ataxia, heart block and high protein content in the cerebrospinal fluid) is a severe variant of chronic progressive external ophthalmoplegia with frequent rearrangements of the mitochondrial DNA (mtDNA). The aim of this paper is to report a sporadic paediatric case of Kearns-Sayre syndrome with mtDNA heteroplasmic deletion, absence of cytochrome c-oxidase in many muscle fibers, autoimmune thyroiditis, complete atrio-ventricular heart block in which the diagnosis of subclinical hypothyroiditis associated with autoimmune thyroid disease was made. The subclinical hypothyroidism, more severe in the presence of thyroid antibodies, may have contributed to the pathogenesis of cardiovascular disease. We hypothesized that in this patient, predisposed by mitochondrial deletion, anti-thyroid antibodies may have interfered with the mitochondrial function of conduction heart system, causing atrio-ventricular heart block. It seems important to study anti-thyroid antibodies in every case of Kearn-Sayre syndrome, specially if cardiac rhythm disturbances are present.

  8. A combination therapy protocol of plasmapheresis, intravenous immunoglobulins and betamethasone to treat anti-Ro/La-related congenital atrioventricular block. A case series and review of the literature.

    Science.gov (United States)

    Ruffatti, Amelia; Marson, Piero; Svaluto-Moreolo, Giorgio; Marozio, Luca; Tibaldi, Maria; Favaro, Maria; Calligaro, Antonia; Grava, Chiara; Hoxha, Ariela; Pengo, Vittorio; Punzi, Leonardo

    2013-05-01

    The aim of this report was to evaluate the efficacy and safety of a combined treatment protocol used to treat 2nd and 3rd degree anti-Ro/La-related congenital atrioventricular block (CAVB). Six consecutive women diagnosed with 2nd degree (three cases) or 3rd degree block (three cases) between 2009 and 2011 referred to our outpatient clinic underwent a combination therapy protocol composed of weekly plasmapheresis, fortnightly 1g/kg intravenous immunoglobulins (IVIG) and daily betamethasone (4mg/day) throughout pregnancy. IVIG (1g/kg) treatment in the neonates was begun at birth and administered every fifteen days until passive maternal antibodies became undetectable. The fetuses affected with 2nd degree block (cases 1, 2 and 3) reverted to a normal atrioventricular conduction after combined therapy, while those with a 3rd degree block remained stable (case 4), showed an increase in the ventricular rate (case 5) or an improvement in cardiac function (case 6). None of the fetuses with 3rd degree CAVB had other cardiac complications such as cardiomyopathy or fetal hydrops. The follow-up of the children affected with 2nd degree CAVB revealed a complete regression of the block in cases 1 and 3, and no signs of relevant worsening in case 2. The infants affected with 3rd degree block (cases 4, 5, and 6) remained stable and until now only one has required a pacemaker at the age of 10months. If these results are confirmed by large-scale studies, this protocol could lead to improved outcomes in the treatment of this devastating disease. Copyright © 2013 Elsevier B.V. All rights reserved.

  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. Occurrence of atrioventricular block during supraventricular tachycardia: What is its possible mechanism?

    Directory of Open Access Journals (Sweden)

    Ho-Shun Cheng

    2014-02-01

    Full Text Available A female patient was admitted to our hospital for catheter ablation arising from paroxysmal supraventricular tachycardia (PSVT. In the laboratory, PSVT (the earliest retrograde atrial activation at the coronary sinus ostium with intermittent atrioventricular (AV block could be induced repeatedly. The tachycardia could be terminated during ventricular pacing without retrograde conduction to the atria. Therefore, orthodromic AV reciprocating tachycardia (AVRT and atrial tachycardia (AT could be ruled out and AV nodal re-entrant tachycardia (AVNRT was subsequently considered. Initial attempts using slow or intermediate AV nodal ablation failed to cure the tachycardia. We considered the possibility of orthodromic AV reciprocating tachycardia (AVRT with AV block occurring during the tachycardia. The tachycardia was successfully terminated during the ablation of the right posteroseptal pathway at the coronary sinus ostium. We hypothesized about the possible explanation that might help to clarify the phenomenon of AV block during SVT in order to provide some guidance to other clinicians confronted with similar patient challenges in the future.

  11. First Degree Pacemaker Exit Block

    Directory of Open Access Journals (Sweden)

    Johnson Francis

    2016-10-01

    Full Text Available Usually atrial and ventricular depolarizations follow soon after the pacemaker stimulus (spike on the ECG. But there can be an exit block due to fibrosis at the electrode - tissue interface at the lead tip. This can increase the delay between the spike and atrial or ventricular depolarization.

  12. A combination therapy to treat second-degree anti-Ro/La-related congenital heart block: a strategy to avoid stable third-degree heart block?

    Science.gov (United States)

    Ruffatti, A; Milanesi, O; Chiandetti, L; Cerutti, A; Gervasi, M T; De Silvestro, G; Pengo, V; Punzi, L

    2012-05-01

    While mainly based on the use of fluorinated steroids, there is no standard management of anti-Ro/La-related congenital heart block (CHB). This is a report concerning two consecutive cases of anti-Ro/La-related second-degree block treated with betamethasone (4 mg/day), weekly plasmapheresis, and intravenous immunoglobulins (IVIGs; 1 g/kg) administered every 15 days, a therapy that was begun shortly after CHB was detected and continued until delivery. The newborns were also treated with IVIG (1 g/kg) soon after birth and continued fortnightly until the anti-Ro/La antibody levels became undetectable. In both cases second-degree AV block reverted to a stable sinus rhythm with a first-degree atrioventricular (AV) block. Moreover, there was no recurrence of CHB when therapy was suspended, as confirmed by a 29 month and an eight month follow-up, respectively.

  13. Functional Capacity of Patients with Pacemaker Due to Isolated Congenital Atrioventricular Block

    Directory of Open Access Journals (Sweden)

    Roberto Márcio de Oliveira Júnior

    2015-01-01

    Full Text Available Background: Isolated congenital atrioventricular block (CAVB is a rare condition with multiple clinical outcomes. Ventricular remodeling can occur in approximately 10% of the patients after pacemaker (PM implantation. Objectives: To assess the functional capacity of children and young adults with isolated CAVB and chronic pacing of the right ventricle (RV and evaluate its correlation with predictors of ventricular remodeling. Methods: This cross-sectional study used a cohort of patients with isolated CAVB and RV pacing for over a year. The subjects underwent clinical and echocardiographic evaluation. Functional capacity was assessed using the six-minute walk test. Chi-square test, Fisher's exact test, and Pearson correlation coefficient were used, considering a significance level of 5%. Results: A total of 61 individuals were evaluated between March 2010 and December 2013, of which 67.2% were women, aged between 7 and 41 years, who were using PMs for 13.5 ± 6.3 years. The percentage of ventricular pacing was 97.9 ± 4.1%, and the duration of the paced QRS complex was 153.7 ± 19.1 ms. Majority of the subjects (95.1% were asymptomatic and did not use any medication. The mean distance walked was 546.9 ± 76.2 meters and was strongly correlated with the predicted distance (r = 0.907, p = 0.001 but not with risk factors for ventricular remodeling. (Arq Bras Cardiol. 2014; [online].ahead print, PP.0-0 Conclusions: The functional capacity of isolated CAVB patients with chronic RV pacing was satisfactory but did not correlate with risk factors for ventricular remodeling.

  14. Primary percutaneous coronary intervention ameliorates complete atrioventricular block complicating acute inferior myocardial infarction

    Directory of Open Access Journals (Sweden)

    Lee SN

    2014-11-01

    Full Text Available Su Nam Lee, You-Mi Hwang, Gee-Hee Kim, Ji-Hoon Kim, Ki-Dong Yoo, Chul-Min Kim, Keon-Woong MoonDepartment of Internal Medicine, St Vincent’s Hospital, The Catholic University of Korea, Suwon, South KoreaObjective: Complete atrioventricular block (CAVB in acute inferior ST-segment elevation myocardial infarction (STEMI is associated with poor clinical outcomes after noninvasive treatment. This study was designed to determine the effect of primary percutaneous coronary intervention (PCI in patients with CAVB complicating acute inferior STEMI, at a single center.Methods: We enrolled 138 consecutive patients diagnosed with STEMI involving the inferior wall; of these, 27 patients had CAVB. All patients received primary PCI. The clinical characteristics, procedural data, and clinical outcomes were compared in patients with versus without CAVB. Results: Baseline clinical characteristics were similar between patients with and without CAVB. Patients with CAVB were more likely to present with cardiogenic shock, and CAVB was caused primarily by right coronary artery occlusion. Door-to-balloon time was similar between those two groups. After primary PCI, CAVB was reversed in all patients. The peak creatinine phosphokinase level, left ventricular ejection fraction and in-hospital mortality rate were similar between the two groups. After a median follow up of 318 days, major adverse cardiac events did not differ between the groups (8.1% in patients without CAVB; 11.1% in patients with CAVB (P=0.702.Conclusion: We conclude that primary PCI can ameliorate CAVB-complicated acute inferior STEMI, with an acceptable rate of major adverse cardiac events, and suggest that primary PCI should be the preferred reperfusion therapy in patients with CAVB complicating acute inferior myocardial infarction. Keywords: major adverse cardiac events, PCI-capable hospital

  15. Functional Capacity of Patients with Pacemaker Due to Isolated Congenital Atrioventricular Block

    Science.gov (United States)

    de Oliveira Júnior, Roberto Márcio; da Silva, Kátia Regina; Kawauchi, Tatiana Satie; Alves, Lucas Bassolli de Oliveira; Crevelari, Elizabeth Sartori; Martinelli, Martino; Costa, Roberto

    2015-01-01

    Background Isolated congenital atrioventricular block (CAVB) is a rare condition with multiple clinical outcomes. Ventricular remodeling can occur in approximately 10% of the patients after pacemaker (PM) implantation. Objectives To assess the functional capacity of children and young adults with isolated CAVB and chronic pacing of the right ventricle (RV) and evaluate its correlation with predictors of ventricular remodeling. Methods This cross-sectional study used a cohort of patients with isolated CAVB and RV pacing for over a year. The subjects underwent clinical and echocardiographic evaluation. Functional capacity was assessed using the six-minute walk test. Chi-square test, Fisher's exact test, and Pearson correlation coefficient were used, considering a significance level of 5%. Results A total of 61 individuals were evaluated between March 2010 and December 2013, of which 67.2% were women, aged between 7 and 41 years, who were using PMs for 13.5 ± 6.3 years. The percentage of ventricular pacing was 97.9 ± 4.1%, and the duration of the paced QRS complex was 153.7 ± 19.1 ms. Majority of the subjects (95.1%) were asymptomatic and did not use any medication. The mean distance walked was 546.9 ± 76.2 meters and was strongly correlated with the predicted distance (r = 0.907, p = 0.001) but not with risk factors for ventricular remodeling. Conclusions The functional capacity of isolated CAVB patients with chronic RV pacing was satisfactory but did not correlate with risk factors for ventricular remodeling. PMID:25387405

  16. Complete atrioventricular block in an adult with congenitally corrected transposition of the great arteries with interrupted inferior vena cava

    Directory of Open Access Journals (Sweden)

    Namsik Yoon

    2012-01-01

    Full Text Available A 56-year-old man got admitted as he was suffering from dizziness for 3 days. Electrocardiogram (ECG showed complete atrioventricular (AV block with ventricular rhythm of 35/min. We found that he had no inferior vena cava (IVC which drained into right atrium in the middle of temporary pacing lead insertion. Venous drainage into superior vena cava from dilated azygos vein was identified after venogram. Echocardiogram revealed a congenitally corrected transposition of the great arteries (CCTGA. Chest computed tomography (CT angiogram revealed AV and ventriculoarterial discordance with reversed ventricles and interrupted IVC with azygos continuation. DDD pacemaker was implanted via left axillary vein without any problem.

  17. Infinite-degree-corrected stochastic block model

    DEFF Research Database (Denmark)

    Herlau, Tue; Schmidt, Mikkel Nørgaard; Mørup, Morten

    2014-01-01

    In stochastic block models, which are among the most prominent statistical models for cluster analysis of complex networks, clusters are defined as groups of nodes with statistically similar link probabilities within and between groups. A recent extension by Karrer and Newman [Karrer and Newman......, Phys. Rev. E 83, 016107 (2011)] incorporates a node degree correction to model degree heterogeneity within each group. Although this demonstrably leads to better performance on several networks, it is not obvious whether modeling node degree is always appropriate or necessary. We formulate the degree...... corrected stochastic block model as a nonparametric Bayesian model, incorporating a parameter to control the amount of degree correction that can then be inferred from data. Additionally, our formulation yields principled ways of inferring the number of groups as well as predicting missing links...

  18. Normalisation of left ventricular systolic function after change from VVI pacing to biventricular pacing in a child with congenital complete atrioventricular block, long-QT syndrome, and congenital muscular dystrophy

    DEFF Research Database (Denmark)

    Ellesøe, Sabrina G; Reimers, Jesper I; Andersen, Henrik

    2013-01-01

    Development of dilated cardiomyopathy in patients with congenital complete atrioventricular block with or without pacemaker is well described. We report a case of dilated cardiomyopathy in a child with congenital complete atrioventricular block, long-QT syndrome, and VVI pacemaker. Temporary pacing...

  19. Radiotherapy as a cause of complete atrioventricular block in Hodgkin's disease: an electrophysiological-pathological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, S.I.; Bharati, S.; Glass, J.; Lev, M.

    1981-04-01

    A 20-year-old man contracted Hodgkin's disease and was treated with mantle radiotherapy. Heart block developed 11 years later. Electrocardiograms revealed predominant atrioventricular (AV) block and occasional AV conduction. Intracardiac electrograms demonstrated that the site of AV block was above the level of the His bundle. A permanent transvenous pacemaker was implanted. Seven months later the patient died of complications from cryptococcal meningitis. Pathological study of the heart revealed marked arteriosclerosis with fibrosis of the epicardium, myocardium, and endocardium. Examination of the conduction system revealed extensive arteriolosclerosis of the sinoatrial node and its approaches. In addition, there was marked fibrosis of the approaches to the AV node, the AV bundle, and both bundle branches. There was no evidence of Hodgkin's disease. This case documents the rare occurrence of AV block due to tissue destruction by radiotherapy. There was a good correlation between block proximal to the His bundle recording site and fibrosis of the approaches to the AV node.

  20. Radiotherapy as a cause of complete atrioventricular block in Hodgkin's disease. An electrophysiological-pathological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, S.I.; Bharati, S.; Glass, J.; Lev, M.

    1981-04-01

    A 20-year-old man contracted Hodgkin's disease and was treated with mantle radiotherapy. Heart block developed 11 years later. Electrocardiograms revealed predominant atrioventricular (AV) block and occasional AV conduction. Intracardiac electrograms demonstrated that the site of AV block was above the level of the His bundle. A permanent transvenous pacemaker was implanted. Seven months later the patient died of complications from cryptococcal meningitis. Pathological study of the heart revealed marked arteriosclerosis with fibrosis of the epicardium, myocardium, and endocardium. Examination of the conduction system revealed extensive arteriolosclerosis of the sinoatrial node and its approaches. In addition, there was marked fibrosis of the approaches to the AV node, the AV bundle, and both bundle branches. There was no evidence of Hodgkin's disease. This case documents the rare occurrence of AV block due to tissue destruction by radiotherapy. There was a good correlation between block proximal to the His bundle recording site and fibrosis of the approaches to the AV node.

  1. Electrophysiological measurements that can explain and guide temporary accelerated pacing to avert (re)occurrence of torsade de pointes arrhythmias in the canine chronic atrioventricular block model

    NARCIS (Netherlands)

    Wijers, Sofieke C.; Bossu, Alexandre; Dunnink, Albert; Beekman, Jet D.M.|info:eu-repo/dai/nl/297687883; Varkevisser, Rosanne; Aranda Hernández, Alfonso; Meine, Mathias|info:eu-repo/dai/nl/304821497; Vos, Marc A.|info:eu-repo/dai/nl/07461522X

    2017-01-01

    Background Pacing at higher rates is known to suppress torsade de pointes (TdP) arrhythmias. Nevertheless, exact application and mechanism need further clarification. In the anesthetized canine chronic atrioventricular block model, ventricular remodeling is responsible for a high and reproducible

  2. Possibility as an anti-cancer drug of astemizole: Evaluation of arrhythmogenicity by the chronic atrioventricular block canine model

    Directory of Open Access Journals (Sweden)

    Hiroko Izumi-Nakaseko

    2016-06-01

    Full Text Available Since astemizole in an oral dose of 50 mg/kg/day was recently reported to exert anti-cancer effect in mice, we evaluated its proarrhythmic potential using the atrioventricular block dogs in order to clarify its cardiac safety profile. An oral dose of 3 mg/kg prolonged the QT interval without affecting the QTc (n = 4, whereas that of 30 mg/kg increased the short-term variability of repolarization and induced premature ventricular contractions in each animal, resulting in the onset of torsade de pointes in 1 animal (n = 4. Thus, proarrhythmic dose of astemizole would be lower than anti-cancer one, limiting its re-profiling as an anti-cancer drug.

  3. [Intra-uterine detection of atrio-ventricular block in two children whose mother had Sjögren's syndrome].

    Science.gov (United States)

    Herreman, G; Betous, F; Batisse, P; Bessis, R; Lesavre, P; Ferme, I

    1982-02-27

    A woman with isolated juvenile Sjögren's syndrome gave birth, at 3 years' interval, to two children with complete atrio-ventricular heart block (AVB). This is the first published case of AVB in children of mothers with Sjögren's syndrome without any clinical and laboratory evidence of connective tissue disease, notably lupus. Ultrasonography showed that the AVB was acquired in utero and occurred during the 23rd week of gestation. In both children the AVB was isolated, without any symptom of congenital malformation of the heart; there were no abnormalities of conduction in the mother. Early corticosteroid treatment of the mother's disease had no beneficial effect on AVB in the foetuses. Attempts to reproduce the condition experimentally met with failure.

  4. Cardiogenic Shock with Complete Atrio-ventricular Block in an Octogenarian Woman: Are we going too far?

    Directory of Open Access Journals (Sweden)

    Ziad Dahdouh

    2014-07-01

    Full Text Available We report a case of an octogenarian woman who suffered from cardiogenic shock following an inferolateral myocardial infarction extending to the right ventricle associated with complete atrioventricular heart block. Her initial status was critical with a poor prognosis. She requested an invasive full management to be able to continue to take care of her ill husband. She was managed with circulatory assistance, temporary pacing and percutaneous coronary intervention. The procedure was successfully performed and the patient showed a remarkable improvement in clinical condition. Cardiogenic shock complicating right heart ventricle in elderly requires careful patient selection for invasive strategies that can sometimes rely on the willingness of the patient, as the procedural outcome appears to be poor in this high-risk population.

  5. Long-term outcome in patients receiving permanent pacemaker implantation for atrioventricular block: Comparison of VDD and DDD pacing.

    Science.gov (United States)

    Liao, Jo-Nan; Chao, Tze-Fan; Tuan, Ta-Chuan; Kong, Chi-Woon; Chen, Shih-Ann

    2016-08-01

    A permanent pacemaker (PPM) with dual chamber pacing (DDD) offers atrioventricular synchronization for patients with atrioventricular block (AVB). Single lead atrial synchronous ventricular pacing mode (VDD) is an alternative, but there are concerns about its efficacy and risk of atrial undersensing. Whether VDD can be a good alternative in patients with AVB remains unknown. The aim of the present study was to compare the long-term risk of mortality of VDD with DDD pacing.A total of 207 patients undergoing PPM implantations for AVB with VDD mode were enrolled from 2000 to 2013. Another 828 age- and sex-matched patients undergoing DDD implantations during the same period of time were selected as the control group in a 1 to 4 ratio. The study endpoint was mortality.A total of 1035 patients (64.3% male) were followed up for 46.5 ± 43.2 months. The mean ages were 75.0 years for VDD, and 74.9 years for DDD. The Kaplan-Meier survival analysis showed no significant difference in long-term survival between the VDD and DDD groups (log-rank P = 0.313). After adjustment for baseline characteristics, the VDD and DDD groups had a similar long-term prognosis with an adjusted hazard ratio of 0.875 (P = 0.445). Further analyses for the risk of cardiovascular and noncardiovascular deaths also showed no significant differences between the 2 groups.The long-term prognosis of VDD mode is comparable to that of DDD mode. Single lead VDD can be considered as an alternative choice in patients with AVB without sinus nodal dysfunction.

  6. Dynamic Electrocardiogram Analysis of Vagal-Related Atrioventricular Block%迷走性房室阻滞动态心电图分析

    Institute of Scientific and Technical Information of China (English)

    潘懿坤; 李永华; 朱志坚

    2012-01-01

    Objective: To investigate the occurrence, development and outcome of vagal-related atrioventricular block (AV block). Methods: Clinical documents from 48 patients with vagal-related AV block were analyzed to explore the relationship and clinical significance between incidence of vagal-related AV block and age. Results: Vagal-related atrioventricular block is more common under 40 years of age, and it often occurs in the night sleep when heart rate is low. Conclusion: Vagal-related atrioventricular block is functional disorder, which is not need to do special treatment, let alone the permanent artificial pacemaker thereapy.%目的:探讨迷走性房室阻滞的发生、发展及转归。方法:通过对48例迷走性房室阻滞患者的年龄及发生时间的观察,研究年龄与房室阻滞的关系及临床意义。结果:迷走性房室阻滞多见于40岁以下,多发生于夜间睡眠(心率减慢)时。结论:迷走性房室阻滞属于功能性,无需特殊治疗,更不必安装永久性人工起搏器。

  7. Right ventricular electrical and mechanical synchronization by properly timed septal pacing in a patient with right bundle branch block and first degree AV block--a case report.

    Science.gov (United States)

    Siliste, Calin; Suran, Maria-Claudia-Berenice; Margulescu, Andrei-Dumitru; Vinereanu, Dragos

    2015-03-01

    We present a case of near-normalization of the QRS by septal pacing in a patient with dual-chamber pacemaker and underlying complete right bundle branch block and first degree atrioventricular block. The right ventricular mechanical synchronization suggested by the ECG was validated as such by strain echo. To the best of our knowledge, this is the first time it has been shown that the narrowing of the QRS corresponds to mechanical synchronization in a case of this seldom-recognized phenomenon.

  8. Mouse Model of Human Congenital Heart Disease: Progressive Atrioventricular Block Induced by a Heterozygous Nkx2-5 Homeodomain Missense Mutation.

    Science.gov (United States)

    Chowdhury, Rajib; Ashraf, Hassan; Melanson, Michelle; Tanada, Yohei; Nguyen, Minh; Silberbach, Michael; Wakimoto, Hiroko; Benson, D Woodrow; Anderson, Robert H; Kasahara, Hideko

    2015-10-01

    Heterozygous human NKX2-5 homeodomain (DNA-binding domain) missense mutations are highly penetrant for varied congenital heart defects, including progressive atrioventricular (AV) block requiring pacemaker implantation. We recently replicated this genetic defect in a murine knockin model, in which we demonstrated highly penetrant, pleiotropic cardiac anomalies. In this study, we examined postnatal AV conduction in the knockin mice. A murine knockin model (Arg52Gly, Nkx2-5(+/R52G)) in a 129/Sv background was analyzed by histopathology, surface, and telemetry ECG, and in vivo electrophysiology studies, comparing with control Nkx2-5(+/+) mice at diverse postnatal stages, ranging from postnatal day 1 (P1) to 17 months. PR prolongation (first degree AV block) was present at 4 weeks, 7 months, and 17 months of age, but not at P1 in the mutant mice. Advanced AV block was also occasionally demonstrated in the mutant mice. Electrophysiology studies showed that AV nodal function and right ventricular effective refractory period were impaired in the mutant mice, whereas sinus nodal function was not affected. AV nodal size was significantly smaller in the mutant mice than their controls at 4 weeks of age, corresponding to the presence of PR prolongation, but not P1, suggesting, at least in part, that the conduction abnormalities are the result of a morphologically atrophic AV node. The highly penetrant and progressive AV block phenotype seen in human heterozygous missense mutations in NKX2-5 homeodomain was replicated in mice by knocking in a comparable missense mutation. © 2015 American Heart Association, Inc.

  9. Lesson Ten Atrioventricular block%房室传导阻滞

    Institute of Scientific and Technical Information of China (English)

    鲁端; 王劲

    2004-01-01

    @@ The specialized cardiac conducting system normally ensures synchronous conduction of each sinus impulse from the atria to the ventricles.Abnormalities of conduction of the sinus impulse to the ventricles may portend the development of heart block,which can ultimately lead to syncope or cardiac arrest1. In order to evaluate the clinical significance of conduction abnormalities,the physician must assess①the site of conduction disturbance, ②the risk of progression to complete block,and ③the probability that a subsidiary escape rhythm arising distal to the site of block will be electrophysiologically and hemodynamically stable2.This latter point is perhaps the most important,since the rate and stability of the escape pacemaker determine what symptoms result from heart block3.

  10. A case of complete atrioventricular block: The use of magnetic resonance imaging conditional pacemakers for diagnosing cardiac sarcoidosis

    Directory of Open Access Journals (Sweden)

    Yosuke Miwa, MD

    2014-04-01

    Full Text Available A 50-year-old man presented to the emergency department with repeated episodes of faintness and exertional dyspnea, and was found to have an atrioventricular (AV block. Chest radiography and transthoracic echocardiography results were normal, without any evidence of heart failure, wall motion abnormalities, interventricular septum thinning, or bilateral hilar lymphadenopathy. A temporary pacemaker was implanted, followed by a permanent pacemaker. Chest computed tomography with contrast enhancement did not show abnormalities, including patent coronary arteries, lymph node adenopathy, and pulmonary abnormalities. Thus, an MRI conditional dual chamber pacemaker and leads were implanted. Six weeks following the implant, a cardiac MRI was performed to test for cardiac sarcoidosis. Although cine imaging showed normal left and right ventricular function, late gadolinium enhancement demonstrated multiple enhanced uptakes. Based on the results of the cardiac MRI, PET, and gallium scintigraphy, the most likely diagnosis was cardiac sarcoidosis. Although no abnormal findings were found on physical examination, blood work, chest radiography, and transthoracic echocardiogram, multiple regions of delayed enhancement were observed in the cardiac MRI. Thus, MRI conditional pacemakers are a useful tool for diagnosing cardiac sarcoidosis and early therapeutic intervention.

  11. First-degree AV block-an entirely benign finding or a potentially curable cause of cardiac disease?

    Science.gov (United States)

    Holmqvist, Fredrik; Daubert, James P

    2013-05-01

    First-degree atrioventricular (AV) block is a delay within the AV conduction system and is defined as a prolongation of the PR interval beyond the upper limit of what is considered normal (generally 0.20 s). Up until recently, first-degree AV block was considered an entirely benign condition. In fact, some complain that it is a misnomer since there is only delay and no actual block in the AV conduction system (usually within the AV node). However, it has long been acknowledged that extreme forms of first-degree AV block (typically a PR interval exceeding 0.30 s) can cause symptoms due to inadequate timing of atrial and ventricular contractions, similar to the so-called pacemaker syndrome. Consequently, the current guidelines state that permanent pacemaker implantation is reasonable for first-degree AV block with symptoms similar to those of pacemaker syndrome or with hemodynamic compromise, but also stresses that there is little evidence to suggest that pacemakers improve survival in patients with isolated first-degree AV block. Recent reports suggest that it may be time to revisit the impact of first-degree AV block. Also, several findings in post hoc analyses of randomized device trials give important insights in possible treatment options. The present review aims to provide an update on the current knowledge concerning the impact of first-degree AV block and also to address the issue of pacing in patients with this condition. ©2013, Wiley Periodicals, Inc.

  12. [Neonatal lupus erythematosus: complete atrioventricular block and SSA/Ro antibodies].

    Science.gov (United States)

    Prados, R; Maroto, E; López Longo, J; Monteagudo, I; Carreño, L; García, E J

    1987-06-01

    A newborn boy with complete A-V block and positive anti-SSA/Ro antibodies is reported. Authors comment on pathological findings of neonatal lupus erythematosus. They also review prognosis and clinical course and point out management of these patients before and after birth.

  13. Prevalence of cardiac dyssynchrony and correlation with atrio-ventricular block and QRS width in dilated cardiomyopathy

    DEFF Research Database (Denmark)

    Anzouan-Kacou, J B; Ncho-Mottoh, M P; Konin, C

    2012-01-01

    Cardiac dyssynchrony causes disorganised cardiac contraction, delayed wall contraction and reduced pumping efficiency. We aimed to assess the prevalence of different types of dyssynchrony in patients with dilated cardiomyopathy (DCM), and to establish the correlation between atrio-ventricular blo...

  14. Hemodynamic effects of chronic prenatal ventricular pacing for the treatment of complete atrioventricular block.

    Science.gov (United States)

    Liddicoat, J R; Klein, J R; Reddy, V M; Klautz, R J; Teitel, D F; Hanley, F L

    1997-08-05

    Increasing the heart rate of the fetus with cardiac failure caused by complete AV block (CAVB) may allow delivery of a full-term, stable neonate with preserved ventricular function. Direct fetal pacing may be a feasible method to achieve this, but the effect of pacing on the structure and function of the rapidly developing fetal heart is unknown. CAVB was created in fetal lambs at 80% gestation by cryoablating the AV node. Epicardial ventricular pacing at 130 bpm was achieved by use of a pacemaker placed under the pectoral muscles. The fetus was returned to the uterus and allowed to continue to term. Ventricular function was assessed 1 week after birth in 7 lambs with CAVB and 10 control lambs. By use of the conductance catheter technique, the end-systolic pressure-volume relationship was determined at different heart rates, pacing conditions, and inotropic states. The contractility was not different between the two groups at their baseline heart rates and rhythms or when they were paced synchronously compared with asynchronously. Also, both groups responded significantly and similarly to inotropic manipulation, indicating preserved contractile reserve. Finally, in both groups, increased heart rates were associated with increased contractility, indicating an intact force-frequency relationship. We conclude that chronic epicardial ventricular pacing is well tolerated by the fetus, can be successfully applied as a treatment for CAVB, and does not adversely affect myocardial function in the rapidly developing, immature heart.

  15. Identification of a New Lamin A/C Mutation in a Chinese Family Affected with Atrioventricular Block as the Prominent Phenotype

    Institute of Scientific and Technical Information of China (English)

    吴小艳; 王擎; 桂乐; 刘木根; 张贤钦; 金润铭; 李伟; 闫露; 杜戎; 王秋芬; 祝建芳; 杨钧国

    2010-01-01

    Even though mutations in LMNA have been reported in patients with typical dilated cardio-myopathy(DCM)and atrioventricular block(AVB)previously,the purpose of this study was to disclose this novel genetic abnormality in one Chinese family with the atypical phenotype of progressive AVB followed by DCM with normal QRS interval.Genome-wide linkage analysis mapped the AVB gene in this family to a marker at chromosome 1q21.2,where the LMNA gene was located.Direct DNA sequence analysis revealed a heterozygous G t...

  16. High-degree atrioventricular block complicating acute myocardial infarction - Incidence, prediction and prognosis

    DEFF Research Database (Denmark)

    Gang, Uffe Jacob Ortved

    2010-01-01

    prognostiske konsekvenser af HAVB har dog ikke ændret sig. Bemærkelsesværdigt var det at mortalitetsraten udlignedes mellem patienter med og uden HAVB 30 dage efter AMI. En række patient karakteristika var forbundet med en øget risiko for udvikling af HAVB i den akutte fase efter AMI. Disse karakteristika var...

  17. Agenesia de cava superior associada a bloqueio atrioventricular de 3º grau Agenesis of the right superior vena cava associated with total heart block

    Directory of Open Access Journals (Sweden)

    Gustavo J. Ventura Couto

    2008-03-01

    Full Text Available A persistência de veia cava superior esquerda com ausência da veia cava superior é uma anomalia rara, principalmente quando associada a bloqueio atrioventricular de 3º grau. Relatamos o caso de uma paciente, na qual durante implante de marca-passo definitivo, para a correção de bloqueio atrioventricular total, foi detectada presença de veia cava superior esquerda com suspeição de ausência de veia cava superior, o que levou ao emprego de técnica diferenciada para fixação do eletrodo ventricular. Para confirmação da provável agenesia, foram realizados diversos exames complementares de imagem, demonstrando-se a dificuldade no diagnóstico da síndrome aqui descrita.The superior left vena cava with the absent superior vena cava is a rare abnormality, especially when associated with total heart block. We report a case of a patient in which the presence of superior left vena cava and the absence of the superior vena cava was detected during the implantation of a pacemaker for the correction of a total heart block, which led us to use a different technique for the fixation of the ventricular electrode. To confirm the supposed absence, several image exams were made showing the difficulty on the diagnosis of the described syndrome.

  18. Complex phenotype linked to a mutation in exon 11 of the lamin A/C gene: Hypertrophic cardiomyopathy, atrioventricular block, severe dyslipidemia and diabetes.

    Science.gov (United States)

    Francisco, Ana Rita G; Santos Gonçalves, Inês; Veiga, Fátima; Mendes Pedro, Mónica; Pinto, Fausto J; Brito, Dulce

    2017-09-01

    The lamin A/C (LMNA) gene encodes lamins A and C, which have an important role in nuclear cohesion and chromatin organization. Mutations in this gene usually lead to the so-called laminopathies, the primary cardiac manifestations of which are dilated cardiomyopathy and intracardiac conduction defects. Some mutations, associated with lipodystrophy but not cardiomyopathy, have been linked to metabolic abnormalities such as diabetes and severe dyslipidemia. Herein we describe a new phenotype associated with a mutation in exon 11 of the LMNA gene: hypertrophic cardiomyopathy, atrioventricular block, severe dyslipidemia and diabetes. A 64-year-old woman with hypertrophic cardiomyopathy and a point mutation in exon 11 of the LMNA gene (c.1718C>T, Ser573Leu) presented with severe symptomatic ventricular hypertrophy and left ventricular outflow tract obstruction. She underwent septal alcohol ablation, followed by Morrow myectomy. The patient was also diagnosed with severe dyslipidemia, diabetes and obesity, and fulfilled diagnostic criteria for metabolic syndrome. No other characteristics of LMNA mutation-related phenotypes were identified. The development of type III atrioventricular block with no apparent cause, and mildly depressed systolic function, prompted referral for cardiac resynchronization therapy. In conclusion, the association between LMNA mutations and different phenotypes is complex and not fully understood, and can present with a broad spectrum of severity. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Analysis of Onset Mechanisms of a Sphingosine 1-Phosphate Receptor Modulator Fingolimod-Induced Atrioventricular Conduction Block and QT-Interval Prolongation

    Energy Technology Data Exchange (ETDEWEB)

    Yagi, Yukihiro [Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143–8540 (Japan); Pharmaceutical Research Center, Meiji Seika Pharma Co., Ltd., 760 Morooka-cho, Kohoku-ku, Yokohama, Kanagawa 222–8567 (Japan); Nakamura, Yuji [Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143–8540 (Japan); Kitahara, Ken [Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143–8540 (Japan); Division of Cardiovascular Medicine, Department of Internal Medicine, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143–8541 (Japan); Harada, Takuma [Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143–8540 (Japan); Kato, Kazuhiko; Ninomiya, Tomohisa [Pharmaceutical Research Center, Meiji Seika Pharma Co., Ltd., 760 Morooka-cho, Kohoku-ku, Yokohama, Kanagawa 222–8567 (Japan); Cao, Xin [Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143–8540 (Japan); Ohara, Hiroshi [Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143–8540 (Japan); Division of Cardiovascular Medicine, Department of Internal Medicine, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143–8541 (Japan); Izumi-Nakaseko, Hiroko [Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143–8540 (Japan); Suzuki, Kokichi [Pharmaceutical Research Center, Meiji Seika Pharma Co., Ltd., 760 Morooka-cho, Kohoku-ku, Yokohama, Kanagawa 222–8567 (Japan); Ando, Kentaro [Department of Pharmacology, Faculty of Medicine, Toho University, 5-21-16 Omori-nishi, Ota-ku, Tokyo 143–8540 (Japan); and others

    2014-11-15

    Fingolimod, a sphingosine 1-phosphate (S1P) receptor subtype 1, 3, 4 and 5 modulator, has been used for the treatment of patients with relapsing forms of multiple sclerosis, but atrioventricular conduction block and/or QT-interval prolongation have been reported in some patients after the first dose. In this study, we directly compared the electropharmacological profiles of fingolimod with those of siponimod, a modulator of sphingosine 1-phosphate receptor subtype 1 and 5, using in vivo guinea-pig model and in vitro human ether-a-go-go-related gene (hERG) assay to better understand the onset mechanisms of the clinically observed adverse events. Fingolimod (0.01 and 0.1 mg/kg) or siponimod (0.001 and 0.01 mg/kg) was intravenously infused over 10 min to the halothane-anaesthetized guinea pigs (n = 4), whereas the effects of fingolimod (1 μmol/L) and siponimod (1 μmol/L) on hERG current were examined (n = 3). The high doses of fingolimod and siponimod induced atrioventricular conduction block, whereas the low dose of siponimod prolonged PR interval, which was not observed by that of fingolimod. The high dose of fingolimod prolonged QT interval, which was not observed by either dose of siponimod. Meanwhile, fingolimod significantly inhibited hERG current, which was not observed by siponimod. These results suggest that S1P receptor subtype 1 in the heart could be one of the candidates for fingolimod- and siponimod-induced atrioventricular conduction block since S1P receptor subtype 5 is localized at the brain, and that direct I{sub Kr} inhibition may play a key role in fingolimod-induced QT-interval prolongation. - Highlights: • Fingolimod and siponimod are S1P{sub 1,3,4,5} and S1P{sub 1,5} receptor modulators, respectively. • Fingolimod and siponimod induced AV block in the halothane-anesthetized guinea pigs. • S1P{sub 1} in the hearts may be the target of fingolimod- and siponimod-induced AV block. • Fingolimod directly inhibited hERG current, which was not

  20. Beneficial and Adverse Effects of Electro-acupuncture Assessed in the Canine Chronic Atrio-ventricular Block Model Having Severe Hypertension and Chronic Heart Failure.

    Science.gov (United States)

    Cao, Xin; Lu, Shengfeng; Ohara, Hiroshi; Nakamura, Yuji; Izumi-Nakaseko, Hiroko; Ando, Kentaro; Zhu, Bingmei; Xu, Bin; Sugiyama, Atsushi

    2015-01-01

    Regarding the effects of electro-acupuncture for severe hypertension, we assessed its acute cardiovascular consequences with 4 subjects of the chronic atrioventricular block dogs having severe hypertension and chronic heart failure. The electro-acupuncture consisting of 2 mA at 2 Hz frequency was carried out for 30 min at Renying (ST-9) and Taichong (LR-3) every other day. Seven sessions were performed within 2 weeks. In the 1st and 7th sessions, the animals were anesthetized with pentobarbital to analyze the effects of the electro-acupuncture on cardiovascular variables. No significant change was detected in any of the basal control values of the cardiohemodynamic or electrophysiological variables between the 1st and 7th sessions. During the 1st session, electo-acupuncture produced a peak increase in mean blood pressure by 8.7% at 35 min (p hypertensive crisis at the beginning, clinicians have to pay attention on its use for patients with hypertension.

  1. Late complete atrioventricular block after closure of an atrial septal defect with a gore septal occluder (GSO™).

    Science.gov (United States)

    Dittrich, Sven; Sigler, Matthias; Priessmann, Helga

    2016-04-01

    Temporary intermittent complete heart block (CHB) occurred the day after interventional closure of an ASD with a 30 mm Gore Septal Occluder (GSO™) in a 2 years and 11-month-old female. CHB disappeared without further treatment and stable sinus rhythm recovered within 3 days. Only short episodes of 2nd degree AV-block (Wenckebach periodicity) at rare intervals were documented in Holter-monitors the following 2 months. Eleven months after device implantation the patient suffered from long lasting episodes of CHB. Surgical removal of the device resulted in incomplete recovery of AV-conduction. Histopathological work-up of the explanted GSO showed complete endothelialization of the device and regular scar formation. One year after surgery, the child had sinus rhythm during daytime but needed VVI-pacing while sleeping. Young age, inferior localization of the defect, and use of a large device have been individual risk factors for CHB in this patient. Clinical course and histologic findings indicate that mechanical compression was the only cause for CHB. The cumulative number of reports of CHB after use of different ASD-devices supports the recommendation to postpone the intervention in asymptomatic patients to preschool-age. Early removal of a pushing device may increase the chance of complete recovery from CHB. © 2015 The Authors. Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc.

  2. Efeitos da mudança de modo de estimulação ventricular para atrioventricular sobre a qualidade de vida em pacientes com cardiopatia chagásica e bloqueio atrioventricular na troca eletiva do gerador de pulsos Health-related quality of life in patients with Chagas' cardiomiopathy and complete atrioventricular block at elective pulse generator replacement: effects of pacing mode upgraded from VVI to DDD

    Directory of Open Access Journals (Sweden)

    Luiz Antonio Castilho Teno

    2005-03-01

    Full Text Available OBJETIVO: Avaliar os efeitos da mudança de modo de estimulação ventricular para atrioventricular sobre a qualidade de vida em pacientes com cardiopatia chagásica e bloqueio atrioventricular, na troca eletiva do gerador de pulsos. MÉTODO: No período de 8 de setembro de 2001 a 18 de março de 2004, no Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo e no Hospital de Beneficência Portuguesa de Ribeirão Preto, foram estudados comparativamente sob estimulação ventricular e atrioventricular 27 pacientes com cardiopatia chagásica e bloqueio atrioventricular, com indicação de troca eletiva do gerador de pulsos. Os pacientes foram analisados na inclusão do estudo e alternadamente no modo ventricular e atrioventricular em duas fases com duração de 90 dias, considerando-se o comportamento clínico, avaliado pela qualidade de vida. A análise estatística foi realizada na condição basal, modo VVI e modo DDD, utilizando-se o teste de variância para medidas repetidas, considerando-se nível de significância de 0,05. RESULTADOS: Não foram detectadas diferenças de comportamento na qualidade de vida, avaliada pela capacidade funcional pelo estado geral e pela vitalidade, entre os dois modos de estimulação cardíaca estudados. Ocorreram três casos de complicações relacionadas à mudança de modo de estimulação: dois casos de taquiarritmias atriais conduzidas pelo marcapasso e um caso de deslocamento de eletrodo atrial. CONCLUSÕES: A análise comparativa da estimulação ventricular com a atrioventricular, na troca eletiva do gerador, demonstrou que não houve diferença de comportamento clínico sobre a qualidade de vida.OBJECTIVE: Health-related quality of life in patients with Chagas' cardiomyopathy and complete atrioventricular block at elective pulse generator replacement: effects of pacing mode upgraded from VVI to DDD. METHOD: From September 8, 2001 to March 18, 2004, at the Instituto do Cora

  3. Advances in fetal immune mediated atrioventricular block%胎儿免疫性房室传导阻滞研究进展

    Institute of Scientific and Technical Information of China (English)

    严华林; 李一飞(综述); 周开宇; 华益民(审校)

    2015-01-01

    Fetal atrioventricular block (AVB) is a type of fetal bradyarrhythmias. The reported incidence of fetal complete atrioventricular block (CAVB) and mortality of perinatal fetuses and neonates are signiifcantly higher in pregnancies of anti-SSA/Ro-positive mothers than that of anti-SSA/Ro-negative mothers. The auto-antibodies in maternal serum that can be transported into fetal circulation through placenta may damage fetal cardiac conductive system and eventually result in fetal AVB. There are evidences that early diagnosis and proper treatment can improve the prognosis and survival rate of affected fetuses. In this article, the pathogenesis, risk factors, prenatal diagnosis, treatment and prognosis of fetal immune mediated AVB is reviewed.%胎儿房室传导阻滞属于胎儿缓慢性心律失常。当母体血清抗-SSA/Ro、抗-SSB/La抗体阳性时,胎儿完全性房室传导阻滞发病率和相关围生期胎儿/新生儿死亡率显著升高。母体血清自身抗体可经胎盘转运进入胎儿体内,可能导致胎儿心脏传导系统免疫损伤,从而引起房室传导阻滞发生。如果能进行胎儿免疫性房室传导阻滞的早期诊断和及时干预,可能阻止病情进展,改善免疫性房室传导阻滞胎儿的预后并提高其生存率。文章综述胎儿免疫性房室传导阻滞的发病机制、危险因素、产前诊断、胎儿期干预及预后等。

  4. Simultaneous conduction over the fast and slow pathways during induction of atrioventricular nodal reentrant arrhythmia with a rate of less than 100 bpm and infra-His block after radiofrequency ablation of the slow pathway.

    Science.gov (United States)

    Amasyalı, Basri; Köktürk, Bülent; Otomo, Kiyoshi; Köse, Sedat

    2011-04-01

    Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common form of paroxysmal regular supraventricular tachycardia in adults. It is typically induced with an anterograde block over the fast pathway (FP) and conduction over the slow pathway (SP), with subsequent retrograde conduction over the FP. Rarely, a simultaneous conduction of a premature atrial complex occurs over the FP and SP to induce AVNRT and is called "one for two phenomenon". We present a 46-year-old woman with atrioventricular nodal rhythm with a rate of 95 beats per minute with distinct electrophysiological characteristics showing simultaneous conduction over the FP and SP during induction of tachycardia and an infra-His block after radiofrequency ablation of the SP.

  5. Bloqueo aurículo-ventricular familiar progresivo tipo I: descripción clínica de una familia Progressive familial atrio-ventricular block type I: clinical description of a family

    Directory of Open Access Journals (Sweden)

    Guillermo Mora

    2011-10-01

    Full Text Available Se presenta el caso de una familia con bloqueo aurículo-ventricular, que compromete varias generaciones, con herencia mendeliana autosómica dominante, que afecta de manera progresiva el sistema de conducción cardiaco llevando a síncope y muerte súbita en edades tempranas. Esta entidad corresponde al bloqueo familiar cardiaco progresivo tipo I, descrito principalmente en Suráfrica. El tratamiento con marcapaso definitivo fue exitoso.We present the case of a family with atrio-ventricular block that involves several generations, with dominant autosomal mendelian inheritance that progressively affects the cardiac conduction system leading to syncope and sudden death in early life. This entity corresponds to progressive familial atrio-ventricular block type I, described mainly in South Africa . Treatment with permanent pacemaker therapy was successful.

  6. In vivo analysis of torsadogenic potential of an antipsychotic drug paliperidone using the acute atrioventricular block rabbit as a proarrhythmia model

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    Mihoko Hagiwara

    2016-09-01

    Full Text Available We assessed electrophysiological effects of an atypical antipsychotic drug paliperidone in acute atrioventricular block rabbits. Intravenous administration of paliperidone at a clinically relevant dose (0.06 mg/kg hardly affected the QT interval or monophasic action potential (MAP duration, and the higher doses (0.6 and 6 mg/kg prolonged the QT interval and MAP duration. Meanwhile, premature ventricular contractions with R on T phenomenon were observed in 3 out of 6 animals at the middle dose, and torsades de pointes (TdP episodes were detected in 2 out of 6 animals at the high dose. Intravenous administration of its chemically related compound risperidone at a clinically relevant dose (0.03 mg/kg hardly affected the electrophysiological parameters, and the higher doses (0.3 and 3 mg/kg prolonged the QT interval and MAP duration. Meanwhile, the premature ventricular contractions with R on T were observed in 2 out of 6 animals at the middle dose, and TdP episodes were detected in 4 out of 6 animals at the high dose. These results suggest that paliperidone showed torsadogenic potential at supra-therapeutic doses, whose potency can be estimated to be equal or slightly subordinate in comparison with that of risperidone.

  7. Atrioventricular Canal Defect

    Science.gov (United States)

    ... doctor See your doctor if you or your child develops signs or symptoms of atrioventricular canal defect. Atrioventricular canal defect occurs before birth when a baby's heart is developing. Some factors, such as Down syndrome, might increase the risk of atrioventricular canal defect. ...

  8. Adverse effects of first-degree AV-block in patients with sinus node dysfunction: data from the mode selection trial.

    Science.gov (United States)

    Holmqvist, Fredrik; Hellkamp, Anne S; Lee, Kerry L; Lamas, Gervasio A; Daubert, James P

    2014-09-01

    Patients with a pacing indication and first-degree atrioventricular (AV)-block pose a clinical challenge. The prognostic impact of first-degree AV-block in patients with sinus node dysfunction and the impact of pacing in this setting are not known. In the Mode Selection Trial (MOST), 2,010 patients with sinus node dysfunction were randomized to either dual-chamber (DDD-R) or ventricular (VVI-R) pacing and followed for a median of 33 months. We report on clinical outcomes in patients with first-degree AV-block (PR interval > 200 ms) compared with patients who had a normal PR interval at baseline. Patients with first-degree AV-block (n = 378) were older (median [Q1, Q3]; 76 [70, 82] years vs 73 [66, 79] years, PAV-conduction (n = 1,159). In multivariable analyses, patients with first-degree AV-block were at greater risk of death, stroke, or heart failure hospitalization (hazard ratio [HR] 1.31, 95% confidence interval [CI] 1.06-1.61, P = 0.013). A trend towards a higher incidence of atrial fibrillation was seen (HR 1.24, 95% CI 0.98-1.55, P = 0.069). No significant interactions between pacing arm and prolonged versus normal PR were found for any endpoint, and hazard ratios were consistent across subgroups. First-degree AV-block is associated with more advanced disease but is still an independent predictor of poor clinical outcome. Neither DDD-R nor VVI-R pacing, as employed in MOST, eliminate the negative effects associated with first-degree AV-block. ©2014 Wiley Periodicals, Inc.

  9. Incidence and predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular block and dual chamber pacemaker implantation.

    LENUS (Irish Health Repository)

    Radeljic, Vjekoslav

    2012-01-31

    AIM: To evaluate predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular (AV) block, normal left ventricular systolic function, and implanted dual chamber (DDD) pacemaker. METHODS: Hundred and eighty six patients with complete AV block were admitted over one year to the Sisters of Mercy University Hospital. The study recruited patients older than 70 years, with no history of atrial fibrillation, heart failure, or reduced left ventricular systolic function. All the patients were implanted with the same pacemaker. Out of 103 patients who were eligible for the study, 81 (78%) were evaluated. Among those 81 (78%) were evaluated. Eighty one (78%) patients were evaluated. Follow-up time ranged from 12 to 33 months (average +\\/-standard deviation 23 +\\/- 5 months). Primary end-point was asymptomatic atrial fibrillation occurrence recorded by the pacemaker. Atrial fibrillation occurrence was defined as atrial high rate episodes (AHRE) lasting >5 minutes. Binary logistic regression was used to identify the predictors of development of asymptomatic atrial fibrillation. Results. The 81 patients were stratified into two groups depending on the presence of AHRE lasting >5 minutes (group 1 had AHRE>5 minutes and group 2 AHRE<5 minutes). AHRE lasting >5 minutes were detected in 49 (60%) patients after 3 months and in 53 (65%) patients after 18 moths. After 3 months, only hypertension (odds ratio [OR], 17.63; P = 0.020) was identified as a predictor of asymptomatic atrial fibrillation. After 18 months, hypertension (OR, 14.0; P = 0.036), P wave duration >100 ms in 12 lead ECG (OR, 16.5; P = 0.001), and intracardial atrial electrogram signal amplitude >4 mV (OR, 4.27; P = 0.045) were identified as predictors of atrial fibrillation. CONCLUSION: In our study population, hypertension was the most robust and constant predictor of asymptomatic atrial fibrillation after 3 months, while P wave duration >100 ms in 12-lead ECG and

  10. Understanding atrioventricular septal defect: Anatomoechocardiographic correlation

    Directory of Open Access Journals (Sweden)

    Keirns Candace

    2008-06-01

    Full Text Available Abstract Objective Correlate the anatomic features of atrioventricular septal defect with echocardiographic images. Materials and methods Sixty specimen hearts were studied by sequential segmental analysis. Echocardiograms were performed on 34 patients. Specimen hearts with findings equivalent to those of echocardiographic images were selected in order to establish an anatomo-echocardiographic correlation. Results Thirty-three specimen hearts were in situs solitus, 19 showed dextroisomerism, 6 were in situs inversus and 2 levoisomerism. Fifty-eight had a common atrioventricular valve and 2 had two atrioventricular valves. Rastelli types were determined in 21 hearts. Nine were type A, 2 intermediate between A and B, 1 mixed between A and B, 4 type B and 5 type C. Associated anomalies included pulmonary stenosis, pulmonary atresia atrial septal defect, patent ductus arteriosus and anomalous connection of pulmonary veins. Echocardiograms revealed dextroisomerism in 12 patients, situs solitus in 11, levoisomerism in 7 and situs inversus in 4. Thirty-one patients had common atrioventricular valves and three two atrioventricular valves. Rastelli types were established in all cases with common atrioventricular valves; 17 had type A canal defects, 10 type B, 3 intermediate between A and B, 1 mixed between A and B and 3 type C. Associated anomalies included regurgitation of the atrioventricular valve, pulmonary stenosis, anomalous connection of pulmonary veins, pulmonary hypertension and pulmonary atresia. Conclusion Anatomo-echocardiographic correlation demonstrated a high degree of diagnostic precision with echocardiography.

  11. Stepwise transition of 2:1 atrio-ventricular block to 1:1 conduction induced by ventricular premature beats in a patient with atypical AVNRT.

    NARCIS (Netherlands)

    Sorgente, A.; Chierchia, G.B.; Asmundis, C. de; Yazaki, Y.; Sarkozy, A.; Brugada, P.

    2010-01-01

    A 55-year-old man with a 2-year history of recurrent paroxysmal palpitations and with an electrocardiogram documentation of atypical atrioventricular nodal re-entrant tachycardia (AVNRT) was referred to us for catheter ablation. After an initial ablation attempt, several episodes of atypical AVNRT w

  12. [Successful selective electrical ablation of the retrograde pathway in atrioventricular nodal reentry tachycardia associated with syncope].

    Science.gov (United States)

    Lukl, J; Cíhalík, C

    1992-01-01

    A 55-year-old man was admitted to the intensive care unit on account of repeatedly occurring syncopes which developed at the peak of physical exertion. The attack was reproduced by exercise on a bicycle ergometer: the patient developed paroxysmal tachycardia with a narrow QRS and a frequency of 160/min leading after 20 sec. to severe hypotension and loss of consciousness. The same tachycardia caused by programmed atrial stimulation caused a drop of tension in the recumbent position by 30 mmHg and after more detailed analysis during electrophysiological examination it was evaluated as atrioventricular nodal reentrant tachycardia. By an electric discharge of 300 J administered by means of a stimulation electrode 7F USCI into the area of the AV node the retrograde conduction through the perinodal rapid pathways was completely interrupted and 1st. degree atrioventricular block developed. Repeated electrophysiological examination and exercise tests on a bicycle ergometer provided evidence of the disappearance of the retrograde pathway and the impossibility to elicit AVNRT. The authors express the view that the rapid perinodal pathway is interrupted in successful cases in both directions and the 1st. degree AV block is due to conduction along a slow pathway and not incidental slowing of conduction along the rapid pathway which is the generally accepted interpretation. Modification of the atrioventricular conduction by interruption of the rapid pathway by fulguration is according to data in the literature and the described patient a method which makes is possible to cure severe atrioventricular nodal reentrant tachycardias.

  13. Olmesartan Reduces New-onset Atrial Fibrillation and Atrial Fibrillation Burden after Dual-chamber Pacemaker Implantation in Atrioventricular Block Patients

    Institute of Scientific and Technical Information of China (English)

    Hang Zhang; Chang Pan; Juan Zhang; Lin-Lin Zhu; Kai Huang; Yun Zhong; Zuo-Ying Hu

    2016-01-01

    Background:Atrial fibrillation (AF) is the most frequent tachyarrhythmia in patients with a permanent pacemaker.Angiotensin II receptor antagonists have a protective effect against the occurrence of AF in patients with heart diseases.This study aimed to assess the effectiveness of olmesartan in the prevention of new-onset AF and AF burden in atrioventricular block (AVB) patients with dual-chamber (DDD) pacemaker implantation.Methods:This was a single-center,prospective,randomized,single-blind,controlled clinical study.A total of 116 AVB patients,who received DDD pacemakers implantation with the percentage of ventricular pacing (VP%) ≥40% from April 22,2011 to December 24,2012,were prospectively randomized to olmesartan group (20 mg per day;n =57) or control group (n =59).Patients were followed up using pacemaker programming,12-lead electrocardiography in the intrinsic sinus rhythm,laboratory examinations,and transthoracic echocardiography at 24 months.Atrial high rate events (AHREs) were defined as 180 beats/min over a minimum of 5 min.AF burden was calculated by the number of hours with AHREs divided by the number of measurement hours.Results:Ten (17.5%) patients in the olmesartan group and 24 patients (40.7%) in the control group occurred new-onset AF,and the difference between two groups was statistically significant (P =0.04).AF burden was lower in olmesartan group than that in control group (8.02 ± 3.10% vs.13.66 ± 6.14%,P =0.04).There were no significant differences in mean days to the first occurrence of AHREs and mean cumulative numbers of AHREs between two groups (P =0.89 and P=0.42,respectively).Moreover,olmesartan group had smaller values of maximal P-wave durations and P-wave dispersion (PD) after 24 months follow-up compared with the control group (109.5 ± 7.4 ms vs.113.4 ± 7.1 ms,P =0.00;and 40.6 ± 4.5 ms vs.43.3 ± 4.4 ms,P =0.02,respectively).Left ventricular end-diastolic diameter and left ventricular ejection fraction were not

  14. Olmesartan Reduces New-onset Atrial Fibrillation and Atrial Fibrillation Burden after Dual-chamber Pacemaker Implantation in Atrioventricular Block Patients.

    Science.gov (United States)

    Zhang, Hang; Pan, Chang; Zhang, Juan; Zhu, Lin-Lin; Huang, Kai; Zhong, Yun; Hu, Zuo-Ying

    2016-09-20

    Atrial fibrillation (AF) is the most frequent tachyarrhythmia in patients with a permanent pacemaker. Angiotensin II receptor antagonists have a protective effect against the occurrence of AF in patients with heart diseases. This study aimed to assess the effectiveness of olmesartan in the prevention of new-onset AF and AF burden in atrioventricular block (AVB) patients with dual-chamber (DDD) pacemaker implantation. This was a single-center, prospective, randomized, single-blind, controlled clinical study. A total of 116 AVB patients, who received DDD pacemakers implantation with the percentage of ventricular pacing (VP%) ≥40% from April 22, 2011 to December 24, 2012, were prospectively randomized to olmesartan group (20 mg per day; n = 57) or control group (n = 59). Patients were followed up using pacemaker programming, 12-lead electrocardiography in the intrinsic sinus rhythm, laboratory examinations, and transthoracic echocardiography at 24 months. Atrial high rate events (AHREs) were defined as 180 beats/min over a minimum of 5 min. AF burden was calculated by the number of hours with AHREs divided by the number of measurement hours. Ten (17.5%) patients in the olmesartan group and 24 patients (40.7%) in the control group occurred new-onset AF, and the difference between two groups was statistically significant (P = 0.04). AF burden was lower in olmesartan group than that in control group (8.02 ± 3.10% vs. 13.66 ± 6.14%, P = 0.04). There were no significant differences in mean days to the first occurrence of AHREs and mean cumulative numbers of AHREs between two groups (P = 0.89 and P = 0.42, respectively). Moreover, olmesartan group had smaller values of maximal P-wave durations and P-wave dispersion (PD) after 24 months follow-up compared with the control group (109.5 ± 7.4 ms vs. 113.4 ± 7.1 ms, P = 0.00; and 40.6 ± 4.5 ms vs. 43.3 ± 4.4 ms, P = 0.02, respectively). Left ventricular end-diastolic diameter and left ventricular ejection fraction were

  15. Atrioventricular Pacemaker Lead Reversal

    Directory of Open Access Journals (Sweden)

    Mehmet K Aktas, MD

    2007-01-01

    Full Text Available During cardiac surgery temporary epicardial atrial and ventricular leads are placed in case cardiac pacing is required postoperatively. We present the first reported series of patients with reversal of atrioventricular electrodes in the temporary pacemaker without any consequent deleterious hemodynamic effect. We review the electrocardiographic findings and discuss the findings that lead to the discovery of atrioventricular lead reversal.

  16. Second-Degree Interatrial Block in Hemodialysis Patients

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    Andres Enriquez

    2015-01-01

    Full Text Available Interatrial conduction delays manifest as a prolonged P-wave duration on surface ECG and the term interatrial block (IAB has been coined. They are usually fixed, but cases of intermittent IAB have been described, suggesting functional conduction block at the Bachmann bundle region. We report 2 cases of patients on chronic hemodialysis therapy presenting with intermittent IAB.

  17. Second-Degree Interatrial Block in Hemodialysis Patients

    Science.gov (United States)

    Enriquez, Andres; D'Amato, Anna; de Luna, Antoni Bayes; Baranchuk, Adrian

    2015-01-01

    Interatrial conduction delays manifest as a prolonged P-wave duration on surface ECG and the term interatrial block (IAB) has been coined. They are usually fixed, but cases of intermittent IAB have been described, suggesting functional conduction block at the Bachmann bundle region. We report 2 cases of patients on chronic hemodialysis therapy presenting with intermittent IAB. PMID:25755895

  18. Bloqueio atrioventricular no pós-operatório de cirurgia cardíaca valvar: incidência, fatores de risco e evolução hospitalar Atrioventricular block in the postoperative period of heart valve surgery: incidence, risk factors and hospital evolution

    Directory of Open Access Journals (Sweden)

    Andres Di Leoni Ferrari

    2011-09-01

    Full Text Available INTRODUÇÃO: Distúrbios do sistema de condução cardíaco são complicações potenciais e conhecidas dos procedimentos de cirurgia cardíaca valvar. OBJETIVOS: Investigar a associação entre fatores peri-operatórios com bloqueio atrioventricular (BAV e a necessidade de estimulação cardíaca artificial temporária (ECAT e, se necessário, implante de marcapasso definitivo no pós-operatório de cirurgia cardíaca (POCC valvar. MÉTODOS: Coorte histórica de pacientes submetidos a cirurgia cardíaca valvar, sendo realizada análise de banco de dados por regressão logística. RESULTADOS: No período de janeiro de 1996 a dezembro de 2008, foram realizadas 1102 cirurgias cardíacas valvares: 718 (65,2% na valva aórtica e 407 (36,9% na valva mitral; destas, 190 (17,2% cirurgias de revascularização miocárdica associadas à cirurgia valvar e 23 (2,1% cirurgias valvares combinadas (aórtica+mitral. Cento e oitenta e sete (17% pacientes apresentaram quadro clínico e eletrocardiográfico de BAV durante o POCC valvar, necessitando de ECAT. Quatorze (7,5% pacientes evoluíram para implante de marcapasso definitivo (1,27% do total da amostra. A análise multivariada evidenciou associação significativa de BAV com cirurgia de valva mitral (OR=1,76; IC 95% 1,08-2,37; P=0,002, implante de prótese biológica (OR=1,59; IC 95% 1,02-3,91; P= 0,039, idade maior que 60 anos (OR = 1,99; IC 95% 1,35-2,85; PINTRODUCTION: Disturbances of the cardiac conduction system are potential complications after cardiac valve surgery. OBJECTIVES: This study was designed to investigate the association between perioperative factors and atrio-ventricular block, the need for temporary cardiac artificial pacing and, if necessary, permanent pacemaker implantation after cardiac valve surgery. METHODS: Retrospective analysis of the Cardiac Surgery Database - Hospital São Lucas/PUCRS. The data are collected prospectively and analyzed retrospectively. RESULTS: Between January

  19. O efeito da morfina na inibição vagal do coração: demonstração da dupla via do nodo atrioventricular = The effect of morphine on vagal inhibition of the heart: demonstration of dual atrioventricular nodal pathways

    Directory of Open Access Journals (Sweden)

    José Geraldo Pereira da Cruz

    2006-07-01

    Full Text Available A estimulação elétrica do nervo vago diminui a freqüência cardíaca e aumenta o intervalo PQ no eletrocardiograma, podendo ativar a via anterógrada do nodo atrioventricular. Neste experimento é investigada a interação da morfina sobre o controle nervoso parassimpático cardíaco em relação à dupla condução do nodo atrioventricular. Aestimulação do nervo vago induz uma significativa bradicardia e um bloqueio atrioventricular de terceiro grau, com a onda P aparecendo negativa na derivação II. Devido aos efeitos moduladores da anestesia sobre o coração, administração de injeções de morfina induz o aparecimento de onda P positiva através de uma ação inibitória sobre a reentrância do nodo atrioventricular. Tudo sugere a presença de duas vias atrioventriculares, anatômica e funcionalmente distintas.That electrical stimulation of the vagus decreased heart rate and increased the PQ interval in electrocardiogram, consistent with anterograde dual atriventricular conduction. The present experiments were investigating the interaction of the morphine with cardiac parasympathetic nervous control in dual atrioventricular node. Electrical stimulation of the vagus nerve induced significantbradycardia and of third degree atrioventricular block and the P wave appearance was negative in leads II. Because background anesthesia modulates the heart, administered morphine injection the P waves appearance was positive through one inhibitory action on atrioventricular nodal reentry. All suggest the presence of two functionally and anatomically distinct atrioventricular pathways.

  20. Clinical analysis of 73 pediatric patients with completely atrioventricular conduction block%儿童完全性房室传导阻滞73例

    Institute of Scientific and Technical Information of China (English)

    曹黎明; 周凯; 秦玉明; 杨世伟; 赵乃铮; 王凤鸣; 钱建华; 龚晓平

    2016-01-01

    目的:探讨儿童完全性房室传导阻滞(CAVB)的病因、临床特征及预后。方法对2004年1月至2013年12月在南京医科大学附属南京儿童医院心脏中心住院的73例 CAVB 患儿的临床资料进行回顾性分析。其中男34例,女39例;年龄3个月~12.5岁,平均年龄6岁。结果73例 CAVB 患儿中,先天性 CAVB 21例,获得性 CAVB 52例,主要为心肌炎和室间隔缺损外科修补术后。先天性 CAVB 患儿药物治疗无效,19例无临床症状者定期检查心电图和心脏超声心动图,2例出现阿斯综合征发作安装永久起搏器。27例暴发性心肌炎有15例阿斯综合征发作,15例心肌炎后遗症有3例阿斯综合征发作,6例室间隔缺损外科修补术有2例阿斯综合征发作,另外4例无症状者定期临床随访。获得性 CAVB 患儿给予营养心肌等药物治疗,27例安装临时起搏器,5例安装永久起搏器,暴发性心肌炎患儿均予肾上腺皮质激素和静脉注射丙种球蛋白。52例获得性CAVB 患儿,治愈31例,好转9例,无效11例,死亡1例。结论先天性 CAVB 大部分无症状,药物治疗无效,需临床随访;心肌炎是儿童获得性 CAVB 的主要病因,暴发性心肌炎引起的 CAVB 的预后取决于是否及时安装临时起搏器;CAVB 经药物治疗无效且临床上频繁阿斯综合征发作或心功能不全应安装永久起搏器。%Objective To explore the causes,clinical characteristics and prognosis of children′s completely at-rioventricular block(CAVB).Methods The clinical data of 73 patients with CAVB were analyzed retrospectively from January 2004 to December 201 3 at the Cardiology Department,Nanjing Children′s Hospital Affiliated to Nanjing Medi-cal University.Within those 73 patients,34 patients were male and the others were female,from 3 months old to 1 2.5 years old,the mean age of 6 years.Results There were 21 congenital CAVB patients and 52 acquired

  1. Bayesian Degree-Corrected Stochastic Block Models for Community Detection

    CERN Document Server

    Peng, Lijun

    2013-01-01

    Community detection in networks has drawn much attention in diverse fields, especially social sciences. Given its significance, there has been a large body of literature among which many are not statistically based. In this paper, we propose a novel stochastic blockmodel based on a logistic regression setup with node correction terms to better address this problem. We follow a Bayesian approach that explicitly captures the community behavior via prior specification. We then adopt a data augmentation strategy with latent Polya-Gamma variables to obtain posterior samples. We conduct inference based on a canonically mapped centroid estimator that formally addresses label non-identifiability. We demonstrate the novel proposed model and estimation on real-world as well as simulated benchmark networks and show that the proposed model and estimator are more flexible, representative, and yield smaller error rates when compared to the MAP estimator from classical degree-corrected stochastic blockmodels.

  2. Lyme Carditis: An Interesting Trip to Third-Degree Heart Block and Back

    Directory of Open Access Journals (Sweden)

    Maxwell Eyram Afari

    2016-01-01

    Full Text Available Carditis is an uncommon presentation of the early disseminated phase of Lyme disease. We present the case of a young female who presented with erythema migrans and was found to have first-degree heart block which progressed to complete heart block within hours. After receiving ceftriaxone, there was complete resolution of the heart block in sequential fashion. Our case illustrates the importance of early recognition and anticipation of progressive cardiac conduction abnormalities in patients presenting with Lyme disease.

  3. O efeito da morfina na inibição vagal do coração: demonstração da dupla via do nodo atrioventricular - DOI: 10.4025/actascihealthsci.v28i2.1102 The effect of morphine on vagal inhibition of the heart: demonstration of dual atrioventricular nodal pathways - DOI: 10.4025/actascihealthsci.v28i2.1102

    Directory of Open Access Journals (Sweden)

    José Geraldo Pereira da Cruz

    2006-03-01

    Full Text Available A estimulação elétrica do nervo vago diminui a freqüência cardíaca e aumenta o intervalo PQ no eletrocardiograma, podendo ativar a via anterógrada do nodo atrioventricular. Neste experimento é investigada a interação da morfina sobre o controle nervoso parassimpático cardíaco em relação à dupla condução do nodo atrioventricular. A estimulação do nervo vago induz uma significativa bradicardia e um bloqueio atrioventricular de terceiro grau, com a onda P aparecendo negativa na derivação II. Devido aos efeitos moduladores da anestesia sobre o coração, administração de injeções de morfina induz o aparecimento de onda P positiva através de uma ação inibitória sobre a reentrância do nodo atrioventricular. Tudo sugere a presença de duas vias atrioventriculares, anatômica e funcionalmente distintasThat electrical stimulation of the vagus decreased heart rate and increased the PQ interval in electrocardiogram, consistent with anterograde dual atriventricular conduction. The present experiments were investigating the interaction of the morphine with cardiac parasympathetic nervous control in dual atrioventricular node. Electrical stimulation of the vagus nerve induced significant bradycardia and of third degree atrioventricular block and the P wave appearance was negative in leads II. Because background anesthesia modulates the heart, administered morphine injection the P waves appearance was positive through one inhibitory action on atrioventricular nodal reentry. All suggest the presence of two functionally and anatomically distinct atrioventricular pathways

  4. Complete atrioventricular block on isolated guinea pig heart induced by an aqueous fraction obtained from Psidium guajava L. leaf Bloqueio atrioventricular completo em coração isolado de cobaia produzido por uma fração aquosa obtida das folhas de Psidium guajava L

    Directory of Open Access Journals (Sweden)

    Antonio N.S. Gondim

    2006-09-01

    Full Text Available This paper aimed to study the electrocardiographic effect produced by the aqueous fraction (AqF obtained from the acetic extract of Psidium guajava L. leaf on the isolated guinea pig heart. Electrocardiographic records (ECG were obtained on isolated hearts beating spontaneously or under regular electrical stimulation. The hearts were mounted in a constant flow Langendorff perfusion system. Until 20 mg/mL, AqF did not change the spontaneous cardiac rate (control: 180 ± 9 bpm, test: 182 ± 10 bpm; N = 3; p > 0.05. Concentrations equal or greater then 20 mg/mL induced complete atrioventricular block (AVB. However, this effect promptly disappeared when AqF was removed from the perfusion fluid (N = 3 hearts. The AVB induced by AqF involves heart muscarinic receptors because atropine sulfate (1.5 mM could prevent the appearance of such disturbance.O presente trabalho visou estudar o efeito eletrocardiográfico produzido pela fração aquosa (AqF obtida do extrato acético das folhas de Psidium guajava L. em coração isolado de cobaia. Os traçados eletrocardiográficos foram obtidos em corações batendo espontaneamente ou então sob estimulação elétrica. Os corações foram montados em uma sistema de perfusão do tipo Langendoff de fluxo constante. A AqF, usada em concentrações menores que 20 mg/mL, não alterou a freqüência espontânea do coração (controle: 180 ± 9 bpm, teste: 182 ± 10 bpm; N = 3; p > 0,05. Todavia, concentrações iguais ou maiores que 20 mg/mL produziram bloqueio atrioventricular completo (BAV. Este efeito, contudo, desapareceu prontamente quando se removeu a AqF do fluido de perfusão coronariana (N = 3 corações. O BAV promovido pela AqF se faz mediado pelos receptores muscarínicos porque o sulfato de atropina (1,5 mM impediu o aparecimento deste efeito.

  5. Influence of lower myocardial infarct patients appeared Ⅲ atrio-ventricular block treatment with thrombolytic recanalization%急性下壁心肌梗死并Ⅲ度房室传导阻滞的溶栓治疗

    Institute of Scientific and Technical Information of China (English)

    吴强

    2009-01-01

    目的 观察急性下壁心肌梗死并Ⅲ度房室传导阻滞患者溶栓后再通对早期恢复窦性心律的影响.方法 急性下壁心肌梗死并Ⅲ度房室传导阻滞患者25例,入院后即行尿激酶溶栓治疗,观察溶栓后6 h内再灌注治疗成功组及再灌注治疗失败组窦性心律恢复情况.结果 17例再灌注成功患者中14例6 h内恢复了窦性心律(82.4%),8例再灌注失败患者中2例6 h内恢复了窦性心律(25%),两组比较差异有统计学意义(P<0.01).结论 急性下壁心肌梗死并Ⅲ度房室传导阻滞患者,尽早溶栓治疗有助于尽快恢复窦性心律,降低死亡率.%Objective To investigate the influence of patients suffered from acute lower wall cardiac infarct appeared Ⅲ atrio-ventricular block tneatment with thrombolytic recanalization for the early recovery of sinus rhythm.Methods From October 01 till October 06, a total of 25 hospitalized patients in our hospital with acute lower cardiac infarct, chest pain persist over thirty minutes, but less than one hour, immediately treatment with urokinase thrombolytic therapy after hospitalization, among them 17 cases reinfusion therapy success ful and 8 cases failed. Divided into reinfusion therapy success group and failed group, observate thromholytic therapy 6 hours recanalization success and fail group the situation of sinus rhythm recovore. Results Among 17 cases recanalization success patients and 14 cases recover sinus rhythm within 6 hours ,and 8 case fail in recanalization 2 cases recover sinus rhythm in 6 hours(25%)compared these two groups statistical are meaningful ( P<0. 01 ). Conclusion Acute lower cardiac infarct patients with Ⅲ atrio-ventricular block must use thrombolytic therapy as soon as possible in order to let oclusive coronary artery recanalize, help to recover sinus rhythm as soon as possible and decrease mortality rate.

  6. Abnormalities of atrioventricular conduction in patients with the Lown-Ganong-Levine syndrome.

    Science.gov (United States)

    Pavlovic, J; Fabián, J; Belán, A

    1978-01-01

    In 18 patients with the Lown-Ganong-Levine syndrome and in 11 control subjects the response of the atrioventricular conduction system to heart rate acceleration by right atrial pacing, and, with the aid of His bundle electrogram, the behaviour of individual levels of the atrioventricular conduction system were studied. At spontaneous sinus rhythm A-H interval was shorter in the patients with the Lown-Ganong-Levine syndrome than in the controls. In the latter the A-H interval became markedly prolonged, up to a Wenckebach-type IInd-degree AV block, already at a minor pacing-induced acceleration of the heart rate, whereas in the patients with the Lown-Ganong-Levine syndrome the atrioventricular propagation of excitation at a 1:1 ratio remained preserved even at substantially higher heart-rate values. On the basis of the responses of the A-H interval to pacing the patients with the Lown-Ganong-Levine syndrome were classed into four types.

  7. Atrioventricular conduction after alcohol septal ablation for obstructive hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Axelsson, Anna; Weibring, Kristina; Havndrup, Ole

    2014-01-01

    .1-9.4) after ASA. Patients with high-grade atrioventricular block at follow-up had longer PR intervals at baseline [205 ms (200-230)] than the rest of the cohort [180 ms (140-200), P = 0.004] and a higher incidence of acute complete heart block (63 vs. 15%; P = 0.007) during ASA. A PR interval of at least 200...... ms at baseline was associated with higher prevalence of high-grade atrioventricular block at follow-up (30 vs. 2%; P = 0.0013). The incidence of late-onset complete heart block was 1.5% per year after ASA. CONCLUSION: We found normalized atrioventricular conduction at long-term follow-up, suggesting...... recovery in 6 of 14 patients with a pacemaker implanted in relation to ASA. Permanent atrioventricular conduction abnormalities were associated with baseline PR intervals of at least 200 ms and acute persistent complete heart block during ASA....

  8. Bloqueo aurículo-ventricular congénito completo: Reporte de un caso y revisión de la literatura Congenital complete atrioventricular block: eport of one case and literature review

    Directory of Open Access Journals (Sweden)

    Alejandro Díaz D

    2008-02-01

    Full Text Available El bloqueo aurículo-ventricular completo congénito, es una entidad poco común, que presenta alta morbilidad y mortalidad con incidencia real que permanece desconocida y requiere alto índice de sospecha para su diagnóstico y, por ende, su temprana intervención. Se observa en hijos de madres con enfermedades autoinmunes del tejido conectivo, en especial, lupus eritematoso sistémico cuando su aparición es congénita. A nivel postnatal, es más frecuente que ocurra por cardiopatías congénitas. También puede manifestarse en corazones normales desde el punto de vista estructural. El hallazgo clínico característico es bradicardia persistente que se manifiesta desde la vida intrauterina y repercute en la estabilidad circulatoria del feto llegando a producir hidrops, complicación seria y letal. Después del nacimiento aparece igualmente con bradicardia que puede o no descompensar la parte hemodinámica del paciente. El diagnóstico se hace por sospecha clínica, con ecocardiografía fetal y postnatal, electrocardiograma y detección de anticuerpos maternos tipo antiRo y antiLa. La implantación de un marcapasos es el tratamiento definitivo que contribuye a mejorar la sobrevida y el pronóstico de estos pacientes. Se presenta el caso de una paciente prematura, de 31 semanas, debido a hidrops no inmune, en quien se diagnosticó bloqueo aurículo-ventricular completo congénito secundario a lupus materno confirmado por anticuerpos anti-nucleares francamente positivos y anticuerpos antiRo y antiLa positivos, quien recibió manejo con soporte inotrópico y posterior implantación de marcapasos. Presentó mejoría completa de la falla cardiaca y se remitió hacia otra institución para manejo convencional del prematuro.Complete congenital atrioventricular block is a rare entity that has a high morbidity and mortality. Its real incidence remains unknown and a high suspicion index is needed for its diagnosis and consequently for its early

  9. Atrioventricular Dissociation following Blunt Chest Trauma

    Directory of Open Access Journals (Sweden)

    Salim Surani

    2014-01-01

    Full Text Available Blunt chest trauma (BCT is a common clinical presentation seen in emergency departments. Few cases of cardiac conduction abnormalities due to BCT have been reported in the medical literature. This dysrhythmias may present as permanent conduction defects requiring permanent pacemaker or may have temporary conduction abnormalities requiring temporary pacemaker or supportive care. We present the case of a young woman who suffered from BCT after being kicked by a horse with the development of a significant substernal hematoma. She developed temporary atrioventricular block, which was completely resolved with the decrease in the size of the substernal hematoma suffered.

  10. Classification and estimation in the Stochastic Block Model based on the empirical degrees

    CERN Document Server

    Channarond, Antoine; Robin, Stéphane

    2011-01-01

    The Stochastic Block Model (Holland et al., 1983) is a mixture model for heterogeneous network data. Unlike the usual statistical framework, new nodes give additional information about the previous ones in this model. Thereby the distribution of the degrees concentrates in points conditionally on the node class. We show under a mild assumption that classification, estimation and model selection can actually be achieved with no more than the empirical degree data. We provide an algorithm able to process very large networks and consistent estimators based on it. In particular, we prove a bound of the probability of misclassification of at least one node, including when the number of classes grows.

  11. Continuous block-symmetric polynomials of degree at most two on the space $(L_\\infty^2$

    Directory of Open Access Journals (Sweden)

    T. V. Vasylyshyn

    2016-06-01

    Full Text Available We introduce block-symmetric polynomials on $(L_\\infty^2$ and prove that every continuous block-symmetric polynomial of degree at most two on $(L_\\infty^2$ can be uniquely represented by some ``elementary'' block-symmetric polynomials.

  12. Bloqueo aurículo-ventricular de primer grado en tirotoxicosis aguda First degree atrio-ventricular block in acute thyrotoxicosis

    OpenAIRE

    Antonio R. Vilches; Jorge Lerman

    2004-01-01

    El cuadro clínico de la tirotoxicosis incluye síntomas cardiovasculares variados. La taquicardia sinusal es el trastorno electrocardiográfico más frecuente y los trastornos de conducción son extremadamente raros como modo de presentación. Comunicamos un caso de bloqueo aurículo-ventricular de primer grado en una paciente con hipertiroidismo recién diagnosticado y que comenzó días antes de la consulta con un cuadro general inespecífico. Su evaluación ulterior demostró que se trataba de una tir...

  13. Takotsubo syndrome with transient complete atrioventricular block

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Takotsubo syndrome (transient left ventricular apical ballooning syndrome) is a novel cardiac syndrome of left ventricular apical ballooning involving reversible left ventricular apical ballooning (during systole) of acute onset with chest pain, electrocardiographic changes, and minimal elevation of cardiac enzymes resembling acute myocardial infarction, but without evidence of myocardial ischemia or injury. Patients have no angiographic evidence of coronary artery stenosis and there is almost always a complete recovery of left ventricular function in days to weeks. The precise etiologic basic of this syndrome is not clear but most likely it is a non-ischemic, metabolic syndrome caused by stress-induced activation of the cardiac adrenoceptors in absence of ischemia and reperfusion.1-3 Reported here is a case of stress-induced transient left ventricular apical ballooning syndrome in an elderly Chinese woman.

  14. Toughening polylactide with polyether-block-amide and thermoplastic starch acetate: Influence of starch esterification degree.

    Science.gov (United States)

    Zhou, Linyao; Zhao, Guiyan; Feng, Yulin; Yin, Jinghua; Jiang, Wei

    2015-01-01

    Native corn starch was esterified with acetic anhydride and plasticized with glycerol to give the thermoplastic starch acetate (TPSA). TPSA was blended with polylactide (PLA) and polyether-block-amide-graft-glycidyl methacrylate (PEBA-g-GMA) to obtain biodegradable PLA/PEBA-g-GMA/TPSA blends with high notched impact resistance and low cost. Compared with PLA/PEBA-g-GMA blends, as much as 9 wt% expensive PEBA-g-GMA elastomer could be substituted by the slightly acetylated thermoplastic starch while retaining high impact strength. The mechanical properties depended on the esterification degree of starch acetate. The impact strength, tensile strength and elongation at break increased to the peak value with increasing the esterification degree from 0 to 0.04, thereafter they decreased on further increasing the esterification degree. The morphological results showed that the TPSA particles were smaller and more uniform at the optimum esterification degree of 0.04, leading to the peak value of the mechanical properties. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Preservation of pre-excitation despite acute myocardial infarction complicated by complete heart block.

    Science.gov (United States)

    Boroomand, K.; Armstrong, P. W.

    1978-01-01

    In a 53-year-old man with ventricular pre-excitation (normal PR interval, QRS interval of 0.12 seconds and delta-waves) acute inferior wall myocardial infarction was complicated by, successively, first-degree atrioventricular block, second-degree atrioventricular block (Wenckebach type) and complete heart block. The QRS pattern of pre-excitation was preserved throughout these events. The classification of ventricular pre-excitation is reviewed and the correlation between the various electrocardiographic patterns (the Wolff-Parkinson-White syndrome and its variants and the Lown-Ganong-Levine syndrome) and the anomalous conduction pathways of Kent, James and Mahaim are discussed. In this case the best possible explanation for preservation of pre-excitation during complete heart block was the existence of accessory fibres of Mahaim. Images FIG. 1 FIG. 2 FIG. 3 FIG. 4 FIG. 5 FIG. 6 FIG. 7 PMID:679113

  16. Angiographic studies of atrioventricular discordance.

    Science.gov (United States)

    Attie, F; Soni, J; Ovseyevitz, J; Muñoz-Castellanos, L; Testelli, M R; Buendia, A

    1980-08-01

    The results and value of conventional and axial angiocardiography were studied in 26 cases of atrioventricular discordance (AVD). The angiographic anatomy of this malformation was analyzed to determine the precise characteristics of atrioventricular and ventriculoarterial connections. The left and right ventricles in atrial situs solitus and levocardia show angiographic features that differ from those seen in atrial situs solitus and dextrocardia. The same differences are found in atrial situs inversus. Regardless of the type of ventriculoarterial connections, the ventricles maintain the same angiographic characteristics. The ventricular septum in AVD in situs solitus and levocardia and situs inversus and dextrocardia has a peculiar orientation. The use of axial angiocardiography facilitates detection and localization of the ventricular septal defect. In cases of malposition of the heart, the conventional frontal view allows visualization of the ventricular septum in all of its length. The axial projection is useful in diagnosing left ventricular outflow tract obstruction.

  17. Atrioventricular Dissociation after Electroconvulsive Therapy

    Directory of Open Access Journals (Sweden)

    Siegfried William Yu

    2011-01-01

    Full Text Available Electroconvulsive therapy (ECT is increasingly used as a treatment for psychiatric disorders. Cardiac effects are the principal cause of medical complications in these patients. We report a case of atrioventricular (AV dissociation that occurred after ECT that was treated with pacemaker implantation. The mechanisms contributing to the onset of AV dissociation in this patient, and the management and rationale for device therapy, in light of the most recent guidelines, are reviewed.

  18. Identifying influential nodes in dynamic social networks based on degree-corrected stochastic block model

    Science.gov (United States)

    Wang, Tingting; Dai, Weidi; Jiao, Pengfei; Wang, Wenjun

    2016-05-01

    Many real-world data can be represented as dynamic networks which are the evolutionary networks with timestamps. Analyzing dynamic attributes is important to understanding the structures and functions of these complex networks. Especially, studying the influential nodes is significant to exploring and analyzing networks. In this paper, we propose a method to identify influential nodes in dynamic social networks based on identifying such nodes in the temporal communities which make up the dynamic networks. Firstly, we detect the community structures of all the snapshot networks based on the degree-corrected stochastic block model (DCBM). After getting the community structures, we capture the evolution of every community in the dynamic network by the extended Jaccard’s coefficient which is defined to map communities among all the snapshot networks. Then we obtain the initial influential nodes of the dynamic network and aggregate them based on three widely used centrality metrics. Experiments on real-world and synthetic datasets demonstrate that our method can identify influential nodes in dynamic networks accurately, at the same time, we also find some interesting phenomena and conclusions for those that have been validated in complex network or social science.

  19. Modeling and estimating change in temporal networks via a dynamic degree corrected stochastic block model

    CERN Document Server

    Wilson, James D; Woodall, William H

    2016-01-01

    In many applications it is of interest to identify anomalous behavior within a dynamic interacting system. Such anomalous interactions are reflected by structural changes in the network representation of the system. We propose and investigate the use of a dynamic version of the degree corrected stochastic block model (DCSBM) as a means to model and monitor dynamic networks that undergo a significant structural change. Our model provides a means to simulate a variety of local and global changes in a time-varying network. Furthermore, one can efficiently detect such changes using the maximum likelihood estimates of the parameters that characterize the DCSBM. We assess the utility of the dynamic DCSBM on both simulated and real networks. Using a simple monitoring strategy on the DCSBM, we are able to detect significant changes in the U.S. Senate co-voting network that reflects both times of cohesion and times of polarization among Republican and Democratic members. Our analysis suggests that the dynamic DCSBM pr...

  20. NEUROMUSCULAR AND CARDIOVASCULAR EFFECTS OF NEOSTIGMINE AND METHYL-ATROPINE ADMINISTERED AT DIFFERENT DEGREES OF ROCURONIUM-INDUCED NEUROMUSCULAR BLOCK

    NARCIS (Netherlands)

    VANDENBROEK, L; PROOST, JH; WIERDA, JMKH; NJOO, MD; HENNIS, PJ

    1994-01-01

    The neuromuscular and cardiovascular effects of neostigmine, 40 mug kg-1, and methyl-atropine, 7 mug kg-1, administered at different degrees of rocuronium-induced (600 mug kg-1) neuromuscular block were evaluated. In one group of patients spontaneous recovery was awaited (Group A; n = 20). Neostigmi

  1. Radiofrequency Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia: Success Rates and Complications during 14 Years of Experience

    Directory of Open Access Journals (Sweden)

    Mansour Moghaddam

    2010-05-01

    Full Text Available Background: Radiofrequency catheter ablation (RFCA has been introduced as the treatment of choice for supraventricular tachycardia. The aim of this study was to evaluate the success rate as well as procedural and in-hospital complications of RFCA for the treatment of atrioventricular nodal reentrant tachycardia (AVNRT.Methods: Between March 1995 and February 2009, 544 patients (75.9% female, age: 48.89 ± 13.19 years underwent 548 RFCAs for AVNRT in two large university hospitals. Echocardiography was performed for all the patients before and after the procedure. Electrocardiograms were recorded on digital multichannel systems (EP-Med or Bard EP system. Anticoagulation was initiated during the procedure.Results: From the 548 patients, 36 had associated arrhythmias, atrial flutter (4%, atrial fibrillation (0.7%, concurrent atrial fibrillation and atrial flutter (0.7%, and concealed atrioventricular pathway (0.4%. The overall success rate was 99.6%. There were 21 (3.9% transient III-degree AV blocks (up to a few seconds and 4 (0.7% prolonged II- or III-degree AV blocks, 2 (0.25% of which required permanent pacemaker insertion, 3(0.5% deep vein thrombosis, and one (0.2% arteriovenous fistula following the procedure. No difference was observed in the echocardiography parameters before and after the ablation.Conclusion: RFCA had a high success rate. The complication rate was generally low and in the above-mentioned centers it was similar to those in other large centers worldwide. Echocardiography showed no difference before and after the ablation. The results from this study showed that the risk of permanent II or III-degree AV block in patients undergoing RFCA was low and deep vein thrombosis was the second important complication. There was no risk of life-threatening complications.

  2. Irreversible third-degree heart block and pacemaker implant in a case of flecainide toxicity.

    Science.gov (United States)

    Lloyd, Thomas; Zimmerman, Jacob; Griffin, Gregory D

    2013-09-01

    An 82-year-old white woman was seen in the emergency department (ED) after ingesting 400 mg of flecainide in an attempt to treat an episode of dizziness and palpitations that occurred while she was gardening. Consequently, she developed bradycardia, hypotension, and complete heart block. In addition to supportive care, she also received sodium bicarbonate, atropine, calcium gluconate, and dopamine in an effort to reverse the heart block. The patient continued to remain in heart block and was sent to the cardiac catheterization laboratory for placement of an external pacing wire, which stabilized the patient. After further evaluation, a permanent pacemaker was implanted during her admission. External pacing wires may be useful in the treatment of complete heart block in cases of flecainide poisoning when a patient is unresponsive to drug therapy provided in the ED.

  3. Cryptanalysis of Block Ciphers with Probabilistic Non-Linear Relations of Low Degree

    DEFF Research Database (Denmark)

    Jakobsen, Thomas

    1998-01-01

    (x,y)=0$ between plaintext $x$ and ciphertext $y$ that hold with small probability $\\mu$.The second attack needs access to $n=(2m/\\mu)^2$ plaintext/ciphertext pairs where $m=\\deg p$ and its running time is also polynomial in $n$. As a demonstration, we break up to 10 rounds of a cipher constructed...... employed is essentially Sudan's algorithm for decoding Reed-Solomon codes beyond the error-correction diameter. The known-plaintext attack needs $n=2m/\\mu^2$ plaintext/ciphertext pairs and the running time is polynomial in $n$.Furthermore, it is shown how to discover more general non-linear relations $p...... by Nyberg and Knudsen provablysecure against differential and linear cryptanalysis.Key words: Cryptanalysis, block cipher, interpolation attack, non-linear relations, Reed-Solomon codes, Sudan's algorithm....

  4. Atrioventricular Septal Defect with Common Atrioventricular Junction Guarded by a Common Valve Consisting of Left Atrioventricular Trifoliate Valve

    Science.gov (United States)

    Krasniqi, Xhevdet; Gashi, Masar; Berisha, Blerim; Pllana, Ejup; Bakalli, Aurora; Abazi, Flora; Koçinaj, Dardan

    2013-01-01

    Introduction: Atrioventricular septal defect with common atrioventricular junction is a rare adult congenital cardiac syndrome. This occurrence with prolonged survival is exceptionally rare. Case report: We present the case of a patient who presented with this defect with common atrioventricular junction who survived to the age of 32. We describe a 32-year-old man with atrioventricular septal defect with common atrioventricular junction guarded by a common valve. His history, clinical course, and anatomic findings are discussed along with the factors which may have contributed to his longevity, which is unique in the medical literature. His management reflected the state of medical knowledge at the time when he presented, and although alternate approaches may have been utilized if the patient presented today. We discuss the findings, frequency, classifi cation, and management of congenital defects. Development of embryonic structure is altered by interaction between genetics and environmental factors toward a rare associated of congenital cardiac defects-complex congenital heart disease. Conclusion: This case demonstrates that patients with very complex congenital cardiac disease may survive to adulthood, presenting challenges in both medical and surgical treatment. PMID:24554809

  5. [Spontaneous grade I bundle of His block. Clinical, electrocardiographic and electrophysiological studies in 37 patients].

    Science.gov (United States)

    Corsini, G; Pette, R; Cardillo, A; Quintiliano, G; Di Donna, V; Malvezzi, A; Mascia, F; Correale, E

    1989-01-01

    The clinical, ECG and electrophysiological data of 37 patients (28 males and 9 females) with spontaneous intra-hisian block are reported. Of these patients, 11 had hypertensive heart disease and 5 had ischemic heart disease with previous myocardial infarction; in 21 patients, clinical signs of heart disease were not evident. In 18 patients, a single or recurrent episode of syncope had occurred. One patient had junctional rhythm and 36 sinus rhythm; among these, 12 patients presented PR greater than 200 msec (7 with a narrow and 5 with a wide QRS); 12 patients had a single or bilateral bundle branch block; 12 had a normal ECG. The electrophysiological study showed a split H-H1 in 22 patients, a wide His deflection (H greater than 25 msec) in 4 and HV greater than 65 msec with narrow QRS in 11. In 17 patients a more or less marked sinoatrial node and/or atrioventricular node dysfunction was present. Atrial pacing, performed in all, induced 2nd degree Mobitz 2 intra-hisian block in 9 patients. Ajmaline was used in 16 patients but induced a complete intra-hisian block in only one. In 28 patients a preventive pacemaker was implanted after electrophysiological study. During the follow-up (mean 25 months/pt.), 38% of the patients developed complete atrioventricular block. No recurrence of syncope occurred in the paced patients. Comparison of patients who developed atrioventricular block and those who maintained normal atrioventricular conduction did not show differences as far as heart disease, previous syncope, ECG pattern and results were concerned.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Factors associated with moderate or severe left atrioventricular valve regurgitation within 30 days of repair of incomplete atrioventricular septal defect

    Directory of Open Access Journals (Sweden)

    Marcelo Felipe Kozak

    2015-04-01

    Full Text Available AbstractIntroduction:Left atrioventricular valve regurgitation is the most concerning residual lesion after surgical correction of atrioventricular septal defect.Objective:To determine factors associated with moderate or greater left atrioventricular valve regurgitation within 30 days of surgical repair of incomplete atrioventricular septal defect.Methods:We assessed the results of 51 consecutive patients 14 years-old and younger presenting with incomplete atrioventricular septal defect that were operated on at our practice between 2002 and 2010. The following variables were considered: age, weight, absence of Down syndrome, grade of preoperative left atrioventricular valve regurgitation, abnormalities on the left atrioventricular valve and the use of annuloplasty. The median age was 4.1 years; the median weight was 13.4 Kg; 37.2% had Down syndrome. At the time of preoperative evaluation, there were 23 cases with moderate or greater left atrioventricular valve regurgitation (45.1%. Abnormalities on the left atrioventricular valve were found in 17.6%; annuloplasty was performed in 21.6%.Results:At the time of postoperative evaluation, there were 12 cases with moderate or greater left atrioventricular valve regurgitation (23.5%. The variation between pre- and postoperative grades of left atrioventricular valve regurgitation of patients with atrioventricular valve malformation did not reach significance (P=0.26, unlike patients without such abnormalities (P=0.016. During univariate analysis, only absence of Down syndrome was statistically significant (P=0.02. However, after a multivariate analysis, none of the factors reached significance.Conclusion:None of the factors studied was determinant of a moderate or greater left atrioventricular valve regurgitation within the first 30 days of repair of incomplete atrioventricular septal defect in the sample. Patients without abnormalities on the left atrioventricular valve benefit more of the operation.

  7. Anti-saturation block adaptive quantization algorithm for SAR raw data compression over the whole set of saturation degrees

    Institute of Scientific and Technical Information of China (English)

    Haiming Qi; Weidong Yu

    2009-01-01

    In order to improve the performance of block adaptive quantization (BAQ) when the output of the analog to digital converter (ADC)is saturated, this paper proposes an anti-saturation BAQ algorithm. First, the concept of the standard deviation of the output signal (SDOS) of the ADC is proposed. Also, unlike traditional normalization processing, SDOS is used and the mapping between SDOS and the average signal magnitude is deduced. Second, the saturation term is introduced to the Lloyd-Max quantizer and an optimal non-uniform scalar quantizer for saturated SAR raw data quantization is proposed. After this, the implementation scheme for the pro-posed algorithm using an FPGA is analyzed in detail. Third, the relationships among the saturation degree of the signal, the peak-to-peak value of the ADC, standard deviation of the input and output signal of the ADC and the average signal magnitude are deduced.Based on these relationships, a power compensation decoder is designed for encoding. Numerical experiment results based on ERS-1 and the simulated data show that the performance of the proposed algorithm is better than that of BAQ.

  8. Atrioventricular septal defects among infants in Europe

    DEFF Research Database (Denmark)

    Christensen, Nikolas; Andersen, Helle; Garne, Ester

    2013-01-01

    OBJECTIVE: To describe the epidemiology of chromosomal and non-chromosomal cases of atrioventricular septal defects in Europe. METHODS: Data were obtained from EUROCAT, a European network of population-based registries collecting data on congenital anomalies. Data from 13 registries for the period...... 2000-2008 were included. RESULTS: There was a total of 993 cases of atrioventricular septal defects, with a total prevalence of 5.3 per 10,000 births (95% confidence interval 4.1 to 6.5). Of the total cases, 250 were isolated cardiac lesions, 583 were chromosomal cases, 79 had multiple anomalies, 58...... of pregnancy owing to foetal anomaly. Among the groups, additional associated cardiac anomalies were most frequent in heterotaxia cases (38%) and least frequent in chromosomal cases (8%). Coarctation of the aorta was the most common associated cardiac defect. The 1-week survival rate for live births was 94...

  9. Closure of the zone of apposition at correction of complete atrioventricular septal defect improves outcome.

    Science.gov (United States)

    Wetter, J; Sinzobahamvya, N; Blaschczok, C; Brecher, A M; Grävinghoff, L M; Schmaltz, A A; Urban, A E

    2000-02-01

    regurgitation was present through the open zone of apposition in 63% of group I cases. The follow-up is 96% (126/131) complete. An increase in degree of left atrioventricular valve incompetence was noted in 28% (11/39) of group I cases and in 9% (8/87) of group II cases (P=0.0131). This study demonstrates the advantage of closing the zone of apposition ('cleft') as part of repair of complete atrioventricular septal defect. Survival, freedom from reoperation for left atrioventricular valve incompetence and over-all outcome were more favourable in patients of group II. The zone of apposition should be surgically addressed whenever the morphology of the left atrioventricular valve allows for closure without producing stenosis.

  10. Asymptomatic Paget's disease of bone presenting with complete atrioventricular block

    Institute of Scientific and Technical Information of China (English)

    A.Rauoof Malik; Nazir A.Lone; Hilal A.Rather; Vicar M Jan; Javid A.Malik; Khursheed A.Khan; S.Jalal

    2008-01-01

    @@ Paget's disease of bone is a deforming bone disease (osteitis deformans) characterized by increased bone remodeling,bone hypertrophy,and abnormal bone structure,leading to bone expansion,deformities,easy fractures,and occasionally,neoplastic transformation.It is the second most common bone disorder after osteoporosis.1 The disease is relatively rare in Asia but is common in Europe and North America,affecting approximately 2% of the population over 50 years,although lately,a decline in the prevalence has been reported.2 Paget's disease commonly affects people in or past their middle age and is slightly more common in men than in women.1 The exact cause of Paget's disease is not known.Environmental agents,particularly paramyxoviral infections (measles and canine distemper viruses) have been postulated as potential etiological factors.3 Recently,a strong genetic component has been described,with candidate loci suggested at 18q,5q35-QTER,and particularly,the squestosome 1/p62.2,3 The pathological process in Paget's disease consists of one or more areas of aggressive and relentless osteoclastic activity,coupled with deposition of structurally abnormal excessive bone and matrix tissues.1,4 Most of the cases involve only one (monostotic) or few bones,particularly skull,vertebrae,pelvis,femur,and tibia.

  11. Orthodromic atrioventricular reciprocating tachycardia conducted with intraventricular conduction disturbance mimicking ventricular tachycardia in an English Bulldog.

    Science.gov (United States)

    Santilli, Roberto A; Diana, Alessia; Baron Toaldo, Marco

    2012-01-01

    Electrocardiographic tracings of an English Bulldog referred for cardiogenic shock due to an orthodromic atrioventricular reciprocating tachycardia conducted with intraventricular conduction disturbance and mimicking ventricular tachycardia (VT) are presented. At admission the surface ECG showed a wide QRS complex tachycardia (WCT) that was converted to sinus rhythm using manual cardioversion (chest thump). This change revealed pre-existing right bundle branch block, and a final diagnosis of supraventricular tachycardia (SVT) with intraventricular conduction disturbance was made. Electrophysiologic study defined the SVT mechanism as an atrioventricular macroreentrant tachycardia mediated by a single mid-septal accessory pathway. The differentiation between various types of WCT is essential when antiarrhythmic therapy is considered. The surface ECG should be systematically evaluated in order to recognize the characteristic features of SVT and VT. Moreover chest thump procedure can be very helpful in the attempt to convert the rhythm to sinus rhythm and to correctly recognize the underlying arrhythmia.

  12. Clinical significance of second degree Wenckebach type sinoatrial block identified during Holter monitoring in patients with symptoms suggestive of arrhythmia.

    Science.gov (United States)

    Kramarz, Elżbieta; Makowski, Karol

    2015-01-01

    To determine the clinical significance of the sinoatrial block II° of the Wenckebach type (block W) identified during Holter monitoring. The study included 300 patients (mean age 54 ± 17 years; 130 women) with symptoms suggestive of arrhythmia who underwent Holter monitoring. Block W was identified by a dedicated computer program and subsequently confirmed by a cardiologist. Block W was diagnosed in 88 patients (29%). It occurred only during sleep in 37 (12%) patients and during both daytime activity and sleep in 51 (17%) patients. Block W only during sleep happened predominately in young patients aged between 20 and 30 years, whereas episodes that occurred during both daytime and sleep were found mainly in patients between 60 and 70 years of age. Prospective observation time averaged 41 ± 11 months, and the time to the diagnosis of sinus node disease was 26 ± 10 months. Cox multivariate analyses showed that block W during both daytime and sleep is an independent predictor for the future diagnosis of sinus node disease [hazard ratio-13.6 (5.2-35.5); P < 0.0001]. Age-specific analyses confined this effect to the patients ≥50 years of age. The results also suggest that in patients ≥50 years of age block W during both daytime and sleep may be related to a significant improvement in survival [hazard ratio-0.03 (0.007-0.16); P < 0.0001]. Block W during daytime activity in patients with symptoms suggestive of arrhythmia indicates an increased likelihood of the future diagnosis of sinus node disease. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  13. Effect of reperfusion therapy for patients prognosis with complete atrioventricular block complicating acute myocardial infarction%再灌注治疗对急性心肌梗死合并Ⅲ度房室传导阻滞患者预后的影响

    Institute of Scientific and Technical Information of China (English)

    徐忠武; 李平

    2013-01-01

    Objective This study the different effect of reperfusion therapy for patients prognosis with complete atrioventricular block (CAVB) complicating acute myocardial infarction (AMI) comparatively.Methods 69 patients with CAVB complicating AMI from 2007 January to 2012 January were divided into control group,reperfusion group and intervention group,and compared the cardiogenic shock,arrhythmia,heart failure incidence and total mortality.The left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVD) were measured by echocardiograma after 6 months for survivors of them.Results (1)The intervention group were significantly lower than those of the thrombolysis group and control group in cardiogenic shock,arrhythmia,heart failure incidence and total mortality after reperfusion therapy (P<0.05),and the thrombolysis group was significantly lower than that of the control group too (P<0.05).(2)The survivors of intervention group were significantly higher than that of the survivors of thrombolysis group and control group in the LVEF after 6 months(P<0.05),and were significantly lower in LVD(P<0.05).Conclusion Patients with CAVB complicating AMI have a significant poor prognosis for the higher cardiogenic shock,arrhythmia,heart failure incidence and total mortality.Coronary reperfusion therapy may contribute to improve the left ventricular function and prognosis,and the effect of primary percutaneous coronary intervention.is more outstanding than that of intravenous thrombolytic therapy.%目的 对比研究不同再灌注治疗对急性心肌梗死(AMI)合并Ⅲ度房室传导阻滞(Ⅲ.AVB)患者预后的影响.方法 2007年1月至2012年1月住院的AMI合并Ⅲ.AVB患者69例,分为对照组、溶栓组和介入组,比较三组患者心源性休克、恶性心律失常、心衰等发生率和总死亡率.于再灌注治疗后6个月对存活者行心脏超声检查,测定左室射血分数(LVEF)和左室舒张末期内径(LVD).结果

  14. Permanent pacemaker implantation and follow-up in 23 infants and children with perioperative complete atrioventricular block%23例先天性心脏病患儿围术期永久起博器的植入及随访

    Institute of Scientific and Technical Information of China (English)

    张惠丽; 李守军; 花中东; 杨克明; 胡盛寿; 张浩; 陈柯萍; 华伟

    2014-01-01

    目的:总结先天性心脏病(congenital heart diseases, CHD)儿童围术期植入永久性起搏器治疗完全性房室传导阻滞(atrioventricular block, AVB)的经验。方法选择需植入永久起搏器CHD患儿23例,男13例,女10例。年龄4个月~8岁,平均(2.8±2.5)岁,体重5~27 kg,平均(10.7±6.8)kg。结果植入心内膜起博器7例、心外膜起博器16例。起搏方式为频率应答心室按需起搏(VVIR)1例,固定频率心室按需起搏(VVI)22例,起搏频率为70~160次/min,平均(111±25.5)次/min,起搏阈值为0.5~0.75V,平均(0.74±0.30)V,感知灵敏度为2.5~2.8 mV,平均(2.78±0.11)mV,电极阻抗为271~726Ω,平均(445.5±148.9)Ω。21例(91.3%)获得随访,随访1个月~5.5年,起搏阈值术后早期略升高,后稳定。1例术后6个月猝死,原因不明。1例术后4.5年重新更换电池。1例随访中恢复窦性心律。4例术后6个月~2年心脏扩大、心功能低下,左室射血分数(LVEF)<50%。结论 CHD患儿围术期植入永久性起搏器治疗AVB是安全可行的,永久起搏器植入对其远期预后的影响需要长期随访。%Objectives We analyzed the results of 23 children with congenital heart diseases (CHD) associated complete atrioventricular block (AVB)who underwent pacemaker (PM) implantation at our center. Methods Between Jan-uary 2007 and July 2012, 23 children with CHD (13 males, 10 females, aged from 4 months to 8 years with the average of 2.8±2.5 years. Their weight ranged from 5 to 27 kg with the average of 10.7±6.8kg) underwent PM implantation for com-plete AVB at our center. Endocardial (ENDO) or epicardial (EPI) pacing systems were implanted in 7 and 16 patients re-spectively. Three patients (1 atrial septal defect(ASD)/pulmonary stenosis(PS),1 partial endocardial cushion defect (PECD) and 1 corrected transposition of the great arteries (CTGA) had complete AVB

  15. Acidosis slows electrical conduction through the atrio-ventricular node

    Directory of Open Access Journals (Sweden)

    Ashley Muir Nisbet

    2014-06-01

    Full Text Available Acidosis affects the mechanical and electrical activity of mammalian hearts but comparatively little is known about its effects on the function of the atrio-ventricular node (AVN. In this study, the electrical activity of the epicardial surface of the left ventricle of isolated Langendorff-perfused rabbit hearts was examined using optical methods. Perfusion with hypercapnic Tyrode’s solution (20% CO2, pH 6.7 increased the time of earliest activation (Tact from 100.5+7.9 to 166.1+7.2ms (n=8 at a pacing cycle length (PCL of 300ms (37oC. Tact increased at shorter PCL, and the hypercapnic solution prolonged Tact further: at 150ms PCL, Tact was prolonged from 131.0+5.2 to 174.9+16.3ms. 2:1 AVN block was common at shorter cycle lengths. Atrial and ventricular conduction times were not significantly affected by the hypercapnic solution suggesting that the increased delay originated in the AVN. Isolated right atrial preparations were superfused with Tyrode’s solutions at pH 7.4 (control, 6.8 and 6.3. Low pH prolonged the atrial-Hisian (AH interval, the effective and functional refractory periods and Wenckebach cycle length significantly. Complete AVN block occurred in 6 out of 9 preparations. Optical imaging of conduction at the AV junction revealed increased conduction delay in the region of the AVN, with less marked effects in atrial and ventricular tissue. Thus acidosis can dramatically prolong the AVN delay, and in combination with short cycle lengths, this can cause partial or complete AVN block and is therefore implicated in the development of brady-arrhythmias in conditions of local or systemic acidosis.

  16. Association of temporary complete AV block and junctional ectopic tachycardia after surgery for congenital heart disease.

    Science.gov (United States)

    Paech, Christian; Dähnert, Ingo; Kostelka, Martin; Mende, Meinhardt; Gebauer, Roman

    2015-01-01

    Junctional ectopic tachycardia (JET) is a postoperative complication with a mortality rate of up to 14% after surgery for congenital heart disease. This study evaluated the risk factors of JET and explored the association of postoperative temporary third degree atrioventricular (AV) block and the occurrence of JET. Data were collected retrospectively from 1158 patients who underwent surgery for congenital heart disease. The overall incidence of JET was 2.8%. Temporary third degree AV block occurred in 1.6% of cases. Permanent third degree AV block requiring pacemaker implantation occurred in 1% of cases. In all, 56% of patients with JET had temporary AV block (P AV block (P = 0.56). temporary third degree AV block did not suffer from JET. A correlation between temporary third degree AV block and postoperative JET could be observed. The risk factors identified for JET include younger age groups at the time of surgery, longer aortic cross clamping time and surgical procedures in proximity to the AV node.

  17. Heart block following propofol in a child.

    Science.gov (United States)

    Sochala, C; Deenen, D; Ville, A; Govaerts, M J

    1999-01-01

    We present the case of a nine-year-old boy afflicted with Ondine's curse, who developed complete atrioventricular heart block after a single bolus of propofol for induction of anaesthesia for strabismus surgery. Ondine's curse, the other name for congenital central hypoventilation syndrome, is characterized by a generalized disorder of autonomic function. Propofol has no effect on the normal atrioventricular conduction system in humans but it reduces sympathetic activity and can highly potentiate other vagal stimulation factors. Heart block has been documented after propofol bolus use in adults but, to our knowledge, not in children. It would appear that propofol is not a good choice for anaesthesia in congenital central hypoventilation syndrome.

  18. Use-dependent properties of flecainide acetate in accessory atrioventricular pathways.

    Science.gov (United States)

    Goldberger, J; Helmy, I; Katzung, B; Scheinman, M

    1994-01-01

    Flecainide acetate has been shown to have use-dependent properties. The use-dependent properties of flecainide were evaluated in 20 patients (13 men and 7 women, mean age 32 +/- 11 years) with accessory atrioventricular connections. Twenty to 30 stimulus drive trains were introduced in either the atrium or ventricle at progressively faster rates. The range of cycle lengths over which anterograde and retrograde conduction block occurred in the accessory pathway was assessed in the drug-free state and after oral loading with flecainide acetate. The block cycle length index was defined as the shortest cycle length during which 1:1 conduction was maintained in the accessory pathway minus the longest cycle length during which block in the accessory pathway occurred on the second paced beat. In the drug-free state, the (mean +/- SD) anterograde and retrograde block cycle length indexes were 20 +/- 12 and 20 +/- 9 ms, respectively. After flecainide therapy, the anterograde and retrograde block cycle length indexes increased to 80 +/- 33 and 65 +/- 29 ms, respectively (p = 0.002 compared with the drug-free state). The block cycle length index did not correlate with serum flecainide levels, but did correlate with other electrophysiologic markers of drug effect on accessory pathway conduction. The change in the block cycle length index demonstrates that flecainide has a progressive effect on accessory pathway conduction at more rapid rates, consistent with its in vitro use-dependent properties. This index is an excellent marker of drug efficacy.

  19. Atrioventricular valve replacement in functional single-ventricle patients

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhong; CEN Jian-zheng; XU Gang; WEN Shu-sheng; CHEN Ji-mei

    2016-01-01

    Background This article summarized the experience of atrioventricular valve replacement operation for functional single ventricle patients whose atrioventricular valve was insufficiency.The follow-up time of operation was arranged from early-to medium-term.Methods From July 2009 to July 2015,there were 40 patients of functional single ventricle receiving the operation of atrioventricular valve replacement,including 23 male and 17 female patients.The age at A-Ⅴ valve replacement was ranged from 6 days to 32 years (the medium age of 9 years),and the body weight ranged from 2.7 to 57 kg (the medium body weight of 21.5 kg).Moreover,the atrioventricular valve replacement was performed on all patients under extracorporeal circulation.Results Atrioventricular valve replacement was performed on 40 patients with function single ventricle in hospital,of which eight (20.0%) died in hospital including two neonate and infant (age range:6 days-2 years old) accounting for 25% (2/8),Among them,seven patients died of low cardiac output syndrome two patients with repeated hypoxemia concurrent infection after operation,and one with bilateral diaphragmatic paralysis and malignant arrhythmia.For the patients suffering the severe perivalvular leakage,there was a reoperation,and the cardiac function before the first operation was class Ⅳ.One patient received heart transplantation finally for severe heart failure after AV valve replacement.For the rest of patients,their cardiac function recovered to class Ⅰ-Ⅱ after operation.Conclusions For function single ventricle patients with atrioventricular valve regurgitation,the mortality rate of atrioventricular valve replacement can be accepted if the operation was indicated.For patients with severe atrioventricular value regurgitation,the result of the operation in the early and medium term was satisfying.Thus,the atrioventricular valve replacement served as a useful treatment for patients diagnosed of A-Ⅴ valve regurgitation and

  20. Morphological aspects of atrioventricular valves in the ostrich (Struthio camelus

    Directory of Open Access Journals (Sweden)

    Marco A. Pereira-Sampaio

    2013-11-01

    Full Text Available Heart anatomy in the ostrich has been reported, but there are few information on the histological features of the atrioventricular valves. Hearts of young ostriches were fixed in 10% formaldehyde for 24 h and dissected to characterize their macroscopic anatomy. Samples of valves were harvested and stained with Mallory’s trichrome, Gomori’s trichrome, and Picro-Sirius red, for later analysis. The right atrioventricular valve consists of a muscle flap with two fixations. The left atrioventricular valve consists of two layers of endocardium with a layer of connective tissue between them. The free border of the tricuspid valve supports a varying number of chordae tendineae. One of the cusps is attached to the septum, while the other two cusps are attached to the opposite wall. The aortic valve, as well as the pulmonary trunk valve, consists of three cusps. The right atrioventricular valve showed up only as a muscle flap of myocardium coated with a thin layer of dense connective tissue, with two fixations. In the connective tissue, we find a predominance of type I collagen fibers and a lesser amount of type III, with a small presence of elastic fibers. The presence of Purkinje fibers were also usual in the valvular subendocardium, suggesting that they directly participate in the transmission of nervous stimulation to the muscle fibers within the valves. The left atrioventricular valve consisted of 3 cusps, a dorsal, a left, and a right.

  1. 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.

  2. 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

  3. [Results of surgical therapy of the partial form of persistent common atrioventricular canal (author's transl)].

    Science.gov (United States)

    Morino, F; Possati, F; Calafiore, A M; Santarelli, P; Malara, D; Ottino, G M; de Nunno, T

    1975-01-01

    20 patients with partial form of persistent common atrioventricular canal underwent surgery at the Centro di Cardiochirurgia "A. Blalock", University of Turin, between 1969 and 1974. In each case the treatment of lesions took place in the following order: the repair or replacement (one case) of the mitral valve; the closing with a patch of the atrial septal defect; the repair, in one case, of the tricuspid. The most frequent post-operative complications were arrhythmias, which in two cases consisted of a total atrioventricular block. Only one patient died postoperatively for an acute pulmonary oedema following an imperfect mitral valve correction. Six months after surgery, another patient died from bacterial endocarditis. Thirteen of the eighteen surviving patients showed excellent results at the clinical and/or hemodynamic check; two had fair results and three had poor results. In two cases, mitral insufficiency was hemodynamically aggravated, whilst in another five it disappeared. In eight, a slight apex systolic murmor 1-2/6 persisted, which was not correlated with any radiological or electrocardiographical sign of mitral insufficiency (and for three of these, not even a hemodynamic one). The authors consider that the most difficult problem in surgical therapy for these malformations is still the treatment of mitral lesions.

  4. [Fetal atrioventricular septal defect associated with Patau and Edwards syndromes, as well as trisomy 22].

    Science.gov (United States)

    Cesko, I; Hajdú, J; Marton, T; Tóth-Pál, E; Papp, C; Papp, Z

    1998-05-03

    The atrioventricular septal defect is usually associated with trisomy 21 and it may be observed in the heterotaxia syndromes. Atrioventricular septal defect may be associated with 8p deletion. There are reported cases of familial atrioventricular septal defect. Atrioventicular septal defect is rarely associated with other chromosomal abnormalities. We are reporting three unusual cases of atrioventricular septal defect that were associated with trisomy 13, 18 and 22. This association may be due to effect of genetic loci on the 13, 18 and 22 chromosome which could play the role in the development and fusion of endocardial cushion and atrioventricular septal defect.

  5. Congenital defect of the partial atrioventricular canal with Klinefelter syndrome

    OpenAIRE

    Zhang, Yejing

    2009-01-01

    The case of a 25-year-old man with a partial atrioventricular canal defect (PAVCD) with Klinefelter syndrome is reported here. The patient had Klinefelter syndrome associated with an atrial septal defect and the cleft of the anterior leaflet of the mitral valve.

  6. "Distal common pathway in atrioventricular node reentrant tachycardia "

    Directory of Open Access Journals (Sweden)

    "Moghaddam M

    2001-06-01

    Full Text Available Anotomical boundary of atrioventricular node reentrant tachycardia (AVNRT is composed of fast and slow pathways right atrium in upper turnaround and common distal pathway in lower turnaround. We performed electophsiologic study (EPS in 152 patients and could show the existence of distal common pathway with decremental conduction properties in approximately 40 patients.

  7. Atrioventricular nodal reentrant tachycardia treatment using novel potential.

    Science.gov (United States)

    Ardashev, Andrey V; Makarenko, Alexandr S; Zhelyakov, Eugeny G; Shavarov, Andrey A

    2010-12-01

    Radiofrequency ablation of atrioventricular nodal reentrant tachycardia is commonly guided by slow and sharp bipolar potentials of the atrioventricular slow nodal pathway. We optimized the morphology of the guiding potential by unipolar mapping of the slow nodal pathway. We identified a novel unipolar dual-component atrial electrogram at the anterior limb of the coronary sinus ostium. The first component was a positive delta-wave type that corresponded to the isoelectric phase on a bipolar electrogram. The second component had fast biphasic morphology and corresponded to the R wave on a bipolar atrial electrogram. Of 104 consecutive patients with typical atrioventricular nodal reentrant tachycardia, 51 were treated with ablation guided by the novel potential, and 53 underwent ablation using the conventional technique. There was no recurrence of tachycardia in any of these patients. In those treated by the novel potential, there was significantly less radiofrequency power applied and a shorter duration of application than in patients treated by the traditional approach. The novel approach to mapping and ablation of the slow nodal pathway in atrioventricular nodal reentrant tachycardia guided by unipolar recording was safe and effective, and comparable to the traditional technique.

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

    Directory of Open Access Journals (Sweden)

    Melikulov A.Kh.

    2014-03-01

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

  9. Defeito completo do septo atrioventricular com cianose Complete repair in total atrioventricular canal defect with cyanosis

    Directory of Open Access Journals (Sweden)

    Carla Tanamati

    2006-09-01

    Full Text Available Os defeitos do septo atrioventricular total (DSAVT representam 4% das mal formações cardíacas e acima de 50% dos defeitos observados na síndrome de Down (SD¹. A apresentação clínica é de insuficiência cardíaca precoce na infância e hipertensão pulmonar por hiperfluxo. Raramente a cianose é observada e sugere hipertensão pulmonar ou associação à tetralogia de Fallot³, dupla via de saída de ventrículo direito², anomalia de Ebstein4, drenagem anômala de cava esquerda persistente em átrio esquerdo (Barbero Marcial, comunicação pessoal. Crianças com SD são particularmente difíceis de avaliação por apresentarem obstrução de vias aéreas superiores, que podem contribuir com o aumento da resistência pulmonar observada no cateterismo cardíaco. A presença de cianose pré-operatória constitui-se um desafio ao tratamento cirúrgico devido ao risco de hipertensão pulmonar irreversível com falência ventricular direita com, a correção dos defeitos intracardíacos.Atrioventricular septal defects account for 4% of congenital cardiac malformations and over 50% of cardiac defects seen in Down syndrome¹. Clinical presentation is marked by congestive heart failure early in infancy. Cyanosis is rarely found in infants and suggests irreversible pulmonary hypertension or associated cardiac defects as tetralogy of Fallot, double outlet right ventricle², Ebstein anomaly³, persistent left superior vena cava draining in the left atrium (Barbero Marcial, personal communication. Children with Down's syndrome is particularly difficult to assess because they often suffer from upper airways obstruction4, which may contribute to the increased pulmonary vascular resistance determined at cardiac catheterization. This association of factors becomes a challenge for operability and, we will report one such case.

  10. An improved in vivo method for atrioventricular node ablation via thoracotomy

    Directory of Open Access Journals (Sweden)

    R.H. MacIver

    2010-02-01

    Full Text Available The atrioventricular (AV node is permanently damaged in approximately 3% of congenital heart surgery operations, requiring implantation of a permanent pacemaker. Improvements in pacemaker design and in alternative treatment modalities require an effective in vivo model of complete heart block (CHB before testing can be performed in humans. Such a model should enable accurate, reliable, and detectable induction of the surgical pathology. Through our laboratory’s efforts in developing a tissue engineering therapy for CHB, we describe here an improved in vivo model for inducing chronic AV block. The method employs a right thoracotomy in the adult rabbit, from which the right atrial appendage may be retracted to expose an access channel for the AV node. A novel injection device was designed, which both physically restricts needle depth and provides electrical information via electrocardiogram interface. This combination of features provides real-time guidance to the researcher for confirming contact with the AV node, and documents its ablation upon formalin injection. While all animals tested could be induced to acute AV block, those with ECG guidance were more likely to maintain chronic heart block >12 h. Our model enables the researcher to reproduce both CHB and the associated peripheral fibrosis that would be present in an open congenital heart surgery, and which would inevitably impact the design and utility of a tissue engineered AV node replacement.

  11. Esclerosis sistémica complicada con síncope y bloqueo AV completo Systemic sclerosis complicated with syncope and complete AV block

    Directory of Open Access Journals (Sweden)

    Francisco Femenía

    2010-10-01

    Full Text Available La esclerosis sistémica es una compleja enfermedad que afecta el tejido conectivo, el sistema vascular y el sistema inmunológico, y se caracteriza por fibrosis cutánea y de órganos viscerales. Los bloqueos de rama y los hemibloqueos se presentan en el 25 a 75% de los casos y constituyen predictores independientes de mortalidad. Los bloqueos auriculoventriculares de segundo o tercer grado son muy raros. Presentamos el caso de una mujer de 47 años de edad, con diagnóstico de esclerosis sistémica, quien presenta episodio sincopal secundario a bloqueo auriculoventricular completo con necesidad de implante de marcapasos definitivo.Systemic sclerosis is a complex disease that affects the connective tissue, the vascular system and the immune system. It typically produces skin and organ fibrosis. Cardiac bundle branch blocks and fascicular blocks occur in 25-75% of the cases and were found to be independent predictors of mortality. Second and third degree atrioventricular block are very rare. We present the case of a 47 year-old female with diagnosis of systemic sclerosis, presented with syncope secondary to complete atrioventricular block requiring permanent pacemaker implantation.

  12. Growth Trajectory in Children with Trisomy 21 with and without Atrioventricular Septal Defect.

    Science.gov (United States)

    Mackman, Chad A; Loomba, Rohit S; Slicker, Julie; Bartz, Peter J

    2016-07-01

    Trisomy 21 is associated with poor weight gain and atrioventricular septal defects. The impact of atrioventricular septal defects on weight gain in the setting of Trisomy 21 has not previously been described in the recent era. This study aimed to determine if such an association is present. Patients with Trisomy 21 with and without atrioventricular septal defects were identified. Clinical, surgical, and postoperative data were collected were for these patients and then compared between patients. Specifically, weight for age z-scores were compared at various time points in a univariate and multivariate fashion. Effect of timing of surgery in those with an atrioventricular septal defect was also studied. A total of 86 patients were identified, 42 with an atrioventricular septal defect. There was a difference in weight for age z-scores between patients with and without atrioventricular septal defects only at 2 months (P value .038) and 6 months (P value .003) of age. This persisted after multivariate regression which demonstrated atrioventricular septal defects as an independent risk factor. There was no difference noted in weight at 2 years of age in patients undergoing atrioventricular septal defect repair before and 150 days of life. There was a statistically significant, but not clinically relevant, difference in weight between the patients with Trisomy 21 with and without atrioventricular septal defects in our cohort. Those with atrioventricular septal defects required more nutritional intervention, such as gastrostomy tube placement. Timing of repair did not alter outcomes at midterm follow-up. © 2016 Wiley Periodicals, Inc.

  13. Hyperkalemia-induced complete heart block

    Directory of Open Access Journals (Sweden)

    Alireza Baratloo

    2015-05-01

    Full Text Available Background: Potassium, as an extracellular ion, plays an important role in the electrophysiologic function of the myocardium and any change in extracellular concentration of this ion might have a marked impression upon myocyte electrophysiologic gain. High serum potassium levels are thought to impair pulse conduction in Purkinje fibers and ventricles more than that in the Atrioventricular (AV node. Therefore, although complete AV block can occur, it is a rare initial presentation. Case Report: We describe a 62-year-old man with a history of diabetes mellitus, ischemic heart disease and previous Coronary Artery Bypass Graft (CABG, who came to our emergency department due to generalized weakness starting 2 days before admission. The patient also had decreased force in lower limbs, exacerbating from the morning, and was finally diagnosed as a hyperkalemia-induced Complete Heart Block (CHB. It should also be noted that the patient responded dramatically to the administration of 10 mL of 10% calcium gluconate along with external pacing until potassium level correction became effective. Conclusion: In spite of the fact that Hyperkalemia can be associated with frequent Electrocardiogram (ECG abnormality, advanced heart blocks (second- and third-degree AV blocks are usually found only in patients with pre-existing heart failure, conduction abnormalities, or other cardiac diseases. Institution of effective treatment rapidly and forgiveness of traditional non-effective, time consumptive and sometimes risking full-adjustment modalities, such as sodium bicarbonate infusion or exchange resins that prevent their use in the emergent phase, can help minimize patient morbidity and mortality.

  14. Coronary sinus and atrioventricular groove avulsion after motor vehicle crash

    Directory of Open Access Journals (Sweden)

    Bradley M Dennis

    2014-01-01

    Full Text Available Simultaneous cardiac and pericardial rupture from blunt chest trauma is a highly lethal combination with rarely reported survival. We report of a case of young patient with a right atrioventricular groove injury, pericardial rupture and a unique description of a coronary sinus avulsion following blunt chest trauma. Rapid recognition of this injury is crucial to patient survival, but traditional diagnostic adjuncts such as ultrasound, echocardiography and computed tomography are often unhelpful. Successful repair of these injuries requires high suspicion of injury, early cardiac surgery involvement of and possible even placement of the patient on cardiopulmonary bypass.

  15. Nitric Oxide Synthase-3 Promotes Embryonic Development of Atrioventricular Valves

    OpenAIRE

    Yin Liu; Xiangru Lu; Fu-Li Xiang; Man Lu; Qingping Feng

    2013-01-01

    Nitric oxide synthase-3 (NOS3) has recently been shown to promote endothelial-to-mesenchymal transition (EndMT) in the developing atrioventricular (AV) canal. The present study was aimed to investigate the role of NOS3 in embryonic development of AV valves. We hypothesized that NOS3 promotes embryonic development of AV valves via EndMT. To test this hypothesis, morphological and functional analysis of AV valves were performed in wild-type (WT) and NOS3(-/-) mice at postnatal day 0. Our data s...

  16. Echocardiographic effects of changing atrioventricular delay in cardiac resynchronization therapy based on displacement

    DEFF Research Database (Denmark)

    Valeur, Nana; Fritz-Hansen, Thomas; Risum, Niels;

    2010-01-01

    In studies showing benefits of cardiac resynchronization therapy (CRT), individual atrioventricular (AV) delays have been optimized using echocardiography. However, the method for AV delay optimization remains controversial.......In studies showing benefits of cardiac resynchronization therapy (CRT), individual atrioventricular (AV) delays have been optimized using echocardiography. However, the method for AV delay optimization remains controversial....

  17. Electrocardiographic and chronobiological features of paroxysmal AV block recorded by ambulatory electrocardiography.

    Science.gov (United States)

    Saito, Ken; Takeda, Shiho; Saito, Yuko; Kawamura, Mami; Yoshikawa, Yoko; Yano, Hayato; Sata, Masataka

    2014-01-01

    The goal of this study was to investigate the electrocardiographic and chronobio-logical features of paroxysmal atrioventricular (AV) block (PAVB) using data from ambulatory electrocardiography (AECG). The study population consisted of five men and six women aged from 47 to 82 years of age. Main presenting symptoms were pre-syncope in five patients (45.5%) and syncope in three patients (27.3%). Organic cardiovascular diseases were seen in eight patients (72.7%), and AV conduction disturbances were seen in six patients (54.5%), such as right bundle branch block, first to second degree AV block on standard 12-lead electrocardiography. Incidence of PAVB events were 1-329 (37.9 ± 98.0) episodes/patient/day, and the maximum pause during Holter recordings was 3.3-12.4 (6.39 ± 3.09) seconds. This maximum pause caused by intrinsic AV block was longer than that of vagally mediated AV block (8.4 ± 3.2 sec vs 4.7 ± 1.0 sec, p<0.05). In chronobiological analysis, episodes of PAVB exhibited a circadian rhythm characterized by a peak between 2:00 am and 4:00 am and a trough between 0:00 pm and 2:00 pm. AECG is a useful tool to detect the maximum pause occurring during sleep and provides critical data necessary to prevent the sudden cardiac death caused by PAVB.

  18. Down Syndrome with Complete Atrioventricular Septal Defect, Hypertrophic Cardiomyopathy, and Pulmonary Vein Stenosis.

    Science.gov (United States)

    Mahadevaiah, Guruprasad; Gupta, Manoj; Ashwath, Ravi

    2015-10-01

    The prevalence of congenital heart disease in infants with Down syndrome is 40%, compared with 0.3% in children who have normal chromosomes. Atrioventricular and ventricular septal defects are often associated with chromosomal aberrations, such as in trisomy 21, whereas hypertrophic cardiomyopathy is chiefly thought to be secondary to specific gene mutations. We found only one reported case of congenital hypertrophic cardiomyopathy and atrioventricular septal defect in an infant with Down syndrome. Here, we report atrioventricular septal defect, hypertrophic cardiomyopathy, and pulmonary vein stenosis in a neonate with Down syndrome-an apparently unique combination. In addition, we discuss the relevant medical literature.

  19. Reentry confined to the atrioventricular node: electrophysiologic and anatomic findings.

    Science.gov (United States)

    Sheinman, M M; Gonzalez, R; Thomas, A; Ullyot, D; Bharati, S; Lev, M

    1982-05-01

    A patient with recurrent disabling, paroxysmal supraventricular tachycardia refractory to drug treatment underwent electrophysiologic studies. The paroxysmal supraventricular tachycardia was found to be due to atrioventricular (A-V) nodal reentry. The patient died shortly after surgical His bundle section and detailed anatomic studies were performed. These showed fatty infiltration of the approaches to the sinoatrial node, atrial preferential pathways, and A-V node and common bundle. The A-V node was mechanically damaged and the common His bundle was completely severed. These abnormalities were clearly delineated and there was no evidence of an atrio-His bundle bypass tract to an accessory A-V node. Specifically, the central fibrous body and pars membranacea were defined and no atrial muscular fibers pierced these structures to joint the A-V bundle. It is concluded that paroxysmal supraventricular tachycardia due to A-V nodal reentry can be confined to the A-V node.

  20. Effect of atrioventricular conduction on heart rate variability

    KAUST Repository

    Ahmad, Talha Jamal

    2011-08-01

    This paper discusses the effect of atrioventricular conduction time (AVCT) on the short-term Heart Rate Variability (HRV) by computing HRV parameters using intervals between the onsets of successive P waves (PP time series) for three groups: normal, arrhythmia and sudden cardiac death (SCD) patients. A very precise wavelet transform based ECG delineator was developed to detect PP, PR and RR time series. Mean PR variation in arrhythmia and SCD group was found to be significantly high as compared to the normal group. It was observed that when PR variations in arrhythmia and SCD cases crossed a certain threshold, RR variability no longer provided a very accurate estimate of HRV. In such cases, PP variability was able to provide a better assessment of HRV. © 2011 IEEE.

  1. Blocked Atrial Bi/Trigeminy In Utero Evolving in Supraventricular Tachycardia after Birth

    Directory of Open Access Journals (Sweden)

    V. Martucci

    2012-01-01

    Full Text Available Transient episodes of fetal bradycardia (heart rate less than 110 bpm are usually benign and typically result from increased vagal stimulation in the fetus. Causes of sustained fetal bradycardia include sinus bradycardia, blocked atrial bigeminy/trigeminy, high-degree atrioventricular block, and long QT syndrome. We present the case of a 34-year-old Caucasian patient referred to our department for “blocked atrial bigeminy with pseudobradycardia” detected elsewhere at 33 weeks of gestation. A fetal echocardiography showed during all the examination a blocked atrial trigeminy with a mean fetal heart rate of 100 bpm. After birth three subsequent ECGs until day 3 showed no evidence of atrial extrasystoles, confirming the well-known frequent regression of this kind of fetal benign arrhythmia, but on day 11 recurrence of supraventricular trigeminy and development of episodes of paroxystic supraventricular tachycardia were observed. On the basis of this observation, we recommend that fetuses with complex atrial ectopic beats should be closely monitored before and after birth for evidence of new arrhythmias.

  2. Acciones bloqueantes alrededor de los setenta grados oeste en el sur de Sudamérica Blocking action arround seventy degrees West in the South of South America

    Directory of Open Access Journals (Sweden)

    Adelia P. Alessandro

    2005-12-01

    esta situación. La presencia de estos sistemas y la falta de viento N o NE inciden en la extremadamente escasa precipitación recibida en el Noreste de la Argentina, en las altas temperaturas en la Patagonia y bajas temperaturas en el NE y centro del país.Blocking situations near 70ºW south of South America are characterised. Cases which initiate to the west and those to the east of the above- mentioned longitude are distinguished. Averaging all cases it is seen that the Atlantic high as well as the Pacific high is displaced to the south for the first and second group respectively. Four different models result from the Principal Component Analysis, three of which representing blocking situations over the south-eastern Pacific Ocean and one of the south-western Atlantic. The trajectory of those highs that commence to the west have a cuasi zonal orientation with a speed of 20 Km/h, meanwhile those that region to the east have a slight component to the north with a speed of 20.5 Km/h. The mean centre of the anticyclones has a geopotential height of 227.7 gpm. The associated temperature anomalies are negative over most of Argentina, excepting the extreme south and the northeast, for both groups. When the blocking high is to the west of 70ºW the anomalies are more negative over Patagonia and more positive over the north-eastern country. Precipitations in Patagonia are superior with blockings beginning to the east of 70ºW with respect to those that first appear to the west, with exception of Ushuaia (54.48ºS, 68.19ºO station and north-eastern Argentina. The situation of February 2004 is described. This month has been selected because has an extreme low zonal circulation index, a high meridional index and a very high blocking index I with respect to southern summer, showing in the study area the presence of several blocking systems to the south of South America. These systems are associated with a lack of N and NE winds giving extremely low precipitations over north

  3. Pineapple and banana pectins comprise fewer homogalacturonan building blocks with a smaller degree of polymerization as compared with yellow passion fruit and lemon pectins: implication for gelling properties.

    Science.gov (United States)

    Yapo, Beda M

    2009-04-13

    Pectins are viewed as multiblock cobiopolymers of different pectic polysaccharides, notably, homogalacturonan (HG) and rhamnogalacturonan I (RG I). Furthermore, on the basis of HGs isolated from different (pectins from) dicot cell walls, HG is supposed to have an average degree of polymerization (DP) of approximately 100 irrespective of the plant source. To validate or invalidate these suppositions, pectins from both monocot (pineapple and banana) and dicot (yellow passion fruit and lemon) cell walls were examined. The results show that all the extracted pectins comprise HGs as well as type I and II arabinogalactan side chain-containing RGs I, but of significantly (p properties of pectin.

  4. Defective Tbx2-dependent patterning of the atrioventricular canal myocardium causes accessory pathway formation in mice

    NARCIS (Netherlands)

    Aanhaanen, W.T.J.; Boukens, B.J.D.; Sizarov, A.; Wakker, V.; de Gier- de Vries, C.; van Ginneken, A.C.; Moorman, A.F.M.; Coronel, R.; Christoffels, V.M.

    2011-01-01

    Ventricular preexcitation, a feature of Wolff-Parkinson-White syndrome, is caused by accessory myocardial pathways that bypass the annulus fibrosus. This condition increases the risk of atrioventricular tachycardia and, in the presence of atrial fibrillation, sudden death. The developmental

  5. Myocarditis Complicated by Complete Atrioventricular Block: Nine Years' Experience in a Medical Center

    Directory of Open Access Journals (Sweden)

    Shao-Ju Chien

    2008-12-01

    Conclusion: The outcome of CAVB complicated with myocarditis is variable. Most of our patients resumed normal heart function. The incidence of persistent CAVB was 22%. VT is a common and serious complication, but it can be effectively treated medically. Persistent low cardiac output after pacemaker implantation and late onset VT should be considered as risk factors of mortality.

  6. [Left ventricular synchrony with septum stimulation vs. septal ventricular outflow tract in complete atrioventricular block].

    Science.gov (United States)

    Rodríguez-Serrano, Gustavo; Lara-Vaca, Susano; Pereyra-Nobara, Texar; Bernal-Ruiz, Enrique

    2016-01-01

    Introducción: el objetivo del presente estudio fue determinar si existe diferencia en la función sistólica y la sincronía del ventrículo izquierdo con estimulación del septum medio o tracto de salida del ventrículo derecho en pacientes con bloqueo auriculoventricular portadores de marcapaso. Métodos: estudio observacional, analítico, transversal. Se seleccionaron todos los pacientes mayores de 18 años portadores de marcapaso con diagnóstico de bloqueo auriculoventricular. Se analizaron dos grupos acorde al sitio de colocación del electrodo de estimulación en región septal media o tracto de salida del ventrículo derecho. Se determinó la fracción de expulsión y sincronía del ventrículo izquierdo. Resultados: se incluyeron 54 pacientes por cada grupo, siendo las características de ambos similares, excepto el tiempo de colocación del electrodo de estimulación ventricular (p = < 0.001). No hubo diferencia significativa en la fracción de expulsión o sincronía del ventrículo izquierdo. Conclusiones: no se encontró diferencia en la fracción de expulsión o sincronía del ventrículo izquierdo independientemente del sitio de colocación del electrodo de estimulación.

  7. Primary cardiac B-cell lymphoma with atrioventricular block and paroxysmal ventricular tachycardia

    Directory of Open Access Journals (Sweden)

    Chen Ke-Wei

    2012-07-01

    Full Text Available Abstract Primary cardiac lymphoma (PCL is very rare, and is extremely challenging to diagnose due to nonspecific symptoms. When discovered, the right atrium and ventricle are most commonly affected, while diffuse cardiac involvement is uncommon. PCL is fatal unless promptly diagnosed and treated. Herein, we present the case of a 36-year-old immunocompetent male who presented with a 5-year history of non-specific chest symptoms and was diagnosed with primary diffuse cardiac large B-cell lymphoma involving the entire heart.

  8. Canonical Wnt Signaling Regulates Atrioventricular Junction Programming and Electrophysiological Properties

    Science.gov (United States)

    Gillers, Benjamin S; Chiplunkar, Aditi; Aly, Haytham; Valenta, Tomas; Basler, Konrad; Christoffels, Vincent M.; Efimov, Igor R; Boukens, Bastiaan J; Rentschler, Stacey

    2014-01-01

    Rationale Proper patterning of the atrioventricular canal (AVC) is essential for delay of electrical impulses between atria and ventricles, and defects in AVC maturation can result in congenital heart disease. Objective To determine the role of canonical Wnt signaling in the myocardium during AVC development. Methods and Results We utilized a novel allele of β-catenin that preserves β-catenin’s cell adhesive functions but disrupts canonical Wnt signaling, allowing us to probe the effects of Wnt loss of function independently. We show that loss of canonical Wnt signaling in the myocardium results in tricuspid atresia with hypoplastic right ventricle associated with loss of AVC myocardium. In contrast, ectopic activation of Wnt signaling was sufficient to induce formation of ectopic AV junction-like tissue as assessed by morphology, gene expression, and electrophysiologic criteria. Aberrant AVC development can lead to ventricular preexcitation, a characteristic feature of Wolff-Parkinson-White syndrome. We demonstrate that postnatal activation of Notch signaling downregulates canonical Wnt targets within the AV junction. Stabilization of β-catenin protein levels can rescue Notch-mediated ventricular preexcitation and dysregulated ion channel gene expression. Conclusions Our data demonstrate that myocardial canonical Wnt signaling is an important regulator of AVC maturation and electrical programming upstream of Tbx3. Our data further suggests that ventricular preexcitation may require both morphologic patterning defects, as well as myocardial lineage reprogramming, to allow robust conduction across accessory pathway tissue. PMID:25599332

  9. Atrioventricular node and input pathways: a correlated gross anatomical and histological study of the canine atrioventricular junctional region.

    Science.gov (United States)

    Racker, D K

    1989-07-01

    To determine the architecture of the atrioventricular (AV) junctional region, structures in atrial preparations were correlated to those in serial sections made either parallel or perpendicular to the long axis of the AV node (AVN)/AV bundle complex. The results demonstrated the following for the first time: 1) A right medial atrial wall (MAW) extends anteriorly from the interatrial septum, superior to the interventricular septum (IVS). 2) An atrial interventricular septum (A-IVS) groove is located between the base of the MAW and the crest of the IVS. 3) Three atrionodal bundles converge to form a proximal AV bundle (PAVB), which in turn is contiguous with the AVN. The atrionodal bundles are associated with the MAW or the superomedial and inferolateral margins of the coronory sinus. Terminal portions of the atrionodal bundles and the PAVB reside within the A-IVS groove. The AV bundle was termed distal (DAVB) to avoid confusion. 4) The location of the AVN/DAVB complex topographically is deep to the apex of the septal cusp of the tricuspid valve subjacent to the MAW. Intracardially, the AVN/DAVB complex is within the central fibrous body. Significantly, this study resulted in the first unequivocal demonstration of discrete bundles of myocardial fibers associated with the atrial end of the AV node. Moreover, it appears likely that the atrionodal AV bundles are continuous with the sinoatrial nodal extensions, thereby forming internodal tracts.

  10. Genome-Wide Association Study of Down Syndrome-Associated Atrioventricular Septal Defects.

    Science.gov (United States)

    Ramachandran, Dhanya; Zeng, Zhen; Locke, Adam E; Mulle, Jennifer G; Bean, Lora J H; Rosser, Tracie C; Dooley, Kenneth J; Cua, Clifford L; Capone, George T; Reeves, Roger H; Maslen, Cheryl L; Cutler, David J; Feingold, Eleanor; Sherman, Stephanie L; Zwick, Michael E

    2015-07-20

    The goal of this study was to identify the contribution of common genetic variants to Down syndrome-associated atrioventricular septal defect, a severe heart abnormality. Compared with the euploid population, infants with Down syndrome, or trisomy 21, have a 2000-fold increased risk of presenting with atrioventricular septal defects. The cause of this increased risk remains elusive. Here we present data from the largest heart study conducted to date on a trisomic background by using a carefully characterized collection of individuals from extreme ends of the phenotypic spectrum. We performed a genome-wide association study using logistic regression analysis on 452 individuals with Down syndrome, consisting of 210 cases with complete atrioventricular septal defects and 242 controls with structurally normal hearts. No individual variant achieved genome-wide significance. We identified four disomic regions (1p36.3, 5p15.31, 8q22.3, and 17q22) and two trisomic regions on chromosome 21 (around PDXK and KCNJ6 genes) that merit further investigation in large replication studies. Our data show that a few common genetic variants of large effect size (odds ratio >2.0) do not account for the elevated risk of Down syndrome-associated atrioventricular septal defects. Instead, multiple variants of low-to-moderate effect sizes may contribute to this elevated risk, highlighting the complex genetic architecture of atrioventricular septal defects even in the highly susceptible Down syndrome population.

  11. VARYING A V BLOCK COMPLICATING SNAKE BITE - A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Vikas

    2014-02-01

    Full Text Available Snake venom toxicities comprise mainly bleeding disorders and nephrotoxicity. Cardiotoxicity is a rare manifestation of snake bite. We describe the case of a previously healthy 23 - year - old man who developed coagulopathy and AV node dysfunction following snake bite. Electrocardiography showed all variatio ns of AV conduction dysfunction . This is the first account of AV node dysfu nction caused by a snake bite with cardiotoxi city presenting as atrioventricular block

  12. Nitric oxide synthase-3 promotes embryonic development of atrioventricular valves.

    Science.gov (United States)

    Liu, Yin; Lu, Xiangru; Xiang, Fu-Li; Lu, Man; Feng, Qingping

    2013-01-01

    Nitric oxide synthase-3 (NOS3) has recently been shown to promote endothelial-to-mesenchymal transition (EndMT) in the developing atrioventricular (AV) canal. The present study was aimed to investigate the role of NOS3 in embryonic development of AV valves. We hypothesized that NOS3 promotes embryonic development of AV valves via EndMT. To test this hypothesis, morphological and functional analysis of AV valves were performed in wild-type (WT) and NOS3(-/-) mice at postnatal day 0. Our data show that the overall size and length of mitral and tricuspid valves were decreased in NOS3(-/-) compared with WT mice. Echocardiographic assessment showed significant regurgitation of mitral and tricuspid valves during systole in NOS3(-/-) mice. These phenotypes were all rescued by cardiac specific NOS3 overexpression. To assess EndMT, immunostaining of Snail1 was performed in the embryonic heart. Both total mesenchymal and Snail1(+) cells in the AV cushion were decreased in NOS3(-/-) compared with WT mice at E10.5 and E12.5, which was completely restored by cardiac specific NOS3 overexpression. In cultured embryonic hearts, NOS3 promoted transforming growth factor (TGFβ), bone morphogenetic protein (BMP2) and Snail1expression through cGMP. Furthermore, mesenchymal cell formation and migration from cultured AV cushion explants were decreased in the NOS3(-/-) compared with WT mice. We conclude that NOS3 promotes AV valve formation during embryonic heart development and deficiency in NOS3 results in AV valve insufficiency.

  13. Coexistent Types of Atrioventricular Nodal Re-Entrant Tachycardia

    Science.gov (United States)

    Marine, Joseph E.; Latchamsetty, Rakesh; Zografos, Theodoros; Tanawuttiwat, Tanyanan; Sheldon, Seth H.; Buxton, Alfred E.; Calkins, Hugh; Morady, Fred; Josephson, Mark E.

    2015-01-01

    Background— There is evidence that atypical fast–slow and typical atrioventricular nodal re-entrant tachycardia (AVNRT) do not use the same limb for fast conduction, but no data exist on patients who have presented with both typical and atypical forms of this tachycardia. We compared conduction intervals during typical and atypical AVNRT that occurred in the same patient. Methods and Results— In 20 of 1299 patients with AVNRT, both typical and atypical AVNRT were induced at electrophysiology study by pacing maneuvers and autonomic stimulation or occurred spontaneously. The mean age of the patients was 47.6±10.9 years (range, 32–75 years), and 11 patients (55%) were women. Tachycardia cycle lengths were 368.0±43.1 and 365.8±41.1 ms, and earliest retrograde activation was recorded at the coronary sinus ostium in 60% and 65% of patients with typical and atypical AVNRT, respectively. Thirteen patients (65%) displayed atypical AVNRT with fast–slow characteristics. By comparing conduction intervals during slow–fast and fast–slow AVNRT in the same patient, fast pathway conduction times during the 2 types of AVNRT were calculated. The mean difference between retrograde fast pathway conduction during slow–fast AVNRT and anterograde fast pathway conduction during fast–slow AVNRT was 41.8±39.7 ms and was significantly different when compared with the estimated between-measurement error (P=0.0055). Conclusions— Our data provide further evidence that typical slow–fast and atypical fast–slow AVNRT use different anatomic pathways for fast conduction. PMID:26155802

  14. Nitric Oxide Synthase-3 Promotes Embryonic Development of Atrioventricular Valves

    Science.gov (United States)

    Liu, Yin; Lu, Xiangru; Xiang, Fu-Li; Lu, Man; Feng, Qingping

    2013-01-01

    Nitric oxide synthase-3 (NOS3) has recently been shown to promote endothelial-to-mesenchymal transition (EndMT) in the developing atrioventricular (AV) canal. The present study was aimed to investigate the role of NOS3 in embryonic development of AV valves. We hypothesized that NOS3 promotes embryonic development of AV valves via EndMT. To test this hypothesis, morphological and functional analysis of AV valves were performed in wild-type (WT) and NOS3−/− mice at postnatal day 0. Our data show that the overall size and length of mitral and tricuspid valves were decreased in NOS3−/− compared with WT mice. Echocardiographic assessment showed significant regurgitation of mitral and tricuspid valves during systole in NOS3−/− mice. These phenotypes were all rescued by cardiac specific NOS3 overexpression. To assess EndMT, immunostaining of Snail1 was performed in the embryonic heart. Both total mesenchymal and Snail1+ cells in the AV cushion were decreased in NOS3−/− compared with WT mice at E10.5 and E12.5, which was completely restored by cardiac specific NOS3 overexpression. In cultured embryonic hearts, NOS3 promoted transforming growth factor (TGFβ), bone morphogenetic protein (BMP2) and Snail1expression through cGMP. Furthermore, mesenchymal cell formation and migration from cultured AV cushion explants were decreased in the NOS3−/− compared with WT mice. We conclude that NOS3 promotes AV valve formation during embryonic heart development and deficiency in NOS3 results in AV valve insufficiency. PMID:24204893

  15. Nitric oxide synthase-3 promotes embryonic development of atrioventricular valves.

    Directory of Open Access Journals (Sweden)

    Yin Liu

    Full Text Available Nitric oxide synthase-3 (NOS3 has recently been shown to promote endothelial-to-mesenchymal transition (EndMT in the developing atrioventricular (AV canal. The present study was aimed to investigate the role of NOS3 in embryonic development of AV valves. We hypothesized that NOS3 promotes embryonic development of AV valves via EndMT. To test this hypothesis, morphological and functional analysis of AV valves were performed in wild-type (WT and NOS3(-/- mice at postnatal day 0. Our data show that the overall size and length of mitral and tricuspid valves were decreased in NOS3(-/- compared with WT mice. Echocardiographic assessment showed significant regurgitation of mitral and tricuspid valves during systole in NOS3(-/- mice. These phenotypes were all rescued by cardiac specific NOS3 overexpression. To assess EndMT, immunostaining of Snail1 was performed in the embryonic heart. Both total mesenchymal and Snail1(+ cells in the AV cushion were decreased in NOS3(-/- compared with WT mice at E10.5 and E12.5, which was completely restored by cardiac specific NOS3 overexpression. In cultured embryonic hearts, NOS3 promoted transforming growth factor (TGFβ, bone morphogenetic protein (BMP2 and Snail1expression through cGMP. Furthermore, mesenchymal cell formation and migration from cultured AV cushion explants were decreased in the NOS3(-/- compared with WT mice. We conclude that NOS3 promotes AV valve formation during embryonic heart development and deficiency in NOS3 results in AV valve insufficiency.

  16. Atrioventricular Conduction Delay in Fetuses Exposed to Anti-SSA/Ro and Anti-SSB/La Antibodies: A Magnetocardiography Study

    Directory of Open Access Journals (Sweden)

    Annette Wacker-Gußmann

    2012-01-01

    Full Text Available Background. The presence of anti-SSA/Ro and anti-SSB/La antibodies during pregnancy is associated with fetal congenital heart block (CHB, which is primarily diagnosed through fetal echocardiography. Conclusive information about the complete electrophysiology of the fetal cardiac conducting system is still lacking. In addition to echocardiography, fetal magnetocardiography (fMCG can be used. fMCG is the magnetic analogue of the fetal electrocardiogram (ECG. Patients and Methods. Forty-eight pregnant women were enrolled in an observational study; 16 of them tested positive for anti-SSA/Ro and anti-SSB/La antibodies. In addition to routine fetal echocardiography, fMCG was used. Fetal cardiac time intervals (fCTIs were extracted from the magnetic recordings by predefined procedures. ECGs in the neonates of the study group were performed within the first month after delivery. Results. The PQ segment of the fCTI was significantly prolonged in the study group (P=0.007, representing a delay of the electrical impulse in the atrioventricular (AV node. Other fCTIs were within normal range. None of the anti-SSA/Ro and/or anti-SSB/La fetuses progressed to a more advanced heart block during pregnancy or after birth. Conclusion. The study identified a low-risk population within antibody positive mothers, where PQ segment prolongation is associated with a lack of progression of the disease.

  17. Sudden death and its risk factors after atrioventricular junction ablation and pacemaker implantation in patients with atrial fibrillation.

    Science.gov (United States)

    Wang, Ru-Xing; Lee, Hon-Chi; Li, Jia-Ping; Hodge, David O; Cha, Yong-Mei; Friedman, Paul A; Munger, Thomas M; Srivathsan, Komandoor; Pavri, Behzad B; Shen, Win-Kuang

    2017-01-01

    Although sudden death (SD) is a rare complication after atrioventricular junction (AVJ) ablation and permanent pacemaker implantation, the risk factors leading to this SD remain unknown. The purpose of this study was to investigate SD and its risk factors after ablate-and-pace strategy for rate control in atrial fibrillation (AF) patients during long-term follow-up. METHODS: From January 2005 to December 2009, we enrolled into this study 517 AF patients with AVJ ablation and right ventricular pacemaker implantation. Patients were divided into 2 groups, SD and non-SD. Cox proportional hazards models were used to assess potential risk factors for overall mortality and SD. During a mean follow-up of 25.8 ± 18.6 months (range, 3 days to 63.8 months), 53 patients died (15 with SD). Cox proportional hazards models showed that the presence of congestive heart failure, New York Heart Association functional class, chronic renal failure, and nonsustained ventricular tachycardia were risk factors that predicted overall mortality. For SD, the presence of dilated cardiomyopathy and mitral stenosis were associated risk factors. SD was exclusively seen in patients who had narrow QRS complex or right bundle branch block prior to AVJ ablation and pacemaker implantation; SD was not seen in any patient with preexisting complete left bundle branch block. Dilated cardiomyopathy, mitral stenosis, and baseline QRS morphology should be examined as potential risk factors for SD after AVJ ablation and pacemaker implantation. © 2016 Wiley Periodicals, Inc.

  18. [Atrioventricular defect with 2 valves associated with absence of the pericardium. Report of a case].

    Science.gov (United States)

    Miranda-Chávez, Irma; Muñoz-Castellanos, Luis; Kimura-Hayama, Erick; Vidal-Rojo, Paola; Figueroa-Solano, Javier; de Micheli Serra, Alfredo; Buendía-Hernández, Alfonso

    2013-01-01

    We present a case of a patient with a cardiac malformation that represents a form of embryo-anatomical transition of an atrioventricular septal defect between a 2 valves form to a common valve form. This entity was associated with pericardium absence. Throughout several studies we have precisely established a diagnostic sequence by determining the adequate contribution of each method and we have been able to clear out the proper nomenclature of the atrioventricular cushion defect. Copyright © 2012 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  19. Tubular hypoplasia of the aorta and right atrioventricular valve dysplasia in a Bulldog.

    Science.gov (United States)

    Robinson, Nicholas A; Armíen, Aníbal G

    2010-07-01

    A Bulldog puppy that died at 1 day of age was presented for postmortem evaluation. Macroscopically, there was marked hypoplasia of the ascending, transverse, and proximal segments of the descending thoracic aorta and almost complete secondary thrombosis of the left ventricle causing a functional stenosis of the left atrioventricular valve. Separately, there was right atrioventricular valve dysplasia with secondary dilation of the right atrium. Microscopically, the left ventricular outflow tract was occluded by chondroid metaplasia, fibrosing recanalization of a left-ventricular thrombus, and isolated Purkinje fiber degeneration and necrosis.

  20. Reversible cardiogenic shock caused by atrioventricular junctional rhythm after percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    Jun Wang; Qi-Gao Zhang; Xiao-Min Cai; Li-Jun Wang; Jian-Bin Gong; Shi-Sen Jiang

    2012-01-01

    An 82-year-old female patient undergoing cardiogenic shock caused by atrioventricular junctional rhythm immediately after percutaneous coronary intervention (PCI) is described. Pharmacotherapy was invalid, and subsequent application of atrial pacing reversed the cardiogenic shock. PCI-related injury of sinuatrial nodal artery leading to acute atrial contractility loss, accompanied by atrioventricular junctional arrhythmia, was diagnosed. We recommend that preoperative risk evaluation be required for multi-risk patients. Likewise, emergent measures should to be established in advance. This case reminds us that atrial pacing can be an optimal management technique once cardiogenic shock has occurred.

  1. Types of Heart Block

    Science.gov (United States)

    ... P wave as it normally would. If an electrical signal is blocked before it reaches the ventricles, they won't contract and pump blood to the lungs and the rest of the body. Second-degree heart block is divided into two ...

  2. A Heart too Drunk to Drive; AV Block following Acute Alcohol Intoxication.

    Science.gov (United States)

    van Stigt, Arthur H; Overduin, Ruben J; Staats, Liza C; Loen, Vera; van der Heyden, Marcel A G

    2016-02-29

    Acute excessive alcohol consumption is associated with heart rhythm disorders like atrial fibrillation but also premature ventricular contractions, collectively known as the "holiday heart syndrome". More rarely but clinically significant are reports of atrioventricular (AV) conduction disturbances in binge drinkers with no underlying heart disease or chronic alcohol consumption. To obtain better insights into common denominators and the potential underlying mechanisms we collected and compared individual case reports of AV block following acute alcohol intoxication in otherwise healthy people. By screening PubMed, Google Scholar, Scopus and JSTOR, fifteen cases were found of which eight were sufficiently documented for full analysis. Blood alcohol levels ranged from 90 to 958 mg/dl (19 to 205 mM). Second and third degree AV block was observed most (6/8) albeit that in two of these patients a vagal stimulus led to deterioration from first into higher order AV block. In all cases, patients reverted to normal sinus rhythm upon becoming sober again. Mildly lowered body temperature (35.9 ± 0.5°C) was observed but can be excluded as a major cause of conduction blockade. We hypothesize that ethanol induced partial inhibition of calcium and potentially also sodium currents in conductive tissue structures may be one of the mechanisms of conduction slowing and block that may become exaggerated upon increased vagal tone. An impairment of gap junction function cannot be excluded as a contributing factor. In conclusion, cases of documented alcohol induced AV block are very rare but events can occur at relatively low serum alcohol levels which should prompt to awareness of this phenomenon in alcohol intoxicated patients.

  3. G protein-gated IKACh channels as therapeutic targets for treatment of sick sinus syndrome and heart block.

    Science.gov (United States)

    Mesirca, Pietro; Bidaud, Isabelle; Briec, François; Evain, Stéphane; Torrente, Angelo G; Le Quang, Khai; Leoni, Anne-Laure; Baudot, Matthias; Marger, Laurine; Chung You Chong, Antony; Nargeot, Joël; Striessnig, Joerg; Wickman, Kevin; Charpentier, Flavien; Mangoni, Matteo E

    2016-02-16

    Dysfunction of pacemaker activity in the sinoatrial node (SAN) underlies "sick sinus" syndrome (SSS), a common clinical condition characterized by abnormally low heart rate (bradycardia). If untreated, SSS carries potentially life-threatening symptoms, such as syncope and end-stage organ hypoperfusion. The only currently available therapy for SSS consists of electronic pacemaker implantation. Mice lacking L-type Cav1.3 Ca(2+) channels (Cav1.3(-/-)) recapitulate several symptoms of SSS in humans, including bradycardia and atrioventricular (AV) dysfunction (heart block). Here, we tested whether genetic ablation or pharmacological inhibition of the muscarinic-gated K(+) channel (IKACh) could rescue SSS and heart block in Cav1.3(-/-) mice. We found that genetic inactivation of IKACh abolished SSS symptoms in Cav1.3(-/-) mice without reducing the relative degree of heart rate regulation. Rescuing of SAN and AV dysfunction could be obtained also by pharmacological inhibition of IKACh either in Cav1.3(-/-) mice or following selective inhibition of Cav1.3-mediated L-type Ca(2+) (ICa,L) current in vivo. Ablation of IKACh prevented dysfunction of SAN pacemaker activity by allowing net inward current to flow during the diastolic depolarization phase under cholinergic activation. Our data suggest that patients affected by SSS and heart block may benefit from IKACh suppression achieved by gene therapy or selective pharmacological inhibition.

  4. Evolution and scaling of atrioventricular conduction time in mammals. [Pt. 1

    NARCIS (Netherlands)

    Meijler, F.L.; Strackee, J.

    2006-01-01

    Scaling can be defined as the adjustment of a structure, a function, or an organ to the size of the mammalian body. An example is the size of the heart in relation to the size of the body. The duration of the PR interval on the electrocardiogram (atrioventricular delay) in relation to the size of th

  5. Electrophysiologic and antiarrhythmic effects of intravenous bisoprolol in atrioventricular nodal reentry tachycardia

    NARCIS (Netherlands)

    vandeVen, LLM; Crijns, HJGM; deMuinck, ED; VanGelder, IC; VanWijk, LM; Lie, KI

    1996-01-01

    Beta-blockade may be useful in the termination and prevention of atrioventricular nodal reentry tachycardia (AVNRT), An electrophysiologic study was performed in 9 patients (4 men and 5 women; mean +/- SD age, 56 +/- 16 years) with documented AVNRT before and after the intravenous administration of

  6. Deterministic model of the canine atrio-ventricular node as a periodically perturbed, biological oscillator

    NARCIS (Netherlands)

    Tweel, I. van der; Herbschleb, J.N.; Borst, C.; Meijler, F.L.

    1986-01-01

    The atrio-ventricular (AV) node may be regarded as a periodically perturbed, biologicaL oscillator. In that case the ventricular response to atrial excitation can be described by a latency-phase curve. The phase is approximated by the time between a QRS-complex and an atrial stimulus S (R-S interval

  7. Comparative aspects of the dual role of the human atrioventricular node

    NARCIS (Netherlands)

    Meijler, F.L.

    1986-01-01

    As well as transmitting the impulse from the atria to the ventric1es the atrioventricular node has two other important functions namely: (a) synchronisation of atrial and ventricular contractions by a varying delay; and (b) protection of the ventricles from rapid atrial arrhythmias. The relative imp

  8. Wnt signaling regulates atrioventricular canal formation upstream of BMP and Tbx2

    NARCIS (Netherlands)

    Verhoeven, M.C.; Haase, C.; Christoffels, V.M.; Weidinger, G.; Bakkers, J.

    2011-01-01

    In the developing heart, the atrioventricular canal (AVC) is essential for separation and alignment of the cardiac chambers, for valve formation, and serves to delay the electrical impulse from the atria to the ventricles. Defects in various aspects of its formation are the most common form of

  9. Cardiovascular magnetics resonance diagnosis of cystic tumor of the atrioventricular node

    Directory of Open Access Journals (Sweden)

    Wang Xuedong

    2009-04-01

    Full Text Available Abstract Late gadolinium enhanced (LGE cardiovascular magnetic resonance (CMR has proven to be the gold standard for viability assessment. LGE CMR is also useful for identifying the nature of cardiac masses or lesions. We report a case of a rare primary cystic tumor of the atrioventricular node, in which CMR proved to be valuable.

  10. Atrioventricular septal defect : advanced imaging from early development to long-term follow-up

    NARCIS (Netherlands)

    Calkoen, Emmeline E.

    2016-01-01

    The aim of this thesis is to review the current knowledge on atrioventricular septal defect (AVSD) (Part 1), to study the pathogenesis of AVSD (Part 2) and finally to analyze cardiac outcome long-term after AVSD correction (Part 3). Studies are performed with novel imaging techniques. In part 2 it

  11. Congenital intermittent atrio-ventricular dissociation in tetralogy of Fallot (a case report.

    Directory of Open Access Journals (Sweden)

    Karande S

    1991-01-01

    Full Text Available A case of tetralogy of fallot with congenital intermittent atrioventricular dissociation is reported. A review of standard postgraduate books of cardiology fails to describe this condition, thus showing its extreme rarity. The therapeutic dilemma in treating such a case is also discussed.

  12. Congenital intermittent atrio-ventricular dissociation in tetralogy of Fallot (a case report).

    OpenAIRE

    Karande S; Sheth S; Dalvi B; Lahiri K; Shah M

    1991-01-01

    A case of tetralogy of fallot with congenital intermittent atrioventricular dissociation is reported. A review of standard postgraduate books of cardiology fails to describe this condition, thus showing its extreme rarity. The therapeutic dilemma in treating such a case is also discussed.

  13. Evolution and scaling of atrioventricular conduction time in mammals. [Pt. 2

    NARCIS (Netherlands)

    Meijler, F.L.; Strackee, J.

    2006-01-01

    Changes of the PR interval (atrioventricular delay) in relation to changes of heart size in mammalian species (scaling) confront us with a perplexing lack of understanding of an essential funetion of the heart. The PR interval controls the duration of late diastolic blood flow from the atria to the

  14. Rock blocks

    OpenAIRE

    Turner, W.

    2007-01-01

    Consider representation theory associated to symmetric groups, or to Hecke algebras in type A, or to q-Schur algebras, or to finite general linear groups in non-describing characteristic. Rock blocks are certain combinatorially defined blocks appearing in such a representation theory, first observed by R. Rouquier. Rock blocks are much more symmetric than general blocks, and every block is derived equivalent to a Rock block. Motivated by a theorem of J. Chuang and R. Kessar in the case of sym...

  15. High-Rate Pacing Reduces Variability of Repolarization and Prevents Repolarization-Dependent Arrhythmias in Dogs With Chronic AV Block

    DEFF Research Database (Denmark)

    Oosterhoff, Peter; Thomsen, Morten Bækgaard; Maas, Joep N

    2010-01-01

    rates (60–65 bpm vs 100–110 bpm) in 7 dogs with chronic atrioventricular block, while recording right and left ventricular (LV) monophasic action potential (MAP) and LV electrogram (EGM). Simulations showed a sampling frequency of 500 Hz is sufficient to capture relevant STV values. High-rate pacing...

  16. Novel OCT flushing technique for complex scenarios: imaging during iatrogenic transient AV block induced by intracoronary adenosine.

    Science.gov (United States)

    Sreckovic, Miodrag J; Jagic, Nikola B; Neskovic, Aleksandar N

    2014-11-01

    We report the application of a novel optical coherence tomography (OCT) flushing technique where OCT run was performed during transient complete atrioventricular block induced by intracoronary bolus of adenosine. This technique may allow lower hydraulic force needed for contrast flush and reduce artifacts, with consequently improved OCT imaging in demanding clinical scenarios.

  17. Spontaneous rupture of atrioventricular valve tensor apparatus as late manifestation of anti-Ro/SSA antibody-mediated cardiac disease.

    Science.gov (United States)

    Cuneo, Bettina F; Fruitman, Deborah; Benson, D Woodrow; Ngan, Bo-Yee; Liske, Michael R; Wahren-Herlineus, Marie; Ho, S Yen; Jaeggi, Edgar

    2011-03-01

    Atrioventricular (AV) block and endocardial fibroelastosis associated with dilated cardiomyopathy are the most common clinical manifestations of anti-Ro/SSA-mediated fetal cardiac disease. Valvar dysfunction has not been a prominent feature of this disease; however, recent anecdotal cases have suggested an association between rupture of the AV valve tensor apparatus and maternal anti-Ro/SSA antibodies. In the present study, we have described the clinical and laboratory findings and reviewed the published data for infants of anti-Ro/SSA-positive pregnancies with AV valve insufficiency due to chordal rupture from the papillary muscles. The histopathologic features of the papillary muscle and ventricular free wall and septum biopsy specimens were examined and compared to the sections of AV leaflets from 6 autopsied fetuses with anti-Ro/SSA-mediated complete AV block without chordal disruption. Specific epitopes to the p200 region of Ro52, and Ro60 antibodies were evaluated in cases with chordal rupture. Severe AV valve insufficiency was detected prenatally (as early as 34 weeks of gestation) or postnatally (as late as 182 days) after areas of patchy echogenicity were noted in the papillary muscle at 19 to 22 weeks of gestation. Postnatally, urgent valve surgery was performed in 5 of 6 patients; 1 of 6 patients died preoperatively. All patients tested positive for Ro52. Valve leaflet tissue from the autopsy specimens was normal. The ventricular free wall and septum biopsy specimens from a patient with chordal rupture showed normal tissue; however, the papillary muscle biopsy specimens demonstrated severe atrophy with near total replacement of myocytes by fibrosis and dystrophic calcifications, and negative immunochemistry findings. In conclusion, these findings have defined an underappreciated complication of fetal antibody-mediated cardiac inflammation.

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

    NARCIS (Netherlands)

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

    1997-01-01

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

  19. Anatomia da valva atrioventricular esquerda: I. As cúspides Anatomy of the left atrio-ventricular valve: I. The cusps

    Directory of Open Access Journals (Sweden)

    Antônio B. Prado Fortuna

    1988-12-01

    Full Text Available Os resultados de um estudo anatômico da valva atrioventricular esquerda, realizado em 30 corações aparentemente normais, conservados em formalina, são comparados aos dados da literatura, tendo por objetivo adequar a nomenclatura e os conceitos anatômicos clássicos aos atuais, baseados na ultra-sonografia e na prática cirúrgica corrente. O presente artigo tratará apenas das cúspides, sendo que os demais elementos anatômicos dessa valva atrioventricular esquerda fazem parte de uma "unidade aortoventricular", onde distinguimos a cúspide anterior, em continuidade com o trígono intervalvar e o anel aórtico, e um grupo de cúspides posteriores, em relação com a parede posterior do ventrículo esquerdo. A cúspide anterior está separada do grupo de cúspides posteriores, tanto no polo valvar superior como no inferior, por uma estrutura anatômica bem definida: a "lâmina juncional", superior e inferior, respectivamente. As cúspides do grupo posterior são designadas pela ordem numeral ordinal, a partir da lâmina juncional superior. Esta nomenclatura tem por objetivo destacar a cúspide como unidade funcional da valva e facilitar as referências ecocardiográficas e cirúrgicas, particularmente nos casos em que mais de 3 cúspides posteriores são encontradas.A review of the left atrio-ventricular valve anatomy is compared to a clinical oriented morphological study on 30 normal adult heart, preserved in formalin. The results will be presented in five separated sections: I. The cusps; II. The comissures; III. The chordae tendinae; IV. The papilary muscles; V. The valvar annulus. The present publication will deal with the cusps. The terms "left atrio-ventricular valve" and "cusps" are to be prefered to the more descriptive and traditional "mitral valve" and "leaflets". The anterior cusp, in continuity with the aortic annulus, and a group of posterior cusps, attached to the posterior left wall, are described. An ordinal numerical

  20. Novel insights on effect of atrioventricular programming of biventricular pacemaker in heart failure – a case series

    Directory of Open Access Journals (Sweden)

    Rafique Asim M

    2006-10-01

    Full Text Available Abstract Background Echocardiography plays an integral role in the diagnosis of congestive heart failure including measurement of left heart pressure as well as mechanical dyssynchrony. Methods In this report we describe novel therapeutic uses of echo pulsed wave Doppler in atrioventricular pacemaker optimization in patients who had either not derived significant symptomatic benefit post biventricular pacemaker implantation or deteriorated after deriving initial benefit. In these patients atrioventricular optimization showed novel findings and improved cardiac output and symptoms. Results In 3 patients with Cheyne Stokes pattern of respiration echo Doppler showed worsening of mitral regurgitation during hyperpneac phase in one patient, marked E and A fusion in another patient and exaggerated ventricular interdependence in a third patient thus highlighting mechanisms of adverse effects of Cheyne Stokes respiration in patients with heart failure. All 3 patients required a very short atrioventricular delay programming for best cardiac output. In one patient with recurrent congestive heart failure post cardiac resynchronization, mitral inflow pulse wave Doppler showed no A wave until a sensed atrioventricular delay of 190 ms was reached and showed progressive improvement in mitral inflow pattern until an atrioventricular delay of 290 ms. In 2 patients atrioventricular delay as short as 50 ms was required to allow E and A separation and prevent diastolic mitral regurgitation. All patients developed marked improvement in congestive heart failure symptoms post echo-guided biv pacemaker optimization. Conclusion These findings highlight the value of echo-guided pacemaker optimization in symptomatic patients post cardiac resynchronization treatment.

  1. [Innervation of the atrioventricular portion of the interatrial septum in the rat].

    Science.gov (United States)

    Pavlovich, E R

    1984-03-01

    A quantitative electron microscopical investigation has revealed reliable differences in contents of muscular, connective tissue and neural elements in the conductive system, on the one hand (in the atrioventricular node and in the internodal specialized pathways) and in the working myocardium of the inferior third of the interatrial septum, on the other hand. Morphometrical analysis of the neuromuscular interrelations, performed separately for every type of specialized conductive myocytes (II, III) and of working cardiomyocytes of the interatrial septum, reveals some differences in size of the neural fibers and their terminals and in distance between them and myocytes. The synaptic vesicles of the efferent terminals are qualitatively different in all types of the myocytes. The afferent terminals situating near specialized cardiac cells are characterized. Criteria for distinguishing small and large granular vesicles in the terminals are discussed. A suggestion is made that the innervational peculiarities revealed reflect certain specificity in regulation the conduction in the atrioventricular area of the heart.

  2. Biological Glue Application in Repair of Atrioventricular Groove Rupture: A Case Report

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    Ahmet Baris-Durukan

    2015-10-01

    Full Text Available Atrioventricular groove rupture is a rare, albeit mortal, complication following mitral valve surgery. Avoidance is the best strategy but it cannot fully prevent the occurrence of this complication. Several repair techniques have been described with varying success rates; however, the rarity of the complication precludes consensus about the safest technique.Here we report two cases of posterior atrioventricular groove rupture. Both cases were diagnosed immediately after the cessation of cardiopulmonary bypass. Repair was performed successfully with a technique involving the use of biological glue. The postoperative course was uneventful for both of them. Both cases are well with normally functioning mitral prostheses; one with a follow-up time of 5.5 years and the other 10 months. We believe that the glue provides additional hemostasis and support to the repaired area.

  3. Ablation of left-deviated dual atrioventricular nodal pathway from coronary sinus

    Institute of Scientific and Technical Information of China (English)

    HUANG Wei-bin; HONG Jiang; WANG Yan; ZHOU Fa-guang; ZENG Zhao-pin; GONG Yan; SUN Bao-gui; WANG Le-xin

    2009-01-01

    @@ Atrioventricular nodal reentrant tachycardia (AVNRT) is one of the most common types of paroxysmal supraventricular tachycardia. The mechanism of AVNRT is reentry associated with dual or multiple atrioventricular nodal (AVN) pathways. Typical AVNRT pathways,including fast and slow pathways, are confined in the right atrium. Radiofrequency catheter ablation of the slow pathway, and occasionally the fast pathway, has become the definitive treatment of choice for most symptomatic patients. Besides typical AVNRT, there exists some atypical AVNRT with various manifestations. Several groups have reported successful ablation of the leftward dual AVN pathway from the left side of the heart.1-3 We present one case of left-sided AVN as well as dual AVN pathway. The tachycardia was successfully eliminated by ablation of the slow pathway deep in the coronary sinus.

  4. Bloqueo atrioventricular completo y reversible en un paciente con corazón estructuralmente sano

    Directory of Open Access Journals (Sweden)

    Oswaldo Gutiérrez-Sotelo

    2008-06-01

    Full Text Available Se presenta el caso de un paciente joven, deportista, quien presentó un episodio de síncope con pródromo breve, durante ejercicio físico. Se encontró el corazón estructuralmente normal y que durante la prueba de inclinación presentó bloqueo atrioventricular completo, que revirtió rápidamente con la posición de decúbito dorsal.

  5. The anatomy and histology of the atrioventricular conducting system in the hedgehog (Hemiechinus auritus) heart

    OpenAIRE

    NABIPOUR, Abolghasem

    2010-01-01

    This study examined the atrioventricular conducting system in 4 adult male hedgehogs (Hemiechinus auritus). The histological structure of these components was studied using routine histological methods. The AVN was located at the lower and anterior part of the interatrial septum, near the root of the aorta. It was almost oval and consisted of twisted cells. Internodal pathways in the hedgehog heart were not observed, but there were numerous purkinje-like fibers within the myocardium of the at...

  6. Intermittent rate-dependent retrograde conduction over a concealed atrioventricular accessory pathway: what is the mechanism?

    Science.gov (United States)

    Rordorf, Roberto; Vicentini, Alessandro; Petracci, Barbara; Landolina, Maurizio

    2009-02-01

    Intermittent retrograde conduction over an accessory pathway (AP) is quite an uncommon phenomenon. We describe the case of a 60-year-old woman with recurrent episodes of palpitations. Atrioventricular re-entry tachycardia was diagnosed at electrophysiological study. Interestingly, retrograde conduction over the AP was detectable only when ventricular pacing was performed at fast rate. Supernormal retrograde conduction over the AP was considered the most likely explanation of this unusual finding.

  7. The structure of the atrioventricular node in the heart of the female laying ostrich (Struthio camelus).

    Science.gov (United States)

    Parto, P

    2012-02-01

    The electrical impulse for cardiac contraction is generated in the Sinoatrial node (SA node), subsequently spreads to the Atrioventricular node (AV node) and continues in the Atrioventricular bundle (AV bundle). The AV node may not always be present in different avian species and seems to differ in location and contents between species. In this study, the anatomy and histology of the AV node were studied five female adult ostriches (Struthio camelus). Routine paraffin sectioning and transmission electron microscopic method were performed. The study showed that in the ostrich, the AV node is located in the endocardium of the atrial surface of the right atrioventricular valve adjacent to the fibrous ring. The parenchyma of the AV node is formed by small specialized muscle fibres that are spread within a loose connective tissue network. The AV node is not covered by a connective tissue sheath and some arterioles are present. Nerve fibres are seen related to the node. Ultrastructurally, they stain lighter and contain fewer organized myofibrils than usual myocardial cells. The myofibril bundles run parallel to one another and have interspersed mitochondria, which display distinct cristae. The cells have a large euchromatic nucleus with a clear perinuclear area, and they connected by desmosomes. The ostrich is, thus, one of the birds that have the AV node, whose position varies from the other birds. © 2011 Blackwell Verlag GmbH.

  8. Population Blocks.

    Science.gov (United States)

    Smith, Martin H.

    1992-01-01

    Describes an educational game called "Population Blocks" that is designed to illustrate the concept of exponential growth of the human population and some potential effects of overpopulation. The game material consists of wooden blocks; 18 blocks are painted green (representing land), 7 are painted blue (representing water); and the remaining…

  9. Population Blocks.

    Science.gov (United States)

    Smith, Martin H.

    1992-01-01

    Describes an educational game called "Population Blocks" that is designed to illustrate the concept of exponential growth of the human population and some potential effects of overpopulation. The game material consists of wooden blocks; 18 blocks are painted green (representing land), 7 are painted blue (representing water); and the remaining…

  10. 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.

  11. Management of paroxysmal atrioventricular nodal reentrant tachycardia in the critically ill surgical patient.

    Science.gov (United States)

    Kirton, O C; Windsor, J; Wedderburn, R; Gomez, E; Shatz, D V; Hudson-Civetta, J; Komanduri, S; Civetta, J M

    1997-05-01

    Paroxysmal atrioventricular nodal reentrant tachycardia is an infrequently encountered supraventricular arrhythmia that continues to present difficult management problems in the critically ill surgical patient. The purpose of this study was to evaluate the efficacy of a new treatment algorithm involving the sequential administration of different classes of antiarrhythmic agents until conversion to sinus rhythm was achieved. Nonrandomized, consecutive, protocol-driven descriptive cohort. University hospital surgical and trauma intensive care unit (ICU). During an 11-month period, we prospectively evaluated all hemodynamically stable patients who sustained new-onset atrioventricular nodal reentrant tachycardia. Vagal maneuver, followed by the rapid, sequential infusion of antiarrhythmic agents (i.e., adenosine, verapamil, and esmolol, respectively) until the arrhythmia was terminated. Twenty-seven patients (4% of all admissions) were evaluated, including 16 trauma patients (injury Severity Score of 20 +/- 8) and 11 general surgical patients (Acute Physiology and Chronic Health Evaluation II score of 17 +/- 7). Time from ICU admission to onset of atrioventricular nodal reentrant tachycardia was 4.5 +/- 5 days (median 2.5). Arrhythmia termination was achieved in all patients within minutes (mean 13 +/- 10 [SD]). Incremental sequential adenosine administration alone, however, was successful in affecting conversion to sinus rhythm in only 44% of initial episodes of atrioventricular nodal reentrant tachycardia (95% confidence interval 21% to 67%). A total of 14 (52%) patients developed 38 relapses of paroxysmal supraventricular tachycardia in the ICU after initial conversion to sinus rhythm. These relapses required additional antiarrhythmic therapy. Adenosine was only effective in 34% of the relapses (95% confidence interval 17% to 53%). Seven (50%) of these 14 patients developed multiple relapses. However, only two patients were receiving suppressive calcium-channel or

  12. Zitongdong Block

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    @@ The Zitongdong Block (Eastern Zitong Block) is located in the northwest of the Sichuan Basin. Tectonically, it is situated in the east part of Zitong Depression, southeast of mid-Longmenshan folded and faulted belt( as shown on Fig. 8 ), covering an area of 1 730 km2. The traffic is very convenient, the No. 108 national highway passes through the north of the block. Topographically, the area belongs to low hilly land at the elevation of 500-700 m.

  13. Correção biventricular em defeito do septo atrioventricular desbalanceado Corrección biventricular en defecto del septo atrioventricular desbalanceado Biventricular repair in unbalanced atrioventricular septal defect

    Directory of Open Access Journals (Sweden)

    Edmar Atik

    2009-04-01

    Full Text Available É apresentada a evolução favorável, após correção operatória biventricular, de criança com 2,5 anos de idade, com defeito do septo atrioventricular desbalanceado, com ventrículo esquerdo (VE pequeno (anel mitral de 10 mm em relação de 0,4 com o anel tricúspide, DDVE de 17 mm, Vd2 VE de 15 ml/m² e relação do índice longitudinal VE/VD de 0,71. Houve desenvolvimento normal do VE, verificado três meses após a operação (anel mitral de 22 mm, em relação de 0,84 com o da valva tricúspide e DDVE de 30 mm. Discutem-se os parâmetros atuais de utilização do ventrículo hipoplásico.Presenta evolución favorable después de corrección operatoria biventricular, de niño con 2,5 años de edad, con Defecto del Septo Atrioventricular Desbalanceado con ventrículo izquierdo (VI pequeño (anillo mitral de 10 mm en relación de 0,4 con el anillo tricúspide, DDVI de 17 mm, Vd2 VI de 15 ml/m2 y relación de ejes longitudinales VI/VD de 0,71. Hubo desarrollo normal del VI, verificado tres meses después de la operación (anillo mitral de 22 mm, en relación de 0,84 con el de la válvula tricúspide y DDVI de 30 mm. Se discuten los parámetros actuales de utilización del ventrículo hipoplásico.We present the case of a 2.5 year-old child with unbalanced atrioventricular septal defect due to a small left ventricle (LV (mitral annulus of 10mm and a 0.4 ratio in relation to the tricuspid annulus, LVDD: 17 mm, LV Vd2: 15 ml/m² and LV/RV long-axis ratio of 0.71; he had a favorable outcome after biventricular surgical repair. Normal LV development was observed three months after the operation (mitral annulus of 22 mm, with a 0.84 ratio in relation to the tricuspid annulus, and LVDD of 30 mm. Current parameters for utilization of the hypoplastic ventricle are discussed.

  14. Allelic Interaction between CRELD1 and VEGFA in the Pathogenesis of Cardiac Atrioventricular Septal Defects

    Science.gov (United States)

    Redig, Jennifer K.; Fouad, Gameil T.; Babcock, Darcie; Reshey, Benjamin; Feingold, Eleanor; Reeves, Roger H.; Maslen, Cheryl L.

    2014-01-01

    Atrioventricular septal defects (AVSD) are highly heritable, clinically significant congenital heart malformations. Genetic and environmental modifiers of risk are thought to work in unknown combinations to cause AVSD. Approximately 5–10% of simplex AVSD cases carry a missense mutation in CRELD1. However, CRELD1 mutations are not fully penetrant and require interactions with other risk factors to result in AVSD. Vascular endothelial growth factor-A (VEGFA) is a well-characterized modulator of heart valve development. A functional VEGFA polymorphism, VEGFA c.–634C, which causes constitutively increased VEGFA expression, has been associated with cardiac septal defects suggesting it may be a genetic risk factor. To determine if there is an allelic association with AVSD we genotyped the VEGFA c.–634 SNP in a simplex AVSD study cohort. Over-representation of the c.–634C allele in the AVSD group suggested that this genotype may increase risk. Correlation of CRELD1 and VEGFA genotypes revealed that potentially pathogenic missense mutations in CRELD1 were always accompanied by the VEGFA c.–634C allele in individuals with AVSD suggesting a potentially pathogenic allelic interaction. We used a Creld1 knockout mouse model to determine the effect of deficiency of Creld1 combined with increased VEGFA on atrioventricular canal development. Morphogenic response to VEGFA was abnormal in Creld1-deficient embryonic hearts, indicating that interaction between CRELD1 and VEGFA has the potential to alter atrioventricular canal morphogenesis. This supports our hypothesis that an additive effect between missense mutations in CRELD1 and a functional SNP in VEGFA contributes to the pathogenesis of AVSD. PMID:25328912

  15. Allelic Interaction between CRELD1 and VEGFA in the Pathogenesis of Cardiac Atrioventricular Septal Defects

    Directory of Open Access Journals (Sweden)

    Jennifer K. Redig

    2014-03-01

    Full Text Available Atrioventricular septal defects (AVSD are highly heritable, clinically significant congenital heart malformations. Genetic and environmental modifiers of risk are thought to work in unknown combinations to cause AVSD. Approximately 5–10% of simplex AVSD cases carry a missense mutation in CRELD1. However, CRELD1 mutations are not fully penetrant and require interactions with other risk factors to result in AVSD. Vascular endothelial growth factor-A (VEGFA is a well-characterized modulator of heart valve development. A functional VEGFA polymorphism, VEGFA c.-634C, which causes constitutively increased VEGFA expression, has been associated with cardiac septal defects suggesting it may be a genetic risk factor. To determine if there is an allelic association with AVSD we genotyped the VEGFA c.-634 SNP in a simplex AVSD study cohort. Over-representation of the c.-634C allele in the AVSD group suggested that this genotype may increase risk. Correlation of CRELD1 and VEGFA genotypes revealed that potentially pathogenic missense mutations in CRELD1 were always accompanied by the VEGFA c.-634C allele in individuals with AVSD suggesting a potentially pathogenic allelic interaction. We used a Creld1 knockout mouse model to determine the effect of deficiency of Creld1 combined with increased VEGFA on atrioventricular canal development. Morphogenic response to VEGFA was abnormal in Creld1-deficient embryonic hearts, indicating that interaction between CRELD1 and VEGFA has the potential to alter atrioventricular canal morphogenesis. This supports our hypothesis that an additive effect between missense mutations in CRELD1 and a functional SNP in VEGFA contributes to the pathogenesis of AVSD.

  16. Konno procedure using atrioventricular groove patch plasty after arterial switch operation.

    Science.gov (United States)

    Kosaka, Yoshimichi; Kurosawa, Hiromi; Nagatsu, Masayoshi

    2004-11-01

    A patient with transposition of the great arteries accompanied by Shaher type 9 coronary anatomy experienced the development of progressive neoaortic valvular regurgitation with a small annulus, supravalvular stenosis, and neopulmonary valvular and supravalvular stenoses 15 years after an arterial switch operation. To implant a prosthetic valve clinically adequate in size, the Konno procedure was necessary. However, the right coronary anatomy precluded the original Konno procedure. My colleagues and I accomplished neoaortic anterior annular enlargement in this case by using atrioventricular groove patch plasty without jeopardizing the right coronary artery, and this resulted in a satisfactory outcome.

  17. Zitongxi Block

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    @@ Zitongxi Block (Western Zitong Block), is located in Zitong County, northwest of Sichuan Province (as shown on Fig. 8 ). Geologically. it is situated in the Zitong Depression, southwest of the middle Longmenshan faulted and folded belt, covering an area of 1 830 km2. Transportation is very convenient. A crisscross network of highways run through the block and the Baocheng railway is nearby. The climate is moderate. Most area belongs to hilly land with the elevation of 500-600 m.The Tongjiang River runs across the area.

  18. Right bundle branch block without overt heart disease predicts higher risk of pacemaker implantation: the study of atomic-bomb survivors.

    Science.gov (United States)

    Kusumoto, Saburo; Kawano, Hiroaki; Makita, Naomasa; Ichimaru, Shinichiro; Kaku, Takashi; Haruta, Daisuke; Hida, Ayumi; Sera, Nobuko; Imaizumi, Misa; Nakashima, Eiji; Maemura, Koji; Akahoshi, Masazumi

    2014-06-01

    We investigated the clinical course of complete right bundle branch block (RBBB) or RBBB with axis deviation (AD) in terms of subsequent pacemaker implantation for high-degree atrioventricular (AV) block or sick sinus syndrome (SSS). Among the 16,170 atomic-bomb survivors in our biennial health examination between July 1967 and December 2010, we detected 520 newly-acquired RBBB subjects with no organic heart disease, and selected 1038 age- (at RBBB diagnosis) and sex-matched subjects without RBBB to serve as comparison subjects. Multivariate Cox regression analysis was used to estimate the hazard ratios (HRs) for the risk of pacemaker implantation due to all causes, AV block or SSS between RBBB and comparison subjects and between RBBB subjects with and without AD. The risk of pacemaker implantation for RBBB was 4.79 (95% confidence interval [CI] 1.89-12.58; P=0.001), 3.77 (95% CI, 1.09-13.07; P=0.036), and 6.28 (95% CI, 1.24-31.73, P=0.026) when implantation was for all causes, AV block and SSS, respectively. RBBB subjects with AD had a higher risk for all-cause pacemaker implantation than subjects without AD (HR, 3.03; 95% CI, 1.00-9.13, P=0.049). RBBB subjects with AD were younger than subjects without AD at the time of RBBB diagnosis (59.4±7.6 vs 74.4±3.1 years old, P=0.019), and their progression from diagnosis to pacemaker implantation took longer (15.1±6.6 vs 6.4±3.0 years, P=0.032). RBBB, especially with AD, progresses to AV block and SSS that requires pacemaker implantation; the mechanisms by which the conduction defect progresses differ among patients with and without AD. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Atrioventricular septal defects among infants in Europe: a population-based study of prevalence, associated anomalies, and survival

    OpenAIRE

    Christensen, Nikolas; Andersen, Helle; Garne, Ester; Wellesley, Diana; Addor, Marie-Claude; Haeusler, Martin; Khoshnood, Babak; Mullaney, Carmel; Rankin, Judith; Tucker, David

    2017-01-01

    Abstract Objective To describe the epidemiology of chromosomal and non-chromosomal cases of atrioventricular septal defects in Europe. Methods Data were obtained from EUROCAT, a European network of population-based registries collecting data on congenital anomalies. Data from 13 registries for the period 2000-2008 were included. Results There was a total of 993 cases of atrioventricular septal defects, with a total prevalence of 5.3 per 10,000 births (95% confidence interval 4.1 to 6.5). Of t...

  20. Pheochromocytoma-induced atrial tachycardia leading to cardiogenic shock and cardiac arrest: resolution with atrioventricular node ablation and pacemaker placement.

    Science.gov (United States)

    Shawa, Hassan; Bajaj, Mandeep; Cunningham, Glenn R

    2014-12-01

    Pheochromocytoma should be considered in young patients who have acute cardiac decompensation, even if they have no history of hypertension. Atrioventricular node ablation and pacemaker placement should be considered for stabilizing pheochromocytoma patients with cardiogenic shock due to atrial tachyarrhythmias. A 38-year-old black woman presented with cardiogenic shock (left ventricular ejection fraction, cardiogenic shock and cardiac arrest unresolved by the placement of 2 different ventricular assist devices, but that was completely reversed by radiofrequency ablation of the atrioventricular node and the placement of a temporary pacemaker. We present the patient's clinical, laboratory, and imaging findings, and we review the relevant literature.

  1. Chengzikou Block

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    @@ Chengzikou Block is located in the north of Hekou district, Dongying City, Shandong Province, adjacent to Bohai Bay. It can be geographically divided into three units: onshore, transitional zone and offshore ultrashallow zone, totally covering an area of 470 km2. The southern onshore area is low and gentle in topography;the northern shallow sea is at water depths of 2-8 m below sea level, and the transitional zone occupies more than 60% of the whole block. The climate belongs to temperate zone with seasonal wind. Highways are welldeveloped here, and the traffic is very convenient. The Chengzikou Block is about 80 km away from Dongying City and 290 km from Jinan City in the south. The northern offshore area of the block is 160 km away from Longkou port in the east and only 38 km away in the west from Zhuangxi port.

  2. Longmenshan Block

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    @@ Longmenshan Block is located in Jiange County of Jiangyou City in the northwest of Sichuan Basin. covering an area of 2 628 km2. Geologically, it is situated in the Mid-Longmenshan fault and fold belt, neighbouring Zitong Depression in its southeast. There are mountains surrounding its northwest , the rest area being hilly land,with the elevation of 500-700 m. The BaoCheng railway and the No. 108 highway run through the block, the traffic is very convenient.

  3. The Dorsal Mesenchymal Protrusion and the Pathogenesis of Atrioventricular Septal Defects

    Science.gov (United States)

    Burns, Tara; Yang, Yanping; Hiriart, Emilye; Wessels, Andy

    2017-01-01

    Congenital heart malformations are the most common type of defects found at birth. About 1% of infants are born with one or more heart defect on a yearly basis. Congenital Heart Disease (CHD) causes more deaths in the first year of life than any other congenital abnormality, and each year, nearly twice as many children die in the United States from CHD as from all forms of childhood cancers combined. Atrioventricular septal defects (AVSD) are congenital heart malformations affecting approximately 1 in 2000 live births. Babies born with an AVSD often require surgical intervention shortly after birth. However, even after successful surgery, these individuals typically have to deal with lifelong complications with the most common being a leaky mitral valve. In recent years the understanding of the molecular etiology and morphological mechanisms associated with the pathogenesis of AVSDs has significantly changed. Specifically, these studies have linked abnormal development of the Dorsal Mesenchymal Protrusion (DMP), a Second Heart Field-derived structure, to the development of this congenital defect. In this review we will be discuss some of the latest insights into the role of the DMP in the normal formation of the atrioventricular septal complex and in the pathogenesis of AVSDs. PMID:28133602

  4. Defeito do septo atrioventricular forma total associado a tricuspidização da valva atrioventricular esquerda na infância

    Directory of Open Access Journals (Sweden)

    DOBRIANSKYJ Aleksander

    1997-01-01

    Full Text Available Entre maio de 1987 e dezembro de 1996, o reparo do defeito do septo atrioventricular, forma total (DSAVT, com duplo retalho de pericárdio bovino e tricuspidização da valva atrioventricular (VAV esquerda, foi realizado em 34 pacientes consecutivos com mortalidade global de 5 (14,7% pacientes (pac.. Grupo I: abaixo de 6 meses (m com 12 pac. (1 óbito; 8,3%; Grupo II: entre 7m e 12m, com 15 pac. (4 óbitos; 26,6% e Grupo III: entre 1 e 5 anos (a com 7 pac. sem óbitos. Ocorreram 2 óbitos tardios (1 por Insuficiência mitral residual + insuficiência cardíaca congestiva e outro por pneumonia + insuficiência respiratória. Duas crianças receberam implante de marcapasso definitivo (após 45 dias e 4 anos. Nenhum paciente foi reoperado, apesar de mais 2 apresentarem insuficiência da VAV esquerda e 1 VAV direita, controlada clinicamente, e as restantes encontram-se nos graus I e II da New York Heart Association (NYHA. Apesar de 29 pacientes apresentarem peso abaixo de 10 kg, utilizou-se circulação extracorpórea (CEC e hipotermia a 25°C sem parada circulatória total. Iniciou-se o reparo pela zona de "aposição" da VAV única com um ou dois pontos em "x", mantendo tricúspide. Sutura-se o primeiro retalho de pericárdio bovino (PB em forma de "gota", insinuando-o entre as cordas do lado direito do septo; a seguir, sutura-se o segundo retalho, fazendo uma aposição concomitante com a VAV única, septando-se, desta forma, as quatro cavidades. As vantagens desta técnica são: preservação da integridade valvar, maior durabilidade funcional da VAV esquerda, menor possibilidade de reoperação mesmo em pacientes mais jovens e que devem ser preferencialmente operados em torno de 6º mês de vida.

  5. EFFECT OF METOPROLOL ON ATRIAL FIBRILLATORY RATE, ATRIOVENTRICULAR NODAL CONCEALED CONDUCTION, AND VENTRICULAR RESPONSE DURING ATRIAL-FIBRILLATION IN PIGS

    NARCIS (Netherlands)

    VANDENBERG, MP; DELANGEN, CDJ; CRIJNS, HJGM; HAAKSMA, J; BEL, KJ; WESSELING, H; LIE, KI

    1994-01-01

    We wished to elucidate the effect of beta-blockade on fibrillatory rate and atrioventricular (AV) nodal concealed conduction during atrial fibrillation (AF). Subsequent to determination of the effect on atrial functional refractoriness with the extrastimulus technique (basic cycle length 400 ms), th

  6. Transmembrane protein 2 (Tmem2) is required to regionally restrict atrioventricular canal boundary and endocardial cushion development

    NARCIS (Netherlands)

    Smith, K.; Lagendijk, A.K.; Courtney, A.D.; Chen, H.; Paterson, S.; Hogan, B.M.; Wicking, C.; Bakkers, J.

    2011-01-01

    The atrioventricular canal (AVC) physically separates the atrial and ventricular chambers of the heart and plays a crucial role in the development of the valves and septa. Defects in AVC development result in aberrant heart morphogenesis and are a significant cause of congenital heart malformations.

  7. Transmembrane protein 2 (Tmem2) is required to regionally restrict atrioventricular canal boundary and endocardial cushion development

    NARCIS (Netherlands)

    Smith, K.; Lagendijk, A.K.; Courtney, A.D.; Chen, H.; Paterson, S.; Hogan, B.M.; Wicking, C.; Bakkers, J.

    2011-01-01

    The atrioventricular canal (AVC) physically separates the atrial and ventricular chambers of the heart and plays a crucial role in the development of the valves and septa. Defects in AVC development result in aberrant heart morphogenesis and are a significant cause of congenital heart malformations.

  8. Chadong Block

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    @@ The Chadong Block, located in the east of Qaidam Basin, Qinghai Province, covers an area of 12 452 km2. It is bounded by Kunlum Mountains in the south and the northwest is closely adjacent to Aimunike Mountain.Rivers are widely distributed, which always run in NWSE direction, including the Sulunguole, Qaidam and Haluwusu Rivers. The traffic condition is good, the Qinghai-Tibet highway stretching through the whole area and the Lan-Qing railway, 20-50 km away from the block, passing from north to west. A lot of Mongolia minority people have settled there, of which herdsmen always live nearby the Qaidam River drainage area.

  9. Complete AV-block secondary to lithium-clozapine therapy and relapsing multiple sclerosis in a bipolar patient

    OpenAIRE

    Gabeler, Edward EE; van Miltenburg, Addy JM

    2011-01-01

    A complete atrioventricular block (CAVB) can be a lethal complication when it is not treated directly with isoprenaline and pacemaker therapy. The overall incidence of CAVB varies between 4 to 8 per cent with a mortality OR of 3.2 within 30 days if untreated. Main causes of CAVB are inferior myocardial infarction, congenital AV node malformation, mitral valve insufficiency and valve surgery, metabolic disorders and intoxications. The authors describe a case with a CAVB due to lithium-clozapin...

  10. Resultados da correção simplificada com enxerto único no defeito septal atrioventricular completo

    Directory of Open Access Journals (Sweden)

    Ana Paula Tagliari

    2013-03-01

    Full Text Available FUNDAMENTO: Desde que Wilcox, em 1997, descreveu uma forma simplificada de correção do Defeito Septal Atrioventricular (DSAV com enxerto único, diversos estudos têm sido realizados comparando-a à técnica com duplo enxerto. OBJETIVO: Relatar os resultados em médio e longo prazos da correção de DSAV completo pela técnica simplificada de enxerto único. MÉTODOS: Estudo retrospectivo de 16 casos consecutivos arrolados entre janeiro de 2001 e dezembro de 2011. A idade média foi 18,31 ± 34,19 meses (2 meses - 11 anos e o peso 7,80 ± 6,12 Kg (3,77 - 25,0 Kg; 6 pacientes eram do sexo masculino e 14 eram portadores de Síndrome de Down. O tempo de seguimento médio foi de 54,97 ± 47,79 meses. RESULTADOS: O tempo médio de circulação extracorpórea foi 74,63 ± 18,48 min (49 - 112 min e o de pinçamento aórtico, de 46,44 ± 11,89 min (34 - 67 min. Foram observados dois óbitos hospitalares (12,5%, ambos por causa cardiovascular. Três pacientes foram reoperados por regurgitação da valva atrioventricular (VA esquerda e dois apresentaram bloqueio atrioventricular (BAV completo com necessidade de implante de marca-passo definitivo. Não houve nenhum caso de obstrução da via de saída do ventrículo esquerdo. Os 14 pacientes sobreviventes permanecem assintomáticos, 10 deles com insuficiência da valva VA esquerda leve (71,42%. CONCLUSÃO: A técnica simplificada com enxerto único para correção de DSAV completo mostrou-se factível, associada à correção adequada dos defeitos e à favorável evolução clínica e ecocardiográfica nos 57,97 meses de seguimento médio avaliados.

  11. 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.

  12. Patologia do bloqueio atrioventricular na cardiomiopatia por depósito de desmina

    Directory of Open Access Journals (Sweden)

    Luiz Alberto Benvenuti

    2012-01-01

    Full Text Available Geralmente, a cardiomiopatia restritiva por deposição de desmina é caracterizada pela restrição ao enchimento diastólico ventricular e por diferentes graus de bloqueio atrioventricular (BAV. Neste relato, são descritas as alterações anatomopatológicas do sistema de condução cardíaco relacionadas ao BAV. O nó sinusal, o nó compacto e o feixe penetrante (feixe de His não apresentavam anormalidades, entretanto, havia extensa fibrose das porções terminais do feixe ramificante e do início dos feixes esquerdo e direito, no topo do septo ventricular. A patogenia dessa substituição fibrosa é provavelmente a mesma que origina a extensa fibrose do miocárdio ventricular contrátil, e permanece por ser elucidada.

  13. O nódulo atrioventricular e o feixe de his no homem

    Directory of Open Access Journals (Sweden)

    C. Magarinos Torres

    1961-09-01

    Full Text Available A demonstração do nódulo atrioventricular e do feixe de His, no coração humano, não oferece dificuldade especial, uma vez que seja seguida a técnica consagrada. A negação da sua existência, feita há cêrca de 20 anos atraz, é atribuível à não observância dêsse cuidado. A documentação apresentada refere-se a um paciente do sexo feminino, de côr branca, com 36 anos de idade, não infectado pelo Schizotrypanum cruzi, cujo coração pesava 310 g, sendo considerado macro e microscòpicamente, normal. Destina-se ela a servir de têrmo de comparação para a que será publicada, oportunamente, sôbre a cardiopatia crônica na doença de Chagas. Confirmamos o que dizem muitos autores quando assinalam a ausência completa de células ganglionares e de nervos, no nódulo atrioventricular, no tronco comum do feixe His e em seus dois ramos, quando observados no homem. Contrasta isso, fortemente, com o que existe, nas mesmas estruturas, no coração dos ungulados. Verificamos, não raramente, continuidade entre fibras musculares do tecido específico, no ramo esquerdo do feixe de His e fibras musculares ventriculares, sendo o ramo esquerdo constituído, em certa proporção, por fibras com caracters intermediários entre fibras musculares ordinárias e fibras de Purkinje (fibras de transição. Algumas vêzes fibras com características das de Purkinie aparecem em grupos musculares do septo ventricular imediatamente adjacentes ao ramo esquerdo, dificultando a demarcação exata daquele ramo. Reproduzimos, textualmente, pontos de mior interêsse, na literatura consultada, quando receavamos que a tradução não pudesse traduzir o pensamento exato do autor ou pudesse dar tal impressão.No particular difficulty was met in the demonstration of the atrioventricular node and bundel of His in the human heart when standard methods such as that described by RÉNON and GÉRAUDEL (posteriorly referred as MAHAIM's method was followed. The figures

  14. Atrioventricular junction (AVJ) motion tracking: a software tool with ITK/VTK/Qt.

    Science.gov (United States)

    Pengdong Xiao; Shuang Leng; Xiaodan Zhao; Hua Zou; Ru San Tan; Wong, Philip; Liang Zhong

    2016-08-01

    The quantitative measurement of the Atrioventricular Junction (AVJ) motion is an important index for ventricular functions of one cardiac cycle including systole and diastole. In this paper, a software tool that can conduct AVJ motion tracking from cardiovascular magnetic resonance (CMR) images is presented by using Insight Segmentation and Registration Toolkit (ITK), The Visualization Toolkit (VTK) and Qt. The software tool is written in C++ by using Visual Studio Community 2013 integrated development environment (IDE) containing both an editor and a Microsoft complier. The software package has been successfully implemented. From the software engineering practice, it is concluded that ITK, VTK, and Qt are very handy software systems to implement automatic image analysis functions for CMR images such as quantitative measure of motion by visual tracking.

  15. Cx30.2 enhancer analysis identifies Gata4 as a novel regulator of atrioventricular delay

    Science.gov (United States)

    Munshi, Nikhil V.; McAnally, John; Bezprozvannaya, Svetlana; Berry, Jeff M.; Richardson, James A.; Hill, Joseph A.; Olson, Eric N.

    2009-01-01

    Summary The cardiac conduction system comprises a specialized tract of electrically coupled cardiomyocytes responsible for impulse propagation through the heart. Abnormalities in cardiac conduction are responsible for numerous forms of cardiac arrhythmias, but relatively little is known about the gene regulatory mechanisms that control the formation of the conduction system. We demonstrate that a distal enhancer for the connexin 30.2 (Cx30.2, also known as Gjd3) gene, which encodes a gap junction protein required for normal atrioventricular (AV) delay in mice, is necessary and sufficient to direct expression to the developing AV conduction system (AVCS). Moreover, we show that this enhancer requires Tbx5 and Gata4 for proper expression in the conduction system, and Gata4+/- mice have short PR intervals indicative of accelerated AV conduction. Thus, our results implicate Gata4 in conduction system function and provide a clearer understanding of the transcriptional pathways that impact normal AV delay. PMID:19592579

  16. RADIOFREQUENCY CURRENT CATHETER ABLATION OF THE LEFT ATRIOVENTRICULAR ACCESSORY PATHWAYS WITH PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA

    Institute of Scientific and Technical Information of China (English)

    王静毅; 郭继鸿; 吴益明; 朱继红; 王伟民; 赵红; 刘喜荣; MichaelA.Lee

    1994-01-01

    Seventy patients with left atrioventricular accessory pathways and paroxysmal supraventricular tachycardia (PSVT) underwent radiofrequency catheter ablation (RFCA).The success rate was 94.3%.Among these pa-tients,26 had manifest preexcitation syndrome,and 44 had concealed preexcitation.Eighteen patients with con-cealed preexcitation underwent coronary sinus(CS) pacinga,and delta wave appeared in 15.The keys to successful RFCA were correct positioning of the radiofrequency (RF) catheter tip,A/V amplitude ratio,AV interval(in si-nus rhythm)and VA interval(during SVT or ventricular pacing).After 1-14 months of follow-up,two pa- tients had supraventricular tachycardia(SVT)recurrence.

  17. TAQUICARDIA POR REENTRADA DEL NODO AURÍCULO-VENTRICULAR / Atrioventricular nodal reentrant tachycardia

    Directory of Open Access Journals (Sweden)

    Jéssica Mirella Mercedes

    2013-01-01

    Full Text Available Resumen La taquicardia por reentrada del nodo aurículo–ventricular representa una parte significativa de las taquiarritmias que los médicos asisten en los servicios de urgencias. Constituye la taquicardia paroxística más frecuente, y es característico que se presente sobre todo en mujeres entre la cuarta y la quinta década de la vida. El diagnóstico puede hacerse con alta fiabilidad mediante el electrocardiograma de superficie y algunos casos complejos o dudosos, mediante los estudios electrofisiológicos. Su tratamiento debe ser dirigido hacia la curación definitiva mediante la técnica de ablación endocavitaria, pero de acuerdo a su disponibilidad o las preferencias del paciente se puede indicar tratamiento farmacológico. En este artículo se resumen las técnicas diagnósticas, los tipos de taquicardia por reentrada intranodal y los principales aspectos del tratamiento. / Abstract Atrioventricular nodal reentrant tachycardia represents a significant part of tachyarrhythmias seen by attending physicians in emergency departments. It is the most common paroxysmal tachycardia, and it occurs primarily in women between their fourth and fifth decades of life. Diagnosis can be made with high reliability by surface electrocardiogram and complex or borderline cases by electrophysiological studies. Its treatment should be aimed towards definitive healing by endocardial ablation technique, but depending on availability or patient preferences drug treatment may be indicated. This article summarizes the diagnostic techniques, types of atrioventricular nodal reentrant tachycardia and major aspects of treatment.

  18. Advanced heart block in acute rheumatic fever.

    Science.gov (United States)

    Hubail, Zakariya; Ebrahim, Ishaq M

    2016-04-01

    First degree heart block is considered a minor criterion for the diagnosis of this condition. The cases presented here demonstrate that higher degrees of heart block do occur in rheumatic fever. Children presenting with acquired heart block should be worked-up for rheumatic fever. Likewise, it is imperative to serially follow the electrocardiogram in patients already diagnosed with acute rheumatic fever, as the conduction abnormalities can change during the course of the disease.

  19. Advanced heart block in acute rheumatic fever

    OpenAIRE

    2015-01-01

    First degree heart block is considered a minor criterion for the diagnosis of this condition. The cases presented here demonstrate that higher degrees of heart block do occur in rheumatic fever. Children presenting with acquired heart block should be worked-up for rheumatic fever. Likewise, it is imperative to serially follow the electrocardiogram in patients already diagnosed with acute rheumatic fever, as the conduction abnormalities can change during the course of the disease.

  20. Msx1 and Msx2 are required for endothelial-mesenchymal transformation of the atrioventricular cushions and patterning of the atrioventricular myocardium

    Directory of Open Access Journals (Sweden)

    Maxson Robert E

    2008-07-01

    Full Text Available Abstract Background Msx1 and Msx2, which belong to the highly conserved Nk family of homeobox genes, display overlapping expression patterns and redundant functions in multiple tissues and organs during vertebrate development. Msx1 and Msx2 have well-documented roles in mediating epithelial-mesenchymal interactions during organogenesis. Given that both Msx1 and Msx2 are crucial downstream effectors of Bmp signaling, we investigated whether Msx1 and Msx2 are required for the Bmp-induced endothelial-mesenchymal transformation (EMT during atrioventricular (AV valve formation. Results While both Msx1-/- and Msx2-/- single homozygous mutant mice exhibited normal valve formation, we observed hypoplastic AV cushions and malformed AV valves in Msx1-/-; Msx2-/- mutants, indicating redundant functions of Msx1 and Msx2 during AV valve morphogenesis. In Msx1/2 null mutant AV cushions, we found decreased Bmp2/4 and Notch1 signaling as well as reduced expression of Has2, NFATc1 and Notch1, demonstrating impaired endocardial activation and EMT. Moreover, perturbed expression of chamber-specific genes Anf, Tbx2, Hand1 and Hand2 reveals mispatterning of the Msx1/2 double mutant myocardium and suggests functions of Msx1 and Msx2 in regulating myocardial signals required for remodelling AV valves and maintaining an undifferentiated state of the AV myocardium. Conclusion Our findings demonstrate redundant roles of Msx1 and Msx2 in regulating signals required for development of the AV myocardium and formation of the AV valves.

  1. The incidence of transcatheter aortic valve implantation-related heart block in self-expandable Medtronic CoreValve and balloon-expandable Edwards valves.

    Science.gov (United States)

    Liang, Michael; Devlin, Gerard; Pasupati, Sanjeevan

    2012-04-01

    Transcatheter aortic valve implantation (TAVI) has been performed at Waikato Hospital for high-risk severe symptomatic aortic stenosis patients who are considered unsuitable for conventional cardiac surgery for the last 3 years. The Medtronic CoreValve (MCV) is a self-expandable device, while the Edwards SAPIEN valve (EV) requires the use of a balloon to expand the device. This observational study reports and compares the incidence of heart block in both Medtronic and Edwards transcatheter valves. All patients who underwent TAVI between the periods of 28 August 2008 and 27 July 2011 were included in this study. Preprocedure and daily postprocedure until discharge electrocardiograms (ECG) were obtained prospectively. New onsets of significant atrioventricular (AV) and bundle branch blocks were recorded. Patients with existing pacemaker and those who did not survive the procedure were excluded. Sixty patients underwent TAVI during the study period, of whom 40 (67%) and 20 (33%) patients had MCV and EV implanted, respectively. Seven patients were excluded from the analysis; 38 MCV and 15 EV patients fulfilled the criteria for analysis. Mean age was 80 ± 7 years, 57% were male. Five patients (9%) required permanent pacemaker (PPM) implantation, which occurred exclusively post MCV TAVI (MCV vs EV: 13% vs 0%, respectively; P=.02). The indications of PPM were complete heart block in 3 patients (60%), Mobitz II second-degree heart block in 1 patient (20%), and symptomatic sick sinus syndrome in 1 patient (20%). The incidence of left bundle branch block (LBBB) was increased after the TAVI procedure and was more significant with MCV implants (MCV vs EV: 42% vs 8%, respectively; P<.01). Of note, 2 of the 5 patients (40%) with pre-existing right bundle branch block (RBBB) who underwent TAVI required PPM (P=.01). MCV implantation is associated with a higher incidence of significant AV block requiring PPM implantation and LBBB compared to EV. The overall rate of PPM requirement

  2. Endogenous RGS proteins modulate SA and AV nodal functions in isolated heart: implications for sick sinus syndrome and AV block.

    Science.gov (United States)

    Fu, Ying; Huang, Xinyan; Piao, Lin; Lopatin, Anatoli N; Neubig, Richard R

    2007-05-01

    G protein-coupled receptors play a pivotal role in regulating cardiac automaticity. Their function is controlled by regulator of G protein signaling (RGS) proteins acting as GTPase-activating proteins for Galpha subunits to suppress Galpha(i) and Galpha(q) signaling. Using knock-in mice in which Galpha(i2)-RGS binding and negative regulation are disrupted by a genomic Galpha(i2)G184S (GS) point mutation, we recently (Fu Y, Huang X, Zhong H, Mortensen RM, D'Alecy LG, Neubig RR. Circ Res 98: 659-666, 2006) showed that endogenous RGS proteins suppress muscarinic receptor-mediated bradycardia. To determine whether this was due to direct regulation of cardiac pacemakers or to alterations in the central nervous system or vascular responses, we examined isolated, perfused hearts. Isoproterenol-stimulated beating rates of heterozygote (+/GS) and homozygote (GS/GS) hearts were significantly more sensitive to inhibition by carbachol than were those of wild type (+/+). Even greater effects were seen in the absence of isoproterenol; the potency of muscarinic-mediated bradycardia was enhanced fivefold in GS/GS and twofold in +/GS hearts compared with +/+. A(1)-adenosine receptor-mediated bradycardia was unaffected. In addition to effects on the sinoatrial node, +/GS and GS/GS hearts show significantly increased carbachol-induced third-degree atrioventricular (AV) block. Atrial pacing studies demonstrated an increased PR interval and AV effective refractory period in GS/GS hearts compared with +/+. Thus loss of the inhibitory action of endogenous RGS proteins on Galpha(i2) potentiates muscarinic inhibition of cardiac automaticity and conduction. The severe carbachol-induced sinus bradycardia in Galpha(i2)G184S mice suggests a possible role for alterations of Galpha(i2) or RGS proteins in sick sinus syndrome and pathological AV block.

  3. [Effect of the preparations amiodarone, pexid and CERM-1978 on sinus rhythm and atrioventricular conduction in unanesthetized dogs].

    Science.gov (United States)

    Georgiev, G

    1977-01-01

    The author examined the influence of Amiodarone, Perexiline maliate (Pexid) and the preparation CERM-1978 (Bepiridil) on the sinus rhythm and atrioventriular conduction of trained dogs with preliminary implanted electrodes for electrostimulation of the right atrium under the conditions of chronic experiment. The three preparations in doses of 2,5 and 5 mg/kg of body weight prolonged the refractory period of the atrioventricular zone, estimated by the method of "the maximal atrioventricular frequency". The br dicaric effect was also present, more manifested in a dose of 2.5 mg/kg of body weight. The established negative chrono- and dromotropic action had their maximum 15 minutes after the administration and lasted more than 2 hours.

  4. Role of electrophysiological study in patients with syncope and bundle branch block

    Directory of Open Access Journals (Sweden)

    Neshat Nazari

    2014-01-01

    Full Text Available Background: The finding of bundle branch block (BBB in patients with syncope suggests that paroxysmal atrioventricular block (AVB or ventricular tachyarrhythmia (VT may be the cause of syncope. Guidelines for cardiac pacing and cardiac resynchronization therapy have been recommended to perform electrophysiological study (EPS for confirming main cause of syncope. Therefore, the aim of our study was to evaluate the role of EPS in patients with syncope and BBB. Materials and Methods: We evaluated 133 patients (mean age 63 ± 13.8 years with past history of syncope and BBB from April 2002 to December 2010 who referred to Arrhythmia clinic in two tertiary care centers. All patients underwent EPS on admission time. The frequency distributions of AVB and VT in patients were determined. Results: Left bundle branch block was diagnosed in 184 (82.1% patients. 133 of them had preserved left ventricular ejection fraction (LVEF ≥45% that in 91 (68.4% of those, EPS finding was normal. In 41 (30.8% patients AVB was reported. In 2 (1.5% patients VT and atrioventricular nodal reentrant tachycardia were seen. Coronary artery disease was more common in patients with AVB and abnormal EPS finding (P = 0.02. Conclusion: Ventricular tachyarrhythmia was a rare electrophysiological finding in those with syncope, bifascicular block, and preserved LVEF. Considering cost-effect benefit, pacemaker or implantable loop recorder implantation is suggested; however, EPS may not be necessary to perform before permanent pacemaker implantation.

  5. Early Correction of Common Atrioventricular Septal Defects: A Single-Center 20-Year Experience.

    Science.gov (United States)

    Vida, Vladimiro L; Tessari, Chiara; Castaldi, Biagio; Padalino, Massimo A; Milanesi, Ornella; Gregori, Dario; Stellin, Giovanni

    2016-12-01

    Over the past 20 years our policy has been to electively repair common atrioventricular canal defects (CAVCD) in patients between 8 and 12 weeks of age. We sought to evaluate the results of our past 20-year experience. From January 1992 to April 2014, 159 consecutive patients underwent CAVCD repair (133 patients had complete CAVCD and 26 patients had a transitional form of CAVCD). Surgical repair was accomplished with a double-patch (n = 137 [86%]) or a modified single patch (n = 22 [14%]) technique. Median age at operation was 96 days (interquartile range [IQR], 73-128 days); 90 patients were younger than 3 months of age. There were 3 operative (1.9%) and 12 late (7.7%) deaths. Median follow-up time after repair was 8.2 years (IQR, 3.6-15 years). Twenty patients (13%) required reoperation-16 (10%) for left atrioventricular valve (LAVV) regurgitation. Reoperation on the LAVV was more frequent in patients with a dysplastic LAVV preoperatively (p = 0.01; odds ratio [OR], 4.2; 95% confidence interval [CI], 1.33-13.5) and in patients who underwent closure for an absent/incomplete cleft at the time of repair (p = 0.01; OR, 5.4; 95% CI, 1.4-21). Late LAVV performance (regurgitation greater than or equal to moderate or the need for reoperation), including late deaths and patients who underwent reoperation, was significantly worse in patients older than 3 months at repair (10 of 83 patients [12%] versus 20 of 73 patients [27%]; hazard ratio [HR], 2.71; 95% CI, 1.19-6.19) and in patients with LAVV dysplasia (19 of 68 patients [28%] versus 11 of 88 patients [12%]; HR, 3; 95% CI, 1.53-8.51). Individualized early repair of CAVCD is safe and beneficial, with good early and long-term results. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Natural and modified history of complete atrioventricular septal defect--a 17 year study.

    Science.gov (United States)

    Frontera-Izquierdo, P; Cabezuelo-Huerta, G

    1990-01-01

    We reviewed 103 cases of isolated complete atrioventricular septal defect. These cases represented 4.4% of the cases of congenital heart disease diagnosed in our hospital by catheterisation and angiography during 1971-88. Most children (n = 76) had Down's syndrome. Banding of the pulmonary artery was performed in seven cases and complete repair in 67 cases. In the period 1971-82 the complete correction was performed at a mean age of 23 months with a surgical mortality of 88.8%. In the period 1983-8 the mean age at complete correction was 13 months, the mortality 43.2%, and the five year actuarial survival was 46.8%. The 22 patients that survived after complete correction were in functional classes I and II of the New York Heart Association classification. After a mean follow up of 10 years only eight (36%) of the 22 who were followed up and treated medically survived; all had developed pulmonary vascular obstructive disease and were in functional classes III or IV. Our findings stress the importance of early complete surgical repair. PMID:2221969

  7. Polymorphic haplotypes of CRELD1 differentially predispose Down syndrome and euploids individuals to atrioventricular septal defect.

    Science.gov (United States)

    Ghosh, Priyanka; Bhaumik, Pranami; Ghosh, Sujoy; Ozbek, Umut; Feingold, Eleanor; Maslen, Cheryl; Sarkar, Biswanath; Pramanik, Vishmadeb; Biswas, Priyanka; Bandyopadhyay, Biswajit; Dey, Subrata Kumar

    2012-11-01

    To explore the role of CRELD1 variants on congenital heart defects, we sequenced the entire reading frame of CRELD1 in the samples from Kolkata and adjoining areas. Nearly, 400 participants were included in the genetic association study and they were stratified as Down syndrome (DS) with atrioventricular septal defect (AVSD), DS without AVSD, euploid with AVSD, and euploid without AVSD. A significant association was found between AVSD and three polymorphisms, namely rs9878047 (c.1049-129T > C), rs3774207 (c.1119C > T), and rs73118372 (c.1136T > C) among the Down syndrome and euploid individuals. The polymorphism rs73118372, involves a transition (c.1136T > C) that leads to change in amino acid methionine to threonine which alters protein secondary structure as confirmed by the bioinformatics software SOPMA. In addition, two haplotypes, C-T-C and C-T-T, in the order of loci rs9878047-rs3774207-rs73118372 were associated with incidence of AVSD among euploid and Down syndrome, with a slightly higher odds ratio in the later group. We hypothesize that these haplotypes increase the risk of AVSD, and the susceptibility is exacerbated in DS, possibly due to the trisomy 21 genetic background. Moreover, we report for the first time on an interaction between the mutant alleles of rs3774207 and rs73118372 which could disrupt the delicate balance between different CRELD1 isoforms.

  8. Optimisation of atrioventricular delay during exercise improves cardiac output in patients stabilised with cardiac resynchronisation therapy.

    Science.gov (United States)

    Sun, Jing Ping; Lee, Alex Pui-Wai; Grimm, Richard A; Hung, Ming-Jui; Yang, Xing Sheng; Delurgio, David; Leon, Angel R; Merlino, John D; Yu, Cheuk-Man

    2012-01-01

    Atrioventricular (AV) delay in cardiac resynchronisation therapy (CRT) recipients are typically optimised at rest. However, there are limited data on the impact of exercise-induced changes in heart rate on the optimal AV delay and left ventricular function. The authors serially programmed AV delays in 41 CRT patients with intrinsic sinus rhythm at rest and during two stages of supine bicycle exercise with heart rates at 20 bpm (stage I) and 40 bpm (stage II) above baseline. The optimal AV delay during exercise was determined by the iterative method to maximise cardiac output using Doppler echocardiography. Results were compared to physiological change in PR intervals in 56 normal controls during treadmill exercise. The optimal AV delay was progressively shortened (pexercise level (baseline: 123±26 ms vs. stage I: 102±24 ms vs stage II: 70±22 ms, pexercise. A linear inverse relationship existed between optimal AV delays and heart rates in CRT patients (AV delay=241-1.61×heart rate, R2=0.639, pheart rate during exercise, which suggests the need for programming of rate-adaptive AV delay in CRT recipients.

  9. Contribution of Copy Number Variation to Down Syndrome-associated Atrioventricular Septal Defects

    Science.gov (United States)

    Ramachandran, Dhanya; Mulle, Jennifer G.; Locke, Adam E.; Bean, Lora J.H.; Rosser, Tracie C.; Bose, Promita; Dooley, Kenneth J.; Cua, Clifford L.; Capone, George T.; Reeves, Roger H.; Maslen, Cheryl L.; Cutler, David J.; Sherman, Stephanie L.; Zwick, Michael E.

    2014-01-01

    Purpose The goal of this study was to identify the contribution of large copy number variants (CNV) to Down syndrome (DS) associated atrioventricular septal defects (AVSD), whose risk in the trisomic population is 2000-fold more compared to general disomic population. Methods Genome-wide CNV analysis was performed on 452 individuals with DS (210 cases with complete AVSD; 242 controls with structurally normal hearts) using Affymetrix SNP 6.0 arrays, making this the largest heart study conducted to date on a trisomic background. Results Large common CNVs with substantial effect sizes (OR>2.0) do not account for the increased risk observed in DS-associated AVSD. In contrast, cases had a greater burden of large rare deletions (p<0.01) and intersected more genes (p<0.007) when compared to controls. We also observed a suggestive enrichment of deletions intersecting ciliome genes in cases compared to controls. Conclusion Our data provide strong evidence that large rare deletions increase the risk of DS-associated AVSD, while large common CNVs do not appear to increase the risk of DS-associated AVSD. The genetic architecture of AVSD is complex and multifactorial in nature. PMID:25341113

  10. Blending of styrene-block-butadiene-block-styrene copolymer with sulfonated vinyl aromatic polymers

    OpenAIRE

    Ruggeri, Giacomo; Passaglia, Elisa; Giorgi, Ivan; Picchioni, Francesco; Aglietto, Mauro

    2001-01-01

    Different polymers containing sulfonic groups attached to the phenyl rings were prepared by sulfonation of polystyrene (PS) and styrene-block-(ethylene-co-1-butene)-block-styrene (SEBS). The sulfonation degree (SD) was varied between 1 and 20 mol% of the styrene units. Polyphase materials containing sulfonated units were prepared by blending styrene-block-butadiene-block-styrene (SBS), with both sulfonated PS and sulfonated SEBS in a Brabender mixer. Such a procedure was performed as an alter...

  11. Straddling mitral valve with hypoplastic right ventricle, crisscross atrioventricular relations, double outlet right ventricle and dextrocardia: morphologic, diagnostic and surgical considerations.

    Science.gov (United States)

    Geva, T; Van Praagh, S; Sanders, S P; Mayer, J E; Van Praagh, R

    1991-06-01

    The clinical, surgical and morphologic findings in five cases of a rare form of straddling mitral valve are presented. Three patients were diagnosed by two-dimensional echocardiography, cardiac catheterization and angiocardiography and two had diagnostic confirmation at autopsy. All five cases shared a distinctive and consistent combination of anomalies: 1) dextrocardia; 2) visceroatrial situs solitus, concordant ventricular D-loop and double outlet right ventricle with the aorta positioned to the left of and anterior to the pulmonary artery; 3) hypoplasia of right ventricular inflow (sinus) with tricuspid valve stenosis or hypoplasia; 4) large right ventricular infundibulum (outflow); 5) malalignment conoventricular septal defect; 6) straddling mitral valve with chordal attachments to the left ventricle and right ventricular infundibulum; 7) severe subpulmonary stenosis with well developed pulmonary arteries; and 8) superoinferior ventricles with crisscross atrioventricular (AV) relations. The degree of malalignment between the atrial and ventricular septa was studied quantitatively by measuring the AV septal angle projected on the frontal plane. The AV septal angle in the two postmortem cases was 150 degrees, reflecting marked malalignment of the ventricles relative to the atria. This AV malalignment appears to play an important role in the morphogenesis of straddling mitral valve. As judged by a companion study of seven postmortem cases, the more common form of straddling mitral valve with a hypertrophied and enlarged right ventricular sinus had less severe ventricular malposition than did the five rare study cases with hypoplastic right ventricular sinus. A competent mitral valve, low pulmonary vascular resistance and low left ventricular end-diastolic pressure were found at cardiac catheterization in the three living patients who underwent a modified Fontan procedure and are doing well 2.2 to 5.8 years postoperatively.

  12. Effectiveness of balloon valvuloplasty for palliation of mitral stenosis after repair of atrioventricular canal defects.

    Science.gov (United States)

    Robinson, Joshua D; Marx, Gerald R; Del Nido, Pedro J; Lock, James E; McElhinney, Doff B

    2009-06-15

    Closure of a mitral valve (MV) cleft, small left-sided cardiac structures, and ventricular imbalance all may contribute to mitral stenosis (MS) after repair of atrioventricular canal (AVC) defects. MV replacement is the traditional therapy but carries high risk in young children. The utility of balloon mitral valvuloplasty (BMV) in postoperative MS is not established and may offer alternative therapy or palliation. Since 1996, 10 patients with repaired AVC defects have undergone BMV at a median age of 2.5 years (range 8 months to 14 years), a median of 2 years after AVC repair. At catheterization, the median value of mean MS gradients was 16 mm Hg (range 12 to 22) and was reduced by 34% after BMV. Before BMV, there was mild mitral regurgitation in 9 of 10 patients, which increased to severe in 1 patient. All patients were alive at follow-up (median 5.4 years). Repeat BMV was performed in 4 patients, 10 weeks to 18 months after initial BMV. One patient underwent surgical valvuloplasty; 3 underwent MV replacement 2, 3, and 28 months after BMV. In the 6 patients (60%) with a native MV at most recent follow-up (median 3.2 years), the mean Doppler MS gradient was 9 mm Hg, the median weight had doubled, and weight percentile had increased significantly. In conclusion, BMV provides relief of MS in most patients with repaired AVC defects; marked increases in mitral regurgitation are uncommon. Because BMV can incompletely relieve obstruction and increase mitral regurgitation, it will not be definitive in most patients but will usually delay MV replacement to accommodate a larger prosthesis.

  13. Atrioventricular canal defect and associated genetic disorders: new insights into polydactyly syndromes

    Directory of Open Access Journals (Sweden)

    M. Cristina Digilio

    2011-07-01

    Full Text Available Atrioventricular canal defect (AVCD is a common congenital heart defect (CHD, representing 7.4% of all cardiac malformations, considered secondary to an extracellular matrix anomaly. The AVCD is associated with extracardiac defects in about 75% of the cases. In this review we analyzed different syndromic AVCDs, in particular those associated with polydactyly disorders, which show remarkable genotype-phenotype correlations. Chromo - some imbalances more frequently associated with AVCD include Down syndrome, deletion 8p23 and deletion 3p25, while mendelian disorders include Noonan syndrome and related RASopathies, several polydactyly syndromes, CHARGE and 3C (cranio-cerebello-cardiac syndrome. The complete form of AVCD is prevalent in patients with chromosomal imbalances. Additional cardiac defects are found in patients affected by chromosomal imbalances different from Down syndrome. Left-sided obstructive lesions are prevalently found in patients with RASopathies. Patients with deletion 8p23 often display AVCD with tetralogy of Fallot or with pulmonary valve stenosis. Tetralogy of Fallot is the only additional cardiac defect found in patients with Down syndrome and AVCD. On the other hand, the association of AVCD and tetralogy of Fallot is also quite characteristic of CHARGE and 3C syndromes. Heterotaxia defects, including common atrium and anomalous pulmonary venous return, occur in patients with AVCD associated with polydactyly syndromes (Ellis-van Creveld, short rib polydactyly, oral-facial-digital, Bardet-Biedl, and Smith-Lemli-Opitz syndromes. The initial clinical evidence of anatomic similarities between AVCD and heterotaxia in polydactyly syndromes was corroborated and explained by experimental studies in transgenic mice. These investigations have suggested the involvement of the Sonic Hedgehog pathway in syndromes with postaxial polydactyly and heterotaxia, and ciliary dysfunction was detected as pathomechanism for these disorders

  14. Complete heart block in a neutropenic patient with aspergillosis: An unusual adverse effect of caspofungins

    Directory of Open Access Journals (Sweden)

    Sasmita Biswal

    2012-01-01

    Full Text Available We present a case of complete heart block (CHB in a 58-year-old female patient with acute myeloid leukemia (AML with no past history of cardiac disease, who received caspofungin in the treatment of disseminated fungal infection. To our knowledge, this is the first case of CHB associated with caspofungins. Subsequent to induction chemotherapy the patient developed invasive pulmonary aspergillosis with sudden tachypnea, dyspnoea, fever, bilateral pulmonary infiltrates and acute respiratory insufficiency consequent to neutropenia with ANC<500. During the first dose of antifungal therapy with caspofungins, she developed complete atrioventricular block and cardiac arrest. Complete heart block is an unusual adverse effect of caspofungins which has not been reported previously. Caspofungins release histamine in peripheral blood cells, so possible histamine-mediated symptoms ranging from severe fatal anaphylaxis can occur. These data suggest that infusion-related reactions associated with caspofungin may be mediated by histamine release secondary to caspofungin therapy.

  15. Celiac ganglia block

    Energy Technology Data Exchange (ETDEWEB)

    Akinci, Devrim [Department of Radiology, Hacettepe University School of Medicine, Sihhiye, 06100 Ankara (Turkey); Akhan, Okan [Department of Radiology, Hacettepe University School of Medicine, Sihhiye, 06100 Ankara (Turkey)]. E-mail: oakhan@hacettepe.edu.tr

    2005-09-01

    Pain occurs frequently in patients with advanced cancers. Tumors originating from upper abdominal viscera such as pancreas, stomach, duodenum, proximal small bowel, liver and biliary tract and from compressing enlarged lymph nodes can cause severe abdominal pain, which do not respond satisfactorily to medical treatment or radiotherapy. Percutaneous celiac ganglia block (CGB) can be performed with high success and low complication rates under imaging guidance to obtain pain relief in patients with upper abdominal malignancies. A significant relationship between pain relief and degree of tumoral celiac ganglia invasion according to CT features was described in the literature. Performing the procedure in the early grades of celiac ganglia invasion on CT can increase the effectiveness of the CGB, which is contrary to World Health Organization criteria stating that CGB must be performed in patients with advanced stage cancer. CGB may also be effectively performed in patients with chronic pancreatitis for pain palliation.

  16. Successful radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia in a patient with dextrocardia due to unilateral pulmonary agenesis: a case report

    Directory of Open Access Journals (Sweden)

    Aksu T

    2015-02-01

    Full Text Available Tolga Aksu, Tumer Erdem Guler, Ebru Golcuk, Ismail Erden, Kazim Serhan Ozcan Department of Cardiology, Kocaeli Derince Education and Research Hospital, Derince, Kocaeli, Turkey Abstract: Radiofrequency catheter ablation of the slow pathway is considered to be the treatment of choice for patients with atrioventricular nodal reentrant tachycardia. We report a 34-year-old female with mirror image dextrocardia due to unilateral pulmonary agenesis who underwent successful slow pathway ablation for typical atrioventricular nodal reentrant tachycardia. Using contrast injection, cardiac anatomy was identified in a short time and successfully ablated. Keywords: dextrocardia, AVNRT, ablation, pulmonary agenesis

  17. Ultrasound guided supraclavicular block.

    LENUS (Irish Health Repository)

    Hanumanthaiah, Deepak

    2013-09-01

    Ultrasound guided regional anaesthesia is becoming increasingly popular. The supraclavicular block has been transformed by ultrasound guidance into a potentially safe superficial block. We reviewed the techniques of performing supraclavicular block with special focus on ultrasound guidance.

  18. STUDY ON POLYSULFONE-POLYESTER BLOCK COPOLYMERS

    Institute of Scientific and Technical Information of China (English)

    DING Youjun; QI Daquan

    1988-01-01

    Synthesis and characterization of a series of Polysulfone (PSF)-Polyester (PEs) block copolymers were studied.The degree of randomness (B) of these block copolymers was calculated from the intensities of their proton signals in 1H NMR spectra and lies in the region of 0 < B < 1. It was shown that the degree of randomness (B) and the average sequence length (L) in block copolymers were relatively dependent on the reaction conditions, various feed ratios and structure of diols.The phenomenon was observed, when the PSF-PEs block copolymers dissolved in different solvents they had different viscosities and molecular conformations.The PSF-PEs block copolymers had better solvent resistance than homo-polysulfone.

  19. The External Degree.

    Science.gov (United States)

    Houle, Cyril O.

    This book examines the external degree in relation to the extremes of attitudes, myths, and data. Emphasis is placed on the emergence of the American external degree, foreign external-degree programs, the purpose of the external degree, the current scene, institutional issues, and problems of general policy. (MJM)

  20. Bridge to success: A better method of cryoablation for atrioventricular nodal reentrant tachycardia in children.

    Science.gov (United States)

    Reddy, Charitha D; Ceresnak, Scott R; Motonaga, Kara S; Avasarala, Kishor; Feller, Christine; Trela, Anthony; Hanisch, Debra; Dubin, Anne M

    2017-07-14

    Cryoablation for atrioventricular nodal reentrant tachycardia (AVNRT) is associated with higher recurrence rates than radiofrequency ablation (RFA). Junctional tachycardia marks procedural success with RFA, but no such indicator exists for cryoablation. The purpose of this study as to determine the impact of voltage mapping plus longer ablation lesions on midterm success of cryoablation for children with AVNRT. We performed a single-center retrospective analysis of pediatric patients with AVNRT who underwent cryoablation from 2011 to 2015. Patients ablated using a standard electroanatomic approach (control) were compared with patients ablated using voltage mapping (voltage group). In the voltage group, EnSite NavX navigation and visualization technology (St Jude Medical, St Paul, MN) was used to develop a "bridge" of lower voltage gradients (0.3-0.8 mV) of the posteroseptal right atrium to guide cryoablation. Kaplan-Meier analysis was used to determine freedom from recurrence of supraventricular tachycardia. In all, 122 patients were included (71 voltage, 51 control). There was no difference between groups regarding age, sex, or catheter-tip size. Short-term success was similar in both groups (98.5% voltage vs 92% control; P = .159), but recurrence rates were lower in the voltage group (0% vs 11%, P = .006). Follow-up time was shorter in the voltage group (15 ± 7 months vs 22 ± 17 months, P < .05). The 1-year freedom from recurrence was lower in the voltage group (100% vs 91.5%, P <.05). Ablation times were longer in the voltage group (43.7 ± 20.9 minutes vs 34.3 ± 20.5 minutes, P = .01), but overall procedure times were shorter in the voltage group (157 ± 40 minutes vs 198 ± 133 minutes; P = .018). No significant complication was seen in either group. Voltage gradient mapping and longer lesion time can decrease recurrence rates in pediatric patients with AVNRT. Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  1. Estudio descriptivo sobre bloqueos atrio-ventriculares en infartos posteroinferiores en el Hospital de Caldas ESE.

    Directory of Open Access Journals (Sweden)

    Wilmar Alberto Díaz

    2009-11-01

    Full Text Available Introducción: El infarto agudo de miocardio (IAM es un problema de salud pública a escala mundial y nacional, que merece una prevención, diagnóstico y tratamiento oportunos. El IAM de cara inferior presenta entre sus complicaciones el bloqueo atrio-ventricular (bloqueo AV en sus diversas manifestaciones. Materiales y métodos: El presente es un estudio de tipo descriptivo, retrospectivo realizado en el Hospital Universitario de Caldas ESE, por medio de la revisión de historias clínicas corresponismo atrio-DACCION diagnóstico, de alta calidad y de gran importancia. dientes a los años 1999 a 2002, de los pacientes que presentaron infarto agudo de miocardio de cara inferior. Se tomaron de las historias variables como edad, sexo, consumo de alcohol, tabaco, sedentarismo y la presencia o ausencia de enfermedades previas tales como hipertensión arterial, diabetes mellitus, dislipidemias e infarto agudo de miocardio previo y el tiempo de aparición del bloqueo (menor o mayor de 24 horas. Resultados: Se encontró una asociación significativa entre la incidencia de bloqueos AV con la edad (p=0.017 y el IAM previo (p=0.001 y entre mortalidad y tipo de bloqueo (p=0.028. No se presentó asociación entre los factores de riesgo asociados para IAM y la presentación de bloqueo, excepto una posible relación con la hipertensión arterial (p=0.176, no del todo clara, por lo cual se recomienda que sea explorada por estudios posteriores; 32.7% de personas con infarto de cara inferior tuvieron algún tipo de bloqueo y 77.1% de los bloqueos fueron en las primeras 24 horas. Conclusiones: Los pacientes que presenten un IAM de cara inferior con una edad >65 años, se deben someter a seguimiento con monitoría continua por electrocardiograma durante las primeras 24 horas; lo mismo todo paciente con IAM de cara inferior, se debe incluir dentro del grupo de seguimiento clínico, electrocardiográfico y de monitoreo estricto.

  2. Characterization and influence of cardiac background sodium current in the atrioventricular node.

    Science.gov (United States)

    Cheng, Hongwei; Li, Jue; James, Andrew F; Inada, Shin; Choisy, Stéphanie C M; Orchard, Clive H; Zhang, Henggui; Boyett, Mark R; Hancox, Jules C

    2016-08-01

    Background inward sodium current (IB,Na) that influences cardiac pacemaking has been comparatively under-investigated. The aim of this study was to determine for the first time the properties and role of IB,Na in cells from the heart's secondary pacemaker, the atrioventricular node (AVN). Myocytes were isolated from the AVN of adult male rabbits and mice using mechanical and enzymatic dispersion. Background current was measured using whole-cell patch clamp and monovalent ion substitution with major voltage- and time-dependent conductances inhibited. In the absence of a selective pharmacological inhibitor of IB,Na, computer modelling was used to assess the physiological contribution of IB,Na. Net background current during voltage ramps was linear, reversing close to 0mV. Switching between Tris- and Na(+)-containing extracellular solution in rabbit and mouse AVN cells revealed an inward IB,Na, with an increase in slope conductance in rabbit cells at -50mV from 0.54±0.03 to 0.91±0.05nS (mean±SEM; n=61 cells). IB,Na magnitude varied in proportion to [Na(+)]o. Other monovalent cations could substitute for Na(+) (Rb(+)>K(+)>Cs(+)>Na(+)>Li(+)). The single-channel conductance with Na(+) as charge carrier estimated from noise-analysis was 3.2±1.2pS (n=6). Ni(2+) (10mM), Gd(3+) (100μM), ruthenium red (100μM), or amiloride (1mM) produced modest reductions in IB,Na. Flufenamic acid was without significant effect, whilst La(3+) (100μM) or extracellular acidosis (pH6.3) inhibited the current by >60%. Under the conditions of our AVN cell simulations, removal of IB,Na arrested spontaneous activity and, in a simulated 1D-strand, reduced conduction velocity by ~20%. IB,Na is carried by distinct low conductance monovalent non-selective cation channels and can influence AVN spontaneous activity and conduction.

  3. Determination of the optimal atrioventricular and interventricular delays in cardiac resynchronization therapy

    Institute of Scientific and Technical Information of China (English)

    Hongxia NIU; Wei HUA; Shu ZHANG; Fangzheng WANG; Keping CHEN; Xin CHEN

    2005-01-01

    In order to provide the maximum benefit of cardiac resynchronization therapy (CRT), we tried to use an echocardiography method to optimize the atrioventricular and interventricular delay. Methods The study included 6 patients who underwent implantation of biventricular pacemakers for drug-resistant heart failure. Two-dimensional echocardiography and tissue Doppler imaging were carried out before and after the pacemaker implantation. The optimal AV delay was defined as the AV delay resulting in maximum timevelocity integral (TVI) of transmitral filling flow, the longest left ventricular filling time (LVFT) and the minimum mitral regurgitation(MR). The optimal VV delay was defined as the VV delay producing the maximum LV synchrony and the largest aortic TVI. Results CRT was successfully performed in all patients. After pacemaker implantation, an acute improvement in left ventricular ejection fraction (LVEF) was observed from 26.5% to 35%. Meanwhile, the QRS duration decreased from 170ms to 150ms. The optimal AV delay was programmed at 130, 120, 120, 120, 150 and 110ms respectively with heart rate corrected, LVFT significantly lengthened and TVI of MR decreased (non-optimal vs optimal AV delay: LVFT: 469ms vs 523ms; TVI of MR: 16.43cm vs 13.06cm, P<0.05). The optimal VV delay was programmed at 4, 4, 4, 8, 12 and 8ms with LV preactivation respectively. Programming the optimal VV delay increased the aortic TVI from 17.33cm up to 21.42cm (P<0.05). In the septal and lateral wall, peak systolic velocities improved from2.70cm/s to 3.02cm/s (P>0.05) and froml.31cm/s to 2.50cm/s (P<0.05) respectively. The septal-to-lateral delay in peak velocity improved from 56.4ms to 13.3ms after CRT (P<0.01). Conclusions Optimization of AV and VV delays may further enhance the efficacy of CRT. However, there was interindividual variability of optimal values, warranting individual patient examination.

  4. Estudio descriptivo sobre bloqueos atrio-ventriculares en infartos posteroinferiores en el Hospital de Caldas ESE

    Directory of Open Access Journals (Sweden)

    Wilmar Alberto Díaz

    2005-09-01

    Full Text Available Introducción: El infarto agudo de miocardio (IAM es un problema de salud pública a escala mundial y nacional, que merece una prevención, diagnóstico y tratamiento oportunos. El IAM de cara inferior presenta entre sus complicaciones el bloqueo atrio-ventricular (bloqueo AV en sus diversas manifestaciones. Materiales y métodos: El presente es un estudio de tipo descriptivo, retrospectivo realizado en el Hospital Universitario de Caldas ESE, por medio de la revisión de historias clínicas corresponismo atrio-DACCION diagnóstico, de alta calidad y de gran importancia. dientes a los años 1999 a 2002, de los pacientes que presentaron infarto agudo de miocardio de cara inferior. Se tomaron de las historias variables como edad, sexo, consumo de alcohol, tabaco, sedentarismo y la presencia o ausencia de enfermedades previas tales como hipertensión arterial, diabetes mellitus, dislipidemias e infarto agudo de miocardio previo y el tiempo de aparición del bloqueo (menor o mayor de 24 horas. Resultados: Se encontró una asociación significativa entre la incidencia de bloqueos AV con la edad (p=0.017 y el IAM previo (p=0.001 y entre mortalidad y tipo de bloqueo (p=0.028. No se presentó asociación entre los factores de riesgo asociados para IAM y la presentación de bloqueo, excepto una posible relación con la hipertensión arterial (p=0.176, no del todo clara, por lo cual se recomienda que sea explorada por estudios posteriores; 32.7% de personas con infarto de cara inferior tuvieron algún tipo de bloqueo y 77.1% de los bloqueos fueron en las primeras 24 horas. Conclusiones: Los pacientes que presenten un IAM de cara inferior con una edad >65 años, se deben someter a seguimiento con monitoría continua por electrocardiograma durante las primeras 24 horas; lo mismo todo paciente con IAM de cara inferior, se debe incluir dentro del grupo de seguimiento clínico, electrocardiográfico y de monitoreo estricto.

  5. Two pedigrees of autosomal dominant atrioventricular canal defect (AVCD): Exclusion from the critical region on 8p

    Energy Technology Data Exchange (ETDEWEB)

    Amati, F.; Mari, A.; Mingarelli, R. [Universita Tor Vergata, Rome (Italy)] [and others

    1995-07-03

    Atrioventricular canal defects (AVCD) constitute the predominant congenital heart defect in Down`s syndrome. For this reason, a candidate gene involved in atrioventricular canal development was previously searched and excluded in dominant pedigrees of AVCD, using linkage analysis of polymorphisms from chromosome 21. Because of the striking association between 8p deletion and AVCD, a search for an AVCD gene was carried out in two pedigrees of individuals with autosomal dominant AVCD using a set of DNA markers of the 8pter{r_arrow}q12 region. These two families include affected individuals and subjects who have transmitted the defect but are not clinically affected. Two-point lod scores were significantly negative for all markers at penetrance levels of 90% and 50%. Multipoint analysis excluded the region covered by the markers LPL-D8S262 and 30 cM to either side of this area. This result corroborates heterogeneity of this heart defect and indicates that the genetic basis of familial AVCD is different from AVCD associated to either trisomy 21 or 8p deletion. 25 refs., 3 figs., 2 tabs.

  6. Outcomes and Prognostic Factors for Adult Patients With Congenital Heart Disease Undergoing Primary or Reoperative Systemic Atrioventricular Valve Surgery.

    Science.gov (United States)

    Stephens, Elizabeth H; Han, Jiho; Ginns, Jonathan; Rosenbaum, Marlon; Chai, Paul; Bacha, Emile; Kalfa, David

    2017-05-01

    Adults with congenital heart disease (ACHD) undergoing systemic atrioventricular valve (SAVV) surgery are a complex, understudied population. We assessed midterm outcomes and prognostic factors in ACHD undergoing SAVV surgery. We performed retrospective evaluation of ACHD undergoing SAVV surgery from January 2005 to February 2016: 14 (33%) patients with congenital mitral valve stenosis/regurgitation, 15 (35%) with atrioventricular septal defect (AVSD), and 14 (33%) with congenitally corrected transposition of the great arteries (ccTGA) with systemic tricuspid valve regurgitation. Adverse events were defined as mortality, reoperation on SAVV, and late more-than-moderate (> moderate) SAVV regurgitation. Statistical analysis was performed using Fisher's exact test and one-way analysis of variance as well as univariate and multivariate risk factor analysis. Fifteen (35%) patients had preoperative systemic ventricular dysfunction, including 13 patients with ccTGA (93%, P moderate SAVV regurgitation, and SAVV reoperation rates were 5% (n = 2), 2% (n = 1), 9% (n = 3), and 7% (n = 3), respectively. On multivariate analysis, predischarge SAVV regurgitation grade was the only significant predictor of adverse events (odds ratio = 8.2, 95% confidence interval: 1.1-63.8, P = .045). Overall outcomes in this challenging population are good. The single factor associated with adverse events was predischarge SAVV regurgitation grade.

  7. Surgical treatment of partial atrioventricular septal defect: functional analysis of the mitral valve in the postoperative period

    Directory of Open Access Journals (Sweden)

    Josué Viana Castro Neto

    2002-11-01

    Full Text Available OBJECTIVE: To study mitral valve function in the postoperative period after correction of the partial form of atrioventricular septal defect. METHODS: Fifty patients underwent surgical correction of the partial form of atrioventricular septal defect. Their mean age was 11.8 years and 62% of the patients were males. Preoperative echocardiography showed moderate and severe mitral insufficiency in 44% of the patients. The mitral valve cleft was sutured in 45 (90% patients (group II - GII. Echocardiographies were performed in the early postoperative period, and 6 and 12 months after hospital discharge. RESULTS: The patients who had some type of arrhythmia in the postoperative period had ostium primum atrial septal defect of a larger size (2.74 x 2.08 cm. All 5 patients in group I (GI, who did not undergo closure of the cleft, had a competent mitral valve or mild mitral insufficiency in the preoperative period. One of these patients began to have moderate mitral insufficiency in the postoperative period. On the other hand, in GII, 88.8% and 82.2% of the patients had competent mitral valve or mild mitral insufficiency in the early and late postoperative periods, respectively. CONCLUSION: The mitral valve cleft was repaired in 90% of cases. Echocardiography revealed competent mitral valve or mild mitral insufficiency in 88.8% and 82.2% of GII patients in the early and late postoperative periods, respectively.

  8. Blending of styrene-block-butadiene-block-styrene copolymer with sulfonated vinyl aromatic polymers

    NARCIS (Netherlands)

    Ruggeri, Giacomo; Passaglia, Elisa; Giorgi, Ivan; Picchioni, Francesco; Aglietto, Mauro

    2001-01-01

    Different polymers containing sulfonic groups attached to the phenyl rings were prepared by sulfonation of polystyrene (PS) and styrene-block-(ethylene-co-1-butene)-block-styrene (SEBS). The sulfonation degree (SD) was varied between 1 and 20 mol% of the styrene units. Polyphase materials containing

  9. Blending of styrene-block-butadiene-block-styrene copolymer with sulfonated vinyl aromatic polymers

    NARCIS (Netherlands)

    Ruggeri, Giacomo; Passaglia, Elisa; Giorgi, Ivan; Picchioni, Francesco; Aglietto, Mauro

    2001-01-01

    Different polymers containing sulfonic groups attached to the phenyl rings were prepared by sulfonation of polystyrene (PS) and styrene-block-(ethylene-co-1-butene)-block-styrene (SEBS). The sulfonation degree (SD) was varied between 1 and 20 mol% of the styrene units. Polyphase materials containing

  10. Complete AV-block secondary to lithium-clozapine therapy and relapsing multiple sclerosis in a bipolar patient.

    Science.gov (United States)

    Gabeler, Edward E E; van Miltenburg, Addy J M

    2011-12-01

    A complete atrioventricular block (CAVB) can be a lethal complication when it is not treated directly with isoprenaline and pacemaker therapy. The overall incidence of CAVB varies between 4 to 8 per cent with a mortality OR of 3.2 within 30 days if untreated. Main causes of CAVB are inferior myocardial infarction, congenital AV node malformation, mitral valve insufficiency and valve surgery, metabolic disorders and intoxications. The authors describe a case with a CAVB due to lithium-clozapine therapy and relapsing multiple sclerosis.

  11. Vagi and dual atrioventricular nodal physiology%迷走神经与房室结双径路研究进展

    Institute of Scientific and Technical Information of China (English)

    马晓华; 徐海

    2012-01-01

    Atrioventricular nodal reentrant tachycardia is a kind of clinically paroxysmal supraventricular tachycardia, anatomically based on dual atrioventricular nodal physiology ( DAVNP ). Studies in the recent years find that there are plenty of vagi in the slow pathway area of DAVNP, affecting the clinical and electrophysiological characteristics of DAVNP. An insight into the relationship of DAVNP with vagi is significant for the diagnosis and treatment of the problem.%房室结折返性心动过速(atrioventricular nodal reentry tachycardia,AVNRT)是临床上常见的阵发性室上性心动过速的类型之一,其解剖基础为房室结双径路(dual atrioventricular nodal physiology,DAVNP).近年来研究发现DAVNP的慢径路区域分布有丰富的迷走神经,影响DAVNP的临床表现及电生理性质.深入了解迷走神经与DAVNP的关系对临床诊断和治疗具有重要的意义.

  12. Atrial and ventricular activation sequence after ventricular induction/entrainment pacing during fast-slow atrioventricular nodal reentrant tachycardia: New insight into the use of V-A-A-V for the differential diagnosis of supraventricular tachycardia.

    Science.gov (United States)

    Kaneko, Yoshiaki; Nakajima, Tadashi; Irie, Tadanobu; Iizuka, Takashi; Tamura, Shuntaro; Kurabayashi, Masahiko

    2017-06-10

    The atrial and ventricular response observed immediately after cessation of ventricular induction/entrainment pacing is commonly analyzed to discriminate atrial tachycardia from other supraventricular tachycardias during electrophysiologic studies. However, the response in fast-slow atrioventricular nodal reentrant tachycardia (F/S-AVNRT) remains poorly investigated. The purpose of this study was to analyze the atrial and ventricular activation patterns after ventricular pacing in F/S-AVNRT. We enrolled 28 patients with F/S-AVNRT incorporating a typical slow pathway (typ-F/S-AVNRT) and 9 patients with F/S-AVNRT incorporating a superior slow pathway (sup-F/S-AVNRT). The V-A-A-V response was observed in 14 patients (38%) with F/S-AVNRT, more commonly in patients with sup-F/S-AVNRT than in those with typ-F/S-AVNRT (89% vs 21%, P = .0003). The underlying mechanisms included (1) a double atrial response (DAR) in 13 patients; (2) an anterograde block at the lower common pathway once after ventricular pacing in 2 patients; and (3) a pseudo-A-A-V response in 2 patients. The DAR was characterized by a V-A-A-V interatrial interval that was 55 ± 60 ms shorter than the tachycardia cycle length, whereas the block at the lower common pathway or infrahisian block had a V-A-A-V interatrial interval that was almost equal to or longer than the tachycardia cycle length. The V-A-A-V activation sequence immediately after ventricular induction/entrainment pacing is observed in patients with F/S-AVNRT, particularly in patients with sup-F/S-AVNRT, and is caused by multiple mechanisms, including a DAR, which is the major etiology. Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  13. Análise dos fatores de risco na correção cirúrgica do defeito septal atrioventricular de forma total Risk factors analysis in the surgical repair of complete atrioventricular septal defect

    Directory of Open Access Journals (Sweden)

    Eduardo Keller Saadi

    1993-06-01

    Full Text Available Pacientes com defeito septal atrioventricular de forma total (DSAVT freqüentemente apresentam insuficiência cardíaca intratável e hipertensão arterial pulmonar nos primeiros meses de vida, e apenas uma minoria sobrevive sem tratamento cirúrgico precoce. Por essa razão, indica-se a correção definitiva para alterar favoravelmente a história natural da doença. Entretanto, vários fatores são responsáveis pela alta mortalidade cirúrgica. O presente trabalho estuda a experiência na correção cirúrgica do DSAVT com o objetivo de identificar alguns fatores de risco estatisticamente significativos para a ocorrência de morte operatória. Analisaram-se, retrospectivamente, 52 pacientes submetidos, entre janeiro de 1974 e dezembro de 1990, a cirurgia definitiva para correção de DSAVT no Royal Brompton and National Heart and Lung Institute, sendo estudadas as seguintes variáveis: idade, peso, sexo, ano da operação, presença de síndrome de Down, grau de regurgitação da valva AV, bandagem prévia do tronco pulmonar, presença de anomalias associadas, pressão sistólica pulmonar, duplo orifício mitral, classificação do defeito segundo Rastelli, emprego de parada circulatória e técnica de correção (1 x 2 retalhos. Todos os fatores foram avaliados isoladamente, mediante a análise univariada. Para determinar quais os fatores que, independentemente da ação de outros, contribuíram significativamente para maior mortalidade cirúrgica, foi utilizada a análise multivariada com regressão logística. A análise multivariada demonstrou que o baixo peso na época da operação e a técnica de correção com um retalho aumentam significativamente a mortalidade cirúrgica.Patients with complete atrioventricular septal defects (CAVSD frequently present with severe heart failure which cannot be controllable medically and pulmonary hypertension in infancy. Just a small number survives without early surgical treatment. For this reason

  14. Evidence that the degree of obstructive sleep apnea may not increase myocardial ischemia and arrhythmias in patients with stable coronary artery disease

    Directory of Open Access Journals (Sweden)

    Cristiana Marques de Araújo

    2009-03-01

    Full Text Available There is controversy regarding whether obstructive sleep apnea is responsible for triggering myocardial ischemia, arrhythmias and heart rate variability in patients with coronary artery disease. OBJETIVE: The objective of this study was to identify relationships between sleep apnea, myocardial ischemia and cardiac arrhythmia in patients with coronary artery disease. METHODS: Fifty-three patients with stable coronary disease underwent simultaneous polysomnography and electrocardiographic Holter recording. The apnea-hypopnea index (AHI was defined as the number of apneas/hypopneas per hour of sleep. Patients were divided into a Control group (AHI15, n=23 pts and an Apnea group (AHI>15, n=30 pts. A subgroup of 13 patients with an AHI>30 (Severe Apnea group was also studied. We analyzed ischemic episodes (ST-segment depressions >1 mm, > 1 min, heart rate variability and the occurrence of arrhythmias during wakefulness and sleep. RESULTS: Baseline clinical characteristics among the groups were similar except for higher blood pressure in the Apnea groups (p<0.05. Myocardial ischemia was recorded in 39 (73.6% patients. The number and duration of ischemic episodes significantly decreased during sleep in all groups; during wakefulness, patients with severe apnea exhibited fewer and shorter episodes in comparison with the controls. There were no significant differences in heart rate variability or in the occurrence of arrhythmias among the groups. Malignant ventricular arrhythmias, atrial fibrillation/flutter, bradycardia and high-degree atrioventricular blocks were not detected. CONCLUSION: Obstructive sleep apnea was not related to myocardial ischemia, heart rate variability or arrhythmias in patients with stable coronary artery disease and did not alter the circadian pattern of myocardial ischemia.

  15. Pseudo cryomapping for ablation of atrioventricular nodal reentry tachycardia: A single center North American experience

    Directory of Open Access Journals (Sweden)

    Vaibhav K. Moondra

    2017-07-01

    Conclusions: In conclusion, anatomic cryoablation of AVNRT utilizing a 6 mm electrode catheter with mapping performed at −80° Celsius is a safe procedure with good long term efficacy. Transient A-V block during the index procedure increases the risk of late recurrence.

  16. Echocardiographic features defining right dominant unbalanced atrioventricular septal defect: a multi-institutional Congenital Heart Surgeons' Society study.

    Science.gov (United States)

    Cohen, Meryl S; Jegatheeswaran, Anusha; Baffa, Jeanne M; Gremmels, David B; Overman, David M; Caldarone, Christopher A; McCrindle, Brian W; Mertens, Luc

    2013-07-01

    Definition and management of right dominant unbalanced atrioventricular septal defect (AVSD) remains challenging because unbalance entails a spectrum of left heart hypoplasia. Previous work has highlighted atrioventricular valve (AVV) index as a reasonable defining echocardiographic measure. We sought to assess which additional echocardiographic features might provide further characterization. From a multi-institutional cohort of complete AVSD, 52 preoperative echocardiograms of patients with presumed right dominant unbalanced AVSD (based on AVV index) and 60 randomly selected preoperative echocardiograms from patients with presumed balanced AVSD were reviewed. Cluster analysis of echocardiographic variables was used to group patients with similar features. Discriminant function analysis was used to explore which variables differentiated these groups. Three groups were identified from the cluster analysis. Echocardiographic variables that differentiated these groups were right ventricle:left ventricle inflow angle, LV width/LV length, left AVV color diameter at smallest inflow, left AVV color diameter at annulus, right AVV overriding left atrium, and LV width. Based on procedures and outcomes, 1 group likely represented balanced patients, whereas 2 groups with similar outcomes likely represented unbalanced patients. The dominant differentiating echocardiographic variable between the 3 cluster groups was the right ventricle:LV inflow angle (partial R²=0.86), defined as the angle between the base of the right ventricle and LV free wall, using the crest of the ventricular septum as apex of the angle. The angle of right ventricle/LV inflow and other surrogates of inflow may be important defining echocardiographic measures of right dominant unbalanced AVSD, although confirmation is needed.

  17. An Excess of Deleterious Variants in VEGF-A Pathway Genes in Down-Syndrome-Associated Atrioventricular Septal Defects

    Science.gov (United States)

    Ackerman, Christine; Locke, Adam E.; Feingold, Eleanor; Reshey, Benjamin; Espana, Karina; Thusberg, Janita; Mooney, Sean; Bean, Lora J.H.; Dooley, Kenneth J.; Cua, Clifford L.; Reeves, Roger H.; Sherman, Stephanie L.; Maslen, Cheryl L.

    2012-01-01

    About half of people with trisomy 21 have a congenital heart defect (CHD), whereas the remainder have a structurally normal heart, demonstrating that trisomy 21 is a significant risk factor but is not causal for abnormal heart development. Atrioventricular septal defects (AVSD) are the most commonly occurring heart defects in Down syndrome (DS), and ∼65% of all AVSD is associated with DS. We used a candidate-gene approach among individuals with DS and complete AVSD (cases = 141) and DS with no CHD (controls = 141) to determine whether rare genetic variants in genes involved in atrioventricular valvuloseptal morphogenesis contribute to AVSD in this sensitized population. We found a significant excess (p < 0.0001) of variants predicted to be deleterious in cases compared to controls. At the most stringent level of filtering, we found potentially damaging variants in nearly 20% of cases but fewer than 3% of controls. The variants with the highest probability of being damaging in cases only were found in six genes: COL6A1, COL6A2, CRELD1, FBLN2, FRZB, and GATA5. Several of the case-specific variants were recurrent in unrelated individuals, occurring in 10% of cases studied. No variants with an equal probability of being damaging were found in controls, demonstrating a highly specific association with AVSD. Of note, all of these genes are in the VEGF-A pathway, even though the candidate genes analyzed in this study represented numerous biochemical and developmental pathways, suggesting that rare variants in the VEGF-A pathway might contribute to the genetic underpinnings of AVSD in humans. PMID:23040494

  18. Eikonalization of Conformal Blocks

    CERN Document Server

    Fitzpatrick, A Liam; Walters, Matthew T; Wang, Junpu

    2015-01-01

    Classical field configurations such as the Coulomb potential and Schwarzschild solution are built from the $t$-channel exchange of many light degrees of freedom. We study the CFT analog of this phenomenon, which we term the `eikonalization' of conformal blocks. We show that when an operator $T$ appears in the OPE $\\mathcal{O}(x) \\mathcal{O}(0)$, then the large spin $\\ell$ Fock space states $[TT \\cdots T]_{\\ell}$ also appear in this OPE with a computable coefficient. The sum over the exchange of these Fock space states in an $\\langle \\mathcal{O} \\mathcal{O} \\mathcal{O} \\mathcal{O} \\rangle$ correlator build the classical `$T$ field' in the dual AdS description. In some limits the sum of all Fock space exchanges can be represented as the exponential of a single $T$ exchange in the 4-pt correlator of $\\mathcal{O}$. Our results should be useful for systematizing $1/\\ell$ perturbation theory in general CFTs and simplifying the computation of large spin OPE coefficients. As examples we obtain the leading $\\log \\ell$...

  19. Atrioventricular Conduction Delay in the Second Trimester Measured by Fetal Magnetocardiography

    Directory of Open Access Journals (Sweden)

    Annette Wacker-Gussmann

    2014-01-01

    Full Text Available Introduction. Fetal AV block in SSA/Ro pregnancies is generally not seen before 18-week gestation and onset is rare after 28-week gestation. If complete AV block appears, it is believed to be irreversible. The purpose of the study was to evaluate precise electrophysiological AV conduction from 18-week gestation onwards. Patients and Methods. 21 fetuses of pregnant women with collagen vascular diseases were included in the study group and 59 healthy fetuses served as controls. In addition to fetal echocardiography, fetal magnetocardiography (fMCG was used to investigate precise electrophysiological fetal cardiac time intervals (fCTIs. Results. The PR segment (isoelectric segment between the end of the P wave and the start of the QRS complex was significantly prolonged (P<0.036 2nd trimester, P<0.023 3rd trimester in both trimesters within the study group. In fetuses less than 23-week gestational age, a nearly complete separation was found, where a PR segment of 60 ms or greater completely excluded control fetuses. All other fCTIs did not differ significantly. None of the fetuses progressed to a more advanced heart block. Conclusion. Slight antibody effects in pregnancy, leading to PR segment prolongation, can already be seen from 18-week gestation onwards by fMCG. Serial fetal Doppler echocardiography and additional fMCG can be useful methods to measure early and precise AV conduction time, to achieve best surveillance for these high-risk pregnancies.

  20. Total Spinal Block after Thoracic Paravertebral Block.

    Science.gov (United States)

    Beyaz, Serbülent Gökhan; Özocak, Hande; Ergönenç, Tolga; Erdem, Ali Fuat; Palabıyık, Onur

    2014-02-01

    Thoracic paravertebral block (TPVB) can be performed with or without general anaesthesia for various surgical procedures. TPVB is a popular anaesthetic technique due to its low side effect profile and high analgesic potency. We used 20 mL of 0.5% levobupivacaine for a single injection of unilateral TPVB at the T7 level with neurostimulator in a 63 year old patient with co-morbid disease who underwent cholecystectomy. Following the application patient lost consciousness, and was intubated. Haemodynamic instability was normalised with rapid volume replacement and vasopressors. Anaesthetic drugs were stopped at the end of the surgery and muscle relaxant was antagonised. Return of mucle strenght was shown with neuromuscular block monitoring. Approximately three hours after TPVB, spontaneous breathing started and consciousness returned. A total spinal block is a rare and life-threatening complication. A total spinal block is a complication of spinal anaesthesia, and it can also occur after peripheral blocks. Clinical presentation is characterised by hypotension, bradicardia, apnea, and cardiac arrest. An early diagnosis and appropriate treatment is life saving. In this case report, we want to present total spinal block after TPVB.

  1. Generalized Block Failure

    DEFF Research Database (Denmark)

    Jönsson, Jeppe

    2015-01-01

    Block tearing is considered in several codes as a pure block tension or a pure block shear failure mechanism. However in many situations the load acts eccentrically and involves the transfer of a substantial moment in combination with the shear force and perhaps a normal force. A literature study...... yield lines around the block leads to simple interaction formulas similar to other interaction formulas in the codes.......Block tearing is considered in several codes as a pure block tension or a pure block shear failure mechanism. However in many situations the load acts eccentrically and involves the transfer of a substantial moment in combination with the shear force and perhaps a normal force. A literature study...

  2. [Fetal myocarditis associated with maternal anti-Ro and anti-La antibodies in the absence of atrioventricular block with good outcome].

    Science.gov (United States)

    De La Villeon, C-G; Dulac, Y; Ohanessian, G; Ziani, A; Paranon, S; Acar, P

    2010-10-01

    We report a case of fetal myocarditis without conductive abnormality in a pregnant woman with anti-Ro/La antibodies. Fetal echocardiography showed myocarditis with ventricular and valvular hyperechogenicity, which was confirmed by postnatal transthoracic echography. Treatment with dexamethasone (4 mg/day) was started in the 22nd week of gestation. The outcome was good, with the child remaining asymptomatic 2 years later. This observation describes one of the rare forms of fetal myocarditis with favorable outcome.

  3. Inverse Degree and Connectivity

    Institute of Scientific and Technical Information of China (English)

    MA Xiao-ling; TIAN Ying-zhi

    2013-01-01

    Let G be a connected graph with vertex set V(G),order n =丨V(G)丨,minimum degree δ(G) and connectivity κ(G).The graph G is called maximally connected if κ(G) =δ(G).Define the inverse degree of G with no isolated vertices as R(G) =Σv∈V(G)1/d(v),where d(v) denotes the degree of the vertex v.We show that G is maximally connected if R(G) < 1 + 2/δ + n-2δ+1/(n-1)(n-3).

  4. BLOCK H-MATRICES AND SPECTRUM OF BLOCK MATRICES

    Institute of Scientific and Technical Information of China (English)

    黄廷祝; 黎稳

    2002-01-01

    The block H-matrices are studied by the concept of G-functions, several concepts of block matrices are introduced. Equivalent characters of block H-matrices are obtained. Spectrum localizations claracterized by Gfunctions for block matrices are got.

  5. Block TERM factorization of block matrices

    Institute of Scientific and Technical Information of China (English)

    SHE Yiyuan; HAO Pengwei

    2004-01-01

    Reversible integer mapping (or integer transform) is a useful way to realize Iossless coding, and this technique has been used for multi-component image compression in the new international image compression standard JPEG 2000. For any nonsingular linear transform of finite dimension, its integer transform can be implemented by factorizing the transform matrix into 3 triangular elementary reversible matrices (TERMs) or a series of single-row elementary reversible matrices (SERMs). To speed up and parallelize integer transforms, we study block TERM and SERM factorizations in this paper. First, to guarantee flexible scaling manners, the classical determinant (det) is generalized to a matrix function, DET, which is shown to have many important properties analogous to those of det. Then based on DET, a generic block TERM factorization,BLUS, is presented for any nonsingular block matrix. Our conclusions can cover the early optimal point factorizations and provide an efficient way to implement integer transforms for large matrices.

  6. Degree by Thesis

    Science.gov (United States)

    Courtis, Barbara

    1974-01-01

    Discusses a student's experience with a research project on the synthesis and reactions of an organo-platinum complex with an organo-Group IV linkage, including the advantages and disadvantages of such a degree by thesis course. (CC)

  7. Lesson Thirteen Trifascicular Block

    Institute of Scientific and Technical Information of China (English)

    鲁端; 王劲

    2005-01-01

    @@ A complete trifascicular block would result in complete AV block. The idio ventricular rhythm has a slower rate and a wide QRS complex because the pacemaker is located at the peripheral part of the conduction system distal to the sites of the block1. Such a rhythm may be difficult to differentiate from bifascicular or bundle branch block combined with complete block at a higher level such as the AV node or His bundle2. Besides a slower ventricular rate, a change in the morphology of the QRS complex from a previous known bifascicular pattern would be strongly suggestive of a trifascicular origin of the complete AV block3. A His bundle recording is required for a definitive diagnosis, however.

  8. Fast-slow and slow-slow form of atrioventricular nodal reentrant tachycardia sustained by the same reentrant circuit: a case report.

    Science.gov (United States)

    Cantù, Francesco; De Filippo, Paolo; Rordorf, Roberto; De Ferrari, Gaetano M; Frattini, Folco; Petracci, Barbara; Russo, Giovanni; Cerrone, Marina; Landolina, Maurizio

    2005-01-01

    It has been suggested that a reentrant circuit confined to the posterior extensions of the atrioventricular node underlies both fast-slow and slow-slow types of atrioventricular nodal reentrant tachycardia (AVNRT). According to this hypothesis the fast-slow reentrant circuit would be formed by two slow pathways, located in the rightward and leftward posterior extension of the atrioventricular node. Thus, the fast pathway would act as a bystander with respect to the reentrant circuit. We describe the case of a 40-year-old woman with several episodes of palpitations unresponsive to antiarrhythmic drugs. The ECG during symptoms showed a narrow QRS tachycardia with a long ventriculo-atrial interval and a negative P wave in the inferior leads. Electrophysiological study showed the inducibility of a slow-slow AVNRT which rapidly shifted to a fast-slow AVNRT without any change in the duration of the tachycardia cycle. Our observation is in agreement with the hypothesis that the fast-slow reentrant circuit consists of two slow pathways with the fast pathway acting as a bystander.

  9. Who Is at Risk for Heart Block?

    Science.gov (United States)

    ... degree heart block caused by an overly active vagus nerve. You have one vagus nerve on each side of your body. These nerves ... the way to your abdomen. Activity in the vagus nerve slows the heart rate. Rate This Content: NEXT >> ...

  10. Influence of the heart rate and atrioventricular delays on vortex evolution and blood transport inside the left ventricle

    Science.gov (United States)

    Hendabadi, Sahar; Martinez-Legazpi, Pablo; Benito, Yolanda; Bermejo, Javier; Del Alamo, Juan Carlos; Shadden, Shawn

    2013-11-01

    Cardiac resynchronization therapy (CRT) is used to help restore coordinated pumping of the ventricles by overcoming delays in electrical conduction due to cardiac disease. This is accomplished by a specialized cardiac pacemaker that is able to adjust the atrioventricular (AV) delay.A major clinical challenge is to adjust the pacing strategy to best coordinate the blood flow mechanics of ventricular filling and ejection. To this end, we have studied the difference in the vortex formation and its evolution inside the left ventricle (LV) for 4 different AV delays in a cohort of patients with implanted pacemakers. A reconstruction algorithm was used to obtain 2D velocity over the apical long-axis view of the LV from color Doppler and B-mode ultrasound data. To study blood transport, we have identified Lagrangian coherent structures to determine moving boundaries of the blood volumes injected to the LV in diastole and ejected to the aorta in systole. In all cases, we have analyzed the differences in filling and ejection patterns and the blood transport during the E-wave and A-wave formation.Finally we have assessed the influence of the AV delay on 2 indices of stasis, direct flow and residence time.The findings shed insight to the optimization of AV delays in patients undergoing CRT. NIH award 5R21HL108268 and grants PIS09/02603 and RD06/0010 from the Plan Nacional de Investigacion Cientifica, Spain.

  11. Blocked Urethral Valves

    Science.gov (United States)

    ... Blocked Urethral Valves Health Issues Listen Español Text Size Email Print Share Blocked Urethral Valves Page Content Article Body Urine leaves the bladder through a tube called the urethra, which in boys passes through the penis. Rarely, small membranes form across the urethra in ...

  12. Related Drupal Nodes Block

    NARCIS (Netherlands)

    Van der Vegt, Wim

    2010-01-01

    Related Drupal Nodes Block This module exposes a block that uses Latent Semantic Analysis (Lsa) internally to suggest three nodes that are relevant to the node a user is viewing. This module performs three tasks. 1) It periodically indexes a Drupal site and generates a Lsa Term Document Matrix. Inde

  13. Related Drupal Nodes Block

    NARCIS (Netherlands)

    Van der Vegt, Wim

    2010-01-01

    Related Drupal Nodes Block This module exposes a block that uses Latent Semantic Analysis (Lsa) internally to suggest three nodes that are relevant to the node a user is viewing. This module performs three tasks. 1) It periodically indexes a Drupal site and generates a Lsa Term Document Matrix. Inde

  14. ALICE Zero Degree Calorimeter

    CERN Multimedia

    De Marco, N

    2013-01-01

    Two identical sets of calorimeters are located on both sides with respect to the beam Interaction Point (IP), 112.5 m away from it. Each set of detectors consists of a neutron (ZN) and a proton (ZP) Zero Degree Calorimeter (ZDC), positioned on remotely controlled platforms. The ZN is placed at zero degree with respect to the LHC beam axis, between the two beam pipes, while the ZP is positioned externally to the outgoing beam pipe. The spectator protons are separated from the ion beams by means of the dipole magnet D1.

  15. Physics to a degree

    CERN Document Server

    Thomas, EG

    2014-01-01

    Physics to a Degree provides an extensive collection of problems suitable for self-study or tutorial and group work at the level of an undergraduate physics course. This novel set of exercises draws together the core elements of an undergraduate physics degree and provides students with the problem solving skills needed for general physics' examinations and for real-life situations encountered by the professional physicist. Topics include force, momentum, gravitation, Bernoulli's Theorem, magnetic fields, blackbody radiation, relativistic travel, mechanics near the speed of light, radioactive

  16. The Block Neighborhood

    CERN Document Server

    Arrighi, Pablo

    2010-01-01

    We define the block neighborhood of a reversible CA, which is related both to its decomposition into a product of block permutations and to quantum computing. We give a purely combinatorial characterization of the block neighborhood, which helps in two ways. First, it makes the computation of the block neighborhood of a given CA relatively easy. Second, it allows us to derive upper bounds on the block neighborhood: for a single CA as function of the classical and inverse neighborhoods, and for the composition of several CAs. One consequence of that is a characterization of a class of "elementary" CAs that cannot be written as the composition of two simpler parts whose neighborhoods and inverse neighborhoods would be reduced by one half.

  17. Split radius-form blocks for tube benders

    Science.gov (United States)

    Lange, D. R.; Seiple, C. W.

    1970-01-01

    Two-piece, radius-form block permits accurate forming and removing of parts with more than a 180 degree bend. Tube bender can shape flexible metal tubing in applications dealing with plumbing, heating, and pressure transmission lines.

  18. Registered Nurse (Associate Degree).

    Science.gov (United States)

    Ohio State Univ., Columbus. Center on Education and Training for Employment.

    This document, which is designed for use in developing a tech prep competency profile for the occupation of registered nurse (with an associate degree), lists technical competencies and competency builders for 19 units pertinent to the health technologies cluster in general and 5 units specific to the occupation of registered nurse. The following…

  19. One Degree of Separation

    Science.gov (United States)

    Johnson, Jean

    2012-01-01

    A 2011 survey of young adults conducted by Public Agenda found that a cluster of obstacles have prevented many of them from competing college. The author describes the opportunity, college awareness, and funding gaps that put a postsecondary degree out of the reach of so many young people. For example, just 3 in 10 non-college-completers are aware…

  20. 自身抗体相关性先天性心脏传导阻滞1例报告%One case report of autoantibody-associated congenital heart block

    Institute of Scientific and Technical Information of China (English)

    冯宗太; 杨晓路; 杨祖铭; 蔡燕; 王三南

    2015-01-01

    ObjectiveTo explore the pathogenesis, clinical manifestations, diagnosis, and treatment of autoanti-body-associated congenital heart block.MethodsThe clinical data of one child with autoantibody-associated congenital heart block was retrospectively analyzed.ResultsIn 24 week gestation, fetal bradycardia had been found by routine fetal echocar-diography. After birth, the anti-SSA/Ro antibodies and anti-SSB/La antibodies were positive in both infant and her mother. The diagnosis of autoantibody-associated congenital heart block was conifrmed. Intravenous immunoglobulin at 1 g/kg was adminis-trated. At 6 months follow-up, the electrocardiogram suggested type I second degree atrioventricular block.ConclusionIn the fetus or neonates found to have bradycardia and excluded the cardiac structural abnormalities, the autoimmune antibody should been tested and early intervention should been promoted.%目的:探讨自身抗体相关性先天性心脏传导阻滞的发病机制,临床表现及诊断和治疗。方法回顾性分析1例自身抗体相关性先天性心脏传导阻滞患儿的临床资料。结果患儿于24周胎龄时即在超声检查中发现胎儿心动过缓,出生后检测患儿及其母亲的抗SSA/Ro抗体和抗SSB/La抗体均为阳性,确诊为自身抗体相关性先天性心脏传导阻滞,予静脉注射免疫球蛋白1 g/kg治疗。6月龄随访提示仍为Ⅱ度Ⅰ型房室传导阻滞。结论当发现胎儿或新生儿心动过缓且排除心脏结构异常时,应完善自身免疫抗体检查并尽早干预。

  1. Effect of Adductor Canal Block Versus Femoral Nerve Block on Quadriceps Strength, Mobilization, and Pain After Total Knee Arthroplasty

    DEFF Research Database (Denmark)

    Grevstad, Jens Ulrik; Mathiesen, Ole; Valentiner, Laura Risted Staun;

    2015-01-01

    BACKGROUND AND OBJECTIVES: Total knee arthroplasty (TKA) is often associated with severe pain. Different regional anesthetic techniques exist, all with varying degrees of motor blockade. We hypothesized that pain relief provided by the adductor canal block (ACB) could increase functional muscle....... CONCLUSION: Adductor canal block provides a clinically relevant and statistically significant increase in quadriceps muscle strength for patients in severe pain after TKA....

  2. Block copolymer battery separator

    Energy Technology Data Exchange (ETDEWEB)

    Wong, David; Balsara, Nitash Pervez

    2016-04-26

    The invention herein described is the use of a block copolymer/homopolymer blend for creating nanoporous materials for transport applications. Specifically, this is demonstrated by using the block copolymer poly(styrene-block-ethylene-block-styrene) (SES) and blending it with homopolymer polystyrene (PS). After blending the polymers, a film is cast, and the film is submerged in tetrahydrofuran, which removes the PS. This creates a nanoporous polymer film, whereby the holes are lined with PS. Control of morphology of the system is achieved by manipulating the amount of PS added and the relative size of the PS added. The porous nature of these films was demonstrated by measuring the ionic conductivity in a traditional battery electrolyte, 1M LiPF.sub.6 in EC/DEC (1:1 v/v) using AC impedance spectroscopy and comparing these results to commercially available battery separators.

  3. Hawaii Census 2000 Blocks

    Data.gov (United States)

    U.S. Environmental Protection Agency — This data layer represents Census 2000 demographic data derived from the PL94-171 redistricting files and SF3. Census geographic entities include blocks, blockgroups...

  4. Using the Stern Blocks.

    Science.gov (United States)

    Stern, Margaret

    1987-01-01

    Extracts from "Experimenting with Numbers" by Margaret Stern demonstrate the use of Stern Blocks to develop the conceptual base on which learning disabled students can build further mathematical skills. (DB)

  5. Steroidal neuromuscular blocking agents

    NARCIS (Netherlands)

    Wierda, JMKH; Mori, K; Ohmura, A; Toyooka, H; Hatano, Y; Shingu, K; Fukuda, K

    1998-01-01

    Since 1964 approximately 20 steroidal neuromuscular blocking agents have been evaluated clinically. Pancuronium, a bisquaternary compound designed on the drawingboard, was the first steroidal relaxant introduced into clinical practice worldwide in the 1970's. Although a major improvement, pancuroniu

  6. Block copolymer battery separator

    Science.gov (United States)

    Wong, David; Balsara, Nitash Pervez

    2016-04-26

    The invention herein described is the use of a block copolymer/homopolymer blend for creating nanoporous materials for transport applications. Specifically, this is demonstrated by using the block copolymer poly(styrene-block-ethylene-block-styrene) (SES) and blending it with homopolymer polystyrene (PS). After blending the polymers, a film is cast, and the film is submerged in tetrahydrofuran, which removes the PS. This creates a nanoporous polymer film, whereby the holes are lined with PS. Control of morphology of the system is achieved by manipulating the amount of PS added and the relative size of the PS added. The porous nature of these films was demonstrated by measuring the ionic conductivity in a traditional battery electrolyte, 1M LiPF.sub.6 in EC/DEC (1:1 v/v) using AC impedance spectroscopy and comparing these results to commercially available battery separators.

  7. Recipient block TMA technique.

    Science.gov (United States)

    Mirlacher, Martina; Simon, Ronald

    2010-01-01

    New high-throughput screening technologies have led to the identification of hundreds of genes with a potential role in cancer or other diseases. One way to prioritize the leads obtained in such studies is to analyze a large number of tissues for candidate gene expression. The TMA methodology is now an established and frequently used tool for high-throughput tissue analysis. The recipient block technology is the "classical" method of TMA making. In this method, minute cylindrical tissue punches typically measuring 0.6 mm in diameter are removed from donor tissue blocks and are transferred into empty "recipient" paraffin blocks. Up to 1,000 different tissues can be analyzed in one TMA block. The equipment is affordable and easy to use in places where basic skills in histology are available.

  8. Superalloy Lattice Block Structures

    Science.gov (United States)

    Nathal, M. V.; Whittenberger, J. D.; Hebsur, M. G.; Kantzos, P. T.; Krause, D. L.

    2004-01-01

    Initial investigations of investment cast superalloy lattice block suggest that this technology will yield a low cost approach to utilize the high temperature strength and environmental resistance of superalloys in lightweight, damage tolerant structural configurations. Work to date has demonstrated that relatively large superalloy lattice block panels can be successfully investment cast from both IN-718 and Mar-M247. These castings exhibited mechanical properties consistent with the strength of the same superalloys measured from more conventional castings. The lattice block structure also accommodates significant deformation without failure, and is defect tolerant in fatigue. The potential of lattice block structures opens new opportunities for the use of superalloys in future generations of aircraft applications that demand strength and environmental resistance at elevated temperatures along with low weight.

  9. Block Cipher Analysis

    DEFF Research Database (Denmark)

    Miolane, Charlotte Vikkelsø

    ensurethat no attack violatesthe securitybounds specifiedbygeneric attack namely exhaustivekey search and table lookup attacks. This thesis contains a general introduction to cryptography with focus on block ciphers and important block cipher designs, in particular the Advanced Encryption Standard...... by an analytic and systematic approach that allows insight to the techniques. Moreover a new procedure of generating and applying probabilistic equations in algebraic attacks on block cipher is proposed and examined. Also, we present practical results, which to our knowledge are the best algebraic results...... on small scale variants of AES. In the final part of the thesis we present a new block cipher proposal Present and examine its security against algebraic and differential cryptanalysis in particular....

  10. Left ventricular atrioventricular plane displacement is preserved with lifelong endurance training and is the main determinant of maximal cardiac output.

    Science.gov (United States)

    Steding-Ehrenborg, Katarina; Boushel, Robert C; Calbet, José A; Åkeson, Per; Mortensen, Stefan P

    2015-12-01

    Age-related decline in cardiac function can be prevented or postponed by lifelong endurance training. However, effects of normal ageing as well as of lifelong endurance exercise on longitudinal and radial contribution to stroke volume are unknown. The aim of this study was to determine resting longitudinal and radial pumping in elderly athletes, sedentary elderly and young sedentary subjects. Furthermore, we aimed to investigate determinants of maximal cardiac output in elderly. Eight elderly athletes (63 ± 4 years), seven elderly sedentary (66 ± 4 years) and ten young sedentary subjects (29 ± 4 years) underwent cardiac magnetic resonance imaging. All subjects underwent maximal exercise testing and for elderly subjects maximal cardiac output during cycling was determined using a dye dilution technique. Longitudinal and radial contribution to stroke volume did not differ between groups (longitudinal left ventricle (LV) 52-65%, P = 0.12, right ventricle (RV) 77-87%, P = 0.16, radial 7.9-8.6%, P = 1.0). Left ventricular atrioventricular plane displacement (LVAVPD) was higher in elderly athletes and young sedentary compared with elderly sedentary subjects (14 ± 3, 15 ± 2 and 11 ± 1 mm, respectively, P cardiac output (R(2) = 0.61, P Longitudinal and radial contributions to stroke volume did not differ between groups. However, how longitudinal pumping was achieved differed; elderly athletes and young sedentary subjects showed similar AVPD whereas this was significantly lower in elderly sedentary subjects. Elderly sedentary subjects achieved longitudinal pumping through increased short-axis area of the ventricle. Large AVPD was a determinant of maximal cardiac output and exercise capacity.

  11. Differential displaying of mRNAs from the atrioventricular region of developing chicken hearts at stages 15 and 21.

    Science.gov (United States)

    Wang, D Z; Hu, X; Lin, J L; Kitten, G T; Solursh, M; Lin, J J

    1996-01-01

    In an effort to isolate novel genes that may be involved in the development of the cardiac cushions and then the formation of cardiac valves and septa, we utilized the differential mRNA display method in conjunction with the whole-mount in situ hybridization. The total RNAs used to differentially display were prepared from atrioventricular (AV) canal regions of stage 15 and stage 21 chicken hearts because critical events known to be important for the AV valve and septum formation occur during this period of the development. We have successfully obtained 14 potential candidate genes. Three examples, 15H16 (phospholamban), E13 (skeletal alpha-tropomyosin) and 21C (a novel gene), are discussed here. Levels of mRNA expression in developing hearts were determined by Northern blot analysis and their expression patterns were revealed and compared using whole-mount in situ hybridization. Both phospholamban and skeletal alpha-tropomyosin messages in the myocardium of the AV canal region showed significant decrease during this period of the development. The 21C differential display product detects a novel 9.5 Kb message whose expression is cardiac-specific at early stages of development. The expression level of the 21C gene appeared to be increased from stage 15 to stages 21 and 25 as determined by both Northern blot analysis and in situ hybridization. From these data, we demonstrate that the differential display method together with the whole-mount in situ hybridization could be an effective means for the isolation of novel and differentially expressed genes.

  12. De Novo and Rare Variants at Multiple Loci Support the Oligogenic Origins of Atrioventricular Septal Heart Defects

    Science.gov (United States)

    Priest, James R.; Osoegawa, Kazutoyo; Mohammed, Nebil; Nanda, Vivek; Kundu, Ramendra; Schultz, Kathleen; Girirajan, Santhosh; Scheetz, Todd; Waggott, Daryl; Haddad, Francois; Reddy, Sushma; Bernstein, Daniel; Burns, Trudy; Steimle, Jeffrey D.; Yang, Xinan H.; Moskowitz, Ivan P.; Hurles, Matthew; Lifton, Richard P.; Nickerson, Debbie; Bamshad, Michael; Eichler, Evan E.; Mital, Seema; Sheffield, Val; Quertermous, Thomas; Gelb, Bruce D.; Portman, Michael; Ashley, Euan A.

    2016-01-01

    Congenital heart disease (CHD) has a complex genetic etiology, and recent studies suggest that high penetrance de novo mutations may account for only a small fraction of disease. In a multi-institutional cohort surveyed by exome sequencing, combining analysis of 987 individuals (discovery cohort of 59 affected trios and 59 control trios, and a replication cohort of 100 affected singletons and 533 unaffected singletons) we observe variation at novel and known loci related to a specific cardiac malformation the atrioventricular septal defect (AVSD). In a primary analysis, by combining developmental coexpression networks with inheritance modeling, we identify a de novo mutation in the DNA binding domain of NR1D2 (p.R175W). We show that p.R175W changes the transcriptional activity of Nr1d2 using an in vitro transactivation model in HUVEC cells. Finally, we demonstrate previously unrecognized cardiovascular malformations in the Nr1d2tm1-Dgen knockout mouse. In secondary analyses we map genetic variation to protein-interaction networks suggesting a role for two collagen genes in AVSD, which we corroborate by burden testing in a second replication cohort of 100 AVSDs and 533 controls (p = 8.37e-08). Finally, we apply a rare-disease inheritance model to identify variation in genes previously associated with CHD (ZFPM2, NSD1, NOTCH1, VCAN, and MYH6), cardiac malformations in mouse models (ADAM17, CHRD, IFT140, PTPRJ, RYR1 and ATE1), and hypomorphic alleles of genes causing syndromic CHD (EHMT1, SRCAP, BBS2, NOTCH2, and KMT2D) in 14 of 59 trios, greatly exceeding variation in control trios without CHD (p = 9.60e-06). In total, 32% of trios carried at least one putatively disease-associated variant across 19 loci,suggesting that inherited and de novo variation across a heterogeneous group of loci may contribute to disease risk. PMID:27058611

  13. De Novo and Rare Variants at Multiple Loci Support the Oligogenic Origins of Atrioventricular Septal Heart Defects.

    Directory of Open Access Journals (Sweden)

    James R Priest

    2016-04-01

    Full Text Available Congenital heart disease (CHD has a complex genetic etiology, and recent studies suggest that high penetrance de novo mutations may account for only a small fraction of disease. In a multi-institutional cohort surveyed by exome sequencing, combining analysis of 987 individuals (discovery cohort of 59 affected trios and 59 control trios, and a replication cohort of 100 affected singletons and 533 unaffected singletons we observe variation at novel and known loci related to a specific cardiac malformation the atrioventricular septal defect (AVSD. In a primary analysis, by combining developmental coexpression networks with inheritance modeling, we identify a de novo mutation in the DNA binding domain of NR1D2 (p.R175W. We show that p.R175W changes the transcriptional activity of Nr1d2 using an in vitro transactivation model in HUVEC cells. Finally, we demonstrate previously unrecognized cardiovascular malformations in the Nr1d2tm1-Dgen knockout mouse. In secondary analyses we map genetic variation to protein-interaction networks suggesting a role for two collagen genes in AVSD, which we corroborate by burden testing in a second replication cohort of 100 AVSDs and 533 controls (p = 8.37e-08. Finally, we apply a rare-disease inheritance model to identify variation in genes previously associated with CHD (ZFPM2, NSD1, NOTCH1, VCAN, and MYH6, cardiac malformations in mouse models (ADAM17, CHRD, IFT140, PTPRJ, RYR1 and ATE1, and hypomorphic alleles of genes causing syndromic CHD (EHMT1, SRCAP, BBS2, NOTCH2, and KMT2D in 14 of 59 trios, greatly exceeding variation in control trios without CHD (p = 9.60e-06. In total, 32% of trios carried at least one putatively disease-associated variant across 19 loci,suggesting that inherited and de novo variation across a heterogeneous group of loci may contribute to disease risk.

  14. Postoperative follow up of patients with complete atrioventricular septal defect%完全性房室间隔缺损修补术后随访分析

    Institute of Scientific and Technical Information of China (English)

    肖婷婷; 李奋; 黄美蓉; 余志庆; 杨健萍; 陈笋; 张志芳

    2009-01-01

    Objective To observe the operative efficacy of patients with complete atrioventricular septal defect (CAVSD). Methods From January 2003 to June 2006, CAVSD patients underwent operative closure were included in this study. Color Doppler with apical four-chamber view was used to evaluate the degree of valve insufficiency before surgery and 2 days, 1 month, 6 months and 1 year after the surgery. Cardiac catheterization was performed to evaluate pulmonary artery pressure and pulmonary arteriolar resistance (PAR) before surgery in patients whose age were over 6 months. The time of staying at ICU, ventilation time after surgery and the occurrence of pulmonary artery hypertension crisis were recorded. Results 105 CAVSD patients underwent operative closure were enrolled in this study. The mean staying time at ICU was (4.7±2.4) days, and the mean ventilation time was (1.7±1.0) days, 9 patients (8.5%) developed pulmonary artery hypertension crisis after surgery. Patients with PAR > 8 Wood unit were older, staying time at ICU and ventilation time were longer compared patients with PAR 8 Wood unit compared patients with PAR 8 Wood unit was associated with increased risk of pulmonary artery hypertension crisis after surgery in patients with CAVSD.%目的 探讨完全性房室间隔缺损修补术的疗效.方法 对2003年1月至2006年6月行完全性房室间隔缺损修补术患儿进行随访分析.通过超声心动图心尖四腔切面评估术前,术后第2天、1个月、6个月及1年的房室瓣反流程度.大于6个月患儿术前行心导管检查了解肺动脉压力及肺小动脉阻力(PAR).记录术后监护时间、呼吸机使用时间及肺动脉高压危象发生情况.结果 105例完全性房室间隔缺损患儿术后监护(4.7±2.4)d,呼吸机使用(1.7±1.0)d,出现肺动脉高压危象9例(8.5%).PAR>8 Wood单位患儿与PAR≤8 Wood单位患儿比较,年龄较大,术后监护时间、呼吸机维持时间较长,肺动脉高

  15. Slickenside developed in chert block

    Science.gov (United States)

    Ando, J.; Hayasaka, Y.; Nishiwaki, T.

    2011-12-01

    We observe the microstructures of slickenside developed in chert block mainly with a TEM, in order to clarify generation mechanism of the slickenside. This chert block occurs in the Jurassic accretionary complex in eastern Yamaguchi Prefecture, Japan. The complex, chaotic sediment, is composed of allochthonous blocks, mainly of chert, limestone, sandstone and mudstone in the argillaceous matrix. The color of the undeformed chert is pale blue to white, while the surface of slickenside is black. The stereo microscopy indicates the top surface of slickenside is covered with a transparent material, whose composition is mainly Si, measured by EPMA. The striation is well developed on the transparent-Si-material. We made thin sections, parallel and perpendicular to striation and slickenside, respectively. On the thin sections, the elongated quartz grains are oriented obliquely to the slickenside with 20-30 degree. Many fluid inclusions, which represent healed microcracks, are observed within the quartz grains. These quartz grains show strong undulose extinction and bulging-recrystallization. Apatite grains are also observed as a main constituent mineral. We made TEM foils from the above thin section by FIB. TEM observation indicates the amorphous layer with several ten nanometers in width distributes along the slickenside. (We speculate the most part of the amorphous layer are taken away during polishing of the thin section, because the strength of the amorphous layer is weak. Therefore we now make thin section again with care.) The tangled dislocations are developed within the quartz grains. They make subgrains with ca. 1 micrometer in size. These results suggest the slickenside was generated by the frictional melting of quartz grains on slip plane under very high stress condition, same as pseudotachylyte.

  16. Genetics progress on atrioventricular septal defect%先天性房室间隔缺损的遗传学进展

    Institute of Scientific and Technical Information of China (English)

    李晓维

    2011-01-01

    先天性房室间隔缺损(atrioventricular sepial defect,AVSD)是一种常见的心血管畸形,由于存在房室间隔(房间隔下部、室间隔上部)以及中央心内膜垫组织的缺损,造成左右心腔之间的异常交通.虽然AVSD的胚胎学、病理生理学以及诊断和治疗目前都已基本阐明,但其确切的发病机制仍无突破性进展.随着分子生物学技术的广泛应用以及分子遗传学研究的深入开展,AVSD在遗传学的研究中取得一系列新进展,一些基因被证实与AVSD的发生发展存在一定的相关性.%Atrioventricular septal defect (AVSD) is a common cardiovascular malformation because of atrioventricular septal (lower atrial septum, ventricular septal upper) and the endocardial cushion defect,resulting in abnormal chambers of the heart. At the present, although the embryology, pathophysiology,diagnosis and treatment of the AVSD are clarified, but its precise pathogenesis has still no breakthrough progress.With the wide application of molecular biology and the depth research of molecular genetics, a series of new progress about AVSD has been made in the genetic study, and some genes are confirmed to be related to the occurrence and development of AVSD. The aim of this article is to review and discuss genetic mechanisms and related genes of AVSD, and to further identify the major genes causing AVSD.

  17. Application of dual-source CT in diagnosis of common atrioventricular canal%双源CT在共同房室通道诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    冯越; 刘铁; 翟利浩

    2012-01-01

    目的 探讨双源CT(DSCT)在共同房室通道(CAC)诊断中的应用价值.方法 选取9例CAC患儿,采用DSCT心电门控下对比增强完成心脏检查,并在图像工作站完成多平面(MPR)、最大密度投影(MIP)和三维容积漫游(VR)处理.同期所有患儿均完成超声心动图检查.比较两种检查方法的诊断结果.结果 DSCT均作出CAC诊断,共发现合并畸形29处;超声心动图亦均作出CAC诊断,共发现合并畸形16处.结论 DSCT可以对CAC患儿作出准确诊断,较之超声心动图能发现更多合并畸形,有助于临床手术方案的制定与完善.%Objective To evaluate the clinical values of dual-source CT (DSCT) in diagnosis of common atrioventricular canal. Methods Nine children aged 135 days to 6 y with common atrioventricular canal (CAC) underwent dual-source cardiac CT scan. Two- and three-dimensional images were processed by means of MPR (coronal, sagital and oblique), MIP and VR. E-chocardiography was performed in all cases at same time; and 2 cases received surgical treatment. Results DSCT confirmed diagnosis of CAC in all 9 cases. DSCT revealed 29 concomitant anomalies and echocardiography revealed 16 in all 9 cases. Conclusion DSCT can confirm diagnosis of common atrioventricular canal, which contributes to the planning of operation and better surgical outcomes of patients.

  18. Modified Senning Procedure for Correction of Atrioventricular Discordance With Total Anomalous Pulmonary Venous Return, Atrial Situs Inversus, Dextrocardia, and Bilateral Superior Venae Cavae.

    Science.gov (United States)

    Sebastian, Vinod A; Guleserian, Kristine J; Juraszek, Amy; Kane, Colin; Hamzeh, Rabih; Forbess, Joseph M

    2015-10-01

    The Senning and Mustard baffles remain important techniques for the treatment of congenitally corrected transposition (cc-TGA), isolated ventricular inversion, and D-transposition of the great arteries with delayed presentation. We describe the treatment of an 8-month old infant with atrioventricular discordance, ventriculoarterial concordance, and dextrocardia with atrial situs inversus. A modified Senning procedure was performed through the "left-sided" atrium. Modifications of the Senning and Mustard baffles remain important tools in the treatment of rare conditions like isolated ventricular inversion.

  19. Construction of cardiac atrioventricular electrical conduction pathway by rabbit bone marrow mesenchymal stem cells%兔骨髓间充质干细胞构建心脏电传导通路的潜能

    Institute of Scientific and Technical Information of China (English)

    周浩粤; 卢炯斌; 邱汉婴

    2014-01-01

    into cardiomyocyte-like cells. After thoracotomy, the left atrium-left ventricular anterior wal was sutured in 14 New Zealand white rabbits (8 in the experimental group and 6 in the control group). One month after the surgery, in the experimental group, autologous bone marrow mesenchymal stem cells induced by 5-azacytidine for 4 weeks were labeled with 4',6-diamidino-2-phenylindole and then injected into the suture area when opening the thoracic again. In the control group, cells cultured in medium were used. One month after celltransplantation, the third thoracotomy was done to insert electrodes into the left atrium and left ventricular anterior wal , for cardiac electrophysiological detection. Whether atrioventricular pathway formed in the suture area was observed. RESULTS AND CONCLUSION:After cells were transplanted into the sutured area, two rabbits in the experimental group were discovered to form the atrioventricular pathway in the sutured area through cardiac electrophysiological examination. After transplantation, transplanted cells were visible on the heart frozen sections under fluorescence microscope in the left ventricle and sutured area, but there was no cellin the control group. In the experimental group, bone marrow mesenchymal stem cells expressed Cx43 and formed gap junction intercellular communication with cardiomyocytes, which was presented as formation of the atrioventricular pathway on cardiac electrophysiology examination. These findings indicate that bone marrow mesenchymal stem cells can be used to treat cardiac conduction system block diseases.

  20. When Graduate Degrees Prostitute the Educational Process: Degrees Gone Wild

    Science.gov (United States)

    Lumadue, Richard T.

    2006-01-01

    Graduate degrees prostitute the educational process when they are sold to consumers by unaccredited degree/diploma mills as being equivalent to legitimate, bona-fide degrees awarded by accredited graduate schools. This article carefully analyzes the serious problems of bogus degrees and their association with the religious higher education…

  1. Right bundle branch block

    DEFF Research Database (Denmark)

    Bussink, Barbara E; Holst, Anders Gaarsdal; Jespersen, Lasse

    2013-01-01

    AimsTo determine the prevalence, predictors of newly acquired, and the prognostic value of right bundle branch block (RBBB) and incomplete RBBB (IRBBB) on a resting 12-lead electrocardiogram in men and women from the general population.Methods and resultsWe followed 18 441 participants included.......5%/2.3% in women, P Right bundle branch block was associated with significantly...... increased all-cause and cardiovascular mortality in both genders with age-adjusted hazard ratios (HR) of 1.31 [95% confidence interval (CI), 1.11-1.54] and 1.87 (95% CI, 1.48-2.36) in the gender pooled analysis with little attenuation after multiple adjustment. Right bundle branch block was associated...

  2. 31 CFR 547.302 - Blocked account; blocked property.

    Science.gov (United States)

    2010-07-01

    .... 547.302 Section 547.302 Money and Finance: Treasury Regulations Relating to Money and Finance... SANCTIONS REGULATIONS General Definitions § 547.302 Blocked account; blocked property. The terms blocked account and blocked property shall mean any account or property subject to the prohibitions in § 547.201...

  3. Exome Sequencing Identifies Compound Heterozygous Mutations in SCN5A Associated with Congenital Complete Heart Block in the Thai Population

    Directory of Open Access Journals (Sweden)

    Chuphong Thongnak

    2016-01-01

    Full Text Available Background. Congenital heart block is characterized by blockage of electrical impulses from the atrioventricular node (AV node to the ventricles. This blockage can be caused by ion channel impairment that is the result of genetic variation. This study aimed to investigate the possible causative variants in a Thai family with complete heart block by using whole exome sequencing. Methods. Genomic DNA was collected from a family consisting of five family members in three generations in which one of three children in generation III had complete heart block. Whole exome sequencing was performed on one complete heart block affected child and one unaffected sibling. Bioinformatics was used to identify annotated and filtered variants. Candidate variants were validated and the segregation analysis of other family members was performed. Results. This study identified compound heterozygous variants, c.101G>A and c.3832G>A, in the SCN5A gene and c.28730C>T in the TTN gene. Conclusions. Compound heterozygous variants in the SCN5A gene were found in the complete heart block affected child but these two variants were found only in the this affected sibling and were not found in other unaffected family members. Hence, these variants in the SCN5A gene were the most possible disease-causing variants in this family.

  4. Modulation by endothelin-1 of spontaneous activity and membrane currents of atrioventricular node myocytes from the rabbit heart.

    Directory of Open Access Journals (Sweden)

    Stéphanie C Choisy

    Full Text Available BACKGROUND: The atrioventricular node (AVN is a key component of the cardiac pacemaker-conduction system. Although it is known that receptors for the peptide hormone endothelin-1 (ET-1 are expressed in the AVN, there is very little information available on the modulatory effects of ET-1 on AVN electrophysiology. This study characterises for the first time acute modulatory effects of ET-1 on AVN cellular electrophysiology. METHODS: Electrophysiological experiments were conducted in which recordings were made from rabbit isolated AVN cells at 35-37°C using the whole-cell patch clamp recording technique. RESULTS: Application of ET-1 (10 nM to spontaneously active AVN cells led rapidly (within ~13 s to membrane potential hyperpolarisation and cessation of spontaneous action potentials (APs. This effect was prevented by pre-application of the ET(A receptor inhibitor BQ-123 (1 µM and was not mimicked by the ET(B receptor agonist IRL-1620 (300 nM. In whole-cell voltage-clamp experiments, ET-1 partially inhibited L-type calcium current (I(Ca,L and rapid delayed rectifier K(+ current (I(Kr, whilst it transiently activated the hyperpolarisation-activated current (I(f at voltages negative to the pacemaking range, and activated an inwardly rectifying current that was inhibited by both tertiapin-Q (300 nM and Ba(2+ ions (2 mM; each of these effects was sensitive to ET(A receptor inhibition. In cells exposed to tertiapin-Q, ET-1 application did not produce membrane potential hyperpolarisation or immediate cessation of spontaneous activity; instead, there was a progressive decline in AP amplitude and depolarisation of maximum diastolic potential. CONCLUSIONS: Acutely applied ET-1 exerts a direct modulatory effect on AVN cell electrophysiology. The dominant effect of ET-1 in this study was activation of a tertiapin-Q sensitive inwardly rectifying K(+ current via ET(A receptors, which led rapidly to cell quiescence.

  5. Radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia guided by magnetic navigation system: a prospective randomized comparison with conventional procedure

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yu-xiao; LU Cai-yi; XUE Qiao; LI Ke; YAN Wei; ZHOU Sheng-hua

    2012-01-01

    Background Atrioventricular nodal reentrant tachycardia (AVNRT) is one of the most common paroxysmal supraventricular tachyarrhythmias.The aim of the study was to prospectively compare the characteristics of radiofrequency catheter ablation of AVNRT guided by a magnetic navigation system with the conventional procedure.Methods Patients with AVNRT diagnosed by electrophysiological tests were randomized into two groups.In the conventional technique group (CMT),a common 4-mm-tip quadrapolar temperature-controlled ablation catheter was used. In the magnetic navigation system guidance group (MNS), a magnetic 4-mm-tip quadrapolar temperature-controlled ablation catheter was used.The following parameters were collected and compared between the two groups: ablation procedure time,patient fluoroscopy time,operator fluoroscopy time,energy delivery numbers,maximal energy per deployment,success rate,complication rate and operative cost.Results Forty patients were enrolled and randomized into CMT and MNS groups.The age,gender,tachycardia history and basic cardiovascular diseases of the two groups were comparable (P >0.05).All procedures were conducted successfully without complications.No tachycardia recurred during the follow-up period of (9.3±2.6) months.In the MNS group,the patient and operator fluoroscopy times ((11.5±4.3) min,(4.2±1.5) min),energy delivery numbers (3.2±0.9),and maximal energy per deployment ((16.9±3.4) W) were shorter or lower than those of the CMT group ((14.3±6.2) min,(13.6±3.5) min,6.3±2.1,(23.7±1.3) W,respectively) (P <0.05).But the operative cost for the MNS group was higher than that of the CMT group (P <0.01 ).Conclusion Magnetic navigation system guided radiofrequency catheter ablation of AVNRT has the advantages of shorter fluoroscopy time and lower energy delivery numbers and maximal energy per deployment compared to the present conventional ablation technique.

  6. Block That Pain!

    Science.gov (United States)

    ... along with the National Institute of Dental and Craniofacial Research (NIDCR) and the National Institute of General Medical Sciences (NIGMS). This finding shows that a specific combination of two molecules can block only pain-related neurons. It holds the promise of major ...

  7. Concrete Block Pavements

    Science.gov (United States)

    1983-03-01

    1967, Cedergren 1974, Federal Highway .’,U .. V,47 -’":: 37 Administration 1980). Block pavements have essentially the same prob- lems with moisture...Vicksburg, Miss. Cedergren , H. R. 1974. Drainage of Highway and Airfield Pavements, John Wiley and Sons, New VOk. I Cement and Concrete Association

  8. TWIN BLOCK (Studi Pustaka

    Directory of Open Access Journals (Sweden)

    Evie Lamtiur

    2015-08-01

    Full Text Available Young patients with class II skeletal malocclusion are often found. To avoid further discrepancy of this case, myofunctional therapy is one of the options. Functional appliance often used for such treatment. Functional appliance has been modified since activator was introduced by Andresen. With its bulky shape, activator makes difficulty for patient to speak and eat. Patient unable to wear it full time due to uncomfortness and negative facial appearance. In 1977, Clark developed twin block to overcome the weakness of previous appliances. A more simple design allows patient to be more comfortable and willing to wear it longer. Twin block is myofunctional appliance to reposition the mandible forward for skeletal class II correction with retruded mandible. This paper describes the design, clinical management effects of twin block treatment and brief case presentation using twin block appliance. Similar to the study reports found, this case revealed improvement of facial appearance, decrease overjet and overbite, improvement of molar relationship and good compliance of patient.

  9. Contaminated soil concrete blocks

    NARCIS (Netherlands)

    Korte, de A.C.J.; Brouwers, H.J.H.; Limbachiya, Mukesh C.; Kew, Hsein Y.

    2009-01-01

    According to Dutch law the contaminated soil needs to be remediated or immobilised. The main focus in this article is the design of concrete blocks, containing contaminated soil, that are suitable for large production, financial feasible and meets all technical and environmental requirements. In ord

  10. Effects of Block Scheduling

    Directory of Open Access Journals (Sweden)

    William R. Veal

    1999-09-01

    Full Text Available This study examined the effects of a tri-schedule on the academic achievement of students in a high school. The tri-schedule consists of traditional, 4x4 block, and hybrid schedules running at the same time in the same high school. Effectiveness of the schedules was determined from the state mandated test of basic skills in reading, language, and mathematics. Students who were in a particular schedule their freshman year were tested at the beginning of their sophomore year. A statistical ANCOVA test was performed using the schedule types as independent variables and cognitive skill index and GPA as covariates. For reading and language, there was no statistically significant difference in test results. There was a statistical difference mathematics-computation. Block mathematics is an ideal format for obtaining more credits in mathematics, but the block format does little for mathematics achievement and conceptual understanding. The results have content specific implications for schools, administrations, and school boards who are considering block scheduling adoption.

  11. [Effectiveness of sympathetic block using various technics].

    Science.gov (United States)

    Weissenberg, W

    1987-07-01

    Blocking of sympathetic conduction aims at permanent or temporary elimination of those pain pathways conducted by the sympathetic nervous system. In order to provide an objective evaluation of sufficient blocking effect, earlier inquiries referred to parameters such as: (1) observation of clinical signs such as Horner's syndrome, Guttman's sign, anhidrosis, extended venous filling; (2) difference in skin temperature of at least 1.5 degrees C between blocked and unblocked side; (3) increase in amplitude of the pulse wave; and (4) depression of the psychogalvanic reflex (PGR) on the blocked side (Fig. 1). In clinical practice, these control parameters are effective because they are time-saving, technically simple, and highly evidential. Further parameters for evaluating sympathetic blockade are examination of hydrosis by means of color indicators such as bromocresol and ninhydrin, oscillometry, and plethysmography. The effectiveness of sympathetic blockade after stellate ganglion and sympathetic trunk blocks has been verified by various authors. In a clinical study, 16 patients were divided into four groups in order to test the effectiveness of sympathetic blockade after spinal anesthesia with 3 ml 0.75% bupivacaine (group I) and 4 ml 0.75% bupivacaine (group II) and after peridural anesthesia with 15 ml 0.75% bupivacaine (group III) and 20 ml 0.75% bupivacaine (group IV) by means of temperature difference, response of pulse wave amplitude and PGR between blocked lower and unblocked upper extremity, and sensory levels of block. The patients were classified as ASA I and II; their ages varied from 20 to 63 years.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Heart block and cardiac embolization of fractured inferior vena cava filter

    Directory of Open Access Journals (Sweden)

    Islam Abudayyeh

    2016-12-01

    Full Text Available Objective: A 66-year-old man underwent a placement of an inferior vena cava filter before a gastric surgery 9 years prior, presented to the emergency room with a complete atrioventricular block. Chest x-ray and transthoracic echocardiogram showed struts migrating to right ventricle with tricuspid regurgitation. Cardiothoracic surgery was consulted and declined an open surgical intervention due to the location of the embolized fragments and the patient’s overall condition. It was also felt that the fragments had migrated chronically and were adhered to the cardiac structures. Methods: The patient underwent a dual-chamber permanent pacemaker implantation. Post-implant fluoroscopy showed no displacement of the inferior vena cava filter struts due to the pacemaker leads indicating that the filter fracture had likely been a chronic process. Results: This case highlights a rare combination of complications related to inferior vena cava filter fractures and the importance of assessing for such fractures in chronic placements. Inferior vena cava filter placement for a duration greater than 1 month can be associated with filter fractures and strut migration which may lead to, although rare, serious or fatal complications such as complete atrioventricular conduction system disruption and valvular damage including significant tricuspid regurgitation. Conclusions: Assessing for inferior vena cava filter fractures in chronic filter placement is important to avoid such complications. When possible, retrieval of the filter should be considered in all patients outside the acute setting in order to avoid filter-related complications. Filter retrieval rates remain low even when a retrievable filter is in place and the patient no longer has a contraindication to anticoagulation.

  13. Degree-degree dependencies in random graphs with heavy-tailed degrees

    NARCIS (Netherlands)

    Hofstad, van der Remco; Litvak, Nelly

    2014-01-01

    Mixing patterns in large self-organizing networks, such as the Internet, the World Wide Web, social, and biological networks are often characterized by degree-degree dependencies between neighboring nodes. In assortative networks, the degree-degree dependencies are positive (nodes with similar degre

  14. Degree-Degree Dependencies in Random Graphs with Heavy-Tailed Degrees

    NARCIS (Netherlands)

    van der Hofstad, Remco; Litvak, Nelli

    2014-01-01

    Mixing patterns in large self-organizing networks, such as the Internet, the World Wide Web, social, and biological networks are often characterized by degree-degree dependencies between neighboring nodes. In assortative networks, the degree-degree dependencies are positive (nodes with similar

  15. Quantitative modeling of degree-degree correlation in complex networks

    CERN Document Server

    Niño, Alfonso

    2013-01-01

    This paper presents an approach to the modeling of degree-degree correlation in complex networks. Thus, a simple function, \\Delta(k', k), describing specific degree-to- degree correlations is considered. The function is well suited to graphically depict assortative and disassortative variations within networks. To quantify degree correlation variations, the joint probability distribution between nodes with arbitrary degrees, P(k', k), is used. Introduction of the end-degree probability function as a basic variable allows using group theory to derive mathematical models for P(k', k). In this form, an expression, representing a family of seven models, is constructed with the needed normalization conditions. Applied to \\Delta(k', k), this expression predicts a nonuniform distribution of degree correlation in networks, organized in two assortative and two disassortative zones. This structure is actually observed in a set of four modeled, technological, social, and biological networks. A regression study performed...

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Abdominal wall blocks in adults

    DEFF Research Database (Denmark)

    Børglum, Jens; Gögenür, Ismail; Bendtsen, Thomas F

    2016-01-01

    Purpose of review Abdominal wall blocks in adults have evolved much during the last decade; that is, particularly with the introduction of ultrasound-guided (USG) blocks. This review highlights recent advances of block techniques within this field and proposes directions for future research.......  Recent findings Ultrasound guidance is now considered the golden standard for abdominal wall blocks in adults, even though some landmark-based blocks are still being investigated. The efficiency of USG transversus abdominis plane blocks in relation to many surgical procedures involving the abdominal wall...... been introduced with success. Future research should also investigate the effect of specific abdominal wall blocks on neuroendocrine and inflammatory stress response after surgery.  Summary USG abdominal wall blocks in adults are commonplace techniques today. Most abdominal wall blocks are assigned...

  18. Recovery from blocking between outcomes.

    Science.gov (United States)

    Wheeler, Daniel S; Miller, Ralph R

    2005-10-01

    Contemporary associative learning research largely focuses on cue competition phenomena that occur when 2 cues are paired with a common outcome. Little research has been conducted to investigate similar phenomena occurring when a single cue is trained with 2 outcomes. Three conditioned lick suppression experiments with rats assessed whether treatments known to alleviate blocking between cues would also attenuate blocking between outcomes. In Experiment 1, conditioned responding recovered from blocking between outcomes when a long retention interval was interposed between training and testing. Experiment 2 obtained recovery from blocking between outcomes when the blocking outcome was extinguished after the blocking treatment. In Experiment 3, a recovery from blocking between outcomes occurred when a reminder stimulus was presented in a novel context prior to testing. Collectively, these studies demonstrate that blocking of outcomes, like blocking of cues, appears to be caused by a deficit in the expression of an acquired association.

  19. SUPERFICIAL CERVICAL PLEXUS BLOCK

    Directory of Open Access Journals (Sweden)

    Komang Mega Puspadisari

    2014-01-01

    Full Text Available Superficial cervical plexus block is one of the regional anesthesia in  neck were limited to thesuperficial fascia. Anesthesia is used to relieve pain caused either during or after the surgery iscompleted. This technique can be done by landmark or with ultrasound guiding. The midpointof posterior border of the Sternocleidomastoid was identified and the prosedure done on thatplace or on the level of cartilage cricoid.

  20. Rethinking the Bachelor Degree Course

    DEFF Research Database (Denmark)

    Toft, Anne Elisabeth; Gammelgaard Nielsen, Anders

    2011-01-01

    The text contains reflections on the background for rethinking the bachelor degree course at the Aarhus School of Architecture.......The text contains reflections on the background for rethinking the bachelor degree course at the Aarhus School of Architecture....

  1. Managing access block.

    Science.gov (United States)

    Cameron, Peter; Scown, Paul; Campbell, Donald

    2002-01-01

    There is pessimism regarding the ability of the Acute Health Sector to manage access block for emergency and elective patients. Melbourne Health suffered an acute bed crisis in 2001 resulting in record ambulance diversions and emergency department (ED) delays. We conducted an observational study to reduce access block for emergency patients whilst maintaining elective throughput at Melbourne Health. This involved a clinician-led taskforce using previously proven principles for organisational change to implement 51 actions to improve patient access over a three-month period. The primary outcome measures were ambulance diversion, emergency patients waiting more than 12 hours for an inpatient bed, elective throughput and theatre cancellations. Despite a reduction in multi-day bed numbers all primary objectives were met, ambulance diversion decreased to minimal levels, 12-hour waits decreased by 40% and elective throughput was maintained. Theatre cancellations were also minimised. We conclude that access block can be improved by clinician-led implementation of proven process improvements over a short time frame. The ability to sustain change over the longer term requires further study.

  2. E-Block: A Tangible Programming Tool with Graphical Blocks

    Directory of Open Access Journals (Sweden)

    Danli Wang

    2013-01-01

    Full Text Available This paper designs a tangible programming tool, E-Block, for children aged 5 to 9 to experience the preliminary understanding of programming by building blocks. With embedded artificial intelligence, the tool defines the programming blocks with the sensors as the input and enables children to write programs to complete the tasks in the computer. The symbol on the programming block's surface is used to help children understanding the function of each block. The sequence information is transferred to computer by microcomputers and then translated into semantic information. The system applies wireless and infrared technologies and provides user with feedbacks on both screen and programming blocks. Preliminary user studies using observation and user interview methods are shown for E-Block's prototype. The test results prove that E-Block is attractive to children and easy to learn and use. The project also highlights potential advantages of using single chip microcomputer (SCM technology to develop tangible programming tools for children.

  3. Foundation Degrees: A Risky Business?

    Science.gov (United States)

    Rowley, Jennifer

    2005-01-01

    Purpose: Foundation degrees, the new proposal for sub-degree vocational education in the UK, are characterised by innovation both in their design (curriculum, teaching, learning and assessment) and in the marketplace for which they are designed. This article argues that the development and delivery of foundation degrees carry a high level of risk,…

  4. Demographic Data - MDC_Block

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — A polygon feature class of Miami-Dade Census 2000 Blocks. Census blocks are areas bounded on all sides by visible and/or invisible features shown on a map prepared...

  5. Demographic Data - MDC_Block

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — A polygon feature class of Miami-Dade Census 2000 Blocks. Census blocks are areas bounded on all sides by visible and/or invisible features shown on a map prepared...

  6. Ear - blocked at high altitudes

    Science.gov (United States)

    High altitudes and blocked ears; Flying and blocked ears; Eustachian tube dysfunction - high altitude ... eustachian tube is a connection between the middle ear (the space deep to the eardrum) and the ...

  7. Habitat Blocks and Wildlife Corridors

    Data.gov (United States)

    Vermont Center for Geographic Information — Habitat blocks are areas of contiguous forest and other natural habitats that are unfragmented by roads, development, or agriculture. Vermonts habitat blocks are...

  8. Degree-degree correlations in random graphs with heavy-tailed degrees

    NARCIS (Netherlands)

    Litvak, Nelli; van der Hofstad, Remco

    2012-01-01

    We investigate degree-degree correlations for scale-free graph sequences. The main conclusion of this paper is that the assortativity coefficient is not the appropriate way to describe degree-dependences in scale-free random graphs. Indeed, we study the infinite volume limit of the assortativity

  9. Degree-degree correlations in random graphs with heavy-tailed degrees

    NARCIS (Netherlands)

    Litvak, Nelli; van der Hofstad, Remco

    2012-01-01

    We investigate degree-degree correlations for scale-free graph sequences. The main conclusion of this paper is that the assortativity coefficient is not the appropriate way to describe degree-dependences in scale-free random graphs. Indeed, we study the infinite volume limit of the assortativity coe

  10. BLOCK BASED NEWTON-LIKE BLENDING INTERPOLATION

    Institute of Scientific and Technical Information of China (English)

    Qian-jin Zhao; Jie-qing Tan

    2006-01-01

    Newton's polynomial interpolation may be the favourite linear interpolation in the sense that it is built up by means of the divided differences which can be calculated recursively and produce useful intermediate results. However Newton interpolation is in fact point based interpolation since a new interpolating polynomial with one more degree is obtained by adding a new support point into the current set of support points once at a time. In this paper we extend the point based interpolation to the block based interpolation. Inspired by the idea of the modern architectural design, we first divide the original set of support points into some subsets (blocks), then construct each block by using whatever interpolation means, linear or rational and finally assemble these blocks by Newton's method to shape the whole interpolation scheme. Clearly our method offers many flexible interpolation schemes for choices which include the classical Newton's polynomial interpolation as its special case. A bivariate analogy is also discussed and numerical examples are given to show the effectiveness of our method.

  11. Origem das artérias dos nós sinoatrial e atrioventricular em população do sul da Índia: um estudo angiográfico Origen de las arterias de los nódulos sinusal y atrioventricular en población del Sur de la India: un estudio angiográfico Origin of the sinoatrial and atrioventricular nodal arteries in South Indians: an angiographic study

    Directory of Open Access Journals (Sweden)

    Lakshmi Ramanathan

    2009-05-01

    Full Text Available FUNDAMENTO: Estudar o suprimento arterial do sistema condutor e sua correlação com a dominância das artérias coronárias em população do sul da Índia. OBJETIVO: Determinar angiograficamente as origens da artéria do nó sinoatrial (AnSA e artéria do nó atrioventricular (AnAV em indianos. MÉTODOS: O ESTudo incluiu 300 pacientes consecutivos (114 do sexo feminino e 186 do sexo masculino; idade média, 55 anos, habitantes da região costeira ao sul da Índia, submetidos a cineangiocoronariografia devido a sintomas como dor no peito, angina pectoris ou teste ergométrico positivo. As angiografias incluíram ambas as artérias coronárias (direita e esquerda em posição oblíqua anterior direita e esquerda. A origem da AnSA e AnAV a partir das artérias coronárias foi observada e correlacionada à dominância arterial. RESULTADOS: O nó SA (sinoatrial recebeu suprimento pela artéria coronária direita (ACD em 53% dos casos, pelo ramo circunflexo (Cx da artéria coronária esquerda (ACE em 42,66% dos casos, e em 4,33% dos casos esse nó foi irrigado por ambas as artérias coronárias. O nó AV (atrioventricular também recebeu suprimento sanguíneo com mais frequência da ACD (72,33% dos casos do que do ramo Cx da ACE (27,66%. Surpreendentemente, em nenhum caso este nó recebeu suprimento de ambas as artérias coronárias. CONCLUSÃO: Os Resultados do presente estudo podem auxiliar os cirurgiões cardíacos, sobretudo em cirurgias relacionadas a valvopatias, devido à franca proximidade entre os ramos nodais e o complexo valvar.FUNDAMENTO: Estudiar el suministro arterial del sistema conductor y su correlación con la dominancia de las arterias coronarias en población del Sur de la India. OBJETIVO: Determinar angiográficamente los orígenes de la arteria del nódulo sinusal (AnSA y la arteria del nódulo atrioventricular (AnAV en indios. MÉTODOS: El estudio incluyó 300 pacientes consecutivos (114 del sexo femenino y 186 del sexo

  12. Appropriate schemata and building blocks

    Institute of Scientific and Technical Information of China (English)

    Yang Haijun; Li Minqiang

    2005-01-01

    Appropriate schemata as a novel concept to characterize building blocks are introduced, and then, the traits of appropriate schemata are presented. The effects of building blocks by search operators are analyzed. Hence, the experiments on RR-8X8 are employed to verify that appropriate schemata construct the building blocks. The validity of appropriate schemata and building blocks from the views of theory and practice is presented.

  13. Properties of blocked linear systems.

    Science.gov (United States)

    Chen, Weitian; Anderson, Brian D O; Deistler, Manfred; Filler, Alexander

    2012-10-01

    This paper presents a systematic study on the properties of blocked linear systems that have resulted from blocking discrete-time linear time invariant systems. The main idea is to explore the relationship between the blocked and the unblocked systems. Existing results are reviewed and a number of important new results are derived. Focus is given particularly on the zero properties of the blocked system as no such study has been found in the literature.

  14. Porous block nanofiber composite filters

    Energy Technology Data Exchange (ETDEWEB)

    Ginley, David S.; Curtis, Calvin J.; Miedaner, Alexander; Weiss, Alan J.; Paddock, Arnold

    2016-08-09

    Porous block nano-fiber composite (110), a filtration system (10) and methods of using the same are disclosed. An exemplary porous block nano-fiber composite (110) includes a porous block (100) having one or more pores (200). The porous block nano-fiber composite (110) also includes a plurality of inorganic nano-fibers (211) formed within at least one of the pores (200).

  15. Graduate Physics Degrees: Largest Departments and Degree Distribution. Focus On

    Science.gov (United States)

    Mulvey, Patrick J.; Nicholson, Starr

    2014-01-01

    In the 2011-12 academic year there were 751 degree-granting physics departments in the U.S. Of these, 195 offered a PhD and 62 departments offered a master's as the highest physics degree. The remaining 494 departments offered a bachelor's as their highest physics degree. There were six universities that had two doctoral-granting physics…

  16. Method of forming oriented block copolymer line patterns, block copolymer line patterns formed thereby, and their use to form patterned articles

    Energy Technology Data Exchange (ETDEWEB)

    Russell, Thomas P.; Hong, Sung Woo; Lee, Dong Hyun; Park, Soojin; Xu, Ting

    2017-08-01

    A block copolymer film having a line pattern with a high degree of long-range order is formed by a method that includes forming a block copolymer film on a substrate surface with parallel facets, and annealing the block copolymer film to form an annealed block copolymer film having linear microdomains parallel to the substrate surface and orthogonal to the parallel facets of the substrate. The line-patterned block copolymer films are useful for the fabrication of magnetic storage media, polarizing devices, and arrays of nanowires.

  17. Counting equations in algebraic attacks on block ciphers

    DEFF Research Database (Denmark)

    Knudsen, Lars Ramkilde; Miolane, Charlotte Vikkelsø

    2010-01-01

    This paper is about counting linearly independent equations for so-called algebraic attacks on block ciphers. The basic idea behind many of these approaches, e.g., XL, is to generate a large set of equations from an initial set of equations by multiplication of existing equations by the variables...... independent equations which can be generated in algebraic attacks within each of these sets of a certain degree. While this does not give us a direct formula for the success of algebraic attacks on block ciphers, it gives some interesting bounds on the number of equations one can obtain from a given block...... to the algebraic attacks as defined here....

  18. Property Blocks: Games and Activities.

    Science.gov (United States)

    Humphreys, Alan, Ed.; Dailey, Jean, Ed.

    This pamphlet describes the property blocks produced by MINNEMAST, and discusses their use in the development of thinking processes. Classification systems, including block diagrams and tree diagrams, are discussed. Sixteen classroom activities and eleven games which use the blocks are described. Suggestions to the teacher for further reading are…

  19. Humanoid by ROBO-BLOCK

    Science.gov (United States)

    Niimi, Hirofumi; Koike, Minoru; Takeuchi, Seiichi; Douhara, Noriyoshi

    2007-12-01

    Humanoid by ROBO-BLOCK (robot block system) and the rational formula of robots were proposed. ROBO-BLOCK is composed of servo motors, the parts for servomotor rotor, the brackets for servomotor fixation, the board parts and the controllers. A robot can be assembled easily by ROBO-BLOCK. Meanwhile, it is convenient when the structure of the robot can be described easily as a character. The whole structure of the robot is expressed as rational formula of the robot to show molecule structure in chemistry. ROBO-BLOCK can be useful for not only the research but also the education. Creative student experiment was done in the college of industrial technology.

  20. Degree Depreciation: A Fait Accompli for the Liberal Arts Degree

    Science.gov (United States)

    Duplass, James A.

    1976-01-01

    The liberal arts degree will continue to lack the credibility needed to compete with professional school degrees in the job market unless a return is made to rigourous standards, subjective tests, term papers, comprehensive exams, improvement in instructional methods, and more stringent curriculum requirements for foreign language, composition,…

  1. Heart block following topical latanoprost treatment

    Science.gov (United States)

    De Smit, Elisabeth; Theodorou, Maria; Hildebrand, Göran Darius; Bloom, Philip

    2011-01-01

    The authors report a case of second degree heart block associated with topical latanoprost treatment. The authors discuss the possibility of a causative effect as the cessation of this treatment resulted in improvement of the arrhythmia. The authors highlight previous reports and research in humans and animals which demonstrate an association of arrhythmias with prostaglandin analogues. This report draws attention to the possibility that an extremely commonly prescribed topical drug may trigger arrhythmias in susceptible individuals. It is important that prescribers are aware of this possible side-effect. PMID:22679164

  2. Atomic Basic Blocks

    Science.gov (United States)

    Scheler, Fabian; Mitzlaff, Martin; Schröder-Preikschat, Wolfgang

    Die Entscheidung, einen zeit- bzw. ereignisgesteuerten Ansatz für ein Echtzeitsystem zu verwenden, ist schwierig und sehr weitreichend. Weitreichend vor allem deshalb, weil diese beiden Ansätze mit äußerst unterschiedlichen Kontrollflussabstraktionen verknüpft sind, die eine spätere Migration zum anderen Paradigma sehr schwer oder gar unmöglich machen. Wir schlagen daher die Verwendung einer Zwischendarstellung vor, die unabhängig von der jeweils verwendeten Kontrollflussabstraktion ist. Für diesen Zweck verwenden wir auf Basisblöcken basierende Atomic Basic Blocks (ABB) und bauen darauf ein Werkzeug, den Real-Time Systems Compiler (RTSC) auf, der die Migration zwischen zeit- und ereignisgesteuerten Systemen unterstützt.

  3. Spintronics: Conceptual Building Blocks

    Science.gov (United States)

    Ansermet, J.-Ph.

    The purpose of this introduction to spintronics is to provide some elementary description of its conceptual building blocks. Thus, it is intended for a newcomer to the field. After recalling rudimentary descriptions of spin precession and spin relaxation, spin-dependent transport is treated within the Boltzmann formalism. This suffices to introduce key notions such as the spin asymmetry of the conductivities in the two-current model, the spin diffusion length, and spin accumulation. Two basic mechanisms of spin relaxation are then presented, one arising from spin-orbit scattering and the other from electron-magnon collisions. Finally, the action of a spin-polarized current on magnetization is presented in a thermodynamics framework. This introduces the notion of spin torque and the characteristic length scale over which the transverse spin polarization of conduction electron decays as it is injected into a magnet.

  4. Rotating ice blocks

    Science.gov (United States)

    Dorbolo, Stephane; Adami, Nicolas; Grasp Team

    2014-11-01

    The motion of ice discs released at the surface of a thermalized bath was investigated. As observed in some rare events in the Nature, the discs start spinning spontaneously. The motor of this motion is the cooling of the water close to the ice disc. As the density of water is maximum at 4°C, a downwards flow is generated from the surface of the ice block to the bottom. This flow generates the rotation of the disc. The speed of rotation depends on the mass of the ice disc and on the temperature of the bath. A model has been constructed to study the influence of the temperature of the bath. Finally, ice discs were put on a metallic plate. Again, a spontaneous rotation was observed. FNRS is thanked for financial support.

  5. Photovoltaic building blocks

    DEFF Research Database (Denmark)

    Hanberg, Peter Jesper; Jørgensen, Anders Michael

    2014-01-01

    it directcompetitive with fossil energy sources a further reduction is needed. By increasing the efficiency of the solar cells one gain an advantage through the whole chain of cost. So that per produced Watt of power less material is spent, installation costs are lower, less area is used etc. With an average...... efficiency of about 15% for commercial Silicon solar cells there is still much to gain. DTU Danchip provides research facilities, equipment and expertise for the building blocks that comprises fabricating the efficient solar cell. In order to get more of the sun light into the device we provide thin film......Photovoltaics (PV), better known as solar cells, are now a common day sight on many rooftops in Denmark.The installed capacity of PV systems worldwide is growing exponentially1 and is the third most importantrenewable energy source today. The cost of PV is decreasing fast with ~10%/year but to make...

  6. Research Degrees as Professional Education?

    Science.gov (United States)

    Barnacle, Robyn; Dall'Alba, Gloria

    2011-01-01

    There is an increasing trend within higher education and, more specifically, in higher degrees by research, to treat a professional skills set as a desirable graduate outcome. The increasing value that is being placed on a professional skills set in large part reflects growing interest around the world in the role of research degrees in labour…

  7. Perpendicularly Aligned, Anion Conducting Nanochannels in Block Copolymer Electrolyte Films

    Energy Technology Data Exchange (ETDEWEB)

    Arges, Christopher G.; Kambe, Yu; Suh, Hyo Seon; Ocola, Leonidas E.; Nealey, Paul F.

    2016-03-08

    Connecting structure and morphology to bulk transport properties, such as ionic conductivity, in nanostructured polymer electrolyte materials is a difficult proposition because of the challenge to precisely and accurately control order and the orientation of the ionic domains in such polymeric films. In this work, poly(styrene-block-2-vinylpyridine) (PSbP2VP) block copolymers were assembled perpendicularly to a substrate surface over large areas through chemical surface modification at the substrate and utilizing a versatile solvent vapor annealing (SVA) technique. After block copolymer assembly, a novel chemical vapor infiltration reaction (CVIR) technique selectively converted the 2-vinylpyridine block to 2-vinyl n-methylpyridinium (NMP+ X-) groups, which are anion charge carriers. The prepared block copolymer electrolytes maintained their orientation and ordered nanostructure upon the selective introduction of ion moieties into the P2VP block and post ion-exchange to other counterion forms (X- = chloride, hydroxide, etc.). The prepared block copolymer electrolyte films demonstrated high chloride ion conductivities, 45 mS cm(-1) at 20 degrees C in deionized water, the highest chloride ion conductivity for anion conducting polymer electrolyte films. Additionally, straight-line lamellae of block copolymer electrolytes were realized using chemoepitaxy and density multiplication. The devised scheme allowed for precise and accurate control of orientation of ionic domains in nanostructured polymer electrolyte films and enables a platform for future studies that examines the relationship between polymer electrolyte structure and ion transport.

  8. The mappings of degree 1

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available The maps of the form f( x = ∑ i=1 n a i ⋅x⋅ b i , called 1-degree maps, are introduced and investigated. For noncommutative algebras and modules over them 1-degree maps give an analogy of linear maps and differentials. Under some conditions on the algebra 𝒜 , contractibility of the group of 1-degree isomorphisms is proved for the module l 2 ( 𝒜 . It is shown that these conditions are fulfilled for the algebra of linear maps of a finite-dimensional linear space. The notion of 1-degree map gives a possibility to define a nonlinear Fredholm map of l 2 ( 𝒜 and a Fredholm manifold modelled by l 2 ( 𝒜 . 1-degree maps are also applied to some problems of Markov chains.

  9. HadISST (1-degree)/HadISST (1-degree)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Monthly version of HadISST sea surface temperature component (1-degree). See Rayner, N. A., Parker, D. E., Horton, E. B., Folland, C. K., Alexander, L. V., Rowell,...

  10. Large Block Test Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Lin, W

    2001-12-01

    This report documents the Large-Block Test (LBT) conducted at Fran Ridge near Yucca Mountain, Nevada. The LBT was a thermal test conducted on an exposed block of middle non-lithophysal Topopah Spring tuff (Tptpmn) and was designed to assist in understanding the thermal-hydrological-mechanical-chemical (THMC) processes associated with heating and then cooling a partially saturated fractured rock mass. The LBT was unique in that it was a large (3 x 3 x 4.5 m) block with top and sides exposed. Because the block was exposed at the surface, boundary conditions on five of the six sides of the block were relatively well known and controlled, making this test both easier to model and easier to monitor. This report presents a detailed description of the test as well as analyses of the data and conclusions drawn from the test. The rock block that was tested during the LBT was exposed by excavation and removal of the surrounding rock. The block was characterized and instrumented, and the sides were sealed and insulated to inhibit moisture and heat loss. Temperature on the top of the block was also controlled. The block was heated for 13 months, during which time temperature, moisture distribution, and deformation were monitored. After the test was completed and the block cooled down, a series of boreholes were drilled, and one of the heater holes was over-cored to collect samples for post-test characterization of mineralogy and mechanical properties. Section 2 provides background on the test. Section 3 lists the test objectives and describes the block site, the site configuration, and measurements made during the test. Section 3 also presents a chronology of events associated with the LBT, characterization of the block, and the pre-heat analyses of the test. Section 4 describes the fracture network contained in the block. Section 5 describes the heating/cooling system used to control the temperature in the block and presents the thermal history of the block during the test

  11. Degree-degree correlations in directed networks with heavy-tailed degrees

    NARCIS (Netherlands)

    Hoorn, van der Pim; Litvak, Nelly

    2013-01-01

    In network theory, Pearson's correlation coefficients are most commonly used to measure the degree assortativity of a network. We investigate the behavior of these coefficients in the setting of directed networks with heavy-tailed degree sequences. We prove that for graphs where the in- and out-degr

  12. Degree-degree dependencies in directed networks with heavy-tailed degrees

    NARCIS (Netherlands)

    Hoorn, van der Pim; Litvak, Nelly

    2015-01-01

    In network theory, Pearson’s correlation coefficients are most commonly used to measure the degree assortativity of a network. We investigate the behavior of these coefficients in the setting of directed networks with heavy-tailed degree sequences. We prove that for graphs where the in- and out-degr

  13. Dimensional Reduction for Conformal Blocks

    CERN Document Server

    Hogervorst, Matthijs

    2016-01-01

    We consider the dimensional reduction of a CFT, breaking multiplets of the d-dimensional conformal group SO(d+1,1) up into multiplets of SO(d,1). This leads to an expansion of d-dimensional conformal blocks in terms of blocks in d-1 dimensions. In particular, we obtain a formula for 3d conformal blocks as an infinite sum over 2F1 hypergeometric functions with closed-form coefficients.

  14. Killing Horizons Kill Horizon Degrees

    Science.gov (United States)

    Bergamin, L.; Grumiller, D.

    Frequently, it is argued that the microstates responsible for the Bekenstein-Hawking entropy should arise from some physical degrees of freedom located near or on the black hole horizon. In this essay, we elucidate that instead entropy may emerge from the conversion of physical degrees of freedom, attached to a generic boundary, into unobservable gauge degrees of freedom attached to the horizon. By constructing the reduced phase space, it can be demonstrated that such a transmutation indeed takes place for a large class of black holes, including Schwarzschild.

  15. Killing horizons kill horizon degrees

    CERN Document Server

    Bergamin, L

    2006-01-01

    Frequently it is argued that the microstates responsible for the Bekenstein-Hawking entropy should arise from some physical degrees of freedom located near or on the black hole horizon. In this Essay we elucidate that instead entropy may emerge from the conversion of physical degrees of freedom, attached to a generic boundary, into unobservable gauge degrees of freedom attached to the horizon. By constructing the reduced phase space it can be demonstrated that such a transmutation indeed takes place for a large class of black holes, including Schwarzschild.

  16. Reliability computation from reliability block diagrams

    Science.gov (United States)

    Chelson, P. O.; Eckstein, E. Y.

    1975-01-01

    Computer program computes system reliability for very general class of reliability block diagrams. Four factors are considered in calculating probability of system success: active block redundancy, standby block redundancy, partial redundancy, and presence of equivalent blocks in the diagram.

  17. Common blocks for ASQS(12

    Directory of Open Access Journals (Sweden)

    Lorenzo Milazzo

    1997-05-01

    Full Text Available An ASQS(v is a particular Steiner system featuring a set of v vertices and two separate families of blocks, B and G, whose elements have a respective cardinality of 4 and 6. It has the property that any three vertices of X belong either to a B-block or to a G-block. The parameter cb is the number of common blocks in two separate ASQSs, both defined on the same set of vertices X . In this paper it is shown that cb ≤ 29 for any pair of ASQSs(12.

  18. Ultrasound guided distal peripheral nerve block of the upper limb: A technical review

    Directory of Open Access Journals (Sweden)

    Herman Sehmbi

    2015-01-01

    Full Text Available Upper extremity surgery is commonly performed under regional anesthesia. The advent of ultrasonography has made performing upper extremity nerve blocks relatively easy with a high degree of reliability. The proximal approaches to brachial plexus block such as supraclavicular plexus block, infraclavicular plexus block, or the axillary block are favored for the most surgical procedures of distal upper extremity. Ultrasound guidance has however made distal nerve blocks of the upper limb a technically feasible, safe and efficacious option. In recent years, there has thus been a resurgence of distal peripheral nerve blocks to facilitate hand and wrist surgery. In this article, we review the technical aspects of performing the distal blocks of the upper extremity and highlight some of the clinical aspects of their usage.

  19. A multicast dynamic wavelength assignment algorithm based on matching degree

    Institute of Scientific and Technical Information of China (English)

    WU Qi-wu; ZHOU Xian-wei; WANG Jian-ping; YIN Zhi-hong; ZHANG Long

    2009-01-01

    The wavelength assignment with multiple multicast requests in fixed routing WDM network is studied. A new multicast dynamic wavelength assignment algorithm is presented based on matching degree. First, the wavelength matching degree between available wavelengths and multicast routing trees is introduced into the algorithm. Then, the wavelength assign-ment is translated into the maximum weight matching in bipartite graph, and this matching problem is solved by using an extended Kuhn-Munkres algorithm. The simulation results prove that the overall optimal wavelength assignment scheme is obtained in polynomial time. At the same time, the proposed algorithm can reduce the connecting blocking probability and improve the system resource utilization.

  20. Adductor Canal Block versus Femoral Nerve Block and Quadriceps Strength

    DEFF Research Database (Denmark)

    Jæger, Pia Therese; Nielsen, Zbigniew Jerzy Koscielniak; Henningsen, Lene Marianne;

    2013-01-01

    : The authors hypothesized that the adductor canal block (ACB), a predominant sensory blockade, reduces quadriceps strength compared with placebo (primary endpoint, area under the curve, 0.5-6 h), but less than the femoral nerve block (FNB; secondary endpoint). Other secondary endpoints were...

  1. Region 9 Census Block 2010

    Science.gov (United States)

    Geography:The TIGER Line Files are feature classes and related database files (.) that are an extract of selected geographic and cartographic information from the U.S. Census Bureau's Master Address File / Topologically Integrated Geographic Encoding and Referencing (MAF/TIGER) Database (MTDB). The MTDB represents a seamless national file with no overlaps or gaps between parts, however, each TIGER Line File is designed to stand alone as an independent data set, or they can be combined to cover the entire nation. Census Blocks are statistical areas bounded on all sides by visible features, such as streets, roads, streams, and railroad tracks, and/or by non visible boundaries such as city, town, township, and county limits, and short line-of-sight extensions of streets and roads. Census blocks are relatively small in area; for example, a block in a city bounded by streets. However, census blocks in remote areas are often large and irregular and may even be many square miles in area. A common misunderstanding is that data users think census blocks are used geographically to build all other census geographic areas, rather all other census geographic areas are updated and then used as the primary constraints, along with roads and water features, to delineate the tabulation blocks. As a result, all 2010 Census blocks nest within every other 2010 Census geographic area, so that Census Bureau statistical data can be tabulated at the block level and aggregated up t

  2. Block storage subsystem performance analysis

    CERN Document Server

    CERN. Geneva

    2016-01-01

    You feel that your service is slow because of the storage subsystem? But there are too many abstraction layers between your software and the raw block device for you to debug all this pile... Let's dive on the platters and check out how the block storage sees your I/Os! We can even figure out what those patterns are meaning.

  3. The Effectiveness of Block Scheduling.

    Science.gov (United States)

    Creamean, Sharon Lightle; Horvath, Robert Jeffery

    This report describes a program for the exploration of block scheduling. The targeted population consists of high school students in a growing, middle-class community, located in a suburban setting of a large mid-western city. The historical background of block scheduling is documented through data gathered using attendance reports, student…

  4. Four-block beam collimator

    CERN Multimedia

    1977-01-01

    The photo shows a four-block collimator installed on a control table for positioning the alignment reference marks. Designed for use with the secondary beams, the collimators operated in vacuum conditions. The blocks were made of steel and had a standard length of 1 m. The maximum aperture had a square coss-section of 144 cm2. (See Annual Report 1976.)

  5. Block Transfer Agreement Evaluation Project

    Science.gov (United States)

    Bastedo, Helena

    2010-01-01

    The objective of this project is to evaluate for the British Columbia Council on Admissions and Transfer (BCCAT) the effectiveness of block transfer agreements (BTAs) in the BC Transfer System and recommend steps to be taken to improve their effectiveness. Findings of this study revealed that institutions want to expand block credit transfer;…

  6. OPAL Various Lead Glass Blocks

    CERN Multimedia

    These lead glass blocks were part of a CERN detector called OPAL (one of the four experiments at the LEP particle detector). OPAL uses some 12 000 blocks of glass like this to measure particle energies in the electromagnetic calorimeter. This detector measured the energy deposited when electrons and photons were slowed down and stopped.

  7. The wild tapered block bootstrap

    DEFF Research Database (Denmark)

    Hounyo, Ulrich

    In this paper, a new resampling procedure, called the wild tapered block bootstrap, is introduced as a means of calculating standard errors of estimators and constructing confidence regions for parameters based on dependent heterogeneous data. The method consists in tapering each overlapping block...

  8. On degree-degree correlations in multilayer networks

    CERN Document Server

    de Arruda, Guilherme Ferraz; Moreno, Yamir; Rodrigues, Francisco A

    2015-01-01

    We propose a generalization of the concept of assortativity based on the tensorial representation of multilayer networks, covering the definitions given in terms of Pearson and Spearman coefficients. Our approach can also be applied to weighted networks and provides information about correlations considering pairs of layers. By analyzing the multilayer representation of the airport transportation network, we show that contrasting results are obtained when the layers are analyzed independently or as an interconnected system. Finally, we study the impact of the level of assortativity and heterogeneity between layers on the spreading of diseases. Our results highlight the need of studying degree-degree correlations on multilayer systems, instead of on aggregated networks.

  9. On degree-degree correlations in multilayer networks

    Science.gov (United States)

    de Arruda, Guilherme Ferraz; Cozzo, Emanuele; Moreno, Yamir; Rodrigues, Francisco A.

    2016-06-01

    We propose a generalization of the concept of assortativity based on the tensorial representation of multilayer networks, covering the definitions given in terms of Pearson and Spearman coefficients. Our approach can also be applied to weighted networks and provides information about correlations considering pairs of layers. By analyzing the multilayer representation of the airport transportation network, we show that contrasting results are obtained when the layers are analyzed independently or as an interconnected system. Finally, we study the impact of the level of assortativity and heterogeneity between layers on the spreading of diseases. Our results highlight the need of studying degree-degree correlations on multilayer systems, instead of on aggregated networks.

  10. Defeito total do septo atrioventricular. Correlação anatomofuncional entre pacientes com e sem síndrome de Down

    Directory of Open Access Journals (Sweden)

    Ferrín Liliana María

    1997-01-01

    Full Text Available OBJETIVO: Comparar o grau de repercussão, fatores responsáveis e época de aparecimento dos sintomas do defeito do septo atrioventricular (DSAV, em pacientes com e sem síndrome de Down. MÉTODOS: Foram estudados 80 pacientes com idade 50mmHg ocorreu em 56% dos casos do GI em relação a 28% do GII p<0,019. A evolução até a cirurgia foi instável (agravamentos da insuficiência cardíaca em 33 (60% do GI e em 21 (84% do GII p<0,03. O tipo A de Rastelli foi o mais encontrado nos dois grupos, 35 (67% pacientes no GI e nos 25 (100% do GII. A alteração anatômica da VAV foi importante em 8% no GI e em 38% no GII. CONCLUSÃO: Há sugestão de predominância de hiper-reatividade vascular pulmonar nas crianças com síndrome de Down e de manifestações de insuficiência cardíaca nas geneticamente normais.

  11. [Partial closure of the atrial septal primum defect and biventricular repair for a case of hypoplastic right ventricle with partial atrioventricular canal defect].

    Science.gov (United States)

    Oshima, Y; Yamaguchi, M; Imai, M; Ohashi, H; Tsukube, T; Hosokawa, Y

    1990-11-01

    An eight-year-old girl with partial atrioventricular canal defect and hypoplastic right ventricle was treated successfully by a palliative open-heart surgery. The preoperative right ventricular pressure was 58/7 mmHg (RVP/LVP = 0.67) and morphology of the right ventricle showed severe tricuspid stenosis and small outflow portion. The preoperative RVEDVI was 31 (41% of normal and tricuspid annulus was 17 mm (47% of normal). The right ventricular outflow was reconstructed with insertion of MVOP and the ASD was partially left open (the amplitude of the interatrial communication was 7 mm). Angiocardiogram two and half years after the operation demonstrated significant right ventricular growth with no right to left shunt through interatrial communication. The RVEDVI was 46 (56% of normal) and tricuspid annulus was 36 mm (90% of normal). This technique can be a procedure of choice in patient with right ventricular hypoplasia, who is not candidate for simple right ventricular reconstruction nor Fontan procedure, as the growth of the right ventricule is expected in the future.

  12. 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.

  13. Conformal Nets II: Conformal Blocks

    Science.gov (United States)

    Bartels, Arthur; Douglas, Christopher L.; Henriques, André

    2017-03-01

    Conformal nets provide a mathematical formalism for conformal field theory. Associated to a conformal net with finite index, we give a construction of the `bundle of conformal blocks', a representation of the mapping class groupoid of closed topological surfaces into the category of finite-dimensional projective Hilbert spaces. We also construct infinite-dimensional spaces of conformal blocks for topological surfaces with smooth boundary. We prove that the conformal blocks satisfy a factorization formula for gluing surfaces along circles, and an analogous formula for gluing surfaces along intervals. We use this interval factorization property to give a new proof of the modularity of the category of representations of a conformal net.

  14. Conformal Nets II: Conformal Blocks

    Science.gov (United States)

    Bartels, Arthur; Douglas, Christopher L.; Henriques, André

    2017-08-01

    Conformal nets provide a mathematical formalism for conformal field theory. Associated to a conformal net with finite index, we give a construction of the `bundle of conformal blocks', a representation of the mapping class groupoid of closed topological surfaces into the category of finite-dimensional projective Hilbert spaces. We also construct infinite-dimensional spaces of conformal blocks for topological surfaces with smooth boundary. We prove that the conformal blocks satisfy a factorization formula for gluing surfaces along circles, and an analogous formula for gluing surfaces along intervals. We use this interval factorization property to give a new proof of the modularity of the category of representations of a conformal net.

  15. Non-Linear Material Three Degree of Freedom Analysis of Submarine Drydock Blocking System

    Science.gov (United States)

    1988-05-01

    TEST FOR KEEL ELOCK LIFTOFF 1 612 1 613 if (flag6.eq. ) then 1 614 go to 450 1 615 else if (rf3. it.O ) then 1 616 time6=dtau*(1-l) 1 617 f1.ag6:1 1 618... flt3 -)3,:) i .-ico: Obs -8500$ 1 .S 0 Q0: * 0 .9ZX - .mE - r -?9m0e.m m5!1 4C tr,4 c .󈧙𔃾%E -!. jC 6 05 X S43: ;- ’ 0:ZJ,, c A: EtX’ BL : = 2 EB

  16. Life after a Humanities Degree

    Science.gov (United States)

    Masola, Athambile

    2016-01-01

    This article explores the experiences of a humanities graduate after leaving the academy. The author considers her own education in light of the historical changes in South Africa's education system. The article is a personal account of the questions and challenges encountered in choosing a humanities degree in a context where a tertiary education…

  17. Aerospace Technology (Aerospace Engineering Degree)

    OpenAIRE

    Tiseira Izaguirre, Andrés Omar; Blanco Rodríguez, David; Carreres Talens, Marcos; Fajardo Peña, Pablo

    2013-01-01

    Apuntes de la asignatura Tecnología Aeroespacial Tiseira Izaguirre, AO.; Blanco Rodríguez, D.; Carreres Talens, M.; Fajardo Peña, P. (2013). Aerospace Technology (Aerospace Engineering Degree). Editorial Universitat Politècnica de València. http://hdl.handle.net/10251/35263.

  18. The Top Theological Degree Producers

    Science.gov (United States)

    Diverse: Issues in Higher Education, 2012

    2012-01-01

    Each year, "Diverse: Issues in Higher Education" publishes a list of the Top 100 producers of associate, bachelor's and graduate degrees awarded to minority students based on research conducted by Dr. Victor M. H. Borden, professor of educational leadership and policy studies at Indiana University Bloomington. This year, for the first…

  19. Real Analytic Machines and Degrees

    CERN Document Server

    Gärtner, Tobias; 10.4204/EPTCS.24.12

    2010-01-01

    We study and compare in two degree-theoretic ways (iterated Halting oracles analogous to Kleene's arithmetical hierarchy and the Borel hierarchy of descriptive set theory) the capabilities and limitations of three models of analytic computation: BSS machines (aka real-RAM) and strongly/weakly analytic machines as introduced by Hotz et. al. (1995).

  20. Effect of preemptive nerve block on inflammation and hyperalgesia after human thermal injury

    DEFF Research Database (Denmark)

    Pedersen, J L; Crawford, M E; Dahl, J B

    1996-01-01

    whether a prolonged nerve block administered before a superficial burn injury could reduce local inflammation and late hyperalgesia after recovery from the block. METHODS: The effects of a preemptive saphenous nerve block on primary and secondary hyperalgesia, skin erythema, and blister formation, were...... compared to the opposite unblocked leg for 12 h after bilateral thermal injuries (15 x 25 mm, 49 degrees C for 5 min) in 20 healthy volunteers. Recovery from the block was identified by return of sensation to cold. RESULTS: Six subjects were excluded because of insufficient initial block (2 subjects......) or because the block lasted beyond the study period (4 subjects). The remaining 14 subjects experienced significantly reduced primary (P = 0.005) and secondary hyperplasia (P = 0.01) in the blocked leg after return of cold sensation compared to the unblocked leg. Erythema intensity and blister formation were...

  1. 食管心房调搏联合阿托品负荷实验在窦房结、房室结病变诊断中的临床应用价值%Clinical application value of transesophageal atrial pacing combined with atropine load experiment in the diagnosis of the lesions of sinoatrial node and atrioventricular node

    Institute of Scientific and Technical Information of China (English)

    盛红宇; 李志军; 王其琼; 许明; 艾斯娅; 班新全; 李惠荣

    2015-01-01

    Objective To evaluate the clinical application value of transesophageal atrial pacing (TEAP) combined with atropine load experiment in the diagnosis of the lesions of sinoatrial node and atrioventricular node.Methods One hundred and forty-four cases selected from the outpatient and hospitalized patients in the People's Hospital of Changji Hui Autonomous Prefecture from September 2009 to December 2012,who with dizziness, syncope and other clinical symptoms and electrocardiogram showe.TEAP combined with atropine load experiment were given to these patients.Results (1) The authors detected in all patients,83 cases (57.6%) were positive, among which, 48 cases (57.8%) male, 35 cases (42.2%) female.(2) The authors detected 57 cases(39.6%) non-increased vagus nerve tension cases in 83 positive cases,among which 33 cases (57.9%) male, 24 cases (42.1%) female;Among which 29 cases (20.1%) were sinoatrial node hypofunction, and 16 cases(55.2%) male;8 cases(5.6%) were atrioventricular node hypofunction,and 4 cases(50%) male;14 cases(9.7%) were double node hypofunction, and 10 cases (71.4%) male;6 cases (4.2%) were tachycardia-bradycardia syndrome, and 3 cases (50%) male;among which, a long interval of greater than 3 seconds appeared when we stimulate one 84 years old man with S1S1 stimulate way, immediately pressed protective pacemaker until his own sinus rhythm was restored, as a safety precaution, stoped further examination and classified him as sick sinus group.Conclusion Detect the common causes of slow sinus and atrioventricular block,such as the sinoatrial node dysfunction, atrioventricular node dysfunction, double node dysfunction and increased vagus nerve tension through TEAP combined with atropine load experiment.Consider that this methods have the best diagnostic value in decreasing its rate of false positivity,and should be used as a necessary check before implantation of pacemaker in such patients, suitable used in clinical, especially

  2. Left bundle-branch block

    DEFF Research Database (Denmark)

    Risum, Niels; Strauss, David; Sogaard, Peter

    2013-01-01

    The relationship between myocardial electrical activation by electrocardiogram (ECG) and mechanical contraction by echocardiography in left bundle-branch block (LBBB) has never been clearly demonstrated. New strict criteria for LBBB based on a fundamental understanding of physiology have recently...

  3. Hawaii Census 2000 Block Groups

    Data.gov (United States)

    U.S. Environmental Protection Agency — This data layer represents Census 2000 demographic data derived from the PL94-171 redistricting files and SF3. Census geographic entities include blocks, blockgroups...

  4. Left bundle-branch block

    DEFF Research Database (Denmark)

    Risum, Niels; Strauss, David; Sogaard, Peter;

    2013-01-01

    The relationship between myocardial electrical activation by electrocardiogram (ECG) and mechanical contraction by echocardiography in left bundle-branch block (LBBB) has never been clearly demonstrated. New strict criteria for LBBB based on a fundamental understanding of physiology have recently...

  5. Recursion Relations for Conformal Blocks

    CERN Document Server

    Penedones, João; Yamazaki, Masahito

    2016-09-12

    In the context of conformal field theories in general space-time dimension, we find all the possible singularities of the conformal blocks as functions of the scaling dimension $\\Delta$ of the exchanged operator. In particular, we argue, using representation theory of parabolic Verma modules, that in odd spacetime dimension the singularities are only simple poles. We discuss how to use this information to write recursion relations that determine the conformal blocks. We first recover the recursion relation introduced in 1307.6856 for conformal blocks of external scalar operators. We then generalize this recursion relation for the conformal blocks associated to the four point function of three scalar and one vector operator. Finally we specialize to the case in which the vector operator is a conserved current.

  6. MarineMineralsProgramBlocks

    Data.gov (United States)

    Bureau of Ocean Energy Management, Department of the Interior — This data set contains OCS block outlines and delineated polygons in ESRI ArcGIS shape file format for the BOEM Gulf of Mexico Region that contain sediment resources...

  7. Multi-block and path modelling procedures

    DEFF Research Database (Denmark)

    Høskuldsson, Agnar

    2008-01-01

    The author has developed a unified theory of path and multi-block modelling of data. The data blocks are arranged in a directional path. Each data block can lead to one or more data blocks. It is assumed that there is given a collection of input data blocks. Each of them is supposed to describe one...

  8. A Novel Tetrathiafulvalene Building Block

    DEFF Research Database (Denmark)

    Jeppesen, Jan Oskar; Takimiya, Kazuo; Thorup, Niels

    1999-01-01

    Efficient synthesis of a novel tetrathiafulvalene building block. 2,3-bis(2-cyanoethylthio)-6,7-bis(thiocyanato-methyl)tetrathiafulv alene (7) useful for stepwise and asymmetrical bis-function-alization is reported.......Efficient synthesis of a novel tetrathiafulvalene building block. 2,3-bis(2-cyanoethylthio)-6,7-bis(thiocyanato-methyl)tetrathiafulv alene (7) useful for stepwise and asymmetrical bis-function-alization is reported....

  9. [Superior gluteal nerve: a new block on the block?

    Science.gov (United States)

    Sá, Miguel; Graça, Rita; Reis, Hugo; Cardoso, José Miguel; Sampaio, José; Pinheiro, Célia; Machado, Duarte

    2017-05-24

    The superior gluteal nerve is responsible for innervating the gluteus medius, gluteus minimus and tensor fascia latae muscles, all of which can be injured during surgical procedures. We describe an ultrasound-guided approach to block the superior gluteal nerve which allowed us to provide efficient analgesia and anesthesia for two orthopedic procedures, in a patient who had significant risk factors for neuraxial techniques and deep peripheral nerve blocks. An 84-year-old female whose regular use of clopidogrel contraindicated neuraxial techniques or deep peripheral nerve blocks presented for urgent bipolar hemiarthroplasty in our hospital. Taking into consideration the surgical approach chosen by the orthopedic team, we set to use a combination of general anesthesia and superficial peripheral nerve blocks (femoral, lateral cutaneous of thigh and superior gluteal nerve) for the procedure. A month and a half post-discharge the patient was re-admitted for debriding and correction of suture dehiscence; we performed the same blocks and light sedation. She remained comfortable in both cases, and reported no pain in the post-operative period. Deep understanding of anatomy and innervation empowers anesthesiologists to solve potentially complex cases with safer, albeit creative, approaches. The relevance of this block in this case arises from its innervation of the gluteus medius muscle and posterolateral portion of the hip joint. To the best of our knowledge, this is the first report of an ultrasound-guided superior gluteal nerve block with an analgesic and anesthetic goal, which was successfully achieved. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  10. NANOSTRUCTURES OF FUNCTIONAL BLOCK COPOLYMERS

    Institute of Scientific and Technical Information of China (English)

    Guojun Liu

    2000-01-01

    Nanostructure fabrication from block copolymers in my group normally involves polymer design, synthesis, selfassembly, selective domain crosslinking, and sometimes selective domain removal. Preparation of thin films with nanochannels was used to illustrate the strategy we took. In this particular case, a linear triblock copolymer polyisopreneblock-poly(2-cinnamoylethyl methacrylate)-block-poly(t-butyl acrylate), PI-b-PCEMA-b-PtBA, was used. Films, 25 to50μm thick, were prepared from casting on glass slides a toluene solution of PI-b-PCEMA-b-PtBA and PtBA homopolymer,hPtBA, where hPtBA is shorter than the PtBA block. At the hPtBA mass fraction of 20% relative to the triblock or the total PtBA (hPtBA and PtBA block) volume fraction of 0.44, hPtBA and PtBA formed a seemingly continuous phase in the matrix of PCEMA and PI. Such a block segregation pattern was locked in by photocrosslinking the PCEMA domain. Nanochannels were formed by extracting out hPtBA with solvent. Alternatively, larger channels were obtained from extracting out hPtBA and hydrolyzing the t-butyl groups of the PtBA block. Such membranes were not liquid permeable but had gas permeability constants ~6 orders of magnitude higher than that of low-density polyethylene films.

  11. Six degree of freedom sensor

    Science.gov (United States)

    Vann, Charles S.

    1999-01-01

    This small, non-contact optical sensor increases the capability and flexibility of computer controlled machines by detecting its relative position to a workpiece in all six degrees of freedom (DOF). At a fraction of the cost, it is over 200 times faster and up to 25 times more accurate than competing 3-DOF sensors. Applications range from flexible manufacturing to a 6-DOF mouse for computers. Until now, highly agile and accurate machines have been limited by their inability to adjust to changes in their tasks. By enabling them to sense all six degrees of position, these machines can now adapt to new and complicated tasks without human intervention or delay--simplifying production, reducing costs, and enhancing the value and capability of flexible manufacturing.

  12. Optimal information diffusion in stochastic block models

    CERN Document Server

    Curato, Gianbiagio

    2016-01-01

    We use the linear threshold model to study the diffusion of information on a network generated by the stochastic block model. We focus our analysis on a two community structure where the initial set of informed nodes lies only in one of the two communities and we look for optimal network structures, i.e. those maximizing the asymptotic extent of the diffusion. We find that, constraining the mean degree and the fraction of initially informed nodes, the optimal structure can be assortative (modular), core-periphery, or even disassortative. We then look for minimal cost structures, i.e. those such that a minimal fraction of initially informed nodes is needed to trigger a global cascade. We find that the optimal networks are assortative but with a structure very close to a core-periphery graph, i.e. a very dense community linked to a much more sparsely connected periphery.

  13. Degree 3 Networks Topological Routing

    DEFF Research Database (Denmark)

    Gutierrez Lopez, Jose Manuel; Riaz, M. Tahir; Pedersen, Jens Myrup;

    2009-01-01

    Topological routing is a table free alternative to traditional routing methods. It is specially well suited for organized network interconnection schemes. Topological routing algorithms correspond to the type O(1), constant complexity, being very attractive for large scale networks. It has been...... proposed for many topologies and this work compares the algorithms for three degree three topologies using a more analytical approach than previous studies....

  14. Optimal Backward Perturbation Analysis for the Block Skew Circulant Linear Systems with Skew Circulant Blocks

    Directory of Open Access Journals (Sweden)

    Zhaolin Jiang

    2014-01-01

    Full Text Available We first give the block style spectral decomposition of arbitrary block skew circulant matrix with skew circulant blocks. Secondly, we obtain the singular value of block skew circulant matrix with skew circulant blocks as well. Finally, based on the block style spectral decomposition, we deal with the optimal backward perturbation analysis for the block skew circulant linear system with skew circulant blocks.

  15. Analysis of ocular cyclotorsion in lying position after peribulbar block and topical anesthesia

    Directory of Open Access Journals (Sweden)

    Newton Kara-Junior

    2014-08-01

    Full Text Available Purpose: Evaluate the magnitude of cyclotorsion during cataract surgery in patients with indication for intraocular toric lenses comparing the results after peribulbar and after topical anesthesia. Methods: This prospective study comprised 112 eyes that underwent cataract surgery with implantation of toric intraocular lens by topical anesthesia or peribulbar block. We estimated how many degrees of cyclotorsion occurred after topical anesthesia and peribulbar block with the patient in supine position. A tag was performed in the position of 180 degrees of the right eye and zero degrees of the left eye, with the patient seated. Afterwards, it was requested a change to the supine position and then a new dial in 180 and zero degrees respectively from right and left eye were made. Results: The current study demonstrated that patients submitted to cataract surgery with implantation of toriclens under local anesthesia showed approximately 6.89 degrees of incyclotorsion (82 eyes and 6.93 degrees of excyclotorsion (38 eyes and a mean of cyclotorsion of 6.91 degrees. Patients undergoing peribulbar block showed 5.68 degrees of incyclotorsion (73 eyes and 4.81 degrees of excyclotorsion (47 eyes and a mean of cyclotorsion of 4.92 degrees. Conclusion: Through the study we can see that the movement of incyclotorsion in patients undergoing peribulbar anesthesia was lower when compared to topical anesthesia. This is relevant since the greater the incyclotorsion, the lower the predictability of the surgery and the lower the chance of obtaining excellent results in the final refractometric.

  16. Irregular conformal block, spectral curve and flow equations

    CERN Document Server

    Choi, Sang Kwan; Zhang, Hong

    2015-01-01

    Irregular conformal block is motivated by the Argyres-Douglas type of N=2 super conformal gauge theory. We investigate the classical/NS limit of the irregular conformal block using spectral curve on a Riemann surface with irregular punctures, which is equivalent to the loop equation of irregular matrix model. The spectral curve is reduced to the second order (Virasoro symmetry, $SU(2)$ for the gauge theory) and third order ($W_3$ symmetry, $SU(3)$) differential equations of a polynomial with finite degree. The Virasoro and W symmetry generate flow equations in the spectral curve and determine the irregular conformal block, hence the partition function of the Argyres-Douglas theory ala AGT conjecture.

  17. Analysis of Selected Maternal Exposures and Non-Syndromic Atrioventricular Septal Defects in the National Birth Defects Prevention Study, 1997–2005

    Science.gov (United States)

    Patel, Sonali S.; Burns, Trudy L.; Botto, Lorenzo D.; Riehle-Colarusso, Tiffany J.; Lin, Angela E.; Shaw, Gary M.; Romitti, Paul A.

    2015-01-01

    Although the descriptive epidemiology of atrioventricular septal defects (AVSDs), a group of serious congenital heart defects (CHDs), has been recently reported, non-genetic risk factors have not been consistently identified. Using data (1997–2005) from the National Birth Defects Prevention Study, an ongoing multisite population-based case–control study, the association between selected non-genetic factors and non-syndromic AVSDs was examined. Data on periconceptional exposures to such factors were collected by telephone interview from 187 mothers of AVSD case infants and 6,703 mothers of unaffected infants. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated from logistic regression models. Mothers who reported cigarette smoking during the periconceptional period were more likely to have infants with AVSDs compared with non-smokers, independent of maternal age, periconceptional alcohol consumption, infant gestational age, family history of CHDs, and study site (aOR 1.5, 95% CI 1.1–2.4). The association was strongest in mothers who smoked more than 25 cigarettes/day. In addition, mothers with periconceptional passive smoke exposure were more likely to have infants with AVSDs than unexposed mothers, independent of maternal age, active periconceptional smoking, infant gestational age, and family history of CHDs (aOR 1.4, 95% CI 1.0–2.0). No associations were observed between AVSDs and maternal history of a urinary tract infection or pelvic inflammatory disease, maternal use of a wide variety of medications, maternal occupational exposure, parental drug use, or maternal alcohol consumption. If the results of this preliminary study can be replicated, minimizing maternal active and passive smoke exposure may decrease the incidence of AVSDs. PMID:22903798

  18. The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P<0.01);the MAP decreased(P<0.01)and the HR increased drastically(P<0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.

  19. Honorary Degree Congregation in Cambridge

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    One day in mid-June 2006 when I was on a visit to the Countryside Restoration Trust at Barton near Cambridge, Mr. Christopher Stevenson, the director of Program of Events for Newcomers & Academic Visitors, gave me a letter enclosing a notice and a ticket I booked nearly two months earlier. He told me that I was very lucky because a strictly limited number of tickets had been allocated to academic visitors. It was a ticket to admit me to the Honorary Degree Congregation and to the reception afterwards on Tuesday 27 June.

  20. Contrasting reduced overshadowing and blocking.

    Science.gov (United States)

    Wheeler, Daniel S; Miller, Ralph R

    2007-07-01

    Preexposure of a cue without an outcome (X-) prior to compound pairings with the outcome (XZ-->O) can reduce overshadowing of a target cue (Z). Moreover, pairing a cue with an outcome (X-->O) before compound training can enhance its ability to compete with another cue (i.e., blocking). Four experiments were conducted in a conditioned bar-press suppression preparation with rats to determine whether spacing of the X- or X-->O trials would differentially affect reduced overshadowing and blocking. Experiment 1a showed that reduced overshadowing was larger with massed trials than with spaced trials. Experiment 1b found that blocking was larger with spaced trials than with massed trials. Experiments 2a and 2b indicated that these effects of trial spacing were both mediated by the associative status of the context at test. The results are interpreted in the framework of contemporary learning theories.

  1. Diversity Gain through Antenna Blocking

    Directory of Open Access Journals (Sweden)

    V. Dehghanian

    2012-01-01

    Full Text Available As part of the typical usage mode, interaction between a handheld receiver antenna and the operator's RF absorbing body and nearby objects is known to generate variability in antenna radiation characteristics through blocking and pattern changes. It is counterintuitive that random variations in blocking can result in diversity gain of practical applicability. This diversity gain is quantified from a theoretical and experimental perspective. Measurements carried out at 1947.5 MHz verify the theoretical predictions, and a diversity gain of 3.1 dB was measured through antenna blocking and based on the utilized measurement setup. The diversity gain can be exploited to enhance signal detectability of handheld receivers based on a single antenna in indoor multipath environments.

  2. Block ground interaction of rockfalls

    Science.gov (United States)

    Volkwein, Axel; Gerber, Werner; Kummer, Peter

    2016-04-01

    During a rockfall the interaction of the falling block with the ground is one of the most important factors that define the evolution of a rockfall trajectory. It steers the rebound, the rotational movement, possibly brake effects, friction losses and damping effects. Therefore, if most reliable rockfall /trajectory simulation software is sought a good understanding of the block ground interaction is necessary. Today's rockfall codes enable the simulation of a fully 3D modelled block within a full 3D surface . However, the details during the contact, i.e. the contact duration, the penetration depth or the dimension of the marks in the ground are usually not part of the simulation. Recent field tests with rocks between 20 and 80 kg have been conducted on a grassy slope in 2014 [1]. A special rockfall sensor [2] within the blocks measured the rotational velocity and the acting accelerations during the tests. External video records and a so-called LocalPositioningSystem deliver information on the travel velocity. With these data not only the flight phases of the trajectories but also the contacts with the ground can be analysed. During the single jumps of a block the flight time, jump length, the velocity, and the rotation are known. During the single impacts their duration and the acting accelerations are visible. Further, the changes of rotational and translational velocity influence the next jump of the block. The change of the rotational velocity over the whole trajectory nicely visualizes the different phases of a rockfall regarding general acceleration and deceleration in respect to the inclination and the topography of the field. References: [1] Volkwein A, Krummenacher B, Gerber W, Lardon J, Gees F, Brügger L, Ott T (2015) Repeated controlled rockfall trajectory testing. [Abstract] Geophys. Res. Abstr. 17: EGU2015-9779. [2] Volkwein A, Klette J (2014) Semi-Automatic Determination of Rockfall Trajectories. Sensors 14: 18187-18210.

  3. OPAL 96 Blocks Lead Glass

    CERN Multimedia

    This array of 96 lead glass bricks formed part of the OPAL electromagnetic calorimeter. One half of the complete calorimeter is shown in the picture above. There were 9440 lead glass counters in the OPAL electromagnetic calorimeter. These are made of Schott type SF57 glass and each block weighs about 25 kg and consists of 76% PbO by weight. Each block has a Hamamatsu R2238 photomultiplier glued on to it. The complete detector was in the form of a cylinder 7m long and 6m in diameter. It was used to measure the energy of electrons and photons produced in LEP interactions.

  4. Kearns-Sayre 综合征并完全性房室传导阻滞1例%Case Report of Kearns-Sayre Syndrome Combined with Complete Atrioventricular Block

    Institute of Scientific and Technical Information of China (English)

    赵亮; 周同甫; 卢国艳; 华益民

    2009-01-01

    @@ 儿童期完全性心脏传导阻滞多见于心脏结构异常、心肌炎、药物影响、电解质失衡及心脏手术后.现报道1例 Kearns-Sayre综合征(KSS)并完全性心脏传导阻滞,以提高KSS并心脏传导阻滞的认识.

  5. The Degrees of Freedom of the Group Lasso

    CERN Document Server

    Vaiter, Samuel; Peyré, Gabriel; Fadili, Jalal; Dossal, Charles

    2012-01-01

    This paper studies the sensitivity to the observations of the block/group Lasso solution to an overdetermined linear regression model. Such a regularization is known to promote sparsity patterns structured as nonoverlapping groups of coefficients. Our main contribution provides a local parameterization of the solution with respect to the observations. As a byproduct, we give an unbiased estimate of the degrees of freedom of the group Lasso. Among other applications of such results, one can choose in a principled and objective way the regularization parameter of the Lasso through model selection criteria.

  6. Effects of ganglion blocking agents on nicotine extensor convulsions and lethality in mice

    Science.gov (United States)

    Aceto, M. D.; Bentley, H. C.; Dembinski, J. R.

    1969-01-01

    1. The ganglion blocking agents, chlorisondamine, pentamethonium, mecamylamine, decamethonium and hexamethonium all block nicotine extensor convulsions when administered intraventricularly in mice. Tetraethylammonium was inactive. 2. For the intraventricular route, there is a relationship between ganglionic blocking potency and blocking of nicotine extensor convulsions. Indirect evidence suggests that the site(s) of action of nicotine extensor convulsions and lethality is central in origin and associated with brain areas near the ventricles. 3. When ganglion blocking agents are given orally, subcutaneously or intravenously varying degrees of protection can be observed probably depending on factors such as whether or not the drugs cross the blood-brain barrier, absorption, etc., and the effectiveness in protecting mice from nicotine is not related to ganglionic blocking potency. 4. Atropine and morphine given intraventricularly or subcutaneously did not protect mice from the LD95 of nicotine. Chlorpromazine gave very erratic results and phenobarbitone was effective subcutaneously and to a lesser extent intraventricularly. PMID:4390479

  7. [Sudden cardiac death due to sarcoidosis. Case report].

    Science.gov (United States)

    Sejben, István; Som, Zoltán; Cserni, Gábor

    2017-07-01

    Sarcoidosis is a systemic granulomatous disease of unknown aetiology, which is characterized by bilateral hilar lymphadenopathy and pulmonary disease. Clinically detected cardiac involvement occurs in 5% of sarcoid patients, although cardiac manifestations are discovered in 25% of the cases at autopsy. Sarcoid heart disease frequently causes atrioventricular block. The authors present the case of a 44-year-old man with bradycardia. On admission, second degree Mobitz II, then third degree atrioventricular block was diagnosed. Coronarography showed normal coronary arteries. 2.5 years following artificial Biotronik Entovis DR type pacemaker implantation, sudden cardiac death occurred. Autopsy revealed sarcoidosis with cardiac, pulmonary, splenic, renal and lymph node involvement. In case of young or middle-aged patients with atrioventricular block, it is best to search for other causes if the most common coronary origin can be excluded. Orv Hetil. 2017; 158(27): 1067-1070.

  8. A conformal block Farey tail

    Science.gov (United States)

    Maloney, Alexander; Maxfield, Henry; Ng, Gim Seng

    2017-06-01

    We investigate the constraints of crossing symmetry on CFT correlation functions. Four point conformal blocks are naturally viewed as functions on the upper-half plane, on which crossing symmetry acts by PSL(2, Z ) modular transformations. This allows us to construct a unique, crossing symmetric function out of a given conformal block by averaging over PSL(2, Z ). In some two dimensional CFTs the correlation functions are precisely equal to the modular average of the contributions of a finite number of light states. For example, in the two dimensional Ising and tri-critical Ising model CFTs, the correlation functions of identical operators are equal to the PSL(2, Z ) average of the Virasoro vacuum block; this determines the 3 point function coefficients uniquely in terms of the central charge. The sum over PSL(2, Z ) in CFT2 has a natural AdS3 interpretation as a sum over semi-classical saddle points, which describe particles propagating along rational tangles in the bulk. We demonstrate this explicitly for the correlation function of certain heavy operators, where we compute holographically the semi-classical conformal block with a heavy internal operator.

  9. Vagal Blocking for Obesity Control

    DEFF Research Database (Denmark)

    Johannessen, Helene; Revesz, David; Kodama, Yosuke

    2017-01-01

    BACKGROUND: Recently, the US FDA has approved "vagal blocking therapy or vBLoc® therapy" as a new treatment for obesity. The aim of the present study was to study the mechanism-of-action of "VBLOC" in rat models. METHODS: Rats were implanted with VBLOC, an intra-abdominal electrical device...

  10. Scattering matrices with block symmetries

    OpenAIRE

    Życzkowski, Karol

    1997-01-01

    Scattering matrices with block symmetry, which corresponds to scattering process on cavities with geometrical symmetry, are analyzed. The distribution of transmission coefficient is computed for different number of channels in the case of a system with or without the time reversal invariance. An interpolating formula for the case of gradual time reversal symmetry breaking is proposed.

  11. Architectures for block Toeplitz systems

    NARCIS (Netherlands)

    Bouras, Ilias; Glentis, George-Othon; Kalouptsidis, Nicholas

    1996-01-01

    In this paper efficient VLSI architectures of highly concurrent algorithms for the solution of block linear systems with Toeplitz or near-to-Toeplitz entries are presented. The main features of the proposed scheme are the use of scalar only operations, multiplications/divisions and additions, and th

  12. Enduring and Diagnosing Reader's Block.

    Science.gov (United States)

    Melanson, Lisa Stapleton

    1990-01-01

    Describes a condition called "reader's block" whereby the mind fails to comprehend the meaning of the text because of digressing thoughts. Suggests that "freereading," like freewriting, can help to clarify thoughts. Argues that it is not necessary to read things correctly the first time through. (PRA)

  13. Cryptanalysis of Selected Block Ciphers

    DEFF Research Database (Denmark)

    Alkhzaimi, Hoda A.

    ciphers initiatives, and the Competition for Authenticated Encryption: Security, Applicability, and Robustness (CAESAR). In this thesis, we first present cryptanalytic results on different ciphers. We propose attack named the Invariant Subspace Attack. It is utilized to break the full block cipher...

  14. Building Blocks for Personal Brands

    Science.gov (United States)

    Thomas, Lisa Carlucci

    2011-01-01

    In this article, the author discusses the four essential building blocks for personal brands: (1) name; (2) message; (3) channels; and (4) bridges. However, outstanding building materials can only take a person so far. The author emphasizes that vision, determination, faith, a sense of humor, and humility are also required.

  15. Simulation of spinal nerve blocks for training anesthesiology residents

    Science.gov (United States)

    Blezek, Daniel J.; Robb, Richard A.; Camp, Jon J.; Nauss, Lee A.; Martin, David P.

    1998-06-01

    Deep nerve regional anesthesiology procedures, such as the celiac plexus block, are challenging to learn. The current training process primarily involves studying anatomy and practicing needle insertion is cadavers. Unfortunately, the training often continues on the first few patients subjected to the care of the new resident. To augment the training, we have developed a virtual reality surgical simulation designed to provide an immersive environment in which an understanding of the complex 3D relationships among the anatomic structures involved can be obtained and the mechanics of the celiac block procedure practiced under realistic conditions. Study of the relevant anatomy is provided by interactive 3D visualization of patient specific data nd the practice simulated using a head mounted display, a 6 degree of freedom tracker, and a haptic feedback device simulating the needle insertion. By training in a controlled environment, the resident may practice procedures repeatedly without the risks associated with actual patient procedures, and may become more adept and confident in the ability to perform nerve blocks. The resident may select a variety of different nerve block procedures to practice, and may place the virtual patient in any desired position and orientation. The preliminary anatomic models used in the simulation have been computed from the Visible Human Male; however, patient specific models may be generated from patient image data, allowing the physician to evaluate, plan, and practice difficult blocks and/or understand variations in anatomy before attempting the procedure on any specific patient.

  16. Endoscopic sphenopalatine ganglion block for pain relief

    OpenAIRE

    Murty, P. S. N.; Prasanna, Atma

    1998-01-01

    The anaesthetic effect of the sphenopalatine (SPG) block has been well utilized for intranasal topical anaesthesia but the analgesic efficacy of (SPG) block, though well documented in literature, has not been put into practice. The methods available for SPG block till date were blind as they do not visualize the foramen. Nasal endoscopies have been used to visualize the foramen for an effective block. The authors present their experience with the endoscopic sphenopalatine ganglion block for p...

  17. Pourfour Du Petit syndrome after interscalene block

    Directory of Open Access Journals (Sweden)

    Mysore Chandramouli Basappji Santhosh

    2013-01-01

    Full Text Available Interscalene block is commonly associated with reversible ipsilateral phrenic nerve block, recurrent laryngeal nerve block, and cervical sympathetic plexus block, presenting as Horner′s syndrome. We report a very rare Pourfour Du Petit syndrome which has a clinical presentation opposite to that of Horner′s syndrome in a 24-year-old male who was given interscalene block for open reduction and internal fixation of fracture upper third shaft of left humerus.

  18. Pourfour Du Petit syndrome after interscalene block.

    Science.gov (United States)

    Santhosh, Mysore Chandramouli Basappji; Pai, Rohini B; Rao, Raghavendra P

    2013-04-01

    Interscalene block is commonly associated with reversible ipsilateral phrenic nerve block, recurrent laryngeal nerve block, and cervical sympathetic plexus block, presenting as Horner's syndrome. We report a very rare Pourfour Du Petit syndrome which has a clinical presentation opposite to that of Horner's syndrome in a 24-year-old male who was given interscalene block for open reduction and internal fixation of fracture upper third shaft of left humerus.

  19. Limiting Spectral Distribution of Block Matrices with Toeplitz Block Structure

    CERN Document Server

    Basu, Riddhipratim; Ganguly, Shirshendu; Hazra, Rajat Subhra

    2011-01-01

    We study two specific symmetric random block Toeplitz (of dimension $k \\times k$) matrices: where the blocks (of size $n \\times n$) are (i) matrices with i.i.d. entries, and (ii) asymmetric Toeplitz matrices. Under suitable assumptions on the entries, their limiting spectral distributions (LSDs) exist (after scaling by $\\sqrt{nk}$) when (a) $k$ is fixed and $n \\to\\infty$ (b) $n$ is fixed and $k\\rightarrow \\infty$ (c) $n$ and $k$ go to $\\infty$ simultaneously. Further the LSD's obtained in (a) and (b) coincide with those in (c) when $n$ or respectively $k$ tends to infinity. This limit in (c) is the semicircle law in case (i). In Case (ii) the limit is related to the limit of the random symmetric Toepiltz matrix as obtained by Bryc et al.(2006) and Hammond and Miller(2005).

  20. Opposite Degree Algorithm and Its Applications

    OpenAIRE

    Xiao-Guang Yue

    2015-01-01

    The opposite (Opposite Degree, referred to as OD) algorithm is an intelligent algorithm proposed by Yue Xiaoguang et al. Opposite degree algorithm is mainly based on the concept of opposite degree, combined with the idea of design of neural network and genetic algorithm and clustering analysis algorithm. The OD algorithm is divided into two sub algorithms, namely: opposite degree - numerical computation (OD-NC) algorithm and opposite degree - Classification computation (OD-CC) algorithm.

  1. Extended degree functions and monomial modules

    OpenAIRE

    2004-01-01

    The arithmetic degree, the smallest extended degree, and the homological degree are invariants that have been proposed as alternatives of the degree of a module if this module is not Cohen-Macaulay. We compare these degree functions and study their behavior when passing to the generic initial or the lexicographic submodule. This leads to various bounds and to counterexamples to a conjecture of Gunston and Vasconcelos, respectively. Particular attention is given to the class of sequentially Co...

  2. Opposite Degree Algorithm and Its Applications

    Directory of Open Access Journals (Sweden)

    Xiao-Guang Yue

    2015-12-01

    Full Text Available The opposite (Opposite Degree, referred to as OD algorithm is an intelligent algorithm proposed by Yue Xiaoguang et al. Opposite degree algorithm is mainly based on the concept of opposite degree, combined with the idea of design of neural network and genetic algorithm and clustering analysis algorithm. The OD algorithm is divided into two sub algorithms, namely: opposite degree - numerical computation (OD-NC algorithm and opposite degree - Classification computation (OD-CC algorithm.

  3. On the Eigenvalues and Eigenvectors of Block Triangular Preconditioned Block Matrices

    KAUST Repository

    Pestana, Jennifer

    2014-01-01

    Block lower triangular matrices and block upper triangular matrices are popular preconditioners for 2×2 block matrices. In this note we show that a block lower triangular preconditioner gives the same spectrum as a block upper triangular preconditioner and that the eigenvectors of the two preconditioned matrices are related. © 2014 Society for Industrial and Applied Mathematics.

  4. Comparison of anti-M2-muscarinic effect of AF-DX 116 on atrioventricular nodal conduction with those of pirenzepine and atropine as antibradyarrhythmic drugs.

    Science.gov (United States)

    Sasaki, S; Motomura, S

    1999-06-01

    Selectivity of antimuscarinic actions of AF-DX 116 (AF-DX) on the atrioventricular (AV) nodal conduction was compared with those of pirenzepine and atropine by using the canine isolated, blood-perfused AV node preparation and the open-chest in situ dog heart. In the isolated AV node preparation, dose-response curves for negative dromotropic effects (prolongation of Atrio-His interval) of carbachol (CCh) injected into the posterior septal artery were shifted to the right in parallel by AF-DX, pirenzepine, and atropine with apparent pA2-values of 13, 27.5, and 0.45 microg, respectively, and slopes of the modified Schild plot of nearly unity. Meanwhile, dose-response curves for coronary vasodilator effects of CCh were shifted to the right by AF-DX, pirenzepine, and atropine with the apparent pA2 values of 68, 12.5, and 0.55 microg, respectively, but the slopes were far from unity. In the in situ open-chest heart, dose-response curves for negative dromotropic effects (prolongation of AV conduction time) of CCh given intravenously were shifted to the right in parallel by AF-DX, pirenzepine, and atropine with apparent pA2 values of 36, 32, and 1.25 microg/kg, respectively, and the slope of nearly unity, whereas dose-response curves for hypotensive effects of CCh were shifted to the right by AF-DX, pirenzepine, and atropine with apparent pA2 values of 105, 15, and 0.65 microg/kg, respectively, but the slopes of AF-DX and pirenzepine were far from unity. In addition, prolongations of AV conduction time by electrical stimulation of the left vagus nerve in the in situ heart were suppressed by AF-DX, pirenzepine, and atropine with the ID50, dose for 50% suppression, of 40, 35, and 1.9 microg/kg, respectively. These results suggest that (a) the potency of antimuscarinic actions of AF-DX on the CCh-induced negative dromotropic effects was almost equal to that of pirenzepine, and approximately 30 times less potent than atropine; (b) the M2-subtype selectivity of AF-DX was

  5. Graphs obtained from collections of blocks

    Directory of Open Access Journals (Sweden)

    Colton Magnant

    2015-03-01

    Full Text Available Given a collection of $d$-dimensional rectangular solids called blocks, no two of which sharing interior points, construct a block graph by adding a vertex for each block and an edge if the faces of the two corresponding blocks intersect nontrivially.  It is known that if $d \\geq 3$, such block graphs can have arbitrarily large chromatic number.  We prove that the chromatic number can be bounded with only a mild restriction on the sizes of the blocks.  We also show that block graphs of block configurations arising from partitions of $d$-dimensional hypercubes into sub-hypercubes are at least $d$-connected.  Bounds on the diameter and the hamiltonicity of such block graphs are also discussed.

  6. Locking mechanisms in degree-4 vertex origami structures

    Science.gov (United States)

    Fang, Hongbin; Li, Suyi; Xu, Jian; Wang, K. W.

    2016-04-01

    Origami has emerged as a potential tool for the design of mechanical metamaterials and metastructures whose novel properties originate from their crease patterns. Most of the attention in origami engineering has focused on the wellknown Miura-Ori, a folded tessellation that is flat-foldable for folded sheet and stacked blocks. This study advances the state of the art and expands the research field to investigate generic degree-4 vertex (4-vertex) origami, with a focus on facet-binding. In order to understand how facet-binding attributes to the mechanical properties of 4-vertex origami structures, geometries of the 4-vertex origami cells are analyzed and analytically expressed. Through repeating and stacking 4-vertex cells, origami sheets and stacked origami blocks can be constructed. Geometry analyses discover four mechanisms that will lead to the self-locking of 4-vertex origami cells, sheets, and stacked blocks: in-cell facet-binding, inlayer facet-binding, inter-layer facet binding, and in-layer and inter-layer facet-bindings. These mechanisms and the predicted self-locking phenomena are verified through 3D simulations and prototype experiments. Finally, this paper briefly introduces the unusual mechanical properties caused by the locking of 4-vertex origami structures. The research reported in this paper could foster a new breed of self-locking structures with various engineering applications.

  7. A conformal block Farey tail

    CERN Document Server

    Maloney, Alexander; Ng, Gim Seng

    2016-01-01

    We investigate the constraints of crossing symmetry on CFT correlation functions. Four point conformal blocks are naturally viewed as functions on the upper-half plane, on which crossing symmetry acts by PSL(2,Z) modular transformations. This allows us to construct a unique, crossing symmetric function out of a given conformal block by averaging over PSL(2,Z). In some two dimensional CFTs the correlation functions are precisely equal to the modular average of the contributions of a finite number of light states. For example, in the two dimensional Ising and tri-critical Ising model CFTs, the correlation functions of identical operators are equal to the PSL(2,Z) average of the Virasoro vacuum block; this determines the 3 point function coefficients uniquely in terms of the central charge. The sum over PSL(2,Z) in CFT2 has a natural AdS3 interpretation as a sum over semi-classical saddle points, which describe particles propagating along rational tangles in the bulk. We demonstrate this explicitly for the corre...

  8. Train-of-four fade during onset of neuromuscular block with nondepolarising neuromuscular blocking agents.

    Science.gov (United States)

    Gibson, F M; Mirakhur, R K

    1989-04-01

    Fade in the train-of-four (TOF) responses during onset of neuromuscular block was studied following administration of atracurium (225 or 450 micrograms/kg), vecuronium (40 or 80 micrograms/kg), pancuronium (60 or 120 micrograms/kg) and tubocurarine (450 micrograms/kg). TOF ratios were measured at approximate heights of T1 (first response in the TOF) of 75, 50 and 25%. Fade in TOF increased as the height of T1 decreased, with maximum fade being observed at T1 of 25%. The greatest difference between relaxants was observed at T1 of 25%, vecuronium showing the least fade and pancuronium, atracurium and tubocurarine showing increasing fade, in that order. The difference between atracurium and tubocurarine or between vecuronium and pancuronium was not significant, but the degree of TOF fade was significantly greater with atracurium and tubocurarine in comparison to vecuronium or pancuronium.

  9. Modification of poly(styrene-block-butadiene-block-styrene) [SBS] with phosphorus containing fire retardants

    DEFF Research Database (Denmark)

    Chernyy, Sergey; Ullah, Saif; Jomaas, Grunde;

    2015-01-01

    application of the H3PO4 modified SBS as a fire retardant additive for bitumen material, in combination with synergetic melamine species, offered 25% better self-extinguishing properties of such formulation already at a low loading level of the fire retardant components (3.5 wt.%).......An elaborate survey of the chemical modification methods for endowing highly flammable SBS with increased fire resistant properties by means of chemical modification of the polymer backbone with phosphorus containing fire retardant species is presented. Optimal conditions for free radical addition...... of the Psingle bondH containing fire retardants to a double bonds of poly(butadiene) block of SBS were found, affording varied degree of the modification (0.2–21 mol%). Alternatively, a two-step procedure based on an epoxidation step followed by hydrolysis of the epoxides with phosphoric acid was developed...

  10. General N-th Degree Stochastic Dominance

    Institute of Scientific and Technical Information of China (English)

    张顺明

    2001-01-01

    This paper examines N-th degree stochastic dominance which isused to compare the risk factor of risky assets after summarizing the definitions of first degree stochastic dominance and second degree stochastic dominance. The paper defines general N-th degree stochastic dominance, presents a sufficient and necessary condition which is the equivalent theorem of general N-th degree stochastic dominance. The feasible utility form is constructed to explain the economic meaning of N-th degree stochastic dominance in the field of financial economics. The equivalent condition is described by the probability distribution functions of risky assets, which are not related to utility functions (preference relations).

  11. Postoperative follow-up of patients with complete atrioventricular septal defect complicated with pulmonary hypertension%完全性房室间隔缺损合并肺动脉高压术后75例预后分析

    Institute of Scientific and Technical Information of China (English)

    肖婷婷; 李奋; 沈捷; 黄美蓉

    2011-01-01

    objective To observe the operative efficacy in patients with complete atrioventricular septal defect compliated with pulmonary hypertension. Methods From January 2003 to March 2007, CAVSD patients with pulmonary hypertension who underwent operative closure were included in this study. Color Doppler with apical four-chamber view was used to evaluate the degree of pulmonary hypertension before surgery and 2 days, 1 month, 6 month and 1 year after the surgery. Cardiac catheterization was performed to evaluate pulmonary artery pressure and pulmonary arteriolar resistance (PAR) before surgery in patients whose age were over 6 months. The time of staying at ICU, ventilation time after surgery and the occurrence of pulmonary artery hypertension crisis were recorded. Results A total of 75 CAVSD patients who underwent operative closure were enrolled in this study. The mean staying time at ICU was (4.9 ± 2.1 )days, and the mean ventilation time was (2.1 ± 0.9) days; 12 patients developed pulmonary artery hypertension crisis after surgery. Patients with PAR > 8 wood unit were older, staying time at ICU and ventilation time were longer compared with patients with PAR < 8 wood unit (all P < 0.05). The incidence of pulmonary artery hypertension crisis after surgery was also significantly higher in patients with PAR > 8 wood unit compared with patients with PAR < 8 wood unit(P < 0.05). Five patients died. Four out of 5 hospital-dead patients had severe hypoplasia of the atrioventricular valve. Pulmonary artery pressure of 39 patients (52%) returned to normal two days after surgery, 51 patients (68%) returned to normal one month after surgery, 64 patients (85%) returned to normal 6 months after surgery,and 68 patients (91%) returned to normal one year after surgery; 7 patients have pulmonary hypertension one year after surgery. Conclusion Our results suggest that early surgical repair for CAVC is safe and beneficial.Preoperative PAR > 8 wood unit is

  12. The Complex Case of Positioning the Foundation Degree: Making Sense of a Degree That Is Not a Degree

    Science.gov (United States)

    Kadembo, Ernest

    2008-01-01

    The Foundation degree was launched in 2001 and has enjoyed growth but remains a controversial qualification. Foundation Degree Forward, the body charged by the UK government with providing a "national network or expertise to support the development and validation of high-quality Foundation degrees" is championing the marketing of the…

  13. Relation of maternal anti-Ro/La antibodies to aortic dilation in patients with congenital complete heart block.

    Science.gov (United States)

    Davey, Debra L; Bratton, Susan L; Bradley, David J; Yetman, Anji T

    2011-08-15

    An association between congenital complete atrioventricular block (cCAVB) and aortic dilation during childhood has recently been reported. We sought to further explore this relation with particular emphasis on the natural history of aortic abnormalities over time. The relation of maternal anti-Ro/La antibody status to the aortic size of children affected with cCAVB was also assessed. The patients were evaluated longitudinally with serial echocardiography. During a 15-year period, 62 patients at our institution were diagnosed with cCAVB, of whom 40% were exposed to maternal autoimmune antibodies and 35% were not. The antibody status in the remaining patients was unknown. The patients underwent 9.3 ± 6.5 echocardiograms during the follow-up period. Dilation of the ascending aorta, defined as a z score >2.0, was present on the initial echocardiogram in all patients exposed to maternal antibodies and persisted during long-term follow-up in 96% of these patients. In contrast, 5% and 10% of patients without exposure to maternal autoimmune antibodies had aortic dilation on the initial and follow-up studies, respectively (p <0.001 and p <0.001, respectively). In conclusion, patients with autoimmune-mediated cCAVB merit periodic echocardiographic monitoring into adulthood to assess persistent or progressive aortic dilation and its attendant complications.

  14. UV Blocking Glass: Low Cost Filters for Visible Light Photocatalytic Assessment

    OpenAIRE

    Dunnill, Charles W.

    2014-01-01

    A number of commercially available art protection products have been compared and assessed for their suitability as UV blocking filters in the application of “visible light” photocatalytic research. Many groups claiming visible light photocatalytic success employ filters to block out stray UV radiation in order to justify that their photocatalysts are indeed visible light photocatalysts and not UV light photocatalysts. These filters come in varying degrees of ability and price and many author...

  15. MULTI-BLOCK CHAINING-BASED AUTHENTICATION MODE

    Institute of Scientific and Technical Information of China (English)

    Huang Yuhua; Hu Aiqun; Zhong Ziguo

    2006-01-01

    A fast authentication mode based on Multi-Block Chaining (MBC) is put forward; and its security is proved. The MBC mode is for new generation block cipher algorithms. Its speed is about 13% faster than that of the authentication modes in common use (for example, cipher block chaining-message authentication code mode). The dependence test results meet the requirement. The MBC mode is complete; its degree of avalanche effect is about 0.9993; its degree of strict avalanche criterion is 0.992 or so. The frequency test results indicate that the output generated by the MBC mode has uniformity. The binary matrix rank test results imply that it is linear independent among disjoint sub-matrices of the output. Maurer's universal statistical test results show that the output could be significantly compressed without loss of information. Run test, spectral test,non-overlapping template matching test, overlapping template matching test, Lempel-Ziv compression test,linear complexity test, serial test, approximate entropy test, cumulative sums test, random excursions test and random excursions variant test results fulfill the requirements of all. Therefore the MBC mode has good pseudo-randomness. Thus the security of MBC mode is verified by the way of statistical evaluation.

  16. Networks with superfat-tailed degree distributions

    CERN Document Server

    Timár, Gábor; Mendes, José Fernando F

    2016-01-01

    A majority of studied models for scale-free networks have degree distributions with exponents greater than $2$. Real networks, however, can demonstrate essentially more heavy-tailed degree distributions. We explore two models of scale-free equilibrium networks that have the degree distribution exponent $\\gamma = 1$, $P(q) \\sim q^{-\\gamma}$. Such "superfat-tailed" degree distributions can be identified in empirical data only if the mean degree of a network is sufficiently high. Our models exploit a rewiring mechanism. They are local in the sense that no knowledge of the network structure, apart from the immediate neighbourhood of the vertices, is required. These models generate uncorrelated networks in the infinite size limit, where they are solved explicitly. We investigate finite size effects by the use of simulations. We find that both models exhibit disassortative degree-degree correlations for finite network sizes. In addition, we observe a markedly degree-dependent clustering in the finite networks. We i...

  17. Hillslope-derived blocks retard river incision

    Science.gov (United States)

    Shobe, Charles M.; Tucker, Gregory E.; Anderson, Robert S.

    2016-05-01

    The most common detachment-limited river incision models ignore the effects of sediment on fluvial erosion, yet steep reaches of mountain rivers often host clusters of large (>1 m) blocks. We argue that this distribution of blocks is a manifestation of an autogenic negative feedback in which fast vertical river incision steepens adjacent hillslopes, which deliver blocks to the channel. Blocks inhibit incision by shielding the bed and enhancing form drag. We explore this feedback with a 1-D channel-reach model in which block delivery by hillslopes depends on the river incision rate. Results indicate that incision-dependent block delivery can explain the block distribution in Boulder Creek, Colorado. The proposed negative feedback may significantly slow knickpoint retreat, channel adjustment, and landscape response compared to rates predicted by current theory. The influence of hillslope-derived blocks may complicate efforts to extract base level histories from river profiles.

  18. Demographic Data - MDC_BlockGroup

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — A polygon feature class of Miami-Dade County Census 2000 Block Groups. A census Block Group is a statistical subdivision of a census Tract consisting of a cluster of...

  19. Demographic Data - MDC_BlockGroup

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — A polygon feature class of Miami-Dade County Census 2000 Block Groups. A census Block Group is a statistical subdivision of a census Tract consisting of a cluster...

  20. LATE ONSET ATRIOVENTRICULAR NODAL TACHYCARDIA

    NARCIS (Netherlands)

    PENTINGA, ML; MEEDER, JG; CRIJNS, HJGM; DEMUINCK, ED; WIESFELD, ACP; LIE, KI

    AV nodal tachycardia may present at any age, but onset in late adulthood is considered uncommon. To evaluate whether onset of AV nodal tachycardias at older age is related to organic heart disease (possibly setting the stage for re-entry due to degenerative structural changes) 32 consecutive

  1. LATE ONSET ATRIOVENTRICULAR NODAL TACHYCARDIA

    NARCIS (Netherlands)

    PENTINGA, ML; MEEDER, JG; CRIJNS, HJGM; DEMUINCK, ED; WIESFELD, ACP; LIE, KI

    1993-01-01

    AV nodal tachycardia may present at any age, but onset in late adulthood is considered uncommon. To evaluate whether onset of AV nodal tachycardias at older age is related to organic heart disease (possibly setting the stage for re-entry due to degenerative structural changes) 32 consecutive patient

  2. Antagonism of non-depolarising neuromuscular block: current practice.

    Science.gov (United States)

    Kopman, A F; Eikermann, M

    2009-03-01

    There is now mounting evidence that even small degrees of postoperative residual neuromuscular block increases the incidence of adverse respiratory events in the Post Anaesthesia Care Unit and may increase longer-term morbidity as well. In the absence of quantitative neuromuscular monitoring, residual block is easily missed. A very strong case can be made for the routine administration of a non-depolarising antagonist unless it can be objectively demonstrated that complete recovery has occurred spontaneously. However, the use of acetylcholinesterase inhibitors is associated with the potential for cardiovascular and respiratory side-effects, so there are cogent reasons for using low doses when the level of neuromuscular block is not intense. As little as 0.015-0.025 mg.kg(-1) of neostigmine is required at a train-of-four count of four with minimal fade, whereas 0.04-0.05 mg.kg(-1) is needed at a train-of-four count of two or three. If only a single twitch or none at all can be evoked, neostigmine should not be expected to promptly reverse neuromuscular block, and antagonism is best delayed till a train-of-four-count of two is achieved.

  3. Cylinder Block Fixture for Mistake Proofing.

    Directory of Open Access Journals (Sweden)

    L.B.Raut

    2014-10-01

    Full Text Available The project idea basically developed from trunnion tables which are one type of fixture having ability to rotate about its axis and able to fix the component at any angle, so there is no requirement of angle plate and sine plates, drilling process is also computer controlled so no guide bush is required, So robust design for extra rigidity, flexibility and simple to use. In this project task is difficult as design rotary cage type fixture for component like cylinder block, which is heavy of 76 kg. it is not possible to rotate or handle component manually and proceed on them to make this process accident proof and automated for this purpose we are designing a rotary cage which rotate 360 degree and allow indexing to process on the component. Processes are to be operated on the component are drilling tapping and air blow washing ,Since drilling don’t need clamping here components self weight will enough to carry drilling force and tapping force coming through power tools. Therefore, rotary cage type fixture is critical importance.

  4. Practical Binary Adaptive Block Coder

    CERN Document Server

    Reznik, Yuriy A

    2007-01-01

    This paper describes design of a low-complexity algorithm for adaptive encoding/ decoding of binary sequences produced by memoryless sources. The algorithm implements universal block codes constructed for a set of contexts identified by the numbers of non-zero bits in previous bits in a sequence. We derive a precise formula for asymptotic redundancy of such codes, which refines previous well-known estimate by Krichevsky and Trofimov, and provide experimental verification of this result. In our experimental study we also compare our implementation with existing binary adaptive encoders, such as JBIG's Q-coder, and MPEG AVC (ITU-T H.264)'s CABAC algorithms.

  5. Writer's block in a Chinese sample.

    Science.gov (United States)

    Lee, Sy-Ying; Krashen, Stephen

    2003-10-01

    To assess whether writer's block occurs in languages other than English, a Chinese language translation of Rose's Writer's Block questionnaire was administered to 98 university students in Taiwan. Analysis suggests that writer's block occurs for Chinese students, and, as in English, it is related to premature editing and to a lack of strategies for dealing with complex writing tasks.

  6. Micellization and Dynamics of a Block Copolymer

    DEFF Research Database (Denmark)

    Hvidt, Søren

    2006-01-01

    Triblock copolymers of the type EPE, where E and P denote ethylene oxide and propylene oxide blocks, respectively, are industrially important copolymers often called Pluronics or Poloxamers. EPE copolymers form micelles with a core of P blocks and different micellar shapes depending on block leng...

  7. Micellization and Dynamics of a Block Copolymer

    DEFF Research Database (Denmark)

    Hvidt, Søren

    2006-01-01

    Triblock copolymers of the type EPE, where E and P denote ethylene oxide and propylene oxide blocks, respectively, are industrially important copolymers often called Pluronics or Poloxamers. EPE copolymers form micelles with a core of P blocks and different micellar shapes depending on block length...

  8. New Considerations of Turbo Block Codes

    Institute of Scientific and Technical Information of China (English)

    YUEDianwu; EdSHWEDYK

    2004-01-01

    It is shown that (1) a general linear systematic block code can be expressed as a turbo block code and therefore can be decoded using any turbo decoding algorithm; (2) a turbo block code can be also encoded and decoded without any interleaver with the same performance as when an interleaver is present.

  9. [Congenital sick sinus syndrome in a healthy heart: case report].

    Science.gov (United States)

    Ben Ameur, Youssef; Hmam, Mohamed; Battikh, Kaïes; Mlika, Azmi; Terras, Mouna; Longo, Salma; Kraïem, Sondes; Slimane, Mohamed L

    2003-06-01

    Isolated congenital sick sinusal syndrome on non harmed heart is a rare affection. Its association with an atrio-ventricular block is exceptional. The authors report a case of a 19 year-old patient, with an early history of bradycardia, hospitalised for effort intolerance. His electrocardiogram reveals a high degree sino-atrial block replaced by a junctional rhythm at 30/mn. During Treadmill test, the sinusal acceleration is satisfactory and an effort atrio-ventricular block was present. He later had a definitive stimulation under DDDR. This report shows that the sinusal node, in the same way as the atrio-ventricular node may be injured by congenital dysimmunitary process. The coexistence of these two conductive troubles worsen the prognosis and should lead more often to the practice of definitive stimulation by the only mode DDDR.

  10. Cardiac sarcoidosis mimicking right ventricular dysplasia.

    Science.gov (United States)

    Shiraishi, Jun; Tatsumi, Tetsuya; Shimoo, Kazutoshi; Katsume, Asako; Mani, Hiroki; Kobara, Miyuki; Shirayama, Takeshi; Azuma, Akihiro; Nakagawa, Masao

    2003-02-01

    A 59-year-old woman with skin sarcoidosis was admitted to hospital for assessment of complete atrioventricular block. Cross-sectional echocardiography showed that the apical free wall of the right ventricle was thin and dyskinetic with dilation of the right ventricle. Thallium-201 myocardial imaging revealed a normal distribution. Both gallium-67 and technetium-99m pyrophosphate scintigraphy revealed no abnormal uptake in the myocardium. Right ventriculography showed chamber dilation and dyskinesis of the apical free wall, whereas left ventriculography showed normokinesis, mimicking right ventricular dysplasia. Cardiac sarcoidosis was diagnosed on examination of an endomyocardial biopsy specimen from the right ventricle. A permanent pacemaker was implanted to manage the complete atrioventricular block. After steroid treatment, electrocardiography showed first-degree atrioventricular block and echocardiography revealed an improvement in the right ventricular chamber dilation. Reports of cardiac sarcoidosis mimicking right ventricular dysplasia are extremely rare and as this case shows, right ventricular involvement may be one of its manifestations.

  11. Cutaneous Sensory Block Area, Muscle-Relaxing Effect, and Block Duration of the Transversus Abdominis Plane Block

    DEFF Research Database (Denmark)

    Støving, Kion; Rothe, Christian; Rosenstock, Charlotte V

    2015-01-01

    into a medial and lateral part by a vertical line through the anterior superior iliac spine. We measured muscle thickness of the 3 lateral abdominal muscle layers with ultrasound in the relaxed state and during maximal voluntary muscle contraction. The volunteers reported the duration of the sensory block...... and the abdominal muscle-relaxing effect. RESULTS: The lateral part of the cutaneous sensory block area was a median of 266 cm2 (interquartile range, 191-310 cm2) and the medial part 76 cm 2(interquartile range, 54-127 cm2). In all the volunteers, lateral wall muscle thickness decreased significantly by 9.2 mm (6......BACKGROUND AND OBJECTIVES: The transversus abdominis plane (TAP) block is a widely used nerve block. However, basic block characteristics are poorly described. The purpose of this study was to assess the cutaneous sensory block area, muscle-relaxing effect, and block duration. METHODS: Sixteen...

  12. 12 Blocks Open in North west China's Tarim Basin

    Institute of Scientific and Technical Information of China (English)

    PetroChina Foreign Cooperation Administration Depa

    2006-01-01

    @@ After having opened up for 20 years, the field of oil/gas exploration and development in China is witnessing a new round of high tide to attract foreign investment.PetroChina, China's biggest oil/gas producer and supplier,decided to offer 12 blocks totaling an acreage of 110,000sq.km. in Tarim Basin to players of the industry globally.The project is the biggest oil/gas deal in China aiming at foreign cooperation for approximately 12 years, in which the 12 blocks that will be offered located mainly in southwestern, central and eastern Tarim Basin. It will enable PetroChina to combine its experience and cognition on the geological condition of Tarim Basin with the updated prospecting concept and advanced prospecting technique in the world, improve the proved degree of oil and gas resources in Tarim Basin and achieve a big breakthrough in oil and gas exploration.

  13. Seismicity of the Jalisco Block

    Science.gov (United States)

    Nunez-Cornu, F. J.; Rutz, M.; Camarena-Garcia, M.; Trejo-Gomez, E.; Reyes-Davila, G.; Suarez-Plascencia, C.

    2002-12-01

    In April 2002 began to transmit the stations of the first phase of Jalisco Telemetric Network located at the northwest of Jalisco Block and at the area of Volcan de Fuego (Colima Volcano), in June were deployed four additional MarsLite portable stations in the Bahia de Banderas area, and by the end of August one more portable station at Ceboruco Volcano. The data of these stations jointly with the data from RESCO (Colima Telemetric Network) give us the minimum seismic stations coverage to initiate in a systematic and permanent way the study of the seismicity in this very complex tectonic region. A preliminary analysis of seismicity based on the events registered by the networks using a shutter algorithm, confirms several important features proposed by microseismicity studies carried out between 1996 and 1998. A high level of seismicity inside and below of Rivera plate is observed, this fact suggest a very complex stress pattern acting on this plate. Shallow seismicity at south and east of Bahia de Banderas also suggest a complex stress pattern in this region of the Jalisco Block, events at more than 30 km depth are located under the mouth of the bay and in face of it, a feature denominated Banderas Boundary mark the change of the seismic regime at north of this latitude (20.75°N), however some shallow events were located at the region of Nayarit.

  14. Isostatic compression of buffer blocks. Middle scale

    Energy Technology Data Exchange (ETDEWEB)

    Ritola, J.; Pyy, E. [VTT Technical Research Centre of Finland, Espoo (Finland)

    2012-01-15

    Manufacturing of buffer components using isostatic compression method has been studied in small scale in 2008 (Laaksonen 2010). These tests included manufacturing of buffer blocks using different bentonite materials and different compression pressures. Isostatic mould technology was also tested, along with different methods to fill the mould, such as vibration and partial vacuum, as well as a stepwise compression of the blocks. The development of manufacturing techniques has continued with small-scale (30 %) blocks (diameter 600 mm) in 2009. This was done in a separate project: Isostatic compression, manufacturing and testing of small scale (D = 600 mm) buffer blocks. The research on the isostatic compression method continued in 2010 in a project aimed to test and examine the isostatic manufacturing process of buffer blocks at 70 % scale (block diameter 1200 to 1300 mm), and the aim was to continue in 2011 with full-scale blocks (diameter 1700 mm). A total of nine bentonite blocks were manufactured at 70 % scale, of which four were ring-shaped and the rest were cylindrical. It is currently not possible to manufacture full-scale blocks, because there is no sufficiently large isostatic press available. However, such a compression unit is expected to be possible to use in the near future. The test results of bentonite blocks, produced with an isostatic pressing method at different presses and at different sizes, suggest that the technical characteristics, for example bulk density and strength values, are somewhat independent of the size of the block, and that the blocks have fairly homogenous characteristics. Water content and compression pressure are the two most important properties determining the characteristics of the compressed blocks. By adjusting these two properties it is fairly easy to produce blocks at a desired density. The commonly used compression pressure in the manufacturing of bentonite blocks is 100 MPa, which compresses bentonite to approximately

  15. A physical model for measuring thermally-induced block displacements

    Science.gov (United States)

    Bakun-Mazor, Dagan; Feldhiem, Aviran; Keissar, Yuval; Hatzor, Yossef H.

    2016-04-01

    A new model for thermally-induced block displacement in discontinuous rock slopes has been recently suggested. The model consists of a discrete block that is separated from the rock mass by a tension crack and rests on an inclined plane. The tension crack is filled with a wedge block or rock fragments. Irreversible block sliding is assumed to develop in response to climatic thermal fluctuations and consequent contraction and expansion of the sliding block material. While a tentative analytical solution for this model is already available, we are exploring here the possibility of obtaining such a permanent, thermally-induced, rock block displacement, under fully controlled conditions at the laboratory, and the sensitivity of the mechanism to geometry, mechanical properties, and temperature fluctuations. A large scale concrete physical model (50x150x60 cm^3) is being examined in a Climate-Controlled Room (CCR). The CCR permits accurate control of ambient temperature from 5 to 45 Celsius degrees. The permanent plastic displacement is being measured using four displacement transducers and a high resolution (29M pixel) visual range camera. A series of thermocouples measure the heating front inside the sliding block, hence thermal diffusivity is evaluated from the measured thermal gradient and heat flow. In order to select the appropriate concrete mixture, the mechanical and thermo-physical properties of concrete samples are determined in the lab. Friction angle and shear stiffness of the sliding interface are determined utilizing a hydraulic, servo-controlled direct shear apparatus. Uniaxial compression tests are performed to determine the uniaxial compressive strength, Young's modulus and Poison's ratio of the intact block material using a stiff triaxial load frame. Thermal conductivity and linear thermal expansion coefficient are determined experimentally using a self-constructed measuring system. Due to the fact that this experiment is still in progress, preliminary

  16. [Public health competencies and contents in Spanish undergraduate medical degrees].

    Science.gov (United States)

    Davó-Blanes, M Carmen; Vives-Cases, Carmen; Barrio-Fernández, José Luis; Porta, Miquel; Benavides, Fernando G; de Miguel, Ángel Gil

    2016-01-01

    To reach a consensus among public health faculty from various Spanish universities about the core public health competencies that should be integrated into undergraduate medical degrees. The 2nd Forum of University Teachers was held at the Rey Juan Carlos University (Madrid, 11-12 December 2014). Twenty-four university professors and lecturers from 19 Spanish universities imparting medical degrees participated in the forum. They were distributed in three working groups during three working sessions. In the first session, they were asked to identify and classify core public health competencies for medical degrees. In the second, they were asked to propose public health contents for the identified competencies. In the third session, the participants organized these contents in thematic blocks. The results were discussed in distinct plenary sessions. The highest number of core competencies was identified in the activities related to the public health functions «Assessment of the population's health needs» and «Developing health policies». The final programme included basic contents organised into five units: Concept of health, public health and its determinants; Epidemiology and health research; Determinants and health problems; Strategies, interventions and policies; and health systems, clinical and healthcare management. The public health core competencies and contents identified in this Forum may be considered as a starting point to improve and update public health training programmes for future medical professionals. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

  17. Transcatheter Heart Valve Selection and Permanent Pacemaker Implantation in Patients With Pre-Existent Right Bundle Branch Block.

    Science.gov (United States)

    van Gils, Lennart; Tchetche, Didier; Lhermusier, Thibault; Abawi, Masieh; Dumonteil, Nicolas; Rodriguez Olivares, Ramón; Molina-Martin de Nicolas, Javier; Stella, Pieter R; Carrié, Didier; De Jaegere, Peter P; Van Mieghem, Nicolas M

    2017-03-03

    Right bundle branch block is an established predictor for new conduction disturbances and need for a permanent pacemaker (PPM) after transcatheter aortic valve replacement. The aim of the study was to evaluate the absolute rates of transcatheter aortic valve replacement related PPM implantations in patients with pre-existent right bundle branch block and categorize for different transcatheter heart valves. We pooled data on 306 transcatheter aortic valve replacement patients from 4 high-volume centers in Europe and selected those with right bundle branch block at baseline without a previously implanted PPM. Logistic regression was used to evaluate whether PPM rate differed among transcatheter heart valves after adjustment for confounders. Mean age was 83±7 years and 63% were male. Median Society of Thoracic Surgeons score was 6.3 (interquartile range, 4.1-10.2). The following transcatheter valve designs were used: Medtronic CoreValve (n=130; Medtronic, Minneapolis, MN); Edwards Sapien XT (ES-XT; n=124) and Edwards Sapien 3 (ES-3; n=32; Edwards Lifesciences, Irvine, CA); and Boston Scientific Lotus (n=20; Boston Scientific Corporation, Marlborough, MA). Overall permanent pacemaker implantation rate post-transcatheter aortic valve replacement was 41%, and per valve design: 75% with Lotus, 46% with CoreValve, 32% with ES-XT, and 34% with ES-3. The indication for PPM implantation was total atrioventricular block in 98% of the cases. Lotus was associated with a higher PPM rate than all other valves. PPM rate did not differ between ES-XT and ES-3. Ventricular paced rhythm at 30-day and 1-year follow-up was present in 81% at 89%, respectively. Right bundle branch block at baseline is associated with a high incidence of PPM implantation for all transcatheter heart valves. PPM rate was highest for Lotus and lowest for ES-XT and ES-3. Pacemaker dependency remained high during follow-up. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by

  18. System Synthesis for Networks of Programmable Blocks

    CERN Document Server

    Mannion, Ryan; Cotterell, Susan; Vahid, Frank

    2011-01-01

    The advent of sensor networks presents untapped opportunities for synthesis. We examine the problem of synthesis of behavioral specifications into networks of programmable sensor blocks. The particular behavioral specification we consider is an intuitive user-created network diagram of sensor blocks, each block having a pre-defined combinational or sequential behavior. We synthesize this specification to a new network that utilizes a minimum number of programmable blocks in place of the pre-defined blocks, thus reducing network size and hence network cost and power. We focus on the main task of this synthesis problem, namely partitioning pre-defined blocks onto a minimum number of programmable blocks, introducing the efficient but effective PareDown decomposition algorithm for the task. We describe the synthesis and simulation tools we developed. We provide results showing excellent network size reductions through such synthesis, and significant speedups of our algorithm over exhaustive search while obtaining...

  19. Cardiac pacing in heart failure patients with left bundle branch block: impact of pacing site for optimizing left ventricular resynchronization.

    Science.gov (United States)

    Pappone, C; Rosanio, S; Oreto, G; Tocchi, M; Gulletta, S; Salvati, A; Dicandia, C; Santinelli, V; Mazzone, P; Veglia, F; Ding, J; Sallusti, L; Spinelli, J; Vicedomini, G

    2000-07-01

    Acute left ventricular pacing has been associated with hemodynamic improvement in patients with congestive heart failure and wide QRS complex. We hypothesized that pacing two left ventricular sites simultaneously would produce faster activation and better systolic function than single-site pacing. We selected 14 heart failure patients (NYHA functional class III or IV) in normal sinus rhythm with left bundle branch block and QRS > 150 ms. An 8F dual micromanometer catheter was placed in the aorta for measuring +dP/dt (mmHg/s), aortic pulse pressure (mmHg), and end-diastolic pressure (mmHg). Pacing leads were positioned via coronary veins at the posterior base and lateral wall. Patients were acutely paced VDD at the posterior base, lateral wall, and both sites (dual-site) with 5 atrioventricular delays (from 8 ms to PR -30 ms). Pacing sequences were executed in randomized order using a custom external computer (FlexStim, Guidant CRM). Dual-site pacing increased peak +dP/dt significantly more than posterior base and lateral wall pacing. Dual-site and posterior base pacing raised aortic pulse pressure significantly more than lateral wall pacing. Dual-site pacing shortened QRS duration by 22 %, whereas posterior base and lateral wall pacing increased it by 2 and 12%, respectively (p = 0.006). In heart failure patients with left bundle branch block, dual-site pacing improves systolic function more than single-site stimulation. Improved ventricular activation synchrony, expressed by paced QRS narrowing, may account for the additional benefit of dual- vs single-site pacing in enhancing contractility. This novel approach deserves consideration for future heart failure pacing studies.

  20. General Floorplans with L/T-Shaped Blocks Using Corner Block List

    Institute of Scientific and Technical Information of China (English)

    Yu-Chun Ma; Xian-Long Hong; She-Qin Dong; C.K.Cheng; Jun Gu

    2006-01-01

    With the recent advent of deep submicron technology and new packing schemes, the components in the integrated circuit are often not rectangular. On the basis of the representation of Corner Block List (CBL), we propose a new method of handling rectilinear blocks. In this paper, the handling of the rectilinear blocks is simplified by transforming the L/T-shaped block problem into the align-abutment constraint problem. We devise the block rejoining process and block alignment operation for forming the L/T-shaped blocks into their original configurations. The shape flexibility of the soft blocks, and the rotation and reflection of L/T-shaped blocks are exploited to obtain a tight packing. The empty rooms are introduced to the process of block rejoining. The efficiency and effectiveness of the proposed method are demonstrated by the experimental results on a set of some benchmark examples.

  1. Incomplete block SSOR preconditionings for high order discretizations

    Energy Technology Data Exchange (ETDEWEB)

    Kolotilina, L. [Steklov Mathematical Institute, St. Petersburg (Russian Federation)

    1994-12-31

    This paper considers the solution of linear algebraic systems Ax = b resulting from the p-version of the Finite Element Method (FEM) using PCG iterations. Contrary to the h-version, the p-version ensures the desired accuracy of a discretization not by refining an original finite element mesh but by introducing higher degree polynomials as additional basis functions which permits to reduce the size of the resulting linear system as compared with the h-version. The suggested preconditionings are the so-called Incomplete Block SSOR (IBSSOR) preconditionings.

  2. Distributed deformation and block rotation in 3D

    Science.gov (United States)

    Scotti, Oona; Nur, Amos; Estevez, Raul

    1990-01-01

    The authors address how block rotation and complex distributed deformation in the Earth's shallow crust may be explained within a stationary regional stress field. Distributed deformation is characterized by domains of sub-parallel fault-bounded blocks. In response to the contemporaneous activity of neighboring domains some domains rotate, as suggested by both structural and paleomagnetic evidence. Rotations within domains are achieved through the contemporaneous slip and rotation of the faults and of the blocks they bound. Thus, in regions of distributed deformation, faults must remain active in spite of their poor orientation in the stress field. The authors developed a model that tracks the orientation of blocks and their bounding faults during rotation in a 3D stress field. In the model, the effective stress magnitudes of the principal stresses (sigma sub 1, sigma sub 2, and sigma sub 3) are controlled by the orientation of fault sets in each domain. Therefore, adjacent fault sets with differing orientations may be active and may display differing faulting styles, and a given set of faults may change its style of motion as it rotates within a stationary stress regime. The style of faulting predicted by the model depends on a dimensionless parameter phi = (sigma sub 2 - sigma sub 3)/(sigma sub 1 - sigma sub 3). Thus, the authors present a model for complex distributed deformation and complex offset history requiring neither geographical nor temporal changes in the stress regime. They apply the model to the Western Transverse Range domain of southern California. There, it is mechanically feasible for blocks and faults to have experienced up to 75 degrees of clockwise rotation in a phi = 0.1 strike-slip stress regime. The results of the model suggest that this domain may first have accommodated deformation along preexisting NNE-SSW faults, reactivated as normal faults. After rotation, these same faults became strike-slip in nature.

  3. [Ultrasound for peripheral neural block].

    Science.gov (United States)

    Kefalianakis, F

    2005-03-01

    Ultrasound is well established in medicine. Unfortunately, ultrasound is still rarely used in the area of anesthesia. The purpose of the article is to illustrate the possibilities and limitations of ultrasound in regional anesthesia. The basic principles of ultrasound are the piezoelectric effect and the behaviour of acoustic waveforms in human tissue. Ultrasound imaging in medicine uses high frequency pulses of sound waves (2.5-10 MHz). The following images are built up from the reflected sounds. The ultrasound devices used in regional anesthesia (commonly by 10 MHz) deliver a two-dimensional view. The main step for a successful regional anaesthesia is to identify the exact position of the nerve. In addition, specific surface landmarks and the use of peripheral nerve stimulator help to detect the correct position of the needle. Nerves are demonstrated as an composition of hyperechogenic (white) and hypoechogenic (black) areas. The surrounding hyperechogenic parts are epi- and perineurium, the dark hypoechogenic part is the neural tissue. The composition of peripheral nerves are always similar, but the quantities of each part, of surrounding perineurium and nerval structures, differ. Further the imaging of nerves is significantly influenced by the angle of beam to the nerve and the surrounding anatomic structures. Only experience and correct interpretation make the ultrasound a valid method in clinical practice. Correct interpretation has to be learned by standardized education. Three examples of peripheral nerve blocks are described. The detection of nerves and the visualization of the correct spread of local anesthetics to the nerves are the main principles of effective ultrasound-guided regional anesthesia, whereas closest proximity of the needle to the target nerve is not necessary. The described examples of ultrasound guidance for nerval block illustrates the specific procedures with reduced probability of nerval irritation, high success and low rate of

  4. Bradyarrhythmias: first presentation of arrhythmogenic right ventricular cardiomyopathy?

    Science.gov (United States)

    Burghouwt, Danielle E; Kammeraad, Janneke Ae; Knops, Paul; du Plessis, Frederik A; de Groot, Natasja Ms

    2015-04-01

    Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a disorder characterized by progressive replacement of myocardial cells by fibro-fatty tissue giving rise to ventricular tachyarrhythmias. In this case report, we describe a pediatric patient with sinoatrial arrests and second degree atrioventricular conduction block several years before ARVC became apparent. These findings suggest that bradyarrhythmias can also be the first expression of ARVC.

  5. [Permanent cardiac stimulation in a patient with isolated dextrocardia and ventricular septal defect].

    Science.gov (United States)

    Słowiński, S; Derlaga, B; Kapusta, J

    A case of pacemaker implantation because of acquired atrioventricular block third degree in woman aged 39 years with rare isolated dextrocardia with inversion of cardiac ventricles, compensatory transposition of both aorta and pulmonary artery, and ventricular septal defect. The end of electrode has wedged in the apex of the arterial ventricle. Following pacemaker implantation, patients clinical course of gynaecological operation was uneventful.

  6. Determination of Even Degree of Animal Population

    Institute of Scientific and Technical Information of China (English)

    SongRen-xue; YangYun-qing

    1999-01-01

    The even degree of animal population is generlay measured by the coefficient of variation of major economic characters.Facing the coefficient of variation,a statistic with complex properties,we achieved indirectly the determination of confidence interval for even degree of an animal population by analysing the reciprocal of the statistic.The sample size which is suitable to the determination of the even degree of an animal population was probed into within the extent of permissive estimation error.

  7. Determination of Even Degree of Animal Population

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    The even degree of animal population is generlay measured by the coefficient of variation of major eco- nomic characters. Facing the coefficient of variation,a statistic with complex properties,we achieved indirectly the determination of confidence interval for even degree of an animal population by analysing the reciprocal of the statistic. The sample size which is suitable to the determination of the even degree of an animal population was probed into within the extent of permissive estimation error.

  8. Degree of Competition of Consumer Loan Industry

    OpenAIRE

    Kohei Kubota; Yoshiro Tsutsui

    2008-01-01

    The purpose of this paper is to estimate the degree of competition of consumer loan industry in Japan utilizing responses to a questionnaire survey conducted by Japan Consumer Finance Association. Estimating the cost function, we found that the industry is characterized by large scale economies. Estimation of Lerner index, H-statistics, degree of noncompetition, and degree of collusion reveals that consumer loan market is highly monopolistic. Consumer loan companies answered to a question tha...

  9. Nazca - South America Convergence and Motion of the North Andes Block

    Science.gov (United States)

    La Femina, P. C.; Mora-paez, H.; Mothes, P. A.; Ruiz, G.

    2012-12-01

    The North Andes block (NAB) is a hypothesized tectonic block that moves (escapes) north-northeast relative to a stable South American reference frame. The motion of this block is thought to be derived by the collision of the Carnegie Ridge in southern Ecuador and/or by oblique convergence and high degrees of interplate coupling north of the ridge (i.e., strain partitioning). We investigate the kinematics of NAB motion utilizing a velocity field based on new continuous GPS networks and existing episodic GPS data in Ecuador and Colombia. The new velocity field and published earthquake slip vectors are inverted to solve for the Euler vector of the NAB and interseismic elastic strain accumulation on block-bounding faults using a block modeling approach. At the latitude of Ecuador, the NAB is rigid with transpressional deformation accommodating northeastward motion along its boundary with South America. In central to northern Colombia, the NAB is dissected by several prominent shear zones. We test a suite of block models to investigate the tectonic nature of the NAB and the style of faulting in the upper plate accommodating block motion. Through the estimation of elastic strain accumulation on all block-bounding faults, we improve the understanding of interseismic coupling along a convergent margin capable of producing M>8 earthquakes and upper plate faults capable of generating M>6 earthquakes.

  10. Degree-layer theory of network topology

    CERN Document Server

    Zhou, Bin; Zhe, He

    2014-01-01

    The network topology can be described by the number of nodes and the interconnections among them. The degree of a node in a network is the number of connections it has to other nodes and the degree distribution is the probability distribution of these degrees over the whole network. Therefore, the degree is very important structural parameter of network topology. However, given the number of nodes and the degree of each node in a network, the topology of the network cannot be determined. Therefore, we propose the degree-layer theory of network topology to describe deeply the network topology. First, we propose the concept of degree-tree with the breadth-first search tree. The degrees of all nodes are layered and have a hierarchical structure. Second,the degree-layer theory is described in detail. Two new concepts are defined in the theory. An index is proposed to quantitatively distinguish the two network topologies. It also can quantitatively measure the stability of network topology built by a model mechani...

  11. Cooperation in an evolutionary prisoner's dilemma on networks with degree-degree correlations.

    Science.gov (United States)

    Devlin, Stephen; Treloar, Thomas

    2009-08-01

    We study the effects of degree-degree correlations on the success of cooperation in an evolutionary prisoner's dilemma played on a random network. When degree-degree correlations are not present, the standardized variance of the network's degree distribution has been shown to be an accurate analytical measure of network heterogeneity that can be used to predict the success of cooperation. In this paper, we use a local-mechanism interpretation of standardized variance to give a generalization to graphs with degree-degree correlations. Two distinct mechanisms are shown to influence cooperation levels on these types of networks. The first is an intrinsic measurement of base-line heterogeneity coming from the network's degree distribution. The second is the increase in heterogeneity coming from the degree-degree correlations present in the network. A strong linear relationship is found between these two parameters and the average cooperation level in an evolutionary prisoner's dilemma on a network.

  12. Characterization of flavor and texture development within large (291 kg) blocks of Cheddar cheese.

    Science.gov (United States)

    Carunchia Whetstine, M E; Luck, P J; Drake, M A; Foegeding, E A; Gerard, P D; Barbano, D M

    2007-07-01

    Cheddar cheese is a natural product that has a variable flavor and texture profile. Many companies produce 291-kg blocks of Cheddar cheese, which are subsequently cut and shipped, or stored and subsequently cut. Previous research has shown that compositional differences exist within 291-kg blocks and that these differences may influence flavor and texture development. The objectives of this study were to systematically characterize flavor and texture differences within 291-kg blocks. On 2 different occasions, a 291-kg block was manufactured at each of 4 manufacturing facilities. After 7 d, the 291-kg blocks were sliced into sixteen 18-kg sample portions using a predetermined diagram, and each portion was labeled appropriately (outer corner, inner corner, etc.) and stored at 7 degrees C. Cheese from different locations within the 291-kg blocks was evaluated at 1, 4, 8, and 12 mo. At each time point, two 18-kg portions representing an inside and outside location with the 291-kg block cross-section (from inside to outside) were sampled. The moisture content was lower in the inner than outer locations within the 291-kg blocks. Protein hydrolysis was higher in the inner location and inner locations developed aged Cheddar flavors sulfur, nutty, and brothy more rapidly than the outer locations. However, plant-to-plant differences in aging were often larger than differences caused by block location. These differences were due to differences in cheese manufacturing practices among plants. Dynamic headspace results for flavor volatiles were consistent with descriptive sensory flavor results, documenting differences between inner and outer locations within 291-kg blocks. The inner locations were more fracturable and the outer locations were more cohesive and had more residual in the mouth. Inner locations had greater fracture strain than outer locations. Documenting the differences in aging of 291-kg blocks of Cheddar cheese is important in understanding how to make a

  13. Elastic Cube Actuator with Six Degrees of Freedom Output

    Directory of Open Access Journals (Sweden)

    Pengchuan Wang

    2015-09-01

    Full Text Available Unlike conventional rigid actuators, soft robotic technologies possess inherent compliance, so they can stretch and twist along every axis without the need for articulated joints. This compliance is exploited here using dielectric elastomer membranes to develop a novel six degrees of freedom (6-DOF polymer actuator that unifies ordinarily separate components into a simple cubic structure. This cube actuator design incorporates elastic dielectric elastomer membranes on four faces which are coupled by a cross-shaped end effector. The inherent elasticity of each membrane greatly reduces kinematic constraint and enables a 6-DOF actuation output to be produced via the end effector. An electro-mechanical model of the cube actuator is presented that captures the non-linear hyperelastic behaviour of the active membranes. It is demonstrated that the model accurately predicts actuator displacement and blocking moment for a range of input voltages. Experimental testing of a prototype 60 mm device demonstrates 6-DOF operation. The prototype produces maximum linear and rotational displacements of ±2.6 mm (±4.3% and ±4.8° respectively and a maximum blocking moment of ±76 mNm. The capacity for full 6-DOF actuation from a compact, readily scalable and easily fabricated polymeric package enables implementation in a range of mechatronics and robotics applications.

  14. 经胸房缺堵闭术对房室瓣反流的影响及术后并发症分析%Effects of transthoracic atrial septal defect occlusion on atrioventricular valve regurgitation and analysis of postoperative complications

    Institute of Scientific and Technical Information of China (English)

    张家庆; 闫玉生; 陈坤棠; 莒瑞红

    2012-01-01

    目的 探讨房室瓣反流程度与经胸房缺堵闭术术后并发症的关系.方法 回顾分析2002年1月~2011年3月我科经胸微创房缺堵闭术患者的临床资料,其中资料完全者43例,40例在食道超声、2例在经胸超声辅助下行房缺堵闭术.术后心脏超声随访,观察心脏各指标的变化,房室瓣反流程度及术后并发症等.结果 41例成功,1例术中改为右侧开胸小切口体外循环下房缺修补术,1例术中并发心跳骤停;1例术后并发肾衰,12例术后即时有少量残余漏,1个月后超声复查消失,手术成功率95.3%.术后超声随访显示:右室、右房直径较前缩小;左室直径较前增大;室间隔厚度、二尖瓣血流速度、主动脉瓣血流速度无明显改变;肺动脉瓣血流速度明显降低;二尖瓣反流程度在封堵术后加重,而三尖瓣的反流程度无明显改变;无瓣膜反流或合并二尖瓣轻度反流及三尖瓣中度以下反流的患者,术后未见严重并发症;合并二尖瓣中重度反流或三尖瓣重度反流的患者,封堵后可见严重的并发症,残余漏的发生几率也较大.结论 在无瓣膜反流或合并二尖瓣轻度反流或三尖瓣中度以下反流的患者中,经胸房缺堵闭术安全有效;而在二尖瓣中重度反流或三尖瓣重度反流的患者中,术后并发症发生率高,尤其是严重罕见并发症.%Objective To discuss the correlation between the regurgitation degree of atrioventricular valve and the occurrence of complications after transthoracic atrial septal defect occlusion. Methods A retrospective analysis was made in the clinical data of patients receiving the minimally invasive transthoracic atrial septal defect occlusion in our department from January 2002 to March 2011. Forty three patients had complete clinical data. Forty ones and 2 ones received the transthoracic atrial septal defect occlusion respectivelywith the assistance of transesophageal ultrasound and

  15. New High in Engineering Degree Production. Facts

    Science.gov (United States)

    Connecticut Department of Higher Education (NJ1), 2010

    2010-01-01

    Several of the state's key industry sectors depend heavily on employees with advanced scientific, analytic and technical knowledge. Among the fields closely related to these sectors, engineering degrees have posted the largest gain. This paper presents details on the following facts: (1) 2009 represented a record high for engineering degrees; (2)…

  16. Competency-Based Business Degree. Issue Brief

    Science.gov (United States)

    Washington State Board for Community and Technical Colleges, 2014

    2014-01-01

    In January 2015, thirteen Washington community colleges launched an online, competency-based business transfer degree--the first in the state's community and technical college system. This issue brief provides answers to commonly asked questions about the new competency-based degree.

  17. Master's Degree Studies: Expectations versus Reality

    Science.gov (United States)

    Swanepoel, C. H.

    2010-01-01

    During the past two decades, higher education in South Africa has been affected drastically by transformation. An issue that has specifically been influenced is master's degrees. A significant increase in the demand for access to course work master's degrees has been experienced, while universities themselves have been confronted with a new…

  18. Experiencing Higher Degree Research Supervision as Teaching

    Science.gov (United States)

    Bruce, Christine; Stoodley, Ian

    2013-01-01

    This article describes higher degree research supervisors' experiences of supervision as teaching. While research education is considered central to the higher degree research experience, comparatively little is known to date of the teaching lenses adopted by supervisors as they go about their supervision. We worked with 35 supervisors engaged in…

  19. The Topological Degree in Ordered Banach Spaces

    Institute of Scientific and Technical Information of China (English)

    Adrian DUMA; Ileana DUMA

    2008-01-01

    This paper is devoted to the applications of classical topological degrees to nonlinear problems involving various classes of operators acting between ordered Banach spaces. In this frame-work, the Leray-Schauder, Browder-Petryshyn, and Amann-Weiss degree theories are considered, and several existence results are obtained. The non-Archimedean case is also discussed.

  20. Powers of the degree of coherence.

    Science.gov (United States)

    Mei, Zhangrong; Korotkova, Olga; Mao, Yonghua

    2015-04-01

    We establish conditions under which a legitimate degree of coherence of a statistically stationary beam-like field raised to a power results in a novel legitimate degree of coherence. The general results and examples relate to scalar beams having uniform and non-uniform correlations.