WorldWideScience

Sample records for wired temporary pacemaker

  1. Clinical and mechanical factors associated with the removal of temporary epicardial pacemaker wires after cardiac surgery.

    Science.gov (United States)

    Elmistekawy, Elsayed; Gee, Yen-Yen; Une, Dai; Lemay, Matthieu; Stolarik, Anne; Rubens, Fraser D

    2016-01-16

    Temporary pacemaker wires are placed in the majority of patients after cardiac surgery. There is no information on mechanical factors related to wire removal. Clinical information related to temporary wire use and removal was prospectively collected from a large cardiac surgical unit over one year. Measurements of maximal tension that nurses and doctors would apply to remove temporary wires was determined using a hand-held portable scale. In a prospective trial, patients (n = 41) had their wires extracted in series to the portable scale to determine the maximal tension required for safe removal. Ventricular wires were placed in 86.5 % of patients during the observed year. Pacing facilitated weaning from CPB in over 15 % of patients and pacer dependence was seen in 2.1 %. No patients suffered major complications after wire removal. There was no difference in the tension that physicians or nurses would apply to comfortably extract temporary wires. In the prospective trial, there was no difference in the tension required for removal of atrial or ventricular wires (atrial 18.3 ± 17.9 oz versus 14.5 ± 14.2 oz, p = 0.430). There were no patient factors that correlated with the degree of resistance and there was no significant difference between the tension required to remove wires with (21.0 ± 22.5 oz) or without (14.1 ± 5.1 oz) an atrial button. Temporary epicardial wire removal is innocuous and was not associated with any complications. In some patients tension required for safe removal exceeded 20 ounces. Strategies to standardize wire removal may prevent complications and may minimize unnecessary wire retention.

  2. 21 CFR 870.3680 - Cardiovascular permanent or temporary pacemaker electrode.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiovascular permanent or temporary pacemaker... § 870.3680 Cardiovascular permanent or temporary pacemaker electrode. (a) Temporary pacemaker electrode—(1) Identification. A temporary pacemaker electrode is a device consisting of flexible insulated...

  3. [Development and research of temporary demand pacemaker with electrocardiosignal display].

    Science.gov (United States)

    Fan, Shounian; Jiang, Chenxi; Cai, Yunchang; Pan, Yangzhong; Yang, Tianhe; Wu, Qiang; Zheng, Yaxi; Liu, Xiaoqiao; Li, Shiying

    2004-08-01

    A temporary demand pacemaker with electrocardiosignal display is introduced in this paper. Double way low-noise electrocardiosignal preamplifier, amplitude limiter, high and low pass filter, 50 Hz notch filter, TTL level generator and stimulating pulse formation circuit are components of the hardware electrocircuit. The demand pacing and the electrocardiosignal display are separately controlled by the software in which the double microcontrollers communications technique is used. In this study, liquid crystal display is firstly used in body surface electrocardiosignal display or intracardial electrophysiologic signal display when the temporary demand pacemaker is installed and put into use. The machine has proven clinically useful and can be of wide appliation.

  4. Rhabdomyosarcoma associated with the lead wire of a pacemaker generator implant.

    Science.gov (United States)

    Thieman Mankin, Kelley M; Dunbar, Mark D; Toplon, David; Ginn, Pamela; Maisenbacher, Herbert W; Risselada, Marije

    2014-06-01

    An 11-year-old female spayed Labrador Retriever was presented for a draining, painful subcutaneous mass palpated over a previously implanted pacemaker generator. Infection was suspected and the mass was removed surgically. On cut surface, the mass was friable and mottled tan to brown with firm pale tan nodules, surrounding the pacemaker lead wire adjacent to the pacemaker generator. Cytologic interpretation of impression smears was consistent with a sarcoma, and suggestive of a rhabdomyosarcoma due to the presence of strap-like cells. On histopathologic examination, a highly invasive nodular mass surrounded the pacemaker lead, composed of pleomorphic round, spindle and strap cells, and multinucleated giant cells. The population exhibited microscopic invasion into the deep portion of the fibrous capsule surrounding the pacemaker generator. There were tumor emboli within small to medium subcutaneous veins adjacent to the mass. Immunohistochemically, the neoplastic cells stained positive for α-sarcomeric actin and vimentin, and negative for α-smooth muscle actin, consistent with a rhabdomyosarcoma arising at the site of the pacemaker generator. To our knowledge, this is the first report of a rhabdomyosarcoma associated with the lead wire of a pacemaker generator in a dog. © 2014 American Society for Veterinary Clinical Pathology and European Society for Veterinary Clinical Pathology.

  5. Clinical application of transvenous temporary cardiac pacemaker in performing extra-cranial carotid angiography and stent implantation

    International Nuclear Information System (INIS)

    Liu Juan; Yao Guoen; Zhou Huadong; Jiang Xiaojiang; Chen Qiao

    2012-01-01

    Objective: To assess the safety and effectiveness of transvenous temporary cardiac pacemaker in preventing hemodynamic instability occurred during the perioperative period of extra-cranial carotid angiography and stent implantation. Methods: Preoperative install of temporary cardiac pacemaker via left femoral vein was carried out in 41 patients who were at high risk for developing hemodynamic instability, which was followed by extra-cranial carotid angiography and stent implantation. The pacing rhythm of the pacemaker was fixed at 60 beats/min. During and after the procedure the patients were under close observation for the signs of discomfort symptoms as well as the changes in blood pressure and heart rate. The working condition of the pacemaker was also monitored. Results: All the installed pacemakers were technically and hemodynamically effective in producing electrical ventricular responses in all 25 patients who had received balloon dilatation of carotid in advance. Transient pacemaker activation appeared in 25 patients. The longest activation time was one day. During pacemaker activation, one patient developed symptomatic hypotension. The longest duration of hypotension lasted for 4 days. No pacemaker-related or procedure-related complications occurred. Conclusion: Hemodynamic instability is a common complication occurred during perioperative period of extra-cranial carotid angiography and stent implantation. As a prophylactic measure, preoperative placement of temporary cardiac pacemaker can promptly and effectively correct the hemodynamic disorders and prevent perioperative complications such as stroke, etc. Therefore, this technique is worth employing in clinical practice, and it is especially useful for patients with high risks. (authors)

  6. Pacemaker

    Science.gov (United States)

    ... heart disease or for people who have had heart transplants . Children, teens, and adults can use pacemakers. Before ... also may give you antibiotics to prevent infection. First, your doctor will insert a needle into a ...

  7. Neck Pain One Week after Pacemaker Generator Replacement.

    Science.gov (United States)

    Graham, Ross F; Wightman, John M

    2015-07-01

    The incidence of cardiac pacemaker implantation has risen markedly in the past three decades, making awareness of possible postprocedural complications critical to the emergency physician. This case is the first documented instance of internal jugular (IJ) deep vein thrombosis (DVT) from an uncomplicated pacemaker generator replacement. A patient presented to an Emergency Department with a 2-day history of mild left temporal headache migrating to his left neck. The patient did not volunteer this information, but review of systems revealed a temporary transvenous pacemaker inserted through the right IJ vein 1 week previously during a routine exchange of a left-sided cardiac pacemaker generator. Manipulation of the existing pacemaker wires entering the left subclavian vein was minimal. Computed tomographic angiography of the neck demonstrated near-complete thrombotic occlusion of the entire length of his left IJ vein. This required hospital admission for observation and treatment with anticoagulation. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: DVT, with thrombotic extension into adjacent vessels anywhere along the course of pacemaker wires, should be considered by the emergency provider in the evaluation of head, neck, or upper extremity symptoms after recent or remote implantation or manipulation of a transvenous cardiac pacemaker, including generator replacement. Failure to identify and treat appropriately could result in significant morbidity and mortality from airway edema, septic thrombophlebitis, superior vena cava syndrome, superior sagittal sinus thrombosis, or pulmonary embolism. Published by Elsevier Inc.

  8. Aggregatibacter aphrophilus pacemaker endocarditis: a case report.

    Science.gov (United States)

    Patel, Sahil R; Patel, Nishi H; Borah, Amit; Saltzman, Heath

    2014-12-08

    Aggregatibacter bacteria are a rare cause of endocarditis in adults. They are part of a group of organisms known as HACEK--Haemophilus, Aggregatibacter, Cardiobacter, Eikenella, and Kingella. Among these organisms, several Haemophilus species have been reclassified under the genus Aggregatibacter. Very few cases of Aggregatibacter endocarditis in patients with pacemaker devices have been reported. We present here what we believe to be the first case of Aggregatibacter aphrophilus pacemaker endocarditis. A 62-year-old African American male with a medical history significant for dual-chamber pacemaker placement in 1996 for complete heart block with subsequent lead manipulation in 2007, presented to his primary care doctor with fever, chills, night sweats, fatigue, and ten-pound weight loss over a four-month period. Physical examination revealed a new murmur and jugular venous distension which prompted initiation of antibiotics for suspicion of endocarditis. Both sets of initial blood cultures were positive for A. aphrophilus. Transesophageal echocardiogram revealed vegetations on the tricuspid valve and the right ventricular pacemaker lead (Figure 1). This case highlights the importance of identifying rare causes of endocarditis and recognizing that treatment may not differ from the standard treatment for typical presentations. The patient received intravenous ceftriaxone for his endocarditis for a total of six weeks. Upon device removal, temporary jugular venous pacing wires were placed. After two weeks of antibiotic treatment and no clinical deterioration, a new permanent pacemaker was placed and the patient was discharged home. This is the first case of A. aphrophilus endocarditis in a patient with a permanent pacemaker. Our patient had no obvious risk factors other than poor dentition and a history of repeated pacemaker lead manipulation. This suggests that valvulopathies secondary to repeated lead manipulation can be clinically significant factors in morbidity

  9. Mid-term outcome comparing temporary K-wire fixation versus PDS augmentation of Rockwood grade III acromioclavicular joint separations

    Directory of Open Access Journals (Sweden)

    Pilotto Susann

    2009-05-01

    Full Text Available Abstract Backround The treatment of acute acromioclavicular (AC joint injuries depends mainly on the type of the dislocation and patient demands. This study compares the mid term outcome of two frequently performed surgical concepts of Rockwood grade III AC joint separations: The temporary articular fixation with K-wires (TKW and the refixation with an absorbable polydioxansulfate (PDS sling. Findings Retrospective observational study of 86 patients with a mean age of 37 years underwent either TKW (n = 70 or PDS treatment (n = 16 of Rockwood grade III AC joint injuries. Mid term outcome with a mean follow up of 3 years was measured using a standardized functional patient questionnaire including Constant score, ASES rating scale, SPADI, XSMFA-D and a pain score. K-wire therapy resulted in significantly better functional results expressed by Constant score (88 ± 10 vs. 73 ± 18, ASES rating scale (29 ± 3 vs. 25 ± 5, SPADI (3 ± 9 vs. 9 ± 13, XSMFA-D function (13 ± 2 vs. 14 ± 3, XSMFA-D impairment (4 ± 1 vs. 6 ± 2 and pain score (1 ± 1 vs. 2 ± 2. Conclusion Either temporary K-wire fixation and PDS sling enable good or satisfying functional results in the treatment of Rockwood grade III AC separations. However functional outcome parameters indicate a significant advantage for the K-wire technique.

  10. Heart pacemaker - discharge

    Science.gov (United States)

    Cardiac pacemaker implantation - discharge; Artificial pacemaker - discharge; Permanent pacemaker - discharge; Internal pacemaker - discharge; Cardiac resynchronization therapy - discharge; CRT - discharge; ...

  11. Pacemaker (image)

    Science.gov (United States)

    A pacemaker is a small, battery-operated electronic device which is inserted under the skin to help the heart beat regularly and at an appropriate rate. The pacemaker has leads that travel through a large vein ...

  12. Cardiac Pacemakers

    International Nuclear Information System (INIS)

    Fiandra, O.; Espasandin, W.; Fiandra, H.

    1984-01-01

    A complete survey of physiological biophysical,clinical and engineering aspects of cardiac facing,including the history and an assessment of possible future developments.Among the topics studied are: pacemakers, energy search, heart stimulating with pacemakers ,mathematical aspects of the electric cardio stimulation chronic, pacemaker implants,proceeding,treatment and control

  13. Advanced Pacemaker

    Science.gov (United States)

    1990-01-01

    Synchrony, developed by St. Jude Medical's Cardiac Rhythm Management Division (formerly known as Pacesetter Systems, Inc.) is an advanced state-of-the-art implantable pacemaker that closely matches the natural rhythm of the heart. The companion element of the Synchrony Pacemaker System is the Programmer Analyzer APS-II which allows a doctor to reprogram and fine tune the pacemaker to each user's special requirements without surgery. The two-way communications capability that allows the physician to instruct and query the pacemaker is accomplished by bidirectional telemetry. APS-II features 28 pacing functions and thousands of programming combinations to accommodate diverse lifestyles. Microprocessor unit also records and stores pertinent patient data up to a year.

  14. Runaway pacemaker: a still existing complication and therapeutic guidelines

    DEFF Research Database (Denmark)

    Mickley, H; Andersen, C; Nielsen, L H

    1989-01-01

    Runaway pacemaker is a rare, but still existing potential lethal complication in permanent pacemakers. Within 4 1/2 years, we saw two cases of runaway pacemaker in patients with multiprogrammable, VVI pacemakers (Siemens-Elema, Model 668). In both cases a pacemaker-induced ventricular tachycardia...... (rate 240-260 beats/min) was documented. One patient died. Runaway pacemakers must be exchanged as soon as possible. Until this can be accomplished, different emergency maneuvers should be tried. As documented in the cases presented, placing a magnet over the pacemaker may result in a lower, more...... pacemaker may be connected to the permanent pacing lead. Thereafter, the lead can be safely cut. As an alternative, a temporary transvenous pacing lead may be established prior to disconnecting the permanent pacing lead....

  15. The influence of radiation therapy on cardiac pacemakers

    International Nuclear Information System (INIS)

    Coles, J.R.; Ciddor, G.S.

    1980-01-01

    The results of an investigation to determine the influence on pacemaking of ionizing radiation and electromagnetic radiation from a number of radiotherapy machines are reported. In vitro tests were carried out on unipolar cardiac pacemakers of the ventricular inhibited type. The pacemakers were largely unaffected by the environment of clinical radiotherapy machines. Ionizing radiation had no detrimental effect on the pacemakers and electromagnetic interference caused only temporary single-beat inhibition at most. With the betatron used, malfunction of the pacemakers regularly occurred whilst in their inhibited made of operation. The demand function became disabled allowing competitive asynchronous pulses to be produced

  16. Heart pacemaker

    Science.gov (United States)

    ... labels Implantable cardioverter defibrillator - discharge Low-salt diet Mediterranean diet Surgical wound care - open Images Pacemaker References Epstein AE, DiMarco JP, Ellenbogen KA, et al. 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based ...

  17. Test and Evaluation of the Zoll Medical Inc., PD2OOO Cardiac Monitor/Pacemaker/Defibrillator System

    National Research Council Canada - National Science Library

    Hade, Edward

    1997-01-01

    The Zoll PD2000 is a portable cardiac monitor, defibrillator and pacemaker that offers synchronized defibrillation, electrocardiogram monitoring, noninvasive temporary pacing and advisory capability...

  18. Cardiac pacemaker

    International Nuclear Information System (INIS)

    Kolenik, S.A.

    1976-01-01

    The construction of a cardiac pacemaker is described which is characterized by particularly small dimensions, small weight and long life duration. The weight is under 100g, the specific weight under 1.7. Mass inertia forces which occur through acceleration and retardation processes, thus remain below the threshold values, above which one would have to reckon with considerable damaging of the surrounding body tissue. The maintaining of small size and slight weight is achieved by using an oscillator on COSMOS basis, where by considerably lower energy consumption, amongst others the lifetimes of the batteries used - a lithium anode with thionyl chloride electrolyte - is extended to over 5 years. The reliability can be increased by the use of 2 or more batteries. The designed dimension are 20x60x60 mm 3 . (ORU/LH) [de

  19. Pacemakers and implantable cardioverter defibrillators - general and anesthetic considerations

    Directory of Open Access Journals (Sweden)

    Amy G. Rapsang

    2014-06-01

    Full Text Available A pacemaking system consists of an impulse generator and lead or leads to carry the electrical impulse to the patient's heart. Pacemaker and implantable cardioverter defibrillator codes were made to describe the type of pacemaker or implantable cardioverter defibrillator implanted. Indications for pacing and implantable cardioverter defibrillator implantation were given by the American College of Cardiologists. Certain pacemakers have magnet-operated reed switches incorporated; however, magnet application can have serious adverse effects; hence, devices should be considered programmable unless known otherwise. When a device patient undergoes any procedure (with or without anesthesia, special precautions have to be observed including a focused history/physical examination, interrogation of pacemaker before and after the procedure, emergency drugs/temporary pacing and defibrillation, reprogramming of pacemaker and disabling certain pacemaker functions if required, monitoring of electrolyte and metabolic disturbance and avoiding certain drugs and equipments that can interfere with pacemaker function. If unanticipated device interactions are found, consider discontinuation of the procedure until the source of interference can be eliminated or managed and all corrective measures should be taken to ensure proper pacemaker function should be done. Post procedure, the cardiac rate and rhythm should be monitored continuously and emergency drugs and equipments should be kept ready and consultation with a cardiologist or a pacemaker-implantable cardioverter defibrillator service may be necessary.

  20. The pacemaker-twiddler's syndrome: an infrequent cause of pacemaker failure.

    Science.gov (United States)

    Salahuddin, Mohammad; Cader, Fathima Aaysha; Nasrin, Sahela; Chowdhury, Mashhud Zia

    2016-01-20

    The pacemaker-twiddler's syndrome is an uncommon cause of pacemaker malfunction. It occurs due to unintentional or deliberate manipulation of the pacemaker pulse generator within its skin pocket by the patient. This causes coiling of the lead and its dislodgement, resulting in failure of ventricular pacing. More commonly reported among elderly females with impaired cognition, the phenomenon usually occurs in the first year following pacemaker implantation. Treatment involves repositioning of the dislodged leads and suture fixation of the lead and pulse generator within its pocket. An 87 year old Bangladeshi lady who underwent a single chamber ventricular pacemaker (VVI mode: i.e. ventricle paced, ventricle sensed, inhibitory mode) implantation with the indication of complete heart block, and presented to us again 7 weeks later, with syncopal attacks. She admitted to repeatedly manipulating the pacemaker generator in her left pectoral region. Physical examination revealed a heart rate of 42 beats/minute, blood pressure 140/80 mmHg and bilateral crackles on lung auscultation. She had no cognitive deficit. An immediate electrocardiogram showed complete heart block with pacemaker spikes and failure to capture. Chest X-ray showed coiled and retracted right ventricular lead and rotated pulse generator. An emergent temporary pace maker was set at a rate of 60 beats per minute. Subsequently, she underwent successful lead repositioning with strong counselling to avoid further twiddling. Twiddler's syndrome should be considered as a cause of pacemaker failure in elderly patients presenting with bradyarrythmias following pacemaker implantation. Chest X-ray and electrocardiograms are simple and easily-available first line investigations for its diagnosis. Lead repositioning is required, however proper patient education and counselling against further manipulation is paramount to long-term management.

  1. What Is a Pacemaker?

    Science.gov (United States)

    ... your pacemaker. • If you work around industrial microwaves, electricity, cars or other large motors, ask your doctor about possible effects. Can I use a cell phone or microwave oven if I have a pacemaker? Microwave ovens, electric blankets, remote controls for TV and other common ...

  2. [Analysis of pacemaker ECGs].

    Science.gov (United States)

    Israel, Carsten W; Ekosso-Ejangue, Lucy; Sheta, Mohamed-Karim

    2015-09-01

    The key to a successful analysis of a pacemaker electrocardiogram (ECG) is the application of the systematic approach used for any other ECG without a pacemaker: analysis of (1) basic rhythm and rate, (2) QRS axis, (3) PQ, QRS and QT intervals, (4) morphology of P waves, QRS, ST segments and T(U) waves and (5) the presence of arrhythmias. If only the most obvious abnormality of a pacemaker ECG is considered, wrong conclusions can easily be drawn. If a systematic approach is skipped it may be overlooked that e.g. atrial pacing is ineffective, the left ventricle is paced instead of the right ventricle, pacing competes with intrinsic conduction or that the atrioventricular (AV) conduction time is programmed too long. Apart from this analysis, a pacemaker ECG which is not clear should be checked for the presence of arrhythmias (e.g. atrial fibrillation, atrial flutter, junctional escape rhythm and endless loop tachycardia), pacemaker malfunction (e.g. atrial or ventricular undersensing or oversensing, atrial or ventricular loss of capture) and activity of specific pacing algorithms, such as automatic mode switching, rate adaptation, AV delay modifying algorithms, reaction to premature ventricular contractions (PVC), safety window pacing, hysteresis and noise mode. A systematic analysis of the pacemaker ECG almost always allows a probable diagnosis of arrhythmias and malfunctions to be made, which can be confirmed by pacemaker control and can often be corrected at the touch of the right button to the patient's benefit.

  3. Test and Evaluation of the Hewlett-Packard CodeMaster 100 Cardiac Monitor/Pacemaker/Defibrillator System

    National Research Council Canada - National Science Library

    Hade, Edward

    1997-01-01

    The CodeMaster 100 is a portable cardiac monitor, defibrillator and pacemaker that offers synchronized defibrillation, electrocardiogram monitoring, noninvasive temporary pacing and pulse oximetery (SpO2) capabilities...

  4. Testing and Evaluation of the Medical Research Laboratories, Inc., 360SLX Cardiac Monitor/Pacemaker/Defibrillator System

    National Research Council Canada - National Science Library

    Hade, Edward

    1998-01-01

    The Medical Research Laboratories (MRL), Inc., model 360 SLx is a portable cardica monitor, defibrillator, and pacemaker that offers synchronized defibrillator, electrocardiogram monitoring, and non-invasive temporary pacing...

  5. Effects of irradiation on the components of implantable pacemakers

    CERN Document Server

    Kawamura, S; Kuga, N; Shiba, T; Hirose, T; Fujimoto, H; Toyoshima, T; Hyodo, K; Matoba, M

    2003-01-01

    The purpose of this study was to examine the effects of irradiation on implantable pacemaker components. The pacemaker was divided into three components: lead wire and electrode, battery, and electrical circuit, and each component was irradiated by X-ray and electron beams, respectively. The pacemaker parameters were measured by both telemetry data of the programmer and directly measured data from the output terminal. The following results were obtained. For the lead wire and electrode, there was no effect on the pacemaker function due to irradiation by X-ray and electron beams. In the case of battery irradiation, there was no change in battery voltage or current up to 236 Gy X-ray dose. In the electrical circuit, the pacemaker reverted to the regular beating rate (fixed-rate mode) immediately after the start of X-ray irradiation, and it continued in this mode during irradiation. In patients with their own heartbeat rhythm, changing to the fixed-rate mode may cause dangerous conditions such as ventricular fib...

  6. Waiting for a pacemaker

    DEFF Research Database (Denmark)

    Risgaard, B.; Elming, H.; Jensen, G.V.

    2012-01-01

    AimsTo determine waiting period-related morbidity, mortality, and adverse events in acute patients waiting for a permanent pacemaker (PPM).Methods and resultsA retrospective chart review of all PPM implantations in Region Zealand, Denmark, in 2009 was conducted. Patients were excluded if they were...... event during the waiting period. The present study indicates that a waiting period is dangerous as it is associated with an increased risk of adverse events. Acute PPMs should be implanted with a 24-h pacemaker implantation service capacity. Published on behalf of the European Society of Cardiology. All...

  7. Nonsurgical treatment of an adult with a skeletal Class II gummy smile using zygomatic temporary anchorage devices and improved superelastic nickel-titanium alloy wires.

    Science.gov (United States)

    Ishida, Yuji; Ono, Takashi

    2017-11-01

    Patients with a severe gummy smile and a skeletal Class II profile are difficult to treat. This case report describes an effective treatment alternative for improving a gummy smile in a patient with a severe Class II molar relationship, severe crowding, and lip protrusion using zygomatic anchorage devices and improved superelastic nickel-titanium wires. A 36-year-old woman had an excessive overjet and a deep overbite with a bilateral Angle Class II molar relationship. The cephalometric analysis demonstrated a Class II skeletal relationship (ANB, 9.5°), retroclination of the mandible (FMA, 38.4°), and severe labial inclination of the mandibular incisors (IMPA, 101.9°). The main treatment objectives included normalizing the overjet and overbite, improving the gummy smile, and establishing a satisfactory occlusion. During treatment with fixed appliances, intrusion of the total maxillary dentition using skeletal anchorage and elimination of the bimaxillary protrusion were achieved. Improvement of the lateral profile and gummy smile enhanced facial esthetics. Intrusion and distalization of the maxillary dentition with skeletal anchorage and improved superelastic nickel-titanium wires provided a satisfactory dental occlusion, esthetic improvement, and adequate function. This approach should be considered as an alternative treatment option to orthognathic surgery for adults with high-angle skeletal Class II malocclusion and a gummy smile. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  8. Temporary pacing

    Directory of Open Access Journals (Sweden)

    L.J. Workman

    1983-09-01

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

  9. Pacemaker Use Following Heart Transplantation

    Science.gov (United States)

    Mallidi, Hari R.; Bates, Michael

    2017-01-01

    Background: The incidence of permanent pacemaker implantation after orthotopic heart transplantation has been reported to be 2%-24%. Transplanted hearts usually exhibit sinus rhythm in the operating room following reperfusion, and most patients do not exhibit significant arrhythmias during the postoperative period. However, among the patients who do exhibit abnormalities, pacemakers may be implanted for early sinus node dysfunction but are rarely used after 6 months. Permanent pacing is often required for atrioventricular block. A different cohort of transplant patients presents later with bradycardia requiring pacemaker implantation, reported to occur in approximately 1.5% of patients. The objectives of this study were to investigate the indications for pacemaker implantation, compare the need for pacemakers following bicaval vs biatrial anastomosis, and examine the long-term outcomes of heart transplant patients who received pacemakers. Methods: For this retrospective, case-cohort, single-institution study, patients were identified from clinical research and administrative transplant databases. Information was supplemented with review of the medical records. Standard statistical techniques were used, with chi-square testing for categorical variables and the 2-tailed t test for continuous variables. Survival was compared with the use of log-rank methods. Results: Between January 1968 and February 2008, 1,450 heart transplants were performed at Stanford University. Eighty-four patients (5.8%) were identified as having had a pacemaker implanted. Of these patients, 65.5% (55) had the device implanted within 30 days of transplantation, and 34.5% (29) had late implantation. The mean survival of patients who had an early pacemaker implant was 6.4 years compared to 7.7 years for those with a late pacemaker implant (Ppacemaker implantation. Starting in 1997, a bicaval technique was used for implantation. The incidence of pacemaker implantation by technique was 2.0% for

  10. New Concepts in Pacemaker Syndrome

    Directory of Open Access Journals (Sweden)

    D. Michael Farmer

    2004-10-01

    Full Text Available After implantation of a permanent pacemaker, patients may experience severe symptoms of dyspnea, palpitations, malaise, and syncope resulting from pacemaker syndrome. Although pacemaker syndrome is most often ascribed to the loss of atrioventricular (A-V synchrony, more recent data may also implicate left ventricular dysynchrony caused by right ventricular pacing. Previous studies have not shown reductions in mortality or stroke with rate-modulated dual-chamber (DDDR pacing as compared to ventricular-based (VVI pacing. The benefits in A-V sequential pacing with the DDDR mode are likely mitigated by the interventricular (V-V dysynchrony imposed by the high percentage of ventricular pacing commonly seen in the DDDR mode. Programming DDDR pacemakers to encourage intrinsic A-V conduction and reduce right ventricular pacing will likely decrease heart failure and pacemaker syndrome. Studies are currently ongoing to address these questions.

  11. Temporary epicardial cardiac resynchronisation versus conventional right ventricular pacing after cardiac surgery: study protocol for a randomised control trial

    Directory of Open Access Journals (Sweden)

    Russell Stuart J

    2012-02-01

    Full Text Available Abstract Background Heart failure patients with stable angina, acute coronary syndromes and valvular heart disease may benefit from revascularisation and/or valve surgery. However, the mortality rate is increased- 5-30%. Biventricular pacing using temporary epicardial wires after surgery is a potential mechanism to improve cardiac function and clinical endpoints. Method/design A multi-centred, prospective, randomised, single-blinded, intervention-control trial of temporary biventricular pacing versus standard pacing. Patients with ischaemic cardiomyopathy, valvular heart disease or both, an ejection fraction ≤ 35% and a conventional indication for cardiac surgery will be recruited from 2 cardiac centres. Baseline investigations will include: an electrocardiogram to confirm sinus rhythm and measure QRS duration; echocardiogram to evaluate left ventricular function and markers of mechanical dyssynchrony; dobutamine echocardiogram for viability and blood tests for renal function and biomarkers of myocardial injury- troponin T and brain naturetic peptide. Blood tests will be repeated at 18, 48 and 72 hours. The principal exclusions will be subjects with permanent atrial arrhythmias, permanent pacemakers, infective endocarditis or end-stage renal disease. After surgery, temporary pacing wires will be attached to the postero-lateral wall of the left ventricle, the right atrium and right ventricle and connected to a triple chamber temporary pacemaker. Subjects will be randomised to receive either temporary biventricular pacing or standard pacing (atrial inhibited pacing or atrial-synchronous right ventricular pacing for 48 hours. The primary endpoint will be the duration of level 3 care. In brief, this is the requirement for invasive ventilation, multi-organ support or more than one inotrope/vasoconstrictor. Haemodynamic studies will be performed at baseline, 6, 18 and 24 hours after surgery using a pulmonary arterial catheter. Measurements will be

  12. Defibrillator/monitor/pacemakers.

    Science.gov (United States)

    1998-02-01

    This study updates our May-June 1993 Evaluation of defibrillator/monitor/pacemakers, published in Health Devices 22(5-6), in which we tested eight units from six suppliers. For this Update Evaluation, we tested three additional units, each from a different supplier. We also present update information, including some new ratings, for most of the previously evaluated units. We judged the new units against the same basic criteria and rated and ranked them using the same scheme--with some minor revisions--as in our original Evaluation. We judged the suitability of these units for three primary clinical applications: (1) general crash-cart use, (2) prehospital (emergency medical service [EMS]) use, and (3) in-hospital transport use. Because our criteria have changed slightly since the original study, we have repeated them in this issue. The test methods have not changed significantly and can be found in the original 1993 Evaluation. For more detailed information about this technology, the environments in which these units are used, and the factors to consider when selecting this type of device, we encourage readers to refer to the following sections in the original Evaluation: the Clinical Perspective "The Importance of Early Defibrillation"; the Clinical and Technical Overview; and the Selection and Use Guide for Defibrillator/Monitor/Pacemakers.

  13. Temporary tracheostomy.

    Science.gov (United States)

    Mazzaferro, Elisa M

    2013-08-01

    Upper airway obstruction can be due to a variety of causes in small animal patients and is often life threatening if left untreated. Placement of a temporary tracheostomy tube may be necessary in the most severe cases of upper airway obstruction until definitive therapy can be implemented. This paper discusses the indications, technique for placement, maintenance, and complications associated with temporary tracheostomy in dogs and cats. © 2013 Elsevier Inc. All rights reserved.

  14. Development of the cardiac pacemaker

    Science.gov (United States)

    Liang, Xingqun; Evans, Sylvia M.

    2017-01-01

    The sinoatrial node (SAN) is the dominant pacemaker of the heart. Abnormalities in SAN formation and function can cause sinus arrhythmia, including sick sinus syndrome and sudden death. A better understanding of genes and signaling pathways that regulate SAN development and function is essential to develop more effective treatment to sinus arrhythmia, including biological pacemakers. In this review, we briefly summarize the key processes of SAN morphogenesis during development, and focus on the transcriptional network that drives SAN development. PMID:27770149

  15. Basic Wiring.

    Science.gov (United States)

    Kaltwasser, Stan; And Others

    This module is the first in a series of three wiring publications; it serves as the foundation for students enrolled in a wiring program. It is a prerequisite to either "Residential Wiring" or "Commercial and Industrial Wiring." The module contains 16 instructional units that cover the following topics: occupational…

  16. Pacemakers and Implantable Defibrillators - Multiple Languages

    Science.gov (United States)

    ... 简体中文) Expand Section Pacemaker - 简体中文 (Chinese, Simplified (Mandarin dialect)) Bilingual PDF Health Information Translations Chinese, Traditional (Cantonese dialect) (繁體中文) Expand Section Pacemaker - ...

  17. Wireless power transfer for a pacemaker application.

    Science.gov (United States)

    Vulfin, Vladimir; Sayfan-Altman, Shai; Ianconescu, Reuven

    2017-05-01

    An artificial pacemaker is a small medical device that uses electrical impulses, delivered by electrodes contracting the heart muscles, to regulate the beating of the heart. The pacemaker is implanted under the skin, and uses for many years regular non-rechargeable batteries. However, the demand for rechargeable batteries in pacemakers increased, and the aim of this work is to design an efficient charging system for pacemakers.

  18. 21 CFR 870.3670 - Pacemaker charger.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pacemaker charger. 870.3670 Section 870.3670 Food... DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3670 Pacemaker charger. (a) Identification. A pacemaker charger is a device used transcutaneously to recharge the batteries of a rechargeable...

  19. 21 CFR 870.3700 - Pacemaker programmers.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pacemaker programmers. 870.3700 Section 870.3700...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3700 Pacemaker programmers. (a) Identification. A pacemaker programmer is a device used to change noninvasively one or more of...

  20. Syncope in Patients with Pacemakers

    OpenAIRE

    Sutton, Richard

    2015-01-01

    Syncope in a pacemaker patient is a serious symptom but it is rarely due a pacemaker system malfunction. Syncope occurs in about 5 % of patients paced for atrioventricular (AV) block in 5 years, 18% in those paced for sinus node disease in 10 years, 20 % of those paced for carotid sinus syndrome in 5 years and 5–55 % of those older patients paced for vasovagal syncope in 2 years. The vastly different results in vasovagal syncope depend on the results of tilt testing, where those with negative...

  1. Minimally invasive resynchronization pacemaker: a pediatric animal model.

    Science.gov (United States)

    Jordan, Christopher P; Wu, Kyle; Costello, John P; Ishibashi, Nobuyuki; Krieger, Axel; Kane, Timothy D; Kim, Peter; Berul, Charles I

    2013-12-01

    We developed a minimally invasive epicardial pacemaker implantation method for infants and congenital heart disease patients for whom a transvenous approach is contraindicated. The piglet is an ideal model for technical development. In 5 piglets we introduced a needle through subxiphoid approach under thoracoscopic guidance, inserting a wire into the pericardial space. Pacing leads were affixed to the left ventricular free wall and left atrial appendage. After verifying functionality with atrial and ventricular pacing and sensing, animals were euthanized. Pacemaker monitoring occurred daily for 4 days in the fifth animal. Through minimally invasive pericardial access, we directly visualized and fixated pacing leads to the left ventricle and left atrial appendage, successfully pacing atrium and ventricle. Epicardial structures were visualized. One piglet had contralateral pneumothorax, which resolved with needle decompression. No other adverse events occurred. Minimally invasive epicardial pacemaker implantation in an infant model is feasible and effective. This innovation may be of value for pacing and resynchronization in infants and congenital heart disease patients. Survival studies with permanent generator implantation are under way. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Interference with cardiac pacemakers by magnetic resonance imaging: are there irreversible changes at 0.5 Tesla?

    Science.gov (United States)

    Vahlhaus, C; Sommer, T; Lewalter, T; Schimpf, R; Schumacher, B; Jung, W; Lüderitz, B

    2001-04-01

    The safety and feasibility of magnetic resonance imaging (MRI) in patients with cardiac pacemakers is an issue of gaining significance. The effect of MRI on patients' pacemaker systems has only been analyzed retrospectively in some case reports. Therefore, this study prospectively investigated if MRI causes irreversible changes in patients' pacemaker systems. The effect of MRI at 0.5 Tesla on sensing and stimulation thresholds, lead impedance and battery voltage, current, and impedance was estimated during 34 MRI examinations in 32 patients with implanted pacemakers. After measurements at baseline and with documentation of intrinsic rhythm and modification of the pacing mode, patients underwent MRI. The rest of the function time of the pacemaker was calculated. Measurements were again performed after 99.5 +/- 29.6 minutes (mean +/- SD), immediately after MRI examination, and 3 months later. Lead impedance and sensing and stimulation thresholds did not change after MRI. Battery voltage decreased immediately after MRI and recovered 3 months later. Battery current and impedance tended to increase. The calculated rest of function time did not change immediately after MRI. MRI affected neither pacemaker programmed data, nor the ability to interrogate, program, or use telemetry. Surprisingly, in the gantry of the scanner, temporary deactivation of the reed switch occurred in 12 of 32 patients when positioned in the center of the magnetic field. Missing activation of the reed switch through the static magnetic field at 0.5 Tesla is not unusual. MRI at 0.5 Tesla does not cause irreversible changes in patients' pacemaker systems.

  3. [Wide QRS tachycardia preceded by pacemaker spikes].

    Science.gov (United States)

    Romero, M; Aranda, A; Gómez, F J; Jurado, A

    2014-04-01

    The differential diagnosis and therapeutic management of wide QRS tachycardia preceded by pacemaker spike is presented. The pacemaker-mediated tachycardia, tachycardia fibrillo-flutter in patients with pacemakers, and runaway pacemakers, have a similar surface electrocardiogram, but respond to different therapeutic measures. The tachycardia response to the application of a magnet over the pacemaker could help in the differential diagnosis, and in some cases will be therapeutic, as in the case of a tachycardia-mediated pacemaker. Although these conditions are diagnosed and treated in hospitals with catheterization laboratories using the application programmer over the pacemaker, patients presenting in primary care clinic and emergency forced us to make a diagnosis and treat the haemodynamically unstable patient prior to referral. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  4. 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.

  5. Pacemakers and Implantable Defibrillators: MedlinePlus Health Topic

    Science.gov (United States)

    ... ClinicalTrials.gov: Pacemaker, Artificial (National Institutes of Health) Journal Articles References and abstracts from MEDLINE/PubMed (National ... Leadless Cardiac Pacemakers: The Next Evolution in Pacemaker Technology. ... on Pacemakers and Implantable Defibrillators is the National Heart, Lung, and Blood Institute Other Languages Find health information in languages other than English on Pacemakers and ...

  6. Wire Chamber

    CERN Multimedia

    Magnetoscriptive readout wire chamber. Multi-wire detectors contain layers of positively and negatively charged wires enclosed in a chamber full of gas. A charged particle passing through the chamber knocks negatively charged electrons out of atoms in the gas, leaving behind positive ions. The electrons are pulled towards the positively charged wires. They collide with other atoms on the way, producing an avalanche of electrons and ions. The movement of these electrons and ions induces an electric pulse in the wires which is collected by fast electronics. The size of the pulse is proportional to the energy loss of the original particle.

  7. Wire chamber

    CERN Multimedia

    1967-01-01

    Magnetoscriptive readout wire chamber.Multi-wire detectors contain layers of positively and negatively charged wires enclosed in a chamber full of gas. A charged particle passing through the chamber knocks negatively charged electrons out of atoms in the gas, leaving behind positive ions. The electrons are pulled towards the positively charged wires. They collide with other atoms on the way, producing an avalanche of electrons and ions. The movement of these electrons and ions induces an electric pulse in the wires which is collected by fast electronics. The size of the pulse is proportional to the energy loss of the original particle.

  8. wire chamber

    CERN Multimedia

    Proportional multi-wire chamber. Multi-wire detectors contain layers of positively and negatively charged wires enclosed in a chamber full of gas. A charged particle passing through the chamber knocks negatively charged electrons out of atoms in the gas, leaving behind positive ions. The electrons are pulled towards the positively charged wires. They collide with other atoms on the way, producing an avalanche of electrons and ions. The movement of these electrons and ions induces an electric pulse in the wires which is collected by fast electronics. The size of the pulse is proportional to the energy loss of the original particle. Proportional wire chambers allow a much quicker reading than the optical or magnetoscriptive readout wire chambers.

  9. Pacemakers in patients with familial dysautonomia--a review of experience with 20 patients.

    Science.gov (United States)

    Gold-von Simson, Gabrielle; Rutkowski, Monika; Berlin, Dena; Axelrod, Felicia B

    2005-02-01

    Familial dysautonomia (FD) is a genetic disease associated with a high incidence of sudden death. If fatal bradyarrhythmia is an etiological factor then the incidence of sudden death should decrease after pacemaker placement. Retrospective review of 596 registered FD patients revealed that 22 FD patients (3.7%) had pacemakers placed between December 1984 and June 2003. Clinical and electrocardiographic indications for placement and demographic data were assessed for 20 of the 22 patients (10 males, 10 females, ages 4 to 48 years). Two patients were excluded because of insufficient data. Prior to pacemaker placement, presenting symptoms were syncope and cardiac arrest, 16/20 (80%) and 6/20 (30 %), respectively. Asystole was the most frequent electrocardiographic finding and was documented in 17/20 patients (85 %). Other electrocardiographic abnormalities included bradycardia, AV block, prolonged QTc and prolonged JTc. The average duration of pacemaker utilization was 5.7 years (range 5 months to 14.5 years). Complications included infection (1 patient) and wire migration (2 patients). In the one patient with infection, the pacemaker was permanently removed. This patient then experienced multiple syncopal episodes and death. There were 7 other deaths. Three deaths occurred suddenly without preceding events, and 4 patients had non-cardiac causes of death. None of these 7 deceased patients had recurrence of syncope after pacemaker placement. In the 12 surviving patients, 6 had recurrence of syncope but none had cardiac arrest. Pacemaker placement may protect FD patients from fatal bradyarrhythmia and may decrease the incidence of syncope. However, data are limited and prospective analysis is needed.

  10. Syncope in Patients with Pacemakers.

    Science.gov (United States)

    Sutton, Richard

    2015-12-01

    Syncope in a pacemaker patient is a serious symptom but it is rarely due a pacemaker system malfunction. Syncope occurs in about 5 % of patients paced for atrioventricular (AV) block in 5 years, 18% in those paced for sinus node disease in 10 years, 20 % of those paced for carotid sinus syndrome in 5 years and 5-55 % of those older patients paced for vasovagal syncope in 2 years. The vastly different results in vasovagal syncope depend on the results of tilt testing, where those with negative tests approach results in pacing for AV block and those with a positive tilt test show no better results than with no pacemaker. The implication of tilt results is that a hypotensive tendency is clearly demonstrated by tilt positivity pointing to syncope recurrence with hypotension. This problem may be addressed by treatment with vasoconstrictor drugs in those who are suited or, more commonly, a reduction or cessation of hypotensive therapy in hypertensive patients. Other causes of syncope such as tachyarrhythmias are rare. The clinical approach to patients who report syncope is detailed.

  11. The nuclear pacemaker: Is renewed interest warranted

    International Nuclear Information System (INIS)

    Parsonnet, V.; Berstein, A.D.; Perry, G.Y.

    1990-01-01

    From 1973 through 1987, 155 radioisotope-powered nuclear pacemakers were implanted in 132 patients at the Newark Beth Israel Medical Center. The longevity of the first 15 devices, all of which were fixed-rate (VOO) pacemakers, was significantly better than that of 15 lithium-chemistry demand (VVI) pacemakers used as control devices (p = 0.0002). Of the entire cohort of 155 nuclear pacemakers, 136 were VVI devices and 19 were VOO units. The patients with VOO pacemakers needed reoperations more often than did those with VVI pacemakers, chiefly for mode change (p less than 0.001). Power-source failure was observed in only 1 case, but 47 nuclear pacemakers were removed for other reasons, including component malfunction (15 units), mode change (12 units), high pacing thresholds (8 units) and lead or connector problems (5 units). The actuarial survival at 15 years was 99% for power sources and 82% for the entire pacing systems (pulse generators plus leads). The frequency of malignancy was similar to that of the population at large and primary tumor sites were randomly distributed. Deaths most commonly were due to cardiac causes (68%). Thus, nuclear pacemakers are safe and reliable and their greater initial cost appears to be offset by their longevity and the resulting decrease in the frequency of reoperations. It is reasonable to suggest that further use be made of long-lasting nuclear power sources for modern pacemakers and other implantable rhythm-management devices

  12. On the Evolution of the Cardiac Pacemaker

    Science.gov (United States)

    Burkhard, Silja; van Eif, Vincent; Garric, Laurence; Christoffels, Vincent M.; Bakkers, Jeroen

    2017-01-01

    The rhythmic contraction of the heart is initiated and controlled by an intrinsic pacemaker system. Cardiac contractions commence at very early embryonic stages and coordination remains crucial for survival. The underlying molecular mechanisms of pacemaker cell development and function are still not fully understood. Heart form and function show high evolutionary conservation. Even in simple contractile cardiac tubes in primitive invertebrates, cardiac function is controlled by intrinsic, autonomous pacemaker cells. Understanding the evolutionary origin and development of cardiac pacemaker cells will help us outline the important pathways and factors involved. Key patterning factors, such as the homeodomain transcription factors Nkx2.5 and Shox2, and the LIM-homeodomain transcription factor Islet-1, components of the T-box (Tbx), and bone morphogenic protein (Bmp) families are well conserved. Here we compare the dominant pacemaking systems in various organisms with respect to the underlying molecular regulation. Comparative analysis of the pathways involved in patterning the pacemaker domain in an evolutionary context might help us outline a common fundamental pacemaker cell gene programme. Special focus is given to pacemaker development in zebrafish, an extensively used model for vertebrate development. Finally, we conclude with a summary of highly conserved key factors in pacemaker cell development and function. PMID:29367536

  13. wire chamber

    CERN Multimedia

    Was used in ISR (Intersecting Storage Ring) split field magnet experiment. Multi-wire detectors contain layers of positively and negatively charged wires enclosed in a chamber full of gas. A charged particle passing through the chamber knocks negatively charged electrons out of atoms in the gas, leaving behind positive ions. The electrons are pulled towards the positively charged wires. They collide with other atoms on the way, producing an avalanche of electrons and ions. The movement of these electrons and ions induces an electric pulse in the wires which is collected by fast electronics. The size of the pulse is proportional to the energy loss of the original particle.

  14. Wire chamber

    CERN Multimedia

    Multi-wire detectors contain layers of positively and negatively charged wires enclosed in a chamber full of gas. A charged particle passing through the chamber knocks negatively charged electrons out of atoms in the gas, leaving behind positive ions. The electrons are pulled towards the positively charged wires. They collide with other atoms on the way, producing an avalanche of electrons and ions. The movement of these electrons and ions induces an electric pulse in the wires which is collected by fast electronics. The size of the pulse is proportional to the energy loss of the original particle.

  15. wire chamber

    CERN Multimedia

    Multi-wire detectors contain layers of positively and negatively charged wires enclosed in a chamber full of gas. A charged particle passing through the chamber knocks negatively charged electrons out of atoms in the gas, leaving behind positive ions. The electrons are pulled towards the positively charged wires. They collide with other atoms on the way, producing an avalanche of electrons and ions. The movement of these electrons and ions induces an electric pulse in the wires which is collected by fast electronics. The size of the pulse is proportional to the energy loss of the original particle.

  16. wire chamber

    CERN Multimedia

    1985-01-01

    Multi-wire detectors contain layers of positively and negatively charged wires enclosed in a chamber full of gas. A charged particle passing through the chamber knocks negatively charged electrons out of atoms in the gas, leaving behind positive ions. The electrons are pulled towards the positively charged wires. They collide with other atoms on the way, producing an avalanche of electrons and ions. The movement of these electrons and ions induces an electric pulse in the wires which is collected by fast electronics. The size of the pulse is proportional to the energy loss of the original particle.

  17. Feasibility of pacemaker therapy after dynamic cardiomyoplasty

    NARCIS (Netherlands)

    Van den Berg, MP; Nagelkerke, D; Brouwer, RMHJ; Mulder, H; De Boer, H; Crijns, HJGM

    1999-01-01

    A 54-year-old man presented with total atrioventricular (AV) block 3 months after dynamic cardiomyoplasty was performed because of heart failure due to idiopathic dilated cardiomyopathy. Though the cardiomyostimulator acted as a back-up pacemaker, a DDDR pacemaker was implanted to optimize

  18. On the Evolution of the Cardiac Pacemaker

    NARCIS (Netherlands)

    Burkhard, Silja; van Eif, Vincent; Garric, Laurence; Christoffels, Vincent M; Bakkers, Jeroen

    2017-01-01

    The rhythmic contraction of the heart is initiated and controlled by an intrinsic pacemaker system. Cardiac contractions commence at very early embryonic stages and coordination remains crucial for survival. The underlying molecular mechanisms of pacemaker cell development and function are still not

  19. Biofilm on artificial pacemaker: fiction or reality?

    Science.gov (United States)

    Santos, Ana Paula Azevedo; Watanabe, Evandro; Andrade, Denise de

    2011-11-01

    Cardiac pacing through cardiac pacemaker is one of the most promising alternatives in the treatment of arrhythmias, but it can cause reactions natural or complex reactions, either early or late. This study aimed to describe the scientific evidence on the risk of infection and biofilm formation associated with cardiac pacemaker. This is a study of integrative literature review. It included 14 publications classified into three thematic categories: diagnosis (microbiological and/or clinical), complications and therapy of infections. Staphylococcus epidermidis and Staphylococcus aureus were the microorganisms most frequently isolated. It was not possible to determine the incidence of infection associated with pacemakers, since the studies were generally of prevalence. In terms of therapy, the complete removal of pacemakers stood out, especially in cases of suspected biofilm. Still controversial is the use of systemic antibiotic prophylaxis in reducing the incidence of infection associated with implantation of a pacemaker.

  20. Surgical removal of infected transvenous pacemaker leads.

    Science.gov (United States)

    Frame, R; Brodman, R F; Furman, S; Andrews, C A; Gross, J N

    1993-12-01

    Infection, though uncommon, can be the most lethal of all potential complications following transvenous pacemaker implantation. Eradication of infection associated with pacemakers requires complete removal of all hardware, including inactive leads. Since 1972, 5,089 patients have had 8,508 pacemaker generators implanted at Montefiore Medical Center. There were 91 infections (1.06%); four of our patients required surgical removal. Nine additional patients were referred for surgical removal of infected transvenous pacemaker leads from other institutions. Surgical methods for removal included use of cardiopulmonary bypass or inflow occlusion. Surgery may be safely used in unstable or elderly patients and should not be reserved as a last resort. This article reviews our surgical experience removing infected pacemaker leads at Montefiore Medical Center.

  1. Radiotherapy for breast cancer and pacemaker

    International Nuclear Information System (INIS)

    Menard, J.; Campana, F.; Bollet, M.A.; Dendale, R.; Fournier-Bidoz, N.; Marchand, V.; Mazal, A.; Fourquet, A.; Kirova, Y.M.; Kirov, K.M.; Esteve, M.

    2011-01-01

    Purpose. - Patients with permanent cardiac pacemakers occasionally require radiotherapy. Therapeutic Irradiation may cause pacemakers to malfunction due to the effects of ionizing radiation or electromagnetic interference. We studied the breast cancer patients who needed breast and/or chest wall and lymph node irradiation to assess the feasibility and tolerance in this population of patients. Patients and methods. - From November 2008 to December 2009, more than 900 patients received radiotherapy for their breast cancer in our department using megavoltage linear accelerator (X 4-6 MV and electrons). Among them, seven patients were with permanent pacemaker. All patients have been treated to the breast and chest wall and/or lymph nodes. Total dose to breast and/or chest wall was 50 Gy/25 fractions and 46 Gy/23 fractions to lymph nodes. Patients who underwent conserving surgery followed by breast irradiation were boosted when indicated to tumour bed with 16 Gy/8 fractions. All patients were monitored everyday in presence of radiation oncologist to follow the function of their pacemaker. All pacemakers were controlled before and after radiotherapy by the patients' cardiologist. Results. - Seven patients were referred in our department for postoperative breast cancer radiotherapy. Among them, only one patient was declined for radiotherapy and underwent mastectomy without radiotherapy. In four cases the pacemaker was repositioned before the beginning of radiotherapy. Six patients, aged between 48 and 84 years underwent irradiation for their breast cancer. Four patients were treated with conserving surgery followed by breast radiotherapy and two with mastectomy followed by chest wall and internal mammary chain, supra- and infra-clavicular lymph node irradiation. The dose to the pacemaker generator was kept below 2 Gy. There was no pacemaker dysfunction observed during the radiotherapy. Conclusion. - The multidisciplinary work with position change of the pacemaker before

  2. 21 CFR 870.3620 - Pacemaker lead adaptor.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pacemaker lead adaptor. 870.3620 Section 870.3620...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3620 Pacemaker lead adaptor. (a) Identification. A pacemaker lead adaptor is a device used to adapt a pacemaker lead so that it...

  3. 21 CFR 870.3640 - Indirect pacemaker generator function analyzer.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Indirect pacemaker generator function analyzer... Indirect pacemaker generator function analyzer. (a) Identification. An indirect pacemaker generator function analyzer is an electrically powered device that is used to determine pacemaker function or...

  4. Pacemakers charging using body energy

    Science.gov (United States)

    Bhatia, Dinesh; Bairagi, Sweeti; Goel, Sanat; Jangra, Manoj

    2010-01-01

    Life-saving medical implants like pacemakers and defibrillators face a big drawback that their batteries eventually run out and patients require frequent surgery to have these batteries replaced. With the advent of technology, alternatives can be provided for such surgeries. To power these devices, body energy harvesting techniques may be employed. Some of the power sources are patient's heartbeat, blood flow inside the vessels, movement of the body parts, and the body temperature (heat). Different types of sensors are employed, such as for sensing the energy from the heartbeat the piezoelectric and semiconducting coupled nanowires are used that convert the mechanical energy into electricity. Similarly, for sensing the blood flow energy, nanogenerators driven by ultrasonic waves are used that have the ability to directly convert the hydraulic energy in human body to electrical energy. Another consideration is to use body heat employing biothermal battery to generate electricity using multiple arrays of thermoelectric generators built into an implantable chip. These generators exploit the well-known thermocouple effect. For the biothermal device to work, it needs a 2°C temperature difference across it. But there are many parts of the body where a temperature difference of 5°C exists – typically in the few millimeters just below the skin, where it is planned to place this device. This study focuses on using body heat as an alternative energy source to recharge pacemaker batteries and other medical devices and prevent the possibility of life-risk during repeated surgery. PMID:21814432

  5. Pacemakers charging using body energy.

    Science.gov (United States)

    Bhatia, Dinesh; Bairagi, Sweeti; Goel, Sanat; Jangra, Manoj

    2010-01-01

    Life-saving medical implants like pacemakers and defibrillators face a big drawback that their batteries eventually run out and patients require frequent surgery to have these batteries replaced. With the advent of technology, alternatives can be provided for such surgeries. To power these devices, body energy harvesting techniques may be employed. Some of the power sources are patient's heartbeat, blood flow inside the vessels, movement of the body parts, and the body temperature (heat). Different types of sensors are employed, such as for sensing the energy from the heartbeat the piezoelectric and semiconducting coupled nanowires are used that convert the mechanical energy into electricity. Similarly, for sensing the blood flow energy, nanogenerators driven by ultrasonic waves are used that have the ability to directly convert the hydraulic energy in human body to electrical energy. Another consideration is to use body heat employing biothermal battery to generate electricity using multiple arrays of thermoelectric generators built into an implantable chip. These generators exploit the well-known thermocouple effect. For the biothermal device to work, it needs a 2°C temperature difference across it. But there are many parts of the body where a temperature difference of 5°C exists - typically in the few millimeters just below the skin, where it is planned to place this device. This study focuses on using body heat as an alternative energy source to recharge pacemaker batteries and other medical devices and prevent the possibility of life-risk during repeated surgery.

  6. Pacemakers charging using body energy

    Directory of Open Access Journals (Sweden)

    Dinesh Bhatia

    2010-01-01

    Full Text Available Life-saving medical implants like pacemakers and defibrillators face a big drawback that their batteries eventually run out and patients require frequent surgery to have these batteries replaced. With the advent of technology, alternatives can be provided for such surgeries. To power these devices, body energy harvesting techniques may be employed. Some of the power sources are patient′s heartbeat, blood flow inside the vessels, movement of the body parts, and the body temperature (heat. Different types of sensors are employed, such as for sensing the energy from the heartbeat the piezoelectric and semiconducting coupled nanowires are used that convert the mechanical energy into electricity. Similarly, for sensing the blood flow energy, nanogenerators driven by ultrasonic waves are used that have the ability to directly convert the hydraulic energy in human body to electrical energy. Another consideration is to use body heat employing biothermal battery to generate electricity using multiple arrays of thermoelectric generators built into an implantable chip. These generators exploit the well-known thermocouple effect. For the biothermal device to work, it needs a 2°C temperature difference across it. But there are many parts of the body where a temperature difference of 5°C exists - typically in the few millimeters just below the skin, where it is planned to place this device. This study focuses on using body heat as an alternative energy source to recharge pacemaker batteries and other medical devices and prevent the possibility of life-risk during repeated surgery.

  7. Pacemaker

    Science.gov (United States)

    ... Heart and Vascular Diseases Precision Medicine Activities Obesity, Nutrition, and Physical Activity Population and Epidemiology Studies Women’s Health All Science A-Z Grants and Training Grants and Training ...

  8. Quality assessment of pacemaker implantations in Denmark

    DEFF Research Database (Denmark)

    Møller, M; Arnsbo, P; Asklund, Mogens

    2002-01-01

    AIMS: Quality assessment of therapeutic procedures is essential to insure a cost-effective health care system. Pacemaker implantation is a common procedure with more than 500,000 implantations world-wide per year, but the general complication rate is not well described. We studied procedure related...... complications for all implantations performed in an entire nation over a 3-year period. METHODS AND RESULTS: A prospective study of complications related to 99% of the 5648 primary pacemaker implantations performed in the 12 Danish pacemaker centres in 1997-1999 was carried out. Overall 76% of the patients...... received a physiological pacemaker system and 91% received the optimal pacing mode according to international guidelines. Perioperative complications requiring reoperation were: haematoma 0.3%, atrial lead related 1.9%, ventricular lead related 1.7%. Late complications requiring reoperation were: infection...

  9. Mathematical Models of Cardiac Pacemaking Function

    Directory of Open Access Journals (Sweden)

    Pan eLi

    2013-10-01

    Full Text Available Over the past half century, there has been intense and fruitful interaction between experimental and computational investigations of cardiac function. This interaction has, for example, led to deep understanding of cardiac excitation-contraction coupling; how it works, as well as how it fails. However, many lines of inquiry remain unresolved, among them the initiation of each heartbeat. The sinoatrial node, a cluster of specialized pacemaking cells in the right atrium of the heart, spontaneously generates an electro-chemical wave that spreads through the atria and through the cardiac conduction system to the ventricles, initiating the contraction of cardiac muscle essential for pumping blood to the body. Despite the fundamental importance of this primary pacemaker, this process is still not fully understood, and ionic mechanisms underlying cardiac pacemaking function are currently under heated debate. Several mathematical models of sinoatrial node cell membrane electrophysiology have been constructed as based on different experimental data sets and hypotheses. As could be expected, these differing models offer diverse predictions about cardiac pacemaking activities. This paper aims to present the current state of debate over the origins of the pacemaking function of the sinoatrial node. Here, we will specifically review the state-of-the-art of cardiac pacemaker modeling, with a special emphasis on current discrepancies, limitations, and future challenges.

  10. Pacemaker diagnostics in atrial fibrillation: limited usefulness for therapy initiation in a pacemaker practice.

    Science.gov (United States)

    Yedlapati, Neeraja; Fisher, John D

    2014-09-01

    We aimed to determine the practical value of pacemaker diagnostics for atrial fibrillation (AF) in an unselected general pacemaker practice, specifically workflow and initiation of anticoagulation or antiarrhythmic drug (AAD) therapy. We prospectively followed consecutive pacemaker interrogations over a period of 1 year to identify patients with AF (burden from 1% to 99%). We contacted referring physicians with AF details, and then determined whether the information resulted in therapeutic changes. Of the 1,100 pacemakers interrogated, 728 were dual chamber (DDDs) with AF diagnostic capability. AF was recorded in 73 (10%) but seven had limited information, leaving 66 patients; of these, 42 (63%) patients were already anticoagulated and in five (7%) patients, anticoagulation had been stopped because of complications. Initial diagnosis of AF was made by the pacemaker in 17 patients (26% of 66; 2% of 728); four (6% of 66) patients were newly initiated on anticoagulation. Of the 66 patients, 17 patients were already on AADs; 49 (74%) had satisfactory rate control or had other issues; only two (3% of 66; 0.3% of 728) received new AADs. Of 728 patients with DDD pacemakers, only 17 were newly discovered to have AF, and six (0.8%) had changes in medications based on the pacemaker data. Adding pacemaker-derived data to existing clinical information had little therapeutic impact, due to a combination of cumbersome workflow, and because AF was usually known to practitioners. Developments in automated monitoring systems may provide more accessible and therapeutically useful information. ©2014 Wiley Periodicals, Inc.

  11. Drugs and pacemakers for vasovagal, carotid sinus and situational syncope

    NARCIS (Netherlands)

    Romme, Jacobus J. C. M.; Reitsma, Johannes B.; Black, Catherine N.; Colman, Nancy; Scholten, Rob J. P. M.; Wieling, Wouter; van Dijk, Nynke

    2011-01-01

    Background Neurally mediated reflex syncope is the most common cause of transient loss of consciousness. In patients not responding to nonpharmacological treatment, pharmacological or pacemaker treatment might be considered. Objectives To examine the effects of pharmacological therapy and pacemaker

  12. Pacemaker patients’ perspective and experiences in a pacemaker outpatient clinic in relation to test intervals of the pacemaker

    DEFF Research Database (Denmark)

    Lauberg, Astrid; Hansen, Tina; Pedersen, Trine Pernille Dahl

    an evident decline in quality of life regarding psychological and social aspects 6 month after the implantation in terms of cognitive function, work ability, and sexual activity. Mlynarski et al (2009) have found correlations between pacemaker implantation and anxiety and depression. Aim The aim...... the pacemaker and psychological reactions. Patients with pacemakers older than 3 months lacked communication with fellowmen. Conclusion The patients express receiving competent and professional treatment when visiting the outpatient clinic, there seems to be a discrepancy between the long test intervals...... and the critical period in which anxiety and depression may occur. Minor problems and questions may grow into fatal conditions if the patients are not offered an opportunity to discuss this with experts. Patients are not informed that it is possible to discuss problems that imply psychological topics and they do...

  13. Safety of implantable pacemakers and cardioverter defibrillators in the magnetic field of a novel remote magnetic navigation system.

    Science.gov (United States)

    Jilek, Clemens; Tzeis, Stylianos; Reents, Tilko; Estner, Heidi-Luise; Fichtner, Stephanie; Ammar, Sonia; Wu, Jinjin; Hessling, Gabriele; Deisenhofer, Isabel; Kolb, Christof

    2010-10-01

    Electromagnetic interference with pacemaker and implantable cardioverter defibrillator (ICD) systems may cause temporary or permanent system malfunction of implanted devices. The aim of this study was to evaluate potential interference of a novel magnetic navigation system with implantable rhythm devices. A total of 121 devices (77 pacemakers, 44 ICDs) were exposed to an activated NIOBE II® Magnetic Navigation System (Stereotaxis, St. Louis, MO, USA) at the maximal magnetic field strength of 0.1 Tesla and evaluated in vitro with respect to changes in parameter settings of the device, changes of the battery status/detection of elective replacement indication, or alterations of data stored in the device. A total of 115 out of 121 (95%) devices were free of changes in parameter settings, battery status, and internally stored data after repeated exposition to the electromagnetic field of the remote magnetic navigation system. Interference with the magnetic navigation field was observed in 6 pacemakers, resulting in reprogramming to a power-on-reset mode with or without detection of the elective replacement indication in 5 devices and abnormal variance of battery status in one device. All pacemakers could be reprogrammed to the initial modes and the battery status proved to be normal some minutes after the pacemakers had been removed from the magnetic field. Interference of a remote magnetic navigation system (at maximal field strength) with pacemakers and ICDs not connected to leads with antitachycardic detection and therapies turned off is rare. Occurring functional abnormalities could be reprogrammed in our sample. An in vitro study will give information about interference of devices connected to leads. © 2010 Wiley Periodicals, Inc.

  14. 21 CFR 870.3710 - Pacemaker repair or replacement material.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pacemaker repair or replacement material. 870.3710... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3710 Pacemaker repair or replacement material. (a) Identification. A pacemaker repair or replacement material is an...

  15. 21 CFR 870.3730 - Pacemaker service tools.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pacemaker service tools. 870.3730 Section 870.3730...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3730 Pacemaker service tools. (a) Identification. Pacemaker service tools are devices such as screwdrivers and Allen wrenches...

  16. 21 CFR 870.5550 - External transcutaneous cardiac pacemaker (noninvasive).

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External transcutaneous cardiac pacemaker... § 870.5550 External transcutaneous cardiac pacemaker (noninvasive). (a) Identification. An external transcutaneous cardiac pacemaker (noninvasive) is a device used to supply a periodic electrical pulse intended to...

  17. 21 CFR 870.3720 - Pacemaker electrode function tester.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pacemaker electrode function tester. 870.3720... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3720 Pacemaker electrode function tester. (a) Identification. A pacemaker electrode function tester is a device which is...

  18. 21 CFR 870.3650 - Pacemaker polymeric mesh bag.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pacemaker polymeric mesh bag. 870.3650 Section 870...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3650 Pacemaker polymeric mesh bag. (a) Identification. A pacemaker polymeric mesh bag is an implanted device used to hold a...

  19. 21 CFR 870.3630 - Pacemaker generator function analyzer.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pacemaker generator function analyzer. 870.3630... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3630 Pacemaker generator function analyzer. (a) Identification. A pacemaker generator function analyzer is a device that is...

  20. 21 CFR 870.3610 - Implantable pacemaker pulse generator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implantable pacemaker pulse generator. 870.3610 Section 870.3610 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... pacemaker pulse generator. (a) Identification. An implantable pacemaker pulse generator is a device that has...

  1. 21 CFR 870.1750 - External programmable pacemaker pulse generator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External programmable pacemaker pulse generator... External programmable pacemaker pulse generator. (a) Identification. An external programmable pacemaker pulse generators is a device that can be programmed to produce one or more pulses at preselected...

  2. 21 CFR 870.3600 - External pacemaker pulse generator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External pacemaker pulse generator. 870.3600 Section 870.3600 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... pacemaker pulse generator. (a) Identification. An external pacemaker pulse generator is a device that has a...

  3. 21 CFR 870.3690 - Pacemaker test magnet.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pacemaker test magnet. 870.3690 Section 870.3690...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3690 Pacemaker test magnet. (a) Identification. A pacemaker test magnet is a device used to test an inhibited or triggered type...

  4. Analysis of a five year experience of permanent pacemaker ...

    African Journals Online (AJOL)

    Introduction: Permanent pacemaker implantation is available in Nigeria. There is however no national registry or framework for pacemaker data collection. A pacemaker database has been developed in our institution and the results are analyzed in this study. Methods: The study period was between January 2008 and ...

  5. Does bipolar pacemaker current activate blood platelets?

    DEFF Research Database (Denmark)

    Gjesdal, Grunde; Hansen, Annebirthe Bo; Brandes, Axel

    2009-01-01

    to the pacemaker can. METHODS: Platelet-rich plasma was prepared from two healthy subjects. Platelet reactivity to the agonist ADP was tested in paired samples in an aggregometer in a case/control setup. RESULTS: Eighteen of 46 tested pairs of platelet-rich plasma showed increased reactivity in the paced sample......OBJECTIVE: The aim of this study was to investigate whether bipolar pacemaker current lead can activate blood platelets. The null hypothesis was that 1 minute of electrical stimulation of platelets would not influence their subsequent reactivity to adenosine diphosphate (ADP). BACKGROUND: Both...... platelets and muscle cells contain actin and myosin filaments, and both cells are activated following calcium influx. Muscle cells open their calcium channels and contract when exposed to an electric current. Current through a bipolar pacemaker lead will expose a small volume of blood, including platelets...

  6. Reflex sympathetic dystrophy following pacemaker insertion.

    Science.gov (United States)

    Londhey, Vikram A; Singh, Nishant; Kini, Seema

    2011-09-01

    A 55 year old male presented with pain and swelling over dorsum of right hand and small joints, and loss of sweating over right hand since two months. He was a known case of mitral valve prolapse (MVP) with mitral regurgitation and complete heart block for which pacemaker was implanted 1 year back. Bilateral wrist X-ray was suggestive of pronounced demineralization (osteopenia) in the right hand. He was thus diagnosed to have reflex sympathetic dystrophy syndrome (RSDS) considered to be induced by pacemaker insertion. After treatment with amitryptiline and indomethacin his symptoms dramatically improved.

  7. Nuclear-powered pacemaker fuel cladding study

    International Nuclear Information System (INIS)

    Shoup, R.L.

    1976-07-01

    The fabrication of fuel capsules with refractory metal and alloy clads used in nuclear-powered cardiac pacemakers precludes the expedient dissolution of the clad in inorganic acid solutions. An experiment to measure penetration rates of acids on commonly used fuel pellet clads indicated that it is not impossible, but that it would be very difficult to dissolve the multiple cladding. This work was performed because of a suggestion that a 238 PuO 2 -powered pacemaker could be transformed into a terrorism weapon

  8. Leadless Pacemakers: State of the Art and Future Perspectives.

    Science.gov (United States)

    Della Rocca, Domenico G; Gianni, Carola; Di Biase, Luigi; Natale, Andrea; Al-Ahmad, Amin

    2018-03-01

    Leadless pacemaker therapy is a new technology that aims at avoiding lead- and pocket-related complications of conventional transvenous and epicardial pacing. To date, 2 self-contained leadless pacemakers for right ventricular pacing have been clinically available: the Nanostim Leadless Pacemaker System and the Micra Transcatheter Pacing System. Additionally, a new multicomponent leadless pacemaker for endocardial left ventricular pacing has been proposed as an alternative choice for cardiac resynchronization therapy. In this review, we describe the state of the art of leadless pacing and compare the currently available devices with traditional transvenous leadless pacemakers. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Permanent Leadless Cardiac Pacemaker Therapy: A Comprehensive Review.

    Science.gov (United States)

    Tjong, Fleur V Y; Reddy, Vivek Y

    2017-04-11

    A new technology, leadless pacemaker therapy, was recently introduced clinically to address lead- and pocket-related complications in conventional transvenous pacemaker therapy. These leadless devices are self-contained right ventricular single-chamber pacemakers implanted by using a femoral percutaneous approach. In this review of available clinical data on leadless pacemakers, early results with leadless devices are compared with historical results with conventional single-chamber pacing. Both presently manufactured leadless pacemakers show similar complications, which are mostly related to the implant procedure: cardiac perforation, device dislocation, and femoral vascular access site complications. In comparison with conventional transvenous single-chamber pacemakers, slightly higher short-term complication rates have been observed: 4.8% for leadless pacemakers versus 4.1% for conventional pacemakers. The complication rate of the leadless pacemakers is influenced by the implanter learning curve for this new procedure. No long-term outcome data are yet available for the leadless pacemakers. Larger leadless pacing trials, with long-term follow-up and direct randomized comparison with conventional pacing systems, will be required to define the proper clinical role of these leadless systems. Although current leadless pacemakers are limited to right ventricular pacing, future advanced, communicating, multicomponent systems are expected to expand the potential benefits of leadless therapy to a larger patient population. © 2017 American Heart Association, Inc.

  10. Pacemaker stimulus amplitude alteration without loss of capture: an unusual ECG finding in cardiac tamponade from pacemaker lead perforation.

    Science.gov (United States)

    Suksaranjit, P; Prasidthrathsint, K

    2014-01-01

    A variation in pacemaker stimulus amplitude can represent pacemaker system dysfunction from generator malfunction, lead insulation defect, lead fracture, or artefact of digital signal processing of the electrocardiography recorder. Pacemaker lead perforation into the pericardial space typically results in loss of capture which was not demonstrated in our patient. In summary, we report an unusual ECG finding of pacemaker stimulus amplitude alteration without loss of capture in the setting of cardiac tamponade from pacemaker lead perforation. Copyright © 2013 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  11. Pseudo SVT in the pacemaker patient.

    Science.gov (United States)

    Modi, Simon; Barker, Diane; Cooper, Robert; Patwala, Ash; Hall, Mark

    2012-07-01

    This is an interesting report of a supraventricular tachycardia in a paced patient with intermittent atrioventricular nodal block. Only electrophysiology testing revealed the correct diagnosis. Images explain how pacemaker timing cycles and refractory periods can confuse an otherwise straightforward diagnosis. ©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.

  12. Quality assessment of pacemaker implantations in Denmark

    DEFF Research Database (Denmark)

    Møller, M; Arnsbo, P; Asklund, Mogens

    2002-01-01

    AIMS: Quality assessment of therapeutic procedures is essential to insure a cost-effective health care system. Pacemaker implantation is a common procedure with more than 500,000 implantations world-wide per year, but the general complication rate is not well described. We studied procedure relat...

  13. The Drosophila melanogaster circadian pacemaker circuit

    Indian Academy of Sciences (India)

    2008-12-07

    Dec 7, 2008 ... large variety of tissues in the fly such as the eye, brain, pro- boscis, antennae, wings, abdomen, Malpighian tubules and testes (Plautz et al. 1997; Giebultowicz 2001). Although cell-autonomous circadian function is attributed to several tissues in Drosophila, circadian pacemaker neurons located in the brain ...

  14. Keeping the Rhythm : Cardiac Pacemaker Cell Development

    NARCIS (Netherlands)

    Burkhard, Silja

    2017-01-01

    The heart is the first organ to form and function in the developing vertebrate embryo. Its proper morphogenesis and function is crucial for survival. Here we focus on the development and characterization of a highly specialized subset of cardiac cells, the pacemaker cells. In the mammalian heart,

  15. Measuring pacemaker dose: A clinical perspective

    Energy Technology Data Exchange (ETDEWEB)

    Studenski, Matthew T., E-mail: matthew.studenski@jeffersonhospital.org [Department of Radiation Oncology at the Jefferson Medical College and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA (United States); Xiao Ying; Harrison, Amy S. [Department of Radiation Oncology at the Jefferson Medical College and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA (United States)

    2012-07-01

    Recently in our clinic, we have seen an increased number of patients presenting with pacemakers and defibrillators. Precautions are taken to develop a treatment plan that minimizes the dose to the pacemaker because of the adverse effects of radiation on the electronics. Here we analyze different dosimeters to determine which is the most accurate in measuring pacemaker or defibrillator dose while at the same time not requiring a significant investment in time to maintain an efficient workflow in the clinic. The dosimeters analyzed here were ion chambers, diodes, metal-oxide-semiconductor field effect transistor (MOSFETs), and optically stimulated luminescence (OSL) dosimeters. A simple phantom was used to quantify the angular and energy dependence of each dosimeter. Next, 8 patients plans were delivered to a Rando phantom with all the dosimeters located where the pacemaker would be, and the measurements were compared with the predicted dose. A cone beam computed tomography (CBCT) image was obtained to determine the dosimeter response in the kilovoltage energy range. In terms of the angular and energy dependence of the dosimeters, the ion chamber and diode were the most stable. For the clinical cases, all the dosimeters match relatively well with the predicted dose, although the ideal dosimeter to use is case dependent. The dosimeters, especially the MOSFETS, tend to be less accurate for the plans, with many lateral beams. Because of their efficiency, we recommend using a MOSFET or a diode to measure the dose. If a discrepancy is observed between the measured and expected dose (especially when the pacemaker to field edge is <10 cm), we recommend analyzing the treatment plan to see whether there are many lateral beams. Follow-up with another dosimeter rather than repeating multiple times with the same type of dosimeter. All dosimeters should be placed after the CBCT has been acquired.

  16. Noncontextual Wirings

    Science.gov (United States)

    Amaral, Barbara; Cabello, Adán; Cunha, Marcelo Terra; Aolita, Leandro

    2018-03-01

    Contextuality is a fundamental feature of quantum theory necessary for certain models of quantum computation and communication. Serious steps have therefore been taken towards a formal framework for contextuality as an operational resource. However, the main ingredient of a resource theory—a concrete, explicit form of free operations of contextuality—was still missing. Here we provide such a component by introducing noncontextual wirings: a class of contextuality-free operations with a clear operational interpretation and a friendly parametrization. We characterize them completely for general black-box measurement devices with arbitrarily many inputs and outputs. As applications, we show that the relative entropy of contextuality is a contextuality monotone and that maximally contextual boxes that serve as contextuality bits exist for a broad class of scenarios. Our results complete a unified resource-theoretic framework for contextuality and Bell nonlocality.

  17. Pacemaker recycling: A notion whose time has come.

    Science.gov (United States)

    Runge, Mason W; Baman, Timir S; Davis, Sheldon; Weatherwax, Kevin; Goldman, Ed; Eagle, Kim A; Crawford, Thomas C

    2017-04-26

    The purpose of this paper is to summarize the need, feasibility, safety, legality, and ethical perspectives of pacemaker reutilization in low- and middle-income countries (LMICs). It will also describe, in-depth, Project My Heart Your Heart (PMHYH) as a model for pacemaker reuse in LMICs. The primary source of the discussion points in this paper is a collection of 14 publications produced by the research team at the University of Michigan and its collaborative partners. The need for pacemaker reutilization in LMICs is evident. Numerous studies show that the concept of pacemaker reutilization in LMICs is feasible. Infection and device malfunction are the main concerns in regard to pacemaker reutilization, yet many studies have shown that pacemaker reuse is not associated with increased infection risk or higher mortality compared with new device implantation. Under the right circumstances, the ethical and legal bases for pacemaker reutilization are supported. PMHYH is a proof of concept pacemaker donation initiative that has allowed funeral home and crematory directors to send explanted devices to an academic center for evaluation and re-sterilization before donation to underserved patients in LMICs. The time is now to pursue large-scale studies and trials of pacemaker reuse for the betterment of society. PMHYH is leading the way in the effort and is poised to conduct a prospective randomized, non-inferiority, multicenter study to confirm the clinical efficacy and safety of pacemaker reuse, for clinical and legal support.

  18. Pacemaker deactivation: withdrawal of support or active ending of life?

    Science.gov (United States)

    Huddle, Thomas S; Amos Bailey, F

    2012-12-01

    In spite of ethical analyses assimilating the palliative deactivation of pacemakers to commonly accepted withdrawings of life-sustaining therapy, many clinicians remain ethically uncomfortable with pacemaker deactivation at the end of life. Various reasons have been posited for this discomfort. Some cardiologists have suggested that reluctance to deactivate pacemakers may stem from a sense that the pacemaker has become part of the patient's "self." The authors suggest that Daniel Sulmasy is correct to contend that any such identification of the pacemaker is misguided. The authors argue that clinicians uncomfortable with pacemaker deactivation are nevertheless correct to see it as incompatible with the traditional medical ethics of withdrawal of support. Traditional medical ethics is presently taken by many to sanction pacemaker deactivation when such deactivation honors the patient's right to refuse treatment. The authors suggest that the right to refuse treatment applies to treatments involving ongoing physician agency. This right cannot underwrite patient demands that physicians reverse the effects of treatments previously administered, in which ongoing physician agency is no longer implicated. The permanently indwelling pacemaker is best seen as such a treatment. As such, its deactivation in the pacemaker-dependent patient is best seen not as withdrawal of support but as active ending of life. That being the case, clinicians adhering to the usual ethical analysis of withdrawal of support are correct to be uncomfortable with pacemaker deactivation at the end of life.

  19. Magnetic Resonance Imaging in Nondependent Pacemaker Patients with Pacemakers and Defibrillators with a Nearly Depleted Battery.

    Science.gov (United States)

    Okamura, Hideo; Padmanabhan, Deepak; Watson, Robert E; Dalzell, Connie; Acker, Nancy; Jondal, Mary; Romme, Abby L; Cha, Yong-Mei; Asirvatham, Samuel J; Felmlee, Joel P; Friedman, Paul A

    2017-05-01

    Magnetic resonance imaging (MRI) in patients with non-MRI-conditional cardiac implantable electronic devices (CIEDs) has been shown to be safe when performed under closely monitored protocols. However, the safety of MRI in patients with devices with a nearly depleted battery has not been reported. Prospective data were collected between January 2008 and May 2015 in patients with non-MRI-conditional CIEDs undergoing clinically indicated MRI under institutional protocol. Patients who were pacemaker dependent were excluded. Patients whose devices were at elective replacement indicator (ERI) at the time of MRI or close to ERI (ERI or replacement for battery depletion within 3 months of scan) were identified through database review and analyzed for clinical events. MRI scans (n = 569) were performed in 442 patients. Of these, we identified 13 scans performed with a nearly depleted battery in nine patients. All scans with implantable cardioverter defibrillators (ICDs, n = 9) were uneventful. However, two scans with pacemakers close to ERI resulted in a power-on-reset (PoR) event. One scan with a pacemaker close to ERI that was programmed to DOO mode reached ERI during MRI and automatically changed to VVI mode. Additionally, one scan with a pacemaker at ERI did not allow programming. All pacemakers with events were implanted before 2005. Patients with pacemakers and ICDs with a nearly depleted battery can safely undergo MRI when patients are not pacemaker dependent. Attention should be paid because old devices can result in PoR or ERI during MRI, which may lead to oversensing and inhibition of pacing. © 2017 Wiley Periodicals, Inc.

  20. Temporary internal pacing.

    Science.gov (United States)

    Ortiz Díaz-Miguel, R; Gómez Grande, M L

    2014-12-01

    Technology and insertion techniques for cardiac temporary internal pacing have experienced a remarkable development over the last few years. Despite this fact, the procedure continues to have potentially fatal associated complications. Temporary internal pacing is indicated for the treatment of bradyarrhythmias or tachyarrhythmias refractory to conventional treatment, or arrhythmias causing cardiovascular or clinical instability of the patient. On the other hand, the indications of temporary cardiac pacing are far less well defined than those of permanent pacing. Since the decision of implementing temporary pacing is complex and delicate, it should always be carefully considered, and over-indication should be avoided. We must base these decisions on robust knowledge of the arrhythmias that may benefit from temporary internal pacing, and should also acquire the habit of considering external temporary pacing among other less aggressive treatments, and to make the best use of new technologies such as echocardiography that add accuracy to the procedure. Copyright © 2013 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  1. Intra-abdominal migration of a k-wire during revision total hip arthroplasty

    OpenAIRE

    Kevin T. Hug, MD; Navin D. Fernando, MD, FRCS(C)

    2017-01-01

    Revision total hip arthroplasty in the setting of severe acetabular bone loss is a challenging problem that is becoming more common. Kirschner wires are often used during acetabular revision for temporary fixation of trial components. We describe an intraoperative migration of a Kirschner wire through the acetabulum into the peritoneal cavity, requiring acute laparoscopic removal.

  2. Pacemaker lead related tricuspid stenosis: a report of two cases

    OpenAIRE

    Heaven, D; Henein, M; Sutton, R

    2000-01-01

    Only four cases of tricuspid stenosis related to endocardial pacemaker leads have been reported. Two further cases associated with perforation of a tricuspid valve leaflet by a pacemaker lead are presented: a 46 year old woman and a 60 year old man. It is possible that tricuspid valve disease related to endocardial pacemaker and non-thoracotomy defibrillator leads is underrecognised. Diagnosis requires clinical suspicion and the use of Doppler echocardiography. Recent evidence of fibrosis aff...

  3. Stretched Wire Mechanics

    Energy Technology Data Exchange (ETDEWEB)

    Bowden, Gordon; /SLAC

    2005-09-06

    Stretched wires are beginning to play an important role in the alignment of accelerators and synchrotron light sources. Stretched wires are proposed for the alignment of the 130 meter long LCLS undulator. Wire position technology has reached sub-micron resolution yet analyses of perturbations to wire straightness are hard to find. This paper considers possible deviations of stretched wire from the simple 2-dimensional catenary form.

  4. Protection of pacemaker wearers: effects on magnetic fields on the operation of implanted cardiac pacemakers

    International Nuclear Information System (INIS)

    Souques, M.; Lambrozo, J.; Frank, R.; Himbert, C.

    2002-01-01

    The aim of this study was to assess the changes in the behavior of cardiac pacemakers exposed to 50 and 60 Hz magnetic fields generated by industrial current and 20 to 50 khz magnetic fields generated by a household in a booming period - the induction cook top - and to study the incidence of these changes in a population of subjects with implanted pacemakers. This will enabled to give patients advices about dealing with electric transport lines and facilities and with induction cook tops and to advise manufacturers about the risks involved

  5. 76 FR 53851 - Effective Date of Requirement for Premarket Approval for Cardiovascular Permanent Pacemaker...

    Science.gov (United States)

    2011-08-30

    ... Approval for Cardiovascular Permanent Pacemaker Electrode; Correction AGENCY: Food and Drug Administration... development protocol for the class III preamendments device: Cardiovascular permanent pacemaker electrode. The...

  6. A Functional Analysis of Circadian Pacemakers in Nocturnal Rodents. IV. Entrainment : Pacemaker as Clock

    NARCIS (Netherlands)

    Pittendrigh, Colin S.; Daan, Serge

    1976-01-01

    1. In the first part of the paper, the model of non-parametric entrainment of circadian pacemakers is tested for the case of nocturnal rodents. The model makes use of the available data on freerunning period (τ) in constant darkness and on phase response curves (PRC) for short light pulses. It is

  7. Cardiovascular patients' experiences of living with pacemaker: Qualitative study.

    Science.gov (United States)

    Ghojazadeh, Morteza; Azami-Aghdash, Saber; Sohrab-Navi, Zahra; Kolahdouzan, Kasra

    2015-09-01

    A pacemaker implantation is considered major life event for cardiovascular patients, so they will probably have very interesting experiences of living with this device. The aim of this study was to explore the experiences of cardiovascular patients living with the pacemaker. In this qualitative study, 27 patients were chosen through purposive sampling to achieve data saturation, and their experiences were examined using semi-structured interviews. The patients' statements were recorded with their consent and analyzed using content analysis method. Participants' experiences included three main themes: "Problems and limitations," "feeling and dealing with pacemaker", and "sources of comfort" and 10 sub-themes including: physical problems, financial problems, social problems, the first encounter, the feeling of living with the pacemaker, how to cope with pacemaker, satisfaction with pacemaker, good family support, hospital and hospital staff performance, and role of religious beliefs. Planning to solve social problems, identifying and changing feelings of patients using pacemakers, reinforcing the resources of comfort especially family support seem to be necessary steps for improving quality of life and impact of using pacemaker.

  8. The Temporary Leave Dilemma -

    DEFF Research Database (Denmark)

    Amilon, Anna

    2010-01-01

    Lone mothers have to take care of a sick child with little or no help from the child’s other parent and have to carry all costs connected to leave-taking. This paper empirically tests whether lone mothers take more temporary parental leave to care for sick children than partnered mothers and whet...

  9. The cardiac pacemaker patient. Might the pacer be directly irradiated?

    International Nuclear Information System (INIS)

    Tsekos, A.; Momm, F.; Brunner, M.; Guttenberger, R.

    2000-01-01

    According to recommendations listed in a recent review, pacemakers generally should not be irradiated directly. They should be shielded from ionizing radiation or their position changed. Direct irradiation can cause pacemaker failure. There are no clinical signals to indicate a near failure. When controlling pacemaker function, there is often a change in the magnetic frequency before malfunction occurs. If a malfunction results in a partial heart failure only, there would be enough time to implant another pacemaker. As can be seen from a case described here, a policy of 'wait and see' may be adopted even if there are changes in the magnetic frequency. if there is any danger to the patient's life, the feasibility of using an external pacemaker system may be explored, especially in cases where there is a strong need for radiotherapy (severe pain, infiltration of plexus). Risks and benefits should be carefully weighed and discussed with the patient

  10. Wire bonding in microelectronics

    CERN Document Server

    Harman, George G

    2010-01-01

    Wire Bonding in Microelectronics, Third Edition, has been thoroughly revised to help you meet the challenges of today's small-scale and fine-pitch microelectronics. This authoritative guide covers every aspect of designing, manufacturing, and evaluating wire bonds engineered with cutting-edge techniques. In addition to gaining a full grasp of bonding technology, you'll learn how to create reliable bonds at exceedingly high yields, test wire bonds, solve common bonding problems, implement molecular cleaning methods, and much more. Coverage includes: Ultrasonic bonding systems and technologies, including high-frequency systems Bonding wire metallurgy and characteristics, including copper wire Wire bond testing Gold-aluminum intermetallic compounds and other interface reactions Gold and nickel-based bond pad plating materials and problems Cleaning to improve bondability and reliability Mechanical problems in wire bonding High-yield, fine-pitch, specialized-looping, soft-substrate, and extreme-temperature wire bo...

  11. Clear cell hidradenocarcinoma developing in pacemaker pocket.

    Science.gov (United States)

    Reyes, Cesar V

    2008-11-01

    An octagenerian woman developed clear cell hidradenocarcinoma, a rare neoplasm of eccrine sweat gland origin, 4 years following pacemaker implantation in her right lateral chest. The tumor immunohistochemically mimicked a metastatic lobular breast carcinoma, for example, strongly positive estrogen, weakly positive progesterone, and weakly reactive mammoglobin. A complete surgical excision of the tumor was complemented with ipsilateral dissection of involved adjacent axillary lymph nodes. Recommended irradiation was refused by the patient. Retrospective 3-year mammogram review, 2-year postsurgery follow-up, and complete postmortem evaluation failed to prove a primary breast malignancy or other metastatic lesion elsewhere.

  12. Pacemaker syndrome with sub-acute left ventricular systolic dysfunction in a patient with a dual-chamber pacemaker: consequence of lead switch at the header.

    Science.gov (United States)

    Khurwolah, Mohammad Reeaze; Vezi, Brian Zwelethini

    In the daily practice of pacemaker insertion, the occurrence of atrial and ventricular lead switch at the pacemaker box header is a rare and unintentional phenomenon, with less than five cases reported in the literature. The lead switch may have dire consequences, depending on the indication for the pacemaker. One of these consequences is pacemaker syndrome, in which the normal sequence of atrial and ventricular activation is impaired, leading to sub-optimal ventricular filling and cardiac output. It is important for the attending physician to recognise any worsening of symptoms in a patient who has recently had a permanent pacemaker inserted. In the case of a dual-chamber pacemaker, switching of the atrial and ventricular leads at the pacemaker box header should be strongly suspected. We present an unusual case of pacemaker syndrome and right ventricular-only pacinginduced left ventricular systolic dysfunction in a patient with a dual-chamber pacemaker.

  13. Pacemaker implantation complication rates in elderly and young patients

    Directory of Open Access Journals (Sweden)

    Özcan KS

    2013-08-01

    Full Text Available Kazim Serhan Özcan, Damirbek Osmonov, Servet Altay, Cevdet Dönmez, Ersin Yildirim, Ceyhan Türkkan, Baris Güngör, Ahmet Ekmekçi, Ahmet Taha Alper, Kadir Gürkan, İzzet ErdinlerDepartment of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, TurkeyAims: To evaluate the complication rate differences between elderly and younger patients who receive a permanent pacemaker implantation.Methods: We reviewed all cases admitted to our institution between January 2008 and June 2009 with symptomatic bradyarrhythmia for whom a permanent pacemaker was implanted. Beginning in June 2009, we prospectively collected data from all patients with the same diagnosis and procedure. The frequency of complications due to the pacemaker implantation procedure was evaluated and compared between young (<70 years old and elderly (≥70 years old patients.Results: Among 574 patients with a permanent pacemaker, 259 patients (45.1% were below and 315 patients (54.9% were above or at 70 years of age. There were 240 (92.7% and 19 (7.3% dual-chamber pacemaker (DDD and single-chamber pacemaker (VVI implanted patients in the younger group, and 291 (76.8% and 73 (23.2% DDD and VVI pacemaker implanted patients in the elderly group, respectively. The complication rate was 39 (15.1% out of 259 young patients and 24 (7.6% out of 315 elderly patients. Postprocedural complications were statistically lower in the elderly patients than in younger patients (P = 0.005.Conclusion: A pacemaker implantation performed by an experienced operator is a safe procedure for patients of advanced age. The patients who are above 70 years old may have less complication rates than the younger patients.Keywords: complications of pacemaker implantation, elderly patients, permanent pacemaker

  14. Temporary Migration and Economic Assimilation

    OpenAIRE

    Dustmann, Christian

    2000-01-01

    In this paper, I study temporary migrations, and its consequences for immigrants' behaviour. I distinguish between temporary migrations where the return time is exogenous, and temporary migrations where the migrant chooses when to return. I then illustrate the consequences both types of temporary migration have for migrants' behaviour (as opposed to a permanent migration). If migrations are non-permanent, then this has also consequences for the way empirical models need to be specified. The p...

  15. Water Desalination with Wires

    NARCIS (Netherlands)

    Porada, S.; Sales, B.B.; Hamelers, H.V.M.; Biesheuvel, P.M.

    2012-01-01

    We show the significant potential of water desalination using a novel capacitive wire-based technology in which anode/cathode wire pairs are constructed from coating a thin porous carbon electrode layer on top of electrically conducting rods (or wires). By alternately dipping an array of electrode

  16. 76 FR 47085 - Effective Date of Requirement for Premarket Approval for a Pacemaker Programmer

    Science.gov (United States)

    2011-08-04

    ... Approval for a Pacemaker Programmer AGENCY: Food and Drug Administration, HHS. ACTION: Proposed rule... preamendments device pacemaker programmers. The agency is also summarizing its proposed findings regarding the... Subject to This Proposal--Pacemaker Programmers (21 CFR 870.3700) A. Identification A pacemaker programmer...

  17. PS wire chamber

    CERN Document Server

    1970-01-01

    A wire chamber used at CERN's Proton Synchrotron accelerator in the 1970s. Multi-wire detectors contain layers of positively and negatively charged wires enclosed in a chamber full of gas. A charged particle passing through the chamber knocks negatively charged electrons out of atoms in the gas, leaving behind positive ions. The electrons are pulled towards the positively charged wires. They collide with other atoms on the way, producing an avalanche of electrons and ions. The movement of these electrons and ions induces an electric pulse in the wires which is collected by fast electronics. The size of the pulse is proportional to the energy loss of the original particle.

  18. Modern Perspectives on Numerical Modeling of Cardiac Pacemaker Cell

    Science.gov (United States)

    Maltsev, Victor A.; Yaniv, Yael; Maltsev, Anna V.; Stern, Michael D.; Lakatta, Edward G.

    2015-01-01

    Cardiac pacemaking is a complex phenomenon that is still not completely understood. Together with experimental studies, numerical modeling has been traditionally used to acquire mechanistic insights in this research area. This review summarizes the present state of numerical modeling of the cardiac pacemaker, including approaches to resolve present paradoxes and controversies. Specifically we discuss the requirement for realistic modeling to consider symmetrical importance of both intracellular and cell membrane processes (within a recent “coupled-clock” theory). Promising future developments of the complex pacemaker system models include the introduction of local calcium control, mitochondria function, and biochemical regulation of protein phosphorylation and cAMP production. Modern numerical and theoretical methods such as multi-parameter sensitivity analyses within extended populations of models and bifurcation analyses are also important for the definition of the most realistic parameters that describe a robust, yet simultaneously flexible operation of the coupled-clock pacemaker cell system. The systems approach to exploring cardiac pacemaker function will guide development of new therapies, such as biological pacemakers for treating insufficient cardiac pacemaker function that becomes especially prevalent with advancing age. PMID:24748434

  19. Routine chest radiography after permanent pacemaker implantation: Is it necessary?

    Directory of Open Access Journals (Sweden)

    Edwards N

    2005-01-01

    Full Text Available Background and Aims: Chest radiographs (CXRs are performed routinely after permanent pacemaker implantation to identify pacemaker lead position and exclude pneumothorax. We assessed the clinical value and need for this procedure. Design: Retrospective analysis of pacemaker data and CXRs following permanent pacemaker insertion between December 2002 and February 2004. Materials and Methods: Post-procedural CXRs were available in 125/126 consecutive patients after either first endocardial pacemaker implantation or insertion of at least one new lead. Subclavian vein puncture was used for venous access in all cases. CXRs were examined to establish the incidence of pneumothorax and assess pacing lead positions. The clinical records were examined in all patients who had subsequent CXRs or a further pacemaker procedure to identify the indication for these and to establish whether CXR had influenced patient management. Results: In total, 192 post-procedural CXRs were performed, either postero-anterior (PA and/or lateral views. Ventricular and/or atrial pacing lead contour and electrode position was considered radiographically appropriate in 86% CXRs. Fourteen per cent of post-procedural radiographs were considered to have radiologically sub-optimal pacemaker lead positioning. None of the patients with these "abnormal" radiographs experienced subsequent pacemaker complications or had further radiographs recorded at a later date. Later repeat CXRs were performed in 16 patients (13% but only 3 patients (2% had pacing abnormalities as the primary indication. All three had satisfactory pacing lead position on initial post-implantation and later radiographs, but required further procedures for lead re-positioning. Iatrogenic pneumothorax occurred in one patient (incidence 0.8% in our series. CXR confirmed the clinical diagnosis and allowed an assessment of size to guide treatment. Conclusion: Routine CXR after permanent pacemaker insertion is not necessary in

  20. Of pacemakers and statistics: the actuarial method extended.

    Science.gov (United States)

    Dussel, J; Wolbarst, A B; Scott-Millar, R N; Obel, I W

    1980-01-01

    Pacemakers cease functioning because of either natural battery exhaustion (nbe) or component failure (cf). A study of four series of pacemakers shows that a simple extension of the actuarial method, so as to incorporate Normal statistics, makes possible a quantitative differentiation between the two modes of failure. This involves the separation of the overall failure probability density function PDF(t) into constituent parts pdfnbe(t) and pdfcf(t). The approach should allow a meaningful comparison of the characteristics of different pacemaker types.

  1. Acute pericarditis with cardiac tamponade induced by pacemaker implantation.

    Science.gov (United States)

    Shingaki, Masami; Kobayashi, Yutaka; Suzuki, Haruo

    2015-11-01

    An 87-year-old woman was diagnosed with third-degree atrioventricular block and underwent pacemaker implantation. On postoperative day 12, she experienced cardiac tamponade that was suspected on computed tomography to be caused by lead perforation; therefore, we performed open-heart surgery. However, we could not identify a perforation site on the heart, and drained a 400-mL exudative pericardial effusion. Subsequently, we diagnosed the pericardial effusion as due to pericarditis induced by pacemaker implantation. It is sometimes difficult to distinguish pericarditis from pacemaker lead perforation, so both should be included in the differential diagnosis. © The Author(s) 2014.

  2. Allergy to pacemaker silicone compounds: recognition and surgical management.

    Science.gov (United States)

    Oprea, Mihaela L; Schnöring, Heike; Sachweh, Jörg S; Ott, Hagen; Biertz, Julia; Vazquez-Jimenez, Jaime F

    2009-04-01

    Silicone is a widely used biomaterial. Contact allergy, particularly to silicone components of pacemaker coatings, is uncommon. We present a 12-year-old girl with a history of complex congenital heart disease and acquired complete heart block excluding transvenous lead placement. Contact allergy to silicone led to multiple surgical interventions until the etiology for recurrent pacemaker wound complications was discovered. The key to diagnosis was a specific manufacturer's patch test. Complete removal of the former pacing system and placement of custom-made silicone free pacemaker components and epicardial use of silicone free transvenous leads were essential for successful therapy.

  3. [Twiddler's syndrome as the cause of pacemaker electrode displacement].

    Science.gov (United States)

    Grønbech, Keea Treu; Hansen, Michael Gilså

    2013-04-08

    Twiddler's syndrome is a rare cause of pacemaker electrode displacement. The displacement is caused by the patient's manipulation with the pacemaker, so the electrode is retracted. We describe a case of a 79-year-old overweight woman with a known psychiatric anamnesis, who was admitted twice with twiddler's syndrome. Age and overweight are known risk factors for twiddler's syndrome; and in this case the patient's psychiatric habitus was probably an additional risk factor. Before performing a pacemaker implantation it is important to take the patient's risk factors into account, and thus consider submuscular implantation.

  4. Endocardial Pacemaker Implantation in Neonates and Infants

    Directory of Open Access Journals (Sweden)

    Canan Ayabakan

    2006-04-01

    Full Text Available Transvenous pacemaker lead implantation is the preferred method of pacing in adult patients. Lead performance and longevity are superior and the implantation approach can be performed under local anaesthetic with a very low morbidity. In children, and especially in neonates and infants, the epicardial route was traditionally chosen until the advent of smaller generators and lead implantation techniques that allowed growth of the child without lead displacement. Endocardial implantation is not universally accepted, however, as there is an incidence of venous occlusion of the smaller veins of neonates and infants with concerns for loss of venous access in the future. Growing experience with lower profile leads, however, reveals that endocardial pacing too can be performed with low morbidity and good long-term results in neonates and infants.

  5. Neutron absorbed dose in a pacemaker CMOS

    Energy Technology Data Exchange (ETDEWEB)

    Borja H, C. G.; Guzman G, K. A.; Valero L, C. Y.; Banuelos F, A.; Hernandez D, V. M.; Vega C, H. R. [Universidad Autonoma de Zacatecas, Unidad Academica de Estudios Nucleares, Calle Cipres No. 10, Fracc. La Penuela, 98068 Zacatecas (Mexico); Paredes G, L., E-mail: candy_borja@hotmail.com [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico)

    2011-11-15

    The absorbed dose due to neutrons by a Complementary Metal Oxide Semiconductor (CMOS) has been estimated using Monte Carlo methods. Eventually a person with a pacemaker becomes a patient that must be treated by radiotherapy with a linear accelerator; the pacemaker has integrated circuits as CMOS that are sensitive to intense and pulsed radiation fields. When the Linac is working in Bremsstrahlung mode an undesirable neutron field is produced due to photoneutron reactions; these neutrons could damage the CMOS putting the patient at risk during the radiotherapy treatment. In order to estimate the neutron dose in the CMOS a Monte Carlo calculation was carried out where a full radiotherapy vault room was modeled with a W-made spherical shell in whose center was located the source term of photoneutrons produced by a Linac head operating in Bremsstrahlung mode at 18 MV. In the calculations a phantom made of tissue equivalent was modeled while a beam of photoneutrons was applied on the phantom prostatic region using a field of 10 x 10 cm{sup 2}. During simulation neutrons were isotropically transported from the Linac head to the phantom chest, here a 1 {theta} x 1 cm{sup 2} cylinder made of polystyrene was modeled as the CMOS, where the neutron spectrum and the absorbed dose were estimated. Main damages to CMOS are by protons produced during neutron collisions protective cover made of H-rich materials, here the neutron spectrum that reach the CMOS was calculated showing a small peak around 0.1 MeV and a larger peak in the thermal region, both connected through epithermal neutrons. (Author)

  6. Biological Rhythms Workshop IB: neurophysiology of SCN pacemaker function.

    Science.gov (United States)

    Kuhlman, S J

    2007-01-01

    Pacemakers are functional units capable of generating oscillations that synchronize downstream rhythms. In mammals, the suprachiasmatic nucleus (SCN) of the hypothalamus is a circadian pacemaker composed of individual neurons that intrinsically express a near 24-hour rhythm in gene expression. Rhythmic gene expression is tightly coupled to a rhythm in spontaneous firing rate via intrinsic daily regulation of potassium current. Recent progress in the field indicates that SCN pacemaking is a specialized property that emerges from intrinsic features of single cells, structural connectivity among cells, and activity dynamics within the SCN. The focus of this chapter is on how Nature built a functional pacemaker from many individual oscillators that is capable of coordinating the daily timing of essential brain and physiological processes.

  7. Intra-cardiac pacemaker infection: Surgical management and outcome

    Directory of Open Access Journals (Sweden)

    Sameh Elameen

    2016-05-01

    Conclusion: Explantation of the complete pacemaker system has proved a reliable method to eradicate infection. Complications were rare, except in patients who present lately in a critically ill condition and septic shock.

  8. Towards plant wires

    OpenAIRE

    Adamatzky, Andrew

    2014-01-01

    In experimental laboratory studies we evaluate a possibility of making electrical wires from living plants. In scoping experiments we use lettuce seedlings as a prototype model of a plant wire. We approximate an electrical potential transfer function by applying direct current voltage to the lettuce seedlings and recording output voltage. We analyse oscillation frequencies of the output potential and assess noise immunity of the plant wires. Our findings will be used in future designs of self...

  9. A temporary face support

    Energy Technology Data Exchange (ETDEWEB)

    Popov, V.I.; Bakhtin, V.N.; Tolkachev, N.I.

    1980-03-30

    A temporary face support is proposed. It includes a beam supported by hydraulic jacks on the housing of the cutter-loader with a working tool and rotary pressure regulator. It differs in that to decrease the volume of unsecured roofing in the face space between the leading edge of the beam and the cutting tool of the cutter-loader, the beam is hinged onto the housing of the rotary pressure regulator by a fastened connecting rod, and the hydraulic jacks are provided with additional powered elements with a mechanism that regulates the length of the cut-off plate of the hydraulic pump when the seam pressure changes.

  10. Successful pacing using a batteryless sunlight-powered pacemaker.

    Science.gov (United States)

    Haeberlin, Andreas; Zurbuchen, Adrian; Schaerer, Jakob; Wagner, Joerg; Walpen, Sébastien; Huber, Christoph; Haeberlin, Heinrich; Fuhrer, Juerg; Vogel, Rolf

    2014-10-01

    Today's cardiac pacemakers are powered by batteries with limited energy capacity. As the battery's lifetime ends, the pacemaker needs to be replaced. This surgical re-intervention is costly and bears the risk of complications. Thus, a pacemaker without primary batteries is desirable. The goal of this study was to test whether transcutaneous solar light could power a pacemaker. We used a three-step approach to investigate the feasibility of sunlight-powered cardiac pacing. First, the harvestable power was estimated. Theoretically, a subcutaneously implanted 1 cm(2) solar module may harvest ∼2500 µW from sunlight (3 mm implantation depth). Secondly, ex vivo measurements were performed with solar cells placed under pig skin flaps exposed to a solar simulator and real sunlight. Ex vivo measurements under real sunlight resulted in a median output power of 4941 µW/cm(2) [interquartile range (IQR) 3767-5598 µW/cm(2), median skin flap thickness 3.0 mm (IQR 2.7-3.3 mm)]. The output power strongly depended on implantation depth (ρSpearman = -0.86, P pacemaker powered by a 3.24 cm(2) solar module was implanted in vivo in a pig to measure output power and to pace. In vivo measurements showed a median output power of >3500 µW/cm(2) (skin flap thickness 2.8-3.84 mm). Successful batteryless VVI pacing using a subcutaneously implanted solar module was performed. Based on our results, we estimate that a few minutes of direct sunlight (irradiating an implanted solar module) allow powering a pacemaker for 24 h using a suitable energy storage. Thus, powering a pacemaker by sunlight is feasible and may be an alternative energy supply for tomorrow's pacemakers. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  11. ARTERIAL HYPERTENSION AND MEDICAL SUPPORT OF PATIENTS WITH PERMANENT PACEMAKERS

    Directory of Open Access Journals (Sweden)

    T. A. Derienko

    2016-06-01

    Full Text Available The review is devoted to clinical problems of arterial hypertension (AH in patients with implanted pacemakers (EKS and cardiac resynchronization therapy (CRT. Indications for pacemaker implantation and CRT are considered, especially the purpose and effectiveness of angiotensin-converting enzyme (ACE inhibitors, angiotensin II receptor antagonists (ARA, sartans, beta-blockers (BAB, diuretics, calcium channel blockers. We prove that the CRT and cardiac pacing and do not cancel, bur modify drug therapy of AH.

  12. ARTERIAL HYPERTENSION AND MEDICAL SUPPORT OF PATIENTS WITH PERMANENT PACEMAKERS

    OpenAIRE

    T. A. Derienko

    2016-01-01

    The review is devoted to clinical problems of arterial hypertension (AH) in patients with implanted pacemakers (EKS) and cardiac resynchronization therapy (CRT). Indications for pacemaker implantation and CRT are considered, especially the purpose and effectiveness of angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor antagonists (ARA, sartans), beta-blockers (BAB), diuretics, calcium channel blockers. We prove that the CRT and cardiac pacing and do not cancel, bur modify...

  13. Photovoltaic Wire, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — This Small Business Innovation Research Phase I project will investigate a new architecture for photovoltaic devices based on nanotechnology: photovoltaic wire. The...

  14. Photovoltaic Wire Project

    Data.gov (United States)

    National Aeronautics and Space Administration — This Small Business Innovation Research Phase I project will investigate a new architecture for photovoltaic devices based on nanotechnology: photovoltaic wire. The...

  15. Charpak hemispherical wire chamber

    CERN Document Server

    1970-01-01

    pieces. Mesures are of the largest one. Multi-wire detectors contain layers of positively and negatively charged wires enclosed in a chamber full of gas. A charged particle passing through the chamber knocks negatively charged electrons out of atoms in the gas, leaving behind positive ions. The electrons are pulled towards the positively charged wires. They collide with other atoms on the way, producing an avalanche of electrons and ions. The movement of these electrons and ions induces an electric pulse in the wires which is collected by fast electronics. The size of the pulse is proportional to the energy loss of the original particle.

  16. 1998 wire development workshop proceedings

    International Nuclear Information System (INIS)

    1998-04-01

    This report consists of vugraphs of the presentations at the conference. The conference was divided into the following sessions: (1) First Generation Wire Development: Status and Issues; (2) First Generation Wire in Pre-Commercial Prototypes; (3) Second Generation Wire Development: Private Sector Progress and Issues; (4) Second Generation Wire Development: Federal Laboratories; and (5) Fundamental Research Issues for HTS Wire Development

  17. Pacemaker implantation after catheter ablation for atrial fibrillation.

    Science.gov (United States)

    Deshmukh, Abhishek J; Yao, Xiaoxi; Schilz, Stephanie; Van Houten, Holly; Sangaralingham, Lindsey R; Asirvatham, Samuel J; Friedman, Paul A; Packer, Douglas L; Noseworthy, Peter A

    2016-01-01

    Sinus node dysfunction requiring pacemaker implantation is commonly associated with atrial fibrillation (AF), but may not be clinically apparent until restoration of sinus rhythm with ablation or cardioversion. We sought to determine frequency, time course, and predictors for pacemaker implantation after catheter ablation, and to compare the overall rates to a matched cardioversion cohort. We conducted a retrospective analysis using a large US commercial insurance database and identified 12,158 AF patients who underwent catheter ablation between January 1, 2005 and December 31, 2012. Over an average of 2.4 years of follow-up, 5.6 % of the patients underwent pacemaker implantation. Using the Cox proportional hazards models, we found that risk of risks of pacemaker implantation was associated with older age (50-64 and ≥65 versus pacemaker implantation between ablation patients and propensity score (PS)-matched cardioversion groups (3.5 versus. 4.1 % at 1 year and 8.8 versus 8.3 % at 5 years). Overall, pacemaker implantation occurs in about 1/28 patients within 1 year of catheter ablation. The overall implantation rate decreased between 2005 and 2012. Furthermore, the risk after ablation is similar to cardioversion, suggesting that patients require pacing due to a common underlying electrophysiologic substrate, rather than the ablation itself.

  18. Wire Array Photovoltaics

    Science.gov (United States)

    Turner-Evans, Dan

    Over the past five years, the cost of solar panels has dropped drastically and, in concert, the number of installed modules has risen exponentially. However, solar electricity is still more than twice as expensive as electricity from a natural gas plant. Fortunately, wire array solar cells have emerged as a promising technology for further lowering the cost of solar. Si wire array solar cells are formed with a unique, low cost growth method and use 100 times less material than conventional Si cells. The wires can be embedded in a transparent, flexible polymer to create a free-standing array that can be rolled up for easy installation in a variety of form factors. Furthermore, by incorporating multijunctions into the wire morphology, higher efficiencies can be achieved while taking advantage of the unique defect relaxation pathways afforded by the 3D wire geometry. The work in this thesis shepherded Si wires from undoped arrays to flexible, functional large area devices and laid the groundwork for multijunction wire array cells. Fabrication techniques were developed to turn intrinsic Si wires into full p-n junctions and the wires were passivated with a-Si:H and a-SiNx:H. Single wire devices yielded open circuit voltages of 600 mV and efficiencies of 9%. The arrays were then embedded in a polymer and contacted with a transparent, flexible, Ni nanoparticle and Ag nanowire top contact. The contact connected >99% of the wires in parallel and yielded flexible, substrate free solar cells featuring hundreds of thousands of wires. Building on the success of the Si wire arrays, GaP was epitaxially grown on the material to create heterostructures for photoelectrochemistry. These cells were limited by low absorption in the GaP due to its indirect bandgap, and poor current collection due to a diffusion length of only 80 nm. However, GaAsP on SiGe offers a superior combination of materials, and wire architectures based on these semiconductors were investigated for multijunction

  19. 25 CFR 11.607 - Temporary orders and temporary injunctions.

    Science.gov (United States)

    2010-04-01

    ...) In a proceeding for dissolution of marriage or for legal separation, either party may move for temporary maintenance or temporary support of a child of the marriage entitled to support. The motion shall... necessities of life, and, if so restrained, requiring him or her to notify the moving party of any proposed...

  20. 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.

  1. Impact of Pacemaker Lead Characteristics on Pacemaker Related Infection and Heart Perforation: A Nationwide Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Yu-Sheng Lin

    Full Text Available Several risk factors for pacemaker (PM related complications have been reported. However, no study has investigated the impact of lead characteristics on pacemaker-related complications.Patients who received a new pacemaker implant from January 1997 to December 2011 were selected from the Taiwan National Health Insurance Database. This population was grouped according to the pacemaker lead characteristics in terms of fixation and insulation. The impact of the characteristics of leads on early heart perforation was analyzed by multivariable logistic regression analysis, while the impact of the lead characteristics on early and late infection and late heart perforation over a three-year period were analyzed using Cox regression. This study included 36,104 patients with a mean age of 73.4±12.5 years. In terms of both early and late heart perforations, there were no significant differences between groups across the different types of fixation and insulations. In the multivariable Cox regression analysis, the pacemaker-related infection rate was significantly lower in the active fixation only group compared to either the both fixation (OR, 0.23; 95% CI, 0.07-0.80; P = 0.020 or the passive fixation group (OR, 0.26; 95% CI, 0.08-0.83; P = 0.023.There was no difference in heart perforation between active and passive fixation leads. Active fixation leads were associated with reduced risk of pacemaker-related infection.

  2. Impact of Pacemaker Lead Characteristics on Pacemaker Related Infection and Heart Perforation: A Nationwide Population-Based Cohort Study.

    Science.gov (United States)

    Lin, Yu-Sheng; Chen, Tien-Hsing; Hung, Sheng-Ping; Chen, Dong Yi; Mao, Chun-Tai; Tsai, Ming-Lung; Chang, Shih-Tai; Wang, Chun-Chieh; Wen, Ming-Shien; Chen, Mien-Cheng

    2015-01-01

    Several risk factors for pacemaker (PM) related complications have been reported. However, no study has investigated the impact of lead characteristics on pacemaker-related complications. Patients who received a new pacemaker implant from January 1997 to December 2011 were selected from the Taiwan National Health Insurance Database. This population was grouped according to the pacemaker lead characteristics in terms of fixation and insulation. The impact of the characteristics of leads on early heart perforation was analyzed by multivariable logistic regression analysis, while the impact of the lead characteristics on early and late infection and late heart perforation over a three-year period were analyzed using Cox regression. This study included 36,104 patients with a mean age of 73.4±12.5 years. In terms of both early and late heart perforations, there were no significant differences between groups across the different types of fixation and insulations. In the multivariable Cox regression analysis, the pacemaker-related infection rate was significantly lower in the active fixation only group compared to either the both fixation (OR, 0.23; 95% CI, 0.07-0.80; P = 0.020) or the passive fixation group (OR, 0.26; 95% CI, 0.08-0.83; P = 0.023). There was no difference in heart perforation between active and passive fixation leads. Active fixation leads were associated with reduced risk of pacemaker-related infection.

  3. Final generic environmental statement on the routine use of plutonium-powered cardiac pacemakers. Update of information on power sources for pacemakers

    International Nuclear Information System (INIS)

    1979-05-01

    The Final Environmental Statement on Routine Use of Plutonium-Powered Cardiac Pacemakers (FES) was issued in July 1976. Supplement 1, prepared in 1978, updates the FES with respect to power sources for pacemakers. Particular attention is given to the non-nuclear lithium batteries as alternatives to 238-Pu power sources in pacemakers. Supplement 1 also considers the current extent of pacemaker use and makeup of the patient population and concludes that the FES' conclusion is still valid that distribution of 238-Pu powered pacemakers for routine use should be authorized subject to specific conditions

  4. Automating wiring formboard design

    NARCIS (Netherlands)

    Van den Berg, T.

    2013-01-01

    Increase in aircraft wiring complexity call for manufacturing design improvements to reduce cost and lead-time. To achieve such improvements, a joint research project was performed by the Flight Performance and Propulsion (FPP) group and Fokker Elmo BV, the second largest aircraft wiring harness

  5. [Right heart failure after pacemaker implantation].

    Science.gov (United States)

    Gallego Galiana, Juan; López Castellanos, Genoveva; Gioia, Francesca; Ruiz Ortega, Raúl Antonio; Cobo Reinoso, Maria Eugenia; Manzano Espinosa, Luis

    2015-06-22

    Severe tricuspid regurgitation (TR) secondary to interference pacemaker (PM) cable is a rare cause of progressive right heart failure (HF), which can worsen patient outcomes. We present 3 clinical cases of right HF secondary to TR after PM implantation. In these patients the clinic is right HF, which can appear early, as in our second patient, or after years of implementation of the PM, as in the first and third patients. The diagnosis is confirmed by echocardiography, the most accurate 3D, followed by transesophageal. The 2D transthoracic can not detect it, because it has low sensitivity for TR associated with PM. Medical treatment is always the first choice, since any other procedure carries significant morbidity and mortality. Probably this is a condition that we will diagnose with increasing frequency, because there are more and more patients with devices and, at the same time, the diagnostic tools are improving. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  6. Thermosonic wire bonding of IC devices using palladium wire

    International Nuclear Information System (INIS)

    Shze, J.H.; Poh, M.T.; Tan, R.M.

    1996-01-01

    The feasibility of replacing gold wire by palladium wire in thermosonic wire bonding of CMOS and bipolar devices are studied in terms of the manufacturability, physical, electrical and assembly performance. The results that palladium wire is a viable option for bonding the bipolar devices but not the CMOS devices

  7. Patients exposure from fluoroscopic guided pacemaker implantation procedures

    Energy Technology Data Exchange (ETDEWEB)

    Alkhorayef, M.; Babikir, E. [King Saud University, College of Applied Sciences, Radiological Sciences Department, P. O. Box 10219, Riyadh 11433 (Saudi Arabia); Sulieman, A. [Prince Sattam bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, P. O. Box 422, Alkharj 11942 (Saudi Arabia); Daar, E. [University of Jordan, Faculty of Science, Department of Physics, Amman 11942 (Jordan); Alnaaimi, M.; Alduaij, M. [Kuwait Cancer Control Centre, Department of Nuclear Medicine, Shwiekh (Kuwait); Bradley, D., E-mail: malkhorayef@ksu.edu.sa [University of Surrey, Centre for Nuclear and Radiation Physics, Guildford, Surrey, GU2 7XH (United Kingdom)

    2016-10-15

    A pacemaker, which is used for heart re synchronization with electrical impulses, is used to manage many clinical conditions. Recently, the frequency of the pacemaker implantation procedures increased 50% worldwide. During this procedure, patients and staff can be exposed to excessive radiation exposure. Wide range of doses was reported in previous studies, suggesting that optimization of this procedure is not fulfilled yet. This study aims to evaluate the patient and staff radiation doses during cardiac pacemaker procedure and quantify the patient effective dose. A total of 145 procedures were performed for five pacemakers procedures (VVI, VVIR, VVD, VVDR and DDDR) two hospitals were evaluated. Patients doses were measured using the kerma-area product meter. Effective doses were estimated using software based on Monte Carlo simulation from National Radiological Protection Board. The effective dose values were used to estimate the cancer risk from pacemaker procedure. Patients demographic data, exposure parameters for both fluoroscopy and radiography were quantified. The mean patients doses (Gy. cm{sup 2}) for VVI, VVIR, VVD, VVDR and DDDR was 1.52±0.13 (1.43-1.61), 3.28±2.34 (0.29-8.73), 3.04±1.67 (1.57-4.86), 6.04±2.326 and 19.2±3.6 (5.43-30.2), respectively, per procedure. The overall patients effective dose is 1.1 mSv per procedure. (Author)

  8. Implantable Cardiac Pacemakers – 50 Years from the First Implantation

    Directory of Open Access Journals (Sweden)

    Ratko Magjarević

    2010-01-01

    Overview: Development of implantable cardiac pacemaker was enabled by another important invention, the silicon transistor. h ough the invention of suitable lithium cells as appropriate power supply was essential for prolongation of battery life cycle and for increased reliability of pacemakers, main milestones in the development were associated with technological breakthroughs in electronics: from transistors, which introduced such features as small size and low power consumption, to hybrid and integrated circuits, which enabled programmability, microprocessors, which added more options in programming (multiprogrammability, diagnostics and telemetry, and the ICT (information communication technology that enabled physicians remote access to patients and interrogation of their implantable devices. Conclusions: Implantable pacemakers are reliable devices indicated for a wide range of dif erent therapies of cardiac rhythm disorders and heart failure. h ere is still a lot to learn about the physiology of a normal heart and even more about the failing heart. Modern pacemakers provide physicians valuable information from pacemakers’ memory via the built-in telemetry system. h ese information help physicians to better understand pathologic processes within the heart, thus contributing to the development of new ideas for treatment of diseases and for precise tailoring of the therapy to the patient’s needs. Although implantable pacemakers have reached the level of mature technology, they will continue to develop with therapies and diagnostics to facilitate a higher quality of life.

  9. Safety of Laser Interstitial Thermal Therapy in Patients With Pacemakers.

    Science.gov (United States)

    Grewal, Sanjeet S; Gorny, Krzysztof R; Favazza, Christopher P; Watson, Robert E; Kaufmann, Timothy J; Van Gompel, Jamie J

    2018-02-10

    Laser interstitial thermal therapy (LiTT) has increasingly been used as a treatment option for medically refractory epilepsy, tumors, and radiation necrosis. The use of LiTT requires intraoperative magnetic resonance (MR) thermography. This can become an issue in patients with other implanted therapeutic devices such as pacemakers and vagal nerve stimulators due to concerns regarding increases in the specific absorption rate (SAR). This is a technical case report demonstrating a successfully and safely performed LiTT in a 1.5-T magnetic resonance imaging (MRI) in a patient with a pacemaker for mesial temporal sclerosis. An 83-yr-old gentleman who had an implanted cardiac pacemaker presented with medically intractable epilepsy and was confirmed to have mesial temporal sclerosis on imaging. Video electroencephalography demonstrated concordant ipsilateral seizures and semiology. He underwent LiTT for ablation of the mesial temporal lobe. This was performed with the below described protocol with a cardiology nurse monitoring the patient's cardiac condition and a physicist monitoring SAR, and MR imaging quality without any adverse events. This study reports on a protocol of cardiac and MR SAR to safely perform MR-guided LiTT in the setting of traditional pacemakers in patients who are not pacemaker dependent. Copyright © 2018 by the Congress of Neurological Surgeons

  10. Towards plant wires.

    Science.gov (United States)

    Adamatzky, Andrew

    2014-08-01

    In experimental laboratory studies we evaluate a possibility of making electrical wires from living plants. In scoping experiments we use lettuce seedlings as a prototype model of a plant wire. We approximate an electrical potential transfer function by applying direct current voltage to the lettuce seedlings and recording output voltage. We analyse oscillation frequencies of the output potential and assess noise immunity of the plant wires. Our findings will be used in future designs of self-growing wetware circuits and devices, and integration of plant-based electronic components into future and emergent bio-hybrid systems. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Pacemaker Dependency after Cardiac Surgery: A Systematic Review of Current Evidence.

    Science.gov (United States)

    Steyers, Curtis M; Khera, Rohan; Bhave, Prashant

    2015-01-01

    Severe postoperative conduction disturbances requiring permanent pacemaker implantation frequently occur following cardiac surgery. Little is known about the long-term pacing requirements and risk factors for pacemaker dependency in this population. We performed a systematic review of the literature addressing rates and predictors of pacemaker dependency in patients requiring permanent pacemaker implantation after cardiac surgery. Using a comprehensive search of the Medline, Web of Science and EMBASE databases, studies were selected for review based on predetermined inclusion and exclusion criteria. A total of 8 studies addressing the endpoint of pacemaker-dependency were identified, while 3 studies were found that addressed the recovery of atrioventricular (AV) conduction endpoint. There were 10 unique studies with a total of 780 patients. Mean follow-up ranged from 6-72 months. Pacemaker dependency rates ranged from 32%-91% and recovery of AV conduction ranged from 16%-42%. There was significant heterogeneity with respect to the definition of pacemaker dependency. Several patient and procedure-specific variables were found to be independently associated with pacemaker dependency, but these were not consistent between studies. Pacemaker dependency following cardiac surgery occurs with variable frequency. While individual studies have identified various perioperative risk factors for pacemaker dependency and non-resolution of AV conduction disease, results have been inconsistent. Well-conducted studies using a uniform definition of pacemaker dependency might identify patients who will benefit most from early permanent pacemaker implantation after cardiac surgery.

  12. 77 FR 39924 - Effective Date of Requirement for Premarket Approval for Cardiovascular Permanent Pacemaker...

    Science.gov (United States)

    2012-07-06

    ... Approval for Cardiovascular Permanent Pacemaker Electrode AGENCY: Food and Drug Administration, HHS. ACTION... protocol (PDP) for the cardiovascular permanent pacemaker electrode. The Agency has summarized its findings... cardiovascular permanent pacemaker electrode. In accordance with section 515(b)(2)(A) of the FD&C Act, FDA...

  13. [TRENDS OF PERMANENT PACEMAKER IMPLANTATION IN A SINGLE CENTER OVER A 20-YEAR PERIOD].

    Science.gov (United States)

    Antonelli, Dante; Ilan, Limor Bushar; Freedberg, Nahum A; Feldman, Alexander; Turgeman, Yoav

    2015-05-01

    To review the changes in permanent pacemaker implantation indications, pacing modes and patients' demographics over a 20-year period. We retrospectively retrieved data on patients who underwent first implantation of the pacemaker between 1-1-1991 and 31-12-2010. One thousand and nine (1,009) patients underwent a first pacemaker implantation during that period; 535 were men (53%), their mean age was 74.6±19.5 years; the highest rate of implanted pacemaker was in patients ranging in age from 70-79 years, however there was an increasing number of patients aged over 80 years. The median survival time after initial pacemaker implantation was 8 years. Syncope was the most common symptom (62.5%) and atrioventricular block was the most common electrocardiographic indication (56.4%) leading to pacemaker implantation. There was increased utilization of dual chamber and rate responsive pacemakers over the years. There was no difference regarding mode selection between genders. Pacemaker implantation rates have increased over a 20-year period. Dual chamber replaced most of the single ventricular chamber pacemaker and rate responsive pacemakers became the norm. The data of a small volume center are similar to those reported in pacemaker surveys of high volume pacemaker implantation centers. They confirm adherence to the published guidelines for pacing.

  14. 77 FR 37570 - Effective Date of Requirement for Premarket Approval for a Pacemaker Programmer

    Science.gov (United States)

    2012-06-22

    ... Approval for a Pacemaker Programmer AGENCY: Food and Drug Administration, HHS. ACTION: Final rule. SUMMARY... approval application (PMA) or a notice of completion of a product development protocol (PDP) for pacemaker... for the pacemaker programmer (the August 2011 proposed rule). In accordance with section 515(b)(2)(A...

  15. Hyperpolarization-activated current, If, in mathematical models of rabbit sinoatrial node pacemaker cells

    NARCIS (Netherlands)

    Verkerk, Arie O.; Wilders, Ronald

    2013-01-01

    A typical feature of sinoatrial (SA) node pacemaker cells is the presence of an ionic current that activates upon hyperpolarization. The role of this hyperpolarization-activated current, If, which is also known as the "funny current" or "pacemaker current," in the spontaneous pacemaker activity of

  16. Cryogenic Pressure Seal for Wires

    Science.gov (United States)

    Ciana, J. J.

    1984-01-01

    High-pressure-seal formed by forcing polyurethane into space surrounding wire or cable in special fitting. Wire or cable routed through fitting then through a tightly fitting cap. Wire insulation left intact. Cap filled with sealant and forced onto the fitting: this pushes sealant into fitting so it seals wire or cable in fitting as well as in cap.

  17. Radioisotope-powered cardiac pacemaker program. Clinical studies of the nuclear pacemaker model NU-5. Final report

    International Nuclear Information System (INIS)

    1980-06-01

    Beginning in February, 1970, the Nuclear Materials and Equipment Corporation (NUMEC) undertook a program to design, develop and manufacture a radioisotope powered cardiac pacemaker system. The scope of technical work was specified to be: establish system, component, and process cost reduction goals using the prototype Radioisotope Powered Cardiac Pacemaker (RCP) design and develop production techniques to achieve these cost reduction objectives; fabricate radioisotope powered fueled prototype cardiac pacemakers (RCP's) on a pilot production basis; conduct liaison with a Government-designated fueling facility for purposes of defining fueling requirements, fabrication and encapsulation procedures, safety design criteria and quality control and inspection requirements; develop and implement Quality Assurance and Reliability Programs; conduct performance, acceptance, lifetime and reliability tests of fueled RCP's in the laboratory; conduct liaison with the National Institutes of Health and with Government specified medical research institutions selected for the purpose of undertaking clinical evaluation of the RCP in humans; monitor and evaluate, on a continuing basis, all test data; and perform necessary safety analyses and tests. Pacemaker designs were developed and quality assurance and manufacturing procedures established. Prototype pacemakers were fabricated. A total of 126 radioisotope powered units were implanted and have been followed clinically for approximately seven years. Four (4) of these units have failed. Eighty-three (83) units remain implanted and satisfactorily operational. An overall failure rate of less than the target 0.15% per month has been achieved

  18. Automatic Capture Verification in Pacemakers (Autocapture – Utility and Problems

    Directory of Open Access Journals (Sweden)

    Ruth Kam

    2004-04-01

    Full Text Available The concept of a closed – loop feedback system, that would automatically assess pacing threshold and self -adjust pacing output to ensure consistent myocardial capture, has many appeals. Enhancing patient safety in cases of an unexpected rise in threshold, reduced current drain, hence prolonging battery longevity and reducing the amount of physician intervention required are just some of the advantages. Autocapture (AC is a proprietary algorithm developed by St Jude Medical CRMD, Sylmar, CA, USA, (SJM that was the first to commercially provide these automatic functions in a single chamber pacemaker (Microny and Regency, and subsequently in a dual chamber pacemaker (Affinity, Entity and Identity family of pacemakers. This article reviews the conditions necessary for AC verification and performance and the problems encountered in clinical practice.

  19. Pacemaker Placement in Patients with Stroke-Mediated Autonomic Dysregulation

    Directory of Open Access Journals (Sweden)

    Ali A. Alsaad

    2017-01-01

    Full Text Available Lateral medullary syndrome (LMS is an ischemic disease of the medulla oblongata, which involves the territory of the posterior inferior cerebellar artery. Lateral medullary syndrome is often missed as the cause of autonomic dysregulation in patients with recent brain stem stroke. Due to the location of the baroreceptor regulatory center in the lateral medulla oblongata, patients with LMS occasionally have autonomic dysregulation-associated clinical manifestations. We report a case of LMS-associated autonomic dysregulation. The case presented as sinus arrest and syncope, requiring permanent pacemaker placement. A dual-chamber pacemaker was placed, after failure of conservative measures to alleviate the patient’s symptoms. Our case shows the importance of recognizing LMS as a potential cause for life-threatening arrhythmias, heart block, and symptomatic bradycardia. Placement of permanent pacemaker may be necessary in some patients with LMS presenting with syncope, secondary to sinus arrest.

  20. Pacemaker patients' perception of unsafe activities: a survey

    Directory of Open Access Journals (Sweden)

    Shafquat Azam

    2008-11-01

    Full Text Available Abstract Background Cardiac pacing is a recognized and widely used treatment for patients presenting with bradycardia. Physicians expect patients to return to normal activities almost immediately post implantation. However, patients themselves may perceive interference to pacemaker function by various routine activities and devices, and hence continue to lead restricted, disabled lives. The aim of this study is to determine if routine activities are perceived by pacemaker patients to interfere with their device function. Methods A descriptive cross sectional survey was carried out on consecutive patients at the pacemaker clinic at a public hospital in Karachi, Pakistan. A 47-question tool was developed and tested. Patients' perceptions of safety of performing various routine activities, along with socio-demographic data were recorded. Results The final sample included 93 adult patients (45% males. 41% were illiterate. 77.4% recalled receiving counselling at implantation, predominantly from the implanting physician and house staff. A considerable proportion of patients considered many routine activities unsafe including driving automobiles (28%, passing through metal detectors (31%, bending over (37%, and sleeping on the side of the pacemaker (30%. Also considered unsafe were operation of household appliances- TV/VCR (television/video cassette recorders (53%, irons (55% and electrical wall switches (56%. For nearly all variables neither literacy nor history of counselling improved incorrect perceptions. Conclusion This study shows that our pacemaker patients perceive many routine activities as unsafe, potentially leading to disabling life style modifications. The tremendous investment in pacemaker technology to improve patient performance is not going to pay dividends if patients continue to remain disabled due to incorrect perceptions. Further studies are required to determine the reasons for these misperceptions, and to determine if these

  1. Copper wire bonding

    CERN Document Server

    Chauhan, Preeti S; Zhong, ZhaoWei; Pecht, Michael G

    2014-01-01

    This critical volume provides an in-depth presentation of copper wire bonding technologies, processes and equipment, along with the economic benefits and risks.  Due to the increasing cost of materials used to make electronic components, the electronics industry has been rapidly moving from high cost gold to significantly lower cost copper as a wire bonding material.  However, copper wire bonding has several process and reliability concerns due to its material properties.  Copper Wire Bonding book lays out the challenges involved in replacing gold with copper as a wire bond material, and includes the bonding process changes—bond force, electric flame off, current and ultrasonic energy optimization, and bonding tools and equipment changes for first and second bond formation.  In addition, the bond–pad metallurgies and the use of bare and palladium-coated copper wires on aluminum are presented, and gold, nickel and palladium surface finishes are discussed.  The book also discusses best practices and re...

  2. The temporary international collective chronicle

    International Nuclear Information System (INIS)

    Kravchenko, Yu.Ya.

    2007-01-01

    The temporary international collective brief history is presented from the time of its establishment in 1972 (and even earlier) till the termination of its activity in 1990 (and even later). Works in the temporary international collective framework demonstrate an example of successful cooperation of specialists from different countries in the field of calculation-theoretical and experimental research on the WWER reactor physics. The results of experimental and calculation studies were reported to the topical meetings, workshops, conferences, and symposia as well as were published in the temporary international collective reports and proceedings. The answers to the questions about the temporary international collective activity-What? Where? When?-are presented in this chronicle (Authors)

  3. Interference with the pacemakers of two workers at electricity substations.

    Science.gov (United States)

    Butrous, G S; Bexton, R S; Barton, D G; Male, J C; Camm, A J

    1983-11-01

    Pacemaker function was tested in two electricity substation workers exposed to high tension electric fields. High intensity electric fields induced reversion to the interference mode, producing in one case competitive rhythm and in the other inappropriately slow pacing which resulted in asymptomatic pauses of up to 2.5 s. A suit designed to shield the body from the effects of high intensity electric fields was tried and proved to be effective in protecting the pacemaker, allowing it to function normally in the substations.

  4. Transcatheter leadless pacemaker implantation in a patient with a transvenous dual-chamber pacemaker already in place.

    Science.gov (United States)

    Karjalainen, Pasi P; Nammas, Wail; Paana, Tuomas

    2016-01-01

    An 83-year-old lady had a DDDR pacemaker inserted in 1997 for symptomatic atrioventricular block. She underwent battery replacement in 2008. In 2010, she developed atrial fibrillation; the pacemaker was switched to VVIR mode. During the last 2years, ventricular lead threshold increased progressively. In December 2015, she presented for elective battery replacement. After successful battery replacement, the ventricular lead threshold remained high; therefore, we implanted a leadless transcatheter pacemaker, via femoral vein access, using a dedicated catheter delivery system. Electrical measurements at this stage revealed a pacing threshold of 0.28V at 0.24msec, and an impedance of 650Ω. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. 5 CFR 213.3199 - Temporary organizations.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Temporary organizations. 213.3199 Section... SERVICE Excepted Schedules Schedule A § 213.3199 Temporary organizations. Positions on the staffs of temporary organizations, as defined in 5 U.S.C. 3161(a). Appointments may not exceed 3 years, but temporary...

  6. 42 CFR 488.415 - Temporary management.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Temporary management. 488.415 Section 488.415... Compliance for Long-Term Care Facilities with Deficiencies § 488.415 Temporary management. (a) Definition. Temporary management means the temporary appointment by CMS or the State of a substitute facility manager or...

  7. 'A pacemaker in my heart' -- classification of questions asked by pacemaker patients as a basis for intervention.

    Science.gov (United States)

    Rassin, Michal; Zilcha, Lia; Gross, Dalia

    2009-01-01

    The research aimed to identify the information patients find necessary, following pacemaker implantation. Although pacemaker devices do not have an adverse impact on lifestyle, they evoke anxiety related to the patient's activities and lifestyle. Survey. A convenience sample of participants was taken from the entire population of patients who attended the cardiology clinic between January-June 2007; 274 individual meetings were held with 123 pacemaker patients in three periods, reflecting different stages of recovery. In the meeting, patients were invoked to ask any question they may have regarding pacemaker implantation. The questions were collected from the patients and categorised chronologically, in accordance with their frequency in three periods, reflecting different stages of recovery. Eight categories, representing common issues and content were raised: motion and effort, environmental influences, personal hygiene, knowledge concerning the pacemaker operation, medical treatment, eating and drinking, clothing and general questions. Findings show that the common factor for most of the questions was the loss of confidence in the various aspects of life. The largest relative question proportion was in the motion and effort (27%) (e.g. may I swim? how many kg may I lift?) and environmental influences (26%) (e.g. may I use a cellular phone? may I use a shaving machine?). A coherent, continuous pattern was found, characterising the different points of measurement where, at the first point, questions were characterised as more existential, related to daily routine activities and as time passed and patients were exposed to non-daily activities and conditions, other questions were raised. Pacemaker implant guidance should be based upon experimental evidence, arranged according to each category's relative weight and take into account the patient's point of view.

  8. An unusual case of pacemaker failure: complete disconnection of connector block and battery of a subpectorally implanted dual chamber pacemaker.

    Science.gov (United States)

    Mellert, Fritz; Esmailzadeh, Bahman; Schneider, Christian; Haushofer, Marcus; Schimpf, Rainer; Wolpert, Christian; Preusse, Claus J; Lüderitz, Berndt; Welz, Armin

    2002-04-01

    Local trauma to patients with implanted pacemaker devices may result in lead fracture or breakage of the lead socket with leakage of fluid into the connector system. This report describes an unusual case of complete entrance and exit block in a subpectorally implanted dual chamber pacemaker due to total disconnection and dislodgement of header block and battery part. Damage may be caused by an interaction of machine fatigue/manufacturing defective and fixation of the header with unusual movability of the battery, leading to breakage with intermittent malfunction and consecutive bradycardia and syncope.

  9. Prophylactic antibiotic for pacemaker surgery: what is optimal ...

    African Journals Online (AJOL)

    One of them, a bed-ridden patient developed severe pocket infection necessitating explantation and replacement 3 weeks later. Conclusions: We noted with satisfaction that short regime of prophylactic parentral ceftriaxone is effective in preventing pacemaker infection and there is no need for the long regimen. Niger Med J.

  10. 238Pu sources for cardiac pacemakers. II. Control

    International Nuclear Information System (INIS)

    Pottier, R.; Merigot, S.

    1976-01-01

    The method and the apparatus used for thermal (power) and radioactive control of radioisotopic sources for pacemakers are briefly described. The cybernetic system is also presented, which assumes almost automatically the monitoring of control, mechanical and electronic works, data processing, the measurements and computations, and the works related to quality control [fr

  11. A pacemaker for asystole in breath-holding spells

    OpenAIRE

    Legge, Leah M; Kantoch, Michal J; Seshia, Shashi S; Soni, Reeni

    2002-01-01

    Two cases of young children with frequent severe breath-holding spells complicated by prolonged asystole and seizures are reported. A ventricular pacemaker was implanted in each child, and both have subsequently remained free of syncope, although they continue to exhibit breath-holding behaviour.

  12. Deactivation of Pacemaker: Ethical Approach or Managerial Failure?

    Directory of Open Access Journals (Sweden)

    Macková Marie

    2017-12-01

    Full Text Available The decision about the deactivation of a pacemaker must be the result of a multicriteria decision-making process where the legal, ethical and effectiveness aspects must be taken into account and delicately balanced, while also considering the risk of managerial failure. Academic as well as professional discussion is necessary because there is a whole range of question marks on this topic and all the aspects mentioned above. The aim of this paper is to contribute to the debate by presenting the views of Czech physicians about the possibility of deactivation of the pacemaker in patients in terminal states. Based on the results of our research, the following steps are recommended to enable the deactivation of pacemakers in the Czech environment. Before the patient’s own indication of pacemaker therapy, treatment should be discussed with the patient in detail, including complications and deactivation options. Czech ethical consultant services should be set up in Czech hospitals. And last but not least, they should take an opinion on this issue as well as the professional society.

  13. [Mid-dermal elastolysis after insertion of a pacemaker].

    Science.gov (United States)

    Kottler, D; Lefèvre, A; Balme, B; Martin-Bourret, V; Zaharia, D; Skowron, F

    2015-11-01

    Mid-dermal elastolysis (MDE) is a rare acquired disease of elastic tissue histologically characterized by focal loss of elastic fibres within the mid-dermis. While the mechanisms leading to MDE remain unknown, increased degradation of elastic fibres may be involved. Many factors potentially triggering such degradation have been suggested. A 58-year-old man consulted for an asymptomatic reticulated eruption that began in the area of a pacemaker implanted six weeks earlier. The eruption consisted of erythematous polycyclic and coalescing macules with a wrinkled centre. Histopathology with orcein staining revealed focal loss of elastic fibres in the superficial reticular dermis only. Hypersensitivity reaction to any components of the pacemaker was ruled out by means of allergy exploration. Laboratory investigations including autoimmunological and haematological factors were unremarkable. A diagnosis was made of a reticular variant of MDE following insertion of a pacemaker. We report the second case of MDE following the insertion of a pacemaker, which could have triggered an inflammatory response directed specifically towards the elastic fibres. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  14. A pacemaker for asystole in breath-holding spells

    Science.gov (United States)

    Legge, Leah M; Kantoch, Michal J; Seshia, Shashi S; Soni, Reeni

    2002-01-01

    Two cases of young children with frequent severe breath-holding spells complicated by prolonged asystole and seizures are reported. A ventricular pacemaker was implanted in each child, and both have subsequently remained free of syncope, although they continue to exhibit breath-holding behaviour. PMID:20046299

  15. A temporary index

    International Nuclear Information System (INIS)

    Thomson, Jon; Craighead, Alison

    2015-01-01

    The ongoing management of low, intermediate and high-level nuclear waste is an unresolved issue for humanity, not least because the time-frames in question when dealing with the hazards of radioactive wastes, range from as little as a few tens of years to more than 100 000 years. It is from this starting point that we are beginning the development of an ambitious multifaceted artwork aiming to help us consider our relationship with deep-time and our nuclear legacy. The expressed aim of Temporary Index is to raise general awareness about these long-term management issues, and in doing so, to embed this knowledge into our collective cultural memory so as to transmit useful information about our nuclear waste into the future. We wish to create a series of decorative, real-time numeric counters based on the probabilistic decay (including decay of daughter products) of existing nuclear waste that we identify from the earliest weapons' development programmes in the United States right through to contemporary wastes being produced by nuclear energy production today across the world. Each display will countdown in seconds, showing the time remaining before the given item of waste (or a particular site) is considered safe to humans. A hypothetical example of one counter could be a bottle of sludge containing plutonium discovered in 2004 during an attempted clean-up of the Hanford nuclear site in Washington State, United States. Another example might be the geological storage facility for vitrified nuclear waste at Horonobe in Japan, should it be established in the future. Accident sites, such as Chernobyl or Fukushima Daiichi could also be tagged with counters, as could low-level waste (LLW) repositories such as the one at Drigg near Sellafield in the United Kingdom. Whatever the items identified and this will be a complex process requiring collaboration with experts in the field, it is important that a wide range of short- and long-term counters are established to

  16. Wired to freedom

    DEFF Research Database (Denmark)

    Jepsen, Kim Sune Karrasch; Bertilsson, Margareta

    2017-01-01

    dimension of life science through a notion of public politics adopted from the political theory of John Dewey. We show how cochlear implantation engages different social imaginaries on the collective and individual levels and we suggest that users share an imaginary of being “wired to freedom” that involves...... new access to social life, continuous communicative challenges, common practices, and experiences. In looking at their lives as “wired to freedom,” we hope to promote a wider spectrum of civic participation in the benefit of future life science developments within and beyond the field of Cochlear...

  17. Wiring and lighting

    CERN Document Server

    Kitcher, Chris

    2013-01-01

    Wiring and Lighting provides a comprehensive guide to DIY wiring around the home. It sets out the regulations and legal requirements surrounding electrical installation work, giving clear guidelines that will enable the reader to understand what electrical work they are able to carry out, and what the testing and certification requirements are once the work is completed. Topics covered include: Different types of circuits; Types of cables and cable installation under floors and through joists; Isolating, earthing and bonding; Accessory boxes and fixings; Voltage bands; Detailed advice on safe

  18. Electric wiring domestic

    CERN Document Server

    Coker, A J

    1992-01-01

    Electric Wiring: Domestic, Tenth Edition, is a clear and reliable guide to the practical aspects of domestic electric wiring. Intended for electrical contractors, installation engineers, wiremen and students, its aim is to provide essential up to date information on modern methods and materials in a simple, clear, and concise manner. The main changes in this edition are those necessary to bring the work into line with the 16th Edition of the Regulations for Electrical Installations issued by the Institution of Electrical Engineers. The book begins by introducing the basic features of domestic

  19. Modern wiring practice

    CERN Document Server

    Steward, W E

    2012-01-01

    Continuously in print since 1952, Modern Wiring Practice has now been fully revised to provide an up-to-date source of reference to building services design and installation in the 21st century. This compact and practical guide addresses wiring systems design and electrical installation together in one volume, creating a comprehensive overview of the whole process for contractors and architects, as well as electricians and other installation engineers. Best practice is incorporated throughout, combining theory and practice with clear and accessible explanation, all

  20. Connecting Temporary and Permanent Organizing

    DEFF Research Database (Denmark)

    Stjerne, Iben Sandal; Velikova, Silviya Svejenova

    2016-01-01

    a novel children’s film and its sequels. The study reveals tensions at different levels as well as boundary work and boundary roles that address them, bringing in shadows of past and future projects. The study extends the understanding of the dialectic between temporary and permanent organizing......This paper investigates the relationship between a permanent organization and a series of temporary organizations. It draws on an in-depth study of the process through which a Danish film production company, seeking to balance innovation and persistence in a troubled industry, struggles to realize...

  1. Practical wiring in SI units

    CERN Document Server

    Miller, Henry A

    2013-01-01

    Practical Wiring, Volume 1 is a 13-chapter book that first describes some of the common hand tools used in connection with sheathed wiring. Subsequent chapters discuss the safety in wiring, cables, conductor terminations, insulating sheathed wiring, conductor sizes, and consumer's control equipments. Other chapters center on socket outlets, plugs, lighting subcircuits, lighting accessories, bells, and primary and secondary cells. This book will be very valuable to students involved in this field of interest.

  2. Wire EDM for Refractory Materials

    Science.gov (United States)

    Zellars, G. R.; Harris, F. E.; Lowell, C. E.; Pollman, W. M.; Rys, V. J.; Wills, R. J.

    1982-01-01

    In an attempt to reduce fabrication time and costs, Wire Electrical Discharge Machine (Wire EDM) method was investigated as tool for fabricating matched blade roots and disk slots. Eight high-strength nickel-base superalloys were used. Computer-controlled Wire EDM technique provided high quality surfaces with excellent dimensional tolerances. Wire EDM method offers potential for substantial reductions in fabrication costs for "hard to machine" alloys and electrically conductive materials in specific high-precision applications.

  3. Wire chambers: Trends and alternatives

    International Nuclear Information System (INIS)

    Regler, Meinhard

    1992-01-01

    The subtitle of this year's Vienna Wire Chamber Conference - 'Recent Trends and Alternative Techniques' - signalled that it covered a wide range of science and technology. While an opening Vienna talk by wire chamber pioneer Georges Charpak many years ago began 'Les funerailles des chambres a fils (the burial of wire chambers)', the contrary feeling this year was that wire chambers are very much alive!

  4. Command Wire Sensor Measurements

    Science.gov (United States)

    2012-09-01

    CFAR Constant False Alarm Rate CWIE Command Wire-Improvised Explosive Device EMI Electromagnetic Induction GPR Ground Penetrating Radar...this, some type of constant false alarm rate ( CFAR ) receiver is required. CFAR automatically raises the threshold level to keep clutter echoes and

  5. Transport in quantum wires

    Indian Academy of Sciences (India)

    Transport in quantum wires. SIDDHARTHA LAL, SUMATHI RAO£ and DIPTIMAN SEN. Centre for Theoretical Studies, Indian Institute of Science, Bangalore 560 012, India. £ Harish-chandra Research Institute, Chhatnag Road, Jhusi, Allahabad 211 019, India. Abstract. With a brief introduction to one-dimensional channels ...

  6. Wire chamber conference

    International Nuclear Information System (INIS)

    Bartl, W.; Neuhofer, G.; Regler, M.

    1986-02-01

    This booklet contains program and the abstracts of the papers presented at the conference, most of them dealing with performance testing of various types of wire chambers. The publication of proceedings is planned as a special issue of 'Nuclear instruments and methods' later on. All abstracts are in English. An author index for the book of abstracts is given. (A.N.)

  7. Morbidity of temporary loop ileostomies

    NARCIS (Netherlands)

    Bakx, R.; Busch, O. R. C.; Bemelman, W. A.; Veldink, G. J.; Slors, J. F. M.; van Lanschot, J. J. B.

    2004-01-01

    Background/Aims: A temporary loop ileostomy is constructed to protect a distal colonic anastomosis. Closure is usually performed not earlier than 8 - 12 weeks after the primary operation. During this period, stoma-related complications can occur and enhance the adverse effect on quality of life. The

  8. Subjective consequences of permanent pacemaker therapy in patients under the age of retirement

    DEFF Research Database (Denmark)

    Mickley, H; Petersen, J; Nielsen, B L

    1989-01-01

    During a 5-year period, 81 patients ages 20 to 60 years old had implantation of a permanent cardiac pacemaker at the University Hospital, Odense. At follow-up, during 1985, the 73 survivors received a semi-structured questionnaire regarding subjective consequences of pacemaker therapy, and 72...... people (98.6%) agreed to participate. The mean pacing period (range) was 33.8 (11-72) months. Surgical intervention was required in 14 patients (19.4%) during follow-up. Regarding all symptoms 67 patients (93.1%) perceived benefit from the pacemaker. The effectiveness of cardiac pacing was most...... or a sensation of "impulses"/palpitations. To the majority (49 patients or 68.1%) pacemaker treatment did not influence quality of sexual activity. Six patients (8.3%) perceived an improvement, whereas a corresponding number felt deterioration in sexual activity following pacemaker implantation. Pacemaker...

  9. [Use of a temporal cardiac pacemaker in patients undergoing a major non-cardiac surgery].

    Science.gov (United States)

    Robles González, L; Vázquez Cabrales, A; Chiw Castillo, G; Sánchez Ibarra, J H; Pérez Redondo, H

    1978-01-01

    This is a report of the use of transvenous temporal pacemaker in 18 patients, with an average age of 59.3 years, that under want non cardiac major surgery. They did not have cardiac simptoms but had conduction abnormalities in the preoperative electrocardiogram. A pacemaker was implanted as a prophylaxis against arrythmia during the transoperative and postoperative periods. There was no incidence of transoperative arrythmia. Three patients died in the immediate postoperative period, two due to duffuse carcinomatosis and one due to diabetic acidosis. The average duration of the implanted pacemaker was 12.7 days, and three patients required a permanent pacemaker. Case five is exemplificative of the benefits of the temporal pacemaker, he had a preoperative electrocardiogram showing trifascicular block, he was taken to the operating room and anesthesia was induced, the patient had a cardiac arrest but recovered without secuela; latter on a temporal pacemaker was inserted and the patient had surgery without cardiac problems.

  10. Complex regional pain syndrome type I following pacemaker implantation

    Directory of Open Access Journals (Sweden)

    Sangita Kamath

    2015-12-01

    Full Text Available A 70-year-old woman presented with burning pain and swelling over dorsum of right hand and small joints of the fingers, associated with redness, feeling of warmth, and stiffness of the fingers, with inability to bend the fingers since 2 months. The symptoms were progressively increasing in intensity for the past 1 month. There was no history of fever or trauma to the hand. Two months before her symptoms started, she had permanent pacemaker implanted for complete heart block with syncope. She was hypertensive and was on regular medication. Her X-ray of right hand showed decreased bone density (demineralisation, suggestive of osteopenia. A diagnosis of reflex sympathetic dystrophy syndrome or complex regional pain syndrome type I induced by pacemaker insertion was made. She was treated with amitriptyline and steroids, after which her symptoms improved dramatically.

  11. Ventricular perforation by pacemaker lead repaired with two hemostatic devices.

    Science.gov (United States)

    Prestipino, Filippo; Nenna, Antonio; Casacalenda, Adele; Chello, Massimo

    2014-01-01

    Cardiac perforation is a rare, but potentially serious, complication of pacemaker implantation that may develop days or weeks after implantation. In the current case, 92-year-old man underwent permanent pacemaker implantation, but he presented 3 weeks later with severe symptoms. Computed tomography showed protrusion of the tip of the ventricular electrode through the right ventricle and into the chest wall. During an urgent surgical intervention, the lead was disconnected and extracted. A sealing hemostatic device and an hemostatic patch were applied to repair the ventricle; the procedure was uneventfull. This case demonstrates how the correct diagnosis of ventricular perforation is crucial, and should be followed immediately by surgical planning. The hemostatic patch is a valuable alternative to sutures in patients with thin and fragile ventricular wall, unable to undergo stitching. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. Transient apical dyskinesia with a pacemaker: Electrocardiographic features.

    Science.gov (United States)

    Núñez-Gil, Iván J; Feltes, Gisela I; Mejía-Rentería, Hernán D; Biagioni, Corina; De Agustín, J Alberto; Vivas, David; Fernández-Ortiz, Antonio

    2015-04-01

    Transient apical dyskinesia syndromes present features similar to acute coronary syndromes, but with normal coronary arteries and rapid complete resolution of wall motion alterations. We report the case of a 73-year-old woman who was admitted to hospital because of typical chest pain at rest after her brother's death. She had had a pacemaker implanted in 2001. Troponin levels were elevated and apical hypokinesia was shown by ventriculography and echocardiography, with normal coronary arteries. Evolving ECG alterations were observed in spite of the continued pacing rhythm. All these alterations were fully resolved after discharge. This case shows that, even in the presence of a pacemaker, evolving ECG alterations can be observed in Takotsubo syndrome. Copyright © 2014 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  13. Leadless pacemaker extraction from a single-center perspective.

    Science.gov (United States)

    González Villegas, Elkin; Al Razzo, Omar; Silvestre García, Jorge; Mesa García, José

    2018-02-01

    Leadless pacemaker can be considered as a technical revolution in cardiac pacing devices, with clear advantages over conventional pacemakers in overcoming all lead-related complications. However, the management of these devices once they reach the end of life (EOL) of the battery is still controversial. In the next years, there will be an increase in the need to define a clear strategy in the management of leadless PM once they reach their EOL. Safe extraction of these devices will define in a great manner this strategy METHODS: We performed the extraction of three functioning Nanostim leadless pacemaker prophylactically in two females and one male patients as part of the Nanostim battery depletion field action recommendation. All patients had a prior transesophageal 3D echocardiography to determine the device intracardiac mobility and the extent of possible endothelialization. For the extractions, we used the Nanostim Retrieval Catheter S1RSIN (St. Jude Medical, St. Paul, MN, USA), which is a proprietary catheter provided by the manufacturing company based on a lasso. Complete extraction of the devices was achieved in all patients using a relatively short fluoroscopic time (16, 19, and 12 minutes). The extraction of leadless pacemakers can be considered as a safe and feasible procedure using the tools provided by the manufacturer and designed for the extraction. However, a very low threshold must be maintained to avoid any risk to the patients. Our extraction time ranges are between 983 and 1,070 days, nevertheless it is necessary to gather more long-term data to assess the feasibility and safety of these procedures. © 2017 Wiley Periodicals, Inc.

  14. Plethyzmography in assessment of hemodynamic results of pacemaker functions programming

    Science.gov (United States)

    Wojciechowski, Dariusz; Sionek, Piotr; Peczalski, Kazimierz; Janusek, Dariusz

    2011-01-01

    The paper presents potential role of plethyzmography in optimization of heart hemodynamic function during pacemaker programming. The assessment of optimal stroke volume in patients, with implanted dual chamber pacemaker (DDD), by plethyzmography was a goal of the study. The data were collected during pacing rhythm. 20 patients (8 female and 12 male, average 77.4+/-4.6 years) with dual chamber pacemaker (DDD) and with pacing rhythm during routine pacemaker control and study tests were incorporated in the study group. Hemodynamic parameters were assessed during modification of atrio-ventricular delay (AVD) for pacing rhythm of 70 bpm and 90 bpm. The time of atrioventricular was programmed with 20 ms steps within range 100-200 ms and data were recorded with two minutes delay between two consecutive measurements. Stroke volume (SV) and cardiac output (CO) were calculated from plethyzmographic signal by using Beatscope software (TNO Holand). Highest SV calculated for given pacing rhythm was named optimal stroke volume (OSV) and consequently highest cardiac output was named maximal cardiac output (MCO). The time of atrio-ventricular delay for OSV was named optimal atrioventricular delay (OAVD). The results have showed: mean values of OAVD for 70 bpm - 152+/-33 ms and for 90 bpm -149+/-35 ms, shortening of the mean OAVD time caused by increase of pacing rate from 70 bpm to 90 bpm what resulted in statistically significant decrease of OSV with not statistically significant increase of MCO. The analysis of consecutive patients revealed three types of response to increase of pacing rhythm: 1. typical-shortening of OAVD, 2. neutral-no change of OAVD and 3.atypical-lengthening of OAVD.

  15. Identification and functional characterization of cardiac pacemaker cells in zebrafish.

    Directory of Open Access Journals (Sweden)

    Federico Tessadori

    Full Text Available In the mammalian heart a conduction system of nodes and conducting cells generates and transduces the electrical signals evoking myocardial contractions. Specialized pacemaker cells initiating and controlling cardiac contraction rhythmicity are localized in an anatomically identifiable structure of myocardial origin, the sinus node. We previously showed that in mammalian embryos sinus node cells originate from cardiac progenitors expressing the transcription factors T-box transcription factor 3 (Tbx3 and Islet-1 (Isl1. Although cardiac development and function are strikingly conserved amongst animal classes, in lower vertebrates neither structural nor molecular distinguishable components of a conduction system have been identified, questioning its evolutionary origin. Here we show that zebrafish embryos lacking the LIM/homeodomain-containing transcription factor Isl1 display heart rate defects related to pacemaker dysfunction. Moreover, 3D reconstructions of gene expression patterns in the embryonic and adult zebrafish heart led us to uncover a previously unidentified, Isl1-positive and Tbx2b-positive region in the myocardium at the junction of the sinus venosus and atrium. Through their long interconnecting cellular protrusions the identified Isl1-positive cells form a ring-shaped structure. In vivo labeling of the Isl1-positive cells by transgenic technology allowed their isolation and electrophysiological characterization, revealing their unique pacemaker activity. In conclusion we demonstrate that Isl1-expressing cells, organized as a ring-shaped structure around the venous pole, hold the pacemaker function in the adult zebrafish heart. We have thereby identified an evolutionary conserved, structural and molecular distinguishable component of the cardiac conduction system in a lower vertebrate.

  16. Modeling the dual pacemaker system of the tau mutant hamster.

    Science.gov (United States)

    Oda, G A; Menaker, M; Friesen, W O

    2000-06-01

    Circadian pacemakers in many animals are compound. In rodents, a two-oscillator model of the pacemaker composed of an evening (E) and a morning (M) oscillator has been proposed based on the phenomenon of "splitting" and bimodal activity peaks. The authors describe computer simulations of the pacemaker in tau mutant hamsters viewed as a system of mutually coupled E and M oscillators. These mutant animals exhibit normal type 1 PRCs when released into DD but make a transition to a type 0 PRC when held for many weeks in DD. The two-oscillator model describes particularly well some recent behavioral experiments on these hamsters. The authors sought to determine the relationships between oscillator amplitude, period, PRC, and activity duration through computer simulations. Two complementary approaches proved useful for analyzing weakly coupled oscillator systems. The authors adopted a "distinct oscillators" view when considering the component E and M oscillators and a "system" view when considering the system as a whole. For strongly coupled systems, only the system view is appropriate. The simulations lead the authors to two primary conjectures: (1) the total amplitude of the pacemaker system in tau mutant hamsters is less than in the wild-type animals, and (2) the coupling between the unit E and M oscillators is weakened during continuous exposure of hamsters to DD. As coupling strength decreases, activity duration (alpha) increases due to a greater phase difference between E and M. At the same time, the total amplitude of the system decreases, causing an increase in observable PRC amplitudes. Reduced coupling also increases the relative autonomy of the unit oscillators. The relatively autonomous phase shifts of E and M oscillators can account for both immediate compression and expansion of activity bands in tau mutant and wild-type hamsters subjected to light pulses.

  17. Brain magnetic resonance imaging examination in a patient with non-magnetic resonance conditional pacemaker

    Directory of Open Access Journals (Sweden)

    Toshiko Nakai, MD

    2017-10-01

    Full Text Available Clinical dilemmas arise when patients with a non-magnetic resonance (MR conditional pacemaker are required to undergo magnetic resonance imaging (MRI. We encountered a pacemaker patient with debilitating non-motor symptoms of Parkinson׳s disease, who required an MRI prior to deep brain stimulation (DBS surgery. MRI was performed safely without adverse events despite the presence of a conventional pacemaker.

  18. Dental Arch Wire

    Science.gov (United States)

    1979-01-01

    Straightening teeth is an arduous process requiring months, often years, of applying corrective pressure by means of arch wires-better known as brace-which may have to be changed several times in the course of treatment. A new method has been developed by Dr. George Andreasen, orthodontist and dental scientist at the University of Iowa. The key is a new type of arch wire material, called Nitinol, with exceptional elasticity which helps reduce the required number of brace changes. An alloy of nickel and titanium, Nitinol was originally developed for aerospace applications by the Naval Ordnance Laboratory, now the Naval Surface Weapons Laboratory, White Oaks, Maryland. NASA subsequently conducted additional research on the properties of Nitinol and on procedures for processing the metal.

  19. Physiological effects of light on the human circadian pacemaker

    Science.gov (United States)

    Shanahan, T. L.; Czeisler, C. A.

    2000-01-01

    The physiology of the human circadian pacemaker and its influence and on the daily organization of sleep, endocrine and behavioral processes is an emerging interest in science and medicine. Understanding the development, organization and fundamental properties underlying the circadian timing system may provide insight for the application of circadian principles to the practice of clinical medicine, both diagnostically (interpretation of certain clinical tests are dependent on time of day) and therapeutically (certain pharmacological responses vary with the time of day). The light-dark cycle is the most powerful external influence acting upon the human circadian pacemaker. It has been shown that timed exposure to light can both synchronize and reset the phase of the circadian pacemaker in a predictable manner. The emergence of detectable circadian rhythmicity in the neonatal period is under investigation (as described elsewhere in this issue). Therefore, the pattern of light exposure provided in the neonatal intensive care setting has implications. One recent study identified differences in both amount of sleep time and weight gain in infants maintained in a neonatal intensive care environment that controlled the light-dark cycle. Unfortunately, neither circadian phase nor the time of day has been considered in most clinical investigations. Further studies with knowledge of principles characterizing the human circadian timing system, which governs a wide array of physiological processes, are required to integrate these findings with the practice of clinical medicine.

  20. Percutaneous Extraction of Transvenous Permanent Pacemaker/Defibrillator Leads

    Directory of Open Access Journals (Sweden)

    Stylianos Paraskevaidis

    2014-01-01

    Full Text Available Background. Widespread use of cardiovascular implantable electronic devices has inevitably increased the need for lead revision/replacement. We report our experience in percutaneous extraction of transvenous permanent pacemaker/defibrillator leads. Methods. Thirty-six patients admitted to our centre from September 2005 through October 2012 for percutaneous lead extraction were included. Lead removal was attempted using Spectranetics traction-type system (Spectranetics Corp., Colorado, CO, USA and VascoExtor countertraction-type system (Vascomed GmbH, Weil am Rhein, Germany. Results. Lead extraction was attempted in 59 leads from 36 patients (27 men, mean ± SD age 61±5 years, with permanent pacemaker (n=25, defibrillator (n=8, or cardiac resynchronisation therapy (n=3 with a mean ± SD implant duration of 50±23 months. The indications for lead removal included pocket infection (n=23, endocarditis (n=2, and ventricular (n=10 and atrial lead dysfunction (n=1. Traction device was used for 33 leads and countertraction device for 26 leads. Mean ± SD fluoroscopy time was 4±2 minutes/lead for leads implanted 48 months (n=21, P=0.03. Complete procedural success rate was 91.7% and clinical procedural success rate was 100%, while lead procedural success rate was 95%. Conclusions. In conclusion, percutaneous extraction of transvenous permanent pacemaker/defibrillator leads using dedicated removal tools is both feasible and safe.

  1. A Systematic Review of Economic Evaluations of Pacemaker Telemonitoring Systems.

    Science.gov (United States)

    López-Villegas, Antonio; Catalán-Matamoros, Daniel; Martín-Saborido, Carlos; Villegas-Tripiana, Irene; Robles-Musso, Emilio

    2016-02-01

    Over the last decade, telemedicine applied to pacemaker monitoring has undergone extraordinary growth. It is not known if telemonitoring is more or less efficient than conventional monitoring. The aim of this study was to carry out a systematic review analyzing the available evidence on resource use and health outcomes in both follow-up modalities. We searched 11 databases and included studies published up until November 2014. The inclusion criteria were: a) experimental or observational design; b) studies based on complete economic evaluations; c) patients with pacemakers, and d) telemonitoring compared with conventional hospital monitoring. Seven studies met the inclusion criteria, providing information on 2852 patients, with a mean age of 81 years. The main indication for device implantation was atrioventricular block. With telemonitoring, cardiovascular events were detected and treated 2 months earlier than with conventional monitoring, thus reducing length of hospital stay by 34% and reducing routine and emergency hospital visits as well. There were no significant intergroup differences in perceived quality of life or number of adverse events. The cost of telemonitoring was 60% lower than that of conventional hospital monitoring. Compared with conventional monitoring, cardiovascular events were detected earlier and the number or hospitalizations and hospital visits was reduced with pacemaker telemonitoring. In addition, the costs associated with follow-up were lower with telemonitoring. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  2. Wire chamber gases

    International Nuclear Information System (INIS)

    Va'vra, J.

    1992-04-01

    In this paper, we describe new developments in gas mixtures which have occurred during the last 3--4 years. In particular, we discuss new results on the measurement and modeling of electron drift parameters, the modeling of drift chamber resolution, measurements of primary ionization and the choice of gas for applications such as tracking, single electron detection, X-ray detection and visual imaging. In addition, new results are presented on photon feedback, breakdown and wire aging

  3. Vienna Wire Chamber Conference

    International Nuclear Information System (INIS)

    Anon.

    1983-01-01

    After those of 1978 and 1980, a third Wire Chamber Conference was held from 15-18 February in the Technical University of Vienna. Eight invited speakers covered the field from sophisticated applications in biology and medicine, via software, to the state of the art of gaseous detectors. In some forty other talks the speakers tackled in more detail the topics of gaseous detectors, calorimetry and associated electronics and software

  4. Pacemaker lead perforation of the right ventricle associated with Moraxella phenylpyruvica infection in a dog.

    Science.gov (United States)

    Ciavarella, A; Nimmo, J; Hambrook, L

    2016-04-01

    A 13-year-old neutered male Border Collie was presented with acute onset syncope, weakness and anorexia 10 months after transvenous pacemaker implantation. The patient was laterally recumbent, bradycardic (36 beats/min) and febrile (40.7°C) on presentation. An electrocardiogram (ECG) revealed recurrence of third-degree atrioventricular block with a ventricular escape rhythm. Fluoroscopy identified migration of the pacemaker tip through the apex of the right ventricle. Echocardiography failed to reveal any evidence of pericardial effusion or cardiac tamponade. Full postmortem was performed after euthanasia. The pacemaker lead had perforated the apex of the right ventricle and lodged in the right pleural space. Culture of blood (taken antemortem), pericardial sac, right ventricular wall (surrounding pacemaker lead), pacemaker lead tip and pericardial fluid revealed a pure growth of Moraxella phenylpyruvica. Bacteraemia associated with M. phenylpyruvica has never been reported in the dog, but sporadic cases are reported in humans. Infection could have resulted from either pre-existing myocarditis or opportunistic infection and bacteraemia post pacemaker implantation. Evaluation of the pacemaker function at regular intervals would allow early detection of poor pacemaker-to-myocardium contact, which would prompt further investigation of pacemaker lead abnormalities such as perforation. © 2016 Australian Veterinary Association.

  5. Interference of cardiac pacemaker and implantable cardioverter-defibrillator activity during electronic dental device use.

    Science.gov (United States)

    Roedig, Jason J; Shah, Jignesh; Elayi, Claude Samy; Miller, Craig S

    2010-05-01

    The authors conducted a study to determine if electromagnetic interference of cardiac pacemaker and implantable cardioverter-defibrillator (ICD) activity occurs during the operation of electronic dental devices. The authors tested nine electronic dental devices in vitro to assess their ability to interfere with the function of two pacemakers and two ICDs as determined by electrocardiographic telemetry. The pacing activity of both pacemakers and the dual-chamber ICD were inhibited during operation of the battery-operated composite curing light at between 2 and 10 centimeters from the generator or leads. The use of the ultrasonic scaler interfered with the pacing activity of the dual-chamber pacemaker at between 17 and 23 cm from the generator or leads, the single-chamber pacemaker at 15 cm from the generator or leads and both ICDs at 7 cm from the leads. The operation of the ultrasonic cleaning system interfered with the activity of the dual-chamber pacemaker at between 15 and 23 cm from the generator or leads, and of the single-chamber pacemaker at 12 cm. Operation of the electric toothbrush, electrosurgical unit, electric pulp tester, high- and low-speed handpieces, and an amalgamator did not alter pacing function. Select electronic dental devices interfere with pacemakers' and ICDs' sensing and pacing activity in vitro. Use of the ultrasonic scaler, ultrasonic cleaning system and battery-operated composite curing light may produce deleterious effects in patients who have pacemakers or ICDs.

  6. Successful Interventional Management for Pulmonary Arterial Injury Secondary to Pacemaker Implantation

    Directory of Open Access Journals (Sweden)

    Hiroyuki Tokue

    2016-01-01

    Full Text Available Subclavian vein puncture is a relatively fast and safe technique to access the right heart for placement of pacemaker leads. Hemothorax related to injury of the pulmonary artery (PA is a rare complication of subclavian vein access but can be life-threatening. We report a case of hemothorax occurring after subclavian vein puncture for pacemaker implantation. No cases of transcatheter arterial embolization for PA injury secondary to pacemaker implantation have been reported. Understanding of this rare complication after pacemaker implantation along with its specific clinical presentation may lead to early diagnosis and intervention.

  7. Multiple photoreceptor systems control the swim pacemaker activity in box jellyfish

    DEFF Research Database (Denmark)

    Garm, Anders Lydik; Mori, S.

    2009-01-01

    Like all other cnidarian medusae, box jellyfish propel themselves through the water by contracting their bell-shaped body in discrete swim pulses. These pulses are controlled by a swim pacemaker system situated in their sensory structures, the rhopalia. Each medusa has four rhopalia each...... with a similar set of six eyes of four morphologically different types. We have examined how each of the four eye types influences the swim pacemaker. Multiple photoreceptor systems, three of the four eye types, plus the rhopalial neuropil, affect the swim pacemaker. The lower lens eye inhibits the pacemaker...

  8. Dual wire welding torch and method

    Science.gov (United States)

    Diez, Fernando Martinez; Stump, Kevin S.; Ludewig, Howard W.; Kilty, Alan L.; Robinson, Matthew M.; Egland, Keith M.

    2009-04-28

    A welding torch includes a nozzle with a first welding wire guide configured to orient a first welding wire in a first welding wire orientation, and a second welding wire guide configured to orient a second welding wire in a second welding wire orientation that is non-coplanar and divergent with respect to the first welding wire orientation. A method of welding includes moving a welding torch with respect to a workpiece joint to be welded. During moving the welding torch, a first welding wire is fed through a first welding wire guide defining a first welding wire orientation and a second welding wire is fed through a second welding wire guide defining a second welding wire orientation that is divergent and non-coplanar with respect to the first welding wire orientation.

  9. Temporary Residences: a becoming project

    Directory of Open Access Journals (Sweden)

    Luisa Ingaramo

    2012-04-01

    Full Text Available Among the experimental actions fostered so far by the Compagnia di San Paolo through its Housing Program, committed in handling the complex and fragmented housing discomfort issue, the Temporary Dwellings initiative represents a unique and innovative experience, as it actually offers the chance to activate a proper managerial direction around and about the real estate development processes. In particular, the Temporary Dwellings action is marked by two key aspects: a structured co-planning vision and projects selected through a requests for proposal system. The process in the whole aims on the one hand at reaching an high transparent level of decision making , while, on the other hand, at developing a continuous and mutual monitoring and matching activity between the Housing Program and the group of cross-curricular experts teamed up in the project: technicians, designers, managers, psychologists, contractors, and the other local stakeholders.

  10. Metering Wheel-Wire Track Wire Boom Deployment Mechanism

    Science.gov (United States)

    Granoff, Mark S.

    2014-01-01

    The NASA MMS Spin Plane Double Probe (SDP) Deployer utilizes a helical path, rotating Metering Wheel and a spring loaded Wire "Holding" Track to pay out a "fixed end" 57 meter x 1.5 mm diameter Wire Boom stored between concentric storage cylinders. Unlike rotating spool type storage devices, the storage cylinders remain stationary, and the boom wire is uncoiled along the length of the cylinder via the rotation of the Metering Wheel. This uncoiling action avoids the need for slip-ring contacts since the ends of the wire can remain stationary. Conventional fixed electrical connectors (Micro-D type) are used to terminate to operational electronics.

  11. Temporary air-raid shelters

    International Nuclear Information System (INIS)

    Jokela, J.; Olin, J.; Koukkari, H.

    1983-05-01

    This report deals with materials and structures of temporary air-raid shelters. At first, the weapon effects against which the temporary shelters can protect are described. These are, primarily, the fragmentation and blast pressure caused by conventional weapons and those effects of the nuclear weapons which exist outside the total disaster and fire areas. Temporary shelters built into existing buildings can give protection either from radioactive fallout or from fallout and collapse of the building above. For fallout protection heavy materials are needed, which simultaneously protect from fragmentation. In the research report, the methods and materials used for the contruction of a fallout shelter into an apartment house and a small house are introduced. The collapse loads acting on a basement ceiling and the design of additional timber supports are also presented. The use of various materials in the construction of shelters outside the buildings are introduced. Separate shelters can be built either under the ground or on the ground. The same materials can be used in both cases, but the underground shelters have a better level of protection. (author)

  12. Connectivity of Pacemaker Neurons in the Neonatal Rat Superficial Dorsal Horn

    Science.gov (United States)

    Ford, Neil C.; Arbabi, Shahriar; Baccei, Mark L.

    2014-01-01

    Pacemaker neurons with an intrinsic ability to generate rhythmic burst-firing have been characterized in lamina I of the neonatal spinal cord, where they are innervated by high-threshold sensory afferents. However, little is known about the output of these pacemakers, as the neuronal populations which are targeted by pacemaker axons have yet to be identified. The present study combines patch clamp recordings in the intact neonatal rat spinal cord with tract-tracing to demonstrate that lamina I pacemaker neurons contact multiple spinal motor pathways during early life. Retrograde labeling of premotor interneurons with the trans-synaptic virus PRV-152 revealed the presence of burst-firing in PRV-infected lamina I neurons, thereby confirming that pacemakers are synaptically coupled to motor networks in the spinal ventral horn. Notably, two classes of pacemakers could be distinguished in lamina I based on cell size and the pattern of their axonal projections. While small pacemaker neurons possessed ramified axons which contacted ipsilateral motor circuits, large pacemaker neurons had unbranched axons which crossed the midline and ascended rostrally in the contralateral white matter. Recordings from identified spino-parabrachial and spino-PAG neurons indicated the presence of pacemaker activity within neonatal lamina I projection neurons. Overall, these results show that lamina I pacemakers are positioned to regulate both the level of activity in developing motor circuits as well as the ascending flow of nociceptive information to the brain, thus highlighting a potential role for pacemaker activity in the maturation of pain and sensorimotor networks in the CNS. PMID:25380417

  13. Wire communication engineering

    International Nuclear Information System (INIS)

    Son, Byeong Tae

    1997-02-01

    This book describes wire telecommunication engineering/ It is divided into eleven chapter, which deal with Introduction with development of telecommunication, voice and sound wave and communication network, Telegraphy with summary of telegraphy, code of telegraphy, communication speed, morse and telex, Telephone on structure, circuit and image telephone, Traffic on telecommunication traffic, transmission of line about theory, cable line and loaded cable, carrier communication with carrier telegraphy and carrier telephone, optical communication with types, structure, specialty, laser and equipment, DATA, Mobile telecommunication on summary, mobile telephone, radio paging and digital mobile telecommunication, ISDN with channel of ISDN, and service of ISDN, and design of telecommunication.

  14. Wiring regulations in brief

    CERN Document Server

    Tricker, Ray

    2012-01-01

    Tired of trawling through the Wiring Regs?Perplexed by Part P?Confused by cables, conductors and circuits?Then look no further! This handy guide provides an on-the-job reference source for Electricians, Designers, Service Engineers, Inspectors, Builders, Students, DIY enthusiastsTopic-based chapters link areas of working practice - such as cables, installations, testing and inspection, special locations - with the specifics of the Regulations themselves. This allows quick and easy identification of the official requirements relating to the situati

  15. The Micro Wire Detector

    Energy Technology Data Exchange (ETDEWEB)

    Adeva, B.; Gomez, F.; Pazos, A.; Pfau, R.; Plo, M. E-mail: maximo.plo@cern.ch; Rodriguez, J.M.; Vazquez, P.; Labbe, J.C

    1999-10-11

    We present the performance of a new proportional gas detector. Its geometry consists of a cathode plane with 70x70 {mu}m{sup 2} apertures, crossed by 25 {mu}m anode strips to which it is attached by 50 {mu}m kapton spacers. In the region where the avalanche takes place, the anode strips are suspended in the gas mixture as in a standard wire chamber. This detector exhibits high rate capability and large gains, introducing very little material. (author)

  16. Epitaxial semiconductor quantum wires.

    Science.gov (United States)

    Wu, J; Chen, Y H; Wang, Z G

    2008-07-01

    The investigation on the direct epitaxial quantum wires (QWR) using MBE or MOCVD has been persuited for more than two decades, more lengthy in history as compared with its quantum dot counterpart. Up to now, QWRs with various structural configurations have been produced with different growth methods. This is a reviewing article consisting mainly of two parts. The first part discusses QWRs of various configurations, together with laser devices based on them, in terms of the two growth mechanisms, self-ordering and self-assembling. The second part gives a brief review of the electrical and optical properties of QWRs.

  17. 46 CFR 111.60-11 - Wire.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Wire. 111.60-11 Section 111.60-11 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Wiring Materials and Methods § 111.60-11 Wire. (a) Wire must be in an enclosure. (b) Wire must be...

  18. Interference of apex locator, pulp tester and diathermy on pacemaker function.

    Science.gov (United States)

    Sriman, Narayanan; Prabhakar, V; Bhuvaneswaran, J S; Subha, N

    2015-01-01

    The purpose of this study was to evaluate the effects of three electronic apex locators (EAL), electric pulp tester (EPT) and diathermy on pacemaker function in vitro. Three EALs: Root ZX (J. Morita Co., Tustin, CA, U.S.A.), Propex (Dentsply), Mini Apex locator (SybronEndo, Anaheim, CA, USA), EPT (Parkell pulp vitality tester Farmingdale, NY, USA) and Diathermy (Neomed 250 B) were tested for any interference with one pacemaker (A medtronic kappa KVDD901-serial number: PLE734632S). Directly connecting the pacemaker lead with the EAL/EPT/diathermy operating on a flat bench top, the telemetry wand was held directly over the pacemaker to monitor the pacing pattern for a period of 30 s. Pacemaker activity was continuously recorded on the telemetric programmer and electro gram (EGM) readings examined for pacer inhibition, noise reversion or inappropriate pacemaker pulses. All the three apex locators showed no pacing interference or background noise during its function or at rest. The EGM readings of EPT showed varying levels of background noise in between pacing however, this did not affect the normal pacing pattern and the pacing interval remained constant. EGM readings of diathermy showed an increase in the pacing interval (irregular pacing pattern) followed by complete inhibition of the pacing system. The tested EALs do not interfere with cardiac pacemaker function. The tested EPT showed varying levels of background noise but does not interfere with cardiac pacemaker function. Use of Diathermy interfered with the normal pacing, leading to complete inhibition of the pacing system.

  19. Sinus venosus atrial septal defect: a rare cause of misplacement of pacemaker leads

    Directory of Open Access Journals (Sweden)

    Bodian M

    2013-07-01

    Full Text Available Malick Bodian,1 Fatou Aw,1 Mouhamadou Bamba Ndiaye,1 Adama Kane,1 Modou Jobe,1 Alioune Tabane,1 Alassane Mbaye,2 Simon Antoine Sarr,1 Maboury Diao,1 Moustapha Sarr,1 Serigne Abdou Bâ1 1Department of Cardiology, Aristide Le Dantec Teaching Hospital, 2Grand Yoff General Hospital, Dakar, Senegal Abstract: Routine implantation of pacemakers and implantable cardioverter defibrillators is not commonly associated with complications. However, in some cases we see misplacement of pacemaker leads which is most often related to the presence of underlying cardiac anomalies. We report the case of misplacement of a pacemaker lead into the left ventricle of a 56-year-old patient paced in VVI/R mode and with a tined type pacemaker lead because of a symptomatic complete atrioventricular block. Electrocardiogram showed a pacemaker-generated rhythm with a right bundle branch block pattern. Chest X-ray showed the pacemaker lead located relatively high in relation to the diaphragm. Echocardiography visualized the pacemaker lead in the left heart chambers (atrium and ventricle, hence confirming its aberrant course. Further, the defect causing its passage to the left heart chambers was a sinus venosus atrial septal defect. The patient reported no complication related to the misplacement of the lead. After a brief period of oral anticoagulation, the lead was inserted into the right ventricle by percutaneous technique. Keywords: pacemaker, lead misplacement, sinus venosus atrial septal defect

  20. Pacemaker and radiotherapy in breast cancer: is targeted intraoperative radiotherapy the answer in this setting?

    International Nuclear Information System (INIS)

    Keshtgar, Mohammed RS; Eaton, David J; Reynolds, Claire; Pigott, Katharine; Davidson, Tim; Gauter-Fleckenstein, Benjamin; Wenz, Frederik

    2012-01-01

    We present the case of an 83 year old woman with a cardiac pacemaker located close in distance to a subsequently diagnosed invasive ductal carcinoma of the left breast. Short range intraoperative radiotherapy was given following wide local excision and sentinel node biopsy. The challenges of using ionising radiation with pacemakers is also discussed

  1. Dizzy Spells in a Patient with Hypertrophic Obstructive Cardiomyopathy and a Pacemaker

    OpenAIRE

    Wilschut, J. M.; de Voogt, W. G.

    2010-01-01

    Pacemaker syndrome represents the clinical consequences of the haemodynamic adverse effects of atrioventricular asynchrony during pacing. Patients suffering from hypertrophic cardiomyopathy may be particularly sensitive to these effects because of the importance of atrial systolic contribution to left ventricular diastolic filling. In this case report, we describe the symptoms and cause of pacemaker syndrome in a patient with hypertrophic obstructive cardiomyopathy.

  2. Subacute Right Ventricle Perforation by Pacemaker Lead Presenting with Left Hemothorax and Shock

    Directory of Open Access Journals (Sweden)

    Julianne Nichols

    2015-01-01

    Full Text Available Cardiac perforation by pacemaker is a rare but potentially fatal complication. Acute perforations occurring within twenty-four hours of insertion of pacemaker can lead to hemopericardium, cardiac tamponade, and death. Hemothorax occurring as an acute complication of pacemaker insertion is reported but extremely rare. Previously, hemothorax and shock as a subacute complication following pacemaker insertion have not been reported. We report the case of an 85-year-old patient who presented with shock from hemothorax caused by pacemaker perforation, two weeks after insertion. Device interrogation showed normal function. Chest X-ray and echocardiogram missed lead dislocation and the diagnosis was made on computed tomogram (CT of the chest. Following surgical repair, a new ventricular pacemaker was placed transvenously in the right ventricular septum. This case illustrates that CT scan of the chest should be performed in all patients in whom cardiac perforation by pacemaker is suspected but not diagnosed on chest X-ray and echocardiogram. Normal functioning of pacemaker on device interrogation does not exclude perforation.

  3. Subacute right ventricle perforation by pacemaker lead presenting with left hemothorax and shock.

    Science.gov (United States)

    Nichols, Julianne; Berger, Natalie; Joseph, Praveen; Datta, Debapriya

    2015-01-01

    Cardiac perforation by pacemaker is a rare but potentially fatal complication. Acute perforations occurring within twenty-four hours of insertion of pacemaker can lead to hemopericardium, cardiac tamponade, and death. Hemothorax occurring as an acute complication of pacemaker insertion is reported but extremely rare. Previously, hemothorax and shock as a subacute complication following pacemaker insertion have not been reported. We report the case of an 85-year-old patient who presented with shock from hemothorax caused by pacemaker perforation, two weeks after insertion. Device interrogation showed normal function. Chest X-ray and echocardiogram missed lead dislocation and the diagnosis was made on computed tomogram (CT) of the chest. Following surgical repair, a new ventricular pacemaker was placed transvenously in the right ventricular septum. This case illustrates that CT scan of the chest should be performed in all patients in whom cardiac perforation by pacemaker is suspected but not diagnosed on chest X-ray and echocardiogram. Normal functioning of pacemaker on device interrogation does not exclude perforation.

  4. Zebrafish heart as a model to study the integrative autonomic control of pacemaker function

    Science.gov (United States)

    Stoyek, Matthew R.; Quinn, T. Alexander; Croll, Roger P.

    2016-01-01

    The cardiac pacemaker sets the heart's primary rate, with pacemaker discharge controlled by the autonomic nervous system through intracardiac ganglia. A fundamental issue in understanding the relationship between neural activity and cardiac chronotropy is the identification of neuronal populations that control pacemaker cells. To date, most studies of neurocardiac control have been done in mammalian species, where neurons are embedded in and distributed throughout the heart, so they are largely inaccessible for whole-organ, integrative studies. Here, we establish the isolated, innervated zebrafish heart as a novel alternative model for studies of autonomic control of heart rate. Stimulation of individual cardiac vagosympathetic nerve trunks evoked bradycardia (parasympathetic activation) and tachycardia (sympathetic activation). Simultaneous stimulation of both vagosympathetic nerve trunks evoked a summative effect. Effects of nerve stimulation were mimicked by direct application of cholinergic and adrenergic agents. Optical mapping of electrical activity confirmed the sinoatrial region as the site of origin of normal pacemaker activity and identified a secondary pacemaker in the atrioventricular region. Strong vagosympathetic nerve stimulation resulted in a shift in the origin of initial excitation from the sinoatrial pacemaker to the atrioventricular pacemaker. Putative pacemaker cells in the sinoatrial and atrioventricular regions expressed adrenergic β2 and cholinergic muscarinic type 2 receptors. Collectively, we have demonstrated that the zebrafish heart contains the accepted hallmarks of vertebrate cardiac control, establishing this preparation as a viable model for studies of integrative physiological control of cardiac function by intracardiac neurons. PMID:27342878

  5. Iatrogenic perforation of the posterior mitral valve leaflet: a rare complication of pacemaker lead placement

    NARCIS (Netherlands)

    Konings, Thelma C.; Koolbergen, Dave R.; Bouma, Berto J.; Groenink, Maarten; Mulder, Barbara J.

    2008-01-01

    An inadvertently placed pacing lead in the left ventricle (LV) is a rare and often underdiagnosed complication of pacemaker implantation. We present a case of a 73-year-old woman who was evaluated for dyspnea, 10 years after transvenous pacemaker implantation. Transthoracic and transesophageal

  6. Twiddler-syndrom er en årsag til pacemaker elektrode displacering

    DEFF Research Database (Denmark)

    Grønbech, Keea Treu; Hansen, Michael Gilså

    2013-01-01

    Twiddler's syndrome is a rare cause of pacemaker electrode displacement. The displacement is caused by the patient's manipulation with the pacemaker, so the electrode is retracted. We describe a case of a 79-year-old overweight woman with a known psychiatric anamnesis, who was admitted twice...

  7. A forced desynchrony study of circadian pacemaker characteristics in seasonal affective disorder

    NARCIS (Netherlands)

    Koorengevel, Kathelijne M.; Beersma, Domien G.M.; den Boer, Johan; Hoofdakker, Rutger H. van den

    2002-01-01

    The circadian pacemaker is an endogenous clock that regulates oscillations in most physiological and psychological processes with a near 24-h period. In many species, this pacemaker triggers seasonal changes in behavior. The seasonality of symptoms and the efficacy of light therapy suggest

  8. Noise-induced effects on multicellular biopacemaker spontaneous activity: Differences between weak and strong pacemaker cells

    Science.gov (United States)

    Aghighi, Alireza; Comtois, Philippe

    2017-09-01

    Self-organization of spontaneous activity of a network of active elements is important to the general theory of reaction-diffusion systems as well as for pacemaking activity to initiate beating of the heart. Monolayer cultures of neonatal rat ventricular myocytes, consisting of resting and pacemaker cells, exhibit spontaneous activation of their electrical activity. Similarly, one proposed approach to the development of biopacemakers as an alternative to electronic pacemakers for cardiac therapy is based on heterogeneous cardiac cells with resting and spontaneously beating phenotypes. However, the combined effect of pacemaker characteristics, density, and spatial distribution of the pacemaker cells on spontaneous activity is unknown. Using a simple stochastic pattern formation algorithm, we previously showed a clear nonlinear dependency of spontaneous activity (occurrence and amplitude of spontaneous period) on the spatial patterns of pacemaker cells. In this study, we show that this behavior is dependent on the pacemaker cell characteristics, with weaker pacemaker cells requiring higher density and larger clusters to sustain multicellular activity. These multicellular structures also demonstrated an increased sensitivity to voltage noise that favored spontaneous activity at lower density while increasing temporal variation in the period of activity. This information will help researchers overcome the current limitations of biopacemakers.

  9. Corrosion of Wires on Wooden Wire-Bound Packaging Crates

    Science.gov (United States)

    Samuel L. Zelinka; Stan Lebow

    2015-01-01

    Wire-bound packaging crates are used by the US Army to transport materials. Because these crates may be exposed to harsh environments, they are dip-treated with a wood preservative (biocide treatment). For many years, zinc-naphthenate was the most commonly used preservative for these packaging crates and few corrosion problems with the wires were observed. Recently,...

  10. Improved superconducting magnet wire

    Science.gov (United States)

    Schuller, I.K.; Ketterson, J.B.

    1983-08-16

    This invention is directed to a superconducting tape or wire composed of alternating layers of copper and a niobium-containing superconductor such as niobium of NbTi, Nb/sub 3/Sn or Nb/sub 3/Ge. In general, each layer of the niobium-containing superconductor has a thickness in the range of about 0.05 to 1.5 times its coherence length (which for Nb/sub 3/Si is 41 A) with each copper layer having a thickness in the range of about 170 to 600 A. With the use of very thin layers of the niobium composition having a thickness within the desired range, the critical field (H/sub c/) may be increased by factors of 2 to 4. Also, the thin layers of the superconductor permit the resulting tape or wire to exhibit suitable ductility for winding on a magnet core. These compositions are also characterized by relatively high values of critical temperature and therefore will exhibit a combination of useful properties as superconductors.

  11. Stroke rehabilitation therapy in a patient with a cardiac pacemaker for chronic atrial fibrillation.

    Science.gov (United States)

    Muramatsu, Hikaru; Koike, Kimiko

    2003-12-01

    A 65-year-old man was implanted with an artificial pacemaker for chronic bradycardic atrial fibrillation associated with hypertensive heart disease. Five years after the pacemaker implantation, he suffered from a cerebral embolism. Approximately 4.5 months after the ictus, he was transferred to the rehabilitation ward. He had flaccid left hemiplegia and severe disuse syndrome. He could not sit and could tilt his head up for only two minutes because of severe orthostatic hypotension. By modulating the rate-responsive mode of the pacemaker every 2-4 weeks, we were able to rehabilitate the patient. Thus, the patient could sit in a wheelchair for more than three hours. This case emphasizes the importance of examining the mode and function of a previously implanted artificial pacemaker. In accord with varying rehabilitation programs and gradual improvement in a patient's physical activities, periodic modulation of a programmable pacemaker can lead to a better functional outcome during rehabilitation therapy.

  12. Virtual planning for vertical control using temporary anchorage devices

    Directory of Open Access Journals (Sweden)

    Mauricio Accorsi

    2015-01-01

    Full Text Available The new and innovative technologies are unprecedentedly improving the level of proficiency in orthodontics in the recent history of this area of expertise. The proliferation of advances, such as self-ligating systems, temporary anchorage devices, shape-memory wires, robotically wire bending, intraoral scanners, cone-beam computed tomography, bring the virtual planning, and confection of dental devices through CAD/CAM systems to the real world. In order to get efficiency and efficacy in orthodontics with these new technologies, we must understand the importance of systemically managed clinical information, medical, and dentistry history of the patients, including the images resources, which ensures the use of a communication that is assisted by the technology, with an interdisciplinary team so that the database is able to help and support the process of therapeutic decision-making. This paper presents the clinical case of a borderline patient for orthognathic surgery who had his final treatment planning supported by these new tools for three-dimensional diagnosis and virtual planning.

  13. A leadless pacemaker in the real-world setting

    DEFF Research Database (Denmark)

    Roberts, Paul R.; Clementy, Nicolas; Al Samadi, Faisal

    2017-01-01

    -approval setting. The safety end point was system- or procedure-related major complications at 30 days post implant. We compared the major complication rate with that of the 726 patients from the investigational study. Electrical performance was also characterized. Results The device was successfully implanted...... were low and stable. Conclusion Performance of the Micra transcatheter pacemaker in a real-world setting demonstrates a high rate (99.6%) of implant success and low rate (1.51%) of major complications through 30 days post implant. In particular, the rates of pericardial effusion, device dislodgement...

  14. Transcending Organization in Temporary Systems

    DEFF Research Database (Denmark)

    Stjerne, Iben Sandal

    are organized by transcending organization that go beyond the individual firm and replaces what used to be organized inside the firm. Following several calls for further research on these topics, this dissertation is a small step along the way as it investigates how work and employment are organized...... in temporary systems that lack stability and formal order. It advances our understanding of transcending organization in creative industries by adopting a practice based perspective. Empirically, the dissertation presents an in-depth study of the Danish film industry, which is an extreme case of a project...

  15. Complications of pacemaker therapy in adults with congenital heart disease: a multicenter study.

    Science.gov (United States)

    Opić, Petra; van Kranenburg, Matthijs; Yap, Sing-Chien; van Dijk, Arie P; Budts, Werner; Vliegen, Hubert W; van Erven, Lieselot; Can, Anil; Sahin, Gulhan; Theuns, Dominic A M J; Witsenburg, Maarten; Roos-Hesselink, Jolien W

    2013-10-09

    This study aims to investigate indications and complications of permanent cardiac pacing in adults with congenital heart disease (CHD). Two-hundred and seventy-four CHD patients were identified who underwent permanent pacemaker implantation between 1972 and 2009. The indication for pacing was acquired sinus node or AV node conduction disease (63%), sinus node or AV node conduction disease after cardiac surgery (28%), and drug/arrhythmia-related indications (9%). Patients with complex CHD received a pacemaker at younger age (23 versus 31 years, ppacemaker implantation (general population: 5.2%). The most common acute complications were lead dysfunction (4.0%), bleeding (2.6%), pocket infection (1.5%) and pneumothorax (1.5%). During a median follow-up of 12 years, pacemaker-related complications requiring intervention occurred in 95 patients (34.6%). The most common late pacemaker-related complications included lead failure (24.8%), pacemaker dysfunction/early battery depletion (5.1%), pacemaker migration (4.7%) and erosion (4.7%). Pacemaker implantation at younger age (pacemaker-related complication (adjusted hazard ratio 1.68, 95% confidence interval 1.07 to 2.63, p=0.023). The risk of periprocedural complications seems higher in the CHD population compared to the general population and more than one-third of CHD patients encountered a pacemaker-related complication during long-term follow-up. This risk increases for those who receive a pacemaker at younger age. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

  16. Wire and Packing Tape Sandwiches

    Science.gov (United States)

    Rabinowitz, Sandy

    2009-01-01

    In this article, the author describes how students can combine craft wire with clear packing tape to create a two-dimensional design that can be bent and twisted to create a three-dimensional form. Students sandwich wire designs between two layers of tape. (Contains 1 online resource.)

  17. Traction test of temporary dental cements

    OpenAIRE

    Román Rodríguez, Juan Luis; Millan Martínez, Diego; Fons Font, Antonio; Agustín Panadero, Rubén; Fernández Estevan, Lucía

    2017-01-01

    Background Classic self-curing temporary cements obstruct the translucence of provisional restorations. New dual-cure esthetic temporary cements need investigation and comparison with classic cements to ensure that they are equally retentive and provide adequate translucence. The objective is to analyze by means of traction testing in a in vitro study the retention of five temporary cements. Material and Methods Ten molars were prepared and ten provisional resin restorations were fabricated u...

  18. A contingency analysis of precarious organizational temporariness

    OpenAIRE

    Karmowska, Joanna; Child, John; James, Philip

    2017-01-01

    This paper extends our current understanding of organizational temporariness. The life of a temporary British trade union branch established to recruit Eastern European migrant workers reveals ‘precarious temporariness’, which is less predictable than the ‘planned temporariness’ typically portrayed in the literature. This different type of temporariness was associated with four key contingencies affecting the branch: dispersed governance, bottom-up initiatives, uncertain resourcing, and an ef...

  19. Wire metamaterials: physics and applications.

    Science.gov (United States)

    Simovski, Constantin R; Belov, Pavel A; Atrashchenko, Alexander V; Kivshar, Yuri S

    2012-08-16

    The physics and applications of a broad class of artificial electromagnetic materials composed of lattices of aligned metal rods embedded in a dielectric matrix are reviewed. Such structures are here termed wire metamaterials. They appear in various settings and can operate from microwaves to THz and optical frequencies. An important group of these metamaterials is a wire medium possessing extreme optical anisotropy. The study of wire metamaterials has a long history, however, most of their important and useful properties have been revealed and understood only recently, especially in the THz and optical frequency ranges where the wire media correspond to the lattices of microwires and nanowires, respectively. Another group of wire metamaterials are arrays and lattices of nanorods of noble metals whose unusual properties are driven by plasmonic resonances. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. On the Sharing of Temporary Parental Leave

    DEFF Research Database (Denmark)

    Amilon, Anna

    2007-01-01

    This paper views temporary parental leave (leave from work to take care of a sick child) as a household public good, produced with time inputs of the parents as the only input. Assuming equal productivities in the production of temporary parental leave and equal utility functions of the spouses......-point of the female is found to push the intra household allocation of temporary parental leave towards greater sharing between the spouses. In addition, an increase in the insurance ceiling will further sharing of temporary parental leave in some families, while reducing it in others....

  1. 3D Wire 2015

    DEFF Research Database (Denmark)

    Jordi, Moréton; F, Escribano; J. L., Farias

    , therefore, we’ve drawn conclusions and recommendations for future editions of the event, also generalizable to other experiences of gamification especially in events. This report details the methodology and working elements from the design phase, human resources and organization of production......This document is a general report on the implementation of gamification in 3D Wire 2015 event. As the second gamification experience in this event, we have delved deeply in the previous objectives (attracting public areas less frequented exhibition in previous years and enhance networking) and have...... proposed new ones (viralization of the event on social networks and improvement of the integration of international attendees). On the other hand we defined a set of research objectives related to the study of gamification in an eminently social place like an event. Most of the goals have been met and...

  2. Excitation model of pacemaker cardiomyocytes of cardiac conduction system

    Science.gov (United States)

    Grigoriev, M.; Babich, L.

    2015-11-01

    Myocardium includes typical and atypical cardiomyocytes - pacemakers, which form the cardiac conduction system. Excitation from the atrioventricular node in normal conditions is possible only in one direction. Retrograde direction of pulses is impossible. The most important prerequisite for the work of cardiomyocytes is the anatomical integrity of the conduction system. Changes in contractile force of the cardiomyocytes, which appear periodically, are due to two mechanisms of self-regulation - heterometric and homeometric. Graphic course of the excitation pulse propagation along the heart muscle more accurately reveals the understanding of the arrhythmia mechanism. These models have the ability to visualize the essence of excitation dynamics. However, they do not have the proper forecasting function for result estimation. Integrative mathematical model enables further investigation of general laws of the myocardium active behavior, allows for determination of the violation mechanism of electrical and contractile function of cardiomyocytes. Currently, there is no full understanding of the topography of pacemakers and ionic mechanisms. There is a need for the development of direction of mathematical modeling and comparative studies of the electrophysiological arrangement of cells of atrioventricular connection and ventricular conduction system.

  3. Plasma chemistry in wire chambers

    International Nuclear Information System (INIS)

    Wise, J.

    1990-05-01

    The phenomenology of wire chamber aging is discussed and fundamentals of proportional counters are presented. Free-radical polymerization and plasma polymerization are discussed. The chemistry of wire aging is reviewed. Similarities between wire chamber plasma (>1 atm dc-discharge) and low-pressure rf-discharge plasmas, which have been more widely studied, are suggested. Construction and use of a system to allow study of the plasma reactions occurring in wire chambers is reported. A proportional tube irradiated by an 55 Fe source is used as a model wire chamber. Condensable species in the proportional tube effluent are concentrated in a cryotrap and analyzed by gas chromatography/mass spectrometry. Several different wire chamber gases (methane, argon/methane, ethane, argon/ethane, propane, argon/isobutane) are tested and their reaction products qualitatively identified. For all gases tested except those containing methane, use of hygroscopic filters to remove trace water and oxygen contaminants from the gas resulted in an increase in the average molecular weight of the products, consistent with results from low-pressure rf-discharge plasmas. It is suggested that because water and oxygen inhibit polymer growth in the gas phase that they may also reduce polymer deposition in proportional tubes and therefore retard wire aging processes. Mechanistic implications of the plasma reactions of hydrocarbons with oxygen are suggested. Unresolved issues in this work and proposals for further study are discussed

  4. Transvenous permanent pacemaker implantation in dextrocardia: technique, challenges, outcome, and a brief review of literature.

    Science.gov (United States)

    Shenthar, Jayaprakash; Rai, Maneesh K; Walia, Rohit; Ghanta, Somasekhar; Sreekumar, Praveen; Reddy, Satish S

    2014-09-01

    Dextrocardia is a rare congenital anomaly. Pacemaker implantation in dextrocardia can be challenging because of the distorted anatomy and associated anomalies. The literature regarding implantation of pacemaker in dextrocardia is scarce. The study involved retrospective analysis of records of patients with dextrocardia who had undergone pacemaker implantation between January 2006 and July 2013 from a single centre. Six patients with dextrocardia (five males and one female) underwent permanent pacemaker implantation (PPI) between January 2006 and July 2013. Of them, three had situs solitus dextrocardia and three situs inversus dextrocardia. All three patients with situs solitus dextrocardia had associated corrected transposition of great arteries. The indication for pacemaker implantation was symptomatic complete atrioventricular (AV) block in four, high-grade AV block in one, and sinus node dysfunction in one patient. A favourable outcome was noted during a mean follow-up of 3.9 years (4 months to 7 years) with one patient needing a pulse generator replacement. Permanent pacemaker implantation in dextrocardia can be challenging because of the distorted anatomy. Use of a technique employing angiography to delineate chamber anatomy and relationship can assist the operator during such difficult PPIs. The medium- and long-term survival after a successful pacemaker implantation in dextrocardia is favourable. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  5. Evaluation of Death among the Patients Undergoing Permanent Pacemaker Implantation: A Competing Risks Analysis.

    Science.gov (United States)

    Ghaem, Haleh; Ghorbani, Mohammad; Zare Dorniani, Samira

    2017-06-01

    Permanent artificial pacemaker is one of the important therapies for treatment of cardiac conduction system problems. The present study aimed to determine the association between some predictive variables and all-cause and cause-specific mortality in the patients who had undergone pacemaker implantation. This study was conducted on 1207 patients who had undergone permanent pacemaker implantation in the hospitals affiliated with Shiraz University of Medical Sciences, Iran, from Mar 2002 to Mar 2012. The variables that existed in the patients' medical records included sex, diabetes mellitus, obesity, cerebrovascular accident, cardiomegaly, smoking, hypertension, ischemic heart disease, congenital heart disease, sick sinus syndrome, and atrial fibrillation. Competing risks model was used to assess the association between the predictive variables and cause-specific (i.e., cardiac and vascular) mortality. The patients' mean age was 66.32±17.92 yr (70.62±14.45 yr in the patients with single-chamber pacemakers vs. 61.91±17.69 yr in those with two-chamber pacemakers) ( P pacemaker decreased this risk. Obesity increased the risk of cardiac death, and diabetes mellitus and heart valve disease increased the risk of vascular death. The variables predicting mortality in all-cause model were completely different from those in cause-specific model. Moreover, death in such patients may occur due to reasons other than pacemaker. Therefore, future studies, particularly prospective ones, are recommended to use competing risks models.

  6. Survival time with pacemaker implantation for dogs diagnosed with persistent atrial standstill.

    Science.gov (United States)

    Cervenec, R M; Stauthammer, C D; Fine, D M; Kellihan, H B; Scansen, B A

    2017-06-01

    To evaluate survival time in dogs with persistent atrial standstill after pacemaker implantation and to compare the survival times for cardiac-related vs. non-cardiac deaths. Secondary objectives were to evaluate the effects of breed and the presence of congestive heart failure (CHF) at the time of diagnosis on survival time. Twenty dogs with persistent atrial standstill and pacemaker implantation. Medical records were searched to identify dogs diagnosed with persistent atrial standstill based on electrocardiogram that underwent pacemaker implantation. Survival after pacemaker implantation was analyzed using the Kaplan-Meier method. The median survival time after pacemaker implantation for all-cause mortality was 866 days. There was no significant difference (p=0.573) in median survival time for cardiac (506 days) vs. non-cardiac deaths (400 days). The presence of CHF at the time of diagnosis did not affect the survival time (P=0.854). No difference in median survival time was noted between breeds (P=0.126). Dogs with persistent atrial standstill have a median survival time of 866 days with pacemaker implantation, though a wide range of survival times was observed. There was no difference in the median survival time for dogs with cardiac-related deaths and those without. Patient breed and the presence of CHF before pacemaker implantation did not affect median survival time. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Outcome and management of pacemaker-induced superior vena cava syndrome.

    Science.gov (United States)

    Fu, Hai-Xia; Huang, Xin-Miao; Zhong, Li; Osborn, Michael J; Bjarnason, Haraldur; Mulpuru, Siva; Zhao, Xian-Xian; Friedman, Paul A; Cha, Yong-Mei

    2014-11-01

    We aimed to determine the long-term outcomes of percutaneous lead extraction and stent placement in patients with pacemaker-induced superior vena cava (SVC) syndrome. The study retrospectively screened patients who underwent lead extraction followed by central vein stent implantation at Mayo Clinic (Rochester, MN, USA), from January 2005 to December 2012, to identify the patients with pacemaker-induced SVC syndrome. Demographic, clinical, and follow-up characteristics of those patients were collected from electronic medical records. Six cases were identified. The mean (standard deviation) age was 56 (15) years (male, 67%). All patients had permanent dual-chamber pacemakers, with a mean 11-year history of pacemaker placement. The entire device system was explanted in five patients; one patient had a 21-year-old pacemaker lead that could not be removed. Eight stents were implanted in six patients: five patients had one stent, one patient had three. A new pacemaker system was reimplanted through the stented vein in five patients. Technical success was achieved in all patients, without any complication. Symptoms rapidly resolved in all patients after stent deployment. The mean follow-up duration was 48 months (range, 10-100 months). Three patients remained symptom free. Reintervention with percutaneous balloon venoplasty was successful in three patients with symptom recurrence. Percutaneous stent implantation after lead removal followed by reimplantation of leads is a feasible alternative therapy for pacemaker-induced SVC syndrome, although some cases may require repeat intervention. ©2014 Wiley Periodicals, Inc.

  8. Evaluation of cumulative effects of MR imaging on pacemaker systems at 1.5 Tesla.

    Science.gov (United States)

    Naehle, Claas P; Zeijlemaker, Volkert; Thomas, Daniel; Meyer, Carsten; Strach, Katharina; Fimmers, Rolf; Schild, Hans; Sommer, Torsten

    2009-12-01

    The purpose of this study was to evaluate possible cumulative effects of repeated magnetic resonance imaging (MRI) examinations on pacemaker systems in patients with cardiac pacemakers. The records of pacemaker patients who underwent repetitive MRI examinations in our institution were reviewed to identify patients who underwent two or more MRI examinations at 1.5T of any anatomical region. Using these criteria, a total of 47 patients who underwent a total 171 MRI examinations were identified and included in this study. Institutional Review Board approval for all pacemaker investigations was obtained. Written informed consent was obtained from all patients. Pacemakers were interrogated immediately before and after MR imaging, and after 3 months, including measurement of pacing capture threshold (PCT), lead impedance (LI), and battery voltage (BV). PCT, LI, and BV were analyzed for changes dependant on the number of MRI exams performed. Mean changes over time and changes between first and last pacemaker interrogation of PCT, LI, and BV were calculated. A statistically significant (P < 0.05), but clinically irrelevant trend for decrease in PCT and BV was found. No significant or clinically relevant changes in LI were observed. In this first study, no clinically relevant, cumulative changes in PCT, LI, or BV could be detected in PM patients who underwent two or more MRI examinations. However, a careful benefit/risk evaluation, among other MRI- and pacemaker-related safety precautions, remains mandatory, as clinically relevant alterations to the PM system cannot be excluded by all means.

  9. Placement Of Cardiac PacemaKEr Trial (POCKET) - rationale and design: a randomized controlled trial.

    Science.gov (United States)

    Magnusson, Peter; Wennström, Leo; Kastberg, Robert; Liv, Per

    2017-01-01

    A pacemaker system consists of one or two leads connected to a device that is implanted into a pocket formed just below the collarbone. This pocket is typically subcutaneous, that is, located just above the pectoral fascia. Even though the size of pacemakers has decreased markedly, complications due to superficial implants do occur. An alternative technique would be intramuscular placement of the pacemaker device, but there are no randomized controlled trials (RCTs) to support this approach, which is the rationale for the Placement Of Cardiac PacemaKEr Trial (POCKET). The aim is to study if intramuscular is superior to subcutaneous placement of a pacemaker pocket. In October 2016, we started to enroll 200 consecutive patients with an indication for bradycardia pacemaker implantation. Patients are randomized to random block sizes, stratified by age group (cut-off: 65 years) and sex, and then randomized to either subcutaneous or intramuscular implant. A concealed allocation procedure is employed, using sequentially numbered, sealed envelopes. Pocket site is blinded to the patient and in all subsequent care. The primary endpoint is patient overall satisfaction with the pocket location at 24 months as measured using a visual analog scale (VAS) 0-10. Secondary endpoints are: complications, patient-reported satisfaction at 1, 12, and 24 months (overall satisfaction, pain, discomfort, degree of unsightly appearance, movement problems, and sleep problems due to device). POCKET is a prospective interventional RCT designed to evaluate if intramuscular is superior to subcutaneous placement of a bradycardia pacemaker during a two-year follow-up.

  10. Lessons learnt from experimental temporary octopus fishing ...

    African Journals Online (AJOL)

    This paper presents evidence of the fisheries effect of experimental temporary fishing closures for Octopus in the then-emergent Velondriake Locally Managed Marine Area (LMMA) in south-west Madagascar during 2004–2006. We present an analysis of the O. cyanea catch data for the first two years of temporary closures ...

  11. Diversity patterns of temporary wetland macroinvertebrate ...

    African Journals Online (AJOL)

    Although macroinvertebrates are potentially useful for assessing the condition of temporary wetlands, little is yet known about them. Macroinvertebrate assemblages were assessed in 138 temporary wetlands in the south-western Cape, recording 126 taxa. However, predicted richness estimates were all higher than the ...

  12. Influence of D-net (EUROPEAN GSM-standard) cellular telephones on implanted pacemakers in children.

    Science.gov (United States)

    Elshershari, Huda; Celiker, Alpay; Ozer, Sema; Ozme, Sencan

    2002-09-01

    This study was designed to evaluate possible interactions between digital cellular telephones and implanted pacemakers in children. The study comprised 95 patients (53 males and 42 females) with a mean age of 11.5 +/- 4.6 years (range 1-22 years). The average time from pacemaker implantation was 2.5 years (range 1 month-12 years). Fourteen (15%) devices were dual chamber and the remaining were single chamber pacemakers. The following companies manufactured the pacemakers tested: Medtronic (n = 42), Telectronics (n = 9), Vitatron (n = 16), Pacesetter (n = 19), CPI (n = 8), and Biotronik (n = 1). All the patients were tested in the supine position during continuous ECG monitoring. After completion of the routine pacemaker check, the effects of the European Global system for mobile communication (GSM) was tested using two cellular telephone models (Ericsson GA 628 and Siemens S 25, 2-W power). For this purpose, atrial and ventricular sensitivity settings were programmed to the most sensitive values, and the tests were carried out in the unipolar and bipolar sensing modes. The evaluation was performed during ringing, switching on/off, and conversation phase with the cellular telephone positioned over the pulse generator and around the pacemaker pocket. A malfunction of the pacemaker was not observed in any patient. Only 1 (1%) of 95 patients showed a brief oversensing problem during calls with the cellular telephone. In this case, an AAIR pacemaker was implanted transvenously in a subcutaneous pocket and the sensing defect occurred only with the unipolar sensing mode and was not reproducible. Once the source of interference was removed, no sensing defect was detected and the patient remained asymptomatic. No symptoms were experienced in this study. The authors believe that pacemaker dependent patients with nonprotected pulse generators manufactured at the beginning of 1990s may be tested by their physicians for possible interferences before they use a digital cellular

  13. Predictors for permanent pacemaker implantation after concomitant surgical ablation for atrial fibrillation.

    Science.gov (United States)

    Pecha, Simon; Schäfer, Timm; Yildirim, Yalin; Ahmadzade, Teymour; Willems, Stephan; Reichenspurner, Hermann; Wagner, Florian Mathias

    2014-03-01

    Concomitant surgical atrial fibrillation (AF) ablation is a safe and feasible procedure, recommended in guidelines. Pacemaker dependency is a known complication of AF ablation. We sought to determine independent predictors for pacemaker implantation after surgical AF ablation. Between January 2003 and November 2012, 594 patients underwent concomitant surgical AF ablation. Various energy sources, including cryoablation (n = 139), unipolar radiofrequency (n = 278), and bipolar radiofrequency (n = 177), were used. Left atrial (n = 463, 77.9%) and biatrial (n = 131, 22.1%) ablation was performed. Univariate and multivariate logistic regression analysis was used to identify independent predictors for pacemaker implantation within 30 days after surgical AF ablation. The mean patient's age was 68.6 ± 9.4 years, and 66.8% were male. No major ablation-related complications occurred. A total of 41 (6.9%) of patients received pacemaker implantation during the 30-day follow-up period. Indications for pacemaker implantation were atrioventricular block in 25 (60.9%) of patients, sinus bradycardia or sinus arrest in 9 (22.0%) of patients, and bradyarrhythmia in 7 (17.1%) of patients. Demographic data, type of surgical procedure, and type of energy source did not have a significant impact on pacemaker implantation rate. However, biatrial ablation led to a significant pacemaker implantation rate compared with isolated left-sided ablation (6.3% vs 13.6%; P = .028). Concomitant surgical AF ablation showed a pacemaker implantation rate of 6.9% after 30-day follow-up. Univariate and multivariate analysis showed biatrial lesion set as the only statistically significant predictor for pacemaker implantation after surgical AF ablation. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  14. Ventricular oversensing of atrial electrical activity that inhibits VVI pacemaker and causes syncope

    Directory of Open Access Journals (Sweden)

    Elibet Chávez González

    2015-10-01

    Full Text Available Far-field oversensing of atrial electrical activity caused by a VVI pacemaker is a rare phenomenon; however, it may have serious clinical consequences. It has several causes and its timely identification may avoid a possible ventricular asystole. This article reports the case of a 72-year-old male who had a Biotronik Axios SR pacemaker implanted, in VVIR mode, six years ago, due to blocked atrial fibrillation. He suffered syncope due to pacemaker inhibition caused by ventricular oversensing of atrial electrical activity.

  15. W/kit gene required for interstitial cells of Cajal and for intestinal pacemaker activity

    DEFF Research Database (Denmark)

    Huizinga, J D; Thuneberg, L; Klüppel, M

    1995-01-01

    The pacemaker activity in the mammalian gut is responsible for generating anally propagating phasic contractions. The cellular basis for this intrinsic activity is unknown. The smooth muscle cells of the external muscle layers and the innervated cellular network of interstitial cells of Cajal......, which is closely associated with the external muscle layers of the mammalian gut, have both been proposed to stimulate pacemaker activity. The interstitial cells of Cajal were identified in the last century but their developmental origin and function have remained unclear. Here we show...... of Cajal associated with Auerbach's nerve plexus and intestinal pacemaker activity....

  16. 49 CFR 393.28 - Wiring systems.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 5 2010-10-01 2010-10-01 false Wiring systems. 393.28 Section 393.28... NECESSARY FOR SAFE OPERATION Lamps, Reflective Devices, and Electrical Wiring § 393.28 Wiring systems. Electrical wiring shall be installed and maintained to conform to SAE J1292—Automobile, Truck, Truck-Tractor...

  17. Modeling birds on wires.

    Science.gov (United States)

    Aydoğdu, A; Frasca, P; D'Apice, C; Manzo, R; Thornton, J M; Gachomo, B; Wilson, T; Cheung, B; Tariq, U; Saidel, W; Piccoli, B

    2017-02-21

    In this paper we introduce a mathematical model to study the group dynamics of birds resting on wires. The model is agent-based and postulates attraction-repulsion forces between the interacting birds: the interactions are "topological", in the sense that they involve a given number of neighbors irrespective of their distance. The model is first mathematically analyzed and then simulated to study its main properties: we observe that the model predicts birds to be more widely spaced near the borders of each group. We compare the results from the model with experimental data, derived from the analysis of pictures of pigeons and starlings taken in New Jersey: two different image elaboration protocols allow us to establish a good agreement with the model and to quantify its main parameters. We also discuss the potential handedness of the birds, by analyzing the group organization features and the group dynamics at the arrival of new birds. Finally, we propose a more refined mathematical model that describes landing and departing birds by suitable stochastic processes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Topology Optimized Photonic Wire Splitters

    DEFF Research Database (Denmark)

    Frandsen, Lars Hagedorn; Borel, Peter Ingo; Jensen, Jakob Søndergaard

    2006-01-01

    Photonic wire splitters have been designed using topology optimization. The splitters have been fabricated in silicon-on-insulator material and display broadband low-loss 3dB splitting in a bandwidth larger than 100 nm.......Photonic wire splitters have been designed using topology optimization. The splitters have been fabricated in silicon-on-insulator material and display broadband low-loss 3dB splitting in a bandwidth larger than 100 nm....

  19. Composite conductor containing superconductive wires

    Energy Technology Data Exchange (ETDEWEB)

    Larson, W.L.; Wong, J.

    1974-03-26

    A superconductor cable substitute made by coworking multiple rods of superconductive niobium--titanium or niobium--zirconium alloy with a common copper matrix to extend the copper and rods to form a final elongated product which has superconductive wires distributed in a reduced cross-section copper conductor with a complete metallurgical bond between the normal-conductive copper and the superconductor wires contained therein is described. The superconductor cable can be in the form of a tube.

  20. 30 CFR 75.701-4 - Grounding wires; capacity of wires.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Grounding wires; capacity of wires. 75.701-4... SAFETY AND HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Grounding § 75.701-4 Grounding wires; capacity of wires. Where grounding wires are used to ground metallic sheaths, armors, conduits, frames...

  1. 1 mil gold bond wire study.

    Energy Technology Data Exchange (ETDEWEB)

    Huff, Johnathon; McLean, Michael B.; Jenkins, Mark W.; Rutherford, Brian Milne

    2013-05-01

    In microcircuit fabrication, the diameter and length of a bond wire have been shown to both affect the current versus fusing time ratio of a bond wire as well as the gap length of the fused wire. This study investigated the impact of current level on the time-to-open and gap length of 1 mil by 60 mil gold bond wires. During the experiments, constant current was provided for a control set of bond wires for 250ms, 410ms and until the wire fused; non-destructively pull-tested wires for 250ms; and notched wires. The key findings were that as the current increases, the gap length increases and 73% of the bond wires will fuse at 1.8A, and 100% of the wires fuse at 1.9A within 60ms. Due to the limited scope of experiments and limited data analyzed, further investigation is encouraged to confirm these observations.

  2. HTS Wire Development Workshop: Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    1994-07-01

    The 1994 High-Temperature Superconducting Wire Development Workshop was held on February 16--17 at the St. Petersburg Hilton and Towers in St. Petersburg, Florida. The meeting was hosted by Florida Power Corporation and sponsored by the US Department of Energy`s Superconductivity Program for Electric Power Systems. The meeting focused on recent high-temperature superconducting wire development activities in the Department of Energy`s Superconductivity Systems program. The meeting opened with a general discussion on the needs and benefits of superconductivity from a utility perspective, the US global competitiveness position, and an outlook on the overall prospects of wire development. The meeting then focused on four important technology areas: Wire characterization: issues and needs; technology for overcoming barriers: weak links and flux pinning; manufacturing issues for long wire lengths; and physical properties of HTS coils. Following in-depth presentations, working groups were formed in each technology area to discuss the most important current research and development issues. The working groups identified research areas that have the potential for greatly enhancing the wire development effort. These areas are discussed in the summary reports from each of the working groups. This document is a compilation of the workshop proceedings including all general session presentations and summary reports from the working groups.

  3. Pacemakers in large arrays of oscillators with nonlocal coupling

    Science.gov (United States)

    Jaramillo, Gabriela; Scheel, Arnd

    2016-02-01

    We model pacemaker effects of an algebraically localized heterogeneity in a 1 dimensional array of oscillators with nonlocal coupling. We assume the oscillators obey simple phase dynamics and that the array is large enough so that it can be approximated by a continuous nonlocal evolution equation. We concentrate on the case of heterogeneities with positive average and show that steady solutions to the nonlocal problem exist. In particular, we show that these heterogeneities act as a wave source. This effect is not possible in 3 dimensional systems, such as the complex Ginzburg-Landau equation, where the wavenumber of weak sources decays at infinity. To obtain our results we use a series of isomorphisms to relate the nonlocal problem to the viscous eikonal equation. We then use Fredholm properties of the Laplace operator in Kondratiev spaces to obtain solutions to the eikonal equation, and by extension to the nonlocal problem.

  4. Unusual Treatment of Pacemaker Pocket Infection: A Case Report

    Directory of Open Access Journals (Sweden)

    Ali Kazemisaeed

    2010-12-01

    Full Text Available Pocket infection of a cardiac device is usually treated by removing the device and re-implanting it in a new site after complete treatment of the infection. This report illustrates a complicated case of pocket infection in the wake of the implantation of a permanent pacemaker (cardiac resynchronization therapy. The patient was treated conservatively through daily irrigation and dressing, broad-spectrum antibiotics, and debridement without the device being removed; the generator was kept out of the pocket for 5 weeks and then re-implanted in the same location successfully. The method of treatment presented herein can be of value, not least in the elderly population who might experience life-threatening events following the replacement of their cardiac devices.

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

    Science.gov (United States)

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

    2012-01-01

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

  6. A novel non invasive measurement of hemodynamic parameters: Comparison of single-chamber ventricular and dual-chamber pacemaker

    Directory of Open Access Journals (Sweden)

    Ingrid M. Pardede

    2008-03-01

    Full Text Available We carried out a cross sectional study to analyze hemodynamic parameters of single-chamber ventricular pacemaker compared with dual-chamber pacemaker by using thoracic electrical bioimpedance monitoring method (Physio Flow™ - a novel simple non-invasive measurement. A total of 48 consecutive outpatients comprised of 27 single chamber pacemaker and 21 dual chamber were analyzed. We measured cardiac parameters: heart rate, stroke volume index, cardiac output index, estimated ejection fraction, end diastolic volume, early diastolic function ratio, thoracic fluid index, and systemic parameters: left cardiac work index and systemic vascular resistance index. Baseline characteristic and pacemaker indication were similar in both groups. Cardiac parameters assessment revealed no significant difference between single-chamber pacemaker and dual-chamber pacemaker in heart rate, stroke volume index, cardiac index, estimated ejection fraction, end-diastolic volume, thoracic fluid index. There was significantly higher early diastolic function ratio in single-chamber pacemaker compared to dual-chamber pacemaker: 92% (10.2-187.7% vs. 100.6% (48.7-403.2%; p=0.006. Systemic parameters assessment revealed significantly higher left cardiac work index in single-chamber group than dual-chamber group 4.9 kg.m/m² (2.8-7.6 kg.m/m² vs. 4.3 kg.m/m² (2.9-7.2 kg.m/m²; p=0.004. There was no significant difference on systemic vascular resistance in single-chamber compared to dual-chamber pacemaker. Single-chamber ventricular pacemaker provides similar stroke volume, cardiac output and left cardiac work, compared to dual-chamber pacemaker. A non-invasive hemodynamic measurement using thoracic electrical bioimpedance is feasible for permanent pacemaker outpatients. (Med J Indones 2008; 17: 25-32Keywords: Permanent pacemaker, single chamber, dual chamber, thoracic electrical bioimpedance, hemodynamic parameter

  7. Analysis of a five year experience of permanent pacemaker implantation at a Nigerian Teaching Hospital: need for a national database

    Science.gov (United States)

    Falase, Bode; Sanusi, Michael; Johnson, Adeyemi; Akinrinlola, Fola; Ajayi, Reina; Oke, David

    2013-01-01

    Introduction Permanent pacemaker implantation is available in Nigeria. There is however no national registry or framework for pacemaker data collection. A pacemaker database has been developed in our institution and the results are analyzed in this study. Methods The study period was between January 2008 and December 2012. Patient data was extracted from a prospectively maintained database which was designed to include the fields of the European pacemaker patient identification code. Results Of the 51 pacemaker implants done, there were 29 males (56.9%) and 22 females (43.1%). Mean age was 68.2±12.7 years. Clinical indications were syncopal attacks in 25 patients (49%), dizzy spells in 15 patients (29.4%), bradycardia with no symptoms in 10 patients (17.7%) and dyspnoea in 2 patients (3.9%). The ECG diagnosis was complete heart block in 27 patients (53%), second degree heart block in 19 patients (37.2%) and sick sinus syndrome with bradycardia in 5 patients (9.8%). Pacemaker modes used were ventricular pacing in 29 patients (56.9%) and dual chamber pacing in 22 patients (43.1%). Files have been closed in 20 patients (39.2%) and 31 patients (60.8%) are still being followed up with median follow up of 26 months, median of 5 visits and 282 pacemaker checks done. Complications seen during follow up were 3 lead displacements (5.9%), 3 pacemaker infections (5.9%), 2 pacemaker pocket erosions (3.9%), and 1 pacemaker related death (2%). There were 5 non-pacemaker related deaths (9.8%). Conclusion Pacemaker data has been maintained for 5 years. We urge other implanting institutions in Nigeria to maintain similar databases and work towards establishment of a national pacemaker registry. PMID:24498465

  8. Psychosocial aspects and mental health in children after permanent pacemaker implantation

    DEFF Research Database (Denmark)

    Andersen, C; Hørder, K; Kristensen, L

    1994-01-01

    The present study was designed to evaluate the psychosocial status and the mental health of children receiving a permanent pacemaker during childhood. Nineteen children under the age of 19 years had a permanent pacemaker implanted. Contact was established to 15 of these patients, 7 girls and 8 boys......, and they were given a child-psychiatric evaluation consisting of a semi-structured and a child-psychiatric interview. The psychological interview used intelligence tests and the Draw-A-Person test as well as the Rorschach test. The patients had had their pacemakers during an average of 6.7 years (range 3......-14). Generally the psychological condition was strained in 7 families, in which psychiatric and social therapy had been necessary. The children's intelligence was within normal ranges, average IQ being 110 (range 80-135). The children had abnormal body image related to the pacemaker. Adults virtually incorporate...

  9. Machines in our hearts: the cardiac pacemaker, the implantable defibrillator, and American health care

    National Research Council Canada - National Science Library

    Jeffrey, Kirk

    2001-01-01

    ... A Device Reliability, Qualification Tests, and Improvements 291 APPENDIX B Number of Implantations 294 APPENDIX C ICHD Pacemaker Identification Code 296 Abbreviations 297 Notes 299 Bibliographical N...

  10. An Unusual Cause of Transient Ischemic Attack in a Patient with Pacemaker

    Directory of Open Access Journals (Sweden)

    Jagadeesh Kumar Kalavakunta

    2014-01-01

    Full Text Available Pacemaker lead malposition in various locations has been described in the literature. Lead malposition in left ventricle is a rare and an underdiagnosed complication. We present a 77-year-old man with history of atrial fibrillation and pacemaker placement who was admitted for transient ischemic attack. He was on aspirin, beta blocker, and warfarin with subtherapeutic international normalized ratio. His paced electrocardiogram showed right bundle-branch block, rather than the typical pattern of left bundle-branch block, suggesting pacemaker lead malposition. Further, his chest X-ray and echocardiogram confirmed the pacemaker lead position in the left ventricle instead of right ventricle. He refused surgical removal of the lead and we increased his warfarin dose. Diagnosis of lead malposition in left ventricle, though easy to identify in echocardiogram, requires high index of clinical suspicion. In asymptomatic patients, surgical removal may be deferred for treatment with lifelong anticoagulation.

  11. Magnetic Resonance Imaging in a Patient with a Dual Chamber Pacemaker

    Science.gov (United States)

    Millar, Lynne Martina; Robinson, Andrew George; O'Flaherty, Maurice Thomas; Eames, Niall; Johnston, Nicola; Heyburn, Gary

    2010-01-01

    Having a pacemaker has been seen an absolute contraindication to having an MRI scan. This has become increasingly difficult in clinical practice as insertion of pacemakers and implantable cardiac defibrillators is at an all time high. Here we outline a case where a 71-year-old male patient with a permanent pacemaker needed to have an MRI scan to ascertain the aetiology of his condition and help guide further management. Given this clinical dilemma, an emergency clinical ethics consultation was arranged. As a result the patient underwent an MRI scan safely under controlled conditions with a consultant cardiologist and radiologist present. The results of the MRI scan were then able to tailor further treatment. This case highlights that in certain conditions an MRI can be performed in patients with permanent pacemakers and outlines the role of clinical ethics committees in complex medical decision making. PMID:21331383

  12. Sikkerhed af magnetisk resonans-skanning hos patienter med pacemaker og implanterbar defibrillator

    DEFF Research Database (Denmark)

    Al-Sabagh, Kifah Hekmat; Christensen, Britta Ege; Thøgersen, Anna Margrethe

    2010-01-01

    INTRODUCTION: The presence of a cardiac implantable device is ICD considered an absolute contraindication to magnetic resonance imaging (MRI). The purpose of this study was to evaluate the safety of performing MRI in patients with cardiac pacemakers and ICDs that had a compelling clinical need...... for MRI examination. MATERIAL AND METHODS: During a period of nine years we have included 65 patients with cardiac devices (60 pacemakers and five ICDs) who underwent a total of 73 MRI examinations at 1.5 T. All pacemakers were reprogrammed before MRI to asynchronous mode to avoid MRI-induced inhibition...... safely in 63 patients. Inhibition of pacemaker output was observed in one patient and induction of ventricular fibrillation was observed in another with ICD. A significant increase in PCT was rare and only detected in 1% of all electrodes. CONCLUSION: MRI can be performed safely in patients...

  13. 76 FR 48058 - Effective Date of Requirement for Premarket Approval for Cardiovascular Permanent Pacemaker...

    Science.gov (United States)

    2011-08-08

    ...-documented case histories conducted by qualified experts, and reports of significant human experience with a... case reports, random experience, reports lacking sufficient details to permit scientific evaluation... Approval for Cardiovascular Permanent Pacemaker Electrode AGENCY: Food and Drug Administration, HHS. ACTION...

  14. The Improvement of the Atrial Flutter Rhythm upon the Removal of the Infected Permanent Pacemaker Lead

    Directory of Open Access Journals (Sweden)

    Ali Azari

    2015-06-01

    Full Text Available Pacemaker infection has multiple risk factors. Its presentation is most often similar to infected endocarditis and the diagnosis is made through studying blood cultures. Transesophageal echocardiography can confirm the diagnosis. The most common microorganisms are staphylococcus speciesis. As a matter of fact, complete pacemaker removal appears to be the only definite treatment. We presented a case of infected pacemaker lead which was firstly referred with fever and nephritic syndrome. She had intermittent atrial flutterrhythm. Therefore, a total infected pacemaker system was removed under cardiopulmonary bypass support. Yet, the lead was firmly attached to the septal leaflet of tricuspid valve while leaflet repair was needed. As a result, atrial flutter rhythm was converted into sinus rhythm after an incidental interruption of the macroreentrant circuit in the process of the tricuspid leaflet surgery.

  15. Magnetic Resonance Imaging in a Patient with a Dual Chamber Pacemaker

    Directory of Open Access Journals (Sweden)

    Lynne Martina Millar

    2010-01-01

    Full Text Available Having a pacemaker has been seen an absolute contraindication to having an MRI scan. This has become increasingly difficult in clinical practice as insertion of pacemakers and implantable cardiac defibrillators is at an all time high. Here we outline a case where a 71-year-old male patient with a permanent pacemaker needed to have an MRI scan to ascertain the aetiology of his condition and help guide further management. Given this clinical dilemma, an emergency clinical ethics consultation was arranged. As a result the patient underwent an MRI scan safely under controlled conditions with a consultant cardiologist and radiologist present. The results of the MRI scan were then able to tailor further treatment. This case highlights that in certain conditions an MRI can be performed in patients with permanent pacemakers and outlines the role of clinical ethics committees in complex medical decision making.

  16. Interference of apex locator, pulp tester and diathermy on pacemaker function

    OpenAIRE

    Narayanan Sriman; V Prabhakar; J S Bhuvaneswaran; N Subha

    2015-01-01

    Aim: The purpose of this study was to evaluate the effects of three electronic apex locators (EAL), electric pulp tester (EPT) and diathermy on pacemaker function in vitro. Materials and Methods: Three EALs: Root ZX (J. Morita Co., Tustin, CA, U.S.A.), Propex (Dentsply), Mini Apex locator (SybronEndo, Anaheim, CA, USA), EPT (Parkell pulp vitality tester Farmingdale, NY, USA) and Diathermy (Neomed 250 B) were tested for any interference with one pacemaker (A medtronic kappa KVDD901-serial ...

  17. A Fully Implantable Pacemaker for the Mouse: From Battery to Wireless Power

    Science.gov (United States)

    Zellmer, Erik R.; Weinheimer, Carla J.; MacEwan, Matthew R.; Cui, Sophia X.; Nerbonne, Jeanne M.; Efimov, Igor R.

    2013-01-01

    Animal models have become a popular platform for the investigation of the molecular and systemic mechanisms of pathological cardiovascular physiology. Chronic pacing studies with implantable pacemakers in large animals have led to useful models of heart failure and atrial fibrillation. Unfortunately, molecular and genetic studies in these large animal models are often prohibitively expensive or not available. Conversely, the mouse is an excellent species for studying molecular mechanisms of cardiovascular disease through genetic engineering. However, the large size of available pacemakers does not lend itself to chronic pacing in mice. Here, we present the design for a novel, fully implantable wireless-powered pacemaker for mice capable of long-term (>30 days) pacing. This design is compared to a traditional battery-powered pacemaker to demonstrate critical advantages achieved through wireless inductive power transfer and control. Battery-powered and wireless-powered pacemakers were fabricated from standard electronic components in our laboratory. Mice (n = 24) were implanted with endocardial, battery-powered devices (n = 14) and epicardial, wireless-powered devices (n = 10). Wireless-powered devices were associated with reduced implant mortality and more reliable device function compared to battery-powered devices. Eight of 14 (57.1%) mice implanted with battery-powered pacemakers died following device implantation compared to 1 of 10 (10%) mice implanted with wireless-powered pacemakers. Moreover, device function was achieved for 30 days with the wireless-powered device compared to 6 days with the battery-powered device. The wireless-powered pacemaker system presented herein will allow electrophysiology studies in numerous genetically engineered mouse models as well as rapid pacing-induced heart failure and atrial arrhythmia in mice. PMID:24194832

  18. Tilt-table testing of patients with pacemaker and recurrent syncope

    DEFF Research Database (Denmark)

    Nielsen, Christian E. Haarmark; Kanters, Jørgen K; Mehlsen, Jesper

    2016-01-01

    The diagnosis of recurrent syncope in patients with pacemakers (PM) is quite challenging and the etiology of syncope is often multifactorial. To portray the mechanism of syncope in PM patients, we report the results of head-up tilt table testing (HUT) in a series of patients with PM, originally...... with pacemakers has a high diagnostic yield. Although, the majority of patients had a vasodepressor or orthostatic hypotensive response, cardioinhibitory response leading to syncope was also seen....

  19. Inward-rectifying potassium (Kir) channels regulate pacemaker activity in spinal nociceptive circuits during early life

    Science.gov (United States)

    Li, Jie; Blankenship, Meredith L.; Baccei, Mark L.

    2013-01-01

    Pacemaker neurons in neonatal spinal nociceptive circuits generate intrinsic burst-firing and are distinguished by a lower “leak” membrane conductance compared to adjacent, non-bursting neurons. However, little is known about which subtypes of leak channels regulate the level of pacemaker activity within the developing rat superficial dorsal horn (SDH). Here we demonstrate that a hallmark feature of lamina I pacemaker neurons is a reduced conductance through inward-rectifying potassium (Kir) channels at physiological membrane potentials. Differences in the strength of inward rectification between pacemakers and non-pacemakers indicate the presence of functionally distinct Kir currents in these two populations at room temperature. However, Kir currents in both groups showed high sensitivity to block by extracellular Ba2+ (IC50 ~ 10 µM), which suggests the presence of ‘classical’ Kir (Kir2.x) channels in the neonatal SDH. The reduced Kir conductance within pacemakers is unlikely to be explained by an absence of particular Kir2.x isoforms, as immunohistochemical analysis revealed the expression of Kir2.1, Kir2.2 and Kir2.3 within spontaneously bursting neurons. Importantly, Ba2+ application unmasked rhythmic burst-firing in ~42% of non-bursting lamina I neurons, suggesting that pacemaker activity is a latent property of a sizeable population of SDH cells during early life. In addition, the prevalence of spontaneous burst-firing within lamina I was enhanced in the presence of high internal concentrations of free Mg2+, consistent with its documented ability to block Kir channels from the intracellular side. Collectively, the results indicate that Kir channels are key modulators of pacemaker activity in newborn central pain networks. PMID:23426663

  20. Frequency of pacemaker malfunction associated with monopolar electrosurgery during pulse generator replacement or upgrade surgery.

    Science.gov (United States)

    Lin, Yun; Melby, Daniel P; Krishnan, Balaji; Adabag, Selcuk; Tholakanahalli, Venkatakrishna; Li, Jian-Ming

    2017-08-01

    The aim of this study is to investigate the frequency of electrosurgery-related pacemaker malfunction. A retrospective study was conducted to investigate electrosurgery-related pacemaker malfunction in consecutive patients undergoing pulse generator (PG) replacement or upgrade from two large hospitals in Minneapolis, MN between January 2011 and January 2014. The occurrence of this pacemaker malfunction was then studied by using MAUDE database for all four major device vendors. A total of 1398 consecutive patients from 2 large tertiary referral centers in Minneapolis, MN undergoing PG replacement or upgrade surgery were retrospectively studied. Four patients (0.3% of all patients), all with pacemakers from St Jude Medical (2.8%, 4 of 142) had output failure or inappropriately low pacing rate below 30 bpm during electrosurgery, despite being programmed in an asynchronous mode. During the same period, 1174 cases of pacemaker malfunctions were reported on the same models in MAUDE database, 37 of which (3.2%) were electrosurgery-related. Twenty-four cases (65%) had output failure or inappropriate low pacing rate. The distribution of adverse events was loss of pacing (59.5%), reversion to backup pacing (32.4%), inappropriate low pacing rate (5.4%), and ventricular fibrillation (2.7%). The majority of these (78.5%) occurred during PG replacement at ERI or upgrade surgery. No electrosurgery-related malfunction was found in MAUDE database on 862 pacemaker malfunction cases during the same period from other vendors. Electrosurgery during PG replacement or upgrade surgery can trigger output failure or inappropriate low pacing rate in certain models of modern pacemakers. Cautions should be taken for pacemaker-dependent patients.

  1. Temporary closure of the tunnel

    CERN Multimedia

    Relations with the Host States Service

    2005-01-01

    Owing to major maintenance work, the tunnel linking the various parts of the CERN site will be closed from Monday 4 July to Sunday 24 July 2005 The Host State authorities have given authorisation for persons employed by CERN or the Institutes to travel and for goods belonging to these entities to be transported between the various parts of the site via Gate E (Charles de Gaulle) while this work is being carried out, subject to strict compliance with the Rules for the Use of the Tunnel (see http://dsu.web.cern.ch/dsu/dsum/hsr/DOCUMENTS/8200980415.pdf). Gate E will thus be open between 7.00 a.m. and 7.00 p.m. from Monday to Friday during the period concerned. The rules governing the use of Gate E to enter the Meyrin site between 7.30 a.m. and 9.00 a.m. or to leave the site between 5.00 p.m. and 6.30 p.m. (see http://dsu.web.cern.ch/dsu/dsum/hsr/DOCUMENTS/12222_041027.pdf)) will remain unaffected by this temporary authorisation. Relations with the Host States Service and TS-FM Group

  2. Development of pacemaker properties and rhythmogenic mechanisms in the mouse embryonic respiratory network

    Science.gov (United States)

    Chevalier, Marc; Toporikova, Natalia; Simmers, John; Thoby-Brisson, Muriel

    2016-01-01

    Breathing is a vital rhythmic behavior generated by hindbrain neuronal circuitry, including the preBötzinger complex network (preBötC) that controls inspiration. The emergence of preBötC network activity during prenatal development has been described, but little is known regarding inspiratory neurons expressing pacemaker properties at embryonic stages. Here, we combined calcium imaging and electrophysiological recordings in mouse embryo brainstem slices together with computational modeling to reveal the existence of heterogeneous pacemaker oscillatory properties relying on distinct combinations of burst-generating INaP and ICAN conductances. The respective proportion of the different inspiratory pacemaker subtypes changes during prenatal development. Concomitantly, network rhythmogenesis switches from a purely INaP/ICAN-dependent mechanism at E16.5 to a combined pacemaker/network-driven process at E18.5. Our results provide the first description of pacemaker bursting properties in embryonic preBötC neurons and indicate that network rhythmogenesis undergoes important changes during prenatal development through alterations in both circuit properties and the biophysical characteristics of pacemaker neurons. DOI: http://dx.doi.org/10.7554/eLife.16125.001 PMID:27434668

  3. Pacemaker rate and depolarization block in nigral dopamine neurons: a somatic sodium channel balancing act

    Science.gov (United States)

    Tucker, Kristal R.; Huertas, Marco A.; Horn, John P.; Canavier, Carmen C.; Levitan, Edwin S.

    2012-01-01

    Midbrain dopamine (DA) neurons are slow intrinsic pacemakers that undergo depolarization (DP) block upon moderate stimulation. Understanding DP block is important because it has been correlated with the clinical efficacy of chronic antipsychotic drug treatment. Here we describe how voltage-gated sodium (NaV) channels regulate DP block and pacemaker activity in DA neurons of the substantia nigra using rat brain slices. The distribution, density and gating of NaV currents were manipulated by blocking native channels with tetrodotoxin and by creating virtual channels and anti-channels with dynamic clamp. Although action potentials initiate in the axon initial segment (AIS) and NaV channels are distributed in multiple dendrites, selective reduction of NaV channel activity in the soma was sufficient to decrease pacemaker frequency and increase susceptibility to DP block. Conversely, increasing somatic NaV current density raised pacemaker frequency and lowered susceptibility to DP block. Finally, when NaV currents were restricted to the soma, pacemaker activity occurred at abnormally high rates due to excessive local subthreshold NaV current. Together with computational simulations, these data show that both the slow pacemaker rate and the sensitivity to DP block that characterizes DA neurons result from the low density of somatic NaV channels. More generally, we conclude that the somatodendritic distribution of NaV channels is a major determinant of repetitive spiking frequency. PMID:23077037

  4. The East Asian Summer Monsoon in pacemaker experiments driven by ENSO

    Science.gov (United States)

    Ding, Hui; Greatbatch, Richard J.; Lu, Jian; Cash, Ben

    2015-03-01

    The variability of the East Asian summer monsoon (EASM) is studied using a pacemaker technique driven by ENSO in an atmospheric general circulation model (AGCM) coupled to a slab mixed layer model. In the pacemaker experiments, sea surface temperature (SST) is constrained to observations in the eastern equatorial Pacific through a q- flux that measures the contribution of ocean dynamics to SST variability, while the AGCM is coupled to the slab model. An ensemble of pacemaker experiments is analyzed using a multivariate EOF analysis to identify the two major modes of variability of the EASM. The results show that the pacemaker experiments simulate a substantial amount (around 45 %) of the variability of the first mode (the Pacific-Japan pattern) in ERA40 from 1979 to 1999. Different from previous work, the pacemaker experiments also simulate a large part (25 %) of the variability of the second mode, related to rainfall variability over northern China. Furthermore, we find that the lower (850 hPa) and the upper (200 hPa) tropospheric circulation of the first mode display the same degree of reproducibility whereas only the lower part of the second mode is reproducible. The basis for the success of the pacemaker experiments is the ability of the experiments to reproduce the observed relationship between El Niño Southern Oscillation (ENSO) and the EASM.

  5. Biological pacemaker created by minimally invasive somatic reprogramming in pigs with complete heart block

    Science.gov (United States)

    Hu, Yu-Feng; Dawkins, James Frederick; Cho, Hee Cheol; Marbán, Eduardo; Cingolani, Eugenio

    2016-01-01

    Somatic reprogramming by reexpression of the embryonic transcription factor T-box 18 (TBX18) converts cardiomyocytes into pacemaker cells. We hypothesized that this could be a viable therapeutic avenue for pacemaker-dependent patients afflicted with device-related complications, and therefore tested whether adenoviral TBX18 gene transfer could create biological pacemaker activity in vivo in a large-animal model of complete heart block. Biological pacemaker activity, originating from the intramyocardial injection site, was evident in TBX18-transduced animals starting at day 2 and persisted for the duration of the study (14 days) with minimal backup electronic pacemaker use. Relative to controls transduced with a reporter gene, TBX18-transduced animals exhibited enhanced autonomic responses and physiologically superior chronotropic support of physical activity. Induced sinoatrial node cells could be identified by their distinctive morphology at the site of injection in TBX18-transduced animals, but not in controls. No local or systemic safety concerns arose. Thus, minimally invasive TBX18 gene transfer creates physiologically relevant pacemaker activity in complete heart block, providing evidence for therapeutic somatic reprogramming in a clinically relevant disease model. PMID:25031269

  6. PC based temporary shielding administrative procedure (TSAP)

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, D.E.; Pederson, G.E. [Sargent & Lundy, Chicago, IL (United States); Hamby, P.N. [Commonwealth Edison Co., Downers Grove, IL (United States)

    1995-03-01

    A completely new Administrative Procedure for temporary shielding was developed for use at Commonwealth Edison`s six nuclear stations. This procedure promotes the use of shielding, and addresses industry requirements for the use and control of temporary shielding. The importance of an effective procedure has increased since more temporary shielding is being used as ALARA goals become more ambitious. To help implement the administrative procedure, a personal computer software program was written to incorporate the procedural requirements. This software incorporates the useability of a Windows graphical user interface with extensive help and database features. This combination of a comprehensive administrative procedure and user friendly software promotes the effective use and management of temporary shielding while ensuring that industry requirements are met.

  7. PC based temporary shielding administrative procedure (TSAP)

    International Nuclear Information System (INIS)

    Olsen, D.E.; Pederson, G.E.; Hamby, P.N.

    1995-01-01

    A completely new Administrative Procedure for temporary shielding was developed for use at Commonwealth Edison's six nuclear stations. This procedure promotes the use of shielding, and addresses industry requirements for the use and control of temporary shielding. The importance of an effective procedure has increased since more temporary shielding is being used as ALARA goals become more ambitious. To help implement the administrative procedure, a personal computer software program was written to incorporate the procedural requirements. This software incorporates the useability of a Windows graphical user interface with extensive help and database features. This combination of a comprehensive administrative procedure and user friendly software promotes the effective use and management of temporary shielding while ensuring that industry requirements are met

  8. Temporary Authorizations at Permitted Waste Management Facilities

    Science.gov (United States)

    This rule under the Code of Federal Regulations (CFR) provides EPA with the authority to grant a permittee temporary authorization, without prior public notice and comment, to conduct activities necessary to respond promptly to changing conditions.

  9. Christo Javacheff’s temporary monuments

    Directory of Open Access Journals (Sweden)

    Sylvia Furegatti

    2014-06-01

    Full Text Available This article deals with the question of temporary configuration adopted by the Bulgarian artist Christo Javacheff in his artistic interventions in the contemporary landscape. Place emphasizes on analysis of his creative process guided by the idea of temporary monuments; attribution given by him to projects that has close relations between the architectural elements and the collective memory of the public participating of these interventions in different urban centers on the planet.

  10. Temporary metal stents in bladder outflow obstruction.

    Science.gov (United States)

    Yachia, D

    1997-12-01

    The use of stents in the management of prostatic obstruction started in 1980 with the development of the "partial catheter" by Fabian in Germany. Since then, a variety of metals and biostable and biodegradable polymers have been made into temporary or permanent stents for the management of infravesical obstructions such as benign or malignant prostatic enlargement, bladder neck stenoses, or urethral strictures. This paper is an overview of two generations of temporary metal stents used in the patients with infravesical obstruction.

  11. Control of flow structure in the wake region of circular cylinder with meshy wire in deep water

    Directory of Open Access Journals (Sweden)

    Burcu Oğuz

    2016-08-01

    Full Text Available In this study the aim is decreasing the effect and the intensity of the temporary loads resulted from vortex shedding that have an impact on the cylinder (chimneys, high buildings etc. located in deep water and the object or objects in the wake region and definition of the optimum values (wire thickness and porosity β With different thickness and different porosity ratios the effect of meshy wire that surrounded a circular cylinder of D=50 mm diameter was observed at Re_D=5000. The porosity ratios were four different values between a range of β=0.5-0.8 with an interval of 0.1. The thicknesses of wire were 1 mm, 2 mm, 3 mm and 4 mm. The flow structure in the wake region of circular cylinder was tried to be controlled by meshy wire that surrounded the cylinder. Experiments were carried out by using particle image velocimetry (PIV technique. Comparing with bare cylinder results, turbulence kinetic energy (TKE and Reynolds shear stress values increase with wire thicknesses of b=1 mm, 2 mm for all porosity ratios and decrease with b=3 mm, 4 mm. With porosity ratio of β=0.6 and wire thickness of b=4 mm TKE and Reynolds shear stress results show that meshy wire controls the flow in the wake region of the cylinder. Frequency value results also define that best flow control is obtained with β=0.6 and b=4 mm.

  12. Use of an active fixation lead and a subpectoral pacemaker pocket may not avoid Twiddler′s syndrome

    Directory of Open Access Journals (Sweden)

    Floris E A Udink ten Cate

    2012-01-01

    Full Text Available Manipulation of a pacemaker with consequent malfunction of the device has been called Twiddler′s syndrome. Use of active-fixation leads and subpectoral pacemaker pockets has been considered to help in avoiding this problem. We describe a child in whom twiddling was not prevented despite implantation of a lumenless atrial lead and insertion of the pacemaker generator in a subpectoral pocket.

  13. 5 CFR 511.615 - Temporary compliance authority.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Temporary compliance authority. 511.615 Section 511.615 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS.... Agencies may use temporary or conditional compliance action, e.g., a temporary promotion or a temporary...

  14. Trends in permanent pacemaker implantation in the United States from 1993 to 2009: increasing complexity of patients and procedures.

    Science.gov (United States)

    Greenspon, Arnold J; Patel, Jasmine D; Lau, Edmund; Ochoa, Jorge A; Frisch, Daniel R; Ho, Reginald T; Pavri, Behzad B; Kurtz, Steven M

    2012-10-16

    This study sought to define contemporary trends in permanent pacemaker use by analyzing a large national database. The Medicare National Coverage Determination for permanent pacemaker, which emphasized single-chamber pacing, has not changed significantly since 1985. We sought to define contemporary trends in permanent pacemaker use by analyzing a large national database. We queried the Nationwide Inpatient Sample to identify permanent pacemaker implants between 1993 and 2009 using the International Classification of Diseases-Ninth Revision-Clinical Modification procedure codes for dual-chamber (DDD), single-ventricular (VVI), single-atrial (AAI), or biventricular (BiV) devices. Annual permanent pacemaker implantation rates and patient demographics were analyzed. Between 1993 and 2009, 2.9 million patients received permanent pacemakers in the United States. Overall use increased by 55.6%. By 2009, DDD use increased from 62% to 82% (p pacemaker use fell from 36% to 14% (p = 0.01). Use of DDD devices was higher in urban, nonteaching hospitals (79%) compared with urban teaching hospitals (76%) and rural hospitals (72%). Patients with private insurance (83%) more commonly received DDD devices than Medicaid (79%) or Medicare (75%) recipients (p pacemakers in the United States. Although DDD device use is increasing, whereas single-chamber ventricular pacemaker use is decreasing. Patients are becoming older and have more medical comorbidities. These trends have important health care policy implications. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  15. Wire Rupture Optimization in Wire Electrical Discharge Machining using Taguchi Approach

    Directory of Open Access Journals (Sweden)

    Maher Ibrahem

    2017-01-01

    Full Text Available Wire electrical discharge machining (WEDM is one of the most important nontraditional machining process that is well-known for cutting difficult to machine materials. The wire electrode along with machining parameters control the WEDM process. This research work focuses on optimizing WEDM parameters using Taguchi technique to minimize wire rupture. Experiments have been done using the L18 orthogonal array. Each experiment is repeated three times to ensure accurate readings of the wire rupture. The statistical methods of signal to noise ratio (S/N ratio is applied to study effects of peak current, pulse width, charging time, wire speed, and wire tension on wire rupture. As a results, the peak current, pulse width, and wire tension have the most significant effect on wire rupture followed by charging time and wire speed. The developed analysis can be used in the metal cutting field to identify the optimum machining parameters for less wire rupture.

  16. Is metabolic rate a universal 'pacemaker' for biological processes?

    Science.gov (United States)

    Glazier, Douglas S

    2015-05-01

    A common, long-held belief is that metabolic rate drives the rates of various biological, ecological and evolutionary processes. Although this metabolic pacemaker view (as assumed by the recent, influential 'metabolic theory of ecology') may be true in at least some situations (e.g. those involving moderate temperature effects or physiological processes closely linked to metabolism, such as heartbeat and breathing rate), it suffers from several major limitations, including: (i) it is supported chiefly by indirect, correlational evidence (e.g. similarities between the body-size and temperature scaling of metabolic rate and that of other biological processes, which are not always observed) - direct, mechanistic or experimental support is scarce and much needed; (ii) it is contradicted by abundant evidence showing that various intrinsic and extrinsic factors (e.g. hormonal action and temperature changes) can dissociate the rates of metabolism, growth, development and other biological processes; (iii) there are many examples where metabolic rate appears to respond to, rather than drive the rates of various other biological processes (e.g. ontogenetic growth, food intake and locomotor activity); (iv) there are additional examples where metabolic rate appears to be unrelated to the rate of a biological process (e.g. ageing, circadian rhythms, and molecular evolution); and (v) the theoretical foundation for the metabolic pacemaker view focuses only on the energetic control of biological processes, while ignoring the importance of informational control, as mediated by various genetic, cellular, and neuroendocrine regulatory systems. I argue that a comprehensive understanding of the pace of life must include how biological activities depend on both energy and information and their environmentally sensitive interaction. This conclusion is supported by extensive evidence showing that hormones and other regulatory factors and signalling systems coordinate the processes of

  17. Enhancing wire-composite bond strength of bonded retainers with wire surface treatment.

    Science.gov (United States)

    Oesterle, L J; Shellhart, W C; Henderson, S

    2001-06-01

    Bonded orthodontic retainers with wires embedded in composite resin are commonly used for orthodontic retention. The purpose of this study was to test, in vitro, various wire surface treatments to determine the optimal method of enhancing the wire-composite bond strength. Coaxial wires and stainless steel wires with different surface treatments were bonded to bovine enamel and then pulled along their long axes with an Instron universal testing machine. Wire surface treatments included placing a right-angle bend in the wire, microetching the wire, and treating the wire with adhesion promoters; combinations of treatments were also examined. The results demonstrated a 24-fold increase in the wire-composite bond strength of wire that was microetched (sandblasted), compared with that of untreated straight wire. The difference between the amount of force required to break the bond produced by microetching alone (246.1 +/- 46.0 MPa) and that required for the bonds produced by the retentive bend (87.8 +/- 16.3 MPa), the adhesion promoters (silane, 11.0 +/- 3.1 MPa; Metal Primer, 28.5 +/- 15.8 MPa), or for any combination of surface treatments, was statistically significant. Microetching a stainless steel wire produced a higher wire-composite bond strength than that obtained from a coaxial wire (113.5 +/- 27.5 MPa). The results of this study indicate that microetching or sandblasting a stainless steel wire significantly increases the strength of the wire-composite bond.

  18. 77 FR 71825 - Notice of Temporary Restriction of Vehicle Use and Temporary Closure to Tree Cutting and Wood...

    Science.gov (United States)

    2012-12-04

    ...: 14X1125] Notice of Temporary Restriction of Vehicle Use and Temporary Closure to Tree Cutting and Wood... motorized vehicles to existing posted roads and two-track trails and issuing a temporary closure to wood... and a temporary closure to tree cutting and wood collecting on areas burned by the TRE and Preacher...

  19. Placement Of Cardiac PacemaKEr Trial (POCKET – rationale and design: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Peter Magnusson

    2017-04-01

    Full Text Available Background: A pacemaker system consists of one or two leads connected to a device that is implanted into a pocket formed just below the collarbone. This pocket is typically subcutaneous, that is, located just above the pectoral fascia. Even though the size of pacemakers has decreased markedly, complications due to superficial implants do occur. An alternative technique would be intramuscular placement of the pacemaker device, but there are no randomized controlled trials (RCTs to support this approach, which is the rationale for the Placement Of Cardiac PacemaKEr Trial (POCKET. The aim is to study if intramuscular is superior to subcutaneous placement of a pacemaker pocket. Methods: In October 2016, we started to enroll 200 consecutive patients with an indication for bradycardia pacemaker implantation. Patients are randomized to random block sizes, stratified by age group (cut-off: 65 years and sex, and then randomized to either subcutaneous or intramuscular implant. A concealed allocation procedure is employed, using sequentially numbered, sealed envelopes. Pocket site is blinded to the patient and in all subsequent care. The primary endpoint is patient overall satisfaction with the pocket location at 24 months as measured using a visual analog scale (VAS 0-10. Secondary endpoints are: complications, patient-reported satisfaction at 1, 12, and 24 months (overall satisfaction, pain, discomfort, degree of unsightly appearance, movement problems, and sleep problems due to device. Conclusions: POCKET is a prospective interventional RCT designed to evaluate if intramuscular is superior to subcutaneous placement of a bradycardia pacemaker during a two-year follow-up.

  20. Placement Of Cardiac PacemaKEr Trial (POCKET – rationale and design: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Peter Magnusson

    2017-04-01

    Full Text Available BackgroundA pacemaker system consists of one or two leads connected to a device that is implanted into a pocket formed just below the collarbone. This pocket is typically subcutaneous, that is, located just above the pectoral fascia. Even though the size of pacemakers has decreased markedly, complications due to superficial implants do occur. An alternative technique would be intramuscular placement of the pacemaker device, but there are no randomized controlled trials (RCTs to support this approach, which is the rationale for the Placement Of Cardiac PacemaKEr Trial (POCKET. The aim is to study if intramuscular is superior to subcutaneous placement of a pacemaker pocket.MethodsIn October 2016, we started to enroll 200 consecutive patients with an indication for bradycardia pacemaker implantation. Patients are randomized to random block sizes, stratified by age group (cut-off: 65 years and sex, and then randomized to either subcutaneous or intramuscular implant. A concealed allocation procedure is employed, using sequentially numbered, sealed envelopes. Pocket site is blinded to the patient and in all subsequent care. The primary endpoint is patient overall satisfaction with the pocket location at 24 months as measured using a visual analog scale (VAS 0-10. Secondary endpoints are: complications, patient-reported satisfaction at 1, 12, and 24 months (overall satisfaction, pain, discomfort, degree of unsightly appearance, movement problems, and sleep problems due to device.ConclusionsPOCKET is a prospective interventional RCT designed to evaluate if intramuscular is superior to subcutaneous placement of a bradycardia pacemaker during a two-year follow-up.

  1. Long-Term Mortality Effect of Early Pacemaker Implantation After Surgical Aortic Valve Replacement.

    Science.gov (United States)

    Greason, Kevin L; Lahr, Brian D; Stulak, John M; Cha, Yong-Mei; Rea, Robert F; Schaff, Hartzell V; Dearani, Joseph A

    2017-10-01

    The need for pacemaker implantation is a well-described complication of aortic valve replacement. Not so well described is the effect such an event has on long-term outcome. This study reviewed a 21-year experience at the Mayo Clinic (Rochester, Minnesota) with aortic valve replacement to understand the influence of early postoperative pacemaker implantation on long-term mortality rates more clearly. This study retrospectively reviewed the records of 5,842 patients without previous pacemaker implantation who underwent surgical aortic valve replacement from January 1993 through June 2014. The median age of these patients was 73 years (range, 65 to 79 years), the median ejection fraction was 62% (range, 53% to 68%), 3,853 patients were male (66%), and coronary artery bypass graft operation was performed in 2,553 (44%) of the patients studied. Early pacemaker implantation occurred in 146 patients (2.5%) within 30 days of surgical aortic valve replacement. The median follow-up of patients was 11.1 years (range, 5.8 to 16.5 years), and all-cause mortality rates were 2.4% at 30 days, 6.4% at 1 year, 23.1% at 5 years, 48.3% at 10 years, and 67.9% at 15 years postoperatively. Early pacemaker implantation was associated with an increased risk of death after multivariable adjustment for baseline patients' characteristics (hazard ratio, 1.49; 95% confidence interval, 1.20, 1.84; p pacemaker implantation as a complication of surgical aortic valve replacement is associated with an increased risk of long-term death. Valve replacement-related pacemaker implantation rates should be important considerations with respect to new valve replacement paradigms, especially in younger and lower-risk patients. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-01

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

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

    International Nuclear Information System (INIS)

    Kirova, Youlia M.; Menard, Jean; Chargari, Cyrus; Mazal, Alejandro; Kirov, Krassen

    2012-01-01

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

  4. Put Your Cable Wiring to the Test.

    Science.gov (United States)

    Day, C. William

    2001-01-01

    Discusses why schools and universities should use testing procedures in any wire bid specification for cable wiring and also know how experienced the installers are in testing and installing structured cabling systems. Key cabling terms are included. (GR)

  5. Novel Wiring Technologies for Aerospace Applications

    Science.gov (United States)

    Gibson, Tracy L.; Parrish, Lewis M.

    2014-01-01

    Because wire failure in aerospace vehicles could be catastrophic, smart wiring capabilities have been critical for NASA. Through the years, researchers at Kennedy Space Center (KSC) have developed technologies, expertise, and research facilities to meet this need. In addition to aerospace applications, NASA has applied its knowledge of smart wiring, including self-healing materials, to serve the aviation industry. This webinar will discuss the development efforts of several wiring technologies at KSC and provide insight into both current and future research objectives.

  6. Clinical bending of nickel titanium wires

    OpenAIRE

    Stephen Chain; Priyank Seth; Namrata Rastogi; Kenneth Tan; Mayank Gupta; Richa Singh

    2015-01-01

    Since the evolution and the involvement of Nickel Titanium wires in the field of Orthodontics. The treatment plan has evolved with the use of low force Nickel Titanium wires. Because of their high springback, low stiffness, they are the key initial wires in leveling and alignment but have poor formability. Since poor formability limits its ability to create variable arch forms thus; limits the form of treatment. We have devised a method to bend the Nickel Titanium wires to help in our invento...

  7. Towards Unconventional Applications of Wire Bonding

    OpenAIRE

    Schröder, Stephan

    2018-01-01

    This thesis presents novel heterogeneous integration approaches of wire materials to fabricated and package MEMS devices by exploring unconventional applications of wire bonding technology. Wire bonding, traditionally endemic in the realm of device packaging to establish electrical die-to-package interconnections, is an attractive back-end technology, offering promising features, such as high throughput, flexibility and placement accuracy. Exploiting the advantages of state-of-the-art wire bo...

  8. Different mechanical properties in Seldinger guide wires

    Directory of Open Access Journals (Sweden)

    Wolfram Schummer

    2015-01-01

    Full Text Available Background and Aims: Most central venous catheters are placed using Seldinger guide wires. EN ISO 11070 is the guideline for testing guide wire flexing performance and tensile strength, and we can safely assume that guide wires in use meet these requirements. Unfortunately, EN ISO 11070 guidelines do not reflect the clinical requirements and we continue to see mechanical failures and their associated complications. Material and Methods: This in vitro study was performed in an accredited laboratory. With regard to flexing, we: (1 Established the minimum flexing performance needed to meet clinical requirements, (2 developed flexing performance tests which mimic clinical requirement, and (3 evaluated the mechanical properties of various guide wires relative to these requirements. With regard to tensile strength, we used the testing method prescribed in ISO 11070, but did not end the test at 5 Newton (N. We continued until the guide wire was damaged, or we reached maximum tractive force. We then did a wire-to-wire comparison. We examined two basic wire constructions, monofil and core and coil. Results: Tensile strength: All wires tested, except one, met EN ISO 11070 requirements for 5 N tensile strength. The mean of the wire types tested ranged from 15.06 N to 257.76 N. Flexing performance: None of the wires kinked. The monofil had no evidence of bending. Two core/coil wires displayed minor bending (angle 1.5°. All other wires displayed bending angles between 22.5° and 43.0°. Conclusion: We recommend that: (1 Clinicians use guide wires with high-end mechanical properties, (2 EN ISO 11070 incorporate our flexing test into their testing method, raise the flexing requirement to kink-proof, (3 and raise the tensile strength requirement to a minimum of 30 N, and (3 all manufacturers and suppliers be required to display mechanical properties of all guide wire, and guide wire kits sold.

  9. Vocational Preparation Curriculum: Electrical Wiring.

    Science.gov (United States)

    Usoro, Hogan

    This document is a curriculum guide for instructors teaching vocational preparation for electrical wiring to special needs students. The purpose of the curriculum guide is to provide minimum skills for disadvantaged and handicapped students entering the mainstream; to supplement vocational skills of those students already in a regular training…

  10. Transparency in nanophotonic quantum wires

    International Nuclear Information System (INIS)

    Singh, Mahi R

    2009-01-01

    We have studied the quantum optics of a photonic quantum nanowire doped with an ensemble of three-level nanoparticles. The wire is made from two photonic crystals A and B. Crystal A is embedded within crystal B and acts as a photonic nanowire. It is considered that the conduction band of crystal A lies below that of crystal B. As a result, photons are confined in crystal A and are reflected from crystal B. The bound states of the confined photons are calculated using the transfer matrix method. It is found that the number of bound states in the wire depends on the size of the wire and the energy difference between the conduction band extrema of crystals A and B. The absorption coefficient of the system has also been calculated using the Schroedinger equation method. It is considered that the nanoparticles interact with the photonic bound states. Numerical simulations show that when one of the resonance energies lies near the bound state, the system becomes transparent. However, when the resonance energy lies away from the bound state the crystal reverts to an absorbing state. Similarly, when the radius of the dielectric spheres is changed the location of the transparency peak is shifted. This means that the present system can be switched between two states by changing the size of the wire and the transition energy. These findings can be used to make new types of optical devices.

  11. Health care's 100 most wired.

    Science.gov (United States)

    Solovy, A; Serb, C

    1999-02-01

    They're wired all right, and America's 100 most techno-savvy hospitals and health systems share one more thing: a commitment to using technology to link with employees, patients, suppliers, and insurers. "We want to be a health care travel agency for our community," says one chief information officer. "And we see Internet technology as a key."

  12. Multi-anode wire straw tube tracker

    International Nuclear Information System (INIS)

    Oh, S.H.; Ebenstein, W.L.; Wang, C.W.

    2011-01-01

    We report on a test of a straw tube detector design having several anode (sense) wires inside a straw tube. The anode wires form a circle inside the tube and are read out independently. This design could solve several shortcomings of the traditional single wire straw tube design such as double hit capability and stereo configuration.

  13. Home and School Technology: Wired versus Wireless.

    Science.gov (United States)

    Van Horn, Royal

    2001-01-01

    Presents results of informal research on smart homes and appliances, structured home wiring, whole-house audio/video distribution, hybrid cable, and wireless networks. Computer network wiring is tricky to install unless all-in-one jacketed cable is used. Wireless phones help installers avoid pre-wiring problems in homes and schools. (MLH)

  14. On the preparation of superconducting wires

    International Nuclear Information System (INIS)

    Topare, R.J.; Chinchure, A.D.; Shah, S.S.; Hadole, G.B.

    1993-01-01

    The different methods of preparation of superconducting wires have been discussed. The powder-in-tube technique is followed for the preparation of YBCO and BISCCO superconducting wires. The results are discussed. The present status of the industries in preparing the superconducting wires having the maximum J c values is discussed. (author). 30 refs., 6 figs., 2 tabs

  15. Pre-wired systems prove their worth.

    Science.gov (United States)

    2012-03-01

    The 'new generation' of modular wiring systems from Apex Wiring Solutions have been specified for two of the world's foremost teaching hospitals - the Royal London and St Bartholomew's Hospital, as part of a pounds sterling 1 billion redevelopment project, to cut electrical installation times, reduce on-site waste, and provide a pre-wired, factory-tested, power and lighting system. HEJ reports.

  16. 75 FR 4584 - Wire Decking From China

    Science.gov (United States)

    2010-01-28

    ... COMMISSION Wire Decking From China AGENCY: United States International Trade Commission. ACTION: Scheduling... retarded, by reason of subsidized and less-than-fair-value imports from China of wire decking, provided for..., producers, or exporters in China of wire decking, and that such ] products are being sold in the United...

  17. [Temporary disability and its legal implications].

    Science.gov (United States)

    Martin-Fumadó, Carles; Martí Amengual, Gabriel; Puig Bausili, Lluïsa; Arimany-Manso, Josep

    2014-03-01

    Temporary disability is the condition that workers face when, as the result of illness (common or professional) or accident (work-related or not), they are temporarily prevented from performing their work and require health care. The management of temporary disability is a medical act that involves (in addition to a complex clinical assessment) obvious social, occupational and financial connotations and requires continuing medical follow-up from doctors, as well as responses to medical-legal conflicts. The regulatory framework on the subject is extensive in the Spanish setting and highly diverse in the European setting. Beyond the regulatory framework, the repercussions of temporary disability are self-evident at all levels. Although determining temporary disability is a common medical act for practicing physicians, it is not exempt from risks or difficulties arising from the assessment itself and the characteristics of practicing medical care. Established medical-legal conflicts include the processing of health data and the requirements for transferring information related to workers' temporary disability to their company's medical services. The interest and usefulness demonstrated by the data obtained from forensic medicine for public health require the incorporation of these data into general healthcare information, as it could be essential to the surveillance of worker health. The recommendations established by medical societies, as good practice guidelines, are especially useful in this type of conflict. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  18. Interference of neodymium magnets with cardiac pacemakers and implantable cardioverter-defibrillators: an in vitro study.

    Science.gov (United States)

    Ryf, Salome; Wolber, Thomas; Duru, Firat; Luechinger, Roger

    2008-01-01

    Permanent magnets may interfere with the function of cardiac pacemakers and implantable cardioverter-defibrillators (ICDs). Neodymium-iron-boron (NdFeB) magnets have become widely available in recent years and are incorporated in various articles of daily life. We conducted an in-vitro study to evaluate the ability of NdFeB magnets for home and office use to cause interference with cardiac pacemakers and ICDs. The magnetic fields of ten NdFeB magnets of different size and shape were measured at increasing distances beginning from the surface until a field-strength (B-field) value of 0.5 mT was reached. Furthermore, for each magnet the distance was determined at which a sample pacemaker switched from magnet mode to normal mode. Depending on the size and remanence of individual magnets, a B-field value of 0.5 mT was found at distances ranging from 1.5 cm to 30 cm and a value of 1 mT at distances from 1 cm to 22 cm. The pacemaker behavior was influenced at distances from 1 cm to 24 cm. NdFeB magnets for home and office use may cause interference with cardiac pacemakers and ICDs at distances up to 24 centimeters. Patient education and product declarations should include information about the risk associated with these magnets.

  19. Pre-ejection period by radial artery tonometry supplements echo doppler findings during biventricular pacemaker optimization

    Directory of Open Access Journals (Sweden)

    Qamruddin Salima

    2011-07-01

    Full Text Available Abstract Background Biventricular (Biv pacemaker echo optimization has been shown to improve cardiac output however is not routinely used due to its complexity. We investigated the role of a simple method involving computerized pre-ejection time (PEP assessment by radial artery tonometry in guiding Biv pacemaker optimization. Methods Blinded echo and radial artery tonometry were performed simultaneously in 37 patients, age 69.1 ± 12.8 years, left ventricular (LV ejection fraction (EF 33 ± 10%, during Biv pacemaker optimization. Effect of optimization on echo derived velocity time integral (VTI, ejection time (ET, myocardial performance index (MPI, radial artery tonometry derived PEP and echo-radial artery tonometry derived PEP/VTI and PEP/ET indices was evaluated. Results Significant improvement post optimization was achieved in LV ET (286.9 ± 37.3 to 299 ± 34.6 ms, p Conclusion An acute shortening of PEP by radial artery tonometry occurs post Biv pacemaker optimization and correlates with improvement in hemodynamics by echo Doppler and may provide a cost-efficient approach to assist with Biv pacemaker echo optimization.

  20. Early Performance and Safety of the Micra Transcatheter Pacemaker in Pigs.

    Science.gov (United States)

    Bonner, Matthew; Eggen, Michael; Haddad, Tarek; Sheldon, Todd; Williams, Eric

    2015-11-01

    The Micra® Transcatheter Pacing System (TPS; Medtronic Inc., Minneapolis, MN, USA) is a miniaturized single-chamber pacemaker system that is delivered via catheter through the femoral vein. In this study, the electrical performance was compared between the TPS and a traditional leaded pacemaker. In addition, the safety profile of the two systems was compared by thorough monitoring for a number of adverse events. The TPS was implanted in the right ventricular apex of 10 Yucatan mini pigs and a Medtronic single-lead pacemaker (SLP) was implanted in the right ventricular apex of another 10 pigs and connected to a traditional pacemaker. The electrical performance of all devices was monitored for 12 weeks. The safety profile of each system was characterized using x-ray, computed tomography, ultrasound, blood work, and necropsy to monitor for a variety of adverse events. At implant the mean pacing thresholds were 0.58 ± 0.17 V @0.24 ms and 0.75 ± 0.29 V @0.21 ms for the TPS and the SLP respectively. After 12 weeks, mean thresholds were 0.94 ± 0.46 V and 1.85 ± 0.75 V (P pacemaker system. © 2015 Medtronic PLC. Pacing and Clinical Electrophysiology published by Wiley Periodicals, Inc.

  1. Characteristics and Prognosis of Pacemaker-Identified New-Onset Atrial Fibrillation in Japanese People.

    Science.gov (United States)

    Ogino, Yutaka; Ishikawa, Toshiyuki; Ishigami, Tomoaki; Matsumoto, Katsumi; Hosoda, Junya; Iguchi, Kouhei; Matsushita, Hirooki; Taguchi, Yuka; Horiguchi, Yoriko; Kimura, Kazuo

    2017-05-25

    The characteristics and prognosis of implanted pacemaker-identified new-onset atrial fibrillation (AF) in Japanese people has not been well evaluated.Methods and Results:A total of 395 consecutive patients with newly implanted pacemakers were retrospectively analyzed between January 2010 and December 2015 at Yokohama City University Hospital. Patients with a prior history of AF, VVI mode pacemaker, congenital heart disease, severe valvular heart disease, and cardiovascular surgery before pacemaker implantation were excluded. Among the remaining patients, 44 (21.3%) developed new AF during follow-up (mean follow-up, 1,115±651 days; range, 9-2,176 days). Patients with new-onset AF had a significantly higher CHADS 2 score (2.09±1.27 vs. 1.31±1.08, Ppacemaker-implanted patients with high CHADS 2 and CHA 2 DS 2 -VASc scores developed new-onset AF during a mean follow-up of 3.1 years; and pacemaker-identified AF was associated with an increased risk of worsening heart failure.

  2. Surgical outcome of Fontan conversion and arrhythmia surgery: Need a pacemaker?

    Science.gov (United States)

    Terada, Takafumi; Sakurai, Hajime; Nonaka, Toshimichi; Sakurai, Takahisa; Sugiura, Junya; Taneichi, Tetsuyoshi; Ohtsuka, Ryohei

    2014-07-01

    Atrial tachyarrhythmias are frequent complications in the late period after the Fontan procedure, and important risk factors for a poor prognosis. The impact of Fontan conversion and arrhythmia surgery in failed Fontan patients has been described in many reports. We evaluated our experience with Fontan conversion procedures, concomitant arrhythmia surgery, and pacemaker implantation. We reviewed the hospital records of 25 consecutive patients who underwent a Fontan conversion procedure from January 2004 to March 2012. Twenty-four patients had arrhythmia surgery using cryoablation and radiofrequency ablation at the time of conversion. A bilateral atrial maze procedure was performed in 6 patients, right-side maze in 15, and isthmus block in 3. Three patients with a diagnosis of corrected transposition of the great arteries underwent simultaneous pacemaker implantation electively. There was no early death and one late death during a mean follow-up period of 21.2 months. Three tachyarrhythmia recurrences developed, and there were 4 occurrences of sinus bradycardia. Five of these patients required postoperative pacemaker implantation. The mid-term results of Fontan conversion and arrhythmia surgery in our institute were satisfactory. The occurrence of unexpected postoperative pacemaker requirement was high in the patients who underwent a right atrial or bilateral atrial maze procedure. Pacemaker or lead implantation is recommended for patients planned to undergo a right-side or full maze procedure. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  3. Pacemaker System Malfunction Resulting from External Electrical Cardioversion: A Case Report

    Directory of Open Access Journals (Sweden)

    Taku Nishida, MD

    2009-01-01

    Full Text Available In May 2005 a 68-year-old woman received a VDD pacemaker implantation in the right pectoral region at our hospital for the treatment of complete atrioventricular block. In July 2008, she was diagnosed with dilated cardiomyopathy based on histological testing. In November 2008, she developed syncope due to ventricular tachycardia while at another hospital. She underwent external electrical cardioversion with an anterior-lateral paddle position using a single shock of 100 J. This shock led to severe bradycardia resulting in a transfer to our hospital. The physician who provided the shock could not have been aware that the patient had an implanted pacemaker. The skin above the pulse generator was burned. The electrocardiogram showed no pacing spikes or ventricular escape rhythm. Investigation of the pacemaker 3 hours after cardioversion revealed reprogramming of the device and a marked rise in the lead impedance (>3,000 ohm. Removal of the generator and implantation of a biventricular cardioverter defibrillator were required. The emergency situation, the small size of the generator, the small incision made using the buried suture method, and the patient's obesity all probably contributed to the physician's not noticing the implanted pacemaker. It is important to increase awareness of the severe consequences that may follow if the physician administering external defibrillation does not know about the patient's implanted pacemaker.

  4. Recovery of Ventriculo-Atrial Conduction after Adrenaline in Patients Implanted with Pacemakers.

    Science.gov (United States)

    Cismaru, Gabriel; Gusetu, Gabriel; Muresan, Lucian; Rosu, Radu; Andronache, Marius; Matuz, Roxana; Puiu, Mihai; Mester, Petru; Miclaus, Maria; Pop, Dana; Mircea, Petru Adrian; Zdrenghea, Dumitru

    2015-07-01

    Ventriculo-atrial (VA) conduction can have negative consequences for patients with implanted pacemakers and defibrillators. There is concern whether impaired VA conduction could recover during stressful situations. Although the influence of isoproterenol and atropine are well established, the effect of adrenaline has not been studied systematically. The objective of this study was to determine if adrenaline can facilitate recovery of VA conduction in patients implanted with pacemakers. A prospective study was conducted on 61 consecutive patients during a 4-month period (April-July 2014). The presence of VA conduction was assessed during the pacemaker implantation procedure. In case of an impaired VA conduction, adrenaline infusio was used as a stress surrogate to test conduction recovery. The indications for pacemaker implantation were: sinus node dysfunction in 18 patients, atrioventricular (AV) block in 40 patients, binodal dysfunction (sinus node+ AV node) in two patients and other (carotid sinus syndrome) in one patient. In the basal state, 15/61 (24.6%) presented spontaneous VA conduction and 46/61 (75.4%) had no VA conduction. After administration of adrenaline, there was VA conduction recovery in 5/46 (10.9%) patients. Adrenaline infusion produced recovery of VA conduction in 10.9% of patients with absent VA conduction in a basal state. Recovery of VA conduction during physiological or pathological stresses could be responsible for the pacemaker syndrome, PMT episodes, or certain implantable cardiac defibrillator detection issues. © 2015 Wiley Periodicals, Inc.

  5. Clinical bending of nickel titanium wires

    Directory of Open Access Journals (Sweden)

    Stephen Chain

    2015-01-01

    Full Text Available Since the evolution and the involvement of Nickel Titanium wires in the field of Orthodontics. The treatment plan has evolved with the use of low force Nickel Titanium wires. Because of their high springback, low stiffness, they are the key initial wires in leveling and alignment but have poor formability. Since poor formability limits its ability to create variable arch forms thus; limits the form of treatment. We have devised a method to bend the Nickel Titanium wires to help in our inventory but also customized the wire according to the treatment.

  6. Emittance growth due to Tevatron flying wires

    Energy Technology Data Exchange (ETDEWEB)

    Syphers, M; Eddy, Nathan

    2004-06-01

    During Tevatron injection, Flying Wires have been used to measure the transverse beam size after each transfer from the Main Injector in order to deduce the transverse emittances of the proton and antiproton beams. This amounts to 36 + 9 = 45 flies of each of 3 wire systems, with an individual wire passing through each beam bunch twice during a single ''fly''. below they estimate the emittance growth induced by the interaction of the wires with the particles during these measurements. Changes of emittance from Flying Wire measurements conducted during three recent stores are compared with the estimations.

  7. Complete Congenital Heart Block in a Neonatal Lupus Erythematosus Associated with Pulmonary Involvement without Pacemaker Implantation: A Case Report

    Directory of Open Access Journals (Sweden)

    Yazdan Ghandi

    2016-10-01

    Conclusion: This case report was conducted on a newborn with CCHB associated with pulmonary disorder. The newborn was intubated due to respiratory distress and did not need pacemaker implantation; however, after 8-month follow up, excellent outcomes were observed. It seems that atelectasis and mechanical ventilation can intolerance, and pacemaker implantation did not need in NLE with CCHB with narrowing QRS complex.

  8. Trends in service time of pacemakers in the Netherlands : A long-term nationwide follow-up study

    NARCIS (Netherlands)

    de Vries, L. M.; Leening, M. J. G.; Dijk, W. A.; Hooijschuur, C. A. M.; Stricker, B. H. C.; van Hemel, N. M.

    2017-01-01

    Aims: After decades of experience and strongly improved technology, service time of pacemaker generators is expected to increase. To test this hypothesis, we conducted a retrospective review of a large cohort of patients with a pacemaker. Methods: We reviewed data collected between 1984 and 2006 in

  9. Trends in service time of pacemakers in the Netherlands: A long-term nationwide follow-up study

    NARCIS (Netherlands)

    L.M. de Vries (Laura); M.J.G. Leening (Maarten); W.A. Dijk (Arnold); C.A.M. Hooijschuur (C. A M); B.H.Ch. Stricker (Bruno); N.M. van Hemel (Norbert)

    2017-01-01

    textabstractAims After decades of experience and strongly improved technology, service time of pacemaker generators is expected to increase. To test this hypothesis, we conducted a retrospective review of a large cohort of patients with a pacemaker. Methods We reviewed data collected between 1984

  10. Short- and long-term need for permanent pacemaker after transcatheter implantation of the Edwards Sapien aortic valve prosthesis.

    Science.gov (United States)

    Moreno, Raúl; Calvo, Luis; Sánchez-Recalde, Angel; Galeote, Guillermo; Jiménez-Valero, Santiago; López, Teresa; Plaza, Ignacio; González-Davia, Rosa; Ramírez, Ulises; Mesa, Jose Maria; Moreno-Gomez, Isidro; López-Sendón, José-Luis

    2015-11-01

    A permanent pacemaker is frequently needed after transcatheter aortic valve implantation, but the available data are mainly on the CoreValve system. To evaluate the need for new permanent pacemaker after implantation of the Edwards Sapien device, as well as related factors. We included the first 100 patients treated with the Edwards Sapien device at our institution. Of these, 12 had a permanent pacemaker before the procedure, and thus our study population was the remaining 88 patients. A permanent pacemaker was indicated in eight patients (9.1%) during hospitalization or at 30 days. After discharge, another four patients needed a pacemaker (at 42 days and three, 18, and 30 months). Two variables were associated with the need for pacemaker during hospitalization: previous dialysis (13% vs. 1%, p=0.042) and complete right bundle branch block before the procedure (25% vs. 5%, p=0.032). More than one month after the procedure, the characteristics associated with the need for pacemaker were plasma creatinine level (2.5±1.7 vs. 1.3±0.6 mg/dl, p=0.001) and previous myocardial infarction (50% vs. 10%, p=0.013). The rate of pacemaker implantation with the Edwards Sapien device was 9.1%. Right bundle branch block and dialysis were associated with this complication.

  11. Cardiac MRI in patients with complex CHD following primary or secondary implantation of MRI-conditional pacemaker system.

    Science.gov (United States)

    Al-Wakeel, Nadya; O h-Ici, Darach; Schmitt, Katharina R; Messroghli, Daniel R; Riesenkampff, Eugénie; Berger, Felix; Kuehne, Titus; Peters, Bjoern

    2016-02-01

    In patients with CHD, cardiac MRI is often indicated for functional and anatomical assessment. With the recent introduction of MRI-conditional pacemaker systems, cardiac MRI has become accessible for patients with pacemakers. The present clinical study aims to evaluate safety, susceptibility artefacts, and image reading of cardiac MRI in patients with CHD and MRI-conditional pacemaker systems. Material and methods CHD patients with MRI-conditional pacemaker systems and a clinical need for cardiac MRI were examined with a 1.5-T MRI system. Lead function was tested before and after MRI. Artefacts and image readings were evaluated using a four-point grading scale. A total of nine patients with CHD (mean age 34.0 years, range 19.5-53.6 years) received a total of 11 cardiac MRI examinations. Owing to clinical indications, seven patients had previously been converted from conventional to MRI-conditional pacemaker systems. All MRI examinations were completed without adverse effects. Device testing immediately after MRI and at follow-up showed no alteration of pacemaker device and lead function. Clinical questions could be addressed and answered in all patients. Cardiac MRI can be performed safely with high certainty of diagnosis in CHD patients with MRI-conditional pacemaker systems. In case of clinically indicated lead and box changing, CHD patients with non-MRI-conditional pacemaker systems should be considered for complete conversion to MRI-conditional systems.

  12. The proportion of asymptomatic recurrence after catheter ablation of atrial fibrillation in patients with a pacemaker for sick sinus syndrome

    Directory of Open Access Journals (Sweden)

    Yuki Osaka

    2017-09-01

    Conclusions: One-third of PAF patients with SSS and pacemakers recurred after multiple CA sessions. However, 65% of them were asymptomatic and difficult to be identified with conventional follow-up. Pacemaker interrogation significantly increased the detection rate of AF-recurrence.

  13. Temporary ischaemia induced by degradable starch microspheres

    International Nuclear Information System (INIS)

    Lote, K.

    1981-01-01

    Possible thrombogenic effects of degradable starch microspheres were investigated. Controlled temporary small intestinal ischaemia was induced by injection into the superior mesenteric artery in cats. Arterial flow consistently recovered after ischaemia. No consumption of blood platelets, fibrinogen, or Factor VIII was observed. Aggregation of human platelets was not influenced by microsphere exposure, and platelet retention in starch microsphere columns was minimal. No thrombosis was detected in feline small intestinal vessels in vivo nor did starch surfaces induce adhesion or aggregation of human platelets in vitro. Thus, no evidence of thrombotic hazards was found by inducing temporary intestinal ischaemia by starch microspheres. (Auth.)

  14. [The computer assisted pacemaker clinic at the regional hospital of Udine (author's transl)].

    Science.gov (United States)

    Feruglio, G A; Lestuzzi, L; Carminati, D

    1978-01-01

    For a close follow-up of large groups of pacemaker patients and for evaluation of long term pacing on a reliable statistical basis, many pacemaker centers in the world are now using computer systems. A patient data system with structured display records, designed to give complete, comprehensive and surveyable information and which are immediately retrievable 24 hours a day, on display or printed sets, seems to offer an ideal solution. The pacemaker clinic at the Regional Hospital of Udine has adopted this type of system. The clinic in linked to a live, on-line patient data system (G/3, Informatica Friuli-Venezia Giulia). The input and retrieval of information are made through a conventional keyboard. The input formats have fixed headings with coded alternatives and a limited space for comments in free text. The computer edits the coded information to surveyable reviews. Searches can be made on coded information and data of interest.

  15. A Parametric Computational Model of the Action Potential of Pacemaker Cells.

    Science.gov (United States)

    Ai, Weiwei; Patel, Nitish D; Roop, Partha S; Malik, Avinash; Andalam, Sidharta; Yip, Eugene; Allen, Nathan; Trew, Mark L

    2018-01-01

    A flexible, efficient, and verifiable pacemaker cell model is essential to the design of real-time virtual hearts that can be used for closed-loop validation of cardiac devices. A new parametric model of pacemaker action potential is developed to address this need. The action potential phases are modeled using hybrid automaton with one piecewise-linear continuous variable. The model can capture rate-dependent dynamics, such as action potential duration restitution, conduction velocity restitution, and overdrive suppression by incorporating nonlinear update functions. Simulated dynamics of the model compared well with previous models and clinical data. The results show that the parametric model can reproduce the electrophysiological dynamics of a variety of pacemaker cells, such as sinoatrial node, atrioventricular node, and the His-Purkinje system, under varying cardiac conditions. This is an important contribution toward closed-loop validation of cardiac devices using real-time heart models.

  16. Pacemaker optimization guided by echocardiography in cardiac resynchronization therapy

    Directory of Open Access Journals (Sweden)

    Trifunović Danijela

    2009-01-01

    Full Text Available Introduction. Cardiac resynchronization therapy (CRT or biventricular pacing is a contemporary treatment in the management of advanced heart failure. Echocardiography plays an evolving and important role in patient selection for CRT, follow-up of acute and chronic CRT effects and optimization of device settings after biventricular pacemaker implantation. In this paper we illustrate usefulness of echocardiography for successful AV and VV timing optimization in patients with CRT. A review of up-to-date literature concerning rationale for AV and VV delay optimization, echocardiographic protocols and current recommendations for AV and VV optimization after CRT are also presented. Outline of Cases. The first case is of successful AV delay optimization guided by echocardiography in a patient with dilated cardiomyopathy treated with CRT is presented. Pulsed blood flow Doppler was used to detect mitral inflow while programming different duration of AV delay. The AV delay with optimal transmittal flow was established. The optimal mitral flow was the one with clearly defined E and A waves and maximal velocity time integral (VTI of the mitral flow. Improvement in clinical status and reverse left ventricle remodelling with improvement of ejection fraction was registered in our patient after a month. The second case presents a patient with heart failure caused by dilated cardiomyopathy; six months after CRT implantation the patient was still NYHA class III and with a significantly depressed left ventricular ejection fraction. Optimization of VV interval guided by echocardiography was undertaken measuring VTI of the left ventricular outflow tract (LVOT during programming of different VV intervals. The optimal VV interval was determined using a maximal LVOT VTI. A month after VV optimization our patient showed improvement in LV ejection fraction. Conclusion. Optimal management of patients treated with CRT integrate both clinical and echocardiographic follow

  17. Setups for in vitro assessment of RFID interference on pacemakers

    International Nuclear Information System (INIS)

    Mattei, E; Censi, F; Delogu, A; Ferrara, A; Calcagnini, G

    2013-01-01

    The aim of this study is to propose setups for in vitro assessment of RFID (radiofrequency identification) interference on pacemakers (PM). The voltage induced at the input stage of the PM by low-frequency (LF) and high-frequency (HF) RFID transmitters has been used to quantify the amount of the interference. A commercial PM was modified in order to measure the voltage at its input stage when exposed to a sinusoidal signal at 125 kHz and 13.56 MHz. At both frequencies, two antennas with different dimensions (diameter = 10 cm and 30 cm, respectively) were used to generate the interfering field, and the induced voltage was measured between the lead tip and the PM case (unipolar voltage), and between the tip and ring electrodes (bipolar voltage). The typical lead configurations adopted in similar studies or proposed by international standards, as well as lead paths closer to actual physiological implants were tested. At 125 kHz, the worst-case condition differs for the two antennas: the 10 cm antenna induced the highest voltage in the two-loop spiral configuration, whereas the 30 cm antenna in the 225 cm 2 loop configuration. At 13.56 MHz, the highest voltage was observed for both the antennas in the 225 cm 2 loop configuration. Bipolar voltages were found to be lower than the unipolar voltages induced in the same configurations, this difference being not as high as one could expect from theoretical considerations. The worst-case scenario, in terms of the induced voltage at the PM input stage, has been identified both for LF and HF readers, and for two sizes of transmitting antennas. These findings may provide the basis for the definition of a standard implant configuration and a lead path to test the EMI effects of LF and HF RFID transmitters on active implantable devices. (paper)

  18. Electrophysiological Evidence for Intrinsic Pacemaker Currents in Crayfish Parasol Cells.

    Directory of Open Access Journals (Sweden)

    DeForest Mellon

    Full Text Available I used sharp intracellular electrodes to record from parasol cells in the semi-isolated crayfish brain to investigate pacemaker currents. Evidence for the presence of the hyperpolarization-activated inward rectifier potassium current was obtained in about half of the parasol cells examined, where strong, prolonged hyperpolarizing currents generated a slowly-rising voltage sag, and a post-hyperpolarization rebound. The amplitudes of both the sag voltage and the depolarizing rebound were dependent upon the strength of the hyperpolarizing current. The voltage sag showed a definite threshold and was non-inactivating. The voltage sag and rebound depolarization evoked by hyperpolarization were blocked by the presence of 5-10 mM Cs2+ ions, 10 mM tetraethyl ammonium chloride, and 10 mM cobalt chloride in the bathing medium, but not by the drug ZD 7288. Cs+ ions in normal saline in some cells caused a slight increase in mean resting potential and a reduction in spontaneous burst frequency. Many of the neurons expressing the hyperpolarization-activated inward potassium current also provided evidence for the presence of the transient potassium current IA, which was inferred from experimental observations of an increased latency of post-hyperpolarization response to a depolarizing step, compared to the response latency to the depolarization alone. The latency increase was reduced in the presence of 4-aminopyridine (4-AP, a specific blocker of IA. The presence of 4-AP in normal saline also induced spontaneous bursting in parasol cells. It is conjectured that, under normal physiological conditions, these two potassium currents help to regulate burst generation in parasol cells, respectively, by helping to maintain the resting membrane potential near a threshold level for burst generation, and by regulating the rate of rise of membrane depolarizing events leading to burst generation. The presence of post-burst hyperpolarization may depend upon IA channels in

  19. Superior transseptal approach to mitral valve is associated with a higher need for pacemaker implantation than the left atrial approach

    DEFF Research Database (Denmark)

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

    2006-01-01

    retrospectively evaluated. The surgeons used either the superior transseptal (group A) or left atrial approach (group B). The risk of pacemaker implantation associated with the superior transseptal approach as compared with the left atrial approach was estimated using the multivariate Cox regression analysis...... to adjust for possible confounders. RESULTS: We included 577 patients, 150 in group A and 427 in group B. Forty-four patients had a pacemaker implanted after the surgery; 17 in group A and 27 in group B (p = 0.010). The superior transseptal approach was an independent risk factor of pacemaker implantation...... in multivariate analysis (hazard ratio 2.2 [1.2 to 4.1], p = 0.014). Nineteen patients had a pacemaker implanted because of sinus node dysfunction; 9 in group A and 10 in group B (p = 0.017). Group A was an independent predictor of pacemaker implantation because of sinus node dysfunction in bivariate analyses...

  20. Risk of pacemaker implantation subsequent to radiotherapy for early-stage breast cancer in Denmark, 1982-2005

    DEFF Research Database (Denmark)

    Rehammar, Jens Christian; Videbaek, L.; Brock Johansen, J.

    2015-01-01

    . Objectives: The aim of this study was to examine the risk of severe conduction abnormalities evaluated by implantation of a pacemaker, subsequent to breast cancer radiotherapy. Methods: From the database of the Danish Breast Cancer Collaborative Group, we identified women treated with radiotherapy for early......-stage breast cancer in Denmark from 1982 to 2005. By record linkage to the Danish Pacemaker and ICD Registry information was retrieved on pacemaker implants subsequent to radiotherapy. Rate ratios (RR) of pacemaker implantation for left versus right sided breast cancer were calculated. Results: Among 18......,308 women treated with radiotherapy for early-stage breast cancer, 179 women had a pacemaker implanted subsequent to radiotherapy, 90 in 9,315 left sided and 89 in 8,993 right sided breast cancers. The unadjusted RR was 1.02 (0.76-1.36 95% CI, p=0.91) and the RR adjusted for year, age and time since...

  1. Gene- and cell-based bio-artificial pacemaker: what basic and translational lessons have we learned?

    Science.gov (United States)

    Li, R A

    2012-06-01

    Normal rhythms originate in the sino-atrial node, a specialized cardiac tissue consisting of only a few thousands of nodal pacemaker cells. Malfunction of pacemaker cells due to diseases or aging leads to rhythm generation disorders (for example, bradycardias and sick-sinus syndrome (SSS)), which often necessitate the implantation of electronic pacemakers. Although effective, electronic devices are associated with such shortcomings as limited battery life, permanent implantation of leads, lead dislodging, the lack of autonomic responses and so on. Here, various gene- and cell-based approaches, with a particular emphasis placed on the use of pluripotent stem cells and the hyperpolarization-activated cyclic nucleotide-gated-encoded pacemaker gene family, that have been pursued in the past decade to reconstruct bio-artificial pacemakers as alternatives will be discussed in relation to the basic biological insights and translational regenerative potential.

  2. Pacemaker neuron and network oscillations depend on a neuromodulator-regulated linear current

    Directory of Open Access Journals (Sweden)

    Shunbing Zhao

    2010-05-01

    Full Text Available Linear leak currents have been implicated in the regulation of neuronal excitability, generation of neuronal and network oscillations, and network state transitions. Yet, few studies have directly tested the dependence of network oscillations on leak currents or explored the role of leak currents on network activity. In the oscillatory pyloric network of decapod crustaceans neuromodulatory inputs are necessary for pacemaker activity. A large subset of neuromodulators is known to activate a single voltage-gated inward current IMI, which has been shown to regulate the rhythmic activity of the network and its pacemaker neurons. Using the dynamic clamp technique, we show that the crucial component of IMI for the generation of oscillatory activity is only a close-to-linear portion of the current-voltage relationship. The nature of this conductance is such that the presence or the absence of neuromodulators effectively regulates the amount of leak current and the input resistance in the pacemaker neurons. When deprived of neuromodulatory inputs, pyloric oscillations are disrupted; yet, a linear reduction of the total conductance in a single neuron within the pacemaker group recovers not only the pacemaker activity in that neuron, but also leads to a recovery of oscillations in the entire pyloric network. The recovered activity produces proper frequency and phasing that is similar to that induced by neuromodulators. These results show that the passive properties of pacemaker neurons can significantly affect their capacity to generate and regulate the oscillatory activity of an entire network, and that this feature is exploited by neuromodulatory inputs.

  3. Autaptic pacemaker mediated propagation of weak rhythmic activity across small-world neuronal networks

    Science.gov (United States)

    Yilmaz, Ergin; Baysal, Veli; Ozer, Mahmut; Perc, Matjaž

    2016-02-01

    We study the effects of an autapse, which is mathematically described as a self-feedback loop, on the propagation of weak, localized pacemaker activity across a Newman-Watts small-world network consisting of stochastic Hodgkin-Huxley neurons. We consider that only the pacemaker neuron, which is stimulated by a subthreshold periodic signal, has an electrical autapse that is characterized by a coupling strength and a delay time. We focus on the impact of the coupling strength, the network structure, the properties of the weak periodic stimulus, and the properties of the autapse on the transmission of localized pacemaker activity. Obtained results indicate the existence of optimal channel noise intensity for the propagation of the localized rhythm. Under optimal conditions, the autapse can significantly improve the propagation of pacemaker activity, but only for a specific range of the autaptic coupling strength. Moreover, the autaptic delay time has to be equal to the intrinsic oscillation period of the Hodgkin-Huxley neuron or its integer multiples. We analyze the inter-spike interval histogram and show that the autapse enhances or suppresses the propagation of the localized rhythm by increasing or decreasing the phase locking between the spiking of the pacemaker neuron and the weak periodic signal. In particular, when the autaptic delay time is equal to the intrinsic period of oscillations an optimal phase locking takes place, resulting in a dominant time scale of the spiking activity. We also investigate the effects of the network structure and the coupling strength on the propagation of pacemaker activity. We find that there exist an optimal coupling strength and an optimal network structure that together warrant an optimal propagation of the localized rhythm.

  4. Runtime Verification of Pacemaker Functionality Using Hierarchical Fuzzy Colored Petri-nets.

    Science.gov (United States)

    Majma, Negar; Babamir, Seyed Morteza; Monadjemi, Amirhassan

    2017-02-01

    Today, implanted medical devices are increasingly used for many patients and in case of diverse health problems. However, several runtime problems and errors are reported by the relevant organizations, even resulting in patient death. One of those devices is the pacemaker. The pacemaker is a device helping the patient to regulate the heartbeat by connecting to the cardiac vessels. This device is directed by its software, so any failure in this software causes a serious malfunction. Therefore, this study aims to a better way to monitor the device's software behavior to decrease the failure risk. Accordingly, we supervise the runtime function and status of the software. The software verification means examining limitations and needs of the system users by the system running software. In this paper, a method to verify the pacemaker software, based on the fuzzy function of the device, is presented. So, the function limitations of the device are identified and presented as fuzzy rules and then the device is verified based on the hierarchical Fuzzy Colored Petri-net (FCPN), which is formed considering the software limits. Regarding the experiences of using: 1) Fuzzy Petri-nets (FPN) to verify insulin pumps, 2) Colored Petri-nets (CPN) to verify the pacemaker and 3) To verify the pacemaker by a software agent with Petri-network based knowledge, which we gained during the previous studies, the runtime behavior of the pacemaker software is examined by HFCPN, in this paper. This is considered a developing step compared to the earlier work. HFCPN in this paper, compared to the FPN and CPN used in our previous studies reduces the complexity. By presenting the Petri-net (PN) in a hierarchical form, the verification runtime, decreased as 90.61% compared to the verification runtime in the earlier work. Since we need an inference engine in the runtime verification, we used the HFCPN to enhance the performance of the inference engine.

  5. Vibrating wire for beam profile scanning

    Directory of Open Access Journals (Sweden)

    S. G. Arutunian

    1999-12-01

    Full Text Available A method that measures the transverse profile (emittance of the bunch by detecting radiation arising at the scattering of the bunch on scanning wire is widely used. In this work information about bunch scattering is obtained by measuring the oscillation frequency of the tightened scanning wire. In such a way, the system of radiation (or secondary particles extraction and measurement can be removed. The entire unit consists of a compact fork with tightened wire and a scanning system. Normal oscillation frequency of a wire depends on wire tension, its geometric parameters, and, in a second approximation, its elastic characteristics. Normal oscillations are generated by interaction of an alternating current through the wire with magnetic field of a permanent magnet. In this case, it is suggested that the magnetic field of the accelerator (field of dipole magnets or quadrupole magnets be used for excitation of oscillations. The dependence of oscillation frequency on beam scattering is determined by several factors, including changes of wire tension caused by transverse force of the beam and influence of beam self-field. Preliminary calculations show that the influence of wire heating will dominate. We have studied strain gauges on the basis of vibrating wire from various materials (tungsten, beryl bronze, and niobium zirconium alloys. A scheme of normal oscillation generation by alternating current in autogeneration circuit with automatic frequency adjustment was selected. A special method of wire fixation and elimination of transverse degrees of freedom allows us to achieve relative stability better than 10^{-5} during several days at a relative resolution of 10^{-6}. Experimental results and estimates of wire heating of existing scanners show that the wire heats up to a few hundred grades, which is enough for measurements. The usage of wire of micrometer thickness diminishes the problem of wire thermalization speed during the scanning of the bunch.

  6. Modifications in straight wire treatment.

    Science.gov (United States)

    Cardona, Alvin

    2010-01-01

    Orthodontic treatments have been modified with each new generation of clinicians. Today the emphasis is on facial esthetics and healthy temporomandibular joints. With orthopedic treatment, we can develop dental arches to get the necessary space to align the teeth and we can reach adequate function and esthetics, all within relatively good stability. By combining two-phase treatment with low friction fixed orthodontics and super elastic wires we produce light but continuous forces and we can provide better treatment than before. These types of forces cause physiological and functional orthopedic orthodontic reactions. The purpose of this article is to demonstrate our fixed orthopedic and orthodontic approach called "Modified Straight Wire" or "Physiologic Arch Technique." This technique is very successful with our patients because it can exert slow and continuous forces with minimal patient cooperation.

  7. Sintered wire cesium dispenser photocathode

    Science.gov (United States)

    Montgomery, Eric J; Ives, R. Lawrence; Falce, Louis R

    2014-03-04

    A photoelectric cathode has a work function lowering material such as cesium placed into an enclosure which couples a thermal energy from a heater to the work function lowering material. The enclosure directs the work function lowering material in vapor form through a low diffusion layer, through a free space layer, and through a uniform porosity layer, one side of which also forms a photoelectric cathode surface. The low diffusion layer may be formed from sintered powdered metal, such as tungsten, and the uniform porosity layer may be formed from wires which are sintered together to form pores between the wires which are continuous from the a back surface to a front surface which is also the photoelectric surface.

  8. Slice of LHC dipole wiring

    CERN Multimedia

    Dipole model slice made in 1994 by Ansaldo. The high magnetic fields needed for guiding particles around the Large Hadron Collider (LHC) ring are created by passing 12’500 amps of current through coils of superconducting wiring. At very low temperatures, superconductors have no electrical resistance and therefore no power loss. The LHC is the largest superconducting installation ever built. The magnetic field must also be extremely uniform. This means the current flowing in the coils has to be very precisely controlled. Indeed, nowhere before has such precision been achieved at such high currents. 50’000 tonnes of steel sheets are used to make the magnet yokes that keep the wiring firmly in place. The yokes constitute approximately 80% of the accelerator's weight and, placed side by side, stretch over 20 km!

  9. Pin Wire Coating Trip Report

    International Nuclear Information System (INIS)

    Spellman, G P

    2004-01-01

    A meeting to discuss the current pin wire coating problems was held at the Reynolds plant in Los Angeles on 2MAR04. The attendance list for Reynolds personnel is attached. there was an initial presentation which gave a brief history and the current status of pin wire coating at Reynolds. There was a presentation by Lori Primus on the requirements and issues for the coating. There was a presentation by Jim Smith of LANL on the chemistry and to some extent process development done to date. There was a long session covering what steps should be taken in the short term and, to a lesser extent, the long term. The coating currently being used is a blend of two polymers, polyethersulfone and polyparabanic acid (PPA) and some TiO2 filler. This system was accepted and put into production when the pin wire coating was outsourced to another company in 1974. When that company no longer was interested, the wire coating was brought in-house to Reynolds. At that time polyparabanic acid was actually a commercial product available from Exxon under the trade name Tradlon. However, it appears that the material used at Reynolds was synthesized locally. Also, it appears that a single large batch was synthesized in that time period and used up to 1997 when the supply ran out. The reason for the inclusion of TiO2 is not known although it does act as a rheological thickener. However, a more controlled thickening can be obtained with materials such as fumed silica. This material would have less likelihood of causing point imperfections in the coatings. Also, the mixing technique being used for all stages of the process is a relatively low shear ball mill process and the author recommends a high shear process such as a three roll paint mill, at least for the final mixing. Since solvent is added to the powder at Reynolds, it may be that they need to have the paint mill there

  10. Permanent Pacemaker-Induced Superior Vena Cava Syndrome: Successful Treatment by Endovascular Stent

    International Nuclear Information System (INIS)

    Lanciego, Carlos; Rodriguez, Mario; Rodriguez, Adela; Carbonell, Miguel A.; Garcia, Lorenzo Garcia

    2003-01-01

    The use of metallic stents in the management of benign and malignant superior vena cava syndrome (SVCS) is well documented. Symptomatic stenosis or occlusion of the SVC is a rare complication of a transvenous permanent pacemaker implant. Suggested treatments have included anticoagulation therapy, thrombolysis, balloon angioplasty and surgery. More recently, endovascular stenting has evolved as an attractive alternative but the data available in the literature are limited. We describe a case in which venous stenting with a Wallstent endoprosthesis was used successfully. The patient remains symptom free and with normal pacemaker function 36 months later

  11. Pacemaker activity and inhibitory neurotransmission in the colon of Ws/Ws mutant rats

    DEFF Research Database (Denmark)

    Albertí, Elena; Mikkelsen, Hanne Birte; Wang, Xuanyu

    2007-01-01

    The aim of this study was to characterize the pacemaker activity and inhibitory neurotransmission in the colon of Ws/Ws mutant rats, which harbor a mutation in the c-kit gene that affects development of interstitial cells of Cajal (ICC). In Ws/Ws rats, the density of KIT-positive cells was markedly...... as indirect innervation via ICC. In summary, loss of ICC markedly affects pacemaker and motor activities of the rat colon. Inhibitory innervation is largely maintained but nitrergic innervation is reduced possibly related to the loss of ICC-mediated relaxation....

  12. Wear of dragline wire ropes

    Energy Technology Data Exchange (ETDEWEB)

    Dayawansa, D.; Kuruppu, M.; Mashiri, F.; Bartosiewicz, H. [Monash University (Caulfield Campus), Caulfield East, Vic. (Australia). Department of Mechanical Engineering,

    2005-07-01

    Wire ropes are one of the most heavily used components in a dragline. Hoist ropes are subjected to fatigue due to the cyclic nature of load handling as well as due to rope bending over the sheaves and the drum under load. This leads to wire breaks due to fatigue. Accumulation of a number of wire breaks close to each other can have a detrimental effect on the rope. Furthermore, to allow for the increasing demand for higher load capacity coupled with the inconvenience of having very large ropes, the factor of safety is often compromised, which increases the wear rate. Drag ropes are also subjected to heavy loads. More importantly, they are allowed to drag along the rough mine surface subjecting them to external physical abrasion. This makes the life of drag ropes one of the lowest among those used in a dragline. Suspension and IBS ropes are relatively uniformly loaded during their regular usage although they need to withstand dynamic load cycles as well as bending. Hence they tend to last for a number of years on average. The paper analyses the wear types and their severity of each of these rope applications, and suggests methods to determine rope wear rates and the resulting rope life. The paper further gives suggestions for good operating and maintenance practice that can extend the rope life and help reduce the large expenditure associated with every major rope change in a dragline. 6 refs., 8 figs., 1 tab.

  13. 78 FR 24239 - Temporary Mailing Promotion

    Science.gov (United States)

    2013-04-24

    ... Temporary Mailing Promotion AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is... with offering a Technology Credit Promotion. This notice informs the public of the Postal Service's filing and takes other administrative steps. DATES: Comment Date: May 6, 2013. ADDRESSES: Submit comments...

  14. Temporary/portable nuclear fallout shelter

    International Nuclear Information System (INIS)

    Hampel, V.E.

    1991-01-01

    The design and invention of a temporary/portable fallout shelter has been described in context of schematic and representative embodiments. Tent structures are described which include disposable, exterior, semi-transparent plastic and/or fabric shield membranes covering a tent composed of stretched, tightly woven, rip-resistant fabric panels supported by tensile rods/wands. 16 figs

  15. Temporary tattoos: a novel OSCE assessment tool.

    Science.gov (United States)

    Gormley, Gerry; Menary, Allison; Layard, Brooke; Hart, Nigel; McCourt, Collette

    2013-08-01

    There are many issues regarding the use of real patients in objective structured clinical examinations (OSCEs). In dermatology OSCE stations, standardised patients (SPs) with clinical photographs are often used. Temporary transfer tattoos can potentially simulate skin lesions when applied to an SP. This study aims to appraise the use of temporary malignant melanoma tattoos within an OSCE framework. Within an 11-station OSCE, a temporary malignant melanoma tattoo was developed and applied to SPs in a 'skin lesion' OSCE station. A questionnaire captured the opinions of the candidate, SP and examiners, and the degree of perceived realism of each station was determined. Standard post hoc OSCE analysis determined the psychometric reliability of the stations. The response rates were 95.9 per cent of candidates and 100 per cent of the examiners and SPs. The 'skin lesion' station achieved the highest realism score compared with other stations: 89.0 per cent of candidates felt that the skin lesion appeared realistic; only 28 per cent of candidates had ever seen a melanoma before in training. The psychometric performance of the melanoma station was comparable with, and in many instances better than, other OSCE stations. Transfer tattoo technology facilitates a realistic dermatology OSCE station encounter. Temporary tattoos, alongside trained SPs, provide an authentic, standardised and reliable experience, allowing the assessment of integrated dermatology clinical skills. © 2013 John Wiley & Sons Ltd.

  16. Meaningful radiation worker training for temporary craftsmen

    International Nuclear Information System (INIS)

    Williams, S.L.

    1976-01-01

    The carefully organized Radiation Worker Training Program presented to permanently assigned personnel at a power reactor facility too often falls by the wayside when temporary craftsmen are brought in for an outage. Even though these temporary workers will frequently be assigned to outage jobs with high radiation and/or contamination exposures, their Radiation Worker Training is often squeezed into an already busy schedule, thus reducing its effectiveness. As an aid for evaluating the effectiveness of an existing Radiation Worker Training Program for temporary craftsmen or for setting up a new program, the following guides are presented and discussed in this paper: the training environment; the interest and meaningfulness of the presentation; the method or methods used for presentation of the training information; the use of demonstrations; trainee participation; and, measuring the amount and type of information retained by a trainee. Meaningful Radiation Worker Training for temporary craftsmen can pay big dividends. Craftsmen can be expected to make fewer mistakes, thus reducing radiation exposure and lessening the chance for the spread of contamination. The craftsmen will also benefit by being able to work longer and utility management will benefit by having lower outage costs

  17. Challenges of temporary protection in Syria

    Directory of Open Access Journals (Sweden)

    Ann Maymann

    2005-05-01

    Full Text Available Forced displacement is now a defining characteristic of Iraqi society and will remain so for years to come. Many have chosen to leave for neighbouring countries, particularly Syria and Jordan, but remain in a limbo of temporary protection.

  18. Temporary Chinese Migration to Madagascar: Local Perceptions ...

    African Journals Online (AJOL)

    This article fills a knowledge-gap in the literature on China in Africa by exploring local perceptions of temporary Chinese migrants in Madagascar, the growth of small-scale Chinese-owned import and retail businesses in the capital, and their impacts on Malagasy producers, utilizing the country's blanket and paper industries ...

  19. Pacemaker endocarditis: approach for lead extraction in endocarditis with large vegetations Endocardite em marca-passo: abordagem na extração do cabo-eletrodo em endocardite com grandes vegetações

    Directory of Open Access Journals (Sweden)

    Guillermo Nuncio Vaccarino

    2009-12-01

    Full Text Available The presence of large lead vegetations poses additional difficulties for explantation because many methods cannot be used due to the potential hazard of embolism. We report two patients with large vegetation on the ventricular lead due to endocarditis and one of them with an atrial septal defect associated. It was applied a combined technique of transvenous lead removal and sternotomy with cardiopulmonary bypass for the complete removal of pacemaker wires. This procedure resolved the pacemakers endocarditis safely and subsequently a new transvenous device was placed on the opposite site.A presença de grande crescimento vegetativo no eletrodo do marca-passo impõe dificuldades adicionais para a sua extração, pois alguns métodos não podem ser aplicados pelo risco potencial de embolismo. Reportamos dois pacientes com grande crescimento vegetativo no eletrodo ventricular, devido a endocardites, um deles com comunicação intraventricular associada. Foi aplicada uma técnica combinada de extração de eletrodo transvenosa e esternotomia com circulação extracorpórea para remoção completa dos cabos do marcapasso. Este procedimento resolveu a endocardite de marcapasso de maneira segura e, subsequentemente, foi colocado um novo dispositivo intravenoso no lado oposto.

  20. 21 CFR 872.3770 - Temporary crown and bridge resin.

    Science.gov (United States)

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3770 Temporary crown and bridge resin. (a... polymethylmethacrylate, intended to make a temporary prosthesis, such as a crown or bridge, for use until a permanent...

  1. En-masse retraction with a preformed nickel-titanium and stainless steel archwire assembly and temporary skeletal anchorage devices without posterior bonding.

    Science.gov (United States)

    Jee, Jeong-Hyun; Ahn, Hyo-Won; Seo, Kyung-Won; Kim, Seong-Hun; Kook, Yoon-Ah; Chung, Kyu-Rhim; Nelson, Gerald

    2014-09-01

    To evaluate the therapeutic effects of a preformed assembly of nickel-titanium (NiTi) and stainless steel (SS) archwires (preformed C-wire) combined with temporary skeletal anchorage devices (TSADs) as the sole source of anchorage and to compare these effects with those of a SS version of C-wire (conventional C-wire) for en-masse retraction. Thirty-one adult female patients with skeletal Class I or II dentoalveolar protrusion, mild-to-moderate anterior crowding (3.0-6.0 mm), and stable Class I posterior occlusion were divided into conventional (n = 15) and preformed (n = 16) C-wire groups. All subjects underwent first premolar extractions and en-masse retraction with pre-adjusted edgewise anterior brackets, the assigned C-wire, and maxillary C-tubes or C-implants; bonded mesh-tube appliances were used in the mandibular dentition. Differences in pretreatment and post-retraction measurements of skeletal, dental, and soft-tissue cephalometric variables were statistically analyzed. Both groups showed full retraction of the maxillary anterior teeth by controlled tipping and space closure without altered posterior occlusion. However, the preformed C-wire group had a shorter retraction period (by 3.2 months). Furthermore, the maxillary molars in this group showed no significant mesialization, mesial tipping, or extrusion; some mesialization and mesial tipping occurred in the conventional C-wire group. Preformed C-wires combined with maxillary TSADs enable simultaneous leveling and space closure from the beginning of the treatment without maxillary posterior bonding. This allows for faster treatment of dentoalveolar protrusion without unwanted side effects, when compared with conventional C-wire, evidencing its clinical expediency.

  2. En-masse retraction with a preformed nickel-titanium and stainless steel archwire assembly and temporary skeletal anchorage devices without posterior bonding

    Science.gov (United States)

    Jee, Jeong-Hyun; Ahn, Hyo-Won; Seo, Kyung-Won; Kook, Yoon-Ah; Chung, Kyu-Rhim; Nelson, Gerald

    2014-01-01

    Objective To evaluate the therapeutic effects of a preformed assembly of nickel-titanium (NiTi) and stainless steel (SS) archwires (preformed C-wire) combined with temporary skeletal anchorage devices (TSADs) as the sole source of anchorage and to compare these effects with those of a SS version of C-wire (conventional C-wire) for en-masse retraction. Methods Thirty-one adult female patients with skeletal Class I or II dentoalveolar protrusion, mild-to-moderate anterior crowding (3.0-6.0 mm), and stable Class I posterior occlusion were divided into conventional (n = 15) and preformed (n = 16) C-wire groups. All subjects underwent first premolar extractions and en-masse retraction with pre-adjusted edgewise anterior brackets, the assigned C-wire, and maxillary C-tubes or C-implants; bonded mesh-tube appliances were used in the mandibular dentition. Differences in pretreatment and post-retraction measurements of skeletal, dental, and soft-tissue cephalometric variables were statistically analyzed. Results Both groups showed full retraction of the maxillary anterior teeth by controlled tipping and space closure without altered posterior occlusion. However, the preformed C-wire group had a shorter retraction period (by 3.2 months). Furthermore, the maxillary molars in this group showed no significant mesialization, mesial tipping, or extrusion; some mesialization and mesial tipping occurred in the conventional C-wire group. Conclusions Preformed C-wires combined with maxillary TSADs enable simultaneous leveling and space closure from the beginning of the treatment without maxillary posterior bonding. This allows for faster treatment of dentoalveolar protrusion without unwanted side effects, when compared with conventional C-wire, evidencing its clinical expediency. PMID:25309863

  3. 30 CFR 47.44 - Temporary, portable containers.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Temporary, portable containers. 47.44 Section... TRAINING HAZARD COMMUNICATION (HazCom) Container Labels and Other Forms of Warning § 47.44 Temporary, portable containers. (a) The operator does not have to label a temporary, portable container if he or she...

  4. A Vibrating Wire System For Quadrupole Fiducialization

    Energy Technology Data Exchange (ETDEWEB)

    Wolf, Zachary

    2010-12-13

    A vibrating wire system is being developed to fiducialize the quadrupoles between undulator segments in the LCLS. This note provides a detailed analysis of the system. The LCLS will have quadrupoles between the undulator segments to keep the electron beam focused. If the quadrupoles are not centered on the beam axis, the beam will receive transverse kicks, causing it to deviate from the undulator axis. Beam based alignment will be used to move the quadrupoles onto a straight line, but an initial, conventional alignment must place the quadrupole centers on a straight line to 100 {micro}m. In the fiducialization step of the initial alignment, the position of the center of the quadrupole is measured relative to tooling balls on the outside of the quadrupole. The alignment crews then use the tooling balls to place the magnet in the tunnel. The required error on the location of the quadrupole center relative to the tooling balls must be less than 25 {micro}m. In this note, we analyze a system under construction for the quadrupole fiducialization. The system uses the vibrating wire technique to position a wire onto the quadrupole magnetic axis. The wire position is then related to tooling balls using wire position detectors. The tooling balls on the wire position detectors are finally related to tooling balls on the quadrupole to perform the fiducialization. The total 25 {micro}m fiducialization error must be divided between these three steps. The wire must be positioned onto the quadrupole magnetic axis to within 10 {micro}m, the wire position must be measured relative to tooling balls on the wire position detectors to within 15 {micro}m, and tooling balls on the wire position detectors must be related to tooling balls on the quadrupole to within 10 {micro}m. The techniques used in these three steps will be discussed. The note begins by discussing various quadrupole fiducialization techniques used in the past and discusses why the vibrating wire technique is our method

  5. Electro-mechanics of drift tube wires

    International Nuclear Information System (INIS)

    Milburn, R.H.

    1997-01-01

    The position and stability of the sense wires in very long drift tubes are affected by both gravitational and electrostatic forces, as well as by the wire tension. For a tube to be used as an element of a high-resolution detector all these forces and their effects must be understood in appropriately precise detail. In addition, the quality control procedures applied during manufacture and detector installation must be adequate to ensure that the internal wire positions remain within tolerances. It may be instructive to practitioners to review the simple theory of a taut wire in the presence of anisotropic gravitational and electrostatic fields to illustrate the conditions for stability, the equilibrium wire displacement from straightness, and the effect of the fields on the mechanical vibration frequencies. These last may be used to monitor the wire configuration externally. A number of practical formulae result and these are applied to illustrative examples. (orig.)

  6. Electromagnetic Behaviour of Metallic Wire Structures

    CERN Document Server

    Chui, S T

    2013-01-01

    Despite the recent development and interest in the photonics of metallic wire structures, the relatively simple concepts and physics often remain obscured or poorly explained to those who do not specialize in the field. Electromagnetic Behaviour of Metallic Wire Structures provides a clear and coherent guide to understanding these phenomena without excessive numerical calculations.   Including both background material and detailed derivations of the various different formulae applied, Electromagnetic Behaviour of Metallic Wire Structures describes how to extend basic circuit theory relating to voltages, currents, and resistances of metallic wire networks to include situations where the currents are no longer spatially uniform along the wire. This lays a foundation for a deeper understanding of the many new phenomena observed in meta-electromagnetic materials.   Examples of applications are included to support this new approach making Electromagnetic Behaviour of Metallic Wire Structures a comprehensive and ...

  7. Phosphorus in antique iron music wire.

    Science.gov (United States)

    Goodway, M

    1987-05-22

    Harpsichords and other wire-strung musical instruments were made with longer strings about the beginning of the 17th century. This change required stronger music wire. Although these changes coincided with the introduction of the first mass-produced steel (iron alloyed with carbon), carbon was not found in samples of antique iron harpsichord wire. The wire contained an amount of phosphorus sufficient to have impeded its conversion to steel, and may have been drawn from iron rejected for this purpose. The method used to select pig iron for wire drawing ensured the highest possible phosphorus content at a time when its presence in iron was unsuspected. Phosphorus as an alloying element has had the reputation for making steel brittle when worked cold. Nevertheless, in replicating the antique wire, it was found that lowcarbon iron that contained 0.16 percent phosphorus was easily drawn to appropriate gauges and strengths for restringing antique harpsichords.

  8. Sikkerhed af magnetisk resonans-skanning hos patienter med pacemaker og implanterbar defibrillator

    DEFF Research Database (Denmark)

    Al-Sabagh, Kifah Hekmat; Christensen, Britta Ege; Thøgersen, Anna Margrethe

    2010-01-01

    INTRODUCTION: The presence of a cardiac implantable device is ICD considered an absolute contraindication to magnetic resonance imaging (MRI). The purpose of this study was to evaluate the safety of performing MRI in patients with cardiac pacemakers and ICDs that had a compelling clinical need fo...

  9. Sikkerhed af magnetisk resonans-skanning hos patienter med pacemaker og implanterbar defibrillator

    DEFF Research Database (Denmark)

    Al-Sabagh, Kifah Hekmat; Christensen, Britta Ege; Thøgersen, Anna Margrethe

    2010-01-01

    The presence of a cardiac implantable device is ICD considered an absolute contraindication to magnetic resonance imaging (MRI). The purpose of this study was to evaluate the safety of performing MRI in patients with cardiac pacemakers and ICDs that had a compelling clinical need for MRI examinat...

  10. Dragoljub (Bata Adamov (1927-1996: The first pacemaker implantation in Serbia

    Directory of Open Access Journals (Sweden)

    Pavlović Siniša U.

    2017-01-01

    Full Text Available It has been over half a century since the implementation of pacemaker therapy in our country and the region. The first successful implantation of a pacemaker in former Yugoslavia and in Serbia took place on September 16, 1965 in “Dr. Dragiša Mišović” Clinical Hospital Centre, and this operation, with a team of doctors of the institution, was performed by surgeon Dragoljub (Bata Adamov (1927–1996. The first permanent pacemaker implantation was with epicardial leads with thoracotomy approach. The patient was operated on under general anesthesia, administered by anesthesiologist Predrag Lalević (1927–, and Dr. Adamov was assisted by Dr. Miša Albrecht (1933– and Dr. Milan Dragović (1933–2009. Although pacemaker therapy has since been widely proven and confirmed, it is necessary to remember the pioneers who introduced this kind of therapy to the region, as they deserve a distinguished place in the history of medicine in Serbia.

  11. Computational Model of Rabbit SA Node Pacemaker Activity Probed with Action Potential and Calcium Transient Clamp

    NARCIS (Netherlands)

    van Borren, Marcel M. J.; Zegers, Jan G.; Verkerk, Arie O.; Wilders, Ronald

    2007-01-01

    In the past decades, various computational models of the pacemaker activity of single sinoatrial (SA) nodal cells have been developed, building on data obtained in patch-clamp experiments on isolated SA nodal myocytes. These models show widely different results regarding the contribution of

  12. Potential interference of small neodymium magnets with cardiac pacemakers and implantable cardioverter-defibrillators.

    Science.gov (United States)

    Wolber, Thomas; Ryf, Salome; Binggeli, Christian; Holzmeister, Johannes; Brunckhorst, Corinna; Luechinger, Roger; Duru, Firat

    2007-01-01

    Magnetic fields may interfere with the function of cardiac pacemakers and implantable cardioverter-defibrillators (ICDs). Neodymium-iron-boron (NdFeB) magnets, which are small in size but produce strong magnetic fields, have become widely available in recent years. Therefore, NdFeB magnets may be associated with an emerging risk of device interference. We conducted a clinical study to evaluate the potential of small NdFeB magnets to interfere with cardiac pacemakers and ICDs. The effect of four NdFeB magnets (two spherical magnets 8 and 10 mm in diameter, a necklace made of 45 spherical magnets, and a magnetic name tag) was tested in forty-one ambulatory patients with a pacemaker and 29 patients with an ICD. The maximum distance at which the magnetic switch of a device was influenced was observed. Magnetic interference was observed in all patients. The maximum distance resulting in device interference was 3 cm. No significant differences were found with respect to device manufacturer and device types. Small NdFeB magnets may cause interference with cardiac pacemakers and ICDs. Patients should be cautioned about the interference risk associated with NdFeB magnets during daily life.

  13. Safety of magnetic resonance scanning without monitoring of patients with pacemakers

    DEFF Research Database (Denmark)

    Bertelsen, Litten; Petersen, Helen Høgh; Philbert, Berit Thornvig

    2017-01-01

    AIMS: The objective of this study was to investigate whether it is safe to perform 1.5-Tesla magnetic resonance imaging (MRI) scans in pacemaker (PM) patients without pulse oximetry or electrocardiogram monitoring and with no special specific absorption rate (SAR) or time limits, provided...

  14. Chronic performance of a leadless cardiac pacemaker: 1-year follow-up of the LEADLESS trial

    NARCIS (Netherlands)

    Knops, Reinoud E.; Tjong, Fleur V. Y.; Neuzil, Petr; Sperzel, Johannes; Miller, Marc A.; Petru, Jan; Simon, Jaroslav; Sediva, Lucie; de Groot, Joris R.; Dukkipati, Srinivas R.; Koruth, Jacob S.; Wilde, Arthur A. M.; Kautzner, Josef; Reddy, Vivek Y.

    2015-01-01

    A leadless cardiac pacemaker (LCP) system was recently introduced to overcome lead-related complications of conventional pacing systems. To date, long-term results of an LCP system are unknown. The aim of this study was to assess the complication incidence, electrical performance, and rate response

  15. Leadless pacemaker implantation in a patient with complex congenital heart disease and limited vascular access

    Directory of Open Access Journals (Sweden)

    Paolo Ferrero

    2016-11-01

    Full Text Available Management of rhythm related issues might be particularly challenging in patients with congenital heart disease due to complex anatomy and restricted vascular access. The leadless technology appears a suitable and attractive alternative for this population. We describe a patient with single ventricle physiology who successfully underwent implantation of a leadless pacemaker.

  16. Cardiac Pacemaker Insertion in the South-South Region of Nigeria ...

    African Journals Online (AJOL)

    TNHJOURNALPH

    MEMORIA. URT. L. TEACHING. SPECIALI. HOSPITAL. ST. HOSPITAL. (BMSH). The Challenges To Pacemaker Insertion. In South-South Nigeria. The challenges based on the current state are that medical tourism booms to the detriment of capacity and infrastructural development in the sub region. In addition many tertiary.

  17. No impact of physical activity on the period of the circadian pacemaker in humans

    NARCIS (Netherlands)

    Beersma, DGM; Hiddinga, AE

    1998-01-01

    The intrinsic period tau of the circadian pacemaker in humans was investigated by means of forced desynchrony. In this protocol, during 6 scheduled days, the sleep-wake alternation was forced to a period of 20h (i.e., 13.5h for wakefulness and 6.5h for sleep). Light intensity was kept below 10 lux.

  18. Improvement of computed tomography scans quality for cancer patients with pacemakers

    Science.gov (United States)

    Kurzyukova, Anastasia; Odlozhilikova, Anna; Sepsi, Milan; Pospisil, David

    2017-09-01

    An increasing number of patients undergoing radiotherapy have pacemakers. The problem is planning computed tomography scans for the patients having metal artifacts. To improve image quality we have tested metal artifacts deletion technique in Masaryk Memorial Cancer Institute (Brno, Czech Republic). The data obtained from this experiment is important for minimizing the dose received by cardiac devices.

  19. Assessment of BNP Level in Patients with Single Chamber and Dual Chamber Pacemakers

    Directory of Open Access Journals (Sweden)

    J Kojuri

    2010-09-01

    Full Text Available Background: Recent years, have witnessed extended and continuous indication of cardiac pacing. However, increasing number of patients suffered new congestive heart failure (CHF and aggravated CHF after pacing therapy. We used blood B type nutriuretic peptide (BNP to predict the occurrence of CHF in patients with different types of pacemakers. To assess single N-terminal brain nutriuretic peptide (NT-pro BNP as a predictor tool for ventricular dysfunction in different cardiac pacing mode.Methods: Out of 480 consecutive patients with pacemaker more than 6 months, 79 patients with average age of 65±13, and more than 90% ventricular pacing participated in the present study. Those with CHF prior to pacemaker insertion were excluded. The patients underwent medical history and examination, echocardiography (M-mode, Doppler, and Tissue imaging and blood sampling for pro-BNP. Twenty five, 12, and 42 patients had Dual chamber (DDDR, single chamber pacing with dual chamber sensing ( VDDR, and Single chamber (VVIR pacemakers respectivelyResults: Single pro-BNP level in patient with DDDR and VDDR pacing was lower than in those with VVIR pacing (P< 0.0001 but in Echocardiography left ventricular (LV dysfunction was not lower in DDDR than VDDR and VVIR pacing patients (P= 0.190. Conclusion: Single level of pro-BNP is lower in double chamber pacing in comparison with single chamber pacing. Therefore, it seems that dual chamber pacing causes less LV dysfunction.

  20. Complications of pacemaker therapy in adults with congenital heart disease: A multicenter study

    NARCIS (Netherlands)

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

    2013-01-01

    BACKGROUND: This study aims to investigate indications and complications of permanent cardiac pacing in adults with congenital heart disease (CHD). METHODS AND RESULTS: Two-hundred and seventy-four CHD patients were identified who underwent permanent pacemaker implantation between 1972 and 2009. The

  1. Cardiac pacemaker insertion in the South-South Region of Nigeria ...

    African Journals Online (AJOL)

    The disease trends in the region have resulted in increasing demand for invasive cardiac procedures which are largely unavailable in this subregion. This review examines the prospects and possible challenges of interventional cardiology care in South-South Nigeria, using cardiac pacemaker implantation as a surrogate.

  2. Cardiac pacemaker treatement of heart block in Enugu: a 5 year ...

    African Journals Online (AJOL)

    Background: Symptomatic heart block is a treatable cardiac cause of death which occurs globally. In Nigeria it is increasingly diagnosed and treated with permanent artificial cardiac pacemaker insertion and pulse generator implantation, sometimes after a period of misdiagnosis and inappropriate treatment. Methods: ...

  3. Reevaluation of the indications for permanent pacemaker implantation after transcatheter aortic valve implantation

    DEFF Research Database (Denmark)

    Bjerre Thygesen, Julie; Loh, Poay Huan; Cholteesupachai, Jiranut

    2014-01-01

    AIMS: Conduction abnormalities (CA) requiring permanent pacemaker (PPM) are a well-known complication after transcatheter aortic valve implantation (TAVI). This study aimed to determine the incidence of TAVI-related PPM and reevaluate the indications for PPM after the periprocedural period. METHODS...

  4. Biological pacemakers in canines exhibit positive chronotropic response to emotional arousal

    NARCIS (Netherlands)

    Shlapakova, Iryna N.; Nearing, Bruce D.; Lau, David H.; Boink, Gerard J. J.; Danilo, Peter; Kryukova, Yelena; Robinson, Richard B.; Cohen, Ira S.; Rosen, Michael R.; Verrier, Richard L.

    2010-01-01

    Biological pacemakers based on the HCN2 channel isoform respond to beta-adrenergic and muscarinic stimulation, suggesting a capacity to respond to autonomic input. The purpose of this study was to investigate autonomic response to emotional arousal in canines implanted with murine HCN2-based

  5. Early performance of a miniaturized leadless cardiac pacemaker: the Micra Transcatheter Pacing Study

    NARCIS (Netherlands)

    Ritter, Philippe; Duray, Gabor Z.; Steinwender, Clemens; Soejima, Kyoko; Omar, Razali; Mont, Lluís; Boersma, Lucas V. A.; Knops, Reinoud E.; Chinitz, Larry; Zhang, Shu; Narasimhan, Calambur; Hummel, John; Lloyd, Michael; Simmers, Timothy Alexander; Voigt, Andrew; Laager, Verla; Stromberg, Kurt; Bonner, Matthew D.; Sheldon, Todd J.; Reynolds, Dwight; Kypta, Alexander; Vamos, Mate; Bordachar, Pierre; El Chami, Mikhael; Hussin, Azlan; Mont Girbau, Josep Lluís; Tolosana, José María; Morgan, John M.; Roberts, Paul; de Groot, Joris R.; Tjong, Fleur V. Y.; Sato, Toshiaki; Bongiorni, Maria Grazia; Soldati, Ezio; Augostini, Ralph; Love, Charles; Neuzil, Petr; Reddy, Vivek; Bracke, Frank A. L. E.; Sagi, Venkata; Lee, Scott; Gornick, Charles; Remole, Stephen; Sra, Jasbir; Nangia, Vikram; Shehata, Michael; Swerdlow, Charles; Schoenhard, John; Milstein, Simon; Saba, Samir; Bernabei, Matthew; Bansal, Sandeep; Stavrakis, Stavros

    2015-01-01

    Permanent cardiac pacing is the only effective treatment for symptomatic bradycardia, but complications associated with conventional transvenous pacing systems are commonly related to the pacing lead and pocket. We describe the early performance of a novel self-contained miniaturized pacemaker.

  6. 77 FR 37573 - Effective Date of Requirement for Premarket Approval for an Implantable Pacemaker Pulse Generator

    Science.gov (United States)

    2012-06-22

    ... Pulse Generator AGENCY: Food and Drug Administration, HHS. ACTION: Final rule. SUMMARY: The Food and... pulse generators. The Agency has summarized its findings regarding the degree of risk of illness or... of a PDP for the implantable pacemaker pulse generator. In accordance with section 515(b)(2)(A) of...

  7. QTC INTERVAL DURATION CLASS AND DRUG THERAPY OF PATIENCE IN A FIRST YEAR AFTER PACEMAKER IMPLANTATION

    Directory of Open Access Journals (Sweden)

    M. S. Brynza

    2016-12-01

    Full Text Available 49 patients (28 female, 21 male with implanted DDD/DDDR, VVI/VVIR and CRT pacemakers are investigated. Purpose frequency and dose rate of anticoagulants, antiplatelet agents, direct thrombin inhibitors, cardiac glycosides, amiodarone; ivabradine, diuretics, aldosterone antagonists, beta-adrenergic blockers, calcium channel blockers, angiotensin-converting enzyme (ACE inhibitors, angiotensin II receptor blockers (ARBs, statins were evaluated before, in acute postoperative period (3–5 days, 6 months and 1 year after pacemaker implantation. Patients were divided into classes 1 (normal QTc (320–440 ms – 24 (49 % patients and 2 (long QTc (> 440 msec – 25 (51 % patients of QTc interval duration. To process the data using standard statistical procedures using Microsoft Excel. It was more often prescriptions of new anticoagulants, beta-adrenergic blockers, ARBs, statins to patients in the first year after pacemaker implantation. QTc interval duration lengthening was associated with a greater purpose frequency and doses of amiodarone, diuretics, beta-adrenergic blockers, ACE inhibitors, ARBs and statins. Patients with implanted pacemaker need individualized drug therapy according to QTc interval duration, in particular, enhancing antiischemic, antihypertensive, antiarrhythmic therapy and therapy of chronic heart failure in patients with QTc interval duration lengthening.

  8. Combined leadless pacemaker and subcutaneous implantable defibrillator therapy: feasibility, safety, and performance

    NARCIS (Netherlands)

    Tjong, F. V. Y.; Brouwer, T. F.; Smeding, L.; Kooiman, K. M.; de Groot, J. R.; Ligon, D.; Sanghera, R.; Schalij, M. J.; Wilde, A. A. M.; Knops, R. E.

    2016-01-01

    The subcutaneous implantable cardioverter-defibrillator (S-ICD) and leadless pacemaker (LP) are evolving technologies that do not require intracardiac leads. However, interactions between these two devices are unexplored. We investigated the feasibility, safety, and performance of combined LP and

  9. Pacemaker Implantation Associated Myocardial Micro-Damage: A Randomised Comparison between Active and Passive Fixation Leads.

    Science.gov (United States)

    Blažek, Patrick; Ferri-Certić, Jerko; Vražić, Hrvoje; Lennerz, Carsten; Grebmer, Christian; Kaitani, Kazuaki; Karch, Martin; Starčević, Boris; Semmler, Verena; Kolb, Christof

    2018-03-20

    Fixation of the pacemaker leads during pacemaker implantation leads to an increase of cardiac Troponin T (cTnT) that can be interpreted as a sign of minimal myocardial damage. This trial evaluates whether the mechanism type of lead fixation influences the magnitude of cTnT release. Patients having a de-novo cardiac pacemaker implantation or a lead revision were centrally randomized to receive either a ventricular lead with an active (screw) or passive (tine) fixation mechanism. High-sensitive Troponin T (hsTnT) was determined on the day of the procedure beforehand and on the following day. 326 Patients (median age (IQR) 75.0 (69.0-80.0) years, 64% male) from six international centers were randomized to receive ventricular leads with an active (n = 166) or passive (n = 160) fixation mechanism. Median (IQR) hsTnT levels increased by 0.009 (0.004-0.021) ng/ml in the group receiving screw-in ventricular leads and by 0.008 (0.003-0.030) ng/ml in the group receiving tined ventricular leads (n.s.). In conclusion pacemaker implantations are followed by a release of hsTnT. The choice between active or passive fixation ventricular leads does not have a significant influence on the extent of myocardial injury and the magnitude of hsTnT release.

  10. Radiofrequency Wire Recanalization of Chronically Thrombosed TIPS

    Energy Technology Data Exchange (ETDEWEB)

    Majdalany, Bill S., E-mail: bmajdala@med.umich.edu [University of Michigan Health System, Division of Interventional Radiology, Department of Radiology (United States); Elliott, Eric D., E-mail: eric.elliott@osumc.edu [The Ohio State University Wexner Medical Center, Division of Interventional Radiology, Department of Radiology (United States); Michaels, Anthony J., E-mail: Anthony.michaels@osumc.edu; Hanje, A. James, E-mail: James.Hanje@osumc.edu [The Ohio State University Wexner Medical Center, Division of Gastroenterology and Hepatology, Department of Medicine (United States); Saad, Wael E. A., E-mail: wsaad@med.umich.edu [University of Michigan Health System, Division of Interventional Radiology, Department of Radiology (United States)

    2016-07-15

    Radiofrequency (RF) guide wires have been applied to cardiac interventions, recanalization of central venous thromboses, and to cross biliary occlusions. Herein, the use of a RF wire technique to revise chronically occluded transjugular intrahepatic portosystemic shunts (TIPS) is described. In both cases, conventional TIPS revision techniques failed to revise the chronically thrombosed TIPS. RF wire recanalization was successfully performed through each of the chronically thrombosed TIPS, demonstrating initial safety and feasibility in this application.

  11. IEE wiring regulations explained and illustrated

    CERN Document Server

    Scaddan, Brian

    2013-01-01

    The IEE Wiring Regulations Explained and Illustrated, Second Edition discusses the recommendations of the IEE Regulations for the Electrical Equipment of Buildings for the safe selection or erection of wiring installations. The book emphasizes earthing, bonding, protection, and circuit design of electrical wirings. The text reviews the fundamental requirements for safety, earthing systems, the earth fault loop impedance, and supplementary bonding. The book also describes the different types of protection, such as protection against mechanical damage, overcurrent, under voltage (which prevents

  12. Minimisation of the wire position uncertainties of the new CERN vacuum wire scanner

    CERN Document Server

    AUTHOR|(CDS)2069346; Barjau Condomines, A

    In the next years the luminosity of the LHC will be significantly increased. This will require a much higher accuracy of beam profile measurement than actually achievable by the current wire scanner. The new fast wire scanner is foreseen to measure small emittance beams throughout the LHC injector chain, which demands a wire travelling speed up to 20 ms-1 and position measurement accuracy of the order of a few microns. The vibrations of the mechanical parts of the system, and particularly the vibrations of the thin carbon wire, were identified as the major error sources of wire position uncertainty. Therefore the understanding of the wire vibrations is a high priority for the design and operation of the new device. This document presents the work performed to understand the main causes of the wire vibrations observed in one of the existing wire scanner and the new proposed design.

  13. Patterns of Abnormal Gastric Pacemaking After Sleeve Gastrectomy Defined by Laparoscopic High-Resolution Electrical Mapping.

    Science.gov (United States)

    Berry, Rachel; Cheng, Leo K; Du, Peng; Paskaranandavadivel, Niranchan; Angeli, Timothy R; Mayne, Terence; Beban, Grant; O'Grady, Gregory

    2017-08-01

    Laparoscopic sleeve gastrectomy (LSG) is increasingly being applied to treat obesity. LSG includes excision of the normal gastric pacemaker, which could induce electrical dysrhythmias impacting on post-operative symptoms and recovery, but these implications have not been adequately investigated. This study aimed to define the effects of LSG on gastric slow-wave pacemaking using laparoscopic high-resolution (HR) electrical mapping. Laparoscopic HR mapping was performed before and after LSG using flexible printed circuit arrays (64-96 electrodes; 8-12 cm 2 ; n = 8 patients) deployed through a 12 mm trocar and positioned on the gastric serosa. An additional patient with chronic reflux, nausea, and dysmotility 6 months after LSG also underwent gastric mapping while undergoing conversion to gastric bypass. Slow-wave activity was quantified by propagation pattern, frequency, velocity, and amplitude. Baseline activity showed exclusively normal propagation. Acutely after LSG, all patients developed either a distal unifocal ectopic pacemaker with retrograde propagation (50%) or bioelectrical quiescence (50%). Propagation velocity was abnormally rapid after LSG (12.5 ± 0.8 vs baseline 3.8 ± 0.8 mm s -1 ; p = 0.01), whereas frequency and amplitude were unchanged (2.7 ± 0.3 vs 2.8 ± 0.3 cpm, p = 0.7; 1.7 ± 0.2 vs 1.6 ± 0.6 mV, p = 0.7). In the patient with chronic dysmotility after LSG, mapping also revealed a stable antral ectopic pacemaker with retrograde rapid propagation (12.6 ± 4.8 mm s -1 ). Resection of the gastric pacemaker during LSG acutely resulted in aberrant distal ectopic pacemaking or bioelectrical quiescence. Ectopic pacemaking can persist long after LSG, inducing chronic dysmotility. The clinical and therapeutic significance of these findings now require further investigation.

  14. German Roentgen Society Statement on MR Imaging of Patients with Cardiac Pacemakers.

    Science.gov (United States)

    Sommer, T; Luechinger, R; Barkhausen, J; Gutberlet, M; Quick, H H; Fischbach, K

    2015-09-01

    The aim of this paper is to inform physicians, especially radiologists and cardiologists, about the technical and electrophysiological background of MR imaging of patients with implanted cardiac pacemakers (PM) and to provide dedicated clinical practice guidelines how to perform MR exams in this patient group. The presence of a conventional PM system is not any more considered an absolute contraindication for MR imaging. The prerequisites for MR imaging on pacemaker patients include the assessment of the individual risk/benefit ratio as well as to obtain full informed consent about the off label character of the procedure and all associated risks. Furthermore the use of special PM-related (e.g. re-programming of the PM) and MRI-related (e.g. limitation of whole body SAR to 2 W/kg) precautions is required and needs to be combined with adequate monitoring during MR imaging using continuous pulsoximetry. MR conditional PM devices are tested and approved for the use in the MR environment under certain conditions, including the field strength and gradient slew rate of the MR system, the maximum whole body SAR value and the presence of MR imaging exclusion zones. Safe MR imaging of patients with MR conditional PM requires the knowledge of the specific conditions of each PM system. If MR imaging within these specific conditions cannot be guaranteed in a given patient, the procedure guidelines for conventional PM should be used. The complexity of MR imaging of PM patients requires close cooperation of radiologists and cardiologists. Conventional pacemaker systems are no longer an absolute but rather a relative contraindication for performing an MR examination. The procedural management of conventional pacemaker includes the assessment of the individual risk/benefit ratio, comprehensive patient informed consent about specific related risks and "off label" use, extensive PM- and MRI-related safety precautions as well as adequate monitoring techniques during the MR exam

  15. Pacemaker Use in New Zealand - Data From the New Zealand Implanted Cardiac Device Registry (ANZACS-QI 15).

    Science.gov (United States)

    Larsen, P D; Kerr, A J; Hood, M; Harding, S A; Hooks, D; Heaven, D; Lever, N A; Sinclair, S; Boddington, D; Tang, E W; Swampillai, J; Stiles, M K

    2017-03-01

    The New Zealand Cardiac Implanted Device Registry (Device) has recently been developed under the auspices of the New Zealand Branch of the Cardiac Society of Australia and New Zealand. This study describes the initial Device registry cohort of patients receiving a new pacemaker, their indications for pacing and their perioperative complications. The Device Registry was used to audit patients receiving a first pacemaker between 1 st January 2014 and 1 st June 2015. We examined 1611 patients undergoing first pacemaker implantation. Patients were predominantly male (59%), and had a median age of 70 years. The most common symptom for pacemaker implantation was syncope (39%), followed by dizziness (30%) and dyspnoea (12%). The most common aetiology for a pacemaker was a conduction tissue disorder (35%), followed by sinus node dysfunction (22%). Atrioventricular (AV) block was the most common ECG abnormality, present in 44%. Dual chamber pacemakers were most common (62%), followed by single chamber ventricular pacemakers (34%), and cardiac resynchronisation therapy - pacemakers (CRT-P) (2%). Complications within 24hours of the implant procedure were reported in 64 patients (3.9%), none of which were fatal. The most common complication was the need for reoperation to manipulate a lead, occurring in 23 patients (1.4%). This is the first description of data entered into the Device registry. Patients receiving a pacemaker were younger than in European registries, and there was a low use of CRT-P devices compared to international rates. Complications rates were low and compare favourably to available international data. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  16. Correlation analysis of the relationship between B-type natriuretic peptide and selected echocardiographic parameters in patients with permanent pacemakers

    Directory of Open Access Journals (Sweden)

    Janusz Sielski

    2016-01-01

    Full Text Available Introduction: The present study was undertaken to evaluate the practical value of BNP measurements and echocardiographic left ventricular volume index in patients with permanent pacemakers because there are no such reports in the literature. Aim of the research: The aim of the study was to reveal multiple correlations between BNP levels and selected echocardiographic parameters of the left atrium in patients with permanent pacemakers. In the literature there are reports on the significance of BNP values and left atrial size in patients with permanent pacemakers. The results of the present study appear to be of value in the outpatient assessment of these patients. Material and methods: We analysed a group of 117 patients with permanent pacemakers (AAI/R 21 patients, DDD/R 59 patients, VVI/R 37 patients and 48 healthy volunteers serving as the control group. BNP measurements were performed on venous blood samples using Triage meters. The Simpson method and the ellipse method were used to assess the left atrium on echocardiography. Results: There was a significant correlation between BNP and maximum left atrial volume, minimum left atrial volume, and left atrial volume index in patients with AAI/R, DDD/R, and VVI/R pacemakers at 3 and 6 months after the implantation. Conclusions : In patients after implantation of permanent pacemakers there are correlations between BNP values and echocardiographic left atrial parameters, especially in patients with DDD/R pacemakers. Left atrial function improves in patients with DDD/R pacemakers. Pacemaker check-up should be extended to include BNP measurements and echocardiographic assessment of the left atrium.

  17. Aircraft Wiring Support Equipment Integration Laboratory (AWSEIL)

    Data.gov (United States)

    Federal Laboratory Consortium — Purpose:The Aircraft Wiring Support Equipment Integration Laboratory (AWSEIL) provides a variety of research, design engineering and prototype fabrication services...

  18. submitter Dynamical Models of a Wire Scanner

    CERN Document Server

    Barjau, Ana; Dehning, Bernd

    2016-01-01

    The accuracy of the beam profile measurements achievable by the current wire scanners at CERN is limited by the vibrations of their mechanical parts. In particular, the vibrations of the carbon wire represent the major source of wire position uncertainty which limits the beam profile measurement accuracy. In the coming years, due to the Large Hadron Collider (LHC) luminosity upgrade, a wire traveling speed up to 20 $m s^{−1}$ and a position measurement accuracy of the order of 1 μm will be required. A new wire scanner design based on the understanding of the wire vibration origin is therefore needed. We present the models developed to understand the main causes of the wire vibrations observed in an existing wire scanner. The development and tuning of those models are based on measurements and tests performed on that CERN proton synchrotron (PS) scanner. The final model for the (wire + fork) system has six degrees-of-freedom (DOF). The wire equations contain three different excitation terms: inertia...

  19. FE modeling of Cu wire bond process and reliability

    NARCIS (Netherlands)

    Yuan, C.A.; Weltevreden, E.R.; Akker, P. van den; Kregting, R.; Vreugd, J. de; Zhang, G.Q.

    2011-01-01

    Copper based wire bonding technology is widely accepted by electronic packaging industry due to the world-wide cost reduction actions (compared to gold wire bond). However, the mechanical characterization of copper wire differs from the gold wire; hence the new wire bond process setting and new bond

  20. 47 CFR 76.804 - Disposition of home run wiring.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Disposition of home run wiring. 76.804 Section... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Inside Wiring § 76.804 Disposition of home run wiring. (a) Building-by-building disposition of home run wiring. (1) Where an MVPD owns the home run wiring in an MDU...

  1. Novel approach to epicardial pacemaker implantation in patients with limited venous access.

    Science.gov (United States)

    Costa, Roberto; Scanavacca, Mauricio; da Silva, Kátia Regina; Martinelli Filho, Martino; Carrillo, Roger

    2013-11-01

    Limited venous access in certain patients increases the procedural risk and complexity of conventional transvenous pacemaker implantation. The purpose of this study was to determine a minimally invasive epicardial approach using pericardial reflections for dual-chamber pacemaker implantation in patients with limited venous access. Between June 2006 and November 2011, 15 patients underwent epicardial pacemaker implantation. Procedures were performed through a minimally invasive subxiphoid approach and pericardial window with subsequent fluoroscopy-assisted lead placement. Mean patient age was 46.4 ± 15.3 years (9 male [(60.0%], 6 female [40.0%]). The new surgical approach was used in patients determined to have limited venous access due to multiple abandoned leads in 5 (33.3%), venous occlusion in 3 (20.0%), intravascular retention of lead fragments from prior extraction in 3 (20.0%), tricuspid valve vegetation currently under treatment in 2 (13.3%), and unrepaired intracardiac defects in 2 (13.3%). All procedures were successful with no perioperative complications or early deaths. Mean operating time for isolated pacemaker implantation was 231.7 ± 33.5 minutes. Lead placement on the superior aspect of right atrium, through the transverse sinus, was possible in 12 patients. In the remaining 3 patients, the atrial lead was implanted on the left atrium through the oblique sinus, the postcaval recess, or the left pulmonary vein recess. None of the patients displayed pacing or sensing dysfunction, and all parameters remained stable throughout the follow-up period of 36.8 ± 25.1 months. Epicardial pacemaker implantation through pericardial reflections is an effective alternative therapy for those patients requiring physiologic pacing in whom venous access is limited. © 2013 Heart Rhythm Society. All rights reserved.

  2. Minimally Invasive Epicardial Pacemaker Implantation in Neonates with Congenital Heart Block.

    Science.gov (United States)

    Costa, Roberto; Silva, Katia Regina da; Martinelli Filho, Martino; Carrillo, Roger

    2017-10-01

    Few studies have characterized the surgical outcomes following epicardial pacemaker implantation in neonates with congenital complete atrioventricular block (CCAVB). This study sought to assess the long-term outcomes of a minimally invasive epicardial approach using a subxiphoid access for pacemaker implantation in neonates. Between July 2002 and February 2015, 16 consecutive neonates underwent epicardial pacemaker implantation due to CCAVB. Among these, 12 (75.0%) had congenital heart defects associated with CCAVB. The patients had a mean age of 4.7 ± 5.3 days and nine (56.3%) were female. Bipolar steroid-eluting epicardial leads were implanted in all patients through a minimally invasive subxiphoid approach and fixed on the diaphragmatic ventricular surface. The pulse generator was placed in an epigastric submuscular position. All procedures were successful, with no perioperative complications or early deaths. Mean operating time was 90.2 ± 16.8 minutes. None of the patients displayed pacing or sensing dysfunction, and all parameters remained stable throughout the follow-up period of 4.1 ± 3.9 years. Three children underwent pulse generator replacement due to normal battery depletion at 4.0, 7.2, and 9.0 years of age without the need of ventricular lead replacement. There were two deaths at 12 and 325 days after pacemaker implantation due to bleeding from thrombolytic use and progressive refractory heart failure, respectively. Epicardial pacemaker implantation through a subxiphoid approach in neonates with CCAVB is technically feasible and associated with excellent surgical outcomes and pacing lead longevity.

  3. Permanent pacemaker implantation in octogenarians with unexplained syncope and positive electrophysiologic testing.

    Science.gov (United States)

    Giannopoulos, Georgios; Kossyvakis, Charalampos; Panagopoulou, Vasiliki; Tsiachris, Dimitrios; Doudoumis, Konstantinos; Mavri, Maria; Vrachatis, Dimitrios; Letsas, Konstantinos; Efremidis, Michael; Katsivas, Apostolos; Lekakis, John; Deftereos, Spyridon

    2017-05-01

    Syncope is a common problem in the elderly, and a permanent pacemaker is a therapeutic option when a bradycardic etiology is revealed. However, the benefit of pacing when no association of symptoms to bradycardia has been shown is not clear, especially in the elderly. The aim of this study was to evaluate the effect of pacing on syncope-free mortality in patients aged 80 years or older with unexplained syncope and "positive" invasive electrophysiologic testing (EPT). This was an observational study. A positive EPT for the purposes of this study was defined by at least 1 of the following: a corrected sinus node recovery time of >525 ms, a basic HV interval of >55 ms, detection of infra-Hisian block, or appearance of second-degree atrioventricular block on atrial decremental pacing at a paced cycle length of >400 ms. Among the 2435 screened patients, 228 eligible patients were identified, 145 of whom were implanted with a pacemaker. Kaplan-Meier analysis determined that time to event (syncope or death) was 50.1 months (95% confidence interval 45.4-54.8 months) with a pacemaker vs 37.8 months (95% confidence interval 31.3-44.4 months) without a pacemaker (log-rank test, P = .001). The 4-year time-dependent estimate of the rate of syncope was 12% vs 44% (P cause death was 41% vs 56% (P = .023), respectively. The multivariable odds ratio was 0.25 (95% confidence interval 0.15-0.40) after adjustment for potential confounders. In patients with unexplained syncope and signs of sinus node dysfunction or impaired atrioventricular conduction on invasive EPT, pacemaker implantation was independently associated with longer syncope-free survival. Significant differences were also shown in the individual components of the primary outcome measure (syncope and death from any cause). Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  4. Conduction Abnormalities and Pacemaker Implantations After SAPIEN 3 Vs SAPIEN XT Prosthesis Aortic Valve Implantation.

    Science.gov (United States)

    Husser, Oliver; Kessler, Thorsten; Burgdorf, Christof; Templin, Christian; Pellegrini, Costanza; Schneider, Simon; Kasel, Albert Markus; Kastrati, Adnan; Schunkert, Heribert; Hengstenberg, Christian

    2016-02-01

    Transcatheter aortic valve implantation is increasingly used in patients with aortic stenosis. Post-procedural intraventricular conduction abnormalities and permanent pacemaker implantations remain a serious concern. Recently, the Edwards SAPIEN 3 prosthesis has replaced the SAPIEN XT. We sought to determine the incidences of new-onset intraventricular conduction abnormalities and permanent pacemaker implantations by comparing the 2 devices. We analyzed the last consecutive 103 patients undergoing transcatheter aortic valve implantation with SAPIEN XT before SAPIEN 3 was used in the next 105 patients. To analyze permanent pacemaker implantations and new-onset intraventricular conduction abnormalities, patients with these conditions at baseline were excluded. Electrocardiograms were recorded at baseline, after the procedure, and before discharge. SAPIEN 3 was associated with higher device success (100% vs 92%; P=.005) and less paravalvular leakage (0% vs 7%; P<.001). The incidence of permanent pacemaker implantations was 12.6% (23 of 183) with no difference between the 2 groups (SAPIEN 3: 12.5% [12 of 96] vs SAPIEN XT: 12.6% [11 of 87]; P=.99). SAPIEN 3 was associated with a higher rate of new-onset intraventricular conduction abnormalities (49% vs 27%; P=.007) due to a higher rate of fascicular blocks (17% vs 5%; P=.021). There was no statistically significant difference in transient (29% [20 of 69] vs persistent 19% [12 of 64]; P=.168) left bundle branch blocks (28% [19 of 69] vs 17% [11 of 64]; P=.154) when SAPIEN 3 was compared with SAPIEN XT. We found a trend toward a higher rate of new-onset intraventricular conduction abnormalities with SAPIEN 3 compared with SAPIEN XT, although this did not result in a higher permanent pacemaker implantation rate. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  5. Utility of the NavX® Electroanatomic Mapping System for Permanent Pacemaker Implantation in a Pregnant Patient with Chagas Disease

    Directory of Open Access Journals (Sweden)

    Alejandro Velasco, MD

    2013-01-01

    Full Text Available Chagas disease is a highly prevalent zoonosis in Mexico, Central, and South America. Early cardiac involvement is one of the most serious complications of this disease, and conduction disturbances may occur at an early age. We describe a young pregnant woman with Chagas disease and a high degree atrioventricular block, who required implantation of a permanent dual chamber pacemaker. Using an electroanatomic navigation EnSite NavX® system the pacemaker was successfully implanted with minimal fluoroscopic exposure. This case demonstrates the safety and feasibility of using an electroanatomic navigation system to guide permanent pacemaker implantation minimizing x-ray exposure in pregnant patients.

  6. Intra-wire resistance and AC loss in multi-filamentary MgB2 wires

    NARCIS (Netherlands)

    Zhou, Chao; Offringa, Wietse; Bergen, Anne-Henriette; Wessel, Wilhelm A.J.; Krooshoop, Hendrikus J.G.; Dhalle, Marc M.J.; Sumption, M.D.; Collings, E.W.; Rindfleisch, M.; Tomsic, M.; ten Kate, Herman H.J.; Nijhuis, Arend

    2013-01-01

    Intra-wire resistance and AC loss of various multi-filamentary MgB2 wires with filaments surrounded by Nb barriers have been measured and analyzed. The intra-wire resistance is measured with a direct four-probe voltage–current method at various temperatures. The AC loss is acquired by both vibrating

  7. THERMO-MECHANICALLY PROCESSED ROLLED WIRE FOR HIGH-STRENGTH ON-BOARD WIRE

    Directory of Open Access Journals (Sweden)

    V. A. Lutsenko

    2011-01-01

    Full Text Available It is shown that at twisting of wire of diameter 1,83 mm, produced by direct wire drawing of thermomechanically processed rolled wire of diameter 5,5 mm of steel 90, metal stratification is completely eliminated at decrease of carbon, manganese and an additional alloying of chrome.

  8. Fracture resistance of various temporary crown materials.

    Science.gov (United States)

    Yilmaz, Asude; Baydaş, Seyfettin

    2007-01-01

    The aim of this study was to evaluate the fracture resistance of various provisional crown materials using an in vitro model test system. In the present study polycarbonate crowns, prefabricated by the manufacturer (3M Polycarbonate Crown), and the temporary crowns, fabricated in the dental laboratory environment, were fabricated using bis-acryl composite (Protemp II), autopolymerizing PMMA resin (BISICO Temp S), and heat-polymerized PMMA resin (Major C&B-V Dentine). All temporary crowns were stored in distilled water for 24 hours at room temperature prior to testing. The crowns were seated on metal dies, fabricated from Cr-Co alloy (AZ Dental, Konstanz, Germany), and then tested using the indenter of a Hounsfield testing machine (Hounsfield Tensometer, Hounsfield Test Equipment, Raydon, England). The tip of the indenter was located at a position one-third of the way down the inciso-palatine surface at 135 masculine. The data were statistically analyzed for differences using one-way analysis of variance (ANOVA) and the Tukey HSD test (P crowns were significantly different from the BISICO Temp S, Protemp II, and Major C&B-V Dentine (P crowns may be preferable to the other types of temporary crowns used in this study.

  9. Evaluation of Safety and Efficacy of Qinming8631 DR Implantable Cardiac Pacemaker in Chinese Patients: A Prospective, Multicenter, Randomized Controlled Trial of the First Domestically Developed Pacemaker of China

    Directory of Open Access Journals (Sweden)

    Mei-Xiang Xiang

    2016-01-01

    Conclusions: This study established the noninferiority of Qinming8631 DR to Talos DR. The safety and efficacy of Qinming8631 DR pacemaker were comparable to those of Talos DR in treating patients with cardiac bradyarrhythmia.

  10. Long-Wearing Wire Guide For Welding Torch

    Science.gov (United States)

    Gutow, David A.; Burley, Richard K.; Gilbert, Jeffrey L.; Fogel, Irving

    1992-01-01

    Insert for wire-guide tube on tungsten/inert-gas welding apparatus extends life of guide tube and increases accuracy of weld. Hardened insert resists wear by sliding tungsten wire. Chamfer guides wire into insert.

  11. 29 CFR 1919.79 - Wire rope.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 7 2010-07-01 2010-07-01 false Wire rope. 1919.79 Section 1919.79 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED... recommended by the equipment or the wire rope manufacturer due to actual working condition requirements. In...

  12. Automatic inspection of railway overhead wires

    NARCIS (Netherlands)

    Smorenburg, C.; Valkenburg, A.L.G. van

    1988-01-01

    For the Netherlands railway company a system for inspection of the degree of wear of the contact wires is being developed. With an active sensor the reflective under-surface of the overhead wire is illuminated with a laserbeam and reflected radiation is detected by fast CCD detectors. With the

  13. Wire compensation: Performance, SPS MDs, pulsed system

    CERN Document Server

    Dorda, U

    2008-01-01

    A wire compensation (BBLR) scheme has been proposed in order to improve the long range beam-beam performance of the nominal LHC and its phase 1 and phase 2 upgrades[1]. In this paper we present experimental experience of the CERN SPS wires (BBLR) and report on progress with the RF BBLR.

  14. WIRED magazine announces rave awards nominees

    CERN Multimedia

    2002-01-01

    WIRED Magazine has anounced the nominees for its fourth annual WIRED Rave Awards, celebrating innovation and the individuals transforming commerce and culture. Jeffrey Hangst of the University of Aarhus has been nominated in the science category, for his work on the ATHENA Experiment, CERN (1/2 page).

  15. Kirschner Wire Breakage during Removal Requiring Retrieval

    Directory of Open Access Journals (Sweden)

    Kai Yuen Wong

    2016-01-01

    Full Text Available Kirschner wires (K-wires are widely used for fixation of fractures and dislocations in the hand as they are readily available, reliable, and cost-effective. Complication rates of up to 18% have been reported. However, K-wire breakage during removal is rare. We present one such case illustrating a simple technique for retrieval. A 35-year-old male presented with a distal phalanx fracture of his right middle finger. This open fracture was treated with K-wire fixation. Postoperatively, he developed a pin site infection with associated finger swelling. The K-wire broke during removal with the proximal piece completely retained in his middle phalanx. To minimise risk of osteomyelitis, the K-wire was removed with a novel surgical technique. He had full return of hand function. Intraoperative K-wire breakage has a reported rate of 0.1%. In our case, there was no obvious cause of breakage and the patient denied postoperative trauma. On the other hand, pin site infections are much more common with reported rates of up to 7% in the hand or wrist. K-wire fixation is a simple method for bony stabilisation but can be a demanding procedure with complications often overlooked. It is important to be aware of the potential sequelae.

  16. Hot-wire anemometer for spirography.

    Science.gov (United States)

    Plakk, P; Liik, P; Kingisepp, P H

    1998-01-01

    The use of a constant temperature hot-wire anemometer flow sensor for spirography is reported. The construction, operating principles and calibration procedure of the apparatus are described, and temperature compensation method is discussed. Frequency response is studied. It is shown that this hot-wire flow transducer satisfies common demands with respect to accuracy, response time and temperature variations.

  17. Percutaneous cerclage wiring followed by intramedullary nailing for subtrochanteric femoral fractures: a technical note with clinical results.

    Science.gov (United States)

    Kim, Joon-Woo; Park, Ki-Chul; Oh, Jong-Keon; Oh, Chang-Wug; Yoon, Yong-Cheol; Chang, Hyo-Won

    2014-09-01

    Although intramedullary nailing is an ideal treatment for subtrochanteric femoral fractures, it is technically challenging in fractures extending into the nail entry area and/or involving the lesser trochanter. Although the application of circumferential wire may facilitate reduction in these situations, its use remains controversial due to possible blood supply disturbances to underlying bone. In the present study, we evaluated complex subtrochanteric fractures treated by percutaneous cerclage wiring followed by intramedullary (IM) nailing for anatomical fracture reduction and union. Twelve patients (mean age 48.3 years) with an unstable subtrochanteric fracture were prospectively treated. Indications of percutaneous cerclage wiring followed by IM nailing were a fracture extending proximally into the nail entry area deemed difficult to treat by anatomical reconstruction by IM nailing or a fracture with long oblique or spiral component. One or two cerclage wires were percutaneously applied for the temporary reduction of main fragments, and then, a cephalo-medullary or a reconstruction nail was fixed. We assessed radiologic results (union time, alignment), functional results, and complications. All 12 cases healed, without a bone graft, at an average of 19.1 weeks after surgery (range 16-24). In 11 cases, acceptable alignment was achieved (mean, valgus 0.3° extension 0.6°) with minimal leg-length discrepancy; the other exhibited 1 cm of shortening. All patients were able to return to pre-injury activity levels, and median Merle d'Aubigne score was 16.9 (15-18). No infection or implant-related complication was encountered to latest follow-up (minimum 12 months postoperatively). Temporary reduction by percutaneous wiring offers a means of satisfactory nailing in difficult subtrochanteric femoral fractures, and affords anatomical reconstruction and favorable bony union.

  18. Risk of pacemaker or implantable cardioverter defibrillator after radiotherapy for early-stage breast cancer in Denmark, 1982-2005

    DEFF Research Database (Denmark)

    Rehammar, Jens Christian; Johansen, Jens Brock; Jensen, Maj-Britt

    2017-01-01

    BACKGROUND AND PURPOSE: To examine the risk of cardiac conduction abnormalities or severe ventricular arrhythmias requiring implantation of a cardiac implantable electronic device (CIED), either a pacemaker or an implantable cardioverter-defibrillator, subsequent to breast cancer (BC) radiotherapy...

  19. Management of radiation oncology patients with a pacemaker or ICD : A new comprehensive practical guideline in The Netherlands

    NARCIS (Netherlands)

    Hurkmans, Coen W.; Knegjens, Joost L.; Oei, Bing S.; Maas, Ad J. J.; Uiterwaal, G. J.; van der Borden, Arnoud J.; Ploegmakers, Marleen M. J.; van Erven, Lieselot

    2012-01-01

    Current clinical guidelines for the management of radiotherapy patients having either a pacemaker or implantable cardioverter defibrillator (both CIEDs: Cardiac Implantable Electronic Devices) do not cover modern radiotherapy techniques and do not take the patient's perspective into account.

  20. Guide Wire Entrapment during Central Venous Catheterization

    Directory of Open Access Journals (Sweden)

    Kyung Woo Kim

    2014-05-01

    Full Text Available We experienced a case of venous vessel wall entrapment between the introducer needle and the guide wire during an attempt to perform right internal jugular vein (IJV catheterization. The guide wire was introduced with no resistance but could not be withdrawn. We performed ultrasonography and C-arm fluoroscopy to confirm the entrapment location. We assumed the introducer needle penetrated the posterior vessel wall during the puncture and that only the guide wire entered the vein; an attempt to retract the wire pinched the vein wall between the needle tip and the guide wire. Careful examination with various diagnostic tools to determine the exact cause of entrapment is crucial for reducing catastrophic complications and achieving better outcomes during catheterization procedures.

  1. [Chronic transvenous pacemaker/implantable cardioverter defibrillator leads implantation induced pathological changes].

    Science.gov (United States)

    Li, Yanhui; Dykoski, Richard; Li, Jianming

    2015-05-01

    Widely pacemaker/implantable cardioverter defibrillator (ICD) implantation is also related to an increasing need for transvenous lead extraction. Understanding the location and extent of pathological changes, including adhesions and fibrous tissue formation along the course of chronic pacemaker/ICD leads, are essential for operators performing lead extraction operations in order to reduce the potential life threatening complications. Three parts are included in the research, pathological examination on 83 extracted pacemaker/ICD leads using excimer laser technique from March 2008 to March 2011, autopsy examination of one died patient during lead extraction for lead-related infective endocarditis, and anatomical analysis on pacemaker/ICD leads from 10 patients died of other non-cardiac causes. Extensive encapsulated fibrous tissue around the leads and extensive adhesion/fibrosis along the course of the leads from venous entry site to the lead/myocardial interface could be detected on transvenous pacemaker/ICD leads. Since the tissue at the junction between superior vena cava (SVC) and right atrium (RA) is very thin, free of pericardium, thus, this is a common place for extensive adhesion/fibrosis and myocardial perforation/tear during lead extraction, which accounted for one death during extraction in our cohort. Extensive adhesion and fibrosis were also observed at the tricuspid valve and subvalvular structures. Leads implanted to the right ventricular apex were close to the epicardial surface and prone to perforation through myocardium. It is common to observe thrombus on the leads or at the interface between leads and myocardial tissue, especially at right atrial appendage (RAA) at the site of lead insertion. Extensive adhesions and fibrosis can be commonly seen along the course of pacemaker/ICD leads, and at SVC to RA junction, the tricuspid valve/subvalvular structures, and RA/RV lead interface. The tissue at SVC to RA junction is very thin, making it

  2. Pacemaker replacement in nonagenarians: Procedural safety and long-term follow-up.

    Science.gov (United States)

    Loirat, Aurélie; Fénéon, Damien; Behaghel, Albin; Behar, Nathalie; Le Helloco, Alain; Mabo, Philippe; Daubert, Jean-Claude; Leclercq, Christophe; Martins, Raphaël P

    2015-01-01

    The rate of pacemaker implantation is rising. Given that the life expectancy of the population is projected to increase, a large number of elderly patients are likely to be implanted in the future. As pacemaker batteries can last for 8-10years, an increasing number of pacemaker recipients will require replacement of their devices when they become nonagenarians. To analyse the short- and long-term outcomes after device replacement in nonagenarians. Patients aged≥90years referred to a tertiary centre for pacemaker replacement from January 2004 to July 2014 were included retrospectively. Clinical follow-up data were obtained from clinical visits or telephone interviews with patients or their families. The primary clinical endpoint was total mortality. Secondary endpoints included early and delayed procedure-related complications and predictive risk factors for total mortality. Sixty-two patients were included (mean age 93.3±2.9years at time of pacemaker replacement). Mean procedure duration was 35.7±17.2minutes. Mean hospital stay was 2.2±1.1days. One patient died from a perioperative complication. Thirty-seven patients (59.7%) died during a median follow-up of 22.1months (interquartile range, 11.8-39.8months). Survival rates were 84.2% (95% confidence interval [CI] 71.8-91.5%) at 1year, 66.9% (95% CI 51.8-78.2%) at 2years and 22.7% (95% CI 10.6-37.7%) at 5years. Atrial fibrillation (hazard ratio 2.47, 95% CI 1.1-5.6) and non-physiological pacing (i.e. VVI pacing in patients in sinus rhythm) (hazard ratio 2.20, 95% CI 1.0-4.9) were predictors of mortality. Pacemaker replacement in nonagenarians is a safe and straightforward procedure. These data suggest that procedures can be performed securely in this old and frail population, with patients living for a median of 30months afterwards. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  3. Feasibility and safety of adenosine cardiovascular magnetic resonance in patients with MR conditional pacemaker systems at 1.5 Tesla.

    Science.gov (United States)

    Klein-Wiele, Oliver; Garmer, Marietta; Urbien, Rhyan; Busch, Martin; Kara, Kaffer; Mateiescu, Serban; Grönemeyer, Dietrich; Schulte-Hermes, Michael; Garbrecht, Marc; Hailer, Birgit

    2015-12-22

    Cardiovascular Magnetic Resonance (CMR) with adenosine stress is a valuable diagnostic tool in coronary artery disease (CAD). However, despite the development of MR conditional pacemakers CMR is not yet established in clinical routine for pacemaker patients with known or suspected CAD. A possible reason is that adenosine stress perfusion for ischemia detection in CMR has not been studied in patients with cardiac conduction disease requiring pacemaker therapy. Other than under resting conditions it is unclear whether MR safe pacing modes (paused pacing or asynchronous mode) can be applied safely because the effect of adenosine on heart rate is not precisely known in this entity of patients. We investigate for the first time feasibility and safety of adenosine stress CMR in pacemaker patients in clinical routine and evaluate a pacing protocol that considers heart rate changes under adenosine. We retrospectively analyzed CMR scans of 24 consecutive patients with MR conditional pacemakers (mean age 72.1 ± 11.0 years) who underwent CMR in clinical routine for the evaluation of known or suspected CAD. MR protocol included cine imaging, adenosine stress perfusion and late gadolinium enhancement. Pacemaker indications were sinus node dysfunction (n = 18) and second or third degree AV block (n = 6). Under a pacing protocol intended to avoid competitive pacing on the one hand and bradycardia due to AV block on the other no arrhythmia occurred. Pacemaker stimulation was paused to prevent competitive pacing in sinus node dysfunction with resting heart rate >45 bpm. Sympatho-excitatory effect of adenosine led to a significant acceleration of heart rate by 12.3 ± 8.3 bpm (p pacemakers. Heart rate response to adenosine has to be considered for the choice of pacing modes during CMR.

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

    Directory of Open Access Journals (Sweden)

    Bruno Kolterer

    2015-01-01

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

  5. Real-time relationship between PKA biochemical signal network dynamics and increased action potential firing rate in heart pacemaker cells: Kinetics of PKA activation in heart pacemaker cells.

    Science.gov (United States)

    Yaniv, Yael; Ganesan, Ambhighainath; Yang, Dongmei; Ziman, Bruce D; Lyashkov, Alexey E; Levchenko, Andre; Zhang, Jin; Lakatta, Edward G

    2015-09-01

    cAMP-PKA protein kinase is a key nodal signaling pathway that regulates a wide range of heart pacemaker cell functions. These functions are predicted to be involved in regulation of spontaneous action potential (AP) generation of these cells. Here we investigate if the kinetics and stoichiometry of increase in PKA activity match the increase in AP firing rate in response to β-adrenergic receptor (β-AR) stimulation or phosphodiesterase (PDE) inhibition, that alters the AP firing rate of heart sinoatrial pacemaker cells. In cultured adult rabbit pacemaker cells infected with an adenovirus expressing the FRET sensor AKAR3, the EC50 in response to graded increases in the intensity of β-AR stimulation (by Isoproterenol) the magnitude of the increases in PKA activity and the spontaneous AP firing rate were similar (0.4±0.1nM vs. 0.6±0.15nM, respectively). Moreover, the kinetics (t1/2) of the increases in PKA activity and spontaneous AP firing rate in response to β-AR stimulation or PDE inhibition were tightly linked. We characterized the system rate-limiting biochemical reactions by integrating these experimentally derived data into a mechanistic-computational model. Model simulations predicted that phospholamban phosphorylation is a potent target of the increase in PKA activity that links to increase in spontaneous AP firing rate. In summary, the kinetics and stoichiometry of increases in PKA activity in response to a physiological (β-AR stimulation) or pharmacological (PDE inhibitor) stimuli match those of changes in the AP firing rate. Thus Ca(2+)-cAMP/PKA-dependent phosphorylation limits the rate and magnitude of increase in spontaneous AP firing rate. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Single wire drift chamber design

    Energy Technology Data Exchange (ETDEWEB)

    Krider, J.

    1987-03-30

    This report summarizes the design and prototype tests of single wire drift chambers to be used in Fermilab test beam lines. The goal is to build simple, reliable detectors which require a minimum of electronics. Spatial resolution should match the 300 ..mu..m rms resolution of the 1 mm proportional chambers that they will replace. The detectors will be used in beams with particle rates up to 20 KHz. Single track efficiency should be at least 99%. The first application will be in the MT beamline, which has been designed for calibration of CDF detectors. A set of four x-y modules will be used to track and measure the momentum of beam particles.

  7. A Review on Pacemakers: Device Types, Operating Modes and Pacing Pulses. Problems Related to the Pacing Pulses Detection

    Directory of Open Access Journals (Sweden)

    Valentin Tsibulko

    2014-06-01

    Full Text Available A pacemaker is a small battery-operated medical device that delivers electrical impulses to the heart in order to guarantee regular contractions. Depending on the number of active leads the pacemakers are single chamber, dual chamber and bi-ventricular. According to their programming the devices could be with fixed-rate, 'on demand' and rate-responsitive. The operating mode of the pacemaker depends on the paced chamber, the sensed chamber, the response to a sensed electrical signal and the rate modulation. Two types of pacing are recognized - unipolar and bipolar, represented with different pacing artifacts in the ECG signal. The pacing pulse on the skin surface usually have very fast rising edges of the order of 10 µs or less and could be as small as few hundreds µV. The pacing artifacts detection is important since they indicate the presence of a pacemaker and help to evaluate the reaction of the heart. All pertinent medical standards require the pacing artifacts to be captured and indicated on the screen of the device. This paper presents a short review on pacemakers - reasons for implementation, device types, different operation modes and pacing pulses. It reveals some common problems with the detection of pacemaker's artifacts.

  8. Risk of pacemaker implantation after uneventful successful cavotricuspid isthmus radiofrequency ablation in patients with common atrial flutter.

    Science.gov (United States)

    Rodríguez-Mañero, Moisés; González-Melchor, Layla; Ballesteros, Gabriel; Raposeiras-Roubín, Sergio; García-Seara, Javier; López, Xesús Alberte Fernández; Cambeiro, Cristina González; Alcalde, Oscar; García-Bolao, Ignacio; Martínez-Sande, Luis; González-Juanatey, José Ramón

    2016-01-01

    Little is known about the risk of pacemaker implantation after common atrial flutter ablation in the long-term. We retrospectively reviewed the electrophysiology laboratory database at two Spanish University Hospitals from 1998 to 2012 to identify patients who had undergone successful ablation for cavotricuspid dependent atrial flutter. Cox regression analysis was used to examine the risk of pacemaker implantation. A total of 298 patients were considered eligible for inclusion. The mean age of the enrolled patients was 65.7±11. During 57.7±42.8 months, 30 patients (10.1%) underwent pacemaker implantation. In the stepwise multivariate models only heart rate at the time of the ablation (OR: 0.96; 95% CI: 0.93-0.98; ppacemaker implantation. A heart rate of ≤65 bpm was identified as the optimal cut-off value to predict the need of pacemaker implantation in the follow-up (sensitivity: 79%, specificity: 74%) by ROC curve analyses. This is the first study of an association between the slow conducting common atrial flutter and subsequent risk of pacemaker implantation. In light of these findings, assessing it prior to ablation can be helpful for the risk stratification of sinus node disease or atrioventricular conduction disease requiring a pacemaker implantation in patients with persistent atrial flutter. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Pacing system malfunction is a rare cause of hospital admission for syncope in patients with a permanent pacemaker.

    Science.gov (United States)

    Ofman, Peter; Rahilly-Tierney, Catherine; Djousse, Luc; Peralta, Adelqui; Hoffmeister, Peter; Gaziano, J Michael; Weiss, Alexey; Lotan, Chaim; Rosenheck, Shimon

    2013-01-01

    Few studies have examined the prevalence of permanent pacemaker (PPM) malfunction among patients with a previously implanted pacemaker admitted to the hospital with syncope. This study sought to examine causes of syncope in patients with a previously implanted pacemaker admitted to our hospital with syncope. We retrospectively reviewed our hospital admission database for patients who had both keywords "syncope" and "pacemaker" as their diagnoses from January 1, 1995 until June 1, 2012. One hundred and sixty-two patients who were admitted to the hospital because of syncope and had a PPM implanted prior to the index syncopal episode were included. All patients had pacemakers interrogated during the admission. Two independent physicians examined the discharge summary of each patient and determined the cause of syncope in each case. Of the 162 patients studied, eight (4.9%) were found to have pacemaker system malfunction as a cause of syncope. In 96 patients (59.2%), the cause of syncope could not be determined prior to hospital discharge. Among the identifiable causes of syncope, orthostatic hypotension was most prevalent (16%) followed by vasovagal (6%), severe aortic stenosis (4.3%), atrial arrhythmia (3.1%), acute and subacute infection (3.1%), and other less prevalent causes (3.1%). In this study, PPM system malfunction was rarely a cause of syncope in patients admitted to the hospital with a previously implanted device. ©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.

  10. Spanish pacemaker registry. 10th official report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2012).

    Science.gov (United States)

    Coma Samartín, Raúl; Ruiz Mateas, Francisco; Fidalgo Andrés, María Luisa; Leal del Ojo González, Juan; Pérez Álvarez, Luisa

    2013-12-01

    Our aim was to analyze the pacemaker implantations and replacements reported to the Spanish Pacemaker Registry in 2012 with special reference to the selection of pacing modes. The analysis was based on information provided by the European Pacemaker Patient Identification Card. Data were received from 115 hospitals, with a total of 12 856 cards. An estimated 745.8 pacemaker generators and 53.1 resynchronization devices were implanted per million population. Active fixation leads were implanted in more than 70% of the patients; of these leads, more than 20% were safe for use with magnetic resonance. The most common electrocardiographic indication for pacemaker implantation was atrioventricular block (56%). In all, 28% of the patients with sick sinus syndrome were paced in VVIR mode. The use of conventional pacemakers remained stable, whereas the implantation of resynchronization devices increased. Active fixation leads are now employed in most patients. The findings of this study confirm the higher incidence of implantation in men and at an earlier age due to the higher rate of conduction disorders. Age is a factor that influences the choice of the appropriate pacing mode. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  11. Spanish Pacemaker Registry. 14th Official Report of the Spanish Society of Cardiology Working Group on Cardiac Pacing (2016).

    Science.gov (United States)

    Cano Pérez, Óscar; Pombo Jiménez, Marta; Fidalgo Andrés, María Luisa; Lorente Carreño, Diego; Coma Samartín, Raúl

    2017-12-01

    This report describes the results of analysis of implanted pacemakers reported to the Spanish Pacemaker Registry. The analysis was based on information provided by the European Pacemaker Identification Card. Information was received from 115 hospitals, with a total of 12 697 cards, representing 32.3% of the estimated activity. Use of conventional and resynchronization pacemakers was 818 and 79 units per million inhabitants, respectively. A total of 200 leadless pacemakers were implanted. The mean age of the patients receiving an implant was 77.8 years, and 52% of devices were implanted in persons older than 80 years. In all, 74.9% were first implants and 23.4% corresponded to generator exchange. Endocardial leads were bipolar, 82.9% with active fixation, and 16.1% had magnetic resonance imaging protection. Most patients received bicameral sequential pacing, although single chamber pacing VVI(R) was used in 26.7% of the patients with sick sinus syndrome and in 23.8% of those with atrioventricular block, despite sinus rhythm. Total use of pacemaker generators in Spain has increased by 1.6% compared with 2015. Most implanted leads have active fixation and less than 20% have magnetic resonance imaging protection. Age and sex directly influenced pacing mode selection, which could be improved in around 32% of patients. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  12. Temporary effects of alcohol on color vision

    Science.gov (United States)

    Geniusz, Maciej K.; Geniusz, Malwina; Szmigiel, Marta; Przeździecka-Dołyk, Joanna

    2017-09-01

    The color vision has been described as one to be very sensitive to the intake of several chemicals. The present research reviews the published literature that is concerned with color vision impairment due to alcohol. Most of this research considers people under long-term effects of alcohol. However, there is little information about temporary effects of alcohol on color vision. A group of ten volunteers aged 18-40 was studied. During the study levels of alcohol in the body were tested with a standard breathalyzer while color vision were studied using Farnsworth Munsell 100 Hue Color Vision Tests. Keywords: Col

  13. Temporary new opening hours for Gate C

    CERN Multimedia

    GS Department

    2010-01-01

    Please note the new temporary opening hours for the gate C as from 22 September 2010 until 29 October 2010 (working days): Morning: between 7:00 a.m. and 9:00 a.m. Lunch: between 12:00 and 2:00 p.m. Evening: between 5:00 pm and 7:00 p.m. Traffic flow will be permitted in both directions during this period. Please minimize your speed accordingly and respect all road signs. GS-SEM Group General Infrastructure Services Department

  14. Polytetrafluoroethylene-coated pacemaker leads as surgical management of contact allergy to silicone.

    Science.gov (United States)

    Vodiskar, Janez; Schnöring, Heike; Sachweh, Jörg S; Mühler, Eberhard; Vazquez-Jimenez, Jaime F

    2014-01-01

    We have previously reported an 18-year-old girl with a congenital heart defect who developed complete heart block after one of her corrective surgeries and who needed an epicardial pacemaker implantation. She developed contact sensitivity to silicone compounds. The problem was solved by implanting a silicone-free pacemaker system utilizing silicone-free transvenous leads. The patient was readmitted 2 years later due to lead failure. As no silicone-free epicardial leads were available, we decided to use standard silicone epicardial leads and enclose the whole system in Gore-Tex material (W.L. Gore & Associates, Flagstaff, AZ). Based on our experience we would discourage the use of silicone-free transvenous pacing leads for epicardial use. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Successful percutaneous retrieval of a leadless pacemaker due to an acute rise in pacing threshold

    Directory of Open Access Journals (Sweden)

    Ngai-yin Chan

    2017-11-01

    Full Text Available Leadless cardiac pacemakers (LCP have become available recently. Both its acute and long-term performance in a large population of patients remain to be tested. Subacute rise in pacing threshold has been reported as an uncommon complication. On the other hand, the retrieval technique for LCP with passive fixation mechanism has not been previously described in details. Herein we report a newly recognized complication of an acute rise in pacing threshold very soon after implantation of an LCP without radiographic dislodgement. Percutaneous retrieval of this LCP with passive fixation mechanism was successful using a novel technique with the cryoballoon steerable sheath and a snare. Keywords: Leadless pacemaker, Percutaneous retrieval, Pacing threshold, Bradycardia, Dislodgement

  16. Pacemakers and implantable cardioverter defibrillators, unknown to chest radiography: Review, complications and systematic reading

    Energy Technology Data Exchange (ETDEWEB)

    Alandete Germán, Salvador Pascual, E-mail: salaiger@gmail.com; Isarria Vidal, Santiago, E-mail: isarria@comv.es; Domingo Montañana, María Luisa, E-mail: domingo.luimon@gmail.com; De la vía Oraá, Esperanza, E-mail: esviao82@gmail.com; Vilar Samper, José, E-mail: vilarsamper@gmail.com

    2015-03-15

    Highlights: •Radiologists have an important function in the evaluation of these devices. •We revise their radiological appearances and possible complications. •The knowledge in normal aspects and complications is important for radiologist. •To ensure an accurate reading of the chest x-ray, we present a systematic approach. -- Abstract: Chest X-ray is the imaging technique of choice for an initial study of pacemakers and implantable cardio-defibrillators (ICD). Radiologists have an important role in the evaluation of its initial placement and in the assessment during its follow-up. For this reason, it is necessary to know not only the different existing devices and its components but also the reasons of malfunction or possible complications. The purpose of this article is to do a systematic review of the different types of pacemakers and ICD. We review their usual radiological appearances, the possible complications which might take place and its causes of malfunctioning.

  17. Combined application of extracorporeal membrane oxygenation and an artificial pacemaker in fulminant myocarditis in a child.

    Science.gov (United States)

    Ye, Sheng; Zhu, Lvchan; Ning, Botao; Zhang, Chenmei

    2017-06-01

    Fulminant myocarditis is severe and aggressive, but it is self-limited and usually has a favorable prognosis if the patients can survive the acute phase. When drug treatment is not effective, extracorporeal membrane oxygenation technology should be applied to support cardiopulmonary function. Extracorporeal membrane oxygenation can simultaneously support function of the left ventricle, right ventricle, and lungs, and provide stable blood circulation for patients with heart and respiratory failure, which allows sufficient time for the cardiopulmonary system to recover. Fulminant myocarditis affects cardiac systolic function, as well as the function of autorhythmic cells and the conduction system. If severe bradycardia or atrioventricular block appears, a pacemaker needs to be installed. We report a child with fulminant myocarditis who was treated with extracorporeal membrane oxygenation combined with an artificial pacemaker.

  18. Minimum quench energy measurement for superconducting wires

    International Nuclear Information System (INIS)

    Seo, K.; Morita, M.; Nakamura, S.; Yamada, T.; Jizo, Y.

    1996-01-01

    The authors have developed a new method of measuring minimum quench energy (MQE) of superconducting wire. There have been conventional methods using heating wires, whose diameters are ∼0.1mm and are glued by epoxy resin. When they induce a pulse heat to superconducting wires, a duration of the pulse must be several hundreds micro seconds to demonstrate actual disturbances (for instance wire motion) in a superconducting magnet. In spite of this fact, thermal diffusion time constants of the conventional heaters are larger than the duration of the actual disturbance, because of these electrical insulator of the heating wire and the epoxy bind. Therefore, this kind of heater is not able to demonstrate the actual disturbance. To solve this problem, they have proposed a new constitution of a heater. In the method, heat generation is introduced in high resistive layer on a surface of a superconducting wire. The high resistive layer is consist of carbon paste. The thickness of the carbon paste layer is ∼20microm, thus a time constant of this heater is expected to be small enough to demonstrate the actual disturbance. Adopting the new method to the MQE measurement, they successfully evaluate MQE of superconducting wires with high precision. Several results are introduced in this paper

  19. Wire pad chamber for LHCb muon system

    CERN Document Server

    Botchine, B; Lazarev, V A; Sagidova, N; Vorobev, A P; Vorobyov, A; Vorobyov, Alexei

    2000-01-01

    2000-003 Wire pad chambers (WPC) have been proposed for the outer Region 4 of the LHCb Muon System. These are double gap MWPCs with small wire spacing allowing to obtain 99% detection efficiency in a 20 ns time window. The chambers have a rectangular shape with the vertical dimension from 20 cm in Station 1 to 30 cm in Station 5. The horizontal dimensions will be different with the maximal size of 3 meters in Station 5. The wires are in the vertical direction. The short wire length allows to use small wire spacing needed for high time resolution. Also, this helps to obtain the uniform gas gain over the whole chamber area. The WPC has one row of the wire pads formed by grouping wires in separate readout channels. Four WPC prototypes have been built at PNPI and tested in the PS beam at CERN. Here we report on the results from these tests. Also, the results of simulation of the WPC performance are presented.

  20. Local hypertrichosis: A rare complication of a temporary henna tattoo.

    Science.gov (United States)

    Akpolat, Nebahat Demet; Aras, Arzu

    2016-01-01

    Temporary henna tattoos have become increasingly widespread among children and young people, especially in holiday spots in recent years. Although reactions to henna tattoo are becoming progressively more common, only few cases of a henna pseudo-tattoo resulting in temporary hypertrichosis have been reported so far. Here, we have reported a 5-year-old girl who developed allergic contact dermatitis and localized hypertrichosis on her right arm after application of temporary henna tattoo during summer holiday.

  1. Morbidity with temporary disability in Kozloduy NPP workers

    International Nuclear Information System (INIS)

    Dobreva, B.; Novkirishki, V.

    1993-01-01

    Changes with time in indicators of disease incidence with temporary disability in Kozloduy NPP personnel have been studied for the period 1974-1991. The data were compared with those for 'Sofia-Iztok' TPP. The causes contributing to formation of the indicators of frequency, severity, and average duration were examined. No temporary disability because of radiation exposure has been recorded. As a whole, less temporary disability has been found at NPP than at TPP. (author)

  2. Generation of locomotion rhythms without inhibition in vertebrates: the search for pacemaker neurons.

    Science.gov (United States)

    Li, Wen-Chang

    2011-12-01

    Locomotion rhythms are thought to be generated by neurons in the central-pattern-generator (CPG) circuit in the spinal cord. Synaptic connections in the CPG and pacemaker properties in certain CPG neurons, both may contribute to generation of the rhythms. In the half-center model proposed by Graham Brown a century ago, reciprocal inhibition plays a critical role. However, in all vertebrate preparations examined, rhythmic motor bursts can be induced when inhibition is blocked in the spinal cord. Without inhibition, neuronal pacemaker properties may become more important in generation of the rhythms. Pacemaker properties have been found in motoneurons and some premotor interneurons in different vertebrates and they can be dependent on N-Methyl-d-aspartate (NMDA) receptors (NMDAR) or rely on other ionic currents like persistent inward currents. In the swimming circuit of the hatchling Xenopus tadpole, there is substantial evidence that emergent network properties can give rise to swimming rhythms. During fictive swimming, excitatory interneurons (dINs) in the caudal hindbrain fire earliest on each swimming cycle and their spikes drive the firing of other CPG neurons. Regenerative dIN firing itself relies on reciprocal inhibition and background excitation. We now find that the activation of NMDARs can change dINs from firing singly at rest to current injection to firing repetitively at swimming frequencies. When action potentials are blocked, some intrinsic membrane potential oscillations at about 10 Hz are revealed, which may underlie repetitive dIN firing during NMDAR activation. In confirmation of this, dIN repetitive firing persists in NMDA when synaptic transmission is blocked by Cd(2+). When inhibition is blocked, only dINs and motoneurons are functional in the spinal circuit. We propose that the conditional intrinsic NMDAR-dependent pacemaker firing of dINs can drive the production of swimming-like rhythms without the participation of inhibitory

  3. Twenty-Seven Years Experience With Transvenous Pacemaker Implantation in Children Weighing <10 kg.

    Science.gov (United States)

    Konta, Laura; Chubb, Mark Henry; Bostock, Julian; Rogers, Jan; Rosenthal, Eric

    2016-02-01

    Epicardial pacemaker implantation is the favored approach in children weighing 5 kg during long-term follow-up. After a median of 14.3 (range, 13.4-17.6) years of pacing, 7 patients continue with their original lead. Transvenous pacing in infants <10 kg results in encouraging short- and long-term clinical outcomes. Subclavian vein occlusion remains an important complication, occurring predominantly in those weighing <5 kg. © 2016 American Heart Association, Inc.

  4. Pacemaker in complicated and refractory breath-holding spells: when to think about it?

    Science.gov (United States)

    Sartori, Stefano; Nosadini, Margherita; Leoni, Loira; de Palma, Luca; Toldo, Irene; Milanesi, Ornella; Cerutti, Alessia; Suppiej, Agnese

    2015-01-01

    Breath-holding spells (BHS) are benign non-epileptic paroxysmal events of infancy, rarely occurring with high frequency and complicated by prolonged syncope, convulsions and even status epilepticus. In these cases response to medical treatment is often unsatisfactory. Pacemaker implantation is a possible therapeutic option, but its indications, efficacy and complications have not been clarified yet. To report a new case of BHS treated with pacemaker and to review its indications and efficacy in patients with severe BHS. We extensively searched the literature in PubMed on cardiac pacing in patients with BHS and we described a new case. A previously healthy boy presented at the age of 4 months with frequent BHS inconstantly associated to prolonged syncope and post-anoxic non-epileptic and epileptic seizures. Parental reassurance, iron supplementation and piracetam were ineffective. After cardiac pacing at the age of 16 months, BHS and their complications disappeared. We identified 47 patients with BHS treated with pacemaker in the literature. Based on the available data, in all patients asystole or marked bradycardia were documented during BHS or stimulating maneuvers; syncope complicated BHS in 100% of cases and post-anoxic convulsions in 78.3%. Medical treatment before pacing, when administered, was ineffective or poorly tolerated. After pacing, BHS complications disappeared in 86.4% of cases, and decreased in 13.6%. Technical problems with the device were reported in 25.7% of patients and mild medical complications in 11.4%. Pacemaker could be reasonably considered in subjects with frequent and severe BHS, poor response to medications, and demonstration of cardioinhibition during spells. Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  5. [Safety of implantation permanent pacemaker at different times in patients with dual antiplatelet therapy].

    Science.gov (United States)

    Wang, Zhanqi; Cong, Hongliang; Li, Zheng; Zhang, Lanfang; Zhang, Fang; Li, Xiangxin

    2016-05-10

    To investigate the safety of implantation permanent pacemaker (PM) at different times in patients with dual antiplatelet (DAPT) therapy after implantation of drug-eluting stent (DES). A total of 105 patients who implanted pacemakers with DAPT therapy (clopidogrel and aspirin) after implantation of DES admitted to our hospital from January 2009 to January 2015 were enrolled in the study. The patients were divided into 3 groups: dual antiplatelet therapy (DAP) group: implanting PM within 3 months after coronary stenting, continuous DAPT during perioperative period; low molecular weight heparin (LMWH) bridging group: implanting PM within 3 to 6 months after coronary stenting, DAPT interruption for 5 days replaced with subcutaneous injection of enoxaparin (1 mg/kg), twice per day, enoxaparin was stopped 12 h before operation; asprin group, implanting PM after coronary stenting 6 months, clopidogrel interruption for 5 days. Oral DAPT was returned 12-24 after operation according to the patients' condition. Peri-operative cardiovascular events and bleedings, infections were observed. There was no major adverse cardiac event (MACE) and pouch infection were observed among 3 groups in perioperation. The incidence of pocket hemorrhage and errhysis in bridging group was significantly higher than that of DAP group and asprin group (16.7%, 8.0%, 0.0% χ(2)=10.431, P=0.005 and 29.2%, 12.0%, 7.1% χ(2)=6.321, P=0.042 respectively). 3 patients had severe bleeding (12.5%, 3/24) in bridging group; compared with the other 2 groups, there were significant difference (χ(2)=9.161, P=0.010). The incidence of hematoma and hemorrhage of asprin group was lowest. LMWH bridging therapy significantly increases the risk of pacemaker pocket hematoma and hemorrhage, and the pacemaker implantation may be safer after DES implantation 6 months.

  6. Utilization of Electrocardiographic P-wave Duration for AV Interval Optimization in Dual-Chamber Pacemakers.

    Science.gov (United States)

    Sorajja, Dan; Bhakta, Mayurkumar D; Scott, Luis Rp; Altemose, Gregory T; Srivathsan, Komandoor

    2010-09-05

    Empiric programming of the atrio-ventricular (AV) delay is commonly performed during pacemaker implantation. Transmitral flow assessment by Doppler echocardiography can be used to find the optimal AV delay by Ritter's method, but this cannot easily be performed during pacemaker implantation. We sought to determine a non-invasive surrogate for this assessment. Since electrocardiographic P-wave duration estimates atrial activation time, we hypothesized this measurement may provide a more appropriate basis for programming AV intervals. A total of 19 patients were examined at the time of dual chamber pacemaker implantation, 13 (68%) being male with a mean age of 77. Each patient had the optimal AV interval determined by Ritter's method. The P-wave duration was measured independently on electrocardiograms using MUSE® Cardiology Information System (version 7.1.1). The relationship between P-wave duration and the optimal AV interval was analyzed. The P-wave duration and optimal AV delay were related by a correlation coefficient of 0.815 and a correction factor of 1.26. The mean BMI was 27. The presence of hypertension, atrial fibrillation, and valvular heart disease was 13 (68%), 3 (16%), and 2 (11%) respectively. Mean echocardiographic parameters included an ejection fraction of 58%, left atrial index of 32 ml/m(2), and diastolic dysfunction grade 1 (out of 4). In patients with dual chamber pacemakers in AV sequentially paced mode and normal EF, electrocardiographic P-wave duration correlates to the optimal AV delay by Ritter's method by a factor of 1.26.

  7. Atrio-ventricular junction ablation and pacemaker treatment: a comparison between men and women.

    Science.gov (United States)

    Carnlöf, Carina; Insulander, Per; Jensen-Urstad, Mats; Iwarzon, Marie; Gadler, Fredrik

    2018-03-14

    To explore sex differences regarding indication for atrio-ventricular junction ablation (AVJ), choice of pacing system, complications to pacemaker treatment, long-term outcome, and cause of death after AVJ ablation. 700 patients who had undergone AVJ ablation between January 1990 and December 2010 were included. Data were retrieved from the patients´ medical records and the Swedish Pacemaker and Implantable Cardioverter-Defibrillator Registry. Information about admission to hospital and cause of death was retrieved from the National Board of Health and Welfare. Mean follow-up was 90 ± 64 months. Indication for AVJ ablation, choice of pacing system, and outcome after AVJ ablation differed between the sexes. The men had more often permanent atrial fibrillation, p = .0001, and a VVIR pacemaker or cardiac resynchronization therapy (CRT) implanted prior to ablation, p = .0001. Heart failure was present in 44% of the men vs. 28% of the women, p = .0001. LVEF decreased slightly in the whole cohort after the AVJ ablation. There were no sex differences in complication rates due to the pacemaker/ICD treatment, p = .3 or mortality due to AVJ ablation. In this long-term follow-up in patients with atrial fibrillation treated with AVJ ablation and pacing, indication, choice of pacing system, and morbidity differed but there were no sex differences regarding survival or primary cause of death found. The main factor influencing survival was age at the time of ablation. Women less often received treatment with ICD and/or CRT when indication was present compared with men.

  8. Treatment of pacemaker-induced superior vena cava syndrome by balloon angioplasty and stenting.

    LENUS (Irish Health Repository)

    Klop, B

    2011-01-01

    Superior vena cava (SVC) syndrome is a rare but serious complication after pacemaker implantation. This report describes three cases of SVC syndrome treated with venoplasty and venous stenting, with an average follow-up of 30.7 (±3.1) months. These cases illustrate that the definitive diagnosis, and the extent and location of venous obstruction, can only be determined by venography.

  9. Kearns-Sayre syndromes an absolute indication for prophylactic implantation of definitive pacemaker?

    Science.gov (United States)

    Barragán-Campos, H M; Barrera-Ramírez, C F; Iturralde Torres, P; Ilarraza-Lomelí, H; Avila-Casado, M C; Estañol, B; Dorantes, J; Oseguera, J

    1999-01-01

    Kearns-Sayre syndrome is a mitochondrial cytopathy characterized by chronic progressive external ophthalmoplegia, retinitis pigmentosa and heart block, the last of which determines the survival of these patients. The case of a 23 year old man with Kearns-Sayre syndrome, conduction disturbances and mitral valve prolapse is presented. The characteristics of this syndrome are described and the criteria for prophylactic installation of a pacemaker discussed.

  10. Can a Self-Diagnostic Digitally Controlled Pacemaker/Defibrillator Device be Used for Alerting Military Personnel When a Soldier Health Condition Becomes Compromised Out in the Field

    Science.gov (United States)

    2007-01-26

    function. In 1947 Dr. Claude Beck defibrillated the first human heart. Dr. John Hopps’ concepts, innovation, and theory of the pacemaker came to...5000 ABSTRACT The Self-Diagnostic Digitally Controlled Pacemaker/ Defibrillator Device (SDDCPDD) has several features that I think may be...very useful to the Armed Services. Even though this device is designed as a pacemaker/ defibrillator device; its applications can be used as a

  11. Resonant tunneling of electrons in quantum wires

    International Nuclear Information System (INIS)

    Krive, I.V.; Shekhter, R.I.; Jonson, M.; Krive, I.V.

    2010-01-01

    We considered resonant electron tunneling in various nanostructures including single wall carbon nanotubes, molecular transistors and quantum wires formed in two-dimensional electron gas. The review starts with a textbook description of resonant tunneling of noninteracting electrons through a double-barrier structure. The effects of electron-electron interaction in sequential and resonant electron tunneling are studied by using Luttinger liquid model of electron transport in quantum wires. The experimental aspects of the problem (fabrication of quantum wires and transport measurements) are also considered. The influence of vibrational and electromechanical effects on resonant electron tunneling in molecular transistors is discussed.

  12. Problems associated with iridium-192 wire implants

    International Nuclear Information System (INIS)

    Arnott, S.J.; Law, J.; Ash, D.; Flynn, A.; Paine, C.H.; Durrant, K.R.; Barber, C.D.; Dixon-Brown, A.

    1985-01-01

    Three incidents are reported, from different radiotherapy centres, in which an implanted iridium-192 wire remained in the tissues of a patient after withdrawal of the plastic tubing in which it was contained. In each case the instrument used to cut the wire had probably formed a hook on the end of the wire which caused it to catch in the tissues. Detailed recommendations are made for avoiding such incidents in the future, the most important of which is that the patient should be effectively monitored after the supposed removal of all radioactive sources. (author)

  13. Investigation of wire motion in superconducting magnets

    International Nuclear Information System (INIS)

    Ogitsu, T.; Tsuchiya, K.; Devred, A.

    1990-09-01

    The large Lorentz forces occuring during the excitation of superconducting magnets can provoke sudden motions of wire, which eventually release enough energy to trigger a quench. These wire motions are accompanied by two electromagnetic effects: an induced emf along the moved wire, and a local change in flux caused by the minute dislocation of current. Both effects cause spikes in the coil voltage. Voltage data recorded during the excitation of a superconducting quadrupole magnet which early exhibit such events are here reported. Interpretations of the voltage spikes in terms of energy release are also presented, leading to insights on the spectrum of the disturbances which occur in real magnets. 15 refs

  14. Safety of the Wearable Cardioverter Defibrillator (WCD) in Patients with Implanted Pacemakers.

    Science.gov (United States)

    Schmitt, Joern; Abaci, Guezine; Johnson, Victoria; Erkapic, Damir; Gemein, Christopher; Chasan, Ritvan; Weipert, Kay; Hamm, Christian W; Klein, Helmut U

    2017-03-01

    The wearable cardioverter defibrillator (WCD) is an important approach for better risk stratification, applied to patients considered to be at high risk of sudden arrhythmic death. Patients with implanted pacemakers may also become candidates for use of the WCD. However, there is a potential risk that pacemaker signals may mislead the WCD detection algorithm and cause inappropriate WCD shock delivery. The aim of the study was to test the impact of different types of pacing, various right ventricular (RV) lead positions, and pacing modes for potential misleading of the WCD detection algorithm. Sixty patients with implanted pacemakers received the WCD for a short time and each pacing mode (AAI, VVI, and DDD) was tested for at least 30 seconds in unipolar and bipolar pacing configuration. In case of triggering the WCD detection algorithm and starting the sequence of arrhythmia alarms, shock delivery was prevented by pushing of the response buttons. In six of 60 patients (10%), continuous unipolar pacing in DDD mode triggered the WCD detection algorithm. In no patient, triggering occurred with bipolar DDD pacing, unipolar and bipolar AAI, and VVI pacing. Triggering was independent of pacing amplitude, RV pacing lead position, and pulse generator implantation site. Unipolar DDD pacing bears a high risk of false triggering of the WCD detection algorithm. Other types of unipolar pacing and all bipolar pacing modes do not seem to mislead the WCD detection algorithm. Therefore, patients with no reprogrammable unipolar DDD pacing should not become candidates for the WCD. © 2016 Wiley Periodicals, Inc.

  15. Magnetic resonance imaging safety in pacemaker and implantable cardioverter defibrillator patients: how far have we come?

    Science.gov (United States)

    Nordbeck, Peter; Ertl, Georg; Ritter, Oliver

    2015-01-01

    Magnetic resonance imaging (MRI) has long been regarded a general contraindication in patients with cardiovascular implanted electronic devices such as cardiac pacemakers or cardioverter defibrillators (ICDs) due to the risk of severe complications and even deaths caused by interactions of the magnetic resonance (MR) surrounding and the electric devices. Over the last decade, a better understanding of the underlying mechanisms responsible for such potentially life-threatening complications as well as technical advances have allowed an increasing number of pacemaker and ICD patients to safely undergo MRI. This review lists the key findings from basic research and clinical trials over the last 20 years, and discusses the impact on current day clinical practice. With ‘MR-conditional’ devices being the new standard of care, MRI in pacemaker and ICD patients has been adopted to clinical routine today. However, specific precautions and specifications of these devices should be carefully followed if possible, to avoid patient risks which might appear with new MR technology and further increasing indications and patient numbers. PMID:25796053

  16. Complete atrial-specific knockout of sodium-calcium exchange eliminates sinoatrial node pacemaker activity.

    Directory of Open Access Journals (Sweden)

    Sabine Groenke

    Full Text Available The origin of sinoatrial node (SAN pacemaker activity in the heart is controversial. The leading candidates are diastolic depolarization by "funny" current (If through HCN4 channels (the "Membrane Clock" hypothesis, depolarization by cardiac Na-Ca exchange (NCX1 in response to intracellular Ca cycling (the "Calcium Clock" hypothesis, and a combination of the two ("Coupled Clock". To address this controversy, we used Cre/loxP technology to generate atrial-specific NCX1 KO mice. NCX1 protein was undetectable in KO atrial tissue, including the SAN. Surface ECG and intracardiac electrograms showed no atrial depolarization and a slow junctional escape rhythm in KO that responded appropriately to β-adrenergic and muscarinic stimulation. Although KO atria were quiescent they could be stimulated by external pacing suggesting that electrical coupling between cells remained intact. Despite normal electrophysiological properties of If in isolated patch clamped KO SAN cells, pacemaker activity was absent. Recurring Ca sparks were present in all KO SAN cells, suggesting that Ca cycling persists but is uncoupled from the sarcolemma. We conclude that NCX1 is required for normal pacemaker activity in murine SAN.

  17. Pacemaker lead fracture without an increase in lead impedance caused by cardiac fibroma

    Directory of Open Access Journals (Sweden)

    Daisuke Sato

    2013-12-01

    Full Text Available We report the case of a 64-year-old man who had a permanent pacemaker with a unipolar silicone electrode positioned in the right ventricle in 1989 for sinus node dysfunction. On a routine checkup in June 2011, a 28-mm-diameter mass was discovered, which appeared to adhere to the tricuspid valve and the ventricular lead. The size of the mass did not change for the next 6 months, and the lead impedance was maintained at around 500–600 Ω. Because pacing failure was observed in January 2012, he underwent an urgent pacemaker check; however, the lead impedance was found not to have increased greatly (689 Ω. Nevertheless, the pacemaker lead was noted to be fractured at the tricuspid level. His echocardiogram showed new severe tricuspid regurgitation and a floating mass around the lead. We extracted the fractured lead, enucleated the tumor, replaced the tricuspid valve, and placed an epicardial lead. Macroscopic examination revealed that the tumor surrounded the fractured lead and covered the stump. Pathological examination revealed that the tumor was composed of fibrous connective tissue. We presumed that electric current continued to flow through the stump of the fractured unipolar lead to the generator, and this might have caused the limited increase in lead impedance.

  18. Powering a leadless pacemaker using a PiezoMEMS energy harvester

    Science.gov (United States)

    Jackson, Nathan; Olszewski, Oskar; O'Murchu, Cian; Mathewson, Alan

    2017-06-01

    MEMS based vibrational energy harvesting devices have been a highly researched topic over the past decade. The application targeted in this paper focuses on a leadless pacemaker that will be implanted in the right ventricle of the heart. A leadless pacemaker requires the same functionality as a normal pacemaker, but with significantly reduced volume. The reduced volume limits the space for a battery; therefore an energy harvesting device is required. This paper compares varying the dimensions of a linear MEMS based piezoelectric energy harvester that can harvest energy from the mechanical vibrations of the heart due to shock induced vibration. Typical MEMS linear energy harvesting devices operate at high frequency (<50 Hz) with low acceleration (< 1g). The force generated from the heart acts as a series of impulses as opposed to traditional sinusoidal vibration force with high acceleration (1-4 g). Therefore the design of a MEMS harvester that is based on shock-induced vibration is necessary. PiezoMEMS energy harvesting devices consisting of a silicon substrate and mass with aluminium nitride piezoelectric material were developed and characterized using acceleration forces that mimic the heartbeat. Peak powers of up to 25μW were obtained at 1 g acceleration with a powder density of approximately 1.5 mW cm-3.

  19. From two competing oscillators to one coupled-clock pacemaker cell system

    Science.gov (United States)

    Yaniv, Yael; Lakatta, Edward G.; Maltsev, Victor A.

    2015-01-01

    At the beginning of this century, debates regarding “what are the main control mechanisms that ignite the action potential (AP) in heart pacemaker cells” dominated the electrophysiology field. The original theory which prevailed for over 50 years had advocated that the ensemble of surface membrane ion channels (i.e., “M-clock”) is sufficient to ignite rhythmic APs. However, more recent experimental evidence in a variety of mammals has shown that the sarcoplasmic reticulum (SR) acts as a “Ca2+-clock” rhythmically discharges diastolic local Ca2+ releases (LCRs) beneath the cell surface membrane. LCRs activate an inward current (likely that of the Na+/Ca2+ exchanger) that prompts the surface membrane “M-clock” to ignite an AP. Theoretical and experimental evidence has mounted to indicate that this clock “crosstalk” operates on a beat-to-beat basis and determines both the AP firing rate and rhythm. Our review is focused on the evolution of experimental definition and numerical modeling of the coupled-clock concept, on how mechanisms intrinsic to pacemaker cell determine both the heart rate and rhythm, and on future directions to develop further the coupled-clock pacemaker cell concept. PMID:25741284

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

    Science.gov (United States)

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

    1976-11-04

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

  1. Ictal asystole in temporal lobe epilepsy before and after pacemaker implantation.

    Science.gov (United States)

    Strzelczyk, Adam; Bauer, Sebastian; Knake, Susanne; Oertel, Wolfgang H; Hamer, Hajo M; Rosenow, Felix

    2008-03-01

    Events of ictal bradycardia or asystole may be of relevance in epilepsy patients presenting with ictal falls, and are a potential contributor to SUDEP. The literature on ictal bradycardia or asystole is anecdotal and consists of case reports and small case series. There are no guidelines for the care of patients with ictal arrhythmias. Insertion of cardiac pacemakers may prevent life-threatening cardiac arrest, syncope and trauma. We report the case of a 41-year-old man who presented with refractory partial seizures resulting in syncope leading to severe head trauma, as the only ictal semiology. During presurgical video-EEG monitoring, two episodes of ictal bradycardia followed by asystole and syncope were recorded. A cardiac pacemaker was implanted. At the nine-month follow-up, the patient reported no overt seizures, syncopes or traumatic falls. Our case demonstrates that implantation of a cardiac pacemaker while continuing AEDs may render a patient free from ictal symptoms and prevent ictal syncope and subsequent trauma. [Published with video sequences].

  2. Low frequency magnetic emissions and resulting induced voltages in a pacemaker by iPod portable music players

    Directory of Open Access Journals (Sweden)

    Bassen Howard

    2008-02-01

    Full Text Available Abstract Background Recently, malfunctioning of a cardiac pacemaker electromagnetic, caused by electromagnetic interference (EMI by fields emitted by personal portable music players was highly publicized around the world. A clinical study of one patient was performed and two types of interference were observed when the clinicians placed a pacemaker programming head and an iPod were placed adjacent to the patient's implanted pacemaker. The authors concluded that "Warning labels may be needed to avoid close contact between pacemakers and iPods". We performed an in-vitro study to evaluate these claims of EMI and present our findings of no-effects" in this paper. Methods We performed in-vitro evaluations of the low frequency magnetic field emissions from various models of the Apple Inc. iPod music player. We measured magnetic field emissions with a 3-coil sensor (diameter of 3.5 cm placed within 1 cm of the surface of the player. Highly localized fields were observed (only existing in a one square cm area. We also measured the voltages induced inside an 'instrumented-can' pacemaker with two standard unipolar leads. Each iPod was placed in the air, 2.7 cm above the pacemaker case. The pacemaker case and leads were placed in a saline filled torso simulator per pacemaker electromagnetic compatibility standard ANSI/AAMI PC69:2000. Voltages inside the can were measured. Results Emissions were strongest (≈ 0.2 μT pp near a few localized points on the cases of the two iPods with hard drives. Emissions consisted of 100 kHz sinusoidal signal with lower frequency (20 msec wide pulsed amplitude modulation. Voltages induced in the iPods were below the noise level of our instruments (0.5 mV pp in the 0 – 1 kHz band or 2 mV pp in the 0 – 5 MHz bandwidth. Conclusion Our measurements of the magnitude and the spatial distribution of low frequency magnetic flux density emissions by 4 different models of iPod portable music players. Levels of less than 0.2

  3. Ca2+-clock-dependent pacemaking in the sinus node is impaired in mice with a cardiac specific reduction in SERCA2 abundance

    Directory of Open Access Journals (Sweden)

    Sunil Jit Ramamoorthy Jeewanlal Logantha

    2016-06-01

    Full Text Available Background: The sarcoplasmic reticulum Ca2+-ATPase (SERCA2 pump is an important component of the Ca2+-clock pacemaker mechanism that provides robustness and flexibility to sinus node pacemaking. We have developed transgenic mice with reduced cardiac SERCA2 abundance (Serca2 KO as a model for investigating SERCA2’s role in sinus node pacemaking.Methods and Results: In Serca2 KO mice, ventricular SERCA2a protein content measured by Western blotting was 75% (P70% Serca2 downregulation.Conclusions: Serca2 KO mice show a disrupted Ca2+-clock-dependent pacemaker mechanism contributing to impaired sinus node and atrioventricular node function.

  4. Radiotherapy with linear accelerator in a patient with permanent pacemaker, methodology and results of dose determination in a case in vivo

    International Nuclear Information System (INIS)

    Diaz A, P.; Dominguez O, X.; Toledo B, V.; Nungaray, H.; Zazueta L, F.

    2010-09-01

    This work presents the methodology used by the radiotherapy department of the Hospital San Javier in the patients handling with pacemaker. By means of dosimetry to the implant area of the pacemaker together with electrocardiography measurements during the radiotherapy sessions, the pacemaker performance is evaluated with the objective of detecting any anomaly to the same caused by electromagnetic interference and/or accumulated dose. It is necessary to follow specific protocols in these patients type that guarantee their security during the exposition to ionizing radiation since a definitive consent that allows to calculate the failure probability of pacemaker in this therapeutic condition does not exist. (Author)

  5. 47 CFR 76.802 - Disposition of cable home wiring.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Disposition of cable home wiring. 76.802... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Inside Wiring § 76.802 Disposition of cable home wiring... cable operator shall not remove the cable home wiring unless it gives the subscriber the opportunity to...

  6. Automatic reel controls filler wire in welding machines

    Science.gov (United States)

    Millett, A. V.

    1966-01-01

    Automatic reel on automatic welding equipment takes up slack in the reel-fed filler wire when welding operation is terminated. The reel maintains constant, adjustable tension on the wire during the welding operation and rewinds the wire from the wire feed unit when the welding is completed.

  7. 47 CFR 32.2321 - Customer premises wiring.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Customer premises wiring. 32.2321 Section 32... Customer premises wiring. (a) This account shall include all amounts transferred from the former Account 232, Station Connections, inside wiring subclass. (b) Embedded Customer Premises Wiring is that...

  8. 30 CFR 77.701-3 - Grounding wires; capacity.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Grounding wires; capacity. 77.701-3 Section 77... MINES Grounding § 77.701-3 Grounding wires; capacity. Where grounding wires are used to ground metallic sheaths, armors, conduits, frames, casings, and other metallic enclosures, such grounding wires will be...

  9. Wire Bonder: Kulicke and Soffa Model 4526

    Data.gov (United States)

    Federal Laboratory Consortium — Description:CORAL Name: Wire BonderNeeds Description.Scientific Opportunities / Applications:Wedge bonderSemi-automatic and manual modesIndependent Z-axis control,...

  10. Beam Profiling through Wire Chambing Tracking

    CERN Document Server

    Nash, W

    2013-01-01

    This note describes the calibration of the Delay Wire Chambers (DWCs) used during test runs of CALICE’s Tungsten Digital Hadron Calorimeter (W-DHCAL) prototype in CERN’s SPS beam line (10 – 300 GeV).

  11. Copyright and Wire Broadcasting Under Belgian Law

    Science.gov (United States)

    Namurois, Albert

    1975-01-01

    A discussion of a case whereby substantial damages, if not criminal proceedings, will sanction, according to circumstances, both television organizations and those who in certain conditions distribute their programs by wire or communicate them to the public. (Author/HB)

  12. Josephson junction arrays and superconducting wire networks

    International Nuclear Information System (INIS)

    Lobb, C.J.

    1992-01-01

    Techniques used to fabricate integrated circuits make it possible to construct superconducting networks containing as many as 10 6 wires or Josephson junctions. Such networks undergo phase transitions from resistive high-temperature states to ordered low-resistance low-temperature states. The nature of the phase transition depends strongly on controllable parameters such as the strength of the superconductivity in each wire or junction and the external magnetic field. This paper will review the physics of these phase transitions, starting with the simplest zero-magnetic field case. This leads to a Kosterlitz-Thouless transition when the junctions or wires are weak, and a simple mean-field fransition when the junctions or wires are strong. Rich behavior, resulting from frustration, occurs in the presence of a magnetic field. (orig.)

  13. Highly stretchable wrinkled gold thin film wires.

    Science.gov (United States)

    Kim, Joshua; Park, Sun-Jun; Nguyen, Thao; Chu, Michael; Pegan, Jonathan D; Khine, Michelle

    2016-02-08

    With the growing prominence of wearable electronic technology, there is a need to improve the mechanical reliability of electronics for more demanding applications. Conductive wires represent a vital component present in all electronics. Unlike traditional planar and rigid electronics, these new wearable electrical components must conform to curvilinear surfaces, stretch with the body, and remain unobtrusive and low profile. In this paper, the piezoresistive response of shrink induced wrinkled gold thin films under strain demonstrates robust conductive performance in excess of 200% strain. Importantly, the wrinkled metallic thin films displayed negligible change in resistance of up to 100% strain. The wrinkled metallic wires exhibited consistent performance after repetitive strain. Importantly, these wrinkled thin films are inexpensive to fabricate and are compatible with roll to roll manufacturing processes. We propose that these wrinkled metal thin film wires are an attractive alternative to conventional wires for wearable applications.

  14. Tensosensitivity of the Hot-Wire Probe

    National Research Council Canada - National Science Library

    Pak, A

    2002-01-01

    ...., on the anemometer type. In a constant current anemometer, it is possible to measure and separate out the noise moving to the electric circuit of the anemometer, it is not the case with hot-wire anemometers of other types...

  15. Molecular wires, switches and memories

    Science.gov (United States)

    Chen, Jia

    Molecular electronics, an emerging field, makes it possible to build individual molecules capable of performing functions identical or analogous to present- day conductors, switches, or memories. These individual molecules, with a nano-meter scale characteristic length, can be designed and chemically synthesized with specific atoms, geometries and charge distribution. This thesis focuses on the design, and measurements of molecular wires, and related strategically engineered structures-molecular switches and memories. The experimental system relies on a thermodynamically driven self-assembling process to attach molecules onto substrate surfaces without intervention from outside. The following topics will be discussed: directed nanoscale manipulation of self-assembled molecules using scanning tunneling microscope; investigation on through-bond transport of nanoscale symmetric metal/conjugated self- assembled monolayers (SAM)/metal junctions, where non- Ohmic thermionic emission was observed to be the dominant process, with isocyanide-Pd contacts showing the lowest thermionic barrier of 0.22 eV; the first realization of robust and large reversible switching behavior in an electronic device that utilizes molecules containing redox centers as the active component, exhibiting negative differential resistance (NDR) and large on-off peak-to-valley ratio (PVR); observation of erasable storage of higher conductivity states in these redox- center containing molecular devices, and demonstration of a two-terminal electronically programmable and erasable molecular memory cell with long bit retention time.

  16. SU-D-18C-06: Initial Experience with Implementing MRI Safety Guidelines for Patients with Pacemakers - Medical Physicist Perspective

    Energy Technology Data Exchange (ETDEWEB)

    James, J; Place, V; Panda, A [Mayo Clinic, Scottsdale, AZ (United States); Edmonson, H [Mayo Clinic College of Medicine, Rochester, MN (United States); Felmlee, J [Mayo Clinic, Rochester, MN (United States); Pooley, R [Mayo Clinic, Jacksonville, FL (United States)

    2014-06-01

    Purpose: Several institutions have developed MRI guidelines for patients with MR-unsafe or MR-conditional pacemakers. Here we highlight the role of a medical physicist in implementing these guidelines for non-pacemaker dependent patients. Guidelines: Implementing these guidelines requires involvement from several medical specialties and a strong collaboration with the site MRI supervisor to develop a structured workflow. A medical physicist is required to be present during the scan to supervise the MR scanning and to maintain a safety checklist that ensures: 1) uninterrupted patient communication with the technologist, 2) continuous patient physiologic monitoring (e.g. blood pressure and electrocardiography) by a trained nurse, 3) redundant patient vitals monitoring (e.g. pulse oximetry) due to the possibility of in vivo electrocardiography reading fluctuations during image acquisition. A radiologist is strongly recommended to be available to review the images before patients are discharged from the scanner. Pacemaker MRI should be restricted to 1.5T field strength. The MRI sequences should be optimized by the physicist with regards to: a) SAR: limited to <1.5 W/Kg for MR-unsafe pacemakers in normal operating mode, b) RF exposure time: <30 min, c) Coils: use T/R coils but not restricted to such, d) Artifacts: further optimization of sequences whenever image quality is compromised due to the pacemaker. In particular, cardiac, breast and left-shoulder MRIs are most susceptible to these artifacts. Possible strategies to lower the SAR include: a) BW reduction, 2) echo-train-length reduction, 3) increase TR, 4) decrease number of averages, 5) decrease flip angle, 6) reduce slices and/or a combination of all the options. Conclusion: A medical physicist in collaboration with the MR supervisor plays an important role in the supervision/implementation of safe MR scanning of pacemaker patients. Developing and establishing a workflow has enabled our institution to scan over

  17. The circadian neuropeptide PDF signals preferentially through a specific adenylate cyclase isoform AC3 in M pacemakers of Drosophila.

    Directory of Open Access Journals (Sweden)

    Laura B Duvall

    Full Text Available The neuropeptide Pigment Dispersing Factor (PDF is essential for normal circadian function in Drosophila. It synchronizes the phases of M pacemakers, while in E pacemakers it decelerates their cycling and supports their amplitude. The PDF receptor (PDF-R is present in both M and subsets of E cells. Activation of PDF-R stimulates cAMP increases in vitro and in M cells in vivo. The present study asks: What is the identity of downstream signaling components that are associated with PDF receptor in specific circadian pacemaker neurons? Using live imaging of intact fly brains and transgenic RNAi, we show that adenylate cyclase AC3 underlies PDF signaling in M cells. Genetic disruptions of AC3 specifically disrupt PDF responses: they do not affect other Gs-coupled GPCR signaling in M cells, they can be rescued, and they do not represent developmental alterations. Knockdown of the Drosophila AKAP-like scaffolding protein Nervy also reduces PDF responses. Flies with AC3 alterations show behavioral syndromes consistent with known roles of M pacemakers as mediated by PDF. Surprisingly, disruption of AC3 does not alter PDF responses in E cells--the PDF-R(+ LNd. Within M pacemakers, PDF-R couples preferentially to a single AC, but PDF-R association with a different AC(s is needed to explain PDF signaling in the E pacemakers. Thus critical pathways of circadian synchronization are mediated by highly specific second messenger components. These findings support a hypothesis that PDF signaling components within target cells are sequestered into "circadian signalosomes," whose compositions differ between E and M pacemaker cell types.

  18. Characterization of a right atrial subsidiary pacemaker and acceleration of the pacing rate by HCN over-expression.

    Science.gov (United States)

    Morris, Gwilym M; D'Souza, Alicia; Dobrzynski, Halina; Lei, Ming; Choudhury, Moinuddin; Billeter, Rudi; Kryukova, Yelena; Robinson, Richard B; Kingston, Paul A; Boyett, Mark R

    2013-10-01

    Although the right atrium (RA contains subsidiary atrial pacemaker (SAP) tissue that can take over from the sinoatrial node (SAN) in sick sinus syndrome (SSS), SAP tissue is bradycardic. Little is known about SAP tissue and one aim of the study was to characterize ion channel expression to obtain insight into SAP pacemaker mechanisms. A second aim was to determine whether HCN over-expression (a 'biopacemaker'-like strategy) can accelerate the pacemaker rate producing a pacemaker that is similar in nature to the SAN. SAP tissue was isolated from the rat and the leading pacemaker site was characterized. Cell size at the leading pacemaker site in the SAP was smaller than in the RA and comparable to that in the SAN. mRNA levels showed the SAP to be similar to, but distinct from, the SAN. For example, in the SAN and SAP, expression of Tbx3 and HCN1 was higher and Nav1.5 and Cx43 lower than in the RA. Organ-cultured SAP tissue beat spontaneously, but at a slower rate than the SAN. Adenovirus-mediated gene transfer of HCN2 and the chimeric protein HCN212 significantly increased the pacemaker rate of the SAP close to that of the native SAN, but HCN4 was ineffective. SAP tissue near the inferior vena cava is bradycardic, but shares characteristics with the SAN. Pacing can be accelerated by the over-expression of HCN2 or HCN212. This provides proof of concept for the use of SAP tissue as a substrate for biopacemaking in the treatment of SSS.

  19. The rationale and design of the Micra Transcatheter Pacing Study: safety and efficacy of a novel miniaturized pacemaker.

    Science.gov (United States)

    Ritter, Philippe; Duray, Gabor Z; Zhang, Shu; Narasimhan, Calambur; Soejima, Kyoko; Omar, Razali; Laager, Verla; Stromberg, Kurt; Williams, Eric; Reynolds, Dwight

    2015-05-01

    Recent advances in miniaturization technologies and battery chemistries have made it possible to develop a pacemaker small enough to implant within the heart while still aiming to provide similar battery longevity to conventional pacemakers. The Micra Transcatheter Pacing System is a miniaturized single-chamber pacemaker system that is delivered via catheter through the femoral vein. The pacemaker is implanted directly inside the right ventricle of the heart, eliminating the need for a device pocket and insertion of a pacing lead, thereby potentially avoiding some of the complications associated with traditional pacing systems. The Micra Transcatheter Pacing Study is currently undergoing evaluation in a prospective, multi-site, single-arm study. Approximately 720 patients will be implanted at up to 70 centres around the world. The study is designed to have a continuously growing body of evidence and data analyses are planned at various time points. The primary safety and efficacy objectives at 6-month post-implant are to demonstrate that (i) the percentage of Micra patients free from major complications related to the Micra system or implant procedure is significantly higher than 83% and (ii) the percentage of Micra patients with both low and stable thresholds is significantly higher than 80%. The safety performance benchmark is based on a reference dataset of 977 subjects from 6 recent pacemaker studies. The Micra Transcatheter Pacing Study will assess the safety and efficacy of a miniaturized, totally endocardial pacemaker in patients with an indication for implantation of a single-chamber ventricular pacemaker. NCT02004873. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  20. Load-Deflection and Friction Properties of PEEK Wires as Alternative Orthodontic Wires.

    Science.gov (United States)

    Tada, Yoshifumi; Hayakawa, Tohru; Nakamura, Yoshiki

    2017-08-09

    Polyetheretherketone (PEEK) is now attracting attention as an alternative to metal alloys in the dental field. In the present study, we evaluated the load-deflection characteristics of PEEK wires in addition to their frictional properties. Three types of PEEK wires are used: two sizes of rectangular shape, 0.016 × 0.022 in² and 0.019 × 0.025 in² (19-25PEEK), and rounded shape, diameter 0.016 in (16PEEK). As a control, Ni-Ti orthodontic wire, diameter 0.016 in, was used. The three-point bending properties were evaluated in a modified three-point bending system for orthodontics. The static friction between the orthodontic wire and the bracket was also measured. The load-deflection curves were similar among Ni-Ti and PEEK wires, except for 16PEEK with slot-lid ligation. The bending force of 19-25PEEK wire was comparable with that of Ni-Ti wire. 19-25PEEK showed the highest load at the deflection of 1500 μm ( p 0.05). No significant difference was seen in static friction between all three PEEK wires and Ni-Ti wire ( p > 0.05). It is suggested that 19-25PEEK will be applicable for orthodontic treatment with the use of slot-lid ligation.

  1. Audio wiring guide how to wire the most popular audio and video connectors

    CERN Document Server

    Hechtman, John

    2012-01-01

    Whether you're a pro or an amateur, a musician or into multimedia, you can't afford to guess about audio wiring. The Audio Wiring Guide is a comprehensive, easy-to-use guide that explains exactly what you need to know. No matter the size of your wiring project or installation, this handy tool provides you with the essential information you need and the techniques to use it. Using The Audio Wiring Guide is like having an expert at your side. By following the clear, step-by-step directions, you can do professional-level work at a fraction of the cost.

  2. Note: Improved wire-wound heater.

    Science.gov (United States)

    Steinmann, Ricardo G; Vitoux, Hugo

    2015-01-01

    The authors have measured, at cryogenic temperature, the upper limit of the heat transfer in different configurations of a wire-wound heater. We found that the heat transferred has an upper limit of about 15 W/cm(2) and is dependent on the diameter of the wire. In this paper, we present three ways of increasing the heat transferred by this type of heater and its application in different continuous flow cryostats.

  3. Graphene wire medium: Homogenization and application

    DEFF Research Database (Denmark)

    Andryieuski, Andrei; Chigrin, Dmitry N.; Lavrinenko, Andrei

    2012-01-01

    In this contribution we analyze numerically the optical properties of the graphene wire medium, which unit cell consists of a stripe of graphene embedded into dielectric. We propose a simple method for retrieval of the isofrequency contour and effective permittivity tensor. As an example...... of the graphene wire medium application we demonstrate a reconfigurable hyperlens for the terahertz subwavelength imaging capable of resolving two sources with separation λ0/5 in the far-field....

  4. Novel use of the "buddy"wire.

    LENUS (Irish Health Repository)

    O'Hare, A

    2008-12-29

    Summary: During interventional procedures the tortuosity of the vasculature hampers catheter stability. The buddy wire may be used to aid and maintain vascular access.We describe a case of acute subarachnoid haemorrhage secondary to dissecting aneurysm of the vertebral artery.We discuss the value of the buddy wire during balloon occlusion of the vertebral artery not as it is typically used, but to actually prevent the balloon repeatedly entering the posterior inferior cerebellar artery during the procedure.

  5. A Magnetic Sensor with Amorphous Wire

    Directory of Open Access Journals (Sweden)

    Dongfeng He

    2014-06-01

    Full Text Available Using a FeCoSiB amorphous wire and a coil wrapped around it, we have developed a sensitive magnetic sensor. When a 5 mm long amorphous wire with the diameter of 0.1 mm was used, the magnetic field noise spectrum of the sensor was about 30 pT/ÖHz above 30 Hz. To show the sensitivity and the spatial resolution, the magnetic field of a thousand Japanese yen was scanned with the magnetic sensor.

  6. COBRA-IV wire wrap data comparisons

    International Nuclear Information System (INIS)

    Donovan, T.E.; George, T.L.; Wheeler, C.L.

    1979-02-01

    Thermal hydraulic analyses of hexagonally packed wire-wrapped fuel assemblies are complicated by the induced crossflow between adjacent subchannels. The COBRA-IV computer code simultaneously solves the hydrodynamics and thermodynamics of fuel assemblies. The modifications and the results are presented which are predicted by the COBRA-IV calculation. Comparisons are made with data measured in five experimental models of a wire-wrapped fuel assembly

  7. Wiring System Diagnostic Techniques for Legacy Aircraft

    Science.gov (United States)

    2003-02-01

    Reunions des specialistes des techniques de estion du cycle de vie pour vehicules aeriens vieillissants ] To order the complete compilation report, use...Ageing Mechanisms and Control. Specialists’ Meeting on Life Management Techniques for Ageing Air Vehicles [Les mecanismes vieillissants et le controle...be identified. Additionally, wiring failures tend to be intermittent in nature and can take considerable time to isolate. Wire modifications and

  8. Subchannel Analysis of Wire Wrapped SCWR Assembly

    Directory of Open Access Journals (Sweden)

    Jianqiang Shan

    2014-01-01

    Full Text Available Application of wire wrap spacers in SCWR can reduce pressure drop and obtain better mixing capability. As a consequence, the required coolant pumping power is decreased and the coolant temperature profile inside the fuel bundle is flattened which will obviously decrease the peak cladding temperature. The distributed resistance model for wire wrap was developed and implemented in ATHAS subchannel analysis code. The HPLWR wire wrapped assembly was analyzed. The results show that: (1 the assembly with wire wrap can obtain a more uniform coolant temperature profile than the grid spaced assembly, which will result in a lower peak cladding temperature; (2 the pressure drop in a wire wrapped assembly is less than that in a grid spaced assembly, which can reduce the operating power of pump effectively; (3 the wire wrap pitch has significant effect on the flow in the assembly. Smaller Hwire/Drod will result in stronger cross flow a more uniform coolant temperature profile, and also a higher pressure drop.

  9. Superconducting wires and methods of making thereof

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Xingchen; Sumption, Michael D.; Peng, Xuan

    2018-03-13

    Disclosed herein are superconducting wires. The superconducting wires can comprise a metallic matrix and at least one continuous subelement embedded in the matrix. Each subelement can comprise a non-superconducting core, a superconducting layer coaxially disposed around the non-superconducting core, and a barrier layer coaxially disposed around the superconducting layer. The superconducting layer can comprise a plurality of Nb.sub.3Sn grains stabilized by metal oxide particulates disposed therein. The Nb.sub.3Sn grains can have an average grain size of from 5 nm to 90 nm (for example, from 15 nm to 30 nm). The superconducting wire can have a high-field critical current density (J.sub.c) of at least 5,000 A/mm.sup.2 at a temperature of 4.2 K in a magnetic field of 12 T. Also described are superconducting wire precursors that can be heat treated to prepare superconducting wires, as well as methods of making superconducting wires.

  10. Si Wire-Array Solar Cells

    Science.gov (United States)

    Boettcher, Shannon

    2010-03-01

    Micron-scale Si wire arrays are three-dimensional photovoltaic absorbers that enable orthogonalization of light absorption and carrier collection and hence allow for the utilization of relatively impure Si in efficient solar cell designs. The wire arrays are grown by a vapor-liquid-solid-catalyzed process on a crystalline (111) Si wafer lithographically patterned with an array of metal catalyst particles. Following growth, such arrays can be embedded in polymethyldisiloxane (PDMS) and then peeled from the template growth substrate. The result is an unusual photovoltaic material: a flexible, bendable, wafer-thickness crystalline Si absorber. In this paper I will describe: 1. the growth of high-quality Si wires with controllable doping and the evaluation of their photovoltaic energy-conversion performance using a test electrolyte that forms a rectifying conformal semiconductor-liquid contact 2. the observation of enhanced absorption in wire arrays exceeding the conventional light trapping limits for planar Si cells of equivalent material thickness and 3. single-wire and large-area solid-state Si wire-array solar cell results obtained to date with directions for future cell designs based on optical and device physics. In collaboration with Michael Kelzenberg, Morgan Putnam, Joshua Spurgeon, Daniel Turner-Evans, Emily Warren, Nathan Lewis, and Harry Atwater, California Institute of Technology.

  11. Needleless electrospinning with twisted wire spinneret

    International Nuclear Information System (INIS)

    Holopainen, Jani; Penttinen, Toni; Santala, Eero; Ritala, Mikko

    2015-01-01

    A needleless electrospinning setup named ‘Needleless Twisted Wire Electrospinning’ was developed. The polymer solution is electrospun from the surface of a twisted wire set to a high voltage and collected on a cylindrical collector around the wire. Multiple Taylor cones are simultaneously self-formed on the downward flowing solution. The system is robust and simple with no moving parts aside from the syringe pump used to transport the solution to the top of the wire. The structure and process parameters of the setup and the results on the preparation of polyvinyl pyrrolidone (PVP), hydroxyapatite (HA) and bioglass fibers with the setup are presented. PVP fiber sheets with areas of 40 × 120 cm 2 and masses up to 1.15 g were prepared. High production rates of 5.23 g h −1 and 1.40 g h −1 were achieved for PVP and HA respectively. The major limiting factor of the setup is drying of the polymer solution on the wire during the electrospinning process which will eventually force to interrupt the process for cleaning of the wire. Possible solutions to this problem and other ways to develop the setup are discussed. The presented system provides a simple way to increase the production rate and area of fiber sheet as compared with the conventional needle electrospinning. (paper)

  12. 75 FR 60480 - In the Matter of Certain Bulk Welding Wire Containers and Components Thereof and Welding Wire...

    Science.gov (United States)

    2010-09-30

    ... COMMISSION In the Matter of Certain Bulk Welding Wire Containers and Components Thereof and Welding Wire... importation, or the sale within the United States after importation of certain bulk welding wire containers, components thereof, and welding wire by reason of infringement of certain claims of United States Patent Nos...

  13. 29 CFR 1926.154 - Temporary heating devices.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 8 2010-07-01 2010-07-01 false Temporary heating devices. 1926.154 Section 1926.154 Labor... Temporary heating devices. (a) Ventilation. (1) Fresh air shall be supplied in sufficient quantities to... heating devices shall be installed to provide clearance to combustible material not less than the amount...

  14. 42 CFR 488.54 - Temporary waivers applicable to hospitals.

    Science.gov (United States)

    2010-10-01

    ... fully with the 24-hour nursing requirement is attributable to a temporary shortage of qualified nursing...) of the Act, see paragraph (c) of this section.) (c) Temporary waiver of 24-hour nursing requirement...) that a hospital must provide 24-hour nursing service furnished or supervised by a registered nurse...

  15. 26 CFR 1.1092(b)-5T - Definitions (temporary).

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 11 2010-04-01 2010-04-01 true Definitions (temporary). 1.1092(b)-5T Section 1.1092(b)-5T Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Wash Sales of Stock Or Securities § 1.1092(b)-5T Definitions (temporary). The...

  16. 20 CFR 655.20 - Applications for temporary employment certification.

    Science.gov (United States)

    2010-04-01

    ... the Department's Internet Web site at http://www.foreignlaborcert.doleta.gov/. The form must bear the... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Applications for temporary employment... Nursing in the United States (H-2B Workers) § 655.20 Applications for temporary employment certification...

  17. Empolder and application of LiveWire program

    International Nuclear Information System (INIS)

    Zhang Bo; Li Jing; Wang Xiaoming

    2007-01-01

    LiveWire is a specific module of Netscape Web server to actualize CGI function; through LiveWire application program one can create dynamic web page on web site. This article introduces how to write LiveWire application code, have to compile, debug and manage LiveWire application programs, and how to apply LiveWire application program on Netscape Web server to create a dynamic web page. (authors)

  18. Wiring design for the control of electromagnetic interference (EMI)

    Science.gov (United States)

    Kopasakis, George

    1995-01-01

    Wiring design is only one important aspect of EMI control. Other important areas for EMI are: circuit design, filtering, grounding, bonding, shielding, lighting, electrostatic discharge (ESD), transient suppression, and electromagnetic pulse (EMP). Topics covered include: wire magnetic field emissions at low frequencies; wire radiated magnetic field emissions at frequencies; wire design guidelines for EMI control; wire design guidelines for EMI control; high frequency emissions from cables; and pulse frequency spectra.

  19. Nutrient mitigation in a temporary river basin.

    Science.gov (United States)

    Tzoraki, Ourania; Nikolaidis, Nikolaos P; Cooper, David; Kassotaki, Elissavet

    2014-04-01

    We estimate the nutrient budget in a temporary Mediterranean river basin. We use field monitoring and modelling tools to estimate nutrient sources and transfer in both high and low flow conditions. Inverse modelling by the help of PHREEQC model validated the hypothesis of a losing stream during the dry period. Soil and Water Assessment Tool model captured the water quality of the basin. The 'total daily maximum load' approach is used to estimate the nutrient flux status by flow class, indicating that almost 60% of the river network fails to meet nitrogen criteria and 50% phosphate criteria. We recommend that existing well-documented remediation measures such as reforestation of the riparian area or composting of food process biosolids should be implemented to achieve load reduction in close conjunction with social needs.

  20. Factors affecting closure of a temporary stoma.

    Science.gov (United States)

    Taylor, Claire; Varma, Sarah

    2012-01-01

    The purpose of the study was to examine time to reversal of a temporary ostomy, reasons for delayed closure, and patient satisfaction with the scheduling of their closure and related hospital care. Cross-sectional, descriptive study. The target population comprised patients who underwent creation of a temporary ostomy and reversal surgery within one National Health System Hospital Trust in the United Kingdom. The population served by this Trust are ethnically and socioeconomically diverse, predominantly living in urban areas around Greater London. Sixty-one persons who met inclusion criteria were identified. A two-step analytical process was undertaken. First, a literature review examining incidence and causes of delayed stoma closure was undertaken. Second, a postal survey of all patients who had had their stoma closed in 2009 was conducted. Respondents were allowed 2 weeks to complete and return the questionnaire. The survey instrument was developed locally and subjected to content validation using ostomy patients, surgical and nursing colleagues. It consisted of 9 questions querying time from original surgery to closure, reasons for delaying closure surgery beyond 12 weeks, and satisfaction with care. Twenty-seven patients returned their questionnaires, indicating they consented to participate; a response rate of 44%. Half of the respondents (n = 14 [52%]) underwent closure surgery within 6 months of stoma formation; the remaining 48% waited more than 6 months (median: 6.5 months, range: 1.5-26 months). Thirteen patients (48%) reported a delay in receiving their stoma closure; the main reason cited was the need for a course of adjuvant postoperative chemotherapy. Three quarters of respondents (22 [74%]) were satisfied with the overall care they received. Findings from this study suggest that stoma closure may be associated with fewest complications if performed before 12 weeks.